My n=1 RemissionBiome/Fasting experiment

Created with Midjourney by D. Troy Roach (20 March 2023).

My n=1 RemissionBiome/Fasting experiment! 

In honor of the wonderful researchers doing a very exciting, live, @RemissionBiome experiment (n=2), I wanted to add my n=1 case study to add to their supporting case studies.

My experiment is different in that it was only about 40% premeditated. A bout with ascending diverticulitis was the unplanned starting gun. The long fast also makes it different. I will try to keep it short and to the point, but I will probably ramble at the end with all my theories ;-).

History Pre-Covid:

46-year-old, male, weekend warrior athlete, experimenting with things like IF and Wim-Hof to improve health, and healthspan. 

Main sports: Hiking, Trekking, Trail running, some small ultra runs (just trying to finish, not compete), and working towards a long ultra (60 to 100k) and maybe doing a few "tourist" 6000m or 7000m peaks.

Covid:

2 infections for sure, a 3rd pretty sure (Elisa blood test), and a 4th not sure (Elisa blood test) after my RemissionBiome experiment.

Long-Covid: 

Started with the first infection in March 2020. Built back up to 80% by Oct 2020, but I did not know about PEM and crashed. The second infection April 2021 (4 days in the hospital) and then a crash in December 2021 (Omicron reinfection?). I believe that my Diverticulitis started because of my second infection, but I do not have proof.

3rd infection June 2022: Only neck pain, swollen nodes, and fatigue. The only proof is the Elisa test. This coincided with me starting truly pacing and my research into the science behind brain training.

Now (March 2023): About 70%, working, pacing, strength training, brain training, and optimistic about recovery!

My Remission Biome Experiment:

The leadup:

I was in the middle of a 6-month long break. I had gone from 35% in June to 50% in October. My bought with Diverticulitis came 10 days after returning from five weeks in the US with family and some short travel. I found it hard to follow a clean Mediterranean diet during my time in the US.

My plans for recovery experiments (pre-infection) included a plan for a long fast. I decided on roughly following the methods outlined by the Buchinger Wilhelmi clinics (BWC).

Starting gun:

October 2022: Acute abdominal pain in the lower right abdomen. I spent 24 hours fasting and only drinking electrolytes. Suspect appendicitis, but a 10-hour wait in the ER and various tests (CT scan with contrast) show Acute Ascending Diverticulitis with inflammation in the appendix due to proximity.

Treatment:
2 strong antibiotics for the infection (Ciprofloxanio 750mg c12h, & Metronidazol 500mg c/12h for 7 days) and a low-fiber, bland diet to let the gut rest, then probiotics.

Fast protocol:

I had already started fasting before getting a diagnosis (to not make things worse) and I was feeling pretty good so I decided to take advantage of the situation and continue. The BWC protocol fit my treatment well. I had 200 to 300 calories a day of broth, mashed potatoes, and vegetable puree. My treat was honey... I slowly added in a few "Maria" cookies.

Movement was a big part! I stayed active, went for walks while avoiding high HR, and enjoyed being out sunbathing and meditating. 

Despite not eating much and taking 2 strong antibiotics, I felt fantastic. I got a huge bump in energy and I was not hungry and I did not notice any side effects from the antibiotics.

I very quickly felt like I was at 60 to 65% (instead of only 50%).

My diverticulitis gut pains were gone 5 and a half days after starting the antibiotic.

I lost about 5kgs (mostly fat since I was active).

My fast (250 calories a day) lasted about 9 days.

I then built up to about 800 calories a day. My body did not want more for about two weeks. I later learned that this is a kind of "fasting mimicking" diet.

Recovery From the acute infection:

Added fiber slowly and slowly building up to about 1800 to 2000 calories.

I have continued to improve. Brain training, diet, movement, etc are all factors.

I did not put the weight back on (good). And I have been slowly adding in weight/strength training while staying within my pacing limits.

I have maintained the gains despite going back to work in January and I have even lost 2kgs more without trying (probably just the increased activity and effects of the PPI?).

Blood tests:

Day 1 tests showed typically elevated levels of the inflammation caused by the Diverticulitis infection.

About 20 days after starting the n=1 experiment I felt a bit weak and the lymph nodes in my neck were inflamed. The Elisa blood test showed positive IgA antibodies for the nucleus of SARSCoV2. However, I did not have any symptoms other than inflamed lymph nodes in the neck.

Based on how I felt. The positive blood test was just my body clearing out the "waste" products from the remnants in the gut or fat cells.

Next steps:

Continue brain training, and strength training, and hopefully increase muscle mass while getting rid of the last couple KGs of visceral fat...all while pacing!

Theories/Confounding factors:

1. See my post on my PH theory. This is where I try to explain why both antibiotics and fasting show benefits for Long-Covid and ME. This theory is still evolving...

2. Muscle mass is a key "buffer" for health. See the notes from the Marc Girdot interview at the bottom of this post. This then correlates well with the long-term health theories postulated by Dr. Attia. Dr. Attia has a podcast, does lots of podcast interviews, and has just published a book that I have not read. He is a doctor in the "longevity-bioscience" sphere. His main idea is to aim for an extended "Healthspan"... not necessarily an extended lifespan.

3. Visceral fat is a toxic playground for SARSCov2 and a better indicator of health outcomes than anything else. Waist to hips ratios serve as a rough measure, but a good measurement of visceral fat BMI and muscle mass can be a great indicator of long-term health outcomes (diabetes, Cardiovascular disease, etc...). Obesity and Diabetes are major risk factors for SarsCov2. However, I think visceral fat to muscle mass would be a better indicator. Just a theory of mine...

4. The digestive system, nervous system, cardiovascular and immune systems are so intertwined that the idea of treating them separately is antiquated! In my opinion, dividing body systems into silos of specialty appears to be an advancement, but it is holding medicine back. I believe that AI and wearable tech will help the field of medicine take a step back and start looking at the root pathology of diseases affecting patients and to start shifting more towards "True Proactive Healthcare" and less "narrow acute sick-care."

5. Possible confounding factors? 

Maybe the inflammation from the gut infection turned on or reset the immune system and it was a factor in my feeling better?

Maybe the red-light therapy (NIR) that I started doing about 2 weeks prior was a factor? I continue to use NIR, but I stopped exposing my lower abdomen after the infection. Maybe the NIR caused a disbiosis or it affected the immune system in that area of the gut?

This was my first time taking antibiotics in about 10 years (pneumonia) and about 10 more years since the previous course of antibiotics. Maybe that affects how well they work?  

Like most people, I try many things to improve my health and heal. Especially if it is free or cheap. I will not bore you with the long list of supplements or other possible confounding factors, but many things could be at play.

6. My global theory. Diseases like LC, ME, MS, Dementia, PD, etc are all triggered by brain and vascular damage caused by infections. There are 1000 other factors like environment, stress, microbiome, etc...but they all should be treated holistically with the mindset that they are all mTBIs.

Take my comments with a grain of salt. I am not a doctor or scientist. I teach technical English to nurses and PTs. I only have a Ph.D. in LongCovid from my 3-year-long n=1 experiment 😜. I am confident that I have the answers to my recovery, but I am still only at 70% and I do not know how long it will take to completely recover. I enjoy constructive feedback. Send me a DM on Twitter.
Note: As an act of self-compassion, I have limited time spell-checking and citing this post. Feel free to bring any error to my attention, but be kind 😘.

Take care of yourself, and if you can, someone else too! --Stephen Dubner