13 replies to this topic

[Ephilation]

Hello everyone!

I'm new to this forum, so first of all: hello to everyone, and thanks in advance for anyone who'll help me out.

I may have posted in this forum before, but I honestly can't remember: my memory is that bad.

Brief info about myself: 25 year old male, 6"1' and 148 lbs as of yesterday. Yes, I know I'm skinny - it's one of my issues that I'd like some help on. I was in med school, but I had to drop out because of difficulty learning the material, which led to anxiety, which lead to more difficulty learning, etc. Your classic vicious cycle. I've been out of school for almost a year now, having different doctors look at me to try and figure out what's wrong with me, but they can't find anything at all. All my lab values come back as perfectly normal - except for my heart rate (which is high) and bp (which is low - 100/60 on a good day, around 95/55 normally). I thought for sure that some of my hormone levels were going to come back off (thyroid or cortisol, for example, which would have explained a lot of the issues I've been dealing with), but they came back mid-to-high normal, so that kinda rules those things out. Still, I definitely have major issues. Usually, I can't concentrate at all - in fact, the only way I'm able to write this right now is that one of the doctors I went to gave me a weeks worth of nuvigil, which is giving me enough energy and focus to enable me to write this out.

So, as you can see, I've got a lot of issues here that I could use some help with, and I know a lot of you have found products and stacks that have worked for you. However, because there's so much information out there, I don't have any idea about where to begin.

1) Concentration - I've heard awesome things about piracetam for concentration, so I'm going to get that, along with CDP-Choline and L-Huperzine A. I've heard good things about creatine as well. Not sure about the doses though, or where to buy these things. Thoughts, anyone? Anything else you would suggest? (Stimulants made me more anxious.)

2) Fatigue - I have a lot of tiredness during the day, which could be an issue in itself, or it could be related to the fact that my appetite is non-existant. Anyone who can offer anything to attack either (or preferably both) of these issues, I would love you forever.

3) Anxiety - Obviously this is a problem for me. I've been tried on SSRIs before, and the only thing they really did was make me super sleepy. Lamictal, a mood stabilizer, made me even more anxious than normal. I've heard good things about bacopa, phosphatidylserine, and stablon.

4) Appetite - Just putting this in another section, because it may be a separate issue from the fatigue stuff.

5) Could a low blood pressure be contributing to any of this?

Ok, that's about it for now. Damn, this nuvigil stuff really helped me get my thoughts out more lucidly than usual - without it, who knows how rambling this post would have been.

Here's hoping you guys can help me out with this! My major problems are that I don't know what's safe to combine with what other compounds, what compounds are going to work in tandem with each other, what dosages to try, etc. Thanks so so much to everyone who even looks at this point.

[LabRat84]

Hello everyone!

I'm new to this forum, so first of all: hello to everyone, and thanks in advance for anyone who'll help me out.

I may have posted in this forum before, but I honestly can't remember: my memory is that bad.

Brief info about myself: 25 year old male, 6"1' and 148 lbs as of yesterday. Yes, I know I'm skinny - it's one of my issues that I'd like some help on. I was in med school, but I had to drop out because of difficulty learning the material, which led to anxiety, which lead to more difficulty learning, etc. Your classic vicious cycle. I've been out of school for almost a year now, having different doctors look at me to try and figure out what's wrong with me, but they can't find anything at all. All my lab values come back as perfectly normal - except for my heart rate (which is high) and bp (which is low - 100/60 on a good day, around 95/55 normally). I thought for sure that some of my hormone levels were going to come back off (thyroid or cortisol, for example, which would have explained a lot of the issues I've been dealing with), but they came back mid-to-high normal, so that kinda rules those things out. Still, I definitely have major issues. Usually, I can't concentrate at all - in fact, the only way I'm able to write this right now is that one of the doctors I went to gave me a weeks worth of nuvigil, which is giving me enough energy and focus to enable me to write this out.

