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Keto Approved Foods

I’ve been living and teaching patients about using a low-carb/ketogenic and carnivorous lifestyles for over 16 years.  I get thousands of questions each month about what to eat. People ask:

  • “What foods are ketogenic lifestyle approved?”
  • “Can you just give me a list of approved keto foods?”
  • “But, can’t I just have some oatmeal?”

In the past, I’ve given people seven day diets, and I’ve given them food lists.  But, you know the proverb, “give a man a fish . . .”  People still seem confused.  I’ve tried teaching people the simple ketogenic principles, “teach a man to fish . . .”  and this helps a few others.  However, there still seems to be great confusion about what foods can and should be used in a ketogenic lifestyle.  Today, I thought I would try to combine both approaches and discuss the basic macro-nutrients that make up a well formulated ketogenic diet.

Carbohydrates

Let’s start with carbohydrates.  The first principle that must be followed to enter and stay in ketosis is keep insulin from spiking.  This is done by keeping total carbohydrate intake less than 20 grams per day.  The liver produces a small amount of carbohydrate every day to protect the brain.  Therefore, a low baseline level of continuous insulin production is essential to maintain life.  However, it’s the large spikes of insulin after ingesting carbohydrate containing meals that cause the problems.  We talk about this at length in my book The Keto Cure.

Carbohydrates are the foods that most commonly cause insulin to spike.  It is the rapid rise or spike of insulin levels that drive weight gain, arterial plaque formation, heart disease, inflammation, neuropathy, kidney stones, gout and thyroid problems.  Simple and complex carbohydrates cause insulin to surge.  Those same simple and complex carbohydrates are the sugars (monosaccharides & disaccharides) and starches (polysaccharides) found in foods.

Fibers are also complex carbohydrates (polysaccharides) in the form of cellulose, lignin and pectin that are more difficult for human digestive enzymes to break down into simple digestible forms of carbohydrate.  However, juicing, blending or cooking fibers releases the carbohydrate from the complex form and makes them available to our bodies.

Carbohydrates in their various forms are present in varying amounts in foods like fruit, vegetables, grains, beans, legumes, milk, and processed foods like candy, soda & sweets. (These are the foods to limit or completely avoid).

In general, raw leafy greens contain cellulose and the carbohydrates in these vegetables when eaten raw do not need to be counted.  You are free to eat as much as you desire.  However, cooking, blending or juicing the leafy green (as noted below) does break the cellulose bonds and increases carbohydrate absorption (that is why cooked, blended, or juiced vegetables taste “sweeter”).

NOTE: I recommend 1-2 cups of raw leafy greens per day.  Leafy greens are one of the highest sources of folic acid (spinach, asparagus & okra) and without them in the diet, there is a potential risk of folate deficiency if it isn’t present in animal fat sourcesa.  This is especially problematic in pregnant and breast feeding mothers.  Yes, I hear you, eggs and meat are another source of folic acid; however, leafy greens like spinach contain four times the folic acid that eggs and meats do.  Even iceberg lettuce contains more folic acid than eggs (this is why I caution pure carnivore diets in women of child bearing age without folic acid supplementation).

Foods that are loaded with sugars and starches that should be AVOIDED or USED WITH GREAT PRUDENCE include:

Non-Leafy Green Vegetables (1 cup raw or 1/2 cup cooked) – 10 grams of carbohydrate

Asparagus
Bamboo Shoots
Beans (yellow or green)
Beets
Broccoli
Brussell sprouts
Cauliflower
Cabbage
Celery Leaves
Egg Plant
Leeks
Mushrooms
Okra
Onions
Green Onions
Scallions
Pea Pods
Peppers: Green, Red, Sweet, Hot
Sauerkraut
Spinach
Summer Squash
Turnips
Tomato
Zucchini
(Corn, Carrots and Potatoes are not listed here due to their higher carbohydrate content)

Fruits (portions below) – 15 grams of carbohydrate

Apple (1 small)
Apple Juice (1/2 cup)
Apple Sauce (1/2 cup)
Apricots (2 fresh) Page | 5
Banana (1/2)
Berries (blueberries, black berries, strawberries, loganberries, raspberries – 1 cup)
Cantaloupe (1/4 of a 6 inch melon)
Cherries (12)
Cranberries (1 cup)
Dates (3)
Figs (Fres
Grapefruit Juice (1/3rd cup)
Grapes (17 small)
Honeydew melon (1/8th of a 7inch melon)
Kiwi (1)
Lemons (2)
Mango (1/2)
Nectar (1/3rd cup canned)
Nectarine (1)
Orange (1 small orange)
Orange Juice (1/2 cup)
Peach (1 medium)
Pear (1 small)
Pineapple (1/2 cup chopped)
Plumbs (2)
Prune Juice (1/3 cup)
Prunes (2 fresh or dried)
Raisins (2 Tbsp)
Rhubarb (1 cup cooked)
Tangerine (1)
Watermelon (4 inch x 1 ½ inch thick wedge)

Breads (portions below) – 20 grams of carbohydrate

Bread: white, wheat, French, rye, pumpernickel (1 slice)
Bagel (1/3rd)
Biscuit or Roll (1 small)
Breadcrumbs (1/4th cup dry, grated)
Bread-stick (1)
Buns: hamburger, hot dog (1/2 bun)
Cereal – cooked (1/2 cup)
Cereal – puffed (1 cup)
Cereal – flakes (1/2 cup)
Corn (1/3rd cup or 1 small cob)
Crackers:
Graham (three 2 ½ inch squares)
Oyster (1/2 cup)
Saltines (5)
Soda (3)
Zwieback (2)

Macaroni noodles (1/2 cup cooked)
Matzo (one 5 inch square)
Muffin – English (1/2 plain)
Muffin – bran (1 small) Page | 6
Toast – Melba (4 rectangles)
Pasta (1/2 cup) Peas – green (1/2 cup)
Pita bread (1 small)
Popcorn – air popped, dry (3 cups)
Potato – New, Russet or sweet (1/2 cup)
Pretzels (3/4th oz)
Rice – cooked (1/3rd cup)
Rice Cakes (2 plain)
Tortilla (1 small)

Dairy (portions below) – 25 grams of carbohydrate

Milk – whole, 1%, 2% and skim (1 cup)
Powdered Skim Milk – dry (1/3rd cup)
Yogurt:
Plain (1 cup)
Light – sweetened with NutraSweet (1 cup)
Regular – fruit filled (1/2 cup)
Cottage Cheese (2 cups)
American Cheese (12 slices)

You may use hard cheeses, cream cheese, sour cream, and mascarpone as great options on a ketogenic diet because they contain very little carbohydrate and are high in fats.

Proteins

Proteins are large molecules made of of long chains of amino acids and are essential for a vast array of functions within the human being including structural formation, enzymatic reactions, immune response, cell adhesion, DNA replication, and molecular transport to name just a few.  There are 22 amino acids that make up the protein molecules used in the human body.  Interestingly, microorganisms and plants can make all 22 of these amino acids on their own.  However, humans (and a number of other mammals) can’t make 15 of these amino acids on our own and we must obtain them from our diets.

How much protein do you actually need? Understanding your individual needs baseline protein needs can be calculated from your ideal body weight (IBW).  IBW can be very easily calculated from your height and your level of activity.  I give you this calculation because many female patients I see do not eat enough protein.  Lack of protein will halt weight loss (as the body thinks it is starving.)

Your daily protein need can be calculated by the following:

Males: IBW =  50 kg + 2.3 kg for each inch over 5 feet.  Males need 1.2 g protein per kg of IBW.

Females: IBW = 45.5 kg + 2.3 kg for each inch over 5 feet. Females need 1.0 g protein per kg of IBW.

If you are exercising more than 30 minutes 3 days per week then those values increase to 1.4 grams per kg for females and 1.6 grams per kg for males.

Example:

A 6 foot male’s IBW would be 50 kg + (2.3kg x 12 inches) = 77.6 kg  x 1.2g/kg if sedentary or 1.6g/kg if exercising 4-5 days per week. 

A 5 foot 4 inch females IBW would be 45.5 kg + (2.3kg x 4 inches) = 54.7 kg x 1.0g/kg if sedentary or 1.4g/kg if exercising 4-5 times per week.

 

This will give you a starting point for your daily protein needs and you can divide this number by the number of meals per day to get the protein needs at each meal.  However, many of my patients after three months of ketogenic living need more protein to continue seeing weight loss.

What if I eat too much protein? There is still significant controversy over exactly how much protein is necessary on a daily basis.  The reason is that many amino acids when ingested in significant amounts stimulate an insulin surge by themselves. These include arginine, lysine and tryptophan.  Eating proteins that are high in these three amino acids in my very insulin resistant patients will raise insulin enough to halt weight loss, cause worsening inflammation, raise blood pressure and cholesterol.

Do you have to avoid these foods on a ketogenic diet? No, however, when you are using them more than 2-3 times a week, weight loss is inhibited and one’s ability to maintain ketosis is blunted.

However, two recent studies(1, 2) demonstrate that when protein intake is increased beyond a certain threshold, growth hormone counterbalances the insulin response and stimulates muscle growth instead of weight gain. That threshold seems to be around 90 grams of protein per day as women and 150 grams of protein as men.

Yes, this is much higher protein in take than the calculation for baseline protein needs we’ve used for years outlined above.  We are learning a great deal about protein.  For years, we’ve been missing the mark on protein needs.  This revolves around the need of leucine to stimulate muscle growth.

What proteins can you use?  The following list should be helpful.  Remember that protein and fat often come packaged together in nature.  As we discuss below, to maintain adequate ketosis, total fat intake should between 70-90% of your total calories.  In order to maintain fat contents greater than 70%, you’ll want to use proteins sources that are the highest in fat (like red meat and pork) or add fat (like cooking in butter or coconut oil) to those that are lower in fat content.

Food:                                                                       Protein Content:                           Fat Content:

Ground Beef (75% Lean) –                                    16 grams per 4 oz.                                  78%

Steak (Ribeye) –                                                      39 grams per 8 oz.                                  74%

Steak (Top or Bottom Round) –                         33 grams per 6 oz.                                  53%

Bacon (pan fried) –                                                 3 grams per 1 slice                                 69%

Sausage (beef) –                                                      14 grams per 3.5 oz.                               79%

Sausage (pork) –                                                      17 grams per 3.5 oz.                               75%

Pork Chop (boneless) –                                         18 grams per 3 oz.                                  31%

Ham (cured whole boneless) –                           19 grams per 3.5 oz.                               28%

Sockeye Salmon –                                                  23 grams per 3 oz.                                  22%

Halibut –                                                                    23 grams per 3 oz.                                  19%

Chicken Breast (boneless, skinless) –                24 grams per 3 oz.                                  18%

Turkey Breast –                                                        24 grams per 3 oz.                                  15%

Tilapia –                                                                      21 grams per 3 oz.                                  13%

Yellowfin Tuna –                                                      25 grams per 3 oz.                                  10%

Light Tuna –                                                             22 grams per 3 oz.                                  8%

Deli Meats:

Pepperoni –                                                              18 grams per 3 oz.                                  83%

Roast Beef –                                                             21 grams per 3 oz.                                  48%

Canadian bacon –                                                   17 grams per 3 oz.                                  42%

Roast Turkey Breast –                                            18 grams per 3 oz.                                  15%

Snacks:

Beef Jerky (Jack Links) –                                          13 grams per 1 oz.                                  9%

Peanut Butter (Peter Pan Crunchy) –                 8 grams per 2 tbsp.                              76%

Macadamia nuts, raw                                             2.2 grams per 12 nuts                           89%

Mixed Nuts –                                                               6 grams per 2 oz.                                  79%

Almonds, raw –                                                          6 grams per 1 oz.                                   66%

Walnuts, raw –                                                           4 grams per 1 oz.                                    85%

Sunflower seeds, raw –                                            6 grams per 1 oz.                                    76%

Tofu –                                                                          12 grams per 3 oz.                                   30%

Greek Yogurt –                                                        23 grams per 8 oz.                                  0%

Cheeses:

Cream Cheese –                                                       11 grams per 3.5 oz.                               79%

Cheddar Cheese –                                                   24.6 grams per 3.5 oz.                           74%

Swiss Cheese –                                                         24 grams per 3 oz.                                 66%

Ricotta cheese –                                                      10 grams per 3.5 oz.                               63%

Eggs –                                                                        6 grams per 1 large egg                        70%

Look for foods who’s ratio of protein to fat is close to or greater than 1:1.  For example, eggs are 6 grams of protein and 6 grams of fat.

