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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by Tomatheus on July 17, 2012, at 13:36:19
So, I was responding reasonably well to my regimen of medications and supplements after I had added four drops (14.4 mg) of liquid SAM-e into the mix. My concentration was improved; my energy, psychomotor retardation, and anhedonia seemed to be better than usual; and even my overall cognition seemed to be better than it's been in the time since I took aminoguanidine. Perhaps what's even more important than the fact that I saw my symptoms improve was that I was more functional than I had been in a while during my response to the liquid SAM-e. I was reading more (and reading is something that I can't do much of when I'm not responding to treatment), listening to music (which is something that I can't normally bear to do), and I even put in an application for a volunteer job. But last night, that all-too-familiar feeling of not being able to concentrate on anything came back, and it came back rather quickly. I've since increased my liquid SAM-e dose to 5 drops (18 mg), which seems to be helping some, although I haven't been feeling as well at this new dose as I was at my old dose before it pooped out.
One of the problems with being at this higher dose of liquid SAM-e is that it, too, will almost definitely lose its therapeutic benefits before too long. It might be the case that I'll be able to return to liquid SAM-e at a later time (once I discontinue the supplement) and still be responsive to the supplement at four drops again, but then again, that might not be the case. In most cases, restarting supplements several months after having tried them and responded to them temporarily, I would get no response. I don't know why this is, but that seems to be the rule when it comes to treating this concentration-dominant depression. What's probably stranger than anything else is that SAM-e used to be pretty much the only treatment option out of those that I've tried that would have a consistent long-term effect without pooping out (even if it was just a partial effect) -- at least when it came to treating my anergic/vegetative depression before I began experiencing psychotic symptoms. But now that I've got the psychotic symptoms to contend with and that my "depression" manifests itself as more of a disorder of concentration than an all-out absence of thought and energy, the disorder has seemingly become more difficult to treat. The fact that even SAM-e poops out leaves me with what I feel are few viable options.
So, what should I do? There is always the possibility that another supplement might do something that the supplements that I've tried previously haven't, but then again, my track record with supplements tends to be of many short-term successes with little to no success in the long run. As far as I'm concerned, I've tried every medication that I think is worth trying, and the same goes for therapies. Exercise has also shown itself to be of no use for treating any of my psychiatric symptoms. So, where does that leave me? I won't accept my symptoms the way they are when they're not responding to treatment because they're simply too unbearable and leave me pretty much useless. I hate to use that term, and I'll probably be accused of being too negative for using it, but if you could observe my functioning when I'm not responding well to treatment, you'd probably agree that it's more or less true (that I'm useless). I do think about ending it all and think that it would be a good idea, but I just don't have the guts to go through with it. So, that's probably not going to happen. So, again, where does that leave me? I don't know, but it doesn't look good.
Thanks for reading. Help and support would be appreciated.
Tomatheus
Posted by Johnnybaklava on July 17, 2012, at 15:09:11
In reply to Another supplement, another poop out, posted by Tomatheus on July 17, 2012, at 13:36:19
I totally understand where you're coming from. I have had, and still do, the same problem. Butand this is just meI've noticed that if I examine where I was a year ago, before taking a supplement that seemed to work then poop out, I noticed I'm in a better place. For some of the supps that come on strong, sometimes they simply become less noticeable, but are actually helping in subtle ways. Some just suck and poop out, but I find, for me, herbs (rhodiola, gingko), vitamins (C, Bs), minerals (magnesium), and a little dmae (at least for now) give me a pretty strong foundation, even though I still experiment to get that "really good" feeling I used to have.
