Eat broccoli sprouts for your liver, Part 2

A 2023 review cited Part 1 and caught up other relevant research on sulforaphane effects through early 2023:

“A growing number of studies have reported that sulforaphane (SFN) could significantly ameliorate hepatic steatosis and prevent development of fatty liver, improve insulin sensitivity, attenuate oxidative damage and liver injury, induce apoptosis, and inhibit proliferation of hepatoma cells through multiple signaling pathways.

SFN inhibits lipogenesis and oxidative stress while enhancing lipid droplet degradation through modulating expression of genes involved in lipid synthesis, metabolism, and oxidation. SFN modulates autophagy, lipolysis, mitochondrial function, and ER stress to alleviate fatty liver through AMPK-, AHR-, PGC1α-, and FGF21-mediated pathways.

fphar-14-1256029-g001

There is still a gap between basic research and clinical application of SFN. More efficient delivery systems and precise dose schedules of SFN are expected to be developed in future studies, which would improve its solubility, stability, and bioavailability, and reduce inter-individual variations in humans.”

https://www.frontiersin.org/articles/10.3389/fphar.2023.1256029/full “Therapeutic potential of sulforaphane in liver diseases: a review”


These reviewers did alright gathering papers. That’s only part of what needed to be done, with the other part being reading, understanding, and interpreting these papers.

First example: Sulforaphane in the Goldilocks zone was cited [reference 12], but applicability to this review with its main point “The stimulatory zone for in vitro studies proved to be consistently in the 1-10 μM range” as in Figure 10 “Effects of R-sulforaphane on phase II enzyme activation in precision-cut liver slices of young adult male Albino Wistar rats” wasn’t understood:

figure 10

These reviewers complained:

“Few dose-response studies on SFN have been reported, and the range of its effective doses is unclear. Doses used in most animal studies have exceeded the highest dose of SFN used in humans.”

So it might have taken a little bit more effort, but these reviewers could have highlighted studies where sulforaphane liver treatments were in the 1-10 μM potentially therapeutic range.

Another example: these reviewers said “The half-life of SFN is very short due to its rapid metabolism in the human body.” They missed a point that the second paper in How much sulforaphane is suitable for healthy people? [reference 46] made in section 6.4. “NQO1 Pharmacokinetics following SFN Ingestion:”

“Maximal induction of NQO1 occurred at around 24 hours, declining thereafter (Figure 8). This peak represents an approximate 2.8-fold induction over baseline.

These findings are useful when considering the effect of SFN as an intervention material in acute compared with chronic conditions. A significant increase in NQO1 occurred between 6 and 12 hours, a timeframe that may not be sufficiently responsive for management of an acute state, leaving one to conclude that NQO1 induction is best suited to chronic conditions where a rapid response may not be necessary.”

OMCL2019-2716870.008

Sulforaphane’s effects of inducing NQO1 for its cytoprotective, antioxidant, and other functions lasts for days, regardless of when sulforaphane leaves the bloodstream.

Taurine’s effects on healthspan and lifespan, Part 2

Four 2023 papers that cited Part 1, starting with a review of hypothetical parameters for taurine clinical trials that aren’t going to happen because:

  • Drug companies can’t make money from a research area that’s cheap, not patentable, and readily accessible.
  • Government sponsors are likewise not incentivized to act in the public’s interest per their recent behavior.

“We propose the rationale that an adequately powered randomized-controlled-trial (RCT) is needed to confirm whether taurine can meaningfully improve metabolic and microbiome health, and biological age.

taurine hypothetical trial

Using long-term survival as a primary outcome is desirable but difficult; any demonstrable difference in this outcome will require a substantial sample size with prolonged follow-up (e.g., 5 years or longer) if the effect size is relatively small (or modest at best). Biological age based on DNA methylation biomarkers according to the Levine PhenoAge or newer biological age models is increasingly being recognized as an important dynamic health parameter, and hence it can also be used as a surrogate outcome in assessing benefits of taurine supplementation.

The recent taurine trial on nonhuman primates used an equivalent dose that was between 3 and 6 g per day for an 80-kg person, and this could represent a reasonable dose range for any human RCTs. We believe that a 6-month or longer interventional period matching what was successfully done on nonhuman primates will be an acceptable time frame in assessing potential efficacy of taurine on human metabolic health in a RCT.”

https://www.sciopen.com/article/10.26599/1671-5411.2023.11.004 “Flattening the biological age curve by improving metabolic health: to taurine or not to taurine, that’s the question”

A six-month duration and a 6 grams per day dose were in the above table’s desirable features column, but epigenetic clock measurements weren’t included as an outcome. I’d guess that its omission reflected disagreements among coauthors, because the desirability of using epigenetic clocks as surrogate measures of human healthspan and lifespan was mentioned several times.


