Regimens for Neuroprotection

[Quest56]

On my doctor's advice (not a neurologist), I've started the following regimen. I'd asked her for a recommendation on supplements to take to limit neurodegeneration and as a best hedge against neuronal atrophy. I now take these daily in addition to Copaxone and verapamil (migraine prevention).

This regimen includes selegiline (l-deprenyl), which is a prescribed medication. I take selegiline at a low daily dose of 5mg. The claims about reducing excitotoxic damage (I understand this as microglia inflammation) and iron-induced memory impairment caught my eye, from this link at The Good Drug Guide (selegiline.com):

Note: I stopped taking selegiline after one month because of side effects. See later posts for more information.

Selegiline has immune-system-boosting and anti-neurodegenerative effects. Its use increases the level of tyrosine hydroxylase, growth hormone, cerebral nitric oxide and the production of key interleukins. Selegiline offers protection against DNA damage and oxidative stress by hydroxyl and peroxyl radical trapping; and against excitotoxic damage from glutamate. In addition, selegiline stimulates the release of superoxide dismutase (SOD). SOD is a key enzyme which helps to quench the production of damaging free-radicals. Potentially, selegiline may prevent or reverse iron-induced memory impairment. The deposition of excess iron in the brain is implicated several neurodegenerative diseases.

Edit-08042011: Stopped LDN again.
Edit-06282011: I give up. 2.0mg LDN nightly from now on, I can't live with the increased bladder dysfunction I get with 2.5mg and higher, even if it will go away in 6-9 months. Also, added 1-siberian ginseng capsule at lunch.
Edit-06112011: Adjusted vinpocetine to 10mg twice daily.
Edit-06082011: Start 2.5mg LDN last night, to stop morning headaches.
Edit-06012011: 500mg N-Acetyl Glucosamine (NAG) 3 times daily.
Edit-05312011: Began 3.0mg LDN last night, up from 2.0mg.
Edit-05182011: Vinpocetine 3 times daily to reduce bladder spasticity.
Edit-04222011: Start 1g Lion's Mane Mycelium twice daily.
Edit-04212001: Start 2.0mg LDN nightly at bedtime.
Edit-04202011: Remove 0.25mg rasagiline.
Edit-04072011: Switch from 5mg selegeline to 0.25mg rasagiline
Edit-04072011: Add DLPA (500mg) before lunch
Edit-04042011: EGCG to slow breakdown of noradrenaline?
Edit-04012011: Add B-Vitamins and P5P

Pre-Breakfast (empty stomach)
------------------------------------
600mg N-Acetyl Cysteine
500mg N-Acetyl Glucosamine
1-Bromelain (500mg)
Baby Aspirin (for IJV stents)
300mg Alpha-Lipoic Acid
400mg SAM-E

Breakfast
-----------
Acidophilus
2-calcium (400mg)
1g Lion's Mane Mycelium
100mg phosphatidylserine
10mg Vinpocetine
1-CoEnzyme B Food Complex Vitamin
30mg OptiZinc (Zinc Monomethionine)
50mg P5P
2000IU Vitamin D3
450mg DHA

Pre-Lunch (Empty Stomach)
--------------------------------
500mg N-Acetyl Glucosamine
1-Bromelain (500mg)
1-DLPA (500mg)

Lunch
-------
Acidophilus
2-calcium (400mg)
2000IU Vitamin D
1-250mg Siberian Eleuthero Root Capsule (50:1 potency)
450mg DHA
400IU Vitamin E
Multi-Vitamin

Pre-Dinner (Empty Stomach)
---------------------------------
500mg N-Acetyl Glucosamine
1-Bromelain (500mg)
300mg Alpha-Lipoic Acid
Copaxone injection

6PM
----
480mg - 600mg Verapamil (prescribed for migraine prevention)

Dinner
-------
2-Acidophilus
2-Calcium (400mg)
1g Lion's Mane Mycelium
1-CoEnzyme B Food Complex Vitamin
10mg Vinpocetine
450mg DHA

