From: Jeffrey Epstein <jeevacation@gmail.com>
Sent: Tuesday, August 14, 2012 2:36 AM
To:
Subject: Re:
call him and ask he would love it
On M=n, Aug 13, 2012 at 7:21 PM, > wrote:
=blockquote class="gmail_quote" style="margin:0 0 0 .8ex;border-left:lp= ticcc solid;padding-left:lex"> It's hard to
know if his encephalopathy is a primary =ymptom or the result of hypoglycemia.
Anyway — was thinking through weird causes of hypogly=emia. Best way to think about it is:
1. Either his bod= doesn't know how to regulate basic metabolism (reactive hypoglycemia)
2. He has fasting=hypoglycemia
3. He's under-p=oducing glucose
There are only these three paths (above) to hypoglycemi=. I've exclude the common stuff or the "not likely" stuff since I
am sure Mayo=has already tried those things.
If his hypoglycemia is postprandial (after meals), then there are some very real things to think of in the category of
reactive hypoglycemia — some are straight forward mechanical and the others are er=ors of metabolism:
=span>* =AO Postoperative =apid gastric emptying (alimentary hyperinsulinism)
=span>• =AO Fructose intol=rance
=span>. =AO Galactosemia
* =AO leucine intole=ance
His diet sounds varied to me. Beans and rice means prot=in and carbohydrates are tolerated to some degree. If it is a
primary structur=l issue (like a glucose transporter gene mutation in the brain GLU-1 or GLU-3) or simple sugar or
carbohydrate intolerance, you'd think he would do really =ell on a ketotic diet, like super Atkins. Has he tried that?
You gotta wonder too about what happens when he fasts. =s that when he gets hypoglycemic? Cancer seems unlikely
since he's had this=whole life. Antibodies or weird islet cells could be the case. Carnitine is reall= interesting, and he can
buy it over the counter and give it a try.
=span>• =AO Islet cell dis=rders (adenoma, nesidioblastosis, cancer) seem unlikely given chronicity
=span>* =AO Excessive isle= cell function
=span>* =AO Antibodies to =ndogenous insulin
* =AO Carnitine defi=iency
Finally, he might be under-producing glucose. There are=tons of tests for this and I bet Mayo has run most of
them.=/font>
=span>• =AO Glycogen metab=lism (glycogen phosphorylase, glycogen synthetase)
=span>* =AO Hexose metabol=sm (glucose-6-phosphatase, fructose-1,6-biphosphatase)
* =AO Glycolysis, Kr=bs cycle (phosphoenolpyruvate carboxykinase, pyruvate carboxylase, malate dehydrogenase)
I guess to start we'd need to know:
...When is he hypoglycemic?=/div>
...Has he tried a protein / ketotic diet?=/font> ...Has he tried supplementation with carnitine?<=> ...Do any of these
things look familiar to him?<=> ...Does he get googly eyes after eating? Or even while sleeping?
Interesting case. Between you and I — I bet we can fi=ure it out.
Original Mes=age
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so Jeffrey west gets goofy sleepy confused dazed every single time he=eats anything„ sugars worse than other he
has live on r=ce and beans„ they say he is also severyly hypoglycemic. 20 and =nder. mayo couldn't figure it out, he
has been to sleep strudies= mri, blood up the kazoo no answer. probarbly stimulatin= the vegus nerve.????
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The information contained in=this communication is confidential, may be attorney-client privileged, =ay constitute
inside information, and is intended only for the use of the a=dressee. It is the property of Jeffrey Epstein Unauthorized
use, di=closure or copying of this communication or any part thereof is strictl= prohibited and may be unlawful. If you
have received this communication in error, p=ease notify us immediately by return e-mail or by e-mail to
jeevacation@gmail.com, =nd destroy this communication and all copies thereof, including all attachm=nts. copyright -all
rights reserved
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