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Rene Sugar
@renesugar.bsky.social
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https://renesugar.substack.com/
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renesugar.bsky.social
"My SIBO wasn't actually SIBO - it was my thyroid the whole time"

www.reddit.com/r/SIBO/comme...
November 13, 2025 at 6:05 PM
renesugar.bsky.social
Infection of B lymphocytes by a human herpesvirus, Epstein-Barr virus, is blocked by calmodulin antagonists. #EBV #MECFS #LongCovid

pmc.ncbi.nlm.nih.gov/articles/PMC...
October 20, 2025 at 4:39 PM
renesugar.bsky.social
Biomarkers in multiple sclerosis: Role of antibodies

scispace.com/pdf/biomarke...
October 11, 2025 at 1:45 AM
renesugar.bsky.social
"Treatment of Epstein-Barr Virus, Chronic Fatigue, Mitochondrial Dysfunction, and Insomnia" #EBV #GABA #MECFS #LongCovid

www.researchgate.net/publication/...
October 8, 2025 at 5:49 PM
renesugar.bsky.social
Mitochondrial function and toxicity: Role of the B vitamin family on mitochondrial energy metabolism #MECFS #LongCovid

www.sciencedirect.com/science/arti...

reven.com/wp-content/u...
October 7, 2025 at 4:53 PM
renesugar.bsky.social
Lactate in skin homeostasis: metabolism, skin barrier, and immunomodulation #MECFS #LongCovid

www.frontiersin.org/journals/imm...
Figure 1. Skin lactate production and clearance. Lactate in the skin is produced through the breakdown of various substrates, including glucose, glycogen, glycerol, and glutamine. The four sources of lactate are as follows: (A) Lactate is a main byproduct of glycolytic metabolism. Pyruvate, generated via glycolysis, is reduced to lactate by LDHA. (B) Glycerol is converted to Gro3P by glycerol kinase, which is then converted to DHAP by α phosphoglycerol dehydrogenase, ultimately entering glycolysis to produce lactate. (C) Glutamine, via glutaminase, is converted to glutamate, which undergoes deamination to produce α-ketoglutarate. This metabolite enters the TCA cycle, generating pyruvate, which is subsequently converted into lactate. (D) Lactate can also be produce from glycogen via glycogenolysis. Lactate has three major fates in the skin cells. Another situation is that lactate is transported out of the cell, which is also a way to clear lactate. ①It is converted to pyruvate, which enters mitochondria and participates in the TCA cycle. ②Although the epidermis lacks the key enzyme for gluconeogenesis, the hair follicle can convert lactate into glucose through gluconeogenesis which is stored as glycogen. ③Lactate participates in protein lactylation by being transformed into lactyl-CoA. LDHA/B, lactate dehydrogenase A/B; SLCs, solute carriers; AQPs, aquaporins; GLUTs, glucose transporters; MCT1/4, monocarboxylate transporter 1/4; Gro3P, glycerol-3-phosphate; DHAP, dihydroxyacetone phosphate; G-6-P, Glucose 6-phosphate; G3P, glyceraldehyde 3-phosphate; TCA, tricarboxylic acid; lactyl-CoA, lactoyl-coenzyme A.
October 1, 2025 at 3:30 PM
renesugar.bsky.social
The Plasma Oxylipin Signature Provides a Deep Phenotyping of Metabolic Syndrome Complementary to the Clinical Criteria #GLA #DGLA #MECFS #LongCovid

www.mdpi.com/1422-0067/23...
September 24, 2025 at 3:14 PM
renesugar.bsky.social
OmniSeq INSIGHT

oncology.labcorp.com/sites/defaul...
September 23, 2025 at 5:06 PM
renesugar.bsky.social
Proteomic discoveries in hypermobile Ehlers–Danlos syndrome reveal insights into disease pathophysiology #hEDS #MECFS #LongCovid

academic.oup.com/immunohorizo...
Figure 1. Significantly altered serum proteins in hEDS. (A) Table of proteins differentially expressed in individuals with hEDS compared to controls. Kallikrein/clotting factors are highlighted in purple and complement proteins in blue. (B) Heatmap of normalized, log2 protein abundances based on mass spectrometry results between control samples and samples from patients with hEDS.
September 20, 2025 at 1:42 AM
renesugar.bsky.social
Discovery of Small Molecules for the Reversal of T Cell Exhaustion #MECFS #LongCovid

www.cell.com/cell-reports...
September 16, 2025 at 1:07 PM
renesugar.bsky.social
@nicktsergas.ca In BC, access to antivirals appears to be a lot more restrictive:

eg. Access and coverage of antiretroviral drugs through Canada’s provincial and territorial drug programs

