How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask Dr. Rick Your Own Question

Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7750
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
Type Your Eye Question Here...
Dr. Rick is online now
A new question is answered every 9 seconds

Hello againI have chronic glomerulonephritis, with terrible

Resolved Question:

Hello again I have chronic glomerulonephritis, with terrible proteinuria. Western treatment options are mainly steroids and powerful immunosuppressive drugs which expose the patient to cancer and fatal viral infections. Therefore, I have opted not to use them. These immune complexes cause inflammation like shards stuck in the skin, destroying the glomerular basement membrane and causing proteinuria. Previously, I asked a retinal specialist (Dr. Rick) whether it would be safe me to take enzymes orally to try and remove the immune complexes stuck in the glomeruli of my kidneys. I mentioned papain, and the specialist said that since the retina is protected by a blood/retinal barrier, the enzyme would not get to the retina. But now, I found an article from 1990 on the Net which specifically states that a combination of dextranase and protease did remove all the immune complexes from the kidney, i.e., IgA, IgG, IgM in a mouse model in which human immune complexes were artificially induced. Therefore, a combination of saccharolytic and proteolytic enzymes can potentially cure this horrible disease normally leading to end-stage renal failure and dialysis. Therefore, I also want to consume a mixture of saccharolytic and proteolytic enzymes on a regular basis. I am taking Chinese herbs for the nephropathy and proteinuria, but progress is very slow, and I imagine that taking enzymes as well may make a rapid and significant improvement.  Now, I recently learnt, on the Net, that the blood-retinal barrier is constituted of heparan sulphate glycosaminoglycan, which is a polysaccharide. So this is the material which prevents proteases from reaching the retinal pigment epithelium and the retina. I also learnt that proteases alone can still challenge the retinal barrier, and degrade it. I imagine the challenge would be far worse if I took saccharolytic enzymes as well as the proteases (because the barrier is a polysaccharide), but this is precisely the combination that can save my kidneys. 13 years ago, I had a retinal detachment repaired by cryopexy and scleral buckle, and at that time I already had a small degree of lattice degeneration in the retinas. I am 66 years old, and I imagine my retina is fairly thin. However, I desperately want to try this enzyme combination to see how much improvement I can get of my glomerulonephritis. In fact, although some people say oral enzymes do not get into the bloodstream anyway, there is a study from 2007 wherein `Wobenzym`, which is a proprietary blend of pancreatic enzymes like trypsin with bromelain and papain, "may have therapeutic value in glomerulonephritis". These would be my proteases. For the saccharolytic enzymes, I would drink a warm water extract made from the spores of a fungi we have here in Japan which is used to pickle fish, known as "koji", which is a food substance known to contain 140 saccharolytic enzymes. I don't know exactly which glomerulonephritis I have, but a previous blood panel showed elevation of IgM. That's it. Just how much risk to causing retinal damage am I running by taking this combination of saccharolytic and proteolytic enzymes which potentially could compromise the RPE cell-surface polysaccharide retinal barrier of heparan sulphate glycosaminoglycan? After all, it is not difficult to imagine that the barrier would easily be degraded by saccharolytic enzymes, leaving the retina completely unprotected to attack from the proteolytic enzymes. I don't believe anybody with glomerulonephritis has ever tried this combination of enzymes, no doubt because nobody ever took any notice of this fantastic discovery that a combination of saccharolytic and proteolytic enzymes can remove most, if not all, immune complexes from the kidneys. Admittedly, the enzymes were injected in this study from 1990, but oral administration would probably still allow enzyme fragments with active sites to be absorbed into the bloodstream. Ideally, we would want enzymes that specifically attacked the immune complexes and leave the retina alone, and I am sure they exist, but since we don't know which ones they are and have no access to them, we can only use the broad spectrum of enzymes that we do have access to, such as "koji" and "Wobenzym". We can only expect good things for the kidneys , but what risk to the retina does this pose? Better to be safe than sorry?


Thank you very much for your kind advice.


 


PS  I know the retinal barrier breaks down in diabetes, causing diabetic retinopathy, although at this moment, I have not been diagnosed with diabetes.  I also know that the barrier can be strengthened by up-regulating heparan sulfate glycosaminoglycan, which can be done by increasing soluble and insoluble dietary fiber, but that is a slow process which takes many months, and I need to start enzyme therapy ASAP provided there is no retinal risk.

Submitted: 1 year ago.
Category: Eye
Expert:  Dr. Rick replied 1 year ago.

Dr. Rick :

Hi. I'm online and happy to answer your question today.

Dr. Rick :

Thank you for your excellent post reviewing your very through research.

