TMAO and heavy hydrogen

May 2, 2026May 4, 2026 gettingwell4 4-5 stars Advanced knowledge, Acetylcholine, Epigenetics, Neurochemicals, Stress DNA methylation

A 2026 review subject was possible involvement of deuterium in TMAO levels, which contrasted with the usual TMAO meme. I’ll curate this paper through an outline of its sections:

“The human gut microbiome plays many essential roles, but an often-overlooked role is to maintain an abundant supply of deuterium depleted (deupleted) nutrients to fuel the host mitochondria. Excess deuterium (heavy hydrogen) damages mitochondrial ATP synthase nanomotors, leading to a decrease in matrix water production with increased reactive oxygen species (ROS) and inefficient ATP production. A microbial metabolite, trimethylamine N-oxide (TMAO) is a powerful signaling molecule whose plasma levels are high in association with many chronic diseases.

In this paper, we present a hypothesis that TMAO is a marker for deuterium overload in the methylation pathway, in addition to its role as an indicator of a disrupted gut microbiome. The original study that brought attention to TMAO involved feeding mice synthetic choline with fully deuterated methyl groups. Fully deuterated TMAO was subsequently detected in the plasma. By contrast, a diet rich in eggs, a natural source of choline (a precursor to TMAO), does not raise TMAO levels. Many of the pathologies that are linked to elevated TMAO can also be viewed as strategies to promote the supply of deupleted water to the mitochondria, systemically.

1. Introduction – DNA and histone methylation regulate epigenetic modifications and imprinting. Phosphatidylcholine is a precursor to acetylcholine, an excitatory neurotransmitter in the brain. Trimethylated lysine molecules, recovered during protein metabolism, are precursors to L-carnitine, which facilitates the transport of fatty acids into the mitochondria to be oxidized for fuel production. Dietary phosphatidylcholine and dietary L-carnitine, in addition to endogenous sources, are important nutrients that provide methyl groups to the methylation cycle. Choline and L-carnitine, as well as a close relative, betaine (trimethylglycine), are all precursors to trimethylamine (TMA), a small methylated amine produced through microbial enzymatic action. Obligate anaerobic hydrogen-dependent archaea called methylotrophs in the gut can reduce the three methyl groups in TMA to methane gas.

2. Evidence that deuterium disrupts mitochondrial function – Deuterium (²H) is a heavy isotope of protium (¹H; hydrogen), and it is pervasive in nature, found in seawater at a concentration of 155 parts per million (ppm) relative to protium. Deuterium is highly damaging to the F₁F₀-ATP synthase (ATPase) nanomotors in the mitochondria that produce ATP, the primary fuel source of the cell. Deuterium loading suppresses the activity of many fundamental biologically important hydrolytic enzymes that depend on proton tunneling. It is likely that deuterium increases the frequency of unrepaired nuclear DNA mutations, by suppressing the activity of deuterium-sensitive repair enzymes.

The inherent collective proton tunneling (ICPT) process, which uses membrane-bound ATPase nanomotors in living organisms, is nature’s ultimate tool for discriminating hydrogen isotopes. This is because a deuteron (²H) cannot replace a proton (¹H) in its tunnel protein during enzymatic transmembrane transport due to its doubled mass and twice larger atomic nuclear size. The result is large compartmental, inter- and intramolecular deuterium disequilibrium in ²H/¹H ratios in all biomolecules, which readily distinguishes respiration from aerobic fermentation with adaptive significance. Deuterons irreversibly clog single proton tunneling ATP synthase nanomotors in mitochondria, resulting in the complete breakdown of ICPT.

This initiates many disease-causing molecular crowding mechanisms, which we review herein from the perspective of prokaryotic proton pumping and H₂ gas formation in the organic molecular realm of mitochondrial proton-donating substrates. Understanding at the systems level how humans protect mitochondrial ICPT processes and ATP synthase is a fascinating journey reviewed herein. We hypothesize that the process uses TMAO as the microbial stepping stone, employing deuterium discrimination to become an active player in forming the biological reaction.

2.1 Quantum tunneling and proton-coupled electron transport – ICPT is a theoretical quantum mechanical phenomenon proposing that a single proton spontaneously passes through a potential energy barrier, typically within a hydrogen bond, in a manner that can be functionally irreversible. Unlike classical particles that must surmount energy barriers, protons can ‘tunnel’ through them due to their wave-like nature. Often, this single proton tunneling is part of a larger process where a proton and an electron are transferred simultaneously (or sequentially) as a single kinetic step, often in the presence of strong electric fields that stabilize the transferred state. This process is referred to as ‘proton-coupled electron transport’ (PCET).

Mitochondria exploit PCET to build the proton gradient that powers the nanomotors to produce ATP in the electron transport chain (ETC). Many enzymes, such as dehydrogenases and lipoxygenases, exploit proton tunneling to carry out their reactions. Deuterons are much less capable of tunneling, so this becomes a way to select for substrates containing protons rather than deuterons. The very large kinetic isotope effect (KIE) for soybean lipoxygenase is an example of this phenomenon.

NADH-ubiquinone oxidoreductase (Complex I) couples the transfer of two electrons between NADH and ubiquinone to the translocation of four protons across the membrane. This process provides the driving force for ATP synthase, which harnesses the gradient to produce ATP, but it also assures that few, or no, deuterons arrive on the other (intermembrane) side of the membrane, protecting the ATPase nanomotors.

SAMe, the universal methyl donor, plays a crucial role in regulating oxidative phosphorylation (OXPHOS). It is primarily synthesized in the cytoplasm and imported into the mitochondria via the import protein SAMC. SAMC is the only mitoSAM carrier and is required for OXPHOS and oxidative tricarboxylic acid (TCA) metabolism, showing a strong dependency of mitochondrial health on one-carbon (1C) metabolism. We hypothesize that the importance of SAMe to mitochondrial health is directly linked to the plausible theory that SAMe’s methyl groups are normally highly deupleted.

3. Are microbially synthesized methyl groups and butyrate deuterium depleted? – A careful tracing of multiple metabolic processes taking place in a human cell reveals that they are plausibly designed to greatly restrict the number of deuterons that are in the mitochondrial water. This strategy helps to minimize exposure of the ATPase nanomotors to deuterons. In part, this feat is accomplished through enzymes such as flavoproteins that greatly favor protium over deuterium in their reaction, i.e., that have a high deuterium KIE. The physics usually involves configuring the enzyme to support proton tunneling, since deuterons are much less capable of such tunneling.

Another way to support a reduced deuterium supply to the ATPase nanomotors is to select nutrients that are naturally low in deuterium to feed into the tricarboxylic acid (TCA) cycle. This is what makes the metabolites produced by the gut microbes via hydrogen recycling very significant. The enzyme expressed by anaerobic archaea that metabolize TMA, TMADH, is a flavoprotein with a high deuterium KIE (~ 8.6) due to vibrationally assisted hydrogen tunneling.

This means that the hydrogen recycling that takes place during its metabolism further scrubs deuterium from methylation pathways, while TMA that is left behind becomes enriched in deuterium. This unmetabolized TMA is converted to deuterium-enriched trimethylamine N-oxide (TMAO) in the liver and released into the circulation. Elevated TMAO levels in plasma are associated with increased risk to cardiovascular disease and a long list of other inflammatory diseases, as we will detail in the coming sections.

4. Natural and synthetic choline have different effects on TMAO levels: does deuterium play a role? – The original 2011 paper that first identified TMAO as a risk factor for heart disease, involved feeding mice phosphatidylcholine where all the protons in the methyl groups attached to the nitrogen atom were replaced with deuterium, so that the researchers could trace the products of the nutrient in the body. It turns out that they accidentally conducted an experiment testing what happens when phosphatidylcholine is extremely enriched in deuterium. 🙂 They also determined that supplementation of mice with deuterated choline, TMAO, or betaine resulted in upregulation of multiple macrophage scavenger receptors linked to atherosclerosis. TMAO was not produced if the mice were pretreated with antibiotics or in experiments with germ-free mice, confirming that microbial enzymatic action was a necessary precondition.

A paper in 2021 on human subjects compared choline intake from natural dietary sources with supplemental choline bitartrate and found that the latter but not the former raised blood TMAO levels. Notably, these authors wrote in the conclusion of the abstract: ‘Despite high choline content in egg yolks, healthy participants consuming four eggs daily showed no significant increase in TMAO or platelet reactivity.’ However, TMAO levels rose significantly following synthetic choline bitartrate supplementation. This occurred even though the subjects had normal kidney function, showing that elevated TMAO is not just a consequence of kidney disease.

