MS: More Women Than Men?

A forum to discuss Chronic Cerebrospinal Venous Insufficiency and its relationship to Multiple Sclerosis.

Re: MS: More Women Than Men?

Postby Cece » Fri Feb 22, 2013 12:01 pm

ljelome wrote:
However, preventing vein wall smooth muscle contraction allows passive dilation
of veins and when a critical diameter is reached, a functioning venous valve becomes dysfunctional
or incompetent. As half of a women’s adult lifetime is under the influence of progesterone,
and this is exacerbated markedly during pregnancy, it is no wonder that primary venous insufficiency
is twice as common in women than in men
.7

Interesting! The difference is that in the legs, a dysfunctional valve means one that is stuck open and weakened and can't close, and so it can't move blood upwards or keep blood from falling downwards, and you end up with pooled blood and varicose veins. That kind of dysfunction can happen in the jugular veins too, and there is some research on it, but until CCSVI there was no research on what is basically the opposite type of abnormality, where the valves are stuck closed.

I am trying to think what effect passive dilation might have on stuck closed valves or on total capacity of the jugulars and other collateral veins. I would think if it does have an effect, it would be a good effect, by increasing capacity in the jugular and collaterals? It would even have an effect on the venules of the brain, but not the capillaries, since those do not have smooth muscle?

Anonymoose, I'm open to the possibility of some CCSVI malformations being congenital and some acquired over time. The valves themselves might be stuck congenitally but not thickened, and then thicken over time. There was the Beirut research that found much more CCSVI in people with RR MS of "advanced duration" which meant over ten years since diagnosis. There is also a new IVUS with 10x the goodness of regular IVUS, and looking at people with CIS using the superIVUS might answer this question. But I don't think any CCSVI researcher has a superIVUS yet! We know that some CCSVI malformations are congenital because they are formed in ways that can't be formed except when initially formed. (I am explaining this oh-so-not-clearly.) Also the emissary veins are fascinating if it can be shown that they are enlarged in people with MS, and if it is true that since the emissary veins are only formed prenatally because they actually run through channels of the skull and so can't be developed later in life, then that is also support for the congenital argument.
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Re: MS: More Women Than Men?

Postby Anonymoose » Fri Feb 22, 2013 1:27 pm

It does seem to make more sense that there is at least one progressive factor leading to the valve malformations causing issues. Otherwise, wouldn't ccsvi'ers wake up around the age of 25 (full maturity?) with the sudden and permanent onset of all of those "disappearing on the table" symptoms? As far as I know, it doesn't happen that way. I don't have any of those symptoms (yet) though so I'm pretty naive as to how they develop.

Regarding the progesterone, I wonder how many of us have varicose veins. I don't. But I've always been short on progesterone. My mother and sister have them and they apparently had plenty of progesterone (fertile myrtles). They don't have MS but one has adult onset diabetes and the other sarcoidosis. But then you have to look at the 297 children and counting mother...Michelle Duggar. If anyone has been exposed to incredible amounts of progesterone, it's that lady. She seems to be quite healthy...must be missing the good genes. :roll:
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Re: MS: More Women Than Men?

Postby ljelome » Sat Feb 23, 2013 5:25 am

Anonymoose wrote:Linda,
That's interesting! "They" seem to be pretty convinced that the valve issues are of a congenital nature rather than something being developed over time. I don't fully understand it but I bet someone else here could explain it better. :)

Dear Anonymoose, i don't fully understand about the book too, i only read about half of the book, but it's too heavy reading stuff for me, the languange and the terms it used....wow God help me...hohoho

But it's really an interesting book to read, maybe we could find out something related to MS.
If anyone needed the link of the book, just search it with the keyword "medicographia95". It's in venous valve topic. There's many writer of the "book" or medical journal who explains about venous disease especially in the lower extremities.
Thank u.
Warm regards,
Linda

|For the joy of the Lord is your strength | A cheerful heart is good medicine, but a crushed spirit dries up the bones| God always leads us to where we need to be, not where we want to be|
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Re: MS: More Women Than Men?

