The Wednesday Wellness threads are meant to encourage users to ask for and provide advice and motivation to improve their lives. It isn't intended as a 'containment thread' and any content which could go here could instead be posted in its own thread. You could post:
-
Requests for advice and / or encouragement. On basically any topic and for any scale of problem.
-
Updates to let us know how you are doing. This provides valuable feedback on past advice / encouragement and will hopefully make people feel a little more motivated to follow through. If you want to be reminded to post your update, see the post titled 'update reminders', below.
-
Advice. This can be in response to a request for advice or just something that you think could be generally useful for many people here.
-
Encouragement. Probably best directed at specific users, but if you feel like just encouraging people in general I don't think anyone is going to object. I don't think I really need to say this, but just to be clear; encouragement should have a generally positive tone and not shame people (if people feel that shame might be an effective tool for motivating people, please discuss this so we can form a group consensus on how to use it rather than just trying it).
Jump in the discussion.
No email address required.
Notes -
In my experience, the strength/severity/pounding nature of my palpitations was connected to calcium intake. As soon as I increased it, the ectopic beats simply felt like a beat in the wrong place, not like someone punching me from inside my own chest. It can be hard to get a high intake of calcium from regular food, so I supplement with ground eggshell powder. It's almost pure calcium carbonate, pretty bioavailable, and free as a benefit of eating eggs. I save my eggshells for a day or two, rinse and boil them, bake them for 30 minutes, and then grind them in a mortar and pestle. You can obviously get quite a lot of calcium from dairy produce, but the calories mount up. From what I've read it's ideal to keep your calcium intake slightly higher than your phosphorus intake - dairy increases both, so you can never get calcium above phosphorus. Again, avoid spinach. You will lose more calcium excreting the oxalate than you will get from the plant itself.
I can't give you any hard numbers, but I weigh 80kg and my own intake is (approximately, give or take ten percent) 1600mg magnesium, 2400mg calcium, 1800mg phosphorus, 5-6000mg potassium, and 3-4000mg sodium. This has massively reduced my stress, anxiety, depression, palpitations and fasciculations (random twitches, especially over broad areas like your whole thigh or upper arm).
Part two: Reflux and hiatal hernia.
I have only been experimenting with this a little recently. Have you tried doing the heel drops, or the associated abdominal massages? There's plenty on youtube which will be more helpful than text. Did they give you any benefit, or provide any relief?
I've seen hiatal hernias called the great pretender or the great mimicker because of the wide range of symptoms they can cause, making people worry they could have any number of serious illnesses. One that is relevant here is that it can cause immense stress to the vagus nerve. The stress can be made worse by stomach acid causing damage in the oesophagus, which won't cause any pain but will cause your body to respond like it's being injured (because it is being burnt by acid). This can make your body release adrenaline for no reason you can see, giving random bursts of panic, sudden increase in heart rate, palpitations and shortness of breath. I would guess this is why you have such bad symptoms when you are lying down, it is making the hernia aggravate the vagus nerve more and/or increasing the reflux. Is one side worse for it? I find lying on my left side immediately triggers palpitations.
My advice here is significantly more "fringe", but it might be worth experimenting with high doses of thiamine (vitamin b1). I have read several people suggesting that many digestion issues are related to it, including Elliot Overton here. I should point out, as interesting as Overton is, I don't believe he has traditional qualifications in medicine or nutrition.
I've been experimenting with this myself, initially to treat a chronic fatigue issue that has been plaguing me for a long time. I'm in the early stages so far and it's had a phenomenal impact not only on fatigue, but also on my digestion. I've been building up towards a higher dose, so I cannot confirm if it completely fixes my own reflux, but I am optimistic. I'll warn anyone reading this, though, it will trigger a "mild" form of refeeding syndrome. "Mild" in this case meaning "non fatal" compared to refeeding in anorexics, but otherwise completely crippling unless you keep your electrolyte intake very high, supplement with biotin and riboflavin, and increase thiamine in small increments. It's startlingly unpleasant. You cannot function in any way until you get your nutrition balanced so the symptoms recede.
