Anxiety N=1

So I’m starting to take myo-inositol to address symptoms of anxiety and some depression.  As I described in a previous post, clinical studies indicate this stuff can be as effective as SSRIs, without the side effects.

So I decided to do my own N=1 study on the effects of myo-inositol on anxiety.  This won’t be the greatest experiment the world has ever known, because there are confounding factors.  I’ve started exercising more recently, and I’ve reduced the stress in my life in the last couple of months. Also, it’s not a single- or double-blind anything, and there’s no control group.  Just me goofing around with some powder I bought on Amazon.  Still, it wasn’t expensive and I thought it would be fun.  Studies indicate it takes about a month to see the effects of myo-inositol on anxiety, and dosing should be in the neighborhood of 12g/day.  I have a 5g scoop so I’m going to do 10g/day (5g 2x a day).

I took this Anxiety Self-Assessment today.  It cost $7 for the full report.  I’ll take it again in about 6 weeks and see if there’s been much change.

Here are my assessment results:

anx1

Anx2

Here’s the text provided verbatim by Psychology Today that describes what you’re looking at in the above graphical representations:

Overall Anxiety (score 53)

Definition – Overall level of anxiety

According to your test results, your level of anxiety is moderate, which means there is a risk that it could become a problem in your life. Although you are generally able to cope, your stress and worry might sometimes interfere with your ability to function in your everyday life. This is nothing to beat yourself up about – anxiety is a very common problem with a wide range of causes. The most important thing however, is that you take active steps to decrease the frequency and intensity of these emotions, so that they don’t dictate the way you carry out your life. Educate yourself by reading informative sources on the subject. You can start by checking out the Advice and Tips section, but if you feel unable to deal with these anxious feelings on your own, don’t hesitate to seek professional help.

Generalized Anxiety (score 36)

Definition – A state of continuous apprehension and anticipation of something horrible, characterized by excessive anxiety and unrealistic worry.

You seem to have very few signs of generalized anxiety and excessive worry. Essentially, this means that you have developed a repertoire of coping strategies as well as a support network for dealing with both the small stressors and the big worries life throws at you. Chances are that you generally sleep well, maintain a stable mood, feel calm, are able to concentrate and are not overly irritable or edgy. Certain things, or just “one of those days”, however, can occasionally take their toll on you. This is not too serious (you are human, after all), but you can always benefit from building on your current coping abilities.

Physiological Anxiety (score 19)

Definition – Somatic manifestations of anxiety such as fatigue, tension, digestive problems, palpitations or pounding heart, sweating, etc.

You appear to show very few, if any physical manifestations of anxiety. Some of the ways our body will signal that it is experiencing high levels of anxiety include fatigue, tension, digestive problems, palpitations or pounding heart, sweating, and a general sense that your health is not up to par. You still may be feeling stress, but you don’t seem to be experiencing any strong somatic symptoms on a regular basis.

Mood Instability (score 60)

Definition – Level of mood instability (mental agitation and psychological distress).

Your score indicates that you sometimes experience a variation in your mood, which may very well be a consequence of an elevated overall anxiety level. You are generally able to remain calm and relaxed but may lose some control of your emotions when faced with stressful situations. This could result in occasional moments of impatience, as well as some moodiness and irritability. Chances are that these mood swings are causing trouble in your relationships with others, although you may not even realize it. Deal with the underlying anxiety that is causing this shift in emotions and it will make you feel better.

Existential Anxiety (score 67)

Definition – Anxiety state related to personal mortality, self-acceptance, guilt, and meaninglessness.

Your score on this scale was moderate, indicating that you are somewhat satisfied with life and are generally able to handle the fact that there are things beyond your control. You feel OK about yourself on the whole, but sometimes experience an excessive amount of discontent. Individuals with this profile may have some difficulty finding meaning in their lives, experience sporadic feelings of futility, or worry about the future. These flashes of existential anxiety have not reached a serious level in your life, but there is the possibility they could create a snowball effect and become more harmful.

Ruminations (score 81)

Definition – Recurrent thoughts that are distressing and disturbing.

According to your results, you tend to over-think your problems. Rather than distracting yourself with more positive activities and thoughts, you almost always dwell on pessimistic feelings. This is an unhealthy habit. Endless reflection can contribute to depression, complicate relationships, and even encourage drug and alcohol abuse. Consider seeking social or professional support, as well as writing your thoughts down.

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So check in with me in 6 weeks or so.  By then perhaps I’ll be a zen-like goddess of harmony and tranquility.

