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HI - Related to Buerger's disease/trombangeitis obliterans

Discussion in 'Health, Safety and Vaping' started by Olix, Sep 4, 2019.

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  1. Olix

    Olix Full Member

    Jun 18, 2018
    Has anyone on this thread ever had been diagnosed with Buerger's disease ( also called trombangeitis obliterans) - a condition almost exclusivelly linked to tobacco consumtion ?

    If so, I would really appreciate if you would share some of your experiences related to the disease, your previous or current smoking habits, and if you considered starting vaping and how has it been since your diagnosis.

    I am trying to find if this disease is also linked to vaping or only to tobacco usage - if it a nicotine related condition, or if the tar and other related intoxicants are the cause.

    Thank you for all your answers in advance! I think your replies have the potential to help a lot of people !!


    • Optimistic Optimistic x 1
  2. Eskie

    Eskie ECF Guru Verified Member ECF Veteran

    May 6, 2016
    Hi, this is something you need to speak with your doctor about for the most accurate information. This vape forum, or really any forum, is not a great place for individual medical information. That said, Buerger's seems closely tied with nicotine in any form of intake, and even NRT such as patches or gum can be very problematic for those affected. I would expect vaping to be no different.
    • Agree Agree x 4
  3. iVapeDIY

    iVapeDIY Senior Member ECF Veteran

    Sep 1, 2017
    Toronto, Canada
    See your doctor immediately!:danger:

    Buerger's disease - Symptoms and causes

    Buerger's disease is a rare disease of the arteries and veins in the arms and legs. In Buerger's disease — also called thromboangiitis obliterans — your blood vessels become inflamed, swell and can become blocked with blood clots (thrombi).

    This eventually damages or destroys skin tissues and may lead to infection and gangrene. Buerger's disease usually first shows in your hands and feet and may eventually affect larger areas of your arms and legs.
    • Informative Informative x 1
  4. Baditude

    Baditude ECF Guru ECF Veteran

    Apr 8, 2012
    Ridgeway, Ohio
    As others have pointed out, if you suspect yourself or another may have this disorder, seeking medical advice is recommended. Why do you ask? Do you or someone else have this disorder?

    The rare disorder affects the distal phalanges (finger tips or toes) by causing inflamation & clotting off of the capillaries and smaller blood vessels. It is believed that nicotine, known to be a vasoconstrictor (shrinks the size of small blood vessels), could be an etiology or at least contribute to its symptoms by causing a lack of oxygen to tissues. Since e-cigarettes use nicotine, their use as well as tobacco and other products that contain nicotine, is to be avoided at all cost.

    • Informative Informative x 1
  5. GOMuniEsq

    GOMuniEsq Self-Proclaimed Member ECF Veteran

    Aug 25, 2012
    Alberta, Canada
    inb4 headline: ECF, the preeminent e-cigarette forum, confirms vaping a cause of gangrene! Vape too much and you'll have no fingers left to hold it with.
    • Agree Agree x 2
    • Funny Funny x 2
  6. Olix

    Olix Full Member

    Jun 18, 2018
    I don't have the disease. I am a strong advocate for e-cigs and currently studying medicine. I would like to know if these new life-saving devices could also be proposed to patients suffering from this disease, so in the future I know what to recommend and what not, and also when.

    Because from my analysis, e-cigarettes represent the best therapeutic alternative to tobacco consumtion, and I would have liked to know where they are relative to this subject. I wanted to underline also that this disease is not as rare as one might assume, and considering its trully awful effects, such an alternative should be analized asap. Thank you for your reply!
    • Optimistic Optimistic x 1
  7. Olix

    Olix Full Member

    Jun 18, 2018
    Well, i was asking because I too have found conflicting information related to this subject.
    The studies have yet to take into account really studying if nicotine was in fact the main culprit, as with most studies (they still struggle to separate nicotine's effects and potentially also it's side effects from tobacco's own).
    From what I read, some people who switched to vaping after being diagnosed with this condition were still feeling that the disease continued to developed, and promtly switched to 0 nic juices, while others started developping symptoms, started vaping, and then the symptoms began fading away.

