Gut I.Q. and the Distal Gut Microbiome as a Driver of Health and Disease

I'd add 'HOW THE DISTAL GUT MICROBIOME IS A 

DRIVER OF HEALTH AND DISEASE'

Source: theberry.com

Human Distal Gut Microbiome

I've been reading this cool article by Marchesi titled 'The Human Distal Gut Microbiome' that summarizes the effects of our distal gut (butt-end) microbiome on longevity, metabolism, disease and mental health.  Naturally having had SIBO, I can't decide if the proximal gut (front-end) or the distal gut is more important. Perhaps it depends on which is more ravaged and broken?  If I had diarrhea or chronic constipation, I guess I'd say distal. But since I've had neither, for me, it's the proximal gut.  When I had SIBO, I couldn't function or digest at my optimal. I was bloated after celery. Looking at water made me fat. This clearly sucks.  

A Few Updates: Post-Parasite Eradication

My family and I just returned from a sunny holiday in Macau and Hong Kong. We've all just finished our anti-parasite courses and the first I noticed is that we can eat dairy and gluten without almost no damage...full restitution of digestive function.  It's been 3 years.  Prior, I couldn't even eat peanuts or drink beer without waking up with ankle edema and abdominal bloating to 7-8 months preggers status for several days. I gained no weight on this trip of daily buffets, pervasively excellent feasting, and endless oral delights... I lost maybe half a pound. We ate some foods that were restricted forever -- Portuguese egg tartlets, ice cream, gelato, cheesecake, and cappucinos.  (TMI -- no fartage, no fatigue, no fat bloated belly).  

Gastrointestinal IQ: What's Your Gut I.Q.??

I'm into testing, not guessing.  Biohackers like fixed numbers and objective metrics.  These give data to track, follow and fix, rather than fuzzy logic or haphazard subjectives like 'I feel better' or 'I have more energy'.  

Body temperatures are alright... OTOH some urine cortisol 4 times a day plus full thyroid panel (rT3, FT4, FT3, antibodies) and full steroid panel (DHEA-S, anabolic progesterone, testosterone, and excess fat-inducing estrogens, E2) are more comprehensive and provide a fuller metabolic profile. 

Fasting or post-prandial glucoses are meh... But give me a darn HgbA1c (or fructosamine), fasting insulin and post-prandial insulin, then we can begin talking.  

What I'd really love to see are the mechanics of the mitochondria, fatty acid intermediaries and the gut dysbiotic end-products and organic acids. (Genova ONE= optimal nutri eval by urine; GI fx stool test; my samples here). What is living in the gut? Do you have the good spikes in Prevotella? Balanced Firmi/Bacteroidetes?? Viruses, CMV, adenoviruses? Mycobacteria? Pathogenic fungi and candida? Worms? Parasites? Protozoa? Pathogenic, opportunistic bacteria that were selected and fostered after those ten rounds of Z-paks from the primary medicine clinic or prophyactic Amoxicillin from the ol' dentist, which extinguished all manners of the soldier microcritters?

 (I'm sorry -- parasites are not paleo...Have you watched Planet Earth??! Even elephants and wild chimps hunt and seek out clay and other zoopharmacognosy to rid themselves of pathogenic parasites...) 

What is the microbiome in the proximal or distal gut? Guessing doesn't get you anywhere... You can speculate for a hundred million years and yet one won't know. I certainly didn't. I had pathogenic overgrowths and an allergy to heavy metals (mercury, titanium) which explains why despite perfect paleo and attempts at GAPS or SCD diets or FODMAP avoidance, nothing worked completely or brought a full, sustained return to normalcy.  Have you been there? Done that too?? 

I remembered what normal was (endless energy, flat tummy) but I think a lot people do not know because either they've never known normal or simply forgot because it was too way way way long ago... Some just have never had normal hormones, normal digestion, or normal mental function.  Yes these are all related to the gut because the gut microbiome is the major driver of all health and disease.  Perhaps this was not quite the case 10,000 - 25,000 years ago.  Certainly now with so many gut-disrupting factors that play into our epigenetics and core health, the gut cannot be ignored.  Fortunately the literature and technology are all catching up to clarify and highlight...

Why We Are Sick and Fat: Calories In (SUPERORGANISM) = Calories Out (MICROBIOTA) + Calories Out (HUMAN) + HEAT*Fluxxx

Source: Marchesi 2011.

Centenarians and the Microbiota

I'll go over this one below soon -- BIG THANK YOU TO TATER/TIM AND M.O. FOR THE PDF!!! What is it about healthy, long-lived centenarians? I dunno... Their immunity? Their guts? let's delve deepper and find out more...

Cultivable and pyrosequenced fecal microflora in centenarians and young subjects.

The above diagram is from the Marchesi piece (adapted from Biagi et al).

Biagi et al studied the microbiota of centarians (C), elderly (E) and young (Y).  Distinct differences were noted.  The microbiota of centenarians were distinctly unique and different from both the young and the elderly groups. Less Clostridium cluster XIVa, higher Bacilli and rearrangement of the Clostridium cluster IV composition were noted in the centenarians. Some things were expected in centenarians -- lower diversity, less of the good butyrate producers, less Bifido, and more pathogenic strains.

Quite unexpectedly, special characteristics of the gut ecosystems of the long-lived were discovered in this Biagi et al 2010 study which may define what an elite microbiota with a high G.I.Q. looks like.

(a) Enrichment of special butyrate producers Anaerotruncus colihominis et rel. (Clostridium cluster IV), and Eubacterium limosum et rel. (Clostridium cluster XV). Biagi et al concluded in a 2012 followup 'The increase of E. limosum is high (approximately 15- fold), and could point to a group of bacteria characteristic of the long life.'  E. limonus is a soil strain which lives in ruminants like sheep and cow. Its very good at converting METHANOL. In one in vitro colitis model experiment, E. limonus had positive outcomes.

(b) Increase in facultative anaerobes, such as bacteria belonging to the groups Bacillus. Does this include my favorite soil based organism Bacillus licheniformis or Bacillus subtilis?  Does B licheniformis and B subtilis produce supercharged bionic Gut I.Q....?!  What are foods that contain these?  ANSWER here.


