Depakote 500 mg

PNES breakthrough episodes
I’ve been having small twitching episodes and just about an hour or so ago, I had a seizure that went up my whole left side, I have both epilepsy and pnes and I know it was a pnes episode because I was aware the whole time (about 3 minutes). I’ve taken all my meds and done breathing exercises, but the small twitching comes back every few hours or so. How do I explain this to my doctor? I also have a therapist and psychiatrist so I’m just worried how to explain it. Tbh I’m having those twitches right now in my hip and leg.
Meds:
Depakote: 1500mg once a day Lacosamide: 200 mg twice a day Zoloft: 100 mg once a day Keppra: 250 mg once a day (til June)

I’ve been having small twitching episodes and just about an hour or so ago, I had a seizure that went up my whole left side, I have both epilepsy and pnes and I know it was a pnes episode because I was aware the whole time (about 3 minutes). I’ve taken all my meds and done breathing exercises, but the small twitching comes back every few hours or so. How do I explain this to my doctor? I also have a therapist and psychiatrist so I’m just worried how to explain it. Tbh I’m having those twitches right now in my hip and leg.
Meds:
Depakote: 1500mg once a day Lacosamide: 200 mg twice a day Zoloft: 100 mg once a day Keppra: 250 mg once a day (til June)

The garden of Life organics men's once daily. Surprisingly it has a pleasant smell to it too.

My mother has put a bug in ear by telling me a story in which someone shut down his kidney completely with too much suplements and tea. My grandma also said to me that he cannot take any vitamin in any dose, because his kidney doesn’t work properly. All of these make me think how much the supplements stresses my body, and how much is too much, what I should be cautious with, etc.. At this moment I’m taking - 500 mg bergamot extract capsule, because it normalizes my cholesterol - omega 3 suggested by my dietitian - 1000 mg vitamin C with vitamin D, because it helps my allergic - B12 (seasonal), because from time to time I have deficits - daily 1 or 2 cup of black/green tea And from now I also wanna take some magnesium, because I’v heard that it can help pains after running.
What is your opinion about this? Isn’t it too much?

Hello, I`m wondering for those of you who "Cured" or got rid off your sibo. What procotol or what drugs/herbals/treatment did you do?
If you decide to answer please include what type of sibo you had hydrogen, methane, mixed, fungal or hydrogen sulfide.
Also specify the dosage of each medication/herbal in milligrams per tablet x tablets taken x the number of times taken daily x duration taken.
Example:
2 tablets 450 mg allicin x 3 times daily for 2 weeks
3 tablets 500 mg berberine x 1 times daily for 2 weeks
Also please include if you confirmed your remission with a SIBO breath test or just by symptoms improving.

Just something I did for fun. Having played a stupid amount of this game, these are changes I believe will make each gun good but most importantly fun to use. All weapons are currently "viable" but most don't feel good to use despite this fact.
Primary Weapons:
AR-23 Liberator:

• Damage 60 70

(breakpoint for 2 hit kill in Devastator head)
AR-23P Liberator Penetrator

• Damage 45 60

(should feel like current Liberator but with worse mag capacity)
AR-23C Liberator Concussive

• Recoil 28 20
• Fire rate 320 475

(same fire rate as SMG 72P with a recoil reduction to make it feel similar to currently)
AR-61 Tenderizer

• Damage 60 80

(hits better breakpoints vs bugs but very similar to base Lib vs Bots)
BR-14 Adjudicator

• Recoil: horizontal recoil reduced by 80%
• Capacity: Extra mags increased 8 9

(with effective mouse/stick drag the recoil can now be controlled. The extra mag brings the total ammo capacity near to that of the other AR's.)
R-63 Diligence

• Damage: 125 128

(allows for 1 tap headshots sub 25m on Devastators. Further cements this as the close range battle rifle compared to the R-63CS.)
R-63CS Diligence Counter Sniper

• Damage: 140 175

(unchanged vs Bots, allows for consistent 1 taps vs bugs.)
MP-98 Knight

• Damage: 50 60
• Recoil: 20 10
• Bug fix: Receives full ammo back on resupply.

(fix the legacy errors and make it controllable in 3rd person. Also makes it more ammo efficient)
SMG-37 Defender

• Unchanged

(gold standard for an SMG)
SMG-72 Pummeler

• Unchanged

(effective side grade to both SMG-37 and Lib-C)
SG-8 Punisher

• Unchanged

(gold standard for a shotgun)
SG-8S Slugger

• Heavy stagger added back.
• Projectile velocity reduced 25%
• Projectile drop increased 25%

(Much better close up but less able to function as a marksman rifle.)
SG-225 Breaker

• Capacity: 13 16

(game has been power crept enough, the nerf is no longer required much like the Railgun)
SG-225SP Breaker Spray&Pray

• Ergonomics: Improved to match other Breaker variants.
• Capacity: 26 30
• Recoil 45 28

(easier to control and better at quickly spraying down light hordes)
SG-225IE Breaker Incendiary

• Unchanged

(gold standard for Breaker family)
CB-9 Exploding Crossbow

• Damage: 420 550
• AOE: increased to original value.

