Quote from puddleduck on July 31, 2023, 11:59 am

P.S. Supplements I Take Currently Daily:

- zinc (80 mg to 130 mg)
- iron (5 mg to 10 mg)
- psyllium (a couple tablespoons, when I feel I need it)
- activated charcoal (a teaspoon or two, when I feel I need it)
- calcium citrate (600 mg to 1200 mg)
- magnesium citrate (100 mg)
- malic acid (800 mg)
- ALCAR (1200 mg to 2400 mg)
- salt (1/2 to 1 teaspoon added to water; I don’t need potassium anymore)
- natural iodine (246 mcg)
- vitamin K2 (5 mg)
- Adenosyl/Hydroxy B12 (smidge)

Quote from Liz on August 2, 2023, 10:51 pm

@puddleduck enjoy your screen free time out in the real world. And when you return, I would love some lentil soup ideas if you have any. I love soups but have not been able to find a recipe I enjoy eating that wasn't full of either coconut milk, cream or a lot of tomato/paste. Would love me some delliscious lentil soup come fall 😍

Quote from Sarabeth on August 18, 2023, 11:56 am

Hey @liz, I'm sure @puddleduck has other great ones, but I wanted to share some of my favorite lentil soup recipes! I don't make them much lately, so might have to adapt (remove carrots/peppers etc.) for low A, but are very good. 🙂 https://www.lifeisapalindrome.com/search/node?keys=lentil+soup

xoxo Sarabeth

Quote from tim on August 18, 2023, 11:36 pm

From Chris Masterjohn's Can Biotin Help Detoxify Oxalate?:

It has never been demonstrated that pyruvate carboxylase can decarboxylate oxalate. However, numerous lines of circumstantial evidence suggest that it is likely to participate in the first step of oxalate detoxification, its conversion to formate. This would allow formate to enter the methylation cycle or be converted to CO2. Together, this would allow oxalate to be broken down into two molecules of CO2 and exhaled.

If this is correct, biotin could help promote oxalate clearance. This may suggest a need to go slow in some cases where rapid clearance would lead to temporary bouts of uncomfortable symptoms.

If biotin promotes an enzyme that catalyses the metabolism of oxalate into CO2 why would that result in symptoms of oxalate excretion? There should be less oxalate to excrete.

@puddleduck wrote:

The Next Experiments: Letting go of my most dearly held diet dogmas...

...by listening to the anti-oil vegan doctors, including: Dr. McDougall, Dr. Brooke Goldner, Dr. Dean Ornish, Dr. Michael Greger, Dr. Caldwell Esselstyn, and Dr. Joel Fuhrman, among others, many of whom have helped patients successfully recover from disabling autoimmune diseases.

If you are still trying to resolve health problems I can understand why you are trying this diet out but I know you are smart enough to see how many problems there are with it.

Something worth noting about a very low fat vegan diet though is that it contains no preformed vitamin A and as you have found that is a bigger contributor to Hypervitaminosis A than carotenoid intake. Fat is required for absorption of beta-carotene so the actual vitamin A intake while following a very low fat vegan diet may often be relatively low. Maybe not though, I'd have to look at data in those following an oil free nut free vegan diet.

If the claims about reducing auto immunity are true perhaps lowering vitamin A explains some of the benefits people see on that diet. Studies show that Hypervitaminosis A triggers the liver to synthesize less bile (perhaps as an attempt to protect the body from further vitamin A intoxication). A very low fat vegan diet could temporarily provide some relief to those with auto immunity, poor bile flow and Hypervitaminosis A. I'm not saying this is the case, it's worth a thought though.

With these high produce vegan diets I am concerned about the consumption of so much raw food. In some areas of Peru 11% of children are infected with Fasciola Hepatica, a liver fluke that can live for decades in the human liver causing undiagnosed morbidity. Fasciola Hepatica is worldwide, 5% of US cattle livers are found to be infected at slaughter yet there seems to be little research as to the prevalence of infection in humans in Western countries. Human infection normally occurs via the consumption of salad. Raw wild watercress is very high risk.

@puddleduck wrote:

Even though what you were saying about the B12 and oxalate connection makes sense for many, in my case it doesn’t seem to apply seeing as I was consuming more B12 than usual by adding eggs to my daily beef meal. Same deal for the carnivores who—despite a high B12 intake—sometimes report getting oxalate dumping for years (ironically while mocking other extreme dieters for mistaking nutrient deficiencies for prolonged “detox”), which seems like a bad sign to me.

