[HN Gopher] Study Reveals Immune Driver of Brain Aging
       ___________________________________________________________________
        
       Study Reveals Immune Driver of Brain Aging
        
       Author : oedmarap
       Score  : 145 points
       Date   : 2021-01-22 13:09 UTC (9 hours ago)
        
 (HTM) web link (med.stanford.edu)
 (TXT) w3m dump (med.stanford.edu)
        
       | nickelcitymario wrote:
       | Because an awful lot of this goes over my head, can anyone tell
       | me if these findings could potentially apply to all auto-immune
       | diseases? Or just those related to the brain?
        
         | theflyinghorse wrote:
         | > an awful lot I am lucky to understand 10% maybe. I wish there
         | was a scientific journal which would dumb it down for the
         | layman.
        
       | nostromo wrote:
       | This reminds me of Rapamycin, an immunosuppressant that also
       | makes most animals live much longer -- something longevity
       | hackers are experimenting with now.
        
       | magoghm wrote:
       | Some day we are going to discover how to apply all research
       | results like this one, and we'll end up with the healthiest mice
       | ever :)
        
       | helge9210 wrote:
       | ...in mice (c)
        
       | Wowfunhappy wrote:
       | ^ This probably needs "in mice" integrated into the title somehow
       | --but it's still a cool article.
        
         | gnicholas wrote:
         | Looks like they've done this with mice and with cultured human
         | cells.
         | 
         | > _If their findings in old mice and in human cell cultures
         | apply to actual humans, they could presage the pharmaceutically
         | managed recovery of older people's mental abilities._
        
       | retzkek wrote:
       | A study from 2014 [^1] indicated that prolonged fasting (2-5
       | days) caused the regeneration of immune cells and "reversed age-
       | dependent myeloid-bias in mice". I don't have the knowledge to
       | fully understand the implications of this, but it seems it
       | supports reports that fasting has positive effects on aging-
       | related brain degeneration.
       | 
       | I fast semi-regularly (I'm just finishing up a four-day fast),
       | and it amazes me how often we by default reach for something
       | (e.g. pills) to put into our bodies to solve or improve
       | something, when sometimes the answer is to _not_ put something
       | (i.e. food) in it (at least for a little bit). It's also a great
       | exercise in self-control and discipline.
       | 
       | ^1: https://pubmed.ncbi.nlm.nih.gov/24905167/
        
       | wizzwizz4 wrote:
       | Original paper: https://doi.org/10.1038/s41586-020-03160-0
        
         | swader999 wrote:
         | From the paper: In ageing macrophages and microglia, PGE2
         | signalling through its EP2 receptor promotes the sequestration
         | of glucose into glycogen, reducing glucose flux and
         | mitochondrial respiration. This energy-deficient state, which
         | drives maladaptive pro-inflammatory responses, is further
         | augmented by a dependence of aged myeloid cells on glucose as a
         | principal fuel source. - I wonder if fasting helps reduce this.
        
       | treeman79 wrote:
       | Brain fog is common with autoimmune conditions.
       | 
       | Often one of the first symptoms that cause people to seek a
       | diagnosis.
       | 
       | Have Sjogrens. Cognitive decline is a real issue for me.
       | Treatment and lifestyle changes make a huge difference.
       | 
       | Basically controlling inflammation becomes your life. Or you
       | won't have much of one.
        
         | forgotmypw17 wrote:
         | What are your strategies for avoiding inflammation?
        
         | dualthro wrote:
         | Absolutely, I'm right there with you. I had 3 different doctors
         | tell me I was crazy before I said fuck this. The most helpful
         | book that I have found is "Why Isn't My Brain Working?" [1] by
         | Dr. Datis Kharrazian, he is both an MD and a naturopath. Lots
         | and lots of insights into why the brain fog is happening, and
         | even more advice on diet, lifestyle and supplementation
         | measures to minimize it.
         | 
         | I seem to have some dietary autoimmune stuff going on as well
         | which is incredibly difficult to deal with, my friends know me
         | as that person who brings home cooked food around everywhere,
         | as I know there are no spices or grains that will set me off.
         | Eating out I usually just order a salad with no croutons, no
         | cheese, no nightshades, no dressing outside of olive oil, and a
         | meat to go on it. But even then, if the meat has spices, I'm in
         | trouble.
         | 
         | [1] http://brainhealthbook.com/ -- also available on the large
         | book piracy site
        
         | atian wrote:
         | I haven't found anything else to be as helpful than Redbull
         | (with actual sugar) for inflammatory brain fog. More on the
         | sugar, but the B6 and Niacin help to bypass whatever it is
         | wrong with brain energetics when inflamed.
         | 
         | It doesn't have to be Redbull, but where else are you going to
         | get 30g of sugar and a few helpful vitamins out in the wild.
        
