Monday, July 7, 2008

Eden: Liver = Heart


HOOVERPHONIC: Eden
Which Samurai with his spunky
spiky haired-side kick deftly defeats PLAQUE?
video
Courtesy of Youtube.com



Eating is definitely a sensory activity that starts with the brain-- have you heard that saying 'eating with your eyes'? Have you ever given your liver much thought while you consuming your meals or snacks? Ever wonder where does the food go before it hits the bloodstream?

In fact, the human liver is the largest internal organ comprising of 3 lobes and receives all the blood after a meal from the stomach and intestines via the portal vein. How does the body sense abundance in the environment?

Through the eyes? No... ye ol' LIVER...

If food (quantity and quality and composition) serves as one of the cues from our external physical environment, then the liver and the PPAR receptors located there there are the sensors of the degree of energy abundance/scarcity. What elements are essential for life outside of air? Food -- water -- light.... Similarly, what senses light? It is likely that VDR (vitamin D receptor) plays an equally important and parallel role. Abundant sunlight for most countries near the equator typically signals abundant food/energy. Vitamin D does rev up energy, productivity, and *hey* fertility! Naturally it follows that the skeletal muscles are the sensor for muscle movement and certainly the PPAR receptors in skeletal muscle do a great deal to command the balance of energy demand and supply/thermogenesis.

What might the holy trinity of human energy look like? mTOR--PPAR--VDR ? How might it have been shaped in our 'evolutionary heritage'...??? (thanks for the term Grey Whale!)

Well, we certainly know a lot of about what contribute's to this trinity's dysregulation...

  1. Lean-muscle-and movement-deficiency

  2. Wheat/grains consumption (including excessive fruit/FRUCTOSE too)

  3. Vitamin D3/sunlight deficiency



Even statins improve this trinity... by activating (!!) PPAR ... This special anti-inflammatory and MMP-stabilizing effect occurs specifically at the macrophage level and for plaque, this translates directly to the surface, volume and core of plaque atheroma. The pleiotropic benefits of statins can now be attributed to a direct activation of PPAR on macrophages via the MAPK pathway.



Paumelle R, Staels B. Peroxisome proliferator-activated receptors mediate pleiotropic actions of statins.Circ Res. 2007 May 25;100(10):1394-5. No abstract available. (see Diagram: Cross-talk of statins/ PPARs in the antiatherogenic properties of statins -- PDF here) PMID: 17525375

Yano M, Matsumura T, et al. Statins activate peroxisome proliferator-activated receptor gamma through extracellular signal-regulated kinase 1/2 and p38 mitogen-activated protein kinase-dependent cyclooxygenase-2 expression in macrophages. Circ Res. 2007 May 25;100(10):1442-51. PMID: 17463321

Paumelle R, Staels B, et al. Acute antiinflammatory properties of statins involve peroxisome proliferator-activated receptor-alpha via inhibition of the protein kinase C signaling pathway.
Circ Res. 2006 Feb 17;98(3):361-9. PMID: 16397146


Landrier JF, Thomas C, et al. Statin induction of liver fatty acid-binding protein (L-FABP) gene expression is peroxisome proliferator-activated receptor-alpha-dependent.
J Biol Chem. 2004 Oct 29;279(44):45512-8. PMID: 15337740


Verreth W, De Keyzer D, et al. Rosuvastatin (INCREASES mRNA of PPAR-GAMMA AND) restores superoxide dismutase expression and inhibits accumulation of oxidized LDL in the aortic arch of obese dyslipidemic mice. Br J Pharmacol. 2007 Jun;151(3):347-55. PMID: 17384667

Roglans N, Sanguino E, et al. Atorvastatin treatment induced peroxisome proliferator-activated receptor alpha expression and decreased plasma nonesterified fatty acids and liver triglyceride in fructose-fed rats. J Pharmacol Exp Ther. 2002 Jul;302(1):232-9. PMID: 12065722

Sanguino E, Roglans N, et al. Atorvastatin reverses age-related reduction in rat hepatic PPARalpha and HNF-4. Br J Pharmacol. 2005 Aug;145(7):853-61. PMID: 15912134



In historical texts (ie, the Bible), the liver was actually considered 'the heart.' And, in the ancient days, harm to the liver was actually worse than to the heart. How were they so wise (without high tech ALT/AST tests or abdominal u/s) ??! For warriors, the liver was an easier, bigger target to hit than the smaller heart. We often neglect this fantastic vital organ. Interestingly, when the trinity is disrupted, this organ becomes metabolically deranged even before the heart.


