Lp(a) and Women's Heart Risks

For women with high Lp(a) and high CAC scores, estrogen (including natural, fake and the horsey-hormones) has been shown to in fact be beneficial in controlling CAD risk, events and reduction in Lp(a). Does this translate to men... *ha* I believe it may -- that is why alcohol-extracted soy protein, phytoestrogens and even... BEER help men with Lp(a) and reduce CAD.


With that said, controlling Lp(a) in post-menopausal women has enormous benefits for heart disease. HRT (hormone replacement therapy) is safe, convenient and promotes longevity and optimal heart health. Plus people report better well-being, sharper minds and unrelenting energy. (They say sex is better too.)

Bioidentical HRT and monitoring via salivary/blood testing is the ONLY way to go, according to my personal research.


Uzzi Reiss MD, Michael Colgan PhD, Suzanne Somers, Cheryle Hart MD (hormonesbyhart.com) are all excellent resources.

Each one of the above authors stress an insulin-controlled diet in conjunction with optimizing all 10 hormones (they forgot vit D -- but one of my pts sees Dr. Hart and she normalizes vitamin D [25-hydroxy-D] now).


1. Melatonin

2. DHEA

3. Pregnenolone

4. Estrogen (we have 3 types floating around -- E3 is the best and shown to be cancer protective; avoid E1, higher cancer rates)

5. Progesterone (Dr. John Lee MD obgyn is a good read esp for insulin, promotes avoidance of plastic/pesticides/poisons, etc)

6. Testosterone (yes for women this is very VERY good too -- and reduces Lp(a))

7. Insulin

8. Cortisol

9. Vitamin D

10. Thyroid



Control of Lp(a) is reviewed in great detail in our Part 3 TYP Diet, TYP Lp(a) reports 1 and 2.


Critical components of a successful Lp(a) reduction program at TYP are:

--control of all the above hormones -- ALL TEN

--good adequate sleep (for cortisol reduction and immune system optimization), rest, relaxation, recovery, etc

--exercise -- to reduce belly fat -- including resistance training which grows lean body mass, muscles

--low carb diet -- no wheat or gluten or grains or legumes; minimal fruit

--moderate diversely-colored nonstarchy veggies

--adequate high quality protein (including organic organ meats)

--avoidance of things which set off the immune system -- excessive cardio, excessive endurance training, infections, excessive mental or physical stress, sleep deprivation, etc

--antioxidants: astaxanthin, krill oil, carotenoids, coenzyme Q10, curcumin, alpha-lipoic acid, carnitine, NAC, flavonoids, pycnogenol, mushroom extracts, et cetera -- they are all EXCELLENT

--saturated fatty acids: unrefined coconut oil, MCT oil, fat on grassfed meat/wild game/free range fowl/wild seafood, egg yolks, butter oil (greenpasture.org), (if not casein-sensitive) raw fermented dairy, high-quality 70+% chocolate, organic lard, etc

--ultra high dose EPA DHA fish oil 6-8.5 grams daily (higher quantity, if inflammation is present)

--avoidance of all omega-6 refined veggie oils: sunflower, safflower, peanut, soybean, canola, etc

--intermittent fasting (this replicates the effects of NIACIN combined with all the above strategies)

--niacin 1-2 grams daily

--avoidance of low-fat diets (eg, the AHA low-fat-diabetogenic-kill-ya diet)



If elevated Homocysteine (greater than 8.0) occurs despite all the above strategies, consider adding high doses of B-vitamins
--Folic acid, 1 - 5 mg daily
--Vitamin B12, 1000 mcg daily (adenosyl- and/or methylated cobalamin) sublingual is the best absorbed form
--Vitamin B6, 50 mg daily
--Trimethylglycine (Betaine) 1.5 - 3 mg daily



Sure sounds like... the optimal Paleo warrior diet/lifestyle, right?

And... not unlike a diet/lifestyle of wolves...?

Hormonal Imbalances: Oprah, Steve Jobs

Hashimoto's Hypothyroidism and Oprah Winfrey

I love Oprah. My sister 'M' loves Oprah. It would be a gigantic understatement to say that all my girlfriends and co-workers love Oprah.

Now, with that said, I feel extremely, deeply saddened when I see the most well connected woman and influential/popular educator sooooo disconnected with her health and hormones. Have you been there? Unable to control your body or weight? Like a typical Oprah nut, I spent a few nights madly emailing her about year ago in Jan 2008 about vitamin D and weight loss and optimal health (and my 50# weight loss story). Where did it go? Filed in the big phat Oprah-empire round file??


Who has not been in her precise shoes?

Read about Oprah's Thyroid Club HERE (NY Times).

Hashimoto's hypothyroidism is one of the most common female (and male) afflictions of the late 20th and 21st centuries. Nearly every one of my diabetes patients has Hashimoto's.

Why??

Why are 45+ million Americans burning their Thyroid to a toast, like Oprah?

In my 20's -- stressed, eating dorm food, trying do everything 'right', instead of gaining the freshman 'fifteen', I gained F-O-R-T-Y lbs (b/c... hey... can you say overachiever?).
[Another college curiosity was observing how my hormones/ cycles/ periods became imperceptibly and immutably N*SYNC with my female dorm-mates. Mense shifts are apparently secondary to pineal gland and pheromones (link and other refs from an astute friend, thanxxx dude). Recall, pheromones are picked up by the nose- vomeronasal system and subsequent hypothalamus/limbic brain (paleopallium).]


