Trying to Sleuth Out how this happened: Part two.

Potential #2

Occurred as a result of increased stomach adipose tissue and the increased inflammation. 

I have always known it was dangerous to be overweight in the 40s to 60s age group.  Thus, in 2012 I decided I was going to get thin. I did a liquid diet and, I got thin, I dropped to 155 lbs. The problem, it took me 9 months to do so eating 800 cals per day. And my metabolism absolutely adjusted downward. Through pure will power, I managed to keep it off until 2014 but several jolts to my willpower made it difficult and I quickly added weight. 

2015 I tried again but I realized something was wrong. I was just not losing weight easily. I went to a weight program and had my metabolism tested - 1100. They literally thought the machine was broken. Thus I realized I had to increase my eating to get it up.

So from 2015 to 2019 I did that, and unfortunately I gained most of the weight back. But by the summer of 2019 I had the metabolism tested and my metabolism was back up around 1590. Now the question was, how do I lose it once and for all so that I do not have my metabolism reduce? 

I never got the chance. During my first attempt (time restricted eating) I was diagnosed with MGUS. 

I believe what happened was this:

• From 2016 to 2019 I started down the menopause road and that helped form where the increased weight went (mostly stomach).
• The increased adipose tissue in the stomach increased inflammation and that sustained increased inflammation over years caused damage to my Haematopoietic stem cells.
• During this time I indulged in sugar and sweets - increasing inflammation. 
• In late December 2019 I came down with an extremely aggressive cold of some sort that is highly unusual for me. I had a high fever and cough and it lasted a week.  My body called for new B-cells and the body created clonal cells from the damaged stem cells. 
• Two months later, I was diagnosed with MGUS. It appeared to just have started as almost all other tests came back normal but for the M-spike which was low. .5 g dl.

Evidence Supporting this

1. New research is laying the feet at MGUS and progression at Chronic Inflammation. Obesity causes chronic inflammation.
2. It just seems to me that whatever happened, happened as a direct result of that "illness" in 2019 which was quite aggressive and unlike anything I had seen before, possibly an early version of Covid-19. 
3. My MGUS results are extremely low, suggesting that whatever happened, happened close in time to discovery.

Evidence against

1. WBC seemingly reducing in summer 2018 could have been the reason that the "cold" I caught in December 2019 was so aggressive... my immune system was not as good as pre menopause.
2. Given that my m-spike hasn't moved in a year, it could be that the problem happened far earlier than December of 2019 and I simply do not know it yet. 

To me, this seems like the most likely explanation given what I know about the health of the body. Things usually take a long time to break and many surveys done on the MGUS board tell me that people usually have a LOT more vaccinations than I do... so one random vaccine seems unlikely to have caused an issue. 

Trying to Sleuth Out how this happened: Part one.

I am sure you're asking what does it matter how it happened? Well, frankly because I don't want to make it any worse and if I have a hint how it happened, maybe I can avoid it.

Potential #1

Occurred as a result of a Tetanus Shot (and cat bite) I had in February 2018. 

Why this seems like a possibility.

• Prior to June of 2018 my White Blood Count (WBC) was consistent and normal at around 6.0. And I have a long history to refer to thanks to a medical monitoring diet plan that did CBCs frequently. 
• I always have a bad reaction to a Tetanus Shot. For two days afterwards I have a relatively high fever and feel very bad. This February 2018 was no different. I actually scheduled it on a Friday so I wouldn't need to take time off.  To me this indicates a strong immune reaction. 
• January 2018, my WBC came back at 6.0 so I know that it was normal then. I had the shot in late February.
• June of 2018, it dropped to 5.5... and has steadily gone down since. 

Why this seems unlikely.

• A reduction in WBCs is associated with menopause due to a reduction in reproductive hormones. I had an FSH test (generally a test to tell you if your body is asking for more sex hormones) in August 2017. It was a tiny.. 3.0. And up to that time it was always lower than 7.  But in January 2018 I had an FSH test and, for the first time, it was up around 45. It has never been close to under 20 since that time. IMHO showing that I truly started the process of lowering hormones in Winter of 2018. 
• I have a theory that after you stop bleeding your RBCs increase and perhaps there is "less room" for WBCs in the blood flow and they naturally reduce. 
• My WBC has gone down, but, it is still normal. 

Conclusion: The WBC reduction is a natural change seen in menopause due to less reproductive hormones.  The reduction coincided with indications of menopause and is likely not related to MGUS.

