Acetyl L- Glutathione, ATP, Baking Soda, Sam-e & Catalase = No PEM after exercise

Sidereal

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My working hypothesis (based on blood, hair, urine and symptoms) is that I have a mercury toxicity, made significantly worse by my taking high doses of alpha lipoic acid starting in Nov 2013. ALA ends up being a very good heavy metal chelator that goes intracellular and across the blood brain barrier. It converts to a dihydroxy form that is a two thiol chelator. So I may have moved mercury, which was very high in blood, into the intracellular environment and into my brain, where it then impaired my electron transport chain and brought on the sudden fatigue and neurological symptoms.

Complex II of the electron transport chain contains a iron-sulfur complex. Mercury has high affinity for those metal binding sites. For example, mercury will bind to a single thiol enzyme or protein was one MILLION times greater affinity than a metal like zinc. So one possibility is that my Complex II was highly impaired and I simply was not able to utilize fats very efficiently. Many complexes in ETC contain the Iron-sulfur complexes. ATP Synthase contains other metals. They are all targets for mercury.

Can you show me a good diagram that illustrates the pathway you are referring to? Because all of the fatty acid metabolism charts I found did not show feeding to Complex II. What I am wondering is if aerobic metabolism is impaired, does the body resort to using fat in a different pathway that is far less efficient?

The thing is, eating larger amounts of glucose did not fix what was broken. What it did do is send my blood glucose over 160 one hour after eating the glucose. And I still felt broken in terms of energy. And I still went into glycolysis and got horrific PEM symptoms after exercise. So I think the change of diet was simply coincidental to the ingestion of the high dose ALA, and I have problems blaming the result on a high fat diet.

The stuff about fat, FADH2 & Complex II is discussed at great length on the blog I linked to in my reply to @Gondwanaland. Wish I had a handy diagram.

Mercury is certainly bad news. I don't doubt this is an issue for many. Having said that, the symptoms you are describing which coincided with the induction of a low carb diet and that you are attributing to inappropriate ALA supplementation, I've experienced those same symptoms on a low carb diet (long before I took ALA or any other supplement) and I've heard this sort of metabolic breakdown described many times over in the paleo/LC blogosphere and some people on this forum like @Vegas. An immense amount of acrimonious debate has occurred in that community over the last few years as a result of all the people experiencing such symptoms who believe (and have various practitioners telling them) that they have hypothyroidism, not understanding that the low T3/high rT3 issue is a sign of much more profound metabolic problems. As you point out, eating glucose again does NOT fix whatever was broken. In fact, glucose is tolerated less well than before LC and now you find yourself spiking to 160 postprandially. I've been there myself. I ate like that for a year and a half and ended up with a temperature of 94-95 F and a host of very severe symptoms verging on death. You might wanna look into the microbiome stuff as a more likely explanation for these symptoms than mercury.
 

pemone

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The stuff about fat, FADH2 & Complex II is discussed at great length on the blog I linked to in my reply to @Gondwanaland. Wish I had a handy diagram.

I like Peter's Hyperlipid blog. He's extremely smart. But he also tends to address things in a very obscure and minute context without revealing the larger picture to people.

I posted a clear metabolic pathway showing fats in beta oxidation feed the Krebs Cycle. He's clearly addressing an alternative pathway, and he is not trying to say that the pathway he is exposing is the only one. I found a good image that exposes what Peter is talking about here:
http://www.intechopen.com/source/html/45280/media/image2.jpeg

I'll try to study this with others and see if it tells me anything new. If my electron transport chain is impaired by mercury, then presumably my fat would go through beta oxidation to Acetyl-CoA and drive the Krebs Cycle. But it's a really interesting question what happens to a person who eats fat and has no problem with the ETC. How do they convert NADH to NAD+ in sufficient quantity? NAD+ is critical to drive all kinds of cellular processes.

Mercury is certainly bad news. I don't doubt this is an issue for many. Having said that, the symptoms you are describing which coincided with the induction of a low carb diet and that you are attributing to inappropriate ALA supplementation, I've experienced those same symptoms on a low carb diet (long before I took ALA or any other supplement) and I've heard this sort of metabolic breakdown described many times over in the paleo/LC blogosphere and some people on this forum like @Vegas.