(550 is the breakpoint to be able to 1 hit Devastators in the weak point or 2 hit otherwise. 2 hit kill Brood Commanders. Can now clear chaff as well while dealing with elites.)
JAR-5 Dominator

• Unchanged

(gold standard of explosive primaries)
R-36 Eruptor

• Damage: 420 650
• AOE: Restored to post AOE nerf value but before the shrapnel was removed.

(A large but fair AOE paired with the ability to 1 shot Brood Commanders/ Devastators like before. Importantly it won't be able to 1 shot chargers due to the shrapnel bug. Despite claims it was +100 shrapnel was much closer to +300 to 500)
SG-8P Punisher Plasma

• Unchanged

(Gold standard for AOE weapon)
ARC-12 Blitzer

• Unchanged

(Already strong but one bug fix for arc weapons away from becoming a monster. May need to be adjusted down once this fix happens depending.)
LAS-5 Scythe

• Scope: Changed to Sickle/Liberator scope
• Damage 350 400

(now able to beam heads with a good scope vs Bots and higher DPS will help vs bugs.)
LAS-16 Sickle

• Unchanged

(with almost 100 shots per mag and the ability to run forever, the lower damage and worse breakpoints is a fair trade vs kinetic AR's.)
Plas-1 Scorcher

• Unchanged

(Gold standard of Plasma weapons)
Plas-101 Purifier

• Rework: 3 tiers of charge up.
• Tier 1: Trigger pull 200 damage 80 fire rate. (no splash)
• Tier 2: Trigger hold 1.25 second 300 damage.(small splash)
• Tier 3: Trigger hold 1.75 seconds 400 damage. (large AOE splash like currently)

(better matches the description of the weapon. High incentive to hold your fire for longer but allows for it to be used as a weaker Plas-1 when required)
Stratagem Weapons
The following are pseudo primaries and so will be looked at as well.
M-105 Stalwart

• Ergonomics: Improved by 25%

(Often struggles to feel competitive with top tier primaries but should blow them out of the water if you are giving up your stratagem slot. Will hit more shots and clean hordes easier.)
MG-43 Machine Gun

• Capacity: reserve mags 2 3
• Reload: able to reload while moving.
• Damage: 80 90

(Very little reason to give up a stratagem slot for a Adjudicator damage equivalent with low max ammo and a stationary reload. With more ammo and the ability to move and shoot this will be a good choice.)
MG-206 Heavy Machine Gun

• Rework: Backpack fed weapon. Does not require reload.
• Capacity: Total ammo 225 250
• Damage: 102 128

(Will have cleaner breakpoints vs Bots allowing for 1 shot headshot kills up close and won't have its current ammo problems. Will still be hard to handle and consumes a backpack slot but worth it)
Bonus:
Recoilless / Quasar Cannon

• Damage: +10%

(Currently both launchers do not 1 shot Hulks or Tanks in their rear weak spot. Both survive on a tiny amount of HP. This change will fix that making launchers viable vs Hulk backs and the backs of tanks)

• Projectile: Hitbox size increased by 25%, projectile has priority on weak spots.

(if the projectile contacts a Hulks front plate and it would have hit the head but instead touches the body armour first it counts as a headshot. Simulates penetration of the round. Also the headshot hitbox is larger and more forgiving. Currently the launchers are completely outclassed by the AMR and Autocannon vs Bot armour, requiring the same level of precision for a headshot but not being versatile weapons or having fast follow up potential.)
SPEAR

• Projectile: Hitbox size increased by 25%, projectile has priority on weak spots.
• AH studios makes a daily sacrifice to the machine god to appease it and fix the SPEAR lock.

(shooting a hulk from the front should always award a headshot kill but currently it's random chance. This change will fix that.)
Extra Wish list:
Bot Trooper Infantry:

• Rework: Hp increased 100 400
• Rework: Appear in higher frequency alongside Devastators at higher difficulties.
• Rework: Accuracy improved

(currently Bot infantry pose 0 actual threat outside of calling in drops. They can be ignored almost indefinitely and they wont kill you. This change makes them more like the terminators they are suppose to be. Taking a decent amount of fire to go down while still being a fodder tier enemy. This is also a massive indirect buff to AR's as dealing continuous damage to low armour targets is where they shine.)
Feel free to offer feedback. and don't forget to downvote.

