I'm near rock bottom, please help. Labs attached

[togeprrriii]

Hi guys,

I'm new to the forum and also kind of new to Ray Peat ideas, I started digging into it in summer 2022. My understanding of physiology/bio chemistry is limited, in regards to Peats ideas I think i get the basic paradigm and some of the basic ideas and recommendations. However, I have a hard time bringing the pieces together to help myself. I have a history of burnout (first breakdown in 2016 being 27 years old), I'm now 33, male, and have had multiple crashes/relapses in the past couple years where I have been bedridden for weeks to months until I very slowly got better again. So basically something like adrenal fatigue (I know of the shortcomings of the term) or chronic fatigue syndrome, but without the virus/infection element. Unfortunately, going through all these relapses in the recent years, my condition overall has worsened. Stress of any kind is the biggest killer for me, it leads to PEM (post exertional malaise) when I overdo it. Right now I'm near the next relapse, as here in Germany where I live the days are getting shorter and darker. Sunlight/bright light and summer time have a positive effect on my condition, so fall/autumn and winter always make me worse. So basically, the only tools I had in the past years were stress mitigation and sunlight exposure, esp. in the morning. But they both have their limits. I tried thyroid T4/T3 combination and NDT (metavive), up to 70mcg T4/12.5mcg T3 or 1.25 grains, respectively, they did only a little improvement, but they didn't give me that underlying stamina or stability in energy levels. For example, I mostly avoid lifting heavy stuff or walking the stairs too often, as they deplete me of my energy the most. Thyroid medication had only a small effect on that. I always suspected that it must be low cortisol and in fact, I had multiple saliva profiles made in the past years and 4 out 5 showed very low levels, someteimes below reference range. Problem always was I didn't know what to do with it. I went to 2 different pracitioners andone only recommended taking amino acids, the other saw no big problem with my lowish or even the clearly low levels. Now I have too little power left to start a new appointment at someones office.

I attached my latest lab works. Please feel free to comment and if possible, please add some rationale or explenation if you want to share some interpretations or advice, so that I have a chance to make better decisions. I started taking advice from Paul Robinson (kind of prominent for his circadian T3 method CT3M), his recommendations are also based on the attached lab work and my story.

Here are some additional information that might be important for interpreting the lab results and my overall condition right now:
- When I had the first big crash in 2020, my body ramped up my appetite and I had to eat like crazy: 5 big meals daily, so every 3 hours. And I mean BIG, ca. 120 grams carbohydrates plus 100 grams fat, so in total 600g carbs, 500 fat EVERY DAY for 8 weeks, then it went down to 4 times a day this big meal. My blood cortisol was at 8.8 at that time, so very low, at the same time i suspect that my thyroid hormones were still working, that's why the big demand? Because cortisol couldn't keep up the blood sugar anymore? And the big amount of fat maybe had some signaling function? - When I got better over time, the frequency and amount of food went down again to my normal levels (3 main meals plus maybe one snack in the afternoon).
- The same thing happened every new crash since 2020: the frequency and amount of food that my body thought was necesarry went up on the day I crashed (you can believe me, the signals my body sent were unambiguous. If I was eating only slightly less than my body said I should, I risked another energy crisis which could easily lead to further deterioration). Of course I always gained weight, from my average 63kg when I was a normal healthy person to around 80kg or above. And note , I am naturally a lean, slim guy who never had been able to put on weight, even if I wanted to.
- In 2022 the crash was a bit different; meal frequency went up again, but 'only' to 4 times a day. Again, mainly carbs plus a lot of fat. Protein didn't work for me, my body told me that. When I started taking venlafaxine out of desperation, as it was the only medication I took during my first clinic stay in 2020, I only had to eat three times per day again. That was kind of a relief because I was so exhausted and worn out that it was a battle every time to get up and get something to eat. My theory is that the increase of serotonin by taking venlafaxine had something to do with it. Interestingly, the meal frequency went down to only 2 times a day, normal meal size. So after this crash and partly regeneration, I was forced by my body to eat less than at any time in my life before.
- Now we're nearing my current situation: The latest crash in spring 2023 at first caused a short increase in meal quantity again (this time not in frequency though), and another reduction when I improved again. So this is where I'm at now: Only one meal per day, late in the evening, of the size of 1.5 to 2 normal meals. The least amount I was ever eating per day. I am feeling full in my belly all day long until 10 PM at night. At the same time, my stamina, energy and resilience against stress is further diminished compared to the periods in 2022 or 2021 after recovery of the respective crash.