Bedtime
---------
0 mg Low Dose Naltrexone

When I meet with her again in a few weeks, I'll make the determination of whether to continue with selegiline (based on how I've adjusted to side-effects by then), and will ask for her opinion of starting a tetracycline such as minocycline or doxycycline. There was a recent report of a benefit of combing minocycline with Copaxone:

Minocycline as Add-on Therapy to Copaxone

I also want to ask her advice about the recent reports that show a reduction in the levels of the neurotransmitter noradrenaline with MS:

Noradrenaline Reduction in Multiple Sclerosis

Is there anything in addition to B-Vitamins, Magnesium, and P5P I should consider taking to boost the level of noradrenaline? I have read that DLPA increases production of noradrenaline and EGCG (catechins) inhibit their breakdown.

--Tracy

[NHE]

Hi Questor,
Regarding lipoic acid, I was wondering if you have looked into the differences between R and S lipoic acid? Here's one of my posts on it which highlighted a few of the differences. http://www.thisisms.com/ftopicp-29715.html#29715

NHE

[Quest56]

NHE,
Thanks for posting the link about the ALA entianomers. I've always bought and used a product called Super Alpha Lipoic Acid plus Biotin (300mg) from Optimal Nutrients, and assume this is a 50/50 mix of the R and S forms. Next time I need to make a purchase, I'll compare the price of this with the pure R form and will consider making a switch.

--Tracy

[NHE]

Here's an R-lipoic acid supplement that looks pretty good.

http://www.supersup.com/supplements-for ... 100mg.html


NHE

[MSBOB]

I am with you. Thanks for the information.

I have a similar plan with a low fat diet. Green Tea Extract is also pretty good, so is curcumin, and many others. I try to diversify antioxidants and I am always on the lookout for neuroprotective supplements. Cannabis is also neuroprotective, although illegal. NAC and Alpha Lipoic Acid are pretty special. I also take extended release vitamin C, B100 tabs, lycopene, selenium in the regimen.

[Quest56]

I've updated the neuroprotective regimen above as I am now going to try 0.25mg rasagiline (Azilect) daily in place of 5mg selegeline. I've had trouble adjusting to the side-effects of selegeline (increased afternoon dizziness, increased lower body weakness, etc).

Rasagiline offers similar hope for neuroprotection as provided by selegeline, but is available in a lower dose, and appears to offer fewer side-effects than selegeline:

Rasagiline - a Neuroprotective Smart Drug?

I hope I adjust to it bettter. My goal in trying to develop a working neuroprotective regimen for myself is not necessarily to feel any bettter, but to definitely not feel worse. I want this to be something I can stick with long-term, in hope of long-term benefit, the same approach I use with Copaxone that I inject daily.

I've also added DLPA (500mg) before lunch, which provides some of the necessary building blocks for the neurotransmitters dopamine and noradrenaline (shown to be low in pwMS).

I'll start rasagiline in about 5 days, after I first verify that the increase in dizziness and lower-body weakness that I have experienced over the last month while taking 5mg selegiline daily lessens as the selegiline leaves my system.

I'm still working with my physician on the minocycline/doxycycline decision, preparing to complete a detailed gut microbacterial DNA analysis before making the decision to start on a long-term antibiotic.

--Tracy

[MSBOB]

That is fascinating, Tracy. Thank you for sharing.

You are approaching things in the same way my gut is telling me to do, but you are further along in your education on it. I look forward to hearing more about your choices and successes.

Thanks,

Bob

[mrbarlow]

I take 500mg of inosine (precurser to Uric acid) and 1000-1500mg when I feel my Optic Neuritis flaring.

Also B12, resvertrol, vit C&E, omega 3 etc etc etc

[Quest56]

It took a 12-day break after stopping the daily dose of selegiline before the worsening balance/equilibrium problem I had noted with it began to lessen and I had returned to my normal/abnormal balance equilibrium.

