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D-Lactic Acidosis in CFS

Discussion in 'Latest ME/CFS Research' started by Glynis Steele, Oct 9, 2010.

  1. MeSci

    MeSci ME/CFS since 1995; activity level 6?

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    Sorry to hear that GSE didn't help you.

    I did a fair bit of reading up on GSE and thought that the evidence was reasonably good that it was effective, at least in vitro, and I think that at least some manufacturers give assurances that their product is not contaminated. There is a paper here on in vitro tests done with a pure product: http://hrcak.srce.hr/file/26006

    I wonder whether some of the accusations come from pharma companies wanting to discredit natural medicine? I don't know - just wondering.

    I haven't had much in the way of gut testing, but have had problems on and off since childhood. I was rushed to hospital as a child with severe gut pain that was thought to be appendicitis but wasn't; however, my colon was found to be inflamed. The only other test I can think of was a FOBS test a few years ago (negative).

    I lost what little faith I had left in doctors in 2010 following hospitalisation due to severe hyponatraemia. The medics have consistently refused to take my views on board about possible causes, and insisted that I must have been overhydrated, when test findings show the opposite. D-lactic acidosis can cause hyponatraemia.
     
  2. brenda

    brenda Senior Member

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    Christine (Dog Person) wanted us to see the following :

    "The following indicates that when your body is starved for manganese, it increases these types of bacteria since they help transport it into the body, along with cadmium. So those that have elevated cadmium (any amount is bad, not just high levels) can see that they are very low in manganese and the body is attempting to bring it in whenever it can find some from the diet.

    Metal Ions in Biological Systems, Volume 37, Manganese and Its Role In Biological Processes, edited by Astrid Sigel and Helmut Sigel, Copyright 2000

    "Lactic acid bacteria accumulate remarkably high concentrations of manganese. Lactobacillus plantarum accumulates 30-35 mM concentrations of manganese [13]. Since manganese can act as a scavenger of superoxide, the extraordinarily high level of manganese accumulated in L. plantarum bypasses the requirement for a superoxide dismutase [14,15]. Studies by Archibald and Duong have revealed a specific active transport system for manganese in L. plantarum that is driven by a membrane proton gradient [16]. Interestingly, the calculated Km for manganese uptake was comparable to that observed for E. coli, S. aureus, and B. subtilis; however, in accordance with the high demand for manganese in L. plantarum, the velocity of uptake was orders of magnitude higher than other bacterial systems characterized [16]. As is the case with S. aureus and B. subtilis, cadmium uptake in L. plantarum involves the manganese transporter. Uptake of both cadmium and manganese is induced by metal starvation, suggesting the existence of a regulatory feedback loop for control of manganese transport [16]."
     
  3. nanonug

    nanonug Senior Member

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    I did pretty much that, too. That's why I decided to try it.

    May I suggest the Metametrix GI Effects Complete Profile, then? Distributor in UK is Nutrition Geeks.

    Welcome to the club! :D
     
  4. MeSci

    MeSci ME/CFS since 1995; activity level 6?

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    Interesting. Does anyone know of any evidence that people with ME are manganese-deficient? I just did a quick search through the abstracts of research held by ME Research UK (which is over 1500 pages long) and manganese isn't mentioned, unless its abbreviated form Mn is used.

    I'm more persuaded at the moment by a paper that finds that acidosis and hyponatraemia can be caused by deficiency in the hormone ACTH, which is required for the production of cortisol, and to which ME sufferers have been found to have auto-antibodies, which could explain our low cortisol levels. There may be no safe way to boost ACTH levels except what sounds perverse, which is to temporarily reduce cortisol levels, which apparently can trigger more ACTH activity (if I remember rightly). ACTH supplementation carries the usual risks accompanying steroid use.

    An interesting paper on ACTH deficiency and hyponatraemia can be read here:

    http://jcem.endojournals.org/content/89/10/5271.1.full

    There is only a brief specific mention of acidosis but this is implied by low plasma bicarbonate (which I had when I had hyponatraemia).
     
