Does May Thurners cause demylination/CNS damage, or just DVT

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Does May Thurners cause demylination/CNS damage, or just DVT

Postby adamt » Fri Aug 20, 2010 3:08 pm

So ive been liberated in the IJVs, azygos was fine, but i also have May Thurners- left illiac vein narrowing,

i only have tenderness/stinging in my left thigh and not Deep vein thrombosis, swelling etc.

As i only got liberated on Sunday i dont want to rush to get the left illiac vein ballooned/stented for at least one month, this is to not make too many changes at once so i wont know what is causing any changes

I have noticed since the ballooning of the IJVs the left leg thigh tenderness/stinging has increased and is more frequent.
im guessing this is because as blood now flows freely through the IJVs, more blood is getting blocked in the left illiac vein,
does that sound right?


But i was wondering can May Thurners cause demylination, lesions or CNS damage, as if it can i think i will have to get the May Thurners treated a/s/a/p

or is it just causing the slight discomfort of tender left thigh?

thanks
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Postby Nunzio » Fri Aug 20, 2010 6:03 pm

This might answer your question; it is from a previous post from May-Thurner and MS.
Nunzio wrote:
KDGO wrote:What should an IR do if there is no symptom of clotting, pain, swelling etc however the MRV picture presents M-T? Do they angio & conctrast nyway to make sure all is ok or just leave it alone?

The idea is that if you have M-T then the return blood from the leg, instead of draining in the IVC it goes through collaterals to the Azygous vein and overload it so it cannot drain blood from the spinal cord properly.
So, if you have MS have M-T fixed, and have them check the renal vein too.
good luck.
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Postby Cece » Fri Aug 20, 2010 6:15 pm

As in Nunzio's post, the reason May Thurners can harm the spinal cord is because the blood that should've gone through the May Thurners blockage is instead rerouted to the azygous which in ccsvi does not have the capacity to carry its own load, let alone the iliac vein's load too, and over time you get the spinal cord damage.
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Postby adamt » Sat Aug 21, 2010 12:29 am

oh dear, i guess i should get the MT ballooned/stented A,s,a,p then

or do you think i sould hold out for a few weeks to watch for changes/improvements first?


Cece - you said:
May Thurners blockage is instead rerouted to the azygous which in ccsvi does not have the capacity to carry its own load, let alone the iliac vein's load too, and over time you get the spinal cord damage.


As my Azygos was fine/normal and had No CCSVI, would this mean i wont get the spinal cord damage?
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Postby jimmylegs » Sat Aug 21, 2010 8:38 am

i can't answer that question adam but i've been having a think about all this:

i looked into DVT, and associated antithrombin (AT) deficiency (AT is not only anticoagulant but also anti-inflammatory and antiproliferative).

where AT is synthesized? in hepatocytes, the main tissue cells of the liver.

how does the body build liver tissue, so that it can make AT? here's what i found:

from Essentials of Stem Cell Biology:
The liver is known to have a very high capacity for regeneration. In fact, mammals (including humans) can survive surgical removal of up to 75% of the total liver mass. The original number of cells is restored within 1 week and the original tissue mass within 2 to 3 weeks.


from wikipedia:
HNF4 (Hepatocyte Nuclear Factor 4) is a nuclear receptor protein ... that is critical for liver development


from J Molecular Endocrinology:
...HNF41 positively regulates genes involved in the transport of lipids and vitamins as well as genes involved in lipid, amino acid, and glucose metabolism. It also regulates genes involved in the regulation of several serum proteins such as blood coagulation factors, erythropoietin, and antithrombin III.


can anything affect the amount of HNF4 available?
from Am J Pathology - an article on alcoholic mice:
Zinc-enhanced liver regeneration was associated with an increase in hepatocyte nuclear factor-4 (HNF-4), a liver-enriched, zinc-finger transcription factor.


so, possibly zinc repletion could optimize antithrombin synthesis and maybe prevent DVT???

however,
Summary: Antithrombin 3 deficiency... an autosomal dominant disorder causing hypercoagulability and recurrent thrombosis.


so, if DVT in may thurner syndrome is from antithrombin deficiency... and antithrombin deficiency is genetic...

could zinc deficiency affect a genetic problem...?

