Unfolded Protein Response and A Possible Treatment for CFS

dannybex

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Seattle
@dannybex

If you had light-colored stools then this could mean that you had Liver / Cholestasis issues. If possible, talk to your Doctor to get a Total Bile Acids test and a Fibroscan.
@mariovitali -- yes, definitely had very pale stools for years. I'm pretty sure I have cholestasis issues, but haven't had a total bile acids test or a fibroscan. I'll google those for more info, thanks.
 

Wayne

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Ashland, Oregon
I've been finally able to increase eggs -- couldn't tolerate them for 10 years -- and eggs are a rich, natural source of choline.

Hey @dannybex, in the past year I've gotten into eating raw egg yolks, and discarding most of the whites. I like putting a couple of egg yolks in a large cup of bone broth, and find it to be one of my favorite "comfort" foods, as it has quite a calming effect on my entire system. I probably have this every other day or so. -- All the Best!
 

Eastman

Senior Member
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529
I have non-alcoholic fatty liver disease...any advice on how to treat our livers naturally? not a fan of milk thistle (too fast of detox for me not happy camper)

The following paper concluded that "adherence to a MedDiet supplemented with certain bioactive compounds and combined with physical exercise may help in the management of liver disease".

Mediterranean Diet and Multi-Ingredient-Based Interventions for the Management of Non-Alcoholic Fatty Liver Disease

And more details on the benefits of olive oil in particular for the liver:

Liver Protective Effects of Extra Virgin Olive Oil: Interaction between Its Chemical Composition and the Cell-signaling Pathways Involved in Protection.

Abstract
BACKGROUND AND OBJECTIVE:
The liver is an organ susceptible to a multitude of injuries that causes liver damage, like steatosis, non-alcoholic steatohepatitis, cirrhosis, hepatocellular carcinoma, and ischemia-reperfusion injury. Extra virgin olive oil (EVOO), presents several protective effects on the liver, reducing hepatic steatosis, hepatocyte ballooning, fibrogenesis, preventing lipid peroxidation, among other effects. Due to its high levels of monounsaturated fatty acids, mainly oleic acid and phenolic compounds, such as hydroxytyrosol and oleuropein, EVOO is able to participate in the activation of different signaling pathways in the hepatocytes involved in the prevention of inflammation, oxidative stress, endoplasmic reticulum stress, mitochondrial dysfunction, and insulin resistance, allowing the prevention or resolution of liver damage. The aim of this work is to offer an update of the molecular effects of EVOO in the liver and its protective properties to prevent the establishment of liver damage through the regulation of different cell-signaling pathways.

METHODS:
Searches that considered the effects of EVOO in in vivo and in vitro models, whith emphasis in the molecular mechanism of liver tissue damage and prevention and/or treatment of steatosis, steatohepatitis, cirrhosis, hepatocellular carcinoma, and ischemia-reperfusion injury.

CONCLUSION:
The most relevant molecular effects of EVOO involved in the prevention or resolution of liver damage are: (i) Activation of the nuclear transcription factor erythroid-derived 2-like 2 (Nfr2), inducing the cellular antioxidant response; (ii) Inactivation of the nuclear transcription factor-κB (NF- κB), preventing the cellular inflammatory response; and (iii) Inhibition of the PERK pathway, preventing endoplasmic reticulum stress, autophagy, and lipogenic response.

Olive leaf extract in high doses, though, has been found to induce undesirable changes in rodents.

High doses of olive leaf extract induce liver changes in mice

Toxicity of Olive Leaves (Olea europaea L.) In Wistar Albino Rats
 

xrayspex

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u.s.a.
thanks--yea I love olive oil and vinegar on my salads
olive leaf extract on the other hand always felt like cr*p after trying that stuff in years past, decided a big NoPe on that one


Liver Protective Effects of Extra Virgin Olive Oil: Interaction between Its Chemical Composition and the Cell-signaling Pathways Involved in Protection.



Olive leaf extract in high doses, though, has been found to induce undesirable changes in rodents.

