New "LTC" Theory

[Cotcha Yankinov]

A New "LTC" Theory

An integrated theory of LTCs is needed. This thread will explore the role that compression of arteries could be playing in various LTC symptoms, especially in particular people (it need not apply to everyone).


Lightheadedness, vertigo/dizziness, visual disturbances that worsen upon standing, tinnitus, headaches and eye pain, weird head sensations, musculoskeletal pain, neuropathy and numerous neuropsychiatric/neurological issues are all pretty common with LTCs and can be explained via musculoskeletal compression of the arteries that supply the brain.

I had really bad dizziness and balance issues, when I tilted my head or when objects where close to my eyes which caused dizziness. I'm 6.5 months in also. Mine has substantially got better. It's still there but it's reduced to the point where it's no longer a problem. Mine only stared to get better when I started to weightlift 3/4 a week
hope this helps

Moving my head produces dizziness that kind of feels like the high when I was on MDMA (I was pretty gone when I last dropped, whole word was spinning around) but like if I'm walking up the stairs when I'm feeling particularly bad I'll sometimes lose track of the steps and nearly miss one because I'm so light headed, if I concentrate the room will breathe as well.

I see visual snow sometimes after standing up from sitting or laying down, lots of little white stars that zip all around

I usually have a "light headed" feeling, feels like I'm floating and bobbing. It's worse when I don't sleep well.

My tinnitus is still present and in full force, basically the same for my floaters and face tingling

I have dp/dr, brain fog and pressure in the head. Floaters, star bursts and visual snow. Inability to exercise also.

i have visual snow, after images, insomnia, constant head sensations, memory issues, brain fog

This was just after a brief search in the latest MDMA recovery thread.

There are these numerous reports that are indicative of cerebrovascular issues that can worsened upon standing and/or are posture-dependent. Two conditions that can produce these various LTC symptoms come to mind: Thoracic Outlet Syndrome (TOS) and Bow Hunter's Syndrome.

Lets talk about the scalenes and TOS for starters. The anterior and medial scalenes are neck muscles that are in a prime position to cause all sorts symptoms and be activated with stimulant use, anxiety and physical exertion.

The scalenes attach to the 1st rib and serve to expand the ribcage during times of stress to assist in inhalation. During anxiety/chest breathing, these muscles are activated. They can cause issues with the relevant arteries - vertebral and carotid arteries, in addition to the carotid sinus which contains baroreceptors that regulate blood pressure. Please note that TOS is primarily a hand/arm neuropathy, but head symptoms are extremely common in TOS patients and are relieved with scalene blocks (lidocaine/botox).


"TOS can be related to cerebrovascular arterial insufficiency when affecting the subclavian artery.^[5] It also can affect the vertebral artery, in which case it could produce vision disturbances, including transient blindness,^[6] and embolic cerebral infarction.^[7]

TOS can also lead to eye problems and vision loss as a circumstance of vertebral artery compression. Although very rare, if compression of the brain stem is also involved in an individual presentation of TOS, transient blindness may occur while the head is held in certain positions.^[8]

If left untreated, TOS can lead to neurological deficits as a result of the hypoperfusion and hypometabolism of certain areas of the brain and cerebellum.^[9]"

https://www.ncbi.nlm.nih.gov/pubmed/10064369 - "Neck and brain transitory vascular compression causing neurological complications"



Now Bow Hunter's Syndrome -
"the patient began to complain of transient visual changes, presyncopal (fainting) spells, and dizziness upon turning his head to the left."

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4934473/
"Some other symptoms, including positional tinnitus, nausea, headache, presyncopal sensation, near loss of consciousness, hemiparesis and numbness were also reported. Rastogi et al. [3] observed that vertigo and syncope were present in 28 and 26% of the cases, respectively, and these were the most prevalent symptoms noticed in patients with BHS in their review."


A particular adverse effects suffer (Suedonym) is a likely candidate for something akin to Bow Hunter's Syndrome or Chiari Malformation - right around the particular night of his MDMA use, he was looking up at the sky (star gazing) which could have messed up his neck http://bluelight.org/vb/threads/771746-MDMA-and-MS?highlight=suedonym (Ignore my sleep deprivation induced posts please)

I have nearly every presenting symptom for MS but my brain MRI came back clear, that's all I can tell you. I'm much more starting to believe I possibly have a chiari malformation as Cotcha proposed, that was harshly worsened by the MDMA. That my symptoms are so much worse when I bend or put pressure on my neck would indicate that, and the symptoms do overlap somewhat."

- Constant pins and needles all over, occasional burning and numbness, itching, sometimes feels like a whole body vibration
- Occasional tremors and twitching
- Gradual reduced sexual sensitivity culminating in near-impotence
- Initially delayed cognitive processing - stunted speech, hazy mind etc. though this has seemingly largely died down
- Difficulty chewing, swallowing, dry mouth, bad breath, unusual taste in mouth
- Difficulty getting to sleep, reduced length of sleep and often waking up with a racing heart, sweating
- Bodily pain and cramping lying in certain positions
- Intermittent aching pressurised feeling in both upper and lower back

He may have had some lifelong issues with artery compression that ran in the family (his mother had similar neurological symptoms but never MS) but they were worsened with use of a stimulant.