It is essential to understand that not all sources of protein are equal in their absorption in the human gut.

  • Egg protein utilization – 50%
  • Meat protein utilization – 40%
  • Cheese protein utilization – 40%
  • Whey protein utilization – 18%
  • Vegetable protein utilization – 14%

Therefore, the two most important things you can do to optimize your ketogenic lifestyle is lower the carbohydrate intake to less than 20 grams per day, and use adequate high quality protein. Muscle gain and fat loss are most effectively achieved when high quality protein is used.

If you are struggling or just getting started, get a copy of Dr. Nally’s Ketogenic Diet here.

Should I Get A Flu Shot?

Before you answer that question let me ask you a question.  Did you know that the influenza viral strain has multiple sub-types? The Influenza A viral strain that has 198 different sub-types and influenza B has just as many, meaning there are at least 400+ different strains of Influenza. Oh, did I tell you that we have recently identified Influenza C & D sub-types as well? Yes, this means that there are over 600+ sub-types of influenza.

Herd Immunity

You might be able to immunize the herd if the average age of those in the herd lived for 200 years. Anyone telling you getting your flu shot improves herd immunity doesn’t understand virology. Herd immunity goes out the window with influenza and with most mRNA viruses like coronaviruses.

In order to vaccinate the population against influenza 33%-44% of the population must have immunity to all viral types in a given year.   With COVID-19, the estimate is 60-75% must be immunized to all 170+ known strains of coronavirus.

You may have antibodies to one of those flu strains, yet what about the other 400-600 strains you might be exposed to next year? Just because you have antibodies, doesn’t mean you are immune. This applies to Influenza and it applies to coronaviruses.

The influenza vaccine (which only covers 4-5 of the 600+ influenza strains possible). Which one do you pick this year? Hence the CDC cartoon.

Does the Influenza Vaccine Reduce Risk of Hospitalizations?

Over 20 years, the percentage of seniors getting flu shots increased sharply from 15% to 65%. It stands to reason that flu deaths among the elderly should have taken a dramatic dip due to increased flu vaccination each year. And at over 40% of the population being immunized, herd immunity should have been achieved.

Instead, flu deaths among the elderly continued to climb. It was hard to believe, so researchers at the National Institutes of Health set out to do a study adjusting for all kinds of factors that could be masking the true benefits of the shots. But no matter how they crunched the numbers, they got the same disappointing result: flu shots had not reduced deaths among the elderly. It’s not what health officials hoped to find.

The two studies below demonstrate that yearly flu vaccine for those over age 65 does nothing to decrease influenza related death. These studies funded by the government in 2005 and 2006 were suppressed. Your doctor and I never heard anything about them. Yet, the CDC still says “Get your flu shot.”

mRNA Vaccines Increase Risk of Other Viruses

Last, the influenza vaccine actually increases your susceptibility to coronavirus infection. Yes, you read that correctly. A recent study by Wolff demonstrates that influenza vaccinations are not benign.  Influenza vaccine increases risk of Coronaviruses by 36%, non-influenza viruses generally by 15%, and human metapneumovirus by 59%.

And, a second study trying to confirm the findings above reveals increased risk of parainfluenza virus in adults (increased by 4.6% of vaccinated adults and only 2.6% of unvaccinated adults.

So, what is the answer? Waiting for the perfect vaccine or an antibody test is not the answer. Anyone telling you this is selling something.

Please be aware, I am NOT an anti-vaccine physician.  Vaccines are life saving.  But, it is essential that you and I understand the pros and cons of each and every vaccine we use or recommend.  I am a huge proponent of most childhood vaccines, pneumonia vaccines and the new shingles vaccine, because they work. The science confirms their effectiveness.  The science does not confirm the effectiveness of the influenza vaccines.

What should I  do?

We now know that ketogenic diets improve resistance to viral infections by enhancing T-Cell immunity. This is specifically important for influenza and coronaviruses.

The answer is protect yourself. Wash your hands, stay home when you are sick, clean and sterilize frequently touched surfaces. Keep yourself healthy and understand how to reverse hyper-insulinemia (the one factor that makes this and coronaviruses significantly more severe.)

So, wash your hands and pass the bacon!

Oh, and take your vitamins.

The Benevolent Tyranny of Social Distancing and Masks

“NowThis News” is a progressive website with cheery music, snackable videos and catchy BLM colors we’ve all subliminally come to recognize designed specifically to deliver leftist education to your newsfeed.  You’ve probably scrolled past their content a few times while doing your daily doom-scrolling: “Elizabeth Warren’s Greatest Moments” or “Drag Queen Kyne Uses Tik Tok to Teach Math.”

Last September, “NowThis News” released a particularly telling video article from a more than chipper young authoritarian millennial demanding that we all “Stop Saying ‘Hey Guys.’” because it excludes women.

Half way through her sinister monologue she mentions a few other goals that the modern feminists want to achieve: “reproductive rights . . . LGBTQ rights, and the general reprogramming of most people’s minds” (italics added).

Wait . . . What?!

This last phrase caught my attention.  “the general reprogramming of most people’s minds” sounds almost unreal.  That’s just too Orwellian, too spot-on-the-nose to really be serious, right?!  Yet, it was published in deadly earnest.  This is an example of progressive social engineering at its finest.  They attempt to nudge and drug each of us into a state of compliance with leftist ideals.   This is the explicit goal of the “woke” progressive leadership.

They aren’t hiding it. They don’t want to persuade you.  They openly want to brain wash you and your children.  And, it’s working.

Today, the first time in months for example, I was able to go back to church services with my family with “Arizona’s Phased attendance protocols” in place.  It was wonderful to meet with other members of my church and “fellowship with the saints.”

Yet, as I read through the attendance instructions required to be compliant in our state and as a “Global Citizen,” I was shocked at the verbiage I read.  A statement found in the opening pages of these instructions read: “. . . we should sustain and uphold the laws where we reside. . .  governments enact such laws as in their own judgments are best calculated to secure the public interest. We acknowledge that in exceptional circumstances all individual rights may be restricted. . .“(Emphasis added).

When is it ever OK to restrict all individual God given rights to “secure the public interest?” Yet, many I spoke with feel that “it’s different today. This is just short term.” The explained that it is justified to give up liberty and rights for short term security.  In the words of Benjamin Franklin, “those who would give up essential liberty to purchase a little temporary safety deserve neither liberty nor safety.”  14 days of quarantine has now become 6-12 months of social distancing, lock-downs, school closures and $10-14 trillion lost in economic output this year alone as calculated by the congressional budget office. That is essentially the equivalent of wiping out the income of 30 million U.S. families this year and over the next five years.

Though it may seem humane to remove ones rights to protect the masses in crisis, it actually just strips the populace of their humanity.  It changes the person, from a subject with rights to a mere object to be controlled for the desired outcome deemed most important to the ruling leader.  This is the worse kind of tyranny because it is tyranny sincerely exercised for the “good of its victims.”  In the words of Lewis, “Those who torment us for our own good will torment us without end, for they do so with the approval of their own conscience.”

C.S. Lewis predicted this development back in 1954 with crystalline precision in a remarkable essay, “The Humanitarian Theory of Punishment.”  Back then, even as today in 2020, a growing number of Westerners became squeamish about the use of the death penalty.  They were then, and many are today, disgusted with the idea of punishing criminals because they simply deserve it; but rather they feel better using rehabilitation as a means to deter them and others from criminal behavior.

C.S. Lewis wrote that the very ideas of “deterrence” and “rehabilitation,” compassionate though they may seem, undermine the entire concept of justice.  This concept is the key to a functioning republic and to society as a whole.  It is the reason the American experiment has been successful for nearly 250 years.

Wait, are you saying that enacting a mandate of social distancing and mask wearing “for the good of the people” undermines justice?

YES.  That’s exactly what Lewis wrote about in the 1950’s and its even more applicable today.

Justice, as defined by Lewis, is nothing more than giving every person what he or she deserves.  The only way we evaluate the justice of a punishment at all is by asking whether the person punished actually deserves it.  The natural objection that “the death penalty is unjust” boils down to the argument that “no one deserves the death penalty,” argued Lewis.

Completely different from justice, deterrence and rehabilitation, much like mask wearing and social distancing, are forms of social engineering.  These forms of punishment are tools for making people do what the punisher’s want, not for providing a consequence of a person’s action that they deserve.  Lewis wrote, “when we cease to consider what the criminal deserves and consider only what will cure him or deter others, we have tacitly removed him from the sphere of justice altogether.” Instead of having a person with rights, we have reduced the person, instead, to a mere object, a patient or a case.  We have removed the justice that is due, instead, to objectify the being under the guise of a cure for the common good.

It’s like the patient shows up at the doctor’s office with a serious case of syphilis, the consequence of promiscuous sexual relationships. Instead of treating the disease and killing the bacteria that causes the rash and terribly painful urogenital discharge, the doctor says, “let me send you to counseling to talk about your rash.  Let’s just rehabilitate the bacteria.  You can describe the discharge and have a few group sessions so others can understand your pain, and the bacteria should be much nicer.”

These two different governing ideas of punishment proceed along entirely separate tracks and arrive at very different destinations.  Justice – though sometimes fearsome and always imperfect – treats the human being as a moral agent of choice whose actions have weight, and therefore whose actions also have consequences.  In contrast, the “moral busybodies” of the world today (we call them “Karens”) are interested not in justice, but in social engineering.  Social engineering is a very dangerous illusion which, in Lewis’ words, “disguises the possibility of cruelty and injustice without an end in sight.”

Exactly as C.S. Lewis predicted, the logic of this social engineering has now begun to careen toward its gruesomely logical conclusion.  Social engineering is based upon the idea that human beings are effectively bags of meat and chemicals, pure matter to be therapeutically manipulated by “compassionate” and “progressive” healers.

However good their intentions may be, those “progressive healers” are in fact proposing to set themselves up as gods over men. “The things done to the criminal, even if they are called cures, will be just as compulsory as they were in the old days when we called them punishments,” wrote Lewis. “If a tendency to steal can be cured by psychotherapy, the thief will no doubt be forced to undergo the treatment.”   If a positive COVID-19 test was seen, a person will no doubt be forced to get vaccinated for the “cure of the populace.”

You can see this everywhere in modern life.  You can see it in the endless classification of EVERYTHING as a mental illness, implying the best way to fix emotional problems is with the right cocktail of medications.

You can see it in the insistence that gender and sexuality are mere social constructs, whose injustices can be rectified with surgery and hormone injections.

You can see it as the Freudian idea that religion is just a holdover from primitive tribal fantasy and really isn’t “essential.”

All of these ideas take for granted that our enlightened leadership – many of whom were never elected, and especially those best versed in Critical Race Theory and inter-sectional politics – have the right to tinker with our brain chemistry until they reprogram our minds “just right.”

This doctrine, merciful though it may appear, really means that each one of us, from the moment he disagrees with leadership or breaks the law, is deprived of the rights of a human being.  And, it is being accepted without resistance in the schools, churches, shops and hospitals across the country.

This isn’t a bug, it isn’t a feature. It is pure leftist Marxism.  It is modern materialism philosophy with the potential to turn even well-intentioned people into coercive monsters.  We were warned.  It is happening.  Now it’s time to fight back.

(adapted from – Spencer Klavan’s “C.S. Lewis On The Leftist Effort to Reprogram People’s Minds”)

Man is Messy

There is this feminist notion that masculinity is a basket of “good” and “bad” characteristics that men can pick and choose from. The pleasant qualities are things like provision of food, provision of funds, providing a home, duty, honor and procreation. The “bad” or distasteful characteristics are things like intense strength, lust, violence and furious indignation.