High doses of olive leaf extract induce liver changes in mice

Toxicity of Olive Leaves (Olea europaea L.) In Wistar Albino Rats[/QUOTE]
 

frozenborderline

Senior Member
Messages
4,405
@Gondwanaland, Articles of Ray Peat and present time forums for Ray Peat type information do advocate calcium as being everything, but I think there has been a big shift in "Ray Peat" information. I started reading Ray Peat many years ago and back in the beginning Ray Peat recommended magnesium way way more than calcium. Someone bought his website and is rewriting his articles. The people who run the forums in his name are not giving you true Ray Peat information.

Ray Peat did always recommend drinking orange juice and even eating ice cream, but he always recommended magnesium as a supplement. And magnesium is a calcium channel blocker, which helps the calcium go where it's supposed to go but not where it's not supposed to go.

Although when you think about calcium issues, it's not really the calcium, it's calcium metabolism. So if K2 is causing pain, it might be doing so because of it's power on calcium, but only calcium that is where it's not supposed to be or bound to something it's not supposed to be bound to. For it to be causing pain is very out of the ordinary, though, so the problem seems rather complicated.

I'm not saying magnesium is the answer, or that your husband doesn't need calcium, though. I truly don't know about that. I wonder if adding sodium bicarbonate to his orange juice might relieve the IBS-D, though.

Where did you hear the bolded?? it would be quite surprising to me if that was true!
 

Gondwanaland

Senior Member
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5,100
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5339475/
Korean J Intern Med. 2017 Mar; 32(2): 213–228.
Published online 2017 Feb 8. doi: 10.3904/kjim.2016.268
PMCID: PMC5339475
PMID: 28171717
Reversal of liver cirrhosis: current evidence and expectations
Young Kul Jung and Hyung Joon Yim
Author information ► Article notes ► Copyright and License information ► Disclaimer
This article has been cited by other articles in PMC.

Go to:
Abstract

In the past, liver cirrhosis was considered an irreversible phenomenon. However, many experimental data have provided evidence of the reversibility of liver fibrosis. Moreover, multiple clinical studies have also shown regression of fibrosis and reversal of cirrhosis on repeated biopsy samples. As various etiologies are associated with liver fibrosis via integrated signaling pathways, a comprehensive understanding of the pathobiology of hepatic fibrogenesis is critical for improving clinical outcomes. Hepatic stellate cells play a central role in hepatic fibrogenesis upon their activation from a quiescent state. Collagen and other extracellular material components from activated hepatic stellate cells are deposited on, and damage, the liver parenchyma and vascular structures. Hence, inactivation of hepatic stellate cells can lead to enhancement of fibrolytic activity and could be a potential target of antifibrotic therapy. In this regard, continued efforts have been made to develop better treatments for underlying liver diseases and antifibrotic agents in multiple clinical and therapeutic trials; the best results may be expected with the integration of such evidence. In this article, we present the underlying mechanisms of fibrosis, current experimental and clinical evidence of the reversibility of liver fibrosis/cirrhosis, and new agents with therapeutic potential for liver fibrosis.

Responses during systemic inflammation and intestinal dysbiosis
During systemic inflammation, the immune response is initiated when bacteria are introduced through portal flow from the intestinal lumen. Pathogen-associated molecular patterns (PAMPs) from enteric bacterial organisms and damage-associated molecular patterns (DAMPs) originating from the host tissue upon injury stimulate innate immune cells [40]. Immune recognition of bacteria and PAMPs including LPS, lipopeptides, glycopolymers, flagellin, and bacterial DNA occurs both locally in the gut-associated lymph node tissue (GALT) and in mesenteric lymph nodes (MLN) as well as systemically [41]. Furthermore, immune cells already activated in the GALT and MLN may enter the peripheral blood and spread the inflammatory response systemically. DAMPs and sterile particulates, also released from necrotic hepatocytes, might also contribute to elicit an inflammatory response and fibrosis [42].
Primary biliary cirrhosis
The only clinically approved medical treatment for primary biliary cirrhosis (PBC) is ursodeoxycholic acid (UDCA) [110,111]. However, there are controversies regarding the interpretation of current evidence. In several studies with crossover from placebo or no UDCA treatment, the crossover patients’ conditions deteriorated despite using UDCA [112]. A Cochrane Review evaluating 16 RCTs using UDCA versus placebo revealed that almost half of these trials had a high risk of bias and concluded that UDCA did not significantly improve liver histology and had no demonstrable effect on improving mortality [113]. Nevertheless, UDCA may have benefits in early stage and asymptomatic PBC. In the asymptomatic PBC cohort described by Prince et al. [114], 45% of the patients taking UDCA did not develop liver-related symptoms during a median follow-up of 7.4 years.

