gardasil narcolepsy

Narcolepsy, Basal Ganglia, Mitochondrial Fitness, and Kickboxing

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Several years ago, when I just beginning to understand the role of nutrient co-factors in mitochondrial health, I was working with a young woman who had been injured by Gardasil. She was my first ‘case’, contacting me online after a post I wrote about the thyroid damage done by this vaccine. Thyroid damage is among the more common disease processes initiated by many drugs and vaccines. It is one of the easiest problems to rule in or out, but more often than not, it is missed by most practitioners. Inasmuch as thyroid and mitochondrial function are reciprocally connected, where there is damage in one, there is damage in the other, and inasmuch as thiamine is requisite for healthy mitochondria, correcting thiamine deficiency can, in many cases, improve thyroid function. When I first met this woman, I did not yet fully appreciate that connection. Eventually, I would be introduced to Dr. Lonsdale and his work on thiamine deficiency, and so began my education. Together, we wrote a book about the role of thiamine deficiency in mitochondrial illness: Thiamine Deficiency Disease, Dysautonomia and High Calorie Malnutrition.

Exercise and Mitochondrial Healing

Her case is unique for a number of reasons, but mainly because, in addition to the thiamine and other nutrients required to heal, she used, and continues to use, exercise to manage her health. That is what I would like to talk about today: the role of exercise in mitochondrial health. Before we do that, below is a synopsis of her case, as reported in our book on pages 286-87. Her full story was provided on our website here.

In 2008, 26-year-old G.C., a previously healthy, athletic young woman, finishing a Master’s program in finance, received the three injections of the Gardasil vaccine. It bears mentioning that 2 years prior  she received several travel-related vaccines including diphtheria, typhoid, yellow fever, hepatitis A and B, the flu vaccine, and a tetanus boost and suffered no apparent ill effects.

After the second injection of Gardasil she experienced a flu-like episode with high fever lasting over a week. Full-blown hypersomnia manifested shortly thereafter and worsened to the point where she was able to sustain wakefulness for only 45 min to a maximum of 3 h per day. She experienced fatigue, muscle weakness, and dizziness. Over the next several months she developed tachycardia, intense salt cravings, with concurrent dizziness and thirst. The salt cravings led to blackouts and as she described “waves of extreme somnolence” that included slurred speech, lack of coordination, and imbalance. She learned to keep salt with her at all times. Both physical (e.g., walking, standing up, cooking) and mental exertion were profoundly draining. She reported that if she became angry or experienced any emotional event, she would immediately fall asleep. Multiple doctors had been seen and tests completed. By 2010, only low levels of vitamin D had been recognized.

Narcolepsy, Hypersomnia and Exercise

In late 2010, the fifth physician seen, it was diagnosed as narcolepsy without cataplexy–hypersomnia. She was prescribed 300 mg per day of Modiodal (Modafinil, Australia; Provigil, United States). Wakefulness increased, but she was still dizzy and required multiple hour naps after any exertion. She returned to working out. By the end of 2010 she began a PhD program and was determined to “power through.” She found that exercise, though difficult, allowed her to avoid blackouts. Of note, cardio-type workouts provided respite from the dizziness for 4–6 h, whereas weightlifting netted 24 h without dizziness. Similarly, she observed that if she ate simple sugars or carbohydrates the dizziness and blackouts would return.

Six months after beginning Modiodal her health continued to decline despite experiencing greater wakefulness. She developed severe noise and light sensitivity, continued to experience dizziness, and required excessive amounts of sleep, sea salt, and water. She developed a thick, dry, painful scale on her scalp. Another series of doctors could offer nothing and suggested the illness was in her head, inferring that she “needed to pull herself together.” Despite her health issues she defended her PhD in July 2013.

By October 2013 she had seen 10 physicians as her health continued to decline. She read our work on post-Gardasil thyroid dysfunction and other adverse reactions and requested additional testing. Hashimoto’s, hypogammaglobulinemia, vitamin B deficiencies, and low potassium levels were identified. On several occasions she attempted to get transketolase testing but was unsuccessful. In Nov. 2013 she decided to treat empirically beginning with 100 mg thiamine tetrahydrofurfuryl disulfide (TTFD). She subsequently developed the paradoxical reactions discussed in Chapter 4, with her symptoms worsening.

The Paradox or Refeeding Syndrome

With the dizziness and increased heart rate she reduced her dose to 50 mg of TTFD. Over the course of the next 5 weeks, the tachycardia landed her in hospital on four occasions. By December 2013 her body adjusted to the dosage of TTFD and the tachycardia and dizziness subsided. This is important to note. Long-term dysfunction of this nature requires new knowledge from the physician. Though not damaging to the patient it is regarded as “side effects” and either the patient or the physician stops the treatment. This effect was known to the ancient Chinese and regarded as examples of yin and yang by acupuncturists.

Over the course of the 5 years of progressively declining health she saw a total of 24 doctors. None of whom was able to identify or treat what was ultimately a metabolic disturbance brought on by thiamine deficiency that was likely triggered by the vaccine. Her final diagnoses included cerebral salt wasting, POTS, beriberi, hypersomnia, and Hashimoto’s. Arguably, the thiamine deficiency and the mitochondrial damage that ensued were at the root of each of these diagnoses.

Maintaining Health Post Gardasil

Since 2013 she has continued to maintain her health with thiamine, magnesium, and a cocktail of other mitochondrial supplements (which included very high doses of coenzyme Q10), along with thyroxine for Hashimoto’s and Modiodal to treat the somnolence. As of this writing she is doing well, training in various Asian forms of kickboxing daily and working full time. Without the balance of heavy training, the cocktail of supplements, the Modiodal, and thyroxine, her symptoms reappear.

Her case is remarkable for a number of reasons. First, that she recovered at all is impressive. Many women injured by Gardasil do not recover. She did and continues to thrive all of these years later. Her recovery was not linear though and her continued health requires aggressive attention. I think this process throws many people. We have been trained to expect that recovery from illness proceeds in a logical, linear, and expeditious manner. It does not. There were many setbacks, including several hospitalizations when she first began supplementing with thiamine. Had she not persisted through these setbacks, she might not have recovered her health. Moreover, had she not recognized the fragility of this recovery and continued to actively manage her health all of these years later, she could have easily become seriously ill again. kickboxing, basal ganglia, narcolepsyIndeed, there have been many relapses over the years, where her health declines significantly and requires extended periods of recovery. Nevertheless, she is able to recover and that is remarkable.