The project of radical feminism has been to convince men, and women alike, that men must rid themselves of all the distasteful qualities and characteristics of their nature. If they don’t, they threaten, the “toxic male” will no longer find acceptance in the feminized world in which we now live.  The term for this is emasculation.

And yet, you cannot cherry-pick the parts of masculinity that you are happy with.  Just as an engineer cannot keep the abutments and dispense with the footings of a wall, bridge or building, the man is the totality of strength and weakness built in perfect tension and relationship to each other. The man is much like a high tension bridge.  You cannot have the strengths without the foundation spanning the weak points.

In every textbook or class on biology, the male and female of a species are dramatically different and can never be expected to act, interact or look similarly.  But, ask any woman and the majority will tell you that men are looked at from the female mind as a hairy, misbehaving woman.

When a man seeks to rid himself of the “nasty parts,” pointed out and perceived as “bad” by the female, the bridge collapses.  You cannot bridge an ocean without tension, without a mass of steel suspended in configurations of terrifying force and power, that steel welded together with white hot heat and molten flux.

The solution is not to rid yourself or conform. It is to admit, acknowledge and own every aspect of your gender, no matter how ugly, volatile or untidy it may appear to the opposite sex.

Man is messy.  He always has been. Try to bury that fact and your gender will bury you.

Denying the mess is a recipe for repression, misery, malaise, fatigue and heart disease.

Make no mistake, when you go off script and embrace the mess, you will feel, and appear, dangerous.

Feminism will treat your masculinity like a loaded gun because unapologetic fully-embraced masculinity IS a loaded gun.  You are dangerous.  That’s what it means to be a man.

Uncocking the hammer does nothing but emasculate you, and render you a useless tool, a dull blade, to your family and the world at large.

The lie is that you can get rid of the “nasty bits” and retain your masculine power.   In truth, you have two choices.

  1. Be dangerous, yet well disciplined
  2. Scale yourself down to a cap gun . . . shooting blanks.

Be warned, the second choice sounds great, and actually is initially pleasant to the females in your life, but it leads to depression and the modern male malaise.

Chose wisely.

If you’re reading this, trying make a choice barraged by voices on all sides . . .  If your reaching has reached its limit . . .  If all the tendons of your soul are straining to hold it together, feeling like their about to snap . . . You’re not alone, my friend.
I can’t fix it for you, same as you can’t fix it for me.  However, I can at least assure you that you’re no stranger to me . . . That your fears are my fears, your longings are identical to my own.
I see you not as some washed-up, broken down grizzly bear, but as one of our finest.  An honorable, noble, disciplined dangerous man yet in the fight, nose split, teeth broken . . . Spitting dust and blood for the hundredth time . . . Swaying in his boots, but still standing.
There is hope.  Read about it here.
Much love always,
DocMuscles

(Adapted from Bryan Ward’s Third Way Man)

Broken Honor

Something is broken. Something shifted over the last 100 years causing a dramatic change to the average man.  As a young boy, the only reason I ever heard about Audie Murphy, one of the most decorated war heroes of our time, is that he is a distant relative.  My father told me stories about him. Audie Murphy was an icon of male history, a true hero.

But something happened to our culture.  Men with the character of Audie Murphy disappeared, and the average male metamorphasized over a generation.  The men of today often lack the basic skills of daily living. They are increasingly immature, anxious, and depressed. They increasingly experience fatigue and malaise and are often bereft of motivation.

I’ve been practicing medicine for over 20 years.  Each year, more and more men show up in my office feeling depressed, anxious, lethargic, and fatigued.  With the backdrop of a pandemic disease like COVID-19, these men are more frequently suicidal than ever before.  And, the majority of them respond poorly to medication and counseling.  Why is there an increasing manifestation of malignant male malaise and depression?

It’s not their lousy childhood, crappy job, lack of desire, or failure to grow up that cause’s these symptoms.  It’s not a lack of serotonin, dopamine or norepinephrine.  And, it’s not even low testosterone levels.  Although these are signs, symptoms and secondary effects of the primary problem.  The problem is lack of honor.  Honor has been lost by both men and women.  But, this lack of honor has a uniquely deleterious effect upon the man.  Honor can be learned by women, however, it is not part of their true nature.  Honor is an instinctual subconscious characteristic found in the men of our species.

The feminization and emasculation of men, the emancipation and objectification of women, and the sexual liberation both sexes in our society has played a huge role in suppressing and repressing the need for honor.  Though many claim we are “better off,” changes to our view of the sexes has removed our desire to hold and retain honor, especially among the younger generations of men.

What changed in the picture above?  Honor is gone.

Honor is Directly Tied to Manhood

Across every culture, and across all of known time, honor and manhood are instinctively tied together.   Honor has been and always will be central to a man’s masculine identity.  Men would go to great lengths to win honor and to prevent the loss of their honor.

In all of classical literature, honor is the central theme because it is central in the life of a man.  It is part of his subconscious identity.  The poems of Homer, the plays of Shakespeare, the writings of the Stoics, the chivalry of the knights and the gallantry of the Victorian Gentleman are all based upon the “fields of honor” where men defend their manhood.

I find it enlightening that penned upon the greatest document of governance ever written, the Declaration of Independence, our founding fathers “mutually pledged to each other [their] lives, [their] fortunes and [their] sacred honor.”

Honor is foundational.  It resonates throughout Christian doctrine as well.  It is part of the Ten Commandments, “Honor thy father and thy mother…” (Exodus 20:12).  Men have been commanded to “give honor to their wives.” (1 Peter 3:7) And, even God himself told the ancient prophets Isaiah and Moses that the fall of Lucifer was because he sought God’s honor, which is His power. (Isaiah 14:12-14; Moses 4:1)

What is Honor?

We throw the word “honor” around a great deal.  But, if you actually ask the question, “What is Honor?” most people scratch their head and struggle to answer.  If you press a person long enough, you’ll probably get an answer like, “being true to a set of personal ideals,” “doing the right thing when no one is looking,” or “being a person of integrity.”

Honor is instinctual in men.  Men define their character around honor, duty and obligation.  This is an inborn trait of the male protector and provider.  A man will do something for his mother out of duty and obligation.  Not because she nagged or pressured him, but because taking care of her is part of his definition of himself as a man.  He may hate it or despise the activity, and he may complain about it, but not doing it is not even an option. Not because he is afraid of upsetting his mother.  It’s because honor, duty and obligation define who he is on an instinctual level.

The Medieval period added “integrity” to its code of chivalry to temper “reflexive” honor (we will discuss this later).  In our society, honor has been watered down and emasculated to the point that it is now defined almost identically to integrity. However, honor does not equal integrity. They are two different characteristics.

Even Mr. Webster himself watered down the definition of honor when he defined it as “adherence to what is right or to a conventional standard of conduct.”  That closely resembles his definition of integrity, “the quality of being honest (doing what is right) and having strong moral principles (following a conventional standard of conduct).”  These two definitions are almost identical.  Yet, honor is not integrity.  Webster’s definition above is not what Homer, or Shakespeare wrote about.  And, that definition is NOT what our Founding Fathers pledged upon the Declaration of Independence.

The Anthropologist Frank Henderson Stewart makes the case that honor comes in two types: Horizontal Honor & Vertical Honor.

Horizontal Honor

Horizontal honor implies mutual respect of two equal men.  But this isn’t the watered-down feminized version of respect that pervades our culture today.  This is not the I’m a human being and you’re a human being and we should respect each other because of “social equality” type of respect.  No, this is honor that is contingent upon an unyielding adherence to a standard maintained within a group.

Horizontal Honor hinges upon three essential elements. The first is a code of honor.  This is a standard that must be reached by any member of the group to receive respect within the group.  There are rules that outline achievements of the standard and rules that delineate how that honor is lost.  Any definition of honor that cannot be lost, is not actually honor.

An honor group is the second element. This is a group of individuals who understand the honor code and have committed to live by it.  Anyone and everyone within the group understands the code and lives by it.  The members of group must therefore be equals and hold respect for others in the group, being both their equal and living and maintaining the standard of the honor code.  Honor is then rendered based on the judgment of others in the group, and therefore the opinion of those members must matter to you.  This respect is rendered in a two-way street.

These honor groups must be exclusive.  If anyone and everyone can be a part of the group, regardless of their adherence to the code, then honor becomes absolutely meaningless.  Egalitarianism (equality of social, political and economic status) and honor cannot coexist.  Social justice destroys honor and the honor code.

Lastly, the honor group must be a tight-knit, intimate group. In a society of people that is governed by respect, a member’s knowledge of every other member and face-to-face interaction is essential.   Honor cannot exist in a society where anonymity dominates.  The rise of social media, and the increased anonymity that comes with it, chips away at the maintenance of honor.

Honor is all or nothing. You either have it, or you don’t.  A person who fails to live up to the group’s code loses his honor.  He loses his right to the respect the other members of the group provide.  This creates shame.  The recognition that one failed to live up to the code is shameful.  For honor to exist, a healthy feeling of shame compels one to check one’s behavior.   When one cares not for the respect of others in the group, honor loses its power to compel living according to the standard.

You either have the respect of your peers within this group or you don’t.  Bringing dishonor upon yourself by failing to meet the minimum standards of the group (or showing disdain or indifference for those standards) results in exclusion or excommunication from the group, including the accompanying shame.  Failure to conform results in your membership card being revoked.

The last semblances of honor can be heard among men in our culture today when they talk about taking away each other’s “man cards.”  Men actually understand this at an instinctual level.  Horizontal honor is essentially the need to actually hold the man card.  It is recognition that you are a man among other men.  Losing one’s man card is an echo of the punishment for violating the original code of men – the honor code.

Vertical Honor

Vertical Honor isn’t about mutual respect between two men of equal stature.  It is about giving praise and esteem to those “who are superior, whether by virtual of their abilities, their rank, their services to the community, their sex, their kinship, their office, or anything else.” (Honor, Frank Henderson Stewart, p.59).

Vertical honor is hierarchical and competitive.  Vertical honor goes to the man who not only lives the code, but excels at the code.  Vertical honor cannot exist without horizontal honor.  First, you must hold the man card.  Excelling at protecting or providing then defines the vertical honor.

The feminization of our society, along with an insistence of social justice for all, makes horizontal honor in-existent, and vertical honor thereby becomes despicable, loathsome and to some, even “toxic.”

There is this feminist notion that masculinity is a basket of “good” and “bad” characteristics that men can pick and choose from. The pleasant qualities are things like provision of food, provision of funds, providing a home, duty, honor and procreation. The “bad” or distasteful characteristics are things like intense strength, lust, violence and furious indignation.

When a man instinctively acts upon his role as provider and protector, gender roles that are repressed in today’s culture, he naturally bases his actions around those things that bring honor.  Being an honorable provider and protector requires the man to excel at those things that are perceived by the feminist as “messy,” “bad” or “toxic.”  Honor is an action word and can only be demonstrated through action.  When that man begins to be true to horizontal and vertical honor, today’s society sees him a “toxic male.”

Men thrive on admiration of their honor, especially vertical honor.  It literally recharges a man’s batteries.  These are the trophies, awards, points and accolades that come from distinguishing yourself as a provider or protector.  It’s why men are drawn to messy tests of their strength, power, and manhood against other men.  It’s what drives a man to run a marathon, become a prize fighter, learn martial arts, to be a hunter, build a home, design cities, write revolutionary computer code, complete medical school and residency, and on, and on, and on.

Honor as Defined by Our Forefathers

Honor as our Forefathers understood it was two-fold: respect from the group (horizontal) and praise from the group (vertical).  Implicit in this definition of honor is that it depends upon the opinion of others.  You may have a sense of honor, but that just does not cut it.  Others must first recognize your honor before it can actually exist.

I can hear some of you say, “Wait a minute, Doc, honor is universal to men and women. What about the honor of women?”

Yes. You are correct.  However, honor differs between the genders.  Though codes of honor have varied across time and cultures, in its most primitive instinctual forms, honor was usually related to chastity for women and courage for men.

