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It sort of appears that the arrhythmia I noticed back in early March was drug-induced. I say that because I stopped taking a drug on the day it dawned on me that I had an arrhythmia (which was probably several days after it first developed) and the arrhythmia seems to have faded away over the next week or so.
What was the drug? Fexofenadine, better known as Allegra. Because of mast cell issues mostly caused by pollen allergies and an allergy to the adhesive used by the barrier seal for my ileostomy, I had been taking 180 mg of fexofenadine every day up until that point. I started taking it daily at the end of summer (when ragweed started to bloom). Before then I only took it occasionally (as needed). That's about 6 months of continuous daily use.
But my serum magnesium actually tested high on the day I went to the ER (and I had taken no magnesium that day) so I cut my magnesium dose in half, to 300 mg. My creatinine also tested high on that day, which made my EGFR (a measure of kidney function) low. The question is, "Did the arrhytyhmia cause an elevated creatinine level or was it caused by too much magnesium in the blood." Or could it have been caused by fexofenadine? I've continued to take 300 mg of magnesium glycinate daily since then and I've had no deficiency symptoms. So did the higher dose of magnesium cause the arrhythmia? Was it the fexofenadine? Or was it something else?
Now I'm just guessing at the cause, but I can't find anything that I've done differently since then except switch from Metanx to the OTC version of the active forms of vitamins B-12, B-9, and B-6 sold by Thorne Laboratories. Surely that didn't do it. But the arrhythmia seems to be gone. Or was it just a coincidence that it faded away? I haven't had much experience with arrytyhmias.
My PCP studied all my test results after the stroke at a followup and when he finished, I asked him what he thought about my prospects of taking an antihistamine in the future. He advised me to get by without using any antihistamines.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Thanks for filling us in. I was curious what your thoughts were. I would think if your mag dose was too high and your kidneys couldn't clear it, you would get diarrhea? I would also have guessed that stopping the Allegra maybe caused your body to need more mag causing an arrhythmia. But that doesn't explain the high serum level of mag. You got me stumped! It just seems like you caught the wrong end of a perfect storm situation.
I know how much Allegra has helped you. I found since starting on Dr. Dean's ReAline And mag, my histamine symptoms have gone way down.
Yes I thought that the Allegra reduced the itching, but I always seemed to be quick to develop mast cell problems (or additional mast cell problems), regardless. Now that I don't take any Allegra, I seem to be no more likely to have any itching or pollen problems than before. I think we eventually develop a tolerance for (or resistance to) antihistamines (or maybe it's just certain antihistamines). Our bodies seem to make a chemical adjustment to accommodate an antihistamine.
A couple of years ago we discussed a rebound effect from Claritin, for example. I believe that Zizzle posted that her daughter had a rebound effect when she discontinued the use of Claritin. Her urticaria and pollen-based symptoms seemed worse than ever when she stopped using Claritin and this was confirmed by her physician. The effect had been reported by others.
Vanessa wrote:I would also have guessed that stopping the Allegra maybe caused your body to need more mag causing an arrhythmia.
Yes, that's what I first thought, but now I'm not so sure. I cut the amount of magnesium in half when I first noticed the arrhythmia and the arrhythmia resolved while taking half as much — (in fact the magnesium dose was cut to zero for several days while I was in the hospital) and I seem to be fine taking half as much magnesium (300 mg). I do have cramps in my right leg at night if I stretch the muscles, but I believe that's an effect of the stroke — the muscles are atrophying in my right leg and right hand, even though I'm exercising them.
I didn't notice any extra D from taking 600 mg of magnesium, but with an ileostomy you're always dealing with some level of D, just not usually WD. That makes it tough to notice any extra D. About the only way to tell is to take note of the volume. Nothing about this seems to make sense in retrospect. The stroke seems to be totally unrelated to the heart issue (the heart issue was apparently gone when the stroke occurred). But the timing seems mighty suspicious.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Tex,
I have been on Fexofenadine for a long time. 4 x day for two years at least and now 1 per day.
