Potassium, Taurine, GABA and withdrawal

[SpinachHands]

This is a complicated one, but with every doctor saying "a supplement/vitamin shouldn't do that much harm" me and my partner are having to figure this out ourselves. Here are the key bits of context:

1. My partner took 0.5mg Lorazepam 3X a day for 4 weeks, then titrated off over 2/3 weeks. They have been experiencing bad withdrawal symptoms for a month now since fully coming off it. We are sure it's withdrawal, it's the same symptoms/feeling they would get every time we lowered the dose, and that would flare at the times the lorazepam was due when they stopped it

2. They had been taking Taurine daily even before starting the lorazepam. During the first two weeks of withdrawal it seemed like the Taurine would help relieve the symptoms. So they increased the dose for a few days. Then it started to seem like it was making the withdrawal worse. They stopped taking it, and then instead started getting withdrawal from the Taurine, flaring up at the same time every day they would usually take it (this is still happening).

3. Benzodiazapine withdrawal is primarily due to gaba receptor down regulation. The benzos increase GABA, so your body stops using/creating receptors, so when the benzo is stopped, your body can't make enough of its own GABA, and needs time to regrow and repair it's receptors. Taurine increases gaba production- we think potentially it was acting similarly to a benzodiazapine, hence why it felt like it helped (increased gaba) but made withdrawal worse (body still wasn't repairing it's gaba receptors), and why it caused withdrawal of its own.

4. At the same time as all this, my partner started having symptoms that seemed like low potassium, separate symptoms to the withdrawal. They tried a potassium supplement, immediate relief. For two weeks we have been increasing potassium in their diet along with spaced potassium supplements throughout the day. However in the past few days, the beneficial effects of the potassium supplements and meals have lasted less and less, with symptoms returning within half an hour to an hour of the potassium. Meanwhile the withdrawal had slowly, slowly been improving.

5. Since magnesium deficiency can often go hand in hand with potassium deficiency, and magnesium is often recommended for helping with withdrawal, my partner tried a magnesium. A few hours later their withdrawal felt like it got much worse. The next day (yesterday) their withdrawal was worse than it's ever been. I know magnesium can have some effect on GABA, so despite it's frequent recommendation, we assume it must have messed with their gaba enough to set back their withdrawal. They had several episodes through the day of severe shaking/muscle twitching, anxiety, agitation, pain, head pressure, and high heart rate.

6. Last night we realised these episodes through the day lined up with the potassium supplements. As did the onset of worsening withdrawal the day before, explaining why it happened so many hours after the magnesium. We're still not sure if magnesium has had some influence, but the potassium is definitely also starting to hurt them.

7. Today we've stopped the potassium supplements but kept the high potassium diet, as they still feel like the low potassium specific symptoms are bad. We had been trying to avoid it knowing what a significant impact a blood test could have on my partner's condition right now, but we are still going to try to urgently get them a blood test when their doctors opens tomorrow. I know that having too much potassium can cause heart problems, but they are still under the daily recommended intake so it doesn't seem likely it's suddenly switched from hypo to hyperkalemia. Plus even yesterday when it felt like the withdrawal got really bad, especially with the increase in symptoms after the potassium, it still relieved the potassium specific symptoms (most noticeably leg cramps)

8. They feel like they're getting withdrawal from stopping the potassium supplements. Same feeling as stopping the Taurine, same time potassium is due. I didn't think that was possible but after all of the above, why not.


So the unsolved mysteries:

- why did potassium start worsening withdrawal? As far as I know in it's interaction with GABA, GABA actually increases potassium channels, which is why it's common for those going through withdrawal to get a potassium deficiency. I don't think it interacts the other way
- why did it only seem to worsen withdrawal after taking a magnesium? Is the potassium just heightening the effects of whatever the magnesium did? Or has the potassium already been doing something else that wasn't noticeable until the magnesium worsened the withdrawal?
- if the blood tests show low potassium, how on earth are we going to treat it?
- can any of this be worsening sympathetic nervous system activity that's mimicking withdrawal symptoms?

