Biotin, fatigue, and acidosis

[Shannon]

I have a partial biotinidase deficiency. I only know cause I asked my doctor to test for it, and I only thought to do that because biotinidase deficiency is associated with Accutane use. And I was on Accutane 10 years ago. Biotinidase is the enzyme that recycles biotin, and deficiency is treated with high doses of biotin. I tried increasing my biotin from 5mg/day to 40mg, with the intention of tapering down to find the right dose. And not only did morning sickness kick in the next day, but my food preferences did a 180 - from living on meat, butter and sulfur veggies to being grossed out by broccoli and actually craving salad for the first time in 3+ years. I had an aversion to greens while pregnant with dd, and it stuck for a while. Pretty soon, I also realized my reliance on pantothenic acid for adrenal support was gone - I could completely stop taking it, just getting what was in foods and my B complex. That's HUGE for me!

Lately, I've been having some crazy fatigue. You know when you go lift weights and by the end of the workout, you're feeling that burn? I've been getting that from walking across the room. Admittedly, at 39 weeks, and having not exercised regularly, fatigue sounds normal, but this just seems excessive. It's been going on for months. So I'm trying to figure it out.

My best guess is that it feels like lactic acidosis. Or maybe just general acidosis. Pyruvate carboxylase is an enzyme responsible for moving acetyl coA into Kreb's cycle to generate energy (ATP). Biotin is a cofactor, and deficiency of this enzyme happens with untreated biotinidase deficiency. But I'm taking a TON of biotin (40mg or so, spread out) and the strange thing is, the fatigue seems worse after taking a dose of biotin. Back to the drawing board.

Manganese is required for the enzyme. I started some electrolyte packets at my midwife's suggestion, for the fatigue, and they actually helped a bit. Contents: calcium, magnesium, potassium, manganese. I'm already taking lots of cal/mag, so manganese and potassium are my two likely suspects. I bought some standalone manganese to try, but nope, that wasn't it. Darn.

Next up - electrolytes. I tend to not get thirsty, and while pregnant, chugging a glass water can actually make me feel sick. I tried pushing salt water and electrolyte packets for a few days. It definitely made me thirstier, but no big/longstanding difference with the fatigue. Sigh.

At this point, I decided to try reducing my biotin. And increasing pantothenic acid to deal with any new adrenal symptoms. At the same time, I finally dug out the high vitamin butter oil, to increase my vit K levels for the baby. Wow, what a difference! Fatigue, gone. Now there was just normal stuff that I'd reasonably attribute to end of pregnancy/being out of shape. Awesome! Turns out acetyl coA is a major activator of pyruvate carboxylase. Pantothenic acid is the precursor for coA. And - get this - biotin and pantothenic acid compete for cellular transport. So with tons of biotin, I was inadvertently creating a coA deficiency. And I'm guessing that I had decent stores of coA and that's why I didn't notice when I first increased my biotin. YAY!

And then I started getting tired again. Boo. We're at just a few days ago, now, so I'm still trying to figure it out. The butter oil definitely is a variable - if I forget it in the morning, then I don't have as much energy later, even with high pantothenic acid and low biotin.

A few more observations - this whole pregnancy, my urine pH has been decidedly alkaline, between 7.5 and 8. Except last week when I had energy and it was a 6. That sounds to me like it could be a general acidosis issue, and that my kidneys are having trouble dumping acid into my urine. Somehow, the pantothenic acid/coA would improve that (aldosterone is responsible for some excretion of H+ ions into the urine. hmmm, and it's responsible for holding onto potassium as well...) There's also a connection between potassium and acidosis that I want to look into more.

And I think I have calcium ion channel regulation issues (I'll go into the details some other time) and so I wonder if the the HVBO is helping that. And as my body gets used to the K2 in it, it starts wanting more and more. Alternatively, I wonder if the butyrate in the HVBO helps tone down inflammation and that's making a difference? And, I've been eating a TON of Kerrygold butter for a loooong time. I don't know what to make of that.
http://wholehealthsource.blogspot.com/2009/12/butyric-acid-ancient-...

[Pat Robinson]

Heading to part 2...