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What's wrong with me? Feel soooo awful...

Discussion in 'General Treatment' started by MMe, May 27, 2013.

  1. MMe

    MMe

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    Hello everyone, I've been reading on this wonderful forum for a few months already. Hoping to find something that will help me to feel well again...:(
    I'm 46, and going through perimenopause.
    Since 18 months, I'm suffering of terrible anxiety/depression. I also have 'adrenaline rushes' when I wake up en when I go to sleep. I can open a shop with all the supplements I've already tried... :(


    Today I received the results of a urine/blood-test. Can someone please help me to interprete them?
    Urine:
    Dopamine: 288 (137 - 338)
    Homovanilline acid: 3 (2 - 4,9)
    MHPG: 1,4 (1,4 - 5,10)
    VMA: 2,6 (2 - 4)
    Serotonin: 70,9 (41 - 120)
    Noradrenalin:: 40 (17 - 40)
    Adrenalin: 4,19 (1,7 - 6,6)
    Metanefrine: 121,9 (41 - 91)
    Normetanefrine: 145,8 (103 - 230)

    Blood:
    Cortisol: 21,5 (7 - 25)
    Transcortin: 67 (20 - 50)
    Free Cortisol: 8,5 (10 - 30)
    ACTH: 20 (must be lower than 46)

    Vitamin B6: 86 (88 - 456)

    My omega 3 also is too low.

    My homocysteine was 6,8 and last year 5,1.
    Vitamin b12 was 567
    Folic acid in rbc: 226

    I ordered a 23andme test to see if there is something wrong with my methylation. Didn't receive the results yet...


    Please, I do feel so awful. Does anyone has some good advise for me? Seems like there is something going on with my adrenals, although my total cortisol is fine. I can't live with this anxiety/ depression anymore. But I'm afraid of taking regular meds like antidepressants because they mask a symptom, but don't cure the cause.

    Thanks in advance!
     
  2. Ema

    Ema Senior Member

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    Transcortin is a carrier protein for cortisol, progesterone, aldosterone, etc. It is mediated by estrogen. So when it is high like yours, generally that means high estrogen which is especially common in perimenopause. Lowering the estrogen level will usually lower transcortin and allow for the free cortisol level to come back up and alleviate some symptoms.

    I would look at doing a saliva cortisol test to see if that supports your bloodwork (ie low free cortisol). Then I would also test your sex hormones, particularly estrogen, on day 21 of your cycle to see if it is high and if progesterone is low.

    I would also test thyroid, specifically TSH, FT3, FT4, and RT3 along with thyroid antibodies, TPOAb and TgAb because low thyroid is especially implicated in depression and anxiety.

    I would look at taking a good B complex at least once or twice a day and sublingual methylB12 lozenges to help with methylation. Fish oil would also be a good choice in my opinion.

    Ema
     
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  3. Valentijn

    Valentijn Activity Level: 3

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    This is somewhat interesting. Aside from serotonin, all of these substances are created from (or create) each other. Basically dopamine turns into norepinephrine which turns into epinephrine. And HVA is a byproduct of dopamine, MHPG and normetanefrine are byproducts of norepinephrine, metafrine is a byproduct of epinephrine, and VMA is a byproduct of both normetanefrine and metanefrine.

    With Dopamine and HVA being in normal range, it's probably safe to assume that the problem is happening downstream from there. There might be an MAO problem. MAO controls the degradation normetanephrine and menatephrine to MHPG. It also controls the degradation of epinephrine and norepinehprine into a substance (let's call it X) that wasn't tested.

    My best guess (and it is entirely a guess) is that because of lowered MAO activity, norepinephrine is having trouble degrading to X, causing it to get high. And perhaps normetanephrine is somehow self-regulating enough to stop breakdown of norepinphrine into too much normetanephrine. So then some of the excess norepinephrine becomes epinephrine, and the excess is broken down into norepinephrine. But because of the MAO problem, the excess metanephrine can't break down into MHPG (or at least not at a normal rate), causing low MHPG. MHPG then has no problem breaking down.

    http://physrev.physiology.org/content/89/2/535/F3.large.jpg has a nice diagram, including the enzymes (MAO, COMT, etc). It's not clear how MAO activity can be increased, but cysteine is an essential part of MAO, and if some of the cysteine is substituted with serine, the MAO ceases to function. So it might be useful to know your cysteine levels, or try supplementing it to see if that helps with anything.

    What time of day was the cortisol taken? It looks like it would normal for a morning value, but quite high at any other time of day.

