Frequently Asked Questions about Mistletoe Therapy 

What are the differences between the three brands of Mistletoe extract?

 

What are the differences between AbnobaVISCUM®, Helixor and Iscador®?

Manufacturer:

All three brands are manufactured in Germany. Although each brand does have their own way of production, all do carry out manufacture and quality control procedures according to legal regulations and in strict adherence to international standards and rules of “good manufacturing practice”, i.e. the GMP guidelines. These regulations are applied and continually updated according to the most current knowledge and technology.

Evidence:

From the references on my Mistletoe Therapy page, the papers which did investigate different brands of mistletoe extracts, none but one, stated them to be different. The one paper which made a difference quotes: "...ADR (adverse drug reactions) frequency differed with respect to preparation type, with Iscador® preparations showing a higher relative frequency, compared to Abnoba viscum®...

Distributor:

Iscador® Oral drops and injections are distributed by Customised 4U Pharmacy: tel: 0800 035 3078, fax 0800 035 3079. Email: enquiries@customised4upharmacy.co.uk. Address: Unit 2 Regents Drive, Low Prudhoe, Industrial Estate, Northumberland, NE42 6PX

AbnobaViscum® injections are distributed by Village Pharmacy Charlton Ltd: tel 0208 858 0907, tel/fax 0208 265 5222. Email: chamaine.patel@nhs.net. Address: 9 The Village, Charlton, SE7 8UG

Helixor® is the only brand which is available worldwide and has different contact details depending on the country. Check out www.helixor.com for more information.

Postage:

Customised 4U Pharmacy (Iscador®) does charge £7 for postage.

The Village Pharmacy (AbnobaViscum®) does charge £15 for postage.

Helixor® shipping prices depend on where you live. 

Needles and syringes:

The Village Pharmacy (AbnobaViscum®) does send needles and syringes together with the AbnobaViscum® ampoules.

Customised 4U Pharmacy (Iscador®) and Helixor® do not send needles and syringes per post. You can go to your GP and request a prescription for subcutaneous needles (0,5x16mm, 25G 5/8", or insulin needles) and 1ml or 2ml syringes, or get them at boots or online.

Please, avoid insulin syringes (1ml syringe with a fixed needle). If needed I will give you a prescription for needles and syringes for only £5.

 

I want to travel, should I take the mistletoe extract with me and do I need to keep it refrigerated?

  • If you are on Iscador® Oral drops, and you travel for less then 1 month, it will be fine to have a few weeks break from it. If you wanted to take it with you or you are leaving for more then 1 month, I recommend that you take enough supply with you. If you are traveling with an already opened bottle and the journey takes less then 8-12 hours, don't worry, otherwise, I'd recommend you take a small refrigerating box with you to keep to cool.
  • If you are on mistletoe therapy injections, and you are traveling for less then 1 week, it should be fine. If you are leaving for a longer period, I'd recommend that you take enough supply with you. If the journey takes less than 4-6 hours there shouldn't be any problem. Otherwise, I recommend you take a small refrigerating box with you to keep it cool.
 

Can the Mistletoe Therapy be used instead of chemotherapy?

The Mistletoe Therapy is not a replacement for conventional medicine and it can be considered to be used alongside appropriate conventional cancer treatments.

Studies have shown that the Mistletoe Therapy can reduce side effects of conventional treatments such as chemotherapy, radiotherapy and hormone therapy. In addition, it seems to increase their tolerability, increasing the likelihood of continuity on recommending dosages.

Chemical interference on treatment outcome, according to research, appears unlikely. Read more

 

For how long should I take the Mistletoe Therapy?

The overall duration of treatment is not restricted but will be individualised in each case.

Generally, after two years of continuous treatment, the frequency of injection can be reduced to 2 ampoules (2 injections) per week.

From the 3rd year onwards, treatment-free intervals can be taken, always adapted specially to each case.

After 5-7 years in total (from the beginning of treatment) treatment can be discontinued, or switched to oral drops if the patient’s condition and prognosis are favourable.

Iscador® Oral Drops are generally recommended to be taken continuously for 2 years. From the 3rd year onwards, treatment-free intervals are recommended in a progressively increasing regime, always adapted to each case. Generally, the recommended overall duration is 5 years, however, in some cases, therapy can be extended up to ten years (from the 6th year up to the 10th year, treatment-free intervals will progressively exceed treatment intervals).

 

How should I take the Iscador® Oral Drops?

The standard recommendation is to take 6 drops in the morning and 9 drops in the evening, from Monday to Friday only, for 3 weeks and then to have one full week break before a new bottle is started. Variations may be recommended to adjust to each case.

