The closest I can come to a warning about sorbitol is this:
http://www.corexcel.com/rw/html/body...tion_page1.htm
Mannitol and mannitol/sorbitol mixtures are used to reduce
cerebral edema, clinically.( following stroke or head injuries).
But I cannot find if sorbitol crosses the blood brain barrier, yet.
I will still look around when I get a chance, and post it here.
Typically with drugs, if you withdraw the suspected agent, allow time (say 2 weeks to wash out) and reintroduce it, that should tell you. So if you reintroduce sorbitol and keep a log, and she gets ill again, you will know definitely. You are forwarned so stopping it quickly at first sign of problems, won't be as bad as the first time.
Another thing to look out for are drugs for cholesterol treatment. In the elderly they cause confusion and loss of memory. The elderly can also get hyponatremia (from drugs, including SSRI antidepressants), and with hyponatremia the
delerium is similar to Alzheimer's.
I found this older article about sorbitol metabolism. I can't find a url for it in adobe (adobe drives me nuts sometimes)...so this is a copy of the Google search with link:
Quote:
[PDF]
The Metabolism of Sorbitol in the Human Subject
File Format: PDF/Adobe Acrobat - View as HTML
of the metabolism of sorbitol in. man. Our initial. experiments. were. with- unlabelled sorbitol,. and. showed that after. an. oral dose of ...
www.biochemj.org/bj/065/0554/0650554.pdf - Similar pages
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What I am thinking, is that we know that the blood brain barrier in the elderly DOES change.
We know that common drugs that in younger people do NOT cross the blood brain barrier, DO in the elderly. This accounts for some of the delirium seen with drugs. For example: Zantac and Pepcid, two common OTC acid blocking drugs can cause serious issues with the elderly.
So while I cannot find proof that sorbitol crosses the blood brain barrier, I am wondering if it does, especially in the elderly.
While searching for this I found a new PubMed paper on MS...which indicates that increased sorbitol occurs in the spinal fluid of people with MS...
This is the article:
Quote:
J Neurol Sci. 2008 Dec 15;275(1-2):106-12. Epub 2008 Sep 9.Click here to read Links
Cerebrospinal fluid evidence of increased extra-mitochondrial glucose metabolism implicates mitochondrial dysfunction in multiple sclerosis disease progression.
Regenold WT, Phatak P, Makley MJ, Stone RD, Kling MA.
University of Maryland School of Medicine, Department of Psychiatry, Division of Geriatric Psychiatry, Baltimore, MD 21201, USA; Baltimore Veterans Affairs Medical Center, Research Service, Baltimore, MD 21201, USA.
In contrast to relapse, the mechanisms of multiple sclerosis (MS) disease progression are less understood and appear not to be exclusively inflammatory in nature. In this pilot study we investigated the relationship between disturbed CNS energy metabolism and MS disease progression. We tested the hypothesis that cerebrospinal fluid (CSF) concentrations of sorbitol, fructose, and lactate, all metabolites of extra-mitochondrial glucose metabolism, would be elevated in secondary progressive (SP) MS patients and would be associated with worsening neurologic disability. We measured metabolite concentrations by gas chromatographic/mass spectrometric and enzymatic methods in archived CSF samples from 85 MS patients [31 relapsing-remitting (RR) and 54 SP patients] and 18 healthy controls. We found that concentrations of all three metabolites, but not concentrations of glucose or myoinositol, were significantly increased in CSF from SP and, to a lesser degree, RR patients, compared to controls. Furthermore, CSF concentrations of sorbitol and fructose (polyol pathway metabolites), but not lactate (anaerobic glycolysis metabolite), correlated positively and significantly with Expanded Disability Status Scale (EDSS) score, an index of neurologic disability in MS patients. We conclude that extra-mitochondrial glucose metabolism is increased in MS patients and is associated with disease progression evidenced by increasing EDSS score. As extra-mitochondrial glucose metabolism increases with impaired mitochondrial metabolism of glucose, these findings implicate mitochondrial dysfunction in the pathogenesis of MS disease progression. CSF metabolic profiling may be useful in clarifying the role of mitochondrial pathology in progression and in targeting and monitoring therapies for disease progression that aim to preserve or boost mitochondrial glucose metabolism.
PMID: 18783801 [PubMed - in process]
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When glucose is metabolized by the cells in the body, a small amount of sorbitol is made as a byproduct. This is called the polyol pathway. It is possible that larger amounts ingested orally may compound this issue, especially in an elderly patient. And even more especially in a diabetic.
In that PDF on metabolism it states that the body rapidly metabolizes sorbitol away as carbon dioxide.
So while I know this seems complex... I do think you have some issues with sorbitol. And also keep in mind in the elderly drugs do not work as they do in younger patients. I have not found concrete papers on sorbitol and dementia or delirium. But I will keep on looking.
This site which I have used many times...and think is very complete..does not include mental
status changes with sorbitol:
http://www.umm.edu/altmed/drugs/sorb...ental%20Status
However, if your mother was developing some METABOLIC change due to the sorbitol, that could
induce some delirium. Sort of a second hand effect.
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All truths are easy to understand once they are discovered; the point is to discover them.-- Galileo Galilei
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Weezie looking at petunias 8.25.2017
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