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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by g_g_g_unit on August 12, 2010, at 6:29:26
Is this common? I found this article by Stahl on the subject: http://www.psy-world.com/Second_Messenger_Issue12_V1.pdf
I've had a chronic sore throat for God knows how long now; I also seem far more susceptible to getting sick than others I'm close to. This phenomenon seems to have been going on as long as I've been more seriously depressed. It's also accompanied by a kind of mental inertia which makes responding to stress extremely difficult.
I've had extensive bloods drawn - which only showed some slight antibody irregularity, but were otherwise fine. Before I investigate some other exotic cause, would it be most logical to assume that depression and chronic anxiety are increasing inflammation/impairing immune function?
Posted by violette on August 12, 2010, at 7:05:17
In reply to 'worried sick' - depression + sickness symptoms, posted by g_g_g_unit on August 12, 2010, at 6:29:26
Are you sure you don't have an allergy to something in the house?
I thought of mono, but wouldn't that show up in a blood test?
There's not doubt depression/anxiety wears you down and affects your immune system; but that doesn't mean its necessarily related to that. If you have it year-round rather than seasonal, it could be an allergy in the home. Newer pets? Newer flooring/carpeting? Newer matress? Some furniture or carpets have strong anti-flammatory chemicals that could be irratating you.
I have had a sore throat and cold-like symptoms from SSRIs before, as the symptoms started upon taking them-which happened more than once; since I rarely get colds, that's the only thing I can connect the symptoms too.
When I stayed at the other end of the country for a long time once, I'd wake up every day with a sore throat though it would get better as the day went on. It seemed to be related to the desert-like climate which I wasn't used to-the dirt which was dusty and had a distinct smell that was irratating.
Didn't you say you moved relatively recently-did the sore throat start then? If you grew up in another country, you're body might have not built up an immunity to allergens/chemicals used in the country you moved to, while people born there would have been exposed to the substances from childhood. You could always see an allergist to rule that out.
Posted by g_g_g_unit on August 12, 2010, at 8:43:38
In reply to Re: 'worried sick' - depression + sickness symptoms » g_g_g_unit, posted by violette on August 12, 2010, at 7:05:17
hey thanks for replying!
> Are you sure you don't have an allergy to something in the house?
pretty sure - we've moved between three houses in the past 5 months, and the problem has transcended abodes
>
> I thought of mono, but wouldn't that show up in a blood test?
>
> There's not doubt depression/anxiety wears you down and affects your immune system; but that doesn't mean its necessarily related to that. If you have it year-round rather than seasonal, it could be an allergy in the home. Newer pets? Newer flooring/carpeting? Newer matress? Some furniture or carpets have strong anti-flammatory chemicals that could be irratating you.hmm, aside from moving into a new house, nothing else is new, and the problem existed before that
>
> I have had a sore throat and cold-like symptoms from SSRIs before, as the symptoms started upon taking them-which happened more than once; since I rarely get colds, that's the only thing I can connect the symptoms too.did the symptoms continue while you were on them?
>
> When I stayed at the other end of the country for a long time once, I'd wake up every day with a sore throat though it would get better as the day went on. It seemed to be related to the desert-like climate which I wasn't used to-the dirt which was dusty and had a distinct smell that was irratating.
>
> Didn't you say you moved relatively recently-did the sore throat start then? If you grew up in another country, you're body might have not built up an immunity to allergens/chemicals used in the country you moved to, while people born there would have been exposed to the substances from childhood. You could always see an allergist to rule that out.interesting. the country i moved to is really similar in climate to my previous one though.
i also have read that 'sickness behaviour' is a part of depression. it's more than just a sore throat for me though - i feel really physically rundown, like sore throat, stomach bloating, my head feels like its swimming. its not the fullblown sickness you might feel with a flu where you're in bed, but this more nefarious, kinda background presence that just makes coping with stress impossible. i feel really rundown basically ..
since when my depression first manifested, i thought i had everything from MS to diabetes, i was trying to take the more 'mature' approach this time and link the malaise to depression before freaking out :) i have a feeling that if i ask a psychiatrist though, they'll just automatically pin everything on depression so i wasnt sure
do you think the best idea would be to treat the depression and see if the symptoms still persist?
