![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 4 to 28 of 93. Go back in thread:
Posted by Ritch on April 2, 2003, at 10:07:13
In reply to Ok- now who takes vitamins/what kind(s)/how many?, posted by Janelle on April 1, 2003, at 21:58:06
> I got some good and helpful answers about how many MEDS some people out there are on; and I'm in the middle range - some take less, others take more, so I feel *reassured*!!
>
> However, several people mentioned taking supplements like vitamins and minerals - gosh, I don't take that - well, just a multivitamin - I used to take more supplements. Think I'll ask pdoc next time, although he probably won't have a clue about that kind of stuff.
I take a multi-vitamin with lunch, +400 units extra E, +teaspoon of fish oil (800mg EPA), +500mg L-tyrosine (on empty stomach with juice in the AM). Thinking of adding Gingko Biloba since Larry Hoover mentioned that it had anti-cortisol effects.
Posted by susan b. anthony on April 2, 2003, at 11:28:56
In reply to Ok- now who takes vitamins/what kind(s)/how many?, posted by Janelle on April 1, 2003, at 21:58:06
>> However, several people mentioned taking supplements like vitamins and minerals - gosh, I don't take that - well, just a multivitamin - I used to take more supplements. Think I'll ask pdoc next time, although he probably won't have a clue about that kind of stuff.
Hi I take a multivitamin, 1500 mg Evening primrose oil, black cohash, soy protein - all of this to help with severe PMS - althought the LEX has been helping with this.
Posted by Larry Hoover on April 2, 2003, at 12:21:29
In reply to Ok- now who takes vitamins/what kind(s)/how many?, posted by Janelle on April 1, 2003, at 21:58:06
> I got some good and helpful answers about how many MEDS some people out there are on; and I'm in the middle range - some take less, others take more, so I feel *reassured*!!
>
> However, several people mentioned taking supplements like vitamins and minerals - gosh, I don't take that - well, just a multivitamin - I used to take more supplements. Think I'll ask pdoc next time, although he probably won't have a clue about that kind of stuff.I was really hoping somebody else would jump in here.....I could go on and on and on....
Most Western doctors are taught a philosophy which places vitamins in a peculiar role in nutrition, i.e. they are useful solely to avoid deficiency diseases. There is no perception that intake above the preventative dose may have some optimization of effects, quite apart from the absence of the particular deficiency syndrome.
If you have a few minutes, you may want to read an essay which discusses the different paradigms of vitamin supplementation:
http://www.internetwks.com/pauling/hoffer.html
One recent study, which ought to have received far greater publicity than it did, found a massive correlation between sugar consumption and the incidence of major depression. We know that correlation does not imply causation, but the obvious implication is that diet can have a major impact on mood. It may not be sugar that is the culprit, as dietary sugar can also be a measure of food processing taken as a whole. Why doesn't this issue get media attention, rather than e.g. comparisons of side-effect profiles of psychotropic drugs?
Depress Anxiety 2002;16(3):118-20
A cross-national relationship between sugar consumption and major depression?
Westover AN, Marangell LB.
Mood Disorders Center (MDOC), Department of Psychiatry, Baylor College of Medicine, Houston, Texas, USA. anwestover@yahoo.com
We have preliminarily investigated the hypothesis that sugar consumption may impact the prevalence of major depression by correlating per capita consumption of sugar with the prevalence of major depression. Major depression prevalence data (annual rate/100) was obtained from the Cross-National Epidemiology of Major Depression and Bipolar Disorder study [Weissman et al., 1996]. Sugar consumption data from 1991 was obtained from the Food and Agricultural Organization of the United Nations. For the primary analysis, sugar consumption rates (cal/cap/day) were correlated with the annual rate of major depression, using the Pearson correlation coefficient. For the six countries with available data for the primary analysis, there was a highly significant correlation between sugar consumption and the annual rate of depression (Pearson correlation 0.948, P=0.004). Naturally, a correlation does not necessarily imply etiology. Caveats such as the limited number of countries with available data must be considered. Although speculative, there are some mechanistic reasons to consider that sugar consumption may directly impact the prevalence of major depression. Possible relationships between sugar consumption, beta-endorphins, and oxidative stress are discussed. Copyright 2002 Wiley-Liss, Inc.
Now, you may have caught the closing statement, which implicates oxidative stress. What is oxidative stress? Broadly, it is a destructive process which degrades the structural and functional integrity of all cells in the body. Many alternative therapies for depression (e.g. SAMe, inositol, fish oil, B-vitamins, minerals such as magnesium, zinc, and selenium) directly address the physiological consequences of oxidative stress. Honestly, I think that ought to be the central theme of any supplement strategy with respect to mood disorders.
You suggested that your pdoc may neither be aware of, nor supportive of, nutritional strategies. I assure you that the information has been available in mainstream journals for some time. Here are a few abstracts which deal with one B-vitamin, folate, and its interaction with another, B-12, in the context of oxidative stress (blood homocysteine is a marker), and neurological dysfunction:
Nutr Rev 1996 Dec;54(12):382-90
Folate, vitamin B12, and neuropsychiatric disorders.
Bottiglieri T.
Kimberly H. Courtwright and Joseph W. Summers Institute of Metabolic Disease, Baylor University Medical Center, Dallas, Texas, USA.
Folate and vitamin B12 are required both in the methylation of homocysteine to methionine and in the synthesis of S-adenosylmethionine. S-adenosylmethionine is involved in numerous methylation reactions involving proteins, phospholipids, DNA, and neurotransmitter metabolism. Both folate and vitamin B12 deficiency may cause similar neurologic and psychiatric disturbances including depression, dementia, and a demyelinating myelopathy. A current theory proposes that a defect in methylation processes is central to the biochemical basis of the neuropsychiatry of these vitamin deficiencies. Folate deficiency may specifically affect central monoamine metabolism and aggravate depressive disorders. In addition, the neurotoxic effects of homocysteine may also play a role in the neurologic and psychiatric disturbances that are associated with folate and vitamin B12 deficiency.
Am J Psychiatry 1997 Mar;154(3):426-8
Folate, vitamin B12, and homocysteine in major depressive disorder.Fava M, Borus JS, Alpert JE, Nierenberg AA, Rosenbaum JF, Bottiglieri T.
Depression Clinical and Research Program, Clinical Psychopharmacology Unit, Massachusetts General Hospital, Boston 02114, USA. favam@A1.mgh.harvard.edu
OBJECTIVE: The authors examined the relationships between levels of three metabolites (folate, vitamin B12, and homocysteine) and both depressive subtype and response to fluoxetine treatment in depressed patients. METHOD: Fluoxetine, 20 mg/day for 8 weeks, was given to 213 outpatients with major depressive disorder. At baseline, depressive subtypes were assessed, and a blood sample was collected from each patient. Serum metabolite levels were assayed. Response to treatment was determined by percentage change in score on the 17-item Hamilton Depression Rating Scale. RESULTS: Subjects with low folate levels were more likely to have melancholic depression and were significantly less likely to respond to fluoxetine. Homocysteine and B12 levels were not associated with depressive subtype or treatment response. CONCLUSIONS: Overall, the results are consistent with findings linking low folate levels to poorer response to antidepressant treatment. Folate levels might be considered in the evaluation of depressed patients who do not respond to antidepressant treatment.
Acta Neurol Scand Suppl 1994;154:27-31
Effects of the disruption of transmethylation in the central nervous system: an animal model.
Scott JM, Molloy AM, Kennedy DG, Kennedy S, Weir DG.
