Heya! 43, diagnosed pcos 20 years ago. SW250 size 22 /cw 150 size 8-10 / goal 135-140 size 6-8
I achieved most of my goals already, albeit the road was long, regained fertility, lost 100+ pounds and have a healthy child. But I recently started metformin at the suggestion of my GP.
My 2+2 has never equaled 4. I’ve always had to work so hard for the smallest of results. I have mastered strong will and a pcos diet that works for me. But it’s SO RESTRICTIVE, and it’s ONLY to tread water. I mean this just keeps me from gaining. And that’s a tough pill to swallow.
So I told my doc I didn’t need miracles but I would love to live in a world where what I did, what I ate and how I treated my body yielded a more normal outcome. We ran bloodwork: Low iron Non-existent vitamin D Almost no cortisol (adrenal fatigue) Slightly sluggish thyroid (low end of normal)
We’ve layered on the supplements and she’s given me metformin. I need to ask her about the mg. It’s not like the US (I live in South Korea) so it’s possible to leave the pharmacy and not know. I’m curious about everyone’s experience. I’m not at the peak of my pcos symptoms, and I’m not sure what expectations in efficacy I have.
Currently do super low carb (under 25mg a day), no fruit, no rice, no bread. Basically veg, proteins. Eat twice a day and start the day with a 30mg protein shake. 2-3 glasses of an under 2g carb per serving wine a week. Don’t drink any calories other than my wine.
I’d like to hear your experiences with the drug and how it worked with your lifestyle.
Stay strong ladies! It’s rough out there!!

I 17f have been working at a company for over 2 years. Recently I have been really busy and I have a lot of stuff going on in my life. From high school graduation to injuries to sickness, you name it, it happened this past month. Some context: I am on antidepressants that make my immune system a little bit weaker than normal so I’m more prone to sicknesses and the only reason I stay on it is because it works like a charm my grandmother who is my legal guardian has been extremely busy for the past year because we adopted two little girls, her step-grandchildren. one of whom had gotten sexually assaulted. So she’s busy with court and therapy and everything for them. I lived with my grandmother and grandfather since I was 2 months old, all the way up until June of last year. this has been extremely hard on me as I have nowhere to direct my anger. I don’t wanna sound like a stuck up little brat, but I’ve always been an only child. This happened out of nowhere, and we was also told that they would only be there for five months max, it’s been over two years. I cannot direct my anger at those little girls because I’m not that kind of person and it is NOT their fault that they got sexually assaulted, I also cannot direct my anger at my grandmother or grandfather bc They were just trying to do a good thing and help these girls. However, I no longer get to go out on Saturday girls dates with my grandmother and my my grandfather never gets to take me fishing anymore. They are old and they will not be here much longer, I would love to spend my time with them, but I can’t because they are so busy. They didn’t even come to my senior prom Pictures.. i’ve been struggling on where to put my anger. Which has left me tremendously depressed and always angry and anxious. So excuse me if I don’t wanna work my shift a day. because I have no motivation. I literally feel like I lost my family. They were like my mother and father and it’s almost like they are just gone. Out of nowhere. As I mentioned, I’m also a senior in high school so I’m dealing with things from class night,senior sunrise, class night practice, graduation practice, baccalaureate, graduation, prom, and my birthday is May 27 but we are doing me a combined graduation party and birthday party on the 25th. I’m a busy girl these days. My grandmother as I mentioned is always busy so I don’t direct my anger towards her at all and I don’t want to sound like I’m being mean but I told her in December 2023 that my Therapy Place had appointments for me, one of which was my one year therapy assessment, my one year medicine assessment, and a nursing assessment, all of my Therapy Place would not let me schedule as I’m not 18 yet. I don’t know if she simply just forgot or just didn’t care, however I have slowly been running out of medicine and I am now taking 25 mg of a medicine that I’m supposed to be taking 150 mg of. This is the same medicine that causes me to be sick occasionally. it really happens whenever I take one and then forget to take one the next day so this drastic change of 150mg to 25mg in the span of 2 months has not been ideal. It’s making me sick and angry and sad and crazy. All of this has also been causing a lot of issues in my relationship with my boyfriend 18m. We’re arguing all the time and it’s not helping anything. So I have a lot going on. And yes, I have been calling out a lot, however, everything with graduation I told my ex boss about a MONTH ago. This is not new information. Out of NOWHERE he scheduled me to work around 40 hours (my normal hours are about 15-20 a week as I’m working on school and applying to colleges and focused on graduation ) However, today he feels the need to call me and explain to me in passive aggressive words how I am making his and everyone else’s life harder and saying a few other things which all equaled up to “your a big inconvenience for everyone” This alone really hurt as my boss and I always got along ok. He knew what I was going through but assumed I was a liar despite me being a manager for 2 years now and still felt the need to call me and tell me how much of a problem I am. I was honestly going to let this slide and work my last shift and then tell him not to put me on the schedule anymore. But this is when I called my best friend for advice! Then she proceeds to tell me, my boss and another female coworker were stalking my social media accounts to see if I was really hurt. ( I had an ankle injury caused by tripping over my dress walking out of prom.) And I’m not going to lie to you. I really really really hurt my ankle. I was wearing a boot. I have been cooped up in the house for about a week and a half and I was sick and tired of it. My sister and her boyfriend and my boyfriend were all over and we decided we want to go to topgolf. I figured I had rested enough and I was really eager to get out of the house. I got all dressed up and was wearing my boot as we went into Topgolf! Only to find out that we had to be 21 or older to go past the certain time. We tried to get our older siblings to come, but they were busy! I had gotten all dressed up for the first time in a while and I wanted to take some Instagram pictures. That way it didn’t feel like I got dressed up for nothing. I took my boot off and slipped a regular shoe on as I didn’t want to wear a big ass boot in my instagram photos. The girls that get it get it! In all of these pictures, I either have my hurt foot up off of the ground or I am holding it up equal to my knee. Because as I said it really hurt. So I posted my pictures and all was fine. I also made a few tick-tock‘s. Well apparently both of these actions were illegal. As my boss and his suck up of a coworker felt the need to stalk my social media to see if I was lying I guess. You can check the images yourself on instagram at @molleigh_1 After I found this out, I texted my boss as follows:
Ok, I was gonna let the whole “ passive aggressively calling me an inconvenience” thing slide, however i just don’t understand why you and Alana feel the need to search up my social media accounts and see what I’m doing but if you must know my instagram pictures were taken while my boot was off because I didn’t want to wear a big boot in my pictures. My boot was still in the car. If you look closely in the pictures you can see that I am leaning my weight on my good foot and have my bad foot either up in the air or I am not fully stepping on it. I also didn’t know it was illegal to post videos of myself on tiktok when I’m sick, that’s New info to me. I also just talked to my best friend who did not know about my foot injury, just told her about it. You can come ask my entire family if you’d like. They have seen me walking around the house in a boot. It’s not fair to assume I’m a liar as you weren’t there. You can’t tell if I’m in pain from a picture or video. it’s weird that you guys are looking up my accounts. That’s honestly creepy. Now that my parents and I know this creepy, unsettling information I will not be working that last shift, (I’m not allowed) you all can go stalk other people! If you feel the need to reply or have anything to say, you can contact (My dads number) Have the day you deserve, and goodbye.
Here’s the reasoning behind why he’s a creep: - 40 yr old man who only hires teen girls. -Would always show up 5 mins after my shift started claiming he had work to do but then would sit in the office with me just to try and chat. - anytime he would arrive I would simply move my things out of the office and set out by the serving area to which he would say “ I didn’t kick you out you can come sit back here with me” - gave me sexual looks more than one time. - places security cameras in odd places such as facing the backs of his workers so he can look at their asses I’m guessing ( it’s not just one camera it’s all of them) - there’s been claims of him sexually assaulting his workers in the past (just found this out) from a previous coworker who was told this by someone who worked at a different location of the company -multiple workers have quit because they felt uncomfortable around him.
Am I the a hole? Did I do the right thing? Am I just being dramatic and overcomplicating this? Help!

I am posting this very cautiously having not put anything on this forum for over two years. This will be a lengthy post and I don’t make it with any claim of cure, or as a recommendation. However, I feel almost duty-bound to share my experience given the impact PSSD has had on my life and the impact it so clearly has had on so many others. I know some people will have had very negative experiences with trazodone and completely respect that. I can only talk about my own recent experience. The headline is that I briefly took trazodone a few weeks ago and have experienced significant benefits. I can’t say strongly enough I am not recommending trying it. I am just relating my own experience. I am happy to reply to comments, but please be aware that I am not prepared to get into any kind of heated debate about the whys and wherefores of this, or any other medication or treatment. At times people can be very confrontational on these forms and I’m not interested in that kind of conversation. Thank you in advance.
Just for context I am a mental health nurse myself although I don’t work in acute mental health and tend to work in more niche areas. However, my employment has been sporadic in the last couple of years in part due to PSSD.
I have had PSSD without out any real improvement (until very recently) since taking sertraline in summer 2019. This manifested itself as lack of sensation, pleasure and associated ED as well as generalised anhedonia. Prior to this, although I had experienced some episodes of anxiety and depression I had no sexual dysfunction whatsoever. I was aware my testosterone level was low as had started to investigate this as a possible cause for my problems with mood. As I say I had no sexual problems so at this point it was not something I had ever really thought about. Over time I tried to accept it and not focus on it as I found this definitely impacted on my quality of life. Like many people I initially spent a lot of time investigating PSSD but found myself becoming increasingly anxious and hopeless doing so.
I have made attempts to find solutions to PSSD. I have been on TRT at points during this time and have also been seen at Imperial College and UCL for the past couple of years. I’ve tried a couple of medications that have been suggested within this community, such as yohimbine and cyproheptadine but did not experience any benefit though equally they did not make things worse. I attempted some lifestyle changes but have struggled to eat as well as I should and, reduce alcohol and caffeine, increase exercise, et cetera due to low mood. Since developing PSSD the existing anxiety and depression which I have managed pretty well for most of my life have become much more prevalent. I have avoided psychotropic medication since the short courses of sertraline in 2019 and mirtazapine in 2020 that in the first case caused PSSD, and in the second case made it worse (after a brief initial improvement). The only PSSD related medication I take is tadalafil 5mg which was prescribed to me by Dr Mears at Imperial to hopefully improve general vascular blood flow.
Last summer my 27 year relationship ended. Before becoming unwell in 2019 and taking sertraline and subsequently developing PSSD, my relationship was solid though of course it had the usual ups and downs. The impact of PSSD was massive and caused many problems. After the first year where I maintained hope that things would improve, the impact on our physical relationship and my mental state began to really caused problems. Associated anxiety resulted in issues with work and increased alcohol consumption. To cut a very long story short in summer last year my wife told me she wanted to divorce and I lost my marriage, my comfortable home and really everything that had kept me together for the past nearly three decades. After initially coping well inevitably my mood deteriorated and I became increasingly depressed and suicidal and found myself sectioned briefly for a couple of weeks in spring this year. Crisis a surprise has a mental health nurse and not an altogether positive experience!
As I say, I’m very reluctant to take psychotropic medication but I did start agomelatine in hospital. On reflection this was somewhat unwise given my history of alcohol use but I asked for it, they prescribed it, and I wasn’t really in a place to logically think it through. In terms of PSSD it wasn’t beneficial but it had a lot of other side-effects that meant I came off it shortly after discharge from hospital whilst under a Crisis Team.
I then started on trazodone 150 mg at night. Like agomelatine it is used as a third line treatment and suggested for people with sexual dysfunction. It is referred to as pro-sexual and is used at times as a treatment for ED. I was given the warnings about priapism when using it. On the first night I took it I woke up with very strong erections on a couple occasions during the night. They were not painful and after a while receded and I returned to sleep so did not take any action. At this point I had had pretty severe ED for months (I think due to poor mental state). This actually wasn’t a significant problem for much of the time I had PSSD, however, the lack of sensation meant that this was somewhat academic. My general health at this time was in a pretty bad way so although concerned about the side effects of psychotropic medication didn’t worry unduly. The same thing happened for the next couple of nights. Of course given this I attempted masturbation and found that I could achieve orgasm and the intensity increased. There was no huge improvement in sensation but the actual orgasm itself was more like normal. The nocturnal erections continued and I started to find that I was having them throughout the day. As I say there was no pain or discomfort and they resolved so I didn’t take any action. However, as I have said I am very reluctant to take psychotropic medication and given this I decided to stop it after a few days. My worry was I would develop full-blown priapism and this can have extremely serious consequences. You are supposed to get immediate medical attention if you have a painful erection that exceeds four hours. I’m not sure what your chances are of being seen the moment you walk through the door in A&E are – it’s more likely you would be there for several hours so I decided this risk was too high as I had started to experience these erections. I have to add I did this without discussing it with the very good Crisis Team I was under. I did discuss this with them subsequently, and they were understanding and supportive but would of course not recommend stopping any medication without seeking advice first. Even though I am a nurse, this isn’t wise.
However, I have now been off trazodone for about three weeks. I have continued to experience strong nocturnal erections but less so, and have some seemingly random erections during the day. After developing PSSD I lost all sense of myself as a sexual being. I wouldn’t experience interest or arousal when seeing someone who was attractive that as did throughout my life beforehand (I was married a long time-don’t judge me!) but this has returned. I have not had sex with anyone since separating from my wife, so can only judge it based on masturbation but as I said above this is easier with much more powerful orgasms. Like I say, there is still a lack of sensation, but it is a vast improvement on how I was before. It may also be coincidence, or possibly a result of this improvement, but over the past couple of weeks my mental state has improved dramatically and in fact I find myself feeling better than I have done in many years. I would give anything to be able to go back in time and not have taken sertraline and not have developed PSSD. Without it I think I would still be in the long and loving marriage I was but I’m on the road to accepting that. That is difficult and it hurts but I have to accept it to move on.
Anyway, I hope this is of help. I’m certainly not advocating taking trazodone and generally speaking feel that the dangers of psychotropic medication outweigh the benefits unless they are absolutely necessary. I would not have taken medication unless if I haven’t found myself in a situation I did. To put it bluntly, I wasn’t going to survive as my suicidal drive was so high had to do something. I appreciate it must seem ironic saying this as a mental health nurse but I am far from alone in this and I have spoken to many nurses and workers, both on a professional and personal level who say the same thing. Something I have noticed in recent time is the huge increase in the knowledge of PSSD in services. The Panorama program broadcast on the BBC last summer seems have made a significant impact. All the best to you all and keep and do your best to remain hopeful though I know how difficult this is.

A couple of months back there was a fairly popular post by u/Bluedot55 :https://www.reddit.com/Helldivers/comments/1azh9fw/weapon\_damage\_isnt\_what\_you\_think\_and\_isnt\_what/
He made some testing, came to a conclusion that aligned with his data, but I saw there were weapons missing on this table, and redid the experiment using all of the game's primaries and secondaries along with some support weapons. That was over a month ago and I've been having sleepless nights over the results since.

• The initial conclusion didn't account for armor (observed by white/red hit maker), making it flawed to begin with.
• If Lib Pen has a higher headshot multipler than Liberator, why isn't it doing more damage to Helldiver heads?
• The same applies to Devestator heads. Both Lib and Lib Pen need 3 shots. Defender needs 2. Signs point to Dev heads having 120-125 HP given how Counter-Sniper oneshots at close enough ranges, but then stops doing that.

We have both, independently, continued to dig into the matter, and a lot of other people have as well.
More extensive testing of this nature was performed by u/Key_Negotiation_9726, now compiled in his excellent DiversDex: https://www.reddit.com/Helldivers/comments/1cec9l4/diversdex_your_pokedex_but_for_helldivers_2/
The tests have not made a point of firing every shot at point-blank. That's fine for practical purposes. You can simply refer to the charts and know how many shots you'll roughly need to kill a thing. For the purposes of deducing the exact damage values and enemy HP, I still needed to dig deeper. For those out of the loop, testing has confirmed that damage drops off over distance for the majority of weapons:
https://www.reddit.com/Helldivers/comments/1bwbo78/guns_lose_damage_over_distance_as_soon_as_they/
Progress in datamining by people much smarter than I am reveals a second damage number for each source of damage. I was made aware of it through this thread: https://www.reddit.com/Helldivers/comments/1c40xkg/weapon_armor_penetration_values_helldive
At the time I didn't know what to make of it. After joining heads with other researchers and testers at the Helldivers wiki (https://helldivers.wiki.gg/) we were able to make leaps of understanding on the matter. I couldn't have gotten to this point without their data and extensive testing.
This extra damage value is sometimes referred to as "Durable damage" or "Damage vs massive body parts". This number is 6 for Liberator (close to the 10% suggested by Pilestedt) and 15 for Penetrator (more of a 33%). For Dominator this is 90, which is about 33% of full damage. The answer to "Is Dominator doing explosive damage?" can be concluded with "yesn't". Glad I could clear it up and prevent any future debates on that one.
The majority of explosions have 100% durable damage, and support weapons are all over the place, generally leaning into "More than a primary, that's for sure". I have listed these values on my stat site as far as I know them:
https://invadersfromplanet.space/helldivers-2/
The wiki might add them once they've been verified more thorougly. The general rule of thumb is that durable damage is 10%, rounded down. Liberator is 60/6, Diligence is 125/13 (or 125/12, it's unclear to me).
Some noteworthy high rollers on durable:

Weapon	Dmg	Dur	Ratio	Notes
AC-8 Autocannon	410	410	100.00%
SG-8P Punisher Plasma	250	200	80.00%
PLAS-1 Scorcher	200	150	75.00%
ARC-12 Blitzer	250	175	70.00%
R-36 Eruptor	380	265	69.74%	Pre-nerf
LAS-98 Laser Cannon	350	200	57.14%	DPS
SG-225IE Breaker Incendiary	250	120	50.00%
CB-9 Exploding Crossbow	420	200	47.61%	:[
MG-206 Heavy Machine Gun	100	35	35.00%
SG-225SP Breaker Spray & Pray	192	64	33.33%
JAR-5 Dominator	275	90	32.27%
APW-1 Anti-Materiel Rifle	450	135	30.00%
SG-8S Slugger	250	75	30.00%
SG-8 Punisher	405	108	26.67%
RS-422 Railgun (Unsafe)	600	120	20.00%
SG-225 Breaker	330	66	20.00%
AR-23P Liberator Penetrator	45	15	33.33%
AR-23C Liberator Concussive	65	15	23.07%
LAS-5 Scythe	350	70	20.00%
ARC-3 Arc Thrower	250	50	20.00%
RS-422 Railgun (Safe)	600	60	10.00%

All the rocket launchers and grenades seem 100% as well.
Does this explain Brood Commander's head? Not yet. If you just plop in the results 16 x 5 vs 8 x 15, you find that this time it's base Liberator that needs significantly less damage than Lib Pen. Just like Lib Pen is an in-between gun, Brood Commander's head is an "in-between" massive body part. A body part can be anywhere between 0%-100% durable, and it seems like Brood Commander's is 60%.
What does this mean? It means take 40% damage from normal damage, 60% from durable. For Liberator that's: (60 * 40 + 5 * 60) / 100 = 27
But hitting armor it reduces to half and becomes 13.5
Lib Pen is (45 * 50 + 10 * 50) / 100 = 30
Lib Pen exceeds the light armor and stays at 30.
8 * 30 vs 16 * 27 suggests Brood Commander's head has 200 HP.
Now you may object and say "Maybe armor isn't 50%, it's a 60%, that's why Lib Pen needs that much less shots. Your mechanic is made up." The recent balance change brought about an interesting counter-example: Liberator Concussive. Defender (70/7) needs 13 shots to kill Brood Commander's head, but Liberator Concussive needs only 12 (65/15) owing to its secretly buffed durable damage. With two guns having an equal amount of penetration yet the lower damage gun needing fewer shots for a kill, it's clear that there has to be more going on. Accounting for 60% durable, Defender is 33.2 damage per shot, and Lib Con is 35 before armor reduction.
That leaves one oddity, which is how a 400 damage impact grenade doesn't immediately pop Brood Commander's head. I believe this to be because radial attacks have no interaction with brood commander heads, just like with helldiver heads. (Rockets headshotting you kill you because of the rocket's direct damage, the explosion is not multiplied.) Notice how some weapons like Plasma Punishere kills Brood Commander faster with body shots than headshots. The direct portion (70 partial) goes to the head, then the explosion (150) touches the body behind the head instead, and these two have seperate health pools.
So what's the takeaway from all of this?

• Weak spot multipliers vs enemies is not a real thing. If it is, no difference has been found between weapons in this department.
• Laser Cannon enjoyers have already figured this out, but this was, and to an extent still is a great weapon for durable targets. 300 sustained, durable DPS isn't bad, and 200 isn't awful either. Autocannon and AMR are still ahead of the pack on this in the short-term.
• Lib Pen should be alright on gunships and tank vents compared to competition. Use it on medium armor durable kill spots, as low as the supply of those are.
• With some weapons, body shots can be preferable.
• Chargers are still a black hole of research into which you can pour hours of your time and understand less than before you started.
• Please show durability damage in-game.
• My soul can finally rest, but probably won't.

There's been great advancements in the knowledge of everything and more importantly great new websites and guides put up! Check them out! I'm going to be retiring this post.
Most accurate weapon stats: https://invadersfromplanet.space/helldivers-2/
Great general enemy guide and hitlocations: https://new.reddit.com/Helldivers/comments/1cec9l4/diversdex_your_pokedex_but_for_helldivers_2/
Some great knowledge that helpled: https://new.reddit.com/Helldivers/comments/1cmg8nu/damage_is_still_not_what_you_think_how_explosive/
Datamine weapon stats (spoilers): Helldivers: Weapons
Datamine enemy stats (even more spoilers): Helldivers: Enemy Data
​
Durability damage: Actual damage dealt to enemies is linearly interpolated between main damage and durability damage based on the percentage durability of the hit part. I.E:
90% durable part? ( damage * 10% + durable * 90% ) = actual damage dealt
25% durable part? ( damage * 75% + durable * 25% ) = actual damage dealt
And as for player HP and various damage resistance percentages? I believe Array and Zeddy will have a post up soon, if they don't already. The short of it is we have 125 HP! yay.