The authors of the original 2011 study had published a follow-on study on human subjects in 2013, in which they supplemented the subjects with D9-PC, essentially repeating the mouse study but with humans as the subjects. They confirmed that D9-TMAO levels were sharply elevated in the plasma and urine following supplementation. Furthermore, an elevated TMAO level predicted an increased risk of major cardiovascular events, after adjustment for traditional risk factors. This study shows that it may not be phosphatidylcholine vs. choline bitartrate that matters, but rather whether the choline is deuterium depleted or deuterium enriched. By contrast, a survey involving over 14,000 participants found that dietary choline protects from both heart disease and stroke. L-carnitine is also a precursor to TMAO, and a mouse study in which the mice were fed deuterated L-carnitine also showed a sharp increase in plasma TMAO following supplementation, further supporting the idea that deuteration is the primary factor promoting TMAO accumulation.

5. TMAO directs metabolism towards deupleting peroxisomal-mitochondrial crosstalk – The synthesis of TMAO from TMA requires hydrogen peroxide. The source of hydrogen peroxide is via peroxisomal fatty acid chain modifications that utilize molecular oxygen dissolved in plasma to produce SCFAs, ketones, NADH and hydrogen peroxide (H₂O₂). The resulting metabolic water of the reaction is deupleted, as fatty acids are inherently deupleted molecules in biology. Although peroxisomes do not produce ATP directly, they reduce NAD⁺ for proton delivery to mitochondria via membrane-based intracellular proton transporters. Although the partial contribution of TMAO synthesis to intermediary metabolism is yet to be determined to efficiently deplete deuterium, it is certain that none of the above works well in the deuterium preserving glucogenic metabolic state. There is a strict dependence of peroxisomes on long chain saturated fatty acid substrates with particularly lower deuterium-related chemical mass.

Peroxisomal metabolism triggered by TMAO turnover utilizes very long and branched chain fatty acids (A) as well as dissolved molecular oxygen (B) carried in plasma. Peroxisomes produce SCFAs via β-carbon oxidation, ketones, NADH (C) and hydrogen peroxide (B). H₂O₂ is rapidly converted to metabolic water by catalase (CAT) that also yields molecular oxygen for the mitochondrial matrix (D) as well as for other cellular compartments. Peroxisomes can also reduce NAD⁺ for proton delivery to mitochondria via membrane-based intracellular proton transporters. oxidation of very long chain saturated fatty acid β carbons, purportedly of animal source, with the help of molecular oxygen, yields the most deupleted H₂O₂ by weight. CAT, one of the fastest enzymes in biology with that of isomerases, rapidly and irreversibly produces water from H₂O₂, while recycling oxygen. Metabolic hydrogen peroxide of fatty acid breakdown with low deuterium consequently provides ATP synthase nanomotor-sparing protons for energy production. High TMAO with hydrogen peroxide turnover can easily depend on CAT-mediated oxygen recycling.

6. Is TMAO an indicator of deuterium overload in the mitochondria?
6.1 TMAO inhibits S-adenosylhomocysteine hydrolase
6.2 TMAO induces reactive oxygen species
6.3 TMAO suppresses autophagy via PI3K/Akt/mTOR activation
7. TMAO and human diseases
8. Does oxidative stress lead to mitochondrial deupletion? – While oxidative stress is a major contributor to cellular damage, the processes involved in resolving ROS are an essential part of the mechanism by which the cell reduces deuterium levels in the mitochondria. Intracellular ROS are derived mainly from NOX, xanthine oxidase, and the mitochondrial electron-transport chain (mETC). Excess mitochondrial deuterium promotes increased ROS generated by the mETC. Superoxide dismutase (SOD) converts ROS to H₂O₂ , which can release the highly destructive hydroxyl radical in the presence of reduced iron (Fe2+). However, H₂O₂ is an excellent source of deuterium depleted water (DDW) in the mitochondria, as long as there is sufficient mitochondrial glutathione and both glutathione peroxidase and glutathione reductase are adequately expressed. H₂O₂ freely crosses the mitochondrial membrane, and, with adequate antioxidant support, it is rapidly converted to two molecules of DDW, catalyzed by glutathione peroxidase.

9. Do lipid-laden foam cells support mitochondrial deupletion?
10. Archaeobiotics
11. A crucial role for A. muciniphila
12. Strategies to lower TMAO levels – It is clear that elevated plasma TMAO is a risk factor for a broad range of chronic diseases, and therefore it is compelling that a strategy that reduces plasma TMAO should show health benefits. However, simply avoiding foods that provide precursors to TMAO is not likely to be productive. Choline, L-carnitine, and betaine are the primary sources that fuel the methylation pathway. Eggs and seafood, rich sources of these nutrients, also contain many valuable micronutrients and healthy fats that are also essential.

Deuterium depleted water (DDW) is commercially available, at dilution levels as low as 5 ppm. It can be mixed with tap water to simulate natural glacier water, typically containing around 100 ppm deuterium. Although the number of studies on the effects of therapeutic deuterium depletion on various health conditions is small, a review paper found that deuterium depletion has shown promise in preventing and treating cancer, improving long-term memory, enhancing sports performance, and reducing symptoms of depression.

It is apparent that the best way to reduce TMAO levels, while simultaneously boosting methylation supplies, is to promote an abundant colonization of anaerobic archaea in the gut, so that they can clear (fully metabolize) TMA before it has a chance to become TMAO.

13. Discussion – In this paper, we develop the argument that TMAO serves as a marker for excess deuterium in the methylation pathway, and, by extension, in the mitochondria, systemically. While methyl groups have powerful epigenetic effects, the ultimate fate of methyl groups is their metabolism to CO₂ and water that is most likely deuterium depleted in the mitochondria. A microbial imbalance leading to reduced colonization by beneficial bacteria and an overgrowth of pathogenic species is the primary cause of overproduction of TMAO.

14. Conclusions – We have shown that TMAO, a causal factor for many diseases, may act as a marker for gut dysbiosis and for excess deuterium load in mitochondria, systemically. We traced through many of the biological pathways involving 1C metabolism and showed the integral role that gut bacteria play in stripping deuterium from methyl groups.”

https://link.springer.com/article/10.1007/s11306-026-02443-3 “The essential role of hydrogen gas recycling by gut microbes in reducing deuterium load in host mitochondria: is trimethylamine oxide a deuterium sensor?”

I take Now brand taurine, acetyl-L-carnitine, flush-free niacin, and betaine. I asked them whether these products are evaluated for their deuterium content. Will update with their response.

Eat broccoli sprouts for ALS?

March 13, 2026 gettingwell4 4-5 stars Advanced knowledge, Acetylcholine, Cerebellum, Cerebrum, Dopamine, Epigenetics, Glutamate, Hippocampus, Immune system, Limbic system, Lower brain, Memory, Neurochemicals, Serotonin, Stress Brain neurons, Control group, Neurodegenerative disease

A 2026 rodent study investigated sulforaphane’s ability to affect ALS-like symptoms:

“The objective of this study was to evaluate neuroprotective efficacy and safety of sulforaphane (SUFP) in a methylmercury (MMHg⁺)-induced preclinical rat model of amyotrophic lateral sclerosis (ALS). ALS is characterized by progressive motor neuron degeneration and muscle wasting, leading to impairments in gait, swallowing, salivation, and routine motor activities.

64 animals were classified into eight groups: 1st: normal control, 2nd: vehicle control; 3rd: SUFP perse (4 mg/kg, i.p.), 4th: MMHg + (5 mg/kg, p.o.), 5th: MMHg + 5 + SUFP (2 mg/kg, i.p.), 6th: MMHg+ 5 + SUFP (4 mg/kg, i.p.), 7th: MMHg+ 5 + omaveloxolone (OVX) (30 mg/kg, i.p.), and 8th: MMHg + 5 + dimethyl fumarate (DIMT) (50 mg/kg, i.p.). Neurotoxin MMHg + was orally administered at 5 mg/kg for the first 21 days. For the next 22 days, SUFP, OVX, and DIMT were administered intraperitoneally (i.p.).

SUFP modulates neurotransmitter levels such as acetylcholine (A), dopamine (B), GABA (C), glutamate (D), and serotonin (E).

SUFP4 exerted broad neuroprotective effects in ALS pathology by restoring antioxidant proteins (Nrf2, HO-1, SIRT1), suppressing apoptotic (Bax, caspase-3, Bcl-2) and inflammatory markers (TNF-α, IL-1β), and enhancing the anti-inflammatory cytokine IL-10. It also downregulated stress-related signaling pathways (PI3K/Akt, p75NTRECD, MAPKs) associated with neurodegeneration. These molecular effects translated into meaningful functional recovery, as evidenced by improvements in grip strength, locomotor performance, spatial memory, and depressive-like behavior.

Histopathological evaluation demonstrated attenuation of demyelination and preservation of neuronal architecture including the cerebral cortex, hippocampus, striatum, midbrain, and cerebellum. Beyond central neuroprotection, SUFP exerted systemic benefits by normalizing hepatic enzymes, improving skeletal muscle integrity, restoring redox balance, stabilizing neurofilament and myelin-associated proteins, and correcting hematological alterations.