Biagi et al also found the connection between "The decrease of both Clostridium cluster XIVa and F. prausnitzii group members was also correlated to frailty condition, hospitalisation, antibiotic treatment and non-steroidal anti-inflammatory therapy."  Clostridium cluster XIVa is also referred to as the Clostridium coccoides/Eubacterium rectale group which are potent cross feeders of resistant starch and raw potato starch in clinical experiments.  E rectale are poor RS fermenters but they live symbiotically with keystone gut species that eat and ferment RS to secondary food (substrates) which E rectale consumes like a hog on fire. Hattip: Tater/Tim.

Smart, Young and Resilient Gut I.Q.
Intestinal IS (Immune System) = HOMEO- and ALLOSTASIS

Source: Biagi et al, 2012

Smart Gut I.Q.

There are a couple of elements that I believe are fundamental in a stable, homeostatic gut ecosystem that will take one to advanced longevity:
--genetics (respect your ancestry... don't mess genetic expression with synthetic hormones, vitamins, endocrine-disrupting pollution, pesticides, GMO food/products, lifestyles, thoughts or people)
--super tight junctions and intestinal IMPERMEABILITY
--balanced flora
--special 'keystone leaders' like E. limosum, B subtilis, B licheniformis, and many others
--seed (return to the earth and intake healthy earth -- soil based organisms in fermented organic vegetables, fresh salads, and supplements if necessary (list here I like))
--weed (avoid mercury, toxins, food allergens/gluten and detox/chelate safely)
--feed with fiber (resistant starches, heirloom and native tubers, organic whole non-gluten grains, lentils, chana dal, legumes)
--exercise daily to move the gut (peristalsis), e.g. 10,000 steps or one hour mild to mod intensity. SIBO causes impaired gastric and intestinal peristalsis (and vice versa, sitting/atrophy can affect SIBO)
--misc (avoid unnecessary hospitalizations, CDAD (iatrogenic or antibiotic-induced C. difficile-associated diarrhoea), antibiotics, and other gut irritants like non-steroidal anti-inflammatories (NSAIDs) -- ibuprofen, motrin, aleve, excedrine, etc)

Resistant Starch Study Results and Positive Outcomes

Source: Conway 2001

My n=1 Pre- and Post-Microbiome, Digestion, SCFA, Fat Malabsorption, Pancreatic Insufficiency, Leanness F:B Ratio, and How I Healed SIBO and the Gut-HPA-Gonad Axis

Functional Lab Testing: GI Effects Stool Test (GI Fx)

There are several tests I think everyone should get if they are suffering from any chronic conditions, cancer, or inflammatory condition. One is the Metametrix/GDX GI Fx Stool test.  This is one of the most advanced tests that accurately, reliably and thoroughly evaluates the entire intestinal tract and the gut microbiota.

Using PCR sequencing on the 16S ribosome of microbial species and parasites, it accurately assesses both our microbiome (genetics) and those of any parasites.  The old 200-year technology of O&P x3 (ova and parasite) from 3 samplings of stool should be over; to achieve a positive identification, one must rely on the luck and fortune of the microbiologist viewing the smear on the slide to observe a parasite glide by or tiny ova like needles in a haystack.  I believe stool cultures are equally primitive technology and unreliable. Over 80-90% of stool microbes are obligate anaerobes and/or symbionts which are difficult or impossible to grow in culture or without their neighboring microbes necessary to sustain life.

***Read the Metametrix/GDX Interpretative Guide for the GI Fx Stool Test: HERE.




Example of a Super Super-Organism: B. Pottenger

My m=1 Microbiome: Data for Epimicrobiomics Thinkering

Brent Pottenger is not only hawwt, lean, muscular, sexxxy and smart... so is his poo.

Characteristics of excellent health and excellent poo:
(a) Pancreatic Enzyme Digestion:  Elastase 1, marker for pancreatic enzymes (greater than 300 = decent; greater than 500 or immeasurable = PALEO AWESOMENESS).  No deficiency of pancreatic enzymes, fat malabsorption, undigested plant fibers, undigested fats
(b) No microbial overgrowths detected. Stunning gradient of Bacteroides/Prevotella. Exceptionally robust Prevotella populations detected
(c) No yeast overgrowths detected
(d) No parasites, worms, flukes, protozoa or pathogenic overgrowths detected
(e) No gut inflammation, anti-gliadin sIgA (current gluten reactions) detected
(f) No excessive or missing SCFA (products of microbial fermentation -- both good and bad flora)
(g) Excellent adiposity ratio of Firmicutes:Bacteroidetes (leanness) and correlates with Mr.Pottenger's BF (~~ 7-9% I estimate).




Digestion, Fermentation 101

Here's a primer on the gastrointestinal tract, digestion and fore/hindgut fermentation in humans.   I co-lectured with Tim Gerstmar ND at the inaugural Ancestral Health Symposium in 2011 at UCLA.

• "The Rainforest in Your Gut: A Brief Tour of the Biome, Why It's Messed Up, and How to Fix It" 
• Slides

Ironically, I was ill at AHS and suffering from chronic fatigue (CFS).  Leanness was difficult to achieve, brain fog massive, and immune tolerances extreme (gluten, dairy, fiber, FODMAPS). It had all started immediately after a titanium dental implant, lasting from 2010 until summer of 2012 when I had it removed.  Nothing worked (yes, I tried everything). Finally, last summer, all the titanium, mercury amalgams, and gold crowns were extracted, and almost within 10 minutes I lost 5 lbs of peripheral edema and gained clear headedness.  Gradually signs and symptoms of metal toxicity, adrenal dysregulation and gut dysbiosis mostly disappeared.  A few months ago, I started dreaming again. Off/on I've been lucky to have leanness but it wouldn't last long.  Gluten actually was no big issue for me after Paleo, but dairy/nut intolerances became very problematic causing ankle swelling, mild joint achiness, and bloating.

Follow up is based on the latest labs below and Dx: bacterial/amoeba overgrowth. Starting to feel already even better and digestion improved.  Here are snapshots of AFTER v. BEFORE treatment.



