Naturopathic Body Scan

Patient will be undergoing a Naturopathic body scan within the next 10 days by a Naturopathic Doctor to see if results reveal any new/compelling information that is helpful in determining the cause of Patient's problems.

Medication Frustration

Here is a recap of what we've seen so far with two medications.

10mg of Zyprexa + 150mg Lamical twice daily = The worst combination so far -- INCREASED physical problems (the worst/really bad--bent over to the ground, pain), INCREASED hallucinations/psychosis. This was the treatment upon leaving early June hospital visit. It was also discovered that Patient was administered HALDOL (dosage not released) during the hospital visit!! This is very upsetting to the family and we know that Patient was in really bad shape upon returning home from the hospital.

7mg of Zyprexa + 150 Lamictal twice daily = Major Dehydration, INCREASED physical problems, INCREASED psychosis.

5mg of Zyprexa + 100mg Lamictal twice daily = REDUCED physical problems, REDUCED hallucinations, INCREASED fainting/seizures.

5mg of Zyprexa + 125mg Lamictal twice daily = INCREASED physical problems, INCREASED paranoia. REDUCED fainting/seizures. (The current prescribed treatment)

75mg of Lamictal twice daily = some relief with back pain, suicidal thoughts, loss of appetite

35mg of Lamictal twice daily = loss of appetite, suicidal thoughts

In sum, Patient is not getting enough relief and there appear to be too many problems. This raises questions as to whether or not Patient should even be taking these drugs. And how much damage has been caused by these drugs?

Questions of concern:
Why does a drug for psychosis increase psychosis for Patient (Zyprexa) when the dosage is increased?

Why does a drug for seizures increase psychosis for Patient when it is increased?

Why are physical problems expected to reduce when Lamictal dosage is raised but physical problems and psychosis increase?

Why are Doctors recommending Zyprexa if there are serious warnings for those taking it that could be suffering from dementia?
Anyone who does a search on Zyprexa will see that " Zyprexa is not for use in psychotic conditions that are related to dementia." If Patient was given a suspected dementia diagnosis based on symptoms, shouldn't Patient go off of this drug, regardless of the dosage? Seems like even just a little (5mg) should be considered too much if there are any doubts about this drug related to Patient's condition. This is very disturbing.

Are seizures happening because of the overuse of anti psychotic medications?

Is patient experiencing drug-induced Parkinson's symptoms?

What if Patient goes off of Lamictal & Zyprexa for a length of time (return to baseline) and is evaluated and treated for nutritional deficiencies/problems using vitamin therapy?

Important findings of B-12

Vitamin B12:
Vital Nutrient for Good Health

By Sally Fallon and Mary G. Enig, PhD

"Vitamin B12 works with folic acid in many body processes including synthesis of DNA, red blood cells and the insulation sheath (the myelin sheath) that surrounds nerve cells and facilitates the conduction of signals in the nervous system. Severe depletion manifests as pernicious anemia, which was invariably fatal until the discovery of B12 in liver. But long before anemia sets in, other conditions may manifest, most often neurological problems (numbness, pins and needles sensations, a burning feeling in the feet, shaking, muscle fatigue, sleep disorders, memory loss, irrational anger, impaired mental function and Alzheimer’s) or psychological conditions (dementia, depression, psychosis and obsessive-compulsive behavior).

"Because the absorption process is so complicated, and therefore subject to various blocks, many people--particularly the elderly--may develop deficiencies even though they are taking in plentiful B12 in their food. Fortunately, the body absorbs about 1-5 percent of free B12 by a process of passive diffusion. Thus supplementation with large doses of crystalline B12 or with foods extremely rich in B12 can successfully treat deficiencies caused by compromised protein digestion or lack of R-protein, intrinsic factor or pancreatic enzymes. Supplementation with the coenzyme forms methylcobalamin and adenosylcobalamin (the forms found in the cells) can overcome B12 deficiency in the cells caused by lack of, or malfunction of, conversion enzymes.

B12 is found almost exclusively in animal foods such as liver, kidney, meat, fish, shellfish, milk products and eggs but the original source of B12 in nature is bacteria, the only creatures able to manufacture this vitamin. In humans and animals, these bacteria produce B12 in the colon; however, little if any is absorbed across the colon wall so we must get our B12 from animal foods. Bivalves such as clams, mussels and oysters contain high levels of B12 because they siphon large quantities of vitamin B12-synthesizing microorganisms from the sea.³ Production of B12 supplements involves fermentation procedures similar to those used for penicillin and other antibiotics.

