![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 14 to 38 of 46. Go back in thread:
Posted by JonW on July 2, 2002, at 13:04:45
In reply to Re: ADD, differential diagnosis help ???, posted by Fuscia on July 1, 2002, at 12:37:21
Hi Fuscia,
I forgot to answer a couple of your questions... must be the ADD ;)
I have a craving for alcohol. I gave it up because it makes my depressed a couple of days after I get drunk (mood elevated the morning after, though), but I used to binge drink every weekend. To this day, I crave beer when I think about it. I don't think I'm an alcoholic or anything but alcohol and I definitely have a special relationship. I avoid caffeine, too. But as I remember, drinking coffee always used to result in me cleaning or organizing. Not really in a hypomanic way but maybe in a good way. However, my impression was always that it was a very extreme reaction and that I was very sensitive to caffeine.
Jon
Posted by Noelle on July 2, 2002, at 22:15:17
In reply to Re: continuous performance test (cpt). » IsoM, posted by katekite on July 2, 2002, at 10:38:37
How do you find this continuous performance test
Posted by IsoM on July 3, 2002, at 0:11:36
In reply to Re: continuous performance test (cpt). » IsoM, posted by katekite on July 2, 2002, at 10:38:37
Kate, the psychologist did decide that I had ADHD but he said even more extensive tests were necessary to gain a "full" diagnosis even though the forms filled out, family history, & the cpt showed very strong indication of ADHD. But I wasn't willing to shell out $300-$400 for the full thing. I figured it was a good enough indication for me.
Yes, I take adrafinil (but it also helps greatly with my narcolepsy) & occasionally I'll take Dexedrine too but I don't need it that often since I've being on adrafinil. SSRIs have served to curb the impulsive side of me. I've never been impulsive about shopping (not enough money perhaps?) or some of the other things that affects others, but with me, speech & ideas were the part I had trouble controlling. I'd often talk out of turn, answer questions before they were finished, finish other's sentences, & just blurt out silly comments before I'd always think of other's reactions.
Now, I'm very well behaved :-) & have learned a great deal of self-control that I think would carry over into normal life even without any meds. But then I'd end up VERY down again & I've gone through that too many times to try again without.
Posted by IsoM on July 3, 2002, at 0:16:52
In reply to Re: continuous performance test (cpt)., posted by Noelle on July 2, 2002, at 22:15:17
Noell, it's a simple software program that a psychologist buys & administers to his clients when asked for an ADD diagnosis. The test is simple but a person needs to be trained to interpret it & so a psychologist who's familiar with ADD is the one who'd have it. You'd need to make an appointment with such a psychologist to be able to take it & get the proper results read from it.
Posted by JonW on July 3, 2002, at 9:52:52
In reply to Re: Bipolar or ADD???, posted by MomO3 on July 2, 2002, at 13:02:49
> Although I am leaning towards bipolar, I am really afraid to get that diagnosis because I don't want to take lithium or anything that will make me any fatter than I already am...
Hi Mom,
I'm a guy and I don't like weight gain so I can only imagine how frustrating that must be for a woman. But at the end of the day, wouldn't you rather be fat and happy? ;-) The truth is not all meds for bipolar cause weight gain. For instance, this is rarely a side-effect for trileptal, lamictal, seroquel, and geodon.
> What meds are you taking (sorry if you already posted that I am just back after a psycho-babble sabatical).
I'm currently taking nardil + risperdal + depakote + neurontin. *All* of these cause weight gain and I've gained about 15 pounds. However, I started riding my bike 3 days ago and am starting to whip myself into shape and have lost 3 pounds already. I'm thin to begin with so it's not a major problem, but anyway...
I've been reading both 'Driven to Distraction' and 'The Bipolar Child' to try to help me answer the question "Is it bipolar or is it adhd?" I would suspect that you have bipolar disorder rather than adhd. Bipolar has nearly all of the symptoms of adhd. Have you been this way since childhood? Here's a list of the 'very common' symptoms seen in childhood onset bipolar disorder according to 'The Bipolar Child':
Separation anxiety, rages and explosive temper tantrums lasting up to several hours, marked irritability, oppositional behavior, rapid cycling(frequent mood swings, occurring within an hour, a day, or several days) or mood lability, distractibility, hyperactivity, impulsivity, restlessness/fidgetiness, silliness, giddiness, goofiness, racing thoughts, aggressive behavior, grandiosity, carbohydrate cravings, risk-taking behaviors, depressed mood, lethargy, low self-esteem, difficulty getting up in the morning, social anxiety, oversensitivity to emotional or environmental triggers.
Jon
Posted by katekite on July 3, 2002, at 10:49:18
In reply to Re: continuous performance test (cpt)., posted by Noelle on July 2, 2002, at 22:15:17
Ask a doctor or pdoc for the name of a psychologist that diagnoses ADD and ADHD.
Or, try the website www.chadd.org which will have some direction towards specialists in your area, I think you would contact the closest regional chapter.
Posted by Fuscia on July 3, 2002, at 11:25:17
In reply to Ooops! Bipolar or ADD? » Fuscia, posted by JonW on July 2, 2002, at 13:04:45
Hi Jon,
I appreciate you answering the questions! I'm still wondering, though, if the symptoms you mentioned occured simultaneously prior to starting any of the meds you are on? I am also curious as to how the current med combo you are taking was initiated. (Excuse me if you mentioned this before, but I didn't catch it). Were you prescribed all at the same time, or start out on one drug, then another drug added? Fact is, that these meds can cause the very symptoms you mentioned, and it's even more of a probability when one is taking a combination of drugs for who can truly say as to the combination effect on the body.
All I know is that you do have a lot of common sense, for you said that it isn't good to self-diagnose and that it's easy to find something when you are looking for it....you and I are much alike in that respect. I am always curious and always trying to figure out the "why" of everything, for I believe that there is a cause for everything. I'm driven to find out what it is. I even do this with everyday stuff - always analysing. There's nothing wrong with that. Just be careful with labels, though, for there are so many grey areas and a person can have more than one disorder that can add to the complication of diagnosing. I have been going through this myself. But, I have to be careful with labels, for I know how easy it would be to wear it like a flag and use it as an excuse for my actions, or that there is no hope for me, just the hope of finding the "right med". It can be a letdown going this route. So, as you told Scott, part science - part oneself as to getting to feeling and acting happy and content. You might consider the Adderall as a starting point since it didn't cause the depression as the dexedrine did (I assumed this depression occured when you discontinued the dexedrine?) And, you might be able to discontinue one of the other drugs you are taking if the Adderal helps.
Okay, so you are sensitive to hearing someone else chew their food. Are you sensitive to bright lights, loud music, annoyed at flashing commercials? I am. I have to turn away when I turn on a flourescent light over our kitchen counter, same for flashy commercials when mute is on. A friend sent me an article about Highly Sensitive People. In a nutshell it states that individuals with HSP are sensitive to external stimuli, caffeine, and medicines. I can take an antihistamine (dyphenhydramine,Benadryl) that only lasts four hours, but feel its effects well into the next day. I'll have to find that article and post it - it's interesting.
I too finish peoples sentences and interrupt them. It is like I am carrying on the conversation 5 seconds ahead of time in my head, and so I don't lose the thought I spew it out - otherwise I can't remember what I was going to say if I let the other person finish. This was prior to start of any meds. I felt like I had early signs of dimentia or Alzheimer's disease, or that I take after my mother who has the same problem. You should hear us on the telephone. She seems to not hear what I am saying, and I talk over her to finish my thought. I also get irritable when my husband and I are having a meal together and he starts to talk about something. I just can't concentrate on what he is saying and wish he would stop talking. Well, maybe other couples that have been married for 16 years go through this, too ; ) This has started after being on SSRI's.
I'm also left handed. I also have a difficult time reading, but more so at the start of a book, say, then once I get into the story - I just want to keep reading it through until the end. I can't read magasine articles. My mind drifts off. I am self-absorbed most of the time, thinking of how I feel, or ruminating over something I said to someone. If I am doing something physical like digging a hole to plant a tree, that is usually when I feel fine for my mind is not on myself. If it is a repetitious task, then I ruminate.
Now, getting lost is a good sign of ADD and not of Bi-polar disorder. But, I've heard this occuring to one that was taking one of the benzodiazepines for anxiety, and also an older person that was taking a beta-blocker for high blood pressure. Also, anxiety can certainly cause forgetting something that one normally wouldn't. I am taking Prozac 20mg weekly now, and I have noticed that since starting on SSRI's two years ago that my short-term and long term memory is terrible. It was bad before, but much worse now. I forget all sorts of stuff now that I used to not forget. It's frustrating.
