So I’ve been suffering with debilitating social anxiety since I was 12 and I’m now 25 years old, it’s gotten progressively worse especially since moving to a new city which just proves to me I kept it at the back of my mind and got used to it but am unable to keep it at bay now that I’m in a new environment. I’ve tried so, so many medications including fluoxetine, sertraline, valdoxan, lamotrigine, Seroquel, diazepam, lorazepam, clonazepam (worked but made me suicidal), TMS, Pregabalin, Gabapentin, Effexor and desvenlafaxine. Honestly nothing has been able to make me functional. The only thing that has somewhat worked is being on dexamphetamine for ADHD but it does nothing for my anxiety, doesn’t worsen it either.
I have been told I’m extremely difficult to treat and I agree, I’m beyond frustrated. I’ve tried an environmental change, CBT, exercise and dietary changes with countless blood tests to rule out common things that could be causing or worsening it, still no answers. I have just found out I have one mutation in my MTFHR gene A1298c but none in the other. I also am suffering from low blood sugar when I wake up and it takes hours for it to rise after eating.
My whole life currently is just researching on a solution because waiting around for doctors to come off leave, psychiatrists to accept my referral is just not an option as I’m getting worse and worse as each week goes by. I’m FED UP of it. Over beyond words of having to live like this, it’s FRUSTRATING!!!!
To all of you who are currently or have been able to keep your social anxiety under control, what has helped you the most? I’m open to try anything at this point, ketamine and am waiting to hear back from a neuro clinic in hopes of getting a spinal tap to check my neurochemicals levels .
I’m currently on duloxetine 60mg, tried 120mg but made my depression worse due to numbing effect, MIRTAZAPINE 7.5mg for sleep, dexamphetamine and testosterone replacement intramuscular injections 125mg a week.

Do you have trouble sleeping at night? Do you find yourself constantly shifting your legs, unable to find a comfortable position? If so, you may be suffering from Restless Legs Syndrome or RLS. In this article, we'll take a closer look at what RLS is, what causes it, and most importantly, what you can do to manage the symptoms and get a good night's sleep.
Key Takeaways:

• Restless leg syndrome can significantly impact daily routines and sleep quality.
• It's the sensation of creeping, burning, tingling, or pulling in the legs.
• RLS symptoms can extend to other body parts like the arms, head, and trunk of the body, causing discomfort.
• Treatment for restless legs syndrome usually includes lifestyle adjustments that limit caffeine, regular physical exercise, good sleep hygiene, and medication like iron supplements, dopamine agonists, and gabapentin to manage symptoms.

What is Restless Leg Syndrome?

Restless Legs Syndrome (RLS), also called Willis-Ekbom disease, is a common neurological disorder. It is characterized by an intense urge to move specific body parts, primarily the legs, to relieve uncomfortable sensations during periods of rest, sitting, or sleeping. RLS can worsen with age and lead to sleep disruption, making it difficult to fall asleep and stay asleep.
Although restless legs syndrome may present in childhood, it is often misdiagnosed as attention deficit disorder or growing pains, and the correct diagnosis may not be made until later in life.
The condition is often accompanied by Periodic Limb Movement Disorder (PLMD), where repetitive, involuntary limb movements occur during non-REM sleep, causing further sleep disruption and worsening sensory symptoms.
While there is no cure for RLS or PLMD, various treatment options and support services, such as the Restless Legs Syndrome Foundation, are available to help individuals manage their symptoms and improve their quality of life.

Symptoms of Restless Legs Syndrome

The major symptoms of restless legs syndrome include:

• An irresistible urge to move the legs often accompanied by an uncomfortable sensation that can be described as creeping, crawling, tingling, or burning.
• Discomfort that worsens when resting or sitting and improves with movement or stretching.
• Difficulty falling asleep or staying asleep
• Repetitive, involuntary limb movements during sleep (known as Periodic Limb Movement Disorder or PLMD) that can cause further sleep disruption and exacerbate RLS symptoms.
• Fatigue and daytime drowsiness due to poor quality sleep.
• Reduced concentration, memory, and productivity.
• Mood changes, anxiety, and depression.

The severity of symptoms can vary from person to person and may fluctuate in intensity and frequency. RLS symptoms are typically most severe in the late afternoon or early evening, but they can also occur when a person sits still for long periods, such as during an exam or while watching a movie.

Causes of Restless Legs Syndrome

The causes of RLS are not fully known, but there are two main types or categories of RLS: primary and secondary, which have different causes and risk factors.
Primary RLS, which accounts for most cases of RLS, has no identifiable cause, and its onset is often hereditary. However, researchers think that it could be related to abnormalities in brain chemicals, such as dopamine or iron deficiency.
Secondary RLS is when another medical condition causes restless leg syndrome. These include iron-deficiency anemia, pregnancy, kidney failure, peripheral neuropathy, or the use of certain medications. In such cases, treating the underlying medical condition may help alleviate the symptoms.
Below we have mentioned in detail a few factors that are related to RLS:
1. Genetic Factors
When a person develops restless legs syndrome at a young age, it may be caused by genetic factors. Research shows that people with an early onset of RLS have as high as 60% of first-degree relatives affected with the same. However, people who develop RLS later on in life tend to have other underlying causes.
2. Neurotransmitter Imbalance
Since it is a neurological disorder, another leading cause suspected is an imbalance of neurotransmitters, especially dopamine. RLS is linked with lower dopamine levels, which causes muscle spasms and involuntary muscle movements. This may also explain why RLS symptoms tend to occur more during the evening. Dopamine levels naturally decrease towards the end of the day, which causes the symptoms to worsen.
3. Spinal cord conditions
Restless Legs Syndrome (RLS) symptoms have been linked to spinal cord lesions caused by damage or injury. Taking spinal cord anesthesia, such as a spinal block, increases the risk of developing restless legs syndrome.
4. Iron Deficiency
Restless Legs Syndrome can also be caused by iron deficiency, which arises from the brain's limited capacity to absorb iron from the bloodstream and transfer it to the neurons. This deficiency can have various impacts on the body, such as controlling dopamine levels, which leads to Restless Legs Syndrome.
5. Kidney Issues
Kidney issues may lead to iron deficiency, which in turn causes restless legs syndrome (RLS). This explains why people with kidney issues are more prone to RLS.
6. Parkinson's disease
People with Parkinson's disease are more likely to develop RLS symptoms. It may be so because both conditions are treated by increasing the brain's dopamine levels. This is achieved by taking certain medications like dopaminergic agonists.
7. Pregnancy
Restless legs syndrome patients may experience a hormonal imbalance during their pregnancy. It is also found that some pregnant women experience RLS symptoms, especially in their third trimester.
8. Chronic Diseases
Certain medical conditions (such as diabetes) can trigger symptoms of restless legs syndrome.

Restless Legs Syndrome Diagnosis

When it comes to diagnosing RLS, your healthcare provider will take note of your medical and family history and ask you to elaborate on any symptoms you may be experiencing. The International Restless Legs Syndrome Study Group has set forth the following criteria that must be met in order for a diagnosis of RLS to be made:

• You feel a strong, sometimes uncontrollable urge to move your legs, usually accompanied by an uncomfortable sensation.
• Your symptoms get triggered when you're inactive (resting, sitting, lying down), especially during the night.
• Symptoms are partially relieved or temporarily improved with physical activity such as walking or stretching.

While the criteria mentioned above are important in diagnosing RLS, your healthcare provider may still conduct additional physical and neurological exams.
Blood tests, specifically those testing for iron deficiency, may also be performed as other potential causes are ruled out. If necessary, they may refer you to a sleep specialist, which could mean an overnight stay at a clinic to evaluate for other sleep disorders, especially sleep apnea.
However, make sure to provide all the information regarding the medications and supplements you take. And also, let your provider know if you have any chronic health conditions.

How is RLS treated?

Sometimes, the key to treating restless legs syndrome lies in addressing an underlying condition. For example, if you have an iron deficiency, correcting it may greatly relieve your symptoms. This could involve receiving iron supplementation orally or intravenously. However, it's important to always take iron supplements under medical supervision and only after your provider has checked the iron level in your blood.
If an underlying condition isn't the culprit behind your RLS symptoms, don't worry - there are still effective treatment options. Your healthcare provider may prescribe medications or recommend lifestyle changes, such as exercise or avoiding caffeine, to help alleviate your symptoms.

Prescription Medications to Treat RLS

When the symptoms are frequent or severe, your healthcare provider will likely prescribe medications to treat the condition. The most prescribed medication options for RLS include:
1. Drugs that increase dopamine
Dopaminergic drugs like ropinorile, pramipexole, and rotigotine patch affect the level of brain chemical dopamine in the brain, thereby helping reduce the motion in your legs.
2. Anti-seizure medications
Anti-seizure drugs like gabapentin enacarbil and pregabalin help reduce sensory disturbances. These medications are particularly effective in patients with painful RLS due to neuropathy.
3. Muscle relaxants and sleep medicines
Drugs like clonazepam, eszopiclone, temazepam, zaleplon, and zolpidem can help you relax and sleep better. However, due to their addictive nature, these drugs are usually reserved for patients with severe symptoms.
4. Opioids
Opioids, such as ramadol (Ultram, ConZip), codeine, oxycodone (Oxycontin, Roxicodone, others), and hydrocodone (Hysingla ER), can also be used to relieve symptoms of RLS. But considering the risk of addiction, they are usually not prescribed unless the case is severe and other medications have not been effective.
Out of the listed choices, the FDA has sanctioned only four medications for Restless Legs Syndrome treatment:This includes ropinirole (Requip), gabapentin enacarbil (Horizant), rotigotine (Neupro), pramipexole (Mirapex). Nevertheless, it is strongly advised that you consult an expert doctor before contemplating any medication.

Lifestyle Changes for Restless Legs Syndrome

Medications alone cannot cure restless legs syndrome; thus, certain lifestyle changes must be adapted to help alleviate symptoms and manage this condition.

Maintaining a consistent sleep schedule

Getting at least seven hours of quality sleep per night can help alleviate fatigue, especially for those with a condition like RLS. It's important to create a comfortable sleep environment and establish a regular waking time to minimize sleep disruption, which can worsen symptoms.

Cutting down on caffeine

Cutting down on caffeine is also recommended. Caffeine can trigger Restless Legs Syndrome symptoms and disrupt sleep by keeping the brain alert and focused, making it harder for individuals with a sleep disorder to fall asleep.

Practicing regular exercise

Regular exercise, particularly moderate activities such as cycling, walking, and leg stretching exercises, can significantly improve symptoms and reduce the urge to move the legs.

Relaxation techniques

Stress worsens symptoms, so relaxation techniques such as yoga and meditation might help. Besides, light exercises, warm baths, massages, and warm or cool packs can also relax muscles and reduce the intensity of symptoms and uncomfortable sensations.

