Olanzapine and triglycerides



D

David Dalton

Guest
I've been on olanzapine for four years now (and lithium for eleven years) and the olanzapine has
caused 55 lb of weight gain and has elevated my blood triglycerides level. However my psychiatrist
told me that there is still some debate as to whether:

1. the olanzapine causes the elevation in triglycerides directly or
2. causes the weight gain which then causes the elevation in triglycerides).

So what is the latest news on whether 1 or 2 or a combination of them both are correct?

My diet and exercise are already fairly good though I guess I could cut down on sugar and alcohol
and overall calories some, and try to walk a little faster, and play badminton twice a week instead
of once a week, and do a half hour of yoga a day.

Do you have any nutrition and/or exercise tips for reducing triglycerides level and increasing HDL
(my HDL/LDL ratio is slightly low too, but I am a non-smoker and just turned 39 so my risk for heart
disease is still considered low)?

And do you have any other tips on solving the problem of high blood triglycerides level while on
olanzapine and also the associated problem of weight gain? And are there alternate drugs that don't
cause the problems? I read some good things about Geodon on the web but don't think it is available
in Canada yet.

My other option is to come off the olanzapine. I tried that in the last few months (tapering
gradually) and ended up having problems last week and had to go back to 10 mg/day for a few days but
now am back down to 5 mg/day, and still hope to come off it in the next few months. I have certain
solar sunspot and lunar patterns in my mood cycles and think I am similar to past mystic/poets such
as Amergin and Taliesin among others, and thus my recent period of low/delusional years should be
over soon, since it has been slightly more than seven years so far, and when they end I should be
able to come off olanzapine but will stay on lithium, at a level of 0.8. My mood cycles since
September 1991 are described on my Salmon on the Thorns web page
http://www.nfld.com/~dalton/dtales.html .

David
 
does it really matter whether olanzapine raises triglycerides, without weight gain, as the two in
tandem seem to be the rule on olanzapine, weight gain plus an increase in triglycerides.
Triglycerides can be counteracted, weight loss while on olanzapine, while not impossible is
difficult.
 
In article<[email protected]>, David Dalton <[email protected]> writes:
>I've been on olanzapine for four years now (and lithium for eleven years) and the olanzapine has
>caused 55 lb of weight gain and has elevated my blood triglycerides level. However my psychiatrist
>told me that there is still some debate as to whether:
>
>1. the olanzapine causes the elevation in triglycerides directly or
>2. causes the weight gain which then causes the elevation in triglycerides).
>
>So what is the latest news on whether 1 or 2 or a combination of them both are correct?

The long and the short of it is that weight gain can be an automatic and unavoidable consequence of
these medication types, inherent in their working. The stress-fighing chemical serotonin at medium
levels in pro-apetite and pro-libido, when it gets high enough to start negative feedback (S2)
receptors these are anti-apetite and anti-libido, further stress on top of this can result in
schizophrenia through abnormal activation of dopamine receptors equivalent to the car sliding
forward with the handbrake on. Your drug olanzapine lowers S2, which is an extreme provocation to
schizophrenic activation, before also lowering dopamine. Anything which removes S2 and/or raises
normal dopamine activity -- some antianxiety, antidepressant, antitremor, and antipsychotic meds --
can quite often raise appetite and raise storage of energy into fat, sometimes excessively. This is
inherent and very hard to get rid of. Any attempt by exercise, low fat diet, etc, to counter this
is going to be a really uphill struggle given the metabolic settings you now have.

You could look at older anti-psychotic drugs that don't have S2 activity. Unfortunately they are
likely to be less effective for your case, and almost certainly will lower dopamine so much that
you get twitch-and-tremor type side effects. You could take a noradrenaline-related stimulant to
lower appetite, but this is very bad idea as likely to bring psychosis back. There are some
drugs for lowering blood-fat (outside my area of knowledge) but I'm not sure how much good they
will do you.

The long and the short is that you are probably stuck with the weight gain -- you should try to
mitigate it with exercise etc but this will be only partially helpful. Other than giving insight
why, I'm afraid I can't see any way to get round this one; IMO, IANAD.

>
>My diet and exercise are already fairly good though I guess I could cut down on sugar and alcohol
>and overall calories some, and try to walk a little faster, and play badminton twice a week instead
>of once a week, and do a half hour of yoga a day. Do you have any nutrition and/or exercise tips
>for reducing triglycerides level and increasing HDL (my HDL/LDL ratio is slightly low too, but I am
>a non-smoker and just turned 39 so my risk for heart disease is still considered low)?
>
>And do you have any other tips on solving the problem of high blood triglycerides level while on
>olanzapine and also the associated problem of weight gain? And are there alternate drugs that don't
>cause the problems? I read some good things about Geodon on the web but don't think it is available
>in Canada yet.
>
>My other option is to come off the olanzapine. I tried that in the last few months (tapering
>gradually) and ended up having problems last week and had to go back to 10 mg/day for a few days
>but now am back down to 5 mg/day, and still hope to come off it in the next few months. I have

I don't know your case but I doubt you will ever be able to come off meds completely, with the one
exception that schizophrenia is likely to fade in old age through progressive loss of dopamine
receptors. Current antipsychotic meds DO NOT CURE THE UNDERLYING DISEASE PROCESS (in the way,
e.g., antibacterial drugs kill the infecting bacteria and then you can cease the drug). They only
relieve symptoms, you are just as badly off if you cease taking them.

>certain solar sunspot and lunar patterns in my mood cycles and think I am similar to past
>mystic/poets such as Amergin and Taliesin among others, and thus my recent period of low/delusional
>years should be over soon, since it has been slightly more than seven years so far, and when they
>end I should be able to come off olanzapine but will stay on lithium, at a level of 0.8. My mood
>cycles since September 1991 are described on my Salmon on the Thorns web page
>http://www.nfld.com/~dalton/dtales.html .