 

I did forget to take the Iscador® Oral Drops, what should I do?

If you didn’t take the drops in the morning, you can take them in together with drops in the evening. (Example: you usually take 6 drops in the morning and 9 in the evening, and you didn’t take you 6 drops in the morning, then take 15 drops in the evening and continue as usual the following day)

If you didn’t take the drops in the evening, you can take them in together with drops the next morning. (Example: you usually take 6 drops in the morning and 9 in the evening, and you didn’t take you 9 drops in the evening, then take 15 drops the next morning and continue as usual having 9 drops in the evening)

If you missed a complete day of treatment, divide the number of drops in 2 half and add each half on the following two treatment days. (Example: you usually take 6 drops in the morning and 9 in the evening, and you missed one day: 6+9=15, 15/2=8, 15+8=23, so for the next two days you have 23 drops in total, 10 drops in the morning and 13 drops in the evening)

If you didn’t take the drops on a Friday, take them on Saturday.

In order to gain the most benefits from the mistletoe therapy, make sure that you take them as prescribed and following the instructions.

 

How should I store the Iscador® Oral drops?

Before opening, Iscador® Oral Drops should be stored at room temperature (15 - 25 ºC).

Once opened, Iscador® Oral Drops should be stored in the fridge (2 - 8 ºC).

The expiry of Iscador® Oral Drops is 3 weeks from opening.

 

How should I store the ampoules containing mistletoe extract?

The mistletoe extract has been protected from oxidation under the strictest conditions during the entire manufacturing process. For this reason, injections must be given immediately after breaking open the ampoules; the contents of opened ampules cannot be used at a later time.
Ampoules containing brown-coloured liquid may not be used as this indicates that the preparation has been exposed to oxygen and spoiled.

AbnobaVISCUM® 20 mg to 0.02 mg strengths and all Iscador® ampoules must be stored in the fridge (2 to 13 °C). The ampoules may not be frozen. If ampoules are transported, e.g. from the pharmacy to the patient’s home, continual cooling at the above-mentioned temperatures is not necessary. However, extreme temperatures such as frost or heat (over 25 °C) should be avoided.

There are no particular storage recommendations for abnobaVISCUM D6 to D30 strengths. These ampoules do not have to be kept in the fridge, although they should not be stored or transported at temperatures above 25 °C.

 

How should I take the mistletoe injections?

Standard regime recommends having 3 injections weekly, on Mondays, Wednesdays and Fridays, at any time of the day.

Adjustments can be recommended as part of an individualised treatment considering each patient’s situation.

 

I do have a red patch around the injection site, is it normal?

Yes! The skin provides us with reliable information about how your body reacts to the mistletoe extract. Check Are there any side effects? for more information.

If you have any question, please, contact me.

 

Are there contraindications with mistletoe therapy?

In the case of acute infections or diseases accompanied by fever (body temperature above 38°C), mistletoe therapy must be discontinued until the fever or infection subside.

The mistletoe therapy should not be administered if there is any known hypersensitivity to mistletoe preparations.

 

I do have fever, what should I do?

The mistletoe extract does stimulate the immune system, therefore, a raise in the body’s temperature can happen, most frequently within 12 hours following the injection. It usually does not last longer than 1 day, and it should not be suppressed with fever-fever-reducing medicines.

If you experience fever for more than 24-48 hours following the injection, it is unlikely to be caused by the mistletoe extract and other causes should be addressed.

If you have any question, please, contact me.

 

Can I have mistletoe therapy during pregnancy and/or lactation?

To date, no effects are known to contraindicate administration of mistletoe extract during pregnancy. Particular caution should be exercised, however, and therefore, during the first three months of pregnancy, the mistletoe therapy should be administered strictly according to the prescribed indications.

There is insufficient knowledge available to make recommendations for administration of mistletoe extract during breastfeeding.

 

Are there any mistletoe therapy side effects?

The following symptoms appear in almost all patients taking the correct “individual dosage”:

Skin: Injection site inflammation up to 5 cm in diameter mostly disappears 8 -12 hours after the injection; rarely lasting longer than 24 hours

General: Minor increase in body temperature within 12 hours following the injection

Blood and lymph system: Temporary, minor swelling of nearby lymph nodes

The symptoms described above are harmless and present no cause for concern; they signal the patient’s responsiveness to treatment. The minor increase in body temperature (up to 38 °C) triggered by the mistletoe extract should not be suppressed with fever-reducing medicines or remedies.

