I am submitting this post (and this thread) as a condensed version of my experiences with vitamin depletions/deficiencies. Although condensed, this is still rather long and detailed. I had begun posting this information at the original BrainTalk site, however due to that site’s crash during the Summer and long outage, the continued unknown status regarding restoration of the BrainTalk database (old posts), and inability to find missing information in other locations (e.g. Google caches), I have decided to place this information here. I have performed a lot of research regarding the following issues and have posted data in other areas of this forum (hopefully it will help others), however any input from others (especially with issues that are still not resolved) would be greatly appreciated. I will plan to add further research data that I have come across to areas of this forum as time permits.

Note: It is not my intent to criticize the use of any medications, etc. The meds were real lifesavers for me for years and I still may need to continue on them, but my experience convinces me that meds do deplete vitamins and nutrients. Hopefully putting all the pieces of this “puzzle” together will enable me (and possibly others) to get back to “life as normal”.

Background:
I have experienced chronic insomnia for many years (gradual onset over 20 years ago) and for a long time could find nothing that would help (incl. medications, relaxation techniques, etc, etc.). Then in 1993 the drug Ambien (Zolpidem) was released and I began taking it. It worked and I took 10 mg every night for over 5 years with no problems. My doctor also had me on some other medications with sedative properties for sleep maintenance, but these meds never seemed to do much for me. After about 5 years I began having intermittent neurological side effects from the medication (Ambien) that got progressively worse over the next number of months/years until every time I took the medication I would experience these severe side effects. The only way to alleviate these side effects (over time) was to stop taking the medication, but then I was unable to sleep (a catch-22 situation).

For the past several years I have seen various doctors and have been switched from one medication to another to another (primarily other sedatives, antidepressants, anxiolytics, and other drugs) with little to no benefit. I have also tried "natural" medications for sleep (e.g. valerian, melatonin, hops, etc.), but these were also ineffective. I tried Lunesta (Eszopiclone) after it was released last year and it did help me sleep, but I experienced similar neurological “side effects” from this medication as well. I have continued to ride this medication “merry-go-round” for the past several years, always going back to Ambien or Lunesta until my symptoms get so bad that I have to go back off of them again.

Last year I was prescribed Xanax (Alprazolam) and after taking it for a short period of time I developed a "dullness" in the side of my head, after which I immediately stopped this medication. After a few more months I began experiencing constant headaches in this same area, which along with the dullness, have continued to today. I have also developed issues with hypertension over the past year or so.

After spending much time (probably about 2000 hours over the past 3-4 years on the internet, working as I felt like it) researching these issues without much success, a few months ago I finally began finding information that appeared to explain my symptoms. These explanations centered on vitamin deficiencies. I found that the neurological symptoms related to B12 deficiency appeared to explain my symptoms quite well (ref. rose’s web site for B12 information http://roseannster.googlepages.com/home). I then began taking sublingual B12 tablets, as well as B-complex vitamins. Seeing yet another doctor and going in with a BP reading of 170/100, I discussed these ideas with this doctor and had a number of blood tests performed. B12 tested as not deficient (actually tested high, but was probably skewed as I had already started taking the B vitamins), however Vitamin D was very low. Homocysteine was also high (reference below for applicable test results; these tests were performed during 5/2006). An MRI of my brain showed up as normal and nerve tests of the head and neck showed little to no loss of sensation:

Attachments:
http://neurotalk.psychcentral.com/at...5&d=1162756520
http://neurotalk.psychcentral.com/at...7&d=1162756629

After adding an initial high dosage of 10,000 IU/day of Vitamin D3 (cholecalciferol) to my regimen, a few weeks later I found information on a lab that specializes in vitamin/nutrient testing, SpectraCell Laboratories (http://www.spectracell.com/). SpectraCell test results showed an additional substantial depletion/deficiency of zinc and a somewhat below-normal level of Vitamin E. Cholesterol was a bit high (known), Lipoprotein-a (Lp(a)) was high (unknown), however there had been a significant decrease in homocysteine (tests performed during 6/2006):

Attachments:
http://neurotalk.psychcentral.com/at...8&d=1162756782
http://neurotalk.psychcentral.com/at...9&d=1162758249
http://neurotalk.psychcentral.com/at...0&d=1162758307
http://neurotalk.psychcentral.com/at...1&d=1162758330
http://neurotalk.psychcentral.com/at...2&d=1162758368
http://neurotalk.psychcentral.com/at...3&d=1162758407

Note: I can provide more information on SpectraCell Laboratories, if anyone is interested.