Another review:

“As described in the first half of this review, recent advances in omics analysis technology have led to research to detect the causative gene of dilated cardiomyopathy. It has been found that rare mutations in the taurine transporter gene contribute to the development of dilated cardiomyopathy in humans. It is unlikely that a taurine-deficient diet is a factor in dilated cardiomyopathy, but taurine intake may have positive cardiovascular effects.

The second half summarizes the relationship between taurine and healthspan and lifespan. It is difficult to summarize the effect of age in whole body taurine content, which may vary in species, strain, sex, and age of animal models. Future human studies will clarify the relationship between dietary taurine intake and healthy life expectancy.”

https://www.sciencedirect.com/science/article/pii/S1347861323000749 “Taurine deficiency associated with dilated cardiomyopathy and aging”


A human study investigated brain chemicals that fluctuate with our circadian rhythm:

“We conducted a MRS study at 7 T, where occipital NAD content, lactate, and other metabolites were assessed in two different morning and afternoon diurnal states in healthy participants. Salivary cortisol levels were determined to confirm that the experiment was done in two circadian different physiological conditions.

Although no significant differences in NAD+, NADH, and NAD+/NADH were detected between the morning and afternoon sessions, there was a significant variance difference in NAD+/NADH, with a higher variance of NAD+/NADH redox ratio in the morning.

None of the over 30 measured brain metabolites were significantly affected by the circadian rhythm (CR) except for taurine, which decreased in the afternoon. Further CR studies should consider the prospective measurement of taurine levels in different regions of the human brain, and explore how taurine supplements could impact brain CR metabolism in health and diseases.”

https://www.frontiersin.org/articles/10.3389/fphys.2023.1285776/full “Effect of circadian rhythm on NAD and other metabolites in human brain”

I omitted findings regarding this study’s pathetic Balloon Analogue Risk Task (BART) test. Older studies that drew spurious findings from this video game include:


A rodent study modeled human childhood cataracts:

“Our analysis identified targets that are required for early normal differentiation steps and altered in cataractous lenses, particularly metabolic pathways involving glutathione and amino acids. Glutathione and taurine were spatially altered, and both taurine and the ratio of reduced glutathione to oxidized glutathione, two indicators of redox status, were differentially compromised in lens biology.

1-s2.0-S2213231723002707-ga1_lrg

Dietary amino acid supplementation has been shown to prevent cataract development, and dietary intake of taurine was protective in a glutathione depletion-derived opacity model. This opens up the possibility that dietary supplementation of taurine could be used as a strategy to prevent human congenital cataracts.

Our findings shed light on molecular mechanisms associated with congenital cataracts, and point out that unbalanced redox status due to reduced levels of taurine and glutathione, metabolites already linked to age-related cataracts, could be a major underlying mechanism behind lens opacities that appear early in life.”

https://www.sciencedirect.com/science/article/pii/S2213231723002707 “Unbalanced redox status network as an early pathological event in congenital cataracts”


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Take acetyl-L-carnitine if you are healthy

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:

  1. The study population may not be representative of the entire Korean adult population.
  2. The study did not have a medication-free control group. Instead, the comparison group comprised patients with medication compliance <80%.
  3. 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.
  4. The study did not consider lifestyle factors such as smoking, diet, and physical activity level, which may affect arterial stiffness.
  5. 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.

ijms-24-14841-g001

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.


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Oat sprout stressors

Two 2023 Avena sativa oat sprout studies, starting with one that found different effects during germination from varying temperature and relative humidity:

“This study evaluated effects of temperature (20, 25, and 30°C) and relative humidity (RH, 55, 60, and 65%) as abiotic stressors during oat germination. We identified eighty polyphenols, nine avenanthramides, twelve lignans, and five phytosterols.

  • 100% germination was achieved at 25°C/60% RH from day 3, yielding the longest radicle size.
  • The highest content of most phenolic acids, avenanthramides, and lignans occurred at 30°C/65% RH, where 100% germination was attained by day 5, but with a shorter radicle size.
  • The best flavonoid and phytosterol profile was obtained at 20°C/55% RH, achieving only a 67% germination rate by day 5.

sprouted oat temp rh

By considering germination conditions, end-users can harness the versatility of oat sprouting to meet their specific needs and maximize potential benefits of this promising cereal crop. For instance, manufacturers of functional foods and beverages could consider using sprouts from conditions that yield high polyphenol content for products targeting antioxidant benefits, whereas nutraceutical manufacturers could focus on sprouting conditions that result in elevated levels of avenanthramides, well-known for their health-promoting properties.”

https://www.sciencedirect.com/science/article/abs/pii/S0308814623027917Impact of temperature and humidity conditions as abiotic stressors on the phytochemical fingerprint of oat (Avena sativa L.) sprouts” (not freely available) Thanks to Dr. Iza F. Pérez-Ramírez for providing a copy.