Here are the liver's awesome functions and roles:
  • first pass effect = all blood during digestion is maximized to flow through the liver. Perhaps this is the role after meal apertifs, Greek grappe or (!!YUM)aged port have -- they relax, increase Vagal communications to the GI system to further shunt blood flow to the stomach and intestines for digestion

  • cytochrome P450 -- detox's, purifies everything we eat including plant toxins and exogenous chemicals like drugs (explains why oral estrogen can worsen HDLs whereas topical/transdermal estrogen improves and RAISES HDLs by bypassing the liver route)

  • cytochrome P450 activates and processes everything we eat including all food components and neutraceuticals (vitamin D3, essential fatty acids, protein)

  • energy sensor (carbs, fats, proteins, alcohol, caffeine, etc -- all my favorite food groups)

  • ultimate CONTROLLER in the financial as well as airtraffic sense because the liver contains the highest concentration of PPAR receptors: alpha, gamma, and D-E-L-T-A (aka beta)

  • producer of lipoproteins which are the energy 'traffickers' for the immune system, skeletal muscles and even brain (which relies on ketones/fatty acids when blood glucose (BG) is naturally lower)

  • producer of TGs -- the lipoprotein fraction where carbohydrate-energy (dietary carb +/- fat) is bundled into for transport to the rest of the body (including clogging up the heart tissues and arteries). Recall that TGs is the second RISK FACTOR most highly associated with plaque. First is... fasting insulin levels.




















  • regulates and synthesizes cholesterol which is the template of EVERY nuclear steroid (and some aromatases, desaturases, and cyt P450 are under the control of VitaminD3) -- steroids like testosterone, estrogen, cortisol -- and composes the structural backbone/shell of every cell in our body and in particular the brain/nervous system which is comprised nearly entirely of cholesterol and fats (should pregnant moms eat 'low fat'? do pregnant moms want brain-deficient, cognitively-challenged children?)

  • vitally crucial for producing mannose-binding lectin (MBL) which is an activator of our host defenses in the innate broad-spectrum non-specific immune system (which fights virus, bacteria, and other foreign invaders including FRUCTOSE attached to our own cells) ; 'fruct-osylated-cells' aint good... sounds pretty bad eh? indeed VERY BAD

  • first organ to become unhappy when carbohydrates are excessive ('fatty liver', NAFLD, NASH, etc); see diagram above

  • one of the most prized organ meats and delicacy (in indigenous cultures and our household with a little soy sauce and honey) highly valued for its nutritional content of metabolically-active and heart protective Vitamins K2, D3, A, E and other essential nutrients and minerals.





In a recent Circulation article, researchers are elucidating the important role of Von Willebrand factor (VWF) in acute coronary syndromes (ACS).

"von Willebrand factor (VWF) plays a pivotal role in platelet adhesion and aggregation at sites of high shear rates (eg, in coronary arteries that have stenotic or ruptured atherosclerotic plaque lesions). Numerous studies have investigated the relationship between VWF plasma levels and thromboembolic cardiovascular events. In contrast to the rather weak association in the general population, in patients with preexisting vascular disease, VWF is significantly predictive for adverse cardiac events, including death. Likewise, VWF typically rises during the course of acute coronary syndrome, and the extent of this VWF release is an independent predictor of adverse clinical outcome in these patients. Various lines of evidence indicate that VWF is not only a marker but also actually an important effector in the pathogenesis of myocardial infarction. This central role of VWF in thrombogenesis has made it a promising target for research into new antiplatelet therapies that specifically inhibit VWF (AND BLAH BLAH BLAH... DRUGS)..."


How is VWF related to the thrombosis and clotting effects in our blood vessels? Obviously there is a healthy balance. Those with VWF deficiency have bleeding gums, mucus membranes and bleeding under the skin.