Several weeks later and after more research, I also requested the following tests from my doctor (performed during 8/2006, some of these were not covered by SpectraCell):

Attachment:
http://neurotalk.psychcentral.com/at...6&d=1162756575

I have added other vitamins/nutrients over the past few months per additional research (for example adding Vitamin B6 (P5P) and folic acid (Metafolin), along with the B12 (Methylcobalamin), to control homocysteine). I have also found benefit (some improvement in neurological symptoms) with Acetyl-L-Carnitine. I have however been unable to find anything as yet to reduce the nerve "dullness" and headaches. Most of the pain medications that I have taken haven’t seemed to help much. Hypertension appears to be under control and I am currently taking 25 mg/day (fairly low dosage) of Toprol XL for this, however I suspect the previous Vitamin D depletion/deficiency was the main cause of the hypertension.

Much of my research has centered on drug-induced vitamin/nutrient depletion utilizing resources such as the “Drug-Induced Nutrient Depletion Handbook, 2nd Edition” http://www.lexi.com/lexistore/market...0000/index.jsp, which is very detailed and well referenced (please see Medication/Drug Induced Vitamin/Nutrient Interaction/Depletion References for various other references). Unfortunately many drugs have not been tested for vitamin depletion (see p. 10 of this handbook under "Limitations of this Handbook"), including most of the drugs that I have taken. I have found by "deduction" however that sedative drugs that act on the GABA-A receptor complex (ref. http://wings.buffalo.edu/aru/PSY402C06.doc, Univ. at Buffalo PSY402 course notes for info. on the GABA-A receptor), such as Ambien, Lunesta, and other drugs such as benzodiazepines, "may" deplete similar nutrients as certain anticonvulsants that also act on GABA-A (see p. 500-501 of the handbook for an excellent chart of nutrients depleted by anticonvulsants, and note that Vitamin D, many of the B vitamins, Vitamin K, and others are depleted by practically all of them).

…

I am hoping that continued use of vitamins and nutrients will eventually help the “dullness” and headaches, but if anyone has any additional recommendations (especially with regards to nerve damage, such as the trigeminal nerve(s)), this would be very appreciated. I am a middle-aged male, otherwise relatively healthy and not overweight, if that makes any difference. I suspect the vitamin/nutrient deficiencies had lasted a long time as I had experienced the abnormal drug “side effects” for several years. I will probably need to continue taking sedatives for sleep, but hopefully I can utilize a comprehensive vitamin/nutrient regimen that will alleviate depletions and side effects. I will plan to submit an additional post soon documenting my current vitamins/nutrients.

...

P.S.
I found there is a limit of 5 attachments/post, so additional post(s) will be added to accommodate attachments.

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There was a study that showed CoQ10 helps some folks with migraine prevention. Same with magnesium. I believe the recommended dosage for the CoQ10 is 300 mg. I started off with 150 and worked my way up...it can cause stomach upset initially.

You need to correct any methylation problems you have in order to properly correct your homocysteine (HCY) levels. Without knowing your histamine levels or how your body methylates (over-methylates or under-methylates) you can't know what form of niacin to take.

One simple test you can do yourself is to get some nicotinic acid in a 50 mg. dose. Nicotinic acid is the flush producing niacin. If you have a flush from one dose of 50 mg. of nicotinic acid (taken on any empty stomach) then you have histamine levels. I would be inclined to think you may not have high histamine levels, but that is just a guess.

A low histamine person would probably require a dose of about 250 mg. of nicotinic acid to have that flush. If no flush from 50 mg. of nicotinic acid then you might try 100 mg. dose to double check this. If that doesn't work you might try once more a total of 200 mg. or 250 mg. of nicotinic acid just to make sure that you do in fact have low histamine levels and that supplement is the kind to cause a flush.

Methylation is important and this is how you get your HCY levels back in line. Even if you HCY levels are good you should not ignore nutrition for proper methylation. But if you take vitamin b6 then you should also take some form of niacin too. The only way to know what form of niacin is best for you is to either have your histamine levels checked with a blood test or try the flush and see what dose will cause a flush for you. Niacin is needed along with glutamine to make NAD. This is more of an explanation of NAD.

Niacinamide-adenine dinucleotide (NAD) is an active enzyme that is required for the proper function of vital areas of the brain. In schizophrenia, there appears to be a failure to deliver enough NAD to the brain. Vitamin b3 is required for the transformation of tryptophan, an amino acid, into NAD. If there is a niacin deficiency, this necessary transformation of trypotphan into NAD is inhibited, and there is not only a NAD deficiency established, but there is also an overload of tryptophan in the brain’s chemistry. Tryptophan is considered to be one of the most toxic of amino acids. An overload of it in the brain can be very harmful, especially if it is not properly converted into NAD, because it can cause undesirable perceptual and mood changes. If there is a b3 deficiency, for whatever reason, the consequent NAD deficiency will lead to ever-increasing tryptophan overload uninterruptedly unless and until the proper levels of b3 are given.

Source: Brain Allergies: The Psychonutrient Connection by William H. Philpott, MD and Dwight K. Kalita, Ph.D.

