Chronic Serotonin Toxicity? Need A Help!

[ginny-red]

Dear all!

I was reading this forum for a while, now it's time for me to post because I still have a lot of questions.
Long story short:
I'm 23 years old female, always very slim and with problems with appetite. Never had any mental illnesses, I was a very happy person with normal life, never felt something like anxiety or anything like that, only wanted to gain weight. The whole life I had a constipation and probably IBS.
At the end of February 2018 (22nd exactly) I bought a nutrient for mass making with a lot of amino acids in it (tryptophan, tyrosine, a little of BCAA, EAA, etc.). When I first took it (as a drink, a high amount, about 800 kcal - it was also 22nd of February), I had a headache almost immediately, but I thought that my organism needs to get used to that, so next day I also drank this and also in next days. During this period, I had a lot of stress (connected with private relationship), but I was always doing well with stress. This time was different. After 4-5 days of stress + a lot of protein nutrient (daily about 800-1000 kcal), I loss my appetite, I was feeling really bad - my muscles were shaking very hard, I was filling really cold, I was blaming myself about everything (connected with relationship) so it was huge feeling of guilt, also I was in really bad mental condition - not crying, but had a HUGE ANXIETY day by day. I thought it's maybe connected with all stress situations (I changed my job, have problems in relationship) so I bought Rhodiola and some calming medications, but it still didn't help (I was also drinking this protein drink every day...). It only got worse. After that I decided to go to psychiatrist first time in my life (8th of March). She didn't know that I'm drinking any protein drinks or taking Rhodiola, so she prescribed me SSRI (Sertraline). She said that I have to take 25mg in first few days, then 50mg. First day of Sertraline was awful, I had goose bumps, huge anxiety, intrusive thoughts, I was afraid of everything, had nightmares, but my doctor said it's normal in first days. Next 3 days were the same, even worse - dry mouth, no appetite, intrusive thoughts, huge feel of guilt, huge anxiety, trouble sleeping, chills, feeling really cold. I had one day of break, I drank protein drink before sleeping, then in the morning I took 50mg of SSRI. This day was a nightmare - 30 minutes after taking SSRI I almost lost my consciousness - largest anxiety I've ever had in my life, suicidal thoughts, huge feel of guilt, headache, pulse 120, tremors, chills, billion thoughts per second. It lasted about 3 hours, I was looking for something connected with serotonin and found that something like serotonin syndrome does exist. After that I realized that I have to go to the doctor. She said it could be serotonin toxicity and gave me propranolol and told me to not take anything connected with serotonin. So I put all medications/protein drinks away. First week was terrible. Huge anxiety, diarrhea, headache, tremors, nightmares, trouble sleeping. I went to the neurologist and he prescribed me Propranolol, which did not help. After that I went to other doc and he prescribed me Cyproheptadine. I was taking this for about one week, it helped a little, but still had headaches, tremors, goosebumps and anxiety. I was looking for medications and solutions so I tried Magnesium + B6, vitamin D, B1, C, Omega 3, phosphatidylserin and Ashwagandha. After almost one month past SS (so after Cypro, vit B6 + Mg, Omega 3 treatment), I did a lot of labor tests.
My results (some of them) in serum from 05.04.2018:
TSH - 3,39 uIU/ml (norm: 0,27 - 4,20)
Cortisol - 28,47 ug/dl (norm: 5,27-22,45 at 7-9:30 AM and it was took about 9AM) - above norm
Prolactin - 12,9 ng/ml (norm: 2,8-29,3)
Serotonin - 98,7 ug/l (norm: 117,5-193,3) - below the norm (!)
Ca - 9,99 mg/dl (norm: 8,1-10,4)

Tryptophan - 13 mg/l (norm: <10) - above norm (!)
Tyrosine - 8 mg/l (norm: <17) - maybe to low?
GABA - <1 mg/l (norm: <5) - maybe to low?
Cystine - 5 mg/l (norm: <34)
Isoleucine - 5 mg/l (norm: <20)
Valin - 23 mg/l
Leucine - 16 mg/l (norm: <25)
If you need more results from amino acids test, I can give them.