The role of immunosuppressive agents in PBC remains controversial. A few studies evaluating methotrexate have presented conflicting results and some studies suggest that methotrexate may worsen mortality [115].

Obeticholic acid, a derivative of chenodeoxycholic acid, has, unlike UDCA, strong activating effects on the nuclear receptor farnesoid X receptor in phase II results [116]. In a recent clinical trial with obeticholic acid as therapy for PBC, favorable effects were also observed in PBC patients with an inadequate response to UDCA [117]. Alkaline phosphatase, γ glutamyl transpeptidase, and alanine aminotransferase levels were significantly improved in patients receiving obeticholic acid compared with those in the placebo group. In this study, the treatment period was only 3 months and liver biopsies were not obtained to identify histologic changes. Subjects were allowed to participate in an open-label extension trial, which demonstrated sustained decreases in liver enzyme levels over 12 months [117]. Future trials to determine the beneficial effects of obeticholic acid on hepatic fibrosis in patients with primary cirrhosis are warranted.
 

frozenborderline

Senior Member
Messages
4,405
Hey @dannybex, in the past year I've gotten into eating raw egg yolks, and discarding most of the whites. I like putting a couple of egg yolks in a large cup of bone broth, and find it to be one of my favorite "comfort" foods, as it has quite a calming effect on my entire system. I probably have this every other day or so. -- All the Best!
haha wayne this is such a ray peat thing to do. But yeah I've been very, very ill recently and the thing I tolerate the best is eggs with potatoes, but especially the yolks, which are easier to digest. it's high quality protein and vitamins and very digestible
 

Violeta

Senior Member
Messages
3,190
Where did you hear the bolded?? it would be quite surprising to me if that was true!
I used to read at one of the Ray Peat forums. I had been reading Peat's papers forever and noticed a huge difference in the type of writing in the newer articles and brought up the subject. Someone there confirmed they were being written by someone else and that the site had been sold.
 

Malea

Senior Member
Messages
260
I‘ve got a question: If I remember it right I read somewhere in this thread that in @mariovitali ‘s theory taking p450-inhibitors would be not good.

Now I was wondering if medications that are metabolised through the p450-cytochromes are automatically inhibitors? (For example the betablocker propranolol or many antibiotics)
 
Messages
22
I would still like to try UDCA/TUDCA but my doctor will never prescribe it as he easily dismissed my pale stools as "absolutely normal" phenomenon. Does anyone know where can I buy a good UDCA without prescription?
I would like to start with UDCA rather TUDCA as taking taurine alone not only doesn't help but makes some symptoms worse(including the pale stools and varicose veins).
 

invisiblejungle

Senior Member
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228
Location
Chicago suburbs
I would still like to try UDCA/TUDCA but my doctor will never prescribe it as he easily dismissed my pale stools as "absolutely normal" phenomenon. Does anyone know where can I buy a good UDCA without prescription?
I would like to start with UDCA rather TUDCA as taking taurine alone not only doesn't help but makes some symptoms worse(including the pale stools and varicose veins).

I found several sources for UDCA:

https://www.mimaki-family-japan.com/item/list?keyword_pc=Ursodeoxycholic+acid&x=0&y=0

http://www.buypharma1.com/Products/search/?keyword=Ursodeoxycholic+acid

brandmedicines.com

goldpharma.cn

I've ordered from all of these pharmacies before and can vouch for them.
 

invisiblejungle

Senior Member
Messages
228
Location
Chicago suburbs
Is UDCA preferred over tudca

I don't know. The poster was asking specifically for UDCA rather than TUDCA, which is available as a supplement.