Exercise

There’s plenty of research that indicates exercise is good for you.  I could tackle the task of doing all the research, but I’m not going to.  I suspect it’s a monumental task, for one thing, but also it’s been done before.  Found a cool blog today – Socratic News –  which is dedicated to researching different topics and summarizing the research in a clear and concise manner. Today I checked out the entry on exercise.  And hey, what do you know…exercise is good for you!  Of course there are details like duration, intensity, and type that need to be worked out.  So what does the research say, exactly?

Why exercise?  Oh…just a few reasons…reduced likelihood of cardiovascular disease, cancer, stroke, T2 Diabetes, Obesity, Osteoporosis, Depression, Alzheimers,, Dementia, Stress, and increasing/improving cognitive function, mood, and self-esteem.  Awesome.

Volume of exercise (amount of exercise per week) – It appears that just getting off one’s arse has benefit.  The largest proportion of gain occurs if you can exercise for 30 minutes 5 times a week.  More is better, but doing this much has a lot of benefit.

Duration (per session) – Even 10 minutes has benefit, and exercising at least 3 times per week is ideal (as opposed to one-two maniac sessions per week).

Intensity – Depends on your goals. Cardiovascular health and aerobic fitness seem to be improved most by engaging in vigorous activity.  It also seems to reduce body fat the best, after controlling for total energy expended.  Moderate activity is good too though, but it takes a greater investment of time.  Low intensity exercise can be awesome for mood (but it seems all intensities help in this respect).

Overtraining – not good.  Exercising at a high intensity for 1.5 hours can depress the immune system.  Also overtraining (> 420 minutes per week) can cause “fatigue, performance decline, and mood disturbance.”

Cool…I’m in.  Overtraining is not likely to be a problem. I’m just not THAT in love with the gym.

Today I went to the Y for 20 minutes of elliptical training and 20 minutes on the treadmill.  I exercised at what would probably be considered a moderate level of activity – heart rate between 65% and 75% of maximum the whole time.  After reading this research, however, I think going forward I’ll do 20-30 minutes of higher-intensity exercise and then switch to weights.

I’ve also started using the MyFitnessPal app for iPhone.  It’s cool cuz you can scan barcodes to get nutritional info input into the device.  No barcodes on many paleo-friendly foods though…but still it’s a cool gizmo.

 

Anxiety and Myo-Inositol

I haven’t talked much about it on here, but I have some problems with Anxiety.  I have Social Anxiety to some degree, which makes me dread having to talk to people I don’t know (or even those I do), despite really liking people in general.  I had to teach myself the importance of looking people in the eye – it’s always been (and still is) very difficult for me.  I learned how to make friends by watching TV.  Turns out there’s kind of a formula to it.  To relate to men be a good listener and know stuff about stuff.  To relate to women be a good listener and be willing to share stories about yourself.

The internet seems to be very helpful as far as getting around my social phobia – I can gain lots of information and even relate to people without having to actually face them.  Practice and experience with people doesn’t lessen the anxiety.  I’ve been in a human services or customer service field for over 20 years…and it’s still there.  I know it’s irrational – I know other people aren’t nearly as scary as I think they are, and I know they’re probably just as scared of me.  And still it persists.

I also have what some might call Generalized Anxiety – I just worry about stuff.  I worry about money, I worry about my child’s health, I worry about getting in a car and driving…normally this stuff doesn’t stop me from doing things I want to do, but I do go through a lot of unnecessary worry, even though I know it doesn’t help anything.  That’s no fun, and I really don’t want to turn my daughter into a worrywart by sending her the message that the world is a scary place.

I’ve been reading buzz lately about myo-inositol being effective in the treatment of anxiety, without the side effects of SSRIs and without requiring a diagnosis and subsequent medical establishment discrimination.  So, because I’m now a data driven consumer of health-related information, and because I now require peer-reviewed evidence of a treatment’s efficacy before trying it, I decided to do a search of scholarly articles on the topic of myo-inositol.  Please join me as I explore the internet.

Article 1:  Of people currently being treated for OCD with an SSRI, they additionally gave half of them myo-inositol, and half got placebo.  Conclusion: myo-inositol is NOT better than placebo in treating OCD (another anxiety disorder) – at least it doesn’t offer added benefit when already taking an SSRI.  Pros: Randomized, double blind study with a control group.  Cons: Only used a very small sample (n=10 – meaning, only 10 subjects participated in the study).

