A treatment for schizophrenia

An article I wrote on the etiology of schizophrenia, Treatment-resistant schizophrenia: focus on the transsulfuration pathway, was published in Reviews in the Neurosciences. Treatment resistant schizophrenia is not a different kind of schizophrenia rather treatment resistant schizophrenia is a very severe schizophrenia. All schizophrenia is severe. The treatment section of the paper is out of date.

Everything should be made as simple as possible, but not simpler. – Albert Einstein.

First of all, a lot my suggestions sensibly should not be followed. I am stumbling around more than a bit. Any advice on the Web on supplements to be followed must pass an absolutely extraordinary set of tests. .

The suggestions must be safe. Tests must be readily available to check for safety. The suggested supplements must work very quickly.. I am talking on the order of a week. The effects of the supplements must be very dramatic. What is more supplements must target very specific symptoms of mental illness. That is very important. The suggested supplements must not be oversold. Given the suggested supplements are taken individuals could still feel far below par.

Carbonyl iron for psychosis passes this extraordinary set of tests.

Iodide from kelp and L-tyrosine for sadness passes this extraordinary set of tests.

Se-methylselenocystiene for anosognosia and disorganization passes this extraordinary set of tests.

Very high dosages of thiamine could be helpful. 300 mg of thiamine taken 3 times a day could be needed.. Lower dosages of thiamine would be tried first.. Supplemental vitamin B6 can also be helpful. No more than 50 mg of vitamin B6 is taken twice a day.

Ill individuals would still require a neuroleptic. Low dosages of risperidone could be the neuroleptic of choice due to the high 5-HT2A to dopamine D2 binding ratio of low dosages of risperidone. Risperidone could be taken once a day at bedtime. The risperidone would not be for psychosis but rather would treat an intensely spaced out feeling.

If my advice on supplements is not followed then my advice is not to take any advice on supplements given on the Web, not to take any supplements except perhaps a Centrum, eat balanced meals, exercise and reduce stressors in life. Avoid sodas, all citric acid based drinks and limit coffee and tea to a couple of cups a day. The Goldilocks rule should be followed in terms of psychiatric medications. Not too much medicine and not too little medicine is the right amount of psychiatric medicine to take.

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With a dysregulation of the transsulfuration pathway (homocysteine to L-cysteine) sufficient L-cysteine for iron-sulfur cluster formation is not synthesized. Sulfur for iron-sulfur cluster biogenesis is derived from L-cysteine. Supplemental iron increases levels of iron-sulfur proteins. Supplemental iron can partly compensate for dysregulation of the transsulfuration pathway in schizophrenia. Selenomethionine, the food form of selenium is metabolized by enzymes in the transsulfuration pathway. Metabolism off Se-methylselenocysteine by-passes the transsulfuration pathway whereby Se-methylselenocysteine can provide bioavailable selenium for individuals with schizophrenia. Taurine is synthesized from L-cysteine. With L-cysteine not synthesized appropriately taurine will not be synthesized at appropriate levels. Taurine is needed to form various bile acids. With low levels of taurine there will not be sufficient taurine conjugated bile acids. Fat absorption requires bile acids. With low levels of taurine due to low levels of L-cysteine fat absorption will be impaired. Supplemental taurine will compensate for low levels of taurine due to low levels of L-cysteine which are in turn due to dysregulation of the transsulfuration pathway. Taurine by sparing L-cysteine will also increase levels of L-cysteine. Taurine will assist in the absorption of fatty acids. The SMVT is dysregulated, likely due to dysregulated sodium homeostasis attendant on dysregulation of taurine.

. Treatment

Approximately 600 milligrams of iron from carbonyl iron is taken once a day at bedtime. at least 6-7 hours away from the last cup of coffee of the day given coffee is drunk. There are way too many interactions of iron with drinks, for example, coffee, and supplements for iron to be taken more than once a day. Changes in iron levels in the gastrointestinal tract due to drinks, and/or supplements can be huge difficulties so iron from carbonyl iron must be taken so there are minimal interactions of iron in the gastrointestinal tract with drinks, for and/or supplements. Iron from carbonyl iron is slowly absorbed from the gastrointestinal tract which is highly beneficial. Carbonyl iron is a very safe form of iron. Supplemented carbonyl iron must, of course, be carbonyl iron that is marketed as a supplement. Anemia panels must be obtained to insure that iron levels are not high.

