Ray Peat Email Advice Depository

bradley

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My questions to Ray regarding T2:

Very curious to hear your thoughts on the use of synthetic T2 therapeutically. I have read that it can be even more effective at raising the metabolic rate than T3. It is also currently over-the-counter, though difficult to source. The products I've seen are 150mcg per capsule, which seems quite high to me. I've seen both 3,5 and 3,3'-Diiodo-L-Thyronine. Have you read or experienced if one is more effective than the other?

His response:

Mitochondria have the enzyme for converting T3 to T2. The potency seems crazy, the body needs only about 4 mcg per hour.
 
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charlie

charlie

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Re: Ray Peat Email Advice: High Ferritin

:hattip Judi

viewtopic.php?f=2&t=801&p=12749#p12746


judi said:
I asked RP about my ferritin in 2009 as it was out of range (upwards), although not as high as yours, narouz.

Ray Peat said:
High ferritin suggests that there's continuing inflammation. Iron and calcium interact, so it might be worth having your parathyroid hormone tested. Despite your good vitamin D, you might not be getting enough calcium in relation to phosphate, and elevated PTH can cause generalized inflammation. Safe antiinflammatory things would be aspirin, calcium carbonate, coffee especially when taken with meat or eggs, salt or baking soda, and sugar.
In the US and Canada, I have noticed that the "normal range" for prolactin has been expanded upward, after a period in the '80s when it was lowered. I think this reflects a change in the population, from estrogen and PUFA, for example, and that the lower range was better for judging health.

Later follow up response:

Ray Peat said:
Although I think knowing your PTH and free fatty acids will be useful (in judging use of calcium, sugar, aspirin, niacinamide, etc.), another test that could help to clarify the nature of the inflammation would be the serum interleukin-18, since it's associated with liver damage and increased ferritin, and symptoms of inflammation. Since TSH increases IL-18, finding it elevated would be another argument for keeping your TSH very low.
 
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charlie

charlie

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Re: Ray Peat Email Advice: DHEA

:hattip everydayimshufflin over at Peatarian

everydayimshufflin said:
I've read that you grew taller on DHEA, is DHEA "safe" to take? What does it do?

Ray Peat said:
It's very common for people in their forties to become deficient in both pregnenolone and DHEA, but occasionally it happens in younger people, usually because of an imbalance of thyroid and estrogen. In women, too much DHEA can have a masculinizing effect, so it's best to work on the diet, or to use pregnenolone, which doesn't lead to an imbalance between progesterone and DHEA, since it turns into either, according to need.

everydayimshufflin said:
How much DHEA is safe to take?

Ray Peat said:
Ten milligrams of DHEA is pretty safe for men, the most common side effects are pimples, oily skin, and sex dreams.

everydayimshufflin said:
How much should a hypothyroid person take?

Ray Peat said:
If your thyroid is very low, you should be cautious with the DHEA, because stress hormones can cause it to turn to estrogen. 5 mg of DHEA taken with a little olive oil or butter can have a noticeable effect on your mood and muscle tone in a few hours.

everydayimshufflin said:
Should I take it topically? Or with butter as you suggested?

Ray Peat said:
 

Birdie

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High Ferritin

One from Danny Roddy's site:

Uric acid is important as an antioxidant. High ferritin doesn't directly imply high iron stores, it has a defensive effect, and can be increased by inflammation. TSH promotes inflammation. Hypothyroidism usually involves low temperature of the extremities, and the bones of the arms and legs form red cells slowly at low temperature, so it's possible that ferritin is involved in an adaptive mechanism, too.
 
J

j.

Guest
From the thread Aspirin: Testimonials, and questions answered, page 14.

Destiny said:
I emailed Dr. Peat since I could not find anything on the suggested amount searching his articles and googling:
Dear Dr Peat,
if I take one baby aspirin three times weekly prior to my weight training sessions, how much Vit K2 do you recommend daily? How much if I don't take any aspirin?

His reply: Vitamin K is good for protecting muscles and bones, so 500 micrograms to one milligram is good anyway, and it would be protective against even more aspirin.
 
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charlie

charlie

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Re: Ray Peat Email Advice: Zinc

Regarding zinc:

Ray Peat said:
Taking zinc orally, 5 or 10 mg, can replenish the body's stores in a few days, but
the supplement can oxidize other nutrients in the stomach or intestine, so it isn't
good to use it for a long time."
 
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charlie

charlie

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:hattip ilovethesea

viewtopic.php?f=56&t=1216&p=13288#p13288

Ray Peat said:
The liver has to convert T4 to T3 for it to be effective. It needs glucose and selenium to make the conversion. Adequate protein, at least 80 grams per day, is necessary. Sea food, once a week will provide selenium, two quarts of milk and a quart of orange juice would provide many of the other essential nutrients. Taking T4 at bedtime sometimes is helpful. Most people feel best on a ratio of T4:T3 of 4:1 or less. Checking the relaxation rate of the Achilles reflex is a quick way to check the effect of the thyroid on your nerves and muscles; the relaxation should be instantaneous, loose and floppy.
 
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charlie

charlie

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Re: Ray Peat Email Advice: Not able to gain weight

:hattip tobieagle

viewtopic.php?f=56&t=1240&p=13339#p13339

Regarding: Not able to gain weight

tobieagle said:
what do make of people like me (21 years, 65kg at a height of 1,80m) who arent able to gain a single gramm of mass although they eat 3000+ calories a day but still showing some hypothyroid symptoms like cold hands and feet when the ambient temperature falls below 22° C or poor sleep (waking up from the tiniest noises).

