Author Topic: The autoimmune theory is bogus  (Read 32087 times)

rosscb

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The autoimmune theory is bogus
« on: October 22, 2012, 03:23:12 AM »
The idea is that sperm are somehow protected by the testicular blood barrier and after ejaculation they come into contact with the immune system, and only after people ejaculate do they get allergic symptoms, but that can't be true.

The sperm in the ejaculate come from the seminal vessicles, if somehow the body was allergic to it's own semen then it wouldn't matter if you ejaculated or not because the immune system can react to whats going on in the seminal vessicles, the same would be true if you were allergic to your own prostate fluid.

So in conclusion, if your symptoms are cured with abstinence you can safely say that you are NOT allergic to your own semen.

The only theory that has any merit to it, in my opinion, is the semen regeneration theory. Obviously if only men get tired after orgasm then it has to have something to do with the semen.

For nearly three weeks I've been taking testosterone injections and every day things keep getting better.

I've had alot of tests done and everything points to hormones, my total testosterone was fine, but my free testosterone was at the bottom of the range, and my SHBG was high and over the range. Also my morning cortisol levels were on the low normal side, but my DHEA levels were high normal and my DHT levels were low.

My theory is that for some men sperm production and spermatogenesis takes alot of testosterone to take place and takes the testosterone that would normally be allocated to a man's health and puts it towards making sperm for the next generation, especially those with high sperm counts. After a week or two of celibacy SHBG goes down and free testosterone rises considerably which is why most men will feel a greater sense of wellbeing with abstinence.

If your body is constantly using your testosterone to make sperm and you don't have enough free testosterone for yourself then I believe the body starts to rely on cortisol and the adrenals. This fits in nicely with the classical taoist view of sexuality and the adrenals being very important for your 'jing'.

However testosterone therapy fixes this greatly in many ways, by increasing the amount of testosterone available and by greatly lowering sperm count. Over 95% of men on exogenous testosterone for life will either have no sperm in their ejaculate or very, very low sperm counts.

With high testosterone and free testosterone levels and low sperm counts your body will have more than enough hormones to play with and your adrenal levels will get back to normal by themselves

So in conclusion, my theory is that this is all to do with the testicular adrenal axis

Case closed :D


 
« Last Edit: October 22, 2012, 03:43:03 AM by rosscb »

kurtosis

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Re: The autoimmune theory is bogus
« Reply #1 on: October 22, 2012, 03:47:53 AM »
Absolutely agree! :)

In mice, exogenous testosterone (i.e. externally provided) reduces the activity of histidine decarboxylase (HD).
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1665824/
I'm not sure if this works the same for humans but I'll look it up.

HD does a very important thing, it enables the body to produce histamine from histidine. Reducing it's activity reduces histamine output, reducing the histamine load on the body, reducing inflammation reactions & reducing the requirement of the body to metabolise histamine which produces a toxic substance in the body (aldehyde).

My belief is that the actual release of semen has nothing to do with what looks like an allergic reaction following an orgasm. It's the release of histamine that's the problem, which happens ANYWAY following an orgasm.
This is commonly known. There is nothing controversial with saying histamine must be released following an O. http://www.livestrong.com/article/120565-histamine-effects/

So in my theory the POIS sufferer either produces too much histamine (hormone deficiencies) cannot metabolise histamine properly (due to inefficient methylation or ALDH deficiencies). EIther way, this affects the ability to clear the dopamine release following an O which also requires ALDH. Following an O you get rashes, flu like symptoms (uncleared histamine) and brain fog (uncleared dopamine metabolites - DOPAL).

 I think all this desens is doing is reducing the histamine production following an orgasm by some mechanism that's not clear yet. I don't believe we're allergic to our sperm at all. I've experienced POIS symptoms without actually ejaculating which doesn't seem at all likely if POIS only happens when semen is released.

Ccconfucius

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Re: The autoimmune theory is bogus
« Reply #2 on: October 22, 2012, 10:18:51 AM »
I get symptoms the from just having an intense sexual dream without orgasm.
« Last Edit: October 22, 2012, 10:30:07 AM by CertainlyPOIS »

demografx

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Re: The autoimmune theory is bogus
« Reply #3 on: October 22, 2012, 10:46:43 AM »
rosscb, excellent discussion, and great to see kurtosis' and CertainlyPOIS' remarks.