Department of Biochemistry, Trinity College, Dublin, Ireland.
INTRODUCTION--Central nervous system (CNS) methyltransferases methylate a wide range of substrates including proteins, lipids, nucleic acids and hormones. In every instance the methyl donor is S-adenosylmethionine (SAMe) and the demethylated product is S-adenosylhomocysteine (SAH). Methylation can be disrupted when there is an inadequate supply of methionine synthase (following vitamin B12 deficiency or folate deficiency), SAMe synthetase (due to ethanol), or SAH hydrolase (for unknown reasons). MATERIAL AND METHODS--5-week-old pigs were maintained in an environment of either air or nitrous oxide, which inhibits methionine synthase, and were fed either a methionine-unsupplemented or methionine-enriched diet. After 3 to 10 weeks, pigs were killed by pentobarbitone injection and the levels of methionine and SAMe in the pigs' brain, spinal cord, plasma, liver, and kidney assessed. RESULTS--Pigs maintained in nitrous oxide displayed a dramatic fall in methionine levels in plasma and brain tissues but maintained relatively normal SAMe levels in these tissues. Brain and spinal cord cystathionine levels were markedly elevated, especially in those animals receiving oral methionine, as in the absence of methionine synthase homocysteine can be metabolized only through the catabolic pathway to cystathionine and cysteine. CONCLUSION--Disorders such as vitamin B12 deficiency or folate deficiency inhibit methylation by limiting the availability of SAMe or by elevating levels of the inhibitor SAH. In either case, the disruption of a wide range of methylation reactions can cause clinical sequelae ranging from structural abnormalities such as myelopathy to functional abnormalities such as depression.
And here's one on the testable deficiency in B-12:
Blood 1990 Sep 1;76(5):871-81
Comment in:
Blood. 1991 Apr 15;77(8):1853-4.
Blood. 1991 Jan 1;77(1):206-7.Clinical spectrum and diagnosis of cobalamin deficiency.
Stabler SP, Allen RH, Savage DG, Lindenbaum J.
Department of Medicine, University of Colorado Health Sciences Center, Denver 80262.
To better estimate how frequently patients with low serum cobalamin (Cbl) levels in current clinical practice are truly deficient in Cbl and to determine the incidence of atypical or nonclassic presentations of Cbl deficiency, we prospectively studied 300 unselected consecutive patients with serum Cbl concentrations less than 200 pg/mL seen at two medical centers over a 2-year period. Baseline hematologic, neuropsychiatric, and biochemical measurements were obtained, followed by a course of parenteral Cbl therapy and reassessment. A response to Cbl therapy was defined as one or more of the following: (1) an increase in hematocrit of 0.05 or more; (2) a decrease in mean cell volume of 5 fL or more; (3) a clearing of hypersegmented neutrophilis and macroovalocytes from the peripheral blood smear; and (4) an unequivocal and prompt improvement of neuropsychiatric abnormalities. Of the 300 patients with serum Cbl levels less than 200 pg/mL, 86 had one or more responses to Cbl therapy and 59 had no response. In 155, insufficient data was available. In the Cbl-responsive patients, normal values were found for the following tests: hematocrit, 44%; mean cell volume less than or equal to 100 fL, 36%; white blood cell count, 84%; platelet count, 79%; serum lactic dehydrogenase, 43%; and serum bilirubin, 83%. Peripheral blood smears were nondiagnostic in 6% when reviewed by the investigators, but 33% as reported by routine laboratories. Serum Cbl levels in the 100 to 199 pg/mL range were present in 38%. Neuropsychiatric abnormalities were noted in 28%, often in the absence of anemia, macrocytosis, or both. Serum levels of methylmalonic acid and/or total homocysteine were elevated greater than 3 SDs above the mean for normal subjects in 94% of the Cbl-responsive patients. We conclude that Cbl deficiency should be considered and investigated in patients with unexplained hematologic or neuropsychiatric abnormalities of the kind seen in Cbl deficiency, even if anemia, an elevated mean cell volume, a marked depression of the serum Cbl, or other classic hematologic or biochemical abnormalities are lacking. Levels of serum methylmalonic acid and total homocysteine are useful as ancillary diagnostic tests in the diagnostis of Cbl deficiency.
For this first-level reply to your question, I just wanted to lay the foundation for any detailed answer. The physiological need for nutrients is very likely enhanced in the case of psychiatric disorders, may be made worse by psychotropic medication, and is confounded by a general decline in the nutrient quality of our food supply (and downwards adjustments in the RDI (Reference Daily Intake) of many nutrients, corresponding to the decline in their availability). Add to that the pervasive attitude that most people obtain adequate nutrition from a typical diet (wrong!), and you've got a recipe for treatment-resistance.How much detail do you want?
Lar
Posted by Ritch on April 2, 2003, at 13:51:42
In reply to Re: Ok- now who takes vitamins/what kind(s)/how many?, posted by Larry Hoover on April 2, 2003, at 12:21:29
Posted by Ron Hill on April 2, 2003, at 14:13:40
In reply to Re: Ok- now who takes vitamins/what kind(s)/how many?, posted by Larry Hoover on April 2, 2003, at 12:21:29
Posted by johnj on April 2, 2003, at 14:40:33
In reply to Re: Yeah but what color Flintstone do you take? (nm) » Larry Hoover, posted by Ron Hill on April 2, 2003, at 14:13:40
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Posted by McPac on April 3, 2003, at 18:21:55
In reply to Re: Ok- now who takes vitamins/what kind(s)/how many?, posted by Larry Hoover on April 2, 2003, at 12:21:29
I am currently being treated for depression at a nutritionally focused center. I have long known that folic acid could greatly help depressed patients. However, my histamine count, tested by this center, was VERY HIGH. Folic acid and niacin help make histamine, thus, they are telling me NOT to take any folic acid or niacin(in order to lower my histamine level). Still, one thing that bugs me is that BEFORE going there I WAS taking folic acid and felt BETTER after taking it. I can't say that the folic acid was THE direct cause because I was taking other supplements as well. So, my question to you is, in a case like this do you think it makes sense for them to tell me NOT to take the folic acid? Thanks Larry!!
Posted by Larry Hoover on April 3, 2003, at 18:42:34
In reply to Larry Hoover Re: Ok- now who takes vitamins/, posted by McPac on April 3, 2003, at 18:21:55
> I am currently being treated for depression at a nutritionally focused center.
Oh, I'm *so* jealous.
>I have long known that folic acid could greatly help depressed patients. However, my histamine count, tested by this center, was VERY HIGH. Folic acid and niacin help make histamine, thus, they are telling me NOT to take any folic acid or niacin(in order to lower my histamine level). Still, one thing that bugs me is that BEFORE going there I WAS taking folic acid and felt BETTER after taking it. I can't say that the folic acid was THE direct cause because I was taking other supplements as well. So, my question to you is, in a case like this do you think it makes sense for them to tell me NOT to take the folic acid? Thanks Larry!!
They must be using the categories defined by Dr. Pfeiffer. According to Pfeiffer, "This syndrome (high histamine) often involves seasonal variations in depression, obsessive-compulsive behavior, inhalant allergies, and frequent headaches." Does that fit you?
What I don't understand is that high-histamine depressives are said to be under-methylated, but they don't advocate methyl donors (e.g. betaine, vitamin B-12) as treatment. Instead, they suppress folate and niacin intake, and push methionine and calcium supplements. In any case, you'll have to follow their advice if you want to see if you get your money's worth. Response is said to take months, as you have to let your folate metabolism "wind down".
