Withdrawal from Anti-Inflamatories can cause AFIB

Case Report:

My Doctors don't believe me, but this story is true, swear to God.

30 out of 35 of my last AFIB episodes occurred within 2-10 days after cessation of pulse Anti-inflammatory therapy.
Most of these episodes occurred at 2-5 days post Anti- Inflammatory therapy.

I had these episodes after taking both NSAID's (Naproxen) and SAID's (Prednisone tablets/injections and Kenalog injections).
I was using Pulse Therapy, taking Naproxen in 2 week intervals, and Prednisone at 5-days on, and 4 weeks off.

There has been studies which have shown a correlation with taking Anti-Inlammatories and AFIB.

NSAID's [www.medscape.com]

SAID's [www.ncbi.nlm.nih.gov]

After reading through these studies they do show not only correlation between taking Anti-Inflammatories and AFIB, but also
an even higher correlation with AFIB after withdrawal. Unfortunately the Doctor's have not put 2 and 2 together to see the obvious, that is the withdrawal from the drugs that is causing the correlation in the studies. When people take a drug, they look at the side effects while they take the drug, not after they stop taking it. Although not the final trigger, this has been a silent devastational instigator to put me into the AFIB High-Suseptibility State (AFHSS).

The mechanism of causing AFIB maybe related to intra-cellular electrolyte fluctuation, or more specifically dramatic inversion of the IC NA+/K+ ratios in the Heart tissue.

With NSAID's as I interpret the studies, IC K+ is increased while taking the drugs, not sure what happens on cessation, but intuitively it seems a inverse Na/K ratio would occur.
With SAID's , as per the studies, the IC Na+ goes high while the K+ goes low while taking the drug, then upon cessation this ratio inverses the other way, and Na+ is low, and K+ is high.

I have started using a long taper-down schedule, when using all of these drugs, even though I don't believe tapering off NSAID's is even ever discussed.

In the case of SAID's tapering is recommended to avoid acute Adrenal Suppression by some Doctors when ever they are used, but other Doctor's think it's unnecessary to taper down, unless the therapy is longer than a week, or a doses above 50mg/day.

Any response is welcome, I am not an expert on Electrolytes.



Edited 5 time(s). Last edit at 10/10/2014 07:01AM by The Anti-Fib.

What is the cause of the inflammation and thus the NSAIDs/steroid protocols? It's always better to try to manage inflammation by natural remedies or at the very least augment with the naturals. Details, please.

Jackie

This is the kind of STUFF that confuses me..........They say inflammation can cause or trigger afib so why would taking something to reduce inflammation cause it???????? Its like this with every reason some one comes up with

tsco,

I believe AntiFib is saying it is the stopping of consuming NSAIDs or SAIDs that can trigger the afib and for electrolyte reasons.

George

I've taken 2 Advil/day for years now. So maybe it's for folks that stop, but definitely not a cause of afibs for me.
np

Tsco:

I think that inflammation is labeled as a factor that contributes to a Heart tissue substrate that is more conducive to maintaining an AFIB episode, and not that it's an actual trigger, like getting drunk (vagal-mediated AF) or high (adrenergic AF). AFIB is a complex medical condition indeed.

The drugs not only effect inflammation, but have numerous other ways it affects the body. Even without taking AFIB into consideration, their is the paradox of taking NSAID's (like Motrin, Naproxen). Even though there is the benefit of aiding healing by reducing inflammation, simultaneously, healing time is slowed down because the drugs have a secondary effect of reducing levels of Prostaglandins which role is to help speed recovery.

Jackie, thankyou for responding, I need your input.

I was taking the anti-inflammatories for what has been diagnosed as borderline (Lupus SLE), which is an over-reactive immune system response in the connective tissues. My condition also seems to fit in with the term MyoFascial Pain Syndrome aka Cronic Myofascial Pain.

In response to acute stress, my muscles/fascia tend to knot up and unlike other normal people, the knots just stay around long after they should have abated. It's like the brain still reacts like it is dealing with an acute trauma by inflaming the area to help recovery, even though the acute trauma is long past. This causes many Tendonitis's as the shortened muscles pull abnormally on the tendons. As far as I know my joints and Organs are not affected by this condition.

My anti-inflammatory regimen is as follows:

Vit C 1g
Vit E 200mg
Fish Oil 6g (4g of omega-3)
Vit D3 10,000iu
Zinc 50mg
MSM 1500mg (just started)
Multivitamin

Also Heart Rhythm supplement regimen:

Mg 500mg (Doctor's Best)
Taurine 2g
Acetyl-l-carntine 1500mg
K+ 400mg

Also taking to increase somewhat low Cortisol levels:

DHEA 100mg
Pregnenalone 15mg
Testosterone



Edited 1 time(s). Last edit at 10/11/2014 03:41AM by The Anti-Fib.