Sodium and Inflammation

So I was born into a family where both parents had high blood pressure. In fact, I believe my dad "died" of it... as after he came down with dementia they found evidence of TIA strokes. My mother had left ventricle heart issues because she had been non compliant with her blood pressure medications.  My brother currently has sky high blood pressure and is on medication.... all of them eat and ate, carbs and fast food. 

But me... I haven't had it done recently, but, until I was 50, I had shockingly good BP. Typically around 110/80.  I reduced my carbs at 30 and pretty rarely eat out. 

I suspect growing up in the household I did I was already a low sodium machine. I always looked for low sodium.  I just liked the taste of low sodium better. I am at heart, a plane jane. 

But recently I have been convinced to start sucking down sodium. In particular because fasting depletes your body of it.. but I think I have been going overboard. 

The day before my blood tests I consumed.

• A can of wax beans - 1200 mg
• 4 sausages  - 450 mg.
• A double cheeseburger (without the roll) 1100 mg.
• 2 servings of nuts - 500 mg for both.
• A electrolyte supplement - 250 mg. 

These were just the big ticket items. Now of course you can argue that since I don't take in any sodium the next day, you need to cut this amount in half, but I wonder what such a mass dose can do to the body.  It is difficult to figure out. There are studies out there showing that salt/ sodium does spike inflammation. But, on the other hand, they seem not to keep track of what kind of food you are eating. For example if the sodium is coming from fast food, well fast food itself can spike inflammation due to seed oils. 

One thing I always go back to is chronic inflammation being associated with excess water in the body. We see that carbs can cause it because each carb molecule attracts 4 water molecules... and it is this excess water which causes the body to react. So it makes sense that something like sodium, which causes excess water in the body is also going to cause inflammation because, temporarily, you will have excess water. 

I did find a good study on Salt and MS. There the study proved that Salt does affect your "T-cells" and cause them to start inflammation. 

"This research shows how sodium affects T cells and causes inflammation. Salt affects signaling at the immune level, not the nerve level,” Schofield explained.This offers “compelling evidence that high salt intake could lead to increased inflammation and could trigger in MS, Schofield said. The body excretes extra salt if too much is consumed. But salt could potentially fluctuate in microdomains, which are small regions of membrane, he explained."

So to me this clearly says salt can increase inflammation - so you do have to be careful of it PERIOD... not just for Blood Pressures sake.

Bummed out some more...

 Do not get it.  My results are super confusing. 

• HS-CRP: so I got the results of the highly sensitive C-reactive Protein... and it was 4.0. That is high. You should have a result under 1.0.  I am really shocked at that. 
• CRP: last time I got blood tests I got regular CRP... and guess what.... my results has gone down since January.  So in January I was at 6.0. Under 8.0 is normal. This time I was down to 4.0.

So, explain this to me will you? 1/2 my inflammation biomarkers come back high, and the other half come back low.  Also, I have lost 20 lbs since January so you would think that would reduce inflammation?

Well some good news..

• IGM: my IGM came back at 277. So that is still normal. Because I have this tested so frequently I am now starting to consider that my IGM just hovers in the high 200s and perhaps... always has. Of course that can be related to my clonal cell but, isn't it possible that we all have different levels of normal? At this same time this kind of worries me... does this, combined with the inflammation mean I have some sort of chronic infection? 

So, my theories. On the day before I got these tests I mistakenly had a lot of sodium. I purchased a can of wax beans forgetting that canned veggies are put in a salt brine.  I ate the entire large can and later learned that it had 3.5 servings at 390 mg of sodium PER SERVING. (1200 mg in the entire can) Since I have eaten a low sodium diet my entire life I may be overly sensitive to salt... I knew it happened right after I ate it because I was soo thirsty.  I suspect that the generalized CRP may take little while to increase while the other inflammatory markers go up immediately.  This to me suggests an acute insult to the body.

In addition, I have really been eating salt with abandon. I even take an electrolyte supplement that is full of salt. Primarily because I was told fasting will deplete it.  But perhaps I have been doing too much. 

Also my ferittin is elevated.  This leads me to believe I might be overdoing it with the red meats. I am having ground beef almost daily and then also having a large steak about 1x per week.  I have always been sensitive to too much iron and now that I am not menstruating any longer I will have to be careful. I did have my iron tested last year and it was right in the middle but still -- need to watch it. 