Restless legs syndrome in children

If you think only adults can feel the tingling and pulling sensations in their legs associated with restless leg syndrome (RLS), think again. Children, too, can experience the same. The only problem is that they may be having a difficult time expressing how they feel. Often, they'll refer to it as a "creepy crawly" sensation.
RLS can interfere with the child's sleep quality, which can affect every aspect of life. A child with this condition may often seem inattentive, irritable, or fussy and may be labeled disruptive or hyperactive.
To diagnose restless legs syndrome in children up to 12 years, the adult criteria (as we mentioned before) must be met. The child must also be capable of describing the sensations they're experiencing in their legs using their own words.
If the child fails to express how they feel, two of the following conditions must be true:

• There's a clinical sleep disturbance that's deemed age-appropriate.
• A close biological family member, like a sibling or parent, has a history of RLS.
• A sleep study confirms a periodic limb movement index of five or more movements per hour of sleep.

In addition to diagnosis, it's important to address any possible dietary deficiencies a child may have. Children with restless legs syndrome should steer clear of caffeine and also develop good sleep habits.

Restless legs syndrome in pregnant women

During pregnancy, many women experience symptoms of restless leg syndrome (RLS) for the very first time. This usually happens in the last trimester, and studies suggest that pregnant women are at two or three times higher risk of developing RLS.
Unfortunately, it's not entirely clear why this happens. However, some theories suggest that nutritional deficits, hormonal shifts, or nerve compression could be the reason.
Well, pregnancy-related symptoms like leg cramps and sleeping difficulties can be hard to distinguish from RLS. But if you're pregnant and experiencing symptoms similar to that of restless legs syndrome, it's important to have a discussion with your healthcare provider.

When to see a doctor?

If you experience symptoms of restless legs syndrome on a regular basis, and they are causing discomfort or interfering with your sleep and daytime activities, you should consult a doctor. Some people may have mild symptoms that do not require medical intervention, but others may need to see a specialist for management of their symptoms. It is also important to rule out any underlying medical conditions that may be contributing to your RLS.

Conclusion

Restless leg syndrome can be a debilitating condition that steals individuals' ability to relax and get the sleep they need to lead a productive life. The frustrating sensations caused by the condition can cause everything from minor discomfort to severe disruptions of daily routines. The good news is that once correctly diagnosed, treatments for restless legs syndrome are relatively straightforward and usually provide relief.
Adopting a healthier lifestyle, limiting caffeine intake, regular physical exercise, and practicing good sleep hygiene habits are usually the first steps in managing RLS symptoms. With the right combination of lifestyle adjustments alongside medication, people can manage restless legs syndrome and its symptoms effectively.

FAQs

1. Is Willis Ekbom disease and restless legs syndrome the same?
Yes, Willis-Ekbom Disease and Restless Legs Syndrome (RLS) refer to the same condition and are characterized by an irresistible urge to move the legs, often accompanied by unpleasant sensations. This can lead to difficulty falling asleep or staying asleep, resulting in sleep deprivation and daytime fatigue. The condition can also affect other parts of the body, such as the arms, torso, and head.
2. Who gets restless legs syndrome?
RLS can affect anyone at any age, although it is more commonly observed in middle-aged and elderly individuals, as well as in women, more frequently than in men. RLS may also be hereditary, with up to 50% of people with the condition having a family history of RLS. Certain medical conditions, such as iron deficiency anemia, kidney failure, and diabetes, as well as the use of certain medications, can also increase the risk of developing RLS.
3. Does restless legs syndrome affect your sleep?
RLS can significantly impact your sleep quality, making it difficult to fall asleep or stay asleep throughout the night. The sensations associated with RLS can vary from person to person but are often described as tingling, crawling, or aching in the legs. These symptoms occur mainly at night, making it difficult to relax and drift off to sleep. In addition to this, the urge to move the legs can be so strong that it wakes a person up from sleep, further disrupting their rest.
4. Is restless legs syndrome life-threatening?
RLS is not a life-threatening condition. However, it can significantly impact a person's quality of life, especially if left untreated.
5. Does sleep medicine help with restless legs syndrome?
While sleep medicine can be effective in managing RLS symptoms, it is not a cure for the condition. It is important to work with a healthcare professional to develop a comprehensive treatment plan that addresses all aspects of RLS, including sleep disturbance, to improve your overall health and well-being.
6. What is PLMD or periodic limb movements disorder?
PLMD is a sleep disorder that is associated with restless legs syndrome and involves involuntary movements of the limbs during sleep. These movements are repetitive and occur in a cyclic pattern, typically every 20-40 seconds.
7. What makes restless legs syndrome symptoms worse?
RLS symptoms can be worsened by lack of sleep, high levels of stress, certain medications and substances, and changes in routine or activity level.
Establishing a regular sleep routine, managing stress through relaxation techniques, exercise, or therapy, avoiding medications that aggravate RLS symptoms, limiting or avoiding substances like caffeine, alcohol, and nicotine, and taking frequent breaks to move around can all help alleviate symptoms.
8. Is RLS a neurological or sleep disorder?
Restless legs syndrome is a neurological disorder that's closely linked to a dysfunctional dopamine system. At the same time, RLS is also considered to be a sleep disorder. The common symptoms of RLS are heightened during periods of rest, and they can seriously disrupt a person's sleep. Many people with this condition report that they find it difficult to fall asleep or stay asleep due to the urge to move their legs.
9. Is restless legs syndrome hereditary?
RLS has been found to have a genetic component, which means it can be inherited from parents to children. Studies have shown that there is a higher prevalence of RLS among family members of affected individuals compared to the general population.
10. What are the home remedies for restless legs syndrome?
Given below are a few home remedies for those struggling with RLS:

• Regular exercise
• Applying warm or cool packs to your legs
• Stretching before bedtime, especially the muscles in your legs
• A gentle massage of the legs before bedtime
• Taking an Epsom salt bath before bedtime

It is important to note that while these home remedies may help reduce RLS symptoms, they may not work for everyone.
11. What prescription medications are available for restless legs syndrome?
There are different types of prescription medications available for treating RLS. This includes dopamine agonists, iron supplements, anticonvulsants, and opioids.
12. What are the side effects of the medications used to treat restless legs syndrome?
Like all medications, the drugs used to treat restless legs syndrome (RLS) can cause side effects, some of which can be serious. Nausea, dizziness, drowsiness, hallucinations, and daytime sleepiness are some of the most frequent side effects of Dopamine agonists.
Using Iron supplements in high doses can lead to side effects such as constipation, nausea, vomiting, and abdominal pain. In rare cases, iron accumulation in the body can cause significant health issues.
Anticonvulsants used to treat RLS may cause dizziness, drowsiness, and blurred vision, while less common side effects include memory problems, depression, and suicidal thoughts. Opioids can cause constipation, nausea, and drowsiness, and they are highly addictive and hazardous when used improperly.
If you have any symptoms or worries regarding medication side effects, it is important to discuss them with a healthcare provider.
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TLDR: My mom has stage IV small cell lung cancer. This is her trying her best and I’m just trying to be there. The key is a good support group.
I previously posted about my mom’s back pain in the post Mom’s Back Pain is Severe.
All of you, were super helpful, and at times some comments were brutally honest but kindly enough. Thank you for taking your time to respond, seriously.
We tried everything for the back pain. What worked best was a recliner with a lumbar support and neck support adjust. I think this helps her sleep on her back. Everytime she turns in her sleep she wakes up. Also added heating pads to the mix. In combination with, Milk of magnesia for the constipation and cramping, Robhots gummy for the sleep aid, fentanyl patch for long relief, oxycodone for the instant relief, clonazepam for the anxiety, cough drops for the… cough.
It’s a lot. We’ve remained hopeful that good news would come and it has eluded us at every turn. But we aren’t gonna go out with a whimper at least not without trying to get more time and if fate would be kind, a miraculous remission.
The Beginning June 7th, mom notices back pain in between her shoulder blades. She brings it to my attention, and I think nothing of it. We just walked a mountain and while she seemed more winded than last year, I just had no idea. This was likely bothering her for months but I don’t see her often enough living 7+ hours away and traveling all the time.
For reference: She’s smoked about a pack a day for 30+ years. Yet at the age of 55 she has kept a great shape and physical strength. She walked everyday for at least an hour if not more. She also lives alone about 2 hours from the nearest family.
July 8th, our family went on a fishing trip and we had a great time (DM me if you ever want to know some good southern Louisiana fishing captains). The only downer was about 4 hours in my mom complained her back hurt too much to fish and the heat was bothering her. I thought this was weird but just kinda mentioned that she should go to the doctor. When we got back that night she immediately went to bed, but she did not sleep. She paced all night long and this concerned me. I told her that she really needed to see a doctor if this didn’t go away soon.
July 26, 2023, Mom went in for an X-ray. They found suspicious areas and ordered a CT. Hope at the time was cysts.
August 1, 2023, Mom went in for her CT scan.
August 3rd, 2023, The results came back highly suspicious for lung cancer and liver cancer. I went to see her the next day.
August 10, 2023, Mom went in for her PET scan. We did such a good job of following the dietary restrictions until she told the doctor she had a wonderful dream of eating an ice cream sandwich and then woke up with a half eaten ice cream sandwich on her nightstand… lol. The doctor said it was fine and the scan still happened.
August 14, 2023, The results came back. Horrible. The cause of the back pain is stage IV small cell lung cancer which has spread to the liver, the pelvic bone, the chest bone, the spine, and yeah it’s not good news. It’s pretty much what you thought in that post. She also has benign tumor in her head. So they ordered a biopsy.
August 15, 2023, Mom went in for her biopsy. God today sucked. We waited for 5+ hours for it to start. We had to wait another 2 hours after the surgery for the doctor to clear us to leave. Ugh. I hate this doctor. She came in with preliminary results and said yeah we think it’s cancer but we’ll know in 2 days. My mom goes “oh that’s not good”. The doctor just responds “yeah not good.” Then just continues explaining the next step.
August 17, 2023, Nurse from Surgeon’s Office calls “results show evidence of small cell lung cancer.” My mom responds, “is it aggressive?” Nurse “Yes. (Pause) I’m very sorry. Your doctor should be calling you soon to explain more.” And that left us speechless. The phone call ended awkwardly and I just watched my mom singly go from not great to absolutely ugly crying in 2 seconds. I was so disgusted at that nurse and doctor to run a place that drops news like that.
August 21, 2023, We met with our oncologist and started chemotherapy. My mom immediately felt better. The oncologist is so good at making you feel like there’s hope.
August 22, 2023, Mom started immunotherapy. Not much to say here. I had to leave for work and my sister took over care. She told me that everything was going well and she was doing good with the medicine log. When I talked to my mom she sounded more like herself but she couldn’t remember simple words and what she ate for breakfast.
August 24, 2023, Moms stomach was killing her so she went to the ER. She waited there for 6 hours before leaving because she couldn’t get help.
August 25, 2023, she saw her primary doctor and they sent an order for an emergency ct scan. They ended up finding evidence of a swollen liver and pancreatitis. They told her to drink more water and sent her home.
I get back to her August 28th. And I look forward to helping her. Her birthday is coming up this weekend. I want to take her out on the lake for a little ride let her experience life outside of cancer.
Any advice on anything? My advice to anyone suffering like me. Please get a buddy to support you. I have my gf and she has been an absolute boulder. I couldn’t thank her enough for being there for me. My sister as well has been stepping up and taking initiative and I love to see it. So not everything is bad.
“On the darkest nights, even if all you can see is what is directly in your headlights, that is enough to make it the whole way home.”

