Posted by Larry Hoover on July 25, 2004, at 10:06:06
In reply to Re: Supplements for brain fog?- Larry, posted by KaraS on July 24, 2004, at 22:17:37
> Hi Lar,
>
> It's time to at least start on some of my questions for you since you raised the issue of adrenal fatigue. It got me to thinking about a lot of my symptoms and wondering now if they're adrenal exhaustion, a manifestation of atypical depression or some combination of both. How does one tell the difference?If reading about both syndromes came with that little light bulb, then my intuition is that both are valid representations of your difficulties. One differentiates, I suppose, by trying the recommended treatments for each.
The concepts themselves are theoretical. The rationale for treatment is theoretical. The treatments are empirical. A witchdoctor treating a patient for spirit possession by exposing the subject to the spiritual vibration of a plant might yet be providing a dose of an active chemical. It may be a collective conceit to think we've moved much beyond the witchdoctor himself.
> I mentioned to you about how I start the day so slowly and how I don't usually come alive or feel normal until late in the afternoon. I've been thinking that my depression is atypical because of the lethargy but I recently read that atypicals tend to do better in the morning and regress as the day goes on. If that's correct, then that might be a clue for me.
There is an inverse of the atypical trend, it has a name, but I can't think of it. In any case, current thinking is that "morning best = atypical" is not valid. http://www.mhsource.com/expert/exp1061200e.html
The key symptoms of atypical seem to be hypersomnia and hyperphagia. Oversleeping and overeating.
> OTOH, few people are a perfect clear cut case for any of the classifcations of depression. In fact, when I read the descriptions I inevitably find aspects of major depression, melancholia and dysthmia that relate to me. (I'm a lot of fun to hang out with!)
Mood reactivity is an element of atypical depression. You can still get happy about a pleasant experience. It's the crushing fatigue that limits the response.
> But getting back to the adrenal fatigue... I've always been a night owl. How do I know that my condition is not just diurnal variation? Wouldn't too much MAO produce the same symptoms?
So might mitochondrial dysfunction. The focus needs to be on interventions, ultimately. What to do? If excess MAO is a thought, then a trial of an MAOI makes sense. Etc. Validation of a model may never occur, though.
> If I don't sleep much, I come alive much sooner in the day. I'm not as groggy and brain dead. I have more energy and I'm not nearly as depressed. Unfortunately, I can't do that very often as I end up feeling sick a day or two later. Hmmm... that might argue for both too much MAO and adrenal fatigue, couldn't it?
Sleep deprivation is a valid treatment for atypical depression. I think SAD, too. Disturbances in the diurnal rhythm are probably best addressed with light therapy, as used for Seasonal Affective Disorder. Hypersomnia precludes the pineal gland from receiving proper diurnal synchronizing stimuli (e.g. morning light). Once out of synchrony, hypersomnia can lock in. Do you have any seasonality to your mood/energy?
> There are a few other things I should mention that might make the waters even murkier. I probably have an overabundance of candida yeast from antibiotics and too much sugar.
Candidiasis is a controversial diagnosis. However, controversy or not, restoration of normalized intestinal fauna and flora can make a big difference. Probiotics, particularly those with the greatest diversity of species, are sometimes very useful.
> I have Hashimoto's thyroiditis
Geez. We don't understand that one very well at all.
> and I was diagnosed with CFS almost 20 years ago. My CFS is not what most people think of when they think of that syndrome. There are so many conditions and viruses that get misdiagnosed or labeled as CFS because they just don't know what the hell they really are.
There is no specific virus that necessarily triggers CFS, but I do lean towards a viral etiology.
> One day when I was incredibly worn out, I got a horrible flu that included stomach symptoms, nausea, swollen glands, sore throat etc. It got better gradually and then a few days later I'd get it again. This went on for years. There's no doubt in my mind that it's viral. (I've known of 3 other people with exactly the same symptoms.) As time went on, the "attacks" started to occur less frequently. I would even go months without it. Now, it only seems to happen if I get really run down. I'm sorry to run on so but I think it might help if you knew what some of the other factors involved are.