Ray Peat said:
I had similar symptoms, I often ate several thousand calories per day without getting fat, and small noises would shock me awake. Taking thyroid reduced my caloric requirement, >and immediately allowed me to sleep deeply. Deficiencies of magnesium, vitamin A, and selenium probably contribute to that metabolic pattern.
 

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J

j.

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Is carrageenan in toothpaste as dangerous as in food?

Ray Peat said:
No, it isn't likely to be a problem unless you are very sensitive to it.
 
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charlie

charlie

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Re: Ray Peat Email Advice: High Metabolic Rate

:hattip Lucy

Source


Lucy said:
Peat told me this in regards to thyroid causing a high metabolic rate:

Ray Peat said:
"About your high metabolic rate and high temperature: In my teens and twenties, I needed about 8000 calories per day when I was physically active, about 4000 to 5000 when I was sedentary, but after I took thyroid, I needed only about half as many calories. Thyroid is the basic regulator of blood glucose, and it causes it to be fully oxidized for energy, so that it produces ATP efficiently, on relatively few calories. If blood glucose falls, because it's being used very quickly, the body responds with stress hormones, including glucagon, adrenalin, and cortisol. They cause fat and protein to be burned for energy, while in hypothyroidism, glucose can still be used inefficiently for glycolysis, producing lactic acid, displacing bicarbonate and carbon dioxide. This causes mineral imbalances, with effects including cramps and nerve-muscle tension, which produce heat and waste energy. When you first start taking thyroid again, your tissues will need some extra magnesium, during the time when the dose is increasing, and when the mineral balance is restored your temperature and metabolic rate might decrease a little. Orange juice, milk, and coffee are good for the main minerals, while salting your food to taste."

Ray Peat said:
"Supplementing thyroid can sometimes reduce the rate of metabolism, by allowing cells to retain enough magnesium, which stabilizes ATP."
 
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charlie

charlie

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Re: Ray Peat Email Advice Depository: Chlorine or Fluorine

:hattip RP Fans

Background: I pace back and forth due to worry, nerve on my bottom of my foot got swollen, PAIN. Dr. Peat recommended Benadryl cream - all pain went away, was able to get some sleep. Pain came back, but less, just put more cream, then it went. Finally all pain is gone. Foot is good. Told Dr. Peat I am thinking about taking Cetirizine for overall health.
He said:

Ray Peat said:
I avoid drugs that contain chlorine or fluorine, because of the risk to the liver.
(and gave me the research)


When I asked him about Benadryl containing chloride, and even salt does, he clarified:


Ray Peat said:
Our enzymes aren't designed for the combination of chlorine with carbon molecules.

He gave me this research:

++++++
1. Pediatr Emerg Care. 2008 Sep;24(9):627-8. doi:
10.1097/PEC.0b013e3181850c35.
Cetirizine-induced dystonic reaction in a 6-year-old boy.
Esen I, Demirpence S, Yis U, Kurul S.
Department of Pediatrics, Faculty of Medicine, Dokuz Eylül University,
Inciralti,
Izmir, Turkey.
Dystonia is a movement disorder that causes involuntary contractions of
the
>> muscles. Dystonia can affect just 1 muscle, a group of muscles, or all of
>> the
>> muscles. The most common cause acquired dystonia in childhood is drugs.
>> Cetirizine is widely used for allergic disorders in childhood. It is
>> without
>> central nervous system side effects at recommended dosages. There is only
>> 1 case
>> of cetirizine-induced dystonia in the literature. We report a second case
>> of
>> cetirizine-induced acute acquired dystonia whose symptoms completely
>> resolved
>> after the discontinuation of the drug.
>>
>> 2. Br J Clin Pharmacol. 2009 May;67(5):577-8. doi:
>> 10.1111/j.1365-2125.2009.03394.x.
>> Epub 2009 Feb 23.
>> Cetirizine-induced anaphylaxis: a rare adverse drug reaction.
>> Afonso N, Shetgaonkar P, Dang A, Rataboli PV.
>>
>> 3. Gastroenterol Hepatol. 2010 Jan;33(1):68-9. doi:
>> 10.1016/j.gastrohep.2009.06.011.
>> Epub 2009 Sep 3.
>> [Benign recurrent intrahepatic cholestasis simulating cetirizine-induced
>> toxic
>> hepatitis].
>> [Article in Spanish]
>> Díaz-Sánchez A, Marín-Jiménez I, Aldeguer M.
>>
>> 4. Eur Ann Allergy Clin Immunol. 2009 Dec;41(6):187-9.
>> Paradoxical exacerbation of chronic urticaria by H1-antihistamines and
>> montelukast.
>> Tedeschi A.
>> Unità Operativa di Allergologia e Immunologia Clinica, Ospedale Maggiore
>> Policlinico, Mangiagalli e Regina Elena, Fondazione Istituto di Ricovero e
>> Cura a
>> Carattere Scientifico (IRCCS), Milano, Italy.
>> Histamine is the main mediator of urticaria and H1-receptor antagonists
>> represent
>> the treatment of choice in all patients with chronic urticaria.
>> Leukotriene
>> receptor antagonists as montelukast have also been used in patients with
>> chronic
>> urticaria unresponsive to H1-antihistamines alone. We report a patient
>> with
>> chronic urticaria whose disease was paradoxically exacerbated by
>> H1-antihistamines and montelukast, and controlled by immunosuppressive
>> drugs as
>> ciclosporin and azathioprine. Urticaria exacerbations were caused by
>> different
>> molecules including either piperidine (fexofenadine, desloratadine,
>> ebastine,
>> rupatadine) or piperazine (hydroxyzine, cetirizine) derivatives as well as
>> by
>> montelukast suggesting that an IgE-mediated mechanism was not involved. A
>> possible explanation of the observed urticaria exacerbation is that
>> H1-antihistamines and montelukast may shift the H1 histamine receptor and
>> the
>> leukotriene receptor to the active conformation instead of the inactive
>> state.
>> The beneficial effects of ciclosporin and azathioprine confirm that
>> immunosuppressive drugs have an important role in the treatment of
>> refractory
>> chronic urticaria and back the hypothesis that an autoimmune/autoreactive
>> mechanism often underlies the disease.
>>
>> 5. N Z Med J. 2010 Feb 19;123(1309):106-7.
>> Severe hepatitis in a primary sclerosing cholangitis patient receiving
>> recent
>> cetirizine therapy.
>> Jurawan R, Smith A.
>>
>> 6. Prescrire Int. 2010 Feb;19(105):26-8.
>> Cetirizine and loratadine: minimal risk of QT prolongation.
>> [No authors listed]
>> Some antihistamines, such as mizolastine and ebastine, can prolong the QT
>> interval and provoke severe cardiac arrhythmias. This review examines the
>> effects
>> of two widely used antihistamines, cetirizine and loratadine, on the QT
>> interval.
>> As of mid 2009 very few clinical data had been published on the risk of QT
>> prolongation with cetirizine or loratadine. The very rare reported cases
>> of
>> torsades de pointes linked to loratadine mainly appear to involve drug
>> interactions, especially with amiodarone and enzyme inhibitors. We found
>> no
>> reports of QT prolongation attributed to desloratadine, the main
>> metabolite of
>> loratadine. Two cases of QT prolongation with cetirizine have been
>> published, one
>> of which involved overdose and renal failure. The reports are too vague to
>> conclude that cetirizine was implicated. We found no reports of QT
>> prolongation
>> attributed to levocetirizine. Cetirizine is a metabolite of hydroxyzine,
>> another
>> antihistamine. In the 1960s, a study of patients with psychosis showed a
>> risk of
>> QT prolongation. A case of recurrent syncope with QT prolongation has
>> since been
>> reported, along with rare cases of cardiac arrhythmia. In practice,
>> cetirizine
>> and loratadine are first-line antihistamines. However, caution is needed
>> in
>> certain circumstances. In particular, it is best that patients who have
>> risk
>> factors for torsades de pointes or who are taking certain enzyme
>> inhibitors avoid
>> using loratadine. It is best to avoid using cetirizine in cases of renal
>> failure.
>>
>> 7. Br J Pharmacol. 2010 Sep;161(2):456-66. doi:
>> 10.1111/j.1476-5381.2010.00907.x.
>> Histamine H1 receptor antagonist cetirizine impairs working memory
>> processing
>> speed, but not episodic memory.
>> van Ruitenbeek P, Vermeeren A, Riedel WJ.
>> Department of Neuropsychology and Psychopharmacology, Faculty of
>> Psychology and
>> Neuroscience, Maastricht University, the Netherlands.
>> [email protected]
>> BACKGROUND AND PURPOSE: The histaminergic neurotransmitter system is
>> currently
>> under investigation as a target for drug treatment of cognitive deficits
>> in
>> clinical disorders. The therapeutic potential of new drugs may initially
>> be
>> screened using a model of histaminergic dysfunction, for example, as
>> associated
>> with the use of centrally active antihistamines. Of the selective second
>> generation antihistamines, cetirizine has been found to have central
