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    Created in 2008, Phoenix Rising is the largest and oldest forum dedicated to furthering the understanding of and finding treatments for complex chronic illnesses such as chronic fatigue syndrome (ME/CFS), fibromyalgia (FM), long COVID, postural orthostatic tachycardia syndrome (POTS), mast cell activation syndrome (MCAS), and allied diseases.

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Poll: Mestinon Trial

Have you tried Mestinon (pyridostigmine) for POTS?

  • Yes and it helps, I still take it.

    Votes: 11 14.1%
  • Yes but it did not help.

    Votes: 13 16.7%
  • Yes, but I had to stop because of side effects.

    Votes: 8 10.3%
  • No I have not tried it.

    Votes: 46 59.0%

  • Total voters
    78

Learner1

Senior Member
Messages
6,305
Location
Pacific Northwest
What beta blocker are you on? What effects have you noticed? The doctor prescribing the pyridostigmine is a dysautonomia specialist, and he says he usually starts people at that dose.

The compounding pharmacy kept flagging the combo as one's heart rate and BP can get too low on propranolol and pyridostigmine together. My heart rate and BP run high, so that's a benefit, but the dicyor also says he has several other patirnts on this specific combo at low doses.
 
Messages
90
What beta blocker are you on? What effects have you noticed? The doctor prescribing the pyridostigmine is a dysautonomia specialist, and he says he usually starts people at that dose.

The compounding pharmacy kept flagging the combo as one's heart rate and BP can get too low on propranolol and pyridostigmine together. My heart rate and BP run high, so that's a benefit, but the dicyor also says he has several other patirnts on this specific combo at low doses.
Thanks for letting me know. My hr runs really high and beta blocker doesn’t help much. My bp is on a lower side, I’ll be monitoring my bp closely.
I see a regular cardiologist who is not knowledgeable about dysautonomia.
Thanks for all info.
 
Messages
27
Hi all,

since the article on healthrising and the video of Dr. Systrome I consider taking Mestinon. By accident I came across some information about Mestinon that worries me. Mestinon is mentioned in connection with gulf war illness and there is a hypothesis that Mestinon (Pyridostigmine) might caused/triggered Gulf War Illness. Mestinon was widely given to soldiers during the war as an anti-nerve agent pill against toxic/nerve gas attacks.

https://www.publichealth.va.gov/exposures/gulfwar/sources/pyridostigmine-bromide.asp
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1116950/
https://www.sciencedirect.com/science/article/pii/S0010945215003329

As Gulf war illness and ME/CFS share similarities, I wonder if I put me in danger taking Mestinon.

Did you hear about that and if so what do you think?

Thanks
Miriam
 

Learner1

Senior Member
Messages
6,305
Location
Pacific Northwest
Thanks for posting @LillyME

The thing here is that they gave pyridostigmine to a bunch of young, healthy people who likely did not need their acetylcholine levels mucked with.

As my mom has Parkinson's, ive had the opportunity to see the range of horrible side effects that can happen with the wrong amount of acetylcholine.

I was prescribed pyridostigmine by a dysautonomia specialist who is a neurologist, and I can only say that it has helped me so far, and that I had full blown ME/CFS 2 years before starting the pyridostigmine.

I've had no bad side effects, so I'm concluding it is what my body needed. But I'm 30 years older, female and sick, so my bio chemistry is different than the young (mostly) men who were given it by the Army.
 

frozenborderline

Senior Member
Messages
4,405
I am possibly starting mestinon soon. I don't really want to or think it will help but I don't want dr to think I'm non-compliant. Have some concerns about it. if there are side effects, should it show up quickly?

I probably have POTS, but it is not my primary complain. I respond well to IV saline though, which is part of why the doctor thinks it will help.