Part three: other nutrition issues
Do you have any idea what your vitamin D levels are? It plays a big role in general health and sleep. The recommended blood levels are "the minimum amount to prevent rickets", which is better than having rickets I guess. All researchers who specialise in vitamin dD recommend a blood level of 35ng/ml, the vast majority of them recommend over 50ng/ml, and it's not uncommon to recommend 60 or even 80 as a minimum. I found this video a good starting point. It's important to make sure your vitamin d intake is daily, as well - some forms of it have a very short halflife as explained here. Monthly mega injections are not helpful. It would be ideal to get it from the sun if you can, and I suspect there are other benefits to sun exposure as well, such as helping set your circadian rhythm (you need to be exposed directly to the sun, not through glass, including spectacles). Increasing your vitamin d intake will also increase how much calcium you absorb, so in turn it's helpful to supplement vitamin K2 to help your body deal with that.
B vitamins in general are essential. As well as obtaining them from food they are naturally produced by bacteria in your gut. Which could mean that if your gut health is off, you might be significantly deficient in them even if your intake from food is ok (the fact they're produced by bacteria internally and also constantly - not as a single dose from food or a tablet - makes it difficult to know how much we need). A b complex can be very helpful, but it's difficult to find a reliable one. Many forms of vitamins (such a folate in the form of folic acid or b12 in the form of cyanocobalamin) are unhelpful at best and damaging at worst. Others, such as folate in the form methylfolate, can have a negative impact on some people (I believe due to methylation issues). If you want to experiment, it might be helpful to purchase them individually so you can tell which specific one is benefiting or harming you. From what I've read and experienced, these forms are least likely to have a negative effect:
b1 as thiamine hcl
b2 is always ok, I think.
b3 comes as niacin (also called nicotinic acid) and niacinamide (also called nicotinamide). Niacin in large doses can cause a "flush" reaction in large doses, which some people like for a reason I haven't been able to understand. Both should be fine.
b5 is pantothenic acid is easily available and fine
b6 is most bioavailable as p5p, from what I've read
b7 is biotin, I'm not aware of it being in different forms
b9 is less likely to cause issues as folinic acid, but methylfolate is fine if you don't have any side effects. I've been advised against the form folic acid
b12 is bioavailable as both methylcobalamin and adenosylcobalamin. Hydroxocobalamin is converted by your body to either form, depending on its needs. Cyanocobalamin should be avoided.
Finally, how is your sleep? A lack of restorative sleep would make these types of issues worse. I'd recommend looking at Dr Gominak's sleep protocol if you struggle with insomnia and regular suggestions like "go to bed early" or "exercise regularly" are more irritating than they are helpful. Her advice is to increase your vitamin d blood level to 60-80ng/ml, supplement with a b complex, supplement with b12 if your blood level is less than 500pg/ml, and stop the b complex after three months. It worked wonders for me, after struggling with insomnia from early childhood.
Part four: Pulling it together
Here's what I, a stranger on the internet with no qualifications in medicine, would advise.
Eat a diet of whole foods with the aim of getting 110% of the RDA at minimum. If you weigh more than 80kg, scale your targets up proportionately (eg, if you weigh 88kg, multiply the RDA value by 1.1). Make sure your vitamin a intake is in the form of retinol, rather than carotene, as carotene is converted into retinol by the body at around 8%. You can get this from either liver (I'd recommend whole, tinned cod livers - they don't taste bad and are much lower in copper than mammal liver, plus they include vitamin d - eat half a tin, approx. 55g on two consecutive days and that will get you just under a week's worth of vitamin a. Eat one tin a week, more if you have a good, educated reason to), or from a combination of eggs and butter. If you go with eggs and butter it will take a lot - around 6 eggs and 60g butter every day. Try to keep your zinc intake at 8x your copper intake at minimum, don't have more sodium than potassium, and experiment with increasing your calcium intake to see if it helps your palpitations. You will need more than the RDA of potassium to really build your body's stores back up. Blood tests can be very helpful, and also very misleading. You will not hurt yourself by eating bananas.
