Perils of Neolithic Plastics: MOOBIES, PCOS

Perils of Plastic: Chemicals in plastics and other products seem harmless, but mounting evidence links them to health problems -- and Washington lacks the power to protect us

TIME magazine (issue: April 12, 2010) featured a special report entitled 'The Perils of Plastic' HERE (or HERE or HERE). Below are are choice quotes I like by reporter Bryan Walsh [including my emphasis].

• "Since World War II, production of industrial chemicals has risen rapidly, and the U.S. generates or imports some 42 billion POUNDS (19 billion kg) of them per day, leaving Americans awash in a sea of synthetics."


• Those chemicals have a habit of finding their way out of everyday products and into the environment — and ultimately into living organisms. A recent biomonitoring survey by the Centers for Disease Control and Prevention (CDC) found traces of 212 environmental chemicals in Americans — including toxic metals like arsenic and cadmium, pesticides, flame retardants and even perchlorate, an ingredient in rocket fuel. “It’s not the environment that’s contaminated so much,” says Dr. Bruce Lanphear, director of the Cincinnati Children’s Environmental Health Center. “It’s US.”


• "As scientists get better at detecting the chemicals in our bodies, they’re discovering that even tiny quantities of toxins can have a potentially serious impact on our health – and our children’s future. Chemicals like bisphenol A (BPA) and phthalates – key ingredients in modern plastics – may disrupt the delicate endocrine system, leading to developmental problems. A host of modern ills that have been rising unchecked for a generation – obesity, diabetes, autism, attention-deficit/hyperactivity disorder – could have chemical connections."


• " Invented in 1891, BPA has been used since the 1940s to harden polycarbonate plastics and make epoxy resin, used in the lining of food and beverage containers, among other products. Polycarbonates can be identified by the recycling number 7 on the bottom of some plastics containing it. Other plastic ingredients – including potentially dangerous ones – are also indicated by the recycling number, known as the resin identification code."


• "BPA does its job well, and today some 6 billion lb. (2.7 billion kg) of the chemical are produced globally each year. The problem is, BPA is also a synthetic estrogen, and plastics with BPA can break down, especially when they’re washed, heated or stressed, allowing the chemical to leach into food and water and then enter the human body. That happens to nearly all of us; the CDC has found BPA in the urine of 93% of surveyed Americans over the age of 6. If you don’t have BPA in your body, you’re not living in the modern world."


• Epigenetics... "In 1998, Patricia Hunt, a geneticist at Washington State University, found that female mice dosed with BPA had serious reproductive problems, including defective eggs. More recently, she published a study showing that the offspring of mice exposed to BPA while pregnant can end up with corrupted eggs, a situation that leads to trouble for their offspring. “That’s a powerful effect,” says Hunt. “You disrupt three generations with one exposure.” "


• Xenobiotics, XENOESTROGENS... "As a synthetic estrogen, BPA can mimic hormones, those powerful chemicals, like testosterone and adrenaline, that run the body. "


• "Tiny amounts of hormones produce immense biological and behavioral changes, so it stands to reason that a chemical that mirrors a hormone might do the same, especially if a human being were exposed to it during critical periods of development, like the first trimester of gestation. (Children are particularly vulnerable to chemical exposure, not just because their smaller bodies are developing rapidly but also because they eat and drink more relative to their body weight than adults.) "


• "That’s exactly what dozens of scientists have found in animal studies, linking fetal BPA exposure in rodents to everything from mammary cancer to male genital defects and even neurobehavioral problems. Nor is BPA the only industrial chemical in common use that may mess with the endocrine system. "


• "Phthalates – a class of chemicals used to soften polyvinyl chloride plastics, found in products ranging from shower curtains to cosmetics to intravenous-fluid bags – have been shown to disrupt hormones in animals and have been linked to reduced sperm counts and other marks of feminization in male rodents. Ditto for a class of long-lived chemical fire retardants known as polybrominated diphenyl ethers (PBDEs), used in electronics, polyurethane foam and other plastics, though they’re being phased out. (PBDEs can remain in the body for years. BPA and phthalates are excreted within a day or so, but their ubiquity means we’re exposing ourselves anew almost daily.)"


• Codes of chemical contempt... picture of recycling codes courtesy of HERE.

Prior Nephropal from Dr. Tourgeman MD: Bisphenol A (BPA) lowers adiponectin, associated with insulin resistance, weight gain, fat gain, twisted testosterone metabolism, lower sperm count

Happy Earth Day... *contemptuous sigh*



Does This Affect Adrenals? Thyroids?

Possibly? Any hormone disruption and dysregulation at the cellular or macro-biology level affects adrenals. Heavy metals are implicated in the formation of free T4 to rT3, which is a useless form of thyroid hormone and not selenium or iodine-dependent (unlike activation of T4 to T3).



MOOBIES: high DHT, high Estrone, high Prolactin, low vitamin D

Boys becoming physically and metabolically like girls... that's called MOOBIES, higher prolactin, higher estrogen expression, erectile dysfunction, hypogonadism, testicular failure, andropause. Pollutants are highly associated with delayed maturation in adolescents and significantly interrupted hormone pathways. (Diagram, courtesy of health-spy.com)
"In 2002, the Centre for Environment and Health in Flanders, Belgium started a human biomonitoring program. For 1679 adolescents, residing in nine study areas with differing pollution pressure, hormone levels and the degree of sexual maturation were measured. Possible confounding effects of lifestyle and personal characteristics were taken into account. Participants from the nine different study areas had significantly different levels of sex hormones (total and free testosterone, oestradiol, aromatase, luteinizing hormone) and the thyroid hormone free triiodothyronine, after correction for confounders. Significantly higher hormone concentrations were measured in samples from participants residing in the area around the waste incinerators, while significantly lower values were found in participants residing in the Albert Canal zone with chemical industry."2


PaleoHacks Forum Thread: Middle-Aged Male Gynecomastia, aka 'Moobs'

Check out this thread HERE. Thank you Dexter -- forgot about my comments! Jae and Kevin Teague covered all the bases. Good job, boys! Eat paleo, do HIIT (to raise T), lose body fat (reduces DHT conversion), take vitamin D (lowers prolactin, raises T), eat fat, eat low carb, etc. This works. Current conventional medicine treatment includes... surgical options (moob-ectomy), aromatase inhibitors, or Tamoxifen (estrogen blocker): HERE.

P-a-t-h-e-t-i-c.



Males: Avoid Xeno-Estrogens

Xenobiotics are found in food, herbs and pharmaceuticals. These are chemical structures which our bodies need to metabolize and eliminate via our P450 enzyme systems in the liver and other tissues. Many are fat-soluble and require a healthy liver (phase 2), gallbladder and biliary system to conjugate and eliminate from the entero-hepatic cycling that occurs in our gut. Our body has evolved to conserve and 'recycle' the 'good stuff' from our skin and oral exposures like cholesterol, vitamins, steroid derivatives, endorphins, sex steroids, fatty acids and other constituents. Unfortunately, toxins get recycled too.

The best is to avoid toxins.

Phytoestrogens are plant-derived xeno-estrogens; they are everywhere but some phytoestrogens have higher biological potency. Both plants and animals utilize estrogen phylogenically. Xenoestrogens vary in their effects. Some may protect against estrogen and xenoestrogen-induced breast cancer and other cancers but the downside for men are the ubiquitious estrogenic effects including breast tissue growth and penile reducing effects.

Some bind estrogen and progesterone receptors and potently or partially enact the below or some combination:
--inhibition of estrogen receptors (block)
--activation of estrogen receptors
--inhibition of progesterone (block)
--activation of progesterone
--inhibition of androgens (block)

Estrogen is producted by men and women (in the adrenals in both genders and ovaries in women). It feminizes however our understanding of estrogen has greatly expanded to include countless brain, neural and immunity related activities. Men need some, but not a lot. Women, we need a lot comparatively and it protects against Alzheimer's, infections and looking wrinkled. Important.