B12 deficiency is normally to do with lack of intrinsic factor rather than lack of B12 in the diet. Anyone with symptoms of auto immunity should suspect problems absorbing B12. How long and with how much have you tried B12 supplementation in the past? B12 is really the only vitamin that I condone megadoses of because only a fraction is ever absorbed. As a very rough guide for a 1000mcg dose in a healthy gut 5mcg will be absorbed via intrinsic factor and 5mcg will be absorbed passively. Someone with autoimmune megablastic anaemia will only absorb about 0.5% of the oral B12 via passive absorption. The next hurdle in autoimmunity is metabolizing the absorbed B12. B12 deficiency in autoimmunity is not the cause but it's still crucial to avoid. You can test for deficiency by supplementing with 1000mcg per day for about six months. Studies show most people don't get acne at that dose. If you get acne the dose can be reduced to 500mcg per day.

Quote from tim on August 19, 2023, 5:01 am

A couple more things to add to what I wrote earlier:

It doesn't sound like you have Hypervitaminosis A anymore but there's a whole list of ways that it causes oxalate issues. Also most chronic illness will cause increased endogenous oxalate to be produced due to biochemical impairments.

With autoimmune diseases almost anything one does is a bandaid measure. Megadosing B vitamins is an example. Under normal conditions the body can just absorb and metabolize the amounts in food easily. Yet some can megadose for months and experience what they perceive to be deficiency symptoms. Maybe it's just retinoic acid and toxins doing that directly but if autoimmunity can occur when serum retinol levels aren't high then it indicates a more complex mechanism involving it.

Over the years I've identified only a few things that can actually improve autoimmunity that aren't bandaids, they are:

• Reducing vitamin A intake.
• Sun exposure.
• Hookworm therapy.
• Improving digestion in ways that reduce pathogens in the gut. e.g. SIBO anti microbials, HCL, TUDCA, choline, taurine.

The interesting thing about this list is that they are all connected to vitamin A depletion. UVB and UVA exposure depletes retinoids. Higher serum vitamin D levels are associated with significantly less autoimmunity yet vitamin D supplementation isn't associated with less autoimmunity meaning that it's sunlight not vitamin D that reduces autoimmunity. Hookworm therapy depletes iron and retinoids while reducing autoimmunity. Improving bile flow and digestion helps to excrete retinoids.

Quote from puddleduck on September 7, 2023, 1:34 pm

So many interesting lentil soup options, @sarabeth-matilsky! Thank you! (And my husband will thank you, too, because I will try them and add some new flavors to the rotation. 😂) 

You’re probably better off with Sarabeth’s recipes @liz, haha. I’m kind of a lousy soup chef. 😆 But I really do like the soups from the Diamond’s “Fit for Life” 80s diet book (maybe because my Mom made them for me when I was a kid):

Old-Fashioned Lentil Soup

• • 7 1/2 cups water
  • 1 clove garlic, minced (I usually add more)
  • 1 large white onion, chopped
  • 2 large carrots, coarsely chopped (or rutabaga, white carrot, radish, white squash, or turnip 😉)
  • 2 stalks celery, coarsely chopped (I usually omit and use celery seed for the flavor instead)
  • 1 1/2 cup dry lentils
  • 1 tablespoon red miso or a vegetable bullion cube or doenjang
  • 1/2 teaspoon dried thyme
  • 1 teaspoon dried oregano
  • 1 to 2 tablespoons fresh parsley, chopped
  • 1 teaspoon sweet Hungarian paprika (I omit)
  • 1 teaspoon salt
  • 1 cup fresh or frozen corn (optional - peeled zucchini can work well, too)

Bring all ingredients to a boil (except for the corn or zucchini - wait until the last 5 to 10 minutes to add them), then simmer covered for an hour.

Since I love this one, and because there’s so much choline in cauliflower, I’ve been using this often as well:

Perfect Creamy Cauliflower Soup

• • • 3 tablespoons butter and/or olive oil (I omit atm)
    • 1 medium onion, chopped
    • 6 - 8 scallions, chopped
    • 1 clove garlic, minced (I tend to add extra)
    • 2 stalks celery, chopped (I tend to omit, and use a little celery seed instead)
    • 2 medium cauliflower, coarsely chopped
    • 1/2 teaspoon salt (I use more)
    • 1/2 teaspoon curry powder (optional)
    • 1/8 teaspoon fresh black pepper
    • 1/2 teaspoon dried thyme
    • 1 teaspoon dried basil
    • 1 teaspoon dried savory or marjoram
    • 6 cups water
    • 2 tablespoons white miso or a vegetable bullion cube or doenjang
    • 1/8 teaspoon fresh ground nutmeg (optional)

Sauté onion and celery in oil (or water), then add everything else and boil until cauliflower is tender. Use a stick blender to puree, if desired. (Sometimes I don’t bother.)