Once again I have to call out the incompetence of my doctors.. almost every single test that I had elevated -- when I look it up... it says it is related to blood cancer. But do you think my doctors tested any of it? Nope.  All of these simple and cheap blood tests $12.00 for some of them, can give me valuable information, but they SIMPLY REFUSE. They are so f***ing cheap. Thank god I can get my own.

My plan is to flush the system out, reduce my sodium, and retest. If these biomarkers are elevated again.. I will know I have a problem. 

Bummed out... but informed...

This will be a little quick because I need to get to work but I was not happy with my labs. 

• Fasting Insulin: hardly moved at all. From 5.7 to 5.5. I have heard of other people with much lower levels. This makes me think that this level of insulin is just my normal - which kind of makes sense as I have always "fattened easily". I have been fasting and keto since November of 2020! 
• Ferritin: 245. That is high for the lab. Not by a ton (the outer edge of normal is 235) so I looked it up and it can be caused by red meat, but also lymphoma. Of course -- my body is so predictable.  But I do think I have to cut back on the red meat -- even though I am not eating a ton.. just like 1x per week.
• SED rate: WHAT THE????  I just find out that inflammation can progress MGUS and then, my sed rate is through the roof. 28 -- my last one in January was 14. Outer edge of normal is 22. To me this make no sense. I am NOT EATING AT ALL every other day. But my only thought it that on Sunday I mistakenly ingested a ton of sodium.... I had a large can of beans forgetting that canned veggies can be high in sodium and yes... the can told me I took in about 1500 mg just with those veggies. I cooked them in the water in the can. One reason I figured it out was right after dinner I was sooooo thirsty.  I am still waiting on inflammation markers CRP and HS CRP.

The good news...

• Ha1c: Well, that is down to 5.0. Truly that is pretty amazing and a level I haven't seen since I was in my early 30s. 
• Prothrombin time: This measures my clotting and it is right in the middle. It should be between 9.0 and 11.7 and mine was 10.6.
• CBC: Absolutely wonderful again but.... my WBC came back at 4.0 (low for me) and my RBC is high for me (4.7) but, I know that red meat can cause it to go high... and I do understand that eating less seems to push my WBC down lower... I am just not sure if that is a good or bad thing.  This and the Ferritin makes me think I need to give blood again.. only I don't want to.. the company was so aggressive about it I blocked them on my phone.  I also remain very unsure that it won't make MGUS progress.

Blood Tests

I admit ever since getting diagnosed I have been VERY sensitive to my health.  To find out that one part of my body failed.... it makes me worried about the rest of it.  But also, I have long felt that at the age of 50 to 60, almost everyone I know had one major health crisis. This is the age for that... so I feel I have to be guarded.  It truly seems like if you make it past 60 you will be relatively ok.

In the last year, not even because I wanted to, I ended up having:

• Several X-rays
• A Coronary Calcium Scan.
• An abdominal CT
• A Pelvic Ultrasound.
• A colonoscopy
• A Dexa Bone Scan.

All normal, yes! But I think now my poor irradiated body needs a rest.  The good news is that I have discovered that I can purchase my own blood tests. I purchase them from "Ulta Labs" -- and they are honestly, cheaper than going through my doctor.  But I have been very happy to be able to get feedback on my body that my doctor refuses to do. I am also lucky that my Flexible Spending Account pays for these blood tests. I highly recommend that you do at least ONE round of tests on your own.

In the last year I had:

• Fibrinogen- tests your blood clotting.
• Regular (not highly sensitive) C-Reactive Protein: Marker for Inflammation.
• Homocysteine : Marker for Inflammation. 
• TSH - I was going to get the full thyroid panel but my result was very good.
• C-Peptide: marker of insulin resistance.
• Fasting Insulin: Marker of insulin resistance and metabolic syndrome.
• IgF-1: A marker of cancer and growth. 
• GGT: Gamma-glutamyl transferase - a marker of liver health and overall health.
• Iron Panel: Transferrin, Saturation %. 
• ESR: Sedimentation rate. A marker of inflammation.
• At least 3 CBCs: Complete Blood Counts.
• Blood Type: It is O Positive.
• Folate, Vitamin B12, Vitamin D, RBC Magnesium: measures Magnesium in your cells.
• ANA screen: this was negative so it seems likely I don't have auto immune.
• IGM: This is a cheap test and I do it just to monitor my antibodies... in between doctors tests.