200 micrograms of selenium from Se-methylselenocysteine is taken once a day.

Amino acids are taken away from food.

3 grams of 2:1:1 mixture of branched-chain amino acids are taken three times a day. Branched-chain amino acids are metabolized by the biotin-dependent enzymes, methylcrotonyl CoA carboxylase and propionyl-CoA carboxylase.%

1000 mg. of taurine is taken 3 times a day.

When intracellular taurine increases above physiological level there is an effux of sodium and taurine via the Na/taurine symporter.. A symporter transports both molecules in the same direction.Taken long term taurine increases extracellular sodium levels.

200 mg of magnesium from magnesium oxide is taken twice a day. I do not have gastrointestinal difficulties with magnesium oxide. This could be due to taking taurine with magnesium oxide. The only formulation of magnesium taken is magnesium oxide. Magnesium oxide is highly soluble and is available in the gut. Calcium supplementation must be avoided when supplementing with magnesium oxide. More than 200 mg. of magnesium taken twice a day from magnesium oxide is not better.

There is apparently a difficulty with calcium metabolism but the difficulty in calcium metabolism is secondary to a difficulty in magnesium metabolism. TRPM6 which is associated with hypomagnesemia with secondary hypocalcemia, and which is highly expressed in the gut, is a likely suspect.Whether magnesium in the gut is affecting calcium utilization indirectly via vitamin D or more directly via TRPM6 is not clear. A magnesium enriched diet stimulated TRPM6 mRNA expression in colon.. The fact that magnesium oxide, which is apparently poorly absorbed, is the most effective magnesium supplementation form, argues for a direct connection of magnesium on calcium absorption in the gut via TRPM6. TRPM6 is regulated by estrogens but not by 1,25-dihydroxyvitamin D.. Down-regulation of TRPM6 could attend menopause. Active vitamin D is mainly synthesized in the kidneys.

1000 mg of L-arginine and 1000 mg, of citrulline are taken three times a day. The arginine and citrulline must be in a 1:1 mixture. Taurine can increase activity of enzymes in the transsulfuration pathway. Hydrogen sulfide and nitric oxide work together. Taurine increases levels of nitric oxide and nitric oxide synthase. Apparently arginine can become depleted with supplemental taurine. L-arginine is rapidly metabolized, however ,citrulline can reach the kidney . Neither arginine or citrulline alone is effective and the mixture must be a 1:1 mixture.

10 milligrams of biotin is taken once once a day 5 PM. 250 milligrams of pantothenic is taken acid three times a day in away from biotin.No more than 250 milligams of pantothenic acid is taken at a time. Biotin and pantothenic acid can interfere with each other. Pantothenic kinase which is activated by pantothenic acid, is the rate limiting step in the synthesis of coenzyme A. Biotin must apparently be available in the gut so sublingual biotin is not taken. See the page on bipolar disorder on how biotin and pantothenic acid metabolism can be dysregulated. . That biotin and pantothenic acid must be taken at different times can not be overstressed, . Biotin should only be taken once a day and away from pantothenic acid. The best time to take biotin appears to be about 4-5 PM.

Very high dosages of thiamine could be helpful. 300 mg of thiamine taken 3 times a day could be helpful. Lower dosages of thiamine would be tried first.. Supplemental vitamin B6 could also be helpful. No more than 50 mg of vitamin B6 is taken twice a day.

Deficiencies of pantothenic acid are associated with neuropathy. Biotin taken more than once a day could result in neuropathy. Biotinylation of histones associated with the SMVT can decrease transcription of the SMVT. Biotinylation of histones associated with the SMVT is apparently short lived.