Mmm, so good! 😃 I have a lot of zucchini in the garden right now, and am really enjoying that low-vitamin A option for a different texture in the veggie soups. 

Quote from puddleduck on September 7, 2023, 2:47 pm

What a nice surprise to receive a response from you, @tim-2! 🙂 It’s good to hear from you and see posts from you about the board. 

Yeah, sun exposure and the UVB lamp make me feel good, for sure. ☀️👍 I crave the sun, lol.

If biotin promotes an enzyme that catalyses the metabolism of oxalate into CO2 why would that result in symptoms of oxalate excretion? There should be less oxalate to excrete. 

That’d make sense. Chris Masterjohn recommends and consumes an imprudent amount of vitamin A, and maybe when he messes around with high-dose B vitamin supplementation he is stirring up...“more than he is yet aware” let’s say...and is trying his best to make sense of it, as do we all.

I don’t know much about oxalate, obviously. But because I was recently able to trigger the same “oxalate dumping” rash by eating too much beta carotene (from watermelon and chili pizza), I feel perhaps it was too much vitamin A causing it in both cases.

With autoimmune diseases almost anything one does is a bandaid measure. Megadosing B vitamins is an example. Under normal conditions the body can just absorb and metabolize the amounts in food easily. Yet some can megadose for months and experience what they perceive to be deficiency symptoms. Maybe it's just retinoic acid and toxins doing that directly but if autoimmunity can occur when serum retinol levels aren't high then it indicates a more complex mechanism involving it.

Dr. Costantini’s thiamine megadosing protocol resolved my thiamine defficiency, apparently. I no longer need to take it anymore, but I was supplementing for years...

Yeah, it seems too much circulating vitamin A causes some sorta transient dysfunction impeding the B vitamins, or in the worst cases eventually leads to a legitimate B vitamin deficiency...hard to tell which is what...I feel like that is part of the explanation for the rash problem I have.

I’m starting to think there is more to autoimmunity than just too much retinoic acid and retinaldehyde, but I do feel hypervitaminosis A is a big part of it. More on that later.

B12 deficiency is normally to do with lack of intrinsic factor rather than lack of B12 in the diet. Anyone with symptoms of auto immunity should suspect problems absorbing B12. How long and with how much have you tried B12 supplementation in the past? B12 is really the only vitamin that I condone megadoses of because only a fraction is ever absorbed. As a very rough guide for a 1000mcg dose in a healthy gut 5mcg will be absorbed via intrinsic factor and 5mcg will be absorbed passively. Someone with autoimmune megablastic anaemia will only absorb about 0.5% of the oral B12 via passive absorption. The next hurdle in autoimmunity is metabolizing the absorbed B12. B12 deficiency in autoimmunity is not the cause but it's still crucial to avoid. You can test for deficiency by supplementing with 1000mcg per day for about six months. Studies show most people don't get acne at that dose. If you get acne the dose can be reduced to 500mcg per day.

Okay thank you. I’ll give that a try!

Honestly, I can’t remember when I last tried supplementing B12 or for how long. I just know my labs have always been fine, and I never noticed any improvements from supplementing it. But this (semi) veganism phase is a good reason to give it another go. 🙃

With these high produce vegan diets I am concerned about the consumption of so much raw food. In some areas of Peru 11% of children are infected with Fasciola Hepatica, a liver fluke that can live for decades in the human liver causing undiagnosed morbidity. Fasciola Hepatica is worldwide, 5% of US cattle livers are found to be infected at slaughter yet there seems to be little research as to the prevalence of infection in humans in Western countries. Human infection normally occurs via the consumption of salad. Raw wild watercress is very high risk.

Super gross, man! Inspires me to do more sprouting at home, for sure. 😂 And to clean my raw veggies real well... 😰

Something worth noting about a very low fat vegan diet though is that it contains no preformed vitamin A and as you have found that is a bigger contributor to Hypervitaminosis A than carotenoid intake. Fat is required for absorption of beta-carotene so the actual vitamin A intake while following a very low fat vegan diet may often be relatively low. Maybe not though, I'd have to look at data in those following an oil free nut free vegan diet.

