How serotonin is the primary driver of digestive problems (and how to address it)

hierundjetzt

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Joined
Feb 27, 2020
Messages
239
I had absolutely debilitating digestive problems for years. I went to all of the “top GI docs'' and they had NO answers. They said we don’t know what’s wrong with you. One even told me it was all in my head. Take pill, drink water, eat fiber, take probiotics, etc.

I was furious. I even tried some of these “expert recommendations” and they made my gut even worse. I was absolutely miserable. Imagine the worst stomach ache or vomiting episode you’ve ever had. Now imagine that nonstop for around 2.5 years. That was me.

I later learned that I was not alone. This one study is remarkable, showing that people with GI problems and brain fog (often go hand in hand) would often take probiotics. But getting them off of the probiotics and giving them antibiotics cured them:

Not just nausea though. ZERO appetite even if I fasted for days. Didn’t defecate for weeks at a time. Acid reflux. Inconceivable bloating. I remember after Thanksgiving seeing my pregnant looking belly in the mirror and starting to cry.
Fortunately, I stumbled upon the right information (Danny's youtube)

I had read about people with similar issues who took a drug called cyproheptadine, an anti-serotonin, antihistamine drug. I wasn’t too keen on pharmaceuticals but at this point I was desperate. So I tried it. The results were absolutely stunning. I had a near complete reversal of ALL symptoms.

I became pretty obsessed with this topic and wanted to learn all there was to know.
I wanted my gut to feel like that all the time, without constantly using cyproheptadine.
I found out that serotonin is elevated in the gut of every GI disease.
Is this overlooked? Or intentionally dismissed by the media?

Well NO, it’s not overlooked. In fact, big pharma tried running clinical trials for a drug that inhibits serotonin synthesis for IBS behind your back. In the meantime, your GI doc has been giving you an SSRI. We already know why this is the case:
View: https://twitter.com/Outdoctrination/status/1677349779163029516


Cyproheptadine has a near curative effect on GI problems in the literature. Ondansetron is a highly efficacious anti-nausea drug, which also blocks serotonin. Meanwhile, to induce IBS in an animal, give them the genetic equivalent of an SSRI.

Serotonin's role in the gut is to trigger the necessary response to irritation or pathogens. This involves stimulating motility to rid the pathogen, pain/sensitization of the area and a lack of appetite to discourage further eating.

Excess bacteria, whether labeled good or bad (even those WITHOUT endotoxin), can stimulate serotonin production in the gut. Antigens on bacteria trigger inflammatory cascades, resulting in increased serotonin. Constipation, leading to bacterial buildup, is a huge issue here.

One way that has been extremely useful for me in diagnosing these issues is looking at the tongue. The tongue should be a vibrant pink, almost red, in good health. Saliva production should be strong. When bacterial issues arise, the tongue gets a white coating, especially in the back.

What most may not understand is that the mouth to the anus is really one long track, and thus bacterial issues in the intestines can cause not just white tongue, but other dental problems like bad breath and even cavities. I still use my tongue to guide what I should do on a day to day basis.

Serotonin can bind to mast (immune) cells, which can in turn release histamine. It’s been hypothesized that histamine intolerance actually starts in the gut. This goes both ways, antihistamines also tend to lower serotonin, and diamine oxidase supplementation shows some promise.

Any type of fiber can promote serotonin production. Soluble fiber feeds bacteria, and insoluble fiber acts as an irritating agent. Other irritants like gums and dyes can cause gut serotonin levels to rise. The short chain fatty acids produced by the microbial fermentation of soluble fibers also drive serotonin production in the gut.

Low or no fiber can CURE many of these problems. IBS patients consistently improve massively from no fiber diets. Again, I think this is because these problems often result from excess bacteria/serotonin, which fiber directly contributes to.

Many people do benefit specifically from insoluble fiber (raw carrot). I think this is mainly due to the pro-motility effect, and the fact that they actually lower the bacterial load over time. However, insoluble fiber by definition works as an irritant. In fact, you can replace insoluble fiber with plastic and get similar results
View: https://twitter.com/Outdoctrination/status/1607786778060279813?s=20


In severe cases (like mine), pharmaceutical antibiotics may be necessary. Docs often like to give very high doses of toxic antibiotics. However, at low doses, using older types of antibiotics and listening to your body, can have some incredible effects. It’s something worth considering [NOT MEDICAL ADVICE].