  5. MeSci

    MeSci ME/CFS since 1995; activity level 6?

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    Thanks for the suggestion. I'll see how things go with the interventions I am trying at the moment, as finances are very limited due to this illness. I've started adding about 5g of sodium bicarbonate per day to my regime, which from a few searches of reputable medical sites looks as though it's worth trying. Anyone else here tried bicarb?
     
  6. nanonug

    nanonug Senior Member

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    Given that manganese is needed by the mitochondrial superoxide dismutase, and given the oxidative stress typical of people with ME, I wouldn't be surprised if a deficiency were to emerge.
     
  7. MeSci

    MeSci ME/CFS since 1995; activity level 6?

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    It's possible, but the body doesn't need much manganese, and my daily multivit/mineral supplement provides 100% RDA (this is 2 mg in the UK). Too much is dangerous - see here:

    http://www.umm.edu/altmed/articles/manganese-000314.htm

    Also, oxidative stress is implicated in a very wide range of conditions, can have a wide range of causes, and can be treated in many ways. I think that taking manganese would be a bit of a shot in the dark, and could do more harm than good. I've just found a thread about it here:

    http://forums.phoenixrising.me/showthread.php?8971-SODASE-TEST-RESULT-manganese-deficiency-help

    Is anyone here taking it now and, if so, have they seen any benefits?
     
  8. Hanna

    Hanna Senior Member

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    Hi meSci,

    Manganese may present a huge problem of absorption and a lot of minerals inhibit its action. It is preferably supplemented alone, and not within a multimineral formula.
     
  9. brenda

    brenda Senior Member

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    I am taking it and it is giving the wow factor. If I lower my dose it shows within an hour in my urine and very soon, my energy levels.

    I am taking it following the advice of Dog Person as it showed up as very deficient in my Hair Mineral Analysis along with b2 which was also extremely deficient as are a lot of PWC.

    I am taking 4 times the recommended amount (WaterOz) which does not give the dosage but can take up to 8 times apparently according to the effect I get in order to repair the damage done by the deficiency. I am balancing it with the b2 and b12 to get the signs of the right amount, that is, dark brown stool and yellow urine (apart from the fluorescent b2 urine) This shows that my RBC`s are using iron now instead of storing it and more APT is being produced.

    It is quite remarkable for me to see good results soon after taking supplements - I am so used to taking things just because I believe they will help.

    I am not taking any other b apart from the ones I mention as I am getting them from my food and there is sufficient b2 not to `take them down`.
     
  10. dga5000

    dga5000

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    I'm an ME / CFS patient who has just tested positive for D-Lactate Acidosis. I'm waiting (and may be waiting for some time) for an explanation from my consultant. Does anyone know anything about this?
     
  11. Noellea77

    Noellea77

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    @dga5000 I just tested positive too. Were you able to get an explanation or any treatment so far? Are you any better?

    Noelle
     
  12. Forebearance

    Forebearance Senior Member

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    I started taking manganese years ago because in her book Dr. Yasko said it was needed by some people for detoxification. Since I take molybdenum to prevent headaches from detoxing, I figured I might have the genetics to also need manganese. But I don't feel anything noticeable from taking it.
     
  13. bel canto

    bel canto Senior Member

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  14. Avenger

    Avenger

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    Dear Glynis,
    I have had ME/CFS and Fibronyalgia for 18 years. I was formally diagnosed with D-Lactic acidosis without short bowel syndrome.

    I am writing this to make others aware. ME/CFS has the same symptoms as D-Lactic acidosis. I was mistreated by doctors and even given a Somatization (psychological) diagnosis because my symptoms were so severe and Doctors could not understand or believe them, much like Jennifer Rhia's. I have included Sheedy et al's report from 2009 stating the simnilarity between CFS/ME and D-Lacic acidosis and speculating that a subset of CFS/ME will have De-La.