    It sounds like transcortin is used to transport various amounts of various steroid hormones. High estrogen (such as during pregnancy) can raise it, as can some genetic disorders. Free cortisol is likely low due to transcortin being elevated and binding a larger percentage of total cortisol.

    Easy to supplement :thumbsup: Just be careful not to take too much B6, as it is fat soluble and overdosing is possible.


    These aren't really useful without the ranges (or at least units).
    Excellent. I'm curious to see if my wild guess about MAO issues might be right, and MAO does get tested. I'm getting my test kit tomorrow to check out my own data :)
     
    Emootje likes this.
  4. MMe

    MMe

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    Ema, Valentijn, thank you so much for your answers. I'm too tired now to understand them completely. I'll read them carefully tomorrow and will give you some more information about my bloodwork etc. But it's nice to know that I'm not alone any more in this situation... There seems to be no one here in Belgium (you will have noticed already that my English is not very well... :love:) who has ever heard of 'methylation', or other things that are discussed on this forum. So I feel pretty alone these days...
     
  5. Sushi

    Sushi Moderator and Senior Member Albuquerque

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    MMe

    Hi, if you are in Belgium Prof. Kenny De Meirleir is very familiar with methylation and most everything that we discuss in this forum.

    Best wishes,
    Sushi
     
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  6. Little Bluestem

    Little Bluestem Senescent on the Illinois prairie, USA

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    Is the P5P form of B6 fat soluble?
     
  7. Valentijn

    Valentijn Activity Level: 3

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    Actually it looks like I was wrong about it being fat soluble (that's the usual reason a vitamin needs to be limited). In the case of B6, the limitation in dosing is due to the toxicity that can result from over-supplementing pyridoxine. P5P has pyridoxine as one of its components, so toxicity concerns are still relevant.
     
  8. Clodomir

    Clodomir In hibernation mood

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    Hi,
    I am Belgian too. i go to Kenny De Meirleir.
    There is a forum in flemish for people like us, where you can find different doctors like Kenny De Merleire, dr hulstaert, etc...
    I read it frequently. It is helpfull also.
    The address http://www.me-gids.net/

    Have a good day

    Clodomir
     
    Valentijn likes this.
  9. MMe

    MMe

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    Thanks!
    I've heard about KDMerleir. Will look for more information about him. But at this moment, by budget is limited and I can't afford his expensive tests...

    Some more information:
    * Cortisol was indeed taken in the morning. So my total cortisol is ok, free cortisol too low and transcortin too high.
    * B12: 567 ng/L
    Folic acid in serum: 7,5 microgr/L (2 - 14)
    Folic acid in rbc: 205 microgr/L (140 - 628)
    Homocysteine: 6,8 micromol/L (bloodtest march 2013)
    5,1 micromol/L (bloodtest august 2012)
    MMA (methyl malon acid): 2,9 mg/g creatinine (0 - 3,8)
    Gluthation peroxydase: 57 U/g Hb

    First I thought that the low homocysteine of last year was very good. Then I learned that it could be a sign of overmethylation. But in March of this year, my homocysteine was 6,8... A normal value I think.
    My levels of B12 have always fluctuated (B12 is tested every year). From ± 250 to 950 (depending on the supplements I took). But my MMA is normal, so I don't need extra B12?

    Valentijn, your MAO explanation sounds very plausible. Is it possible I also do have a CBS upregulation? (because of the 5,1 homocysteine last year). And what about my folic acid? Too low?

    My vitamin B6 is too low and I've read that cysteine needs B6 and sulfur... Is this another fact that points out to overmethylation/CBS upregulation?


    The anxiety/depression is horrible. The adrenalin surges too (they always start at 5 a.m.).
    In 2012 I had a partial hysterectomie (fibroids) and after that I developed IC (interstitial cystitis). When my bladder hurts, my panic attacks also increase. There is a strong link between them. (Histamine? MCAD?)
    I also have itchy armpits (strange and very uncomfortable):(, and muscle spasms around my mouth.


    Since january I've canceled gluten, mais and (almost all) millk. I drink 1 cup of coffee a day.
    This morning I've started with a balanced B-complex (200% of the daily value). And fish oil caps.
    At night I use a little natural progesteron cream (last 14 days of cycle).

    I hope this information makes the picture more complete.
    Any advice is welcome!
    Tnx!
     
