Why do some B vitamins make me extremely tired?

Learner1

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Yes, I had one doctor tell me to take B12 to reduce fatigue. When I reported that it made me feel very strongly suicidal, he refused to accept that, because that's not a textbook response for B12 (for normal people). I think it's important to tell doctors that PWME may have unusual responses to treatments because some processes in our bodies are not functioning normally.
It's important to test fir all the co-factors of B12 and toxicity in order to be able to make an intelligent analysis of the situation and not just rely on ME/CFS patients are different. I believe you have Bastyr trained naturopaths in your geographic area who could assist you with this.yih Nat very well need B12, but are missing some key info that might cause your unhappy symptoms even you take it and Allie you to take it. B12 deficiency can cause fatigue, inability to detoxify, inability to properly copy DNA, inability to make neurotransmitters, inability to properly run the immune system, and irreversible neurological damage. Best to figure out why your symptoms are occurring, and if you truly need B12, and what it would take to allow you to successfully take it, rather than to experience the downside of these risks.
 

Pyrrhus

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So, what is your status for:
  • B1
  • Molybdenum
  • Glutathione
  • B6
  • Heavy Metals
  • Mycotoxins
These can all greatly affect one's ability to tolerate B12.
Please remember that every ME patient is different. There is no "one size fits all" approach because patients can have very different metabolic factors at play.

A strong negative reaction to B12 can be quite common in ME, although it shows up as a distinct minority in the poll. Methylcobalamin especially is reported to be the worst offender in these cases.
 
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Learner1

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Please remember that every ME patient is different. There is no "one size fits all" approach because patients can have very different metabolic factors at play.
Exactly. That is why comprehensive nutrient testing and testing for toxins is so important. Then patients can figure out their individual situation and address it.

Every single human, whether they have ME/CFS or not, has a need for each of these nutrients. And, being deficient in any one of them or having imbalances between them can be detrimental to health.
 
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Wishful

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Every single human, whether they have ME/CFS or not, has a need for each of these nutrients. And, being deficient in any one of them or having imbalances between them can be detrimental to health.
Yes, that's true, but the supplement industry blows it all out of proper proportion in order to sell more. Our bodies seem to have quite large reserves of most nutrients, with VitC being unusual in its low reserves, probably because we lost the gene for producing it not all that long ago, in evolutionary terms. The marketers imply dire consequences if you don't get your RDA of each nutrient. However, I lived on cornstarch and water for a year or two, with only an occasional VitC tablet, and didn't notice any deficiency symptoms. I was trying to cause TRP deficiency, and never managed it.

So yes, some people can suffer health problems from nutrient deficiency or imbalance--or toxins--but that's probably a fairly small percentage of the population, and due to some genetic, epigenetic or other disorder. I don't feel that the majority of the population would benefit significantly from comprehensive testing and a personalized cocktail of supplements.
 

Learner1

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Perhaps living on cornstarch for 2 years contributed to your illness? The quotes below discuss the pitfalls of a diet devoid of nutrients, and these are for healthy people. A significant part of the US population is deficient in several nutrients which do contribute to illness.

https://lpi.oregonstate.edu/mic/micronutrient-inadequacies/overview
A recent US national survey, NHANES 2007-2010, which surveyed 16,444 individuals four years and older, reported a high prevalence of inadequacies for multiple micronutrients. Specifically,

94.3% of the US population do not meet the daily requirement for vitamin D,
88.5% for vitamin E,
52.2% for magnesium,
44.1% for calcium,
43.0% for vitamin A, and
38.9% for vitamin C.

For the nutrients in which a requirement has not been set,

100% of the population had intakes lower than the AI for potassium,
91.7% for choline, and
66.9% for vitamin K.

The prevalence of inadequacies was low for all of the B vitamins and several minerals, including copper, iron, phosphorus, selenium, sodium, and zinc
However, micronutrient inadequacies — defined as nutrient intake less than the EAR — are common in the United States and other developed countries. Such inadequacies may occur when micronutrient intake is above the level associated with deficiency but below dietary intake recommendations (17).

