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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 20 of 20. This is the beginning of the thread.
Posted by IsoM on February 1, 2002, at 6:14:52
I just read, in case anyone is interested, that folic acid can increase the efficacy & reduce the side effects of fluoxetine (Prozac®). Which makes me wonder if it may also work similarly with other SSRIs?
(from Coppen A, Bailey J. Enhancement of the antidepressant action of fluoxetine by folic acid: a randomised, placebo controlled trial. J Affect Disord 2000;60:121–30.)
Posted by jane d on February 1, 2002, at 11:56:06
In reply to Prozac and Folic Acid, posted by IsoM on February 1, 2002, at 6:14:52
This is interesting. I had heard that even larger doses of folic acid (5+mg, 10x that in the study) might help depression but I haven't found any documentation of that. I wonder if they would get the same results running this experiment on a US population. They might not because the US has mandatory food supplementaion with folic acid and the UK, where the study was run, does not. That might mean that US residents are already getting as much folic acid as the subjects in the study (or of course it might not). So I'd really like to know whether the positive effect gets greater with higher doses of folate.
I found this on the UK's current supplementing debate while I was looking for information on higher doses. http://bmj.com/cgi/content/full/323/7323/1198 This is an BMJ editorial from which you can get to all the rest of their material (free by the way).
What does Canada currently do about supplementing?
Jane
Posted by IsoM on February 1, 2002, at 14:01:47
In reply to Re: Prozac and Folic Acid » IsoM, posted by jane d on February 1, 2002, at 11:56:06
From what I read years ago, the States put a limit on the amount of folic acid that was allowed to be added to supplements because of the tie-in vitamin B12 has with folic acid related to pernicious anemia.
If a person develops pernicious anemia & is taking folic acid, it can mask the symptoms of pernicious anemia but still cause physical deterioration from the anemia. So the FDA (? -not certain it's them) put a limit on the amount of folic acid allowed in supplements, especially considering the meaning of pernicious - death dealing.
In Canada, I think one can buy tablets of 5 mg, but that amount is unnecessarily high. Most folic acid supplements are 1 mg. In multivitamin supplements, the level is much lower.
Thanks for the link - I'll read it over a little later.
Posted by OldSchool on February 1, 2002, at 14:54:42
In reply to Prozac and Folic Acid, posted by IsoM on February 1, 2002, at 6:14:52
> I just read, in case anyone is interested, that folic acid can increase the efficacy & reduce the side effects of fluoxetine (Prozac®). Which makes me wonder if it may also work similarly with other SSRIs?
>
> (from Coppen A, Bailey J. Enhancement of the antidepressant action of fluoxetine by folic acid: a randomised, placebo controlled trial. J Affect Disord 2000;60:121–30.)
>Im skeptical of this. Remember you dont need much Folate to be healthy. Multivitamins typically only have 400 mcg, even the B-100 complex you buy at the health food stores only contain 400 mcg of folic acid, while containing 100 mg of each of the other B vitamins. And note thats micrograms of folic acid, not milligrams. The only person for whom a folic acid supplement would probably make any difference in would be someone who was folate deficient to begin with.
Its also easy to overdo folic acid, thats why vitamin supplements dont generally contain more than 400 micrograms of this B vitamin.
Old School
Posted by jane d on February 1, 2002, at 18:10:30
In reply to Folic Acid in Canada » jane d, posted by IsoM on February 1, 2002, at 14:01:47
IsoM
Folic acid in doses higher than 800mcg require a prescription in the US. This was not because there was a risk in taking higher doses of folic acid itself but because higher doses could prevent the the anemia caused by B12 deficiency but not the nerve damage which wouldn't be recognized by itself in time.
At the same time the US requires manufacturers to add folic acid to prepared cereals and bread to prevent deficiency caused birth defects. I think they supposedly add enough that your morning cornflakes should provide enough all by itself but I'm not sure of this. That's why I wondered whether people in the UK, without the added folic acid in their rice krispies, might have responded because they were slightly deficient.