My overall hypothesis: I am now in fat burning mode (elevated free fatty acids on my lab) all day long. That means oxidative metabolism of sugar is reduced significantly (see my low insulin and low hba1c) and I must rely on cortisol for blood sugar regulation and/or releasing of free fatty acids for energy production. But unfortunately, my cortisol is still low after all these crashes (blood AND saliva results), therefore even the inefficent metabolic mode the body chooses to go into because of stress can't work properly, that's why I am feeling so bad (low stamina, resilience etc.) even on better days.

What are your thoughts? I am grateful for any advice, thanks!

 

[togeprrriii]

I guess my main question at this moment is: what can I do NOW to gain at least a little stability or improvement? rest, sunshine if available, sleep, stress mitigation I know. I'm at my parents' house, so I don't have to take care of much. I also have access to aspirin powder, hydrocortison tablets 10mg, T4/T3, NDT, T3 only (by Deus Medical), various b-vitamins and other stuff. Problem being I am very risk averse right now as I don't want to lose the little energy I have left...

 

[youngsinatra]

I personally have my concerns with cortisol saliva test. I know some who had tested both at the same day and had high-normal serum cortisol and low-normal saliva cortisol simultaneously.

Low serum DHEA-S (and serum cortisol too right?) tho, could indicate a real adrenal problem.

Many adrenal practioners and people I texted with swear on high dose vitamin B5 (or the active pantethine) to stimulate adrenal steroidogenesis and cortisol/aldosterone production. Sufficient vitamin C is also important.

 

[youngsinatra]

High reverse T3 is usually associated with high cortisol, but I know that some people like Dr. Izabella Wentz think that the rT3 stays elevated as you move through the different stages of stress (acute stage, resistance stage and burnout)

In the last stage, the body keeps reverse T3 elevated even tho low cortisol is present, to prevent active T3 from clearing even more cortisol according to her logic.

 

[togeprrriii]

High reverse T3 is usually associated with high cortisol, but I know that some people like Dr. Izabella Wentz think that the rT3 stays elevated as you move through the different stages of stress (acute stage, resistance stage and burnout)

In the last stage, the body keeps reverse T3 elevated even tho low cortisol is present, to prevent active T3 from clearing even more cortisol according to her logic.

That's exactly what it feels like to me. RT3 has been elevated every time I tested for it the past 2 years. Before that I have no data. At the same time - to reply to your first post - my saliva cortisol was always really low, and also serum morning cortisol never went above 11 mcg/dl since 2020 when I tested for it. And yes, DHEA saliva and serum too, is low. Thanks for your replies!

 

[togeprrriii]

I personally have my concerns with cortisol saliva test. I know some who had tested both at the same day and had high-normal serum cortisol and low-normal saliva cortisol simultaneously.

Low serum DHEA-S (and serum cortisol too right?) tho, could indicate a real adrenal problem.

Many adrenal practioners and people I texted with swear on high dose vitamin B5 (or the active pantethine) to stimulate adrenal steroidogenesis and cortisol/aldosterone production. Sufficient vitamin C is also important.

Can you name dosages for pantethine? and vitamin C, and which form of it?

 

[mostlylurking]

The least amount I was ever eating per day. I am feeling full in my belly all day long until 10 PM at night. At the same time, my stamina, energy and resilience against stress is further diminished compared to the periods in 2022 or 2021 after recovery of the respective crash.