Just be aware if you do take a test for ADD that the current drugs you are taking could effect the outcome.
Well, I hope I didn't come across too strong in my first post to you. I can lack tact.
Take care, and hope that all works well and we hope you keep us posted on how things go for you.
Fuscia
Posted by Fuscia on July 3, 2002, at 11:34:05
In reply to Re: Ooops! Bipolar or ADD?, posted by Fuscia on July 3, 2002, at 11:25:17
After all is typed and done, I read the first of two posts you wrote to me. "Erneener" as me and my friend used to say when we felt stupid.
So, this was before meds. Thanks for letting me know.
I'd say, go for the Adderall, but I also wonder if you do try something like Ritalin or Adderall that if you can drop one of the other meds. then by all means, do so. One less med is one less substance that your liver has to clear.
Take care Jon!
Fuscia
Posted by cybercafe on July 3, 2002, at 14:28:41
In reply to Re: Bipolar or ADD??? » MomO3, posted by JonW on July 3, 2002, at 9:52:52
> I'm a guy and I don't like weight gain so I can >only imagine how frustrating that must be for a >woman. But at the end of the day, wouldn't you >rather be fat and happy? ;-) The truth is not
good point dude :) ... yeah when you're anxious and irritable you tend to have irrational expectations of how horrible side effects will be... but when you're happy, you could care less! ...
look if you are taking an antidepressant and are totally depressed about the side effects, that antidepressant probably isn't exactly working 100%, am i right?
hmmm... if you are in a position where you can actually survive without medication... or wonder if you have the disorder or not.... you probably aren't going to need to large dose no? ....
> I'm currently taking nardil + risperdal + >depakote + neurontin. *All* of these cause >weight gain and I've gained about 15 pounds.
not for me dude :)
depakote didn't give me any weight gain...
gabapentin 0 weight gain...i'm taking gabapentin and i'm 6'1" and 155 pounds....
i used to be 160, but with Parnate i have trouble keeping the weight on.. :)
i'm afraid i am going to die of starvation and not even know it :) :).. i suppose i could also add that a mood stabilizer might not be necessary, just an antidepressant (if your doctor returns his phone calls in the event of mania) -- assuming you're type II ... i assume if you were type I you'd know it :)
>However, I started riding my bike 3 days ago and >am starting to whip myself into shape and have >lost 3 pounds already. I'm thin to begin with >so it's not a major problem, but anyway...
yeah i'm totally in better shape on meds...
i hit the weight room after taking Parnate, and laughed at my old max weights ...good luck mom :)
oh and btw... contrary to popular belief, bipolar disorder is not caused by a doctor's diagnosis :)
in other words -- you have no reason to fear seeing a doctor -- either you have it, or you don't... seeing a doctor ain't gonna change that fact :)
Posted by MomO3 on July 3, 2002, at 16:45:50
In reply to Re: Bipolar or ADD??? » MomO3, posted by JonW on July 3, 2002, at 9:52:52
Jon,
Thanks for responding... I really needed a response... my self-esteem is sinking by the day, and I am having dreams about chocolate and cocaine (all on the same table)... I called the pdoc today because unless something changes quickly a binge of some sort is inevitable. I have been wringing my hands for 3 days trying to ignore this "i need SOMETHING" feeling.
> I'm a guy and I don't like weight gain so I can only imagine how frustrating that must be for a woman. But at the end of the day, wouldn't you rather be fat and happy? ;-)
My weight issue is that I have spent the last 5 months working very hard to lose some post-baby weight. I am 5'8" and at the 1st of the year was 190, today I am 162. I bought cigarrettes and 2 bags of chocolate chips yesterday. I was very hesitant to give up the dexadrine in favor of ritalin because the dex curbs my appetite - ritalin does not.
> I've been reading both 'Driven to Distraction' and 'The Bipolar Child' to try to help me answer the question "Is it bipolar or is it adhd?" I would suspect that you have bipolar disorder rather than adhd. Bipolar has nearly all of the symptoms of adhd. Have you been this way since childhood?
Yes, I think so... also, my dad is very clearly an un-diagnosed BP I - but he is fortunate to make enough money to cover the credit card payments on his shopping sprees.Here's a list of the 'very common' symptoms seen in childhood onset bipolar disorder according to 'The Bipolar Child':
>
> Separation anxiety, rages and explosive temper tantrums lasting up to several hours, marked irritability, oppositional behavior, rapid cycling(frequent mood swings, occurring within an hour, a day, or several days) or mood lability, distractibility, hyperactivity, impulsivity, restlessness/fidgetiness, silliness, giddiness, goofiness, racing thoughts, aggressive behavior, grandiosity, carbohydrate cravings, risk-taking behaviors, depressed mood, lethargy, low self-esteem, difficulty getting up in the morning, social anxiety, oversensitivity to emotional or environmental triggers.Pretty good descriptors there.
Questions: What is the difference between mixed-states and rapid cycling?
What to do about depression at this point? My friend said that mood stabilizer (and is neurontin really a mood stabilizer??) without AD causes depression... I read BP shouldn't take ADs.
And what about klonopin? Does it cause depression?Thanks for any advice,
Mom
Posted by BarbaraCat on July 6, 2002, at 0:10:11
In reply to Re: Bipolar or ADD??? Now what?, posted by MomO3 on July 3, 2002, at 16:45:50
Hi Mom o'
I've also struggled with the BP-II vs. ADD question and asked my pdoc. He said that a good test is how consistent your chaotic, disorganized thinking and behaviors are. If it's an all the time thing, it's probably ADD. If it's cyclical, it's probably BP-II. I've used that criteria and looking back over my life I've seen that the frantic overwhelmed life is falling apart feeling has been cyclic and is always followed or accompanied by a huge black engulfing depression. This despairing wailing black hole kind of agitated depression accompanying it is called bipolar mixed states and is presumably the most dangerous suicide prone kind of depression. I can vouch for that. It's hideous in the extreme. However, there are long periods of blessed calmness and relative normalcy. My concentration is generally excellent, except for periodic plunges into madness. This is not indicative of ADD.Have SSRI's alone exacerbated your anxiety or symptoms? For me all SSRI's and their analogs righteously pooped out and any increase in dosage would drive me into panic attacks, until I started adding lithium. This is pretty classic and sure wish I had known about it years ago - would've saved some singed nerves from all those panic attacks. So, SSRI non-response and/or agitation is a BP-II thing, but not an ADD thing.
The extreme weariness you describe is what raises a red flag, however. You've probably gotten your thyroid tested but has it been recently? As someone who suffers from hypothryoidism, fibromyalgia as well as BPII mixed states (yikes! that sounds serious) I can relate to crawling on all fours as you describe, and a bone crunching fatigue. Hypothyroidism is rampant among women, you could say a true epidemic. It's a tricky thing also because many, many doctors will let a subclinical case slide 'oh, it's borderline low'. Crapola! TSH levels need to be 2.0 and lower, period. Also, the kind of thyroid you take is important, with the natural hormone generally better for those of us with mood disorders. Anyhow, long story short, I just raised my dose recently hoping to kick start my weight loss efforts and lo and behold, even my fibro symptoms are improving. Your tiredness truly sounds like it has a physical basis and perhaps a small dose of thryoid just to see is in order. It's worth a try, Mommy. - BarbaraCat
Posted by Fuscia on July 7, 2002, at 11:25:03
In reply to Bipolar or ADD??? » Fuscia, posted by JonW on July 2, 2002, at 12:34:41
> > Hi Jon the poet,
>
> Hey, your nickname alone is far more poetic than I'll ever be! :-)
>
> > It is good to see you question your diagnosis. It can take years to properly diagnose bi-polar
>
> I understand it takes like an average of 8 years from the first report of symptoms and 2 to 3 pdocs to get a correct diagnosis of bipolar disorder. Sometimes I think my symptoms are the result of bipolar disorder and sometimes of ADD. It seems more like ADD, but I don't know a lot about differential diagnosis. I'm not sure how much it matters at this stage of the game.
>
> >have a friend that is a rapid cylcer bi-polar - days start out very depressing, don't want to get out of bed, and then are pretty high by late afternoon. SSRI's worked pretty well the first
>
> I'm dead in the morning (slow, depressed, low energy), and I'm a noticeably better by say 10:00am. I have trouble falling asleep (Nardil has made this worse) and trougle waking. I wouldn't describe anything I experience as "high". I feel like I suffer more from mood lability and less from mood cycling. Any so-called cycle certainly wasn't and isn't too profound in terms of "high" and "low" -- but I've definitely always had sleep problems, trouble getting to sleep, trouble waking. By the way, my mood is very sensitive to sunlight. Agitation and irritability have definitely been a *big* problem and are usually aggrevated by anti-depressants. Should I be called bipolar simply because of this reaction to anti-depressants? What do you think? Please ask any questions you want...
