Hypothesis symptoms and conditions

I have type 2 diabetes for a few years and am 59 yrs old-and do not have fibromyalgia or kidney,liver problems or depression or a history of any painful muscles ever. I work up to 90 hrs a week as a doctor for the past 12 years and am a DIY renovator of my home in mt free time. I exercise regularly and am fairly fit, I do have a congenital mitochondrial myopathy characterized by non painful arm and leg muscle weakness- but have not been symptomatic significantly for 20 years. I take vitamins and one aspirin a day and have no medication allergies. weeks ago I started Januvia- my only diabetes medication. I worked well to normalize my mild to moserate elevation of BS.Over the past 2 weeks or so, I have had an increased somnolence without feeling rested upon awakening. I felt like I had been beaten with telephone poles and hammers, More distressing is the insidious onset of neuromuscular pains episodic sharp ones, more persistent aching and burning and tingling tingling, with a dense heaviness in legs more than arms worse with exertion and relieved by rest. 3 days ago it was to the point where I had to stop walking after 8 steps and could not climb a ladder beyond one step . I should not curl 2 lb weights even twice, Typing on a keyboard fatigued my arms after 5 minutes. I stopped Januvia three days ago, slept 30 hours,, felt better yesterday,restarted januvia last pm, Today, after 12 hours of sleep I feel exhausted like I did hard manual labor for a few days without ant sleep. The telephone pole beaten feeling returned, My weakness and pain are back with a vengeance and I cannot walk very well and have to stop typing this every 2 or 3 minutes to rest my arms, and have weakness also in my back muscles with curious sparing of abdominal muscles. Heat and massage do not help and are uncomfortable. I feel tired like I do when my myopathy acts up and my Krebs cycle is disrupted and thus my mitochondria do not make ATP to power my muscles- with the additional new symptom of significant pain. Aside from a mild tachycardia of about 100 at rest, my vital signs are normal, my cpk, Mg, thyroid function tests, comprehensive metabolic panel and sed rate are all normal . Heavy metal screen is negative. I will stop Januvia and probably never take it again, If my glucose goes back up I will go back to metformin which I took a few months about a year ago,
I suspect in my case that Januvia disrupted my mitochondrial function as well as being additionally toxic to my muscles and nerves by some additional pathogenesis, I question whether those individuals who have weakness, somnolence and neuromuscular symptoms might have some underlying mitochondrial dysfunction - a very under diagnosed condition - patients being told that their symptoms are of psychiatric origin.

I have been on nuvaring for about 14 days and have been spotting ever since my period ended. Today at work I got a sudden onset of really debilitating lower back pain and cant figure out what could have happened to cause it. My only relief comes from lying down or sitting. When I came home i started researching side effects for the ring and lower back pain didn't come up. However this site did and has helped me shed light on what i think is the problem. I'm left to wonder if this pain will subside after a complete 3 month cycle of taking it? Part of me just wants to take the darn thing out to prove the hypothesis correct. But I really have a hard time taking the pill. Very thankful that I found this site because it will probably save me time and money of going to the doctors and trying to figure out what the hecks wrong.

I was put on Singulair about three weeks ago, and noticed immediately that my mood had changed. I am an adult ,and felt this sense of sadness, anxiety, solitude, not wanting to be around anyone. I took myself off the drug and have tics all over my body and eyelids ,which is driving me crazy! I even had heart palpitations ,which are very distressing. Today it seems to be better, and this is day three off the med. The only way I can explain how I felt on this drug is doom and gloom.

I started using lipitor from my doctor, it lowered my cholesterol all around but I started to have lower back pains. At first I thought it might be prostate cancer, but after having to MRI's done they found no cancer, thank god. But I went to an orthopedic surgeon to see what the problem was. He looked at the mri's and saw lower dics hitting my nerve endings. He also thought that it might be muscle problems so he gave me 3 epidurals and that helped for a while took away about 50% of my pain, but I still have the pain, It is hard for me to get comfortable when I sit or even when I am sleeping. I don't want to think that it is the lipitor that is doing it to me but after talking with others I feel it is time to talk to my doctor about it. My doctor said that lipitor is the safest one that will do very little harm to my liver. I am not a doctor so I would not know.. My cholesterol level was 246 at one time now it is 175. I am now facing possible spine fusion to help correct my disc problem. But will also ask doctor to prescribe something else.