Postby vesta » Sun Feb 24, 2013 3:57 am

I'm glad to see we are moving away from the dogma that vein malformations are solely "truncular" in origin. Why is it so difficult to consider that persistent muscle tension could actually deform the veins? And this could account for the very high incidence of female MS in Scotland, for example.Even Dr. Sclafani is willing to consider muscle tension as a factor (well, more in the immediate than in development.)

Here are some quotes

Cece July 12, 2012
I agree with the truncular malformation argument, ever since the consensus document from the phlebologists back in 2009 or early 2010. But I have wondered if cold affects blood flow and angiogenesis differently than hot does. In the south, if veins are ever dilated due to heat, do the main veins or collateral veins grow bigger during childhood development, and it is enough to counter the effects of the outflow obstructions?

Cece posted Jan 25, 2013
“Certain findings suggested
a reorganization after birth of the venous valves which are frequently met in
fetus. The close relation between hemodynamic mechanisms and the blood guiding
structures may explain the changes (disappearance or persistence) of venous
valves in some areas after birth.”

Cece "I thought this was
interesting. We've talked about the malformation of internal jugular vein
valves as happening during embryological development. I had never heard about
changes in the valves occurring after birth. What sort of changes?
"Disappearance or persistence"? How could a valve disappear?"

Cece posted:Feb 22,2013
However, preventing vein wall smooth muscle contraction allows passive dilation
of veins and when a critical diameter is reached, a functioning venous valve becomes dysfunctional
or incompetent. As half of a women’s adult lifetime is under the influence of progesterone,
and this is exacerbated markedly during pregnancy, it is no wonder that primary venous insufficiency
is twice as common in women than in men.7

Jan 31, 2013. Dr. Sclafani
“if the valve is obstructed, generally what happens is that the
vein above the stenosis starts to dilate or enlarge. Slow flow or stasis
(absence of outflow) occurs. This leads to reduced arterial inflow, poorer
perfusion with oxygenated blood into the brain and reduction in cerebrospinal
fluid drainage and possibly hydrocephalus. Additionally, when the muscles of
the 1neck contract, they MAY cause the pressurization of the blood within the
vein. In the presence of obstruction toward flow into the heart, this blood may
jet into the skull and injure deep cerebral veins.”

Ms Cure Enigmas.net

http://www.mscureenigmas.net/index.html
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Re: MS: More Women Than Men?

Postby Cece » Sun Feb 24, 2013 1:10 pm

vesta wrote:Why is it so difficult to consider that persistent muscle tension could actually deform the veins?

I want more autopsy studies like Dr. Fox's. It showed that actual vein wall stenosis was equally distributed between the pwMS and the healthy controls, but that within-the-vein abnormalities such as septums and bad valves were seen with much greater frequency in the pwMS.

I don't think that persistent muscle tension could deform the valves within the veins? But it could cause "physiological stenosis" which is a temporary narrowing due to being squeezed from outside the vein by the muscles. It's possible that botox to the muscles will help this.

That last quote from Dr. Sclafani is talking about Dr. Schelling's theory of backjets. Congested blood flow in the neck is sitting around, then the neck muscles squeeze, and sudden back jets are forced back up into the cranium at a force great enough to cause injury and/or the MS lesions.

It's ISNVD this weekend. Where is the ISNVD news???? :)

Thanks vesta for putting those quotes together. I sure do talk a lot.
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Re: MS: More Women Than Men?

Postby 1eye » Sun Feb 24, 2013 2:26 pm

Does aldosterone fit the questions about M/F ratio? Is there that kind of difference? The only one I know anything of is testosterone. This peaks at around 18 in men but in women (they do have some) it must be later. There must be both high and low points that can be identified, which might be related to pregnancy or changes in some hormone level related to reproduction.

