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. 

Another Interesting Theory

So I am reading a book that is just blowing my mind. Very interesting. It is by an evolutionary biologist who has spent the last ten years with "hunter gatherers" in Africa. He notes that by and large they have very little cancer, heart disease or other chronic health problems.  They pretty much exercise most of the day while out hunting or with women doing home type work.

His theory: we all believe that excess energy will be turned into fat... but what if some of it isn't? Let's say that we need 1500 calories per day and we eat 2000 calories - constantly. Sure 400 of it may be turned into fat... but 100 will be used by the body before the excess is turned into fat.  It is this chronic excess energy that causes bad things in the body: simply because the body has excess energy and has to do something with it. 

So what does it do? Increases inflammation, increases cell proliferation, causes an overactive immune system, and who knows what else? Essentially we should not be running on an excess energy situation each day.  The excess energy causes the body to have to do something with it - and that something may not be a positive thing.  

This is my commentary but IMHO this makes sense.

• It is well known that Calorie Restriction improves health, longevity, and biomarkers across all species...
• Exercise also has been shown to to improve health, longevity, and biomarkers across all species. But sometimes it doesn't... perhaps due to overeating?
• Part of his theory is what what you really need energy for are "big ticket items" like reproduction. Well, it is well known that people start having health issues in their 40s and 50s... when your body downshifts and no longer needs the energy for reproduction.  I have long stated that if menopause MUST mean something and we should listen to its apparent demand that we eat less... here is some evidence that failure to heed its warnings about less energy will cause problems. 
• Diet interventions that invariably cause less energy to be eaten (or increase the energy needs of the body) are more likely to result in health. E.g., fasting, keto, etc.
• Many diseases of modern calorie excess imho have evidence of an "overactive" body. Sink tags, Acanthosis nigricans, even uterine fibroids - etc. Does your body make these because it has to do something with the excess energy? Are these signs that your body has energy excess? 

What is most interesting about it is that it is kind of like a toggle... when you are younger you have massive energy needs... so you very rarely are in energy excess. But as you age you have less and less energy needs, and, you eat by and large the same (or more) you flip over to a chronic energy surplus which causes complete havoc with the body. 

Another part of his book that is interesting is that he has done extensive studies on it and it turns out that exercise does NOT increase your Total Daily Energy Expenditure.  This is another reason why we have all messed up so badly. He has measured the TDEE with these hunter gatherers and it the same as any person in the modern world. He has also studied it with animals... apes - and a captive ape in a zoo has by and large, a similar TDEE to an ape in the wild.  This number is determined by YEARS of evolution and factors like famine and reproduction. You cannot increase it substantially on a short term basis. 

So you see, people who are exercising may believe they can eat more than they really should be eating.  They may believe they burned off 2000 calories per day because they went to the gym, but they didn't and eating 2000 calories gives them excess energy that they didn't need. 

A NEW THEORY ON CANCER

So as I mentioned I am doing Keto. Everything on my blood tests has gotten better - except my cholesterol.  It is well known in the Keto community that Cholesterol goes way up on Keto and mine did that.  But why? I mean we know that food itself does not relate to the cholesterol level. Your cholesterol level is controlled by the liver.  We also know that people on Keto usually have their cholesterol stabilize once they have been on Keto for a while. 

Finally someone figured it out Cell Walls

Cholesterol in cell walls "Most people think of cholesterol as something that is mainly found in the blood," says Zinöcker. “But only a small part of it is found there. Most cholesterol is distributed throughout our cells.” Cholesterol is an indispensable part of the cell membrane – a kind of flexible wall along the surface of the cells. This membrane protects the cell contents inside, but it’s not completely impermeable. The cell needs substances like nutrients, building blocks and signaling substances from the rest of the body. It also has to get rid of waste. The cell membrane allows substances in and out in a very controlled way. In fact, a well-functioning cell membrane is extremely important for the cell to function.Research has shown that cholesterol is an essential component of this membrane. Between 30 and 50 percent of the cell membrane consists of cholesterol, where it has a very important task.Adjusts membrane stiffness "Cholesterol adjusts how fluid the membrane is," says Zinöcker. The cell membrane can become more or less rigid, depending on how cold it is and what kinds of fats it consists of. The latter depends on what we eat. When we eat more polyunsaturated fat, the cells incorporate more polyunsaturated fat into the cell membrane, making it more fluid. To compensate, the cell also incorporates more cholesterol in the membrane. Cholesterol has a stabilizing effect on the soft membrane. If we eat more saturated fat, the opposite happens. The cell membrane becomes stiffer and no longer needs that much cholesterol.

