Jason_X

There are other forms of magnesium that are less likely to cause digestive problems. Magnesium Citrate is used as a laxative, and it is going to cause problems unless you take small doses. Magnesium Glycinate: Supposed to be well tolerated. I've had good luck with it at bedtime. Seems to help with sleep. Magnesium Malate: Supposed to be well tolerated. I've had good luck with it at bedtime. This seemed to help with lethargy after getting off of Gabapentin when Mg Glycinate didn't seem to help. Magnesium Theonate: Supposed to be somewhat better for reaching the brain. It didn't seem to help me sleep. Magnesium Taurate: Supposed to be somewhat better than the others for heart rate issues.

I've had good luck with magnesium malate. It's well tolerated, so that it gets absorbed without being a laxative. Magnesium citrate is absorbed well, but it's usually a laxative at anything other than a small dose.

I have gastroparesis, too. I have found that it can be highly variable from week to week, with no obvious triggers.

I can chug a triple shot cappuccino and my heart rate will barely go up. If I have one drink of alcohol of any form (beer, wine, liquor, etc…), my heart rate goes up and I feel extremely tired. I feel pleasantly relaxed for about 15 minutes, but I then I often feel terrible (but not always). Does anyone else have this reaction? For what it’s worth, I have inappropriate sinus tachycardia, stage one gastroparesis, and nearly POTS symptoms on the tilt table test.

For me, anaerobic is much worse than aerobic, but yes, I often experience elevated heart rate for several hours afterward. Aerobic exercise is never 100% aerobic, though. I often have to pace myself if I haven't been exercising lately, because it's easy for me to feel nauseous with anaerobic. Exercise induced elevated heart rate is also a sure sign that I'll have insomnia in the evening as well

There has been so many medications over the years, I had forgotten that I had switched from Bisoprolol to Bystolic shortly before finding the Ivabradine. Bystolic seemed to disrupt sleep at higher dosages (I think that I was taking 5 to 10 mg at the time). My doctor suggested that I continue to take a small dose of bystolic (2.5 mg) even while on the Ivabradine because there was no literature at the time about using Ivabradine without any beta blocker. I'm not sure that it makes much difference whether or not I include the 2.5 mg of Bystolic with the Ivabradine. If you dislike the Bisoprolol and don't have access to Ivabradine, you may consider Bystolic as an option. What dose were you taking with the gabapentin? Some doctors prescibe it at high doses (1800 mg/day) for various purposes. I was taking only 300 mg once a day at bedtime.

Melatonin helps a little bit with sleep for me, but I've repeatedly found that I feel depressed after taking it for several days. I've found (and I've read about medical research that is consistent with this), that 0.25 mg works about as well as 5 mg. I'd feel slightly hung over the next morning with 5 mg, but I could easily shake it off with some coffee. It also seemed like the lower doses didn't affect my mood as quickly as the higher doses, but it also seemed like my mood would plummet after a while with the higher dose. I've also had better luck with the non-sublingual forms. With sub-lingual melatonin, I seemed to have rebound insomnia in the middle of the night. I don't know whether it's really the sublingual method, or the fact that sublingual melatonin always has vitamin B12. Gabapentin (neurontin) is another sleep aid that has helped me in the past. It's used to treat chronic pain, and I"m pretty sure that it was originally used as an anti-seziure medication. If I remember correctly, there is no lethal dose for gabapentin... they couldn't kill the rats no matter how much they gave them. Unfortunately, for me, it also makes my gastroparesis worse. I used to be able to take it before the gastroparesis, so it may be an option for you. About 300 mg was a good dose for insomnia for me.

Correction: The beta blocker Bystolic (Nebivolol) is be better than Bystolic. Not nearly as much fatigue. I'll explain more in a follow up post. Hello SolusUmra! I've tried lots of beta blockers over the years. They were all bad, but Bisoprolol was my favorite. For a long time, I was able manage my IST with a small dose. However, over the years, I had to increase the dose, and the side effects increased. It disrupted my sleep and I felt very tired during the day. I think that the tiredness was primarily a direct cause of Bisoprolol, and not entirely because of the bad sleep. I'm on Ivabradine now. I live really close to an electrophysiologist (cardiologist) who prescribes it. I've seen lots of cardiologists over the years who all pretty much told me "It's not THAT fast, so you shouldn't be bothered by it." My current cardiologist told me "They are plumbers. I'm an electrician." Find a cardiologist who is also an electrophysiologist. If you don't already have one, you may consider getting a blood pressure monitor for $30-$70. Also, I have an exercise heart monitor (Wahoo TICKR Heart Rate Monitor for iPhone and Android, $50) that has been helpful in gauging the effectiveness of medications and dosages. I've lots of heart tests over the years with various doctors, and my heart is fine. I also have Stage 1 gastroparesis. My doctor said that a significant number of his IST patients have gastroparesis. There is evidence that both of these conditions may be caused by damage to the vagus nerve. For what it's worth, I had my gallbladder removed about a year before being diagnosed with gastroparesis. An internet search shows a lot of people who began having symptoms of gastroparesis after having their gallbladder removed. My heart symptoms began about 20 years before the gallbladder issue. Insomnia and poor sleep quality is still an issue, and Lunesta is usually helpful for this. A while back my testosterone levels plummeted, and I am now on testosterone therapy.