Excess folate (if that's what you had been doing) can "hide" deficiencies in other B-vitamins. It will give most anyone some amount of "boost", but may coincidentally induce functional defiencies elsewhere.
That's my speculation, pure and simple.
Posted by McPac on April 3, 2003, at 22:42:46
In reply to Re: Larry Hoover Re: Ok- now who takes vitamins/, posted by Larry Hoover on April 3, 2003, at 18:42:34
Larry, first let me say what a pleasure and privilege it is for me to be able to read your extremely informative and insightful posts. I have wanted to ask you some questions about my psychiatric predicament (symptoms/treatment) for some time now but I've been unable to think of "specific" questions (I have so many questions and wouldn't know where to begin,lol).
Let me respond to your response to me:
"They must be using the categories defined by Dr. Pfeiffer".Guess what Larry, they are....you know why they are....because I am being treated at The Pfeiffer Treatment Center in Illinois! I must tell you though, when I went there it was very neat and interesting for me. First, my visit consisted of a 2 1/2 hour session with a nurse who asked me a ton of questions, many of which were from their questionnaire. She tried to get a comprehensive idea about my problems, medicines; you name it, she asked it. Then I talked to a doctor there who further asked questions for quite some time. Then they took a blood sample, hair sample and urinalysis of me. Before going there, I did send them written info. about me which they asked in advance of my first visit. The facility was nice but rather small, NOT some huge laboratory-type place....more like a regular doctor's office but somewhat larger than that. They do have their own little pharmacy there also.
"According to Pfeiffer, "This syndrome (high histamine) often involves seasonal variations in depression, obsessive-compulsive behavior, inhalant allergies, and frequent headaches." Does that fit you?"
That fits me VERY WELL. Obsessive Compulsive Disorder, at one time in my life, was at absolutely UNBEARABLE levels. My main problems have always been OCD, depression (bipolar-type, mainly lows) and anxiety/nervousness. But my meds have worked VERY well for these problems (raising my serotonin levels has always seemed to be the key for me), although my Zoloft appeared to start losing it's effectiveness recently. That's what scared me and got me to go to Pfeiffer. I didn't want to have my entire life and well-being revolve around a med that could stop working at any time. I've always read about alternative ideas, w/ nutrition and supplements being something I've read a LOT about. As I was leaving Pfeiffer, the nurse put together a folder to take with me. One of the papers that they gave me was a sheet on high histamine levels. After I left, I read that sheet (this was of course BEFORE my test results ever came back and it was NOT written specifically for me. They obviously deduced that I may be high histamine just from my symptoms). As I read the paper I almost fell off my chair! I saw that high histamine was often linked with OCD. No shrink EVER mentioned ANY of the stuff that I learned while there! Then the results came back with VERY high histamine levels. I've always had terrible allergies as well. And my depression gets worse in the winter....I HATE these long, DARK, sunless, winters! I feel much, much better with SUNLIGHT! And I've always had my share of headaches.
"What I don't understand is that high-histamine depressives are said to be under-methylated, but they don't advocate methyl donors (e.g. betaine, vitamin B-12) as treatment".
Larry, check this out....maybe they have modified their approach because my treatment prescription consists of TMG (betaine anhydrous) 500mg/day....also vitamin B-12, 2000mcg/day. Just what you were wondering about!
Yes, methionine is a big part of the plan it seems....2000mg/day.....many other ingredients also."they suppress folate and niacin intake"
Yep.
"and push methionine and calcium supplements".
Yep.
"Response is said to take months, as you have to let your folate metabolism "wind down"."
Larry, could you explain "letting my folate metabolism "wind down"?
"Excess folate (if that's what you had been doing) can "hide" deficiencies in other B-vitamins.
It will give most anyone some amount of "boost", but may coincidentally induce functional defiencies elsewhere".I was only taking a "normal" one-a-day-type folic acid supplement, no super dose....I'd like to take it but they say "No niacin, no folic acid because it builds the histamine...so I do listen to them. They said that the high histamine BLOCKS serotonin production...it all makes so much sense to me! Oh yeah, other problems they discovered about me----a very high COPPER level (the symptoms of high copper were EXTREMELY close to many of mine! But, I don't know if that means the "nutrient" copper OR the heavy metal copper? (There is a difference in types of copper, right???) Also, a zinc deficiency. Also, a "mild" test level result for Pyroluria (a genetic stress thing)....that makes sense and fits me when I read about pyroluria and how stress "builds". But I don't know if the pyroluria level is a "constant", stable kind of level or if it's the type that may vary widely depending on when it is taken, i.e. would next month's test show relatively the same level OR does it change from week to week, month to month, depending on stress levels??? AFTER I LEAVE Pfeiffer, I don't have much communication w/ them (I "can" call but don't much) so I have many questions with no answers. I will have a follow-up appt. in the somewhat near future though. Larry, it is a pleasure conversing with you Larry. I RARELY type much at all, my "finger" is tired now, lol! I look forward to any response! Take care!!
Posted by Larry Hoover on April 4, 2003, at 10:42:40
In reply to Larry Hoover Re: Ok- now who takes vitamins/, posted by McPac on April 3, 2003, at 22:42:46
> Larry, first let me say what a pleasure and privilege it is for me to be able to read your extremely informative and insightful posts.
I thoroughly enjoy the interaction. Kewl, eh?
>I have wanted to ask you some questions about my psychiatric predicament (symptoms/treatment) for some time now but I've been unable to think of "specific" questions (I have so many questions and wouldn't know where to begin,lol).
I'm glad you started.
> Let me respond to your response to me:
> "They must be using the categories defined by Dr. Pfeiffer".
>
> Guess what Larry, they are....you know why they are....because I am being treated at The Pfeiffer Treatment Center in Illinois!Lucky guess! <wink>
>I must tell you though, when I went there it was very neat and interesting for me. First, my visit consisted of a 2 1/2 hour session with a nurse who asked me a ton of questions, many of which were from their questionnaire. She tried to get a comprehensive idea about my problems, medicines; you name it, she asked it. Then I talked to a doctor there who further asked questions for quite some time. Then they took a blood sample, hair sample and urinalysis of me. Before going there, I did send them written info. about me which they asked in advance of my first visit. The facility was nice but rather small, NOT some huge laboratory-type place....more like a regular doctor's office but somewhat larger than that. They do have their own little pharmacy there also.
I can't understand why this approach isn't used more generally. Doesn't it make sense to ask enough questions up front, so that guesswork is avoided? Ineffective treatment is a massive waste of time, money, and effort.
> "According to Pfeiffer, "This syndrome (high histamine) often involves seasonal variations in depression, obsessive-compulsive behavior, inhalant allergies, and frequent headaches." Does that fit you?"
>
> That fits me VERY WELL. Obsessive Compulsive Disorder, at one time in my life, was at absolutely UNBEARABLE levels. My main problems have always been OCD, depression (bipolar-type, mainly lows) and anxiety/nervousness. But my meds have worked VERY well for these problems (raising my serotonin levels has always seemed to be the key for me), although my Zoloft appeared to start losing it's effectiveness recently. That's what scared me and got me to go to Pfeiffer. I didn't want to have my entire life and well-being revolve around a med that could stop working at any time. I've always read about alternative ideas, w/ nutrition and supplements being something I've read a LOT about. As I was leaving Pfeiffer, the nurse put together a folder to take with me. One of the papers that they gave me was a sheet on high histamine levels. After I left, I read that sheet (this was of course BEFORE my test results ever came back and it was NOT written specifically for me. They obviously deduced that I may be high histamine just from my symptoms). As I read the paper I almost fell off my chair! I saw that high histamine was often linked with OCD. No shrink EVER mentioned ANY of the stuff that I learned while there!A typical doctor (so I'm told) receives one four-hour session on nutrition. I'm sure a shrink studies the way neurotransmitters are synthesized, and their dependence on nutrients, but they still seem to rely on the assumption that the only disruption or imbalance in depressives is in neurotransmitters. How could that be, if everything else worked right?