    I'll be posting citations as I gather them.
    • Optimistic Optimistic x 1
  8. Baditude

    Baditude ECF Guru ECF Veteran

    Apr 8, 2012
    Ridgeway, Ohio
    I am interested in what you find, so please post.

    Cigarette smoke has not only tars and nicotine, but other harmful chemicals such as carbon monoxide which isn't good for the cardiovascular system.

    I agree that most studies involve smoking side effects and don't distinguish what harm nicotine alone causes. But we do know that nicotine is a vasoconstrictor. I'm a retired surgical physician's assistant and RN, and I know plastic reconstruction surgeons who do breast reconstructions and tram flap surgeries had their patients sign a contract agreement to stop smoking and stop using all nicotine products for two weeks prior to their surgeries because of the effects of nicotine could cause these delicate surgeries to fail. No surgeon wants a 3 -6 hour surgery to fail because the patient was using nicotine.

    It's possible that zero-nicotine vaping might be approved by some surgeons, but my guess is the vast majority would say no smoking, no vaping, no nicotine gum or patches. Maybe consider oral prescriptive meds like Chantix for Buerger's disease patients who smoke?
    • Agree Agree x 1
    • Informative Informative x 1
  9. United States

    United States Ultra Member ECF Veteran

    Aug 17, 2018
    In some people tobacco smoke causes our natural colesterol to become sticky-er than normal. In some that contributes to the onset of Buergers disease.

    My pop and my oldest brother have blood flow in the leg issues from standing up at the factory for decades. Neither have ended up with Buergers disease, just clogged arteries or what the doctor said is premature hardening of the arteries. He also said smoking was a huge factor.

    Some who've never smoked can get it and folks who chew tobacco can as well. Something to do with swelling blood vessel walls. Long term gum infection (like walking around with a tooth broken below the gum) can also contribute to it.

    It is said that ceasing tobacco use in time can allow the body to cure itself of Buerger disease.
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  10. stols001

    stols001 Mistress of the Dark Nicotinic Arts Verified Member ECF Veteran

    Supporting member
    May 30, 2017
    I know almost nothing about this subject but I'd have to say based on other NTR being not a good idea, I can't imagine vaping being any better. Certainly, I'd say that 0 nicotine might be a possibility but may not be worth the other possible risks in these cases, flavorings etc. just haven't been around long enough.

    I would not suggest Chantix as an alternative, although I guess it's one of the few options out there for these patients. Frankly, I'd be more inclined to try Wellbutrin first, the effect may not be as robust but for those it works for, it does really work and the side effect profile is a bit nicer.

    I would also point out to any WB user who has quit using that method-- they would do well to STAY quit (and I have known doctors who find that a patient stable on WB with the urge to smoke returning as it is tapered well some doctors have been known to continue the medication indefinitely and it does certainly seem to be less dangerous than smoking) as the "Wellbutrin effect" will fade in some users with each attempt. The first attempt is likely to be the most successful, and each subsequent "quit" has a less robust effect.

    I'm not a doctor, by the way, I am a person on the internet so take the above for what it is worth.

    • Like Like x 1
  11. Olix

    Olix Full Member

    Jun 18, 2018
    Well, from what I could find on the internet as far, the studies are very sparse and I was yet to find one that had specifically tested nicotine to see if the disease kept advancing or not. The only study I found talked about someone chewing tobacco, and further studies that cited that one made the false distinction of chewable tobacco as only nicotine.

