Vascular health

If it's on your mind and it has to do with multiple sclerosis in any way, post it here.
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gibbledygook
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Vascular health

Post by gibbledygook »

My mother had very severe MS and always used to bruise like a peach and had lots of little spidery veins in her legs as she got older but not many varicose veins. I too used to bruise like a peach but seem to have, perhaps temporarily, stopped. I was wanting to find out from everyone how they view their vascular health. Do you bruise easily? Do you have many spider veins on your face/legs? Do you have any coagulation disorders? Do you have blood viscosity disorders? What is your blood pressure like in general?
3 years antibiotics, 06/09 bilateral jug stents at C1, 05/11 ballooning of both jug valves, 07/12 stenting of renal vein, azygos & jug valve ballooning,
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CureOrBust
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Post by CureOrBust »

My mother has had vascular issues (no MS); spidery veins, she also had an issue with constant pulse sound coming into her ear, but that just went (the dr's were advising to operate). As i am getting older, on my ankles I am noticing slightly spider'ed veins.

I had 1 case of thrombosis in one leg, but that appears to have resolved.

I have very good pressure, as in low.

However, I always find my heart rate at rest is on the high side. When I exercise, it appears good, and recovers well which indicates good health (cardio).

I don't think I have explicitly had a test of my blood viscosity, so dont explicitly know that one either way.

As for bruising, I don't think I bruise easily (I had a girlfriend that bruised VERY easily, so I feel like concrete). However, having MS means I bump into things often, and end up with bruises more than the average person.
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cheerleader
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Post by cheerleader »

Hi Alex-
Thanks for the poll.
Jeff has always bruised easily. His arm was green and yellow the day we got married, because his blood test for our license ruptured a vessel. 8O
He's always got a few bruises.

He has normal/low blood pressure.
Lots of petechiae (bloodspots) on lower legs are forearms.
Since testing, we know he has hypercoagulating (sticky) blood
Has had elevated liver enzymes, high SED rate on ESR test
He gets those headaches where the veins in the head bulge (intracranial hypertension headaches)
Temperature issues (cold feet and hands) sensitive to heat and cold-
-He's doing better on our blood thinning routine-past two weeks, no new petechiae, no headaches, no new bruises.
Husband dx RRMS 3/07
dx dual jugular vein stenosis (CCSVI) 4/09
http://ccsviinms.blogspot.com
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gibbledygook
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Post by gibbledygook »

Interesting. I am now, after my salvia and gingko experiments, convinced that a very significant role in MS is played by a dysfunctional vasculature and a tendency to very thick/coagulated blood. I myself always have had low blood pressure which is kind of odd. If one has a lot of vasoconstriction and coagulating blood one would have thought that one would get high blood pressure. Equally a tendency to bruise is usually considered a sign of thin blood. I reckon in MS there is something very unusual happening to the blood and endothelium.
3 years antibiotics, 06/09 bilateral jug stents at C1, 05/11 ballooning of both jug valves, 07/12 stenting of renal vein, azygos & jug valve ballooning,
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jimmylegs
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Post by jimmylegs »

i am sort of starting to notice the odd spidery vein here and there on the insides of my feet just below the ankle. i am kind of bruisy, but i'm not wrapped in padding most of the time so i don't know if it's 'abnormal'. i tend to have low blood pressure with the lowest test i can recall at 80 over 50 or something like that.
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lyndacarol
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Vascular issues

Post by lyndacarol »

Gibbledygook--I think this informal poll could collect some very important ideas. I, too, think vascular health is critical to MS. (Of course, I think that excess insulin is damaging the inside walls of the blood vessels. I think this accounts for the burning sensation I have--like lye in the pipes.)

In my case, my extremities (hands and feet--even up to my knees!) are constantly cold. I get bruises on my legs and arms for no reason at all--they come and go at will. No spider veins. My blood pressure is always normal. No coagulation testing ever done. You do know that insulin promotes blood clots, don't you?
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gibbledygook
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Post by gibbledygook »

Hi Lyndacarol, I must confess to not knowing much at all about the insulin connection with damage to the endothelium. What I do know is that endothelin 1, a signalling protein, which causes vasoconstriction is massively overexpressed in MS patients and that if you take salvia which inhibits this you get a complete change in MS symptoms!! It seems like quite a few of us have an inexplicable tendency to bruise yet tend to have low blood pressure. Maybe the blood is so thick it doesn't move at all!! Here are some interesting bits and pieces on blood flow:
1: Eur J Neurol. 2008 Jul;15(7):725-9. Epub 2008 May 24. Links
Changing cerebral blood flow velocity detected by transcranial Doppler ultrasound during head up tilt in patients with multiple sclerosis.Gonul M, Asil T, Balci K, Celik Y, Turgut N, Uzunca I.
Erzurum Numune Hospital, Clinics of Neurology, Erzurum, Turkey.