(a) Pancreatic Enzymes (SIBO)
In 2011, my gut was not digesting. Enzymes were not produced at either the brush border (microvilli/small intestine) or apparently secreted in adequate amounts by the pancreas. Why? Gut stress, immune dysregulation from both microbial overgrowth and metal toxicity/suppression. With undigested carbs, fermentation occurs producing volative SCFA (small chain fatty acids) where it's not supposed: the small intestine. Undigested fats are delivered to the large intestine causing sometimes greasy, floating stools. I never had this, but the GI Fx test was positive. Undigested proteins (vegetable, meat) ferment into volatile SCFA, polyamines and stinky compounds (sulfur groups are stinky, like rotten eggs). Together, these further damage the small intestinal mucosal surface and induces SIBO (small intestine bowel overgrowth). Good protective flora are lost and both good and pathogenic flora overgrow, in the wrong place. Undigested fats and plant fibers make it intact to the feces. After treatment (surgery, Hg removal, diet, exercise, lifestyle, supps), this imbalance all reversed.  See AFTER, 2013. No red zones.

(b) Microbial Overgrowth (SIBO, Caecum/Appendix, Large Colon)

Overgrowth of 'good' flora occurred: Clostridias, Fusobacteria, E.coli.  A spike in SCFA propionate increased correspondingly.  I lost good species -- carb-eating Bacteroides, Prevotella, and huge populations of Lactobacillus and Bifidobacter. In his NYT article on the gut microbiota, Michael Pollan talks about how he lost his brawny Prevotella spike and developed a 'creepy E.coli bloom' after only one round of oral antibiotics, HERE.  He appears to eat a metric ton of fermented foods, so no doubt he has regained his Prevotella by now.  I'm so grateful that my gut did!  In fact the little tube became enriched by most of what seemed to be lost --Firmicutes, Bacteroides, Prevotella, Lactobacillus --- except some Bifido.  Prevotella is considered one of the best ecological microbiome metrics for neurotypical and healthy guts. In a recent study of autistic v. neurotypical children, it was found that the main 'core' genus missing was Prevotella by B Kang and James B Adams, PLoS, 2013.  In the enterotypes of neuroatypical autistic children, Prevotella was entirely absent.  The researchers also noted that a gradient of both abundant Bacteroides and Prevotella appeared optimal. Prevotella is also one of the top 3 genera observed to line our GI tract from mouth to anus. Its primary role in the large intestines is digestion of human-indigestible plant polysaccharides from cellulose, xylan, glycan, resistant starch, pectin, plants, shoots/roots/tubers, fruits, legumes/lentils, seeds/nuts, and whole grains.   Children in Burkino Faso have the most stellar Prevotella spikes (53% of total B + F) on earth -- they eat little meat (or gluten grains) but obtain protein from both (1) consumption of termites and (2) I hypothesize... microbiota-N2-fixation (amino acid byproducts from air (N2) + cellulose fermentation... ??incl carnitine, etc) from Prevotella, Bacteroidetes and N2-fixing symbionts from the termite gut microbiota.

For more info, read Dr. Leo Galland: Intestinal Permeability, aka Leaky Gut.  Once gut imbalance occurs, SIBO can take over and wreak havoc. Recall the gut epithelial layer tis one single cell layer thick. Undigested food and enteric bacteria, yeasts and parasites can quickly breach a damaged gut-barrier and proceed straight into blood circulation.  They can translocate to other organs and induce food allergies (soy, corn, nuts, eggs, citrus, dairy, wheat, oats, etc).  When the immune system tries to eradicate these perceived invaders with antibodies, then auto-immune diseases unfold. Muscles/joints, body fat and organs start to dysfunction when the immune-complexes (antigen+antibody) junk up joints, receptors, tissues and blood/lymph vessels.

(c) Yeast/Fungi Overgrowth (SIBO, Caecum/Appendix, Large Colon)
Normal is 'zero' yeast. Except for Mr. Pottenger's, I've never seen a report where yeast is less than 2. NEVER.  (I've never seen parasite-free/overgrowth-free result either.)  I run the GI Fx on nearly every client. Everyone shows fungal overgrowth and  it's indicative of dysbiosis.  Yeast is opportunistic and quite literally a bugger.  For over one year, I was on oral fluconazole 1-2x/month (I h**te pharmaceuticals especially liver-damaging ones). Nothing else controlled the yeast and in fact I had to dose escalate for only marginal control. When I returned to the U.S. my sister introduced me to Natren, and with immense gratitude, it worked in 24hrs (despite titanium/mercury).  Later, Natren, Prescript Assist, FloraMend and FloraBalance all helped to restore balance and minimize out-of-control fungi and allowed me to 100% discontinue Rx fluconazole.

(d) Parasites Are Not Paleo (generally speaking)

Overgrowth of pathogens, parasites and worms do not cause problems for everyone when the gut is anti-fragile, robust and resilient.  In fact, these stressors can even improve gut health and stability by stimulating the immune system.

However for the great majority of individuals sadly this isn't the case in my clinical experience. Perhaps, people's toxome is too excessive. When parasites or pathogenic overgrowth are found in the context of dysbiosis symptoms, IMHO it is best to treat.  Test, not guess... Or treat empirically like you would treat a dog/cat/pet. There are many sources of parasites in the USA and third world countries (like China).  They are overlooked, underdiagnosed, and ultra prevalent. The CDC reports more than 60 million men, women and children carry the Toxoplasmo gondii parasite. Salads, fresh fruit and vegetables, pet dogs, pet cats, tap water, cash $$, electronics, work computers, open bodies of water, licking doorknobs, camping, etc. are all common sources of parasites.  Read Dr. Leo Galland: Parasites.

D*mn, can't get lean. Though I gradually appeared to regain health and hormones, I couldn't achieve leanness. Somewhere between 2010 and now, I picked up an amoeba growth (Endolimax nana, see above) and opportunistic bacteria Morganella morganii.  Both are relatively easy to treat with 2-3 rounds of combination botanicals which have anti-microbial/anti-parasitic/anti-candidal spectrums (berberine, wormwood/artemisinin, oregano oil, curcumin, black walnut, herbs/garlic/ginger/biopiperine, etc). Sometimes these overgrowths can be benign. I have no symptoms except inability to achieve desired leanness and mild (but annoying) residual food intolerances.  Being compromised by metal toxicity, CFS and adrenal exhaustion may also have been factors for the inability to 'crowd' out overgrowth. In countries, like South America, anti-parasitics are sold over-the-counter. Several excellent botanical formulations are at iherb, my favorite international farmacy: Para-Shield, Thorne Berberine-500, Curcumin +Biopiperine, Tricyline, Paradex, Scram, Vermi-Purge, Paracid Forte, etc. I've used Metagenics Parex before, but it appears no longer made in the US. Metagenics Candibactin-BR is also excellent but no longer at iherb.