Another study compared and contrasted eight sprouted grains to their ungerminated grains and to each other. I’ll highlight oat sprout results:

“The method used was germination for up to 72 h at temperatures ranging from 19–23°C. Oat germination rate was 80%.

Linoleic acid (omega-6) was the predominant fatty acid in oat grain powder, followed by similar amounts of oleic and palmitic acids and smaller amounts of stearic and linolenic (omega-3) acids. Since omega-6 content remained unchanged and omega-3 quantity increased slightly in sprouted oats, the omega-6/omega-3 ratio decreased.”

https://www.mdpi.com/2304-8158/12/17/3306 “Effect of Germination on Fatty Acid Composition in Cereal Grains”


My kitchen cupboard’s oat sprouting conditions are closer to this second study’s temperature, where relative humidity wasn’t specified. I doubt that kitchen winter-time relative humidity ever rises to the 55% lower threshold of the first study for more than a few minutes.

At this time of year in Sprouting hulled oats, I got a 97% germination rate over three days with an estimated 21°C (70°F) and a relative humidity closer to 30% than 55%. Couldn’t tell you why the first study’s germination rate with 20°C/55% RH was only 67% at day 5, or why the second study’s germination rate was only 80% at day 3 with 19–23°C.


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What you expect may not be what you find

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”


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Building your plasmalogen savings account

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.”


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What is the health utility of white blood cell type count ratios?

This post explores CBC ratios of neutrophils-to-lymphocytes (NLR) and lymphocytes-to-monocytes (LMR) as healthy biomarkers.

Uses of the neutrophils-to-lymphocytes ratio asserted:

A normal range of NLR is between 1–2, and values higher than 3.0 and below 0.7 in adults are pathological.

I saw only one study out of 151 references, reference 61 from 2017, that demonstrated a “below 0.7” range. All of its sampled subjects had sepsis or septic shock, though. Not exactly people from which to derive healthy parameters for the general population.

I looked through all 2023 papers of the 223 papers that cited this review. I didn’t see any that questioned a healthy status of a low neutrophils-to-lymphocytes ratio in humans. Almost all 2023 papers focused on diseases, not health, as if that’s what we want from researchers and medical professionals.

So if a review gets enough citations, its assertions become a fait accompli, elevated to an indisputable fact. Nevermind that unlike study researchers, reviewers aren’t bound to demonstrate evidence from tested hypotheses. Citing paper writers also aren’t obligated to actually read and understand what they cite.


I looked at papers that cited any of the four papers in Uses of the lymphocytes-to-monocytes ratio. There were hundreds of citations over the years, but I didn’t see any 2023 papers that related the LMR to health rather than disease.

The reciprocal monocytes-to-lymphocytes ratio may have prognostic value or “association with” other disease conditions. But do patients care about abstract values such as area under the curve?

Are hormone ratios useful in explaining health? Behavior? Neurobiology? Anything? had a similar situation:

“Analysis of individual variables offers more information and a more accurate picture of underlying relationships.”

This paper suggested by analogy that researching treatments to increase lymphocyte and/or decrease monocyte absolute counts rather than change ratios should be emphasized for health.


Labcorp blood tests from earlier this week came back yesterday. I’ll repeat a paragraph from another blog post that illustrates my viewpoint on them:

“Every explanation of those reference ranges, and optimal ranges built from all-cause mortality statistics, requires a suffix “of people who didn’t positively change their healthspan and lifespan.”

  • What value is there in optimizing (pick a measurement) against those outcomes?
  • Why compare my efforts, or results, or any other aspect of my life, to people who didn’t actionably care about their one precious life?”

Relevant white blood cell type counts and ratios from the current and three previous blood tests are:

nlr lmr

I’ve trained my innate immune system every day for the past 19 years with yeast cell wall β-glucan because every disease is connected to the immune system. I also haven’t been sick even one day this decade.

Let’s start with high-specificity C-reactive protein (hsCRP). Bookend values show very low inflammation over the past 2.5 years. Missing and regular CRP <1 values were due to medical professionals ignoring my written instructions.

Next are innate immune system monocytes, counts of which haven’t changed over the past 2.5 years. There have been no viruses, bacteria, fungi, or parasites that survived initial defenses. So monocyte-derived dendritic cell and macrophage activity hasn’t changed.

Next are adaptive immune system lymphocyte (T cells, natural killer cells, and B cells) counts that had a steady 31% increase from 1.6 to 2.1. It would be interesting to see which lymphocyte subtypes responded to the various therapeutic regimes I’ve implemented over these past 2.5 years. But I won’t become a lab rat to find out.

