Bacterial Prostatitis and I'm unable to treat it

[bbb]

this won't help but it may be interesting. the last section is about a few medications that have caused nerve damage

Peripheral Nervous System Manifestations of Infectious Diseases - PMC (nih.gov)

 

[bbb]

Hello, I am very glad to hear that you were able to get some improvement from getting your dental work done and increasing the quercetin. It sounds like those were both really wise choices!

 

Have you looked into the possibility of consulting a private-practice urologist in Wales? I wonder if any would be willing to give you a short consultation by email or by phone?

Private Consultant Urologists | Specialists in Wales | Private Healthcare UK

So that's my two cents. I'm sure you'll continue to find your way back to health!

Edited November 26, 2022 by bbb

[bbb]

I'm worried since the original poster Matt hasn't added more messages that I can see. I hope you are doing alright! This may not be relevant, but I was just reading that it may be best to take zinc every day, and that the body doesn't store it. I don't know if that is true, but for me I've since been cutting my zinc supplement into pieces and taking a small piece each day.

[Gordo]

Matt after reading your blog post:

Quote

The first time the nerve pain showed up was actually 2 days after I had the Td/IPV vaccine... My immune system seemed to overreact to the vaccine and caused damage to my nerves...

It seems like you might have Guillain-Barré Syndrome which is a rare (and serious) side effect of vaccines.

[Matt]

Sorry for the lack of response everyone. I'm still going through the same thing, my doctor or regular GP has basically just given up at this point. They told me there is nothing they can do, and they have to follow prescribing guidelines. They can't offer me other alternative antibiotics even if clinical studies show they can work.

I may have developed a mild form of GBS... I'm trying to get my GP to investigate what is going on here with my nervous system and immune system. 

I tried Doxy again the other day after my infection symptoms flared, only having to stop after 4 doses because I had severe burning sensation over my entire body, even my face. This is so ridiculous now I can't even believe what is happening to me. 

I'm going to see private urologist now as my waiting time on the NHS is between 1-2 years at this point. I am in pain daily, many days I need to pee like 24/7, even at night. It can be unbearable. It's what led me to trying Doxy again. The doxy worked very well, again, many of my symptoms got better, I stopped needing to go toilet every 10 minutes. The pain went away, and the low grade fever went away after the 3rd dose. 

I'm going to write more but probably on my phone as it's uncomfortable trying to sit here.

I've created a GoFundMe page. I'd appreciate if anyone can share or donate any little amount they can. I was extremely reluctant and nervous about doing this but I have to get something done. 😞

https://www.gofundme.com/f/donate-to-help-me-beat-this-infection

[BrianA]

Sorry to hear you're still suffering. If you would like another rabbit hole to research, you can look into post-covid bladder issues. A lot of folks in the long haulers have reported this as a symptom:

 

reddit search:

https://www.reddit.com/r/covidlonghaulers/search?q=bladder&restrict_sr=on

Long COVID and COVID-19-associated cystitis (CAC)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8597545/

[Gordo]

Hope you can raise what is needed for a lasting cure. Keep us updated. 

[Neil Tomlin]

Sorry to hear about your troubles Matt.

I have recently come across Heart Coherence Breathing which has greatly helped me. I have hesitated to tell you about this but its effects upon me have been profound in a short period of time so I thought I would mention it.

It is a very gentle exercise only employing belly breathing to a set rhythm for 20 minutes (think of it as inflating and deflating a balloon) and is widely discussed in the breath community, easily found on google.

Take A Deep Breath has a 20-minute guided YouTube video if you’re interested.

[Matt]

Thank you all, 

I might've had a bit of a breakthrough recently and I can't believe I missed this. I've had to figure this out for myself as my doctors have been almost useless sadly. They don't have the time to try to figure this out with me when I'm just pushed out the door in 10 minutes.

I had time off work and was able to do more research and try to really think about the sequence of events, without any kind of bias towards what I thin may have caused all of this and what could actually be going on.

So I'm going to continue to document here just in case anyone else ends up in a rubbish situation like myself.

So let's start from early 2022:

Feb 22 - Joint / muscle pains

I develop Omicron infection sometime late January or early Feb 2022 (I don't remember). My only symptoms were muscle aches and feeling of strained/pulled muscles or tendons. It was odd, but these symptoms persisted for quite a while (weeks) and then eventually faded. However, on and off throughout the year I would get muscle pain or joint pains, mainly in my legs, and particularly in the morning.