If you want to eat raw eggs, make sure you supplement biotin. Raw egg white contains avidin, which binds to biotin and stops you using it. Each raw egg white will bind approximately 90mcg of biotin. This means if you want to go full Gaston and have a dozen each day, you'd need to supplement more than 1000mcg of biotin just to avoid deficiency.
Avoid all the things that are sensible to avoid. Cut out sugar, syrup, alcohol, caffeine, artificial sweeteners, any recreational drugs, . Consider avoiding gluten or sticking to a FODMAP diet as best you can, which will involve cutting out pulses and many grains. In the long term you should be able to return to eating these foods, but in the short term avoiding them might improve your health by 10%, and it's a 10% that you could really benefit from right now.
Supplement magnesium, and experiment slowly increasing your intake to 20mg/kg of bodyweight, or even a little higher if you're still experiencing benefit. Initially try magnesium chloride, as it's the most reliable, but be aware that it will loosen your stools or even cause some diarrhoea. Make sure your other electrolytes are sufficiently high while doing this, or you'll feel quite unwell. Try applying magnesium topically on your neck for immediate effect, and it should give you some indication of whether or not it will be helpful for you.
If you find yourself having compulsive, negative thoughts and actions from them - things like skin picking, hair pulling, self harming, or other addictive and destructive behaviour - a supplement called inositol can be very helpful. It's a sugar, both made by your body and available from food. Experiments have used up to 18g of it without serious side effects, although I try to stay under 12g myself, and only use it when I feel I need to. It has a powerful anti anxiety effect for a certain "type" of anxious feeling, and zero addictive properties or side effects beyond mild flatulence.
Make sure you get regular vitamin D, ideally from the sun (an app called dminder is very helpful for measuring the actual amount of vitamin d you’re synthesising, particularly if you have a light sensor on your phone), and increasing b12 plus a b-complex alongside this as recommended by Dr Gominak can really help with insomnia. 4-8000iu of vitamin d is probably sufficient if you're supplementing a decent amount of magnesium, higher if not.
After establishing everything above, consider starting with a low dose of thiamine and increasing up to 1000mg-2000mg depending on your body type, size, and individual response. I would recommend thiamine hcl. More expensive forms such as TTFD might be more bioavailable but they're also more likely to cause other issues, such as mentioned here. If you start to feel truly awful on higher dose thiamine, it's not an allergy or negative response, it's refeeding syndrome. Depending on what you diet has been that day, eat 2g of salt, eat 100g of dried fruit for potassium, drink a pint of water with 2.5g of magnesium chloride dissolved in it, supplement 30mg of riboflavin (despite some much bigger supplements, your body doesn't absorb more than that at one time - feel free to supplement again later in the day though) and make sure you're already taking a biotin supplement above 1000mcg. MAKE SURE YOU HAVE THIS AVAILABLE BEFORE YOU START SUPPLEMENTING THIAMINE! You don't want to experience refeeding syndrome at 3 in the morning, or 40 miles from the nearest shop, and not have the resources to hand.
If you struggle with getting everything you need from the diet, a good starting point is 4 eggs, 40g of cheese, 150-200g potato, 1/4-1/2lb of red meat and 1/4-1/2lb of low mercury oily fish. Low mercury oil fish is unsalted anchovies, sardines, mackerel, herring, salmon or trout. Salmon and trout are usually farmed if you're in Europe, and farmed fish are exposed to antibiotics as well as being much higher in parasites. Wild salmon may have higher levels of mercury depending on the species, as do different species of mackerel, but searching the name of the specific type should give you clear results. Fill up the rest of your diet with fruit, vegetables, orange juice, potatoes, rice, cold pressed oils and butter, always aiming to hit nutritional surplus before filling up on carbs or fats. Fish/meat weights are raw values, so cooked weight will be about 15% lighter - in practice, a 90g tin of fish is the same as 1/4lb fresh. Almond oil and styrian pumpkin seed oil are both good sources of vitamin e if you're struggling to get enough. Probiotics such as kefir or kimchi could prove helpful, especially if you've had antibiotics. Homemade is vastly superior to store bought, especially as some companies make the insane move of pasteurising their product before putting it on the shelves.
