Chapter 28: Heavy Metals Testing is Extremely Controversial!

This video makes me laugh!  Laughing makes me feel better.

Switzerland's finance minister collapsed into a fit of giggles as he tried to read the unintelligible bureaucratic language in his report while answering a parliamentary question about imports of cured meats. 

Update on my treatment plan from the Amen Clinic:

It has taken seven months to make the needed medication changes in my treatment plan from the Amen Clinic.  I have been on 300 mg of Effexor XR for two weeks and still taking 300 mg of Neurontin 4 times per day.  I have been off the beast clonazepam since May 7, 2010, and still taking supplements.  

I have been talking to my psychiatrist at the Amen Clinic about every 4-6 weeks by phone.  He has recommended I stay on 300 mg of Effexor XR for 8-12 weeks before we decide to increase the dosage.  He has found increasing the dose causes more side effects, without being more effective on the depression symptoms.  

I am having short periods of time I feel a little better.  I am hoping the depression symptoms will improve as this dose of Effexor XR gets into my body.  The thought that it might not help is frightening!

Mercury Toxicity

I thought I wanted to be tested to see if I have mercury poisoning.  The whole issue of metal poisoning and testing is extremely controversial.  There is a blood test panel for heavy metals; it is approximately $105.00.  Medical insurance will pay for this test if it has the code for Alzheimer's or dementia, but usually will not cover this test if it is being done for depression.  This test would probably be recommended by a medical doctor.

Dr. Mark Hyman (The UltraMind Solution) is a Functional Medicine M.D., and his experience has shown that the blood test will be positive if the heavy metal exposure has been recent.  If the exposure has been over a long period of time the metal will accumulate in tissues and bones.  Taking a chelating agent will pull the toxins out of tissue and bone, then a 24-hour urine sample is taken, and the amount of toxins your body excretes will be measured.  This test is usually done by Functional Medicine doctors or doctors trained in detoxification.  Removal of dental mercury or silver fillings should be performed by a biological dentist.  Go to www.iaomt.org to find a biological dentist.

The chelating agents or drugs used to test for and and treat heavy metal toxicity are DMPS and DMSA.  There is a lot of information online about these drugs being toxic themselves.  I have decided I would not feel comfortable using a chelating agent unless I could go to Lenox, Massachusetts and be treated by Dr. Hyman himself or one his colleague's.  I am going to Dr. Hyman's website (www.ultrawellness.com) and see if there is more information about heavy metals testing, or if I can ask a question about it.

The GSTM1 gene is a key gene necessary for the detoxification of mercury and many other 21st Century poisons.  About half of the population in the United States is missing this gene.  Mercury poisoning is more common in people with the apo E4 gene.  About 20% of the population has this gene.  I wonder if it would be better to test for these genes first?  (How much would it cost to have genetic testing?)

I will include some information about heavy metals testing, and some websites if you would like to read more about this subject.  Some people believe the available tests are either inaccurate or will make you sicker than you already are!

Research Article

Diagnostic chelation challenge with DMSA: a biomarker of long-term mercury exposure?

H Frumkin, C C Manning, P L Williams, A Sanders, B B Taylor, M Pierce, L Elon, and V S Hertzberg

Department of Environmental and Occupational Health, Emory University, Atlanta, Georgia, USA. medhf@sph.emory.edu

Abstract

Chelation challenge testing has been used to assess the body burden of various metals. The best-known example is EDTA challenge in lead-exposed individuals. This study assessed diagnostic chelation challenge with dimercaptosuccinic acid (DMSA) as a measure of mercury body burden among mercury-exposed workers. Former employees at a chloralkali plant, for whom detailed exposure histories were available (n = 119), and unexposed controls (n = 101) completed 24-hr urine collections before and after the administration of two doses of DMSA, 10 mg/kg. The urinary response to DMSA was measured as both the absolute change and the relative change in mercury excretion. The average 24-hr mercury excretion was 4.3 microg/24 hr before chelation, and 7.8 microg/24 hr after chelation.

There was no association between past occupational mercury exposure and the urinary excretion of mercury either before or after DMSA administration. There was also no association between urinary mercury excretion and the number of dental amalgam surfaces, in contrast to recent published results. We believe the most likely reason that DMSA chelation challenge failed to reflect past mercury exposure was the elapsed time (several years) since the exposure had ended. These results provide normative values for urinary mercury excretion both before and after DMSA challenge, and suggest that DMSA chelation challenge is not useful as a biomarker of past mercury exposure.

The Full Text of this article is available as a PDF (77K).

ARTICLES: IAOMT Medicine  (A new test to determine mercury toxicity.)