Posted by Tomatheus on July 17, 2012, at 16:39:50
In reply to Re: Another supplement, another poop out, posted by Johnnybaklava on July 17, 2012, at 15:09:11
Johnnybaklava,
Thank you for your quick response. I would have to say that my response pattern to supplements is probably similar to yours in the sense that some of the supplements that I take continue to have subtle benefits. The folic acid, coenzyme q10, Korean ginseng, DHA, and vitamin B12 that I take all seem to do a little something, mostly for my depressive symptoms, even though they don't have the impact on my concentration that I feel that I need. I may keep taking the SAM-e that I'm taking, even if it seems to lose most of its effects on my concentration and other depressive symptoms at this new higher dose, because it seems that it might have still been helping with my overall cognition even when it seemed to poop out as an antidepressant. So, maybe this SAM-e will continue to help me down the road in subtle ways (along with the other supplements that I take) even if it does seem to poop out again at this higher dose that I'm taking.
Anyway, thanks again for posting and for letting me know which supplements seem to give you at least a foundation for mental well being. I'm sorry that you still seem to have the same kind of problem that I have with supplements becoming less effective, though, and I wish you well with any more supplement trials that you might undertake.
Tomatheus
Posted by Johnnybaklava on July 18, 2012, at 12:02:57
In reply to Re: Another supplement, another poop out » Johnnybaklava, posted by Tomatheus on July 17, 2012, at 16:39:50
You could try Trimethylglycine, as this is converted to SAM-E. Maybe you would react differently since your body would be making it. I tried it for a bit and didn't notice much of an effect, but I tend to take really small amounts of things. What I am realizing is that I have a shelf full of herbs and vitamins I've tried and, while I have my maintenance supplements I take every day, I tend to cycle through the herbs which may increase their "novelty" to my brain. Everyone is different, and I know I respond well to adrenal-nourishing herbs like Rhodiola and Holy Basil, and poorly to Gotu Kola and Bacopa. Also, I take phenylalanine every day, which is great for me, but tyrosinewhich should have a similar effectmakes me terribly irritable. I'm not taking any drugs and haven't for about four or so years and feel great, considering where I was, but it took a lot of time to become adjusted. A few years on zoloft and klonopin left me with a lot of sludge in my system that took at least a year if not more to start feeling okay again.
Posted by Tomatheus on July 18, 2012, at 18:11:03
In reply to Re: Another supplement, another poop out, posted by Johnnybaklava on July 18, 2012, at 12:02:57
Johnnybaklava,
Thank you for the reply and the suggestions. I do think that trimethylglycine is a good idea. I too have tried the supplement and didn't notice anything the last time that I took it, but that was before the onset of my psychotic symptoms, so perhaps it might affect me differently if I were to take it now.
I also think that cycling my supplements isn't a bad idea, but unfortunately, every time since the onset of my psychosis that I've tried taking a supplement that's pooped out a second time (months later, usually), the supplement wasn't at all effective like it was the first time around.
It is encouraging, I think, that you say that you're feeling great compared to how you were feeling previously and that the supplements that you're taking seem to be helping you. I don't really think that I can say the same thing right now, but maybe I too will get to a point where I can at least feel satisfied with the progress I've made as far as my mental health is concerned.
Tomatheus
Posted by Johnnybaklava on July 19, 2012, at 13:00:20
In reply to Re: Another supplement, another poop out » Johnnybaklava, posted by Tomatheus on July 18, 2012, at 18:11:03
I'm sure you will! Just the fact that you are trying alternative options is a great sign. You'll eventually happen upon what works for you and, like you said, sometimes it's all about timing.
Posted by Hyena on August 3, 2012, at 3:22:19
In reply to Another supplement, another poop out, posted by Tomatheus on July 17, 2012, at 13:36:19
hi. just want to give you my experience. i tried several supplements in the past that worked for a short while then pooped out. i suffer from anxiety and depression.
about 2 years ago i started using high epa fish oil. after a lot of tinkering with doses, brands, and combinations with other sups i settled on a regimen that works. epa is absolutely central to this. im still taking epa today and it hasnt pooped out on me yet.
i can honestly say the last 2 hears have been the best of my life. ive been almost totally symptom free and have done things i could only dream of before.
i know everyone is different biologically but it might be worth it for you to give high epa fish oil a try.
if you need any advice on doses, brands, etc please let me know.