I attributed this to my on-going dental abscess as I had experienced this around 2006 until I had removed the tooth and then it went away.

March 22 - Palpitations. higher heart rate, dizziness / lightheadedness 

My doctor said anxiety, gave me a beta blocker (never took it). The dizziness went away but palpitations and higher heart rate remained throughout the year. Briefly helped after taking out tooth but both issues came back a week or more later.

April to August - chronic gastritis and gut motility issues / gastroparesis, with constant use of antacids for months.

This lasted months, no idea what caused it, but I had feeling of overwhelming fatigue, weak hands and legs, and my bowels were not functioning correctly. Doctor said IBS. I started a multivitamin in July and other supplements, and then by August the issue had resolved.

Spring / early summer 22 - Twitching muscles, pain at back of legs when walking long distance, dizziness and vertigo

Hadn't gone out much as I worked from home, but was still mobile around the house and garden. Went for a walk one day, maybe around April and noticed that the back of my legs were painful and muscles were tight and stiff. I had barely started walking... Never had experienced this before even with deconditioning over months in previous years of being just, well, lazy and staying home a lot.

I had dizziness on and off but it would generally go away after a few days. I put this down to BPPV. A benign condition where calcium particles go into the wrong back of the ear.

August 22 - shortness of breath

I met up with my friend, and we took a walk and just talked and caught up with each other. At normal walking pace, I noticed that I was easily becoming out of breath when walking and talking. I had no chest tightness, no chest infections recently. I thought it was a bit weird at the time but I put it down to deconditioning over the past few months.

September 22  - Neuropathy

I develop a tooth infection flare up and get put on amoxicillin. It helps with the infection and things calm down. One day later I take the tetanus vaccine and two days after that I develop burning sensations on my thigh and hands. I automatically connected the vaccine with the neuropathy.

Weeks later I develop an infection / UTI and then I start taking Doxycycline and then Trimethoprim, both significantly exacerbating neuropathy and I was unable to take them.

September to November

Dealing with prostatitis and neuropathy at this point. My symptoms were low grade fever, brain fog, overwhelming fatigue, night sweats, feeling generally unwell. Weeks of dizziness and vertigo. Increased muscle pain, gut issues, twitches and increased palpitations.

Minor and odd symptoms appeared in October to November

- sores all over my tongue and it was painful to eat.

- Angular cheilitis (I had no idea what this was until today! But they lasted weeks.

----------------------------------------------------------------------

So let's just do a quick list of ALL symptoms I've experienced and and off during 2022:

- Vertigo / dizziness lasting days at a time

- Gastritis / gut motility and IBS-like symptoms (I had fatigue and weak arms/legs during this time)

- Worsening eyesight / can't focus with right eye on things in the distance

- Tingling when resting against things, sitting on toilet, etc.

- Very cold feet and poor nail growth on feet 

- Cramping in back of legs when walking. Muscles feeling stiff. Joint / muscle achiness mainly in morning. Curling foot and cramps during the summer when pointing toes forward.

- Daily palpitations, many throughout the day

- Increased heart rate

- Anxiety on and off

- More tinnitus spikes

- Mouth sores and sore tongue (sept). Would bite side of my tongue often this year...

- Angular Cheilitis

- Tingling / burning sensations over my body (very prominent after vaccine in September)

 

-------------------------------------------------------------------------

WHAT IS THE PROBLEM????

I attributed many of the symptoms to the on-going dental infection. My doctor attributes many things to anxiety. I blamed the vaccine for the neuropathy. Some of these might only be partially correct, and other, wrong.

I spoke to my mother and she experienced most of these symptoms when she had a B12 deficiency. My dad experienced some of them when he had a B12 deficiency and had injections. My aunt who I just spoke on the phone with yesterday has a B12 deficiency right now and many of the symptoms were identical to hers. I've been watching stories on YouTube about other people with B12 deficiencies and their stories are almost identical to mine.

So I need to go back to Feb/March 2022. I took a blood test and it showed that I was in the normal range of 371 ng/L. 

