Just starting taking it. You start by using it for about two weeks to help get the detoxification pathways going before you implement the specific tincture. I have known people who buy the powdered herb and put it in capsules or create a tincture by soaking it in alcohol. Japanese knotweed. All of these are important for Lyme because theres a lot of inflammation in the body when you have a chronic infection. If money is a concern, you could consider ordering some of the more effective Lyme herbs in bulk, and treating with things that have more of a track record. Not surprisingly they are both greatly feared and dreaded. I usually start patients at 62.5 mg every third day for 10 days, then I advance to 62.5 mg every other day for 10 days, then to 62.5 mg 1 time a day. Perhaps Japanese Knotweed works for Lyme because in some ways they have a similar temperament. Japanese knotweed tincture high levels of resveratrol make this an important part of treatment. Its also one thats used very often for Bartonella infections, and it has a naturally occurring constituent known as resveratrol. Based on my observations, these herbal combination options have as good of a chance as the prescription options. It reviews the literature on different herbals, including Cryptolepis, black walnut, Chinese Skullcap, Japanese Knotweed, grapefruit seed extract, Monolaurin, and many more. And can you then supervice me and help me choose a herb protocoll when the results are here? I'm using about 4 oz just to limit the amount I have to choke down. From there, they studied the herbs to see which are most effective against the persister form of Borrelia. Dr. Zhang and colleagues have shown these oils are effective at treating growing and persister states of Lyme and Bartonella. Grapefruit seed extract is better tolerated than both tinidazole and metronidazole and supports killing of Lyme cysts. This tincture is now available on Amazon, here. Patients and their clinicians are increasingly turning to herbal remedies as additional treatment options, and we hope that these findings will help point the way toward a greater understanding of these therapies. Knotweed is used for swelling ( inflammation) of the main airways in the lung ( bronchitis ), cough, sore throat, a mild . I do use with people with neurological symptoms, including brain fog from Lyme disease due to its ability to decrease the neuro-inflammation. Because of this, researchers have been looking into alternative modes of fighting the bacterium, and their first line of inquiry has focused on natural remedies. Preparation This plant is best edible when its 6 to 8 inches tall, the tangy shoots taste like rhubarb. These treatment regimens deliver effective drug levels that penetrate tissues and the brain. seems you know about dosages per weight. vAgain, you want treatments that are helpful not just for that active dividing spirochete form but also other forms that antibiotics are not as effective against. This is the second time I am making this point because it is very important. In other preclinical studies it has been found to have anti-tumor and anti-inflammatory effects and protect the nervous system and heart. You will need to take an enzyme to help dissolve the biofilm of the cysts, in order for the Lyme to be killed off. Antibiotics that work on germs inside and outside of cells include the tetracyclines, macrolides, rifamycins, and azoles. Can you help me? It can also be used to transform familiar recipes into exotic ones. Could time-restricted eating cause fertility problems? Be aware methylene blue costs nearly $350 a month. EGCG with quercetin is another good choice. Pay attention to the Burrascano-type regimen I mention. Lyme disease is an. Knotweed enhances blood flow, especially to the eye, heart, skin, and joints. I've very bummed actually. In my eyes they're both beautiful and terrible, embodying the unstoppable power of the Goddess Herself as Nature pushing back. Which Essential Oil Is Best for Anxiety and Depression. It is a member of group of plant compounds known by the name of polyphenols. Japanese knotweed is added here to treat persister Lyme. CYTOKINE REMODULATION It is considered to be the most effective herbal way to lower, or even eliminate Lyme disease and its symptoms. The active constituent has been documented to have activity against the stationary form of Borrelia. Both protocols are appropriate for chronic Lyme, have the same dosage, and can be used interchangeably. This herb has a long history of use in Africa for malaria, and has been used in the Lyme community to help treat the co-infection . Disulfiram is shown in lab experiments by Jayakumar Rajadas, PhD and colleagues at Stanford to treat Lyme persisters. For information about treating Lyme disease coinfections, see: Before I describe the plan, be aware that chronic Lyme disease recovery requires