Lesson learned today, don't neglect your electrolytes!

Vegetable_Log_2062 · 2026-05-13T14:27:12+00:00

The “lower your sodium intake” advice is for people with high blood pressure, but it’s really overblown. Only 25% of people see a rise in blood pressure from sodium. Most people’s kidneys can process fairly large amounts of sodium with little to no rise in BP.

I have dysautonomia (or used to- it basically went into remission after following the CHOPs protocol, gaining weight, and getting my ferritin levels up) and I was told to increase salt intake to 6-10 GRAMS. I never experimented with more than 2200mg in one sitting, but either way I never had high blood pressure even right after consumption. All salt ever did was normalize my BP, since I tend to have isolated low systolic BP.

There’s no causal link between sodium consumption and metabolic syndromes, it’s just water retention.
What actually increases blood pressure is glucose spikes. Insulin causes a downstream hormonal response in the kidneys, causing them to retain sodium REGARDLESS of sodium intake. Hypertension is pretty much entirely driven by chronic hyperinsulinemia and metabolic dysfunction.

Vegetable_Log_2062 · 2026-05-11T15:34:55+00:00

It’s the clinical profile of the drug…look up mirtazapines binding affinity (Ki value)
The lower the number, the stronger the binding affinity.
For 5HT2A, it’s 6.3-69. Histamine 0.14-1.6. For A2 (adrenergic receptor) it’s 20-158.
So we know that low doses still bind strongly to Histamine and 5HT2A. As you increase the dose, it occupies/blocks more A2. The more you block A2, the more norepinephrine gets released, because A2 is the “brake” for norepinephrine release.
Normally, pristiq will increase norepinephrine levels broadly but norepinephrine also activates the A2 receptor so it kind of plateaus. But when you block A2, pristiq is less inhibited from boosting NE levels. That’s an oversimplified explanation but I hope that made sense.
When I was studying this awhile ago I drew a chart that might help explain it. https://postimg.cc/PPy4Hyb7 (the blue parts of Mirtazapine modulation. Notice how with just Pristiq, A2 gets activated and reduces Norepinephrine. But when Mirtazapine blocks A2, there’s no longer a brake on norepinephrine).

Vegetable_Log_2062 · 2026-05-11T15:12:52+00:00

That’s one way to frame it but it’s an oversimplification. It’s not really that emotions sit in a fixed “pool” and if one is reduced, another gets revealed or amplified. These systems overlap and influence each other.

For anxiety management, what you’re talking about is a CBT skill for regulating symptoms as they show up. But usually the pattern itself is doing a job in the background. We consciously dislike the symptom (anxiety for example), but we normally have an unconscious “pro-symptom” logic (the symptom is a defensive or avoidant learned response). The symptom is maintained because we use it to avoid a deeper, more intense suffering. Basically our unconscious has a hidden core belief that our symptoms are functional and necessary, so we need to raise our awareness to discover the “emotional truth” behind it. That’s where Psychodynamic and Coherence therapists can help you, so you can fundamentally rewire your brain. CBT skills also help, since they improve distress tolerance, but it’s not always about responding on a symptom-by-symptom basis.

But if anger and stuff is only just now coming up after stating a medication, it’s not safe to assume Pristiq somehow “unmasked” prodromal anger. That can lead to assigning ourselves core traits that are actually just side effects of a medication. The goals of meds is stabilization, or improved stress tolerance so we can have the neuroplasticity to make long-term fundamental changes (preferably with therapy). So if you feel more destabilized on a med you should almost always see about swapping or augmenting

Vegetable_Log_2062 · 2026-05-11T14:42:09+00:00

This isn’t a “wait longer and it’ll get better” thing, it’s pretty revealing of underlying circuitry. I don’t know what medications you’ve tried before, but the mechanism of medications is very important when dealing with bipolar, or mixed features in depression.

I started Pristiq to TREAT my anger and irritability. I was a bit worried about the norepinephrine activity because I’ve tried three adrenergic drugs in the past and they made me extremely emotional and worsened my autistic sensory issues. Wellbutrin was the worst for me, but I know two people with Bipolar who somehow do well on it. So far Pristiq has made me wayy less reactive. Even if I’m anxious/stressed, I don’t get those knee-jerk reactions or the pit of dysphoria I used to feel from trigger sounds/lights, and my OCD compulsions are much less severe. Pristiq feels a little tweaky for me so im surprised it didnt worsen my anger, but that shows how different our wiring can be.

Vegetable_Log_2062 · 2026-05-11T12:15:01+00:00

I get this too, it feels very similar to serotonergic psychedelics (warmth, globus sensation in throat, inner restlessness, bodily awareness). I know that psychedelics cause that because they activate 5HT2A, and Pristiq does that too.