>Then the results came back with VERY high histamine levels. I've always had terrible allergies as well. And my depression gets worse in the winter....I HATE these long, DARK, sunless, winters! I feel much, much better with SUNLIGHT! And I've always had my share of headaches.
You and me both, dude.
> "What I don't understand is that high-histamine depressives are said to be under-methylated, but they don't advocate methyl donors (e.g. betaine, vitamin B-12) as treatment".
>
> Larry, check this out....maybe they have modified their approach because my treatment prescription consists of TMG (betaine anhydrous) 500mg/day....also vitamin B-12, 2000mcg/day. Just what you were wondering about!Good! I was baffled by the articles I'd read. Probably, they were written by people who don't understand biochemistry. Pfeiffer has written books. Perhaps I'll search them out.
Betaine causes insomnia in me, so be wary. It can be extremely activating. And that B-12 dose is nearly 1,000 times the RDA. It's quite safe, nonetheless. The RDA is based on a number of fallacious assumptions, IMHO.
> Yes, methionine is a big part of the plan it seems....2000mg/day.....many other ingredients also.
Did your blood work include an assessment of homocysteine? (It's probably elevated.)
I don't quite follow the need for supplemental methionine, as betaine will remethylate homocysteine to methionine, as will B-12.
In chronic depression, homocysteine accumulates in the blood, and can lead to heart attack and stroke. In simple terms, depression is associated with defects in sulphur metabolism. Methionine is an amino acid with a sulphur atom in it.
Methionine reactics with adenosine (as found in RNA and ATP), at the sulphur atom, to form S-adenosyl methionine (SAMe). The S- just says where the adenosine binds to the methionine. It is the "universal methyl donor", an essential molecule in a vast array of enzymatic processes and DNA transcription. After it donates a methyl group, you're left with S-adenosyl homocysteine. The adenosine is recycled, freeing homocysteine. Here's where problems occur in depressives. Stress blocks the normal recycling of homocysteine to methionine. Homocysteine accumulates while SAMe is depleted. You could take SAMe, but that doesn't fix the homocysteine problem. In fact, it makes it worse. Betaine induces an enzyme (the concentration of the enzyme increases if betaine is detected) called betaine-homocysteine methyltransferase. So, that will recycle homocysteine. And the B-12 will activate another enzymatic process which transfers a methyl group from the B-12 to the homocysteine.
> "they suppress folate and niacin intake"
>
> Yep.
>
> "and push methionine and calcium supplements".
>
> Yep.I'd still take magnesium, too.
> "Response is said to take months, as you have to let your folate metabolism "wind down"."
>
> Larry, could you explain "letting my folate metabolism "wind down"?Enzyme concentrations often rise in response to higher concentrations of co-enzymes (enzyme activators) like the B-vitamins. Withdrawing folate will only reduce enzyme concentrations over a period of time. There's a lag time.
> "Excess folate (if that's what you had been doing) can "hide" deficiencies in other B-vitamins.
> It will give most anyone some amount of "boost", but may coincidentally induce functional defiencies elsewhere".
>
> I was only taking a "normal" one-a-day-type folic acid supplement, no super dose....I'd like to take it but they say "No niacin, no folic acid because it builds the histamine...so I do listen to them. They said that the high histamine BLOCKS serotonin production...it all makes so much sense to me!I'm not sure that high histamine and blocked serotonin synthesis aren't both caused by something else. Whatever. You don't need to know a mechanism to know if something works or not.
>Oh yeah, other problems they discovered about me----a very high COPPER level (the symptoms of high copper were EXTREMELY close to many of mine! But, I don't know if that means the "nutrient" copper OR the heavy metal copper? (There is a difference in types of copper, right???)
Copper is a heavy metal. The different effects are due to the ionization state of the copper atoms. You need some copper, and in the ionic form. Your diet will surely contain all the copper you need.
>Also, a zinc deficiency.
Zinc deficiency causes copper overload. I can't see how you can separate out the symptoms of one from the other (unless you have the genetic defect which leads to Wilson's disease).
Zinc regulates copper, and blocks its uptake. So you really need zinc supplements. Also, selenium.
>Also, a "mild" test level result for Pyroluria (a genetic stress thing)....that makes sense and fits me when I read about pyroluria and how stress "builds". But I don't know if the pyroluria level is a "constant", stable kind of level or if it's the type that may vary widely depending on when it is taken, i.e. would next month's test show relatively the same level OR does it change from week to week, month to month, depending on stress levels???
It should balance out as the other abnormalities stabilize.
>AFTER I LEAVE Pfeiffer, I don't have much communication w/ them (I "can" call but don't much) so I have many questions with no answers.
Ask as many as you want to.
>I will have a follow-up appt. in the somewhat near future though. Larry, it is a pleasure conversing with you Larry. I RARELY type much at all, my "finger" is tired now, lol! I look forward to any response! Take care!!
I'm really interested in how well this works for you.
Lar
Posted by Ron Hill on April 4, 2003, at 17:37:07
In reply to Re: Larry Hoover Re: Ok- now who takes vitamins/ » McPac, posted by Larry Hoover on April 4, 2003, at 10:42:40
> The adenosine is recycled, freeing homocysteine. Here's where problems occur in depressives. Stress blocks the normal recycling of homocysteine to methionine. Homocysteine accumulates while SAMe is depleted. You could take SAMe, but that doesn't fix the homocysteine problem. In fact, it makes it worse.
Larry,
I hope we do not wear you out with our questions. Feel free to tell me to go away if it gets to be too much.
As I mentioned to you previously, about a year ago I had five months of good results using 200 mg/day of SAM-e to treat the atypical depressive phase of my BP II disorder. But then, rather suddenly, it started to make me VERY irritable (GRRRRRRRRRRRRRRRR!).
I took plenty of B-6, B-12 (sublingual, bioactive), and folate in an attempt to prevent the build up of homocysteine. As I understand it, when the body has proper levels of folic acid, vitamins B6 and B12, the enzymatic break-down of homocysteine occur either through remethylation, which converts it into methionine, or through transsulfuration, which turns it into glutathione.
> Stress blocks the normal recycling of homocysteine to methionine.
What stress related compound is the suspected culprit? Is it cortisol? In other words, does cortisol push the reaction equilibrium to the left?
Do you think that elevated levels of homocysteine could cause irritability?
Thanks Larry.
-- Ron
Posted by Larry Hoover on April 4, 2003, at 18:55:51
In reply to Re: Homocysteine » Larry Hoover, posted by Ron Hill on April 4, 2003, at 17:37:07
> > The adenosine is recycled, freeing homocysteine. Here's where problems occur in depressives. Stress blocks the normal recycling of homocysteine to methionine. Homocysteine accumulates while SAMe is depleted. You could take SAMe, but that doesn't fix the homocysteine problem. In fact, it makes it worse.