[Patient has a known allergy to penicillin]

"A surprising source of cobamides is bacterial overgrowth in the small intestines, which can produce B12 analogs.¹³ The use of antibiotics, or a diet high in refined carbohydrates, can encourage the proliferation of bacterial overgrowth and lead to B12 deficiencies.

"Yet another area for concern is multivitamin products! The late Victor Herbert, a noted B12 researcher, maintains that many multivitamin products contain spurious and even dangerous analogs of B12 possibly formed when crystalline B12 interacts with other nutrients in multivitamin products, such as vitamin C, iron and copper.¹⁴

"High levels of folic acid can accelerate neuropsychiatric complications in persons with B12 deficiency.¹⁵ Since folic acid intakes of vegetarians tend to be high (from green vegetables and from grain products that have been fortified with folic acid), those following a vegetarian lifestyle may be at increased risk of neurological and psychological problems.

"The body stores considerable B12 in the liver. Thus a delay of 5-10 years may separate the beginning of a vegetarian diet (or absorption problems) and the onset of deficiency symptoms. Interestingly, the body can recycle over 75 percent of the B12 it uses.¹⁶ Used B12 is excreted in bile and then reabsorbed in the small intestine by the same complex process described earlier. Some people have a more efficient recycling system than others and hence can go longer on a vegetarian diet without signs of deficiency. However, more B12 is excreted in the presence of high levels of fiber, a common feature of vegetarian diets.¹⁷

MEASURING B₁₂ DEFICIENCY

"American medical opinion defines blood levels lower than 200 pg/mL as an indication of deficiency. This number is based on the level associated with the most severe manifestation of deficiency, pernicious anemia. In contrast, the lower limit in Japan and some European countries is 500-550 pg/mL, the levels associated with psychological and behavioral manifestations such as dementia and memory loss. Physicians in these countries consider blood levels of 500-1300 to be the normal range.¹⁹

"According to Dr. John Dommisse, an expert in B12 deficiency, the acceptance of high levels as normal in Japan, and the willingness to readily treat psychiatric symptoms with B12 explains the low rates of Alzheimer’s dementia in that country--as well as the reason for the very high rates of Alzheimer’s in the US.²⁰

"Even with the very low cutoff currently considered the risk point, large numbers of Americans are deficient. In the ongoing Framingham Offspring Study, involving 3000 men and women in the town of Framingham, Massachusetts, researchers found that 39 percent had B12 levels in the so-called "low normal" range, that is below 258.²¹ Had the researchers chosen the optimal range of 1100-1300 as a measure of B12 status, very few would have qualified as B12 replete.

"One of the most surprising findings of this study was the fact that the youngest group (26 to 49 years old) had about the same B12 status as the oldest group (65 and up), an indication that deficiencies are becoming more common.

SYMPTOMS OF AGING

"B12 deficiency mimics many of the features of old age--ataxia (shaky movements and unsteady gait) muscle weakness, spasticity, incontinence, slowed reactions, memory loss, disorientation, depression and confusion can all occur when B12 levels are low.

"Whether or not Alzheimer’s disease constitutes a condition of B12 deficiency is the subject of considerable debate among physicians. A recent and fascinating study of a family in Wales provides convincing evidence that low levels of B12 and Alzheimer’s are linked.²²

"Research shows tremendous potential for B12 to reverse mental decline in elderly patients. In one study, 61 percent of patients with mental impairment had complete recovery with supplementation; investigators speculate that those that did not recover had suffered from deficiency so long that damage to the nervous system had become irreversible.²⁴²⁵ Thus, routine early testing for B12 has the potential to prevent mental decline in the vast proportion of the elderly. By the time Alzheimer’s is conclusively diagnosed, it may be too late for supplementation to be effective. Supplementation results in little improvement for those who have had full blown Alzheimer’s symptoms for greater than six months.

NERVOUS DISORDERS

"One condition that would seem obviously correlated with B12 deficiency is multiple sclerosis (MS), a disease characterized by demyelination of the central nervous system. Yet many studies indicate that those with MS have normal blood levels of the vitamin. Japanese researchers have found that in MS patients, there is a decrease in the binding capacity of B12, thus inhibiting the transport of B12 into the cells, even in patients with normal levels in their blood.³³ Even so, they were able to achieve some improvement with high-dose supplementation.