Now I'm taking all of the vitamins (B1, D, C, Omega 3, B6, Mg) + BCAA (for last 4 days). I tried also phenylalnin and l-tyrosine, but it made me worse (more chills, anxiety, goosebumps). I decided to take only BCAA.
Today I took BCAA before breakfast but still have everyday symptoms: diarrhea every morning, strong headache, feel of guilt (I must to admit to my all lies from my whole life, I wasn't like that before!), anxiety, small appetite, tremors, chills - I still feel cold, goosebumps, a lot of thoughts, hard to focus, somnolence. The good thing is that I sleep very well without breaks, but I wake up anxious and stressed - I think those two symptoms are much stronger in the morning. I'm not sad, I don't cry, sometimes I laugh and I don't have problems with humor, I'm just anxious and it's hard for me to focus and motivate, I still feel stressed.
I try to eat regularly, I drink coffee (1-2), work every day, but it's really hard.

Could you please somehow help me and advice what to do? Doctors in my country do not know how to treat this, even they told me that they didn't know if serotonin or amino acids can be tested.
I'm just thinking if it's some type of chronic serotonin toxicity or maybe it is caused by to low serotonin (looking at the test)? Also I'm thinking about my diarrhea and IBS, if my whole life I had a constipations, could it be somehow connected with serotonin metabolism in my whole life?
It's weird that I have excess tryptophan and to low serotonin... Please advise!

If you have any questions, please ask. I'll be very grateful for help because I'm really tired of this and I'd like to back to my normal life. Thanks.

 

[InChristAlone]

Your calcium is at top end of range, ( over 10 is cause for concern), so I would consider stopping vitamin D. Also maybe everything else to get back to baseline. Serotonin in the blood is not indicative of what it is doing in the brain, but yeah definitely lay off high tryptophan. What is your diet like?

 

[ginny-red]

Your calcium is at top end of range, ( over 10 is cause for concern), so I would consider stopping vitamin D. Also maybe everything else to get back to baseline. Serotonin in the blood is not indicative of what it is doing in the brain, but yeah definitely lay off high tryptophan. What is your diet like?

Hello! Thank you for your answer. And how can I lower Calcium? I did vit D test as well (with all these tests), and my result is: 26 ng/ml (norm: 30-100), but it was before supplementing with vit D, now I'm taking dose of 2000 IU per day. So now I think I have much higher vit D than I had. Is this somehow connected with Ca?

 

[Koveras]

High calcium can definitely contribute to anxiety

What was the nutrient for mass?

 

[ginny-red]

High calcium can definitely contribute to anxiety

What was the nutrient for mass?

Mutant Mass - it was this one, Mutant Mass.
Is there any possibility that I have a lower dopamine after SS? I'm still wondering why I'm feeling so sleepy and have these type of headaches (strong and all day). And this anxiety... How to reduce Ca?

 

[ginny-red]

Your calcium is at top end of range, ( over 10 is cause for concern), so I would consider stopping vitamin D. Also maybe everything else to get back to baseline. Serotonin in the blood is not indicative of what it is doing in the brain, but yeah definitely lay off high tryptophan. What is your diet like?

I forgot about replying for question about my diet - so I'm eating almost everything - meat (chicken, pork), rice, pasta, vegetables, milk, cheese, nuts, bread... Everyday something different.

 

[Constatine]

Isolated amino acids such as those found in such protein drinks are readily fed upon by gut bacteria and produce a lot of ammonia immediately. This is worse in people with ibs as their gut flora is pathogenic. My guess is that your intestinal wall became sabotaged increasing bacteria and endotoxin translocation. Over time this can damage the blood brain barrier. Some amino acids by themselves can also cause damage to the BBB. Serotonin causes damage and increases the permeability of the BBB as well. Serotonin syndrome which is synergistic and almost synonymous with sepsis can cause extreme damage to the BBB. So you are left in a state where lps and other neurotoxins are elevated in your blood due to translocation from the gut and these toxins are able to freely pass into the brain causing neuroinflamation and damaging nearly all brain function. Chronic caffeine (from pills but not necessarily from coffee or tea as both have compounds that modify caffeines effects, coffee also irritates the intestines) can restore the BBB and reduce neuroinflamation. The next step is to improve gut flora and function. I have found unpasteurized goat milk to be very useful for this. Note that cyproheptadine can be protective in the short term but over time due to it's constipating effects it can worsen your gut flora (the most important regulator of the gut flora is regular bowel movements).