>
> Larry,
>
> I hope we do not wear you out with our questions. Feel free to tell me to go away if it gets to be too much.If it gets too much, *I'll* go away.
> As I mentioned to you previously, about a year ago I had five months of good results using 200 mg/day of SAM-e to treat the atypical depressive phase of my BP II disorder. But then, rather suddenly, it started to make me VERY irritable (GRRRRRRRRRRRRRRRR!).
>
> I took plenty of B-6, B-12 (sublingual, bioactive), and folate in an attempt to prevent the build up of homocysteine. As I understand it, when the body has proper levels of folic acid, vitamins B6 and B12, the enzymatic break-down of homocysteine occur either through remethylation, which converts it into methionine, or through transsulfuration, which turns it into glutathione.Quite correct, and your supplements were quite appropriate.
Two thoughts occur to me. Folic acid, the typical folate supplement, must pass through two enzymatic transformations before it is useful as a coenzyme. If you have a defect or inefficiency in one of those two steps, you may have been functionally deficient, even with routine intake. That's probably unlikely as an explanation, though, and I doubt it would take months to show itself.
The other possibility involves the whole concept of taking fully active exogenous substances, such as SAMe (or 5-HTP). In doing so, you bypass the normal regulatory processes which govern the concentration of these potent molecules. Perhaps, over five months, you gradually increased the concentration of one of the products of SAMe-dependent reactions because you kept taking it every day, and that product led to irritability. Your body will have a number of feedback inhibition signals which would have been activated by the increased product concentration; these would have been to no effect because the daily SAMe supply was independent of feedback control. My intuition lies with this latter explanation. Maybe you took too much/over too long a period of time.
> > Stress blocks the normal recycling of homocysteine to methionine.
>
> What stress related compound is the suspected culprit? Is it cortisol? In other words, does cortisol push the reaction equilibrium to the left?No, stress depletes B-vitamins, and increases oxidative stress (leading to enhanced SAMe demand). You looked after that with your supplements.
> Do you think that elevated levels of homocysteine could cause irritability?
I've never heard of that connection before. I'll look into it further.
> Thanks Larry.
>
> -- RonWelcome.
Lar
Posted by Ron Hill on April 4, 2003, at 19:08:47
In reply to Re: Homocysteine, posted by Larry Hoover on April 4, 2003, at 18:55:51
Posted by mopey on April 4, 2003, at 21:01:54
In reply to Re: Ok- now who takes vitamins/what kind(s)/how many? » Janelle, posted by Ritch on April 2, 2003, at 10:07:13
Have been trying to keep up with all the info here, and so far have only figured out how much fish oil to take.
Can you list what vitamins/supplements you'd recommend for someone with depression and anxiety to take?
Thanks!
Posted by McPac on April 5, 2003, at 0:34:00
In reply to Re: Larry Hoover Re: Ok- now who takes vitamins/ » McPac, posted by Larry Hoover on April 4, 2003, at 10:42:40
"Did your blood work include an assessment of homocysteine? (It's probably elevated.)"
Yes! Before I began their treatment plan I had to go to a local lab in my town and have the homocysteine test.......a typical 30-second blood draw that cost $180!!A very expensive test. (I don't even know what the results were as I was going to wait until going back to Pfeiffer to ask, since they were sent the results).
"I don't quite follow the need for supplemental methionine, as betaine will remethylate homocysteine to methionine, as will B-12".
I don't know Larry. A lot of this stuff is very new to me.
"I'd still take magnesium, too".
I do! Pfeiffer also has me on calcium/magnesium, 1000mg/day of each. I like my magnesium...I think it relaxes me and helps me sleep more sound.
"Response is said to take months, as you have to let your folate metabolism "wind down"."
I know that Carl Pfeiffer wrote that high histamine reduction requires great patience and often takes 6-12 months to accomplish. I wondered why it would take so long (in contrast, many other nutritional treatments of Pfeiffer's, for other conditions that people have, produce dramatic results often in very short time periods). Is the long amount of time required for achieving the lowered histamine level mainly due to the lengthy folic acid metabolism process that you wrote about...or is it because of MANY various physiological factors that need corrected?
"I'm not sure that high histamine and blocked serotonin synthesis aren't both caused by something else".
Very interesting Larry....re: serotonin, what things do you speculate (or know of) that may block it's production?
"Zinc deficiency causes copper overload. I can't see how you can separate out the symptoms of one from the other (unless you have the genetic defect which leads to Wilson's disease)".
I was reading a list of high copper toxicity symptoms on-line and the list of symptoms were dead-on to so many of mine (some symptoms which I had often wondered about for sooo many years and knew there must be a biochemical basis for; of course I STILL can't say for SURE but so many of my symptoms were there). I know that zinc-copper go together.
"Zinc regulates copper, and blocks its uptake. So you really need zinc supplements. Also, selenium".
Right again Lar! Pfeiffer has me taking zinc also! Soooooo funny that you mention selenium though....because that is one supplement that I myself have been wanting to add and now that you say that I am going to ask the Pfeiffer folks if I can add that!
"Ask as many (questions) as you want to".
I have one other question but I will need to gather a bit of info. before posing it correctly(re: sodium-potassium ratio).
"I'm really interested in how well this works for you".
Larry, you would sure make an awesome Pfeiffer employee! Every comment you made, every question you asked were all like it was coming from the Pfeiffer people. I have NO IDEA how you can understand, retain and explain the incredible mountain of information of biochemistry that you have. These fields (chemistry, biology, nutrition, physiology, etc.......all this info gives me a headache and I can't keep too much of it straight, lol. Take care and thanks!!!
--------------------------------------------------------------------------------
Posted by Larry Hoover on April 5, 2003, at 9:53:22
In reply to Larry, I'm lost!, posted by mopey on April 4, 2003, at 21:01:54
> Have been trying to keep up with all the info here, and so far have only figured out how much fish oil to take.
>
> Can you list what vitamins/supplements you'd recommend for someone with depression and anxiety to take?
>
> Thanks!I know you're looking for a simple answer, so I'll try to give one. You may want to think of my advice as a starting point. Later on, if certain symptoms persist, then more focussed supplementation trials would be worthwhile.
B-vitamins: B-vitamins work together as a team, and you should take them together. There are a number of ways they're marketed, but you'll generally see them as B-complex, or B- followed by some number, like B-50. The number just gives the potency of each component, in either miligrams or micrograms, as appropriate. If you're just starting out, for one week, you can take three B-50s a day. The B's are water soluble, and any excess will simply spill into your urine, which will take on a yellow colour. But before your kidneys get at them, those B's are flooding your body with nutrients in your blood. From the blood, and only from the blood, can the different organ compartments of the body obtain their supplies. Your brain can't get any if your blood didn't have it first. So, ignore people who claim that you're just creating expensive urine. B's are cheap, and you've got to flood your body to replenish all your organs. After one week, you can cut back to 50-100/day.
A good multi, like Centrum (or equivalent). Just because it's got a variety of nutrients.
Minerals: You've seen lots of talk about magnesium. 2/3 of all people are chronically deficient in magnesium. Zinc and selenium are key components of many enzymes, and most people are deficient here, as well. Zinc 40 or 50 mg/day. Selenium, 200 micrograms/day. Chromium wouldn't hurt, either. 200-500 micrograms/day.
Antioxidants: Vitamin C, 2,000 mg/day, in divided doses. This nutrient is far more important to mental health than most people realize. Alpha-lipoic acid, up to 200 mg/day.
