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glad you had a better day today!

Dentist experience with MS

Diagnosis: 5 tooth decay, 2 wisdom tooth removal, gum treatment.

Doc said they could not do tooth filling because my gum was in terrible condition. He even warned me that bad gum health could trigger a relapse. I had 2 sessions of gum treatment and 1 tooth filling. I am not going to tell the details because it simply sucks. Local anesthesia and the treatments did not increase my symptoms. I said I did not want to use antibiotics. Since the treatment continues he checks for infection signs all the time. Daily 4 times tooth brushing with ultra soft brush, 2 times special mouth wash and 2 times special paste for gum.

Wisdom tooth removal after I improve my dental health because of infection risk. I think he perfectly knows how I am sensitive to infections and takes care of it.

In short: Bad dental health can trigger a relapse with an infection. Go to your dentist, don't give that chance to MS.

After dental treatment finishes in 7 days, I will do my regular tests. Psychiatrist tomorrow. Take care ;)

ouch! improving status for antibacterial and antiviral nutrients won't hurt. zinc and selenium leap first to mind.

i was looking for something more general re zinc's antibacterial and antiviral activity, but this was pretty on the nose so:

Zinc: A precious trace element for oral health care?
https://www.researchgate.net/profile/Ze ... 5391ce.pdf

Zinc and immune function: the biological basis of altered resistance to infection.
http://ajcn.nutrition.org/content/68/2/447S.short

recall also, re zinc and MS in particular (April 2017 study):
http://www.thisisms.com/forum/natural-a ... ml#p247341

Dietary Selenium in Adjuvant Therapy of Viral and Bacterial Infections
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4288282/
A balanced and sufficient supply of macro- and micronutrients is important to support host immune defense and resistance against pathogens. The habitual diet is often not sufficient to meet the increased demands for micronutrients in infectious diseases. Dietary multimicronutrient supplements containing selenium up to 200 μg/d have potential as safe, inexpensive, and widely available adjuvant therapy in viral infections (e.g., HIV, IAV) as well as in coinfections by HIV and M. tuberculosis to support the chemotherapy and/or to improve fitness and quality of life of the patients (Table 1). Because many of these patients experience broad nutritional deficiencies, multimicronutrient supplementation appears to be a more promising approach than the use of selenium alone. Dietary supplementation with selenium-containing multimicronutrients might also be useful to improve supportive care and to strengthen the immune system of patients suffering from newly emerging viral diseases, such as in the current epidemic of Ebola fever in West Africa. Populations in several countries most afflicted by past and current outbreaks of Ebola fever (e.g., Liberia, Guinea, Democratic Republic of Congo) exhibit a high risk of selenium deficiency, and strikingly, the lowest dietary selenium supply in Africa was reported from Liberia, with a daily intake of only 23 μg Se (15).

you may already be getting se via 2 brazil nuts per day - i don't remember if we've been over that. hope that helps!

Selenium is one of the reasons that I take a multivitamin. 3 days of Solgar VM75 gives me 75 mcg selenium weekly. 4 days of Solgar Advanved Antioxidant gives me another 100 mcg. I feel like my regimen is quite good for macro and micro nutrients.

multis are good for health maintenance. sometimes longer term deficits and chronic illness states suggest a more therapeutic intake at least in the short term. the upper limit for selenium is 400 mcg per day.

one contribution to the serum target picture:
Serum selenium is low in newly diagnosed Graves’ disease: a population-based study
http://onlinelibrary.wiley.com/doi/10.1 ... 12185/full
“S-Se [serum selenium] was lower in patients with GD than in controls (mean(SD), GD:89.9 μg/l (18.4); controls:98.8 μg/l (19.7), P < 0.01).”

More funny experience

My one wisdom teeth is removed. No antibiotics, no infection and no swelling. I had feet numbness for 10 days. Absolutely zero numbness after removal. I feel like MS is very opportunistic about infections. Plenty headaches but paracetamol does the job. I lost 1.5 kilograms body weight in 2 days. Now recovering.

