5 ms·

I wonder if antidepressants protect your gut microbiome and the SSRI aspect is over stated. Would be very hard to disambiguate those two effects I suspect.

theGnuMe 4y ago
Yeah the gut microbiome is the next big thing for sure. It should be easy to study. Food logs, mood logs, medication logs, next generation sequencing and maybe some metabolic profiling and we should be able to find interesting correlations. I know my mood changes drastically down when I fail to eat properly for a period of time.
- __MatrixMan__ 4y ago
  As if omics research isn't hard enough, there's a confounding layer of privacy and incentive problems here. From a science angle it makes more sense to just collect this data from everybody all the time and let the studies be post hoc explorations of that giant dataset. But how do you get people to cooperate when they have reason to believe that the data will be used against them? Either we accept the diminished value of isolated study-at-a-time datasets (as we're doing now), we figure out how to do this kind of research through a layer of homeomorphic encryption which the layman trusts (a tall order), or we wait for an era with more trustworthy institutions (potentially a long time). For this reason, I think it'll be like fusion power: the perpetual "next big thing".
  - Pilottwave 4y ago
    give out equity to the study participants. I'll hand over data of you give me some equity on future ideas built on that data. l Like artists getting payed royalties.
- John23832 4y ago
  > Yeah the gut microbiome is the next big thing for sure. It should be easy to study. It won't be. We aren't able to culture most gut bacteria. Most die immediately in oxygen. The best we can do at the moment is correlation.
lr4444lr 4y ago
That was exactly my first thought. We could definitely throw the SSRI efficacy into doubt though by sampling CS fluid or something for actual serotonin content in cohorts who are subjectively feeling improved by SSRIs.
- andy_ppp 4y ago
  It would also explain why SSRIs take time to work - as I understand it the SSRI action is immediate and yet it takes weeks for people to notice the effects.
  - kayodelycaon 4y ago
    SSRIs aren’t the only medication that requires weeks to work.
- NickM 4y ago
  SSRI efficacy is already in doubt, as roughly 80% of the beneficial effects are replicated by placebos; some research has suggested that the remaining difference is due to the side effects, which make SSRIs active placebos and mess with study blinding. And, even if they are better than just an active placebo, the mechanism is probably not the effects on serotonin levels. (Discussed previously here: https://news.ycombinator.com/item?id=32160703 https://news.ycombinator.com/item?id=32160703)
  - deleted 4y ago
    [deleted]
- deleted 4y ago
  [deleted]
nerdponx 4y ago
But SSRIs reverse depression symptoms, they don't prevent it from happening in the first place. so the mechanism would have to be not just protection but some kind of restoration or rebalancing, maybe by selectively protecting some bacteria but not others. That seems a little less plausible to me.
- tokai 4y ago
  SSRIs do lower the risk of further depressive episodes. "To conclude, this review provides evidence that continuing SSRIs for 1 year reduces risk of MDD and relapse." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5761909/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5761909/
  - password11 4y ago
    I took SSRIs for 14 months and after I stopped this was my subjective experience as well. (And luckily only mild withdrawal/discontinuation symptoms.)
zackmorris 4y ago
Good insight. I went through a profound burnout in 2019 after I lost my digestive health and got low serotonin due to a combination of work stress, overtraining at the gym, dehydration and a finger of booze after particularly hard days. Also food sensitivities to legumes, nightshades and almond butter, which I wasn't aware of at the time. I just learned that 25% of people who get food poisoning go on to develop IBS. Don't eat gas station sushi when you're on vacation! https://experiencelife.lifetime.life/article/the-food-poisoning-ibs-connection/ https://experiencelife.lifetime.life/article/the-food-poison... Ashwagandha basically restored my gut health in 3 months, in combination with psyllium husk capsules, kefir, and large plain lettuce salads with a vinegar-based dressing. My theory is that my cortisol levels got so high after decades of stress and negative reinforcement that I had symptoms like Cushing's syndrome. So ashwagandha mopped that up, which raises testosterone/estrogen and probably fixes a whole host of issues. But I never tested those levels, so take that with a grain of salt. I've experienced the connection between gut health and mood, now I do everything I can to stay in good shape. But I've noticed a resistance to this line of thinking, especially in older people who just want a pill from their doctor.
- deleted 4y ago
  [deleted]
- nick__m 4y ago
  Your are sensitive to plants from the nightshade family and you take ashwagandha? Either your ashwagandha doesn't contains active substances or you are not really sensitive to plants from the nightshade family.
- PragmaticPulp 4y ago
  > profound burnout in 2019 after I lost my digestive health and got low serotonin due to a combination of work stress, overtraining at the gym, dehydration and a finger of booze after particularly hard days. Also food sensitivities to legumes, nightshades and almond butter, which I wasn't aware of at the time Ashwagandha is a nightshade, so you likely weren't allergic to nightshades if it helps. Also, I'm not sure how you concluded that you have "low serotonin" due to gut issues. Serotonin in the gut doesn't migrate to the central nervous system. It serves different purposes throughout the body, but the synthesis in your brain remains local to the brain. There are a lot of unrealistically specific claims in your post about cortisol and serotonin, but it's impossible to make such specific diagnoses. You might be reading too much into the alternative medicine world that misuses surface-level knowledge about hormones and neurotransmitters to provide false comfort. Real medical diagnoses aren't so specifically centered on singular chemicals.
alienalp 4y ago
Most SSRI doesn't do much. The ones that work seems like related to dopamine metabolism. SSRI aspect is already debunked. Fluoxetine for example works and i think additionally confirmed by dramatically increased mortality since depression should decrease mortality which is why it exists.

theGnuMe 4y ago

Yeah the gut microbiome is the next big thing for sure. It should be easy to study. Food logs, mood logs, medication logs, next generation sequencing and maybe some metabolic profiling and we should be able to find interesting correlations. I know my mood changes drastically down when I fail to eat properly for a period of time.

