Posted by KaraS on July 25, 2004, at 19:48:25
In reply to Re: Supplements for brain fog?- Larry » KaraS, posted by Larry Hoover on July 25, 2004, at 10:06:06
> > 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.
>Ah, yes, the placebo effect. I've been reading all about it's half-life on the main board.
> > 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.I have hypersomnia but not hyperphagia. I have a healthy appetite now, no more & no less than that. Still not sure if I'm atypical and/or if the hypersomnia is due to adrenal fatigue. I agree with you, though, that it really doesn't matter. I need to treat the symptoms.
>
> > 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.
>I'm not completely anhedonic so that makes sense.
> > 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.
>How does one treat mitochondrial dysfunction? (co-Q10? Phosphatidylserine? NAC?) Is that even possible?
> > 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?
>No seasonality that I've noticed here in southern California where it's sunny most of the time. I did get worse in winter time when I lived back east. I have a light box that I am going to start using again. I read recently (in the article that you recommended?) to reset your time clock using a lightbox, methylcobalamin (B3), and/or melatonin. That will definitely be a part of my healing program.
> > 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.
>
Can I take your response to mean that you are one of the ones who do not believe in it? I don't know if I do but would like to err on the side of safety and try to stabilize the situation. I was planning on starting the diet (not necessary?) and I purchased NOW brand "Candida Clear" with Pau D'Arco, Oregano Oil, Black Walnut and Caprylic Acid. I also bought probiotics (Enzymatic Therapy's Acidophilus Pearls as I've read that they hold up well and don't need to be refrigerated).How about triphala? Any thoughts on that? Can/should it be taken along with probiotics?
> > I have Hashimoto's thyroiditis
>
> Geez. We don't understand that one very well at all.We know that it's an autoimmune problem. We just don't know why the body attacks its own thyroxine.
>
> > 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.
My point was that there is so much that is labeled CFS but we just don't know what the causes are. Some could be viral. Others not. Too much is labeled CFS and thrown into one category. In my case I believe it's viral. I don't know about anyone else's case. Some who are diagnosed with this have much different symptomology than I have.>
> > 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.Yes, my sense with my CFS is that it will always be there. My immune system has learned to deal with it better but it is always there lurking and ready to strike should my defenses let down.
>
> 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.
>No, I hadn't. I'll have to do some research.
> > 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.
>You're too young for Andropause!
> 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?Interesting. Are you oversleeping or do you have a sleep/wake cycle that's off? I'm thinking that if B3 is used to reset the sleep cycle and it's also involved with histamine, then malfuncioning of it's metabolism could be responsible for my allergies, urticaria AND sleep/wake cycle problems??? Am I way off here or do you follow me?
>
> 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.
>You are too funny. I can just see you researching for days on end and forgetting to eat, sleep etc. I never forget to eat. Oh, I forgot to add to my list of ailments that I'm hypoglycemic. That never lets me forget to eat. I doubt that I would anyway. I enjoy it too much.
> > 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.
>Isn't that the most frustrating thing? And they're so smug about it. I want them to know what a disservice they do to their patients when they respond like that. It's all about their egos - if they don't know what's wrong with you, then there can't possibly be anything wrong with you. It's the "I don't know therefore I diagnose hypochondria" rule.
> > 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?There have been times in the past when I was anhedonic and had no sense of humor to fall back on. Not fun. I imagine you've been there as well.
>
> > 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"
>You're so slick, Hooverman.
> 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.
>So you're saying to deal with the stressors that got me to this place to begin with. Easier said than done but I'll be working on it.
> Yes, adding dopaminergic and noradrenergic stimuli would be counterproductive. Your focus ought to be more on mitochondrial activation. That's more like Dr. Pall.
>Don't know anything about his/her work. Can you recommend a book or give me a first name? The article you had me read advised taking l-tyrosine every day though I'm not sure why. I think they recommended 500 mg. I didn't feel any antidepressant effects when I took it before but if it's going to help my adrenal situation, then I'll go back on it. I already have some here.
> > 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.You're a sweetheart. Thanks. I'll hold you to it. Do you play the lottery regularly? (Just trying to assess the odds of that happening...)
>
> > 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. ;-)
>I wouldn't think of it! The rest of the babblers would be all over me. I wouldn't survive it.
Thanks again,
Kara
>
> You're welcome,
> Lar
poster:KaraS
thread:359642
URL: http://www.dr-bob.org/babble/alter/20040718/msgs/370484.html