Lesser known symptoms of TS
I've always found that the absolute best way to learn about Tourette's is to talk to other Touretters. They tend to know or reveal things about the condition that no-one knows yet (at least not publicly).
Talking to other Touretters I discovered that Tourette syndrome appears to be more than just tics. There are other "symptoms" of the condition which seem to be reasonably common within the Tourette population.
· Polydipsia - Excessive water drinking
People with Tourette syndrome polydipsia drink about 15 bottles of water a day. Toilet trips are very frequent. It is believed that the altered serotonin levels in Tourette's is to blame. Serotonin levels affect vasopressin levels and vasopressin controls the amount we drink.
· Sensitivity to heat
This topic is apparently discussed in Dr Comings book Tourette syndrome and human behaviour. With this symptom, the person is always warm. In hot weather, the person boils, in cold weather they wear much less heavy clothing than would be expected. No theories were offered as to why this happens, but one person guessed that their body temperature was actually lower than the norm.
I haven't found anything yet to suggest this is the case, but my theory is this is to do with Norepinephrine, the derivative of dopamine. Norepinephrine is used to trigger off the fight or flight response in humans. One of the effects of fight or flight is the heart rate increases. This heats the body as the warmer blood from the centre of the body reaches the extremities at a higher temperature trapping the heat in the centre. The excess work of the heart and the excess sugars burnt during this response also heat up the body considerably. You know this because after exercise or a fright you tend to sweat. In Tourette syndrome the levels of Norepinephrine in the system are lower than normal. This means we are burning sugar slower and in many cases our heart is beating slower than the norm.
A couple of people, over the years, have mentioned to me that they have low blood pressure...this norepinephrine theory would explain that. It would also explain why many Tourette drugs raise blood pressure a bit.
· Tactile hypresensitivity
5 out of the 13 Touretters mentioned they had this symptom. Some of them couldn't stand the feel of hair on their skin. Most cannot wear synthetic material or wool. Pure cotton undergarments seem to be the only acceptable alternative and a couple of women go bra-less because they are too uncomfortable otherwise. There seems a higher than normal level of allergies to things like detergents and cheap metal jewellery. Even the thought of touching chalk makes some of them squirm. Often a person with this symptom will feel suddenly itchy all over, for no discernable reason. This itchiness can be triggered by watching seeing a biting insect, seeing someone else scratch, and even talking about scratching or itches. Because it is so suggestible, I have come up with a theory for why this happens. I believe this is a kind of 'reverse tic'.
It is known that tics are contagious (I will discuss this at a later date. In the meantime, don't panic! It's not what you're thinking.) and that they can be started or worsened just by mentioning them. I suggested before that tics are caused by the small "housecleaning" impulses sent around the brain being amplified at each synapse by the extra dopamine receptors until they are strong enough to turn into an action. I think a similar thing happens with Tactile hypersensitivity, but in reverse.
the human body is covered in hair, most of it thin and blonde (unless you're particularly hairy). In our ancestors this hair was probably used as protection from the elements. But as we've evolved it has taken on a different purpose, the detection of pressure. All over the skin there are nerves that measure pressure. On some places, like the tips of the fingers, there are millions of them ever square centimetre. However on other places, like the back, there is only one a square centimetre. Instead of using nerves, which are very precise, to measure pressure on such a large area, they use hairs. Wrapped around the root of each hair is a nerve that notices when the hair is moved. It then sends a message to the brain stating that its hair has moved and the brain uses this information, subconsciously, to build a picture of the body's surroundings. It is subconscious because, if we could feel every time a hair on our body moved, we wouldn't have the mental capacity for thought or movement.
My theory is that, in people with Tactile hypersensitivity, sometimes these messages are amplified by the extra dopamine receptors in the same way as tics are. When it has been strengthened enough it breaks through the barrier between subconscious and conscious and you become aware of the movement.
And, in the same way thinking about tics reinforces and strengthens the tic pathways, thinking or talking about itchiness will make it easier for that amplification to take place.
If you doubt that hair movement can cause all over itchiness, try this experiment: Take a toothpick or matchstick and, in a place with no wind, choose a single arm hair and lift it up bending it against the natural direction of the hair. Then imagine that feeling happening, not for a fraction of a second, but for a couple of minutes. Also imagine that, instead of one hair, it's every hair on your body. Makes you want to scratch doesn't it?!
· Weight issues
Many people have told me that they have weight issues. This didn't surprise me; Low levels of serotonin are known to cause increased appetite and cravings for fatty foods. (The cravings are an attempt to raise serotonin levels using the proteins to manufacture more, but this is a very inefficient way of doing it and you'd have to eat heaps!) So I've always expected that Touretters would have a propensity for being obese. But to my complete shock the vast majority of Touretters I talked with were excessively thin. So much so that a couple of them, if offered a cure for Tourette's or a way to put on weight would choose to gain weight.
Through the upbeat page TS is fun I found my way to an article from the journal SCIENCE 283(5399)pp184 from the 8th of January 1999. The article is titled Beyond Sloth--Physical Activity and Weight Gain and is by Eric Ravussin and Elliot Danforth jr. The study attempts to find out why, in times of plenty, some people become obese and some don't. The study found two things:
i. The fidgetiness of an individual plays a larger role in daily energy expenditure than previously thought. This is the conclusion that the newspaper article quoted on the TS is Fun website runs with. It has been found that fidgeting accounts for an average energy expenditure of 348 kcal/day (range 100 to 700 kcal/day). To put that into perspective, an average sized person burns up about 300 calories on a one kilometre run. So just by fidgeting you can burn the equivalent of an 100km run a day!!!
The actual study from science, however, suggests that the study is a bit flawed. You can say that fidgeting plays a part in weight loss, but how much of a part is not yet clear.
ii. Overfeeding activates the sympathetic nervous system. This in turn causes energy to be "wasted" and converted to heat. This was not mentioned by the newspaper, but may well be the main reason why many Touretters are excessively light. Touretters in general appear to have higher levels of norepinephrine than normal. Norepinephrine is one of the trigger hormones that activate the sympathetic nervous system. So perhaps one of the reasons Touretters can be so thin is because a large amount of what they eat is being classed as unnecessary and is burnt off.
Jones, C. (2001) Tourette Syndrome 101 - Australia
Author Qualification in BSc, and Tourette sufferer.
URL is http://au.geocities.com/jones_kacm