Methyl donors: Betaine (trimethylglycine or TMG), 500 mg/day, and/or B-12 1,000 mcg/day. (Betaine can be extremely activating, so you have to adjust the dose according to your individual response. 500 mg is just a suggestion.)
You may wonder why I've listed B-12 separate from the other B's, but it is kind of unique. It contains a mineral ion (cobalt), unlike the other B's, and it is stored in the body (unlike any other B). I have come to believe that there is a sub-clinical B-12 deficiency syndrome, which is to say, one that has a number of symptoms but is not so well developed as to be identified as pernicious anemia. The RDA is something like 9 mcg, but you may not absorb it efficiently. B-12 is like magnesium in that a deficiency state in this nutrient will actually make it harder to absorb any from your food. By taking a large amount, some will diffuse across the gut membranes, even if the active transport mechanism isn't working.
These are all relatively cheap. Walmart sells them all (there's no need to buy more expensive brand names, IMHO).
Take with food, and let me know how things go.
Lar
Posted by noa on April 5, 2003, at 10:08:41
In reply to Re: Larry Hoover Re: Ok- now who takes vitamins/, posted by Larry Hoover on April 3, 2003, at 18:42:34
I take folic acid, too, on the advice of my pdoc, for depression. The other supplement I take at his advice is chromium picolinate.
I take a multivitamin, as well. Not the Flintstones, though.
On last blood work, my folic acid and B12 levels were very high.
I also take Carlson's fish oil.
Posted by Larry Hoover on April 5, 2003, at 10:09:20
In reply to Larry Hoover Re: Ok- now who takes vitamins/, posted by McPac on April 5, 2003, at 0:34:00
> "Did your blood work include an assessment of homocysteine? (It's probably elevated.)"
>
> Yes! Before I began their treatment plan I had to go to a local lab in my town and have the homocysteine test.......a typical 30-second blood draw that cost $180!!A very expensive test. (I don't even know what the results were as I was going to wait until going back to Pfeiffer to ask, since they were sent the results).It is direct confirmatory evidence that your methylation biochemistry has been screwed up for an extended period of time.
> "I don't quite follow the need for supplemental methionine, as betaine will remethylate homocysteine to methionine, as will B-12".
>
> I don't know Larry. A lot of this stuff is very new to me.Can't hurt, I suppose. Probably unnecessary, IMHO.
> "I'd still take magnesium, too".
>
> I do! Pfeiffer also has me on calcium/magnesium, 1000mg/day of each. I like my magnesium...I think it relaxes me and helps me sleep more sound.My response, as well.
> "Response is said to take months, as you have to let your folate metabolism "wind down"."
>
> I know that Carl Pfeiffer wrote that high histamine reduction requires great patience and often takes 6-12 months to accomplish. I wondered why it would take so long (in contrast, many other nutritional treatments of Pfeiffer's, for other conditions that people have, produce dramatic results often in very short time periods). Is the long amount of time required for achieving the lowered histamine level mainly due to the lengthy folic acid metabolism process that you wrote about...or is it because of MANY various physiological factors that need corrected?Absolutely, it's many things. I keep coming to the conclusion that the histamine thingie is a marker of the general disturbance in biochemistry, rather than a causative factor, per se.
Your body has been burdened by a prolonged chronic stress reaction. It takes time for everything to come back into a healthier balance. I'm still bouncing back after *years* of nutritional supports.
Here's an automotive metaphor. Let's say you buy a brand new car, but you get totally caught up in the demands of work and family, and you forget to change the oil. Hell, you forget to even check it routinely. One day, the little red light comes on, you pull the dipstick, and there's none on the stick at all. Even though you rush off the get the oil changed, you now find that you are constantly having to check and top up the oil, just to keep it running. I think we're something like that. We're high maintenance.
> "I'm not sure that high histamine and blocked serotonin synthesis aren't both caused by something else".
>
> Very interesting Larry....re: serotonin, what things do you speculate (or know of) that may block it's production?There's a theoretical model proposed by Dr. Pall, one involving oxidative stress. You can get locked into a vicious biochemical circle which depletes B-vitamins and SAMe (among many other essential chemicals). Anything that depends on these depleted substances in turn gets depleted. The result is fatigue, depression, insomnia, cognitive problems.....
It just makes sense to me, fully explains all my symptoms, and has responded to the appropriate nutritional supports.
> "Zinc deficiency causes copper overload. I can't see how you can separate out the symptoms of one from the other (unless you have the genetic defect which leads to Wilson's disease)".
>
> I was reading a list of high copper toxicity symptoms on-line and the list of symptoms were dead-on to so many of mine (some symptoms which I had often wondered about for sooo many years and knew there must be a biochemical basis for; of course I STILL can't say for SURE but so many of my symptoms were there). I know that zinc-copper go together.
>
> "Zinc regulates copper, and blocks its uptake. So you really need zinc supplements. Also, selenium".
>
> Right again Lar! Pfeiffer has me taking zinc also! Soooooo funny that you mention selenium though....because that is one supplement that I myself have been wanting to add and now that you say that I am going to ask the Pfeiffer folks if I can add that!If you feel more comfortable asking, it's OK with me. ;-)
Selenium works with zinc in protecting against oxidative stress. Moreover, it directly blocks mercury toxicity (another possible burden).
> "Ask as many (questions) as you want to".
>
> I have one other question but I will need to gather a bit of info. before posing it correctly(re: sodium-potassium ratio).I'll be waiting.
> "I'm really interested in how well this works for you".
>
> Larry, you would sure make an awesome Pfeiffer employee! Every comment you made, every question you asked were all like it was coming from the Pfeiffer people. I have NO IDEA how you can understand, retain and explain the incredible mountain of information of biochemistry that you have. These fields (chemistry, biology, nutrition, physiology, etc.......all this info gives me a headache and I can't keep too much of it straight, lol. Take care and thanks!!!I did really well in school......
My *life* depends on my understanding these things. I'm not exaggerating. <shrug>
Lar
Posted by mopey on April 5, 2003, at 11:55:18
In reply to Re: Larry, I'm lost!, posted by Larry Hoover on April 5, 2003, at 9:53:22
Thanks, Larry, for your time, patience and expertise. I'll start on these and keep you posted.
> > Have been trying to keep up with all the info here, and so far have only figured out how much fish oil to take.
> >
> > Can you list what vitamins/supplements you'd recommend for someone with depression and anxiety to take?
> >
> > Thanks!
>
> I know you're looking for a simple answer, so I'll try to give one. You may want to think of my advice as a starting point. Later on, if certain symptoms persist, then more focussed supplementation trials would be worthwhile.
>
> B-vitamins: B-vitamins work together as a team, and you should take them together. There are a number of ways they're marketed, but you'll generally see them as B-complex, or B- followed by some number, like B-50. The number just gives the potency of each component, in either miligrams or micrograms, as appropriate. If you're just starting out, for one week, you can take three B-50s a day. The B's are water soluble, and any excess will simply spill into your urine, which will take on a yellow colour. But before your kidneys get at them, those B's are flooding your body with nutrients in your blood. From the blood, and only from the blood, can the different organ compartments of the body obtain their supplies. Your brain can't get any if your blood didn't have it first. So, ignore people who claim that you're just creating expensive urine. B's are cheap, and you've got to flood your body to replenish all your organs. After one week, you can cut back to 50-100/day.
>
> A good multi, like Centrum (or equivalent). Just because it's got a variety of nutrients.