1000 micrograms of iodide from kelp is taken three times a day Sadness can pop up in almost any illness and everywhere depression as sadness pops could be due to dysregulation of iodide transporters. 1000 milligrams of L-tyrosine is taken with each dosage of kelp. L-tyrosine is involved in the synthesis of thyroid hormones. Sadness in all depressions could be treated by iodide from kelp, l-tyrosine and Se-methylselenocysteine. Iodide from potassium iodide reacts with too many substances with the effect of iodide from potassium iodide not dependable. Kelp and L-tyrosine are taken three times a day away from food. 200 micrograms of Se-methylselenocysteine in taken once a day. More Se-methylselenocysteine is not better.

2000 IU’s of vitamin D in capsules or as tablets is taken once a day. Approximately 300 mcg of vitamin K2 MK-7 in capsules is taken 4 times a day. Vitamin K is involved in calcium utilization. Vitamin K MK-7 is much better absorbed than other forms of vitamin vitamin K. Vitamin K MK-7 is the form of vitamin K supplemented. 1000 mg of taurine is taken four times a day. Taurine is involved in calcium homeostasis.

Olive oil is supplemented. Three tablespoons of extra light olive oil are taken a day. Extra light olive oil will contain lesser levels of polyphenols than extra virgin olive oil. .The tricarboxylic acid cycle requires acetyl-coenzyme A. Coenzyme A is synthesized from fatty acids. Supplementing with olive oil, which contains high levels of the fatty acid oleic acid, will result in the synthesis of acetyl-coenzyme A for the tricarboxylic acid cycle. Dysregulation of branched-chain amino acids degradation due to dysregulation of biotin transport, various enzymes involved in branched-chain amino acid degradation are biotin-dependent enzymes, could dysregulate beta-oxidation. Enzymes involved in branched-chain amino acid degradation are enzymes that are also involved in beta-oxidation. Olive oil would not be a supplement that would be helpful taken alone. Olive oil has beneficial effects on cardiovascular health and has been very frequently prescribed.

Blood pressure must be monitored. Individuals with low blood pressure must watch their blood pressure carefully as taurine especially when taken away from food can decrease blood pressure noticeably. Metabolic panels, anemia panels, thyroid tests and CBCs must be obtained.

The treatment could also be effective in Alzheimer’s disease. There are a lot of biological commonalities between schizophrenia and Alzheimer’s disease. See my papers Treatment-resistant schizophrenia: focus on the transsulfuration pathway and A disease-modifying treatment for Alzheimer’s disease: focus on the trans-sulfuration pathway. Indivduals could question whether taking iron from carbonyl iron for Alzheimer’s disease is appropriate. A meta-analysis, however, indicates that serum iron levels are significantly lower in AD patients than in healthy controls. Another meta-analysis also indicates that serum iron is significantly lower in patients with Alzheimer’s disease than in healthy controls. Iron from carbonyl iron is regulating aconitase 1 in the gut, the citric acid cycle in the gut and iron metabolism in the gut. As iron levels are only regulated by absorption and excretion regulating iron levels in the gut can affect iron metabolism systematically.

Iron must be iron from carbonyl iron as carbonyl iron stays in the gut for an extended time. Iron sulfate is avoided as iron sulfate is quickly absorbed. Iron bisglycinate is avoided as iron from iron bisglycinate is apparently not available in the gut. The difficulty with heme iron polypeptide is that the iron in heme iron polypeptide may not have much of an effect on iron metabolism in the gut. Supplementation with heme iron polypeptide is avoided.

Feosol carbonyl iron, 45 milligams of iron per tablet, is a brand of carbonyl iron that is effective.

Supplements should never be formulated for better absorption. Supplements must be bioavailable in the gut as well as systematically for supplements to be effective..

Taurocholic acid, derived from taurine, is a bile acid which aids in fat absorption. Supplemental taurine upregulates cystathionine beta-synthase and cystathionine gamma-lyase which are the two enzymes in the transsulfuraiton pathway (Sun et al., 2016). Supplemental taurine reduces homocysteine levels (Ahn, 2009) likely due to the upregulation of the transsulfuration pathway by taurine. Taurine reduces cholesterol levels in animals (Guo et al., 2017; Chen et al., 2012). Taurine also has an anti-obesity effect. Taurine deficiencies result in premature aging. Taurine is negatively associated with ischemic heart disease. Taurine ameliorates diabetes. The Observed Safe Level for supplementation with L-taurine is 3 grams a day (Shao and Hathcock, 2008). Supplemental taurine can by aiding fat absorption and calcium homeostasis positively affect brain function. 300 micrograms of vitamin K2 (MK-7) is taken twice a day. Vitamin K is fat soluble vitamin whose absorption could be impaired by low levels of taurine.