I don't mind if noone has answers, we're going to keep trying to figure this out so we can get their withdrawal on a stable recovery track, and deal with the low potassium symptoms. Their GP doesn't even believe this could be withdrawal, claiming it's so unlikely to get bad withdrawal from just a few weeks of a low dose of lorazepam. But sadly, we know better.

 

[linusbert]

electrolyte imbalance in chronic disease and deficient state can flip flop from one side to the other.
magnesium and calcium balance each other, if magnesium makes trouble, a calcium and or vitamin D deficiency could be the problem.
also sodium and potassium balance the scales.
and there is also phosphor.
also vitamin b6 is related to magnesium absorption.

so i would recommend do a mixture with everything and of the thing you think is deficient add more of that.

you can be deficient in the body but having too much of it for a short time as well. its weird. the body seams to not be able to keep the balance or process the stuff to go where it should.
somewhat like diabetes, where there is too much sugar in the blood but the cells are starving of energy.

 

[SpinachHands]

An amendment/update:
Roughly 48hrs after the magnesium was taken, they are suddenly feeling much better, like night and day. Magnesium supplements apparently "wear off" after 24-48hrs.
The taurine withdrawals usually happen an hour before the time the dose is due. What we thought was potassium withdrawal was then likely magnesium withdrawal. As insane as it sounds getting withdrawal from one tablet, with how sensitive they are to things at the moment, it's not impossible.

 

[SpinachHands]

electrolyte imbalance in chronic disease and deficient state can flip flop from one side to the other.
magnesium and calcium balance each other, if magnesium makes trouble, a calcium and or vitamin D deficiency could be the problem.
also sodium and potassium balance the scales.
and there is also phosphor.
also vitamin b6 is related to magnesium absorption.

so i would recommend do a mixture with everything and of the thing you think is deficient add more of that.

you can be deficient in the body but having too much of it for a short time as well. its weird. the body seams to not be able to keep the balance or process the stuff to go where it should.
somewhat like diabetes, where there is too much sugar in the blood but the cells are starving of energy.

I agree, it's such a delicate balancing scales right now. I'm hoping to get most of the above tested so we can get a clear picture before experimenting with anything else.

 

[linusbert]

I agree, it's such a delicate balancing scales right now. I'm hoping to get most of the above tested so we can get a clear picture before experimenting with anything else.

i do not know of any reliable tests for those. blood serium definitely is not reliable. some suggest doing whole blood.. but its also not that reliable. others suggest to measure metabolites which are increased if certain metabolic pathways which require e.g. magnesium are not working properly. i do not know those markers.
some do hair mineral analysis. also that is not that reliable.

but getting any of those is better than having none. if serum is much out of bounds like to low or too high you definitely know there is something off.. but if the values are in normal range it doesnt mean that there is not a deficiency.

 

[SpinachHands]

A new and concerning development- after a high potassium meal (banana milkshake) they really didn't feel good. They'd taken some supplements with it so to be sure what was the cause they later had a high potassium soup. A few gulps in they suddenly got extremely dizzy, faint, and shaky. It only lasted tenish seconds and they were back to feeling ok. Figuring it's the potassium I made them a simple broth/stock to keep them going until I made a new soup. Same reaction. So assuming it was the salt and potentially it's a full electrolyte imbalance at this point, they tried some cranberry juice- same reaction! I have no idea what to feed them, I'm calling 111 for advice, and hope we can get some electrolyte blood tests run asap.

 

[linusbert]

you also got your partner high histamine foods. banana as well , especially as well bone broth. that sudden feeling could be due to that. but banana is also a food which disturbs insulin a lot, so it could be a temporary hypoglycemia.
i am not sure its due to the electrolytes with potassium here if it was from natural food, because i dont think it happens so fast and goes away that fast. (from powder maybe). also i would think it lasts longer if this was the cause like a hour or so. but i am just guessing here.

you said your partner suffers from mcas like symptomatic.. so i would think that high histamine foods are a no no. you might wanna try some DAOsin. with the meals or before as said on the label.
but if histamine foods disturbed your partners body, you need to do like 1-2 weeks a histamine avoiding diet and then slowly reintroduce those again.

bone broth is a REAL PROBLEM with histamine. its absolute no go.
also to consider is salicylate intolerance when your partner already is sensitive to histamine.