And, of course, I'm also wondering if there is something unique about Prozac here.
Posted by Willow on February 1, 2002, at 23:20:37
In reply to Re: Folic Acid in USA in food and OTC » IsoM, posted by jane d on February 1, 2002, at 18:10:30
My doctor years ago had prescribed a 5mg tablet for myself. Guess what we learnt? Only sold in 1mg tablets.
For any woman trying to get pregnant it is recommended here that they start prenatal supplements three months before. I think this is for the folic acid.
Whistling Willow
Posted by sid on February 3, 2002, at 11:32:22
In reply to Re: Folic Acid in Canada - CAM, posted by Willow on February 1, 2002, at 23:20:37
> For any woman trying to get pregnant it is recommended here that they start prenatal supplements three months before. I think this is for the folic acid.
>
> Whistling WillowIndeed, that's to avoid nervous system problems in the baby, especially spina bifida.
I took folic acid during my major depression (over-the-counter supplements), hoping it would help, but all it gave me was a constant headache, worse than the "depression headache" that the illness gave me. So I had to stop. I didn't take meds then however. Taken alone during depression, I couldn't stand the side effect of folic acid. Without depression it may be different of course. Or with meds.
Posted by IsoM on February 3, 2002, at 15:44:44
In reply to headaches, posted by sid on February 3, 2002, at 11:32:22
Sid, you're sure it was folic acid that gave you headaches? Is this a common problem with it, or what? First time I've heard about that but I'd like to know more. You see, I include folic acid in my supplements & I get fairly frequent headaches.
Some are tension, some are migraines with auras & some are related to muscle soreness from old injuries- they get so interwoven with one another that it's hard to know what's what sometimes. Any info would be greatly appreciated.
The only 'cure' I've ever found that works consistently is frequent (+4 times per week), & fairly strenuous, physical activity lasting at least 1 or 2 hours. But then if I slip in my activity level & develop a prolonged headache (they can last days or even a week or more), it's difficult to get that physically active again due to the thumping pain.
It was due to the re-emergence of *severe* headaches from sitting too much that I had to give up my attempt to return to university after a year & half of headaches & study. (They also make me stupid - very hard to think, it hurts more)
Posted by sid on February 3, 2002, at 21:24:23
In reply to Re: headaches and folic acid » sid, posted by IsoM on February 3, 2002, at 15:44:44
Hi IsoM,
well, I don't remember if it was a B complex or just folic acid I took. It could have been either because I had heard that a lack of folic acid and possibly other vitamins from the B complex could lead to depression. Sorry, I am not sure what I took exactly.
But yes, I am sure that these B-vitamin or folic acid supplements gave me headaches. These headaches (different from the ones I often had during major depression, due to the illness) started a few days after I started taking the supplements and stopped when I stopped taking them. I took the supplements for a couple of weeks, then decided to stop and see if these headaches would go away, and I threw the bottle out after realizing they did.
I have no idea why it happened, I just preferred to live without those headaches. Now everyday I take Centrum Strong, which have folic acid in them, but surely not as much as the supplements I used to take. No problem with those.
Try changing your supplements, taking the folic acid out if possible, and see if it changes anything to your symptoms.
- sid
> Sid, you're sure it was folic acid that gave you headaches? Is this a common problem with it, or what? First time I've heard about that but I'd like to know more. You see, I include folic acid in my supplements & I get fairly frequent headaches.
>
> Some are tension, some are migraines with auras & some are related to muscle soreness from old injuries- they get so interwoven with one another that it's hard to know what's what sometimes. Any info would be greatly appreciated.
>
> The only 'cure' I've ever found that works consistently is frequent (+4 times per week), & fairly strenuous, physical activity lasting at least 1 or 2 hours. But then if I slip in my activity level & develop a prolonged headache (they can last days or even a week or more), it's difficult to get that physically active again due to the thumping pain.
