Sian, I have one more question if that's ok. Do you have any theories on how sugar is implicated in m.e? Any thoughts on candida? Thanks
Hi, anniekim.
I'm not Sian, but for what it's worth, here is how I think sugar is implicated in M.E.:
1. Most people who have M.E. seem to have intestinal bacterial dysbiosis and yeast infection. I don't think that sugar is what causes this, but once it is present, sugar feeds this situation, because yeast ferments sugar, and some of the dysbiotic bacteria do, too.
2. Most people who have M.E. have depletion of reduced glutathione, and this gives rise to oxidative stress. In the mitochondria, aconitase, an enzyme located early in the Krebs cycle, becomes partially blocked because of this. Sugar, being a carbohydrate, must be processed by the glycolysis pathway to form pyruvate, and that then is converted to acetyl CoA by the pyruvate dehydrogenase complex. The acetyl CoA then enters the Krebs cycle by its conversion to citric acid. Unfortunately, the partially blocked aconitase is then supposed to convert citric acid to cis-aconitic acid and then isocitric acid. But since it is partially blocked, these conversions are hindered, and if the intake of sugar is too high, what happens is that citric acid goes into formation of fatty acids, which are stored. If the cells are not able to even accept the glucose that comes from ingesting sugar at the rate is is put into the blood, the insulin level rises, and that also will cause glucose to be converted to stored fat. So the bottom line here is that if sugar is taken in at a higher rate than it can be utilized, the person will gain weight. Some people gain 40 pounds or more if they continue to eat carbs (including sugar, but also starch, which is converted into glucose (a sugar) in the gut). It's important for the insulin to rise in order to lower the blood glucose level, because otherwise the glucose will react with proteins (glycation reactions) and that causes other problems (advanced glycation end-products).
3. When insulin rises to convert the glucose to stored fat, it tends to overshoot, and then the blood glucose level goes too low (hypoglycemia). Since most people with M.E. also have dysfunction of the HPA axis, there is not very good control over hypoglycemia. If cortisol is not able to come up to control it, the fallback is epinephrine (adrenaline) to make sure the brain will get enough glucose, which is its main fuel. This can produce an adrenaline rush, or even a panic attack.
So I think there are three issues with consuming sugar in M.E.--feeding the bad guys in the gut, building up stored fat, and producing hypoglycemia, with its unpleasant results.
The solution to this is to restore the glutathione level so that carbohydrates can be used normally by the mitochondria. That requires lifting the partial block in the methylation cycle, and that is what the methylation protocols are designed to do.
Best regards,
Rich