In contrast to micronutrient deficiencies that result in clinically overt symptoms, micronutrient inadequacies may cause covert symptoms only that are difficult to detect clinically.

For example, micronutrient inadequacies could elicit symptoms of general fatigue (18), reduced ability to fight infections (19), or impaired cognitive function (i.e., attention [concentration and focus], memory, and mood) (19). Micronutrient inadequacies may also have important implications for long-term health and increase one’s risk for chronic diseases like cancer (17, 20), cardiovascular disease (20), type 2 diabetes mellitus (21), osteoporosis (20, 22), and age-related eye disease (23).

Many Americans are not reaching micronutrient intake requirements from food alone (24, 25), presumably due to eating an energy-rich, nutrient-poor diet. About 75% of the US population (ages ≥1 year) do not consume the recommended intake of fruit, and more than 80% do not consume the recommended intake of vegetables (1). Intakes of whole grains are also well below current recommendations for all age groups, and dairy intake is below recommendations for those ages 4 years and older (1).

The 2015-2020 Dietary Guidelines for Americans highlighted the nutrients that are underconsumed in the US population, i.e., "shortfall nutrients," labeling a few as "nutrients of public health concern" because low intake may lead to adverse health effects: Vitamin D (adverse health effect: osteoporosis), calcium (osteoporosis), potassium (hypertension and cardiovascular disease), dietary fiber (poor colonic health), and iron (anemia in young children, women of childbearing age, and pregnant women) were such labeled (1). Other nutrients, including vitamins A, C, and E; choline, and magnesium, were identified as also being underconsumed by the US population.
Multiple researchers have found nutrient deficiencies and imbalances in ME/CFS patients, including B vitamins, lipids, antioxidants, and amino acids in their metabolomics studies.

It is indeed prudent to investigate ones individual situation, as genetics, toxins, infections, and lifestyle factors like diet and activity level all can affect an individual's nutrient status.
 

percyval577

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... Our bodies seem to have quite large reserves of most nutrients, with VitC being unusual in its low reserves, probably because we lost the gene for producing it not all that long ago, in evolutionary terms. The marketers imply dire consequences if you don't get your RDA of each nutrient. However, I lived on cornstarch and water for a year or two, with only an occasional VitC tablet, and didn't notice any deficiency symptoms. I was trying to cause TRP deficiency, and never managed it.

So yes, some people can suffer health problems from nutrient deficiency or imbalance--or toxins--but that's probably a fairly small percentage of the population, and due to some genetic, epigenetic or other disorder. I don't feel that the majority of the population would benefit significantly from comprehensive testing and a personalized cocktail of supplements.
Generally speaking there is also the logical possibility that not the absolute amounts of nutritions are the problem, but an imbalance in their action.

E.g. a virus might have elevated the action of, say, Vit B2, and now, when the virus has gone, everything is normal again, only that too much action from Vit B2 has been implemented, and this is reiterated. So in this case one might elevate the actions of any counteractions, maybe the ones of the others, although you ever get enough from them through nutrition.

This might actually be the chance and danger of supps to quite some percentage, I could imagine. In a sense comparable to the derivative in mathematics.

(So, as having said earlier, I only agree a bit here in that sense that any detected deficiency might not announce a problem. But the other way around I really don´t think that supps in the normal sense are per se useless, in addition to the above mentioned.)
 
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Not having the right balance of all these nutrients can really cause the body to suffer, can cause all sorts of mood abnormalities, lead to cancer, as well as all sorts of immune system problems.
Which is why I prefer to get much smaller amounts than those provided in B-comp supps from food sources, where they're accompanied by the necessary co-factors ...
The only way to figure out what you need, is not to get hints from other people on a web forum who may have totally different biochemistry and genes than you do, and who may have been exposed to an entirely different batch of toxins than you, but to do a comprehensive nutrient test, or a batch of single nutrient tests, to figure out what your status is of each one of these nutrients.
This pretty much vitiates the point of about 80% or more of the posts on this site. While I agree that the best way is to get tested and find out exactly what's going on in your particular landscape, I've always found the posts in PR to be helpful and informative signposts, and I deeply appreciate the members who take the time to post them in the hopes of helping the rest of us, struggling towards our own personal truths in terms of treatments.
 