Big Table Of Weapon Armor Penetration And Damage Values

Table Notes:

There's 10 armor pen levels we've seen so far but everything beyond 6 done by stratagems. Every single "light" pen weapon has an Armor Penetration of 2, equal to light armor; Medium pen weapons have AP 3 And so on.
Weapons penetrating equal tier armor gives a white hit marker and do half damage. Superior penetration gives a red hit marker and full damage. Insufficient penetration gives a ricochet indicator and do no damage. Shots hitting armor at shallow angles will also be deflected.
​

Weapon	Armor Pen	Damage	sHP Dmg	Stun	DPS	Notes
Liberator	2	60	?6	10	640
Liberator penetrator	3	45	?10	10	480
Liberator Concussive	2	65	?12	100	346
R-63 Diligence	2	125	?12	14	729
R-63CS DC	3	140	?14	14	816
Adjudicator	3	80	?8	?14	733
Jar-5 Dominator	3	275	?55	?30+	1145
Eruptor	3	230	?46	20	175	Deals additional explosive damage. Destroys Fabs+Holes. Projectile self detonates at 125m
+Eruptor aoe	3	?+190	?190	30		~2 Meter Radius. 'Buffed' in Patch 1.000.302.
Crossbow	3	270	?50	?25	350	Does NOT destroy Fabs+Holes.
+Crossbow aoe	2	+150	150	?25		2 Meter Radius
Energy Weapons	Armor Pen	Damage	sHP Dmg	Stun	DPS	Notes
Scythe	2	350/s	?35/s	0	350	Can shoot for 8 seconds before overheat.
Sickle	2	55	5	5	687	Can shoot for 7 seconds before overheat. Aprox 86 shots before overheat.
Blitzer	3	?50(250)	10(50)	?10(50)	187	?Shoots 5 bolts? Really hard to tell.
Scorcher	2	100	50	10	416	Deals additional explosive damage.
+Scorcher aoe	3	+100	100	?25+		3meter radius
Punisher Plasma	2	100	50	?	333	Deals additional explosive damage.
+Punisher Plasma aoe	3	+150	150	?25+		4 meter radius
Shotguns	Armor Pen	Damage	sHP Dmg	Stun	DPS	Notes
SG-8 Punisher	2	45(405)	9(81)	30	480	9 pellets
Breaker	2	30(330)	6(66)	20	1650	11 pellets
Breaker Incendiary	2	20(240)	2(24)	?20	1200	12 pellets
Spray & Pray	2	12(192)	1(16)	?20	1056	16 pellets
SG-8S Slugger	3	250	75	?20	333
SMGs	Armor Pen	Damage	sHP Dmg	Stun	DPS	Notes
MP-98 Knight	2	50	5	4	1150	One Handed
SMG-37 defender	2	70	7	5	606	One Handed
Sidearms	Armor Pen	Damage	sHP Dmg	Stun	DPS	Notes
P-2 Pistol	2	75	?5	4
P19 redeemer	2	60	5	4	1100
P-4 Senator	3	175	?17	10		Hold reload button to style on foes.
Las-7 Dagger	2	200/s	?20/s	0	200
Grenade Pistol Direct Hit	?2	250	?			Destroys Fabs+Holes.
+Grenade Pistol Explosive	3	+350	350			8 Meter Radius

​

Grenades	Armor Pen	Damage	sHP Dmg	Notes
G-3 Smoke	-	-	-	~15m diameter. Lasts ~30 seconds.
G-6 Frag	3	250	250
G-10 Incendiary	3	150	150
G-12 High Explosive	4	400	400
G-16 Impact	4	400	400
G-23 Stun	5	--	--
G-123 Thermite	7	100	100

Thermite notes: Can light target on fire dealing 8 damage/tick. Burns for 7.5 seconds doing aprox 25-35 damage/ticks over this time. Aprox 5 ticks a second. 100 damage explosion at the end. Does about 1500+ total damage before enemy fire resistance. Most of the thing's you want to use it on tend to be resistant to fire. They should be good, a patch will likely tweak them.
​

Support Guns	Armor Pen	Damage	sHP Dmg	Stun	Notes
Anti-materiel rifle	4	450	?90	25
MG-43	3	80	8	12
MG Stalwart	2	60	5	10
Heavy Machine Gun	4	100	35	20
Autocannon	4	260	130	20	Deals additional explosive damage.
+Autocannon explosive aoe	3	+150	150	20
Laser Cannon	4	350/s	?90/s	0
Arc Thrower	7	250	50	50
Flamethrower	?	?	?		Cooks chargers fast.
+ "Fire DOT"	4	?75dot	?		patch 01.000.300 changed fire again. Fire deals damage about 5 times a second. Fire will burn for 10 ticks after the last application of an ignition source.
Grenade Launcher	3	350	350	?20	8 Meter Radius. Does additional AP 0 / 20 Dmg on direct hit
Railgun safe 80% Charge	?5/4/3/0	600	?60	?40
Railgun Unsafe charging	5~8	600	++		Pen increases as charge increases
Railgun Unsafe 100% Charge	?8/7/6/0	600	?120	?40

Big Note about penetration: Every weapon in the game has multiple penetration values that indicate that weapon's penetration at various angles of impact. As the slope increases the penetration decreases. Most notably affects anti-tank weapons.

Anti-Tank	Pen	Damage	sHP Dmg	Stun	Notes
Expendable Anti Tank	6/6/5/3	650	650	25
+EAT AoE	3	150	150	25
Recoilless	6/6/5/3	650	650	25
+Recoilless AoE	3	150	150	25
Quasar	6/6/5/3	650	650	25
+Quasar AoE	3	150	150	25
Spear	8/7/6/0	1000	1000	25	Loses penetration based on angle of impact
+Spear AoE	5	200	200	25

​

Best Boys	Armor Pen	Damage	sHP Dmg	Notes
Guard Dog Ballistic	2	?60	5
Guard Dog Laser	2	?200/s	?20/s
MECH	Armor Pen	Damage	sHP Dmg	Notes
Mech Gatling	3	80
Mech Rocket	6/5/4/0	400	?400	Loses penetration based on angle of impact
+Mech Rocket AoE	?5	?400	?400

Upgrades to stratagems are in (parentheses)

Turrets	Armor Pen	Damage	sHP Dmg	Stun	Notes
MG Emplacement	4	200	40	15	Ammo:300
MG turret	3	80	8		Ammo: 130(195)
Gatling turret	3	80	8		Ammo: 390(585)
Autocannon turret	5	300	?100		Ammo:24(36)
+Autocannon turret AoE	3	+150	150
Rocket Turret	?5				Ammo:32(48)
+Rocket Turret AoE	?3
Tesla Tower	4	600	?125
Mortar Turret	3	400	400		Ammo:36(54)
EMS Mortar	5				Ammo:15(23)
Antipersonnel Mines	5	150	?150
Shield Emplacement					I tested the shield to have about 4000 HP

Upgrades to stratagems are in (parentheses)

EAGLE	Armor Pen	Damage	sHP Dmg	Stratagem Uses	Eagle delivery direction	Notes
Strafing Run	3	150		3 (4)	Forward
500kg direct hit	7	1400	?1400	1 (2)	Forward
+500kg AoE	6	1200	1200
Cluster Bomb	3	350	350	4 (5)	Perpendicular to facing	8(9) Bombs that split into smaller munitions.
110mm Direct hit	5	600	?600	2 (3)	Forward	4 Rockets
+110mm Explosive AoE	5	200	200
Airstrike Direct hits	5	500	?500	2 (3)	Perpendicular to facing	6(7) Bombs
+Airstrike Exp. AoE	5	800	800
Napalm Strike Exposion	3	250	250	2 (3)	Perpendicular to facing	4(5) Bombs
+Ground Fire	2	+400 Dot	?
Smoke Strike	?	?	?		Perpendicular to facing	5 Smoke bombs are deployed in a line giving a approximate rectangle of 40m x 20m. Lasts ~30 seconds.

Upgrades to stratagems are in (parentheses)

Orbitals	Armor Pen	Damage	sHP Dmg	Cooldown	Call in time	Notes
Gatling Barrage	4/3/2/0	300	?	80s (72s)	3s (2s)	32 (40) shots
+Gatling AoE Blasts	3	250	?250
Airburst Strike Blast	3	350		120s (108s)	4.5s (3.5s)	3 blasts about 2.5 seconds apart. Basically uses the same munitions as eagle cluster bomb.
Precision Strike Direct Hit	?8/7/6/0	?450		100s (90s)	6.5s (5.5s)
+Precision Strike Blast	?6	?1000
120mm HE Direct Hit	?7	?300		240s (216s)	7.5s (6.5s)	5 (6) salvos of 3 rounds
+120mm HE Blast AoE	?5	?750
380mm HE	8/7/6/0	450		240s (216s)	8.5s (7.5s)	5 (6) salvos of 3 rounds
+380mm HE Blast AoE	6	1000
Walking Barrage Direct Hit	8/7/6/0	450		240s (216s)	5.5s (4.5s)	3 (4) salvos of 3 rounds
+Walking Barrage AoE	6	1000
Railcannon Strike	10/9/8/0	2000		210s (189s)	1s (instant)
+Rail AoE Blast	8/7/6/0	800
Orbital Laser	?6	30/tick	?	300s (270s)	2s (1s)	?Aprox 5 ticks per second? So 150/s. Could be dealing more hits/second. Deals additional Fire DoT
Smoke Strike	?	?			4.5s (3.5s)	6 shells deployed giving you aprox ~30~40 m diameter of smoke. Lasts ~30 seconds.
Gas Strike Impact	4	300		75s (68s)	4.5s (3.5s)	Stays active for aprox 15 seconds
+Gas DoT	6	50/tick				Aprox 5 ticks per second? So 250/s
EMS Strike	3	250		75s (68s)	4.5s (3.5s)	Stays active for aprox 18 seconds
+Explosion	4	600
+Status effect AoE	4	0
Hellbomb	10	4000	4000

Precision strike and 120mmHE seems wrong in Lone_Recon stats , going to have to do some testing. For now I switched their stats assuming they got mixed up.
​

Miscellaneous Stuff	Armor Pen	Damage	sHP Dmg	Notes
Player Melee	1	50
Player Melee + Muscle Enhancement	1	70		Muscle Enhancement also enhances Melee damage
Hellpod Impact	10	100	?
+Impact Explosion	10	150	?
+Additional Explosion	5	300	?
Shrapnel	?2-3	?+200	?20	Removed from Eruptor in Patch 1.000.302. Likely used by other things

​

Helldiver Body Armor damage reduction values

These numbers are old and slightly inaccurate. Based on the assumption we have 100hp. Will link to updated stats once I find a good post for that.

Armor Value	Headshot damage taken	Chest	Arms	Legs	Explosive Damage Reduction
50	x1.55	11.5%	28.5%	18.5%	50%
100	x1.55	30%	43.4%	35.5%	58.3%
150	x1.25	42.3%	53.3%	46.8%	66.6%
200	x1.05	60%	67.7%	63.1%	75%

Headshots do more damage. multipliers shown. patch 01.000.300 reduced overall headshot damage taken. Patch 01.000.300 also fixed armor reducing explosive damage.
Vitality reduces damage taken by a multiplicative 20%. This is massive, always take Vitality!
​

Credits:

The entire community effort to figure everything out and the dataminers helping along the way.
Figuring out the penetration numbers was largely thanks to a unencrypted game file of a bunch of numbers. Patches have happened since then so numbers might be different. In addition to some testing and extrapolating and collating data from various discord users and youtubers efforts. Gotten so much data thanks to discord users. Major props to everyone there.
Reddit thread: https://www.reddit.com/HellDiversLeaks/comments/1bc4qtx/datamining_for_damage_and_weapon_stats/
The magic numbers: https://docs.google.com/spreadsheets/d/1J4fyz_GiaancKNrMT3lQZ4ZSBTgg9Pe8xFS82_DsGII
Ryken: https://www.youtube.com/@rykenxiv/videos Videos: https://www.youtube.com/watch?v=4GerSUUpDoY , https://www.youtube.com/watch?v=tccz3X49fFk , https://www.youtube.com/watch?v=Q7WF1M0xruY , https://www.youtube.com/watch?v=Qh4DkuuCAKI
Eravin: https://www.youtube.com/@Eravinttv/videos Videos: https://www.youtube.com/watch?v=-sB0d93B18Y , https://www.youtube.com/watch?v=ImARLFl7ZnY
GamingExistence: https://www.youtube.com/@GamingExistence/videos , Videos: https://www.youtube.com/watch?v=7XvsSQEx7Z0
Array71: https://www.reddit.com/Helldivers/comments/1bsecb0/armor_calc_and_how_to_stop_oneshots_from_rockets/
Lone_Recon: https://www.reddit.com/Helldivers/comments/1bz4frb/updated_data_list_of_weaponstratagems_armou
The Wile Spice: https://www.youtube.com/@TheWileSpice Videos: https://www.youtube.com/watch?v=0VxYYYwMzRE
And the leaks discord.
There's so many great youtubers putting out top tier videos. Give them all a sub and watch their stuff.
Helldivers 2 wiki has added a good amount of data now too!: https://helldivers.wiki.gg/wiki/Helldivers_Wiki
There's probably a ton more data out there I've missed. Share what you know! We're all in this together.

Foreword

This is an overly verbose account of my recent ablation. If you don't care about the back story, jump to the Doctors Notes at the bottom. They are the coolest part.
I'm in my 40s, about 6 feet tall and >300 pound. I live in the US. I have been obese my entire life. This is a throw away account for privacy.
Your experience might be different. Your doctor may use different equipment, drugs, protocols or procedures. Trust your doctor. They train for this and do it every day.
Some things may not be 100% correct or complete. I've made a couple assumptions. Some is from ChatGPT interpreting the doctors notes. I’m not a doctor. Again: Trust your doctor.
What I have learned on AFIB is everyone's afib is different. My afib always comes with 160bpm. I don't go in and out of afib daily like others.
​

The start of symptoms

5+ Years ago I started have heart symptoms. I thought I was dieing, but really it was just PVC's (Premature ventricular contractions). I ended up in the emergency room 3 times because of PVCs, but every time I went to the ER they stopped. I got a cardiologist and started taking Metoprolol, worked my way up to the 100mg I am on today. He described my PVCs as nuisance PVCs since they were annoying but they are not actually causing problems. PVC's are harmless unless greater then 20% of your beats over 24 hours, although they feel concerning. I had 2% over 24 hours. Metoprolol controlled them for many years, but they slowly came back.
My cardiologist sent me for a sleep study. Sleep apnea can cause PVCs and AFIB. I was diagnosed and was given and use a CPAP machine. It took me at least a year to fully get used to it. Don't give up trying. Most people say once they get used to it, it changes their life (more energy, less tired, etc). Unfortunately I did not experience that, but I still do it for heart health.
About a year ago my first afib symptoms started. One night my heart felt like it spun around in my chest and continued to feel funny. I know the moment it started and it continued to feel funny and different then PVCs. I used an apple watch and it said 160bpm and Afib. I laid down and waited an hour. It was still 160bpm and afib.
When I arrived at the ER they took an EKG almost immediately, like they did with my previous trips. But previously I would wait 4 hours for a room. This time within 15 minutes I was in an room and they were putting in two IVs (One in each arm, standard protocol for my hospital for any heart issues, just in case). I spent 26 hours at 160bpm. They used IV meds to try to bring my rate down and try to convert me to sinus rhythm. They discussed cardoverting me. Luckily the medicine finally converted me to sinus rhythm (They say it doesn't work for the majority of people). They sent me home on Flecainide 100mg twice daily for rhythem control and Xarelto 20mg once daily to prevent blood clots (you may not be given blood thinners, depending on your risk factors). I continued taking Metoprolol 100mg which helps with rate control. I joked with my cardiologist that I finally have a real problem. He said the PVCs were probably related to the AFIB.
I later learned AFIB runs in my family and one of my uncles had a pace maker. AFIB is farily common, especially as you get older. So all of my older relatives had it but my uncle got it relatively young.
I later had a couple more episodes of AFIB with 160 Bpm. Each time I could tell exactly when it started and my apple watch confirmed. Both resolved on their own in 2-3 hours. Due to the medicine not controlling it and family history, I decided to more forward with the procedure. My electrophysiologist said studies have shown the earlier you address, the higher success rate.
​

The Procedure

A week before I was scheduled for a heart structure CT scan with contrast. They warn you that the contrast will make you feel like you peed yourself when it’s injected. The scan took less then 20 minutes and I was in and out in a hour. The scan was imported into the cath lab (catheterization lab) equipment to help build the map of my heart.
3 days before I stopped taking Flecainide as instructed.
I arrived at the hospital at in the morning to be admitted. My blood was drawn drawn to test blood clotting, blood type, cbc with differential, and a basic metabolic panel. They need the results before the start of the procedure. I was taken to my hospital room to wait. A hour or two later then scheduled, I was wheeled to the cath lab.
In the cath lab there was a lot of people. They had me transfer to the procedure table and I sat up so they could put sensors on my back and then on my front. These are for the mapping system to sense where the tools are in the heart.
Before I knew it I was out. I woke up in the recovery room and felt no pain. I was a little groggy for about 1 hour.
Around 7pm I attempted to get up for the first time to use the bathroom. I had two groin incisions, one on each side for the catheters. The right side started bleeding pretty good. There was no pain and the only reason I noticed was I felt warm stuff running down my leg. I yelled for the nurse and they jumped into action. Because there was no pain and the nurses were professionals it was not scarey. They held pressure for 10 minutes and it stopped. They redressed the incision. It was decided I would spend the night as a precaution.
Overnight I had some chest discomfort that came and went. I only got a couple hours of sleep. My heart rate after the procedure was in the 90s and came down to the 70s overnight. After breakfast it was back up to in the 90s.
​

Post Procedure

They performed a standard pulmonary vien isolation. My doctor said this fixes 80% of people. During the procedure they were able to trigger AFIB and AFIB Flutter. I was not diagnosed with flutter beforehand. Because of the flutter, they also performed a linear ablation of the cavotricuspid isthmus (CT isthums). I'm supper happy they were able to trigger both during the procedure. They also cardoverted me out of them during the procedure! (Read the doctors notes below, this seems to be very standard procedure stuff).
I was sent home with a couple new drugs and keep taking the existing drugs. They said they will take me off everything after 30 days.
Let me know if you want a follow up after my 30 day checkup!

Doctors Notes

My hospital's medical records system lets you see the doctors notes. They are highly technical and I only understand about 25% of his original notes. I fed them through ChatGPT (GPT-4) to explain them. Below are a summary of the notes, which if you are a nerd like me, are really cool. Note that there may be errors.
Procedure Summary:

1. At baseline patient was in sinus rhythm: Before the procedure began, the patient's heart was beating in a normal rhythm, which is known as "sinus rhythm."
2. Procedure was performed under general anesthesia: The patient was made unconscious with medications so they wouldn't feel pain during the procedure.
3. Successful trans-septal puncture performed under ICE guidance: A technique was used to create a small hole in the septum (the wall that separates the left and right sides of the heart) under the guidance of Intracardiac Echocardiography (ICE), a type of ultrasound used inside the heart to provide real-time imaging.
4. Using fluoroscopy and 3D Anatomic mapping (CARTO), 4 pulmonary veins, esophagus (using temperature probe) identified and left atrium shell created: Fluoroscopy (a type of X-ray) and a 3D mapping system were used to visualize and map the heart's anatomy. This included identifying the four pulmonary veins (which bring oxygenated blood from the lungs to the heart) and the esophagus (to monitor its temperature and prevent damage). A "shell" or model of the left atrium (the upper left chamber of the heart) was also created.
5. Using irrigated tip ablation catheter, wide area circumferential ablation (WACA) performed around both left (2 veins) and right (2 veins): A special catheter with a tip that can deliver cooling fluid (to prevent overheating) was used to perform ablation. This procedure involves creating scars around the four pulmonary veins to isolate them electrically and prevent irregular heartbeats from spreading. This technique is known as "Wide Area Circumferential Ablation."
6. Isolation was confirmed of all 4 pulmonary veins: It was verified that the ablation successfully electrically isolated all four pulmonary veins, a key goal in treating atrial fibrillation.
7. CTI ablation was performed for typical atrial flutter: An ablation was also performed on the cavotricuspid isthmus (CTI), a specific area in the heart, to treat a type of heart rhythm problem known as "typical atrial flutter."
8. Post RFA - no effusion on ICE: After the Radiofrequency Ablation (RFA), no fluid accumulation (effusion) was detected in the heart when examined with ICE, indicating no immediate complications from the procedure.
9. Normal sinus node function: The sinus node, which acts as the heart's natural pacemaker, was functioning normally after the procedure.
10. Normal AV node conduction: The atrioventricular (AV) node, responsible for the electrical connection between the heart's upper and lower chambers, was conducting signals normally.
11. Normal infra-Hisian conduction: The electrical signals below the bundle of His (part of the heart's electrical system) were normal, indicating proper conduction through the heart's ventricles.
12. Decremental concentric VA conduction, no evidence of an accessory pathway: The electrical signals from the ventricles to the atria (VA conduction) showed a decreasing pattern when the heart was stimulated, and there was no evidence of an additional electrical pathway, which could cause irregular heartbeats.

Preoperative Diagnosis:

1. Paroxysmal Atrial Fibrillation - This is a type of heart rhythm disorder where the upper chambers of the heart (the atria) experience erratic electrical signals, causing them to quiver or fibrillate. "Paroxysmal" means that these episodes start and stop suddenly and unpredictably. This condition can lead to symptoms such as palpitations, fatigue, or shortness of breath but might not present any symptoms in some individuals. It's important because it can increase the risk of stroke.

Postoperative Diagnosis:

1. Paroxysmal Atrial Fibrillation - The same condition as mentioned above was confirmed or remained after the surgery.
2. Typical Atrial Flutter - After the surgery, an additional diagnosis of typical atrial flutter was made. Atrial flutter is another type of heart rhythm problem, where the atria beat very fast but at a regular rhythm, unlike the irregular rhythm of fibrillation. "Typical" refers to the most common form of atrial flutter, which involves a specific electrical circuit in the right atrium. Like atrial fibrillation, atrial flutter can cause palpitations, shortness of breath, and other symptoms, and also carries a risk of stroke.