For that reason, I did not even consider that B12 could have been the issue. However, I've since found out that Serum B12 is not totally accurate with levels below 400 ng/L. You can still have a functional deficiency at this level. Between 200-400 is a grey area. More accurate tests is active B12 or MMA. I've read plenty of stories now how people have been in the 200s and 300s and had neurological effects and other B12 deficiency symptoms that went away with B12 injections.

Now considering some facts

I stopped supplementing my multivitamin in July 2021. I forgot to replace B12 with a supplement. I've calculated my B12 intake as approximately 1 ug / day B12 because my diet is vegan. Meaning, for an entire year, I was very deficient in B12 in my diet. 

Now consider the fact that I went through many months with gastritis and stomach issues, for which I was taking antacids and my diet was even more restrictive. I may have developed an issue with absorbing the B12 from my diet that I did get from the fortified foods.

I'm trying to think as hard as I can but it's difficult to know if I had developed very early signs of neuropathy even prior to the vaccine. I honestly don't remember, because if I had, they were very subtle. i.e when mildly compressing nerve, it tingles more easily. 

The sore tongue and angular cheilitis

These both developed a little after I took the antibiotics that further worsened the neurological symptoms such as burning and tingling. They persisted for weeks and I had no idea they were signs of B12 deficiency.

WHAT MIGHT'VE HAPPENED

1. I think that if I had low B12 stores, the infections, vaccine, antibiotics, might've worsened the situation. With nerve damage, there is an increase in demand for B12 and this would have depleted my B12 even more. And from July to December, I was only taking in around 160 ug/ day of B12, which is nowhere near the amount you need to recover from a B12 deficiency and correct neurological effects. Typically, this requires injection or very high dose supplementation if no issue with absorption.

2. I think that my B12 test that I had around Feb 22, although "normal", it can still be deficient in a small number of people. And furthermore, with all the stress and increased demand from my body for B12, this ultimately lead to a worsening deficiency over time.  I've looked at B12 blood results from other people who became B12 deficient, and it can in some cases drop rapidly. Ultimately, I'm never going to know what my levels were in September, but it's not hard to believe they were somewhere in the 200s with such a deficient diet.

3. The vaccine might've only been partially to blame but the underlying issue might've been low B12 levels / stores and not enough to repair the damage to myelin, which was further exacerbated by the antibiotic intake (trimethoprim is one antibiotic that affects folate and can induce a B12 deficiency). More damage, means more need for B12. B12 is also important in regulating an overactive immune response with Tregs.

4. I think that my bizarre responses to these antibiotics might've ultimately be caused impaired cell metabolism from lack of B12, demyelination and fragile myelin, leading to abnormal nerve cell function and oversensitivity to antibiotics.

5. From my research, I've found a few case reports with COVID vaccine in vegan and vegetarians, where both had neurological side effects from the vaccine and were found to be B12 deficient. The researchers hypothesized that the deficiency predisposed them to the side effects. Interestingly, injections of B12 rapidly cured one person and significantly improved the other within a month. Also, in chemotherapy-induced B12 deficiency, it's found that a B12 deficiency can lead to worsening neuropathy with treatment. In an interesting case study, a woman developed grade 3 neuropathy and she needed to stop treatment. They found she was B12 deficiency. Once they corrected it, she was able to resume treatment and her neuropathy did not progress beyond a grade 1. I

HOW DO I FEEL NOW I AM TAKING B12?

It's been about 9 days so far and here's what I've noticed

- The burning sensations are about 90% better in terms of severity and 90% less frequent

- The tingling is now largely limited to my feet and hands, but mostly left foot (this foot got bad after I took trimethoprim)

- My mind is a lot clearer and the brain fog is gone

- My palpitations have completely gone since I started taking B12 5000 mcg. 

- My muscle pains seem to be getting better slow, but I need more time to judge this one

- Vision in my right eye has improved significantly

- My heart rate is more consistently lower

- My body temperature is lower

- My prostatitis symptoms are more manageable (could be just a coincidence as there have been quiet periods before; but I'm also being more consistent with Ibuprofen lately).

I may have screwed up and I didn't put it all together because I and my doctor were blaming other things the entire time. I WISH I had done a blood test around July or September, but because I was within the range in Feb (before I developed the stomach problems for months), I thought it was a very low chance of it being related to B12.

Although other supplements have helped my nerves, none have come close as taking B12.

