Supplements are a great way to help our brains recover from the trauma, and to also feel better while in the process of recovery.

I feel there are some mistakes people do with supplements that are sometimes potentially dangerous.

Here are a few warnings you should know about supplements:

1. Vitamin B6 is an important vitamin, since it is mainly required for the synthesis of neurotransmitters (it is a cofactor). High doses (especially 100mg+) of B6 are suspected of being neurotoxic, causing neuropathy with extended use. The nerve damage from overdoses of B6 can be either temporary or permanent. The recommended daily intake is 1-2mg, but most supplements contain 50mg or more, at least 25 times the recommended daily intake (especially in B-50 Complex supplements). B6 toxicity cannot happen when it is supplemented from natural sources, because it is easily degraded by the body when no more is needed. Therefore, if you want to take B6, try to find a supplement with doses as close as possible to 1-2mg of it.

2. 5-HTP is a supplement sold for improving anxiety and sleep issues. It is metabolized to Serotonin in the body and in the brain (it can cross the blood-brain-barrier). The problem here is that serotonin is cardiotoxic, causing damage to the heart valve (by activating 5HT-2B receptors on it), which ultimately requires an heart valve replacement surgery. Rats treated with long-term, high doses of serotonin show heart valve damage. There is no solid evidence for this kind of toxicity happening in humans, but it is heavily suspected that it's possible. Therefore, if you take 5-HTP, you should take it with an AAAD inhibitor - AAAD is the enzyme that converts 5-HTP to serotonin outside of the brain. An inhibition of this enzyme will cause the 5-HTP to be metabolized ONLY inside the brain, leaving the heart unaffected. A good inhibitor of this enzyme is EGCG, which is found in green tea and can be bought as a supplement itself. Also, make sure not to take too high doses of 5-HTP if you do.

Now, I have a few questions to people who already take supplements here:

1. Is Magnesium potentially neurotoxic? Antagonists of the NMDA receptor (such as Ketamine and Dextromethorphan) produce Olney's Lesions, a type of brain damage, when they are given to rats (NMDA receptors bind Glutamate, which excites the neuron and generates an action potential). Magnesium is a non-competitive antagonist of the NMDA receptor. If NMDA receptor antagonists produce brain damage, and Magnesium is a non-competitive antagonist of this receptor, can it produce brain damage as well? Can Magnesium help with nerve regeneration and reconnection in the brain after an injury?

2. Why is it recommended in the supplements thread to take Magnesium with Calcium? From what I've understood, Magnesium and Calcium are antagonists of each other; Magnesium tends to be inhibitory, while Calcium tends to be excitatory in nerve tissue (Calcium is required for the generation of action potential by Glutamate). From this reason, wouldn't it mean that taking a supplement that combines them will cause them to cancel some of the effects of each other? And can Calcium specifically help with recovery?

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My personal planned supplement stack (all of them are in pill/capsule/tablet/softgel form unless stated otherwise):

Omega 3 - 500mg EPA/250mg DHA/day
Vitamin Methyl-B12 - 1500mcg/day
Vitamin D3 - 5000IU/day
Magnesium Citrate - 200-500mg/day

Melatonin - 0.3mg (only taken at night, never during the day)

I am already taking 1mg of Melatonin right now, as a matter of fact, and it is helpful for sleep. I would like to reduce the dosage to 0.3mg, however, since I've heard lower doses work better.

I know many other supplements are recommended in the thread - I've chosen these because they seem the most important to me for recovery, dealing with ADHD and OCD. I'm quitting Adderall entirely next week, and would only take supplements for my ADHD (this decision is final - the side effects of Adderall just got too bad for me to handle).

What do you think? Are the dosages OK?

What side effects did you experience with Adderall that have made you decide to quit?

Personally I think looking at what we eat should come before deciding on a vitamin supplement regime. Eating fresh fruit and vegetables, cutting back on red meat, caffeine, alcohol, processed foods and especially sugar are likely to be more beneficial in the long term.

I should have said, take calcium with magnesium. Calcium is important but problematic without adequate magnesium. They are often sold together.

I have always said to take the minimum amount of 5-HTP to get a benefit. More is not better. If 50 mgs does not help, try 100.