During the periods of history when governments did not exist, professional military’s were few and far between, and there was no one to enforce the “rule of law,” the moral force that governed the tribe and maintained survival was “honor.”  Men were expected to act as the tribe’s protectors, a role in which strength, courage and vitality were essential.  If the man was not physically strong, then he was expected to contribute through mastery of a skill (shaman, medicine man, scout, black-smith, weapons maker, shepherd, etc.) that provided benefit to the tribe.  Honor is the driving force that motivated men to fulfill these expectations.

Demonstration of courage and mastery provided horizontal honor as men.  That honor provided privileges of being a full member of the tribe.  As they excelled at the code, the were granted even greater status and more privilege within the tribe (vertical honor).  However, cowardice, laziness, and weakness were shamed as unmanly causing loss of access to privilege within the tribe.

Defending Your Honor

Defending your honor or reputation was a matter of life or death for many of our ancestors and forefathers.  It is literally instinctual in the male.  Even into the late 19th century, one could not get a good job as a lawyer or politician without maintaining one’s honor.  Thus, to maintain privileges, men were highly motivated and tremendously vigilant about maintaining their honor.

Insult to one’s reputation or honor, or the honor (chastity) of a female member of your family, required immediate remedy. If you were hit, you hit back. Saving face was supreme.  Retaliation was necessary to prove you still had the courage that made one worthy of honorable status. The chasity of a female member of your household could be remedied by the courageous act of the protector. Dueling was a common and acceptable means of defending that honor.

Defending honor can lead to what anthropologists call reflexive honor.  This was inspiring and, also, problematic.  When taken to the extreme, reflexive honor becomes an “irrational pissing contest” between men, clans or even communities.  This could destroy a community.   So, as societies became more civilized, they attempted to temper the male instinct to retaliate when honor has been maligned.  This tempering is what brought about the honor code of chivalry with the Medieval knights and the gentleman’s code of the Victorian era.

A Man’s Honor vs The Group’s Honor

Concern for one’s honor is both selfish and selfless.  On one hand, men want to be respected as men, respected in the tribe and desire the privileges of membership (horizontal honor).  Membership in the tribe entitled the person to gain vertical honor and status through worthy deeds.  One’s reputation for strength and honor also kept other members of the tribe from picking on them or casting them out.

A man’s honor benefited the tribe as a whole. Each individual’s reputation for courage and strength added to the group’s courage and strength.  The more formidable a tribe’s reputation, the less likely other tribes would try to bother them.  This is why men who do not care about the tribe’s honor are shamed by the group.  Disloyalty of an individual puts the whole group at risk.

20th Century Honor is Depressing

In the 20th Century, urbanization and anonymity dissolved the intimate face-to-face relationships that honor requires.  People have grown uncomfortable with violence and shame.  Individuals feelings and desire have been elevated above the common good of the tribe or society.  People began forming their own personal honor codes and refused judgement of those codes by anyone but themselves.  This transformed honor into a concept synonymous with personal integrity.

Yet, the instinctual male defines his character around honor, and true honor has been whitewashed into personal integrity, the man experiences depression.   Honor is the moral imperative of men.  Obedience is the moral imperative of boys.

As a child, you did the right thing out of obedience to authority and out of fear of punishment from that authority.  As we mature, we begin to recognize that our behavior affects others and the needs of groups to which we belong.

Honor is a moral imperative. As we age, we begin to operate and act out of honor instead of out of obedience to authority.  Men begin to recognize that they have a role to play in helping the group to survive or thrive.  Men recognize that their individual actions add to the strength or weakness of a group.

Honor in a Man Begets Love

The mindset of honor is different.  When men function from a mindset of rules and laws, they do the bare minimum they can without being punished. Or they push the law to see how far it bends.  When men function from the mindset of honor, they seek to pull their own weight, and then add further to strengthen the group.

Honor moves a man’s motivations to act from the base, childlike fear of authority, to a higher, nobler respect that becomes love.  The love of family, love of church, and love of country are all borne of honor.  A man will NEVER let those he loves (or himself) down by slacking off.  Love, from the perspective of a man, is born of his honor and strengthens his honor.

If a man leaves his church, or is disinterested in and organization, it is likely because he’s lost the sense of mutual respect in the horizontal honor of that group or congregation.  He has lost faith in that congregation’s ability to provide the innate horizontal honor he seeks.

Not only is honor a more mature moral imperative than obedience, it is often a much more powerful motivator.  Social pressure, the very thing that drives honor, is more powerful than rules and laws in getting people to do things.   Studies show that people are more likely to change their behavior when they think their respected peers are watching them.   The key driver is respect of peers considered to be equal in group or standing.  We are still social animals at heart – we still feel motivated by shame, loneliness and/or desertion.

Lack of Honor Breeds Ineptitude

Without honor mediocrity, corruption and incompetence rule.  Honor is based in reputation and when people stop caring about their reputation, shame disappears.  When there is no shame, people devolve into creatures with little inertia that do the very least they can without getting into trouble, getting fined or getting fired.   This breeds a culture of mediocrity, corruption, and blatant incompetence.  You can see this in any business or customer service network today.   People no longer have any fear of their history following them and have no incentive to perform with excellence.  Instead, we have a culture of employees with mind blowing ineptitude.

This lack of honor has resulted in a society that now relies upon obedience to rules, regulations and restrictions to govern behavior.  The minutia of rules in your office, town, city, community, and state seem innumerable is because they are.  We must now be policed by external authority to constantly check behavior in the absence of honor.

Honor Creates Meaning

The reason people tend to like old movies and books better than the modern variety is honor.  It’s not nostalgia, or talent or lack of topics.  The drama of old literature captures our attention because the characters had to operate in a culture of honor.

Honor provides structure to navigate and push up against.  The struggle of moving up through a group by following a code, avoiding shame and earning honor.

The reason reality shows have become popular is that these shows create temporary groups of people experimenting with unique situations forcing the creation of and adherence to the groups temporary honor codes.   Otherwise life is mundane and boring.

Without honor life feels like a great charade with our own self-constructed realities that lack comparison, competition and esteem of others.  Life seems empty and insubstantial. Evil runs unchecked. Good goes unrewarded. True merit goes un-honored and everyone gets a participation trophy that holds absolutely no meaning.  Everyone gets a piece of the egalitarian pie that does not nourish or satiate our hunger.

Arlington Cemetery – horse drawn casket for fallen soldier

Every Man Needs a Platoon

We are all part of large groups that provide us identity and belonging.   You might be associated with a political party, a company, a church, a company, a town, a state or a nation.  Yet these groups are usually too large to provide the intimacy necessary for honor to thrive.  In these groups, no one really cares if you are living honorably or not.  We must give up the notion that honor can be revived at the macroscopic level.

Initially, I thought each of us needed a community or congregation.  That may work, but I realized the average size of a military company is 150 people.  This is also “Dunbar’s number.”  It is the maximum number of people in which stable social relationships can occur at any given time.  It is the maximal number in a group in which honor and shame can govern effectively before rules and regulations are required to govern behavior.  Interestingly, this is also the number of people to which ancient villages would grow before they would break off to form separate settlements.

Withing each military company, there are 3-5 platoons consisting of 16-44 men.  Platoons are the smallest “self-contained” unit in the army.  Each one has a medic, radio operator, headquarters element, and forward observer.   A platoon of men usually sleeps together, eats together, fights together and, under severe conditions, dies together.

I have always been fascinated by comments made to me by soldiers when asked about their allegiance to one another.  This was reinforced by journalist Sebastian Junger in his book, War.  Soldiers admit they would risk their lives “without hesitation for anyone in the platoon or company.”  This sense of identity, loyalty, and brotherhood drops off in groups larger than the platoon or the company.

Junger states, “For some reason there is a profound and mysterious gratification to the reciprocal agreement to protect another person with your life, and combat is virtually the only situation in which that happens regularly.

Only a small percentage of those in the military are directly involved in regular firefights.  The rest serve in support roles.  Though support roles experience an honor culture in degrees lower than combat soldiers, it is of a more profound degree than civilians.  Other than combat soldiers, police officers and firefighters are the only others who experience a similar degree of honor.  They may not have their lives directly threatened every day, but they constantly work under the risk that they could, and they know that their comrades are willing to risk their own lives to protect them.

Where Do You Find A Platoon?

Not all of us can be a soldier, police officer or firefighter, even if they if they wanted to be.  Yet, every man can, and should be part of a small, tight-knit honor group.   This may be a sports team, men’s group at church, fraternity, professional group, etc.

If you can’t find one, start your own. It doesn’t have to be formal and you don’t need a lot of people.  2-3 people are enough to start.

For your physical survival and your psychological health, you need to be part of a group.  Men want meaning in their lives, meaning that comes from being a part of something larger than themselves.  But, if you are like me, until I understood the importance of honor groups, we are often unwilling to trade some of our individualism to get it.

Studies done decades ago showed that men who belonged to a group that was close-knit showed less fear when jumping from an airplane than groups of men who shared only weak ties. The studies demonstrated that men could also withstand greater pain from electric shocks when they were part of a highly-bound group, as opposed to one with loose associations. The military found that tightly-knit units suffer less cases of mental breakdown, depression and PTSD than units where morale and bonding is low. The reason for these findings is that men in a tightly-bonded group both know that the man on either side of him has his back.  The fear of dishonoring their brothers drives them to overcome their own fears and move forward and not let others down. One of the men Junger interviewed said, “As a soldier, the thing you were most scared of was failing your brothers when they needed you, and compared to that, dying was easy. Dying was over with. Cowardice lingered forever.”

Men of Today Must Have Honor to Survive

Men around us in society break down and cave to depression and stress, just fighting their individual battles.  I see it every day.  They lack the strength to deal with life’s difficulties because they don’t have honor pushing them forward.  They don’t have honor because they lack a platoon.

The core of honor, then, is this – to act in such a way that does not let the man on your right and the man on your left down when they need you most.

Conclusion

People talk about wanting honor. They desire the end, but do not want the means.  Honor, then, will only live on in small units and platoons of men willing to accept and carry the burden and responsibility that must accompany it.

James Davidson Hunter put it this way, “We say we want a renewal of character in our day but we don’t really know what we ask for. To have a renewal of character is to have a renewal of a creedal order that constrains, limits, binds, obligates, and compels. This price is too high for us to pay. We want character but without unyielding conviction; we want strong morality but without the emotional burden of guilt or shame; we want virtue but without particular moral justifications that invariably offend; we want good without having to name evil; we want decency without the authority to insist upon it; we want moral community without any limitations to personal freedom. In short, we want what we cannot possibly have on the terms that we want it.”

Are you one of those men of honor? Or, will you settle for the pain and depression of living true to only a part of yourself?

Are You the King or the Second Queen?