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Our bodies seem to have quite large reserves of most nutrients, with VitC being unusual in its low reserves, probably because we lost the gene for producing it not all that long ago, in evolutionary terms.
I'm not sure homo sapiens ever had the ability to produce its own Vit C, altho some other mammals can. Many millions of years ago, some distant members of ancient primate families were able to synthesize their own Vit C to some degree, but we're talking about anywhere from 65 to 85 MILLION years ago. Things change.


It has been proposed that a biochemical action of some sort might have occurred, way way way back, crippling the human capacity to produce ascorbic acid endogenously, but tht hasn't been definitively proved beyond hypothesis.

All water soluble vits tend to be in lower reserves in our bodies precisely because, being water soluble, they can often be washed out before they're fully utilized, depending on genetics, etc ...
 

Wishful

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Perhaps living on cornstarch for 2 years contributed to your illness?
No, I didn't start that diet until several years into my ME. I probably felt better during that diet because I was avoiding several factors that would have worsened my symptoms. I didn't notice any particular improvement in health when I went back to a more nutritional diet. It sure felt good to eat meat again. :thumbsup:

That experience sure convinced me that missing my RDA for all those nutrients was not the major disaster that supplement marketers try to make us believe.
 

Wishful

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I'm not sure homo sapiens ever had the ability to produce its own Vit C, altho some other mammals can.
I found this: https://academic.oup.com/emph/article/2019/1/221/5556105

"CONCLUSION
Transport and accumulation of vitamin C into RBCs increases intra-RBCs electron pool and cross membrane electron transfer. This results in efficient extracellular recycling of vitamin C from AfR, produced during the redox reaction of vitamin C with free radicals. This recycling is energetically more economic compared with the de novo synthesis of the micronutrient. RBCs Glut-1 expression and resulting vitamin C recycling decreased the required daily amount by up to 100-fold and led to the evolutionary selection of this phenotype which is better adapted to a changing and unsecure supply of this important micronutrient."

They used a figure of 40 million years. Several other species of mammals followed the same evolutionary path at different times.
 

Learner1

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Rather than reading studies to justify your view that ME/CFS patients shouldn't have their arms twisted by supplement marketers @Wishful , perhaps it might be wise to look at what real patients are experiencing.

These 2 tests, one of which is blood, the other urine, correlate well with other brands of lab tests, and I've found them to be a valid measure of nutrient status and the response to changes in nutrient intake.

These examples were done a year apart, both taking far more than the recommended DV of each nutrient, excepting biotin, which was not taken.
Screenshot_20200903-164439.png
Screenshot_20200903-164709.png


Environmental factors can cause dramatic changes in needs. This is another of the second test, taken 2 years prior, when this same patient was much more ill.
Screenshot_20200903-165418.png


I don't think this is a case of the supplement manufacturers pushing supplements. This is an ill patient running through a lot of nutrients, due to toxicity, infections, autoimmunity, and mitochondrial dysfunction.

Lack of C can cause deficiencies in collagen production which may affect spinal issues and result in pinched nerves and ME/CFS symptoms. It can also affect glutathione recycling, as well as acetyl-CoA and the ability to metabolize and get rid of toxins. Lack of B6 can affect heme production, sulfur balance, methylation and over 90 different reactions. Lack of folate and B12 affect methylation and immune system function, neurotransmitter production, BH4 recycling, peroxynitrite production and proper copying of DNA. Lack of B1 and molybdenum affect the transsulfuration pathway and the ability to get rid of toxins. Lack of vitamin D and zinc affect ability to fight COVID. And lack of B2 affects methylation and complex II of mitochondria.

