DoctorMyhill:Sandbox Master bullet list with definitions

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  • The most obvious reason for this of course is mitochondrial failure, which I believe is a major cause of chronic fatigue syndrome.
If mitochondria cannot supply sufficient energy to cells, cells will switch into glycolysis with a resultant build up of lactic acid. In the heart, this switch into anaerobic metabolism because of mitochondrial failure will present with angina (chest pain). There are many causes of mitochondrial failure (see handout - causes of CFS, mitochondrial failure and mitochondrial function test) such as lack of nutrients for mitochondria to work (D-ribose, magnesium, Vitamin B3, co-enzyme Q10 and acetyl L-carnitine), toxic stress (which is blocking oxidative phosphorylation, or blocking translocator protein function), poor antioxidant status (so mitochondria are damaged by biochemical activity), poor hormonal control (poor levels of thyroid or adrenal hormones) and so on.
  • Lack of oxygen to muscles.
There was a fascinating paper in the Lancet recently by John Yudkin explaining how a high carbohydrate diet could cause high blood pressure. He demonstrated that high levels of sugar in the blood were very damaging to muscles and the body compensates for this by shutting down the blood supply to muscles when blood sugar levels are running too high. Whilst this protects muscles from damage by sugar, it restricts oxygen supply to that muscle. Therefore one can see how if that muscle was asked to suddenly work quite hard, it would rapidly switch into glycolysis with production of lactic acid. Therefore I suspect high carbohydrate or high sugar diets are a risk factor for fibromyalgia. In horses with azoturia, a high carbohydrate diet is a known risk factor.
  • Exercise - too much or too little!
Muscles are extremely dynamic organs. Blood is obviously supplied to them by the heart. However, for blood to come out of muscles requires the muscle itself to contract. Thanks to a serious of valves within veins, when muscles contract they squeeze the blood out of themselves, then as they relax the muscles fill with blood from the heart and then as they contract, the blood is pumped out of them again. Indeed during

Another type of bullet list

Co-enzyme Q10

This is the most important antioxidant inside mitochondria and also a vital molecule in oxidative phosphorylation. Co-Q10 deficiency may also cause oxidative phosphorylation to go slow, but interestingly not invariably. My experience is that levels are almost always down and that they can be corrected by taking Co-enzyme Q10 300mg daily for three months, after which continue with a maintenance dose of 100mg.

Superoxide dismutase (SODase)

is the most important super oxide scavenger in muscles. Deficiency can explain muscle pain and easy fatigability in some patients. SODase is dependent on copper, manganese and zinc and I would expect this to be maintained in people taking my physiological mix of minerals (MMMs). However, when there is a deficiency, these minerals are taken separately. Experience shows that the bet results are achieved by copper 1 mg in the morning, manganese 3 mg midday and zinc 30 mg at night. Low dose SODase may also be caused by gene blockages and these are also looked at when the SODase test is done. Blockages are most often caused by toxic stress, such as heavy metals and pesticides.

Glutathione peroxidase (GSH-Px)

is made up of glutathione, combined with selenium. There is a particular demand in the body for glutathione. Not only is it required for GSH-Px, which is an important frontline antioxidant, but it is also required for the process of detoxification. Glutathione conjugation is a major route for excreting xenobiotics. This means that if there are demands in one department, then there may be depletions in another, so if there is excessive free radical stress, glutathione will be used up and therefore less will be available for detoxification and vice versa. Of course, in patients with chemical poisoning or other such xenobiotic stress, there will be problems in both departments, so it is very common to find deficiencies in glutathione.
If there is a deficiency of GSH-Px, then I recommend that patients eat a high protein diet (which contains amino acids for endogenous synthesis of glutathione), take a glutathione supplement 250mg daily, together with selenium 200mcg daily (which is present in my physiological mix of minerals MMMs).