Posted by Tomatheus on August 3, 2012, at 11:33:55
In reply to Re: Another supplement, another poop out, posted by Hyena on August 3, 2012, at 3:22:19
Hyena,
Thank you for the feedback. I tried taking a high-EPA omega-3 supplement a few years ago: the EFA Gold "Mood Aid" supplement, if I remember correctly. I ended up discontinuing the supplement after my first day taking it because my ideas of reference became somewhat worse. I didn't notice any change in my depressive symptoms from taking the supplement, but then again, I don't think that I gave the supplement nearly enough time to exert any mood-boosting benefits. Given your success with high-EPA omega-3 supplements, I think that retrying such a supplement might be a worthwhile thing for me to do, if the benefits from my current treatment regimen give way. I'll probably notice an increase in ideas of reference again if I end up trying a high-EPA omega-3 supplement for a second time, but maybe it might be worth enduring some ideas of reference if it means that I'll get some long-term relief from my depressive symptoms.
Could you tell me the brand and dose of omega-3 fish oil that you're taking? As I see it, the more information I have, the better.
Thanks again,
Tomatheus
Posted by Johnnybaklava on August 3, 2012, at 15:53:07
In reply to Re: Another supplement, another poop out » Hyena, posted by Tomatheus on August 3, 2012, at 11:33:55
I have had an on-again, off-again relationship with fish oil. I recently tried Nordic Natural's EPA supplement and, at just one capsule every other day, have felt noticeably better. Only issue, though, is my sleep. I woke up last night at 3 AM and couldn't get back to sleep until 6. This isn't necessarily due to the fish oil. It could be something else, such as a new brand of rhodiola, or the fact that my wife turned on our sunlamp in the afternoon as opposed to the morning. It could have messed with my circadian rhythm. Anyway, I will still continue with it and if sleep stays messed up, I may try reducing.
Posted by Tomatheus on August 3, 2012, at 16:23:17
In reply to Re: Another supplement, another poop out, posted by Johnnybaklava on August 3, 2012, at 15:53:07
Johnnybaklava,
Thank you for your feedback regarding your experiences with fish oil. It's good to hear that the Nordic Natural's EPA supplement has been helping you, although I'm sorry to hear about your sleep. The supplement that you mentioned (Nordic Natural's EPA) is something that I will consider.
Tomatheus
Posted by Hyena on August 4, 2012, at 5:49:50
In reply to Re: Another supplement, another poop out » Hyena, posted by Tomatheus on August 3, 2012, at 11:33:55
if you are getting ideas of reference from epa it may be wise to start with a small dose and discontinue if the effects are getting worse. please also consult your doctor if you are going to try it again.
the brand of epa i use now is morepa from minami. ive also used Dr Tolonen's E-EPA with good results also.
i have found that epa can react powerfully with many different supplements. sometimes this reaction can be negative. for example, i take a potent multivitamin occasionally and i have to cut the pill into quarters and only take a quarter at a time or i will get worse depression and anxiety when its taken on the same day as epa. small amounts of the multi actually boost the good effects though. ive read many posts where people had bad reactions to epa and i think it may have to do with the other supplement they are taking.
i would advise to try epa on its own for a few days and then slowly reintroduce your other supplements to see of there is any reaction. the only exception i would make is vitamin E which ive found to boost the positive effects of epa greatly. i take natural mixed tocopherols vitamin e.
the dose of epa is also very important. taking too much can paradoxically have the same effect as taking too little. there seems to be a sweet spot. you can find this through trial and error.
something ive found very useful is to keep a daily journal of every supplement i take, what i eat, what exercise i do and how i felt on the day. this way i can see patterns over time and decide what is working and what is not. it also helps me avoid repeating experiments and wasting time. ive learned a huge amount about what affects my mood from doing this.
hope this helps.
Posted by Hyena on August 4, 2012, at 5:53:26
In reply to Re: Another supplement, another poop out, posted by Johnnybaklava on August 3, 2012, at 15:53:07
i had sleep problems when i first started epa but over time they disappeared. your right, maybe reducing the dose might help.
