Sugar and Seed Oil

A speculative prediction, from the "So I can tell you 'Told Ya!'" department: Sugar is pathogenic only in the presence of Seed Oils ("Vegetable Oils").

Speculation on Type 2 Diabetes

I just wanted to post here one more piece of speculation, that it is seed oils that cause or primarily contribute to Type 2 Diabetes (and possibly Obesity) – so in two or three decades I can say: "Told you."

Some more speculation on ME/CFS

• Efforts to finger the family of Enteroviruses as the causative agent in a large sub-group seem to have gone nowhere (e.g. Chia, or the British in the Eighties)
• Efforts to finger the family of Herpesviruses as the causative agent in a large sub-group seem to have gone nowhere (e.g. Montoya)
• Efforts to finger Retroviruses as the causative agent in a large sub-group turned out to be a large fraud
• Cytokine studies seem to have gone nowhere to identify large sub-groups
• Lot's of things can be misdiagnosed as ME/CFS (e.g. Newton et. al 2010)
• Many pathogens can cause Post-Viral-Fatigue, that may or may not be the same thing as ME/CFS (among others Hickie et. al 2006)

At the moment I would say:

• The ME/CFS patients are not suffering all from the same disease. 
• ME/CFS is an umbrella term for many different diseases. 
• Localized outbreaks (localized both in time and in space) are most likely caused by one distinct causative agent.
• The agent in one outbreak is most likely different from the agent in another outbreak.
• There is not one single causative agent that is shared by a majority of people with ME/CFS.
• The ME/CFS patient population is heterogenous. 

Therefore I would say:

Any research that works under the assumption of a homogenous ME/CFS patient population will fail.

Symptoms alone are probably not specific enough to delineate sub-groups*, objective measurable data (e.g. exercise challenge ala Snell, gene expression ala Light, RNA deep sequencing ala Lipkin, orthostatic measurements, and so on) is needed to delineate sub-group.

The question that remains: How do patients divided up into sub-groups? Are there a few disease entities that make up a majority of ME/CFS cases? (Of which I am no so sure any more) Or are there many many sub-groups, with a highly fractioned "landscape" with many many diseases hiding under the label ME/CFS?

[Addendum]
I think certain properties (non-refreshing sleep, VO2max exercise intolerance) can be shared by different disease entities. And even the neurological symptoms may be a (common) result of different pathological processes.

* Possibly with the exception of the POTS/Ad2A sub-group, which has the potential to be a single disease entity in its own right.

Is Acne caused by the Hormones in Milk and Dairy?

So, do the hormones in milk cause acne? I isolated pasteurized cow milk (and dairy) as the cause my acne.

• If I eat cheese made from raw milk, I get no acne
• If I eat cheese made from pasteurized milk, I get acne

I think the hormone levels in both raw and pasteurized products should be comparable. Of course it is possible that some producers of raw milk use different production methods, and the raw milk might contain less hormones – but then again I tried three different brands of raw milk cheese, and ate each time a large amount of raw milk cheese in one go, without getting acne. So, I don't think it's the hormones.

Another thing that makes me think it is not the hormones in milk, is that if I eat some dairy, I get about three distinct points of acne (pimples/papules/nodules) for about 100 to 150 grams of dairy from pasteurized milk. If it were hormones, I would expect slightly increased inflammation everywhere. But instead I see "the winner takes it all" with a mainly "all or nothing" inflammation.

Now this is pure speculation, but I suspect that "something" from milk (bovine IgA immunoglobulins?), that was changed during pasteurization, traverses intact from the gut to the blood. Then human immunoglobulins attach to this "something" and start forming immune complexes. Some of these immune complexes either dock to the relevant skin tissue, or they form there in the first place – and these would be the distinct points were then inflammation arises, because now leukocytes rush in and start a giant gang-bang at the expense of my no longer acne-free skin.

Still much to learn…

Thoughts on psychological/psychiatric problems

Some speculation on psych* problems after my recent post on depression:

1. Psych* (psychological/psychiatric) problems exist (I'd be stupid to deny that)
2. Many (if not most or even all) psych* problems haven an organic root cause (environmental / dietary / pathogenic / etc.)
3. Even those psycho* problems with an established psych* cause (PTSD comes to mind) have an substantial environmental/organic component
4. Therefore few (if any at all) psych* problems have a psychiatric root cause, and few are therefore actually psych* problems
5. Furthermore, the response of such an psych* problem with an organic cause to psych* treatment will be weak – at best

And as a addendum: Good psych* therapy, with a good understanding of the pathological problems, and a good understanding of its own limitations, can (at best) improve the quality of life – but should be careful not to mistake improved quality of life with an cure.

Is Myalgic Encephalomyelitis (ME) an Neurological Disease?

First of all, let me say that Myalgic Encephalomyelitis (ME) is classified as a Neurological Disease (ICD 10 G93.3, or F286).

And I don't want to change that.

At least not now. Not until we know whether ME is one disease, or several distinct diseases, and until we know what the pathological processes at the root of ME are.

So regardless how ME is classified, what is the reality of ME? About that I want to speculate a bit.

Personally, I think it will turn out that the ME patient population, very much like CFS, will be composed of several diseases. Maybe there are, compared to CFS, less people who are (mis-)diagnosed with ME but have actually something else – but I doubt that ME is only one disease.

From the Norwegian Rituxan study by Fluge and Melle we know that a sizable portion of ME/CFS patients may have an autoimmune condition – which may or may not exclude neurologic problems to be the root cause. We can't tell from the Norwegian study one way or the other.