Procedure Performed:

1. EP Study Complete with 3D Mapping: An electrophysiological study involves threading catheters into the heart through blood vessels to record electrical activity. 3D mapping creates a detailed model of the heart's electrical signals, helping to pinpoint the source of the arrhythmia.
2. EP Study with Left Atrial Recording and Pacing: This is a specific part of the EP study where doctors focus on the left atrium (one of the upper chambers of the heart) to record its electrical activity and to pace it (stimulate it to beat) artificially to study its responses.
3. Transeptal Puncture: This procedure involves making a small hole in the septum (the wall between the left and right sides of the heart) to allow catheters to pass from the right side of the heart to the left side. This is often necessary for procedures that require access to the left atrium, like ablation for atrial fibrillation.
4. Intracardiac Ultrasound: This is an ultrasound done from inside the heart, using a special catheter equipped with an ultrasound device. It gives doctors a detailed view of the heart's structures to guide the procedures accurately.
5. Ablation of Atrial Fibrillation by PVI and Confirmed Isolation of Both Right and Left Pulmonary Veins: Ablation is a procedure to create small scars in specific areas of the heart that are responsible for the abnormal electrical signals causing atrial fibrillation. PVI (Pulmonary Vein Isolation) specifically targets the areas around the veins that bring blood from the lungs back to the heart, as these are common sources of the problematic signals. Isolation means that the electrical activity in these veins is successfully blocked from reaching the rest of the heart.
6. DCCVx2: This stands for Direct Current Cardioversion, performed twice. It's a procedure where an electric shock is given to the heart through the chest wall to reset the heart's rhythm back to normal. It's often used when medication fails to correct arrhythmias.
7. US Guided Venous Access: Ultrasound-guided venous access means using ultrasound imaging to help guide the insertion of catheters into the veins, ensuring accuracy and reducing the risk of complications.
8. LV Pacing and Recording: Similar to the atrial recording and pacing, this involves the left ventricle (the lower left chamber of the heart). The procedure studies how the ventricle responds to artificial pacing and records its electrical activity.
9. Adenosine Injection with Induction Attempts: Adenosine is a drug that can temporarily slow down the heart rate, often used during heart studies to trigger (induce) arrhythmias under controlled conditions so they can be studied and treated.
10. Linear Ablation of CT Isthmus for Typical Flutter: This refers to a specific type of ablation targeting the cavotricuspid isthmus, a part of the right atrium near the tricuspid valve. It's done to treat a type of atrial flutter (a rapid, regular heart rhythm) by creating a line of scar tissue that blocks the abnormal electrical circuit causing the flutter.

Operative Course:

• General anesthesia was utilized: This means that the patient was put into a state where they were completely unconscious and didn't feel any pain during the procedure. General anesthesia affects the entire body.
• The patient presented in sinus rhythm: This means that, when monitored, the patient's heart was beating in a normal rhythm. Sinus rhythm indicates a healthy heart function where the electrical impulses originate from the sinoatrial node (a natural pacemaker in the heart) in a regular pattern.
• Access was obtained by modified Seldinger technique to right femoral vein: The Seldinger technique is a medical procedure to gain safe access to blood vessels and other hollow organs. It involves using a thin, flexible tube called a catheter. "Modified" suggests a variation of the standard method was used. This technique was applied to the right femoral vein, which is a large vein in the thigh.
• An 8 French and a 9 French sheath was placed in the right femoral vein and an 8 Fr sheath was placed in the left femoral vein: A French (Fr) is a unit of measurement for the outer diameter of catheters and other tubular instruments. One French is equal to 1/3 millimeter. Sheaths of 8 and 9 French sizes were inserted into the veins in the thighs to facilitate the procedure.
• Using ultrasound: Ultrasound is a technique that uses sound waves to create images of structures inside the body. It was used here to guide the placement of the sheaths, ensuring accuracy and safety.
• Documentation of vessel patency, needle access with permanent recording, and reporting was performed: This indicates that the procedure included checking that the blood vessels were open and unobstructed (patency), recording the needle's entry into the vessel, and reporting these details for permanent medical records.
• All sheaths were flushed appropriately: After the sheaths were placed, they were flushed, likely with a saline solution, to ensure they remained open and free of blood clots.

​

• A baseline ACT was obtained: ACT stands for Activated Clotting Time. It's a test that measures how long it takes blood to clot. This baseline measurement is important for adjusting medications that affect blood clotting, such as heparin, which is commonly used in procedures involving the heart and blood vessels.
• An intracardiac echo Soundstar phased array catheter was inserted into the right atrium through the 9 Fr sheath: This device is used for echocardiography, which creates an ultrasound image of the heart. It was inserted into the right atrium (one of the heart's upper chambers) through a previously placed sheath. This allows the medical team to see the heart's structures in real-time during the procedure.
• An 8 Fr sheath was then exchanged over a long wire for the Baylis Versacross sheath: This describes replacing one type of sheath with another (the Baylis Versacross), which is specifically designed for certain types of cardiac procedures, over a guide wire.
• Using fluoroscopic and ultrasound guidance, the trans-septal puncture was performed: A trans-septal puncture involves creating a small hole in the septum, the wall separating the left and right sides of the heart. This is done under the guidance of fluoroscopy (a type of live X-ray) and ultrasound to ensure accuracy.
• The Baylis Versacross sheath was then advanced into the left atrium without issue: After the puncture, the Baylis Versacross sheath was moved into the left atrium (another upper chamber of the heart), allowing access to this area.
• Heparin was given with periodic ACT with goal ACT of 300 to 400: Heparin is a medication that prevents blood clots. The ACT levels were monitored and maintained between 300 to 400 seconds to balance the risk of clotting and bleeding. The mentioned ISTAT values (230 - 250) refer to a specific measurement range, likely indicating the target range for clotting times under different conditions or measurement methods.
• Intracardiac echocardiogram was used to visualize the heart with no effusion noted after trans-septal access and at the conclusion of the case: An echocardiogram was used throughout to monitor the heart and ensure there was no effusion (accumulation of fluid) around the heart, which could be a complication.
• Under fluoroscopic guidance, a 20 pole CS catheter was placed in the CS: This involves placing a catheter with multiple electrodes (20 poles) into the coronary sinus (CS), a large vein on the heart's surface, under X-ray guidance.
• The Octaray catheter was then placed into the left atrium through Baylis Versacross sheath and all four veins were interrogated: The Octaray catheter, likely used for mapping electrical activity, was placed in the left atrium to study the veins there.
• High output pacing was performed anterior to the right pulmonary veins with phrenic nerve capture: Electrical pacing was used to stimulate the heart, specifically near the right pulmonary veins. This stimulation captured the phrenic nerve, which controls diaphragm movement, indicating its location to avoid damage.
• Area of phrenic nerve capture was marked: This location was marked to ensure safety during the procedure.
• During high output pacing, patient developed atrial fibrillation: The patient's heart went into atrial fibrillation, a common but serious heart rhythm disorder.
• Therefore, synchronized DCCV with 300 J energy was performed: DCCV (Direct Current Cardioversion) is a procedure to restore normal heart rhythm using electric shocks. Here, it was synchronized with the heart's rhythm and performed with 300 Joules of energy, successfully returning the heart to normal rhythm.

​

• 3D map with voltage was constructed with the CARTO system and CT scan of the left atrium: The CARTO system is an advanced 3D mapping system used in electrophysiology studies (EPS) and ablation procedures. It creates a detailed 3D map of the heart's electrical activity by combining data from the CARTO system with anatomical information from a CT scan of the left atrium. This map helps in identifying areas of abnormal electrical activity that may be causing atrial fibrillation.
• Wide antral circumferential ablation and segmental antral isolation: This part of the procedure involves creating scars (ablations) around the areas where the pulmonary veins enter the left atrium (the vein's antrum). These scars block the abnormal electrical signals that cause AFib. "Wide antral circumferential ablation" (WACA) means making a wide ring of ablation around these entry points, while "segmental antral isolation" refers to targeting specific segments of these areas.
• With a 3.5 mm EZ steer Thermocool Biosense Webster ST SF catheter: This describes the specific tool used for the ablation. This catheter can be steered (directed) precisely to the areas needing ablation and is equipped to deliver cooling to the site, helping to prevent damage to surrounding tissues while the ablation is performed.
• Performed around the left and right pulmonary veins, paying close attention to remain outside of the pulmonary veins themselves: The ablation is carefully done around the entrances of the four pulmonary veins (two on the left, two on the right) that connect to the left atrium, ensuring not to enter the veins. This is crucial because the goal is to isolate the pulmonary veins electrically without damaging them.
• Multiple applications were placed until isolation was confirmed in all 4 pulmonary veins: The procedure involves applying the ablation multiple times as needed to achieve electrical isolation of all four pulmonary veins from the left atrium. This isolation is necessary to prevent the pulmonary veins from delivering abnormal electrical signals to the rest of the heart.
• Using the mapping catheter and differential pacing from the atrium and within the pulmonary vein: After the ablations, the electrophysiologist uses the mapping catheter to confirm that the veins are isolated. "Differential pacing" refers to stimulating the heart at different sites (both in the atrium and inside the pulmonary veins) to ensure that electrical signals are not passing between the atrium and the veins, indicating successful isolation.

​

• On the posterior wall, all applications were 50W or less to achieve an ablation index of 400: The "posterior wall" refers to the back wall of the left atrium, near where the pulmonary veins enter the heart. The energy delivered by the ablation catheter is measured in watts (W). In this case, the energy applied was kept at 50 watts or lower. The "ablation index" is a composite measure that takes into account the power, contact force, and duration of the ablation; an index of 400 is targeted for effective ablation while minimizing the risk of damage to surrounding tissues.
• The esophageal temperature was monitored with a temperature probe: Since the esophagus lies just behind the heart's left atrium, there's a risk of heating the esophagus during ablation procedures on the posterior wall. Monitoring the esophageal temperature with a probe allows the medical team to ensure that the esophagus does not become overheated, which could cause injury.
• No increase of > 1 degree Celsius was noted: This indicates that during the procedure, the temperature in the esophagus did not increase by more than 1 degree Celsius. This is a good sign, indicating that the procedure was conducted safely without causing significant heating or potential damage to the esophagus.
• Anterior applications were performed at 50 watts or less to achieve an ablation index of 500: Similar to the posterior wall, ablations on the anterior wall (the front part of the left atrium) were performed with energy settings of 50 watts or lower. However, for the anterior wall, a higher ablation index of 500 was targeted. The anterior wall might tolerate more aggressive ablation due to the absence of structures like the esophagus nearby, allowing for a higher index to ensure effective isolation of the pulmonary veins.

​

• Once PV isolation was complete: PV isolation refers to the process described previously, where the pulmonary veins are electrically isolated from the left atrium to prevent abnormal electrical signals that cause atrial fibrillation from reaching the rest of the heart. Completing this step is a crucial part of treating atrial fibrillation.
• I placed the ablation catheter in the LV: "LV" stands for the left ventricle, which is one of the heart's four chambers and responsible for pumping oxygenated blood to the body. After isolating the pulmonary veins, the ablation catheter is moved to the left ventricle. This is done for further diagnostic or therapeutic purposes, depending on the specifics of the patient's heart condition.
• Performed pacing at 10mA to ensure decremental conduction: Pacing refers to the use of electrical impulses to stimulate the heart muscle. In this context, a specific current (10 milliamperes, mA) is used to pace the heart. The goal here is to ensure "decremental conduction," which means assessing how the heart's electrical conduction system slows down the electrical impulses. Decremental conduction is a property of certain heart tissue, like the atrioventricular (AV) node, which helps regulate the heart rate by slowing the electrical signals from the atria to the ventricles. This step is likely performed to assess the integrity and function of the heart's conduction pathways after the ablation procedure, ensuring that the heart's electrical system is functioning properly and safely

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• Reconfirmation of pulmonary vein isolation were performed prior to end of case with differential pacing: Before concluding the procedure, the medical team reassessed the isolation of the pulmonary veins from the left atrium. This reconfirmation used differential pacing, a technique where electrical impulses are applied at different locations (within the pulmonary veins and in the atrium) to test if electrical signals can pass through the isolated areas. The absence of conduction into the atrium from the veins confirms successful isolation.
• 12 mg of IV Adenosine was then administered in each pulmonary vein: Adenosine is a drug that temporarily slows down the heart's electrical conduction, particularly affecting the atrioventricular (AV) node, which mediates the electrical signals between the heart's chambers. By administering adenosine intravenously (IV) into each pulmonary vein, the medical team can further test the effectiveness of the vein isolation. Adenosine can provoke transient reconnection of the pulmonary veins to the atrium, revealing areas that might not be adequately isolated.
• All pulmonary veins were found to be isolated: After the administration of adenosine, the test confirmed that all pulmonary veins remained isolated from the left atrium. This means the procedure was successful in electrically disconnecting these veins, thereby preventing them from transmitting erratic electrical impulses to the atrium that could cause atrial fibrillation.

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• With burst atrial pacing down to 230 ms: Burst pacing is a technique used in cardiac electrophysiology to assess the heart's electrical stability and to diagnose arrhythmias. It involves delivering a series of rapid electrical impulses to the heart to stimulate it at a certain rate. Here, the pacing rate was set to intervals of 230 milliseconds (ms) between each pulse. This rapid pacing is performed in the atria, the upper chambers of the heart.
• Patient developed typical atrial flutter that degenerated to atrial fibrillation: As a result of the burst pacing, the patient developed atrial flutter, a type of cardiac arrhythmia characterized by a rapid but organized rhythm in the atria. Atrial flutter can sometimes degenerate into atrial fibrillation, which is a more chaotic and disorganized rhythm. This transition indicates that the patient's heart is susceptible to rhythm disturbances, which can be critical information for diagnosis and treatment planning.
• Therefore, synchronized Direct Current Cardioversion (DCCV) with 250 J was performed: DCCV is a procedure used to restore a normal heart rhythm by delivering a controlled electric shock to the chest. The shock is synchronized with the patient's cardiac cycle to minimize the risk of inducing more dangerous arrhythmias. In this case, a shock of 250 joules (J) was used, which indicates a relatively high energy level, reflecting the seriousness of the arrhythmia (atrial fibrillation) needing conversion.
• This led to the restoration of sinus rhythm: The DCCV was successful in converting the patient's heart rhythm back to normal sinus rhythm, which is the natural, regular rhythm originating from the sinoatrial node (the heart's natural pacemaker). Restoring sinus rhythm is essential for normal heart function and to reduce the risk of complications associated with atrial fibrillation, such as stroke.

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• Removed ablation catheter to the RA and annotated the HIS bundle: The ablation catheter, initially used for other purposes in the procedure, was repositioned to the right atrium (RA). Here, the HIS bundle was annotated. The HIS bundle is a collection of heart muscle cells specialized for electrical conduction that transmits impulses from the atrioventricular node, located at the center of the heart, to the ventricles (the heart's lower chambers). "Annotating" in this context likely means mapping or marking the area for reference, which is crucial for avoiding damage to this vital conduction pathway during the ablation.
• Given typical atrial flutter, decision was made to perform CTI ablation: Atrial flutter is a type of heart rhythm disorder characterized by rapid, regular heartbeats. The decision to perform Cavotricuspid Isthmus (CTI) ablation indicates that the atrial flutter was identified as being caused by electrical signals traveling in an abnormal circuit through the CTI, a region in the right atrium near the tricuspid valve. Ablation of this area can interrupt the circuit and restore normal heart rhythm.
• TV and IVC geometry were created: Before performing the CTI ablation, geometrical maps of the tricuspid valve (TV) and the inferior vena cava (IVC) were created. These maps help in navigating the ablation catheter and in planning the ablation line to ensure it effectively blocks the abnormal electrical circuit causing the flutter.
• Linear ablation was performed from the TV to the IVC at 40W: A linear ablation line was created using 40 watts of power, extending from the tricuspid valve to the inferior vena cava. This line is intended to block the abnormal electrical pathway that contributes to atrial flutter.
• Several applications were placed until bi-directional block was achieved: Multiple ablations were performed along the planned line until a bi-directional block was confirmed. A bi-directional block means that electrical impulses can no longer travel in either direction through the ablated region, effectively interrupting the circuit causing the flutter.
• Post-ablation, the CT isthmus conduction time was 150 ms: After the ablation, the conduction time through the cavotricuspid isthmus was measured to be 150 milliseconds (ms), which is likely indicative of successful interruption of the abnormal circuit.
• This and the atrial activation sequence were c/w bi-directional block: The measured conduction time, along with the pattern of electrical activation in the atria observed after the ablation, were consistent with (c/w) a successful bi-directional block. This means the procedure effectively disrupted the circuit responsible for atrial flutter, a crucial step in restoring normal heart rhythm.

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• IV protamine was given after a test dose: Protamine is a medication used to neutralize the effects of heparin, an anticoagulant (blood thinner) commonly used during cardiac procedures to prevent blood clots. Given intravenously (IV), protamine helps reduce the risk of bleeding after the procedure. A "test dose" is administered first to check for any adverse reaction to the medication before the full dose is given.
• Sheaths were removed in the EP lab: Sheaths are tube-like devices inserted into blood vessels to provide access for catheters during the procedure. Removing the sheaths is a critical step toward concluding the procedure. This is done carefully to prevent bleeding from the puncture sites in the vessels.
• Hemostasis was obtained using Vascade closure devices: Hemostasis is the process of stopping bleeding. The Vascade is a type of vascular closure device used to seal the small hole in the vessel where the sheath was inserted. These devices can significantly reduce bleeding complications and speed up the recovery process by providing an immediate mechanical seal at the arteriotomy site (the site in the artery where the incision was made).
• The patient was sent to the recovery room in stable condition: After the procedure, the patient was transferred to a recovery room for close monitoring as they wake up from anesthesia and begin the initial phase of recovery. "In stable condition" indicates that the patient's vital signs (like heart rate, blood pressure, and oxygen levels) were within normal ranges, and there were no immediate complications following the procedure.

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• No pericardial effusion was noted: This means that after reviewing the images obtained from the intracardiac echocardiogram, the medical team did not observe any abnormal accumulation of fluid around the heart. This is a favorable finding, indicating that the procedure did not cause pericardial effusion, thereby reducing the risk of complications such as cardiac tamponade, a condition where pressure from the accumulated fluid affects the heart's ability to pump blood effectively.

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Hi all,

1. Are trig blood tests a snapshot or is it equally weighted and averaged over a period of months (like the way an A1C is for blood sugar)?
2. Secondly, I would love to hear real world experiences with how others have gotten their trig numbers down.
3. Third, any insights you'd like to share about cholesterol/heart health given all my stats as I can see there are some pretty experienced/knowledgable folks on this board.

I was shocked to see my trig #s almost double from 8 months prior. While it's not off the chart, the rate of change is alarming and is above the normal range of 150 when historically my trig #s have been in the normal range. I never really paid attention to my trigs as a result, as I've put more relative focus/interest/education on LDL.
My LDL started to get above 100 in my mid 30s and that is something I've struggled w/ but finally started seeing it go down this year which is why I was initially surprised to see my trig #s higher! I have a better understanding of how to lower my LDL but not so much w/ my trigs.
Many thanks!
Here are my stats:
45(F), 125 lbs, BMI healthy/normal, exercise 0-6x/week (highly variable but avg 2-3x), intermittent fast a few weeks/month, try to eat healthy most of the time but have a horrible sweet tooth. In the spring/summer of 2022 I got into Keto baking so I can do better on the sugacarbs department but it quite literally did a number on my lipids as seen in the #s below.
Family history of heart disease on my mom's side that I just learned recently (mom had a triple bypass in her 60s, uncle passed away from heart attack in his late 40s).
Lipid Panels (all fasted state)
4/2024 - Trigs: 174 HDL: 76 LDL: 135 Total: 246 Total/HDL Ratio: 3.24
8/2023 - Trigs: 88 HDL: 67 LDL: 148 Total: 233 Total/HDL Ratio: 3.48
8/2022 - Trigs: 132 HDL: 59 LDL: 154 Total: 239 Total/HDL Ratio: 4.05
10/2021 - Trigs: 68 HDL: 68 LDL: 148 Total: 230 Total/HDL Ratio: 3.38
Other relevant numbers:
2/2024 - Calcium Score - 0
2/2024 - Lp (a) test - 19 nMol/L. Optimal Ref Range: <75 nMol/L.
4/2024 - BP: 104/69 Glucose (fasted): 87 mg/dL A1C: 5.0
Recent factors that may have caused the trigs to double:
So going back to my question about whether the trig blood test is a snapshot or a weighted average, I think I have a pretty good idea of what may have caused it to double from the last test. I was on my period and had 1-2 hrs of sleep on one of these nights due to having to deal w/ painful cramps. I only had 5 hours of sleep a few nights before which is very unusual. Also more unusual is having 2 sleepless nights a day apart (it was torture. I would not wish this on anyone!!!).
I ate a lot of chocolate this past week including 2 king sized Twix. Had a gigantic carrot cake on Easter with an excessive amount of the heavenly but deadly cream cheese frosting. In the past month I had a lot of other pastries and breads w/ jams that I indulged in, lots of bagels w/ cream cheese etc. I basically got off the wagon, including an entire month of not working out after catching a really bad cold at the gym.
So that is why I strongly suspect that the trig #s are more of a snapshot of recent lifestyle activity than a cumulative report card. Because March 2024 was an F- but most of the time, I'm more of an A-B student. LOL. Either way, it tells me exactly what happens when I eat these types of foods and how it impacts my other #s. I was really surprised carbs affected trigs/lipids like this! What a lesson.
Thank you for reading through my post and offering any insight!