Last are innate immune system neutrophil counts, which our bone marrow makes copious amounts every day to fight infections. Mine have undergone a 43% decrease over the past 2.5 years. My bone marrow apparently doesn’t have metabolic imperatives to produce more short-lived neutrophils, probably because there isn’t a health emergency to immediately defend against.

To summarize, focusing on white blood cell type counts rather than their ratios better serves health purposes. The CBC test has coarse measures, though, so more refinement could be achieved.


Here’s an epigenetic clock summary of this week’s metabolomic results:

2023 epigenetic age

This summary from 2.5 years ago used the same calculations:

2021 epigenetic age

Maybe the additional 5.6 year difference in this first measurement instead of an opposite 2.5 year change along with chronological age is a signal that I’m getting more healthy. Maybe it’s noise. Recent memories argue against phenotypic age having anywhere near the impact of chronological age.

Comparing my two results against people who didn’t positively change their healthspan and lifespan has limited value, although this could reduce their denominator’s influence. We each have our life at stake, and bad things will happen on their own. If we want good things to happen, we have to make them happen.


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A good activity for bad weather days

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 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.


PXL_20231123_194849211.MP

Brain restoration with plasmalogens

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:

1. Nutritional Supplementation Strategy

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

2. Advanced MRI Technologies

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:

3. Reversing Brain Shrinkage

“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:

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

No changes:

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

Decreased adaptations in brain measurements included:

  1. White matter microstructure radial diffusivity -10%.
  2. Amygdala connectivity to the anterior cingulate cortex to suppress / ignore / deny anxiety response.
  3. Amygdala connectivity to the dorsal lateral prefrontal cortex.
  4. Entorhinal cortex volume -14%.
  5. Hippocampus volume -6%.
  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:

etable 3

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.

A smell and taste anecdote

Two 2023 papers, starting with a study of smell and taste disorders:

“This study investigates the impact of etiology on the epidemiologic profile, disease severity, type of treatment, and therapy outcome in smell and taste disorders.

Hyposmia has a prevalence of about 15%, while approximately 5% of the population suffers from anosmia. Multiple innervation of the taste mucosa with fibers from the seventh, ninth, and tenth cranial nerves assures robustness of the gustatory system compared to smell.

Conservative therapy employs corticosteroids, antibiotics, vitamins and and minerals as well as functional rehabilitation by olfactory training. Data regarding outcome of therapy were only available for 71 (26.3%) of patients. Only the sinunasal etiology was significantly more likely to show improvement after therapy (27.4% show improvement vs. 9.6% show no improvement).”

https://link.springer.com/article/10.1007/s00405-023-07967-1 “Characteristics of smell and taste disorders depending on etiology: a retrospective study”

This study was a little light on describing effective treatments for smell and taste problems. For example, olfactory training was said to have good therapeutic response. Looking it up, though, it seems to be whatever each practitioner feels like doing.


A review introduced the subject of olfactory ensheathing cells:

“Olfactory ensheathing cells (OECs) are glial cells of the primary olfactory nervous system, which are composed of the olfactory nerve and outer nerve fiber layer of the olfactory bulb. The primary olfactory nervous system is unique in that it can constantly regenerate.

It is now possible to remove olfactory bulb tissue and olfactory mucosa (outermost layer and lamina propria, which belong to the central nervous system and peripheral nervous system, respectively), which also suggests the potential value of OECs therapy in central nervous system and peripheral nervous system diseases. OECs can survive and renew in the central nervous system, and have been widely used in nerve regeneration and tissue repair.

Schwann cells (SCs) form the myelin sheath of the peripheral nerve, protect and nourish neurons, and play an irreplaceable role in the repair of peripheral nerve injury. There is no transcriptional difference between OECs and SCs. OECs are highly similar to SCs, and express the biomarkers of SCs.

fimmu-14-1280186-g002

Functional mechanisms of OECs in the treatment of neurological diseases include neuroprotection, immune regulation, axon regeneration, improvement of nerve injury microenvironment and myelin regeneration, which also includes secreted bioactive factors. Results obtained in clinical trials are not very satisfactory, and the effectiveness of these cell-based therapies remains to be proved.”

https://www.frontiersin.org/articles/10.3389/fimmu.2023.1280186/full “Potential therapeutic effect of olfactory ensheathing cells in neurological diseases: neurodegenerative diseases and peripheral nerve injuries”


Something interesting may have unexpectedly started with my 90-day trial of Prodrome Glia and Neuro products. Here’s an abbreviated look that omits my intermittent fasting and resistance exercise data:

day 7-15

Both product labels have a loading dose suggestion of 4-8 softgels (2 to 4 times the standard two-softgel dose) for 1-3 months. Two days after I started a Glia loading dose, my sense of smell, then sense of taste, were noticeably better.