Progesterone is made by both men and women (again in the adrenals of both genders and ovaries of women). Progesterone has some androgenic action for fat burning, muscle building, mood, immunity, neuroprotective (give me 'P' if I ever have a cerebral edema) and well being. Progesterone is the MAIN hormone in pregnancy. It sustains the pregnancy and allows for exponential tissue growth. At high levels, tissues and collagen relax and cortisol and insulin go up (providing even sustained glucose supplies for the fetus). Women make ~20 mg/d of 'P' but during pregnancy, fetal adrenal and maternal production increase to ~200 mg/d. Fetal adrenal glands are 10-20x that of an adult. It shrinks after birth and post-natally.

Many xeno-estrogens block progesterone and lead to anti-adrogenic actions. In women, pomegranate, like RU486, was once used in ancient Greek as an abortifacient and to induce uterine contractions.

Below are known to raise estrogen effects and lead to gynecomastia should be limited in exposure by mouth, skin, or breath if you are trying to limit your moobie growth:
--soy SOY SOY (!OY)
--BEER (hops contains high phytoestrogens)
-- whisky in oak (per Paleo hacks)
--omega-6 (peanuts, sunflower, cottonseed, safflower oils) which increase inflammatory steroidogenesis including cortisol which raises DHT and endogenous estrogens
--pomegranate, red clover, yucca
--topical use of tea tree oil, lavender oil
--excessive caffeine (raises cortisol and depletes adrenals too; fibrocystic breasts)

Synthetic xeno-estrogens, unlike some of the natural, plant-derived compounds that exist in food and plants, are chemicals and therefore not recognized by our mammalian receptors for appropriate metabolism and elimination. Worse, they are stored in the fat tissues with extremely long biological half-lives. Synthetic xeno-estrogens and xeno-progestins may take weeks, months or decades to be excreted. Birth control, Provera (medroxyprogesterone), Depo-Provera, plastics, BPA, environmental pollutants are in this class.



Bisphenol A Elevated in Women with PCOS Compared With Non-PCOS Women

Girls. We are affected too. PCOS is the female version of moobies... females veering toward male dimorphic expression (hirsutism/facial hair, higher androgens (T, DHT), male pattern baldness/alopecia, masculinization, low estriol/estradiol, PMS, ovarian failure, sterility, early menopause). Takeuchi et al discuss the dose-related bisphenol A effect and how related to degree of hormonal dysregulation in women with PCOS. Obese women without PCOS also showed higher BPA levels compared to non-obese without PCOS. Not surprising. BPA, mercury and other pollutants have been shown to increase insulin resistance and body fat.

This study was performed to investigate the serum levels of bisphenol A (BPA), an endocrine disruptor, in women with ovarian dysfunction and obesity. Fasting serum samples were obtained from 19 non-obese and 7 obese women with normal menstrual cycles: 7 patients with hyperprolactinemia, 21 patients with hypothalamic amenorrhea, and 13 non-obese and 6 obese patients with polycystic ovary syndrome (PCOS). BPA was measured by an enzyme-linked immunosorbent assay. BPA was detected in all human sera. Serum BPA concentrations were significantly higher in both non-obese and obese women with polycystic ovary syndrome (1.05 +/- 0.10 ng/ml, 1.17 +/- 0.16 ng/ml; p < 0.05, respectively) and obese normal women (1.04 +/- 0.09 ng/ml, p < 0.05) compared with those in non-obese normal women (0.71 +/- 0.09 ng/ml). There was no difference among women with hyperprolactinemia, women with hypothalamic amenorrhea, and non-obese normal women. There were significant positive correlations between serum BPA and total testosterone (r = 0.391, p < 0.001), free testosterone (r = 0.504, p < 0.001), androstenedione (r = 0.684, p < 0.001), and DHEAS (r = 0.514, p < 0.001) concentrations in all subjects. These findings show that there is a strong relationship between serum BPA and androgen concentrations, speculatively due to the effect of androgen on the metabolism of BPA.

Boys and Girls: Avoid BPA and other Xenoestrogens

• Avoid plastics for food containers
• Avoid drinking water from water bottles (esp heated) -- use metal
• Never heat up food in plastics (even BPA-free) -- use glass or pot on the stovetop
• Minimize/avoid Starbuck and Peet's coffee cups (I KNOW! I don't follow)
• Buy local and organic and avoid pesticides, especially for the Dirty DOZEN
• Leave your shoes at the door (very ASIAN *wink*)
• Avoid consuming synthetic hormones fed to and pesticide-exposed, mass produced chickens, pork, beef, dairy; eat grassfed and local
• Avoid/minimize wild seafood (heavy metals, PCBs, flame retardants)
• Avoid inferior produced omega-3 fish oil or cod liver oil (heavy metals, PCBs, flame retardants)
• Avoid consuming synthetic hormones fed to and pesticide-exposed farm-raised salmon, tilapia, catfish, shrimp, and other seafood
• Avoid certain cosmetics
• F*CKIN AVOID BIRTH CONTROL (oral, insertable, injected), Premarin, Provera, PremPro, Ergocalciferol (D2), Accutane, and ALL synthetic Big Pharma non-bioidentical steroid hormones

Detoxification

I've had to deal with synthetic progestin toxicity for the last 2 years. There was not that much I could do but what helped the most in excreting the xenobiotic I found was the below. Whenever I gained body fat (holiday eating, stress, stopping vitamin D, etc), I found the symptoms I was having were exacerbated and acutely worsened. When I dropped body fat with exercise and yoga, then the symptoms curbed down again. Body fat for me has been the biggest factor I can vary which affected symptoms and the control symptoms.

--exercising frequently to lower body fat and control insulin/cortisol/leptin (cardio 50-70% max HR four to seven hours per week) (leptin RAISES aromatase)
--HIIT 1-2x/wk (NONE unless rested/relaxed; don't over do it;BSS rocks)
--yoga, massage (relieves stress, prevents injury, resets adrenals which produce cortisol and hormones, moves lymph and circulation)
--hypocaloric high protein diet with carb cycling (900-1200 kcal/d -- I'm ~120 lbs)
--fiber -- this removes bile acid conjugates (metamucil, non-starchy vegetables dominated diet, cruciferous, seaweed, leeks, green apples, etc)
--fat (coconut milk, grassfed meat eggs, etc), omega-3, flaxseed oil
--cilantro, garlic (helps glutathione which uncouples toxins from binding), NAC (glutathione precursor, keeps liver/kidneys strong), Vitamin C, tocopherols/ tocotrienols, chlorella (antioxidant and removes toxins), coenzyme Q10 (tags proteins and DNA for proper disposal or recycling), pycnogenol (antioxidant and removes toxins), silymarin (helps glutathione and keeps the liver strong), trace minerals (metal detox and detox enzyme functions), lipoic acid (increases glutathione in WBC RBCs)
--normal bile conjugation, synthesis and elimination (fermented foods, digestive enzymes, betaine (TMG), indole-3-carbinol/DIM, taurine/glycine (and/or raw grassfed or uncontaminated-seafood), egg yolks, low carb/high sat fat diet) (when my adrenals were shot x6-12 months, I couldn't tolerate much taurine which made me dizzy and ataxic; need a modicum of decent adrenals)
--GUT, thyroid, adrenal and vitamin D optimization (affect temperature and metabolism of enzymes, P450 detox enzymes, liver, steroidogenesis and neutrotransmitters)





