TNF-Alpha antagonists are exactly what I mean. Slight overall systemic and appetite improvements have been noted from Milk Thistle and Cat's Claw herbs, these are only slight - but consistent. I do wonder whether a systemic corticosteroid or TNF-Alpha reducing medication would have any effect on the illness.
Tianeptine does unreliably help my mood, but had no effect on my sleep. I have no desire to try opiates because of the risk of dependence and side effects such as constipation. However the fact that they help rather than making things worse is quite interesting. Opiates are known to help with Restless Legs Syndrom (and Periodic Limb Movement Disorder), which causes fragmented sleep. I have not been diagnosed because I am "too young" to have such a condition, but I am persuing the dopamine agonist Pramipexole to test the theory for myself; as DA agonists are usually effective.
Amisulpride in low doses acts oppositely to it's higher-dose antipsychotic action; as a result the improved dopamine neurotransmission does help a little with my cognition until tolerance sets in. Definitely an occasional thing, but it helps.
Melatonin also helps set my circadian rhythm and improves sleep onset, but doesn't help sleep quality. However Agomelatine has been noted to improve disrupted sleep architecture by both melatonergic mechanisms and it's blockade of 5HT-2C receptors; which normally limit dopaminergic neurotransmission. The interaction of these and the longer half life of the drug makes it function differently to melatonin. I think it's worth a shot if I can get it prescribed, if not then I have ruled out something else.
Lastly, I have tried Sulbutiamine to assist with the fatigue, as it is often used in other fatigue conditions such as CFS/ME. So far some limited improvements in brain fog, but these are dependent on my sleep still. Continuing to persue as the prolonged effects are what I want to test.
I am very interested in tests or other info to elucidate a mystery gut condition that presents in nutrient malabsorption, postprandial fatigue/sedation, and potential sleep disruption as the only apparent symptoms. It seems to me that every gut condition I've read about also presents some mix of pain, motility abnormality, constipation or diarrhea, bloating, intense fatigue ALL THE TIME, or food allergies. Beyond the three symptoms I mentioned, I do not have the last six.
I have tried a course of cat's claw and didn't get anything beyond the supplement acting as a weak stimulant. I have never tried Humira but am curious to if I could ever afford it without copay, or for some far-out reason a VA doc prescribed it. I have tried a 3-month course of prednisone and methyl-prednisolone, and both are very effective alternatives to ibuprofen for me at low doses. In fact, those corticosteroids are so effective for the things I use ibuprofen for, that I didn't use any ibuprofen at all while on the steroids. Unfortuntately, I am sensitive to both the steroids I mention and anything beyond 5mg or so make me very wired and tired when taken after unrefreshing sleep and in fact, I believe the steroids also gave me sleep onset insomnia and lower sleep quality while using them - thus making ibuprofen the better solution after all.
Tianeptine and other opiates are remarkably effective if I am having a borderline-malaise day, or I just need some relief right now to power through the zombieness and get something done. If I am in full-on run-down and half-dead mode, opiates do not salvage the day or make me able to get things done. Tianeptine is the only effective anti-depressant I have ever tried, instead of acting like sedatives and apathy pills like the dubiously-named SSRI/SNRI antidepressants. Tianeptine does build tolerance for me and might have had some noticeable withdrawal when I have quit after regular prolonged use - just like other opiates. Tianeptines and real opiates are not the answer, let alone a really sustainable answer, so I use them sparingly as they do definitely help if used wisely.
I'm familiar with amisupride's action at low doses, and how other AAPs can act as partial dopamine agonists at low dose. I am also familiar with the theories of how dopamine is probably mostly an inhibitory NT and can also calm down an immune system that is overactive or devoting resources to the wrong things. I just don't think dopamine/NE is really the answer though as I have lots of experience with psychostimulants, both illicit and prescribed, and have never gotten consistent ADHD relief from them (beyond reducing hyperactivity) in the last 3.5 years - let alone a solution to the core problems. When stimulants work for me, such as after a night of refreshing sleep, which is the only time they do work, they don't do enough for my executive function to work, and they don't boost my cognition enough for schoolwork. And yes, stimulants or low dose AAPs taking a D2-agonist route will lead to inevitable tolerance.