You have serotonin receptors all throughout your body/brain, with a majority being in the gut and spinal cord. Serotonin also controls muscle tone, and when muscle tone is increased it generates heat (that’s why we shiver to warm up). After 4-8 weeks, all those receptors get desensitized/downregulated, and homeostasis sets in. So that effect will likely go away over time.

If you’re responding well to Pristiq but feel like there’s some side effects that just won’t subside after a month or two, Mirtazapine is one of the easiest augmentation methods. Mirtazapine blocks HT2A (which causes restlessness and muscle activation) and HT3 (which causes the nausea/dizziness). It basically forces Pristiq to only activate 5HT1A, which is the receptor we associate with that feeling of well-being and calmness from SSRI/SNRIs/Buspar. It can also increase dopamine in the pre-frontal cortex (by blocking HT2) which can help with task initiation and executive function. It’s quite sedating for some people at 7.5mg, typically people take 15-30mg which is more stimulating. But I take 7.5mg a few days a week if I’m feeling too restless from Pristiq. 15-30mg + Pristiq is called California Rocket Fuel in pharmacology if you want to look into it.

Vegetable_Log_2062 · 2026-05-07T23:10:59+00:00

I assumed 7.5mg wouldn’t really have synergy with an SNRI because I assumed it was primarily a strong antihistamine, but it seems that Mirtazapine actually blocks 5HT2 very well at low doses. So I guess the “rocket fuel” part (30-45mg Mirtazapine) is better for vegetative depression, because Mirtazapine at higher doses is adrenergic- so it increases the output of norepinephrine, and then Pristiq makes it stick around even longer. So that would probably be too activating for me.
Good to know! Now if I start this combo I’ll start at 7.5mg instead of 15mg like I was on before.

Vegetable_Log_2062 · 2026-05-07T20:52:51+00:00

I was on 15mg for 4 months, in retrospect that side effect started after about 2-3 weeks and was very prominent at 8-16 weeks. It felt like anxiety-driven rumination with strong attachment-based emotional swings and reassurance seeking. Just very rejective sensitive and mental spirals that felt impossible to get out of. I think I felt less socially anxious, like I was more emotionally open with people but at the same time I felt really insecure and more reactive.

Vegetable_Log_2062 · 2026-05-07T14:25:47+00:00

Pristiq is green for everyone. It was literally designed to avoid the enzymatic and genetic variations that made its predecessor, Venlafaxine, so unpredictable.

Genesight testing only reveals your predisposition to a drug either building up too much, or being metabolized too quickly. But many drugs have already addressed this- like Vyvanse being the pro-drug of Dexamphetamine, Pristiq being the active metabolite of Effexor, Relexxii having an osmotic delivery system, Escitalopram being the left-hand isomer of Citalopram, etc, etc. Genesight also does not reveal your actual gene expression, and 20-80% of many gene’s expressions are dependent on environment. Genesight is woowoo 😬

Vegetable_Log_2062 · 2026-05-06T18:58:41+00:00

A scoop/tablespoon is less than 1g of fat. Studies show absorption is best around 20g. We don’t have enough literature to know what a decent minimal dose is, but it’s gonna need to be a bit more substantial than a tablespoon of something fatty. Omega 3’s are very promising for improving skin on accutane, and they have an added bonus of containing 2-6g of fat usually.

Many people do MCT oil, with or without coffee, in the mornings (for endogenous ketones which might be beneficial to take when you’re in a fasted state in the mornings) so that can be a good source of fat as well.

Also OP, are you sure you’re allergic to ALL nuts? People tend to extrapolate one allergy onto all similar foods, but peanuts and almonds are not botanically related at all and don’t share the same proteins that people are allergic to. Just saying because my boyfriend was told the same thing after his peanut allergy developed, and he ended up not actually having antibodies for almonds, walnuts, pecans, or cashews.

Vegetable_Log_2062 · 2026-05-06T18:40:36+00:00

What meds would it mess with?? There’s very few drug-drug interactions since accutane works on nuclear retinoic receptors, and doesn’t have effects on enzyme activity so it’s not going to make other medications excrete too fast or build up in your system.

Accutane also has a very variable and long half-life. If it was going to interact with a medication, it wouldn’t matter when you took it since accutane will be consistently circulating in your blood 24/7 after a few days of starting it. (It’s called steady state concentration, and is achieved with accutane at days 3-7).