References1. The Perils of Plastic. Walsh B. TIME Magazine 175(14);April 12, 2010, pp.44-54.
2. Hormone levels and sexual development in Flemish adolescents residing in areas differing in pollution pressure. Croes K, Baeyens W, Bruckers L, Den Hond E, Koppen G, Nelen V, Van de Mieroop E, Keune H, Dhooge W, Schoeters G, Van Larebeke N. Int J Hyg Environ Health. 2009 Nov;212(6):612-25.
3. Relationship of thyroid hormone levels to levels of polychlorinated biphenyls, lead, p,p'- DDE, and other toxicants in Akwesasne Mohawk youth.Schell LM, Gallo MV, Denham M, Ravenscroft J, DeCaprio AP, Carpenter DO.Environ Health Perspect. 2008 Jun;116(6):806-13.
4. Relationship of lead, mercury, mirex, dichlorodiphenyldichloroethylene, hexachlorobenzene, and polychlorinated biphenyls to timing of menarche among Akwesasne Mohawk girls.Denham M, Schell LM, Deane G, Gallo MV, Ravenscroft J, DeCaprio AP; Akwesasne Task Force on the Environment.Pediatrics. 2005 Feb;115(2):e127-34.
5. Human thyroid in the population exposed to high environmental pollution by organochlorinated pollutants for several decades.Langer P, Kocan A, Tajtakova M, Petrik J, Chovancova J, Drobna B, Jursa S, Pavuk M, Trnovec T, Seböková E, Klimes I.Endocr Regul. 2005 Jan;39(1):13-20.
6. Reproductive hormone levels in men exposed to persistent organohalogen pollutants: a study of inuit and three European cohorts. Giwercman AH, Rignell-Hydbom A, Toft G, Rylander L, Hagmar L, Lindh C, Pedersen HS, Ludwicki JK, Lesovoy V, Shvets M, Spano M, Manicardi GC, Bizzaro D, Bonefeld-Jorgensen EC, Bonde JP.Environ Health Perspect. 2006 Sep;114(9):1348-53. [FREE PDF]
7. Exposure to bisphenol A is associated with recurrent miscarriage. Sugiura-Ogasawara M, Ozaki Y, Sonta S, Makino T, Suzumori K. Hum Reprod. 2005 Aug;20(8):2325-9.
8. Positive relationship between androgen and the endocrine disruptor, bisphenol A, in normal women and women with ovarian dysfunction.Takeuchi T, Tsutsumi O, Ikezuki Y, Takai Y, Taketani Y.Endocr J. 2004 Apr;51(2):165-9. [Free PDF]
9. Exposure of newborn male and female rats to environmental estrogens: delayed and sustained hyperprolactinemia and alterations in estrogen receptor expression.Khurana S, Ranmal S, Ben-Jonathan N.Endocrinology. 2000 Dec;141(12):4512-7. Free Article
10. Effects of xenoestrogen bisphenol A on uterine and pituitary weight, serum prolactin levels and immunoreactive prolactin cells in ovariectomized Wistar rats. Goloubkova T, Ribeiro MF, Rodrigues LP, Cecconello AL, Spritzer PM. Arch Toxicol. 2000 Apr;74(2):92-8.
11. The environmental estrogen bisphenol A stimulates prolactin release in vitro and in vivo. Steinmetz R, Brown NG, Allen DL, Bigsby RM, Ben-Jonathan N.Endocrinology. 1997 May;138(5):1780-6.
12. Prepubertal gynecomastia linked to lavender and tea tree oils. Henley DV, Lipson N, Korach KS, Bloch CA. N Engl J Med. 2007 Feb 1;356(5):479-85.
13. Red clover isoflavones biochanin A and formononetin are potent ligands of the human aryl hydrocarbon receptor. [like DIM and indole-3-carbinol] Medjakovic S, Jungbauer A. J Steroid Biochem Mol Biol. 2008 Jan;108(1-2):171-7.
14. Early life and adult exposure to isoflavones and breast cancer risk. Tomar RS, Shiao R.
J Environ Sci Health C Environ Carcinog Ecotoxicol Rev. 2008 Apr-Jun;26(2):113-73. Review.
15. The red clover (Trifolium pratense) isoflavone biochanin A inhibits aromatase activity and expression. Wang Y, Man Gho W, Chan FL, Chen S, Leung LK.Br J Nutr. 2008 Feb;99(2):303-10.
16. Effect of curcumin on the aryl hydrocarbon receptor and cytochrome P450 1A1 in MCF-7 human breast carcinoma cells. Ciolino HP, Daschner PJ, Wang TT, Yeh GC.Biochem Pharmacol. 1998 Jul 15;56(2):197-206.
17. Effect of biochanin A [red clover] on the aryl hydrocarbon receptor and cytochrome P450 1A1 in MCF-7 human breast carcinoma cells.Han EH, Kim JY, Jeong HG.Arch Pharm Res. 2006 Jul;29(7):570-6.
18. The effects of pomegranate seed extract and beta-sitosterol on rat uterine contractions.Promprom W, Kupittayanant P, Indrapichate K, Wray S, Kupittayanant S.Reprod Sci. 2010 Mar;17(3):288-96.
19. Dominant transmission of prepubertal gynecomastia due to serum estrone excess: hormonal, biochemical, and genetic analysis in a large kindred. Binder G, Iliev DI, Dufke A, Wabitsch M, Schweizer R, Ranke MB, Schmidt M.J Clin Endocrinol Metab. 2005 Jan;90(1):484-92.
20. An unusual case of gynecomastia associated with soy product consumption. [this happened to my daughter age 2 on soy formula. The Pedi knew nothing. wtf. Resolved when we stopped.] Martinez J, Lewi JE.Endocr Pract. 2008 May-Jun;14(4):415-8.
21. Role of testosterone and dihydrotestosterone in spontaneous gynecomastia of adolescents. Villalpando S, Mondragón L, Barrón C, Pérez-Pastén E, Castañeda G, Alonso-Uriarte R, Cortés-Gallegos V.Arch Androl. 1992 May-Jun;28(3):171-6.
22. Neonatal Exposure to Bisphenol A and Reproductive and Endocrine Alterations Resembling the Polycystic Ovarian Syndrome in Adult Rats.Fernandez MO, Bourguignon N, Lux-Lantos V, Libertun C.Environ Health Perspect. 2010 Apr 22.

The Brain and Adrenal Health

Our big phat brain is not only our largest sexual organ but also the most vital and important organ for rapid responses, reflexes and ultimately both short-term and long-term survival. [Image courtesy of daviddarling.info]

Another wonderful medical image of the adrenal glands which sit at top the kidneys at our flank, below.
http://www.netterimages.com/image/9021.htm

Note the proximity of adrenals to our major blood highways, the aorta and the vena cava which feed from the BRAIN and the heart which pumps and circulates 5 liters of your blood every second.

Nephropal post: Evo Brain, Survival of the PHATTEST

Instantly in less than one minute, chemical messengers that are integrated from the brain and its structures -- hypothalamus and the pituitary -- as a response to environmental and internal cues elicit changes immediately in the adrenals glands.



What Do the Adrenals Control?

The adrenals produce ~50 hormones (98% cholesterol-derived): all the sex hormones and their intermediaries, adrenaline (NE, EPI), aldosterone and cortisol. We need cortisol like we need insulin. Type 1 diabetes individuals make no insulin as a result of autoimmune damage and insults at the pancreatic islet cell level; to survive insulin must be injected or I.V. basal dosing all day at low levels. Insulin is necessary to make muscles and fat but not mandatory for fuel utilization. On the other hand, cortisol is necessary to integrate all food -- carbs, proteins and fats -- as well as to burn and produce energy -- ketones, glycogen, gluconeogenesis (GNG), and fatty acids. Cortisol may be the master hormone because it may control insulin and leptin, not the other way around. And... the BRAIN controls cortisol.



Natural Cortisol Secretion Patterns

Cortisol secretion follows a circadian pattern under normal relaxed circumstances. Generally, cortisol blood levels are highest in the morning as we are getting up and ready for the day. Shifting from a comatose, restful sleep tone to an alert, reposed, wakeful tone requires all the products from the adrenal glands, as directed by the brain (pineal gland downshifts melatonin, our internal 'clock' and 'calendar for seasons', light hits past the eyelids to crank out chemical messengers from the hypothalamus and pituitary to turn us 'on' for the day).

Spikes occur with 3 types of stimuli:
1) to produce energy from fats, protein, glycogen/glucose/GNG -- for waking, lower blood glucose, starvation/fasting, exercise training
2) to store energy -- post meal storage
3) to react to stimulation to maintain blood pressure and suppress inflammation -- caffeine, environmental cues (scent, sight, hearing, touch), mental stress, physical stress, sleep deprivation, nutritional deprivation




Cortisol Pathologies

Chronic 'spiking' may be pathologic if all the above are present or stimulus from an autoimmune or hyperplasia of growth at the hypothalamic, pituitary or adrenal cellular level (pheochromocytoma, Cushing's disease, hyperadrenocorticism).

Over time, alternatively, production can be halted, staggered or even chronically depleted.