           | tayo42 wrote:
           | How do you know your not just addicted to caffeine?
        
             | atian wrote:
             | I've determined it's not the the caffeine amount from the
             | coffee I drink on the side.
        
           | datameta wrote:
           | An alternative would be to make some tea/coffee/yerba mate,
           | sweeten it, and take a B-complex vitamin. Now you know
           | exactly what you're getting and what you aren't. For the
           | record, excess sugar and processed/packaged/canned goods
           | highly correlate with inflammation in my own experience.
           | 
           | Also there was a study that showed greater than 160mg of
           | caffeine per day may increase inflammation in those
           | predisposed to it, whereas the group that consumed <120mg had
           | no negative effects. Can try to dig it up if someone is
           | interested.
        
             | nitrogen wrote:
             | _Now you know exactly what you 're getting and what you
             | aren't._
             | 
             | If I remember right, the only ingredients in Red Bull not
             | listed by name are the artificial flavors (and maybe some
             | colors). And those have to be drawn from GRAS don't they?
             | 
             | It's always seemed strange to me that we are more willing
             | to trust plants with thousands of unknown chemicals, over a
             | simple energy drink with like ten chemicals, all listed.
        
           | [deleted]
        
         | MetalGuru wrote:
         | What have been the most effective lifestyle changes you've
         | made? And how long did it take you before noticing their
         | effects? Hope they continue working for you!
        
           | treeman79 wrote:
           | Support groups are best. Knowing your not alone. A safe place
           | to ask questions. Facebook groups are biggest and best.
           | Reddit has a lot too. Various podcasts and foundations. From
           | these you start seeing patterns in what works for people, how
           | to find doctors.
           | 
           | For me.
           | 
           | In order of improvement. Prescription: plaqunial. Blood
           | thinners.
           | 
           | Avoiding flare triggers, Sun, heat, most foods.
           | 
           | Diet is huge. Autoimmune protocol diet is best for me.
           | Similar to keto, etc. Personally I'll eat a lot of sweet
           | potatoes when I need relief. Safest food I have found.
           | 
           | Supplement: Vit D, magnesium, Vit E, fish oil, B complex,
           | CQ-10 turmeric.
           | 
           | Autoimmune often means a lot of secondary conditions, or
           | autoimmune is the secondary.
           | 
           | Increased cranial pressure is somewhat common with Sjogrens
           | for example. High pressure is brutal on the mind and body.
           | 
           | Went from bed ridden in horrific agony all day to kayaking or
           | equivalent every weekend.
        
             | dualthro wrote:
             | Could you please provide links to these reddit support
             | groups, and podcasts and foundations?
             | 
             | Have you tried using the mushroom [extract] Cordyceps as a
             | supplement? It seems to help abate some symptoms when I eat
             | an autoimmune triggering food.
        
               | 7thaccount wrote:
               | Wait...isn't cordyceps the fungus that takes over ants,
               | bursts out of their skull, and then cause them to effect
               | others? That sounds like something I'd run away from at
               | full speed.
        
               | dualthro wrote:
               | Do you have a link with more info? I just popped 2 of
               | these [1] an hour ago as I had eaten some kind of
               | food/protein bar that tasted like it contains pea
               | protein, a known trigger of mine. I live in a country
               | where I can't read the language so I'm not sure exactly
               | what I ate.
               | 
               | https://www.nowfoods.com/supplements/cordyceps-750-mg-
               | veg-ca...
        
               | wizzwizz4 wrote:
               | The Wikipedia article contains basically all the
               | information in this bit of the thread, but accurate:
               | https://en.wikipedia.org/wiki/Cordyceps
        
               | 7thaccount wrote:
               | Google zombie ants. Maybe it's ok for people?
        
               | treeman79 wrote:
               | https://www.facebook.com/groups/476448932387693/?ref=shar
               | e
               | 
               | /r/Sjogrens /iih
               | 
               | Podcast Sjogrens Strong
               | 
               | Good resource Sjogrens foundation John Hopkins Sjogren
               | foundation for more up to date testing and articles
        
             | wtetzner wrote:
             | Have you looked into the Carnivore Code in regards to
             | autoimmune issues? https://carnivoremd.com/book/
             | 
             | It's full of useful information even if you don't intend to
             | go full carnivore.
        