Eterra is dead Orobees is free.
Hi i am Astrex and would like to present you my bees build, my achievements with the build :

• Julra under 30s
• corruption 1000 is a walk in the park
• Top 10 primalist ladder (i DC my attempt as arena is very very very very too long, I will try again when my will bee back)

Video Demo : https://youtu.be/wQ06xESgdiY
Link to my current build, I will do the cheapest version either build and video when i have the time and if it interess people : https://www.lastepochtools.com/planneBxyPYrmo
Link to the massive ward version : https://www.lastepochtools.com/planneoX9Vqw6A
Cons :

• Very rare item needed so in Cof just don’t try it. You can only do it if you already looted a good relic and the 2 bees idols needed. I was in MG to build this, and, as it is not a meta build, things were very cheap. My whole set up cost me less than 150 millions for both version, when any single meta item cost lot more. If this get popular somehow then the idols will cost you as much as your most expensive item ever.
• It is not a level up guide (as soon as you get the shield you can go retaliate then later get the bees)

Pro :

• 24 bees at max set up and they are so cute ! (i am joking they look like hornet and not bees put some hairs EHG !)
• decent single target damage
• very very tanky as you play spriggan druid with thorn shield and eterra blessing
• decent mobility with werebear form
• you can add 50k ward when needed (for ladder or a no brain no dodge orobyss fight)

It play in dual form : Spriggan you spam thorn shield non stop, it boost your defense, it heal you with eterra blessing, it stack reflect and you wear the reflect shield. Then werebear and cry to stack maelstorm for frenzy and haste (with the weaver boots it boost your bees too) then change monster pack with rampage. And repeat
Yours bees scale very well :

• with number of bees
• with attack speed
• with chance to bleed
• with bleed duration
• with attunement, your main stats that add you retaliation with the shield but add your bee an insane amount of life and increase damage (+16 % per atunnement with the right relic)
• with strenght that give a very good bleed penetration (+6 % with the the right relic)

That is a lot of multipliers ! you can expect between 2millions dps with good stuff to 5 milions dps with the the max damage stuff attaigneable. But it is a dot dps so it take a little time to grow since max charge need to be applied.
How to stuff :

• Zero : get the shield everything will die around you with just a few attunement
• One : you need the relic with perfect stats on attunement and strenght, and only if these stats are max a good bees number. It is more important to get these perfect damage stats than LP on relic as everything scale with it.
• Second your need more bees so bees idols (the best is with minions bleed chance or atta speed but it is hard to get) and other idol with minion bleed chance
• Third You need the armor that make your minion bleed with a good duration roll it is possibly the only duration you need, then minion bleed chance on LP armor and minion bleed chance on helmet.
• On your stuff you neeed the maximum of attunement possible, then strengh a 3-4 attunement for 2 strengh is the good ratio. -On your main hand you need only cast speed -To push corruption get some minion life, for example on the amulet as you dont need other stats there.

The ward bonus : When you need ward (for corruption 1000 it is not necessary ofc) you change stuff to replace life with cooldown reduction and you spam the shappeshift between werebear and spriggan to get the massive bonus of ward when entering spriggan form. You lose dps as you cant have as much strengh and attunement but that is still godd enought. Take the OPstupid new axe that give int equal to your strenght so you dont need anything for ward retention.
Variant : if you really want to use summon bleed bear it can scale well with the build just throw wearbear skil and transform both to human and spriggan fast when needed, to put summoned bear instead and you will have an other 400k bonus dps. No need to change items.

38f- white - 5’4-180lb- non smoker- diagnosed with anxiety and depression. I take klonopin 1 mg a day , Levothyoxine 150 mcg a day, Lamictal 100 mg a days- location of the problem is my esophagus and bothering last 3 weeks. Have been take nystatin 4 ml 4x a day . overall general health is good.. have had thyroid removed due to nodules non cancerous and a knee replacement.. suffer from year around allergies take Allegra as needed
I accidentally shared a straw with my boyfriend a few times after finding out I had it. Kind of did it out of habit not thinking. I know it was stupid.. now I feel so guilty. What are the chances they he’s going to get. Equally as stupid I continued to drink out of the same straws.. I’ve had a lot stress going on so I’ve kinda been out of it.. how likely is it that I keep the Infection alive. By doing this even though taking medicine
And how will my Gastro know if the thrush is gone on my follow up without another endoscopy bc I can’t really tell him if symptoms are gone bc I never knew had to begin with and I always have a sore throat bc of allergies and my anxiety will make Me believe I have all the symptoms

The Baker Protocol
This piece of writing will lay out a number of steps that can be used for the purposes of body fat reduction without purposefully counting and restricting total calories. The plan is as follows:

1. Implement the method given in whatever step you’re on while still implementing the previous steps.
2. Once you’re able to follow the method in that step in addition to all the other steps well enough that you’re comfortable moving on, meaning you’re disciplined with following the previous methods and the method you’re currently on with relative ease, move on to the next method.
3. Continue this until out of methods or not wanting to move to the next steps.

Some things are more vital to body fat loss than others. The purpose of this protocol is to make one comfortable with a technique that will assist with body fat loss, adding it to the repertoire they have already been following, then moving on to the next, less foundational, but still helpful, technique.
It is recommended to gain the knowledge of how to count macronutrients and calories before starting this protocol. There are many great resources online. I would recommend searching “How to count calories for beginners” and “How to count macros for beginners” on YouTube.
At the end, the things that the author of this protocol does will be listed. These are not things to be attempted right off the bat, but can be followed once comfortably experienced.
Step 0, Walk:
If you are not already, start walking. Start with 5 minutes of walking three times a day and increase the amount of time spent on each walk until at 10 to 15 minutes on each.
Rationale:
Walking, if it is not already being done, is the best starting point. It is movement, will get blood flowing, will condition the leg muscles, will serve as a form of cardiovascular exercise, and will build confidence. As to why walking is done three times a day rather than once, multiple sessions of walking in a day is shown to be more effective at weight loss and metabolic function than walking the same amount in one session as the multiple put together.
Step 1, Resistance Training / Weight Lifting and / or Calisthenics:
Start a resistance training routine. If new to resistance training, start with something simple, like picking up and putting things down, body weight squats, knee pushups, and crunches. If more advanced, follow whatever program you desire, hypertrophy focused or otherwise. Make sure to properly warm up a muscle before working it out intensely to prevent injury. The resistance training will be hard in the beginning, but once you make a consistent habit out of it, you won’t be able to fathom not consistently working out.
Rationale:
The purpose of resistance training in this context is to build muscle. Having more muscle on the body generally looks better, think big arms and shoulders for guys and big glutes for women. Also, muscle burns calories even at rest, so building more muscle will cause your body to burn more calories every day. As long as you’re not taking steroids, 99% of people who start a resistance training program will not look “too bulky”, especially while losing weight.
Step 2, 1/3 BMR Protein:
Have an amount of protein each day equal to 1/3 your BMR, or basal metabolic rate. Google “BMR calculator”, enter in your information, divide that number by 3, and eat at least that many calories in protein each day. It’s recommended, but not required, that you eat this from whole food sources, like lean meat rather than protein powder, and that you eat this protein before eating the majority of your other calories. If you want to eat more protein than this, feel free to, but don’t eat less.
Rationale:
Protein is an extremely important macronutrients for fat loss. Protein is muscle sparing, the most satiating macronutrient, very thermogenic (it takes a lot of calories to digest, that’s why people get hot after eating meat), and the most satiating macronutrient.
Step 3, Sleep:
Do everything you can to get good sleep, meaning you want your sleep quantity and quality to both be as high as possible. There will be tips on how to sleep better towards the end of this protocol after the steps.
Rationale:
Studies show that sleep deprivation causes people to be hungrier throughout the day, consume more calories, and choose more calorie-dense food options. In the same way that thirst can mimic hunger, being tired can also make you want to eat. Getting great sleep will drastically increase your willpower, which will make things like sticking to the right food choices and fasting for longer far easier. In addition to this, good sleep will make your willpower much higher, which will assist in following everything else in this protocol. “The difference between hope and despair is a good night’s sleep.”
Step 4, Cardio:
Find a hard, exhausting cardiovascular exercise routine and follow it. The cardio must be hard enough that, by the end, you’re out of breath, sweating, and exhausted. It is recommended that you do something I call prolonged intense alternating cardio to exhaustion, or Piacte. Piacte is similar to HIIT in that it is quick, efficient, and great for an adaptive response. Prolonged means that it is done for more than a few minutes, intense means that you are really pushing yourself, alternating refers to alternating between exertion and rest, cardio is a type of exercise that works the cardiovascular system, meaning the heart, lungs, blood vessels, and a myriad of other things, and to exhaustion means you alternating between exertion and rest until absolutely exhausted. A good version of this is to find a stretch of land roughly equal to 100 yards (90 meters), sprint / run very fast the 100 yards, walk the 100 yards back, repeat until absolutely exhausted. Once more conditioned, it’s recommended to sprint / run fast the 100 yards, jog back 50 yards, walk the other 50 yards, repeat until absolutely exhausted. A good metric for true exhaustion is if you become nauseous, feel like you’re going to “pass out” (not literally, but that wording gives you an idea), and if your performance is significantly, significantly decreased. It is strongly recommended to do the cardio either first thing in the morning or after your resistance training if your resistance training takes place in the morning, as attempting to do Piacte with food in your stomach will make you have stomach cramps and potentially vomit before you are truly exhausted. Do Piacte at least 4 times a week, as that will give you the adaptive response. The cardio will be mentally hard in the beginning and you won’t want to do it, but force yourself to start and it will be significantly mentally easier after around 5 minutes.
Rationale:
Cardiovascular training that significantly elevated your vital signs (heart rate, blood pressure, respiratory rate, temperature to a lesser degree) for an extended period of time is shown to cause an adaptive response in the body and make the body consume less calories than it would otherwise in an effort to make the body more lean, as the body cannot differentiate between running hard on a treadmill vs running away from a lion. Heavier bodies move slower and are less efficient, so the body “wants” to become more lean to avoid such a situation becoming fatal. Hard cardio also aids in weight loss with things like burning calories (although burning calories is not the main purpose of this kind of cardio) and increasing insulin sensitivity and leptin sensitivity (leptin sensitivity being the mechanism of action for the adaptive response listed above). As a bonus, hard cardio gives someone a “runner’s high” afterwards that is similar to a mild stimulant, meaning you will get a mental boost throughout the rest of the day, and generally increases “energy levels” when consistently done.
Step 5, Restrict Carbs to 1/3 BMR Calories:
Using the same process as outlined in step 2 to find 1/3 of the calories in your BMR, have an amount of carbs each day equal in calories to 1/3 your BMR, no more, no less. Preferably, get this source of carbs from something that is “good” for humans, meaning something that doesn’t have plant defense chemicals in it; a good thing to eat is fruit.
Rationale:
Increasing carbohydrates as a total amount of calories, especially overly processed carbohydrates, has been shown to increase appetite due to spiking and plummeting blood sugar and insulin levels, leading to an overconsumption of calories. Not only this, but a higher carbohydrate diet has been shown to impair sleep quality, specifically decreasing total deep (slow wave) sleep (this may be another mechanism of action for the overconsumption of calories). Anecdotally, many people find that restricting carbohydrates is a very useful tool for unintentionally eating less calories. The reason for not doing less, ie keto, is that keto tends to lead to binging on carbohydrates (statistically more than other diets), sleep issues, electrolyte imbalances, cramps, lethargy, elevated SHBG levels, lower free testosterone, lowers t4 to t3 conversion (makes you akin to having hypothyroidism), and other unwanted effects. It’s shown that most of our hunter gatherer ancestors wouldn’t have spent most of their time in ketosis, as ketosis is more of a survival state. Another point of evidence - the bodies of the hunter gatherer societies of Inuit people in Alaska and the Arctic have evolved to not enter ketosis, even in the complete absence of eaten carbohydrates, due to having such a limited amount of carbohydrates for most of their generational existence.
Step 6, 18:6 Intermittent Fasting:
Restrict your eating window to 6 hours a day. An example of this is if you go to sleep at 9:30pm and wake up at 6:00am, start eating at 11:30am and don’t eat anything after 5:30pm. If you want, you can push this even further by doing an omad (one meal a day) at 6ish to 7ish hours to bedtime; definitely don’t have your omad after 5 hours to bedtime, as that will ruin your sleep.
Rationale:
Intermittent fasting done in this way has been shown to have a plethora of benefits, such as mental clarity, increasing cellular autophagy, and what we’re concerned about, aiding in fat loss via giving the body time to burn fat due to not having calories being digested and currently utilized. Also, fasting during the day then eating around 6 to 5 hours before bedtime keeps you productive and keeps your energy levels high as long as you’re eating enough during this meal. If you want to do omad at 6 hours to bedtime but find yourself getting too hungry, experiment with increasing the amount of fat you eat, such as upping it to 1/2 BMR instead of 1/3 BMR; omad is good because many people find that it increases their productivity and makes them “mentally sharper”.
Step 7, Omad, One Meal a Day, at 6 Hours to Bedtime, and Only 1/6 BMR Carbs:
Do not eat until 6 hours to bedtime, meaning if you go to bed at 9pm, eat at 3pm. Start your meal with 1/3 BMR a lean protein source / lean meat, then have 1/6 BMR whole food carbohydrates that don’t make you feel lethargic, fruit is ideal, then have 1/3 BMR from a fat source, like coconut flakes, avocado, extremely fatty meat, peanuts, etc, just not processed refined seed oils, then the rest of your meal be a combination of fat and protein, like fatty meat. If you get overwhelmingly hungry during the day before your omad, try to busy yourself with something, then when that doesn’t work consider doing a bit of cardio, like walking around, then if that doesn’t work, have 1/20 BMR a fat source, like 90 calories of sunflower seeds, then repeat from busying yourself. If you do have the fat source during the day, subtract that from the fat you eat during your omad. You do only fat because it will raise your ketones and make you feel more energetic and decrease your hunger, whereas carbs and proteins would make you far hungrier after eating them. If you’re eating enough the day before and getting great sleep, you should be able to fast this long. If you can’t eat at exactly 6 hours to bedtime, it’s preferable to eat a bit before than a bit after, as that will protect your sleep. Make sure to eat your omad to true satiety. If you get hungry in the evening after eating or feel a bit “peckish”, go for a walk.
Rationale:
Fasting during the day lets your body burn fat, but also lets you become more insulin and leptin sensitive, which will help you be less hungry and consume less calories in the long run. Still, absolutely do not eat after 5 hours to bedtime, as that will really hurt your sleep. Also, afternoon omad will let you be more productive, sharp, clear-minded, productive, and generally happier during the day, partially due to not having your blood sugar fluctuate, partially due to your body not having to spend calories on digestion. Eating a large amount of food and / or carbs seems to increase lethargy. The reason for now restricting carbs to 1/6 BMR is that eating more carbs than this at 6 hours to bedtime will noticeably hurt your sleep quality. Going this low on carbs will still give you a good insulin spike and keep you out of ketosis, which is a good thing, but it will also suppress your appetite even further.
Step 8: Gradually Increase Protein:
Gradually raise the amount of lean meat you eat at the beginning of omad. For example, if your BMR is 1800 and at this point you’re eating 600 calories of lean meat to start your omad, eat 610 calories one day, then 620 two days later, then 630 four days later, etc, or increase by 20 calories every other day, the most important thing is to gradually increase. Do this until you find a point where the thought of more protein makes you very repulsed, not just a little repulsed; the more protein, the better.
Rationale:
Eating more protein while following this protocol will make you naturally consume less calories during your omad, because you will consume less fat, less to an amount that is greater than the amount of calories you ate in protein. Fat is extremely calorically dense (9 calories per gram compared to protein and non-fiber carbohydrates being 4 calories per gram) and has been shown in studies to be less satiating per calorie than protein and most whole food carbohydrates, especially if carbohydrates are still included in the diet. You mustn't eat much below 1/3 BMR calories of fat, as some nutritional fat intake is required for optimal hormone production and a plethora of other bodily functions.
Step 9, Do Not Consume Entertainment While Eating:
Do not consume entertainment while eating, primarily do not look at a screen while eating.
Rationale:
Studies show that consuming entertainment while eating, specifically watching TV while eating, causes overeating. This is probably due to the entertainment distracting us from our satiety signals, but probably also due to it feeling good to watch TV and eat, so we continue to do it past satiety.

General Tips:
-A lot of this protocol, ie eating high protein, low carb, doing cardio, intermittent fasting, getting great sleep, resistance training, is all geared towards making you more insulin and leptin sensitive; a high carb, specifically high calorie highly refined carbohydrate diet, is a huge reason why modern man is overweight and obese.
-Meal prep, as doing so will help tremendously with you choosing “good” food and avoiding food not part of the protocol.
-Do not crash diet, as you may lose a good amount of weight initially, but you will almost definitely gain it all back. If you doubt this, google “crash diet rapid weight loss weight regain”; studies show that weight lost rapidly in this manner is not sustainable, as binge eating at the end is very common, and that most people end up heavier than they were to begin with.
-Do things in a sustainable manner, meaning find ways to follow this protocol that you can do for months. Find fibrous carbs that you enjoy the taste of, find a resistance training program that you enjoy, find a bedtime and rise-time that you can consistently adhere to, don’t keep junk food in the home, get some comfortable, well-made running shoes, things like this.
-If you feel lethargic after eating, look into food intolerances you may have, such as being allergic to gluten or being sensitive to histamines.
-Drink plenty of water throughout the day and before, during, and after eating, as being hydrated is healthy and makes you feel and sleep better, but also because thirst can mimic hunger. Also, drinking water before and while eating can help you not overeat. It is a myth that drinking water with food will hurt digestion.
-Avoid foods that make you feel lethargic / bad. For the author, this is foods with a high histamine content, such as ground beef or meat left in the fridge for too long, and foods containing high amounts of lectins, such as legumes.
-Consume a lot of nutrients daily and take a good multivitamin each day, as studies show nutrient dense diets tend to lead to a decreased calorie intake than those diets that are nutrient poor. One study took a group of obese women, divided them into two groups, and gave them the exact same foods and let them eat to satiety, except for one group they gave one multivitamin a day to, and the group that consumed the multivitamin a day ate less calories and lost more weight than the control group.
-Tip for those wanting “aesthetics, not just weight loss and muscle gain: feel free to tan, as a tanned body and face generally looks more defined. The saying goes, “If you can’t tone it, tan it.” As long as you are increasing UV exposure gradually (you shouldn’t sunburn), consuming a healthy nutrient rich diet, and getting great sleep, the sun exposure shouldn’t age you faster
-Try to find music that you enjoy working out to and work out to it, as music can help someone get excited to lift.
-When resistance training, make sure to use a weight light enough that you can get the full contraction for most of the set, as you will build much more muscle doing full contraction reps to failure than ego lifting.
-If you are addicted to a recreational drug, consider slowly titrating yourself off said drug, as most drugs will either make sticking to a diet much harder or make your overall mental wellbeing worse.
-Keto seems to be unnatural due to the very high amount of electrolytes one has to consume to make it sustainable. The Alaskan Inuit, a population with very little access to carbohydrates, evolved to stay out of ketosis. Also, going too low carb tends to make sleep very bad.
-You may not want to start your workout or cardio, but once you start, you’ll get your adrenaline going and it will be enjoyable, you just have to start each day.
-Fiber is very overrated, you don’t need a lot of it. The amount you get naturally in the fruit you eat is fine, but avoid high fiber foods like vegetables. A bit of evidence that fiber is not ideal for humans: 1) All parts of plants high in fiber are parts that a plant “doesn’t want” us to eat and is usually defended with poor taste and plant defense chemicals, 2) people get the best GI symptoms when they go low fiber; many people have “cured” their constipation with a low fiber diet, and a low fiber diet reduces gas, and gas is gross, 3) Hadza hunter-gatherer kids who have to eat a high fiber diet to survive are seen having very large, protruding bellies that were mistaken for malnutrition. We are told that the Hadza eat 100 to 150 grams of fiber a day, mainly from the tubers they rely on when meat, honey, and baobab fruit are scarce, but the Hadza are seen spitting out the fiber from the tubers, meaning they’re seen chewing the cooked tubers, then swallowing the spit, then spitting out the fiber. If you have doubts, do 2 days of eating low fiber (no vegetables, no added fiber supplements), then do 2 days of eating high fiber, and see how your digestion fairs on each.
-Paul Saladino is a good source of dietary information for beginners.
-Mike Isratael is a good source of resistance training information.
-Research high-histamine foods, the effects of eating high-histamine foods, and consider avoiding these; this is included because histamine-containing foods really affect the author. The most common high-histamine foods are aged meats and ground meats.
General Sleep Tips:
-As stated in the above steps, front load your carbs. If eating 1/3 BMR carbs, have all your carbs before noon, and if doing omad at 6 hours to bedtime, make sure you're not having greater than 1/6 BMR carbs. Going to bed with carbs in your system can very noticeably hurt your sleep quality; studies show that a diet higher in carbs than a low carb diet measurably decreases slow wave / deep sleep.
-Consider going to bed earlier, such as at 8.5 or 9 hours before you need to wake up. If your alarm is waking you up, you need more sleep, so start going to bed earlier. You should be waking up just a bit before your alarm.
-Don’t consume drugs in a way that will have a negative impact on your sleep. Alcohol, for example, wrecks sleep due to acting like a stimulant once the sedating properties wear off. In the same vein, do not consume caffeine in the afternoon, evening, or night, only have it in the morning if you are going to. Nicotine is also a sleep disruptor, both itself and craving it throughout the night.
-Have your sleeping environment be cold, quiet, dark, and comfortable. Sleeping too hot will cause your sleep quality to suffer, as it has been shown that the body needs to drop its internal temperature by a few degrees for proper repair. The others are self explanatory. If you wake up hot in the middle of the night, sleep with less layers from then on. As an example, the author used to sleep with a blanket and sheet, then Summer arrived and he woke up hot, couldn't go back to sleep until he cooled down, and felt unrested the next day, so he slept with a sheet for the rest of the Summer and slept much better. Also, if you sleep on memory foam, consider getting a cool sleeping topper for it, like a wool or latex topper, as that also helped the author a lot.
-Consider very slowly titrating down your caffeine consumption if it is high and / or if you are having sleeping problems. Caffeine has a long half life, so consuming even just one cup of coffee in the morning will leave caffeine in your system by bedtime. This is not something you must do, but lowering caffeine consumption does help certain individuals, especially those who genetically process caffeine in the liver slower than average. If you want to titrate down, titrate down by something like 1 tablespoon of coffee a week (or 10 mg of caffeine a week); this is slow, but will negate needless cravings and withdrawal symptoms.
-Do not eat after 3 hours to bedtime (preferably 4 hours to bedtime), as eating close to bedtime has been shown to increase resting heart rate while sleeping and lower heart rate variability while sleeping, both of which indicate that eating close to bed reduces sleep quality. If you’re doing omad at 6 hours to bedtime, do not eat after 5 hours to bedtime. Basically, to get great sleep, your stomach can’t be empty, but it can’t be full either, so if you’re eating most of your calories early in the day, you can get by with cutting off food at 3 hours to bedtime, but if you’re eating most of your calories later in the day, you have to extend the window that you don’t eat before bed. Fat before bedtime causes you to sleep poorly due to increasing your ketones and making you alert, protein hurts your sleep by being very thermogenic to digest, and carbs hurt your sleep by spiking your blood sugar.
-This one will be a bit difficult for some to follow, but consider restricting, and even eliminating, overt sodium during the day. This means do not consume salt and do not consume food with added sodium. Consuming sodium will make your body drink much more water throughout the day to flush out this excess, and if you’re not actively drinking water while you’re sleeping (which you won’t be), your body will become dehydrated, will will cause your internal body temperature to climb and seriously hurt your sleep quality. This is more a rule for those who are getting very lean, as those without much body fat have a harder time storing sodium. To bring evidence supporting this, it is believed our ancestors consumed roughly 1000 mg of sodium a day, of which came from the meat they ate, and 1000 mg is much, much less than most modern westerners consume nowadays. Also, it takes the body multiple days to clear out excess sodium from the body, meaning that eating very high sodium one day could hurt your sleep for a few days after. Again, this is optional, if you’re thinking, “Absolutely not, I need to salt my food,” don’t let this stop you, but if you find yourself waking up hot throughout the night, having to wake up to pee, or sleeping poorly in general, this is a good technique to implement.
-Make sure to eat enough throughout the day, enough that you’re not going to bed too hungry, as going to bed too hungry can leave you sleepless. This happens due to your body “saying” “Hey, let’s get up and look for food,” but also due to your body raising epinephrine (adrenaline) levels to burn fat. This protocol will allow you to “naturally” eat less calories than you burn and lose weight, but you shouldn’t be overly hungry. A very small bit of hunger may be okay, but anything more and you should be eating more. If you find you have a problem with not being able to sleep due to hunger, have a meal at 6 hours to bedtime to satiety consisting of mostly lean protein, as protein will help you sleep.
-Eat a high protein diet, as studies show that high protein diets are shown to increase sleep quality.
-Do not nap during the day, as doing so will make it take longer for you to fall asleep at night, which will hurt your sleep quantity overall. If you find yourself wanting to take a nap during the day, follow the tips to increase your sleep quantity and quality.
-Avoid eating high fiber, as it holds water in your stomach then leads to nocturia, which can ruin your sleep.
Reasons to Eat More Protein:
-Animals, including humans, will keep consuming food until they have reached the amount of protein they need; google protein leverage hypothesis. If someone is eating a high protein diet, the amount of protein they need will be reached in far fewer calories than someone consuming a low protein diet, so the person eating a low protein diet will eat more calories overall. It’s the same for certain micronutrients as well.
-Protein is far more satiating than any other macronutrient. As far as satiety goes, it’s protein > carbs > fats.
-Protein takes about 21% of the calories ingested from protein to metabolize, meaning it is very thermogenic. This is why “meat sweats” are a thing.
-Protein is a very, very poor substrate for lipogenesis, meaning the body really doesn’t turn protein into body fat very well. A study was done on two groups of people in an identical caloric surplus, except one group was on a very high protein diet and the other was not. The group on the very high protein diet gained hardly any body fat, whereas the other group gained the amount of body fat that would be expected with a caloric surplus of the amount they were on.
-Protein preserves muscle mass, whether bulking or cutting, and may increase fat mass loss.
-Increased protein up until about 1.6 g/kg of bodyweight is shown to increase muscle math and strength gains.
-Most meat is extremely nutrient dense, which is one of the reasons lean meat is so satiating.
-A high protein diet helps your immune system.
-A high protein diet is shown to increase sleep quality.
-IF YOU ARE EATING A LOT OF PROTEIN, MAKE SURE YOU ARE DRINKING A HUGE AMOUNT OF WATER. Not doing so can hurt your kidneys over the course of years. The author drinks about 2 to 2.5 gallons of water a day.
-WARNING: if you have kidney problems, such as an acute kidney injury, chronic kidney disease, end stage renal disease, or are on dialysis, do not do high protein.
Niche Tips:
-Consider not climaxing for a few days at least and seeing how it affects your hunger. Go at least 3 days in between climaxes but no more than 7, as effects start to diminish after 7 days. This tip is probably for males only, as the author is unsure of if it would work for females or not. Many people report that abstaining from climaxing, ejaculation specifically, reduces their hunger by quite a bit, and the author has found this to be the case as well. An example of it happening to another animal is that male elks will regularly lose 100 to 200 pounds during mating season, partially due to defending their harem against other bulls, but partially because they’re so constantly sexually aroused that food is an afterthought. Another strange example is neutered animals, whether it be dogs, cats, or cattle, have an increase in appetite (up to 25%) and almost always gain a significant amount of body fat after being neutered when compared to their non-neutered counterparts; this may or may not be relevant, and it is probably due to the decrease in testosterone released, but the author has a fat neutered cat and found it interesting. This may only work if you are doing everything else right, mainly cardio, great sleep, and eating healthy, nutrient dense foods. Again, this seems absurd, and maybe it is, but feel free to experiment with it and see if it works for you.
Possible Steps To Add (Untested):
-Fast as long as possible each day, meaning once you wake up, don’t eat for as long as possible, but for sure do not eat after 4 hours to bedtime.
Rules / Tips taken out:
-Have your carbs only early in the day. Carbohydrates eaten closer to bedtime have been shown to disrupt sleep due to the blood glucose fluctuations, so once you’ve had your carbohydrates in your first meal, don’t have any for the rest of the day.
-Front load your calories. Studies show that going to bed with too much food in your system reduces REM and deep sleep. An example of this is eating a very large meal at either brunch or lunch, then having a bit of food when hungry throughout the rest of the day. Basically, have your first meal be at or before lunch, eat your first meal to true satiety, meaning it will be the largest and contain most of your calories for the day, and eat when hungry throughout the day until your eating window is done.

