When Supplements (or Meds) Cause or Worsen Brain Symptoms
5 Reasons & What Can Be Done
In previous newsletters, I’ve addressed many of the more common contributing factors to brain symptoms, including high pyrroles, copper-zinc imbalances, methylation imbalances, candida overgrowth, mast cell activation, mold and other forms of toxicity, and genetic variants, such as COMT and MAOA.
Supplements can be needed to address each of these. Medication can also be necessary when treating mold and mast cell activation.
But what happens when someone can’t tolerate a supplement or medication because it worsens or creates new brain symptoms?
In this newsletter, I’ll discuss:
Five common reasons a supplement or medication may worsen symptoms.
Specific supplements and medications that are more likely to do this.
How these reactions can point to root causes.
Steps that can improve tolerance.
There can be a wide range of brain symptoms that can occur when someone is having an adverse reaction, such as fatigue, brain fog, depression, anxiety, agitation, and even psychosis or mania. I’ll use “reactivity” to refer to this range of possibilities. While physical side effects can also occur, the focus here will be on brain symptoms.
5 Common Reasons Supplements or Meds May Worsen Symptoms
1. Immune Reactivity
Our immune system is intertwined with our central nervous system. When our body’s immune system reacts to a toxin, microbe, injury, or trauma, we can have inflammatory brain and physical symptoms.
“Feel Like I’m Reacting to Everything” - Mast Cell Activation
If someone is experiencing severe immune reactivity, such as mast cell activation, they may react to many supplements and medications, as well as triggers in their environment and stress. The number of triggers can help point to an exaggerated immune response. In my practice, this high immune reactivity is usually driven by mold toxicity.
For many with this obstacle, starting very low and slow can prevent reactions. For others, interventions may be needed to lower immune reactivity and stabilize mast cells. This, however, can require certain supplements. For those who can’t tolerate those treatments, limbic system retraining programs help calm the immune system so people can move forward more easily.
Sensitivity & Intolerance
It is possible to have immune sensitivity (or even allergy) to a supplement, though I find this less common. Herbal supplements, for example, which are high in salicylates, may cause symptoms in those with salicylate sensitivity. Certain probiotics have bacterial strains high in histamine. This is an issue for those with histamine intolerance.
2. Too Much or Too Little Neurotransmitter Activity
Some people with brain symptoms have high neurotransmitter (NT) activity, and some have low. Common NT’s include serotonin (5-HT), dopamine (DA), and norepinephrine (NE). I use the term “neurotransmitter activity” because it’s not just about the amount of neurotransmitters present; it’s also about the amount of receptors present that pick up NTs and remove them from the space between nerve cells.
High Neurotransmitter Activity
Too much neurotransmitter activity can cause brain symptoms such as mania, psychosis, agitation, anxiety, panic, obsessions, compulsions, and hyperactivity. Reactions can occur if supplements or medications are given that further increase NT activity.
Examples include:
Slow COMT (involved in clearing DA and NE) and/or slow MAOA (involved in clearing 5HT, DA and NE)
A variant on COMT and/or MAOA doesn’t mean they are being expressed.
What Increases Neurotransmitters?
SSRIs (Selective Serotonin Reuptake Inhibitor) increase serotonin activity
SNRIs (Serotonin and Norepinephrine Reuptake inhibitors) increase serotonin and norepinephrine activity.
Stimulant medications such as Ritalin and Adderall increase dopamine activity
SAMe and methionine increase serotonin and dopamine activity
Remember that there can be times when there is a mixed picture, such as when someone is undermethylated and has a slow COMT.
Low Neurotransmitter Activity
Reactions can occur if supplements or medication decrease the neurotransmitter activity when it is already low. This could look like depression, apathy, fatigue, and brain fog.
Examples include:
Fast COMT (involved in clearing DA and NE) and/or fast MAOA (involved in clearing 5HT, DA and NE). The NTs are getting cleared too fast.
What Decreases Neurotransmitters?
Folate, a nutrient that is good for a lot of people happens to be a big problem for many with psychiatric conditions. Most with underemethylation have low serotonin symptoms (depression and/or anxiety). While folate can help methylation, as an unfortunate aside, it can also further lower serotonin activity. Folate is in most multivitamins and B Complex vitamins. To learn more: Undermethylation, MTHFR & The Great Folate Debate.
Niacinamide can lowers DA and NE.
Looking closely at someone’s symptoms and traits and assessing methylation through bloodwork can help determine if NTs are too high, low, or mixed and what types of treatment to consider.
3. Poor Detoxification or Toxic Overload
Zinc