Adrenal Insufficiency in the 21st Century

If there is one condition that may characterize neolithic living in our hyper-informed, hyperaware, super active, 'go-go-go', multi-tasking, 24/7 plugged-in age, adrenal insufficiency is IT. Btw, don't bother asking your conventionally trained physician about this condition. Currently, as far as I am aware, adrenal insufficiency just as vitamin D insufficiency and gluten/wheat-intolerance is not a part of the med school curriculum. Current M.D.s' are not trained to identify, diagnosis or treat this 'subclinical' condition unless you are about to keel over and display non-existent, undetectable serum levels of cortisol. Addison's is at the extreme end of the adrenal insufficiency 'spectrum' and is considered life-threatening, leading to complete shut down of organs if untreated. Like diabetes and celiac sprue, it's all a SPECTRUM which we may all be on... somewhere. Pre-diabetes? Silent-celiac? Show me someone who is not...

Trivia: who was a notable famous person with Addison's? [John F. Kennedy]


Signs of Low Adrenal Function

What are the signs and symptoms of poopy adrenals? The same as poopy thyroids? YES.

Adrenal Fatigue Symptoms (courtesy and adapted from HERE)

Low body temperature
Weakness
Lack of energy (reduced energy metabolism)
Unexplained hair loss (grrrrrls, pay attn)Nervousness
Difficulty building muscle (hitting WODs but no gains??!)
Difficulty losing weight (grrrrls and boys...)Irritability
Mental depression
Difficulty gaining weight
Apprehension
Reactive hypoglycemia (feeling shaky/cranky/palpitations after high carbs)
Inability to concentrate
Excessive hunger
Tendency towards inflammation
Moments of confusion
Indigestion, irritable bowel syndrome
Poor memory
Alternating diarrhea and constipation
Osteoporosis, osteopenia, bone fractures
Auto-immune diseases
Poor resistance to infections
Frequent infections
Asthma
Respiratory infections, pneumonia, bronchitis
Low blood pressure (but high occcurs too)
Lightheadedness especially upon standing
Palpitations [heart fluttering]
Dizziness that occurs upon standing
Insomnia
Food and/or inhalant allergies
PMS
Craving for sweets and carby foods
Dry and thin skin, dry skin, acne
Headaches, Migraines, Abdominal Refractory Migraines
Scanty perspiration (or excessive with reactive hypoglycemia)
Alcohol intolerance
Caffeine intolerance
Iodine intolerance (heart palpitations, racing heart, jittery? probably adrenal fatigue)
Thyroid replacement intolerance (ditto... with Armour, Cytomel, Synthroid, Levoxyl, Nutri-med Thyroid, etc therapy)

Causes of Low Adrenal Function

I've tried to look into the multivaried causes of adrenal insufficiency. They are the same as other organ and subsequent hormone failures (thyroid, kidney, coronary vasculature, brain/migraines, brain/Parkinson's, ovaries/PCOS, testicles/T-deficiency, etc) and insufficiency spectrums.

Causes Of Adrenal Fatigue (courtesy and adapted from HERE)

Stress, Stress, and more Stress!
THE SHEER HEAVY ONSLAUGHT OF NEOLITHIC STRESSORS + FOOD/ENVIRO TOXINS
Work pressure
Death of a loved one including beloved pets
Moving
Changing jobs, losing jobs
Physical illness
Marital and interrelationship problems
Anger
Fear
Feelings of helplessness and powerlessness
Worry/anxiety
Depression
Guilt
Overwork/ physical or mental strain
Excessive exercise, endurance training, elite athletic events
Sleep deprivation
Light-cycle disruption
Going to sleep late
Skin burns, sunburns involving extensive areas
Surgery
Trauma/injury
Head trauma/injury
Frequent fevers
Chronic inflammation
Chronic infection
Chronic pain
Temperature extremes
Toxic exposure (live near a refinery? have silver-mercury-filled cavities?)
Environmental toxins (smells, pesticides, heavy metals, PCBs, dioxin, and other endocrine disruptors)
Food toxins (gluten/casein, MSG, nitrates, preservatives/fungicides, bromides in flour, bromides in yellow sodas and veg oils, deep-sea fish (tuna, ahi, shark, etc), seafood/mercury, etc)
Drinking water toxins (alum, aluminum, cadmium, lead, mercury, FLOURIDE, CHLORIDE)
Malabsorption
Maldigestion
Poor gut biofilms
Chronic illness
Chronic-severe allergies
Food allergies (gluten, casein, corn, egg-whites, legumes, SOY, nightshades, etc)
Hypoglycemia
Nutritional deficiencies (B-vitamins, pantethenic acid, vitamin C, vitamin D, mixed tocopherols/trienols, vitamin K1 K2s/probiotics, vitamin A, coenzyme Q10, trace minerals: magnesium iodine selenium zinc chromium manganese molybedenum, omega-3 EPA DHA ALA, protein, saturated fat, cholesterol, egg yolks/caviar/organ meats, etc)
Drugs that cause autoimmune diseases (statins, all drugs with sulfur groups, hydralazine, SYNTHETIC HORMONES: oral contraceptives, progestins, Premarin, Provera, treatments for prostate cancer, prednisone, methylprednisone, dexamethasone, etc)

Adrenal Recovery

Inducing the adrenals to perform and function the way that we are meant to evolutionarily involves a multi-tiered program geared at feeding and recovering the adrenals. I am no expert but I am getting through recovering. Part of how my thyroids and adrenals pooped out can probably be traced back to childhood and even the in utero environment. Children can be born with adrenals working subpar (like many autism and spectrum children/adults). The factors for me: mother with IBS (gluten intolerance) and probably vitamin D/EPA+DHA deficiency, childhood 3rd degree burn involving majority of L-thigh (comatose for a few days), mother's death during childhood, asthma, bronchitis, infections, decades of gluten/n-6/candy toxicity, college and other stressors, finally use of synthetic birth control hormones, C-section surgery, 4 years straight not sleeping (pregnancy/lactation), our cat falling unrecoverably ill and passing away, stopping yoga and exercising less last year, caffeine dependency, progesterone-excess and extreme endocrine disruption from Mirena hormone IUD, 18-24 month lowgrade dental inflammation/abscess, and a bike accident (proverbial last straw).

One the best resources I have found is Dr. J. Wilson PhD ND's book 'Adrenal Fatigue: The 21st Century Stress Syndrome'. So far I agree with everything except the use of omega-6 (he advises a Tbs of sunflower oil daily) and whole grains, though he addresses gluten sensitivity. Achieving success in an evolutionary fashion would be far superior I believe and prevent further taxing of the adrenal organs. Otherwise, Dr. Wilson's recovery plan appears complete, thorough and borne out of deep 20+ years of research and experience. He covers medical data and research from 100 years ago combined with current medical publications but has written the book for the layperson. Part IV reviews the anatomy and physiology excellently and explains very well role of adrenals and the pathophysiology of damage.

The recovery program is multi-tiered:
(a) Pro-active relaxation and 'programmed' laughing (seriously, LAUGH LAUGH GIGGLE)
(b) SLEEP and nap
(c) Address nutritional deficiencies which occurred in the course of burning out the adrenals or from incomplete diets (iodine and mineral deficiencies are in fact very common as shown in the medical literature)
(d) Routine regular eating combining small amounts of carbs at each meal with plenty of fats and protein, including starting the day off w/good breakfasts; often people with low adrenals have low hunger in the morning (few in the morning however, and no fruit for most secondary to hyperglycemic effects)
(e) Routine regular deep breathing: exercise, yoga, meditation, massage, stretching (more sex)
(f) Avoiding as much of the above listed 'causes' because they are all adrenal depletors

Adjusting our internal cues is the key. I have observed in my hypertension and diabetes patients incredible blood pressure lowering and even glucose lowering with simple 5 minute breathing relaxation exercises in the clinic.

We indeed have extreme control of mind and therefore body. Tap into the mental inner core. (In yoga they say 'the breath is the bridge between the body and the mind')

Easy? Incredibly so. Once one is not in denial *haa!*

Part of the recovery plan, I'll be on vacation for several weeks in Beijing and Shanghai. YIPPEE! More to follow (or not *hee*).

Thank you Gentle Readers for your insights (you know who you guys are) and those sharing your adrenal stories with us at animal pharm and nephropal.

Mark Sisson ROCKS

My sister 'M' adores Mark.

He featured also her delish cookie recipe HERE.