Secondly, and what I think is particularly unique about her case, is the role that exercise has played in her ability to recover and maintain her health. It is not something that conventional or even functional medicine gives much credence too. Sure, we all recognize the role of exercise in health generally, but mostly, we ignore it. I think this is a mistake. In her case, exercise was and remains critical to maintaining her mitochondrial health and as I have come to understand recently, the type of exercise that she gravitated towards naturally, kickboxing, may be exactly what her brain needs to function.

The Role of Exercise in Recovery

From the beginning of her illness, she forced herself to exercise, even though it was an immense struggle. On her own, she learned that certain types of exercise would prevent her dizziness and blackouts. Specifically, if she did cardio-type exercise, she could prevent a blackout for 6 hours or so, but if she added some weightlifting, the effects would last for up to 24 hours. I attributed this to exercise-induced mitochondrial biogenesis. That is, exercise was forcing the birth of new mitochondria, and somehow, shifting her balance of unhealthy to healthy mitochondria more favorably. It was also likely improving the respiratory capacity of her existing mitochondria. Although it is still not clear to me why one modality yielded better results than another, as the research in this area seems to suggest that the opposite is true, that cardio yields more mitochondrial benefits than weightlifting, the research is clear that exercise induces both mitochondrial biogenesis while improving their functionality.

Her seemingly innate realization of this was and remains one of the more noteworthy aspects of her case. Remember, for several years after Gardasil vaccine, she was seriously ill. When she first contacted me, she weighed less than 100 lbs, was severely fatigued, and could not maintain wakefulness for more than a few hours at a time without blacking out; and yet, somehow, she managed to drag herself to a gym to exercise (and maintain her graduate work in finance). Not only that, she observed a pattern of response to exercise (and salt and other dietary components) and used what she learned to help herself function better. Indeed, throughout her recovery, she would actively observe the patterns and optimize those that appeared beneficial and eliminate those that did not; something that we all should be doing as a matter of course, and yet, very few of us do.

To exercise throughout an illness where intractable fatigue, excessive somnolence and blackouts dominate is very difficult to do, and more often than not, would be discouraged. When I first wrote about her using exercise to heal, the backlash was immediate and intense. For her though, the exercise became an integral component of maintaining her health just as surely as the nutrient elements. Even now, 12 years from initial vaccine-induced illness and with 7 years of recovery under her belt, she indicates that when she misses training because of work or travel, her health declines rapidly and does so in a fairly specific manner. She becomes dizzy, loses balance, and her cognitive capacity diminishes significantly. Her ability to maintain wakefulness declines while fatigue increases. Additionally, when the stress of normal everyday illnesses come into play, a viral infection for example, and her exercise program naturally takes a hit, in order to fully recover she has to double-down on the training for a period of time once the illness passes.

Is this need to exercise unique to her case specifically or could we learn something about how we approach recovery from illness? I would argue that given the mitochondrial fitness attributable to exercise and the noted mitochondrial decline in its absence, some form of movement or exercise should be approached with any recovery plan. If this is the case, the questions become, at what point in the illness or recovery should exercise be considered, how much, and in what form? While the answers to these questions are far too individual to explore fully here, what we learn from her case is that exercise, when implemented early, improves recovery. That brings us to a more complicated question; why kickboxing, boxing, or other dynamically challenging programs might be useful for narcolepsy specifically. From what I have learned, it may be related to activating and training neural connections in a region of the brain called the basal ganglia. And of course, the mitochondria are still involved.

Enter Kickboxing and the Basal Ganglia

I believe there is damage to the basal ganglia for her and other Gardasil injured women. To this point, among the more common symptoms associated with Gardasil injury are tremors, ataxia, and gait issues. While those symptoms can easily be attributed to cerebellar and thyroid damage as well, and both of which are affected by the vaccine and thiamine deficiency, it is not without warrant that we look at the basal ganglia for these symptoms, as well as for the sleep and wakefulness issues. Neural tracts between the cerebellum and basal ganglia suggest that if one is damaged, messaging and functioning to the other would be impaired. Indeed, research shows both efferent and afferent disynaptic (from and too, two neuron) connections between the cerebellum and the basal ganglia. Additionally, personal communications with other women affected by Gardasil regarding imaging results confirm damage to the basal ganglia in some women. This is in addition to potential cerebellar damage.

Symptomatically, many post-Gardasil women display an ataxic, drunken sailor like gait, which is indicative of cerebellar involvement while their tremors occur at rest, along with muscle rigidity and dystonia, indicating basal ganglia involvement. All of them suffer from what could be termed hypersomnia and excessive fatigue, but none that I have met thus far were diagnosed with narcolepsy, like this patient. Of course, that does not exclude the possibility that it does not exist. The post vaccination symptoms are diverse as one might expect with mitochondrial damage and autonomic system dysfunction.

Why the Basal Ganglia?

The basal ganglia are set of nuclei buried deep in the brain that are responsible for controlling movement, motor learning, executive function (via connections with the frontal cortex) and emotional regulation and motivation (via connection to the limbic system). See figure 1.

brainstem basal ganglia
Figure 1. Tracts of the basal ganglia.

The basal ganglia act as a breaking system to complex movement patterns and activities.

The most well known disorders of these nuclei include Parkinson’s and Huntington’s diseases. These are dis-inhibition syndromes, where the normal inhibitory control that the basal ganglia hold over motor movements is lost resulting in tremors and chorea respectively. There are also problems with initiating movement. This occurs via connections to the limbic system, particularly a set of nuclei located in what is called the ventral tegmental area (VTA). These nuclei are central to motivating behavior, addictive behavior in many cases, but also, behavior in general. The dopamine released by the VTA neurons provide reward and reward, as we all know, encourages habit and learning. That hit of dopamine gives us the drive to act. As Parkinson’s disease progresses, patients lose these connections and with them that internal, unconscious motivation that initiates behavior. They become stuck and so absent an external cue, patients will become unable initiate a movement internally on their own. This stuckness might sometimes also manifests as a sort of depression; one where there is no motivation to act at all.