I’ll guess that my primary olfactory nervous system glial cells are responding to these changes. At the beginning I thought that my peripheral nervous system Schwann cells might be affected regarding my left ulnar nerve. Since olfactory ensheathing cells are highly similar to Schwann cells, it doesn’t seem to be that much of a stretch to think that they could also be affected by my current regimen.

More testing is warranted, of course. I’ve had diminished smell and taste for decades, though. If the gardenias, roses, magnolias, honeysuckles, and other scents in past summers that had fainter scents than I remembered come across stronger, so much the better.

IMG_20200425_154336

Eat broccoli sprouts to inhibit brain cancer

This 2023 rodent study by Our model clinical trial group investigated effects of broccoli seeds, 8-day-old sprouts, 95-day-old florets, and pure sulforaphane on glioma:

“This study employs a C6 rat glioma model to assess chemoprotective potential of aqueous extracts from broccoli seeds, sprouts, and inflorescences, all rich in sulforaphane (SFN), and pure SFN as positive control.

In plant material, seeds and sprouts exhibited a heightened concentration of aliphatic-type glucosinolates (GSLs), while broccoli heads showcased a more substantial amount of indole group GSLs. Similar to the GSL trend, the highest concentration of phenolic compounds was evident in sprouts, succeeded by seeds, with broccoli heads exhibiting a subsequent lower content.

seed-sprout-inflorescence

Within freeze-dried aqueous extracts obtained from plant material samples, seeds exhibited the most substantial SFN content, trailed by sprouts and inflorescences. This hierarchy aligns with precursor GSL content, specifically glucoraphanin (GRA). These outcomes imply that approximately 5% of GRA content converted into SFN.

Sinapic acid derivatives emerged as the primary category of phenolic compounds. Higher concentrations of these phenolic compounds were observed in inflorescences, succeeded by seeds, and lastly, broccoli sprouts.

sfn phenolics

Aqueous extracts from seeds, sprouts, and inflorescences were administered to rats over 30 days before the introduction of C6-glioma cells. This specific time frame corresponds to a critical risk factor and initiation of the tumor niche in humans. The objective was to assess whether this consumption could protect against tumor development.

Tumor volume within the control SS group significantly increased compared to the sprout group. Volume fluctuations observed in the seed and inflorescence groups did not demonstrate any statistically significant differences when compared to the control group.

1-s2.0-S0753332223015184-gr2_lrg

Subjects administered with 0.1 mg/kg of SFN displayed a notable decrease in tumor growth. A stark contrast is evident when compared to the corresponding control group (control OO) and the 0.7 mg/kg SFN-treated group.

These findings substantiate the notion that elevated doses of the pure compound might potentially assume a pro-oxidant role, while lower doses hold promise in fostering an environment rich in antioxidants and conducive to chemoprotection.

1-s2.0-S0753332223015184-gr4_lrg

All experimental groups developed gliomas. However, the group administered with aqueous extract of broccoli sprouts and the group treated with pure SFN at 0.1 mg/kg exhibited formation of diffuse low-grade gliomas. Conversely, the remaining groups exhibited malignant characteristics, and manifested development of thrombosed vessels.

Incorporating broccoli sprouts into one’s regular diet emerges as a highly promising strategy for averting onset of specific types of cancer. It is the most cost-effective option for society when contrasted with consumption of nutraceuticals. While achieving a standardized effective dose of SFN via food consumption, such as sprouts, poses challenges, forthcoming clinical studies are poised to determine an appropriate dosage for shaping human intervention trials.”

https://www.sciencedirect.com/science/article/pii/S0753332223015184 “The preventive effects of broccoli bioactives against cancer: Evidence from a validated rat glioma model”


This study’s Discussion section had a lot of hand waving regarding broccoli seeds’ failure to outperform broccoli sprouts despite its 1.06 mg/kg to 0.63 mg/kg sulforaphane advantage. Although not specifically referenced, hormetic effects described in Sulforaphane in the Goldilocks zone and subsequent studies probably account for pure sulforaphane’s dose / response findings that 0.1 mg/kg better inhibited glioma than did 0.7 mg/kg.

For those who think this post’s title is over-the-top:

  • Although eating non-patentable broccoli sprouts is safe and cheap, how many people will wait for clinical trials to determine whether these rodent findings translate to humans?
  • If today there was already human clinical trial evidence confirming translatable findings, how many people would still wait for incorruptible, morally upright, honest, and trusted medical authorities’ approvals?

ray liotta laugh


PXL_20231027_111038664

Plasmalogens, Part 3

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

fcell-10-864842-g003

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.”

