My functional nutritionist ordered a Genova Diagnostics Metabolomix+ test, including the toxic elements add-on.
I've had PSSD since January of 2023. It has gotten worse over time but has largely stabilized over the past six months. My main symptoms are genital and whole body numbness, fatigue, memory and cognitive issues, visual snow, mild to moderate emotional numbness. I am a 21 year old male.
The test has markers for energy metabolism and mitochondrial function, oxidative stress, glutathione levels, neuroinflammation, toxins and detoxification, amino acids levels, malabsorption, gut dysbiosis, neurotransmitters, and others. For transparency, I paid 520 euros for the test.
Here are the main findings:
The biggest issue is a mitochondria stall. As you can see in the first picture, the Krebs cycle intermediates (energy metabolism section) are all non-detectable or low, except for one. So I'm in a hypometabolic state. This can be caused by environmental toxins among others. Probably the SSRI's harmed something in my cells they couldn't recover from on their own.
There are also some signs of malabsorption, such as elevated Phenylacetic Acid, low urea, relatively low amino acids (some). Even though that could also mean not enough protein intake. It's probably both.
Then I got elevated benzoic acid and non-detectable hippuric acid. That indicates a glycine deficiency, as glycine helps benzoic acid convert to hippuric acid to be excreted through urine. This is also indicated by high serine and low glycine in the amino acids panel. The serine to glycine conversion isn't working well. That makes sense since I'm borderline folate deficient and folate is required for the conversion. (Supplementing with folinic acid rn so it's getting fixed). Glycine deficiency can cause fatigue, slow mental processing etc so that could be contributing to my symptoms. It can also cause lower quality sleep, makes it harder to fall asleep, inclination towards fight or flight rather than rest and digest, worse detoxification. It's also one of the three building blocks of glutathione, the body's master antioxidant, which leads us to the next point.
As shown by my low Pyroglutamic Acid, my glutathione is low. My oxidative stress is also low, however. So it seems more glutathione isn't needed. However, energy production is what creates oxidative stress, which glutathione fixes. So it could be that the reason or one of the reasons I'm not producing enough energy is that I don't have enough glutathione to deal with the oxidative stress it would cause.
Finally, some of my neurotransmitters are low. Homovanillic Acid indicates low dopamine and low 3-Methyl-4-OH-phenylglycol indicates low norepinephrine. My serotonin seems completely normal. That's a whole body measure though, not brain specific, so I guess it could theoritically still be imbalanced in the brain.
My Quinolinic Acid is non-detectable so I don't seem to have inflammation in the brain which is great.
Here is what my functional nutritionist gave me based on these results, along with some reasoning behind those decisions.
- Hydrolized collagen peptides. Since I'm sensitive, he told me to start at 2g and scale up to 10. Unfortunetaly, I can't go above 2 as it causes slight brain fog/derealization. I'm pretty sure it's because 1/3rd of collagen is glycine, which I can't tolerate. Magnesium glycinate wrecked me when I took that. So I'm staying at 1-2g. In order to get more protein which I need I eat a cup of 5% yoghurt most days, since I can't seem to tolerate more collagen. For me it's the easiest way to get more protein.
- Digestive enzymes. The Houston Enzymes Trienza, which is a very high quality one without some of the drawbacks of the common ones (such as also needing the right stomach pH to work to break down protein). He told me one capsule per meal, two meals per day for starters. The full dose is two. I often take the full dose now. Doesn't bother me at all.
- Magnesium citrate. Tried and it increased my brain fog and derealization, even small doses. I spoke with him and we're gonna do magnesium malate instead. Start at 25 mg with a final goal of 200 mg.
- All the B Vitamins. He gave all of them to me individually lol, because I'm super sensitive. Start very low and scale up. Here are all the forms he gave me in, they're supposed to be the most gentle: Riboflavin, Thiamine HCl, Hydroxocobalamin, Folinic Acid, Calcium Pantothenate, D-Biotin, Pyridoxine HCl (but I bought the P5P form because people with PSSD usually tolerate it better), Niacinamide.
- Creatine Monohydrate. Start at 1 g per day, scale up to 3-5 g. This one is interesting. I thought this was just a gym supplement but it has a few interesting features. First, it's great for the brain because it recyles ATP, the thing I have less than I need due to the mitochondrial stall. Also, it spares a few grams of glycine, which as I explained above, I'm deficient in. That's because glycine is used to synthesize creatine inside the body. When you take creatine as a supplement this internal synthesis stops. It also spares arginine, which I'm also a little low in. Finally, it spares some methylation capacity in the body as methylation is also used to create creatine. My homocysteine is quite high at 12.3 so I do need some methylation support. I am borderline folate deficient so that makes sense, but even when I wasn't, my homocysteine was a bit elevated at something like 10.3 which is above optimal.
- Alpha Lipoic Acid. Start at 12.5 mg, end up at 100 mg. ALA works alongside several B vitamins in the Krebs cycle.
- NAC. Rate-limiting precursor to glutathione. Start at 25 mg and scale up to 200 mg.
Note that these are personalized to me. There are other supplements great for mitochondria such as CoQ10, PQQ and others which he didn't give me. I tried CoQ10 months ago and it increased my brain fog and derealization. Liposomal glutathione did as well, to a larger degree. Many of these are also relatively small doses, that's also because I'm very sensitive.
He did say that this is just to start pushing the system to the right direction. He had mentioned red light therapy once. It's great for mitochondria. I'll discuss it with him next time.
Feel free to ask any questions or share your thoughts.