I take 60mg methylphenidate daily. Despite this, I often become exhausted and need to nap.
Taking small amounts of pure glucose (150-300mg every 20-60 minutes) eliminates this fatigue. This works even when I already eat carbohydrates. E.g. 120g of oats in the morning don't prevent the exhaustion.
Proposed Mechanism
Facts:
Wiehler et al. (2022) found that cognitive fatigue correlates with glutamate accumulation in the prefrontal cortex.
Glutamate is the brain's main excitatory neurotransmitter.
Excess glutamate is neurotoxic.
Hypothesis-1: The brain throttles cognitive effort when too much glutamate has accumulated.
If these hypotheses hold, supplementing small amounts of pure glucose while working on stims, should reduce fatigue by supporting astrocyte glycogen replenishment, which in turn increased how much glutamate can be cleared. Possibly this has an effect even when not on stims.
Protocol
150-300mg glucose every 20-60 minutes, taken as a capsule.
My mother is a diabetic, and on medication for it. Her fasting sugar in the mornings used to be ~150, and she naturally wakes up at ~7 AM.
After doing a few minutes of moderately strenuous exercise ~25-20 min after a meal and before sleeping (blood sugar spikes slightly later after a meal than after straight glucose ingestion), on my suggestion, she now occasionally finds herself waking up due to hunger pangs at ~5-6 AM; her blood sugar at this point is often ~80-100. Even when she sleeps through the night, her fasting sugar in the morning is now almost always in the 80-120, usually 80-100 range after waking up, whenever she has followed the protocol.
(We're probably going to reduce her medication dosage after this after consulting and confirming with her doctor, since it appears the reduction is significant enough that her current dose is now slightly too high.)
This seems to be an absolutely busted intervention for hyperglycemia, to the extent that I think a case can be made to upgrade this to the level of population-level general advice ("exercise semi-strenuously for a few minutes ~15-30 min after a meal as just a default thing you do and everyone else does").
Observation
I take 60mg methylphenidate daily. Despite this, I often become exhausted and need to nap.
Taking small amounts of pure glucose (150-300mg every 20-60 minutes) eliminates this fatigue. This works even when I already eat carbohydrates. E.g. 120g of oats in the morning don't prevent the exhaustion.
Proposed Mechanism
Facts:
Hypothesis-1: The brain throttles cognitive effort when too much glutamate has accumulated.
Facts:
Hypothesis-2: Sustained stimulant use depletes astrocyte glycogen faster than it can be replenished.
Hypothesis-3: Elevated blood glucose helps glycogen synthesis, thereby maintaining clearance capacity.
If these hypotheses hold, supplementing small amounts of pure glucose while working on stims, should reduce fatigue by supporting astrocyte glycogen replenishment, which in turn increased how much glutamate can be cleared. Possibly this has an effect even when not on stims.
Protocol
150-300mg glucose every 20-60 minutes, taken as a capsule.