So, as you can see, I've got a lot of issues here that I could use some help with, and I know a lot of you have found products and stacks that have worked for you. However, because there's so much information out there, I don't have any idea about where to begin.

1) Concentration - I've heard awesome things about piracetam for concentration, so I'm going to get that, along with CDP-Choline and L-Huperzine A. I've heard good things about creatine as well. Not sure about the doses though, or where to buy these things. Thoughts, anyone? Anything else you would suggest? (Stimulants made me more anxious.)

2) Fatigue - I have a lot of tiredness during the day, which could be an issue in itself, or it could be related to the fact that my appetite is non-existant. Anyone who can offer anything to attack either (or preferably both) of these issues, I would love you forever.

3) Anxiety - Obviously this is a problem for me. I've been tried on SSRIs before, and the only thing they really did was make me super sleepy. Lamictal, a mood stabilizer, made me even more anxious than normal. I've heard good things about bacopa, phosphatidylserine, and stablon.

4) Appetite - Just putting this in another section, because it may be a separate issue from the fatigue stuff.

5) Could a low blood pressure be contributing to any of this?

Ok, that's about it for now. Damn, this nuvigil stuff really helped me get my thoughts out more lucidly than usual - without it, who knows how rambling this post would have been.

Here's hoping you guys can help me out with this! My major problems are that I don't know what's safe to combine with what other compounds, what compounds are going to work in tandem with each other, what dosages to try, etc. Thanks so so much to everyone who even looks at this point.

Obviously you've seen a psychiatrist and probably an endocrinologist (often other docs check your thyroid). One of the medications my psych tried early on was Depakote (valproic acid/sodium valproate). It made me really, really hungry. (Not good since I'm overweight already.) Maybe you'd benefit.

To answer 5) Yes, all of the above. Low blood pressure=blood reaching the brain slower=slower glucose uptake. Lower concentration, less energy. A sleep study wouldn't be a bad idea; lack of good sleep could be contributing to your anxiety.

How high is your heart rate? It sounds like your body is trying to increase cardiac output to compensate for reduced pressure. (At least some of your adrenal system is functioning normally.) You should certainly see a cardiovascular specialist.

For now, stay away from nootropics that are vasodilators (e.g. vinpocetine, nicergoline). They're only going to make your problems worse. But I'd also be careful with vasoconstrictors because of potential effects on heart rate - but that's something you should discuss with a doctor.

Edited by LabRat84, 27 April 2010 - 02:50 PM.

[KimberCT]

Sounds similar to me... low blood pressure but high-end normal heart rate. Diagnosed with panic disorder.

I've recently started drinking at least a gallon of water daily, increased my magnesium intake to roughly 300% RDA, and increased my salt intake (mostly through salt tablets).

Have you had a CBC? How's your red blood cell count? Mine has always been slightly low.

[Imagination]

You must of been pretty smart to get into med school, did the symptoms only start once you where there?

I don't think piracetam is good for concentration, most people use it for creativity, it has no effect on me, choline is also more for memory than focus.

Tyrosine is good for focus energy and motivation, but could cause anxiety if you are an anxious person. For anxiety something like magnesium, theanine or taurine would allieviate it with out causing any tiredness. It's also very difficult to focus when you are anxious, so fixing the anxiety will probably fix the focus issue.

Edited by Imagination, 27 April 2010 - 04:30 PM.

[Ephilation]

Thanks both of you for your questions and comments!

Labrat84 - First of all, yes I have had a sleep study - 2 actually. The first one was "abnormal", but I found out that the doctor who ran that sleep study likes to tell everyone that they have sleep apnea so that he can give them CPAPs. How very kind of him to abuse the medical system to make a few extra bucks. The second sleep study came back totally normal.

Yes, I've seen psychiatrists, endocrinologists, and a cardiologist. The psychiatrists were completely unhelpful, but I have an appointment with another one next week - I'll suggest depakote to him and see what he says.

