What was it that helped reduce your PEM? I am collecting "PEM Buster" treatments.
A couple of things. I don't talk about what happened that much because I don't really understand it at all. Compounded by the lack of coherent physiologic explanation (lots of studies hint at various mechanisms but there is no synthesis or meta-analysis of anything published that explains what happened to me) is the fact of my fairly poor cognition. While my physical functioning has gotten better, my brainfog and cognition seems to have gotten somewhat worse. I read things, I get hints of what seem like fairly ground-breaking ideas in relation to what I read...and then I forget it all. Can't hang onto it long enough to elucidate. Interestingly in connection with this thread, it all ties into choline and bile and how those work on the liver and the gut.
Also, I'm not sure what happened to me can ever be replicated. I'm not sure it should. But it happened and my health improved dramatically afterwards.
I'm going to tell it sort of like a story instead of just giving a straighforward list of supps because the context matters.
Anyway, first thing: back at the end of 2014 I started trying this nootropic stack comprised of Alpha GPC, citicholine, sulbutiamine, ALCAR, and a failed pharmaceutical cum nootropic called Noopept. I'd been doing
@Freddd's protocol since the end of 2013 with great improvement in overall physical functioning, but stamina was lacking. I would still crash with too much physical exertion, and lingering PEM was still an issue. PEM was much better than it was when I started Freddd, and it took much more stimulus to push me into an episode, but exertion tolerance was not normal and it was still a problem. I also had really high blood sugars that just wouldn't go down. Not because of Freddd protocol, they were high years before I started, but they weren't going down even with the other physical improvement. And cognition had gotten somewhat worse than it was before I started Freddd.
After reading around a bit I decided to stack theses supps to see how they might help my cognition. After about a month on them my motivation went through the roof. I had a couple of days where I was able to clean my house for 8 solid hours, without getting bored, overwhelmed, having a screaming meltdown due to frustration, needing to lay down every five minutes, etc. It was like magic. But at the same time, I was also getting anxiety and fuzzy-headedness. I could stay on task better but my thoughts in other areas seemed more scattered, if that makes sense. I realize now this was probably classic ACh overload but what it temporarily did for my motivation and ability to stay on task was miraculous. Also seemed to improve my physcial stamina, otherwise I wouldn't have been able to clean my long-neglected house the way I did.
Then I crashed. Hard. It was a vomiting stomach flu unlike anything I'd experienced since I was a kid. Then I started (sorry for TMI) spewing algae-green water out the other end. Vomiting stopped after about 24 hours but the algae dump went on for several days. It was *green*. Probably bile straight from the liver. I ran a fever of about 101 for a week. Didn't drink anything but grape juice and ginger ale for until my fever broke.
At the end of this my blood sugars had come down 30-50 clicks, and stayed down permanently.
Food cravings were gone. I truly didn't feel the need to eat the same crap I'd been eating my whole life. I wanted good food not cheeseburgers and fries.
My energy was changed. I didn't get up and start doing HIIT the week I recovered, but as I cautiously experimented I realized I no longer got PEM, I no longer crashed, and I could do much, much more than before.
That was also my last crash. I haven't had one since. Not to say I'll never get another, probably I will at some point, but so far it hasn't happened. It's been a year and a half. It's rare I even get that minor flu-y feeling these days, the one that never tips into a crash but makes you afraid you're gonna if you don't slow down. Flu-y feeling was a fairly regular companion for years. For all practical purposes it's gone since the "choline flu".
The second thing I did to get rid of PEM was pre- and pro-biotics. After the "choline flu" I recognized some very strong connections between my physical energy and the state of my gut and liver, so I got into the big Resistant Starch thread and did a bunch of that. I used (and still use) pretty much all the stuff we chattered about in that thread, including VSL3, c.butyricum, l.plantarum, potato starch, etc. With the gut therapeutics my physical stamina continued to increase and stabilize. It's stable to this day. I can do an hour of exercise per day and still have enough energy to do whatever else I need to do without crashing.
Motivation still remains a problem, however. Still working on that. I've never been able to replicate those magical couple of days where I cleaned my house without melting down.
And of course, cognition is a problem. As is digestion and gut motility, interestingly. Both digestion and gut are much better but still seeking permanent and total resolution of issues there.
All my remaining problems point to dysfunction of the liver and dysregulation of ACh. But frak me if I can figure it all out. I start reading and thinking about the different actions of muscarinic receptors and nicotinic receptors and yada yada yada and it makes me want pull the blinds down again and head for the couch.
I'm pretty good at intuiting what might work for me based on what I read, but if someone asks me to tell them why it works, I wind up sounding like a big damn goober. So I mostly just keep my mouth shut. But I'm still nosing around trying to bring about the next big break that's going to fix the rest of this mess.
My primary POV is if I don't get fixed, and I wind up dying, I'm going to be dead and I won't care that I wasted all this time and money on this stuff.
But if I do manage to get fixed, then my time and money isn't wasted.
Even if I die early, at least I had some functional time instead of waiting around in dysfunction for someone to drop the miracle on me like manna from heaven.
Aaaaanywaaaay...those are my two PEM-busters and energy stabilizers.
1) A nootropic stack consisting of Alpha GPC, citicholine, sulbutiamine, ALCAR, and something called Noopept. IMO they did something to both my gut and liver (which brings us also back around to ER stress and
@mariovitali's thread), but I couldn't tell you what.
2) Pre- and probiotics.
HTH.