Urinary Porphyrin Profile: A Quantitative and Qualitative Laboratory
Indicator of Mercury Toxicity   John Wilson, MD
http://www.iaomt.com/articles/category_view.asp?intReleaseID=277&month=6&year=2007&catid=35

Did "Doctor's Data" know of "false positives" from mercury tests? (Doctor's Data Incorporated is a lab that is the subject of litigation.)

http://www.examiner.com/special-education-in-mesa/did-doctor-s-data-know-of-false-positives-from-mercury-tests

 

Topic: Heavy Metal Toxicity and Detoxification  (Good information on heavy metal testing and treatment.)

http://www.facebook.com/topic.php?uid=175751934758&topic=12151

 

Heavy Metal Detoxification in the Treatment of ASD (ASD=Autism)

http://www.developmentalspectrums.com/index.php?option=com_content&view=article&id=142:heavy-metal-detoxification-in-the-treatment-of-asd&catid=71:detoxification&Itemid=238 

 

MERCURY DETOXIFICATION   The Truth About DMPS  (Reports from people who have become very ill after taking DMPS.)

http://www.dmpsbackfire.com/default.shtml

 

Added on Sunday, October 10, 2010

I looked on Dr. Mark Hyman's website for answers to some of my questions on mercury toxicity.  If you are interested go to, www.ultrawellness.com, click on blog, look on the left side at blog topics (after scrolling down for awhile), click on mercury toxicity.  There is so much information the blogs are divided into sections.

I am still considering mercury poisoning testing, but I would only feel comfortable doing it under the supervision of a well qualified Functional Medicine doctor.

Chapter 27: Has the Mercury I Have Been Exposed to Caused Toxicity?

The level of mercury considered to be normal in the adult human body is less than 3 mcg/g of creatinine.  Any count over 50 mcg/g of creatinine is considered poisoning.

  

These are the ways I have been exposed to mercury.  Is it enough to have caused poisoning? 

1.  I used a popular topical disinfectant for wounds when I was young called Merthiolate.  Mercurochrome and Merthiolate are similar products and were silently banned by the FDA in 1998 because it was no longer considered safe due to its mercury content. 

2.  My dentist used mercury fillings, or silver amalgams, when I had a cavity filled while growing up.  I had several cavities during my childhood years.  Fluoride wasn't in the water supply and I did not take a fluoride supplement.  I think it is interesting I gave my two children fluoride supplements from infancy to the age of 16.  Neither of them have ever had a cavity.  Several years ago I had all of my silver amalgam fillings replaced with white composite, but I still have crowns that are lined with silver to give them more stability.

3.  I ate many tuna fish sandwiches for lunch when I was growing up.  I liked them with pickle relish and lettuce.  Tuna is a large marine fish contaminated by mercury.

4.  I received immunizations as a child starting in 1953.  Thimerosal was used in vaccines until 2001.  "Thimerosal is a mercury-containing organic compound (a Thimerosalorganomercurial). Since the 1930s, it has been widely used as a preservative in a number of biological and drug products, including many vaccines, to help prevent potentially life threatening contamination with harmful microbes."  http://www.fda.gov/biologicsbloodvaccines/safetyavailability/vaccinesafety/ucm096228.htm

 5.  I started teaching first grade students in 1975.  I had a flu shot that year and continued to get one almost every year for the next 35 years.  There were a few years I didn't get one, but I don't know if the small amount of thimerosal in each shot has accumulated in my body.

6.  Coal-burning industrial facilities emit mercury at the rate of 2,900 tons, or over 6 pounds per year.  I don't know if I live in an area that has, or has had coal burning facilities.  I need to find out.

(I found this list in, The UltraMind Solution, by Mark Hyman, M.D.)

The article below discusses the possible ways we can be exposed to mercury.  Do citizens in the United States know that mercury toxicity is a threat to their health?

Mercurochrome, Merthiolate, and Thimerosal

Mercury Exposure and Public Health in the U.S.A

Nov 8, 2009 Yana Marshal

Governments need more help from their citizens in order to produce and enforce public policies to eliminate toxins from industrial and technological productivity.

In the 1950s, mercurochrome was in every household medicine cabinet. If there wasn’t a vial of mercurochrome, there was merthiolate. When a child fell and got a cut or scrape, out came the mercurochrome in a little bottle with a glass tube attached to the inside of the cap. The tube was dipped in the solution and used to paint the mercurochrome all over the surface of the wound. Then a bandaid, or gauze patch with some tape was placed over that to keep it clean. Everyone did this. There was no question. Children would scream and run if there was no mercurochrome or merthiolate in the house because that meant iodine would be used instead. And everyone knew that iodine stung - much worse than merthiolate. 

Mercurochrome

Mercurochrome was not taken off the market in the United States until 1998, but hardly anyone noticed. Bactine had replaced those colorful liquid antiseptics by the mid 1960s. People born after 1980 may not ever have heard of mercurochrome or merthiolate (often pronounced mathiolade by children).