The absorption explanation I thought made sense, and I still think it is part of why it helps...but I seem to have been able to reach a threshold of beta carotene intake that is too high for me even eating this way

Perhaps this is because watermelon contains so little fiber, though...I don’t always react to watermelon, but I noticed usually I was consuming it with loads of fiber. The time I reacted I ate loads of watermelon alone, and Chronometer tells me the quantity I ate only had 5 grams of fiber.

However, many of Dr. Goldner’s patients consume flax oil with their dark leafy greens...so...you’d think that’d increase carotenoid absorption too much. 🤷‍♀️ 

It doesn't sound like you have Hypervitaminosis A anymore but there's a whole list of ways that it causes oxalate issues. Also most chronic illness will cause increased endogenous oxalate to be produced due to biochemical impairments.

Interesting possibility...It’s a difficult puzzle to sort out.

The thing I find weird, is that right now I still react much worse to vitamin A than I do to oxalate, even in amounts I would think someone without chronic hypervitaminosis A would be able to tolerate... An egg every other day was way too much for me. So I dunno if that means Chris Masterjohn is right, that maybe I have some genetic defect in my ability to produce dehydrogenase enzymes, or if 5 years simply isn’t enough time to detoxify all the carotenoids and retinol from blue-green algae, carrot powder, and cod liver oil I consumed as a minor. The latter seems kind of absurd, but there are posts here estimating a ten year timeframe for eliminating stored carotenoids.

If the claims about reducing auto immunity are true perhaps lowering vitamin A explains some of the benefits people see on that diet. Studies show that Hypervitaminosis A triggers the liver to synthesize less bile (perhaps as an attempt to protect the body from further vitamin A intoxication). A very low fat vegan diet could temporarily provide some relief to those with auto immunity, poor bile flow and Hypervitaminosis A. I'm not saying this is the case, it's worth a thought though.

I’ve read enough mind-blowing personal reports by now (dozens if not hundreds) that I believe at least some of them are true, and yeah there are probably multiple reasons Dr. Goldner’s protocol works specifically (I’ll leave the other vegan doctors’ lowfat diets aside for now), some of which she is understands, some of which she doesn’t. She says she’s more interested in finding what works rather than why it does.

Dr. Goldner was raised in a pizza shop. She ate pizza every day, and because she was vegetarian she ate eggs and cheese instead of meat. Her lupus was so bad she was in kidney failure as a teenager and had to go on chemotherapy treatment to save her life, but remained quite sick, suffering mini-strokes in med school. She recovered from lupus when she went on a low-fat vegan weight-loss diet in her twenties which her now husband, a professional fitness coach, devised for his clients. 

Considering how much faster she recovered than most people here tend to recover, I’d really like to know what factors aided her healing process. Her symptoms were gone in like 3 months, and her blood tests were normal within a year, as I recall. And she has been well for 18 years now, even giving birth to two healthy children in that time. It’s a pretty remarkable story, and there are similar stories from her patients.

Here are a few possibilities I was wondering about:

1. There was some paper I read where they talked about types of carotenoids which down-regulate retinoic acid receptors. I wondered if that might have something to do with why raw foodists and fruitarians can see such rapid recoveries from serious symptoms that we would attribute to chronic hypervitaminosis A...David had evidence it is possible for these carotenoids to be converted to retinoic acid themselves, even though they are not actually pro-vitamin A carotenoids. So I thought that was maybe a dead end, but I can’t help but wonder if that’s the only way for them to leave the body, or if there are conditions where the body will manage the conversion process more safely. Not sure if this is yet known.
2. Too much preformed AA in the diet could be contributing to autoimmunity, especially when the body is deficient in ALA. Dr. Goldner’s protocol removes all dietary AA, and overloads ALA with the 1/2 a cup of flaxseed and/or chia per day requirement...It is even possible an EFA imbalance (too much omega 6 vs omega 3 in the diet for a prolonged period) may discombobulate whatever biological mechanisms the body has for preventing excess absorption and conversion of beta carotene, though I’m not sure if those processes are fully understood yet either. (I’m not great with such biochemical details even if they were lol.) 