I found testosterone injectables stopped working for me. I've been told by my endocrinologist that patches and gel work much more "like the real thing", distributing T evenly throughout the body 24/7. Injections, he says, "spike" in and out of the system. I have been POIS-free about 3 years, via daily (365x) application of testosterone patches and antiinflammatory/mood meds.
« Last Edit: October 22, 2012, 11:12:04 AM by demografx »
10 years of significant POIS-reduction, treatment consisting of daily (365 days/year) testosterone patches.

TRT must be checked out carefully with your doctor due to fertility, cardiac and other risks.

40+ years of severe 4-days-POIS, married, raised a family, started/ran a business

demografx

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Re: The autoimmune theory is bogus
« Reply #4 on: October 22, 2012, 10:51:07 AM »
I get symptoms the from just having an intense sexual dream without orgasm.

I think this disputes the allergy theory well.
10 years of significant POIS-reduction, treatment consisting of daily (365 days/year) testosterone patches.

TRT must be checked out carefully with your doctor due to fertility, cardiac and other risks.

40+ years of severe 4-days-POIS, married, raised a family, started/ran a business

kurtosis

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Re: The autoimmune theory is bogus
« Reply #5 on: October 22, 2012, 02:33:25 PM »
I get symptoms the from just having an intense sexual dream without orgasm.

I think this disputes the allergy theory well.

I'm similar. I don't actually have to have an orgasm to experience POIS.
I wonder if we should do a poll on this (if we could get people to respond :))

haidcat

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Re: The autoimmune theory is bogus
« Reply #6 on: October 22, 2012, 02:46:37 PM »
In regards to sexual dreams, I have found that If I wear really loose boxers, as opposed to boxer briefs, I never wake up aroused or on the verge of having a NE. Do any of you guys find that tighter underwear= more likelihood of sexual dreams/NE?

Andy451

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Re: The autoimmune theory is bogus
« Reply #7 on: October 22, 2012, 04:17:31 PM »
The idea is that sperm are somehow protected by the testicular blood barrier and after ejaculation they come into contact with the immune system, and only after people ejaculate do they get allergic symptoms, but that can't be true.

The sperm in the ejaculate come from the seminal vessicles, if somehow the body was allergic to it's own semen then it wouldn't matter if you ejaculated or not because the immune system can react to whats going on in the seminal vessicles, the same would be true if you were allergic to your own prostate fluid.

So in conclusion, if your symptoms are cured with abstinence you can safely say that you are NOT allergic to your own semen.

The only theory that has any merit to it, in my opinion, is the semen regeneration theory. Obviously if only men get tired after orgasm then it has to have something to do with the semen.

For nearly three weeks I've been taking testosterone injections and every day things keep getting better.

I've had alot of tests done and everything points to hormones, my total testosterone was fine, but my free testosterone was at the bottom of the range, and my SHBG was high and over the range. Also my morning cortisol levels were on the low normal side, but my DHEA levels were high normal and my DHT levels were low.

My theory is that for some men sperm production and spermatogenesis takes alot of testosterone to take place and takes the testosterone that would normally be allocated to a man's health and puts it towards making sperm for the next generation, especially those with high sperm counts. After a week or two of celibacy SHBG goes down and free testosterone rises considerably which is why most men will feel a greater sense of wellbeing with abstinence.

If your body is constantly using your testosterone to make sperm and you don't have enough free testosterone for yourself then I believe the body starts to rely on cortisol and the adrenals. This fits in nicely with the classical taoist view of sexuality and the adrenals being very important for your 'jing'.

However testosterone therapy fixes this greatly in many ways, by increasing the amount of testosterone available and by greatly lowering sperm count. Over 95% of men on exogenous testosterone for life will either have no sperm in their ejaculate or very, very low sperm counts.