Can I give you some cognitive counselling on your ups-and-downs
viz: they are just rubbish produced by your brain not working properly. I doubt you can predict
their course by anything external. I doubt they tell you anything useful when they happen.
>
>David
>
>
>

-- . . : : ,; . : ' ___. uno, dos, tres, |FUEGO| .:. .:. .:': :' .:':' :. . : (") #oH| ' ' :' : :' :
.::. H_ ~~~| < > __ ,;;,. \\::// R_) | '-|"""(") {__}::===== ....'''' ' ' ' ___..\||/....L\. ...|
____||--|_'--/__\___ '' .--'''::::::::::::::::::::: \ / /////////////S.Coronado/////
;'^';-._.-;'^';-._.-;'^';-._.-;'^';-._;'^';-._.-;'^';-._.-;'^';-._.-;'^ LRonHubbard is shelled
byGoats inHell.READ http://www.ronthewarhero.org
 
In article<%CP5a.2866$xa.455874@localhost>, David Dalton writes:
>Dave Bird <[email protected]> wrote:
>
>>David Dalton wrote
>>>My other option is to come off the olanzapine. I tried that in the last few months (tapering
>>>gradually) and ended up having problems last week and had to go back to 10 mg/day for a few days
>>>but now am back down to 5 mg/day, and still hope to come off it in the next few months. I have
>
>> I don't know your case but I doubt you will ever be able to come off meds completely, with the
>> one exception that schizophrenia is likely to fade in old age through progressive loss of
>> dopamine receptors. Current antipsychotic meds DO NOT CURE THE UNDERLYING DISEASE PROCESS (in
>> the way,
>> e.g., antibacterial drugs kill the infecting bacteria and then you can cease the drug). They only
>> relieve symptoms, you are just as badly off if you cease taking them.
>
>I don't have schizophrenia, I have bipolar mood disorder and my main medication is lithium, and I
>have just needed the olanzapine to combat mild delusions and mild shakiness in the last few years.
>I haven't had severe waxing moon problems since I now abstain from marijuana always and from
>alcohol during waxing moon (and I haven't ever had waning moon alcohol related problems).

Well, OK, it is there to combat the delusions. You may feel that the cure is worse than the disease
i.e. weight gain is a worse problem than the delusions. In which case you could cease altogether or
change drug, but that word "shakiness" troubles me: if you go onto older anti-psychotic drugs which
are less likely to produce weight gain then shakes and tremors, possibly irreversible, are
precisely what they're likely to produce instead.

If the psychotic over-activation comes transiently during the manic swing, then obviously it comes
from (lack of) control of mania, and the prognosis depends on whether the swing will ever ease off
without meds. It would be nice if this were so. Be aware, though, that any period of out-of-control
bipolar swings makes for stronger and more frequent swings in future.

__ .\|/////..
||_.-' '. /\\|// ----
// ; | ----- --._// .\|/. .==== =====. --- (( //(####) \d]>||<[d]>\ (~\ The only real
crime for which
|| v '--'\\ . | \ | one can be punished by govern- ; v . {_ \ : \/ ments of today is lack
|| of money
// .' : .'___' : ' In other crimes, if one has the // ; '. ~===~ /\ huge sums necessary to hire
// . .... o : /__\'''' / \ lawyers, one can often get off.
. \\\\~~~~|~~~~~~~|\\ / /\/,,,L.RON HUBBARD,
. | .\''. |/''''/.|,,\\ //,,,,,,,Phat Dead Phounder of '.|: O :|[ / ]|,,,,\/,,,,,,,,,
the $cientology cult. ----------------| '...' |[__O__]|,,,,,,,,,,,,,,,[in HCOPL
20/sept/1976]-------
|_______|_______|,,,,,,,,,,,,,,,
 
In article<%CP5a.2866$xa.455874@localhost>, David Dalton <[email protected]> writes:
>I don't have schizophrenia, I have bipolar mood disorder and my main medication is lithium, and I
>have just needed the olanzapine to combat mild delusions and mild shakiness in the last few years.

Some more things you could do. Search around for a few mental health related terms and you well
probably come up with WEB-BASED discussions. These have a lot of well informed people both patients
and therapists who may have more directly relevant experience.

Also, look up whether blood-fat reducing drugs might be of help to you (statins are the commonest).
They may be only moderately useful but you could discuss them with your doctor. A google search for
DRUG, REDUCE, TRIGLYCERIDES found....

Drug Treatments for Lowering Cholesterol Levels

In many cases, a real change in diet along with more physical activity may not be enough to lower
elevated LDL cholesterol to recommended levels. Drug treatment should be considered for patients
who, in spite of dietary changes, regular physical activity and weight loss, need further treatment
for an elevated LDL cholesterol level.

In addition, drug therapy should be initiated immediately for anyone who has elevated LDL
cholesterol and either coronary heart disease or diabetes.

There are four main classes of cholesterol-lowering medications currently available.

Medication should be started for people who, in spite of dietary changes, regular physical activity
and weight loss, need further treatment to get to their LDL target. In addition, drug therapy should
be initiated immediately for anyone who has high LDL cholesterol and either coronary heart disease
or diabetes.

A medication can change your levels of “good” and “bad” cholesterol and triglycerides. By
reducing LDL cholesterol, certain drugs can help prevent plaque buildup inside your arteries.7

However, it is important to remember that cholesterol-lowering medication is not a cure. You also
still need to stay on a low- cholesterol, low-saturated fat diet.

Currently, there are four main classes of medications available that lower cholesterol. Your doctor
can advise which may be appropriate for you. His or her choice will depend on many factors,
including how much good (HDL) or bad (LDL) cholesterol you have, and whether other lipids or
triglycerides in your blood are high. Your age or medical history may also be a factor. Sometimes a
doctor will recommend a combination of medications.

Statins

Statins are the newest group of cholesterol-lowering medications and have quickly become the most
widely prescribed class of the four.8 They act at the source of the problem by preventing the liver
from producing possibly harmful LDL cholesterol. With less cholesterol in your liver, the cells
start to remove the LDL cholesterol from the bloodstream and the plaque, reducing your risk of heart
disease. Statins have been widely studied and shown to significantly reduce the risk of heart attack
and death in people with no signs of heart disease and even in patients who have already suffered a
heart attack.

Statins as a class can lower your “bad” cholesterol by 20-60%. Statins somewhat decrease
triglycerides and increase HDL cholesterol. These medications cause relatively few side effects.
Only a small number of patients have any problems.

People taking statins have been able to lower their risk of heart attack by 25 to 40% – depending
on their initial overall risk. They also need fewer surgeries such as angioplasty and coronary
bypass operations.9, 10, 11,12

The statin medications currently available are atorvastatin (Lipitor*), fluvastatin (Lescol*),
lovastatin (Mevacor®), simvastatin (Zocor®) and pravastatin (Pravachol®). Some of these have been
used in major studies proving the lifesaving benefits of reducing cholesterol with a statin. All are
available in once-a-day tablet form.

