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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 21 of 21. This is the beginning of the thread.
Posted by sedona on January 15, 2003, at 2:41:18
Hi
I just started using Omega-3 as an adjunt to other medications. It seem to be a very promising treatment. I know that many people here have talked about it, and I have a few questions for those that are using it or have used it. 1)In what ways has it been beneficial(or not)? 2)How long did it take for you to notice the effects?Thanks
Posted by Pfinstegg on January 15, 2003, at 10:56:37
In reply to Omega-3 questions, posted by sedona on January 15, 2003, at 2:41:18
I started taking fish oil about two months ago; however, I was not taking enough to get 1000 mg. EPA until the last month. I think that it began to have a beneficial effect after a month. I'm doing other things, too, such as T3 and T4 supplementation, and TMS. In preparing for the TMS, I was asked to fill out the Beck Depression Inventory several times in November and December. Initially, I was in the "severe depression" category, but by the time I began the TMS in January, I was on the border of "moderate-mild" depression. The improvement had to have been either the regular ups and downs of life, the T3-4 supplementation, or the fish oil. Who knows? I do knows, however, that I am going to continue with the fish oil and thyroid meds as long as I live!
I may take this for granted now, but without the invaluable contributions from Psychobabble, I would never have known that TMS existed, that fish oil was helpful, or that one should take T3 as well as T4 when thyroid abnormalities are associated with depression. Basically, my wonderfully successful treatment of an eight year depression came right from the posts on the board! (with follow-up research of course!) I can never express how grateful I am to have found PB and the intelligent and highly informed folks here. Even though I feel really well now, I want to keep checking in to see what's happening!
Pfinstegg
Posted by Noa on January 15, 2003, at 18:14:33
In reply to Omega-3 questions, posted by sedona on January 15, 2003, at 2:41:18
I've been taking fish oil for about 2 weeks and I have definitely noticed improvement in my mood. Like Pfinstegg, I am wary of concluding too quickly about the cause-effect thing, but it seems to me that the fish oil really is helping.
FYI--I also take effexor xr, serzone, adderall xr, and thyroid meds (t4 and t3).
But I was having a episode of depression recently, which spurred me to start the fish oil, which I had been thinking about for a while.
Posted by Sara Field on January 16, 2003, at 8:10:16
In reply to Re: Omega-3 questions » sedona, posted by Pfinstegg on January 15, 2003, at 10:56:37
> I started taking fish oil about two months ago; however, I was not taking enough to get 1000 mg. EPA until the last month. I think that it began to have a beneficial effect after a month. I'm doing other things, too, such as T3 and T4 supplementation, and TMS. In preparing for the TMS, I was asked to fill out the Beck Depression Inventory several times in November and December. Initially, I was in the "severe depression" category, but by the time I began the TMS in January, I was on the border of "moderate-mild" depression. The improvement had to have been either the regular ups and downs of life, the T3-4 supplementation, or the fish oil. Who knows? I do knows, however, that I am going to continue with the fish oil and thyroid meds as long as I live!
>
> I may take this for granted now, but without the invaluable contributions from Psychobabble, I would never have known that TMS existed, that fish oil was helpful, or that one should take T3 as well as T4 when thyroid abnormalities are associated with depression. Basically, my wonderfully successful treatment of an eight year depression came right from the posts on the board! (with follow-up research of course!) I can never express how grateful I am to have found PB and the intelligent and highly informed folks here. Even though I feel really well now, I want to keep checking in to see what's happening!
>
> PfinsteggWhat are T3, T4 and TMS?
Thanks
Posted by Noa on January 16, 2003, at 16:16:57
In reply to Re: Omega-3 questions » Pfinstegg, posted by Sara Field on January 16, 2003, at 8:10:16
>
> What are T3, T4 and TMS?