Bactine probably replaced the colorful antiseptics because it was clear. Bandaids were changing shapes and colors too. Mercurochrome may have faded from memory as a result of marketing and fashion more than any health reason, such as mercury poisoning. The scare of mercury poisoning in canned tuna didn’t begin until 1970. 

Thimerosal and Merthiolate

The connection between thimerosal and vaccinations became a health issue in the 1990s. Thimerosal was added to vaccinations to aid in healing the needle puncture and prevent infection of the site. Thimerosal and merthiolate are interchangeable by definition.
Mercury poisoning was not an issue in the 1950s, when every parent was using merthiolate and mercurochrome. But awareness of changes in the environment had grown enough by 1998 to take mercurochrome off of the market. Thimerosal had been implicated as a possible cause of autism. Mercurochrome had been in every household, Now, as adults, these children of the 50s who dressed their wounds with mercury tincture, were worried that a mercury tincture could cause autism in their children.

But, the emphasis has been on the mercury that is in the mixture of the vaccination serum, rather than all of the other possible sources for mercury poisoning in our present environment. If mercury is the possible source of autism and other neurological and physiological disturbances, why aren’t these sources being looked at as well? Could it be that the other industries that could be implicated in mercury exposure are holding their breath? Mercury, after all, is a naturally occurring substance. But it is more prevalent in some of our largest industries, such as the processing of coal. 
 
Mercury in the Environment
Mercury exposure is, and has been the subject of many public health studies, but the public has been slow to recognize that their own use of products and technology which increases mercury exposure is the source of the problem. It is another case of marketing and availability. Government studies have kept up to date, but organizations such as the World Health Organization , FDA and EPA have been relegated to the positions of public health educators, with little power to regulate the many toxic contaminants pervasively used in the technology of today. According to the EPA, global mercury emissions today range from 4,400 to 7,500 tons per year.

Regulation of Mercury Emissions

To many, “environmentalists” and “ecologists” are still the enemy of progress, and the cause of lost jobs in a failing economy. Because industrial toxins are a public health issue, they are also a political issue for countries which have some form of self-government. Governments have the ability to regulate the marketplace and industry. This does not have to mean a decline in jobs, or goods, but rather a restructuring and retooling of many businesses and practices. This can be an opportunity to remove many toxic substances from our daily lives, while providing jobs that use healthier materials and practices. Rather than a painful loss, this change can mean healthier jobs and a healthier environment.

Although a great stride was made when the Environmental Protection Agency announced that controls will be put on hazardous emissions, which include mercury from coal-fired power plants for the first time by November 2011, other recent mercury poisoning news involves the eating of seafood, again. Mercury contamination of the world’s oceans and streams did not disappear after the tuna scare in the 1970s, or the Clean Air Act, which was later revised during the Bush administration, or the EPA’s mercury study and report which was completed in 1997.

Disillusioned citizens on both sides of the issue complain about the ineffectiveness of government, while governments worldwide are torn between employment and productivity versus the pollution of the earth’s oceans, rivers, streams, soil, and atmosphere.

Though awareness has increased, and many manufacturers and industries have removed mercury use from their formulae, there is still much to be improved. And there is much to clean up in the way of water treatment, and soil and atmospheric contamination. There is much work to do in public services. So far, the private sector has not found clean-up after production to be lucrative.

Mercurochrome, Merthiolate, and Thimerosal: Mercury Exposure and Public Health in the U.S.A http://www.suite101.com/content/mercurochrome-merthiolate-and-thimerosal-a167442#ixzz11EmMQt4f

Michael C. Goldman, DDS 

VIDEO of Mercury coming out of a normal silver / amalgam filling !!!

This  video made  for IAOMT  graphically shows mercury vapor coming  out of a regular ordinary old silver-mercury amalgam filling in a tooth that has been extracted.  I could say a lot more about  it, but I think  watching  this video is so dramatic that you  will be amazed  by it - as I was!  I knew it has been demonstrated by  measurement instruments but I had never actually SEEN it happening !  Now you can see it too....

Silver Fillings vs. Composite Fillings

Mercury, Toxicity, Bonding, the Law, and You 

Controversy

Since its introduction onto this continent in the early 1800's, the use of a mixture of half silver and half mercury as dental "Amalgam" to fill teeth has created controversy. To this day the arguments continue. Much scientific research has been done, but the divisions seem to be so strong that those in favor of its use rationalize away the condemning research. Those against its use claim that politics and personal interest motivate amalgam's proponents.

The Facts (as I see them...) 
Mercury is a known poison. It is, in fact, one of - if not the - most toxic of all the elements known!!!  It is fact  that mercury is fully one-half of the mass of the filling you see when you look at any "silver" filling. It is fact  that mercury vaporizes in the mouth and that the vapor is inhaled and also directly absorbed into the body. It is fact that mercury travels to all body tissues and concentrates in tissues where it can do damage in several known ways. 

