OK I thought of several titles for this thread so I hope someone a) reads it and b) replies.

I have been suffering for well over 30 years and only about 2 years or so ago was started on MTX and have been largely free of P since then. OK I have a little on my butt however I don't flash that around.

Now the summer is here it feels great not thinking about it on my elbows and knees. I can wear a t-shirt and shorts if I want to.

I even go swimming.

Psoriasis stole many many years from me and I suffered not only from psoriasis but sweltering in long sleeves in the summer.

How is everyone elses life with P.

Mine was horrible for far to long and it stole many probably happy times when I was self concious about things.

Diagnosed in 2007 with Psoriasis and Psoriatic arthritisa after GP thought it was a fungal infection. Tried various creams, sulfasalazine, methotrexate tablets and then injections but couldn't not tolerate the nausea and just feeling crap/hungover all the time so stopped. Coped without medication for a few years and then separated from wife suddenly , Psoriasis flared on shins , back , scalp - about 6 months after started getting pains and stiffness in lower back/hips/pelvis area and upper neck and shoulders also very tired and run down - diagnosed with ankylosing spondylitis ... so today i should get cosentyx - currently only taking naproxen and tramadol - hopefully can kick the tramadol into touch soon :

Hello to all 

Eli Lilly announced today that patients with active psoriatic arthritis (PsA) who had inadequate response to one or two TNF inhibitors or were intolerant of TNF inhibitors treated with Taltz® (ixekizumab) achieved significant improvement in signs and symptoms of their disease at 24 weeks when compared to placebo.

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Eli Lilly and Company (NYSE: LLY) announced today that patients with active psoriatic arthritis (PsA) who had inadequate response to one or two TNF inhibitors or were intolerant of TNF inhibitors treated with Taltz® (ixekizumab) achieved significant improvement in signs and symptoms of their disease at 24 weeks when compared to placebo. Detailed results of the SPIRIT-P2 study, a pivotal Phase 3 trial, will be presented in an oral presentation today during the Annual European Congress of Rheumatology (EULAR) 2017, taking place June 14-17, in Madrid. Results from the SPIRIT-P2 study were also recently published in The Lancet in May 2017.

"Psoriatic arthritis is a chronic, progressive disease that affects more than 37 million people worldwide, and can cause a range of signs and symptoms, including pain, swelling and stiffness of the joints that can lead to impaired physical function, as well as itchy and painful skin plaques," said Dr. Lotus Mallbris, global brand development leader, Taltz, Eli Lilly and Company. "We are pleased this data will be presented at the Annual European Congress of Rheumatology (EULAR) 2017, as it represents an invaluable opportunity to foster discussion among experts from around the world on the importance of new treatments for this debilitating disease."

Study Design
The SPIRIT-P2 study evaluated the safety and efficacy of Taltz (80 mg every four weeks or every two weeks, following a 160-mg starting dose) compared to placebo after 24 weeks in patients with active PsA who were previously treated with TNF inhibitors and had an inadequate response to one or two TNF inhibitors or were intolerant to TNF inhibitors. Patients were required to have a diagnosis of active PsA for at least six months and at least three tender and three swollen joints.

In this study, the primary endpoint was the percentage of patients achieving at least a 20 percent reduction in a composite measure of disease activity, as defined by the American College of Rheumatology (ACR20).[1] This study also evaluated secondary endpoints including ACR50 and ACR70, which represent 50 percent and 70 percent reductions in disease activity; improvement in physical function as assessed using the Health Assessment Questionnaire Disability Index (HAQ-DI); and improved skin clearance as measured by the Psoriasis Area Severity Index (PASI).

Taltz Demonstrated Significant Improvements in Disease Signs and Symptoms
Patients treated with either dosing regimen of Taltz demonstrated significant improvements at 24 weeks compared with placebo in disease activity of PsA.

At 24 weeks, patients achieved the following response rates:

  ACR 20: 53 percent of patients treated with Taltz every four weeks, 48 percent of patients treated with Taltz every two weeks and 19 percent of those treated with placebo (p < 0.0001).
  ACR 50: 35 percent of patients treated with Taltz every four weeks, 33 percent of patients treated with Taltz every two weeks and 5 percent of those treated with placebo (p < 0.0001).
  ACR 70: 22 percent of patients treated with Taltz every four weeks, 12 percent of patients treated with Taltz every two weeks and zero percent of those treated with placebo (p < 0.0001).