At the same time... last year I stumbled upon a researcher who was looking at how cells started their journey to cancer. Mina Bissell has been researching the extra cellular Matrix (the area surrounding your cells) for about Thirty years. Her amazing information is, that when the area surrounding your cells starts to break down, your cells start to "break free" / "become deformed" and proliferate. It is the area surrounding the cell that keeps it in shape. That keeps it from proliferating.  To use an example... maybe sausage. It has a thin layer that keeps the stuffing inside. But if that breaks down it will come spilling out. Well, what about this polyunsaturated fat making the cell wall more fluid? And saturated fat making the cell wall more stiff?  Dr. Bissell has shown that once you replace the outer layer of any cell that is proliferating it will return to normal and stop proliferating. 

And then it hit me... are an excess of polyunsaturated fats causing cells to break down more easily?  If we ate more saturated fats would the cell wall get stronger? Less fluid leading to less proliferation?

And let's go further, going back to my last post talking about inflammation in the cell due to excess carbs and water. If the cell interior is stuffed full of water, pushing on the cell wall, at the same time was we are eating fats that make the cell wall more fluid, does this not explain how the cells "break down" and proliferate? There is pressure on the cell wall from the inside due to sugar and the fats that make up the cell wall are less strong and firm. 

SO GOT MY RESULTS

And I am happy to say that I am thrilled.

M-spike: Went down.  From .5 g/dl to .4 g/dl. 

Light Chains: Went down massively. Both Lamda and Kappa were normal and my ratio went from an abnormal 1.9 to a very normal, and the best ever 1.4. That takes me out of the high(er) risk range.

IGM Immunoglobin: Well this one went up a little. From 290 to 296. But it is still normal and, if seems as if it might just be something that could run high in the winter.  Both my IGA and my IGG were higher and are in the normal range as well.  Remember this number can include polyclonal antibodies.

Hemogram and Differental: Absolutely spectacular.  Everything was normal. 

Comprehensive Metabolic Panel: Absolutely spectacular. Everything was normal. 

I have to lay this at the feet of keto / fasting. My thought is that it has to be related to inflammation. Now to be fair, it also might have to do with my getting my tests last time after having blood drawn for research donation. However, I think it is more likely to do with inflammation and its effects on MGUS. For me the only possible reasons I could have gotten MGUS in the first place seems to have been inflammation. Almost everything else was really ruled out. 

You see, last June I also was doing Keto and fasting.  And those tests too, were also spectacular. My M-spike came back lower than now. .3g/dl and all the other tests were normal and great. So it seems obvious to me that perhaps, doing this keto and fasting could actually lead to this going away. The problem so far is that I haven't stayed fasting for long enough.

I have been listening to a doctor on you tube called Dr. Cywes... he is amazing. The explanations he gives for things are pretty spectacular and, when I look them up... he is right.  He talks about how inflammation is really a disorder of water -- caused by glucose molecules.  He says that 1 molecule of glucose goes into the cell with 4 or 5 of water. Eventually the cell uses the glucose but the water remains. This is inflammation. Now your cell(s) are running around with too much water and inflammation.  And doesn't this seem likely? Haven't you noticed the "puffiness" of people today?

Normally, your body uses inflammation to denote to the immune system what cells need to be looked at. Inflammation is normally something triggered when there is a virus or bacteria.  He says that inflammation is not a bad thing. There is a normal homeostasis of autophagy and inflammation that keeps your system working right. But if you are eating carbs a far too great number of cells are "inflamed" and your immune system is disposing off far too many good cells and calling for more cells to be created. Is that not a recipe for a mistake?

I will include the link at the end. For the moment I am going to see what happens the rest of the year as I do keto and fast for a longer period. 

WORRIED ABOUT MY NEXT TESTS

So my next blood tests are due. I called on Monday and they are sitting there waiting for me. My last tests were done on November 17, 2020. So today is exactly three months. 

I was going to go today, it is a beautiful bright day.... but I just couldn't bring myself to do so. 

The reason in my head is that I have been fasting and am probably dehydrated. And also, I am not sure about my CBC and other results because, I have been fasting and I am not sure I have been getting really strong nutrition. 

But, truth is... probably scared. 

Mostly scared because at the moment I am without a primary care doctor and also, without a hematologist. I said that the blood test results would tell if I needed to go to Dana Farber or just find a hematologist / oncologist.... 