Dental health is extra important for us.

agree. i recall my doc suggesting that certain of my infectious issues were secondary opportunistic. i wasn't having any of it at first. my infections were causal, damnit.
now, i agree wholeheartedly re secondary opportunistic. anyone who tells you the immune system doesn't need help in autoimmune disease is doing you a disservice. and don't get me started about immune system 'boosters' :S lol

New results

Previous results 3 months ago

D3 60.98 ng/mL (Down from 69.17, with 4000 IU daily, increasing to 5000 IU)
PTH 42.00 pg/mL (Just for information)
Magnesium 2.11 mg/dL (Up from 1.98, with 600 mg citrate daily, increasing to 800 mg, GYM maybe?)
Vitamin B12 528 pg/mL (Down from 560, with 3000 mcg weekly, increasing to 5000 mcg)
Calcium 10 mg/dL (Up from 9.8)
Iron 101 μg/dL (Up from 81, with 4 x 25 mg iron bisglycinate weekly)
Copper 90 μg/dL (Down from 114)
Zinc 75 μg/dL (Down from 100, with 4 x 22 mg zinc picolinate weekly, increasing it to daily 22 mg)

*Ferritin 925 ng/mL (Down from 1084, still going down, considering phlebotomy)

Now something funny, liver:

ALP 50 IU/L
AST 21 IU/L (Down from 42)
ALT 28 IU/L (Down from 76)
GGT 32 IU/L (Down from 54)

However *total bilirubin is over limit with 1.35 mg/dL and *indirect is 0.31. It suggests checks for hemolysis or gilbert syndrome. Last bilirubin was 0.75 mg/dL. So perfect liver but high bilirubin.

HbA1c %5.3 (Up from %5.1)

Thyroid all good

CBC all good

White blood cell count 1.48 K/mm3
Hemoglobin 14.10 g/dL (down from 14.4, dental treatment maybe?)
IgA 93 mg/dL (Up from 85, good increase, no longer worries)

CRP is 0.7 mg/L (down from 1.35, much better dental health now)

Still going to GYM 3 times weekly. Pushing hard. I have started 20mg Citalopram for depression and panic attacks and 0.7 mg Rivotril for better sleep quality.

Take care

yes to gym being suspect where sluggish mag response is noted. could also be that the citrate form is less than ideal.
any luck finding/ordering magnesium glycinate for later? you'd likely need less per day to maintain levels. how many mgs do you get per day via foods/fluids?

remind me why you're supplementing iron? levels seem ok, having had a more recent look at the normals (i know, yes it's actually me)

nice work on the copper!!!! if serum zinc had stayed at 100 (or been anywhere between 100-120) your ratio would be ideal.

re bilirubin

https://www.mayoclinic.org/tests-proced ... c-20019986
"Bilirubin test results are expressed as direct, indirect or total bilirubin. Total is a combination of direct and indirect bilirubin. Typically, you'll get results for direct and total bilirubin.

Normal results for a bilirubin test are 1.2 milligrams per deciliter (mg/dL) of total bilirubin for adults, and usually 1 mg/dL for those under 18. Normal results for direct bilirubin are generally 0.3 mg/dL.

These results may vary slightly from laboratory to laboratory. Normal results may be slightly different for women and children, and results may be affected by certain foods, medications or strenuous exercise. Be sure to tell your doctor about any foods or medications you've taken and your activity levels so that your results can be interpreted correctly.

Lower than normal bilirubin levels are usually not a concern. Elevated levels may indicate liver damage or disease.

Higher than normal levels of direct bilirubin in your blood may indicate your liver isn't clearing bilirubin properly. Elevated levels of indirect bilirubin may indicate other problems.

One common, and harmless, cause of elevated bilirubin is Gilbert's syndrome, a deficiency in an enzyme that helps break down bilirubin. Your doctor may order further tests to investigate your condition. Bilirubin test results also may be used to monitor the progression of certain conditions such as jaundice."

related:

The Effect of Different Doses of Aerobic Exercise Training on Total Bilirubin Levels
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3267007/
"Low serum total bilirubin concentrations are associated with increased risk of cardiovascular disease (CVD) (9, 18, 26), metabolic syndrome (11), and type-2 diabetes (12). Conversely, mild hyperbilirubinemia within the normal clinical range has been associated with reduced risk (9, 11, 12, 18, 26). Bilirubin modulates CVD risk by reducing lipid peroxidation, decreasing inflammation, and may be a reflection of heme-oxygenase activity (10). ... To our knowledge, there is only one published report examining the effect of aerobic exercise training on serum bilirubin levels... it is unknown if there is a threshold dose of exercise necessary to significantly increase bilirubin levels...