My diet is far from perfect, I’ve just followed some simple rules: no dairy, no red meat, don’t buy a product if it has more than 5g of saturated fat per 100g. Other than that I ate everything. These rules forced me to choose healthier snacks, sweets and meats. With diet only my LDL went down to 110 in 4 weeks, which was insane. The next 2-3 months I struggled to make it better, actually it started to slowly go back to 130 when I allowed myself some cheat meals. Then I discovered bergamot as a supplement, I took 500 mg daily for 3 weeks and it helped me to get my LDL to 98. I am really surprised how much can bergamot help.

I’m 15 1/2 and just recently got prescribed 10 mg of adderall (about a week ago) and 2 days ago I bought 500 mg capsules of ashwagandha (once per day). I recently started weight training at the gym and read about ashwagandha and the benefits/cons and decided I’d try it out. The point I’m trying to get at is will this affect me really negatively or do the benefits outweigh the cons. I’ve done my research about cycling and what time of day to take it but I know there isn’t much testing surrounding teenagers taking it. The reason I wanted to take it is the boost in testosterone and stress relieving factors, I know I shouldn’t really be worrying about testosterone levels at my age but I can’t see a downside with having a bit more (I want to grow taller lol) I’ve not contacted my psychiatrist about this which I probably should’ve but I found no harmful reactions between the ashwagandha and my other medications. Do I stop taking it now or try it out for a few weeks? Would creatine be a better replacement?

34 AFAB 183lbs 5'4"
For the past 6-7 weeks, I've been dealing with what my PCP diagnosed as Candida Albicans infection. It started around the anal area. It has now moved to the entire genital area (vaginal and anal), under both arms, inside and outside my right ear, my stomach, neck, and face [also, both forearms, top of the right hand, , and moving down both upper thighs]. I've taken 4 doses of Fluconazole and treat with Nystatin cream twice a day. I'm taking daily showers or a 15-20 minute bath with Domeboro soak. Nothing is working, I'm in extreme pain, and I would appreciate some guidance.
Other relevant information:
Pregnancy w/ vaginal birth 12 years ago.
PCOS w/ metabolic syndrome and insulin resistance 7 years ago. Taking 1500 MG Metformin daily.
GSHV2 9 years ago. Taking 500 MG Valtrex daily.
Depression/Anxiety. Taking Lexapro.
ADHD-Inattentive. Taking 40 MG Vyvanse.
Other supplements: Magnesium glyconate (sleep), prenatal multivitamin (low Vitamin D and Iron in the past).
Former cigarette smoker. Current vape user.
No new sexual partners in the last 5 years. No new soaps, detergents, etc.
The amount of pain I'm in is just miserable. I've been trying to follow my PCP's instructions to the letter, but nothing is working. I can barely walk around my house at this point and it's interfering with my job and being able to take care of my kid who was diagnosed with Type 1 Diabetes this past year and may have celiac's disease. I may just be impatient to have this clear up and I know my PCP has given what's considered the gold standard for Candida skin infections. I'll be talking to her on Monday about seeing a dermatologist.
My questions:
Has anyone seen this situation in their practice before?
What are the next steps usually taken?
How can I stop it from spreading further?
Is there any possibility the infection could have gotten into my bloodstream (I started having headaches, chills, fatigue, abnormal amount of gas, and dizziness w/in the last 3 days)?
Is there some way to get some relief or speed up the healing process?
Are there any best practices for this type of infection besides keeping it clean, dry, and medicated?
Would anything described warrant a trip to the ER (asking bc my partner has been very worried about me and has mentioned it several times)?
Thank you for any feedback.
Edit: Formatting since I'm on mobile and additional observations from tonight's bathing and applying medicated cream included in [ ].

Boa noite, pessoal!
Vejo muitos amigos falando aqui que dá para ganhar dinheiro com contabilidade na iniciativa privada, ter inglês e fazer processos em empresas grandes, multinacionais e nas big4 e ter salário de 5 dígitos.
Essa realidade talvez exista na capital. Sou do interior de MG (cidade com mais de 500 mil habitantes) e estou no 9º período de contabilidade na federal e não conheço nenhum colega que esteja trabalhando em vaga que necessite de inglês, apesar de alguns trabalharem em grandes empresas.
Deem uma pesquisada nas vagas da região de vocês antes de entrar no curso para ter uma noção da realidade.
Tenho dois anos de experiência na mesma empresa (estágio + CLT) e vou começar a ganhar R$ 2 mil agora (salário líquido + vale).
Estou pensando seriamente em me mudar para a capital (Belo Horizonte) assim que me formar em busca de mais oportunidades e melhores salários.