>
> It was due to the re-emergence of *severe* headaches from sitting too much that I had to give up my attempt to return to university after a year & half of headaches & study. (They also make me stupid - very hard to think, it hurts more)
Posted by IsoM on February 3, 2002, at 23:42:28
In reply to Re: headaches and folic acid » IsoM, posted by sid on February 3, 2002, at 21:24:23
If other vitamins are okay for you to take & just that brand that bothers you, it may be the extras that are added or the binder for the tabs - something like that.
I'll leave my B complex alone for a week. I do take B vitamins mostly as nutritional yeast flakes with juice, but I get lazy & often find it easier to pop a pill instead. I've been doing that lately. I'll see how I feel after a week of no B complex tabs. Thanks, sid!
Posted by Willow on February 4, 2002, at 7:30:53
In reply to Re: headaches and folic acid » sid, posted by IsoM on February 3, 2002, at 15:44:44
> some are migraines with auras (They also make me stupid - very hard to think, it hurts more)
Iso
How often do you get the migraines? I get them infrequently. My first one appeared in grade school. Now I don't get the pain anymore, but do get all the other symptoms, aura, and yes my mind goes blank. This terrified my family and myself, the doctor diagnosed it as a migraine. So even without the pain the mind stops. Weird, huh! If they are frequent you may want to inquire with your doctor about treating them.
Regarding the muscle pain and tension headaches, (I'm going to sound like a broken record here,) inquire about baclofen. I just take 5-10mg every night and it has made a differnce. Whenever I skip it the aches return, so it isn't a cure but it helps. It does take a couple weeks to feel the real benefits.
Hang in there!
Willow
Posted by IsoM on February 4, 2002, at 14:02:41
In reply to Re: headaches and folic acid, posted by Willow on February 4, 2002, at 7:30:53
Thanks, Willow. I'll look into baclofen. From the word, it looks like a NSAID. I do have a prescription for Vioxx, the most effective NSAID I've found, but I prefer to use it sparingly. Whenever I take NSAIDs, I bruise horribly from the slightest thing - even pressure on the same place for long leaves bruises. I had complete blood work done as one doctor thought I looked like I was beaten. My tests came back very, very good, but I have (I think it's genetic) a mild enough reaction to NSAIDs with my platelets.
I'm 52, & like you, I get more auras now that don't progress to pain, but still leave me a little spacey. I get a lot of lights, spots, etc in my vision. Yet eye tests showed nothing different. It's one reason I was so excited when I tried the Subsyndromal Epilepsy questionnaire on another page of Dr. Bob's. I scored high on it.
All three of my sons tried it too. One got a higher score than me, another was similar to mine, & my oldest only answered yes to one single question - weird! He said if that's what we have to operate under, no wonder we feel like our brain doesn't work at times. He had no idea we experienced these things.
I did have tests done by a neurologist & he suggested valproic acid as the main med. I figured at this point that I've lived with headaches for years (& according to tests, manage my pain well) that I didn't want to add another drug with such potentially harmful side-effects.
I just need to kick myself in the rear to get physically more active. I used to walk 5 miles 4 times a week, rain or shine, & weight train at one time. I don't have the room in this place & I hate going to a gym full of people. I prefer working out alone. And it's just very easy for me to break habits but very difficult to form new ones.
I'm curious how often you get migraines, pain or not now, too. Mine seem to have no pattern, no triggers that I've ever found. How about yours? I can get them once a week or more; or other times, a month or two will pass without one. No seasonal pattern either. Actually any headache makes me stupid. A concept that I could easily grasp other times has me struggling to put it together when I have a headache. And it HURTS like hell then to think! You too?
The neurologist who tested me said more & more, it's thought that migraines & frequent tension headaches are part of the same spectrum of a disorder - serotonin problems. He suggested an AD for me but I told him I was already using one. That's when he suggested valproic acid. I still consider it at times, but it does make me nervous.
There I went again, blithering on...
