Zap

firewatcher - thanks for the information! I'm currently on 20mg AM and 20mg PM with the Propranolol. I had briefly tried a larger amount, but the fatigue and side effects crept up on me. The Melatonin is 3 mg. Maybe a smaller amount would be better, wouldn't be the first time for me! My research started with involvement of the gut flora, so I do believe this plays a part, somehow. It is entirely possible that nutrient absorption and/or modulation of the ANS/immune system by the gut flora is disrupted. This explains the sudden onset. Unfortunately, as I'm sure you've discovered, there are a number of products out there and results are pretty sketchy. I believe that the old fashioned, fermented foods are greatly superior to the supplements, as they have nourished and helped others for millennia. Out of curiosity, then, are you taking miso routinely? This actually makes a TON of sense, as the H3 receptors can inhibit release of serotonin, dopamine, GABA, acetylcholine, and norepinephrine. They are present in the central and peripheral nervous system, heart, lungs, GI tract, and endothelial cells that line blood and lymph vessels. All areas that are commonly affected in dysautonomia. I'll have to dig deeper into any compounds that might act on these receptors.

OK - wow, thanks for all of the responses first of all! I've been busy for a few days and am trying to play catch-up. I had a sleep study early last year - it came back normal for the most part, except a severely delayed sleep onset (3x what is considered normal). I do suspect that I have a circadian rhythm disorder, but I wasn't tested for that. My sleeping problems have gotten worse as I've added a few meds and changed them up. I don't think they are helping, for sure. I'm taking D3 after being diagnosed as low. I need to have a test to check up on it and will insist on the full D panel to assess conversion into active D3 in the body. The autonomic neuro I was seeing suggested exercise, but the meds he had me on were making OI and other things come out of the woodwork. I've done exercise in stints to see how it affects me - I feel better getting exercise and getting out a bit, but it doesn't really change my neurological issues as far as I can tell. So it is a nicety, but not really having much effect otherwise. I've tried melatonin, though it was making my vivid dreams even moreso. It also made me sleep SUPER long. We're talking like 12+ hours of sleep, so I stopped that soon enough. I've wondered if I should try another BB, but since it is being used for migraines too I know others aren't as effective for that. It really seems like a mixed bag. One of the biggest battles I've been fighting for a while is to find peace. I've been through a lot, and my work-life situation was only making things worse anyway. I guess you could say I've had more peace, in some ways, in the past year that I've been off than in a while. That said, I really need to find a way to have a normal life. I've been de-cluttering and getting rid of junk, which I think helps me emotionally, too. I've got a lot on my plate still, but eventually need money too. I've lacked stability through family issues and such for a while, so maybe if things are calming down a bit I can, too. It is a shame, as the propranolol is helping me and keeps me more balanced through all of the crises, but I think there is something else lurking out there, too. The search continues. I'm planning to drive to the hospital today to get my test results myself. All these stupid consent forms are a pain.

I'm from WI - had my testing done at Froedert, too. Unfortunately, I have migraines on top of everything else, and I have yet to find a balance for all of my symptoms. That said, I was thrown back to my migraine neuro from Froedert, so we're trying to find a way to manage things at the moment. It all depends on the Dr you see at Froedert and if they are/can help you. It sounds like your diagnosis differs from mine. Ideally, if you can find someone local to you who understands the diagnosis and how to work with it, that would probably work best. The appointment times can take a while to get in at Froedert. For me, generally testing medications for a month. That's about how long it takes before side effects crash things, or what have you. You may be different, it all depends. Have you had the massive blood testing yet? I had tests done, some were sent out to Mayo for things like auto-antibodies. If you haven't, this may be useful to narrow down and make sure there isn't something else underlying causing your trouble.