SSRI's can cause high serotonin and other problems. For people who are struggling to have enough serotonin, rather than taking an SSRI, take a small amount of 5-HTP (or L-Tryptophan) and slowly dose up to get benefit. I do very well with 100 mgs. It took high doses of an SSRI to get the same effect.

From ncbi:

Vitamin B6 (pyridoxine) causes neuropathy at intakes of 1000 mg per day or more, which is about 800 times the daily intake from foods. There have also been occasional reports of toxicity at intakes of 100-300 mg per day.

50 mgs is rarely a problem. My doctor recommended more than 50 mgs.

The recommended daily intake of 1-2 mgs is to prevent B-6 deficiency, not to prevent B-6 toxicity. The report linked has cited many maximum doses. 500 mgs or 8 mgs/kg is considered the maximum safe level to avoid a risk of B-6 pathologies. 100 mgs showed a non-statistical difference in some subtle neurological functions.

But, more importantly, the full range of B vitamins is important. Folic acid is important to maintain the blood brain barrier and myelin sheath repair. There are other B vitamin balancing factors that I have read but did not focus on because a B-50 Complex addressed these issues without needing to take individual B vitamins other than supplemental B-12.

Thiamine (B-1) is important, Riboflavin (B-2) is also. And niacin. My doc who started me on the regimen actually had me taking additional thiamine and niacin. He gave me weekly B-12 injections until I was 'over the hump' with my symptoms. From then, I took B-12 supplements.

There is increasing evidence that daily, long-term supplementation of vitamins may not only not be beneficial, but may also increase some disease risks. Many nutritionists actively advocate against daily supplementation. Issues with supplementation have only started to become recognised, and over the next decade I suspect more information on this will be synthesised.

Personally I believe the vitamin regime advocated on this site is done too freely. I believe individuals within the first 3 months are likely to derive some benefit from the supplementation, but past that it is too sweeping an assumption to believe that all individuals will benefit from it. Recall, each concussion is unique and what works for one certainly should not be applied universally to all others.

Factor in some known risks, and possibly risks not identified, and I think daily, long-term supplementation should be considered thoroughly.

Eating a healthy, balanced diet is the safest strategy towards wellness.

Eating a balanced diet is very difficult these days.

I'd like to see the evidence of the harmful use of supplements.
Surely the extreme dosing and typical high dose use by body builders, does cause concern. But for the doses suggested here, which are very moderate, that is another thing entirely.

Many people today use acid blocking drugs chronically and this alone creates a malabsorption issue with deriving benefit from the nutrients in foods. Removing acid from the stomach impairs
Calcium, magnesium, iron, zinc, B12, folate and some trace minerals like copper and chromium.

Many people therefore are suffering from hidden low values of B12, folate, magnesium, and Vit D as well. Studies show many do not receive the RDA in magnesium alone, in fact.

Also 10-30% of people have the DNA mutation for methylation systems, which are called MTHFR. This means they need a special B12 and folate (methylcobalamin and methylfolate) in order to make neurotransmitters as well as metabolize food properly, and make normal blood cells. People with this DNA error may just starve in the midst of plenty.

People may be gluten intolerant and have inflamed GI linings and not absorb food nutrients properly. Crohn's disease also
is well known for causing many nutrient deficiencies.

So being the diverse population that we are, we cannot really trust blanket statements like some are making here against using supplements.

People can get tested for many nutrients today. Vit D, B12, B1, and B6 can be tested for, from your doctor.

You have highlighted specific segments of the population, which actually supports my argument. As I had stated, the blanket statement that everyone reading this forum should get on the vitamin sticky regimen is, in my opinion, something that should not be done. Many may not be informed that there are possible negative outcomes associated with long-term vitamin supplementation. In my personal opinion the recommendation to get on the vitamin sticky regimen is misguided and inappropriate. Every concussion is different and individuals may or may not need such supplementation

Recommending someone have blood testing for potential vitamin deficiencies and subsequently developing a vitamin regimen based on the results is completely different. This is both appropriate and possibly relevant for people recovering from an mTBI, and would be done under the care of a physician rather than through and e-based forum suggestion. I think the moderators should carefully consider restricting such endorsements, and I have to admit I'm surprised that this is not only permitted but appealingly endorsed.

On the note of a healthy diet, I do not think this is difficult to achieve if one chooses to do so. We have a globally-enabled food supply with a wealth of choices available usually year-round (e.g. season-based produce are no longer seasonal). However, for a minority of the population they may be faced with challenges (lactose intolerance, vegan, use of proton antagonists, etc) in which other choices are needed. If the diet is unable to meet nutrient needs, then of course supplements are a viable option.

