Psych meds and mutant genes

A little while back, I mentioned that I was having a pharmacogenomic test done, i.e., a genetic test to suss out how my body might respond to different medications.  In my case, the test was looking at antidepressants and other psych meds.  The results are in; they’re nothing dramatic, but they’ve validated my experiences with certain medications.

For example, I had been taking aripiprazole (Abilify) as a sort of helper drug to complement my primary antidepressant.  I started out taking the very lowest available dose, and when that seemed to be going well, my psychiatrist recommended increasing it.  I tried that for three weeks, went “NOPE, not OK,” and dropped back to the lower dose.  Even though my psychiatrist had given me permission to do this, she seemed disappointed and continued suggesting the higher dose.

Well, guess what?  It turns out that I have genetic markers for processing aripiprazole very efficiently; the test results note that I should “use with caution” and “lower doses may be required.”

I was right.  I was right that the higher dose was wrong for my body, even though it’s a “normal” dose for other people.

The test also looked at a gene called MTHFR, which produces the gloriously long-named enzyme methylenetetrahydrofolate reductase.  It converts folic acid to a form called L-methylfolate, which is the form used by the body and brain.  (Moms, remember how important it was to take folic acid while you were pregnant?  It’s because L-methylfolate is super important for brain and nervous system development.)

Long story short, it turns out one of my MTHFR genes is a mutant version, meaning my body might not be processing folic acid as well as it ought.  There’s some preliminary research that this is associated with depression and maybe with low energy levels.  [Cautionary note: If you’re curious about this for yourself and decide to start Googling about MTHFR, put your critical thinking hat on tight.  Those search results are going to pull up a lot of BS.  Real medical research about MTHFR seems to be fairly scarce.]

In an odd sort of way, it’s exciting to finally have a test actually find something wrong with me.  I’m depressed and I’m anxious and I’m tired, and yet all the normal tests (iron levels, thyroid hormones, etc.) are always, well, normal.  I now have a new and different thing to try: taking L-methylfolate supplements.  I’m not incredibly optimistic that they’ll make much of a difference, but one can dream.

Vitamin B12 does nothing for me

A couple of months ago, I mentioned that I’d added a daily megadose of Vitamin B12 to my diet.  My doctor thought it might combat my general fatigue and help with the dizzy spells I’d been having.

Did it do anything?  Nope.

Just following up, in case anyone was curious.  I finished out the bottle and won’t be buying any more.  Not going to keep taking 16,000% of the recommended daily value of something if it has no apparent benefits.

So, I’m still tired.  I can sleep 8 hours a night and still want to nap and nap and nap all day.  On the plus side, I did figure out what was causing my dizziness, which I’ll explain in my next post.  Stay tuned!

The Vitamin B12 experiment begins today

I took four vitamins with breakfast this morning.  For the curious, I’ve been taking my prenatal multivitamin—as most breastfeeding moms should—along with extra Vitamin D and a fish oil DHA supplement, both recommended by my doctor to help combat depression.  Today, I added Vitamin B12, again on the recommendation of my doctor.  We’re hoping it will alleviate some of my ongoing fatigue and (fingers crossed) the odd dizzy spells I’ve been getting on occasion.

The bottle tells me that the 1000-microgram dose is equal to 16,667% of the recommended daily allowance.  That… seems like a lot.  Certainly more than I would take without explicit medical advice.  I’m pretty convinced that it’s not going to poison me or Little Boy: it’s a water-soluble vitamin, meaning it won’t build up in the body, and legitimate medical websites assure me that there aren’t any weird side effects.

I’m not holding out any hope that this new supplement will do much of anything for me—no vitamin in the past ever has.  Still, I’m willing to try.  Heck, if it makes me feel better, I’m completely fine with a placebo effect.

We shall see.  I’ll report back in a month or so.