Interesting thing about TUDCA. It's found naturally in large amounts in bear bile, and Asian bears have a lot more than American bears. Bear gallbladders have been used in traditional oriental medicine for millennia. I'm Korean, and my parents said that when they were growing up in Korea, bear gallbladder was known as a panacea and was one of the most expensive medicines.
 
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Although Ive seen positive effects in my gut irritation and some kind of anxiety lowering effect from UDCA, I´ve noticed it has increased some nasty overgrowths. This hypothesis made sense after readig this :
"UDCA increased mortality of mice following Escherichia coli infection due to the worsening of infection". Seems it lowers lymphocites so those of us with poor inmune funcion should be careful with it.

I´ve also noticed increased fatigue while on it. Has anybody experienced something similar?



Glucocorticoid receptor-dependent immunomodulatory effect of ursodeoxycholic acid on liver lymphocytes in micehttps://www.physiology.org/doi/full/10.1152/ajpgi.00205.2012
 

Mick

Senior Member
Messages
141
OK, so I got here while searching for keywords "choline PEM". This thread drew my attention so I decided to read it in whole but I immediately found that the thread and the theory have issues, multiple issues.

In case you are wondering if you should read this thread (and devote your mental resources to it for a few days experiencing different "mental PEM states" in the meantime) I am trying to provide a critical review - after reading it. It may also be easier for you to understand what is going on in this thread.

Introductory remarks:
How long did it take to read? 20 days. On and off. Maybe 10 days of pure reading, maybe less.

Was it worth reading? Not exactly. The first post summarizes the protocol and the theory pretty well, I'd only add rhodiola rosea to the protocol (or to the list of things that you should try if you prefer it this way) as it is mentioned within the thread in one of the posts but it is not mentioned in the first post (I think).

However, there is a lot of articles mentioned along the way, at least two of which I found very interesting. So, if one is willing to learn something new, there is something to be learned here but beware: the path is treacherous and you have to be very careful.

Background/experience: 20 years of CFS, whole genome sequenced 2 times (research facility + commercial) + 23 and me, worked on my own genetic data for 6 months after receiving the research genome sequence as those were the times when no commercial sequencing was available (and I was actually a subject #1 in the research facility), worked with the professor, queried the databases, etc.
***

Good things about this thread and theory:
- it introduces TUDCA and shows that it is used to battle Parkinson's disease so it IS actually working on a cellular level. I'd never find out about TUDCA if it wasn't for this thread. However, even though I planned I am not using it currently because something else worked for me very well in the meantime. Yes, it's a very strange coincidence indeed but it is what it is.
- it shows how important choline and taurine is - not only for the muscle and nerve cells but also for the liver. This is probably why high dose lecithin worked for my gut issues and consequently other things. This high dose lecithin - started two weeks ago.
- it shows how to look for research papers in a more ordered fashion ie. using data mining. However, this approach will lead to problems when incorrectly used with SNPs, see below.
- provides you with many articles, many stories, a few starting points for other protocols

Bad things about this thread and theory:
- the data mining approach to SNPs (ie. assigning scores to all possible SNPs within a gene, summing the scores up and assuming that the higher the sum the worse your condition potentially is) is completely incorrect - as described by Valentijn in post number 1365: https://forums.phoenixrising.me/thr...-possible-treatment-for-cfs.37244/post-690695
... among other posts.

The readers (if you decide to read it) should be aware of that from the beginning as this approach is presented much much earlier within the thread. Why was this model of data mining constructed this way (I'm trying to understand mariovitali here)?

In data mining it is common to construct a model like this, find correlations, refine the model (or change it completely) based on these correlations, etc.

Given a lot of data and many iterations we will arrive at a correct answer (in theory). However SNPs and gene interaction will not fit to any simple model like this. Besides: why start with such a simple model when it is already well known how to approach this problem?

But it gets even worse. You simply can't do such an analysis with 23 and me data. There are too many errors. Many years ago I compared my data from research quality genome sequencing (= very high quality, many passes, error ratio less than one in a thousand) to 23 and me data. Looks like the error rate is about 4%. With such an error rate there is almost no way any analysis can give correct results. And the professor that I worked with, when we found a suspicious SNP, he ordered a sequencing procedure of that gene called Sanger sequencing - that's how certain you need to be when it comes to looking for very rare (disease-causing) SNPs. Basically the error rate has to be lower than that of the frequency of that SNP otherwise it's turning to a guessing game. With Sanger sequencing, the error rate is lower than 1 in 1000.