Age: 27- Sex: Male Diagnosis: LPHS/Loin Pain Haematuria Syndrome Medications: OxyCodone 120mg/day, Fentanyl 500mcg sublingual/day, Diazepam 10mg/day, Mirtazapine 30mg/day, Propranolol 40mg/day, Clonazepam 1mg PRN, Tizanidine 4mg/day, Ondansetron 8mg/day, Prednisolone 20mg/day PRN max 3x days a month.
My post today is regarding my blood test results from April. My cholesterol levels seem really high and other things are out of the UK NHS ranges. My GP hasn't contacted me at all. I won't go on a Statin, but what else can I do apart from dietary changes & exercise? I'm trying to follow a Ketogenic diet and exercising more. Test results as follows: White Cell Count 14.5 10*9/L (Range 4-10). MCHC 351 g/L (Range 315-345). Neutrophils 14.4 10*9/L (Range 2-7). Cholesterol 7.9mmol/L (Range 2-5). HDL 1.06mmol/L. LDL 5.95mmol/L. HDL Ratio 7.5. Phoning the doctor tomorrow but it's very hard to get through at the moment in the UK. Many thanks for reading.
TLDR; Recent bloods show high cholesterol, levels above. Should i be concerned/what can I do?

Hello again, hoping you're all as well as can be...
Writing this time with a question for anyone who's experienced - and ideally overcome - what seems to be my worst and longest lasting symptom group. Before covid I had some intermittent anxious periods which could be likened to occasional background noise, but during and since the acute phase, it's been off the handle. It feels as if the way my brain functions has been changed. Totally innocuous things can at times make me feel as though I'm going to pieces; hypothetical yet unlikely scenarios seeming quite distressing, legitimately "troubling" though incredibly improbably things can do the same (usually by thinking they will in fact happen), and most of all of this tends to persist long after whatever the thing in question is no longer present i.e. I continue thinking/being fearful of it.
Not only is that fight/flight thing in regular high gear but it's being fed into disproportionately by things it shouldn't! Like a lot of normal things I used to enjoy I either can't do as they now make feel bad, or just have a lot of resistance before getting into, expecting that they will. Sometimes I feel incapable of very much at all, which sometimes comes to a head as a more depressive state, unsurprisingly...So, if anyone has any info re: similar experiences, potential timeline for resolutions, tips on what may have hurt or helped, I'd seriously appreciate.
Cursory digging points to potential brain inflammation and subsequent incorporation of things like healthful, anti-inflammatory food, as well as certain supplements, medications, and so on. I have a pretty decent diet devoid of meat and is 90% plants, eat/take probiotics and omegas, as well as the normal specific vitamins for someone of my dietary inclinations (B12; iron; zinc; vit. D). I know this isn't the place to ask for specific advice and that natural product use can be hard to tie to direct positive outcomes, especially if used as a cocktail, but I'm mainly curious about others' experiences.
I have a great GP but given my past/other health profile has been (unsuccessfully) trying to have this dealt with by someone with more expertise and has only given me a short course of clonazepam, which I'm wearing of using for obvious reasons and haven't tried yet. Thanks in advance for any input 🙇‍♂️

Hi, I am a young adult male with symptoms of mild chronic fatigue that has been worse since slowly cutting my benzo dose last summer from .25mg/day clonazepam to .125mg. It's difficult to explain, and I'm feeling a bit of it now, but it severely affects my mood/cognition, and I have pretty bad anxiety and OCD. A feeling of feeling unsettled within my own consciousness, fear and worry, almost an "ill" feeling in the head. Kratom tends to help, or at least superficially push me through the feeling so I can function socially, but it quite easily causes dependence/withdrawal and my depression to become even worse in time.
I'm continuing to work on dietary stuff (have been eating paleo for a decade, following the Root Cause Protocol of whole food supplementation), I'm working with a drug-free mental health practitioner to help with my benzo brain, have sublingual ketamine 1-2x/week, and some other things and habits.
I could talk for a while about what I'm doing, and it's a lot, but I'm curious if you have any recommendations for ND (or others!) supplements.
-a few tsp glycine, mostly at night -1000mg Taurine at night -Gastrodia extract (ActiveHerbs) 2x/day -Magnolia extract (ActiveHerbs) 2x/day -Lemon Balm extract (ND) 2x/day -Apigenin (usually 50mg, recently 100mg at night) -Baikal Skullcap extract (ND) 2x/day -Lithium Orotate ~2mg/day (any more has me a bit dehydrated and in a poor mood) -NAC (600mg timed released) 2x/day -Creatine ~2g/day -Magnesium Malate in morning, Glycinate at night
I eat a bit of beef liver and 2 raw egg yolks a day (allergic to egg whites).
Thank you for any advice. This is all very disheartening, and I'm considering all my options before going the psychiatric route again.