With high testosterone and free testosterone levels and low sperm counts your body will have more than enough hormones to play with and your adrenal levels will get back to normal by themselves

So in conclusion, my theory is that this is all to do with the testicular adrenal axis

Case closed :D


 
Good discussion for keeping treatment options open, but the case is certainly not closed until scientifically proven. You must remember, there are different types of POIS. To be perfectly clear, it does not matter in my case whether I ejaculate or not I always experience a baseline POIS symptoms which can change in terms of severity according to sexual arousal with ejaculation being the most severe. That being said, I realize the where "autoimmune" theories my run into problems.  I know that POIS is not as straight forward as the science may suggest specifically because there is not enough information out there, but do not discount an entire theory based on your personal experience. And remember autoimmune does not refer to one specific reaction, hormones are effected i varying levels depending on the individuals immunological response to a stimuli. There are too many variables to consider when just deciding you know an overarching solution to POIS. Your immune system and hormones play into each others roles in your body. We just need more data and do not need to discount possibilities at this point in time. I like your vigilance, but don't direct it at a theory you cannot disprove or prove on your own. Direct it towards giving sound advice, as you did with your hormone treatment. We all want to know whether the chicken or the egg came first, yet must work on a solution together and with professionals before being considered a real condition by mainstream society. Every single one of us knows the harsh realities of POIS, but scientific or medical funding is where real solutions and acceptance can be found, not though our own amateur opinions. We must work together for support, funding and research, but please don't discount theories. You have no business doing so unless people see your name in The Journal of Sexual Medicine with apple data to support your claim.
       So in fact you made a presumption based on personal experience not a "conclusion" which requires a sample size of people tested based on your original hypothesis. If your treatment is working for you than great, do not stop, keep getting better and please share what your doing. To reiterate though, do not claim you know the endgame of a theory unless you have real proof. A negative opinionated rant about anything we cannot control is unfounded and not productive and possibly confusing or offensive toward others on this site. Perhaps we should should just offer positive advice for one another about what works, organizing ourselves better and offering connections to professionals ; willing to work with us.    ;D
37 yo M- POIS for 25yrs (since age 12). Chronic POIS- always there

Tried desensitization for 1.5yrs & was unsuccessful (POIS worse at 1/1000)

 Exercising- (running/weights/situps) Low sugar diet. Supplements- limited success.Meds- Oxcarbazepine/Buspar (past-Depakote10yrs)

Ccconfucius

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Re: The autoimmune theory is bogus
« Reply #8 on: October 22, 2012, 05:22:08 PM »
In regards to sexual dreams, I have found that If I wear really loose boxers, as opposed to boxer briefs, I never wake up aroused or on the verge of having a NE. Do any of you guys find that tighter underwear= more likelihood of sexual dreams/NE?

never stopped it for me. I wear this super over sized jeans pant  for that reason and it never stopped it.  I thought maybe all the moving at night and rubbing the bed created arousal so i bought several layers of foam to raise me of my bed and created a nice size hole for my penis so it dosen't rub on anything. That to didnt work.  I think the brain is programmed to cause NE and it cant be stoped. Unless maybe with drugs like rapaflo.

Some claim not eating to much and watching out for fatty and spicy foods right before sleep should reduce NE. I never really tried it.
« Last Edit: October 22, 2012, 05:24:04 PM by CertainlyPOIS »

Nightingale

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Re: The autoimmune theory is bogus
« Reply #9 on: October 23, 2012, 09:39:52 AM »
I just learned that "both men and women treated with histamine supplements have reported increases in the quantity and quality of orgasms."

Read more: http://www.livestrong.com/article/120565-histamine-effects/#ixzz2A8J2RHEr

I think this explains a mystery of mine that I've thought about for a long time.  If I have a second O shortly after the first, anywhere within 6-8 hours or so of the first, the O is MUCH stronger AS WELL AS my symptoms.  The second O hits me like a hit of some amazing drug, only to make my POIS symptoms twice as bad.  A third O is the same, but it seems by that point I'm so suffering from POIS that I am like in a coma.

As pleasureful as the second O is, I've avoided it even with niacin.
Turmeric and Rosemary 30-45 minutes before orgasm for anti-inflammatory and immune support has helped me a lot. Faster and easier than niacin approach.