Article 2: Studied myo-inositol compared to Fluvoxamine (Luvox, an SSRI) for panic disorder (an anxiety disorder that involves panic attacks.  I don’t have those.)  Conclusion:  They both work for reducing panic attacks, and the myo-inositol had fewer side effects than the Luvox.  Pros: Randomized, double-blind.  Cons: Small sample size (n=20).

Article 3: This is a meta analysis (meaning an analysis of many studies done on the topic) of myo-inositol.   Here’s a rundown of the studies they analyzed:

  • #1:
    • N=21
    • Dx (Diagnosis): Panic Disorder
    • IV (Independent Variable):12g of myo-inositol per day.
    • Outcome: Frequency and severity of panic attacks decreased significantly with myo-inositol compared to placebo, with minimal side effects
    • Pros: Double-blind, placebo-controlled, randomized
    • Cons: Small sample size
  • #2
    • N=13
    • Dx: OCD
    • IV:18g myo-inositil daily
    • Outcome:Inositol significantly reduced scores of OCD symptoms compared with placebo
    • Pros:double-blind controlled crossover trial with placebo
    • Cons:Small sample size
  • #3
    • N=12
    • Dx: Schizophrenia
    • IV: 12g myo-inositil daily
    • Outcome: No beneficial effects
    • Pros:controlled, double-blind
    • Cons:Small sample
  • #4
    • N=11
    • Dx: Alzheimers
    • IV: 6g of myo-inositil daily
    • Outcome:No clear therapeutic effect
    • Pros:double-blind, placebo controlled
    • Cons: Small Sample
  • #5
    • N=11 children
    • Dx: Attention Deficit Disorder with Hyperactivity (ADDH)
    • IV: 200mg per day per kg of body weight
    • Outcome: Kids got worse on the myo-inositil
    • Pros:double-blind, crossover, placebo controlled
    • Cons: Small sample
  • #6
    • N=9 children
    • Dx: Autism
    • IV: 200mg per day per kg of body weight
    • Outcome: No benefit
    • Pros: double-blind, crossover, placebo controlled
    • Cons: Small sample
  • #7
    • N=12
    • Dx: ECT (Electroconvulsive therapy)-induced memory impairment
    • IV: 6g daily
    • Outcome: No effect
    • Pros:crossover–double-blind
    • Cons: Small sample

Overall conclusions of the study?

These results suggest that inositol has therapeutic effects in the spectrum of illness responsive to serotonin selective re-uptake inhibitors, including depression, panic and OCD, and is not beneficial in schizophrenia, Alzheimer’s, ADDH, autism or ECT-induced cognitive impairment.

Hm….Ok, it’s looking good.  Of the 4 studies testing the effects of myo-inositil on anxiety, 3 demonstrated improvement.  It doesn’t appear to help schizophrenia, brain damage, autism, or ADDH (…I thought it was ADHD…).  There were also a number of studies citing the effects of myo-inositil on depression, with favorable effects being demonstrated.

Ok, good enough.  I’m ordering some!

ETA: Given the high average doses, I bought it in bulk.

Progress

It feels like progress when I have a normal period.

Ok, if you’re male (and maybe if you’re female) this will be TMI.  So skip down a paragraph or two.

Since I’ve been on the Wiley Protocol, I haven’t had a “normal” period.  At first they were really heavy and inconvenient…and then they didn’t show up till 8 or 9 days after they were supposed to, plus they were really heavy and inconvenient.  But THIS TIME is consistent with most of my life.  On time, and then heavy on day 1, and then light.  And then over. I can’t speak for the duration right now…cuz it’s only day 2.  But all signs point to “normal.”

I don’t know what to do anymore.  And honestly, I’m not looking for advice.  Feel free to give it, but it will likely be disregarded.  My ONLY criteria now for changing my life and the life of my child will be peer reviewed research.  YES, I know that means I may be missing out on some cutting-edge stuff…some stuff that no one has had time to study, or (worse) no one has bothered to study because they stood to make a profit.

One of the things I’ve done wrong up til now was trust the research of others.  For example, Jack Kruse has citations after his blog posts (which looks mighty scientific, I must say).  It doesn’t mean the citations refer to peer-reviewed, double-blind studies, which have been replicated and have demonstrated ANYTHING of consequence.  Often, if you check his citations he just links to an entire book on Amazon – no page number, no context.  The purpose of naming your sources is so you can check up on the author (in this case, Kruse) to see if he’s full of crap.  I’m not going to read an entire 317 page book to find out if he’s full of crap.  Many of his citations are also junk articles off the internet (not science) and some dude’s ramblings about his theories (also not science).