Fibrates

Fibrates, or fibric acid derivatives, are mainly used for lowering triglycerides and increasing HDL
cholesterol. They work by increasing the activity of an enzyme that breaks down some kinds of
cholesterolhelping the liver to eliminate cholesterol and blocking the production of triglycerides
and cholesterol . Fibrates can significantly reduce triglyceride levels and can increase HDL
cholesterol, but they don't lower LDL cholesterol levels as effectively. The currently available
fibrates are bezafibrate (Bezalip), fenofibrate (Lipidil) and gemfibrozil (Lopid). Their most common
side effects include nausea, stomach pain, gas, diarrhea, constipation, itching, rash, tiredness and
muscle aches.

Niacin

Large doses of niacin (vitamin B3) can affect cholesterol levels by reducing the liver's production
of LDL cholesterol and another kind of cholesterol called VLDL cholesterol. Niacin also increases
the blood levels of HDL cholesterol, and can reduce total cholesterol by up to 15% and triglyceride
levels by up to 30%. However, the most common side effects of niacin (flushing, nausea, gas,
heartburn, diarrhea, itching and low blood pressure) occur most often with the high doses used to
lower lipid levels.

Resins

Resins, or bile acid sequestrants, are primarily used to lower total cholesterol and LDL
cholesterol. They work by making the liver use more of its own cholesterol, which lowers the amount
of cholesterol in the blood.] The two currently available resins, cholestyramine (Questran) and
colestipol (Colestid), can reduce LDL cholesterol levels but tend to raise triglyceride levels
slightly. Side effects may include constipation, stomach pain, gas, heartburn, nausea, diarrhea and
loss of appetite.


--

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
8====3 (O 0) GROETEN --- PRINTZ XEMU EXTRAWL no real OT has |n| (COMMANDER, FIFTH INVADER FORCE)
ever existed ................................................................. A society without a
religion is like a maniac without a chainsaw.
 
For your weight gain issue, I suggest a simple test you can do:

Try to calculate exactly the number of calories going in, and the number of calories going out
(burning per 24 hours).

Average this over 1 week if possible to see if you are actually positive or negative for the week.
55 lbs of weight gain, assume that if 40 lbs of it are pure fat, that is 10lbs per year, or 1 lb per
5 weeks, or about 3500 calories extra per 5 weeks, or about 100 calories too high per day. If you
simply eat 4 sugar cubes less per day, or skip that muffin per day you should lose weight instead.
Or try to burn the extra 100 per day, which is about a 1/2 hour walk extra per day, or even waking
up 1 hour earlier per day.

"David Dalton" <[email protected]> wrote in message news:[email protected]...
> I've been on olanzapine for four years now (and lithium for eleven years) and the olanzapine has
> caused 55 lb of weight gain and has elevated my blood triglycerides level. However my psychiatrist
> told me that there is still some debate as to whether:
>
> 1. the olanzapine causes the elevation in triglycerides directly or
> 2. causes the weight gain which then causes the elevation in triglycerides).
>
> So what is the latest news on whether 1 or 2 or a combination of them both are correct?
>
> My diet and exercise are already fairly good though I guess I could cut down on sugar and alcohol
> and overall calories some, and try to walk a little faster, and play badminton twice a week
> instead of once a week, and do a half hour of yoga a day.
>
> Do you have any nutrition and/or exercise tips for reducing triglycerides level and increasing HDL
> (my HDL/LDL ratio is slightly low too, but I am a non-smoker and just turned 39 so my risk for
> heart disease is still considered low)?
>
> And do you have any other tips on solving the problem of high blood triglycerides level while on
> olanzapine and also the associated problem of weight gain? And are there alternate drugs that
> don't cause the problems? I read some good things about Geodon on the web but don't think it is
> available in Canada yet.
>
> My other option is to come off the olanzapine. I tried that in the last few months (tapering
> gradually) and ended up having problems last week and had to go back to 10 mg/day for a few days
> but now am back down to 5 mg/day, and still hope to come off it in the next few months. I have
> certain solar sunspot and lunar patterns in my mood cycles and think I am similar to past
> mystic/poets such as Amergin and Taliesin among others, and thus my recent period of
> low/delusional years should be over soon, since it has been slightly more than seven years so far,
> and when they end I should be able to come off olanzapine but will stay on lithium, at a level of
> 0.8. My mood cycles since September 1991 are described on my Salmon on the Thorns web page
> http://www.nfld.com/~dalton/dtales.html .
>
> David
 
Dave Bird <[email protected]> wrote:

>David Dalton wrote
>>My other option is to come off the olanzapine. I tried that in the last few months (tapering
>>gradually) and ended up having problems last week and had to go back to 10 mg/day for a few days
>>but now am back down to 5 mg/day, and still hope to come off it in the next few months. I have

> I don't know your case but I doubt you will ever be able to come off meds completely, with the one
> exception that schizophrenia is likely to fade in old age through progressive loss of dopamine
> receptors. Current antipsychotic meds DO NOT CURE THE UNDERLYING DISEASE PROCESS (in the way,
> e.g., antibacterial drugs kill the infecting bacteria and then you can cease the drug). They only
> relieve symptoms, you are just as badly off if you cease taking them.

I don't have schizophrenia, I have bipolar mood disorder and my main medication is lithium, and I
have just needed the olanzapine to combat mild delusions and mild shakiness in the last few years. I
haven't had severe waxing moon problems since I now abstain from marijuana always and from alcohol
during waxing moon (and I haven't ever had waning moon alcohol related problems).

>>certain solar sunspot and lunar patterns in my mood cycles and think I am similar to past
>>mystic/poets such as Amergin and Taliesin among others, and thus my recent period of
>>low/delusional years should be over soon, since it has been slightly more than seven years so far,
>>and when they end I should be able to come off olanzapine but will stay on lithium, at a level of
>>0.8. My mood cycles since September 1991 are described on my Salmon on the Thorns web page
>>http://www.nfld.com/~dalton/dtales.html .

> Can I give you some cognitive counselling on your ups-and-downs
> viz: they are just rubbish produced by your brain not working properly. I doubt you can predict
> their course by anything external. I doubt they tell you anything useful when they happen.

