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Help with NutrEval results

Discussion in 'Diagnostic Guidelines and Laboratory Testing' started by qwerty42, May 5, 2012.

  1. Sushi

    Sushi Moderator and Senior Member Albuquerque

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    Hi Paul,

    Some members can probably comment to some extent but I don't know of anyone who could put it all together like Rich. Do you have a copy of the Doctor's NutraEval Report? My doctor gave me a copy of mine and it had quite a few pages of computer generated analysis. Not the same as an expert commenting, but helpful.

    Sushi
  2. paulb

    paulb

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    Hi ,Sushi. My report is at the on a thread i posted recently, think you can find it under my recent postings......sorry should have put it on my profile, i will edit later. probably helpful to read first also...........Its 07:40am here in the U.K and my insomnia leaves me not going to sleep till midday, i should be asleep.:( But as many people the quest for better health has completely taken over my life, and i spend every hour of every day researching to find a way out.........I thought there might be other physicians on here to help.........Let me know if you can make anything of my results.....Thanks Sushi

    PaulB
  3. Sushi

    Sushi Moderator and Senior Member Albuquerque

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    Hi Paul,

    I hadn't seen your other post. Good that you linked your full test for members to see. Rich was not a physician but a Ph.D. researcher who devoted all his time to this disease and to trying to help us. There are a couple of physicians who are members here, but they do not normally look at test results.

    Hope you get some help with this,

    Best wishes,
    Sushi
    merylg likes this.
  4. qwerty42

    qwerty42

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    Hi sorry that you are struggling as well. Rich has been a loss to us all for sure - I'm only a recent member but he was such a help with me.

    Had some new labs back which tend to support problems with my methylation and b-vitamin conversion, namely sky high serum B12 and over range Folate (Not entirely sure HOW high folate is as the lab doesn't measure past 20). My iron also seems to be creeping up again after last giving blood to get it down in April.

    Serum B12: 1940 ng/L (211 - 911)
    Serum folate: >20 ug/L (4.6 - 18.7)

    Ferritin 95 ug/L (30-330)
    Serum TIBC 52 umol/L (40-70)
    Serum iron level 30 (10-30)
    Saturation iron binding capacity 58%
  5. roxie60

    roxie60 Senior Member

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    Hi Qwerty, curious, is there a difference between B12 and serum B12 (or is this just a ref to it being blood tested)?

    My latest B12 is very high now but I am taking MB12, Bmulti and Metanx so I expected it to go up. Just not sure if it is actually working
  6. Sushi

    Sushi Moderator and Senior Member Albuquerque

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    Yes, there is a difference. B12 values vary considerably according to how they are measured.

    Sushi
  7. qwerty42

    qwerty42

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    As above ^^ it differs. You can measure, serum, RBC or WBC as far as I know in terms of blood testing.

    This thread has evolved from just my Nutreval results really but guess its a good log.

    Had a brisk 4 mile walk with the dogs along the beach today - didn't feel any more tired doing it or afterwards. Its strange but its like a persistant fatigue that doesn't seem worsened by activity. It wasn't any worse or better after my two 1.5 mile jogs last week.

    That, in conjunction with my cortisol levels which are now perfect (and usually low in CFS) is making me wonder about things.

    I do have the low gluthatione as in the nutreval and some of the other markers but I don't have

    * low cortisol levels
    * fatigue worsened by activity
    * any kind of physical muscle ache / pain either during or following activity. Only physical pain is with the eyes

    Therefore other than the sinus congestion / eyes:

    * Low /normal serum testosterone with zero libido
    * Low mood - no enjoyment of any food / activity
    * Poor motivation
    * Fatigue
    * Difficulty concentrating and poor memory

    Could well fall under the major depression banner I suppose.

    The only caveat being that my mood has only really started to suffer these past few months. The previous 18 months I'd been fairly motivated to find out why I was feeling so terrible and had stayed fairly upbeat.

    I guess it is something to consider and the story that gave me the idea was that of Alberto Salazar the famous marathon runner (now coach of Mo Farah) who overtrained and suffered with fatigue, malaise etc for 10 years before trialling prozac and being able to run and function again within two weeks.
  8. qwerty42

    qwerty42

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    Three weeks into low sulphur diet and new methylation supps. Changed from hydroxy b12 to methyl b12 yesterday.

