Half-Life: Not the game but supplements!

This week I have been pinged by several people with ME/CFS who have seen drops in Saturated Oxygen Level (SO2) during the day. One model of many symptoms of ME/CFS (brain fog, easy fatigue) is that of diminished oxygen deliver and reduced products clearance (like CO2 and Lactic Acid). This reduction of oxygen can be due to many causes: Coagulation, Inflammation, Hemoglobin (iron) disruptions, etc.

Long COVID: This also applies here, “Tiny, Menacing Microclots May Explain Long COVID’s Symptoms

People who follow me knows, know that I prefer to work from facts, models and objective measurements. Saturated Oxygen Level (SO2) gives us an objective measurement. Personally, my wife and I use a smart watch that records my (SO2) and other factors every 10 minutes. The data has been helpful to us to triage some events — it is not a Star Trek Tricorder, but better than speculation.

Importance of Half Life

What is called half-life is actually critical for dosage size and timings. MDs prescribing drugs specify one tablet a day, two tablets every 12 hours, a tablet every 8 hours; are based on half-life typically.

What is half-life? It is simply the time it takes to reduce the level in the body to half of the prior amount.

This is not always simple, it takes time to get the supplement or drug into the body as the following quote indicates:

“In healthy volunteers who have taken oral doxycycline, the maximum doxycycline plasma concentrations (Cmax) of 1.5 to 7.0 μg/ml are usually reached within 3 h, and the drug has a half-life of 14 to 24 h” [2005]

Step One — Find Half Lifes!

This is actually pretty easy, usually typing in the supplement and “half-life” will return answers from the web. For the above people, I assembled a list of possible testing supplements from prior posts on coagulation to see if we can determine the possible mechanism for the SO2 drop they saw. The purpose is to identify a probable cause which should then be discussed with your medical professionals.

See this post for the literature on these. We want to then find the half-life and the maximum safe dosage. Many of the maximum deemed safe (i.e. used in studies dosages) are listed here.

SupplementHalf LifeMax Dosage
Alpha Lipoic Acid30 minutes [Full article: Alpha lipoic acid intoxication, treatment and outcome (tandfonline.com)2400 mg/day (see Src)
Aspirin3 hours at lower doses (300 to 600 mg), 5 to 6 hours (after 1 g), 10 hours with higher doses [source]4000 mg/day [Aspirin Dosage – Drugsdb.com]
Grape Seed Extract / Resveratrol2-5 hours [source]
2000   mg/day
Nattokinase4-6 hours [source]
14,000   fibrinolytic units/day
Lumbrokinase 8.6 hours [source]1470   mg/day
 SerrapeptaseCould not find30   mg/day
Boswellia Gum6 hours4800 mg/day [src]
Bromelain6-9 hours2000 mg/day
 Piracetam5 hours
24000   mg/day
 Turmeric6-7 hours3000 mg/day
Licorice3.5 hours32   g/day
 Ginsengn/a2000 mg/day
Coenzyme Q1033 hours1200   mg/d

As above, there can be time to get it into the body as the following states for CoQ 10.

The T(max) is around 6 h, with an elimination half-life of about 33 h. The reference intervals for plasma CoQ10 range from 0.40 to 1.91 micromol/l in healthy adults. With CoQ10 supplements there is reasonable correlation between increase in plasma CoQ10 and ingested dose up to a certain point. Animal data show that CoQ10 in large doses is taken up by all tissues including heart and brain mitochondria. Coenzyme Q10: absorption, tissue uptake, metabolism and pharmacokinetics – PubMed (nih.gov)

This is a useful exercise to do for ALL OF YOUR SUPPLEMENTS. This will answer the question, should you do one mega dose a day or 4 small dosages thru the day or even 6 or 8 small dosages per day – to get the best results. You want to maintain a reasonable level in your body for the whole day.

One possible strategy

There are many possible approaches, my preference here would to start with the longest half life and work down. This leads to the following suggestions (to be discussed with your medical professional)

  • CoQ10: 300mg day 1, 600 mg day 2, 900 mg day 3, then 1200 mg/day for at least 2 weeks.
    • 4 capsules per day for some products
  • Bromelain: : Given the half life, I would start with 1 capsule every 12 hours (typically 500mg), doubling the dosage on the second day and then keep repeating for the rest of the week
  • Lumbrokinase: Given the half life, I would start with 1 capsule every 12 hours, doubling the dosage for the next 4 days keep repeating for the rest of the week
  • etc

You want to identify the substance that hints at the source, then get your MD involved. Do not try all of them at once. Introduce one item a week and see what the response is. Personally, I did the Aspirin route which had me running up and down the walls after 7 days — that response persuaded the MD to order the Hemex Lab Coagulation Panels which identified issues. That lead to appropriate treatment.