   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6834330/

3. Excess in the diet can contribute to dysbiosis. There are oils I ate often which have been demonstrated to increase levels of microbes in the gut which have been shown to be high in those with Parkinson’s Disease, and other neurological illnesses. Dr. Goldner claims to improve gut health rapidly! I do think there are a few reasons the low-fat diets can work miracles for some people, but alleviating dysbiosis may be a major one for some.
4. Dr. Goldner also recommends a minimum of 1 pound raw cruciferous vegetables daily. Both the vitamin K and glucosinolates may improve immune function. 

5. Flaxseed also has some other possible benefits aside from the omega 3 content...I found a paper explaining how it can increase SAM levels: https://pubmed.ncbi.nlm.nih.gov/34577143/

   It is used to tread many diseases: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4152533/

6. Fruits and veggies are alkalizing. Meat, dairy, eggs, and grains are acidifying. Many of Dr. Goldner’s patients have kidney problems, leading to acidosis. So that’s another factor important in those cases.
7. As you said, bile flow matters here. I have wondered, too, if the raw diet, being so much lower in protein and fiber than a cooked plant-based diet, is just...slowing bile flow (cholestasis would be a bad thing, and not lead to lasting improvements, however). Could raw vegetable matter be less stimulating to bile flow than some foods...but still offer enough fiber and roughage to bind and remove bile adequately, while still offering a hearty meal for the microbiome? I dunno how raw versus cooked foods affect the microbiome...I’ve read a bit about bile flow, cholestasis, and bile malabsorption, but unfortunately most of the papers on the subject are focused on drugs not food. I need to read more about it.

Dr. Goldner’s “Rapid Recovery” program is only 6-weeks-long, and yet she sees dramatic recoveries in that short period of time...much faster symptom relief than what Karen Hurd or Dr. Smith tend to see...and many of Dr. Goldner’s patients have severe, life-threatening autoimmune disease.

So unless she hires actors and is running a scam, she has stumbled upon something helpful with her protocol. Dr. Goldner isn’t at all concerned about oxalates. Fascinating bunch of case studies, imo.

Quote from puddleduck on September 7, 2023, 4:06 pm

3-MONTH UPDATE: The Lowfat Whole Foods Plant Based Self-Experiment

In short, it has gone better than expected so far and I’ve had a great summer! I hope all of you have had the same. 😎☀️ There was too much rain for the garden to be entirely successful, but this means the forests are still teeming with chanterelles (a vegan source of B12)! 😁

🩸 TMI WARNING: This Section Involves Explicit Feminine Gore🩸

As I may have mentioned in previous updates, inositol was of help to my unpleasant menstrual situation, which egg consumption severely exacerbated even when I was still taking inositol.

The graphic description of this unpleasant eight-day-long ordeal: Each cycle I was losing somewhere in the realm of 1/2 cup clots, in addition to bleeding through literal towels. It wasn’t fun.

In August, my period lasted only 4 days, and my blood loss was maybe 30% of what it had been! And there were far smaller and fewer clots, too. 

It was such a relief. I’m so, so, sooo happy about this!  😭🌈 If this trend continues, I will hopefully be able to get my iron and zinc levels up finally!! 🤞 (Since the other positive hormonal changes have stuck, I’m hopeful it will. 👍)

/END TMI

New Symptom Improvements:

• Bloating has significantly reduced.
• Elimination is better than ever before in my entire life.
• My gut feels soothed and less inflamed somehow.
• Energy is more consistent; I’ve been able to work out for 30 minutes every morning, and go on an evening walk in the same day!!  😁
• My ability to “stay on top of things” has increased, perhaps because my motivation, stamina, and focus are improving. I don’t have to rest as often, so I feel more capable and less overwhelmed. Still not where I want to be insofar as energy levels go, but seeing the executive function improvements is both surprising and encouraging.
• Abdominal adipose tissue has reduced (still eating lots and my appetite is strong)
• Hemangioma in my eye went away almost immediately after my last log entry

Negative Symptoms:

• Allergy symptoms have flared-up since adding gluten; throat is itchier, sneezing often, runny nose, voice more hoarse...
• mild night sweats will happen from time to time (instead of starting inositol again, I’ve decided they’re a useful metric to observe when I change something 😅)

Overdosing On Carotenoids

I feel I am at risk of engaging in reasoning as faulty as that of the flat earthers in this documentary, because I believe in Grant’s hypothesis so strongly, but I am trying to challenge myself to consider alternative possibilities...

