13 replies to this topic

[Kyle McGill]

So this is my first topic, and I would like to start off by saying how grateful I am to have found this wonderful forum, and the wealth of knowledge I have acquired from it thanks to all of you!

So a little history. I am a 26 year old male, who up until about 3 years ago had been a relatively healthy and charismatic person. That all changed however when chance and circumstance led me to discover the wonderfully convenient high of Tylenol 3's, which in turn led to chronic use of codeine through over the counter purchasing of Tylenol 1's.

Although I remained quite functional in my day-to-day activities, I became progressively socially isolated and less like the quick-witted, intelligent speaker I was known to be.

A lot has happened since giving up codeine entirely, such as developing what I believed to be Candida, mercury poisoning, and food intolerance's that resulted in symptoms of tremors, brain fog, poor speech, etc. I believe these to be a result of poor digestion and elimination caused by the constant use of codeine, but I could be wrong.

Anyway, since my health-crisis (2 years ago) I have been ableto over a long period of time finally get myself to a relatively balanced state, through diet mediation, meditation, exercise, and supplementation (antifungals, mercury chelation etc.), and am incredibly grateful to have made it through that hell of an experience, because frankly, I never thought I actually would!

At this point now though, I am quite sure that the effects of the codeine use are still ringing through, because I am still suffering from symptoms relating to motivation,low libido, anhedonia, occasional poor speech and memory issues, and a highly impaired ability at long-term planning and impulse control.

Here is a list of supplements I've purchased, and the planned purposed for which I purchased them:

Overall cognitive enhancement:
Piracetam
Noopept
Oxiracetam
Sunifiram
R-ala
Alcar
Vinpocetine

Ashwaghanda (for mood and libido benefits)

Ciltep stack (for dopamine re-regulation benefits)

Macuna (also for dopamine related benefits)

Chlorella (been using for chelation alongside R-ala, and haven't stopped since)

Tyrosine (Dopamine increase)

MB (used originally as an antifungal against Candida)


So as you can see, I have plenty of supplements, but what I need more at this point is the understanding of exactly what mechanisms were involved with prolonged codeine use, so I can properly ascertain the best steps to ensure the balance that I have most definitely disrupted!

Any advice and suggestions is greatly appreciated!

[Tom_]

As with the abuse of any opioid protracted withdrawal; chronic organic brain syndromes are common. This will explain the psychocogntive problems you are having. This will be caused my dysregulation of your opioid system which will be effecting the monoamine system - most commonly and often most severely down-regulation of serontergic neurons - you are showing some signs of a depressive disorder.

The brain fog, tremors and aphasia where signs of withdrawal, unless you were exposed to and found to have high levels of mercury - which I doubt. There is no reason codeine would cause mercury poisoning or elimination problems. P.s I don't mean a tiny amount above

Chronic administration of paracetamol (with the codeine) can damage hepatocytes (liver cells) and this can cause mood problems, memory problems etc...

Opioid use can also cause thyroids problems

Get to a doctor, have them run a full blood panel with FBC, LFT's, electrolytes, TFT's.

Providing your liver is functioning normally then you can proceed with a stack looking more like this:

You are using way to many cognitive enhancers.

An SSRI (I'd advise sertraline) start at 50 go up to 150mg, if no effect follow STAR*D or Texas treatment resistant depression algorithm.
Noopept 10-20mg/day
multi vitamin
b vit complex
omega 3 1-2grams
ALCAR 500mg 1-2 times daily
Alpha GPC 500mg 1-2 times daily
Piracetam/Pramiracetam
DLPA 500-1500mg 1/3 times daily

What is MB?

Edited by Tom_, 11 April 2013 - 06:33 PM.

[nowayout]

The acetaminophen (paracetamol) in Tylenol 3 could have damaged your liver, if you took 8 or more tablets per day for a significant amount of time. It is possible that that may be underlying your current problems, since the liver is involved in many aspects of metabolism. First thing you should do is go to the doctor and have him test your liver function.

All those supplements are as likely to harm as help. Many of those drugs and herbs like Mucuna are strong drugs that are not well understood, should not be combined, and messing with dopamine metabolism can cause many more problems for you. For liver support, you might want to take some milk thistle and possibly some NAC for a while, but don't go crazy.

[Kyle McGill]

I had been taking liver support for a long time, and although I do believe liver damage was a factor at one time, it no longer should be anymore; I will have my liver enzymes checked in the very near future though. I was under the impression that opiates mainly affected the regulation of dopamine and not serotonin?
To be honest, I have no real interest in getting into SSRI's. If there is any way of balancing myself out naturally, I would much prefer that route!

Thanks for the advice so far though.

MB is Methylene Blue. There is a topic on it in the supplements sub-section.

For the record Tom, the list I had written out is only a list of products I have purchased, not what I am currently taking!

[Tom_]

Its cool, I know what it is, just wasn't used to the acronym.

Until you actually have liver tests there is no evidence either way. You also need the electrolytes and FBC to check for metabolic acidosis. If they return a positive you may still have liver problems even without obvious decreased or increased LFT's. You would then need urine analysis and further tests, including imaging studies of your liver (ultra scan).

'Liver support' tends not to be all that supporting.

