Hi Dr Lam,

I have an unusual question. I've seen several docs here in LA for that but they didnt know.

When I try to study or do my research, I get lots of trouble balancing water and electrolytes to maintain cognitive abilities.

Scenario 1 (most often):
I need to drink 10-15 liters of water a day, spread every half-hour, to be able to solve (academic) problems. It also keeps my memory fairly good (although not what it once was) and has a stimulant effect. If I dont drink for a while I quickly loose my focus/train of thought and remembering things become difficult. In scenario 1 I'm never thirsty.

Scenario 2 (less often):
I'll wake up very thirsty, drink but as the day progress I remain thirsty, drink more and start to feel confused/buzzed up. Perhaps an osmotic shift into brain cells to compensate for some hyponatremia. The end result, as in scenario 1, is 'brain fog'.

Short background: Up to 2-3 years ago I was very healthy, except a few glitch (that I believed were minor) and very athletic and mentally sharp. Then a few things changed in my life pretty much at the same time, and my health dropped. Recent tests showed low cortisol, etc. very low pregnenolone, ACTH, zinc. High copper. I have low testosterone symptoms, orthostatic intolerance, heat/cold intolerance, etc. I have reasons to believe that it's likely that I have a pretty severe adrenal fatigue, but I'm still kind of functional (I suppose thanks to adrenaline).

Hypothesis (mostly for scenario 1):
1) I'd get so low in some corticosteroid like aldosterone that my blood volume would drop constantly, hence the need to keep pouding water to get enough blood/oxygen to the brain. Maybe fludrocortisone (florinef) could test that.

2) When I pound lots of water, the barorelfex ends up inhibiting the rostral ventrolateral medulla, and basically activate the PRNS (parasympathetic) while deactivating the SNS (sympathetic). There is a glutaminergic signal and a GABAergic signal involved, but my hypothesis is that its end up being temporarily beneficial mostly via its cholinergic activity. That is it would basically act as a parasympathomimetic drug. Could try physostigmine or galantamine.

3) Pouding water would quickly increase hydrostatic pressure of cerebrospinal tissues, which would lead to cerebral ischemia and the cushing reaction. This is a SNS ischemic response, therefore the SNS is rapidly and strongly stimulated (the goal is to increase blood flow to the brain). Maybe that could give me the stimulant effect.

4) My clearance system as you call it, would be completly gone, so I'd fill up with toxins and metabolites. Somehow pouding water would clear the brain fog for 30-60 min. I did read the places on your website where you discuss that, and this was actually my first hypothesis. Drs all told me this sounded like nonsense (not that I thrust any of them but anyway). When I take lots of vitamins/minerals things definitly get worse, as you wrote. Potassium chloride is pretty bad, so is my ADAM muti. The absolute worst for me is Gaia Herbs milk thistle - I need to drink about 2 gallons of water following a single dose.

5) Something else

Although 4) definetly fits with what I read from your website, its doesnt really explain the stimulant effect. And I dont understand by what mechanism my clearing system could have become so bad. Extremely low glutahtione? Under/over methylation induced by something like pyroluria? Severe ascorbic acid depletion in my HPA tissues?

I think hypothesis 1 to 3 are also likely.

Right now what helps is I take 60 grams a day of powered vit C with 20 g baking soda. I added progressively 50mg pregnenolone and 5 pellets isocort, which I can feel a difference on libido. And on and off several other vitamins/minerals/amino acids/NAC/ALCAR/ALA/maca/etc. I know you'll say its too much, you might be right.

I hate to do this but I'm going to get a prescription for adderall to patch the symptoms until I find a solution.

Any suggestions are welcome