There is no substitute for testing. These tests were all from the same patient at different times, in a different illness state, different activity levels, and different interventions. And, even the same interventions with different results...
 
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Wishful

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@Learner1 , as I said in a a previous post some people do have medical problems that can be helped by supplements. Posting a few examples of those doesn't mean anything about the general population, which lacks those special problems. A quick google shows health.harvard saying: "Most of us living in developed nations and eating a balanced diet don't need a daily multivitamin or specific vitamin pills—but there are situations where we do."

From Johns Hopkins:

"The researchers concluded that multivitamins don’t reduce the risk for heart disease, cancer, cognitive decline (such as memory loss and slowed-down thinking) or an early death. They also noted that in prior studies, vitamin E and beta-carotene supplements appear to be harmful, especially at high doses.

“Pills are not a shortcut to better health and the prevention of chronic diseases,” says Larry Appel, M.D., director of the Johns Hopkins Welch Center for Prevention, Epidemiology and Clinical Research. “Other nutrition recommendations have much stronger evidence of benefits—eating a healthy diet, maintaining a healthy weight, and reducing the amount of saturated fat, trans fat, sodium and sugar you eat.”

The exception is supplemental folic acid for women of child-bearing potential, Appel says. “Folic acid prevents neural tube defects in babies when women take it before and during early pregnancy. That’s why multivitamins are recommended for young women.” The Centers for Disease Control and Prevention recommends that all women of reproductive age get 400 micrograms of folic acid daily. The amount of iron in a multivitamin may also be beneficial for women of child-bearing potential, Appel adds.

“I don’t recommend other supplements,” Appel says. “If you follow a healthy diet, you can get all of the vitamins and minerals you need from food.”"


Just a quick check showed respected educational institutes saying that for the general population supplements are a waste of money, but that some people have medical conditions that do benefit from them. I'm guessing that peer-reviewed papers would say the same, but google ranks paid_by_the_supplement_industry papers higher, so I didn't feel like digging possibly tens of pages deeper.

Just as a guess, the percentage of PWME having specific problems that can be identified by testing and treated by supplements is probably a bit higher than the general population. That doesn't mean that all of us are likely to benefit that way. My way of testing this on me was to take a multivitamin tablet, to see if boosting the level of any of those nutrients would make a difference. Yes it did, and I identified iodine as the beneficial factor. None of the other nutrients had noticeable beneficial effects (well, B1 did, but only for the first tablet or two). That testing also identified B2 and B3 as making my symptoms worse.

Likewise, I tried various diets, from the nutritionally deficient cornstarch diet, to a nutritionally-rich rotation diet. Neither had a really significant effect on my general symptoms, the kind that I would expect if I had an actual nutritional deficiency.

If someone does notice significant effects from dietary changes or supplements, then further testing and experimentation on those lines might be useful.

I admit that I'm a bit skeptical about commercial nutrient analysis. I feel that their goal is profits, not patient health. I expect that they'd rather have a lot of customers giving glowing reviews about (placebo) benefits from the testing, rather than only a few patients giving good reviews because they did have a medical disorder that the analysis was actually useful for. I'd be interested to read a peer-reviewed paper on the value of such testing for the general population.
 

Learner1

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Patients with ME/CFS are not the general population. Researchers researching patients with ME/CFS have found them to have several nutrient deficiencies, and some patients have been found with research quality testing to be as far as 17 standard deviations from the norm in nutrient status.

As was stated in the references I quoted, it is not necessary to have a symptom to have a nutrient imbalance or deficiency. Rather the nutrient imbalance or deficiency can be quietly causing serious disease.

And, as I mentioned, the labs shared have been correlated with numerous other labs including those from Quest Diagnostics and LabCorp who are the two largest labs in the United States. They are believable.

