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Non-esterified fatty acids, the link between sympathetic dominance and chronic fatigue?

Discussion in 'Autonomic, Cardiovascular, and Respiratory' started by Emootje, Oct 10, 2016.

  1. Emootje

    Emootje Senior Member

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    Non-esterified fatty acids (NEFA), also known as free fatty acids (FFA), are produced from triglycerides by the actions of adipose triglyceride lipase (ATGL) and hormone sensitive lipase (HSL):

    v2i1a5_006lg.jpg
    source

    High sympathetic tone causes an increase in catecholamines which causes an increase in FFA/NEFA’s release. If you don’t burn these FFA/NEFA’s they accumulate and cause lipotoxicity.

    Excess of FFA/NEFA’s and their metabolites [fatty acids acyl-CoA (FA-acyl-CoA), diacylglycerol (DAG), protein kinase C (PKC) and ceramides] causes lipotoxicity by:
    *Impaired mitochondria function [1]
    *Impaired glucose metabolism [2] [3]
    *Insulin resistance [4] [5]
    *Inflammation [6]
    *Lowers aldosterone [7]

    Comp 1_00000.jpg

    High levels of NEFA’s are seen in:
    Sympathetic dominance:
    *Pheochromocytoma
    *Heart failure
    *Sleep apnea
    *Sleep deprivation
    *Hyperthyroidism
    *Acute myocardial infarction
    Others:
    (Pre)diabetes
    Fatty Liver
    Alcoholism
    Cachexia
     
    Last edited: Oct 11, 2016
  2. Emootje

    Emootje Senior Member

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    Any other members who have elevated FFA/NEFA levels like me?
     
  3. Little Bluestem

    Little Bluestem All Good Things Must Come to an End

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    If I get them tested and they are, is there anything I can do about it?
     
  4. Emootje

    Emootje Senior Member

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    In theory there are some strategies that can help:

    Inhibit FFA/NEFA's release by:
    *Increasing insulin (high sympathetic tone also stimulates the alpha 2 adrenergic receptor which inhibit insulin release)
    *Acipimox or niacin (acute lowering of FFA/NEFA's, but there is a rebound effect)
    *Beta blocker
    *Low fat diet

    Stimulate fat beta oxidation:
    *AMPK agonists (e.g. vinegar, gynostemma pentaphyllum, fasting and other AMPK agonists)
    *PPAR gamma agonists (PPAR gamma agonists)
    *PPAR alpha agonist (PPAR alpha agonists)
     
    Last edited: Oct 13, 2016
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  5. Sidereal

    Sidereal Senior Member

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    A very low fat diet (<10% of total calories) is one of very few things that noticeably improves my energy.
     
    Emootje likes this.
  6. Thinktank

    Thinktank Senior Member

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    WHat are the biomarkers to test for?
     
  7. Mij

    Mij Senior Member

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    What type of test was this?
     
  8. Emootje

    Emootje Senior Member

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    I guess the glucose tolerance test is a convenient budget test that could indication if your ffa/nefa's are high but it is not very specific. You can test for ffa/nefa's directly but the serum must be frozen soon after it is drawn.
    Ganzimmun did my test (freie fettsäuren) but also many other labs do this test.
    There are point of care ffa/nefa analysers for humans and cows that you can use.
    Lastly you can test for ceramides but as far as I know is Mayo the only clinic that test for this.
     
  9. Mij

    Mij Senior Member

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    @Sidereal does this include good fats too?
     
  10. Sidereal

    Sidereal Senior Member

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    Not sure what you mean by good fats.
     
  11. Mij

    Mij Senior Member

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    @Sidereal healthy fats, olive oils etc (as opposed to animal fats).
     
  12. Sidereal

    Sidereal Senior Member

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    I mean no animal fats, no oils of any kind (including olive and coconut oil), little to no high fat plant foods like nuts, seeds, avocados. Just naturally occurring fats in low fat foods. A total daily fat intake of about 20 grams max. It's VERY hard to do because it requires a dramatic change in cooking and eating habits. Some people get worse on very low fat diets so it's important to reverse course quickly if things seem to be deteriorating.
     
  13. adreno

    adreno PR activist

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    I suppose l-carnitine and pantethine would help?
     
  14. Mij

    Mij Senior Member

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    @Sidereal. I see. So if you are feeling improved energy on a low fat diet then is a good indication that this is beneficial in your case.

    I feel better on a high fat diet.
     
    Sidereal likes this.
  15. Emootje

    Emootje Senior Member

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    I guess that they could help by increasing beta oxidation.
    Thanks Adreno
     

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