1-s2.0-S2667325823001425-gr3_lrg

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

Plasmalogens, Part 2

This post compares Dr. Goodenowe’s clinical trial mentioned in Part 1 with other researchers’ human plasmalogen studies this decade. One of its findings was:

“Figure 1A illustrates that plasmalogen precursor DHA-AAG dose-dependently elevated both direct and indirect target species [DHA-PL, DHA-PE, and (LA + AA)-PL] and had no effect on levels of biochemically unrelated PE species index (LA + AA)-PE.

  • DHA-AAG had a greater elevating effect on its direct target, DHA-PL than its indirect targets.
  • The 1-month washout period resulted in decreased levels of both direct and indirect target species and no effect on unrelated PE species.

Figures 1A,B illustrate that DHA-AAG is converted to its direct and indirect target species in humans as predicted from animal studies on similar AAG plasmalogen precursors (Wood et al., 2011d).”

fcell-10-864842-g001A

Given this century’s background of numerous animal studies, there’s a need to know what translates to humans. Here are the three most recent human plasmalogen studies in descending order where I could access the full study:

2022

“Forty unmarried male students aged 18–22 years (20 in the plasmalogen group and 20 in the placebo group) were randomly allocated to either plasmalogen (2 mg per day) or placebo treatment of 4 weeks’ duration and ingested two capsules of 0.5 mg plasmalogen or placebo twice daily.

  • The primary efficacy outcome was the Total Mood Disturbance (TMD) T-score of POMS 2–Adult Short.
  • Secondary outcomes included the seven individual scales of POMS 2, other psychobehavioral measures (Athens Insomnia Scale and Uchida-Kraepelin test), physical performance test (shuttle run, grip muscle strength, and standing long jump), plasmalogen levels in plasma and erythrocytes, plasma levels of brain-derived neurotrophic factor (BDNF), urinary 8-hydroxy-2′-deoxyguanosine (8-OHdG), body mass index, and percent body fat.

Lipid composition of purified ether phospholipids from scallop is shown below. One capsule contained 0.48 mg of ethanolamine plasmalogen and 0.02 mg of choline plasmalogen. Plasmalogen and placebo capsules were prepared by a manufacturer (B&S Corporation, Tokyo).

fcell-10-894734-t001

There were no between-group differences in physical and laboratory measurements. It is suggested that orally administered plasmalogens alleviate negative mood states and sleep problems, and also enhance mental concentration.”

https://www.frontiersin.org/articles/10.3389/fcell.2022.894734/full “Orally Administered Plasmalogens Alleviate Negative Mood States and Enhance Mental Concentration: A Randomized, Double-Blind, Placebo-Controlled Trial”

There was no dose / response investigation, so there’s no data to corroborate that this 2 mg treatment produced these effects. It isn’t difficult to think of other factors that could influence the primary outcome of a 18-22 year-old unmarried male’s moods.


2020

“Effects of ascidian-derived plasmalogens on cognitive performance improvement were assessed in a randomized, double-blind, placebo-controlled study including Japanese adult volunteers age 45.6 ± 11.1 years with mild forgetfulness. An allocation controller who was not directly involved in the study equally, but randomly, assigned participants to either the intervention group (n=33) or the placebo group (n=33), based on normalized Cognitrax composite memory score (the primary outcome), sex, and age at time of screen. Participants were administered either one active capsule (200 mg medium-chain triglyceride (MCT) oil including ascidian plasmalogen oil) or placebo capsule (200 mg MCT oil) per day with water, any time during the day for 12 weeks.

Ascidian plasmalogen oil was extracted from ascidians (Halocynthia roretzi) and sold by NIHON PHARMACEUTICAL CO., LTD. Based on a previous study, 33% of lipids contained in ascidians are phospholipids, 23% of which are plasmalogens, and fatty acids of the sn-2 position of plasmalogens are mainly EPA, DHA, oleic acid, and arachidonic acid. The active capsule contains 1 mg plasmalogen.

Compared to the placebo group, the intervention group showed a significant increase score in composite memory (eight weeks: 3.0 ± 16.3 points, 12 weeks: 6.7 ± 17.5 points), which was defined as the sum of verbal and visual memory scores. These results indicate consumption of ascidian-derived plasmalogen maintains and enhances memory function.”

https://www.jstage.jst.go.jp/article/jos/69/12/69_ess20167/_article “The Impact of Ascidian (Halocynthia roretzi)-derived Plasmalogen on Cognitive Function in Healthy Humans: A Randomized, Double-blind, Placebo-controlled Trial”

Again no dose / response investigation, so no corroborating data. Standard deviations many times larger than a sample’s mean indicated wild variability (aka noise). Maybe intervention participants experienced memory loss (3.0 mean – 16.3 SD = -13.3; 6.7 mean – 17.5 SD = -10.8)? Yet statistics inferred a signal that allowed interpreting this treatment as producing meaningful positive changes in cognitive function.