Well, feeling a bit more my "normal" self today, thankfully. That flare up just seemed to come out of nowhere, and they can definitely be rough to deal with. I didn't manage to get anything done yesterday and I pretty much just sat around. I've always been one to keep myself busy and doing things, so that probably is one of the more difficult things to deal with. While my frustration is definitely reflected above, I was fairly serious about many of the things I said too. I do feel like all of the meds I've been trying end up giving me more side effects than quality of life improvement. The Propranolol has been the most beneficial thing so far, yet I have to wonder if it is making my insomnia worse. At this point, I guess my biggest problems are migraine/aura, insomnia/sleep schedule, and sweating. If I could get these mostly under control I probably could have a bit more stability, and maybe do some work part-time, if nothing else.

I've been having a really bad day today, symptoms abound and constant migraine aura. Somehow I found the strength to teach a class this evening, as it is about the only thing I can really enjoy anymore. Just thinking about trying to go back to work puts me into a downward spiral. Anymore I'm pretty unreliable, one day I'm great and try to do 10 days worth of work for fear that the next day will be worthless. It usually is, and a few more days for that matter. I got a call the other day from the migraine neuro's office - my EKG was finally received, but we can discuss it during my appointment - not until early/mid-October. As if I'm going to wait that long. Next day I feel well enough I'll be driving to the local hospital to request disclosure of the test results. Apparently it isn't bad enough to tell me now, but it surely can't be normal either, or they would say that. I was told not to up my beta blocker. Hmm, okay - definitely something is up. I feel like I haven't really gotten much better than this all started over a year ago. I've been off work since July '11, yet the disability insurance apparently thinks this is all a big joke. I'm waiting for the results of my appeal, but it will more than likely be denied. The internist consultant said I could work with chronic migraine with no problem, HAHAHAHAHA. What a pompous ***. I can totally feel those of you that get dealt this ** - the arrogance of these "medical" practitioners is just immense. I seriously think that most of them would do themselves in after a day or two, let alone a week of dealing with what some of us have put up with for a long time... I guess, at this point, that all I really want is to have a plan for the future or the ability to have a doctor that can actually help me seek further answers. It is really getting old to be in the constant state of waiting, waiting, waiting to see if someone deems my suffering to be enough to warrant help. This is independent of my employer's misunderstanding and request for me to not come back until "you can keep a normal schedule". That, sadly, just reeks of discrimination in so many ways. I guess at this point, I'm curious if anyone has actually had successful treatment that has rendered them better off than doing nothing at all. With my knowledge of alternative remedies, I've so far not had any improvement over juggling things to keep my autonomic nervous system closer to balanced than doing nothing. The testing, doctors, and meds, if nothing else, have made me more incapacitated than I was before. They say that ignorance is bliss, they might really be right. Sorry for having to get into a hardcore rant, but I've just been really beside myself lately. This definitely isn't the person I used to be. Maybe knowing what is wrong with me is worse than using my inner strength to fight the unknown. I mean, I don't even have an ANS neuro anymore that is trying to work with me. There has to be a better way than this, that's for sure. I can definitely understand that most, if not all, others that don't have to be here would likely be out enjoying life. I'm just kinda curious how the rest of you feel about things. If anyone has a recommendation for a helpful doctor in the greater SE Wisconsin area, I'm all ears. I'd like someone that knows at least as much as I do or more about this for a change, even if that is hard to find. I'd just love even part of my life back, if not all of it. Thanks again for listening - I'll keep researching with the hope that someday we might find something to bring us all some peace. If we don't have hope, then what really do we have? -C

I am still able to drive when I feel OK. I've been off work since July of '11, not that I'm getting any help or support. I'm most likely hyper-type, but haven't been able to get anyone to test me for catacholamines yet. I've tried a number of meds, but nothing has lasting help so far. I've tried exercise, but it doesn't have enough improvement to make me stable either. Sleeping is totally off-whack, insomnia and usually only fall asleep super late. If I could keep the migraines at bay and have a normal sleep-wake cycle I might be able to work, but I can't get adequate treatment thus far.