When you were a boy, much like me, you likely dreamed of the day you would be a king.  You dreamed of the day you would marry a beautiful maiden, have children, own lands . . . You dreamed of the day you would be loved, feared, and venerated.
You saw the way of the king, and you knew in your belly that this was your call:
  • To build the kingdom that you dreamed about
  • To live a life of benevolent power
  • To be admired, respected and beloved.
But somewhere along the way, the dream was corrupted. For we saw that kings can be craven.
We saw that some kings can be cruel.
And when the queens of the land bristled in unison . . . men, seeking to appease them, broke their scepters over their knees. And, men, the world over, resolved not to be king, but to be a second queen.  They resorted to work in cheerful cooperation as a second wife, without the danger or the terror that lives within the man, that husband king.
Thus, the path of misery for man, and wife alike, was paved. . . the emasculated king, living his life as a second queen.  Yet, man was never meant to take a wife and father children only to relinquish his God given dominion to become the “second queen.”
You and I, we come to marriage and family for kingship:
  • To provide safety and shelter for your queen and her cubs
  • To ravish the queen and see the animal heat in her eyes
  • To live in glory and honor
  • And when called upon, to willingly go heart-in-mouth into the fray
You may not have servants or lands or chests of gold. But, if you have a wife, if you have children, if you have an audience to serve . . . you have everything required for true, abiding kingship.
For a king is king not by the command he claims for himself or the fealty others pay him.  He is king by pressing and wielding his dangerous power to the noble service of others in the creation of value and honor.
Kingship is the exercise of dangerous magic nobly.  It is an exercise in unconditional love applied. Through force of will and force of imagination, you make your visions manifest.
Kingdoms are not won, they are not granted, they are not inherited . . . Kingdoms are CREATED.
Do not wait for your wife to become the queen. Do not wait, grumbling, for her to adulate or serve you. The principle buried by the softened souls of this civilization, by generations of absentee fathers, by generations of fatherless homes, by generations of men without their scepters is this . . .
It is the KING that makes the queen, not the other way around.
You stare foggy and angry at the hole in your drywall, at the un-replaced light bulbs, at the broken fence in the yard . . . at the mind-numbing banality all around you.  Yet you want to feel alive again . . . deeply, lastingly, the way you dreamed as a young boy that you would feel when you became king.
That feeling doesn’t come from a manicured yard, a check in the mail, or even from some bestowed title from an Ivy League tower.  It comes from indwelling and OWNING the role you’ve already won. You “have” a family, but it will not glow until your breathe everything you have into it . . . until you animate it with all your might and mind and heart and lungs.
Why are you waiting for some outside appointment? Rise up. Stand up. Throw out the box of cereal.  Give the macaroni to the neighbor. Eat the bacon, fire up the smoker. Take on that task that’s been gnawing at you for months.
Create your kingship NOW.  Do it TODAY: one kiss, one meal, one light bulb, one filled hole-in-the-drywall, one meal, one poem-in-the-lunchbox at a time.  Stop sitting there braiding each other’s hair.
BE THE DAMN KING because the queen is already taken.  Whether or not she returns that love does not matter.  It is the act of loving her that actually fires you, it is not the reciprocation.  Any love or adoration she returns is immaterial.  The essential magic has already happened inside you.  The fire has already been lit.
“Why would I kiss that mouth?” you say. “Why would I gaze into those cold, bitter eyes? How could I treat as queen this woman who sneers and scorns so unbearably?”
And that, there, is the double-bind that has been holding your very kingship, holding your marriage captive.  This love, this respect, this adoration you long for her to give to you . . .
It is not hers to give, but for YOU TO CREATE within her.
You see, it is the KING that molds the maiden into the queen, into her best and highest self.  Not with silence or criticism or ultimatums, but with acts of imagination and love.  No matter how deep your disillusionment, it is the only way.  You must create the queen.
The power is within you . . .
Click Here Now To Learn How.
(Adapted from Brian Ward’s Third Way Man)

Masks Are Symbolic

Over the last few months, our fearless infectious disease leader, Dr. Anthony Fauci,  and the Ivory Tower of medical journals, the New England Journal of Medicine, have clearly informed us that mask wearing by the healthy is little more than symbolic ‘Virtue Signaling.’

For those Karen’s and Felicia’s who have tried to shout me down like a Tourette’s tick with ‘Social Media Science,’ in Wal-Mart, in the big box stores, at the gas station and at the burger shop, lets look closely at what the New England Journal of Medicine said on May 21, 2020.

We know that wearing a mask outside health care facilities offers little, if any, protection from infection. Public health authorities define a significant exposure to COVID-19 as face-to-face contact within 6 feet with a patient with symptomatic COVID-19 that is sustained for at least a few minutes (and some say more than 10 minutes or even 30 minutes). The chance of catching COVID-19 from a passing interaction in a public space is therefore minimal. In many cases, the desire for widespread masking is a reflexive reaction to anxiety over the pandemic.

So, why have we been ordered to wear are masks everywhere by mayors and governors and city officials across the country?  Symbolism.  Pure and simple symbolism.  From that same NEJM article:

It is also clear that masks serve symbolic roles. Masks are not only tools, they also serve as a talisman [an object that acts as a charm to avert evil and bring good fortune] that may help increase health care workers’ perceived sense of safety, well-being, and trust in their hospitals.

The Surgeon General was widely mocked and ridiculed for suggesting in March that masks might even increase the spread of the virus.  Yet, here, in the “journal of all medical journals,” the NEJM provides the same warning to mask-wearers:

What is clear, however, is that universal masking alone is not a panacea. A mask will not protect providers caring for a patient with active COVID-19 if it’s not accompanied by meticulous hand hygiene, eye protection, gloves, and a gown. A mask alone will not prevent health care workers with early COVID-19 from contaminating their hands and spreading the virus to patients and colleagues. Focusing on universal masking alone may, paradoxically, lead to more transmission of COVID-19 if it diverts attention from implementing more fundamental infection-control measures.

However, suddenly on June 17th, 2020, Dr. Fauci suddenly changed his tune, and contrary to all the scientific evidence and over 50 years of medical literature on the subject, said wearing a mask is “better than nothing.” Within weeks, executive orders for mask wearing were signed across the nation. 

The argument should have been over.  Anyone advocating for universal mask wearing by the healthy, according to all the mask wearing literature, is merely engaging in virtue signaling, not actual public health.

Cities and states across the nation have mandated mask wearing (some even advocate using bananas). I’m not telling you to break the law.  I am saying that the mask mandate has done nothing to “slow the spread” as so many people have now bought into.  Research demonstrates that homemade masks do little to stop the spread of viral infections.  It also demonstrates that properly fitted surgical masks worn correctly decrease this risk of viral spread in a highly controlled setting at the very best by only 2-5%.

In the most recent comprehensive review of the mask wearing literature, the authors stated, “The evidence is not sufficiently strong to support widespread use of face-masks as a protective measure against COVID-19. However, there is enough evidence to support the use of face-masks for short periods of time by particularly vulnerable individuals when in transient higher risk situations.”

What is effective is washing your hands regularly with soap and water, avoiding those who are actually sick or have fevers over 101 degrees, eating a healthy diet that prevents diabetes risk and getting adequate sleep.  Those at high risk for infection can and should be vigilant about avoiding exposure to those who are sick.

For the rest of us, it’s time to unmask.  I, myself, struggle daily to maintain enough virtue in my bones for myself, let alone signal others about it all day long.

 

Coronavirus, Mask Wearing & Death – Similarities to 1918 Flu

Isn’t it interesting, back in April and May, 2020, those of us closely watching the data stated that this virus would look much like the influenza pandemic of 1918.  Look closely at the numbers of deaths in St Louis (who participated in the 1918 quarantine – red line) and Arizona, who has done much the same in our approach (in the 2nd graphic below).

The death count curves are nearly identical.   Interestingly, the numbers of those that died St Louis are almost identical to Arizona’s graph below, directly from the Arizona Department of Health Website.  We know that the rates of infection differ between the two viruses and a number of things including domicile proximity, health of the city or state, transportation methods, sanitary condition, etc. play a significant role in the infection rates.  My point is not to compare the two viruses, but to point out that the effect of quarantine did exactly what we expected it to do.

We expected the resurgence of the virus.  Let’s say that again.  We expected it.  However, the media and many health professionals that I interact with seem horrified that it occurred.

 

We predicted this pattern months ago.

I am surprised at the number of health professionals that are just beside themselves about this virus.  I recognize that, in its most severe form, this virus can be deadly.  And, so is the flu, RSV and other RNA viruses.  Do these professionals not read history?  Do they not read the actual scientific literature?  Do they not see the patterns that diet and control of hyperinsulinemia have on this virus?

Instead, these medical professionals have remained quiet, and in some cases cheered, as our government over-reach and personal liberty infringement took place.  We’ve lost our ability to travel, participate in group gatherings and church services.  Quarantine, mask wearing and social distancing has essentially done nothing for our community in the last 3 months.

Our initial reasoning for quarantine was to take the peak off of hospitalizations.  That was done.  Yet continued suppression of personal liberties has done nothing for the overall health of our society.  The second wave of infection was going to occur no matter what we did.

Instead, the media fear mongering, social distancing and force wearing of masks has lead to increased risk of suicide, overdose and drug addiction.  Estimates are as high as 150,000 deaths due to the effects of quarantine and social distancing mandates.  In fact, much of the anxiety and PTSD that is expected will not be seen until 4-6 month after the quarantine occurs.

According to a recent JAMA report, “It is possible that the 24/7 news coverage of these unprecedented events could serve as an additional stressor, especially for individuals with preexisting mental health problems.” Our routines have been completely upended and even things like wearing a mask or waiting in lines at the grocery store can make you feel tense.

Some common signs of pandemic-induced stress are:

  • Fear and worry about your own health and the health of your loved ones
  • Changes in sleep or eating patterns
  • Difficulty sleeping or concentrating
  • Worsening of chronic health problems
  • Worsening of mental health conditions
  • Increased use of alcohol, tobacco, or other drugs

What we know from research after the SARS outbreak is that post-traumatic stress (PTSD) is possible, especially in front line healthcare workers. In one particular study, about 10 percent of the hospital employees had had high SARS-related PTSD symptoms post-outbreak. And about half of them still had symptoms three years later. Other studies have shown that when a person’s PTSD symptoms persist for more than 6 months after an event, they are very likely to continue to persist over the long term.

A significant part of the problem in both the lay public and among health care workers is confusion about actual risk of disease, what can be done to prevent/treat the disease, and how to access treatment.  I see this confusion today in many physicians and nurses I interact with in my community.

If you are having symptoms of anxiety, stress or depression, don’t be afraid to reach out for help.  Knowledge is power.  The more you know, the less fear and anxiety you will have.

Wear your mask if you want.  Initially, when we didn’t know how invective this virus was, I was all for using any protection available.  But, since the end of April, the data has changed my mind.  Wearing a mask isn’t doing anyone any good.

Some cities and states have mandated mask wearing. I’m not telling you to break the law.  I am saying that the mask mandate has done nothing to “slow the spread” as so many people have now bought into.  Research demonstrates that homemade masks to little to stop the spread of viral infections and surgical mask that have been properly fitted and worn correctly decrease this risk of viral spread by only 2-5%.  In the most recent review of the mask wearing literature, the authors stated, “The evidence is not sufficiently strong to support widespread use of face-masks as a protective measure against COVID-19. However, there is enough evidence to support the use of face-masks for short periods of time by particularly vulnerable individuals when in transient higher risk situations.”

What is effective is washing your hands regularly with soap and water, avoiding those who are actually sick or have fevers over 101 degrees, eating a healthy diet that prevents diabetes risk and getting adequate sleep.  Those at high risk for infection can and should be vigilant about avoiding exposure.

 

 

 

Tyranny

One more Star-Spangled day of hamburgers, brisket and hot-dogs has passed.  The fireworks have exploded and the dogs are not freaking out any more. 

The kids had fun. Smiles were had.  Bellies were filled.

So, let’s talk about what this holiday really means, today, for you and I, here in grownup land . . .

The Fourth of July is no longer for celebrating “independence.”

It’s to see its loss, and planning to re-take it once again.

Our “free” country has slowly been covered with a slow mold that has crept into every corner and under every wall and in every crack and crevice.

Under the pen of every lawmaker some of that “freedom” has been usurped.

With every government circumvention. . .

With every bail out. . .

With every re-distributive measure . . .

With every affirmative action . . .

With every mask over the face . . .

With every closed gathering place, church and gym . . .

The mold gets thicker, darker, and deeper . . . all the while bringing us one step closer to outright tyranny.

“Never let a good crisis go to waste” they said. . . and continue to say this morning.

COVID-19 has been a gift for tottering regimes around the world . . .

A chance to sweep decades of fiscal incompetence and unkeepable promises under the rug of the economic shutdown . . .

It’s provided the mother of all scapegoats to pin it upon.

“Your freedom will return when we have a vaccine,” they say.

“This is for the public good . . .” they say.

“This is too difficult for you to think for yourself . . .” they say.

We’ll give you back your liberty when we’re all “inoculated,” they promise.

Yet, the plan backfired.

Behind closed doors many have talked of forced quarantine as the “test run”

. . . as a means to measure your backbone and mine . . .

