Lab Results - 5+ Years Of Chronic Fatigue/insomnia + Brutal SSRI Withdrawals

[Johnson Bagfoot]

As follows are my chronic symptoms, brief plan of what I'm trying currently, then full blood work which I got on the advice of some forum members here

I would greatly appreciate any interpretation of the values, since I lack any biochemistry knowledge, and know that reference ranges are not necessarily optimal ranges. And likewise, that clusters of suboptimal ranges add up to a more insightful picture than any given value alone.

And also, absolutely anything I could try to improve symptoms would be very very very much appreciated. I've posted elsewhere in detail about this, but I have lived around 8 years of an almost unlivable hell, largely bedridden and at best chronically fatigued, trying many things, and not succeeding in finding lasting relief anywhere so far.

Lots of gratitude, Johnson

Primary symptoms (5 years +)

• Chronic fatigue, anxiety, insomnia. To the point of being bedridden for 6 months several times.
• Weak, dizzy, fragility
• Hypersensitive to senses, many substances/foods and any stimulants
• Low temperature, low pulse (<50 as a non-exerciser), slow metabolism
  
• Fight or flight triggered by minor exertion or stress
• Very poor concentration, alertness, memory, etc.
• Signs of high estrogen and lots of hair loss in the last few years.
• Brutal and lasting SSRI withdrawals (tried 3 times and went through hell), that seemed to trigger many of the symptoms I currently experience. Ie set up a stress cycle which perpetuated itself after the pharmaceuticals were out of my system.

Current plan of attack:

• Have tried 100s of things.
  
• Currently trying a peaty / paleoy diet consistently of rare steak, gelatin, milk, oranges, dark chocolate, eggs, high fat dairy, coconut oil, and getting high-ish total cals
• Currently trying mirtazapine @ 3.5mg before bed. Minor improvement, but seems to have a stress rebound the following day.

Out of lab reference range (not that these mean much, or mean optimal):

IRON 10.4 umol/L 10.6- 28.3
TRIGLYCERIDES * 2.7 mmol/L < 2.3
Albumin/Globulin Ratio 2.7 range <2.0
GAMMA GT* 9 IU/L 10-71
Prostate Specific Ag(Total) 0.87 ug/l 0.00-1.40
Prostate Specific Ag(Free) 0.13 ug/l 0-0.90
Free:Total ratio 0.15 >0.19 is normal

Full Blood work:

Thyroid:

 

[Johnson Bagfoot]

Bump

Any suggestions based on the lab readings?

I'm at a dead end other than being about to try cyprohepdatine.

 

[marsaday]

Chronic fatigue is a tough nut to crack. It needs a total approach to hormone replacement, diet, and vitamin and mineral sups.

Very often CFS is actually a thyroid issue. Your thyroid results look good though. Vitamin B12 is good and vitamin D is good.

All i can help with is a link to a great resource in the UK. She is a real doctor, but has an alternative approach to looking at many illnesses. She does a lot of work with CFS and i thunk has some specific tests for this illness. Her ideas on this area centre around mitochondria damage.

She is called Dr Myhill. Here is a link:

Category:Fatigue - DoctorMyhill

Of all the things you have tried, have you tried some T4 supplementation? I just wonder what a small amount taken at bedtime would do for you. Sleep is crucial to getting better and T4 production takes place at night, as does cortisol. The two hormones link closely. T4 at bedtime can really be helpful. Your results look good, but a small 25mcg supplement of T4 may be useful at bedtime. T3 may also be useful, but i would try T4 first and then T3 second. If you use T3 always start with a tiny dose as these amounts can really help. So something like 1/8th of a 25 mcg tablet is the most to use per day for a while if you give it a go. This = approx 3mcg T3.

Another thing i would look at using is progesterone in small doses as well. Use the ProgestE product create by Ray Peat. One drop initially per day is a good start. This = approx 3mg. A male doesn't need much progesterone, but it is a very useful hormone and feeds into the cortisol pathways.

