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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by KarenB on May 7, 2003, at 12:54:15
Ron,
I went to my health food store and found TMG in a powder form(5g) and caps(750g). Nothing close to 250mg. Where are you finding this dosage?
I started NADH but seem to be aggitated more than usual in the afternoon - I am rapid cycling Bipolar. Maybe the TMG would help with this?
Also, have you ever suffered from migraines and has this aggravated those at all?
Anyone else's input is surely welcome.
Thanks!
KarenB
Posted by Ron Hill on May 9, 2003, at 2:32:59
In reply to Ron Hill: Enada TMG?, posted by KarenB on May 7, 2003, at 12:54:15
Hi Karen,
> I went to my health food store and found TMG in a powder form(5g) and caps(750g). Nothing close to 250mg. Where are you finding this dosage?
I use my handy-dandy pill cutter to hack up the 500 mg tablets (Life Extension brand) into smaller portions.
Or, alternatively, I use my handy-dandy razor blade to slice capsules of a product called "SAMe Kick Start" into my approximate dose size. The granules inside the capsules have a strong taste, so I mix the dose in a small amount of juice and drink it down. SAMe Kick Start is marketed by Living Earth and each capsule contains 695 mg of TMG, 185 mg of DMG, 250 mg of L-methionine, 15 mg of B-6, 800 mcg of folic acid, and 200 mg of B-12. I'm taking the Kick Start 'cause I already had it lying around. After it’s gone, I plan to use the much more affordable TMG.
> I started NADH but seem to be aggitated more than usual in the afternoon - I am rapid cycling Bipolar.Sounds like you might be taking too much. How much are you taking? I love this stuff, but I can only take 2.5 mg once per week or else I get VERY IRRITABLE. Even at the once a week dosing frequency, it induces some irritability on the day that I take it. What mood stabilizer(s) are you taking and at what dosage(s)? What other meds and dosages? Do you feel more motivated when you take the Enada NADH? What symptoms are you trying to treat with the Enada NADH?
> Maybe the TMG would help with this?
No, probably not. At least not directly. TMG has an activating kind of action and, therefore, will most likely not reduce the irritability. In fact, for a given dosage of Enada NADH, the addition of TMG might make the irritability worse. The benefit I find in adding TMG is that it seems to extend the time period of effectiveness for the Enada NADH. In other words, without the TMG, a 2.5 mg dose of Enada NADH loses its effectiveness after about four days. But with TMG, it lasts a full week. Therefore, TMG indirectly reduces my irritability by reducing my Enada NADH dosing frequency.
Having said all this, irritability is still a problem that I have not fully resolved. I'm thinking about adding a trial of Neurontin to see if that would help.
> Also, have you ever suffered from migraines and has this aggravated those at all?
No, I have no experience with this. Have you ever tried Depakote to treat the migraines? I can't imagine the pain of having migraines on top of all the other generic bipolar woes.
-- Ron
Posted by Larry Hoover on May 9, 2003, at 9:10:53
In reply to Re: Enada NADH and TMG? » KarenB, posted by Ron Hill on May 9, 2003, at 2:32:59
> > Maybe the TMG would help with this?
>
> No, probably not. At least not directly. TMG has an activating kind of action and, therefore, will most likely not reduce the irritability. In fact, for a given dosage of Enada NADH, the addition of TMG might make the irritability worse. The benefit I find in adding TMG is that it seems to extend the time period of effectiveness for the Enada NADH. In other words, without the TMG, a 2.5 mg dose of Enada NADH loses its effectiveness after about four days. But with TMG, it lasts a full week. Therefore, TMG indirectly reduces my irritability by reducing my Enada NADH dosing frequency.Ron, the first thing I want to do is thank you for noting the complementary action of NADH and TMG. I am grateful for the tip. The combination is great for me.
Just to insert my personal experience into the mix.... Taking NADH alone gives me an initial feeling which is a weird mix of activation and sedation. The nearest description I can come to is drinking coffee when you're really tired and should be sleeping. You're more alert, but you really don't want to be. However, if I take TMG with the NADH, I am quite comfortably activated. I just get sharper, while also being calmer.
Going along with another of our mutual thoughts, I tend to go with pulse supplementation with certain supplements. I don't take them daily. I use them more "as needed", and in sharp bursts. What has worked for me is 10 mg ENADA NADH, and 1000 mg TMG, perhaps once a week or ten days or so.
Given my long-standing pattern of working a month, and seriously slumping the following month (a pattern that has been consistent for years), my experience last month stands in sharp contrast. I did not slump, and I had pneumonia on top of everything. About one week after I got out of the hospital, I had a slumpish feeling (Oh no!, I thought), and I did the NADH/TMG thing. It vanished.
I just got back from a gruelling series of road trips. All told, 9 days straight on the road, nearly 5,000 miles, and too many deliveries and pickups to count off the top of my head. I did the NADH/TMG thing yesterday, and I feel superb today (again, contrary to long-standing patterns).
