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Tuesday, May 17, 2016

Effect of modified paleo diet on insulin resistance, brain fog and stuttering

For the past few months, I have been taking the following diet and medications. It appears to clear my brain fog and increase my working memory.

Morning coffee:
Coffee with milk powder without any sugar

Breakfast:
Two eggs as omlette
or
one patty of burger chicken/beef fried with vegetable oil
1 tablet of centrum multivitamin + 25 mg of benfotiamine

Lunch:
Two chapathis or rice mixed with ghee or fried rice with fish/chicken/mutton with vegetables

Evening coffee around 8 pm:
Coffee with milk/milk powder without any sugar

Dinner:
Two chapathis or dosas made from wheat and little bit of ghee or butter followed by one apple.
If I consume protein in night, it severely affects the neurotransmitter levels and after 5 days, I got mild headache throughout the day. If i consume butter or ghee in night, it gives good mood, good focus and concentration next morning.
25 mg of benfotiamine

Positive effects:

Good stress handling capacity
Able to juggle between complex and demanding works with less perceived stress
Good focus and concentration
Slightly increased libido
Slightly reduced stuttering
Less argumentative


Negative effects:
Increased cholesterol levels in blood (increased LDL-C and total cholesterol) - Also, in the blood heamogram, increased RBC (7.56 x 1012 /L) and heamoglobin (20/g.dL) levels were observed. The doctor suspected that some dehydration is occurring in the body. I did not tell the doctor that I had been avoiding sugar for past couple of months. Due to these effects, I had to discontinue following this diet.


Update on 24 March 2017:
Due to the hypercholesterolemic effect of modified paleo diet, I had to discontinue that although i got some benefit out of that. However, I decided to implement a lighter version of paleo diet. So, I cut down refined sugar (white sugar) fully. Earlier, I used to add white sugar to my morning and evening coffee/tea. From September 2016, I stopped adding any sugar to my tea/coffee.

Positive effects:
Slightly increased energy, focus and concentration


Negative effects:
Increased stuttering - stuttering is more characterized with vocal blocks during middle of conversation. The vocal blocks happen as a sudden inability to produce the intended syllable for 3-5 seconds. If the other person disturbs with some prompting or other words, then the fluent speech is resumed. It is highly embarrassing when it happens in middle of an argument.

I sensed that the increased stuttering may be due to increased dopamine. So I tried to decrease the dopamine by using fluoxetine 20 mg once daily at night. But, not much of use. Although fluoxetine increased mood but did not reduce stuttering. I took GTF chromium (200 mg) once daily in the morning. It reduced stuttering in the first week. But, after a week, it increased stuttering. I took 5-HTP 50 mg once and twice daily for two weeks. Not much of improvement in stuttering. All of these medications worked effectively for me in the past. So, I was curious to find out what went wrong. To my knowledge, it appears that no sugar intake for the last 6 months might have resulted in improved dopaminergic tone especially the tonic release of dopamine. So, I searched the references. To my surprise, I could find a research study supporting my hypothesis.

https://www.bnl.gov/newsroom/news.php?a=111548 

Therefore, it appears that abstinence from sugar increases dopaminergic tone. Increased dopaminergic tone is very good to have as it can increase mood, focus, concentration and libido. Unfortunately, it increases my stuttering problem. So, I need to find ways to solve this. I assume that the increased dopaminergic tone might be causing a decrease in serotonergic and GABAergic tone. This also might be contributing to my increased stuttering. So, I may have to increase serotonin and GABA to balance the increased dopaminergic tone. I don't want to take sugar again. I have to try with folic acid and thiamine. Currently, I am taking centrum silver Men50+ multivitamins (once daily in the morning) and 50 mg 5-HTP once daily in the morning.

Update on 3 June 2017:

I am still continuing the "no white sugar" approach. Still the stuttering problem is there. The 5-HTP as usual reduced stuttering and improved fluent speech a little. Not much of fluent speech. With folic acid 1.25 mg at night, Mega-3 1 capsule at night, thiamine mononitrate 25 mg b.i.d. at night and morning and Multi B+C 1 tablet in morning, the stuttering was manageable. But, still stuttering occurs severely if protein is consumed. However, the benefits of this "no white sugar" approach is very much visible.

