Wednesday, December 2, 2020

Comments by NoHarmacy

Showing 2 of 2 comments.

  • Thankyou for sharing your story David, it can’t be easy to bare your soul like that for the world to read. I wish you all the best in your continued (and hopefully permanent) recovery.

    Have you ever considered having any genetic testing done (on more than one level)?
    Firstly, genetic testing for drug metabolism may have helped you identify an antidepressant that you may have responded to better, through better understanding your CYP450 Enzyme phenotypes, SLC6A4 and ABCB1 status etc. One such product, CNSDOSE, was able to achieve remission rates of 72% compared with the usual 25-30% remission rate that can be achieved by the conventional “throwing the antidepressant at the dart board” method.
    Secondly, genetic testing of things like your folate cycle and COMT status might have helped identify micronutrients that may have supported your production of neurotransmitters from the start. I think there is a strong possibility that you have a folate cycle defect that may have resulted in you undermethylating your COMT enzyme which reduced your ability to break down catecholamines, inducing a functional type of bipolar depression.
    This would probably make sense in light of your positive response in regards to change of diet, as by increasing your intake of green vegetables you have undoubtedly increased your folate intake (and by eliminating gluten based products you have reduced your intake of folic acid which your body most likely cannot metabolize efficiently). Your changed dietary habits have also probably improved your intake of many other micronutrients that may support your production of neurotransmitters such as B1, B2, B3, B5, B6 and B12, as well as zinc and selenium, and a host of antioxidants.

    Bonnie Kaplan and Julia Rucklidge have done a tonne of good work on micronutrient supplementation to support recovery from various mental health conditions. Unfortunately not a lot of it is placebo controlled so the results have been largely ignored by the psychiatrists but the research is compelling none the less.

    Personally, I think tapering is likely to be a lot easier if your body has all of the micronutrients it requires to support the production and metabolism of the vast array of neurotransmitters that all combine to create “mood”.

    Once again, all the best with your continued recovery, I look forward to reading your book.

  • Hi Robert,

    Have you considered the potential role of mandatory fortification with folic acid in relation to the increase in suicide rates. This was introduced in the US in 1998 I think and there are a couple of reasons why this might be significant in the US.
    Firstly there is a high percentage of folate cycle genetic defects in the population which means that a lot of people can’t convert folic acid (which is the synthetic form of folate) into the reduced form of folate and ultimately 5 methyltetrahydrofolate which helps to recycle BH4 in the CNS and is ultimately responsible for conversion of tryptophan to serotonin and tyrosine to dopamine and noradrenaline.
    Secondly this failure to be able to process folic acid can result in high levels of unmetabolised folic acid (UMFA) in the blood and UMFA has been shown to block endothelial uptake of the reduced forms of folate (which includes the FOLR1 transporter in the blood brain barrier). The end result of this can be an induced form of cerebral folate deficiency which leads to a deficiency of serotonin in the brain and probably dopamine and noradrenaline as well.
    A recent paper highlights how this might look in depressed patients with 1/3 of patients with treatment resistant depression having cerebral folate deficiency in the absence of FOLR1 mutations.

    https://www.ncbi.nlm.nih.gov/pubmed/27523499

    By trying to reduce the incidence of neural tube defects, the FDA may have unwittingly contributed to the “suicide epidemic” that you are talking about.

    It is certainly a line of research that requires further investigation.