~RIGL Thesis – 5/18/2024~
Outstanding Shares 175M
131 Institutional Holders
111,129,461 Total Shares Held
63.36% Institutional Ownership
Total Cash on Hand 3/31/2024 = $49.6M
Total Debt: $101.5M
Cash Burn Approximate = $8M per quarter (6 quarters of cash without any increases in revenue)
Q12023 REV = $26M
Q22023 REV = $26.8M
Q32023 REV = $28.1M
Q42023 REV = $35.8M
Q12024 REV = $29.5M (Decline from Q4 likely from end of year versus new-year tracking of Rx and shipments of drugs, resetting of Copays)
Most Recent EPS -$0.05 per share
May 22, 2024 - Vote on S will take place, caution
~Statistics Applicable To Thesis~
333.3 million US Population (2022)
8,109,679,892 Global Population (2024)
~Drugs On Market~
~Tavalisse – Treatment for ITP, FDA Approved April 17, 2018~
~What is ITP?~
Immune thrombocytopenia (ITP) is an illness that can lead to bruising and bleeding. Low levels of the cells that help blood clot, also known as platelets, most often cause the bleeding.
Once known as idiopathic thrombocytopenic purpura, ITP can cause purple bruises. It also can cause tiny reddish-purple dots on the skin that look like a rash.
Children can get ITP after a virus. They most often get better without treatment. In adults, the illness often lasts months or years. People with ITP who aren't bleeding and whose platelet count isn't too low might not need treatment. For worse symptoms, treatment might include medicines to raise platelet count or surgery to remove the spleen. Immune thrombocytopenia (ITP) - Symptoms and causes - Mayo Clinic
~What is Tavalisse?~
TAVALISSE is a prescription medication used to treat adults with low platelet counts due to chronic immune thrombocytopenia (ITP) when a prior treatment for ITP has not worked well enough. It is not known if TAVALISSE is safe and effective in children.
The cost for Tavalisse oral tablet 100 mg is around $15,404 for a supply of 60 tablets, depending on the pharmacy you visit. Quoted prices are for cash-paying customers and are not valid with insurance plans. This price guide is based on using the Drugs.com discount card which is accepted at most U.S. pharmacies.
Tavalisse Prices, Coupons, Copay & Patient Assistance - Drugs.com
TAVALISSE IS AN ORAL MEDICATION TAKEN TWICE DAILY WITH OR WITHOUT FOOD¹
A 12-week evaluation period is recommended
60 tablets = 1 month supply, evaluation period = 3 months, Cost for 3 months = $46,212 Cash, assuming cheaper through wholesale, insurance, discount cards, etc.
Dosing TAVALISSE® (fostamatinib disodium hexahydrate) tablets (tavalissehcp.com)
~Addressable Market~
“Our findings suggest that nearly 20,000 children and adults are newly diagnosed with ITP each year in the US, substantially higher than previously reported. Among patients requiring formal medical care, the economic burden during the first 12 months following diagnosis is high, with estimated US expenditures totaling over $400 million.”
Primary immune thrombocytopenia in US clinical practice: incidence and healthcare burden in first 12 months following diagnosis - PubMed (nih.gov)
The estimated prevalence of ITP in the United States is 9.5 per 100,000 people, with a global prevalence of over 200,000 people at any given time [1].
Immune thrombocytopenia. [ Oct; 2022 ]. 2022. https://rarediseases.org/rare-diseases/immune-thrombocytopenia
~Author Calculations/Estimates~
ITP estimated cases based on measured statistics 31,635 cases a year in the US and 770,355 cases globally each year.
~Rezlidhia – R Acute Myeloid Leukemia, FDA Approved December, 22, 2022~
~What is Relapsed or Refractory Acute Myeloid Leukemia?~
Relapsed, or recurrent, acute myeloid leukemia (AML) means the leukemia has come back after treatment and remission.
Refractory AML means the leukemia did not respond to treatment. Complete remission has not been reached because the chemotherapy drugs did not kill enough leukemia cells.
Both relapsed and refractory AML need more treatment to reach complete remission.
Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan. Some factors considered for your treatment include:
your age
your health
how long the leukemia was in remission
treatments you had before
where the leukemia comes back
Treatment options usually include chemotherapy and a stem cell transplant if possible. Targeted therapy may also be used.
Treatments for relapsed or refractory acute myeloid leukemia Canadian Cancer Society
~What is IDH1?~
Somatic mutations in isocitrate dehydrogenase (IDH) genes occur frequently in adult Acute myeloid leukemia (AML) and less commonly in pediatric AML… Enhanced genomic and epigenomic profiling of acute myeloid leukemia (AML) has led to identification of recurrent mutations that are prognostic and are candidates for targeted therapy. Somatic mutations in isocitrate dehydrogenase (IDH) genes, IDH1 and IDH2, occur in ∼6% to 16% and ∼8% to 19% of adult patients with AML, respectively.^1-5 In pediatric AML, IDH mutations are rare, occurring in <4% of patients.^6-11
Characteristics and prognostic impact of IDH mutations in AML: a COG, SWOG, and ECOG analysis Blood Advances American Society of Hematology (ashpublications.org)
~What is Rezlidhia?~
