How Long Does It Take For PPS To Work?

Pentosan Polysulfate Sodium (PPS) is an FDA-approved drug in the United States under the brand name ELMIRON. ELMIRON is an oral medication indicated for treating bladder pain and discomfort associated with interstitial cystitis.

As usual, the Boulder Longevity Institute gets ahead of the crowd by finding a way PPS can be used in the U.S. as a beneficial regenerative medication. While not effective orally outside of its use as a bladder pain relief drug, PPS can be beneficial in the treatment of arthritis when administered via injection.

BLI partners with a compounding pharmacy to get PPS to patients now. The drug, in phase III trials approved by the FDA, will go to market in the coming years as Zilosul. 

As we know, arthritis is an inflammatory process at its core. Sure, the inflammation can be instigated by injury but we can say with confidence that addressing the inappropriate inflammatory response as quickly as possible leads to markedly better outcomes.

PPS works to address the entire inflammatory process in ways that typical treatments for arthritis pain – anti-inflammatories, steroids, joint replacements – do not. Pentosan works through various mechanisms like pain control, halting the progression of degeneration, and encouraging an environment for regeneration. 

Once a better environment for regeneration has been completed, stem cells or platelet cells can be introduced into a space where they can thrive. 

So how long does it take to work? Well, Dr. Yurth of Boulder Longevity Institute believes it depends on the extent of arthritis. Studies show pain control in 6-8 weeks with one to two injections per week. However, this is not the case for every user.

The more damage, or the further along the arthritic process, the longer PPS takes to fully engage in the work of improvement. With that said, there are those who see quick pain relief that is typically experiencing the impact PPS has on the inflammatory process.

While a relatively new use for pentosan, BLI has been using it long enough to note that 80 – 90 percent of clients see improvement over time. Patience is key, as it can take six months or so to really see regenerative impacts in the more damaged knee. 

Dr. Yurth has seen the value of pentosan firsthand, as she has been taking it for years and notes marked improvement in her chronic knee issues. Whether for chronic arthritic knees or an acute injury, pentosan is a game changer in the fight against damage brought by inflammation.

Depending on your clinical presentation, you may have to be patient. However, in the end, the benefits of pentosan polysulfate sodium are well worth the wait.

The Importance of Supplement Cycling

Most of us have understood the importance of taking a daily vitamin since childhood. Any Flintstone kids still growing out there? Taking some basic supplements on a daily, long-term basis makes sense. 

Dr. Elizabeth Yurth of the Boulder Longevity Institute points out that Vitamin D, B-Complex vitamins, or general multivitamins are logical additions to your daily supplement routine. What about the more aggressive supplements like spermidine, NAD, or antioxidants?

Using a process of supplement cycling (time on – time off specific vitamins and supplements) can help the body reap the benefits without doing unintentional damage. Certain supplements can be overwhelming when taken regularly over long time periods. 

The overwhelm can be physical, including burdening the liver as it works to filter the body of unwanted chemicals. There can be a financial toll associated with overconsuming supplements, as most of them would not be considered inexpensive. Finally, trying to keep up with supplement dosages, timing, and ingredient interactions can be downright stressful.

Human bodies are indescribably complex. The interaction of pathways, messengers, and metabolism can all be impacted by supplements. A short period of intake of certain supplements may not overwhelm these systems but over time could have negative impacts. 

Dr. Yurth offers a couple of examples, of the hundreds she can think of, describing how supplements could have unintended consequences. She notes that many supplements are tested over short periods of time, leaving us in the dark of how they impact our bodies with extended intake. 

We constantly hear about how oxidative stress is overwhelming our bodies. Social media has convinced us that throwing antioxidants at the supposed problem will tamp down the oxidative stress, and be beneficial in the long term. While many of us are inundated with this stress occurring in the body, the thought process that antioxidants are a cure all is problematic.

The problem with this approach is that not all oxidative stress is a bad thing. This stress can encourage mitochondria to respond appropriately, improving damaged cells on their own. This is a prime example of how the complicated systems in our bodies can be thrown off balance by what we think is best. Balance (homeostasis) is key.

5-HTP is another example of how less might be more. We know 5-HTP is a good supplement that positively impacts sleep, encourages true rest, and reduces stress through the increase in serotonin and melatonin it induces. What happens if we intake 5-HTP for extended periods?

Tryptophan finds another route and drives down the kynurenine pathway. This throws the appropriate system out of balance, possibly leading to neurological damage, depression, and a reduction in sleep. This is the opposite outcome we would be hoping for and is instigated by too much 5-HTP.

The loss of vital homeostasis is a real threat when taking certain supplements for long durations. This is how cycling helps. Taking breaks via these cycles allows the balance to remain in place. Your liver gets a break and the body is allowed to reset. 