So... with 23 and me you'd need to look for SNPs with a frequency higher than around 4% but then SNPs with such a frequency will most often not cause any disease at all. These are simply too frequent and had it been a disease-causing SNP there would have been too many patients and somebody would have identified this SNP as a disease-causing and this disease a long time ago.

For comparison: incidentally 4% ie. 1 in 25 people carry a mutation for cystic fibrosis which is the most frequent genetic disease.

But it gets even worse: with whole-genome sequencing you will receive data about all possible SNPs within your genes and with 23 and me data... you'll only receive data on the SNPs handpicked based on many different criteria (a very very pitiful subset of what you get with WGS actually) - most of the time these will not be the less frequent SNPs - so, again, it's pointless to even start the analysis. The data is skewed.

Of course, even though this way of explaining the genetic origin of CFS is incorrect, the theory about unfolded protein response in CFS looks quite solid.

- it's not all about genes. A simple dietary deficiency of choline or taurine or mechanical obstruction of gallbladder may cause you similar symptoms as if you had a genetic condition. When people report different symptoms mariovitali is always somehow able to connect them to a liver dysfunction via genes. That's pretty amazing but that would be too easy... there are dietary, mechanical, bacterial and god knows what other factors involved...

****
OK, now I have a few remarks.

3) A user called ppohadjski said that these agents (Taurine, TUDCA, etc) should not be used but instead we should use Biotin and FMN which are key cofactors for regulating redox functions.
I'd say - try whatever you can as fast as you can (ie. without hesitation if money permits) because you can never know what will work for you. You may try both of these approaches but try them anyway.

I will continue working to reach the absolute basics. I started FMN, Biotin, Molybdenum per @ppodahjski suggestions.
If this all is just a matter of providing cofactors then why not, i will follow it.
No, don't try to reduce the number of supplements solely for the purpose of reducing it. It will end up badly.

Just wanted to let you know that i just crashed really badly. ATM I have SEVERE brainfog, OI, irregular heartbeat. I am a mess actually :( :depressed:

I stupidly decided to stop TUDCA *and* Choline...i feel so bad now because i realize how fine i felt and my condition reminds me of the s**t i've been through having this for so long
When I reached that post... I knew it. I know from experience. It's not worth it.

What we've seen from Yasko is a lot of strict SNP claims which turned out to be obvious BS. Some people then moved to assuming that there must be some mechanism involving genetic expression which causes these irrelevant SNPs to suddenly become relevant.
Yup, looks like a marketing ploy. Just trying to sell ordinary vitamins (or whatever she sells? books, appointments?) as a part of an elaborate protocol. And statistically, this protocol will work for a fraction of people implementing it - after all it's the vitamins that we're talking about so they have to work for some people. Then she can claim that it's all because of her discovery of methylation problems...
But from a broader perspective - if it helps like 20% (maybe more, who knows but I personally doubt it) of the people who follow her advice - it is still worth it for the people to try it, right? You have to try something or die trying, right? Like you just can't be sick and stay in bed for the rest of your life...
From an even broader perspective - that 80% of the people who pay her and it doesn't work for them still pay her so for her it actually works 100% of the time. This quick business calculation shows that this venture will be/is profitable... ;)
 

Mick

Senior Member
Messages
141
@Mick - please share, what worked for you?

That will be the most unhelpful answer ever. But... everything. I literally take every supplement there is. Every vitamin, every mineral, every body-building compound. I invented my own "Theory of everything" (the pun is intended - for those who like physics and understand what I'm talking about).
But it's been only day 5 (?) of the improvement so I'd rather not to be so joyful about it yet. But it's promising - some aspects are better than ever before, even when I was supposedly healthy (ie. before the onset of the CFS but actually I had CFS for my whole life). Right now I'm at a capacity of 50% of a normal man. Today I was lifting 60-pound boxes for 5 hours... Completely unreal. But I said to myself: if this improvement is to wear off at least these boxes will be moved... so long overdue... And all of this time I was between 1 and 5% depending on the day. Anyways... there are many aspects to it and like 20 years of research. And I'd rather not hijack this thread... but...