For the short half-life items, You want to take a SO2 measurement no longer than the half-life. For Alpha Lipoic Acid, the typical capsule is around 300 mg, so I would go for one capsule every hour for 4 hours and monitor the levels for at least 6 hours. This will keep the concentration at a reasonable level. Going above the maximum dosages has significant risk. This is an example for ALA, Alpha lipoic acid intoxicatıon: An adult [2018]. As always, have your plan reviewed by your medical professional before starting.

Remember: Record in Excel or other product your base line — the daily or weekly pattern before you start. Keep up the recording of SO2 as you walk thru the substances. For me, having a smart watch that does it makes it so so easy with awesome data to show my MD.

The Unique Possibility of Symptom Treatment Resolving the Cause

My model of coagulation issues is simple: some group of bacteria are dumping chemical signals into the body that triggers one or another form of coagulation. Why would they be doing that? SurvivalThese bacteria prefers a low oxygen environment so they are taxa-forming your body for their needs. Increasing the oxygen level in the body will typically inhibit these bacteria – but may not be enough to suppress them. The use of other substances (in the personal experience that I cited above, following Cecile Jadin’s “Occult Rickettsia” protocol of rotating antibiotics) may be needed to suppress these troublesome bacteria, to “rid me of this meddlesome taxa”. Note: The virus or bacteria that trigger the illness is unlikely to be the meddlesome ones, rather, other bacteria that saw opportunity in its disruptions of the body and exploited it. I believe these bacteria are seen in stool microbiome samples.

2023 Walk thru of Personal Microbiomes Suggestions

The two videos below are intended as quick introductions to the microbiome prescription site. The site is dynamic with continuous changes of data available and being used.

16s Samples

This covers sites that provides comprehensive reports on your microbiome. The better reports typically report on over 500 different bacteria from a sample.

Lab/ProcessorLowTypical CountHighSamples Uploaded
AmericanGut7315621318
BiomeSight1157213051635
BiomeSightRdp27957386215
CosmosId643670536
es-xenogene5761522524
Medivere5307219347
Microba5312618621
OmbreLabs/Thryve18567122381241
SequentiaBiotech16631346036
uBiome6249589814

Statistics at the start of January 2023

Older Labs

These are older technology and often are focused on a small number of bacteria. Often the focus was based on what was deemed significant 10 or even 20 years ago.

Lab NameSamples
Viome (No objective measures) 5
All Taxonomies from tests 67
Medivere: Gesundsheitscheck Darm (16s Limited) 15
GI360 Stool (UK) 29
Medivere: Darn Magen Diagnostik (16s Limited) 15
All Bacteria [Family] Reported 25
Smart Gut (ubiome 16s – Limited Taxonomy) 2
GI EcologiX (Invivo) 19
GanzImmun Diagnostics AG Befundbericht 14
DayTwo 8
GanzImmun Diagnostic A6 (cfu/gm) 80
Nordic Laboratories 2
InVitaLab (cfu/gm) 3
Biovis Microbiome Plus (cfu/g) 18
Diagnostic Solution GI-Map (cfu/gm) 498
Metagenomics Stool (De Meirleir) (16s Limited) 4
Genova Parasitology (cfu/g) 4
Verisana (cfu/ml) aka (kbe/ml) 2
Medivere: Darm Mikrobiom Stuhltest (16s limited) 12
Genova Gi Effects (cfu/g) 116
Kyber Kompakt (cfu/g) 2
All Bacteria [Genus] Reported 188
Bioscreen (cfu/gm) 13
NutriPATH 12
Gut Zoomer (vibrant-wellness) 6

New Food Features

This feature was added because many of the suggestions were for flavonoids or other items that may or may not be available as supplements. Most people do not know what is in different foods, especially items you are wishing to avoid. The intent is to allow a more comprehensive and rich diet to be developed by users.

Exploring DAO / Mast Cells / Histamine Issues

In a dialog with a reader, the question was raised “If you assume that these issues are due to low levels of DAO, are the low levels dues to an absence of precursors or the bacteria producing these precursors?

This type of issue is often co morbid with ME/CFS and IBS.

See this update Mast Cell Moderators — non-drugs and suspect bacteria also

Diamine oxidase, also known “amine oxidase, copper-containing, 1”, formerly called histaminase, is an enzyme involved in the metabolism, oxidation, and inactivation of histamine and other polyamines such as putrescine or spermidine in animals. It belongs to the amine oxidase family of amine oxidase enzymes.