>
> ThanksT3 refers to the thyroid hormone with three iodine molecules. It is the active form of the thyroid hormone--the form that acts on cells in the body, and it is also the less stable form--cannot be stored in the body for long in this form. One of the brands of T3 is cytomel. I know there are others, but I don't know their names.
T4 is the thyroid hormone with four iodine molecules. It is the more stable form of thyroid hormone, the form in which the hormone is stored. One of the brands of T4 is synthroid, but there are other brands, and a relatively new one that was approved by the FDA last year that I cannot remember the name of (someone please help with this).
When the hormone is needed, apparently one iodine molecule is dropped to convert the T4 to T3, so it can be used by the body.
Hypothyroidism is when there is not enough thyroid hormone. But sometimes, people have enough T4 but it doesn't convert sufficiently to T3 for the body to use it. This is another form of hypothyroidism, but one that is often not detected on the basic thyroid test, TSH.
(I know you didn't ask about this, but TSH is thyroid stimulating hormone--it signals the thyroid to produce more thyroid hormone. In hypothyroidism , the TSH is high, meaning that the thyroid gland is requiring a louder signal to respond to the need for thyroid hormone. It is an efficient way to test for thyroid disorders. However, the statistical range of "normal" is not normal for every individual, and too often, doctors rely too heavily on it, and ignore other signs and symptoms.)
For more info, see the thyroid and depression folder (link is in the intro to Babble at top of Babble main page).
TMS refers to Transcranial Magnetic Stimulation, which I will leave to someone else to explain.
Posted by Sara Field on January 16, 2003, at 16:31:16
In reply to Re: Omega-3 questions, posted by Noa on January 16, 2003, at 16:16:57
Thanks. DUH me. I take levoxyl that is the one approved last year. I have known I have hypo for about 10 years and have been on medications.
I totally agree with you that it can be missed. My gyn thought that might have been a cause of some of my problems for years but was missed.
Is there a non-prescription way to supplement? Both of my husband's parents, who are first cousins just found out in their late 70s that they are hypo.
My husband who is exhausted all the time and of course depressed asked his doctor to test him. It came back negative but I do not think he did the sensitive testing. I still firmly believe it could be one of the causes.
Thanks for taking the time to write all that information.
I love this board.
>
> T3 refers to the thyroid hormone with three iodine molecules. It is the active form of the thyroid hormone--the form that acts on cells in the body, and it is also the less stable form--cannot be stored in the body for long in this form. One of the brands of T3 is cytomel. I know there are others, but I don't know their names.
>
> T4 is the thyroid hormone with four iodine molecules. It is the more stable form of thyroid hormone, the form in which the hormone is stored. One of the brands of T4 is synthroid, but there are other brands, and a relatively new one that was approved by the FDA last year that I cannot remember the name of (someone please help with this).
>
> When the hormone is needed, apparently one iodine molecule is dropped to convert the T4 to T3, so it can be used by the body.
>
> Hypothyroidism is when there is not enough thyroid hormone. But sometimes, people have enough T4 but it doesn't convert sufficiently to T3 for the body to use it. This is another form of hypothyroidism, but one that is often not detected on the basic thyroid test, TSH.
>
> (I know you didn't ask about this, but TSH is thyroid stimulating hormone--it signals the thyroid to produce more thyroid hormone. In hypothyroidism , the TSH is high, meaning that the thyroid gland is requiring a louder signal to respond to the need for thyroid hormone. It is an efficient way to test for thyroid disorders. However, the statistical range of "normal" is not normal for every individual, and too often, doctors rely too heavily on it, and ignore other signs and symptoms.)
>
> For more info, see the thyroid and depression folder (link is in the intro to Babble at top of Babble main page).
>
> TMS refers to Transcranial Magnetic Stimulation, which I will leave to someone else to explain.