 

[InChristAlone]

Isolated amino acids such as those found in such protein drinks are readily fed upon by gut bacteria and produce a lot of ammonia immediately. This is worse in people with ibs as their gut flora is pathogenic. My guess is that your intestinal wall became sabotaged increasing bacteria and endotoxin translocation. Over time this can damage the blood brain barrier. Some amino acids by themselves can also cause damage to the BBB. Serotonin causes damage and increases the permeability of the BBB as well. Serotonin syndrome which is synergistic and almost synonymous with sepsis can cause extreme damage to the BBB. So you are left in a state where lps and other neurotoxins are elevated in your blood due to translocation from the gut and these toxins are able to freely pass into the brain causing neuroinflamation and damaging nearly all brain function. Chronic caffeine (from pills but not necessarily from coffee or tea as both have compounds that modify caffeines effects, coffee also irritates the intestines) can restore the BBB and reduce neuroinflamation. The next step is to improve gut flora and function. I have found unpasteurized goat milk to be very useful for this. Note that cyproheptadine can be protective in the short term but over time due to it's constipating effects it can worsen your gut flora (the most important regulator of the gut flora is regular bowel movements).

Good info!

@ginny-red You could try vitamin K2 for the high calcium, but ultimately if it keeps creeping up that's a sign of a parathyroid tumor. Just watch it over the yrs.

 

[ginny-red]

Isolated amino acids such as those found in such protein drinks are readily fed upon by gut bacteria and produce a lot of ammonia immediately. This is worse in people with ibs as their gut flora is pathogenic. My guess is that your intestinal wall became sabotaged increasing bacteria and endotoxin translocation. Over time this can damage the blood brain barrier. Some amino acids by themselves can also cause damage to the BBB. Serotonin causes damage and increases the permeability of the BBB as well. Serotonin syndrome which is synergistic and almost synonymous with sepsis can cause extreme damage to the BBB. So you are left in a state where lps and other neurotoxins are elevated in your blood due to translocation from the gut and these toxins are able to freely pass into the brain causing neuroinflamation and damaging nearly all brain function. Chronic caffeine (from pills but not necessarily from coffee or tea as both have compounds that modify caffeines effects, coffee also irritates the intestines) can restore the BBB and reduce neuroinflamation. The next step is to improve gut flora and function. I have found unpasteurized goat milk to be very useful for this. Note that cyproheptadine can be protective in the short term but over time due to it's constipating effects it can worsen your gut flora (the most important regulator of the gut flora is regular bowel movements).

Thank you so much for your help!
So in this case, I’ll focus on caffeine and goat milk. What dose of caffeine do you recommend? Also, I’d like to ask about probiotics, should I take them?
Yesterday my doc prescribed me pantroprazol (Controloc) for my gastritis, what do you think about it?
And what should I take for my huge headaches and nausea (really horrible today)? Will be Aspirin good for these symptoms? As I know, Aspirin decreases serotonin levels. Also, I didn’t take any BCAA today as you said it produces ammonia, so I’m struggling with increased anxiety and stress.
I’ll be grateful for your answer because I’m kinda scared of my brain and damages in it.

 

[lvysaur]

IMO take K2 for proper calcium metabolism
Possibly aspirin
Drop the Omega 3, or at least severely reduce intake
Drop the workout supplements, they're all trash
Drinking coffee is an appetite stimulant and increases stomach acid, if you don't do so already

 

[ginny-red]

IMO take K2 for proper calcium metabolism
Possibly aspirin
Drop the Omega 3, or at least severely reduce intake
Drop the workout supplements, they're all trash
Drinking coffee is an appetite stimulant and increases stomach acid, if you don't do so already

Thank you! And what about berberine? I read that it’s great anti-inflammatory and antioxidant suplement.
Also I took Controloc (pantroprazol) today for my gastritis, it decreases stomach acid, is it good for me?

 

[lvysaur]

Thank you! And what about berberine? I read that it’s great anti-inflammatory and antioxidant suplement.
Also I took Controloc (pantroprazol) today for my gastritis, it decreases stomach acid, is it good for me?

I don't really know or care about berberine, but in general don't get obsessed with trivial new plant chemicals. There are millions of them, and they all do something. Better to eat raw fruits and fresh spices like ginger/garlic whatever than some dried impotent stale supplement in a bottle.