Rare side effects:

Skin: Larger injection site inflammation over 5 cm in diameter, injection site nodule

General: Pyrexia over 38 °C, fatigue, chills, malaise, headache, short spells of dizziness, triggering of inflammations

Blood and lymph system: Injection site lymphadenopathy

Digestive tract: Diarrhoea

Urogenital tract: Increase urge to urinate

The general symptoms described here do not indicate an intolerance of the medication but rather that the dosage is effective. However, if these symptoms do not subside during the course of the day following the injection, or if you are unable to tolerate the symptoms, please, contact me as soon as possible (this may indicate a reduction in dosage)

Very rare allergic reactions:

Skin: Injection site or generalised urticaria, blistering, rash, erythema multiforme (one documented case), angioneurotic oedema

General: Generalised pruritus, chills

Circulation system: Anaphylactic shock

Airways: Dyspnoea, bronchospasm

If any of these symptoms appear, discontinue administration of the mistletoe extract immediately. Emergency medical measures should be taken immediately.

 

I did forget to inject myself, what should I do?

You can inject the mistletoe extract at any time of the day.

Generally, take the injection as soon as you notice that you have forgotten.

If you remember the next day, inject the mistletoe extract that day and then have the following injection(s) 1 day apart until the weekend. Then continue as usual.

Example: You usually inject yourself on Mondays, Wednesdays and Fridays. However, on a Tuesday you realise you didn’t have your injection the day before. No worries! Have one injection on Tuesday, then the next ones on Thursday and Saturday. Continue the following week as usual (Mon, Wed, Fri).

If you do realise that you did forget one injection 48 hours after, just continue as usual.

Example: You usually inject yourself on Mondays, Wednesdays and Fridays. However, on a Wednesday you realise you didn’t have your injection on Monday. Have now one injection on Wednesday and continue as usual (Fri, Mon, Wed, Fri…).

 

I broke one ampoule by accident, what should I do?

Just use another ampoule and continue as usual.

 

I haven’t injected myself for more than a week, what should I do?

Each case needs to be addressed individually as it depends on many different factors.

Generally, if you didn’t have the mistletoe therapy for less then a month and you were having only minor skin reaction, the therapy can be continued on the same dose. However, some adjustments should be made. If theses your case, please, request a telephone consultation.

If the therapy was interrupted for a longer period of time, the mistletoe therapy can be continued but starting on a lower dose is generally recommended. Here as well, individual adjustments should be made taking different factors into account. For more information, feel free to request a telephone consultation.

 

I want to start the mistletoe therapy, what should I do?

The first thing to do is to book an appointment with me (for Integrated Medicine).

During this appointment, I’ll explain how it works and what to expect.

After this appointment, you can have different follow-up modalities . The quickest option is the “Mistletoe Therapy F/U” where you will create an online account entering only the required data of your medical record. This account is password protected and encrypted and your data are stored according to the GDPR legislation. Every time you need a repeat prescription, you can log in, answer a few questions about your current state and response to the mistletoe extract, and then book an appointment for the telephone consultation where we will have a brief catch-up.

* I may recommend you to come and see me in person if your medical state does require so.

Mistletoe Therapy 


Find more about mistletoe therapy

When should mistletoe therapy begin?
Mistletoe therapy can be start early, even immediately after diagnosis or before surgery, if this is planned. Since mistletoe therapy activates the immune system and thus promote resistance, the body will be well prepared for the stress that surgery causes to the organism. But a later start is also possible.

Can mistletoe therapy also be performed during chemo- and/or radiotherapy?
Yes, because mistletoe therapy can reduce the adverse effects of chemo- radio-, hormone or antibody therapy. However, it is essential to ensure that the injection is given outside the radiation field, otherwise the skin can become highly inflamed.

Does mistletoe interfere with the effects of other drugs?
No, so far there are no known negative interactions with other drugs. The studies available so far show that mistletoe therapy can be well combined with conventional treatment methods like chemo- radio-, hormone or antibody therapy. It can also reduce some of their undesirable effects. 

How long does the treatment take?
Mistletoe therapy is often a long-term therapy but needs to be accompanied by a health professional. How long the therapy lasts in individual cases depends on how the disease develops and how the organism reacts to the therapy.

Do blood levels need to be measured? 
In most cases the blood levels are determined once at the beginning of mistletoe therapy and monitored repeatedly at longer intervals during the course of the treatment. However, such laboratory controls are not absolutely necessary. Each doctor decides which examinations are necessary in the individual case on the basis of the disease situation.

Does mistletoe therapy influence tumour markers?
The tumour markers change depending on the course of the disease. If the general condition improves or the tumour size reduces as a result of mistletoe therapy, the tumour markers may also decrease again.

