18 - Perispinal Etanercept

As of September 14, 2023, I affirm that Perispinal Etanercept has had a significant positive impact in my personal case. While individual experiences may vary, my results following the first injection were notably positive.

The treatment schedule is as follows:

• Second injection: September 21, 2023

• Third injection: December 14, 2023

• Fourth injection: May 16, 2024

• Fifth injection: November 2024

• Sixth injection: May 2025

• Seventh injection: November 2025

Treatment Journey Videos:

• Visits 1 and 2: Watch here

• Visit 3: Watch here

Visit 4 (May 16, 2024):

This visit, although not recorded, was encouraging. I received the fourth shot, and the improvements extended further, reaching my knee. I anticipate one or two more treatments. Notably, Dr. Tobinick significantly reduced the treatment cost, and I experienced a modest return in my sense of smell—a welcomed development given my interest in cooking.

Scientific Rationale for Etanercept:

There are five TNF (tumor necrosis factor) blockers currently in use:

1. Infliximab (Remicade, 1998)

2. Etanercept (Enbrel, 2003)

3. Adalimumab (Humira, 2008)

4. Certolizumab (Cimzia, 2008)

5. Golimumab (Simponi, 2013)

Etanercept is a fusion protein biologic consisting of two soluble TNF receptors attached to an Fc portion of an antibody. This unique structure grants it high affinity and extended activity, making it particularly potent in neutralizing excess TNF, a key inflammatory mediator.

Blood-Brain Barrier & Perispinal Administration:

The blood-brain barrier (BBB) restricts entry of large molecules (over 600 Daltons) into the brain. Etanercept bypasses this barrier via perispinal delivery—an injection within 10 cm of the spine—leveraging the vertebral venous system (VVS) to carry the drug to the brain and surrounding tissues via retrograde flow.

Cytokine Antagonists:

Cytokine antagonists like Etanercept bind to inflammatory mediators, preventing their activity. Fusion proteins are especially effective due to their increased binding strength and prolonged presence in the body.

Professional and Research Opinions:

A quote from a stroke survivor's community highlights the results:

"Correcting brain TNF imbalances with Perispinal Etanercept can restore movement, speech, and communication in some patients."

A 2014 rebuttal to critiques emphasized:

Brain and Body Research Institute Findings:

Their research shows that elevated TNF levels disrupt brain connectivity. Perispinal Etanercept rapidly neutralizes excess TNF, reduces microglial activation, and improves neurological function. They note the method’s potential for stroke, TBI, dementia, depression, and more.

Defining Success:

Success is personal. It doesn’t always mean full recovery, but even regaining partial movement or sensation can be meaningful.

Example: Watch this patient’s experience

August 29, 2024 – Discussion with Dr. Spengler:

I met with Dr. Robert Spengler of the Brain and Body Institute. He testified in support of Dr. Tobinick’s method and noted that partial benefits—like restored taste—can still signify effectiveness. He plans to publish five related papers, aiming to satisfy scientific scrutiny.

Legal and Regulatory Background:

A 2015 California court decision supported Dr. Tobinick’s off-label use of Etanercept, declaring it within the standard of care. Despite this, major U.S. neurology institutions continue to resist the treatment, citing insufficient clinical evidence. Many neurologists remain skeptical.

Academic Outreach and Personal Milestones:

• September 24, 2024: First guest lecture at Advent Health University

• October 29, 2024: Follow-up class visit

• December 3, 2024: Students presented final projects successfully

I look forward to returning for the Spring/Fall 2025 semesters. This will go on as long as they will have me.

Fifth, Sixth, and Seventh Shots:

• November 14, 2024: Received the fifth shot with continued improvement

• May 15, 2025: Received the sixth shot, observed significant progress in my knee, ankle, and foot. Administered by Danielle. Shot #7, scheduled for November 13, 2025, is expected to be the final treatment.