First round of testing by u/Bluedot55 : https://www.reddit.com/Helldivers/comments/1azh9fw/weapon_damage_isnt_what_you_think_and_isnt_what/
Some testing on a Spore Spewer by u/blastedcheerios : https://www.reddit.com/Helldivers/comments/1bkkoau/the_damage_numbers_of_weapons_seem_off_what_am_i/
The above threads are interesting and I'm thankful for the work, but I haven't seen any of them even mention armour, so I will. I've spent most of the day gathering this table on a D1 Brood Commander mission:

Weapon	Dmg	Hits	Hit Confirm	Speculated AP	Min Total	Max Total	More than
AR-23 Liberator	55	17	White	1	459	476	432
AR-23P Lib. Pen	45	8	Red	3	360	360	315
AR-23C Lib Con	55	17	White	1	459	476	432
SMG-37 Defender	70	14	White	1	490	490	455
R-63 Diligence	112	8	White	1	448	448	392
R-63CS D. CS	128	8	White	1	512	512	448
SG-8 Punisher	405	2	White	1	396	414	202
SG-8S Slugger	280	2	Red	2	560	560	280
SG-8P P. Plasma	Red	6	Red		600	600	500
SG-225 Breaker	330	3	White	1	495	495	330
JAR-5 Dominator	200	2	Red	3	400	400	200
PLAS-1 Scorcher	Red	6	Red		600	600	500
P-2 Peacemaker	60	16	White	1	480	480	450
P-19 Redeemer	60	16	White	1	480	480	450
P-2 Senator	150	3	Red	2	450	450	300

"Min Total" refers to if, after damage is reduced by 50%, it's further rounded down, while "Max Total" is if the damage is rounded up. Liberator does 55 damage normally, but when halved by light armor it could be doing 27, 27.5, or 28 per bullet. I have no idea.
"Speculated AP" referrs to a tweet I can't find anymore where Pilstedt explained where enemy armor and player AP was a range 0-10, where 0-2 where all considered "Light Armor"/Penetrating, and that equal armor to AP reduces damage 50%. Most weapons are 1, Spray & Pray probably used to be 0. I think the "hidden medium" primaries have 2, but for this test they acted identical actual medium armor penetration and I wasn't able to produce a bounce on the brood commander. I speculate that the change that made EAT unable to hit askew for 50% reduction actually stopped any weapon with enough AP to hit askew for 50% reduction, and only already reduced shots can hit askew and bounce. I'll verify this later on a Devestator with Diligence.
The hit confirm, a little cross that appears each time you hit an enemy, can either be red (full hit), white (partially blocked, assumed 50% damage reduction), or a shield (complete bounce, no damage). Based on the results, I assume Brood Commander's head has 450 health. Not all entries align with this:

• Defender has too much total damage. I've tried for over an hour to produce a run where I only spent 13 shots instead of 14, but I was never able to. It's possible Defender has a small additional damage reduction of about 5% when hitting armour, or perhaps the displayed damage number is wrong and should be 65. If someone can kill a Brood Commander in only 13 headshots, (ending up at 33/45 ammo from the max of 46/45) please tell me.
• Diligence hits too low. It probably has bonus damage for certain weak spots, that could be about 10%.
• Bluedot55 managed 7 shots with Counter-Sniper, I wasn't able to replicate this. The gun is unwieldy so it could be a skill issue on my part.
• Punisher's total is much below. Perhaps it's also enjoying a large weakspot bonus that could be somewhere in the 20% range or even much higher. I'm also not sure how many pellets Punisher had. I've simply halved the total damage, but the pellets would get damage halved individually.
• Punisher Plasma and Scorcher needed 6 hits. I think it's likely that explosive damage gets a bit of a penalty on weak spots meant for bullets, maybe about 20%.
• Dominator definitely has a juicy weakspot bonus as previously speculated. I'm guessing this is about 20%. (Poor Diligence.)

A lot of this changes if the actual HP is different from 450. Who even knows with this game.
However, assuming that holds, I decided to estimate damage on some suppport weapons:

Weapon	Hits	Hit Confirm	Speculated AP	Min Damage	Max Damage
M-105 Stalwart	17	White	1	55	58
MG-43 Machine Gun	6	Red	2	77	92
APW-1 Anti-Material Rifle	1	None		460
GL-21 Grenade Launcher	3	None

I hope to test on other enemies later, but this was pretty time consuming as is. It looks like Stalwart is just a Liberator with a whole boatload of ammo and AM Rifle seems to be a very big JAR Dominator to me.
Thanks for reading. Please share data and critique if you have them.

After 3 lovely years on Vyvanse (30 mg, 1x a day), I (34F) grew frustrated with the meds shortage and asked my doctor to switch me to Bupropion. After about a month of low, slow titration, I recently started the 150 mg XR dose. Similar to Vyvanse, Bupropion/Wellbutrin works on dopamine and norepinephrin reuptake in the brain -- that's why I though I'd try it. It's also inexpensive and easy to obtain. I'm sharing my experience so others can learn from it.
What was the first month / titration like?

• Immediate dopamine rush, despite being told it takes 4 weeks to build up. Even on day 1, I felt very sleepy.
• Sleepiness persisted while I titrated from 75 mg IR once a day to 150 mg IR 2x a day. I tried taking the meds before bed. This made my daytime better, but also led to sort of weird, restless sleep (NOT insomnia, though).
• My appetite stayed the same.
• I did not feel unable to focus / do stuff at any time, but did feel foggy and sleepy for the first 3-4 weeks. Now on week 5, I feel like myself again.
• I felt a little more easily overstimulated than I used to on Vyvanse; as I have ASD in addition to ADHD, this was a big thing to notice for me. On week 5, I think I am doing ok again.
• My affect felt very flat. My wife said I didn't seem upset, just very calm / serene and not as goofy and silly as usual. "Less chipper, but still happy" she said.

​
How is it different than Vyvanse / what do I notice?

• Vyvanse has more of a caffeinated rush to it in the morning, for sure.
• Vyvanse blocks appetite a bit more. I'm hungrier now than I had been.
• I pee less now! Who knew? Vyvanse is a strong stimulant, though, so it makes sense.
• I'm still adjusting, sleep-wise. I'm sleeping but waking up a lot. Because Vyvanse leaves your system by bedtime, that wasn't as much an issue before. Buprion is "always" in your system to a degree once you're titrated, so I think that will just take adjustment.
• Vyvanse gave me... liquid bowels. Bupropion seems to do the same.
• I don't feel my heart beating quite so hard, though my HR remains pretty unchanged. I feel more "restful" than I did on Vyvanse.
• While Vyvanse gave me tremendous energy, it also made me a bit like an energizer bunny. I couldn't STOP go-go-going while the meds were in effect. On Bupropion, I do feel more able to stop tasks / take breaks / rest / recovery.
• I feel a little more tired in the afternoons. I haven't tried supplementing caffeine, though. Also, the tiredness is to be expected and not to be blamed on meds: I do work out a LOT, 5 days a week for 1.5 hours, so it makes sense that I get a lil cozy as days draw on.
• Vyvanse can't be delivered by mail or meds delivery; Bupropion can. Bupropion is not considered a controlled substance.

Does it help with the same symptoms as Vyvanse?

• It's not the same category of med, of course, but has been known to be used as a second-line treatment for ADHD for folks who can't tolerate stimulants.
• My energy levels feel good now that I'm on the extended release. My first doses (75mg and 150 mg of the IR) had me feeling very, very lethargic. XR has me feeling more like myself.
• I think that I am focusing and accomplishing about the same as I always have.
• My motivation and enjoyment for things has returned after a few weeks of feeling pretty sluggish -- again, I think this was just dopamine flooding / the titration process.

Which one do I prefer?

• Still too early to meaningfully say. I really, REALLY loved Vyvanse minus that it made my HR pretty wild / I could feel my heartbeat at all times.
• I do feel calmer / more able to rest on Bup, and I like that. A win for Bup.
• Vyvanse made me like an energizer bunny, so I WAS a little more productive on it. But I am not un-productive on Bup. I don't think this is about anything more than a strong stimulant effect. So this one holds equal I think.
• Bup will be easier on my heart longer term, so that's a big win for Bup.
• Bup is cheaper. Another win for Bup.
• I felt more "myself" on Vyvanse than I have on Bup so far, excluding since I switched to XR. I don't know if this is because I was on Vyvanse for years? Or was just titrating? In any event, I now feel more like myself again. So this is a wash I think.
• TL;DR: Hard to say. If Bup continues to go well as I titrate to the XR, I will stay on it instead of Vyvanse.

Notes / Caveats

• Every person's experience will be different; I've only shared mine so folks can have insight into what a possible meds switch could be like.
• I have a very high-pressure and brain-heavy job, but have always had strong coping strategies to manage my time. I don't think Vyvanse managed my time for me; nor does Bupropion.
• I also am an athlete; I weight-lift 5 days a week, run 3 days a week, and do yoga twice a week. I eat 150g or so of protein daily. I hydrate. I eat fiber. I am a good candidate for healthy metabolizing of meds. I also don't really drink caffeine or alcohol much at all. (I do take a single 100 mg theanine/caffeine pill in the morning since starting bupriopion, but since I don't drink coffee, and this caffeine is less than that of a coffee, I'm not really sure it's a big deal to mention, lol. Pre-workout also has more caffeine than that pill.)
• For general cost comparison, I have good insurance that covered even name brand Vyvanse for $60. Meanwhile, Bupropion costs $10.

A number of bad sources who aren't even playing MG, or are stuck in Early-Access mindsets are supplying new players with, frankly, misinformation. MG is flawed, the top-end rep grind is abhorrent, and people are listing stuff for zero gold because they simply want to get rep faster. So let's breakdown the pros and cons of MG from my eyes and why the system is actually pretty genius on the whole and needs some QoL but ultimately functions well when put in the right context and has the right expectations.
Early
You can buy rares and Idols very early, and you can get very good rare items that will power you all the way to 250 corruption if you know what to look for. Lazy streamer-supplied loot filters are hiding them because they are built primarily by automated processes that are improperly set up for a market, people are just getting caught in a no-man's land of progression. It costs 150 favor to list a rare, and these items can have up to 20 tiers of mods. These are easy to roll, and fairly easy to craft granted you are picking up glyphs and taking advantage of plentiful shattering runes from the vendor.
The root problem the community is having is that they want to skip this progression and go straight to Exalted items. Which is just not how the system is designed; nor should it. EHG is clearly trying to incentivize you to value yellow items more, and that is a perfectly fine progression path that lets new players learn the crafting system in a low-pressure environment. This is a community issue. Buy and craft rares, stop whining.
Mid Rep
Your mono progression then shifts to your rank 4 unlock, Idols. Idols are insane money-makers early and will be the first area you look to for powering up your characters in MG. Day 3(the first day I could not crash loading into the Bazaar) there were near-perfect Healing Effectiveness/Block Effectiveness Idols available to me for about 100-200k each. But it took the market forever to populate out with idols because most people's filters are set up to only show 2 mods for their build. Idols cost 200 favor to list and you can very easily find ones early on that can help populate this market. I've listed almost 100 idols to date, all it takes is a second to mouse over these things and find stuff people will buy. Fix your filters.
This feels very good up to empowered monos. However, you then fall into a black hole of progression. I do not understand why weapons are segregated from other things. A much better idea would be to implement a system that encouraged people to list underprovided items in the 5 and 8 slot and move exalted items and 1-2 LP uniques to 5 and 6.
Making the progression look more like: 1-4 as is, 5 Rare, Idol bounties for stats not on the market at the time the bounty is taken, with a big favor and reputation reward. 6 exalted items, 7 1-2LP uniques, 8 Bounties for everything else. then 9 becoming 3-4LP uniques, and 10 being all legendary items.
Right now a 2LP Woven Flesh isn't even worth the listing favor fee, which just feels awful to a new player trying to get a foothold in the economy. While a good roll 0LP version is actually something sellable. This is kinda inexcusable. And it has borked the unique market to the point I do not participate in it. And I recommend the same, unless you want to grab some freebies and have the favor to burn. I expect this to normalize once people get to the point they can even buy these things.
Speaking of the Gambler, (EDIT: see bottom) they don't have any reason to exist and the items here are not worth the 2k gold a shatter rune costs. This needs to be looked at and adjusted. The bases are undesirable, at least have them spawn with personal mods or be guaranteed to roll with max tiers or something. Maybe a locked increased gold find stat exclusive to this vendor.
Endgame
I really can't comment on this. Because at the time of posting, I'm lvl 95 on my Holy Trail Paladin and I recommend you try it BTW. Healing Hands off Lunge makes the build so much smoother too, don't have to self-cast Sigils of Wrist Pain anymore. However, even at my current state in 250+ corruption, I have just unlocked rank 7. So I can't even buy LP uniques or Legendaries despite having the gold and gear to a LONG time ago. I think this is fine for the most part, but you need to get access to Exalteds and 1-2LP uniques much sooner. I like the gate causing the market to phase in over time and allowing players to find and sell items without needing to max sweat to get there before the market inflates. This is a good thing not a bad thing, the execution could use some work though.
Other than that, there's nothing I can comment on yet.
TL:DR - Learn to love Yellows, Stop hiding Idols, and post more items.
EDIT: Thanks to new information from EHG related to a visual bug in the way it displays reputation gain, I was misled into believing the favor gambler in the bazaar was the optimal favor sink over listing items. It is exactly equal and you can keep spamming your 4LP Laddle and getting equal amounts of Favor.
I apologize for any confusion this may have caused.

Recently, I have become interested in the export-oriented toy industry in China: the productive forces and productive relations behind this multi-billion dollar industry. Virtually every corporation in the imperial core has at least some of its supply chain running through China, and especially since China entered the WTO in 2001, Chinese labor has become a critical pillar for the profits acquired by most imperial core bourgeoisie. Furthermore, the high consumption of the imperial core’s population is undergirded by “cheap” imports from the capitalist semi-periphery and periphery, as demonstrated by many Marxist writers such as Zak Cope in his Divided World: Divided Class.
While pursuing this interest, I read many things that I believe would be of interest to the readers. Examples include the vast scale of the Chinese toy industry, overviews of various machines, the rise of Chinese plastic production, how Chinese levels of administration are organized, how the Hukou system works, and how Labor Market Intermediaries are parasites on the Chinese working class. I then end on how the vast exploitation on the Chinese mainland supports the existence of non-value producing workers, labor aristocracy, petite bourgeois, and bourgeoisie in the USA and elsewhere. Finally, even if the reader considers my post boring or wrong in and of itself, it will still show the reader very interesting websites they may have never seen before, such as Import Yeti, OEC, and Simply Wall Street, all of which are free and are fantastic resources for investigating capitalism.
The company I decided to select for analysis, is one US-based toy firm called “Bonkers Toys.”
Founded in 2015 by an individual with toy industry experience, Bonkers is a privately owned toy company based in San Diego, California. Since its foundation, Bonkers has pursued the clever idea of partnering with child-oriented YouTube influencers to sell branded toy merchandise to fans. One of their most successful toy lines was with the English language YouTube channel called Ryan’s World, which has 36 million subscribers and regularly racks up hundreds of thousands of views per video. Bonkers also produces toys for the gamer YouTube channel Aphmau, which has 19 million subscribers, and recently entered into partnership with another channel called “Moriah Elizabeth,” which has nearly 10 million subscribers.
As is common for US-based firms selling consumer goods, Bonkers does not own any factories; rather, they contract out their manufacturing to third parties. In the USA, whenever goods are imported by sea, the bill of lading is automatically considered public information, and remains so unless the importing firm moves to make the bill private. A bill of lading is a legal document issued by a carrier to a shipper, detailing the type, quantity, and destination of the goods being carried. Thanks to a website called ImportYeti, which compiles these documents, I am able to see Bonkers Toys’s suppliers, and which port the suppliers ship their goods from.
According to ImportYeti, 100% of Bonkers Toys’s overseas suppliers come from China. When I am able to locate the factory location for these suppliers (not always easy online), it appears that the top suppliers all have their manufacturing based in the metropolitan Guangzhou-Shenzhen-Hong Kong area, with the corporate offices being listed in Hong Kong and the factories being located on the mainland.
The use of Chinese manufactures by Bonkers Toys is not surprising. The Hong Kong Trade Council Research website writes in a 2023 report that “An estimated 75% of all toys produced worldwide are made in mainland China, with local producers dominating the market…Guangdong is the leader, with manufacturing there centred around Shenzhen, Dongguan, Guangzhou, Shantou’s Chenghai, and Foshan. 30% of the world’s toys are said to be produced in Chenghai, where there are over 10,000 toy enterprises.” HKTC also writes that “The bulk of toy exports are produced for foreign brands on an OEM basis” - OEM standing for Original Equipment Manufacturer, which means that the manufacturer manufactures the product to be sold under another company's brand name.
Luckily for my research purposes, Bonkers Toys’s top supplier is named Sun Wing Ming, and they have a website with detailed explanations and photos of its production process. Sun Wing Ming was founded in 1970, is headquartered in Hong Kong, and operates its factory in the city of Dongguan, Guangdong. Sun Wing Ming made at least 87 sea shipments of product for its client Bonkers Toys since 2018, weighing a total of 755,000 kilograms. I am going to hone in on Sun Wing Ming’s productive process and relations from here on out, breaking my focus into three parts: machines, raw materials, and then labor. Finally, I will follow the journey of the finished product, and how the entire distribution process of Sun Wing’s Ming’s goods relies on expropriated surplus value from the Chinese proletariat. Each of these three parts will be extensive, so skip ahead if one part interests you more than the others.