 

[SpinachHands]

you also got your partner high histamine foods. banana as well , especially as well bone broth. that sudden feeling could be due to that. but banana is also a food which disturbs insulin a lot, so it could be a temporary hypoglycemia.
i am not sure its due to the electrolytes with potassium here if it was from natural food, because i dont think it happens so fast and goes away that fast. (from powder maybe). also i would think it lasts longer if this was the cause like a hour or so. but i am just guessing here.

you said your partner suffers from mcas like symptomatic.. so i would think that high histamine foods are a no no. you might wanna try some DAOsin. with the meals or before as said on the label.
but if histamine foods disturbed your partners body, you need to do like 1-2 weeks a histamine avoiding diet and then slowly reintroduce those again.

bone broth is a REAL PROBLEM with histamine. its absolute no go.
also to consider is salicylate intolerance when your partner already is sensitive to histamine.

Yeah their MCAS has been ok with bananas up until now and they said it didn't feel like their usual MCAS reaction, but we're definitely considering it. Also it wasn't bone broth as they're vegetarian, just a vegetable stock. I am also wondering about blood sugar, especially with the immediate onset of the symptoms. Strangely I don't think their blood sugar has ever been tested so I'll ask they include that on the tests.

 

[linusbert]

i strongly recommend getting one of those continous glucose monitors , GCM. they cost like 70$ and work for 2 weeks. you will get very good data out of it. like glucose while sleeping or over the day.

 

[Wayne]

it wasn't bone broth as they're vegetarian,

I tried being a vegetarian many years ago, and discovered it didn't work. My wife is a vegetarian, and it does work for her. Living together, I tended for many years to eat far less meat that most people. But a couple of years ago, I started increasing my meat intake, and I did better with that.

Just wondering if your partner might consider experimenting with eating some meat, and see how that goes. Besides being rich in nutrition, for me, eating meat seems to ground me in ways other foods just don't, perhaps regulating my blood sugar better. We're all different. -- Good luck figuring this all out.

 

[bad1080]

make sure they get enough vit.b12 (which also depletes potassium, manifests as headaches for me. avoid cyanocobalamin!)
and here is a useful link for how to wean off medications: https://www.survivingantidepressants.org (it says antidepressants but the method can be applied for others just the same)

 

[Lara*~]

Many people tapering from or withdrawing from benzos (both chronically ill and not) report an intolerance to any supplement that interacts with gaba receptors. It’s a very common experience that things like taurine and magnesium can worsen people’s withdrawals. If possible I’d back off of all supplements as much as us possible since so many of them if not all of them directly or indirectly impact gaba, and focus on whatever foods are tolerable to them with a focus on unrefined fats like eggs, avocado and coconut if they tolerate them. Good idea getting an electrolyte panel

 

[Wayne]

Many people tapering from or withdrawing from benzos (both chronically ill and not) report an intolerance to any supplement that interacts with gaba receptors. It’s a very common experience that things like taurine and magnesium can worsen people’s withdrawals.

Hi @Lara*~ -- Thanks much for your post, that's some very interesting information. I withdrew from clonazepam over 20 years ago with the help of a microcurrent device to help me through the last bit withdrawal symptoms. The whole very gradual process took me a bit over a year. My brother is considering quitting some long-term clonazepam usage, and this information will be useful to know.

BTW, for anybody that can afford it, I would recommend mHBOT (home unit) to help get through the benzo withdrawal symptoms. From my experience of benzo withdrawal and regularly experiencing the profound relaxation that I experience in an HBOT chamber, I think HBOT would make the whole process much easier, and almost assuredly much safer. HBOT is so good for the brain and neurological system and likely help heal the GABA receptors that have been impacted.

