18 replies to this topic

[fighter]

Hi everyone, I have been experiencing rapid muscle wasting in my entire body which has now affected my eyesight, tongue, tonsils. I've been to 2 specialists, an internist and multiple GPs, have done various lab work, and only had 3 abnormal results namely, an insignificant inconclusive urinary protein leakage, slightly elevated ALT liver enzyme, and a very low Vitamin D 25-OHD 10 (25-79 ng/mL)

I'm quite confused with which strength training exercise to follow that would prevent me to lose even more muscle. SHould I do HIIT?

I ask because according to this study http://jn.nutrition....35/7/1824S.full "The shift toward increased activity of the glycolytic enzymes in atrophied muscle is accommodated by an increase in gluconeogenic capacity in the liver."

Thank you and if you have any more tips like which supplements could stop muscle wasting like HMB, OKG, GSE, please do share your expertise.

[Lufega]

I agree with Niner in that you should be treating this as a Cushings Disease in the meanwhile. There is a supplement called RELORA that very effectively reduces cortisol levels. I was taking this while I did a morning/evening cortisol test and one of them came back low enough to lead my Doctor to suspect Addison's Disease (the opposite of Cushings). I knew it was the relora, ofcourse. If you want to lower cortisol, look for a substance the reduces the activity of the enzyme 11 beta-hydroxylase.

Cortisol upregulates the enzyme PNMT, which increases Adrenaline production. That's why, when I was using relora it produced a degree of exercise intolerance. You need adrenaline to get things going. In your case, you probably have waaaaay too much of it. On the other hand, you need DHEA to counter the effects of cortisol but this also increases in Cushings to compensate for the extra cortisol so I do not know if more is better in this case.

[fighter]

Lufega it's not Cushing, the test came out normal

[niner]

Hi fighter, I though that the proteinuria was pretty significant. Did one of the docs say that there wasn't much to it? What about your cortisol level? Which test came out normal?

[Lufega]

Lufega it's not Cushing, the test came out normal

Oh.. Your urine cortisol came back a little high, right ? Have they tested blood of saliva cortisol at different times ? I have a bunch of tabs open right now with pertinent information if your problem is cortisol related. Otherwise, I can close them all..

Edited by Lufega, 08 June 2012 - 02:30 AM.

[fighter]

HI NINER, I thought I had already posted the recent test results in the other thread, alongside the vit d test. The proteinuria was high but they told me not high enough to be considered alarming or be diagnosed as CKD or FSGS or nephrotic synd.

BUT...
I spoke with the doctor this morning asking for a urologist referral, he declined but he ordered a microalbuminuria test with protein creatinine ratio.

They tested for a lot, EBV, CK, ESR, HIV, Hepa A B C, Thyroid theres a lot more, antibodies

[fighter]

Hi all sorry I think I misinterpreted the results in my head. My last cortisol test was done May 20th, and although the results came out Normal, I don't think it necessarily meant my cortisol levels are indeed normal:
3-DAY LOW DOSE DEXAMETHASONE TEST WITH 24 HR URINE AND BLOOD TEST AT DAY 3
Collection duration, urine 24 hrs
Specimen volume, urine 1045 mL
Creatinine, 24 hr urine 2080 (630 - 2500 mg/TV)
CORTISOL, FREE, 24H URINE Very low undetected (< 50.0 ug/TV)
ACTH <5 (< 46 pg/mL)

The April 30 Test came out abnormal, however this is not a specific test for Cushing, only sensitive, so perhaps I may still have high cortisol from other causes (stress, etc):

Urinary Free Cortisol 73.2 (4.0 - 50 mcg / 24 hrs)

Do you think this older UFC value 23.2 units above normal range is enough to cause muscle wasting? I guess this would be the next question I would ask my endo but I'm not confident in her knowledge, it took her a second to respond to my question whether or not a high cortisol may lead to catabolic wasting.

[niner]

HI NINER, I thought I had already posted the recent test results in the other thread, alongside the vit d test. The proteinuria was high but they told me not high enough to be considered alarming or be diagnosed as CKD or FSGS or nephrotic synd.

BUT...
I spoke with the doctor this morning asking for a urologist referral, he declined but he ordered a microalbuminuria test with protein creatinine ratio.

They tested for a lot, EBV, CK, ESR, HIV, Hepa A B C, Thyroid theres a lot more, antibodies

Maybe the proteinuria isn't enough to be alarming on its own, but what do they say about the muscle wasting and central obesity? Are they aware that it all started from a combination of Ribose and a ketogenic (or nearly so) diet, and that there is another person who reported the same symptoms from that combination? These facts argue in favor of some sort of metabolic dysregulation rather than an infectious cause. The doctor was right to skip the urologist referral. You might want a nephrologist if you wanted to explore kidney issues more deeply.

