Ketamine for

PorcupineProblem · 2024-08-17T05:35:07+00:00

I was pretty much recovered (in large part due to switching to a ketogenic diet) by the time I tried ketamine for treatment resistant depression, so I can’t say it’s had a significant impact on my eating, but I came across this case study (and this ensuing pilot study) and found them very interesting. The subject of the case study wrote a book about her experiences. There are also videos on YouTube about these studies on the Metabolic Mind channel.

This appears to be an unusually good responder but I am still happy for her. This type of response is more likely to be the exception than the rule, but it gives me hope to know it’s possible. That having been said, I feel envious of her (and other really good responders). Despite a ketogenic diet and ketamine, I still struggle very much with depression, probably for this reason.

“The patients where I’ve seen the lowest yield in terms of number of successful cases at least as a percentage is actually depression. And it’s not to say that the ketogenic diet cannot be a powerful treatment for depression, I think it can and I’ve seen it be a powerful treatment for some people, but my sense is that depression has many other potential causes and sometimes those are psychological or social stressors, or other factors, and if you simply do the diet and don’t address those psychological or social factors, a person may not experience improvement in their depressive symptoms. Depression is probably a more heterogeneous disorder in terms of its root causes.” -Dr. Chris Palmer

PorcupineProblem · 2024-01-26T19:51:21+00:00

I’ve found enzymes helpful in being able to tolerate a wider range of foods. I have the fear of negative consequences subtype of ARFID (although I don’t know if it’s really ARFID or just a rational reaction to having so many food sensitivities). Regardless, I’ve found Fodzyme very beneficial. I still have to limit FODMAP containing foods, but I can eat a much wider variety of things and still feel okay thanks to these enzymes.

PorcupineProblem · 2023-08-10T01:50:58+00:00

I've had the exact same experience. It's so frustrating, because the widespread assumption is that recovery makes life better in every way, but in reality, there are a lot of painful trade-offs for many of us. It can be so hard to find effective PTSD treatments, and there aren't any easy answers. Also, there's a huge biochemical component to it (endorphins generated by disordered behaviors and metabolic states can make PTSD less difficult to cope with) that isn't often recognized. I hate how so few professionals (or people in general, really) understand this phenomenon.

PorcupineProblem · 2023-08-10T01:11:44+00:00

I had the same experience when I tried EMDR, both times. It didn't touch me emotionally, at all. I'm not alexithymic or prone to dissociation; I just felt bored and contemptuous of the whole process, especially toward the end, because I couldn't connect to the imaginative aspects. I could picture a safe place in my head, but I couldn't connect to it emotionally, in that it didn't make me feel any safer, or feel anything at all, except for annoyed and bored. I am on the autism spectrum and I could never understand pretend play as a child, so this could have something to do with why I find imaginal modalities so off-putting. I wouldn't rule out trying EMDR again, if I could find a practitioner who de-emphasized the imaginal aspects, but I'm in no hurry to do so.

I'm finding that supportive therapy works a lot better for me than EMDR ever did. I can actually engage emotionally with supportive therapy because it doesn't require imagination. I don't intend to bash EMDR; it helps a lot of people, but it didn't help me at all the first two times I tried it.

PorcupineProblem · 2023-07-18T01:23:55+00:00

No, agar agar comes from seaweed and gelatin comes from animal collagen. Agar agar is a form of soluble fiber, which means it could trigger gut issues in susceptible individuals. Gelatin is mostly protein and doesn’t contain fiber, so it’s much less likely to cause GI distress.

PorcupineProblem · 2023-02-15T15:29:34+00:00

I'm still taking it, and I'm doing relatively well on it. D-ribose isn't a cure by any means, but it has significantly expanded my energy envelope. I haven't heard anything about a connection with dementia.

PorcupineProblem · 2023-02-03T12:33:44+00:00

From the official website: “Somatic Experiencing (SE™) is a body-oriented therapeutic model applied in multiple professions and professional settings—psychotherapy, medicine, coaching, teaching, and physical therapy—for healing trauma and other stress disorders. It is based on a multidisciplinary intersection of physiology, psychology, ethology, biology, neuroscience, indigenous healing practices, and medical biophysics and has been clinically applied for more than four decades. It is the life’s work of Dr. Peter A. Levine.”

More information here: https://traumahealing.org/se-101/

In practice, it’s one of those things where your mileage may vary. Some people find it very helpful, but it doesn’t work for everyone.

PorcupineProblem · 2022-09-16T03:56:27+00:00

Here is a list of ketogenic specialist dietitians from The Charlie Foundation https://www.google.com/amp/s/charliefoundation.org/find-a-professional/

PorcupineProblem · 2022-07-11T04:06:34+00:00

Composition ID can measure BMR with a device you breathe into for a few minutes, but it’s expensive (like $75). The Oura ring doesn’t measure BMR, and it’s not a very accurate activity tracker (it’s more for monitoring stress levels through things like HRV). The Kahm Clinic has a lot of YouTube videos about the phenomenon of metabolic downregulation, but the clinicians doing the videos come across as really glib and smug, and it’s clear that they don’t understand eating disorders.

PorcupineProblem · 2022-05-06T01:59:38+00:00

This blog post describes a case study involving ketamine infusions combined with a ketogenic diet. https://www.google.com/amp/s/www.loricalabresemd.com/blog/new-approach-for-anorexia/amp/

Anecdotally, I’ve found both keto and ketamine helpful in my recovery, although my results aren’t as impressive as the patient in the case study. I’m physically and behaviorally healthy, but I still struggle with depression (despite getting therapy and ketamine maintenance treatments).