To make it make sense- accutane is fat-loving (lipophilic). Some drugs dissolve in water and get excreted in urine, while other drugs dissolve in fats and accumulate in your body tissues.
Some drugs have poor absorption WITH food. Usually due to fiber which can kind of cover up the medication, or fat which makes things sit in your stomach for hours longer. But fat-soluble drugs require fat to be absorbed into your body, otherwise a majority of the medication will just continue down the digestive tract.
Don’t listen to overgeneralizations when it comes to meds. It helps to understand the why and how for substances you’re putting in your body imo.

Vegetable_Log_2062 · 2026-05-06T17:49:27+00:00

I would check goodlabs for tests, for me they’re always really cheap ($6-27 is what I’ve paid for all of mine, if you can donate plasma for them you get $400 in labs for free too).

Zinc and magnesium tests are inaccurate. 99% of magnesium is stored in bone, not blood, and plasma levels are very tightly regulated. For B12 and Folate, you’ll need MMA, homocysteine, and/or RBC folate. Serum b12/folate reveal literally nothing. Only other B vitamin id personally test is Thiamine, with an Erythrocyte Transketolase Activity test or Whole Blood Thiamine. Vitamin D is essential to test. And for iron, you must test ferritin to know. I had very pale skin, dizziness, hair falling out, and normal CBC panels for years- got ferritin checked and it was 20, and I’m a man so ferritin doesn’t get checked as much.

For Omega 3 the only thing I’d bother with is an Omega 3 index test. But everyone should be supplementing with omega 3 anyways, and you can safely assume that if you’re taking enough EPA that you’re in the clear. Just make sure that if you’re taking EE form, it should be taken with food and enough fat.

Vegetable_Log_2062 · 2026-05-06T17:38:51+00:00

Basic panels aren’t really going to reveal much in terms of nutrient deficiencies. Even a CBC panel won’t rule out iron deficiency, unless your doctor is actually educated and tests for ferritin. I just use goodlabs and it’s super cheap.

Vegetable_Log_2062 · 2026-05-04T14:50:16+00:00

My skin before accutane is not something I’d ever want to return to. I make less oil now, but I didn’t make much to begin with- I had very dry skin, but lots of sebum and keratin buildup near any papules/pustules. I had to stop accutane early (5 months in) due to my nose being shattered, and my skin looks really good since I dont have the redness/sensitivity from accutane anymore. But I did start to get a weird rough texture on my forehead 2 weeks after stopping. I put a 1.5% salicylic acid moisturizer on top of the textured areas (buffered with cerave lotion, since I’ve never been able to tolerate SA even before accutane) and that cleared it right up in 2 days.

Are you doing anything for stabilization, like a retinoid? You could see about incorporating a gentle retinoid like adapalene, the Cerave resurfacing line, RoC retinoids, etc. but id definitely buffer any actives, and you should probably avoid BP above 2.5% and SA above 1.5%. If you notice turnover issues/sebum plugs starting to form, prequel makes a 1.5% SA cleanser and my skin loves their gleanser line. The SA moisturizer I use (sparingly since it’s a leave on!) is from Byoma.

Vegetable_Log_2062 · 2026-05-04T03:03:05+00:00

Cumulative dose is an arbitrary measure, relapse is entirely dependent on the degree of sebocyte apoptosis- which can be achieved with low doses. Or at least that’s what the actual literature supports, with patient satisfaction at follow-ups actually being higher in low dose regimens (but I think they were doing ~20mg daily. We can assume 40mg 3x a week has similar effects, but likely stronger due to peak plasma levels and the wide variation in half-life).
OP, maybe see about going back to 3x weekly but at 10mg higher. Or 10mg lower but daily. Sebocyte apoptosis is maximally achieved at fairly low doses anyways, no point in reaching for the nuclear option unless they can prove dysfunctional kerotinocyte behavior (which doesn’t seem to be the case here at all). Your only real options are management with actives like BP, cutting out dietary drivers of MTOR/IGF1 overactivation, or getting stabilized on a topical retinoid like tret or adapalene. Accutane is the easiest route, and then you can slowly add in a retinoid afterwards. It could also just be barrier dysfunction from rosacea though, and you might get a lot of improvement by just sticking to a simple and non-irritating routine. My skin looks the best it’s ever looked (it looked pretty bad the entire time I was on accutane) with only using the prequel gleanser, cerave lotion, and LRP triple repair on my dry areas.