Well, I definitely do have certain patterns in my highs, trials and low years. My five highs from
1991 to 1994 all occurred during waning crescent moon, three had onsets marked by clear sky
lightning, one by highly variable weather, and all five were preceded s few days before by an
M-classs solar flare, and all five occurred during high to medium years of the solar sunspot cycle.
Also three of the highs were preceded 5.5 lunar months (six solar rotations) before by a waxing
gibbous moon trial (mixed/psychotic episode). My current low years (no highs, occasional delusions,
occasional downs, low creativity) began a few months before the low of the solar sunspot cycle (and
a mild depression in 1986 was also during a low year of the sunspot cycle). From these patterns I
have found a similarity between myself and past mystics including Taliesin and Amergin. Their low
years lasted seven years so I expect another waning crescent high soon, at the latest by late April,
not much more than seven years after my low years started, and not much more than eleven years after
my first high. If that occurs I will have more evidence that I am similar to them and for a solar
sunspot cycle variation in my mood.

But in my data so far, I definitely do have lunar patterns, clear sky lightning and weather effects,
solar flare effects, and probably an eleven year sunspot cycle effect though I won't know for sure
for a few more decades of self-observation.

For more detail on my cycles, see my Salmon on the Thorns web page
http:/www.nfld.com/~dalton/dtales.html .

Thanks for your comments on olanzapine. David
 
In article<[email protected]>, Brian Sandle
<[email protected]> writes:
>I am wondering if weight gain is a natural human way to help calmness. Does the atypical
>antipsychotic just encourage a normal process or something like that?

Sort of. Neural paths promoted by (dopamine or) a moderate amount of serotonin link of to the
alternative parasympathetic nervous system which goes to the stomach and genitals, and to outward
fluid secretion i.e. of saliva, stomach acid, etc. Stress activates negative feedback, S2,
receptors of serotonin, and too much "hard braking" like that is the number one provocation for
things to run away into complete psychosis. Atypical, of antipsychotics, means they block these S2
receptors as well as directly addressing the psychosis.

Anything which (promotes dopamine or) reduces this negative feedback promotes appetite, digestion,
and weight gain. Yes there are sub-types within S2, but the odds are that most drugs will be
non-selective between those areas which have a pro-calming effect versus those which have a
pro-appetite effect. Bottom line: the circuitry for appetite is closely related to that for
calmness, so it is very easy to get your signals crossed.

-- . . : : ,; . : ' ___. uno, dos, tres, |FUEGO| .:. .:. .:': :' .:':' :. . : (") #oH| ' ' :' : :' :
.::. H_ ~~~| < > __ ,;;,. \\::// R_) | '-|"""(") {__}::===== ....'''' ' ' ' ___..\||/....L\. ...|
____||--|_'--/__\___ '' .--'''::::::::::::::::::::: \ / /////////////S.Coronado/////
;'^';-._.-;'^';-._.-;'^';-._.-;'^';-._;'^';-._.-;'^';-._.-;'^';-._.-;'^ LRonHubbard is shelled
byGoats inHell.READ http://www.ronthewarhero.org
 
In article<[email protected]>, Brian Sandle
<[email protected]> writes:
>In sci.med.cardiology Dave Bird <[email protected]> wrote:
>> In article<[email protected]>, Brian Sandle <[email protected]>
>> writes:
>>>I am wondering if weight gain is a natural human way to help calmness. Does the atypical
>>>antipsychotic just encourage a normal process or something like that?
>
>> Sort of. Neural paths promoted by (dopamine or) a moderate amount of serotonin link of to the
>> alternative parasympathetic nervous system which goes to the stomach and genitals, and to
>> outward fluid secretion i.e. of saliva, stomach acid, etc. Stress activates negative feedback,
>> S2, receptors of serotonin, and too much "hard braking" like that is the number one provocation
>> for things to run away into complete psychosis. Atypical, of antipsychotics, means they block
>> these S2 receptors as well as directly addressing the psychosis.
>
>> Anything which (promotes dopamine or) reduces this negative feedback promotes appetite,
>> digestion, and weight gain. Yes there are sub-types within S2, but the odds are that most drugs
>> will be non-selective between those areas which have a pro-calming effect versus those which
>> have a pro-appetite effect. Bottom line: the circuitry for appetite is closely related to that
>> for calmness, so it is very easy to get your signals crossed.
>
>I do not have perseonal experience but I believe olanzapine increases weight even with the same
>food intake. There must be more retention.

Yes. One of the pro-appetite functions simply turns up the rate of fat fat deposit at the same
level of fuel input: less burned, more stored.

-- .---. It was once believed that a million monkeys at a million { o o } keyboards would eventually
type the works of Shakespeare, _(---)_ but the Internet has since disproved this theory. / \
 
>I don't have schizophrenia, I have bipolar mood disorder
:>and my main medication is lithium, and I have just needed the olanzapine to combat mild delusions
:>and mild shakiness in the last few years. I haven't had severe waxing moon problems since I now
:>abstain from marijuana always and from alcohol during waxing moon (and I haven't ever had waning
:>moon alcohol related problems).

: Well, OK, it is there to combat the delusions. You may feel that the cure is worse than the
: disease i.e. weight gain is a worse problem than the delusions. In which case you could cease
: altogether or change drug, but that word "shakiness" troubles me: if you go onto older
: anti-psychotic drugs which are less likely to produce weight gain then shakes and tremors,
: possibly irreversible, are precisely what they're likely to produce instead.

The tremors are likely caused by the Lithium, not the olanzapine. That's been what we notice in
our patients.

Emma
=)
 
In sci.med.cardiology Emma Chase VanCott <[email protected]> wrote:
> :>I don't have schizophrenia, I have bipolar mood disorder and my main medication is lithium, and
> :>I have just needed the olanzapine to combat mild delusions and mild shakiness in the last few
> :>years. I haven't had severe waxing moon problems since I now abstain from marijuana always and
> :>from alcohol during waxing moon (and I haven't ever had waning moon alcohol related problems).

> : Well, OK, it is there to combat the delusions. You may feel that the cure is worse than the
> : disease i.e. weight gain is a worse problem than the delusions. In which case you could cease
> : altogether or change drug, but that word "shakiness" troubles me: if you go onto older
> : anti-psychotic drugs which are less likely to produce weight gain then shakes and tremors,
> : possibly irreversible, are precisely what they're likely to produce instead.

> The tremors are likely caused by the Lithium, not the olanzapine. That's been what we notice in
> our patients.