"The benefit of B12 for depression may be due to B12’s ability to activate a substance called tetrahydrobiopterin (BH4), a compound which in turn helps activate "feel good" neurotransmitters like serotonin and dopamine.³⁴
Surprisingly, B12 has also proven successful in treating diabetic neuropathy, possibly because the condition of diabetes deranges B12 metabolism.³⁵

"Recurrent seizures may be a manifestation of B12 deficiency. One study found that individuals who suffered from seizures had low B12 levels.³⁶

Other neurological problems associated with B12 deficiency include urinary incontinence³⁷ and migraine headaches.³⁸ In one case history, B12 worked better than steroids as a treatment for Bell’s palsy.³⁹ Another case study reports that shaky leg syndrome responds well to B12 injections.⁴⁰

AN EXCEPTION TO OUR RULE

"In these pages, we have consistently advised obtaining vitamins from food (including superfoods) rather than with vitamin supplements. One good reason to avoid supplements derives from research indicating that they can interfere with B12 uptake, exacerbate the symptoms of B12 deficiency or even cause the creation of B12 analogs that increase the body’s need for B12.

"However, when it comes to B12 itself, supplementation with isolated B12 is often necessary and appropriate. The many factors in our modern lifestlye that block the complicated uptake pathways of this important nutrient--from nutrient deficiencies to exposure to toxins to factors in processed foods that cause reduced stomach acid, autoimmune disease and enzyme disruption--make it difficult to obtain sufficient quantities from our normal diet; and since vitamin B12 in supplements is produced in exactly the same way as B12 in nature, that is, by bacterial fermentation, the danger of high doses in most cases is negligible.

The authors wish to acknowledge the contribution of Lee Clifford, MS, CCN, for providing her extensive files on vitamin B12.

http://www.westonaprice.org/basicnutrition/vitaminb12.html

PREVIOUS POST

We need to revisit the blog post that was dated 11/20/07 and explore it further.

Current Diagnosis.

Patient has been given two diagnosis - one by the Neurologists, the other by the Psychiatrists: Temporal Seizure vs. Frontotemporal Dementia. However, it is important to note that even though Patient's symptoms were classified as frontotemporal dementia, there is no enlargement of the frontal temporal, which is commonly associated with this dementia. This raises the question of whether or not Patient truly has that disease, or the symptoms brought on as a result of the medication.
Also, it is important to note that Patient did not experience current type of seizures prior to going on psychiatric medications.

Perhaps testing and evaluation performed by a holistic doctor would be worth considering at this point and that some damage could be reversed.

Notes for followup

http://en.wikipedia.org/wiki/Ketogenic_diet

http://addspouse.proboards29.com/index.cgi?board=comorbid&action=display&thread=760

http://www.dr-bob.org/babble/20070719/msgs/772724.html

Patient Overview

A recap of Patient's history is highly beneficial/crucial at this point.

Around the time patient was turning 50 years old, patient tried to communicate to daughter that a problem in the brain was occurring, yet little explanation or details were given about what exactly was happening. Patient mentioned something about issues involving confusion or other supposed cognitive issues, yet there appeared to be no concern or cause of alarm from the family. No symptoms were visible from members of the family. Patient was convinced of having cancer, yet no confirmed reports ever surfaced from doctors. Patient appeared to have some sort of psychosis related theory.

At age 53 Patient experienced a blow to the head after being struck by a steel parking lot gate. No hospital visit occurred - patient did not lose consciousness.

Patient did experience at age 56 some depressing feelings when daughter moved away and got married.

Patient received positive mood lifts from taking DHEA, however use was discontinued due to hair loss.

A few years went by and then patient began to show signs of paranoia that family misunderstood to be a relationship conflict pertaining to a family member. Then, hallucinations, delusions and disturbing paranoia all began to surface and become very stressful for Patient and noticeable by family members. When evaluated by a doctor, Patient was given medication for supposed depression. The drug, Celexa was prescribed but it did not reduce patients paranoia, rather it sent Patient into a heightened, very paranoid state.

Celexa was halted and then switched to a different medication (an anti-psychotic).

Patient experienced continued paranoia and hallucinations while on Abilify.

On Respirdal, Patient's cognitive functioning was significantly reduced along with diminished personality. Patient also suffered from Tardive like symptoms, in which Patient's eyes would continuously close/want to stay closed involuntarily. This occurred within days of taking the drug. It was then halted due to these alarming/disturbing side effects.

Patient also tried Seroquel, which also produced negative side effects.
When seizures were suspected, Patient tried Tegredol and Keppra. Patient had a serious reaction to Keprra, which involved increased anger and paranoia.

