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D Lactate Acidosis Treatment

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D-lactic Acidosis With Encephalopathy Subsequent To Short Bowel Syndrome In Bariatric Surgery. A Case Report In Emergency Room

D-lactic acidosis with encephalopathy subsequent to short bowel syndrome in bariatric surgery. A case report in emergency room Roberta Rocchi, MD Laura Magrini, MD Enrico Ferri Emergency Medicine Department, S. Andrea Hospital, Rome, Italy We describe the case of a patient admitted in Emergency Department with D-lactic acidosis associated to encephalopathy secondary to short bowel syndrome following bariatric surgery. D-lactic acidosis with encephalopathy is a severe complication of short bowel syndrome. It is characterized by metabolic acidosis due to increase of lactic acid determining neurological signs and symptoms of encephalopathy. In short bowel syndromes patients there is a malabsorption or lack of absorption of carbohydrates; this causes an accumulation of lactic acid that reduces pH and promotes bacterial growth, mainly lactobacillus, which in turn produce D-lactic acid (1,2). D-lactic acid is metabolized, and eliminated more difficult than L-lactic acid normally produced (2). Patients with short bowel syndrome secondary to intestinal bariatric surgery can show D-lactic acidosis from few months to several years after the surgery (2). Patients with D-lactic acidosis show Continue reading >>

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  1. Remy

    I was blown away by the presentation of Dr Richard Veech on Bulletproof Radio a few months ago.
    He studies ketones, specifically ketone esters which are super fascinating (and would be a much better use for all this crap corn than high fructose corn syrup but that is a story for another day).
    Some of you probably know that ketones are another kind of fuel for the body. They are a fuel that can be especially well-utilized in a state of hypoxia...when the body is trying to product ATP mostly through anaerobic metabolism which isn't very efficient at all compared to glycolysis.
    Higher ketone levels are also used to prevent seizures and to treat Alzheimer's disease and Parkinson's but it is difficult to get to the levels required through diet alone.
    Nutritional ketosis is about 1.0-1.5 on a blood meter optimally but a lot of these therapeutic effects happen at higher levels like 3-4.
    One way to increase ketone levels in the body is by consuming C8 oil like Brain Octane.
    Another way is by consuming beta-hydroxybutyrate in the form of a ketone salt like KetoCaNa or KetoOS.
    Dr Veech is very much against consuming these ketone salt products. He explains it much better in the video but basically they are racemic mixtures of ketones. A racemic mixture means a molecule is chiral (handed) and the mixture contains both "hands". Examples of this are amino acids which are often differentiated by the letter L or D which refers to their handedness - think of L-carnitine.
    In nature, typically only one hand is active (usually the L) and has metabolic function. The D form may fit but it may or may not have the same metabolic activity. The drugs Zyrtec/Xyzal are an example (Zyrtec is racemic, Xyzal is the L form only) but there are many others. Drug makers exploit this handedness to produce two drugs that do the same thing but get double the patent time out of it. First they produce the racemic mixture and then they produce the "clean" form next.
    So Dr Veech says that we shouldn't consume racemic ketone salts like the beta-hydroxybutyrate because they will interfere with our body using the active form. He goes as far to say that it may be dangerous and he makes a convincing argument.
    But another ketone expert, Dominic D'Agostino, was also interviewed on this subject and has a totally different view on exogenous ketone salts. He makes the argument that they are no different than other racemic mixtures like Ringer's lactate which works exactly the same in the D and the L form.
    https://thequantifiedbody.net/ketone-bodies-dominic-dagostino/
    Frankly, I'm not at all sure who is right on this topic. I don't think that science has answered this definitely one way or another.
    Dr Veech's theory makes sense to me because I do believe that chiral molecules have different metabolic effects. But Dr D'Agostino is certainly no slouch either in the qualifications department.
    He is clearly perturbed by Dr Veech and Dave Asprey and it's kind of funny to listen to him go on about other people's opinions not backed up by science. He seems to think that Dave Asprey and Dr Veech both may have conflicting interests (which may very well be true) but who really knows? I think they are all probably acting in good faith, personally.
    Dr D'Agostino may also have conflicting interests. He may (or may not!) be involved with the company that makes Keto OS. And he would like to partner with companies making ketone salts so that they can help fund his research.
    In the meanwhile, I may experiment some more with exogenous ketone salts (if I can find some that don't taste like powdered sugar, @SanDiego!) and see how they affect me personally. I'd personally rather use ketone esters but until they are commercially available, the salts (or the C8 oil) will have to do.
    Anyway, I highly recommend anyone who is interested in using higher levels of exogenous ketones to promote mitochondrial health and energy levels to listen to these two podcasts. There is a wealth of information to be had.

  2. Remy

    @San Diego, I tried to tag you but I got your name wrong.

  3. San Diego

    Remy said: ↑
    @San Diego, I tried to tag you but I got your name wrong. Thanks for tagging me! This might be just what I need.
    I’ve been in ketosis for a couple of months and easily stay there with a combo of MCT oil, ghee, and olive oil. There’s so much confusing information out there and I’m slowly sifting through it.

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