[fighter]

Maybe the proteinuria isn't enough to be alarming on its own, but what do they say about the muscle wasting and central obesity? Are they aware that it all started from a combination of Ribose and a ketogenic (or nearly so) diet, and that there is another person who reported the same symptoms from that combination? These facts argue in favor of some sort of metabolic dysregulation rather than an infectious cause. The doctor was right to skip the urologist referral. You might want a nephrologist if you wanted to explore kidney issues more deeply.

The endo does not seem to be forth coming and the internist although she means well and generously ordered a ton of tests and neuro referral, the supplement info just fall into deaf ears, which is why I was asking the other day for an RD/nutritionist referral so maybe they can help me. The endo does not seem to know much about metabolic disorders related to muscle wasting. They all have nice credentials great school backgrounds but don't know anything about my condition. The neuro even said she doesn't see any muscle wasting but concedes that she is not me and if I feel it then I am more aware of my body. I just told her that I can form a cup now out of my hand when i try to measure the back of my neck, that a lot of inches lost. She stated at the end that it could be disuse atrophy.

But niner, so assuming the supplement had something to do with it, with D-Ribose, it causes hypoglycemia when you OD, I also read that it can cause hyperinsulinemia, but prolonged effects? So we have either of the two, how do you address the hyperinsulinemia?

edit:
Also, I remember taking a digestive enzyme called Pancreatin for some months. It has lipase in it, and I read that lipase is implicated in muscle wasting, but I'm not sure, can you kindly look it up because I don't know a lot of the terms surrounding it in the studies I found.

Finally, that I think I have high cortisol as evident in the first 24hr urine test, so it could still be the reason why I'm catabolizing right, so I purchased Relora and CLA as per Lufega's advice. Does CLA cause hypertension do you know?

Edited by fighter, 09 June 2012 - 01:33 AM.

[zorba990]

Have you looked into this ?
http://www.medicalne...eases/22610.php

Not sure how one goes about detoxing this if it is an issue...

[tunt01]

you should consider taking l-carnitine. a lot of kidney disease patients take it and it can help prevent muscle wasting.

and maybe keep your eyes out for Merck MK-677 anti-muscle wasting hormone still in clinicals

Edited by prophets, 09 June 2012 - 07:08 PM.

[nowayout]

Have you had your testosterone tested? Hypogonadism is one of the prime diagnoses that come to mind when it comes to muscle wasting (assuming you are male).

Have you been to a specialist in autoimmune conditions (e.g. rheumatologist), several of which can cause cachexia?

If these don't lead to anything, it wouldn't hurt to see a neurologist to rule out problems with the nervous system.

Edited by viveutvivas, 09 June 2012 - 08:09 PM.

[fighter]

Thanks, like I said previously, I have been to the neurologist, and endocrinologist. My Internist checked for RA came out negative.


The L-Carnitine suggestion I'm a little afraid of taking again. Last time I did, I went into ketosis and something was burning in my lower back area. Definitely the kidneys, sometimes the left, other times on the right. Not sure how this could be connected to what I am having now. I took l-carnitine alongside D-Ribose right around the time i first experienced foamy urine.

[niner]

The endo does not seem to be forth coming and the internist although she means well and generously ordered a ton of tests and neuro referral, the supplement info just fall into deaf ears, which is why I was asking the other day for an RD/nutritionist referral so maybe they can help me. The endo does not seem to know much about metabolic disorders related to muscle wasting. They all have nice credentials great school backgrounds but don't know anything about my condition. The neuro even said she doesn't see any muscle wasting but concedes that she is not me and if I feel it then I am more aware of my body. I just told her that I can form a cup now out of my hand when i try to measure the back of my neck, that a lot of inches lost. She stated at the end that it could be disuse atrophy.

But niner, so assuming the supplement had something to do with it, with D-Ribose, it causes hypoglycemia when you OD, I also read that it can cause hyperinsulinemia, but prolonged effects? So we have either of the two, how do you address the hyperinsulinemia?

edit:
Also, I remember taking a digestive enzyme called Pancreatin for some months. It has lipase in it, and I read that lipase is implicated in muscle wasting, but I'm not sure, can you kindly look it up because I don't know a lot of the terms surrounding it in the studies I found.

Finally, that I think I have high cortisol as evident in the first 24hr urine test, so it could still be the reason why I'm catabolizing right, so I purchased Relora and CLA as per Lufega's advice. Does CLA cause hypertension do you know?

Neither an RD nor a nutritionist are going to know a thing about what happened with the ribose. I doubt any doctors would either. That is such an unusual result that I'm starting to think it would take a scientist who does metabolic research to explain it, if anyone could. One thing that the doctors can do well is evaluate your musculature. If your doctor says she doesn't see muscle wasting, that's actually a good thing. Maybe you aren't as close to death as you think. We still need to explain what it is that you're experiencing, though. I'm not sure what you mean about being able to form a cup out of your hand. If I turn my palm upward, I can form a cup with my hand- is that what you mean?

You said that you had a very pronounced central adiposity, and that you had gained about 50 lbs, all of it around your midsection. Is it possible that what you're experiencing as muscle wasting is actually a migration of fat from your extremities to the center? That could certainly leave your hands and feet looking hollowed out. What did the endocrinologist say about the central obesity?