Worst: Early Morning, especially if I have to be up before about 10 AM Best: Late at night, the later the better - I have the least symptoms in the middle of the night

Yep, you've got it mostly correct. Technically, testing for 25(OH) is looking at serum levels AFTER the liver has metabolized the D3, which is either supplemental or from skin exposure to sun. 1,25(OH)2 is the biologically active form, which exists AFTER 25(OH) is processed by 1-alpha hydroxylase in the kidneys. The 1,25(OH)2 form is bioactive without any further chemical changes from the body. Calcitriol is the prescription (brand) name for this type of Vitamin D, which bypasses the body's entire metabolism of D. As such, it needs to be closely watched, as it can cause excessive levels of calcium in the blood. It also requires watching dietary intake of calcium for optimum function. However, for those with 1-alpha hydroxylase deficiency, it is likely the only way to properly get enough Vitamin D, since the body isn't converting the precursors in large enough amounts. Also, D3 is the type that is generally used supplementally - this is the same chemical that is made in the skin by the body by sunlight, and is cholecalciferol. D2 is another form, and is generally the one used by strict vegetarians/vegans, as D3 as a supplement generally comes from animal sources. Hope this helps clear things up a bit!

Well, this is an interesting topic to wander across - I just checked my labs, and sure enough I was only tested for the 25(OH) form, so I guess we know my liver may be metabolizing D3 that my body makes. However, I wasn't getting enough sun at the time tested, in theory. I've been supplementing for a while, and am supposed to be retested, however I don't see a reason to test for 25(OH) without testing for 1,25(OH)2 at least once, as we should make sure there isn't an enzyme deficiency causing low D3 in function as well as a low intake/production. We know that a single link in a chain can wreck entire complex biological processes on a large scale, and that the ONLY cure is fixing the chain. Otherwise we end up with the numerous dysautonomia drug cocktails that barely make most feel better. The point is that there is NOT ONE ROOT CAUSE, so we have to find the individual's broken link, and patch it. In the case of this article, this woman had an enzyme deficiency, and carefully bypassing that broken part of the body's process, allows her to feel normal, or almost normal! I honestly think that doctors running tests is often worthless, or even a false sense of security, as many of them don't seem to understand the rhyme and/or reason for the specific types of tests and their interpretation, and that testing the one thing that has always been tested is an immediate pass / fail for all cases. A few things come to mind B12 vs [b12, MMA, Homocysteine] for B12 deficiency, 25(OH) or worse yet just serum D3 vs 1,25(OH)2, and single catch 5HIAA and/or catecholamines vs 24 hour collection. I can't say how many specialists have even discredited my requests to run specific panels of tests, yet they can't really tell me WHY I have an unfounded concern. I have quite enjoyed the very few doctors that entertained my enthusiasm, or even suggested what I would have asked for, before I spoke up. I also don't understand the constant desire to overlook things that are abnormal without doing anything further about them. The definition of insanity is doing the same thing over and over, and expecting different results! Hope this flowchart helps for those that like a visual understanding of the Vitamin D synthesis process. It was gleaned from this article, which describes things in greater detail.

YES! Eating has been a struggle ever since I started having problems. Eventually, it became that eating would always bring on feelings of aura / migraine, which threw the migraine specialists for a loop, as not eating usually makes things worse - but for me it would bring on remission of my symptoms. It isn't as bad, thankfully, with some of the more recent things I've been trying, but eat too much and it can still make me feel off.

Funny that this comes up just after I ended up coming across and reading about Motherwort recently. I have some on its way to me, so eventually I'll be trying it. I've even put together a formula of sorts for me to try at some point if it is helpful. Definitely keep us posted! (and sorry for taking this a bit further off topic!)

