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Metabolic trap: what to do / avoid ??

Pearshaped

Senior Member
Messages
580
this metabolic trap thing is just a bit too high for me so i wanted to know what did you guys learn from it or what you think one should avoid(some supplements?)or what can be done by the patient.

also am wondering if this theory could explain why many uf us can't tolerate antidepressants in normal doses..or is this a misconception?
Thank you for your thougts
 

JadeD

Senior Member
Messages
165
Location
UK
You read my mind. I was wondering the same thing today and was thinking about asking the following question:

My widespread pain is one of my main compliants. I’m concerned about starting duloxetine (cymbalta) that I’ve had sitting in my drawer for months now because of the metabolic trap theory suggesting that our symptoms can be attributable to too much serotonin in the CNS.

As duloxetine is an SNRI are PwME at a higher risk of serotonin syndrome if we already have an underlying excess of serotonin in the first place?

It’s hard to know how to treat pain when the underlying theory has not been proven. Is it lactic acid/neuropathic/cytokine driven etc etc.
 

Pearshaped

Senior Member
Messages
580
thank you for your replies@andyguitar and @JadeD

@JadeD am glad pain is not one of my major problems.Have you tried Tryptophan?that,of course won't help your pain but PERHAPS it could give you a clue if you d react good or bad to dulexetine?

i feel worse with Tryptophan but have some cognitive improvement with 15mg Mirtazapin.
 

Pearshaped

Senior Member
Messages
580
BUT when i increase the dosage i feel worse as well(and still can't sleep.

Ok so if you happen to come across things that could help or or to avoid
let me know.
Its
 

JadeD

Senior Member
Messages
165
Location
UK
@Pearshaped that’s a good idea. Given that tryptophan is an essential amino acid I guess it may be a little “safer” to experiment with despite still contraindicting the trap hypothesis.

Are you better with mirtazepine at lower doses as opposed to higher or are you referring to tryptophan?

Because mirtazepine has more antihistamine effects at 15mg so is more sedative vs the 30-45mg dose which has more serotinergic and noradrenergic effects which offsets the sedative effects.
 

JES

Senior Member
Messages
1,320
No you are on the right track in some respects as tryptophan is the main constituent of Serotonin which is raised by ssri type antidepressants.

SSRIs used over a longer period of time actually lower brain serotonin levels (source). SSRIs don't raise serotonin levels as such, they just prevent serotonin from being reuptaken in the cells. This over time fools the body to think there is too much serotonin available, which in turn will turn on compensatory mechanisms to reduce the brain's serotonin synthesis over time. It's pretty mind boggling, but the end result from taking SSRIs is actually less serotonin synthesis.

Since the metabolic trap predicts that serotonin is high in the cells, going by common sense, SSRI/SNRIs used over a longer time could actually get you out of the metabolic trap. But common sense is almost never how things work, so the truth is probably that it's impossible for anyone to say how taking antidepressants would impact someone being stuck in a metabolic trap. It's all a big puzzle.
 
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Pearshaped

Senior Member
Messages
580
about the tryptophan;
yes thats what i was was thinking.

Mirtazapine 15mg does help while 30mg
make me feel worse but not sedated at all.
now i know why.
Seems to fit your explanation. :)
 

JadeD

Senior Member
Messages
165
Location
UK
@JES completely agree with you about SSRI/SNRI pharmacology over longer term use due to downregulation of receptors etc. However acute use certainly raises serotonin which is compounded if using other medicines with the same effect. I’ve seen serotonin syndrome once before in a patient and it’s really not nice. Some of our symptoms seem to overlap - excess sweating, tachycardia, insomnia. So not wanting to precipitate this is a valid concern I think.

But maybe I’m getting the wrong end of the stick with the trap hypothesis in that it’s intracellular only and maybe only in certain cell types? I guess we won’t know all the ins and outs until it’s proven or disproven. Does anyone know if Ron/Robert Phair have publicly suggested to avoid certain medications acting on the metabolic trap pathway?
 

Judee

Psalm 46:1-3
Messages
4,461
Location
Great Lakes
Just be careful with tryptophan because it set off my IBS worse than it's been in years when I tried it recently. Before that I had tried 5htp which helped me sleep but gave me the worst headache/neck ache ever. (HERE's a post where I talked about that.)

Does anyone know if Ron/Robert Phair have publicly suggested to avoid certain medications acting on the metabolic trap pathway?

This is a good question. I've wondered it too. Could something that non-ME/CFS doctors are prescribing actually be working against us?

I also have a rx for Cymbalta that I'm afraid to try. Plus some of the side effects, specifically lowering blood pressure, lowering sodium levels (hyponatremia), and feeling more dizzy/faint on standing seem like they would worsen some of the OI symptoms a lot of us experience.
 
Messages
171
Location
London
Does anyone have any insight with regard to how IDO blockade could mediate cranio cervical stability which myself and others are increasingly often being co-diagnosed with?

Symptoms profoundly improve (muscle weakness, sensory hypersensitivity) after applying manual traction.

If IDO attenuation leads to non-specific immune activation due to loss of immuno-suppresive kynurenine metabolism I don't see how this could impact collagenases, metalomatrix proteinases, tryptase or other enzymes capable of regulating collagen metabolism.
 
Messages
171
Location
London
The idea Ron mentions in one of the videos about using hyperbaric oxygen therapy to increase enzymatic activity is interesting. I wonder if this could be used alongside a tryptophan deficient diet and 5-hydroxy tryptophan supplementation with an incremented re-introduction of tryptophan to a liquid diet.

Alternatively, I'm surprising recombinant Interferon-gamma has not been mentioned yet, but from a cost perspective IFN-y is rather prohibitive.