From the studies by Christopher Snell we know that VO2 max and exercise tolerance are reduced in a CFS patient population, which would point to cardiovascular causes, lung causes, or muscle-metabolic causes – a neurological root cause seems IMHO unlikely in the sub-group characterized by Dr. Snell, but still possible. The results from Dr. Snell are not particular specific and can be caused by different pathological processes, so there could be several diseases out there having the same VO2 max presentation (as seems already to be the case with other known non-CFS diseases).

From the studies by Kathleen and Alan Light we know that there are at least two sub-groups in the ME/CFS (and FM) patient population:

• People with a specific presentation of POTS like gene-expression
• People with a nonspecific presentation of fatigue and pain gene-expression

The specific POTS presentation may be indicative of a cardiovascular orgin, possibly with the involvement of endocrine system (beta-receptors seem to be implicated in a sub-group in the Lights studies). So the POTS sub-group IMHO may be one distinct disease, and I think it is unlikely to be several diseases.

The later sub-group (fatigue/pain) may IMHO most likely originate from metabolic problems in the muscle. It could be possibly caused by several pathways, which would possibly mean several distinct diseases.

These problems could in turn affect the brain in a negative way, showing up as neurological symptoms ("brain fatigue" or "brain fog", etc.)

So in conclusion, at the moment a sizable portion of patients seem to have a non-neurological root cause, especially hinted by the work of Kathleen and Alan Light.

Still, a minority of ME/CFS patients may be suffering from one (or more) – as of now – unknown and/or poorly understood neurological diseases – though it seems unlikely to me that a majority of ME/CFS patients have a neurological problem as root cause.

Of course, this does not preclude an neurological involvement in ME/CFS patients with non-neurological root causes.

This picture may change when more research brings us more data, until then we have to consider non-neurolgical etiologies for a majority of ME/CFS patients – I would not cling on to the neurological label forever.

Some Speculation on Fibromyalgia (FM), Chronic Fatigue Syndrome (CFS) and Myalgic Encephalomyelitis (ME)

There was recently a paper by an Israeli group about the question whether Fibromyalgia (FM) and ME/CFS are same. This was followed by some speculation in the ME/CFS community. The general assumption seems to be that some consider FM a distinct illness/disease, and ME an different distinct illness/disease, and that CFS is some sort of "catch all" category.

I recently speculated how the "landscape" for ME/CFS might look like. I came to the conclusion that once proper biomedical tests (like done in the currently running Lipkin study) yield results, that ME/CFS will be shown to consist of several discrete illnesses/diseases.

I think a similar picture will emerge for FM.

Furthermore I think some (but not all) of the illnesses/diseases that will be found to cause FM will be the same as will be found to cause ME/CFS.

And on a related note: Some people want to get rid of the "CFS" label – to which I say bravo! Alas, I have the impression these advocates consider ME one distinct illness/disease (which I think is wrong), and they think that CFS is some sort of hodgepodge. Well assuming it so, then there are still many people (and I mean many people) who have an diagnosis of CFS, but actually have this "distinct ME" illness/disease. By cutting off these ME patients, that have been misdiagnosed as CFS patients, what do you accomplish?

Furthermore, these advocates seem to have no problem that people with the diagnosis "CFS" get slandered as psycho(somatic) cases, as long as "their ME" illness/disease is taken seriously. To which I say: If you don't fight for protection of CFS patients from psychobabblers, then why should ME patients be protected from psychobabblers?

A prediction for ME/CFS

Here's my prediction for what Lipkin will find in ME/CFS patients (take it with some grains of salt):

• He will find two dominant distinct diseases in roughly 60% of patients: One disease will have an share of about 40% of patients, while the other will be about 20%.
  
  The two dominant diseases he will find will be either: in the form of an "new" autoimmune disease (as of now undocumented autoimmune-antibody/antigen and target tissue), or an undocumented presentation of a known virus (e.g. one of the HHVs or Enteroviruses), or an combination thereof.
  
  An unknown virus is possible, but seems to me unlikely.
• About 25% of patients will be comprised of patients with on of about 10 diseases. Diseases will be e.g. atypical presentations of known common diseases, and possibly some novel diseases.
• The remaining 15% of patients will have a multitude of diseases, some common and some rare, some known and some currently unknown.

The great unknown seems to be the role of HHVs. Interesting will be whether the majority of patients have an "simple" disease (e.g. with one autoimmune-antibody targeting one tissue type as prime cause) that "simply" causes the complex "multi-organ" disease presentation, or whether there is actually multi-organ involvement as prime cause.

Let's see – I'm not taking bets.

On Cereal Grains, Dairy and Milk

Some speculative predications:

1. Gluten is not the only agent in cereal grains that causes disease or health problems.
2. Celiac disease is not the only disease or health problem caused by the consumption of cereal grain products.
3. Lactose is not the only agent in (pasteurized cow) milk and dairy that causes disease and health problems.
4. Lactose intolerance in not the only disease or health problem caused by the consumption of dairy.
5. The diseases and health problems caused by both cereal grain and dairy do not necessarily manifest with gastrointestinal symptoms.

Could Milk and Dairy cause Cancer?

Here is an heretic idea: Could the consumption of (pasteurized) cow milk and dairy cause some forms of cancer? Specifically: breast cancer?

Well, this is pure speculation – yet an epidemiologist worth his/her salary should have no problem confirming or refuting this idea.

I just leave this idea here, so I can say in 30 years: "Told you so."