The question  is not whether the above facts are true, but whether enough of it occurs to be significant. Organized dentistry in the USA has taken the position that amalgam use is perfectly safe. Those against its use have found compelling relationships to many serious illnesses ranging from depression to cancer, and from kidney disease to Alzheimer's. How can it be thought to cause so wide a range of problems? The suggested answer is that mercury from fillings doesn't cause a specific disease. It causes poisoning. And depending on which tissues it concentrates in, the symptoms will differ from one person to another. Two of the most common sites of concentration and damage, however, seem to be the brain and the kidneys.

Sweden and Germany have passed laws to stop or greatly curb the use of mercury-silver fillings. Their nationalized dental plans even help to pay for removal and replacement with alternate non-mercury materials.

Canada may soon do the same. The excellent dental school in Zurich has stopped teaching "silver fillings" technique.

The Dilemma
We are faced with compelling data that the mercury in fillings may be a real hazard to our health, but both sides seem so sure about their positions.  What should we do?  Is there a way to reason through this? 
 

I think there is! First, we are being constantly bombarded with all sorts of chemical and biophysical noxious influences in our food, air, water...everywhere. Our immune systems are being stressed more and more. I believe we are seeing more chemically sensitive people and more illness from "environmental" causes. I think it makes sense to avoid known toxins. . .

Regarding mercury (in fillings), a friend of mine, a Virginia dentist, stated:

"Somehow I just don't feel comfortable using a substance designated by the EPA to be a waste disposal hazard. I can't [legally] throw it in the trash, bury it in the ground, or put it in a landfill, but they say it's OK to put it in people's mouths. That just doesn't make sense."

http://www.mgoldmandds.com/amalgam.htm

Mercury - How to Get this Lethal Poison Out of Your Body

Mercury poisoning could be leading to your ill health and weight gain, and you may not even realize it. In this weeks UltraWellness blog, Mark Hyman MD reviews some of the most recent research on the effects of mercury toxicity, explains how you can find out if you have a heavy load of mercury in your body, and offers suggestion on how to limit your exposure.  This is podcast is excellent and I am sorry I was not able to embed it in the post. 

http://www.youtube.com/profile?user=ultrawellness#p/search/1/KOhcUvHOTVk 

Chapter 26: Is Mercury Toxicity Causing Depression?

"Mercury, I believe (because of the hundreds of patients I have seen with mercury toxicity), is one of the most serious threats to our brain, and is responsible for or contributes to much of the modern epidemic of autism, ADHD, depression, dementia, and other versions of broken brains.  Finding it and getting rid of it in my patients is one of the most effective ways I have to improve mood, attention, and memory."  Mark Hyman, M.D., The UltraMind Solution, page 72.

Mercury is the second-most toxic substance known to human biology, after plutonium.

"Throughout the centuries, several incidents of mercury toxicity have been reported. Mercury has been found in Egyptian tombs, indicating it was used as early as 1500 BC. In the late 18th century, anti-syphilitic agents contained mercury. It was during the 1800s that the phrase "mad as a hatter" was coined because of the chronic mercury exposure that the felters (hats were made of felt) faced because mercury was used in hat making.  (Think of the "mad hatter" character in, Alice In Wonderland.)

In the 1940s and 1950s, mercury became known as the product that caused acrodynia, also known as pink disease. Manifestations of acrodynia include pain and erythema (abnormal redness of the skin resulting from dilation of blood vessels as in sunburn or inflammation) of the palms and soles, irritability, insomnia, anorexia, diaphoresis (perspiration: the process of the sweat glands of the skin secreting a salty fluid), photophobia (a morbid fear of light), and rash.

Some of the more recent occurrences include exposures in Minamata Bay in Japan (1960) from toxic dumping into the ocean, mercury contaminated fish in Canada (1960), methylmercury treated grain in Iraq (1970) mercury was applied to prevent spoilage of grain used for planting, but the grain was eaten by accident, and in the United States (1996), a beauty cream product from Mexico called "Crèma de Belleza-Manning.

For centuries, mercury was an essential part of many different medicines, such as diuretics, antibacterial agents, antiseptics, and laxatives.  Mercury poisoning is usually misdiagnosed because of the insidious onset, nonspecific signs and symptoms, and lack of knowledge within the medical profession."    
http://emedicine.medscape.com/article/819872-overview

"One thing is absolutely clear though: coming in contact with mercury can be a health risk.  Once having been accumulated in the body, mercury is not easily released and flushed out with regular detoxification as it hides deep within the organs and tissues.

Depression?

Not only does mercury poison affect the brain adversely as in Alzheimer’s disease, as well as affecting the heart, thyroid and immune system, it may also be the cause of emotional and behavioral problems:  Depression, mood swings, irritability, fear, extreme anger, insomnia, ADHD and loss of energy – there is a long list of symptoms of possible mercury poisoning.