Methods
Participants (n= 419) were randomized to the control group or 4, 8 and 12 kilocalories per kilogram per week (KKW) of exercise training at an intensity of 50% of aerobic capacity. Total bilirubin levels were evaluated at baseline and at follow-up.

Results
Exercise training significantly increased serum bilirubin levels only in the 12 KKW group (0.044 mg/dL, p=0.026) compared to control (0.004 mg/dL).

figure 1 The effect of different doses of aerobic exercise training on total serum bilirubin levels. Shown are the effect of exercise training on total serum bilirubin levels in 419 participants from the DREW trail. Analysis was adjusted for baseline value, ethnicity and age. Results are presented as adjusted least-square means with 95% confidence intervals.
https://www.ncbi.nlm.nih.gov/pmc/articl ... figure/F1/

...Another plausible mechanism is elevated heme catabolism via exercise induced hemolysis due to increased heel strike, elevated core temperature, and oxidative stress during aerobic training (27). Since heme is the pre-cursor to bilirubin production (10), greater heme bio-availability may promote elevated bilirubin levels downstream."

aside from all that, might not hurt to have a look into potential nutrient depletion effects associated with rx, if any.

I have no idea about my daily mag intake. I eat everything and try to avoid bad fat/oils. With gym, mag increase is OK but can be better.

Iron was low so I started supp. It was 81 μg/dL, not good.

Nothing different with test conditions. No gym 2 days before the test.

I am mostly worried about zinc. I have no idea why it is low now. D3 is another surprise. I can not maintain 70 ng/mL with 4000 IU and winter is coming. B12 is same, increased dose and level decreased.

I can easily say that gym messed up my regimen and people with MS should be extra cautious with deficiencies. So this is a new chapter about regimen. All my maintenance doses are changed.

Living with MS, Gilbert's Syndrome hahahahaha

interesting - i would have thought serum iron of 81 was fine. per the authoritative wikipedia:

Serum iron:[1]
Men: 65 to 176 μg/dL
Women: 50 to 170 μg/dL

since zinc is affected by iron supplementation. looks like you're working towards striking the right balance between the two to achieve your goals, but perhaps not quite there yet.

interesting detail re iron and zinc from the turkish food guide:
http://www.fao.org/3/a-as697e.pdf

"Bread: It is most consumed cereal product. In our country three type of bread are consumed. They are yufka (a paper thin layers of dough), bazlama (thicker than yufka) and regular fermented bread.
Yufka and bazlama are cooked on a hot thin iron plate."

all news to me, but it seems yufka is not fermented, while bazlama is fermented.

"Nutritive value of fermented bread is higher than others. Since absorption of some of the minerals such as iron and zinc, it should be refreined consuming unfermented bread."

looks like *no yufka for you*

i don't know what 'regular fermented bread' means in the turkish context specifically, but in general i assume we are talking about fermentation -> reduced phytate content -> improved nutrient absorption. eg:

Prolonged fermentation of whole wheat sourdough reduces phytate level and increases soluble magnesium.
https://www.ncbi.nlm.nih.gov/pubmed/11368651

fwiw, oysters win when it comes to dietary zinc. 1 serving per week could help reduce your reliance on supplements.

re the gym, i used to be a fan of progressive multivitamins for active ppl. can't recall exactly why i switched but i can guess that at the time it might have been in the attempt to find a multi that used methylcobalamin not cyanocobalamin for b12 (i'm not as fussed about it these days - feel much less vulnerable)

more info: https://www.progressivenutritional.com/ ... ctive-men/
note under ingredients, daily *supplemental* zinc for active men is 20mg. these are for daily use. upper limit for daily zinc intake over the long term is 40mg so no worries about excess (other than being aware of potential consequences for iron and copper status over the long term).
meanwhile for the regular mens product, zinc content is just 10mg.

headed in the right direction overall i think! won't be long before you've fine tuned the maintenance regimen to suit your lifestyle.

lol J, Here it is a good Turkish joke: "All you need is lahmacun"

Classic Turkish bread is not healthy. I eat sourdough bread whenever I can.

