The Wednesday Wellness threads are meant to encourage users to ask for and provide advice and motivation to improve their lives. It isn't intended as a 'containment thread' and any content which could go here could instead be posted in its own thread. You could post:
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Requests for advice and / or encouragement. On basically any topic and for any scale of problem.
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Updates to let us know how you are doing. This provides valuable feedback on past advice / encouragement and will hopefully make people feel a little more motivated to follow through. If you want to be reminded to post your update, see the post titled 'update reminders', below.
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Advice. This can be in response to a request for advice or just something that you think could be generally useful for many people here.
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Encouragement. Probably best directed at specific users, but if you feel like just encouraging people in general I don't think anyone is going to object. I don't think I really need to say this, but just to be clear; encouragement should have a generally positive tone and not shame people (if people feel that shame might be an effective tool for motivating people, please discuss this so we can form a group consensus on how to use it rather than just trying it).
Jump in the discussion.
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Supplement magnesium, and experiment slowly increasing your intake to 20mg/kg of bodyweight, or even a little higher if you're still experiencing benefit. Initially try magnesium chloride, as it's the most reliable, but be aware that it will loosen your stools or even cause some diarrhoea. Make sure your other electrolytes are sufficiently high while doing this, or you'll feel quite unwell. Try applying magnesium topically on your neck for immediate effect, and it should give you some indication of whether or not it will be helpful for you.
If you find yourself having compulsive, negative thoughts and actions from them - things like skin picking, hair pulling, self harming, or other addictive and destructive behaviour - a supplement called inositol can be very helpful. It's a sugar, both made by your body and available from food. Experiments have used up to 18g of it without serious side effects, although I try to stay under 12g myself, and only use it when I feel I need to. It has a powerful anti anxiety effect for a certain "type" of anxious feeling, and zero addictive properties or side effects beyond mild flatulence.
Make sure you get regular vitamin D, ideally from the sun (an app called dminder is very helpful for measuring the actual amount of vitamin d you’re synthesising, particularly if you have a light sensor on your phone), and increasing b12 plus a b-complex alongside this as recommended by Dr Gominak can really help with insomnia. 4-8000iu of vitamin d is probably sufficient if you're supplementing a decent amount of magnesium, higher if not.
After establishing everything above, consider starting with a low dose of thiamine and increasing up to 1000mg-2000mg depending on your body type, size, and individual response. I would recommend thiamine hcl. More expensive forms such as TTFD might be more bioavailable but they're also more likely to cause other issues, such as mentioned here. If you start to feel truly awful on higher dose thiamine, it's not an allergy or negative response, it's refeeding syndrome. Depending on what you diet has been that day, eat 2g of salt, eat 100g of dried fruit for potassium, drink a pint of water with 2.5g of magnesium chloride dissolved in it, supplement 30mg of riboflavin (despite some much bigger supplements, your body doesn't absorb more than that at one time - feel free to supplement again later in the day though) and make sure you're already taking a biotin supplement above 1000mcg. MAKE SURE YOU HAVE THIS AVAILABLE BEFORE YOU START SUPPLEMENTING THIAMINE! You don't want to experience refeeding syndrome at 3 in the morning, or 40 miles from the nearest shop, and not have the resources to hand.
If you struggle with getting everything you need from the diet, a good starting point is 4 eggs, 40g of cheese, 150-200g potato, 1/4-1/2lb of red meat and 1/4-1/2lb of low mercury oily fish. Low mercury oil fish is unsalted anchovies, sardines, mackerel, herring, salmon or trout. Salmon and trout are usually farmed if you're in Europe, and farmed fish are exposed to antibiotics as well as being much higher in parasites. Wild salmon may have higher levels of mercury depending on the species, as do different species of mackerel, but searching the name of the specific type should give you clear results. Fill up the rest of your diet with fruit, vegetables, orange juice, potatoes, rice, cold pressed oils and butter, always aiming to hit nutritional surplus before filling up on carbs or fats. Fish/meat weights are raw values, so cooked weight will be about 15% lighter - in practice, a 90g tin of fish is the same as 1/4lb fresh. Almond oil and styrian pumpkin seed oil are both good sources of vitamin e if you're struggling to get enough. Probiotics such as kefir or kimchi could prove helpful, especially if you've had antibiotics. Homemade is vastly superior to store bought, especially as some companies make the insane move of pasteurising their product before putting it on the shelves.