...the thing is, I see the pattern of chronic hypervitaminosis A everywhere I look. Even in Dr. Brooke Goldner’s private facebook group, where members are following her raw vegan protocol and often successfully reversing even severe autoimmune diseases, I notice complains of reactions to watermelon, mango, and spinach...

Last week, for the first time on the vegan diet, my leg rash flared-up following consumption of watermelon, and a salad topped with pico de gallo (raw salsa with tomato and jalapeños). After I had vegan chili pizza (yes, with olive oil) the day after the rash appeared, I developed severe brain fog (awful spelling, poor word recall, couldn’t maths; I remember it being like that when I first got CFS 😱), constipation, (TMI) mucus in stool, my joints ached on and off (unusual for me), the hemangioma in my eye puffed up and reddened and itched... Because I like to push it, the next day I ate raw jalapeño in a salad, which triggered the CFS brain-inflammation reaction (it doesn’t usually do anymore). 

The gut microbiome may be one of the most mysterious factors here...the worse it is doing, the more sensitive? Or maybe I was just too overloaded with beta carotene I couldn’t handle any more?

Another possibility: having a few low fiber days after my body had adjusted to a high fiber routine is potentially disastrous...so perhaps inadequate intake of fiber is the primary root of this response? 😬 

To test this idea, I switched back to eating more fiber again, but continued to eat watermelon for a few days. My digestion improved (maybe the lower fiber intake and eating olive oil was the main problem there), but the rash stayed inflamed and my joints still hurt a bit here and there.

It has been 5 days back on a much lower carotenoid intake, and my rash is clearing up, hemangioma is back to normal, and my gut is much happier. I’ve been having cold symptoms, a headache, and night sweats. Today, finally, the headache has improved...

I’d like to do some longer and more extreme self-experiments to try to figure out what specifically is causing what reactions, but I like feeling good so...maybe I’ll give my gut a break and wait until the New Year! 😅

What Seems to Work

I tend to feel best when I keep:

• oxalates > 180 mg
• beta carotene > 100 mcg (250 mcg seems to be too much 😥)
• choline/betaine < 400 mg 
• folate < 300% of the RDA
• fiber < 100 g (60 g is too low for me 🤷‍♀️)

On Fear and Having Hope

It has been a year since I started working with my life-coach who specializes in polyvagal theory. She has helped me to be more aware of my emotional state. This has been worthwhile.

I have noticed fear is a generally unhelpful motivator in my life, as it often sends me into a spiral or keeps me from exploring new paths. I honestly would’ve been too scared to try what I’m doing now a year ago... But being open to trying has led to significant, positive changes for me in a short amount of time. This has shifted my thinking, too...what if symptom improvement doesn’t always have to take ages? What if there are specific approaches that may help move us back to a baseline faster?

Of course, I’ll stay open to adjusting as I go if I run into any further problems, but for now it feels like I’m not spinning my wheels as much. 😊 It’s always exciting to see other people find a change here or there that helps them, whether it be eggs or pumpkin oil or bacon, and such positive reports always give me hope I’ll find a piece or two I’ve been missing, too. Flaxseed is apparently one of mine. Who knew? 🙃

Quote from tim on September 7, 2023, 9:10 pm

What a nice surprise to receive a response from you, @tim-2! 🙂 It’s good to hear from you and see posts from you about the board.

Thank you. I enjoy your posts too, always thoughtful and articulate.

Yeah, sun exposure and the UVB lamp make me feel good, for sure. ☀️👍 I crave the sun, lol.

Yeah it can definitely fast track vA depletion. I love the sun too.

That’d make sense. Chris Masterjohn recommends and consumes an imprudent amount of vitamin A, and maybe when he messes around with high-dose B vitamin supplementation he is stirring up...“more than he is yet aware” let’s say...and is trying his best to make sense of it, as do we all.

How much does he take? I think he recommends "at least the RDA".

I don’t know much about oxalate, obviously. But because I was recently able to trigger the same “oxalate dumping” rash by eating too much beta carotene (from watermelon and chili pizza), I feel perhaps it was too much vitamin A causing it in both cases.

Hypervitaminosis A promotes increased oxalate. It does this by causing gut dysfunction that leads to hyperabsorption of oxalate, by accelerating collagen turnover and by causing liver dysfunction and enzyme impairment.

Dr. Costantini’s thiamine megadosing protocol resolved my thiamine defficiency, apparently. I no longer need to take it anymore, but I was supplementing for years...