I'd like to suggest that you consider the possibility that you have a thiamine deficiency. Thiamine can become deficient/functionally blocked for multiple reasons. Anything that increases body stress will help deplete thiamine, for example: Polyunsaturated fatty acids (PUFA) will use up thiamine because it is used to counteract the inflammation caused by PUFA. Likewise, heavy metal toxicity will use up the available thiamine. Many pharmaceutical drugs block thiamine function.

suggested reading:

How Can Something As Simple as Thiamine Cause So Many Problems? - Hormones Matter

Is thiamine deficiency too simple to explain the devastating nature of the systemic adverse reactions to some vaccines and medications?

www.hormonesmatter.com

My overall hypothesis: I am now in fat burning mode (elevated free fatty acids on my lab) all day long. That means oxidative metabolism of sugar is reduced significantly

Thiamine is required for oxidative metabolism of sugar (and also of fatty acids) to happen.

suggested reading:

Hiding in Plain Sight: Modern Thiamine Deficiency

Thiamine or vitamin B1 is an essential, water-soluble vitamin required for mitochondrial energetics—the production of adenosine triphosphate (ATP). It is a critical and rate-limiting cofactor to multiple enzymes involved in this process, including ...

www.ncbi.nlm.nih.gov

I must rely on cortisol for blood sugar regulation and/or releasing of free fatty acids for energy production.

Cortisol dissolves muscle tissue to convert it to glucose. It's a very stressful way to go. If thiamine is deficient, that glucose won't get converted to ATP either.

But unfortunately, my cortisol is still low after all these crashes (blood AND saliva results), therefore even the inefficent metabolic mode the body chooses to go into because of stress can't work properly, that's why I am feeling so bad (low stamina, resilience etc.) even on better days.

I agree that you are in an "innefficient metabolic mode" but I think that it's probably thiamine related, because it fits with your symptoms that you have provided.

I have a higher need for thiamine due to my heavy metal toxin body load. I found great benefit from taking thiamine hcl. I discovered my need for thiamine by taking about 300-350 mgs of thiamine hcl WITH WATER ONLY; within 45 minutes all my inflammation disappeared, my brain fog cleared, and my body temperature increased a full degree to normal (98.6 degrees).

I am also hypothyroid; I am taking an optimized dose of prescription desiccated thyroid with the help of a good endocrinologist. But the thyroid med alone did NOT resolve my problems. I also need the high dose thiamine hcl.

 

[togeprrriii]

I'd like to suggest that you consider the possibility that you have a thiamine deficiency. Thiamine can become deficient/functionally blocked for multiple reasons. Anything that increases body stress will help deplete thiamine, for example: Polyunsaturated fatty acids (PUFA) will use up thiamine because it is used to counteract the inflammation caused by PUFA. Likewise, heavy metal toxicity will use up the available thiamine. Many pharmaceutical drugs block thiamine function.

Thiamine is required for oxidative metabolism of sugar (and also of fatty acids) to happen.

Yes thanks for the suggestion, I was thinking about this myself already, but still don't know enough about cellular energy production, so I was/am not sure about it. But it could def. be the case that I have a low thiamin status. Didn't know about the PUFA/thiamine connection, nor about thiamine being needed for fatty acid oxidation also. My understanding was that it's only/mainly needed for glucose metabolism. So thanks for mentioning it.

Are you taking the high dose thiamine hcl in one single dose? I started a b-complex with 15mg B1 1x/day a week ago and extra thiamine hcl 1x 30mg yesterday. I want to go up slowly, see what it does.

Btw: I'm at a circadian T3 dose of 12.5 mcg at 4:00 AM for 5 days now and intend to go one more 30 mins. earlier in the next days, and probably also higher in dosage.

 

[mostlylurking]

Are you taking the high dose thiamine hcl in one single dose? I started a b-complex with 15mg B1 1x/day a week ago and extra thiamine hcl 1x 30mg yesterday. I want to go up slowly, see what it does.

I take 1 gram (1000mg) of thiamine hcl 2Xday, once mid-morning and once mid-afternoon, with water only (not with anything sweet). Because thiamine hcl has a poor absorption rate in the intestine, higher doses are needed. I spent 4 months slowly increasing my dose to get up to this high dose. I started with about 300mg, 2Xday. I follow Dr. Costantini's protocol.

Although I took 100mg of thiamine hcl daily for years, I do not believe that I got much if any benefit from it.

Btw: I'm at a circadian T3 dose of 12.5 mcg at 4:00 AM for 5 days now and intend to go one more 30 mins. earlier in the next days, and probably also higher in dosage.

I am not familiar with what you are describing. Can you provide any info?