My husband [40M] is sick, and I fear for his life. I am so afraid for him.
Two weeks ago I was holding him as he sobbed on the bathroom floor, and he told me he's giving this one more year. That he doesn't want to feel like this anymore.
I'm watching him waste away. He says every day that he feels like a 90 year old man. Getting off the couch is tough for him most days. If he can find a bout of energy for a very small home workout, he's trashed for days after. He no longer does any of the things he used to love like hiking, biking, or working out at the gym. He can't walk the dogs, and can barely check the mail. He's surviving currently on turkey, fruit, and vegetables with basically no fat, because he feels sick if he eats anything else. I am positively convinced he is dying, but I could never tell him that, because my hope is the only thing keeping him going. I keep telling him he's going to be okay, that we will figure it out, but I just don't know anymore.
We need help. I need your help. Please help us.
I am willing to listen to anything anyone has to say, answer any and all questions we can, get further testing, or see further specialists.
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My husband began to feel ill just over 5 years ago. Since then his health has been in steady decline.
Patient:
40 year old male 5'11 Caucasian Previously a powerlifter Took a regular low dose (his words) of anabolic steroids for approximately 10 years, quitting cold turkey in 2015. Previously ate a TERRIBLE diet (carbo loading as part of workout regimen), but stopped that in 2015, and was also vegan for about a year in 2019. Currently eats very healthy- daily fruits/veggies, NO fast food, fried food, and little to no processed food. (what is processed is basically just grain free crackers) Appendectomy in 2015, first bout of pancreatitis the very next week. Childhood asthma which was resolved until 2017 Allergy to Penicillin and amoxicillin (as told by his mother) One previous blood clot in leg (prior to 2013, but do not know the date or specifics) Recovering alcoholic who has not had alcohol since he was 21. (I am 100% positive he has had none since we met, but happy to explain further) Weight in 2015 was around 215 lbs, weight at beginning of decline in health was around 185, current weight around 155 lbs. Up to, and into 2017 he was working out (lifting-heavy) approximately 10 hours per week, now only an occasional light dumbbell workout at home. History of finicky sleep, but nothing like it is now Some history of bowel issues, which seem to occur and resolve repeatedly over years, and may not be related to a health problem. [May or may not be related, but years ago he did develop a large white patch on his head seen here https://imgur.com/a/jQInUur although it does not seem to have changed since then, nor have others appeared]
​
Currently taking:
Occasional modafinil to help with brain fog for work, but he does not take a full dose, nor take it regularly. Coffee enemas daily (only thing that seems to help at all)
In the past he has taken a great many supplements and medications to try to find a cure for this illness. Those include Alpha blockers, trazadone, clonazepam, RLS medication (Can't recall the name) saw palmetto, bacopa, gotu kola, st. john's wart, valerian, melatonin, benadryl, probiotics, prebiotics, iodine, colloidal silver, vitamins (you name it he's probably tried it), passionflower, lemon balm, catnip, and chamomile. Certainly there are more.
He has tried dietary changes many times over the years also. He's been vegan, vegetarian, low fodmap, low amylose, paleo, and lectin free. He's done exclusionary diets many times, and we have not been able to pinpoint a cause that is specifically food related. (He does not do well with Cauliflower, Eggplant or avocado oil, though.)
​
[[Illness begins around June 2017, these earlier results are included for informational purposes]]
​
EARLIER RESULTS:
10/10/2013
https://imgur.com/a/Rh9B45Y
DUAP CBC W/DIFF
https://imgur.com/a/a35Xbop
Comprehensive metabolic panel
https://imgur.com/a/ONDQC3v
Lipid Panel Direct Low Density Lipoprotein (LDL) Cholesterol
​
03/31/2014
https://imgur.com/a/FNrTXBc
H Pylori C Breath Test
​
2/10/2015
https://imgur.com/a/H92mubo
Lipase
https://imgur.com/a/rBPvGkA
Comprehensive Metabolic Panel
​
6/05/2015
https://imgur.com/a/c1jYiar
Creatinine
https://imgur.com/a/tYHnKVl
IGG SUBCLASSES, SERUM
https://imgur.com/a/Hx7CY1X
Lipase
https://imgur.com/a/AidL36e
Amylase
https://imgur.com/a/RH0gmCx
Lipid panel
​
6/15/2015
https://imgur.com/a/nzArUox
Abdominal MRI
​
[[ BEGINS TO EXPERIENCE MOST SYMPTOMS FROM THIS DATE]]
​
​
In early 2017 my husband and I moved from New England, to New Mexico.
The day before we moved, he found four embedded ticks on his thighs. We do not know how long they had been attached. (He was later tested for tickborne diseases, twice. Both were negative)
In NM, we rented a home and beginning a few months after we moved in, he began to notice some strange symptoms, but nothing too alarming.
His first biggest symptom was lack of sleep. He would wake up after a few hours, and not be able to get back to sleep. If he did manage, he'd still wake feeling very unrested in the morning. He felt very fatigued, and we attributed this to lack of sleep.
His doctor ran tests but said he found no reason for his fatigue and sleeplessness, and referred him for a sleep study. He did diagnose him with an enlarged prostate, and some sort of bacterial infection of either the bladder or prostate (We cannot recall which) and put him on a long dose of CIPRO. He was taking that for quite a while (perhaps a month) when he began to notice his ankles hurting. At that time, the doctor took him off of CIPRO. I believe he replaced it with another antibiotic, and in total he was on an antibiotic for probably 3 months (as best we can recall). This same doctor's office also tried Alpha blockers (to stop nightmares?), clonazepam, trazadone, and a medication for restless leg syndrome.
​
At the sleep study, he was incorrectly diagnosed with obstructive sleep apnea. He used a CPAP nightly for close to a year before another sleep study revealed the first diagnosis was incorrect, and he had no apnea (central, nor obstructive- we were at higher altitude)
He also saw a cardiologist during this time, due to him having heart palpitations. They fitted him with a holter monitor. Due to an error in the office (we lived remotely and it was an issue with the cell carrier the monitors used) only about an hour of data was collected. They did say that the data showed no cause for concern, though.
He visited an ENT (thinking breathing problems may be causing sleep disturbances) and they ran a scope way up in his face. They told him he had roughly 90% blockage due to deviated septum.
He had surgery to repair this, but it did not improve his symptoms. The end also ran a test for skin allergies, showing he was highly reactive to dust mites, but not much else from their test panel.
During this time my husband also militantly tried sleep hygiene (about 3 months) but it did not help. He also tried cutting screen time 3 hours before bed, as well as a cutoff for eating and drinking.
06/19/2017
https://imgur.com/a/TZUSt5M
Lipid Panel+
https://imgur.com/a/Oc06Nz6
CBC w/ Diff/Platelets+
https://imgur.com/a/Bgx2w7C
Comprehensive Metabolic Panel+
https://imgur.com/a/B9NOcjy
Borrelia burgdorferi Ab (Lyme), Total by ELISA, Reflex to IgG & IgM by Western blot (Acute)+
https://imgur.com/a/Zzqatjc
PSA, Serum+
https://imgur.com/a/EicHkwR
UA Dip w/o micro +
https://imgur.com/a/sLkxZyT
Urine culture
​
11/26/2018
https://imgur.com/a/0LV9Ix2
CBC w/ Diff/Platelets+
https://imgur.com/a/H2BAj2G
Comprehensive Metabolic Panel+
https://imgur.com/a/wDTeJnN
Ferritin+
https://imgur.com/a/qce4FNr
Borrelia burgdorferi Ab (Lyme), IgG and/or IgM by ELISA with Reflex to IgG by Western Blot (Late Disease)+
https://imgur.com/a/xDRSbwc
Rheumatoid Factor+
https://imgur.com/a/I8u21vC
TSH W/ FREE T4+
​
12/03/2018
https://imgur.com/a/1GGjeHf
HIV ABS W/ CONF SCREEN*
https://imgur.com/a/9Qs6W9M
BABESIA MICROTI ANTIBODY PANEL*
https://imgur.com/a/cNykvMu
EHRLICHIA DETECTION PCR*
https://imgur.com/a/QTUtNX7
ESR (SED RATE) Westergren*
https://imgur.com/a/16WYTHi
VITAMIN B12*
https://imgur.com/a/XEHn0WG
FEBRILE Ab PROFILE*
​
05/29/2019
https://imgur.com/a/26nbBOy
VITAMIN B12 AND FOLATE*
https://imgur.com/a/vforvFx
TSH W/ FREE T4*
​
By 2020, his symptoms were documented as follows:
Insomnia Fatigue (extreme) Body aches Weakness Headaches, with sensitivity to light Memory impairment Difficulty concentrating/ brain fog Stiffness and joint pain Shortness of breath Heart palpitations Difficulty regulating body temperature Blurred vision Night sweats Mood swings Abdominal pain Vertigo Recurrance of childhood asthma
​
We discovered that mold illness can cause most of these symptoms, and so found a doctor who specializes in mold and follows the Shoemaker protocol. He ran many tests, including a genetic test. He said roughly 25% of the population has a genetic problem that makes it so their bodies cannot rid themselves of mycotoxins, and that my husband was part of that group. (lab attached)
He prescribed clay binders, and moving. We did both.
We took a precious few belongings with us when we left, and then only hard items that could easily be cleaned. All soft goods like clothing, and pillows, etc were discarded.
After moving, most of the acute symptoms died down dramatically, leading us to believe this was the cause of his problems, and he would slowly improve over time, like his mold doctor said.
He stopped experiencing the headaches and light sensitivity almost immediately, along with the stiffness and joint pain, blurred vision, night sweats, and the worst of the mood swings. He also stopped needing to use his inhaler daily. However, now 3 years later, he has not improved further, and has developed other symptoms, and some existing ones are worsening.
2/25/2020
https://imgur.com/a/ddvd6K4 genetic
​
2/25/2020
https://imgur.com/a/scqt0o3
​
3/04/2020
Envirobiomics mold test in our rental home
https://imgur.com/a/nYRallL
​
11/16/2020
https://imgur.com/a/2P2cGym
​
In the beginning of 2021 we moved again, out of state. He visited another cardiologist, who did an EKG (although most of the leads were not touching his skin due to body hair they did not shave) for his heart palpitations, and said he was fine. They too fitted him for a holter for 24 hours. It took roughly 4 months to get the results, but they said there were no concerning findings.
​
In 2022, his pancreatitis has flared up multiple times, and he has seen a few more doctors, including a GI. The GI has done many blood tests, and also did an endoscopic ultrasound. The findings were that there was minor flattening of the duodenum, but the doctor said (over the phone) that he saw no evidence of celiac disease, pancreatic, or stomach cancer or ulcers. The pancreatitis is now chronic, and most foods (unless they pretty much have zero fat, and still even then sometimes) cause him abdominal discomfort. He has pain in his stomach area, and into his back. This is often accompanied by abdominal bloating, belching, and passing gas. There are times when eating or drinking causes these symptoms, and other times where eating or drinking relieves them. It makes no sense.
He also had an infected dental crown removed in early 2022, and was placed on antibiotics. He developed C-Diff, and was treated. The GI did a test to confirm it was gone, and told us that he needs to be taking a certain brand of both probiotics and fiber (benefiber, specifically), although he was already taking another brand of both.
4/19/2022
https://imgur.com/a/NA0BtUx
Iron, TIBC, and Ferritin panel
​
5/25/2022
https://imgur.com/a/poHFM9h
Comprehensive Metabolic Panel
​
We began to wonder about his previously infected dental crown. The dentist had removed that, and the tooth, and put in a bone graft. We started researching more on that, and found it plausible that he had other infection in his mouth which could be causing problems, perhaps having spread from the initial crown. We found a dentist who specializes in that type of thing. He had the bone graft removed, as well as another crown removed (which was also apparently infected) and they cleaned out (I think) two wisdom teeth cavitations. They sent in samples for testing.
It's worth noting that he did not have this work done on the opposite side of his mouth, so if there is infection there somewhere we do not know.
Dental
6/23/2022
https://imgur.com/a/xITsXzh
Dental DNA
​
5/24/2022
https://imgur.com/a/AD3QUYA
Dental vitamin D
​
07/28/2022 (GI doc again)
https://imgur.com/yiCOhMn
Comprehensive Metabolic Panel
​
We recently discovered we are able to order some tests ourselves through a third party, and have them processed at Labcorp or Quest. We tested for Lead poisoning, and toxoplasmosis. Lead because we do use cast iron, and occasionally antique ones, and they can have an unknown history in smelting. Toxoplasmosis because we got our first cat right around the time this all started in 2017.
I messed up though: I saw it said to discontinue Biotin 72 hours prior to this test. He did not take anything called Biotin, and we thought nothing of it. However today, after getting these last results, I looked more into it. Turns out his B complex vitamins he's taking do have a high dose of Biotin (and apparently makes his urine bright yellow). Also, he began coffee enemas two days before these labs were drawn. I understand that this may skew some results, but I'm including these anyway, just in case.
​
12/28/2022
https://imgur.com/a/JZLoMrD
Lead Toxoplasmosis Hormone profile ACTH
For the last year and a half we have been living in a brand new home (in yet another state), where we are the first occupants. We now believe that he is sensitive to mold, and it may have triggered something else, or allowed some other illness to take hold/run rampant. When he enters a place now that (probably) has mold, he begins to feel what he calls "mold sweats". IE acute symptoms immediately. Those symptoms resolve within a day of exiting the building.
​
His daily symptoms now:
Extreme fatigue and lethargy Occasional heart palpitations Insomnia Malaise Tinnitus (developed early 2022) Chronic pancreatitis (or more accurately, stomach pain we associate with pancreatitis due to his previously diagnosis)
I tried to cover everything here, but I know I will have missed some things. I've pared it down as much as I can, but I am glad to provide any and all information I can get my hands on, if it will help in any way.
I know this has been a really long post, and if you're here at all, even if you scrolled straight to the bottom, I appreciate you. I am looking for ideas, direction, even just your curiosity. We have nothing else to lose at this point. I need to find a way to save his life. He's my whole world, my best friend, and I can't make it without him. I hope someone here has some ideas where we should go next, because I don't know what else to do but post on reddit.
​
Thank you all very much