Posted by Willow on February 4, 2002, at 17:49:53
In reply to Headaches and Baclofen » Willow, posted by IsoM on February 4, 2002, at 14:02:41
> Whenever I take NSAIDs, I bruise horribly from the slightest thing - even pressure on the same place for long leaves bruises.
Regarding the bruising, I too often look like a punching bag, turns out my ferritin (iron reserves) are low. You may want to inqire about this, note my haemoglobin (sp) is fine.
I too cannot take NSAIDS because of the bruising and my stomach. (Many other things my stomach disagrees with, the joys of smoking I think!) Baclofen is a muscle relaxant. It actually lessens tension in the muscles compared to some others that just knock me out.
>
>I get a lot of lights, spots, etc in my vision.These I refer to floaters or "star wars" shows. They I only find annoying when driving because I find myself concentrating on them and have to keep forcing myself to focus on the road. Distracting!
What I meant by auras are like halos around objects, and with these I get the slowing of mind and extreme fatigue. I don't know if the fatigue is a cause of the auras or vice versa or if they just by chance come together because of an effect. I'm beyond questioning and just accept them as signs. (Not the spiritual type though!) >
> He had no idea we experienced these things.
I can remember reading about "yuppy flu" as a teenager and thinking it was just burnout for old folks trying to live like teenagers. The fatigue I can't compare to anything else I've experienced before so how can I explain it.
>
> And it's just very easy for me to break habits but very difficult to form new ones.Welcome to the human race! I think it's easier to do stuff that we enjoy. Try finding an activity that appeals to you.
>
> I'm curious how often you get migraines, pain or not now, too. And it HURTS like hell then to think! You too?Mine are pretty much hormone related, menstrual, and stress. After a car wiped out in front of me, about an hour later the migraine hit. They seem to come for awhile and pulse away with more frequency for several months and then their gone.
I can't say it hurts for me to think when my mind goes blank, there's just no zap in the old brain. Unable to comprehend anything that I read sort of thing.
>
> That's when he suggested valproic acid. I still consider it at times, but it does make me nervous.Despite the problems I had with my past doc I generally trust that between my docs and pharmascist they can keep track of any problems that may arise from medications.
>
> There I went again, blithering on...Blithering is good!
Willow
Posted by IsoM on February 4, 2002, at 19:04:41
In reply to Re: Headaches and Baclofen, posted by Willow on February 4, 2002, at 17:49:53
>"...You may want to inqire about this, note my haemoglobin (sp) is fine."
When my blood work was done, they checked out different mineral & vitamin levels too. Everything was either at normal or above normal levels. (I haven't had periods for 16 years now too.)
>"... Baclofen is a muscle relaxant. It actually lessens tension in the muscles compared to some others that just knock me out."
So I see from looking it up! I need to see my doc for prescription refills this Friday. I'll bring it up to him then - thanks!
> "...These I refer to floaters or "star wars" shows. They I only find annoying when driving because I find myself concentrating on them and have to keep forcing myself to focus on the road. Distracting!"I get floaters too but lots of weird other lights & movements. I don't mind them though but I notice a real increase in them whenever I do have a headache. Much harder to focus too with a headache. Words are more blurry.
> "...What I meant by auras are like halos around objects, and with these I get the slowing of mind and extreme fatigue. I don't know if the fatigue is a cause of the auras or vice versa or if they just by chance come together because of an effect. I'm beyond questioning and just accept them as signs. (Not the spiritual type though!)
Fatigue, hmmm? I don't get fatigue with the headaches, auras or not. I get different auras depending, I think, in what part of the brain the extra activity is going on. Most are the ordinary scintillating scotomas but some are smells & some real irritability. The day after a headache I feel drugged & woozy though. :-)
> "...And it's just very easy for me to break habits but very difficult to form new ones."
I actually found it so easy to quit smoking but I'd only smoked 2 years. I don't tend to form bad habits - I just don't form good habits easy. More of a non-doer than doer, I guess.
> I can't say it hurts for me to think when my mind goes blank, there's just no zap in the old brain. Unable to comprehend anything that I read sort of thing.
