Hey Dan.
For the K-bicarb, I would suggest starting at 1/2 tsp dissolved in 1-2 cups juice (something acidic), which will become a carbonated juice, to be drunk with each meal. OJ, apple juice, or whatever will work. Let the bubbles dissipate mostly, which should take a couple minutes after stirring the K-bicarb in. Theoretically, taking enough to bring your total ‘net endogenous acid production’ (NEAP) to zero would be ideal. This would depend on what you eat. But 1/2 tsp K-bicarb 3x daily with meals is a good guideline for most people, I think. You can always adjust from here.
I would also say that persons with adrenal insufficiency problems, which may be a big part of CFS, have a hard time expelling potassium and tend toward high potassium in the blood, even if tissue levels are low. Increasing blood potassium normally results in increased aldosterone secretion from the adrenals, which then increases potassium excretion, increases potassium uptake into tissues, and decreases sodium excretion. Thus, if one has healthy adrenals, increasing dietary potassium may actually lower sodium needs to a point. However, if one’s adrenals are not up to par and/or if ‘aldosterone resistance’ is present, then the increased blood potassium will lead to a natiuresis (a wasting of sodium into the urine), which will lower blood volume, drop blood pressure, and make you feel terrible. Independent of aldosterone, alkaline (from the bicarb) helps increase potassium uptake into cells, so K-bicarb is much less likely to cause this problem than K-chloride would. However, it should be guarded against when first supplementing with the K-bicarb. So, I recommend eating and/or drinking plenty of salt throughout the day to ensure the potassium isn’t lowering blood sodium. You can do this any way you want, including adding salt to your juice mix, or drinking salted water or whatever. But 20-40 grams of salt daily is not unreasonable for Addison’s or hypoaldosteronism patients.
As I said before, magnesium may also be needed. So, in sum, I recommend 1/2 tsp K-bicarb dissolved in at least 1 cup juice with each meal, along with ample salt and some magnesium. Ultimately experimentation is needed to sort out the ideal ratios and so on. Using sodium bicarbonate (baking soda) is a way of adding extra alkaline without the potassium, and perhaps one day you decide to do a combo of potassium and sodium bicarbonates, and other experiments. But for starters, I would recommend keeping it at potassium bicarb and sodium chloride since that is how the minerals come in foods and nature most often.
Many of your symptoms–dry, sensitive eyes; poor peripheral circulation; potential diabetes–sound like they could be Sjogren’s like issues and ‘mixed connective tissue disorder’. From some of the things I’ve read, the symptoms of Sjogren’s–which is said to be an autoimmune issue of secretory and excretory glands–are manifestations of acidosis, which is induced due to kidney damage. I would think fixing the acidosis with bicarbonate supplements could solve the eye, skin, and circulation problems. It will be interesting to see if you notice any benefit. Of course we both will be hoping for good improvement in your symptoms.
For digestion, you mentioned ox bile. Sure, try whatever. Some studies indicate taurine can glycine can both help increase bile acids, which can assist with fat digestion. But I would not assume that this will make you ‘handle’ fat better. In fact it may make you feel worse after eating fat, depending on why it is you feel worse after eating fat. If it is the absorption of endotoxin from the intestinal lumen, then any emulsifier (phospholipids from egg yolks, ox bile, or your own bile) will likely increase endotoxin influx and make your symptoms worse. But there are other possible causes of your problems, so giving ox bile a try is not a bad idea. And remember, fat needs alkaline to help digest (lipase enzymes from pancreatic excretions require an alkaline environment), so metabolic acidosis and/or too much betaine HCl with meals may severely hinder fat digestion, independent of emulsifying agents. Keep that in mind.
For your eyes and sleep, perhaps you would find a blue-light filter on your computer helpful? I know I have benefited from a blue light filter on my computer. I use F.Lux, but there are also others. I put the ‘color temperature’ usually to 2700 on bright sunny days when I have the windows open, and 1900 otherwise. Melatonin synthesis is also inhibited with blue and green light peaks, so yellowish-orangeish-redish lights before bed are likely best. A healthy person may not be bothered, but I have found it helps. It’s free and something to consider.
As for people in the Seattle area: I grew up in the Seattle area, myself. Though I don’t have any recommendations for doctors or persons to get in touch with, I would say to anyone and everyone that many (though not all) churches offer a number of supportive programs to those with disabilities and financial troubles. Catholic churches vary considerably in their help based on the assigned priest and the parishioners; Mormon churches, especially wealthy ones in upper-middle-class venues may be the best bet for getting support. Some may take offense to me saying this, but our society does not have great out-reach programs for those who, through no fault of their own, fall through the cracks, especially those with serious physical disability. The goal should always be to get back on one’s feet, and I think you can get there. But even if all goes well, it won’t happen overnight. And just surviving in the meantime, as you well know, can be near impossible. Many Mormon and Catholic churches often have support programs for persons who are not even attending or registered parishioners. Many other groups force attendance in order to get any help, which, while I understand, is less helpful for most.
Hopefully you will notice benefit soon from alkaline potassium, and perhaps soon you’ll be able to tolerate egg yolks in your diet. I am less concerned with absolute levels of fat in your diet than I am with choline-rich fats (yolks, liver) and the EFAs ARA and DHA (again, yolks and liver). While it’s not cheap, desiccated liver is a convenient option for people on the run or who can’t stand liver taste but want the health benefits of liver. It’s very low total fat but high in the phospholipids, so it may (or may not) be something you could tolerate better.
http://www.perfectsupplements.com/Perfect-Desiccated-Liver-p/desiccatedliver120.htm
I wish you well. Stay strong. Keep in touch. I’ll be here if you have any questions for me, but I’m afraid I don’t have the answers. But perhaps you can pick up a thing here or there from me and from others and from your own experimentation and ultimately find some good answers. But I enjoy our dialogue so don’t be a stranger.
Peace, CP