In looking back on everything the past few years, one of the most crucial factors to point out is that as soon as Patient began treatment with psychiatric drugs as well as anti-seizure drugs, PATIENT HAS SLOWLY DECLINED IN MANY AREAS. PERSONALITY HAS DIMINISHED, THINKING ABILITY, RATIONALIZING, REMEMBERING DETAILS -- HAVE ALL BECAME A STRUGGLE. PATIENT'S HALLUCINATIONS AND DELUSIONS HAVE NOT GONE AWAY. Patient became less involved in social activities and has in the past 6 months suffered physical symptoms and episodes that the Family has never before witnessed in Patient.

Patient has not improved but clearly is struggling from something that is affecting the ability to live a normal life. Those who know Patient well can see that Patient is not the normal self they once knew.

Some friends have even described Patient to appear to be in a "drugged like state."
Patient is aware of some of the problems that are occurring with speaking, getting up, walking, pain side effects, etc and is very discouraged. At times the Patient's personality does seem to surface with moments of laughing and emotion expressed. Yet Patient has suffered so many physical symptoms it has interfered with many daily activities.

While on Zyprexa and Lamictal Patient has experienced decline in energy, fainting episodes, dehydration, dizziness, sleep disturbances, trouble carrying on conversations, troubles with word finding, memory disturbances, delusions, hallucinations (some related to smell). back pain, leg pain, weight gain.

When physical problems related to getting out of a chair or bed began to surface, family members noted that Patient could get up with no help if a motivation had occurred like the phone ringing. However, if Patient was sitting and then decided to get up, Patient would have difficulty initiating that act and gaining the muscle strength to rise out of a chair. In the past couple of months, Patient has needed more and more help getting out of a chair or bed regardless of a stimulant/outside motivation present.

At this point it is hard to know whether or not the physical problems and night time issues are due to an undiagnosed disease or condition, or a result of being medicated by the WRONG drugs. Patient has suffered MORE BURDENSOME/NEGATIVE side effects than one should undergo for drugs that should be providing relief from a suspected problem/illness.

Since patient's psychiatric symptoms did not significantly improve on medication, there appears to be no clear behavioral illness or psychiatric illness. From a common sense standpoint, if psychiatric illness was the main health problem, drugs should have done a much better job of correcting Patient's symptoms, especially after undergoing treatment with several types of psychiatric drugs. Also, medical professional has indicated that behavioral illness onset is rare for Patient's age group.

Regardless of what the real problem is, the Family has witnessed a gradual decline.

We can say with assurance that Patient was significantly altered once Anti-psychotic medications were introduced for treatment and has not returned to normal self -- the self that Patient's family remembers.

Members of the family still suspect that there could be an allergy, or chemical imbalance/deficiency that could have produced the initial symptoms of paranoia a few years back. Patient has suffered stomach/gastrointestinal upset on a regular basis for many years.
Perhaps there is a link that to this day, has still not been identified.
Likewise, the Family is interested and open to the natural medicine approach, as it may provide a valuable/added evaluation that has not been considered by all of the doctors involved up to this point.

Patient has not been clearly diagnosed, yet the journey continues and the family has not given up on finding the right treatment for Patient.

Currently, patient is being evaluated and tested again for seizures.

Patient Update

Since being released from the last hospital stay in early June, patient has been experiencing on-going physical problems that make it difficult to get out of bed or out of a chair without assistance. Patient has experienced frequent sleep walking episodes throughout the night in which patient has difficulty moving around without falling/passing out. Patient grumples/groans during these episodes. Cannot recall these episodes the next morning.

Upon leaving the hospital, Patient was prescribed a higher dosage of Zyprexa (10mg) and 150mg of Lamictal, whereas patient was previously taking 7mg and 150mg respectively (no increase). Patient had severe problems walking around and complained of pain in the legs. Could not stand up straight without discomfort. Hallucinations and delusions had not improved. Upon hearing of this, the doctor decreased the medication down to 5mg Zyprexa and 100mg Lamictal. Psychiatric doctor believes patient has been suffering from a temporal lobe problem and has suspected seizures to be a culprit, therefore has prescribed these medications.

Since being reduced to 5mg, the problems with walking decreased. The degree of hallucinations and delusions reduced as well but did not completely go away. Fainting spells started to occur more often. Patient experienced 4 episodes in one day. Patient has been unable to sleep throughout the night for months.