Many viral infections are lifelong. Herpes zoster (chicken pox) emerges decades later as shingles.
Have you considered the possibility that you might be infected by a non-viral, non-bacterial agent? Mycoplasma, (oh, my brain is shutting down)...there are other possible infective agents.
> Some other issues of mine that might also be important are that I've had a lot of allergy problems in the last few years including cholinergic urticaria when I exercise (which hasn't been that often). The last time few times I've taken a walk, I feel good at the time but then an hour or two later I'm exhausted and have to sleep. I'm menopausal as well.
Okay, I can't give you personal experience on the menopause. Andropause, yes, but not menopause.
I've had life-long inhalant allergies, and I often require steroids just to breathe. Last year, I did a trial of NADH (reduced nicotinamide adenine dinucleotide) for fatigue, and my allergies and asthma disappeared. Not reduced. Absent. Also, the anti-histaminic effects of niacinamide are well-known. I'm thinking there might be a connection to B3 metabolism. What do you think?
You see why I love questions so? Not only am I just the most geekiest of geeks when it comes to questions (the world is so fascinating, I sometimes forget to eat for whole days while I research something), but I get distracted, and forget all about stuff like what works for me and that I need to buy some and I need to remember to take it and all of that. Absent-minded professor is not apt. Distracted professor. That's the label.
> I must sound like a mess to you but surprisingly, I still present well.Oh, honey, you don't wanna hear my list. ;-) And presenting well.....I have great facility with language (I'm a powerful speaker), and my geek-brain is a core trait. I've had doctors refuse to accept that I was anything but a malingerer.
> Ironically, I still look like I'm in good shape and I look younger than I really am. (The last nurse practitioner I saw was alarmed that I was having menopausal symptoms until told of my age so I think it's legit.)
That's a pretty good clue.
> My sense of humor is still intact.
Geez, without that, where would we be?
> All of this deceives most people (esp. my family and friends) who think that I'm just lazy. They don't get it that I just don't have the energy or the motivation to get a job or take care of my apartment.
Oh, I know. I know.
> At any rate, I know that it's critical for me now to diagnose this correctly because otherwise treatment of the wrong condition could make things so much worse.
I'm not so sure of that, if you choose wisely. The diagnoses arise from symptoms and their treatments. Diagnoses are patterns linking the two. What modern medicine sometimes forgets, IMHO, is that diagnosis is nothing more than a memnonic for the link between symptom and treatment. Many doctors treat from diagnosis, once that decision is made, rather than from presenting symptom(s).
> I had been planning on trying everything noradrenergic and/or dopaminergic until I found relief. However, if adrenal fatigue is a major factor here then I'd, in effect, be whipping a dead horse (or a very sick one), wouldn't I? (metaphor not simile, right?)
I'll answer the second question first. Yes. Metaphor is symbolic. Simile is comparative.
Notice how I built in my cognitive escape route,
above? "not...if you choose wisely"Treatment for adrenal fatigue is two-fold. One, is to let the adrenals rest. They're already whipped. Two, is to address the dysregulated signal that is whipping the adrenals. In other words, the problem isn't in the adrenals to begin with.
Yes, adding dopaminergic and noradrenergic stimuli would be counterproductive. Your focus ought to be more on mitochondrial activation. That's more like Dr. Pall.
> What I'd like to do right now is go to a good holistic Dr. and get a lot of testing done. I know of 2 near me who fit the bill but I can't afford to see them right now.If I win the lottery, I'll send you.
> Thanks for listening and considering all of this, Dr. Hoover.You're too kind.
> Let me know your thoughts when you get a chance.
Try and shut me up. ;-)
> Gratefully,
> KaraYou're welcome,
Lar
poster:Larry Hoover
thread:359642
URL: http://www.dr-bob.org/babble/alter/20040718/msgs/370262.html