REZLIDHIA is a prescription medicine used to treat adults with acute myeloid leukemia (AML) with an isocitrate dehydrogenase-1 (IDH1) mutation when the disease has come back or has not improved after previous treatment(s).
Targeted Treatment REZLIDHIA® (olutasidenib) capsules
The cost for Rezlidhia oral capsule 150 mg is around $17,468 for a supply of 30 capsules, depending on the pharmacy you visit. Quoted prices are for cash-paying customers and are not valid with insurance plans. This price guide is based on using the Drugs.com discount card which is accepted at most U.S. pharmacies.
Rezlidhia Prices, Coupons, Copay & Patient Assistance - Drugs.com%20is%20a%20member,on%20the%20pharmacy%20you%20visit.)
~Addressable Market~
The annual incidence of new cases in both men and women is approximately 4.3 per 100,000 population, totaling over 20,000 cases per year in the United States alone.[13] The median age at the time of diagnosis is about 68, with a higher prevalence observed among non-Hispanic Whites. Furthermore, males exhibit a higher incidence compared to females, with a ratio of 5:3.
Acute Myeloid Leukemia - StatPearls - NCBI Bookshelf (nih.gov)
~Author Calculations/Estimates~
Cases of AML with IDH1 would be 11% based on the median of statistics above (6% to 16%) leaving approximately 1500 to 2000 cases a year in the US. Appling the same calculations to world population would amount to approximately 38,500 cases a year globally.
~Gavreto – Treats RET+ Non-Small Cell Lung Cancer In Adults and RET+ Thyroid Cancer in Kids and Adults, FDA Approved August 9, 2023~
For the sake of common ground, I am going to assume these types of cancers do not need to be elaborated on as we all likely have a basic understanding of what they are. The medical conditions treated by Tavalisse and Rezlidhia I felt needed a more in-depth explanation because they are not common. I will elaborate on RET+ a little later in this writing.
~What is Gavreto?~
GAVRETO is an oral once daily prescription medicine used to treat certain cancers caused by abnormal rearranged during transfection ~(RET+)~ genes in:
Adults with non-small cell lung cancer (NSCLC) that has spread
Adults and children 12 years of age and older with advanced thyroid cancer or thyroid cancer that has spread who require a medicine by mouth or injection (systemic therapy) and who have received radioactive iodine and it did not work or is no longer working*
It is not known if GAVRETO is safe and effective when used to treat cancers caused by abnormal RET genes in children for the treatment of NSCLC or in children younger than 12 years of age for the treatment of thyroid cancer.
Home GAVRETO® (pralsetinib)
The cost for Gavreto oral capsule 100 mg is around $11,745 for a supply of 60 capsules, depending on the pharmacy you visit. Quoted prices are for cash-paying customers and are not valid with insurance plans. This price guide is based on using the Drugs.com discount card which is accepted at most U.S. pharmacies.
The recommended dosage for adults and children 12 and over is 400mg orally once daily. Each capsule is 100mg, which means you will take 4 capsules. Gavreto should be taken on an empty stomach, at least 1 hour before or 2 hours after a meal.
Gavreto Prices, Coupons, Copay & Patient Assistance - Drugs.com
~What is Rearranged During Transfection Positive (RET+)?~
RET-positive cancer is caused by a mutation or abnormal re-arrangement of the RET gene. It occurs most commonly in lung cancer and several types of inherited and sporadic thyroid cancers. RET alterations also occur in an estimated 1-2% of multiple other cancers, including ovarian, pancreatic, salivary, breast, and colorectal cancers.
RETpositive Empowering Patients and Driving Research
Rearranged during transfection (RET) rearrangements were first identified as oncogenic drivers in NSCLC in 2012. The proportion of patients with NSCLC who have RET rearrangements (ie, fusion-positive disease) is approximately 1%-2%.
RET Fusion-Positive Non-small Cell Lung Cancer: The Evolving Treatment Landscape The Oncologist Oxford Academic (oup.com)
RET alterations occur most commonly in lung cancer (non-small cell lung cancer (NSCLC)) and the number of new cases diagnosed each year is considerable, accounting for approximately 37,500 [IG1] cases worldwide and 4,000 cases in the US (2% of NSCLC) (2,3). RET alterations are also common in several types of inherited and sporadic thyroid cancers and can occur in other types of cancers like ovarian, breast, pancreatic, and colorectal cancers, among others (4-8) adding >110,000 cases yearly worldwide (9).
What is RET Positive Lung Cancer? - The Happy Lungs Project
(2) Although medullary thyroid carcinoma represents 5-10% of all thyroid cancers, activating RET gene abnormalities occur in over 90% of hereditary and approximately 40%-60% of sporadic medullary thyroid carcinoma cases.
Patients – RETpositive%20Although%20medullary%20thyroid%20carcinoma,sporadic%20medullary%20thyroid%20carcinoma%20cases.)
~Prevalence of Non-Small Cell Lung Cancer~
Most lung cancer statistics include both small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). In general, about 10% to 15% of all lung cancers are SCLC, and about 80% to 85% are NSCLC.