Even to condition a compliant populace.

However, from this side of the fence . . . it’s had the opposite effect.

You and I have tasted tyranny.

Have they really softened us up for another dose?

Or, have they hardened resolve

. . . Awakened the sleeping giant that is a still-free, still-sovereign people?

There is no “effective” vaccine for COVID-19 . . . There never will be.

There is no means of “inoculation.”

Yet through their overreach, they’ve unwittingly created a different immunity . . .

We’ve been inoculated against a disease fare worse: tyranny.

As long as we’ve not been emasculated . . .

As long as we remind our public servants that it is the will of WE THE PEOPLE, not themselves that they are bound to serve . . .

Then their plans have failed.

Where they see the “great unwashed” in need of a corral . . .

I see you, my compatriots.

I see my brothers and sisters, woken from a deep sleep . . .

Seeing perhaps for the first time how precious, how easily lost freedom can be.

So, on the week following the remembrance of Independence Day, let us resolve:

  • There shall be no slow frog boiling here
  • There shall be no toe-hold for tyranny, no matter how sweet the promise of familiarity or safety may be.
  • We cannot afford the “help” of an over-reaching government if the price is freedom and liberty.
  • No matter the cost, we must prevail as a free people . . . come what may.

To your freedom and a renewed and wonderful 2020!

Adam Nally, D.O.

Aka @DocMuscles.

(Adapted from Bryan Ward’s Third Way Man)

Coronavirus Risk, Vaccines and Herd Immunity

In order to fully understand the current “pandemic” coronavirus (COVID-19) infection, it is essential that one understands some basics about the immune system.  Second, we will look at how a poor understanding of the immune system has duped many about how the body actually responds to this virus.

Normal functions of the immune system include defense against infections and detection and destruction of malignant or abnormal cells. As our immune system ages and these capabilities decline, there is increased susceptibility to infections and cancer and an increased incidence of autoimmune disorders. The study of age-related changes in immune function is a relatively new area of investigation, which is limited by incomplete understanding of the complexities of immune mechanisms in general.  These age related changes make it clear why COVID-19 is mild in some and severe in others.

July 5, 2020 – ADHS -Data Dashboard – COVID-19 Deaths by Age Group

The coronavirus tends to be more problematic in those over age 55.  In fact, 87% of all deaths in Arizona due to COVID-19 are in those over age 55.  The clinical presentation of infections in older patients may be different from that in younger patients. Older adults with severe infections tend to have fewer symptoms, and fever is absent or blunted in 20 to 30% of those over age 55 years old. This suggests a decreased ability to mount inflammatory cytokine responses (small proteins used as signaling molecules between cell) in the face of infection. Signs of infection in older adults can be nonspecific and include falls, delirium (confusion), anorexia (loss of appetite), or generalized weakness (Norman DC, Clin Infect Dis. 2000;31(1):148).

Immune System & Aging

All immune cells originate from stem cells in the bone marrow, and there is a general decline in the total bone marrow cellular tissue as we age (Geiger H, Rudolph KL. Trends Immunol. 2009;30(7):360). Production of pro-B cells is significantly decreased with aging, resulting in a smaller number of B cells leaving the bone marrow, while T cell precursors seem to be less affected (Cancro MP, Hao Y, Scholz JL, Riley RL, Frasca D, Dunn-Walters DK, Blomberg BB., Trends Immunol. 2009;30(7):313. e-pub 2009 Jun 18). 

The immune system is divided into innate and adaptive immunity. The innate immunity refers to immune responses that are present from birth and not learned, not adapted, and not refined as a result of exposure to micro-organisms/antigens. In contrast, adaptive immunity, which consists of the responses of T and B lymphocytes, is generated and then refined over the lifetime of a person as a result of repeated exposure to antigens from bacteria, viruses or fungi. Aging affects both innate and adaptive immunity, although innate immune mechanisms are better preserved overall (Weiskopf D, Weinberger B, Grubeck-Loebenstein B, Transpl Int. 2009; 22(11):1041).

Innate Immunity

The innate immune system consists of epithelial barriers (skin, gastrointestinal and respiratory protective lining), macrophages, neutrophils, natural killer (NK) cells, natural killer T (NKT) cells, dendritic cells (DCs), and complement proteins. Additional normal defenses include production of mucus in the proper quantity and viscosity, local antimicrobial proteins, and normal sweeping function ciliary cells.

Though some innate immune mechanisms are decreased in the adult over 55 years old, other mechanisms appear to be more active.. The result of these changes is a propensity to develop chronic inflammation. The result of aging of the innate immune system may be most accurately characterized as a state of immune dysregulation characterized by low-grade, chronic inflammatory changes  (Shaw AC, Joshi S, Greenwood H, Panda A, Lord JM, Curr Opin Immunol. 2010;22(4):507).  This is why many of my patients feel that the “Golden Years” are full of lead.

Adaptive Immunity

 Adaptive immunity consists of the functioning of two types of white blood cells: T and B lymphocytes.  T and B lymphocytes mediate control cellular and humoral immune responses, respectively.

Cellular Immune Response and the T Cells

There are several key changes that occur to T cells during aging.

Thymus – The thymus gland is most active early in life, reaches maximum size within the first year of life, and then undergoes a steady decline with age. By age 7, the part of the thymus and it’s activity decrease to less than 10 percent of the total thymic space. The functional thymic cortex and medulla are progressively replaced by fatty tissue. These changes become almost complete some time between the ages of 40 to 50 (Flores KG, Li J, Sempowski GD, Haynes BF, Hale LP. J Clin Invest. 1999;104(8):1031).  As a result, the number of T cells exiting the thymus is significantly decreased and gets progressively lower between the age groups of 40 to 54, 55 to 69, and 70 to 90 (Naylor K, Li G, Vallejo AN, Lee WW, Koetz K, Bryl E, Witkowski J, Fulbright J, Weyand CM, Goronzy JJ. J Immunol. 2005; 174(11):7446).

T Cells Change Over Time – T cell receptors become less divers after age 65.  The production of new T cells is dramatically reduced in the very old. T cell populations are largely composed of persistent long-lived lymphocytes. Age-related defects in the signaling pathways of CD4 T cells have been identified due to changes in T cell receptors (Li G, Yu M, Lee WW, Tsang M, Krishnan E, Weyand CM, Goronzy JJ. Nat Med., 2012 Sep;18(10):1518-24. e-pub 2012 Sep 30).

T Cell Numbers Decrease – There is a decrease in the numbers of (helper) CD4 T cells, an increase in CD8 T cells, and a decrease in CD28 with aging. Reduction in CD28 results in an impaired ability of T cells to proliferate and secrete IL-2, an essential cytokine in promoting growth of T cells (Kaltoft K, Exp Clin Immunogenet., 1998;15(2):84).  Because (helper) CD4 T cells are important in stimulating B cells, the ability of T cells to help B cells grow, expand and produce antibodies diminishes with aging (Haynes L, Maue AC., Curr Opin Immunol, 2009;21(4):414. E-pub 2009 Jun 6).

Decreased Cytokine Signaling – T cells respond specifically to cytokines like IL-2, IL-6, TNF-alpha. With aging over 50 years, production and signaling of these cytokines diminishes and has been found to be directly correlated with degree of frailty in older adults (Marcos-Pérez D, et al., Front Immunol. 2018;9:1056. Epub 2018 May 16).

Humoral Immunity

B Cells – B cells produce their own surface membrane immunoglobulin and differentiate into plasma cells, which then make immunoglobulin for the blood or secretions. These immunoglobulins are the mediators of humoral immunity. B cells respond to antigen exposure (protein markers or flags on the surface of bacteria or viruses) by producing antibodies, which then bind to antigens to fight concurrent infections or prevent future infections.  B cells produce primarily the immunoglobulin IgM. Upon stimulation with and antigen, B cells switch to the production of IgG, IgA, or IgE. The ability of B cells to respond to antigens and produce antibodies is their main job.

The numbers of B cells precursor in the bone marrow (pre-B cells), as well as peripheral B cells, decrease with age.  Immunoglobulin levels (IgM), on the other hand, do not change with aging, and may actually increase (Frasca D, Landin AM, Lechner SC, Ryan JG, Schwartz R, Riley RL, Blomberg BB. J Immunol. 2008;180(8):5283). However, quantities of specific antibodies (ie, those generated by encounters with antigens through infection or vaccination) decline with age (Lazuardi L, Jenewein B, Wolf AM, Pfister G, Tzankov A, Grubeck-Loebenstein B, Immunology. 2005;114(1):37).

Antibody production from vaccination is also noted to be lower in those over age 55.  This is why booster vaccinations are required (Weinberger B, et al, Front Immunol. 2018;9:1035. Epub 2018 May 15).

Memory B & T Cells – The generation of long-lasting protective immune memory is one of the most unique and important characteristics of the adaptive immune system. Memory is essential for individual defense from infections to which you have previously been exposed. As the thymic output declines, individuals rely more on re-expansion of experienced memory cells for defense against infections.

Memory responses from immunoglobulins to previous infections appear to be relatively well-preserved as we get older, compared with new responses of B and T cells. Data suggest that memory B and T cells, once elicited by antigen during youth, are quite resilient to the impact of age (Stacy S, et al, Mech Ageing Dev, 2002;123(8):975Kovaiou RD, et al, Int Immunol, 2005;17(10):1359. Epub 2005 Sep 1).

An example of this  was seen during the 2009 H1N1 influenza pandemic, in which older adults were better protected from H1N1 infection than middle-aged adults, probably because of the persistence of memory lymphocytes producing antibodies generated in response to an H1N1 virus that circulated prior to 1957 (Hancock K, Veguilla V, Lu X, Zhong W, Butler EN, Sun H, Liu F, Dong L, DeVos JR, Gargiullo PM, Brammer TL, Cox NJ, Tumpey TM, Katz JM. N Engl J Med. 2009;361(20):1945). The antibody avidity for 2009 H1 was higher in older adults than in middle-aged adults (Monsalvo AC, Batalle JP, Lopez MF, Krause JC, et al. Nat Med. 2011;17(2):195. E-pub 2010 Dec 5).

Ketogenic Diets Improve T Cell Function

T Cells were found to function more efficiently on fatty acid oxidation, instead of glucose metabolism.  Ketogenic diets have been found to have a protective effect on preservation of T cell immune responses  (Goldberg EL, et al, Sci Immunol Nov 2019 4(41): eaav2026).  The ketogenic diet was found to expand the presence of T cells and improve the inflammatory changes common with aging and diminished immune function (Goldberg EL, Shchukina I, Asher JL, et al. Nat Metab 2020: 2, 50–61).

COVID-19 and the Immune System

Mechanism of COVID-19 infection. ( https://pediaa.com/difference-between-innate-and-adaptive-immunity/)

Information about the coronavirus has dramatically changed in the last six months since it was discovered.  Initially, it was suspected that humoral related antibodies were essential to mount an effective attack against COVID-19.  This is why the focus has been directed at screening for active infection, quarantine and measurement of antibodies.

What we now know is that most individuals with asymptomatic or mild symptoms generate a highly functional T cell response.  In fact, 50% of  those who have been exposed to coronavirus formed a T cell (cellular immunity) response without activation of B cell response (humoral immunity) and had no antibody formation  (Li X, Geng M, Peng Y, Meng L, Lu S. J Pharm Anal. Apr 2020; 10(2): 102-108).

A large Swedish study demonstrated that twice as many exposed family members and healthy individuals who donated blood during the pandemic of COVID-19 generated memory T cell responses (cellular immunity) versus those generating antibody responses (humoral immunity). This imply’s that the seroprevaleance (presence of antibodies like IgG & IgM found on B-cells) as an indicator has grossly underestimated the extent of population level immunity against SARS-CoV-2 (COVID-19). And none of these patients with this type of immune response have experience further episodes of COVID-19 to date (Sekine T, Perez-Potti A, Rivera-Ballesteros O, et al. bioRxiv (Biology) Jun 2020; e-pub:  174888).