Yeah, it seems too much circulating vitamin A causes some sorta transient dysfunction impeding the B vitamins, or in the worst cases eventually leads to a legitimate B vitamin deficiency...hard to tell which is what...I feel like that is part of the explanation for the rash problem I have.

Did it actually or did depleting vA levels lead to you not needing to supplement anymore? Any improvement in your liver function could have resulted in you not feeling the need to supplement anymore, why would megadosing have resolved a deficiency if it hadn't over a period of years?

I’m starting to think there is more to autoimmunity than just too much retinoic acid and retinaldehyde, but I do feel hypervitaminosis A is a big part of it. More on that later.

Yeah autoimmunity may be partly epigenetic. I think excess retinoic acid plays a massive role in it. Healing may require not just the normalization of retinoic acid levels but consistently low levels for a period of time.

Okay thank you. I’ll give that a try!

Let me know how it goes.

Super gross, man! Inspires me to do more sprouting at home, for sure. 😂 And to clean my raw veggies real well... 😰

Yep. I don't want to eat much salad anymore after researching it. 😂 Cleaning won't help unfortunately, only cooking prevents it.

The absorption explanation I thought made sense, and I still think it is part of why it helps...but I seem to have been able to reach a threshold of beta carotene intake that is too high for me even eating this way

Perhaps this is because watermelon contains so little fiber, though...I don’t always react to watermelon, but I noticed usually I was consuming it with loads of fiber. The time I reacted I ate loads of watermelon alone, and Chronometer tells me the quantity I ate only had 5 grams of fiber.

However, many of Dr. Goldner’s patients consume flax oil with their dark leafy greens...so...you’d think that’d increase carotenoid absorption too much. 🤷‍♀️

Conversion of beta carotene to retinol differs by the individual. Consumption of preformed vitamin A from fortified foods, liver, CLO, supplements and dairy products is a more direct and serious problem in someone with existing Hypervitaminosis A. I think if someone begins a vegan diet and by doing so cuts out dairy and retinyl palmitate fortified food they will lower retinoic acid levels especially if the diet is low in fat.

There are studies showing significant post prandial increases in retinoic acid levels after retinol and liver consumption. @ggenereux2014 Have you seen any similar studies done for beta carotene consumption?

Interesting possibility...It’s a difficult puzzle to sort out.

The thing I find weird, is that right now I still react much worse to vitamin A than I do to oxalate, even in amounts I would think someone without chronic hypervitaminosis A would be able to tolerate... An egg every other day was way too much for me. So I dunno if that means Chris Masterjohn is right, that maybe I have some genetic defect in my ability to produce dehydrogenase enzymes, or if 5 years simply isn’t enough time to detoxify all the carotenoids and retinol from blue-green algae, carrot powder, and cod liver oil I consumed as a minor. The latter seems kind of absurd, but there are posts here estimating a ten year timeframe for eliminating stored carotenoids.

Eggs have many potentially problematic components, people can have an allergy to egg white which contains no vitamin A. You can't automatically assume that it's the carotenoids or retinoids in a given food that are causing the issue.

The bigger issue with oxalate can be endogenously produced oxalate, not dietary oxalate. You can't determine if oxalate is not an issue by comparing your reactions from high oxalate foods to high carotenoid foods. It is a  different substance that can exert its toxicity in a different way. Often people with oxalate toxicity feel better after consuming high oxalate foods.

I’ve read enough mind-blowing personal reports by now (dozens if not hundreds) that I believe at least some of them are true, and yeah there are probably multiple reasons Dr. Goldner’s protocol works specifically (I’ll leave the other vegan doctors’ lowfat diets aside for now), some of which she is understands, some of which she doesn’t. She says she’s more interested in finding what works rather than why it does.

Dr. Goldner was raised in a pizza shop. She ate pizza every day, and because she was vegetarian she ate eggs and cheese instead of meat. Her lupus was so bad she was in kidney failure as a teenager and had to go on chemotherapy treatment to save her life, but remained quite sick, suffering mini-strokes in med school. She recovered from lupus when she went on a low-fat vegan weight-loss diet in her twenties which her now husband, a professional fitness coach, devised for his clients.

Considering how much faster she recovered than most people here tend to recover, I’d really like to know what factors aided her healing process. Her symptoms were gone in like 3 months, and her blood tests were normal within a year, as I recall. And she has been well for 18 years now, even giving birth to two healthy children in that time. It’s a pretty remarkable story, and there are similar stories from her patients.