>
> Minerals: You've seen lots of talk about magnesium. 2/3 of all people are chronically deficient in magnesium. Zinc and selenium are key components of many enzymes, and most people are deficient here, as well. Zinc 40 or 50 mg/day. Selenium, 200 micrograms/day. Chromium wouldn't hurt, either. 200-500 micrograms/day.
>
> Antioxidants: Vitamin C, 2,000 mg/day, in divided doses. This nutrient is far more important to mental health than most people realize. Alpha-lipoic acid, up to 200 mg/day.
>
> Methyl donors: Betaine (trimethylglycine or TMG), 500 mg/day, and/or B-12 1,000 mcg/day. (Betaine can be extremely activating, so you have to adjust the dose according to your individual response. 500 mg is just a suggestion.)
>
> You may wonder why I've listed B-12 separate from the other B's, but it is kind of unique. It contains a mineral ion (cobalt), unlike the other B's, and it is stored in the body (unlike any other B). I have come to believe that there is a sub-clinical B-12 deficiency syndrome, which is to say, one that has a number of symptoms but is not so well developed as to be identified as pernicious anemia. The RDA is something like 9 mcg, but you may not absorb it efficiently. B-12 is like magnesium in that a deficiency state in this nutrient will actually make it harder to absorb any from your food. By taking a large amount, some will diffuse across the gut membranes, even if the active transport mechanism isn't working.
>
> These are all relatively cheap. Walmart sells them all (there's no need to buy more expensive brand names, IMHO).
>
> Take with food, and let me know how things go.
>
> Lar
Posted by mopey on April 5, 2003, at 12:00:14
In reply to Re: Ok- now who takes vitamins/what kind(s)/how many?, posted by Larry Hoover on April 2, 2003, at 12:21:29
This sugar study is interesting. I always find I "need" a sugary treat when I'm feeling particularly depressed... wonder if it actually adds to the depression after an initial comfort benefit?
Will need to read more about this.
Thanks for the info.
Posted by Ron Hill on April 7, 2003, at 0:50:21
In reply to Re: Homocysteine, posted by Larry Hoover on April 4, 2003, at 18:55:51
Larry,
> > As I mentioned to you previously, about a year ago I had five months of good results using 200 mg/day of SAM-e to treat the atypical depressive phase of my BP II disorder. But then, rather suddenly, it started to make me VERY irritable (GRRRRRRRRRRRRRRRR!).
> The other possibility involves the whole concept of taking fully active exogenous substances, such as SAMe (or 5-HTP). In doing so, you bypass the normal regulatory processes which govern the concentration of these potent molecules. Perhaps, over five months, you gradually increased the concentration of one of the products of SAMe-dependent reactions because you kept taking it every day, and that product led to irritability. Your body will have a number of feedback inhibition signals which would have been activated by the increased product concentration; these would have been to no effect because the daily SAMe supply was independent of feedback control. My intuition lies with this latter explanation. Maybe you took too much/over too long a period of time.
Larry, would you expect that I would have the same problem if I were to take TMG instead of SAM-e?
Enough about me, lets talk about you for a minute. Is the Enada NADH providing any on-going benefit for you?
Okay, the minute’s up; back to my issues. What is your opinion of the information in one of the articles posted by JLx addressing the cortisol:DHEA hormonal ratio issue? More to the point, what is your position regarding DHEA supplementation as a method of balancing out elevated cortisol levels? For some time now, I have been interested in low dose DHEA supplementation. However, I’ve held off on conducting the trial because of what I have here-to-fore perceived to be risky manipulation of hormone levels. Here is the link to the article: http://www.drdebe.com/fitness.htm
-- Ron
Posted by Larry Hoover on April 7, 2003, at 9:39:59
In reply to Re: TMG » Larry Hoover, posted by Ron Hill on April 7, 2003, at 0:50:21
> Larry,
>
> > > As I mentioned to you previously, about a year ago I had five months of good results using 200 mg/day of SAM-e to treat the atypical depressive phase of my BP II disorder. But then, rather suddenly, it started to make me VERY irritable (GRRRRRRRRRRRRRRRR!).
>
> > The other possibility involves the whole concept of taking fully active exogenous substances, such as SAMe (or 5-HTP). In doing so, you bypass the normal regulatory processes which govern the concentration of these potent molecules. Perhaps, over five months, you gradually increased the concentration of one of the products of SAMe-dependent reactions because you kept taking it every day, and that product led to irritability. Your body will have a number of feedback inhibition signals which would have been activated by the increased product concentration; these would have been to no effect because the daily SAMe supply was independent of feedback control. My intuition lies with this latter explanation. Maybe you took too much/over too long a period of time.
>
> Larry, would you expect that I would have the same problem if I were to take TMG instead of SAM-e?No, I think not. We're deep into speculation, though.
> Enough about me, lets talk about you for a minute. Is the Enada NADH providing any on-going benefit for you?
I think it has. My pattern, established and reinforced over years now, has been that I slump after any prolonged exertion. I can't work a full-time job of any sort because of this. I've been lucky enough to find an employer who will take from me all that I can give them. In essence, I've been working one month on, one month off. The month off has been characterized by profound fatigue, cognitive and memory problems, irritabliity, mood decline. I'm usually already starting the slide before I even finish the month on, and the minimum takes a further two weeks to fully develop. I don't seem to be having this happen to me this time. I'm a little low, but it's not what I've come to expect.
I've been taking the NADH quite irregularly after that first week. It certainly had a cumulative effect, and I feared having taken too much. Anyway, I think it's helped. Too soon to be conclusive, but there's a positive trend.
> Okay, the minute’s up; back to my issues. What is your opinion of the information in one of the articles posted by JLx addressing the cortisol:DHEA hormonal ratio issue? More to the point, what is your position regarding DHEA supplementation as a method of balancing out elevated cortisol levels? For some time now, I have been interested in low dose DHEA supplementation. However, I’ve held off on conducting the trial because of what I have here-to-fore perceived to be risky manipulation of hormone levels. Here is the link to the article: http://www.drdebe.com/fitness.htm
>
> -- RonYa, I know. Hormones are potent. Hormones are tricky. Still, 50 mg of DHEA isn't going to do too much adverse, even if you didn't need it.
My intuition has led me to take "pulses" of some of the stimulating supplements. Little bursts of enhancement, rather than chronic supplementation. I feel more comfortable with one finger on the scale, rather than my fist.
Lar
Posted by Ron Hill on April 7, 2003, at 13:46:12
In reply to Re: TMG, posted by Larry Hoover on April 7, 2003, at 9:39:59
Hi Larry,
Thank you for your response.
> In essence, I've been working one month on, one month off.
Given your posting frequency lately, I assume you are currently off. When do you go back on?
> The month off has been characterized by profound fatigue, cognitive and memory problems, irritabliity, mood decline.
Have you ever had your cortisol levels measured?
As an aside, some of johnj's symptoms are somewhat similar to yours. Maybe there is a CFS component to John's dx (as you have alluded to in prior posts to John). In John's case, however, his "CFS-like" symptoms seem to be caused by the TCA he is taking.
> Ya, I know. Hormones are potent. Hormones are tricky. Still, 50 mg of DHEA isn't going to do too much adverse, even if you didn't need it.
YIKES! 50 mg?! I was thinking about 5 mg! In his book titled "Mind Boosters", Ray Sahelian, M.D. urges individuals to use the least amount possible and to take breaks from use. But Larry my real question for you was do you have an opinion regarding the idea that there may be some efficacy in using DHEA supplementation to bring cortisol in balance (as implied in the previously posted article)?