Then, I tried a 0.25mg dose of rasagiline. From the specs, I've read this drug is absorbed quickly, "peak plasma concentration is reached after 30 minutes". Within an hour, the worsening balance/equilibrium sensation had returned. This was the most common side effect noted in the Parkinson trials. I guess I'm one of the unlucky few who experience this, and I'm definitely not up to sticking-it-out in hopes this side-effect will lessen with time.

I'm done experimenting with rasagiline/selegiline. Neurotransmitters be damned (dopamine, anyway).

I'm now off to reinvestigate LDN (very low dose of 2.0mg with the use of the "cork-trick" to manage spasticity), then maybe helminths (Ovameds TSO variant), as much exercise as I can tolerate, Copaxone, and the over-the-counter supplements listed above.

Given my experience with CCSVI and my ever slowly-repairing shoulder issue from the stent-related nerve damage, I'm not interested in being evaluated at the moment for "restenosis" by anyone on Earth. Been there, done that, thank-you very much.

--Tracy

[joeymia]

I've been taking Lion's Mane which is known to increase levels of NGF. Might want to also give that a try.

[Quest56]

I've been taking Lion's Mane which is known to increase levels of NGF. Might want to also give that a try.

Thanks for this, I've picked some up and added it in. I did not know about it before your post, but like what I've read so far.

--Tracy

[joeymia]

I've been taking Lion's Mane which is known to increase levels of NGF. Might want to also give that a try.

Thanks for this, I've picked some up and added it in. I did not know about it before your post, but like what I've read so far.

--Tracy

This is a good article about it

http://www.longecity.org/forum/topic/41 ... our-brain/

Thats also a great forum btw

[MSBOB]

Dilinoleoyl-phosphatidylethanolamine from Hericium erinaceum and hericenones and erinacines seem too big of a molecules to pass through the blood brain barrier. I know the claims, but I haven't seen much proof on that.

I would suspect that neuroprotective or neuro-regenerative molecules would need to be smaller than those in Lion's Mane.

I could be wrong, but many neuroprotective molecules look to have a typical benzene ring with two hydroxyl groups spaced by one carbon and a double bonded oxygen atom or in another scenario a hydoxyl group followed by a methyl group in succession on the ring.

In the case of flavonoids, there are two benzene rings but the placement of the hydroxyl groups look like they make a significant difference in the quality of the neuroprotective ability. Look at Luteolin, quercitin, anthocyanin, egcg in green tea, compared to other less effective flavonoids. For the methyl to hydroxyl group look at curcumin or maybe some synthetics.

I am very interested in the molecules, but I am not an expert by any means. I only stared at this stuff long enough to pick out some similarities. I could be super wrong. I welcome the criticism because I want to know what to look for.

[ikulo]

This site has some good information on the absorption of some phytonutrients, like curcumin. http://lpi.oregonstate.edu/infocenter/p ... icals.html

For example: "In contrast, curcumin was not detected in the liver tissue of patients with liver metastases of colorectal cancer after the same oral dose of curcumin (11), suggesting that oral curcumin administration may not effectively deliver curcumin to tissues outside the gastrointestinal tract."

[MSBOB]

Tricky stuff. Many of the polyphenols look awesome in a petri dish, but don't absorb very well at all. Luteolin requires something like one gram a day to be active in the blood and then it disappears or accumulates or no one really knows and there goes $100+. Lipoic Acid takes something like 1.2 grams a day to show an assumed therapeutic response depending on if it absorbs, disappears, or no one really knows and there went $50.

Then there is B6, which at too high of levels causes "decreased sensation to touch, temperature, and vibration, poor coordination, staggering, numb feet, awkwardness of the hands, numbness around the, mouth; and tiredness." (http://www.revolutionhealth.com/drugs-t ... pyridoxine) I want to cure those things not cause them! Tricky.

Don't look at my dosages. I am most likely wrong because I have been making a lot of mistakes lately.