"milner Acetylcholine Protocol" For Tachyarrhythmia

[kmpower]

Hi everyone. It has been a very long time since I posted last. I have been pretty stable with a low dose beta blocker along with careful management of my triggers (eating, bending, being too still too long, etc.) But I have never stopped looking for therapies which make sense.

The new Townsend Letter for Patients and Doctors has an award-winning article about using choline bitartrate and pantethine to antagonize sympathetic cardiac stimulation which is either excessive or not optimally opposed by vagal tone. Vagal tone requires acetylcholine, made in the body from nutrients supplied in the diet. It (the article as well as the therapy) is called the "Milner Acetylcholine Protocol" and is described by the naturopathic cardiologist who developed it and a resident naturopathic cardiologist. They explain the probable mechanisms and offer case histories. Many of us, especially older people, or vegetarians who don't eat eggs, or people who have unhealthy diets, are choline deficient, and therefore acetylcholine deficient.

"There are no naturally occurring beta blockers", the article begins. If you are interested you will need to actually get the magazine to read the entire article. It is not available online, but here is a link about it:

http://www.ncnm.edu/images/News/Best_of_Naturopathic_Medicine_2013.pdf

Here is another study I found on acetylcholinesterase inhibition being helpful in POTS:

Acetylcholinesterase inhibition improves tachycardia in postural tachycardia syndrome

Forgive me if I have missed a discussion of this in my recent absence from this forum, but I didn't find anything in searching for it. Also, forgive me for posting this before I have tried it. Townsend is a highly respected journal of alternative therapies. I would like anyone else who might be interested to have an opportunity to also try this. It is promising for a variety of tachyarrhythmias, including patients with cardiac damage or ectopic foci. There is no specific mention of POTS, but it would seem to exactly fit with many of us here.

Anyway, there it is.

Old Lady Lighthead

[ramakentesh]

Interesting angle. I think vagal tone is enhanced by CNS parasympathetic activity so the protocol would hopefully looking at CNS acetylcholine rather than ANS as with mestinon.

[kmpower]

That is the point. Rather than block receptors, nature (Milner says) stimulates antagonists. For people with high beta-adrenergic activity, that would mean stimulating parasympathetic activity.

An interesting sidebar is something I was told a few years ago by a holistic neuropsych friend of mine. He said rather than a beta-blocker, I should have been given an alpha-agonist; that is, rather than slow the heart, I should increase return from the lower extremities. He said that the first hormones to decrease with age are the alpha-adrenergic hormones/receptors. Midodrine would have been a better choice.

One more thing, I learned at a class that the best nutrient to support the alpha-adrenergic system is inositol. In nature, choline and inositol are associated (think: lecithin).

So, perhaps some of us (non-egg eating vegetarians like myself, for instance) would become deficient in both choline and inositol. So beta activity increases unopposed while alpha activity decreases. It is almost a set up for tachycardia!

[issie]

For some of us - constricting the veins is not the answer and this is what midodrine does. Some of us already have overly constricted veins, and other issues with blood flow. We all are so different and what works for one may not work for another.

Interesting the thoughts on choline and inositol. I'll have to look into that more. I don't know of a choline source that is not soy. I react to soy and can not take even supplements with it. Does anyone know of another source?

Issie

[AllAboutPeace]

Thanks for the info! I'm also a vegetarian (no eggs), so I really appreciate you bringing this up .

Issie, I found a rather lengthy list from USDA of choline and the amounts in certain foods.Starts at page 11. http://www.ars.usda.gov/SP2UserFiles/Place/12354500/Data/Choline/Choln02.pdf

I know I eat a bunch of these foods, but I highly doubt I'd be getting the recommended Dietary Reference Intake of 425mg/day. That's quite a bit. Some of the non-meat foods with higher levels are Quinoa (which is also an excellent source of protein), pistacchio nuts, flax seeds, sundried tomatoes, brussel sprouts, mung beans, lentils, chickpeas, etc.

Rich sources of inositol are cereals with high bran content, lecithin, bananas, citrus fruits - oranges, grapefruits and canteloupes and green leafy vegetables. Other sources with less content are red/kidney beans, brewers yeast, brown rice, cabbage, nuts, raisins, whole grains.

[issie]

Thanks - AllAboutPeace for the link. Since, I'm now vegan and trying to slowly get off of all supplements - eating foods with what we need in them - is what I'm trying to do. I do still take some supplements - but, am cutting back on what I take. If we are truly deficient in some of these things and taking a supplement to support it ---I'm all for it. But, like I said - with choline the only supplement source, that I know of, comes from soy. Maybe, concentrating more on these foods will give us an idea if this will help or not.

Thanks for the info.

Issie

[looneymom]

Issie, do you juice foods? I have started using a nutribullet with my son. I make a juice with spinach, bananas, orange, pinapple, and blueberries. My son and I have become hooked and do this everyday.

[issie]

Yes, my husband and I do smoothies and also we add pea protein powder. It's pretty yum and we get enough plant protein with this combo.

Issie

[ramakentesh]

I would be careful with Inositol. It is involved in a number of cerebral processes including the serotonic and norepinephric systems. it has a number of different actions in the body many of which are poorly characterised.

[ramakentesh]

For some of us - constricting the veins is not the answer and this is what midodrine does. Some of us already have overly constricted veins, and other issues with blood flow. We all are so different and what works for one may not work for another.

Interesting the thoughts on choline and inositol. I'll have to look into that more. I don't know of a choline source that is not soy. I react to soy and can not take even supplements with it. Does anyone know of another source?

Issie

The problem with this statement is that midodrine only constricts via one particular receptor. There are other receptors such as the At-1 receptor that are involved in vasoconstriction. Different regions rely on different receptors. A failed experience with midodrine probably really only indicates that you didnt tolerate midodrine and not that you have overly constricted veins,

In all forms of cases and in nearly all peer reviewed research there is inappropriate vasodilation or abnornal cerebral autoregulation. Systemic vasoconstriction normally results in essential hypertension.