Does ME/CFS have the same symptoms as d-lactic acidosis?

[Mimi]

fyi -

Probiotics Provoked D-lactic Acidosis in Short Bowel Syndrome: Case Report and Literature Review
WH KU, DCY LAU, KF HUEN
Metabolism of D-lactic Acid
When the condition of D-lactic acidosis was first described in human by Oh et al in 1979,2 it was thought that the metabolism of D-lactic acid is very slow in humans. Subsequent studies showed that healthy human subjects can metabolise D-lactic acid rapidly.30 The L-lactic acid is metabolised by the L-lactate dehydrogenase (L-LDH). Although humans do not possess D-lactate dehydrogenase (D-LDH), they can still metabolise D-lactic acid with the D-2-hydroxyacid dehydrogenase (D-2-HDH).31 The D-2- HDH is an intramitochondrial flavoprotein with highest activity in the kidney and liver. Experiments showed that in healthy human subjects, they can metabolise the intravenously or orally administrated D-lactic acid efficiently. However, when D- and L-lactic acids are present in high concentration they will cross inhibit each other's metabolism.31 D-lactic acidosis results from its overproduction and accumulation. The formation of organic acids during bacterial carbohydrate fermentation also inhibits the oxidation of D-lactic acid, which is prerequisite for its metabolism.31 These may explain why administration of D-lactic acid to healthy human subjects fails to produce D-lactic acidosis.
Mechanism of Neurological Manifestations
The neurological manifestations in D-lactic acidosis cannot be explained by the acidosis alone, as patients with acidosis resulting from other causes do not demonstrate the clinical features of D-lactic acidosis. In some patients with D-lactic acidosis the correction of acidosis with bicarbonate failed to improve the neurological symptoms. There are two proposed mechanism for the encephalopathy. The first one is the direct toxic effect of D-lactic acid to the brain.8,32 D-lactate can diffuse into the brain cells, causing decrease in intraneuronal pH, inhibits the pyruvate decarboxylation by the pyruvate dehydrogenase comlpex. Subsequently the production of acetyl CoA and adenosine triphosphate is impaired, resulting in altered neurotransmitter production. The cerebellum has particularly little reserve of pyruvate dehydrogenase complex, thus the cerebellar symptoms such as ataxia and slurred speech is prominent in D-lactic acidosis. The activity of pyruvate dehydrogenase complex is also impaired by thiamine deficiency. This may explain the difference in susceptibility to D-lactic acid in different subjects.
Clinical Manifestations of D-lactic Acidosis
Upon review of the patients in our case series, impaired mental status was a universal feature in D-lactic acidosis. Patients could present with confusion, stupor, or impaired conscious level ranging from somnolence, lethargy, drowsiness, to lost of consciousness and coma. There were cerebellar symptoms with ataxia, nystagmus, slurred speech and gait disturbance. Higher cognitive function impairment included aggressive behaviour, inability to concentrate, agitation, carbohydrate craving, "unhappy" and irritability. Other neurological manifestations were weakness, headache, bruxism and opisthotonus. The metabolic acidosis led to hyperventilation and tachypnoea. There were non-specific symptoms including nausea or pallor.

 

[MeSci]

Hi Enid,

Thanks for your interest. I think most will be relevant, but at different times. Also there were other dla symptoms I could have added, but the poll only allows for 10boxes. Could also have had blurred vision, aggressiveness, abusive behaviour, anger, the feeling of being drunk in the absence of alcohol, teeth grinding, stupor and more. I know when a short bowel patient presents with dla, they will not have all the symptoms. I could also have asked folk if they had improved neurologically whilst on antibiotics. In dla, the GI sometimes has to play around to get the right antibiotics, depending on whether there is already resistance. Some dla sufferer's need an ongoing treatment, to keep the dla at bay. Some respond to low carb diets, while some need IV sodium bicarbonate.

It's such a shame that dla is only taught to GI's though. Imagine if a dr who has known a patient for years and has seen them well, were to be presented with a similar list of symptoms, in that same patient. Makes you think. I've read the KDM study again recently, and wonder whether a dr would be prepared to order a stool test, as a place to start, specifically looking for an overgrowth of dla producing bacteria. If the sample did show a higher degree of d-lactic acid producing bacteria, and they were more aware of the symptoms of dla, they might investigate further. Then again.... probably not :-(. The patient should then be referred to a GI, who could test, monitor and treat the dla.

Hopefully, more people will respond and do the poll, maybe add other symptoms as above. We'll see.