What was going on with that college weight gain, mood fluctuations, difficult concentrating, sluggishness, coarse hair/skin, skin tag growth/insulin resistance, cold intolerance, resistance to weight loss/exercise, high cholesterol, mental fog and general feeling of clinical cr*ppiness??

I wish I knew back then...



Oprah... let's try to clue you in, my honeybun... from my sad life lessons.

For me, in hindsight, there were a few situations that may parallel Oprah's, that are backed up by the medical literature that cause thyroid dysfunction.



How to Give Yourself Hashimoto's Thyroiditis 101:

--lack of sunlight/vitamin D/indoor habitation
--mental stress
--more mental stress
--sleep deprivation... (excessive mochas/lattes at Berkeley cafes)
--excessive 'social' calendar
--inherent family history of autoimmune disorders (who doesn't??)
--wheat, wheat, and more wheat ingestion ('comfort foods' craved in times of high cortisol/stress, right? how did I know the carbs were killing me?)
--lack of nutritious food containing EPA DHA, vitamin A, sat fats, minerals, iodine, etc
--lack of play, exercise, movement (or ?overtraining perhaps for Oprah's case)
--weight gain -- which begins an endless self-perpetuating vicous cycle of all the above (Is it stressful to balloon out for no apparent reason? YES)





Of course, it turns out there is a hheeeyyuuggee link between sunlight/vit D/melatonin and the neuroendocrine system.



These four research groups below discuss how our Hypothalamus-Pituitary-Thyroid-Gonad Axis is tightly affected by melatonin, Thyroid Hormones, neuropeptides like brain tachykinins, and our reproductive sex steroids (Estrogen and Testosterone).

Melatonin influences on the neuroendocrine-reproductive axis.
Díaz López B, Díaz Rodríguez E, Urquijo C, Fernández Alvarez C. Ann N Y Acad Sci. 2005 Dec;1057:337-64.
The neuroendocrine-reproductive axis designates the functional activity of the hypothalamus-pituitary-gonadal axis. A delicate synchronization of many inputs at these three different levels is vital for normal reproductive function. From the median basal hypothalamus, the median eminence releases gonadotrophin releasing hormone into the portal circulation to reach the anterior pituitary gland.


Evidence for pineal gland modulation of the neuroendocrine-thyroid axis.
Vriend J. Neuroendocrinology. 1983;36(1):68-78.
Although melatonin administration has been reported to inhibit blood T4 levels in both rats and hamsters, under certain experimental conditions melatonin administration can be demonstrated to have a counter-antithyrotrophic effect resulting in increased blood levels of T4 and thyrotrophin... The effects of melatonin on the neuroendocrine-thyroid axis are similar to its effects on the neuroendocrine-gonadal axis, leading to the hypothesis of a common site of action for the thyroid and gonadal effects of melatonin.


Modulation of the hypothalamo-pituitary-gonadal axis and the pineal gland by neurokinin A, neuropeptide K and neuropeptide gamma.
Debeljuk L, Lasaga M. Peptides. 1999;20(2):285-99.
Tachykinin concentrations in the hypothalamus and pituitary are regulated by steroid hormones. In the hypothalamus, estrogens and testosterone increase tachykinin concentration. In the anterior pituitary gland, estradiol and thyroid hormones markedly depress tachykinin concentrations.


REVIEW. Melatonin and the thyroid gland.
Lewinski A, Karbownik M. Neuro Endocrinol Lett. 2002 Apr;23 Suppl 1:73-8.
The confirmation of these relations in clinical studies in humans meets numerous difficulties, resulting - among others - from the fact that, nowadays, human beings, as well as certain animal species, used in experimental studies, have been living far away from their natural and original habitat. It makes almost impossible to compare the results obtained in particular studies performed in different species, on the pineal-thyroid interrelationship. (Yes...we may be jacking up our hormones with artificial light, computer screens and TV.)

Oprah Likely Needs Vitamin D

Vitamin D ties everything together. The above two pictures come from the below research article (Sunlight--can it prevent as well as cause cancer?). The authors review: "The active form, 1.25D,, is a full member of the endocrine system, and as such interacts with virtually every organ in the body (31, 32). Especially noteworthy is its interaction with the sex and pituitary hormones (32-34), e.g.,the promotion of l-a-hydroxylation of 25D, by prolactin (34), since some of these interactions provide a mechanism for participation of 1.25D, in the control of cell growth in the reproductive organs . . . The Darwinian view of evolution suggests that loss of body hair in Homo sapiens should have some survival advantage, and it is difficult to think of reasons other than that this provides ready access of sunlight to the skin . . . lack of sufficient sunlight contributes to the known high incidence of carcinoma of the prostate in black American men and to the more aggressive progression of carcinoma of the breast in black women."



Vitamin D interacts with all the steroid nuclear receptors especially Thyroid Receptors and Vitamin A/Carotenoid Receptors (The concept of multiple vitamin D signaling pathways. Carlberg C. J Investig Dermatol Symp Proc. 1996 Apr;1(1):10-4.)

