B Complex Deficiency, Sympathetic Nervous Dysregulation, & Starvation

[Creative Nature]

This post is both testimony to the importance and healing power of the B vitamins and an urgent request for help.

A couple of years ago, I often had low energy but was strong, athletic, and active. Now, I cannot leave home without a wheelchair, and in April, I was hospitalized for starvation. After a miraculous recovery lasting until a few weeks ago, I am again struggling to eat.

What explains these drastic changes of fortune?

My History, Part I: The Risks of Taking Peat's Ideas Out of Context
Like many newcomers to Ray Peat's work, I was captivated by the potential rewards of raising metabolism and did not pay enough attention to the less sexy tasks of correcting nutritional deficiencies and recovering from the stresses of years of excessive work and over-training. After experiencing great benefits from liver and B vitamins, I gradually lost interest in them -- figuring I'd fixed any deficiencies -- and increased use of thyroid, caffeine, white rice, and sucrose. But no matter how hard I pressed the metabolic accelerator, and no matter how many other improvements Peating brought me, I experienced long periods of fatigue, which should have been a warning sign.

Then the racing pulse and heart palpitations started, to be followed later by chest pains, elevated blood pressure, shortness of breath, and other fun symptoms. As time passed, even small stresses could set off these reactions. Anything that raised metabolism made the problems much worse. I had to keep cutting activity to prevent the symptoms from ratcheting up. Eventually, I couldn't leave home except to go to medical appointments, and often had to rest after walking around the room -- not because of any cardiovascular or muscular weakness, but because of the need to keep the adrenergic symptoms from spiraling out of control.

In early 2019, I became unable to eat without causing huge and ever-worsening stress reactions. (Same adrenergic symptoms as above: chest pain, shortness of breath, etc.) I starved, lost 50+ lbs (from an initial weight of roughly 250), and in April, was hospitalized. Doctors could not do anything, so they discharged me. Still couldn't eat. Outlook was grim.

My History, Part II: Saved by B Vitamins
Around Easter, I experimented again with vitamin B1. It greatly reduced the intensity of my reactions to eating, and, indeed, to all other activity. The connection between my adrenergic symptoms and my B1 intake is so close that I now believe a B1 or B complex deficiency likely caused all my problems. Taking small amounts of salt every 15-30 minutes when stressed (idea stolen from @theLaw) also helped, as did liver and IdeaLabs' Energin B complex. The months of May-October were a dream: I was able to return to eating almost normal amounts of food and gradually increase my activity. It looked like I was on my way to recovery.

Two problems brought the dream to an end.

First, as my B1 doses increased, I developed (or discovered) a B3 deficiency; main symptoms are GERD, intense stress before bowel movements, and diarrhea. Niacinamide eliminates these symptoms, but seems to aggravate the B1 deficiency symptoms, and B1 seems to worsen the B3 deficiency. So just pounding back ever-larger amounts of B1 to eliminate the B1 deficiency seems risky.

Second, and more importantly, each time I encounter excessive physical stress, I need more and more B1 to recover, and the recovery is less and less complete. Over-exertion on a few consecutive days can wipe out weeks or months of progress.

Current Challenges
In late October and November, the combination of an experiment gone bad and a few consecutive days of accidental over-exertion put my adrenergic symptoms back into overdrive. I'm again getting bad reactions to eating. The reactions occur almost immediately as soon as enough food reaches my stomach, so I suspect they're triggered by some sort of sympathetic nervous response rather than endotoxin, etc. I'm already taking a lot of B1, and it's not enough to enable me to eat more than tiny meals. Of course, inability to eat causes a vicious cycle, intensifying my stress reactions, which in turn make eating even more difficult.

The Biskinds fixed suspected B complex deficiencies with individual B vitamins and desiccated liver (equivalent to at least 2-3 oz of whole liver per day). My version of their protocol is B1, B3, Energin, and desiccated liver. Even the equivalent of 2 oz/day of liver seems to reduce my (already low) metabolism, so most days I use 1-1.5 oz, but I'm open to trying more.

Diet, Supplements, Lifestyle
When I can eat normally, my diet is mostly fruit, fruit juice, eggs, gelatin, shellfish, beef and beef liver, dairy, occasional low-fat fish, and carrots. I handle liquids fine and starch poorly. I'm currently taking around 4 g of thiamine HCl per day and a few hundred mg of allithiamine. For me, allithiamine is vastly more effective than Thiamine HCl. Other supplements include Energin B complex (20 drops per day), niacinamide (30 mg 0-5 times/day), magnesium, methylene blue, vitamins E and D. I also take clonidine, cyproheptadine, and very low doses of diamox. By necessity, I'm completely sedentary and get little sunlight.