> Emma
> =)

U.S. National Library of Medicine Gateway

Related Articles : PUBMED ; PUBMED_ID ; 12504071 Publisher Link : 2

Atypical antipsychotics in the EPS-vulnerable patient.

Friedman JH.

Psychoneuroendocrinology. 2003 Jan;28 Suppl 1:39-51. Division of Neurology, Memorial
Hospital of Rhode Island, 111 Brewster Street, 02860, Pawtucket, RI, USA

'Typical' antipsychotic agents can lead to a variety of extrapyramidal symptoms (EPS),
including parkinsonism. The efficacy of a number of atypical antipsychotics in reducing
PPychosis without a detrimental effect on motor function has been studied in the group of
patients most vulnerable to EPS, those who already have parkinsonian symptoms. Multiple
open-label studies with clozapine strongly suggested that at low doses the drug was an
effective antipsychotic and did not impair motor function. This was confirmed by two
double-blind, placebo-controlled studies. A disadvantage of clozapine is that it can
cause agranulocytosis and therefore patients require ongoing hematological monitoring.
Studies with both risperidone and olanzapine have produced conflicting results, with
some ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^ patients showing an overall
improvement and others exhibiting severe deterioration of motor function. As with
clozapine, multiple open-label studies with quetiapine have consistently demonstrated
that it improves psychosis without impairing motor function. Double-blind trials are yet
to be performed: however, the existing data, coupled with the lack of required blood
monitoring, have led some experts to recommend quetiapine as the drug of choice for
treatment of drug-induced psychosis in patients with parkinsonism. The atypical
antipsychotics have also been tested in the largest group of EPS-vulnerable patients,
the demented elderly. Results from a number of trials are described here. These data are
more difficult to interpret as the number of variables is far greater than for the
population with parkinsonism. However, the evidence to date indicates a generally low
incidence of tardive dyskinesia with atypical antipsychotics.

PMID: 12504071 [PubMed - in process] From PubMed

I find a gram or more of fish oil daily takes down triglycerides.

I am wondering if weight gain is a natural human way to help calmness. Does the atypical
antipsychotic just encourage a normal process or something like that?

Reducing cholesterol does not help everyone. Isn't there study which says reducing fat causes extra
stress therefore the body tries to make more cholesterol or something like that? Note that
cholesterol is the basis for the anti-cancer hormone vitamin D amongst others.

Must ake another look at fats like stearic acid in cocoa butter.

Here are my cholesterol results.

Date Choles Triglyc HDL-Chol Chol/HDL LDL-Chol Glucose Gluc-Fast

16/6/97 (Time of knee op) 6.8 Taking about 3g fish oil daily
16/7/01 Date of Heart Attack 8.3
16/8/01 5.9* 0.7 1.49* 3.9 4.0 5.0
16/9/01 Stopped fish oil about now to avert intestinal pain
16/10/01 5.3* 1.9* 0.95* 5.5* ........not fasting
16/11/01 4.5 1.0 0.83* 5.4* 3.2 4.4
16/12/01 Coronary Bypass Op 6.7
16/13/01 2.7 1.3 0.70* 3.9 1.4
16/14/02 4.6 1.1 1.2 3.8 2.9
16/15/02 Started 1g fish oil daily
16/16/02 4.1 0.6 1.2 3.4 2.6 Sep 02 4.6 0.5 1.35 3.4 3.0 Started Lipex
16/17/03 4.8 0.8 1.7* 2.8 2.7

stopped Lipex (simvastatin) & started heavy chocolate eating, 5/2/03, some 125g daily, and coenzyme
Q10 some 20 mg daily 10/2/03

16/18/03 5.2 0.5 1.66 3.1 3.3 Desirable ranges fasting 3.2-5.2 0.3-1.5 1.04-1.30 <5.0 <3.5 3.5-6.0
non-fast 3.5-7.8

Date Choles Triglyc HDL-Chol Chol/HDL LDL-Chol Glucose Gluc-Fast

Despite heavy chocolate eating (lots of stearic acid and lecithin) my total cholesterol has only
gone up to the maximum recommended for the normal population.

My HDL has stayed 0.4 above.

My triglycerides have come back from what Lipex was doing to them.

To bring my total cholesterol to 4, which the cardiologist recommends for post bypass, would require
LDL drop of 1.2, or some of that could be made up from HDL drop.

It would be very interesting to know HDL-C or other components.

I read that high HDL is not protective when triglycerides are high. It needs to be medium, and the
types of HDL are important.

For those who may have been following my CK data, I had a CK isoenzymes test also on 18/2/03, almost
2 weeks after stopping statin and CKMM showed, not CKMB which had been 3 times over the limit, or
the other CK isoenzyme related to prostate.

The electrophoresis isoenzymes test is not very sensitive and does not give a figure.

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In sci.med.cardiology Dave Bird <[email protected]> wrote:
> In article<[email protected]>, Brian Sandle
> <[email protected]> writes:
>>I am wondering if weight gain is a natural human way to help calmness. Does the atypical
>>antipsychotic just encourage a normal process or something like that?

> Sort of. Neural paths promoted by (dopamine or) a moderate amount of serotonin link of to the
> alternative parasympathetic nervous system which goes to the stomach and genitals, and to outward
> fluid secretion i.e. of saliva, stomach acid, etc. Stress activates negative feedback, S2,
> receptors of serotonin, and too much "hard braking" like that is the number one provocation for
> things to run away into complete psychosis. Atypical, of antipsychotics, means they block these
> S2 receptors as well as directly addressing the psychosis.

> Anything which (promotes dopamine or) reduces this negative feedback promotes appetite,
> digestion, and weight gain. Yes there are sub-types within S2, but the odds are that most drugs
> will be non-selective between those areas which have a pro-calming effect versus those which have
> a pro-appetite effect. Bottom line: the circuitry for appetite is closely related to that for
> calmness, so it is very easy to get your signals crossed.

I do not have perseonal experience but I believe olanzapine increases weight even with the same food
intake. There must be more retention.

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On Wed, 26 Feb 2003 03:59:42 +0000, Dave Bird <[email protected]> wrote:

>>I do not have personal experience but I believe olanzapine increases weight even with the same
>>food intake. There must be more retention.
>
> Yes. One of the pro-appetite functions simply turns up the rate of fat fat deposit at the same
> level of fuel input: less burned, more stored.

So less burned means you do less and must wear more clothes to feel warm?