BACKGROUND AND PURPOSE: Multiple sclerosis (MS) is a chronic inflammatory disease of central nervous system. We aimed to investigate the cerebral blood flow velocity (CBFV) changes in MS by transcranial Doppler. METHODS: Twenty patients with MS, 20 age-matched healthy controls were included in the study. In both groups, blood flow velocities (BFVs) of middle cerebral arteries (MCAs) were evaluated. The changes of blood pressure, heart rate along with the changes in BFV of MCA were recorded after the patients were raised to upright position. RESULTS: In both groups, upon raising the tilt table to the upright position, the mean CBFV values were found to be lower in comparison with the recorded baseline values (P values <0.05). The decline in the mean CBFV values was more significant in patients with MS (P = 0.01). CONCLUSION: Our study showed upon raise of the tilt table, the mean BFVs decreased more in MS patients than control group with a more prominent change in the subgroup of MS patients with expanded disability scale scores > or =2. By use of transcranial Doppler ultrasound, it may be possible to evaluate BFV changes in patients with MS.

PMID: 18505409 [PubMed - indexed for MEDLINE]
link
1: Med Hypotheses. 2008;70(6):1112-7. Epub 2008 Feb 20. Links
Raised venous pressure as a factor in multiple sclerosis.Talbert DG.
Institute of Reproductive and Developmental Biology, Imperial College School of Medicine, Du Cane Road, London W12 ONN, United Kingdom. d.talbert@imperial.ac.uk

It is hypothesised that the inflammatory condition seen in MS and the progressive myelopathy that is being successfully halted by obliteration of dural arteriovenous fistulas (DAVFs), may actually be two sides of the same coin. Excessive venous hypertension can stretch vein walls sufficiently to separate the tight junctions between endothelial cells forming the blood-brain-barrier (BBB). Colloids, etc., but not necessarily erythrocytes, could then pass through the exposed porous basement membranes. The resulting changes in osmotic pressure, etc. would disrupt the axon and dendrite internal transport systems, leading to their disintegration. The normal inflammatory processes which would follow, might be indistinguishable from those associated with autoimmune disease. Ascending progressive myelopathy and disablement are associated with an intracranial DAVF when its outflow enters the spinal venous system and descends past the cervical region. This can be arrested, and some degree of recovery produced, if the DAVF can be successfully eliminated or blocked. However, if the DAVF outflow is entirely into the spine, intracranial venous pressure may be normal and so there is nothing to alert the clinician to the presence of an intracranial DAVF. It is suggested that where spinal MS has been diagnosed from clinical observations, patients should be referred for angiological investigation to search for DAVFs within the head to identify any treatable subjects.

PMID: 18079069 [PubMed - indexed for MEDLINE]
link
1: Clin Neurophysiol. 2004 Jun;115(6):1473-8. Links
Cardiovascular autonomic dysfunction correlates with brain MRI lesion load in MS.Saari A, Tolonen U, Pääkkö E, Suominen K, Pyhtinen J, Sotaniemi K, Myllylä V.
Department of Neurology, Oulu University Hospital, P.O. Box 25, 90029 OYS, Oulu, Finland. anne.saari@ppshp.fi

OBJECTIVE: The aim of the present study was to investigate the cardiovascular autonomic control in clinically definite multiple sclerosis (MS) patients with a standardised battery of cardiovascular tests and to correlate these findings with the brain magnetic resonance imaging (MRI) lesion load. METHODS: Fifty-one patients with MS and 50 healthy controls were studied. Brain MRI was performed in all patients showing typical MS lesions. The cardiovascular tests were carried out using a standardised battery. RESULTS: Heart rate (HR) responses to deep breathing (P < 0.05) and tilt table testing (P < 0.001) were significantly decreased in MS patients when compared to those of the controls. Blood pressure (BP) responses in the tilt table test were also impaired in MS patients (diastolic P < 0.001, systolic P < 0.05). Of the different brain areas investigated the total volume of the midbrain MRI lesions (P < 0.05) was the one most clearly associated with the impaired BP responses. CONCLUSIONS: MS results in both reduced HR variation and decreased BP reactions indicating disturbed cardiovascular regulation. In particular, the midbrain lesions found in MS are associated with cardiovascular dysfunction.

