neurotransmitters cause of HH

Jezza

Jezza

Well-known member
Hi people,

So, at this point, I have a sneaky suspicion a neurotransmitter imbalance is causing HH, so I looked into it and found this;

Peripheral amplification of sweating – a role for calcitonin gene-related peptide

I found out recently that apart from acetylcholine, which we all know and hate, is not the only neurotransmitter responsible for sweating but that several others have been identified, like VIP, CGRP (the focus of the study above), serotonin (because it likely increases acetylcholine production) etc.

Also, yesterday I read a study that nitric oxide (NO) levels were significantly higher in EH patients than in a control group with healthy individuals. I didn't know what to make of it but now in this study I read the following...

First; CGRP significantly enhanced ACh-induced sweating

and then The second messenger for CGRP-induced vasodilatation is nitric oxide (NO)

Now what this means in terms of treatment I don't know...but does it feel like some pieces are falling together or what?
 
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jjubbs

Active member
Thank God there are people like you out there Jezza that are actually looking for the root of the problem instead of focusing on the current remedy options.

I have general HH and partially blame that on using the drionic machine for my extreme underarm sweating during high school - when my underarms temporarily stopped sweating, my back/check/groin/trunk/feet all started sweating far worse. I wish I had just gotten Botox for the underarms in the first place and avoided the drionic.

Anyway, I don't want this thread to get sidetracked. If I can find more info about studies on the cause of HH, I'll be sure to post.

Thanks!
 
Jezza

Jezza

Well-known member
Check this out guys; Nitric oxide synthase inhibitors decrease sweating according to this and some other studies. Makes sense with the previous.

Role of nitric oxide in methacholine-induced sweating and vasodilation in human skin--?????????--????--?????

Study is by Japanese scientists, maybe that has something to do with the Japanese being more inclined to have HH than the rest of us humans. In any case it explains for the question marks in this link. Japanese characters ftw.

All the studies are pretty new. I wonder if there's has already been a clinical trial that failed or if this isn't actually tested yet on HH sufferers. The latter would definitely be exciting...
 
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jjubbs

Active member
Thanks Jezza, this sounds very promising!
I tried reading the article, but it was far too complex for a guy that comes from a business background rather than biology. I wonder if I should show my doctor this article and see what he thinks.

Do you know what they are referring to by NOS inhibitors? Are there prescription drugs that act as NOS inhibitors?
 
Jezza

Jezza

Well-known member
Hi there jjubs,

NOS= Nitric oxide synthase. It's an enzyme that's responsible for the creation of NO (Nitric Oxide) in the human body.

Unfortunately, the inhibitors aren't prescription meds (yet), from what I gather, they're investigating NOS inhibitors for several diseases.

11.6 NOS inhibitors

Seems like we will have to wait then...*sigh*. Although there might be something in a Calcitonin Gene related Peptide blocker, those are available since recently I believe. Have to look into it. Will post right here if it's promising.

So as for taking it to your doctor right now; in the best scenario he/she is interested in the matter, will read this stuff and do nothing. More likely, he/she will dismiss something like this, because nowadays in medicine, the researchers do the research and the docs just stick to what they know, and don't bother with 'could we do this, could we do that?'. At the end of the day, you'd probably not get much out of it, except maybe showing your doc you're serious about this stuff.

Hope that helps...
 
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Jezza

Jezza

Well-known member
Don't know...it might be the only way for now to reduce NOS, since the only other way is with intravenous injection so that will be out of the question.

Also, Merck just 2 weeks ago cancelled development of their CGRP blocker because 11 out of 660 people had some mild signes of liver damage. Once again a promising med falls because of some potential liver damage, while many people would gladly take that small risk.

Not so great news allround then...
 
cm123

cm123

Well-known member
I think it is a neurotransmitter imbalance as well because currently i am on Zoloft Therapy for HH. Which is Zoloft on its lowest dose 25mg, and zoloft corrects neurotransmitter imbalances in the brain and I have noticed a reduction in sweat. So much to the put where I now wonder if i could wear sandals. Although things aren't perfect yet, I have noticed a difference.....
 