Questions
Let me know your thoughts on fixing my B complex deficiency (e.g. more liver or B1?) or managing the adrenergic symptoms. Also let me know if you think something else besides B complex deficiency is at work. Top priority is to be able to eat enough to keep me out of the hospital.

It's common for people deficient in one B vitamin to be deficient in other Bs as well. Does my story make you suspect any other particular deficiencies besides B1 and B3?

Thanks
I want to thank everyone whose posts and comments on this forum (especially about B vitamins) helped me recover from starvation, including: @charlie, @Amazoniac, @haidut, @RatRancher, and @theLaw. Without your help, I don't know if I'd be writing this post today. Please share any thoughts you may have on my case.

Thanks in advance for all contributions.

Concluding Thought
Part of my intent in posting is to help others avoid the hell I've experienced by conveying in a graphic way the importance of the B vitamins. If metabolic stimulants like thyroid create problems for you or you have any other reasons to suspect B deficiencies, read the posts by @charlie, @haidut, @Amazoniac, and many others on this topic.

 

[paulwalkerrip]

I would get out and walk around in the sun if you can.

 

[Creative Nature]

I would get out and walk around in the sun if you can.

Can't walk far, but I get sun on my balcony. When I'm able to eat and I've had enough B1, sun is great for me. Otherwise, it's too metabolically stimulating.

 

[professor_sue]

I recall a post a little while back that @charlie made regarding how IBS, SIBO, and other gut issues may be due to a B vitamin deficiency. I read something similar on a Chris Masterjohn blog post, but his was more specific to Vitamin B2 (riboflavin). Having suffered from IBS for 25 years or so (1/2 my life), I decided to give the Bs a shot. I take a whole foods multivitamin but also supplement with B1, B2, niacinamide (which also has NAC), magnesium, and three Ancestral Supplements brand supplements: Beef Organs, Kidney, and Bone Marrow, along with some other supplements.

My results? I still struggle a little bit with IBS and constipation but I feel sooooo much better and can eat a wider array of foods than I did in the past. I'm still afraid to try any kind of dairy with casein, lactose ot whey, but I can eat more of the "fodmaps" than I could prior to my B vitamin supplementation, or my current stack. I also take l-glutamine, zinc, and vitamin c powder daily, which definitely helps.

Anyway, my situation is not exactly the same as yours but B vitamins are definitely helpful for gut health or issues as well as the parasympathetic nervous system, I think. I had struggled with panic attacks and anxiety and looked into parasympathetic dysregulation. But I think that the issue was tied to my Adderall prescription. I was on it for 5 years but stopped taking it at the end of April of this year after an ER visit for what I thought was a pinched nerve impacting my ability to breathe. I do have degeneration in my spine (I'll be 50 in January) but the doctor said that it was likely the adderall causing my panic attacks. I now know that he was right since I have not had breathing problems since quitting that drug. I also now think that my focus challenges were probably due to menopause and not ADHD but who knows.

Anyway, I wish you the best in your health recovery process!! Cheers and peace, Sue

 

[RatRancher]

Search here for the Minnesota Starvation Study.
A major takeaway is that without sufficient calories most supplements are worthless. The body cannot rebuold,rebound or function unless therebis sufficient energy bia food.
If we found the perfect forms of b vitamins,they would not help without a substrate of calories.

Currently you seem to be in a hypercatabolic state of stress hormones. Your body has gone on to use itself as a primary energy source.
Your digestive system seems to have shut down. If i had any medical training I would probably put you on beta blockers initially. Then lower your cortisol levels. I may have also said your digestive system nneds help and perscribed digestive enzymes and betaine hcl in an attempt to take what you eat and make it useful. I would then probably speculate that you would need 3500-4000 calories a day to recover.
Thats probanly what I would tell you if I had any medical training. But I dont,

Since I dont, all I can say is " wow op. Good luck."

 

[Creative Nature]

I recall a post a little while back that @charlie made regarding how IBS, SIBO, and other gut issues may be due to a B vitamin deficiency. I read something similar on a Chris Masterjohn blog post, but his was more specific to Vitamin B2 (riboflavin). Having suffered from IBS for 25 years or so (1/2 my life), I decided to give the Bs a shot.

Thanks for the lead to CM's post and the reminder to read up on B2 and experiment more with it. Could be important.

Glad the Bs are helping with IBS.

But I think that the issue was tied to my Adderall prescription. I was on it for 5 years but stopped taking it at the end of April of this year after an ER visit for what I thought was a pinched nerve impacting my ability to breathe. I do have degeneration in my spine (I'll be 50 in January) but the doctor said that it was likely the adderall causing my panic attacks.