Moosh:)
 
In article<[email protected]>, Moosh:) <[email protected]> writes:
>On Wed, 26 Feb 2003 03:59:42 +0000, Dave Bird <[email protected]> wrote:
>
>>>I do not have personal experience but I believe olanzapine increases weight even with the same
>>>food intake. There must be more retention.
>>
>> Yes. One of the pro-appetite functions simply turns up the rate of fat fat deposit at the same
>> level of fuel input: less burned, more stored.
>
>
>So less burned means you do less and must wear more clothes to feel warm?

Pass, I'm not sure. It may not even be the only mechanism that glucose and fats liberated from food
are "burned" otherwise; it may be that the limits are set low to excrete glucose via the kidneys
and fats via the liver. So if you ate a lot of fat it would just be excreted not stored. This
wouldn't feel any warmer or colder, of course. Equally the appetite-related thing probably boosts
building glucose into fats and blocks excretion of fats. Where it will rob from is muscle activity,
and you will just feel inclined to less physical activity, take the left instead of the stairs or
whatever. If you exercise anyway then it will make you will feel inexplicably more tired and/or
hungry than it used to.

--

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
8====3 (O 0) GROETEN --- PRINTZ XEMU EXTRAWL no real OT has |n| (COMMANDER, FIFTH INVADER FORCE)
ever existed ................................................................. A society without a
religion is like a maniac without a chainsaw.
 
Moosh:) wrote:

> On Wed, 26 Feb 2003 03:59:42 +0000, Dave Bird <[email protected]> wrote:
>
>>>I do not have personal experience but I believe olanzapine increases weight even with the same
>>>food intake. There must be more retention.
>>
>> Yes. One of the pro-appetite functions simply turns up the rate of fat fat deposit at the same
>> level of fuel input: less burned, more stored.
>
>
> So less burned means you do less and must wear more clothes to feel warm?

No, somehow the olanzapine reduces your metabolism so that even with the same food intake and
activity level that once mainatained a steady weight you gain weight. For example your metabolism
can change from that of a skinny person who can eat anything they want and never gain weight to
someone who steadily puts on weight.

David
 
In article<[email protected]>, Moosh:) <[email protected]> writes:
>On Wed, 26 Feb 2003 18:25:10 +0000, Dave Bird <[email protected]> wrote:
>
>>In article<[email protected]>, Moosh:) <[email protected]> writes:
>>>On Wed, 26 Feb 2003 03:59:42 +0000, Dave Bird <[email protected]> wrote:
>>>
>>>>>I do not have personal experience but I believe olanzapine increases weight even with the same
>>>>>food intake. There must be more retention.
>>>>
>>>> Yes. One of the pro-appetite functions simply turns up the rate of fat fat deposit at the same
>>>> level of fuel input: less burned, more stored.
>>>
>>>
>>>So less burned means you do less and must wear more clothes to feel warm?
>>
>> Pass, I'm not sure.
>
>So many aren't. There is one thing for certain. All calories MUST be accounted for. They can't just
>disappear into the woodwork. Say there are 1000 calories swallowed. Every one of these must be
>found and listed as to its fate. It can be absorbed from the gut and used for muscular activity,
>metabolic activity, stored, excreted (many ways -- urine, faeces etc)
>
>>It may not even be the only mechanism that glucose and fats liberated from food are "burned"
>>otherwise; it may be that the limits are set low to excrete glucose via the kidneys
>
>Called diabetes mellitus
>
>>and fats via the liver.
>
>Stored or excreted?

It may be that excretion of glucose begins at a lower level of blood glucose (within normal range,
short of full diabetes), or that fats are excreted via the biliary route into faeces.

A switch from deposition to defecation of fat would not affect your body temperature.

>>This wouldn't feel any warmer or colder, of course.
>
>But with inadequate clothes in a cold climate, you burn more energy.
>
>> Equally the appetite-related thing probably boosts building glucose into fats and blocks
>> excretion of fats.
>
>Appetite influences the brain to swallow more or less food.

Yes but there are a number of parasymathetic outputs which influence things like feeding behaviour
up or down, rate of glucose to stored starch conversion (insulin), rate of glucose to fat
conversion, rate of fat deposition, blood-glucose threshold for glucose excretion via kidneys,
blood fat threshold for fat excretion via liver, fluid retention, etc.
>
>>Where it will rob from is muscle activity,
>
>This is generally a voluntary activity. What causes the choice to not exercise?

I can only appeal to our friend common observation that reduced calorie intake produces a drive to
a corresponding reduction in activity, sure as eggs is eggs. Yes, it can be overcome if you observe
what is happening and make a constant deliberate effort but
> If you
>> exercise anyway then it will make you will feel inexplicably more tired and/or hungry than it
>> used to.

Looking at your words "the (conscious) choice not to exercise", I think you have the wrong end of
the stick: there isn't one. What causes the conscious choice not to exercise if you are lying on
your bed with a severe dose of influenza? You feel exhausted and weak, you haven't the energy, and
you JUST DON'T FEEL LIKE getting up and rushing around. That's the "choice" you feel like making.
Not surprising, really, as your brain is in a fairly altered state. Most of these viruses are
dopamine lowering. You feel like you could really murder a dose of mild opiate to blank the dull
ache in the centre of your back which has spread into your limbs, and dry up all the saliva and
mucus pouring out of you.

>But with free will, you can overcome this.

These words free will are bandied around an awful lot, but in actual fact most of your well-adapted
regular behaviours happen at a level of unconscious habit. To try maintaining correct activity
without the prompts, to eat correctly when not automatically prompted by appetite or protect
yourself from harm without proper pain signals, becomes rather like trying to ride a bike by
conscious voluntary thought of "first the right foot, now the left foot, then the left foot, now
the right foot..."

-- . . : : ,; . : ' ___. uno, dos, tres, |FUEGO| .:. .:. .:': :' .:':' :. . : (") #oH| ' ' :' : :' :
.::. H_ ~~~| < > __ ,;;,. \\::// R_) | '-|"""(") {__}::===== ....'''' ' ' ' ___..\||/....L\. ...|
____||--|_'--/__\___ '' .--'''::::::::::::::::::::: \ / /////////////S.Coronado/////
;'^';-._.-;'^';-._.-;'^';-._.-;'^';-._;'^';-._.-;'^';-._.-;'^';-._.-;'^ LRonHubbard is shelled
byGoats inHell.READ http://www.ronthewarhero.org
 
In article<[email protected]>, John H.

