jimrandomh comments on Humans are not automatically strategic - Less Wrong

153 Post author: AnnaSalamon 08 September 2010 07:02AM

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Comment author: jimrandomh 09 September 2010 05:09:51AM *  7 points [-]

I predict with p=0.95 that you have at least one micronutrient deficiency which is greatly contributing to your depression, and that starting to take a multivitamin regularly would be enormously to your benefit. I predict with p=0.6 that you are specifically deficient in thiamine, and that a single dose of sulbutiamine (a molecule that crosses the blood-brain barrier and then breaks into two thiamine molecules) would cause a large and sudden reduction in your depression. I am basing this on my own experience with thiamine deficiency (caused by T1 diabetes), which produced in me a specific type of apathy which I recognize in your comments.

Unless you either lied about taking a multivitamin to your current doctor, or ignored their advice to take one, fire him or her and find a new one. Also, thoroughly research every drug you're currently taking. At a minimum, search for the name of each one on PubMed, skim the first few pages of titles and read some of the abstracts. Don't adjust anything without consulting a qualified doctor, but do make sure to have that consultation.

Following up on this may be the most important thing you ever do.

EDIT: One other thing - if you're on antidepressants, you should be getting blood work, of the "large checklist of tests" variety, done on a regular basis. Make sure your TSH has been tested at least once in the past two years (result will be interesting with p=0.1, but very interesting if it is).

Comment author: datadataeverywhere 09 September 2010 03:53:29PM 8 points [-]

I'm with wnoise, but I have a question to clarify my position.

How many diagnoses do you expect a competent physician to get wrong? I would say that more than 1 in 20 is at least reasonable. However, without meeting CronoDAS, or performing tests of any kind, based purely on the scant evidence in his posts, you have diagnosed him with a micronutrient deficiency, and have a confidence of 95% in your diagnosis. Seriously? What's your prior? Even for thiamine, a 60% confidence that this near-stranger is deficient in it seems dramatically too high.

Comment author: jimrandomh 09 September 2010 05:08:15PM 5 points [-]

These numbers are uncalibrated estimates (I spent 60s looking for population statistics to use as priors, and didn't find any), but I don't think they're at all unreasonable. Keep in mind that deficiencies come in degrees, and only the most severe ones ever get diagnosed. Anyways, here's a breakdown (again, just estimates) of that 0.95:

P(micronutrient deficiency) = 0.2
P(micronutrient deficiency|no multivitamin) = 0.8
P(micronutrient deficiency|no multivitamin & depressed) = 0.95

I certainly wouldn't say it's the only problem, but it's very likely a contributing factor.

Anyways, we can find this out directly. CronoDAS, could you take a look at the wikipedia page on thiamine, go through the lists of thiamine-containing and thiaminase-containing foods, and estimate your intake? Or better yet, order sulbutiamine and report its effects here?

Comment author: datadataeverywhere 09 September 2010 06:02:58PM *  10 points [-] 
P(micronutrient deficiency) = 0.2

I would go as high as 0.3 if you extend to third world countries, but suspect it's lower among people like ChronoDAS who can afford a variety of food. Either way, it's good enough.

P(micronutrient deficiency|no multivitamin) = 0.8

The law of conditional probability indicates that you think that a minimum of 75% of the population takes a multivitamin. I think this is way too high, especially for a population that has a 20% micronutrient deficiency rate.

P(micronutrient deficiency|no multivitamin & depressed) = 0.95

So the rate of depression among those with micronutrient deficiencies (and who don't take their vitamins) is about 119% that of the general population? I can buy that, but if it's that low, then why are you so sure that a micronutrient deficiency is "greatly contributing" to his depression?

I agree that there's no harm in having CronoDAS gather data or experiment a little, since sulbutiamine seems to have very few negative side effects with recommended doses.

My main reason for brining it up is that I see some very high probabilities tossed about on Less Wrong, and it bothers me when I feel like they're assigning numbers that they can't justify. I'm still skeptical about your 95% confidence, but it's nice to see a break down.

Would you be willing to take a bet at a 2/3rds payoff that CronoDAS has no thiamine deficiency? How about a 1/19th payoff that taking a daily multivitamin wouldn't significantly alter how he feels?

[EDIT: Revised payoffs in bet to reflect professed certainty]

Comment author: CronoDAS 13 September 2010 04:25:25PM 2 points [-]

From Wikipedia:

Thiamine is found in a wide variety of foods at low concentrations. Yeast and pork are the most highly concentrated sources of thiamine. In general, cereal grains are the most important dietary sources of thiamine, by virtue of their ubiquity. Of these, whole grains contain more thiamine than refined grains, as thiamine is found mostly in the outer layers of the grain and in the germ (which are removed during the refining process). For example, 100 g of whole-wheat flour contains 0.55 mg of thiamine, while 100 g of white flour contains only 0.06 mg of thiamine. In the US, processed flour must be enriched with thiamine mononitrate (along with niacin, ferrous iron, riboflavin, and folic acid) to replace that lost in processing.

Some other foods rich in thiamine are oatmeal, flax, and sunflower seeds, brown rice, whole grain rye, asparagus, kale, cauliflower, potatoes, oranges, liver (beef, pork and chicken), and eggs.

Hmmm... as it turns out, I've been eating quite a lot of thiamine-fortified pasta lately, and it's also in cold cereal, orange juice, and bread. I don't think I have an unusually low amount of thiamine in my diet when compared to the average American.

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