We had the chance to meet him at Catalyst Crossfit in San Jose, then I had a 2nd chance at my DiabloCrossfit.

We got to chat about blogging (his, at the time he didn't know about mine *hee*) and just life. I wasn't that into him initially because he is SOOOO BEACHY PUUUUURRTY. But after talking to him and seeing his genuine thrust to help people be optimally healthy, I succumbed.

OK... rather instantly.

My sister and I cherish Sisson and his work b/c not only does he understand the science but he understands the application. The use of supplements are KEY to optimal health. In no way can diet and exercise alone fulfill our mitochondrial or bioenergetic potential destinies for full, maximal, complete HEALTH. The decades of neolithic damage are difficult to undo for those genetically susceptible (which I believe are 80-90% of world). Additionally, we were both impressed by the acknowledgement page where he gives hat tips to Peter/Hyperlipid and Stephan/WholeHealthSource, our all-time favorite educators and bloggers on earth *BIG SMILE*.

Prior animal pharm:
Paleo is... SHWINGTASTIC

I've given a dozen of his books away as gifts, to my dearest friends, family and colleagues. My patients who are endurance athletes love his book.

Sisson has hit #2 at Amazon yippee. Go DUDE!



Am I the big P*MP or what? Aren't we all paleo pimps *wicked eye*. Let's see this evo paleo world grow a little faster...

*NSFW* Sunlight: Rama to the Max

The avatar (reborn spirit) for the Sun is 'Rama'; the Sanskrit root of Rama corresponds to 'light and fire'. I have always been a sun-baby even as kid and enjoy HEAT. My little sisters and I used to frolick for hours everyday after school in Pennsylvania where the backyards were wide and fenceless. *haa* My brain still connects those warm, nice, sun-drenched days... with baby bunnies and butterflies...

In Northern Cal, we've had on/off S*CKY rain for like 7 weeks which feels like CENTURIES... finally the SUN is out and my vitamin D serum levels among other things (mood) are soaring up again *haa*.





Thank you Sis and B-I-L for the iPod shuffle...

UR so awesome. Technology rocks.


LOVE IT LOVE IT LOVE IT.




My favorite sun songs...

1. Sunlight, Natalie Imbruglia (see below)
2. Here Comes the Sun, BEATLES
3. Summer Skin, Death Cab For Cutie
4. SummerLove, Justin Timberlake
5. Cafe Del Mar Adios Ayer, Jose Padillo
6. You Are My Sunshine, Angelina Jolie version Mr. & Mrs. Smith
7. Sunlight, Plain White T's
8. In the Sun, Joseph Arthur
9. Summer Romance (Anti-Gravity), Incubus (acoustic)
10. Welcome to My Sunny Day, AKON
11. Tik Tok 'fight until we see the sunlight...', Kesha
12. Into the Light, Rolling Stones
13. Rough Cut, Alex Wong & Amber/Paper Raincoat, RSVP here for a house concert in SF 3/28th 4pm. See you THERE and bring RED RED WINE and ur hawwwt evo *ss WINKY
14. Amber... Sun Studio Sessions, You Will Love This Song and Another Perfect Sunset

Auto-Tuning Lp(a): Value of Low Carb, High Sat Fat

Disgusting

I've got a big tolerance for stupidity. Even supersized-stupidity. Mostly this is because I am somewhat a bit of ding-dong myself. Luckily... my husband has not divorced me yet after realizing for the millionth time that I'm a complete retardo (and too late, the genes have been dispersed to our offspring *haa*). Recently I put my cellphone through the wash. Seriously.

So.

The stupidity over saturated fat nonsense and low cholesterol diets *sigh* are over the top lately indeed and require a rant. Some cardiologists appear to fear the 'large buoyant LDL' created by saturated fat. I don't get this. Don't our cells possess the biochem to burn our b*tt PHAT? Maybe scientists lack this gene??

Conventional docs aim at LDL which is clearly the wrong target. In the primal/ancestral/crossfit world, the aim is focused on dense LDL. Yes -- this is emphasized by Cordain. He was courageous to stop condemning saturated fat. Xfit nutri certs *big smile* reinforced hyperlipidemia.

Here, biochem tiger Peter deciphers the medical literature. The core of atherosclerotic plaque is made up of lipids, mainly glycolated ones and oxidized LDL (oxLDL).

OxLDL is Lp(a)...
* Lipoprotein (a) is oxLDL
* Statins raise oxLDL and Lp(a)




Mouth

Let me speak freely.

Saturated fat controls Lp(a). (HERE, HERE, Krauss and DELTA)
Low carb controls Lp(a). (HERE and Volek; insulin-Lp(a))

This translates to the control of atherosclerotic plaque and regression.

It doesn't matter what level of Lp(a) one has (remember, Hecht showed that disease is associated with levels of 2 to 200 mg/dl) -- Lp(a)/oxLDL is like a 'spark' when lit. What lights up Lp(a)??! OMG. Saturated Fat Deficiency and Insulin. Hyperlipidity fixes Lp(a) and regresses plaque -- let Big Pharma chew on that. Are they colluding to keep us 'low sat fat'? It's not difficult.

Again. The only quartile associated with regression in women in ERA was the high saturated fat quartile. Mozzafarian et al. This is what I observe as well in real life.

Niwamae et al analyzed biometrics in 203 patients with peripheral vascular disease using IVUS. Plaque morphology was also analyzed: soft, hard/calficifed and lipid cores.

Should you be scared of intimal flaps? Errr. Yeah. If I had plaque -- I'd prefer 4-digit calcifications with stable hard-cores, than 2-digit FLAPPY soft-core plaque. Plaque rupture has been highly associated with the presence of intimal flaps -- like a poorly treaded Firestone, they are ready to burst with collision with sticky highway rubbish or pounding speeds.

Intimal flaps were only associated with 3 things according to Niwamae (see Fig 3, above):
(1) insulin resistance (read: high carb)
(2) low HDL (read: REALLY dense LDL, low sat fat, high carb)
(3) high total cholesterol (read: denseLDL/apoB/TG, high carb)

What lights up insulin? Carbs.

Read. High carbs KILL.

Carbs cause cancer. Carbs cause cholesterol concerns. Carbs cause PLAQUE.




Butterscotch

I like butter. *aah* EAT MORE BUTTER.

Recall, Ai M et al (boy the Japanese scientists ARE SO D*MN SMART) demonstrated that carbs trigger insulin, NOT SATURATED FAT. Previous animal pharm: Insulin and Aging, How Paleo Works

Soft plaque known as fatty streaks even develop in young hearts (Peter has a picture) and don't calcify unless oxidation occurs. EBT studies show that 95% of diabetics have calcified plaque, the other 5% probably have soft plaque which are vulnerable to stenosis. Why? Individuals withi diabetes are damaged/oxidized from carbs and insulin. How do you prevent oxidation? Eat some saturated fat d*mn it (ghee, butter, animal PHAT, coconut products, lard, beef, seafood, organ meats, schmaltz, etc) and keep your insulin low with a carb-appropriate diet (minimal fruit, no grains, no oats, no legumes, no soy) and lifestyles that are aligned to your evolutionary genetics. Maintain an intake of very low n-6 oils. Anything > 2-4% of the diet is excessive because it is associated with raising insulin resistance, CAD, cancer rates and inflammation. Walter Willet at Harvard and certain heart programs advise 40% fat with only *gasp* 8% sat fat and 15+% n-6 oils. Heart stopping and insane, isn't it?




Get In Line

Well.

There are a lot ding-dongs out there. In academia, the USDA, the ADA, the AHA and conventional cardiac programs (Dean Ornish)... T. Colin Campbell *haa* GO PALEO KING 'the stupidest think I've read'.




Take It Off

One thing I hate about the radio is the overuse of auto-tuning, a software technology employed that takes normal voices and 'tunes' up to desired levels, usually 'pitch perfect'.

The imperfect sounds better to me -- texture, depth, emotions shine through.

Naked. It ROCKS. Naked is true. *HA HAA*



Blah Blah Blah

How many times do we hear about low saturated fat diets? Too often.

Do they work? Hardly. Heart disease is still #1 in killing Americans. Low fat isn't working. Americans are SICKER, FATTER, and MORE TIRED than before 'low saturated fat'.