As for the supportive literature, if I feel I'm up to it I'll see if I saved the articles or whether I need to find them again. As an aside, I worked closely with high-level human nutrition researchers who specifically study supplementation and not one of them recommends a daily vitamin. Even supplementation of our staples (milk, bread, grains, etc.) is being evaluated in at risk populations, particularly pregnant women. I suspect the next decade of macro and micro-nutrient research is going to illuminate a number of issues with community and self-administered supplementation, but this is speculative on my behalf and may not be true.

How is eating a balanced diet difficult these days? We have access to more food types from around the world than ever before and healthy organic produce markets in every town. Vitamins are more easily adsorbed via natural foods rather than synthetically. I'm not saying vitamin supplements are bad but taking then without knowing whether you are deficient in them is a hit and miss affair and could be harmful. I think it has to be judged on an individual basis rather than glibly recommending the taking of vitamins for everyone. Before we know it we'll have fluoride in the water supply ;-)

@ MicroMan.... I am ever waiting to see you post links to
valid studies showing your point of view.

The people who tend to end up on NT IMO, as I have been here since 2006, are those who are not healing well, who have been overlooked by numerous doctors who do not check for low B12, accept the horrid side effects from several drug families, (acid blocking drugs, fluoroquininolones, statins) and need interventions of certain nutrients, and have other masked and/or unidentified chronic issues.

Many of them find that replacing certain nutrients (not just taking a daily multivitamin), helps them considerably. The MS forum is one that uses certain things to treat MS...vitamin D, and a few other things. Our PN forum, has several nutrients that help with nerve pain, and we also recommend lowering sugar and white carbs in the diet, and avoidance of foods that may have histamine consequences.

What we discuss here on NT is not the same as Yahoo news items, or other typical internet self help dietary advice.
What I have seen HERE are people suffering from MTHFR mutations who doctors don't even know what that is! People going to 5, 10, yes and even more doctors, who never have tested them for B12 levels.

Here is one example of what is going on in medical offices in this country:
https://www.youtube.com/watch?v=BvEizypoyO0

So I would like to see some links from you. No hurry...
And I'd like to reiterate, that I have not seen anyone on NT suggesting all adults in the US need to take a daily multivitamin. The people who come here are damaged, and need healing help. Check out Dr. Blaylock MD's website. He was recommending certain nutrients to his neurology patients long before this board, or the complementary medical movement. He is now retired but was a neurosurgeon for many years. He follows the research closely and offers a newsletter for a small fee to share his current opinions and insights.
http://www.blaylockreport.com/about_blaylock.html

Rather than dig out individual papers, as I cannot find the ones I had, here is an editorial I recall reading from Annals of Internal Medicine (2013) on vitamin supplementation and measure outcomes linked to controlled and often ranked studies.

Enough is enough: Stop wasting money on vitamin and mineral supplements
http://annals.org/article.aspx?articleid=1789253

Some of the doses, if I recall correctly in the vitamin sticky being recommend to our recommended are highish in nature (note: pretty much every first-time poster is told to follow the vitamin sticky regimen). As the article highlights, danger is in the dose.

Also, I am glad that you are familiar with so many of our community but I think it is likely fair to say that you are not familiar with many of our health dispositions. Assuming that most of the population is the minority for allelic issues, nutrient deficiencies, etc. is not responsible.

The reason why I am speaking up about possible issues linked to vitamin supplementation is that each time I see it being promoted to a member I think of the possible risks that are associated with this regimen. It makes me very uncomfortable, particularly when several of the vitamins being endorsed for daily supplementation have been linked to early mortality and/or cancer.

It is my opinion that people should be presented with information such that they make an informed decision. I think people should be encouraged to work with their physician, endochrinologist, etc. to have tests done so that accurate supplementation, if needed, be used. This may allow some micro/macro-nutrients linked to risks be avoided. This seems sensible and responsible. Having an intensive vitamin regimen associated with high levels of many vitamins and minerals without any risks presented is irresponsible, and, as I said earlier, I'm surprised it is permissible.

Information is always a good thing, and right now the picture of vitamin supplementation here on Neurotalk is not balanced.