ETA: While all of this should help, it will be massively limited if you are still fighting other stresses in your life. If you going through a divorce, grieving a recently departed loved on, or feuding with your local drug dealer, you will be less able to benefit from this. Similarly, if you are staying up late staring at computer screens, not getting to bed before 10pm, not getting fresh air and daylight, spending an unreasonable amount of energy arguing with strangers on the internet, or any number of other stressors that are obvious when you think about it, you'll be hindering your ability to recover. Doing the small, healthy obligations of life might only get you a 10% benefit, but again it's a 10% you need right now, and could you push you from "spiraling downwards" into "finally recovering."
Wow. First off thank you for such thorough write up. I'm thankful for my doctors but none have given me this thorough of an examination of my problems.
I don't know why but it really hadn't occurred to me to question whether the RDAs were accurate/appropriate for me.
I have started using Cronometer since the beginning of this year, which would be after I changed my diet to start eating a wider variety of foods. Inputting my old diet in which I skipped breakfast and had the same lunch everyday, I was really low on a lot of vitamins and minerals depending on my dinner.
Back when this first happened, my salt intake was probably low considering my exercise level. My diet wasn't intentionally low salt but in practice it most likely was.
For the potassium RDA, I had been using whatever RDA is in Cronometer, which was 3400mg. I'll update this manually so I start using it in the future. The easiest food for me is milk. OJ and some fruits are hard because of GERD. Since learning that I had low potassium, I began drinking a bunch of milk.
I had started taking magnesium supplements before I had tried restoring my potassium. I was worried about taking too much so I eventually stopped. I think I noticed I had soft stools and assumed I must be taking too much. But on Cronometer I am getting about 50-60% of the 400mg that is recommended there, which would be an even smaller percentage of the even higher RDA numbers you stated. After looking up low magnesium, I see it causes low potassium. You would think a doctor would have mentioned that at one point. Do you have a brand of magnesium that you recommend?
My calcium intake should be good after I started having multiple cups of milk a day. I'm not supplementing K2.
Part 2:
I initially started heel drops before I had been diagnosed with a hiatal hernia but felt like it really didn't accomplish anything. I'll look into these massages further though.
Now that you mention it, I recall it being impossible for me to sleep on my left side when my symptoms were at their worst. I could feel my pulse through my left ribs.
I'll probably hold off on high doses of thiamine and maybe try as a last resort.
Part 3:
My vitamin d levels should be good. I did discover how important vitamin d was when I was initially feeling bad. Since then, I've made it a priority to get out in the sun each day for 15-20 minutes at solar noon and as much as I can handle on the weekends (I have been using dminder for a while and love it). I live in a northern latitude so the winter is limiting for vitamin D but I get a lot in the summer.
For B vitamins, I take a multivitamin that has multiple B vitamins that has worked pretty well for me I think.
My sleep is okay. I have been getting to be too late and sometimes I wake up early and can't fall back to sleep. I average around 7 hours.
I like your diet suggestion. I appreciate the point about holding off on carbs until I hit my nutrition markers. I thought for a while I had maybe just been eating too low of calories and that's why I didn't feel good so I started including some more carbs, but they were mostly empty nutrition.
There is so much to digest here. I'll be coming back to this post often. Thanks again for all your help.
You're very welcome, I only hope it's of some use to you. I'm glad to hear you're using Cronometer already. It's both intimidating and liberating to realise you have to take your health into your own hands.