Hey everyone! I have a couple questions abour medication response, based on previous responses to medication.
I just had my first two ketamine infusions, one being 0.4mg/kg, and the one this morning being 0.5mg/kg. I’ve has the strongest response from this treatment than from any i’ve had at all. This morning i went through an event after my infusion that reminded me of a traumatic event, it really scared me, not knowing why i was upset because of the effect of the ketamine.
My psychiatrist walked into the room and saw me crying, and i told her the situation that had occurred, she started to ask me a few questions, ending in a realization it made me remember a traumatic event, and since she helped me through it during, and made my reaction seem normal, i think it’s not going to bother me anymore.
I’d usual get mad at a person not involved in what triggered me, but rhis time i had a natural reaction and cryed, feeling pure pain without a hostile reaction. I’m so proud of myself and i’m so happy ketamine is working for me. Yes i’m on a fairly low dose, but it’s already working very well. It’s helping with my anxiety, depression, and drug cravings since the first infusion, and now trauma.
My question is, is there any medications that you can take daily that working on the same receptors as ketamine without the psychoactive effect? Anything that i could use so the periods between infusions where my symptoms come back, or somerhing i could use for maintenance so i wouldn’t have to get infusions as regularly as the usual one month?
I’m thinking about maybe selegiline, patch form, 6mg so no dietary restrictions or hypertensive crisis (yes i know it’s not that bad but i’d rather not go through it or risk it), if you have any recommendations please share!
Diagnosis i have: • Treatment Resistant Generalized Anxiety Disorder • Traatment Resistant Depression • Social Phobia • Panic Disorder • Post Traumatic Stress Disorder • Substance/Opioid Use Disorder • Attention Deficit-Hyperactivity Disorder Type 2 • Chronic Insomnia • Irritable Bowel Syndrome Type M • Gastroesophageal Reflux Disorder • Gilbert’s Syndrome • Was Misdiagnosed With Bipolar 1 Disorder During Substance Abuse, Now Not Diagnosed
I’ve trialed 30 medications as of now. Those being: • Benzos: 2mg qd + 2mg did Lorazepam (Ativan), 0.25mg prn Alprazolam (Xanax), 0.25mg qd + 0.5mg did Clonazepam ODT (Klonopin Wafers), and 1.75-5mg a day Clonazepam (Klonipin) • Z-Drugs: 5mg Sonata (Zaleplon) • Gabapentinoids: 300-3,600mg a day Neurontin (Gabapentin) • Antidepressant: 5-20mg qd Escitalopram (Lexapro), 30-60mg qd Duloxetine (Cymbalta DR), 12.5-50mg qd Trazodone (Desyrel), 150mg qd Bupropion (Wellbutrin XL), and 7.5mg qd Mirtazapine (Remeron) • Antipsychotics: 25-400mg qd + 25mg tid Quetiapine (Seroquel), 300mg qd Quetiapine ER (Seroquel ER) 5mg qd Olanzapine ODT (Zyprexa Zydus), 2.5-10mg a day Asenapine Maleate (Saphris) • Mood Stabilizers: 250-750mg a day Sodium Valproate DR (Depakote DR), 1,000mg qd Sodium Valproate ER (Depakote ER), 300mg did Lithium Carbonate ER (Lithobid) • Stimulants: 20-30mg qd Mixed Amphetamine Salts ER (Adderall XR), 7.5-15mg qd Mixed Amphetamine Salts IR (Adderall IR), 20-35mg a day Dextroamphetamine Sulfate SR (Dexedrine Spansules) • Medication Assisted Treatment: 25mg qd Naltrexone (Revia), 2-12mg a day Buprenorphine/Naloxone (Suboxone), 8.6/2.1mg qd Buprenorphine/Naloxone (Zubsolv) • Atypical Anxiolytics: 187-266mg a day Medical Marijuana, 50mg tid Hydroxyzine HCL (Atarax), 10-40mg qd Propranolol (Inderal), 5mg did Buspirone (Buspar), 50mcg qd Clonidine (Catapres) • Dissociative Anesthetics: 0.4-0.5mg/kg Intravenous Ketamine (Ketalar)
As well as these medications for anxiety-related ibs: Antiemetics: 4-12mg tid Ondansetron (Zofran), 2-4mg a day Lorazepam (Ativan), 4-8mg tid Ondansetron ODT (Zofran ODT), 25mg did Promethazine (Phenergan), 1mg did Granisetron (Kytril), and 300mg qd Trimethobenzamide (Tigan) Antacids: 1g did Sucralfate (Carafate), 40mg qd Omeprazole (Prilosec), and 40mg qd Famotidine (Pepcid) Gut Antispasmodics: 20mg did Dicyclomine (Bentyl), and 0.125mg did Hyoscyamine Sulfate (Levsin SL)
I’m currently on the following: 20mg Dexedrine Spansules q8am 15mg Dexedrine Spansules q12pm 8.6/2.1mg Zubsolv q3pm 50mcg Catapres qhs 40mg Famotidine qhs
I currently have these meds as prn: 0.125mg Levsin SL did 300mg Tigan
“Recreational” Drugs I Use: Caffeine Vaping Smoking (Cigarettes)
Drugs I Mainly Used When I Active Abused Drugs: (Three Months Sober Tomorrow • Fentanyl (Smoked) (Daily) • Meth (Smoked) (Daily) • Cocaine (Insufflated) (Daily) • Weed (Smoked/Vaped/Oral) (Daily) • Klonopin (Insufflated) (Daily) • Alcohol (Oral) (Daily) • Dilaudid(Insufflated) (Weekly) • Opana (Insufflated) (Weekly) • Phenobarbital (Oral/IN) (Weekly) • Propylhexedrine (PO) (Weekly) • MDMA (Snorted/Bombed) (Biweekly) • LSD (Sublingual) (Biweek/monthly)
Drugs I Used When I Started Using: • Soma (Oral) (Daily) • Flexeril (Oral) (Twice Weekly) • Hycodan (Oral) (Every Other Day) • Ultram (Oral) (Every Other Day) • Oxycodone (Oral) (Daily) • Meth (Insufflated/Smoked) (Weekly) • Vyvanse (Oral) (Weekly) • Ambien (Oral) (2-3x Weekly) • Weed (Vaped/Smoked/Oral) (Daily) • Alcohol (Oral) (Weekly) • Xanax (Oral/Ate) (Daily) • LSD (Sublingual) (Every 2 Months)

I tell myself about the medical coding job and I tell myself that that's what I'm trying to shoot for since it's away from people and all I'd need to do is go to school for it and learn how to do it and then find a job but I still fucking worry because I'm scared of it. I'm scared of everything even the part time job I have. For such a long time I never know what job I want to do for a living and I feel anxious about working in general. People ask me what I'm in college for and the honest truth is I'm not going for really anything specific yet and I won't even get the AA degree because I had to withdraw from classes because of my mental health. My mental health is so bad I get panic attacks before work and I only work 1 day a week. I'm a dietary aid. I'm so worried about not functioning at all like today I went to Walmart and I was super anxious in the store because there was so many people around and I felt paranoid when people would look at me I thought they were out to get me. My dad tells me that if I cant be independent in the future I'd go homeless or be in a group home or something. I'm 20. The future would be when my dad is like half dead in old age and I'm zoinked out of my mind. I would hate to be living this way hardly functional for the rest of my life. There has to be a way out of this shit that isn't just ending my life all together. I'm on some strong meds rn too. Clonazepam, remeron, and abilify.

Before I jump into things, I want to make it clear that I am not a doctor. What advice included below should not be taken as a diagnosis or as a replacement for seeking attention from appropriately credentialed medical personnel. HOWEVER, I am a speech-language pathologist who has worked primarily in Head and Neck Cancer at a major university affiliated hospital on the east coast. I know many of you unfortunately are met with head scratches from your physicians, but in our ENT clinic "Burning Mouth Syndrome" is actually quite common. Common enough where there is a very standardized procedure of testing.
Now, as someone who personally experiences this particular syndrome and has a touch more knowledge than the layman, I wanted to help lay a few things out in the hopes of helping those that I can. Especially as I see a LOT of incorrect information related to this syndrome either born of total anecdotal evidence or perhaps cursory googling.
Now, after all of that and before I go any further, I want to do something very important: If you have just started feeling symptoms. GO. SEE. YOUR. DOCTOR. Do not use this website or specific subreddit as a surrogate. Stop reading the posts. Stop reading the replies. Stop seeking reassurance from faceless denizens of the internet. Visit your dentist. Visit your doctor. Get a referral to a specialist if you feel it is necessary. The reason for this? Many posting on this sub have been suffering with this syndrome for years. For some it is extreme, for others less so. BUT THEY ARE NOT YOU. Your experience may differ wildly. Should you fall too far down the rabbit hole what awaits you is a whole new problem, being some serious panic and anxiety. Reading stories of crying themselves to sleep at night and making homemade tonics of tabasco and water is not going to help you right now. It will only bring you grief. Brief you walk down that road, PLEASE speak to an appropriate medical professional.
With that out of the way, let's talk about some basics. Folks who have had this for awhile and have been marched around various specialists may already be familiar. But for others:

1. Burning Mouth Syndrome is just that, a syndrome. It is a collection of symptoms that do not necessarily imply a specific disease. Beyond that, the research behind this syndrome is HIGHLY limited because the primary variant is fairly rare and, as someone who works in medicine, the sad truth is it isn't a money maker (For better or worse, a lot of the research is driven by the promise of pharmaceutical profit.)
2. What are the typical symptoms? This is an important one, as a lot of posters seem to come with the question, "Could this be burning mouth?"
   1. First, "true" or primary burning mouth presents with no mucosal changes. If you notice an swelling or redness this would be burning mouth secondary to some other process, such as a viral illness or autoimmune disease
   2. The pain can present as a burning, tingling, or numb sensation. It can be quite mild or sometimes very severe. The actual sensation varies wildly.
   3. The syndrome is very often accompanied by the sensation of dry mouth. Interestingly, salivary tests will often return normal, meaning that this is somaticized more than a true xerostomia
   4. Possible taste alteration. Some report metallic or bitter tastes.
   5. For many burning mouth cases pain will subside when you eat. We'll get into this later.
   6. In primary burning mouth, symptoms will actually tend to get worse when an analgesic is applied. For instance, a local application of viscous lidocaine will cause a significant increase in experienced pain. Again, we'll get into this later.
3. What do you mean by primary variant? Because Burning Mouth Syndrome refers more to a collection of symptoms than to a specific disease, there is the conundrum of how we classify or categorize it. Most peer reviewed research prefers to break it down as such:
   1. Primary Variant- Also referred to often as idiopathic burning mouth. This is variant identified when all other reasonable explanations have been ruled out. Idiopathic meaning the cause is unknown. This is the variant that is, unfortunately, most difficult to treat and very very common among women of a certain age.
   2. Secondary Variant- This refers to all other cases of burning mouth. That is to say, the symptoms you are experiencing have a cause.
4. What can cause the secondary variant? This is a huge question. At our hospital a local biopsy is accompanied by a whopping 32 or so tests(!) For those not in the know, that is a lot. These tests, as well as clinical profiles look for a variety of issues. I will give a very brief list, starting with what I think may be the most important for this subreddit.
   1. Psychological Factors: This one can't be overstated. Really. Yes, anxiety, OCD, and depression can cause the physiological symptoms you are experiencing. In fact, the majority of people that walk into a clinic with complaints of burning mouth walk out with a diagnosis of psychogenic origin and referral to psychiatrics. Some may have strong opinions on this, I only share what is often the case. Much research reports this, too, with something like 40% of cases being attributed to psychogenic origin. Somatization of anxiety is extremely common and in many cases of recalcitrant burning mouth is a root cause. This is why you may run across studies that successfully treated BMS with things like TCAs, SSRIs, SNRIs, or atypical antipsychotics. It may also be the case that this medications are used to help those with primary burning mouth by reducing anxiety or depressive sequelae. Anxiety can making pain worse. The more you worry and fixate, the worse it will get.
   2. Vitamin Deficiencies/Metabolic Causes: This one you will see brought up a lot. A thorough panel of tests will assess your folate, zinc, magnesium, and a variety of B vitamins that are often implicated in BMS symptomology. It is also important that a Complete Blood Count be completed with either an automatic or manual WBC differential. Reason? vitamin or dietary deficiencies can cause a burning or tingling sensation. Especially B vitamins. Complicating issues even more is the fact that magnesium does have some relationship to psychological state.
   3. Infections: This is another important one. Candiasis (thrush) can easily be evaluated by your dentist. This is a big reason, aside from neuropathy, that diabetes is thrown around. Sometimes it can do a good job of hiding, but it is generally very apparent (and the dental subreddit is replete with people asking if they have it, much to the chagrin of the practitioners over there.) A variety of other infections can also be to blame. An emerging possibility is HSV-1. If you have a history of cold sores, it would behoove you to ask for an oral swab and/or a serum blood test. There is also specious research out there indicating that the COVID-19 vaccine may activate VZV or HSV viruses in your trigeminal ganglion. It doesn't rise to the level of establishing a basis of appropriate care, nor should it dissuade folks from getting the vaccine, but it may help some of you on your road to recovery (A regimen of valacyclovir is a pretty affordable and straight forward solution to that problem.)
   4. Autoimmune Diseases: The one you'll see brought up most often is Sjogrens (if you have issues with eye dryness, this becomes much more reasonable.) But you will also see things like vasculitis or Crohn's disease come up. An ENT visit may turn into a rheumatology visit as a consequence. ANCA, ANA, and IGG tests may help get to the bottom of this one.
   5. Oral Status: This would be a very long list. Licen Planus, Geographic Tongue, salivary gland dysfunction. Heck, even TMJ. All may be a cause.
   6. Allergic Reactions: Another common one, I doubt this one needs to be explained. And I expect that for most it is fairly obvious. Within this we can also dump reactions to chemicals (things like vaporized irritants that one may encounter in an industrial setting.)
   7. Neuropathy: Most often this will accompany a dental or surgical procedure and not be highly localized. It may also be caused by systemic or metabolic issues, such as diabetes. Can also be a consequence of nerve compression. Another reason to see your doctor.
   8. Medications: Often ignored, but certain medications can have a burning mouth sensation as a side effect. Again, converse with your doctor.
5. What is the mechanism of pain? We don't have super clear answers on this one. But I will see it is a bit funny to see people on this sub throwing out nerves in the cervical plexus. Without going too much into neuroanatomy, you have 12 cranial nerves aside from your peripheral spinal nerves, that provide somatic and motor innervation to your mouth. Foremost among these are your trigeminal nerve (CV) and the facial nerve (CVII). The former provides much of the sensory processing you would be familiar with, like pain. While the facial nerve is what collects taste information from the anterior 2/3rds of your tongue. Any of the above could cause a release of pain information by your fifth (trigeminal) cranial nerve.
6. Why is this mechanism of pain interesting, specifically with the idiopathic variant? Well, there is emerging research that the pain you are experiencing is because CV and CVII aren't playing nice. Put simply, there is central inhibitory mechanism between the fifth and seventh cranial nerves. Meaning that alteration to your taste pathways (through the facial nerve) can lead to hypersensitivity in your pain pathway (through your trigeminal nerve) resulting in pain. This would also explain why for many eating or drinking can calm pain. You are providing a gustatory input the promotes that inhibitory mechanism. It also explains some of the other symptoms, such as taste alteration. What causes all of this? We still aren't sure. Most seem to continue to subscribe to hormones in some way. The research by Grushka out of Canada seems to be some of the best.
7. How do we treat it? What will make me feel better? This depends on your etiology. For example, a psychogenic cause would need to be treated through psychotherapy and possibly a regimen of anxiolytics or antidepressants. Thrush would of course be treated as an antifungal, while HSV-1 would be treated with an antiviral. Vitamin deficiencies would be treated by supplementation. Idiopathic variant is a different story, the only real successful treatment that I have seen is with a somewhat low dose of clonazepam (klonopin.) Some say this is because of how this particular benzo interacts with certain neural pathways. Others say it is simply because of its sedating effect. Couldn't say. I will say that I take about 1mg a day, and the relief I get is minimal at best. Other things that may be tried are topic analgesics, various psychotropic medications, capsaicin rinses, and salivary replacements/stimulants (biotene tends to be readily available in most grocery stores.)
8. Is this hopeless? No. NO NO NO. It is a hard condition to live with. I have lived with it myself for quite awhile. For the VAST majority of people out there some solution is found. In many others a spontaneous recovery occurs. It is important to remember that peripheral nerves (including cranial nerves) can naturally heal. Even if the cause of your pain is due to some sort of nerve damage, regardless of cause, your body is capable of healing. Unfortunately it is just that this can take a long long time. It is important to remember, no matter how hard it gets, that this too shall pass. You may run into folks that have had this for decades, but again they are not you. In fact, research points to them being a very small (and unlucky) minority. Over time though, hopefully those folks have find coping mechanisms to help with pain management.

I feel like this is a decent overview, though I am sure I missed pieces. Again, while I am not a doctor, this has come up in clinic several times and the folks who trained me (and remain at this hospital) have quite a bit of expertise at least in the neuroanatomy of the head and neck. I think it would be good to dive deeper, should anyone want to and feel comfortable. But remember, this too shall pass.

Main question: would taking 1/2 a 0.5mg clonazepam pill before sleep affect my 5hiaa levels in the test?
I am 36 yrs old, Male, USA, 5'9, 140lbs, white/european, getting a 5HIAA 24hr urine test due to symptoms I've been having - I want to make sure I give a clean sample for most accurate results.
My doc and the office didn't give me very clear "things to avoid" instructions, but agreed I should avoid stuff I find online.
I have been following these guidelines, but also wanted to clarify:

1. Are some seeds okay (sunflower, sesame etc.) in small amounts?
2. Are berries okay (blueberries, raspberries, blackberries mostly)?
3. Is Ibuprofen allowed for pain reliever (since Tylenol and similar ones aren't)?
4. Caffeine is not allowed - what about decaf green tea 1 packet/day?
5. I've been staying away from supplements, but is melatonin okay?
6. Muscle relaxants and valium aren't allowed - what about clonazepam (klonopin)?

Now hear me out. Firstly, I believe that these people who are diagnosed, have pain. But their diagnosis is just a fake label they’ve used to make their job easier. So they don’t actually investigate what’s causing the problem! They just say that your nerves are too sensitive, and that you have a low pain tolerance.
I have chronic back pain, chronic knee pain, Erb’s Palsy and HAD carpal tunnel syndrome (surgery fixed it). But I’ve heard of fibromyalgia, which has the symptoms:
“Pain areas: in the muscles, abdomen, back, or neck Pain types: can be chronic, diffuse, sharp, or severe Pain circumstances: can occur at night Whole body: fatigue, feeling tired, or malaise Muscular: muscle tenderness, delayed onset muscle soreness, or muscle spasms Gastrointestinal: constipation, nausea, or passing excessive amounts of gas Mood: anxiety, mood swings, or nervousness Cognitive: forgetfulness or lack of concentration Hand: sensation of coldness or tingling Sensory: pins and needles or sensitivity to pain Sleep: difficulty falling asleep or sleep disturbances Also common: depression, flare, headache, irritability, joint stiffness, painful menstruation, sensitivity to cold, or tingling feet”
These are a collection of symptoms for many different things. The pain could be due to a physiological issue. The gastrointestinal problems could be IBS, food intolerances, allergies or GI tract issues, such as gastroparesis. The mood symptoms could be generalised anxiety disorder, the mood swings could be an endocrine issue, it could be from ADHD or bipolar disorder. The cognitive issues I believe are from the medications. I’ve been prescribed amitriptyline, which put me to sleep. Lyrica highly sedated me. I’m trying duloxetine in 2 weeks, so I’ll see how that goes. Then there’s muscle relaxants and opioids. You’re put on a lot of depressants, that slow down your nerves, slow down reaction times, affect cognition, affect memory. Lyrica reduces the excitability of neurones. So that’s good for seizures in epilepsy or in neuropathic pain. But it also affects normal signals, such as thought. Being alert of your surroundings. Communication with people. Etc. I was on 300mg of Lyrica and 1.5mg of Clonazepam. Terrible combination. I was a zombie. I came off the clonazepam really easily, but it’ll have taken me over a year to come off of Lyrica. I’m down to 100mg, and my cognition is much better. I actually remember things. I don’t have brain fog anymore. I think that’s not a symptom of chronic pain, but simply being doped up with all this s***! Hand coldness could be from old age (older people feel the cold), frail hands with little muscle or fat, poor circulation (decongestants and stimulants such as speed, cause blood vessels to narrow, which reduces blood flow and can cause extremities to die). Then tingling could be neuropathy or carpal tunnel syndrome. Sleep problems are common with all kinds of chronic pain. The body is releasing epinephrine and norepinephrine, as a result of being in pain. Your body is constantly in fight or flight. Which is taxing and generally results in endocrine problems. Actually tackling the source of the pain or reducing the intensity of the pain signals, will help with sleeping. This could also explain the anxiety, as those neurotransmitters are designed to make you feel on edge. Depression could be from clinical depression or the hopelessness, that untreated chronic pain brings. Flares are like acute attacks of pain. So chronic pain has a baseline pain, and then it has flares. So say you have back pain, and you bend over, it may cause a flare, because you’re putting stress on that region. So your pain may go from 4/10 to 8/10. Headaches could be attributed to so many things, I won’t go over it. Irritability: go up to an injured dog and try to pat them. What will they do? Try to bite you? Yep! Someone in pain is in fight or flight mode. It’s an evolutionary adaptation to protect our injury, by fighting off a potential predator. Joint stiffness? Possibly arthritis. Painful menstruation? Possibility of endometriosis. Sensitivity to the cold or tingly feet? Could be poor circulation, low amount of body fat or muscle or simply being frail, low metabolic rate, neuropathy, etc.
So they’ve taken symptoms from multiple conditions, and packaged them into one thing. Something else I found interesting, was the similarity to lupus. Now look at the symptoms for lupus:
“Pain areas: in the muscles Pain types: can be sharp in the chest Pain circumstances: can occur while breathing Whole body: anaemia, fatigue, fever, or malaise Hair: hair loss or loss of scalp hair Skin: red rashes or scaly rashes Mouth: dryness or ulcers Also common: anxiety, blood in urine, clinical depression, face rash, flare, headache, joint stiffness, raynaud's syndrome, sensitivity to light, swelling, water retention, or weight loss”
Very similar right. Now let’s discuss treatment.
“The treatment of fibromyalgia can be difficult. Recommendations often include getting enough sleep, exercising regularly, and eating a healthy diet. Cognitive behavioral therapy (CBT) may also be helpful. The medications duloxetine, milnacipran or pregabalin may be used. Use of opioid pain medication is controversial, with some stating their usefulness is poorly supported by evidence and others saying that weak opioids may be reasonable if other medications are not effective. Dietary supplements lack evidence to support their use. While fibromyalgia can last a long time, it does not result in death or tissue damage.”
Getting enough sleep, exercising regularly and a healthy diet? Shouldn’t everyone be doing that?
CBT is used to treat psychological conditions. Is fibromyalgia a psychological condition?
Medications: antidepressants and anti-epileptics are pretty much ubiquitously prescribed for fibromyalgia and chronic pain in general. Benzodiazepines (Valium) and nonbenzodiazepine Z drug sleeping pills (Ambien) are generally not used (due to addiction risk), but may be prescribed short term or long term to elderly patients. These are all psychiatric medications! Then we finally get to pain management! Such as: muscle relaxants, acetaminophen, NSAIDS and (very rarely) opioids. Again, there’s the addiction risk of <5% becoming addicted. They’re also saying that, in general, chronic (non-malignant: non-cancerous) pain shouldn’t be treated by opioids. But especially for fibromyalgia.
It sounds like the discrimination between malignant cancer pain and regular chronic pain, is them betting on the cancer patient dying before addiction. Whereas regular chronic pain sufferers live decades, and no doctor wants to prescribe opioids for decades. Oh, and there’s the opioid epidemic, where people are dying from opioid overdoses. But most of the cases are from heroin and fentanyl or illicitly pressed pills with fentanyl inside. Actually, overdose deaths have increased, as opioid prescribing drops. Chronic pain patients are committing suicide at a higher rate, since opioid prescribing has gone down. But we’re not quitters, we know the issue MUST be prescription opioids. Even though patients say that opioids work better than Tylenol or ibuprofen. We’re going to do studies to prove them wrong. We’re going to under-dose the opioids in the study and use extremely high doses of Tylenol and acetaminophen. What we’ve proved, is that 5mg of oxycodone is really no more effective than 1000mg of acetaminophen and 800mg of ibuprofen. So even though we compared the absolute minimum opioid dose to the absolute maximum NSAID dose, like the opioid’s dose could be increased a lot, but the NSAIDS become toxic above that dose when administered at once.
So in conclusion, I feel that fibromyalgia is really synonymous with hypochondriac, as far as the doctor is concerned. So we’re going to tell them that their pain is real, but treat them as if they have a psychiatric disorder. Hopefully that pesky patient stops asking for tests, and becomes a good little docile customer, who takes what I prescribe, and won’t mind me putting my fear of the DEA ruining my life, if I prescribed them even 1 Percocet a day.