Of course that was the first thought I had as well. I reversed the diet for six months with no effect on my energy levels at all. I have very precise control on what I eat, and I did test more than 150 grams of starchy carbs every day. The condition did not reverse.

Now, could you argue that a low carb diet pushed me over some threshold for some metabolite, and that then started me onto a self-feeding cycle that is not so easily reversed? And could mercury possible work together with this effect to make restarting the aerobic metabolism more difficult? Sure, I can believe all of that. But I assure you have exhaustively tested eating sugar, starchy carbs, and starchy carbs together with fruit, and there is no combination of those things that gets me anywhere close to where I was prior to Nov 2013.

I am curious why do you think sugar is better than starchy carbs + fruit? Metabolically they should be identical.

An immense amount of acrimonious debate has occurred in that community over the last few years as a result of all the people experiencing such symptoms who believe (and have various practitioners telling them) that they have hypothyroidism, not understanding that the low T3/high rT3 issue is a sign of much more profound metabolic problems. As you point out, eating glucose again does NOT fix whatever was broken. In fact, glucose is tolerated less well than before LC and now you find yourself spiking to 160 postprandially. I've been there myself. I ate like that for a year and a half and ended up with a temperature of 94-95 F and a host of very severe symptoms verging on death. You might wanna look into the microbiome stuff as a more likely explanation for these symptoms than mercury.

How did you fix this problem for yourself?

If mankind was so fragile that a change in diet composition was enough to kill us, I don't think we would have made it as a species. I think it was common for our ancestors to eat vastly different diets from one month to the next. You eat what is available on a given day or week. You are ketogenic one week, eating 80% fruit the next week, eating mostly protein and fats when you catch some fish, etc. That kind of metabolic flexibility must be hard wired into our species, and it explains why we have so many metabolic pathways for creating energy. The body has to be able to adjust to such things, and it cannot be so fragile that it requires a specific balance of carb/protein/fats to survive.

Whatever hypothesis you choose, it has to explain both a collapse of aerobic metabolism and a glucose intolerance. Mercury does this very well. It binds to critical proteins in the ETC and breaks it. It binds to insulin receptors and breaks glucose metabolism. And - very important to my case - once you get mercury in a bad compartment of the body, it can take years to get it out. It completely explains the persistence of symptoms despite a wide variety of diets, and more to the point it is actually present in very high amounts in my blood, my urine, and my hair. How can I ignore experimental evidence that the metal is present in me at high levels, when it also explains perfectly every symptom I am having?

Why should I prefer a gut biome diagnosis when my Genova gut test shows fairly normal levels of bacteria, no infections, no pathogens, etc?
 
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zzz

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Dave Whitlock says ME/CFS has low NO, whereas Prof Martin Pall says the opposite, that ME/CFS has high NO (and high peroxynitrite).

I have an idea that they both might be right.

And Dr. Jay Goldstein agrees with you.
I remember from (Nobel Laureate co-discoverer) Ignarro's book that NO has a very short half life. Maybe <1 sec?

That's correct; it's just around a second. One of NO's actions is as a neurotransmitter, and one second is a long time for a neurotransmitter in the brain.
Have you ever tried a nitroglycerin tablet just to see what happens?

I probably want to stay away from that stuff. It apparently does not give the same kind of nitrate / nitrite response that you get from food, and I think dependency on that would be dangerous.

You can't become dependent on nitroglycerin; it is not dangerous. A review of the literature on it (including the prescribing information) will confirm this.
The body will eventually respond to nitroglycerin and compensate for it, requiring higher doses.

Some people can use nitroglycerin patches for a long time with no problem; others develop tolerance after a single dose. It depends on the person. When tolerance develops, higher doses don't work, at least for ME/CFS. Stopping nitroglycerin produces no withdrawal symptoms; at worst, it returns the person to baseline. This is why it is not dangerous.
 

pemone

Senior Member
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448
You can't become dependent on nitroglycerin; it is not dangerous. A review of the literature on it (including the prescribing information) will confirm this.

Some people can use nitroglycerin patches for a long time with no problem; others develop tolerance after a single dose. It depends on the person. When tolerance develops, higher doses don't work, at least for ME/CFS. Stopping nitroglycerin produces no withdrawal symptoms; at worst, it returns the person to baseline. This is why it is not dangerous.