I agree with your assessment and answer to #5. Based on my limited understanding of cardiac physiology from 2nd year med school, it does sound like my heart rate is trying to compensate for the low blood pressure. Low blood volume = low blood pressure = less oxygenation to all cells of the body, which can be compensated by the body by increasing heart rate. However, getting to the source of the problem and increasing blood volume seems like it would be more beneficial in the long run. A pulmonogist I saw last week suggested that I might have something called "pulmonary orthostatic tachycardia syndrome," which they treat with high salt and water intake and a drug called flurinef (basically an aldosterone mimic). My doctors are somewhat against empirically trying to use the flurinef to see if it gives me symptomatic relief if they don't have a confirmed diagnosis of POTS, though, so it's going to take some work to try to convince them to go down that route.

I'm curious as to your suggestion not to use vinpocetine, however. I was under the impression that it's cerebro-selective? Am I wrong on that? I'm not going to try ANY drugs for the time being, while the doctors run their tests, because I want them to have as accurate of a picture of my health as possible. Don't want to muddy the waters any.

---

KimberCT: Thanks for your response as well. I think you may have POTS also (see above paragraph where I talk about POTS), although I am NOT in a position to diagnose you. An increased salt and water intake is part of the treatment for POTS, and I myself am going to look into salt pills (because salting all my food doesn't seem all that appetizing). I've had a number of CBCs done this year while I've been out of school, and all of them have come back normal. On paper, I'm as healthy as I should be - except for the lowish BP and high-normal HR. I figure, if that's the only problem I seem to have, then let's treat that and see what happens, right? The doctors don't always agree!

[Ephilation]

You must of been pretty smart to get into med school, did the symptoms only start once you where there?

I don't think piracetam is good for concentration, most people use it for creativity, it has no effect on me, choline is also more for memory than focus.

Tyrosine is good for focus energy and motivation, but could cause anxiety if you are an anxious person. For anxiety something like magnesium, theanine or taurine would allieviate it with out causing any tiredness. It's also very difficult to focus when you are anxious, so fixing the anxiety will probably fix the focus issue.

Haha, thanks for the compliment, bro. The symptoms were always present to some extent, but I think med school really exacerbated them. The stress that med school places on a person will do that to a person.

I have been suggested something like magnesium taurate in the past (I think that was the name of it), so I'll try to do some research on tyrosine, magnesium, theanine and taurine. I do agree that the anxiety makes my focus worse, for sure. The two feed off of each other horribly.

[kassem23]

Damn, really sorry to hear about your story bro. Med-school is a dream for many, and not being able to complete must be even worse. This is a real House MD case it seems.. First of all, I would like to ask you whether you do the following:

1. Follow a strict diet plan?
2. Follow a strict and rigorous exercise routine?
3. Follow a strict sleep plan?

Most of my problems with anxiety and concentration are alleviated when I fix the above three issues. I have yet to fix them though and still have problems. I just don't see there is any easy way out of concentration problems. Yes, methylphenidate or adderall might give you alleviation of symptoms and you might be able to function again, but it's not a panacea and ultimate cure. If I were you I would really look at my life and how I spend my days and then how I can improve them.

Do I have enough social-relationships? Do I enjoy myself once in a while? Can I relax? Am I stressed all the time, and if yes, why so? Find out all things about you, and maybe check out one of those neurotransmitter defiency test's. They are pretty good for self-evaluation (not the science itself)..

Best of luck!


NB: If you want I can ask my dad as well. He's an endocrinologist and stem cell researcher (check him on wiki: en.wikipedia.org/wiki/Moustapha_Kassem). He could check your tests out as well if you'd like. Just give me an PM or post in here, whatever you like.

Regards from a person wishing to go to med school!

Edited by kassem23, 27 April 2010 - 06:04 PM.

[chrono]

Nice to see you here! A few questions which occurred to me:

Have you had other bloodwork done for vitamin/mineral/etc deficiencies? Probably not the main or even significant cause of your symptoms, but at this point it seems like it would behoove you to address any easily-detected deficits.