 

[Marie-Christine]

Different suggestions:

If I understand correctly, you eat at the moment 1 meal a day , and burning fat.?
I have been there for some years - now for a few months reading and following the information Dr. Peat , Mercola and Georgi Dinkov.

Strongly suggest to start eating more times a day , burning only fat and eating one time had given me more stress, use of cortisol , and probably use of the proteins to make sugar of it. Eating three times with lot of fruits, honey, good proteins en starch now and then has given me more rest.

For the Thiamine, You can start with 3OO mg, when not more energy after two days, third day 2 X 300 mg and build up to 1800 (if not more results before). This is something I learned in a course of orthomoleculair therapist. ( can not give studies). I understand 1800 is not toxic. You can take also niacin amide 3 times a day (find the replay mercola and dinkov) 3X50 mg a day , weekends 100 mg of powder

More possibilities for chronic fatigue and vitamines.

Both “long” COVID-19 and CFS are likely caused by hypometabolism – To Extract Knowledge from Matter

Reverse T3 can mean your immune system is active all the time, and take part of the energy to fight inflammation, bacterial overgrowth or ...
Think of aspirine : lot of posts www.haidut.me and here on the forum. I will helps fight inflammation, so you have more energy for doing other things

Not pure psychical but mental/emotional: do I read a possible fear and anxiety to have the same problem as in the past? Try to find/do something to find more rest and feeling secure. This idea can raise your cortisol t. Your mind has a situation (hippocampus, amygdala and other parts) that was not good and perhaps

I wish you lot possitiv steps in the right direction,

 

[togeprrriii]

I am not familiar with what you are describing. Can you provide any info?

So Paul Robinson has had hashimotos which led to practically a CFS-like state, and after years on T4 without improvement he first began taking T3 in the daytime which led to some improvement. then he discovered that his cortisol was also low and found that there's a temporal association between the circadian rhythms of normal (i.e. in healthy people) FT3 concentrations in the blood and cortisol in the blood. So, FT3 apparently peaks at night, 2 or 3 hours after midnight, and cortisol production starts just then and peaks in the morning. So he put the pieces together and tried taking his first T3 dose a few hours before getting up. The earlier before getting up he was taking it, the more cortisol there was in his 24-hour-urine-tests, so it was a linear relationship in his case between the timing of the T3 dose and the cortisol output of his body the following day. And he felt better, basically this was his breakthrough to normal health again, after T3-only daytime dosing had only a partial positive effect. There are quite a few success stories by other people who report similar things with their trials of nighttime T3 dosing, and Paul claims that he has seen hundreds to thousands of people reporting improvement by his circadian method.
So it's basically a cortisol restoring technique - if it works in an individual. There are certainly potential inhibiting factors, and there seem to be great differences as to what dose a person needs and how long it takes to see an effect. some got better within days of using it, others had to wait weeks to months for improvement.
So in a sense, without knowing the full picture, Ray (and many other people) seem to be right about T3 being necessary for proper adrenal function. But the timing of enough available T3 for the body seems to have a big influence on that.

Low Cortisol - The Circadian T3 Method (CT3M) Can Improve Cortisol Levels Throughout the Day - Paul Robinson Thyroid

The Circadian T3 Method (CT3M) is a means of improving cortisol levels for thyroid patients. I originally created it because I had very low cortisol throughout the day. CT3M successfully raised my cortisol. I have been using CT3M for about twenty years and continue to be well. There are many...

paulrobinsonthyroid.com

 

[togeprrriii]

If I understand correctly, you eat at the moment 1 meal a day , and burning fat.?

Yes, not hungry all day long, even a feeling of fullness and firmness in the belly. That I am burning fat is my theory, yes. Elevated free fatty acids plus the lacking need for food the whole day until late evening. No cravings, nothing. The only thing I can do at the moment is drinking sugary stuff, like fruit juice, every 2.5 or 3 hours. That gives me slightly more energy and calms me down a bit and alleviates body aches a little bit, but these are all very small effects, they don't change the substance of my situation.
That's why I can't follow your advice of eating during the day. Especially not protein or fat, only those easy carbs are working somehow for me (so it seems I'm not insulin resistant yet? Because it feels like my body can utilize the sugars from juice if I drink some, but then after that seems to switch to his default mode of low energy fatty acid oxidation?).