What this all means is that 50% of people get exposed and form immunity with T cells, instead of B cells an may never even know they’ve had the virus.

Increased Susceptibility to COVID-19

As you can see above, age over 55 places one at greater risk for severe COVID-19 infection and complications.  This is due to the effect age has on the immune system.

Three additional maladies (hypertensiondiabetes, elevated cholesterol & coronary artery disease) are also significant risk factors for severe COVID-19 infections.  These are also are the four most common medical problems that I see in my clinic, and they affect 85% of the people in my practice.  All four are caused and driven by hyperinsulinemia.

Hyperinsulinemia is defined as an elevated insulin production (2-30 times normal) when ingesting any form of carbohydrate or starch.  It starts 15-20 years before the onset of diabetes and is the cause of hypoglycemia, elevated fasting blood sugar, pre-diabetes, metabolic syndrome, chronic kidney disease, idiopathic neuropathy, hypertension and coronary artery disease.

Elevated insulin, even small elevations, puts a load on the immune system.  The higher your insulin response to starches or sugars, the more likely you are to have hypertension, diabetes and heart disease.  We found that those with elevated insulin levels and those over 45 years old with stressed immune systems are the most susceptible to severe COVID-19 infection.

We know that just four or more hours of elevated blood sugar and insulin increases the cytokine IL-6 significantly.  This has a suppressive effect on T cell immunity.  The body raises insulin chronically to protect itself from the damage caused by chronic elevation in blood sugar.  Chronic elevated blood sugars can lead to severe inflammation and clotting disorders.  The body attempts to raise insulin to protect angainst these issues, however, the chronic elevation in insulin leads to chronic elevation in the cytokines IL-2, IL-6, TNF-alpha, PAI-1, NF-kB, ROS and eventually IL-33.

Innate immunity affected by elevated glucose, insulin and PKC (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3130196/#R56)

Should We Be Waiting For A Vaccine?

As a preface to this section, please be aware that I am a very strong proponent of safe and effective vaccine use.  Because the RNA vaccines are so new, long-term efficacy, safety and adverse reaction studies are essential before these vaccines can be recommended across the board.  It takes at least 4-5 years to 1) bring a vaccine to market and 2) complete adequate safety studies.

Let’s start by looking at the effectiveness of current RNA viral vaccines. The most common RNA vaccine currently in use is the influenza vaccine, quadravalent (four flu strains) and high dose (five flu strains) versions.  Over the last 20 years, the percentage of seniors getting flu shots increased sharply from 15% to 65%. It stands to reason that flu deaths among the elderly should have taken a dramatic dip due to increased flu vaccination each year.

Instead, as you can see above, influenza deaths among the elderly continued to climb. It was hard to believe, so researchers at the National Institutes of Health set out to do a study adjusting for all kinds of factors that could be masking the true benefits of the shots. But no matter how they crunched the numbers, they got the same disappointing result: flu shots had not reduced deaths among the elderly.

It’s not what health officials hoped to find.  I was shocked when I read these studies.  Two studies, here and here, demonstrate that yearly flu vaccine for those over age 65 does nothing to decrease influenza related death. These studies funded by the government in 2005 and 2006 were suppressed and I never heard about them. Yet the CDC still emphasizes to the elderly, “Get your flu shot.”

One reason these vaccines are ineffective is that viruses like influenza and corona-viruses are highly antigenic.  That means that there are hundreds of strains and the virus is changing rapidly.  Influenza has over 600 strains.  Our current high dose vaccine only covers five of these strains.

SARs-CoV-2 (COVID-19) is known to have over 160 strains. “There are too many rapid mutations to neatly trace a COVID-19 family tree.” Said Peter Forster, geneticist at the University of Cambridge.  “We used a mathematical network algorithm to visualize all the plausible trees simultaneously.” (Proceedings of the National Academy of Sciences, 2020).  Dr. Forster’s research identifies 160 genomes within the hundreds of additional variants of the three central COVID-19 strain variants.

A second reason, as stated above, is that 50% of people who are exposed to COVID-19 mount a T cell immune response without ever forming antibodies through B cell immunity.  And, the antibodies that do form only give 3-4 months of protective effect.

Another other very fascinating concern found when making RNA virus vaccines is the potential to increase susceptibility to other viruses.  In a Department of Defense study, looking at 6000 military personal vaccinated in the 2017-2018 season, those who got the influenza vaccine demonstrated an increases susceptibility to corona-viruses by 36%. Those who were vaccinated with the flu vaccine had additional increased susceptibility to non-influenza viruses by 15%, and increased susceptibility to human metapneumovirus by 59%.

second influenza study demonstrated an increased risk of para-influenza virus in adults (increased by 4.6% of vaccinated adults and only 2.6% of un-vaccinated adults.)  Though the researchers dismissed it as calculation error, the p value reflects that the vaccine played some roll (P=0.04) in the increased susceptibility.

Herd Immunity?

As with any other infection, there are two ways to achieve herd immunity: A large proportion of the population either gets infected or gets a protective vaccine. Based on early estimates of this virus’s infectiousness, we will likely need at least 70% of the population to be immune to have herd protection.

If the Penn State study is correct, the up to 50% of the U.S. population may have already been exposed as of the first week in March 2020, and by today, we may already be at Herd Immunity levels.  This may be why we are now seeing continued drop in death rates across the country, despite increase infection counts (due to increased testing frequency).

Should we push for a vaccine?  Do the math on a vaccine that covers only four out of 600+ strains like the quadravalent influenza vaccine.  For a vaccine to create “herd immunity,” currently being touted across the airwaves as the way to return to normal, it would require the average human to be vaccinated every year for 100 years, and would take 200-400 years to create any semblance of herd immunity.  And, that’s after 4-5 years studying the safety of a vaccine in large populations.

Influenza and HPV, the two most widely used RNA vaccines, still have a number of post-market adverse reactions including: Guillain-Barré syndrome (GBS), convulsions, febrile convulsions, myelitis (including encephalomyelitis and transverse myelitis), facial palsy (Bell’s palsy), optic neuritis/neuropathy, brachial neuritis, syncope (shortly after vaccination), dizziness, and paresthesia (tingling of the extremities) (Package-Insert—Gardasil.pdfPackage-Insert—Fluzone High Dose.pdf).  Though these adverse events occur more rarely, it is essential you and I understand the risks of these newer RNA vaccines.  Because it is an RNA virus, any coronavirus vaccine will come with similar risks.

What Can You & I Do?

First, our focus should be continued protection of our elderly and immune-compromised.  Our focus should be placed on improving the immune systems of those at risk through diet, hand washing & quarantine of the ill.  The evidence does not support quarantine of the healthy.  Evidence does not support general public mask wearing.  And there is no evidence that continued business closure is beneficial.

  • Reduce your risk of hyperinsulinemia.  Follow a carbohydrate restricted diet, exercise, control blood sugar, blood pressure, cholesterol and limit risk factors that suppress your immune system. Quit smoking, vaping, etc.
  • For my patients with insulin resistant/hyperinsulinemia, I recommend Berberine 500mg twice daily with meals. (Talk to your doctor before you add any supplements or medications.)
  • Use over-the-counter Zinc 10-30mg once daily – this has been shown to improve T cell control of viral replication.
  • Use over-the-counter Melatonin 5-10mg nightly – this helps in sleep recovery and strengthening the T and B cell immune response.
  • If you have been diagnosed with COVID-19, using Vitamin B3 (Niacin) has been show to be protective on the lungs.  Niacin is found in meat, fish and eggs (there’s reason for that ketogenic diet, again!)
  • Ensure your loved ones, especially the elderly and immune suppressed, understand the truth about their risk of infection.
  • Make a list of the things this pandemic has taught you. What can you do to better protect yourself in the future?
    1. We live in a society with a limited supply chain.
    2. We have become excessively dependent upon foreign business and supply
    3. We have become dependent upon “just-in-time” and over-night delivery systems
    4. We have a number of local and Federal deficiencies in our health care system
    5. How important to your health, personal liberty and constitutional rights is defense of the borders?
    6. How has freedom of speech, freedom of religion and freedom of assembly affected your family and your physical, emotional or spiritual health?

Consider the following poem in all of this:

Don’t be afraid to go outside and be a human being again.  And, pass the bacon.

Coronavirus, the Cancel Culture and Tiny Betrayals of Purpose

In the last two decades, it has become more and more clear that the average American has trouble facing reality.  The average American has trouble facing truth.  It affects each of us, and it is affecting physicians, nurses and health professionals individually.

At least once a week, one of my patient’s refuses to get on the scale.  Why would you visit the doctor to improve your health, and yet refuse to look at a measure of health?  Yet, that is the accepted culture of today.

Language of Euphemism

Another evidence of this can be seen in the changes to our language. Our language has become flowered with euphemism and politically correct phrases.  It is why we have a whole generation hyper-focused on “cancel culture.”  People have set aside their faith to live by their feelings.  People no longer accept another’s right to share their perspective or express themselves, especially if it hurts another’s feelings.  We’ve created soft language that has taken the life out of life and medicine.

Shell Shock to PTSD

An example of this change is the softening of language describing what happens to a persons nervous system when in combat.  During World War I from 1914 to 1918, if a soldier’s nervous system became overwhelmed due to the fatigue, stress and horror of battle it was called “shell shock.”  The term describes the power and struggle that occurs with this overwhelming stress. The word almost echos the rattle of a cannon on one’s soul.  Men would return home with hysteria, muscle contractions, heart palpitations, dizziness, depression, blindness, paralysis, insomnia, loss of appetite, flashbacks, nightmares or unable to speak without any physical damage to explain the symptoms.  Because little was understood about the cause, it was seen as a sign of emotional weakness.  Many were even branded as deserters or cowards because of the condition shell shock would cause.  At the end of the war, 80,000 men were diagnosed with shell shock in the British Army medical facilities.

But instead of addressing the pain and addressing the trauma, we buried it under the jargon and euphemisms.  After the second world war in 1945, we toned the term down because we didn’t want to hurt anyone’s feelings describing them as “shell shocked.” So, we called it “Battle Fatigue.”  It is the same problem, overwhelming a person’s emotional coping mechanisms and nervous system with stress to the point of failure, but “battle fatigue” just sounded better, and softer.

Enter the Korean War of 1950-1951.  Actually, we softened that too.  It wasn’t really a war, we were told, and our leaders turned it from war into a softer more acceptable “Korean Conflict.”  Men and women who encountered the same overpowering effects on the nervous system from witnessing the horror of battle, death and destruction were told they had “operational exhaustion.”  This was an even softer term that allowed for a further avoidance of the truth.

Five years later, the U.S. entered a 19 year “conflict” with Vietnam.  The politicians of the time didn’t want to call it war either.  The same trauma causing shell shock in World War I was experienced by men and women in Vietnam.  Seeing the horrors of battle on a daily basis and only being allowed to police those attacking you with guerrilla warfare in a foreign country led to severe trauma in many of our soldiers.  Fighting was intense and millions of people were killed including 60,000 U.S. soldiers.  Yet, we further softened the term “operational exhaustion” with the same symptoms of shell shock to “Post-traumatic Stress Syndrome (PTSD).”  (Hey, at least they added a hyphen, right?)

Waking The Tiger – Working Through Trauma

Trauma is trauma, no matter how or where you experience it.  Because of it’s complexities, the treatment of trauma can’t be addressed here, but according to Peter Levine in his book Waking the Tiger, trauma, no matter what the cause, must be worked through.  Peter Levine does a wonderful job in explaining this in his second follow up book In An Unspoken Voice.  There are additional treatments for burnout.  The brain has a consistent pattern that it follows to resolve trauma and burnout.  If that pattern is disrupted, shell shock, battle fatigue, operational exhaustion or PTSD ensues.

Elizabeth Metraux describes this in her 2018 article this way:
“I was on my honeymoon in Colombia when I first became aware of the true extent of my post-traumatic stress disorder. My husband and I were walking across a smooth, granite platform to take a closer look at a fountain in downtown Cartagena. As we neared the structure, mist from the fountain’s jets dampened the ground at my feet.