I was meant to start taking it months ago but I completely forgot about it 😞

- 

 

 

 

 

Edited January 5, 2023 by Matt

[Dean Pomerleau]

Wow Matt,

That is quite a saga. If it turns out that it is indeed a B12 deficiency, it sucks you didn't discover it earlier, but on the bright side you have figured it out now and most of your symptoms have taken a turn for the better rather quickly!

If low B12 is indeed the culprit, it is a cautionary tale for many of us vegans to be careful not to get complacent about this important vitamin, among all the bashing we do around here on one failed supplement after another.

I'm glad you are starting to feel better!

--Dean

[Matt]

On 1/5/2023 at 4:05 PM, Dean Pomerleau said:

Wow Matt,

That is quite a saga. If it turns out that it is indeed a B12 deficiency, it sucks you didn't discover it earlier, but on the bright side you have figured it out now and most of your symptoms have taken a turn for the better rather quickly!

If low B12 is indeed the culprit, it is a cautionary tale for many of us vegans to be careful not to get complacent about this important vitamin, among all the bashing we do around here on one failed supplement after another.

I'm glad you are starting to feel better!

--Dean

I do believe that I am on the right path now. The issue now is how to proceed from here.  How long does it take for extensive remyelination do occur in humans? 

I am noticing gradual improvements in my nerves over time. The burning sensations have mostly gone now and are only present here and there and for a few seconds, usually when in bed under the blankets. 

I am noticing that when I am sitting down (on the toilet for example) or leaning against things with my elbows, forearms, or hands... my limbs are not tingling as intensely anymore. I am guessing this indicates demyelination of large fiber nerves, making them more susceptible to reduced conduction even under mild compression. The tingling mostly shows up distally, around the feet or hands, rather than the whole limb, though. 

I'm waiting for another bacterial culture result this week. I should get it back tomorrow. Then from there I will have the weekend to think about how I should proceed from here. And that's when I'll make the update. I may just do a voice recording and post it on my blog, as it's quite difficult to sit at the computer and type of this out with how I am right now.

I'm tempted to try another antibiotic like Pivmecillinam or Fosfomycin. The urologist appointment is going to cost £195 to have access to these. And I think because it's private, I will have to pay for the medication, too. Fosfomycin is £25 per dose, and I may need to take it for weeks (every other day).

I have to be very careful about how I spend the money that I've raised so far. It's not like I have unlimited amounts of money to start throwing it around without thinking what is the best approach and one that will help stay within budget.

I've asked a few friends about what I should do, some suggest I just give it another 2 months or so to wait until my nerves heal more before trying any kind of antibiotic. This is mainly to reduce the risk of further toxicity when nerves are hypersensitive. So that would leave me with trying phage therapy first (the most expensive option).

A couple interesting studies I came across showing that Doxycycline can be neurotoxic directly or indirectly. While this is not the same thing exactly, the first study does say that Doxycycline can disrupt myelin sheath and cause inflammatory reactions to unprotected nerves. Which I guess may make sense in the context of B12 deficiency and demyelination? 

Histologic effect of doxycycline sclerotherapy on rat femoral nerve

 

"Results: The results suggest that topical doxycycline induces tissue reactions which are different from normal saline. These reactions include stimulation of a local giant cell inflammatory reaction and disruption of the myelin sheath."

"Conclusions: Despite the fact that this study does not give physiologic evidence of neurotoxicity, the histologic results suggest that topical doxycycline may cause nerve damage directly or indirectly. We conclude that doxycycline should not be used for sclerotherapy where unprotected nerves are exposed to the agent until further physiologic tests are performed to prove its safety."

https://pubmed.ncbi.nlm.nih.gov/8902563/

Neurotic effects of doxycycline sclerotherapy

"Complete nerve block was seen frequently. This effect was not seen with topical application of doxycycline or normal saline solution or with intraneural injection of normal saline solution. This study demonstrates that doxycycline can induce a marked decrement in neural function when applied to the subepineural layers of the sciatic nerve in the rat. Therefore doxycycline sclerotherapy should be used with great caution in situations in which it could become exposed to nerves that have sustained surgical trauma."

https://pubmed.ncbi.nlm.nih.gov/9527117/

 

I also found this from the NHS website, which says that Trimethoprim can induce B12 deficiency. I know that it has the ability to induce folate deficiency in humans, as that is it's primary antibacterial mechanism.