Is the liver involved? It appears the liver is involved in everything!

Platelets require the intervention of a blood protein known as Von Willebrand factor (vWF), which facilitates platelet adhesion to the sub-endothelial matrix of damaged, exposed endothelium. When the liver is aged, i.e. metabolically/oxidatively affected, a corresponding increase in vWF occurs intrahepatically (see below). Can this also occur systemically? To the coronary arteries? Or carotids? If we keep the endothelium of one of our most vital organs, the liver, happy... clear and uncongested, then endothelium elsewhere is likely to be protected as well. Prevent hardening of the liver, and you'll prevent hardening of the arteries. Reverse liver damage, and you'll reverse artery damage.

Timing as usual makes a difference. Even young-obese children are displaying NASH/NAFLD and early changes in myocardial structure such as diastolic dysfunction/heart failure.

The below changes including the increase in vWF from the endothelium in the liver blood circulation sounds a lot like instigation of arteriosclerosis of the liver...


Love your liver... and both hearts will appreciate it...

Ways to maximize liver function and productivity:
** Movement, play, movement, work, intervals of intensity, play, grow your muscles... especially with our children. 'The family that plays together, stays together...and doesn't have heart attacks together,' quoted by a member at my CF gym
** Complete Wheat/Grain avoidance and minimal fruit
** Adequate vitamin D3 (achieve: 25(OH)D 60-70 ng/ml)


Old age and the hepatic sinusoid.

Anat Rec (Hoboken). 2008 Jun;291(6):672-83. Le Couteur DG, et al.

Morphological changes in the hepatic sinusoid with old age are increasingly recognized. These include thickening and defenestration of the liver sinusoidal endothelial cell, sporadic deposition of collagen and basal lamina in the extracellular space of Disse, and increased numbers of fat engorged, nonactivated stellate cells. In addition, there is endothelial up-regulation of von Willebrand factor and ICAM-1 with reduced expression of caveolin-1. These changes have been termed age-related pseudocapillarization (SOUNDS TO ME LIKE CALCIFICATIONS AND ARTERIOSCLEROSIS). The effects of old age on Kupffer cells are inconsistent, but impaired responsiveness is likely. There are functional implications of these aging changes in the hepatic sinusoid. There is reduced sinusoidal perfusion, which will impair the hepatic clearance of highly extracted substrates. Blood clearance of a variety of waste macromolecules takes place in liver sinusoidal endothelial cells (LSECs). Previous studies indicated either that aging had no effect, or reduced the endocytic capacity of LSECs. However, a recent study in mice showed reduced endocytosis in pericentral regions of the liver lobules. Reduced endocytosis may increase systemic exposure to potential harmful waste macromolecules such as advanced glycation end products. Loss of fenestrations leads to impaired transfer of lipoproteins from blood to hepatocytes. This provides a mechanism for impaired chylomicron remnant clearance and postprandial hyperlipidemia associated with old age. Given the extensive range of substrates metabolized by the liver, age-related (I.E. METABOLIC DEREGULATION) changes in the hepatic sinusoid and microcirculation have important systemic implications for aging and age-related diseases.
PMID: 18484614

25 comments:

Andrew said...

Don't the benefits of consuming fruits outweigh the possible negative impacts on one's liver, given a diet that seeks to avoid wheat already?

Dr. B G said...

Hey Andrew,

No...(and I LOVE blueberry pie)

Our bodies evolutionarily were designed to grow very fat with fruit. We're not meant to eat/drink gatorade or fruit (nature's candy/JUNK FOOD) all day long. Fruit/fructose is actually worse than table sugar biochemically (pls see below). Hundreds of studies like this exist.

Berries, like blueberries, have a little less carbs then bananas, grapes and other fruits, so they are maybe a little more permissible imo. Much fruit has been genetically engineered or bred to have very high fructose content and are bigger than the fruit that we grew up with... probably not great for us.

I'd prefer to get my antioxidants from seafood, nuts/seeds, fish oil, egg yolks, grass fed beef/milk, and organic locally grown veggies. And supplements!