For the Thiamine, You can start with 3OO mg, when not more energy after two days, third day 2 X 300 mg and build up to 1800 (if not more results before). This is something I learned in a course of orthomoleculair therapist. ( can not give studies). I understand 1800 is not toxic. You can take also niacin amide 3 times a day (find the replay mercola and dinkov) 3X50 mg a day , weekends 100 mg of powder

Yes thanks, also to mostlylurking, I ordered some Thiamine Hcl and TTFD (the fat soluble thiamine that also seems to be able to enter the brain) and will try it.

I will be taking other stuff and post about it, maybe tomorrow.

Reverse T3 can mean your immune system is active all the time, and take part of the energy to fight inflammation, bacterial overgrowth or ...
Think of aspirine : lot of posts www.haidut.me and here on the forum. I will helps fight inflammation, so you have more energy for doing other things

The thing is, how can I know if I have inflammation? I only know CRP, which always had been zero or nearly zero in the past years. The standard lab tests that doctors ran on me when I was in the clinic didn't seem to reveal any inflammation, neither. At least no physician mentioned anything to me about possible inflammation.

Not pure psychical but mental/emotional: do I read a possible fear and anxiety to have the same problem as in the past? Try to find/do something to find more rest and feeling secure. This idea can raise your cortisol t. Your mind has a situation (hippocampus, amygdala and other parts) that was not good and perhaps

Yes, Izabella Wentz also talks about sending your body safety-signals in order to have better chances of recovery from adrenal issues. Easier said than done for me, as I find it hard to cope with the fact that I am a prisoner in my own body right now with little positive contact. With chances of becoming worse and bedridden again. It's quite terrible. But I'm glad that some people here want to help and have some advice :) So thanks again!

 

[mostlylurking]

So in a sense, without knowing the full picture, Ray (and many other people) seem to be right about T3 being necessary for proper adrenal function.

Additional things that affect adrenal function:
magnesium:

Magnesium and stress - Magnesium in the Central Nervous System - NCBI Bookshelf

Please note that Ray Peat said that hypothyroid people have a hard time holding onto their magnesium.
thiamine:

Thiamin deficiency, altered circadian rhythm, and adrenal fatigue

Have you been diagnosed with adrenal fatigue? Have you recently removed processed foods from your diet and had a tough go of it? Have you ...

synergyhw.blogspot.com

Please note that supplementing thiamine will improve the body's ability to tolerate magnesium so a higher dose of magnesium can be tolerated without ill effects. I think this means that if thiamine stores are good then magnesium works better?

 

[togeprrriii]

Additional things that affect adrenal function:
magnesium:

Magnesium and stress - Magnesium in the Central Nervous System - NCBI Bookshelf

Please note that Ray Peat said that hypothyroid people have a hard time holding onto their magnesium.
thiamine:

Thiamin deficiency, altered circadian rhythm, and adrenal fatigue

Have you been diagnosed with adrenal fatigue? Have you recently removed processed foods from your diet and had a tough go of it? Have you ...

synergyhw.blogspot.com

Please note that supplementing thiamine will improve the body's ability to tolerate magnesium so a higher dose of magnesium can be tolerated without ill effects. I think this means that if thiamine stores are good then magnesium works better?

Okay, good to know. Have you seen my labs? I seem to have very high magnesium levels, I supplemented very regularly in the past (mostly around 300-400mg) but left it out in the weeks prior to the lab visit - and it shows very high in my blood. (These are whole blood values but I don't know what implications that might have in terms of storage/holding capacity).

thiamine:

Thiamin deficiency, altered circadian rhythm, and adrenal fatigue

Have you been diagnosed with adrenal fatigue? Have you recently removed processed foods from your diet and had a tough go of it? Have you ...

synergyhw.blogspot.com

Please note that supplementing thiamine will improve the body's ability to tolerate magnesium so a higher dose of magnesium can be tolerated without ill effects. I think this means that if thiamine stores are good then magnesium works better?

thanks, will read it later when I have more brain capacities again!

 

[TheSir]

Your issues are severe enough and your blood tests inconclusive to the degree that I would suggest getting a hair analysis (HTMA) from ARL and having an expert take a look at it. HTMA will give you a precise picture on what's happening with your thyroid and adrenals as well as how to proceed. It's the only scientific, no-guesswork-involved way to get to the bottom of your illness.