But I don't know anything about aldosterone, or even if there is that kind of difference. I get that women's stress levels are changing, The changes over time might be driven by society, etc., even in a large subset, even along political lines. It seems to be pretty universal that there is a difference. I think in terms of ballpark numbers and I can't see how epidemiology is going to give us a reliable answer. That there is a difference at all, is IMHO the Big Clue.

I think it's more important to identify which specific hormones, reactions, by-products, etc., are responsible for the clear differences in men and women's risk of having the disease at all, as well as their severity and course if they do get it.

I have heard tell of a "double peak" in incidence. Could that be related to the different M/F curves' peaks of sex hormones?
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Re: MS: More Women Than Men?

Postby Anonymoose » Sun Feb 24, 2013 3:56 pm

Howdy 1eye,

I think the difference between man ms and woman ms lies in the estrogen and progesterone levels. Women's estrogen protects the blood vessels until menopause, which is when, in "normal" women, cardiovascular issues tend to hit. Men obviously dont have that much estrogen to protect their endothelium. So, the aldosterone ruins their veins and causes reduced cerebral perfusion from day 1.

Progesterone is present in both women and men though at different levels.
http://www.ehow.com/facts_5275816_proge ... s-men.html
Normal progesterone levels for men range from 15 to 100 pg/ml. "Pg/ml" stands for picogram per milliliter, with a picogram being one millionth of a gram. In premenopausal women, the normal progesterone levels are 75 to 270 pg/ml.
Progesterone blocks both aldosterone and cortisol receptors. When progesterone drops in women at menopause, ms tends to pick up the pace. I don't think any of this is coincidence. I can feel more ms when my progesterone drops. A post menopausal woman w/ms progresses like a man with ms (Average rate of progression. I recognize there are exceptions but I think a lot of those differences are caused by venous abnormalities like malformed valves and lifestyle factors that influence hormone levels). The difference in progression is ultimately found in the hormones.

And that BIG CLUE leads us directly to the answer. "They" are on the verge of figuring this out. They are sooo close with the amiloride and the lisinopril. They have identified the gene group (CYP450). They have realized there is a connection between congenital adrenal hyperplasia (the form that lacks natural aldosterone production yielding lesions via na/k imbalance and osmotic demyelination) and MS. It's the aldosterone. The one thing MSers all have in common is a constant release of aldosterone and cortisol. As far as I can tell, everything else can be explained from that starting point.

I can also tell you that I have experienced improvements whilst inhibiting aldosterone and cortisol with low dose clonidine and a couple 1/2 cups of hibiscus tea a day (I need between .1 and .2 mg of clonidine and they don't have in between patch doses). My chronic painful stiff neck and shoulders are relaxed. I have regained sensitivity in my hands and nothing buzzes like it used to with stress or activity. I did have some weird sensations while finding the right dose. My energy is back to normal. My mind is crystal clear. I'm very early in ms so I don't really have anything else to improve beyond getting the rest of my hands back. It's working. If there weren't a strong connection, it would not be working.

I think it is a big mistake to ignore our constant release of aldosterone...even for those who have been given a PTA reprieve. The willful denial makes me feel like I am pounding my head against the wall everyday. I suppose we all feel that way about our pet theories though. :/. Sometimes it sucks to care.

What is this double peak??? New to me!
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Re: MS: More Women Than Men?

Postby 1eye » Mon Feb 25, 2013 12:34 pm

Yes, that's what I was on about. CCSVI vs health:

| hormone | EXACERBATES symptom | LESSENS symptom || MALEs |FEMALEs
| | | | | | (y/n/no change) | | | (y/n/no change) | | (more/less/none)

estrogen
progesterone
testosterone
aldosterone
...etc.
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Re: MS: More Women Than Men?

Postby 1eye » Mon Feb 25, 2013 2:10 pm

The double peak is of incidence versus age. I guess there are two ages to get it. Don't think gender applies.
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Re: MS: More Women Than Men?