Who should be more concerned about mercury poison?

Some groups of people are susceptible to mercury poisoning more than others:

     • Dentists and those who work in dental offices

     • People with silver dental fillings
       (for a directory of dentists providing safe removal of mercury fillings, click here)

     • People who live in the vicinity of coal-fired power plants

     • Workers in environments that use mercury for:  barometers, neon lights, explosives, insecticides, and paint    

     • Film developers

     • People who eat fish grown in fish farms

     • Mirror makers

     • Embalmers

     • Dye and ink makers

     • Jewelers      
     • Cosmetic makers"

http://www.cleansing-for-depression.com/mercury-poisoning-symptoms.html 

Mercury is toxic in low doses as in dental amalgam fillings, vaccines, and environmental exposures.  The largest environmental exposure is from consumption of large fish contaminated with mercury such as tuna, swordfish, shark, tilefish, and sea bass, as well as nearly all river fish.  Large fish eat smaller fish and toxins bio-concentrate up the food chain.  The bigger the fish, the higher dose of mercury you are likely to get.  So eat only fish that are small enough to fit in your frying pan.  (Information taken from, The UltraMind Solution, by Mark Hyman, M.D. pages 72 & 73)

Very interesting article about Abraham Lincoln:

By Melissa Lee Phillips
Neuroscience for Kids Consultant
July 10, 2002

In the years before he became president, Abraham Lincoln exhibited many behaviors inconsistent with his dignified image. According to writings of some of his friends and acquaintances, Lincoln was prone to highly unpredictable moodiness, to fits of extreme rage, and to unexplained bizarre actions. Most of these behaviors stopped soon after his inauguration. Researchers, led by medical historian and retired physician Norbert Hirschhorn, published a report in 2001 hypothesizing that Lincoln suffered from mercury poisoning for years prior to his presidency.

For many years, Lincoln took pills referred to as "blue mass." The main ingredient in blue mass was elemental mercury. In the 1800s, these blue pills were commonly prescribed for a wide variety of conditions, including worms, tuberculosis, toothaches, and cholera. They also were often prescribed for "hypochondriasis," a very general medical term that was used to describe many different physical and mental problems. Lincoln was said to have suffered from one condition often attributed to hypochondriasis: melancholia or depression. It is likely that a physician recommended that Lincoln take these blue pills for his depression.

Physicians in the 1800s did not know that mercury is a powerful neurotoxin. Once ingested, mercury binds to molecules in the central nervous system and can cause behavioral problems. Common symptoms of mercury poisoning are irritability, anxiety, hostility, depression, insomnia, memory loss, nerve damage, tremor, and problems with dexterity. Lincoln apparently suffered many of these symptoms during the time he is believed to have taken mercury pills.

Fortunately, many of the toxic effects of mercury are reversible. If mercury consumption stops, eventually some of the adverse symptoms stop too. A friend of Lincoln's wrote that Lincoln stopped taking blue pills about five months after the presidential inauguration. Lincoln felt that the pills made him "cross." After that, Lincoln's behavior changed: the rage attacks ceased, he remained calm in stressful situations, and the deep melancholy seemed to subside." 

http://faculty.washington.edu/chudler/linc.html

I am wondering if mercury poisoning could be a part of the depression symptoms tormenting me?

Chapter 25: Effexor XR, $260.59 or $160.80 Every Month

If you take the drug Effexor XR and you do not have medical insurance to help pay for the medication, this will be the cost.  These prices are taken from the pharmacy at Costco.com.  

Name                                                                       Quantity (number of capsules)

(manufacturer)                                                            30                60                90

VENLAFAXINE HCL ER 37.5 MG                            $121.69       $234.14       $344.48

CAP (TEVA) Generic Alternative

EFFEXOR XR 37.5 MG                                           $133.40       $261.50       $389.61

VENLAFAXINE HCL ER 75 MG                               $131.98        $258.88      $385.47 

CAP (TEVA) Generic Alternative

EFFEXOR XR 75 MG                                              $145.41       $238.18       $474.00

CAPSULE (WYETH)

VENLAFAXINE HCL ER 150 MG                             $139.86        $274.52       $410.70

CAP (TEVA) Generic Alternative

EFFEXOR XR 150 MG                                             $156.82        $260.59       $525.79

CAPSULE (WYETH)

My medical insurance has a $5,000.00 deductible, does not have a copay, and gives us a small discount on prescription drugs.  To help save money I buy my Effexor XR from Canada Pharmacy at http://www.canadapharmacy.com.  These are the prices of Effexor XR from Canada Pharmacy.