• November 13, 2025: Got my seventh shot, and it was again administered by Danielle. This shot finally went through my ankle and into my foot a little bit. By now, you have to be asking why so many shots? The shots are administered between the fourth and sixth vertebrae in my neck and it is given right in the middle of the spine. Danielle told me that as long as we are seeing progress, we can keep going. Going to determine how I am doing after the Softwave Therapy (#27 in my blog) and make a go/no decision at that time. I have also been invited by Bill Gasiamis (https://recoveryafterstroke.com/episodes/) to share my experiences with both the Perispinal Etanercept and the Softwave Therapy in 2026.

Pharmacokinetics:

Etanercept’s half-life is 70–132 hours. Its effects can last from several weeks to six months. The body metabolizes it via proteolytic enzymes (proteolytic degradation), primarily in the liver and spleen.

Final Remarks:

This journey with Perispinal Etanercept has been transformative. I remain hopeful that the upcoming treatment will mark the conclusion of my recovery protocol. I also want to acknowledge the exceptional students at Advent Health University for their engagement and curiosity throughout this educational journey.

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Discovery and Background

While conducting research online, I came across information regarding an innovative treatment method developed by Dr. Edward Tobinick. At the time of this writing, Dr. Tobinick is 71 years old and is known for administering Etanercept—a TNF (Tumor Necrosis Factor) blocker commonly prescribed for conditions such as psoriasis and juvenile idiopathic arthritis—as an off-label treatment for neurological recovery.

His website is here:

www.nrimed.com

In 2010, Dr. Tobinick began administering Etanercept via perispinal injection, a technique that delivers the medication near the spinal column. According to his clinical observations, patients often experience noticeable improvement within ten minutes. TNF is a cytokine that plays a central role in inflammation and cell death, and its inhibition has been shown to positively affect neurological function following injury.

The procedure involves a 25mg dose of Etanercept injected near the cervical spine, after which the patient is placed in the Trendelenburg position (lying flat with feet elevated approximately 16 degrees for five minutes). This treatment has reportedly yielded promising outcomes in thousands of patients from all 50 U.S. states and 101 countries, according to the Institute of Neurological Recovery (INR). Studies suggest that previously inactive neural circuits may be reactivated following stroke or other brain injuries, potentially leading to rapid neurological improvement.

Candidate Criteria for Etanercept Therapy

In a 2012 article published by The Philadelphia Examiner, Dr. Tobinick detailed the characteristics of suitable candidates for this therapy:

Patients not considered suitable include those who:

• Have multiple sclerosis, tuberculosis, severe immune suppression, or an active infection

• Are currently hospitalized

• Are comatose

A Case Study of Interest

Skeptical yet intrigued, I began reviewing various video testimonials. One in particular stood out. The patient featured had suffered an intracerebral hemorrhagic stroke on the left side of the basal ganglia, caused by hypertension, a condition very similar to mine. As a result, her impairments were primarily on the right side of her body. Her treatment involved three doses of perispinal Etanercept, and the results were remarkable.

The video documents significant and sustained improvements in her stroke-related symptoms—reduction in pain, improved right-hand function, greater shoulder range of motion, clearer speech, and increased mobility—three years after her stroke.

Documented Improvements From Perispinal Etanercept

Patient reports and anecdotal data suggest that perispinal Etanercept may offer benefits in the following areas:

• Behavioral responsiveness

• Central post-stroke pain syndrome (CPSP)

• Cognitive function

• Hand strength and coordination

• Hemiparesis (partial paralysis)

• Hemisensory deficits (numbness or tingling on one side)

• Swallowing ability

• Mood and emotional regulation

• Pain and movement in affected limbs

• Spatial awareness

• Speech clarity and speed

• Gait and mobility

Other improvements reported include restored bladder control and reduced emotional outbursts.

Cost and Decision

Despite its promise, the treatment is expensive and not covered by insurance. There are no guarantees, and patients must sign waivers acknowledging that outcomes may vary. For me, though, living with chronic pain—often rated at 5 out of 10 or higher—meant even partial relief would be worth it.

