Can PCT be cured?
Although the underlying cause of PCT cannot be cured, the symptoms can be controlled. Attention to known exacerbating factors, such as sunlight exposure, stopping the combined contraceptive pill and avoiding excess alcohol, is important.
What triggers porphyria cutanea tarda?
Porphyria cutanea tarda (PCT) is usually acquired but may be hereditary. Triggers include elevated hepatic iron, alcohol use, halogenated hydrocarbon exposure, and hepatitis C virus or HIV infection. Drugs that commonly trigger acute porphyria do not trigger PCT.
What doctor treats porphyria tarda?
Doctors for porphyria You might see: Hematologists, doctors who treat blood diseases. Dermatologists, specialists in skin diseases. Hepatologists, doctors who treat liver diseases.Jan 20, 2021
What does porphyria skin look like?
Sensitivity to the sun and sometimes artificial light, causing burning pain. Sudden painful skin redness (erythema) and swelling (edema. Blisters on exposed skin, usually the hands, arms and face. Fragile thin skin with changes in skin color (pigment)Jun 3, 2020
What foods should be avoided with porphyria?
The main dietary advice for persons with Porphyria Cutanea Tarda is to avoid all alcohol in any form. In addition, adherence to a low iron diet with avoidance of any medicinal iron and with ingestion of limited amounts of liver or red meat, is recommended, at least until remission of active PCT has been achieved.
What causes PCT?
PCT occurs when the body's ability to make UROD is interrupted. PCT can be caused by hepatitis C, HIV, and excessive alcohol consumption. Some drugs containing estrogen, such as oral contraceptive pills or prostate cancer treatments, can also lead to a build-up of porphyrins in the blood, liver, and skin.Jul 23, 2017
What is the life expectancy of someone with porphyria?
Patients with porphyria generally have a normal life expectancy. However, those with acute hepatic porphyria are at increased risk of developing high blood pressure, chronic kidney disease, and hepatocellular carcinoma (liver cancer), which may reduce their lifespan.Jul 21, 2020
What triggers porphyria?
Porphyria can be triggered by drugs (barbiturates, tranquilizers, birth control pills, sedatives), chemicals, fasting, smoking, drinking alcohol, infections, emotional and physical stress, menstrual hormones, and exposure to the sun. Attacks of porphyria can develop over hours or days and last for days or weeks.Apr 18, 2013
How do you test for porphyria?
Lab tests are required to make a definitive diagnosis of porphyria and to determine which form of the disease you have. Different tests are performed depending on the type of porphyria your doctor suspects. Tests include a combination of blood, urine or stool testing.Jun 3, 2020
Can porphyria go into remission?
With treatment, most people go into remission, meaning they don't have symptoms after their skin is exposed to sunlight and their porphyrin levels return to normal. To help people go into and stay in remission, doctors also recommend avoiding or eliminating factors that can cause porphyria cutanea tarda.
Is porphyria a mental illness?
Porphyria is important in psychiatry as it may present with only psychiatric symptoms; it may masquerade as a psychosis and the patient may be treated as a schizophrenic person for years; the only manifestation may be histrionic personality disorder which may not receive much attention.
Why is porphyria called the vampire disease?
Porphyria cutanea tarda (PCT) is a type of porphyria or blood disorder that affects the skin. PCT is one of the most common types of porphyria. It's sometimes referred to colloquially as vampire disease. That's because people with this condition often experience symptoms following exposure to sunlight.
What is PCT in psychotherapy?
PCT was initially developed as a nonspecific comparison condition to test the effectiveness of trauma-focused cognitive behavioral therapy (TF-CBT). The goal of PCT was to control for therapeutic elements that are present in psychotherapy more generally, to allow conclusions about the effects of the unique interventions in trauma-focused therapy. The theoretical basis for PCT is derived from the large literature on such "common factors" and their role in psychotherapy. The idea that factors that are present in different forms of psychotherapy play an important role in outcome was introduced in 1936 (3) and expanded upon by Jerome Frank (4). Examples of common factors include a supportive therapeutic relationship, a psychotherapeutic rationale that explains the patient's symptoms and the procedures of therapy for relieving them, the experience of talking about problems in a safe environment, and the creation of positive expectations and hope. PCT was developed to embed such common factors within a supportive, problem-solving treatment framework addressing PTSD symptoms and associated features.