Postby Anonymoose » Mon Feb 25, 2013 6:07 pm

1eye wrote:Yes, that's what I was on about. CCSVI vs health:

| hormone | EXACERBATES symptom | LESSENS symptom || MALEs |FEMALEs
| | | | | | (y/n/no change) | | | (y/n/no change) | | (more/less/none)

estrogen
progesterone
testosterone
aldosterone
...etc.

Estrogen and testosterone (http://www.sciencedirect.com/science/ar ... 6010000482) are both good for endothelial health. I suppose that's a wash between men and women. Aldosterone definitely bad for endothelial health in high or chronic doses. Progesterone protects by blocking aldosterone. Men have less progesterone and progress faster.

I think the constant release of aldosterone causes ms ccsvi in its own way if you define ccsvi as reduced cerebral perfusion. (Study earlier in this thread)

Soooo...if you even suspect there might be a grain of truth in this theory, why not try to do something about it? This might be the next step or the first step in ccsvi treatment. It's an extension of the central ccsvi premise...and it might be what we need to get the neurologists to take ccsvi seriously...and that just might help raise some funding for the cause...oh, and you might even experience improvements. :roll:

I don't like being so pushy but if I'm the only one who tries this and therefore I'm the only one it helps, I'll just get better and nothing else will come of it. If other people try it and it helps, we move forward and we do it from grass roots. I want that for us. Speaking of grass roots, hibiscus tea is an ACE inhibitor and aldosterone blocker. If you aren't on other meds, you can test the theory w/o a trip to the doctor. 3 cups a day...probably two weeks until you feel improvement which should continue if there is anything to this theory. (More info in clonidine diary thread)
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Re: MS: More Women Than Men?

Postby vesta » Tue Feb 26, 2013 4:34 am

Hi Anonymoose:
I'm willing to try. Where and what do you buy? Do you need to get a Doctor's prescription or is it a supplement? I looked up Aldosterone on Standard Process and the supplement Drenamin came up which I already take one tablet a day. (I have to have someone to send it to me from the US since I live in France.) If I understand correctly you take between .1 and .2 mg of clonidine a day ane drink hibiscus tea. Please clarify (just because I'm lazy, you probably have already said all I need to know.) Thanks
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Re: MS: More Women Than Men?

Postby Anonymoose » Tue Feb 26, 2013 8:41 am

vesta wrote:Hi Anonymoose:
I'm willing to try. Where and what do you buy? Do you need to get a Doctor's prescription or is it a supplement? I looked up Aldosterone on Standard Process and the supplement Drenamin came up which I already take one tablet a day. (I have to have someone to send it to me from the US since I live in France.) If I understand correctly you take between .1 and .2 mg of clonidine a day ane drink hibiscus tea. Please clarify (just because I'm lazy, you probably have already said all I need to know.) Thanks

Hi Vesta,

The clonidine will require a prescription, at least it does in the States. It's used for a lot of off label things, including ADHD in children, so I think you shouldn't have too much trouble finding a doctor to prescribe. I use a .1mg Catapres patch plus 2-3 half cups of hibiscus tea spread throughout the day.

How I got there:
I started on .1mg with a really bad caffeine habit and felt overnight improvements which continued. When I gave up caffeine I could feel my neck tensing up again so my neurologist agreed to up my dose to .2mg. My neck tension went away again but my fingers started shriveling...too much. Call me Goldilocks. So, I went back down to .1mg (felt like I'd thrown myself into relapse for a day YIKES!) and my neck tension started coming back again. I did some googling and found that hibiscus tea (which btw used to be a very common drink in equatorial regions...hmmm) is an ACE inhibitor/aldo blocker that rivals lisinopril in effectiveness. So, I added the tea to my day to find that happy place. I feel so good. If it weren't for the residual sensory issues in my hands, I wouldn't know I have MS. Knock on wood.