I am going on Monday for another round... some of the tests will be redos just to see how fasting has effected them (and I need to get blood for the "Impact" study)  but I am getting:

• C-Reactive Protein (regular)
• Highly Sensitive C-reactive Protein (argued to be a better test for inflammation)
• Ferritin: hear this is a biomarker of health
• Fasting Insulin, A1c.
• IGM
• ESR Sedimentation rate.
• Prothrombin Time (PT): a measure of clotting. 

The location for my blood draw is about 5 minutes from my house... so it could NOT be easier. You go to the lab, check in, your order is already in their system. They draw your blood and usually within a day I have 50% of my results. In fact last year before my colonoscopy I ordered a CBC and electrolytes...  and then a week after my colonoscopy I did another CBC so get a sense if I was bleeding internally or anything.... what a weight off my shoulders to be able to compare and contrast on my own. What a great tool to know if I was fully stocked on electrolytes before I had to take the prep which, of course, cleans you out. And the cost for these tests was minimal... only $30 for both tests.

A very nice part of these tests as well is they don't go on your medical record. Now it is possible that if you had an insurance company demand that you provide all blood tests, you might have to turn them over... but if they don't ask, don't tell. 

Finally a hint at cause and cure.

So just after my last post came out this study came out. Study reveals how long-term infection and inflammation impairs immune response as we age. I have to admit this has me excited. 

First for the relatively long discussion of clonal hematopoiesis (creation of clonal cells). I mean I knew I had a clone but I wasn't aware that it was a "thing".  And it absolutely is a thing that is much more broad and effects far more people than just MGUS.

Clonal hematopoiesis is characterized by the overrepresentation of blood cells derived from a single clone. Clonal hematopoiesis of indeterminate potential, or CHIP, is a common aging-related phenomenon in which hematopoietic stem cells or other early blood cell progenitors contribute to the formation of a genetically distinct subpopulation of blood cells.

So is MGUS just another name for this "Clonal hematopoiesis" except that it is a type of clonal hematopoiesis that just limits the potential end results (MM or WM)? So accordingly it is taken out of the CHIP sub type and given its own name. 

Then there is this:

This common phenomenon known as clonal hematopoiesis (CH) is known to start in early fifties and is frequently associated with loss of function mutations in the DNMT3A gene.

Well that is bang on for me. With mine appearing to start at age 49 and 1/2.  

Then there is this:

CH is associated with a significantly higher risk of blood cancers, cardiovascular disease, stroke and all-cause mortality.

What... wait, my doctor says it is nothing to worry about ! Well, I am suspecting this is because of increased blood viscosity that comes along clonal cells.

But this is where I get excited.

shows for the first time that long-term infection and chronic inflammation drive CH (clonal cell creation) mediated by the loss of Dnmt3a function. . . HSCs (blood stem cells) in mice lacking Dnmt3a gene did not differentiate (form into proper normal cells) much . . . We undertook the current study to test our prediction that defective differentiation (defective normal cell creation) and increased duplication of Dnmt3a HSCs (blood stem cells) allows them to overtake and outcompete normal HSCs when fighting chronic infections or facing long-term inflammatory conditions.

So let's unpack this. Long term infection alone is probably not the precise issue it is only that long term infection causes "chronic inflammation".  It is chronic inflammation that causes Clonal hematopoiesis (creation of clone cells). This says, that in response to chronic inflammation.... it seems that it is your STEM CELLS hematopoietic stem cells (HSCs) break first.  So when your body calls them up to make a plasma cell they are already defective. 

Ok, it is me? This seems to be a MAJOR answer in what and how to prevent progression of MGUS.  And it brings it all together. 

Under the Umbrella of "CHRONIC INFLAMMATION" are many different things.

• Being overweight. 
• Having auto immune.
• Having long term infections.
• Metabolic Syndrome.
• Diabetes.

And we already know that things that reduce inflammation will assist with MGUS

• Tumeric
• Reduction in Auto Immune disease.
• Fasting 
• Keto / Carnivore
• Anti inflammatory foods.

So it appears to me that right now, today, anyone with MGUS should be getting inflammation biomarker tests and doing what they can to reduce inflammation. 

Blood Tests for Inflammation

• CRP blood test (C-reactive protein) - my last result was 5, it should be under 3.
• Plasma viscosity (PV) - never had this test hard to find.
• ESR blood test - my last result was 14, normal is  0-29 mm/hr for women