>
> > Anyway, I was curious, are the above listed symptoms prior to the meds you are currently taking? Do you have any impulses? Shopping? Sex? Aversion to sex? Substance abuse? How does caffeine effect you? How about sugar or bready sugar foods, like doughnuts, waffles, and other simple carbs? How do you do when you're all by yourself? There's lots more questions I could ask, but I don't want to be too nosey ; )
>
> Please, be as nosey as you want and ask as many questions as you like! I'm open to anything that could ultimately lead to insight. As for the questions you asked... Yes, the symptoms I described precede being on medication. If anything, I would describe myself as hyper-sexual -- but I have severe social phobia, so you do the math! ;) I *love* carbs! French toast is one of my favorites! When I was a kid I used to eat sugar from the packets at restaurants, my parents would have to stop me. I hate being alone and I hate being bored. If I'm alone or bored I'll often go out in my car for a drive.
>
> Thanks for the reply! You've been very helpful.
>
> JonHi Jon,
I didn't have time to really think over and answer your post, but now I do (hubby is still in bed - he's an at home engineer (mechanical/design) and usually gives me the elbow to "MOVE OVER" when he needs to use this computer).
Anyway, I was thinking about what you said concerning craving beer, that you love sweets, and how you used to down packets of sugar when you were a child. Well, I started thinking about hypoglycemia. You've probably heard about this low blood sugar problem. It can cause a variety of symptoms that can be mistaken for other health disorders. So, I thought I'd post you the following, just in case you don't need to start taking Adderall or Ritalin. It could just be a diet thing.
I mentioned to my rapid cycling friend that he might try taking a spirulina supplement in the middle of the night in case his morning lows were due to low blood sugar. He never tried it and so I don't know if this was what was causing his morning blues - it was so bad that he didn't even want to get out of bed most mornings.
I have had problems with simple carbohydrate cravings most of my life that started when I was in my early teens. I began to upchuck food after binging in order to stay thin - didn't work. I blimped out anyway, this when I was 16 or 17. I had bulimia. Anyway, throughout my life I've been at a fairly normal weight, though my low-self esteem told me I was fat and ugly. I binged and purged for years until my husband was laid of from the aerospace industry during the early Clinton days. Aerospace was then a dead dog, it still is. We moved out to the country and I think this made me not be self-conscious of myself for what did I care what our hillybilly neighbour thought of me. I began to relax more and care less about my appearance, and stopped the purging, but still had problems with the binging on cookies, cake, white flour stuff like homemade bread, etc. Then, when I was started on Zoloft over two years ago, (25mg) the cravings instantly ceased. I had no appetite, and I began to lose a pound or two. It is still this way for me. SSRI's have completely changed my appetite and I no longer have food cravings - in fact, many times I could easily skip a meal, but I force myself to prepare something for my husband's stomach. This was one appreciated effect from the SSRI's, for it was THAT BAD. Anyway, I used to get very lethargic in the daytime from these food binges, especially mid to late afternoon. Now my energy seems to start at that time of day - quite the opposite. I can't say I was this way on Celexa for it made me lazy - too sedating. It has been shown that bulimia folks have low serotonin levels, so this may be why I no longer see food in the same light. I've been on SSRI's for 2 years and I've not become overweight like so many others complain of. I'm of average weight for my bone size and height, which I am pleased with, especially living in Arkansas where folks tend to be extremely overweight. Anyway, I thought I'd share that with you.
I wouldn't call you bi-polar just from aggravation from SSRI's. That is just an indicator. I must be bi-polar as well for they say a rapid response from SSRI's is a good indicator of bi-polar disorder, and I had one rapid response - two days.
The aggravation could have simply been from too high a start up dose of the SSRI. Like I said, there are some folks that are super sensitive to the effects of drugs. This is very true for high adrenaline Panic Disorder folks. These people are running on fight or flight hormones and this would make any medicine's effects very pronounced.
Here is the information you might find interesting: I'll probably post some more for you on this subject. Maybe you can try reducing the simple carbs from your diet (yes, you'll go through withdrawals for the first few days - I did when I tried it, but I felt so much better by the 5th day of no sugar and no butter sauted flour tortillas that I was truly amazed!) I think you gave me an idea for tomorrows breakfast - French toast. That has eggs in it, so can't be too bad for you ; )
From the book, The Antidepressant Survival Guide by Rober J. Hedaya, M.D.
Hypoglycemia Self-Evaluation
1. If you miss a meal or go more than three or four hours without eating, do you experience any of the following symptoms: irritable, restless, jittery, dizzy, nauseous, lightheaded, sweaty, trouble concentrating, headache?
If so, are these symptoms alleviated by food?
2. Do you frequently crave sugar, cakes, cookies, sweets, or alcohol?
3. Have you gained ten pounds or more since beginning antidepressants?
These are all signs that you may have a condition known as hypoglycemia, or low blood sugar.The control of blood sugar within a normal range is a very complex process, which involves multiple chemicals (epinephrine, insulin, glucagon, cortisol) and minerals (chromium, selenium, manganese, and vanadium). With careful questioning I have found that about 50 % of my patients experience symptoms of hypoglycemia. Hypoglycemia contributes to the weight gain caused by antidepressants.
What exactly is hypoglycemia? It is an intermittent but usually long-term condition that causes blood-sugar levels to fall below the normal range necessary for optimal functioning of the brain and body. Your body can respond to the early stages of hypoglycemia by causing intense cravings for sweets and starches. This is your body signaling your brain that you need more glucose in your bloodstream-NOW! Once your body is in this state, you may either feed these cravings with carbohydrates or drink something with caffeine-which temporarily causes a release of adrenaline, which raises your blood sugar. If you don't respond, you will feel woozy, irritable, and nervous. Most people take a quick sugar fix. This causes temporary relief by increasing blood sugar, but it also increases the output of insulin and cortisol, both of which lead to weight gain and further blood-sugar problems. It's a vicious cycle that quickly spins out of control.
If you're hypoglycemic, your pancreas gradually becomes ill-equipped to handle foods high in sugar or other simple carbohydrates. These are foods that have a high glycemic index, which means your body rapidly breaks them down into glucose and shuttles this glucose into your bloodstream to give you instant energy. Eventually, your pancreas responds too forcefully, by releasing too much insulin to help your cells use the glucose in your blood. So instead of giving you a sustained amount of energy, your blood-sugar levels spike temporarily before plunging again. Any excess sugar not used by your cells gets carted away to be stored as fat-which is why you gain weight. The more you feed your sugar cravings, the less efficient your body becomes at using the sugar. As a result, you feel more intense hunger, which makes you eat more sugar, which causes you to gain weight. Starting to get the picture?
When you bring antidepressants to the mix (with the exception of Serzone and Wellbutrin), you frequently add at least one or two other mechanisms to the weight gain dilemma. All antidepressants that affect serotonin initially cause an increase in serotonin availability. This reduces appetite and contributes to weight loss (which is why the makers of Prozac, Eli Lilly, initially considered marketing it to help with weight reduction). Eventually, however, for most people, the nerve cells adjust to this state, and the net effect can be less (but more efficient) serotonin activity, resulting in increased appetite. In addition to this mechanism, many antidepressants can have an antihistamine effect, which in and of itself may cause weight gain.
The bottom line is that when you add the hypoglycemic drive to eat simply carbohydrates to the serotonin and antihistamine mechanisms, you have a prescription for serious weight gain-and serious loss of self-esteem. Not only have you gained twenty pounds but you can't seem to get a handle on your sugar cravings!
Diagnosis of and Treatment for Hypoglycemia
If you have any of the signs of hypoglycemia, you need to discuss your symptoms with your doctor. Before your appointment, keep a food diary for a week. Write down everything you ate, how you felt right after eating, and whether you experienced any symptoms (fatigue, wooziness, irritability, and so on) one to three hours later. Keep a record of your food cravings and how you dealt with them.
Take this food diary to your doctor. It will be a basis of your diagnosis. Unfortunately, there is no reliable test to confirm whether you have hypoglycemia. (Many doctors perform a glucose tolerance test, in which peaks and valleys of your blood-sugar levels are measured for several hours after drinking a high-sugar beverage. I've found that this test frequently enough misses clinically confirmed cases of hypoglycemia. For this reason, I don't perform it on my patients.)
If you do have signs of hypoglycemia, following the nutrition plan will help get the condition under control. Forgoing sugar, alcohol, caffeine, and refined carbohydrates will help stabilize your blood-sugar levels very rapidly. Eating an increased amount of protein will give you sustained energy. Replenishing your minerals will be critical.