             | datameta wrote:
             | It makes me so happy to read this! I too have had a drastic
             | transformation in terms of life quality.
             | 
             | I second the Anti-inflammatory diet and exercise (even just
             | walking contributes greatly). I echo the supplement
             | suggestions and also recommend glucosamine+chondroitin
             | (which happens to lower all-cause mortality significantly).
             | 
             | Red meats (high omega 6 content), deeply fried foods,
             | gluten (plenty of grain alternatives to wheat and corn),
             | uncultured dairy (cheese seems ok, plenty of alt-milks out
             | there), and sugar not from fruit can trigger inflammation
             | for me. I might describe my diet as vegan+eggs+fish (ovo-
             | pescaterian?)
             | 
             | There is a wealth of information online to tailor one's
             | diet. Honestly - this is a diet that everyone can benefit
             | from health wise.
        
               | dualthro wrote:
               | I'm jealous that you can eat grains! Any kind sets me off
               | unfortunately. And yeah it took me a while to realize but
               | any kind of fried food is bad for me. So even eating
               | coconut tortilla chips sets me off, despite the fact that
               | they contain no grain. I am hopeful that in the future,
               | more paleo / autoimmune paleo targeting brands come out.
               | There was already a pleasantly surprising amount of
               | brands catering to this, last time I was at a whole
               | foods.
               | 
               | For those who can't tolerate dairy, or any kinds of nuts
               | or seeds or grains, one kind of food that you might enjoy
               | is coconut yogurt. Not cheap but it helps to break some
               | of the dietary monotony.
        
               | datameta wrote:
               | Ah, that's a shame... Nuts and seeds actually make me
               | feel a lot better (was my only snack for a while, when I
               | couldn't eat fruit) and I feel lucky to be able to eat
               | brown rice. If I eat wheat-based pasta or bread however,
               | my body will let me know in minutes.
               | 
               | It really is awesome that we can find what fits us with
               | large store brands that deliver! Never knew how many
               | forms of vegan protein exist out there
        
         | uyt wrote:
         | How do you bring up the topic of brain fog to your doctor?
         | 
         | Can I really just say some days I feel dumber than usual and
         | he'll be able to diagnose and fix me?
        
           | treeman79 wrote:
           | My experience was that almost all doctors will declare you
           | depressed.
           | 
           | I printed out 4 page list of all the weird symptoms I had,
           | and what affected me.
           | 
           | One crazy old neurologist-ophthalmologist read the list and
           | declared I had Sjogrens. Something I had not considered.
           | 
           | Through research and Support groups I found out my symptoms
           | were normal, and mostly ignored by doctors.
        
             | notabee wrote:
             | Seconding this experience. Western medicine is bad in
             | general at treating chronic conditions that aren't
             | immediately life threatening, but you would really think
             | that general doctors would be more aware of autoimmune
             | issues considering how common they are.
             | 
             | For anyone going through this fresh hell currently, I'd
             | estimate my hit rate at about one out of 6 or 7 for doctors
             | who'll actually look in depth versus those who were
             | apparently just good at memorizing things for tests and
             | can't diagnose their way out of a wet paper bag. If you
             | haven't gotten at least that many opinions and are still
             | suffering, keep trying.
             | 
             | Also, quacks are a problem too. Too many of those promising
             | cure-alls.
        
               | treeman79 wrote:
               | Most doctors think Sjogrens means dry mouth and dry eyes.
               | They advise eye drops and gum.
               | 
               | I basically quiz doctors until I find one that knows the
               | basics. I have a rheumatologist. But if I need forms
               | filled out only a PCP will unusually do that. Unless they
               | don't, then your screwed royal.
        
             | AQuantized wrote:
             | This has been my experience with some ongoing/recent
             | neurological symptoms. Ahidrosis, brain fog, reduced
             | sensation, the list goes on. No doctor has outright said it
             | was wholly a mental issue, but they're basically only
             | willing to prescribe antidepressants or benzos. Sadly for
             | most obscure problems you have to seek out help yourself.
        
               | erentz wrote:
               | WRT reduced sensation and sweating: you may want to find
               | a neurologist who deals with dysautonomia, and maybe get
               | autonomic function testing done. Also look into small
               | fiber neuropathy. There are support groups for these on
               | FB and the like that may have useful information or
               | referrals to good doctors. A lot of doctors hear small
               | fiber neuropathy and only think diabetes. But it's
               | frequently associated with dysautonomia, progressive and
               | autoimmune/inflammatory in origin.
        
               | treeman79 wrote:
               | I have reduced sweating. It sucks big time.
               | 
               | Best I can tell its from Sjogrens Or neuropathy problems
               | from Sjogrens.
               | 
               | Also dysatonomia is often caused by IIH. Treating IIH,
               | drastically improved symptoms. Literally draining off
               | spinal fluid.
        
               | dualthro wrote:
               | Can salt intake/blood pressure affect IIH at all?
        