This Love...

For low fat is pervasive. People feel guilty and 'not healthy' if they fail to follow this advice from their esteemed cardiologist or doctor... I nearly choke when I see HDLs as low as 30's or 40's and people tell me they cut out egg yolks and fat. This is reflected in a heart-deadening drop from HDL of fantastic 60's 70's earlier. Their LDL's are subsequently auto-tuned with a statin to TESTOSTERONE-NUMBING levels of 40's to 50's.

AAAAARRRRRGGGGHHHH.

Then they tell me they are using more canola oil, olive oil and wholeheartdisease grains and oatmeal, and I wanna CRINGE and puke out loud. No wonder their numbers S*CK. Initiation and promotion of atherosclerosis and other inflammatory conditions (cancer, autoimmune, migraines, etc) are indeed inevitable.




You're Freaking Me Out

No. Unlike the current management of CAD (coronary artery disease) and the 'tuning' of LDL-cholesterol where Big-Pharma-sponsored heart disease management guidelines (NCEPIII) advise LDL < 70-100 mg/dl for for those with CAD or heart disease equivalents (EBT calcifications, diabetes, aneurysm, peripheral vascular disease, etc)... or other programs that endorse LDL of 60 or below, in contrast, low carb high sat fat evolutionary diets WORK. Small dense LDL are obliterated to zero or near zero. These individuals have heart scans of zero calcifications and definitive regression over time. Show me zero dense LDL and I will show you reversal. Here to be redundant are those succeeding: My Paleo Peeps.

Pushing the LDL below natural, naked, endogenous baselines with Big Pharma drugs (statins, zetia, vytorin, etc) miserably fail from my extensive observations, EBT statin trials (10 out of 12 show progression w/statins) and new ones like ARBITER-6 (vitamin B3 beats the cr*p out of zetia). EBT calcifications continue at unacceptable rates (20-50+%), heart attacks and re-stenosis of stents and bypasses still occur, and disability from lower extremities, kidneys, and failed hearts flagrantly progress despite *cough cough* 'life-saving' statins.




D-I-N-O-S-A-U-R

Archaic guidelines need to go extinct. Now.




Animal

Kesha's one of my favorite animals right now... The grrrrl cracks me up: Rolling Stone interview. If there's auto-tune, I can't tell... She sounds perfectly IMPERFECT.




While You Were Sleeping

Stuff is happening. Pro-active work in the blogsphere, media outlets, movies like Fathead, books like BSS, Primal Blueprint, and 6-Week Cure and... how 'bout infomercials with some haaaawwt Paleo peeps? We need some. Cordain and Wolf are putting together continuing education for docs -- he said they need a pharmaco person... so might fill in and express my st*pidity *haa*.




Boots And Boys

Not only are Crossfit boys and grrrrls ridiculously super HAAWWT but also require no auto-tuning w/drugs as optimal health falls naturally into place. Avoiding neolithic toxins (legumes, graines, dairy, refined n-6 oils, statins/drugs glyphosate herbicides, etc), eating whole foods, and taking nutraceuticals maximize our evolutionary heritage (omega-3, digestive enzymes, probiotics, vitamin D, insulin sensitizers, etc). These endogenously 'auto-tune' employing our inherent software, e.g. DNA and nutrigenomics.

Ultimately, Crossfit + Paleo (Robb Wolf + Nicki Violetti) and our ancient/primal/Protein-Power blogosphere are where I find unprecedented reversal stories. Mr. Billy E did so with only diet (Evo/Paleo low carb, high sat fat) and vitamin D!



A Bad Girl's Lament

What I've noticed is that the athletic field often 'get it' before the medical. A great example is the use of omega-3 fish oil by Dara Torres and other athletes. Ultimately performance trumps lipid panels. To me, results are strikingly self-evident with low abdominal obesity, X-image '300' buff xfit-trained warriors, NBA stars, cycling and Tour de France competitors, and Olympic stars like Apolo Ohno. Slowly people will figure it out and stop listening to their low-fat, conventional, Big Pharma-bribed, Koolaid-drinking doctors.
--Apolo Ohno, 4X Olympic Speedskater (NYT: coconut oil, eggs, low carb, appears grain-free (except rice prior to events))
--Christian Vande Velde, Tour de France (MH: Winning Without Wheat)
--Runner's World, Aug 2004, Should You Be Eating Like A Caveman?
--Men's Health: How the Low Fat Craze is Making Us Fat
--Beijing Olympic gluten-free foraging, runner Amy Yoder Begley

Dietary Carb 20-40 grams/day To Control BG

BG = Battlestar Galactica... *ha* j/k

BG = Blood Glucose

I loathe giving a limit to dietary carbohydrate intake but I get a lot questions regarding this.



Ideal Carb Intake for the Metabolically Challenged

20 to 40 grams daily
(with carb cycling 40 - 80 g on rare days -- to replenish glycogen after full depletion)

Why? This works, for broken metabolism.


Broken Metabolism

Carb intake for those with 'broken metabolism' like myself who used to carry 50 lbs of fat previously require meticulous and vigilant control of dietary carbohydrates and maintenance of basal metabolic rates via exercise. For us, carbs, fructose and omega-6 signal 'INSTANT' hibernation (fat gain, impaired immunity, sdLDL, low HDLs, autoimmunity, poor gut-brain axis). INFLAMMATION.

Why?

It is the Winterization v. Over-Summerization concept where our bodies are furtively storing for the winter that never comes. The adipose organ is damaged and continues to believe it is fulminant fat-storage time, not fat-burning time. Prior nephropal: Phat Fat Accumulation versus Mobilization

20 to 40 grams per day is an amount that helps to control insulin, BG (blood glucose) and improves body fat recompositon. Yes -- improves sdLDL (small dense LDL) and Lp(a) as well and allows subcutaneous and visceral fat regression, regression of vascular calcifications (e.g. plaque, hypertension), prevention of senility (Alzheimer's also known as Type 3.0 Diabetes), cancer protection and overall optimal health and lifespan (and an X-image *wink*). Carb cycling (+resistance training/exercise) prevents long-term reduction in basal metabolism as well as maintains enough subcutaneous fat. Under the skin fat, subcutaneous, is brown GLORIOUS fat which provides the youthful, X-image, in all the right places. Without brown fat we can get excessively saggy, droopy, wrinkly skin folds. (also that just takes TIME to tighten up after dramatic weight loss... like 18-24 months... sorry) Intermittent ketosis (intermittent fasting and ketogenic diets) improve insulin sensitivity and insulin secretion. Ketosis is like a cheat... simulates a negative energy balance (as carbs are taken out of the picture). We are built to be ketotic and use the prime fuel of our mammalian systems: fatty acids and ketones. Newbornes are ketotic the first 2 weeks of life as the maternal colostrum and milk are coming in.


What the h*ll are carbs?
Anything your tongue perceives as sweet (including fruit) or starchy.

Use Nutritiondata.com for help. Do note their reported servings sizes which are often not typical. Take into account in the calculations. Fitday.com is good as well I've heard.

Examples of 15 grams of carbs:
--1/3 cup oat bran (i.e. 2 bites and I have a big MOUTH; this raises my BG in 5-10min to 150-180 g/dl. No SH*T)
--palm-size orange, apple, banana (the worst due to starchiness), grapes, CUTEYS
--1/3 cup brown or white rice (doesn't matter they ALL raise BG)
--candy -- 1 bite
--ice cream 1/2 cup (not as huge a BG rise due to fat buffering effect from full cream)
--1 cup of milk (doesn't matter if low fat or full fat)
--1/3 to 1/2 cup juice or reg soda (depends on brand and HFCS content)
--1/3 cup pasta
--1 slice bread (rice bread is worse due to higher density)
--1/2 cup mashed potatoes




BG Mini Curve: Monitoring

Do you have a glucometer? The blood glucose curves for cats are better done than for humans IMHO (see diagram, courtesy of Vetsulin). Consider doing a 'mini curve' examining the effects of dietary carbs and combinations of food and lifestyle effects (exercise, intermittent fasting, STRESS STRESS, sleep deprivation, resistance/weight training, etc). Consider monitoring closely and tightly from 5-15min after food and additionally 30 v. 60 v. 45 v. 60 v. 90 min after food.