Fructose I believe sets off our immune system if excessive. An overactive immune system causes plaque to grow exponentially. For those with plaque, we need to minimize and control inflammation. That is the singlemost important key to regression. Many bacteria/virus/ prokaryotes have fructose or mannose on the outside of the cell membranes. Our innate first line host defense recognizes this as 'foreign'. Recognition subsequently sets off the immune system via complement and MBL (mannose-binding lectin). Unfortunately, I believe when fructose from our diet spills through the liver via the first pass effect for dietary meals, our immune system gets a big 'orange alert' that TERRORISTS are in the VICINITY. You know what I suspect then happens? Like the airports and bridges after 9/11 an overexaggerated security system stops all traffic and causes congestion.

Hey, my dad was a medic for the cornhuskers for 1-2 seasons! That's one of the proudest moments for him :) I was born in Lincoln.

BTW did you check the Gladiator post??
http://drbganimalpharm.blogspot.com/2008/06/wheat-raises-insulin-and-upregulates.html

J Nutr. 2008 Jun;138(6):1039-46.
Dietary sugars stimulate fatty acid synthesis in adults.Parks EJ, Skokan LE, Timlin MT, Dingfelder CS.

The goal of this study was to determine the magnitude by which acute consumption of fructose in a morning bolus would stimulate lipogenesis (measured by infusion of 13C1-acetate and analysis by GC-MS) immediately and after a subsequent meal. Six healthy subjects [4 men and 2 women; aged (mean +/- SD) 28 +/- 8 y; BMI, 24.3 +/- 2.8 kg/m(2); and serum triacylglycerols (TG), 1.03 +/- 0.32 mmol/L] consumed carbohydrate boluses of sugars (85 g each) in a random and blinded order, followed by a standardized lunch 4 h later. Subjects completed a control test of glucose (100:0) and a mixture of 50:50 glucose:fructose and one of 25:75 (wt:wt). Following the morning boluses, serum glucose and insulin after 100:0 were greater than both other treatments (P < 0.05) and this pattern occurred again after lunch. In the morning, fractional lipogenesis was stimulated when subjects ingested fructose and peaked at 15.9 +/- 5.4% after the 50:50 treatment and at 16.9 +/- 5.2% after the 25:75 treatment, values that were greater than after the 100:0 treatment (7.8 +/- 5.7%; P < 0.02). When fructose was consumed, absolute lipogenesis was 2-fold greater than when it was absent (100:0). Postlunch, serum TG were 11-29% greater than 100:0 and TG-rich lipoprotein-TG concentrations were 76-200% greater after 50:50 and 25:75 were consumed (P < 0.05). The data demonstrate that an early stimulation of lipogenesis after fructose, consumed in a mixture of sugars, augments subsequent postprandial lipemia. The postlunch blood TG elevation was only partially due to carry-over from the morning. Acute intake of fructose stimulates lipogenesis and may create a metabolic milieu that enhances subsequent esterification of fatty acids flowing to the liver to elevate TG synthesis postprandially.

PMID: 18492831

Take care!
BG

Andrew said...

So what happens if fruit is consumed with a very active lifestyle? I exercise a LOT (perhaps too much, with high-intensity cardio 11 hours per week, but such is the nature of playing a sport you love), and I try to avoid carbs as much as possible. However, I simply don't perform as well if I don't consume a banana and oranges before such intense exercise. Am I to understand that I should just deal with the lower performance and exclude this fruit from my diet altogether?

Dr. B G said...

Stephen Phinney, UC Davis emeritus professor, has written some articles about training in ketosis. It's quite possible and in fact I think performance improves when our bodies have trained to effectively use fatty acids (instead of relying on glucose and glycogen only which are just 'kindling').

RobbWolf.com and the Atkins Advantage are written by athletes who advise intensive exericse without excessive carbs (incl fruit). The Atkins author in fact has done the IronMan several times and placed in the Ultra-Ironman! The general range for carbs (from vegs, low GI fruit, oat bran, etc) is < 20-40-60 g/day dep on wt loss/maintenance/body fat re-composition.

