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.

Business Premier eases chronic pain on 13 hour Air New Zealand long haul flight: Part 1 (OneUp upgrade bid win)

On the economics of getting into business class for members of the 99% with chronic pain: how I did it for 37% of the paid fare with an upgrade bid, and why every penny was totally worth it.

I didn’t know until I arrived at LAX for my 13 hour flight from the USA to Auckland that my bid for upgrade to business class had been accepted. Air New Zealand might surprise you with such information at the very last minute. Luckily, this is the best kind of surprise.

I am a frequent flier in US domestic economy who occasionally splurges or upgrades with miles/status to first class. I also live with an autoimmune disease and chronic pain.

In spite of this, I continue to indulge my love of travel as often as I can. Now, however, I must sometimes make adjustments to accommodate my body’s varying demands.

What follows is my assessment of a very long haul flight in the Business Premier cabin. I’ll try to specifically address the experience of a traveler with chronic pain.

While I’ve found a plethora of reviews sharing the opinions of healthy business and luxury flyers, my own sometimes odd and very specific wonderings are rarely addressed.

Air NZ awards upgrade bids up to the last minute

Last year’s Swiss International Airlines (SWISS) upgrade from economy to SWISS Business was awarded several days before my flight. SWISS may even have provided a full week’s notice.

This time, I received a “too bad, you lost” email from Air New Zealand in the days before my trip. I took off from an intermediate stop at PDX with no knowledge of the highly beneficial change of plans.

Try to imagine my delight upon receiving a text message of congratulations for having my OneUp Business Premier upgrade bid accepted by Air New Zealand at the last minute. I learned of it as my Alaska flight touched down in Los Angeles and I resumed cellular connection to the world.

Having chatted with my nearest seatmate about our respective travels during lunch on Alaska 568, I couldn’t help but turn to her to share news of my good fortune:

“I just got the upgrade from Premium Economy to Business Premier for the long flight to New Zealand!” I crowed

“That’s great!” She replied. “Now your husband won’t have to feel guilty or to share his better seat.”

Air NZ Business Premier pix - airport espresso

It was reason for both DH and myself to celebrate, indeed. He is a gentleman, and he worries about me.

Of course, a man who will wait in line to buy an espresso for his tired wife in a busy airport even though he thinks caffeine is a pernicious addiction like heroin that shouldn’t be catered to or socially acceptable will always give his seat up to a lady.

To be crystal clear, however, on our return, when we were seated in different classes of service, I never did ask him to shove over or swap with me. I spent 13 hours in Premium Economy flying AKL-LAX towards home. I’ll add a link here to my post on the subject once I’ve finished writing it.

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Angelrox “The Loop” scarf vs. the Shawl: sustainable fashion well suited for travel

If you’re anything like me, you’ve browsed the Angelrox online store and yearned for one of each garment in all your favorite colors.

I love this women’s clothing brand from designer Roxi Suger for reasons I’ve gone on about before. A quick recap, Angelrox offers:

  • Made in the USA
  • Woman owned business
  • Small New England (Maine) company
  • Celebrates bodies of all sizes in its imagery
  • Beautiful colors in figure flattering silhouettes
  • Comfortable, sustainable knit fabrics including organic cotton
  • Great customer service

Most of these factors also make Angelrox garments moderately expensive. The prices are fair, but you’re not going to hit a big closeout sale and overhaul your entire wardrobe at a bargain price like you might at a retail giant importing its goods from low wage nations.

Angelrox is not fast fashion. Consider a purchase from them a way to shop your values and invest in a sustainable wardrobe.

You might like Angelrox if you also wear Eileen Fisher.

The Loop and the Shawl by Angelrox

Here’s a preview of the two specific pieces I’m comparing today, The Loop $38 (infinity scarf) and the Shawl $78 (wrap)

I make repeat buys of the silhouettes that I know and love. Between the Goddess dress $158, Glow gown $188, and Doublet $78, I’m dressed in Angelrox several times each week.

With most orders, I also splurge on at least one new accessory. I’m curious about many styles, and there’s always another color I’d like to see in person. You can only judge hue so well using pictures on the internet.

