Hot mess express

Ritalin, excommunication, and neurotransmitters

PAST

Before hyperactive was a diagnosis truly in vogue, it was applied to me, and I was medicated with Ritalin. The doctor who prescribed it was a kind looking man with a deep, resonant voice name Dr Robert Allyn Kramer. He was a mensch; a kind and gentle man with impeccable credentials who died too young. Yale graduate, leader, educator and author in the field of child and adolescent psychiatry, president of his synagogue, he was even president of a non-profit arts organization. Who would have thought that a dear and trustworthy person could prescribe a drug that would addle my brain for decades? Certainly not me.

Dr Kramer was always seated behind his enormous desk, looking across the organized surface of it at little me in an oversized chair. He wore these half-lens reading glasses which made him look like the scholar he was. He was dressed in a suit, with pressed oxford and tie, and I remember he had a faint scent of something which smelled both manly and clean.

Getting down on the floor and playing with blocks wasn’t Dr Kramer’s style. It seems so odd to me now, that this imperious behind-the-desk approach was considered effective. It certainly reinforced the aura that he was the authority, and in control of the situation.

When I reached my teen years and was introduced to Re-Evaluation Counseling or RC, I began decades of work to try and recover my brain from the wreckage of my youth, while still emerging from it. Not until I was eighteen years old and joined a men’s support group one summer in Philadelphia, did I began to suspect that the Ritalin had a legacy for my mind. To put it in a sentence: as smart as I am, I still have to work pretty hard at learning and comprehending, and I think this is because of the years I was on that drug. Anyone who has spent much time around me, my wife especially, may have experienced the frustration of getting a quick and brief answer to a question. Sometimes what they get is silence, and aren’t sure if I heard them. This is more understandable in recent years as the COVID shots rendered me a candidate for hearing aids with persistent tinnitus, so I don’t always hear the question. But what it happening in my head, is that the wheels are turning, and I’m thinking. It’s kind of like trying to get up to 60mph in second gear, which by the way is kind of fun in the weathered Volvo C30 I just acquired, but not as much fun for the person listening and waiting for a reply.

MORE RECENT HISTORY

BVS Orientation San Francisco Summer 1991

After college I volunteered with the Church of the Brethren or BVS. The Church of the Brethren (COB), Mennonites, and Quakers are three Protestant denominations with a history of pacifism. The Quakers have the American Friends Service Committee, which doesn’t have as many volunteer opportunities for entry level positions as the Brethren Volunteer Service (BVS), and the Mennonites mostly have Mennonite volunteers. We had our orientation in San Francisco, and for three weeks, the men and women in my group slept on the floor in a COB church basement, and shared meals which we cooked in the church kitchen. During the week we would each spend time visiting a room which had dossiers on the different potential volunteer assignments and engaging in discernment about what our first, second and third choices would be.

Laura and me in San Francisco

As you can see from the group photo, we were a young group, and the three weeks we spent together was an intense period of spiritual and personal exploration. It’s easy to be attracted to people when they show their inner selves with honesty and vulnerability. This was a particularly dynamic and vivacious cohort. During the next two years, I fell in love with multiple people, and have had plenty of time to reflect upon what drew me to each of them. Above is Laura, with whom I had a fleeting romance during orientation. She was a foot shorter than me, but strong enough to lift me up like a feather. Her heart was pure and true. If I had my head screwed on straight, I would have figured out how to keep that connection for a lifetime.

In reviewing our potential assignments, I was really drawn to one related to sustainable agriculture, but the opportunities were slim. There was a farm in Ireland, and one in New Mexico, but either the slots weren’t open (Ireland), or they didn’t think I was the right person (New Mexico). I don’t clearly remember how I ended up at a homeless shelter for families in San Antonio, TX, but I did. It was a Catholic Worker House on the East Side, a primarily African American neighborhood, which was sketchy at a time when crack was big and gangs were picking up speed. I sported a ponytail down to my butt and being a skinny white guy with John Lennon gold-rimmed glasses, stood out like an Ostrich on a chicken farm.

The Catholic Worker movement was started by Dorothy Day and Peter Maurin during the Depression in the 1930s. Dorothy Day’s life and legacy is a radical movement, faithful to the Gospel and the church, immersed in the social issues of the day. In 1933, they began publishing a paper called The Catholic Worker, through which they encouraged people to live out the ideals they wrote about, founding “houses of hospitality” for the poor and “farming communes” for the unemployed. The simplest way I can describe their ethos was to enact the Sermon on the Mount, which is a collection of sayings spoken by Jesus of Nazareth found in the Gospel of Matthew that emphasizes his moral teachings.

Homer and Rosetta Fry

When I first arrived at the San Antonio Catholic Worker, there was an eclectic assortment of volunteers. Homer and Rosetta were a retired couple from Indiana. He had worked for Indiana Bell as a lineman, and she had been a foreperson at a Singer Sewing Machine factory. Homer was super chill, and Rosetta was pretty high strung. She had developed a habit from years of supervising people to repeat everything she said twice. “Scott, you need to go collect the donated produce before breakfast. Scott, you need to take the truck and collect the donated produce before breakfast.”

