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My ADD Stack in Development

add adhd sct stack fog anxiety concentration motivation

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#151 reqless

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Posted 10 February 2014 - 09:10 AM

Hi GetOutofBox,

I have been following your thread for a few months, and I just had to register to see if I could add credibility to your 'corticosteroid' theory.

About me:
- I am a 19, almost 20-year-old male living in Canada.
- My symptoms of ADHD-PI almost exactly mirror yours (although I have had a few more OCD tendencies thrown in along with the compulsive thoughts you mentioned).
- I have a gynoid body type like you since puberty; storing fat primarily on my buttocks and thighs.
- I was on Dexedrine Spansues + Memantine for the past 8 months, but I discontinued the Dexedrine. I couldn't tolerate it because it aggravated my Raynaud's in hands and feet.
- I did indeed take corticosteroids for a period when I was a child, for some kind of a lung inflamation (but not full blown asthma). My mother, however, has had asthma since she was a child and takes corticosteroids regularly.

In my next doctors appointment I will be bringing Intuniv to the attention of my doctor, and trying to get a script for it.

Thank you for all of your research and work putting this thread together!

Edited by reqless, 10 February 2014 - 09:12 AM.


#152 GetOutOfBox

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Posted 10 February 2014 - 10:53 PM

UPDATE:

Tried Ritalin again today, 10 mg Instant Release coupled with a 20 mg SR version 2 hours after taking the instant release (Ritalin SR, duration of effects about 8 hours, you can probably shorten that to ~5 hours of consistent effects). I experienced a major lift in mood, and a huge improvement in motivation and subjective pleasure from tasks. Cleaned my room (which is normally very difficult, feels like being asked to scrub a gymnasium floor), and got a lot of programming work done. Lately I've been having so much trouble working on anything that spending 2 hours straight programming is amazing for me. I think 10 mg is better than 20 mg for me, as it's enough to give me just a push, but it doesn't give me the laser focus that 20 mg does (which sounds good, but really is only good for very linear work. Anything that requires tangential thinking such as writing, programming, or learning in general is more difficult as I cannot shift my train of thought as easily. It's almost like inverse ADD).

So I definitely think that I'll be pursueing Ritalin on an as-needed basis. I've found that in the past using it regularly eventually leads to it not only becoming useless after tolerance develops, but it introduces crashes later in the day when it wears off and endogenous dopamine levels are insufficient as a result of decreased dopaminergic sensitivity brought on by regular stimulant use. I've mentioned the dosing schedule before, no more than two days in a row at a time, with a full day break between blocks.

I would say that this still doesn't mean that I don't have thyroid, corticosteroid-dementia or other issues, as stimulants will produce similar effects in healthy people at low doses. I'm still going to rule out secondary issues before settling on an ADHD diagnosis. Basically the goal is to exlude the things that CAN be tested for (unlike ADHD which is based off of psychological observations, not biological tests) and are reasonably likely (I'm not going to pursue extremely obscure possibilities like atypical lupus, etc).

One thing that I should mention that I've also been considering, is the potential that my motivational issues are part of comorbid depression. I can definitely say that I battle chronic depression, but I've never been sure if it's simply because I feel bad that I'm not productive (I certainly am justified to be frustrated with myself), or if the depression is CAUSING me to be not productive (obviously depression does interefere with productivity, but my question is a "which came first; the chicken or the egg?" kind of thing). It's definitely not Major Depressive Disorder, as my mood does quite regularly react to positive events (whereas patients suffering from Major Depressive Disorder quite often fail to emotionally react strongly or at all to positive events). It's more like atypical depression or dysthymia (which is also linked to HPA issues interestingly). I am however, extremely adverse to starting an SSRI regimen to test this hypothesis, as they quite often have a negative impact on mood for several weeks (due to serotonin autoreceptor reactivity), produce several side-effects (including some of the ones I'm trying to fix, such as anhedonia :P), and finally, aren't particularly more effective than placebos in the first place (55% positive response to SSRI, vs 30% positive response to placebo in depressed patients treated with either SSRIs or placebo). If my chronic depression persists and no other avenue of investigation helps, than I'm willing to try an SSRI as a last ditch effort. Just a note, if I had to choose, I would recommend Escitalopram (Lexapro) due to it seeming to produce the least side-effects while still being very effective.

Hi GetOutofBox,

I have been following your thread for a few months, and I just had to register to see if I could add credibility to your 'corticosteroid' theory.

About me:
- I am a 19, almost 20-year-old male living in Canada.
- My symptoms of ADHD-PI almost exactly mirror yours (although I have had a few more OCD tendencies thrown in along with the compulsive thoughts you mentioned).
- I have a gynoid body type like you since puberty; storing fat primarily on my buttocks and thighs.
- I was on Dexedrine Spansues + Memantine for the past 8 months, but I discontinued the Dexedrine. I couldn't tolerate it because it aggravated my Raynaud's in hands and feet.
- I did indeed take corticosteroids for a period when I was a child, for some kind of a lung inflamation (but not full blown asthma). My mother, however, has had asthma since she was a child and takes corticosteroids regularly.

In my next doctors appointment I will be bringing Intuniv to the attention of my doctor, and trying to get a script for it.

Thank you for all of your research and work putting this thread together!


Wow, we're like twins lol. I too am 19, almost 20. I would definitely agree with getting the Intuniv from the doctor if you have a lot of OCD issues. I myself found it completely eradicated obsessive tendencies I experienced, as well as alleviated much of the remaining social anxiety issues I had (I feel less sensitive to rejection/disapproval and I get over it faster). It's really a great drug, it simply improves prefrontal-cortical connectivity, giving the PFC more control over other areas such as the amygdala (thus reducing and modulating fear-type responses). Strattera would do something relatively similar, though indirectly, by increasing endogenous stimulation of alpha-2-adrenal receptors (that Intuniv agonises). However, since Intuniv is a selective agonist, it has much less side-effects than Strattera, most notably it doesn't not usually seem to cause nervousness/peripheral over stimulation that Strattera can. I highly advise you print and bring your doctor this document from Health Canada and this one from Shire's product website , as it is very likely that Intuniv is not in his "book of drugs", and thus he will likely be adverse to prescribing it. The first document will provide all of the information about the drug he needs including DIN numbers. The second one provides dosing information. Explain that although Intuniv is marketed for children ages 12-17, it's mechanism of action should still logically work in adults, and has been evaluated in adults in several studies. Also emphasize that it's a new non-stimulant, and that you feel it might be best for your anxious/OCD tendencies. Doctors like non-stimulants as there is no abuse potential. Do not take a "no" answer, if your family doctor refuses to even allow you to try it, you can still get a prescription from any walk-in doctor. Just explain that your family doctor refused to allow you to try a non-stimulant drug simply because it's new, and that you feel it might work better for you than traditional stimulants. Finally, bring the Health Canada document with you to the pharmacy, and explain it's a new drug that they will likely not have in stock. Give them the DIN number for the dose you need (start with 1mg and increase to 2 after a week).

Do note that Intuniv could worsen Raynauds, as it reduces blood pressure (Tenex, instant release Guanfacine, is used for high-BP patients), however I too have raynauds that affects my toes (not my hands), I have found it no better or worse with Inuniv use. That may just be me however, as I had relatively high blood pressure to start with (still safe, but high-normal). Instead of going by your subjective evaluation of your raynauds, I would just keep an eye on your blood pressure (get checked once a week), if it stays within the normal range, your Raynaud's is unlikely to be affected.

There is also a possible risk with Intuniv that I just discovered that I will put in a separate post so it's easily noticeably.

