An n=1 anecdote/cautionary tale

As is obvious, I’m currently on long service leave, travelling in our new caravan with my lovely hubby of 35 yrs. This trip has been long-planned and anticipated after all the cancer crap I went through last year.
We left on the 1st of July and I should have been feeling wonderful. Instead, I was gripped with horrible anxiety and a return of depression that I had not felt for more than 20yrs.
I couldn’t figure out what the hell was going on - why would I be feeling dread and anhedonia, instead of joy and relief? Rob was equally confused - why was I miserable and irritable every day, with bouts of crying? We were supposed to be on holidays and happy.
I even doubled my (very low) dose of anti-depressants. For context, I had never done this in 15yrs of taking them - not even during cancer treatment.
This feeling had started a couple of weeks before we left. I had put it down to the stress of trying to get out the door and worrying about border lockdowns. As it continued, I blamed disruptions in routine, but was very confused.
What I had also done a couple of weeks before I left was started to take a daily large Vitamin B complex pill. Why? I never take vitamins, apart from the occasional Vit D during winter, when I remember.
But I’d seen a few people on the camping forums recommend Vit B as a good way to avoid getting bitten by sandflies and midges in northern Qld and NT. I HATE sandflies. I remember what I went through in Thailand many years ago when I’d been bitten all over.
So I started taking one of these every day. Then, a few days ago, I was asking a chemist up here about Vit B for bug bites and she told me not to bother - she said I’d need really massive doses for it to have any effect.
So I stopped taking the Vit B complex three days ago. And guess what? All anxiety/depressive symptoms GONE. Rob noticed the difference straight away and I felt this enormous sense of relief as my normal robust mood restored.
But it’s still taken me a couple of days to put two and two together. The timing and the pronounced changes in my mood in a short time frame. I should have twigged.
I looked it up:…
Are Vitamins Triggering Your Anxiety? ( You'd think I - of all people - should have known this, but I don't personally research supps and I'm not a dietitian by background.
I’ve always been very sensitive to anything I take - something about the way my liver processes things, I only ever need small doses of anything for a large effect. And I never take nutritional supplements as a general rule.
But I just didn’t think about this as I was taking them to prevent bug bites - not for any other reason. So I don’t suspect placebo/nocebo as the explanation.
Of course it could all just be coincidence - I was stressed getting out the door and having a change of routine and now I’m in the swing of things. But really - the timing is exactly in line with when I started and stopped taking them & the changes/effect were really pronounced
Key message? Just because something is ‘natural’ doesn’t mean it can’t hurt you. DUH! I’m such an idiot. I'm interested to hear if others have had this experience with Vit B.
Interesting - in this RCT, folate nullifies the effect of Lamotrigine in Bipolar Disorder

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More from @FeliceJacka

2 Aug
1/n Warning: long thread approaching (I should have done it as a blog, but that requires too much effort on LSL). Hi @ChrisPalmerMD and @evolutionarypsy. I haven’t forgotten our Twitter convo on the KD in relation to diet and the gut microbiota...
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@dnunan79 @ellenfallows Lots to discuss here and I'd strongly welcome input. Will address qs and issues in a thread here:
SMILES was the only RCT conducted in a depressed population included in our recent meta-analysis (
@dnunan79 @ellenfallows Findings are consistent with the observational evidence (e.g.
@dnunan79 @ellenfallows Plenty of limitations (I’ll put links to papers at the end)

1. Small sample size. We’d hoped/intended to recruit nearly 170 and managed less than n=70 after three years of trying. A shoe-string budget didn’t help
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