Natural laxatives like coffee or Cascara are helpful for alleviating constipation by stimulating motility, as well as ensuring adequate magnesium intake.
Gentler antibacterial agents like raw honey, white button mushrooms, coconut oil, vinegar and mastic can be beneficial. Cop some mastic gum here: Mastic Droplets

Not only does this gum have antibacterial effects (always cleans up my tongue), it is also pro-motility and thus increases bowel movements, and increases saliva output, our endogenous antimicrobial. Motility is slowed in all types of gut problems, even diarrhea.

Poor stool quality/infrequent movements lead to incomplete bacterial elimination and thus excess serotonin. This can become a vicious cycle, as bacteria use serotonin as a signaling molecule, enhancing their virulence through biofilm formation. Focusing on this in the long term has been CRUCIAL for me
View: https://twitter.com/Outdoctrination/status/1553386855126671365?s=20


One thing that has helped me tremendously in inducing more frequent and healthier bowel movements has been focusing on relaxation, breathing and movement. I cover that here:
View: https://twitter.com/Outdoctrination/status/1657019737908592640?s=20


Vitamins A, D, and zinc inhibit TPH, the key enzyme responsible for serotonin synthesis. All of the fat soluble vitamins also have direct antimicrobial properties. K2 has been vital for me personally. Health Natura has the highest quality fat soluble vitamins I know of, individually or as a mix: Products - Liquid Vitamins - healthnatura.com

Bacterial issues can especially arise when gut metabolism is suboptimal, and thus oxygen is not used for energy, and instead leaks into the gut. Higher oxygen environments foster the growth of more / more pathogenic gut bacteria, and this is seen in every GI disease.

A lack of allopregnanolone (a primary metabolite of pregnenolone) and/or DHT, is known to induce gut problems via serotonin increase. Allopregnanolone reverses this effect. You can cop some pregnenolone here, again the one I use: Pregnenolone 20 grams

Dopamine inhibits serotonin synthesis and promotes colonic motility. We’ve touched more on that here:
View: https://twitter.com/Outdoctrination/status/1659949243598245888?s=20


Of course, there are also antiserotonin drugs. Cyproheptadine played an absolutely huge role in my recovery from debilitating gut problems. Some other antiserotonin agents are L-Lysine, methysergide, metergoline, LSD, ketanserin, and ondansetron. [NOT MEDICAL ADVICE]

The serotonin transporter relies on sodium to pull serotonin into cells and deactivate it, and consequently low salt diets increase serotonin. Lower salt diets also impair insulin sensitivity and can raise cortisol. Insulin helps dampen serotonin signaling, while cortisol promotes serotonergic function. Salt Loading Affects Cortisol Metabolism in Normotensive Subjects: Relationships with Salt Sensitivity

Fasting actually increases serotonin levels in the gut and systemically. One of the ways it might do this is by increasing cortisol and its precursor, CRH. Again, pregnenolone has been massive for me in this regard as it is our endogenous anti-CRH steroid. https://twitter.com/Outdoctrination/status/1671525436172513286

This hit home for me big time because my issues STARTED after a lot of fasting and carnivore dieting. I get that it may help in certain situations, but I wouldn’t personally advocate for such an approach.

Some foods contain serotonin, but I wouldn’t worry too much about this, at least to start. Same goes for tryptophan, the serotonin precursor amino acid. It may help in really bad circumstances, but to me, there’s much bigger fish to fry.

how much cyproheptadine did you take and for how long? I've tried small (0.5mg) as well as medium (8mg) doses at night and the next day I'm always a zombie...
 

youngsinatra

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How did you fix these things?
I am not that knowledgeable on this topic and I would never claim that I fixed my IBS, but I can say that I can manage it. I did lot of gut-focused protocols in the past, but with very very limited progress. So I think it‘s a difficult problem to tackle. I think like Ray, that thyroid is the principal organizing element in most bodily functions and this is also true for GI issues.

I still have lots of food intolerances (unfortunately) but it’s not that I get digestive symptoms but rather I get systemic symptoms (esp. brain related/neurological) to foods. (gluten, dairy, eggs, night shades, red meat, onions, garlic etc.)