I will respond shortly. Thanks for providing the details.
Jackie

Anti-Fib,

I have no idea what rabbit holes you've pursued, but here are a few thoughts.

Two MD's, Terry Wahls & Steven Gundry, have focused on autoimmune issues. From 30,000', their approaches are very similar.

Dr. Wahls was a traditional doc, running research at the University of Iowa and a clinician at the VA hospital nearby. She was diagnosed with MS around 2001. She went to the Cleveland Clinic for the best treatment. She followed their protocol and degenerated into a zero gravity wheelchair. Realizing her prognosis was awful, she spent her own time looking at all the animal research for a possible solution. She also took functional medicine courses. Bottom-line, she went from being in the zero-gravity wheelchair to riding her bike to work. Her thesis is that MS, Parkinson's, Alzheimers and many of these other illnesses are similar at the cellular level but present differently. Her approach includes minimizing autoimmune responses as well as creating as nutrient dense diet as possible. Her TED talk is here: <[www.youtube.com] Her FB page: <[www.facebook.com] website: <[terrywahls.com] and book <[www.amazon.com] You can also search for podcasts & interviews. As you will see in the TED talk, she went from being very bad with her MS to being very functional.

Gundry is a cardiac surgeon of some international renown. In the last 12-15 years, while still operating, he has focused the majority of his practice on prevention. A large part of this is dealing with autoimmune responses. Website: <[www.drgundry.com]
Book: <[www.amazon.com]
Podcasts: <[www.askthelowcarbexperts.com] <[body.io] Include and exclude food lists from his most recent "Matrix" approach are available in the files section of his FaceBook group (closed, must apply), <[www.facebook.com] or I can send you.

They both also look at gut biome, which includes not only lacto probiotics but soil based bacteria as well as bacterial food (prebiotics). SIBO- Small Intestine Bacterial Overgrowth - can also be an issue.

I know I'm sensitive to what I consume. I started to have rheumatoid symptoms in my hands and was able to eliminate them by changing my food consumption.

I've also successfully worked with myofascial trigger point therapy to release the spasms in others. My ex-wife had was prone to these and I was usually successful releasing them. However, even though 20 years past her early menopause, she had monthly cyclical times when she was hyper "triggery." During these times, I could reduce, but not eliminate the spasms. If you care, I can send info on manual self-treatment.

George

Anti-fib.... Sorry for the delay… I wanted to dig out some notes on Lupus that I had accumulated some years ago. These random notes follow. Sorry also that they are not organized…but wanted you to see the general focus of treating Lupus from a natural or holistic focus.

[ I'm adding in this edit... I had meant to begin this reponse by commenting that when I finally do post my report on Stealth Infections, readers will note that the doctors treating and writing about their findings often note that arrhythmias and 'palpitations' are frequent symptoms associated with stealth infections because of the high prevalence of inflammation which also affects heart tissue. Important to rule out. Details forthcoming.]

I have first-hand experience with the severity of Lupus as my mother was diagnosed in the mid- 1960’s with both Lupus and RA when at age 50. Back then, all they knew for treatment was cortisone/steroids to help with inflammation and no focus on what caused it in the first place. She suffered miserably and eventually became bedridden. No testing was known or even considered then and no assessments of causative factors such as dietary triggers, (gluten and dairy avoidance) heavy metal toxicity, fluoride-associated toxicity or addressing the gut/bowel discomfort and dysfunction and eitology.

Today, there are many functional medicine type practitioners who understand the importance of treating the cause of autoimmune conditions like Lupus and accordingly do specialized testing, and recommend dietary changes and specific nutrients based on the results. Most doctors today are still following the protocols from decades ago, unfortunately.
As for the connection to your situation and Afib… inflammation is definitely going to have an influence on promoting Afib. Magnesium levels are going to be very suppressed because of your drug regimen. It’s important to continually push optimizing intracellular magnesium which will not only help your heart, but help your muscles relax as well. I’ve always maintained that it’s important to rule out all possible causes of Afib in the first place as often it involves an inflammatory reaction to a dietary exposure, chemical or pathogen that cardiologists just don’t get into testing so no treatment is targeted in that direction.

Pay attention to the comment about Epstein Barr Virus being the cause of the Lupus. Have the appropriate testing to learn your levels. I’ve recently been through this with a reactivation of EBV causing a significant flare up of Afib. Glad to share my files on managing EBV. If you like, send me a PM.