Realize, though, that when you begin the nutrition plan you may not feel well as your body adjusts to less sugar. The first three or four days are the hardest: Many of my patients report feeling weak, dizzy, tired, and moody. After this initial stage, though, your energy will rebound, your depression will lift, and you'll be free from your cravings. By six weeks your taste buds and preferences will have changed so much that you will be surprised you once thought those sweet foods tasted so good. You'll probably also notice that your clothes are looser as you begin to lose weight and retain less fluid. On the flip side, if you cheat a little and sneak some cookies or ice cream, you'll see that your hypoglycemic symptoms will quickly return, and your taste buds and preferences will not change.You also need to make four additional modifications to your eating habits to keep hypoglycemia at bay:
1. Eat five or six small balanced meals a day. More frequent meals will keep your blood-sugar levels stable and should prevent hypoglycemic symptoms.
2. Be sure these meals or snacks contain the right carbohydrate-to-protein ratio. Snacks should have at least 7 grams of protein for every 10 grams of carbohydrates. Read the food labels. Or, if there is no label to read, eyeball the food. The protein (meat, fish, turkey, and so one) portion should be slightly more than one-third the volume of the meal, with the other two-thirds being carbohydrate. Snacks that are balanced will help reduce sugar cravings and keep your appetite under control. Some great balanced snacks include a handful of nuts with some fresh fruit, a cup of plain yogurt sprinkled with wheat germ, cottage cheese on a rye cracker.
3. Avoid artificial sweeteners. No, they aren't sugar, but they can contribute to sugar cravings. If your body is used to getting something sweet, it will continue to crave sugar.
4. Learn to recognize the difference between fatigue and hunger. We often gravitate toward sweet foods thinking they will give us an energy boost when the real problem is fatigue and stress. This depletion usually is associated with cravings toward the end of the day (when you are most tired) or after a night or more of inadequate sleep. Five minutes of simple relaxation will usually alleviate the problem for a while. Catching up on your nighttime sleep will also help a lot.Note To Your Doctor
In my experience, antidepressants can cause or worsen hypoglycemia in many patients. Antidepressants may increase appetite via histamine or serotonergic mechanisms (possibly via the 5-HT2c receptor). Initially, with the serotonergic reuptake inhibition caused by the antidepressant, you will note decreased appetite in your patients. As the postsynaptic serotonergic receptors downregulate in response to the increased serotonin output, the net effect is often a decrease in serotonergic activity, probably in the serotonergic neurons that run from the raphe (mid-brain) to the hypothalamus. Decreased serotonergic activity in this pathway is associated with increased eating. Serzone is unique in that is increases serotonergic output from the presynaptic neuron but blocks the 5-HT2c receptors, so there is no increased serotonergic activity at these receptors and perhaps then no alteration in the raphe-hypothalamic serotonin pathway.
Patients who are clinically hypoglycemic already have a tendency to overeat (independent of the serotonergic and antihistamine drives), particularly carbohydrates. Intervening in this mechanism will help reduce this contribution to weight gain, which occurs at least in part via elevated glucose levels, with gradual insulin resistance, increased insulin output, consequent increased levels of cortisol, and sequestration of glucose in adipose tissue.
I don't put much stock in the glucose tolerance test because of its high rate of false negatives. A far more reliable method is to have your patients keep a written record of what they've eaten and when they experience the onset of symptoms. They should note the effect of a high-carbohydrate snack on their symptoms. I keep a box of fruit cookies in my office and offer a few to fasting patients whom I suspect are experiencing low-blood-sugar levels at the time of their appointments. I then see if they feel any better.
If you suspect hypoglycemia based on history, you can try putting the patient on the Five-Day Jump Start to confirm whether dietary intervention will help improve symptoms. If the patient closely follows the plan and notes significant improvement, you should consider the diagnosis of hypoglycemia reasonably likely. Treating the hypoglycemia with frequent meals balanced with low glycemic index carbohydrates as well as high-quality protein generally has a very beneficial impact on the patient's energy, weight, and mood.
In addition, you should perform a mineral profile, since low chromium, vanadium, and possible manganese and selenium levels are clearly associated with glucose tolerance. If the patient's mineral profile comes back with low or borderline low levels of these minerals, I recommend supplementing fairly aggressively, rechecking the levels in two to three months. Vanadium has been associated with mood-altering properties, but I have not had the occasion to intervene with this mineral in any of my patients. Chromium can be used in doses of 150 to 200 micrograms three times a day. Patients need to be monitored because toxicity can occur, manifested by dermatitis, gastrointestinal ulcers, and kidney and liver disease.
Posted by JonW on July 9, 2002, at 5:37:34
In reply to Re: Back to Jon __, posted by Fuscia on July 7, 2002, at 11:25:03
> Hi Jon,
>
> I didn't have time to really think over and answer your post, but now I do (hubby is still in bed - he's an at home engineer (mechanical/design) and usually gives me the elbow to "MOVE OVER" when he needs to use this computer).Hi Fuscia,
My dad's an engineer and I know how they can be :-)
> Anyway, I was thinking about what you said concerning craving beer, that you love sweets, and how you used to down packets of sugar when you were a child. Well, I started thinking about hypoglycemia. You've probably heard about this low blood sugar problem. It can cause a variety of symptoms that can be mistaken for other health disorders. So, I thought I'd post you the
Thanks for posting this info on blood sugar, but I *think* I've got that base covered. I used to think that I had some sort of a blood sugar problem so I've insisted on checking this out in the past. Several years ago I had blood sugar tested and it actually came back high -- I was drinking lots of soda and eating lots of sugar and carbs at the time, though. I've since modified my diet. Actually, for the benefit of my mood disorder I've completely eliminated alcohol and caffeine. I eat low sugar, and rarely drink anything other than water. My two recent hospital stays included a blood sugar test and they both came back fine. I asked my GP if I should get a glucose tolerance test and he said that in my case it wasn't necessary. I do know that mint chocolate chip ice cream will pull me out of a bad mood so I wonder if that means anything, but that also has chocolate in it and I know people with atypical depression get relief from chocolate. However, it seems like there is something special about mint chocolate chip ice cream.
> I mentioned to my rapid cycling friend that he might try taking a spirulina supplement in the middle of the night in case his morning lows were due to low blood sugar. He never tried it and so I don't know if this was what was causing his morning blues - it was so bad that he didn't even want to get out of bed most mornings.
If morning lows are due to low blood sugar, wouldn't they resolve when you eat breakfast? Just curious if this could be used as an indicator.
> I wouldn't call you bi-polar just from aggravation from SSRI's. That is just an indicator. I must be bi-polar as well for they say a rapid response from SSRI's is a good indicator of bi-polar disorder, and I had one rapid response - two days.
I get a rapid response as well -- first or second day, but then it stops working in the next few days after that. I have some other indicators of bipolar disorder as well like winter intensification of depressions and atypical depression symptoms, but I think it's safest to say I have some degree of bipolarity before saying anything more. I'm unique :) I'm actually quite confused, and have come to the conclusion that I don't know enough to diagnose myself -- not that I should ever diagnose myself, anyway! My sense is that I have both ADD and bipolar and that's about as much as I can say about myself. I don't know which is predominant or if one or the other may not even be present at all. I just don't know. Thank god I'm draining my bank account on a good doctor ;-)
Once again, thanks for your input!
Jon
Posted by JonW on July 9, 2002, at 5:55:53
In reply to Re: Bipolar or ADD??? Now what?, posted by MomO3 on July 3, 2002, at 16:45:50
> Questions: What is the difference between mixed-states and rapid cycling?
Hi Mom,
The symptoms during a mixed state often include agitation, trouble sleeping, significant change in appetite, psychosis, and suicidal thinking.
> What to do about depression at this point? My friend said that mood stabilizer (and is neurontin really a mood stabilizer??) without AD causes depression... I read BP shouldn't take ADs.
Neurontin doesn't appear to be a very effective mood stabilizer, but it works for some. I believe the current thinking is that people with bipolar should avoid ADs altogether. However, sometimes this is unavoidable. If you can take it, it is probably wise to first try treatment without any pro-cycling influences -- just classic, well-established mood stabilizers. Everyone is unique and has a unique brain chemistry which may require a complex med combination that includes an AD. It seems like many folks with bipolar II do, but that's just my impression from reading psycho-babble.
> And what about klonopin? Does it cause depression?
Klonopin can cause depression. Some pdocs believe it makes difficult to treat mood disorders even more challenging to treat.