hivclinic.ca/wp-content/u...
September 13, 2025 at 2:38 PM
renesugar.bsky.social
Senator Says Radioactive Shrimp Will Turn You Into the Alien From ‘Alien’ “It had a radioactive isotope in it called cesium-137. It’ll kill you. Even if it doesn’t turn you into the alien if you eat this stuff, I guarantee you’ll grow an extra ear,” Kennedy said.
September 4, 2025 at 4:50 PM
renesugar.bsky.social
eg. what ChatGPT says about the test results and the symptoms you mentioned
Your Health Summary This report explains your recent blood test results, symptoms, and possible next steps in clear, everyday language. It is not a diagnosis but a guide to help you discuss your health with your doctor. Your Test Results - Your bad cholesterol (LDL) is well controlled by your medication. - Your good cholesterol (HDL) is very low, which increases heart risk. - The balance between total and good cholesterol is high, which also increases risk. - Your triglycerides are a little high, which can point to blood sugar problems. Your Symptoms You are experiencing fatigue (tiredness) and nerve symptoms (numbness, tingling, burning). These can sometimes happen with statin medication, but they can also be caused by low vitamin levels, thyroid issues, or diabetes. What This Could Mean - Your cholesterol medicine is helping, but your heart risk is still higher because your good cholesterol is very low. - Your tiredness and nerve symptoms may be linked to your statin, but other causes like vitamin B12 deficiency, thyroid problems, or blood sugar issues should also be checked. Possible Next Steps to Discuss with Your Doctor - Check blood sugar (HbA1c or fasting glucose) - Check vitamin levels (especially B12, folate, vitamin D) - Check thyroid function - Discuss whether your statin dose or type should be changed - Ask about CoQ10 supplements (may help with fatigue and nerve symptoms) - Keep focusing on healthy lifestyle changes (exercise, weight, balanced diet, no smoking) Important: This summary is for your information only. Please use it as a guide when speaking with your doctor about your symptoms and results. Clinical Summary Patient Context On statin therapy Reports: fatigue and neuropathy Lipid panel shows: Total cholesterol: 4.31 mmol/L (controlled) LDL: 2.85 mmol/L (controlled) HDL: 0.71 mmol/L (low) Chol/HDL ratio: 6.07 (high) Triglycerides: 1.65 mmol/L (borderline) Key Findings LDL cholesterol well controlled by statin. Isolated very low HDL with elevated Chol/HDL ratio, increasing residual cardiovascular risk. Triglycerides mildly elevated → possible metabolic syndrome component. Fatigue + neuropathy could relate to: Statin side effects (e.g., CoQ10 depletion, mitochondrial effects) Vitamin B12 deficiency Thyroid dysfunction Diabetes / glucose dysregulation Other causes of peripheral neuropathy Differential Diagnoses Residual dyslipidemia (low HDL, high risk ratio despite statin) Metabolic syndrome / insulin resistance Statin-associated side effects (fatigue, neuropathy, possible CoQ10 deficiency) Nutrient deficiency–related neuropathy (B12, folate, vitamin D) Endocrine/metabolic cause (diabetes, hypothyroidism) Peripheral neuropathy of other cause (autoimmune, idiopathic, small-fiber neuropathy) Suggested Next Investigations Metabolic: HbA1c, fasting glucose, insulin resistance markers Nutritional: Vitamin B12, folate, vitamin D Endocrine: Thyroid panel (TSH, free T4) Cardiac risk: BP, waist circumference, family history, CRP (if available) Neuropathy workup: Nerve conduction studies if progressive Optional: CoQ10 supplementation trial or serum level (rarely tested) Clinical Plan (to discuss with physician) Continue LDL control but address residual risk from low HDL (lifestyle: exercise, weight management, reduced refined carbs, smoking cessation if relevant). Evaluate for secondary causes of neuropathy and fatigue (B12, thyroid, diabetes). Consider statin adjustment if symptoms remain disabling (dose change, alternate statin, or non-statin adjunct). Regular monitoring of lipid profile, glucose control, and neuropathy progression.
August 22, 2025 at 2:37 PM
renesugar.bsky.social
STAT Family Proteins and Interferon Interactions (Claude AI summary) #MECFS #LongCovid
August 21, 2025 at 5:48 PM
renesugar.bsky.social
Initial findings from the @decodemestudy.bsky.social genome-wide association study of myalgic encephalomyelitis/chronic fatigue syndrome #MECFS

www.research.ed.ac.uk/en/publicati...

eg.

- FBXL4 (MITOCHONDRIAL DNA DEPLETION SYNDROME 13)
- ZNFX1 (IMMUNODEFICIENCY 91 AND HYPERINFLAMMATION)
August 7, 2025 at 3:36 PM
renesugar.bsky.social
eg. FBXL4 mutations seen in DecodeME study can cause heart problems and others.

FBXL4-Related Encephalomyopathic Mitochondrial DNA Depletion Syndrome

www.ncbi.nlm.nih.gov/books/NBK425...