Alan

How does montelukast affect laminin beta2? I don't know but this came up when I cross referenced N106A.

Synthesis of tenascin and laminin beta2 chain in human bronchial epithelial cells is enhanced by cysteinyl leukotrienes via CysLT1 receptor

Cysteinyl leukotrienes (CysLTs) are key mediators of asthma, but their role in the genesis of airway remodeling is insufficiently understood. Recent evidence suggests that increased expression of tenascin (Tn) and laminin (Ln) beta2 chain is indicative of the remodeling activity in asthma, but represents also an example of deposition of extracellular matrix, which affects the airway wall compliance.

We tested the hypothesis that CysLTs affect production of Tn and Ln beta2 chain by human bronchial epithelial cells and elucidated, which of the CysLT receptors, CysLT1 or CysLT2, mediate this effect.

Methods: Cultured BEAS-2B human bronchial epithelial cells were stimulated with leukotriene D4 (LTD4) and E4 (LTE4) and evaluated by immunocytochemistry, Western blotting, flow cytometry, and RT-PCR.

CysLT receptors were differentially blocked with use of montelukast or BAY u9773.

Results: LTD4 and LTE4 significantly augmented the expression of Tn, whereas LTD4, distinctly from LTE4, was able to increase also the Ln beta2 chain.

Although the expression of CysLT2 prevailed over that of CysLT1, the up-regulation of Tn and Ln beta2 chain by CysLTs was completely blocked by the CysLT1-selective antagonist montelukast with no difference between montelukast and the dual antagonist BAY u9773 for the inhibitory capacity.

Conclusion: These findings suggest that the CysLT-induced up-regulation of Tn and Ln beta2 chain, an important epithelium-linked aspect of airway remodeling, is mediated predominantly by the CysLT1 receptor.

The results provide a novel aspect to support the use of CysLT1 receptor antagonists in the anti-remodeling treatment of asthma.

Author: Siiri Altraja, Martin Kadai, Erki Rekker and Alan Altraja
Credits/Source: Respiratory Research 2008, 9:44

Published on: 2008-05-26

I have had really bad anxiety and panic disorder for a year now from being a former pot smoker. My doctor prescribed me adderall xr 20mg after I asked her to. I'm in college and I have a friend I go to school with who takes it. I found out about it from her and she gave me a few. When I took it I was fine. Even the come down wasn't as bad as what I am experiencing now. I took the first pill out of the bottle yesterday. The first 5 hours were great. I was focus on what I was doing and I had no anxiety or weird side affects what so ever. Around 2am I started feeling dizzy, fatigue, parts of my body was going numb, my limbs were getting weak and they hurt, i got massive migraines, chest pains, weird shots of pain that felt like lightning going up my spine to my neck, blurred vision, and my speech was slurred. I did not want to wake my parents up because I thought maybe i was just having a panic attack. My doctor put me on metadate prior to adderall and I had some panic disorders with it, but this was far worse. Then I realized that all of these horrible feelings couldn't be from anxiety. I usually just get the rapid heart beat, short breath, numbness due to hypertension, and chest pains. This was far worse! I felt like a thousand needles were poking into my chest, at time I felt so weak I thought I was going to faint, if I got up too fast I got dizzy spells and everything became a blur to me. I was so scared that I felt like I was going to die. I had read the papers given with the drug and it said to seek medical attention immediately with the symptoms that I had. I didn't want to do anything drastic like call 911, because thats what I did with the metadate and over time i felt fine, so instead I called the poison control hotline on the pamphlet. The woman over the phone said that what I was experiencing was normal and that everything only seems more intense because its late and i'm tired but I can't get any sleep. Her voice and assurance made me feel slightly better, but afterwards things just got worse. I don't understand why this drug had these effects on me when I took the same thing before with no problem! During that time I had anxiety as well, and I still did not have any issues. I love the fact that this drug helps me to remain focus, but the after affects are so horrible. Does anyone know if I can just sprinkle half of the pill in some food or something and I won't have these problems, or if there is something equivalent to adderall without those horrid side effect?