I don't know about hyperinsulinemia. Did you ever have an insulin level done? That seems like the kind of thing that an endocrinologist would know about. Pancreatin is just a mixture of digestive enzymes. It might help you digest proteins, carbohydrates, or lipids if you have any enzyme defects in those areas. I don't really see a relationship between lipase and muscle wasting. CLA is considered a treatment for metabolic syndrome, and is reported to prevent the hypertension that comes with obesity, so it doesn't sound like it would cause hypertension; more like prevent it...

[fighter]

Neither an RD nor a nutritionist are going to know a thing about what happened with the ribose. I doubt any doctors would either. That is such an unusual result that I'm starting to think it would take a scientist who does metabolic research to explain it, if anyone could. One thing that the doctors can do well is evaluate your musculature. If your doctor says she doesn't see muscle wasting, that's actually a good thing. Maybe you aren't as close to death as you think. We still need to explain what it is that you're experiencing, though. I'm not sure what you mean about being able to form a cup out of your hand. If I turn my palm upward, I can form a cup with my hand- is that what you mean?

You said that you had a very pronounced central adiposity, and that you had gained about 50 lbs, all of it around your midsection. Is it possible that what you're experiencing as muscle wasting is actually a migration of fat from your extremities to the center? That could certainly leave your hands and feet looking hollowed out. What did the endocrinologist say about the central obesity?

I don't know about hyperinsulinemia. Did you ever have an insulin level done? That seems like the kind of thing that an endocrinologist would know about. Pancreatin is just a mixture of digestive enzymes. It might help you digest proteins, carbohydrates, or lipids if you have any enzyme defects in those areas. I don't really see a relationship between lipase and muscle wasting. CLA is considered a treatment for metabolic syndrome, and is reported to prevent the hypertension that comes with obesity, so it doesn't sound like it would cause hypertension; more like prevent it...

Niner I replied at the other thread. My testosterone results just came out a few minutes ago. It's abnormally low. With muscle tissue loss, my biceps have shrunk. My neclk circumference has shrunk, tongue atrophied. I mean my biceps have totally shrunk in size from last February! I am 100% positive that I am losing muscle tissue and I am this close to feeling insulted if they would brush it off yet again tomorrow.

[nowayout]

My testosterone results just came out a few minutes ago. It's abnormally low. With muscle tissue loss, my biceps have shrunk. My neclk circumference has shrunk, tongue atrophied. I mean my biceps have totally shrunk in size from last February! I am 100% positive that I am losing muscle tissue and I am this close to feeling insulted if they would brush it off yet again tomorrow.

Okay, this is progress. Your doctors should rule out certain other conditions that may cause this, but even in the absence of a clear cause (the most common case), this is something that can normally be very effectively treated with TRT with dramatic improvement possible.

[niner]

Niner I replied at the other thread. My testosterone results just came out a few minutes ago. It's abnormally low. With muscle tissue loss, my biceps have shrunk. My neclk circumference has shrunk, tongue atrophied. I mean my biceps have totally shrunk in size from last February! I am 100% positive that I am losing muscle tissue and I am this close to feeling insulted if they would brush it off yet again tomorrow.

It must be really frustrating if they don't get it. They don't know what you were like then, they only see you now. If you were really bulked out, and now you're skinny, it would be obvious to you, but they wouldn't see anything out of the ordinary. If you were really big because you were lifting and eating a bodybuilder's diet, and then you stopped exercising and changed your diet, you would shrink a lot. That would be a normal response. I'm not saying what's happening with you is normal; I'm just trying to get a better sense of what's happening. For example, I presume the strength in your large muscles fallen off dramatically. What could you do on the leg press or bench press before this started, and what can you do now? Numbers like that would help us get a sense of the magnitude of the loss. It would be a good thing to tell the doctor, too.

TESTOSTERONE, ULTRASENSITIVE, LC MS/MS 227 (250 - 1100ng/dL)
Testosterone free 42.5 (35.0 - 155.0 pg/mL)

I'm scared of doing the T prescription if that will be the case. Are there any recommendations you guys have to increase my T without doing the T replacement? I'm scared of the side effects :(

Your T is pretty low for a young guy. I wouldn't have too many qualms about doing some replacement. Just take it slow and check your levels after you've been supplementing to figure out what the right dose is. You'd probably use something like Androgel; I don't think the side effects are bad as long as you don't abuse it. Getting your T levels right would have to help the muscle situation. I suspect there is something deeper that underlies the low T, and I hope we can figure that out, but fixing the T might be almost as good. It might even help the central obesity problem.

[fql]

On another note, I hope you are taking Whey (protein) as that is arguably the most important muscle sustaining supplement.

Edited by juryben, 28 June 2012 - 07:18 AM.

[kevinseven11]

muscle wasting is not eating enough carbs. Carbs in the morning and after you workout.