Serotonin Sensitivity!

Yesterday my Salvation Army support person turned up with three presents from a nearby school. I assumed they were boxes of chocolate and was considering just adding them to the donations pile at Tesco because of the fact I’m really sensitive to changing my diet at the moment and wary of anything upsetting the delicate balance of my mood, or my skin itchiness due to dermatitis.

Anyway I opened one of the presents and it was a Cadbury’s milk tray. I hadn’t eaten chocolate for ages, probably two years, and honestly the mood boost was incredible. It actually helped to get out of OCD. An issue I have with chocolate (or any similar foods) is I eat it too quickly until it’s all gone. I ate 7 then put the box somewhere which takes multiple steps to retrieve :).

An amazing benefit of having a consistent diet is that you can immediately figure out if you have food allergies or reactions to new things. I never had any such issues with food until 2016 when I originally developed dermatitis/eczema. Since then I’ve ruled out alcohol because of the ferocious itch it causes in my skin now, as well as things like salted peanuts or similar things. Basically the simpler the raw ingredients I use the better for my skin. My mood is also very very sensitive to food, which was something I figured out in my teenage years (but not nearly as sensitive as to exercise, haha).

MSG And Itch

I recently rediscovered marmite again and my skin became lava. I couldn’t sleep without taking paracetamols and ibuprofens (and hence why I started taking those often! they also had the side effect of helping with knee pain). After 3 days I worked out it was probably the monosodium glutamate in Marmite.

Marmite has 1750mg of monosodium glutamate in every 100g: more MSG than any other substance in the average British larder.

Prospect Magazine

MSG is one of several forms of glutamic acid found in foods, in large part because glutamic acid (an amino acid) is pervasive in nature. Glutamic acid and its salts may be present in a variety of other additives, including hydrolyzed vegetable protein, autolyzed yeast, hydrolyzed yeast, yeast extract, soy extracts, and protein isolate, which must be specifically labeled.

Wikipedia

So when salt (which provides the sodium) is added to yeast extract (which provides the glutamates) to create Marmite or Vegemite etc., the result is lots of MSG, even if the label says “no added MSG”. Anyway I’m not saying anything about the nutritional value of MSG, simply that it’s apparently a problem for me because of this reaction. And getting an answer to “Does Marmite contain MSG?” is needlessly complicated! It might just be the glutamates causing the problem, in any case.

Chocolate And Itch

What happened yesterday when I tried chocolate was I developed an unbearable itch which stopped me sleeping for hours. And because I know it was the only thing I changed in my diet yesterday I had inspired the idea to research chocolate and itching!

This article (some stuff I already knew with SSRIs and itching) was a bit of a revelation:
Itch and skin rash from chocolate during fluoxetine and sertraline treatment: Case report

Key parts:

The skin contains a system for producing serotonin as well as serotonin receptors. Serotonin can also cause pruritus when injected into the skin. SSRI-drugs increase serotonin concentrations and are known to have pruritus and other dermal side effects.

After approximately two weeks of sertraline treatment he noted an intense itching sensation in his scalp after eating a piece of chocolate cake. The itch spread to the arms, abdomen and legs and the patient treated himself with clemastine and the itch disappeared. He now realised that he had eaten a chocolate cake before this episode and remembered that before the first episode he had had a chocolate mousse dessert. He had never had any reaction from eating chocolate before and therefore reported this observation to his doctor.

This case report suggests that there may be individuals that are very sensitive to increases in serotonin concentrations. Dermal side reactions to SSRI-drugs in these patients may be due to high activity in the serotonergic system at the dermal and epidermo-dermal junctional area rather than a hypersensitivity to the drug molecule itself.

(SSRIs inhibit re-absorption of serotonin thus increasing its concentration).

Also:

Serotonin can induce nasal itch, sneeze and hypersecretion.

Now the nasal symptoms are something I’ve already noticed and thought it might be due to my living within one room all the time, even though I keep it clean. It could be a combination, or it could just be Sertraline.

But the stuff about serotonin sensitivity and how certain foods can upset this balance whilst taking SSRIs makes so much sense. Even the fact that serotonin occurs naturally within foods was total news to me— I hadn’t realised it was that basic of a chemical.

Serotonin Sensitivity

If anyone has serotonin sensitivity, it is so me! My god, this is exactly what I’ve felt whilst taking Sertraline. Whilst previously taking Elvanse (lisdexamphetamine) for ADHD, and now Sertraline, with both medications I’ve found extreme food sensitivity in how well they work for me. And since I’m so hypersensitive to sensations within my body and the effects of foods, I was able to figure out which foods maximise the effect. Sertraline can go from not working at all (and causing me serotonin syndrome) to making me feel almost high, depending on what I eat. I can balance the effect of Sertraline with coffee and exercise to give me the level I want.

The benefit for me from exercise is also highly dependent on what I eat both before and after.

The effect of Sertraline (or Elvanse) were both highly dependent on exercise (which boosts serotonin & other things).

If I miss a dose of Sertraline, I start suffering within 12 hours. Within 6 hours I can tell by how I feel whether I’ve forgotten to take it. It is not nice if I forget to take the evening dose before going to bed. I split my dose into two precisely because I’m so sensitive to the rise and fall of serotonin concentrations within my body throughout the working of the medication. If I don’t spread it, the high is too great and the low sends me into OCD.

Serotonin And Itch

Bonus info on relation between eczema and serotonin:

The serotonin receptor, HTR7, caught the scientists’ attention because the itchiest mice expressed the most HTR7 in the neurons that innervate the skin, and because abnormal serotonin signaling has long been linked to a variety of human chronic itch disorders, including eczema.

Serotonin receptor is involved in eczema and other itch conditions

However, the reaction of skin to serotonin from food is poorly studied and further studies are necessary to determine how much alimentary serotonin can increase serum serotonin concentrations and to what extent SSRI-medication affects this process. More knowledge in this field could be of help for physicians who encounter patients with dermal reactions to SSRI-drugs and there might be food and beverages containing serotonin that these patients should avoid.

Itch and skin rash from chocolate during fluoxetine and sertraline treatment: Case report

👀

I’ve always been itchy, and it’s always been very linked to my mood. My skin is extremely sensitive in general. Eczema is a really big deal for me. But I love the internet.

🌪