Taking high doses of nutritonal supplements is how you correct any king of nutritional deficiencies you may have. But taking high doses of nutrtional supplements is a lot like taking drugs and should only be done with the proper medical supervision. Sometimes people try some supplements which may not make them feel any better, and that is not because they don't have deficiencies but they are not taking either the proper doses or the proper combo of nutrients. If you miss just one nutrient in this process you can end up causing a whole net set of symptoms. You really need to work with a qualified doctor who has experience with treating nutritional deficiencies. I happen to think that orthomolecular training is great but not many doctors have this kind of background. It is not easy to find someone who knows how to treat nutritional deficiencies.

The internet may have a wealth of information, but sometimes you also have to do research with other sources, like books, articles, forums, etc. But, the right doctor is absolutely critical to this process.

to clarify the statement that tryptophan is toxic.

From what I have learned about tryptophan is that it is converted to
niacin in ratios of 60mg tryptophan =1mg niacin.

It is an essential amino acid, and will also enhance formation of serotonin.
This later effect IN EXCESS is undesirable in schizophrenia. Some researchers
have found increased positive symptoms when serotonin levels increase in this patient population. (hence SSRIs are not recommended typically either).
http://www.acnp.org/g4/GN401000117/CH115.html

However, when reading ortho's post, it was not clear about that reference to
tryptophan. I would not call it "toxic" myself. This is a rather loaded word, and open to misinterpretation.

Tryptophan has to be transported across the blood brain barrier and is often blocked by 8 other aminos. So typically this feature prevents excessive
movement into the brain.

Tryptophan is toxic. But finding this reference on the internet is not that easy.

"In people who are even marginally vitamin B6 deficient, tryptophan may be rapidly degraded into mildly toxic metabolites such as hydroxykynurenine, xanthurenic acid and hydroxyanthranilic acid."

source:
http://intelegen.com/nutrients/ltryp...nswer_to_p.htm

Tryptophan will not pass the BBB from eating a high protein meal because it has to compete with other amino acids. That is why people craving carbohydrates may be low in tryptophan or serotonin. A high carb snack is the best way to supplement tryptophan or 5-htp so that it gets into your brain. And it is better to take 5-htp with a high carb snack than on an empty stomach. And if you don't have a b6 deficiency you may still want to supplement b6 when you take 5-htp (or tryptophan) just to be safe.

Tryptophan is considered a potentially toxic amino acid. There is no misinterpretation about that statement. HOW it becomes toxic depends on which of several different pathways it can follow in the brain. But this toxicity is not that commonly known about. And if not supplementing enough of ALL necessary b vitamins (in the right doses) then it is likely to become toxic.

I think if anyone wants to increase their tryptophan levels they would be better off taking some form of niacin (with vitamin b6, of course).

Orthomolecular

I am interested to know if you are a physician, or a pharmacist, or in any other way qualified to make such emphatic statements and recommendations?

Or are you stating your opinion, based on your own experience and/or research?

As previously mentioned, here is my current vitamin/nutrient regimen. This continues to be subject to change as research continues. I started out with a higher dosage of some of these and then reduced down to a "maintenance" level. I have also tried some other nutrients/herbs/amino acids, but have not continued on the ones that didn’t seem to help. One of the nutrients I tried was magnesium taurate, but it didn’t seem to help with the headaches and I also had an initial negative reaction between it and the Toprol XL, so I am not taking it right now.

Thanks for any input!

Note: I am providing my neurologist with these supplement lists.

It is your interpretation that my statement was emphatic. It is not my opinion if it is based on facts.

I stated a fact that I supported with one website and one reference from a book I own. Philpott is an MD, the other other of that book, Kalita, is a phd.

Asking me a personal question is making this personal about me. I won't dignify that question.


http://www.ceri.com/fftrypto.htm
"In addition, tryptophan catabolism in the brain and peripheral tissues produces toxic chemicals which stimulate excitatory neurotransmitter pathways."
"Given the known adverse influences of some IDO-induced tryptophan metabolites, supplementing tryptophan may be an inappropriate strategy."

Another reference to tryptophan metabolites (that are potentially toxic) but in reference to AD.

http://www.ncbi.nlm.nih.gov/entrez/q...&dopt=Abstract

One subcellular mechanism which may underlie degeneration of neurons in AD is decreased axonal transport with accumulation of enzymes and their potentially toxic metabolites in the cell body.

These three metabolites of tryptophan are toxic: hydroxykynurenine, xanthurenic acid and hydroxyanthranilic acid. Therefore tryptophan can be toxic if it is not converted properly. That toxicity depends on the pathway it takes in the brain. To avoid the possibility of toxicity there has to be enough b6 and niacin.

http://www.pubmedcentral.nih.gov/pic...6&blobtype=pdf

Actually Orthomolecular, I wasnt referring to any one particular statement or recommendation........and I was INTERESTED not being critical

I have noticed that you often have very fixed views and do, in my opinion, make very emphatic statements and recommendations and so I was just curious as to whether this was from training, or experience.

Emphatic usually means people are confident in what they are talking about, so sorry that you took it as some kind of personal criticism. It was not.
It was simply a question based on observation of your detailed posts.