>> nervous
>> system effects. The aim of the present study was to determine whether
>> cetirizine
>> can be used as a tool to model cognitive deficits associated with
>> histaminergic
>> hypofunction.
>> EXPERIMENTAL APPROACH: The study was conducted according to a three-way,
>> double-blind, cross-over design. Treatments were single oral doses of
>> cetirizine
>> 10 and 20 mg and placebo. Effects on cognition were assessed using tests
>> of word
>> learning, memory scanning, vigilance, divided attention, tracking and
>> visual
>> information processing speed.
>> KEY RESULTS: Cetirizine 10 mg impaired tracking performance and both doses
>> impaired memory scanning speed. None of the other measures indicated
>> impaired
>> performance.
>> CONCLUSION AND IMPLICATIONS: Cetirizine affects information processing
>> speed, but these effects were not sufficient to serve as a model for
>> cognitive deficits in
>> clinical disorders.
>>
>> 8. Med Clin (Barc). 2011 Sep 10;137(6):283-4. doi:
>> 10.1016/j.medcli.2010.09.027.
>> Epub 2010 Dec 8.
>> [Cetirizine hepatotoxicity].
>> [Article in Spanish]
>> Prieto de Paula JM, Franco Hidalgo S, Nalotto L, Ginés Santiago A.
>>
>> 9. Allergol Immunopathol (Madr). 2011 Sep-Oct;39(5):307-9. doi:
>> 10.1016/j.aller.2010.08.003. Epub 2011 Jan 3.
>> Antihistamines in chronic urticaria: threat or treat?
>> Aydin O, Celik G, Misirligil Z.
>>
>> 10. Ann Allergy Asthma Immunol. 2011 Mar;106(3):258-9. doi:
>> 10.1016/j.anai.2010.12.005. Epub 2011 Jan 7.
>> Positive basophil activation test result in a patient with acute urticaria
>> induced by cetirizine and desloratadine.
>> Bobadilla-González P, Pérez-Rangel I, Cámara-Hijón C, García-Menaya JM,
>> Sánchez-Vega S.
>>
>> 11. J Investig Allergol Clin Immunol. 2011;21(1):66-8.
>> Urticaria due to antihistamines.
>> Sánchez Morillas L, Rojas Pérez-Ezquerra P, Reaño Martos M, Sanz ML,
>> Laguna
>> Martínez JJ.
>> Allergology Department, Hospital Central de la Cruz Roja, Madrid, Spain.
>> [email protected]
>> Erratum in
>> J Investig Allergol Clin Immunol. 2011;21(2): 2 p following 161.
>> H1-antihistamines are probably the most frequently used drugs in allergic
>> diseases, with widely established efficacy, tolerance, and safety. We
>> report a
>> patient with urticaria due to ingestion of ebastine and fexofenadine. Skin
>> prick
>> tests, patch tests, and basophil activation tests with the implicated
>> drugs and
>> antihistamines from other families were negative. The oral challenges with
>> the
>> implicated antihistamines and other antihistamines tested were positive,
>> but the
>> patient tolerated an oral challenge with cetirizine. We present a patient
>> with
>> urticaria induced by different antihistamines in whom the diagnosis was
>> established by oral challenge. The mechanism of sensitization remains
>> unclear.
>>
>> 12. Ann Hepatol. 2011 Apr-Jun;10(2):237-8.
>> Levocetirizine induced hepatotoxicity in a patient with chronic urticaria.
>> Ekiz F, Yüksel I, Ekiz O, Coban S, Basar O, Yüksel O.
>>
>> Ann Dermatol Venereol. 2002 Nov;129(11):1295-8.
>> [Cutaneous drug eruption with two antihistaminic drugs of a same chemical
>> family: cetirizine and hydroxyzine]
>> [Article in French]
>> Assouere MN, Mazereeuw-Hautier J, Bonafe JL.
>> Service de Dermatologie, Hopital de Rangueil, 1, avenue Jean Poulhes,
>> 31403
>> Toulouse Cedex 4, France. [email protected]
>> BACKGROUND: H1-antihistamines are widely used to relieve symptoms of
>> allergic
>> disorders. A few skins reactions to H1-antihistamines have been described
>> in the
>> literature. We report the first case of cutaneous drug eruption as fixed
>> drug
>> eruption with 2 antihistamines of the same chemical family: cetirizine and
>> hydroxyzine. CASE REPORT: A 73 year-old man was admitted because of a
>> third
>> cutaneous eruption with the same morphologic features of the same sites as
>> before. The first and second eruption appeared after 4 hours of cetirizine
>> intake, the third eruption appeared after 4 hours of hydroxyzine intake.
>> Healing
>> was obtained after stopping the medication. Histology showed induced drug
>> reaction. Patch tests with cetirizine and hydroxyzine were negative,
>> except
>> false positivity with dimethylsulfoxide vehicles. DISCUSSION: The
>> diagnosis of
>> cutaneous drug eruption as non pigmenting fixed drug eruption related to
>> cetirizine and hydroxyzine was retained. Allergy to both H1 antihistamines
>> can
>> be explained by the fact that they've got the same chemical node that is
>> piperazine, and by the fact that cetirizine is the main metabolite of
>> hydroxyzine. Oral test provocation was omitted because the patient had
>> already
>> reexposed himself to the drugs. To identify the drug responsible for fixed
>> drug
>> eruption, peroral provocation tests are the most valuable method, but
>> carry the
>> risk of a strong reaction. Some authors use patch tests, but their
>> positivity is
>> inconstant. Their interest in fixed drug eruption is undergoing
>> assessment.
>>
>> Ann Allergy Asthma Immunol. 2002 Dec;89(6):561-5.
>> Facial swelling and eosinophilia in a 44-year-old woman.
>> Abraham D, Saltoun CA.
>> Division of Allergy-Immunology, Ernest S. Bazley Asthma and Allergic
>> Diseases
>> Center, Department of Medicine, Northwestern Memorial Hospital,
>> Northwestern
>> University Medical School, Chicago, Illinois 60611, USA.
>> Case Reports
>> Clinical Conference
>>
>> J Investig Allergol Clin Immunol. 2002;12(2):136-7.
>> Urticaria to cetirizine.
>> Tella R, Gaig P, Bartra J, Garcia-Ortega P.
>> Allergy Unit, Hospital Universitari Joan XXIII, Tarragona, Spain.
>> A patient with recurrent idiopathic urticaria reported exacerbations after
>> treatment with cetirizine. Prick test to cetirizine was negative.
>> Double-blind
>> challenge tests with mizolastine, loratadine, fexofenadine,