Posted by violette on August 12, 2010, at 9:55:14
In reply to Re: 'worried sick' - depression + sickness symptoms » violette, posted by g_g_g_unit on August 12, 2010, at 8:43:38
Yes, I remember your medical fears. :)
If by small chance (lol) you missed celiac disease-Here's an article for you. The thing about celiac is-the older you get, the more prounced your symptoms are likely to become. I learn more from the comments of people who post in response to these articles than I do from the articles themselves. Maybe you could read through the comments and find people with similar problems?
http://well.blogs.nytimes.com/2009/07/02/celiac-disease-becoming-more-common/
As for treating your depression, I'm not sure how I would approach it right now if I were you. I think though, you could rule things out in terms of medical problems which would increase your chances of getting better overall. Aside from the anxiety, maybe you feel like sh*t more from your medical problems than from depression itself (depression being the side effect)?
And rather than feel guilty about using medical services-why not accept it for now? How about starting with a celiac test-maybe allergists do them...if no conclusions are reached, then go to and get that neuropsych test done. Schedule both at once might be even better. Really, there are neurological infections that can cause many of your symptoms-simple blood tests can find them. And you don't have to go through the full neurological work up afterwards if you don't want to. i think you'd be very intested in the neuro psych test results-and the people who do them are very good at determining possible medical cuases, such as heavy medals, bipolar, schitzophrenia, etc., they really are an asset to any psychiatrist and I am surprised more psychitrists do not prescribe those tests. No guilt!!
I understand about the medical fears, really, I do. And they can get out of hand. But how about allowing yourself 2 tests-celiac/allergy and the neuropsych testing - without feeling guilty about it! And write to Dr. Adams, whose forum I linked. And coordinate everything with your internist/primary care doctor-bring everything; call and ask for a double appointment. Bring a list of your symptoms, dates, medications you've taken, and all the tests you've had done.
And you know me-I always say to try a psychodynamic therapist who is also a psychiatrist. There are more versed in psychosomatic symptoms than conventional psychiatrist. I think some of my symptoms are psychosomatic, some of yours may or not be. But psychosomatic symptoms are real illnesses-it's not the same thing as hypochondrias.
Here's a doctor-Dr. Adams-who specializes in psychosomatic illnesses (and hypocondrias). If you write on that forum, he normally answers right away. There's a lot of good research conclusions he posts all the time as well. Take a look:
http://www.psychological.com/forums/forum.php
There are a lot of mystery inflammatory problems going on with people. Sometimes people end up with diagnoses of chronic fatigue syndrom or fibromylagia. Doctors generally do not like to give those dx as they are mostly unsure what causes them; if your care is coordinated and you are proactive in getting the tests/exams done, despite your feelings about it, it could lead to a better outcome. Those are places to start-what do you think?
Here's the article about Celiac, followed by comments if you go to the link I posted above:
Celiac Disease Becoming More Common
By TARA PARKER-POPE
Celiac disease, a serious immune system reaction to the protein in wheat and other grains, is far more common today than it was 50 years ago, a new study shows.People who have celiac disease cant tolerate gluten, a protein found in wheat, rye or barley. Life with celiac is difficult because gluten is found in many medications and processed foods. When gluten is consumed, the bodys immune system damages the small intestine and nutrients cant be absorbed.
While its been known that the incidence of celiac is on the rise, it hasnt been clear whether doctors are simply looking for it more often, and therefore finding more cases. But new research from the Mayo Clinic in Rochester, Minn., suggests that the disease is four times more common today than it was in the 1950s, and not just because doctors are more likely to test for it.
The study, published in the journal Gastroenterology, analyzed blood samples collected from 9,133 healthy adults collected at Warren Air Force Base between 1948 and 1954. Another 12,768 gender-matched subjects from a study in Olmsted County, Minn., were also analyzed for signs of celiac disease.
Of the blood samples collected 50 years ago, only 0.2 percent had celiac disease. In the more recent blood samples, the incidence of celiac disease was more than four times greater. Today, its estimated that about one in 100 people have celiac disease.