There are also comments that the underlying cause of Lupus is Lyme disease. People learn later they were treated for Lupus but actually had Lyme. Testing right now can rule out both EBV and Lyme but if positive, then you need to address those infections. Apparently, I had Lyme exposure long ago and was mistakenly treated for CFS/FM for 10 years… when it was Lyme all along. Once my low vitamin D level was detected and treated, the pain and fatigue went away. There is a previous post about EBV that indicates the majority of the population is has been exposed to that virus by the time they are age 3, but our immune system typically remain strong enough to keep it managed. Failing that, then symptoms show up… big time.

My heart goes out to you because I know how terrible it is to live with Lupus.
Sincerely,
Jackie



Following are the random notes. (This first segment is from 2014 by Garry Gordon, MD)

Mainstream medicine is beginning to recognize the multifactorial etiology of chronic autoimmune disease. The attached article sets the stage for a real change in mainstream medicine. Lupus is finally seen by mainstream, as being multifactorial in etiology.

There are many amazing statements in the attached paper that include comments about the prognostic implications of early increases in non-specific autoantibody levels, as Dr. Vojdani has taught us for years now, about the recognition that diet influences these diseases even recognizing that the diet alters the microbiome.

One day they might even admit the need to deal with total body burden of pathogens, toxins, heavy metals, and who knows, one day these same authorities may even be ready to admit that frequencies, as now being studies at MIT and GLAXCO could also offer effective non-drug management of many serious degenerative conditions like Lupus and RA.
Who knows, maybe one day nutrients like Omega 3 and Vitamin D and oxidative therapies like Ozone and maybe even energy medical devices, like lasers and PEMF and microcurrent therapies, as well as acupuncture and chiropractor/osteopathic care will no longer be alien to mainstream doctors.
[lup.sagepub.com]

Clue to How the Environment Acts Via the Genes to Produce Lupus
"We have thought for a long time that lupus and other autoimmune and inflammatory diseases like it are caused by both genetic and environmental factors and their interactions. Epigenetic modifications, influenced by the environment and controlling the expression of the genes, may explain how the environment acts via the genes to produce lupus,” Dr. Costenbader told Medscape Medical News. “We still don't know very much about exactly which factors are involved or how those interactions and the coordination of gene expression across the genome work, though," he added. Dr. Costenbader is associate professor of medicine, Harvard Medical School, and codirector of the Lupus Center at Brigham and Women's Hospital, Boston, Massachusetts.

Epigenetics refers to changes in gene expression resulting from changes in the structure of DNA that influence how available a gene is for transcription. Two key epigenetic processes are the addition of methyl groups to the DNA itself and the modification of histone proteins that bind to and help condense and package DNA.

The microbiome is the total population of bacteria and other microorganisms that reside in the gut. These bacteria aid in digestion, influence the host immune system, and produce epigenetic changes. Lupus May 2014 vol. 23 no. 6 505-506

Gluten is found to be a culprit in Lupus.
Diet needs to be free of cow’s dairy and gluten and organic fruits and vegetables with fowl, fish and grass-fed beef to eliminate toxins from the food chain. No sugar, no caffeine Also no artificial sweeteners such as aspartame....highly toxic.

[bastyrcenter.org] Lupus May be Gluten Allergy
[www.ncbi.nlm.nih.gov] Gluten sensitivity masquerading as systemic lupus erythematosus
[lupusandhumor.blogspot.com]

Considerations for lupus are heavy metal exposure and other toxins such as fluoride and aluminum in the water supply and other aluminum exposure… cooking utensils, acidic tissue pH, Often comes from exposure to dental mercury fillings… Do chelaton challenge with DMSA and calcium EDTA) – sodium has a poor yield.

Aluminum-fluoride complexes perfectly mimic Thyroid Stimulating Hormone. Check for both thyroid and adrenal dysfunction.

Test both serum and saliva adrenal hormones. DiagnosTechs has the saliva Adrenal Stress Index and the Expanded Female Hormone Panel. Test all the aminos, minerals and organic acids and omegas and or allergy or infection testing. Test adrenal function with Adrenal Profile (Genova Diagnostics)

B 12 injections often required. Use high dose Omega 3’s.. and high-dose vitamin C to bowel tolerance. (The new Liposomal vitamin C eliminates bowel issues) High dose vitamin C manages EBV.

Lupus, Sjogren's and Reynaud's are all associated with fluoride poisoning but this connection is rarely made. Fluorinated cortisone and anti-inflammatory drugs can make them worse. Aspartame poisoning also comes to mind. If fluoride and aspartame are contributors, rapid improvement should happen if they are strictly avoided.