Alcoholism, smoking, Dietary habits and rising geriatric population are the major factor driving the antiepileptic drugs market. Additionally, wide availability of technically advanced Anti-Epileptic Drugs, improvement in diagnosis and treatment of epilepsy and rising demand for home based Anti-Epileptic Drugs treatment are likely to push the growth of global Anti-Epileptic Drugs market in the forecast years.
Request Sample Report Now at Link - https://www.gmiresearch.com/report/global-anti-epileptic-drugs-market-by-spectrum-type/sample-request
Antiepileptic drug can also be known as anti-seizure drug, developed for asymptomatic and Idiopathic treatment of epilepsy and seizures. Antiepileptic drugs can also be used for the treatment of neuropathic pain. Causes of epilepsy seizures are not defined or undetermined which has led many Antiepileptic drugs approved in the past years. Major factors which causes epilepsy include brain injury, stroke, and substance use disorders. Treatment of epilepsy, antiepileptic drugs or medicines (AEDs) are prescribed based on age of the patient, type of seizures to be treated, and which part of the brain is involved.
Valporic Acid segment is expected to hold maximum share in the market during the forecast period due to effective drug structure and its usage in most type of seizures. However, the highest growth rate is predicted to be exhibited by Lacosamide during the forecast period owing to surging adoption of Anti-Epileptic Drugs market among healthcare professionals and patients due to its homogenous structure.
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North America held the largest market share in global Anti-Epileptic Drugs market in 2018 owing to increasing social awareness, social acceptance, awareness among the population and government and private players inclination on Anti-Epileptic Drugs issues. Rest of the World is predicted to be the attractive regional market in global Anti-Epileptic Drugs market and is likely to show the maximum growth in the next few years.
Various notable players operating in global Anti-Epileptic Drugs market include Abbott Laboratories, Cephalon, Inc, Sunovion Pharmaceuticals, Valeant Pharmaceuticals International, Sanofi S.A, UCB Pharma Ltd, GlaxoSmithKline plc, Johnson & Johnson, Novartis, AG, Pfizer Inc among others.
The Global Anti-Epileptic Drugs Market has been segmented on the basis of spectrum type, drug type, and key geographies. Based on spectrum type, the market comprises of Narrow Spectrum and Broad Spectrum. The drug type includes Phenytoin, Phenobarbital, Carbamazepine, Oxcarbazepine, Gabapentin, Pregabalin, Lacosamide, Vigabatrin, Valproic Acid, Lamotrigine, Topiramate, Zonisamide, Levetiracetam, Clonazepam, Rufinamide
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Key questions answered in this research report: • At what pace is the Anti-Epileptic Drugs market growing worldwide? What will be the growth trend in future? • What are the key drivers and restraints in the current market? What will be the impact of drivers and restraints in the coming years? • What are the regional revenue and forecast breakdowns? Which are the major regional revenue pockets for growth in global Anti-Epileptic Drugs market? • What are the various application areas and how they are poised to grow?
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Hi everyone, I’m new to the group, but from reading and listening to Paleo lifestyle “media”, it seems to be the closest thing I’ve found to a solution.
So I've been struggling with a group of symptoms that seem to be some kind of chronic/auto immune thing since about 19 years old. Many have gone on and off, but many have worsened over the years.
I was hoping to write out the full story and get some feedback on the ?’s in the title.

Here is an as FULL of a picture as I was able to put together about myself:

About me (sorry if this sounds like dating-profile info haha, just want to paint a full picture):
I am a 33/M, 5’9, 155lbs, athletic(looking) build, live in Northeastern USA, emigrated from Eastern Europe as a kid.
General Physical/Psych symptoms:
General anxiety, OCD (nervous ticks, little rituals, trying to control all variables), Low Stress Tolerance/easy overwhelm, chronic pain/stiffness/trigger points (upperback/neck/rear shoulder +lowerback/hips), IBS-C, sleep issues (waking up at night/problems falling back asleep, vivid bad dreams on with themes of insecurities), Low Sex Drive + Low semen volume on ejaculation, some Depression (sometimes), some difficulty concentrating.

• Chronic pain/stiffness better with phys activity, hard trigger point massage, heating/cooling sauna, but only temporarily (although I've never done these things very regularly).
  
• Back and joints also crack/pop and always feel like I need to do it to get relief.
  
• My PT says I have lax ligaments making it harder to stretch muscles, but not hypermobile like "double-jointed" people
  
• Physical activity: trying to get into functional training and swimming, but have really barely done either due to the bad sleep and aches/pains (probably should be doing it despite that). Go on a hike ~1/week.
  
• IBS-C seems to be physical and mental: having quiet/private/calm time in the morning helps be go to the bathroom, as does eating well. If I don't go in the morning, I feel more tired/stiff/not as sharp all day.
  
• Sleep has been better last couple of weeks (not waking up at night is a big win for me), but not being very refreshed in the morning is a baseline for me.
  

Mental health:
Apart from described symptoms above, I have some complexes and insecurities that definitely seem to have a link to the past. More specifically problems fitting in in school as a kid and publicly shamed by classmates, strict/difficult parents, parent leaving the family in a bad way, 2 of my relationships being horribly toxic.

• It seems that many symptoms I described in General, are psychosomatic, and get better with better mood and conditions, worse with more stress.
  
• I am currently researching a good therapist for my situation.
  
• I took Clonazepam in small doses (~.25mg) before sleep for ~4yrs, but stopped fully a few weeks ago.
  
• Have struggled with getting into a career and being lost for the last 12 years, contributing to my distress. Finally taking some solid steps towards something in coaching/counseling/therapy though.
  

Dietary:

• I have been eating a Paleo diet for the last couple of months, which seems to let me tolerate hunger easier, as well as improve my IBS-C - making it easier to go to the bathroom with better quality BMs (could also be the probiotic I take 2x a day).
  
• I haven't drank alcohol for a couple of months.
  
• I am sensitive to sugar and dairy - feel more problems digestions and stiffness/pain-wise when I consume either.
  
• Have been taking 5000IU Vit D 2x a day and 30 mins sun exposure (see below - deficiency)
  

Labs:
I have 3 tests from the last 2 years - blood and urine. Some are a little more comprehensive, but from just a normal PCP. Testosterone, TSH, B 12 levels seem to be pretty normal, but a deficiency in Vitamin D. I can post if needed.
Please let me know if I should include any other info, and I will do so. Thank you for your attention and help
P.S. might make a separate post later, but how do I find a good functional medicine practitioner near me? Will they have someone on staff for my psychological component as well?

So I've been struggling with a group of symptoms that seem to be some kind of chronic/auto immune thing since about 19 years old. Many have gone on and off, but many have worsened over the years.
I was hoping to write a comprehensive report on this, and perhaps you fine people in different subreddits could help me figure out what the condition could be or at least share some information that would help me research it better and optimize treatment.

Here is an as FULL of a picture as I was able to put together about myself:

About me (sorry if this sounds like dating-profile info haha, just want to paint a full picture):
I am a 33/M, 5’9, 155lbs, athletic build, live in Northeastern USA, emigrated from Eastern Europe as a kid.
General Physical/Psych symptoms:
General anxiety, OCD (nervous ticks, little rituals, trying to control all variables), Low Stress Tolerance/easy overwhelm, chronic pain/stiffness/trigger points (upperback/neck/rear shoulder +lowerback/hips), IBS-C, sleep issues (waking up at night/problems falling back asleep, vivid bad dreams on with themes of insecurities), Low Sex Drive + Low semen volume on ejaculation, some Depression (sometimes), some difficulty concentrating.

• Chronic pain/stiffness better with phys activity, hard trigger point massage, heating/cooling sauna, but only temporarily (although I've never done these things very regularly).
  
• Back and joints also crack/pop and always feel like I need to do it to get relief.
  
• My PT says I have lax ligaments making it harder to stretch muscles, but not hypermobile like "double-jointed" people
  
• Physical activity: trying to get into functional training and swimming, but have really barely done either due to the bad sleep and aches/pains (probably should be doing it despite that). Go on a hike ~1/week.
  
• IBS-C seems to be physical and mental: having quiet/private/calm time in the morning helps be go to the bathroom, as does eating well. If I don't go in the morning, I feel more tired/stiff/not as sharp all day.
  