               | treeman79 wrote:
               | Yes. Blood pressure pills help out. Salt is weird.
               | 
               | Oddly salt can at times improve IIH. But it's not
               | something to mess around with.
               | 
               | Basically too much water causes organs to swell. Most
               | organs handle this well enough. Brain will swell, but has
               | no room to do so.
               | 
               | A big dose of salt will draw water out of organs,
               | including brains.
               | 
               | Very good medical case I read up on, but can't find now.
               | 
               | A lot of Sjogrens people recommend adding pink salt to
               | water or other hydration packs.
               | 
               | Pure water seems to worsen dehydration. I have found this
               | to true.
               | 
               | Be careful as this is a complicated thing, and can hurt
               | yourself by having too much or too little.
        
             | paperwasp42 wrote:
             | A veterinarian was the one who diagnosed me with Addison's
             | disease, after noticing that my neuromuscular symptoms were
             | similar to German Shepherds with the condition. This was
             | after seeing 5+ human specialists who either couldn't
             | figure out what was wrong, or (more commonly) didn't
             | believe anything was wrong.
             | 
             | Addison's is deadly if left untreated. According to my
             | endocrinologist, I was scarily close to death.
             | 
             | Doctors are quick to discourage patients from "Googling
             | their symptoms", but patients (and their veterinary
             | friends, lol) need to advocate for themselves. If I hadn't
             | taken the tip about Addison's seriously and demanded tests
             | from my primary care, I could very well be dead.
        
               | cstejerean wrote:
               | One of the things I discovered a few years ago is that I
               | can order my own lab tests and pay out of pocket (in the
               | US, not sure how this works in other countries with
               | functional healthcare systems). This way instead of
               | wasting 1 doctor visit on ordering a test I can go to my
               | doctor directly with test results in hand and discuss any
               | outliers, etc
        
               | paperwasp42 wrote:
               | Yes, this is a brilliant development!
        
               | kgin wrote:
               | In New York state, it's illegal to get any kind of
               | medical testing without a doctor's order. Very
               | frustrating.
        
               | treeman79 wrote:
               | This has been one of the things slowing me down.
               | 
               | Some tests took over a year for me to get run.
               | 
               | Some I still haven't.
               | 
               | Other more exotic tests were super easy to get.
        
               | zingermc wrote:
               | Wow, does this apply to Covid tests?
        
               | treeman79 wrote:
               | You have to do your own research. You will be dismissed
               | as a hypochondriac. Learning to live with all the labels
               | from a chronic condition is one of the hardest parts.
        
               | paperwasp42 wrote:
               | > Learning to live with all the labels from a chronic
               | condition is one of the hardest parts.
               | 
               | If this isn't the truest thing. It's very difficult when
               | you have doctors--who society tells you to deeply respect
               | --calling you a lazy liar.
               | 
               | I don't think I would have been diagnosed if I didn't
               | have a supportive family who insisted it wasn't "all in
               | my head" and that I needed to keep searching for answers.
               | It's very easy to start believing what the doctors say,
               | no matter how loudly your body is screaming otherwise.
               | 
               | And then there's the opinions of general people... It's
               | surprising how ignorant highly-educated engineers can be
               | about medical issues. Again, I credit my family and
               | friends for having kept my sanity all these years.
        
               | wtetzner wrote:
               | Interesting that it was a veterinarian that diagnosed
               | you. I've noticed a pattern of veterinarians seemingly
               | being better doctors than human doctors. They seem to pay
               | more attention to current research and continue their
               | learning, and rely less on what they learned 20 years ago
               | in med school.
        
               | paperwasp42 wrote:
               | Agreed. They are perhaps the most underestimated
               | professionals in the medical field.
               | 
               | They don't just memorize information about one species,
               | they need to know how to treat 5+. They do all their work
               | without the patient giving verbal clues/feedback. And
               | they often have limited resources/tests/treatments they
               | can use to save a life.
               | 
               | They are some of the most creative, intelligent, and
               | passionate minds in society. Although I may be a bit
               | biased, based on my experiences. ;)
        
             | elliekelly wrote:
             | > My experience was that almost all doctors will declare
             | you depressed.
             | 
             | This is so painfully true. My lupus was repeatedly treated
             | with prozac despite my insistence that I didn't feel at all
             | depressed.
        
               | treeman79 wrote:
               | Yep. Got PTSD from doctors.
        
           | dualthro wrote:
           | I saw 3 different doctors, they all just figured I was
           | depressed. I then started reading and searching online like
           | crazy, most helpful resource I've found so far is at
           | http://brainhealthbook.com (also easily pirated), that author
           | is both a naturopathic doctor and an MD.
           | 
           | edit to add: You said 'diagnose and fix me' ... even if they
           | can diagnose you, they won't be able to fix you. Just a
           | warning. Best you can do is to manage the condition.
        
