LindsayYou would never have guessed it from my tough tomboy-ish demeanor, but I was kind of a sensitive kid growing up. I remember feeling like the world was ending when someone was sad, and feeling the heaviness of other people’s emotions on a physical level. I just thought that was part of the human condition.
My parents split up when I was 13. They told my sister and I one night after dinner, and that same night my mom took her prepacked suitcase that somehow I hadn’t noticed sitting next to the front door, and moved into a new house. My parents made a decision to separate, went house hunting, made an offer, went through escrow, and had furniture delivered before there was ever any sign that something was wrong. In fact, 30+ years later, I have still never seem them argue, although there are fewer opportunities, now that my mom is dead. But looking back, I remember feeling physically uncomfortable every time they were in the same room, even years before the divorce.
I’m not an empath, or anything of the sort. I’m too big of an asshole for that and I’m not at all insightful. But sometimes I respond to external stimuli, like bright lights, certain smells, and loud noises. I startle very easy and have overly active reflexes – the most sensitive any of my doctors have ever seen. I don’t respond well to change and I can feel husband’s stress, even if he hasn’t said a word. And sometimes, especially when I’m already feeling overwhelmed, I feel discomfort or pain in my chest in response to external emotions.
I always chalked up the sensitivity to mismanagement of my own emotions. I came from a family of scientists on one side and depression-era practicalists on the other, where emotions were viewed as liabilities. In my 20s I found myself with a college degree in one hand and a broken heart in the other, finally learning how to just feel. For a long time, I thought it was easier to respond to others’ emotions rather than learning to identify my own. It probably was.
But once I received my POTS diagnosis, it all made sense. Our nervous systems are made up of the sympathetic and parasympethic systems. In POTS, the sympathetic nervous system is often stuck in overdrive, and as a result, it can be difficult to get out of fight-or-flight mode. So any stimuli that ignites my sympathetic nervous system increases my already excessive adrenaline and presents physically as typical exaggerated norepinephrine, including physical discomfort in the chest. When I was younger, I though it was pain in my heart, and found almost a romance in the idea that maybe my heart hurt because it was too full with love. But in reality, the pain or discomfort likely emanates from the vagus nerve. Less sentimental, but perhaps equally interesting.
For those of you with a passing interest in genetics, I have mutations in all of my COMT genes. My sensitivity is essentially written into my DNA. And if you have read this blog long enough, you know that the sensitivity isn’t limited to external stimuli, but also extends to things I put inside my body. Like medications. To the point where I can feel how my body reacts to three drops. And that’s how I started the low dose naltrexone (LDN)…three measly little drops.
Let me back up for a moment for those who aren’t familiar with LDN. Naltrexone is an opioid antagonist. It blocks the euphoric affects of opioids and other drugs on your brain, and thus is often prescribed to help fight addiction. It can also block the affects of other drugs and alcohol. If you took narcotics while on naltrexone, you wouldn’t feel high, but your body would still process the drugs. It can be dangerous to take both at the same time, as it’s easy to overdose on narcotics when you’re not feeling the effects.
Naltrexone is generally prescribed for drug addiction at 50mg. In the 1980’s, a physician was searching for a drug that could raise endorphins in HIV patients, but didn’t completely block the effects of opioids. So, he experimented with low doses of naltrexone ranging from 1 mg to 4.5mgs and found that it raised patients’ endorphins and as a result, boosted their immune systems.
Studies have shown that low doses of naltrexone, especially when taken at night, can help improve a variety of autoimmune and other conditions. The body’s highest production of endorphins occurs between 2:00 am and 4:00 am. When taken before bed, LDN helps increase that production. Endorphins decrease inflammation and help relax an overactive immune system. They also relieve pain, reduce stress, and make us happy.
In recent years, there has been an increasing interest in prescribing LDN for POTS. While (at least to my knowledge) LDN doesn’t have any cardiac benefits, it can help with pain, fatigue, and brain fog – common symptoms of POTS. My heart rate is well controlled these days, so I’m on board with anything that could potentially help with pain and brain fog without affecting HR or BP. Add in LDN’s minimal side effects, and I was dying to try it.
Except that I’m a coward, and throwing back a 1.5mg pill prescribed by my doctor requires more courage than I have. So, I followed instructions for diluting it in water. Dissolving a 1.5mg pill in 15mL of distilled water equals 0.1mg of LDN per 1 mL. Throw the pill in the bottle, shake it up, give it an hour to dissolve, and BOOM…very low dose naltrexone. Using a 1 mL dropper, I could measure out 0.1mg at a time. But, like always, I started with a much smaller dose. Just 3 drops of LDN to test it out.
I want to be clear about something here. I counted it out, and 1 mL is 24 drops of LDN. So, my three drops is 0.0125 mg. That’s basically an immeasurable amount of LDN. There’s probably more dog hair than LDN in my three drops. The standard dose of naltrexone for addiction is 50 mg. The standard dose of LDN is 4.5mg. The pills I was prescribed – which my doctor felt was a perfectly safe dosage – are 1.5mg. That’s still 120x my tiny dose of three drops.
But while my fear might seem unwarranted, it is in fact justified. I had a fairly moderate headache and vivid dreams – common side effects of LDN – with just three drops. The vivid dreams were intense and woke me regularly throughout the night. It also felt as if my adrenaline was increased. I have an Apple Watch that I use to track my resting heart rate. Before starting LDN, my average daily HR was 54. I still had standing tachycardia, but dropping into the 40s at night helped keep the average low. My average resting HR on three drops of LDN was 67. Still a healthy average, but an increase of 13 bpm on three drops of anything is a pretty significant response.
But the sensitivity isn’t limited to negative effects. The three drops of LDN also had a noticeable improvement on my pain levels. It took a day or two to notice, but moving was easier. Pain didn’t wake me up throughout the night. And I had a better range of mobility. I never expected such a major response from something so minor.
The side effects improved after a week at 3 drops, and I finally worked my way up to 0.4mg, but the adrenaline effect became unbearable at that point. I’ll discuss that in the next post, because the journey is still important. And because I have a plan B.
David Jones once said, “It is both a blessing and a curse to feel everything so very deeply.” And right now, I’m feeling that quote pretty deeply.
Smell ya later.
– Linds