>
>"Dave Bird" <[email protected]> wrote in message news:eek:[email protected]...
>> In >Looking at your words "the (conscious) choice not to exercise", I think you have the wrong
>> end of the stick: there isn't one. What causes the conscious choice not to exercise if you
>> are lying on your bed with a severe dose of influenza? You feel exhausted and weak, you
>> haven't the energy, and you JUST DON'T FEEL LIKE getting up and rushing around. That's the
>> "choice" you feel like making. Not surprising, really, as your brain is in a fairly altered
>> state. Most of these viruses are dopamine lowering. You feel like you could really murder a
>> dose of mild opiate to blank the dull ache in the centre of your back which has spread into
>> your limbs, and dry up all the saliva and mucus pouring out of you.
>
>Dopamine may well be a downstream effect but with respect to viruses and systemic inflammation a
>number of other factors need to be taken into account.
>
>1.
>
>Tnf a released during fever has the effect of downregulating G protein coupling thereby reducing
>overall cerebral metabolic activity. This effect on G proteins, I think, will impact on Da
>production but Da itself is only one player in the field.

I'm only a piker at this, but... dopamine is useful in resisting viral breakthrough of the cell
wall, and some viruses have adapted to depress dopamine levels to make their life easier, the drug
Amantidine is useful against flu viruses (if caught within 2 or 3 days of initial infection,
especially when there is a difficulty with other treatments)

I didn't enter the whole area of immune activation via interleukins causing physical and mental
slowdown, such as I know of it.
>
>2.
>
>il 1 released under a wide variety of stressors and can generate NO via iNOS. This impacts on a
>number of metabolic processes but more particularly excess NO can inhibit neuronal energy
>production via NO competing with O2 for occupation on the electron chain transport elements. As il
>1 and tnfa are often released concurrently, this constitutes a double whammy on cerebral
>metabolism.
>
>3.
>
>Immunological activation will lead to increased IDO production by various immune cells including
>microglia. IDO catabolizes tryptophan (useful in fighting microbes which often need that amino) and
>this may be why people on interferon therapy(hep c and MS) and cytokine therapy (cancer) experience
>depression. Robbed of extra cellular tryptophan, serotonin synthesis is inhibited.
>
>4.
>
>The generic pain often experienced in fevers is via cox 2 generation, many painkillers are cox 2
>inhibitors. Again, immunological activation generally raises cox 2 levels in a variety of cells.

Um, newer ones are COX2 inhibitors I think. I'm not sure, your knowledge is mostly ahead of mine.

Your advice is very sensible though. In sum, the changes caused by olanzapine will cause
difficulties not just metabolically (fat which used to be excreted is now deposited) but
behaviourally (a lot of things will be making you feel less like exercise), and it needs systematic
effort and self-training to overcome these barriers: you don't just decide and reach it without
considerable effort.
>
>---
>
>You can get all muddled up trying to understand the weight gain in relation to your drug regime. I
>suggest an alternative approach.
>
>Exercise in the morning, light to moderate, as exercise increases overall metabolic rate and if
>intense enough will maintain the increase for a number of hours.
>
>You could very well be under estimating the amount of sugars, especially via alcohol, think about
>this. Try and do an accurate analysis of your total caloric intake, it can be upsettingly
>surprising sometimes. Fact is: if you reduce your caloric intake and maintain exercise then weight
>must fall. I know this from my gym days, would starve myself and train like mad. Very difficult to
>do, may not be advisable for you, but it works. You need to be bloody determined though ... .
>
>Try to develop a fasting habit. As with caloric restriction, fasting can have significant health
>benefits and both have been demonstrated to have favourable impacts on cerebral health
>(neuroprotective) and metabolism. You see, those old mystics weren't that stupid ... . It takes
>time and in my case at least I now find it very difficult to eat a full meal. Don't eat full meals,
>rather half meals throughout the day. Healthy ones! I think my stomach must have shrunk over the
>years. It will take many months to do this but the effects may well last a very long time. Caloric
>restriction is the only proven method for improving longevity in lab studies. Reducing caloric
>intake doesn't necessarily reduce overall activity. I can easily go for 24 hours without eating,
>and put in a 12 hour day on the books.
>
>Vaguely, I recall reading an abstract indicating that administration of vitamin E can help reduce
>tardive dyskinesia. How is your anti-oxidant status generally? If you are drinking alcohol are you
>taking a vit B group s upplement (another study stated administration of B groups slightly improved
>anti-depressant drug response). L-carnitine supplement may help in weight problems. With regard to
>this paragraph see your doctor first! Eg. in a manic phase, though doubtful, L-carnitine may not be
>such a good idea as it increases ATP production and overall energy availability. Also consider
>omega 3 supplementation, though not demonstrated for bipolar these fats have shown efficacy in a
>number of conditions, including mental health ones.
>
>The choice not to exercise is part of the human condition, trust me you're not unique on this one.
>One way to overcome it is to coax yourself into exercise, beyond a certain level exercise becomes
>natural and fun. I saw this so often at the gym, people became addicted to exercise. But then if
>you like pot that ain't gonna happen. A lot of **** is said about pot but the one thing I have
>noticed in myself and others time and again is that pot makes life too good, who wants to struggle
>when just a cone away is another relaxing evening ... . Damn I've run out again. Maintain the
>meditation, recent research shows it can have significant benefits. One recent study claimed it
>elevated left cerebral activity over right, hence help in ameliorating depression. Also , some
>meditation types boost melatonin production, good endogenous anti oxidant. See, told you those
>mystics weren't that dumb. Tell me, can you meditate in the manic phases? Have your tried
>vispassana meditation during these times? Hmmm, what an interesting show that would be ... .
>
>The comments re moon, weather and sunspot activity are interesting. One of my side projects for a
>number of years now. Something subtle may be going on here but having searched the literature I
>have never been able to find anything convincing. However, on the weather side I'm sure there is
>some subtle effect. No idea why though.
>
>Learn to stay hungry, you'll get used to it.
>
>John H.
>
>PS: No more pot for you sunny Jim! Too dangerous.
>
>> >But with free will, you can overcome this.
>
>If free will is free then explain:
>
>multitude of separated twin studies showing v. similiar preferences re mates, jobs, lifestyles,
>haircuts, political leanings ... . The list goes on and on. Very little of our choices are actually
>"free", often we make choices because of constraints imposed upon us. That doesn't sound like
>freedom to me. "Free will" is a concept that has its origins in religious thinking, particularly
>christianity and 'choosing' salvation; though a brief reading of theology (cf predestination,
>calvinism, arminianism) quickly reveals how much grief the concept of free will has created. "Free
>will" explains nothing about human behaviour, it is essentially a 'black box' concept revealing
>more about our ignorance of our decision making processes than our personal and collective
>awareness of our decision making processes. Free will is one of the greatest straw men ideas of
>history. As the Buddha would say, "Throw it down!"
>
>
>
>

--

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
8====3 (O 0) GROETEN --- PRINTZ XEMU EXTRAWL no real OT has |n| (COMMANDER, FIFTH INVADER FORCE)
ever existed ................................................................. A society without a
religion is like a maniac without a chainsaw.
 
