Choline on the Brain? A Guide to Choline in Chronic Fatigue Syndrome
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Methylation Startup - Refeeding Syndrome

Discussion in 'Detox: Methylation; B12; Glutathione; Chelation' started by healing1, Dec 5, 2013.

  1. healing1


    The parallels to CFS and refeeding syndrome are striking, body using mostly protein/fat for energy (ketones) and low potassium, magnesium, phosphorous and B1...

    Any individual who has had negligible nutrient intake for more than 5 consecutive days is at risk of refeeding syndrome. Refeeding syndrome usually occurs within four days of starting to feed. Patients can develop fluid and electrolytedisorders, especially hypophosphatemia, along with neurologic, pulmonary, cardiac, neuromuscular, and hematologic complications.

    During prolonged fasting the body aims to conserve muscle and protein breakdown by switching to ketone bodies derived from fatty acids as the main energy source. The liver decreases its rate of gluconeogenesis thus conserving muscle and protein. Many intracellular minerals become severely depleted during this period, although serum levels remain normal. Importantly, insulin secretion is suppressed in this fasted state and glucagon secretion is increased.[3]

    During refeeding, insulin secretion resumes in response to increased blood sugar; resulting in increased glycogen, fat and protein synthesis. This process requires phosphates, magnesium and potassium which are already depleted and the stores rapidly become used up. Formation of phosphorylated carbohydrate compounds in the liver and skeletal muscle depletes intracellular ATP and 2,3-diphosphoglycerate in red blood cells, leading to cellular dysfunction and inadequate oxygen delivery to the body's organs. Refeeding increases the basal metabolic rate. Intracellular movement of electrolytes occurs along with a fall in the serum electrolytes, including phosphate, potassium and magnesium.Glucose, and levels of the B vitamin thiamine may also fall. Cardiac arrhythmias are the most common cause of death from refeeding syndrome, with other significant risks including confusion, coma and convulsions and cardiac failure.

    This syndrome can occur at the beginning of treatment for anorexia nervosa when patients are reintroduced to a healthy diet. The shifting of electrolytes and fluid balance increases cardiac workload and heart rate. This can lead to acute heart failure. Oxygen consumption is also increased which strains the respiratory system and can make weaning from ventilation more difficult.
    dannybex, Mogwai, Sidereal and 2 others like this.
  2. priya

    priya permanently dislabeled

    it's true. i was also in the ED over xmas + apparently have electrolytes out of whack along with a critically low level of phosphate [also present in various myopathies].yet, i don't starve myself + must eat ev 4 hours to maintain BS levels. it seems the common denominator in refeeding syndrome + my own test results is the weirdly low phosphate level. has anyone researched this more, or know how to treat hypophosphatemia?
  3. nandixon

    nandixon Senior Member

    I don't know if this would be of interest:
  4. Freddd

    Freddd Senior Member

    Salt Lake City
    Hi Healing1,


    The syndrome was first described after World War II in Americans who, held by the Japanese as prisoners of war, had become malnourished during captivity

    Now for an parallel to CFS. The Japanese prisoners specifically were, even when fed some carbs, totally devoid of B12 and most amino acids. At many prison camps if the prisoner military doctor was aware of the need for protein factors would start a bug/worm stew for all those willing and contributing. Those people generally survived whereas those eating only the provided foods didn't. I've read an account of such by a British doctor who was a prisoner and fed them bug stew and realized the B12 factor in retrospect.

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