         | Abishek_Muthian wrote:
         | I wish you well and hope the treatment is successful.
         | 
         | > Cognitive decline is a real issue for me.
         | 
         | How do you track this? Do you have any self tests to keep the
         | cognitive state in check or are they standard medical tests?
        
           | treeman79 wrote:
           | 2 ways. I started tracking my memory score over time.
           | https://memtrax.com/ At my lowest it would frighten people to
           | watch me take the test.
           | 
           | "You just saw that image 3 times in the last 60 seconds" Me:
           | I have never seen that image before. At my best I could
           | outscore most anyone in the office.
           | 
           | Second is more arbitrary, but more important.
           | 
           | Been programming for decades. Since I was a kid. A task that
           | normally would take me a few minutes might take me a week.
           | Harder concepts were beyond me, felt like I was trying to
           | tackle calculus after learning fractions. I "knew" I could do
           | it, except I couldn't anymore.
           | 
           | Then I would have some good days, and I would go around the
           | office solving all the really hard problems for people.
        
             | Abishek_Muthian wrote:
             | As person with disabilities and physical health problems
             | people are often at awe at me for how I go on with my life
             | and now I'm looking at the same awe at you.
             | 
             | Do you feel there's anything missing with memtrax or any
             | other tool which can make your life easier i.e. help track
             | your cognitive health or help your current lifestyle?
        
               | treeman79 wrote:
               | Time to diagnosed is one of the biggest things. Gig
               | economy kept family off the street when I was at my
               | worst.
               | 
               | I had symptoms 20 years ago, serious problems 10 years
               | that were warning signs of autoimmune.
               | 
               | When it got really bad it was 20-40 doctor visits to get
               | a diagnosis.
               | 
               | It's the Second most common autoimmune condition, behind
               | lupus.
               | 
               | Also getting ride of American diet. A lot of people are
               | predisposed to autoimmune, but need a trigger.
        
           | dualthro wrote:
           | Not OP but I live in a different country where I barely speak
           | the language. I can turn on the TV in the morning and
           | depending on how easy or difficult it is for me to parse what
           | they are saying, tells me how sharp my mind is that day.
           | 
           | Similarly to the sibling comment, I spent years struggling.
           | There were points where I sat down to write a super simple
           | Craigslist scraper and couldn't do it, my working memory was
           | so poor that it was like I couldn't hold more than 2 or 3
           | concepts or ideas/variables in my head at the same time. This
           | task is something that I knew just a few years before I could
           | have whipped up in 30 minutes or less.
        
             | Abishek_Muthian wrote:
             | Thank you for taking the time to answer.
             | 
             | Do you use any tools like OP to help with your lifestyle? I
             | know memory is a complex problem even for those who don't
             | usually face explicit issues like you do; but does common
             | memory retention practices like 'spaced repetition' made
             | any positive improvements for you?
        
               | dualthro wrote:
               | Definitely. Most of the time I'm pretty sharp, although I
               | definitely have days where I basically can't get anything
               | done. I have just started using Anki to great effect
               | (preparing for programming interviews is a nightmare if
               | your brain is a sieve).
               | 
               | Since I know that my symptoms are almost entirely caused
               | by diet, I have written down everything that I've eaten,
               | every supplement that I've taken, every hour that I've
               | slept, every noise or pain I feel in my stomach, and
               | information about all of my bowel movements since 2017.
               | 
               | I thought I had things under control last year, and
               | didn't take any notes for 2 months. Now I have an issue
               | with H2S bacterial overgrowth, essentially a sulfur
               | sensitivity. "If it can be measured, it can be managed."
               | 
               | The fact that I moved to Europe in October to avoid the
               | pandemic and election nonsense, hasn't helped me. There
               | are tons of supplements and tests that I would be able to
               | get in the states that are simply unavailable in the
               | country that I'm residing in. Pretty frustrating, and
               | tbh, I can't wait to get back, hopefully late
               | spring/summer.
        
         | RobRivera wrote:
         | sorry to bother, but have any good source for identifying anti-
         | inflammatory dietary choices? an old boss went antigluten to
         | great effect (knee issues)
        
           | treeman79 wrote:
           | Look up Auto immune protocol diet.
           | 
           | Theme is few carbs, but not exactly. Chicken, green
           | vegetables and sweet potatoes are my life.
           | 
           | I always regret cheating.
        