(f) Gut Inflammation, Anti-Gliadin sIgA
Gut inflammation all normalized after treatment. I had been gluten-free for months prior to the initial GI Fx test but we had gone to France and Germany for Thanksgiving six months earlier and ate hordes-of-irresistible-gluten (e.g.buttery croissants). The positive anti-gliadin sIgA shows that the immune system was apparently still reacting. Depending on the person, antibodies may require 6-24 months or longer to clear.

(f) Volatile SCFA (products of microbial fermentation)
With gut dysbiosis, butyrate and SCFA were all disrupted and low.  Propionate spiked -- likely due to excessive fermentation in the small intestines by overgrowth of supposedly 'good' gut flora (Clostridias, Fuso and E coli).  After treatment, this trend flipped.  Butyrate and total SCFA were all up to upper-normal ranges. This indeed matches my overall health -- less food intolerances, better digestion, far less bloating/distention, improved sleep, resumption of REM/brain-dreaming, adrenal tolerance, good adrenal hormones, great gonadal hormones, regained ability to do endurance training.

(g) Adiposity Profile: Firmicutes to Bacteroidetes ratio
Too much of either Firmicutes or Bacteroidetes is not ideal. Both help in extracting energy from chemical bonds in food. SCFA are metabolites of Firmicutes and Bacteroidetes fermentation in the caecum/appendix and large intestine. Partly the way they work is that the SCFA end products bind to G-proteins (GPR41) to control inflammation, brain-gut-gonad axis (cortisol/heart rate/etc), immunity and fatness. Just as omega-3 EPA + DHA increase lean muscle, reduce body fat and improve insulin sensitivity and inflammation, SCFA appear to do the same. Approx 55/45 to 60/40 may appear ideal.

Urine Organic Acids, Oxidative Stress, Toxin Evaluation:  2013

The urine organic acids (ONE=optimal nutrition eval) confirms that the gut dysbiosis was not severe.  No yeast dysbiosis was detected outside of normal range (very happy about the lack of brain fog/aldehydes/mycotoxins, too). In fact, vitamins, minerals, adrenal function, mitochondrial energy production and fat burning were all decent or exceptional.  It did point out that I'm a little low on detox nutrients -- vitamin A, all the B vitamins (being COMT (+/-) heterozygous), tocopherols, glycine, glutamine, magnesium and zinc.

The O.N.E. shows toxins -- alpha-ketophenylacetic acid (from my #*$&@ iPhone cover, styrene, synthetic rubber, resins, polyesters (sports bras, workout outfits), plastics, Saran wrap) and a-hydroxyisobutyric acid (from MTBE, gasoline additive meant to help gas burn 'clean' now major contaminant in California drinking water despite banning in 2003). Apparently mod-high levels of both are being excreted in the urine (after having spent 2mon in Cali 'detoxing' LOL aha). These are endocrine disruptors and damage DNA.

My kids and I have the GSTT1 deletion (glutathione S-transferase T1), and do not detox many xenobiotics well. Studies are finding oxidative, DNA damaging, and hormonal effects with even low exposures of polyaromatic hydrocarbons, pollution, benzene, acrylonitrile (gloves, plastics), styrene, gasoline, mercury (thimerisol sensitization -- eye drops, vaccines), mercury (low birthweight babies), mercury (compromised urine detox-elimination), mercury in medical students (increased mercury body burden), and countless other chemicals/metals in GSTT1 null individuals.  This genotype is even linked to whacked gender ratios of their offspring when chemically exposed... Dr. Mark Hyman MD reports he has the GSTM1 deletion and its effects, here.

SIBO Treatment, Healing the Gut-Brain-HPAT-Gonad Axis, and Followup

How did this SIBO &!amp;#$@ mess get fixed? Functional medicine labs, diagnostics, and treatment provided all the tools that were needed to finally reclaim my prior health, leanness, and brain-gut-gonad axis.  I am thankful for the opportunities to interact with several practitioners, my brilliant sister 'M', functional medicine doctors, and WAPF leaders over the last few years -- some very briefly -- they gave me the insight that I needed.

The root cause and antecedent event was the titanium implant which appeared to trigger some immune compromised reaction. There are implant failures (not me -- purrrfect, excellent ossification) but not many test Ig-positive on traditional or functional testing (MELISA, Clifford) at this time. Clifford CCR testing showed reactions to all mercury amalgam and nickel, but nothing for gold or titanium. After it and all metal were removed, the typical integrative medicine strategies all worked -- probiotics, raw fermented vegetables, exercise (earlier too fatigued to do any workouts), naps, yoga, laughter/friends, spiritual support, digestive enzymes, omega-3, mag/zinc/minerals, adrenal adaptogens, adrenal protocols (carb+protein+fat, every 4 hrs, sea salt 1/4 tsp daily), pycnogenol, gut support (marshmallow, slippery elm), betonite clay, charcoal, ghee, organic lard, rainbow vegetables, pastured pork and egg yolks, frequent bone broths, etc.  For followup, I hope the next phase will yield further insights.



SHOW ME

Share and show me your GI Fx tests or integrative medicine lab testing results... I'd love to see it!

Phylogenetic Tree of Caecums, Appendectomies, Microbiota Maintenance, and Anecdotal Failure of Fecal Transplants

Human Guts = Super-Organs

Human intestines are really part-carnivore, part-frugivore and part-microbe. As living entities, we are 'super organisms' or hybrids of microbes (over 100 trillion cells) + human (~10 trillion cells).  Did you do the arithmetic? (sorry -- I can't do math)

We are ~90% microbial cells. In fact all living organisms have gut flora microbes from termites, cockroaches to fish to frogs to birds to carnivores to omnivores.  Recall SFB (segmented filamentous bacteria; Firmicutes; Clostridia; Candidatus Savagella) the commensal (symbiotic) bacteria intimately residing in the ileum (small intestine) of insects, humans, chickens and rodents improving TH17 and immune system regulation and protecting against autoimmunity and T1DM.