I have tentatively decided to perhaps go on Saturday. The lab is open for 4 hours. I will be on a "eat day" on Friday and hopefully can drink a lot of water. 

BONES

I remain quite afraid of what this disease can do to bones. On the one hand if I progress to WM it appears bone complications are rare (as opposed to MM). I hang out on a WM group and rarely hear people asking about bones or fractures.  While a lot of people I know with MM were diagnosed with it via fracture. 

That being said, I need to keep my bones strong.  Being single, healing from a fracture could be devastating. 

So for the moment I am looking into osteoporosis.  The good news, I thought, was that I had a DEXA scan last year and all was well. I didn't have osteoporosis or osteopenia. That test measures Bone Mineral Density. But, looking further, BMD has been scientifically determined to mean nothing as to fracture risk.  The way I have heard it... BMD measures essentially the calcium in your bones. Sounds like a good deal right? But your bones have a structure to them that underlies the calcium. If that structure is not strong, you can have all the calcium in the world and not have strong bones. 

In addition, your DEXA scan is compared to a 28 year old female. But as some doctors have noted, it is not scientifically sound to do that. Our bodies at 28 are primed for childbirth and accordingly have high supply of calcium in case needed for childbirth. Once you are no longer going to have children it lets go of some that supply. They argue that if anything standards should be made with regard to normal for women at age 50, 60, 70 and 80. 

Also, this was pretty interesting to me but your blood type can play a role in your risk for fracture. O blood type is the least likely to have fractures.  This may be due to the fact that O blood type is less likely have have diabetes. And diabetes is a major factor in fractures. 

The shocking but never mentioned biggest thing to destroy bone turns out to be sugar. There are tons of studies showing that sugar destroys bone -- in particular with soft drinks. But also, diabetics have a much higher fracture risk even though many type two have strong bone mineral density. (showing that BMD means nothing to fracture risk).

People say that animal foods destroy your bones. But I think that is faulty thinking. If the bones do need a "structure" for the calcium to sit on... and that structure is made up of things like collagen and protein... it would seem that you need meat. In addition, in the last thirty years we have largely gotten rid of meat, and it hasn't done a body good. Fractures are at a highest point ever and Vegan and Vegetarian diets have shown themselves to increase the risk of fracture. Vegan diet higher risk of fracture It also doesn't make sense from a historical point of view. When we were hunter gatherers we at almost exclusively meat / animal foods. If it could cause the bones to fracture, well, that would have ended us as a species.  It also doesn't make sense looking at other animals. Who often do not eat dairy of any kind and do not seem to have their bones melt. 

The theory seems to be that acid from animal products will melt the calcium in your bones... but, all of that imho is speculative. There is great debate about our ability to make our body acid or alkaline for very long. Further calcium is just one of the factors that go into bone health. Not 100%... that is outdated thinking.

I saw a theory on Pub med last year that really capture my imagination. It was proposed by scientists and to me makes a lot of sense. It is fact that the countries with more calcium consumption have worse rates of fracture. The theory is that the more calcium that goes into your blood, the more the body must get rid of. Calcium in the blood is tightly controlled. The body can dispose of it via urine but, if there is too much, it must find another place to hide it until it can be removed by urine - so the body stuffs calcium into your bones until it can later be removed. Sound good right? But no. We have bone remodeling cells. Osetoblasts and Osteoclasts. Osteoblasts put the calcium in - Osteoclasts take the calcium out. One problem the process of putting calcium in destroys the osteoblasts -- forever.  They are not reproduced like osteoclasts. So if you have been overdosing on calcium for your entire life, you will have drastically reduced the cells that put calcium in your bones. 

Finally, I have long had a theory that insulin resistance is, in part, caused by calcium blocking/ gumming up.. insulin receptors in cells. This is my theory but, is seems there is a lot of circumstantial evidence. First, every single thing that reduces calcium in the body also helps insulin resistance -- Vitamin D, Vitamin K2, Magnesium, Apple Cider Vinegar, fasting/ autophagy.   In addition, insulin resistance tends to ultimately cause worse glucose control in the blood stream. And what does that end up causing.. bone damage from sugar in the blood stream. It just seems obvious that when you constantly have high levels of calcium in your body, no cofactors, some calcium is going to gum up the works and over years could gum up the insulin receptors on cells - there is absolutely is science showing that excess calcium is associated with insulin resistance. Association of Serum Calcium and Insulin Resistance -- this is just what I could find easily.