Oprah has a few risk factors for low blood vitamin D:
--stress -- our body burns up Vitamin D to maintain cellular processes under stress and infections
--wheat consumption (Stephan discusses this very well: Vitamin D and Celiac/Gluten Sensitivity) (and ?leaky gut prevent absorption of fat soluble vitamins)
--pigmented skin
--indoor lifestyle
--makeup/sunscreen
--living north of the 37th latitude where UVB solar radiation (the activating wavelength for vitamin D) is scarce for 40-50% of the calendar year
--age


Unless Oprah is receiving bio-identical hormone replacement, then her natural steroid sex hormones are likely to be 'off' and this would affect her Thyroid as well. Women from age 35 yo and up start experiencing declines in sex hormone due to the atresia (dissolving) of the eggs in the ovaries, one of the main sources of Estrogen and Testosterone. After Menopause (average age: 51 yo), nearly all the eggs are gone. Again, as the above emphasizes, the lack of significant sex hormones will profoundly affect the Hypothalamus-Pituitary-Thyroid glands.



What can help Oprah's Thyroid and take her to optimal health?
--Richard, at Free the Animal Oprah's Recipe For Failure -- And My Solution For Success, started this conversation and many of his fans chimed in.
--Scott Miller wrote:

"Here are ten quick mistakes I see her making that will sabatoge her efforts:
[1] Eating starches and grains.
[2] Eating low fat foods (like the egg whites rather than full eggs)
[3] Eating too often...How many omnivores in nature eat five times per day, regularly, like clockwork?
[4] Using fat-free dressings.
[5] A stunning lack of variety in salad-type vegetables (pretty much always romaine lettuce).
[6] Having a killer temptation like those blue chips in the house.
[7] Stead-pace aerobics violate the power law of human conditioning.
[8] And doing aerobics too often.
[9] Slow-twitch-fiber-only strength training.
[10] Strength training too often. "

Besides the paleolithic lifestyle, Oprah could use some natural neolithic bio-identical hormone replacement, starting with the big 'D':
--Vitamin D to blood [25(OH)D = 70 ng/ml] which will probably require about 8000 IU daily in the morning (Cannell doses 1000 IU per 25 lbs -- Oprah reports weight is ~200 lbs)
--Cortisol Reduction -- rest, relaxation, meditation, turn off the Crackberry
--Correct hGH Deficiency-- eat enough fat/protein, carb restrict, sleep well and enough, induce some strain/pain/gain on the muscles, food deprivation 18-36 hr 2-3x/wk
--Correct excess insulin -- stop wheat
--THYROID Replacement-- correct gradually to tolerance and mood, energy, cognition (Dr. Davis goal TSH: 1.0; Free T3: upper nl)
--Estrogen (estriol E3 primarily) -- restore to personal youthful levels prior to peri- and menopausal changes; provides cognition (our brains are FULL of estrogen-receptors), mentation/memory, skin/hair/mucuous membrane functioning, immunity, etc
--Natural Progesterone -- calms and restores all the other cycles (Avoid Provera, Levonorgestrol, which are progestins, man-made, associated with cancer and lower HDL 20-30%)
--Testosterone -- yes women need this just like men... provides confidence, vitality, well-being, affiliation, motivation, zest, in addition to libido
--DHEA-S
--Melatonin





How to Stop the Autoimmune Process of Hashimoto's

When one of our organs is jacked how do we recover it? Can we induce our immune system to heal and restore function? Certainly! With time, appropriate nutrients and stimulus, I believe depending on the extent of the incurred damage, our bodies have the capacity to regenerate itself. With Vitamin D repletion and Wheat-Cessation, I have observed a trend of improved TSH (including my own from 1.3-1.9 to 1.0 when my 25(OH)D stays above 60 ng/ml). Why? Vitamin D interacts intimately with thyroid, vitamin A/carenoid and other steroid hormone controls, including the sex hormones.

These below nutrients and lifestyle changes have been shown to aid the Thyroid to heal and restore functionality:
-stopping wheat which triggers our immune systems: innate+humoral
-stopping wheat which triggers genetic expression of stress responses
-stopping wheat which results in rapid rises of insulin
-stopping gluten/wheat/barley/rye
-stopping beans, peanuts, legumes (lectins)
-stopping dairy (which contain opioid-like proteins like wheat)
-stopping grains (rice, corn, etc) -- which are all grass-derived (*ha * I didn't say WEEDS but that's what I mean)
-proper nutrients which are the building-blocks of the Thyroid Gland and Thyroid Enzymes: proteins (taurine, leucine, arginine, OKG, L-carnitine, etc), minerals (IODINE, Mg, Zn, Se, Chromium, Bo, etc)
-B-vitamins (including α-lipoic acid)
-Vitamin D3 (goal 25(OH)D=70 ng/ml)
-Vitamin E (tocopherols, tocotrienols)
-Vitamin K1 K2
-Vitamin A
-Carotenoids (grassfed meat, wild seafood, Krill oil/Astaxanthin)
-EPA + DHA (ditto) -- high dose if extreme inflammation is present
-Antioxidants (Flavonoids, CoQ10, ALCAR/α-LA, Pycnogenol, etc)
-Avoid dietary and environmental toxins (nitrite preservatives, plastic, petroleum, bisphenol, heavy metals (Lead, Mercury), endocrine disrupters, pesticides, dioxins, etc)