Shame SSRI's when used correctly are very effective. Another option is tryptophan or 5HTP or as a least favorite St Johns wort. No, the major area of effect is the sertonergic system which in turn screws the dopaminergic and noradrenalergic systems. So increased serotonin will normally re-regulate noradren and dopamine.

Noopept taken correctly is likely to be very effective within a few weeks even more so incombo with a racetam.

[Kyle McGill]

I was taking SAM-e (in regards to 5HTP and St. Johns) for a couple months during a break-up, and it appeared to do wonders for my overall well-being upon reflection. So would something that boosts serotonin be more prudent towards re-regulation as opposed to the current CILTEP stack (including mucana) that I have embarked upon starting?

I guess I only imagined that dopamine was the culprit, considering the overall anhedonia and lack of motivation I've been enduring.

[freeman]

Former opiate addict here. My opiate use was connected to an anxiety disorder combined with chronic pain from a joint hypermobility issue.

I quit cold turkey, and then was tormented by a variety of problems. My anxiety disorder began manifesting in ways more disruptive to my life and my sensitivity to pain and daily pain levels increased tremendously (not in conjunction with any worsening of joint condition however).

I started with taking 50mg sertraline daily, this (in four weeks) reduced my anxiety to pre-opiate levels but had little effect on aches and pains and opiate cravings.

After about 6 months on sertraline I began supplementing magnesium to 50% RDA before bed (I use l-threonate currently but have found it interchangeable with the lysinate/glycinate) which GREATLY reduces opiate cravings and also tremendously reduces aches and pains. If I have a post-exercise strain I go ahead and supplement up to 75 or 100% RDA. Magnesium also has been instrumental in re-normalizing my sleep patterns I'd reckon.

I'm no way to be 100% sure, but experientially I suspect Mg's action on NMDARs has a restorative effect on one's response to endorphins following opiate addiction.

Shortly thereafter I started taking a 3:1 EPA:DHA fish oil with ~2g of Omega-3s, after several weeks this had a noticeable positive effect on bodily comfort and inflammation (enabling me to almost entirely eliminate NSAIDs from my joint care regimen excepting acute injury). This also further reduced anxiety and improved my mood.

I then embarked on a 6 month course of 2x daily 800mg piracetam in conjunction with 3-4x weekly aerobic exercise. I've since stopped the piracetam (a month or two ago) but continued the exercise and this period seemed to mostly eliminate the chronic feeling of cold which had stuck with me after quitting.

Imprecise and just a few notes, but hopefully helpful.

Be mindful to not re-map your opiate addiction onto supplements and nootropics.

Edited by freeman, 11 April 2013 - 06:58 PM.

[Kyle McGill]

What are the more common symptoms of overall liver dysfunction that I should be aware of?

[peakplasma]

Kyle, there is a silver bullet to restore long-term changes induced by opioid use: the very powerful opioid antagonist, naltrexone.

Have you considered attempting a low-dose ntx regimen? It's not for everyone but when it works the results are impressive.

Edited by peakplasma, 11 April 2013 - 07:05 PM.

[Tom_]

Naltrexone is an opioid antagonist - used to reduce opioid cravings etc, not reverse damage caused.

SAMe + tryptophan/L theanin might be a good idea.

The problem with liver disease is until its severe there is almost never any obvious symptoms, other than in some cases mild sleep and mood problems. The only way to rule it out with a high degree of accuracy is bloods.

[Kyle McGill]

Reading up on naltrexone is actually what inspired me to create this thread, funnily enough. But you're saying that unless I am going through withdrawal currently, that there would be no real benefit to starting low dose Naltrexone, Tom?

[Tom_]

Low dose Naltrexone is not an evidence based treatment for ANY disorder.

Normal dose therapy has a range of applications including reducing opioid cravings. It won't however repair damage caused by opioid abuse and any claims to the contrary at least since last I checked are entirely unevidenced. Sorry to have to break that to you.

[Kyle McGill]

It's okay, I'm smart enough not to expect any kind of miracle cure. I am however, interested in the mechanisms involved, and how to best lead my brain in the right direction of homeostasis so to speak.

It sounds to me, from what I've read, that the best course of action would be an overall healthy lifestyle, coupled with a boosting in serotonin metabolism, and health benefiting supplements such as Omega 3's, multi-vitamins, exercise, meditation, and perhaps a few nootropics such as piracetam, noopept, and additionally Alcar/Alpha GPC?

Would there be any qualms with the additional use of Ashwaghanda, lithium orotate and the CILTEP stack?

[Tom_]

I wouldn't be using any supplements until you have had your liver examined to death.

I personally wouldn't use Ahwaghanda due to lack of substantial evidence. However a lot of people have found it useful, so its a discretion thing. I prefer evidence based interventions some people like to hear other experience.

I have a massive problem with the use of lithium orotate. Lithium is a potentially lethal chemical agent that shouldn't be used without the careful monitoring of bloods under the eye of a doctor and it certainly shouldn't be used in a form (orotate) that is not evidence based. I also wouldn't recommend it as a memory and cognitive enhancer, its effective in affective disorders and reducing risk of suicide.

CILTEP stack is reasonable but I wouldn't use it until you have started and charted the response to life style changes and supps/pharms already advised.

I would lay off the ALCAR until you have gauged the response from the above as they can worsen depressive symptoms. Although the use of Alpha GPC would be important when using a racetams to ensure you have enough choline.

B vitamins are important.

How is your sleep by the way?