Doctors dont know why celiac is on the rise. It may be due to changes in the way wheat is grown and processed, or the ubiquity of gluten in medications and processed foods. Symptoms of celiac disease include diarrhea, abdominal pain and weight loss. Nutritional problems are also common, and anemia, loss of teeth and premature bone loss can occur.
The trend is concerning because celiac disease is often misdiagnosed as irritable bowel syndrome or another condition. Its been estimated that for every person diagnosed with celiac disease, another 30 people have it but havent been diagnosed. Once diagnosed, the disease can be managed by eating a gluten-free diet. But when people dont know they have the problem and continue to eat gluten-containing products, the intestines become severely damaged, leading to long-term health problems and a higher risk of dying compared to people who dont have celiac.
Posted by Phillipa on August 12, 2010, at 10:21:48
In reply to 'worried sick' - depression + sickness symptoms, posted by g_g_g_unit on August 12, 2010, at 6:29:26
You mention antibody irregularities are you referring to ANA? If so could but doesn't always point to an autoimmune illness. What does your medical doctor say? Any preexisting medical conditions? Phillipa
Posted by sigismund on August 12, 2010, at 20:32:51
In reply to Re: 'worried sick' - depression + sickness symptoms » violette, posted by g_g_g_unit on August 12, 2010, at 8:43:38
That was a great article, suggesting the sorts of interventions used by integrative doctors.
Posted by maya3 on August 13, 2010, at 10:37:20
In reply to 'worried sick' - depression + sickness symptoms, posted by g_g_g_unit on August 12, 2010, at 6:29:26
Are you on any meds?
I had similar problems while on a low dose of AP.
Posted by bleauberry on August 13, 2010, at 18:47:49
In reply to 'worried sick' - depression + sickness symptoms, posted by g_g_g_unit on August 12, 2010, at 6:29:26
The lab tests you had really aren't going to show what is going on. They paint a broad brush but don't show the tiny details. It's in those tiny details where we find the dramatic problems.
Funny, I hadn't studied up on LDN for months but did so last night. Revisited a lot of stuff. I found it strange how almost everything you said jumped right off the page almost word for word as exact descriptions of the kinds of people that respond well the LDN.
I'm going to start a new thread on it, but I would say it would be a fair and justified approach to take a look at the endogenous opioid system. A simple short trial (few days) of Vicadin would tell you a lot. A longer trial of LDN to follow. DLPA a possible stand-alone or add-on. If you haven't already, do some searching and reading on tag words such as "LDN", "LDN depression", "endogenous endorphin depression", and such. You'll see what I mean. All that stuff explains it better than I can. You will see direct strong links between the immune system and mood.
I'm not saying that depressed doesn't make you more sick. I'm sure it does. But I've been depressed for 15 years and haven't had a cold or flu in probably a decade. Yet, I cannot fight off a simple boil, and a mere scratch can takes weeks to heal and leave a scar.....clearly a confused immune system....which is corrected by LDN or opioids. The depression cured too. But again, a simple diagnostic test is maybe 2 Vicadin tabs per day for 3 or 4 days and see what happens. If you feel normal, you just made a diagnosis and now know where to focus. Vicadin is not a longterm answer, but instead a diagnostic tool, one that pinpoints specific meds and supplements to focus on for both the immune system, disease in general, and mood, all simultaneoulsy.
Posted by morgan miller on August 13, 2010, at 20:18:28
In reply to 'worried sick' - depression + sickness symptoms, posted by g_g_g_unit on August 12, 2010, at 6:29:26
I definitely think depression and anxiety could be increasing inflammation and impairing immune function.
How do you feel about herbs that may alleviate some of your depression and anxiety, and, strengthen your immune system and fight off inflammation?
Posted by g_g_g_unit on August 14, 2010, at 6:47:44
In reply to Re: 'worried sick' - depression + sickness symptoms » g_g_g_unit, posted by violette on August 12, 2010, at 9:55:14
thanks again for your thoughtful reply :)
> Yes, I remember your medical fears. :)
>
> If by small chance (lol) you missed celiac disease-Here's an article for you. The thing about celiac is-the older you get, the more prounced your symptoms are likely to become. I learn more from the comments of people who post in response to these articles than I do from the articles themselves. Maybe you could read through the comments and find people with similar problems?
