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Old 08-12-2011, 07:32 PM #1
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Confused Mestinon & Blood Sugar

I have a question.

Does anyone know if Mestinon effects blood sugar levels?

I have a list of symptoms that occurs mostly after I take Mestinon, but it seems to be becoming more and more common, especially if I take Mestinon with a large amount of food

The most common thing is that my heart rate increases as well as my breathing and I feel nervous. After meals sometimes I get shaky. How bad these symptoms get are directly related to how much Mestinon I take. This has been happening for a long time now, right after I started to take Mestinon, but it seems to be getting worse recently. I am getting stressed for no reason, and my hunger is not functioning correctly...sometimes I won't get hungry all day and others I feel like I am starving and can't get enough food and I get all sorts of odd cravings. Occasionally I feel light headed, as if I am going to faint.

I can feel my body out of balance....and if I reduce the Mestinon to the lowest amount I can go to these symptoms are tolerable...and so I am recently suffering more weakness because it is preferable to these scary symptoms. I can't take them anymore, they are starting to make me feel crazy as well, as if my mind is thinking too fast for me to understand what I am thinking.

I am wondering if I am developing hyperglycemia or diabetes or something along those lines...but I am also worried that the Mestinon is the cause. I'm pretty sure it is.

I've talked to my neurologist about this on numerous occasions and he says it has nothing to do with the Mestinon. He doesn't seem to be concerned about these symptoms and focuses on things like double vision and strength, the MG symptoms.

It seems I am going to have to take a trip to my regular doctor, but first I wanted to know if anyone else has this effect. I'm trying to figure out how to explain why I want to go to the doctor. What should I ask them to test for if anything? How do I explain these strange symptoms? I have had so many bad experiences with doctors that for my own sanity I need to have something in mind before I can make an appointment. Should I request my blood sugar levels tested? Blood pressure? cholesteral? Or let the doctor decide?

Sorry for all the questions...the main thing is that I am wondering if anyone notices similar effects from taking Mestinon, or if anyone has blood sugar related problems as well as MG...

Thank you for listening.
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Old 08-13-2011, 02:33 AM #2
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I can't help as I already was diagnosed with diabetes and I'm on insulin. With the infusions I am getting my sugars are out of control because of the solu-medrol with the IVIG.

If I were you I would definately ask for a blood test of my glucose levels and you may need to be fasting for this. Your regular PCP could check this out for you.

Medicine is so specialized that you need a bunch of specialists to sort it all out as they only want to treat or test you for what is in their field. Your PCP acts as the gatekeeper and should find any other problems that you might have. Lots of luck.

Gabriella
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Old 08-13-2011, 02:42 AM #3
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My first rule of thumb is that any medication can cause anything.

I have seen the most obscure and unusual adverse reactions to commonly used medications. This is not surprising if you think that one small mutation in one protein can lead to a host of changes in the entire organism. Pharmacological agents never work on one system. All we know from large scale studies is that in the vast majority of the population this medication has a significant beneficial effect, without significant unwanted reactions. But, this does not mean that it will be so in the entire population. A mutation in one protein, that would have no effect in life, can lead to significant and unexpected changes once a pharmacological agent is added (and there are numerous known examples for that, and probably numerous more that have not yet been described).

Practically, If you clearly see a relation between your symptoms and the mestinon your are taking (eg-dose-wise and time-wise) then even if it has never been described before, this is your response to this medication.

If those side effects are worse then the illness itself, then clearly it does not make sense to keep on taking this treatment. take into account that mestinon is no more and no less than symptomatic treatment, so if you have worse symptoms with it, than without it, why take it?

I stopped taking mestinon, because it made my illness much less stable. It sometimes worked like Popeye's spinach, sometimes did nothing, and sometimes made it much worse. As it is the most bothersome aspect of my illness is the extreme and unexpected fluctuations, so even though with mestinon I had times when I had a near-normal strength, it was not worth the price of other times in which I had to be in bed for a few days connected to my respirator.

none of my neurologists understood why this is so (or even tried to understand it). most of them just told me it is "impossible". I have possible explanations, but it doesn't really matter. we don't always know the cause of what is happening, yet we do know for sure that it is happening.
Many times in science and medicine, the explanations are found years after the first observation.
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Old 08-13-2011, 07:45 AM #4
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Interesting. I noticed the last two times I've had my blood work done before IVIG my blood sugar has been very low, once 44 and the next time 65, even though I was not fasting. It does make me wonder but I never related it to mestinon. A visit to the GP is in order.
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Old 08-13-2011, 08:12 AM #5
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Insulin secretion as a response to glucose is a complex biological process.

Theoretically, increased levels of acetyl-choline could increase this response, in certain conditions.

See this for instance-

http://www.ncbi.nlm.nih.gov/pmc/arti...df/1001174.pdf

http://endo.endojournals.org/content.../1765.abstract

http://www.jbc.org/content/254/10/3921.full.pdf

This means that in most people it would not have this effect. But, it could become significant if there is also some underlying sub-clinical metabolic abnormality.
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Old 08-13-2011, 05:23 PM #6
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No, I've never had that kind of reaction.