from J Human Nutrition: Human Zinc Deficiency
Notable examples that have been suggested but that require further research include involvement in the regulation of cellular growth and differentiation, including gene expression, and in the regulation of apoptosis(Zalewski et al. 1994 ).
The other is the central but still incompletely understood role, or complex combination of roles, that zinc has in gene expression and in cellular growth and differentiation.
Even a partial understanding ... alerts us to the special vulnerability to an inadequate supply of zinc of the rapidly growing embryo, fetus, infant and young child or of the patient mounting an immune response or requiring tissue repair. ...the extraordinary rapidity ... effects of dietary zinc restriction on growth and differentiation ... correctly alerts us to the special vulnerability to zinc deficiency of cells that are rapidly turning over, notably those of the immune system...
. or, the liver.

and lastly, recalling '(HNF-4), a liver-enriched, zinc-finger transcription factor' (same article Human Zinc Deficiency)
Other zinc atoms have specific structural roles in enzyme molecules as well as in many other proteins and in biomembranes. ... One outstanding example that has generated a great deal of recent interest is the zinc finger motif (Berg and Shi 1996 , Rhodes and Klug 1993 ), the most common recurring motif in transcription proteins. The configuration of these "fingers," which determines their binding to DNA, is determined by the single zinc atom at their base. The linking of these zinc fingers to corresponding sites on DNA initiates the transcription process and gene expression.


so it looks like yes, zinc deficiency could affect a genetic problem, especially in high cell turnover areas of the body like the liver.

we know that zinc tends to be in the lower end of the 'normal range' in MS patients, compared to healthy controls. could low zinc be linked to comorbities such as DVT in patients with more serious manifestations of may thurner syndrome?
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Postby adamt » Sat Aug 21, 2010 9:29 am

thank you jimmy for this detailed reply, but was this posted in the wrong message?

i cant make out how this all applies to may thurners and increased tenderness of the left thigh since liberation and whether i should get treated for MT a.s.a.p?
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Postby jimmylegs » Sat Aug 21, 2010 6:21 pm

it's a may thurner syndrome potential treatment theory. it would be cheap and non-invasive. you may want to find out what your zinc level is and optimize it, could have an effect on your ms and your may thurner syndrome because of the links described above.
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Postby adamt » Sun Aug 22, 2010 11:44 am

oh i see jimmy,

i always take 50mg zinc each morning with 2mg copper at night,

ill try increasing the zinc dose to 75-100mg every morning and hopefully that will alleviate my MT symptom - stinging/tender left thigh

thanks
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Postby selkie » Sun Aug 22, 2010 12:14 pm

Adam you may also want to check w/Dr. S on this or a vascular doctor. If you azygos is truly fine (and depending on your age), I'd think they wouldn't want to do anything invasive, just a guess. Maybe there's non-invasive ways like the supplements jimmylegs suggested. But for your own peace of mind, you may want to check w/a dr too
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Postby jimmylegs » Sun Aug 22, 2010 12:48 pm

adam, yeeks!! do you do bloodwork so that you know where your copper/zinc ratio is at?

i would not say right off to add zinc. (edit: especially now that i can see your daily intakes of copper and zinc).. you might want to back off on the copper. hard to say without a lab result or two.
Last edited by jimmylegs on Mon Aug 23, 2010 10:03 am, edited 1 time in total.
my approach: no meds so far - just nutrient-dense anti-inflammatory whole foods, and supplements where needed
info: www.whfoods.com, www.nutritiondata.com
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Postby adamt » Sun Aug 22, 2010 1:15 pm

jimmylegs wrote:adam, yeeks!! do you do bloodwork so that you know where your copper/zinc ratio is at?

i would not say right off to add zinc. might want to back off on the copper. hard to say without a lab result or two.


oh right i didnt realise the ratio had to be precise,

but for the last 3 years i have been taking etween 50-100mg of zinc, and 2-8mg of copper,

aslong as im taking both zinc and copper, does the ratio matter so much ?
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Postby adamt » Sun Aug 22, 2010 1:16 pm

selkie wrote:Adam you may also want to check w/Dr. S on this or a vascular doctor. If you azygos is truly fine (and depending on your age), I'd think they wouldn't want to do anything invasive, just a guess. Maybe there's non-invasive ways like the supplements jimmylegs suggested. But for your own peace of mind, you may want to check w/a dr too


thanks Selkie, i have asked the question on Dr S's thread,

Im 25 . why wouldnt they want to do anything invasive ?
- it would just be a stent or balloon angioplasty of the left illiac , instead of the IJVs, which seems closer/easier than the IJVs