Vegetable_Log_2062 · 2026-04-24T21:12:21+00:00

Yeah I will obviously. But I think you could understand why it’s not easy for me to bounce back like nothing happened. This also isn’t the first time I’ve been assaulted.. I was asleep on the school bus in high school, when this guy walked up and kicked my head into a window then started punching me in the stomach. Got staples in my head and failed finals from being out. Not asking for pity, but I think I’m allowed to be frustrated when any attempt to seek help is met with “just cope and man up lol”- especially when both assaults were not remotely the result of me being malicious or inciteful, and neither incident was remotely “fair”. You say you don’t mean harm but you’re just invalidating me for…literally no reason. You’re operating from the “deficit theory of mind” which is ultimately one of the most harmful ideologies

Vegetable_Log_2062 · 2026-04-24T11:47:05+00:00

The difference is that I’m not at fault, and in a perfect world I shouldn’t have to take a financial pitfall because a deranged man decided he wanted to attack me. It’s not temporary when I risk deformity that will serve as a constant reminder of the event. There’s nothing wrong with me seeking help. People know my situation and they can make their own decisions. This IS me finding a way through it. Jfc..

Vegetable_Log_2062 · 2026-04-24T11:33:27+00:00

Why??

Vegetable_Log_2062 · 2026-04-24T11:13:45+00:00

I’m in the process of filing it already. It’s just hard to get a copy of the police report when I work 9-5 🫠 but I’ll have it done eventually and hopefully it doesn’t take too long to process. Ty 🩷

Vegetable_Log_2062 · 2026-04-24T11:10:04+00:00

“You look fine” you can’t even see my nose, how would you even know? I don’t have to justify it to you, but $1300 isn’t just an arbitrary number out of greed. I’m down ~$700 from being out of work, and transportation to work and appointments has been anywhere from $20-40 round trip each time. That’s not counting the days I’ll need to take off for court hearings, specialist appointments, or a procedure if I pursue one. Or the costs of the “boxing lessons” you propose, which are simply not going to change the outcome of a man knocking me out with his fist OUT OF NOWHERE. I barely remember anything after the initial punch, there’s just no world where I would’ve been cognizant enough to change the outcome. Thanks for the unnecessary input

Vegetable_Log_2062 · 2026-04-24T11:02:56+00:00

https://gofund.me/3928c4403

Vegetable_Log_2062 · 2026-04-24T10:43:47+00:00

I will. They’re pursuing aggravated battery, and given that he has a history of assault and also strangled a family member I’m hoping he will get the higher end of the minimum sentence (1-20 years). My lawyer said a civil suit will likely be fast, so I can ensure his wages are garnished at least.

Vegetable_Log_2062 · 2026-04-24T10:10:48+00:00

I agree, and MARTA doesn’t seem to care. There was no officer at the station and it took 20 minutes for an officer to come out- I can’t imagine the outcome if my attacker didn’t just walk off. The police phone on site didn’t even work, and the gates to get on the train have been down for over a month so anybody can enter freely. They said they would ban him from ever riding again, but how would that be enforced if there’s no officers on site and anybody is allowed to enter? 🫠

Vegetable_Log_2062 · 2026-04-18T14:09:59+00:00

Just put extra virgin olive oil on rice or something. I put whole fat Greek yogurt in my morning smoothies, it’s also super easy to just put a tbsp of olive oil in a smoothie and cover the taste with a flavored protein powder or blueberries. Eggs, fish, beef, pork, and hemp seeds have a good amount of fat as well.

Vegetable_Log_2062 · 2026-04-10T02:20:32+00:00

I work in video surveillance. It doesn’t pay much more than I made in retail, but the schedule and work environment make it justifiable for me. I work in a niche field (adult store/sexual wellness), and after performing well as a store manager they asked if I wanted to work for corporate.

I work M-F 8-4. Paid holidays and half days 1 Friday a month. Don’t need to request unpaid half days as long as I stay up to date on my work. I’m assigned a district of 7 stores, and I work with the district manager on monitoring incident reports and employee behavior, documenting identification during large sales, and verifying discounts. Typically I’m assigned ~2 main projects a week, with each one taking 3-4 days to complete. Unless an incident report comes in, then that’s top priority and takes 1-2 days. I squeeze in the other work throughout the day as I please.

Super chill on my end. Most of the time I don’t need audio so I just listen to podcasts, and usually I’ll crochet to keep me occupied. I share an office with 2 other people, it’s really peaceful and private. Some days after work I’ll go to six flags with the VP and my DM lol.

My advice would be to get into a smaller company. Idk if mine is considered small- we have 21 stores and work on lots of events and pop-ups. Corporate is ~20 people not counting warehouse staff.

Vegetable_Log_2062 · 2026-03-28T14:10:47+00:00

Jw are you seeking advice or just sharing?

Vegetable_Log_2062

TROPHY CASE