For reference, I had terrible reactions to beta blockers, which are supposed to be pretty mild drugs, but caused awful air hunger and I'm just paranoid about stuff that might impair cellular bioenergetics in any way.
 

frozenborderline

Senior Member
Messages
4,405
I don't get crazy heart rate or blood pressure problems, that bother me more than the general symptoms of awful fatigue etc
 

Learner1

Senior Member
Messages
6,305
Location
Pacific Northwest
My ME/CFS specialist identified my MCAS and prescribed a beta blocker for my adrergic antibody-driven high BP. My dysautonomia specialist agreed with the beta blocker and added pyridostigmine, says he hss lots of patients on both. Neither mentioned the possibility of mast cell degranulation, though, and i haven't had any problems.
 

frozenborderline

Senior Member
Messages
4,405
My ME/CFS specialist identified my MCAS and prescribed a beta blocker for my adrergic antibody-driven high BP. My dysautonomia specialist agreed with the beta blocker and added pyridostigmine, says he hss lots of patients on both. Neither mentioned the possibility of mast cell degranulation, though, and i haven't had any problems.
I haven't really had high bp or much adrenergic problems and beta blockers make me feel like death itself, so I really wonder about trying mestinon
 

frozenborderline

Senior Member
Messages
4,405
hmm apparently the mestinon costs a LOT which might be good in this case as I can have a good excuse to put off trying it
 

Learner1

Senior Member
Messages
6,305
Location
Pacific Northwest
I haven't really had high bp or much adrenergic problems and beta blockers make me feel like death itself, so I really wonder about trying mestinon
Beta blockers and Mestinon do different things, you may not need both. I have found that being able to stand in a grocery line or talking to someone without passing out adds to my quality of life. And it has increased my ability to exercise without crashing as often.
 

bombsh3ll

Senior Member
Messages
287
Decent laxative but no help with POTS. I am in the UK so have to buy anything for POTS online, whereas I get a prescription laxative which does the job so there was no point in me continuing mestinon.
 

Ruthie24

Senior Member
Messages
219
Location
New Mexico, USA
I tried Mestonin several years ago. I found it helped with my high HR but it didn't help with the hand tremor and some other symptoms that the low dose beta blocker helped with so my doc and I decided to go back to the beta blocker.
 

*GG*

senior member
Messages
6,389
Location
Concord, NH
Are you taking any other medications for POTS like beta blockers or fludrocortisone?

I am, my Dr Just prescribed me 60 mg Mestinon 2 times a day (took 1 dose 11/16 and 2 doses yesterday), so daily dosage of 120 mg. He also increased my Florinef from 0.1 mg to 0.2 mg a day, can go up 0.3 he told me.

GG
 

Mel9

Senior Member
Messages
995
Location
NSW Australia
Beta blockers and Mestinon do different things, you may not need both. I have found that being able to stand in a grocery line or talking to someone without passing out adds to my quality of life. And it has increased my ability to exercise without crashing as often.


I have been on mestinon for three days now. So far I think I may feel a little better. I am really hoping for the ability to stand in grocery line without the worst of the POTS symptoms.
 

Learner1

Senior Member
Messages
6,305
Location
Pacific Northwest
@*GG* Are you still on 120mg of Mestinon? Did it help? And Mel9, what dose are you on and is it helping? Have either of you noticed changes in heart rate?

On a beta bl8cker plus Mestinon, my BP is better, I can stand in a grocery line without fainting now, but my heart rate is too fast. Been in multiple drugs and nothing has worked yet, but I'm only on 60mg Mestinon. Wondering if increasing it would help...
 

*GG*

senior member
Messages
6,389
Location
Concord, NH
@*GG* Are you still on 120mg of Mestinon? Did it help? And Mel9, what dose are you on and is it helping? Have either of you noticed changes in heart rate?
/QUOTE]

No, I am now up to 180 mg for about 2 weeks now. Nothing significant yet, hope it works for me!

GG
 

Learner1

Senior Member
Messages
6,305
Location
Pacific Northwest
Wow, thats a lot! Do you take it a at once? I was started on 10mg 3x a day...

Why were you given so much and are you taking anything else for POTS with it?
 

*GG*

senior member
Messages
6,389
Location
Concord, NH
I don't think I have been diagnosed with POTS. Don't really know what that is. Would florinef count?

I am taking that much to try to get better from the ME/CFS.

GG