I think it might be worth it to be evaluated by an endocrinologist. I love the neuroscience for kids site.

http://faculty.washington.edu/chudler/chnt1.html

This is interesting (look at the bottom). I can't find my favorite website! When I do, I'll post it.

http://ocw.mit.edu/ans7870/SP/SP.236.../drugchart.htm
http://www.brainexplorer.org/neurolo...smitters.shtml

The body is complex. I really think seeing an endo would be the most useful. Your primary doctor can run some basic tests, like a morning, fasting comprehensive metabolic panel. But an endo would have to do more complicated tests like catecholamines. If you have an imbalance of a hormone in your body, Mestinon might be just "highlighting" it.

Another thought would be that you are allergic to something in it but you don't mention any allergic type symptoms other than heart rate.

Suddenly, You need to get to your doctor right away for an endo referral. A low blood sugar is just as harmful as a high one. If you have essential hypoglycemia (low blood sugar), then you might have a small tumor or other endocrine problem. It could be reactive hypoglycemia. That's often where you eat too big of a meal or eat meals too high in carbohydrates without enough opposing proteins and the body goes from a high glucose and plummets down to a low one. Please ask to see an endocrinologist!

Ditto on what Abby said. I think Mestinon might just be bringing something else to your attention. Who knows. Just see a doctor, even if that isn't fun!

Annie
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Old 08-14-2011, 02:01 AM #7
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I don't believe foods work as medicine (although I had to try it after reading this), but for those who do and who have both problems:

http://jcsp.org.pk/index.php/jcsp/ar...ewFile/453/171

I love it but it's not for everyone.
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Old 12-05-2019, 10:30 AM #8
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Default it's the cortisol -

Cortisol counteracts insulin, contributes to hyperglycemia-causing hepatic gluconeogenesis and inhibits the peripheral use of glucose (insulin resistance) by decreasing the translocation of glucose transporters (especially GLUT4) to the cell membrane.

Quote:
Originally Posted by alice md View Post
Insulin secretion as a response to glucose is a complex biological process.

Theoretically, increased levels of acetyl-choline could increase this response, in certain conditions.





This means that in most people it would not have this effect. But, it could become significant if there is also some underlying sub-clinical metabolic abnormality.
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Old 12-05-2019, 10:09 AM #9
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Default Other interactions - a note on your comment

This is a note on your comment below. You are also a woman, and as such - you have varying levels of hormones in your body to contend with; this is also a factor. Your hormone fluctuations will affect your body's cortisol production, which is also cyclic. Cortisol adversely affects mestonin effectiveness.

Source: Adverse interaction between steroid hormones and anticholinesterase drugs BERNARD M. PATTEN, KATHARINE L. OLIVER, W. KING ENGEL



Quote:
Originally Posted by alice md View Post
My first rule of thumb is that any medication can cause anything.

I have seen the most obscure and unusual adverse reactions to commonly used medications. This is not surprising if you think that one small mutation in one protein can lead to a host of changes in the entire Yourorganism. Pharmacological agents never work on one system. All we know from large scale studies is that in the vast majority of the population this medication has a significant beneficial effect, without significant unwanted reactions. But, this does not mean that it will be so in the entire population. A mutation in one protein, that would have no effect in life, can lead to significant and unexpected changes once a pharmacological agent is added (and there are numerous known examples for that, and probably numerous more that have not yet been described).

Practically, If you clearly see a relation between your symptoms and the mestinon your are taking (eg-dose-wise and time-wise) then even if it has never been described before, this is your response to this medication.

If those side effects are worse then the illness itself, then clearly it does not make sense to keep on taking this treatment. take into account that mestinon is no more and no less than symptomatic treatment, so if you have worse symptoms with it, than without it, why take it?

I stopped taking mestinon, because it made my illness much less stable. It sometimes worked like Popeye's spinach, sometimes did nothing, and sometimes made it much worse. As it is the most bothersome aspect of my illness is the extreme and unexpected fluctuations, so even though with mestinon I had times when I had a near-normal strength, it was not worth the price of other times in which I had to be in bed for a few days connected to my respirator.

none of my neurologists understood why this is so (or even tried to understand it). most of them just told me it is "impossible". I have possible explanations, but it doesn't really matter. we don't always know the cause of what is happening, yet we do know for sure that it is happening.
Many times in science and medicine, the explanations are found years after the first observation.
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Old 08-13-2011, 08:04 AM #10
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Quote:
Originally Posted by DesertFlower View Post

The most common thing is that my heart rate increases as well as my breathing and I feel nervous.
Hi, DesertFlower, this is your local Graves disease patient reporting for duty. I know you associate these symptoms with Mestinon and meal times, but since 10% of people with MG also have Graves, you should have your thyroid checked anyway! In my experience, hyperthyroid symptoms fluctuate with blood sugar. Nervousness, shaking, and fast heart-rate could be hyperthyroid symptoms.

Once I was sure I had athlete's foot, so I used fungicide lotion, which didn't work at all. So I tried the powder, and that worked beautifully! So I concluded that the powder was better than the lotion, even though they had the same ingredients. Later I found out that what I had was not athlete's foot, but chilblains. And when I used the powder, I wore socks to contain it, which kept my toes warm. This is not to say that you're as much of a dunderhead as I am--just that cause-and-effect relationships can be surprising sometimes!

Abby
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