Several comments here, including n=1, so take them in that context.
My B12 was low and was given shots until my level was normal. I didn't feel any different but at least my B12 levels are now normal, so yes I needed the shots. Unless you have a deficiency, vitamins won't help you.
I have no idea about glutamate levels but as far as the neurotransmitter test which is used by alternative practitioners, is that the level in your blood does not coincide with the level of neurotransmitters in your brain.
Barb C.:>)
Anecdotal evidence is a clue, but it cannot be generalized to a group. So that is an important context to note.
B12? I am not convinced that old B12 tests are necessarily relevant. What percentage was metabolically active B12, and were both methyl and adenosyl B12 at required levels? "B12 is normal" is a nonsense claim according to current science. Which B12? What about biochemical pathways that utilize these?
Glutamate levels are not much more than a clue unless in context with other factors. From known biochemistry the taking of magnesium is one of the simplest solutions, though its only a modifier.
Sleep is induced by PGD2. It is a series two prostaglandin which is dependent on a bunch of enzymes. Delta 6 and delta 5 desaturase (two key enzymes) activity directly correlate with glutathione levels. We often have low glutathione, in part because its depleted in oxidative stress disorders, in part because many of us have issues with synthesizing it (which is the point of the methylation threads). Taking NAC leads to more glutathione, and so more d5d and d6d activity. This means more arachidonic acid is available on demand. This means the potential for sleep is higher. However it also means more arachidonic acid is available for synthesis of pro-inflammatory eicosanoids.
So if you make too much PGD2, goes my current model, then you get hypersomnia and some brain fog. African sleeping sickness has a parasite that makes more of it. It can also induce airway hyper-reactivity, and is over used in allergies as mast cells release it. This might, though I am not sure, also explain sleep paralysis.
If you run out of substrate for PGD2 you get insomnia. The brain needs to make more. NAC and even evening primrose oil might help, but might also trigger inflammatory processes.
You can switch between the two symptom sets.This kind of switching has been observed and tracked in many patients since the late 1980s. Some of it was published but not all. I was a guinea pig in some of this.
It is incorrect to say that vitamins are only of use if you have a deficiency. That is a public health message, and biochemically insupportable. Le Chateliers principle, a 19th century principle that is a bedrock of chemistry, is in direct conflict. It is fair to say that vitamins do not correct a vitamin deficiency if you have no deficiency. Well, duuhh. That is not all they do though, and it is scientifically and medically insupportable to claim this. Key chemicals drive the rate of chemical synthesis. This includes substrates, products, enzymes and cofactors. Vitamins are typically cofactors. So they increase chemical synthesis. However this is not selective. They increase synthesis on all pathways if you take more. Hence they lead to side effects. This is a use of natural substances, including vitamins, as
drugs. Its a drug like response.
Now there are complications due to biochemical feedback loops. That is far too complex to discuss here though, and my brain might need to be working better than it is at the moment to discuss this. I have a fogwall moving in.
The issue of brain levels of chemicals versus blood levels is very important, and in fact applies to all tissues. Blood has its own filtering and homeostatic mechanisms, as does urine, but tissue levels may not reflect blood levels. A case in point is that about half of all CFS patients are potassium deficient, yet this almost never shows up in blood tests. Its a tissue level deficiency. Blood levels are homeostatically maintained or you would die.
One of the problems is that doctors are not chemists, organic chemists or biochemists. The appropriate discipline for medicine is probably physiology. These systems can be measured, interpreted and modified. This is expensive, complex and beyond the capacity of most doctors and pathology labs. The subdiscipline of Functional Medicine (which is about physiology and biochemistry not psychology or psychiatry) is a new area that is looking at these issues. They have a long way to go. This is all complex stuff and difficult to research. This is complicated by issues that public health messages are generalized and dumbed down. They try to keep it simple even if that means its not accurate.
I have not even discussed issues with things like folic acid. The public health message is folic acid is good, eat more, and legally many countries fortify bread etc with it. Yet research is now showing it is probably a toxin, and few (though not on these forums) are aware its not even a vitamin, its a drug equivalent. Folic acid was recently associated with dementia, cancer and natural killer cell dysfunction. This is still being researched, and is considered contraversial.
With respect to CBT and GET, I don't think most of us object to their potential use as adjunctive therapies for patients who want to try them. I have done both, though the CBT I had was about coping strategies and didn't teach me anything new. The GET made me worse ... every time I tried it with one exception, which led to a limited temporary improvement and was probably nothing to do with GET but with other things I was trying. I am a stubborn cuss.
I am aware, anecdotally, of several cases where biochemical research on ME was denied publication in major journals because one of the reviewers wrote something like "CFS is psychiatric, this paper has no value." That kind of bias means that biological papers on ME get published in lower prestige journals. It
does have an impact.
Bye, Alex