Personally I'm still experimenting with my endurance events (1/2 marathons, tri's). I noticed I do better without GU and don't bonk if I train sans meals. Getting acclimated may take several weeks of training is my observation (been doing now for ~2mos). Others how are really conditioned notice in fact improvements in performance IMMEDIATELY. Now I only bonk if I cheated and ate too many carbs on the wkend... sucks...

In my opinion it's not necessary for performance to suffer (and this is the observation for many people I know who intermittent fast and do Crossfit).

For you to best know if the carbs are affecting your lipoproteins, heart health and cardiac risk, check out your TG/HDL ratio which is a good surrogate for insulin sensitivity and presence of small dense LDL (except for those with hetero- or homozygous FH and exaggerated risk for famililial hypertrig). TG/HDL < 0.50-0.60 is optimal. For more reassurance/evaluation, even better to check out the calcium burden on EBT (radiation is minimal equivalent to ~3 Xrays; 30-sec test). DR. Davis advises > 40 men, > 45 yo for females (or earlier if any premature CAD in the family).

Let me know how it goes it you experiment!

-G

Andrew said...

Well, my most of exercise is of the sprint variety (soccer mostly). I could definitely see a benefit with an endurance activity, because that makes sense.

Correct me if I'm wrong, but it's my understanding that in activities with extremely high heart rates (mine is anywhere from 150-190 while playing), fat isn't used as the primary fuel source, hence the carbo-loading theory. If I don't consume a large number of carbs before I play, I always seem to "run out of gas" after about half an hour. I've tried it for a couple of weeks to go without, but if it truly takes as long as you say to properly acclimate, I fear I may never reach that point, as my competitive drive regularly overrides my good sense.

Dr. B G said...

Actually, according to my understanding (which is hampered by my poor physics/biochem) the energetics of both the heart and skeletal muscles prefer fatty acids, not glucose. Glucose only becomes preferred for brief seconds during anoxia to protect the heart by preventing free radicals. The 'nuclear energy' for the body is actually fat -- our stored white adipose (long term storage depot) and fatty acids in skeletal muscles/liver (temporary storage from carbs/fat). If you train on an empty stomach, you train the body's machinery to tap immediately and quickly into all the fat stores. For long endurance events, our bodies always go a little ketotic. Did you know we are a little ketotic on some mornings? The brain relies on only 2 energy sources -- glucose and ketones. The body easily switches depending on what's going on.

Just living generates free radicals. The trade off with more powerful energy like nuclear/fatty acids is more pollution. But the body has several layers of 'self-protection' which include antioxidants from food -- vitamin E, flavanoids from food, and the (!!best) EPA DHA from fish oil. The multitude of double bonds on these long chain fatty acids accept the damage from many electron donors like pollution generated from fat utilization and disposal. Many athletes take fish oil... did you know?

I've been experimenting the last 2-3 wks and finished a half-marathon yesterday (although I didn't train and got in < 10 miles/wk). I have to say that performance was a little hard despite hitting a PR at this race. People say acclimiting takes several wks. The recover from this race was the best ever -- no achiness, no sore tired feeling at all, no tight hams!

Have you heard how we have maximal hormone secretion with 'muscle confusion'? I think also that maximal hormonal controls occur with random, mixed up eating times. Matching veggie-carbs with protein at meals/snacks is a good way to balance (the hormones). Zone/Paleo is the way to go!

-G

Dr. B G said...

BTW Mark at OD life is awesome (and an endurance athlete like you)...

http://projectfit.org/iflifeblog/2008/07/11/insulin-and-sugar-the-one-hormone-you-need-to-control-and-the-one-enemy-you-need-to-avoid/

Andrew said...

I'm still not sure I am totally convinced of being able to perform at my best without carbs, but I am willing to give it a go. As I'm still young, I don't find recovery from athletic events a problem, so I won't be able to use that measuring stick ;)

BTW, the link you posted for projectfit.org is a bit too long and I can't click it for some reason. Thanks for the info and keep up the great work!

Dr. B G said...

Yeah, I'm still figuring the adaptation part...