    I have D-Lactic acidosis without short bowel syndrome (there are many causes including poor motility and diabetes). D-Lactic acidosis may be far more common than we think (Dr. Luke white has written that anyone with bacterial overgrowth may be at risk and many CFS/ME have bacterial overgrowth and gastrointestinal symptoms).

    I noticed that my symptoms stopped after using antibiotics temporarily (metronidazole), only to return again and made an appointment with a D-Lactic Consultant Gastroenterologist and was diagnosed virtually on the spot, because I was responding to antibiotics.

    I was put on a 0% Carbohydrate and Simple Sugar diet. Even small amounts will cause symptoms. 64 hours or more will stop symptoms if the diet is adhered to. The diet should be adhered to for at least 6 weeks and all foods checked for Carbohydrates and Sugars. I still make mistakes and the diet is hard to adhere to, but the benefits are astounding if you fall into this category!

    Please pass this on to all who you feel may benefit. Anyone who responds or whose symptoms decrease after using antibiotics may benefit and the diet is not dangerous except for people who need high levels of Carbohydrates such as Glycogen Storage Disease. But please check with your doctor before starting any diet to make sure it is appropriate.

    Increased D-Lactic Acid Intestinal Bacteria in Patients with Chronic Fatigue Syndrome
    1. JOHN R. SHEEDY1,
    2. RICHARD E.H. WETTENHALL1,
    3. DENIS SCANLON2,
    4. PAUL R. GOOLEY1,
    5. DONALD P. LEWIS3,
    6. NEIL MCGREGOR4,
    7. DAVID I. STAPLETON1,
    8. HENRY L. BUTT5 and
    9. KENNY L. DE MEIRLEIR6
    +Author Affiliations

    1. Kenny.De.Meirleir@vub.ac.be

    Next Section
    Abstract
    Patients with chronic fatigue syndrome (CFS) are affected by symptoms of cognitive dysfunction and neurological impairment, the cause of which has yet to be elucidated. However, these symptoms are strikingly similar to those of patients presented with D-lactic acidosis. A significant increase of Gram positive facultative anaerobic faecal microorganisms in 108 CFS patients as compared to 177 control subjects (p<0.01) is presented in this report. The viable count of D-lactic acid producing Enterococcus and Streptococcus spp. in the faecal samples from the CFS group (3.5×107 cfu/L and 9.8×107 cfu/L respectively) were significantly higher than those for the control group (5.0×106 cfu/L and 8.9×104cfu/L respectively). Analysis of exometabolic profiles of Enterococcus faecalis and Streptococcus sanguinis, representatives of Enterococcus and Streptococcus spp. respectively, by NMR and HPLC showed that these organisms produced significantly more lactic acid (p<0.01) from 13C-labeled glucose, than the Gram negative Escherichia coli. Further, both E. faecalis and S. sanguinis secrete more D-lactic acid than E. coli. This study suggests a probable link between intestinal colonization of Gram positive facultative anaerobic D-lactic acid bacteria and symptom expressions in a subgroup of patients with CFS. Given the fact that this might explain not only neurocognitive dysfunction in CFS patients but also mitochondrial dysfunction, these findings may have important clinical implications.

     
    Dan_USAAZ likes this.
  15. J.G

    J.G

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    Thank you for this. Could you break down your diet for us?
     
  16. MeSci

    MeSci ME/CFS since 1995; activity level 6?

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    Just want to point out that the full-text pdf is available via the link in message 4 in this thread (at the end of the message).

    Glad it helps you.
     
    Last edited: Feb 9, 2018
  17. Avenger

    Avenger

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    D-Lactic acidosis awareness in ME/CFS;

    Dear J.G,
    the diet is relatively simple. I am using mainly protein/meat based with vegetables and a small amount of fruit. I also use yoghurt, handfulls of nuts that are low in Carbohydrates (Cashews are high in Carbs).