It depends on your problems, if you've always had heartburn and ulcer problems then you probably have naturally high stomach acid, so it's fine. If you have low stomach acid, food doesn't get digested, meaning you get less nutrients. In addition, the food then gets fermented by bacteria, making you feel worse via endotoxin.

 

[Constatine]

Thank you so much for your help!
So in this case, I’ll focus on caffeine and goat milk. What dose of caffeine do you recommend? Also, I’d like to ask about probiotics, should I take them?
Yesterday my doc prescribed me pantroprazol (Controloc) for my gastritis, what do you think about it?
And what should I take for my huge headaches and nausea (really horrible today)? Will be Aspirin good for these symptoms? As I know, Aspirin decreases serotonin levels. Also, I didn’t take any BCAA today as you said it produces ammonia, so I’m struggling with increased anxiety and stress.
I’ll be grateful for your answer because I’m kinda scared of my brain and damages in it.

The dose of caffeine depends on your tolerance. I would start out at 200mg and work your way up from there. I think as much as 1400mg of caffeine is safe though thats quite a lot. I would be careful with probiotics. It made my symptoms much worse when I tried them. But if you do people tend to respond well to Bifidobacterium bacteria but Lactobacillus makes myself and many others worse. I'm sure Lactobacillus works for many but I've definitely noticed many people have problems with it. Proton Pump Inhibitors like pantroprazol are highly associated with cognitive impairment: Cognitive impact after short-term exposure to different proton pump inhibitors: assessment using CANTAB software so I would stay away from them if possible. I would avoid aspirin as the intestinal barrier is already challenged (if that is indeed your issue).

 

[ginny-red]

I don't really know or care about berberine, but in general don't get obsessed with trivial new plant chemicals. There are millions of them, and they all do something. Better to eat raw fruits and fresh spices like ginger/garlic whatever than some dried impotent stale supplement in a bottle.

It depends on your problems, if you've always had heartburn and ulcer problems then you probably have naturally high stomach acid, so it's fine. If you have low stomach acid, food doesn't get digested, meaning you get less nutrients. In addition, the food then gets fermented by bacteria, making you feel worse via endotoxin.

Thanks, so pantroprazol increases or decreases stomach acid? I've never had any problems like heartburn or ulcer, so I think I have low stomach acid, I rather have problems with nausea and vomiting after alcohol (even small amount).

 

[lvysaur]

Thanks, so pantroprazol increases or decreases stomach acid?

Well, you just told me that it decreases acid. You said you have gastritis, which tends to indicate higher acid production.

Alcohol should ideally be drunk with fruit juice or something else fructose-rich.

Proton Pump Inhibitors like pantroprazol are highly associated with cognitive impairment:

I actually just stumbled upon this paper regarding Proton Pump inhibitors, gastritis, and H. Pylori

https://watermark.silverchair.com/5...LI0nYn6G6j3cyh-LxDhfFGSCbFOrj7QbgN0uimPo--KZg

 

[ginny-red]

The dose of caffeine depends on your tolerance. I would start out at 200mg and work your way up from there. I think as much as 1400mg of caffeine is safe though thats quite a lot. I would be careful with probiotics. It made my symptoms much worse when I tried them. But if you do people tend to respond well to Bifidobacterium bacteria but Lactobacillus makes myself and many others worse. I'm sure Lactobacillus works for many but I've definitely noticed many people have problems with it. Proton Pump Inhibitors like pantroprazol are highly associated with cognitive impairment: Cognitive impact after short-term exposure to different proton pump inhibitors: assessment using CANTAB software so I would stay away from them if possible. I would avoid aspirin as the intestinal barrier is already challenged (if that is indeed your issue).

Thank you. And what about huge headaches? How can I treat them if I have inflammation? And what about anxiety, will it pass after I restore my intestine to norm?
Regarding caffeine, should I take this dose once per day or spread it into 2-3 doses? And before or after breakfast? Thanks!

 

[ginny-red]

Well, you just told me that it decreases acid. You said you have gastritis, which tends to indicate higher acid production.

Alcohol should ideally be drunk with fruit juice or something else fructose-rich.



I actually just stumbled upon this paper regarding Proton Pump inhibitors, gastritis, and H. Pylori

https://watermark.silverchair.com/5...LI0nYn6G6j3cyh-LxDhfFGSCbFOrj7QbgN0uimPo--KZg

My doc said that I should take pantroprazol because he SUSPECTS that I have gastritis, but I don't have such symptoms like heartburn, only nausea (sometimes) and vomiting after alcohol. For him, it's a sign that I have gastritis, but for now I'm not so sure... I don't want to make it worse.