Ok... sorry about the link -- try cut and pasting...
http://projectfit.org/
iflifeblog/2008/07/11/
insulin-and-sugar-the-
one-hormone-you-need-to-
control-and-the-one-enemy-
you-need-to-avoid/

Hope that works! I'll probably make a link on a post soon since Mark's info is so GOOD.

Thank you for your kind words. Let me know how it goes!
G

Dr. B G said...

Try this link

mathman said...

I do not consume any wheat/starch and my typical carb intake is around 50g per day all from veggies. what should I make of elevated ALT/AST enzymes( in the 60's)? I am eating clean, mostly saturated fats I believe, and an ultrasound showed no damage. I want to keep my liver in tip-top shape so what should I do?

Dr. B G said...

Hi MathMan,

How long have they been elevated and what's your weight/height? Any medications, supplements you are taking?

Thanks,
G

mathman said...

I have only discovered it 4 months ago while learning that my cholesterol has doubled over the past year. Tri-66 LDL-160 HDL-69. I take fish oil,Lipoic Acid, CoQ10, Vit. E, Magnesium, and Vit. C for supplements and testosterone cream for drugs (androgel).
Liver inflammation is scaring me. My tests also came back mildly anemic and my white blood cell count is low as well (3.8). All of this as I am fanatical about being healthy, I weightlift, and I am only 33. What gives? Could it be the HRT, my endo says no relationship between HRT and cholesterol.

Dr. B G said...

Hi mathman...

Have you ever been anemic before? Are you a recent recovering wheataholic?

Wheat can trigger many damages in the gut and GI tract leading to a condition called 'leaky gut' syndrome. Red blood cells frequently leak out as well subsequently causing anemia and pica (cravings for ice or stuff like iceberg lettuce or children tend to randomly 'chew' on things).

Wheat also triggers fatty liver (NASH=non-alcholic steatosis hepatitis) and frequently elevated liver tests. I've noticed this takes about 2-3 mos to resolve after one stops wheat, loses weight, and/or controls their blood sugars.

Are all your supplements natural (v. synthetic which you never want)?

Androgel is absorbed in the skin and therefore bypasses the liver so I doubt that is it.

You haven't taken any antifungals like Lamisil (for toe fungus) or statins or niacin which may affect the liver?

-G

mathman said...

I have only been anemic since low carbing (about 3 years now). When I first started low carb I would eat the phony products made with soy and wheat gluten, but I have been eating paleo/Optimal Diet for the past 8 months so wheat was eliminated long ago.
I am at a fantastic weight, even a little "buff" since I do high intensity strength training 3 X week. My supplements are all natural and I forgot to mention I also take Vit.D and/or CLO. I do not believe I have any digestive issues. I do not take niacin or any anti-fungals.
I used to make and drink Kombucha tea in the past, but I stopped that several months ago.

mathman said...

My one non-real food vice is non-caloric sweetners (splenda, saccarine, and stevia). I figured I would just add that in case there is any relevance.

Dr. B G said...

mathman,

How Paleo/OD are you? Dairy free completely?

For some (or many including my younger sister 'M') are intolerant of casein, which displays opioid peptide like/damaging/addictive properties like wheat/gluten. Casein can induce NASH and elevated liver tests as well.

It is interesting that you mention artificial sweeteners! I noticed you mentioned that at Peter's blog too... forgot to ask about that!

High insulin from artificial sweeteners can increase blood sugars, TGs and fat infiltration into the liver. Consider reduction or complete elimination of sweeteners? Studies do indicate that fake sweeteners cause just as much diabetes and insulin resistance as real sugar. Robb Wolf at his Crossfit nutrition cert discussed the harm and lack of benefits associated with use of all the artificial sweeteners.

Let me know how it goes. Are you taking fish oil? Fish oil, carb restriction, reduction of fructose, weight loss (though it appears your wt, BF are fine), etc help liver function tests. Good luck and thanks for your comments.

G

mathman said...

Thank you for all of your advice. Yes I am dairy free (I am basically a LC and high saturated fat Paleo guy) and I take 4 fish oil pills daily.
The frustrating part is I'm under 10% BF, relatively young, and I feel well but there is always this doubt in my head whether this diet is the healthiest due to the indoctrination we all receive from the AHA, USDA, etc. Hard evidence lies in lab results, and my wife has used these liver/anemia/cholesterol test results to confirm her belief that how I eat is unhealthy.
If you are aware of any further tests that I can request from my doctor I would greatly appreciate your input.