Feline 'mini curve'
Remember Ai M's study on carb loading v. fat loading and the insulin effects? Click here: insulin and aging. The same curve can be superimposed for dietary carbohydrates -- blood glucose rises within 5-10 minutes of a carb load. If I consume (depending on the time of the month and how much exercise I'm doing), my sugars can climb and peak to 180 mg/dl easily with 1 cup of rice in less than 10 minutes. And... I generally feel cr*ppy for the rest of the day (flushed, fast heart rate, hypersensitive).

When a diabetic patient has a hypoglycemic reaction (low glucose < 60 mg/dl; signs and symptoms include sweating, hot flash, tremor/shakes, fast heart rate, irritability, anxiety, palpitations, hunger, tunneling vision, headache/migraine), a glucose source will generally start to raise the blood glucoses within 5 to 10 minutes. Usually only medications lower the glucose so significantly (insulin or an oral drug, e.g. glyburide, glipizide, Amaryl). Exercise + medications is a potent combination. Exercise for some individuals is equivalent to 10 to 20 units of insulin.

What are goal glucoses? Why are they elevated in the first place? Adrenal insufficiency (which is associated with reactive hypoglycemia)? Untreated, undiagnosed hypothyroidism? Excessive carb intake? Lack of resistance training? Sarcopenia? Lack of exercise? Sleep deprivation? Excessive mental stress?

Fix these first then consider focusing on BG.

Here is the relationship between HgbA1c and average glucoses (click HERE) -- written by a fan of Dr. Bernstein's , a patient educator and advocate who has an A1c of 4.7% and is a Type 1 diabetes patient himself and medical physician.

Goals stated previously (HERE): HgbA1c < 5.0%

Glucoses > 140 mg/dl are associated with AGEs RAGEs and other glycosylation products and damage, including diabetic complications (kidney, eyes, nerves, brain, blood vessels, erectile dysfunction, hormone dysregulation, endocrine glands, etc).

We are not M&Ms. Don't sugar-coat yourselves.

Ultimate goal for health: as normal as possible (flat curve at 97 mg/dl or lower)


Success Stories

See prior paleo CAC success stories achieved with low carb, high sat fat Paleo or 'Dai-leo'(update Jimmy Moore and Scott have zero plaque): My Paleo Peeps With High HDLs

Mr. Billy E is my HERO! Reversed CHF, chronic kidney disease, Type 2 Diabetes (T2D), dyslipidemia (high TG, low HDLs) and hypertension on low carb, high sat fat Paleo. Click HERE and HERE Look what happened on the way back to the cave.



Control of BG, Insulin, and Leptin
Stephan has articulately enlightened on leptin ( still I just don't completely get it yet... coz I'm a ding-dong). Leptin appears to be the long-term messenger for energy balance, reproduction and control of hunger and certain behaviors...
Wholehealthsource: Leptin
Excellently expressed and illuminating insulin resources which have helped me in my understandingof the hormone cascades are below. Though I have a CDE, certified diabetes educator 'credential', these broadened my knowledge by a ~milllion-fold... because... I admit *blechVOMIT* I used to be a card-carrying ADA member.
-Dr. Guyenet (Stephan) at WholeHealthSource: Body Set Point series, Paleo Diet series, Low carb diets, Fatty Liver, Visceral Fat, Omega-6/Fructose, Butyrate, etc
-Drs. Mary and Mike Eades: ProteinPower books
-Dr. Harris at PāNu: How to lose weight and Get Started
-Dr. McGuff of Body By Science: Internal Starvation and Especially for Women

Robert McLeod's thoughts on insulin and other hormones are what I have been thinking about for a while and what I have found personally to work for lifestyles. I would agree and concur on all his 13 points.

Entropy Production: Hormone posts by Robert McLeod (I consolidated)

INSULIN, GHRELIN
1. Very long and very slow exercise (4+ hrs), typically hiking or cycling in my case. This is a far cry from the type of anaerobic-limit cardio exercise one typically sees recommended, for example, by the American Heart Association. There is a yawning gulf between walking and jogging. I personally approve of anaerobic exercise, such as sprint intervals or plyometrics.

2. Consistently eat carbohydrates at a low enough level that the brain (which prefers glucose over ketones) consumes the entirety of carbohydrates that you eat, leaving the body to burn ketones. This is a slow process.

3. Periodically fast for an extended period of time so that your basal metabolism burns through your glycogen reserve and then begins to mobilize fat. This is not a calorie reduction method, rather you are simply not eating three times a day (on average), and as such having more extremely calories negative and calorie positive periods.

GROWTH HORMONE
4. Get adequate sleep. GH production spikes during sleep. Try not to eat before bedtime.

5. Fast occasionally, for relatively short durations.

6. Conduct intense exercise. Don't eat before or during your exercise.

PALEO PRINCIPLES
7. Control appetite hormones like gherlin by eating regular, satiating meals. By satiating I mean protein, fat, and fibre. Try to avoid snacking.

8. Restrict fructose and alcohol consumption to reasonable levels, day-to-day. 20 g/day of both combined would be a very healthful level, 50 g/day is I think an upper bound for people with healthy livers.

9. Eliminate industrial, refined oils, particularly refined polyunsaturates such as soy and canola oil. Go for fresh and high quality fats, in particular clarified butter, extra-virgin coconut oil, extra-virgin olive oil, and the fats from animals fed their native diet. Unstable oils should be stored in the refrigerator or freezer to prevent them from going rancid, e.g. Omega-3 fish oil capsules. Most industrial oils are deodorized to prevent you from smelling when they go bad.

10. Eat more than just muscle meat from an animal. Have you eaten liver pate or roasted heart lately? Bone broth?

11. Fast occasionally for approximately 24-hours to give your liver a break and restore insulin sensitivity. Many religious groups noted for their good health (i.e. Seventh-day Adventists, Mormons, and the Greek-Orthodox of Crete and Corfu) regularly fast — is the the shared common trait. Fasting and starving are not the same thing, don't conflate the two.

12. Go on elimination dietary trials of the common food allergies: wheat (including barley and rye), cow dairy, legumes, especially soy and peanuts, tree nuts, eggs, fish, and shellfish. Test assays may be insufficient to recognize many of the idiopathic problems (i.e. autoimmunity, neurological disorders) that these types of food may induce. It took me six months wheat-free to get better.

13. Supplement with Vitamin D, on the order of 1000 IU/12 kg of body mass per day. Consider that the recommended doses for infants are 400 IU/day, so if you mass ten-times that of an infant, you need ten-times as much vitamin D; recommended adult doses are a joke. Also consider that you produce about 10,000 IU/ 30 minutes in full-sun. Vitamin D is not a vitamin, it is the precursor material to most of the steroid hormones in your body. When the endocrine (hormone) system has adequate signaling compounds, the whole body works better.

Leptin and Leptin Resistance

Dr. A's post is eye-opening. Mastering Leptin book report (but note her '????'s where I think she politely says wtf)

Factors that shut our brain off to messages like leptin and therefore raise leptin resistance and impair transport of leptin across the blood-brain-barrier are non-paleo foods and lifestyles:
--excessive fructose
--maternal magnesium deficiency (epigenetic changes in rats)
--dairy fats (?unfermented A1 casein)
--lectins (grains, oats, corn, legumes, soy, peanuts) -- (unsoaked seeds and nuts too -- these are fattening if excessive!)
--screwed up gut-brain axis
--lack of sustained 2-4 hr exercise and/or resistance training
--factors that induce hypertriglyceridemia: omega-3 deficiency, excessive carbohydrate diets, sedentary lifestyle, synthetic hormones (progestins, endocrine disruptors, Teflon, pesticides, bisphenol, etc), estrogen/vitaminD/testosterone/DHEA deficiencies
--deficiency of saturated fatty acids (short- medium- long-chain)
--excess omega-6 and/or deficiency of omega-3
--high cortisol (stress, endurance train/events, poor sleep)
--starvation (excessive intermittent fasting, hypocaloric diets)
--gender (females more affected, esp with all factors listed above)
--genetic programming (epigenetic influences -- stressors: drought, famine, protein-restriction)

Hypertension and the X-Image

From the left: Mechad Brooks (from True Blood), Spanish tennis player Fernando Verdasco and Japanese soccer player Hidetoshi Nakata.