With deficiencies in taurine fat absorption is impaired and vitamin D and vitamin K are not absorbed from the diet. Supplemental vitamin D and supplemental vitamin K are required. Vitamin D will help with calcium absorption and and vitamin K will assist with calcium utilization. Supplemental vitamin D and supplemental vitamin K are not helpful without supplemental taurine.

Surprisingly iodide is of assistance. Thyroid tests can be apparently be normal but still supplemental iodide from kelp is required.

Below are some comments on supplements that could also be helpful and also some comments on what supplements must be avoided.

Free antioxidant supplements must be avoided. A whole lot can go askew given free antioxidant supplements are taken. Iron in the gastrointestinal tract will become dysregulated, With iron dysregulated in the gastrointestinal tract aconitase 1 in the gastrointestinal tract will become dysregulated. With aconitase 1 dysregulated in the gastrointestinal tract the TCA cycle in the gastrointestinal tract will become dysregulated. With the TCA cycle is the gastrointestinal tract dysregulated individuals will not be able to tolerate B vitamins used by the TCA cycle.

Softgels are highly effective increasing absorption via active ingredients of such softgels not being available in gastrointestinal tracts of individuals. Any softgels taken have to be bitten on though supplementing with softgels is avoided given there are capsule or tablet alternatives. Supplemental vitamin vitamin D3 MK-7 and supplemental vitamin K MK-7 as capsules or tablets are taken rather than as softgels.

EPA + DHA could be helpful. Increasing levels of EPA decreases activity of delta-5 desaturase. Delta-5 desaturase (D5D), is the rate-limiting enzyme for the conversion of dihomo-γ-linolenic acid (DGLA) to arachidonic acid (AA). In humans supplementation with EPA can decrease synthesis of arachidonic acid from dihomo-γ-linolenic acid. EPA + DHA must be about 65% EPA and 35% DHA. Softgels must be bitten and the contents swallowed. Enteric coated fatty acid supplements do not work. EPA + DHA is slightly helpful in major depressive disorder as EPA + DHA is would be slightly helpful for everyone on Western diets which are low in omega-3 fatty acids. There is likely nothing specific to EPA + DHA and major depressive disorder. The fatty acid supplement that has to be taken is extra light olive oil. .

A difficulty with polyphenols is that polyphenols complex with iron making iron unavailable in the gut. Another difficulty with polyphenols is that polyphenols can increase beta-oxidation which can result in difficulties if there are problems in fat absorption and fatty acid metabolism.

Polyphenols in sodas, coffee and tea including herbal tea can adversely affect absorption of iron. Caffeine is apparently not the culprit. Polyphenols in polyphenol supplements could be highly available and are particularly avoided.  Flavonoids are polyphenols. Flavonoid supplements are avoided.  Getting off caffeine by switching to non-caffeinated sodas and herbal teas is a disastrous move. Coffee and tea are huge interactions. Iron from carboyl iron can only be taken 6-7 hours after the last cup of coffee for the day

Seltzer water which lists only carbonated water and zip else on the ingredients label could be OK to purchase and drink. Labels must be looked at before Seltzer water is purchased. Seltzer water can not contain any natural flavors, be ‘essenced’ or contain any citric acid. Club Soda is avoided. Club Soda contains sodium citrate. One can buy devices that make carbonated water.

Getting of caffeine by switching to non-caffeintated sodas with citric acid is a disastrous move. Carbonated waters frequently add added citric acid and these carbonated waters are avoided. Perrier ‘carbonated water’ now frequently contains citric acid and natural flavors and is avoided.

