![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 433 to 457 of 479. Go back in thread:
Posted by marfaith on March 31, 2004, at 9:58:37
In reply to Re: Remeron, posted by LyndaK on March 31, 2004, at 1:48:29
> I have to agree that what I grip around my middle is NOT water retention -- it's FAT. I agree that fat is produced when calories consumed is greater than calories burned, which is why I'm convinced this has SIGNIFICANTLY lowered my metabolism. I don't eat any more than I did before, I probably watch WHAT I eat more than I did before, and I am definitely more physically active than I was before. But the weight doesn't budge. I too have wondered if the weight gain was a sign of something more serious going on inside, but if I go by how I FEEL, I feel healthy -- my immune system is good, all my blood-work at my last physical was fine including the one that checks liver function. So I don't now whether to just stick with it and put up with my fat body or try to go off it (or go down to a lower dose and see what that does). I'll be discussing it with my pdoc at my next visit in a couple weeks.
>
> Thanks for all the responses. It really does help to know that there are other people with the same experience -- that I'm not just imagining things or making up excuses.
>
> LyndaI also had a physical and they also checked my thyroid and everything checked out to be fine. I increased my exercising and watch what I ate. I could only lose 1-2 lbs. I was in size 12 pants and now I am back in a 8. It is definitely not water, it was fat. Hope you get some help from your doctor. Marfaith
Posted by j-lo on April 8, 2004, at 10:56:31
In reply to Re: Remeron, posted by marfaith on March 31, 2004, at 9:58:37
yeah, i just started remeron 6 weeks ago now, and i've gained 14 pounds. i was put on it to replace trazodone to help me sleep at night....which it certainly does...i'm out for a good 10 hours on average. but i'm quite worried about the weight gain as i have no motivation to exercise or even walk my dog. i've also experienced an all over body ache (muscular), but mainly my back. i haven't had much success with any of the ssri's or effexor (made me a "bitch") but am also on wellbutrin which i've been on the max dose for 2.5 years now. i'm trying to get an appt. with my p doc asap....i feel like i just want to discontinue on my own, but i know i shouldn't.
Posted by PoohBear on April 8, 2004, at 11:50:43
In reply to Re: Remeron, posted by j-lo on April 8, 2004, at 10:56:31
> yeah, i just started remeron 6 weeks ago now, and i've gained 14 pounds. i was put on it to replace trazodone to help me sleep at night....which it certainly does...i'm out for a good 10 hours on average. but i'm quite worried about the weight gain as i have no motivation to exercise or even walk my dog. i've also experienced an all over body ache (muscular), but mainly my back. i haven't had much success with any of the ssri's or effexor (made me a "bitch") but am also on wellbutrin which i've been on the max dose for 2.5 years now. i'm trying to get an appt. with my p doc asap....i feel like i just want to discontinue on my own, but i know i shouldn't.
How long did you try Effexor? It could very well have been the Wellbutrin that made you feel like a *itch; it does that to alot of people. It made me want to climb the walls...
Remeron is known to be a rather weak AD. It's great for sleep, but not as effective as and AD as it's usually taken at night. I gained 12 pound in 2 weeks that I still ahve not been able to take off after three months.
Tony
Posted by j-lo on April 13, 2004, at 18:25:55
In reply to Re: Remeron, posted by PoohBear on March 30, 2004, at 10:57:48
thanks pooh bear,
not only was i a bitch on effexor, but also could not acheive orgasm (if i ever felt the urge). since on here, i did a bit of research. remeron is an antagonist which fights/blocks histamine receptors. it actually lowers serotonin, but it increases norepinephrine in the brain. an increase in norepinephrine increases: heart rate and pressure, conversion of glycogen in glucose and therefore increases the conversion of fats into fatty acids in adipose (fat) tissue. what this means to me is that the rate that the glucose is being converted is increased, which in turn means that your body would need to burn off the glycogen so many times faster than normal to keep up. now what i don't know is how you could cut that action off at the pass...if possible. though if there was a way, i'm sure that drs. would know about it by now. someone mentioned taking a drug for narcolepsy which would stimulate, but i don't know if it would help the metabolism of glucose. taking an anti-histamine maybe? such as sudafed...
though, then you're just adding more drugs into the mix...
i've put on another 5 pounds since my last post and i can't get an appt. with my p doc for three weeks, but i think i'll just wean myself off on my own. i'm seeing my family physician tomorrow.
see what she says...