Does nuvigil give you anxiety? What other stimulants have you tried?

Have you considered/discussed the possibility of ADD? I ask because the cycle of not being able to study leading to more anxiety keeping you from studying is exactly what forced me to drop out of college several years ago. Have you tried any ADD meds or dopaminergic substances? This is probably not the fatigue issue, but may be a factor in the original learning problem?

I wrote out a pretty long response this afternoon, and lost it just now when restarting my browser because it was too large for the text buffer -_- I'll start again tomorrow, when I'm not too tired to remember ideas.

[babcock]

Sorry to hear about your issues! Just because no one has mentioned it yet I would say you should start off with getting your diet stabilized and start a regular exercise routine. Nothing increases your blood flow better than some good cardio while your body has some fuel to burn. Sit down, force yourself to eat a healthy balanced meal (fruit, veggie, grain, protein) with water, wait an hour then go run, bike, swim etc. Do this for at least a week before you try supplementing. Noots can't cure malnutrition and the effects of a sedentary lifestyle. Burning off this energy may also help you sleep better.

Like Chrono suggested I would also suggest a sleep study if you find things don't improve. If nothing conclusive comes from the sleep study THEN I would suggest looking into noots.

Sorry that I'm not suggesting you hit the ground running with racetems, pyritinol, PS etc. but if you don't have the basics (healthy diet, exercise, good sleep cycle) first you'll just end up getting frustrated/depressed and wasting money.

Keep us posted.

[Ephilation]

Damn, really sorry to hear about your story bro. Med-school is a dream for many, and not being able to complete must be even worse. This is a real House MD case it seems.. First of all, I would like to ask you whether you do the following:

1. Follow a strict diet plan?
2. Follow a strict and rigorous exercise routine?
3. Follow a strict sleep plan?

Most of my problems with anxiety and concentration are alleviated when I fix the above three issues. I have yet to fix them though and still have problems. I just don't see there is any easy way out of concentration problems. Yes, methylphenidate or adderall might give you alleviation of symptoms and you might be able to function again, but it's not a panacea and ultimate cure. If I were you I would really look at my life and how I spend my days and then how I can improve them.

Do I have enough social-relationships? Do I enjoy myself once in a while? Can I relax? Am I stressed all the time, and if yes, why so? Find out all things about you, and maybe check out one of those neurotransmitter defiency test's. They are pretty good for self-evaluation (not the science itself)..

Best of luck!


NB: If you want I can ask my dad as well. He's an endocrinologist and stem cell researcher (check him on wiki: en.wikipedia.org/wiki/Moustapha_Kassem). He could check your tests out as well if you'd like. Just give me an PM or post in here, whatever you like.

Regards from a person wishing to go to med school!

Hello there kassem23! I'm on a medical leave of absence from med school, so I haven't been "kicked out" or anything. I just left so I could take care of my own health issues before trying to treat others.

Eating is difficult, to be honest. I don't eat much *at all*, it's an issue that I don't know how to deal with. If anyone could offer me a suggestion about something to STIMULATE my eating, I'd actually really appreciate that. I just don't feel hungry most of the time, which means I skip meals. That definitely doesn't help my fatigue and brain fog issues, I'll tell you that.

Exercise is difficult as well. The anxiety and fatigue interfere with it a lot, but I push myself to take walks and go on bike rides and such. Overall, I'd say I'm relatively active for a guy my age.

Social interactions are pretty good as well. Since I'm out of school, it would be easy for me to just sit around the house and do nothing all day, but I definitely do not do that. I meet up with people, call people, try to get out of the house as much as possible.

In fact, the first year I took out of med school was spent trying to get my eating and sleeping habits, as well as social relationships, in order. That was the entire focus of that year. I completely agree with you that these kinds of life issues are the place to start, and I think I've addressed them to the best of my ability. I think it's now time to look at other options.

But what neurotransmitter deficiency tests are you talking about? I've never heard of those ...