>
Posted by Pfinstegg on January 16, 2003, at 22:55:50
In reply to Re: Omega-3 questions, posted by Sara Field on January 16, 2003, at 16:31:16
TMS is a treatment for depression which is roughly equivalent to ECT, but which can be given while you are awake. A magnetic coil is placed over you left frontal lobe and an electromagnetic current is delivered at just below the level which would cause a seizure. ECT, given while you are anesthetized, is supposed to cause a seizure. Unlike the electric current given in ECT, which is scattered by the bones of your skull, and therefore has to be quite powerful, the electromagnetic current given in TMS passes easily through the skull to a precise location in your left dorsolateral prefrontal lobe. The effect there is to increase the blood flow, which is decreased in major depression, and to help reset the levels of neurotransmitters towards normal. The magnetic current is also thought to spread to deeper structures, such as the hippocampus and basal ganglia, and to have a similiar effect on the blood flow and neurotransmitters there. One session consists of 400 electromagnetic impulses, which takes about 20 minutes; a usual course of treatment is 15 sessions, but can be as many as 25. You can talk and think normally during the treatments, and drive yourself there and back.
For some people, the treatment is reasonably comfortable; for me. it was quite painful, but once I was given Tylenol with codeine to take an hour before, I got through them fairly comfortably. I didn't ever have a headache or any other side-effect. They have helped me tremendously; I had a treatment-resistant depression for 8 years, with many drug trials, but, for now, at least, it is completely gone. And it is very comforting to know that I can come for "boosters" if I need them in the future- as some people do with ECT.
Well, that's about the extent of what I know!
Pfinstegg
Posted by HenryO on January 16, 2003, at 23:15:43
In reply to Re: what is TMS? » Sara Field, posted by Pfinstegg on January 16, 2003, at 22:55:50
Pfinstegg, very interesting. Thank you.
Posted by Pfinstegg on January 16, 2003, at 23:34:57
In reply to Re: what is TMS?, posted by HenryO on January 16, 2003, at 23:15:43
Posted by Noa on January 17, 2003, at 5:41:17
In reply to Re: what is TMS?, posted by HenryO on January 16, 2003, at 23:15:43
Yes, thanks. Were you part of a research study, or is TMS now available clinically?
Posted by Pfinstegg on January 17, 2003, at 12:36:29
In reply to Re: what is TMS?, posted by Noa on January 17, 2003, at 5:41:17
I initially tried to be part of a research study but was not eligible due to being left-handed. However, by calling the people doing those studies, I received the names of two psychiatrists who were considered well-trained and reputable and were doing it privately. It is not generally available as yet.
You probably know that it's not FDA-approved, so the cost is not covered by insurance. If you are interested, I'd be glad to provide more information.
Pfinstegg
Posted by susan C on January 17, 2003, at 15:52:46
In reply to Re: what is TMS? » Noa, posted by Pfinstegg on January 17, 2003, at 12:36:29
Hi,
This is all very interesting, as I just came home with a recommendation from doc to start taking Omega three oil (might help, cant hurt)and that the local expert had just opened up TMS to those taking Depakote and that, since I had insurance, it would be covered, and be a back up for me if things fall apart. I haven't tried the thyroid as all the tests come back normal. I have had some success with depakote and most recently adding verapamil a calcium channel blocker.
Thank you. I now have a couple more specific things to ask about if my positive improvement is only a spontanious remission.Positive Thinking mouse
"There is little to be left behind if you take it all with you." -S.I.Clark
Posted by Ritch on January 17, 2003, at 22:19:55
In reply to TMS and more choices for the future, posted by susan C on January 17, 2003, at 15:52:46
> Hi,
> This is all very interesting, as I just came home with a recommendation from doc to start taking Omega three oil (might help, cant hurt)and that the local expert had just opened up TMS to those taking Depakote and that, since I had insurance, it would be covered, and be a back up for me if things fall apart. I haven't tried the thyroid as all the tests come back normal. I have had some success with depakote and most recently adding verapamil a calcium channel blocker.
> Thank you. I now have a couple more specific things to ask about if my positive improvement is only a spontanious remission.