On Wed, 26 Feb 2003 14:01:40 -0330, David Dalton <[email protected]> wrote:

>Moosh:) wrote:
>
>> On Wed, 26 Feb 2003 03:59:42 +0000, Dave Bird <[email protected]> wrote:
>>
>>>>I do not have personal experience but I believe olanzapine increases weight even with the same
>>>>food intake. There must be more retention.
>>>
>>> Yes. One of the pro-appetite functions simply turns up the rate of fat fat deposit at the same
>>> level of fuel input: less burned, more stored.
>>
>>
>> So less burned means you do less and must wear more clothes to feel warm?
>
>No, somehow the olanzapine reduces your metabolism so that even with the same food intake and
>activity level that once mainatained a steady weight you gain weight.

Sorry, that can't happen. You must account for EVERY calorie. They are indestructible.

> For example your metabolism can change from that of a skinny person who can eat anything they want
> and never gain weight to someone who steadily puts on weight.

And what do you think the calorie balance sheet would be for these two examples. Remember EVERY
calorie must be accounted for -- you must state where every single one goes.

Moosh:)
 
On Wed, 26 Feb 2003 18:25:10 +0000, Dave Bird <[email protected]> wrote:

>In article<[email protected]>, Moosh:) <[email protected]> writes:
>>On Wed, 26 Feb 2003 03:59:42 +0000, Dave Bird <[email protected]> wrote:
>>
>>>>I do not have personal experience but I believe olanzapine increases weight even with the same
>>>>food intake. There must be more retention.
>>>
>>> Yes. One of the pro-appetite functions simply turns up the rate of fat fat deposit at the same
>>> level of fuel input: less burned, more stored.
>>
>>
>>So less burned means you do less and must wear more clothes to feel warm?
>
> Pass, I'm not sure.

So many aren't. There is one thing for certain. All calories MUST be accounted for. They can't just
disappear into the woodwork.

Say there are 1000 calories swallowed. Every one of these must be found and listed as to its fate.
It can be absorbed from the gut and used for muscular activity, metabolic activity, stored, excreted
(many ways -- urine, faeces etc)

>It may not even be the only mechanism that glucose and fats liberated from food are "burned"
>otherwise; it may be that the limits are set low to excrete glucose via the kidneys

Called diabetes mellitus

>and fats via the liver.

Stored or excreted?

> So if you ate a lot of fat it would just be excreted not stored.

Vomited or defaecated?

>This wouldn't feel any warmer or colder, of course.

But with inadequate clothes in a cold climate, you burn more energy.

> Equally the appetite-related thing probably boosts building glucose into fats and blocks excretion
> of fats.

Appetite influences the brain to swallow more or less food.

>Where it will rob from is muscle activity,

This is generally a voluntary activity. What causes the choice to not exercise?

>and you will just feel inclined to less physical activity,

But with free will, you can overcome this.

>take the lift instead of the stairs or whatever. If you exercise anyway then it will make you will
>feel inexplicably more tired and/or hungry than it used to.

Sure there are influences on the brain to eat more or lesss and do more or less, but this does not
excuse the accounting for every calorie involved.

Moosh:)
 
Hulda Clark is working on a FAT Zapper ........

Same effect ......... eat tons of **** while losing weight painlessly ....... (Gain a slimmer waist
through eating tons and tons of potato chips ......)

Joel M. Eichen DDS

Moosh:) <[email protected]> wrote in message news:[email protected]...
> On Wed, 26 Feb 2003 18:25:10 +0000, Dave Bird <[email protected]> wrote:
>
> >In article<[email protected]>, Moosh:) <[email protected]> writes:
> >>On Wed, 26 Feb 2003 03:59:42 +0000, Dave Bird <[email protected]> wrote:
> >>
> >>>>I do not have personal experience but I believe olanzapine increases weight even with the same
> >>>>food intake. There must be more retention.
> >>>
> >>> Yes. One of the pro-appetite functions simply turns up the rate of fat fat deposit at the same
> >>> level of fuel input: less burned, more stored.
> >>
> >>
> >>So less burned means you do less and must wear more clothes to feel warm?
> >
> > Pass, I'm not sure.
>
> So many aren't. There is one thing for certain. All calories MUST be accounted for. They can't
> just disappear into the woodwork.
>
> Say there are 1000 calories swallowed. Every one of these must be found and listed as to its fate.
> It can be absorbed from the gut and used for muscular activity, metabolic activity, stored,
> excreted (many ways -- urine, faeces etc)
>
> >It may not even be the only mechanism that glucose and fats liberated from food are "burned"
> >otherwise; it may be that the limits are set low to excrete glucose via the kidneys
>
> Called diabetes mellitus
>
> >and fats via the liver.
>
> Stored or excreted?
>
> > So if you ate a lot of fat it would just be excreted not stored.
>
> Vomited or defaecated?
>
> >This wouldn't feel any warmer or colder, of course.
>
> But with inadequate clothes in a cold climate, you burn more energy.
>
> > Equally the appetite-related thing probably boosts building glucose into fats and blocks
> > excretion of fats.
>
> Appetite influences the brain to swallow more or less food.
>
> >Where it will rob from is muscle activity,
>
> This is generally a voluntary activity. What causes the choice to not exercise?
>
> >and you will just feel inclined to less physical activity,
>
> But with free will, you can overcome this.
>
> >take the lift instead of the stairs or whatever. If you exercise anyway then it will make you
> >will feel inexplicably more tired and/or hungry than it used to.
>
> Sure there are influences on the brain to eat more or lesss and do more or less, but this does not
> excuse the accounting for every calorie involved.
>
>
> Moosh:)