FBXL4 mutations seen in NHS cases:

panelapp.genomicsengland.co.uk/panels/entit...

bsky.app/profile/deco...
August 7, 2025 at 2:42 PM
renesugar.bsky.social
The NHS should be collecting WGS data, metagenomic sequencing of CSF and gut, from rare disease patients including #pwME to improve future treatment.

National Genomic Test Directory
Testing Criteria for Rare and Inherited Disease
Version 8.1 July 2025 (Official)

www.england.nhs.uk/wp-content/u...
August 3, 2025 at 2:38 PM
renesugar.bsky.social
Spinal neurocysticercosis
albendazole and praziquantel

Efficacy of combined antiparasitic therapy with praziquantel and albendazole for neurocysticercosis: a double-blind, randomised controlled trial

pmc.ncbi.nlm.nih.gov/articles/PMC...
July 28, 2025 at 1:47 AM
renesugar.bsky.social
Insulin Autoimmune Syndrome – An After-Meal Roller Coaster Ride #MECFS #LongCovid

asean-endocrinejournal.org/index.php/JA...
July 27, 2025 at 5:19 PM
renesugar.bsky.social
Cerebral venous sinus thrombosis: Comparison of multidetector computed tomography venogram (MDCTV) and magnetic resonance venography (MRV) of various field strengths

www.researchgate.net/publication/...
Figure 3. Superior sagittal sinus thrombosis. Figure 3a. CTV in reformatted sagittal plane showing hypodense filling defect within the anterior ½ of superior sagittal sinus (white arrowhead). Figure 3b. Triangular shaped ‘Delta sign’ of the similar thrombus (white arrow) in reformatted coronal plane of the CTV.
July 27, 2025 at 1:33 AM
renesugar.bsky.social
A Meningioma Exclusively Located inside the Superior Sagittal Sinus Responsible for Intracranial Hypertension #MECFS #LongCovid

pmc.ncbi.nlm.nih.gov/articles/PMC...
A, Angiographic exam: the arterial phase reveals a tumor blush typical of meningiomas' hypervascularization. The arterioles come from the left middle cerebral artery. B, The venous phase shows a SSS stenosis.
July 27, 2025 at 12:04 AM
renesugar.bsky.social
Oncogenic virus immune evasion #SARSCoV2 #HPV #MECFS #LongCovid

viavid.webcasts.com/viewer/event...
July 26, 2025 at 3:23 PM
renesugar.bsky.social
Small Molecule EGFR Inhibitors as Anti-Cancer Agents: Discovery, Mechanisms of Action, and Opportunities

pmc.ncbi.nlm.nih.gov/articles/PMC...
July 26, 2025 at 2:14 PM
renesugar.bsky.social
HDACi: The Columbus’ Egg in Improving Cancer Treatment and Reducing Neurotoxicity?

www.mdpi.com/2072-6694/14...
July 26, 2025 at 2:14 PM
renesugar.bsky.social
Acute hepatic porphyria ( #AHP) #MECFS #LongCovid

www.porphyria.com/hcp/signs-an...
AHP FEATURES A BROAD RANGE OF SYMPTOMS† In addition to severe, diffuse abdominal pain without fever or leukocytosis, other common symptoms of AHP include nausea and vomiting, limb weakness or pain, anxiety, confusion, and skin lesions on sun-exposed areas (HCP and VP primarily). Tachycardia and hyponatremia are often present in acute attacks of AHP.2,3,6 These symptoms reflect neurotoxic effects across the autonomic, peripheral, and central nervous systems. Patients may experience one characteristic symptom or multiple symptoms that may lead to a diagnosis2,3: Acute hepatic porphyria symptoms Central3,8 anxiety, depression, confusion, seizures, hallucinations, insomnia Peripheral3,8 muscle weakness, neuropathic pain in limbs, sensory loss, paralysis, fatigue, respiratory paralysis Autonomic3,8,9 nausea and vomiting, hypertension, tachycardia, constipation, severe diffuse abdominal pain, diarrhea, pain in back or chest Cutaneous symptoms2,4 lesions on sun-exposed skin occur primarily in hereditary coproporphyria (HCP) and variegate porphyria (VP) Other Manifestations3,9 hyponatremia, dark or reddish urine †These are not all the possible symptoms of AHP. As healthcare providers working with porphyria patients, it’s critical that we remember many are suffering from mentally-imparting brain fog. The brain fog is a warning signal of a beginning attack and makes the caregiver’s role so critical. R.J. Desnick, MD, PhD R. J. Desnick, MD, PhDDean for Genetics and Genomic Medicine, Icahn School of Medicine at Mount Sinai Take a Closer Look at the Pathophysiology of AHP
July 21, 2025 at 11:36 PM