Despite limitations related to study duration and animal sex, this work strongly positions SUFP as a promising, multi-target therapeutic candidate for ALS with both neural and systemic protective efficacy.”

https://link.springer.com/article/10.1007/s12035-026-05683-5 “Sulforaphane-Mediated Multitarget Therapeutic Effects in Methylmercury-Induced ALS-Like Pathology: Comparative Analysis and Multifaceted Approach to Neuroprotection and Systemic Recovery” (not freely available) Thanks to Dr. Sidharth Mehan for providing a copy.

Unlike A Nrf2 treatment for ALS?, this study didn’t present evidence that its treatment compound was effective for preventing ALS. For one thing, currently-known disease factors involving heat shock proteins and associated genes, some of which are Nrf2 targets, weren’t investigated.

Two Nrf2 activators were used in both studies as comparators of Nrf2 activation effects. Neither omaveloxolone nor dimethyl fumarate are ALS causal treatments, though, and have undesirable side effects.

A human equivalent of this study’s higher sulforaphane dose is ((4 mg x .162) x 70 kg) = 45 mg. 45 mg of sulforaphane might be too much to consistently take at one time because of unpalatability. But I documented taking an estimated 52 mg for a year during 2020-2021 by eating microwaved 3-day-old broccoli sprouts twice a day.

A Nrf2 / NAD+ connection?

December 19, 2025January 9, 2026 gettingwell4 4-5 stars Advanced knowledge, Acetylcholine, Dopamine, Epigenetics, Glutamate, Hippocampus, Immune system, Limbic system, Neurochemicals, Serotonin, Stress Control group, Genetic factors, Neurodegenerative disease, Prefrontal cortex

Here are two 2025 papers, starting with a rodent study that investigated interactions between the Nrf2 and kynurenine pathways:

“Exposure to the tryptophan metabolite kynurenine and its electrophilic derivative kynurenine-carboxyketoalkene (Kyn-CKA) leads to an increase in the abundance of transcription factor Nrf2 and induction of Nrf2-target genes. The Keap1/Nrf2 system is the main orchestrator of cellular defence against environmental stress, most notably oxidative and inflammatory stress.

Nrf2 can be activated pharmacologically by small molecules, the majority of which are electrophiles and oxidants that modify specific cysteine-based sensors in Keap1. C151 in Keap1 is the target of the isothiocyanate sulforaphane, a classical Nrf2 activator that has been employed in ∼90 clinical trials, as well as for the two Nrf2 activators that are clinically in use: dimethyl fumarate, for relapsing remitting multiple sclerosis, and omaveloxolone, for Friedreich’s ataxia.

Kynurenine is an endogenous metabolite derived from the essential amino acid tryptophan. Kynurenine and its metabolites, such as the electrophilic kynurenine-carboxyketoalkene (Kyn-CKA), have been demonstrated to activate Nrf2 in other pathologies, including sickle cell disease, attenuating inflammation. Moreover, identification of the gene encoding the kynurenine-metabolising enzyme kynureninase as a gene transcriptionally upregulated by Nrf2, provides a plausible negative feedback regulatory mechanism.

Because kynurenine is not electrophilic, whereas its metabolite Kyn-CKA is, we considered the possibility that Kyn-CKA is the actual Nrf2 activator. Using biochemical and cell-based assays, we found that Kyn-CKA reacts with C151 in the BTB domain of Keap1 and increases the thermostability of Keap1, indicating target engagement. Consequently, Nrf2 accumulates and induces transcription of antioxidant/electrophile-responsive element (ARE/EpRE)-driven genes.

These findings demonstrate that Kyn-CKA targets C151 in Keap1 to derepress Nrf2, and reveal that Nrf2 is a main contributor to the anti-inflammatory activity of Kyn-CKA in macrophages.”

https://www.sciencedirect.com/science/article/pii/S2213231726000078 “The electrophilic metabolite of kynurenine, kynurenine-CKA, targets C151 in Keap1 to derepress Nrf2”

A review subject was targeting nicotinamide adenine dinucleotide, oxidized form (NAD⁺) for clinical use:

“Mammalian NAD⁺ biosynthesis includes four known pathways, primarily occurring in cytoplasm:

(a) the NRH pathway;

(b) the salvage pathway;

(c) the Preiss–Handler pathway; and

(d) the kynurenine pathway.

The de novo kynurenine pathway metabolizes tryptophan (Trp) to NAD⁺, producing various intermediates that serve as biomarkers for different diseases. These intermediates show alterations in various pathological conditions.

While kynurenine and its metabolic derivatives are intermediates in the de novo NAD⁺ biosynthesis pathway, these are also produced independently in various physiological contexts, particularly in immune cells, where they act as immunomodulatory compounds.”

https://www.nature.com/articles/s43587-025-00947-6 “Emerging strategies, applications and challenges of targeting NAD⁺ in the clinic” (not freely available) Thanks to Dr. Jianying Zhang for providing a copy.

This second paper above showed a graphic of the Nrf2 and kynurenine pathways together in a diagram showing relationships between NAD⁺ augmentation and the hallmarks of aging, but didn’t elaborate other than labeling their box Dysbiosis. So how these two pathways interact is better outlined in the first paper above with explaining how a kynurenine-metabolizing enzyme is one of the hundreds of Nrf2 target genes, creating a natural feedback loop between Nrf2 activation and the kynurenine pathway.

These reviewers also lumped SIRT1 in their Dysbiosis box, and into several other boxes, probably due to the penultimate coauthor’s influence:

However, repeating something over and over doesn’t make it scientifically valid regardless of the number of citations. Or, as a 2022 review Sirtuins are not conserved longevity genes concluded:

“A global pursuit of longevity phenotypes was driven by a mixture of framing bias, confirmation bias, and hype. Review articles that propagate these biases are so rampant that few investigators have considered how weak the case ever was for sirtuins as longevity genes.

Acknowledging that a few positive associations between sirtuins and longevity have been identified after thousands of person-years and billions of dollars of effort, we review the data and suggest rejection of the notions that sirtuins (i) have any specific connection to lifespan in animals and (ii) are primary mediators of the beneficial effects of NAD repletion.”

Practice what you preach, or shut up

April 20, 2025April 20, 2025 gettingwell4 0-1 star Wasted resources, Acetylcholine, Amygdala, Anterior cingulate cortex, Beliefs, Brain development, Brain hemispheres, Brainstem, Cerebellum, Cerebrum, Cortisol, Dopamine, Epigenetics, Glutamate, Hippocampus, Hypothalamus, Immune system, Limbic system, Locus coeruleus, Lower brain, Memory, Neurochemicals, Serotonin, Stress, Thalamus Brain neurons, Control group, Genetic factors, Infants, Neural plasticity, Neurodegenerative disease, Prefrontal cortex

A 2025 review subject was sulforaphane and brain health. This paper was the latest in a sequence where the retired lead author self-aggrandized his career by citing previous research.

He apparently doesn’t personally do what these research findings suggest people do. The lead author is a few weeks older than I am, and has completely white hair per an interview (Week 34 comments). I’ve had dark hair growing in (last week a barber said my dark hair was 90%) since Week 8 of eating broccoli sprouts every day, which is a side effect of ameliorating system-wide inflammation and oxidative stress.

If the lead author followed up with what his research investigated, he’d have dark hair, too. Unpigmented white hair and colored hair are both results of epigenetics.

Contrast this lack of personal follow-through of research findings with Dr. Goodenowe’s protocol where he compared extremely detailed personal brain measurements at 17 months and again at 31 months. He believes enough in his research findings to personally act on them, and demonstrate to others how personal agency can enhance a person’s life.

It’s every human’s choice whether or not we take responsibility for our own one precious life. I’ve read and curated on this blog many of this paper’s references. Five years ago for example:

So do more with their information than just read.

https://www.mdpi.com/2072-6643/17/8/1353 “Sulforaphane and Brain Health: From Pathways of Action to Effects on Specific Disorders”

Polyphenol Nrf2 activators

December 19, 2024May 3, 2025 gettingwell4 2-3 stars Required further work, Acetylcholine, Amygdala, Cerebrum, Cortisol, Dopamine, Epigenetics, Glutamate, Hippocampus, Hypothalamus, Immune system, Limbic system, Memory, Neurochemicals, Oxytocin, Serotonin, Stress, Vasopressin Brain neurons, Control group, Genetic factors, Neural plasticity, Neurodegenerative disease, Prefrontal cortex

Two 2024 reviews by the same group that published Sulforaphane in the Goldilocks zone investigated dietary polyphenols’ effects as “hormetic nutrients”:

“Polyphenols display biphasic dose–response effects by activating at a low dose the Nrf2 pathway resulting in the upregulation of antioxidant vitagenes [see diagram]. We aimed to discuss hormetic nutrients, including polyphenols and/or probiotics, targeting the Nrf2 pathway and vitagenes for the development of promising neuroprotective and therapeutic strategies to suppress oxidative stress, inflammation and microbiota deregulation, and consequently improve cognitive performance and brain health.