Dr. Yurth also points out how the body typically reacts to inputs like supplements or exercise. It adapts. Doing the same thing over and over leads to a plateau in results. Cycling supplements or changing exercise routines challenges the body to keep improving.

The assistance of someone like the specialists at Boulder Longevity Institute is certainly helpful. We have seen how challenging it can be to know what to take, how long, and how much. Getting the perspective of a professional is the best bet for those taking supplements other than the typical everyday vitamins. 

For those seeking a DIY approach, take your basic supplements regularly. For more aggressive supplements, consider 12 weeks on and 12 weeks off cycles to allow your body to rest, recuperate, and react appropriately.

The body needs homeostasis. Cycling supplements can protect the cells and maintain balance over time. Balance is key.

Reasons to NOT Worry if You Run Out of Your Prescription

There can be an overwhelming dread when you realize you have run out of your prescription unexpectedly. Whether it be a hormone, peptides, or drugs like pentosan polysulfate sodium, you likely do not need to be worried. 

The majority of hormones, peptides, and drug treatments offer a build up effect in our system. This allows their impact to remain even without taking the prescription for a short time.

Additionally, the ideal benefit of these treatments is some semblance of a systemic improvement. Thus, the improved cellular function can tolerate short durations of change.

Ideally, keep an eye on your supplies. If a weekend or vacation is approaching, take stock of how much you have remaining and what you might need. 

In the event you do run out, remain calm. Your body will handle the downtime by using built-up impacts, improved cellular function, and may even benefit from a short break from treatments. Have your prescription refilled or addressed as soon as possible and rest easy knowing you will be okay.

Is this the year we finally take a new approach to treating joint & back pain?


In this recorded live lecture, Dr. Yurth shares the latest science and research on what’s causing your joint & back pain and how to treat it – not simply patch, replace, or fuse it. In this intimate hour-long session, you’ll learn why our traditional approach to joint & back pain is largely stuck in the Dark Ages, how to think about arthritis as a disease that we must address at the cellular level, and what science-backed methods are available to treat, and even reverse, your pain.


  • The technology used for hip and knee replacements looks virtually identical to that used 30 years ago.
  • Scoping a knee has become a largely obsolete practice in Europe due to its minimal, and sometimes harmful, effect in treatment of osteoarthritic knee pain.
  • Just like your brain doesn’t wear out from thinking too hard, your joints don’t wear out from continued use – arthritis is a degenerative disease state!

With her combined expertise in orthopedics and functional medicine, Dr. Yurth will share regenerative and cellular treatment options aimed at helping to address the root cause of your pain and how to not only alleviate issues, but actually regenerate and heal.

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Unraveling the Myths of Hormone Replacement Therapy and Cancer

Unraveling the Myths of Hormone Replacement Therapy and Cancer

There is a good chance you have heard that hormone replacement therapy (HRT) or hormone therapy (HT) causes cancer. If you have a family medical history that includes cancer, you have almost certainly been told by a physician that HRT carries a high risk.

Unfortunately, this is a wildly dangerous myth being propagated by countless physicians based on a study from 2002, called the Women’s Health Initiative (WHI). What you should know right away is the study has been largely disproven. 


Trigger Autophagy Without Fasting – Dr. Elizabeth Yurth Talks Spermidine with Dave Asprey

Dr. Yurth is thrilled to be a guest on Bulletproof Radio with Dave Asprey.  Dave Asprey is a three-time New York Times bestselling science author, host of the Webby award-winning podcast Bulletproof Radio, and has been featured on the Today Show, CNN, The New York Times, Dr. Oz, and more.  

Follow along as Dave Asprey hosts Dr. Yurth on his 773rd episode of Bulletproof Radio, discussing the latest ways to upgrade your mind, body, and life.
“In this episode of Bulletproof Radio, my guest Dr. Elizabeth Yurth explains how spermidine, a substance found in the human body and almost all plants and animals, can slow down the cellular aging process and influence your overall health.
‘Where we see spermidine work is at a very, very base level to correct the autophagy to get rid of those bad mitochondria so that now we’re not being overwhelmed by reactive oxygen species,’ Dr. Yurth says. ‘We actually will start to recycle the bad parts of the cell and start with a new cell at that point.’”

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SpermidineLIFE is featured in this podcast, a product that is available on the BLI Store, OHP Health.  For 25% off, Go to and use the code DAVE25 at checkout. 

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Recipe for Injury Rehab & Prevention

Enjoy this healthy recipe which features Collagen, a key ingredient if you’re concerned about inflammation.  Collagen helps in these areas:

  • Support for the health of your joints, tendons and connective tissue
  • Comfort and mobility support
  • Assistance in building muscle
  • Heart and blood vessel health support
  • Overall health with gut and promotion of healthy hair, nails & skin