Ccconfucius

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Re: The autoimmune theory is bogus
« Reply #10 on: October 23, 2012, 10:48:15 AM »
I just learned that "both men and women treated with histamine supplements have reported increases in the quantity and quality of orgasms."

Read more: http://www.livestrong.com/article/120565-histamine-effects/#ixzz2A8J2RHEr

I think this explains a mystery of mine that I've thought about for a long time.  If I have a second O shortly after the first, anywhere within 6-8 hours or so of the first, the O is MUCH stronger AS WELL AS my symptoms.  The second O hits me like a hit of some amazing drug, only to make my POIS symptoms twice as bad.  A third O is the same, but it seems by that point I'm so suffering from POIS that I am like in a coma.

As pleasureful as the second O is, I've avoided it even with niacin.

In that same article it said mast cells collect in human genitalia during intercourse. May be why allergy so strong, if pois is an allergic reaction. I think it is time to look into mast cell stabilizers.

kurtosis

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Re: The autoimmune theory is bogus
« Reply #11 on: October 23, 2012, 10:52:22 AM »
I just learned that "both men and women treated with histamine supplements have reported increases in the quantity and quality of orgasms."

Read more: http://www.livestrong.com/article/120565-histamine-effects/#ixzz2A8J2RHEr

I think this explains a mystery of mine that I've thought about for a long time.  If I have a second O shortly after the first, anywhere within 6-8 hours or so of the first, the O is MUCH stronger AS WELL AS my symptoms.  The second O hits me like a hit of some amazing drug, only to make my POIS symptoms twice as bad.  A third O is the same, but it seems by that point I'm so suffering from POIS that I am like in a coma.

As pleasureful as the second O is, I've avoided it even with niacin.

Yes, the role of histamine in orgasms and allergic reactions is fascinating isn't it? It's almost like an orgasm is an allergic reaction but one combined with a huge dopamine surge. Stung by a thousand bees and a morphine hit at the same time :) The morphine is so good we're mostly willing to risk the bee stings!

Have a look at http://www.walshinstitute.org/Undermethylation.asp
and see how many of those factors you identify with.

kurtosis

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Re: The autoimmune theory is bogus
« Reply #12 on: October 23, 2012, 10:56:22 AM »
I just learned that "both men and women treated with histamine supplements have reported increases in the quantity and quality of orgasms."

Read more: http://www.livestrong.com/article/120565-histamine-effects/#ixzz2A8J2RHEr

I think this explains a mystery of mine that I've thought about for a long time.  If I have a second O shortly after the first, anywhere within 6-8 hours or so of the first, the O is MUCH stronger AS WELL AS my symptoms.  The second O hits me like a hit of some amazing drug, only to make my POIS symptoms twice as bad.  A third O is the same, but it seems by that point I'm so suffering from POIS that I am like in a coma.

As pleasureful as the second O is, I've avoided it even with niacin.

In that same article it said mast cells collect in human genitalia during intercourse. May be why allergy so strong, if pois is an allergic reaction. I think it is time to look into mast cell stabilizers.

See the concurrent thread on poiscenter at http://poiscenter.com/forums/index.php?topic=782.msg7160#msg7160

LAPOISSE

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Re: The autoimmune theory is bogus
« Reply #13 on: October 23, 2012, 11:45:45 AM »
Very interesting theory...it makes a lot of sense for me
how many persons have recovered by taking testosterone ?..Hearing testimonies, it seems more efficient than desens

Nightingale

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Re: The autoimmune theory is bogus
« Reply #14 on: October 23, 2012, 03:37:32 PM »
Have a look at http://www.walshinstitute.org/Undermethylation.asp
and see how many of those factors you identify with.

Lots.  "The presence of 30-50% of the factors may be sufficient for diagnosis."  I got 56%, and without those lab tests done.  I included past delusional beliefs that I had while psychotic.  The weirdest one is "high preponderance of male relatives."  This is sort of a going joke in my family, my entire generation is male with the exclusion of my sister.  All my cousins are male.