Posted by PoohBear on April 13, 2004, at 18:36:27
In reply to Re: Remeron » PoohBear, posted by j-lo on April 13, 2004, at 18:25:55
Sorry to hear about the extra 4 pounds :-(
I really miss the sleep I got on Remeron. It was superb!
Too much Sudafed makes me jumpy.
I thought of Cortisol, but the research I did on the web seems to indicate that it's not as effective as the commercial would lead one to believe. (Why am I not surprised...)
Your explanation of the weight gain mechanism of Remeron makes sense. It seemed to me like I gained alot of weight in water, as I ended up with swollen joints and extremities.
Take care!
Tony
> thanks pooh bear,
>
> not only was i a bitch on effexor, but also could not acheive orgasm (if i ever felt the urge). since on here, i did a bit of research. remeron is an antagonist which fights/blocks histamine receptors. it actually lowers serotonin, but it increases norepinephrine in the brain. an increase in norepinephrine increases: heart rate and pressure, conversion of glycogen in glucose and therefore increases the conversion of fats into fatty acids in adipose (fat) tissue. what this means to me is that the rate that the glucose is being converted is increased, which in turn means that your body would need to burn off the glycogen so many times faster than normal to keep up. now what i don't know is how you could cut that action off at the pass...if possible. though if there was a way, i'm sure that drs. would know about it by now. someone mentioned taking a drug for narcolepsy which would stimulate, but i don't know if it would help the metabolism of glucose. taking an anti-histamine maybe? such as sudafed...
> though, then you're just adding more drugs into the mix...
> i've put on another 5 pounds since my last post and i can't get an appt. with my p doc for three weeks, but i think i'll just wean myself off on my own. i'm seeing my family physician tomorrow.
> see what she says...
Posted by ravenstorm on April 14, 2004, at 12:04:23
In reply to Re: Remeron, posted by PoohBear on April 13, 2004, at 18:36:27
Hi, I've only been on Remeron 5 days and i haven't gained any weight according to the scale, however, pants that were hanging on me 5 days ago due to weight loss from depression/anxiety are now tight in the waist. In other words my abdomen is extremely bloated/distended. I am pretty tiny (5'5" 115lbs) so this, of course looks very attractive (lol). I was actually looking forward to eating like a pig to put on 5-10lbs that I lost, but I can't see going back up to my previous weight if my pants are already snug around the middle!
Anyway, my appetite doesn't seem to be increased yet (knock wood) but I've heard that it sometimes takes a week before it happens. Have been watching what I eat carefully and "trying" to avoid processed sugar. Although, like I said I have a huge belly now even without weight gain.
When I brought up the weight gain with my new pdoc before starting the remeron, he replied with: well only 17% of people gain weight on remeron. I snorted and said: "And the makers of Lexapro claim that only 1% of people (or something like that)have sexual disfunction on their drug, do you find that to be true? He admitted he did not.
Honestly, I wish they would come to these boards instead of just believing whatever the drug companies tell them!!!!!!!!!!
He is the second pdoc to say with a straight face: "Effexor isn't hard to stop taking".
Unbe-frickin-lievable!!!
Posted by j-lo on April 15, 2004, at 10:58:50
In reply to Re: Remeron, posted by ravenstorm on April 14, 2004, at 12:04:23
hi raven...
that was how it started with me...my pants wouldn't close, but no change on the scale. then, WHAM! in a matter of 8-10 days (2 week total)...the scale showed 10 pounds...since then, another 5. i went to my family doc yesterday and we're going to wean me off the remeron. maybe slowly taper me off wellbutrin too, and start all over again :(
c'est la vie, or is it?
Posted by ravenstorm on April 15, 2004, at 12:14:25
In reply to Re: Remeron, posted by j-lo on April 15, 2004, at 10:58:50
Just yesterday and now today I am experiencing what I believe to be severe blood sugar lows. I have to eat every four hours because I am hypoglycemic, but yesterday and now today, 3 hours after my last meal I am shaking and weak.