 

[SpinachHands]

make sure they get enough vit.b12 (which also depletes potassium, manifests as headaches for me. avoid cyanocobalamin!)
and here is a useful link for how to wean off medications: https://www.survivingantidepressants.org (it says antidepressants but the method can be applied for others just the same)

Thankfully they already take a high dose B12 so hopefully their levels should be ok. What's cyanocobalamin?

 

[SpinachHands]

Many people tapering from or withdrawing from benzos (both chronically ill and not) report an intolerance to any supplement that interacts with gaba receptors. It’s a very common experience that things like taurine and magnesium can worsen people’s withdrawals. If possible I’d back off of all supplements as much as us possible since so many of them if not all of them directly or indirectly impact gaba, and focus on whatever foods are tolerable to them with a focus on unrefined fats like eggs, avocado and coconut if they tolerate them. Good idea getting an electrolyte panel

Unfortunately we found that out the hard way- it did seem like Taurine was helping at first, but I think it was just increasing gaba where there weren't receptors for it, so it quickly started having the opposite effect, as their body wasn't repairing the damage done to the gaba receptors from the benzos. I've seen a lot of positive reports of magnesium helping, but seems like my partner is in the group where anything interacting with GABA is harming them.
How do unrefined fats help?

 

[andyguitar]

A new and concerning development- after a high potassium meal (banana milkshake) they really didn't feel good.

they tried some cranberry juice- same reaction!

Could be the result of a sugar hit.

Strangely I don't think their blood sugar has ever been tested so I'll ask they include that on the tests.

Probably the first thing i would suspect.

 

[Lara*~]

Unfortunately we found that out the hard way- it did seem like Taurine was helping at first, but I think it was just increasing gaba where there weren't receptors for it, so it quickly started having the opposite effect, as their body wasn't repairing the damage done to the gaba receptors from the benzos. I've seen a lot of positive reports of magnesium helping, but seems like my partner is in the group where anything interacting with GABA is harming them.
How do unrefined fats help?

Unrefined fats are a gentle way to support healing in the brain. If I had more scientific info for you I’d offer it, but I don’t, it’s just been my understanding through some research. For very sensitive people or people in complex medical/ medication situations I just tend to think it’s lower risk to introduce foods rather than rely on supplements. There’s a whole list of supplements that are contraindicated for people coming off benzos, if I find it I’ll link it here. Unfortunately your partner might really rely on some of these like b12 for instance and all other b vitamins. So it’s something to look out for if they start reacting to those, but hopefully getting off the taurine and mag will be enough to settle their nervous system.

 

[SpinachHands]

Unrefined fats are a gentle way to support healing in the brain. If I had more scientific info for you I’d offer it, but I don’t, it’s just been my understanding through some research. For very sensitive people or people in complex medical/ medication situations I just tend to think it’s lower risk to introduce foods rather than rely on supplements. There’s a whole list of supplements that are contraindicated for people coming off benzos, if I find it I’ll link it here. Unfortunately your partner might really rely on some of these like b12 for instance and all other b vitamins. So it’s something to look out for if they start reacting to those, but hopefully getting off the taurine and mag will be enough to settle their nervous system.

We just got back the results of a metabolomix test they did a few weeks ago and it says their Taurine was too high, so, but late but at least that's resolved now. Useful to know about unrefined fats though, especially when we want to start moving them back to soft/solid food in a gentle way!

 

[SpinachHands]

Man, we think we may have solved it!
It wasn't the food, it was the act of eating triggering their nervous system, and their nervous system was messed up because their Amantadine dose was too high! They were still seeing some benefit after increasing a little while ago, but we think it also started having a paradoxical effect. All the symptoms- the heart palpitations, dizziness, feeling anxious but also exhausted, can all be attributed to their nervous system issues, it was just lining up with food because that was a triggering activity/exertion!
Have reduced the dose today and immediately they said they were feeling the benefit of Amantadine more than they have in previous weeks. Will take a few days for their nervous system to settle from the change but, jeez...got there in the end.
We think they probably did have a potassium deficiency, but we didn't realise it had resolved because it probably was around the time they increased the Amantadine dose.

 

[bad1080]

What's cyanocobalamin?

it's a form of b12 (sadly still the most common one in certain places)