I had found some info on histadelia earlier but did not realize it was also undermethylation.  With this past week or so of info I've learned, I think I've got a landmark session with my psychiatrist ahead.  If things move in this direction enough, I will be asking him about colleagues at the NIH who could lend their expertise.
Turmeric and Rosemary 30-45 minutes before orgasm for anti-inflammatory and immune support has helped me a lot. Faster and easier than niacin approach.

kurtosis

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Re: The autoimmune theory is bogus
« Reply #15 on: October 23, 2012, 04:18:13 PM »
Have a look at http://www.walshinstitute.org/Undermethylation.asp
and see how many of those factors you identify with.

Lots.  "The presence of 30-50% of the factors may be sufficient for diagnosis."  I got 56%, and without those lab tests done.  I included past delusional beliefs that I had while psychotic.  The weirdest one is "high preponderance of male relatives."  This is sort of a going joke in my family, my entire generation is male with the exclusion of my sister.  All my cousins are male.

I had found some info on histadelia earlier but did not realize it was also undermethylation.  With this past week or so of info I've learned, I think I've got a landmark session with my psychiatrist ahead.  If things move in this direction enough, I will be asking him about colleagues at the NIH who could lend their expertise.

POIS may not be histadelia or there may be concurrent problems that are not specifically histadelic. However, I was over 30% also so by Walsh's quiz I'd be an undermethylator. I also have the high-achieving family and general allergy problems. When my POIS was bad I found myself feeling phobic about things that I never worried about before. It's odd. Very difficult to explain considering I'm a very rational person. Actually "hyper-rational" according to the psychologist I saw.

Anyway, if there's something to this theory then increasing methylation and mitochondrial energy production will improve the overall health (immune and energy levels) of the sufferer. Hence NADH & D-Ribose seem ideal. I'm back taking them as I couldn't wait for the anti-fungals to be finished.  It's like rocket fuel after a few days. You don't notice it the first day or so but the energy affect seems cumulative. There's probably enough methionine in my diet and also glutamic acid from my whey protein so it's possible that this gives a bigger energy boost as the ATP created by NADH and D-Ribose can help create SAM-e, glutathione and other helpful substances in my body.

In people where they don't work, then perhaps SAM-e would as that's the normal treatment for under-methylation. Again, neither of these things work immediately. You have to give it a few days.

Starsky

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Re: The autoimmune theory is bogus
« Reply #16 on: October 23, 2012, 06:03:13 PM »
Why taking L-methionine 500mg daily is bad?

kurtosis

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Re: The autoimmune theory is bogus
« Reply #17 on: October 24, 2012, 05:29:59 AM »
Why taking L-methionine 500mg daily is bad?
It's not but there's an optimum amount and I can't really calculate it because it would be different for each person with POIS.
It depends how much histamine is being produced that requires methylation. Basically, you could take 500mg a day and if you start to notice an improvement you could reduce it. You don't want to stay constantly at a high dose of methionine as too much SAM-e may actually cause cognitive problems.

That assumes the problem is methylation which it may be.
The histamine metabolism cycle is explained in detail at http://www.ehrs.org.uk/schwelberger.pdf

The first step in processing is methylation
Quote
Histamine N-methyltransferase (HMT, EC 2.1.1.8) catalyzes the transfer of a methyl group from S-adenosyl-L-methionine (SAM) to the secondary amino group of the imidazole ring forming N-methylhistamine (NMH)

The 2nd stem uses Diamine Oxidase to deanimate the resulting NMH.
Quote
Diamine oxidase (DAO, EC 1.4.3.6) uses molecular oxygen to oxidatively deanimate histamine to imidazole acetaldehyde, ammonia and hydrogen peroxide4.

And then the 3rd step that isn't mentioned is that your body has to get rid of the imdiazole acetaldehyde via the ALDH that I've mentioned in previous posts.

So that's 3 sets of genes controlling methylation, DAO and ALDH that can go wrong. I found some posts by somebody called Defsync last night (before I joined POIScenter) that suggested a problem with histamine metabolism. He decided it wasn't undermethylation but DAO. I think this is unlikely as the the NMH is a lot less damaging than the Imidazole acetaldehyde but it's possible too. But Defsync's ideas are very interesting.