Hormetic nutrition through polyphenols and/or probiotics targeting the antioxidant Nrf2 pathway and stress resilient vitagenes to inhibit oxidative stress and inflammatory pathways, as well as ferroptosis, could represent an effective therapy to manipulate alterations in the gut microbiome leading to brain dysfunction in order to prevent or slow the onset of major cognitive disorders. Notably, hormetic nutrients can stimulate the vagus nerve as a means of directly modulating microbiota-brain interactions for therapeutic purposes to mitigate or reverse the pathophysiological process, restoring gut and brain homeostasis, as reported by extensive preclinical and clinical studies.”

https://www.mdpi.com/2076-3921/13/4/484 “Hormetic Nutrition and Redox Regulation in Gut–Brain Axis Disorders”

I’m not onboard with this study’s probiotic assertions because most of the cited studies contained unacknowledged measurement errors. Measuring gut microbiota, Part 2 found:

“The fecal microbiome does not represent the overall composition of the gut microbiome. Despite significant roles of gut microbiome in various phenotypes and diseases of its host, causative microbes for such characteristics identified by one research fail to be reproduced in others.

Since fecal microbiome is a result of the gut microbiome rather than the representative microbiome of the GI tract of the host, there is a limitation in identifying causative intestinal microbes related to these phenotypes and diseases by studying fecal microbiome.”

These researchers also erroneously equated isothiocyanate sulforaphane’s Nrf2-activating mechanisms with polyphenols activating Nrf2.

This research group did better in clarifying polyphenols’ mechanisms in a review of hormetic dose-response effects of the polyphenol rosmarinic acid:

“This article evaluates whether rosmarinic acid may act as a hormetic agent, mediating its chemoprotective effects as has been shown for similar agents, such as caffeic acid, a derivative of rosmarinic acid.

Rosmarinic acid enhanced memory in institute of cancer research male mice in the Morris water maze (escape latency).

Of importance in the evaluation of rosmarinic acid are its bioavailability, metabolism, and tissue distribution (including the capacity to affect and/or cross the BBB and its distribution and half-life within the brain). In the case of polyphenols, including rosmarinic acid, they are typically delivered at low doses in the diet and, in most instances, they do not escape first-pass metabolism, with the prominent chemical forms being conjugates of glucuronides and sulfates, with or without methylation.

These conjugated metabolites are chemically distinct from the parent compound, showing considerable differences in size, polarity, and ionic form. Their biological actions are quite different from the parent compound.

Bioavailability studies reveal that maximum concentrations in plasma typically do not exceed 1 µM following consumption of 10–100 mg of a single phenolic compound, with the maximum concentration occurring typically less than 2 h after ingestion, then dropping quickly thereafter. In the case of the in vitro studies assessed herein, and with few exceptions, most of the studies employed concentrations >10 µM with some studies involving concentrations in the several hundred µM range, with the duration of exposure typically in the range of 24–72 h, far longer duration than the very short time interval of a few minutes to several hours in human in vivo situations.

We strongly recommend that all experiments using in vitro models to study biological responses to dietary polyphenols use only physiologically relevant flavonoids and their conjugates at appropriate concentrations, provide evidence to support their use, and justify any conclusions generated. When authors fail to do this, referees and editors must act to ensure that data obtained in vitro are relevant to what might occur in vivo.”

https://www.degruyter.com/document/doi/10.1515/med-2024-1065/html “The chemoprotective hormetic effects of rosmarinic acid”

An elevator pitch for plasmalogen precursors

November 24, 2024November 24, 2024 gettingwell4 4-5 stars Advanced knowledge, Acetylcholine, Dopamine, Epigenetics, Glutamate, Hippocampus, Immune system, Limbic system, Lower brain, Memory, Neurochemicals, Serotonin, Stress, Thalamus Brain neurons, Genetic factors, Infants, Neurodegenerative disease

An excerpt from the latest video at Dr. Goodenowe’s Health Matters podcast, Episode 7 “The Truth about Parkinson’s”, starting at 50:30:

“What’s exciting about this community medicine focus that we’ve switched to which basically says: How do we develop technologies in a way that they can be incorporated into a community model versus a pharmaceutical drug model? People can actually do I would say self-experiment just the way you self-experiment with your own diet because these are fundamentally dietary nutrition molecules.

Could you give me an elevator pitch because there are probably people listening who are thinking what is this plasmalogen precursor and for sure how is it having this dramatic effect?

Plasmalogens are the most important nutrient that nobody knows about. Normally you don’t know about it because the body is usually pretty good at making them. What makes plasmalogens unique is that your body makes them kind of like cannon fodder, the first group of people that go into war. Your body throws them out for destruction. They absorb oxidative stress and get destroyed in the process.

They’re stored in your cell membranes. 50% of the membranes of your heart are these plasmalogen molecules. When your heart gets inflamed, what your heart does is it dumps these plasmalogens out of its membranes to douse the flame of inflammation. After inflammation is under control, your body naturally builds these things back up again.

But if you have an inability to make enough plasmalogens, these inflammation events knock you down and keep you down. So plasmalogen precursors are critical for maintaining high levels of plasmalogens across your body, not just in your brain (30% of the lipids in your brain) but in your heart, your lungs, your kidneys.”

Brain restoration with plasmalogens, Part 2

October 7, 2024October 7, 2024 gettingwell4 5+ stars Premium, Acetylcholine, Amygdala, Brain development, Brainstem, Cerebellum, Cerebrum, Dopamine, Hippocampus, Hypothalamus, Limbic system, Locus coeruleus, Lower brain, Memory, Neurochemicals, Stress Brain neurons, Control group, Corpus callosum, Infants, Neurodegenerative disease

This September 2024 presentation adds data points and concepts to Part 1:

“Your brain is dynamically connected to and adaptively responsive to its environment.

You are in control of this environment (nutrition, stimulation, adversity).

Need to measure the environment (lab testing, physiology) and adaptive response to the environment (MRI) to optimize your environment (nutrition, lifestyle) to achieve optimal brain structure, function, health, and longevity.

From a global cortical volume and thickness perspective, 17 months of high dose plasmalogens reversed about 15 years of predicted brain deterioration. 31 months reversed almost 20 years. So you can get more out of life.”

https://drgoodenowe.com/immortal-neurology-building-maintaining-an-immortal-brain/

Dr. Goodenowe also added case studies of two patients:

1. A 50-year-old woman with MS who had been legally blind in one eye for 32 years who regained sight in that eye after eight months of supplementation.

“This is the adaptability of the human brain. Her eye is not actually impaired. What’s impaired is the ability, the adaptability of the brain to the signal of light, to actually start interpreting what that light signal is.”

2. A 61-year-old man with dementia from firefighting work for the U.S. Navy in a toxic environment with head injuries after nine months of supplementation.

“The brain can heal itself is the point of the story. His executive function skills in everyday life are getting better.”

Maintaining your myelin, Part 1

April 25, 2024April 27, 2024 gettingwell4 4-5 stars Advanced knowledge, Acetylcholine, Brain development, Brainstem, Cerebellum, Cerebrum, Epigenetics, Glutamate, Hypothalamus, Immune system, Limbic system, Lower brain, Memory, Neurochemicals, Stress, Thalamus Brain neurons, Control group, Corpus callosum, Critical period, Embryo development, Genetic factors, Infants, Neural plasticity, Neurodegenerative disease, Prefrontal cortex

Three papers on myelin and oligodendrocytes, starting with a 2023 review:

“Myelin is the spiral ensheathment of axons by a lipid and cholesterol-rich glial cell membrane that reduces capacitance and increases resistance of the axonal membrane. Axonal myelination speeds up nerve conduction velocity as a function of axon diameter.

While myelination proceeds rapidly after birth in the peripheral nervous system, central myelination is a spatially and temporally more regulated process. Ongoing myelination of the human brain has been documented at up to 40 years of age. This late myelination in the adult cortex is followed by exhaustion of oligodendrocyte precursor cells (OPC) with senescence and a gradual loss of myelin integrity in the aging brain.

The brain is well known for its high energy demands, specifically in gray matter areas. In white matter tracts, energy consumption is lower. Myelination poses a unique challenge for axonal energy generation where myelin sheaths cover more than 95% of the axonal surface areas.

Oligodendrocytes help support axonal integrity. Oligodendrocytes survive well in the absence of mitochondrial oxidative phosphorylation, and without signs of myelin loss, cell death, neurodegeneration or secondary inflammation.

Glycolysis products of oligodendroglial origin are readily metabolized in axonal mitochondria. Oligodendroglial metabolic support is critical for larger and faster-spiking myelinated axons that also have a higher density of mitochondria. An essential requirement for the direct transfer of energy-rich metabolites from oligodendrocytes to the myelinated axonal compartment is ‘myelinic channels’ within the myelin sheath.

Interactions of oligodendrocytes and myelin with the underlying axon are complex and exceed the transfer of energy-rich metabolites. Continuous turnover of myelin membranes by lipid degradation and fatty acid beta-oxidation in mitochondria and peroxisomes leads to recycling of acetate residues by fatty acid synthesis and membrane biogenesis.