Hashimoto's Thyroiditis Related to Autoimmune Genes

All autoimmune conditions are related to differences in our immune system. Even Migraines are associated with a certain type of immunity variation (Prevalence of HLA DQB1*0602 allele in patients with migraine). Hashimoto's is strongly tied to HLA DR5 types, vitamin D receptor anomalies, and CYP1 alpha hydroxylase (vitamin D activation enzyme) variations. It turns out also that Addison's Disease is tied to the same Cyp enzyme variant or what is known as a polymorphism.
A promoter polymorphism of the CYP27B1 gene is associated with Addison's disease, Hashimoto's thyroiditis, Graves' disease and type 1 diabetes mellitus in Germans.
Association of vitamin D receptor gene 3'-variants with Hashimoto's thyroiditis in the Croatian population.
Vitamin D receptor gene polymorphisms are associated with risk of Hashimoto's thyroiditis in Chinese patients in Taiwan.
Vitamin D receptor genotype is associated with Addison's disease.
Vitamin D 1alpha-hydroxylase (CYP1alpha) polymorphism in Graves' disease, Hashimoto's thyroiditis and type 1 diabetes mellitus.
Vitamin D receptor gene polymorphisms in Hashimoto's thyroiditis.
[Genetic markers in thyroid autoimmune diseases]





Steve Jobs: Addison's Disease?

Via Apple headquarters, Mr. Jobs issued a statement reporting that he was receiving treatment for 'protein wasting' for what doctors believed was caused by a 'hormonal imbalance.' He states he does not have cancer. Could Mr. Jobs be suffering from the same ailment as our late great president John F Kennedy? Mr. Jobs was reported to consume a vegetarian diet which are often devoid of EPA and DHA -- protectors against autoimmune disease as well as pancreatic cancer (see below). EPA and DHA are long chain omega-3 polyunsaturated fatty acids (PUFA) which ONLY come from animal sources. EPA and DHA are like Comcast and DSL -- they provide the reliable high-spped connections for electronic conductions in our nervous systems (compare v. lame lowtech modem/omega-6). Our brain is comprised of inordinate amounts of DHA and EPA. Every cell membrane. Unfortunately humans do not induce enough of the enyzmes to convert vegetarian omega-3 ALA to EPA + DHA in our bodies. If you are not stressed, then it is unlikely to matter. ALA from vegetarian sources would sufficiently maintain health. Most people however undergo some degree of stress or oxidative damage from daily living (like...umm...breathing or... hard breathing at Crossfit or HIIT). Although Mr. Jobs apparently did not have the most aggressive form of pancreatic cancer, he had surgery a few years ago for a neuroendocrine tumor in the pancreas. Addison's may also originate from metastatic tumors to the adrenal glands.

Has Mr. Jobs been under stress? Maybe...
(1) Cancer survivor
(2) Rolled out the best neolithic tech advances of our times: iPOD, iPHONE
(3) Apple innovator/revivor/evolver

o Modulatory effects of EPA and DHA on proliferation and apoptosis of pancreatic cancer cells.
o Omega-3 fatty acids improve liver and pancreas function in postoperative cancer patients.
o Fish oil and treatment of cancer cachexia.




Do you want Pancreatic Cancer??

Consume a lotta Omega-6 refined veggie oils like Sunflower or Safflower oil
and/or develop Omega-3 Deficiency
and/or eat a lot of Fructose
and/or a USDA Whole Grain Diet:
Opposing effects of n-6 and n-3 polyunsaturated fatty acids on pancreatic cancer growth.
Effect of dietary omega-3 and omega-6 fatty acids on development of azaserine-induced preneoplastic lesions in rat pancreas.
Carcinogen-induced lesions in the rat pancreas: effects of varying levels of essential fatty acid.
Effect of dietary intake of fish oil and fish protein on the development of L-azaserine-induced preneoplastic lesions in the rat pancreas.
Dietary glycemic load, added sugars, and carbohydrates as risk factors for pancreatic cancer: the Multiethnic Cohort Study.
Dietary sugar, glycemic load, and pancreatic cancer risk in a prospective study.
Etiology of nonresponsive celiac disease: results of a systematic approach.
Aldolase C in neuroendocrine tumors: an immunohistochemical study.
Dietary fructose enhances the development of atypical acinar cell nodules in the pancreas of rats pretreated with N-nitrosomorpholine.




Hormone Imbalances and Organ Failure

Like Oprah, several hormonal imbalances can lead to organ failure due to an autoimmune process. In Addison's, the organ mainly affected is the adrenal glands which provide Cortisol and other cholesterol-derived hormones to the body. Without a minimal amount of Cortisol, we do not make muscles or store fat. Addison's leads to muscle wasting, weight loss, dizziness, and depression. Excessive Cortisol, on the other hand, causes a condition known as Cushing's where excessive abdominal weight gain, moon-face, thin-skin, muscle wasting, fatigue and insomnia occur.