Lots of things are possible. Histamine release triggers a cascade of the other chemicals to deal with it. For example histamine release triggers DAO. If you don't effectively methylate then the DAO (half life of about 2 hours I think) is either getting used up in other histamine reactions or isn't present to properly deanimate the NMH when it is produced (more slowly). If methylation takes place slowly then there's too much histamine in the blood and more chance of allergic reactions in places where there's likely to be receptors.

Also, I haven't been able to find out the precise mechanism for histamine release as part of an O. Normally, histamine gets released with a histamine storing cell (mast cell or basophil) meets an allergen. The mast cell has IgE antibodies attached and these tell the cell to release when they encounter the right allergen. (Or so I understand it). It seems sensible that a similar mechanism must trigger the histamine release at O but it's some kind of O-specific IgE. I need to research this more as it's outside my knowledge and I'm finding it difficult to find material in textbooks. Perhaps it's not fully understood, perhaps I'm looking the wrong place.

Anyway, what's happening to all this histamine. What if we can't deactivate it fast enough and it's ending up causing the allergic reaction. Women get the sex face flush more than men and some get allergic responses from it. Runny nose etc. What if the difference between female and male sex response is testosterone and faster methylation.

Of course too much circulating histamine is a bad thing as it's part of rate limiting the synthesis of neurotransmitters in the brain via the H3 receptors. Quite why POIS sufferers would be so affected I'm not sure but it may be to do with prostaglandin e2 to e1 imbalance which encourages over production of histamine. Too much histamine, too much acetaldehyde which affects PGE1 synthesis from GLA which exacerbates the problem of a low PGE1 to PGE2 ratio.

Also, some interesting information and theories at http://orthomolecular.org/library/jom/1985/pdf/1985-v14n03-p162.pdf

So from reading all this I have the following ideas.
- Increasing methylation seems a very good idea but should probably be supported by b3 (or NADH) to assist in the clearing the aldehyde produced when NMH is deanimated. This should reduce POIS symptoms.
- The main cognitive symptoms may be the result of histamine causing rate limiting on neurotransmitters required for alertness via the H3 receptor action.
There is a medicinal plant called Mangosteen which may reduce PGE2 and histamine
http://www.ncbi.nlm.nih.gov/pubmed/12230104
OR
there are H3 receptor antagonists that would stop the POIS brain fog by acting on the H3 receptor.
See http://en.wikipedia.org/wiki/Histamine_H3_receptor 
e.g. Cirproxifan

B_Daniel

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Re: The autoimmune theory is bogus
« Reply #18 on: October 28, 2012, 02:11:31 AM »
I used to see a very well known internal medicine doctor with a phd in sexual medicine.  he never said the autoimmune theory is bogus, but he said many times that it makes absolutely no sense that the body flares up in response to the allergen (semen) leaving the body.  At the time I was a bit annoyed by him saying that, as I was a big supporter of the autoimmune theory.  Now though, after numerous skin prick and intradermal tests with no significant reaction, and a few months of SLIT with no positive results, I think that all the time I spent viewing POIS through the lens of an allergy was i giant waste of time.  I'm currently focused on neurotransmitter and hormonal imbalances.

kurtosis

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Re: The autoimmune theory is bogus
« Reply #19 on: October 28, 2012, 05:25:27 AM »
Why taking L-methionine 500mg daily is bad?

I'm taking the methionine more often now. 500mg / day. I couldn't get enough from food it seems. As I've increased the dose I've felt better and calmer.

To explain the chemistry at work here. The basic formulas are the one for glycosis.
Quote
Glucose + 2 NAD+ + 2 Pi + 2 ADP → 2 pyruvate + 2 NADH + 2 ATP + 2 H+ + 2 H2O + heat
See http://en.wikipedia.org/wiki/Cellular_respiration
So NADH helps increase ATP, see the Krebs cycle.

and (very roughly)

Quote
Methionine + ATP → SAM-e

You can think of SAM-e as a kind of universal methylator which assists in the methylation (donation of a methyl group ) to various neurotransmitters including histamine. Methylation is the first step in your body clearing histamine. The 2nd is deanimation and the 3rd is the conversion of the aldehyde byproduct into acetic acid. To achieve all this efficiently you need various B vitamin co-factors and healthy cellular energy (ATP).
Things which boost ATP are NADH and D-Ribose powder. Creatine donates a phosphate to ATP to help recycle the ATP that's created using NADH and D-Ribose. Some athletes combine Creatine and D-Ribose for a big energy boost.