Lunesta (2 mg) is the only thing that has worked reliably for me. Trazodone only worked for a couple of weeks for me. Elavil (Amitritypline) (less than 10 mg) improves sleep wonderfully for one night, but also causes rapid heartbeat for me. Only get about one night’s good sleep before heartrate keeps me up. If you don't have a problem with it increasing your heart rate, even a tiny dose can improve stage 3 & 4 sleep. The smallest pill size is 10 mg, but even 1-2 mg can noticeable improve sleep quality. At one time, I could take it, but I can't tolerate even 1 mg anymore. It's cheap. Antihistamines are similar to Elavil, though not quite as good. I can't tolerate the increased heart rate. Benzodiazepines give me really poor quality sleep. I've tried about a half dozen, and none worked very well at all. Ambien gave me rebound insomnia in the middle of the night, and memory loss of the hours before I took it. Sleep quality deteriorated after about a week or so. Neurontin (Gabapentin): Worked great for a month or so. Then worked fair. Then quit working, and I had a horrific withdrawal. My doctor said that withdrawal like mine is extremely rare, so it's not an issue for most people. Magnesium: No noticeable effect. I’ve tried just about everything. If you are curious about something that I didn’t mention, just ask. I use a CPAP machine, even though my sleep study didn’t measure any apneas. I’m an extremely light sleeper, and woke from light snoring. The new CPAP machines are great. They assist with breathing, and I sleep much better with one.

Sarah, thank you so much for your response. It was one of your posts that brought me to this forum. I now have Dr. Suleman’s website bookmarked. One of his offices is nearby. I’m encouraged to hear about your good results with Ivabradine. This started as an intermittent problem about 25 years ago and has become a continuous daily problem. Thank you for correcting the title. I tried to edit the post, but I couldn’t change the title to “IST”.

EDIT: The title should read IST, not Isp. I blame autocorrect. Mild, But Disruptive IST. Ivabradine? Finding A Doctor. I’m so happy to have found this forum. I found this site from an internet search of the word “Ivabradine”. It looks like some here have some similar experiences to mine. My primary complaints are elevated heart rate (IST), insomnia, fatigue, and brain fog. I don’t seem to have POTS, but I do have Inappropriate Sinus Tachycardia (IST). For me, this is much more than an inconvenience. The fatigue and brain fog are seriously affecting my career and my ability to support and enjoy my wonderful family. I’d be grateful for any advice from anyone! Here’s a little background: Long Term Insomnia: I’ve been an extremely light sleeper all my life. It doesn’t take much to disrupt my sleep. Mild tachycardia will keep me awake and will wake me up. Tachycardia: I don’t have sudden episodes of severe tachycardia. If I take an antihistamine, drink alcohol, eat certain foods, etc…, it will gradually rise and remain elevated for several hours. I get REALLY tired if my resting heart rate is even slightly elevated (80-90 bpm). I am unable to sleep if it’s slightly elevated (80 bpm). If I don’t take a beta-blocker in the evening, I’ll typically wake up in the middle of the night. I don’t typically feel a racing heart. I usually have to check my pulse to determine that it’s high. As I’ve gotten older, my sensitivity has gotten worse. Oddly, I’m not very sensitive to coffee, but I’m very sensitive to alcohol. No anxiety: Some doctors have suggested that maybe I suffer from anxiety. I REALLY don’t think so. I’ve done the online anxiety questionnaires, and my anxiety levels aren’t just low, they are very low. Gastroparesis: Diagnosed with stage 1-2 gastroparesis a year ago, which was about a year after I had my gallbladder removed. I’m always a little hungry, but it’s not that bad. Exercise intolerance: I need beta blockers to exercise. If I exercise too much, my heart rate stays elevated for ~18 hours. If I overdo it at noon, I won’t sleep that night, and feel awful the next day. I wear a heart monitor to keep track of my heart rate. It's easy to tell when I've done too much. I immediately feel nauseous and my heart rate stays eleveated. I still manage to keep reasonably fit. Drug Treatment: I’ve had best luck so far with Bisoprolol and Bystolic. Bisoprolol seemed great when I only needed it a couple of times a month. Now that I need it daily, it really seems to produce brain fog, and I suspect that it disrupts sleep. Bystolic is expensive, but my brain fog seems better. I suspect that it also disrupts sleep, though. Verapamil did nothing. Tenormin (Atenolol) and Inderal (Propranolol) were awful. I’m also currently taking Lunesta to help with sleep. I don’t think that I’d need the Lunesta if I weren’t taking the beta blockers. Maybe I can eliminate the Bystolic and Lunesta with Corlanor. Can’t Find a Good Doctor: Every cardiologist I’ve seen has the attitude: “Your heart rate shouldn’t be much of a problem for you. Come see me when you have a real problem.” The treadmill tests, EKGS, an holter monitor tests are always fine. My cardiologist didn’t know anything about Ivabradine. I’ve seen neurologists in the past, and they’ve never been helpful. A GP I saw was just insulting and condescending. I’m excited to read about Ivabradine (Corlanor) being available in the United States. I’m currently looking for another cardiologist in the Dallas area. This time, I’m looking for Cardiac Electrophysiologist, instead of a generic cardiologist. Some of them seem to specialize in ablation techniques, which I understand would not likely be a good solution for me. I’d be grateful for any suggestions from anyone!