Since Dave Whitlock has been quoted in this thread, consider his assertion that:
"“NO donors” have been suggested, but NO/NOx chemistry is more complicated than most researchers appreciate. Nitroglycerine has been called an NO donor, it is not. It does have some NO/NOx effects, but the precise mechanisms are not well understood. It likely has to do with generation of NO/NOx species in mitochondria, but at the expense of mitochondria aldehyde dehydrogenase (which is destroyed). This is thought to be the mechanism behind what is called “nitrate resistance” where people lose the ability to respond therapeutically to nitroglycerine. Nitroglycerine does cause migraines, and does cause oxidative stress. It may be exerting more of a long term “anti-NO” effect following a short term “NO effect” because of compensatory rebound. Some NO donors (such as sodium nitroprusside) do work as NO donors, but because NO has such a short lifetime (less than a minute), it must be administered continuously and intravenously and again, only in a hospital setting."

This is from his blog at:
http://www.chronicfatiguetreatments...fatigue-syndrome-nitric-oxide/comment-page-1/

I have no idea if he is correct or not.

I guess I always prefer food as a nitrate source, if I can satisfy the requirement that way. It just seems like a more conservative approach.
 

MeSci

ME/CFS since 1995; activity level 6?
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In my case polyuria was from high acidity.

I have two types of polyuria - one that responds to desmopressin, so is presumably due to low vasopressin levels, and another that seems to be associated with PEM, that I have been struggling to prevent for years. Desmo has little or no effect on that, so I have assumed that it is an osmotic/solute diuresis. There are threads on polyuria, including reference to this.

But although I take 8-10g of sodium bicarb a day, it doesn't prevent it.

This paper that I think I linked to earlier (It's such a busy thread and my brain and I are struggling to keep up!) relates to the biochemistry of d-lactate/d-lactic acidosis but may throw some light on the polyuria issue, as it refers to sodium ions being excreted with lactate. I think that throws light on my tendency to low blood sodium - through losing sodium in urine along with lactate. This appears to have been further exacerbated in my case by an ACE inhibitor, which also increases natriuresis (loss of sodium in urine).

Is your blood sodium OK, @Gondwanaland? Sorry if I've asked before - brain foggy!

I can relate to the acidic feeling in the urinary tract that you mentioned in another post. I have been trying to describe it in my health diary - possibly hot, possibly cold, definitely a kind of burning (but not like cystitis) and rather metallic. (How can you have a metallic feeling in your urinary tract? I don't know!)
 
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I just got PEM due to being overactive after a short period of feeling good.

After reading this thread I tried some baking soda. It seems to help with muscle fatigue and burning. I will try it next time before exertion. I will also order some Catalase from super smart.

What do you think about this kind of product that contains a mix of alkaline mineral salts :

http://www.amazon.co.uk/Pascoe-PH-Balance-Pack-Tablets/dp/B005AUKOY2

Would it be better than just taking bicarbonate?
 

MeSci

ME/CFS since 1995; activity level 6?
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I don't understand this definition of "ash" being the residue left over after combustion. If by combustion you mean oxidation, well, there's not a lot of that going on in the body as far as I am aware. The liver employs oxidation to breakdown some dietary components, but oxidation is not the universal fate of dietary components.

I'm puzzled by this, @Hip. I think most of your input is sound, but unless I have misunderstood you, this must be wrong. Oxidation in the body is widespread, continuous and essential to life. Sorry I'm late coming to this but am struggling to keep up!
 

pemone

Senior Member
Messages
448
I just got PEM due to being overactive after a short period of feeling good.

After reading this thread I tried some baking soda. It seems to help with muscle fatigue and burning. I will try it next time before exertion. I will also order some Catalase from super smart.

What do you think about this kind of product that contains a mix of alkaline mineral salts :

http://www.amazon.co.uk/Pascoe-PH-Balance-Pack-Tablets/dp/B005AUKOY2

Would it be better than just taking bicarbonate?

I would avoid using minerals to treat acidity. Stick to bicarb sodium and potassium. You could overdose on some of the minerals if you took that too often.