What is PCT in VA?
PCT was developed as a comparison condition within the context of two large multi-site VA clinical trials. The first (7) compared PCT using a group format to a trauma-focused group therapy; the second compared individual PCT to Prolonged Exposure (PE) therapy (8). Independently, a different version of Present-Centered Therapy was developed to serve as a comparison condition in an RCT of cognitive behavioral therapy (CBT) for PTSD in adult female survivors of childhood sexual abuse (9). Like the version developed for the VA multi-site RCT, this version includes psychoeducation about trauma and PTSD, focuses on current life difficulties, and excludes cognitive behavioral interventions. Differences include the use of a theoretical framework specific to childhood sexual abuse for the psychoeducational component, a more formalized and systematic emphasis on problem-solving, and assigned homework to write about problem-solving efforts in a journal reviewed with the therapist. This version of PCT has been used in one additional study (10); all other studies have used the VA (7-8) versions.
What is present center therapy?
Present-Centered Therapy (PCT) is a time-limited treatment for PTSD that focuses on increasing adaptive responses to current life stressors and difficulties that are directly or indirectly related to trauma or PTSD symptoms. Findings from many randomized clinical trials (RCTs) that included PCT as an active control condition have led to PCT being recognized by Division 12 of the American Psychological Association as a research supported psychological treatment for PTSD (1). It is also recommended as a second-line treatment in the VA/DoD clinical practice guideline and given a similar ("standard") recommendation in the updated ISTSS guidelines (2).
How long is a PCT session?
The number of sessions has ranged from 12 to 32 for the group format and 10 to 12 for individually delivered PCT; the length of sessions has varied from 60 to 90 minutes. The first two sessions in both formats provide an overview and rationale for PCT and psychoeducation about PTSD symptoms and other common responses to trauma, presented in an interactive format. Subsequent sessions are less structured, focusing largely on topics chosen by patients, who (in the individual format of PCT) are encouraged to use a daily diary to record issues and problems of concern throughout the week. The final session is devoted to reviewing progress and processing termination. Therapist interventions include close listening, reflection, providing validation and support, encouraging expression of feelings, and encouraging problem-solving to enhance coping.
What are some examples of therapeutic relationships?
Examples of common factors include a supportive therapeutic relationship, a psychotherapeutic rationale that explains the patient's symptoms and the procedures of therapy for relieving them, the experience of talking about problems in a safe environment, and the creation of positive expectations and hope.
Is PCT a second line treatment?
PCT is recommended as a second-line treatment for PTSD in the Department of Veterans Affairs/Department of Defense (VA/DoD) Clinical Practice Guideline for PTSD, and has a standard recommendation (also second line) by the International Society for the Study of Traumatic Stress (ISTSS).
What is a PCT?
A Post Cycle Therapy, otherwise referred to as PCT, is a process you go through after a cycle of SARMs or steroids, in order to get your body's natural testosterone levels back up to normal. When on a cycle of SARMs or steroids, your natural testosterone levels might dip, so a post cycle therapy is meant to bring them back to normal.
Why is PCT important?
This is the reason why PCT is so important. It helps your body get back on track faster than it could without one. If you don’t have a post cycle therapy, you won’t keep a lot of your gains. As your testosterone is suppressed (temporarily), much of that muscle will be lost.
What is PCT after steroids?
Put simply, post cycle therapy, or PCT for short, is how you get your natural hormone levels back to normal, after a SARMs or steroids cycle. …and while often overlooked, finding a good PCT is one of the most important things to do when you’re planning a SARMs or steroids cycle. Why?
How long after SARMs can you start PCT?
PCT, or post cycle therapy, is typically started the day after you take your last SARMs dosage. For steroids, users might wait up to a week after taking their last injection however, since the half-life of steroids is relatively long.
What is post cycle therapy?
The whole idea behind post cycle therapy, is it minimizes the “recovery” time after a SARMs, steroids, or prohormone cycle. In other words, not only does it help get your hormone levels back to normal, but it also helps you keep most of your gains.
Do steroids affect testosterone?