So my sketch idea is the following. 
- Lower histamine using methionine or SAM-e.
- Take b vitamins as they are required co-factors in many enzymatic reactions triggered by methylation. The v vitamin I take has coq10 as this is depleted in many illnesses and helps immune function.
- Increase ATP to help the body recover. If the histamine is caused by an underlying infection then the body has some chance of fighting it with more ATP. By adding NADH and D-Ribose from external sources (i.e. supplements) you're giving your body something that it would have to use precious energy to create.  If high histamine is caused by a genetic defect in the methylation process then taking SAM-e should sort that out.

There are people who have made huge improvement in dealing with chronic fatigue syndrome by just adding NADH and/or D-Ribose. I hadn't thought of myself as chronically fatigued until I started taking NADH and D-Ribose and realised that there were lots of active things that I used to do that I had stopped because I felt tired. This is not normal for someone in their mid 30s. If you feel tired, don't want to go out etc. that's not normal and it's gotta be put right!

It wasn't always that way but this illness became worse since my late 20s and I think that has a lot to do with a decrease in hormone production and fatigue.

I think the reason why TRT works as a treatment is that POIS is actually something our body is continually fighting, which leads to inflammation and "cortisol steal". Untreated POIS would therefore naturally lower testosterone levels.  It may be viral or it may be just a genetic inefficiency but the end result is that we end up being in an "allergic" state. This does not mean that I think anyone is allergic to sperm. It's is 100% known that histamine is released during an orgasm anyway. The allergist I spoke to said she already had women patients with some allergic reactions following orgasm it's just that they're not that severe (but some suffer headaches, some get rashes, signs of nasal allergy etc.). She told me that  you don't need an allergy to sperm to produce histamine during an orgasm. A simple google confirms this.

It is also understood that the H3 histamine receptor will inhibit both histamine and the release of other neurotransmitters in the brain
This is why novel drugs like http://en.wikipedia.org/wiki/Ciproxifan are being produced that threat attention disorders &/ dementia via the H3 receptor.

It has been suggested that testosterone may inhibit the allergic reactions in men so increased testosterone may lower histaminergic reactions but the occasional orgasm related rash or flush in some men does happen. What if POIS is just that but ramped up because we have too much circulating histamine ANYWAY?

The Raising ATP and lowering Histamine path is not a quick fix by any stretch of the imagination. It's giving the body a chance to recover and assisting the body's natural healing processes by giving the cells the thing they most need to heal (energy).

If you have high histamine and reduced ATP output, you may get infections. Increasing ATP output and reducing histamine may actually make you feel sicker for a few days (or even more than a week) like I felt during the anti-fungals.

People with above average levels of histamine are very driven apparently but, one of the problems with this, is that high-histamine types often have unrealistic expectations. For example, people who are taking SAM-e to reduce the effects of osteoarthritis inflammation don't expect to take it for a day or so and play professional soccer :) But I can see numerous examples of people on NSF saying
"I took X and I had a bad orgasm so X obviously won't help with POIS".
This is like predicting the average rainfall for the year based on one day :) but it's symptomatic of our personalities and the neurotransmitter balance that produce POIS (and that includes histamine). It's one reason why doctors think we have anxiety disorders.

Some of us come into them with histories of what most people would consider solid or even outstanding academic achievement and say we have a serious physiological problem and can't think. In some cases, we're probably smarter and more driven than the doctors themselves. The doctor assumes you're nuts and doesn't question what genetic or physiological conditions may produce someone who is clearly smart but knows they could be smarter if not for a problem that's holding them back. I believe the thing that's driving us to beat POIS may be the thing making us sick but it's not "psychological". 

My own expectations involve looking at every week and seeing did I have more energy on average and did I function better in work. If I can't decide whether I improved or disimproved that week, I decide to be positive about it and assume it was better. The next trend is monthly. Daily trends tell me nothing.