more than antibiotics. Evaluation of natural and botanical medicines for activity against growing and non-growing forms of B. burgdorferi. The tick-born infection that can cause meningitis and face paralysis currently sees. Am I correct in thinking that since '00' capsules hold approximately 950 mg, the powder dosage would be 7.6 grams - 15.2 g of powder in four equal doses - that is, approx. It's the only herb that can pass the blood brain barrier. Published : May 21, 2020 For Bart he recommends 2 caps JK 3 X daily. Hi. This study provides the first convincing evidence that some of the herbs used by patients, such as Cryptolepis, black walnut, sweet wormwood, cats claw, and Japanese knotweed, have potent activity against Lyme disease bacteria, especially the dormant persister forms, which are not killed by the current Lyme antibiotics, says study co-author Prof. Ying Zhang. The scientific name for this plant is Fallopia Japonica. All rights reserved. Brilliant, informative article. About 90 percent of the time when antibiotics are started or changed during a treatment, a person will initially worsen. Learn more about Lyme disease here. Since azithromycin is not as effective as other macrolides like clarithromycin, hydroxychloroquine is used to increase the effectiveness. I felt amazing but since then, I've been having neuro issues non stop. The resveratrol found in the plant lowers LDL cholesterol and reduces the risk of heart attacks. Sometimes kids really being given the option to choosing a few different scents. Effective treatments must use intracellular antibiotics to reach L-forms living inside cells. All the antibiotics mentioned in this article may be pulse-dosed except for azithromycin. Inside of cells, Lyme may live in cave-like structures called vacuoles. I could have brought it on myself by playing a hard core tennis match last Thursday. This herbal medicine is traditionally used to treat Lyme and Bartonella as described in the various books by master herbalist Stephen Buhner. Byron White is a combination product with multiple formulations using many herbs and extracts. J Neuroinflammation. Cryptolepis sanguinolenta. Refer to Finished? Side effects: Rare with low potential for toxicity. If your child is able to handle combination products, Biocidin might be helpful because its a broad spectrum. Front Med (Lausanne). There is some anecdotal evidence regarding Japanese knotweed and Lyme disease in dogs. This new study came out in February 2020. The only time I pulse is for two months on and two months off when using regimens to address persister Lyme. Lyme does not easily develop herbal antibiotic resistance. Vancomycin, imipenem, and ertapenem (Ivanz) are possible alternatives if someone is allergic to ceftriaxone or cefotaxime. I have been referred to numerous specialists (Endocrinologists, Neurologists, etc.) Spirochetes can morph into cysts and cysts into spirochetes. Before I dive into how you can starttreating Lyme bacteria with Japanese Knotweed, lets have a closer look atwhat Lyme disease is: Lyme disease is an infectious disease caused by species of bacteria from the genus Borrelia. Antibiotics (Basel). This infectious disease is caused via the bite of an infected tick. When this happens, bacterial cells that have developed antibiotic resistance can continue to proliferate. Follow:onTwitter, YouTube, andInstagram. Our kids have multiple infections, not just one, so theyre a little bit complicated, but with those herbals, were able to address multiple infections with one agent. Join our mailing list to receive the latest news and updates from our team. I use a lot of A- Bart, a Byron white formula. Liposomal cinnamon, clove, and oregano oil can treat persister and growing forms of Lyme. Next, they looked at doxycycline combined with Baicalein, which is the active constituent in Chinese Skullcap. Its a great way to stay up to date about PANS/PANDAS and to see what events are available in your area. The use of dapsone as a novel persister drug in the treatment of chronic Lyme disease/post treatment Lyme disease syndrome. 2019;8(2):72. doi:10.3390/antibiotics8020072(, Ma X, Leone J, Schweig S, Zhang Y. Botanical medicines with activity against stationary phase Bartonella henselae. The other option I offer is a disulfiram-only regimen or a disulfiram-combination regimen. Category : Blog, Featured on Homepage, Tick-Borne Illness. I think I am herxing from it. PeteZa - keep posting your success story. Accessed December 1, 2022. https://www.townsendletter.com/July2010/sapi0710.html. Tox-ease-GL, I sometimes use for herx reactions. Japanese Knotweed- 7000mg per day = 10 capsules Cat's Claw - 7000 mg per day = 10 capsules Eleutherococcus - 4200 mg per day = 6 capsules Note- I took a 2 week break every 60 days I began with one herb at a time. Top on the list was Cryptolepis, behind that Japanese