Lung cancer (both small cell and non-small cell) is the second most common cancer in both men and women in the United States (not counting skin cancer). In men, prostate cancer is more common, while breast cancer is more common in women.
The American Cancer Society’s estimates for lung cancer in the US for 2024 are:
About 234,580 new cases of lung cancer (116,310 in men and 118,270 in women)
About 125,070 deaths from lung cancer (65,790 in men and 59,280 in women)
Lung Cancer Statistics How Common is Lung Cancer? American Cancer Society
Worldwide, an estimated 2,206,771 people were diagnosed with lung cancer in 2020. These statistics include both small cell lung cancer and NSCLC.
Lung Cancer - Non-Small Cell: Statistics Cancer.Net
~Author Calculations/Estimates~
Approximately 187,664 cases of NSCLC in the US based on an 80% factor.
Approximately 1,765,416 cases of NSCLC worldwide based on an 80% factor.
~Prevalence of Thyroid Cancer~
Rate of New Cases and Deaths per 100,000: The rate of new cases of thyroid cancer was 13.5 per 100,000 men and women per year. The death rate was 0.5 per 100,000 men and women per year. These rates are age-adjusted and based on 2017–2021 cases and 2018–2022 deaths.
Lifetime Risk of Developing Cancer: Approximately 1.2 percent of men and women will be diagnosed with thyroid cancer at some point during their lifetime, based on 2017–2019 data. Lifetime risk based on data through 2022 will available soon.
Prevalence of This Cancer: In 2021, there were an estimated 979,295 people living with thyroid cancer in the United States.
Thyroid Cancer — Cancer Stat Facts
About 44,020 new cases of thyroid cancer (12,500 in men and 31,520 in women)
About 2,170 deaths from thyroid cancer (990 in men and 1,180 in women)
Thyroid cancer is often diagnosed at a younger age than most other adult cancers. The average age when a person is diagnosed with thyroid cancer is 51.
This cancer is about 3 times more common in women than in men. It is about 40% to 50% less common in Black people than in any other racial or ethnic group.
Key Statistics for Thyroid Cancer American Cancer Society)
Addressable Market
Given Gavreto’s dual treatment capacity, the total amount of potential patients with NSCLC with RET+ indications would be approximately 2,800 cases in the US and approximately 26,500 cases worldwide each year using a factor of 1.5% of total NSCLC cases. The total amount of treatable cases for Thyroid Cancer would be approximately 650 in the US and 16,500 cases worldwide respectively each year applying the same 1.5% RET+ percentage rate. DOUBLE CHECK MATH…
~Rigel Pharmaceuticals Pipeline~
~IRAK/4 – Clinical Trials~
Rigel’s investigational candidate, R289, is an oral, potent and selective inhibitor of interleukin receptor-associated kinases 1 and 4 (IRAK1/4).
Toll like receptors (TLRs) and the interleukin 1 receptor family (IL-1Rs) play a critical role in the innate immune response and dysregulation of these pathways can lead to a variety of inflammatory conditions such as psoriasis, rheumatoid arthritis, and inflammatory bowel disease. Chronic stimulation of both receptor systems has also been implicated in causing a pro-inflammatory bone marrow environment leading to persistent cytopenias in lower-risk myelodysplastic syndrome (LR-MDS) patients1.
R835 is a selective dual inhibitor of IRAK1/4 that blocks TLR4 and IL-1R-dependent systemic cytokine release. In preclinical studies, R835 demonstrated activity in multiple animal models of inflammatory disease2,3 and showed that dual inhibition of IRAK1 and IRAK4 provided more complete suppression of inflammatory cytokines when compared to an IRAK4-selective inhibitor4.
Development of R289:
In a Phase 1 clinical trial, R835 was well tolerated and inhibited LPS-induced inflammatory cytokine production in healthy volunteers, demonstrating proof-of-mechanism.5 Phase 1 clinical studies of R289 (an oral prodrug that is rapidly converted to R835 in the gut) are also complete.
A Phase 1b open-label, multicenter trial of R289 in patients with relapsed/refractory lower-risk MDS is currently enrolling (NCT05308264). The primary endpoint for this trial is safety with key secondary endpoints including preliminary efficacy and evaluation of pharmacokinetic properties.
~Bemcentinib – Bergenbio Partnership~
In June 2011, Rigel entered into an exclusive, worldwide research, development and commercialization agreement with BerGenBio for its investigational AXL receptor tyrosine kinase (AXL) inhibitor, R428 (now referred to as bemcentinib).
Bemcentinib is a potent, selective and orally bioavailable AXL inhibitor and the furthest along in clinical trials. In preclinical studies, bemcentinib was shown to have an effect as a single agent therapeutic in the prevention and reversal of acquired resistance to standard of care cytotoxics and targeted therapies and may also slow or prevent tumor metastasis.
Rigel received an upfront payment and is eligible for milestone payments and potential sublicensing revenue, as well as tiered royalty payments on any future net sales of products emerging from the collaboration.