When you get on steroids, prohormones, or SARMs, your body’s natural testosterone production is going to slightly decrease. Now, when you’re ON CYCLE, this doesn’t matter, because the drugs you’re taking are compensating for this side effect. …when you get OFF CYCLE, however, all of a sudden those drugs aren’t boosting testosterone ...
What is a PCT after a cycle?
A Post Cycle Therapy, otherwise referred to as PCT, is a process you go through after a cycle of SARMs or steroids, in order to get your body's natural testosterone levels back up to normal. When on a cycle of SARMs or steroids, your natural testosterone levels might dip, so a post cycle therapy is meant to bring them back to normal.#N#Common PCT's include Nolvadex, Clomid Therapy, and other testosterone boosting ingredients. The PCT you'll want to take will vary, depending on the length of your cycle, and what you were on during your cycle.
What is a PCT?
Porphyria Cutanea Tarda (PCT) is a rare disorder characterized by painful, blistering skin lesions that develop on sun-exposed skin (photosensitivity). Affected skin is fragile and may peel or blister after minor trauma. Liver abnormalities may also occur. PCT is essentially an acquired disease, but some individuals have a genetic ...
How rare is PCT?
The disorder usually develops after the age of 30 and its onset in childhood is rare. PCT is found worldwide and in individuals of all races. PCT is a rare disorder; the prevalence is estimated to be approximately 1 case in every 10,000 to 25,000 individuals in the general population.
What causes Porphyria Cutanea Tarda?
Porphyria Cutanea Tarda is caused by deficient levels of an enzyme known as uroporphyrinogen decarboxylase (UROD). In approximately 75% to 80% of cases this deficiency is acquired (PCT type 1 or sporadic PCT); in the remaining cases, individuals have a genetic predisposition to developing the disorder, specifically a mutation in the UROD gene (PCT type 2 or familial PCT). Most individuals with this genetic mutation do not develop symptomatic PCT; the mutation is a predisposing factor and additional factors, known as triggers, are required for the development of the disorder in these individuals. These factors are called susceptibility factors and are required for the development of both sporadic and familial PCT. Generally, PCT develops in mid to late adulthood. In extremely rare cases, individuals have mutations in both UROD genes. This autosomal recessive form of familial PCT is known as Hepatoerythropoietic Porphyria (HEP). HEP occurs in childhood and is usually more severe than PCT types 1 or 2. NORD has a separate report on HEP.
What is the treatment for porphyria?
Treatment. PCT is the most treatable form of Porphyria and treatment appears equally effective for both the sporadic and familial forms. The standard treatment of individuals with PCT is regularly scheduled phlebotomies to reduce iron and porphyrin levels in the liver.
What is the role of hepcidin in hemochromatosis?
Hemochromatosis is associated with low levels of hepcidin, a specialized protein that is the primary regulator of iron absorption in the body, including regulating the uptake of iron by the gastrointestinal tract and liver.
What happens if you get blisters on your hands?
Affected individuals may develop blistering skin lesions on areas of the skin that are frequently exposed to the sun such as the hands and face. These lesions may crust over. Eventually, scarring may develop, and affected skin may darken (hyperpigmentation) or fade (hypopigmentation) in color.
Is PCT an iron dependent disease?
The relationship between iron levels and PCT has long been established and PCT is classified as an iron-dependent disease. Clinical symptoms often correlate with abnormally elevated levels of iron in the liver (iron overloading). Iron overloading in the liver may only be mild or moderate.
What is PCT in steroid treatment?
A post cycle therapy plan or “PCT”, it’s a phrase that’s often thrown around inappropriately on many steroid message boards. In many cases, people expect way too much out of post cycle therapy, and others won’t give it a chance based on a lack of understanding. With this in mind, we want to explain the purpose of post cycle therapy, ...
Do steroids affect testosterone?
When we supplement with anabolic androgenic steroids, our natural hormone levels are altered. Most anabolic steroids suppress our natural testosterone production to one degree or another, and if we’re not careful our estrogen and progesterone levels can increase beyond a healthy range.
What is PCT blood disorder?
Overview. Porphyria cutanea tarda (PCT) is a type of porphyria or blood disorder that affects the skin. PCT is one of the most common types of porphyria. It’s sometimes referred to colloquially as vampire disease. That’s because people with this condition often experience symptoms following exposure to sunlight.