Lupus, like many autoimmune diseases, seems to be associated with allergy to gluten, dairy and sometimes soy or other allergens. The allergy doesn't always show up in testing but a very strict elimination diet should show a reduction in flares. And, unfortunately, gluten abstinence needs to be total.

Naturopathic treatment for lupus includes Low dose allergen therapy. LDA

Maintaining an alkaline tissue pH is critical. (Our WW can help with this)

Always rule out Epstein Barr Virus… as a causative agent for Lupus… Conclusively proven by John Harvey, PhD at the Oklahoma Medical Research foundation, although results not widely published.

Lupus does not respond well to conventional treatment …It does respond to UVBI; Ultraviolet blood irradiation, aka photoluminescence

Prednisone brings on edema.

Mary Ann Block, DO, uses Enzyme Potentiated Densitization for Lupus and RA patients… who are free of meds in about 4 months

Most autoimmune disorders are considered allergy-like. Start with genetic testing and be sure to evaluate the 25 OH D levels. Some cases respond to DHEA Digestive problems should be addressed immediately.

Lupus responds well to MSM powder… dosing 1500 mg 3 4 times daily and a complete complement of all 17 vitamins and 30+ minerals, EFAs and the 8 essential amino acids.

Low-dose naltrexone has been useful as an anti-inflammatory for chronic pain
[www.ncbi.nlm.nih.gov]
[www.lowdosenaltrexone.org]

Look into the use of Moducare ™ Sterinol to increase DHEA levels naturally and thereby increase the number of effective T-cells and natural killer cells to enhance immunity. Sterinol also reduces the negative stress hormone (cortisol) and the pro-inflammatory agent Iinterleukin-6, both known to inhibit good immune function.
Be sure your testing includes Interleukin 6 levels… (IL-6)

Resetting epigenetic code could aid lupus patients
WINSTON-SALEM, N.C. - Researchers at Wake Forest University School of Medicine and the University of Virginia hope to reset part of the "epigenetic code" in lupus patients and thus improve treatment.

The epigenetic research focuses on histones, the tiny spools in the nuclei of cells around which DNA winds and compacts when it is not in the process of copying in cell division. Epigenetic changes in the histones are those that can alter gene expression - and associated proteins - without altering the underlying DNA sequence, said Nilamadhab Mishra, M.D., a rheumatologist at Wake Forest University Baptist Medical Center.

"The histone code is one of the master regulators in gene expression," he said.

In the Journal of Proteome Research of the American Chemical Society, Mishra and colleagues said their study was the first to establish the association between aberrant histone codes and the mechanisms underlying lupus (systemic lupus erythematosus), which is an autoimmune disorder. The online version appeared this weekend. The researchers identified three new histone modifications in mice with a lupus-like condition that were not found previously. The team found that by using compounds called HDAC (histone deacetylase) inhibitors, they could reverse the modifications and reset the histone code.

In the mice with lupus, Mishra has been testing several HDAC inhibitors, one called trichostatin A (TSA) and another called SAHA, both of which successfully treat lupus symptoms. The new research may help explain the reasons why the treatments work.

Without treatment, he said, these mice have an accelerated autoimmune disorder that produces a host of symptoms from arthritis and enlarged spleens to failing kidneys. Half are dead in 24 weeks, primarily of kidney failure. Control mice of the same type, but without lupus, live much longer; the females dying at 73 weeks and the males at 93 weeks.

In essence, Mishra said, the HDAC inhibitors reset the histone modifications, reducing or eliminating the lupus condition. "If we modify the histone with a drug, we can also cure the lupus."

The work is part of the effort to unravel a number of the mysteries of lupus: Why does it occur in one identical twin and usually not the other, though they have exactly the same DNA? Why does lupus strike predominantly women? Why does it abruptly strike some while they are still young, others in middle age and others not until old age?

Mishra said the proteins expressed through the histones vary between healthy individuals and lupus patients. There also is variation among lupus patients. These differences may explain why some lupus patients develop kidney disease and others do not, or other symptoms like arthritis or skin disorders.

Prior to this research, the prevailing theory is that the variations were due to differences in genetic background and the influences of the environment. Mishra's mouse models are all genetically identical, yet variations exist. "They are the same, but different," he said. Histone changes could explain these differences. Mishra said that in addition to the use of HDAC inhibitors, combination treatment for lupus might also include a methylase inhibitor. But those don't exist yet.

Lupus is a chronic inflammatory autoimmune disorder that affects the skin, kidneys, joints, lungs, blood and central nervous system. Systemic lupus affects more than 1 million Americans, mostly women.