5HT-2C antagonism does look great on paper, but agomelatine does not have a very high affinity for that receptor subtype. Unfortunately, everything that does have a relatively good affinity as a 5HT-2C ligand is non-selective. Indeed, 5HT-2C antagonists are usually anti-histamines as well, which massively sedate me and worsen sleep quality if I take them at bedtime. I don't have circadian rhythm complaints anymore and have no problem going to bed just after sunset and waking up (unrefreshed) at dawn, so I have reason to believe my endogenous melatonin production is OK.
Sulbutamine is interesting in that it has made me feel much better at times. On the other hand, that was probably because I was heavy drinking and B1 depleted. Nowadays, acute or regular use of thiamine or sulbutamine in 200-500mg doses has subtle effects at best and I often times can tell nothing.
I don't understand this guy. There is a difference between living an easier life and being so mentally and physically fatigued you can barely function at all. Dichotohmy, like myself, is not recovering. Eustress and truth have absolutely nothing to do with it.
I was living on 3 hours a night in high school, while crashing for 12 hours on weekends, and doing this for over 3 years. I was always one good night sleep away from recovery. I held 3 jobs while in high school and worked myself like crazy. If i was going to suffer something major from stress it would have been then. Getting older has nothing to do with it either, since these symptoms of mine started around 22 or 23, only a few years after high school (and the Army). Life (school, work, play) was so easy it was a joke, and I regularly pushed myself to extremes because I could.
A big difference indeed. While I have recovered in the areas I have recently mentioned, it really is the poor-recovery from work and other energy expenditure, and ensuing malaise that follows, that is the true obstacle to functioning. Honestly, I am limited to a productive time of of 4-5 hours tops, in the morning, and then I am just done for the day. That's 33% of functioning. I could have a part-time job and I would have nothing left in the tank once I got off work to devote to feeding myself or seeking food, taking care of bills and other errands, and definitely not enough left in the tank for any sort of meaningful leisure. Full-time work is completely out of the question, and I can't make enough from part-time work to make my finances sustainable. And yes, I am constantly testing this 33% rule to avoid becoming complacent or deconditioned, but also because I'm constantly hoping this is where I break through, because I want to surpass that 33% and live my life again.
I think for me that the notion of eustress is important. Like I said, I simply do not feel fully alive outside of stressful, dangerous, or otherwise extreme situations - a piece of me is missing. I actually thrive under the exertions of more mundane stress and duress as well, but as in extreme situations, I only have the energy for a little while until eventually the 33% rule catches up and I crash. To a big extent, this stress-tolerance pattern has always been true for me, but in the past, I would just mentally shut down after a while instead of physically and mentally crashing from stressful exertions like I do now. When I was in the Marines I would frequently get put in stressful leadership billets, or get important responsibilities, and I would enjoy it do great for a little while. Inevitably, I'd get fired after my superiors saw that I started doing a shitty job after the honeymoon period was over. So yes, stress in MODERATION is good for me. Eliminating all stress is bad because it makes me unhappy and instead of not being able to function because I've crashed, I don't function because of not doing anything. The happy medium of moderation is hard to find.
I'm 35 now so maybe age has caught up with me to some extent. I went through middle school and ninth grade on 3-5 hours of sleep every night because of delayed-sleep-phase, plus had big family, social, and academic stress and it was comparably easy. I went through a year of using meth almost everyday, with all that entails, and it was comparably easy. All of the physical and mental stress of the Marines was comparably easy. Indeed, the difference back then is that my ability to recover from exertions was normal and I could always depend on AND take an opportunity for a good night's sleep being a reset switch that would leave me recharged the next day.
In essence, the real core issue is that my body (that includes the brain) just cannot, or does not, recover from the rigors of daily life like a healthy person's does. Everything else stems from that. The recovery doesn't happen because something is happening in sleep to make sleep unrefreshing and no-longer a recharge.