Reduced Disability in Physical Function, Significant Improvements in Skin Clearance
Patients treated with either dosing regimen of Taltz also experienced significant improvements compared with placebo in other key secondary measures, including physical function as assessed by the HAQ-DI and skin clearance in patients with at least 3 percent body surface area of skin involvement as measured by PASI 75, PASI 90 and PASI 100 at 12 weeks and 24 weeks. A PASI 75 score indicates at least a 75 percent reduction in a patient's plaque psoriasis from the patient's baseline assessment, while PASI 90 reflects a 90 percent reduction. PASI 100 represents a 100 percent reduction and reflects complete skin clearance.

"Many patients with psoriatic arthritis have tried a variety of therapies and have either lost response over time, had an inadequate response or been intolerant of therapy," said Associate Professor Peter Nash, lead author, University of Queensland, Queensland, Australia. "If approved, ixekizumab may provide physicians with a new option in this difficult-to-treat patient population."

The incidence of treatment-emergent adverse events was greater with Taltz treatment compared with placebo. The most common (≥5 percent in Taltz groups combined) treatment-emergent adverse events observed with Taltz treatment were injection site reaction, upper respiratory infection, nasopharyngitis and sinusitis. Serious adverse events and discontinuation rates due to adverse events were not significantly different between treatment groups.  

Other warnings and precautions for Taltz include pre-treatment evaluation for tuberculosis, hypersensitivity reactions, inflammatory bowel disease and immunizations. See Important

Lilly has filed a supplemental Biologics License Application (sBLA) with the U.S. Food and Drug Administration (FDA) for Taltz as a treatment of adult patients with active PsA. Taltz is approved for adult patients with active PsA in Japan. Submissions to other regulatory agencies around the world are expected later this year.

This study assess whether psoriasis comorbidity affected the progression of multiple sclerosis (MS)

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Background:
Multiple sclerosis (MS) and psoriasis are inflammatory disorders, with epidemiological and biological associations. The impact of one disease on the course of the other has not been studied.

Objective:
To characterize patients with psoriasis and MS, and to assess whether psoriasis comorbidity affected the progression of MS.

Methods:
A retrospective case control study. Patients with psoriasis comorbidity were identified from 3456 patients included in the Sheba Hospital Multiple Sclerosis Center database. Clinical and demographical characteristics and MS progression-related outcomes in patients whose follow up exceeded 5 years were analyzed and compared to those of a matched control cohort of MS-only (MSO) patients.

Results:
Forty-five (1.3%) MS patients had psoriasis comorbidity. Psoriasis preceded MS in thirty-five (78%) cases. The psoriasis was defined as mild, moderate, and severe in twenty-four (53%), twelve (27%), and nine (20%) cases, respectively. MS progression-related outcomes were evaluated in 35 patients that had follow-up over 5 years. Patients with psoriasis onset preceding relapsing-remitting MS (RRMS) had slower progression of disease compared to MSO patients, as manifested by a longer time to second relapse (p<0.01) and a longer time to significant neurological disability scores (p<0.03).

Conclusion:
Psoriasis comorbidity preceding the onset of MS is associated with slower progression of disability.

This study evaluated the effects of Cosenty (Secukinumab) V Stelara (Ustekinumab) on patient's daily activities and personal relationships.

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Background:
Psoriasis can greatly impact patients’ lives by influencing clothing worn as well as by impairing sexual functioning. Secukinumab, a human monoclonal antibody selectively neutralizing interleukin-17A, has demonstrated good efficacy and safety in the treatment of moderate-to-severe psoriasis and psoriatic arthritis with a rapid onset of action and sustained response.

Objective:
This analysis using the CLEAR study, a phase 3b double-blind study comparing the efficacy and safety of secukinumab versus ustekinumab in adults with moderate-to-severe plaque psoriasis, evaluated the treatment effects on patient's daily activities and personal relationships.

Methods:
Impact on daily activities (interference with home/shopping/garden, and influence on clothes worn) and impact on personal relationships (problems with partner/others, and sexual difficulties) as well as their corresponding subscales were selected from the Dermatology Life Quality Index scale and evaluated for patients treated with secukinumab vs. ustekinumab from the CLEAR study. Treatment differences in mean scores and proportions of responders (score = 0, indicating no impact) were evaluated through 52 weeks. Time to response was evaluated through week 16.