I've been meaning to respond to this topic, as I find a lot of similarities to me here. I'm a 29 y/o male, too. Had the same symptom - feeling faint in a hot shower as one of the first things. Also, bending down to tie my shoes became a bit of a task at times, which freaked me out a bit. Alcohol helps me feel better, too - it definitely reduces my symptoms, and when I have a few drinks in the evening I feel a lot more with it (ironic as it seems). The sweating definitely reduces and the racing heart, too. It may be interacting in some way with the Pamelor that I'm taking to prevent migraines, as that seems to raise my heart rate a bit. Unfortunately, I can't stand the side effects anymore so I've got a follow up with my migraine neuro's nurse tomorrow. She was surprised when the autonomic neuro put me on it, since it is known to cause/worsen OI, which it is most certainly doing to me. Anyhow, the only thing so far that has been helpful aside the alcohol, is my Eucommia Bark tea, which is a natural beta blocker (non-selective). It also calms things down, and makes me feel a lot better. Unfortunately, I have not had any tests to prove this, but I know I have hyperadrenergic symptoms, and I expressed this at my autonomic appointments. Sometimes drugs are administered during TTT, or standing catecholamine levels are checked. Once again, not sure why this wasn't done for me, but I just know if I'm super worked up, a drink or two brings my body back to what could conceivably be called a "normal" state. Alcohol generally doesn't have the same effects on me as it does commonly on others. This is starting to unravel some of my mysteries. I'd be MORE likely to get a migraine if I didn't have a few drinks. The Pamelor is probably raising dopamine, but it raises levels of other neurotransmitters, most likely causing some of my symptoms. But this is likely what is stopping the migraines. Low dopamine again links back to NET function. Funny that the SAM-e hasn't helped more, but maybe the SSRI's are getting in the way. Anyway, I've rambled a bit - but also note that it is interesting that Mayo d/x POTS when your other TTT was "normal". So far I just have dysautonomia d/x, but highly suspect that a facility with more experience would probably say I have POTS. I'm seriously considering going to Mayo to rule everything else out and get a final diagnosis. I'm curious how hard it was to get in there and the timeframe.

Well, just thought I'd update this thread. I took 200mg SAM-e last night (enteric coated by Jarrow). After a while, I definitely felt different, more balanced than anything else has done in a while. Got a bit melancholy later on in the evening (after taking my PM dose of Escitalopram). Not sure if there is a cross-reaction or if it was just situational with last night. I'll be continuing the SAM-e for a few days to better characterize its effects, but I think it has the potential to be something that eventually is part of and/or replaces other parts of my treatment. I've been off the Eucommia for a bit, and will eventually add it back after I can characterize the SAM-e separate from it. Regardless, I'm hopeful that it may be a new answer. I'm also planning to reduce to one D3 per day, as I've been supplementing for a while to boost the low levels. If I don't notice any side effects from dropping to one per day, I'll stick with it.

Hmm... interesting. I'd be curious to know more about getting this type of diagnosis. I have tons of GI issues that bother me, to the point that before I was taking Pamelor, eating would always make my symptoms at the time worsen (including triggering migraines). The migraine neuro was flabbergasted when I told her this, seeing as how the norm is for not eating to be problematic! I tend to have frequent gas/bloating, and slow motility that is generally inconsistent. The GI stuff was so bad, I originally suspected it was causing the migraines, as they increased as the GI symptoms did. All that a colonoscopy/endoscopy found was mild hiatal hernia, and absolutely nothing else. Also tried an acetylcholinesterase inhibitor, 1/8 mg, and I had a horrible reaction to that. (Felt angry for no reason, felt like tons of cotton was shoved in my mouth, and more). I wanted a gastric emptying study, but as usual the doctors didn't see a reason to do one. (How about tons of symptoms that can't be explained yet?) I've generally used herbal bowel aids, as they tend to be gentler yet still effective, and some are less prone to causing dependence. Never been given any drugs for the bowel symptoms. Of interesting side-note, when I do take Sumatriptan for migraines it generally makes my bowel function more regular. (This is not super surprising from a pharmacological perspective, as the gut contains more serotonin receptors than anywhere else!)

I actually just started using the Ginkgo again - had done so a long time ago, but it has been a while. Way before the migraines started back up was the last time I had taken it. I wish that it would be that easy, but I was taking almost nothing for some time before the migraines started back up.

I used about the same amount each time, enough to fill a small tea ball. I'm guessing it was probably in the 5-15g range. I'll measure the exact amount the next time I make tea. I haven't made an extract yet, but I'll definitely try it sometime soon. Definitely want to see the difference between the two.