Three years before my MC diagnosis, I, also out of the blue like MC, broke out in hives. Chronic urticaria. Mine is of the delayed pressure type. It is a miserable thing to have, the itching unbearable! My allergist assured me that food had nothing to do with it, that it is autoimmune. In addition to 4 Fexofenadene a day, I was started on Singulair (Montelukast, a selective leukotrine receptor antagonist) which is normally prescribed for asthma. Then, over two year ago, I began receiving monthly injections of Xolair (Omalizumab) which blocks IgE. It was approved for chronic urticaria in addition to asthma. Apparently, I, too, have mast cell issues.
The Xolair began to work after several months. While the hives had disappeared some time ago, the itching had continued to a much lesser degree. Before my MC diagnosis and going gluten free, my itching was under control 93-98% of the time, I'd say. Now that I have been gluten and dairy free for three months and soy and egg free for almost two months, my itching has gone away. I did notice that the deodorant I was using (an organic brand without the bad stuff) began giving me a rash under my arms a couple of weeks ago, but not hives. I quit using it and that rash disappeared.
Do you believe that, while the Xolair helped greatly, that my change in diet was also a big factor to the cessation of my itching? I have thought of stopping the Xolair but am hesitant to because of its blockage of IgE. And I have thought of stopping the Fexofenadine. Your arrhythmia, which may or may not be related to the Allegra, gives me pause.
I wish I could offer you good advice as you are always the one offering it to us.
Yes, antihistamines 4x a day for many months is the standard treatment for urticaria. Allergists prescribe to many patients every day. That's why I always assumed that antihistamines were safe. Only now I'm not so sure that they're safe for everyone (especially me).
Susan wrote:My allergist assured me that food had nothing to do with it, that it is autoimmune.
The problem with that comment is that food sensitivities are responsible for most autoimmune diseases.
Susan wrote:Do you believe that, while the Xolair helped greatly, that my change in diet was also a big factor to the cessation of my itching?
Sure I would believe it, because it's true.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
I have been doing an experiment regarding the Allegra since last September 2016 when I was in mid cholestyramine use.
I have not taken the 180 mg Allegra since September 2016. (although I do believe it did relieve symptoms while I was in the beginning stages of healing).
I stopped the cholestyramine February 2017 when I had my short lived bout with a flu.
I did not resume Allegra at all this Spring 2017 after the advice of Gabes and upping my B6 to 100mg when I felt mucus start to rev up and have alternated that B6 vitamin from 50mg to 100mg as needed and have not had to go above that amount (which I understand a person can safely take up to 400mg if needed - but I wouldn't do it long term).
I have been basing my foot cramps that happen mainly right foot arch and usually Midnight-5 a.m. if they happen at all to low magnesium so have to make adjustments daily on that front. (I've noticed a fairly stressing day leads me to these crampy foot nights) I have also found that KAL Magnesium comes in a 200mg capsule and have been taking one of those every so often (ya they are kinda big, but they get really slippery and go down fine).
I am like you in that I thought the Fexofenadine would be ok on a fairly long term basis, but my intuition kept telling me I need to back off on this and try to let my body do the fending for me as much as possible.
I don't know just how much proof this may be but when I got my 23andMe results back the Allegra was red a BAD for me nothing was green in my results for it. I took that sign as I may want to only use it on an as needed basis and then not for very long at a time.
With the 24 months of healing I have put myself thru I seem to be getting thru this Spring ok....I'm not taking any chemical type medicines (including the cholestyramine - haven't had to use it after my 7 month use of it - I don't even notice the yellow bile with stools anymore), just VitD, Mag, B's, Potassium, VitC, Manganese, L-Ornithine, and the occasional Krill oil (to get some Omega 3 essential oil in me).
I'm just sharing this in case someone else is feeling like something may be off for them too.
I hope all your tweaking is working in your favor Tex.
Big Hugs
Erica
To Succeed you have to Believe in something with such a passion that it becomes a Reality - Anita Roddick
Dx LC April 2012 had symptoms since Aug 2007
interesting that both Tex and Erica had reaction to Allergra -
I am wondering if they have changed the production process or ingredient sourcing?? or if over time the body just 'rejects' it??