>
> http://well.blogs.nytimes.com/2009/07/02/celiac-disease-becoming-more-common/i was in fact tested for celiac again recently (about a month ago) when my new doctor did a comprehensive blood test and i turned up negative
>
> As for treating your depression, I'm not sure how I would approach it right now if I were you. I think though, you could rule things out in terms of medical problems which would increase your chances of getting better overall. Aside from the anxiety, maybe you feel like sh*t more from your medical problems than from depression itself (depression being the side effect)?
>
> And rather than feel guilty about using medical services-why not accept it for now? How about starting with a celiac test-maybe allergists do them...if no conclusions are reached, then go to and get that neuropsych test done. Schedule both at once might be even better. Really, there are neurological infections that can cause many of your symptoms-simple blood tests can find them. And you don't have to go through the full neurological work up afterwards if you don't want to. i think you'd be very intested in the neuro psych test results-and the people who do them are very good at determining possible medical cuases, such as heavy medals, bipolar, schitzophrenia, etc., they really are an asset to any psychiatrist and I am surprised more psychitrists do not prescribe those tests. No guilt!!
i did go over this with myself. unfortunately because i am not earning much at the moment (and every penny i do get is going towards psychotherapy) i decided to nix the neuropsych testing. i *was* also diagnosed with ADD by my therapist, so i figured it might be better to try and treat the ADD/depression and see if the cognitive issues persist, before turning to testing.also regarding feeling worn out (versus depressed): i wish i could truly believe that were the case, but i do sometimes think that all this hypochondria stuff is a convenient distraction from my OCD. the truth is my OCD has reached painful, completely debilitating heights and just getting out of bed/trying to engage in basis tasks has become extremely difficult. so i may very well be sick!! but there's no doubt that the OCD and related stress is contributing. so i think i'll try treating the OCD/depression first, just to give me room to breathe, and then start investigating other possibilities!!
i have however organized an appointment with my GP to have a throat swab done, so that's a start ..
>
> I understand about the medical fears, really, I do. And they can get out of hand. But how about allowing yourself 2 tests-celiac/allergy and the neuropsych testing - without feeling guilty about it! And write to Dr. Adams, whose forum I linked. And coordinate everything with your internist/primary care doctor-bring everything; call and ask for a double appointment. Bring a list of your symptoms, dates, medications you've taken, and all the tests you've had done.
>
> And you know me-I always say to try a psychodynamic therapist who is also a psychiatrist. There are more versed in psychosomatic symptoms than conventional psychiatrist. I think some of my symptoms are psychosomatic, some of yours may or not be. But psychosomatic symptoms are real illnesses-it's not the same thing as hypochondrias.
>
> Here's a doctor-Dr. Adams-who specializes in psychosomatic illnesses (and hypocondrias). If you write on that forum, he normally answers right away. There's a lot of good research conclusions he posts all the time as well. Take a look:
>
> http://www.psychological.com/forums/forum.php
>
> There are a lot of mystery inflammatory problems going on with people. Sometimes people end up with diagnoses of chronic fatigue syndrom or fibromylagia. Doctors generally do not like to give those dx as they are mostly unsure what causes them; if your care is coordinated and you are proactive in getting the tests/exams done, despite your feelings about it, it could lead to a better outcome. Those are places to start-what do you think?
>
> Here's the article about Celiac, followed by comments if you go to the link I posted above:
>
> Celiac Disease Becoming More Common
> By TARA PARKER-POPE
> Celiac disease, a serious immune system reaction to the protein in wheat and other grains, is far more common today than it was 50 years ago, a new study shows.
>
> People who have celiac disease cant tolerate gluten, a protein found in wheat, rye or barley. Life with celiac is difficult because gluten is found in many medications and processed foods. When gluten is consumed, the bodys immune system damages the small intestine and nutrients cant be absorbed.
>
> While its been known that the incidence of celiac is on the rise, it hasnt been clear whether doctors are simply looking for it more often, and therefore finding more cases. But new research from the Mayo Clinic in Rochester, Minn., suggests that the disease is four times more common today than it was in the 1950s, and not just because doctors are more likely to test for it.
