Dr. Marrs and I became aware of the symptoms and some of the laboratory results in a 38 year old woman. We wish to describe the case because it represents what should be an entirely new approach to medicine in general.
The patient had been an active 38-year-old woman caring for her home and two children, ages 7 and 9 that were her focus, prior to Lupron. She had walked her dog daily, worked out at the gym twice a week and she had renovated her home in the summer of 2017. She had had her gallbladder removed in 2016, said to be because of a polyp. She had received allergy shots once a month for a couple of years. She took birth-control pills. Her history revealed that she had had a severe reaction to penicillin as a child, resulting in a rash and joint swelling causing inability to walk for a short time. She also had a history of frequent sinus infections and antibiotic treatment. In 2017, she began experiencing heavy menstrual bleeding and hysterectomy was recommended. She refused this and a second doctor recommended Lupron in an attempt to change her hormonal balance before hysterectomy.
She had received an injection of Lupron into her left hip and side effects, beginning within a few days, included:
- Skin redness
- Severe weakness in the legs, and tingling in the left side of the head and right leg.
- A few days later she developed severe headaches and vomiting.
An initial estradiol patch caused no improvement, so another one at double the dose was prescribed with some improvement (presumably in menses). By November 2017 the patches were discontinued. She began to experience
- Joint pain
- Pain throughout her body
- Panic attacks
- Changes in personality.
- In December she experienced cyclic vomiting and weight loss.
The estrogen patches were prescribed again. She saw an endocrinologist and some laboratory tests were abnormal, including what was described as a borderline high blood glucose.
These symptoms continued and in February 2018, three drugs were prescribed (Celexa, Neurontin, Ambien). They were discontinued two weeks later because there was no relief of symptoms.
In March, she experienced severe fatigue and had episodes of difficulty in walking which were intermittent and described as “almost like being paralyzed”.
In April, she saw a geneticist and some lab tests were performed that I will comment on shortly. A diagnosis of fibromyalgia and possible chronic fatigue syndrome were each entertained. The endocrinologist said that test results indicated that she was not producing estrogen or progesterone.
Based upon conversations with us, she began supplements of thiamine, fish oil, alpha lipoic acid, B complex, folinic acid, ferrous sulfate and methyl B12. Estradiol patches were resumed. We suggested the use of intravenous water-soluble vitamins, since Dr. Marrs and I agreed that giving the nutrients by mouth probably could not reach the necessary concentration of vitamin therapy needed. This was not followed through on by her current physician.
Discussion of Symptoms and Side Effects
The patient’s medical history indicated that she had experienced many different symptoms throughout her life. These included a severe reaction from penicillin and multiple sinus infections. The side effects from Lupron were fatigue, leg weakness, headaches, general body pain, panic attacks and cyclic vomiting. In other words, she had been a classic “problem patient” to her physicians. Since the symptoms could not be defined by usual and customary laboratory evidence the general conclusion was repeatedly that this was evidence of psychosomatic disease. Curiously, this common diagnosis in modern medical circles appears to be that the patient is thought of as inventing her symptoms neurotically without ever considering an underlying mechanism. Even worse, polysymptomatic disease of this nature is usually experienced by the brightest and the best. This is because high intelligence is developed within a brain which is more energy consuming than that of a less intelligent person. Such individuals are much more prone to unforeseen stress events, making them more susceptible to side effects from medication and inoculations. A car engine uses more energy to climb a hill. Stresses that we meet in life are like “hills to be climbed” and involve a commensurate supply of energy.
Laboratory Results: Low Amino Acids, Vitamin Deficiency and Defective Energy Metabolism
Many tests were performed on this patient. Two amino acid tests were performed, one measuring the amino acids found in blood plasma, the other measuring those excreted in urine. A word of explanation is necessary. Amino acids are the building blocks of proteins in the body and finding a given amino acid in very low or unusually high concentration can be used to define important aspects of body chemistry. Of 34 amino acids recorded in the plasma of this patient, aspartic acid, serine, ethanolamine, and tyrosine were severely decreased, while glutamine, histidine, alanine, ethanolamine and tyrosine were severely decreased in urine. All the others were in their expected normal concentration.
