Another interesting study - Fatty Bone Marrow causes CP.

In 2021 a study came out that honed in on how blood cancers basically begin, suggesting that inflammation messes up the creation of blood cells and causes clonal hematopoiesis. Good to know, and I then concentrated on reducing inflammation and weight loss. 

For me though that confused me.  I am overweight but have had very low inflammation markers and do now.  Well,  just got another piece of the puzzle. 

Inflammatory signals from fatty bone marrow support DNMT3A driven clonal hematopoiesis

https://www.nature.com/articles/s41467-023-36906-1?fbclid=IwAR3ichvOW0E-AzcHIWRLrNSLRzzBk3NU0V5SPo_js4QCBcMz_H_i61C3V0s

This study basically suggests that we have "fat" in our bone marrow. Who knew that? And that there is such a thing as "fatty" bone marrow - like fatty liver.  And it is THIS fat which puts out the inflammatory signals corrupting the bone marrow.   So you see your overall body could be relatively low in inflammation - and not really make a difference to your bone marrow. 

The accumulation of FBM with age is ubiquitous, however, large variability exists in its extent58. Epidemiological studies suggest that several factors can explain this high variability including: the age-related decline in renal function, increased body mass index (BMI), andropenia and menopause. Interestingly, FBM continues to increase steadily in males, while in females it increases dramatically following menopause. This phenomenon might be related to the rapid estrogen deficiency during menopause as oppose to the gradual decrease of testosterone in males. Previous studies demonstrated enrichment of DNMT3A mutations among females. The sharp increase in FBM during menopause could suggest that it is the dynamics of FBM accumulation that shape CH rather than the actual FBM mass. Interestingly, a recent report suggested that DNMT3A mutations were significantly associated with premature menopause.

So we see that the increase in fatty bone marrow is essentially a side effect of menopause and reduction in estrogen. And my MGUS started after menopause. However, it can also be contributed to by a decline in renal function (guessing this relates to sugar), increased body mass index (likely insulin resistance). 

The study concludes with 

Based on the results presented here, it is becoming clear that FBM is more than just hypocellular marrow, and that it can shape CH evolution and contribute to other adverse metabolic effects. More research could be directed toward the prevention of FBM accumulation and its interaction with other mutations and with human HSCs. With the ultimate goal of correcting the very first steps in leukemia evolution and aging.

I completely agree. I wonder if we could reduce the FBM by increasing estrogen. HRT might be an option but I still worry about that for other cancers... but perhaps just changing the foods we eat and increasing estrogen slightly could assist.  Though I am hesitant to take any action until we know for sure. To me it doesn't make sense that your body would essentially "screw" you in this way at Menopause. I have a feeling that it could simply be related to massive weight gain at Menopause in a great number of women. And perhaps fatty bone marrow, like fatty liver, could be drastically reduced eating less and eating less sugar / reducing insulin. Fatty liver is caused by

Too much refined sugar and high-fructose corn syrup causes a fatty buildup that can lead to liver disease. 

Does it not make sense that another fatty build up could be caused in a similar way? Your body has to find places to put the fat as you keep showering it with sugar and the mere fact that it tends to happen at menopause could be related to a lowering of the metabolic rate while not lowering the level of food. 

This seems to be a very promising study. 

Update: my M-spike went away.

So at my December 2022 Dana Farber appointment I was stunned and very happy to get this result...

Protein Electrophoresis:

-Immunofixation shows a faint M-spike that is not apparent on the

electropherogram and, therefore, cannot be quantitated.

Now I know, a previous doctor already warned me, the electrophoresis is just an interpretation and not an exact value.  So it might show up slightly more more or slightly less depending on the judgment of the person looking at it.  And I know... plenty of people on the MGUS group have had the Mspike go away and come back. 

But, this is the first time in 3 years that the spike could "not be quantitated."  I feel like this means progress.

My light chains are still slightly high and my IGM is also slightly high. But I would imagine it would take time to clear if the clone went away. 

I guess we will see. My doctor doesn't want me coming back for a year but I am still planning on getting IGM tests every 4 months to make sure that isn't increasing.