Considering antidepressant medication? Try vitamin B-12 first.

This isn’t medical advice. I’m not qualified* to offer that.

Vitamin bottle B12 - 1I am simply a self-educated consumer who lives with a chronic health condition. I’ve drawn my own conclusions from research done as an intelligent lay person, tempering it with common sense. I invite you to do the same.

Many of us diagnosed with autoimmune conditions, degenerative neurological diseases, and chronic pain will be prescribed antidepressants. There are fine reasons for this.

Some chronic pain responds positively to antidepressant medications. Given in lower doses than those prescribed for psychological reasons, side effects are often less as well.

Here’s a link to a (long, almost 2 hrs!) YouTube presentation by Dr. Dan Clauw, M.D. that offers a great explanation for the current understanding of why these drugs may help certain types of pain.

Depression is also a normal human response to learning you can expect to spend the rest of your life with constant pain or in a rapidly degenerating physical condition.

That is a depressing situation for any rational person to contemplate. Treating mental health problems is important, and I do not sit in judgement of anyone who takes pharmacological steps toward better self care.

If you are a danger to yourself, please seek immediate, aggressive care. Do whatever it takes to get well. Your life matters.

That said, I’ve recently learned that the major physical symptoms of depression mirror almost exactly those of a vitamin B-12 deficiency. Hmm…

Even patients with valid diagnoses of other conditions—here’s a study about multiple sclerosis, for example—often have other stuff going on in the body that can make symptoms worse. Large numbers of hospitalized, depressed patients have measurable Vitamin B-12 deficiencies.

It isn’t known yet whether B vitamin deficiencies help create conditions that allow us to develop disease, result from lifestyle responses to living with chronic illness, or are direct side effects/symptoms of disease processes.

I’d argue that the underlying mechanism doesn’t matter so much when we’re talking about supplementing with vitamin B-12.

Why? There is no known upper tolerable limit for safety for supplemental B-12. Say that in plain English? No one ever “overdosed” on this vitamin.

Here’s a link to a more reputable (than me) resource, a state university, for detailed mainstream medical information on the subject of Vitamin B-12. And another to a US government fact sheet on the vitamin for American consumers.

B-12 is water soluble. If you take too much to be used by your body, it will leave your system naturally via your urine. You might “waste” the vitamins you’ve bought and paid for, but odds are tiny** that they will hurt you in any appreciable way.

If someone is ready to prescribe antidepressants to a patient, that patient must have at least one medical doctor who could also be consulted about taking vitamin supplements. Ask your doctor before starting a new treatment, including Vitamin B-12, but, odds are, you will be told this is safe to try.

You may also hear that vitamin B-12 won’t help you. But, then again, antidepressants aren’t a guarantee either. They include a long list of side effects, some of which are very unpleasant. Those prescription pills can also be expensive.

Also, it’s just as unscientific to assume the vitamins won’t help you as to assume that they will.

I’ve come to realize that no one cares as much about my health outcomes as I myself do. With good insurance and caring doctors, I’m still left with unanswered questions and a merely tentative diagnosis for what causes my chronic pain and fatigue. Where stakes are low and scientific certainty is lacking, I choose to perform nutritional experiments upon myself.

If it is highly unlikely to hurt you, and it could help you, why not take some extra vitamins for a while and see if you feel better, too?

Assuming your doctor said such a trial is safe, the only possible barrier is cost.

I picked up a bottle of store brand vitamin B-12 at wholesale giant Costco with 300 pills for $19. Each offered thousands of percent (20,833%) of the RDA***, making a bottle good for the better part of a year taking one per day.

That works out to $23.12 annually. Costco typically offers very good value.

At an expensive local vitamin specialty retailer, a three month supply (of 16,667% RDA pills) cost $16, coming out to about $64 per year. I suspect it would be hard to spend much more than this for these vitamins.

vitamin-bottle-b12-2.jpgThere are several forms of B-12 available, and both of these offerings are for the most expensive type, Methylcobalamin.

Some users have reported that the most common, cheaper form, Cyanocobalamin, doesn’t resolve their symptoms, but the Methylcobalamin form does. At less than $20 per bottle, it seems within financial reach of most Americans to do this self experiment with the potentially most effective version of the supplement.

My two sample bottles also both contain dissolving lozenges to be held under the tongue rather than swallowed and processed through the digestive system. Again, some argue that a sublingual or injected B-12 is more effective than a swallowed dose. I went out of my way to test this type of supplement, just in case, though science tends to think it is irrelevant for most.

In all of this, note that my primary interest is in clinical results, i.e., how I feel. It will be great if research comes to understand why and how B-12 or any other supplement improves patient outcomes. But I am not a working scientist.

The bottom line for how I make a decision about self-treatment comes down to whether or not I feel better, and at what risk.

The “clinically small” improvement of a group of MS study participants quoted above may be of only slight statistical significance, but when your function or your sense of well being has descended to, say, 25% of your old normal, well, then, 27% or 30% represents a win.

I don’t know what you should do to help yourself live a healthier life. I do have some opinions about which alternative health practices represent good risks worth a try for a person in pain. Perhaps this little experiment can ease some of yours, too.

Your body; your choices. Make them in good health.

*My education in both Biology and Chemistry ended in high school as my college science classes were limited to Physics courses. My major was Mathematical & Physical Sciences with a concentration in Computer Science.

Make no mistake that the side effects can be significant, however. They are also likely to affect your offspring, not just yourself. There are studies showing this in very obvious and less direct ways.

Powerful drugs are appropriate to treat significant illness, but I’d argue that they should be employed after milder alternatives have been tried and found insufficient.