Posted by Tomatheus on August 4, 2012, at 8:54:58
In reply to Re: Another supplement, another poop out, posted by Hyena on August 4, 2012, at 5:49:50
Hyena,
Thank you for the information and for the sensible advice.
Tomatheus
Posted by starblue88 on March 8, 2013, at 5:08:00
In reply to Re: Another supplement, another poop out » Hyena, posted by Tomatheus on August 3, 2012, at 11:33:55
Hi,
I find with most supplements there can be an initial boost and then a tapering out, BUT I have been advised that then the real therapeutic effect subtly builds up over the coming 3 to 6 weeks, then 3 to six months, so patience is required (something that I really need to learn & practise myself).
If you have schizoaffective disorder you may be over-methylated in which case SAM-e is the worst thing you could be taking. But you would need blood tests in a lab to determine histamine levels to diagnose this for sure.
hope this helps..
Posted by Tomatheus on March 8, 2013, at 11:41:50
In reply to Re: Another supplement, another poop out, posted by starblue88 on March 8, 2013, at 5:08:00
Hi starblue88,
Thank you for your reply. I understand what you're saying about many experts saying that the therapeutic benefits of supplements take at least several weeks to become evident, but there are some supplements that I ended up staying on for several months that didn't seem to do anything positive after several weeks or months. Maybe there is a supplement or two out there that might be an exception to this for me, but I think that the only way to know if this might be the case would be to try every supplement that I can tolerate over a long period of time to see if they might have any long-term benefits, and I don't know how worthwhile that would be, especially given the results I've had so far.
My test results from the orthomolecular treatment center I went to did recently come back, and all they found was that my vitamin D level was low and that my white blood cells were elevated (the second of which is a reading that keeps coming back every time I'm hospitalized). My histamine levels were normal. I've tried supplementing with vitamin D in the past, and my psychotic symptoms became worse when I tried to do so, so I don't think that supplementing with vitamin D again would be a good idea.
The lab value that I think I need to pay the most attention to is the fact that my white blood cells are chronically elevated. I've pretty much always felt that my chronic fatigue and related symptoms (the slow thinking, hypersomnia, and difficulty concentrating) were brought on by prolonged sleep deprivation, and not too surprisingly, sleep deprivation has been shown to bring about elevations in white blood cells that can't be reversed with recovery sleep. Taking supplements that address things like neurotransmission or methylation are probably going to be of no value unless they address my underlying problem with white blood cells. No medical professional seems to know what to do with my white blood cell problem. All they do is ask if I've had an infection recently, and when I tell them that I haven't, they basically brush that off. Anyway, I might be trying some anti-inflammatory supplements with the potential to lower white blood cells, but given my track record with supplements, I'm certainly not expecting anything that will produce lasting results. I mean, I wouldn't be trying the supplements if I didn't think that there was some chance that they might do some long-term good, but I know how supplements normally affect me and thus have to be realistic about my treatment outcome.
Tomatheus
Posted by Tomatheus on March 9, 2013, at 8:48:16
In reply to Re: Another supplement, another poop out » starblue88, posted by Tomatheus on March 8, 2013, at 11:41:50
Hello again starblue88 and anybody else reading this.
This morning, I decided that at this point in time, I'm not going to take the anti-inflammatory supplement that I was planning on starting today and that instead, I'm actually going to give vitamin D another try. I decided this because I thought back to the trials I had with some other supplements that lowered white blood cells (which produced only temporary benefits) and figured that I'd stand a better chance of getting lasting results in the treatment of my fatigue by taking vitamin D. An increase in psychotic symptoms with vitamin D supplementation is still a concern of mine, but I think that any increase in psychosis is likely to be much less intense than it was the last time I supplemented with vitamin D because I'm taking Abilify now and was taking no antipsychotic then. I have some thoughts on what I might do if my psychotic symptoms become too severe on vitamin D (some of which revolve around increasing my Abilify dose), but hopefully my psychotic symptoms won't get too severe with the Abilify in place.
So, as of this afternoon, it will be on to vitamin D for me.
Tomatheus
This is the end of the thread.
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