Long term hiccups

[flounder7]

My brother who is 25 has had constant hiccups for over 3 months now and they are really affecting his life.

He was trying to bulk up and gained 30 lbs in 4 months eating a bunch of trash foods. He then fasted for a day and broke the fast with milk and has been hiccuping ever since.

He has good days and bad days. He’s lost all of the weight that he put on. He says he’s not able to eat much. He’s been to a bunch of doctors and they just keep trying to give him pills.

Any suggestions would be greatly appreciated.

 

[Hiep]

According to the Mayo Clinic

Myoclonus refers to a quick jerking movement that you can't control. Hiccups are a form of myoclonus, as are the sudden jerks or "sleep starts" that you may feel just before falling asleep. These forms of myoclonus occur in healthy people and usually aren't serious.

Other forms of myoclonus may occur because of a nervous system disorder, such as epilepsy, a metabolic condition, or a reaction to a medicine.

Treating whatever condition causes myoclonus can help control symptoms. Sometimes the cause of myoclonus is unknown or can't be specifically treated. In these cases, the goal of treatment is to reduce the effects of myoclonus on quality of life.

Suggestion: When doing research in the scientific literature, broaden your search and use the term myoclonus (instead of just hiccups).

Doctors & researchers don't know what causes myoclonus but a while back, I came across a published case study: Adult-Onset Cerebral Folate Deficiency that points "cerebral folate deficiency" (or a Vitamin B9 deficiency in the brain) as one possible cause.

Q: What are some possible causes of cerebral folate deficiency?
A: Prescription meds, eating a diet that is deficient in natural folate, MTHFR SNP genetic variation, a riboflavin deficiency, and/or supplementing obscene amounts of folic acid, etc.
e.g. it's standard practice for rheumatologists to prescribe to rheumatoid arhtritis patients a weekly injection of methotrexate + 5000 mcg folic acid the day after the injection OR 5000 mcg folic acid per day, 6 days a week!

The NIH Folate Fact Sheet for Health Professionals states the tolerable upper limit for folate is 1000 mcg per day.

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In the "trash foods" that your brother ate, was it sufficient in folate content or was it fortified with folic acid? e.g. breads, cereals, pastas, pastries, nut or animal milks (e.g. in Canada, goat milk is often fortified with folic acid to bring its level up to par with cow's milk), etc.

Even without any MTHFR genetic variations and in the best case scenario, humans are only able to convert ~200 mcg of folic acid into methylfolate (the form the body requires and uses) at one time. So if one consumes a bolus dose of more ~200 mcg folic acid, the excess unmetabolized folic acid ends up in the blood stream, some of it clogs up folate receptors, and over time, this causes a folate deficiency. And if/when the doctor decides to check serum folate levels, the results will likely come back normal or above the reference range. Having an adequate or excessive concentration of (unmetabolized) folic acid in the blood does NOT mean a person is folate sufficient.

TL;DR It's best to get your folate from real food. If that is not possible, then consider supplementing with methyfolate (L-5MTHF) or folinic acid (prescription drug name: Leucovorin). In terms of which form is best, that really depends on the person. Avoid supplements or foods "fortified" with folic acid.

A final thought: Since myoclonus is a nervous system disorder, I'd also make sure the other B vitamins are topped up: specifically: B1, B12, B2 and (possibly) B6.