Being an ill-patient is not a time to dismiss the importance of nutrition in one's health. Nutrients are essential to run a healthy body. It is prudent to understand one's nutrient status and to optimize what we have. I've gone from being in a heap on the floor to being a functioning human being with a IV of mitochondrial cocktail nutrients and have gone from being foggy-brained to clear-headed within 15 minutes of taking sublingual nutrient. Experiences like this have made me a believer.
 
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Learner1

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@Wishful These are the researchers findings on nutrients:
  • From the 2019 Emerge conference in Australia - Neil McGregor (Melbourne University) described the metabolome as “a molecular soup”, and spoke of a number of interesting biochemical abnormalities in ME/CFS. They could subgroup patients by symptom scores and biochemical changes after exercise. Changes in glucose and lactate (indicating glycolysis deregulation) correlated with increasing PEM severity, reduced hypoxanthine (an ATP breakdown product) in serum, and low levels of amino acids normally carried in muscles cells. Severity scores were also related to the amounts of various metabolites in the urine. Patients were losing metabolites and electrolytes in the urine that they should have retained.
  • From Robert Naviaux's landmark metabolomics paper - CFS has a chemical signature that can be identified using targeted plasma metabolomics. Receiver operator characteristic (ROC) curve analysis showed a diagnostic accuracy that exceeded 90%. The pattern and directionality of these changes showed that CFS is a conserved, hypometabolic response to environmental stress similar to dauer (35). Only about 25% of the metabolite disturbances found in each person were needed for the diagnosis of CFS. About 75% of the metabolite abnormalities were unique to the individual and useful in guiding personalized treatment. He specifically found reduced levels of B2 and lipids that make up cell and mitochondrial membranes, as well as numerous other abnormalities.
  • From Oysted Fluge's PDH paper - Analysis in 200 ME/CFS patients and 102 healthy individuals showed a specific reduction of amino acids that fuel oxidative metabolism via the TCA cycle, mainly in female ME/CFS patients.
  • Maureen Hansen found 33 metabolites that were significantly different in ME/CFS patients. Those pathways that were affected were fat metabolism, energy and sugar metabolism, and amino acid and purine metabolism. And in that particular study 29 of the 33 metabolites were lower in ME/CFS than controls.
These are just a few of the plethora of studies that have found abnormalities in nutrients in ME/CFS patients. And they say that there are commonalities, patients can be grouped into subsets and that we have individual differences and that individualizing treatment is appropriate. Ron Tompkins has said that testing personalized medicine is one of their four main goals. And many of us are doing this today.

It is foolish and short-sighted to ignore this as a potential area for individualized treatment and improvement. Granted, none of this is a cure, but optimizing the way the bodies pathways are working is a useful step on the path to wellness. my doctors and I have been reviewing the research, comparing my labs to what the researchers found, and responding by trying treatment plans that incorporate the concepts uncovered by the researchers. This has greatly helped my situation and I know of many other patients who have been similarly successful.
 
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From Johns Hopkins:

"The researchers concluded that multivitamins don’t reduce the risk for heart disease, cancer, cognitive decline (such as memory loss and slowed-down thinking) or an early death. They also noted that in prior studies, vitamin E and beta-carotene supplements appear to be harmful, especially at high doses.
This from the premiere center of allopathic medicine, which makes their mega bucks by treating patients with expensive procedures, often damaging Rx's, and keeping them dependent on hospitals and medications, which would make anything that might undermine that richly rewarding income stream extremely unwelcome, soooooo .....

And the studies showing Vit E to be damaging and to cause lung cancer, among other things, were discounted long ago .... they were done on the equivalent of Skid Row inhabitants, whose health was already so compromised that drawing any conclusions from tht testing was deemed to be .... questionable ...

I'm beat all to hell today, but I'll be back to contest your carefully chosen 'proof' that homosapiens were capable of producing endogenous Vit C in the not-to-distant past ....everything I read, and in the past I'd read quite a bit anout it because I found it interesting, stated that the conclusions of various studies were really hypothetical and based on the use of 'scientific' methods to arrive at those hypotheses ....
 