EDIT: Ignore the above, as after further investigation I do not believe there is enough information suggesting a risk. A recent study found Guanfacine to be a 5HT-2B agonist, overstimulation of which are implicated in contributing to valvular heart disease. However the study failed to specific it's Ki affinity (strength of binding), and whether it was selective for CNS 5HT-2B receptors (in which case there is no major concern) or if it does indeed bind at significant levels to cardiac 5HT-2B receptors. Overall the study was not very clear in regards to it's methods and seems to draw large conclusions from little data (claiming Guanfacine contributes to valvulopathy based on very limited data is not appropriate). I am not yet convinced of a risk, as more detailed data must be made available before drawing any conclusions from that study, instant-release Guanfacine as Tenex has been around for a couple of decades without any concerning trends being noticed, and finally SSRIs such as Prozac have been implicated in the same way (but to a larger degree due to being primarily serotonergic agents) and yet were not found to cause rapid heart disease or sudden cardiac arrest. My point is that even if it arises that Guanfacine contributes to heart disease through the 5HT-2B receptor, it would not be a concern for several years to decades (it does not cause sudden valvulopathy but gradually contributes to it). So if you're worried, get an electrocardiogram once yearly. If any valve abnormalities pop up, you'll notice them soon enough to discontinue your use of Intuniv before they become pathological.

Edited by GetOutOfBox, 10 February 2014 - 11:25 PM.

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#153 Duke318

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Posted 11 February 2014 - 08:58 PM

This thread has been extremely helpful for me, as your symptoms are almost a carbon copy of mine. I just started Intuniv last night, hopefully I will have similar results.

#154 Metagene

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Posted 22 February 2014 - 07:40 PM

Boom.

Posted Image

Stack
Adderall XR 20mg
Intuniv 2mg
Nicotine gum 4mg x2
Uridine 250mg
nawgan alertness beverage x2

I was stuck at 6% b4 lol.

Edited by Metagene, 22 February 2014 - 07:43 PM.


#155 lone rider

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Posted 22 February 2014 - 09:33 PM

hello all .. and a very good thread i must say to getoutofbox

i do not intend to go off topic from this thread but i do need some help from all u guys in the form of your valuable advice

DAY 2 on piracetam .. and i am damnn forgetfull !!!!

yesterday on day 1 i took about 4gm of piracetam in totall divided over 3 doses 200 mg modafinil and the day was so smashing and was getting my studies at good speed n stuff really going into my head and before sleeping i took 800 mg as well..

today i got up did a nice brk fast with chicken for my choline and then took 1.6 gm piracetam + 200 mg modafinil +1 multi vit. +1 B complex with almost 2 glasses of semi skimmed milk.
and i am much more forgetfull today fogetting where i kept my calculator 10 mins back, forgetting what i have studied in past two days. . i am though feeling enhanced colour thing as the computer screen do look bright to me but not being able to concentrate.
i must say past two days were nice infact i was smashing being able to do revisions jst at the back of my mindn everything was straight comming to me but today damn i cant get it on paper even if i am getting something written on it i lack confidence if its correct or not gotta chk it again n again... what the heck went wrong!!!!!

i did altered my sleep cycle though . was awake yesterday almost abt 2 hrs on modaalert but slept agood sleep inday for abt 6 hrs.

i would like to mention that before day one i did a trial with piracetam call it DAY 0 .. 800 mg in morning and 400 mg in evening + 100 mg modalert.

kindly help...:( .

#156 GetOutOfBox

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Posted 24 February 2014 - 12:49 AM

hello all .. and a very good thread i must say to getoutofbox

i do not intend to go off topic from this thread but i do need some help from all u guys in the form of your valuable advice

DAY 2 on piracetam .. and i am damnn forgetfull !!!!

yesterday on day 1 i took about 4gm of piracetam in totall divided over 3 doses 200 mg modafinil and the day was so smashing and was getting my studies at good speed n stuff really going into my head and before sleeping i took 800 mg as well..

today i got up did a nice brk fast with chicken for my choline and then took 1.6 gm piracetam + 200 mg modafinil +1 multi vit. +1 B complex with almost 2 glasses of semi skimmed milk.
and i am much more forgetfull today fogetting where i kept my calculator 10 mins back, forgetting what i have studied in past two days. . i am though feeling enhanced colour thing as the computer screen do look bright to me but not being able to concentrate.
i must say past two days were nice infact i was smashing being able to do revisions jst at the back of my mindn everything was straight comming to me but today damn i cant get it on paper even if i am getting something written on it i lack confidence if its correct or not gotta chk it again n again... what the heck went wrong!!!!!

i did altered my sleep cycle though . was awake yesterday almost abt 2 hrs on modaalert but slept agood sleep inday for abt 6 hrs.

i would like to mention that before day one i did a trial with piracetam call it DAY 0 .. 800 mg in morning and 400 mg in evening + 100 mg modalert.

kindly help...:( .


Unless your question or experience is ADD/ADHD/SCT (Sluggish Cognitive Tempo) related, don't post in this thread. That's what new threads are for, it's perfectly fine to make a new thread for a question, even if there are similar ones (though first search for threads and make sure none directly answer your question). Don't get me wrong, I don't mind personally helping via PM or weighing in on a thread, but it dilutes the purpose of this thread to post unrelated stuff here.

As for your question, I will weigh in briefly. Memory impairment is a common side-effect of many drugs which are known to be beneficial to memory. That's because the neurotransmitter systems most target have an inverse-U shaped response curve; there is a specific and small dose range that is optimal, too little won't help much, too much won't help much either or can even adversely affect memory. When it comes to neurotransmitter systems, instead of thinking of them like "brain energy" (as in, increasing dopamine linearly increases performance, like pouring gas on a fire), think of them more like musical instruments in an orchestra. For optimal performance, an orchestra must be completely in tune; synchronized (musical harmony). Now, even a person without any cognitive disorders likely has minor neurotransmitter imbalances (perhaps slightly lower or higher densities of dopamine receptors, or the same for dopamine itself, or maybe serotonin, etc). They are small enough to not disrupt function in a significant way, but they could be better harmonized. So figuratively, the person's "orchestra" (their brain) is playing relatively in harmony, but not quite. Thus certain drugs, like Ritalin, in very low doses might help to correct a minor imbalance and thus bring about a positive increase in brain function (essentially increasing efficiency of neurotransmission). So in the metaphor I'm using, the "orchestra" is made to play more in key, and thus sound better.

So in your case, you might be pushing those doses of one of the drugs you're taking too high. Too much Piracetam and too much modafinil could both on their own (and possibly together) cause memory issues in excess. Also, keep in mind that those variations in neurotransmitter levels I mentioned are not uniform amongst everyone, some people have relevant variations in the dopaminergic system, some in the cholinergic system. And the magnitude of the variations are also different. Further complicating things, people often have different levels of various enzymes involved in drug metabolism, and thus respond differently to different doses. So what might be a high dose of Piracetam for you, could be a low dose for someone else. In any case, I would advise halving your dose of Piracetam and Modafinil and starting from there. Slowly work your way higher (try each dose level for 3 days before raising again) until you again hit that barrier where you're adversely affected, then return to the last dose that worked best for you.

Boom.

Stack
Adderall XR 20mg
Intuniv 2mg
Nicotine gum 4mg x2
Uridine 250mg
nawgan alertness beverage x2

I was stuck at 6% b4 lol.


Impressive! I would exercise caution in your usage of both Adderall and Nicotine. Both have great potential to improve performance, and I think your chosen doses are very prudent, but they both produce tolerance relatively quickly, and addiction can set in soon after (at those doses addiction is not a serious issue if you don't begin escalating doses, but tolerance is a bummer :P). I would make sure you cycle them, perhaps in a schedule of 3 days on, 4 days off or similar, to maintain maximum efficacy on the days you use them. Also keep in mind that Adderall as an ampetamine has neurotoxic potential. At 20 mg, acute neurotoxicity is not a concern, though it's unclear if it causes minor cumulative damage over time. I would not be extremely concerned, but it might be worth adding on a regular antioxidant supplement to make sure you have optimal levels.