Sun Wing Ming’s Machines

In this section and at the beginning of the second section, I rely on ChatGPT for information about machines and science. Why? I consider ChatGPT reliable for broader scientific and “factual” questions such as “how does x machine work?” and “how many workers are typically required to operate x machine?” I also rely on Sun Wing Ming’s descriptions of what their workers do in the factory, and the photos on their website. The following are the machines used in the Sun Wing Ming production process:

• 130 injection molding machines, the machines in the photo being Chen Hsong machines, a Hong-Kong based industrial machinery manufacturer which manufactures their injection machines in Pingshan, Shenzhen, Guangdong. Sun Wing Ming’s injection molding department “fully adopts automation” implying that little to no value is created in this section of the production process, with small chunks of pre-existing value instead being transferred from the injection machine to the raw materials it works on.
• 22 “highly efficient” rotational casting machines and 1 automatic rotational casting machine. Rotational casting machines are used to create hollow parts of various sizes and shapes. The raw material for their rotational casting machines is most likely plastic powder. I could not easily find through online sources how many workers are typically required to operate these machines; however, ChatGPT says 2-4 is typically required. This should be taken with a grain of salt, but even if just one worker is needed to operate each “highly efficient” machine, then there is some new value creation from this worker's labor being infused into to the raw materials, along with value-transfer from the machine to the raw materials.
• 300 sets of “normal” sewing machines, 150 sets of “computerized” machines. I assume the hundreds of workers operating these machines making various clothes and fabrics for Sun Wing Ming’s dolls and certain action figures. I could not find which companies manufacture Sun Wing Ming’s sewing machines, but I have read that China hosts many large sewing machine manufacturing firms, so there is a strong chance they are produced domestically. As is the case with the rotational casting machines, each worker is infusing new value into the textile raw material with their labor, while simultaneously transferring pre-existing value from the sewing machines into the raw material.
• “Numerous” single needle and three needle hair rooting machines. Sun Wing Ming’s website writes that in this section, “skillful rooting workers root the hair for dolls in different head size and thread thickness before passing it onto the grooming department.” A hair rooting machine is a machine that takes doll hair threads, and quickly “roots” then into the head of a doll. I likewise could not find the origin of Sun Wing Ming’s hair rooters; however, on Alibaba and other retail websites, it appears that there is an abundance of Chinese firms selling hair rooting machines domestically. These machines all appear to require one worker.
• In the grooming department, Sun Wing Ming writes that “craftsmen are able to create customized hairstyle that involves braiding, gluing, combing, cutting, styling to achieve the character’s signature hairstyle. Sometimes, they also style the eyelashes for dolls with prominent eyelashes design created from thread.” The tools here are various paintbrushes, glue guns, combs, brushes, etc., meaning that these workers are not machine workers, but instead are tool workers. Since tools are less productive than machines, I assume that the socially necessary labor time for the grooming department workers department to complete their step in the production process is higher than the socially necessary labor time for the machine workers in previous steps. Therefore, the value created in this department is higher per worker than that in previously listed departments.
• The Carton & Packaging Department has six different machines listed on Sun Wing Ming’s website. The are the Automatic Blister High Frequency Machines, Shrink-Wrap Tunnels, Vacuum Packs, Heat Seal Machines, PS Foam Machines, and Air-Bubble Blister Stuffing. Each of these machines require workers; however, I had to delete the entire section on these machines due to post character limits.
• then there is the Fabric Die Cutting Department. Sun Wing Ming writes that “Our engineers digitize the cut pattern via CAD [computer aided design], and then optimize it for the laser beam cutting machine to proceed. Our laser beam cutting machines allow high production of fabric sheets and ensure minimal wastage during the procedure.” It sounds like the engineers are programing the machine to cut fabric sheets a certain way, presumably to be sent to the sewing department - therefore, an infusion of value comes from the engineers programming the machine, as well as bits of old value being transferred by the laser-beam cutting machine onto the fabric sheets.
• The final listed department is the Spraying Department. This department has 300 spraying booths, 200 automatic spraying booths, and 60 Tampo printing machines. A Tampo printing machine is a label/design printing machine, that can place designs of ceramics and plastics. From videos of tampo machines I have watched online, it appears that one worker is required per machine to manipulate the object being pressed. Finally, in this section, Sun Wing Ming’s website also writes that “We own an aesthetic design team who works on the expression of doll eyes and detail features. The designed doll face will pass onto the spraying team for mass production. Some of our experienced craftsmen are responsible for hand-applied paint and other touch-up procedure.” Again, since the experienced craftsmen sound like they are tool workers and not machine workers, they likely create more value per commodity with their labor than most of the other productive workers in the Sun Wing Ming Factory.

Sun Wing Ming’s Raw Materials

Based on Sun Wing Ming’s products offered, and the types of machines they use, we can infer what some of their most important raw materials most likely are. The raw materials analyzed below are:

1. ABS Plastic Pellets - common plastic used injection machines especially for figurines
2. Polyethylene - main plastic used in rotational casting machines
3. Polyester - doll clothes

Acrylonitrile Butadiene Styrene (ABS Plastic Pellets)
ABS is a type of plastic frequently used in toy production to make plastic figurines. It is a combination of three different monomers (small individual molecules) into the single polymer ABS. I am not a chemist, so I asked ChatGPT to explain the process of how ABS is created. I summarized by results below. The three monomers which create ABS are:

• Acrylonitrile - produced by mixing Propylene, ammonia, and air over a catalyst, typically containing molybdenum and bismuth.
• Butadiene - produced by putting Butane either through the process of “steam cracking,” or the process of “dehydrogenation.”
• Styrene - produced through the “dehydrogenation” of ethylbenzene.

Acrylonite is then combined with Butadiene in a polymerization process, with the Styrene later being “grafted” on to create ABS. Then ChatGPT writes that “After polymerization, the ABS resin is compounded with additives like stabilizers, pigments, and flame retardants.”
All this to say, the ABS raw material has a very complicated and customizable production process requiring many different ingredients. So how does the ABS production process look in practice?
We will turn to the brand-new Ineos and Sinopec joint venture in the city of Ningbo, Zhejiang to investigate. On November 21st, 2023, these two firms opened up a brand new, state of the art ABS production facility with a capacity of 600,000 tons a year. This is a significant development -according to the industry website PlastEurope, “[The new facility] utilises the Terluran technology from Ineos Styrolution, covers an area of 26.7 hectares, and provides work for more than 360 people…ABS capacity in China is now more than 6.5 mn t/y, or almost 46.5% of available global output.”
If China’s capacity as of December 2023 is 6.5 mn tons a year, and that is 46.5% of global ABS available output, this implies that total global ABS available output is roughly 13.98 million tons a year. Therefore, since the new facility in Ningbo has a capacity of 600,000 tons a year, it is responsible for 4.3% of global ABS available output.
Despite 4.3% of global ABS production being concentrated in a single facility, the Ningbo plant only has 360 employees. This number of employees in a such a huge facility is due to the ABS production process being mostly automated. This means that little to no new value is created in the ABS production process, with values instead being a combination of value already crystallized in the raw materials, and the value transferred from the various plastic-making machines to the ABS product.
The final interesting note about the Ningbo Facility, is PlastEurope’s prediction on how it will impact the global market. They write: “Even though manufacturing at the new plant is primarily intended for the Chinese market, it is still likely to have an impact on Europe as China will probably have to import less ABS in the future, meaning manufacturers from South Korea and Taiwan may try to sell their material in other markets to an even greater extent than before.” This perhaps signals to a wider trend for foreign capital, that as the Chinese bourgeoisie becomes more self-sufficient in supplying their domestic industries in coming years, the foreign capitalists will have to find new markets or face decline.
Polyethylene
Polyethylene is an extremely common type of plastic, and is the most commonly used plastic as a feedstock for rotational casting machines. Sun Wing Ming, possessing 23 rotational casting machines, likely uses polyethylene in its production process. So what is polyethylene?
Polyethylene is a polymer (combination of monomers) composed of Ethylene monomers. Ethylene itself is produced in a chemical process called “steam cracking,” where certain hydrocarbons are combined with steam and heated at high temperatures. The ethylene monomer can then be polymerized in a variety of different methods, which can produce different types of polyethylene. The ingredients used for the polymerization can include benzoyl peroxide, titanium, zirconium, to name a few.
As was the case with ABS plastic, Polyethylene production is a highly capital-intensive production process, and based on everything I have read, has little to no direct labor.
The Chinese chemical company MIT-IVY, which writes about industry news, wrote an “An Analysis of Supply Pattern of Polyethylene in China 2023.” The main points are:

• “From 2019 to 2023, China’s polyethylene production capacity increased steadily, with a compound growth rate of 13.31%”
• “...dependency on polyethylene imports is also gradually declining, and the dependency on polyethylene imports is expected to drop to about 32% in 2023.”
• “By region, the enterprises put into production are mainly concentrated in South China, South China’s new production capacity totaled 1.8 million tons, accounting for 69.23% of the annual increase, and the supply pressure in South China increased.”

What is interesting is that the same phenomenon occurring with ABS plastic, is likewise occurring with Polyethylene - Chinese domestic production is expanding, and I predict it will be at the expense of foreign imports. While this will presumably hurt all polyethylene exporters to China across the board, increased domestic production will be especially problematic for the following three countries: Iran, Saudi Arabia, and South Korea, which in that order are the top 3 exporters of polyethylene to China. This is especially dangerous for Iranian producers, since 77.5% of Iran’s polyethylene exports go to China.
Returning to Sun Wing Ming, an increase in China’s domestic polyethylene production should result in less value being destroyed in the distribution and inventory holding process of polyethylene. If China requires a certain amount of polyethylene per year, and a chunk of it has to be imported to meet demand, that means value must be destroyed in the process of transportation - the depreciation of the cargo ships and all related equipment, and expending values by maintaining of the labor of the cargo ships. This same logic is expanded to the dock workers and equipment, truck drivers and equipment, all warehousing, etc. Thus, if less value is destroyed in the process of moving polyethylene, the polyethylene will become cheaper in China.
Polyester
Polyester is a plastic fiber that can be made into synthetic fabric. In the textile industry, polyester fiber is considered strong and resistant to stretching and shrinking, and creates a quick-drying, wrinkle-resistant, and abrasion-resistant fabric. Polyester is also relatively lightweight, can be easily dyed, and can be blended with other fibers like cotton. As such, polyester is likely used by Sun Wing Ming.
Polyester is a combination of ethylene glycol and terephthalic acid, both of which are derived from petroleum. These two materials are then engaged in the polymerization process, where they are both heated to high temperatures and sometimes combined with a “catalyst,” which can make the polymerization process more faster and more efficient. Examples of catalysts include antimony trioxide, germanium dioxide, and titanium-based compounds. After polymerization, various machines are used to spin, heat, and strengthen the polyester fibers. After that, the fibers are either ready to be spun into fabric and potentially dyed.
According to an industry report by the Chinese synthetic fibers marketing firm Hubei Decon, “The top 10 Polyester Manufacturers in China mainly lie in Jiangsu and Zhejiang provinces. The polyester production capacity of these two provinces accounts for about 77% of the total national capacity. Zhejiang area is the largest production and marketing province, in which Huzhou, Xiaoshao, and Ningbo areas are the relatively concentrated industry layout.”
Meanwhile, in 2021 the top 10 polyester manufactures accounted for 61.90% of China’s market share, with the top 3 accounting for almost 30% of market share. On a global scale, Decon writes that “Relevant data shows that China’s polyester production has increased from 43.54% of the global share to around 64.35% in the past ten years.”
This follows the pattern observed in the first two examples - China’s production of plastic has shot up in recent years, conquering new market share domestically and abroad. In the case of polyester, the three countries whose bourgeoisies have lost the most market share to China’s bourgeoisie are Taiwan, South Korea, and Japan. Using the Organization for Economic Complexity’s trade data, between 2011 and 2021, exports to China of textured dyed polyester fabric, fell 47% from Taiwan to China, and 42% from South Korea to China. For non-textured dyed polyester fabric, exports from Japan to China fell 60%, and fell 75.8% from South Korea to China. Meanwhile, China’s share of total global exports in these two polyester categories has grown since 2011, while Taiwan, South Korea, and Japan’s has shrank. Finally, these patterns prevailed even before the pandemic, so they cannot be blamed on the 2020 economic and health crisis.
Sun Wing Ming would use polyester in their production of doll clothes. Based on everything I have read, I would assume the polyester fabric would arrive at the Sun Wing Ming facility, be cut into desired shapes by the “laser beam cutting machines.” Then the cut polyester would likely end up in the sewing department to be turned into doll clothes.

Sun Wing Ming’s Labor

Sun Wing Ming’s website writes that “…we Hire Over 2000 Skilled Workers At Peak.” At this point, we know the values Sun Wing Ming starts with, in both machine and raw material form - now, let’s see the value Sun Wing Ming workers add. Let us determine the surplus value added, and once we do this, we can see who steals it.
It is impossible from my standpoint to know with certainty the exact wages, working hours, and living expenses for the Sun Wing Ming workers. Nevertheless, by investigating the conditions of Chinese workers as a whole, I can form a blurry image of how the Sun Wing Ming workers are exploited. This image will then become more and more focused as I investigate the conditions of productive workers, export-oriented workers, and workers in Dongguan. By the end of this process, a much clearer image of Sun Wing Ming’s workers and their exploitation will come into focus - and even if this still slightly unfocused image on their particular conditions is incorrect, my process of investigation into these types of workers will reveal the factual, gargantuan exploitation of the Chinese proletariat on the national and international scale.
We will start in Dongguan. The state-owned media outlet CGTN wrote in a 2018 article that “It's estimated that over six million migrant workers work in Dongguan, a manufacturing hub producing clothes, toys and electronic devices.” This is in a city with a 2020 census population of 10.5 million people. With the majority of Dongguan’s population being “migrant workers,” it is likely that the majority of Sun Wing Ming workers are migrants.
But what is a migrant worker in the Chinese context? A migrant worker is a worker who left their hometown to seek living and employment opportunities in a new hometown. These migrant workers can be broken down into two-subgroups: those who have household registration status where they live, and those who do not have household registration status where they live. This household registration system is called “Hukou,” and having or not having Hukou status carves out two separate classes of labor, one that is more highly exploited than the other.
Understanding the Hukou system requires knowledge of how China’s levels of government are organized. The lowest level of administration is the towns, followed by counties, themselves inside prefectures, which are themselves inside provinces. Furthermore, since prefectures are centered around big cities, the highly urban areas of the prefectures are subdivided into districts rather of counties, and these districts do not have any subdivisions. There are a few exceptions to these administrative divisions; however, what I have described above is generally the rule.
Every Chinese person is registered as living on a particular street or in a particular neighborhood - their Hukou location. If a Chinese citizen leaves their Hukou registration location to live and work in a new location, they become a migrant worker. If the migrant worker left their registered address, but moved to a nearby place within their Hukou location, then they will maintain their Hukou Status. If a migrant worker left their registered area but moved outside the Hukou location, this worker will not have Hukou status where they moved.
A government summary of the 2020 Chinese Census writes that “The number of population who lived in places other than their household registration areas reached 492.76 million. Specifically, the population who lived in places other than their household registration but still in the same city totaled 116.94 million and the floating population [Migrants without Hukou] numbered 375.82 million. Of the floating population, the population moving to other provinces reached 124.84 million.” So, 23.7% of migrant workers have Hukou status, while 76.3% do not. This also means that roughly 4.7% of the world’s population live as migrant workers in China without Hukou status.
Extrapolating this data onto the migrant workers of Dongguan, it is likely that the majority of Dongguan migrants, and by extension the Sun Wing Ming workers, lack Hukou status.
What are the implications of having or not having Hukou? The Hukou system has 2 functions: to allocate government services to registered Hukou citizens, and to regulate which type of workers can and cannot live inside the Hukou location legally. So if a Sun Wing Ming worker in Dongguan lacks Hukou residency, what services and privileges will they potentially be denied?
Answering this question is difficult, for a variety of reasons. First, there have been reforms to the Hukou system to provide more equality and easier Hukou enrollment, though the extent of reforms varies significantly by locality. Secondly, the studies I consult below indicate that laws enshrining rights and privileges for workers without Hukou are routinely violated without consequence. Thirdly, even if Hukou workers on paper have the right to pay into social security insurances, it appears that the large majority do not do so. The five social security insurances are medical, pension, work-injury, maternity, and unemployment insurance, and the majority of of Hukou-less workers do not pay into them due to prohibitive costs, or employer fraud (which we will explore later). Meanwhile, there is a minority of migrant workers with a child who appear not to send their kid to local public school - due to illegal fees charged by certain public schools, migrants have send their child to low-quality migrant private schools, or they send their child back to their “proper” Hukou to receive public education.
Essentially, for every metric of access to government provided services and protections, workers without Hukou measure worse against workers with Hukou by a significant margin. Their standard of living is also worse on average - they are the most exploited urban proletarians in China. The sources for my above assertions are in the comment section because I ran out of space - I acknowledge that some are western-based academics , but most are not, and all peer reviewed.
The first three Chinese social securities - pension, medical, and unemployment insurance - are paid by both the employer and the employee, with employers contributing a larger chunk to the fund than the employee The final two securities - the maternity and workplace injury insurance’s - are wholly funded by China’s employers. The monetary value of insurance contributions is set as a percentage of an employee’s salary, and these “insurances” are essentially the government pension, healthcare, and unemployment benefits funds. A worker’s ability to draw from these insurances requires that they have paid into them for some period of time.
In the A—B—C visualization of value creation in Marx’s Capital Volume 1 Chapters 10 and 12, A-B is the value created by workers and then returned to workers in the form of wages, and B-C is the surplus value created by workers but then stolen by various bourgeois actors, who use this surplus to pursue their own material class interests. One of these bourgeois actors is the various levels of government in China, all of whom collect surplus value in the form of taxes. After various bureaucrats, government workers, and contractors pocket a chunk of this surplus, a fraction of it is redistributed to a the Chinese proletariat in the form of services like public education, infrastructure, and the five parts of Chinese social security.
If Sun Wing Ming’s workers are even able to access these government programs when building toys for Bonkers Toys, this is the only instance when they even receives crumbs of the surplus value stolen from them. The rest of the surplus value leaves the factory upon creation, is partially shared amongst the Chinese bourgeoisie, the rest being dragged across the sea for the USA to feast upon.
So who are these expropriators, getting rich off Chinese labor? First, there are the parasitic Labor Market Intermediaries (LMIs), and the “scalpers” working for the LMIs. Export firms like Sun Wing Ming are in fierce competition with one another to buy Chinese labor, especially at peak production - as such, they hire “labor Service companies” to find workers.
This is the only time I will insist the reader should consider reading the following study linked here, written by two academics named Zixi Liu and Jianghuafeng Zhu at the University of Xiamen in Fujian, China. Their social investigation into the LMIs, their associates, and the workers they exploit, reveals a class of exploiters in Chinese cities that suck surplus value out of labor through social security fraud, lying about promised wages, scams, and cheap tricks such as requiring workers to buy the very pens they sign their contracts with. These are people who produce absolutely nothing, yet are tasked by capital to headhunt labor, drop off labor at factories sometimes under false pretenses, and frisk labor for everything they can in the process.
The study is done in the Yangzi Delta - around Shanghai. However, a 2023 WSWS article reporting on Dongguan, Guangdong, tells the story of how a worker named Yin killed one of these labor agents, as well as two other factory managers, when he “lost control” after being beaten on numerous occasions for trying to collect wages promised to him. This article’s interviews with Dongguan workers imply that in Dongguan, there is a strong chance the LMI agents are just as rapacious there as in the Yangzi Delta.
Once the Sun Wing Ming workers are in the factory, they are set to work on the raw materials and machines to produce Bonkers Toys’s toys, such as Ryan’s World “mystery eggs.' We have already gone over this productive process in great detail, so we will move on to a final analysis of Sun Wing Ming, before the toys themselves are backed up and shipped to the USA, where we will end our journey.
Sun Wing Ming’s factory is in Dongguan; however, their headquarters is in Hong Kong. Using a website called “Webb-Site Who’s Who,” which is a business directory owned by the billionaire Hong Kong investor David Webb. I also learned that in 2020, Sun Wing Ming received Coronavirus employment subsidies from the Hong Kong government for “38 Heads.” It appears to me, then, that there are at least 38 people who make up the corporate Hong Kong office staff for Sun Wing Ming. These employees, who create no value through their labor, instead live off of the value generated by the Dongguan workers, and likely live lives of greater comfort and upward mobility than the Dongguan workers could ever expect in this capitalist system. Unfortunately, throughout this whole process I have been unable to figure out who owns Sun Wing Ming. It will remain a mystery - what we know for sure is that the owner(s) is likewise parasitic on the Dongguan factory workers, and likely lives far better than the Sun Wing Ming workers he subsists off of.
Then there are the landlords, both commercial and residential. Does Sun Wing Ming own the land where they make their toys? Do they own their headquarters's office space? This is unlikely. Therefore, a portion of the surplus generated by the Sun Wing Ming workers is pocketed by the commercial landlords of Hong Kong and Dongguan. Furthermore, the Hongkonger office workers likely have rents or mortgages to pay; therefore, the apartment owners and mortgage providers are likewise parasitic on the Sun Wing Ming workers’ stolen surplus value.