Amino acids are used in the body to create proteins, and this is an energy consuming mechanism. One of the deficient amino acids was aspartic acid whose metabolism is important in a mechanism known as transamination. The enzyme that carries out this function requires vitamin B6.
Two of them, ethanolamine and serine, play an important part in transmethylation, a mechanism that is dependent on folate and B12.
The fourth one was tyrosine and it is involved in the synthesis of thyroid hormone.
These low levels suggested that their respective vitamin dependent mechanisms were at fault. Since all the vitamins involved are water-soluble, it invited their administration by intravenous infusion. However, because they were energy dependent reactions, it is likely to construe the possibility that the underlying common fault was energy synthesis.
Was there any evidence from these laboratory results for defective energy metabolism? Yes.
Isocitric and citric acids were reported to be low in the urine and they are vital metabolites in the citric acid cycle, the “engine” of the cell. Also, there was a deficiency of pyruvic acid and this is the fuel that enables the citric acid cycle to function. This constituted strong evidence for energy deficiency with its major effect on the brain and nervous system.
Mitochondrial Energy Synthesis
Our bodies consist of 70 to 100 trillion cells that are being broken down and reconstructed throughout life. Relatively simple molecules are acted on by enzymes in a series of chemical reactions known by biochemists as “pathways”. Each enzyme requires a vitamin and/or essential mineral that assists the action of the enzyme and are known as cofactors to the enzyme. Several pathways reflect the synthesis of energy that is stored in the cell as ATP (adenosine triphosphate). ATP is a little like a battery that is being continuously charged and discharged and most of this occurs in the mitochondria. All the other pathways consume energy, either in enabling function or rebuilding cells. They might be compared loosely to the transmission in an automobile. In other words, the healthy body functions because energy synthesis meets energy demand. The abnormally low amino acids each could be used to suggest a defect in the energy consuming pathways and possibly a reflection of missing cofactors, making the “transmission” defective.
Vitamin Cofactors, Energy Deficiency, and Symptomology
The symptoms expressed by this unfortunate patient pointed strongly to cofactor deficiencies derived from diet that could easily be tested by their administration and clinical effect. The net effect is produced by a gap between energy synthesis and its utilization to meet the stresses of life in general. The administration of cofactors does not necessarily answer the underlying question because of the possibility of unknown genetically determined factors. However, it is safe, non-toxic, may have an epigenetic effect and is relatively cheap. It therefore should be the first approach. The greater the urgency or the severity of symptoms, the stronger the indication for intravenous administration of all the water-soluble vitamins. I have successfully treated many polysymptomatic patients this way, suggesting that mitochondrial function is as much an acquired disease as well as being genetically determined.
A Note About Oxidants and Antioxidants
Think of the body as a machine that consumes fuel by uniting it with oxygen to produce energy. This combination is called oxidation. Like a fire or any form of burning, it can be slow or fast and cellular oxidation seeks an intermediate level. If the oxidation is too slow, energy production is imperiled. If it is too fast or too vigorous, oxygen atoms are “thrown out” of the oxidation process like sparks are thrown out of a vigorously burning fire. These are referred to as “free oxygen radicals”. Like sparks from a fire, they can do damage. Some vitamins act to assist or accelerate oxidation, an example being B complex. They are known as oxidants. Others quench the free oxygen radicals (sparks) and are known as antioxidants. Vitamins C and E are examples.