#157 Metagene

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Posted 24 February 2014 - 03:20 AM

Yeah I'm thinking about laying off the Adderall on weekends to avoid tolerance. Nicotine gum is nice but the plan is to drop it all together once EVP-6124 arrives. As far antioxidant are concerned I'm pretty well covered. Unfortunately my stack tends to remain in a constant state of flux xD. Raw cacao is my number #1 go to supplement along with Vitamin D but I recently add wild blue powder and Fish oil to start the day. Then I usually take Ashwagandha at noon and cycle Reishi mushroom with Chaga at night. Everything else is used sporadically or when necessary like uridine and CDP choline. I also swapped Jiaogulan for Matcha and have the occasional glass of red wine instead of beer.

Edited by Metagene, 24 February 2014 - 03:22 AM.


#158 broadbean

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Posted 26 February 2014 - 05:53 AM

Just found your post and appreciate the detail and rigor of your entries.

I have ADHD and have been on Adderall for about four years. At times I've been on up to 80mg XR a day, but for the past year have been on only 30mg XR daily. Even though the Adderall does make me less lethargic, I've never felt that it delivered on producing mental clarity. Over the last year I had been experiencing a lack of focus while still feeling the physical "speedy" affects of Adderall. One of the symptoms of my ADHD was that I was easily agitated and frustrated, which in turn made me agitating and frustrating to the people around me. I was in talk therapy for a couple years before I was diagnozed with ADHD, and I always felt that the therapists message of "you're smart, just be conscious of your actions" was a great idea but unacheivable for me. I felt there was a biochemical component missing which led me to being diagnosed as ADHD and going onto Adderall.

About two months ago I found Longcity and started on the following modified CILTEP stack in addition to my Adderall:

900Mg Artichoke Extract
250mg Forskolin (20% active)
500mg ALCAR
1 B-Complex vitamin
250mg CDP Choline
100mg Phenylpiracetam
+ normal dosage of 30mg Adderall XR

On the very first day of using this stack I had noticeable mental clarity, ability to focus and simply felt calm and composed rather than jumpy and anxious. I've continued this stack with the addition of adding Now 800mg Quercetin for anti-inflamitory affects (lifelong asthma) and 500mg L-Phenylalanine.

The stack has improved my ability to access states of deep concentration as well as allowed me to be less reactive. Over the past week due to my prescribing doctor being on vacation and my Adderall supply running low, I first halved my daily dose of Adderall to 15mg, then to 10mg with no real noticeable affects on my productivity or emotional state. I defintely notice when I'm off my Adderall, so do others.

Also I've always drank a cup of coffee in the morning. During the last four years, it's simply made me extra jumpy on top of the Adderall. After taking the stack, it's like I can tell I've had coffee, but it's a welcome compliment to the stack. That was unexpected.

My only concern is my daily use of Phenylpiracetam, since its not well tested. But i think this is the main item in my stack that has allowed me to reduce my Adderall dose.

Just adding more data points to the thread. Thanks.

Edited by broadbean, 26 February 2014 - 06:00 AM.


#159 Metagene

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Posted 26 February 2014 - 07:00 PM

This is most encouraging. I work the A.M shift and only had around 5 hours of sleep. :wacko:

Posted Image


On to paired associates.

Edited by Metagene, 26 February 2014 - 07:23 PM.


#160 GetOutOfBox

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Posted 26 February 2014 - 07:53 PM

Found out that I wasn't dosing Noopept right previously. Somehow I got the assumption that the scoop newstarnootropics provided was roughly 10 mg. Turns out it's not and their website says nothing like that (maybe it did?). Anyways, so I weighed out 10 mg of Noopept today and it was more like 4 scoops lol.

So I just tried about 15 mg Noopept and am finding a very nice modest effect. It doesn't seem to have much effect on my concentration (the ritalin I took does, but it didn't increase with the addition of the noopept). However I do find an improvement in my memory function, so far I'm noticing that my working memory seems a bit better and my ability to pull things I've learned from long-term memory and apply them to new things seems a bit improved too. It's too early to tell whether it's improving my memory encoding efficiency, though we'll see.

I'm definitely going to use this daily for a while to see what happens.

Just found your post and appreciate the detail and rigor of your entries.

I have ADHD and have been on Adderall for about four years. At times I've been on up to 80mg XR a day, but for the past year have been on only 30mg XR daily. Even though the Adderall does make me less lethargic, I've never felt that it delivered on producing mental clarity. Over the last year I had been experiencing a lack of focus while still feeling the physical "speedy" affects of Adderall. One of the symptoms of my ADHD was that I was easily agitated and frustrated, which in turn made me agitating and frustrating to the people around me. I was in talk therapy for a couple years before I was diagnozed with ADHD, and I always felt that the therapists message of "you're smart, just be conscious of your actions" was a great idea but unacheivable for me. I felt there was a biochemical component missing which led me to being diagnosed as ADHD and going onto Adderall.

About two months ago I found Longcity and started on the following modified CILTEP stack in addition to my Adderall:

900Mg Artichoke Extract
250mg Forskolin (20% active)
500mg ALCAR
1 B-Complex vitamin
250mg CDP Choline
100mg Phenylpiracetam
+ normal dosage of 30mg Adderall XR

On the very first day of using this stack I had noticeable mental clarity, ability to focus and simply felt calm and composed rather than jumpy and anxious. I've continued this stack with the addition of adding Now 800mg Quercetin for anti-inflamitory affects (lifelong asthma) and 500mg L-Phenylalanine.

The stack has improved my ability to access states of deep concentration as well as allowed me to be less reactive. Over the past week due to my prescribing doctor being on vacation and my Adderall supply running low, I first halved my daily dose of Adderall to 15mg, then to 10mg with no real noticeable affects on my productivity or emotional state. I defintely notice when I'm off my Adderall, so do others.

Also I've always drank a cup of coffee in the morning. During the last four years, it's simply made me extra jumpy on top of the Adderall. After taking the stack, it's like I can tell I've had coffee, but it's a welcome compliment to the stack. That was unexpected.

My only concern is my daily use of Phenylpiracetam, since its not well tested. But i think this is the main item in my stack that has allowed me to reduce my Adderall dose.

Just adding more data points to the thread. Thanks.


Great to hear you're having good results with CILTEP. I think it's very important to emphasize in this thread that there appears to be no single answer to AD(H)D like symptoms, it seems the medical research in those areas are still in it's infancy, as so many people with similar symptoms (inattentiveness, poor working memory, emotional lability, etc) seem to respond to different things. I would definitely make sure you're actually testing your performance with objective tests and not just your subjective experience, as you should keep in mind many "treatments" mentioned here will have an effect in everyone, and for the things we're targeting, it's easy for something to "feel" helpful, when it's actually not. A lot of dopaminergic things tend to produce the interesting effect of "feeling" like you're performing better when you're actually not (pretty much the whole point of Cocaine and Methamphetamine use, they make you feel on top of the world while only bring a minor to no improvement in actual cognitive ability).

#161 Duke318

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Posted 28 February 2014 - 10:03 PM

How is Intuniv working for you? I'm seeing a reduction in anxiety but not much help for ADHD. Ever research or try Agmatine? It's also an alpha 2 agonist and NMDA antagonist.