Generic 37.5 mg       90 capsules       $20.00 

Brand 37.5 mg          28 capsules       $45.00

Brand 37.5 mg          84 capsules       $125.00

Generic 75 mg          30 capsules       $45.00

Generic 75 mg          90 capsules       $120.00

Brand 75 mg             28 capsules        $60.00

Brand 75 mg             84 capsules        $147.00

Generic 150 mg        90 capsules       $86.00

Brand 150 mg           28 capsules        $80.00

Brand 150 mg           84 capsules        $225.00

I will be increasing the dose of Effexor XR from 262 mg to 300 mg next Tuesday morning.  I want to figure out the difference in price from Costco Pharmacy and Canada Pharmacy.  My doctor has recommended I stay on 300 mg for 8-12 weeks before we decide to increase the dose again.

Costco:  60 capsules would be a 30 day supply so the cost would be $260.59

60 capsules for $260.59 are $4.34 per pill

90 capsules for $525.79 are $5.84 per pill

Canada Pharmacy:  It would be less expensive to buy 84, 150 mg capsules for $225.00.  Each pill is approximately $2.68 each:  $2.68 X 60=$160.80

28, 150 mg capsules would be $2.86 per pill

So I will save about $100.00 buying Effexor XR from Canada Pharmacy, but it is still expensive to be on a drug that is $160.80 every month.  It will be even more expensive if I need to raise the dose.  When I purchase my medication I miss the years we had a small copay for prescription drugs, but I don't miss the high premiums we paid for medical/pharmacy coverage for our small business.

To get started on Effexor XR I bought 21, 37.5 capsules from a prescription at Walgreen's pharmacy.  Retail price was $111.69, my medical insurance gave me a $22.17 discount, so the cost was $89.52.  Retail price for one pill is $5.32.  The discounted price for one pill is $4.26.

I needed more 37.5 capsules so I bought 40 from the prescription at Walgreen's.  Retail price was $209.29, my medical insurance discount was $41.94, so the final cost was $167.35.  This time retail price for one pill was $5.23, and the discounted price was $4.18.

The following editorial discusses the "indirect" costs of mental disorders.  I thought it was interesting.  If you would like to read the whole article go to:
http://ajp.psychiatryonline.org/cgi/content/full/165/6/66 

Editorial 
Assessing the Economic Costs of Serious Mental Illness 
Thomas R. Insel, M.D.

"What do mental disorders cost the nation? The costs of health care are considered one of the greatest challenges in U.S. public policy (2). In 2006, health care costs reached 16% of the nation’s gross domestic product, on a path to reach 20% by 2016 (3). While mental disorders contribute to these costs at an estimated 6.2% of the nation’s spending on health care (4), the full economic costs of mental disorders are not captured by an analysis of health care costs. Unlike other medical disorders, the costs of mental disorders are more "indirect" than "direct." The costs of care (e.g., medication, clinic visits, or hospitalization) are direct costs. Indirect costs are incurred through reduced labor supply, public income support payments, reduced educational attainment, and costs associated with other consequences such as incarceration or homelessness. Another kind of indirect cost results from the high rate of medical complications associated with serious mental illness, leading to high rates of emergency room care, high prevalence of pulmonary disease (persons with serious mental illness smoke 44% of all cigarettes in the United States), and early mortality (a loss of 13 to 32 years) (5). While indirect costs have been challenging to quantify, they are critical for informing public policy. Once we assess the key components of the economic burden of mental disorders, we can have a more informed discussion about what should be invested to prevent and treat these illnesses."

Am J Psychiatry 165:663-665, June 2008

doi: 10.1176/appi.ajp.2008.08030366

© 2008 American Psychiatric Association


-

Chapter 24: Effexor XR, Please "Kick In" Soon

It felt good to vent in Chapter 23! :)

Effexor XR Catchup:  I did not feel any side effects from Effexor XR until I started on 150 mg.  I had a mild headache and constipation.  These are frequent side effects with this medication.  After 10 days the side effects diminished quite a bit, so I raised the dose to 187.5 mg.  I was relieved the side effects did not flare up again and my depression symptoms improved a little bit.  

Ten days later I raised the dose to 225 mg.  On this dosage I have noticed my appetite isn't as good.  I am not nauseated, but food doesn't sound or taste good.  It will be interesting to see if this side effect decreases in the next week to 10 days.  I have not been able to lower my dose of Luvox to less than 25 mg in the morning and 25 mg in the afternoon.  If I do, the depression symptoms become worse.

It has now been 9 days since I increased the dose of Effexor XR to 225 mg.  My lack of appetite has improved as well as the headaches and constipation.  I will probably wait to raise the dose to 262.5 mg until next Tuesday, which will be two weeks.  The improvement in the depression symptoms is subtle.  It has been a long wait!  I am hoping for a big improvement soon.

