Need Herb Advice

I'm hoping folks can weigh in about whether any of the recent changes I've made to my supplement regimen might be aggravating an ongoing retinal condition.

about two weeks ago, I had a flare of central serous retinopathy, which I've had consistently to one degree or another for eight years (it began when everything else related to chronic TBDs began). Blood vessels in the retina leak and cause swelling, leading to a blurry or dark spot in the central vision of the affected eye. Usually it clears up on its own, but scar tissue can form, affecting vision, and the fluid buildup can recur. Most of the time I have a small amount of swelling and scar tissue, and barely notice it anymore. Some days it's almost gone. Initially this condition can be caused by a cortisol spike or infection (including Bartonella), both of which are possibilities in my case, or can be idiopathic. It's crucial that people with this condition not take steroids or do anything to raise cortisol, regardless of the initial cause, or they risk retinal rupture. Historically, for me it has flared with stress associated with other physical symptom flares and with pushing myself too hard, and it flares right away, like within 24 hours.

But two weeks ago, nothing stressful or taxing was going on. Due to a recent broken ankle (October) and sudden bilateral knee pain (July), I have altered my supplements, so perhaps those are responsible for leaking blood vessels, raised cortisol (of which I have no other symptoms), or affecting the retinas in some other way.

Here's what I was already taking:
Curcumin, quercetin, bromelain, Host Defense medicinal mushroom complex, vitex, milk thistle, vitamin C, magnesium glycinate, ashwagandha, B complex.

Here's what I added: Solomon's seal, BioSil, Japanese knotweed. I've also been consuming more protein than usual.

Anything jump out at folks with herbal medicine knowledge that might be causing the retinal swelling?

Thanks, Rainy! I hadn't read that about niacin. Interesting!

I take the B complex about once per week (and also take a B12-folate-B6 complex once per week), and have for the past couple of years. I don't think it's the initial trigger or the cause of the flare, just because the timing doesn't add up, but now that I know it could be contributing, I will find a niacin-free option!

hi Sara
these type of things are always tricky to pin down

on the one hand - its possible to find possible mechanisms linked to many compounds that could potentially have some impact on something that it could be reasoned might contribute to this health issue through a variety of pathways

but on the other - the problem may have arisen independent of anything added or changed.
or could be due to some long term mechanism not currently in the scope of monitoring.

i also did not know that association with Niacin - but it does have a reputation for flushing of the skin - which is presumably due to some expansion of small blood vessels - which could be some how linked mechanistically with leaking blood vessels in the eye - so worth checking that out.

by the way there is non flushing niacin - niacinamide - which since it does not have the flushing effect may not have the same issue - if indeed that is the cause.

my own logic process for things such as this is to make an analysis that takes account of both timing fit and documented fit in the scientific literature ( eg score both of these as how well they fit out of 10, multiply them together to get a total probability) - and use this to shortlist the top 5 or 10 potential causes -

I then run trials on these to try to refine the list further. its a probabilistic type problem - not a deterministic one - as we never have enough knowledge or data to generate perfect answers - but its way better than going for some kneejerk reaction, full of its inevitable blind spots and biases.
i find more than 50% of the time this yields a useful answer - often one i would not have spotted if i were doing it informally in my head. Records of past trials can often be helpful in ruling out some of the things on the shortlist and narrowing the list of suspects down to a manageable number.

for me the things that have changed most recently would receive much higher probabilities as being causal than things i have been taking for a long time and the condition seemed stable.
i would also include lifestyle factors and things that i took out( not just added in) - as important changes to have in the analysis

I am sure this seems almost pathogenically obsessive to some - but where your recovery to health is concerned - and where one's eyesight is concerned - in my view it is certainly warranted

on the list of supplements - there are several with mild potential associations in your initial list - like bromelain is a fibrinolytic - so reduces fibrin build up - and i think a platelet activation inhibitor - which all sound pro bleeding - but in practice even huge doses do not seem to induce bleeding in humans - and the LD50 in rabbits is truly massive - so that's what i mean about having to be careful about finding a potential mechanism associated with your concern in everything you look into if you search with the almost inevitable confirmation bias - and again - i think if indeed its due to any of the supplements - its more likely due to the more recent additions than any you have used for a long time

i don't see anything obvious there in the recent additions list
i don't know much about Solomon seal
knotweed is known to increase microcirculation to some degree - but again i doubt its anything to be worried about - and may even be a good thing as its known to improve endothelial cell function / be protective of endothelial cells - which is exactly what you need

my feeling is that, if anything, the condition is less to do with bleeding / clotting per se - and more to do with endothelial cell dysfunction ( the reason why endothelial cells are unable to contain the blood in the first place - as they are supposed to do - rather than what happens to the blood after there is a hole in the blood vessel wall)

known drivers for this are:
-infection esp bart and lyme which both infect and damage endothelial cells directly
-high blood blood sugar / blood sugar spikes - worth testing post prandial levels - esp if recent diet change - (there is a v high degree of individual variation - and unexpected things in the diet can for some people drive big excursions).
-stress - due to cortisol driving blood sugar and insulin - see above
-unhealthy fats - i doubt you have much of these in your diet - but basically seed oils and anything from processed food
-smoking/pollution/toxins etc - all poke holes in the endothelial cell lining of the blood vessels

i hope its of some help