Is this how you end up putting on weight? I can't get like this every three hours!! this is how I would feel if I went more than 5 hours without eating. I ate every four hours to avoid the feeling all together. I can't eat every two hours!!!!!!!!
Posted by ravenstorm on April 15, 2004, at 14:08:10
In reply to Re: Remeron, posted by ravenstorm on April 15, 2004, at 12:14:25
OK, I know I just posted about this above, but I thought if I put it in the subject line it would garner more attention.
I just have to reiterate that these are sugar lows unlike anything that I have experienced. Very, very intense. Todays was worse than yesterdays. Almost passed out trying to get a sandwhich made for myself and eaten. Also, a drop in blood sugar only makes my anxiety that much worse.
The only difference in the last two days versus the previous 5 days on remeron is that I felt good enough to go rollerblading the last two days. Usually exercise helps, not hurts my blood levels.
Am bummed, because, the last two nights I started sleeping better again on the Remeron and thought the worst of the start up effects had passed.
Don't know if I can stay on a drug that does this. Why do I have to have weird reactions to everything???????????
If you are the praying sort, please pray for me. I just want to be able to take an AD and get better and I'm not looking forward to trying a tricyclic!
Posted by j-lo on April 19, 2004, at 20:57:13
In reply to Re: Remeron, posted by ravenstorm on April 15, 2004, at 12:14:25
no , initially it's not from the cravings....the eating...you gain weight for different reasons. however, if you overeat because of the carbohydrate/sweet cravings, then yes, you're just adding to the whole process. it does suck though because i haven't had better sleeps than when on remeron. i am also still doing the trail and err of ad's and it is frustrating! since i've weaned down from the remeron though, i've felt alot better in general...more energy. everyone is different.
Posted by j-lo on April 19, 2004, at 21:03:08
In reply to Re: Remeron » PoohBear, posted by j-lo on April 13, 2004, at 18:25:55
just to reiterate: remeron is an antagonist which fights/blocks histamine receptors. it increases norepinephrine in the brain which in turn increases heart rate and pressure, conversion of glycogen in glucose, and therefore increases the conversion of fats into fatty acids in adipose (fat) tissue. what this means to me is that the rate that the glucose is being converted is increased, which in turn means that your body would need to burn off the glycogen so many times faster than normal to keep up. so, because your body is using the glycogen so quickly and converting it before you can replenish...thus, the carbohydrate/sweet cravings...
Posted by ravenstorm on April 20, 2004, at 9:04:34
In reply to Re: Remeron, posted by j-lo on April 19, 2004, at 21:03:08
two weeks in. Still no weight gain but my blood sugar is still being affected. It drops dramatically about two to three hours after I eat. At this rate I will have to eat about six small meals a day!
Posted by ravenstorm on April 20, 2004, at 20:43:33
In reply to Re: Remeron, posted by ravenstorm on April 20, 2004, at 9:04:34
I've been on Remeron for about two weeks. I'm not seeing a bunch of improvement in anxiety...
Can it take four to six weeks for it to help?if you got help with anxiety< how long for you to see results?
thanks
Posted by j-lo on April 21, 2004, at 12:01:51
In reply to How long for Rem to help anxiety?, posted by ravenstorm on April 20, 2004, at 20:43:33
hi raven...
it was week three-four when the weight gain hit. and it hits very quickly and suddenly! i began to feel sluggish after that point...as far as treatment for anxiety? i actually found myself getting angry more often and had difficulty controlling my outbursts. i didn't notice any of my agitations/depression/anxiety improve over the seven weeks. i am almost finishing weaning off and this past week, i've not felt better than i do now in a long time. another friend of mine who is at the three week mark now, whom had previously said "well, if it works...what's the problem with gaining a bit of weight?", just called me yesterday to apologize. she told me that in a matter of days (the past three), she'd put on five pounds and was seriously concerned. it seems to gain around the middle/thighs and hip area, so it's very noticable. anyway, she also experienced some anger, though great sleeps. she has started to wean herself off...
i just don't know what to tell you. i'm disappointed in yet another ad...but this one was by far the worst (with the exception of those that decreased the ability to orgasm ;) today i actually went for a one hour walk with my dogs! and i'm thinking i may also mow the lawn...at least i have some motivation/energy now.