Maybe Cronometer is using a European RDA for potassium. The American FDA increased theirs to 4700mg in 2016, partly because the average American was so much heavier than when they set the original RDA. Cronometer also set an incredibly high target for protein by default, something like 1.8g per kg of body weight. If it works for you that's great, but I think that's a target for athletes rather than the everyman. Reflux is a pain like that - I found sticking to the fodmap diet reduced the symptoms, and as you reintroduce food it helps you pinpoint which are giving you trouble. For example I've found I tolerate dried figs, apricots and dates well, but apples, pears and raisins still cause discomfort. It's worth experimenting if you're struggling to get the potassium, but obviously you know your own body best. Never try and ignore obvious pain just because someone thinks it shouldn't happen, whether that’s a medical doctor or some anonymous poster online.
I understand the worry when supplementing. I suspect if you're the kind of person who spends time on here you will be ok - the fact you're worried means that you're also researching this and you’re bright enough to do so successfully. There are certainly studies showing high dose magnesium (up to 1500mg supplemented) was effective in rapidly reversing treatment resistant depression, but I don't know enough to vouch for how strong those studies are. There are also plenty of testimonies online from people who have taken high doses for a variety of ailments, usually attached to warnings not to take it if you have kidney issues. If you're worried you can always discuss it with a doctor, but it's possible they won't be open to the idea. There are plenty of articles like this online, with doctors lamenting how little they are taught about nutrition. That's probably why no doctor you visited has mentioned it, nutritional approaches are not a major part of their tool kit despite how useful it can be. I buy magnesium from a brand called Heiltropfen, but I don't have any particular loyalty to them - they were the only company I could find selling magnesium chloride flakes that were listed as food grade. The cheaper versions marketed as bathing salts are probably fine, but I didn't feel the need to risk it at that price.
If you find the loose stools too unpleasant to deal with, Magnesium Glycinate, Taurate, Malate, and L Threonate should not have that particular side effect (although they may have others instead). The most important thing when taking high magnesium is to keep calcium/phosphorus/sodium/potassium at least as high as the RDA.
In terms of calcium, I was taking around 1500mg when the ectopic beats felt like they were pounding in my chest, but once I increased it to 2,400mg the beats only felt out of rhythm, not worryingly forceful. I think my situation is unusual, the high dose thiamine I'm currently taking means I need a higher calcium intake for now. In your situation it could be the relation between any of the electrolytes being too high or too low, but I think that is worth investigating.
I'm not so experienced with the heel drops, but it's worth looking through youtube to see the variety (and other exercises). Some people say that having your arms raised when you do them makes a huge difference, and there's probably other tricks. I hope you can find something else that helps there, though, and hey, it’s free.
Did the symptoms get worse when you were on your left side, or did they just become more noticeable? If it definitely gets worse then that indicates it could be related to the vagus nerve becoming irritated by the posture, or alternatively because it's changing the position of your heart - but this also something I've only just started reading about, so take this as an avenue to explore rather than something that is definitely the problem. Like so many other things, there are arguments for sleeping on either side. Sleeping on the right side avoids stimulating the vagus nerve but it's worse for acid reflux, so I don't see a good option there. But it might be useful information to narrow down what's affecting you.
Vitamin D can be tested privately and cheaply, if your doctor isn't willing to do it themself. The test can be ordered by post with the kit to take a tiny blood sample and return it. Your ability to synthesise vitamin d depends on a lot of nutritional factors. Bruce Hollis, the researcher I mentioned in the earlier post, says that when he started supplementing magnesium (I think it was 400mg, it definitely wasn't a huge dose) he saw his vitamin d level rise by 10ng/ml in his blood work, from something like 50 to 60 ng/ml. Sorry, it's late here and I haven't got the time to pinpoint it, but it was in one of those two videos. On the other hand, too much vitamin d can cause issues too, usually from absorbing too much calcium. I think that's mainly in people taking huge doses, or life guards who have really high sun exposure. It sounds like you've got a lot of this under control already, so I think it's unlikely to be an issue, but testing lets you know for certain instead of guessing.
And maybe I was too harsh on carbohydrates! We need them too, and there's a big difference between a healthy diet that involves decent portions of rice/potatoes/pasta, and a diet of purely hyper processed carbohydrates like pizza. It sounds like you're doing a lot better with your diet now compared to when you initially fell ill. I really hope you find some relief soon.
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