Results:
Significant differences between secukinumab and ustekinumab were observed for daily activities and personal relationship at week 16 and sustained through Week 52 (Week 52 response rates for daily activities: 82.9% vs. 73.5%, including interference with home/shopping/garden: 88.5% vs. 78.2%, and influence on clothes worn: 85.6% vs. 74.4%; personal relationship: 86.1% vs. 73.7%, including problems with partner/others: 86.6% vs. 74.8%, and sexual difficulties: 88.5% vs. 74.3%; all P < 0.01). The median time to response was 4 weeks for secukinumab versus 8 weeks for ustekinumab for daily activities and personal relationships (both P < 0.05).

Conclusion:
Secukinumab treatment helps patients with moderate-to-severe plaque psoriasis have a more normal life faster when compared to ustekinumab, by providing greater and sustained improvement in clothing choice and sexual functioning.

Hello everybody,

I was wondering why the psorinovo/fumaderm medication progression is like it is. And especially the gap from 3 x 30 mg each day, 1x 120 mg and than the gap to 2 x 120 mg at once. (Is the question clear?)

Is the answer habituation/acceptance of the body? If you remember did you (your body) noticed the difference?

With kind regards, Nico.

I read an article:

Allergy to dimethyl fumarate.

I don't understand???

Still timid and difficult. Lot of itching (4th week psorinovo??!!). I hope so that it will work. I am from Amsterdam.

Sorry for short reply

Mornin folks 

I have had my 2nd fortnightly blood tests after starting Leflunomide and have been given the results from my 1st test. me being the kind of guy i am, i'm very curious as to what it all means, what's high, what's normal etc.... so that i can understand each time if things are improving.
is there a good resource indicating normal levels of everything?
i know i can talk to my rheumy nurse and ask (and i will), but next appointment is 2 weeks away

Cheers

Hello,

My name is Maryam. I have psoriasis since I was 19. Definitely inherited from my mother. 
I am now 30 years old. I live in the Netherlands with my 2 daughters and husband. 
Currently experiencing my second worst flare up, I started using psorinovo 1,5 week ago. I use enstilar to keep the itching at bay :-).

Following on from this thread Siliq gets FDA approval for treating psoriasis here could be another reason not to try Siliq (brodalumab)

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Background:
Biological agents targeting IL-17 are very effective for clearing moderate to severe psoriasis. There is limited information regarding the frequency and pattern of psoriasis relapse upon treatment cessation.

Objective:
To investigate the pattern of psoriasis recurrence in patients who were treated with brodalumab following Amgen's decision to stop the clinical program in June 2015.

Materials and Methods:
Between June 2015 and March 2016, we constructed a retrospective multicenter cohort study including patients who were treated with brodalumab in Amgen's protocols after the abrupt interruption of the drug development program. The relapse was defined as the request of patient to initiate a new treatment after brodalumab withdrawal.

Results:
Seventy seven patients were followed up. At the time brodalumab treatment was stopped, 67 (87%) patients had reached PASI 90. After brodalumab discontinuation, all 77 patients relapsed after a follow up of 9 months. The median time to relapse was 46 days (range 7 to 224 days). Concerning the type of relapse, 73 patients presented with plaque psoriasis, one patient presented with erythrodermic psoriasis and 3 patients experienced pustular psoriasis. In 7 patients who had no previous history of psoriatic arthritis (PsA), the relapse of psoriasis was associated with inflammatory joint pain suggestive of PsA. At week 36, eight patients who had a limited relapse were controlled with topical treatment, 43 patients received a biological agent, two patients were included in a clinical trial with an investigational drug and 15 patients were treated with conventional systemic agents.

Conclusion:
Abrupt cessation of brodalumab is associated with a rapid relapse of psoriasis with some patients experiencing a rebound. It seems not advisable to stop treatment with IL-17 receptor antagonists abruptly even in patients who experience complete clearance of psoriasis.

This study investigated if methotrexate increases the risk of cutaneous malignant melanoma.

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Background:
Methotrexate (MTX) is frequently used as an immunosuppressive drug in inflammatory diseases. It is controversial and it has not been thoroughly investigated whether MTX increases the risk of cutaneous malignant melanoma (CMM).

Objectives:
The aim of the present study was to investigate whether MTX exposure increases the risk for CMM.