PMID: 15134718 [PubMed - indexed for MEDLINE]
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1: Med Hypotheses. 1986 Oct;21(2):141-8. Links
Damaging venous reflux into the skull or spine: relevance to multiple sclerosis.Schelling F.
Unequal propagation of central venous excess pressure into the different cerebral and spinal venous drainage systems is the rule rather than the exception. The intensity of the forces thus to be exerted on vulnerable cerebrospinal structures by the resulting pressure-gradients in the craniovertebral space is unknown. There is a need to consider the various conditions which may cause individual proneness to heavier reflux into particular cerebral as well as epi- and subdural spinal venous compartments. An attempt is made to indicate eventual consequences of excessive retrograde dilatation especially of internal cerebral veins. The importance of elucidating the neuropathological and clinical implications of undue reflux into the skull or spine is deduced from the probability of relations between localized backflow into the craniovertebral space and unexplicated cerebrospinal diseases. In this regard the features of multiple sclerosis are discussed.

PMID: 3641027 [PubMed - indexed for MEDLINE]
link

If we all generally have low cerebral blood pressure, perhaps as a result of problems in the renin-angiotensin system ie the kidney/heart, then the veins and capillaries might try to overcompensate by vasoconstricting. This might cause a sort of venous hypertension which from time to time becomes too much and then bursts allowing blood and inflammation into the CNS. Howzat as a theory?!!!

How many people have had kidney infections? My mother had several debilitating attacks on her kidney. I was hospitalized for 5 days with one.

Anyone else have kidney infections/problems?
3 years antibiotics, 06/09 bilateral jug stents at C1, 05/11 ballooning of both jug valves, 07/12 stenting of renal vein, azygos & jug valve ballooning,
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CureOrBust
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Post by CureOrBust »

nope, kidneys been quiet, as one would hope for most internal organs.
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lyndacarol
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Post by lyndacarol »

My contribution: no kidney problems--function is fine (unless you count the painful passing of a kidney stone a year ago; CT scan found no other stones in either kidney).
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gibbledygook
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Post by gibbledygook »

mmm. Okay, I think the renin-angiotensin link may be more difficult to establish, but there does seem to be signs that many people have vascular issues. This is interesting. I can't wait to complete my experiment on gingko, horsechestnut and hesperidin, all of which are active on the vascular system.
3 years antibiotics, 06/09 bilateral jug stents at C1, 05/11 ballooning of both jug valves, 07/12 stenting of renal vein, azygos & jug valve ballooning,
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gibbledygook
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Post by gibbledygook »

Vascular dysfunction also characterizes rheumatoid arthritis:
1: J Rheumatol. 2008 Mar;35(3):398-406. Epub 2008 Jan 15. Links
Endothelial dysfunction and atherosclerosis in rheumatoid arthritis: a multiparametric analysis using imaging techniques and laboratory markers of inflammation and autoimmunity.Kerekes G, Szekanecz Z, Dér H, Sándor Z, Lakos G, Muszbek L, Csipö I, Sipka S, Seres I, Paragh G, Kappelmayer J, Szomják E, Veres K, Szegedi G, Shoenfeld Y, Soltész P.
Cardiovascular Unit, Division of Rheumatology, and Laboratory of Immunology, Third Department of Medicine, Hungary.

OBJECTIVE: Cardiovascular disease is a leading cause of mortality in rheumatoid arthritis (RA). Endothelial dysfunction often precedes manifest atherosclerosis. We assessed endothelial dysfunction and atherosclerosis in RA in context with laboratory markers. METHODS: Fifty-two patients with RA and 40 matched healthy controls were studied. We assessed common carotid intima-media thickness (ccIMT) and flow- (FMD) and nitroglycerine-mediated vasodilation (NMD). We also assayed numerous immunological and metabolic laboratory markers. RESULTS: FMD was significantly lower in RA (5.32% +/- 4.66%) compared to controls (8.30% +/- 3.96%) (p = 0.001). NMD was preserved in RA. ccIMT was significantly greater in patients with RA (0.63 +/- 0.14 mm) versus controls (0.54 +/- 0.15 mm) (p = 0.012). In patients with RA, ccIMT correlated with FMD% (R = -0.318, p = 0.022), age (R = 0.831, p < 0.001), and anti-dsDNA levels (R = 0.463, p = 0.006). FMD% correlated with serum interferon-gamma (IFN-gamma) levels (R = 0.516, p = 0.014). NMD% correlated inversely with the percentage of Th0 lymphocytes (R = -0.636, p = 0.006), serum immune complex (R = -0.692, p < 0.001), and IgM levels (R = -0.606, p = 0.003). Patients with RA were divided as "low" (< 0.65 mm) versus "high" (> 0.65 mm) ccIMT groups, and into "normal" (> 5%) versus "impaired" (< 5%) FMD% subsets. Low and high ccIMT groups differed significantly in age and serum interleukin 1 (IL-1) and anti-dsDNA levels. RA patients with normal versus impaired FMD% differed significantly in age, disease duration, and serum IFN-gamma levels. Lipoprotein(a) [Lp(a)] also correlated with rheumatoid factor (RF) and C-reactive protein (CRP); homocysteine (HCy) correlated with CRP and correlated inversely with folate and vitamin B12 production. Paraoxonase-1 (PON-1) activity correlated with serum tumor necrosis factor-alpha(TNF-alpha) and IL-6 levels. CONCLUSION: This was a well characterized RA population, where FMD and ccIMT were impaired, indicating early endothelial dysfunction and accelerated atherosclerosis, respectively. RA-related autoimmune-inflammatory mechanisms and metabolic factors including anti-CCP, RF, CRP, circulating immune complexes, IgM, TNF-alpha, IL-6, Th0/Th1 ratio, HCy, folate, vitamin B12, and PON-1 may all be involved in the development of vascular disease in RA. Although ccIMT and FMD, as well as some laboratory factors, have been assessed by other investigators in RA-associated atherosclerosis, our results regarding the possible involvement of anti-CCP, anti-dsDNA, Lp(a), some cytokines, and PON-1 activity are novel. Early determination of FMD% and ccIMT may be useful to assess RA patients with high cardiovascular risk.