In human multiple sclerosis (MS) and its animal model myelin oligodendrocyte glycoprotein-experimental autoimmune encephalomyelitis (MOG-EAE), acute inflammatory demyelination is followed by axonal degeneration in lesion sites that is mechanistically not fully understood. It is widely thought that demyelination and the lack of an axon-protective myelin sheath in the presence of numerous inflammatory mediators are the main causes of axon loss.

But unprotected axons improve rather than worsen the overall clinical phenotype of EAE mice which exhibited the same degree of autoimmunity. Thus, ‘bad myelin is worse than no myelin’ because MS-relevant myelin injuries perturb the integrity of myelinic channels and metabolic support.

Dysfunctional or injured oligodendrocytes that do not allow for compensation by any other cell types turn the affected myelin ensheathment into a burden of the underlying axonal energy metabolism, which causes irreversible axon loss. Any loss of myelin integrity, as seen acutely in demyelinating disorders or more gradually in the aging brain, becomes a risk factor for irreversible neurodegeneration.”

https://www.sciencedirect.com/science/article/pii/S0959438823001071 “Expanding the function of oligodendrocytes to brain energy metabolism”

A 2024 review focused on myelin and oligodendrocyte plasticity:

“This review summarizes our current understanding of how myelin is generated, how its function is dynamically regulated, and how oligodendrocytes support the long-term integrity of myelinated axons.

Apart from its unique ultrastructure, there are several other exceptional features of myelin. One is certainly its molecular composition. Another is its extraordinary stability. This was compellingly illustrated when 5000-year-old myelin with almost intact ultrastructure was dissected from a Tyrolean Ice Man.

Myelin is a stable system in contrast to most membranes. However, myelin is compartmentalized into structurally and biochemically distinct domains. Noncompacted regions are much more dynamic and metabolically active than tightly compacted regions that lack direct access to the membrane trafficking machinery of oligodendrocytes.

The underlying molecular basis for stability of myelin is likely its lipid composition with high levels of saturated, long chain fatty acids, together with an enrichment of glycosphingolipids (∼20% molar percentage of total lipids) and cholesterol (∼40% of molar percentage of total lipids). In addition, myelin comprises a high proportion of plasmalogens (ether lipids) with saturated long-chain fatty acids. In fact, ∼20% of the fatty acids in myelin have hydrocarbon chains longer than 18 carbon atoms (∼1% in the gray matter) and only ∼6% of the fatty acids are polyunsaturated (∼20% in gray matter).

With maturation of oligodendrocytes, the plasma membrane undergoes major transformations of its structure. Whereas OPCs are covered by a dense layer of large and negatively charged self-repulsive oligosaccharides, compacted myelin of fully matured oligodendrocytes lacks most of these glycoprotein and complex glycolipids.

Schematic depiction of an oligodendrocyte that takes up blood-derived glucose and delivers glycolysis products (pyruvate/lactate) via monocarboxylate transporters (MCT1 and MCT2) to myelinated axons. Oligodendrocytes and myelin membranes are also coupled by gap junctions to astrocytes, and thus indirectly to the blood–brain barrier.

Adaptive myelination refers to dynamic events in oligodendroglia driven by extrinsic factors such as experience or neuronal activity, which subsequently induces changes in circuit structure and function. Understanding how these adaptive changes in neuron-oligodendroglia interactions impact brain function remains a pressing question for the field.

Transient social isolation during adulthood results in chromatin and myelin changes, but does not induce consequent behavioral alterations. When mice undergo a social isolation paradigm during early life development, they similarly exhibit deficits in prefrontal cortex function and myelination, but these deficiencies do not recover with social reintroduction. This implicates a critical period for social deprivation effects on myelin dynamics. Experience-dependent changes in myelin dynamics may depend on not only the age, brain region, and cell type studied, but also the specific myelin structural change assessed.

Local synaptic neurotransmitter release along an axon not only affects the number of OPCs and oligodendrocytes associated with that axon and local synthesis of myelin proteins, but also drives preferential selection of active axons for myelination over the ensheathment of electrically silenced neighboring axons. Neuronal activity–induced plasticity may preferentially impact brain regions that remain incompletely myelinated compared to more fully myelinated tracts.

Whereas the myelin sheath has been regarded for a long time as an inert insulating structure, it has now become clear that myelin is metabolically active with cytoplasmic-rich pathways, myelinic channels, for movement of macromolecules into the periaxonal space. The myelin sheath and its subjacent axon need to be regarded as one functional unit, which are not only morphological but also metabolically coupled.”

https://cshperspectives.cshlp.org/content/early/2024/04/15/cshperspect.a041359 “Oligodendrocytes: Myelination, Plasticity, and Axonal Support” (not freely available) Thanks to Dr. Klaus-Armin Nave for providing a copy.

A 2024 rodent study investigated oligodendrocyte precursor cell transcriptional and epigenetic changes:

“We used single-cell RNA sequencing (scRNA-seq), single-cell ATAC sequencing (scATAC-seq), and single-cell spatial transcriptomics to characterize murine cortical OPCs throughout postnatal life. One group (active, or actOPCs) is metabolically active and enriched in white matter. The second (homeostatic, or hOPCs) is less active, enriched in gray matter, and predicted to derive from actOPCs. Relative to developing OPCs, both actOPCs and hOPCs are less active metabolically and have less open chromatin.

In adulthood, these two groups are transcriptionally but not epigenetically distinct, indicating that they may represent different states of the same OPC population. If that is the case, then one model is that the parenchymal environment maintains adult OPCs within an hOPC state, whereas those OPCs recruited into white matter or exposed to demyelinated axons may transition toward an actOPC state in preparation for making new oligodendrocytes. We do not yet know the functional ramifications of these differences, but this finding has clear implications for the development of therapeutic strategies for adult remyelination.

Another finding is that developing but not adult actOPC chromatin is preferentially open for binding motifs associated with neural stem cells, transit-amplifying precursors, and neurogenesis. Although this may simply reflect their origin as the immediate progeny of neonatal neural precursor cells, it may also explain why developing but not adult OPCs have the capacity to make neurons in culture.

If we could, at least in part, reverse the global chromatin shutdown that occurs between development and adulthood, then perhaps adult OPCs may reacquire the ability to make neurons or become better able to generate new oligodendrocytes for remyelination.”

https://www.cell.com/stem-cell-reports/fulltext/S2213-6711(24)00077-8 “Single-cell approaches define two groups of mammalian oligodendrocyte precursor cells and their evolution over developmental time”

Continued in Part 2.

Changing a cancerous phenotype

April 9, 2024April 11, 2024 gettingwell4 4-5 stars Advanced knowledge, Acetylcholine, Epigenetics, Glutamate, Immune system, Neurochemicals, Stress Control group, Genetic factors, Neurodegenerative disease

A 2024 Dr. Goodenowe presentation to a professional audience. He ended the presentation by using his 86-year-old father as a case study of treatment to create an inhospitable environment for cancer.

1. Get the body ready

2. Starve the cancer and boost the immune system

3. Characteristics

4. 2019 sample biochemistry

5. 2023 biochemistry (compare HDL (33 vs. 80), see off-the-chart hsCRP, Hcy 16)

6. Treatment details #1

7. Treatment details #2

https://drgoodenowe.com/tfim-2024-recording-now-available/ “Breaking Cancer: The Biochemistry of Cancer Risk Assessment, Prevention, and Treatment—Real Knowledge That You Can Use In Your Practice”

Take acetyl-L-carnitine if you are healthy

December 30, 2023December 30, 2023 gettingwell4 4-5 stars Advanced knowledge, Acetylcholine, Cerebrum, Cortisol, Dopamine, Epigenetics, Glutamate, Hippocampus, Immune system, Limbic system, Memory, Neurochemicals, Serotonin, Stress Brain neurons, Control group, Genetic factors, Neural plasticity, Neurodegenerative disease

Eight 2023 acetyl-L-carnitine / L-carnitine papers, starting with three healthy human studies:

“Thirty healthy volunteers aged between 19 and 52 years were divided randomly into two equal groups, one of which received 1000 mg of L-carnitine (LC) per day over a 12-week period. Total cholesterol and HDL-C increased significantly after supplementation. LC could be useful in impeding development of heart diseases in subjects with low HDL-C.”

https://journaljammr.com/index.php/JAMMR/article/view/5166 “L-Carnitine Increases High Density Lipoprotein-Cholesterol in Healthy Individuals: A Randomized Trial”

Rationale for dose selection wasn’t provided, and the possibility of limited results due to poor study design wasn’t mentioned.

“This study examined effects of 12 weeks of LC supplementation on bone mineral density (BMD) and selected blood markers involved in bone metabolism of postmenopausal women participating in a resistance training (RT) program. Participants’ diets were supplemented with either 1 g of LC-L-tartrate and 3 g of leucine per day (LC group) or 4 g of leucine per day as a placebo (PLA group), in a double-blind fashion.