But with the right dose of thyroid and low dose B1 (TPP), I was at least able to normalize my motility, stomach acid levels, bile flow and digestive enzyme production and I cleared SIBO that way.

I went from mixed constipation and diarrhea with yellow, sometimes pale, loose stool that was floating and falling apart immediately in toilet water with visible undigested food particles.
My stool today is dark brown, sinks, is well-formed, and no-malabsorbed food particles are seen - that are signs to me that HCL, bile and digestive enzymes are adequate.
 
Last edited:

Peating Force

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I think that’s because I did not address other issues with my overall digestion system like impaired bile flow, low HCL, low digestive enzyme production and so on.

I needed to improve those before real significant improvements could be made with digestion. I think good amounts of HCL and bile are our endogenously made disinfectants for the bowels, but if those get low, bacterial overgrowth and dysbiosis is always the consequence and it does not resolve by just taking antibiotics.

I'm 100% on this.
I recently used a new enzymes brand (something I saw discussed here I think). And I felt really great, recovered - good mobility, good form - lots of energy during the day. Then I ran out... and the IBS came back with a force, bringing with it the good ol' severe depression.
I'm quite sure the problem is badly digested food in the stomach that ends in the guts where it is not expected -> hence irritation -> hence IBS (D in my case).

how much cyproheptadine did you take and for how long? I've tried small (0.5mg) as well as medium (8mg) doses at night and the next day I'm always a zombie...

Agreed, I tried 0.5mg too but then it's hard to get up from bed, to work or to exercise... It's sad because it sure does help a lot with my IBS
 
OP
Outdoctrination
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Messages
53
I'm 100% on this.
I recently used a new enzymes brand (something I saw discussed here I think). And I felt really great, recovered - good mobility, good form - lots of energy during the day. Then I ran out... and the IBS came back with a force, bringing with it the good ol' severe depression.
I'm quite sure the problem is badly digested food in the stomach that ends in the guts where it is not expected -> hence irritation -> hence IBS (D in my case).



Agreed, I tried 0.5mg too but then it's hard to get up from bed, to work or to exercise... It's sad because it sure does help a lot with my IBS
how much cyproheptadine did you take and for how long? I've tried small (0.5mg) as well as medium (8mg) doses at night and the next day I'm always a zombie...
I routinely used to take 4 mg. recently, after optimizing metabolism more (especially B vitamins), i haven't noticed that effect too much from lower doses. I think it's more of a diagnostic than anything, i.e if it helps you can bet there is a serotonin / bacterial root cause.
 

peter88

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Fruit juice seems to be the main thing to induce serotonin symptoms for myself. Terrible diarrhea, stomach pains/nausea, and anxiety.
 

golder

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Fruit juice seems to be the main thing to induce serotonin symptoms for myself. Terrible diarrhea, stomach pains/nausea, and anxiety.
Who would’ve thought something as innocent as natures own source of vitamins/hydration would cause such a cascade of negative health events. Do you think the issue is mainly your physiology or do you think fruit is common to cause these issues in people?
 

mostlylurking

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nice finds! thanks for sharing
For your consideration:
"To clarify the relationship between thiamine metabolism and peripheral vasodilation symptoms seen in the early stages of dietary magnesium deficiency, various synthetic diets were administered to rats. After a 4-wk period of thiamine excess and magnesium-deficient diet, blood serotonin levels increased significantly. A thiamine-deficient and magnesium-deficient diet revealed no elevation of blood serotonin. Serotonin in stomach and intestine increased in the excess-thiamine, magnesium-deficient group. Blood magnesium concentration decreased markedly in thiamine-supplemented, magnesium-deficient groups but not in the thiamine-deficient magnesium-deficient group. A possible explanation of the mechanism is presented."

also this thread:

Both thiamine and magnesium are needed to normalize serotonin.

Also, when I emailed Ray Peat back in 2020, he advised me to use both thiamine and magnesium to heal my gut issues that happened after taking Bactrim antibiotic.
 
