Paging VOS: 72 year-old male with idiopathic anemia, dyspnea
#11
Can't thank you enough VOS.
[color=#222222][size=medium]"I have no religion, no political affiliation: I believe in me, above everything else." -Chasing Good & Evil[/size][/color]
#12
(12-20-2016, 05:50 PM)VoS Wrote:
(12-20-2016, 03:36 PM)ChasingGoodandEvil Wrote:
(12-20-2016, 11:00 AM)VoS Wrote:
Quote:You're exactly correct, his UpH wa 6.0 earlier, now down to 5.5. Ive attached his arterial blood gasses. You're also right his sodium is low. If his blood ph is high, wouldn't bicarbonate make it more basic, since it presumably increases serum bicarbonate? I dont want to make his blood more basic. Ayways wouod doses would you recommend? 

H has severe dsypna, hene my desire to control ammonia, do you think i should address ammonia a different way or am i getting urea confused with ammonia in terms of redcing it with ceylon cinnamon?

He will do all these things.

High blood pH is something else. That is the result of very serious hyperventilating. His pCO2 is 25 mmhg, which is about the lowest possible reading, and critical. He must be breathing very heavy or panting with difficulty. This would also make it difficult to get a good restorative sleep. 

A good thing to do here would be a bag breathing or slow breathing. Sleeping on the stomach will also help. 

Is he on hemodialysis? Unless there is a hemodialysis, then taking the combination of salt and bicarbonate (preferably sodium and potassium bicarbonate in powder (2:1 ratio), and magnesium bicarbonate in water) will eventually make the urine pH come up. There is not one dose for everybody. I just keep checking the urine pH to see when it reaches 6.4. A tablespoon or even two per day is not unusual in my experience. The dose should be whatever keeps the urine pH at 6.4.

Taking a tablespoon of salt over the course of the day also balances the fluids. The most common reason for high blood pH (other than vomiting or gastric suction) is lack of chloride ion. Salt prevents this. The second most common would be severe potassium depletion, but the potassium bicarbonate should prevent that.

Also, ammonia is poisonous, but urea is non-toxic. Poisonous ammonia should be converted to non-toxic urea and then excreted. But this requires an abundance of CO2. 

When there is a lack of CO2, as there is here, then the ammonia can never be converted to urea, leading to a poisonous accumulation of ammonia.

However, once the fluids and pH are balanced, then there will be more CO2, and poisonous ammonia should start to be converted to non-toxic urea and excreted. But this only happens in the presence of sufficient CO2. 

Limiting low quality protein intake will also reduce ammonia and other toxin buildup, and help the kidney. High quality protein is found in eggs, fermented dairy such as kefir or yogurt, and collagen hydrolysate. But even high quality protein should be limited to 40 grams a day or less, if there seems to be a kidney injury, as there seems to be here, with the electrolyte imbalance. 

As long as protein intake is low, then a urea powder in capsule form can be used to keep the urea level high and improve the fluid balance and eliminate ammonia.

A half teaspoon to a teaspoon of urea powder can be swallowed in capsules, several times a day. If the capsules cause gastric disturbance, then the urea can be dissolved in water and simple syrup. 

For a fuel source, the only really safe one is ketones from MCT emulsified with egg yolk and then mixed with any dessert. The liver and kidneys use ketones for fuel if it is available.

Amazing information, you're right again on the electrolytes. So it sounds like the goal of the alkaline salts is to improve renal function, there might be a temporary increase in blood ph,  but in the long run it will bring blood ph down? I this correct? Thank you. So much vos, this is great information!

The effective thing to bring down blood pH is more CO2. Some ideas are bag breathing, slow breathing, breath holding, and sleeping on the stomach. 

In anesthesiology, they will simply administer CO2 at 68 mmhg, and this brings the blood pH down right away. 

Yes, chloride ions and potassium also prevent it from going even higher.