Thanks Larry!
-- Ron
Posted by Larry Hoover on April 7, 2003, at 15:04:21
In reply to Re: Cortisol and DHEA Balance » Larry Hoover, posted by Ron Hill on April 7, 2003, at 13:46:12
> Hi Larry,
>
> Thank you for your response.
>
> > In essence, I've been working one month on, one month off.
>
> Given your posting frequency lately, I assume you are currently off. When do you go back on?The end of this month. There's a very close match-up with the calendar.
> > The month off has been characterized by profound fatigue, cognitive and memory problems, irritabliity, mood decline.
>
> Have you ever had your cortisol levels measured?Yes, and DHEA, and DHEA/S. My blood had "normal" levels, but the question remains, what should be termed normal? If peoples' experience with thyroid hormone measurement is any indication, the normal range (an entire order of magnitude! for TSH) is not normal at all.
> As an aside, some of johnj's symptoms are somewhat similar to yours. Maybe there is a CFS component to John's dx (as you have alluded to in prior posts to John). In John's case, however, his "CFS-like" symptoms seem to be caused by the TCA he is taking.Well, I'd be concerned about the logical fallacy "post hoc, ergo propter hoc", i.e. after this, therefore because of this. Coincidence, in other words. You cannot exclude coincidental correlation by any logical means. The TCA could be a red herring.
> > Ya, I know. Hormones are potent. Hormones are tricky. Still, 50 mg of DHEA isn't going to do too much adverse, even if you didn't need it.
>
> YIKES! 50 mg?! I was thinking about 5 mg! In his book titled "Mind Boosters", Ray Sahelian, M.D. urges individuals to use the least amount possible and to take breaks from use. But Larry my real question for you was do you have an opinion regarding the idea that there may be some efficacy in using DHEA supplementation to bring cortisol in balance (as implied in the previously posted article)?
>
> Thanks Larry!
>
> -- RonI have trouble with mechanistic explanations. I'm more comfortable with empiricism. What do people feel like when they take DHEA? I don't need to know why. I'm interested in whether.
I've never seen DHEA in 5 mg doses, but that doesn't mean it isn't out there. DHEA supplementation studies have used up to 500 mg/day. The following studies used more than 50.
Surprisingly, I had trouble finding appropriate abstracts. Recently published studies had no abstract available.
Biol Psychiatry 1999 Jun 15;45(12):1533-41Comment in:
Biol Psychiatry. 1999 Jun 15;45(12):1531-2.
Dehydroepiandrosterone treatment of midlife dysthymia.Bloch M, Schmidt PJ, Danaceau MA, Adams LF, Rubinow DR.
Behavioral Endocrinology Branch, National Institute of Mental Health, Bethesda, MD 20892-1276, USA.
BACKGROUND: This study evaluated the efficacy of the adrenal androgen, dehydroepiandrosterone, in the treatment of midlife-onset dysthymia. METHODS: A double-blind, randomized crossover treatment study was performed as follows: 3 weeks on 90 mg dehydroepiandrosterone, 3 weeks on 450 mg dehydroepiandrosterone, and 6 weeks on placebo. Outcome measures consisted of the following. Cross-sectional self-ratings included the Beck Depression Inventory, and visual analogue symptom scales. Cross-sectional objective ratings included the Hamilton Depression Rating Scale, the Cornell Dysthymia Scale and a cognitive test battery. Seventeen men and women aged 45 to 63 years with midlife-onset dysthymia participated in this study. Response to dehydroepiandrosterone or placebo was defined as a 50% reduction from baseline in either the Hamilton Depression Rating Scale or the Beck Depression Inventory. RESULTS: In 15 patients who completed the study, a robust effect of dehydroepiandrosterone on mood was observed compared with placebo. Sixty percent of the patients responded to dehydroepiandrosterone at the end of the 6-week treatment period compared with 20% on placebo. A significant response was seen after 3 weeks of treatment on 90 mg per day. The symptoms that improved most significantly were anhedonia, loss of energy, lack of motivation, emotional "numbness," sadness, inability to cope, and worry. Dehydroepiandrosterone showed no specific effects on cognitive function or sleep disturbance, although a type II error could not be ruled out. CONCLUSIONS: This pilot study suggests that dehydroepiandrosterone is an effective treatment for midlife-onset dysthymia.
Biol Psychiatry 1997 Feb 1;41(3):311-8
Dehydroepiandrosterone (DHEA) treatment of depression.Wolkowitz OM, Reus VI, Roberts E, Manfredi F, Chan T, Raum WJ, Ormiston S, Johnson R, Canick J, Brizendine L, Weingartner H.
Department of Psychiatry, University of California, San Francisco, School of Medicine 94143-0984, USA.
Dehydroepiandrosterone (DHEA) and its sulfate, DHEA-S, are plentiful adrenal steroid hormones that decrease with aging and may have significant neuropsychiatric effects. In this study, six middle-aged and elderly patients with major depression and low basal plasma DHEA f1p4or DHEA-S levels were openly administered DHEA (30-90 mg/d x 4 weeks) in doses sufficient to achieve circulating plasma levels observed in younger healthy individuals. Depression ratings, as well as aspects of memory performance significantly improved. One treatment-resistant patient received extended treatment with DHEA for 6 months: her depression ratings improved 48-72% and her semantic memory performance improved 63%. These measures returned to baseline after treatment ended. In both studies, improvements in depression ratings and memory performance were directly related to increases in plasma levels of DHEA and DHEA-S and to increases in their ratios with plasma cortisol levels. These preliminary data suggest DHEA may have antidepressant and promemory effects and should encourage double-blind trials in depressed patients.
Am J Psychiatry 1999 Apr;156(4):646-9
Double-blind treatment of major depression with dehydroepiandrosterone.Wolkowitz OM, Reus VI, Keebler A, Nelson N, Friedland M, Brizendine L, Roberts E.
Department of Psychiatry, University of California Medical Center, San Francisco, USA. owenw@itsa.ucsf.edu
OBJECTIVE: This study was designed to assess possible antidepressant effects of dehydroepiandrosterone (DHEA), an abundant adrenocortical hormone in humans. METHOD: Twenty-two patients with major depression, either medication-free or on stabilized antidepressant regimens, received either DHEA (maximum dose = 90 mg/day) or placebo for 6 weeks in a double-blind manner and were rated at baseline and at the end of the 6 weeks with the Hamilton Depression Rating Scale. Patients previously stabilized with antidepressants had the study medication added to that regimen; others received DHEA or placebo alone. RESULTS: DHEA was associated with a significantly greater decrease in Hamilton depression scale ratings than was placebo. Five of the 11 patients treated with DHEA, compared with none of the 11 given placebo, showed a 50% decrease or greater in depressive symptoms. CONCLUSIONS: These results suggest that DHEA treatment may have significant antidepressant effects in some patients with major depression. Further, larger-scale trials are warranted.
Posted by johnj on April 7, 2003, at 15:17:49
In reply to Re: Cortisol and DHEA Balance, posted by Larry Hoover on April 7, 2003, at 15:04:21
Hi Larry,
Could you tell me what the S in DHEA/S is? I have never had my levels of cortisol tested and am thinking maybe this is a good idea along with my DHEA.
I am going to add some zinc to my cocktail and I also added alpha lipoic acid today too.
Still a little freaked by bursting with energy to none at all. The time change didn't help either. Thank you and have a good one.johnj
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