Preparing for Treatment: April – September 2023

April 12, 2023I had a consultation with Dr. Tobinick and was recommended two doses, one week apart. The success rate was cited at 80%. Given my positive surgical history and the physician’s optimism, I scheduled my first treatment for September 14, 2023.

April 21, I completed and submitted my CBC (Complete Blood Count). Results were clear—one step closer.

April 29, My neighbor Kevin offered to help with lodging through his job with Choice Hotels. I’m grateful.

May 2, Gary, a longtime friend, offered to fund the second shot if the first proved successful.

June 30, Another friend, Tony, initially pledged partial support, then later committed to covering the cost of one shot.

June 30 (also), PPD skin test for tuberculosis came back negative.

July 13, Laura, another dear friend, stepped in to sponsor one injection. These generous acts reminded me of the power of community.

Understanding the Method: Insights from Dr. Tobinick’s Patent

By August 10, with five weeks remaining, I began reviewing the scientific foundation behind the method. Dr. Tobinick’s U.S. Patent 7,214,658 B2 outlines a perispinal approach that avoids direct spinal injection. Instead, Etanercept is delivered near the spine, then gravity is used to induce retrograde venous flow, moving the drug toward the brain. This method is considered counterintuitive but scientifically plausible due to the valve-less vertebral venous system.

The technique is minimally invasive, uses a small needle, and is designed to reduce inflammation directly in the central nervous system.

Caution and Criticism

Despite patient testimonials, many in the medical community remain skeptical due to a lack of large-scale clinical trials. Amgen, the maker of Enbrel (Etanercept), has issued statements distancing itself from Dr. Tobinick’s off-label use of their product. Some experts argue the rapid results are biologically implausible.

Critics like Dr. Karen D. Sullivan (via YouTube) dispute the validity of the treatment, though notably, many omit discussion of the delivery mechanism, which may be key to its effectiveness.

September 14, 2023 – First Injection

I arrived at INR and completed pre-treatment evaluations before receiving my first injection. Within two minutes of entering the Trendelenburg position, I began to feel my fingertips. My pain level dropped from 7/10 to 4/10, my neck loosened, and I was able to touch my toes and walk more easily.

I did not expect a complete recovery from one shot—but this was a significant first step.

Alternative Outcomes

Some patients, such as jmolloypisacane on Reddit, reported minimal improvement. He shared a complex stroke history and a wide range of treatments he had pursued. Our chat confirmed that outcomes can vary greatly. His journey reminded me that every recovery is different.

September 21, 2023 – Second Injection

After a second evaluation, I received my second dose. We discussed how the site is chosen (typically midline posterior cervical), how long effects last (varies), and that patients with hemorrhagic strokes often need more treatments.

To my surprise, my tinnitus improved. Dr. Tobinick referenced U.S. Patent 2001/0004456 A1, which discusses TNF blockers for treating hearing loss.

My pain dropped again:

• Upper body: 2/10

• Midsection: 4/10

• Lower extremities: 5/10

The most incredible moment: for the first time in six years, I was able to move my right foot and toes.

A Related Case of Hearing Improvement

The 2001 patent includes a case where a 73-year-old woman regained significant hearing function following two doses of Etanercept. She eventually had to remove her hearing aids because sounds became too loud. While my hearing hasn't improved to that extent, I’ve experienced a 50% reduction in tinnitus, and I’ll gratefully accept that.

December 14, 2023 – Third Injection

By the time I returned for my third shot, my results had held steady. I also met Michael Skivesen and Tobias from Denmark, who were training at INR before opening a clinic in Europe. It was exciting to see this treatment expand internationally.

Giving Back

On December 16, 2023, I participated in a 5K event, pushing my friend Jonathan in his wheelchair the entire way. We completed the course in 53 minutes. This act of service symbolized how far I’ve come and how much I have yet to give.

Looking Ahead: Shot #4 is scheduled for May 2024. Hope continues.

Isn't God good!