Jezza

Jezza

Well-known member
Hmm...

Zoloft is an SSRI though (as you know)...SSRIs are often under suspicion for causing hh secondary to medication. But if it works for you, all the better.

Since SSRI induced sweating is (alledgedly) well controllable, I have considered a couple of times to try an SSRI to override the usual HH, and then use medication to counter the SSRI induced sweating...but I don't think a doc would be too happy to sign off on that, and I don't know if it would work...

The cyprohep doesn't work btw...I see the topic has gone under in the meantime, but anyway...

I'm now setting my sights on topiramate, a glutamate blocker, glutamate has a connection to NO production in humans. Alternatively I still have to try an alfa2 blocker (have tried about everything but not this, since honestly I wouldn't know why it would work).

What could be a better idea is to use a triptan, because it indirectly blocks CGRP (but unfortunately also Substance P, which in theory lower the longevity of sweating)...Still, something to bring up next time at the doc's office.

Darn, I just hate meds being cancelled because of an outside chance of liver damage.
 
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Jezza

Jezza

Well-known member
Well,

Once again...It will have to wait...this monday I suggested topiramate to the doc and she requested if I could give here some studies regarding its use and safety in the treatment of HH. I sent her the studies you mentioned above (access via university like yourself) along with another study on the presumed workings of the drug in reducing sweating, but today, she told me she wouldn't prescribe it to me because she didn't feel comfortable with it. I have been there a couple of times lately for different types of meds and I guess she developed a problem with that. Shame really...

I told her about it being prescribed in similar daily dosages for the prevention of migraines, but since she doesn't usually prescribe it...She had made up her mind already.

In fact I had to once again listen to the terrible speech of having to at some point accept HH since I've already tried so much. Seems like you can have only so much shots at finding something that works. I have heard that before and I think it's bizarre. Like a game show...the best treatment for your disease is behind one of these 5 doors...however, you're only allowed to open 3. Good Luck!

Anyway, as I haven't tried clonidine yet, I now got prescribed that (albeit in a much too low dosage IMO) and then when it doesn't work, I'll have to be referred to a neurologist who will quite possibly prescribe topiramate (like they do all the time for epilepsy and migraines).

It's by no means harmless candy but the way I look at it...These drugs have past through tons of approval studies, they're not going to kill you, they will almost certainly not have lasting side-effects, but they have the huge upshot of just maybe, possibly, improving the HH. Unfortunately, most docs don't get that, they think 'why the hell is this guy taking the risk of all these side-effects, just to reduce a little sweating, he must be insane, let's not take him seriously'. I've come to realize a long time ago that people without HH can't begin to understand what it is really like. They will always mirror the sweating to their own experience with sweating and not realize it's something completely different altogether. Hell, if I didn't have HH I'd probably not get it either. Thing is though, a doc SHOULD know better...

Before I actually end up at the neurologist...it will probably take some weeks again....Have to officially give this clonidine a chance first, and then it will no doubt take some time before you can actually have the appointment...

Really frustrating.
 
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MyShadow

Member
I'm new here, but I just wanted to mention that I took Topiramate a couple of years ago.
I took 50mg for 6 months. It didn't really do much to reduce sweating, but it did help with anxiety and depression, and it completely eliminated headaches.

The study mentioned mainly facial sweating and a higher dose of Topiramate. My main problem is palmar HH.
 
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Stuckwithme

Well-known member
Jezza, I totally agree with you and see where you're coming from. I think you should show this thread including your post to your doctor so she will understand your situation better. I think the written word is more effective. It's a shame really that doctors dont take us seriously.
 
Jezza

Jezza

Well-known member
That's interesting MyShadow,

One of the studies is about facial HH, one is about palmoplantar. The one about craniofacial HH actually mentions topiramate works better on palmoplantar HH.

But good to hear from someone who has actually tried it already. The dosage in the studies was at ultimately 200mg though. Did you see any reduction at all? Or was it one of those 'yeah, maybe it's slightly less sweating but it doesn't change anything' things.
 
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