Nicorandil.....A role in treating CFS

[maryb]

@Hip
thanks, how can I tell if chloramine is in my water, sorry I'm not up to reading a lot of research.

 

[Hip]

@Hip
thanks, how can I tell if chloramine is in my water, sorry I'm not up to reading a lot of research.

It should be detailed on the website of the company that supplies your drinking water. If not, you might want to email them and ask. In the UK, pretty much all the companies put chlorine in the water supply; that is standard. But some companies put chloramine in as well.

 

[RustyJ]

@Hip. I cant find any direct references for chloramines and hypoperfusion, perhaps because the term hypoperfusion means different things to different people.

Says here that Monochloramine selectively inhibits the transient outward potassium current in colonic smooth muscle.

The language of this research area is confusing to me. Perhaps someone could offer a better explanation. I could have it wrong, but this paper clearly shows monochloramines affect potassium current.

Is this the mechanism that could explain what is going on in me/cfs? The key for me is hypoperfusion, which can body-wide.

I cant find much research detailing multiorgan hypoperfusion in me/cfs, because there has been a focus on the brain. But given that this thread is about hypoperfusion in the intestines, then it is a possibility that many me/cfs patients have body-wide hypoperfusion (or whatever you want to call it, eg reduced blood flow).

I know that I have contracted veins and arteries in my arms - the nurses tried about 20 times to get a canula in. I also have spect scans showing hypoperfusion in the brain. Hypoperfusion in my stomach and in muscle tissue would explain most of my other symptoms.

 

[RustyJ]

Nicorandil is available as Ikorel Tablets in Australia. I don't know how to get my doctor to prescribe it tho.

 

[Hip]

Says here that Monochloramine selectively inhibits the transient outward potassium current in colonic smooth muscle.

That's very interesting, because the drug that benefited kangaSue so much, nicorandil, increases outward potassium current.

So from this fact you might assume that anything which decreases outward potassium current would make kangaSue's symptoms worse. The above study you cited says that chloramines do indeed decrease transient outward potassium current, suggesting that chloramines in drinking water would be detrimental to kangaSue's mesenteric bowel ischemia condition.

@kangaSue, you might want to check with your water supplier to see if they do put chloramines in the water.

 

[RustyJ]

That's very interesting, because the drug that benefited kangaSue so much, nicorandil, increases outward potassium current.

So from this fact you might assume that anything which decreases outward potassium current would make kangaSue's symptoms worse. The above study you cited says that chloramines do indeed decrease transient outward potassium current, suggesting that chloramines in drinking water would be detrimental to kangaSue's mesenteric bowel ischemia condition.

@kangaSue, you might want to check with your water supplier to see if they do put chloramines in the water.

Okay, so I am reading it right. My head is not clear enough to chase down this lead. It is exciting because there is a suggestion that removal of chloramines and treatment with the K channel modulator could potentially reverse many symptoms.

For me, the hypoperfusion is the major symptom. I believe it causes most of the fatigue and cognitive problems and probably the digestive problems. If chloramines cause hypoperfusion and not just contribute, then I am very hopeful of finding some relief with potassium channel modulator.

 

[RustyJ]

@kangaSue @Hip

Problems may not be limited to chloramines, may also include chloride if I have read this passage correctly. I think they are saying that bacteria in our body can manufacture monochloramine from chloride.:

Under physiological conditions, bacteria ferment nitrogen-containing compounds in the lumen of the colon resulting in large amounts of ammonia in the local environment. Monochloramine is a highly potent lipophilic oxidant produced during colitis when the destruction of the epithelial barrier results in accumulation of ammonia within the submucosa.

My sudden onset coincided with me taking up swimming every day before work.

 

[maryb]

@RustyJ
yes I used to swim every week for years until I got an inner ear virus which gave me terrible vertigo and lasted for a couple of months. These were the same symptoms I started with again when I developed ME. Coincidence ?maybe......

 

[Hip]

Under physiological conditions, bacteria ferment nitrogen-containing compounds in the lumen of the colon resulting in large amounts of ammonia in the local environment. Monochloramine is a highly potent lipophilic oxidant produced during colitis when the destruction of the epithelial barrier results in accumulation of ammonia within the submucosa.

I think this is only relevant to those who have colitis — which occurs in Crohn's disease and ulcerative colitis, but not in IBS or ME/CFS.

 

[RustyJ]

I think this is only relevant to those who have colitis — which occurs in Crohn's disease and ulcerative colitis, but not in IBS or ME/CFS.

I think the terms colitis and IBS are loosely applied and interchangeable. Someone could have mild colitis and be classified with IBS only.

I have all of the following symptoms of colitis except for bleeding (although I havent really checked). The urgency I have is accompanied by unbelievable pain and cramping.

Symptoms of colitis may include: abdominal pain, loss of appetite, fatigue, bloody diarrhea, mucus in the stool,[1]cramping, urgency and bloating.

Signs may include: abdominal tenderness, weight loss, changes in bowel habits (increased frequency), fever, bleeding (overt oroccult)/bloody stools, diarrhea, and distension.

Signs seen on colonoscopy include: colonic mucosal erythema(redness of the inner surface of the colon), ulcers, bleeding.

Also the references were applied to a broader definition of gastro inflammation, not limited to colitis, in other parts of the article, as far as I could tell. I acknowledge I could have got this completely wrong. I will read it again tomorrow.

 

[RustyJ]

I think this is only relevant to those who have colitis — which occurs in Crohn's disease and ulcerative colitis, but not in IBS or ME/CFS.

