Disulfiram: Part 2 What you need to know

Disulfiram: Part 2 What you need to know

Some of the side effects could potentially be linked to various enzyme disruptions in the body, e.g.: Disulfiram is known to inhibit of the dopamine ?-hydroxylase (DBH) enzyme, which is involved in the conversion of dopamine to norepinephrine.  A urine test from a specialized laboratory can test for functional levels this enzyme, while a genetic test can show genetic vulnerabilities of the DBH enzyme.  The combination of both tests provides helpful information whether treatment with disulfiram is appropriate, or not.

Disulfiram also has heavy metal, copper and nickel chelating properties, and this might also be a contributing factor with reported neuropathy. Individuals are now supplementing with zinc, to improve the zinc/ copper ratio.  A dietary intervention, i.e. a reduction of high copper foods, is also discussed by Dr. Rajadas. Copper, ceruloplasmin (an enzyme required for copper transport) and zinc can be checked in a blood test. In addition, elevated iron levels increase inflammation, and these are also best monitored in a blood test.

Hair mineral analysis testing (HTMA) can be a helpful as a component within this complex picture. Genetic testing (saliva testing done at home) adds another dimension as it can show up vulnerabilities in various enzyme and detoxification pathways involving, e.g. copper, ceruloplasmin, vitamin A, nitric oxide, heme, and iron. There is a lot we do not know at this time.

Disulfiram is widely known as Antabuse, a drug used in the treatment of alcohol dependence in conjunction with cognitive-behavioral therapy. Its action is by inhibiting an enzyme that metabolizes alcohol in the body. Through this inhibitory effect, any exposure to alcohol accumulates in the body in the form of acetaldehyde. Within 5-10 minutes after alcohol exposure, acute reactions can occur that can last for a few hours. These reactions have also been described as ?hangover symptoms? and symptoms can range from mild to severe. The below are examples:

  • Flushing
  • Throbbing in the head
  • Vomiting
  • Chest palpations
  • Metallic taste in the mouth
  • Fainting
  • Vertigo
  • Convulsions
  • Hyperventilation
  • Neck pain
  • Psychosis
  • Seizures
  • Refractory headaches

Other side effects from use of Disulfiram (Antabuse) can be found at this website: https://www.rxlist.com/antabuse-side-effects-drug-center.htm

Thyroid function must be monitored, in particular iodine levels, as disulfirmam has anti-thyroid properties. It induces an iodine deficiency resulting in thyroid dysfunction that was already documented as early as 1954.  Based on this information, a thorough evaluation of thyroid function and optimizing of iodine levels would be warranted.  (An iodine-loading test can be ordered by the physician to assess current iodine levels, and thyroid function is assessed with a blood test.)

Rika Keck

NY Integrated Health

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