> "...I generally trust that between my docs and pharmascist they can keep track of any problems that may arise from medications."
Not me. I'm not cynical, just know that human error can creep in so easily especiailly when someone's overworked & tired so I make sure I keep abreast of anything & always double-check. I've caught errors in the past before - one time just before an operation of mine that could've been life-threatening. Papers were mixed up & I had someone else's notes in my file. I was being asked questions just before prepping & asked a question back & caught it. Scary!
Thanks for answering, Willow. (I'm also supposed to have fibromyalgia but not as bad as some seem to have.) Oh, a pill to help me sleep & relax my muscles! Heaven!
Posted by sid on February 6, 2002, at 19:59:20
In reply to Re: Headaches and Baclofen » Willow, posted by IsoM on February 4, 2002, at 19:04:41
Posted by IsoM on February 7, 2002, at 13:52:01
In reply to Headaches: changes w/o folic acid? (nm) » IsoM, posted by sid on February 6, 2002, at 19:59:20
uhmm... what do you mean by your no message post, sid? Maybe I'm a little thick, but I don't understand. Is it for me or a general comment?
Posted by sid on February 7, 2002, at 20:41:08
In reply to Re: Headaches: changes w/o folic acid? » sid, posted by IsoM on February 7, 2002, at 13:52:01
That was not clear, sorry.
Have you seen any change since you stopped the folic acid you were taking? Perhaps I'm confused... I think you were trying to see if your headaches would go away or at least be less painful without the folic acid (vitamin B-12).- sid
Posted by IsoM on February 8, 2002, at 11:11:32
In reply to Re: Headaches: changes w/o folic acid? » IsoM, posted by sid on February 7, 2002, at 20:41:08
Right now, there's other things that clouded the headaches/vitamins thing. I had a toothache causing my head to hurt on that side. I went to the dentist Wed to find that there was a very large absess underneath the tooth. She opened & drained it & I have further appointment to get a root canal. (It became infected under an intact old filling.)
Strangely, I'm still feeling groggy & have slept so much. I think it may be my natural way of handling infections - I've got a very tough immune system. But on the other hand, no headaches!! The absessed tooth has been around for about a month, so that's definitely not the cause of prior headaches. I'll let you know later about the vitamins as of now, I'm not sure.
Posted by Dinah on February 8, 2002, at 18:09:39
In reply to Re: Headaches » sid, posted by IsoM on February 8, 2002, at 11:11:32
Ouch!!
It sounds like you have been having a rough time. Absesses and root canals! I'll be sending good wishes your way. And so Dr. Bob doesn't redirect this, I hope your pain medications are working for you. A toothache is so miserable that grogginess might be a good thing.
Dinah> Right now, there's other things that clouded the headaches/vitamins thing. I had a toothache causing my head to hurt on that side. I went to the dentist Wed to find that there was a very large absess underneath the tooth. She opened & drained it & I have further appointment to get a root canal. (It became infected under an intact old filling.)
>
> Strangely, I'm still feeling groggy & have slept so much. I think it may be my natural way of handling infections - I've got a very tough immune system. But on the other hand, no headaches!! The absessed tooth has been around for about a month, so that's definitely not the cause of prior headaches. I'll let you know later about the vitamins as of now, I'm not sure.
Posted by IsoM on February 8, 2002, at 18:15:49
In reply to Re: Headaches » IsoM, posted by Dinah on February 8, 2002, at 18:09:39
Yes, just to make sure this doesn't get shifted - no need for painkillers or benzo now.
As soon as the dentist opened up the absess, the pain went. She didn't prescribe antibiotics unless I needed them but I don't. Slept most of Wed & Thur, but today I'm bright & chipper! I'm not bothered by dentists so I don't mind having the root canal done later. If the freezing works (like it should), I like to watch with a mirror if I can. I wish I could ask questions at the same time. Crazy, huh?
This is the end of the thread.
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