May Thurner treatment has been done for years whereas CCSVI treatment is new
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Postby jimmylegs » Sun Aug 22, 2010 4:27 pm

cu/zn ratio is in a lot of literature on health. the levels and balance are quite important!

i would say your zinc intake is dangerously high and it's only the size of your copper intake that might *possibly* be keeping your zinc in a suboptimal state..high copper can still give the effect of low zinc... it's impossible to say without bloodwork.

i can't even really hypothesize as i have never heard of someone taking up to 100mg zn and up to 8mg cu per day, in the long term.

i will get you a bit more info on levels and ratios but seriously please get some tests, it's dangerous to have too much of these metals in your system.

i'll dig up some info for you. i'll look for possible connections to your symptom also.

ttfn

oh right i didnt realise the ratio had to be precise,

but for the last 3 years i have been taking etween 50-100mg of zinc, and 2-8mg of copper,

aslong as im taking both zinc and copper, does the ratio matter so much ?
Last edited by jimmylegs on Mon Aug 23, 2010 4:54 am, edited 2 times in total.
my approach: no meds so far - just nutrient-dense anti-inflammatory whole foods, and supplements where needed
info: www.whfoods.com, www.nutritiondata.com
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Postby Cece » Sun Aug 22, 2010 11:36 pm

adamt wrote:oh dear, i guess i should get the MT ballooned/stented A,s,a,p then

or do you think i sould hold out for a few weeks to watch for changes/improvements first?


Cece - you said:
May Thurners blockage is instead rerouted to the azygous which in ccsvi does not have the capacity to carry its own load, let alone the iliac vein's load too, and over time you get the spinal cord damage.


As my Azygos was fine/normal and had No CCSVI, would this mean i wont get the spinal cord damage?

I don't honestly know, I'd recommend a doctor with MT experience to help with that decision. And even then the doc with MT experience won't have CCSVI experience.

Different docs find azgyous stenosis in different ratios; Dr. Zamboni found a lot of azgyous involvement, so I tend to think he's right and other docs are missing and undertreating it, but who knows?

Other thing to consider would be if you have any spinal cord involvement or lesions. They might indicate a azgyous or MT problem, I think, but so much not known still.

If the azygous is truly fine, then maybe it can handle the extra flow from the MT back-up. Just love (not) how big medical decisions are made on the strength of a 'maybe'...wish this were easier.

There is still risk in stenting a MT narrowing. Over time the stent could occlude and block the flow. But a doctor would help with the decision of if the benefit outweighs the risk.
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Postby jimmylegs » Mon Aug 23, 2010 5:03 am

adam, i put together a bunch of abstracts but why don't you go to
scholar.google.com
and paste in these search terms:

high cu/zn ratio patients controls

and have a scan of the study titles returned..

here are one or two pertinent results:

Significance of serum trace element status in patients with rheumatic heart disease
http://www.springerlink.com/content/906k0757nq123l3m/
...RHD patients had significantly lower serum concentrations of Se and Zn than control subjects (p<0.05 and p<0.001, respectively). However, the serum Cu concentration was significantly higher in RHD patients than in controls (1.93±0.59 μg/L vs 1.06±0.29 μg/L; p<0.001). Similarly, the Cu/Zn ratio in RHD patients was higher than in control subjects (4.70±0.92 vs 1.68±0.45; p<0.001)... We suggest that Se and Zn deficiency might be contributory factors in the development of rheumatic heart disease, and a high Cu concentration and a high Cu/Zn ratio might reflect an ongoing inflammatory process in this disease.

Analysis of serum copper and zinc concentrations in cancer patients
http://www.springerlink.com/content/m4874785647477k0/
...The aim of the present study was to compare the serum copper and zinc levels in patients with cancer of the lung (PC), breast (BC), gastrointestinal tract (GIC), and gynecological (GYNC) malignancy with progress of the disease. The results of the study have shown a significant increase in the mean total serum Cu levels and the serum Cu/Zn ratio in all patient groups with cancer compared to a control group..
my approach: no meds so far - just nutrient-dense anti-inflammatory whole foods, and supplements where needed
info: www.whfoods.com, www.nutritiondata.com
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