The caecum and appendix (animals that have one -- see photo) may serve the job of storing and maintaining the microbiota that seed the gut (fore and hind). In a phylogenetic analysis of a variety of animals, evolutionary biologists have various theories that the appendix was retained for a functional purpose (Smith et al, 2010. Photo credit: PDF.)



The Human Appendix is Not Vestigial 

The appendix is not a vestigial organ. In modern healthcare, broad spectrum antibiotics are handed out carelessly and tonsils and appendices are removed without much thought -- acute symptoms or persistent infections precipate the surgery in otherwise healthy and young folks. However, a recent study shows that there is an un-ignorable and increased relative risk of unexpected sequelae (e.g. subsequent heart attack) in these people following surgery -- 44% and 33%, respectively.

Why? Tonsils and appendices are part of the hybrid microbiota-immune system and control of inflammation.  According to Smith et al, our ancient predecessors most likely had appendices for at least since 60 million years ago if not extensively longer, 80 mya.  Come on... 80 mya... that's a long time.

"The appendix has evolved independently at least twice
and has been extensively maintained, albeit not uniformly,
in at least three and perhaps four groups of
mammals; glires, primates, Diprotodont marsupials and
perhaps monotremes. The possibility that the appendix
occurred at the base of the primates suggests that the
appendix may have been preserved in that clade since
before the two primate suborders, Strepsirrhini and
Haplorrhini, diverged an estimated 60–63 million years
ago (Gingerich, 1986; Shoshani et al., 1996; Pouydebat
et al., 2008). Similarly, the conclusion that the appendix
evolved at the base of the glires indicates that the
appendix has been maintained since before the K–T
extinction, when rodents and lagomorphs diverged
approximately 80 million years ago (Bininda-Emonds
et al., 2007)."

Caecums, Carb/Fiber Digestion, VFAs

Caecams are organs at the juncture between small and large intestines. Mammals have one, gallinaceous birds (ground-feeding) two, and fish several.  Humans and primates have a small caecum and vermiform appendix (worm-like, blind pouch). Caecums appeared to have evolved as chambers for microbial fermentation. It has made multiple appearances in evolution. Sizes vary in the animal kingdom from none to some to fully functional appendices. In species without appendices, the great majority of microbial fermentation occurs in the stomach (ruminant herbivores).  Ruminants have evolved small caecum (no appendix) since most of the fermentation occurs in the foregut. Smith et al theorize "Thus, the evolution of small ceca in some species that are foregut fermenters seems likely to have involved loss of the digestive function of a cecum with an appendix, with maintenance of the immunologic function of the cecal appendix."

Certain herbivores do a HUGE amount fermentation in the caecum -- rabbits, pika, guinea pigs.  These vegan-animals also exclusively practice coprophagia to obtain nerve/brain nutrients (vitamin B12) from caecal protein and vitamin synthesis (e.g. poo consumption).  [Curiously, porcupines have big caecums but no  observed coprophagia behavior (though dogs and tortoises have been observed to eat porcupine poo).  Yet in one study 16% of energy requirements were produced in caecal fermentation (versus 4.7%, rat).  BTW resistant starch (RS -- corn) provides different volatile acids, caecum expansion and improved insulin and blood glucose profiles in rodent studies, compared to high GI wheat/gluten starch.]

Photo credit: talkorigins

Our caecum is microscopic (see below); herbivores, gargantuan.  The human caecum and appendix serve more of an immune function, reservoir for microbiota; the function for digestion is minor.  Both our caecums and large intestines can ferment carbs (fiber, resistant) then release the digested products into the blood circulation as volatile organic acids.  The small intestines should not... except under illness (SIBO, small intestinal bowel overgrowth).  We are not foregut fermenters.  These metabolites can be measured (propionate, acetate, butyrate, etc). GDX/Metametrix organic acids testing is available-- Nutri Eval, Organix, ION, ONE.  I favor the ONE -- requires only the first morning void urine (FMV) so non-invasive and you get the cancer/inflammatory marker 8OHdG, mineral/vitamin deficiencies are other functional metrics.

Photo credit: Smith et al, 2010

Fig. 1 The cecal appendix (a through l) or appendix-like structures (m through o) in a
variety of mammals. The cecum ⁄ appendix is oriented toward the top of each drawing,
the distal end of the small intestine toward the left and the proximal end of the largeintestine toward the bottom.
  (a) human, Homo sapiens;
  (b) Pongo pygmaeus, orangutan;
  (c) Lepilemur leucopus, sportive lemur;
  (d) Lasiorhinus latifrons, Southern hairy-nosed wombat;
  (e) Oryctolagus cuniculus, rabbit;
  (f) Phalanger gymnotis, ground cuscus;
  (g) Anomalurus derbianus, scaly-tailed flying squirrel;
  (h) Trichosurus vulpecula, common brushtail possum;
  (i) Bathyergus suillus, Cape dune mole-rat;
  (j) Atherurus africanus, brushtailed porcupine;
  (k) Castor canadensis, beaver;
  (l) Microtus pennsylvanicus, meadow vole, shown with a partially uncoiled large bowel//
  (m) Phascolarctos cinereus, koala;
  (n) Ornithorhynchus anatinus, platypus;
  (o) Tachyglossus aculeatus, echidna.

Volative organic acids include polyamines, short chain fatty acids (VFA) and others.  These can be quantified on the GDX/Metametrix GI function stool test and blood/urine organic acids testing.  This test is the best on earth. It assesses both large and small intestine function, and additionally accurately pinpoints pathogenic overgrowth, parasites, and worms which are frequent invaders despite 'clean' air, water and soil in modern continents. If pathogens exist in the small intestines, caecum and/or large intestines, putrification of undigested fats, proteins and carbs occurs.  Certain volative by-products are highly odiferous-- cadaverine, putrescene, spermidine, etc.

Treatment includes pathogen killing (charcoal, clay, herbals), healing the broken gut/brush border/GI peritalsis/acidity/pH, and replacing lost gut flora (commensal Firmicutes, Bacteroides, facultative anaerobes, SBO, good yeasts, etc).

The entire human gut has only ~17% of surfaces for fermentation compared with 50% for an animal like guinea pig. (TO ME, this is like the diff betw a select post-harvest wine versus mass produced Coors light.)