And thanks for the offer about your dad. :-) I appreciate the offer, he seems like a very hard-working guy. For now, I think I'm good, but I may take you up on that later on if nothing else comes through.

Good luck with getting into med school - the only suggestion I would make is that you make sure you're as healthy as possible before you start!

[babcock]

If anyone could offer me a suggestion about something to STIMULATE my eating, I'd actually really appreciate that. I just don't feel hungry most of the time, which means I skip meals. That definitely doesn't help my fatigue and brain fog issues, I'll tell you that.

Marijuana is generally a good appetite stimulator.... :-P j/k Don't smoke pot, it's bad for you. Couldn't resist.

Actually Ginger is highly recommended to stimulate appetite as well as various other herbs like fenugreek, thyme and rosemary. There are also several medical drugs which increase appetite such as Periactin, Migraleve and Megestrol. You'll want to research these more in depth and I'm not advocating you take any of them. I just came across them in wikipedia articles.

Also, it is suggested that malnutrition leads to a loss of appetite so maybe start hitting up your crucial vitamins in supplement form and you may feel better.

HTH.

[rvdvaart]

Hello everyone!

I'm new to this forum, so first of all: hello to everyone, and thanks in advance for anyone who'll help me out.

I may have posted in this forum before, but I honestly can't remember: my memory is that bad.

Brief info about myself: 25 year old male, 6"1' and 148 lbs as of yesterday. Yes, I know I'm skinny - it's one of my issues that I'd like some help on. I was in med school, but I had to drop out because of difficulty learning the material, which led to anxiety, which lead to more difficulty learning, etc. Your classic vicious cycle. I've been out of school for almost a year now, having different doctors look at me to try and figure out what's wrong with me, but they can't find anything at all. All my lab values come back as perfectly normal - except for my heart rate (which is high) and bp (which is low - 100/60 on a good day, around 95/55 normally). I thought for sure that some of my hormone levels were going to come back off (thyroid or cortisol, for example, which would have explained a lot of the issues I've been dealing with), but they came back mid-to-high normal, so that kinda rules those things out. Still, I definitely have major issues. Usually, I can't concentrate at all - in fact, the only way I'm able to write this right now is that one of the doctors I went to gave me a weeks worth of nuvigil, which is giving me enough energy and focus to enable me to write this out.

So, as you can see, I've got a lot of issues here that I could use some help with, and I know a lot of you have found products and stacks that have worked for you. However, because there's so much information out there, I don't have any idea about where to begin.

1) Concentration - I've heard awesome things about piracetam for concentration, so I'm going to get that, along with CDP-Choline and L-Huperzine A. I've heard good things about creatine as well. Not sure about the doses though, or where to buy these things. Thoughts, anyone? Anything else you would suggest? (Stimulants made me more anxious.)

2) Fatigue - I have a lot of tiredness during the day, which could be an issue in itself, or it could be related to the fact that my appetite is non-existant. Anyone who can offer anything to attack either (or preferably both) of these issues, I would love you forever.

3) Anxiety - Obviously this is a problem for me. I've been tried on SSRIs before, and the only thing they really did was make me super sleepy. Lamictal, a mood stabilizer, made me even more anxious than normal. I've heard good things about bacopa, phosphatidylserine, and stablon.

4) Appetite - Just putting this in another section, because it may be a separate issue from the fatigue stuff.

5) Could a low blood pressure be contributing to any of this?

Ok, that's about it for now. Damn, this nuvigil stuff really helped me get my thoughts out more lucidly than usual - without it, who knows how rambling this post would have been.

Here's hoping you guys can help me out with this! My major problems are that I don't know what's safe to combine with what other compounds, what compounds are going to work in tandem with each other, what dosages to try, etc. Thanks so so much to everyone who even looks at this point.