Posted by LyndaK on April 21, 2004, at 14:25:31
In reply to Re: How long for Rem to help anxiety?, posted by j-lo on April 21, 2004, at 12:01:51
In my opinion (I've been on Remeron for nearly 2 years now), this is a drug you HAVE to give some time to really know if it's going to work for you or not. The start-up side-effects are awful -- almost made me quit. The weight-gain is a real bummer. But it gave me my life back -- there's no denying that for me. It obviously isn't going to do that for everyone -- not everyone is the same. It turned out to be the right chemical whatever that my head needed to straighten out -- but I wouldn't have known that if I didn't give it plenty of time to work. I seem to remember being less inhibited at first too (getting angry and letting it show). I seem to remember a significant lessening of my anxiety within the first month or two, I really wasn't sure WHAT it was doing for me during the first couple of weeks, that just isn't enough time -- there's still alot of the start-up side-effects going on during that time.
Posted by ravenstorm on April 21, 2004, at 22:49:20
In reply to Re: How long for Rem to help anxiety?, posted by LyndaK on April 21, 2004, at 14:25:31
Thanks for the responses LyndaK and J-lo.
May I ask what dosages you are both on? (I'm sure it is in past posts--but you know how depression is--hard to concentrate on anything very long!)
I went to the pdoc today and he said I could either up my dosage to 30mg now (I've been on it almost two weeks) or wait another two to three weeks and see how the 15mg works out.
My day time energy is just fine on 15mg, but I do have extreme dry mouth (don't really care about that) and blood sugar problems (do care about this!)
He doesn't care what I do either way and really doesn't seem to be very knowledgeable about this drug.
Tomorrow I will try to read more old posts and decide what to do. I'm leaning towards just staying at 15mg for a full four to six weeks and then upping it to 30mg if I don't get good results. (But then I worry--what if the 30mgs is what I need and I "waste" those weeks waiting--ain't anxiety grand?!)
I am going to do my best to give the drug a good month or two to show me what it can do.
Any advice, input on remeron from veterans would be greatly appreciated.
J-Lo, I'm so sorry this hasn't worked for you. I know how frustrating it is. This is the third AD I've tried since December. Hang in there and thanks so much for posting.
Raven
Posted by ivy sperry on April 22, 2004, at 9:57:57
In reply to Re: How long for Rem to help anxiety?, posted by ravenstorm on April 21, 2004, at 22:49:20
I'm up to 60 mg, and have the lovely belly others are complaining of. pretty icky. recently added 10 mg of lexapro- anybody else tried this combination? Hate being on so many chemicals, but feeling a bit more energy. Anybody figured out how to lose the weight? I'm pretty active and don't know if I can keep taking it if this goes on...
Posted by Zena on April 22, 2004, at 10:11:49
In reply to Re: How long for Rem to help anxiety?, posted by ravenstorm on April 21, 2004, at 22:49:20
> Thanks for the responses LyndaK and J-lo.
>
> May I ask what dosages you are both on? (I'm sure it is in past posts--but you know how depression is--hard to concentrate on anything very long!)
>
> I went to the pdoc today and he said I could either up my dosage to 30mg now (I've been on it almost two weeks) or wait another two to three weeks and see how the 15mg works out.
>
> My day time energy is just fine on 15mg, but I do have extreme dry mouth (don't really care about that) and blood sugar problems (do care about this!)
>
> He doesn't care what I do either way and really doesn't seem to be very knowledgeable about this drug.
>
> Tomorrow I will try to read more old posts and decide what to do. I'm leaning towards just staying at 15mg for a full four to six weeks and then upping it to 30mg if I don't get good results. (But then I worry--what if the 30mgs is what I need and I "waste" those weeks waiting--ain't anxiety grand?!)
>
> I am going to do my best to give the drug a good month or two to show me what it can do.
>
> Any advice, input on remeron from veterans would be greatly appreciated.
>
> J-Lo, I'm so sorry this hasn't worked for you. I know how frustrating it is. This is the third AD I've tried since December. Hang in there and thanks so much for posting.