OP
Outdoctrination
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Messages
53
For your consideration:
"To clarify the relationship between thiamine metabolism and peripheral vasodilation symptoms seen in the early stages of dietary magnesium deficiency, various synthetic diets were administered to rats. After a 4-wk period of thiamine excess and magnesium-deficient diet, blood serotonin levels increased significantly. A thiamine-deficient and magnesium-deficient diet revealed no elevation of blood serotonin. Serotonin in stomach and intestine increased in the excess-thiamine, magnesium-deficient group. Blood magnesium concentration decreased markedly in thiamine-supplemented, magnesium-deficient groups but not in the thiamine-deficient magnesium-deficient group. A possible explanation of the mechanism is presented."

also this thread:

Both thiamine and magnesium are needed to normalize serotonin.

Also, when I emailed Ray Peat back in 2020, he advised me to use both thiamine and magnesium to heal my gut issues that happened after taking Bactrim antibiotic.
have you seen anything on magnesium decreasing serotonin?
 

mostlylurking

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have you seen anything on magnesium decreasing serotonin?
Well, yeah, in relationship to thiamine supplementation. If you supplement thiamine and you are low in magnesium, the result is increased serotonin (refer to the article I posted above). Logically speaking, if you remedy the low magnesium by increasing the amount you take when supplementing thiamine, then the serotonin problem would improve.

I have had problems with high serotonin in the past, to the point that I could not eat a banana or a little pineapple without major issues and a tiny trial dose of methylene blue made me feel awful (it is an MAO inhibitor). I've been high dosing thiamine hcl for around 2.5 years and have also been supplementing magnesium glycinate (fairly high dose as my tolerance for it was improved via the high dose thiamine hcl). I no longer have any issues with serotonin.
 

mostlylurking

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have you seen anything on magnesium decreasing serotonin?
The smoke screen that has been installed regarding the wonderful magic of serotonin has made this topic extremely difficult to research. The idea presented over and over in easy to read hype is that because magnesium helps with depression it must be increasing that happy hormone, serotonin. The popular idea that serotonin is actually desirable has confused the research. Pretzel logic runs rampant.

But here's a good article about magnesium:

this one is pretty technical:

and this one:

CONCLUSION:
"Mg still represents an emerging research field despite being entered into medicine in the XVIIth century as a constituent of Epsom salts (Durlach 2007). Although much has been discovered, many aspects of magnesium still remain unclear and await discovery. Undoubtedly, the future will uncover new Mg compounds of medicinal value, will further characterize Mg as a common factor in more stress-related pathologies, and will result in the discovery of more Mg transporters, while better methods for the determination of intracellular levels of the cation will pave the way for an improvement in simple diagnosis of true Mg2+ deficiency."
-END PASTE-

Ray Peat's articles about serotonin are very good:
 

TeslaFan

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Messages
346
The smoke screen that has been installed regarding the wonderful magic of serotonin has made this topic extremely difficult to research. The idea presented over and over in easy to read hype is that because magnesium helps with depression it must be increasing that happy hormone, serotonin. The popular idea that serotonin is actually desirable has confused the research. Pretzel logic runs rampant.

But here's a good article about magnesium:

this one is pretty technical:

and this one:

CONCLUSION:
"Mg still represents an emerging research field despite being entered into medicine in the XVIIth century as a constituent of Epsom salts (Durlach 2007). Although much has been discovered, many aspects of magnesium still remain unclear and await discovery. Undoubtedly, the future will uncover new Mg compounds of medicinal value, will further characterize Mg as a common factor in more stress-related pathologies, and will result in the discovery of more Mg transporters, while better methods for the determination of intracellular levels of the cation will pave the way for an improvement in simple diagnosis of true Mg2+ deficiency."
-END PASTE-

Ray Peat's articles about serotonin are very good:

🎯

The language has been inverted so that it became impossible to search for a research or ask a question about serotonin in any context other than how "amazing" it is.
 

mostlylurking

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The language has been inverted so that it became impossible to search for a research or ask a question about serotonin in any context other than how "amazing" it is.
Yes.

without a doubt evident when reading any of the research
Only if you read the Ray Peat articles first. Ray Peat's knowledge is protective; his articles exercise one's brain.
 

Prota

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Messages
139
I had absolutely debilitating digestive problems for years. I went to all of the “top GI docs'' and they had NO answers. They said we don’t know what’s wrong with you. One even told me it was all in my head. Take pill, drink water, eat fiber, take probiotics, etc.

I was furious. I even tried some of these “expert recommendations” and they made my gut even worse. I was absolutely miserable. Imagine the worst stomach ache or vomiting episode you’ve ever had. Now imagine that nonstop for around 2.5 years. That was me.