Best Wishes

Glynis

As there is currently a lot of discussion about acidosis, I thought it might be a good idea to bump up this fascinating thread. I did a bit more searching today and found this interesting page about different kinds of metabolic acidosis:

http://fitsweb.uchc.edu/student/selectives/TimurGraham/Lactic_Acidosis.html

I have been taking sodium bicarbonate for about a year along with reducing carb intake, taking l-glutamine, etc., but as an experiment I am trying going without the bicarb for a while from today to see if things get better or worse.

 

[Sparrowhawk]

MeSci any update on your experiment? "I have been taking sodium bicarbonate for about a year along with reducing carb intake, taking l-glutamine, etc., but as an experiment I am trying going without the bicarb for a while from today to see if things get better or worse."

 

[MeSci]

MeSci any update on your experiment? "I have been taking sodium bicarbonate for about a year along with reducing carb intake, taking l-glutamine, etc., but as an experiment I am trying going without the bicarb for a while from today to see if things get better or worse."

I got worse, so went back on the bicarb after a few days, and soon improved again. Can't be 100% sure that it was the bicarb, but I'm staying with it as there are no obvious adverse effects for me, and it appears to help.

 

[Thinktank]

MeSci, how do you supplement with bicarb? Before or after each meal and at what dosage?
I might want to try it out.

 

[MeSci]

MeSci, how do you supplement with bicarb? Before or after each meal and at what dosage?
I might want to try it out.

I take it in water divided into 4 doses about an hour after meals. I started on 4-5 g (1 teaspoon) a day, then increased it to about 10 g (2 teaspoons), which seemed too much, tried about 7.5 g and was OK, then eventually increased to about 10 g with no problems and stayed on that.

I got general info on dosage from this info which I saved:

http://www.mayoclinic.com/health/drug-information/DR601241/DSECTION=proper-use

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For sodium bicarbonate powder:

To relieve heartburn or sour stomach:
Adults and teenagers—One-half teaspoonful in a glass of water every two hours. Your doctor may change the dose if needed.
Children—Dose must be determined by your doctor.
To make the urine more alkaline (less acidic):
Adults and teenagers—One teaspoonful in a glass of water every four hours. Your doctor may change the dose if needed. However, the dose is usually not more than 4 teaspoonfuls a day.

from http://www.nlm.nih.gov/medlineplus/druginfo/meds/a682001.html

If you are using sodium bicarbonate as an antacid, it should be taken 1 to 2 hours after meals, with a full glass of water. If you are using sodium bicarbonate for another reason, it may be taken with or without food. Do not take sodium bicarbonate on an overly full stomach.

Do not use sodium bicarbonate for longer than 2 weeks unless your doctor tells you to.

tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially other antacids, aspirin or aspirin-like medicines, benzodiazepines, flecainide (Tambocor), iron, ketoconazole (Nizoral), lithium (Eskalith, Lithobid), methenamine (Hiprex, Urex), methotrexate, quinidine, sulfa-containing antibiotics, tetracycline (Sumycin), or vitamins. Take sodium bicarbonate at least 2 hours apart from other medicines.
tell your doctor if you have or have ever had high blood pressure, congestive heart failure, or kidney disease or if you have recently had bleeding in your stomach or intestine.

Sodium bicarbonate may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

increased thirst
stomach cramps
gas

If you have any of the following symptoms, stop taking sodium bicarbonate and call your doctor immediately:

severe headache
nausea
vomit that resembles coffee grounds
loss of appetite
irritability
weakness
frequent urge to urinate
slow breathing
swelling of feet or lower legs
bloody, black, or tarry stools
blood in your urine

NB I do not speak to doctors about it as it would be a waste of time. I also do not expect doctors or anyone else to tell me what to do as the info suggests! But maybe doctors in Thailand are more enlightened than those in the UK.

If you burp/belch after taking the bicarb that is supposedly a good sign! I do.

Don't take washing soda as although that is basically the same chemical it often has things added which may not be safe to take. I get mine either from the baking section of a supermarket or from a pharmacy.

 

[Sparrowhawk]

I got worse, so went back on the bicarb after a few days, and soon improved again. Can't be 100% sure that it was the bicarb, but I'm staying with it as there are no obvious adverse effects for me, and it appears to help.

Thanks for the response on this -- can you tell me exactly what it is you feel bicarb helps you with? I know when I was drinking high bicarb mineral water, I just felt generally better. Wasn't a digestion thing at all, just well being. But they stopped selling it in our region so I switched brands. Don't get the same bump out of it even though it has roughly the same cal/mag ratio, no bicarb.

Thanks.