Sun Wing Ming Products: From Factory to Final Customer

Now it is time to send the finished product off - because even though the LMIs, the office workers, the Chinese governments, the landlords, and Sun Wing Ming’s owners themselves have all had their cut of the surplus value, there are other bourgeoisies chomping at the bit to get their slice.
After leaving the Sun Wing Ming factory, the Bonkers Toys are brought to the port of Yantian, a city south of Dongguan. The port authority and port employees all get their cut of the Sun Wing Ming surplus in the form of port dues, terminal handling charges, documentation fees, etc. From there, the Bonkers toys are finally placed into a shipping container and set onto a boat.
Thanks to a bill of lading provided on Import Yeti, we can analyze one concrete example of Bonkers Toys being loaded onto a ship in the city of Yantian. In this case, the Bonkers Toys shipped are 6,368 kilograms of “Aphmau Mystery Box MeeMeow Mini Figures.”
The ship they were loaded onto in November 2023 is called the “Ever Fashion,” and is owned by the Taiwanese shipping company Evergreen Marine Corporation. Evergreen Marine Corporation itself is a publicly traded stock, its largest shareholders being members of the Taiwanese shipping tycoon Chang family, followed by private equity groups Vanguard and Blackrock. Simply Wall Street tells me that over half of the stocks are owned by the “general public,” which I assume to be various Taiwanese small investors.
The Ever Fashion then shipped the Aphmau toys from Yantian to Los Angeles. All of these toys were shipped in just one single container, the estimated freight cost being $1,029.50. Evergreen Marine Corporation did not create any value moving the toys from Yantian to Los Angeles, since they did not infuse any labor into the commodities - they simply moved the commodities from point A to point B. While distribution is important for the bourgeoisie to realize value, the process of distribution simply destroys value, though machine depreciation and labor costs. The way that the distributors acquire the surplus value to make their firms profitable, is by leeching off the surplus value created by the proletariat such as the Sun Wing Ming workers, and all other workers who have their surplus value shipped across the sea. This parasitic relationship applies to all the workers for Evergreen, as well as their landlords, the taxing governments, and the shareholders. That being said, the lowest paid in the Pacific shipping industry - typically the ship workers - often face terrible working conditions, and very low wages. Still, I would argue they are only being oppressed in the profit-realization process, and are not having any surplus value stolen from them like the Sun Wing Ming workers are. Even their paltry wages are still dependent on surplus value being expropriated from the productive proletariat.
The Ever Fashion’s workers docked the ship on December 4th, 2023, in Los Angeles. From there, the shipping container holding Bonkers good came off the boat, the port workers and government took a slice of the surplus value, and the toys were moved onto trucks.
What happened next? There are no sources that can tell me exactly what happened - but on Bonkers Toys’s website, they say they sell through 6 American retailers: Target, Walmart, Amazon, Walgreens, Five Below, and Kohl’s. What usually happens with imported goods to America, is that they are put on various trucks, brought to various warehouses, put on retail shelves or sold online, before finally being bought by the end customer - and then, the profit is finally realized. The only way, then, that surplus value is ultimately realized as profit, is that these retailers and Bonkers “buy low” from Sun Wing Ming, and “sell high” on the American side of the border. This entire process allows the imperial core bourgeoisie to hire vast armies of unproductive workers, and to pay America's salaries, wages, landlords, YouTubers, and shareholders. Crucially, none of these American actors in the buy low/sell high process create any value, whether they are importing from Sun Wing Ming or anywhere else. Instead, they leech off the B—C value created by the non-American proletariat.
The vast misery chain of value creation all stops creating value after the factory seals its commodity in the box. What comes afterwords becomes a matter of different bourgeois actors pushing and pulling against each other trying to grab some of that B—C for themselves. While I believe many conclusions can be drawn from my post, I hope that one conclusion is the following: any imperial core politics that engages in the squabble of trying to grab a chunk of surplus value stolen from the peripheral and semi-peripheral proletariat, is not socialism. Instead, that type of politics is opportunistic parasitism, only viable if the proletariat held at knifepoint.

TLDR;
-is a fluid mix,
2.5 litres tapwater 1/4 tsp 50/50 sodiumcl/potassiumcl mix 1/2 tsp pink or sea salt
Ok to sip from while eating boiled or raw whole plant foods that have no added salts?
What salts are missing that might be in salty meats? Should I drop in any aminos in monohydrate form? Mix with any lipids or emulsifiers?
Long story:
I’m interested in fluid hydration while working on the periods between eating.
Any suggestions would be appreciated.
Situation: Rarely crave salt. Plant based / flexi exploring vegan eating, but still gathering skill to meal prep & get full nutrition (eg. Daily cronometer but with trace lithium and other things not on the limited cronometer list)
Concern: Not enough salt intake while consuming the plant diets I’m trying, and less happy with adding it to the food recklessly, as my original flexi/junk food supplemented diet broke my sensing capacity, so I probably would tend to over-salt things.
Goal: A low cost home made simple electrolyte I can have in conjunction with the mostly vegan foods I am eating, so I don’t need to salt the foods themselves.
Products available:
50/50 lite salt with equal sodium chloride / potassium chloride.
Sea salt
Pink salt
Sucrose
Sources:
Simon Hill & Stacey Simms discussing. Episode #259 - ‘the proof’ podcast/yt
https://theproof.com/hydration-for-optimal-health-and-performance-stacy-sims-phd/
The Science Of Hydration pdf Stacey Simms / CPSDA / TheRightStuff
https://www.sportsrd.org/wp-content/uploads/2018/11/The-Science-of-Hydration.pdf
(Please note I don’t accept these positions or perspectives as accurate, I simply consider them as different to the usual ’drink lots of water’ perspective, and a point to improve on, I seem to be OK on water, but want to cut junkfood out for financial but mostly longevity reasons)
Ok! That’s out of the way.
I need an easy way to make an affordable second table drink to go with water. I asked an AI, to get measurements. I have some spoons that have ml and grams, ranging from 1/8th tsp to 1tbsp.
Here’s the result:
AI: Human, I am gpt-4-1106-preview. (GPT4 Turbo) 128000 tokens, LLM trained to Apr 2023 Guest: I have a training rehydration food supplement, that addresses some limited loss of electrolytes and helps with water absorption. It’s 8 fl oz water, 7gm sucrose, 150mg sodium, 75 mg potassium. Please convert to metric assuming the smallest dry powder measurement tool for the potassium i have is a eight tsp 0.6ml AI: Let's do the conversions step by step.
Water: 8 fluid ounces (fl oz) is typically converted to milliliters (mL). The conversion factor is 1 fl oz = 29.5735 mL, so for 8 fl oz:
( 8 \text{ fl oz} \times 29.5735 \text{ mL/fl oz} = 236.588 \text{ mL} )
Therefore, 8 fl oz of water is approximately 236.6 mL.
Sucrose: 7 grams (gm) is already in metric units, so no conversion needed.
Sodium: 150 milligrams (mg) is also already in metric units, so no conversion needed.
Potassium: 75 milligrams (mg) is already in metric units, but you want to know how to measure this with a ( \frac{1}{8} ) teaspoon (tsp) measuring tool. The volume of ( \frac{1}{8} ) tsp is typically about 0.6 mL. This measurement is for volume, not mass, so to convert mg to mL for a solid like potassium, we'd need to know the density of the potassium compound you're using. However, in cooking and informal measurements, we sometimes use volume (like teaspoons) to approximate the mass of solids, since most solutes in small quantities have a density close to 1 g/mL.
Assuming we're using this approximation (which is not precise but can be used for small, non-critical measurements), 75 mg would be 0.075 grams. If we consider that 1 mL of the potassium compound is roughly equivalent to 1 gram, then 0.075 grams would be approximately 0.075 mL. Since you have a tool that measures 0.6 mL, you would need about one-eighth of that ( \frac{1}{8} ) tsp to measure 75 mg of potassium.
Keep in mind this is an approximation and can vary greatly depending on the actual density of the powder you're measuring. For precise dosing, you'd need a scale that can measure milligrams.
Guest: Redo in table form, quantities Of powder to add assuming using 2.5l tapwater as the base. AI: Certainly! If you are preparing a larger batch of your rehydration supplement using 2.5 liters of tap water as the base, we need to scale up each of the individual components accordingly. Here is the conversion to metric units and the calculations done for the larger volume, assuming linear scaling:
Ingredient Original Quantity Original Metric Equivalent Scaled Quantity (for 2.5L) Water 8 fl oz 236.588 mL 2,500 mL Sucrose 7 gm 7 gm 73.91 gm Sodium 150 mg 150 mg 1,578.95 mg Potassium 75 mg 75 mg 789.47 mg To find the scaled quantities for 2.5 liters, we consider that 8 fl oz is approximately 0.236588 liters. Thus, we are increasing the volume by ( \frac{2.5L}{0.236588L} ) times. We apply this scaling factor to each component:
Sucrose: ( 7 \text{ gm} \times \frac{2.5L}{0.236588L} \approx 73.91 \text{ gm} )
Sodium: ( 150 \text{ mg} \times \frac{2.5L}{0.236588L} \approx 1,578.95 \text{ mg} )
Potassium: ( 75 \text{ mg} \times \frac{2.5L}{0.236588L} \approx 789.47 \text{ mg} )
To measure the potassium accurately with your ( \frac{1}{8} ) tsp tool, which is 0.6 mL in volume, let's use the previous approximation where 1 mL is roughly 1 g of the compound (specifically for the sake of this example; actual density may vary).
Since we need approximately 789.47 mg (or 0.78947 g) of potassium, and assuming the density of your potassium powder is near 1 g/mL, you would need slightly more than 0.78947 mL of the powder. Given your smallest measurement tool is 0.6 mL, you would measure out just over one ( \frac{1}{8} ) tsp scoop to get the required amount of potassium.
Please remember this is an approximation and for the most accurate measurements, especially for dietary supplements, it is best to use a precise scale that can measure milligrams.

Hey!
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We got some new items and balance changes - what is good. Take a closer to them.
​
Armor Plating: Im glad to see that there is no more general undefendable dr item, like Haven was. This new plitting of the dr bonus might will be easier to handle for new players. But the balance of the distribution is far from perfect. Approximately 80% of the damage dealt is from weapon. Also many skills are counted as weapon damage. E.g. Lian's skills, Talus' Overcharge, Tiberius' Combat Trance... So weapon damage is WAY MORE significant than skill damage. Haven was an OP item, and Armor plating became even better... Its sclaing should be 8%->5%, or base cost 275->350.
Arcane Warding: On the other hand this item seems to be a little bit weak. Buff effect 12%->15% or lower cost 250->225
Unbound: Its a nerfed Resilliance. I feel it okey, resi was really strong, but needed...
Sentinel: Its balance seems to be ok, but that fact it has 2 total different bonuses make it confusing to use.
Guardian: It used to have 8% scaling. Noone used it for long patches. Buffed to 10%. Ppl tried it but still just lowered their winrates. And now gained the biggest buff in all Paladins history. Doubled the scaling and ALSO reduce the price... Guys, watch statistics and do some math before applying changes, coz it's just funy already. At least its already definitely seems to be more balanced than ever.
​
Master Riding: I agree with the slight buff, it was viable only on few maps.
Nimble: I can't see the reason why it has been buffed. It was one of the best item in the game already. except for Evie, Ruckus and a handful of champions.
Hoard: It is the new noob trap. You will get millions of credits, but nothing to spend on with the fewer item slots... Also buying an other new item is worth much more coz of the lower initial prize. Only champion will by it is like Io, who needs only dr and speed.
​
Meditation: I love to see to old kind of healing mechanic returns to play more undependently from the most important class of Paladins, and also somehow finally with a reasonable scaling. Why couldn't you make Veteran like this 6 years earlier? And it's also a huge indirect buff to Yago, who definitely deserves it! So huge thumbs up!
Life rip: this item always suffered coz of cauterize. Using it were officially feeding. Finally after long years it feels to be viable. thanks!It still needs a buff for frontliners, coz their health points worth less than for any other champions (because thay have double HP, but not double value in the team).
Rejuvenate: It abolutely deserves its nerf, its an uncounterable item with a huge buff. Ppl think it can be countered, but no, its not. It will give the constant 10%/lvl heal bonus no matter how much cauterize you apply. Cauterize can only counter base healing, not healing bonus percent. Only Willo can reduce it's efficiency for short durations.
Veteran: It got double buffs: cost 300->275, scaling 5.5%->7%. It was already one of the most picked item besides Haven and Rejuvenate. Why getting even more buffs?
Blood bath: Here we go. The reason I decided to made this whole post. It is literally the new Kill to Heal (KtH). KtH had recieved many buffs, nerf and changes, but one point was stable: It was a support item. Because it equally rewarded assist as kills. And healers had the most assists, moreever the most eliminations. Especially when it had no true-healing effect it helped healer much more, because they were not couterized the most thimes they got eliminations, coz they can heal from covers. Anyways its best state where when it had 250 true-healing.But now we got Blood Bath. It got 1 buff and 2 huge nerfs from its last KtH form, which item was already overnerfed to 200 scaling and rarely used. Not just a huge cost increasing 200->325, but the fact it can be cauterized again makes it super underpowered. Because it doesn't reward kills more than simple assits, and it can be cauted it has double reason to pick it for healers. But its new bonus gives you double reward if you dont kill, but assist! And healers don't kill that much, but assist that muc: so basically it has triple reason to pick as supports. For all other classes this item sucks. This new bonus seems to be interesting, but at the end it just pulls the item towards supports even more, so it just ruins its balance.It would work if it gave 150 true-healing for assists, which doubles for kills and also for frontliners. With 200 base cost. So e.g. its lvl3 form for frontliners for kills would give 450 heal for Ying for an assist, 900 for Tyra for a kill, and 1800 for terminus for a kill.
​
Trigger Scent: Great idea! Seems to be a little weak, but since players hate to play against damage bonuses, I understand why it has been toned to a low value. It definitely helps some low fire-rate champions more than others to secure them kills for less shots. E.g. Fusillade Drogoz will kill most champions 3->2 shots.
Deft Hands: It was always a niche item, so some love definitly cannot be wrong.
Wrecker: Wrekcer was still good against Barik-Nando, especially against 2 shielder tank comps. And it will be even more important with the new Guardian. I wish it wont be the new must buy item, the new caut you always have to max out asap.
​

Help. To try to make a long story as short as possible. My new pain doctor started me on lyrica because I have nerve damage (trigeminal neuralgia) in my face. I’ve been treated with methadone for 20 years, but new pain doctor, so let’s try something new. Plus I also suffer from crippling anxiety, so bonus, right? Well they started me at 75 mg twice a day but I was freaking out couldn’t breathe tightness in chest probably because of the methadone which they also prescribed so they should know the contraindications. But then we went down to 25 mg twice a day, and slowly went up And my cognitive functioning slowly went to shit, but my cat died, and grief overwhelmed me and I couldn’t function and I thought it was grief because she was my life for 17 years. Mid November I took my last step up to 75 mg twice a day (total 150) from 125, I just started losing my shit. Utter complete hopelessness, unable to do anything right or even remember the names of people I’ve known forever, and then thoughts of of ending myself …. thoughts I never had in 40 years of mental and physical health issues no matter how bad things got. So, even though my doctor had told me the only side effect I had to be concerned about with Lyrica was tremors 😡 I googled and saw that yeah, the emotional side effects can be caused by Lyrica, so I talked to the pain doctor and he gave me schedule weaning off going down 25 mg a week. Well, last Sunday a week ago tomorrow i went down to 50 mg, 25 in the morning and 25 at night and I am a MESS I can’t function. I can’t think. I can’t do anything but cry. I am in pain from head to toe worse than my entire life…. compounded by a root canal I had to have on Monday, which triggered my trigeminal neuralgia (which is unbearable, nerve pain in the mouth) and then, I have a tear in my hip labrum and for some reason, THAT pain has been a billion times worse and I cannot even move without agony. I know my mind well enough to know that these irrational thoughts about canceling myself that I’m having are irrational thoughts, and I will not act on them. because things have to get better because they cannot get worse. But I can’t get hold of a medical professional because it’s a loooong holiday weekend. So I’m looking for reassurance that all these issues I’m having this week are triggered (or not helped) by the lyrica reduction? Can it make pain WORSE? How long til the feelings of not wanting to exist anymore go away? I feel like I’ve already ruined the holidays but there’s so much pressure for Xmas Eve and Xmas Day and I don’t know how I can just turn these feelings off so I can function and put on a happy face for the holidays. Any help advice or empathy would be inexplicably immeasurably appreciated. I’ve never felt so lost scared and alone in my life. I wish I’d never trusted my doctor enough to try this medication. I should’ve done my research but after 20 years on disability and my cognitive functioning so poor and I can’t make decisions, I HAVE to trust my doctors ….but that seems to be a mistake every time 😞💔

As a followup to the my previous post below, at the request of several redditors, I'm sharing my tips, mental approach, strategy and just a few recipes I used over the past year.
https://www.reddit.com/CICO/comments/18c7pgb/1_year_in_191_lbs_gone_40m_6_sw_366_cw_175_gw_180/

WEIGHT LOSS & FOOD STRATEGY

Outline

• General Tips
• My Personal Daily Food Target
• Tools
• Eating Out
• Proteins
• Substitutions: Make the Most of your Calories
• Recipes

General Tips

1. The first few weeks are the hardest, if you feel discouraged don’t be! You’re already winning!
2. Figure out WHY you overeat: is it hunger? Boredom? Comfort? Find a way to replace it with a healthy habit. I feel better 1 hr after I clean a room or do a project, I don’t feel better or remember a dessert I ate 1 hr later.
3. Give yourself TIME to adapt and adjust to a healthy diet with reasonable portions.
4. Focus on mental toughness and mental health, it’s 2023 if you need help get it!
5. Work with a dietician if your insurance covers it or you can afford it, but follow reputable sources like Mayo or Cleveland clinic for health advice if not.
6. Do something SUSTAINABLE: calculate maintenance calories at your target weight and plan what you would eat each day, eat the same stuff but less to lose weight
7. Non-scale victories are real! Focus on how you feel mentally, physically, bloodwork, blood pressure, blood sugar, how your clothes fit, energy level and otherwise. I felt better only 5 days into my new lifestyle.
8. Avoid fad diets (I won’t list what I think are fads or transition only, but realize nutrition/dieting has more misinformation online than politics)
9. Use a TDEE calculator to figure out your maintenance calories and target deficit
10. Vet calories in apps or online, I’ve found huge errors in Loseit and myfitness pal and other rules of thumb. USDA FoodData Central and the manufacturer’s nutrition label are what I trust. USDA is very useful for things you don’t have nutrition facts. Is there error? Yes, but error goes both ways and overtime it cancels out.
11. Spend calories wisely like money (don’t waste them on non-nutritious or non-filling food)
12. Track calories, even if it’s a questionable estimate
13. Use a meal app such as LoseIt to track meals or a google sheet on your phone
14. Weigh everything you can to the gram, it’s much more accurate than volume or servings per container, just hit zero as you add things to your plate. It’s also a heck of a lot easier than measuring things in cups and scraping them out. Things like avocado’s and sweet potatoes there is no other way to be accurate, not 1 large or small fruit etc. The only thing I measure by volume is salad dressings and condiments at times with a 1 TBSP measuring spoon, but they can be weighed too. (baking is a different issue-I obviously use volume). Over time you’ll become skilled at eyeballing food and portions.
15. Don’t let a bad meal or day carry on to the next meal or day, it happens and isn’t a reason to get discouraged or an excuse to binge the rest of the day. You went over 500-1000 calories? Guess what that’s probably a lot less than you would’ve gone over before you started your journey. It’s actually a victory. I went 1500 calories over on my birthday, totally unplanned, but a year prior I would’ve been 3000+! That is a WIN!
16. Plan meals ahead for the day
17. Have a reserve contingency heading into late afternoon/evening
18. Eating out can be controlled, don’t view it as you have to give up or will always go over
19. Eat high protein, high fiber food and get plenty of VARIED greens and fruits. Variety is important because no one fruit or vegetable has everything you need.
20. If you have a lot of extra calories available because you skipped a meal, don’t eat them all at once, spread them out an hour especially if you are still training your body to a reasonable portion
21. COOK! You can make better, more filling meals for your money and calories than you can buy!
22. Healthy foods without a corn subsidy can be more costly, but are cheaper than chronic issues associated with a bad diet
23. Meal prep so you have options available if you’re short on time
24. I usually batch cook a lot of chicken on the grill and freeze it in Ziploc freezer bags and defrost as needed and it’s the base in most of my meals if I don’t have time to cook fresh-this leaves me with no excuses to eat healthy
25. Meal prep and freeze complete meals-I do this with my chicken pasta, chilli, soups, etc. These reheat very well and are my go to when strained or working 12 hour shifts.
26. Weigh only once a week, your weight varies too much day to day to track and for many it is discouraging when they see weight from either a delayed bowel movement or a salty meal making the “numbers” look bad when in reality they are doing well.
27. Your palate will get better! If you’re a foodie like me you’ll become able to taste and appreciate things you couldn’t before because you were overwhelmed by junk foods and insane amounts of sugar or Guy Fieri entrees that use every spice known to humanity.
28. Plan a cheat day or reward, but be reasonable and don’t let a meal turn into a day or week, we hit reset every morning
29. Do what works for YOU, this is just what worked for me and is supported by my goals and dietician

My Personal Daily Targets
Most of my days are 30-40% protein, 35-45% carbs and 20-25% fat (note: I eat high fiber foods)
140 grams of protein a day minimum (usually higher)
35 grams of fiber minimum
Saturated Fats <20 grams (or lower)
Sodium <3500 mg
Multiple servings of leafy greens
Multiple servings of vegetables
Multiple servings of fruit (varied fruits)
No white bread, white rice, or processed food
Limited sugar
Healthy Fats
Healthy Oils
At least one treat a day
Tools

1. $10 electronic food scale
2. 1 TBSP measuring spoon (I recommend a stubby coffee scoop)
3. Travel stainless/silicone condiment containers (can also be used for nuts or cheese to add to salads, not just dressing or BBQ sauce)
4. Cooler with ice packs (so you can bring meals when needed)