Other Thyroid Sources:

• Dr. Stephen Langer MD, Berkeley physician and author Solved: The Riddle of Illness
• Dr. Mark Hyman: Thyroid Blog I and Thyroid Blog II
• Mary Shomon Resources

Hormone Balancing Resources:

• Dr. Uzzi Reiss, MD OBGYN: Natural Hormone Balance
• Dr. Michael Colgan, PhD: Hormonal Health -- Nutritional & Hormonal Strategies for Emotional Well-Being & Intellectual Longevity
• Colgan, The Sports Nutrition Guide
• Dr.Cheryle Hart, MD OBGYN: Hormones By Hart

Brain: Sexual Dimorphisms

Striving to optimize all hormones to evolutionarily-normal youthful levels brings about optimal regression/stabilization of any insulin resistance and vascular calcifications. A side effect is optimal lifespan and vitality. These are lessons learned from trial and error, and backed up by meager medical science (albeit exploding in volume). Though we are all a self-experiment of n=1, I find it astounding that we are more bound by our experiences by our vast similarities than by our vast differences.
--Vitamin D (Calcidiol [25(OH)D] blood levels: 60 - 70 ng/ml)
--HDL-cholesterol (Yes... I believe it is a hormone; HDL-receptor=SR-BI. Large HDL has powerful anti-inflammatory, anti-cancer, anti-atherogenic, pleiotropic anti-aging effects. Goal HDL: Concentration greater 60 mg/dl with Large-HDL outsizing and outnumbering Small-HDL by greater than 60% of the total (because HDL2 tracks with longevity). Goal HDL: Avg particle size greater than 9.2 nm on NMR/VAP)
--Insulin (less than 5 mIU)
--Cortisol (stress hormone: low end of normal)
--PTH (parathyroid hormone: lower end of normal)
--Free T4 (active thyroid hormone: upper end of normal)
--TSH (thyroid stimulating hormone: ~ 1.0 mIU)
--Free Estrogen (E2, E3: normal)
--Progesterone (P: normal)
--Free Testosterone (T: normal)
--DHEA-S (normal)
--Omega-6/Omega-3 (Fatty acid profile test: 1.5 to 1.0 ratio (similar to traditional Okinawan and Inuit))
--(Adiponectin, Leptin, Human Growth Hormone, IGF-1, Pregnenolone, Myostatin, Melatonin, Eicosanoids, Retinoids, Essential/nonessential Fatty acids, Saturated Fatty Acids, Essential/nonessential Amino acids (eg Arginine, Taurine), Neuropeptides (eg Tyr-Arg=kyotorphin), etc)



Why are hormones so important? I've wondered this frequently lately after being diagnosed with Vitamin D deficiency. Not only are hormones (and pro-hormones like vitamin D) a focus of many disease reversal protocols (i.e. cancer, infertility, etc), but they define who we are... what we are... what gender... social interactions... moods... libido... bone health... inflammatory status...


Our hormones and/or lack of hormones makes us do a lot of things... Sometimes unconscious thoughtless things... A recent study in oral contraception-users demonstrated how hormone-manipulation lead to different mate selection. Millions of women use hormonal contraception to prevent ovluation, control acne or reduce painful PMS/peri-menopausal/fibroid conditions.
The pill makes women sniff out wrong partner
Effect of Putative Male Pheromones on Female Ratings of Male Attractiveness: Influence of Oral Contraceptives and the Menstrual Cycle


Can these be creating a generation of children with less hardy genetic stock? Does how we perceive sexual characteristics and dimorphisms (like a deep baritone voice, sexy/symmetrical body) affect our future progeny?

Evolution-wise it does indeed make sense that 'opposites attract.'


Let's geek out. Science-wise, this could be translated into 'dichotomous Major Histocompatibility Complexes captivate.'

Our body odor in fact may indicate our MHC's which are genes that encode our immunity. MHCs help determine matches between organ donors and organ receivers. Pheromones are emitted from glands and detectable in body odor. How do we sense pheromones?
Body odour preferences in men and women: do they aim for specific MHC combinations or simply heterozygosity?
MHC-dependent mate preferences in humans.
Human body odour, symmetry and attractiveness.


Through our noses which are connected to our reptilian/fish-brain which control unconscious, visceral functions (cardiac, vascular, GI, pulmonary, reproductive), and other roles vital for self-preservation like focus/flight/fright/fight/fertilization/repetition. Dr. Perricone the tan, attractive dermatologist who knows his hormones discusses the benefits of pheromones in reducing cortisol and adrenaline and the effects on mood and mate selection HERE. PBS television endlessly showcase his lectures during pledge drives. I wonder why? He does offer good science (and he's certainly easier on the eyes vs. Weil or Orman) and good entertainment. His line offered a $200 pheromone product previously, but apparently it has been scaled down to a smaller, less expensive solution (probably more suited to the recession... but uuummmm I wouldn't really know). Does having optimal pheromones make you look younger, more radiant, less wrinkly?? More irresistible to the opposite sex?? Does having optimal hormones build better houses, hunt for bigger bison, fish for copious catches? Does having optimal hormones make you smarter? More alert? More strong? Does having optimal hormones guarantee getting laid??!? I sure hope so...*wink* Being a more attractive and 'appealing' mate sort of guarantees continuation of ancestral genes. Would you want to mate a potato? Attraction to opposite immune MHC's guarantees diverse traits which can increase more optimal gene-environment interactions. Makes immense sense to me. In my little n=1 experiment I started on a topical hGH (human growth hormone) product similar to one offered at Bloomingdale's for the skin. After 1-2wks, I noticed that the skin looked fantastically better. Personally I'm convinced that youthful hormones -- even topical ones -- bring about youthful results. With oral Vitamin D for one year, I have already experienced more youth, ageless abundance of hair/nails/skin, lean muscle gains/speed, imperviousness to infections, and breathing easier (no more asthma). Drowning in your own lung secretions is slightly non-conducive to survival.