    From the studies that I've found, which helped explain in part how the disease works, I took this information and combined it with what i've learned so far from med school and this is a summary of what I think of this problem:

    Buergers disease is an immune condition coused specifically by an antigen in the tobacco plant, that if smoked, or chewed enters in the blood. Although it has weak antigenic properties, it stimulated the immune system specifically in the capillary region, where blood circulates more slowly than in the big arteries (like the aorta or the arterioles). This gave me the clue that this substance is relatively large in size as it doesn't cross the vascular wall, because otherwise it would get an immune reaction going in the tissue also, but Buerger's disease is almost exclusivelly a vascular condition at it's roots. This was the first indication that that antigen was almost certainly not nicotine, as nicotine has a very small relative molecular size.

    The immune system starts an immune reaction in the capillary region, and then thromocytes start morphing together and creating thrombuses, as well as the couagulation cascade being activated (fibrin is a pillar of the immune system and of inflammation).

    Because of nicotine's small molecular size, not only is it capable of traversing the capillary wall very easily compared to most antigens, it is also too small to exert antigenic properties, that is to bind to an antibody and form an immune complex. Even compared to meds, nicotine has a very small size (that is why it can get through the blood brain barrier and cause all the psychologic effects), and molecules of that size are nonimmunogenic.

    Some very strange facts, which (because I am a stark person) lead me to believe that nicotine is almost certainly not the underlying cause of this disease is:
    1. it was incriminated in a lot of studies, but those cited other studies to support that fact, and that other studies were allways talking about something else (several studies said that nicotine could be the cause, and for that cited other studies that talked in fact about chewable tobacco); futhermore, all studies stated in the end that the antigen was yet to be found (then why incriminate nicotine) - so there was a dissimulation going full on from what I could tell.

    2. there wore no studies in which doctors continued to give their patient which had buerger's only nicotine to test the hypothesis. They could have done this safely because after givimg up om tobacco, the body clears capillaries that are not fully thrombosed. So they could let their patients off tobacco for some time, than only introduce nicotine and see if the condition reactivates, and then quickly stop nicotine. There could also be animal model studies, which have also not been done yet, or cell culture studies from patients............. -weren't they supposed to find the culprit already ??

    Some people said that nicotine could be the cause because it is a potent vasoconstrictor ( and adding to it that the whole vasodilation/vasoconstricion debucle is also complicated, because never does the body do vasoconstriction in all areas -when muscle arteries vasoconstrict, organ arteries vasodilate, most notably thr brain, and vice versa; the brain's arteries very rarelly vasoconstricts, and only to a minor degree, because it is a critical region).

    So while nicotine generally being a vasoconstricting substance, this disease is all about an immune reaction that activates the coagulation cascade , which in turn ends up clogging arteries. Capillaries don't constrict as they don't have muscles, only bigger arteries and arterioles leading to the capillaries. But visually, even if it was the case, after the nicotine's effects dulled down, the arteries would vasodilate and the blood clot would advance it's way further.

    The only other possible way for this immune reaction to occur would be if the endothelial cells (cells that line the vascular wall) would get damaged, and fast (lile in a lot of antigen that would bind to the cells and destroy them or a lot of smoking), and the inside contents of that cell would get released outside and start an immune reaction. While this is also an alternate explanation for this disease, still, nicotine also doesn't damage any cell in the organism in any way. The effects it has are because of it binding to different receptors in the organism. It is a pretty "inert substance".

    If it were for me, I would start studying the relation between this disease and nicotine asap, as NRTs and particullarly electronic cigarettes are a very good alternative to smoking, are the best "gateway" to stopping tobacco addiction altogether. The e-cig has always intrigued me, because as I once put it, it's a modified asthma inhalator that could save a billion lives.

    This is the link to the o only two cases I could find that specifically talk about this subject: in the first case, i thinl the person stopped vaping before he/she could figure out it's profile related to the disease, and in the second case I would like to note that she didn't tell if she was also diagnosed with buerger's, or if she made that assumption. They are both pretty good reads:

    1. Vaping over analogs ..... Something you should know.
    2.Real Stories - Jennifer Berger Coleman - Part 1 | Five Pawns Blog
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