Me and Joel at the CWH, carrying hot water to dunk recently slaughtered chickens and pull their feathers

Matt was a Minnesotan frat boy who had done something vaguely illegal and was doing community service. Joel was another BVS volunteer, who had been in my orientation group, and came from an established COB family which had a organic farm in Ohio and was famous in their own circles. (For reasons I never understood, he saw me as a competitor, and later on, he would ally himself against me with Phyllis). There was a young hetero couple who came from I-don’t-remember-where. I just remember that they had each other and a working car, and were planning to have lots of kids. There was Heila, a red-headed German in her fifties who owned an art gallery back in Germany, and was taking a few months to work on her English and explore the underbelly of America. Ulla was another German volunteer who had a primary education and language therapy background. Then there was Phyllis. She was a BVS volunteer who had been at the Catholic Worker for nearly a year, and had worked at the BVS headquarters in Elgin, IL.

We all attended, well, except for Matt, a community Mennonite church. There was a contingent of Mennonite volunteers, kind of like us BVS volunteers, except that they had their own house, with an older couple who were the house parents and kept watch over the youngsters. In retrospect, I can see how very wise this arrangement was, because soon after Homer and Rosetta completed their volunteer assignment and departed, the organic stability which resulted from their elder’s wisdom began to dissolve. Then Heila left, then Ulla left. The remaining twenty-somethings energy became a bit contentious and our relationships suffered.

Given the passionate ideology and religious fervor which we all shared, it isn’t actually surprising that our community became fractious. Unfortunately, I became the lightning rod for this bad mojo. My sense of where things went south for me personally relates to Phyllis. I can’t say this without sounding like a shallow cad, but Phyllis was one of the ugliest humans I have ever met. It wasn’t just an external ugliness, although her disproportional lumpiness, bad hair and unique facial features were challenging to behold. But she was the living antithesis of Christian acceptance, and was strident in her wokeness, decades before woke was part of the lexicon. Matt drove her crazy, because he was a beer-drinking, baseball-watching frat boy, registered Republican, and when they worked the soup kitchen together, he would listen to Rush Limbaugh. Her daily rants about Matt were tiresome.

Phyllis

That shouldn’t have been my problem, but Phyllis fell in love with me. It was obvious. Have you ever had someone else’s dog with a hard-on try to hump your leg? It’s never comfortable, but it really doesn’t help when the owner stands there as if nothing is happening. So, Phyllis fell in love with me. To say that I wasn’t interested is an understatement. But to make matters worse, I was falling head over heels in love with one of the Mennonite volunteers from our church, Theresa. Ooooff! A curly haired beauty with a kind spirit who ended up becoming a minister’s wife.

From left, Joel’s Mennonite girlfriend (future wife?), my love, Theresa, and me

Phyllis may have been delusional, but she had eyes, and she saw where mine were looking, so of course she befriended Theresa, then proceeded to push the issue with me. Have you ever seen the connived workings of Livia in I Claudius? In our community meetings, Phyllis asserted that I was not acting as a friend to her, and well, because we were living in a Christian community, I needed to be her friend. I didn’t see it quite the same way. To me, we needed to be respectful and cooperative in our endeavors, but friendship was a matter of free will and proclivity. It got worse, as Phyllis continued to push her demands for closeness upon me, and the harder she pushed, the more vocal I became. After living in Philly for a decade, I would say that I got Philly on her. Back the f___ up before I tune you up. That was a mistake.

There isn’t a clause in some Catholic Worker handbook somewhere about excommunicating unruly members, in part because historically, Catholic Workers have attracted civilly disobedient roustabouts who are inherently unruly, right down to their haircuts or lack thereof. But excommunication is a fair word for what happened with me. In the end, I was voted off the island, so I lost the girl (Theresa agreed to a last dinner out before I left San Antonio), the current assignment, and even my next assignment (I had been accepted after all to volunteer at the farm in New Mexico). It was quite dramatic and traumatic. I got sick as a dog and was in bed for a week, laid up in the home of an older lesbian couple I had befriended through Dignity, a GLB Catholic organization with which I had attended services while in San Antonio. A decade later, there was a reunion of volunteers at the CWH in San Antonio. They actually invited me, and I almost went, then I thought the better of it and stayed put in Philadelphia. Some battlegrounds aren’t worth revisiting.

PRESENT

Before I begin this last section, I want to remind each of you, dear readers, that this is not meant to be individual health advice. Individual questions pertaining to your unique history and questions are not within the scope of my responses when writing this Substack. Please consider becoming a patient by going to our website. If you are an existing patient, please address this in the context of a visit, your overall clinical condition, and response to current therapies in your plan of care.