__MatrixMan__ 4y ago
As if omics research isn't hard enough, there's a confounding layer of privacy and incentive problems here. From a science angle it makes more sense to just collect this data from everybody all the time and let the studies be post hoc explorations of that giant dataset. But how do you get people to cooperate when they have reason to believe that the data will be used against them? Either we accept the diminished value of isolated study-at-a-time datasets (as we're doing now), we figure out how to do this kind of research through a layer of homeomorphic encryption which the layman trusts (a tall order), or we wait for an era with more trustworthy institutions (potentially a long time). For this reason, I think it'll be like fusion power: the perpetual "next big thing".
- Pilottwave 4y ago
  give out equity to the study participants. I'll hand over data of you give me some equity on future ideas built on that data. l Like artists getting payed royalties.
John23832 4y ago
> Yeah the gut microbiome is the next big thing for sure. It should be easy to study. It won't be. We aren't able to culture most gut bacteria. Most die immediately in oxygen. The best we can do at the moment is correlation.

lr4444lr 4y ago

That was exactly my first thought. We could definitely throw the SSRI efficacy into doubt though by sampling CS fluid or something for actual serotonin content in cohorts who are subjectively feeling improved by SSRIs.

andy_ppp 4y ago
It would also explain why SSRIs take time to work - as I understand it the SSRI action is immediate and yet it takes weeks for people to notice the effects.
- kayodelycaon 4y ago
  SSRIs aren’t the only medication that requires weeks to work.
NickM 4y ago
SSRI efficacy is already in doubt, as roughly 80% of the beneficial effects are replicated by placebos; some research has suggested that the remaining difference is due to the side effects, which make SSRIs active placebos and mess with study blinding. And, even if they are better than just an active placebo, the mechanism is probably not the effects on serotonin levels. (Discussed previously here: https://news.ycombinator.com/item?id=32160703 https://news.ycombinator.com/item?id=32160703)
- deleted 4y ago
  [deleted]
deleted 4y ago
[deleted]

nerdponx 4y ago

But SSRIs reverse depression symptoms, they don't prevent it from happening in the first place. so the mechanism would have to be not just protection but some kind of restoration or rebalancing, maybe by selectively protecting some bacteria but not others. That seems a little less plausible to me.

tokai 4y ago
SSRIs do lower the risk of further depressive episodes. "To conclude, this review provides evidence that continuing SSRIs for 1 year reduces risk of MDD and relapse." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5761909/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5761909/
- password11 4y ago
  I took SSRIs for 14 months and after I stopped this was my subjective experience as well. (And luckily only mild withdrawal/discontinuation symptoms.)

zackmorris 4y ago

Good insight. I went through a profound burnout in 2019 after I lost my digestive health and got low serotonin due to a combination of work stress, overtraining at the gym, dehydration and a finger of booze after particularly hard days. Also food sensitivities to legumes, nightshades and almond butter, which I wasn't aware of at the time. I just learned that 25% of people who get food poisoning go on to develop IBS. Don't eat gas station sushi when you're on vacation! https://experiencelife.lifetime.life/article/the-food-poisoning-ibs-connection/ https://experiencelife.lifetime.life/article/the-food-poison... Ashwagandha basically restored my gut health in 3 months, in combination with psyllium husk capsules, kefir, and large plain lettuce salads with a vinegar-based dressing. My theory is that my cortisol levels got so high after decades of stress and negative reinforcement that I had symptoms like Cushing's syndrome. So ashwagandha mopped that up, which raises testosterone/estrogen and probably fixes a whole host of issues. But I never tested those levels, so take that with a grain of salt. I've experienced the connection between gut health and mood, now I do everything I can to stay in good shape. But I've noticed a resistance to this line of thinking, especially in older people who just want a pill from their doctor.

deleted 4y ago
[deleted]
nick__m 4y ago
Your are sensitive to plants from the nightshade family and you take ashwagandha? Either your ashwagandha doesn't contains active substances or you are not really sensitive to plants from the nightshade family.
PragmaticPulp 4y ago
> profound burnout in 2019 after I lost my digestive health and got low serotonin due to a combination of work stress, overtraining at the gym, dehydration and a finger of booze after particularly hard days. Also food sensitivities to legumes, nightshades and almond butter, which I wasn't aware of at the time Ashwagandha is a nightshade, so you likely weren't allergic to nightshades if it helps. Also, I'm not sure how you concluded that you have "low serotonin" due to gut issues. Serotonin in the gut doesn't migrate to the central nervous system. It serves different purposes throughout the body, but the synthesis in your brain remains local to the brain. There are a lot of unrealistically specific claims in your post about cortisol and serotonin, but it's impossible to make such specific diagnoses. You might be reading too much into the alternative medicine world that misuses surface-level knowledge about hormones and neurotransmitters to provide false comfort. Real medical diagnoses aren't so specifically centered on singular chemicals.

alienalp 4y ago

Most SSRI doesn't do much. The ones that work seems like related to dopamine metabolism. SSRI aspect is already debunked. Fluoxetine for example works and i think additionally confirmed by dramatically increased mortality since depression should decrease mortality which is why it exists.