>
> Positive Thinking mouse
>
> "There is little to be left behind if you take it all with you." -S.I.ClarkSusan, so the verapamil is still working for you OK? Can you tell us what the worst side effect of taking it is? When you came back from your doctor with the recommendation of Omega-3's was it because you were having some breakthrough depression probs? Sorry for the questions. I am going to see my pdoc soon, and verapamil has been brought up by my pdoc and I wonder if I should go for a trial. I stopped my low-dose Trileptal because it was making me a little "flighty" and uptight. Unfortunately, I am now more depressed as a result. So, I don't know whether to go back on the Trileptal and put up with the anxiety, or ask my pdoc to add back in some Neurontin, or... give the verapamil a try. Any comments greatly appreciated..Mitch
Posted by susan C on January 17, 2003, at 23:06:22
In reply to Re: TMS and more choices for the future » susan C, posted by Ritch on January 17, 2003, at 22:19:55
Hi Mitch,
I think the Omega 3 is to even out the "lower amplitude", not so much break-through, as underlying turbulance...The worst side effect is constipation. But even that isn't so bad and is quite managable. Doc said, of the 20 or so patients that were non responsive, and tried verapamil, 3 of them had some kind of response...not a very big number, but, we know we are all special, don't we?
As to how things are going, they are going just fine. I am trying to keep to a regular schedule, not push with too much stimulation, though I can stand much more uncertainty and stress.I would give it a try, esp. if doc is recommending it. The University of Miami, Goodnick, is a Doctor who has studied this. I am looking now for more specifics of how and why it works.
Keep me posted...siclathotmail.com
mouse with furry ear to the ground"Little can be lost if little is kept."
-S.I.Clark
Posted by Ritch on January 18, 2003, at 8:51:35
In reply to Re: TMS and more choices for the future » Ritch, posted by susan C on January 17, 2003, at 23:06:22
Posted by Noa on January 18, 2003, at 9:11:03
In reply to Omega-3 questions, posted by sedona on January 15, 2003, at 2:41:18
Someone on this board asked if anyone knows how the omega 3 works in improving depressive symptoms. I am really curious about this too. I have been feeling better. But I have noticed lately that my motor restlessness has increased; I don't know if it coincides with the initiation of omega-3, but I wonder.
By motor restlessness, I mean
1)what I call "helicopter feet"--when sitting, I twirl my ankles; 2)leg shaking/bouncing--I do this all the time. I caught myself doing this at the dinner table with other people. I realized I was shaking the table, so I supressed it, but I can't suppress it for very long. 3)sometimes when sitting at the computer, I find that I have been "bouncing" in my seat.I get motor restlessness from the Effexor--this is one of the reasons I had decreased the effexor dose and added serzone to balance it out. And also why I take .25 mg of ativan at night in order to sleep, because I have restless legs otherwise.
But it seems like the daytime leg bouncing, etc. has increased lately. Could it be from the omega-3? Could it be that since my mood starting getting better, I have been more anxious than depressed, and the restlessness is a symptom of the anxiety? Does omega 3 work by incresing serotonin? If so, I wonder if I should ask my pdoc about lowering my effexor dose a bit.
Any thoughts? Thanks.
Posted by judy1 on January 18, 2003, at 11:11:03
In reply to Re: more Omega-3 questions, posted by Noa on January 18, 2003, at 9:11:03
my guess is that your akathesia (sp?) is the result of the Omegabrite working and not needing your effexor anymore. You are on such a small dose as it is- have you asked your pdoc or considered stopping it to see if your symptoms stop- I know how annoying that is, I get it from APs, but I actually have to pace up and down. I'm glad you've seen an improvement in mood, I plan on starting back on it myself. take care, judy
Posted by Noa on January 18, 2003, at 11:33:29
In reply to Re: more Omega-3 questions » Noa, posted by judy1 on January 18, 2003, at 11:11:03
Thanks Judy. Is 262.5 mg a small dose? I will ask him if it makes sense to go down a bit, at least, maybe to 225 (which, btw, would save me money by not having to buy two strengths of effexor!).