Sodas, for example, Mountain Dew, as this advertisement shows  are frequently associated with goofyness where the goofyneness could be due to  polyphenols and/or citric acid in the sodas adversely affecting iron metabolism in the gut. Citric acid drinks really do befuddle thinking. Someone might say, ‘Individuals would have to consistently take substances that befuddle thinking. Is that even possible?’ I cite the terrible narcotics problem throughout the world and rest the case.

That citric acid drinks can befuddle individuals can be tested in a very straightforward way. An only citric acid and water drink with 4 grams of food grade citric acid drunk 4 times a day for 5 days would test whether citric acid befuddles individuals.

Magnesium glycinate can apparently be taken in much higher dosages than other magnesium forms, Magnesium glycinate has no effect on the gut. Spaced out feelings than arise with magnesium oxide are due to enhanced calcium metabolism. Magnesium oxide cannot be taken with a calcium supplement however with magnesium oxide supplement a calcium supplement is not required. .Magnesium glycinate does to give a spaced out feeling when taken with a calcium supplement as magnesium glycinate has no effect on the gut.

Coffee drinking is very widespread. Here is a coffee advertisement from another planet.

Very surprisingly taking large dosages of vitamin C must be avoided. Vitamin C increases iron absorption at least initially but long term ascorbic acid can down-regulate iron absorption by down-regulating iron independent and iron dependent Nramp2 (DMT1) and duodenal cytochrome B (Dcytb) expression. Vitamin C will also decrease copper absorption. Megadosages of vitamin C are definitely to be avoided. Vitamin C can be very surprising. Initially large dosages of vitamin C appear to have very positive effects but long term those positive effects are lost. First impressions of megadosages of vitamin C are incorrect impressions.

Both iron absorption enhancers and iron absorption inhibitors can have very undesirable effects. A goal is for iron to be available both in the gastrointestinal tract and available systematically whereby iron can not be complexed with either iron absorption inhibitors or iron absorption inducers in the gastrointestinal tract.

Sulfur amino acids can be very toxic. Increasing extracellular L-cysteine levels can be disastrous. L-cysteine taken as supplements can be very toxic. N-acetyl-l-cysteine and alpha lipoic acid are, for example, disastrous as supplements.  Any supplement that increases extracellular L-cysteine by decreasing levels of extracellular cystine, as do n-acetyl-l-cysteine  and lipoic acid, must be avoided. N-acetyl-l-cysteine and alpha lipoic acid are appropriately not OTC. Alpha lipoic acid had best never be used and now N-acetyl-l-cysteine had best be used only for for acetaminophen poisoning . Lipoic acid could also competitively inhibit biotin and pantothenic acid transport by the SMVT as biotin, pantothenic acid and lipoic acid are all transported by the SMVT. L-methionine taken as a supplement could result in inappropriate DNA methylation. Cystine supplements must not be taken. L-Cystine could be quite toxic as a supplement. L-cystine could result in an large effux of glutamate from cells via the cystine/glutamate antiporter which could be associated with excitoxcity. Absolutely the worst supplement strategy, that has some scientific support, is trying to increases L-cysteine levels via sulfur containing amino acids except via taurine which spares cysteine.

Lipoic acid is also a total disaster as a supplement. Lipoic acid will competitively inhibit biotin and pantothenic acid transport. Lipoic acid and pantethine also must not be supplemented as lipoic acid and pantethine  will reduce cystine  to L-cysteine, howver, cystine must be available to enter cells via the cystine/glutamate antiporter. Import of L-cystine into cells and export of glutamate out of cells are both key..

Supplemental glycine is avoided. Serine is needed for homocysteine metabolism and serine can be synthesized from glycine but still glycine is not helpful. However, taurine, which can spare cysteine, is of assistance. Attempting to increase synthesis of L-cysteine by supplementing with amino acids except taurine can have very negative effects.

Coenzyme Q10 could be of assistance. Coenzyme Q10 could support activity of succinate dehydrogenase which is an enzyme both in the TCA cycle and the oxidative phosphorylation pathway. Ubiquinol is avoided. Ubiquinol is the reduced form of coenzyme Q10. Ubiquinol could increase succinate levels and could as antioxidant have undesirable effects.