Without going into the highly technical details, thiamine acts as an oxidant and an antioxidant, thus increasing its importance in metabolism. From this it is easy to see the essential importance of these substances that are obtained from naturally occurring foods and why their deficiency causes disease. Of course, we have known this for a long time, but current medical belief is fixed in the concept that “vitamin deficiency disease has been conquered and the resultant diseases are only of historical interest”. For example, this patient had “borderline high glucose”, something that would occur in the thiamine deficiency disease beriberi. She also had frequent “infections”, now known to be related to free oxygen radical production, indicating that her regulation of metabolism was extremely inefficient. The amino acids that were extremely low in the plasma and urine could be used to interpret the possibility of missing cofactors, reflecting a chaotic state of metabolism. I must end this by saying that the use of vitamins and minerals in this manner is not (repeat not) simple vitamin replacement. We believe that the vitamin/mineral combination used in high-doses is resuscitating the activity of the corresponding enzyme and it is therefore acting as a drug. Identifying the underlying biochemical lesion is the essential nature of future diagnosis.
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This article was published originally on July 25, 2018.
I got 3 monthly Lupron depot injections March April may of 2021.
I was unable to drive a car safely without Ritalin to restore energy and cognitive function
extreme cognitive dysfunction
impaired long term memory
wiped out short term memory
no capacity for focus of attention
altered mental status
bizarre thoughts, paranoid thoughts
-secondary skin problems
easy bruising, eccymosis
Thiamine disulfie with Mg+ plus overtons suggested add ons are saving my life.
I now have full tilt dysautonomia.
Did these symptoms gotten better over time?
To a degree they have improved since beginning thiamine disulfide (+ + the other factors) now I’m into the third or fourth month of thiamine dosing. I have passed thru a period of scant improvement from those factors and seem to be improving more and now i’m doing better with higher dosing on thiamine etc. There did seem to be a worse before better period and higher dosing initially did not imrove response. So I backed off for a while on dose, paid attention to the other pertinent factors (diet, low or no alcohol, get good sleep, drink lots of water per dysautonomia recommendations from medical and patient community) I still have most of those terrible symptoms but they are less corrosive to my ability to function and have improved vigorous energy for long productive workdays. In other words the thiamine etc seems to have improved cellular energy across the board and I feel lots better. The symptoms toward the top of that list were rapid early onset, the first several months , after 1.5 yr the symptoms toward the bottom of the list tapered off while those toward the top did not. Amphetamine has been a huge benefit (and or methylphenidate) and I’m had a pretty damn cool life due to those meds offsetting the crushing fatige and brain fog, however the medical community is slightly insane freaking out when they hear the names of those things because some people do abuse those drugs. They allowed me to avoid a horrible auto accident due to lightning speed reactions on a freeway while symptoms were most severe in the first few months.
I have not gotten a workup for dysautonomia yet. The symptoms seem to have gotten worse as it is known dysautonomia symptoms do worsen and changed a bit from the the initial period.
This drug is nothing but a real life horror show…it needs to be banned.
Do you see patients? How do I work with you?
No, I am retired
Hello Dr Lonsdale….What are your thoughts on heavy metal toxicity and its role in causing symptomatic “but you look and test fine” chronic illiness..aka “fibromyalgia”? I have read how down through history heavy metal toxicity has caused many societies sickness and ruin. Lead in the Roman cups, lead in madhatters hats, mercury in japanese fish, todays vacines and gadolinium used in contrast mri’s.
How should one first test and then attempt to Chelate heavy metals out of the body? Is this a fruitless endeavor ? Getting something out of one’s bones just seems like a major undertaking if not an impossible task to me.
As always thanks for sharing your knowledge with us
There is no question that heavy metals have a part to play in causing disease. My book, entitled “A Nutritional Approach to a Revised Model for Medicine”, contrasts lead poisoning in the Roman empire with the high calorie malnutrition that is so widespread in our culture today. My book is available on Amazon books
I forgot to mention that hair analysis often gives information on heavy metal deposition. Chelation with EDTA is practiced by members of the American College for Advancement in Medicine and the International College of Integrative Medicine, both of which can be contacted online.