One fish species in Central America known as the wrasse (see picture) in fact changes genders via hormone changes. When the male leader becomes absent or a pre-ponderance of female wrasses occurs, a female wrasse will undergo a 'sex change' and transform into a secondary male wrasse.

Male sex organs transform into female structures.

I find that a-s-t-o-n-i-s-h-i-n-g.

We don't need exogenous stem cells. Does all life on earth contain an inherent ability to transform when giving the appropriate hormonal cues and environmental triggers? I witness transformations everyday...from my own practice, co-workers and friends' stories, on the cardiology forums and my Crossfit gym/network. Men with 'man-boobs' (who I envy if they're cup-D or higher *wink*) become male-gendered again. Women with testosterone/estrogen (xenobiotic) excess and progesterone deficiency resume feminine secondary traits. An interesting story that Nicki and Robb Wolf told at a nutrition certification at their Crossfit gym in Chico was how they were going to add a disclaimer on their waiver: Paleo nutrition and Crossfit can cause pregnancy; do Crossfit at your own risk! They reported 11-12 pregnancies ALL in the same month among women who stated they couldn't become pregnant for years...!! I wonder why?? (stopping canola/Mazola/toxic-omega-6s + those 'd*mn dirty grains'; eating fats, fish oil, seafood/grassfed, vegs, nuts/seeds, and adding functional movement with intensity)
Sex Change in the Bluehead Wrasse: Temporal Concordance of Changes in Brain and Behavior (See the Table: great review of neuropeptides Arg-vasotocin v. Arg-vasopressin in mammals and brain, behavior, and subsequent sexual dimorphisms)
Surroundings cause tropical fish to change sex: scientists
Crowds cause sex change



Our middle brain is known as the limbic system (PALEOpallium) which is believed to be derived from early mammals. The limbic system controls ludic behavior (not lewd, l-u-d-i-c, from Latin 'to play'). It is also associated with passion, happiness, fear, love, joy. Have you noticed on Planet Earth that only the mammals play? Birds and bees do not. Neither do reptiles. The genetic advantage of 'playing' maybe connecting learning experiences from the past to the present. Can the promotion of curiosity, exploratory thoughts, and artful/inquisitive natures be a survival benefit? A shore-based diet rich in mollusks, seafood and fish is believed to be the turning point for human dominance of the earth and the food chain (yes, it can be argued otherwise, probably depends on the continent? I dunno). Mollusks and seafood are abundant sources of omega-3 long-chain fats known as EPA and DHA. Land mammals also contain EPA and DHA in organ meats and grassfed dairy/muscle meat/adipose. Omega-3 fats EPA and DHA have been shown in infants to raise IQ points and at high dose, improve signs and symptoms of depression and schizophrenia.

DHA deficits of the third brain, the neocortex/neopallium, are severely correlated to brain disorders like bipolar and schizophrenia. R.C. Caspar, a Stanford researcher, wrote "Human neurodevelopment is the result of genetic and environmental interactions. This paper examines the role of prenatal nutrition relative to psychiatric disorders and explores the relationship among nutrients, mood changes, and mood disorders. Epidemiologic studies have found that adults who were born with a normal, yet low birth weight have an increased susceptibility to diseases such as coronary heart disease, diabetes, and stroke in adulthood. (Nutrients, neurodevelopment, and mood. Curr Psychiatry Rep. 2004 Dec;6(6):425-9.)" He discusses beneficial placebo-controlled research results of EPA and DHA on depression and bipolar.
Effects of nutrients (in food) on the structure and function of the nervous system: update on dietary requirements for brain. Part 1: micronutrients.
Attention deficit disorders--drugs or nutrition?
A meta-analytic review of double-blind, placebo-controlled trials of antidepressant efficacy of omega-3 fatty acids.
Role of omega-3 fatty acids in brain development and function: potential implications for the pathogenesis and prevention of psychopathology.
The role of omega-3 fatty acids in mood disorders.



Paleo exercise has a component of 'playfulness' and random spontaneity. At Crossfit, we hardly repeat the same routine. In fact, at with paleo and Crossfit, omega-3 fish oils are highly-suggested. EPA and DHA fish oils can affect physical results, performance and notable gains, as well as cardiovascular disease reversal. Omega-3 oils can allow us to play harder and longer. With stronger hearts and muscles. With great endurance. Without electrical conductance disturbances (like atrial fibrillation).
Omega–3 Fatty Acids, Exercise, Physical Activity and Athletics
Fish oil reduces heart rate and oxygen consumption during exercise.
Intakes of long-chain n-3 polyunsaturated fatty acids and fish in relation to measurements of subclinical atherosclerosis.
Effect of Erabu sea snake (Laticauda semifasciata *SNAKE OIL he hee*) lipids on the swimming endurance of aged mice.


