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rick
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Questions: CH and Serotonergic Transmission
« on: Apr 20th, 2002, 12:48pm »
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Newbie questions:
 
How much do we (and the medical community) understand about the function of serotonin in relation to ch?  Is it known (or assumed) that our brains malfunction as far as producing enough serotonin?  Or is it thought that a certain group of 5-HT receptors within our brains are possibly taking up too much (or too little) serotonin as a result of their own malfunction?  Or is it possible that neither situation exists, and that there may even be another unrelated mechanism disrupting normal serotonergic transmission?
 
I realise that we may know little about any of the above, but am interested to hear what we do know.  I'm also interested in hearing everyones theories on these subjects.  
 
Thanks,
 
-Rick  
« Last Edit: Apr 20th, 2002, 1:56pm by rick » IP Logged
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Re: Questions: CH and Serotonergic Transmission
« Reply #1 on: Apr 20th, 2002, 1:55pm »
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Dont know much about that but i do know no one wants to buy mine on Ebay...
 
I tried to give up "free to a good home" my Trigamnil Nerve, Neurotransmitters, 5HT receptors and Serotonin.
 
no takers yet   Roll Eyes
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Bob P
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Re: Questions: CH and Serotonergic Transmission
« Reply #2 on: Apr 20th, 2002, 6:00pm »
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Lots of info in the OUCH Research LIbrary under serotonin.
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Re: Questions: CH and Serotonergic Transmission
« Reply #3 on: Apr 20th, 2002, 6:40pm »
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Looked up seratonin on the OUCH site.  Read as much as I could but whoops forgot to get my medical degree!  Sorry fellas but that stuff makes no sense to me!
 
Perhaps if you will allow me a stupid question?
 
I thought that ch was caused by a lowering of seratonin levels, however, if I read any of the OUCH stuff right I thought that says that it is the increase of seratonin levels.
 
Which is it?
 
Thanks.  PFDAN to all, Linda T.
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Re: Questions: CH and Serotonergic Transmission
« Reply #4 on: Apr 20th, 2002, 9:21pm »
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Things to think about:
The triptan drugs we take to abort clusters are 5HT agonists.  Agonist meaning that they act like 5HT.  This would lead me to think that we have too little 5HT and need this added boost.
 
5HT has many different sub-types.  Certain sub-types tell the muscle surrounding the blood vessles to constrict or relax.  If they relax, the vessel dialates putting pressure on the trigeminal nerve, causing pain.  We take the triptans, which act like 5HT, to tell the muscles to constrict (why some people feel the tightness in their chest when they take them) and take the pressure off of the nerve.
 
Why don't we have enough 5HT naturally.  Maybe because the hypothalamus, which controls 5HT levels, is whacked out?  Or maybe the hypo is getting bad feedback from other nerves and thinks the vessles are too constricted and cuts back on the level of 5HT?  Maybe the hypo goes into some kind of seizure?  Not sure?
 
We can be pretty sure that the pain is caused by the vessles dilating and putting pressure ont he nerve.  We can be sure that the triptans tell the muscles to constrict and relieve the pressure.
 
An added item: the triptans also inhibit some neuropeptides.  Neuropeptides which make us more sensitive to pain.  Extra benefit from the triptans.
 
We do know from Goadsby's research that the hypothalamus is involved.  Activity is seen in the hypo during a cluster that isn't seen when other pain is inflicted so we know it's not a reaction to the pain.
 
The BIG question is what causes the hypo to not function correctly?
 
Some of what I've written here is from articles I've read.  Some may be my own assumptions from those articles.  It all kind of makes sense to me though.
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Re: Questions: CH and Serotonergic Transmission
« Reply #5 on: Apr 21st, 2002, 3:59pm »
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Bob,
 
Thank you for the information and ideas.  This is only my third bout, and I only began to understand that I had CH this past December (official diagnosis came this past February).  So far, I've been doing most of my online reading on this site, and hadn't really been over to the OUCH site yet.  I'll be spending some quality time over in the library there.
 
I had read a link where Dr. Goadsby explained that there was some enlargement of the hypothalamus in patients he examined.  This enlargement existed on the side where the headaches occured.  As CH is known to switch sides in some individuals, I'm wondering if this enlargement only occurs during attacks or cycles.  This may lend support to your theory that the hypothalamus goes into some form of seizure or "blow-up".
 