I started with this particular approach 12 months ago. And slowly increased the number of supplements. But I knew that there would be problems along the way because I tried many of these supplements some time ago and knew that they will cause side effects, sometimes severe. I was basically oversensitive to 50% of them (and it's not about allergy, it's about stupid interactions). So the first attempt was to try it again - if it worked then it's OK and I'd continue to take it. If it didn't work I'd try to work around it. If I failed - the supplement had to be interrupted. But that was most unfortunate because what if it was the right supplement in the first place? I have come across this situation multiple times.

One such example, the worst one: I was never able to take niacin. It made me so terribly drowsy (it works just like GABA neurotransmitter). Even very small doses (like in the RDA range). But it gets worse. Niacin causes flushing (causes production of PG2 prostaglandin) and I got this flushing when taking even normal RDA doses but after a few days in a row. So when I took it 3 times in a row - I got this flushing and I got drowsy (once it made me sleeping 20 hours a day so I had to stop it and that was it).

And it gets worse. Niacin is recommended when you get overmethylated and inflamed after taking methyl-folate. So there was no way to do this. Bummer.

I tried many many times to find a way to reduce that stupid drowsiness after taking niacin.
But when you take everything you may finally come across something that works. And something worked, namely L-aspartic acid and tyrosine. Though it's kind of hard to identify what worked and what didn't.

What else interesting is there... polyphenols... they reduce my joint inflammation... you might wanna ask what works best? What is that I'm taking... almost everything: quercetin, green tea, green coffee (ie. chlorogenic acid as a supplement, I hate brewed coffee), fisetin, chamomile tea, and resveratrol. I also tried to take luteolin which might be even better in quenching the inflammation but there is no place to buy it easily. Of course, there is artichoke extract (contains luteolin) but I am allergic to it (this time it's a real allergy to it or to a tablet component, I think). I'm mentioning resveratrol here because it tipped the balance. But... 5 days ago only 1 capsule was more than sufficient (made me terribly hot) and today 2 are not working as good.
No need to say that I tried this resveratrol 5 years ago and it didn't do anything for me, just the opposite. So this one is actually the one that was left on the bottom shelf for 5 years... and I'm wondering if there may be something that happened to it during such a long storage... some kind of breakdown...

It is still possible that I will get back to old miserable me.
Nevertheless, during these last 5 days I proved that it is possible for me to get better. Up until now I was kind of convinced that there is no simple way to make me better (haha, this is not a simple way neither, I have to take so many capsules and tablets but first I need to purchase them at an affordable price so it's a logistical nightmare but it's still simpler than getting involved with doctors and the healthcare system, begone!).

Obviously, prescription drugs, injections and gene therapy are beyond our capabilities even though I'd try any of them, one by one, doesn't matter if there was a good reason to do it or not. I simply didn't care.
So when I'm thinking that I might actually do something in and with my life - that doesn't mean anything to me yet. I'm in the 5-th stage after a loss: acceptance. So I've accepted that I mean nothing and I have to struggle to survive.

I guess it would be best to first figure out exactly what helped me and share that information with those in need... but I have no idea how to do it, how detailed the information should be, etc.

PS. Along the way there were also some other things that helped me. Many of them, like MCT oil and BCAA (I'd say every other supplement that I took helped me but some of them more than others). But I guess there is no point in listing them all - these will be different for everybody. There was a slow improvement, a build-up over time and then bam, resveratrol, and everything clicked into place.
On the other hand, there were supplements that made me feel terrible: arginine, folate, niacin... and yeah... even MCT oil made feel sick for a long long time but then when other supplements kicked in I only experienced benefits and no side effects.

PS2. My condition is actually strange because for example tendons kill me (inflammation), I can barely move in the morning but then I can walk it off and it gets better...

PS3. Yesterday I also moved heavy boxes for 5 hours. I guess I have a lot of boxes to move :)

EDIT: PS4. Mick, after all these years you get a break, and all you can do is move boxes? Come on, you've got to be kidding me...
 
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