~R552 Systemic – Eli Lilly Partnership~
Rigel’s investigational candidates are oral, potent and selective inhibitors of receptor-interacting serine/threonine-protein kinase 1 (RIPK1).
RIPK1 is a critical signaling protein implicated in a broad range of key inflammatory cellular processes including necroptosis, a type of regulated cell death, and cytokine production. In necroptosis, cells rupture leading to the dispersion of cell contents, which can trigger an immune response and enhance inflammation. RIPK1 inhibition has therapeutic potential in treating autoimmune, inflammatory, and neurodegenerative disorders.
Rigel’s RIPK1 inhibitor program includes R552, a systemic molecule being developed for the treatment of autoimmune and inflammatory disorders, and brain penetrating RIPK1 inhibitors for central nervous system (CNS) diseases. In preclinical studies, R552 demonstrated prevention of joint and skin inflammation in a RIPK1-mediated murine model of inflammation and tissue damage.
Development of R552:
In Q2 2023, the initial Phase 2a trial (NCT05848258) in moderately to severely active rheumatoid arthritis (RA) was initiated by partner Eli Lilly.
Development CNS-penetrating RIPK1 inhibitors:
Currently in preclinical studies.
~Milademetan – Daiichi Sankyo Partnership~
Rigel has a long-standing collaboration with Daiichi-Sankyo for developing murine double minute 2 (MDM2) protein inhibitors in cancer, which were discovered in Rigel’s laboratories.
Preliminary safety and efficacy data from an early Phase 1 study of milademetan (formerly DS-3032), an oral selective MDM2 inhibitor, in hematological malignancies suggests that it may be a promising potential treatment for oncology indications.
Rigel received an upfront payment and is eligible for milestone payments, as well as tiered royalty payments on any future net sales of any products emerging from the collaboration.
~Rxxx (CNS Penetrant) – Eli Lilly Partnership~
Rigel’s investigational candidates are oral, potent and selective inhibitors of receptor-interacting serine/threonine-protein kinase 1 (RIPK1).
RIPK1 is a critical signaling protein implicated in a broad range of key inflammatory cellular processes including necroptosis, a type of regulated cell death, and cytokine production. In necroptosis, cells rupture leading to the dispersion of cell contents, which can trigger an immune response and enhance inflammation. RIPK1 inhibition has therapeutic potential in treating autoimmune, inflammatory, and neurodegenerative disorders.
Rigel’s RIPK1 inhibitor program includes R552, a systemic molecule being developed for the treatment of autoimmune and inflammatory disorders, and brain penetrating RIPK1 inhibitors for central nervous system (CNS) diseases. In preclinical studies, R552 demonstrated prevention of joint and skin inflammation in a RIPK1-mediated murine model of inflammation and tissue damage.
Development of R552:
In Q2 2023, the initial Phase 2a trial (NCT05848258) in moderately to severely active rheumatoid arthritis (RA) was initiated by partner Eli Lilly.
Development CNS-penetrating RIPK1 inhibitors:
Currently in preclinical studies. Pipeline :: Rigel Pharmaceuticals, Inc. (RIGL)
~Summary and Prediction~
The current share price of sub $1 does not feel justified. I would anticipate financial breakeven by the end of 2024 or potentially in Q1 or Q2 of 2025. The robust pipeline, progress, and expected revenue growth are enough to justify a much higher valuation. The debt load is manageable, but the potential for S is concerning. I believe that the S is not necessary and revenue growth and progress should speak for itself. I am not as bullish as the analysts at HC Wainright for a $15 PT, but the valuation should be at least 3x to 5x from the current value. This thesis does not highlight the patents surrounding their drugs either which some extend into 2035 and beyond. Perhaps what Wall Street is discounting is the fact that most of the drugs are very niche. However, the currently available drugs have an addressable market, albeit less universal than some, but you should value it in the sense of multiple facets (a 1000 headed snake is the phrase I wanted to use). I believe the company should be valued with specialty drugs in mind which would command a higher PE ratio. At the current day and time of writing, the value should be at least $1.50 to $1.75 ~at a minimum~ with a 12 month price target of $3 to $5+. I will be looking for continued revenue growth in each quarter this year and realization of revenue from Gavreto in Q2 or Q3 this year. The partnerships should not be discounted either and the current share price if it lingers here perhaps may attract a merger or acquisition. I initially began the research thinking that perhaps the drugs were too niche, but given the multiple drugs they are working with, I believe their revenue sources will continue to grow if you do not focus on one particular drug as the main performer. With the most recent inflation report being cooler than expected, I would suspect larger funds and institutions will be circling back to riskier assets.