Thanks for your guidance, Ron. Much appreciated.
Lar
Posted by Ron Hill on May 9, 2003, at 10:27:12
In reply to Re: Enada NADH and TMG? » Ron Hill, posted by Larry Hoover on May 9, 2003, at 9:10:53
Larry,
I'm happy to hear that Enada NADH in combination with TMG appears to be providing some amount of benefit for your CFS. I hope it continues long-term!
Thanks for all you do around here, Lar.
-- Ron
Posted by SLS on May 9, 2003, at 14:35:34
In reply to Re: Enada NADH and TMG? » Larry Hoover, posted by Ron Hill on May 9, 2003, at 10:27:12
> I'm happy to hear that Enada NADH in combination with TMG appears to be providing some amount of benefit for your CFS. I hope it continues long-term!
Would NADH be good for severe anergic depression? Mg2+ and fish oil don't seem to put a dent in it.
- Scott
Posted by Ron Hill on May 9, 2003, at 16:22:51
In reply to Re: Enada NADH and TMG?, posted by SLS on May 9, 2003, at 14:35:34
Hi Scott,
> Would NADH be good for severe anergic depression?
Maybe yes, maybe no. Refresh my memory and list the specific symptoms of your depression. I'll get back to you after you post.
As always, best wishes my friend.
-- Ron
Posted by SLS on May 9, 2003, at 17:10:15
In reply to Re: Enada NADH and TMG? » SLS, posted by Ron Hill on May 9, 2003, at 16:22:51
Hi Ron.
> > Would NADH be good for severe anergic depression?
> Maybe yes, maybe no. Refresh my memory and list the specific symptoms of your depression. I'll get back to you after you post.These are the major ones that I can think of:
anhedonia
decreased libido
hyperphagia
hypersomnia
impaired memory
listlessness
poor concentration
psychomotor retardation
slow thinking
social inhibition/anxiety
The only things that help at all are the following combinations:Lamictal + TCA
Lamictal + MAOI + TCA
Lamictal + Effexor + TCA
- Scott
Posted by Ron Hill on May 9, 2003, at 19:58:04
In reply to Re: Enada NADH and TMG? » Ron Hill, posted by SLS on May 9, 2003, at 17:10:15
Scott,
> These are the major ones that I can think of:
>
> anhedonia
> decreased libido
> hyperphagia
> hypersomnia
> impaired memory
> listlessness
> poor concentration
> psychomotor retardation
> slow thinking
> social inhibition/anxietyBased on your atypical depressive symptoms, I think that a trial of Enada NADH would be well worth a try. Therefore, trot down to the local GNC or other local nutritional store and purchase a box of eight 10 mg sublingual ENADAlert NADH tablets. The particular brand name doesn't matter so long as it is ENADAlert NADH.
The good news is that, within a few minutes after placing the first sublingual tablet under your tongue, you will likely feel remarkably better and within a day or so your atypical depression may go into full remission. The bad news is that, if you continue to take 10 mg/day, it will more than likely begin to make you anxious and/or irritable after a week or so. Therefore, I recommend that you take 10 mg/day of the sublingual product for several days or a week (depending on how it makes you feel) as the acute treatment phase and then switch to the oral down-the-hatch enteric coated Enada NADH formulation (available in 2.5 and 5 mg dosage). Then taper down to a maintenance dose.
My current maintenance dose is 2.5 mg taken once per week. I have a hunch that your maintenance dose might be higher than mine. However, the sixty-four thousand dollar question is whether you will be able to find a maintenance dose that is high enough to adequately treat your atypical depression while at the same time not causing irritability and/or anxiousness.
Further, as you know, TMG seems to make the positive benefits of the Enada NADH last longer for me, which in turn, allows me the opportunity to take it less frequently thereby reducing the irritability attributed to the Enada NADH. TMG might help you in a similar fashion. If I were you I’d start with the ENADAlert NADH first and then add the TMG (if you so choose) after a week or so. This will allow you to determine which is doing what with regard to mood improvement.
Scott, it goes without saying that you should take everything I have just said with a grain of salt. For all I know this stuff might not help you at all. But I do think it is worth the ten bucks or so it will cost you to buy the initial box of ENADAlert NADH. And coenzyme 1 (NADH) is certainly not going to harm you at the doses discussed.
As an aside, I still have unresolved irritability issues (e.g.; flash rage, anger, inpatient, etc) that I am trying to fix. I view my main bipolar mood problems as falling into three major categories; 1) atypical depression, 2) dysphoric mood states, and 3) mildly euphoric hypomania. Clearly, it is an oversimplification to delineate these mood states into separate and distinct problems since, in fact, they are probably all interrelated. However, it seems to help me conceptually to compartmentalize my mood problems in this fashion and then work on each category independently. You know, break a large problem down into smaller more manageable problems. I bring this up only to say that I am currently successfully treating my atypical depression category using Enada NADH, TMG, and other supplements and vitamins, and I’m successfully treating my hypomania with Lithobid. However, the dysphoric mood state category still needs work and, in fact, it is greatly worsened if I take too much Enada NADH.
