Functional tests lead to insights
Hormone, organic acids, and neurotransmitter tests reveal a chronic infection that induces neurological toxicity
The round of rTMS experiments I last described were unsuccessful, so since then, I’ve turned all my attention to a diagnostic approach. I’ve wanted to do diagnostic testing for a while, but I’ve needed an improved baseline to do the right research and find capable practitioners to guide the work.
Functional medicine practitioners often advise that it's important to have as much data as possible to treat underlying systemic problems. This round of test results included an organic acids test, a hormone test, a gut test, and a neurotransmitter test. The results are fascinating. I've also done a DNA test, and I hope it will provide further insights into how my body uses certain building blocks.
As I had written about before, one of the questions that often comes up is whether or not my strong reactions to medication have anything to do with underlying causes and impaired detox pathways. This trial-and-error approach has improved my functioning significantly, but without further data, I will likely hit roadblocks from here forward. Testing of this kind is expensive, but I'm ultimately happy that I've taken this step.
Underlying infections and their impact on the gut and brain
By comparing the results of the OATS test with the neurotransmitter test, it's clear that I have a clostridium (“C Difficile”) infection in my gut because my HPHPA marker is high and I have low levels of norepinephrine in my body. HPHPA refers to “3-(3-hydroxyphenyl)-3-hydroxypropionic acid,” and this marker essentially reveals that my body is having trouble converting dopamine to norepinephrine. This once again reveals the connection between the brain and the gut, where neurotransmitters are produced.
Instead of converting dopamine to norepinephrine, my body is converting dopamine to a biotoxin, which is possibly contributing to a range of neurological problems, including paresthesia, sluggishness, and other symptoms. I have some curiosity about whether it impacts tinnitus and vision as well.
When dopamine converts into a toxic shock, it induces a vicious cycle where motivation is punished rather than rewarded (ie. “this is going to hurt but I’ll do it anyway”). It causes disturbances to movement, memory, reward and motivation, cognition, attention, sleep, pain perception, blood vessel function, the “fight-or-flight” mechanism, and it even reduces immune activity by impairing lymphocytes.
Concerning blood vessel function, my naturopath recently discovered that my blood pressure spiked to a level that I’ve never seen before – suggesting that it’s either a systemic issue feeding in on itself or perhaps a post-COVID phenomenon — since it’s known to induce cardiovascular issues (or both!). That’s for another day.
C difficile infections are commonly associated with gut issues, but more recent literature on this infection reveals that it's also associated with a range of neurological and behavioural changes ranging from ADHD to Autism, ALS, and other neuropsychiatric problems, including PTSD. While my markers are not off the charts, they might be a piece of the puzzle.
Papers on the topic also highlight that there are often underlying physiological explanations for a range of problems that are commonly classified as either purely physical (ALS and Parkinson’s) or purely mental (ADHD). For all of our technology and incredible knowledge, the allopathic system commonly misdirects our attention away from dealing with root causes. We are in some ways living through a dark age of medicine.
Relatively straightforward treatment
The treatment for this infection is fairly straightforward, and I should be able to keep clostridium levels low with attention and management. There are a range of antimicrobials and antifungals that will help bind to and dispose of the seven species of clostridia that produce HPHPA in my gut. My gut test reveals that I should be avoiding gluten and dairy, which are common naturopathic suggestions. Specific probiotics will also help to populate the gut with better bacteria. Depending on the success or failure of this initial course of treatment, vancomycin, a targeted antibiotic, might also be recommended, but antibiotics often a treatment of last resort due to rebound effects (some C diff infections are caused by antibiotics). Other biotoxin binders like cholestyramine could also be considered. Some people with more bowel-inflaming symptoms undergo fecal transplants to save their intestines.
Treating the underlying infection in my gut does not preclude ongoing rewiring efforts to improve my perceptual and vestibular systems, which I'm undertaking simultaneously through a clinic in Toronto. When I was there a couple of weeks ago, I interacted with two of the most competent neurologists I've ever met. I will describe that adventure in a future post.
And some other good news
This set of tests also revealed that my metabolic and hormone health is otherwise pretty good. I can digest fatty acids and ketones, my body's other detox pathways seem to work pretty well, and my hormones are in a good place for a dude of my age. I've been controlling inflammation with low-dose naltrexone (LDN), so my inflammatory markers are also pretty good.
With that information, I can stop worrying so much about other common underlying metabolic and hormone issues, and focus now on finding the right substrates and doses to fix this dopamine conversion problem (including P5P, Iron, BH4, Vitamin D).
When I receive my DNA test results, it will shed further light on my body systems and enzyme conversion process. Specifically, genetic COMT mutations are known to impact the nervous system and adrenal function and prevent the proper breakdown of dopamine and adrenaline. There are straightforward strategies to deal with this issue, too.
I’m happy to have solved this piece of the puzzle, and I’m excited to see what treatment will reveal in the coming weeks.