Other sources, regarding. depression.and .neurological and psychiatric disorders

**There are some instances of allergic reactions to vitamin B-12, but I only read of such response to injections (shots), not over the counter vitamin pills. Reports of acne or skin rash in response to large dose vitamin pills do occur with some regularity.

You decide whether temporary skin issues are something that would stop you trying a larger dose of this vitamin for yourself.

***In most cases, we do NOT know the “optimal” level of vitamin intake. Vitamin B-12 reference ranges vary from 180-914 ng/L in the USA, 135-650 pmol/L (183-881 pg/mL) in Australia, and 500 – 1300 pg/mL. (ng/L=pg/mL, so no conversion necessary there.)

If you think this is an important thing for people to know, write to your government representatives and tell them you support basic nutrition research. Private companies have very little motivation to pay for this kind of work; there’s no resulting drug patent to fund the endeavor.

There’s a reason some public services, like infrastructure and basic research, are paid for by taxation. Otherwise, they simply aren’t available to all of us.

Flu

Just one word: flu.

I never use one word when one thousand will do, so, naturally, I will elaborate.

As if winter’s lingering darkness and New England’s coldest temperatures in years weren’t enough, we have to add widespread influenza infection to the list of legitimate complaints for still nascent 2018.

If my local children’s librarian* is to be believed, our corner of our state is the hardest hit in the area with this more-severe-than-average flu.

My situation isn’t even so bad. We are a house divided: only one of us has flu. I’m hunkering down with the sick one while DH keeps his distance and manages the healthy one. They leave us trays of food outside the door and occasionally send word about the outside world.

flu gear - 2The good news is that we have space enough to almost completely quarantine the sick kid. He hasn’t been downstairs for several days. Our over-the-top 1980s house came complete with a wet bar in the spacious master bedroom; between the mini fridge and the microwave, I can cover most of our needs without venturing forth myself.

We’re also lucky that the vicious cold spell is over. I can crack a window for ventilation between the child’s Petri dish of a nest and my frequently wiped down seat on the other side of the room. He isn’t lonely, and I haven’t caught the Plague yet. The separate heating zone for this room also assuages some of my guilt about sending so much heat literally out the window.

The bad news is that it’s the kid with the underlying condition making flu particularly dangerous that caught it.**

The doctor didn’t even want me to bring him in, citing the risk of exposure for others. He called in a prescription for Tamiflu and told me to plan on spending four to five days at home. The drug is the best thing medicine has got for reducing flu symptoms, but it only knocks half a day or so off the illness’s expected duration.

flu gear - 1Since the only side effect we’ve noticed is mild nausea and the evidence suggests Tamiflu reduces my son’s risk of hospitalization, I have no regrets about following this course of action.

An interesting aside: my husband’s doctor recommended getting the nasal swab flu test, but the pediatrician did not want to risk exposing others at a medical facility. DH’s internist would also have prescribed Tamiflu as a preventative to the rest of our household. The pediatrician did ask if my other son needed an Rx, too, but didn’t suggest Tamiflu for the adults.

We generally prefer to avoid taking drugs until they are absolutely necessary, so none of the rest of us are taking antiviral medication, but I found the variety of approaches interesting.

I should add here that, though I have a chronic illness, I am not considered immunocompromised at this point. If I were, I would take the Tamiflu without argument; as it is, I will play the odds.

We’ve increased the dosage on my son’s usual meds as directed, and I know the danger signs of severe illness for which I should watch, but the primary treatment for my sick kid is the same as for the rest of us unlucky enough to catch the flu: plenty of fluids and lots of rest at home.

I’m keeping myself sane by the following means:

  • Alphabears app on my iPad ~ the best word game I’ve played since my paid version of Bookworm stopped being supported after wretched EA bought innovative game developer PopCap.
  • Skullduggery Pleasant audiobooks ~ a great story that amuses both mom and child in the sickroom, but my older son had to jump through hoops to get the later books since they were only released in the UK. Read what you can get your hands on here in the USA, then agitate for the rest of Derek Landy’s series to be readily available where ever it is wanted.
  • Refining my packing list—and taking photos of same—for an upcoming trip that I will blog about after the fact ~ if you see better than usual pics after my next big adventure, you can thank 100 hours or so of enforced idleness wherein the closet became a welcome break from the monotony of the bedroom.
  • Wiping down doorknobs, light switches, and remote controls with disinfectant ~ okay, so that one isn’t so much fun as functional, but it does keep my brain occupied. “What did the child touch?” Right. Just about everything. Sigh.

Stay healthy, dear readers!

Wash yours hands often, or use hand sanitizer. Humidify your air if it approaches arid arctic conditions. The influenza virus is weakened at normal to high humidity levels aim for 50% RH***, and simple soap and water or the alcohol in sanitizer are sufficient to deactivate it on your skin before you transfer it to your vulnerable mucus membranes (i.e., nose and mouth, where the virus usually gets in.)

And if you do get sick with the flu, please, stay home until you’re no longer contagious.

Not sure if it is just a cold or the dreaded flu? Call your doctor!

If you’re not willing or able to do that, your best clues are:

  • sudden onset of symptoms,
  • severity of symptoms, and
  • presence of a fever.

When in doubt, stay home while sick. You are most contagious during the first few days with influenza.

If you have flu, you are spraying a cloud of virus into the surrounding environment with every breath. The person standing next to you could have a compromised immune system or a preemie at home.

Keep your germs to yourself. Let’s all work together so that this flu season winds down soon.

*I didn’t ask if she’d used her librarian superpowers to find out this fact, or the same gossip mere mortals employ to assess epidemic illness trends, so that might just be hearsay. As it served my preexisting notions, I just assumed she was correct.

**When I called his school to let them know he would be out sick, I learned that several other children from his class had the same symptoms. Ah, children. They’re the cutest little vectors for disease.

***Relative Humidity