Scott, you have probably read most of my history with Enada NADH, but I’ll include a link to a recent summary just in case you have not seen it:
http://www.dr-bob.org/babble/20030429/msgs/223139.html
Also, here is a page on a web site that shows the ENADAlert NADH, and the 2.5 and 5 mg Enada NADH products:
http://www.iherb.com/enada.html
Let me know how it goes if you try it. Best wishes.
-- Ron
Posted by SLS on May 10, 2003, at 7:39:25
In reply to Re: Enada NADH and TMG? » SLS, posted by Ron Hill on May 9, 2003, at 19:58:04
Dear Ron,
Thanks for your appraisal of my case. I already went out and bought Enada NADH capsules. I didn't happen to see the sublingual on the shelf, but I didn't ask for it either. I went to the Vitamin Shoppe. Would it be a waste of time to start out taking the oral preparation?> The good news is that, within a few minutes after placing the first sublingual tablet under your tongue, you will likely feel remarkably better and within a day or so your atypical depression may go into full remission.
Hmmm. I could live with that. :-)
It's hard to believe that dosing once a week is sufficient to glean such a robust improvement. I am so happy for you.
Thanks again.
- Scott
Posted by KarenB on May 10, 2003, at 15:27:59
In reply to Re: Enada NADH and TMG? » SLS, posted by Ron Hill on May 9, 2003, at 19:58:04
Ron,
Thanks so much for your input.
I think what is most important for me now is to get a mood stabilizer in place, then experiment with the NADH. It made me irritable and restless from the first 5mg dose (not sublingual). It seems that so many "activating" antidepressants throw me into dysphoric hypomania and SSRIs make me sleepy and more depressed. Mood stabilizers are not any better, with side effects such as constant nausea, blurred vision, weight gain, etc, etc. ad nauseum.
I am trying a new doc on Friday and hope to start with Verapamil, then add the antidepressant when I am at least a little more stable. I rapid cycle sometimes more than once in a day.
Heavy sigh...
Thanks again. I'll let you know what happens later with the NADH.
Karen
Posted by Ron Hill on May 10, 2003, at 17:00:07
In reply to Re: Enada NADH and TMG? » Ron Hill, posted by SLS on May 10, 2003, at 7:39:25
Scott,
> I already went out and bought Enada NADH capsules.
Capsules? I've never seen it in a capsule. It is Enada NADH and not just NADH or NAD, right?
> Would it be a waste of time to start out taking the oral preparation?
My best friend tried Enada NADH (per my suggestion) and he was non-responsive to the enteric coated tablets. However, he then tried the sublingual ENADAlert NADH and it reduces his depressive symptoms. He continues to take it and benefit from it.
If I were in your shoes Scott, I'd go buy a box of the sublingual product to use during the acute treatment phase and use what you've already purchased during the maintenance phase. How many milligrams are in each capsule of the stuff you bought?
> It's hard to believe that dosing once a week is sufficient to glean such a robust improvement.
Yeah, I agree. I am very med-sensitive, however.
> I am so happy for you.
Thanks Scott. Your well wishes mean a lot to me. Now I just need to figure out a solution to the periodic dysphoric mood states and I'll be done with this home improvement project (assuming the wheels don't fall off of the recent renovations). I'm sending my best wishes for you and your brainchemistry issues. You have been in pain too long as it is.
-- Ron
Posted by Ron Hill on May 10, 2003, at 17:20:16
In reply to Re: Enada NADH and TMG? » Ron Hill, posted by KarenB on May 10, 2003, at 15:27:59
Hi Karen in Denver,
> I think what is most important for me now is to get a mood stabilizer in place, then experiment with the NADH. It made me irritable and restless from the first 5mg dose (not sublingual). It seems that so many "activating" antidepressants throw me into dysphoric hypomania and SSRIs make me sleepy and more depressed.
Yes, I agree. The first time I took it I felt like it would have pushed me into hypomania if I had not already had my moodstabilizer (Lithobid) fully in place. It is my opinion that all bipolar patients should be on a moodstabilizer prior to taking Enada NADH.
> Mood stabilizers are not any better, with side effects such as constant nausea, blurred vision, weight gain, etc, etc. ad nauseum.
Yeah, none of this stuff is straightforward, huh? I'm fortunate that a low dosage (600 mg/day) of Lithobid controls my hypomania without any noticeable side effects.
> I am trying a new doc on Friday and hope to start with Verapamil, then add the antidepressant when I am at least a little more stable. I rapid cycle sometimes more than once in a day.
SusanC (a.k.a.; the friendly mouse) has reported positive results with Verapamil. You might talk to her.
-- Ron
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