Wishful

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This from the premiere center of allopathic medicine, which makes their mega bucks by treating patients with expensive procedures, often damaging Rx's, and keeping them dependent on hospitals and medications,
They did say: Other nutrition recommendations have much stronger evidence of benefits—eating a healthy diet, maintaining a healthy weight, and reducing the amount of saturated fat, trans fat, sodium and sugar you eat.” That doesn't sound like they're pushing drugs and surgery. They were just saying that supplementing nutrients beyond the levels of a normal diet didn't show significant benefits in reducing those diseases. As I understand it, our bodies have mechanisms for maintaining nutrients at appropriate levels: miss some in your diet, and it enters conservation mode; add extra and you excrete it.

An analysis can show that a nutrient is higher or lower than the median level for humans, but I'm not convinced that it necessarily shows that those levels are unhealthy for that individual, or that adding more will necessarily correct something. The 'differing from median' levels might be normal for that person, or they could indicate a problem that won't be solved by adding more of that nutrient.

I leave it as a matter of personal judgement. If you feel that it might be worth doing the analysis and supplementation, go for it! If you'd rather spend less money on a few new foods or supplements, do that. If you're a true believer in the latest offerings from Big Pharma, you're free to go that route too. I just don't think that nutrient analysis and supplementation should be touted as something that everyone should do. Let people see that there are differing opinions on the likelihood of benefits from it.

I believe that if I made the effort to have the analysis done, the results would show some red flags of some sort, even if they have to play with the figures to make it look like I'm getting value for my money, and that taking supplements based on the results wouldn't have any noticeable effects on me.

I do wonder: what percentage of their customers get a report saying "All is normal, nothing needs correction via diet or supplements."

I'll be back to contest your carefully chosen 'proof' that homosapiens were capable of producing endogenous Vit C in the not-to-distant past
I look forward to that. I've only read a few books that mentioned the defective gene, and didn't dig deeply for further data. It simply seems reasonable to me that this mutation--which seems to provide an overall increase in survival rate and has apparently occurred in several species independently--should happen.
 

Wishful

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Researchers researching patients with ME/CFS have found them to have several nutrient deficiencies, and some patients have been found with research quality testing to be as far as 17 standard deviations from the norm in nutrient status.
Yes, but what percentage of those patients actually had significant benefits from attempts to correct those abnormalities? That's the critical question. There could be all sorts of possibilities for those patients to have abnormal readings but not benefit from supplements. Theories are nice, but for a situation like this (simple theory for a very complex system), I want to see statistical results.

As was stated in the references I quoted, it is not necessary to have a symptom to have a nutrient imbalance or deficiency. Rather the nutrient imbalance or deficiency can be quietly causing serious disease.
Yes, I wasn't saying that deficiencies had to cause symptoms on their own. However, if a nutrient deficiency or imbalance was causing me symptoms of some sort indirectly, then the dietary changes I made should have made a noticeable difference, especially after a year or two of only cornstarch. They didn't, which convinced me that detailed analysis and tailored supplementation wouldn't have made a difference either. Your experiences convinced you that your body is very sensitive to nutrient levels. My experiences convinced me that my body is fairly insensitive to nutrient intake. I expect that we're both right, and the sensitivity of individuals is something for statistical analysis, with a standard bell curve between the two extremes.
 

Learner1

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Theories are nice, but for a situation like this (simple theory for a very complex system), I want to see statistical results.
You're joking, right? How exactly do you propose gathering statistical results on a large number of ME/CFS on an individualized nutrient protocol of multiple nutrients in vet a year time? How exactly would that work, please? Would the individualized nutrients get changed over time as each individuals needs changed? Would there be a control group? How would you assess progress? Would you break people into subsets of different etiologies and symptoms of ME/CFS?