• Sleep has been better last couple of weeks (not waking up at night is a big win for me), but not being very refreshed in the morning is a baseline for me.
  

Mental health
Apart from described symptoms above, I have some complexes and insecurities that definitely seem to have a link to the past. More specifically problems fitting in in school as a kid and publicly shamed by classmates, strict/difficult parents, parent leaving the family in a bad way, 2 of my relationships being horribly toxic.

• It seems that many symptoms I described in General, are psychosomatic, and get better with better mood and conditions, worse with more stress.
  
• I am currently researching a good therapist for my situation.
  
• I took Clonazepam in small doses (~.25mg) before sleep for ~4yrs, but stopped fully a few weeks ago.
  
• Have struggled with getting into a career and being lost for the last 12 years, contributing to my distress. Finally taking some solid steps towards something in coaching/counseling/therapy though.
  

Dietary

• I have been eating a Paleo diet for the last couple of months, which seems to let me tolerate hunger easier, as well as improve my IBS-C - making it easier to go to the bathroom with better quality BMs (could also be the probiotic I take 2x a day).
  
• I haven't drank alcohol for a couple of months.
  
• I am sensitive to sugar and dairy - feel more problems digestions and stiffness/pain-wise when I consume either.
  
• Have been taking 5000IU Vit D 2x a day and 30 mins sun exposure (see below - deficiency)
  

Labs
I have 3 tests from the last 2 years - blood and urine. Some are a little more comprehensive, but from just a normal PCP. Testosterone, TSH, B 12 levels seem to be pretty normal, but a deficiency in Vitamin D. I can post if needed.
Please let me know if I should include any other info, and I will do so. Thank you for your attention and help

I had made some dietary changes in the last year. I have lost about 40 pounds and thought I had been doing well. Monday, I got my blood drawn. Today, they said my cholesterol is about 30 points too high, on both numbers that they gave me. Well, for the past week or so I completely went off my diet. I was really sick, wanted some comfort food, and it was Thanksgiving week. I topped it off Sunday night with a pint of chicken salad and pimento cheese.
I am already back to my diet, but I am wondering if I should amend it more. Was my high cholesterol likely effected by 8-10 days of incredibly bad eating, or is it more reflective of the past few months? If it’s the latter, I’ll further amend my diet.
30 years old/white Latino/6 feet/230 pounds/on lexapro and clonazepam for anxiety.

Keep these products away from your Dogs, or better yet, don’t buy them at all. Xylitol causes seizures, liver failure and death in dogs.
Products with Xylitol -
Sugarless gum, Candy, Chewable vitamins, Rx suspensions/melts (i.e. Neurontin®, Abilify®, Allegra®, Mobic®, RioMet®, clonazepam, Emtrivia®), OTC liquid medications, OTC digestive aids (Beano®, antacids), Dental/oral care products, Nasal sprays, Nicotine gum, Chewable dietary supplements, Stool softeners, Barium liquid and pudding, Ice cream, Jell-O® sugar free pudding, Energy drinks, Peanut butter and other nut butters
Courtesy of - http://princetjfoundation.org/xylitol-and-dogs/

I'm a drug addict and an alcoholic. I'm 24 yrs old and my physical health is almost as poor as my mental health. My life really isn't bad, especially at this moment. I've got a box of wine, a gram of heroin, and as luck would have it, some clonazepam. Yet in the few minutes between nodding out and my next dose of H I'm writing this. I'm not really sure why or for what reason I'd post this, I suppose because I've had so many thoughts for so long and no form of expression.
I've been incredibly depressed since I was old enough to have an original thought. At that point I was depressed in a more childish way. I thought things would change as I got older. I'd go to middle school and miraculously be able to make friends, same when going to high school and then college. It never happened. I never was able to make friends. I was always very shy and quiet. But so what, right? Lots of people struggle with shyness. I am very shy, it's hard for me to go to the store and buy something because I'll have to talk to the cashier. Thank god for self checkouts. I know this is not normal, and I know this is more social anxiety, but depression and anxiety go hand in hand. I've wanted for so long to have friends, to be attractive and to not be so lonely. But over the past few years I stopped caring about these things. I became incredibly apathetic.
Around the age of 18-19 I started to really figure out the reason for all this sadness and self loathing. I had gone to a psychiatrist and tried a number of drugs. I was put on Zoloft, Cymbalta, trazadone, mirtazapine, lexapro, etc. I had thought that anti-depressants would help me. My girlfriend at the time knew about my depression and had told my mom who got me an appt. I was relieved, I wanted to see a psych for a long while, but was too shy/nervous to ask. After using these drugs I began to realize something. I gave some of them a fair chance, not all, but some. I realized that my problem is not an imbalance of monoamines, nor do I need BCT to correct improper thought processes, nor is it a dietary or environmental issue. I realized my problem was ME. I will always be depressed, sad and lonely, I will always have low self esteem and no confidence. This is the way I SHOULD feel. I figured out I was depressed for a reason, not because I was thinking incorrectly, but because I was thinking CORRECTLY. I realized I hate myself because I actually am ugly, I am actually stupid, I do have a learning disability. I have no reason to not be depressed. And it's not that I didn't know these things before, but I finally understood this is why I feel this way and it's not some neurological issue telling me I'm ugly when I'm actually not. It was great to come to that conclusion, this is why I'm so depressed...at least now I knew. These things cannot be changed. No drug will make me handsome, no drug will make me more intelligent, or correct my LD, which is a permanent brain disorder. These things are static. The only thing that would help would be a new body and new brain...basically reincarnation.
This leads up to where I am now. I have given up. I have decided I want to die by suicide. I'm not sure when or how but that is something I do see in my future. I am so disgusted with myself. I'm too pathetic to even pull the trigger. I can't look at myself in the mirror without wanting to cry. But I can't. I can't even cry, I feel so fucking silly wanting to cry, but I can't. I am so fucking hideous and so far below average intelligence. I have no friends, why would I? I have absolutely nothing to offer them. I am trash. Not even nice and tidy trash. I'm like wet newspaper somebody jizzed on that has maggots crawling out of it. I can't even hold a job because I'm too fucking afraid of fucking things up, even though I work really hard.
I don't really know what I'm doing, or why I randomly decided to write. I'm sorry for polluting this subreddit with such a pointless stream of consciousness.
I really don't believe I'm an awful human being. I really try to be nice to people and be extra polite. I guess I try to hide my sadness etc from people. I don't want them to know. And I also hate when people "compliment" me. It's like they obviously see I'm not a desirable friend or partner or anything. They know nobody thinks anything positive of me. The only people to ever " compliment" me is my grandma and my mother. They tell me I'm good looking, but I know they only say it because they care about me and they are family. It obviously means nothing to me because they arnt woman in my age range. But they say it because they know I won't ever hear it from anybody else. It really has the opposite effect. I know I'm not good looking, and when they say I am its somewhat hurtful because I know why they're saying it.
It upsets me that so many people think my problem is drugs. My problem is me being ugly and stupid which makes me depressed. And NO! I'm not "self-medicating" god i fucking hate that term so much. Like yea, o.k. I'm treating myself with heroin and alcohol and I think that's going to make me "undepressed". It's not like I get high and completely forget why I'm depressed. And fuck, no I don't do heroin and be like "OH, this is what normal people feel like." No, there is no way "normal" people feel that much pleasure all the time. I hate it when people say that. They say it in a way like, this doesn't get me high it just makes me feel normal, like a frat boy bragging how he can down a six pack before he feels anything. I don't know, it's a hard concept for me to explain and now I probably sound like a total cunt waffle. Well while I'm ranting, here's a really short story. About 2-3 yrs ago, I was living at my moms. She had just kinda found out I was using drugs like a month before this incident. I was up in my room with my girlfriend and I see this car pull up and instantly knew it was like an intervention guy. He comes up to my room and this awkward bull shit happens when I obviously don't want to talk to him at all and he won't leave till I let him in. It's like I don't want to be forced to act like a child. I let him in and Andy (I believe that was his name) tries to convince me to go on one of those wilderness retreats for like 3 weeks with a bunch of 14yr olds whose mommy found a dime bag of shitty weed in their dresser. He was incredibly condescending. He asks me "do you like music?" I reply "yea", " what bands do you listen to?" " I like..." Andy interrupts me and say "nirvana?" I do a short angry nassaly giggle. He ask why do you laugh at that. Like seriously??? Fuck you, you asshole. What makes you assume and judge me that I like nirvana? Just because you think I do drugs doesn't mean I wear a black dead smiley face hoodie from hot topic. Then he fucking goes down and talks with my mom about everything we talked about, with my younger brother right next to her. Thanks for the fucking privacy, this guy can fucking die. I just hate that everyone thinks drugs are my problem. It's so ridiculously frustrating.
God I just hate being "here" I just hate it. I cant take it anymore. Hopefully someday I will be courageous enough to end it, I'm low enough already but lack the balls to just do it. The only thing I have to cherish about me is that I realized the things I think about me are true. I can't excuse thinking I'm worthless and undesirable on a chemical imbalance or faulty thinking. I am worthless. I am unattractive. I am stupid. I'm just glad to know that my self esteem being located in the Marianas trench is where it belongs. And that people telling me to show confidence are wrong. Confidence is the last thing I need because I have nothing to be confident about.
Well it's a new night than when I started this, so time to continue drinking. Sorry again for such a lame post in a subreddit I don't even lurk. I'm sure you guys are a cool group of people.
TL;DR: I'm trash. Have a good one.

I want to run a general symptom check with my new EDS friends.
About two weeks ago, I started having dizzy attacks. Literally, it feels like the inside of my head spins and I loose balance. Fortunately I've been seated for all of these so far. Has anyone else experienced this kind-of sudden onset random dizziness?
Background Q&A:
*I was diagnosed back in late 2006 / early 2007.
*Rx: .5 mg clonazepam for restless body and a 7.5 APAP hydroco as needed every 4 hours
*Two weeks ago I pulled both sides of my hips out of place. My right hip inflammed so badly I thought I'd finally put on some weight because my pants fit better. I was off work on the 8th under doctor's orders.
*I have stereotypically low blood pressure. I average at 110/65-70.
*I'm still within healthy height / weight, but have lost about 25 pounds in the last year. (Stress and illness.) 5'6" 130lbs
*I promise to be super patient and answer everyone's questions and take all advise into consideration. I should hope so; that's why I'm asking.
*I'm asking you guys to have a better idea what to ask my rheumy (or whomever) next month.
Thanks!
UPDATE: So most of my problem was dietary. I've eaten 2/3 of my calories before 2p for a week. I've also been super vigiliant about taking all my vitamin suppliments properly (meaning with food). It's helped significantly. I'm still going to take the list of weird symptoms in to the doctor's, along with your experienced questions. Thanks for taking the time to help!