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Administering immunotherapy in the morning seems to matter. Why?

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Re: Administering immunotherapy in the morning seems to matter. Why?

#21

Post by finnh »

leereeves wrote: post #9
vhanda wrote: post #3

Earlier quoted context omitted.

From the article - > this paper was not a retrospective study of electronic health records, it was a randomized clinical trial, which is the gold standard. This means that we’ll be forced to immediately throw away our list of other obvious complaints against this paper. Yes, healthier patients may come in the morning more often, but randomization fixes that. Yes, patients with better support systems may come in the m…

> Yes, maybe morning nurses are fresher and more alert, but, again, randomization fixes that How does randomization fix that?

exactly. that one clause casts doubt on all the other reasoning; randomization controls for patient selection bias but not diurnal clinic performance

Re: Administering immunotherapy in the morning seems to matter. Why?

#22

Post by unnamed76ri »

I used to be on a chemo drug and had to take folic acid every day to stop it from doing bad things to me.

I had awful ulcers in my mouth from the chemo drug and had been taking the folic acid in the morning. Through forgetfulness I ended up shifting the folic acid to the afternoon and the ulcers went away and never came back.

Re: Administering immunotherapy in the morning seems to matter. Why?

#23

Post by annoyingnoob »

detourdog wrote: post #12
rendaw wrote: post #6

I'm doing CedarCure. You're required to not exercise or bath/shower for 2h after taking, which is fairly difficult in the morning, so I asked the doc if I could do it in the evening instead (despite explicit instructions to do it in the morning). The doc said it was fine, confirmed by the pharmacist. I should know better by now than to trust doctors to act based on research and not gut feeling, but I hope this doesn'…

I looked up CedarCure and what I found is that it is a pesticide. What is the treatment about?

https://synapse.inc/medicine/9101/

Re: Administering immunotherapy in the morning seems to matter. Why?

#24

Post by iamtheworstdev »

rendaw wrote: post #6

I'm doing CedarCure. You're required to not exercise or bath/shower for 2h after taking, which is fairly difficult in the morning, so I asked the doc if I could do it in the evening instead (despite explicit instructions to do it in the morning). The doc said it was fine, confirmed by the pharmacist. I should know better by now than to trust doctors to act based on research and not gut feeling, but I hope this doesn'…

a brand new study comes out and you're mad the doctors didn't know about it a year ago?

do you carry any of the blame on yourself since you knew there were explicit instructions but apparently waiting to shower or exercise was too much of an inconvenience for you?

Re: Administering immunotherapy in the morning seems to matter. Why?

#25

Post by tomcam »

unnamed76ri wrote: post #22

I used to be on a chemo drug and had to take folic acid every day to stop it from doing bad things to me. I had awful ulcers in my mouth from the chemo drug and had been taking the folic acid in the morning. Through forgetfulness I ended up shifting the folic acid to the afternoon and the ulcers went away and never came back.

Thanks for sharing, and I’m very glad you are here to discuss it.

Re: Administering immunotherapy in the morning seems to matter. Why?

#26

Post by tomcam »

iamtheworstdev wrote: post #24
rendaw wrote: post #6

I'm doing CedarCure. You're required to not exercise or bath/shower for 2h after taking, which is fairly difficult in the morning, so I asked the doc if I could do it in the evening instead (despite explicit instructions to do it in the morning). The doc said it was fine, confirmed by the pharmacist. I should know better by now than to trust doctors to act based on research and not gut feeling, but I hope this doesn'…

a brand new study comes out and you're mad the doctors didn't know about it a year ago? do you carry any of the blame on yourself since you knew there were explicit instructions but apparently waiting to shower or exercise was too much of an inconvenience for you?

Where did they say they’re mad?

Re: Administering immunotherapy in the morning seems to matter. Why?

#27

Post by tialaramex »

justsomehnguy wrote: post #17
rendaw wrote: post #6

I'm doing CedarCure. You're required to not exercise or bath/shower for 2h after taking, which is fairly difficult in the morning, so I asked the doc if I could do it in the evening instead (despite explicit instructions to do it in the morning). The doc said it was fine, confirmed by the pharmacist. I should know better by now than to trust doctors to act based on research and not gut feeling, but I hope this doesn'…

There is always an option what taking it in the evening is magnitudes better than not taking it in the morning at all because you skipped it because you need a shower. Always remember what you are just an another patient with your own quirks.

For the drug I take every day (Levothyroxine), research found that evening was worse, but the explanation was poor compliance - people forget to do it more often compared to the morning. Same reason the contraceptive pill is less effective than you'd expect in real populations, compliance is poor. If you're the sort of person who can actually take it on time, every day, without fail, it's extremely effective, if you aren't, not so much. The choice to include "dummy" pills is because of improved compliance - remembering to take it every single day on the same schedule is just easier, so adjust the medication not the instructions.

Re: Administering immunotherapy in the morning seems to matter. Why?

#28

Post by anigbrowl »

tines wrote: post #16
kelnos wrote: post #11

Earlier quoted context omitted.

Patients in the study are randomly assigned to the early group or the late group. They don't get to schedule their own appointments for whatever time of day they want.

How does this control for the "alert nurses" variable? In that case, patients would do better in the morning, regardless of the patient.

Why would you assume nurses are scheduled on a 9-5 basis?

Re: Administering immunotherapy in the morning seems to matter. Why?

#30

Post by NotGMan »

Perhaps it's due to overnight fasting, that people in the morning don't eat yet/as much?

Autophagy is increased during fasting, it usually takes 3 days of water fasting to fully ramp up to its maximum, so no food overnight might just slightly start it up.

I watched a youtube video of guy who did low carb and fasted at least 24h before and after chemo (or even 48h, forgot which) and he didn't experience the negative side effects of chemo as much.

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