One of the latest alternative treatment modalities for Parkinson’s disease, aside from thiamineinvolves boxing. Yes, boxing. Boxing, because of the balance requirements, the bilateral, stop/go and cognitively active nature of the exercise seems to activate tracts in the basal ganglia that increase inhibitory control, reduce tremors, and allow for a smoother initiation of movement patterns. It also improves gait speed and balance, conditioning, cognitive ability, and overall quality of life.

What does all of this have to do with the ability to maintain wakefulness, and as our patient indicated, cognitive clarity? This, as far as I can tell, has not been studied, but I suspect it has to do with enhancing motivation. Not motivation in the psychobabble sense, but motivation as a fundamentally physiological, survival-based behavior; motivation that is controlled by the basal ganglia via connections to the limbic system and the frontal cortex, respectively. That hit of dopamine that engenders motivation is key for not only movement but arousal. When there is damage to that system, wakefulness is near impossible. Rodent studies have born this out. Without ‘motivation’ we cannot remain awake and we cannot sustain the arousal necessary for mental acuity.

Consider for a moment, the key aspect among all of the behaviors controlled by basal ganglia is that they necessitate wakefulness. Given that, it makes sense from a purely logical perspective that the basal ganglia might be involved in maintaining the arousal necessary to perform these activities. Similarly, it makes sense that damage to certain tracts within these nuclei could impair not only one’s ability to maintain wakefulness, but also, one’s ability to manage motor movement with altered sleep/wakefulness patterns. Finally, absent sustained and vigilant wakefulness, mental acuity is impossible. The cognitive fogginess, so often reported by these patients, may very well be linked to disruptions in basal ganglia functioning.

But Wait, There is More: The Orexin System and the Basal Ganglia

When narcolepsy and other sleep/wake disorders are researched, the basal ganglia have only recently come into view. This is despite the fact that the most well-known disorders of the basal ganglia, like Parkinson’s, demonstrate clear sleep/wake disturbances. Instead, another set of neurons located in the hypothalamus, called the orexin/hypocretin neurons (same neurons, different name), dominate the research landscape. Damage to these neurons is clearly linked to narcolepsy, cataplexy and other sleep/wake disturbances, and for our purposes, directly attributable vaccine reactions, especially the flu vaccine. The basal ganglia, not so much. How do we reconcile the known connections between orexin system, narcolepsy, and vaccine damage, the paucity of research on the basal ganglia. Well, like everything in the brain and body, we look for communication patterns. And it just so happens, the orexin neurons clearly interact with the basal ganglia to manage arousal, both directly via orexin receptors in various regions of the basal ganglia and indirectly, via vast projections throughout the limbic system, which then project to the basal ganglia.

Backing up just a bit, the release of orexin induces wakefulness. I have written about this system here, here, here, and here. When orexin neurons are turned on and firing appropriately, arousal is maintained. When orexin neurons are turned off, diminished or dysfunctional, melatonin, the sleep promoting hormone, is turned on. The two work in concert to manage wakefulness and sleep. Orexin receptors are located throughout the central nervous system and in the body. For our purposes, the orexin receptors in the amygdala and throughout the limbic system directly activate the release of dopamine from the VTA. Recall, dopamine projections from the VTA to the basal ganglia are critical for motivating and sustaining wakefulness in Parkinson’s patients. Additionally, orexin receptors have been found in different regions of the basal ganglia themselves, suggesting direct regulation of arousal. Perhaps even more importantly, the orexin neurons have been found to be instrumental in integrating motor movement patterns.

“…numerous neuroanatomical and immunohistochemical studies reveal that essential subcortical motor structures, such as the basal ganglia, cerebellum, and vestibular nucleus, receive direct innervation from orexin neurons. Moreover, during movements, orexinergic neurons are particularly active and orexin release increases. The evidence suggests that the orexinergic system directly participates in central motor control.”

So what we have is an integrated system of arousal, movement control, and cognitive behaviors that relies heavily on the health and functioning of the basal ganglia and its connections through out the brain, including with orexin system in the hypothalamus. And the orexin system itself relies heavily on functioning mitochondria, as does everything, but the orexin neurons are particularly sensitive to diminished mitochondrial function as these neurons require as much as 5-6X the amount of intracellular ATP to maintain firing compared to other neurons. The orexin neurons cease firing when ATP stores become low, inducing sleep to allow the reallocation energy towards more basic survival functions like heart rate and respiration. That means that excessive sleep is to be expected with mitochondrial damage.

Putting It All Together

With direct stress to the mitochondria via vaccines and medications we can expect  a variety of negative symptoms. In this case, our patient developed thyroid damage, autonomic dysfunction (cerebellar and brainstem involvement), and likely also, some degree of basal ganglia injury. The hypersomnia, so commonly experienced during illness or adverse medication/vaccine reactions, represents diminished orexin activity likely initiated by diminished mitochondrial capacity. Narcolepsy suggests a specific injury to oxexin system. With the diminished orexin capacity, we can anticipate that basal ganglia function would be impacted, and with it, the ability to maintain the requisite ‘motivation’ for arousal and wakefulness and to coordinate movement and maintain cognitive acuity. Nutrients and exercise improve the respiratory capacity of mitochondria, which in turn, provides the requisite energy to manage autonomic function from the brainstem and cerebellum and to sustain wakefulness by maintaining orexin firing in general and to the basal ganglia more specifically. Additionally, exercise that demands dynamic, bilateral, complex movement patterns, such as kickboxing, may serve to retrain or maintain the strength of synaptic connections to, through, and from the basal ganglia, which ultimately, may offset any damage done by the initial insult.

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This article was published originally on March 12, 2020. 

Five Years After Gardasil: Nursing my Mitochondria

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My journey with Gardasil began innocently in Australia. In 2008 after two years of pervasive marketing, I fit right within the 26 years old ‘market segment’. I qualified for a free vaccination. Little did I know what was about to hit me; not once, but three times.

Health and Vaccination History Pre-Gardasil

I was in good health prior to Gardasil; hard working, athletic and traveling extensively. I had all the required vaccines by the French medical authorities for a person from my generation.

