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Pyridostigmine

Pyridostigmine

Get a safe and clinician approved prescription for Pyridostigmine.

ME/CFSLong COVIDPOTS
FatiguePEMBrain FogPalpitationsMuscle PainOrthostatic IntoleranceExercise IntoleranceSweating
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Pricing Example

RTHM Safety Assessment

Only charged if approved

$59

Pharmacy Cost

90-day supply + shipping

$30

Total for 90 days

With RTHM discount

$89

RTHM Safety
Assessment Fee

Paid every 90 days
(only charged if approved)

$59

Pharmacy
Cost

90-day supply + shipping, paid to the pharmacy

$30

Estimated total
for 90 days

With RTHM discount

$89

Stabilize Your Heart Rate

Pyridostigmine helps to alleviate a rapid heart rate that occurs when standing, promoting stability for those experiencing autonomic dysfunction.

Improve Exercise Tolerance

By regulating the autonomic nervous system, pyridostigmine may enhance exercise capacity and neurovascular dysregulation, helping you regain physical activity.

Improves Orthostatic Hypotension (OH)

By enhancing nerve transmission, pyridostigmine improved standing blood pressure in patients with OH, without raising blood pressure while laying down.

Is Pyridostigmine right for me?

Pyridostigmine is particularly effective for:

  • Orthostatic intolerance
  • Fatigue and exercise intolerance
  • Post-exertional malaise
  • Dizziness and syncope

Patients with POTS, Long COVID, and ME/CFS experiencing these symptoms may benefit from pyridostigmine as it addresses underlying autonomic dysfunction.

Pyridostigmine has been used for decades to treat conditions like myasthenia gravis. Studies in patients with ME/CFS and POTS suggest it is generally well-tolerated, though gastrointestinal side effects can occur, and in some cases, lead to discontinuation of the drug.

Starting with a low dose, tapering up slowly, and taking doses with food can help reduce the risk of side effects. If gastrointestinal side effects occur, reducing the dose or taking Pepto-Bismol can be helpful in mitigating them.

You should not take pyridostigmine if you:

  • Have severe gastrointestinal obstructions
  • Have a blockage in your urinary system, or kidney disease
  • Are allergic to pyridostigmine or its ingredients
  • Have bronchial asthma or significant lung disease
  • Have significant cardiovascular disease

Research Studies

In this randomized, placebo-controlled trial at Harvard involving 45 patients with ME/CFS, pyridostigmine was found to improve peak oxygen uptake (VO2), indicating enhanced exercise capacity.

"Neurovascular Dysregulation and Acute Exercise Intolerance in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Randomized, Placebo-Controlled Trial of Pyridostigmine"

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This single-center study from Toledo Medical Center found that 43% of 203 total POTS patients experienced significant improvements in orthostatic intolerance. The symptoms that improved the most included fatigue (55%), palpitations (60%), presyncope (60%), and syncope (48%). [Syncope = fainting]

"Pyridostigmine in the Treatment of Postural Orthostatic Tachycardia: A Single-Center Experience"

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In this observational study at Brigham and Women’s Hospital, 55% of patients with ME/CFS treated with pyridostigmine for over 6 months reported improvements in exercise tolerance, fatigue, and cognitive function.

"Exercise Capacity in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Treated with Long-term Pyridostigmine"

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In this retrospective study, long term treatment with pyridostigmine showed improved aerobic capacity in ME/CFS as measured by improvements in central cardiac hemodynamics.

"Exercise capacity in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) treated with long-term pyridostigmine"

View Study

What are patients saying about Pyridostigmine?

"I’ve tried many drugs for my POTS/Dysautonomia with no success, but Mestinon is really helping me. I’m able to function more, and my fatigue is reduced. It sometimes has a side effect of extreme perspiration, but I can manage. It has been a game changer for me."

Chrdrugs.com

"Pyridostigmine is way better for me. Propranolol helped somewhat with POTS but made the fatigue worse, and didn’t do much for the fight or flight. Pyridostigmine doesn’t cross the blood brain barrier though, it helps with POTS and shifting the body to a parasympathetic state but it’s unlikely to hel..."

wyundsrreddit.com

"It’s been a life saver for me. I’ve been on it almost two years now…I find mestinon really helpful for blood pooling, fatigue and brain fog. It was a game changer in allowing me to be upright again."

Treadwell2022reddit.com

"Roughly 70% of patients reported that pyridostigmine was at least somewhat effective for POTS."

Anonymousstuffthatworks.health