>
> The study, published in the journal Gastroenterology, analyzed blood samples collected from 9,133 healthy adults collected at Warren Air Force Base between 1948 and 1954. Another 12,768 gender-matched subjects from a study in Olmsted County, Minn., were also analyzed for signs of celiac disease.
>
> Of the blood samples collected 50 years ago, only 0.2 percent had celiac disease. In the more recent blood samples, the incidence of celiac disease was more than four times greater. Today, its estimated that about one in 100 people have celiac disease.
>
> Doctors dont know why celiac is on the rise. It may be due to changes in the way wheat is grown and processed, or the ubiquity of gluten in medications and processed foods. Symptoms of celiac disease include diarrhea, abdominal pain and weight loss. Nutritional problems are also common, and anemia, loss of teeth and premature bone loss can occur.
>
> The trend is concerning because celiac disease is often misdiagnosed as irritable bowel syndrome or another condition. Its been estimated that for every person diagnosed with celiac disease, another 30 people have it but havent been diagnosed. Once diagnosed, the disease can be managed by eating a gluten-free diet. But when people dont know they have the problem and continue to eat gluten-containing products, the intestines become severely damaged, leading to long-term health problems and a higher risk of dying compared to people who dont have celiac.
>
Posted by g_g_g_unit on August 14, 2010, at 6:52:28
In reply to Re: 'worried sick' - depression + sickness symptoms, posted by bleauberry on August 13, 2010, at 18:47:49
i suffer from post-traumatic stress disorder (with the associated depersonalization and 'numbing') and have read that some of the symptoms may be linked to the opiod system.
LDN was something i was interested in investigating at some point.
i know that naltrexone has efficacy in treating OCD, but how do the effects differ from LDN? wouldn't LDN potentially make it worse?
> The lab tests you had really aren't going to show what is going on. They paint a broad brush but don't show the tiny details. It's in those tiny details where we find the dramatic problems.
>
> Funny, I hadn't studied up on LDN for months but did so last night. Revisited a lot of stuff. I found it strange how almost everything you said jumped right off the page almost word for word as exact descriptions of the kinds of people that respond well the LDN.
>
> I'm going to start a new thread on it, but I would say it would be a fair and justified approach to take a look at the endogenous opioid system. A simple short trial (few days) of Vicadin would tell you a lot. A longer trial of LDN to follow. DLPA a possible stand-alone or add-on. If you haven't already, do some searching and reading on tag words such as "LDN", "LDN depression", "endogenous endorphin depression", and such. You'll see what I mean. All that stuff explains it better than I can. You will see direct strong links between the immune system and mood.
>
> I'm not saying that depressed doesn't make you more sick. I'm sure it does. But I've been depressed for 15 years and haven't had a cold or flu in probably a decade. Yet, I cannot fight off a simple boil, and a mere scratch can takes weeks to heal and leave a scar.....clearly a confused immune system....which is corrected by LDN or opioids. The depression cured too. But again, a simple diagnostic test is maybe 2 Vicadin tabs per day for 3 or 4 days and see what happens. If you feel normal, you just made a diagnosis and now know where to focus. Vicadin is not a longterm answer, but instead a diagnostic tool, one that pinpoints specific meds and supplements to focus on for both the immune system, disease in general, and mood, all simultaneoulsy.
Posted by bleauberry on August 15, 2010, at 12:17:45
In reply to Re: 'worried sick' - depression + sickness symptoms » bleauberry, posted by g_g_g_unit on August 14, 2010, at 6:52:28
> i suffer from post-traumatic stress disorder (with the associated depersonalization and 'numbing') and have read that some of the symptoms may be linked to the opiod system.
>
> LDN was something i was interested in investigating at some poin
t.
>
> i know that naltrexone has efficacy in treating OCD, but how do the effects differ from LDN? wouldn't LDN potentially make it worse?
>Well, anything could potentially make it worse including OCD meds. So who knows.
Because the dose is so tiny, risk of anything bad happening is miniscule.
I think it makes sense that if someone has never explored the opioid side of things....they've only been in the serotonin/ne/dopamine merry-go-round, there is absolutely no harm in trying such a benign treatment that has so many potential benefits to it.
This is the end of the thread.
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