           | dualthro wrote:
           | Following the below diet changed my life for the better. Like
           | night and day. I was able to get back into the software
           | industry. I remember the summer that I started it, literally
           | every week I felt like I was 10% smarter. And I also was
           | regaining memories that I had completely lost prior to that.
           | Kind of surreal.
           | 
           | https://drknews.com/autoimmune-gut-repair-diet/
        
         | solaxun wrote:
         | Very interesting to hear your experiences. I have long
         | suspected some sort of autoimmune condition (specifically
         | undifferentiated spondyloarthropathy) resulting in me having
         | similar symptoms. My first symptom was tendonitis, but I was 22
         | back then (37 now) and very physically active so doctors just
         | attributed it to overuse. Then both elbows tricep tendons
         | developed enthesis and ossified at the insertion point. I have
         | similar enthesis in basically every major joint now, and they
         | still think it's from the exercise. I did push my limits with
         | weights when younger but it's difficult to imagine that being
         | the cause of all the issues I've had.
         | 
         | Similar to you, CRP tests were fine and bloodwork was all good,
         | however they did find I was positive for the HLA-B27 antigen
         | which is a known marker for autoimmune conditions and only
         | present in about 5% of the population, but present in 90-95% of
         | those with spondylitis, so there's one red flag. The issue is
         | as you mention, there is no definitive diagnoses until they see
         | joint damage on X-ray, and by then you've missed years of
         | potential intervening treatment.
         | 
         | Eventually I developed brain fog like you describe, but it was
         | gradual and difficult to tell if the symptoms were related.
         | It's not always debilitating but I'd say 4/5 days I'm foggy to
         | varying degree, and then one day where I'm about 3x sharper.
         | I've learned to just ride the productivity wave those days and
         | do mundane stuff other days.
         | 
         | I thought it may be sleep related, and although getting more
         | sleep does seem to give me a higher probability of a "good"
         | day, it's not a panacea. There are days where even after 10
         | hours I'm still foggy, and I can tell immediately upon waking
         | up how the day will go.
         | 
         | While I'm sympathetic to those who say googling your way to
         | diagnoses can be harmful (and no doubt it may frustrate some
         | doctors), I don't entirely agree. You have to live with your
         | body and mind 24/7, and you have one and only one patient to
         | care for - yourself. You will always be more motivated to find
         | the answer than your doctor. A doctor cannot read your mind or
         | feel your pain, and simply pattern matching symptoms is
         | something anybody can do. It can never hurt IMO to go into the
         | discussion informed and ask pointed questions.
         | 
         | The medical field is an evolving science, they don't have all
         | the answers, they don't even have most of the answers.
        
           | o-__-o wrote:
           | How do you manage your job with so many days being out of
           | commission?
           | 
           | I have noticed a drastic difference since catching COVID and
           | fear the days of my youth being able to churn anything out on
           | a whim is over
        
             | solaxun wrote:
             | On my out of commission days, I'm foggy but I can still get
             | stuff done, I just won't be able to operate at the level I
             | could on a good day. It's frustrating because you know your
             | capabilities, but you just can't get there. Imagine running
             | a 6 minute mile, and the next day you give it 100% and 8
             | minutes is a struggle.
             | 
             | I try to prioritize creative work, e.g. building something
             | new, really hard problems, etc. for "good days", and I
             | focus on work that I've already begun and can see the
             | completion path for on bad days. I do occasionally have
             | days where I'm totally useless, and if that happens I'll
             | just do mundane rote tasks that I've been putting off.
        
         | dsizzle wrote:
         | There's a lot of discussion of "inflammation" in this thread,
         | but does this mean anything other than "feeling bad" in
         | practice? It seems C-reactive protein (CRP) is the main
         | biomarker for inflammation. Do people get tested for CRP to
         | diagnose their triggers? I don't think I've ever been tested
         | for it. Will a typical GP give you a CRP test if you ask for
         | one?
        
           | nowandlater wrote:
           | I see it in my lipid panel (there's heart disease risk in my
           | family) so that may be one way to get it. But INAD and
           | welcome other comments on how to ask for this; it may just be
           | my gp.
        
           | treeman79 wrote:
           | At some point "feeling bad" turns into organ damage.
           | 
           | CRP, is limited value test.
           | 
           | In general my blood work is great, yet I have lots of
           | internal damage. It's just not progressed enough to show up
           | on typical blood tests.
           | 
           | Various antigen tests can pick up on it.
        
             | dualthro wrote:
             | Which kind of antigen tests? I have had a CRP test that
             | wasn't really indicative of any problems. I would love to
             | be able to get a doctor to agree with me that there is
             | something wrong.
        
             | nojs wrote:
             | Could you explain in some more detail how you know you have
             | lots of internal damage?
        
