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  #16  
Old 02-26-18, 08:33 PM
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Re: Alternative Drugs to Treat ADHD Besides Nicotine

Sarah,

Funny: I must have started on nicotine after the gum companies improved the formula.

Nicotine gum is thicker or denser than sugar-free gum, which I also chew. But not unpleasantly thick.

There are all kinds of flavors ... mint ... fruity ... taste lasts a decent amount of time ... but I find that I don't need the gum to taste good for long because it soon delivers that nicotine to the brain. And the neutral flavors actually work for me as well, because they deliver the nicotine focus and relaxation (for lack of better words).

I had never heard of the "chew and park" method until you mentioned it. I chew the gum like I would chew sugarless gum ... though when I think about it, I do stop chewing after a while ... not sure I park the gum in the cheek, but I stop after a while. But that just happens naturally.

Hope that helps.

Tone
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  #17  
Old 03-13-18, 06:31 PM
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Re: Alternative Drugs to Treat ADHD Besides Nicotine

Swedish snus is the safest tobacco product there is. Not linked to cancer since many of the nitrosamines in the tobacoo used in snus are eliminated.

There's also more medications to treat adhd other than the traditional stimulants. For example, you might want to try the antidepressive medication "Wellbutrin".
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Old 03-14-18, 11:41 PM
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Re: Alternative Drugs to Treat ADHD Besides Nicotine

If nicotine is helping you you have to ask the reason why.
This you tube presentation by a Dr Patrick Nemechek, is of great interest as it proposes a mechanism for this.

Whats more the mechanism it proposes is consistent with symptoms I have seen in myself and in others- it is not the standard mechanism proposed for the effectiveness of stimulants- but stimulants do have a sympathomimetic effect and are known to improve cerebral blood flow.

I do not think this model is the whole picture as it does not identify the actual nature of the brain injury- however the treatment model he proposes both on his website and elsewhere on You Tube, makes sense and is well in line with understandings of neruroinflammation in chronic brain based illnesses.

The advantage of this proposed cause of symptoms is that it can be easily identified by seeing what happens to the pulse on standing up (it should spike then settle back towards the sitting level, but it is likely to either abruptly rise, or to slowly rise and keep on rising.

However the model does provide a clear rationale for the effectiveness of nicotine.



For reference I'm following the Nemechek protocol - which does involve a lot of DHA (fish oil).
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Last edited by namazu; 03-14-18 at 11:49 PM.. Reason: fixed link -- YouTube URLs starting with "https" don't work right -- use "http" instead.
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  #19  
Old 03-15-18, 02:57 PM
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Re: Alternative Drugs to Treat ADHD Besides Nicotine

Hi KD,

What I got from reviewing the presentation is;
  • Low enough Orthostatic blood pressure causes ADHD symptoms. (He seemed to imply that it was all ADHD diagnoses. Is he saying all diagnoses or just subset.)
  • If nicotine addresses your ADHD symptoms, that is determinant that your ADHD is caused by low orthostatic blood pressure.
  • It was implied the laying horizontal should address ADHD symptoms if you are horizontal or inclined with your head at lowest elevation for those that have ADHD symptoms due to low enough orthostatic blood pressure regulation.
    It was implied that the rate of smoking is based on the amount that is needed to correct the orthostatic BP dysregulation and is evidenced by people able to go without smoking during sleep. If it was a true addiction to nicotine, they couldn't go that long.
Is my understanding correct? If so, then;
  • Those people diagnosed w/ ADHD while laying down should have their ADHD symptoms go away.
  • If smokers lay horizontal or have their head at lowest point will not have a desire to smoke a cigarette.
  • If you are a smoker and in a sitting position you would still have nicotine cravings and be unable to sleep for an extended period.
  • When I used to smoke upon waking I would ALWAYS have a strong cigarette craving. The first thing I ALWAYS did upon waking was to reach for my cigarettes/lighter on the headboard and light one up while still horizontal. At that point I would put an ashtray on my chest and smoke the cigarette or head to the bathroom.
  • Also, I would typically go horizontal for extended periods if watching television or reading. My rate of smoking never dropped off.