Because the study protocol consisted of both exercise and supplementation, some favorable changes in the BMD could be expected. However, it was not possible to detect them in the short study period. No significant modification in BMDs of the spine, hip, and total skeleton and no differences between groups in one-repetition maximum could be due to the relatively short duration of the RT intervention.”

https://nutritionandmetabolism.biomedcentral.com/articles/10.1186/s12986-023-00752-1 “Effect of a 3-month L-carnitine supplementation and resistance training program on circulating markers and bone mineral density in postmenopausal women: a randomized controlled trial”

Same comments as the first study regarding no rationale for dose selection, and no mention that limited results were possibly due to an inadequate dose.

In a letter to the editor, a researcher took issue with a study’s methodology:

“Based on finding that intravenous provision with carnitine alone does not increase muscle carnitine accretion, and on the above-reevaluated data, it appears that the basis for carnitine with caffeine being able to increase muscle carnitine levels, and thereby manipulation of muscle metabolism and exercise performance, is uncertain.

Carnitine bioavailability in any group would have been 9.5%. This assessment would be in line with previously recorded values of 5%–18% carnitine bioavailability. It is firmly believed that low carnitine bioavailability is attributable to the inability of kidneys to reabsorb carnitine when the threshold concentration for tubular reabsorption (about 40–60 μmol/L) has passed this value.

The authors’ proposed long-term use of carnitine supplementation as an aid to improve fat oxidation in type II diabetes also seems to lack provision.”

https://physoc.onlinelibrary.wiley.com/doi/10.14814/phy2.15736 “LTE: Does caffeine truly raise muscle carnitine in humans?”

Two genetic studies:

“Our findings suggest that humans have lost a gene involved in carnitine biosynthesis. Hydroxytrimethyllysine aldolase (the second enzyme of carnitine biosynthesis) activity of serine hydroxymethyl transferase partially compensates for its function.”

https://www.researchsquare.com/article/rs-3295520/v1 “One substrate-many enzymes virtual screening uncovers missing genes of carnitine biosynthesis in human and mouse”

“Reported prevalence of primary carnitine deficiency (PCD) in the Faroe Islands of 1:300 is the highest in the world. The Faroese PCD patient cohort has been closely monitored and we now report results from a 10-year follow-up study of 139 PCD patients.

PCD is an autosomal recessive disorder that affects the function of organic cation transporter 2 (OCTN2) high-affinity carnitine transporters, that localizes to the cell membrane and transport carnitine actively inside the cell. Without proper functioning OCTN2 carnitine transporters, renal reabsorption of carnitine is impaired, and as a consequence, patients suffering from PCD have low plasma levels of carnitine. This can disturb cellular energy production and cause fatigue, but also in extreme cases lead to cellular dysfunction and severe symptoms of coma and sudden death.

PCD patients seem to adhere well to L-carnitine treatment, even though they have to ingest L-carnitine tablets at least three times a day. Overall mean L-carnitine dosage was 66.3 mg/kg/day.”

https://onlinelibrary.wiley.com/doi/10.1002/jmd2.12383 “Patients with primary carnitine deficiency treated with L-carnitine are alive and doing well—A 10-year follow-up in the Faroe Islands”

The average daily dose is (66.3 mg x 70 kg) = 4,641 mg. A third of this dose would be about 1.5 g.

The first study of Acetyl-L-carnitine dosing also suggested dosing L-carnitine three times a day because of 10-20% bioavailability.

A study with unhealthy humans:

“This retrospective study analyzed medical records of adult patients between March 2007 and April 2019, with presenting complaints of fatigue and lethargy. Acetyl-L-carnitine has physiological functions similar to L-carnitine but has higher bioavailability and antioxidant properties. This study confirmed that a triple combination therapy with γ-linolenic acid, V. vinifera extract, and acetyl-L-carnitine can improve arterial stiffness in patients.

Our study had some limitations:

The study population may not be representative of the entire Korean adult population.

The study did not have a medication-free control group. Instead, the comparison group comprised patients with medication compliance <80%.

Drop-out rate of the triple-combination therapy (46.2%, 147/318) was relatively high, indicating the possibility of bias due to loss to follow-up.

The study did not consider lifestyle factors such as smoking, diet, and physical activity level, which may affect arterial stiffness.

The study did not examine interactions among drugs comprising the combination therapy, although all drugs are known to positively impact blood vessels.”

https://onlinelibrary.wiley.com/doi/10.1111/jch.14708 “Efficacy of γ-linolenic acid, Vitis vinifera extract, and acetyl-L-carnitine combination therapy for improving arterial stiffness in Korean adults: Real-world evidence”

This study’s acetyl-L-carnitine dose was 500 mg three times a day.

Wrapping up with two rodent studies:

“Acetyl L-carnitine (ALCAR) has proved useful in treatment of different types of chronic pain with excellent tolerability. The present work aimed at evaluating the anti-hyperalgesic efficacy of ALCAR in a model of persistent visceral pain associated with colitis.

The acetyl group in the ALCAR molecule can enhance cholinergic signalling by promoting synthesis of neurotransmitter acetylcholine, which plays an important role in both the enteric and central nervous systems. Acetylcholine signalling has significant antinociceptive effects in development of visceral pain, so it has been proposed as a therapeutic target.

ALCAR significantly reduced establishment of visceral hyperalgesia in DNBS-treated animals, though the interventive protocol showed a greater efficacy than the preventive one.

The interventive protocol partially reduced colon damage in rats, counteracting enteric glia and spinal astrocyte activation resulting from colitis.

The preventive protocol effectively protected enteric neurons from inflammatory insult.

These findings suggest the putative usefulness of ALCAR as a food supplement for patients suffering from inflammatory bowel diseases.”

https://www.mdpi.com/1422-0067/24/19/14841 “Anti-Hyperalgesic Efficacy of Acetyl L-Carnitine (ALCAR) Against Visceral Pain Induced by Colitis: Involvement of Glia in the Enteric and Central Nervous System

This study cited multiple animal studies that found acetyl-L-carnitine was effective for different types of pain. I’ve taken it every day for nineteen years, and haven’t noticed that effect.

“Repetitive mild traumatic brain injuries (rmTBI) may contribute to development of neurodegenerative diseases through secondary injury pathways. Acetyl-L-carnitine (ALC) shows neuroprotection through anti-inflammatory effects, and via regulation of neuronal synaptic plasticity by counteracting post-trauma excitotoxicity. This study aimed to investigate mechanisms implicated in etiology of neurodegeneration in rmTBI mice treated with ALC.

ALC is an endogenously produced carnitine metabolite present in tissue and plasma, and readily crosses the blood brain barrier, unlike its unacetylated form. ALC is also a commonly available nutritional supplement, with a known safety profile, and had been well-studied for its role in aiding β-oxidation of long chain fatty acids in the mitochondria.

While some studies have shown promise for improving clinical and psychometric outcomes in individuals with probable Alzheimer’s disease (AD) and mild cognitive impairment, other studies that included participants with moderate AD progression were less conclusive. It may be that this lack of improvement is related to a therapeutic window of opportunity. Once neurodegenerative mechanisms have commenced, a reversal of these processes is not attainable.

There is currently a lack of evidence for safe therapeutics that can be administered long-term to reduce the risk of individuals developing cognitive and neuropsychological deficits after rmTBIs. Prophylactic ALC treatment in a paradigm of neurotrauma may be a way to maximize its therapeutic potential.

While brain structures display differential vulnerability to insult as evidenced by location specific postimpact disruption of key genes, this study shows correlative mRNA neurodegeneration and functional impairment that was ameliorated by ALC treatment in several key genes. ALC may mitigate damage inflicted in various secondary neurodegenerative cascades – confirmed by improvements in behavioral and cognitive function – and contribute to functional protection following rmTBI.”

https://www.frontiersin.org/articles/10.3389/fphar.2023.1254382/full “Repetitive mild traumatic brain injury-induced neurodegeneration and inflammation is attenuated by acetyl-L-carnitine in a preclinical model”

I read many traumatic brain injury papers earlier this year, but only curated two in Brain endothelial cells. I came away thinking that there’s no permanent recovery from TBIs, as just symptoms are effectively treated.

Most TBIs happen to old people who have diminished brain reserves. I didn’t see studies that factored in evidence of what happened earlier in injured people’s lives that created TBI susceptibility but wasn’t remembered.

Unlike other years, I haven’t watched any football this season. It’s unsettling that transient entertainment value continues to take precedence over permanent effects on players’ lives.

What you expect may not be what you find

December 12, 2023December 12, 2023 gettingwell4 2-3 stars Required further work, Acetylcholine, Epigenetics, Glutamate, Hippocampus, Immune system, Limbic system, Memory, Neurochemicals, Stress Brain neurons, Control group, Genetic factors, Happiness, Neural plasticity, Neurodegenerative disease

I’m halfway through a 90-day trial of plasmalogens coincident with improving peroxisomal function via resistance exercise and time-restricted eating. I haven’t curated related 2023 papers I’ve read concerning plasmalogens, peroxisomes, sphingolipids, ceramides, and mitochondrial interactions with these, mainly because I haven’t seen human-pertinent aspects similar to Dr. Goodenowe’s efforts.

