Conversation with ChatGPT Situation and 2 questions (see preceding post). How could biotin help get rid of byproducts? You're absolutely right that biotin is essential for amino acid metabolism, and this is especially relevant when protein intake is high. Biotin's role in detoxifying byproducts of branched-chain amino acids (BCAAs): • Branched-chain amino acids (leucine, isoleucine, valine) are metabolized through branched-chain α-ketoacid dehydrogenase (BCKD) and further steps that require several cofactors, including biotin indirectly. • Biotin is a coenzyme for carboxylases, like: o Propionyl-CoA carboxylase (converts propionyl-CoA to methylmalonyl-CoA), o Pyruvate carboxylase, and o Acetyl-CoA carboxylase. These enzymes are needed to clear out intermediates from amino acid catabolism, preventing the buildup of toxic organic acids and ketoacids. If biotin is deficient: • Toxic intermediates from BCAA metabolism (e.g. 3-hydroxyisovaleric acid, propionic acid) accumulate, which are neurotoxic and pro-inflammatory. • This is why subtle signs like tingling, crawling sensations, or mood imbalances can appear — they’re often early indicators of organic acid buildup affecting the nervous system. In short: Biotin is a critical “cleanup crew” member in the breakdown pathway of amino acids, especially branched-chain ones consumed in high-protein diets. How much biotin do we need when eating 4 x 35g protein per day? You’re talking about 140 grams of protein/day, which is well above average — especially if you're around 70 kg (which would be 2 g/kg, a high-protein regimen). In such a case: RDA vs Functional Need: • RDA of biotin = 30 mcg/day (just to avoid frank deficiency, e.g. hair loss or dermatitis). • For high-protein consumers or athletes, functional needs may be significantly higher. o According to researchers like Chris Masterjohn, 50–300 mcg/day may be more appropriate depending on protein load and symptoms. Why more? • Biotin is not stored well and is water-soluble, so excess is excreted. • Heavy amino acid metabolism, gluconeogenesis, and lipolysis all draw upon biotin-dependent enzymes. • Some signs of marginal deficiency can occur well before frank deficiency, especially if: o You're taking raw egg whites (avidin binds biotin). o You have gut dysbiosis (biotin-producing bacteria are disrupted). o You’re low-carb/keto, which raises demand for gluconeogenesis (a biotin-intensive process). Suggested supplemental intake for you: For someone consuming 140g of protein per day, consider: • 50–100 mcg/day as a maintenance dose. (LucH's note: but higher at the beginning when suffering from the described symptoms. I'd take 150-200 mcg as first dose and adapt afterwards, towards 300 mcg, until better neuro sensations. Afterwards, after 2 or 3 days of improvement, a lower dose. • Up to 300 mcg/day if experiencing symptoms like oily/itchy/red skin, mood dips, blood sugar swings, or neuropathic sensations. • Biotin is generally safe up to 5,000–10,000 mcg/day, but high doses can interfere with lab tests (especially thyroid and troponin levels). Summary: RDA : 30 mcg/day Functional needs (HPD) : 50-300 mcg/day (possibly higher when symptomatic, at the beginning). Let me know if you want guidance on symptom tracking, food sources, or how to test for biotin deficiency (e.g. urine organic acids).

@Kvirion thank you for recommendations, eu sources are particularly useful! Appreciate it

@Aethelflaed if the surgery is elective or unnecessary, maybe it can be postponed (possibly indefinitely). Nothing like surgery to increase stress and stress hormones including estrogen.

@CrumblingCookie that is very interesting, first time hearing about this aspect of "auto"immune disease. What you describe about the cortisone treatment pretty much summarized the attitude of my doctors, absolutely no interest in the underlaying process, just hoping it'd go away in the meantime. I don't blame them tho, it's a hell of a job. Actually think it might not be the worst course of action: let the cortisone keep it down while I get healthy in the back. Just gotta find out how to do that

@polba don’t let it bother you. as miles davis said, if you’re not making a mistake, it’s a mistake.

@Mulloch94 true about the importance of balance. while I have vitamin E, it's not something I take. daily but only when I would need it therapeutically. I think that keeping PUFA intake low and free iron low with the help of histidine in a progesterone rich setting enabled by good mitochondrial respiration should keep the oxidative stresses of peroxidation chain reactions minimal, and ensuring enough collagen and sulfur intake gives me enough reserves of glutathione for intracellular protection from oxidative stresses, while antioxidants such as albumin and uric acid, to name a few, protects me from extracellular oxidative stresses. I could be wrong though, but in the times I. take vitamin E regularly, it is hard for me to detect any improvement. Which led me to just keep a bottle or two of vitamin E in reserve.

@winters2, I felt really hot while hypothyroid, due to adrenaline compensating for poor thyroid function. However, my lethargy wasn’t caused by high prolactin. My prolactin has never been high.

I’ve had it solved a couple times from deep tissue massage in the forearms especially the meat right under the boney inner part. The same nerves will light up when hitting the right spots of tension

@Wabi-sabi I will give it a try. @wester130 I have not tried it yet. Just trying to be careful about taking multiple herbs/enzymes at once since I'm not trying to make the situation worse.

@lobotomize-me during valsalva maneuver is it still noticeable? Did you confirm its disappearance with an ultrasound while standing up and performing a Valsalva maneuver? Or was it symptom relief / not being able to feel the swollen veins anymore?

@DavidPS thanks for reposting! When I post stuff no one looks at it! Ha! Maybe I smell? This was a fantastic interview I thought!

@mm33 methylene blue is a neurotoxin, It has the same basic chemical composition and harmful clinical effects as the oldest monoamine oxidase inhibitors (MAOIs). Don’t fall for the massive push seen everywhere to take it. Look deeper.

@winters2 a google search (https://www.google.com/search?q=palmar+erythema&ie=UTF-8&oe=UTF-8&hl=en-us&client=safari) says “It's generally benign and can be primary or secondary, resulting from an underlying systemic disease”

@serotoninskeptic where do they cite that high carb diets leads to obesity? Any proof of this detached from processed food and pufa fats?

@16characterstwas thanks

@Meursault said: would eat one meal all day often and it was just when we had time. Also wouldn't drink much water. then try make up for it on days off. That's not how sufficient drinking and good homeostasis of bodily fluids and electrolytes works btw. If you are on of those people who simply don't drink water because they forget and/or because it tastes boring I don't know how that can be taught. @Meursault said: Liver markers (Bilirubin, ALP, ALT, GGT) all came back within range That never excludes functional liver issues. It simply means whatever's going on is not killing the liver cells very much. Since I've currently been reading up on B5 pathways ("hammer") everythings looks a nail to me as in lack of B5 causes strong somnolence, irritability, insomnia. Its transport protein also carries biotin and iodide into all bodily tissues hence there's a lot of possibilities wrt wakefulness, energy and endocrine and thyroid hormone secretions. Depending on the parameters range of the urinary organic acids test you have ordered there should be a lot of insight to be gained about which steps of the TCA aren't running well enough. E.g. elevated lactic/pyruvic/3-hydroxyvaleric/-propionic/oxalic/xanthurenic acid etc. Will be interesting to see what that shows.

@Mulloch94 Thank you