What is the treatment for porphyria cutanea tarda?
iron chelators. treating the diseases that cause the porphyria cutanea tarda, such as HCV or HIV. Phlebotomy is one of the most common treatments for porphyria cutanea tarda. Antimalarial tablets are also frequently used.
What does it mean when you have blisters on your face?
photosensitivity, which means your skin is sensitive to the sun. thin or fragile skin. increased hair growth, usually on the face. crusting and scarring of the skin. redness, swelling, or itching of the skin.
What does it mean when your skin is red?
redness, swelling, or itching of the skin. sores developing after minor injuries to the skin. hyperpigmentation, which means patches of skin become darker. urine that is darker than normal or reddish brown. liver damage. After the blisters form on your skin, the skin may peel.
Can you get porphyria cutanea tarda from smoking?
Risk factors. You’re at a higher risk of porphyria cutanea tarda if you smoke or use alcohol. You’re also more likely to get this condition if you have hepatitis C or HIV. Being exposed to certain chemicals, such as Agent Orange, can also increase your risk.
How long does it take to take Nolvadex for PCT?
Most users will require 4 weeks of Nolvadex for PCT, but longer or more powerful steroid cycles can often need to be followed up with 8 weeks of post cycle therapy combining Nolvadex with other drugs including aromatase inhibitors.
Why do you take Nolvadex?
The primary, and for most of us the only reason to use Nolvadex during a steroid cycle is to protect against male breast tissue enlargement – a.k.a gynecomastia. Any anabolic-androgenic steroids you are taking which have aromatizing properties will need gyno to be addressed and Nolvadex provides a cheap, simple and safe way to do that.
Does tamoxifen help with breast cancer?
Since Nolvadex was originally created as a breast cancer treatment drug, as we would expect it plays a powerful role in reducing the estrogen levels that allow cancer to progress in the breast area. It does this by binding to estrogen receptors in that particular part of the body, ...
Does tamoxifen cause night sweats?
Another listed side effect of Tamoxifen Citrate (brand name Nolvadex) amongst women using it for breast cancer treatment is impairment of sleep and more specifically, night sweats which can bring about difficulty in sleeping well.
Is Nolvadex good for gynecomastia?
Nolvadex for Gynecomastia. In its function as an anti-estrogen breast cancer treatment drug, Nolvadex targets the breast tissu e and this means it’s highly useful for the prevention of d readed gynecomastia in male anabolic steroid users. Because estrogen can cause cancer to progress in the breast area, when Nolvadex binds to estrogen receptors in ...
Why do women use Nolvadex?
When females use Nolvadex for performance enhancement it is often used for just that: to enhance performance as a result of increased testosterone levels. This can make Nolvadex a viable alternative for women not wanting the more powerful effects of steroids that bring high risk of masculinization side effects.
How much does Nolvadex cost?
The average cost in the United States for Nolvadex on prescription when bought from a local pharmacy is about $60-$80 for a box of 60 tablets of 10mg. This is more than enough for most post cycle therapy usage purposes where one tablet is taken per day. Prices in other countries will differ.
Theoretical Model
Session Content
- There are manuals for PCT in group and individual formats. As a result of trying to match the amount of therapy in different RCTs, the number and length of PCT sessions studied has varied. The number of sessions has ranged from 12 to 32 for the group format and 10 to 12 for individually delivered PCT; the length of sessions has varied from 60 to 90 minutes. The first tw…
Overall and Relative Effectiveness
- PCT was developed as a comparison condition within the context of two large multi-site VA clinical trials. The first (7) compared PCT using a group format to a trauma-focused group therapy; the second compared individual PCT to Prolonged Exposure (PE) therapy (8). Independently, a different version of Present-Centered Therapy was developed to serve as a co…
Pct in Clinical Practice Guidelines
- PCT is recommended as a second-line treatment for PTSD in the Department of Veterans Affairs/Department of Defense (VA/DoD) Clinical Practice Guideline for PTSD, and has a standard recommendation (also second line) by the International Society for the Study of Traumatic Stress (ISTSS). PCT is not mentioned in the American Psychological Association,...
