So this is how I understand Mgus.

I had to explain this to a friend the other day.  Not sure this is right but I thought I would post it. 

The process starts when your body calls for "new" plasma cells. Your body releases a "stem cell" which goes out and finds a group of plasma cells to emulate. What it is supposed to do is follow and learn from the plasma cell and become just like it (differentiate). Sort of like an intern at your job learns to become a good employee. 

But something goes wrong. The stem cell does not quite make it / graduate. It doesn't become a full fledged normal plasma cell. It becomes a "clone" or a clonal cell.  Usually becoming an IGM, IGG, or IGA (kappa or lambda) based on what cell it tries to emulate.  These clonal cells release a protein (M-protein) which is how you know if you have an M protein you could have a clonal cell.  It is not always the case.

To me the best way to understand it is the movie "Multiplicity". In that movie Michael Keaton makes clones of himself. But each clone degrades a little bit more than the last one. Now each clone is functional (so for Mgus the body doesn't destroy the clonal cell because the cell is still functional and the body probably sees nothing wrong with it) but it is "off" and a bit hyperactive. Whereas the normal Michael Keaton reproduces with two children... the clone of Michael Keaton may have 6 kids. (all a little off because they are reproductions of a clone).  The real Michael Keaton may go to work and produce 40 widgets at his job but hyperactive clonal Michael Keaton will produce 150. 

In the same way, the clonal cell may reproduce more than normal cells. And just because you have more clonal cells, and they are a bit hyperactive, they are going to produce more of the type of antibody that they were trained to produce (in my case it is IGM kappa). And with an increase in antibodies, there will be an increase in "light chains" because light chains are essentially a bi-product of antibodies.  So because I am kappa my ratio will likely always go up.  

The clonal cells live in your bone marrow so a way of working backwards and trying to figure out how many clonal cells could be in your bone marrow is by testing the levels in your blood of the "M-Protien", "The Antibodies", and "the light chains".  These give a hint as to how aggressive the replication of the clonal cell is.  

So it seems to me that at its source...  the goal is to keep the clonal cell suppressed and from reproducing too much.  More modern treatments, immunotherapy, are looking to "tag" these clonal cells and tell the immune system to go destroy them. The immune system doesn't generally because, as mentioned, the cells are not recognized as defective. You and I know they aren't right, but they are not wrong enough to activate an immune response. 

And go watch Multiplicity if you haven't seen it. Super funny.

LETS DISCUSS DIET AND MGUS

I believe strongly that *diet* is one of the only things that can stop, reverse, and or slow down MGUS. But every time this question is asked I think they get it wrong.

The question is: can diet effect Mgus? The answer is insanely complex. 

First, people say "no" but that answer is wrong. The correct answer is "NOT THAT WE KNOW OF YET". The studies simply have not been done. For instance, there is one study that says that being overweight will lead to progression of MGUS. But then a subsequent study says it will not.  I am a member of PC Crowd and even there, the questions about diet are so basic - I do not see how they can come to any conclusion.  From my own internal polling of the MGUS Board.... it seems obvious that being normal weight does not keep you from getting MGUS as there are many people on the board with it who are normal weight.  But we don't know if being overweight will cause progression.  Which, it makes send that it could.

Then, it seems obvious that if you have MGUS because of a reason that is unrelated to diet... - diet probably won't help much. For instance... many people with MGUS have auto immune disease. Diet could, but probably won't do much for a serious auto immune disease.  (though there are many people that claim a cure with the carnivore diet) Other people may have MGUS due to poisoning from being in the Military - that damage is probably not going to be reversed by diet.  Finally many people with MGUS have a genetic predisposition (family had it) that probably is not going to be reversed by diet. Though it is possible it can be inhibited.

On the other hand, there is increasing evidence that proliferation of any cancer can be slowed down or reversed due to what you eat.  See How to Starve Cancer: Without Starving Yourself by Jane McLelland. Jane actually had serious lung cancer and cured it with a combination of diet AND off label drugs. Now... you're like, *but the drugs...* but remember she had cancer.. we just have a precursor. If we can keep the precursor under control with diet, we are all set.  We won't need drugs. 

We all also need to discuss exactly what we mean when we discuss "diet" as I think that term has gotten warped lately. I often hear people state that they "eat healthy" well what does that mean?  There really is no evidence as to what is "healthy".  So I hate to hear that.  What we need to be doing is eating an anti cancer diet. A diet that specifically targets proliferation and dysfunction in the body.  

I often hear people saying "sugar" is bad for cancer. Let's clarify. This is an insanely complex subject.  But yes, cancer does not use the normal pathway to make energy. It makes it via "fermentation" - and fermentation requires glucose. It is also very messy - using 60% more energy just to accomplish the same energy as going through the regular process. This is known as the Warberg effect.   So yes, if you are consuming a TON of sugar, your body is going to progress easily. And yes, reducing sugar will reduce the proliferation fo cancer. See "Anyway you can" by Annette Bosworth (keto substantially reduced her mom's leukemia). But it will not stop it alone. Cancer can also switch to feeding of other substances. Such as amino acids. (Glutamine)

It seems to me that there are three things at play.

1. Something causes the cells to break down and proliferate.  To me this seems like this is related to protein and IGF-1. Sugar also has an effect as it activates insulin which increases IGF-1.

2. Once they proliferate -- they don't die as easily because of all the sugar easily feeding it.  To me this seems like it is related to glucose. 

3. for some reason, especially with clonal cells... they are broken but they don't die. Well of course, there is a diet intervention that could cause them to die, called Autophagy. Fasting for a long period of time does cause your body to basically eat itself.  There are people with blood cancers on the books that had big improvements with 21 day fasts -- what could a 21 day fast do for MGUS? -- I am too afraid to find out.  But, hoping I can work up to that soon.

It is my position that if we really wanted to know we would get serious about this and measure on people with MGUS..

- exactly what they ate each day,

- exactly how much exercise they did each day,

- exactly their TDEE each day,

- exactly the drugs they may be taking,

- exactly the supplements they may be taking. 

At the moment the big medical institutions are struggling on the big issues and will not be looking to diet.