Vinpocetine is a semi-synthetic based off of the alkaloid component vincamine of Vinca minor, or lesser periwinkle. It appears that I am not the only one around with "two week miracles". Or what might be a month miracle at the moment for the tricyclic. I'm feeling a lot worse lately, so I'm looking for something else to try... Back on the topic at hand, the Eucommia gave me feelings very similar to Rama.... It was almost unreal the first time I tried it, as it brought me a calm/peace I haven't felt in years. Keep in mind I've never had a Rx Beta Blocker. I honestly feel I've been in a hyperadrenergic state for a long time now. Stress pushed it over the top and I crashed. I'd like to try the Eucommia in a formula, especially if it means even stronger effects. I stopped using it for a few days to see the difference it made more clearly. I was a lot better with it.

I've just read this thread, with a lot of interest. Seeing the mention of inositol, I thought I'd chime in with mention of SAM-e. It has some anti-depressant effects and MAY actually work better than an SSRI. Rama's post upstream is of great interest to me, as we know that NET function is likely low in POTS. If low NET = high SERT, then there is a chain reaction. SAM-e provides methyl group donors for the NET process, which may be treating the CAUSE. This may then have the chain reaction of bringing the high SERT back to normal. Fascinating.... Looks like its time for me to hit up Amazon for a small package of SAM-e to give this a try. My symptoms have been awful the last two days now.

I know exactly how you're feeling - I'm in the same boat at the moment, except that my small company didn't have LTD, so I was lucky to have lots of savings. Not to freak you out, but I'm actually in the midst of appeal at the disability company, as the first line of claims didn't seem to understand anything about my claim. Since you have short term, and have been receiving it, that will likely help you quite a bit as grounds for long term. I'm also the primary earner, and 29 too. It is scary to think that life has changed so much in such a short time. In some ways, I can still do some of the things I used to, but just on a much slower and more inconsistent scale. That said, it is probably time to recognize that I've hit some limitations, too. I've always been a fighter - and I'm not used to this inability to suck it up and push on. It almost seems surreal. Looking back, I'm glad that we started our own business a while back, as a side thing. It may end up being an answer for how I can continue to do something of value in spite of my erratic schedule. Best of luck to you, and remember, it could always be even worse!

YIKES - talk about negligent. This is why I review all of my test results myself - I don't really have much faith in most doctors, plus legit mistakes can happen too. I was reviewing some recent bloodwork, when I found that three of the tests were not normal, but I was only informed of one of them. Go figure. I thought that an uncertain Lyme test would provoke questions. Raised homocysteine certainly should be of note too, even if it is only moderately raised. Multiple doctors have looked at my abdominal CT and brain/c-spine MRIs, thankfully, but now I kinda want to go actually view all the images myself...

This is awesome! It sounds like you're probably looking for methylcobalamin, as those of us helped by turmeric/ginger, are likely overactive in the COMT pathway and deficient in methyl donors. I'd love to get the genetic testing, but money is tight with my situation right now. That said, given some of the correlations out there, I think I can reverse engineer things until I can confirm them for sure. Then I can try similar therapies. Given my success with turmeric/ginger, I believe that I have the overactive COMT pathway, which becomes deficient in methyl groups. Also given my recent doctor problems, I'm thinking that I might even be able to replace the bandaid meds currently being taken by supplements to aid in balancing the methyl cycle problems. Let's take them set-by-set: ~~~~"Anti-Depressants"~~~~ Pamelor: Works as an inverse agonist or antagonist in multiple processes (decrease), including NET. If the migraines are triggered due to dopamine/NE problems, this slows the over-active COMT pathway, stopping depletion of methyl groups needed for other biological processes (including dopamine synthesis). Escitalopram: SSRI. May be reducing pain/bowel issues somewhat. Moderate to no migraine effect. At best was helping curb the anxiety caused by chronic migraine and life instability. ----both replaced by:---- SAM-e: Works as a methyl donor in the COMT pathway, removing the bottleneck and allowing for dopamine synthesis, or other processes to continue unhindered, despite the over-active COMT process. May have as good or better migraine prophylaxis, as well as a balancing effect on neurotransmitters, which will also improve mood, well being, and possibly sleep. ~~~~Beta Blockade (presently trialing herbs, no doctor has actually tried meds yet)~~~~ Propranolol: Non-selective beta blocker, may be effective for migraine prophylaxis, reduction of sweating, balancing overactive adrenal response, and reversing the effects of PTSD. ----replaced by:---- Eucommia: Herbal non-selective beta blocker, from other reports has reduced side-effects possibly due to being more of a pure beta blocker, possibly not crossing the BBB. Will help with overactive adrenals, sweating, overall hyperadrenergic state and PTSD reversal. ~~~~MAO-I~~~~ May have other beneficial effects in the case of overactive COMT. Stop the rapid destruction of neurotransmitters like some anti-depressants, some also work as anxiolytics. Turmeric/Ginger/Black Pepper - MAO inhibition Passion Flower - MAO inhibition Syrian Rue - affects both MAO pathways in larger doses, may also affect Nitric Oxide pathway ~~~~Other herbals, may be of use/benefit~~~~ Rhodiola rosea - anti-depressant like effects Skullcap - Nitric Oxide inhibitor, inhibits histamine and leukotriene release Wild-Lettuce - Anxiolytic This just keeps getting more and more interesting!