Hang in there,
Jon
Posted by Fuscia on July 9, 2002, at 20:01:26
In reply to Re: Back to Jon __ » Fuscia, posted by JonW on July 9, 2002, at 5:37:34
Hey,
My Dad was an engineer as well - mechanical. That is why I married one - sorta just like Dad, but glad to say not exactly. What is it about engineers....they like doing things from scratch - making beer, wine, growing fruit trees, growing a vegetable garden, mending their clothes with a sewing machine, building a blast furnace in the backyard, and making a self-dispensing cat food feeder for your seven cats for when you go on a 4 day trip, so as to leave nothin' for the oppossums ; ) Engineers are great!
That is interesting that you blood sugar test was high. I hope you keep that door open as a possibility to symptoms, as I think you will since you mentioned that you "*think* you've got that base covered (aren't I forceful?-I'm a pain in the bum). The problem is those blood glucose tests, even the fasting one, can be innacurate, especially for diagnosing hypoglycemia. A better indicator is if sugar has a calming effect on you while in an agitated state, as well as symptoms improving after a diet free of sugar and simple carbs. But, sounds like you watch your intake of the badies, like too much sugar, caffeine, and alcohol. That is great to hear. I still think sugar is a drug in food form, just from how I feel after eating some, and how I used to crave it. My fasting blood sugar test came back normal. I tried the five-day jump start program suggested in the book, The Antidepressant Survival Guide, where you make a clean cut from sugar, caffeine, alcohol, and sweets. I was lethargic and irritable for the first three days, but by day 4 or 5 I was feeling energetic and able to concentrate much better. I was amazed. I haven't stuck to a no sugar, no caffeine, no alcohol diet. It lasted a few weeks, but I love to bake (but this has been more difficult since being on SSRI's - I don't want to like I once did). I also like to enjoy my homemade homebrew - can't let hubby drink it all - but at least I don't drink to get drunk and only drink a half-pint now and then. I used to binge drink in my late teens and early 20's from being around the California party scene where there was a kegger party somewhere every weekend.
Mint chocolate chip - there might be something there - maybe it is the mint (there are some healthy substances in spearmint and peppermint), but more than likely it is the dark chocolate bits. I hear that chocolate contains the same chemical found in Wellbutrin - phenylethylamine, which is an endorphin releasing agent. Sugar has it's own endorphin releasing effect as well, not to mention the creamy fat/sugar feel of chocolate on the pallete. Place a bit of sugar on the tongue of a crying baby and it instantly stops crying. But chocolate has the effect to stumulate and soothe at the same time. Here is a bit of info about phenylethylamine:Sustained antidepressant effect of PEA replacement
http://www.selegiline.com/pea.htmlTake care Jon, and eat your bowl of mint chocolate chip icecream - R/x dosage is two scoops!
F.Y.I. While an one-ounce chocolate bar has 10-20 milligrams of caffeine, a six-ounce cup of coffee contains approximately 105 milligrams. Chocolate has about a 10th of the caffeine found in a cup of coffee.
Fuscia
P.S. I don't mean to bother you, but just one last question. Have you ever tried Wellbutrin SR? It has stimulant effects - distantly related to cocaine. It is supposed to be the choice of antidepressant for bi-polars as it is the least likely to induce mania as can occur with the SSRI's. I have tried it when it was augmented to Zoloft 25 mg to counteract anorgasmia - didn't work for me, but it was stimulating. Then I stopped taking it after two months. Later, another psychiatrist I saw prescribed solo Wellbutrin SR 150 once a day - strange, but this time it made me sleepy, relaxed, but I was irritable at the same time - would vocally snap at poor hubby that was much more than I normally would without any antidepressant. I was supposed to increase dose to twice daily, but I couldn't handle the irritability, so I discontinued it after a month +.
Posted by MomO3 on July 10, 2002, at 0:33:17
In reply to Re: Bipolar or ADD??? » MomO3, posted by BarbaraCat on July 6, 2002, at 0:10:11
> Hi Mom o'
> I've also struggled with the BP-II vs. ADD question and asked my pdoc. He said that a good test is how consistent your chaotic, disorganized thinking and behaviors are. If it's an all the time thing, it's probably ADD. If it's cyclical, it's probably BP-II. I've used that criteria and looking back over my life I've seen that the frantic overwhelmed life is falling apart feeling has been cyclic and is always followed or accompanied by a huge black engulfing depression. This despairing wailing black hole kind of agitated depression accompanying it is called bipolar mixed states and is presumably the most dangerous suicide prone kind of depression. I can vouch for that. It's hideous in the extreme. However, there are long periods of blessed calmness and relative normalcy. My concentration is generally excellent, except for periodic plunges into madness. This is not indicative of ADD.I think that there is a cycle to it.. it's really hard to say... I guess being in crisis mode - angry, irritable, depressed, and running around to the point of exhaustion, it's hard to remember times of 'normalcy'.. but I know I have not always felt like this.
>
> Have SSRI's alone exacerbated your anxiety or symptoms?
I took Prozac off and on for 9 years. I was being prescribed by whichever GP I was going to that week so I self-regulated the whole prozac thing. When I got depressed I would take it, when I felt better or it ran out I would stop until one of my parents would ask.. "are you taking your prozac?" I also drank heavily during those years (19-25) I think drinking was to self medicate the anxiety and agitation.>For me all SSRI's and their analogs righteously pooped out and any increase in dosage would drive me into panic attacks
Once in college things were not going well, I got my dosage of Prozac increased to 40mg from 20 and it made me CRAZY... I couldn't explain any other way than that. I took Paxil for 2 week last year and experienced the same feeling. For the last few months I have been mood charting and I needed something for depression and anxiety and I tried Paxil again... for a week I thought - aahhh... I have found the right cocktail and then things changed. On the mood chart I found extreme highs and lows all in the same day for over a week. The only way I could describe that feeling is that I felt like a caged animal - you know the one who smashes his body against every wall trying to get out of the cage and then just lays down and gives up.
, until I started adding lithium. This is pretty classic and sure wish I had known about it years ago - would've saved some singed nerves from all those panic attacks. So, SSRI non-response and/or agitation is a BP-II thing, but not an ADD thing.
>
> The extreme weariness you describe is what raises a red flag, however. You've probably gotten your thyroid tested but has it been recently? As someone who suffers from hypothryoidism, fibromyalgia as well as BPII mixed states (yikes! that sounds serious) I can relate to crawling on all fours as you describe, and a bone crunching fatigue. Hypothyroidism is rampant among women, you could say a true epidemic. It's a tricky thing also because many, many doctors will let a subclinical case slide 'oh, it's borderline low'. Crapola! TSH levels need to be 2.0 and lower, period. Also, the kind of thyroid you take is important, with the natural hormone generally better for those of us with mood disorders. Anyhow, long story short, I just raised my dose recently hoping to kick start my weight loss efforts and lo and behold, even my fibro symptoms are improving. Your tiredness truly sounds like it has a physical basis and perhaps a small dose of thryoid just to see is in order. It's worth a try, Mommy. - BarbaraCatMy thyroid was checked in February and the levels are normal - I have a nodule on my thyroid that was biopsied while I was in college and declared benign. They put me on thyroid meds at that point to try to keep the nodule from coming back... I immediately went from 150 to 175 lbs at 19 years old. My boyfriend was none too pleased. And I have struggled with my weight ever since. My current Dr wants to send me to a surgeon to check out this nodule, but I can't handle a gaping scar or those big needles in my neck again. Since the thyroid levels in my blood are normal, if there is something wrong with my thyroid (god-forbid) then it will probably be much more serious than my psycho-struggles.
What do you think about Chocolate? Someone posted something about the chemicals in chocolate being similar to wellbutrin. I have often thought about my drugs of choice and the order I would chose them - chocolate always comes first (followed by cocaine then alcohol). Last week when I was devastatingly depressed, I didn't call my dealer, but instead I bought a bag of chocolate chips - I finished them today...there were no cookies involved (although there was a separate batch of brownies the other day) - my husband didn't get any, they were hidden, I might as well just the whole bag directly to my postpartum belly.
Thanks!
Holly (aka mom)
Posted by BarbaraCat on July 13, 2002, at 15:27:13
In reply to Re: Bipolar mixed states and chocolate » BarbaraCat, posted by MomO3 on July 10, 2002, at 0:33:17
Hi Mom,
Actually, it's Effexor that has a relationship with PEA, phenylethylalanine. Same chemical that's in chocolate (I hope you like dark chocolate. Milk chocolate is just a tease, as far as I'm concerned). PEA is also the chemical isolated from spinal fluid of people in the bouncing off the walls stages of 'in-love'. It's a very interesting substance, related to amphetamines.Unfortunately, Effexor didn't work so well for me and the coming off was ghastly. I used to crave chocolate about 12 hours before I started my period. It would have to be dark chocolate. I once jumped out of bed, pulled my jeans on over my PJs and drove 20 miles down twisty mountain roads in the middle of a stormy February night to get a hot fudge sundae. I remember thinking 'I have a major chocolate jones, yessirree'. Since I'm over that stage of life, these chocolate crazies no longer bother me. If someone could synthesize the sweet craziness of falling in love, ah, now there would be a drug! Don't think anyone's done that yet, and Effexor sure ain't it.