Between 2006-2007 corresponding to the beginning of my Master’s degree, I was injected with a number of vaccines that I thought, based on medical advice, were needed to cover international travel: diphtheria, typhoid, yellow fever, hepatitis A and B, the flu vaccine, and a tetanus boost.

Mid-2008, I had my first shot of Gardasil (20/06/2008 GARDASIL SEQUENCE 1, Batch No.K0176). My second shot was in October 2008 (10/10/2008 GARDASIL SEQUENCE 2, Batch No.K2307). The 3rd sequence of Gardasil was injected in February 2009 (05/02/2009 GARDASIL SEQUENCE 3, Batch No.K5754).

Post Gardasil: Severe Hypersomnia, Dizziness, Tremors and Weight Loss

A flu-like episode with high fever lasting over a week occurred following the second vaccine shot. Full-blown hypersomnia first manifested when I fell into a deep sleep for 17 hours straight. Somnolence worsened for several months after the 2nd and 3rd Gardasil shots, until suddenly, and seemingly out of the blue, I was able to be awake for an average of 45 minutes to 3 hours a day.

During that initial phase of the syndrome, lifting a fork to eat, cooking and even walking to the kitchen were all too much effort. I needed to lie down or I would fall asleep on my computer keyboard. As I did not know the difference between tiredness and somnolence, I had difficulty explaining my initial symptoms to my doctors; yawning away through consultations until my post-consultation nap.

I experienced severe dizziness for the first time in what was to become a recurrent manifestation of this syndrome for the next five years. The dizziness intensified to the point of losing balance. I could no longer attend my regular weight-lifting classes: the floor would spin when I would pick up the weights. I tried to fight the lack of balance with my mind-over-matter method. I even managed to drag myself to a gym class during those first days of illness, seeking to force my body back into action. I thought willpower alone could jerk my body back into functioning. It didn’t work. My attempt was met with a record 10 minutes in a BodyPump class, followed by several hours of sleep. After 10 days of this dizziness and somnolence, I asked a friend to drive me to a doctor.

The Parade of Doctors Begins: Untangling the Gardasil Reaction

Doctor #1, my regular GP, said I was fine and just to rest. By then I also had hand tremors as well as dizziness and somnolence. I went to doctor #2, this time at our University Health Center. She ordered blood tests, all of which came back normal. I recall her telling me that I was healthy and that it was ‘all in my head’. Supposedly, the tremors that she could clearly observe were ‘all in my head’. She thought I was faking my symptoms. Within the next six weeks, I went to see doctor #3. Her diagnosis was Chronic Fatigue Syndrome (CFS) because I had – in her terms – ‘burned out my neurons’ through extensive intellectual efforts.

The next five months are a blur. I don’t recall much other than sleeping. I remember falling asleep everywhere instantly. I would fall asleep slumped on my desk or anywhere I sat. I would warn taxi drivers that I might fall asleep in their cab, and ask them to kindly wake me up at destination should this happen. This was in addition to the 10-12 hours per night I would sleep and the several hour naps I had in the morning and in the afternoon every single day.

More Doctors and More Symptoms

I moved from Australia to France and saw doctor #4. Soon, a new symptom began. It was tachycardia (rapid heart rate). My heart would pound furiously and I would be out of breath going up stairs, despite how athletic I had been just a few months before. Doctor #4 exhausted all possible tests and he referred me to an internal medicine specialist at Foch Hospital in France, doctor # 5. He suggested narcolepsy in his referral letter.

By then I had developed intense salt cravings which went hand in hand with the dizziness and tremendous thirst. During ‘waves’ of extreme somnolence, I had noticed that eating salt helped. I would ask for a bag of potato chips, to which I would add a lot of extra salt. Overtime, I figured out that it had to be sea salt otherwise it did not have the same effect on the dizziness or other symptoms. During these episodes I slurred my speech and had trouble speaking. This was often accompanied by major episodes of somnolence. I had noted that any exertion of physical energy was profoundly draining (e.g. walking, standing up, cooking); so too would mental energy demands such as strong emotions, empathy or anger. If became angry, I would fall asleep, as if the energy output required for anger was too much demand on my already drained body.

Since my salt cravings were so intense, doctor #5 suggested a series of tests, including one for adrenal gland tumors. This was July 2010. All the tests came back normal apart from a vitamin D deficiency.

Doctor #5: Narcolepsy without Cataplexy?

Doctor #5 concluded that I had narcolepsy without cataplexy since I had the capacity to sit down before falling asleep, rather than the cataplexy associated with collapsing asleep. He prescribed 300mg/day of Modiodal (Modafinil-Australia; Provigil-US).

The results of the treatment with Modiodal were tremendous. Since this ‘wake-promoting agent’ is used in combat by special forces, it was bound to help me control my somnolence. I was able to get much more done during the day, although I was still extremely somnolent. I began my weight-lifting class again, with better results, but I still needed 2 to 3 hours of sleep after a class and I was still dizzy and had all the other associated, up-to-then unexplainable symptoms.

Oh Wait, not Really – Says Doctor #6

In October 2010, I saw a sleep specialist, doctor #6. She told me:

“I see a lot of women like you. Women in your generation have a lot of pressure professionally and personally. You don’t have narcolepsy. You have psychogenic hypersomnia because you have been through a lot professionally and personally.”

In other words, she was implying that it was all in my head. She suggested that I would recover in about six months and did not run any tests in the sleep lab. She prescribed 400mg of Modiodal a day and told me to resist somnolence during the day to seek to force my body back into a wake-sleep routine. So I tried, although not too successfully. By then I had my nap armchair at work where I would have 10-minute power naps when I was too somnolent and dizzy. The increase in medication helped me resist the daytime somnolence but all of the other symptoms remained and some new ones appeared. I was now very sensitive to sound and light and needed sunglasses even indoors.

Powering Through my Declining Health Post Gardasil

Gradually, it seems that my body adjusted to the higher dose of Modiodal and I developed a tolerance for the dizziness and the somnolence. I enrolled in a Ph.D. program in November 2010. By early 2011 – I was both working full-time and starting a Ph.D. Being highly determined, I thought I would make my body function again, and yes, I was going to do this Ph.D. and to have this full-time job despite whatever tantrum my body was having with its dizziness, somnolence and other symptoms. I kept powering through. I thought the diagnosis of hypersomnia was final.