>> dexchlorpheniramine,
>> ebastine, ketotifen, and placebo were negative, whereas hydroxyzine and
>> its
>> active metabolite, cetirizine, reproduced the urticaria. Identification of
>> uncommon adverse reactions to H1 antihistamines is important, particularly
>> because they may mimic the underlying disease.
>>
>> Toxicol Lett. 2002 Feb 28;127(1-3):279-84.
>> Cardiotoxicity of new antihistamines and cisapride.
>> Paakkari I.
>> Institute of Biomedicine/Pharmacology, Biomedicum Helsinki, University of
>> Helsinki, P.O. Box 63, FIN-00014, Finland. [email protected]
>> Although the new second-generation nonsedative antihistamines terfenadine
>> and
>> astemizole were launched as highly selective and specific H(1)-receptor
>> antagonists, they were later found to cause prolongation of the
>> QT-interval and
>> severe cardiac arrhythmias. The prolongation of the QT-interval is caused
>> by the
>> blockade of one or more of the cardiac potassium channels, among which the
>> delayed rectifier I(Kr), encoded by the HERG-gene, appears to be the most
>> significant. The potency of the prokinetic drug cisapride to block I(Kr)
>> appears
>> to be similar to that of terfenadine (IC(50) about 50 nmol/l). These drugs
>> cause
>> problems when overdosed, used in combination with inhibitors of their
>> CYP3A4-mediated metabolism, or when given to individuals with altered drug
>> kinetics (the aged) or patients with existing cardiac disease
>> (congenitally long
>> QT). Moreover, interactions with other QT-interval prolonging drugs
>> require
>> special attention. Active hydrophilic metabolites of the second-generation
>> antihistaminic compounds (ebastine-carebastine, loratadine-desloratadine,
>> terfenadine-fexofenadine, astemizole-norastemizole) are new compounds with
>> probably reduced risk for drug interactions and cardiac toxicity.
>>
>> J Clin Gastroenterol. 2000 Oct;31(3):250-3.
>> Cetirizine-induce cholestasis.
>> Fong DG, Angulo P, Burgart LJ, Lindor KD.
>> Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester,
>> Minnesota
>> 55905, USA.
>> Cetirizine, a human metabolite of hydroxyzine, is a selective H1-receptor
>> antagonist currently approved for the treatment of seasonal allergic
>> rhinitis,
>> perennial allergic rhinitis, and chronic urticaria. In U.S. clinical
>> trials,
>> transient reversible hepatic transaminase elevations were observed in <2%
>> of
>> patients during cetirizine therapy. We report a case of cetirizine-induced
>> cholestasis in a 28-year-old man with no previous hepatobiliary disease
>> after a
>> 2-year period of taking cetirizine on a daily basis. The treatment of this
>> patient included the use of ursodeoxycholic acid, as well as hydroxyzine,
>> for
>> symptomatic relief of pruritus. In light of the patient's clinical and
>> biochemical improvement while using hydroxyzine, it appears that the
>> hepatic
>> metabolism of hydroxyzine to metabolites, including cetirizine, is not
>> involved
>> in the pathogenesis of this particular case of drug-induced
>> hepatotoxicity.
>> Cetirizine should be considered as a potential cause of drug-induced
>> cholestasis.
>>
>> Ann Intern Med. 2001 Jul 17;135(2):142-3.
>> Severe hepatitis in a patient taking cetirizine.
>> Watanabe M, Kohge N, Kaji T.
>> Case Reports
>> Letter
>>
>> J Clin Gastroenterol. 2002 Apr;34(4):493-5.
>> Acute hepatitis associated with cetirizine intake.
>> Sanchez-Lombrana JL, Alvarez RP, Saez LR, Oliva NP, Martinez RM.
>> Case Reports
>> Letter
>>
>> Ann Pharmacother. 2004 Nov;38(11):1844-7. Epub 2004 Sep 21.
>> Recurrent acute hepatitis associated with use of cetirizine.
>> Pompili M, Basso M, Grieco A, Vecchio FM, Gasbarrini G, Rapaccini GL.
>> Department of Internal Medicine, Universita Cattolica del Sacro Cuore,
>> Rome,
>> Italy. [email protected]
>> OBJECTIVE: To describe a case of recurrent acute hepatitis related to the
>> use of
>> cetirizine, a selective histamine(1)-receptor antagonist approved for the
>> treatment of common allergic diseases. CASE SUMMARY: A 26-year-old man was
>> hospitalized with a week-long history of weakness, nausea, anorexia, and
>> hyperchromic urine, which had developed after 6 days of therapy with oral
>> cetirizine 10 mg/day for allergic rhinitis. Admission laboratory testing
>> revealed evidence of acute hepatitis and seropositivity for liver-kidney
>> microsome antibodies. Liver biopsy findings of diffuse portal tract and
>> lobular
>> inflammation with a prominent eosinophilic infiltrate were consistent with
>> drug-related hepatitis. The patient was discharged after one week of
>> treatment
>> with tocopherol and glutathione. Three months after discharge,
>> transaminase
>> levels were normal. At 6 months, seropositivity for liver-kidney microsome
>> antibodies was still present, but considerably less intense. The patient
>> had
>> suffered 2 previous episodes of "acute hepatitis of unknown origin," and
>> both
>> had occurred after cetirizine use. DISCUSSION: Use of the Naranjo
>> probability
>> scale indicated cetirizine as the probable cause of acute hepatitis, and
>> the
>> positivity for liver-kidney microsome antibodies is suggestive of an
>> autoimmune
>> mechanism for liver damage. As of September 13, 2004, ours is the fourth
>> reported case of acute hepatitis associated with cetirizine and the second
>> in
>> which liver-kidney microsome antibodies have been documented. CONCLUSIONS:
>> Although cetirizine is considered to have low potential for severe hepatic
>> toxicity, the possibility that it can provoke autoimmune-mediated
>> hepatotoxicity
>> should be considered.
>>
>> Ann Allergy Asthma Immunol. 2004 Mar;92(3):294-303; quiz 303-5, 355.
>> Erratum in:
>> Ann Allergy Asthma Immunol. 2004 Jun;92(6):675.
>> Ann Allergy Asthma Immunol. 2005 Mar;94(3):409-10.
>> Comment in:
>> Ann Allergy Asthma Immunol. 2005 Mar;94(3):407.