The 2023 papers I’ve read have more to do with researcher incentives rather than actual human benefits. I’d guess that researchers care about these related subjects to the extent that they want to be the first to publish arcane details about them, like peroxisomes in the parotid salivary gland.

One area I expected to see a difference at the regimen’s beginning was in my peripheral nervous system Schwann cells. Instead, I had taste and smell improvements in my primary olfactory nervous system olfactory ensheathing cells, which are highly similar to Schwann cells. I was also happy to experience an immediate halt to my ulnar nerve elbow pain after what I interpret as ProdromeNeuro effects and perhaps coincident ProdromeGlia effects on items upstream of Schwann cells.

Here are three papers on Schwann cells that I haven’t yet seen as applicable to my current regimen, starting with a 2022 review:

“We summarise contributions of neurotransmitter receptors in regulation of morphogenetic events of glial cells, with particular attention paid to the role of acetylcholine receptors in Schwann cell physiology. This redundant and complex integrated regulation system could be explained as a mechanism of preserving glial cell physiology. In case of a single receptor signalling dysfunction, other neurotransmitters can overcome the deficit, preserving functions of glia and health of the nervous system.

Increased knowledge in medicinal chemistry and in bioinformatics accompanied by drug delivery studies might open a fascinating therapeutic perspective for cholinergic mimetics for treatment of several nervous system pathologies, and in reducing neuroinflammation both in the central and peripheral nervous systems.”

https://www.mdpi.com/2227-9059/11/1/41 “Emerging Roles of Cholinergic Receptors in Schwann Cell Development and Plasticity”

A 2023 study investigated the vagus nerve’s Schwann cells’ impact with gut function:

“The vagus nerve is the longest extrinsic cranial nerve in the body. It regulates gut physiology through the intrinsic nervous system (myenteric and submucosal plexus) and enteric glial cells interactions, which participate in controlling intestinal absorption, secretion, immune homeostasis, and motility.

Normal intestinal motility is critical for nutrition assimilation and several biological functions. The loss of normal gut function aggravates inflammation, oxidative stress, and other cellular stressors.”

https://bmcbiotechnol.biomedcentral.com/articles/10.1186/s12896-023-00781-x “A critical role for erythropoietin on vagus nerve Schwann cells in intestinal motility”

I haven’t curated a Buck Institute for Research on Aging sponsored study for a while, since their 2015 A study of how “age” itself wasn’t a causal factor for wound-healing differences detracted from science and their 2020 Linear thinking about biological age clocks wasted resources.

This 2023 rodent study couldn’t investigate anything outside of Buck’s limited paradigm’s echo chamber. This sponsor would rather break their arms patting themselves on their backs pretending they’re advancing science than fund relevant human research successes that do advance science:

“Following peripheral nerve injury, successful axonal growth and functional recovery require Schwann cell (SC) reprogramming into a reparative phenotype. This work provides the first characterization of senescent SCs and their influence on axonal regeneration in aging and chronic denervation.”

https://www.embopress.org/doi/full/10.15252/emmm.202317907 “Senescent Schwann cells induced by aging and chronic denervation impair axonal regeneration following peripheral nerve injury”

Building your plasmalogen savings account

December 8, 2023January 6, 2024 gettingwell4 4-5 stars Advanced knowledge, Acetylcholine, Brain development, Cerebrum, Dopamine, Epigenetics, Immune system, Limbic system, Lower brain, Memory, Neurochemicals, Stress Brain neurons, Control group, Embryo development, Genetic factors, Infants, Neural plasticity, Neurodegenerative disease

A webinar from earlier this week with Dr. Goodenowe, a clinical trial facilitator, and a physician:

From the Q&A segment:

“Is there a particular age where it’s recommended to test for plasmalogen levels? And what levels would be considered normal?

That’s a good question. That actually raises this whole concept of optimal health and this concept of aging.

The best way to think about it – we talked about this paycheck-to-paycheck situation, where as long as our bills are paid every day, technically we think we’re normal. But we still feel this sense of health anxiety – if you will – like we just don’t know if my car breaks down, or my water heater breaks down, do I have enough money to pay these events in my life?

That’s what health feels like to a lot of people, because they’re just kind of getting by. From a health perspective, they’re considered normal, but they have no reserve capacity, and they have no vitality in terms of health.

Plasmalogens are a type of molecule that you build a savings account of, over years, over decades. Your heart builds them up, your brain builds them up, and you slowly accumulate them. Then when you get an oxidative stress like what’s happening now in today’s world with all the covid and myocarditis and brain fog – a lot of these things are being caused because that reserve of plasmalogens has been depleted.

We want plasmalogens for a longevity perspective. There are other situations that can have low plasmalogens, other things can really knock your plasmalogens down.

So you want to start early, you want to build a savings account, and you want to maintain it. Maintain health and function, and create a sustained surplus for optimal health, for optimal neuromuscular performance.”

A good activity for bad weather days

November 26, 2023January 19, 2025 gettingwell4 4-5 stars Advanced knowledge, Acetylcholine, Beliefs, Brain hemispheres, Cerebellum, Cerebrum, Dopamine, Epigenetics, Glutamate, Immune system, Limbic system, Lower brain, Memory, Neurochemicals, Stress, Thalamus Brain neurons, Control group, Corpus callosum, DNA methylation, Genetic factors, Happiness, Neural plasticity, Neurodegenerative disease, Prefrontal cortex

A free educational series recorded in 2021-2022 available at https://drgoodenowe.com/dr-goodenowes-educational-seminars/ takes the viewer through underlying research and principles of Dr. Goodenowe’s approach to health. It’s advertised as lasting four hours, but took me two days to view.

The series’ discussions and references are background material to better understand later presentations and interviews. Points of interest included:

Seminar B100 shows that the metabolomic profile of people who regularly eat broccoli is different than others.
B109 clarifies how peroxisomal function is improved through resistance exercise and intermittent fasting.
C103 and C104 show how plasmalogens act against neurodegeneration (Parkinson’s disease and multiple sclerosis).

Texts below videos are additional information, not transcripts. C101 text is historically informative.

The B200 ProdromeScan tutorial will take more study. But unlike Labcorp tests, ordering a ProdromeScan requires using a practitioner in Dr. Goodenowe’s network.

I sent the following to Prodrome customer service earlier this month:

Please add me to your approved list for ProdromeScan.

Customer service replied:

“We only add health professionals to an approved list, not individuals.”

I responded:

Good morning. I looked at the websites of doctors who are associated with Dr. Goodenowe who are near me. All of them are too compromised for me to establish a doctor / patient relationship. But I’m glad they left up their blog posts from earlier this decade so I could see who they really were before I reached out to them.

I request an exception to the policy.

Customer service replied:

“There is no exception that can be made to this policy. You need to be a patient of a certified practitioner.”

I’ll escalate my request before my 90-day trial of Prodrome Glia and Neuro products ends so I can get an appropriate metabolomic status. Right now, I won’t involve someone I can’t trust just to know my ProdromeScan information that’s additional to next week’s Labcorp tests.

My treatment-result metabolomic data is probably not mature today on Day 29 of ProdromeGlia and ProdromeNeuro supplementation, resistance exercise, and intermittent fasting. I otherwise wouldn’t have experienced these two events:

I’m happy that after starting normal ProdromeGlia and ProdromeNeuro doses at Day 1, then taking a ProdromeGlia loading dose starting from Day 11, my sense of smell and taste improved by Days 13-14.
Still jazzed that starting a ProdromeNeuro loading dose at Day 22 immediately resolved my left ulnar nerve pain that had been intermittently bothering me for over 5 years.

I have a quibble with the series’ recommendations for taking N-acetyl cysteine. Relevant views and research:

Switch on your Nrf2 signaling pathway pointed out:

“We use NAC in the lab all the time because it stops an Nrf2 activation. So that weak pro-oxidant signal that activates Nrf2, you switch it off by giving a dose of NAC. It’s a potent antioxidant in that right, but it’s blocking signalling. And that’s what I don’t like about its broad use.”

If someone bombs themself everyday with antioxidants, they’re doing nothing to improve training of their endogenous systems’ defensive functions. What happens when they stop bombing? One example was a 2022 human study that found GlyNAC-induced improvements dissolved back to baseline after supplements stopped.

Also, Precondition your defenses with broccoli sprouts highlighted NAC’s deleterious effects on autophagy and lysosome functions:

“TFEB activity is required for sulforaphane (SFN)-induced protection against both acute oxidant bursts and chronic oxidative stress. SFN-induced TFEB nuclear accumulation was completely blocked by pretreatment of cells by N-acetyl-cysteine (NAC), or by other commonly used antioxidants. NAC also blocked SFN-induced mRNA expression of TFEB target genes, as well as SFN-induced autophagosome formation.”

