thanks so much for your speedy reply!
So much detail and really interesting that the supplements you list are where I'm starting to gravitate towards (I've tried pretty much all of them - but obviously not all together) It is very clear to me that I have liver issues, alongside positive tests for EBV, CMV and HSV (god knows what else i have!).
I would be really interested in doing the protocol but not the fasting one - I've already been to ER after giving myself refeeding syndrome and don't want to go there again!
As for the list of supplements, i have major issues with b vitamins, and glycine triggers migraines, phosphatidylcholine causes severe irritability not sure if the bitartrate versions would be better so, is it possible to miss out some of the supps?
Do you think i could achieve any success JUST using the mushrooms, ECGC and ALA/NAC?
This is essentially the CFS/ME paradox I was describing in the third paper - the primary reason that taking any nutrients which are (measurably - see NutrEval FMV or other pathology) depleted can/will lead to headaches, PEM, etc., is all downstream from oxidative stress (ROS) and ammonia creation / metabolism.
By "filling any nutritional gap(s)" which were stalling any/all cellular activities, these cells with faulty metabolism are now able to "get back to work"... unfortunately now increasing the oxidative stress and further increasing the ammonia load which now has to get metabolised.
This ammonia load starts a couple of excretion processes (which are also the origin of PEM, headaches, etc) which further drain key metabolites "creating all the gaps" again.. this becomes a vicious cycle. Those induced "nutritional / metabolite gaps" create all of the other neurological dysfunctions, thyroid issues, etc.
GABA and B vitamins, especially B12 can be readily converted into "succinate" in the TCA cycle
(needs Vitamin B6 / P5P for this to work).
The urea cycle can also allow the TCA cycle to be fueled at "fumarate" .. which is a useful way to manage some of the ammonia being created.
This will reduce pathology markers for "urea" and reduce PEM.. briefly.. This also temporarily bypasses the mitochondrial limiter, allows normal respiration and corrects a number of issues around collagen synthesis, energy levels and hypoxia induced transcription factors, etc.. alleviating those symptoms..
However, the ongoing (faulty) mitochondrial activity continues, the ROS increases and the ammonia overload forces heavier use of the "expensive" ammonia excretion process - via "phenylacetylglutamine" (PAGN).
This is where it all starts to get ugly.
With the ongoing metabolite depletions, including cysteine (via acetyl-CoA and CoA) and glycine,
glutathione production and regeneration gets impaired. This means that oxidative stress (ROS) cannot be reduced / scavenged.. this leads to DNA transcription errors, cancers and...
more ammonia to metabolise.. fortunately, the B vitamins get depleted, aspartate gets depleted and the whole thing shuts down and cools off...
.. creating issues with hypoxia, connective tissue disorders, neurological disorders, thyroid disorders, fatty acid oxidation issues, insulin resistance, etc..
This is pretty savage.. as we all have experienced.. people are left between a choice of:
A) a body crippled with a personal selection of every disease we have named in the papers..
B) headaches, PEM, being incredibly overstimulated / overpowered by their environment to the point of being shutdown or placed on benzodiazapines.
C)
an ongoing mix of both, every time we eat... often leading to a snowball effect where you can't eat... which is a slippery slope to hell*.
*NB. The thing about (C) is.. if someone didn't eat *anything* for say 5 days, while keeping water and electrolytes up.. they'd later see a vast reduction in symptoms, by having killed off many of the infected cells (perhaps 1-2 weeks after the fast). The catch-22 is, 5 days of fasting is likely going to consume 2-2.5kg of body fat. If someone is already in a fragile state, this option may not be available to them, initially.
Adding an ongoing high dose of EGCG (and resveratrol) to the fasting process speeds this up dramatically, by removing the other large source of stored energy available to the cell (from glutamine->glutamate-aKG). It also completely disables the transamination I described in the papers - this is why the first day has "low dose" EGCG - giving time for the ROS to drop and transamination to "turn off".
This should mean that 3 days of EGCG fasting could be equivalent to 5-7 days of traditional water fasting. You're diving into the "pointy end of the fast" earlier.
So, circling back.. when implementing the treatment protocol, the expectation is that the first 3-4 days is going to generate a LARGE amount of ammonia, as various pathways start working again. For this reason, we have been using sodium benzoate + glycine (and b5, NAC) to create an outlet for this initial surge. Even with that, someone could expect a stunning headache for 3-4 days. "Ammonul", if they have deep pockets and a friendly doctor, would be an ideal adjunct to include at this time.
After that, thanks to the alterations provided by the reishi, EGCG and ROS scavengers (ALA / glutathione / NAC / Vitamin C / Vitamin E), someone would expect to be able to consume normal amounts of B vitamins and not create headaches, PEM, or other symptoms... providing they're NOT creating additional "pressure" inside the mitochondrial reactions by overloading the cell with glucose (hence the dietary aspects). Excessive doses of B vitamins will still be expected to create mitochondrial pressure and ROS, also.
At this point, things our model suggests things may start improving.. although they'll still have lytic phase "autoimmunity" to wade through for the next 6-8 weeks, unless they've previously been using eg. spironolactone / tenofovir, etc.
However, while all of these life improvements are happening... they're going to get tested.
Their ongoing immune response is going to cause flare-ups of every single tissue they've historically had issues with. It may be quite acute, at times.
Having trust that this is both necessary and one of the last times someone would have to experience these symptoms requires personal satisfaction that they're doing the right thing. Having exhaustive pathology markers to refer to during this process may help their resolve. EBV VCA IgG should be decreasing, with a 6-8 week lag (if titres are within the maximum lab ranges... most people's are not..)
If someone has other infections, IVIg may be an absolute panacea.. however this is going to prevent them from tracking their own serology markers / IgG. If someone doesn't need IVIg, they'll have better reporting.
