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As i wrote in my other thread (diff diagnoses?), I'm not diagnosed yet. I'm meeting the neurologist for (hopefully) final tests on Tuesday and am trying to map and time-line my symptoms.

When thinking back I think I have had fatigue for the past year. Besides work (PhD-student, lots of cognitive pressure/activity) I am not really able to do anything else. My partner and daughter do ALL the house work while I pass out on the sofa after coming home. I do a physical hobby for two hours a week and that's it. Sometimes I have a few good days and then I crash again.

During that year I have had 4-5 flare ups of other symptoms.

In MS, how does fatigue "behave"? Should it stick to your flare "rythm/pattern" or does it have a life of its own or is it just always there?

I have found that long term fatigue is caused by ATP depletion and cell death. If your urine is pumpkin colored you have excessive cell death through apoptosis which uses ATP furthering the ATP depletion. this creates a cascade of cell death.The urine color is key.
Supplementing with ATP can help some
Taking low dose Benadryl (diphenhydramine) can inhibit the cell death effectively stopping the cascade
Take 1 mg per 15 lbs twice per day for 3 or 4 days.... you'll know if it's working by then.
Using a measured amount of the children's liquid is the easiest way to get the low dose.

Do not use this if you are using LDN

David

Doesn't it make as much if not more sense to eat a diet that promotes cell health?

Hi,

If we follow the ATP (adenosine triphosphate) argument for a moment, then we should understand how it influences energy.

Each cell has a balance of sodium and potassium. Through many different channels sodium leaks in and potassium leaks out. To help keep the balance a gate operates in the cell wall called a sodium potassium pump. To open the gate a phosphate molecule is donated by ATP to the pump. That changes its conformation so the pump opens for a rapid exchange of sodium and potassium. It happens continuously. It is through this exchange that energy is released. Prior to that it is only potential energy. An example of how flow becomes energy can be seen at a hydroelectric dam. The water has potential energy but it just sits behind the the dam wall. When the spillways are opened the water pours out driving turbines and the energy is released. That's what happens in every cell. Here is a good animation of how it works -
The issue is that it is dependent on ATP to donate the phosphate molecule. The next animation is complex so don't worry about it too much (https://highered.mheducation.com/olcweb ... 0Synthesis ) . Just note that Co enzyme Q10 is needed. At an earlier stage if this bit is broken then you can't make ATP. This involves gycolysis and the krebs cycle.
In simple terms, if ATP is unable to be formed correctly then you expend what you have and cell gradually becomes sodium clogged whilst you cease to make energy from the exchange through the Sodium Potassium pump.
In the absence of ATP, two spent versions called ADP (adenosine diphosphate) will combine to make one ATP and one AMP (adenosine monophosphate). The AMP washes out of the cell as it has no function whilst ATP keeps forming from ADP in ever diminishing amounts.
Finally you become exhausted as you cannot make energy.
Adenosine is a purine. Uric acid is the final stage in the metabolism of purines. If your Uric acid level is low that is a pretty good sign that you cant make energy because your adenosine levels are depleted as AMP kept washing out of the cell.
The trick is to improve the ability to acess Q10 to drive the formation of ATP. That is the backbone behind why Terri Wahls likes offal and a Q10 rich diet.

I take quite large doses of CoQ10 (750mg a night) and aceytl-l-carnitine to allow ATP and ADP to shuttle easily across the membrane of the mitochondria. I would caution that it might be a waste of time to do that if you have not dealt with sources of inflammation first. Simple things to fix are mycoplasmas, chlamydia and bacterial infections. I also take valacyclovir to interrupt the cycle of Epstein Barr virus which is often implicated in MS.
Diets cover a broad spectrum but all the diets that seem to provide some benefit are low/no added sugar.

Regards,