               | treeman79 wrote:
               | Various Ultrasounds, cat scans. I basically don't sweat.
               | Tears are very rare. I cried for first child born, I
               | didn't for second, even though I felt the same. Was an
               | early symptom. But felt bad for years.
               | 
               | In case of pancreases, I got pancreatitis. Turned out
               | that was an early sign of Sjogrens. At that point
               | ultrasound was clean. Years later, Now it shows damage.
        
           | aksss wrote:
           | You don't need to ask a GP for blood work, just order it
           | online and go to the lab, then get your results via the lab's
           | portal (e.g. Quest).
           | 
           | I'm not sure these tests are good for diagnosing triggers
           | though, compared to quarterly or biannual management of a
           | disease (to make sure you're not headed off the rails). The
           | range for CRP, for instance, is relatively broad. What's
           | serious is when you're exceeding the reference high.
           | 
           | In these cases (like maxed out SED rate) chronic inflammation
           | is a thing and more than "feeling bad". It does lasting
           | damage so the quicker you can respond to it the better, and
           | IME that kind of inflammation sneaks up on a person and often
           | goes undiagnosed until other downstream problems start to
           | present themselves.
           | 
           | There's a bit of fashion to talking about "cytokine storms"
           | and inflammation that is partly healthy to be aware of (and
           | interesting to the seriously curious) but also a lot of
           | faddish health nuttery lately. Be careful of the snake oil
           | salesmen out there, folks.
           | 
           | Diets, supplements, exercise equipment, OTC meds, are as
           | often nets to harvest disposable income more than they are
           | serious approaches to managing disease.
           | 
           | For people suffering autoimmune disorders, much can be done
           | with simple balanced diets and regular low stress body weight
           | exercising. The key is avoiding things like excessive
           | drinking, high mental stress levels, sleep dep. All the good
           | advice for Puritan living that really applies to all of us,
           | just that they have far, far lower tolerances for deviation.
           | Response to NSAIDs may indicate what you're fighting but if
           | you're there you've already failed upstream from where you
           | are now. Chronic NSAID use isn't all that great either but is
           | often an unavoidable supplement for those trying to hold a
           | normal career these days. This kind of internal feedback loop
           | is more cost effective and probably more accurate for
           | behavior correction than looking at daily blood work.
        
             | dsizzle wrote:
             | Do you think SED rate is better than CRP then? It doesn't
             | seem like I've had that test either. I have hypothyroidism,
             | which can be autoimmune related, but no doctor has ever
             | suggested either test, nor mentioned inflammation. I get
             | TSH tested every 6 months though, and sometimes have to
             | adjust Synthroid. I've asked about the causes of these
             | fluctuations and doctors basically just shrug. I have no
             | theory for it either.
        
               | treeman79 wrote:
               | My sed is always good. Usually ANA, is first step.
               | 
               | Time to see a rheumatologist
        
               | dsizzle wrote:
               | What's ANA?
        
           | stonecraftwolf wrote:
           | Not all autoimmune conditions show up in bloodwork, and
           | sometimes they only show up when they've progressed to the
           | point of organ damage. Typically this lack of positive tests
           | is used to invalidate the experience of people with those
           | conditions (usually women). This often seems to come from the
           | implicit assumption that we know all the physiological
           | markers and mechanisms of autoimmune disease, when nothing
           | could be further from the truth. We know very little, and how
           | a patient feels matters.
        
             | aksss wrote:
             | I've met people with "all the markers but one" and thus
             | never get a neat diagnosis of a known disease, and it's
             | very devastating to live with that kind of an unknown where
             | doctors have so few answers or cures (not that they have
             | all that much more with known AI diseases, but it's more
             | comforting to be bucketized than most people know). For
             | lack of better solutions they can get put on daily
             | prednisone for months (or years!) which causes a wholly
             | different set of health challenges to manage the first. It
             | can be very hard for folks walking homeless through a
             | desert of autoimmune knowledge. Often my advice is, "what
             | would you do if you had that last marker? Adopt a lifestyle
             | as if you did: watch your food intake, do gentle but
             | _regular_ exercise, get plenty of sleep, reduce mental and
             | physical stress, avoid excess (sun, drink, food, etc)."
             | I've yet to meet anyone with a neat diagnosis that _wants_
             | to be on immunosuppressive drugs, so even these folks must
             | strive to manage their disease through disciplined
             | lifestyle changes.
             | 
             | I also understand the need for doctors to be measured in
             | their diagnosis, so I don't begrudge them for following
             | protocols established for disease qualification. I don't
             | think of it as invalidating experiences of patients (though
             | it can feel that way to patients) but everyone is aware of
             | those that _want_ a diagnosed health problem, and to a more
             | frequent extent, those that want a tidy answer to their
             | experiences even if there isn't one. Denying a diagnosis of
             | a known disease is not denying a diagnosis at all.
        