I have been reflecting on the past 29 years of dealing with the disease of depression.  I am going to talk about random memories I have.  If anyone would like to share their memories, opinions, or experiences about psychiatric diseases, please comment on my blog.  I would like to read your comments.

During the 1980's I was seeing a psychiatrist who had a psychologist working with him.  The psychologist met with support groups on different subjects.  For those of you who have never gone to a psychiatrist, you do not lie on a couch and talk about your dreams, hopes and desires.  (Like in some movies or shows.)  I have always sat in a chair and focused on my symptoms and what medications may be effective.  My life situation was discussed, but not in detail.  I have talked about my life situation in detail with a psychologist and a therapist.  It can be very helpful.  The psychiatrist I started going to in the 1980's was my doctor until he retired in 2009.  He had known me for so long I think he did know my life situation in great detail! 

I decided to join a depression support group led by the psychologist mentioned above.  The first night we met there were several of us sitting in the room waiting for the psychologist.  A man came to the doorway and said, "I'm not sure I am in the right place.  What group is this?"  The man sitting across from me said, "This is the depression support group."  The man in the doorway said, "Oh, thanks", and walked away.  "He doesn't want to be associated with the likes of us.  I can't say that I blame him."  This was said as a joke by the man who told him which group it was, and we were all laughing as the psychologist came into the room to begin the meeting.

I hope the prejudice against people with psychiatric diseases has improved since the 1980's.  When I was first diagnosed with depression in 1983 there were no ads on television about depression or the medications used to treat it.  There is more media attention in 2010, but I don't know if people are being educated about the fact that psychiatric disorders are diseases caused by areas of the brain not functioning correctly.  They are not a character flaw, or something you can just snap out of.  They are brain diseases that can be severely debilitating! 

A lot of people don't realize that depression is an illness. I don't wish it on anyone, but if they would know how it feels, I swear they would think twice before they just shrug it. 
Jonathan Davis 

Depression is a treatable medical illness like cancer and heart disease. – Judith Peacock 

For me being depressed means you can spend all day in bed, and still not get a good night’s rest. – Unknown 

That’s the thing about depression: A human being can survive almost anything, as long as she sees the end in sight. But depression is so insidious, and it compounds daily, that it’s impossible to ever see the end. The fog is like a cage without a key. – Elizabeth Wurtzel

Depression is a prison where you are both the suffering prisoner and the cruel jailer.  -- Dorothy Rowe 

"We don't see things as they are, we see them as we are." — Anaïs Nin

 

Chapter 23: Angry At The Disease

I am angry at the disease depression and I need to put the reasons why in writing.

I am tired of:

having withdrawal symptoms from every psychiatric medication I have stopped taking.

having side effects from every psychiatric medication I have started.

having to wait 4-8 weeks to see if a medication is going to be effective.

needing medications that are expensive.

having a psychiatrist who tried 15 different drug combinations in a year and a half with few results; and then didn't support me after I went to the Amen Clinic for help.

"traditional psychiatrists" using an educated guess in determining which medication would be effective for me.  They decided after hearing my list of symptoms.  Other medical fields look at the organ they are treating.

letting things I need to do just sit. 

having everything I do take so much effort.

having to put my life on hold because I don't feel like doing anything. 

having thoughts that come from a brain not functioning correctly, not from anything real.

having things that were important to me lose their value. 

not having any energy. 

not finding pleasure doing things I used to enjoy.

not feeling well enough to attend activities.

my body not creating enough neurotransmitters on its own.

people I love having to deal with this disease.

having a genetic predisposition for depression.

not having advanced medical care in the treatment of depression where I live.  I needed to go to another state.

families and friends losing someone they love because of suicide.

depression causing extreme misery.

available technology not being used with every patient it could help.  SPECT Brain Scans and the research that goes with them gives a psychiatrist more information to diagnose and treat psychiatric disorders.  The Amen Clinics have been using this technology for about 10 years.

Information from, The UltraMind Solution, by Mark Hyman, M.D.

Taken from pages 11 and 12; book published in 2009

• Psychiatric disorders affect 26 percent of our adult population or more than 60 million Americans.
• More than 20 percent of children have some type of psychiatric disorder.
• More than 40 million people have anxiety.
• More than 20 million people have depression.
• One in ten Americans takes an antidepressant.
• The use of antidepressants has tripled in the last decade.
• In 2006, expenditures on antidepressants soared to over $1.9 billion.
• Psychiatric disorders like depression and anxiety are expensive.  They are among the top five most costly medical conditions, including heart disease, cancer, trauma, and lung disorders.  The cost to our health-care system exceeds $200 billion a year, which is over 12 percent of total health-care spending.
• Alzheimer's disease will affect 30 percent (and some experts say 50 percent) of people over eighty-five years old, which is the fastest-growing segment of the population.  It will affect 16 million people by 2050.
• Attention deficit hyperactivity disorder is a label we now give 8.7 percent of children between the ages of eight and fifteen.
• More than 8 million, or one in ten, children now take stimulant medications like methylphenidate (Ritalin).
• Autism rates have increased from 3 in 10,000 children to 1 in 166 children--an elevenfold  increase--over the last decade.
• Learning disabilities affect between 5 and 10 percent of school-age children.
• The indirect costs of all these broken brains to society are mammoth.  They include loss of productivity at school, home, or in the workplace, accounting for a loss of over $80 billion a year. 