    No positive effects yet - still feeling dreadful.

    I'm wondering if a main problem for me really is low noepinepherine. Two of the markers for its urinary metabolites 3methyl-4-OHphenylglycol and vanillyl mandelic acid are both low on my nutreval and only just in range in comparison to the serotonin and dopamine ones which seem at good levels.

    Low mood, no libido, low energy, difficulty concentrating, low body temperature in the prescence of goodl thyroid / adrenals, temperature that drops following exercise, mild hypotension on rising from a chair quickly, and sinus congestion could quite neatly fit under low NE symptoms could they not?

    And just further to that I'm additionally thinking low NE over low dopamine due to the fact my prolactin is always in range and low - middle.
  9. qwerty42

    qwerty42

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    Just tested urine with quantofix strips and its saying the suplur content is between:

    >200 - >400 mg/L although I would say closer to the less than 200 reading.

    So in terms of reducing sulphur I'd have to hazard that diet / supps are doing the job. I don't feel any different however.

    Just posting as an update anyway, will discuss with my ND.
  10. qwerty42

    qwerty42

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    Just tested using sulfur strips on first urine in the morning and it was slightly higher - 800mg/L

    So its somewhere in the region of 200 - 800mg/L overall - not particularly accurate I suppose, but also not hugely high.
  11. caledonia

    caledonia

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    Qwerty, it sounds like you have the CBS/sulfur thing pretty well resolved. What delivery method of B12 are you doing? The hydroxy or methyl forms are good, but will barely absorb if taken through the stomach (only 2%). It has to be sublingual or an injection. Sublingual can either be liquid drops under the tongue or a pill that you suck on until it dissolves.
  12. qwerty42

    qwerty42

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    Thanks - hopefully I do yes.

    I've been on hydroxyb12 1000mcg sublingual for 3 weeks and changed 2 weeks ago to 1000mcg sublingual methylb12.

    I actually collected 24 hours worth of urine last nigh for some further heavy metals testing and leaky gut testing - got them for my birthday, just what I've always wanted! - and the sulfate strips showed a definite >400mg/l.

    The nutritionist I'm working with wants me to carry on for another few weeks working on CBS before stepping up the methylation supplements apparently. I'm yet to feel any symptom improvement unfortunately..
  13. paulb

    paulb

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    What is CBS and its connection with the methyl pathway?
  14. qwerty42

    qwerty42

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  15. qwerty42

    qwerty42

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    Ok so as an update.

    Felt no benefits from the Testosterone replacement trial and had my levels re-checked, they were at 23.5 or 680. Libido was unchanged. (See the bottom of the post for a little study I performed)

    Transitioned off it onto HCG 1500iu EOD + 1mg Arimidex for the last couple of weeks along with TOCO 8 (Vit E supp) & Dopa Mucuna (15% L-Dopa)

    Finished the HCG and in the first week of DAA and Torem which I'm running at 3g and 120/90/60/30 respectively. Adex dropped to 1/2mg Mon / Thurs.

    Testicle size doesn't seem to have grown much - maybe a little. Have felt some hints of libido when on the HCG.

    Symptoms remain pretty much unchanged with eyes being the most pressing. Physical energy is not as bad as it was but mental acuity is terrible compared to what it was - memory especially poor and 'brain fog' quite apparent.

    Last week I saw an opthamologist regarding my photophobic / dry eyes / floaters and he suggested a diagnosis of blepharitis but couldn't suggesta cause. He has suggested bathing them morning and night which I am trying. Doesn't seem like a particularly accurate diagnosis however..

    I have also had the results of two more tests back - urinary heavy metals (have already had hair and blood) and leaky gut testing.

    My gut is ok and the heavy metal I was suspecting - lead (in a way hoping - by way of an answer) is within the reference range.

    The only toxic elements outside the reference range are:

    Thallium: 0.468 (<=0.273)
    Gadolinium 0.027 (<=0.019)
    Cesium 10.89 (<=10.10)
    Rubidium 2,674 (<= 2,486)

    I'm not sure how pressing they are or if they could even affect my symptoms.

    My sulfur levels are now consistently down to around 400 mg/L and I have been following the methylation protocol as laid out. No positive changes to report so far really.

    I have continued to try and add 120 - 130 bpm cardio in on a stationary bike, sometimes with a sweatsuit, and don't feel any worse for doing it. In fact quite the opposite, I feel better after doing it and don't seem to encounter any delayed fatigue as a result.

    I would also note that over the Xmas period I spent more time with friends and, having not drank for 8 months, allowed myself several drinks on one or two nights. I felt much better during - sharper, more like my old self and didn't suffer any ill effects other than the usual foggy head in the morning - I definitely noticed libido upon waking. The rest of my symptoms were no better or worse for having a few drinks.

    I definitely think that a dopamine / noepineiphrine problem has something to do with my symptoms.

    In fact when I read Dr Myhills 'The Difference between CFS & Depression' I'd have to agree more with the depression descriptors:

    * Light exercise seems to help or at least doesn't make me worse
    * Alcohol seems to help and don't feel any worse the next day
    * No joint / muscle pain
    * Cortisol levels are now normal (good)
    * Sleep cycle on the whole is not pushed back




    ------------------

    Un-related but interesting study:

    A few of my close friends who have seen how much I've been struggling and know a lot of the ins and outs of it decided to get their T levels checked with me. It has definitely re-inforced one and for all that people shouldn't wholly chase numbers when it comes to Testosterone.

    Its obviously not scientific but we all had blood drawn at roughly the same time in the AM and had all been to bed at a normal time the night before with no alcohol consumed. None of them have used AAS before and none of them have had T levels checked. We are all mid twenties.

    Friend 1: Rugby player - heavily muscled, not that lean but very strong , drinks a fair bit. Single but gets through a lot of women - self reported libido is very high. T level - 16 (464)

    Friend 2: Non - exerciser and pretty weak in general, average build, verging on overweight, in a long term relationship. Libido is so - so but no problems. Very confident demeanour. T level - 23 (667)

    Friend 3: Gym goer - lean and fit with a good amount of muscle. Eats well etc Reported libido very high and have shared a flat with him so can attest to this. T level - 12 (350)

    Obviously non of the above is scientific and I am relying on their reported information but I thought it was interesting neverthless.
  16. paulb

    paulb

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    What is HCG and L-Dopa?
  17. qwerty42

    qwerty42

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    HCG is an extract from pregnant women's urine and serves as an artificial LH (Luetenizing hormone) signaller. In men LH signals the testes to produce Testosterone.

    L-Dopa is an immediate prescursor to dopamine and noepinepherine (noadrenaline in the UK)
  18. qwerty42

    qwerty42

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    I'd like to add to the above - self administered testosterone replacement, HCG and then the use of selective estrogen receptor modulators like Toremifine Citrate and Clomiphene Citrate was really meant for discussion on some of the other forums I post on. I merely included it for context.

    I would strongly advise against self medication with the above. I only dabbled in it after more than 18 months of research and it was to sate my own curiosity that lowish Testosterone might have been a causative factor. It now seems unlikely, at least in my case.
  19. qwerty42

    qwerty42

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    Update -

    I'm in week 3 of my SERMs of Toremifine Citrate @ 60mg and Clomid at 25mg BID. Prior to that I did 8 shots of 1500iu of HCG spread over 2 weeks with 1mg Adex on the day of the shots. I've also been taking 3g DAA and a serving of TOCO 8 (Vit E Supplement) each day.

    Just had bloods back drawn 7 days ago:

    FSH 10.6 (2.0 - 14)
    LH 11.4 (2.0 - 14)
    Oestradiol <50 (28 - 156)
    SHBG 28 nmol/l (15-47)
    Testosterone 13.5 nmol/l (392 US units) (Was 14.4 back in Nov prior to trying TRT)
    Prolactin 136 (86 - 324)
    Progesterone 2.6 (0.95 - 3.82)
    Vitamin D 169 nmol/l (>75) (Checking the web optimal is 150 - 180)

    TSH 1.9 (0.2 - 5.0)
    FT4 17.0 (9.0 - 24)
    LDL Cholesterole 1.83 mmol/l (0 - 2.0)
    HDL 1.5 No range mmol/l
    Cholesterol 3.7 mmol/l (0 - 4)
    Chol / HDL ratio 2.47
    Albumin 44 g/l (34 - 48)
    Sodium 143 (133 - 146)
    Potassium 4.0 (3.5 - 5.5)


    So it looks like I'm recovered back to where I was prior to the trial of Testosterone replacement which is a relief. I'll continue to run it for the remainder of the planned 4 weeks.

    One good piece of news is my Vitamin D, which was 83nmol/l back in Nov 11 then 74 nmol/l when checked is April 2012 is now well into the optimal range. I have been supplementing with 5000iu for around 18 months now so can only conclude that my body is now absorbing it and fats in general more efficiently now. I think my cholesterol numbers would support this as well.

    I have also tapered up to 5000mcg of B12 and 3000mcg of 5-Methlfolate; supplements to support the methylation cycle. Having felt no discernible difference I have dropped back to 1000mcg of each.

    I am still off work. My GP, while supporting, cannot prescribe Wellbutrin in the UK, not even off label, so any hopes of a trial of that are out of the window. I broached the topic of a trial of an SNRI (Effexor of Cymbalta) but while willing to try in the future, he does not thinking I present as particularly depressed.

    I have now got an appointment to see the ENT specialist again regarding my sinuses in February. When I last saw him he suggested I may need Septoplasty, SMD and Outfracture of the turbinates. My GP and I are both keen for me to have this done on the off chance that it improves my eyes and energy levels in general.

    Symptom wise I am pretty much unchanged in terms of tiredness, visual problems, concentration and libido. Psychologically I would say I am better than where I was before Christmas. Getting out with my friends and having a few drinks for the first time in a long time has definitely helped that, but unfortunately it has not changed the rest. Still, important to keep track of the positives.

    I have also been able to do some light exercise. Checking my heart rate the morning after with the orthostatic test, I am recovering fine from it. Definitely not 'overtrained' in the classic sense any more. Have lifted some light weights and also tried hot yoga (not really light!) which I enjoyed and had some interesting benefits as well. I felt immeasurably better when I had finished and for the couple of hours afterwards. On checking my body temperature it was around 98.6 whereas at most other times the highest it gets is 97.7.

    This brings me back to the concept of Wilson's Temperature Syndrome:

    -I've got the thyroid symptoms - dry eyes, dry brittle hair (changed from thick and full), cold extremeties, low normal serum T, no libido, brain fog and low body temp but obviously my FT3, FT4, Rt3 are ok
    -I've got the perfect history - chronic dieting / overtraining with stressful period and noticeable crash
    -I now know one or two professionals personally who have people who have sorted themselves through it, coming from similar backgrounds.
    -I've excluded so much else and WTS is definitely a diagnosis of exclusion.


    I have managed to find a UK GP who treats this now, based on Harley Street, and am hoping to get enough money together to be able to see him. I have enough Cytomel to try it myself but would be unsure and better to defer to a Dr. It would seemingly also be the first time a qualified doctor in the UK has actually had a clue what may be wrong.

    It may be a longshot and I know Matrix disagrees with the use of T3 like this and I respect his opinion wholeheartedly, but I am running out of options really and don't seem to be improving currently.

    If anyone has any experience of people undergoing WTS therapy I would appreciate experiences.
  20. qwerty42

    qwerty42

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    As an update. I've tapered up to 50mcg of T3 taken at night and am now 10 days into it. I've also added 12.5mcg of iodine.

    My basal underarm temperature is still 97.1 and hasn't really budged despite the T3. Symptom wise I haven't felt any worse or better. Noteably I haven't experienced any classically low cortisol symptoms which is good.

    Again though on Saturday, similar to last weekend, I had a large amount of food and this time also had some alcohol as well. Didn't do basal temperature on the Sunday but by the afternoon it had got to 98.6 and by the evening was 99. I didn't feel hyper at all and, despite feeling hungover, felt great. Sharper mind, noticeable libido, eyes not so dry.

    So is it the large calorie surplus or is it the alcohol, or a mixture of both that drives my temperature up?

    Today I had a little N1 experiment.

    Basal temperature - 97.1
    4.20pm temperature - 98.0
    4.30pm 1 25ml measure of Johnny Walker whiskey
    5.00pm temperature 98.5

    Everything I have read in the literature suggests that alcohol depresses body temperature. This would seem to suggest otherwise.

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