Macro, Horrible Prami Experiance....Help

[thomasfouraker]

I was on day 4 of Prami yesterday to alleve some prolactin gyno I have. I started at .5mg for the first 3 days then bumped it to 1mg yesterday. I took 1mg around 7pm last night. Around 8:30pm, I began to feel a little nauseated. I was at a restuarant drinking sweet tea so I know this is not a low blood sugar problem. I had been gettin nauseous off .5mg so I figured it to be normal even at 1mg. I began to get extremely tired and felt like I needed to throw up. I layed my head down on the table and could feel myself wanting to black out. Next thing I know, my 3 friends are shaking and yelling at me telling me I just passed out. I was diaphoretic, cool, my heart was racing and I didnt know what was going on. My lips were ashen and my face was really white. All last night after the fact I felt I had a little orthostatic hypotension when I would stand up to go use the bathroom. My resting pulserate was around 120 which is about 40 above normal for me.

The only thing I can think caused it was a rapid dopamine rush which caused peripheral vasoconstriction and sped my heart rate so much that it wasn't adequatly perfusing my brain thus causing me so have a syncopal episode. I feel I am extremely sensitive to this drug and will probably discontiue usage. Please tell me if you think my conclusion is reasonable or if perhaps it was something else. The only other supplement I am on right now is clomid 50mg/day in the morning. Sorry it was so long, all help is appreicated. Thanks guys.

Thomas

 

[Showy0023]

I think you jumped your dose too quick. From what I have researched and done myself are weekly increases based on how you are reacting to the sides:

Week 1: 0.25 mg
Week 2: 0.5 mg
week 3: 0.75 mg
week 4: 1.0 mg

..........etc.

Increasing your dose by 100% after just 3 days is a little much apparently. I would back the dose back down......and SLOWLY increase it.

Just my 0.02$

 

[thomasfouraker]

I think you are right, my body hasnt yet built up concentrations high enough to tolerate the sides yet. I think I am gonna give my body a week off of everything and diet clean to see if the lactation subsides, if not, I will start the prami again at .25mg for a few weeks before ramping up the dose.

 

[1bigun11]

I thought .5 was the optimum dose? Now its 1.0? Does it depend on whether your taking it intermittent for prolactin gyno or taking it every night for Hgh release?

 

[Macro]

I took 1mg around 7pm last night. Around 8:30pm, I began to feel a little nauseated. I was at a restuarant drinking sweet tea so I know this is not a low blood sugar problem. I had been gettin nauseous off .5mg so I figured it to be normal even at 1mg. I began to get extremely tired and felt like I needed to throw up.

this could be either hyper or hypoglycemia, really depends on the constituents in tea (caffeine content, sugars used, amount consumed).

The first signs of hyperglycemia or ketoacidosis are frequent urination and increased thirst. The person may then show any of the following symptoms:

flushed face
dry skin
dry mouth
headache
abdominal pain
nausea and vomiting
drowsiness and lethargy
blurred vision
fruity-smelling breath
rapid heartbeat
deep and labored breathing



Early symptoms of severe hypoglycemia, particularly in the drug-induced type of hypoglycemia, resemble an extreme shock reaction. Symptoms include:

cold and pale skin
numbness around the mouth
apprehension
heart palpitations
emotional outbursts
hand tremors
mental cloudiness
dilated pupils
sweating
fainting
Mild attacks, however, are more common in reactive hypoglycemia and are characterized by extreme tiredness. Patients first lose their alertness, then their muscle strength and coordination. Thinking grows fuzzy, and finally the patient becomes so tired that he or she becomes "zombie-like," awake but not functioning. Sometimes the patient will actually fall asleep. Unplanned naps are typical of the chronic hypoglycemic patient, particularly following meals.

Additional symptoms of reactive hypoglycemia include headaches, double vision, staggering or an inability to walk, a craving for salt and/or sweets, abdominal distress, premenstrual tension, chronic colitis, allergies, ringing in the ears, unusual patterns in the frequency of urination, skin eruptions and inflammations, pain in the neck and shoulder muscles, memory problems, and sudden and excessive sweating.

--------------------------------------

prolactin acts to clear glucose, so your prolactin production may also have been covering up some blood sugar issues. IMO its more likely that you had a hyperglycemic reaction, though it could be either depending on you.

1. doing cardio frequently (more likely hypo)
2. overweight (more likely hyper)
3. on gear (more likely hyper- but depends on gear type, ratios, and ancillaries)
4. time between episode and last meal (with protein)--- tea with sugars is not really ever a good idea alone
5. constituents of tea and amount consumed. hydration level prior as well as electrolyte intake is also relevant (sodium and potassium levels significantly affect blood sugar and insulin, as does their osmolity)


keeping in mind that whether you had initially hyper or hypoglycemia, likely the reaction to either induced the other afterwards.

 

[Macro]

as mentioned, would venture to guess that there is some underlying blood sugar issue that ran into somewhat a perfect storm.

again, pretty sure hyperglycemia. especially since you strongly mentioned it was "sweet" tea. if it had sucrose or HFCS with no caffiene, its almost a certainty that it was hyperglycemia.

 

[thomasfouraker]

It was good old fashioned southern sweet tea, caffiene and regular granulated sugar. I am a firefighter/paramedic, and while not an expert, am considerably familiar with hypo and hyperglycemia. This was neither I know for sure. With a blood sugar less than 60 one would expect an altered mental status with possible combativness, this was not the case. I remained 100% coherent until I blacked out. Hypoglycemia needs an intervention of sugars to pull oneself back into a normal range. Your body isnt just gonna raise its blood sugar without an outside introduction of glucose. As well, hyperglycemia wouldnt have fixed itself within the 30 seconds I was out either. I have no history of blood sugar problems and still do not think this was sugar related. I believe it is accredited to a tachy non perfusing rythm as well as some orthostatic hypotension. I believe blacking out for a short period of time while not breathing would slow my heart rate down to an acceptable speed to reperfuse my brain and reset everything back to homeostatis.