Benefits of avoiding white sugar:
1. Abdominal fat is selectively reduced (face fat is not reduced) and my hip size is reduced to 2 inches in 8 months time. No active exercise was done during this period.
2. Muscle strength is very much improved. I could lift 20 L water can in my office at one shot and can mount it without any noticeable discomfort. Earlier, I could not do it. Earlier, I needed to put the water can on top of the dispenser and with one more effort to place it properly. Now, I am able to fully maneuver it at one shot.
3. Better clarity in thinking and decision making
4. Increased affection towards family
5. Increased muscle flexibility with reduced muscle stiffness

Negative effects: 
1. Music is not enjoyable as before
2. Increased anger and irritability
3. Increased disagreeableness in office
4. Generally increased anxiety and displeasure - possibly due to increased stuttering


The increased stuttering is most likely be the result of increased dopaminergic tone and possibly by decreased serotonergic tone. Decreased serotonergic neurotransmission could be probably due to decreased serotonergic synthesis subsequently due to decreased transport of tryptophan into the brain. After a protein meal consumption, the individual amino acids are released from the protein and the released amino acids circulate in the plasma. All amino acids compete at the large neutral amino acid transporter through which tryptophan is also transported into the brain. Due to the competition, usually, less amount of tryptophan can only enter into the brain. Insulin, secreted as a response to increased plasma glucose levels, enhances the uptake of large neutral amino acids into skeletal muscles, thereby reducing the competition at large neutral amino acid transporter. The relative abundance of tryptophan at the large neutral amino acid transporter increases the tryptophan uptake into the brain and subsequently increased the serotonin synthesis in brain. This process happens efficiently in the presence of insulin and with more abundance of skeletal muscle mass. But, if insulin release is muted, then, this process would not be efficient. Hence, the serotonin synthesis in the brain would be less. I think this might be the reason for my increased dopaminergic tone and increased stuttering. This could be the reason for failure of fluoxetine. But, I don't know the reason for failure of 5-HTP. Because, 5-HTP should increase serotonin in serotonergic neurons and 5-HTP may not be affected by the competition at large neutral amino acid transporter. However, there can be changes in the dopamine receptor density as mentioned in the website http://www.independent.co.uk/life-style/food-and-drink/features/what-happens-to-your-body-when-you-give-up-sugar-10081689.html

Like drugs, sugar spikes dopamine release in the nucleus accumbens. Over the long term, regular sugar consumption actually changes the gene expression and availability of dopamine receptors in both the midbrain and frontal cortex. Specifically, sugar increases the concentration of a type of excitatory receptor called D1, but decreases another receptor type called D2, which is inhibitory. Regular sugar consumption also inhibits the action of the dopamine transporter, a protein which pumps dopamine out of the synapse and back into the neuron after firing.

Quote from Wikipedia:
It has been demonstrated in both animal[28] and human tests[29][30][31] that ingestion of a meal rich in carbohydrates triggers release of insulin. Insulin in turn stimulates the uptake of large neutral branched-chain amino acids (BCAA), but not tryptophan into muscle, increasing the ratio of tryptophan to BCAA in the blood stream. The resulting increased tryptophan ratio reduces competition at the large neutral amino acid transporter (which transports both BCAA and aromatic amino acids), resulting in more uptake of tryptophan across the blood–brain barrier into the cerebrospinal fluid (CSF).[32][33] Once in the CSF, tryptophan is converted into serotonin in the raphe nuclei by the normal enzymatic pathway.[28][30]

Strategies to try to increase serotonin synthesis in the brain without consuming white sugar or increased carbohydrate intake.
1. Aerobic exercise - Running or jogging - particularly in the evening
2. Consumption of infant milk formulas with high tryptophan content
3. Consumption of whole or full cream milk daily in the night or in the evening
4. Consumption of yogurt daily in the evening or night

Update on 24 July 2017:

From the above choices to increase serotonin synthesis and serotonergic neurotransmission, I selected consumption of infant milk formula. I purchased an infant milk formula from Nestle that contains Lactobacillus reuteri as a probiotic and used as a milk powder to make my tea/coffee. Also, I added palm sugar (sugar obtained from the sap collected from Palmyra palm tree) to my tea/coffee. This combination improved my mood and reduced my stuttering especially vocal blocks. I am not taking any multivitamin or any other supplements during this time. I have stopped multivitamins around three weeks before.

Positive effects:
1. Improved mood
2. Reduced anxiety - I feel calm and quiet
3. Reduced stuttering and improved loudness of voice and diction - no gasping for breath; significant reduction in vocal blocks especially starting first syllable blocks
4. Music is enjoyable as before
5. No throat clearing
6. Reduced angryness
7. While singing, the voice hits the pitch easily with good loudness in the starting syllable


Negative effects:
1. Slightly increased lethargy in initiating things
2. Reduced focus and concentration

Possible mechanism:

The palm sugar consumption might have caused enhanced tryptophan transport into the brain and resulted in increased serotonin synthesis. Likewise, Lactobacillus reuteri might have resulted in increased production of GABA. But, as this GABA cannot cross blood-brain barrier, probably other mechanisms may exist. I could sense increased GABAergic and serotonergic tone in my brain. I need to further explore on this.

Update on 18 Feb 2018: