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GUT Transit Time and Nutrient Absorbtion

Freddd

Senior Member
Messages
5,184
Location
Salt Lake City
As usual a combination of what I have been experiencing and others reports of experiences and questions brings up this question for me. This is speculative as to effect. Let me explain.

Consider that peak absorption of potassium to serum is at 14 hours after consumption. What happens with a <12 hour GUT transit time? I developed a software model for time release medication serum level. Most of these drugs claimed 12-24 hour effective release of medication and often an even longer tail going out to 36 hours I'll describe the original Oxycontin since that is the one I have done the most extensive modeling with. The original Oxycontin released 70% of medication during the first 6 hours, another 20% during the next 6 hours and 10% in the following 24 hours. So what happens to the person with IBS with a GUT transit time of 12 hours? They lose 10% of their dose. This 10% trickle isn't much but it is the series of 4 or so doses all trickling out their last 10% of drug that contributed to the "smoothness" of pain relief. What happens is the shorter the GUT transit time the shorter the effective duration of the medication. A person with 12 hour transit time typically finds that Oxycontin is a 6-8 hour medication, not a 12 hour medication.

Perhaps with a short transit time, all sorts of things that would be absorbed after 8 hours are not absorbed. So maybe the hypokalemia is as much from impaired absorption from food as from increased need. When my GUT transit time dove under 24 hours to 8-12 hours I couldn't get enough potassium in me, my intestines were paralyzed from lack of potassium and when I took Reglan, and it started up so everything went rapidly south rather than coming back up as vomit. Even when I did get the potassium barely back up and managed the problem, it was always barely enough. So now with the transit time of 36 hours I no longer am having all the muscle spasms I get with low potassium. The angular cheilitis is fading rapidly. My nerves are not getting worse.

So how many nutrients don't get adequately absorbed if transit time is under 36 hours, such as under 12 hours? Then there is the effect of the inflammation itself on absorption. It appears to be one of those cycles that once established feeds upon itself getting worse and worse as nutrients become more deficient making the digestive system work even less well.

Does this make sense to any of you? How does this correlate with your experiences?
 

pela

Senior Member
Messages
103
Yes, this does make sense to me. My gut transit time is quite short. It's 12 hours overnight but may be shorter during the day. It might explain why I am taking a higher than average dose of thyroid medicine and I am not hyper. On the other hand, I do not need extra potassium (at least not this week). For the record, I was gluten intolerant and most likely celiac for decades before I figured it out (no thanks to any doctors). Even though I have been GF for 6 years, and grain/soy/sugar free for 5 years, I still have a rapid-transit gut.

Any research? You mention a software model.
 

Freddd

Senior Member
Messages
5,184
Location
Salt Lake City
HI Pela,

It is a serum level modeling software with which any medication with adequate information of release pattern, usually shown as a graph for time release opioids for instance, based on an average serum halflife. The model allows me to generate a curve at any serum halflife. Also, to make corrections based on GUT transit time, liver effects, kidney effects on clearance and things like that.
 

Red04

Senior Member
Messages
179
My wife had a strong "tolerance" to Xanax and painkillers.

People would joke about it. We went on vacation with some friends. My wife has a fear of flying and will take a Xanax when we go through security. She gave one of our friends 1/2 of a xanax who also has a fear of flying. The friend was out for the rest of the day and had to be basically carried to our destination. My wife was basically fine and said sometimes I take two.

Additionally, her tolerance has dropped. She no longer takes much of that stuff. Maybe 2-3 times a year. But her tolerance has gone way down since recovering with methylation.

I always attributed her tolerance to the numbness of me/CFS and taking a lot of Rx her entire life. But, the hypothesis fits that it was her absorption the entire time.
 

Victronix

Senior Member
Messages
418
Location
California
Perhaps with a short transit time, all sorts of things that would be absorbed after 8 hours are not absorbed. So maybe the hypokalemia is as much from impaired absorption from food as from increased need.

It would be wonderful if this ends up being an AH-HAH! moment . . . I am *really* trying to figure out what this hypoK thing is about.

My husband starting taking mfolate and has no increased potassium need. Same as those who take B-12 with no deficiency.

What is the probability that most people on here (the majority who post seem to end up needing potassium) have impaired absorption? What are the issues that cause this? I have hashitmoto's which is notorious for creating problems with absorption, but usually that's because of SLOW transit time, not fast, that I know of.

I know that I have a big problem absorbing fats, which even showed up in a test one time. I've known I have major gut issues with absorption but have not yet been able to figure it out.

Interestingly, with the B-12, although I got hypokalemia, it went away. I never took potassium.