 

[mostlylurking]

Okay, good to know. Have you seen my labs? I seem to have very high magnesium levels, I supplemented very regularly in the past (mostly around 300-400mg) but left it out in the weeks prior to the lab visit - and it shows very high in my blood. (These are whole blood values but I don't know what implications that might have in terms of storage/holding capacity).

Well, very high magnesium levels are pretty dangerous I think.

Hypermagnesemia - StatPearls - NCBI Bookshelf

"Decreased renal excretion

Hypermagnesemia occurs primarily in patients with acute or chronic kidney disease. In these individuals, some conditions, including proton pump inhibitors, malnourishment, and alcoholism, can increase the risk of hypermagnesemia. Hypothyroidism and especially cortico-adrenal insufficiency, are other recognized causes.

Hyperparathyroidism and alterations in calcium metabolism involving hypercalcemia and/or hypocalciuria can lead to hypermagnesemia through an increased calcium-induced magnesium absorption in the tubule. Patients with familial hypocalciuric hypercalcemia (FHH), a rare autosomal dominant condition, can manifest hypermagnesemia.[5][6]

Lithium-based psychotropic drugs can also lead to hypermagnesemia by reducing excretion.

Increased intake

The disorder may rarely develop even without renal impairment, mostly in the elderly, where an underlying bowel condition may lead to increased absorption through a decreased gut motility. Patients treated with anticholinergics or opioids, or those with inflammatory bowel diseases are at higher risk.[7]

Some drugs such as laxatives and antacids that contain magnesium (e.g., magnesium oxide) can lead to increased values of magnesium, especially in elderly patients with renal function impairment. For instance, although poor bioavailability makes magnesium oxide relatively safe, its prolonged use may lead to risks of hypermagnesemia.[8] Periodic evaluation is a recommendation in geriatric patients treated with magnesium oxide for extended periods. Nevertheless, magnesium oxide intake under 1000 mg/day seems to be relatively safe.[9]

Severe hypermagnesemia has also been described after the administration of bowel preparation agents (e.g., sodium picosulphate magnesium citrate).[10] Moreover, excessive oral intake can lead to hypermagnesemia in patients on hemodialysis, as ingestion primarily influences plasma levels in these patients.[11]

Patients with milk-alkali syndrome due to the ingestion of large amounts of calcium and absorbable alkali are more susceptible to develop hypermagnesemia.

Since magnesium is useful in the management of eclampsia (e.g., therapeutic serum magnesium level 1.7 to 3.5 mmol/L), the excessive infusion can induce iatrogenic hypermagnesemia. Newborns of mothers who have received magnesium sulfate parenterally during labor may present with toxicity even with normal serum magnesium levels. "
(more at the link)

 

[cs3000]

Hi guys,
I have a history of burnout (first breakdown in 2016 being 27 years old), I'm now 33, male, and have had multiple crashes/relapses in the past couple years where I have been bedridden for weeks to months until I very slowly got better again.
What are your thoughts? I am grateful for any advice, thanks!

i would fix that folate deficiency
likely the reason why your homocysteine is elevated too Folic Acid Supplementation in Patients with Elevated Homocysteine Levels - PubMed
you can start folic acid 1mg a day for a bit. id see how you feel after a few weeks.

& i'd be curious if your low transferrin saturation is fixed with this (+ ensuring good riboflavin intake too). otherwise you probably need heme iron polypeptide/iron protein succinylate or an infusion
hemoglobin & ferritin still up but transferrin saturation low Normal Ferritin in a Patient with Iron Deficiency and RLS.
in iron deficiency cortisol response to ACTH secretion is lowered. but id see where you get with folic acid & riboflavin initially & i would avoid zinc supplements
high blood magnesium can indicate high rates of cell death (more need for folate which is involved in cell replication) / lack of oxidative metabolism because magnesium isnt being used by cells with ATP

 

[togeprrriii]

lack of oxidative metabolism because magnesium isnt being used by cells with ATP

yes that was my thinking, too: my low cellular energy production leads to magnesium being unused, hence high in the blood. Anyway, for the moment I'll stop the magnesium supps.

i would fix that folate deficiency
likely the reason why your homocysteine is elevated too Folic Acid Supplementation in Patients with Elevated Homocysteine Levels - PubMed
you can start folic acid 1mg a day for a bit. id see how you feel after a few weeks.

right, that was my plan. still waiting for shipment, I ordered two products, folinic acid and methylfolate, and will start right when they arrive. Maybe first the methylfolate, to see if I tolerate the methyl-part.