Difficulty breathing: Now that's a side effect.

Anyway, I wish you the best in your health recovery process!! Cheers and peace, Sue

Thanks for your support.

 

[Creative Nature]

Search here for the Minnesota Starvation Study.
A major takeaway is that without sufficient calories most supplements are worthless. The body cannot rebuold,rebound or function unless therebis sufficient energy bia food.
If we found the perfect forms of b vitamins,they would not help without a substrate of calories.

You're right. Thanks. I was never able to eat enough to recover from starving in the spring, and insufficient food intake is likely at least part of the reason my body reacts so poorly to stress. But I currently don't eat much fat, and might be able to squeeze in a little more CO or beef fat without either inducing adrenergic symptoms or getting run over by the Randle cycle.

Currently you seem to be in a hypercatabolic state of stress hormones. Your body has gone on to use itself as a primary energy source.
Your digestive system seems to have shut down. If i had any medical training I would probably put you on beta blockers initially. Then lower your cortisol levels.

Well said. Lowering cortisol is tricky. I have difficulty eating, can't tolerate pregnenolone or DHEA, and am wary of too much niacinamide because (as mentioned above) it somehow seems to increase my B1 deficiency symptoms. Did you have any cortisol blockers in mind?

I may have also said your digestive system nneds help and perscribed digestive enzymes and betaine hcl in an attempt to take what you eat and make it useful.

Thanks for these tips. I'll read up on them.

I would then probably speculate that you would need 3500-4000 calories a day to recover.

I've been closer to 2500 May through October. And lately? Don't ask. And I need extra calories for my height and lean mass.

Thats probanly what I would tell you if I had any medical training. But I dont,

Since I dont, all I can say is " wow op. Good luck."

Thanks.

 

[methylenewhite]

Watch out for b1 and biotin. High doses could cause NAFLD and this creates a nasty metabolic bottleneck.

 

[milkboi]

Watch out for b1 and biotin. High doses could cause NAFLD and this creates a nasty metabolic bottleneck.

Never heard that before, care to elaborate?

 

[methylenewhite]

Never heard that before, care to elaborate?

Does Biotin Cause Fatty Liver, Esp. With Thiamine?

 

[Amazoniac]

You don't take vitamin K or forgot to include? Given that the diet provides plenty of poison A, have you tried venom D, vitamin E complex and mk-4 topically at the same time to balance it? Are those fruits rich in boron? Because it may help to sustain the effect of venom D (Hafterson, 2017). It's difficult to find a stressful condition that doesn't benefit from extra vitamin C. Some oranges a day are a joke if your needs are high and you push them higher with others supplements.

Regarding the B-vitamins, lactic acid bacteria can be protective when they outcompete others that are more problematic for depriving them of important nutrients, compromising their ability to utilize tryptophan for example. But when the situation escaped your control, to compensate for what they're stealing risks fueling them each time more. If you suspect gut infections, it's preferable the transdermal route, or oral while taking substances that enhance the immune system.

Absorption of isolated B-vitamins can also be too fast for magnesium to support, being better to have it in advance or topically. Renewal has to be constant if retention isn't great.

If you're not consuming leafy greens, it's worth considering different menaquinones (for the functions that they're better at than mk-4), and trying to include seasoning herbs as much as it's enjoyable (their compounds can be protective and some are poorly adsorbed; the quinones, unique sugars like sulfoquinovose, chlorophyll, and so on).

What about Raj's heat lamps and sodium bicarbonate? The latter is likely to be helpful since you feel fatigued at rest.
When you log your diet in nutrition apps, how the averages of amino acids look like?

 

[Jennifer]

@Creative Nature — Not necessarily endotoxin related but when you eat or take your supplements, do you notice any digestive disturbances or pain at all? I was dealing with similar symptoms as you this past September and October, even dropped weight because food seemed to make my symptoms worse. Putting a pinch of salt under my tongue and drinking coconut water with sucanat helped, but wasn't a cure. The adrenaline attacks got so bad that I started passing out daily and was in and out if the hospital. It all started with B supplementation for me, though. It caused poor sleep/insomnia, and heart palpitations and spiking blood pressure soon followed.

My doctor prescribed l-theanine for the adrenaline symptoms, said it was like a natural Xanax, but it made my blood pressure skyrocket and I'd pass out. I finally got her to prescribe me NDT and the syncope episodes stopped but I find I have to be very careful in not consuming any irritating/allergenic foods or supplements — I'm now avoiding most fiber and fruit (because of unripeness/acidity) — and getting extra calories to avoid the heart palpitations and shortness of breath. Even the NDT I take is as pure as I could find — WP Thyroid. I suspect the true cause was years of irritating food and insane amounts of fiber lowering my thyroid function.