 

*Other causes include; malabsorption, diet, Combined Oral Contraceptive pill (COCP), pregnancy, drug induced B12 deficiency – includes Metformin, Trimethoprim, Colchicine, Neomycin, anticonvulsants, long term use of PPI or H2- antagonist drugs. • *MHRA now advises V"

https://www.nottsapc.nhs.uk/media/1330/vitamin-b12-treatment-guideline.pdf

Someone on reddit replied to my post about this issue with antibiotics. And she said that she said she had "recreationally used nitrous oxide". This induces B12 deficiency by inactivated B12 in the body and can be quite serious. What was interesting here is that she ALSO had issues with Bactrim (also contains Trimethoprim). She would get intense burning all over here body, just like I was experiencing.

I think all of this is starting to make sense and it actually does feel like my nerves are healing now, rather quickly as well. 

 

 

Edited January 12, 2023 by Matt

[IgorF]

My newer b12 experience started with switching to plants only regimen. I had no deficiency and decided that 2x100mcg daily should support me.

After some time I developed a special shortage of breath that far away in my teenage years happened with me several times and I had no idea what it was and nobody were to advice me on it. It feels like an inability to use the whole volume of lungs, like you are filling the 80-90% and can't go further with it, really unpleasant.

Now I know what is it - b12-deficiency anemia. It could be distinguished in cbc test but undernourished people practicing cr could miss it due to some changes in expected cbc values. When I finally understood what is wrong I switched to 5000mcg daily for a week and then to 1000mcg daily, planning to get to 500mcg in several weeks. Just to discover in several months that with 500mcg I started to feel the same anemic effect. So I switched  to 900-1000mcg daily and decided that this will be my normal regimen, unless my b12 tests will show 600+ for several shots (the test is unreliable and biotine-fooling prone in addition, so modern multivit can easily mangle the result). The additional unpleasant thing is that after the first signs of anemia there is no quick solution - the blood cells will get better shape in 9-12 weeks. I discovered an earlier sign of coming anemia also - an exhale became stronger (e.g. 650 instead of 550) if somebody is  not lazy to check it regularly, I wondered what is going on..

It is very contrintuitive that b12 from pills is so weak from absorbtion perspective, during my investigation I saw many time this recomendation to have 1000mcg daily on vegan regimens. So it can not be supported from usual multivit doses of it, a separate huge pill seems mandatory, at least for some people.

 

Getting back to the main topic I think - if a prepending infectious decease is suspected to deplete the functional molecular stores then getting them fixed is a part of a solution, in my similar case decades ago it was a part of the second and finally successfull attempt, so I assume my original issue was undernourishment and bad habits together with stress and some usual colds I have often in that age.

 

Hope you are on a way to recovery, it takes time to deal with such things but body supported with all required should manage it, somehow it is known to it because a part of attack seems comes from commensials.

 

Br,

Igor

 

 

 

[Dean Pomerleau]

Igor, 

Was your iron level normal and just your B12 level low when you were feeling the effects of the anemia? The one time many years ago (early in my CR days) that I got anemic with the same sort of symptoms you describe, it was a result of iron deficiency, not B12. After correcting the deficiency with daily doses, I've been supplementing iron twice a week ever since. 

--Dean 

[IgorF]

@Dean

for the plants only regimen debugging I am sure I had pure b12 deficiency, my folate levels are upper than many labs report and my ferritine is still around 70 while it was 120-200 in the different measures in the past, serum iron, tibc, transferine all were ok. Also iron deficiency causes characteristic small MCV values while my were slightly bigger that higher norm and this was another hint for me that it is not an iron case. Unfortunately I have no measurements from my older cases, so no idea what it was but intuitively I think it was also b12, the effects of b12 deficiency were not widely known in the 80s-90s, at least in the place I lived and food rich in b12 was also not a common thing.

@Matt

since b12 issue is already discovered I would also suggest to ensure 5000U vitD (+50-100mcg K2) is a part of daily regimen, it is also known to be depleted after infections and is important to make many things working better. Plus zinc in 1-2 RDA daily for some time, it is also known to be not ok. When I had such prostatitis I also had periodic issues with fungal attacks on my feet and now I am almost sure that deficiencies like I described (together with bad regimen and improper energy b-vits intake) weakened my immunity and the fix was vits+minerals repletion and 2 lines of antibiotics for several weeks - antibiotics are doing the "heavy lifting" by preventing bacteria from further growth while vits+energy are allowing to create a plenty of different proteins that are on their own and as a part of weaponry finally wiping out the overgrew commensials and/or intruders.