Another Six Months and Still No Improvement

Six months after doctor #6 told me I would be healed, I was no better. Her explanation for my lack of recovery was my “hectic” lifestyle. She told me, “you work too hard, give it another year, you should be fully resting for 6 full months but I understand you have to work.”

I was not making any progress on the somnolence, the dizziness, the light and noise sensitivity, or the salt cravings and thirst. I could barely hold it together on the physical front to keep up a career and my PHD. I did not have any energy to look more into the medical puzzle I was facing.

During the treatment when Modiodal was working well, doctor #6 tried another medication on me – to replace the Modiodal due to some changes in government funding for this medication which apparently did not qualify anymore for non-narcoleptics. She prescribed 80 mg of Ritalin. By early 2012, this new anti-somnolence medication made me extremely ill, so she changed the prescription back to Modiodal. My weight had plummeted to a low 48kg, despite eating normally.

US Doctors Post Gardasil: Pieces to the Puzzle

From late 2012 to early 2013, I spent six months in the US. I needed to follow-up on the hypersomnia. I met doctor #7 in the US and put him in touch with doctor #6 in France. I told him that I was convinced I was not properly diagnosed. ‘Psychogenic’ hypersomnia sounded like nonsense to me and it was increasingly obvious that we needed to reassess the symptoms. I told him that I was very dizzy most of the time, that light sensitivity had increased to a point of needing sunglasses indoors, that I had salt cravings etc. Also by then I was particularly skinny. I told him that I had discovered that exercise was allowing me to function without dizziness for a few hours, post weight-lifting especially. I started noticing a thick dry scale on my scalp. It was not dandruff and the inflammation – whatever it was – was very painful. Some new diagnoses emerged.

  • Hypothyroid. Doctor #7 in the US identified that I was hypothyroid. The thyroid stimulating hormone (TSH) levels came back high at 7.89 uIU/mL indicating that I was hypothyroid in spite of being skinny. Gaining weight is more common with this thyroid condition. Doctor #7 thought that the hypersomnia was due to the hypothyroidism, and that levothyroxine would fix it all, the hypersomnolence, the dizziness, and the light sensitivity. This was in January 2013. He referred me to a sleep specialist for further testing and a dermatologist for the scalp problem.
  • Low Potassium. I was also found to have low potassium levels although nothing much was thought of it at the time. This was a relevant clue as we shall see later in this post.
  • Vitamin B Deficiency. The dermatologist, doctor #8, tested me for tropical parasites given the countries I had traveled to. All came back normal. She seemed concerned though and suggested a complex of vitamin B supplements because in her experience, deficiencies in certain forms of vitamin B can trigger these sort of dermatological manifestations. I had no time to follow-up with her due to travel, nor to order the vitamins. I was too focused on the dizziness and hypersomnia and newly discovered thyroid problems and could not fathom a link to a vitamin deficiency. In retrospect, with what I now know of thiamin deficiency, I realize she was probably correct.
  • Back to Narcolepsy. The sleep specialist in the US, doctor #9, requested a sleep study because he suspected narcolepsy without cataplexy. He told me that I did not fit into the typical narcoleptic profile. The sleep study was done in February 2013 after 13 days of weaning myself off the Modiodal (yet having started the levothyroxine). By the time I completely weaned myself off the Modiodal for the sleep study, I could not exercise anymore and I was back to falling asleep all the time. In fact the sleep technician had to walk into the test room to wake me up during the day-time part of the sleep study because – as those who have done sleep studies know – you have to stay awake during certain periods of time for the tests to be valid. I was unable to resist the somnolence and was falling asleep uncontrollably on my ‘wake-up’ chair. I had an average of 4.75 minutes in a Multiple Sleep Latency Test (MSLT), indicative of severe somnolence. I communicated the information to doctor #6 in France.

Post Gardasil Idiopathic Hypersomnia, Plus Hypothyroid

Doctor #9, seeing the results of the sleep test, told me it was clearly NOT psychogenic hypersomnia and clearly not Chronic Fatigue Syndrome (CFS). It was not narcolepsy either. He suggested ‘idiopathic’ hypersomnia or ‘vaccine-related’ hypersomnia. I was also shown to have mild sleep apnea. By April 2013 I had abnormally high Reverse T3 levels and Thyroxine (T4) levels despite normal TSH levels. I went back to doctor #7. We agreed to increase the levothyroxine to 100Mcg per day.

Back to France – Finding Support at Monastery

I had to leave the US in April 2013 to defend my PhD in France. Doctor #9, the sleep-specialist in the US, kindly gave me the equivalent of Modiodal samples for 3 months: I could not order more than one month of Modiodal at a time and had no more medical coverage in France. To manage the hypersomnia, I was given instead of 400mg of Modiodal per day, 250mg of Armodafinil a day. So there I was in France, in a new town, actually in a monastery, between April 2013 and August 2013.

Diet and Exercise Clues: Possible Mitochondrial Dysfunction Post Gardasil

By then I had noticed that sugar and other carbohydrates triggered somnolence. Complex carbohydrates did not affect me. This was in addition to the extra sea salt at strategic times to reduce episodes of somnolence. The extra salt induced extreme thirst most of the time. I found that weightlifting would allow me to function without dizziness for about 24 hours, and 15 to 30 minutes of jogging would give me 4-6 hours of functioning without dizziness. In fact, when I felt most dizzy – if I did pushups or lifted weights – I was guaranteed a reduction in dizziness. I communicated this with Dr. Marrs at her website, Hormones Matter. She had found research showing that exercise induced mitochondrial biogenesis. Somehow, my body knew that too, although, at the time I had no idea why it worked.

At one point during my stay at the monastery, my symptoms worsened. I developed what is called “tunnel vision” and the light sensitivity became extreme. I needed to wear my sunglasses most of the time, even indoors. I needed eye drops otherwise my eyes would burn. I felt like I was passing out most of the time. My eye bags were strange. They went down to my jawbones across the cheeks. Noise and conversations would exhaust me. I started eating on my own, not in the commissary with the others. This coincided with the re-emergence of heart palpitations. I was unable to run. Some monks and nuns began asking me if I was eating enough. No matter what or how much I ate, I would not gain wait. I kept losing weight.