Is mistletoe therapy useful if metastases are already present? 
Yes, because mistletoe therapy can improve quality of life and strengthen the immune system, which may be manifested, for example, in an increase in appetite and weight, normalization of sleep quality and stimulation of the vital spirits revive. 

Can mistletoe therapy relieve pain?
Mistletoe therapy may reduce the need for analgesics. Pain intensity depends on the tumour growth, your general condition and physical strength. As your condition improves and energy returns, yours pain also decreases.

Which mistletoe preparation is the appropriate one? 
There is no "right" or "wrong" mistletoe preparation. The most important aspects in the selection of the mistletoe preparation are the type and stage of the tumour, the patient's individual symptoms and situation of the patient and above all, the question of what is to be achieved with mistletoe therapy. Considering these factors, the doctor needs to find the most suitable preparation. People who are sensitive to drugs may initially be given a rather low-dose mistletoe preparation – some manufacturers offer special preparation series with particularly low initial concentrations for this purpose.

Who can prescribe mistletoe preparations? 
Every doctor, and in Germany, also non-medical practitioners, can prescribe mistletoe preparations.

Is the reddening of the skin an allergy? 
No, redness at the injection site up to 5 cm in diameter is a sign that the immune system reacts to mistletoe therapy. 

The red spot itches – is that an indication of an allergic reaction? 
No, this is not an indication of an allergy either. The itching can occur when the mild local inflammation caused by the mistletoe extract subsides. 

Is it dangerous if mistletoe therapy causes fever? 
An increased temperature of up to 38 °C is desired because the organism is stimulated to regulate the body temperature. This ability is often weakened in cancer patients. Many cancer patients who are always shivering feel comfortably warmed up following subcutaneous mistletoe therapy. If temperatures exceed 38° C and persist for more than 3 days, an infectious process or tumour fever should also be considered.

If higher fever develops during mistletoe infusion (up to 39.5 °C), this may be therapeutically useful. However, this therapy variant is an off-label application and should therefore always be under medical supervision. If the body temperature remains above 38 °C for more than three days, you should consult your doctor. 

Can mistletoe stimulate tumour proliferation? 
Neither laboratory experiments nor more than 150 clinical studies have found evidence that mistletoe therapy could stimulate tumour proliferation. 

Should mistletoe preparations always be injected? 
Mistletoe therapy is approved for subcutaneous application. In the form of an oral application, the protein-containing mistletoe extracts would be "digested" in the stomach and made ineffective.  

Do the injections hurt? 
No, the injection can only be felt as a small prick. It may be as well slightly painful if injection has been given intra cutaneously or when a nerve end has been struck by mistake, being however harmless. The needle used for injection is extremely fine and thin. You can look for a place to inject where your body is as insensitive as possible (abdomen, thighs). At the beginning, you should be instructed how to inject by a professional, because there are a few tricks and tips on how to inject painlessly.

Hardenings form at the injection site. Why? 
The hardening is called induration, and it is caused by the migration of white blood cells into this region. This induration disappears within a few days, usually the day after the injection. 

At what time should injection take place? 
If it is important to stimulate the activity of the organism, it is useful to perform the injection during the rising of the body temperature, i.e. in the morning (between 7 and 9 a.m.). If the warming aspect of mistletoe is to be preferred, it is advisable to inject it at the time of maximum body temperature, i.e. in the evening (between 5 and 6 p.m.). In principle, a change of both methods is possible.

If the next injection is due but the redness has not yet subsided, what can be done? 
Normally, you do not inject into the same place again. Nevertheless, you should wait with the next injection until the redness of the previous injection has completely subsided, because otherwise the redness that still exists could intensify to such an extent that a strong and painful inflammatory reaction develops. A redness that does not disappear within two days is often greater than five centimetres, indicating that the dose of mistletoe extract is too high or that the injection was wrong.

Dr Saskia Kloppenburg Vieth Medical doscotr and holistic and complementary care practitioner

Consultant in General Internal Medicine (GMC reg. number: 7541548) and Specialist in Complementary Cancer Care
MBBS, MRCIM (Spain), MSc Homeopathy, MFHom, Master practitioner in Ericksonian Hypnotherapy and Neurolinguistic Programming, MSc in Nutrition

Integrated medicine Doctor and Holistic Medicine Practitioner

INTEGRATED MEDICINE AND HOLISTIC HEALTHCARE CLINIC

Private Complementary and Alternative clinic.
Appointments
1st Floor
185 Tower Bridge Road
London,
SE1 2UF
United Kingdom
info@integratedmedicine.co
Integrated medicine Clinic
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