    Breakfast; Eggs, Bacon, Mushroom, Tomatoes (Sausages can only be used if they have no sugar and flower).

    or Kippers and or Yoghurt (Low Carb Yoghurt which can be from 2% to 15 % Carbs)

    Mid Day and Evening Meals; Any Meat or Fish, Chichen, Eggs, with vegetables but definitely no potatoes, chickpeas, rice, bread or pasta.

    Fruit Sugars can also lead to Overgrowth so have to be limited to small amounts of fruit and non starchy vegetables.

    Much of the diet entails experimentation, but looking at product labels because similar products differ greatly in Carbs and Sugars. Some will have added Sugars.

    You are trying to avoid anything that will feed the Bacteria producing D-Lactic acid, which due to the failure to metabolise becomes a poison that causes illness fatigue, weakness and neurological symptoms.

    There is more to this and finding the individual cause of Bacterial Overgrowth is the key. Bacterial overgrowth may be caused by a number of underlying health problems. Poor motility can also cause or add to Bacterial Overgrowth and D-La, but Diabetes can also cause Overgrowth and D-La. The use of Opiates for pain can also add to poor motility and increased Overgrowth. A list of causes of Bacterial Overgrowth can be found in the abstract below.

    Dr. Sarah Myhill has been actively giving free advice online concerning Bacterial Overgrowth which she has stated for many years may be causing ME/CFS in some patients. You can find further advice concerning Bacterial Overgrowth diet which is the same for D-Lactic acidosis on her website.

    I have contacted the NHS and also the different ME/CFS organisations after my diagnosis, but all have failed to investigate the possibility for even a subset. I am very suspect of their individual motivations.

    My belief is that Sheedy et al are being cautious when they stated a subset of ME/CFS may have D-La. I think that there are going to be many angry people who have been failed due to lack of understanding of Gut Dysbiosis. D-La can also be fatal and can at worst cause seizure coma and death. I also had many years of heart arrhythms which are also associated with D-La and can be pronounced during the worst exaccerbations. It can cause a host of problems which fluctuating symptoms.

    Please pass this on to all who may benefit.

    Published online 2010 Jun 28. doi: 10.3748/wjg.v16.i24.2978
    PMCID: PMC2890937
    Small intestinal bacterial overgrowth syndrome
    Jan Bures, Jiri Cyrany, Darina Kohoutova, Miroslav Förstl, Stanislav Rejchrt, Jaroslav Kvetina, Viktor Vorisek, and Marcela Kopacova
    Author information ► Article notes ► Copyright and License information ►
    This article has been cited by other articles in PMC.

    Go to:
    Abstract
    Human intestinal microbiota create a complex polymicrobial ecology. This is characterised by its high population density, wide diversity and complexity of interaction. Any dysbalance of this complex intestinal microbiome, both qualitative and quantitative, might have serious health consequence for a macro-organism, including small intestinal bacterial overgrowth syndrome (SIBO). SIBO is defined as an increase in the number and/or alteration in the type of bacteria in the upper gastrointestinal tract. There are several endogenous defence mechanisms for preventing bacterial overgrowth: gastric acid secretion, intestinal motility, intact ileo-caecal valve, immunoglobulins within intestinal secretion and bacteriostatic properties of pancreatic and biliary secretion. Aetiology of SIBO is usually complex, associated with disorders of protective antibacterial mechanisms (e.g. achlorhydria, pancreatic exocrine insufficiency, immunodeficiency syndromes), anatomical abnormalities (e.g. small intestinal obstruction, diverticula, fistulae, surgical blind loop, previous ileo-caecal resections) and/or motility disorders (e.g. scleroderma, autonomic neuropathy in diabetes mellitus, post-radiation enteropathy, small intestinal pseudo-obstruction). In some patients more than one factor may be involved. Symptoms related to SIBO are bloating, diarrhoea, malabsorption, weight loss and malnutrition. The gold standard for diagnosing SIBO is still microbial investigation of jejunal aspirates. Non-invasive hydrogen and methane breath tests are most commonly used for the diagnosis of SIBO using glucose or lactulose. Therapy for SIBO must be complex, addressing all causes, symptoms and complications, and fully individualised. It should include treatment of the underlying disease, nutritional support and cyclical gastro-intestinal selective antibiotics. Prognosis is usually serious, determined mostly by the underlying disease that led to SIBO.