Mishra's coauthors are Benjamin A. Garcia, Ph.D., Scott A. Busby, Ph.D., Jeffrey Shabanowitz, Ph.D., and Donald F. Hunt, Ph.D., of the University of Virginia, Charlottesville.



Edited 1 time(s). Last edit at 10/12/2014 11:22AM by Jackie.

GoergeN:

Thankyou so much for the info, I will look over that.

Yes, if you have any special insight on manual self-treatment of muscle spasms/trigger points, I am interested.
I would get massages every day, if I could afford it. I wonder if I could get cheap massages in Mexico?
I do alot of specialized exercises and stretches in the Gym to try to keep physically functional.

I feel over-whelmed right now, After a great deal of study,(part of it here), and going against my Doctor's advice on almost every visit, I really turned the corner My Heart issues in which I made a recovery that The Doctors said I wasn't supposed to make. I managed to go from Dilated Cardiomyopathy with EF of only 20% to %64, and went from Persistent AFIB requiring a multitude of ECV's, to paroximal AFIB of short duration, and now not even taking AAM (also No Ablations).

Now I get to try another daunting task of overcoming another degenerative health issue with little in the way of any clear cure.

My Rheumatologist wants me to take Methylotrexate, which is a drug when given in high doses is used as chemotherapy for Cancer patients. It sounds kind of counter-intuitive to anything natural, kind of a toxic way to suppress the immune system.



Edited 1 time(s). Last edit at 10/14/2014 08:08AM by The Anti-Fib.

Anti - You should try to have the appropriate testing for Stealth Infections to rule that out as an underlying cause of the Lupus symptoms. Many of the physicians treating these infections indicate that in people diagnosed with labels such as Lupus, MS and other autoimmune disorders who are treated for the underlying infections go on to be free of all the debilitating physical symptoms.

Jackie

Besides what has been discussed, I would highly recommend genetic testing before starting a treatment plan. For about $100, you can go online to 23andme.com and read about their genetic testing. They will mail you a saliva test, and then when you return it, they will post your results, which you can then download. Until I did this, my doctor was trying all kinds of supplements that kept making me worse instead of better. We found out through my genetic testing that I cannot take sulfur based supplements or methyl based supplements. My doctor has found a way around this, so now all four of my methylation cycles are working properly, but it has taken months of work to get to this point. Now my Krebs cycle is low and we are working on that by adding Healthy Choice d-ribose and l-carnatine fumerate (must be fumerate in my case) to bring it up. My Krebs cycle was at 15 and a healthy person should be at 35. Also, as far as B12 shots, again, genetic testing will show which type to take. I must only take hydroxo B12, not methyl B12.

I also just finished reading a book by Ronald Drucker, MD entitled The Code of Life which discusses a special form of Aloe that helps autoimmune diseases like lupus, arthritis, etc. Regular aloe won't do it. He references a website in his book where you can buy this special polymannon (Aloe). It is www.digestacure.com. I just ordered some and will let afibbers.com know how well it works once I use it for awhile. It is expensive, $159 for a one month healing dose supply. You must take the healing dose for about 4 months and then you can reduce to the maintenance dose of about $30 a month. You can download Dr. Drucker's book free on the www.digestacure.com website. It is a good read and I highly recommend it. I've had a lower esophageal sphincter muscle that causes lots of burning in my digestive tract that my doctor can't seem to correct, so we decided to try this Digestacure Autoimmune X formula. As was stated above, much of what happens in the rest of our bodies starts in the gut, especially autoimmune problems.

Many blessings to you,
Nancy M

Thankyou Jackie and Windstar

Yes, I am on a strict Gluten Free diet, and also I am avoiding MSG, and Artificial Sweeteners.
I was somewhat improved after making this change. I did this on the advice of Mother who is very sensitive to Gluten and I think also Celiac, she doesn't even consume diary products either.

Thankyou Jackie and Windstar

Yes, I have been on a strict Gluten Free diet for 3-4 years, and I avoid toxins like MSG, and Artificial Sweeteners.
I was somewhat improved after making this change. I did this on the advice of Mother who is very sensitive to Gluten and I think also Celiac, she doesn't even consume diary products either.

The Autoimmune Epidemic: Donna Jackson Nakazawa
She has a few AI diseases and does a good job describing the triggers...environmental, EBV, pesticides, in layman's terms.

Jackie so sorry to hear aobut your mother. How long did she live after diagnosis and what was her cause of death? So sad.

Anti Afib
Get the book the New Arthritis Breakthrough by Henry Scammell and then go to rheumatic dot org. He uses low dose minocin.