Do you know how the fish oil works? I am going to try to do some searching today to see what I can learn about how it works, and its relation to serotonin, which I believe is the culprit in my restlessness.
Posted by Noa on January 18, 2003, at 12:00:42
In reply to Re: more Omega-3 questions » judy1, posted by Noa on January 18, 2003, at 11:33:29
Here are results from my pub med search, and any assistance in udnerstanding or interpreting the info is welcome!!
Phospholipid metabolism and depression: the possible roles of phospholipase A2 and coenzyme A-independent transacylase.
Horrobin DF.
Laxdale Research, Kings Park House, Laurelhill Business Park, Stirling, Scotland FK7 9JQ, UK
*excerpt* from the abstract:
".....They are essential for neuronal and especially for synaptic structure and play key roles in the signal transduction responses to dopamine, serotonin, glutamate and acetyl choline. The unsaturated fatty acid components of phospholipids are abnormal in depression, with deficits of eicosapentaenoic acid and other omega-3 fatty acids and excesses of the omega-6 fatty acid arachidonic acid..."
For the above, I did not paste any text because this was very chemistry oriented and hard to understand. However, if someone who can understand it wants to look at it and try to explain it to me (us) that would be great--it seemed to have some info about fish oil and serotonin. Thanks.
The role of dietary n-6 and n-3 fatty acids in the developing brain.
Innis SM.
Here is the abstract:
Department of Paediatrics, University of British Columbia, Vancouver, B.C., Canada. sinnis@interchange.ubc.ca
The dietary requirements for essential fatty acids and the possibility of a specific role for the polyunsaturated fatty acid docosahexaenoic acid (DHA) is one of the most controversial areas in infant nutrition. DHA is found in unusually high concentrations in the brain and is selectively accumulated during fetal and infant brain growth. DHA can be synthesised through a complex series of chain elongation-desaturation reactions from alpha-linolenic acid, but the efficiency of this process in young infants is not clear. Clinical studies on the potential benefits to neural development of dietary DHA have yielded conflicting results. Recent studies have provided evidence that plasma DHA is available to developing brain and that DHA is involved in dopamine and serotonin metabolism. These findings should guide clinical studies to more sensitive measures of the functional roles of dietary n-3 fatty acids and to clinical conditions where n-3 fatty acids may have benefit. Copyright 2000 S. Karger AG, Basel
Posted by judy1 on January 18, 2003, at 13:06:15
In reply to Re: more Omega-3 questions » judy1, posted by Noa on January 18, 2003, at 11:33:29
I thought you had written 26.2, duh, which is impossible- aren't they in 75mg scored tabs? Actually you are on a pretty high dose so you'll have to taper, which according to this forum isn't a whole lot of fun. But maybe if you cut a pill in half? and tried that for a week... My brain is not functioning too well right now, but I think fish oil relaxes (smoothes) the synapses so they function properly- but as far as what receptors, sorry I don't remember but I just bet serotonin is part of this. (And people out there if I'm totally wrong don't pounce on me!) I'll post after I talk to my pdoc. take care, judy
Posted by Noa on January 18, 2003, at 21:14:51
In reply to OMG, sorry! » Noa, posted by judy1 on January 18, 2003, at 13:06:15
Thanks, Judy. I take the xr version, which comes in 37.5 mg and 75 mg and I think 150 mg as well. For the 262.5 I take 3 of the 75's and one of the 37.5's. It was that I was on 300 and it was too much, but I didn't want to go allthe way down to 225. But maybe now I can.
The other thing I noticed today about the bounciness ist hat it subsided about 1 hour after I took my adderall! Most of the time, the bounciness/restlessness bothers me in the evening, and I guess this is when the adderall is wearing off. I should also go back to exercising and see if that helps.
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