#162 GetOutOfBox

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Posted 28 February 2014 - 11:02 PM

Pretty much the same results for me. I experienced reduced anxiety, reduced impulsiveness and reduced addictive tendencies. I did not however feel a huge increase in my ability to concentrate, but my observation of that is limited by the fact that my main issue is with initiating work, not maintaining it. I still think it's worth it, but I'll probably cycle off to see if I'm adversely affected.

As for the Agmatine, I have tried it. Didn't really notice much at all actually, at least acutely. I didn't use it daily, so there could be a long term benefit. It's definitely one of the more interesting agents and has a huge amount of applications (augmenting pain relief, potentiation of various substances, possible augmentative effectiveness with lithium in bipolar patients, etc), in theory.

One thing to note is that it competes for the alpha-2 adrenal receptors and will dissociate other substances from them. So taking it alongside another alpha-2 agonist is probably pointless as it will blockade the effect of the other substance, though still provide some measure of effect in turn, however it's probably less efficacious in that regard (Guanfacine is nice because it's very selective, and binds specifically to post-synaptic receptors).

#163 GetOutOfBox

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Posted 03 March 2014 - 08:27 PM

Just got my ZRT Lab blood spot test results back. I tested: Total Testosterone, DHEA-Sulfate, Free T4, Free T3, TSH, TPO (Thyroid Peroxidase).

Most of my results were all within ZRT Lab's reference ranges, however my Free T4 was in the upper end of their range, and was way over other labs ranges. My Free T4 was measured at 2.2 ng/dL (ZRT ref range: 0.7-2.5). The highest Tolerable Upper Limit I could find from other labs was 1.8, some being as low as 1.4.

TPO antibodies were also elevated (23 IU/mL), but below their reference range. However, their reference range was again huge, whereas the recommendation from other sources was an Upper Limit of 9 IU/mL.

What does this mean? It POSSIBLY confirms a thyroid issue, specifically that I may have Graves Disease (which my grandmother had). I called ZRT Lab and asked them for some more info as to why their lab has a higher reference range, and was told that the reference range depends on the testing setup the lab has (which does not make sense, as computerized testing hardware is calibrated using a densitometer in order to compensate for hardware-induced differences. There's no reason why the lab would have to artificially raise the reference range to compensate for hardware differences, they just have to factor in a calibration factor when calculating the results). I was also fed a suspiciously PR-sounding line when I inquired whether I should do a follow-up test with a local lab using drawn blood ("Oh no, we standby the accuracy of our tests, and blood spot testing is just as good and maybe better than drawn serum testing."). When I asked about my TPO results, she had to consult a doctor on-staff (she didn't seem to know what TPO meant), which gave away that she was not a doctor herself and was just feeding me back standard PR lines. There's nothing wrong with that, she was very polite and helpful, but I'm not so confident in her answers.

If I had no symptoms of hyperthyroidism, and no family history of it, I would accept the results I've been given and just move on. However, my Free T4 is very much above the Upper Limit of all the other labs as well as my TPO antibodies. I DO have symptoms and a family history (both sides of the family had diagnosed hyperthyroidism quite a bit up the family tree). The symptoms that I have for certain include:

Nervousness, tremor, irritability, anxiety, fine brittle hair, muscular weakness. I don't gain weight even when I binge on candy for weeks. I used to infrequently experience heart palpitations, though it's likely the Intuniv has put a stop to them. Fatigue and concentration issues are also characteristic of hyperthyroidism.

I'm going to go to my doctor and insist on having a lab test of my Free T4 done. I suspect he'll be reluctant, so I may go to a walk-in and ask for a referral to an endocrinologist.

It's frustrating that the medical community will diagnose ADHD at the snap of a finger (a condition which is not known to be curable, but manageable. In my case, it was not even managed), but will make patients jump through hoops just to rule out other conditions which ARE treatable. Many patients experience complete remission of symptoms within 1-2 months of restoring thyroid levels to normal!

Edited by GetOutOfBox, 03 March 2014 - 08:35 PM.


#164 GetOutOfBox

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Posted 03 March 2014 - 10:33 PM

UPDATE:

Got a walk-in doc to refer me for bloodwork to get my TSH and Free T4 checked.

#165 Mind_Paralysis

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Posted 04 March 2014 - 01:49 AM

Will be rather interesting to hear what your results are there.

I took a TSH-test for hypothyroidism myself, but according to the Dr, my values were well within limit. In Scandinavia it's apparently very uncommon that they check for free T4 as well, if the TSH comes out normal - so he didn't order a test of Free T4 as well.

I did some testing of my body-temperature as well, continously for a week, which did show that it's quite low, which is indicative of a thyroid-problem, however - I was always skirting the lowest end of the recommended value for the Braun termometer which I bought, about 35.5 degrees Celsius, so my Dr felt that I'm within the body-temp range of healthy individuals, just on the far end.

If you are once again on the Thyroid-track, I would suggest doing some body-temp testing while you wait for the results, if your body-temp is contionuously low, something is off.
I definitely recommend Braun as a manufacturer of accurate thermometers - they're cheap, and hella' good. German quality, my friend.

#166 GetOutOfBox

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Posted 04 March 2014 - 02:59 AM

Well I'm not set on any one possible cause of my symptoms. I'm merely trying to rule out the diagnosable ones before settling on a psychiatric diagnosis (as my symptoms are not typical of ADD). If thyroid issues are ruled out, I'll look at cortisol (it's unlikely I have elevated cortisol, as I don't have weight gain issues or immunosuppression. But low cortisol is possible). I was originally concerned about sleep apnea, but I most definitely do not have issues with daytime sleepiness. I have no problem staying awake, even when just sitting idly. It seems to me that sleep apnea in virtually all cases would produce tiredness, since you're essentially not getting quality sleep. I've always been alert (and I don't take stimulant meds regularly anymore, nor do I drink caffeinated beverages), the fatigue issues I have are more related to concentration and exercise intolerance. I might try to get a doctor to give me a ACTH Stimulation Test to check adrenal function, but I don't know how I'll be able to convince one.

The other major possibility I'm considering is malabsorption of nutrients. However I skipped checking that as I don't have nausea, bloating, diarrhea, or constipation, all of which usually present with gastrointestinal issues. About the only possible "symptom" I have is excessive flatus (fart) production, which I'm not even sure is pathological and quite honestly is more likely just me looking for symptoms. A routine blood test a year ago showed my Vitamin B levels were normal towards their reference ranges (though Japan recently raised the lower limit which puts me slightly deficient, though a B vitamin deficiency typically produces peripheral neuropathy which often manifests as strange sensations in hands/feet, which I have not experienced).

I have ruled out hyper/hypoglycemia (diabetes), simply because it's the nature of that disorder that the symptoms fluctuate. Diabetic individuals have their blood sugar go up and down, it doesn't stay constant throughout the day by definition (hence the symptoms are like a rollercoaster ride, clearing up then coming back in full force in as short as an hour or less). Symptoms would also react to sugar consumption, which in my case they do not. My symptoms stay pretty much constant, which suggests a cause which is relatively constant (or at most fluctuates very slowly throughout the day).

Basically, I'll get an AM cortisol test from ZRT assuming no thyroid issues are revealed. If that comes back normal, I think I'll just stick with the ADHD diagnosis for the time being, however I'll keep checking cortisol and thyroid levels every year to see if there's a progressive change (as I may be diagnostically subclinical at the moment).

As for thyroid testing, TSH is basically a positive indicator or thyroid issues when it is abnormal, but a normal TSH does not rule out thyroid issues. There are several conditions in which TSH is not even relevant, such as thyroid hormone resistance (where due to a mutation in T3 receptors cells respond less to the hormone). In these cases, the hypothalumus is unable to recognize any problem (as it is only able to respond to serum levels of thyroid hormones, there is no mechanism for it to detect an innate failure to respond to T3 or T4), and thus will not release more TRH, which in turn means the pituitary gland won't release more TSH. Yet the patient has hypothyroid symptoms. Even regular cases of hyperthyroidism or hypothyroidism can present with only a minor or no abnormal TSH level. It's not unheard of.