This was probably the worst time of the illness. When the dizziness would manifest, I would feel like my energy was being completely drained from my body. If I could put to words the mental image I had when this would happen, it was as if light – I take as representing my energy levels – was leaking or rather shooting upwards from the top middle part of my skull. However delirious this sounds, and I was very ill, somehow I took it as my body telling me through the delirium that there was ‘an energy leak’. That was my inspiration to find a way to heal and my task was to find the biochemical source of this ‘leak’.

Hashimoto’s and Low Gammaglobulin

I went to see doctor #10 in a small village in Southern France. TSH levels had gone down to 0.1 so I had shifted from hypothyroid to hyperthyroid. We found out that I had in fact Hashimoto’s disease in addition to the ‘idiopathic’ hypersomnia. I had hypogammaglobulinemia and low total protein levels. I had lost 7 kilos between February 2013 and June 2013. Here again, Dr. Marrs had written about post Gardasil Hashimoto’s.

Doctor #10 told me to reduce the levothyroxine, and that I should see a blood specialist in hospital due to the hypogammaglobulinemia. The blood specialist was on holiday. Concerned with the way my health was degrading, I called a friend in Paris. Worried, and with the best of intentions, he sought to help me out and called another doctor in Paris for advice. I was subsequently told I had an appointment with doctor #11.

Doctor  #11 was Lecherous

I saw doctor #11 in Paris and he told me that the Gardasil vaccine had no side effects, and that obviously all of my symptoms are in my head. So there, about 4 weeks before defending my Ph.D., an expensive doctor who knew nothing about my health asked that I stop taking the medicine that keeps me awake despite the hypersomnia and gave me a prescription for lithium ‘to help’ me wean myself off the Modiodal. He then proceeded to quiz me on my sex life, alluding to some throwback of female hysteria and repressed sexuality as a diagnosis. He seemed way too tickled by what he imagined was my sex life than in the debilitating health problems I was bringing to the medical consultation. Out of the blue, he asked: ‘do you have any issues climaxing?’. To this day I do not know how to relate his question to my light sensitivity, hypersomnia, salt-cravings, hand tremors, thirst, Hashimoto’s, dizziness and palpitations.

I became concerned when he intimated that, should all results come back negative, and he made sure I knew he thought they would come back negative, that he would prescribe appointments with a retired psychiatrist, a friend of his, to work on my thought patterns. He then calmly alluded to electroshock treatment on patients around my age at a clinic he was working at in Canada decades ago as a very good technique to retrain psychosomatic women. Yes, an expensive doctor who liked at one point in his life to experiment with electroshocks on ill women. As my exit strategy with this strange character, I told him I would indeed stop the Modiodal and go ahead with the lab tests.

I headed straight back to the monastery in Southern France, more perplexed with my health than before traveling. I arrived at the monastery almost destabilized. When I told the Mother Superior about the tone of the appointment, she burst out laughing. Her humor comforted me tremendously.

Doctor #12 – Managing the Hashimoto’s Post Gardasil

The next day, other friends had organized a medical appointment in a hospital in Montpellier, in Southern France, with an endocrinologist, doctor #12. She confirmed Hashimoto’s and asked that my thyroxine dosage be reduced. She referred me to an internist doctor closer to the monastery in another hospital.

Doctor # 13 – Probably Gardasil but You’ll Have to Live with It

Doctor #13 was an oncologist, in-hospital internal medicine. He ran a number of other tests and another MRI for pituitary issues. All came back normal apart from the thyroid function, but we already knew that. At one point he suggested we test for Breimer’s disease, however, the tests showed normal vitamin B12 levels. Tests for Lupus came back negative.

Doctor #13 told me that medicine was not advanced enough to offer me a clear diagnosis. He told me that possibly Gardasil triggered the hypersomnia, but that at this point in time without the exact mechanisms or the source of my syndrome, I’d have to live with the state of ‘no diagnosis’.

Despite my degrading health, somehow I defended and passed my Ph.D. in July 2013. In August 2013, I headed back to Australia.

Treating Post Gardasil Reactions in Australia – Doctors 14, 15 and 16

I needed a sleep specialist in Australia for the treatment of the hypersomnia. I had to get another GP (doctor #14) and sleep specialist in Australia, doctor #15. The sleep specialist was very attentive and made sure I could continue with the anti-somnolence medication. He also suggested we try a CPAP machine due to the minor sleep apnea. He started communicating with doctor #9 in the US. He mentioned that in children, what is considered ‘minor’ sleep apnea can trigger all sorts of health problems. Excessive coughing did not make it possible to continue with the trial test.

Since finding out I had Hashimoto’s in addition to the hypersomnia, and that my blood results were off, I was convinced of the need to refine the diagnosis. It was time to change tactics.

I went back to doctor #14, my new GP in Australia and shared my concerns. I also requested a referral to an endocrinologist to manage the thyroid disease I now have. She organized a referral to an endocrinologist, doctor #16. The endocrinologist was oblivious to the set of symptoms that accompanied Hashimoto’s. In only two visits, she managed to stabilize my TSH levels with 93.25 Mcg Eutroxsig per day and that was it. She did not want to see me for another year – to her the entity she was treating was Hashimoto’s and was unrelated to the other set of symptoms. She suggested yoga to reduce salt-cravings and light sensitivity; thereby implying these other symptoms were unrelated to an underlying medical condition.

I went back to doctor #14. My thirst and salt cravings, my light and noise sensitivity were so bad. I was exercising with military discipline to fight the dizziness, to counter what I now understand to probably be mitochondrial injury. I asked doctor #14 to run a number of tests and also to find an immunologist for me. The sleep specialist, doctor #15 in Australia, supported my consulting an immunologist because of my difficulties fighting infections and also low IgA, Hashimoto’s etc. Doctor #14 listened to him and while organizing an appointment with the immunologist he suggested, she also sent me to see a General Physician, doctor #18. Doctor #18 was more interested to know whether or not I had had breast augmentation ‘due to their shape’ than in my actual health concerns. He was an Australian version of French doctor #11. Needless to say, I never went back.