Dr. B G said...

Mathman,

I would consider a taking break in the Androgel (see below). You are only 33, is that correct?

Is there any Alzheimer's in the family history? Apo E4 may contribute to some changes when saturated fat intake is 'excessive'. I haven't looked deeply into this yet but there is some evidence the type of fat can make a difference for certain genotypes.

Abdominal ultrasound.


The below is from Micromedex an online drug database. Androgel in the drug manufacturer findings list liver problems.

"Testosterone therapy has been associated with increases
in total bilirubin and alterations in liver function
tests (Prod Info AndroGel(R), 2003)."

Thank you,
G

mathman said...

No history of Alzheimers and yes I am 33. I had the ultrasound on my liver already and luckily it came back negative. I will ask MD if I stop Androgel if I can get re-tested. I want to thank you immensely for your generous advice.

BTW- the weird thing is that my liver/cholesterol tests were great while doing Atkins. Now that I went Paleo, cut out the crap and upped the veggies big time, my health indicators seem to be nose-diving. Lifes a bitch!

Dr. B G said...

mathman,

I'm only ~37 and I also have iatrogenic synthetic hormone-induced problems
--melasma
--wt gain
--hair loss
--sucky mood
--acne (finally gone)
--libido issues
--etc

Don't estimate how horrible synthetic drugs/hormones are.

Good luck and let me know is you see progress soon! Paleo is still the best prescription I believe (even for apo E4 imho -- I just don't have the data yet).

-G

Dr. B G said...

Add'l mathman have you considered ways to naturally increase T?
A wonderful book a good friend recommended is Michael Colgan PhD Hormone Balance (for Intellectual Longevity)!

At TYP we achieve this also via:
--vitamin D (yes this raises ALL hormone levels -- reck T in 2-3 mos after getting vitamin D 25(OH)D to 75 ng/ml -- testosterone free always improves sometimes from 200s to 700s.)
--Slo niacin (requires some MD monitoring of liver tests, uric acid)
--strength work like HIIT, tabata or Crossfit followed by adequate protein 30-60min after the workout
--adequate sleep -- good quantity, good quality; Sleep is where we make Testosterone and hGH
--reduction in stress (reduces Cortisol which wrecks Testosterone and other hormone levels)
--fats -- egg yolks, cholesterol, the fats that you are doing a good job of consuming adequately
--low carb, low insulin diet (it's great ur wheat free)
--hormone normalization (no low thyroid? TSH=1.0? etc)

You'll get there!!

-G

mathman said...

I have definitely been toying around with the idea of dumping the androgel and seeing if I can resume production. "T" was at 200 before I started supplementing last year and now I am at 460. So much of how I live (workout intensity, fasting, etc.) is designed to maximize hormone production and I lose out on a lot of that since I am no longer in control of at least T production. My TSH was 1.86 when tested in Sept. but I have no idea what that number means. I do feel cold quite often and for a guy that seems odd.
I already supplement with Vit. D but should I use Niacin with the elevated liver tests?

Dr. B G said...

Mathman,

There is potential for the thyroid and other glands to heal and re-operate properly. Supplying the building blocks of the immune system and certain co-factors and nutrients are vital for optimal regeneration.

Read:
Michael Colgan PhD -- Hormone balance for intellectual longevity

Check this out:
DR.Hyman's blog--Thyroid
He advises for thyroid health:
--Magnesium
--Zinc
--Selenium
--B-complex vits
--Vitamin ADEK
--Fish oil EPA DHA

I think Flaxseed oil is excellent too. Have you had any potential heavy metal poisoning (play with mercury as a kid??)...fillings falling out?? etc

Is your vitamin D 25(OH)D at 75 ng/ml? This could be the missing link for you!

-G

trinkwasser said...

(should pregnant moms eat 'low fat'? do pregnant moms want brain-deficient, cognitively-challenged children?)

Hey someone has to produce the next generation of dieticians

(currently reading through your blog from the beginning)