Glucose Supplementation for Sustained Stimulant Cognition

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:

  • 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.

Facts:

  • Glutamate is cleared by astrocytes.

  • This process costs 2 ATP per glutamate molecule (Escartin et al. 2006).

  • The ATP comes from astrocyte glycogen stores.

  • Sickmann et al. (2009) found that blocking astrocyte glycogenolysis impaired glutamate uptake.

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.