Research with Military Personnel and Veterans
- Ten of the eleven studies comparing PCT with TF-CBT included in the meta-analysis (11) were conducted with active duty military (12,13) or Veteran (7-8,14-19) samples. Thus, the cumulative evidence shows that for active duty personnel and Veterans combined, PCT has lower dropout rates, but is less effective than TF-CBT in reducing PTSD severity at post-treatment. In a recent a…
Research with Comorbidities and Special Populations
- Not much evidence is available regarding the effectiveness of PCT for comorbid conditions. Findings from the Cochrane meta-analysis (11) showed that PCT results in similar improvement in depression symptoms compared to TF-CBT. PCT appears to be as effective as PE in female Veterans with the dissociative PTSD subtype (21). As noted, the majority of research on PCT ha…
Pct in Group Format
- Four studies (7,12,15,17) have compared a group version of PCT with a TF-CBT using a group format. Resick et al. (12) found greater decreases in self-reported (although not clinician-rated) PTSD with Cognitive Processing Therapy (CPT) group compared to PCT group in active duty military service members. The other studies (all Veteran samples) did not find significant differe…
References
- Division 12 of the American Psychological Association. (2016). Present-Centered Therapy for posttraumatic stress disorder.https://www.div12.org/PsychologicalTreatments/disorders/ptsd_main.php
- Hamblen, J. L., Norman, S. B., Sonis, J. H., Phelps, A. J., Bisson, J. I., Nunes, V. D., Megnin-Viggars, O., Forbes, D., Riggs, D. S., & Schnurr. P. P. (2019). A guide to guidelines for the treat…
- Division 12 of the American Psychological Association. (2016). Present-Centered Therapy for posttraumatic stress disorder.https://www.div12.org/PsychologicalTreatments/disorders/ptsd_main.php
- Hamblen, J. L., Norman, S. B., Sonis, J. H., Phelps, A. J., Bisson, J. I., Nunes, V. D., Megnin-Viggars, O., Forbes, D., Riggs, D. S., & Schnurr. P. P. (2019). A guide to guidelines for the treatme...
- Rosenzweig, S. (1936). Some implicit common factors in diverse methods of psychotherapy. American Journal of Orthopsychiatry, 6,412-415. doi:10.1111/j.1939-0025.1936.tb05248.x
- Frank, J. D. (1981). Therapeutic components shared by all psychotherapies. In J. H. Hawey & M. M. Parks (Eds.) Psychotherapy research and behavior change.(pp. 9-37). Washington DC: …
Cause
- Porphyria Cutanea Tarda is caused by deficient levels of an enzyme known as uroporphyrinogen decarboxylase (UROD). In approximately 75% to 80% of cases this deficiency is acquired (PCT type 1 or sporadic PCT); in the remaining cases, individuals have a genetic predisposition to developing the disorder, specifically a mutation in the UROD gene (PCT type 2 or familial PCT). …
Signs and Symptoms
- Skin abnormalities characterize this disorder. Affected individuals are particularly susceptible to damage of the skin from sunlight (photosensitivity). Extremely fragile skin that can peel or blister on minimal impact is common. Affected individuals may develop blistering skin lesions on areas of the skin that are frequently exposed to the sun such as the hands and face. These lesions ma…
Diagnosis
- The preferred screening test for PCT is a measurement of porphyrins in plasma. This can differentiate PCT from Variegate Porphyria. The patterns of porphyrins in urine (predominately uroporphyrin and 7-carboxylate porphyrin) and feces (predominately isocoproporphyrin) help to confirm the diagnosis. The presence of an inherited deficiency of UROD can be demonstrated b…
Treatment
- PCT is the most treatable form of Porphyria and treatment appears equally effective for both the sporadic and familial forms. The standard treatment of individuals with PCT is regularly scheduled phlebotomies to reduce iron and porphyrin levels in the liver. This is the preferred treatment of affected individuals at many Porphyria centers regardles...
Investigational Therapies
- Information on current clinical trials is posted on the Internet at www.clinicaltrials.gov. All studies receiving U.S. government funding, and some supported by private industry, are posted on this government web site.
Pct and Hepatitis C Virus
- Because PCT is frequently associated with Hepatitis C Virus (HCV) infection, it is worth noting the issues involved in treating a patient with both PCT and HCV infection. Infection with HCV is much more common than PCT, and most people with HCV do not have PCT. However, at least in some locations, as many as 80 percent of individuals with PCT are infected with HCV. Therefore, HCV …