Gabes Ryan
"Anything that contradicts experience and logic should be abandoned"
Dalai Lama
Thank you for bringing that up because it reminds me that I have a MAO-A R297R +/+ mutation. That means that I have trouble breaking down neurotransmitters (including serotonin, norepinephrine, and dopamine). In combination with a COMT V158M +/- mutation (which I also have), it means that I'm prone to even more severe neurotransmitter imbalances. These imbalances (in neurotransmitters) can lead to obsessive compulsive disorder (OCD), mood swings, and aggressive and/or violent behavior, according to the interpretation. I've never displayed any violent behavior, but I have to say that I'm sometimes aggressive, and OCD seems to be about as common as dirt among the members here.
And as far as that difficulty in breaking down neurotransmitters goes, it probably played a big role in the Parkinson's diagnosis I received over 7 years ago. I even took an irreversible monoamine oxidase (MAO) inhibitor (rasagiline) for 6 or 7 months following the diagnosis. That (the neurotransmitter imbalance) affects my balance, gait, and most of the things that this stroke affected. The stroke was like having a neurotransmitter imbalance on steroids.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
It's not commonly remembered these days, but about 30 years ago terfenadine was removed from the market because it was shown to cause arrhythmia in certain patients. It was replaced in the 1990s by, you guessed it, fexofenadine.
However I can't conclude anything from this fact because it caused heart problems by lengthening what's known as the QT-interval. My QT- interval appeared to be normal in the tests that I looked at (of course my arrythmia was gone when most of the tests were done (after the stroke). It makes me wonder, though.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Wow Tex... imbalance on steroids really!....ok that is not funny, but I have a good picture in my mind ;-)
I have the same SNPs so I suspect I need to watch out for those same requirements regarding transmitters. I am OCD....and have personal mood swings (which I try not bestow on others), and my aggressiveness might be during an OCD episode while I am cleaning house!
your welcome dear friend.....
Hugs
Erica
To Succeed you have to Believe in something with such a passion that it becomes a Reality - Anita Roddick
Dx LC April 2012 had symptoms since Aug 2007
I don't know if it has anything to do with it, but I cannot take Claritin or I will have a super fast heart rate. I took Claritin for years in spring for seasonal allergies without any problems. But a few years ago, I took it, and my heart rate was so fast, I would wake up from it at night. It was around 120 in the middle of the night, while lying in bed. My PCP ordered all kinds of testing of the heart, and everything was fine. They couldn't find anything wrong with it. When I stopped the Claritin, the heart rate went back to normal. Later on, I tried it again, and the heart rate went back up again.
This year, my seasonal allergies have been really bad but so far I did not dare take anything because I was afraid it would bring back the racing heart.
Love, Patricia
Be gentle with yourself. Be kind to yourself. You may not be perfect, but you are all you’ve got to work with.
- Bhante Gunaratana
I suspect that happens more often than the manufacturers of antihistamines or the FDA will admit. I believe that some of us are a lot more sensitive to antihistamines and we shouldn't take them. Maybe this is due to prior use. When I was young, I took a lot of chlorpheniramine maleate (sold as Chlor-trimeton in this country). It was very effective for pollen allergies (which I've had all my life, and my allergy symptoms were really bad when I was young), but it was one of those first-generation anihistamines that had anticholinergic attributes.
Prior to the 1980s when the second-generation antihistamines came along, if we took an antihistamine we were taking a first-generation antihistamine (with anticholinergic features and a tendency to cross the blood/brain barrier). Second and third-generation antihistamines are far less likely to cross the blood/brain barrier. Still, for all we know the first-generation antihistamines may have been safer than the second and third-generation antihistamines that superseded them.
Love,
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
I would also have guessed that stopping the Allegra maybe caused your body to need more mag causing an arrhythmia. But that doesn't explain the high serum level of mag. You got me stumped! It just seems like you caught the wrong end of a perfect storm situation.