Methods:
A retrospective cohort study was conducted using statistics from the National Board of Health and Welfare. All patients over 18 years in the time period August 2005 to December 2014 that were dispensed MTX from Swedish pharmacies were registered (n = 101 966). For every MTX-exposed patient, five age- and sex-matched patients who had been dispensed a random drug other than MTX during the same time period were randomly selected (n = 509 279). The lists were matched with the Swedish Cancer Registry.

Results:
Overall, a small but statistically significant (P < 0·001) risk increase for CMM was observed in MTX-exposed patients compared with patients without MTX exposure. The Kaplan–Meier estimates for the 5-year risk of CMM was 0·48% [95% confidence interval (CI) 0·43–0·53] in the MTX-exposed group and 0·41% (95% CI 0·39–0·43) in the MTX-unexposed group. However, in a subgroup analysis, the difference between the groups was preserved only in women older than 70 years at treatment start. Moreover, there was no significant difference in incidences between the MTX-exposed and MTX-unexposed patients in the time period.

Conclusions:
Our results suggest a small but significant increase in risk for CMM in patients treated with MTX. However, the risk increase observed was considerably lower than in earlier observations.

This study looked at the relationship between genetic polymorphisms in the IL10 gene cluster and psoriasis.

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Background:
Interleukin (IL)-10 family cytokines IL-10, IL-19, IL-20 and IL-24 have been implicated in autoimmune diseases and we have previously reported that genetic variants in the IL10 gene cluster were associated with psoriasis.

Objectives:
To analyse the relationship between genetic polymorphisms in the IL10 gene cluster and psoriasis. This study also explores whether there are gene–gene interactions among these genetic polymorphisms.

Methods:
A total of 377 patients with psoriasis and 403 matched healthy controls were enrolled to carry out a case–control study for 48 single-nucleotide polymorphisms (SNPs) of the IL10 gene cluster. Genotyping for the SNPs was conducted on the Applied Biosystems 3730 DNA Analyzer using SNPlex® technology. Generalized multifactor dimensionality reduction (GMDR) analysis was applied to discover a likely gene–gene interaction model among the SNPs.

Results:
The results showed that the allele distributions of IL10 gene cluster SNPs are significantly different between the case and control groups. Carriers of the IL10 T allele (rs1554286) and the IL20 T allele (rs1400986) conferred protection from psoriasis [odds ratio (OR) = 0·63, corrected P-value (Pc) = 0·007; OR = 0·62, Pc = 0·038, respectively]. GMDR analysis displayed a significant gene–gene interaction between IL10 (rs1554286) and IL20 (rs1518108) variants. The strongest protective effect was found with the block 1 haplotype ACATA in the IL10 gene (Pc = 0·004).

Conclusions:
This study presents a novel finding that the combination of the two SNPs, IL10 (rs1554286) and IL20 (rs1518108), is associated with a reduced risk of psoriasis. Our results indicate that genetic variants of the immunomodulatory IL10 and IL20 genes may offer a protective effect in Europeans from Russia. Independent studies are required to verify the results and find a possible functional explanation.

Here's a great idea that could help with psoriasis diagnoses and treatment.

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A newly developed tissue scanner allows looking under the skin of psoriasis patients. This provides clinically relevant information, such as the structure of skin layers and blood vessels, without the need for contrast agents or radiation exposure. A team of researchers from Helmholtz Zentrum München and the Technical University of Munich (TUM) recently introduced the technology in ‘Nature Biomedical Engineering’.

Currently, physicians evaluate the severity of the disease based on visual assessment of features of the skin surface, such as redness or thickness of the flaking skin. “Unfortunately, these standards miss all parameters that lie below the surface of the skin, and may be subjective,” Dr. Juan Aguirre points out. “Knowing the structure of the skin and vessels before treatment can provide the physician with useful information,” explains the group leader at the Institute of Biological and Medical Imaging (IBMI) at the Helmholtz Zentrum München.

In order to provide clinicians with this information, Aguirre and his team developed a new technique that gets under the skin. It bears the name RSOM and works as follows: A weak laser pulse excites the tissue of interest, which then absorbs energy and heats up minimally. This causes momentary tissue expansion, which generates ultrasound waves. The scientists measure these ultrasound signals and use this information to reconstruct a high resolution image of what lies under the skin.