-LN
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  #20  
Old 03-15-18, 09:59 PM
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Re: Alternative Drugs to Treat ADHD Besides Nicotine

Quote:
Originally Posted by Little Nut View Post
Hi KD,

What I got from reviewing the presentation is;
  • Low enough Orthostatic blood pressure causes ADHD symptoms. (He seemed to imply that it was all ADHD diagnoses. Is he saying all diagnoses or just subset.)
  • If nicotine addresses your ADHD symptoms, that is determinant that your ADHD is caused by low orthostatic blood pressure.
  • It was implied the laying horizontal should address ADHD symptoms if you are horizontal or inclined with your head at lowest elevation for those that have ADHD symptoms due to low enough orthostatic blood pressure regulation.
    It was implied that the rate of smoking is based on the amount that is needed to correct the orthostatic BP dysregulation and is evidenced by people able to go without smoking during sleep. If it was a true addiction to nicotine, they couldn't go that long.
Is my understanding correct? If so, then;
  • Those people diagnosed w/ ADHD while laying down should have their ADHD symptoms go away.
  • If smokers lay horizontal or have their head at lowest point will not have a desire to smoke a cigarette.
  • If you are a smoker and in a sitting position you would still have nicotine cravings and be unable to sleep for an extended period.
  • When I used to smoke upon waking I would ALWAYS have a strong cigarette craving. The first thing I ALWAYS did upon waking was to reach for my cigarettes/lighter on the headboard and light one up while still horizontal. At that point I would put an ashtray on my chest and smoke the cigarette or head to the bathroom.
  • Also, I would typically go horizontal for extended periods if watching television or reading. My rate of smoking never dropped off.

-LN
There are always individual variations for a number of reasons, which may include psychological dependency.

Dosing first thing while still in bed MAY pre-empt a sudden onset of symptoms on rising.

Re your observation about the sitting position- it is to be expected that any upright position - sitting or standing- would be problematic. Certainly that is what I have observed. It is easy to spot- usually people with the problem are much more pale in the face sitting up or standing than when they subsequently lie down.

If you look a little further Nemechek's observations are backed up with formal autonomic nervous system output measures. I actually have on my laptop quite a few peer reviewed papers that support his model.

Im currently interested in what is the minimum testing that is required for this question of dysautonomia.

High sympathetic activity is clearly capable of producing hyperactive and impulsive symptoms ( though there is a subset of hyperactive symptoms that is associated with basal ganglia/dopamine issues).
Very low sympathetic /high parasympathetic activity will be associated with drowsy/ inattentive spells.

As for symptoms going away when lying down - that depends on what stage of the response you are in. A significant increase in sympathetic tone always takes at least 20 minutes to resolve.

If you are anything like i am and you have been running that kind of response for hours or days or years- there is also the exhaustion factor to consider. That can go for some days- as I just found out when I had my sympathetic response turned off by some well targetted physical therapy.
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  #21  
Old 03-16-18, 12:46 PM
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Re: Alternative Drugs to Treat ADHD Besides Nicotine

KD, Would it be relatively accurate to say that Nemechek (and you) are saying that ADHD is the result of inadequate bloodflow to the brain in most or all cases? I listened to the presentation you linked and Nemechek was saying it was that the Orthostatic pressure was too low to give adequate blood flow that causes ADHD. I posted my comments based on that. Then when I looked over your reply to my comments it implied that ADHD is really just the blood flow to the head being too low. For some people it may be only when standing, for others even when laying down and for the rest everything in between. I understand that you did not explicitly state that, but that is what is implied by your response. -LN
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  #22  
Old 03-17-18, 01:34 AM
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Re: Alternative Drugs to Treat ADHD Besides Nicotine

Quote:
Originally Posted by Little Nut View Post
KD, Would it be relatively accurate to say that Nemechek (and you) are saying that ADHD is the result of inadequate bloodflow to the brain in most or all cases? I listened to the presentation you linked and Nemechek was saying it was that the Orthostatic pressure was too low to give adequate blood flow that causes ADHD. I posted my comments based on that. Then when I looked over your reply to my comments it implied that ADHD is really just the blood flow to the head being too low. For some people it may be only when standing, for others even when laying down and for the rest everything in between. I understand that you did not explicitly state that, but that is what is implied by your response. -LN
The thing with ADHD that we all have to come to terms with is that it is a syndrome and not all cases will be the same.

However the ADHD diagnostic criteria have some glaring flaws:

ADHD is classed as a neurobehavioural condition-- but the diagnostic criteria contain no info as to the clinically identifiable neurological signs that we can expect.

I am coming to this with several biases and a few interesting sources of background knowledge:

1) I have had initial substantial improvement from treatment to a malalignment in the upper neck. That was great when it lasted but the benefit waned and the reason was not clear.
2) More recently since coming across this cerebral blood flow issue I have been collecting data and monitoring myself. I have been using transauricular vagal nerve stimulation to help correct the problem in myself.