I know very well the caged animal feeling. I've gotten that while starting up on too high a dose of Zoloft, Prozac, SSRI du-jour, as well as being a symptom of a Bipolar episode. It's become obvious to me that I need a benzo, or some kind of smoother. I'm almost convinced that I'm BP-II with mixed states. The mixed states are what causes the suicidal caged animal depressions for me - mania bleeding into depression, a deadly brew.
BTW, I commend you on raising 3 kids while going through the difficulties of a mood disorder. Don't think I could do it, and admire you tremendously. If I can give some advice based on experience, try to keep a steady state with your meds and not run out and just stop and then start up with a new one. I've done that many times and it's havoc on the poor brain. Also, if you have access to a naturopath it would be a good idea to see one. They have a deeper take on the thyroid issue and if your's is even a little out of whack it can be the missing link to everything. Your blood tests do NOT tell the whole picture - trust me on this - and the fact that you have a nodule is significant. - BCat
Posted by Fuscia on July 14, 2002, at 17:02:30
In reply to Re: Bipolar mixed states and chocolate  » MomO3, posted by BarbaraCat on July 13, 2002, at 15:27:13
Hi BarbaraCat,
Maybe it's because it's just prior to that time of the month for me to be knit-picky, but I wanted to add that yes, Wellbutrin is related to phenylethylamine, as is Effexor, as well as the street drug MDMA.
This is from the Rxlist:
Bupropion HCl, an antidepressant of the aminoketone class and a non-nicotine
aid to smoking cessation, is chemically unrelated to tricyclic, tetracyclic,
selective serotonin re-uptake inhibitor, or other known antidepressant agents. Its
structure closely resembles that of diethylpropion; it is related to
phenylethylamines. It is designated as
(±)-1-(3-chlorophenyl)-2-[(1,1-dimethylethyl)amino]-1-propanone
hydrochloride.Venlafaxine hydrochloride is a structurally novel antidepressant for oral
administration. It is designated (R/S)-1-[2-(dimethylamino)-1-(4
methoxyphenyl)ethyl] cyclohexanol hydrochloride or (±)-1-[a
[(dimethylamino)methyl] p-methoxybenzyl] cyclohexanol hydrochloride.I thought I was the only one that ate chocolate chips from the bag. I love Belgian Chocolate Chips by Private Selection from Kroger. I think part of the pleasure is in the mouth feel - thems pure extacy!
Take care, Fuscia
Posted by BarbaraCat on July 15, 2002, at 0:06:03
In reply to Re: chocolate/phenylethylamine, posted by Fuscia on July 14, 2002, at 17:02:30
Hi Fuscia,
Yes, I figured MDMA was related to PEA. Why else would it be called the 'love drug'? Sure sent me into lovely transports of empathic bliss - wish life could be like that without resorting to something that's so hard on the body.I didn't realize Wellbutrin was related. I wonder what denaturization process goes on with these meds, i.e., Wellbutrin, Effexor, that renders them so far removed from the scintillating effects I associate with love, MDMA, chocolate (my fave is Hagen-Daz dark chocolate covered vanilla ice cream bar-- oh, Jeez, is the store still open?)?...
Posted by Iago Camboa on July 15, 2002, at 14:21:27
In reply to Re: chocolate/phenylethylamine » Fuscia, posted by BarbaraCat on July 15, 2002, at 0:06:03
Barbara, I feel really happy to see you 'like yourself' and in such a good mood and I've got to tell you just that. I just love it that you love to live, it is as simple as that...
I also love dark chocolate (I now know your fave brand by heart) and know reasonably well PEA's 'scintillating effects' to understand all that you say...Truly yours,
Iago
>Hi Fuscia,
> Yes, I figured MDMA was related to PEA. Why else would it be called the 'love drug'? Sure sent me into lovely transports of empathic bliss - wish life could be like that without resorting to something that's so hard on the body.
>
> I didn't realize Wellbutrin was related. I wonder what denaturization process goes on with these meds, i.e., Wellbutrin, Effexor, that renders them so far removed from the scintillating effects I associate with love, MDMA, chocolate (my fave is Hagen-Daz dark chocolate covered vanilla ice cream bar-- oh, Jeez, is the store still open?)?...
Posted by BarbaraCat on July 15, 2002, at 19:35:52
In reply to Re: chocolate/phenylethylamine » BarbaraCat, posted by Iago Camboa on July 15, 2002, at 14:21:27
My Dear Iago,
Yes, that was a very bad turn for me for a few days there. It seems that the worst fears can come and strike at times when we're not feeling strong or well enough to face them down. One of the mixed blessings of being sensitive, empathic, bipolar, or whatever, is that we can go down as well as up, experience the darkest terrors as well as the most sublime raptures.I know I felt so cared for by all of you who I reached out to that awful night. Like angels I couldn't see, but sensed their loving presence, I felt lifted up and enveloped by your concerns. We've all grown close in sharing our difficult and interesting lives here on this board. I appreciate your gentleness, elan vitale, and compassion so very much, Iago. Glad you're in my life. - BarbaraCat
Posted by Fuscia on July 17, 2002, at 17:12:15
In reply to Re: chocolate/phenylethylamine » Fuscia, posted by BarbaraCat on July 15, 2002, at 0:06:03
> Hi Fuscia,
> Yes, I figured MDMA was related to PEA. Why else would it be called the 'love drug'? Sure sent me into lovely transports of empathic bliss - wish life could be like that without resorting to something that's so hard on the body.
>
> I didn't realize Wellbutrin was related. I wonder what denaturization process goes on with these meds, i.e., Wellbutrin, Effexor, that renders them so far removed from the scintillating effects I associate with love, MDMA, chocolate (my fave is Hagen-Daz dark chocolate covered vanilla ice cream bar-- oh, Jeez, is the store still open?)?...Hi BarbaraCat,
Well, looks like we might have to scrape the PEA and chocolate idea, at least according to the following information:
Chocolate and Anxiety
http://panicdisorder.about.com/library/weekly/aa980211.htm?terms=%2Bchocolate%2BanxietyTests have been done that shows chocolate does contain PEA, but that it doesn't reach the brain. The good feeling might be a combo-effect with the chocolate chemicals, sugar effect of endorphine release, plus mouth feel. I've never heard of anyone craving unsweetened chocolate.
That's a good question and I wonder why too. I've never tried MDMA, but I have tried solo Wellbutrin SR for one month. I couldn't stand the non-stop verbal snapping at my husband, so I went off it - funny though that I was in a relaxed state while being short of tongue. I hear that a hormone that is released during that wonderful being-in-love feeling is oxytocin. They even think that oxytocin might counteract anorgasmia caused by SSRI's.
I do agree with the article that you gotta find what amount of chocolate is right for you. I get lethargic and then hours later can't go to sleep if I eat too much chocolate, which I would think is from the sugar causing rollercoaster ride on my insulin levels, besides the caffeine. This is more so if I eat it after mid-afternoon. But about a tablespoon or two of Belgian chocolate chips is just right.I better stop talking about chocolate before I talk myself into an urge for we have no chocolate in the house : 0
Take care, Fuscia
Posted by BarbaraCat on July 18, 2002, at 0:49:51
In reply to Re: BarbaraCat-chocolate/PEA ...it looks like.., posted by Fuscia on July 17, 2002, at 17:12:15
Regarding oxytocin, I was of the understanding that it's produced especially during lactation and creates more of a bonding protective response than the amphetamine-like errogenous response associated with mad passionate PEA love. Your article also related PEA and love. But oxytocin is especially interesting to me (now, that is, of course PEA has certainly been of great use at other times) because it's had some benefits with fibromyalgia. It's not a well-known treatment at all, and I haven't thought about it for a while, but will get on the research trail once again - thanks for the reminder. Oxytocin causes uterine contractions and is in massive supply during labor - wonder if that's part of why it might be good for SSRI anorgasmia? And does it work only for women?