ETA: While all of this should help, it will be massively limited if you are still fighting other stresses in your life. If you going through a divorce, grieving a recently departed loved on, or feuding with your local drug dealer, you will be less able to benefit from this. Similarly, if you are staying up late staring at computer screens, not getting to bed before 10pm, not getting fresh air and daylight, spending an unreasonable amount of energy arguing with strangers on the internet, or any number of other stressors that are obvious when you think about it, you'll be hindering your ability to recover. Doing the small, healthy obligations of life might only get you a 10% benefit, but again it's a 10% you need right now, and could you push you from "spiraling downwards" into "finally recovering."
Wow. First off thank you for such thorough write up. I'm thankful for my doctors but none have given me this thorough of an examination of my problems.
I don't know why but it really hadn't occurred to me to question whether the RDAs were accurate/appropriate for me.
I have started using Cronometer since the beginning of this year, which would be after I changed my diet to start eating a wider variety of foods. Inputting my old diet in which I skipped breakfast and had the same lunch everyday, I was really low on a lot of vitamins and minerals depending on my dinner.
Back when this first happened, my salt intake was probably low considering my exercise level. My diet wasn't intentionally low salt but in practice it most likely was.
For the potassium RDA, I had been using whatever RDA is in Cronometer, which was 3400mg. I'll update this manually so I start using it in the future. The easiest food for me is milk. OJ and some fruits are hard because of GERD. Since learning that I had low potassium, I began drinking a bunch of milk.
I had started taking magnesium supplements before I had tried restoring my potassium. I was worried about taking too much so I eventually stopped. I think I noticed I had soft stools and assumed I must be taking too much. But on Cronometer I am getting about 50-60% of the 400mg that is recommended there, which would be an even smaller percentage of the even higher RDA numbers you stated. After looking up low magnesium, I see it causes low potassium. You would think a doctor would have mentioned that at one point. Do you have a brand of magnesium that you recommend?
My calcium intake should be good after I started having multiple cups of milk a day. I'm not supplementing K2.
Part 2:
I initially started heel drops before I had been diagnosed with a hiatal hernia but felt like it really didn't accomplish anything. I'll look into these massages further though.
Now that you mention it, I recall it being impossible for me to sleep on my left side when my symptoms were at their worst. I could feel my pulse through my left ribs.
I'll probably hold off on high doses of thiamine and maybe try as a last resort.
Part 3:
My vitamin d levels should be good. I did discover how important vitamin d was when I was initially feeling bad. Since then, I've made it a priority to get out in the sun each day for 15-20 minutes at solar noon and as much as I can handle on the weekends (I have been using dminder for a while and love it). I live in a northern latitude so the winter is limiting for vitamin D but I get a lot in the summer.
For B vitamins, I take a multivitamin that has multiple B vitamins that has worked pretty well for me I think.
My sleep is okay. I have been getting to be too late and sometimes I wake up early and can't fall back to sleep. I average around 7 hours.
I like your diet suggestion. I appreciate the point about holding off on carbs until I hit my nutrition markers. I thought for a while I had maybe just been eating too low of calories and that's why I didn't feel good so I started including some more carbs, but they were mostly empty nutrition.
There is so much to digest here. I'll be coming back to this post often. Thanks again for all your help.
You're very welcome, I only hope it's of some use to you. I'm glad to hear you're using Cronometer already. It's both intimidating and liberating to realise you have to take your health into your own hands.