>> Ann Allergy Asthma Immunol. 2005 Mar;94(3):407-9; author reply 409-10.
>> Antihistamines and driving ability: evidence from on-the-road driving
>> studies
>> during normal traffic.
>> Verster JC, Volkerts ER.
>> Utrecht Institute for Pharmaceutical Sciences, Department of
>> Psychopharmacology,
>> University of Utrecht, Utrecht, The Netherlands. [email protected]
>> BACKGROUND: All antihistamines are capable of crossing the blood-brain
>> barrier
>> and thus may cause sedation. Most antihistamine users are ambulatory
>> patients
>> and therefore presumably drive a car. OBJECTIVE: To summarize the effects
>> of
>> antihistamine drugs on driving ability. DATA SOURCES AND STUDY SELECTION:
>> A
>> literature search (MEDLINE and cross-references) was performed using the
>> keywords driving and antihistamine. Sixteen studies using the on-the-road
>> driving test during normal traffic were included in the review. Studies
>> were
>> double-blind and placebo-controlled and included a positive control.
>> RESULTS:
>> First-generation antihistamines (diphenhydramine, triprolidine,
>> terfenadine,
>> dexchlorpheniramine, clemastine) significantly impair driving performance
>> after
>> both one-time and repeated (daily) administration. Second-generation
>> antihistamines (cetirizine, loratadine, ebastine, mizolastine,
>> acrivastine,
>> emedastine, mequitazine) may also impair driving performance, but the
>> magnitude
>> and extent of impairment depend on the administered dose, sex, and time
>> between
>> testing and treatment administration. Tolerance develops after 4 to 5 days
>> of
>> administration, but impairment is not absent. Third-generation
>> antihistamines
>> (fexofenadine and levocetirizine) have been shown to produce no driving
>> impairment after both one-time and repeated administration. CONCLUSIONS:
>> First-
>> and second-generation antihistamines may significantly impair driving
>> performance. In the context of driving safety but also taking into account
>> the
>> cardiotoxic properties of some of the second-generation antihistamines, we
>> advise treating patients with third-generation antihistamines such as
>> fexofenadine and levocetirizine.
>>
>> Am J Ophthalmol. 2004 Feb;137(2):355-7.
>> Oculogyric crisis in patients taking cetirizine.
>> Fraunfelder FW, Fraunfelder FT.
>> Casey Eye Institute, Oregon Health and Science University, Portland,
>> Oregon
>> 97201, USA. [email protected]
>> PURPOSE: To report oculogyric crisis in patients receiving cetirizine and
>> inform
>> clinicians on the characteristics of this drug-induced ocular side effect.
>> METHODS: For this retrospective, observational case series, case reports
>> were
>> collected from the National Registry of Drug-Induced Ocular Side Effects
>> (Casey
>> Eye Institute, Portland, Oregon). The World Health Organization Causality
>> Assessment Guide of Suspected Adverse Reactions was used to categorize the
>> cases. RESULTS: Nine cases were reported, with eight occurring in the
>> pediatric
>> age group. Dosage ranged from 5 to 10 mg orally and onset of symptoms
>> ranged
>> from 3 to 184 days. Six cases of oculogyric crisis had positive
>> rechallenge
>> data. Eight cases had complete neurologic consultation including
>> radiographic
>> studies. CONCLUSIONS: Cetirizine can cause oculogyric crisis, especially
>> in the
>> pediatric age group. Extensive neurologic workups may be avoided if
>> clinicians
>> recognize this drug-induced ocular side effect.
>>
>> Ann Allergy Asthma Immunol. 2004 Nov;93(5):460-4.
>> An evaluation of the ocular drying effects of 2 systemic antihistamines:
>> loratadine and cetirizine hydrochloride.
>> Ousler GW, Wilcox KA, Gupta G, Abelson MB.
>> Ophthalmic Research Associates Inc, North Andover, Massachusetts 01845,
>> USA.
>> BACKGROUND: Systemic antihistamines, such as loratadine and cetrizine
>> hydrochloride, have proven efficacious in the control of many allergic
>> conditions; however, patients complain about their drying effects.
>> OBJECTIVE: To
>> investigate the ocular drying effects of loratadine and cetirizine
>> hydrochloride
>> in individuals with normal ocular health exposed to a controlled adverse
>> environment (CAE). METHODS: Eighteen individuals completed a randomized,
>> double-masked study. Participants were evaluated in a CAE (a chamber that
>> regulates humidity, temperature, airflow, and visual tasking) at baseline
>> and
>> after taking 10 mg of either loratadine or cetirizine hydrochloride daily
>> for 4
>> days. Keratitis, conjunctival staining, and tear film break-up time
>> (TFBUT) were
>> examined before and after a 45-minute CAE exposure. Participant-reported
>> ocular
>> discomfort was recorded every 5 minutes during CAE challenge. RESULTS:
>> After 4
>> days, use of loratadine yielded a mean increase of 0.75 points (107%) in
>> keratitis (P < .001), a mean increase of 1.35 points (133%) in
>> conjunctival
>> staining (P < .001), a mean decrease of 1.38 seconds (33.7%) in TFBUT (P <
>> .001), and a mean increase of 0.32 points (24.8%) in ocular discomfort (P
>> = .05)
>> vs baseline. After 4 days, use of cetirizine hydrochloride yielded a mean
>> increase of 0.57 points (60%) in keratitis (P < .001), a mean increase of
>> 0.7
>> points (49.7%) in conjunctival staining (P = .005), and a mean decrease of
>> 0.76
>> seconds (19.6%) in TFBUT (P = .05) vs baseline. Loratadine was shown to
>> induce
>> 93% greater conjunctival staining after 4 days of use and CAE exposure vs
>> cetirizine hydrochloride (P = .04). CONCLUSIONS: Loratadine and cetirizine
>> hydrochloride induced signs and symptoms associated with ocular dryness,
>> including increased corneal and conjunctival staining, decreased TFBUT,
>> and
>> increased ocular discomfort in healthy individuals. Loratadine induced
>> significantly more conjunctival staining than cetirizine hydrochloride.
>> Clinical Trial
>> Randomized Controlled Trial
 