An info link for Catapres. http://reference.medscape.com/drug/cata ... BWUg%3D%3D

Posts with links/info about hibiscus tea (also works for insulin resistance, link in lyndacarol's insulin: could this be key? thread)
general-discussion-f1/topic21505-30.html#p205243

If you can't get the clonidine, I think the hibiscus tea might help anyway. As for the adrenal supplement, I'd probably take a break from that and maybe add it back in later??? I don't think that it would necessarily hurt though.

If/when you start clonidine, you'll probably be a bit sleepy the first day. Just take it easy. It will go away. My neck/shoulder tension disappeared over the first night. If you enjoy the same kind of result, I think it will work for you too. The protective patch included with the drug itches like crazy! I use waterproof silicone body tape to cover it instead. You will also want to ensure you are getting adequate potassium as clonidine can lower it via it's diuretic effect (I didn't even notice this until my fingers shriveled on .2mg). Drink lots of orange juice and coconut water and eat bananas, potatoes with skin, and other foods rich in potassium.

Finally, YAAAAAAAAAYYYYY! I can't wait to see if I'm not just the best placebo effectee in the world. And if I'm not...maybe everyone here can feel better with a sticker and some tea. :D Thank you, Vesta.
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Re: MS: More Women Than Men?

Postby vesta » Wed Feb 27, 2013 7:26 am

Hi Anonymoose :
Your theory on Aldosterone and Cortisol would seem to give a Scientific biochemical explanation for thousands of years of Chinese Medical Theory observation as well as bridge the gap between the practices of Neurology and Interventional Radiologists, thus reconciling Neurologists to treating MS as a circulatory disorder. If a low dose Clonidine patch and Hibiscus Tea suffice to put an end to a “chronic painful stiff neck and shoulders” and accompanying MS symptoms (caused by blood reflux into the CNS), Neurologists can prescribe this at least at first before launching the patient into potentially harmful (and useless ?) immunosuppressive drugs, and patients will feel re-assured they are being treated by real medicine since they are often wary of anything smacking of “natural” healing. Also, if the patient suffers from a more serious CCSVI stenosis, Neurologists might more freely refer her to an Interventional Radiologist without feeling upstaged.

Allow me to explain. I have described on my site how I feel Chinese Medical theory might explain the epidemiological factors in MS with emphasis on the Meridiens running from the head down the neck, shoulders and spine – Gall Bladder and Bladder. After I heard about Dr. Zamboni’s CCSVI theory I began to give myself daily Acupressure treatments to open blood circulation from the head using these Meridiens, thus keeping my disease under control. The Bladder meridian partner is the Kidney meridian which is actually the Kidney/Adrenals, belonging to the Water element which is injured through cold and Fear. There you have it. Fight or Flight. Stress. So the Acupuncture treatments open the blood circulation, at least temporarily, and relieve the blood reflux. I believe the detoxification/supplement/nutritional therapies minimise the muscle tension and probably have a biochemical impact on the hormones triggering the muscle/vascular stress. Do they have any impact on the Aldosterone or Cortisol? Don't know. People should refer to your discussion under this thread “MS:More Women Than Men” to see how you link the role of female hormones to Aldosterone – vascular health and all the rest because I’m not equipped to do so. It makes much sense and the solution for many strikes me as so simple.

I myself will start the Hibiscus tea today. As for the patches I will see a Doctor in 2 weeks, though when I see all the side effects I’m a bit wary. But most people want a Doctor to prescribe a drug rather than be bothered with TENS self acupressure or other self help protocols so I think you’ve found an opening for drug therapy to treat the body tension leading to the blood reflux, that is to say, drug therapy for the real problem rather than immunosuppressive drugs which aim at a secondary problem. (Well, diet change is still a good idea to enhance one's health overall.)
Already Doctors are prescribing drugs "off label" for MS patients which treat blood circulation issues.