When it comes to thyroid function, in most cases the T3 is the most accurate gauge of it's function. It's the end of the "thyroid chain" (TRH-> Stimulates TSH release -> Stimulates T4 release -> T4 is converted to T3 while circulating) (there's also "bound" versions of T3 and T4, which are inactive until unbound, they aren't really relevant to testing, though some clinicians order them for some reason. Free T3 is always a better test than Total T3), so if your T3 levels are normal, the only other possibility is your cells are resistant to T3, which is fairly rare and most of the people who do have T3 resistance would have had thyroid issues for their entire life (as the mutation is congenital).

Unfortunately in my case the doc referred me for a Free T4 test, which while much better than just a TSH is still not the complete picture. I didn't fight him on it however, as my Free T3 on the ZRT test was smack in the middle of their range, which would require a huge margin of error to push it into the clinical range.

#167 Duke318

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Posted 04 March 2014 - 03:14 AM

I think you're on to something with the Thyroid route. Even someone whose results lie in the "normal range" can have a malfunctioning thyroid, which would effect all of the neurotransmitters.



I'm currently doing a trial of Iodine...hoping that it will clear out years of toxins and cure my lifelong appetite issues via thyroid.

#168 GetOutOfBox

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Posted 04 March 2014 - 03:25 AM

UPDATE:

Just double checked the DHEA-S levels vs common reference ranges, and they're actually a bit on the low end compared to most, and clinically low compared to some. So it's still on the table. I might go back to the Pregnenolone/DHEA-S/7-Keto stack and give it a go for a month to see what happens. It's not something I would do long-term without careful monitoring, as both pregnenolone and DHEA-S convert to sex hormones downstream. Elevating sex hormones for an extended period can cause an exacerbation of masculine traits and/or feminization (and vice versa for women). Any minor changes that occur in a month will reverse themselves gradually over a month or two once I've ceased taking the hormones (it's not likely that I'll develop noticeable breasts or fat around the hips in the space of a month, though at worst I might see a minor enlargement). If I'm not noticing a signifigant improvement in objective and subjective symptoms, I'll discontinue them. If I do notice a great improvement, I'll get monthly blood tests until I can find a dose that keeps me in a safe hormone range (I'll have to test female and male sex hormones, as pregnenolone and DHEA convert to both as well as having actions as themselves).


UPDATE in regards to other nootropics I've been taking:

I'd also like to note that I've been using Ashwagandha, Bacopa, and Rhodiola Rosea daily for a bit over a month now. The Bacopa and Rhodiola I take once daily in the morning (Bacopa: 1.2 grams, Rhodiola 100 mg normally, 450 mg for days I anticipate to be very stressful, or when I'm not feeling very rested), the Ashwagandha I was originally just taking once at night, but I've recently been taking 2-3 times spread throughout the day (in doses of 2 grams).

I've had great results, firstly, I suspect the Ashwagandha has been living up to it's supposedly immune enhancing qualities (the research seems to indicate a broad-range enhancement of the immune system, increasing Immunoglobulin, Macrophages, Natural Killer Cells, and T Cells), as I've not even had a minor cold during the time I've been taking it. It's still early yet, but I'm usually pretty cold-ridden during the winter.

As for all of them reducing anxiety, I've had a particularly noticeable reduction in anxiety in the last 2 weeks. It's like that final bit left over from the Intuniv use is finally taken care of. I'm still not the most confident person ever, but the chronic anxiety seems taken care of (and acute anxiety is greatly reduced). I'd definitely advocate them for this purpose (particularly the Ashwagandha and the Bacopa).

Cognitive fatigue is also reduced, but not as dramatically, and I've found no noticeable benefit to my concentration or memory (I'm not saying my memory is not a bit improved, but I haven't had any moments where I've been impressed with it. I have had an overall improvement during my nootropic use, but it stabilized prior to my commitment to this new stack).

I'm still unsure how Noopept has been affecting me. I've been sticking to a dose of about 10-15 mg sublingually, as it does not seem wise to go any higher (the way I see it, I shouldn't be using doses higher than what patients with brain trauma use, in fact the dose really should be a bit lower. I definitely advise against doses higher than 30 mg, that's outside even the clinical range and should not be necessary). So far haven't noticed a whole lot. I was a bit worried that it was temporarily impairing me slightly, and I'm still not sure if that's the Noopept or other factors (sleep, etc). Haven't noticed any miraculous effects, which isn't very surprising, as that's not really what it's supposed to do.

Edited by GetOutOfBox, 04 March 2014 - 03:53 AM.


#169 GetOutOfBox

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Posted 05 March 2014 - 04:51 PM

I've been noticing that Noopept seems to give me slight time dilation, in a pleasant way. Not enough that I feel like time is actually slowed down (which LSD and to a lesser extent cannabis can produce), but I'll look over at the clock feeling like 20 minutes has past, and be pleasantly surprised that only 10 have. It may be related to greater alertness or perhaps increased memory formation in the hippocampus, as it doesn't feel like my perception of time is altered, more my use of it. And as always, it's possible it's just a placebo symptom, but I've noticed it fairly consistently.
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#170 rowebil

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Posted 05 March 2014 - 09:24 PM

I have the same issues as your first post, so I am closely following this as well.

I seem to have issues with comprehension. I am a true fan of learning on my own and applying my own common knowledge to such tasks, but when it comes to reading out of a textbook and putting ideas together to form a discussion - I find it difficult.

And I've also seen a video where this female told her boyfriend to take adderall because he was unable to focus, and also couldn't see the body language and hints that she was showing him. After taking Adderall, he was shocked that he was now able to read these 'hints' and messages that she was showing him. I have trouble with this as well. I would hang out with a girl, and explain the issue later to my friends, only to know that she showed me 100 signs that she wanted me emotionally and sexually.
So I have a hard time focusing on a task, motivational issues, and reading body language and comprehending it.

I have many noots, due to the supplier on Amazon who had sent me a sample pack -- and then again, when I said I didn't receive it. So they had treated me extra well. I do have Phenylpiracetam, but none of the others. It seemed to work when I had taken it first, but not anymore. And thinking about it, I can almost taste the bitterness of it (even though I hadn't taken it for two weeks).

So I think I am going to try Oxiracetam for studying, and Aniracetam both alone and together.
I've seen multiple posts about Aniracetam being good for writing, and talking to new people and getting shit down. Oxiracetam being a pure focus tam, but not good for flexible thinking. I guess I will start there.

I would definitely enjoy hearing the opinion of the OP about my stack above.

I take 8 fish oil capsules -- 2 capsules have 720mg of omega-3, so it is around 2880 a day in omega-3. And now I take magnesium, 300mg a day. Vitamin D is also essential (just as magnesium) so I will be taking that shortly.
I really want a stack for studying because I really do have trouble. In middle school, I would go to a woman who would test me for reading comprehension. I can read perfectly - perfect pronunciation, and perfect speed. I was the best in my class. Also, I am perfect for writing with knowledge I have acquired through doing. College is reading, not doing something. In high school, she proved that I had a hard time concentrating, and remembering what I read. I looked it up today, and reading comprehension issues said people have issues remembering what they read, get confused after reading several pages, find it difficult to explain things (omg yes), answers the wrong questions, difficulty maintaining relationships because they don't understand or communicate well, and feel frequently frustrated that they can't 'break through' no matter how many things they've tried.

This happens with me a lot. I also feel frustrated with my dumb car, no matter how many things I tried. For instance, this stupid clip had me swearing and all haha.