When I first started to get PEM, I noticed that salt water helped me. I thought I had an electrolyte problem, and I annoyed my doctors insisting on this, but the tests were clear that this was not the issue. I migrated from salt to electrolyte solutions, then to various other solutions. After I realized more clearly that I had some kind of persistent acidosis, I started to experiment with bicarb, and after many experiments it became clear that nothing treats me better than bicarb. You can use a lot of it during the day as long as it is between meals, and taking a lot of sodium and potassium is usually well tolerated as long as you are not taking huge single doses.
 

Hip

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18,162
I'm puzzled by this, @Hip. I think most of your input is sound, but unless I have misunderstood you, this must be wrong. Oxidation in the body is widespread, continuous and essential to life. Sorry I'm late coming to this but am struggling to keep up!

Not much oxidation in the digestive process though, as far as I am aware.

The context here is the metabolic fate of dietary substances, and how according to the alkalizing/acidifying theory that @swfowkes outlined, once these components of food are processed by the body, they end up as either increasing, decreasing, or not affecting body pH levels.

The idea of this alkalizing/acidifying theory is that it is not the pH of the food when you eat it that affects body pH, but rather the pH of the food when it is turned into "ash" via the metabolic pathways that process the food, ie digestion and assimilation of the food.

@swfowkes said "ash" is defined as the resulting chemical substances left after combustion of the food, But where is this combustion taking place in the digestive process? I am not aware of much combustion going on during digestion, apart from a bit oxidation performed by the liver to break down certain substances.

OK, the sugar and fat components of the food are combusted in the mitochondria to produce energy, but in general, don't think combustion is the fate of most of the various substances in food.
 
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Gondwanaland

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I have two types of polyuria
Actually I did too. One from low magnesium (and wathever hormone is negatively influenced by - a bioressonance test showed low aldosterone), and other one driven by inflammation/HIT and that's when S. boulardii took care of it.

Low magnesium ~ high acidity (Na bicarb helped as well)
 

MeSci

ME/CFS since 1995; activity level 6?
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If mankind was so fragile that a change in diet composition was enough to kill us, I don't think we would have made it as a species. I think it was common for our ancestors to eat vastly different diets from one month to the next. You eat what is available on a given day or week. You are ketogenic one week, eating 80% fruit the next week, eating mostly protein and fats when you catch some fish, etc. That kind of metabolic flexibility must be hard wired into our species, and it explains why we have so many metabolic pathways for creating energy. The body has to be able to adjust to such things, and it cannot be so fragile that it requires a specific balance of carb/protein/fats to survive.

A central problem in ME is that our homeostatic mechanisms are awry, and so are numerous other physiological systems. So I can believe that, for us, a narrow dietary tolerance is possible. I know that if I stray just slightly from my own regime I suffer for days or weeks. This can just be from having an extra whole or half apple. I actually find apples very useful for adjusting my diet to keep my gut healthy!

But I can also see how, after changing diets, the gut microbiome may no longer be able to cope with the previous diet. Diet is a/the main determinant of gut microflora. When you change diet, the gut microbiome takes time to change, and also to change back.
 

MeSci

ME/CFS since 1995; activity level 6?
Messages
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Location
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Actually I did too. One from low magnesium (and wathever hormone is negatively influenced by - a bioressonance test showed low aldosterone), and other one driven by inflammation/HIT and that's when S. boulardii took care of it.

Low magnesium ~ high acidity (Na bicarb helped as well)

I suspect that I may have constitutively low aldosterone, as I have always craved salt (as have about half the respondents to this poll). The ACE inhibitor clearly pushed the aldosterone even lower, causing a worsening of the polyuria and leading to hyponatraemia.

I don't supplement magnesium, but I should be getting quite a lot from my diet, and there is also magnesium in my multivit/mineral and my mineral supplements. I might try having more though.

I tried addressing inflammation but with no obvious success, except that turmeric temporarily reduced the numbness I had developed in my hands. No effect on polyuria.
 

Gondwanaland

Senior Member
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5,103
I tried addressing inflammation but with no obvious success, except that turmeric temporarily reduced the numbness I had developed in my hands. No effect on polyuria.
How about histamines? I never suspected I could have histamine issues and never expected to get such a relief from one dose of S. boulardii.