I am a thyroid patient and i have found progesterone to be super useful along with my thyroid meds. Getting better is a tough nut to crack, but hang in there as you can make improvements.

 

[Frankdee20]

Yeah this antidepressant discontinuation syndrome and all of its manifestations are often paradoxes. Only time will help this, I've experienced it dead on, with hypersensitivity of the nervous system. Forum members need to remember that he's sensitive to most substances that would otherwise be helpful.

 

[CaliforniaKat]

I would also look at cortisol. Many of the symptoms you listed could be related to cortisol. A 4 or 6 point saliva test will tell you what your cortisol levels look like across the day and evening, high or low, etc.
.......Although I see now that this was asked a year ago and my suggestion may be long overdue and very potentially irrelevant..sorry I didn't catch the timing sooner.

 

[akgrrrl]

Hypersensitivty of the nervous system, along with many of the symptoms offered up, are a part and parcel of benzos withdrawal. Since the 1980's, the work of Professor Emeritus Heather Ashton's Manual has offered titration schedules and compassionate understanding of the impact of pharmaceuticals that fall in the class of benzodiazapines. Her manual, and the most comprehensive collection of information on this rarely discussed topic is contained in a website which has been stacking up awards since 2008, www.beyondmeds.com.

 

[General Orange]

Serotonin receptor dysregulation from SSRI use with low GABA activity can create those symptoms.
This means glutaminergic activity is relatively high and overexciting and sensitizing the system.

First concentrate on increasing GABA activity to temper glutamate.

GABA can be fixed with :

• Thyroid T3 plus lemon balm or rosemary extract
  
• Taurine with high dose vitamin B3
• Apigenin, Orange juice, chamomile.

- Rosmarinic acid increases GABA levels by indirectly inhibiting the enzyme (4-aminobutyrate transaminase) that converts GABA to L-glutamate [R].

EDIT:
- Increasing DHT will lower serotonin and can increase GABA and get back your energy.
- Natural ways to increase DHT
- Boron, 12mg helps too
- L-carnitine increases ATP for extra energy

 

[Terma]

Yeah, hypersensitivy relates highly to acetylcholine (which also potentially enables the serotonergic pathways). Which in turn is amplified by Benzo withdrawal.

So you want to avoid nightshades like potatoes and tomatoes, potentially, as well as eggs and high doses of choline.

[It's not black and white, however; muscarinic receptor activation by acetylcholine is generally inhibitory]

 

[Frankdee20]

Serotonin receptor dysregulation from SSRI use with low GABA activity can create those symptoms.
This means glutaminergic activity is relatively high and overexciting and sensitizing the system.

First concentrate on increasing GABA activity to temper glutamate.

GABA can be fixed with :

• Thyroid T3 plus lemon balm or rosemary extract
  
• Taurine with high dose vitamin B3
• Apigenin, Orange juice, chamomile.

- Rosmarinic acid increases GABA levels by indirectly inhibiting the enzyme (4-aminobutyrate transaminase) that converts GABA to L-glutamate [R].

EDIT:
- Increasing DHT will lower serotonin and can increase GABA and get back your energy.
- Natural ways to increase DHT
- Boron, 12mg helps too
- L-carnitine increases ATP for extra energy

When you say high dose B3, you mean Niacinamide ? Exactly how much ? I’ve only ever gone as high as 500-1000

 

[Frankdee20]

Lemon Balm might have some anti thyroid activity. It’s also an acetylcholinesterase inhibitor, like most herbs. Any GABA boost may be cancelled out by Choline increase.

Magnolia Bark and Gotu Kola can also help GABA.

 

[Terma]

Yeah, I completely avoid herbs for that reason [and some others: excessive hormesis], and even limit vegetable intake now (mixed bag).