So I definitely think my issue is comprehension. There was this guy I was trying to explain a situation to, and he mentioned reading comprehension issue as well. He was completely rude and failed to understand what I was telling him. I knew he said that just to win this argument we had, but now I am really thinking that I do have issues comprehending my thoughts and what I read.

It sucks because I do fail at realizing body language and these hints these women throw at me. :-/ and personal relationships are something I REALLY strive to maintain.
http://www.understan...om/i-adults.htm

#171 GetOutOfBox

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Posted 10 March 2014 - 11:20 PM

UPDATE on Intuniv: If you start noticing the development of depressive mood patterns (not just being depressed all the time, but abnormal psychological signs, such as a paradoxically depressed reaction to a positive or neutral event), it's possible the Intuniv might be inducing them. Most meds affecting neurotransmitters have the potential to cause depression (as it seems depression manifests as a sign of abnormal brain function, not just any one neurotransmitter being too low or high), but adrenergic medications seem to have a greater tendency to induce it then other medications. Strattera (Atomoxetine) is an example of an adrenergic ADHD med well known to often cause depression, especially if the dose is too high. It seems Intuniv is less likely than Strattera to cause depression (being specifically an alpha-2 adrenal receptor agonist, rather than a reuptake inhibitor for norepinephrine like Strattera, which increases activity at all adrenal receptor sites), but there's still the possibility.

So if you noticed increased frequency of depressive episodes (or chronic mild depression that was not present before starting Intuniv), perhaps taper off the dosage, and see if taking a break gets rid of the depressive symptoms.

I have the same issues as your first post, so I am closely following this as well.

I seem to have issues with comprehension. I am a true fan of learning on my own and applying my own common knowledge to such tasks, but when it comes to reading out of a textbook and putting ideas together to form a discussion - I find it difficult.

And I've also seen a video where this female told her boyfriend to take adderall because he was unable to focus, and also couldn't see the body language and hints that she was showing him. After taking Adderall, he was shocked that he was now able to read these 'hints' and messages that she was showing him. I have trouble with this as well. I would hang out with a girl, and explain the issue later to my friends, only to know that she showed me 100 signs that she wanted me emotionally and sexually.
So I have a hard time focusing on a task, motivational issues, and reading body language and comprehending it.

I have many noots, due to the supplier on Amazon who had sent me a sample pack -- and then again, when I said I didn't receive it. So they had treated me extra well. I do have Phenylpiracetam, but none of the others. It seemed to work when I had taken it first, but not anymore. And thinking about it, I can almost taste the bitterness of it (even though I hadn't taken it for two weeks).

So I think I am going to try Oxiracetam for studying, and Aniracetam both alone and together.
I've seen multiple posts about Aniracetam being good for writing, and talking to new people and getting shit down. Oxiracetam being a pure focus tam, but not good for flexible thinking. I guess I will start there.

I would definitely enjoy hearing the opinion of the OP about my stack above.

I take 8 fish oil capsules -- 2 capsules have 720mg of omega-3, so it is around 2880 a day in omega-3. And now I take magnesium, 300mg a day. Vitamin D is also essential (just as magnesium) so I will be taking that shortly.
I really want a stack for studying because I really do have trouble. In middle school, I would go to a woman who would test me for reading comprehension. I can read perfectly - perfect pronunciation, and perfect speed. I was the best in my class. Also, I am perfect for writing with knowledge I have acquired through doing. College is reading, not doing something. In high school, she proved that I had a hard time concentrating, and remembering what I read. I looked it up today, and reading comprehension issues said people have issues remembering what they read, get confused after reading several pages, find it difficult to explain things (omg yes), answers the wrong questions, difficulty maintaining relationships because they don't understand or communicate well, and feel frequently frustrated that they can't 'break through' no matter how many things they've tried.

This happens with me a lot. I also feel frustrated with my dumb car, no matter how many things I tried. For instance, this stupid clip had me swearing and all haha.

So I definitely think my issue is comprehension. There was this guy I was trying to explain a situation to, and he mentioned reading comprehension issue as well. He was completely rude and failed to understand what I was telling him. I knew he said that just to win this argument we had, but now I am really thinking that I do have issues comprehending my thoughts and what I read.

It sucks because I do fail at realizing body language and these hints these women throw at me. :-/ and personal relationships are something I REALLY strive to maintain.
http://www.understan...om/i-adults.htm


I think noots definitely have the ability to help cases like yours. In terms of studying nootropics, I tend to disagree with the idea that the various racetams each have their own very specific effects that people often ascribe too them. I think some might help certain general areas of cognition more than others, but I'm very skeptical of claims that one is good for reading, and one is good for writing, etc. Most cognitive tasks involve pretty much all of the brain's systems, for example, we now know that language is nowhere near as localized in the brain as we previously thought, but that it involves pretty much all regions of the brain. We've also found that the brain seems to encode memories pretty much everywhere instead of just one specific spot. Most of the claims about certain racetams causing very specific effects probably originated from a couple of users erroneously ascribing a coincidentally good day of writing too the nootropic, and then the placebo effect perpetuates it for a few days. I can guarantee you won't see any actual studies noting such specific effects.

In regards to some of the racetams you mentioned, I would not bother with aniracetam. It has a ridiculously short half-life, you'd need to dose it pretty much every hour you wanted to feel it's effects. It's also not water soluble, which means every time you dose it, you'll need to eat or drink something fatty with it for optimal absorption. If you like the sound of it's effects, there are other AMPAkines that are much more practical (Nefiracetam or Sunifiram are good options).

I liked Oxiracetam most out of all the racetams, it's definitely one I'd take daily. It was just the right amount of "stimulation" (not Ritalin like stimulation, but increased awareness, memory retention, clearer thought streams, etc), but it wasn't excessive like other racetams. Note that in my experience the effects of racetams follow an inverse-U shaped curve of performance. They all have effects after a certain dosage is surpassed, but those effects are not always positive. It's like they put your brain in overdrive; a little bit squeezes a bit more performance out of your brain, but excessive stimulation starts causing errors and other dysfunctions (i.e mood instability). Some racetams I found to simply be too strong at their functional doses, others didn't do much. Oxiracetam sat comfortably in the area that I felt just a little bit of a boost, but without side-effects. I wouldn't limit your use of it to just studying, it's definitely a very good all-around nootropic. As always though, start with a low dose, and work your way up until you reach that sweet spot where your performance increases, but no side-effects appear.

As for the fish oil, you can probably cut your doses to 2 grams a day (that numbers for the weight of the fish oil itself, not the concentration of fatty acids) for most cognitive goals. Most of the studies for fish oil's effect on brain health in healthy people (so excluding those who are deficient, elderly or are trying to treat some sort of disorder), used between 1-2 grams. That's assuming it's quality fish oil of course, if it has lower concentrations of EPA and DHA than most, a higher dose is prudent.

I can't agree more with your decision to supplement magnesium, I'm constantly recommending it to people. A few studies have calculated that a very large portion of Americans have clinical magnesium deficiency (their serum levels are below the recommended range. Not all of them are necessarily pathological or have any symptoms at all, but it definitely doesn't hurt to keep your magnesium levels optimal). Slightly reduced levels of magnesium can affect the brain in very subtle ways, whereas levels need to drop signifigantly to produce pronounced systemic symptoms. A slight deficiency can contribute to anxiety disorders, produce general nervousness, fatigue, difficulty concentrating, cause mild tremors or cramps, etc. So definitely a good idea to take a daily supplement (although the study examined Americans, it's results likely extend to Canada and any other country with a diet similar to Americans). Just don't overdo it, like most metals, taking excessive amounts of one can disrupt the absorption of others, so stick to the recommended dose for the form you take (it differs between Magnesium Citrate, Gluconate, L-Threonate, etc, so look it up for whichever type you choose). Vitamin D is also something good to take regularly, though less so than magnesium. Making sure you have adequate levels will reduce the risk of some cancers (particularly colon cancer), and supplementing it might be ideal for those with Seasonal Affective Disorders (mood disorders which have been found to definitively correlate with winter, and hence possibly reduced Vitamin D levels).