>
> RavenRaven,
I have been on 15mg. remeron for 2 yrs. I take it for anxiety & it worked pretty quick for me. But I also take 1 mg. klonopin a day with the remeron. I love it & have had very few side effects. The tire feeling does go away after your body gets used to it. My side effects were muscle weakness in my legs which seem to come & go & constipation. I tried 30mg. but my ankles & feet swelled & constipation was much worse. In Nov. the depression hit so the Dr. added lexapro to my mix & everything seems to be going fine now.I hope this information has helped you.
Zena
Posted by LyndaK on April 23, 2004, at 2:37:20
In reply to Re: How long for Rem to help anxiety?, posted by ravenstorm on April 21, 2004, at 22:49:20
I have been on 60 mgs. per day but recently moved down to 45 mgs. to see if I can get by on less now, or perhaps taper off altogether, but taking it slow and easy and seeing how I do. I needed to be at 60 mgs. to maintain the anxiety control; now I'm going to see if that's still true.
I think it's interesting what others have suggested about other meds in combination to increase the anxiety control. I didn't try that.
Good luck.
Lynda
Posted by ravenstorm on April 24, 2004, at 11:50:41
In reply to Re: How long for Rem to help anxiety?, posted by LyndaK on April 23, 2004, at 2:37:20
Thanks for the posts Lynda and Zena. Lynda it was good to hear that going up in dosage actually helped your anxiety, because I was under the mistaken impression that if I went higher it actually might make my anxiety worse.
I have two weeks in now and definitely have more day time energy am feeling less anxious in that I can go do more things in public now (but that may be bbecause I have more physical energy to get things done now!) but I still get the Physical signs of anxiety (like the explosions in my chest) that are not related to anything imparticular.
All of my mucous membranes are still really dried out and my hunger is through the roof but I just don't let myself eat when I'm hungry (but I don't know if I'm going to want to live like this indefinitely). In your experience, did your appetite lessen or increase as you went up in dose. Does dry mouth lessen when you go up?
Keep in touch about your titration downward. Hope all goes well for you. Did you notice any significant difference between 60mg and 45mg?
Raven
Posted by Zena on April 24, 2004, at 15:04:16
In reply to Re: How long for Rem to help anxiety?, posted by ravenstorm on April 24, 2004, at 11:50:41
> Thanks for the posts Lynda and Zena. Lynda it was good to hear that going up in dosage actually helped your anxiety, because I was under the mistaken impression that if I went higher it actually might make my anxiety worse.
>
> I have two weeks in now and definitely have more day time energy am feeling less anxious in that I can go do more things in public now (but that may be bbecause I have more physical energy to get things done now!) but I still get the Physical signs of anxiety (like the explosions in my chest) that are not related to anything imparticular.
>
> All of my mucous membranes are still really dried out and my hunger is through the roof but I just don't let myself eat when I'm hungry (but I don't know if I'm going to want to live like this indefinitely). In your experience, did your appetite lessen or increase as you went up in dose. Does dry mouth lessen when you go up?
>
> Keep in touch about your titration downward. Hope all goes well for you. Did you notice any significant difference between 60mg and 45mg?
>
> RavenRaven,
On remeron I had the hunger for several months so I chewed gum & drank lots of water. I haven't gained any weight. I was afraid when I added lex I would gain but so far I haven't. But I do have the belly-which I don't like.
Zena
Posted by ravenstorm on April 24, 2004, at 16:01:52
In reply to Re: How long for Rem to help anxiety?, posted by Zena on April 24, 2004, at 15:04:16
Yeah, the belly thing really sucks, doesn't it? My problem with the hunger is that I just don't feel more hungry, my blood sugar actually drops, so I feel really weak and dizzy and have to eat to feel better. Trying to eat healthy thing, though! Makes me feel better that it passed for you after a few months. Hope it does for me too, cause I don't think I could handle it long term.
I've actually heard of lexapro being fairly weight neutral, or people even losing weight on it (without trying). Good Luck!
Will decide in a couple of weeks whether to try 30mg or not. If I knew it would decrease the hunger I would do it tomorrow! Still no weight gain, but having to fight it hard (ie, I'm hungry almost all the time)
Posted by Sad Panda on April 25, 2004, at 1:07:54
In reply to Re: How long for Rem to help anxiety?, posted by ravenstorm on April 24, 2004, at 11:50:41
> Thanks for the posts Lynda and Zena. Lynda it was good to hear that going up in dosage actually helped your anxiety, because I was under the mistaken impression that if I went higher it actually might make my anxiety worse.
