For the non-accidental part of health management, there are the following components:

DNA Damage as the Underlying Mechanism for Aging

Pathways

  1. AMPK Pathway, sensing the nutrient availability, bifurcating between growth mode and repair mode.
  2. SIRT1 Pathway, DNA repair related pathways.
  3. Insulin Signal Pathway, Insulin might be the most important signaling molecule out there and its production should be minimized.

Stanford Health Library

One of the best resources out there for general medical information.

Disease States

Anemia

One of the best review article that I have come across.

The symptoms of anemia is shown in the following table. 1

  • Ferritin, 40ug/L
  • Serum iron, 50ug/dL
  • Red Cell Count, 4e+6
  • Red Cell Distribution Width, 14.5%
  • Hemoglobin 12g/dL

The termination of the treatment should be determined by serum ferritin level.

Autoimmune Disease

Autophagy might be utilized as maintenance of the immune system. Autophagy only kicks in after at least 5 days of water only fasting. Supposedly, your organ would shrink at that point. The same can be achieved through fasting mimicking diet. One caveat is how to transfer from the fasting state into feeding state, if don’t pay attention, then the entire fasting can be rendered useless.

Metabolic Disease

most of modern diseases, including cancer(controversial) and Alzheimer can be seen as metabolic disease. There are three path ways for out body to sense availability of nutrient. Insulin pathway, which is mostly used to sense glucose; mTOR pathway, which is used to sense 3 amino-acid; AMPK pathway, which is used to sense level of ATP.

Statin is prescribed to lower LDL. However, it is later found the the smaller sized cholesterol is more damaging, since it would enter the blood cell, cause inflammation and a series of pathological changes. It would be ideal if there is a drug targeting small LDL directly.

Another thing surprise me is that the dietary recommendation might be completely wrong. refined sugar is found to cause the liver to produce smaller sized LDL. There seems to be an awakening to this fact.

What are the manifestations of cardiovascular disease?

Hypertension, since the blood vessels get stiff (not necessarily narrowed);myocardial infraction, specific to coronary artery;stroke, when there is no blood flow or aneurysm travels to brain vessel; sudden death.

Also one should notice that men and women manifest the symptoms differently. The decline of physical capacity I experience is probably a sign that something is going on.

The best thing one can do is probably low salt intake (keep in mind that Chinese food has the highest salt level in the world and as a result the highest stroke rate); regular exercise, maybe considering high intensive exercise; no carbohydrate.

Actions:

Diet

Insulin tells the muscle, adipose tissue and liver to take in blood glucose. It was found that people with better metabolic capacity have larger and more mitocondria. Exercise can increase muscle’s intake and utilization of glucose. Ideally, one should have an average glucose level of 85mg/dl, with a deviation of less than 15mg/dl. If one can measure the amount of glucose secreted throughout the day, that number should be minimized.

One should be mindful that a lot of the added sugar is in processed food instead of table sugar. For instance, in order to retain water and increase shelf life, bread has quite a copious amount of sugar added to them. Always go for real food, since the insoluble and soluble fibers would create a mesh to make sure the microbione are feed.

mTOR seems to be the key to control the size of an organism. However, rapamycin probably has too broad of a target. Although the effect on skin is quite interesting.

A dietary way to avoid mTOR pathway is to restrict protein intake. Mathematically, one should aim to be nitrogen balanced, but since we don’t empirically know where that level really is, so it is safer to just eat less protein.

Oil should be more important. I gave keto a try at the beginning of the week. The second day, I can detect copious amount of ketone in my urine. There is minimum effect on my function, a easy transition for me. I can feel that visceral fact has been reduced some, but it could also be water since I did not take enough salt to retain water.

There is a possibility that thin people are metabolically diseased. For instance, those vegetarian Indians who get most of the food intake from carbohydrate turns out to be insulin in-sensative. Depressed people would lose weight but cortisone would induce visceral fat accumulation. This is a very informative article.

Fasting

This is a proven tactic that works. There are all kinds of fasting styles such as 16h fasting, 5-2 fasting etc. I think it would probably work if I rotate between them. To engage autophage, one need to do water only diet longer than 5 days. If you don’t have the energy to do a long term fasting, then make sure everyday you feel hungry at certain point.

Tips on fasting:

  1. drink water in the morning
  2. when the hunger strikes, drink water slowly
  3. stay busy, to keep you mind off hunger
  4. drink coffee
  5. hunger comes in waves, device ways to overcome them, knowing the feeling is gonna fade
  6. the second day is usually the hardest. After that things would become a lot easier.
  7. you may have trouble falling asleep
  8. there will be muscle breakdown on a prolonged fasting, and it is OK.
  9. break a fast gentally, don’t binge on food all of a sudden as it would burden your stomach.
  10. drink bone broth( I think I would replaceRonesh’s clinical treatment focus of metabolic illnesses in South and East Asian patient populations [8:45]; this with gelitin)
  11. there might be muscle cramp because of lack of magnesium. take the supplement would solve it.
  12. body need salt to retain water.
  13. there might be withdrawn symptoms such as headache, uneasiness etc. This is more psychological than physical but it is OK
  14. the feeling of hunger is more psychological than physical, it is part of the withdrawn symptoms.