In the last two months I have made a lot of work for myself by ordering ZRT urine neurotransmitter testing on nearly eighty patients. I spend up to an hour reviewing the results for each patient, considering their clinical course and individual plan of care. I work feverishly to get caught up, then six more results come back and I’m in the hole again. My colleague in The Leading Edge Clinic, India Scott, FNP-C, has been doing neurotransmitter testing like this for more than a decade. I’d finally had enough (and maybe she did too!) of asking her to translate the results for me, and dedicated myself to the task.

You might wonder why your neurologist, psychiatrist or PCP doesn’t use this testing. Easy. Insurance doesn’t cover it, and the captured medical journals haven’t published articles about them, validating their use in formulating effective treatment plans. That doesn’t mean we can’t use accessible tools like this to help our patients heal.

What I have found during my lab reviews is a jaw-dropping, global disregulation of neurotransmitters in patients across the spectrum of pathologies and symptoms. The spike protein has disregulated all of us, and there are things which we can do about it. It helps to have a little peak under the hood in order to guide interventions.

One noteworthy point is the difference between people who had pre-Omicron COVID, and pan- or post-Omicron COVID. As I presented in October of 2023 at the second FLCCC conference in Fort Worth, TX, we had great results using Memantine in patients with cognitive and emotional disregulation. We understood that glutamate levels in the brain were elevated as a result of the spike protein, that high glutamate levels are neurotoxic, and that Memantine is a glutamate antagonist which gently lowers glutamate levels. But at a certain point, Memantine stopped working as well for as many people. Reviewing neurotransmitter results, I can now see that some people have low normal or low glutamate levels, and using Memantine would make matters worse. Only a couple of patients have had elevated glutamate levels on the ZRT testing which I’m using.

Another noteworthy point is that many patients have low tryptophan and low serotonin. This is precisely what the UPenn researchers pointed to in their study of post acute sequelae of COVID (PASC) patients in their clinic: spike inhibits tryptophan production in the GI tract. Tryptophan is a raw material for T-cells (think reactivated viruses), melatonin, nicotinamide and serotonin. The tryptophan highway is blocked by a jack-knifed eighteen wheeler, so we can’t merely eat a lot more turkey. What can we do? UPenn researchers identified this also, recommending the use of 5-HTP, which produces tryptophan via a different pathway. In patients who I started on 5-HTP prior to the ZRT testing, we could see tryptophan normalizing, and serotonin levels in normal or high normal range with concurrent improvements in mood and cognition.

What about Lithium Orotate? Dr Michael Nehls, the neuroscientist from Germany, has been talking a blue streak about Vitamin D and Lithium Orotate to protect our brains from the onslaught of spike. Pierre and I had the pleasure of a private meeting with Dr Nehls nearly two months ago, and he helped us understand that Lithium Orotate was a key tool in the fight to reclaim our brains in general, and hippocampi in particular. If therapeutics such as Vitamin B6 (as P5P 50), or 5-MTHF, or L-Theanine are useful to rebalance specific neurotransmitters, then Lithium Orotate is a general tonic which helps rebalance all neurotransmitters, because it reestablishes neuronal connections, decreases neuro inflammation, and enables the brain to start making new neurons. The particulars for inidividual patients have proven to be nuanced. I generally start with 130mg, but India prefers to start with 20mg of Lithium Orotate and work up to 130mg, stopping if clinical benefit is achieved earlier. Dr Nehls strongly recommended 130mg for symptomatic patients, dropping back to 20-30mg for maintenance when stability has been achieived. It’s important to note that 20-30mg of Lithium Orotate equals 1mg of active Lithium and 130mg of Lithium Orotate equals 5mg of active Lithium.

Because most health professionals, and many laypeople have preconceptions about Lithium as solely the province of psychiatry and bipolar schizophrenia, it’s important to note that we are talking about Lithium as a trace mineral. Would you be concerned about toxicity from a pinch of Celtic sea salt in your water, or 25mg of Vitamin C? No. Neither should you be concerned about trace amounts of Lithium which are many times less than the doses used in psychiatry. You can get 1mg of active Lithium by drinking a pricey bottle of San Pelligrino mineral water, or eating a lot of seafood, but you’ll also quickly empty your wallet, and in the case of seafood, there are so many toxins in the ocean that you’ll poison yourself with mercury before you reach therapeutic levels of lithium. And it’s cheap, cheap, cheap. Horbaach makes a 130mg capsule of Lithium Orotate which costs $15, including shipping, and provides six months woth of the supplement.

My parting thought is regarding MRIs of the brain with a NeuroQuant study. Our beloved colleague Dr Suzanne Gazda has been recommending this test for more than a year now. I don’t think it is financially viable or practically necessary for every patient we see, but the results of the handful I have reviewed are stunning. Patients’ neurological status may have subjectively improved, and they feel themselves returning to their baseline level of cognitive function. Then they get a NeuroQuant and find that their hippocampus is shrinking, and registers in the 2nd, or 12th, or 22nd percentile. Dr Nehls is right. The spike is targeting our brains in general, but our hippocampi in particular, and we need to fight back.