Humira or Pill Therapy?

I'm sorry you're having such a rough time, Heather. Choosing meds is much more difficult than most people realize...

When I need to pick a new med, I kind of visualize a triangle or hierarchy of sorts. I see "natural" stuff and vitamins at the bottom/widest part... they're safe, but they can also be the least powerful as far as mounting an attack against your crohn's and sometimes to cover everything it seems like it takes 27 different horse pill vitamins a day.

Next up on the pyramid I see the pills like Purinethol and Imuran, etc. They are more aggressive than the "natural" remedies, but also come with greater risk.

At the top of the pyramid I see the biologics like Remicade and Humira. These drugs mount a full-on attack to actively combat your disease, often providing relief in a fraction of the time that the other methods can take. But again, the increased aggressive nature also increases the seriousness of the side effects.

In order to choose a new med, I usually choose which step on the pyramid I feel is necessary. Am I at my wits end and ready to do whatever might work regardless of potential long term effects? When I was diagnosed my answer was yes. I started Remicade within a few months of being diagnosed.

Is my quality of life compromised, but maybe not bad enough to warrant such powerful stuff? Will the potential side effects of the biologics stress me out so badly that they won't work? I've been here before too and stepped down from the biologics to the pills.

Or, am I in a position where I can take a little more time and pay a little more attention.. enough so that I could try to integrate some natural therapies without spiraling further downward in the mean time? That's where I am now, getting ready to start some new supplements and learn yoga for stress relief. If that doesn't cut it, I'll probably start researching pills again.

I don't know if that'll help ya, but that's how I wrap my brain around things. I hope you find the info and help you need, Heather, and that you start feeling better soon! I'll be thinking about ya.

I think I would try the Immunesuppressants first and if that don't work go up to the Humira. Just my humble opinion. I think that Patientspiders had some good thoughts on this.

Heather -- try the Humira. I have a relative who has been on the medication for 1 1/2 years now ... with no side effects. She can now go to school and attend everyday events without Crohn's running the show. It takes about 20 seconds to give yourself a shot and then you can get on with your life. You can alternate legs every other week. At first it seems scary, but it's well worth it.

Hey! I think patientspider has definitely made some good points. You really have to know a lot about your disease, about the medicines that are out there and about how every decision you make about your CD affects your life.

I have a few pieces of advice for you. Before you decide whether you want to take Imuran or Humira make your doctor do this genetic test for Imuran. This genetic test shows if your body would block Imuran I guess. It's still not a guarantee that Imuran will work for you since only 30-40% percent of people respond to Imuran, but there's no point of you taking it if this genetic test proves that Imuran isn't for you. I have no idea how it's called, I just know I had it and it came out ok, I started taking Imuran, haven't had any big side-effects minus the fact that my leukocytes are under the normal level. I started with 100mg and waited for about 3 months and it wasn't really helping so we increased it to 125mg (it all depends on how much you weight) and it started working. We were patient and I'm so glad that we didn't switch to Remicade right away.

For me Imuran made a huge difference, it kept me from having a surgery yet, I have a stenosis but it's doing pretty ok now! The only thing that Imuran didn't fix for me is my anal canal inflammation, which is why now I have to choose between Humira and Remicade, after being on Imuran for 2.5 years. Imuran is a powerful drug, it really is and it's no joke...but those are pills and it's definitely easier to live with pills (but then again "easy" is relative since Humira doesn't take much of your time). If you choose Imuran please know that it might make you feel sick - some people can't deal with it, others say you have to overeat yourself before taking it and that you won't throw up then, and some people like me take Pantoprazole in the morning.

Humira is a powerful drug too, it can help you so much. But just like patientspider I put it at the top of my pyramid list. I've always thought that Humira/Remicade would be my last resort since there isn't anything else after that and life is long. But sometimes you just can't have it the way you want it. All in all...just do this genetic test and then make your decision. I hope everything goes well!

:) Be strong