Monday, October 15, 2018

Huperzine-A May Be A Low Cost Replacement For Mestinon For Some Myasthenia Gravis Patients

My search for a substitute for pyridostigmine (Mestinon) lead me down many paths several years ago. It was fascinating research. I discovered two natural botanical supplements that can inhibit acetylcholinesterase - the enzyme that breaks down the acetylcholine that helps our muscles work. Just as with pyridostigmine,
they are temporary inhibitors and the effects wear off after a period of time. I decided to to stick with what my doctor had prescribed because I was just starting to become stabilized and didn't want to mess things up. But things changed.

Recently the price of pyridostigmine has skyrocketed for me. That pushed me to once again look for cheaper alternatives. The two candidates that I settled on have been researched by scientists and are medically useful inhibitors of acetylcholinesterase. Both have been proven to be effective for the treatment of myasthenia gravis symptoms although you may not have heard of either one.

Before I go any further, I want to underscore something that all of us with MG should thoroughly understand by now: The disease presents itself in such a variety of ways that what may work for one person may not work for another. And even though we have many things in common with each other, regarding symptoms and treatments, we have many more that are unique to our individual conditions. So consider this paragraph my disclaimer along with the fact that I'm not a doctor and I'm not giving medical advice.

The two botanicals are Huperzine A and Galantamine. Both are completely legal substances, primarily sold as supplements for cognitive enhancement in the United States.

Galantamine was first available in eastern Europe as a treatment for myasthenia gravis and other neurological disorders. It is currently approved by the FDA as a treatment for Alzheimer's disease and is available as a medical prescription (Nivalin, Razadyne, Razadyne ER, Reminyl, Lycoremine) with myasthenia gravis listed as 'other uses' by some of the manufacturers. It is also available over the counter as a supplement.

Huperzine A (from the chinese plant club moss) has also been researched and proven to be effective for short term memory enhancement and myasthenia gravis. Although the manufacturers begin with the plant, it is highly manipulated in the laboratory creating the active drug itself, without any natural plant constituents.

I have tried both supplements and both do a good job of controlling my generalized MG symptoms. In my opinion, in addition to regaining muscle use, they have several benefits that Mestinon lacks.

The supplement that I now use regularly is the Huperzine-A. It's been about a year since I made the switch from  pyridostigmine and I do just fine with it. The only other drug that I take for the MG is azathioprine (Imuran), having been off prednisone now for about 2 years.

The most popular dose sold over the counter for Huperzine-A seems to be 200 micrograms. I spelled out 'micrograms' rather than using the abbreviation (mcg) to underscore how potent it is. In addition to only needing a low dosage to have an effect on muscle use, it stays active in the bloodstream longer than pyridostigmine (Mestinon). Additionally, symptom relief seems to begin and dissipate in a smoother way.  For me, pyridostigmine drops off quickly and it takes 45 minutes to an hour for the next dose to start working. Huperzine-A begins working in about 20 minutes and  tapers off slowly rather than suddenly stopping.

In my case, the 200 mcg dose usually works for about five or six hours. On bad days I might need a booster dose after three or four hours. Even when I was taking pyridostigmine I would vary the dose depending on the severity of my symptoms. Back then I would occasionally take too much and occasionally I would experience twitching. That hasn't happened with the Hupe. Nevertheless, you don't want to take too much because, just like Mestinon, it can make your myasthenia gravis symptoms worse. Since Hupe is an acetylcholinesterase inhibitor the side effects and precautions are the same as any other drug that has the same mode of action.

There's a lot of information on the internet about about Huperzine-A and Galantamine. I encourage you to read both the anecdotal and the research reports. If you decide that you would like try one or both, they are easily available from Amazon. I put together a shopping page for each as follows:
Shop for Huperzine-A, Shop for Galantamine.

I am an Amazon Authorized Affiliate and would appreciate it if you use the above links but there are plenty of places online that offer one or both supplements. If you shop locally, your best bet to find them will be a health or vitamin store. They would probably be in the nootropic or memory aids sections.

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