I should say though, that consuming low-doses of choline with food (as found in milk or low doses or Alpha-GPC or CDP-choline) should be good (essential) for liver without altering blood levels too high enough to increase Acetylcholine. Overall, dietary choline can be used in great part for phosphatidylcholine synthesis, and it's possible for it to avoid the brain completely, while acetylcholinesterase inhibitors affect acetylcholine especially. So you could hypothesize that too low choline intake while too high acetylcholinesterase inhibitors is what ***** the general population over, though eggs could cause one bad exception. [However, this is confounded by the TMAO issue, and for that reason among others I use Alpha-GPC in low doses instead of food sources]

 

[Frankdee20]

Yeah, I completely avoid herbs for that reason [and some others: excessive hormesis], and even limit vegetable intake now (mixed bag).

I should say though, that consuming low-doses of choline with food (as found in milk or low doses or Alpha-GPC or CDP-choline) should be good (essential) for liver without altering blood levels too high enough to increase Acetylcholine. Overall, dietary choline can be used in great part for phosphatidylcholine synthesis, and it's possible for it to avoid the brain completely, while acetylcholinesterase inhibitors affect acetylcholine especially. So you could hypothesize that too low choline intake while too high acetylcholinesterase inhibitors is what ***** the general population over, though eggs could cause one bad exception. [However, this is confounded by the TMAO issue, and for that reason among others I use Alpha-GPC in low doses instead of food sources]

I never understood how the different Choline forms effect people. How is GPC different from CDP or straight Choline Bitartrate ?

 

[Terma]

I never understood how the different Choline forms effect people. How is GPC different from CDP or straight Choline Bitartrate ?

I knew this would come in handy (2 days later):
https://raypeatforum.com/community/...ble-notes-on-choline.23228/page-3#post-362197

 

[Frankdee20]

I knew this would come in handy (2 days later):
https://raypeatforum.com/community/...ble-notes-on-choline.23228/page-3#post-362197

Hmm, no thanks lol. Acetylcholine is no good for me. But I’ll still smoke, even that gets similar in high doses

 

[General Orange]

When you say high dose B3, you mean Niacinamide ? Exactly how much ? I’ve only ever gone as high as 500-1000

Oh, yes indeed Niacinamide, my bad. starting around 100mg and up.

 

[General Orange]

Lemon Balm might have some anti thyroid activity. It’s also an acetylcholinesterase inhibitor, like most herbs. Any GABA boost may be cancelled out by Choline increase.

Magnolia Bark and Gotu Kola can also help GABA.

Thats right, lemon balm is indicated to have anti-thyroid effects, that's why it's better combined with some thyroid T3, or better yet go for rosemary extract / Rosmarinic acid.

"Test tube studies have found that lemon balm blocks attachment of antibodies to the thyroid cells that cause Grave's disease (hyperthyroidism), though clinical trials proving lemon balm's effectiveness as a treatment are lacking.
Flavonoids, phenolic acids, and other compounds appear to be responsible for lemon balm's anti-herpes and thyroid-regulating actions. Test tube studies have found that lemon balm blocks attachment of antibodies to the thyroid cells that cause Grave's disease (hyperthyroidism). The brain's signal to the thyroid (thyroid-stimulating hormone or TSH) is also blocked from further stimulating the excessively active thyroid gland in this disease. However, clinical trials proving lemon balm's effectiveness in treating Grave's disease are lacking."

 

[Frankdee20]

I wonder if Rosemary supplies sufficient Rosemarinic Acid to yield a noticeable effect on GABA Transaminase inhibition. I can only find the actual herb, and not it’s constituent, available for supplementation.

 

[General Orange]

I wonder if Rosemary supplies sufficient Rosemarinic Acid to yield a noticeable effect on GABA Transaminase inhibition. I can only find the actual herb, and not it’s constituent, available for supplementation.

I find 20% Rosmarinic acid extracts on amazon

 

[General Orange]

There is only 7.2 mg per gram dry weight of Rosmarinic acid in Rosemary.

link

 

[Frankdee20]

I guess combining it with Magnolia Bark and Kava would be the ***t