Wikipedia

The Kyoto Encyclopedia of Genes and Genomes technical description is ENZYME: 1.4.3.22

Product (produces)Substrate (Consumes)
(imidazol-4-yl)acetaldehyde;
NH3 [CPD:C00014] – Ammonia
H2O2 [CPD:C00027] – Hydrogen Peroxide
histamine [CPD:C00388];
H2O [CPD:C00001]; – Water
O2 [CPD:C00007] – Oxygen
Note: Ammonia and Hydrogen Peroxide are both inhibitors of some bacteria

.The obvious factors to consider are: being hydrated (plenty of water in the body) and oxygen (Saturated O2 should be 98 or better).

A more obtuse speculation is that bacteria that does not like ammonia or hydrogen peroxide are somehow impacting the production of this enzyme.

Over Consumption Elsewhere?

Like most things in the body, one enzymes may have multiple purposes. What if a different process is over-consuming this enzyme?

Looking at the pathways that it is involved with:

Arginine and proline metabolism https://www.kegg.jp/pathway/ec00330+1.4.3.22

Histidine metabolism https://www.kegg.jp/pathway/ec00340+1.4.3.22

Tryptophan metabolism https://www.kegg.jp/pathway/ec00380+1.4.3.22

So high levels of Tryptamine and/or Putrescine may result in over consumptions. I went to the new AI expertChatGPT, which gave me the following answers:


Tryptamine is a compound that is produced by the breakdown of the amino acid tryptophan in the body. High levels of tryptamine in the body can be caused by a number of factors, including:

  1. High tryptophan intake: Consuming a diet that is high in tryptophan can lead to increased production of tryptamine in the body.
  2. Certain medications: Some medications, such as serotonin reuptake inhibitors (SSRIs) and monoamine oxidase inhibitors (MAOIs), can increase the production of tryptamine in the body.
  3. Genetic factors: Some people may have a genetic predisposition to produce higher levels of tryptamine due to variations in their DNA.
  4. Tissue damage: Tryptamine can be produced as a result of tissue damage, such as from injury or surgery.

Putrescine is a compound that is produced by the breakdown of proteins in the body. High levels of putrescine in the body can be caused by a number of factors, including:

  1. High protein intake: Consuming a diet that is high in protein can lead to increased production of putrescine in the body.
  2. Bacterial infections: Some types of bacteria, such as Escherichia coli and Proteus mirabilis, produce putrescine as a byproduct of their metabolism.
  3. Tissue damage: Putrescine can be produced as a result of tissue damage, such as from injury or surgery.
  4. Certain medications: Some medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), can increase the production of putrescine in the body.
  5. Genetic factors: Some people may have a genetic predisposition to produce higher levels of putrescine due to variations in their DNA.

What we have in common is: a result of tissue damage, such as from injury or surgery. So, a person with Crohn’s Disease or other conditions that has tissue damage would have over production of both of these. To this situation, we have the concurrent consumption of Nonsteroidal anti-inflammatory drugs (NSAIDs) which could contribute to a feedback loop. Common NSAIDs include: Aspirin, Ibuprofen, Naproxen, Celecoxib and Diclofenac.

So how can we reduce these levels, again, I went to the new AI expert on the block and got:


Tryptamine is a compound that is produced by the breakdown of the amino acid tryptophan in the body. It is not possible to directly reduce tryptamine levels in the body through dietary changes, as tryptamine is produced through the breakdown of tryptophan. However, there are some steps you can take to reduce tryptophan levels in the body, which may in turn lower tryptamine production:

  1. Reduce intake of foods high in tryptophan: Some foods that are high in tryptophan include turkey, cheese, nuts, seeds, and tofu. Limiting your intake of these foods may help to reduce tryptophan levels in the body.
  2. Eat a balanced diet: Ensuring that you are consuming a varied and balanced diet can help to maintain healthy tryptophan levels in the body.
  3. Get enough sleep: Adequate sleep is important for maintaining healthy tryptophan levels in the body.
  4. Manage stress: Chronic stress can lead to increased tryptophan levels in the body. Practicing stress management techniques such as meditation, yoga, or deep breathing can help to reduce stress and lower tryptophan levels.