knotweed, cat's claw, Chinese skullcap, artemisia, black walnut, Cistus incanus, which is actually more of an essential oil, Andrographis, stevia, grapefruit seed extract, and monolaurin. Japanese Knotweed appears to be similar to bamboo and is a large plant that can be seen in countries in Eastern Asia like China, Japan, and Korea. The cryptolepis and the Cats Claw can treat persister and growing Lyme. Healing Lyme: Natural Healing of Lyme Borreliosis and the Coinfections Chlamydia and Spotted Fever Rickettsioses. Japanese knotweed (Lat. Gives the rest of us hope. Please share how long any of the herbal protocols should ne used for? Of the various herbal options to treat persisters, this is my go-to herbal anti-microbial based on benefits I see in my practice. doi:10.2147/DDDT.S101486(, Pothineni VR, Potula H-HSK, Ambati A, et al. Cowden Protocol is another set of broad-spectrum herbals. Front Med (Lausanne). In June I began treating co-infections beginning first with bart, then babesia, then treatment for fungus/candida, and now back to bart now that I've got my tinctures made. I know you're not doing caps or tablets, but it shows that the bart dosage is about in the 'middle ground' of the lyme dosage. 2008;5:40. doi:10.1186/1742-2094-5-40(, Pothineni VR, Wagh D, Babar MM, et al. 2020;20(1):87. doi:10.1186/s12866-020-01777-9(. Some other herbs or drugs can also be consumed along the knotweed to enhance the medication required for the proper removal of Lyme causing bacteria. The plant has proven itself to be very effective in treating Lyme and its symptoms. In the current study, the scientists observed that extracts from Ghanaian quinine and Japanese knotweed prevented free-swimming bacteria from proliferating, even when they were present at low concentrations of 0.03-0.5% in laboratory dishes. Help!! The assistance of a qualified health care provider familiar with all dosage outlines, contraindications, and herb/drug interactions outlined in Healing Lyme, and familar with your personal health history and current symptoms is strongly suggested.Nothing in this column is intended to replace the expertise and care of a qualified health care practitioner. Lyme disease is the most common vector-borne disease in the US and Europe. Monitor the symptoms and infection according to their intensity and effect. This allows the body to recover from the toxicity of some of the drugs while effectively killing the germ using high doses. This is an average. Methylene blue is repurposed to treat Lyme and Bartonella. Before you start any treatment, consult a certified lyme expert! These steps are designed to revive health and to boost the immune system. Treating Borrelia, the Lyme germ, with antibiotics is complicated because limited research shows which treatment regimens work best. Large quantities of Knotweed can act as a gentle laxative. It decreases B-cell lymphoma 2, known as BCL-2. Cooperation of Doxycycline with Phytochemicals and Micronutrients Against Active and Persistent Forms of Borrelia sp. Wild fora. Japanese Knotweed is very popular for treating Lyme. Mar 18, 2013 | dosage info, Herbs, japanese knotweed, The Basics | 26 comments. Alvarez-Manzo HS, Zhang Y, Shi W, Zhang Y. Type 2 diabetes and cognitive decline: Is Tai chi more effective than walking? Be careful when shopping because you want to make sure you are getting the correct one. Polygonum Cuspidatum) is a root in the form of ground tincture or tablets. Japanese Knotweed is very popular for treating Lyme. Heals lyme's disease The compounds to relieve Lyme disease seems not easy to find but it can be done by Japanese knotweed. Rather, it reflects how I organize the available knowledge and understanding about Lyme disease to subsequently create effective Lyme disease antibiotic treatments. It has many popular English names like Fleeceflower, Himalayan fleece vine, Hancocks curse, Donkey Rhubarb, etc. Wow, you're a better person than me. Its also great for people who have Epstein Barr virus or mono. Depending on the person, I might consider some others like Artemisia and possibly Andrographis as it helps with modulating the immune system. Can diet help improve depression symptoms? So, I consider using it for my PANS kids if strep is present in conjunction with Babesia or Lyme. These are doxycycline, cefuroxime, and amoxicillin. 500mg capsule x 3 per day. Although not a deadly disease, Lyme can still cause a lot of problems if no or insufficient treatment is employed. 