Meanwhile, I had learned through the Hormones Matter website, thanks to Dr. Chandler Marrs’ work, Dr. Derrick Lonsdale’s expertise, and a courageous mother, that four patients with unusual symptoms post-Gardasil (3 girls and a boy) had been tested and found to be thiamine (thiamin) deficient, using the erythrocyte transketolase test. Beriberi was at the core of their symptoms, and for whom doctors were able to do nothing prior to that diagnosis.

I tried to get the correct test for this deficiency. This was in September 2013. After six weeks of emails to three doctors (two in-hospital specialists and doctor #14), explaining the different types of thiamine testing, I realized I was getting nowhere. I learned then that doctor #14, was under pressure by the boss of her practice to stop ordering tests for me. Even though I am not depressed, she offered anti-depressants. I decided not to return. I went on a hunt for another GP to replace doctor #14. The new GP, doctor #19 ran a number of tests linked to nutrient absorption issues. All were normal.

Finally, an Ally – Doctor #17

In October 2013, my total protein levels were still low, IgA was low and I had very low vitamin D. Antithyroid peroxidase (TPO) was high. I had low potassium levels again (3.1mmol/L), which was consistent with the low potassium levels noted months earlier. (I now understand that this is typical of thiamine deficiency, or Beriberi). I also had a consistently low white cell count measured in France and in Australia.

Thanks to doctor #15, I met doctor #17, an Australian in-hospital immunologist who ordered another series of tests. He was interested in Derrick Lonsdale’s articles on the post Gardasil thiamine deficiency. Thanks to Dr. Marrs’ encouragement, they wrote to each other. We tried to get the thiamine deficiency test done in Australia. It was impossible to locate one lab that could do the correct testing. In September 2013 and October 2013, whole blood B1 levels were normal, at 143nmol/L (lab range: 66-200) and at 65ug/L (lab range: 28-85). Yet what needed to be tested was the activity of thiamine. Dr. Derrick Lonsdale makes it exceedingly clear that measuring transketolase is the only way to show that the activity of thiamine is normal. Transketolase requires two cofactors, thiamine and magnesium. The erythrocyte transketolase test is designed to show their deficiency or abnormal chemistry by detecting the activity of the enzyme.

While I was in a Southeast Asian country in November 2013, I tried again to get the erythrocyte transketolase test done. No luck. I tried getting the test in Japan through doctor #20, a researcher who was contacted for me in Japan. Beriberi is more common in Japan – I thought – they had to have labs for this, right? I asked the Japanese through a researcher in France, doctor #21. He tried six labs in Japan. No luck.

By late November 2013, after repeated failed attempts to get the transketolase test and my continued worsening health, Doctor #17, the immunologist, and I decided we would just try the thiamine replacement treatment with TTFD suggested by Derrick Lonsdale.  Dr. Lonsdale tells me that TTFD stands for thiamine tetrahydrofurfuryl disulfide. It is the synthetic equivalent of allithiamine, the naturally occurring disulfide derivative of vitamin B1(thiamine) in garlic. Clinical, animal experiments and biochemical research all have shown that it has therapeutic properties far beyond those of simple thiamine replacement.

Please do not try this alone without a doctor’s supervision as there can be dangerous paradoxical reactions.

Thiamine Replacement Treatment – Surviving the Paradoxical Reactions

I started in November with 100mg / day of TTFD. After 5 days I decreased the dose to 50mg / day. I had been warned by Dr. Lonsdale of the initial worsening of symptoms that he calls ‘paradox’. So I knew that my symptoms might get worse before they got better. I had no idea how severe that paradoxical reaction would be!

I want to explain this thing that Dr. Lonsdale calls ‘paradox’. He explained it to me as follows:

Unfortunately, we disregard history and the struggles that researchers went through in order to define the cause of the vitamin deficiency disease, beriberi. These are simply lost to the awareness of the modern physician. It was well known, when this disease was common, that the dangerous time of initiating treatment was directly proportional to the severity of the disease and how long it had been in existence. Under no accounts whatever should POTS be treated with TTFD without the care of a knowledgeable physician.

The initial phase of TTFD intake landed me four times in hospital emergency with extreme dizziness and heart palpitations over a period of five weeks. On one occasion, I was in two different hospitals in one day with chest pains and palpitations and very severe dizziness. On another instance, the gym called in an ambulance when my heart rate would not go down and I was extremely dizzy and incoherent. I recall blurting out to some petrified gym staff that I needed to have my ‘heart pulse’ monitored when in fact I meant heart rate.

In ER visits, I met resident doctors #22 and #23. One wanted me to see a neurologist and an endocrinologist. Her letter: ‘Presents L sided chest pain – sharp pinching pain…objectively in emergency. No criteria for admission @ present… would benefit from a review by both neurologist and endocrinologist’. One other resident in another hospital wanted me to see a cardiologist: ‘intermittent palpitations… thank you for seeing this patient for consideration of halter monitor’. Both were baffled by my symptoms. Dr. Lonsdale explained that this was a normal and expected temporary effect. My last ER visit was early December 2013.

Are the Post Gardasil Illnesses Related to Thiamine Deficiency?

Dr. Lonsdale’s work shows a connection between thiamine deficiency and dysautonomia. Thiamine deficiency Beriberi is actually a prototype for dysautonomia in its early stages because it affects the hypothalamic/autonomic/endocrine axis. I am inclined to agree, given my recent experience. Whether I was thiamine deficient prior to the vaccine or not, is now impossible to determine. What has become clear is that post Gardasil vaccine, my body went into a tailspin, for which no prior diagnosis or offered treatment worked.

I now understand that the symptoms of my condition are indicative of three forms of dysautonomia, all of which appear to have been induced by thiamine deficiency: the postural and orthostatic components of POTS were indicated by dizziness and fainting upon standing up. Cerebral Salt Wasting Syndrome was indicated by the intense salt cravings and Beriberi was confirmed with my positive reaction to thiamine treatment. The hypersomnia, since it has improved, appears to be caused by thiamine deficiency as well. Hashimoto’s disease, to which I have a genetic predisposition, was part of the mess and I have since learned that it is very common post medication or vaccine. It is of course possible, according to Dr. Lonsdale, that a latent, asymptomatic thiamine deficiency was triggered into clinical significance by the Gardasil vaccination.