Based on your symptoms, it sounds like you might have a Vitamin D deficiency. Its especially common around this time of year when we're just getting out of winter. If you live at a latitude above Georgia/North Carolina, our bodies don't produce Vitamin D between the months of November-March. Check this out and tell your doctor to give you a Vitamin D test so you know your levels.

http://www.associate...me_vitamin.html

[Ephilation]

Nice to see you here! A few questions which occurred to me:

Have you had other bloodwork done for vitamin/mineral/etc deficiencies? Probably not the main or even significant cause of your symptoms, but at this point it seems like it would behoove you to address any easily-detected deficits.

Does nuvigil give you anxiety? What other stimulants have you tried?

Have you considered/discussed the possibility of ADD? I ask because the cycle of not being able to study leading to more anxiety keeping you from studying is exactly what forced me to drop out of college several years ago. Have you tried any ADD meds or dopaminergic substances? This is probably not the fatigue issue, but may be a factor in the original learning problem?

I wrote out a pretty long response this afternoon, and lost it just now when restarting my browser because it was too large for the text buffer -_- I'll start again tomorrow, when I'm not too tired to remember ideas.

Hey there chrono:

This is going to be short and "terse", but not because I mean it to be - only because I'm not taking anything right now and my mind is so fogged up that I can't think enough to write properly enough to give you the response you deserve. :( Sorry

I've had a *lot* of bloodwork done recently. In fact, I just saw a rheumatologist last week who tested me for all sorts of random shit. I did have a vitamin D deficiency, which I'm getting treated for - 50,000 IU per week, and it's helping.

Nuvigil hasn't seemed to give me anxiety so far, but I also have no idea if it was helping at the dosages I was taking. It would probably be prudent for me to take larger dosages and see what happens.

I have considered ADD, and I think both my mom and dad have signs of ADD - bummer for me. I've tried a number of the stimulants, with less than spectacular results. I remember specifically that the concerta gave me horrible, horrible, horrible anxiety for the few hours that it was in my system. I do think I have attention deficit, but I'm hoping that by going through these forums, I can find treatments for it that are going to be a lot less hard on my system than the stimulants were. (I've heard good things about galantamine and piracetam, and I think I'm going to try each one out. Probably going to get it from RelentlessImprovement.)

I don't know a single thing about the dopaminergic system, or what might help with that. Why do you think it might help, and can you offer me any suggestions on what to do about it?

Well, that wasn't as "terse" as I thought it was going to be

Looking forward to your response!

[Ephilation]

Sorry to hear about your issues! Just because no one has mentioned it yet I would say you should start off with getting your diet stabilized and start a regular exercise routine. Nothing increases your blood flow better than some good cardio while your body has some fuel to burn. Sit down, force yourself to eat a healthy balanced meal (fruit, veggie, grain, protein) with water, wait an hour then go run, bike, swim etc. Do this for at least a week before you try supplementing. Noots can't cure malnutrition and the effects of a sedentary lifestyle. Burning off this energy may also help you sleep better.

Like Chrono suggested I would also suggest a sleep study if you find things don't improve. If nothing conclusive comes from the sleep study THEN I would suggest looking into noots.

Sorry that I'm not suggesting you hit the ground running with racetems, pyritinol, PS etc. but if you don't have the basics (healthy diet, exercise, good sleep cycle) first you'll just end up getting frustrated/depressed and wasting money.

Keep us posted.

Hey there babcock!

Thanks for your input. I really am trying to get my diet stabilized, but it's a bit difficult because of the lack of appetite. I saw in your other post some tips for that, so I'll try to do some research on that and go from there. Lol, but my primary care doctor wants to start me on zyprexa for my anxiety issues (I'm going to ask for a *very* small dose), so that should help the appetite issue considerably.

I did get a sleep study done, and it showed nothing :( Very frustrating.

My first year off from school, my entire focus was on getting my sleep and eating patterns back to normal. That was literally all I did for the first 8 weeks, in the hopes that my mind issues would get better as a result. Didn't really help, so I'm looking into other alternatives at this point. I do understand where you're coming from by not jumping straight to suggesting nootropics for me though, and I respect that.