               | alach11 wrote:
               | There's a huge benefit to getting a specific diagnosis.
               | Treatments for Lupus vs. MS vs. vasculitis vs. other AI
               | diseases are very different. And many of these are life-
               | threatening without proper treatment; lifestyle changes
               | won't cut it.
               | 
               | My wife struggled with weird autoimmune symptoms that
               | eventually progressed enough to get a diagnosis. At the
               | time of her diagnosis, her life expectancy without
               | treatment was 1-2 years. I empathize a lot with patients
               | and doctors who are trying to dial-in on a mysterious
               | illness.
        
               | treeman79 wrote:
               | Lost a year due to this.
               | 
               | Had to push hard for further testing. Plus just trying
               | the treatment. Had a big positive response. If I hadn't
               | pushed they would have just had me come in once a year to
               | "check".
               | 
               | One of the factors that got me a diagnosis.
        
         | quotz wrote:
         | Had loads of brain fog for 2-3 years straight in college. Kept
         | gradually getting worse, changed about 20 docs, nobody knew how
         | to treat it and they thought I had mental health problems.
         | 
         | Then I took matters in my own hands, joined some forums and
         | subreddits, turn out loads of people were like me. Literally
         | thousands of people in online communities had undiagnosed Low
         | Testosterone. Most docs are uneducated about this as they just
         | look at the blood test lab results, and group everyone from age
         | 20 to age 70 in the same category. Went to a mens health doc,
         | gave me TRT, symptoms gone in a week. Literally saved my life
         | and career, I almost dropped out of college. I put my dad on
         | TRT too, and litterally I tell everyone about this. The Low T
         | epidemic is a really serious issue!
        
           | danielscrubs wrote:
           | I was very tired all the time. Doctors took blood tests and
           | found out I was low on testosterone, called in a specialist
           | that looked at the same blood tests and said it was ok
           | because I had enough free testosterone if I remember it
           | correctly. Never did solve it. Any advice?
        
             | quotz wrote:
             | Of course, join r/testosterone read the info. Then, go do
             | blood tests again. Total T has to be >600 ng/dl no matter
             | ur age or what anyone says. If you dont want to bother
             | diagnosing yourself, find a mens health doctor in your area
             | on the subreddit. If you cant, then I can advise you
             | further I will give you my contact. I am on it for 2 years
             | already, I put my 60yo dad on it as well, I have a doc in
             | NYC called Dr Rotman, I can give you his contact if you
             | live nearby
        
           | the_drunkard wrote:
           | Did you have blood work done to diagnose low T?
           | 
           | My understanding is that T levels can vary based on the time
           | of day they're taken, so they likely need to be taken
           | multiple times.
           | 
           | In any event, glad you arrived at a solution!
        
         | tunnuz wrote:
         | Can you elaborate on treatment and lifestyle? How does one know
         | if they have brain fog? Sorry if the question is silly.
        
       | arnonejoe wrote:
       | Originally reported in Nature on Jan 20.
       | https://www.nature.com/articles/d41586-021-00063-6
        
       | xwdv wrote:
       | Lately I haven't really been too convinced about the benefits of
       | fasting. While fasting is probably good, exercising regularly and
       | putting a consistent stream of good nutrients into your body is
       | still probably better at preventing all kinds of aging. Fasting
       | is just more accessible to those who do not have access to steady
       | source of good nutrition, and it takes no real effort beyond not
       | eating.
        
       | sradman wrote:
       | The paper _Restoring metabolism of myeloid cells reverses
       | cognitive decline in ageing_ [1]:
       | 
       | > Here we show that in ageing mice myeloid cell bioenergetics are
       | suppressed in response to increased signalling by the lipid
       | messenger prostaglandin E2 (PGE2), a major modulator of
       | inflammation. In ageing macrophages and microglia, PGE2
       | signalling through its EP2 receptor promotes the sequestration of
       | glucose into glycogen, reducing glucose flux and mitochondrial
       | respiration. This energy-deficient state, which drives
       | maladaptive pro-inflammatory responses, is further augmented by a
       | dependence of aged myeloid cells on glucose as a principal fuel
       | source. In aged mice, inhibition of myeloid EP2 signalling
       | rejuvenates cellular bioenergetics, systemic and brain
       | inflammatory states, hippocampal synaptic plasticity and spatial
       | memory. Moreover, blockade of peripheral myeloid EP2 signalling
       | is sufficient to restore cognition in aged mice. Our study
       | suggests that cognitive ageing is not a static or irrevocable
       | condition but can be reversed by reprogramming myeloid glucose
       | metabolism to restore youthful immune functions.
       | 
       | [1] https://www.nature.com/articles/s41586-020-03160-0
        
       | [deleted]
        
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