Dr. Rick :

While you have raised very good points concerning the blood/retinal barrier I firmly believe your retina will not be affected by the compounds you are going to be taking orally.

Customer:

Hello Dr. Rick, I am delighted to chat with you again. I am so happy to get this answer! It means I can go ahead with targeted kidney therapy.

Dr. Rick :

As far as your history of retinal detachment repair and lattice degeneration I do not feel there will be any problems from using these compounds. I can not, however, speak toward your findings concerning positive effects you feel this therapy will have on your kidneys

Dr. Rick :

As far as your retina is concerned, that is correct.

Dr. Rick :

It's good to chat with you again. If you have a moment please drop me a note in the future and let me hear how things turn out.

Dr. Rick :

It must be Friday already in Japan.....

Customer:

Well, at least I can go ahead now and try to see what the therapy does for the kidneys.

Customer:

No it's not Friday yet here in Japan!

Customer:

It is still Thursday

Customer:

About 1 PM. Where are you located, Dr Rick?

Dr. Rick :

Oh....just turned thursday here.

Customer:

Where in the United States?

Dr. Rick :

11 pm here.

Customer:

Are you on the West Coast or the East Coast?

Dr. Rick :

Oops...it is still Wednesday here in the Midwest of USA

Customer:

I have never been to the Midwest

Customer:

About two weeks ago I went to Oregon to get the Chinese herbs from a Chinese

Customer:

Kidney specialist

Customer:

Just to get back to the enzymes, I will start on a low dose to make sure there is no

Customer:

vitreal haemorrhage. The risk of bleeding has been mentioned by the manufacturer in Berlin, Germany.

Customer:

Sometimes, I get a bloodshot eye after having a hot shower or bath.

Customer:

But your response has certainly reassured me.

Dr. Rick :

That is of no concern as it only affects the outside of the eyeball.

Dr. Rick :

Flying to Oregon from Japan is quite a trip.....

Customer:

Yes but you have to do what you have to do. I speak Chinese, so I turned to Chinese herbs in time of need.

Customer:

In Japan, Chinese doctors are not allowed to practice Chinese medicine

Dr. Rick :

Since you are already into Thursday afternoon, could you check the stock market and let me know what I should buy when they open in NYC in the morning?

Dr. Rick :

LOL!

Customer:

And when I brought the herbs back here, the hospital refused to give me any more blood tests

Customer:

Because I was taking Chinese herbs

Customer:

Can you imagine that

Dr. Rick :

weird.....that would never happen in the USA

Dr. Rick :

You are in my future ;)

Customer:

Do you mean the Japanese stock market?

Dr. Rick :

No....just trying to see if time travel really works..... lol!

Customer:

That would be a wonderful idea

Customer:

Are you still practising surgery?

Dr. Rick :

easy way to make money.....too bad crossing the international date line doesn't, actually, fling you into the future....

Customer:

Yes, I also thought of doing that!

Dr. Rick :

Yup. Had 11 cases last week and an emergency macula on RD this afternoon after work....getting too old to work this hard.

Customer:

I really hope that we can find a way to keep the retina more firmly attached!

Customer:

May be some superglue

Customer:

Sometime ago, we were enthusiastic about a light treatment to cure most eye diseases

Customer:

It was invented by Dr William Luftig in the 1930s

Customer:

He used it on thousands of patients until 1960

Dr. Rick :

laser and cryo scars down things pretty tight

Customer:

He built colour reflectors made of crystal glass, to direct specific colour wavelengths

Customer:

Onto closed eyelids

Customer:

But he did not leave any disciples who knew how to use his equipment

Customer:

He wrote 8 books altogether, one of them used to be available in Moorfields eye Hospital

Customer:

In London at the same university I graduated

Dr. Rick :

That happens...nowadays with modern residency and fellowship programs knowledge gets passed on, and improved, without fail....

Dr. Rick :

Moorefields is one of the very best in the world.

Customer:

I wonder why his colour light therapy was never built upon and develop further

Dr. Rick :

Anyway, it is almost midnight and I have a full clinic schedule in the morning...at least I am not on call :)

Customer:

Yes, I want to thank you so much for your learned advice and reassurance. Many, many thanks, XXXXX XXXXX do not work so hard!

Dr. Rick :

I'm not sure how light on the closed eyelids would work to help the retina...

Customer:

You can read it in a rather unscientific description in his main book: "The natural treatment of eye diseases", by Dr William Luftig.

Dr. Rick :

I'm trying to get my wife a second job in the evening, but she is, for some strange reason, resisting the idea ;)

Dr. Rick :

I'll look it up.