Back to chocolate - I remember someone actually suggesting the reason women get chocolate crazed premenstrually is because they need extra magnesium, hence, a craving for Mg rich chocolate. Well, I sure don't crave wheat germ or oysters or nuts or anything but CHOCOLATE!!! so it must be something besides seeking a magnesium fix. Don't think we really need a reason since it's a substance put here primarily for hedonism. It'll also keep me awake if I have it too late at night. The short time I was on Wellbutrin SR I felt like my eyeballs were permanently bulging out of my head, like those boingy springy eyeball glasses. Plus it made me sweat. - Barbara
> > Hi Fuscia,
> > Yes, I figured MDMA was related to PEA. Why else would it be called the 'love drug'? Sure sent me into lovely transports of empathic bliss - wish life could be like that without resorting to something that's so hard on the body.
> >
> > I didn't realize Wellbutrin was related. I wonder what denaturization process goes on with these meds, i.e., Wellbutrin, Effexor, that renders them so far removed from the scintillating effects I associate with love, MDMA, chocolate (my fave is Hagen-Daz dark chocolate covered vanilla ice cream bar-- oh, Jeez, is the store still open?)?...
>
> Hi BarbaraCat,
>
> Well, looks like we might have to scrape the PEA and chocolate idea, at least according to the following information:
> Chocolate and Anxiety
> http://panicdisorder.about.com/library/weekly/aa980211.htm?terms=%2Bchocolate%2Banxiety
>
> Tests have been done that shows chocolate does contain PEA, but that it doesn't reach the brain. The good feeling might be a combo-effect with the chocolate chemicals, sugar effect of endorphine release, plus mouth feel. I've never heard of anyone craving unsweetened chocolate.
>
> That's a good question and I wonder why too. I've never tried MDMA, but I have tried solo Wellbutrin SR for one month. I couldn't stand the non-stop verbal snapping at my husband, so I went off it - funny though that I was in a relaxed state while being short of tongue. I hear that a hormone that is released during that wonderful being-in-love feeling is oxytocin. They even think that oxytocin might counteract anorgasmia caused by SSRI's.
> I do agree with the article that you gotta find what amount of chocolate is right for you. I get lethargic and then hours later can't go to sleep if I eat too much chocolate, which I would think is from the sugar causing rollercoaster ride on my insulin levels, besides the caffeine. This is more so if I eat it after mid-afternoon. But about a tablespoon or two of Belgian chocolate chips is just right.
>
> I better stop talking about chocolate before I talk myself into an urge for we have no chocolate in the house : 0
>
> Take care, Fuscia
Posted by Fuscia on July 18, 2002, at 12:48:54
In reply to Re: BarbaraCat-chocolate/PEA ...it looks like.. » Fuscia, posted by BarbaraCat on July 18, 2002, at 0:49:51
Hi Barbara,
Then you'll have to go to this link plus check out the links at this page:
Neural oxytocinergic systems
http://oxytocin.org/oxy/estradiol.htmlOne book I checked out on Fibromyalgia suggested oxytocin for muscle spasms I believe, but I'm not certain of that. Here is some info you might find interesting.
Fibromyalgia Syndrome (excerpt from "Prescription for Nutritional Healing" by Phyllis Balch, CNC, and James Balch, M.D.
Fibromyalgia is a rheumatic disorder characterised by chronic achy muscular pain that has no obvious physical cause. It most commonly affects the lower back, the neck, the shoulders, the back of the head, the upper chest, and/or the thighs, although any area or areas of the body may be involved. The pain is usually described as burning, throbbing, shooting, and stabbing. The pain and stiffness is often greater in the morning than at other times of day, and it may be accompanied by chronic headaches, strange sensations in the skin, insomnia, irritable bowel syndrome, and temporomandibular joint syndrome (TMJ). Other symptoms often experienced by people with fibromyalgia include premenstrual syndrome, painful periods, anxiety, palpitations, memory impairment, irritable bladder, skin sensitivities, dry eyes and mouth, a need for frequent changes in eyeglass prescription, dizziness, and impaired coordination. Such activities as lifting and climbing stairs are often very difficult and painful. Depression is frequently part of the picture as well. The most distinctive feature of fibromyalgia, however, is the existence of certain "tender points"--nine pairs of specific spots where the muscles are abnormally tender to the touch:
-Around the lower vertebra of the neck.
-At the insertion of the second rib.
-Around the upper part of the thigh bone.
-In the middle of the knee joint.
-In muscles connected to the base of the skull.
-In muscles of the neck and upper back.
-In muscles of the mid-back.
-On the side of the elbow.
-In the upper and outer muscles of the buttocks.Most people with fibromyalgia also have an associated sleep disorder known as alpha-EEG anomaly. In this disorder, the individual's deep sleep periods are interrupted by bouts of waking-type brain activity, resulting in poor sleep. Some people with fibro are plagued by other sleep disorders as well, such as sleep apnea, restless leg syndrome, bruxism, and sleep myoclonus (a sudden rapid contraction of a muscle or a group of muscles during sleep or as one is falling asleep). Not suprisingly, given all these sleep difficulties, people with fibromyalgia often suffer from chronic fatigue that can range from mild to incapacitating.
This disorder is much more common in females than in males, and most often begins in young adulthood. In most cases, symptoms come on gradually and slowly increase in intensity. They can be triggered (or made worse) by a number of different factors, including overexertion, stress, lack of exercise, anxiety, depression, lack of sleep, trauma, extremes of temperature and/or humidity, and infectious illness. In the majority of cases, symptoms are severe enough to interfere with normal daily activities; a significant number of people with fibro are actually disabled by the condition. The course of the disorder is unpredictable. Some cases clear up on their own, some become chronic, and some go through cycles of flare-ups alternating with periods of apparent remission.
The cause or causes of fibromyalgia are not known. Some evidence points to a problem with the immune system; certain immunologic abnormalities are common among people with fibromyalgia. Their significance and relationship to the syndrome are not understood, however. A disturbance in brain chemistry may also be involved; many people who develop fibro have a history of clinical depression. Other possible causes that have been proposed include infection with the Epstein-Barr virus (EBV), the virus that causes infectious mononucleosis, or with the fungus Candida albicans; chronic mercury poisoning from amalgam dental fillings; anemia, parasites, hypoglycemia; and hypothyroidism. Some experts believe that fibro may be related to chronic fatigue syndrome (CFS), which causes similar symptoms, except that in fibromyalgia, muscle pain predominates over fatigue.
Because malabsorption problems are common in people with this disorder, higher than normal doses of all supplemental nutrients are needed. Wherever possible, it is best to use sublingual vitamins and other supplements because they are more easily absorbed than tablets or capsules.
NUTRIENTS
Essential
CoEnzyme Q10 (75mg daily) Improves oxygenation of all tissues, enhances the effectiveness of the immune system, and
protects the heart.Acidophilus (as directed on label) Candida infection is common in people with fibro. Acidophilus replaces "friendly"
bacteria destroyed by candida. Use a non-dairy formula. Store in the refrigerator.Lecithin (as directed on label, with meals) Promotes energy, enhances immunity, aids in brain function, and improves
circulation.Malic acid -the stuff that makes apples sour (as directed on label) and magnesium Involved in energy production in many
cells of the body, including the muscle cells. Magnesium is needed for sugar metabolism.Manganese (5mg daily, take separately from calcium) Influences the metabolic rate by its involvement in the
pituitary-hypothalamic-thyroid axis.Proteolytic enzymes
or
Infla-Zyme Forte from American Biologics or Wobenzym N from Marlyn Nutraceuticals (as directed on label, 6 times daily,
with meals, between meals, and at bedtime) Reduces inflammation and improves absorption of foods, especially protein,
which is needed for tissue repair.Vitamin A (25,000 IU daily for one month, then slowly reduce to 10,000 IU daily. And
Vitamin E (800 IU daily for one month, then slowly reduce to 400 IU daily) Both powerful free radical scavengers that
protect the body's cells and enhance immune function. Use emulsion forms for easier assimilation.
Or
ACES+Zinc from Carlson Labs (as directed on label) Contains vitamins A,C, and E plus the minerals selenium and zinc, to
protect immune function.Vitamin C with bioflavonoids (5,000-10,000mg daily) Has powerful antiviral effect and increases the body's energy level.