Is it because of TRT or some other cause ? I’m on 120 mg test with 500 ui hcg weekly. Never had symptoms before. Just curious. My first blood test is in 2 weeks at 10 weeks in.

I am pretty sure this is what is going on with me! Without me realizing it originally….
Short story; about 2 weeks ago I noticed that I had some frontal neck tightness, like my veins I could feel more blood flow happening in them? Or my pulse? Idk, but it didn’t feel right. Also had some irritability and hot flashes. Then I noticed my chest was tightening! I had already experienced some pins and needles feelings in my hands and arms. I had just started an upper dose of my thyroid medicine which can also cause quite a bit and thought it was just that. So because of the cardiovascular issues I was feeling, I decided to completely stop caffeine just in case bc I didn’t want to exasperate my symptoms. Important to note, I had already decided to bring down my caffeine content because I know it was too high, but I did not really connect any of this to lowering or tapering my caffeine at all until the last couple of days! I truly thought it was just my medication. However, seeing as I was very dependent upon caffeine for the last 20 some years at anywhere between 500 to 700 mg of caffeine a day throughout the day, caffeine withdrawal makes total sense! Could my thyroid medicine have contributed? Absolutely, probably so but at this point I think that I’m really in the thick of it when it comes to caffeine withdrawal because I have completely stopped my medication. Symptoms included: I have been experiencing some chest tightening/discomfort. It was never painful but it was just very tight and heavy feeling. I have had heart palpitations that I could feel in my chest and in my neck, along with neck restriction, almost strangulation feeling! Bad headaches and I would say the oddest one were cold tremors. There was one night where I was wearing a full clothing plus a onesie and a blanket and my whole body was tremoring. I ended up going to the hospital ER twice thinking that it was something to do with my heart and each time they ran an EKG which came back totally normal. The first time they also checked my blood for troponin which signifies whether or not you may have had a heart attack and it was fine. They did a CT scan on my neck since I complained of tightening and restriction and it completely came back fine and a chest x-ray to check my heart and lungs which was also fine. The second time I went to the hospital they did, like I said another EKG, which was fine and another x-ray which was also fine and basically asked if I was stressed or have anxiety (which I never have!)
So, all this to say, it’s gotta be the caffeine withdrawal! I’ve always been someone who has tried to be physically fit and today I felt probably the best I have felt in two weeks so I went on the smallest jog ever and it felt fantastic during but after resting for about 10 to 15 minutes that sudden rushed pulsing in my neck came back and after doing some research it looks like caffeine normally will restrict the blood flow to your head and so it seems like maybe I’m getting more blood flow now that I’m not having caffeine to restrict blood flow, which is causing the pulsating to where I can feel it as well as the headaches. It’s insane!
Please tell me I’m not alone?! How long does this last!

23F. Condition: Epilepsy. Medication: 500 mg Keppra, 250 mg Lamictal. Height: 5'5, Weight: 169. Race: Mixed Caucasian and Asian. No smoking, drinking, or drug use.
Yesterday afternoon something on my arms started itching, I looked and they kind of looked like mosquito bites. I woke up this morning and they were still there, still as itchy, and now I am panicking thinking they might be bed bugs. I can't exactly tell whether these are bed bug bites, mosquito bites, or just an allergic reaction to something? I have a picture below along with a link to an imgur album and I am hoping that someone would have a clue? I have no idea what might have caused these bumps. Thank you for any help or advice you are able to give me!
Edit: I totally forgot to add, that I do not currently have any pets or recently been on any nature walks/hikes. I really should have remembered to add that in. Sorry!
https://imgur.com/a/wgN9jvv