Putrescine is a compound that is produced by the breakdown of proteins in the body. It is not possible to directly reduce putrescine levels in the body through dietary changes, as putrescine is produced through the breakdown of proteins. However, there are some steps you can take to reduce protein intake, which may in turn lower putrescine production:

  1. Reduce intake of high-protein foods: Some high-protein foods include meat, dairy products, beans, and nuts. Limiting your intake of these foods may help to reduce protein intake and lower putrescine production.
  2. Eat a balanced diet: Ensuring that you are consuming a varied and balanced diet can help to maintain healthy protein levels in the body.
  3. Get enough sleep: Adequate sleep is important for maintaining healthy protein levels in the body.
  4. Manage stress: Chronic stress can lead to increased protein breakdown in the body. Practicing stress management techniques such as meditation, yoga, or deep breathing can help to reduce stress and lower protein breakdown.

This boils down to: reduce stress, get sleep, and removing some foods from the diet.

Reducing by Bacteria?

I again asked ChatGPT with the following responses:


Tryptamine is a compound that is produced by the breakdown of the amino acid tryptophan in the body. It is not a common source of energy for bacteria and is not essential for their growth and survival. Some bacteria may be able to consume tryptamine as a source of nitrogen, but it is not widely studied.


Putrescine is a compound that is produced by the breakdown of proteins in the body. Some bacteria are able to consume putrescine as a source of energy and nitrogen.

Examples of bacteria that can consume putrescine include:

  1. Escherichia coli: E. coli is a type of bacteria that is found in the intestinal tract of humans and animals. It is able to consume putrescine as a source of energy and nitrogen.
  2. Proteus mirabilis: P. mirabilis is a type of bacteria that is found in the intestinal tract of humans and animals. It is able to consume putrescine as a source of energy and nitrogen.
  3. Pseudomonas aeruginosa: P. aeruginosa is a type of bacteria that is commonly found in soil and water. It is able to consume putrescine as a source of energy and nitrogen.
  4. Klebsiella pneumoniae: K. pneumoniae is a type of bacteria that is found in the respiratory tract of humans and animals. It is able to consume putrescine as a source of energy and nitrogen.

Escherichia coli is especially interesting because there are 30+ studies on an E.Coli probiotics helping a variety of conditions including: Inflammatory bowel disease (IBD), Crohn’s disease and irritable bowel syndrome. Unfortunately, 16s microbiome analysis does not report E.Coli levels (which would be expected to be low).

E.Coli is available as a probiotic (good strains!)

Proteus mirabilis is similarly poorly reported with 16s, shotgun (Xenogene) reports that it is likely seen in 56% of samples. However, the special handling done by BiomeSight, appears to detect it around the same rate.

With our special studies of MCAS, we do find Pseudomonas (parent of Pseudomonas aeruginosa) being statistically significant as too low.

This suggests that some people with MAST cell/histamine issues may benefit from either of the E.Coli probiotics: Mutaflor (E.Coli Nissle 1917) or Symbioflor-2.

Naïve Diet Changes?

I went to Microbiome Prescription and picked 3 genus (Pseudomonas, Escherichia, Proteus ) cited above to see what would encourage their growth (and thus reduce levels of Putrescine). The results are below and interesting: especially the to-avoid probiotics.

Items to TakeItems to Avoid
iron
lactulose
glucose (sugar)
rhubarb
symbioflor 2 e.coli probiotics
* US Source
* World Wide Source

oregano (origanum vulgare, oil) |
foeniculum vulgare (Fennel)
lactobacillus plantarum (probiotics)
lactobacillus casei (probiotics)
lactobacillus rhamnosus gg (probiotics)

Bottom line

This is an exploration on the infrastructure around DAO and thus mast cell issues. The most likely explanation is that DAO is being consumed by alternative processes connected to Putrescine and Tryptamine. Over production of these appear to be associated with GI injury. Reduction of these competitors may be possible by diet and by the use of E.Coli probiotics. Common lactobacillus probiotics may make things worse. Thus “histamine-free probiotics” may actually encourage the competitors (at least one brand contains lactobacillus plantarum )

Alcohol Intolerance in ME/CFS – A Model

While working on a different blog post on brain fog, the light went on for a model that may explain newly developed alcohol intolerance in ME/CFS. People tolerated and enjoyed alcohol before ME/CFS so the cause is not DNA for these people, but some change caused by ME/CFS.

A major subset of people with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) has excessive lactic acid, typically d-lactic acid, especially with cognitive issues (see Systematic review and meta-analysis of cognitive impairment in myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS). [2022])

What would consuming alcohol (known as ethanol) do to such a person? The answer is clear from the literature:

So the model is simple:

High Lactic Acid + alcohol => severe lactic acidosis

So the key issue is to reduce lactic acid levels. I have written about this many times over the years, a few examples:

Bottom Line

As a FYI, a few people using their microbiome results and my analysis site, Microbiome Prescription, has reported the ability to enjoy a glass of wine when they were intolerant before. There is hope.