  10. Clodomir

    Clodomir In hibernation mood

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    Hi,

    About KDM
    Some test are reimbursed... ( not a lot). You can always explain your budget problem and he understand. You can also refuse some test. My sister do that sometimes, and there is no problem. She is still her patient since 15 years...
    So don't be afraid. Go with your analysis, he can maybe work with them.
    Maybe an advice, can be useful.

    Have a good sunny day

    Clodomir
     
  11. xks201

    xks201 Senior Member

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    The elevated transcortin causing low free cortisol is clearly a problem, if not THE problem. I am unaware of how to lower transcortin other than potentially the estrogen modification another poster mentioned here.

    Synthetic glucocorticoids like prednisone and dexamethasone I believe bypass transcortin. Therefore they may be able to alleviate your symptoms.
     
  12. MMe

    MMe

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    Thanks xks201! What I've found about transcortin on the internet is that it is indeed linked to estrogen (high levels of estrogen cause high transcortin levels, which happened for ex when I took a bcp to control my fibroids, a few years ago. Wrong, wrong... I learned afterwards, because high estrogen feeds fibroids...)
    But high transcortin levels are also linked with 'adrenal dysfunction'. And I do have some trouble with my adrenals too...

    My total estrogen is lower than ever (cf perimenopause) but it seems that I still am estrogen dominant, although I use natural progesteron cream at night. I've read somewhere that even this cream can be converted to estrogen in your body. Don't know if that's the case with me... But the NPC makes me sleep better:)

    I've tried hydrocortisone and prednison. They make me feel awful and very anxious.
    And because my total cortisol is ok for the moment, I think it's better not to add more cortisol to my body.
    Honestly, I think there's nothing wrong with my adrenals, the problem is situated 'upstream'.
    THE question: where?:(
     
    Valentijn likes this.
  13. MMe

    MMe

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    I've been 'studying' on the MAO defect Valentijn suggested...
    How can I boost my MAO activity? There isn't any 'treatment'... :(
    I've found a link in which someone explains a connection between low MAO activity and copper deficiency.

    There are many studies which show that monoamine oxidase (MAO) is a copper-containing enzyme which deactivates the catecholamines (norepinephrine, epinephrine, and dopamine) after their function has ended. There are some studies showing that MAO deficieny increases thyroid hormones. One study showed that a copper deficiency causes a deficiency of MAO. Another study stated that MAO contains iron. Several studies showed that long-term exposure of rats and humans to manganese (a copper and iron antagonist) causes MAO deficiency. Many of the symptoms seen in hyperT and pheo are appear directly attributable to MAO deficiency from copper deficiency. Stress initiates higher production of catecholamines which require more MAO for degradation, and thereby may cause decreased copper levels. These nutrients appear to be necessary for MAO production: copper, iron, riboflavin, histidine, and vitamin C.

    http://www.ithyroid.com/mao_and_maoi.htm

    My serum copper level is normal. For what it's worth (not much, from what I've read...):rolleyes:

    Has anyone on this forum tried to boost MAO with copper, iron, riboflavin...?
     
  14. caledonia

    caledonia

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    I suggest completely getting off coffee or anything with caffeine. Even decaffeinated coffee still has some caffeine in it.

    What kind of deodorant/antiperspirant are you using? I had itchy armpits when I developed an allergy to formaldehyde (ingredient in the deodorant). I now use alum. It's extremely effective. You can buy alum deodorants, but any more I just get it from the spice section of the grocery store (it's used in making pickles). I just mix some of the powder with water to make a paste and apply.

    Any kind of muscle spasms could be magnesium deficiency.

    How do you know these things at night are adrenalin surges? Have you had a sleep study? Has anyone observed you while you're sleeping?

    What is the normal range for glutathione peroxidase?
     
  15. MMe

    MMe

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    Caledonia, thanks for your advice!

    I eliminated all coffee for 2 months. It made no difference...:(

    I tried several deodorants (organic) and even stopped using a deo. No difference... I will look for the alum version. Tnx!
    But since I've started taking fish oil caps and a low dosed B-complex, symptoms improved!! (± a week, maybe to soon to sing hallelujah... ;))

    Magnesium blood level is low normal, so yes, I'll try some extra magnesium.

    Adrenalin surges: cf my high noradrenaline/metanefrine levels in urine. I do have them mostly when my body is in a 'relaxed' state: before falling asleep, in the early morning in bed. Valentijn suggested I have a MAO problem.
    And that's not an easy one to fix...:(

    I don't have the normal range for gluth peroxidase, I've read somewhere it should be at least 60.
     
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