Anyway, I hope you find a solution soon. It's miserable!

 

[RatRancher]

Known anti- cortisol agents

Aspirin, glycine, red light

 

[tara]

Hi Creative,
Other possible factors to check or try -
Have you had a go at logging your diet - what you actually manage to eat - for a few days to get a rough idea of what you are getting from it, and specifically look for any other micros you may be low in? If you have an extended period with lots of refined calories, which you think resulted in B deficiencies, maybe it's resulted in other deficiencies too? Then supplementing B's could further deplete other essentials. I like Amazoniac's idea of seeing to fat-soluble vitamins and other nutrition. All the essential minerals are important - check that you are getting them all. Zinc deficiency can reduce appetite. Mg deficiency has many effects, including increased susceptibility to stress.
It may not be the same for you, but for me, I don't feel well if I skip veges, including greens, for too long.

Also, if you pay attention to symptoms and intuition, is there anything you are eating that is working against you in a serious way? Could there be a specific allergy or intolerance that hinders you? Again, not to say this applies to you, but if I eat dairy every day, after a few days I feel unwell and lose energy. Could there be something?

Are there foods or ways of preparing them that make them easier to eat? Do super-palatable recipes help?

Good luck.

 

[Creative Nature]

Does Biotin Cause Fatty Liver, Esp. With Thiamine?

Thanks for the thread and warning.

 

[Tenacity]

You sound like you have dysautonomia to be honest.

 

[charlie]

Paging Dr. Lonsdale...

Dysautonomia and Hypoxia- Hormones Matter

 

[charlie]

Just found this thread where a lady with dysautonomia through the knowledge from Dr. Lonsdale was able to pull herself out of it with topical TTFD and magnesium.

Vitamin B1 And Dysautonomia

 

[Nokoni]

I do have degeneration in my spine (I'll be 50 in January) but the doctor said that it was likely the adderall causing my panic attacks.

Boron is essential for bones and joints so a boron supplement might help with your spine. It made a really big difference for me and my daughter. And lithium is essential for neuronal health so a lithium supplement might help with the panic attacks. (Low dose lithium, not the huge doses used in psychiatry.) For me, lithium turns down the volume on worrisome thoughts, which enables relaxation. Both problems might simply be mineral deficiencies.

 

[Creative Nature]

You don't take vitamin K or forgot to include? Given that the diet provides plenty of poison A, have you tried venom D, vitamin E complex and mk-4 topically at the same time to balance it? Are those fruits rich in boron? Because it may help to sustain the effect of venom D (Hafterson, 2017). It's difficult to find a stressful condition that doesn't benefit from extra vitamin C. Some oranges a day are a joke if your needs are high and you push them higher with others supplements.

Thanks for these ideas. I have used vitamins K2 and C fairly often in the past and have not seen obvious benefits, but agree that they make sense at least as insurance policies and plan to try them again. I'm getting more A from liver than I'd like. Tocovit is my primary vitamin E supplement; I replace it with high-gamma mixed tocopherols a couple of days per week. The thread on boron should help fill a gap in my knowledge.

Regarding the B-vitamins, lactic acid bacteria can be protective when they outcompete others that are more problematic for depriving them of important nutrients, compromising their ability to utilize tryptophan for example. But when the situation escaped your control, to compensate for what they're stealing risks fueling them each time more. If you suspect gut infections, it's preferable the transdermal route, or oral while taking substances that enhance the immune system.

I take part of my dose of Energin topically and will experiment with increasing that portion. In view of my poor GI function, topical use makes sense, but I doubt I can take my currently large doses of B1 topically without covering myself in B1 paste.

Absorption of isolated B-vitamins can also be too fast for magnesium to support, being better to have it in advance or topically. Renewal has to be constant if retention isn't great.

Aha. I stumbled on the method of taking magnesium before B1, and it works well for me.

What about Raj's heat lamps and sodium bicarbonate? The latter is likely to be helpful since you feel fatigued at rest.

I rinse my mouth with (and then swallow) a solution of sodium bicarb a few times a day. Feels good, and I can easily do it more often. Thanks for the tip.

The chicken lamp helps when I'm well fed and B1 is adequate; when I'm depleted, it's neutral or worse.

When you log your diet in nutrition apps, how the averages of amino acids look like?

Haven't logged recently, but when I can eat, I try to get at least 20-30 g of gelatin or glycine per day, so I'm balancing some of the undesirables.

Liver helps replenish nutrients at the expense of potentially suppressing metabolism. It seems that the Biskinds resolved this tradeoff in favor of nutrition, giving their patients hefty doses of desiccated liver. Do you recall reading anything about how to choose the dose of liver?