Healing Post Gardasil

Since the ‘paradox’ passed early December 2013, with the TTFD treatment, I have had more energy than I have had in five years. The constant dizziness is gone. My extreme salt cravings are gone. My skin has improved. Light and noise sensitivity both have diminished. I have been able to put on weight. I do not need sunglasses when driving at night or earplugs in noisy environments anymore.

Going forward, I am giving my body what it needs to heal. Gradually, we are titrating my hypersomnia medications downward while providing my body with critical nutrients to feed the mitochondria. Currently – in addition to crucial daily exercise – my strategy is the following per day:

  • Early morning: probiotics; 200mg Modiodal; 93.25 thyroxine
  • Mid-morning: 50mg TTFD (Allithiamine, Ecological Formulas); 150mg Magnesium (works with TTFD); 1000 iu vit D3 (to counter vit D deficiency)
  • Lunch: 200mg or 175mg Modiodal
  • Mid-afternoon: 500mg Acetyl L-Carnitine; 150mg Co-Enzyme Q10
  • Night: 66mg TTFD, 1000µg B12, 66mg B6, 69mg vit.E, 66mg dl-α-as tocopheryl succinate, 20mg pantothenic acid calcium, 6.6mg γ-Oryzanol (2 pills of EX-PLUS Alinamin, Takeda Pharmaceuticals)

Note that initially between November 2013 and February 2014, I was on only 50mg of TTFD and 150mg of magnesium, plus a multivitamin. Now beyond the paradoxical phase,  with the TTFD supplements my energy levels have soared. I decided to gradually increase the TTFD to 83mg. I am now at 116mg. Since my ailment seems to point to the mitochondria, I decided early March 2014 to add Acetyl L-Carnitine and Co-enzyme Q10. I also added probiotics to counter damage from ongoing medication. I now seek to decrease the Modiodal levels, gradually.

Post Script: I Was Given the Key to my Health at the Monastery

During the worst of my illness, a key was given to me in the form of both a pair and a trio. The trio was Dr. Chandler Marrs, Dr. Derrick Lonsdale, and the mother of Gardasil-injured patient. And the trio was paired with a context conducive to finding answers. Let me explain what I mean by the context.

I was in the last leg of my Ph.D. in France. During this challenging time physically, mentally and intellectually, but also financially, I was offered refuge in a monastery. My health was severely degrading. It was in this context of prayer, under the protection of this religious community while finishing my Ph.D. dissertation and preparing my Ph.D. defense, with a fantastic Wi-Fi connection at the monastery, that I began searching furiously for answers.

I needed to understand this complex biochemical mess that was manifesting in my body. What doctors were consistently discarding could not be this complicated to understand. The symptoms of this syndrome were not psychogenic: they did not occur in a chemical vacuum. Yet my doctors were baffled. And they were discarding my symptoms as an unsolvable mystery in not just one country, but in three countries: Australia, France and the United States.

Research on adverse reactions to Gardasil, as presented on Hormones Matter changed my perspective of this illness. A growing body of evidence seemed to indicate a link between Gardasil and a set of side effects ranging from Postural Hypotension Tachycardia Syndrome (POTS) to cerebellar ataxia, autoimmune disease and debilitating somnolence.

After countless GPs, I was referred to three in-hospital specialists to treat multiple conditions: a sleep specialist, an endocrinologist and an immunologist.

It turns out that the Gardasil vaccine-induced hypersomnia and vaccine-triggered Hashimoto’s was just the tip of the iceberg. I also had Cerebral Salt Wasting Syndrome, Postural Orthostatic Tachycardia Syndrome and Beriberi, all forms of dysautonomia, all potentially related to thiamine deficiency. None of this was detected or even considered by the physicians I sought help from, barring the dermatologist doctor #8 who mentioned the B vitamins as potentially involved in my illness. Even if the doctors had considered thiamine deficiency, testing in commercial labs was insufficient to detect it, leaving patients like me to fend for ourselves.

Through Hormones Matter, Dr. Chandler Marrs’ research and writing has helped me to connect the dots for my post Gardasil ordeal. Along with Dr. Derrick Lonsdale’s work showing the array of symptoms caused by thiamine deficiency, I now have a more accurate diagnosis and the treatment needed to heal. Together, Dr. Lonsdale’s research and Dr. Marrs’ articles on mitochondrial injury, are the closest I have come to a well-rounded explanation for the complex range of symptoms that I experienced over the last five years. Their work is giving me and my physicians treatment options that were otherwise unknown.

A few days ago, I discovered the work of Dr. François-Jérôme Authier and Dr. Romain K. Gherardi. Their work unveils even more of the complex chemical interactions at the core of this multifaceted syndrome.

What I Learned

Complex diseases sometimes have simple solutions, but to get there requires communication and collaboration amongst patients, doctors and researchers. My illness crossed medical boundaries requiring a multidisciplinary approach. There were no immediately knowable diagnoses, no medications that could effectively treat what was ailing me and, because of which, many physicians disregarded my symptoms as unsolvable, and the worst of them – thankfully a limited number – attributed my illness to psychogenic manifestations. If it were not for the online publication Hormones Matter, where patients, researchers and physicians work to find solutions to complex diseases and reactions, I would not be writing this post. I would be too ill.

A Note of Gratitude

I am profoundly grateful to the eclectic, geographically dispersed medical team which has helped me make sense of my ordeal. I am particularly grateful to Dr. Chandler Marrs for her out-of-the-ordinary patience and dedication to research and understanding adverse reactions, for making sure patients with complex diseases are heard. I am very grateful to Dr. Derrick Lonsdale for both his wisdom and his generosity in sharing, at 88 years old, his depth of knowledge on thiamine. May this knowledge be put to good use. His research legacy is a powerful one. I am grateful to Doctor #15 for being attentive and considering the possibility of a link between thiamine deficiency and some sleep disorders; to Doctor #17 for being willing to listen to a patient and to try the TTFD treatment; and to Doctor #21 for activating medical research networks both in Japan and France to seek to help me out. I am making sure that Doctors #15 in Australia and #9 in the US are in touch regarding the impact TTFD has had on the hypersomnia in my case.