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Re: Ray Peat Email Advice: Organic Coffee

:hattip Judi

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(from an email exchange in 2011)

Ray Peat said:
Organic coffee is preferable (in the coffee orchards I have seen no pesticides were needed), but the roasting process probably eliminates any added chemicals.
 
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Re: Ray Peat Email Advice: 84 year old grandmother with deme

:hattip David

Re: 84 year old grandmother with dementia

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David said:
I asked Ray Peat if giving my 84 year old grandmother with dementia 3mcg of Cynomel twice a day would be safe and this was his response:

Ray Peat said:
"If someone is in a precarious condition, even smaller amounts at a time might be better. For example, a man in the hospital right after a heart attack started taking one mcg per hour; the doctors had said that at the rate his enzymes were rising they would be expected to keep rising for another day, but they started decreasing exactly when he started the small doses, and they had decreased the next day when he left the hospital, without symptoms. T3, sugar, and aspirin are the most heart-protective things."
 

juanitacarlos

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Talking about taking thyroid medication after thyroidectomy (I'm currently on 4 grains NDT):

The working thyroid gland produces about the equivalent of 4 grains of desiccated thyroid per day, and that is about 70% thyroxine, T4, which allows the liver to make as much of the active T3 hormone as needed (if it is well nourished, and not blocked by PUFA or estrogen or other inhibitor). So taking that amount makes up for what your gland would be producing; by suppressing TSH, which stimulates the growth and activity of the thyroid, it also protects against the recurrence of cancer if it wasn't all removed (some types of cancer were treated just by supplementing thyroid, without surgery). Since the desiccated thyroid is made available by being digested, it's best to divide the day's dose, with some at each meal and at bedtime, so that the amount of active hormone entering the blood isn't too high at any time.

What he said about me (female) taking 15mg DHEA (stopped) and currently testosterone (I incorrectly told him I was taking 5 mg - I'm actually on 1mg):

DHEA and testosterone at those doses are likely to grow whiskers. 5 mg. of testosterone is about ten times what a woman produces in a day, and is about what a muscular young man produces.[*][*]

[*][*]The Journal of Clinical Endocrinology & Metabolism |May 1997. 82 (5): 1492
Determination of Testosterone Production Rates in Men and Women Using Stable Isotope/Dilution and Mass Spectrometry1
H. Vierhapper, P. Nowotny and W. Waldhäusl
Clinical Division of Endocrinology and Metabolism, Clinic for Internal Medicine III, A-1090 Wien, Austria
Address all correspondence and requests for reprints to: H. Vierhapper, M.D., Clinical Division of Endocrinology and Metabolism, University Clinic for Internal Medicine III, Wahringer Gurtel 18–20, A-1090 Wien, Austria.
Production rates of testosterone were determined in healthy men and women during the follicular phase of their menstrual cycle using the stable isotope dilution technique and analysis by gas chromatography/mass spectrometry. In an initial series of experiments, 0.07 mg/h (men) or 0.01 mg/h (women) 1,2-d-testosterone was infused for 36 h. After an equilibration period of 12 h, blood samples were obtained at 20-min intervals throughout 24 h. In men, no diurnal rhythmicity of testosterone production was observed, whereas in women, testosterone production rates were largest from 0400–1200 h. In a second series of experiments, the infused dose of 1,2-d-testosterone was reduced to 0.015 mg/h (men) and 0.0001 mg/h (women), respectively. Blood samples were obtained at 20-min intervals during the last 12 h (0800–2000 h) of the observation period. In accordance with results obtained by others using radioactive tracers, estimated production rates were 147 ± 31μ g/h (3.7 ± 2.2 mg/day in men) and 1.8 ± 0.6 μg/h (0.4 ± 0.1 mg/day in women). To reduce both the duration of the experiment and the number of samples to be processed, we subsequently demonstrated that similar production rates may be obtained when the equilibration period before blood sampling is reduced to 6 h and the period of blood sampling is reduced to 4 h. This protocol is suitable for clinical use in a routine setting to obtain analytically correct estimates of testosterone production in vivo.
!

Grow whiskers - yikes!!

On sourdough bread:

Naturally fermented sourdough is less harmful than standard or unleavened wheat products, but any starch tends to stimulate appetite by activating fat synthesis. The same number of calories in fruit would be less fattening, and would keep your blood sugar steadier, improve your sleep and mental energy.

On protein in eggs (I told him I have 2 eggs for breakfast most days):

To use the protein of 2 eggs efficiently it would be good to have a glass of milk and a large glass of orange juice.

When I asked him if there is anything really inhibiting T3 from entering cells, he said:

It isn't a matter of T3 entering cells, it's assuring that it is either made by conversion from the T4, or taken as a supplement.
 
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I asked RP about his thoughts on using raw garlic as an antibiotic. His response:

Ray Peat said:
It's about as hard on the stomach as on the germs.
 
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Would pork rinds and Knox gelatine be a problem for someone with MS?