Maybe Cronometer is using a European RDA for potassium. The American FDA increased theirs to 4700mg in 2016, partly because the average American was so much heavier than when they set the original RDA. Cronometer also set an incredibly high target for protein by default, something like 1.8g per kg of body weight. If it works for you that's great, but I think that's a target for athletes rather than the everyman. Reflux is a pain like that - I found sticking to the fodmap diet reduced the symptoms, and as you reintroduce food it helps you pinpoint which are giving you trouble. For example I've found I tolerate dried figs, apricots and dates well, but apples, pears and raisins still cause discomfort. It's worth experimenting if you're struggling to get the potassium, but obviously you know your own body best. Never try and ignore obvious pain just because someone thinks it shouldn't happen, whether that’s a medical doctor or some anonymous poster online.
I understand the worry when supplementing. I suspect if you're the kind of person who spends time on here you will be ok - the fact you're worried means that you're also researching this and you’re bright enough to do so successfully. There are certainly studies showing high dose magnesium (up to 1500mg supplemented) was effective in rapidly reversing treatment resistant depression, but I don't know enough to vouch for how strong those studies are. There are also plenty of testimonies online from people who have taken high doses for a variety of ailments, usually attached to warnings not to take it if you have kidney issues. If you're worried you can always discuss it with a doctor, but it's possible they won't be open to the idea. There are plenty of articles like this online, with doctors lamenting how little they are taught about nutrition. That's probably why no doctor you visited has mentioned it, nutritional approaches are not a major part of their tool kit despite how useful it can be. I buy magnesium from a brand called Heiltropfen, but I don't have any particular loyalty to them - they were the only company I could find selling magnesium chloride flakes that were listed as food grade. The cheaper versions marketed as bathing salts are probably fine, but I didn't feel the need to risk it at that price.
If you find the loose stools too unpleasant to deal with, Magnesium Glycinate, Taurate, Malate, and L Threonate should not have that particular side effect (although they may have others instead). The most important thing when taking high magnesium is to keep calcium/phosphorus/sodium/potassium at least as high as the RDA.
In terms of calcium, I was taking around 1500mg when the ectopic beats felt like they were pounding in my chest, but once I increased it to 2,400mg the beats only felt out of rhythm, not worryingly forceful. I think my situation is unusual, the high dose thiamine I'm currently taking means I need a higher calcium intake for now. In your situation it could be the relation between any of the electrolytes being too high or too low, but I think that is worth investigating.
I'm not so experienced with the heel drops, but it's worth looking through youtube to see the variety (and other exercises). Some people say that having your arms raised when you do them makes a huge difference, and there's probably other tricks. I hope you can find something else that helps there, though, and hey, it’s free.
Did the symptoms get worse when you were on your left side, or did they just become more noticeable? If it definitely gets worse then that indicates it could be related to the vagus nerve becoming irritated by the posture, or alternatively because it's changing the position of your heart - but this also something I've only just started reading about, so take this as an avenue to explore rather than something that is definitely the problem. Like so many other things, there are arguments for sleeping on either side. Sleeping on the right side avoids stimulating the vagus nerve but it's worse for acid reflux, so I don't see a good option there. But it might be useful information to narrow down what's affecting you.
Vitamin D can be tested privately and cheaply, if your doctor isn't willing to do it themself. The test can be ordered by post with the kit to take a tiny blood sample and return it. Your ability to synthesise vitamin d depends on a lot of nutritional factors. Bruce Hollis, the researcher I mentioned in the earlier post, says that when he started supplementing magnesium (I think it was 400mg, it definitely wasn't a huge dose) he saw his vitamin d level rise by 10ng/ml in his blood work, from something like 50 to 60 ng/ml. Sorry, it's late here and I haven't got the time to pinpoint it, but it was in one of those two videos. On the other hand, too much vitamin d can cause issues too, usually from absorbing too much calcium. I think that's mainly in people taking huge doses, or life guards who have really high sun exposure. It sounds like you've got a lot of this under control already, so I think it's unlikely to be an issue, but testing lets you know for certain instead of guessing.
And maybe I was too harsh on carbohydrates! We need them too, and there's a big difference between a healthy diet that involves decent portions of rice/potatoes/pasta, and a diet of purely hyper processed carbohydrates like pizza. It sounds like you're doing a lot better with your diet now compared to when you initially fell ill. I really hope you find some relief soon.
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link