Bergman talks in-depth about VFAs. "Current estimates are that VFA contribute approximately 70% to the caloric requirements of ruminants, such as sheep and cattle, approximately 10% for humans, and approximately 20-30% for several other omnivorous or herbivorous animals. The amount of fiber in the diet undoubtedly affects the amount of VFA produced, and thus the contribution of VFA to the energy needs of the body could become considerably greater as the dietary fiber increases."  I don't think we are gorillas (57.3% energy obtained from VFAs) though some humans may exist as such (functional..? debatable?).




Role of Appendix and Failed Fecal Transplants

Our comparatively tiny human appendix is nearly non-functional yet appears to serve a purpose for maintaining maternal, birth- and early life-derived microbiota and biofilms.  This is why -- I've heard -- that fecal transplants often fail 1-3 years post-transplant (anecdotal communication,  Metametrix/GDX Tony Hoffman).  Were these cases Paleo? Consuming fermented foods frequently? Root causes for dysbiosis/permeability identified and reversed?  Toxins, mercury, pathogens addressed??




Appendectomies, Gluten Sensitivity, Gallbladders, Nutrigenomics and TMI

Not all animals have an appendix...... including members of my family; two out of 4 siblings have had surgical removal of the appendix. We also have 3/4 (diagnosed) autoimmune disorders. And 2/4 have documented gliadin sensitivity (me, positive fecal anti-gliadin sIgA in 2011 on Metametrix GI fx stool testing). Is there a connection? You tell me.

I'm Paleo because I'm protecting my gallbladder, appendix and other precious ~~.  Not into chopped off organs, boobies, etc.

Integrative medicine, treatment and prevention for gallbladder disease HERE (Gaby 2009).

Recently my kids and I did 23andme genotype testing. Have you done it? It revealed many gluten-sensitivity related conditions we are susceptible to based on known SNP analysis (alkylosing spondylitis, primary biliary cirrhosis, T1DM, etc).  Not a shock. I'm grateful for discovering the Paleo and gluten free diet in 2007, then functional medicine and intestinal permeability/gut dysbiosis in 2010.  We have made appropriate changes and seen improvements -- some mild, some dramatic.

This is the year of personal nutrigenomics.  We are negative for MTHFR but have the GSTT1 (glutathione, detox, heavy metals), deletion and are heterozygous for COMT (methylation -- detox of toxins, metabolism of adrenaline, dopamine, estrogens, 4OHE1, cortisol, etc).

Gallbladder stones and removal are super super super common in primary biliary cirrhosis (one of many celiac/silent-celiac conditions -- just like fatty liver, fatty pancreas, fatty heart, blah blah blah). Why? Look how anatomically close they are together to the liver, portal vein, stomach and duodenum/small intestine. When intestinal permeability allows undigested gluten through (or gluten just opens zonulin), gluten causes immunogenic havoc, scarring and immune system activation.  Same with the appendix.  When gluten and resident microbes translocate from the caecum/small/large intestines to proximal and distal organs, they hit neighbors the hardest.  Appendectomies are mega-crazy-common (my dad's a surgeon; gluten paid for my college).

Often I hear stories that the spasms and pain remain despite surgery.  Despite diligently avoiding 'high fat diets', they suffer (eating wholehealthylectins).  It's not just the 'fat, forty, fertile female' (4F's) who are afflicted (as all hazed med students are taught).  Males are affected too. Children are now affected.

It's a silent epidemic across the world in sync with vegetarianism (vegetarian males: 3-fold; vegetarian +alcohol, 7-fold) and westernized, Big Agra crop-users (like Saudi Arabia).

Gluten? Dietary removal of gluten helps a ton as Gaby above reports (two studies in celiacs 1985 and 1999).  Gluten is heat/cooking resistant. The toxic gliadin peptides can resist GI enzymatic digestion when microvilli DPP-IV  is disabled (by mercury) and when brush border enzymes are missing (SIBO, gut dysbiosis, pathogens/parasites).  At least 60 gliadin protein sequences are immunotoxic, triggering immune system reactions for susceptible individuals.  These were in relatively low concentration in ancient wheat but 50-100 years ago, transgenic hydridization and GMO techniques have bred (pun, bread) the concentration of the toxic gliadins to an estimated 500-fold amplication.

Peter at Hyperlipid cogently discusses Gluten and Gallbladders (circa 2008); good stuff, good comments.





Safe Guarding Appendices?

Smith et al talks about how the caecum is a "‘safe-house’ for biofilms containing commensal bacteria." How does antibiotics affect this? Antibiotics in food, cattle/chicken feed, eggs and their products?  How do we revive extinct commensals and healthy biofilms....? Wish I knew definitively because there are few ways to test the contents of the caecum and appendix.

If I could repeat preconception, conception, birth, postnatal, and lactation periods with my kids, I would certainly do a million things differently from the gut and gut microbe perspectives.

Further Smith et al concludes on the relationship between the caecum (which contains a region of lymphoid tissue), gut microbiota and the immune system....

 'Although microbial biofilms in the proximal large
bowel are apparently a hallmark of immune support for
the microbial flora in a wide range of mammalian species,
the biofilm distribution in the gut of an outgroup for
mammals had not been evaluated previously. Thus, the
observation that biofilms are distributed in frogs in a
manner similar to mammals, with a preference for the
proximal large bowel (Fig. 4), strongly suggests an
ancient origin for a pro-microbial immune function in
the proximal large bowel. Specifically, this observation
suggests that the adaptations supporting biofilm growth
by commensal bacteria are more ancient than blind sacs
of the gut, such as the cecum, which are involved in
fermentation. In support of this idea, microbial biofilms
are not only strengthened by secretory Immunoglobulin
A (SIgA) produced by the adaptive immune system, but
can also be supported by mucin (Orndorff et al., 2004;
Bollinger et al., 2005), a major biomolecule produced by
the more ancient innate immune system. This finding
points toward increased immune support of the gut
microbes as one of the potential driving forces for the
evolution of blind sacs in the proximal large bowel.'

Our Gut Anatomy and Physiology:  Part Carnivore + Part Frugivore

The curious thing is that advanced hominids are not exclusive frugivores. Though it makes sense that we lost the capacity to synthesize Vitamin C and must find and outsource this to dietary Vitamin C, our digestive tract length, volume and capacity to produce low pH and secretions are akin to carnivores.  Additionally, our shrunken small intestines possess really exceptional digestive capacities and efficient absorptive surfaces synonymous with carnivores, not herbivores (3-5X our height, not 10X as in herbivores).