While developing the method, the scientists were able to reduce the size of the scanner to a handheld device. “This technology, which is easy to use and does not involve any radiation exposure or contrast agent, is allowing us to acquire the first new insights into the disease mechanisms. It also facilitates treatment decisions for the physicians,” explains Prof. Dr. Vasilis Ntziachristos, Director of the IBMI at the Helmholtz Zentrum München and Chair of Biological Imaging at the Technical University of Munich.

In the recently published study, the scientists demonstrated RSOM’s performance by examining cutaneous and subcutaneous tissue from psoriasis patients. RSOM allowed them to determine several characteristics of psoriasis and inflammation, including skin thickness, capillary density, number of vessels, and total blood volume in the skin. They compiled these to define a novel clinical index for assessing psoriasis severity that may be superior to the current clinical standard because the new index also takes into account characteristics below the skin surface.

The researchers plan to use the same imaging method to assess other diseases such as skin cancer or diabetes in the future. Patients with diabetes often suffer from damaged blood vessels that, if detected early enough, may allow earlier treatment and therefore greater efficacy.

Hi there,

My name is Martyn and over the past few months I have started to research my psoriasis more and have stumbled upon this forum.

I have had plaque psoriasis for about 13 years, from the age of 17, and it started out on my elbows, knees and scalp.

Fast forward to present time and my psoriasis has long disappeared from my elbows and knees but remains heavier on my scalp. Also, over the past 12 months I have developed what started as small red dots on the outside of both eyes (kind of high up on my cheek bones) which has further developed into smooth un-raised red patches - appears like sunburn.

I have a few questions to begin with which I'm struggling to find out online. I used to use Dovobet (white tube, red stripes). Has this cream been discontinued? It was the only cream that has really worked for me :(

Secondly, has anyone ever had any experience with my redness around my eyes? My doctor prescribed me creams which haven't worked but its appearance doesn't fit any psoriasis descriptions. Maybe I need to put a picture to really show you what I have.

Lastly, has anyone got any shampoo tips to ease my scalp psoriasis? I have seen an online shop selling nettle shampoo which is dubbed a psoriasis 'life saver', but unsure if the claims are untrue - not putting the link on as I'm not plugging any products.

Thanks for taking the time to read. I fully appreciate my psoriasis is very very mild - reading other people's stories on here makes me feel lucky - but maybe my experiences in the future could also help others out.

Cheers,
Martyn.

Hi everyone!

I am Angie from Sydney, Australia! I am 32 years old and am a psoriasis sufferer.

I discovered this forum while I was doing my weekly search into different options to treat my psoriasis. 

I have had psoriasis for 8 years now, when I was pregnant. Initially, it was on different spots on my back, which didn't really bother me until it started appearing on my arm and now my leg and knees. 
The problem I have is being able to afford creams and wanting to ideally purchase my own UV light that I can do treatment at home.
I find that the prescription creams and coal tar help more than the natural method, but I find that my psoriasis likes to attack my body when I am on the off chance of not having any creams :(

But anyway, this is me and my journey.

Angie

Hi All

My name is Beth Anne I'm 30 and I've had Psoriasis ever since I was 14. It was so severe first time I was under derm and prescribed cream upon cream (diprobase, Dovobet, Dovonex, Cocois and Alphosyl) nothing worked it eventually cleared upon its own accord at 24 came back when I was diagnosed with polycystic ovarian syndrome and hormone imbalances 

Now at 30 it's back with a vengeance I'm covered from head to toe I'm constantly have to hoover as I'm so flaky lol I'm using emollients to moisturise and Dovonex cream but it's too widespread for cream anymore UVA therapy didn't work "( I've just resigned myself to the fact I'm meant to be itchy and flaky for life. I suffer bad from Anxiety and depression. People like to stare at me when I'm out so I tend to hide away at 30 this is not how I envisioned living 
  
Doctor also thinks I'm developing psoriatic athritis in my fingers and wrists too 

I joined here to hopefully talk to people who can understand my pain 

Beth Anne

Just have to say congratulations to Fred and the gang for doing a great job of keeping this site going, and helping lots of people in the process.
When I saw how many member's there are now, I was astounded, 973 I believe, WOW, when I joined I think it was 70.
Keep up the great work everyone, hope to get back on again soon.