 

[MeSci]

Thanks for the response on this -- can you tell me exactly what it is you feel bicarb helps you with? I know when I was drinking high bicarb mineral water, I just felt generally better. Wasn't a digestion thing at all, just well being. But they stopped selling it in our region so I switched brands. Don't get the same bump out of it even though it has roughly the same cal/mag ratio, no bicarb.

Thanks.

Mainly digestion/bowels really, but I am doing lots of other things too. However, when I experimentally stopped the bicarb, and didn't change anything else, I suffered recurrence/worsening of the following:

• mild head- and neck-ache
• nausea
• disorientation
• dizziness
• difficulty getting to sleep
• restless-leg syndrome
• increased frequency of rectal burning (assumed due to acidity but not sure)

and a symptom I have only had once before: peripheral visual shimmering which lasted about 25 minutes and may have been scintillating scotoma.

All disappeared/improved after I restarted the bicarb. But it may not help everyone.

Re cal/mag, I take a supplement containing these too, plus other bone minerals, Vitamin D and other things. Maybe the new mineral water you are drinking contains a different form of the minerals that is less effective or less well-absorbed?

 

[Sparrowhawk]

"Maybe the new mineral water you are drinking contains a different form of the minerals that is less effective or less well-absorbed?" Yes that may well be the case. Almost none of the so called mineral waters at the store actually have significant cal/mag content. Mountain Valley is the only one left that I've found to have any significant values. I had previously used Pure Swiss, but they kept changing things, and at one point had added chlorine (!) so I think WF discontinued them.

Appreciate the detail on what sodium bicarb helps you with. I've ordered some to trial.

 

[MeSci]

"Maybe the new mineral water you are drinking contains a different form of the minerals that is less effective or less well-absorbed?" Yes that may well be the case. Almost none of the so called mineral waters at the store actually have significant cal/mag content. Mountain Valley is the only one left that I've found to have any significant values. I had previously used Pure Swiss, but they kept changing things, and at one point had added chlorine (!) so I think WF discontinued them.

Appreciate the detail on what sodium bicarb helps you with. I've ordered some to trial.

You're very welcome. I really hope it helps you.

In case you or anyone else is interested, the Cal-Mag etc supplement I use is by Deva, which I chose because it is vegan (and so am I!). It can be bought in the USA as well as the UK, and elsewhere. You can find outlets from Deva's website here:

http://www.devanutrition.com/Where.html

For anyone in the UK, I must give a plug for the supplier I use as they are so good - it's Green Valley who can be found here:

http://www.gvtc.co.uk/

 

[Thinktank]

MeSci, do you have any idea why the bicarb is helping your digestion? I'm going to try it tonight. I have very unspecific inflammatory bowel disease and i read bicarb has helped some suffering from Crohn's.

Do you believe you have d-lactic acidosis or is there something going wrong in digestive process?

 

[MeSci]

MeSci, do you have any idea why the bicarb is helping your digestion? I'm going to try it tonight. I have very unspecific inflammatory bowel disease and i read bicarb has helped some suffering from Crohn's.

Do you believe you have d-lactic acidosis or is there something going wrong in digestive process?

Bicarbonate neutralises lactic acid. I would not be surprised to hear of it helping with Crohn's - it has been found beneficial for a wide range of conditions. I suspect that Big Pharma is involved in pushing it off the shelves and the prescription pads in favour of their own more expensive, artificial, more hazardous and probably less-effective drugs.

I might have d-lactic acidosis; I'm pretty sure I have some kind of intestinal acidosis due to my symptoms (ME ones and digestive problems) and the fact that they have all improved with the kind of diet recommended for it.

Hope it helps you!

 

[Mimi]

Hi MeSci,

Thanks for posting. I have persistently acidic urine (pH 5.75) which my healer says is from all the viruses and bacteria. So I am very interested in trying your method and will start with half a teaspoon right now. I have terrible problems with tooth decay, and I've noticed I tend to burp up acid, especially at night.

Mimi

 

[MeSci]

Hi MeSci,

Thanks for posting. I have persistently acidic urine (pH 5.75) which my healer says is from all the viruses and bacteria. So I am very interested in trying your method and will start with half a teaspoon right now. I have terrible problems with tooth decay, and I've noticed I tend to burp up acid, especially at night.

Mimi

Hi, Mimi,

I'm not sure whether you can tell much about your overall pH from urine pH.

If your tooth decay is due to mineral depletion you would probably benefit from taking a mineral supplement. I take a bone mineral supplement.