(I also failed to manage my issues in winter times and managed it finally in may-june when I started to get natural vitD, that is why I recommended to have it covered, despite the pills D is not equal the natural way to get it)

Br,

Igor

Edited January 13, 2023 by IgorF
fixing quoting

[mccoy]

21 hours ago, Dean Pomerleau said:

The one time many years ago (early in my CR days) that I got anemic with the same sort of symptoms you describe, it was a result of iron deficiency, not B12. After correcting the deficiency with daily doses, I've been supplementing iron twice a week ever since. 

Dean, how much of the iron RDA were (or are) you taking from food? From what I read on your regime, many green leaves, nuts and whole grains, it should be at least 200% or more. If so, it's source of some concern the fact that we can absorb or utilize so much less of the plant-based iron we ingest.

[Dean Pomerleau]

It was 2002, about a year after I went vegan, so I don't have good records. But on paper I was getting plenty of iron (per Cronometer). But I got anemic nonetheless and I attributed it to the low bioavailability and potentially anti-absorbative properties of my diet.

That's why I've continued to supplement with iron (one tablet of these) twice per week ever since. Doing so keeps my hemoglobin and ferritin at the low end of the reference range (~13.5 g/dL and ~40 ng/mL, respectively) and I am free from any symptoms of anemia.

-Dean

 

[IgorF]

A useful article (the autors have also a book on it) https://www.researchgate.net/publication/330943702_Iron-Deficiency_Anemia/link/5c5cdee845851582c3d59c94/download

it contains some hints for differential analysis of iron deficiency anemia.

Br,

Igor

[pwonline]

On 1/12/2023 at 10:09 PM, Dean Pomerleau said:

Igor, 

Was your iron level normal and just your B12 level low when you were feeling the effects of the anemia? The one time many years ago (early in my CR days) that I got anemic with the same sort of symptoms you describe, it was a result of iron deficiency, not B12. After correcting the deficiency with daily doses, I've been supplementing iron twice a week ever since. 

--Dean 

Dean I'm surprised you supplement iron, your diet as I recall was rich in nutrition, cronometer says my iron is significantly above RDA and I believe I eat a fraction of the food and nutrition you consume. And iron accumulates in our bodies, it causes oxidation, too much is really bad. How much iron do you supplement?

[pwonline]

17 hours ago, mccoy said:

Dean, how much of the iron RDA were (or are) you taking from food? From what I read on your regime, many green leaves, nuts and whole grains, it should be at least 200% or more. If so, it's source of some concern the fact that we can absorb or utilize so much less of the plant-based iron we ingest.

lmao I didn't read ahead and just realised we had the EXACT SAME thought. Sorry Dean for repeating a question

[IgorF]

I think with non heme iron sources there should be 300% rda to be safe or depleting it very slow (off course for men), so it is not a surprise that even rich in iron but plant diet can miss the goal.

AFAIR there are subtle nuances for 2+ metal ion transporters - the ions themselves have concurrency and depending on many factors there could be 5-90% of the consumed ions actually transported to the circulation from the intestines, under some normal (childhood) and unwanted (bad 2+ iones like cadmium) circumstances the person could become depleted for some of such even when consumption is proper, so I personally check periodically the basic iron panel (+cbc and reticulocites) after switching to plants only, to capture a moment when I will perhaps also need to follow a regimen similar to described by Dean.

 

edited to add:

checked my data in cronometer - I have 400-500% RDA on iron (200% comes from dryed marjoram and smoked dried paprika) and I am still going down in ferritin, from 127 to 67 for the whole 2022

no idea if I will stabilize or I will soon have to add some iron pills...

 

Br,

Igor

Edited January 14, 2023 by IgorF
adding own data

[pwonline]

37 minutes ago, IgorF said:

I think with non heme iron sources there should be 300% rda to be safe or depleting it very slow (off course for men), so it is not a surprise that even rich in iron but plant diet can miss the goal.