That backs up my hypothesis about how these low fat vegan diets can help (at least in the short term), that they're lowering retinoic acid levels. Most people don't consume CLO or liver so cheese is often going to be the main source of retinol in the diet. 100g of cheese contains 330mcg of retinol. One egg contains 70mcg of retinol.

Here are a few possibilities I was wondering about:

There was some paper I read where they talked about types of carotenoids which down-regulate retinoic acid receptors. I wondered if that might have something to do with why raw foodists and fruitarians can see such rapid recoveries from serious symptoms that we would attribute to chronic hypervitaminosis A...David had evidence it is possible for these carotenoids to be converted to retinoic acid themselves, even though they are not actually pro-vitamin A carotenoids. So I thought that was maybe a dead end, but I can’t help but wonder if that’s the only way for them to leave the body, or if there are conditions where the body will manage the conversion process more safely. Not sure if this is yet known.
Too much preformed AA in the diet could be contributing to autoimmunity, especially when the body is deficient in ALA. Dr. Goldner’s protocol removes all dietary AA, and overloads ALA with the 1/2 a cup of flaxseed and/or chia per day requirement...It is even possible an EFA imbalance (too much omega 6 vs omega 3 in the diet for a prolonged period) may discombobulate whatever biological mechanisms the body has for preventing excess absorption and conversion of beta carotene, though I’m not sure if those processes are fully understood yet either. (I’m not great with such biochemical details even if they were lol.)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6834330/

Excess in the diet can contribute to dysbiosis. There are oils I ate often which have been demonstrated to increase levels of microbes in the gut which have been shown to be high in those with Parkinson’s Disease, and other neurological illnesses. Dr. Goldner claims to improve gut health rapidly! I do think there are a few reasons the low-fat diets can work miracles for some people, but alleviating dysbiosis may be a major one for some.
Dr. Goldner also recommends a minimum of 1 pound raw cruciferous vegetables daily. Both the vitamin K and glucosinolates may improve immune function.
Flaxseed also has some other possible benefits aside from the omega 3 content...I found a paper explaining how it can increase SAM levels: https://pubmed.ncbi.nlm.nih.gov/34577143/
It is used to tread many diseases: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4152533/

Fruits and veggies are alkalizing. Meat, dairy, eggs, and grains are acidifying. Many of Dr. Goldner’s patients have kidney problems, leading to acidosis. So that’s another factor important in those cases.
As you said, bile flow matters here. I have wondered, too, if the raw diet, being so much lower in protein and fiber than a cooked plant-based diet, is just...slowing bile flow (cholestasis would be a bad thing, and not lead to lasting improvements, however). Could raw vegetable matter be less stimulating to bile flow than some foods...but still offer enough fiber and roughage to bind and remove bile adequately, while still offering a hearty meal for the microbiome? I dunno how raw versus cooked foods affect the microbiome...I’ve read a bit about bile flow, cholestasis, and bile malabsorption, but unfortunately most of the papers on the subject are focused on drugs not food. I need to read more about it.
Dr. Goldner’s “Rapid Recovery” program is only 6-weeks-long, and yet she sees dramatic recoveries in that short period of time...much faster symptom relief than what Karen Hurd or Dr. Smith tend to see...and many of Dr. Goldner’s patients have severe, life-threatening autoimmune disease.

So unless she hires actors and is running a scam, she has stumbled upon something helpful with her protocol. Dr. Goldner isn’t at all concerned about oxalates. Fascinating bunch of case studies, imo.

Yeah from memory lycopene can reduce the toxicity of high retinoic acid levels. I've never heard of retinoic acid being formed from non provitamin A carotenoids, if it occurs I doubt it's in any significant amount. Carotenoids like lycopene and lutein are metabolized by BCMO2 which cleaves carotenoids in a different way from BCMO1 which cleaves beta carotene down the middle in order to produce retinol.

It takes at most a few months for most carotenoids to be metabolized. You can see this when cattle are grain finished. Their fat is white after a few months of grain feeding.

You aren't going to want to hear this but I think those ideas are problematic. Eating a pound of raw cruciferous veges per day is very anti thyroid. The linolenic acid in flax seed oil has a very poor conversion rate to DHA and is more susceptible to oxidation (including within the body) than linoleic acid meaning consuming flax seed oil for many years may contribute to causing disease.  Apart from taking fish oil in small amounts (if seafood isn't consumed), EFA supplementation contradicts basic physiological understanding. pH balance has little to do with dietary intake.