When my teeth are bad I also use dilute grapefruit seed extract twice a day as an antibacterial mouthwash, swilling it thoroughly over and between the teeth as well as around the mouth. If I feel that I may have an infection in the gut or urinary tract I will swallow the mouthwash afterwards. Might as well get maximum benefit from it!

 

[Mimi]

Thanks, MeSci. I have no idea what's causing it. I take a lot of minerals - maybe 8 individual ones plus a bone support supplement - but only for the past 6 months to a year. I take both ionic and solid forms and do bone broths once in a while. Still, there could be some reason I'm not absorbing them. Like aluminum toxicity. I read that aluminum displaces fluoride and iron. And aluminum toxicity gives some weird symptoms like dry eyes only at night which I match.

Since my mouth tastes acidic, I assume the urine test is telling me something, even if it isn't completely accurate. Acidic pH will affect teeth, according to my dentist. But it wouldn't hurt to try the grapefruit seed extract - how do you dilute it?

Mimi

 

[MeSci]

Thanks, MeSci. I have no idea what's causing it. I take a lot of minerals - maybe 8 individual ones plus a bone support supplement - but only for the past 6 months to a year. I take both ionic and solid forms and do bone broths once in a while. Still, there could be some reason I'm not absorbing them. Like aluminum toxicity. I read that aluminum displaces fluoride and iron. And aluminum toxicity gives some weird symptoms like dry eyes only at night which I match.

Since my mouth tastes acidic, I assume the urine test is telling me something, even if it isn't completely accurate. Acidic pH will affect teeth, according to my dentist. But it wouldn't hurt to try the grapefruit seed extract - how do you dilute it?

Mimi

The dilution may depend on the brand you buy. This is the one I am using, and it includes info on dilution.

If your mouth is acidic, maybe you need to try using sodium bicarbonate as a mouthwash, but unfortunately it tastes pretty unpleasant! Or try chewing a bit of chalk!

Seriously, I expect there are some things you can swill around your mouth that are alkaline, safe and palatable.

 

[Mimi]

 

[Sparrowhawk]

Mimi great to see you posting.

"And aluminum toxicity gives some weird symptoms like dry eyes only at night which I match." I have never heard of that but test high aluminum on my hair test, and have dry eyes at night/morning (red all day)interesting.

I was told by the ophthalmologist it was a low grade bacterial thing, but with my weakened immune issues he didn't want to give me an antibiotic in case I bred superbugs in my eyes. I tended to agree that would be bad.

On the mouthwash thing, i use a 1:8 oregano essential oil (1 part essential oil to 8 parts olive oil) -- just three drops of that, swish it 30seconds and spit into the sink, then rinse with water, a few times a week. It is unholy strong but it does measurably reduce the number of "pockets" and bleeding gums when I go to the dentist. When I don't use it during a three month period, those go back up.

I found grapefruit seed extract too strong to use internally but it's great for external when I have an itchy patch, seems to help fight fungal. I'm at the same place with colloidal silver, I'll use it externally but I'm too spooked to use it internally any more.

 

[Mimi]

Hi Sparrowhawk, thanks for your suggestion.

Yeah, I worked in a little posting time between packing. Only 2 more days to go!

There are a bunch of interesting aluminum symptoms which you can surf up on the net. One of them is this one: http://home.earthlink.net/~joannefstruve/_wsn/page3.html. Notice all the neurological symptoms.

Here's an interesting book: http://books.google.com/books?id=3-sXofRnbLsC&pg=PA4&lpg=PA4&dq=aluminum poisoning 1907&source=bl&ots=QrCwk99Zo5&sig=lh3o8DlQRE62BP9KoH5Xi3hO3ks&hl=en&sa=X&ei=64tDUqrDEMKCiwKthoCYCA&ved=0CDkQ6AEwAw#v=onepage&q=aluminum poisoning 1907&f=false
I like how you can make your own amalgams by rolling mercury around on an aluminum pan!

Mimi

 

[Fogbuster]

@

Bicarbonate neutralises lactic acid. I would not be surprised to hear of it helping with Crohn's - it has been found beneficial for a wide range of conditions. I suspect that Big Pharma is involved in pushing it off the shelves and the prescription pads in favour of their own more expensive, artificial, more hazardous and probably less-effective drugs.

I might have d-lactic acidosis; I'm pretty sure I have some kind of intestinal acidosis due to my symptoms (ME ones and digestive problems) and the fact that they have all improved with the kind of diet recommended for it.

Hope it helps you!

Hi @MeSci what diet did you go onto to improve your acidosis? Thanks

Also wondering if anyone has had any success with improving symptoms by reducing supposed acidosis?

Very interesting theory.

Best wishes
Jamie