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I took Nitroglycerin tonight and it helped! What does this mean?

Gingergrrl

Senior Member
Messages
16,171
Just curious (to Alex and everyone)- if you are not taking Nitro for chest pressure, shortness of breath and angina, then what are you supposed to feel? This is not a sarcastic question and I am really asking.
 

Gingergrrl

Senior Member
Messages
16,171
Yikes! :eek: My daughter's has been that low and she gets inosine. Hard to know what your doc is thinking. Maybe it has to do with how sensitive you are to meds...?

I honestly cannot remember why he told me not to take Inosine but some day I will ask him again as I have always been curious about it.
 

Hip

Senior Member
Messages
17,874
Tip: Folic Acid Prevents Nitroglycerin-Induced Nitric Oxide Synthase Dysfunction

Note that this study says:
In healthy humans, continuous treatment with nitroglycerin (GTN) causes nitric oxide synthase dysfunction, probably through the reduced bioavailability of tetrahydrobiopterin.

Recent studies proposed that folic acid is involved in the regeneration of tetrahydrobiopterin in different disease states. Therefore, we investigated whether folic acid administration would prevent this phenomenon. We also sought to determine if folic acid supplementation could prevent the development of tolerance to GTN.

And the study concludes:
Our data demonstrate that supplemental folic acid prevents both nitric oxide synthase dysfunction induced by continuous GTN and nitrate tolerance in the arterial circulation of healthy volunteers. We hypothesize that the reduced bioavailability of tetrahydrobiopterin is involved in the pathogenesis of both phenomena. Our results confirm the view that oxidative stress contributes to nitrate tolerance.


And this study demonstrates that folic acid reverses the endothelial dysfunction induced by BH4 depletion.

More info on BH4 as an essential cofactor for the activation of nitric oxide synthase is found in this article. The article mentions that methylfolate (L-5-MTHF) may help substitute for BH4 when BH4 is deficient.

So folic acid and BH4 supplementation may help nitroglycerin regain its vasodilating effect. You can buy BH4 in 2.5 mg capsules at these places: 1, 2, 3, 4. But 2.5 mg is quite low compared to the 100 mg found in the prescription BH4 medication called Kuvan. I understand that BH4 is sensitive to degradation by free radicals, so you would be advised to take antioxidants when you take BH4.


By the way, the reason tetrahydrobiopterin (BH4) is so expensive, and without a prescription is only available in small dose tablets, is because BH4 was given orphan drug status in 2002, and this gives specific companies the exclusive right to sell BH4. Biomarin and Merck Serono have this right, and they sell their BH4 (trade name Kuvan) in 100 mg tablets.

However, this BH4 orphan drug status is due to expire in June 2015, ending the exclusivity, so thereafter we can expect the price of BH4 to drop, and the general availability and dosage amounts of BH4 to increase.
 
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alex3619

Senior Member
Messages
13,810
Location
Logan, Queensland, Australia
I have wanted to test BH4 for years. I responded to methyl folate and B12 three years ago then it slowly stopped working.

If the glyceryl trinitrate works via NOS then it may be subject to the same limitations as arginine etc. Indeed, a NOS problem might prevent it working right.

Today I have a threatening headache that never really happens. I am maybe a little less fatigued, and have slightly better sleep. Its nothing dramatic and might even be wishful thinking.

Yet I am mindful that it can take several weeks to kick in, I have not tried different dosage schedules, I have not tried cofactors like methyl folate and adenosyl cobalamin, and so on. So there is a way to go on my testing yet.

One thing it does seem to do is boost my mood. Almost immediately. I am almost never depressed or down, but for a while after taking the nitro I am cheerful. This has happened twice now. Is it boosting brain function?
 

alex3619

Senior Member
Messages
13,810
Location
Logan, Queensland, Australia
I also found vague references to lipoic acid and resveratrol improving tolerance effects to nitro compounds i.e. they work for longer with less of a loss of effect. I have yet to look into this in detail. Furthermore there appears to be a huge range of mechanisms mediating how glyceryl trinitrate works, and so there is furious debate about what it all means. Polyphenols in tea may also be beneficial. I am too tired right now to do the science justice, I should be sleeping but someone is supposed to be turning up shortly.

I took my third dose a little while ago, and for a minute it looked like I might get a headache and it went away.

The spray I am using is not sustained release, so it means that it wears off very quickly. It also means that its useful for acute attacks, it is after all designed to be used in angina. The maximum dose is, I think, about 2400mcg over 15 minutes, and I am only taking 400mcg. I may try a sustained release version at another time.
 

deleder2k

Senior Member
Messages
1,129
Can you get Imdur?? Looks like they have been using that. Sustained release. I think it is available in 30 and 60 mg.
 

taniaaust1

Senior Member
Messages
13,054
Location
Sth Australia
I have a script for nitro right now, and I am hoping if I am well enough I might go with my shopper today and pick it up from the pharmacist. If so I will be testing it soon. I do wonder what percentage of us respond to this kind of therapy.

It would be great if we could do some kind of PR study on this...enrol people ourselves into it BEFORE they try it and then find out how they went. If 20 of us did this.. we'd have a small study on our hands.

Nominating alex to be research subject 1
 
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taniaaust1

Senior Member
Messages
13,054
Location
Sth Australia
One thing it does seem to do is boost my mood. Almost immediately. I am almost never depressed or down, but for a while after taking the nitro I am cheerful. This has happened twice now. Is it boosting brain function?

I've no idea how that works but I get a cheerful affect from a couple of bags of saline IV as soon as my blood volume is increased. It certainly helps something in my brain.. maybe the nitro helps a similar thing to give a mood boost?? (better oxygen to brain due to increased fluid or due to something else?)
 
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deleder2k

Senior Member
Messages
1,129
It would be great if we could do some kind of PR study on this...enrol people ourselves into it BEFORE they try it and then find out how they went. If 20 of us did this.. we'd have a small study on our hands.

Nominating alex to be research subject 1

Will you be subject number two?