“Ten Parkinson’s disease (PD) patients age 67.80 (7.41) years received oral administration of 1 mg/day of purified ether phospholipids derived from scallop for 24 weeks. Clinical symptoms and blood tests were checked at 0, 4, 12, 24, and 28 weeks. Blood levels of plasmalogens in patients with PD were compared with those of 39 age-matched normal controls.

B&S Corporation Co. Ltd. (Tokyo) was involved in provision of capsules containing ether phospholipids derived from scallop. Ethanolamine ether phospholipids (ePE) in plasma from PD and relative composition of ethanolamine plasmalogen (plsPE) of erythrocyte membrane in PD were significantly low as compared to those of age-matched normal controls.

Oral administration of purified ether phospholipids derived from scallop for 24 weeks increased plasma ePE and erythrocyte plsPE to almost normal levels, and concomitantly improved some clinical symptoms of patients with PD. Results indicate the efficacy of oral administration of purified ether phospholipids derived from scallop to some nonmotor symptoms of PD. Physiological mechanisms of the efficacy of purified ether phospholipid derived from scallop remained to be elucidated.”

https://www.hindawi.com/journals/pd/2020/2671070/ “Improvement of Blood Plasmalogens and Clinical Symptoms in Parkinson’s Disease by Oral Administration of Ether Phospholipids: A Preliminary Report

Again no dose / response investigation, so no corroborating data. These researchers asserted their 2017 study to be a plasmalogen gold standard, as did the other two above studies.

Here’s part of what Dr. Goodenowe said about that 2017 study in a 2019 review Plasmalogen deficiency and neuropathology in Alzheimer’s disease: Causation or coincidence?:

“They did not observe a significant elevation of plasma levels of plasmalogens in the treated group relative to the baseline. Lower dose of plasmalogens (1 mg twice daily) and the labile nature of the vinyl-ether bond might have limited absorption of the intact molecule and might have contributed to the lack of response in terms of plasmalogen levels in blood as well as the cognitive function. Reported instability of plasmalogens in acidic environments questions the stability of preformed plasmalogens in gastric juice during digestion which might reduce plasmalogen bioavailability.”

Also see Part 1’s explanation of why using age-matched controls in plasmalogen studies is ridiculous.

Continued in Part 3.

Plasmalogens, Part 1

The person who knows the most about this subject is Dayan Goodenowe, PhD. Some recent publications include:

https://www.frontiersin.org/articles/10.3389/fcell.2022.864842/full “Targeted Plasmalogen Supplementation: Effects on Blood Plasmalogens, Oxidative Stress Biomarkers, Cognition, and Mobility in Cognitively Impaired Persons”

https://www.frontiersin.org/articles/10.3389/fcell.2022.866156/full “Brain ethanolamine phospholipids, neuropathology and cognition: A comparative post-mortem analysis of structurally specific plasmalogen and phosphatidyl species”

plasmalogens and cognition


A sample of links freely available at https://drgoodenowe.com/.

1. Presentations to professional groups. Have your mouse ready to click the pause button.

https://drgoodenowe.com/dr-goodenowe-presents-at-the-iagg2023-in-yokohama-japan/ “A rare children’s disease that may be the key to reversing neurological decline in aging”

Includes videos of a treatment’s effects on a child.

https://neomarkgroup.wistia.com/medias/0qln0wy93t “The most influential biomarkers for aging and disease”

Despite the title, a considerable number of studies were presented on prenatal, infant, and early childhood development. He misspoke a few times, so read the slides.

Phenotype is reality. Genotype is possibility. Communications links between different fields are very poorly connected in science.

Peroxisomes are islands. They don’t have DNA like your mitochondria do. Peroxisomal transport issues are important things to understand.

All aging-related cross-sectional analyses are on the rate of decline. You’re declining from a previous well state. Age-matched controls are the most ridiculous thing to do.”


2. I’ll highlight the longest of several interviews because there was plenty of room to expand on points. Maybe the best detailed explanations came as responses to that interviewer challenging with contrasting AD, traumatic brain injury, and cholesterol paradigms. Its transcript is more accurate than a usual YouTube interpretation, but there are still mistakes such as “fossil lipid” vs. phospholipid.

https://www.betterhealthguy.com/episode186 “Plasmalogens with Dr. Dayan Goodenowe, PhD”

“Science is how do you push things to its failure, until you can’t fail it again. We’ve lost that. It’s become more hypothesis proving.

Plasmalogens levels go up for a different reason than people think. The reason why it peaks in our 40s and 50s is because we’ve been myelinating. The white matter of our brain is still increasing. It’s not because we’re making more plasmalogens. It’s because the lake, the reservoir, gets full. What you’re measuring in blood is overflow from the lake. The lower plasmalogens start trickling down in your blood, the bigger drain that’s occurring on that system.