PMID: 18203326 [PubMed - indexed for MEDLINE]
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Last edited by gibbledygook on Tue Oct 21, 2008 8:02 am, edited 1 time in total.
3 years antibiotics, 06/09 bilateral jug stents at C1, 05/11 ballooning of both jug valves, 07/12 stenting of renal vein, azygos & jug valve ballooning,
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Sharon
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Post by Sharon »

I have had varicose veins since high school - an inherited trait from my mother's side. In 1991 I had a vein stripping on my left leg - started having minor problems with my leg and foot soon after the stripping. (this was thirteen years prior to the MS dx). My blood pressure is low to normal.

My brother who also has MS has low blood pressure and has had vein strippings on both legs.

Sharon
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gibbledygook
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Post by gibbledygook »

No way, really?! Have you tried horsechestnut? Or hesperidin? Or diosmin? These are said to be good for varicose veins and generally strengthen the veins and capillaries. Maybe gingko would be good. If you can strengthen the vasculature I'm sure all the problems in the CNS will diminish or even disappear.

I've been trying quite high dose gingko (4.8grams daily) for the last few weeks and the good results have been very noticeable (much reduced night pain/hardly a spasm). I'm sure a lot of us should be trying herbs/drugs that affect the vasculature such as gingko, horsechestnut, hesperidin, salvia, diosmin etc.
3 years antibiotics, 06/09 bilateral jug stents at C1, 05/11 ballooning of both jug valves, 07/12 stenting of renal vein, azygos & jug valve ballooning,
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cheerleader
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Post by cheerleader »

There's our old foe, endothelium dysfunction, Alex!
For those (like me) who didn't know what this was all about...
the endothelium is the thin cellular lining of the blood vessel wall. Endothelium dysfunction is implied in all inflammatory diseases, as well as cardiovascular disease and diabetes....and MS.
If the endothelium is damaged, cells can leak out of the vessels into the blood stream (or break the blood brain barrier) Vasoconstriction, blood pressure, temperature sensitivity, fatigue, hypercoagulation, all vascular issues can be related to this damage.

Science is FINALLY catching up with monitoring this process. Endothelium dysfunction can now be measured by Doppler Ultrasonography
Doppler

Healing the endothelium can happen by many means: statins, antioxidants, flavonoids, diet and lifestyle changes (no smoking!) Toxins (esp. smog, metals and PCBs) are especially tough on the endothelium.

We're tackling this issue with quercetin and EGCG (green tea)....see natural thread for more info. I really, truly believe this is a large part of the MS puzzle. Thanks for continuing the dialogue, GG!
AC
Husband dx RRMS 3/07
dx dual jugular vein stenosis (CCSVI) 4/09
http://ccsviinms.blogspot.com
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Sharon
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Post by Sharon »

I remember trying horse-chestnut years ago but I am sure it was for a short period of time.
I agree with you that the supplementation of vitamins and herbs can have a very positive effect. I wish now that I would have never had the stripping done as I think it was the cause of an exacerbation (even though I did not know I had MS at the time). I will be very cautious in having further surgeries - I want to stay away from all anesthesia and trauma to the body.
The veins on my legs have improved over the past few years which I attribute to my vitamins. I do not have pain in my legs and I do not get the spasms which you seem to have. On your suggestion though, I will try the ginko and the horse-chestnut - it would be great to restore the CNS to somewhat normalcy. Thanks for the tip.

Sharon
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