Since this thread is about lactic acid after all, I would like to link an old thread here:
Lactic Acidosis from Probiotics

BTW L. acidophilus causes me "panic attacks".
 

MeSci

ME/CFS since 1995; activity level 6?
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How about histamines? I never suspected I could have histamine issues and never expected to get such a relief from one dose of S. boulardii.

Since this thread is about lactic acid after all, I would like to link an old thread here:
Lactic Acidosis from Probiotics

BTW L. acidophilus causes me "panic attacks".

Thanks, but I avoid probiotics as they seem prone to harm as well as heal. I'm more in the prebiotic camp.

I do find sedating antihistamines helpful though, as I said, and also the supposedly only slightly-sedating cetirizine, which is quite sedating for me.

I had that acid-type feeling in my urinary tract at bedtime last night, and had already taken one chlorphenamine for sleep, but took another one 4 hours later - the burning went away and I slept well.

I don't think I get such benefit from the non-sedating antihistamines, but may give it a try next time I have desmo-resistant polyuria during the day.

EDIT - I did get remission/reduction in a lot of the symptoms you list in the Lactic Acidosis thread, from my change in diet and supplements, as detailed in my profile. Maybe S. boulardii is safe, but maybe I don't need much due to low sugar/low grain diet?
 
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Sherlock

Boswellia for lungs and MC stabllizing
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What do you think of the use of fibrin dissolvers like nattokinase? My sedimentation rate showed very low inflammation but also suggested I have very thick blood. I have been using fibrin thinners hoping that this would increase oxygen flow to deep tissues.
I have never looked into that (I have thin blood). You probably know that:
CFS is known for rouleaux (stacked) RBCs.
That the worst danger of nattokinase Rx would be from an intracranial bleed.
That a non-CAD non-CVA danger of hypercoagulable blood would be DVT/PE a la' Virchow's Triangle --- also perchance involving immobility from e.g. PEM

During another lower-body ultrasound procedure a few years ago the tech made a comment to me that "you have the cleanest arteries I have ever seen." I have a feeling that my low inflammation markers, together with those kinds of ultrasounds, suggest I do not have an immediate risk of LDL blockage. I'll get the carotid ultrasound done and if that is clean I think I have bigger problems to worry about in the short term.
Your conclusion sounds reasonable.
 

Gondwanaland

Senior Member
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5,103
Sorry everyone for the cross-talk and for going a little off-topic (it's all related after all...;))
Thanks, but I avoid probiotics as they seem prone to harm as well as heal. I'm more in the prebiotic camp.
I never got sustained benefit from probx. I feel that both prebx and probx are immunostimulants and harmful to me right now (trigger inflammation).
EDIT - I did get remission/reduction in a lot of the symptoms you list in the Lactic Acidosis thread, from my change in diet and supplements, as detailed in my profile. Maybe S. boulardii is safe, but maybe I don't need much due to low sugar/low grain diet?
My feeling towards S. boulardii is that it transiently reduces the gut flora diversity, and the only time it helped was for the 1st time I took it - every other day for 2 weeks. My suggestion is to take it once and see if you get benefits. No need to fear it, since it does not repopulate. It's like a flush (I can attest to that). And to stick to the topic, it reduces circulating histamines and acidity.

I try to stay away from pharma drugs as much I as can now. Most of my symptoms could be attributed to their side effects (anti-acids, cipro & other abx, warfarin, accutane etc.). I can account for 2 occasions when they have been helpful though: metronidazole put my rosacea into remission and heparin saved my life.
 

Sherlock

Boswellia for lungs and MC stabllizing
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Wow thanks for posting that, @Sherlock ! Apparently no dr around here ever heard of that!!! It describes exactly what caused my DVT in 2011.
Glad you got through it okay. There was a big publicity push in 2008 by the US Surgeon General:
http://www.surgeongeneral.gov/library/calls/index.html
The Surgeon General's Call to Action to Prevent Deep Vein Thrombosis and Pulmonary Embolism
and
http://circ.ahajournals.org/content/119/15/e480.full

Does anybody remember the guy from Jethro Tull who stood on one leg while playing the flute? He got a DVT in one leg a few years ago from a long plane flight..
 
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