& i'd be curious if your low transferrin saturation is fixed with this (+ ensuring good riboflavin intake too)

How much riboflavin would you recommend daily in my case? I got capsules with 10mg R5P each and a b-complex with 5mg R5P per capsule.

in iron deficiency cortisol response to ACTH secretion is lowered. but id see where you get with folic acid & riboflavin initially & i would avoid zinc supplements

Yes, I also already stopped zinc because of its cortisol suppressing properties, and because I was supplementing on a quite regular basis in recent months.
Re: iron, that's interesting, I didn't know about iron deficiency leading to lowered cortisol response. Too bad the lab didn't do the ACTH, as the doctor's assistant did some mistake with the blood sample. I actually asked for ACTH alongside cortisol to get a better picture.

 

[cs3000]

yes that was my thinking, too: my low cellular energy production leads to magnesium being unused, hence high in the blood. Anyway, for the moment I'll stop the magnesium supps.
right, that was my plan. still waiting for shipment, I ordered two products, folinic acid and methylfolate, and will start right when they arrive. Maybe first the methylfolate, to see if I tolerate the methyl-part.
How much riboflavin would you recommend daily in my case? I got capsules with 10mg R5P each and a b-complex with 5mg R5P per capsule.
Yes, I also already stopped zinc because of its cortisol suppressing properties, and because I was supplementing on a quite regular basis in recent months.
Re: iron, that's interesting, I didn't know about iron deficiency leading to lowered cortisol response. Too bad the lab didn't do the ACTH, as the doctor's assistant did some mistake with the blood sample. I actually asked for ACTH alongside cortisol to get a better picture.

aye was gonna ask if youve been supplementing zinc, (your zinc-copper ratio is skewed), copper needed for iron utilization
and your low copper is probably the reason for your low end dhea Copper deficiency halves serum dehydroepiandrosterone in rats - PubMed
~1mg-2mg total intake needed but can be hindered if low estrogen & thyroid

i think its better not to megadose b vits generally unless for a specific reason. theyre more tolerable than over supplementing minerals but still can skew things sometimes. only need like 2mg riboflavin total daily to fix low levels by 4 weeks. thiamine lowers lead levels so if it can do that for other metals like iron also (idk if it does maybe it doesnt), might be best to just get through diet initially unless u rule out iron deficiency / see transferrin sat come up after fixing folate. & cant get iron levels up effectively if riboflavin levels are low (u have low folate which suggests you might have low riboflavin intake too so thats why i mentioned it)

 

[togeprrriii]

aye was gonna ask if youve been supplementing zinc, (your zinc-copper ratio is skewed), copper needed for iron utilization
and your low copper is probably the reason for your low end dhea Copper deficiency halves serum dehydroepiandrosterone in rats - PubMed
~1mg-2mg total intake needed but can be hindered if low estrogen & thyroid

i think its better not to megadose b vits generally unless for a specific reason. theyre more tolerable than over supplementing minerals but still can skew things sometimes. only need like 2mg riboflavin total daily to fix low levels by 4 weeks. thiamine lowers lead levels so if it can do that for other metals like iron also (idk if it does maybe it doesnt), might be best to just get through diet initially unless u rule out iron deficiency / see transferrin sat come up after fixing folate. & cant get iron levels up effectively if riboflavin levels are low (u have low folate which suggests you might have low riboflavin intake too so thats why i mentioned it)

Alright, thanks. I'll have a look at copper rich foods and maybe some copper supp.

If I understand you correctly, you're saying that there's a close relationship between riboflavin intake/levels, folate, and iron status? Sorry I have very little knowledge about all this and I am curious to understand more. So taking iron supplements would be the last thing you would recommend? First folate + riboflavin and see if it affects transferrin saturation levels?