Best Regards to all

Micky

Hi all,

Had tonsillitis before Christmas & what I though may have been eczema. In March had another flare up & been diagnosed with palmoplantar Pustulosis. Had one lot of Duvobet with occlusion which knocked back now on diprosalic which does not appear to be effective. Was referred to hospital but when I rang for apt been told it will be at another go surgery!

Struggling with daily activities & beginning to realize just how much I use my hands without fully appreciating them! 

My condition starts with blisters/pustules on hands & feet that feel like tiny shards of glass, they dry & peel & the skin catches on everything, then peels before repeating the whole process again. Needless to say very sore despite lots of moisturiser & using emollient!

Any tips for making life easier gratefully received!

Thanks

McJu

This first human phase 1 study was to determine the safety and tolerability of ascending single doses of KHK4083 in patients with mild to moderate plaque psoriasis.

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Background:
OX40 (CD134) is expressed in lesional but not healthy skin of patients with psoriasis. KHK4083 is a fully human monoclonal antibody against OX40.

Objective:
The primary aim of this first-in-human phase 1 study was to determine the safety and tolerability of ascending single doses of KHK4083 in patients with mild to moderate plaque psoriasis. Secondary aims were to determine the pharmacokinetics and immunogenicity of KHK4083, and an exploratory objective was to assess clinical activity.

Methods:
In phase 1a single doses of KHK4083 0.003 and 0.001 mg/kg IV was administered open-label in two cohorts (each n = 6). Phase 1b had a multicenter, randomized, double-blind, placebo-controlled, ascending single-dose design in seven cohorts. Randomization was performed 3:1 to KHK4083 (n = 6) or placebo (n = 2) within each cohort. Ascending doses of KHK4083 were 0.03, 0.1, 0.3, 1.0, 3.0, and 10 mg/kg IV, and 1.0 mg/kg SC.

Results:
There were no severe or serious adverse events (AEs), or discontinuations because of AEs. The most frequent treatment-related AEs in the 55 patients who received KHK4083 were mild or moderate chills (9.1%), and infusion/injection site reactions (7.3%). No clinically meaningful or dose-related changes from baseline in laboratory values, vital signs, ECG recordings, or physical examinations were observed. Some KHK4083 recipients (10/54) developed anti-KHK4083 antibodies following treatment. Mean elimination half-life (t1/2) increased with dose, maximum serum concentration increased in a dose-proportional manner, and area under the serum concentration-time curve increased in a more than dose proportional manner with increasing IV dose. Absolute bioavailability following SC administration was 73%. There was some indication of improvement of PASI and sPGA scores at the highest IV doses (1.0 and 10 mg/kg) and the SC dose (1.0 mg/kg). The largest PASI 50 response and improvement of sPGA score ≥2 occurred with KHK4083 1.0 mg/kg SC.

Conclusion:
KHK4083 administration as a single dose up to 10 mg/kg IV or 1.0 mg/kg SC was generally safe and well tolerated in patients with mild to moderate plaque psoriasis with no dose-limiting AEs.

Hello everyone!
I was diagnosed with psoriasis about 3 years ago after having a bout with strep throat. A few months later I noticed these weird itchy, scaly patches on my calves and hairline...made an apt. with my dermatologist and she diagnosed it as psoriasis. I'd never had it before and I'm in my 50's.

It was manageable at first but in the last year, it has been spreading to more of my calves and the itching has intensified. I've been using topical steroids (Taclonex) and a Vit. D cream. I've gone through about 11-12 Exemer light therapy sessions but the itching, scaling, stinging and burning sensations have turned me off to continuing....plus, my legs now look like leopard skin! The Dr. has suggested Stelara but not sure I want to go down that path. I hate the thought of the side effects...thank you to all who have posted on here your experiences with it....seems like the side effects can be worse than the disease. I really don't want to end up damaging other organs (kidneys? liver? etc) in trying to clear up my skin.

I've cleaned up my diet, thinking that would help...not noticeably other than lost some weight (not complaining). Read the threads on here about eliminating gluten, sugars, etc. which is what I have done. Eliminated wine/alcohol for awhile but sometimes, you just need that lil' sumthin' sumthin'. Aiming for just the weekends for now. Someone posted about "leaky gut" which I've been hypothesizing about, as well. Been on probiotics for about 7 months. After I started on those, the onset of PA went away! #Win!

That's my story...look forward to all the great information on this site and thank you, everyone, for sharing your stories, trials, and information!