Keto Diet

a guy inadvertently come across the fact that cancer cell on the keto substrate can’t grow. Now there are clinical trials going on seems to suggest that keto diet plus inhibitor drugs could starve cancer cell, as a potential metabolic route of treatment. Other study seems to suggest that when out brain is burning keto instead of glucose, the neuron is more active and the blood flow seems to have increased.

NO CARBOHYDRATE

this seems to be a cross the board consensus. There are doctors hypothesis that PCOS could be the result of hyperinsulimia or could be related to excessive IGF1. Both of which could be reduced through a low carbohydrate diet. A lab test that could tell your average exposure to blood glucose is A1C test, which exams the amount of red blood cell with a glucose attachment.

Insulin Resistance:

  • Increased visceral fat
  • Increased triglycerides formed and released by the liver, which by the way has the secondary effect of lowering HDL (good cholesterol) and increasing the formation of dangerous small, dense LDL
  • Fatty liver due to a carbohydrate-overwhelmed liver that desperately switches on fat synthesis
  • Elevated blood glucose. If your carbohydrate intake overwhelms your parking capacity, especially that of muscle, your blood glucose levels will rise. We need our muscles to be sensitive to insulin and we need to frequently create space in our muscles through increased activity and exercise to effectively control our blood glucose levels.

Supplement

  1. NMN looks promising

  2. Dr. Vamsi Mootha hypothesis that Metformin blocks the mitocondria electron transport chain just enough to cause the homeostatic adaptation which could stimulate mitocondria growth. (this remind me of the physiology of high altitude training for increasing of blood cell seems that you can only disturb the dynamic equilibrium by a small amount before toxicity kicks in).

  3. vitamin D 1 NIH website

Stress Exposure

Cold exposure in particular seems to activate the keto pathway. It is actually not hard to do. Try to expose to head in winter, alternating showering temperature. Again, take in the insight in homeostasis.

Exercise

the key to exercise is to have a clear understanding of muscular loading. Try not to load the joint, let most of the force be taken by the muscles.

HIT is a proven technique for cardiovascular health.

Zone 2 is a bit more advanced for me at this point, I would just log it here in case I want to take it up one day.

Gout:

1

This is crystalized uric acid from urine. The shape edges are whats iritate the nerve cells and make it so painful.

source

  • High salt diet encourages body to produce fructose itself. There is a pathway in the liver which can be activated with excessive fructose. aldose reductase-fructokinase pathway. Once it is activated, even glucose can be converetd into fructose and wreck havec. source
  • It is found that people with hypertention also have a mild form of renal impairment. Originally, it was thought that maybe the uric acid crystals damaged the kidney in a microscopic manner, but it turns out not to be the case. They suspect that the soluable uric acid may played a role as some sort of signal molecule.
  • the relationship between uric acid and fructose. People think of Uric Acid as the breakdown product of DNA and RNA. Therefore people with gout are suggested to avoid DNA rich food (such as sadin, beam, beer with loads of yeast). However, there is actually another pathway for the production of uric acid. The body need to consume some ATP in order to break down glucose and fructose. For the glucose breakdown pathway, when ATP is striped into AMP, there would be a enzyme sensing ATM/AMP proportion, sort of feedback mechanism to keep the ATP level relatively stable. However, that is not the case for Fructose. When ATP is tripped into AMP in fructose metabolism, instead of AMP goes back to become ATP, it would go directly into the path to become Uric Acid. That is why sugar rich food also increase serium uric acid (seems that 3mmol/l is a good stat to aim for).
  • the mechanism that high salt food can increase fructose production is unknown. but he speculate that it might be our body’s way to preserve water. When there is high salt intake, we would feel thirsty, which is out body’s way of saying that there isn’t enough water. When fat is generated, it would store water, such that when it is breakdown, there would be metabolically generated water. Therefore, there seems to be a pathway, salt->thirsty->store engegy as fat as a way to store water->frucose production pathway->high uric acid production->impaired renal function->hypertention since the renal regulation function is impaired.

Action:

  • most processed food have fructose in them. They need to be avoid.
  • when the fructose production pathway is activated, even glucose would be converted directly into fructose. Try not to activate that pathway.
  • could monitor serum uric acid level.
  • when you feel thirsty, means your body has already started the fructose production process. Try keep yourself hydrated. Moderate salt intake.