AFAIR there are subtle nuances for 2+ metal ion transporters - the ions themselves have concurrency and depending on many factors there could be 5-90% of the consumed ions actually transported to the circulation from the intestines, under some normal (childhood) and unwanted (bad 2+ iones like cadmium) circumstances the person could become depleted for some of such even when consumption is proper, so I personally check periodically the basic iron panel (+cbc and reticulocites) after switching to plants only, to capture a moment when I will perhaps also need to follow a regimen similar to described by Dean.

 

Br,

Igor

when rda was set (and kept constant over decades?) there was nothing like iron tablets you get nowadays. what i'm implying is surely they expected you to get from natural (wholefood) souces and took into account that fact to reach RDA ?

[IgorF]

2 minutes ago, pwonline said:

there was nothing like iron tablets you get nowadays

there is a mass solution to the issue with iron - bread is fortified with it and for those who can't eat a lot of meat the problem was partially solved in many countries

the similar thing is for folate (in a cheap and unoptimal folic acid form but it is much better then deficiency)

 

unfortunatelly getting the things from wholefoods is a privilege, most of the people on the planet will not have for the next decades, so fortification is the way for mass fixing (not ideal but on the countries level is still a good thing)

 

Br,

Igor

 

[pwonline]

1 hour ago, IgorF said:

there is a mass solution to the issue with iron - bread is fortified with it and for those who can't eat a lot of meat the problem was partially solved in many countries

the similar thing is for folate (in a cheap and unoptimal folic acid form but it is much better then deficiency)

 

unfortunatelly getting the things from wholefoods is a privilege, most of the people on the planet will not have for the next decades, so fortification is the way for mass fixing (not ideal but on the countries level is still a good thing)

 

Br,

Igor

 

okay but we are not discussing if you met RDA with wholefoods. We are discussing if you show to have met RDA (cronometer) through whole foods then should one still need to supplement, the RDA is written in a time when we were consuming more whole foods

[Dean Pomerleau]

The RDAs were set at a time when virtually nobody in the US was getting all (or most of) of their nutrients from strictly plant-based foods.

So for example, this page on the Vegetarian Resource Group website clearly indicates that the RDAs may not be sufficient for vegetarians, and especially vegans:

Recommendations for iron for vegetarians (including vegans) may be as much as 1.8 times higher than for non-vegetarians[1].

-Dean

[IgorF]

6 minutes ago, pwonline said:

if you show to have met RDA (cronometer) through whole foods then should one still need to supplement

yes, RDAs can not cover all the nuances of absorbtion and malabsorption, they cover 2 or 3 sigmas (don't remember) in the statistics model, thus they should be read as - the amount of nutrient when it is absorbed is enough for 99.8% of people to avoid serious consequences or something close to this statement

but every individual element has its own nuances and there are plethora of them, of different kinds, some examples are

- very small rda for b12 is working when it comes from food but with supplements the dozes in orders of magnitude are required

- fe3+ from animal sources is absorbed 50%+ in average" while fe2+ from is perhaps 20% or something like this

- excess zn can cause issues with copper and there are other similar pairs

- non-soluble salts of 2+ iones and organic/carboxy acids (and the place where they are met)

- selen in one selenoacid is regulated while in other is not

- brcaa aminoacids can be used for proteins building but also destroyed for energy

- proteins in RDA quantities will not support muscle mass gaining

and the list can be continued with many more such things.

so RDAs (when they exists!) sometimes could be taken as is and sometimes multiplied, there is no general rule how to deal with them, they just describe the amount of nutrient to be sucessfully absorbed when target is severe issue avoidance.

Another aspect - optimality, RDAs are not about this but in some subtle way they could cause an issue because people will believe they are good because they are reaching the RDA while in reality they will cause unoptimal functioning of something that under some circumstances will make things fishy.

That is what I suspected with Matt's case and why I recommended to ensure that energy, protein and energy-related bvits are in a good shape, after the reading of the longer story I am even more convinced that the issue Matt has/had is slightly  decreased immune function, caused by depletion of some important molecules (of those we know and we don't like enzymes and their activities - the things that produces weaponry to control commensals and/or fight intruders).

So my answer in general - yes, with many things just hitting the RDA "on paper" is not enough, supplementation is required, unless a person is not limiting herself to less than 2000kcal dayly and the same foods for months. But I am not a nutritional expert or medical worker, I just trying to arrange all I faced on my own, read in books, learned from others etc.

 

Br,

Igor