 

[Macro]

the problem is that you should not have seen a dopamine surge within that time period. now orthostatic hypotension is a common issue when starting pramipexole or GH.

actually hyperglycemia would have been "fixing itself" the whole time (gh still utilizes glucose, the release of glucagon would force the release of NE (which is inhibited to some extent by dopaminergics like prami).


you are probably familiar with diabetic hypo and hyperglycemia, perhaps some forms of drug induced.


basically would venture to guess that your body has become used to relying on prolactin to some extent to clear glucose. You are taking a very high dose of clomiphene, which can inhibit insulin release and cause hyperglycemia. part of the reason that its effective in PCOS is because it lowers insulin, which increases SHBG. Dopaminergics can also cause hyperglycemia though its less common, with pramipexole and cabergoline (fairly common with bromocriptine).

your reaction is certainly an uncommon one, there seem to be a lot of factors at play here. Sucrose not only raises BG but blunt insulin sensitivity as well.

unlike most people with BG issues, you likely have "normal" functioning endocrine system (hence when you have a glucose crisis, your body can overcome it rather quickly, just not quickly enough in this particular case.

so here you have blunted insulin release, blunted response to insulin (as GH would be peaking right around this time), blunted response to insulin due to fructose, a probably several other factors at play here including hydration, HEAT and electrolytes.

what was meal prior and how long before?

 

[Macro]

btw- this is not to say that there might not be other contributing factors.

and note- dont run 100mg clomid, especially not for that long. there really is no need to dose that high, and frontload of any kind just increases sides rather than benefits.


JMHO

 

[thomasfouraker]

My meal prior to that was a tuna fish sandwich on white bread. Mayo, Mustard and relish. approx 3 hours prior to when this happened. I had ate about 8 chicken wings and a few pieces of celery when I began to feel too nauseous to eat anymore. I began to feel extremely weak not even thinking I could make it to the bathroom to try and throw up. I put my head down and thats when I blacked out. What makes me think it was more cardiac was my resting heartrate the rest of the night was well into the 100's. And when I got up to use the bathroom at around 3am, I started feeling extremely dizzy. I went back to lay down and felt my radial pulse and it was not present. This usually indicates a systolic less than 90. When my radial pulse returned after a few seconds of lying down it was weak, rapid and thready. I am a healthy 22 year old male with no past medical problems. I find no coincidence that this happened when I doubled the dose of the Prami.

 

[Macro]

never said that it was coincidence, merely that it was unlikely due to dopamine surge.

the first sign of hyperosmolar dehydration with hyperglycemia may be syncope. you did say you were eating chicken wings, with sucrose based tea. so fried (transfatty acids) and saturated fats, likely salty to say the least.

again not saying that increasing the prami was not a big factor, just that it was one of several factors and that the cause of your issue was most likely hyperglycemia (because of prami, clomid, salty foods, sucrose and dehydration... to name few).

so to be clear, doubling the prami was certainly a factor, but it was not the doubling ALONE that caused your issues (it certainly may have been the tipping factor... but all those other things mentioned were factors already at play).

 

[thomasfouraker]

would that explain a higher resting heart rate and lowering blood pressure? There is no doubt I can tell when Prami starts to kick in. At .5mg I felt nauseated and tired, but this time it seemed to get overwhelming to the point of feeling weak and wanting to throw up. I think my body just couldnt tolerate such a rapid increase in dose. I will look up a lil more info on hyperglycemia, however I have been to numerous people with blood sugars in the 4, 5 and even 6 hundreds that were conscious and alert.

 

[Macro]

would that explain a higher resting heart rate and lowering blood pressure? There is no doubt I can tell when Prami starts to kick in. At .5mg I felt nauseated and tired, but this time it seemed to get overwhelming to the point of feeling weak and wanting to throw up. I think my body just couldnt tolerate such a rapid increase in dose. I will look up a lil more info on hyperglycemia, however I have been to numerous people with blood sugars in the 4, 5 and even 6 hundreds that were conscious and alert.

again, certainly the prami, as well as the clomiphene and the sugars with saturated and transfats, and what looks to be high sodium, low potassium intake (at least in the meals described) all seemed to work against you, perhaps all just in timing, plus the nausea that the prami itself may have caused might have triggered other hormones and the spike in GH which would have been at its peak in relation to dose timing... just trying to paint a picture here, so you and other can avoid such.


just as a note-
Symptoms of severe high blood sugar include:

A rapid heart rate with a weak pulse.
Drowsiness and difficulty waking up.
Increased weakness.
Sometimes, loss of consciousness.

 

[Macro]

pramipexole may not be suitable for you. or you may really need to slow and low it.

do think that the high dose clomid and dietary choices were strong factors here as well.

 

[thomasfouraker]

i never entertained hyperglycemia as the culprit given the symptoms being so cardiac related in nature, however considering the decreased insulin production brought upon by these drugs it could most definitly been a high blood sugar related event. My blood glucose never travels above 120 under normal circumstances regardless of diet. Its quite feasable that my threshold for blood glucose tolerance might be in the 300's and when it climbed that high my body began to compensate by whatever means possible (increased HR, sweating to excrete excess sugars etc.) It almost makes me want to start taking the Prami @ .25mg again with 25mg clomid and monitor by blood glucose thru ou the day.

 

[pirateman]

Thomas shoot me a pm and let me know how it went!!! Have not heard from you in a while.

 

[thomasfouraker]

Pirate, good to see you around man, havent heard from you in a good bit. You got PM!