I later learned that I was not alone. This one study is remarkable, showing that people with GI problems and brain fog (often go hand in hand) would often take probiotics. But getting them off of the probiotics and giving them antibiotics cured them:

Not just nausea though. ZERO appetite even if I fasted for days. Didn’t defecate for weeks at a time. Acid reflux. Inconceivable bloating. I remember after Thanksgiving seeing my pregnant looking belly in the mirror and starting to cry.
Fortunately, I stumbled upon the right information (Danny's youtube)

I had read about people with similar issues who took a drug called cyproheptadine, an anti-serotonin, antihistamine drug. I wasn’t too keen on pharmaceuticals but at this point I was desperate. So I tried it. The results were absolutely stunning. I had a near complete reversal of ALL symptoms.

I became pretty obsessed with this topic and wanted to learn all there was to know.
I wanted my gut to feel like that all the time, without constantly using cyproheptadine.
I found out that serotonin is elevated in the gut of every GI disease.
Is this overlooked? Or intentionally dismissed by the media?

Well NO, it’s not overlooked. In fact, big pharma tried running clinical trials for a drug that inhibits serotonin synthesis for IBS behind your back. In the meantime, your GI doc has been giving you an SSRI. We already know why this is the case:
View: https://twitter.com/Outdoctrination/status/1677349779163029516


Cyproheptadine has a near curative effect on GI problems in the literature. Ondansetron is a highly efficacious anti-nausea drug, which also blocks serotonin. Meanwhile, to induce IBS in an animal, give them the genetic equivalent of an SSRI.

Serotonin's role in the gut is to trigger the necessary response to irritation or pathogens. This involves stimulating motility to rid the pathogen, pain/sensitization of the area and a lack of appetite to discourage further eating.

Excess bacteria, whether labeled good or bad (even those WITHOUT endotoxin), can stimulate serotonin production in the gut. Antigens on bacteria trigger inflammatory cascades, resulting in increased serotonin. Constipation, leading to bacterial buildup, is a huge issue here.

One way that has been extremely useful for me in diagnosing these issues is looking at the tongue. The tongue should be a vibrant pink, almost red, in good health. Saliva production should be strong. When bacterial issues arise, the tongue gets a white coating, especially in the back.

What most may not understand is that the mouth to the anus is really one long track, and thus bacterial issues in the intestines can cause not just white tongue, but other dental problems like bad breath and even cavities. I still use my tongue to guide what I should do on a day to day basis.

Serotonin can bind to mast (immune) cells, which can in turn release histamine. It’s been hypothesized that histamine intolerance actually starts in the gut. This goes both ways, antihistamines also tend to lower serotonin, and diamine oxidase supplementation shows some promise.

Any type of fiber can promote serotonin production. Soluble fiber feeds bacteria, and insoluble fiber acts as an irritating agent. Other irritants like gums and dyes can cause gut serotonin levels to rise. The short chain fatty acids produced by the microbial fermentation of soluble fibers also drive serotonin production in the gut.

Low or no fiber can CURE many of these problems. IBS patients consistently improve massively from no fiber diets. Again, I think this is because these problems often result from excess bacteria/serotonin, which fiber directly contributes to.

Many people do benefit specifically from insoluble fiber (raw carrot). I think this is mainly due to the pro-motility effect, and the fact that they actually lower the bacterial load over time. However, insoluble fiber by definition works as an irritant. In fact, you can replace insoluble fiber with plastic and get similar results
View: https://twitter.com/Outdoctrination/status/1607786778060279813?s=20


In severe cases (like mine), pharmaceutical antibiotics may be necessary. Docs often like to give very high doses of toxic antibiotics. However, at low doses, using older types of antibiotics and listening to your body, can have some incredible effects. It’s something worth considering [NOT MEDICAL ADVICE].

Natural laxatives like coffee or Cascara are helpful for alleviating constipation by stimulating motility, as well as ensuring adequate magnesium intake.
Gentler antibacterial agents like raw honey, white button mushrooms, coconut oil, vinegar and mastic can be beneficial. Cop some mastic gum here: Mastic Droplets

Not only does this gum have antibacterial effects (always cleans up my tongue), it is also pro-motility and thus increases bowel movements, and increases saliva output, our endogenous antimicrobial. Motility is slowed in all types of gut problems, even diarrhea.