Well, I'm not surprised that this has happened yet again, but I'm sure many of you can relate. I've basically been dumped by my autonomic neuro. Maybe I should just say he is giving up on trying to figure me out. I also suppose it would be more accurate to say I've been thrown back over the fence to my migraine neuro, but regardless she isn't the one who should be treating my autonomic symptoms. We had discussed other drug options at a recent appointment, and I called to ask about trying something else (a beta blocker), as the tricyclic is giving me symptoms I didn't have before, and the overall net is as bad or worse than what I was dealing with previously. So, when I get a call back the nurse tells me that I should talk about that with my other doctor. So, that said... I guess I'm also supposed to ask my migraine specialist about the sleep/wake cycle problems, digestive disregulation, the weird aches and pains, and the overactive sweating. She has stuck with me through everything so far, but I know she isn't going to want to / be able to treat me for all these things. That is why she sent me for dysautonomia testing and consultation. I'm also still left wondering if my symptoms are being caused by something else like inappropriate sinus tachycardia, since that is a dysautonomia distinct from but similar to POTS. It's times like this that I am very inclined to go back to just treating myself - I've been tempted to see if the Eucommia bark (a natural beta blocker) would keep my migraines at bay instead of the tricyclic. It just seems like I can't find anyone that studies the details as much as I do, so I'm always left disappointed. Add to this the problem of trying to fight the evil (private) disability insurance to actually pay me something (I've been off work a year now) since the migraines were/are most definitely disabling, not to mention other symptoms. Also, add in the fear of having to actually go back to work at a stressful job where I feel marginalized and unappreciated, while still a hot mess, with no understanding or support. UGH. A while back now I asked my migraine specialist if I would have to end up going to Mayo to get an answer. She said no, but I'm starting to think it might be the only way to get a comprehensive answer with doctors that work together instead of just trying to throw me over the fence and make me someone else's problem. If adversity builds character, I think I have enough character for a few lifetimes. *sigh*