Accessories are the most affordable way to get my hands on the whole rainbow of Angelrox options. The least expensive choice, The Band $10, doesn’t suit my positively Medieval forehead, but I wear their fingerless gloves (Sleeves, Aria $22 or Opera $28) almost daily as a balm to my arthritic small joints.

Recently, I’ve added The Loop and the Shawl to my Angelrox collection. I ordered both in Violet, a bold magenta.Angelrox Loop Shawl comare table

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Jigsaw puzzle as travel diversion: Wentworth offers tiny wooden treasures you can work on a tray table

I’ve written about the joys of wooden jigsaw puzzles before.

Jigsaw puzzle wood Wentworth Artifact Dowdle Liberty Ravensburger - 1They are exactly what you’d expect if you’ve ever done a modern cardboard puzzle. Visualize a similar product cut from thin sheets of wood instead of flimsier paper. For those who get annoyed with ill fitting or torn pieces in the Springbok or other puzzles sold at the local big box store, wooden puzzles offer a much more satisfying experience.

Ordering my first wooden puzzle was a leap of faith. They cost a lot more than mass market cardboard ones. No one I knew had any experience to share, and the least expensive choices seemed to have tiny numbers of pieces compared to my usual 1000 piece behemoths. I was afraid I would feel I’d wasted my money.

I didn’t. Now I own about a dozen, and I covet a great many more.

While its true that the most common wooden puzzles are smaller—and made of fewer pieces—than the typical paper version, this didn’t affect my enjoyment of the new type. In fact, I found they offered a whole new realm of possibilities for portable puzzling.

Something about the cut of a wooden puzzle, and perhaps its more three dimensional nature, makes me focus more on shape and less on the image. I feel like my brain gets a different kind of workout from doing a wooden puzzle.

But aside from that difference, my wooden puzzles are so small, I can work them in more places. Instead of needing my much loved but bulky Jigthings Jigboard 1000 plus half of the dining room table, I can sit on the couch with a lap desk or a half sheet baking pan to complete most of my Liberty and Artifact puzzles.

I ordered my first Wentworth wooden puzzle for $16.99 from Amazon when I noticed how tiny its listed dimensions were. I wondered if they could possibly be accurate. They were!

Wentworth 40 piece puzzle retail price appears to be $19.99.

Jigsaw puzzle wood Wentworth AirNZ tray table - 3

Wentworth 40 piece wooden jigsaw puzzle on Air New Zealand Premium Economy tray table

The finished puzzle is about the size of a printed photograph: 4 x 6″. A 40 piece Wentworth puzzle is easily completed on an airplane tray table, and the pieces themselves take up just a bit more room than a deck of cards in their roughly 3.5″ square box.

The 54 piece Artifact puzzle, Kessel Shells, with which I’m comparing the Wentworth in most of these photographs is scarcely any larger. It just comes in a bigger, higher quality, tissue lined box with an elegant magnetic closure. I paid $18.

Small (< 90 piece) Artifact puzzles retail for $18-40.Jigsaw puzzle wood Artifact shells inside box - 1

Assembled, it fits easily inside its own box with an inch or more to spare in all three dimensions. Please note that this wouldn’t be true of all Artifact puzzles; they use one type of box for puzzles from this size on up to a medium.

Note also that the particular Artifact puzzle that I photographed for this post has a unique conceit: all of the pieces are very similar squares, and straight edges are used in the middle of the puzzle as well as for edges.

It turns out that I don’t enjoy this type of puzzle as much as a standard cut ideally with whimsies, like most other Artifact options, but it does make for pieces that are easy to re-package and transport in a small cardboard jewelry box or one’s Wentworth 40 piece box if one so desires.

Say, for example, to bring along on a plane!

Jigsaw puzzle wood Wentworth Artifact travel - 6

Re-packaged Artifact Kessel Shells puzzle’s 54 pieces into Wentworth puzzle box to show how compactly they could be stored for travel

For use after re-packing in this manner, I tried assembling the Kessel Shells puzzle using a photo stored on my iPad for reference, and that worked fine. If your puzzle fits in your carry on bag but its box won’t, just snap a quick picture.