For your social issues, you'll probably find that the racetams don't help a whole lot. You'll see some individual case reports of seemingly remarkable improvements in those with such issues, but there haven't been any studies noting such effects in those trying the racetams, so it seems unlikely. What's more likely to help those conditions is either an adrenergic agent (Strattera, Intuniv, etc) or a dopaminergic agent (i.e Adderall or Ritalin). Adrenergic agents seem to directly affect concentration (usually increasing one's ability to focus, as well as the duration one can focus) amongst other things, whereas dopaminergic agents seem to induce exploratory behavior (i.e socializing, work initiation, etc), as well as produce some improvements in working memory related tasks (though this portion of their effects tends to follow an inverse-U shaped performance curve; too much potency and/or too high of a dose can cause decreased working memory performance, and I can back this up from experience). Note that neurotransmitter systems tend to indirectly affect others, hence why some people find Strattera improves their ability to socialize, or Ritalin reduces their hyperactivity (hint: it has downstream adrenergic activity, so it helps that symptom in the same way Intuniv does).

I would advise trying Ritalin for your social issues. Don't start with one of the time release ones, as they can be a bit finnicky and inconsistent, so I wouldn't judge the performance of methylphenidate based on them. Also start low. I found higher doses certainly feel good, but they don't help me, and even adversely affect me (i.e making me focus too much, to the point I would forget other things easily). A dosage of 10 mg to start should be fine if you have an average body weight. If you're in the upper end of things, 20 mgs would be the highest I'd go to start. Be cautious if the doctor prescribes amounts greater than 40 mg daily (they frequently will, but that's higher than needed and will probably produce lots of side-effects, tolerance, and addiction).

#172 Metagene

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Posted 11 March 2014 - 05:37 PM

I think Ashwagandha can possibly counter intuniv's depressive effect as it does with Clonidine.

The antidepressant effects of Ashwagandha appear to be blocked by the pretreatment of prazosin (general α-adrenergic receptor blocker)[124] while the depressive symptoms induced by clonidine (α2 adrenergic and imidazoline agonist) and reserpine (catecholamine depleter) were abrogated with pretreatment of Ashwagandha at the antidepressive dose, while haloperidol (dopamine antagonist) was not involved in the antidepressive effects.[124] These effects are similar to Yohimbine which can block the depressive effects of clonidine directly and both Ashwagandha[124] and yohimbine[125] potentiate the effects of SSRIs.


http://examine.com/s...ha/#summary5-11

I wanted to experiment using higher doses of Intuniv but right now 2mg costs me $60 a month. I going to drop it and look for some modafinil in bulk quantities.



#173 Jeoshua

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Posted 11 March 2014 - 06:37 PM

I would echo the idea that Ashwagandha can be effective in someone with ADHD. I've tried it, myself, 250mg of KSM-66 extract mellows me out to a great degree. It also mitigates the side effects of nearly every medication or supplement that I have tried in conjunction with it, up to and including Cannabis (500mg of KSM-66 and I barely even feel stoned after several grams of potent cannabis).

#174 Mind_Paralysis

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Posted 12 March 2014 - 08:38 AM

I think Ashwagandha can possibly counter intuniv's depressive effect as it does with Clonidine.

The antidepressant effects of Ashwagandha appear to be blocked by the pretreatment of prazosin (general α-adrenergic receptor blocker)[124] while the depressive symptoms induced by clonidine (α2 adrenergic and imidazoline agonist) and reserpine (catecholamine depleter) were abrogated with pretreatment of Ashwagandha at the antidepressive dose, while haloperidol (dopamine antagonist) was not involved in the antidepressive effects.[124] These effects are similar to Yohimbine which can block the depressive effects of clonidine directly and both Ashwagandha[124] and yohimbine[125] potentiate the effects of SSRIs.


http://examine.com/s...ha/#summary5-11

I wanted to experiment using higher doses of Intuniv but right now 2mg costs me $60 a month. I going to drop it and look for some modafinil in bulk quantities.


Ey, excellent find Metagene! =) Definitely going to look into Ashwaganda for my stack now.
Question btw - do you guys figure Ashwaganda would inhibit the depressive effects of Methylphenidate as well? I find that when I've been on it uninterupted for a week or so, I get depressed.

2-3 days as GetoutofBox mentions, seems to work ok tho', but recently I had the need to produce a very great deal of artistic work, so I took Concerta for a week straight, to get things done, and it ended badly, with a lot of anxiety on the last day.

Would ashwaganda help, for those longer periods? I've got two of those study-related binges coming up, one in order to produce comic-book pages, and one in order to learn mathematics, so a bit of a band-aid on the meth-induced anxiety would be nice.

Btw, Metagene, what is your final review of Intuniv? Here in Sweden we have a public medical insurance, so price isn't much of an issue here. Is it worth using? Depressive effects compared to meth? Better? Worse?

#175 Metagene

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Posted 13 March 2014 - 06:44 PM

I think Ashwagandha can possibly counter intuniv's depressive effect as it does with Clonidine.

The antidepressant effects of Ashwagandha appear to be blocked by the pretreatment of prazosin (general α-adrenergic receptor blocker)[124] while the depressive symptoms induced by clonidine (α2 adrenergic and imidazoline agonist) and reserpine (catecholamine depleter) were abrogated with pretreatment of Ashwagandha at the antidepressive dose, while haloperidol (dopamine antagonist) was not involved in the antidepressive effects.[124] These effects are similar to Yohimbine which can block the depressive effects of clonidine directly and both Ashwagandha[124] and yohimbine[125] potentiate the effects of SSRIs.


http://examine.com/s...ha/#summary5-11

I wanted to experiment using higher doses of Intuniv but right now 2mg costs me $60 a month. I going to drop it and look for some modafinil in bulk quantities.


Ey, excellent find Metagene! =) Definitely going to look into Ashwaganda for my stack now.
Question btw - do you guys figure Ashwaganda would inhibit the depressive effects of Methylphenidate as well? I find that when I've been on it uninterupted for a week or so, I get depressed.

2-3 days as GetoutofBox mentions, seems to work ok tho', but recently I had the need to produce a very great deal of artistic work, so I took Concerta for a week straight, to get things done, and it ended badly, with a lot of anxiety on the last day.

Would ashwaganda help, for those longer periods? I've got two of those study-related binges coming up, one in order to produce comic-book pages, and one in order to learn mathematics, so a bit of a band-aid on the meth-induced anxiety would be nice.

Btw, Metagene, what is your final review of Intuniv? Here in Sweden we have a public medical insurance, so price isn't much of an issue here. Is it worth using? Depressive effects compared to meth? Better? Worse?


Probably not directly. Methylphenidate is mostly a dopamine reuptake inhibitor. Ashwaganda still maybe useful for treating anxiety and depression so I wouldn't hesitate giving it a try.

As for Intuniv I'd say it's worthy adjunctive strategy for individuals who have comorbid sleep and/or anxiety disorders. Since those are no longer an issue my primary objective is to address cognitive impairments. unfortunately cost is the limiting factor in terms of dosage. 20mg of Adderall XR is about $40 a month but as a shift worker it doesn't offer the flexibility and coverage I'm looking for alone.