Poor stool quality/infrequent movements lead to incomplete bacterial elimination and thus excess serotonin. This can become a vicious cycle, as bacteria use serotonin as a signaling molecule, enhancing their virulence through biofilm formation. Focusing on this in the long term has been CRUCIAL for me
View: https://twitter.com/Outdoctrination/status/1553386855126671365?s=20


One thing that has helped me tremendously in inducing more frequent and healthier bowel movements has been focusing on relaxation, breathing and movement. I cover that here:
View: https://twitter.com/Outdoctrination/status/1657019737908592640?s=20


Vitamins A, D, and zinc inhibit TPH, the key enzyme responsible for serotonin synthesis. All of the fat soluble vitamins also have direct antimicrobial properties. K2 has been vital for me personally. Health Natura has the highest quality fat soluble vitamins I know of, individually or as a mix: Products - Liquid Vitamins - healthnatura.com

Bacterial issues can especially arise when gut metabolism is suboptimal, and thus oxygen is not used for energy, and instead leaks into the gut. Higher oxygen environments foster the growth of more / more pathogenic gut bacteria, and this is seen in every GI disease.

A lack of allopregnanolone (a primary metabolite of pregnenolone) and/or DHT, is known to induce gut problems via serotonin increase. Allopregnanolone reverses this effect. You can cop some pregnenolone here, again the one I use: Pregnenolone 20 grams

Dopamine inhibits serotonin synthesis and promotes colonic motility. We’ve touched more on that here:
View: https://twitter.com/Outdoctrination/status/1659949243598245888?s=20


Of course, there are also antiserotonin drugs. Cyproheptadine played an absolutely huge role in my recovery from debilitating gut problems. Some other antiserotonin agents are L-Lysine, methysergide, metergoline, LSD, ketanserin, and ondansetron. [NOT MEDICAL ADVICE]

The serotonin transporter relies on sodium to pull serotonin into cells and deactivate it, and consequently low salt diets increase serotonin. Lower salt diets also impair insulin sensitivity and can raise cortisol. Insulin helps dampen serotonin signaling, while cortisol promotes serotonergic function. Salt Loading Affects Cortisol Metabolism in Normotensive Subjects: Relationships with Salt Sensitivity

Fasting actually increases serotonin levels in the gut and systemically. One of the ways it might do this is by increasing cortisol and its precursor, CRH. Again, pregnenolone has been massive for me in this regard as it is our endogenous anti-CRH steroid. https://twitter.com/Outdoctrination/status/1671525436172513286

This hit home for me big time because my issues STARTED after a lot of fasting and carnivore dieting. I get that it may help in certain situations, but I wouldn’t personally advocate for such an approach.

Some foods contain serotonin, but I wouldn’t worry too much about this, at least to start. Same goes for tryptophan, the serotonin precursor amino acid. It may help in really bad circumstances, but to me, there’s much bigger fish to fry.

Nice post! Thank you!
If you don't mind, can you tell us some info about your diet?
 

AinmAnseo

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Fruit juice seems to be the main thing to induce serotonin symptoms for myself. Terrible diarrhea, stomach pains/nausea, and anxiety.
Would organic pear halves in "organic pear juice from concentrate" count as fruit juice?
 

AinmAnseo

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For your consideration:
"To clarify the relationship between thiamine metabolism and peripheral vasodilation symptoms seen in the early stages of dietary magnesium deficiency, various synthetic diets were administered to rats. After a 4-wk period of thiamine excess and magnesium-deficient diet, blood serotonin levels increased significantly. A thiamine-deficient and magnesium-deficient diet revealed no elevation of blood serotonin. Serotonin in stomach and intestine increased in the excess-thiamine, magnesium-deficient group. Blood magnesium concentration decreased markedly in thiamine-supplemented, magnesium-deficient groups but not in the thiamine-deficient magnesium-deficient group. A possible explanation of the mechanism is presented."

also this thread:

Both thiamine and magnesium are needed to normalize serotonin.

Also, when I emailed Ray Peat back in 2020, he advised me to use both thiamine and magnesium to heal my gut issues that happened after taking Bactrim antibiotic.
Mostly,
How much thiamine and magnesium, and what form, did he suggest?
 
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