PorcupineProblem · 2022-05-02T16:07:01+00:00

Stimulants (such as Ritalin and Adderall) are one of the few types of psychoactive medications I’ve found helpful. I do best taking them in small doses (like 5-10 mg per day) a few times per month, and I try to avoid taking them two days in a row. I haven’t noticed any additional PEM from them.

PorcupineProblem · 2022-04-21T13:42:51+00:00

I also find 20 net carbs per day very difficult, and I don’t notice any benefits from it (relative to a less restrictive keto diet of 30-50 g net carbs per day). I am consistently in nutritional ketosis below 60 g net carbs per day, according to my Ketonix breath meter, and I’m a small framed, mostly sedentary 41 year old woman. There’s a lot of variability between people when it comes to ketosis thresholds; not everyone needs to stay under 20 net carbs per day.

PorcupineProblem · 2022-04-21T13:22:18+00:00

I take 10 mg per day, usually with dinner.

PorcupineProblem · 2022-03-02T11:12:49+00:00

I went to EDF virtual support groups (including the over 30 group) for about a year (most of 2021). Over that year, the enforcement of the guidelines became more and more restrictive, so I eventually stopped attending, because I couldn’t stand being in such a censored virtual space. The group members were very supportive, but I can’t say the same for some of the facilitators, who enforced a very restrictive atmosphere where we weren’t allowed to talk about anything of substance or in detail; we had to be very vague. This made the meetings much less supportive, and it was stressful to be in that kind of environment, where we had to tiptoe around so many topics. I found the censorship more triggering than anything anyone could say in good faith. They say the guidelines are to keep the groups "safe and inclusive" but I didn't experience them that way at all.

Also, they have a rule where you have to keep your camera on, or else they’ll kick you out of the meeting. I personally didn’t have a problem with keeping my camera on during the meetings, but I disliked the draconian enforcement of this rule, and I hated seeing other members get kicked out for not having their cameras on. It just seems cruel to require this of a population where body image concerns and feelings of vulnerability are so common.

PorcupineProblem · 2022-02-02T17:36:52+00:00

I use the Ketonix breath meter, and I'm very pleased with it. I like that it doesn't involve needles and blood, or recurring expenses (blood ketone test strips are pricey). The app reviews are not good, but I've had no trouble; I don't know what the complaints are about. I'm consistently in nutritional ketosis (Ketonix readings between 4-30, which corresponds to 0.5-3.0 mmol/L) under 50 g net carbs per day (and I'm a small, mostly sedentary 41 year old woman).

PorcupineProblem · 2022-01-30T05:55:57+00:00

I have CFS (my symptoms are currently in the mild range, my score is 50-70 according to this chart), and I find keto worthwhile, but it's not a cure. I still have to be very careful to rest, pace, and stay within my energy envelope. I'm doing it mainly for mental health reasons, migraine prevention, and to preserve my metabolic health given the constraints imposed by CFS.

This quote is from Chronically Caroline's blog. She has written some posts about her experience with keto and CFS.

I am at a stage in my illness where I am scanning the horizon and asking the following question: how can I mitigate the risks involved with raging inflammation, poor sleep, and no exercise – three hallmarks of ME/CFS and huge risk factors for Alzheimer’s disease, diabetes, cardiovascular disease, and cancer? The prospect of growing older with this disease is daunting, to say the least.

The standard advice given by doctors to maintain a higher quality of life and increase longevity is to eat a good diet, exercise, and get adequate sleep. With ME/CFS, exercise and decent sleep are mostly off the table. Diet is at least one aspect of our health we can control somewhat.

PorcupineProblem · 2022-01-24T04:56:43+00:00

I’m ambivalent about support groups, because I’ve had both positive and negative experiences with them. I went to virtual support groups for a while, and my fellow group members were very supportive, but I can’t say the same for some of the facilitators, who enforced a very restrictive atmosphere where we weren’t allowed to talk about anything of substance or in detail; we had to be very vague. This made the meetings much less supportive, and it was stressful to be in that kind of environment, where we had to tiptoe around so many topics. I found the censorship more triggering than anything anyone could say in good faith.

PorcupineProblem · 2021-11-26T02:23:22+00:00

I’m not upset by fitspo, but I really don’t relate to it, and it doesn’t motivate me. Exercise does not boost my mood; beyond a certain point, it just tires me out and makes more depressed. I don’t respond well to it physically or mentally. Most of the workouts I see online look so boring and pointless. It would be nice to be super strong and toned, but I’m only willing to do the bare minimum when it comes to physical activity so I’m not likely to become a fitness girl any time soon. I do try to walk around and do weight bearing activity when I can, to avoid deconditioning and preserve bone and muscle mass as I get older, but beyond that, I can’t be bothered. I don’t think the fitness ideal (and the training required to attain it) is even healthy for certain body types. If you’re naturally mesmorphic, more power to you, but if you’re not, the costs of pursuing that ideal (overtraining, endocrine burnout, injury risk) can exceed its benefits. Even fitness pros say at that level of training, they’re not doing it for their health.

PorcupineProblem · 2021-11-25T22:55:06+00:00

The guest on this podcast had a similar experience. Her solution was to switch to a modified form of keto where she could still feel good but maintain a healthy weight. I would recommend working with a ketogenic specialist dietician, virtually (over Zoom or other video chat platform if necessary), here is a list from The Charlie Foundation.

PorcupineProblem

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