3) More recently I encountered the idea that chronic neck alignment problems can cause kinking and twisting of the membranes around the spinal cord, and that these can, if unlucky, through torsion on the dural membranes, impair blood flow to the brainstem, leading to a range of possible problems which include blood flow dysregulation- which will be worse when upright. This mechanism has been demonstrated in fibromyalgia and is relevant to fibro brain fog.

This latter treatment (craniosacral) has been dramatically effective for me. It has required about 6 treatments over 2 months though for my therapist and I to work out why things keep on going out of place and re-twisting the membranes- but my dex dose has dropped from about 45mg/d 2 weeks ago down to 2 doses of 10 mg in the last week.

Another mechanism that might be at play here is episodic elevations of intracranial pressure due to obstructed cerebrospinal fluid flow. These would produce fluctuations in conscious state that would be to some extent related to posture but would take much longer to resolve. However this is an area which is neglected by conventional medicine. Now we have upright MRI that problem may be corrected soon.

4) While Nemechek ascribes foot tapping and fidgetting to a low cerebral blood flow and an attempt to get the blood flow up to the brain in a socially acceptable way, it is clear that some hyperactivity at least relates to failure of inhibition in the basal ganglia pathways- which is at least partially responsive to stimulant treatment. That's a different mechanism than poor cerebral blood flow. However- stimulants do improve cerebral blood flow.

5) There is a big cluster of symptoms in ADHD which are not adequately explained by the poor blood flow model (though I will be proposing a model that can account for both sets of symptoms- once I have written it up properly.)
These symptoms are dyspraxia (according to Barkley at least 50% of ADHD kids fit the criteria for Developmental Coordination Disorder, and a good number more must lie just below the cut off for the syndrome), dyslexia, ocular convergence insufficiency and related eye coordination disorders, and various learning disabilities. These problems relate much more to the vestibulocerebellar system and its inputs rather than specifically to blood flow problems- they also occur in areas of the brain that are less prone to blood flow compromise than the brain stem.

6) My own experience-- while I have been off work due to illness for a while (hoping to be back soon) I have seen many people with ADHD- and the orthostatic intolerance dynamic was obvious once you knew how to look.

Based on that lot
Orthostatic intolerance is a common part of the symptom and clinical sign profile I have seen in ADHD-- but not universal.
In my experience it is common for the signs of orthostatic intolerance to largely resolve especially after first exposure to stimulants.
(My experience is unusual because I was primed to look for this change).
When someone comes in with a nice pink face and sitting up straight with no restlessness, after having been pale,sweaty, slumped and fidgety, you have a good idea that you are going in the right direction

There may be ADHD patients in whom this is not an issue.

Obstruction of the basilar artery, secondary to dural torsion in the upper neck (itself secondary to malalignment issues) is a likely suspect as a cause of the blood flow impairments. Ive got no firm idea of the frequency here- but I would say it is common- at a guess over 50%.

Issues with confusing input signals (aka dysafferentation) from the neck to the brainstem, vestibulocerebellar system, and the superior and inferior colliculi in the tectum are sufficient to explain the dyspraxia etc as well as issues like sensory processing disorder.

Id be very interested to assess someone with the supposed "slow cognitive tempo"- as the causes may be very different there- maybe a metabolic issue of some sort.

Nemechek's model, is certainly incomplete, but still has a lot to go for it- and certainly the recommendations he is making in terms of dealing with neuroinflammation are very mainstream.

I hope this is making sense- it is a lot of ground to cover.
Let me know if you need more clarification.
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  #23  
Old 03-17-18, 01:43 AM
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Re: Alternative Drugs to Treat ADHD Besides Nicotine

Quote:
Originally Posted by Kunga Dorji View Post
The thing with ADHD that we all have to come to terms with is that it is a syndrome and not all cases will be the same.

However the ADHD diagnostic criteria have some glaring flaws:

ADHD is classed as a neurobehavioural condition-- but the diagnostic criteria contain no info as to the clinically identifiable neurological signs that we can expect.

I am coming to this with several biases and a few interesting sources of background knowledge:

1) I have had initial substantial improvement from treatment to a malalignment in the upper neck. That was great when it lasted but the benefit waned and the reason was not clear.
2) More recently since coming across this cerebral blood flow issue I have been collecting data and monitoring myself. I have been using transauricular vagal nerve stimulation to help correct the problem in myself.

3) More recently I encountered the idea that chronic neck alignment problems can cause kinking and twisting of the membranes around the spinal cord, and that these can, if unlucky, through torsion on the dural membranes, impair blood flow to the brainstem, leading to a range of possible problems which include blood flow dysregulation- which will be worse when upright. This mechanism has been demonstrated in fibromyalgia and is relevant to fibro brain fog.

