Genetics & treatment
Current medications
Prozac: 15mg
Lamotrigine: 200mg
Olanzapine: 5mg
Levothyroxine: 400mcg
Clonazapam: 0.5mg
RTMS: 6 Weeks
Having a concrete medical explanation for the tornado in my brain has brought quite a bit of relief. When experiencing this depression, my mind desperately tries to find an explanation for why I am ill, ‘It was the breakup that was too much for me’, or ‘it was the trauma of my dads death’ etc. But at the end of the day I need to accept that it’s not my fault, its just a genetic fault and should be seen as that.
Dr Zamar has explained that mood disorders, anxiety disorders, all psychiatric conditions are brain diseases. They start with periods of instability and then the nerve cells in the brain begin to malfunction and eventually atrophy as explained in the video below at the 10:30 minute mark.
Also, bipolar patients are shown to have mitochondrial dysfunction.
The treatment I am receiving aims to restore the mitochondrial function and invoke neural-plasticity to heal the nerves and create new neural pathways.
I will outline the treatment below.
High dose Levothyroxine
I am currently taking 400mcg of Levothyroxine which is thyroid replacement hormone. If you read the NHS websites guidelines on Levothyroxine it states: ‘Adults usually start with a dose between 50 micrograms and 100 micrograms taken once a day. This may be increased gradually over a few weeks to between 100 micrograms and 200 micrograms taken once a day’ It also states: ‘Levothyroxine is a medicine used to treat an underactive thyroid gland (hypothyroidism). The thyroid gland makes thyroid hormones which help to control energy levels and growth. Levothyroxine is taken to replace the missing thyroid hormone thyroxine.’
As you can see, my dose is already double the maximum recommended dose for this condition, and I have the potential to go up to 1000mcg if necessary. The fact that I show no side effects is astonishing, if people without my genes took this, it would cause them a lot of harm.
The reason for this is that my problem isn’t hypothyroidism, its a thyroid conversion problem in my genes.
Bipolar patients produce thyroid hormones (T4) normally but lack the genetic ability to convert T4 into its active form, T3, which is essential for brain function. This conversion involves two genes: deiodinase type 1 (DIO1) and deiodinase type 2 (DIO2).
There also mutations in the thyroid protein transporter known as SLCO1C1. This transports the thyroid hormones in to the brain.
You can see my genetic tests below. The ‘result’ column uses a traffic light colour system:
Red - the effect of the variant is negative
Amber- the effect of the variant is somewhat negative
Green - no variation, or the effect of the variant is positive
Repetitive Transcranial Magnetic Stimulation (RTMS)
I know if sounds a mouthful.
When talking about brain stimulation, a lot of people may have heard of ECT or Electroconvulsive Therapy and their mind quickly jumps to this. ECT is a very outdated treatment that involves putting the patient under anaesthetic and placing electrodes on their temples. They then send an electric current through the electrodes, triggering a seizure in the patient. In a hope to reset the brain chemistry.
My treatment is NOT THIS.
RTMS is a relatively new treatment that is known as non invasive. This means that you don’t need to be under anaesthetic, and it does not cause any memory loss. Some people have even attempted to use it to improve memory, and it does have a small effect.
The London Psychiatry website explains:
rTMS influences electrical brain activity through a pulsed magnetic field. This magnetic field is created by passing quick current pulses through a coil of wire. The coil of wire is encased in plastic and placed close to a client’s scalp in order for the magnetic field to be focused on particular areas of the brain. The magnetic field can safely penetrate the scalp and scull without pain, to create a current in targeted brain cells. Because this stimulation is given at regular intervals it is referred to as repetitive TMS, or rTMS.
When I tell my friends about the treatment they ask me what the RTMS feels like. The best way I can describe it is like a rubber band being smacked against your head, at the speed of a woodpecker!
RTMS is known to increase the process of neural-plasticity which involves nerve repair and regrowth. The London Psychiatry Centre also states:
The human brain is inherently an electrical organ that functions through the transmission of electrical signals between nerve cells. rTMS treatment works with your body’s natural processes by simply increasing the number and frequency of such transmissions.
Update from Dr Zamar
I had a session with Dr Zamar on Friday.
He explained that we can not increase my Levothyroxine until we have tapered the antidepressants down to at least 10mg, with a view to removing them entirely.
The reason for this is that antidepressants make bipolar disorders worse, including sub-threshold bipolar.
In fact, Dr Zamar said he hasn’t used anti-depressants in years and finds they are ineffective and give patients lots of side effects.
He showed me a consent for that he gives to patients who request anti depressants, and the form shows exactly why he doesn’t like them.
Thanks for reading.
George