How is the X-Image and Hypertension Related?

[This is not a stretch... *wild wink*]

For men, this is the balanced, broad shoulders, narrow hips image. For women, strong symmetrical shoulders, narrow waist, wide child-bearing hips, long gams. The X-look was coined by Prof DeVany. Evolutionarily, secondary sex traits are associated with high fertility. For both genders, a narrow waist signifies high hormones -- testosterone (not hair-losing-DHT), estrogen, progesterone, DHEA, pregnenolone, etc. And... Low insulin, low insulin resistance and low inflammation and, thus, high immunity and resistance to lethal infections, the biggest killer of ancestral man besides predators and famine/drought.

Low insulin and low insulin resistance also corresponds (typically) to no visceral fat (intra-abdominal adiposity)... and narrower waists, precisely, the X-image.

Many genetic adaptations derive to push forward genetic material to the next generation and to provide for a stronger immune surveillance and protection system. Peter will soon be discussing the (protective) role of Lp(a) and the evolutionary disadvantages of vegetarianism. Bantu vegetarians not only have higher Lp(a) but also higher blood pressures.



Brain, Neuropeptides, and Hormones

The primary controller of fertility and sexual function is our... BRAIN.

I am not joking. Indeed, the brain is our biggest sex organ.

The pituitary-gonadal axis influence sex hormones and fertility by incorporating multilevel inputs from the intestines/GI, muscles, senses (eyes, ears, mouth/ philematology, smell/ pheromones), fat stores, liver, etc .

Scheider JE discusses the balance of energy and reproduction thoroughly. Two diagrams are from Energy Balance and Reproduction, click for PDF HERE.



Energy Balance and Reproduction

The physiological mechanisms that control energy balance are reciprocally linked to those that control reproduction, and together, these mechanisms optimize reproductive success under fluctuating metabolic conditions. Thus, it is difficult to understand the physiology of energy balance without understanding its link to reproductive success. The metabolic sensory stimuli, hormonal mediators and modulators, and central neuropeptides that control reproduction also influence energy balance. In general, those that increase ingestive behavior inhibit reproductive processes [e.g. excessive carbohydrates], with a few exceptions. Reproductive processes, including the hypothalamic–pituitary–gonadal (HPG) system and the mechanisms that control sex behavior are most proximally sensitive to the availability of oxidizable metabolic fuels. The role of hormones, such as insulin and leptin, are not understood, but there are two possible ways they might control food intake and reproduction. They either mediate the effects of energy metabolism on reproduction or they modulate the availability of metabolic fuels in the brain or periphery.

This review examines the neural pathways from fuel detectors
to the central effector system emphasizing the following points:

0 First, metabolic stimuli can directly influence the effector systems independently from the hormones that bind to these central effector systems. For example, in some cases, excess energy storage in adipose tissue causes deficits in the pool of oxidizable fuels available for the reproductive system. [Recall, insulin stores/locks in fat. We need 'some' insulin for muscle growth, but really not much. Hard-gainers have insulin resistance in the liver and elsewhere, I strongly suspect.] Thus, in such cases, reproduction is inhibited despite a high body fat content and high plasma concentrations of hormones that are thought to stimulate reproductive processes. The deficit in fuels [fatty acid fuel deficits caused by carb-pathways turned on] creates a primary sensory stimulus that is inhibitory to the reproductive system, despite high concentrations of hormones, such as insulin and leptin.

o Second, hormones might influence the central effector systems (including gonadotropin-releasing hormone (GnRH) secretion and sex behavior) indirectly by modulating the metabolic stimulus.

o Third, the critical neural circuitry involves extrahypothalamic sites, such as the caudal brain stem, and projections from the brain stem to the forebrain. Catecholamines [adrenaline, stress], neuropeptide Y (NPY) and corticotropin-releasing hormone (CRH) are probably involved.

o Fourth, the metabolic stimuli and chemical messengers affect the motivation to engage in ingestive and sex behaviors instead of, or in addition to, affecting the ability to perform these behaviors. Finally, it is important to study these metabolic events and chemical messengers in a wider variety of species under natural or seminatural circumstances.

Insulin and Leptin 101 Basics

For more insulin and leptin 101 basics, please see Dr. A, my soul sister in science *BIG SMILE!*
--Mastering Leptin book report (but note her '????'s where I think she politely says wtf)

Stiffness. Caused by Insulin and ROS.

OK sometimes we want stiffness.

Er... But not forever...

Like a rubber tubing left outside to the elements, the vascular system in mammals (and fish) will stiffen and crack if it loses contractility and elasticity from oxidative damage. Rubber is resilient, yielding and flexible until it starts to break down from damaging factors such as UV, heat, cold, salt, oxidation, radiation, etc. In biologic systems, unlike rubber, there is respite and forgiving repair. Damage only occurs when the destructive factors outpace the rate of repair. The coronary arteries are most affected due to narrow relative diameters and high shearing forces as blood is pumped from the heart to the peripheral tissues. The higher the pressure, the more potential damage to the endothelium (lining of blood vessels). As the body tries to heal these tiny 'nicks' in the endothelium, scar tissue and calcifications form. If the immune system is on abnormal 'hyper-overdrive' or if the BP is abnormally high, then the scarring and calcifications can be more extensive, more keloidal, more thick with plaque. Those with Lp(a) (at any level, according to Dr. Harvey Hecht's research) tend to over-scar, it appears when the Lp(a) particles are small and oxidizable. Don't be dense. Saturated fat increases the size of LDL as well as Lp(a) (which is just LDL plus apo(a)), which improves the buoyancy and anti-atherogenic properties of LDL and HDL.





Insulin, Insulin Resistance Raise BP and Coronary Calcifications

High blood pressure is a 'gateway' condition to heavier, harder, stiffer conditions. BP greater than 110/70 is one of the first indicators that something is going on... See prior Nephropal post: Insulin.

BP is reflective of our inflammatory status and health of the endothelium. What causes BP to rise? Well. If you ask a cardiologist or any primary doc, they will tell you that essential hypertension has no known cause. WTF. With going paleo, BP, insulin, and insulin resistance are all lowered. Frasetto et al at UCSF showed this (as well as EVERYONE in the paleo community who was previously ill). Click HERE prior nephopal. With going low carb, Meckling et al has shown that BP, insulin and glucose were all also lowered (click HERE).

In the low-fat arm, of course, this was not the case. Low-fat is killing America by raising and maintaining high insulin levels which make us fat and STIFF.

Dr. Houston has discussed known causes of hypertension: ROS (reactive oxygen species), e.g. inflammation. Nephropal post: Nutrigenomics and Hypertension.

o Blood pressure and fasting plasma glucose rather than metabolic syndrome predict coronary artery calcium progression: the Rancho Bernardo Study.

o Insulin resistance independently predicts the progression of coronary artery calcification.

o Adiponectin, visceral fat, oxidative stress, and early macrovascular disease: the Coronary Artery Risk Development in Young Adults Study.

o Psychological stress, insulin resistance, inflammation and the assessment of heart disease risk. Time for a paradigm shift?

o Relationship of adiposity to subclinical atherosclerosis in obese patients with type 2 diabetes.




What Does NOT Raise Insulin?

Fat.

Pure unadulterated fat.

I aint talking olive oil honey.

See prior animal pharm: Insulin and Aging -- how low carb, high saturated fat works.


What Raises Insulin?

--Dietary carbohydrates (e.g. oatbran, grains, corn, legumes)
--(protein, mildly)
--Fructose
--Omega-6
--Gluten (via both the carb route and the endorphin system)
--Cortisol (stress, sleep deprivation, endurance training, etc)
--Hormone deficiencies (vitamin D, testosterone, estrogen, omega-3 fish flax, thyroid, etc)
--Drugs (steroids, birth control, Crestor/ rosuvastatin, Provera/ progestins, water pills, etc)
--Lack of ketones (MCT oil, coconut oil, periodicity of exercise or fasting)
--Sedentary atrophying lifestyle
(Last X-Image: Kellan Lutz, from Twilight series and 90210)



Dr. T's Winterization (good) v. Over-Summerization (bad)

Diagram from Schneider, modified.