Strength manifests in a variety of avenues. For survival, it appears to me that mental vigor, intelligence, genetic disposition, and physical power are all indispensable. Is it unusual that a convergence between the best things for our brain/sexual-dimorphisms, our also the best for our body and heart. Maybe not! Finally a 19-year study in the BMJ by Dr. S. Blair demonstrates that superior muscle strength relates to lower mortality from heart disease, cancer, and all cause-death in men, even after adjusting for cardiovascular fitness (on treadmill testing). Full PDF click here. I first came across this landmark trial in my fave mag FitnessRx for Men Jan 2009 issue, p. 142-144. I love this journal... for the ummmmm... in-depth... uummm scientific articles.
Association between muscular strength and mortality in men: prospective cohort study.

As the author Fahey EdD concluded in his review...'Get STRONG and live long.'


Don't be sarcopenic.

Greek: Poverty of the Flesh

Waning Estrogen and HDL3b

In Krauss and Williams et al research on lipoproteins in Bay Area Mormon kindreds, they talked about my favorite things (other than the sound of music)... on their relationship with HDL2b, the regression lipoprotein subfraction which performs in the vasculature like liquid D-R-A-N-O:
--young age
--low BMI/fat body composition
--more alcohol (for women only -- j/k --the stats didn't reach significance)
--estrogen (for getting our both mojo-jo-jo and HDL2b on) -- both natural and substituted

Estrogen has great affects on improving HDL2b from birth to menopause for women (and men too?). And after menopause, women have a pattern of elevated HDL3c/3b like men (not pretty -- the blip above for 3b is even greater than the 3b blip for men Fig 1 below). Not shown in the data or graphs, the authors note that for the subjects taking estrogen replacement did display greater levels of the larger-sized HDL3a and HDL2a. No mention of HDL2b which was odd since estradiol has been shown to increase HDL2b quite significantly in menopausal women. The authors also didn't report the specific type of estrogen estradiol (better) v. Premarin (bad).

I found this article so neat on many levels -- the authors really focused on subfractions of a previously under-appreciated lipoprotein ignored by statinators, the HDLs 'happy' good cholesterol. They are not from a major medical academic institution (LBL does not have that distinction around here). And lastly they used technology that we love at TYP to 'track' health/health status.


-BG

HDL2b -- Age, Adiposity, Alcohol and Estrogen

The lipoprotein subfraction HDL2b is emerging as the marker for regression of plaque and longevity. Even evidence from 10-15 yrs ago revealed this remarkable relationship. Looking to centenarians, scientists often search for answers and clues to longevity and control of chronic illnesses. These Italian researchers examined the the relationship between 2 subfractions of HDL -- small dense HDL 3a and large fluffy HDL 2b. The HDL 2b subfraction appear protective (at 32.4%) compared to younger/healthy matched controls (at 23.4%) and HDL 3a, appear degenerating for longevity. The interesting thing to note is that total HDLs were similar between all groups. In other words, the HDL from traditional labs tells nothing about HDL2 or HDL2b or HDL 3a. (Here Dr. Davis rails about the failures and weaknesses of conventionalist-type medicine in their overreliance on Friedewald's equation. )

"In order to assess the role of HDL on longevity, we studied HDL subfraction distribution in centenarian women compared with a group of weight- and gender-matched healthy normolipidemic controls. We did not find any significant difference in the mean plasma lipid, apolipoprotein, and Lp(a) levels. On the contrary, in spite of similar HDL-cholesterol concentrations (1.32 +/- 0.41 mmol/l in centenarians vs. 1.32 +/- 0.25 mmol/l in controls, p = not significant), HDL2b and HDL3a levels were, respectively, significantly increased and significantly reduced in centenarians in comparison with controls (HDL2b 32.4 +/- 9.2% in centenarians vs. 23.4 +/- 7.7% in controls, p less than 0.002) and HDL3a 26.3 +/- 9.8% in centenarians vs. 34.1 +/- 7.3% in controls, p less than 0.01). HDL2b levels were significantly raised and HDL3a levels were significantly reduced in centenarians in comparison with both 'middle-aged' and 'elderly' subjects, whereas no difference for any HDL subfraction was found between the two groups of controls of different ages."

• Barbagallo CM, Averna MR, Fradà G, Noto D, Cavera G, Notarbartolo A.
  Lipoprotein profile and high-density lipoproteins: subfractions distribution in centenarians. Gerontology. 1998;44(2):106-10.
  PMID: 9523222

HDL Subclasses

The subclasses of total HDL are defined via absorbency of a protein stain which serves as an index of mass concentrations at intervals of 0.01 nm. We desire a reduction in CETP activity to prevent transfer of mass from HDL to VLDL (small dense LDL).