Also this transformation takes place in swimming pools: Controlling Chloramines in Indoor Swimming Pools

Further, amines combine with chlorine to form chloramines. Many people with me/cfs have amine sensitivities (cooked meat, if kept overnight, other proteins like cheese). I have this.

So it does appear that there are multiple sources of chloramines, not just drinking and showers. The actual intake might be quite high from all sources. No study has touched on this.

 

[Hip]

I think the terms colitis and IBS are loosely applied and interchangeable. Someone could have mild colitis and be classified with IBS only.

Absolutely not the case at all.

One of the reasons that IBS is classed as a functional disorder (as is ME/CFS) is because in IBS, there are no obvious physical abnormalities to be seen at all.

Whereas in colitis, there is clearly observed swelling, inflammation, and scarring in the intestines (see these images of colitis). If you think you might have colitis, you might wan to get your intestines internally examined in order to get a diagnosis, as colitis is a serious condition of the intestines.

 

[kangaSue]

I think the terms colitis and IBS are loosely applied and interchangeable. Someone could have mild colitis and be classified with IBS only.

I have all of the following symptoms of colitis except for bleeding (although I havent really checked). The urgency I have is accompanied by unbelievable pain and cramping.

Symptoms of colitis may include: abdominal pain, loss of appetite, fatigue, bloody diarrhea, mucus in the stool,[1]cramping, urgency and bloating.

Signs may include: abdominal tenderness, weight loss, changes in bowel habits (increased frequency), fever, bleeding (overt oroccult)/bloody stools, diarrhea, and distension.

Signs seen on colonoscopy include: colonic mucosal erythema(redness of the inner surface of the colon), ulcers, bleeding.

Also the references were applied to a broader definition of gastro inflammation, not limited to colitis, in other parts of the article, as far as I could tell. I acknowledge I could have got this completely wrong. I will read it again tomorrow.

Have you had a CT scan of your Mesentery arteries by any chance, Mesenteric ischemia is pretty much ischemic colitis without the bleeding and with an onset of, or an increase in pain shortly after eating, the pain usually being epigastric but not necessarily so.

 

[RustyJ]

Have you had a CT scan of your Mesentery arteries by any chance, Mesenteric ischemia is pretty much ischemic colitis without the bleeding and with an onset of, or an increase in pain shortly after eating, the pain usually being epigastric but not necessarily so.

I think the blood supply problems with many me/cfs are quite subtle, but body wide.

My next move will be to try the K channel activator. My digestive problems (also hiatus hernia and serious reflux) are not really disabling. I am confined to bed most of the time because of the brain hypoperfusion.

 

[Hip]

I think the blood supply problems with many me/cfs are quite subtle, but body wide.

My next move will be to try the K channel activator. My digestive problems (also hiatus hernia and serious reflux) are not really disabling. I am confined to bed most of the time because of the brain hypoperfusion.

I have found the supplement vinpocetine 10 to 30 mg daily helpful for my brain fog. Vinpocetine improves blood flow to the brain. †

Vinpocetine should be taken with food: it's bioavailability is 7% on an empty stomach, but 80% with food.

 

[maryb]

@Hip
I have horrendous brain issues and much worse 3 months after having a mercury filling out, despite using a dentist trained in holistic practice
so if vinpocetine improves blood flow to the brain do you think that means it may help clear the brain of toxins - in my case mercury, I know you're not a doctor just value your opinion.

 

[Hip]

@maryb If you want to remove mercury from the CNS, you might want to look into the effects of coriander (aka cilantro or Chinese parsley), taken four times a day, which pulls mercury out of the brain. Ref: 1, 2. It would be advisable to take coriander with other mercury chelators/eliminators such as: selenium, iodine, zinc, silica, alpha lipoic acid, chlorella, vitamin C, in order to not only remove mercury from the brain, but expel from the body. See also: Mercury Toxicity and Systemic Elimination Agents.

 

[maryb]

@Hip thanks - I still have 2 mercury fillings to go so its an ongoing problem for me. I think cilantro is contra-indicated in my situation also ALA - I struggle to tolerate so much, especially minerals, I'm glad I read that pure water is one of the best chelators of all - so I can at least do that

I'll look again at the link thanks.

I was hoping to get rid of the last of my fillings sooner rather than later but having been so ill since the last one don't think its wise to have them done just yet.

 

[Aileen]

RustyJ wrote: Problems may not be limited to chloramines, may also include chloride if I have read this passage correctly. I think they are saying that bacteria in our body can manufacture monochloramine from chloride.:

Under physiological conditions, bacteria ferment nitrogen-containing compounds in the lumen of the colon resulting in large amounts of ammonia in the local environment. Monochloramine is a highly potent lipophilic oxidant produced during colitis when the destruction of the epithelial barrier results in accumulation of ammonia within the submucosa.

My sudden onset coincided with me taking up swimming every day before work.

@RustyJ
yes I used to swim every week for years until I got an inner ear virus which gave me terrible vertigo and lasted for a couple of months. These were the same symptoms I started with again when I developed ME. Coincidence ?maybe......

Or not. My second bout with this illness started after I began doing laps in the university's pool 3x per week. That only lasted 2 or 3 weeks. Then I came down with what was initially thought to be mono.

 

[kangaSue]

I have found the supplement vinpocetine 10 to 30 mg daily helpful for my brain fog. Vinpocetine improves blood flow to the brain. †

Vinpocetine should be taken with food: it's bioavailability is 7% on an empty stomach, but 80% with food.

Now that's interesting being a phosphodiesterase inhibitor, the same class as cilostazol which has also been used successfully to treat bowel ischemia. This was my next option if taking nicorandil didn't work for me. It is already used for peripheral artery disease,particularly intermittent claudication.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3284045/