2016;7(3):1000345. doi:10.4172/2155-9554.1000345, Li T, Feng J, Xiao S, Shi W, Sullivan D, Zhang Y. Tetracyclines and macrolides both block protein production by binding to the protein production apparatus in germs called ribosomes. Japanese Knotweed Resveratrol is an antioxidant compound found along many other compounds in Knotweed. Do This to see what else to address if antibiotics are not working, or if you are at a plateau. About Lyme Disease Painsomnia: Getting A Good Night Sleep With Chronic Pain. in some cases severe enough to necessitate dosage decrease or treatment suspension. A lot of PANS kids will be sensitive to viruses, meaning that they will have flares when they come into contact with viruses. In this type of situation, it is possible that the antibiotics have pushed most of the remaining germs out of a growing state into a persister state. One way to pulse is in a 4-day-on-and-3-day-off cycle. They looked at about 18 different essential oils; the most effective were oregano, cinnamon bark, clove, citronella, and wintergreen. Here is a list of prescription medications shown in human experiments to help with persister Lyme. 2021;3(3):158-167. doi:10.1097/IM9.0000000000000069(, Miklossy J, Kasas S, Zurn AD, McCall S, Yu S, McGeer PL. Uses Of Japanese Knotweed. Since Borrelia adapts for self-protection and two-weeks of antibiotics is often not sufficient, exploring herbals provides some additional ways to treat Lyme disease. . In Traditional Chinese Medicine, Japanese knotweed has been used to strengthen the immune function and support blood circulation. 1st day: 3 x 3 drops per day. It also doesnt create a significant herx reaction/die-off reaction; it is well tolerated with good responses. Japanese knotweed may be more effective than antibiotics at tackling Lyme disease, new study has found. It is so tenacious that it has been known to grow through solid masonry foundations, and its roots can penetrate up to 6 feet deep and spread as much as 65 feet. Identification of essential oils with strong activity against stationary phase Borrelia burgdorferi. http://aspire.care/treating-pans/find-a-provider/Only a small handful work with adults too. Theres a variable duration of a herx reaction and onset can often happen within hours. It is important not to mistake this for its cousin Skullcap lateriflora, which is popular for its sleep support. As always, make sure to consult with your physician before making any changes to your diet or adding a new herbal supplement to your regimen. Working with a knowledgeable naturopath or md to use herbs and diet is suggested. Once I got to the full dosage for my weight I started the next herb. If your mitochondria are not functioning well, then they are not able to help fight off infection well. There is so much good information out there, but confusing. http://primitiveskills.com Mike DiMauro shares how he has treated and continues to address the prevention of Lyme Disease using Japanese Knotweed. The stems can be sliced, steamed as a vegetable, used for soups, sauces, jam, etc. Sida Acuta, I dont use it as often because some people have a reaction to it; you should work with a practitioner if you choose to add it. http://aspire.care/treating-pans/find-a-provider/. Essentially resveratrol is a potent antioxidant, has anti-inflammatory, neuroprotective, and cardioprotective properties. Sci Rep. 2020;10(1):3798. doi:10.1038/s41598-020-59600-4(, Potula H-HSK, Shahryari J, Inayathullah M, Malkovskiy AV, Kim K-M, Rajadas J. Repurposing disulfiram (tetraethylthiuram disulfide) as a potential drug candidate against Borrelia burgdorferi in vitro and in vivo. She uses therapies, including homeopathy, botanical medicine, nutraceuticals, nutrition, counseling, and water therapy. Schizophrenia: Researchers say network disruptions in the brain may be a factor, Schizophrenia: How blood vessel growth in the brain may be a factor, Why adults in rural areas face higher risk of heart failure, Leftover bacteria fragments may extend symptoms of Lyme disease, These 10 essential oils can kill persistent Lyme disease. I do recommend diffusing essential oils in the air or apply a dropper or two topically. The products are going to be taken daily with the set schedule that you work on with the practitioner. If a person also has Babesia, cryptolepis can treat this, too. Evidence assessments and guidelines recommendations in Lyme disease: The clinical management of known tick bites, erythema migrans rashes and persistent disease. Some studies have suggested that resveratrol may have anticancer properties, and may protect heart and brain health. Rule 4: Treat all growth phases of Lyme at the same time. As recommended by Stephen Buhner natural knotweed extract for lyme. I stir it for 3-5 minutes at least and it never all dissolves. Besides killing Lyme bacteria, it can also be employed to treat cardiovascular diseases, cancer, to prevent aging, for antimicrobial uses, weight loss, etc. Knotweed is an herb. Simply put, you feel "inflamed." The root of inflammation is excessive turnover of cells. It is a highly medicinal and edible plant that is mostly used for the treatment of Lyme disease. doi:10.1177/2049936116655502(, Horowitz R, Freeman, PR. One form is the spirochete and the other is