Thanks for reading.  My heart goes out to everyone who is angry and tired of depression!

Chapter 22: Serotonin, Deep Limbic System

"Depression is known to be caused by a deficit of certain neuro-chemicals or neurotransmitters, especially norephinephrine and serotonin.  In my experience, this deficit can cause increased metabolism or inflammation in the deep limbic system, which in turn causes many of the problems associated with depression. . .  Because the deep limbic system is intimately tied to moods, when it is overactive the ensuing problems with depression snowball and affect all the other deep limbic system functions."

Daniel G. Amen, M.D.; From the book, Change Your Brain, Change Your Life:  The Breakthrough Program for Conquering Anxiety, Depression, Obsessiveness, Anger, and Impulsiveness, page 47

FUNCTIONS OF THE DEEP LIMBIC SYSTEM  (page 37)

• sets the emotional tone of the mind
• filters external events through internal states (creates emotional coloring)
• tags events as internally important
• stores highly charged emotional memories
• modulates motivation
• controls appetite and sleep cycles
• promotes bonding
• directly processes the sense of smell
• modulates libido 

 

PROBLEMS IN THE DEEP LIMBIC SYSTEM  (page 43)

• moodiness, irritability, clinical depression
• increased negative thinking
• negative perception of events
• decreased motivation
• flood of negative emotions
• appetite and sleep problems
• decreased or increased sexual responsiveness
• social isolation

"We thought that excessive activity in the part of the brain that controlled emotion might correlate with enhanced feelings of all kinds, not solely negative ones.  Yet we noticed, again and again, that when this area was overactive on SPECT, it correlated with the subject's depression and negativity.  It seems that when the deep limbic system is inflamed, painful emotional shading results.  New research on depression from other laboratories around the world has borne this out."  (page 39)

     SPECT Brain Scans 3D Active View

                      White arrows are pointing to the Deep Limbic System/Thalamus areas

These scans show hyperactive areas in the brain.  A normal scan shows increased activity in the front of the brain, the cerebellum, with all else being relatively quiet. 

NORMAL SPECT BRAIN SCANS

Scans are from the Amen Clinics

I believe my body does not make enough serotonin, and other neurotransmitters, because of a genetic predisposition.  The incidence of depression is high on both sides of my parents families.  The information on page 105 in, The UltraMind Solution, by Mark Hyman, MD was interesting to me.  He says the activity of any neurotransmitter can malfunction is some way.  Below are some of the reasons why serotonin levels go down.  I want to do all I can to help my antidepressant assist my body in creating more serotonin.

1.  A tryptophan-deficient or low-protein diet.  Tryptophan is the primary amino acid out of which serotonin is created.  No tryptophan equals no serotonin equals a very unhappy mood.  In fact, studies show that if you feed a group of people a mixture of amino acids without tryptophan you can induce depression within hours! 

2.  Stress and high cortisol levels (the stress hormone).  Cortisol increases the activity of enzymes that break down tryptophan.  That leaves less around to make serotonin.

3.  Anything that causes inflammation (such as food allergies, infections, toxins, or a high-sugar diet).  Inflammatory messenger molecules called cytokines such as interferon gamma stimulate the enzymes TDO and IDO, which break down tryptophan and force it into a pathway that makes the excitatory neurotransmitter glutamate, which kills brain cells.

4.  Simply not making enough serotonin.  This happens for many reasons.  You may not have enough of the building blocks (the amino-acid tryptophan) because you eat too much sugar and not enough protein as suggested above, or you may have genetic predispositions that make it more difficult for you to create the neurotransmitter in the first place.  Those who have an SNP (single nucleotide polymorphism) or genetic variation of the enzyme THP2 have an 80 percent reduction in ability to make serotonin.

5.  Blood-sugar imbalances (insulin resistance or prediabetes).  This condition comes from eating a processed-food, high-sugar diet.  It depletes your serotonin after a short spike, leading to mood swings.

6.  You may be deficient in vitamin B-6. B-6 is the helper or catalyst for the enzyme that converts tryptophan into serotonin.  Deficiency in B-6 is often caused by stress, alcohol, and medications like birth-control pills.

7.  Magnesium deficiency.  This is so common in our society because stress, caffeine, sugar, and alcohol all deplete magnesium, which in turn prevents the body from making serotonin.