That there is oxidant stress is many illnesses is well established, however, thousands and thousands of oxidation reactions are needed. Greatly increasing levels of free antioxidants, for example, vitamin C or vitamin E is not of assistance.

Free antioxidants much in excess of amounts obtained from food can have very undesirable effects while increasing activities of antioxidant enzymes via supplements can have desirable effects or even very desirable effects. Supplementation with Se-methylselenocysteine can have very desirable effects.

Manganese and copper levels should be tested. Divalent metal transporter 1 which transports iron also transports manganese and copper.

Zinc in amounts more that what is in a Centrum is not supplemented. Zinc can increases metalthionein levels which can decrease copper absorption.

Both taurine and magnesium are associated with decreased cardiovascular risks. Decreased cardiovascular risk from taurine and magnesium could depend on supplementing with both taurine and magnesium. Magnesium taurinate is marketed magnesium formulation but due to enhanced absorption and a bypassing of the gut by magnesium taurinate magnesium and taurine would be taken as separate supplements.

As always though ‘increased absorption’ is presented as beneficial in marketing mineral supplements, mineral formulations should be available in the gut. Magnesium chelates, for example, magnesium glycinate, are avoided. Magnesium oxide could be the optimal magnesium formulation. Taurine would be taken with magnesium.

That increasing re-methylation of homocysteine to L-methionine, via supplemental folic acid and vitamin B12 in more that RDA amounts, is counterproductive, is another surprising rule. Homocysteine must be available to be metabolized to cysteine via the transsulfuration pathway. Supplementation with taurine decreases homocysteine levels. Absent an inactivating mutation in CBS supplemental taurine appears now to to be only helpful way to reduce homocysteine levels via supplement. Folic acid and vitamin B12 supplements do not prevent cognitive decline though the supplements can reduce homocysteine levels.

Thiamine will support activities of pyruvate dehydrogenase and 2-oxoglutarate dehydrogenase which are the E1 components of pyruvate dehydrogenase complex and 2-oxoglutarate dehydrogenase complex respectively. The E1 step in the pyruvate dehydrogenase complex is the rate-limiting step in the whole pyruvate dehydrogenase complex. To increase activities of the E2 components of the pyruvate dehydrogenase complex and 2-oxoglutarate dehydrogenase complex  activities of the E1 components have to first be increased. The E1 components have thiamine diphosphate as cofactors.

Very high dosages of thiamine could be required to address fatigue. The idea is that very high oral dosages of thiamine will increase intestinal alkaline phosphatase activity and improve phosphate absorption.. Very high dosages of thiamine would have to be considered a kludge. 300 milligrams taken four times a day can be helpful for a profound fatigue.. This is way more thiamine that would be required to treat a thiamine deficiency.

Vitamin B6 can be helpful. Do not take more than 50 mg. of vitamin B6 twice a day. Both enzymes in the transsulfuration pathway, cystathionine beta synthase and cystathionine gamma-lyase are vitamin B6 dependent enzymes. Vitamin B6 dependent enzymes are involved in amino acid and glucose metabolism. Given biotin is taken more than once a day and pantothenic acid is not supplemented away from biotin then a neuropathy could develop in which case supplemental vitamin B6 would worsen the neuropathy.

Supplemental niacin or niacinamide and/or riboflavin in much more than RDA amounts are avoided as supplemental niacin or niacinamide and riboflavin could increase activity of the E3 components of the pyruvate dehydrogenase complex and and alpha-ketoglutarate dehydrogenase complex whose products can inhibit E1 components of the pyruvate dehydrogenase complex and and alpha-ketoglutarate dehydrogenase complex. Supplementing with niacin or niacinamide and/or riboflavin in much more than RDA amounts is a very large misstep.

All B-50 vitamin formulations are avoided. One Centrum a day could be okay. Centrum does not contain chelated minerals which is a huge advantage of Centrum.