• HDL3c (7.2 to 7.8 nm) -- plaque-builder (bad)
• HDL3b (7.8 to 8.2nm)
• HDL3a 8.2 to 8.8 nm)
• HDL2a (8.8 to 9.7 nm)
• HDL2b (9.7 to 12 nm) -- plaque-BUSTER (good)

Research that came out of the Lawrence Berkeley Labs in 1993 also reinforced how reductions of HDL2b parallels how known risks for CAD go up with age, adiposity and lack of estrogen. Williams et al studied HDL subfractions in Mormon men and women here in the Bay Area. Some Mormons kindreds did drink and smoke -- *HOLY MOLY BATMAN* don't tell the church of LDS -- and their data were excluded from relevant analyses). The alcohol factor is curious -- for women it may appear protective however for men no distinct protective benefit for HDL2b appears strong because a corollary increase in HDL3b and 3c occurs with alcohol consumption (??did that potentially negate the mild protective 2b increase?).

• Williams PT, Vranizan KM, Austin MA, Krauss RM.
  Associations of age, adiposity, alcohol intake, menstrual status, and estrogen therapy with high-density lipoprotein subclasses.
  Arterioscler Thromb. 1993 Nov;13(11):1654-61.
  PMID: 8218107

Here are their conclusions as they summarized:

• HDL3b concentrations were higher after menopause than before
• Eighty-eight percent of the increase in HDL associated with estrogen replacement (conjugated/horse hormones most likely) in postmenopausal women occurred within HDL3a (bad) and HDL2a.
• Adult men (> or = 18 years old) had significantly higher HDL3c and HDL3b
• Adult men had significantly lower HDL2b and HDL2a levels than younger boys (why?)
• There were no significant differences between the HDL profiles of women and younger boys, suggesting that divergence in HDL occurs during puberty
• Compared with the women, adult men had higher levels of HDL3c and HDL3b
• Adult men had lower levels of HDL2b, HDL2a, and larger-diameter HDL3a particles compared with women (is this why women live longer then men??? )
• In both men and premenopausal adult women, increasing levels of body mass index were associated with higher levels of HDL3b (bad) and lower levels of HDL2b (very very bad).
  

The authors noticed that "Reported alcohol intake in adult men correlated with two HDL regions: one within the HDL2b region (good) and a second within the HDL3a/2a region (bad), whereas in women the positive correlation between alcohol and HDL levels was within the HDL2b region only."












So what are the most potent things we can do to raise HDL2? We know that most of the HDL2 increases are due to HDL2b increases. HDL2 in fact is a good surrogate for the regression marker HDL2b. Studies show this -- and the TYP program reinforces this:

--Achieving normal BMI. Reducing adiposity (esp central though the above study does note that central vs. peripheral was not measured) will raise HDL2b and lower HDL3a/HDL3b/HDL3c

--Reduce your 'biological age' -- how? movement movement movement, vitamin D3, etc

--Take Niacin -- this B3-vitamin which mimics fasting and ketosis raises HDL2 100% (or occasionally get ketotic with intermittent fasting -- when you're not stressed/sleep deprived which is when Cortisol is excessively high) in trials

--Take Fish Oil -- at 'low dose' 4 g DHA per day HDL2 increases of 30% are observed (is more better? yes)

--Restrict carbohydrates (yes sirree, that includes F - R - U - I - T - S , ie, Nature's candy) and again the same researchers at Lawrence Berkeley Labs Williams, Krauss et al confirm this here. And even for you elite athletes out there -- the low HDL corresponds to CAD risk -- and carb (yes fruit) will trigger concomitant huge magnitudes of insulin eruptions and reductions in HDL2b and increases in VLDL/small LDL. The research demonstrated that here well.

--Consume a higher fat and saturated fat intake...like lauric acid (unprocessed coconut oil), caproic/caprylic and butyric acid (raw pasture raised butter oil)

--Get on Bio-idential/tx estrogen which raises HDL2b 150% (see below) (if you're lacking -- yes even men? perhaps... Post-menopausal women do apply Testosterone cream, why not vice versa?) In the study below Ethinyl Estradiol 0.1mg orally was taken by pre-menopausal women and resulted in total HDL increasing 38.3% and HDL apoA1, 25-27%. Oral estrogen sometimes worsens cholesterol for some -- transderm/topically applied are preferable for some. Are women the superior species?

Well... though what would we be without the men we stand behind?

• The effects of estrogen administration on plasma lipoprotein metabolism in premenopausal females. Schaefer EJ, et al. J Clin Endocrinol Metab. 1983 Aug;57(2):262-7.
  PMID: 6408108

--BG


P.S.
If you want plaque and a reduction in heart-protective HDL2b, follow the AHA Step I low-fat diet. The researchers are GENUISES... they repeated the same results in obese, postmenopausal women (but at least their conclusions were rationale this time).
Effects of an American Heart Association step I diet and weight loss on lipoprotein lipid levels in obese men with silent myocardial ischemia and reduced high-density lipoprotein cholesterol.Katzel LI, Coon PJ, Dengel J, Goldberg AP. Metabolism. 1995 Mar;44(3):307-14.

ENJOY! And...give a copy to your conventionalist MD... you have my permission...no need to wait for April Fool's Day or another heart attack...