I am intrigued by a theory put forth by Monique in an old post.  She stated that she believed the enlarged hypothalamus may be effectively blocking the uptake of serotonin into the proper synapses.  So depending on which side the hypothalamus would have a "blow-up", it's possible that serotonin is effectively cut off on the given side, causing the attack.  
 
This would lead me to believe that the enlargement is a temporary occurence, if all the above is true.  Which would leave us with the question: is the hypothalmus malfunctioning because it is defective, or is their some third party irritating the gland into a "blow-up".  I know there are triggers for some people, but I still get hit even when I avoid everything that seems to aggravate me.  
 
Also, I have heard stories of clusterheads having other issues in the course of their lives which seem to be related to the gland itself being defective.  Recently Duckflor posted a topic about human growth hormones, in which some individuals came forth and stated that they were "late bloomers", experienced growth and development problems in their youth.  It is widely known that many cluster sufferers suffer from sleep pattern disorders, and many experience issues with regulation of body temperature.
 
I have definitely had problems with the last two, and in high school, during my "development years", I inexplicably suffered from malnutrition even though I ate 3 good meals a day and then some.  A further case could be made for this as most of the men in my family are significantly larger than me (many football sized), although this may only be speculation.
 
I recently posted my most unusual (and still unexplained) experience as a response under Duckflor's above mentioned post:
 
...when I was 14, I experienced a cycle where I completely broke out in hives every day for a period of months.  Changed the diet, tried and tried to determine allergies, and came up with nothing.    
 
The pattern of the cycle was totally similar to a ch cycle.  It started every night when I would be outside playing basketball or football with my friends, around the same time every day.  If I was indoors that night, it would happen in my house.  Gradually, the cycle shifted, and I would break out in hives every afternoon at the same time.  Finally, after months, it all just stopped.    
 
I know that hives are caused by histamine, and there is some relation to histamine and ch.  I told a neuro this story, and she said there was no relation.  She also wanted to put me on a slow drip histamine IV to try and kill this cycle...
 
I would think that all of the above would allow us to postulate that the hypothalamus is defective in cluster sufferers, as it can be found to malfunction in a number of ways.  What do you think?
 
-Rick
 
P. S.  Linda T-Don't be discouraged, I read all these things 3 times over before it sinks in ;D
« Last Edit: Apr 21st, 2002, 4:00pm by rick » IP Logged
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Re: Questions: CH and Serotonergic Transmission
« Reply #6 on: Apr 21st, 2002, 4:07pm »
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Thanks for the enlightenment Bob.
 
Now a question for the ladies:
 
I have been doing some research into the effect of hormones and ch.  For the past five months while I have been in cycle I have been convinced that my ch cycles are connected to my hormones.  I have only had 4 cycles and each one came after I changed or stopped birth control.
 
According to some things that I have read on the net when estrogen levels drop so do seratonin levels.  I'm really not sure at this point how this relates to my bc since I'm still trying to absorb and digest alot of it, however, I'm wondering if any of you find that your ch gets worse prior to or when you have your menstrual cycle.  Is anyone out there currently on bc and still getting ch.  How about menopause?  If menopause depletes the estrogen then it must wreak havoc on the seratonin again and thus ch.  
 
Two weeks ago after an unusually horrific night of 8 attacks ranging 8-10 on the kip I called by GYN and had him give me a depo shot (which is the same thing I stopped last year prior to getting into this cycle.)  I'm sorry to say that so far little luck if any.  I'm hoping that it just may take some time to get my hormones in balance again.  Also, the pred and inderal may also be working.
 
Can anyone relate?  PFDAN to all, Linda T.
 
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Re: Questions: CH and Serotonergic Transmission
« Reply #7 on: Apr 21st, 2002, 4:38pm »
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Of all the articles in the Library on 5HT, "5HT, Neurotransmitter of the 90's" is probably the best for a full understanding of 5HT.
 
I believe the extra dense bundle of nerve fibers on the hypo is a permanent deformity whether in or out of cycle.
 
As far as reuptake goes.  A neuron sends out 5HT to another neuron therby sending a message acress the synapse between the two neurons.  When the second neuron is through with the 5HT it sends it back to the original nerve.  Some of the 5HT is metabolized by the body, other is diffused into other tissue and some is taken back by the first neuron.  The later is reuptake.  Blocking reuptake is a good thing for us because it keeps more 5HT in the synapse to be used by the second neuron.
 
Hopmones: there is an article in the Library about treating CH with testosterone.  Food for thought.
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