This latter treatment (craniosacral) has been dramatically effective for me. It has required about 6 treatments over 2 months though for my therapist and I to work out why things keep on going out of place and re-twisting the membranes- but my dex dose has dropped from about 45mg/d 2 weeks ago down to 2 doses of 10 mg in the last week.

Another mechanism that might be at play here is episodic elevations of intracranial pressure due to obstructed cerebrospinal fluid flow. These would produce fluctuations in conscious state that would be to some extent related to posture but would take much longer to resolve. However this is an area which is neglected by conventional medicine. Now we have upright MRI that problem may be corrected soon.

4) While Nemechek ascribes foot tapping and fidgetting to a low cerebral blood flow and an attempt to get the blood flow up to the brain in a socially acceptable way, it is clear that some hyperactivity at least relates to failure of inhibition in the basal ganglia pathways- which is at least partially responsive to stimulant treatment. That's a different mechanism than poor cerebral blood flow. However- stimulants do improve cerebral blood flow.

5) There is a big cluster of symptoms in ADHD which are not adequately explained by the poor blood flow model (though I will be proposing a model that can account for both sets of symptoms- once I have written it up properly.)
These symptoms are dyspraxia (according to Barkley at least 50% of ADHD kids fit the criteria for Developmental Coordination Disorder, and a good number more must lie just below the cut off for the syndrome), dyslexia, ocular convergence insufficiency and related eye coordination disorders, and various learning disabilities. These problems relate much more to the vestibulocerebellar system and its inputs rather than specifically to blood flow problems- they also occur in areas of the brain that are less prone to blood flow compromise than the brain stem.

6) My own experience-- while I have been off work due to illness for a while (hoping to be back soon) I have seen many people with ADHD- and the orthostatic intolerance dynamic was obvious once you knew how to look.

Based on that lot
Orthostatic intolerance is a common part of the symptom and clinical sign profile I have seen in ADHD-- but not universal.
In my experience it is common for the signs of orthostatic intolerance to largely resolve especially after first exposure to stimulants.
(My experience is unusual because I was primed to look for this change).
When someone comes in with a nice pink face and sitting up straight with no restlessness, after having been pale,sweaty, slumped and fidgety, you have a good idea that you are going in the right direction

There may be ADHD patients in whom this is not an issue.

Obstruction of the basilar artery, secondary to dural torsion in the upper neck (itself secondary to malalignment issues) is a likely suspect as a cause of the blood flow impairments. Ive got no firm idea of the frequency here- but I would say it is common- at a guess over 50%.

Issues with confusing input signals (aka dysafferentation) from the neck to the brainstem, vestibulocerebellar system, and the superior and inferior colliculi in the tectum are sufficient to explain the dyspraxia etc as well as issues like sensory processing disorder.

Id be very interested to assess someone with the supposed "slow cognitive tempo"- as the causes may be very different there- maybe a metabolic issue of some sort.

Nemechek's model, is certainly incomplete, but still has a lot to go for it- and certainly the recommendations he is making in terms of dealing with neuroinflammation are very mainstream.

I hope this is making sense- it is a lot of ground to cover.
Let me know if you need more clarification.

To strip that overly long answer back:

I would say that orthostatic intolerance is a major cause of many symptoms inmost cases of ADHD.
It cannot account for all cases.
It cannot account for all symptoms- some of the hyperactivity- especially that in hyperactive little boys, and the dyspraxic, dyslexic, eye coordination problems.
As i said though it is possible to devise an overarching model that covers the whole lot.
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  #24  
Old 03-17-18, 10:23 AM
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Re: Alternative Drugs to Treat ADHD Besides Nicotine

Quote:
Originally Posted by Kunga Dorji View Post
To strip that overly long answer back:

I would say that orthostatic intolerance is a major cause of many symptoms inmost cases of ADHD.
It cannot account for all cases.
It cannot account for all symptoms- some of the hyperactivity- especially that in hyperactive little boys, and the dyspraxic, dyslexic, eye coordination problems.
As i said though it is possible to devise an overarching model that covers the whole lot.
KD, I understood your points and ty for taking the time to explain in your posts. Regards, -LN
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Old 03-18-18, 07:14 PM
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Re: Alternative Drugs to Treat ADHD Besides Nicotine

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KD, I understood your points and ty for taking the time to explain in your posts. Regards, -LN
Thats good. I can be too long winded at times, though these are complex problems and they require careful explanation.

Im working at this all the time, because I think this is a common mechanism- so the explanation is as much for my benefit as anything else
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