Low plasmalogens don’t just predict dementia in the elderly population. It predicts the rate of decline of that dementia. It predicts the rate of death.

The biggest drivers of plasmalogen manufacturing and the biggest reasons why they decrease with age, or in other circumstances is two things. One, the failure to maintain a fasting state of the human body. The second one is muscle atrophy.

Amyloid has absolutely nothing to do with Alzheimer’s, or dementia. It’s just a bystander on the road watching an accident happen.

Age-related cognitive decline is clearly where plasmalogens have the greatest impact. You’re always going to have mixed pathologies in the brain.

Nutritional availability of plasmalogens is virtually non-existent. As soon as they hit the hydrochloric acid of your stomach, they’re gone. They don’t make it past the stomach, or the upper intestine.”


I came across Dr. Goodenowe’s work last month from clicking a comment on this blog that linked back to her blog. Always be curious.

Continued in Part 2.

Dietary choline

Two 2023 papers on choline intake, beginning with an analysis of 14323 people:

“Choline is an essential ingredient that is required for many biological processes in the human body, including formation of cell membranes, preservation of liver and kidney function, and production of neurotransmitters. For humans, only a small amount of choline can be endogenously generated through the liver. It is vital to supplement it in the diet to prevent deficiency.

Mean dietary choline intake was 316.5 ± 164.1 mg/d, and incidence of cardiovascular disease (CVD) was 8.8% in study participants.

nutrients-15-04036-g002

New findings of our study are as follow:

  1. In contrast to previous studies, higher dietary choline intake was associated with a lower incidence of CVD, especially incidence of stroke, in this large, nationally representative US population.
  2. The protective role of higher dietary choline intake was accompanied by reduced inflammation and heart rate.
  3. In the subgroup study, higher dietary choline intake – in participants aged ≥60 years, and in participants with BMIs < 30 kg/m2 – was found to be a protective factor for the presence of CVD.

Our results suggest that adequate choline intake acts against CVD, and choline deficiency should be avoided.”

https://www.mdpi.com/2072-6643/15/18/4036 “Association between Dietary Choline Intake and Cardiovascular Diseases: National Health and Nutrition Examination Survey 2011–2016”


A randomized control trial investigated choline intake effects on resistance exercise training:

“Choline plays crucial roles in several physiological processes, such as:

  • Neurotransmission, muscle contraction, and force generation via synthesis of chemical messenger acetylcholine;
  • Lipid transport via lipoprotein synthesis; and
  • Methyl-group metabolism as a precursor to betaine.

It supports cell membrane integrity/function as a precursor to phosphatidylcholine. Choline may also affect muscle responses to exercise via betaine, which is important for gene expression/protein synthesis.

The present study determined effects of different amounts of choline intakes (approximately 50%, 70%, and 120% of Adequate Intake (AI)) on muscle responses to resistance exercise training (RET). Three groups of 50-to-69-year-old healthy adults underwent a 12-week RET program, and submitted >48 diet logs (>4x/week for 12 weeks). Participants were randomly assigned to one of three choline groups in a double-blind manner: zero additional egg yolk (low), one additional egg yolk (medium = med), or three additional egg yolks (high) per day. 

nutrients-15-03874-g003

  • We found that low choline intake (~51% of AI) resulted in diminished strength gains compared to choline intakes of ~68% or ~118% of AI.
  • We observed that a high choline intake (greater than AI) did not provide additional positive effects on RET responses.
  • Together with choline, betaine was independently associated with change (%) in composite strength, suggesting that multiple mechanisms are at work.
  • There was no effect of choline consumption on any blood lipids and lipoproteins, indicating that a moderately low choline intake may not negatively affect blood lipid profiles.
  • Dietary cholesterol did not contribute much to variability of strength gains.

The consistency of about 50% of AI is particularly significant, as much as 40% of the older population is consuming this low level of choline where there are no overt clinical signs of deficiency, and considering potential effects of choline on age-associated loss of muscle function. This research was supported by U.S. Poultry and Egg Association.”

https://www.mdpi.com/2072-6643/15/18/3874 “The Effect of Choline and Resistance Training on Strength and Lean Mass in Older Adults”


For over a decade, I supplemented phosphatidylcholine via a small amount of lecithin every day. I stopped that three years ago when I started supplementing betaine, thinking that I wouldn’t need as much choline oxidized to plentiful betaine.

Don’t have any choline blood tests to indicate whether or not that has been the right decision. It seems like there’s more risk than reward in continuing, though, so I’ll restart 1200 mg lecithin next week at $.07 a day. That provides about the same amount of choline as does one egg.


Rocket launch followed by telemetry plane

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