Dr. Rick :

Take care and have a good day.....

Dr. Rick :

G'night.

Dr. Rick :

I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. You may also receive an email survey after our chat, if you don’t feel that I have earned a “10” rating in all areas, please let me know what I can do to meet your expectations.

Thanks in advance,

Dr. Rick MD FACS

Customer:

Peace out, and thank you!

Dr. Rick :

The pleasure is all mine.

Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7750
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
Dr. Rick and other Eye Specialists are ready to help you
Expert:  Dr. Rick replied 1 year ago.
Our chat has ended, but you can still continue to ask me questions here until you are satisfied with your answer. Come back to this page to view our conversation and any other new information.

What happens now?

If you haven’t already done so, please rate your answer above. Or, you can reply to me using the box below.

JustAnswer in the News:

 
 
 
Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.
 
 
 

What Customers are Saying:

 
 
 
  • I feel so much better today, and upon further investigation believe that there is a chance that the responses I got saved me from a serious, even life threatening situation. I am very grateful to the experts who answered me. Susan O. USA
< Last | Next >
  • I feel so much better today, and upon further investigation believe that there is a chance that the responses I got saved me from a serious, even life threatening situation. I am very grateful to the experts who answered me. Susan O. USA
  • Wonderful service, prompt, efficient, and accurate. Couldn't have asked for more. I cannot thank you enough for your help. Mary C. Freshfield, Liverpool, UK
  • This expert is wonderful. They truly know what they are talking about, and they actually care about you. They really helped put my nerves at ease. Thank you so much!!!! Alex Los Angeles, CA
  • Thank you for all your help. It is nice to know that this service is here for people like myself, who need answers fast and are not sure who to consult. GP Hesperia, CA
  • I couldn't be more satisfied! This is the site I will always come to when I need a second opinion. Justin Kernersville, NC
  • Just let me say that this encounter has been entirely professional and most helpful. I liked that I could ask additional questions and get answered in a very short turn around. Esther Woodstock, NY
  • Thank you so much for taking your time and knowledge to support my concerns. Not only did you answer my questions, you even took it a step further with replying with more pertinent information I needed to know. Robin Elkton, Maryland
 
 
 

Meet The Experts:

 
 
 
  • Dr. Dan B.

    Board Certified Ophthalmologist

    Satisfied Customers:

    2903
    Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
< Last | Next >
  • http://ww2.justanswer.com/uploads/DoctorDanB/2010-6-7_6228_just_answer_profile_picture_60_pixels.jpg Dr. Dan B.'s Avatar

    Dr. Dan B.

    Board Certified Ophthalmologist

    Satisfied Customers:

    2903
    Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
  • http://ww2.justanswer.com/uploads/anupamadesai/2010-04-13_122313_Dr._A.S.Desai_new_photo.jpg Dr. A.S. Desai's Avatar

    Dr. A.S. Desai

    Ophthalmologist

    Satisfied Customers:

    1903
    MS Ophthalmology with 11 years of surgical expereince
  • http://ww2.justanswer.com/uploads/gsokoye/2009-10-28_181751_Dr._Stan.JPG Dr. Stan's Avatar

    Dr. Stan

    Ophthalmologist

    Satisfied Customers:

    895
    Johns Hopkins Fellowship Trained, Certified and Licensed Medical Physician and Surgeon
  • http://ww2.justanswer.com/uploads/eyemd/2009-04-07_180315_pic.jpg Dr. Stevens's Avatar

    Dr. Stevens

    Ophthalmologist

    Satisfied Customers:

    629
    Board Certified Ophthalmologist
  • http://ww2.justanswer.com/uploads/CO/CorneaDoc/2012-2-18_0390_photo6.64x64.jpg Dr. Susan's Avatar

    Dr. Susan

    Ophthalmologist

    Satisfied Customers:

    217
    Board Certified & Fellowship trained eye surgeon.
  • http://ww2.justanswer.com/uploads/neuph94/2009-10-11_164729_gif_pic.GIF Dr. JP's Avatar

    Dr. JP

    Ophthalmology, Oculoplastic Surgery

    Satisfied Customers:

    28
    Harvard Medical School, Massachussetts Eye and Ear
  • http://ww2.justanswer.com/uploads/JA/JACUSTOMERjcufyksv/2012-3-13_44825_crop3.64x64.jpg Dr-Trace's Avatar

    Dr-Trace

    Board Certified Ophthalmologist

    Satisfied Customers:

    26
    Board Certified in General Ophthalmology
 
 
 

Related Eye Questions