Molybdenum from sodium molybdate will increase levels of xanthine oxidase. Xanthine oxidase,  is a molybdenum containing protein. Xanthine oxidase is a powerful ferroxidase and could assist with iron transport. Molybdenum from sodium molybdate would be readily available in the gut which could be a strong advantage. Molybdenum chelated to glycine is avoided as xanthine oxidase levels  must be increased in the gut. Molybdenum from molybdenum glycinate may not be readily available in the gut. The advertising of Albion Minerals which states that glycine is very tightly bound to minerals in glycine chelates is absolutely accurate.

No minerals bound to glycine should should supplemented. Advertising of Albion Minerals is absolutely accurate. Glycine in minerals bound to glycine is tightly bound to minerals which makes the minerals unavailable in the gut, however, minerals to be of assistance must be available in the gut as well as be available systematically. Taking any glycinated minerals is a very large misstep.

Albion Minerals makes absolutely outstanding chelates. However a lot of supplement manufactures make outstanding chelates. Albion Minerals has tried to spin than only glycinated minerals are true chelates. That is very far from the case. If the mineral supplement says chelated there is a very high probability that in fact the mineral is chelated. And chelated minerals flat out do not work and can have very adverse health effects.

At this time the treatment is complementary medicine rather than alternative medicine. Prescribed medications should not be stopped without consultation with MDs.

Supplements are a minefield. Do not start the treatment unless contraindicated supplements  are at the same time avoided.

What not to supplement is as important as what to supplement with.  Supplementing with L-methionine or S-adenosyl-l-methionine are avoided. Supplementing with N-acetyl-l-cysteine, L-cysteine, cystine, r-lipoic acid and/or alpha lipoic acid supplements is avoided. N-acetyl-l-cysteine and alpha lipoic acid increase L-cysteine levels by decreasing cystine levels which is not of assistance. Supplementing with iron sulfate is avoided. Carbonyl iron will reside in the gut longer whereby aconitase 1 in the gut can be better regulated by carbonyl iron compared to iron sulfate. Carbonyl iron is also safer that iron sulfate. Pantetheine is not supplemented as pantetheine could decrease cystine levels. Sodium selenite and any form of L-selenomethionine are not supplemented. Minerals bound to succinate should be avoided. All supplements bound to TCA cycle intermediates, except in miniscule amounts, are avoided. Folic acid and vitamin B12 are not supplemented in much more than RDA amounts. To produce L-cysteine via homocysteine there must be homocysteine. Increasing re-methylation of homocysteine to L-methionine by taking more that RDA amounts of folic is counterproductive. Huge doses of B12 are not helpful. Supplementing with more than RDA amounts of niacin, niacinamide and/or riboflavin are avoided. B-50 formulations are avoided. Supplementation with iron sulfate and ferrous bisglycinate are avoided. No minerals bound to glycine should should supplemented. All minerals bound to citrate must be avoided. All whey protein supplements are avoided due to quick absorption. ‘Quickly absorbed’ and ‘highly absorbed’ are the enemy of supplements being of assistance. Calcium supplements are avoided. All soft drinks and bottled waters with citric acid must be avoided. All minerals bound to succinate must be avoided. 2-oxoglutarate is not supplemented. Zinc in amounts more that what is in a Centrum is not supplemented. Vitamin C supplements much above RDA amounts are avoided. All citric acid based drinks are avoided. Beta-carotene supplements much above RDA amounts are avoided. Vitamin E supplements much above RDA amounts are avoided. Apparently there are various needed oxidant reactions that free antioxidants adversely affect. Free antioxidants supplements are avoided. Free antioxidants are basically only healthy in amounts found in food. Antioxidant plant extracts are avoided, including natural flavors derived from plants., as such extracts act as free antioxidants. Soft drinks are completely avoided both for added acids, for example, citric acid and phosphoric acid acid that can affect iron absorption, and for the natural flavors derived from plants. Bottled waters and/or canned waters that have added acids that can affect iron absorption, for example, citric acid, and/or plant natural flavors are avoided. Evening primrose oil and and borage oil are avoided. Coffee given coffee is drunk must be stopped around 6-7 hours before before iron from iron carbonyl is supplemented. 100% tea could be OK, however, the last cup of tea of the day would have be drunk around 6-7 hours before iron from iron carbonyl is taken. Both coffee and tea have deleterious effects given iron from iron carbonyl is not supplemented around mid evening. Coffee can have beneficial effects.