Is this ok for urea? I use it topically, not sure if it's USP. How many mgs per pill? http://m.ebay.com/itm/1-lb-bag-99-UREA-F...nav=SEARCH
[color=#222222][size=medium]"I have no religion, no political affiliation: I believe in me, above everything else." -Chasing Good & Evil[/size][/color]
#13
(12-20-2016, 06:10 PM)ChasingGoodandEvil Wrote:
(12-20-2016, 05:50 PM)VoS Wrote:
(12-20-2016, 03:36 PM)ChasingGoodandEvil Wrote:
(12-20-2016, 11:00 AM)VoS Wrote:
Quote:You're exactly correct, his UpH wa 6.0 earlier, now down to 5.5. Ive attached his arterial blood gasses. You're also right his sodium is low. If his blood ph is high, wouldn't bicarbonate make it more basic, since it presumably increases serum bicarbonate? I dont want to make his blood more basic. Ayways wouod doses would you recommend? 

H has severe dsypna, hene my desire to control ammonia, do you think i should address ammonia a different way or am i getting urea confused with ammonia in terms of redcing it with ceylon cinnamon?

He will do all these things.

High blood pH is something else. That is the result of very serious hyperventilating. His pCO2 is 25 mmhg, which is about the lowest possible reading, and critical. He must be breathing very heavy or panting with difficulty. This would also make it difficult to get a good restorative sleep. 

A good thing to do here would be a bag breathing or slow breathing. Sleeping on the stomach will also help. 

Is he on hemodialysis? Unless there is a hemodialysis, then taking the combination of salt and bicarbonate (preferably sodium and potassium bicarbonate in powder (2:1 ratio), and magnesium bicarbonate in water) will eventually make the urine pH come up. There is not one dose for everybody. I just keep checking the urine pH to see when it reaches 6.4. A tablespoon or even two per day is not unusual in my experience. The dose should be whatever keeps the urine pH at 6.4.

Taking a tablespoon of salt over the course of the day also balances the fluids. The most common reason for high blood pH (other than vomiting or gastric suction) is lack of chloride ion. Salt prevents this. The second most common would be severe potassium depletion, but the potassium bicarbonate should prevent that.

Also, ammonia is poisonous, but urea is non-toxic. Poisonous ammonia should be converted to non-toxic urea and then excreted. But this requires an abundance of CO2. 

When there is a lack of CO2, as there is here, then the ammonia can never be converted to urea, leading to a poisonous accumulation of ammonia.

However, once the fluids and pH are balanced, then there will be more CO2, and poisonous ammonia should start to be converted to non-toxic urea and excreted. But this only happens in the presence of sufficient CO2. 

Limiting low quality protein intake will also reduce ammonia and other toxin buildup, and help the kidney. High quality protein is found in eggs, fermented dairy such as kefir or yogurt, and collagen hydrolysate. But even high quality protein should be limited to 40 grams a day or less, if there seems to be a kidney injury, as there seems to be here, with the electrolyte imbalance. 

As long as protein intake is low, then a urea powder in capsule form can be used to keep the urea level high and improve the fluid balance and eliminate ammonia.

A half teaspoon to a teaspoon of urea powder can be swallowed in capsules, several times a day. If the capsules cause gastric disturbance, then the urea can be dissolved in water and simple syrup. 

For a fuel source, the only really safe one is ketones from MCT emulsified with egg yolk and then mixed with any dessert. The liver and kidneys use ketones for fuel if it is available.

Amazing information, you're right again on the electrolytes. So it sounds like the goal of the alkaline salts is to improve renal function, there might be a temporary increase in blood ph,  but in the long run it will bring blood ph down? I this correct? Thank you. So much vos, this is great information!

The effective thing to bring down blood pH is more CO2. Some ideas are bag breathing, slow breathing, breath holding, and sleeping on the stomach. 

In anesthesiology, they will simply administer CO2 at 68 mmhg, and this brings the blood pH down right away. 

Yes, chloride ions and potassium also prevent it from going even higher.

Is this ok for urea? I use it topically, not sure if it's USP. How many mgs per pill? http://m.ebay.com/itm/1-lb-bag-99-UREA-F...nav=SEARCH

I think all urea is the same, as long as it's 99+% purity. 

A large 000 capsule holds about 1 ml, which is a fifth of a teaspoon. Three teaspoons of urea is about 10 grams. So each 000 capsule holds about 0.66 grams of urea. 