So far with a minescule amount of mfolate, I continue to have a huge potassium need that does not go away. And the need for it seems to be more than for B-12

Could taking potassium change the need for it somehow? There are all the mechanisms to keep electrolytes balanced that kick in, so could taking potassium alter those somehow, making it more difficult to return to normal? Just a thought.
 

Victronix

Senior Member
Messages
418
Location
California
Other thoughts:

Could it be something going on with aldosterone, since hyperaldosteronism can lead to hypokalemia? How many on here have endocrine problems?

Dbikta also mentioned potential potassium channel problems, in which case, could we isolate a genetic marker for that? Could there be a predisposition for potassium channel problems that also includes ME/CFS? For example, a recent genome wide study implicated a calcium channel polymorphism in a range of psychiatric disorders (bipolar, schizophrenia, etc.).
 

BadBadBear

Senior Member
Messages
571
Location
Rocky Mountains
Hmmmm. I think my gut transit is fairly slow, but I'm not finding that I absorb potassium especially well. I don't know if transit time is as much of a factor for me as poor absorption. I have been wondering if it a biofilm problem? Maybe something else I am taking is blocking uptake? Maybe lack of magnesium is causing poor uptake?

Yesterday and today I took a couple of doses (~7 mEq) of liquid potassium rather than my usual pills, and felt that it might have worked better...

I am taking another blood test for my potassium level tomorrow, and will be interested to see which direction my K level is heading. Hopefully upward.
 

Victronix

Senior Member
Messages
418
Location
California
One problem with digestive disorder research is the inevitable wading into of incredible minutae of every possible infection and food type and symptom. Ultimately, an absorption issue has got to be a larger issue, not due to a particular food or microbe or infection, but more like a more broad hormone issue, inflammation issue, an immune issue, a genetic mutation leading to many symptoms, etc., things happening system-wide.
 

Phred

Senior Member
Messages
141
For example, a recent genome wide study implicated a calcium channel polymorphism in a range of psychiatric disorders (bipolar, schizophrenia, etc.).

Do you have a link to that study? I'd be very interested in seeing it. My mother was both bipolar and schizophrenic. She also had a slew of digestive issues, but I'm sure that was due to undiagnosed Celiac.
 

Victronix

Senior Member
Messages
418
Location
California
Do you have a link to that study? I'd be very interested in seeing it. My mother was both bipolar and schizophrenic. She also had a slew of digestive issues, but I'm sure that was due to undiagnosed Celiac.

Yes although it's at home, I printed it out, so I'll let you know when I get there.

A coworker was saying that the study was not that important because although it identified the genes with the disorders, the actual risk they found in getting those disorders was extremely small. But my experience has been that the association of genetic polymorphisms and the disorders they may be associated with is typically very robust.

I suspect that in our lifetimes the whole framework of disorders like schizophrenia and bipolar will change radically.
 

Little Bluestem

All Good Things Must Come to an End
Messages
4,930
Could taking potassium change the need for it somehow? There are all the mechanisms to keep electrolytes balanced that kick in, so could taking potassium alter those somehow, making it more difficult to return to normal? Just a thought.
Or maybe you are low on some other electrolyte, so your body is keeping the potassium low to keep the balance.

I have been doing hair mineral testing for 3 years. During most of that time my potassium was extremely low. I am not good about getting the testing done regularly. The test previous to this month was last September. In that time, my potassium has come up dramatically into the normal range. During the time that my potassium was low, my sodium was skating along the lower border of the normal range. Now that my potassium has come up, the sodium has also come up farther into the normal range.

When I first began trying to bring the potassium up, I was drinking salt water with both potassium and sodium salt, thinking I should drink a balance. My dietitian told me to leave out the sodium because we did not want it to come up until the potassium had. During the time I was taking sodium, it did not come up. I assume my kidneys were getting rid of it, which made more work for them.
 

Victronix

Senior Member
Messages
418
Location
California
Do you have a link to that study? I'd be very interested in seeing it. My mother was both bipolar and schizophrenic. She also had a slew of digestive issues, but I'm sure that was due to undiagnosed Celiac.

There was a story on it in the NYTimes
http://www.nytimes.com/2013/03/01/h...s-shared-by-5-psychiatric-disorders.html?_r=0

The study is here:
Identification of risk loci with shared effects on five major psychiatric disorders: a genome-wide analysis
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)62129-1/fulltext


Interpretation

Our findings show that specific SNPs are associated with a range of psychiatric disorders of childhood onset or adult onset. In particular, variation in calcium-channel activity genes seems to have pleiotropic effects on psychopathology. These results provide evidence relevant to the goal of moving beyond descriptive syndromes in psychiatry, and towards a nosology informed by disease cause.
 

Phred

Senior Member
Messages
141