Ray Peat said:
I haven't had experience with Knox gelatin, I have mostly used either Great Lakes or Gelatin Innovations brands, which are economical by the pound. When I'm not sure of the origin of the pork, I heat the pork rinds in coconut oil and then drain the oil off, to reduce the PUFA.

I was wondering if the pork used in the packaged pork rinds snack or the pork used in making gelatin should be avoided by someone with MS?
Is there any one book that you have written that might help someone with MS?

Ray Peat said:
Beef gelatin is available from Great Lakes; some people say they have trouble digesting the pork gelatin. Because the pork rinds contain a lot of fat, which in pork is highly unsaturated, I re-heat mine in coconut oil and then drain them well, to reduce the amount of polyunsaturated fat. Since the polyunsaturated fats interfere with energy production and promote inflammation, I think it's better to avoid them. (They interfere with thyroid and progesterone, and activate estrogen production.)
 
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Re: Ray Peat Email Advice: Amount of Vitamin K in Liver

:hattip Mittir

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Mittir said:
I just got a reply from Dr Peat. I asked him about the amount of vitamin K in liver. Here is his reply

Ray Peat said:
I made extracts myself, and there was a lot of it, but I didn't measure it exactly, just a few milligrams per kilo.
 

4peatssake

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Ray Peat said:
Starting with the nosebleeds, thyroid has probably been the basic problem, so checking your temperature and resting pulse rate (at least twice a day, at waking, and about an hour after breakfast) would be a place to start. Having someone check your Achilles tendon reflex relaxation rate is helpful; the relaxation should be instantaneous, so that your foot falls floppily. A daily carrot might take care of the itch, if not, 10% sulfur soap, or dusting with flowers of sulfur, USP, should do it. Milk with sugar or honey (about an ounce in a glass) at bedtime would help to get to sleep, and reduce the night stress. Blood sugar falls at night, too low if your thyroid is deficient, and is compensated by the stress hormones. Your lowest temperature should be at night, but the stress hormones can cause your waking temperature to be higher than the midday temperature. Pulse rate should follow the same pattern, rising with breakfast, and staying above 80/minute during the day. Aspirin can help with increasing your metabolic rate. Mary Shomon's thyroid website and http://www.tpauk.com have good information about thyroid. I use Cynoplus and Cynomel from http://www.mymexicandrugstore.org, which are generally more economical and more consistent than some of the glandular products.

Context for his reply

Childhood:

1. Chronic nosebleeds - around 10-12 yrs old had nose cauterized and this I think stopped them.
2. Chronic sore throat - had pediatrician who was against removing tonsils so was given antibiotics on a regular basis - it was always penicillin as I recall.
3. Mother diagnosed in her 40s as hyperthyroid, was on radioactive iodine ever since.

Teen/Adult:

4. yo yo dieting from late teens/early adulthood onward. Weight up and down and then ongoing weight gain around the late 30s. Tried every diet in existence. Bought fully into false notion that sugar was the worst thing one could eat. Did entire low carb gambit atkins/paleo/zone/protein power, plus raw vegan, green smoothies, vegetarian, weight watchers, Nutrisystem, probably many more. Could never successfully quit sugar.

5. Infertility, (unexplained in me, definite in partner) - took powerful infertility drugs over the course of 4 years - about 6 treatments - had 2 miscarriages, 2 nothing and 2 children. Drugs taken were first, clomid and then Fertinorm HP (urofollitropin).

6. In early 30s, diagnosed with major depression, SAD, dysthymia, post traumatic stress disorder. Took SSRI meds (zoloft) for only a short time thankfully. Also self medicated with 5HTP, tryptophan and St. John's Wort but not long term nor to any significant degree.

7. Diagnosed and treated (laser surgery) for cervical dysplasia in late 20s/early 30s

Current:

8. Extreme fatigue and brain fog (fog sometimes lifts, thankfully). Depressed, lacking motivation and lethargic at times. But also periods of motivation and activity.

9. Extreme, sudden onset insomnia in the last 2-3 weeks.

10. Perimenopausal. Menses had become extremely heavy. Began using Project E only a few days before the last period and it was normal (even less that normal) and of shorter duration. Big wow there.

11. Racing heartbeat at times. Pulse high (often over 100) and temps low, usually in 96s/97s - been as low as 95s...only rarely in the 98s.

12. Severe neck pain - left side. Diagnosed with degenerated disc disease in neck in 30s. Debilitating pain for years that went away suddenly but returned in recent years. Severe nerve pain when pressing on left side of neck.

13. Overweight with weight gain increasing particularly as menopausal symptoms increase.

14. Sudden and rapid deterioration of eyesight in last 2 months.

15. Severe skin itching
 
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Re: Ray Peat Email Advice: Prostate Problems

:hattip Kelly

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Regarding Prostate Problems

Ray Peat said:
Correcting hypothyroidism will usually reduce prostate problems, and often pregnenolone helps with that as well as with increasing testosterone. Checking temperature and pulse rate at waking and in the middle of the day, and checking the Achilles tendon reflex relaxation rate, can help to judge the hormonal situation. Having a carrot salad every day (shredded carrot, with a little olive oil, vinegar, and salt) can help to lower the stress hormones that are usually associated with prostate inflammation.

Kelly said:
I asked about if it was ever a good idea to supplement testosterone. His reply:

Ray Peat said:
Yes, pure testosterone on the skin is safe if the diet and thyroid function are good, but it's better to try supplements of pregnenolone first, and then DHEA, to normalize the testosterone production.
 

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