A typical dose is about 2 grams or three 000 capsules. More is fine if it does not cause gastric upset.
My avatar: William Blake, Vision of Strength
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#14
(12-20-2016, 05:54 PM)ChasingGoodandEvil Wrote: Can't thank you enough VOS.

You are welcome. If low CO2 can be resolved, everything else will get better from there. 

I wish CO2 could be given more easily. In the early 1900s first aid teams always carried a tank of CO2 with them as a first line of resuscitation.
My avatar: William Blake, Vision of Strength
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#15
I tried some urea to test it, down the hatch. Healthnatura sells 99+% urea for like a million dollars, hope this one, which I obtained much cheaper on amazon, is really 99%. Interesting about co2 canisters, so sad so many critical situations could be so readily reversed. U got your shit together VOS and I thank you again.
[color=#222222][size=medium]"I have no religion, no political affiliation: I believe in me, above everything else." -Chasing Good & Evil[/size][/color]
#16
I found more info on urea and hyponatremia. Evidently it was popular in the 50s and 60s but went off the approval list in the 2000s, having been replaced by mannitol.

https://www.google.com/url?sa=t&source=w...hxBd3PDEnA
[color=#222222][size=medium]"I have no religion, no political affiliation: I believe in me, above everything else." -Chasing Good & Evil[/size][/color]
#17
(01-04-2017, 09:38 AM)ChasingGoodandEvil Wrote: I found more info on urea and hyponatremia. Evidently it was popular in the 50s and 60s but went off the approval list in the 2000s, having been replaced by mannitol.

https://www.google.com/url?sa=t&source=w...hxBd3PDEnA

Yes, urea is still used in preference to everything else in some clinics that are results driven. 
http://www.mdpi.com/2077-0383/3/3/1043/pdf
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3488535/

There is no profit motive to test it further, since it is very inexpensive. 
My avatar: William Blake, Vision of Strength
[img]http://i.imgur.com/7sD2Hod.jpg[/img]
#18
So VOS, normally acidic urine would be good, from carbonic acid, i presume. Or hydronium resulting from CO2, correct me if I'm wrong. What causes very low (out of range low) urine pH, is the body retaining bicarbonate? Thx. Want to get a clearer understanding.
[color=#222222][size=medium]"I have no religion, no political affiliation: I believe in me, above everything else." -Chasing Good & Evil[/size][/color]
#19
(01-05-2017, 06:25 PM)ChasingGoodandEvil Wrote: So VOS, normally acidic urine would be good, from carbonic acid, i presume. Or hydronium resulting from CO2, correct me if I'm wrong. What causes very low (out of range low) urine pH, is the body retaining bicarbonate? Thx. Want to get a clearer understanding.

When the cells lack CO2, the cells become more alkaline and anabolic. As cells become more alkaline, the opposite occurs in the fluid outside the cell, which becomes more acidic by the accumulation in blood of lactic and pyruvic acids. Lactic acidosis is one condition that makes pH go very low. Glycolysis is another, because it produces lactic acid. 

The formation of carbon dioxide lowers the intracellular pH. In a cell with a low pH and decreased negative electrical charge, water is drawn out of the cytoplasm.

The formation of lactic acid raises the intracellular pH (through the reaction of NADH with pyruvate). In the cell with high pH and increased negative electrical charge, water is drawn into the cytoplasm. 

The acidity of the extracellular fluid is reflected in the urine and saliva pH. This is like a window into the events generated by metabolism. As Ray writes:

Quote:Electrical and osmotic (and electro-osmotic) events are generated by metabolism, and affect other factors, including pH, oxidation and reduction, cell motility and cell shape, ionic selectivity and other types of cellular selectivity and specificity.
My avatar: William Blake, Vision of Strength
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#20
Ok thanks, so even though his serum lactate is low, what you're saying is it's lactic acid that is keeping his urine so acidic. I read on one of the papers you gave me that kidneys and bicarbonate is like water and a bucket, viz., it all is retained until maximum capacity, then all is let go. I'm wondering if low bicarbonate and low chloride is related to the glycolytic status.
[color=#222222][size=medium]"I have no religion, no political affiliation: I believe in me, above everything else." -Chasing Good & Evil[/size][/color]
  


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