Harder core jigsaw puzzlers than myself are known to work puzzles without using the finished image at all. It is harder that way. Personally, I don’t enjoy the process as much, but I have done it to test myself. I find it boring with a paper puzzle’s usual standard shapes, but better with a wooden one; the pieces are almost universally more interesting when cut from wood. More care and expense goes into a typical wooden puzzle’s hand- or laser- cut craftsmanship, after all.

The smallest Liberty wooden puzzles retail for $39; they aren’t sold on Amazon, but direct from the manufacturer. I think all of their XS options are round, and most contain more pieces than other brands’ size Small.

I’ve given a few Liberty XS puzzles to my mom for gifts, so I’ve laid hands on them, but don’t have any to photograph for comparisons. They had 107-115 pieces and I found them wonderful to assemble. The attractive gift box would be bulky for travel, however, like the Artifact boxes are.

The tiny Wentworth 40 piece puzzle comes in a much smaller box than any of its competitors. It also proved to be cut from noticeably thinner wood.

Jigsaw puzzle wood Wentworth Artifact travel - 14

Wentworth piece (top) compared to Artifact piece (bottom); both from wooden jigsaw puzzles

Jigsaw puzzle wood Wentworth Artifact travel - 7

Storage box sizes for wooden puzzles of similar finished size; Wentworth (top) & Artifact (bottom)

Though this might affect my overall ranking of “best wooden jigsaw puzzles” for gifting purposes or in terms of total quality, it doesn’t mean Wentworth is a low quality brand! The pieces click together well enough to make for satisfying puzzle building. They just aren’t quite as luxurious as Artifact or Liberty puzzle pieces, and the whimsies seem a bit less special.

I would absolutely consider ordering another Wentworth puzzle if I liked the image depicted. My ideal puzzle size is at least several hundred pieces, and I’d love to try a really large 1000+ piece wooden puzzle someday. I do lean toward a brand with thicker pieces for the high price a large wooden puzzle commands, however.

A thinner puzzle does make for one which is easier to transport. For example, to bring along on a plane.

Jigsaw puzzle wood Wentworth cardboard Ravensburger zoom

Compare jigsaw puzzle pieces of Ravensburger cardboard (top) to Wentworth wood (bottom)

A “thin” wooden piece from Wentworth is still thicker than that of a high quality cardboard puzzle. Here’s a picture of one to compare with a Ravensburger piece in cardboard. You can judge for yourself.

My recent trip to New Zealand was my first time bringing along an actual jigsaw puzzle for entertainment in midair. I’ve tried an iPad “jigsaw puzzle” app, but found it unappealing in practice.

Usually, I find the hours of a flight pretty easy to while away with a few books loaded on a Kindle to conserve weight and space plus some saved video content and a few casual games on my iPad or phone. I stocked up on digital and other distractions much more heavily for the marathon Transpacific flight where no wifi was available even if I got desperately bored.

When I get very tired on a long flight, my eyes stop wanting to read before my brain is willing to sleep. That’s about the only time I resort to screen time, or, more often, the crossword puzzle from the in flight magazine. This time, I followed up a lot of reading with some jigsaw puzzling. It helped me to pass the time in a fun and novel way.

If you take particular enjoyment from completing jigsaw puzzles, like I do, you might consider packing along a small one on your next long haul flight. It’s definitely better for your brain than more screen time, and it’s strangely satisfying to do something tangible with your hands instead of spending all those hours inside your jetlagged, slightly muddled mind.

I used to knit on a plane for similar reasons, but I gave it up when I couldn’t carry my mini scissors any longer. Also, I heard horror stories about knitting needles being confiscated as weaponry. There’s no way I could stay calm if the TSA made me dispose of a project well under way with the argument that my slightly pointy wooden sticks were sufficient to bring down a plane.

I would be livid, and, deprived of my project, I might also be bored.

I’m a pretty creative thinker, but I find it hard to imagine even the most overzealous security agent seeing wooden puzzle pieces as a credible threat. I’ll just avoid any puzzles with scenes of soldiers or battles, or overtly political themes, just in case.

Happy puzzling!