Here's a way out theory about my unique and to me mystifying medical situation....

I recently read where Singulair, an asthma medicine, is suspected of causing suicides, obviously an effect on the brain function. The FDA notes that over the past year, Merck has updated Singulair's prescribing information and patient information to include the following post marketing adverse events: TREMOR (March 2007), (April 2007), suicidally (October 2007), and anxiousness (February 2008). (the tremor highlight is mine since this is a major symptom of Parkinson's )

Well, I took Singulair from 1998 to 2004 and I wonder if maybe, just maybe Singulair could be a contributing factor to my strange Parkinson's but not Parkinson's problems that is
gait,
balance,
freezing of gait problems

Any thoughts or ideas on how I might follow up on my hypothesis?

I have a question that will help me continuing looking for information. I can understand that in the case of asthma that Singulair would provide immediate relief. If it is used for seasonal allergies or other allergies without asthma, does it work right away or does it take a period of days or weeks to be effective? If it takes time, could you tell me how long it took in your situation.

A report from the Netherlands discusses depression. I had failed to notice that the report stated that in three cases the onset of the depression after taking Singulair was from 3-14 days.

Discussion and conclusion
Lareb received four reports of depressive symptoms in patients using montelukast.Possible confounding includes that asthma itself has been associated with the development of depression . Inhalated corticosteroids can also exert effects on the central nervous system. Fluticason in combination with salmeterol which is used by patients A, B and D, is associated with hyperactivity and irritability whereas budesonide, which is used by patient C also has been associated with depression .
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The latency of montelukast-induced depressive symptoms varies from 3-14 days.
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In three of the cases a positive dechallenge was seen. The fact that the patients (except for one) did not suffer from depressive symptoms before they started montelukast, the short latency, and recovery after withdrawal of the drug all strengthen our hypothesis that depressive symptoms are an ADR
related to the use of montelukast.

According to the Marketing Authorisation Holder of montelukast, depression will be added to the product information.

I have mixed feelings about Advair. Quick history-at 30 I was dx with Asthma, at 32-COPD. I went on Advair after the COPD dx. Primarily-it certainly helped my breathing-gloriously. I have since gone on and off Advair periodically. Before last year (Pneumonia)-I had not been on the Advair for more than four months. BUT the Pneumonia combined with the COPD reduced my lung capacity by 25%. I allowed my Dr. to prescribe it indefinitely. However within a year I had gained thirty pounds. I started reading more, and found out that the AMA recommends only a six month duration of Advair therapy. My asthma symptoms had worsened over the last three months of that therapy. My untrained hypothesis is that if you exceed the recommended six month treatment-you will suffer the above outlined side affects. I simply quit it. Granted, my asthma symptoms increased for about three weeks-so I kept my handy little inhaler nearby, and gave myself one month to see if the asthma symptoms would decrease. They did. The long term-I have now been off of the Advair for nine months, and I rarely use my inhaler (knock on wood). The long term benefits of the extended Advair use has been a decreased problem with SOB- yes upon exertion(that is one of the symptoms of COPD), it is still present, but I can usually ride that out with patience, and rest. In conclusion-I would not hesitate to go back on the Advair upon my next COPD exacerbation, but I will absolutely stay within the six month suggested period. And, this time I will eat a lot of lo cal foods. Smile. It is always nice when people with chronic illness can smile over their disease. This has been my experience over the last five years that I have been introduced to Advair. One more suggestion-see if you can get your doctor to try you on the 250/50 before jumping right on the 500. The 500 is noted to have the side affect of increased SOB, and Asthma attacks-more often than the 250. One more note-although your doctor might forget to mention this-Advair is a steroid- and, steroids are known to cause weight gain. What can be done to reduce this affect-I do not know-Prednisone will do it too,now a combination of the two-which I have, of course, utilized a half dozen times or so in the last five years of my dx- is almost a guaranteed weight gain. If you manage to find out how to avoid that particular side affect-please let me know, and suggesting a vigorous work out to a patient with COPD in a bit insensitive, but if you have any other plausible ideas-I am anxious to hear them.