Your statements earlier about the uselessness of antioxidants like vitamins A, C, and E as shown in studies illustrates the challenges, If you use them as an example. Antioxidants need to be taken as a part of a balanced antioxidant network, according to noted antioxidant scientist, Lester Packer, who ran the antioxidant lab at UC Berkeley for decades. Giving people high doses of one antioxidant at a time is a recipe for trouble, which is why these studies did not show benefit, and some of them actually showed harm. All nutrients work as a part of pathways, with cofactors, so figuring out which cofactors each patient needs, and in what amounts is a tricky business. As stuck pathways get started up When a deficient nutrient is brought up to a better level, one then hits the next bottleneck, with the next deficient nutrient, and the pathway gets stuck again, or the next pathway gets stuck. All of these work in concert, similar to how a symphony works in playing multiple instruments in a coordinated fashion to produce a musical performance.
. I expect that we're both right, and the sensitivity of individuals is something for statistical analysis, with a standard bell curve between the two extremes.
I don't know how you measure the sensitivity of individuals on a bell curve statistically. This is the problem with nutritional studies. It is a mistake to treat them like a drug trial, give a group of patients X dosage of a drug in isolation. Food and nutrients just don't work that way, unless I suppose one eats cornstarch for 2 years. I'm curious, did you do any tests to look for any deficiencies after that 2 years?

Even most doctors wouldn't recognize a deficiency in a patient. My mother literally had curved shin bones she was so deficient in vitamin D, and her doctors completely missed it. She lost 6 in in height, starting at 5ft 9 in and ending up at 5 ft 3. It was only when she broke her shoulder and required a reverse total shoulder replacement (think reversing the ball and socket) that the Cleveland Clinic put her on 50,000 units of D a week when they found her vitamin D level was 8. That took a lot of ignoring to miss a problem that large and that serious. I suppose you can gather statistics on vitamin D deficiency and patients having severe bone breaks, on the other hand bones need far more than just vitamin D - they need K2, calcium, magnesium, boron, strontium, etc.
 

Learner1

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They did say: Other nutrition recommendations have much stronger evidence of benefits—eating a healthy diet, maintaining a healthy weight, and reducing the amount of saturated fat, trans fat, sodium and sugar you eat.”
My daughter has a PhD in Biochemical and Molecular Nutrition from the top US program. We have discussed this at length. The problem with the statement is that it's at an epidemiological level, making broad statements across an entire population of people with individual genetics and environmental factors.

For some people, ME/CFS patients in particular, reducing sodium could be a bad thing and increase symptoms, for example. The brain is 70% fat and saturated fat is needed for healthy cell membranes that make up the brain and other tissues, and cholesterol is needed to make hormones.

Having strong evidence of benefits across an entire population does not do anything to improve an individual ill patient's health.
As I understand it, our bodies have mechanisms for maintaining nutrients at appropriate levels: miss some in your diet, and it enters conservation mode; add extra and you excrete it.
Sorry, though The body tends towards homeostasis and different areas, this is not always true across the board, particularly with nutrients. Deficiencies can and do exist and the body does nothing to conserve. That's why diseases like scurvy, beri beri, and rickets exist, as well as dementia caused by B12 deficiency.
I just don't think that nutrient analysis and supplementation should be touted as something that everyone should do. Let people see that there are differing opinions on the likelihood of benefits from it.
Perhaps not for an entire population of healthy individuals. But given the strength of the evidence across the many studies of ME/CFS patients, it is incredibly likely that there are nutrient deficiencies or imbalances that are impacting our health, and it would be prudent to do at least one comprehensive nutritional test, and see what might be going on. There may be clues that can dramatically improve symptoms.

Fact and not people's opinions should drive health decisions. This isn't a debate on whether to wear skinny jeans or a bell bottoms with people having different opinions. These are biochemicals that affect people's health and having factual information is critical.
I do wonder: what percentage of their customers get a report saying "All is normal, nothing needs correction via diet or supplements."
I've seen maybe 500 sets of results from NutrEval and OAT tests over time, and of those, only three were pretty normal and none of these three were ME/CFS patients. The rest, including all the ME/CFS patients, had some pretty significant deficiencies that provided insight into their symptoms and pattern of illness.