Cancer

Cancer cell seems to have alternative metabolic pathways, and their mitochondrias function differently compare to that of the normal cell. Therefore, in addition to chemotherapy, immunotherapy, there might be another path for cancer treatment, utilizing this altered metabolic pathway. There are two ideas. First, keto diet (not so much because of the lowering of blood glucose since even there are high level of keto in the circulation, there would still be a base level of glucose present. ) plus the inhibitors; second, mitochondria is the oxygen sink of a cell. When the functionality of mitochondria is impaired, there seems to be excessive amount of oxygen in the cell. It has been shown that low level of oxygen might help certain rare disease patient. Can that same principle be applied to cancer. If it is true that cancer cell mitochondria functions differently, they maybe when exposed to increased or decrease oxygen, the cancer cell would be killed while leaving the normal cell intact.

Infection

EBV is linked to auto-immune disease while H. Pyloris Gastric Cancer. HPV can cause head and neck cancer.

Action:

  1. I should check for both EBV and H. Pyloris
  2. for the vaccine I’ve taken I should check if I have potent antibodies.

Endocrine/Hormonal Malfunction

Stress can be a major risk factor with the secretion of cortisone. It raise the blood glucose level etc.. Depression increase visceral fat.

After menopause, hormonal replacement therapy might be something to consider, but I have yet to look into it.

Mental Decline

there are three types of cognitive function decline:

  1. metabolic kind, I read that someone actually called Alzimers disease the diabetes of the brain.
  2. atrophic kind, somehow the brain is in the state of getting smaller and some of the functions are in jeopardy.
  3. toxic kind. apparently, the tooth filling thing could be a toxin for the brain. For me there might be a balance to strike between iron deficient anemia and excessive amount of blood iron. it would be a good information to have, blood iron level. Dental amalgam is a risk factor that I should monitor. I choose not to take it out for now, in accordance to FDA recommentation. But I know now that it could be trouble for MRI imagery and Toxically Induced Mental Disorder. It should be monitored. Eating too much fish can also result in mercury accumulation. I think I read a study that people from mainland maintain a extremely high level of toxins.

Osteoperosis

Dermatological Care

As we age, the skin would sag as a result of volume loss and collagen loss. There are few techniques:

  1. oral intake of collagen (gelatin in my case) with vitamin C and zinc.
  2. RF therapy for local heating. Collagen and fat respond to 45-70 heat.
  3. rapamycin might be a wonder drug for skin paper
  4. retin A, keep it going
  5. SUNSCREEN SUNSCREEN SUNSCREEN
  6. micro-current to stimulate ATP generation. it might be useful to use it with the NMN stuff.
  7. fractional laser treatment as an alternative to micro-needling
  8. Dr Tray and Devin’s channel are good source of information

This is an area that just exploded. While surgery is a bad idea, those routine treatment can be interesting options.

Psychological Wellbeing

One of the most helpful resources I find. There are tactics that people developed over the years that is proven to be helpful such that we are more likely to act on things that are benefit to us.

One the most important take away is that there is a mind-body connection via nerve system. For supporting evidence, one only need to look at stories with regard to white hairs throughout history. But the nerve system can be trained, just like that kid who climb mountains without a harness. There is a way to train yourself to be calm even when faced with life and death decision processes. And it is a valueable skill to acquire.

It can be painful, that feeling of being left behind and don’t have a path to follow. I think the key is to shift the driving force from comparative position to love and the ultimate questions: loneliness, freedom, death and meaninglessness.

loneliness stems from the contradiction between the desire to share the life and the fact that truth is inherently an individual experience. Like all things that people have wrapped their brain one since antiquity, the key lies in the balance.

meaninglessness doesn’t mean you shouldn’t make the effort to make something of yourself. Quite the contrary, it is a journey to devote yourself to something even knowing it is useless.

Freedom as seem by Wallace:

The really important kind of freedom involves attention and awareness and discipline, and being able truly to care about other people and to sacrifice for them over and over in myriad petty, unsexy ways every day.

the most powerful thing is to refrain from using power; the hardest thing is to be on one’s own.

The awareness he is talking about might be the feeling of “in the zone”.

I think the necessary conditions for getting into the zone is the ability to see things from two perspectives simultaneously. One perspective is the entirely of the object, all its possible path and evolution; another is the immediate next steps. I have hunch that being in the zone is one of the most addictive experiences there.

If I make “being aware” my goal, maybe the rest would follow.

Pharmacological/Toxin Exposure

  1. 甘草片 turns out to be Opium. 马蔸铃酸 cause liver failure.
  2. Generic drugs may contain carcinogen (it is best to use the branded version if possible)
  3. Metformin is beneficial for cancer prevention. However, recently FDA discovered that there might be NDMA contamination. I think I would wait and see.
  4. Sauna can be beneficial in terms of detoxification.
  5. Aluminum in Chinese food, particularly in the Northern part of the country.

In many cases, medicines taken for one condition would cause another condition. This is like a never ending game for the healthcare system, once you are in it, you never get out of it. The best thing one can do for oneself is to never be in that system in the first place.

Ophthalmological Conditions

Dry Eyes

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