#176 Mind_Paralysis

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Posted 14 March 2014 - 01:21 PM

Adderall, or the similar Concerta, is soon going generic, so there might be cheaper versions coming out soon. I actually heard that this is happening in Sweden, so no doubt you guys in the U.S and Canada will get those generics first.

I'd suggest Modafinil as a replacement, since the effects actually seem much better, less of a sledge-hammer, more smooth, less crash, but I think it might actually be more expensive than Adderall... On the other hand, I think it's going generic soon as well, yeah? If so, then that's definitely a med for you to keep an eye out for.

#177 GetOutOfBox

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Posted 14 March 2014 - 07:25 PM

I think Ashwagandha can possibly counter intuniv's depressive effect as it does with Clonidine.

The antidepressant effects of Ashwagandha appear to be blocked by the pretreatment of prazosin (general α-adrenergic receptor blocker)[124] while the depressive symptoms induced by clonidine (α2 adrenergic and imidazoline agonist) and reserpine (catecholamine depleter) were abrogated with pretreatment of Ashwagandha at the antidepressive dose, while haloperidol (dopamine antagonist) was not involved in the antidepressive effects.[124] These effects are similar to Yohimbine which can block the depressive effects of clonidine directly and both Ashwagandha[124] and yohimbine[125] potentiate the effects of SSRIs.


http://examine.com/s...ha/#summary5-11

I wanted to experiment using higher doses of Intuniv but right now 2mg costs me $60 a month. I going to drop it and look for some modafinil in bulk quantities.


Great study, I had noticed that before. However, it doesn't specify how the alleviation of depressive symptoms is achieved; it could possibly simply be dissociating clonidine from the alpha-2 adrenal receptors or acting as an antagonist (as activation of those receptors can cause depressive symptoms). Thus there's a possibility it interferes with treatment. The tough part about evaluating this is that unlike dopaminergic agents like Ritalin, I've noticed that at regular doses there are almost no actual subjective effects to agents like Intuniv (Guanfacine), so it's difficult to evaluate your performance subjectively. I would definitely do regular cognitive tests via cambridgesciences to assure that the improvement is still present, elsewise you're just wasting your meds.

#178 Metagene

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Posted 15 March 2014 - 12:49 AM

From what I can surmise Ashwagandha acts independently of alpha 2 receptors. Although it's no way to be certain with a herbal blend that contains 50mg of Ashwagandha this study on BR-16A aka Mentat seems to make a case for no opposing actions.

http://www.ncbi.nlm....les/PMC2978492/

BR-16A is a herbal preparation with several putative psychotropic effects. Recent work has suggested that it facilities certain aspects of cognition and that it ameliorates ECT-induced amnesia in animal models. The present study sought to assess whether it affects noradrenergic and dopaminergic functioning in the central nervous system. Adult male Sprague-Dawley rats received BR-16A (200mg/kg) or vehicle for one month. The animals were subsequently challenged with clonidine (100 mg/kg I.P.), apomorphine (2mg/kg I.P.), or saline in a factorial design, and motility of the animals was immediately thereafter assessed using a small open field. BR-16A neither attenuated clonidine induced alpha-2 noradrenergic receptor-mediated hypomotility nor accentuated apomorphine-induced dopamine postsynaptic receptor-mediated hypermotility, suggesting that it does not interfere with alpha-2 noradrenergic and dopamine postsynaptic receptor functioning.


Knowing Prazosin is a alpha 1 antagonist which blocks Ashwagandha's ant-depressant effects suggest this as well. Regardless I totally agree cognitive tests should be held above subjective reports.

Edited by Metagene, 15 March 2014 - 12:56 AM.


#179 GetOutOfBox

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Posted 17 March 2014 - 06:46 PM

So I received the second blood test results (the tests only looked at TSH and Free T4 this time, but I feel that's sufficient for a confirmation test). The results were normal. TSH is smack in the middle of the range, as is Free T4. The fact that the results are in the median of the range increases my trust in their reliability, as even accounting for possible fluctuations in thyroid hormone levels (i.e normal time of day fluctuations, or phases of hyperthyroidism, etc), I still would not be hyper or hypothyroid. However if you get yourself tested and you're very close to the lower or upper end of the range, I would definitely say more tests are warranted (perhaps wait a few weeks and get another test and/or get yourself tested at another lab). Also make sure you cross-reference your results with other ranges (some labs use outdated reference ranges).

So it seems thyroid is not likely the cause here (it's still possible that I have thyroid resistance, but my family history was madeup of classic either hypothyroid or hyperthyroid, which I've ruled out for the time being).

I'm going to look into giving psychiatric treatment a try, specifically an ADHD-specializing therapist. I've documented several odd symptoms that indicate a systemic disorder, but I'm open to the possibility they're just seperate mundane quirks. I had great success treating my social anxiety disorder with self-administered exposure therapy, so I'm very open to trying therapy for ADHD. It may actually be prudent, as one thing I've noticed is that I've never had trouble reading for pleasure. I've always loved it (I could spend hours and hours reading), though I've had less time lately. However it struck me as odd that it would not be affected by my ADD, since it's a task that's traditionally not very stimulating and requires maintanence of concentration for long durations.

So what may very well be the case is that I could have developed "psychological blocks" that are impeding my ability to work, or perhaps I've developed self-defeating tendencies. I'm very open to at least trying this approach, and will definitely work as hard as I can with it. If I still notice attention impairments, I may investigate other biological issues, but for now I think that'll be my main focus.

I am not giving up on Intuniv or Ritalin however. I've found Intuniv to be great for stabilizing my mood in a non-invasive way, and Ritalin when used infrequently helps to give me a motivation boost, which is helpful, artificial or not. I'm going to keep investigating supplements as well, as so far I feel I've had good success with them.

From what I can surmise Ashwagandha acts independently of alpha 2 receptors. Although it's no way to be certain with a herbal blend that contains 50mg of Ashwagandha this study on BR-16A aka Mentat seems to make a case for no opposing actions.

http://www.ncbi.nlm....les/PMC2978492/

BR-16A is a herbal preparation with several putative psychotropic effects. Recent work has suggested that it facilities certain aspects of cognition and that it ameliorates ECT-induced amnesia in animal models. The present study sought to assess whether it affects noradrenergic and dopaminergic functioning in the central nervous system. Adult male Sprague-Dawley rats received BR-16A (200mg/kg) or vehicle for one month. The animals were subsequently challenged with clonidine (100 mg/kg I.P.), apomorphine (2mg/kg I.P.), or saline in a factorial design, and motility of the animals was immediately thereafter assessed using a small open field. BR-16A neither attenuated clonidine induced alpha-2 noradrenergic receptor-mediated hypomotility nor accentuated apomorphine-induced dopamine postsynaptic receptor-mediated hypermotility, suggesting that it does not interfere with alpha-2 noradrenergic and dopamine postsynaptic receptor functioning.


Knowing Prazosin is a alpha 1 antagonist which blocks Ashwagandha's ant-depressant effects suggest this as well. Regardless I totally agree cognitive tests should be held above subjective reports.


Great find! Definitely worth trying as a preventative measure, or if you're already experiencing Guanfacine-induced depression in that case.

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#180 Duke318

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Posted 22 March 2014 - 01:45 AM

Did you check Free T3 and Reverse T3? TSH and T4 alone can be misleading. You can have normal TSH, normal T4, and have low-normal T3 with high reverse T3 and still be hypothyroid. TSH should be around 1.0, and T4 and T3 should be on the higher end of normal for optimal functioning. It's also interesting to note that Hyperthyroidism is associated with increased cognition (hence it's association with hyperactivity). There are supplements to optimize thyroid functioning, some being L-Tyrosine, Guggul, Forskolin, and more. I think having T3 at the upper end of normal (at least 3.7) can be beneficial to pretty much anyone.





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