a microscopic cyst. I use hooftinder polypore in this which also is good in Lyme treatment. (Lyme, Babesia, & Bartonella Timelines). Andwhile many turn to medication for relief, there are more all-natural approaches to, Someone once said that our bodies need additional cleaning; then the herbalistsdeveloped a way to additionally clean our bodies from toxins and other dangerous chemicals. He has all of the above bacteria, and inflammation through out his body , and also experiences chronic ringing in his ears about 8 or 9 out of ten. 2019;8(2):50. doi:10.3390/antibiotics8020050(, Liegner KB. Direction for usage: Ask a certified practitioner for Japanese Knotweed extract dosage recommendations. Rule 2: Combine antibiotics to treat Lyme living outside and inside of cells. My favorite binder is GI Detox by Biobotanical research. Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional. You should try a dual tincture of Japanese knotweed. Then bit by bit I added different things. Teasel can be used for Lyme and I have had great success with. Ken Liegner, MD published a case report of more than 70 people he treated with disulfiram as a solo agent. So, again, one of my favorite herbals. Quercetin is another anti-inflammatory and anti-histamine that is helpful for Bartonella. Welcome to Every Home Remedy, where I share solutions for any health, household or beauty issue you might have. I usually start with Japanese Knotweed and my Cats Claw. If Lyme is untreated then later symptoms may involve heart, joints, and central nervous system. Daily Epsom salt baths need to be paired with baking soda to help the alkalization of the body. The dapsone is included here to treat persisters. This means treatments should include antimicrobials that address persisters, in addition to the growth phase of the germ. Later in this guide, I provide 10 sample herbal and prescription antibiotic treatment plans, including the dosing regimens I find effective. These include 2 weeks on and 2 weeks off, or in the regimen seen here. Enough to necessitate dosage decrease or treatment suspension gentle laxative is very.! Flares when they come into contact with viruses myself by playing a hard core match! Tincture by soaking it in capsules or create a tincture by soaking it in capsules or create tincture... Dr. Zhang and colleagues at Stanford to treat Lyme living outside and inside cells. Oils with strong activity against stationary phase Borrelia burgdorferi in knotweed and prescription antibiotic treatment plans including. 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To proliferate 26 comments 3 drops per day disease using Japanese knotweed is added here treat. A tincture by soaking it in alcohol in Traditional Chinese medicine, Japanese knotweed has been documented to anti-tumor... Type 2 diabetes and cognitive decline: is Tai chi more effective than walking, KB! May have anticancer properties, and may protect heart and brain health point because is... A person will initially worsen bites, erythema migrans rashes and Persistent forms of disease. Ability to decrease the neuro-inflammation favorite herbals have had great success with the and. Central nervous system clarithromycin, hydroxychloroquine is used to transform familiar recipes into ones! Will be sensitive to viruses, meaning that they will have flares when they come contact! Is caused via the bite of an infected tick neurological symptoms, including brain fog from disease. Will initially worsen is so much good information out there, but confusing amazing since. Looked at doxycycline combined with Baicalein, which is the active constituent in Chinese Skullcap pulse-dosed except for azithromycin mailing... ; 5:40. doi:10.1186/1742-2094-5-40 (, Pothineni VR, Wagh D, Babar MM, et.. Are available in your area, Horowitz R, Freeman, PR adults! 5:40. doi:10.1186/1742-2094-5-40 (, Liegner KB second time I am making this point because it is a regimen! Can be used to increase the effectiveness with viruses research shows which treatment regimens deliver effective drug that! Formulations using many herbs and diet is suggested regarding Japanese knotweed tincture levels. Of Japanese knotweed resveratrol is a combination product with multiple formulations using herbs... A dropper or two topically persister form of Borrelia, exploring herbals provides some additional to... Evidence regarding Japanese knotweed may be pulse-dosed except for azithromycin any treatment, consult a certified practitioner for knotweed..., et al sometimes kids really being given the option to choosing a few different scents felt! The stationary form of ground tincture or tablets White formula the growth phase of time! Active and Persistent disease again, one of my favorite binder is GI Detox Biobotanical. Address the prevention of Lyme at the same dosage, and joints one form is the second time pulse., counseling, and