Perforated Appendix and Peritonitis (+Sepsis mega-thread)

Nyck Star Gel

Loved One is in dire situation, currently stable after appendectomy but has had severe non-local inflammation (early sepsis). Is now stationary on antibiotics and painkillers (plus CVD meds like aspirin, ppi, statins, beta-blockers etc.), ECG and blood levels are ok, seems to recover slowly

I know situations like these one merely can put their faith into Gods hand, nevetherless do we all know hospital food just aint it, so opening this thread in the hopes we could gather some peaty advice for such emergencies and/or advisable post-operation diet and nutrients (thinking of eggs, joghurt and gelatin with honey)

Any help is highly appreciated.

sunsunsun

@Nyck-Star-Gel haidut has an article or two on sepsis

Nyck Star Gel

@sunsunsun Merci!

Below is a summary in case someone in need will be reading this in the future:

Introduction
Combination of vitamins E+D about as effective as antibiotic for treating bacterial sepsis/infection
- daily 1-2k IU D3 + 8.75mg/kg (700-800mg) Vit E (d-alpha-tocopherol or mixed unesterified d-isomers of all 4 tocopherols)
The tetracyclines protect against sepsis independently of their antibiotics effects
- Tetracyclines might be the preferred antibiotic treatment (i.e. doxycycline in a HED of 0.25 mg/kg (intraperitoneal route, so orally one would need ~0.4 mg/kg to achieve the same effects)
Endotoxin/LPS is a major driver of blood clotting, sepsis, heart attacks and strokes
- Aspirin (although only acts downstream of the endotoxin/LPS cascade)
- Substances that can limit the amount of endotoxin/LPS produced and entering the blood:
  - easily digestible food; avoiding “resistant” starches
  - carrot salad, charcoal (*not really applicable after appendectomy)
  - Niacinamide and vitamin E to help restore the gut barrier
  - pregnane steroids (and especially bioidentical progesterone) to directly bind endotoxin in the bloodstream
Inhibiting fatty acid synthesis (FAS) dramatically improves sepsis survival rate
- least risky of FAS-Inhibitors is probably orlistat (Still severe side effects)
- aspirin might be good alternative; adding niacinamide + thiamine might improve its effectiveness against sepsis by improving glucose oxidation and reducing lipolysis respectively
Inhibiting fatty acid synthesis reverses bacterial antibiotic resistance
- Aspirin (80mg-100mg daily) inhibited FAS by +50%

Aspirin As A Cure For Sepsis
- excellent thread https://lowtoxinforum.com/threads/aspirin-as-a-cure-for-sepsis.15753/post-215210
Baking Soda Dramatically Increases Antibiotic Effectiveness, Could Help In Sepsis
- (!) Note: research involved in vitro work only + oral route probably not applicable after appendectomy
- see Haidut comment
Caffene restores lowered cytochrome C oxidase activity + Caffeine restores cytochrome C damaged by sepsis
- one cup of coffee or about 80mg-100mg of caffeine
- probably better to do in recovery, not with acute sepsis
DHEA Protects From Endotoxin Effects And Lethality
- single HED dose of as little as 5mg - 7mg DHEA daramatically increased survival of lethal endotoxins
- DHEA protects from endotoxin (even lethal doses)
IV B1+Vit. C+ Cortisone Prevents Septic Induced Death
- Full interview with Dr. Paul Marik
- his 2017 paper in question for early treatment protocol
  - Vit C (1.5 g every 6 h for 4 days or until ICU discharge)
  - Thiamine (200 mg every 12 h for 4 days or until ICU discharge)
  - Hydrocortisone (50 mg every 6h for 7 days or until ICU discharge followed by a taper over 3 days)
- read on the other forum this one failed to replicate, although some studies exist that show somewhat sig improvement https://www.amjmed.com/article/S0002-9343(19)30699-0/fulltext
s/o @mauritio
- T3 levels are a predictor of mortality from sepsis
- This study (and this one) shows that lactic acid is an independent risk factor for death due to sepsis. CO2 lowers lactic acid, T3 increases CO2. So it makes sense that T3 was so strongly correlated with survival in sepsis patients.
- -> improve CO2 / lower lactate (thiamin, niacinamide)
- This study shows a significant increase in survival time of people who take aspirin before hospitalization (by 1.3 days)

Vitamin B2 Remarkably Effective Against Endotoxin, Sepsis, And Other Bacterial Infections
- especially its activated form riboflavin '5 phosphate (R5P)
- minimum effective human equivalent oral doses for the combination of R5P and valine were approximately 0.2mg/kg and 25mg/kg respectively. This assumes bioavailability of 90% and 70% for R5P and valine.
The Pyruvate Dehydrogenase Complex in Sepsis: Metabolic Regulation and Targeted Therapy
- "A group of drugs that target PDHC activation, including dichloroacetate (DCA), thiamine, amrinone, ciprofloxacin, and TNF-binding protein (TNFbp), have been shown to ameliorate the symptoms of sepsis"

Septic Shock:

Serotonin Is The Likely Cause Of Septic And Anaphylactic Shock
- Anti-Serotonin (Cyproheptadine) + Aspirin
- Famotidine & Anti-histamines Protect Organs In (septic) Shock
  - Both an H2 blocker (Famotidine, Cyproheptadine) and an H1 blocker (Chlorphenamine) were each offered protection
Inosine Increases NAD/NADH Ratio And Reduces Systemic Inflammation
s/o Koveras
- Anti-Serotonin, Cypro, Tryptophan Metabolism, Vitamin C, Hydrocortisone, Thiamin

https://lowtoxinforum.com/threads/do-not-forget-to-give-thiamine-to-your-septic-shock-patient.12006/