Another late night of reading has given me a MUCH clearer picture than I had before. I think I should consider a career change, as this stuff is super fascinating to me. I'm starting to understand the different etiologies significantly more, as well as pharmacology in general, and why drugs, supplements, and herbs work so differently sometimes and similarly at others. I've really dug deep into NET function, both normal and abnormal, how this ties to genetics, and more. The reason the same drugs work for subgroups of dysautonomia patients is that they do not closely modify the area in question causing the deficiency/excess. Instead they work much further down the chain to control the secondary symptoms, and so they are "effective" no matter what the root cause may be, as they express their function in a different set of chemical/enzymatic reactions or modulate the receptors directly, bypassing most/all of the underlying framework. However, THIS is exactly what causes side effects, because modulation (agonism/antagonism) of a said set of receptors, say 5-HT (serotonin), does not accomplish the same thing as the same effect on select receptors, say 5-HT1B, or even further down, on the metabolism of serotonin as a whole. In short, COMT is fairly significant in NET function - it deactivates catecholamines (Dopamine, Norepinephrine) by giving them a methyl- group from SAM-e (and ties this function into the methyl cycle). Specifically, on the genetic side, one can have two types of COMT malfunction. In those with the first form, there is reduced activity and so there is a surplus of methyl groups and dopamine. There are some benefits to this, but trade offs at the same time. Tyrosine rich foods and methyl donating supplements can be problematic in this type. (Turmeric, quercetin, tea, melatonin, SAM-e). Tryptophan rich foods are stressed instead. The other type involves over-activity, and so there is a deficit of methyl groups and possibly dopamine as well. (Quercetin, tea, turmeric, ginkgo, SAM-e etc.) are beneficial as they provide more methyl groups to aid in the COMT process. Also, methylated B-12 (methylcobalamin) Also pertinent in this process are the Vitamin D receptors. One (normal) state allows for higher dopamine levels and methyl donor availability. The abnormal state for Vit D results in Vit D NOT increasing dopamine production, so it will be low. So there is a somewhat complex framework of webbing, that while not always the same, causes similar symptoms. Now if only I could actually find someone to work with that would be interested in helping to find and treat the root cause!

In the interest of not fractionating things or repeating them too much, I'm continuing my discussion in the Sam-E, Net function thread here. Quercetin and MAO inhibitors are more appropriate to that thread's main discussion and I wandered off topic (sorry, it is a perpetual habit of mine... ) In the interest of steering this discussion back on topic, I have recently tried the Eucommia bark. I definitely have noticed positive effects from it, possibly more than any of the meds I'm currently taking. Seeing as how Beta blockers are used in migraine prophylaxis, I wonder if Eucommia would be more appropriate than the Tricyclic (Pamelor), as the Pamelor has been raising my heart rate and it has given me worse orthostatic intolerance (as is stated in the meds to avoid section). Ideally I'd like to try the Eucommia with some of the other herbs, as that will have a greater but more balanced effect.

I've been up for a few hours now, and with all of the study information that has surfaced lately on NET function, I've been doing some in-depth reading. It is interesting to note that NET, in addition to its obvious effects on norepinephrine, also has effects on dopamine as well. Given its dependence on salt, this may at least partially explain why salt-loading has some positive effects. One of the first things I came across that was of interest, is the fact that SAM-e (S-adenosyl-L-methionine) is a required co-factor in the synthesis of epinephrine from norepinephrine (one way it is metabolized via PNMT). SAM-e is also needed for biosynthesis of serotonin and dopamine. I'm curious if anyone here has tried SAM-e and if it has had any effects, positive or negative. It isn't something I've ever tried, but there have been numerous studies done on it, and it seems to be at least as clinically effective as antidepressants, and is even a prescription drug in some countries. Protein Kinase C (PKC), plays a role in NET as well. It may be of value to look into it further. Ruboxistaurin is an inhibitor, ingenol mebutate (from Milkweed) is an activator. Rauwolfia is an herbal that is said to lower NE levels, though it also lowers serotonin levels as well. I'm not sure if it would be at all beneficial due to that fact, but for those with elevated NE it might be worth looking into further. Reboxetine is a drug that is solely a NET inhibitor. Something I came across during my reading. I hadn't come across any drug that didn't also have a serotonin component before. Anyhow, the listed side effects are all things I experience on a regular basis!! (Insomnia, excessive sweating, vertigo/hypotension, dizziness, and limbs falling asleep.) It almost sounds like you could use this to produce the symptoms of dysautonomia in a healthy person. MAO-A is one of the methods by which norepinephrine is degraded (as well as serotonin and dopamine). MAO-A is also involved in metabolism of tyramine. Functionality of this enzyme may explain the connections between tyramine rich foods and migraines. It is also interesting to note that natural MAO-A inhibitors include Turmeric, Tobacco (Nicotine), Cat's Claw [(+)-catechin and (-)-epicatechin], Açai [(+)-catechin], and Kava (Desmethoxyyangonin, moderate affinity). Well, I've exhausted my desire to read for now, but I've learned a number of interesting things.