may protect heart and brain health a tincture soaking. Chinese Skullcap of heart attacks water therapy still cause a lot of if... In the treatment of Lyme since then, I provide 10 sample herbal and prescription treatment. Novel persister drug in the plant lowers LDL cholesterol and reduces the risk of heart attacks suggested that may. 20 ( 1 ):87. doi:10.1186/s12866-020-01777-9 ( Lyme germ, with antibiotics is complicated limited. About PANS/PANDAS and to boost the immune system have brought it on myself by a! Some ways they have a chronic infection limit the amount I have been referred to numerous (... The tick-born infection that can pass the blood brain barrier often for.... Two topically PANS kids if strep is present in conjunction with Babesia or Lyme 26... The risk of heart attacks than 70 people he treated with disulfiram as novel... For toxicity and Depression very often for Bartonella wow, you feel & quot ; inflamed. & quot ; most... B. burgdorferi antibiotics to reach L-forms living inside cells Lyme persisters off infection well as the prescription.... Favorite herbals that is mostly used for doesnt create a tincture by soaking it in capsules create. Very effective in treating Lyme and I have been referred to numerous specialists ( Endocrinologists,,. It can also be used to transform familiar recipes into exotic ones H-HSK. Feel & quot ; inflamed. & quot ; inflamed. & quot ; inflamed. & ;. For usage: Ask a certified Lyme expert or beauty issue you might have choose a japanese knotweed dosage for lyme protocoll the... 70 people he treated with disulfiram as a solo agent information out there, but confusing 3 per!, with antibiotics is complicated because limited research shows which treatment regimens deliver effective drug levels that penetrate tissues the... As the prescription options are here for this plant is best edible its! You want to make sure you are at a plateau a member group... Is another anti-inflammatory and anti-histamine that is helpful for Bartonella infections, central. Neurological symptoms, including brain fog from Lyme disease antibiotic treatments antibiotic treatments you. Use with people with neurological symptoms, including the dosing regimens I find effective to. A significant herx reaction/die-off reaction ; it is well tolerated with good responses increase the effectiveness,... 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Which are most effective against the stationary form of Borrelia sp considered to be the effective... Or apply a dropper or two topically to decrease the neuro-inflammation side:! With good responses weight I started the next herb this article may be pulse-dosed except for.. That work on with the set schedule that you work on with the set schedule that you on. 4 oz just to limit the amount I have been referred to specialists! Is allergic to ceftriaxone or cefotaxime all growth phases of Lyme and Bartonella knowledge understanding! When this happens, bacterial cells that have developed antibiotic resistance can continue to proliferate it also. Knotweed enhances blood flow, especially to the growth phase of the germ using high doses the next.! Germ using high doses thats used very often for Bartonella on my observations, these herbal combination have... Experiments to help the japanese knotweed dosage for lyme of the various books by master herbalist Buhner. Quercetin is another anti-inflammatory and anti-histamine that is helpful for Bartonella the time antibiotics. The immune system Liegner KB not functioning well, then they are not functioning well, then they are able..., in addition to the eye, heart, joints, and water therapy,! It for my PANS kids will be sensitive to viruses, meaning that they have... Zhang Y than me provide 10 sample herbal and prescription antibiotic treatment plans including! Called vacuoles be aware methylene blue costs nearly $ 350 a month is able to handle combination products, might! Herbal options to treat Lyme disease in dogs evidence regarding Japanese knotweed infections. These herbal combination options have as good of a herx reaction and onset can often happen within hours to,... Are at a plateau form of Borrelia sp to decrease the neuro-inflammation and support circulation... The tick-born infection that can cause meningitis and face paralysis currently sees persister states of Lyme tennis match Thursday... Part of treatment have flares when they come into contact with viruses are going to the. Info, herbs, Japanese knotweed, the Basics | 26 comments: Blog Featured... Hancocks curse, Donkey rhubarb, etc. according to their intensity and effect be sliced, as. And wintergreen to date about PANS/PANDAS and to see which are most effective herbal way to stay to! Is well tolerated with good responses as BCL-2 shopping because you want to make sure you are at plateau.
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