If a secondary goal of taking NAC per is also necessary for the formation of glutathione, taurine can do that without an antioxidant bomb. Taurine supplementation will free up cysteine to do things other than synthesize taurine, like synthesize glutathione.

Brain restoration with plasmalogens

November 20, 2023October 7, 2024 gettingwell4 5+ stars Premium, Acetylcholine, Amygdala, Anterior cingulate cortex, Beliefs, Brain development, Brain hemispheres, Brainstem, Cerebellum, Cerebrum, Dopamine, Epigenetics, Glutamate, Hippocampus, Hypothalamus, Limbic system, Locus coeruleus, Lower brain, Memory, Neurochemicals, Primal Therapy, Serotonin, Stress, Thalamus Brain neurons, Control group, Corpus callosum, Dr. Arthur Janov, Genetic factors, Levels of consciousness, Neural plasticity, Neurodegenerative disease, Prefrontal cortex, Unconscious feelings, Unconscious memories

In this 2023 presentation for a professional audience, Dr. Dayan Goodenowe showed an example of what could be done (in the form of what he personally did at ages 53-54) to restore and augment brain structure and function over a 17-month period by taking plasmalogens and supporting supplements:

https://drgoodenowe.com/recording-of-dr-goodenowes-presentation-from-the-peptide-world-congress-2023-is-now-available/

Follow the video along with its interactive transcript. Restorative / augmentative supplements included:

Forms of MRI used to document brain structure and function changes were:

Brain volume decreases are the rule for humans beginning at age 40. Dr. Goodenowe documented brain volume increases, which aren’t supposed to happen, but did per the below slide of overall results:

“From a global cortical volume and thickness perspective, 17 months of high-dose plasmalogens reversed ~15 years of predicted brain deterioration.”

Specific increased adaptations in brain measurements over 17 months included:

Cortical thickness .07/2.51 = +3%.
White matter microstructure fractional anisotropy +8%.
Nucleus accumbens volume +30%.
Dopaminergic striatal terminal fields’ volume +18%.
Cholinergic cortical terminal fields’ volume +10%.
Occipital cortex volume +10%.
Optic chiasm volume +225%.
Nucleus basalis connectivity.
Neurovascular coupling signal controlled by noradrenaline integrity.
Amygdala volume +4% and its connectivity to the insula, indicating ongoing anxiety and emotional stress response.
Parahippocampus volume +7%.
Hippocampus fractional anisotropy +5%.

No changes:

Amygdala connectivity to the ventral lateral prefrontal cortex, the same part of the brain that relates to placebo effect.
Hippocampus connectivity.

Decreased adaptations in brain measurements included:

White matter microstructure radial diffusivity -10%.
Amygdala connectivity to the anterior cingulate cortex to suppress / ignore / deny anxiety response.
Amygdala connectivity to the dorsal lateral prefrontal cortex.
Entorhinal cortex volume -14%.
Hippocampus volume -6%.
Hippocampus mean diffusivity (white matter improved, with more and tighter myelin) -4%.

The other half of this video was a lively and wide-ranging Q&A session.

The referenced 2023 study of 653 adults followed over ten years showed what brain deterioration could be expected with no interventions. Consider these annual volume decrease rates to be a sample of a control group:

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2806488 “Characterization of Brain Volume Changes in Aging Individuals With Normal Cognition Using Serial Magnetic Resonance Imaging”

Also see a different population’s brain shrinkage data in Prevent your brain from shrinking.

The daily plasmalogen precursor doses Dr. Goodenowe took were equivalent to 100 mg softgel/kg, double the maximum dose of 50 mg softgel/kg provided during the 2022 clinical trial of cognitively impaired old people referenced in Plasmalogens Parts 1, 2, and 3.

He mentions taking 5 ml in the morning and 5 ml at night because he used the Prodrome oil products. 1 ml of a Prodrome oil plasmalogen precursor product equals 900 mg of their softgel product.

“My brain is trying to minimize long-term effects of pain/stress by suppressing my memory of it. But this can only go on for so long before it becomes an entrenched state.

I have solved the sustenance side of the equation. I need to work harder to solve the environmental side.”

While I agree that we each have a responsibility to ourselves to create an environment that’s conducive to our health, the above phenomenon isn’t necessarily resolvable by changing an individual’s current environment. My understanding is that long-term effects of pain, stress, and related human experiences are usually symptoms of causes that started much earlier in our lives.

Adjusting one’s present environment may have immediate results, but probably won’t have much therapeutic impact on long-term issues. Early life memories and experiences are where we have to gradually go in order to stop being driven by what happened back then.

See Dr. Arthur Janov’s Primal Therapy for its principles and explanations. I started Primal Therapy at a similar age, 53, and continued for three years.

Continued with Part 2.

Plasmalogens, Part 3

November 5, 2023March 31, 2024 gettingwell4 4-5 stars Advanced knowledge, Acetylcholine, Brain development, Brain hemispheres, Brainstem, Cerebellum, Cerebrum, Dopamine, Epigenetics, Hippocampus, Hypothalamus, Immune system, Limbic system, Locus coeruleus, Lower brain, Memory, Neurochemicals, Stress, Thalamus Brain neurons, Control group, Genetic factors, Infants, Neural plasticity, Neurodegenerative disease, Prefrontal cortex

The 2022 plasmalogen clinical trial mentioned in Parts 1 and 2 bypassed peroxisome metabolism of cognitively impaired people per discussion of the below diagram:

Increasing the body’s fasting state with time-restricted eating, and preventing muscle atrophy with resistance exercise, were offered as the two most important ways to improve peroxisomal function.

I didn’t find any relevant 2023 human studies (where I could access the full study) on different non-drug treatments that I was willing to do. A 2023 review outlined aspects of peroxisomes, to include a few older human studies:

“Peroxisomes are small, single-membrane-bound organelles, which are dynamic and ubiquitous. Peroxisomes directly interact with other organelles, such as endoplasmic reticulum, mitochondria, or lysosomes. Peroxisomes exert different functions in various cells through both catabolic and anabolic pathways.

The main functions of peroxisomes can be categorized as reactive oxygen species (ROS) metabolism, lipid metabolism, and ether-phospholipid biosynthesis. Peroxisomes also play important roles in inflammatory signaling and the innate immune response.”

https://www.sciencedirect.com/science/article/pii/S2667325823001425 “Peroxisome and pexophagy in neurological diseases”

1. Since I haven’t recently tried the two main ways to improve peroxisomal function, I’ll give them a go over the next three months:

Expect to get my feeding timeframe to within eight hours. Don’t know about making it short like 6 hours, because my first meal of the day is 35 calories of microwaved cruciferous sprouts, then I wait an hour before eating anything else.
Resistance exercise progress should be measurable, as I recorded exercises during the first ten weeks of eating broccoli sprouts every day 3.5+ years ago.

2. Don’t know that I’ll recognize any cognitive improvements to the extent I did during Week 9.

I don’t have a young brain anymore, and I’m sure some decline could be measured in memory tests. But I’m not going to become a lab rat.
There’s an occasional annoyance that’s been going on for some time, especially when I’m distracted. It happens when I think of something to do, and it somehow becomes a short-term memory that I did it, instead of going into a Things To Do queue. It’s largely self-correcting. For example, regardless of what I paid, I’ll drive back to the grocery store self-checkout to retrieve a third bag that didn’t make it home. A pink-haired employee said young people leave their paid-for groceries behind all the time. It’s usually more of a reality disconnect for me than forgetfulness, because I have a memory that I performed the action. Definitely room for improvement.

3. Don’t know that I’d see biochemical changes such as some described in Part 1. Maybe I’ll move up an annual physical to compare it with the last one in May?

I already have very little oxidative stress, very little inflammation, low triglycerides, high HDL, and no major improvements are indicated on CBC / CMP / lipid panels.
Take supplements to ensure other things like acetylcholine neurotransmitter availability, one-carbon / methylation metabolism, vitamin / mineral adequacy.

4. I started the two Prodrome plasmalogen precursor supplements (ProdromeGlia and ProdromeNeuro) a week ago, and take their standard doses. My thought is that resultant plasmalogens won’t degrade very much if their primary use isn’t to immediately address oxidative stress and inflammation. That could give these extra plasmalogens a chance to make larger homeostatic contributions in myelin and membrane areas.

I don’t expect any particular effects to manifest. But I’m interested to see if these two areas would be affected:

My left ulnar nerve has been giving me problems for over five years, and several resistance exercises aggravate it. I’ve had two nerve continuity tests during that time to confirm. Numbness and pain are intermittent, though.
I still take acetaminophen several times a day for other pain.

None of the above treatments are specifically indicated. But if time-restricted feeding and/or extra plasmalogens have an effect on left ulnar or other pain, maybe I’ll be able to make better progress on resistance exercise.

Update #1 11/13/2023

Update #2 11/22/2023

Update #3 12/13/2023 comments

Update #4 1/30/2024

Update #5 3/31/2024