Quotes from your posts above.

“The one thing MSers all have in common is a constant release of aldosterone and cortisol. As far as I can tell, everything else can be explained from that starting point…

I can also tell you that I have experienced improvements whilst inhibiting aldosterone and cortisol with low dose clonidine and a couple 1/2 cups of hibiscus tea a day (I need between .1 and .2 mg of clonidine and they don't have in between patch doses). My chronic painful stiff neck and shoulders are relaxed. I have regained sensitivity in my hands and nothing buzzes like it used to with stress or activity. I did have some weird sensations while finding the right dose. My energy is back to normal. My mind is crystal clear. I'm very early in ms so I don't really have anything else to improve beyond getting the rest of my hands back. It's working. If there weren't a strong connection, it would not be working.

I think it is a big mistake to ignore our constant release of aldosterone...even for those who have been given a PTA reprieve. The willful denial makes me feel like I am pounding my head against the wall everyday.”

Thanks for the great idea. Let's hope more consider the option.

MS Cure Enigmas.net
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Re: MS: More Women Than Men?

Postby Anonymoose » Tue Mar 12, 2013 8:59 am

Vesta,

In case you didn't notice my warning against clonidine or hibiscus tea in the other thread, step away from the tea!! I don't think we all have the exact same endocrine or whatever issues and someone with low blood pressure is likely to be worse off taking clonidine or drinking hibiscus tea. I didn't want it to be so, but darn it if MS is indeed an overly-complicated beast.

Anyway, to get back on topic...the men vs women thing. I just ran into this.
http://onlinelibrary.wiley.com/doi/10.1 ... x/abstract
Observations so far obtained in experimental autoimmune encephalomyelitis (EAE) have revealed the promising neuroprotective effects exerted by progesterone (PROG). The findings suggest that this neuroactive steroid may potentially represent a therapeutic tool for multiple sclerosis (MS). However, up to now, the efficacy of PROG has been only tested in the acute phase of the disease, whereas it is well known that MS expresses different features depending on the phase of the disease. Accordingly, we have evaluated the effect of PROG treatment in EAE induced in Dark Agouti rats (i.e. an experimental model showing a protracted relapsing EAE). Data obtained 45 days after EAE induction show that PROG treatment exerts a beneficial effect on clinical score, confirming surrogate parameters of spinal cord damage in chronic EAE (i.e. reactive microglia, cytokine levels, activity of the Na+,K+-ATPase pump and myelin basic protein expression). An increase of the levels of dihydroprogesterone and isopregnanolone (i.e. two PROG metabolites) was also observed in the spinal cord after PROG treatment. Taken together, these results indicate that PROG is effective in reducing the severity of chronic EAE and, consequently, may have potential with respect to MS treatment.

This perhaps more directly explains the slower progression in women due to our much higher levels of progesterone. (I've seen claims that women progress at the same rate as men too. What's up with that?) I'm not sure how that would play into our higher incidence of MS though. Maybe greater fluctuations in electrolytes causing more opportunity for BBB breakdown?
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Re: MS: More Women Than Men?

Postby dania » Tue Mar 12, 2013 9:57 am

Just some food for thought.
Dr Scott Rosa's theory, accidents/trauma causing misalignment of the spine can impair CSF flow. This is what he thinks starts the downhill spiral of MS. Because women are less strong muscularly they are less likely to hold the Atlas in alignment with a trauma.This theory can also answer why MS is more prevalent in countries further away from the equator. We ski, snowboard, horseback ride, etc, in other words engage in dangerous sports that can cause trauma. The countries closer to the equator are hot, poorer and do not engage in risky sports. Canada has one of the higher rates of MS but oddly the Inuit that live the closest to the north pole rarely get MS.They do not engage in risky sports but get less sunshine then most people.
Also see link below to how a woman's vascular system changes with pregnancy.

http://www.ehow.com/about_4707241_vascu ... nancy.html
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