Treatment failure is predicted unless the recommendations as to what not to supplement with are adhered to.

The treatment is clearly a lot but the treatment treats schizophrenia which is either the worst disease humans face or is in a tie for worst disease humans face. Carbonyl iron and Se-methylselenocysteine can treat psychosis and cognitive symptoms of schizophrenia stopping schizophrenia from being treatment resistant. Biotin and pantothenic acid, and sodium bicarbonate are of assistance. Taurine, vitamin K2 MK-7, vitamin D3 magnesium oxide and very high dosages of thiamine address negative symptoms of schizophrenia. As negative symptoms of schizophrenia are due to hidden osteomalacias that affect bones is the back of heads taurine, vitamin D3 and vitamin K2 MK-7 and magnesium oxide can take very long while to be completely effective. Calcium is not supplemented.

Avoid the supplements on the to be avoided list. L-methionine, S-adenosyl-l-methionine, N-acetyl-l-cysteine, L-cysteine, cystine, r-lipoic acid and/or alpha lipoic acid supplements must be absolutely avoided. Do not take glycinated minerals. Get anemia panels, thyroid panels, metabolic panels and CBCs done regularly. Supplements formulated for better absorption are a disaster. Anemia panels, thyroid panels, metabolic panels and CBCs can be ordered online in most states.

In sum

Iron from carbonyl iron – must be taken at bedtime away from iron enhancers and iron inhibitors – treats psychosis – very quickly effective – 2 or or 3 days

Se-methylselenocysteine – treats cognitive symptoms – can be toxic in high doses – very quickly effective – 2 or or 3 days.

Amino acids are taken away from food.

Branched-chain amino acids are supplemented 3 times a day.

Mineral tests are absolutely essential. High levels of trace minerals must be avoided. No mineral that says chelated on the label can be supplemented. All mineral chelates are excellent chelates.

.Taurine, magnesium oxide, vitamin K2 MK-7 and vitamin D3 are supplemented Vitamin D3 should be dry vitamin D. K2 MK-7 should be in a capsule not a softgel. Taurine is taken three times a day. Magnesium oxide in taken 1 or 2 times a day, vitamin MK-7 in taken three times a day and vitamin D3 is taken once a day.

200 mg of magnesium from magnesium oxide is taken one or two times a day.

Biotin, pantothenic acid, bicarbonate, and thiamine and vitamin B6 improves mood and energy. Biotin and pantothenic acid must be taken apart. Very high dosages of thiamine could be required. Biotin can only be taken once a day. Biotin taken more than once a day can result in neuropathy due to pantothenic acid shortages.

Iodide from kelp, L-tyrosine, and Se-methylselenocysteine will address sadness.

A tablespoon of extra light olive oil is taken three times a day. .Extra light olive oil will contain lesser amounts of polyphenols.

The treatment cannot be criticized as being too complex as research has foreclosed there being a simple treatment for schizophrenia that is also effective. Proper packaging of supplements could greatly reduce number of pills taken a day.

Basic tests, CBC’s, metabolic panels, anemia panels, thyroid panels, must be obtained regularly. I cannot overemphasize this.. High values are to be avoided.

There are a lot of uncertainties as to exactly what would be the optimal treatment. Lots and lots of research is required. Carbonyl iron,. Se-methylselenocysteine, iodide from kelp, L-tyrosine and very high dosages of thiamine taken alone could change everything about schizophrenia and work very quickly, for example, in a week’s time. Psychosis, anosognosia and intense sadness are mental health emergencies. Proceeding further without much more research would not be advisable. Doctors would know that psychosis is due to dysregulation of iron-sulfur proteins which is a huge clue. Doctor’s would know cognitive difficulties in schizophrenia are due to dysregulation of selenoproteins. Doctors would also know that dysregulations of the thyroid plays a major role in depression as sadness.. A basic set of tests are required, for example, every three months though at the start even more frequently. ‘Supplements to be avoided’ must be avoided.

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