I have spotted white spots on my nails. A sign of zinc deficiency, test result confirms. So here it is my new regimen:

Daily:

5000 IU D3 + 200 mg magnesium citrate after breakfast
22 mg zinc picolinate after lunch
200 mg magnesium citrate daily after lunch or right after gym
5000 mcg biotin between lunch and dinner
200 mg magnesium citrate daily after dinner

Not daily:

25 mg iron biglycinate on monday/wednesday/friday/sunday before breakfast, right after wake up
Solgar VM 75 on tuesday/thursday/saturday after lunch
1000 mcg B12 on tuesday/thursday/saturday/sunday after lunch (the days that I don't take rebif)
B50 complex on monday, friday after lunch
Solgar Advanced Antioxidant on monday/wednesday/friday/sunday between lunch and dinner

GYM:

Monday/Wednesday/Friday 45 minutes of weight training, pushing hard and doing good.

I need to increase my protein intake and maintain my cholesterol. Whey and soy protein is not good. Any ideas? I am currently at 60-80 grams of protein daily. I need to double it. I can use an "MS-Safe" protein supplement.

Stress/panic attack management and sleep quality:

10 mg Citalopram daily after lunch
0.75 mg Clonazepam 30 minutes before sleeping

I had some very very hard days with my job. It looks like stress is not a flare maker for now.

Take care, stay healthy ;)

lahmacun - had to look it up. turkish pizza sounds delish

sourdough = good as breads go. i also like breads made with sprouted flour for same reason (phytate management)

fingernails are such excellent indicators. i used to have the white spots too (among other fingernail issues all now resolved). once i saw a kid in a program i was running, and he was just pure polka-dots for fingernails. never seen anything like it before or since. i had to bite my tongue and say nothing.

if you can push your mealtime mag to *before* food (just by a few mins) you will better optimize absorption. by chucking it in *after* meals, mag can get tied up in complexes with other things being digested, reducing its availability for absorption into tissue.

i look forward to seeing the impact of your revised zinc regimen!

when i was first dxd my dietary protein had been atrocious. the klenner protocol was the first ms diet that made some sense to sick vegan me (did best job of reversing previous habits). klenner recommends 'high protein diet with 2-3 eggs for breakfast'. at the time my naturopathic doc (also dxd w ms) had advised against eggs or any possible allergen but i ignored that advice bc i had not had eggs in years, and had still become sick. and as i've said many times i'd rather fix a broken immune system, than baby it by food avoidance. food avoidance caused my problems in the first place!!!
with the klenner protocol i experienced the most rapid and widespread improvements of all from the day i was diagnosed til the present.

that said, this: https://www.healthaliciousness.com/arti ... rotein.php

i checked out citalopram and clonazepam for potential nutrient depletion issues. so far, found the following (source info not necessarily authoritative however)

SELECTIVE SEROTONIN REUPTAKE INHIBITORS (SSRIs): citalopram (Celexa, Cipramil, Talohexane), escitalopram (Cipralex, Lexapro), fluoxetine (Fluctin, Fontex, Lovan, Prozac, Sarafem), paroxetine (Aropax, Paxil, Seroxat), and sertraline (Apo-Sertral, Gladem, Lustral, Stimuloton, Serlift, Zoloft)

NUTRIENTS DEPLETED: None reported.*

*SSRIs have several side effects that should be discussed with your health care professional. Although no nutrient loss has been reported, it is still a good idea to discuss using a multi-vitamin mineral supplement with your health care professional whenever there is consideration of needing to take a prescription drug.

Benzodiazepines: Diazepam (Valium), (Ativan), clonazepam (Klonopin), temazepam (Restoril), chlordiazepoxide (Librium), flurazepam (Dalmane) and triazolam (Halcion)

NUTRIENTS DEPLETED: Barbiturates deplete biotin, folic acid, and vitamins D and K. Benzodiazepines deplete these nutrients plus calcium and melatonin

i'm really surprised to hear SSRIs used for anything to do with stress or panic attacks. my friend and former roommate was prescribed - as a teen - too many SSRIs for so-called depression (her mum worked in mainstream mental "health care"). she went manic and it was off to the psych ward where her intake forms said 'SSRI induced?' but she was ultimately given a bipolar dx. i think it was all a steaming pile of something other than health care.

happy halloween

Both low-medium dose and very effective for me. I don't think some depletion will happen.

Happy halloween

that's good and at least you know. it's not like you have low levels of everything, no supplement regimen *and* are taking these meds. hope the switch up with magnesium timing helps too.