>
> I have two weeks in now and definitely have more day time energy am feeling less anxious in that I can go do more things in public now (but that may be bbecause I have more physical energy to get things done now!) but I still get the Physical signs of anxiety (like the explosions in my chest) that are not related to anything imparticular.
>
> All of my mucous membranes are still really dried out and my hunger is through the roof but I just don't let myself eat when I'm hungry (but I don't know if I'm going to want to live like this indefinitely). In your experience, did your appetite lessen or increase as you went up in dose. Does dry mouth lessen when you go up?
>
> Keep in touch about your titration downward. Hope all goes well for you. Did you notice any significant difference between 60mg and 45mg?
>
> Raven
>Hi Raven,
I would consider trying an SSRI again added to your Remeron as it counters SSRI's side effects brilliantly(Insomnia, Anorgasmia & Nausea). Lexapro seems like it is worth a try.
Cheers,
Panda.
Posted by LyndaK on April 25, 2004, at 3:10:41
In reply to Re: How long for Rem to help anxiety?, posted by ravenstorm on April 24, 2004, at 11:50:41
> Thanks for the posts Lynda and Zena. Lynda it was good to hear that going up in dosage actually helped your anxiety, because I was under the mistaken impression that if I went higher it actually might make my anxiety worse.
I have to tell you that some people DID get worse anxiety at higher doses, but that is not how it worked for me.
>
> I have two weeks in now and definitely have more day time energy am feeling less anxious in that I can go do more things in public nowI would take that as a sign that it probably IS helping your anxiety. One of the things that happened for me was, at my job, when I went to a meeting that ususally made me really nervous, not feeling very nervous at all, but being able to speak very clearly and calmly. I walked out of the meeting going "WOW!" That's when I was sold. But I probably had that experience 6 to 8 weeks into it.
< (but that may be bbecause I have more physical energy to get things done now!) but I still get the Physical signs of anxiety (like the explosions in my chest) that are not related to anything imparticular.
Stick with it a little longer and see if that gets better.
>
> All of my mucous membranes are still really dried out and my hunger is through the roof but I just don't let myself eat when I'm hungry (but I don't know if I'm going to want to live like this indefinitely). In your experience, did your appetite lessen or increase as you went up in dose. Does dry mouth lessen when you go up?I honestly don't remember having a dry mouth, though I may have and just don't remember now. I can tell you it definitely didn't stay that way. SSRI's gave me a worse dry mouth than this does. I remember the intense hunger -- just awful! Felt like I was literally STARVING even though I wasn't -- no matter how much I ate it never fully quenched the hunger. That definitely went away too, but I don't know if it was increased dose that did it or just length of time on the med. I seem to remember low-fat yogurt as something that worked well for those ravenous times in between meals.
>
> Keep in touch about your titration downward. Hope all goes well for you. Did you notice any significant difference between 60mg and 45mg?Thankyou. I seem to be a little more emotional, but not depressed. I had some increased fatigue, but that seems to be leveling off again. No significant increase in anxiety so far.
Hang in there.
Lynda
Posted by ravenstorm on April 25, 2004, at 9:41:01
In reply to Re: How long for Rem to help anxiety? » ravenstorm, posted by LyndaK on April 25, 2004, at 3:10:41
Thanks again everybody.
My "gut" tells me just to hang in at this dosage for another couple of weeks and see what happens.
I'm pretty sure the dry mouth,nose etc is from the histamine effect, so if it doesn't get better after four to six weeks I'll try upping to 30mg.
Not ready to add an SSRI again at this point, but it is a good suggestion for down the road if I'm still having problems.
Basically, I think its time to sit tight and see what happens. I am seeing some improvement already, so it is enough to keep me hanging in there.
Yes, Lynda, I feel like I am starving!! Never feel full. But no weight gain yet (but feel like I'm starving myself, even though I absolutely am not!!)
Again, all the posts from you "remeron veterans" are incredibly helpful.
Sad Panda--read a post somewhere from you that absolutely cracked me up--how you can have any mood stabilizer you want (because you live in Australia) as long as it is lithium.
Go forward in thread:
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.