Feverfew

[ramakentesh]

Unusually heavy methylation of the Norepinephrine transporter gene promoter has been implicated in POTS. This increased promotor methylation basically silences the gene. It is unclear why this happens.

There are medications that are able to restrict donors for methyltransferase and they can clean up the methylation of genes in cancer. However these medications have significant side effects.

Its interesting that in the search for new agents that can demethylate genes, feverfew demonstrated great promise:

http://jpet.aspetjournals.org/content/329/2/505.abstract

[firewatcher]

$#(*^%%^&^&%!!!!!!!! Insert your favorite expletive here________________!

I did a bit more research because something was tickling the back of my brain after I got a description of the plant itself:

"The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, contain components that can trigger side effects and that can interact with other herbs, supplements, or medications. For these reasons, herbs should be taken with care, under the supervision of a health care provider qualified in the field of botanical medicine.

Side effects from feverfew can include abdominal pain, indigestion, flatulence, diarrhea, nausea, vomiting, and nervousness. Mouth ulcers, loss of taste, and swelling of the lips, tongue, and mouth may occur in some individuals who chew raw feverfew leaves. Rarely, allergic reactions to feverfew have also been reported. In fact, people with allergies to chamomile, ragweed, or yarrow will likely be allergic to feverfew and, therefore, should not take it.

Feverfew may increase the tendency to bleed, especially in individuals who have bleeding disorders or take blood-thinning medications, such as aspirin or warfarin. Do not use feverfew if you have bleeding disorders or are taking blood-thinning medications unless you are under the supervision of a doctor. Storage of the prepared extract is also important. At normal temperatures, some constituents in feverfew can degrade from capsules."

I am almost (probably) anaphylactic to ragweed! It is the allergy shot that I keep having systemic reactions to!

[potsgirl]

Ragweed is definitely my major allergic problem, too, although I have several. Youch.

[ramakentesh]

Oh that is a downer. Just thinking out allowed.

[firewatcher]

Oh that is a downer. Just thinking out allowed.

Yes, a definite party pooper! I'd do about anything to get rid of this headache and it looked very promising at first glance. Something in the back of my head kept telling me to check the botany section instead of the pharmacological section (all those years in the yard) and whaa-laaa! I can't take echinachea or several other herbals because of that blasted allergy! Perhaps once there is a pure extract it will work for me.

[scarfgirl]

I took Feverfew back in college, when my only symptoms were migraines, and it after six weeks on it I was in agony. It made all my symptoms WORSE. Feverfew is a vasodilator, and that's seems like a bad idea for a lot of POTSies.

[ramakentesh]

LOL ok back to the drawing board...

[erik]

Hmm. Valproate may be a DNA hypomethylating drug... reportedly it can act as such inside neurons where at least some others don't... cancer targeted hypomethylators might miss this mark unfortunately. I've no idea if it has affinity for these NETenesian Islands, tho! I guess lab tests can be done to determine that though.

I don't know if feverfew's content has that trait... if so, I guess it might link things. I guess it acts on GABA too.

Some background references here:

Altered Sympathetic Nervous Reactivity and Norepinephrine Transporter Expression in Patients With Postural Tachycardia Syndrome

Which mentions underactive NET in a sample of POTS patients.

The neuronal noradrenaline transporter, anxiety and cardiovascular disease

Which mentions "hypermethylation of CpG islands in the NET gene promoter region" and "Panic disorder commonly coexists with essential hypertension and the postural tachycardia syndrome".

Here is an interesting use of intentional NET reduction:

Norepinephrine Transporter Inhibition Prevents Tilt-Induced Pre-Syncope

For those with peripheral denervations or other things that by themselves would just make you faint when you stand up, I suppose this indicates that NET reduction could act as a partial compensation? They might cure their NCS and become POTS and at least keep conscious more often... though now suffering a different fate.

[ramakentesh]

I think the NET thing is interesting - it appears that it increases transduction peripherally and in the heart while strangely reducing transduction centrally - pooling in the stomach and head from low norepinephrine levels paradoxically with signs of too much norepinephrine in the hands and feet. A weird situation.

[erik]

I bumped into this article which I had bookmarked when trying to understand some details of MSA (Multiple System Atrophy), PAF (Pure Autonomic Failure) & PD (Parkinson's). Looking at it now from a NET activity perspective instead, it seems to indicate that at least one expected/assumed NET inhibition response is not as simple as one would think. They even have their study hypothesis partially contradicted (whereas most studies tend to be designed with every intent to prove a hypothesis)... which is a subtle flag to me of an extra informative study since it doesn't simply confirm prior assumptions and instead the body talks back to the researchers a little.

Essentially, the assumed hypertensive tendency of NET blockade is sometimes countered by central regulatory compensation. This distinction is drawn out, coincidentally, by differences between a couple potential autonomic function disrupting conditions.

In addition to central (upstream) counter regulations like in this study, it seems to me there could also be at least 4 other natural compensations to reuptake inhibition (a.k.a. more umph to each firing):

Long term receptor population adjustment;

Temporary receptor antagonist increases (some localized regulatory messengers appear to do this);

Feedback to the ion channel regulation (if the firing threshold is not met, the neurotransmitters never come in to play in the first place and both upstream and localized messengers apparently affect this... some perhaps still being discovered);

Inherent mixed effects of stimulation (the receptor complex for vasoconstriction is said to locally feed back to inhibit it's own subsequent triggering... ), etc.

Basically it seems like the story wouldn't end even in cases where a specific mechanism of NET inhibition is found.

[ramakentesh]

Indeed - pharm. NET inhibition does result in decreased central outflow rather than the increase seen in POTS. NET inhibition is also found in some patients with essential hypertension (id prefer that over POTS any day)