    Keywords:

    I hope this is helpful, Paul
     
    Last edited by a moderator: Feb 10, 2018
  18. cigana

    cigana Senior Member

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    Thanks Avenger.
    I'm confused though, in your post above you said that you were put on a diet with 0% carbs and sugars, but the diet you described is just a low-carb diet.
    Did you first go on a 0% carb diet, and then switch to a low carb diet?
     
  19. Avenger

    Avenger

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    Hi, the aim is for 0%, but there will be some small amount of Carbs in the foods that you eat to get a wide enough range of nutrients. The Diet is really a Ketigenic or Stone Age Diet (please read Dr. Myhills diet; She states that Carbohydrates lead to Gut Fermentation, Dysbiosis and Bacterial Overgrowth and many CFS/ME have gastrointestinal symptoms).

    If you want to trial the diet it would be best to try only eggs, meats, fish, cheese, any fats, and vegetables low in carbs for the trial period. You should notice results within 64 plus hours, but continue for a few weeks (You may also need to take wide ranging multivitamins because Bacterial Overgrowth can cause loss of vitamins through malabsorption). Fats are used instead of Carbohydrates (sorry I had missed this from my earlier thread).

    The same diet works for pre-diabetes and insulin resistance which may also be a part of the negative Carbohydrate cycle which may be implicated.

    I started on 0% for only six weeks while waiting for a dietitian and ate only meat and vegetables along with very low carb yoghurts. The results were astounding and my symptoms stopped after 18 years of often terrifying and painful illness.

    I did have some problems when I tried to add other foods some of which was because I did not understand Carbohydrate levels or that they varied from product to product, such as yoghurts. I also had a lot of misconceptions which come down to trial and error! Low Sugar fruits should be used but only in small quantity (Raspberries, Strawberries. Lemons, Kiwis, Blackberries, Watermellon, Avacado, Grapefruit etc.).

    I was told 0% Carbs and Sugars by the Consultant but there are some in the Diet given to me by the Hospital Dietitian.

    If you want to try the diet to see if your symptoms improve then you have to be very strict for the trial period.

    Bacterial Overgrowth and abdominal symptoms have been found in many CFS/ME sufferers.

    Some of the other benefits are better control of Blood Sugar and abdominal symptoms. I had frequent Hypoglycemia (caused by bacterial overgrowth), abdominal pain and bloating at times and had frequent high Fasting Blood Sugars (but not high enough for Diabetes). I also had periods of difficulty with my stomach emptying and falling asleep after a heavy Carb based meal later in the day as though I had been knocked out.

    All of the abdominal symptoms resolved with just lowering my Carbohydrates, but you need to be stricter to stop D-La symptoms.

    I have had periods when i have been forced to eat Carbohydrates eg. while on holiday because I had not planned properly and for other reasons. Symptoms do not return immediately and may take some days often lulling you into a false belief that you are now over the illness, but symptoms often return very quickly if I continue to use Carbohydrates and even faster if using Simple Sugars (Chocolate, Sweets etc.).

    Please message me if you have any further questions, I hope that this will help those with Bacterial Overgrowth or D-Lactic Symptoms. My belief is that there may be variations of Bacterial Overgrowth affecting from mild IBS to more serious neurological symptoms in D-La.


    Paul.
     
  20. cigana

    cigana Senior Member

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    Thanks for all the info. I tried a diet like that for about 2 years, but it didn't change any of my symptoms. Glad it worked for you.
     

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