 

[Constatine]

Well, you just told me that it decreases acid. You said you have gastritis, which tends to indicate higher acid production.

Alcohol should ideally be drunk with fruit juice or something else fructose-rich.



I actually just stumbled upon this paper regarding Proton Pump inhibitors, gastritis, and H. Pylori

https://watermark.silverchair.com/5...LI0nYn6G6j3cyh-LxDhfFGSCbFOrj7QbgN0uimPo--KZg

Yeah it seems very dangerous actually.

Thank you. And what about huge headaches? How can I treat them if I have inflammation? And what about anxiety, will it pass after I restore my intestine to norm?
Regarding caffeine, should I take this dose once per day or spread it into 2-3 doses? And before or after breakfast? Thanks!

The anxiety should pass when your intestinal health normalizes. Everyone's anxiety is related to their intestinal health, not just those with intestinal problems. Caffeine might get rid of the headaches over time as it opposes serotonin and again reduces neuro-inflammation as well as toxin exposure in the brain. Feverfew may help with the headaches by reducing serotonin release from mast cells but I don't really know how it would interact with all this, so be careful with it if you try it. I would start with just dosing the caffeine in the morning as sleep is very important for gut function. Overtime you should become tolerant enough to sleep with later doses.

 

[damngoodcoffee]

I'm eating almost everything - meat (chicken, pork), rice, pasta, vegetables, milk, cheese, nuts, bread...

PUFA increases serotonin. I'd choose only lean cuts of chicken and pork and ditch the nuts. Nuts are hard to digest too, and that can increase serotonin.
I'd also recommend cooking your food with coconut oil.

 

[ginny-red]

Yeah it seems very dangerous actually.

The anxiety should pass when your intestinal health normalizes. Everyone's anxiety is related to their intestinal health, not just those with intestinal problems. Caffeine might get rid of the headaches over time as it opposes serotonin and again reduces neuro-inflammation as well as toxin exposure in the brain. Feverfew may help with the headaches by reducing serotonin release from mast cells but I don't really know how it would interact with all this, so be careful with it if you try it. I would start with just dosing the caffeine in the morning as sleep is very important for gut function. Overtime you should become tolerant enough to sleep with later doses.

Thank you! I hope it will help somehow. I was looking for probiotics only with Bifidobacterium bacteria but I cannot find any in my country, so I think I'm obliged to give up on them... I don't want to take a risk and make it worse.
Lady from drugstore recommended me Buy ABOCA COLILEN irritable bowel syndrome 96 capsules in pharmacy - maybe it could be a good replacement for probiotics (also quite expensive), what do you think?
Also, I've been wondering for a long time, is it good to deplete serotonin totally? How is it possible that all mental medications affect on serotonin (by increasing it) and reduce anxiety by that and all of you are opponents of serotonin (I read some articles by Ray Peat but I'm still curious)? I know that I could be somehow sensitive to serotonin uptake (even excess tryptophan made me sick) but I have lower serotonin in blood than normal levels, so some time ago I wondered maybe anxiety is induced by those low levels... Maybe SSRI somehow blocked my receptors and depleted serotonin from blood? And I think there's something with my metabolism, because I have excess tryptophan and too low serotonin in serum. Could you please explain me this somehow? Every psychiatrist in my country would prescribed me SSRI for my symptoms, so it's really interesting for me how it works and why serotonin is so bad if it's called "happy hormone" - and I can see that you have a lot of knowledge about that. :)
I was also wondering about dopamine deficiency (low motivation, somnolence) caused by SS, but it's just my conjecture and I only read articles about that... I wish I had a chance to talk with someone with a knowledge about that because my docs are helpless.

PUFA increases serotonin. I'd choose only lean cuts of chicken and pork and ditch the nuts. Nuts are hard to digest too, and that can increase serotonin.
I'd also recommend cooking your food with coconut oil.

So should I discontinued Omega 3? It's sometimes hard to me to control my meals because I buy lunches in my work... I think I should start cooking by myself, buy goat milk and coconut oil. My dietitian suspects that I have leaky intestinal syndrome, maybe everything is connected somehow and I should not eat a lot of things. Thank you! You all have great advises.