Serotonin is implicated in breathing mechanics (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4988959/figure/Fig1/) and there is often physical stress and heavy breathing during psychostimulant use, not to mention during bad trips. The scalenes and other muscles could get blown up during drug use and they may remain in spasm and hypertrophy.

Transient serotonin dysfunction post-MDMA could lead to altered breathing/scalene mechanics and hence scalene hypertrophy with delayed symptom appearance. https://www.ncbi.nlm.nih.gov/pubmed/26659645

"Spinal afferents such as nociceptive afferents and group III-IV muscle afferents are known to exert an acute excitatory effect on breathing when activated. Here, we report the surprising existence of latent spinal afferents which exerted tonic inhibitory influence on breathing subliminally in anesthetized rats, an effect which was reversed upon activation of serotonin-1A receptors (5-HT_1ARs) in lumbar spinal cord"

SSRIs and benzodiazepines could alleviate stress and hence calm the scalenes/chest breathing, and benzos could reduce muscle tension directly while activation of the aforementioned 5-HT1A receptors via SSRI administration may assist in inhibiting scalenes. Benzos and SSRIs are both known to help with LTCs and HPPD.

I theorize that issues with artery compression related to the scalenes and other muscles could be playing a (large) role in some LTC sufferer's symptoms.


Anterior scalene and SCM stretches could provoke symptoms but also be diagnostic. This would be something to talk about with a physical therapist - its important to be careful when stretching the neck. Myofascial release of the anterior neck could also be very helpful as well, but once again this is something that should be done professionally due to the fickle nature of the arteries that supply the brain.

Another diagnostic tool could be anterior scalene injections - lidocaine (and other local anesthetics) can numb the muscle for a few hours, while botox can paralyze the muscle for about 3 months. TOS patients very often receive great relief of their head symptoms with botox into the anterior scalene, and there are cases where injection into the medial scalene is helpful as well.

Surgical removal of the scalenes (scalenectomy) is also done for TOS, typically if the blocks are successful.

Vipassana meditation is well equipped to help with these symptoms as well - mindfulness using deep diaphragmatic breathing as the anchor may help decrease the use of scalene muscles, as well as increase awareness of aberrant muscle tone.

Fixing forward head posture could be critically important as well, though once again this should be done with the guiding of a medical professional.

Hope this was helpful. Any questions are welcome. I am not a medical health professional and I urge you to consult a doctor on any and all health related matters. Also, TOS is not well known, so don't be surprised if people look at you funny. A physical medicine doctor or physiatrist would be a good doctor subtype to see.

I personally got TOS after E/amphetamine use.

TL;DR Neck muscles may cause compression of arteries that results in symptoms similar to LTCs/HPPD

 

[LucidSDreamr]

Any recommendation on how to avoid these issues proactively when using MDma? Magnesium comes to mind.

 

[socrilus]

Arent hormones involved in BP regulation etc? Aldosterone comes to mind and maybe even Cortisol still somehow?

 

[Cotcha Yankinov]

Any recommendation on how to avoid these issues proactively when using MDma? Magnesium comes to mind.

There could be more physical preventative measures as well, like regular stretching/massage of the scalenes/SCM (anterior neck muscles) and correcting forward head posture and hunched/rounded shoulder posture.

Correcting dysfunctional breathing patterns with vipassana style mindfulness meditation should help but it seems like some people "chest breathe" even more when first trying to learn how to breathe diaphragmatically.

I would hope that people only try these things far in advance of a roll, and not the day before the roll or during the roll et cetera

 

[Cotcha Yankinov]

Arent hormones involved in BP regulation etc? Aldosterone comes to mind and maybe even Cortisol still somehow?

Sure. And in addition to exerting a direct vasoconstrictive effect on the arteries, I assume adrenaline/cortisol can alter breathing patterns/muscle tone and increase compression of the arteries.

Caffeine is also known for causing vasoconstriction, and 5-HTP could increase peripheral serotonin and cause vasoconstriction. The arteries express 5-HT receptors.

Overdose of psychedelics can cause cerebral vasoconstriction via activation of 5-HT2A receptors located on arteries. Various drugs (5-HTP, caffeine) could cause an exacerbation of symptoms due to classical vasoconstriction compounding with compression of the arteries.


Another thing to consider is that a primary symptom of serotonin syndrome is muscle rigidity. I assume that muscle tone generally increases even below "serotonin syndrome" producing serotonin levels with serotonin releasing agents.

So there could be

1. A muscle compressing the arteries component
2. A direct vasoconstrictive effect component, both from hormones, increased peripheral serotonin and e.g. MDMA's direct effects on 5-HT2 receptors located on arteries
3. An effect on blood pressure regulation component causes hypotension

In addition, Fastnbulbous said the following regarding MDMA and low blood pressure

"It's most likely due to metabolites such as alpha-methyldopamine (3,4-dihydroxyamphetamine) which act as false neurotransmitters. There is a drug on the market for treating high blood pressure calde alpha-methyl DOPA, which is metabolized (by decarboxylation) to alpha-methyldopamine - same metabolite as from MDA/MDMA.

It also has a high incidence of depression when used clinically - starting to sound similar to the Tuesday blues? That's 'cause it's the same final metabolite"


The typical reaction to low blood pressure/hypoxia is going to be hyperventilation, which is going to activate these inhalation muscles (scalenes).