 Photo credit: Biocyclopedia.

Nearly ALL digestive work and absorption are concentrated in the small intestines, which varies in length by individuality, 15 -30 feet. This is why illness in the small intestines (SIBO/gut dysbiosis) disrupts all health, including even distant, peripheral tissues (brain, breasts, fat/belly, bones, joints, vasculature, gonads-b**ners), not only proximal (liver, pancreas, gallbladder). Energy dense food provide long acting fuel (fats, complex carbs). Our small intestines, gallbladder bile acids for fats and carbs, pancreatic enzymes (lipases, proteases, carb-ases) compensated.   Our carnivorous small intestines are the super gift we acquired through evolution.

Our immune system is 70-80% based in the gut. Despite, our immunity being outsourced to microbes (caecal, appendix, intestines), only a fraction of our nutrition is (~10% from VFAs) because we obtain the energy from broken down, digested high-energy bonded food (e.g. fatty acids, complex carbs) in the small intestines.  Our sophisticated and elite human small intestines suck all this energy up taking what first-pass at the liver misses. Human nutrition is super nutrient dense and fat based (my diet is 30-40% fat) allowing us to forgo chewing and grazing but only every 3-5 hours.

The remaining marginal allotment of our nutrition is brewed by symbiotic bacteria and yeasts... It's arguable that butyrate is both a nutrient for the intestinal cells as well as an extension of the ancient immune system for the entire body. Our hindgut (large intestines) continues methodical fermentation and microbial metabolite harvesting (organic acids, volatile fatty acids, B12, butyrate, other bacterial Firmicutes/Bacteroides end-products).  It's absolutely not necessary to produce heaps and heaps of dung like our four-legged herbivore friends all day post-digestion without anal control.

Paleo, Muscles, Homunculus, and Natural Selection

Paleo, Muscles, Homunculus, and Natural Selection

Low Carb Paleo: Weight Loss 50 Pounds

Courtesy Shouts

A couple of acknowledgements to my uber COOL blog buddies...

Thank you NephroPal for being an amazing party-geek pal!! The above lovely SPOOKY graphics are courtesy of Dr. T.

Thank you Jimmy Moore for the recent shout-out at Livin La Vida LOCA! Jimmy, you are my HERO . . .


*evil laugh* HAAA HAA HE

Thank you Gentlereaders, today I am going scare the cr*pola out of you.


I haven't posted any 'before' vs 'after' pictures until now. I hope it might possibly inspire people to make and reach their goals. Truly NOTHING is impossible.

Transformation is about releasing what is already inside. One of the best tools that I found to motivate myself is to visualize what I want to transform myself into... like... gentle yoga-ites, wicked Angelinas, bad*ss DC comixxx superheroes.

OK so now you know my secret... mind over matter... mind over MASS... mind over the MIDDLEGUT. Feel free to share yours...


AFTER: Low Carb Paleo 19% Body P H A T

I've come a long way BABY... and I intend to stay that way. As a former fatty (yeah I can say that but you can't) like many others, you get into a mindset where you know what behaviors may trigger a so-called relapse back to former fattiness. For myself I have found through many trials and errors that certain things work. What works without fail is having good hormone control by exercising frequently (low intensity, long duration + high HIGH intensity, short short duration... yeah s*x counts unless your cardiologist told u 'no') and watching the intake of carbohydrates (fruit, ice cream, rice, potatoes, french fries MY DOWNFALL, etc). All CARBS. I indulge only if I know that I will be doing some workout later, otherwise I'll pay for it by gaining 2-5 lbs the following week. Yeah, that is just the mitochondrial biomechanics of my formerly thrashed pancreas and the intense quantity of adipose cells that I have from being 50 lbs fat.

Fat cells shrink but never go away...





BEFORE: High Carb USDA S.A.D. 38++% Body Fat

Being overweight since my teens makes me really appreciative of the transformative changes that other individuals have gone through or are currently going through. It is not easy sometimes.

Hurdles and obstacles can be like running a Navy Seal gauntlet. Holidays are even more brutal! Summers can be cake to stay active doing jogs and summer sports but I find for myself winters absolutely require strategic planning. I organize going w/friends to half-marathon events to guilt myself into not flaking on them (and me). The cold freezes my BOOTAH off. (And I live in Cali, sorry!!! *aaah*) Another deterrant for bad habits creeping back is scheduling 'rewards', for instance, going to day spas for relaxing massages. In fact, calming massages helped me to lose weight and improved athletic performance. Is everyday too much? j/k.





Diet Diet Diet

At my all-time high weight, I became committed to embrace changes when I could no longer fit into size 10 jeans... Vanity can be a great motivator. Whatever floats your boat. No I don't really care about heart disease or strokes. Just. My. JEANS.

First I started jogging again. What a cr*ppy lame*ss way to lose weight. Didn't lose more than 10 lbs per year the first three years. I had to discontinue my oral contraceptive at one point because it was giving me irregular skipped heart beats (from high insulin/ glucoses) which prevented exercising beyond a threshold.

The weight really came off when the diet came into line.

I stopped nearly all CARBS (1 carb = 15 grams high glycemic index):
--rice (2 cups daily = 6 servings carbs)
--bread, chocolate croissants, granola cereal (1-2 servings carbs)
--cranberry juice (O M G 2-3 servings carbs)
--caramel walnut sticky buns (bottomless pit)
--Peet's mochas XTRA LARGE (7 servings carbs incl HFCS)

Kept the meat, seafood and non-starchy veggies.



Low Carb Paleo Reverses Obesity

Inadvertently I went low carb Paleo though I had not even heard of Paleo back in 2005. My main grain was rice (coz I am Asian). In the beginning, it was hard to stop but when I felt lighter, stronger and less HUNGRY, it wasn't difficult.

For Asians, Pacific Rim and Indo-Asians, BMIs of 27 or greater than are considered obese (HERE). As you can see from the above 'before' pictures, no doubt about it I was obese. Metabolic syndome. Low HDL, high Triglycerides/sdLDL and blah blah blah. Back then, I would've failed any glucose or insulin tolerance test... if I didn't know how to cheat and pass (e.g. no carbs x2 days prior; I educate diabetes patients).