Eating Out
Research beforehand
Don’t be afraid to ask for a menu item to be modified or a side changed
Look for chicken, particularly boneless skinless, fish not breaded or fried, salmon, or grilled shrimp
Realize some “grilled” items sometimes are really cooked in oil on a flat top or skillet
Salads are a good option but you have to watch salad dressing as restaurant dressing can be very calorie heavy, obviously cheese is not low fat or calories, nuts and candied nuts you need to watch.
Almost every restaurant, even if they don’t have a healthy option, I’ve managed to find one. My panic button is a salad with lean protein. If there is an adder for chicken or shrimp I have them do that and often I ask to double the adder as usually it’s not a whole lot of meat. I bring my own salad dressing that is 5-10 calories a serving in small pocket cups (stainless with silicone lids). There are squeeze silicone bottles you can use but they are more difficult to clean properly.
Proteins
I eat primarily boneless skinless chicken breast, cod, salmon and shrimp. Most of my protein is chicken as it's cheap, has a lot of protein for the calories and is low in saturated fat. I view calories as money and I get a lot more bang for my buck with chicken versus 80/20 ground beef. For less calories I hit my protein target more easily and have calories to spare on other items I enjoy. Cod, crab and shrimp are good too, particularly prepared in a non-stick pan with a minimal amount of healthy fat. I eat salmon once a week for the Omega 3. If I do eat ground beef I use 93/7 to get more protein for the calories and less saturated fat. My cholesterol numbers were poor before and now optimal with this strategy.
Substitutions: Make the Most of your Calories
Potatoes
I love sweet potatoes, they are so good they can be eaten plain, but I sometimes top with cinnamon, splenda brown sugar blend, a sugar free syrup, or cheese.
Greek Yogurt
Greek yogurt is a great food. It is reasonable in calories and has a lot of protein for the calories and if bought in low fat or nonfat versions has low saturated fat. I use it as a sub for sour cream, to create dips (fiesta ranch seasoning, ranch seasoning, add sals or hot sauce). I also use it with fruit to create a nutritious snack or pre or post workout snack that's high in protein. In that case I add splenda to it and pure vanilla extract. You can even strain it in the fridge overnight, add artificial sweetener and vanilla and it's almost like an icing or frosting.
Sauces
BBQ sauce for example look at Sweet Baby Ray's the primary ingredient is sugar (HFCS). If you look at a sauce like Stubb's you'll see the first ingredient is tomato's so it has a lot lower calories and isn't as bad for you. You can take that a step further and use a sugar free sauce like G Hughe's line of BBQ sauces that are only 10 calories for 2 TBSP's. There are a lot of low calories hot sauces, but you have to watch sodium content.
Salad Dressing
Look for light or reduced calorie dressings as they are often 45-60 cals per 2 TBSP versus 110+. You can take it further and utilize a dressing like I use at times called Skinny Girl which is 5 cal for 2 TBSP Balsamic vinaigrette or 10 cal for 2 TBSP for Honey Dijon. I also like Bolthouse Farms for ranch dressing. Take those calorie savings, add extra protein, fruits, nuts or avocado! Watch the salad dressings for sodium level-some are insane.
Cheese
Cheese can be high in calories, sodium and watch the saturated fat. I use skim mozarella, it's low in calories and has the most protein per calories out of most cheeses. Alternatively I use a reduced fat mexican cheese which is 10 calories more a serving. You still need to watch the saturated fat.
Fats
With eating boneless skinless chicken breasts I found my fat consumption too low. I add back in heathy fats. I bake or cook with olive oil or avocado oil. I also eat nuts or avocado's. I vary the nuts but primarily use almonds. I'll have nuts plain or add them to salads. Avocado's I eat by themselves, as part of a salad or on taco's.
Cooking Oils/Baking Fats
I only cook with Olive Oil or Avocado oil to keep fats healthy and avoid unsaturated fats. I use Avocado oil when I need a high temp oil to avoid smoking. As a butter substitution when baking I use avocado oil 1:1 where it calls for butter or for lower calorie usage I substitute greek yogurt or a mix of greek yogurt and avocado oil. Some Keto diets push coconut oil, but the saturated fat is very high.
Fruits
Fruits are full of all sorts of things so I won't write an article on these. My big takeaway is that they aren't all equal so I eat a variety to get the full picture. I love tomatoes, apples, strawberries, raspberries, blue berries, and blackberries. I add them to salads or soemtimes I add the latter to greek yogurt.
Rice
I avoid white rice and utilize brown rice or a rice subsitution. Cauliflower rice is popular and a good low calorie filler. My favorite rice is Right Rice which is 165-170 cal per serving and has 10g of protein and fiber. I use Right Rice 90% of the time in place of regular rice because I'm getting more for my calories.
Pasta
I use pasta from Barilla either their Protein+ line or the red lentil pasta made from chckpeas and/or red lentils. I like both, but they have higher protein content than regular pasta and the Protein+ tastes like regular pasta. Like Right Rice I like that I'm getting more for my calories.
Tortillas
I love Mexican food. I use La Banderita Carb Counter tortillas. They are much lower in calories and add a small amount of protein and fiber. I make taco's, quesadillas, and even toast them to add to salads.
Snacks
Kind mini nut bars 90 cal
Clif mini energy bar 100-110 cal
Clif energy bar 260 cal before cardio/run
Yasso greek yogurt bars
Lowfat Greek Yogurt and Fruit Bowl (Greek yogurt, Splenda, pure vanilla extract, then add raspberries, strawberries, blackberries and blueberries for a high protein snack)
Optimum Nutrition protein powder plus frozen fruit above, add 1% milk if calories allow, but still tastes good with water
KETO Products
They’re not all equal and some have really high saturated fats if that concerns you as it does me.
Salads
I eat a salad once a day. I aim for 500-550 calories and 40g or greater protein and good vitamins and plenty of fiber. It makes me feel good and keeps me full. Early on I skipped some of the higher calorie adders. I sometimes add a fairly plain salad to add volume and fiber to keep me full if I feel my entree isn't filling enough or needs a healthy balance of fruits and veggies.
I eat primarily a romaine blend and or spinach as they are both well regarded versus iceberg.
For protein I add chicken, shrimp or salmon.
The volume helps in feeling full and you need greens.
I add any of the following:
Tomato
Red onion
black olive
almonds or other healthy nuts
apple
peppers
low fat cheese
toasted low carb tortilla strips
shredded carrots
cucumber
raspberries or other berries such as strawberries
avocado
Some Recipes (I have lots more)
Fajitas & Quesadillas
This usually comes out to be 350-500 cal and 40-55ish protein plus fiber depending upon how I adjust
4.5-6oz chicken breast grilled seasoned with fajita seasoning
1 bell pepper sliced and cooked in non-stick skillet with limited olive oil spray and fajita seasoning
1 yellow onion sliced and cooked in non-stick skillet with limited olive oil spray and fajita seasoning
3-4 Street/snack size La Banderita Carb Counter tortillas toasted n skillet at medium high heat
1 serving reduced fat Mexican shredded cheese as desired
1 serving low fat Greek yogurt as desired
Street tac sauce as desired
Avocado as desired
Fish Tacos or Shrimp (from Mayo Clinic)
Note: I use frozen cod or shrimp and thaw in cold water
Paprika, ½ tsp(s)
Thyme, dried, ¼ tsp(s), ground
Onion powder, ½ tsp(s)
Garlic powder, ½ tsp(s)
Sugar, ½ tsp(s)
Salt, ½ tsp(s)
Black pepper, ¼ tsp(s), ground
Cayenne pepper, 0.13 tsp(s), (1/8 tsp)
Oregano, dried, ¼ tsp(s), ground
Cumin, ground, 0.13 tsp(s), (1/8 tsp)
Pineapple, ½ cup(s), chunks, cut into small cubes
Roasted red peppers, ¼ cup(s), chopped
Jalapeno pepper, ½ pepper(s), seeded and diced
Cilantro, fresh, 2 tbsp(s)
Red onion, chopped, 2 tbsp(s)
Salt, 0.13 tsp(s), (1/8 tsp)
Honey, 1 tsp(s)
Mahi mahi, raw, 4 x 3 oz fillet (I use cod or shrimp)
Flour tortilla, 4 tortilla, medium (approx 6" dia), warmed (I use carb counter tortillas)
Avocado, ½ medium avocado(s), chopped
Feta cheese, reduced-fat, crumbled, ¼ cup(s)
Method
Prepare the Blackening spice by mixing together in a small bowl the paprika, thyme, onion powder, garlic powder, sugar, ½ teaspoon salt, black pepper, cayenne pepper, oregano, and cumin.
To make the Roasted red pepper pineapple salsa combine the pineapple, roasted red pepper, jalapeno, cilantro, red onion, 1/8 teaspoon salt, and honey.
To make the tacos, preheat the grill. Rub mahi-mahi with blackening spices for at least 4-5 minutes. Lightly coat with cooking spray on each side of fish fillets.
Grill fish for 3-4 minutes a side, depending on size of fillet, until you reach an internal temperature of 140°F.
To assemble tacos, place a warm tortilla on a plate. Top with 3 ounces fish, ¼ of the roasted red pepper pineapple salsa, ¼ of the chopped avocado, and 1 tablespoon feta cheese.
Chicken Parm (Grilled)
This usually is 500-550 cal and 50g protein plus fiber depending on exact proportions
6 oz boneless skinless chicken breast seasoned with Italian seasoning (you can lightly bread and bake)
56g Barilla Protein+ pasta in noddle or penne form
28g Skim mozzarella or Parmesan in noodles (some I put on the chicken breast and broil it to melt/brown)
½ cup homemade marinara sauce
Marinara Recipe (This is NY times)
28oz can San Marzano Tomato’s crushed or pulsed in blender (San Marzano really does matter)
2 cloves fresh garlic minced, adjust quantity to taste-I use more
1 TBSP olive oil (recipe calls for 2)
2 Tbsp fresh basil chopped, fresh!
½ t sugar or more as needed
Salt if desired
Chicken Chilli (fit foodie modified)
This is usually around 470 calories 45-50g protein and a bunch of fiber and carbs to fuel you, you can add cheese or greek yogurt or sometimes I add a healthy homemade cornbread
Ingredients-4 servings
24 oz boneless skinless chicken breast or 24 o 93/7 ground beef (either cooked in chunks or crockpot just the chicken and shred)
1 yellow onion finely diced
1 bell pepper diced
1 tablespoon minced fresh garlic or more
1 15-oz. can pinto beans drained and rinsed
1 15-oz. can dark red kidney beans drained and rinsed
1 15-oz. can tomato sauce no salt added
2 10-oz. cans no salt added rotel or more, may consider sub’ing one can with hot
3 tablespoons tomato paste
3 tablespoons chili powder
2 teaspoons garlic powder
2 teaspoons ground cumin
1/2 teaspoon smoked paprika
1/2 teaspoons salt
1/4 teaspoon ground pepper
1 cup reduced sodium chicken broth
Crab Cakes & Remoulade
I adapted this from a cooking class I took a while back.
Crab Cakes
Mix everything but the crab first! Then lightly fold the crab in, divide and handle as little as possible, you can bake and broil to get some crust or cook in pan with limited oil-I adjust to my calorie target, but baked they are low calorie and high protein combined with the Greek yogurt remoulade sauce
Makes 2-4 servings depending upon if it’s your main or a side
16 oz lump crab
2 eggs
½ cup breadcrumbs (it’s very little, but if worried use whole wheat)
2-4 Tbsp fresh parsley minced
2 Tbsp Light Mayo
2 tsp old bay seasoning
3 tsp dijn mustard
1 tsp lemon juice
½ dry mustard
Traditional recipe has you add 2 TBSP butter to this, but you can sub a healthy oil, yogurt or leave it out
Remoulade
This is a great all purpose sauce
½ cup lowfat Greek yogurt (if you’re not going to use much you could use light mayo)
1-2 Tbsp dijon mustard to taste (this varies for a lot of people)
1 Tbsp Ketchup
‘1 Tbsp Paprika (no smoked)
1 t horseradish
1 t lemon juice
½ t garlic powder
Dash hot sauce
Salt/Pepper as desired
Korean Ground Beef (Recipe Critic modified)
Adjust the quantities and portions, I usually adjust the batch/servings to be somewhere around 400-450 cal a serving
1 pound lean ground beef 93/7
3 garlic cloves minced
1/4 cup Splenda brown sugar
1/4 cup reduced-sodium soy sauce
2 teaspoons sesame oil
Fresh ginger grated quantity to taste
1 teaspoon crushed red pepper flakes to taste
1/4 teaspoon pepper
Right rice or brown rice
sliced green onions and sesame seeds for garnish
Fajita Bowl
500-650 cal 50-60 g protein 10-15 g fiber (adjust as needed for your target)
4.5-6oz chicken breast grilled seasoned with fajita seasoning and then cut up
1 serving right rice
1 can rotel no salt or lime cilantro
Avocado
Reduced fat Mexican cheese as desired
Lowfat Greek Yogurt seasoned or plain
Cilantro and lime or other items including street taco sauce
85 g Romaine
Salads
This is varied and I listed my salad strategy above, but here’s just one example of items and ranges:
400-600 cal 40-50 g protein 16 g fiber
6 oz chicken breast grilled seasoned and cut up Or shrimp Or salmon
200 grams romaine salad blend
35 grams shredded carrots
100-150 grams tomatoes
30 grams red onion
40 grams cucumber
45 grams avocado
15-30 grams nuts (usually that OR avocado)
70 g slice apples or strawberries or raspberries
28 g skim mozzarella
6-8 TBSP salad dressing varies but a sugar free one
Toasted carb counter tortilla strips
Sweet Potato
Bake 1 sweet potato (250g is my typical size) 450 degrees 50-70 minutes until very soft inside
Top with Splenda brown sugar, sugar free syrup and or cinnamon or cheese or just eat plain with cinnamon which is what I usually do since they are naturally sweet
Grilled Chicken Sandwich
4.5-6oz chicken breast grilled seasoned with cajun or BBQ seasoning
Kroger Carbmaster Bun (high protein, low calorie)
1 TBSP light mayo
2 TBSP Hughes Sugar Free BBQ sauce
Red onion
Lettuce, Tomato, banana or jalapeno peppers as desired
Cheese as desired
Chicken Fried Rice
4.5-6oz chicken breast grilled seasoned with cajun or BBQ seasoning
1 serving Right Rice or Brown Rice
1 egg scrambled
2 tsp sesame oil
28 g unsalted cashews if calories allowed
1 serving frozen peas and carrots no sodium or sauce added
1-2 servings frozen broccoli no sodium or sauce added
Add Siracha or other sauces as desired, you can even use a sweet hot bbq sauce or reasonable amount of low sodium soy or Thai chili sauce
Salmon
4 oz salmon seasoned with lemon pepper seasoning
Leave skin on cook flesh side down in skillet with olive oil medium high heat to sear
Flip to skin at medium – medium low heat and cook a few more minutes
Cook on sides until done
Rice and broccoli or a side salad for sides
Pumpkin Pie
You can use all Splenda and its 218 calories a slice or you can use some Splenda some regular sugar, this is a spiced one, not a boring grocery store pumpkin pie. You may top with sweetened Greek yogurt (sweetener and vanilla)
t is teaspoon
1 cup Splenda
½ t allspice
½ t salt
½ t cloves
1-1/2 t cinnamon
½ t nutmeg
½ t ginger
1 regular can pumpkin-pure pumpkin
12 oz can evap milk
2 eggs
Uncooked pie crust
Standard pyrex 9” pie dish
Bake in an oven preheated to 425 for 20 minutes
Lower heat to 350 and bake at least 35 minutes and likely more until done enough
Pancakes or Waffles
I use Kodiak and depending upon targets for the day add either milk or eggs for more protein, I also eat a bowl of Greek yogurt with these and fruit to ensure I have enough protein. I use Kroger sugar free pancake syrup
Here’s a great fruit topping:
1 lb strawberries cut up
1/4 cup Splenda
1 tsp Lemon juice
1/2 tsp Pure vanilla extract
Heat on low-medium low heat stirring occasionally until strawberries are soft and liquid builds
Do not add water, the strawberries will liquify
Taco Enchilada Bowl
Stuffed Peppers
Tortilla Soup
Black Bean Soup
Black Bean Chili

I got a medicine syrup for my cough and I read it has the following, the question is will it kick me out of keto and how much do all this equal to in carbs and calories?:
Thyme 40 mg
Iceland Moss 30 mg
Plantain 20 mg
Grindelia 20 mg
Resveratrol 3 mg
Fructose 150 mg
Purified FU water
Wildflower honey 2,160 g
Eucalyptus Honey 360 mg
Citric Acid 20 mg
Potassium Sorbate 16 mg
Xanthan gum 350 mg

Soooo I would really appreciate if someone could help me with a few questions
First is a rating/commentary on my current supplement stack (I have severe adhd, and depression and anxiety, which i take meds for)
Meds (all generic obv) - Wellbutrin - Buspirone - Effexor - Guanfacine - Adderall IR - Adderall XR
Supplements - Omega 3 high EPA as per dr. amen from TikTok for adhd and general detox

• Magnesium Threonate 144mg as per the bottle, for brain health…?
  
• N-acetyl L-Tyrosine 2,800mg split into 2 doses. I read on maybe this subreddit that high amounts of NALT turned into Tyrosine can be good at increasing energy for adhd
  
• Alpha GPC 600mg good for increasing or helping choline in the brain…?
  
• Ashwaganda 600mg recently increased to 1,200mg cuz 600 didnt seem to do anything
  
• L Theanine 400mg split into 2 doses
  
• Gingko Biloba 280mg split into 2 doses, recently increased to double
  
• Inositol 1000mg split in 2, recently doubled
  
• Glycine 2000mg split in 2, recently doubled
  
• Magnesium Glycinate 350mg for sleep
  
• Tongkat Ali 200mg I take it daily and heard that a week off every two weeks or something is advised
  
• Fiber supplement
  

Lots of water and “relyte hydration powder”
And daily greens powder and a super fancy probiotic called “Seed”
And i wanna add these in order of importance:

• Vitamin C
• Vitamin B complex
• Vitamin D3 with K2
• Zinc
• Acetyl L- Carnitine
• Folic acid
• Magnesium Citramate (Citrate and Malate together)

And im looking at the life extension products on Amazon (and im like a kid in a candy shop…)
Theres “bio circumin” and “curcumin elite”
Bio circumin BCM-95° Bio-Curcumin° turmeric 25:1 extract (root) [std. to 95% Total Curcuminoids Complex with Essential Oils of Turmeric Rhizome by HPLC (380 mg)]
Equaling 400mg per serving size/capsule
Circumin elite Proprietary CGM Blend providing 40% curcuminoids (200 mg) and 3% turmerones (15 mg) [from turmeric (rhizome)), 30% galactomannans (150 mg) [from fenugreek (seed)]
Equaling 500mg… per serving/capsule according to the nutrition facts
There’s also 2 vitamin E products
“super vitamin E” Vitamin E 268 mg (as d-alpha tocopherol from sunflower oil) On the front it says 268mg (400 IU)
And “gamma E” Vitamin E (as D-alpha tocopherol) 30.15 mg Gamma E Mixed 524 mg Tocopherol/Tocotrienol Complex [providing 374 mg mixed tocopherols, 56 mg mixed tocotrienols]
Also Milk Thistle for detox/liver health, especially cuz the meds which are hard on my liver.
Also wondering about N-acetyl L-Cysteine which is an anti oxidant, not sure how important it is.
Also I’ve seen ubiquinol CoQ10 for heart health…?

• 5 HTP
• Lithium

And I’ve heard these can be good for energy - Resveratrol - NAD - DHEA - Pregnenalone - Mitochondrial Energy Optimizer with PQQ - Adrenal Energy
To anyone who is able to help, thank you so much in advance. I know that was a lot lol ❤️❤️ (Im 22 and my mom thinks there’s no way all of these can be good for me much less necessary 🙄)

Bloodwork is all normal, blood pressure all normal, non smoker
Meds I'm currently taking: lyrica 75mg maybe 3x weekly for breakthrough nerve pain in neck due to work accident, 40 mg methadone down from 140mg 12 years ago for OAT, 2.5mg bisoprolol for the mysterious heart issue and 1mg clonazepam up to 2x daily sublingual to calm my nerves for the 24-7 total dread the mysterious heart issue causes whenit flares up everyday. Now, To business:
Something is going on between my digestion and my heart that is making my heart beat race and not able to be slowed by controlled breathing. About 20-30 minutes after I eat literally anything I feel something in my center abdomen get tight/ pressure and my heart rate has gone as high as 150 at rest, doing nothing but digesting food. After about 2 hours I will start feeling gurgles or spasms in my center abdomen in about a 6 inch line just below my solar plex to just above my belly button but deep inside, to me it feels like something loosening up or relaxing, than once I get those sensations for a few minutes they completely go away and my heart rate quickly returns to between 65 and 77 bpm which is normal resting heart rate for me. I've been put on beta blockers (2.5 mg bisoprolol) and that has helped but not enough. And is just a band aid anyway. As the day goes on and I eat my 2nd and 3rd meal of the Day it happens less intensely and less intensely. But never doesn't happen by supper it'll go from about 65bpm to maybe 95-100bpm, stay there for about 2 hours, I get the gurgles (I dont know how else to describe the sensation) than about 10-15 mins later my heart beat eases up, palpitations go away and I'm back to about 65-77bpm again. It's causing me immense stress, can't go out to eat with family, constantly worried about having a major heart issue like arrest or something. Ive been to the ER probably 100+ times since it first started in January 2016. For about 2.5 years from 2019 to 2022 it hardly bothered me, now over the past 9 ish months it's worse as ever. I remember the what I was eating the very first yime it happened I thought I was having a heart attack. Montreal smoked meat on a toasted everything bagel with Swiss, lettuce, tomato, honey mustard. The last thing I ever ate stress free. Jan 12th 2016 at about 830pm. ECG after ECG just shows sinus tachycardia but normal rhythm. Something irritating my vagus nerve? Which is then irritating my heart or exciting it to the point it thinks in running a triathlon? I mean cmon 110-150 bpm for doing NOTHING but digestion...something is happening and no "doctor" can figure it out. I also get these weird gurgles or spasms that I can literally hear in and around the center of my chest/ heart area . Any ideas ANYONE?