Use a buffered form.Very Important
Vitamin B complex injections (2cc twice weekly for 1 month, or as prescribed by physician) Essential for increased energy
and normal brain function. Injections (under doctor's supervision) are best. All injectables can be combined in a single
syringe. Plus extra
Vitamin B6 (pyridoxine, 1/4 cc twice weekly for 1 month or as prescribed by physician. And
Vitamin B12 (1 cc twice weekly for 1 month or as directed by physician) or Vitamin B12 (100mcg, on an empty stomach, to
help with iron absorption. Take with Blackstrap unsulphured molasses, 1 tbsp. daily, if blood test reveals you are
anemic--unsulphured molasses is a safe form of iron.Or,
Vitamin B complex (100mg 3 times daily, with meals) If injections are not available, or once the course of injections has
been completed, use a subligual form, and be sure to take any separate vitamin B12 on an empty stomach.Dimethylglycine (50mg 3 times daily) Enhances oxygen utilisation by the muscles and destroys free radicals that can damage
cells.Free-form amino acid complex (as directed on label) To supply protein essential for repair and rebuilding of muscle tissue
and for proper brain function. Use a formula containing all the essential amino acids.Grape seed extract (containing pycnogenols, as directed on label) A powerful antioxidant that protects the muscles from free
radical damage and enhances immunity.Garlic (Kyolic, 2 capsules 3 times daily, with meals) Promotes immune function and increases energy. Also destroys
common parasites. Plus
Kyo-Green from Wakanuga (as directed on label) To improve digestion and cleanse the bloodstream.Important
Calcium (2,000mg daily) Needed to balance with magnesium.
and
Magnesium (1,000 mg daily) Needed for proper functioning of all muscles, including the heart; relieves muscle spasms and
pain. Deficiency is common in people with this disorder.
Or
Bone Support from Synergy Plus (as directed on label) Contains calcium and magesium plus other minerals to aid
absorption. PlusPotassium (99mg daily) Involved in proper muscle function. And
Selenium (200mcg daily) An important antioxidant. And
Zinc (50mg daily. Do not exceed a total of 100mg daily from all supplements) Needed for proper functioning of the immune
systemCapricin from Probiologic (as directed on label) To combat candida, which is associated with fibromyalgia.
DL-phenylalanine (DLPA, 500mg daily every other week) This form of phenylalanin amino acid can be very effective for
controlling pain. Also increases mental alertness. Caution: Do not take this supplement if you are pregnant or nursing, or
suffer from panic attacks, diabetes, high blood pressure, or PKU.Essentail Fatty Acids (black currant seed oil, flaxseed oil, and primrose oil are good sources, as directed on label, 3 times
daily, with meals) Protects against cell damage. Helps to reduce pain and fatigue.Gamma-aminobutryic acid (GABA, or GABA Plus from Twinlab-contains a combination of GABA, inositol and
niacinamide, as directed on label) For proper control of brain function and to control anxiety.L-Leucine
plus
L-isoleucine
plus
L-valine(500mg each daily, on an empty stomach. Take with water or juice. Do not take with milk. take with 50mg of
vitamin B6 and 100mg of vitamin C for better absorption) These amino acids are found primarily in muscle tissue. They are
available in combination formulas.L-Tyrosine (500-1,000mg daily, at bedtime) Helps to relieve depression and aids in relaxing the muscles. Caution: Do not
take this supplement if you are taking an MAO inhibitor drug or SSRI-type antidepressant.Note on taking singular amino acids: Individual amino acids should not be taken for long periods of time. A good rule to
follow is to alternate the individual amino acids that fit your needs and back them up with an amino acid complex, taking the
supplements for two months and then discontinuing them for two months. A safe, daily alternative to amino acid complex
supplement is Nutritional yeast or Brewer's yeast--contains all essentail amino acids, plus trace minerals, and certain B
vitamins.Melatonin (as directed on label, 2 hours or less before bedtime) Promotes sound sleep. A sustained release formula is best.
Multivitamin and mineral complex plus natural carotenoids 15,000IU daily. All nutrients are necessary in balance. Use a
high-potency hypoallergenic formula.Taurine amino acid (500mg daily, on an empty stomach, same precaution applies as mentioned above concerning singular
amino acid therapy) An important antioxidant and immune system regulator necessary for white blood cell activation and
neurological function.Vanadyl sulfate (as directed on label) Protects the muscles and reduces overall body fatigue.
Herbs
Astragulus and echinacea enhance immune function.
Teas brewed from burdock root, dandelion, and red clover promote healing by cleansing the bloodstream and enhancing
immune function. Combine or alternate these herbal teas, and drink 4 to 6 cups daily.Ginkgo biloba improves circulation and brain function.
Milk Thistle protects the liver.
Pau d' Arco, taken in tea or tablet form, is good for treating candida infection.
Skullcap and valerian root improve sleep.
Recommendations
Eat a well-balanced diet of 50 percent raw foods and fresh "live" juices. The diet should consist mostly of vegetables,
fruits, whole grains (primarily millet and brown rice), raw nuts and seeds, skinless turkey or chicken, and deep-water fish.
These quality foods supply nutrients that renew energy and build immunity.Eat four or five small meals a day to keep a steady supply of protein and carbohydrates available for proper muscle function.
If the body does not have enough fuel for energy, it will rob the muscles of essential nutrients, causing muscle wasting and
pain.Drink plenty of liquids to help flush out toxins. The best choices are steam-distilled water and herbal teas. Fresh vegetable
juices supply necessary vitamins and minerals.Limit your consumption of green peppers, eggplant, tomatoes, and white potatoes. These foods contain solanine, which
interferes with enzymes in the muscles, and may cause pain and discomfort.Do not eat meat, dairy products, or any other foods that are high in saturated fats. Saturated fats raise cholesterol levels and
interfere with circulation. They also promote the inflammatory response and increase pain. Also avoid fried foods,
processed foods, shellfish, and white flour products such as bread and white pasta.Do not consume caffeine, alcohol, or sugar. Eating sugar in any form-including fructose and honey-promotes fatigue,
increases pain, and disturbs sleep. If these substances have been a regular part of your diet, your symptoms may actually get
worse for a short period as a result of the "withdrawal" effect, but after that, you should experience a noticeable improvement
in your condition.Avoid wheat and brewer's yeast until your symptoms improve (in case of allergy to these)
Maintain a program of moderate exercise. A daily walk followed by some gentle stretching exercises is good. If you have
been sedentary before, start slowly and be careful not to overexert yourself; this can aggravate symptoms. Keep in mind that
what you need is some amount of daily exercise, not a strenuous workout two or three times a week. Once your body is
accustomed to regular exercise, sysmptoms are likely to improve.Be sure to give your body sufficient rest. Set aside at least eight hours for sleep each night.
Take a hot shower or bath upon arising to stimulate circulation and help relieve morning stiffness. Or alternate between hot
water and cold water while showering. Recent studies have shown cold showers to be beneficial for relieving the pain of
fibromyalgia.Take chlorophyll in tablet form or in "green drinks" such as Kyo-Green from Wakunaga of America. Spiru-tein from Nature's
Plus is a good protein drink to use between meals to aid in maintaining energy levels and to reduce muscle pain.Considerations
Chronic pain sufferers, especially those with fibromyalgia and chronic fatigue syndrome, tend to be deficient in magnesium.
Common painkillers such as aspirin, acetaminophen, and ibuprofen are not usually effective at relieving the pain of
fibromyalgia. Other approaches, including attention to diet, exercise, and nutritional supplementation, are more likely to be
of benefit.Food allergies can exacerbate the discomfort of many disorders.
Many different disorders can cause symptoms similar to those of fibro, including anemia, depression, hepatitis, and Lyme
disease, among others. Anyone who experiences muscular pain and/or fatigue that persists for longer than a week or two
should consult a health care provider. There may be an underlying medical disorder that requires treatment.Recent research points to the possible involvement of chemical and/or food sensitivities in fibro, CFS, and the pain
associated with these disorders. This would hardly be suprising, as humans have been exposed to more chemicals in the last
fifty years than in all the rest of our history combined.Because malabsorption problems are common in this disorder, all nutrients are needed in greater than normal amounts, and a
proper diet is essential.Many doctors prescribe low-dose antidepressants for fibro. These drugs can be beneficial in some cases, but can also cause
a number of side effects, such as drowsiness. Other medical treatments that may or may not be of helpt to any given
individual include muscle relaxants and/or local anesthetic sprays or injections for relief of pain. The antianxiety drug
lorazepam (Ativan) is sometimes prescribed as well. This drug can cause a loss of equilibrium.
Posted by BarbaraCat on July 18, 2002, at 23:31:09
In reply to Re: BarbaraCat-oxytocin-fibromyalgia info, posted by Fuscia on July 18, 2002, at 12:48:54
Thanks so much, Fuscia. I'm on a good portion of that list to control fibro, but there's some stuff I haven't heard of. The malabsorption is starting to be a major player. I eat very well and take all the necessary stuff to keep the old gut healthy but things just ain't moving and I'm suspecting that there's toxicity involved. Irritable bowel is also a symptom of fibro so it's a chicken egg thing. I'll definitely study the oxytocin article and give it to me doctor. Yeah, get HMO to pony up the money for oxy shots. But you never know. Thanks again! - Barbara
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