During pharmacy school I learned how to jog with my drinking buddies and girlfriends... but when I strained a hamstring and didn't know how to heal it, I turned to a 10 lb box of See's chocolate and regained 20 lbs. I was lucky enough that after re-injurying the same pathetic hamstring, my wonderful doctor gave me a referral to physical therapy. The skills from physical therapy changed my training and conditioning forever. I learned the benefits of stretching, strengthening and yoga, and learned that I could re-build my physical body.

Rebuild my brain? Gluten, omega-6 and obesity are toxic to the brain. Diet, yoga and fish oil rebuilt my brain.



Saturated Fat Grew My B**BIES Back

Like any anal retentive pharmacist, you go to the nth degree. I chronically ran a lot (really hard, really far) because I thought it was 'healthy'. My lowest weight was too low (lost lean mass, sarcopenia). My diet was too low saturated fat... though back then I 'thought' it was sufficient and actually high.

The result was I got really sick. In 2004, I developed asthma and coughing spells for 6-8wk durations annually. The birth control contributed (raised insulin, decreased B12, lowered estrogen and testosterone which maintain healthy bronchodilation and lung immunity). I was a stupid pharmacist; I didn't know. A couple of courses of antibiotics likely j*cked up the inflammation further by imbalancing the gut flora and biofilms. Later I was fortunate to discover vitamin D in 2007 (via the heartscanblog) and cured myself and my kids. We are now all off inhalers, antibiotics, steroid tapers, albuterol breathing treatments and same-day urgent care visits. THANK GOD for the stellar Dr. Davis, his healing strategies and opening my eyes to the lies behind the fairy stories. When my daughters were on steroid inhalers, I noticed that they stopped growing for 3 months. I always wonder if my oldest is permanently stunted from the effects of antibiotics and steroids. Now... the only steroid we do is vitamin D!

When I lost 50 lbs of weight by 2007, I also lost some feminine A S S E T S . My BMI at the time was 18.2-18.6 and weight 108-110 lbs (lifetime low). Took 5 years to lose 50 pounds. And the t&a. Bra size: (---) A ! (normal: D). When I started blogging February 2008 for Dr. Davis, the timing coincided with the beginning of my personal trial with Crossfit and high saturated fat diets for the purpose of attaining and regaining health benefits. Petro turned me on to Hyperlipidemia.

It worked.

My muscles and mammaries all grew (back). I started Crossfit shortly afterwards in March 2008 after reading Volek, Drs. Eades and Robb Wolf. At my DiabloCrossfit affiliate I met several others who had also lost 50+ lbs in only 1-2 yrs (not 5). Our family went gluten-free July 2008 and threw our first Paleo princess bday party (albeit high carb) in August for our daughter. Got Xfit nutrition certified in October 2008. Got more sat fat in and did some more Xfit, gained some muscles... some gluts... more mammaries... good stuff. What a rollercoaster of the best times of my life!

Muscles and mammaries net GAIN: 11 lbs ! Boo !

Prior Posts:
--What To Do After You've Lost 50#
--Get Into My Genes


Pubmed Reference (THANK YOU nocarb! Will try out ur COOL handy dandy TOOL):
Prevalence of overweight and obesity and their association with hypertension and diabetes mellitus in an Indo-Asian population. Jafar TH, Chaturvedi N, Pappas G. CMAJ. 2006 Oct 24;175(9):1071-7.

Don't Blow Your WOD on Your First Snatch...

...Or First Jerk *ahhhh*
...Or First 2 Rounds of Tabata Torture


I don't know what attracted me to Crossfit first...

How Crossfit diet and health principles are aligned with TYP... The Paleo diet which 80-90% of all members and trainers follow for optimal performance, gains and superior health... Robb and Nicki's gym (ranked top 30 in the U.S. By Men's Health)... the HAWWT people at my gym... my first warrior trainer Luca who could rip your head off if he wanted to... the MLF who keep us safe (military, law enforcement, firefighters)... how T-Muscle (formerly known as T-Nation) tries to knock it but can't like HERE...

Or the raunchy, hilarious inside jokes about our workouts!

So here is my progress (in my tri Zoot suit)...



Finally my insulin is better controlled (no more tooth abscess b/c it was pulled and the synthetic progestin nearly out of my f*&#$(@ system) after a year of Hormone H*LL... and the 6-paks are re-emerging...again...

Insulin.

It can be your friend or your enemy. It can grow great hypertrophic muscles or screw your metabolism, jack your hsCRP and prevent loss of belly fat.

Low carb, mod-high fat Paleo and bursts of anaerobic exercise at Crossfit control insulin.

As does
--avoiding dental infections
--avoiding dental inflammation
--avoiding synthetic/FAKE hormones which increase inflammation and insulin

OK I learned the hard dumb way.

In my experience (and Robb Wolf's), Paleo and Crossfit control autoimmune diseases and chronic inflammation, the crux of today's modern illnesses including heart disease. Our gym has a story of normalization of NASH/fatty liver disease within ONLY 1 month of Crossfit/Paleo, in addition to stories of complete reversal of IBS cases and many fantastic stories of 30-50 lb-weight loss. Robb has a tale of two pharmacists *cough cough* with NASH/fatty liver (which is autoimmune) and resolution with Paleo eating and Crossfit (one case the liver tests were so high, he was on a liver transplant list), and numerous other stories including one painful/burning, autoimmune lower extremity vasculitis (who I met at his b-day party) and another lifelong cutaneous tarda.


Here are my studmuffin Xfit homeys. Our Diablo Crossfit affiliate gym came in 16th out of 100 Xfit gyms. Congrats babes and boys! Y'll R-O-C-K.



Today for Sunday's WOD (workout of the day) we did TABATA... torture... *haa*

Workout:
Tabata deadlift (135lb men, 95lb women, barbell deadlifts)
Tabata dumbbell push press (men 45lb dbs, women 25lb)
Tabata burpee

A "Tabata" is 20 seconds of work followed by 10 seconds of rest. 8 rounds total (4 minutes). Count reps for each round. Your 'score' for each exercise is the lowest number of reps completed in any one round.

My score: DL 43# 11 times; DB PP 15# b/c I suck 6 times; burpee 4

The key of course to Tabata is to pace yourself. Don't blow your WOD on the first one to two successive rounds.

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