You know, before I was in a scientific field, I didn’t fully understand what real research was…so for a moment here, let’s talk about that.

True science is rigorous.  It involves peer-review, which means experts in the field of study (peers) actually review the article (study) and rate many aspects of it before it has the chance of being published.  If it does not appear to be scientifically sound and unbiased, it doesn’t pass peer-review, and it doesn’t end up getting into that journal (and later on Yahoo News). “Double-blind” means that neither the experimenters nor those experimented on know what the hell is going on with the study…so they can’t accidentally influence it with their own beliefs or hopes for the outcome of the study.

In other words, I’ve become convinced that anecdotes (personal stories) don’t cut it anymore.

Lesson learned.

And YES I know some science is manipulated by corporations.

But geez….it’s better than nothing.  And this try-anything approach I’ve been following is expensive…and its not working.

Oh And….

I did manage to get short-term insurance for my family.  They don’t cover pre-existing conditions (apparently a loophole avoiding the promises of Obamacare) so if we have a heart attack or stroke it’s probably not covered, since we’ve been diagnosed with high cholesterol and David with high blood pressure.  Cancer though….keep your fingers crossed for cancer!  Cuz that would be covered.

Hormone Crash

FYI – expect it 2 days after quitting the Wiley Protocol cold turkey.  I’ve added some estrogen back in to make the transition smoother.  Not looking forward to the hormonal mayhem on the horizon.

Quitting Wiley and Insurance Woes

So…3 days after going to see my old PA about continuing my BHRT with the Wiley Protocol, I’ve decided to quit it altogether.  On Friday – yesterday – I had a horrible hormone-driven mood swing that involved intentionally causing some damage to my husband’s car.  I wish I could say this kind of thing was rare – I have problems like this at least one or two times a month, including arguing, throwing things, threats of divorce.  It’s ugly.  I’m embarrassed to be not only involved but at the root of these events.

Later my husband did some research on this hormone protocol that I embarked upon 8 months ago, ostensibly to help with mood swings, libido, and overall health and well-being…none of which have improved.  His findings have resulted in my decision to quit the BHRT.  The Wiley Protocol, it seems, has not been researched and has been at the root of many health problems for many women.  Apparently T.S. Wiley has no formal education in health or medicine.  Bent Formby, Ph.D., a molecular biologist who has published over 100 scientific publications, was named by Wiley as a coauthor of her book, Sex, Lies and Menopause.  However, he has not given endorsement of the Wiley Protocol. He reports that when he recommended a 6-month clinical trial of the Wiley Protocol, T.S. Wiley refused.

Apparently, many women have problems with the high dosing of hormones called for by the protocol, and demonstrate progesterone toxicity.  I have had some of these symptoms myself over the past few months, including feeling sedated, feeling sleepy all day, anxiety, heart palpitations, extreme irritability (sorry about the car, honey), cravings/increased appetite, high blood pressure, puffy face, belly fat.   The last symptom on the list is completely me – “second trimester pregnancy tummy sticking out.”

Side story:  At a yoga class a couple weeks ago, the instructor asked me…in front of the class…if I was “expecting.”  I was humiliated.  I know she had to ask to avoid leading me into positions that could hurt a baby…but it was a bad bad moment.

Anyway, I attributed all that to stress…the cravings, the weight gain, the belly fat, the fatigue and sedated feeling.  Interestingly though my life was more stressful back in September and October…and these symptoms started showing up months later…after being on the Wiley Protocol for 6 months.  Apparently these high doses of progesterone accumulate in your fat cells – moreso than the estrogen – and can build up over several months, causing increased problems the longer you’re taking it.  And none of these symptoms have resolved in the 5 weeks since I quit my stressful job.  If the stress was the problem, wouldn’t things be getting better by now?

Oh well….I’m done taking it now.

As far as getting off the hormones, these folks offer some suggestions, including maintaining a low dose of estrogen to balance the progesterone that takes longer to get out of the system.  I think I’m going to just quit and add a few mg. of estrogen if I seem to need it later.  I realize that’s not very scientific but NOTHING ABOUT THE WILEY PROTOCOL IS.

I should have done my own research.

And in other news….My family can’t seem to buy health insurance.  Know why?  Because we’re not taking the statins we’re prescribed.  Noncompliance with medical advice.  Awesome.

So it looks like we’ll either have to ditch our dreams of being self-employed or we’ll have to start taking statins again.

I think I’ve about had it with woo medicine.

Where’s my damn Lipitor