“I froze, paralyzed with fear by a flashback — my first — triggered by something as ordinary as wet pavement on a warm day.

“Two years earlier, I was working in civic engagement efforts in Baghdad. One morning, as I walked across a smooth, granite platform toward my apartment, gunfire erupted. I tried to run, but my flip-flops bested me on the pavement, still damp from an early mopping. I slipped and fell backward, hitting my head hard enough to knock me out. When I opened my eyes minutes later, the platform was covered with my blood.

“That happened 15 years ago this week, those Ides of March when American forces invaded Iraq.

“Back home in the U.S., it was clear to those around me that I had PTSD. It wasn’t until six months after my honeymoon, however, that I had the courage to acknowledge that I needed help. It’s not easy seeing your own weaknesses, much less conceding them. But when my habitual glass of wine with dinner became a bottle, and fireworks left me sore and sleepless for days, it was hard to fight the signs.

“Celexa for guilt. Ambien for sleep. Therapy for months. My psychologist and primary care physician spoke regularly to coordinate my care. Most importantly, family and friends became members of my care team. Isolation is a trauma victim’s ill-advised drug of choice, one my loved ones and clinicians wouldn’t let me take.”

Most Physicians Suffer from Moral Trauma combined with PTSD

What concerns me is that many of today’s heath-care workers, physicians and nurses, suffer from PTSD and moral trauma.  Dr. Metraux goes on to describe a conversation she has that is reminiscent of many recent conversations I’ve had with my colleagues:

“A few weeks ago, I was talking with a physician who served our country in Iraq. We chatted nostalgically about the taste of sand and shawarma before he said something that gave me pause: ‘You know, I’d go back to the field any day. Beats practicing in my clinic.’
“‘Why’s that?’ I asked.
“’I didn’t become a doc to put up with billing codes and power struggles. I thought that PTSD would hit when I came home from Fallujah. It’s so much worse when I come home from the office. Truth is, I’ve lost my sense of purpose.’”

Physician burnout is easily chalked up to the 4-8 minute hurried visit with 30-40 patients per day, and the additional 6-8 hours spent each day entering patient information into an electronic medical record, combined with the life-and-death decisions this profession requires routinely every day.  Add to it a time when a physicians and nurses are called upon to be the only people in the clinics and hospitals taking care of a viral infection still unknown in its full spectrum.  But, that doesn’t even scratch the surface.

Thousands of Tiny Betrayals of Purpose

The real cause of injury is the fear created by a society that doesn’t really want to hear or face the truth, and the hundreds and thousands of tiny betrayals of purpose that occur every day in the clinic or the hospital.  Most physicians find themselves expressing horror and disgust at how far they’ve been steered away from their primary purpose of taking care of people.  Clinicians and nurses, much like combat veterans, are forced to take actions every day that contradict their core purpose – sometimes compulsory, sometimes voluntary.  It causes a slow imperceptible unwinding of character.

The 4-8 minute visit means the physician can’t take time to build a real relationship with you or take care of the whole person whose real diagnosis can’t be logged into a computer.  The 8 hours of daily charting requires the clinicians eyes to be taken off their patients, missing the humanity that brought us to the work in the first place.  The government mandated “quality metrics” imposed on every patient encounter by Medicare, Medicaid and intrusive insurance plans that crowds out the deeper connection with patients to help them manage triggers, feel truly cared for and navigate treatments.  Each of these are a “tiny betrayals of purpose,” 30-40 times a day over the course of weeks and months and years.  When you subconsciously betray yourself with every interaction you have throughout the day, it adds up.

Medicine now requires clinicians to practice in a manner inconsistent with their values, because it saves costs, increases access and improves quality, . . . maybe.  Then, add a new virus with an unknown morbidity, mortality and infectivity to the spectrum without a clear treatment protocol. Then add to that layers of bureaucratic regulation and mandates around treatment and insurance.

In 20 years of medical practice, including battlefield medicine, I’ve never seen physicians express public fear, angst and fatigue in the course of their duty.  I’ve seen it every day in the last year.

We Lose a Physician Every Day

Since 2018, over 400 physicians committed suicide per year.  Every day, at least one physician commits suicide (Tanwar D, Amer Psych Asso 2018 Annual Meeting).  That is the highest rate of suicide in any profession.  40 suicides per 100,000  is twice that of the general population.   This rate is higher than the military.  The claim is that doctors are under-treated or untreated for their depression.  It is more than that.  Doctors and nurses alike are experiencing “shell shock,” or in today’s vernacular, “post-traumatic stress disorder” and being force to live, work and function all while suffering with subconscious moral injury.   It goes untreated and unrecognized.

It’s why your doctor is curt with you.  It’s why he or she can only spend five minutes with you in the exam room.  It’s why you get the sense of fear from them when dealing with COVID-19.  It’s why there is confusion about wearing masks and why so many physicians struggle to keep up with the ever changing science.  It’s why 30% of them are divorced.  It’s why 73% of the physicians and 50% of nurses you meet are effected by burnout, trauma and PTSD.

The challenge, is it’s only going to get worse before it gets better.  Some will leave medicine, some will leave life.  Others will suffer until it kills them.  Unless, you and I change it.  Until then, society will be offended.

Is COVID-19 Really Getting Worse?

600% Increase in COVID-19 Testing

COVID-19 testing in Arizona as of June 21, 2020 (azdhs.gov).

The media keeps stating that corona virus has “spiked” in Arizona.  What they’ve not been saying is that the frequency with which Arizona doctors and hospitals are testing went from 2500 tests per day to almost 15,000 tests per day just after the first week in May.  In fact, 17,663 tests were reported on yesterday alone.

Our testing frequency increase 600% in the last 6 weeks.  Of course we are going to see increased numbers of positive tests.  That is to be expected.  Additionally, what you are not being told is that the number of positive tests has remained consistent around 8-10% of all those tested.  We are not seeing a “spike.” We are getting a much clearer picture of the prevalence of this virus.  And, the large majority of those being tested are under 45 years old, those with the least likelihood of severe symptoms.

The Virus Can Be Lethal, But So Is Influenza and Childhood Pneumonia

Don’t get me wrong, this virus has the potential to be lethal in 1-2% of those that are infected, those who are immuno-compromised, but the majority of those getting positive tests (98-99%) will quickly recover without significant problems.  That is identical to influenza.  And you can see from the graphic below that the majority of those who have died in Arizona are those over 65 years old with significant other disease risk factors.

CDC estimates that there have been 62,000 deaths from influenza from October 2019 to April 2020.

As of this week, the CDC’s provisional death counts for COVID-19 from January to June 2020, excluding influenza, are 45,524. That’s still less than influenza numbers above.

809,000 children died in 2017 from bacterial pneumonia in 2017.  That’s 2200 children that die every day from preventable pneumonia, yet we haven’t mandated masks for this epidemic.

As you can see below, death from COVID-19 has continued to decline, despite what the media is saying.  If it were truely spiking, we would have seen a rise in COVID-19 deaths around June 6th-15th (Arizona’s Quarantine Orders ended on May 31st), giving a 7-14 day incubation period after people began working and interacting.   Yet that isn’t what the Arizona Department of Health is reporting.  The number of deaths continues to fall.

Death from coronavirus in Arizona as of June 21, 2020 (azdhs.gov)

12,285 people died in Arizona from heart disease in 2017 and 11,719 died from cancer.  We know that high carbohydrate intake combined with high fat foods is the number one risk factor for both of these diseases, yet there has been no city or state mandate on these risk factors.  And, we know that hyperinsulinemia (the underlying cause of diabetes, hypertension, heart disease, and most cancers) is the primary risk factor in severity of illness in COVID-19 patients.

I have yet to hear Governor Ducey or Mayor Hall issue an executive order on time spent in a bakery or proximity to Krispy Kreme.

Is Hospital Bed Space Still an Issue?

Possibly, but during our low point in hospitalization at the beginning of April in Arizona, hospitals were still at 60-70% of capacity.  As of the writing of this article, Arizona is at 85% of capacity.  This was to be expected.

Will we reach capacity over the next 2-4 weeks?  Epidemiological projections claimed that even with quarantine of the state we would max out our hospital capacity in April.  We didn’t even come close.

A Rise in COVID-19 Cases is Expected

St. Louis vs Philadelphia Quarantine vs No Quarantine – 1918 Spanish Flu Deaths

If you look at history, the only time where viral infection quarantine was incorporated into a city versus one that was not (St. Louis & Philadelphia), you will see that a rise in viral infection and death naturally occurred after removing the quarantine orders.  This is visible in the red indicator at 80-110 days in St. Louis.  Our rise in COVID-19 cases and fatalities is to be expected.

The whole point of this was to unload burden on hospital facilities, not stop the spread of infection all together, as that will never happen.  The goal of decreased hospital burden has been accomplished. 

Why All the Hype?

Your guess is as good as mine.  I have wracked my brain as to why our leaders persist in forcing the average healthy American to feel anxious, fearful and insecure over a virus that is no more problematic than the flu.

Why would mandates for mask wearing occur 6 months after the outbreak of the virus occur when death rates are falling and data shows us that many people have already had this infection without knowing it?  If you look at the cities in Arizona where mask and social distancing mandates have been enacted in the last week, you may recognize that these are the more progressive left leaning cities.  This push to change the way we live our lives seems to come from this group and is amplified by the left-leaning media.  Motive may revolve around the poll box in November.

Though you and I have felt this deeply in our homes and wallets, liberals running for office at all levels across the state and nation likely feel they have politically benefited from the outbreak of the coronavirus. The subsequent regulations on social distancing, mask wearing and business closures gave Democrat elected officials more power over individual lives and business operations than they have ever had before. Combine that with the ability to blame our current president for the economic consequences of the virus and you can see why some would salivate for another outbreak to rescue their hopes for unseating this president.

Is This A Method to Move Us to Main Streamed Contact Tracing?

A second reason for the hype could be a desire to move people to allow wide spread “contact tracing.”  This is much like facial recognition software that we see used so often in the latest spy thrillers. However, contact tracing uses the GPS in your phone to track your location, travel and your contacts.

As of last month, contact tracing software was added to Android and IOS phones.  Apple released iOS 13.5 and iPadOS 13.5 for iPhones, iPods, and iPads on May 20th. They went live alongside minor software updates for Apple TV and HomePod devices. The iOS update mainly adds new health-related features—most notably the much-discussed Exposure Notification API that was co-developed with Google to help local, regional, and national governments enact contact-tracing strategies to battle the COVID-19 pandemic.  These are not automatically turned on, but you can find them under the privacy settings of your phone.  Added without your consent, contact tracing and facial recognition cameras used individually or in coordination are arguable violations of human rights and rights to privacy.

Several Supreme Court cases have recognized a right to travel. For example, in Kent v. Dulles (1958), the court wrote, “The right to travel is a part of the ‘liberty’ of which the citizen cannot be deprived without due process of law under the Fifth Amendment. . . . Freedom of movement across frontiers in either direction, and inside frontiers as well, was a part of our heritage. . . . Freedom of movement is basic in our scheme of values.”

In addition to the right to travel, in Toomer v. Witsell (1948), the Supreme Court asserted that the act of shrimping (and, more generally, pursuing one’s livelihood) was protected by the Fourteenth Amendment’s Privileges and Immunities clause. (“Shrimping” means to fish for shrimp.)

And in the well-known case of Meyer v. Nebraska, the Supreme Court determined that constitutionally protected liberty “denotes not merely freedom from bodily restraint but also the right of the individual to contract, to engage in any of the common occupations of life, to acquire useful knowledge, to marry, establish a home and bring up children, to worship God according to the dictates of his own conscience, and generally to enjoy those privileges long recognized at common law as essential to the orderly pursuit of happiness by free men.”

There is a strong argument that the Constitution protects the freedom to move, travel, and do business. However, constitutional interests are not absolute, and argument arises that this could be limited by pressing public health interests, especially during a state of emergency.  Hence the need for cities and states to declare “state of emergency” before enacting these orders.

In order for liberty-infringing public health laws to be constitutional, they must be the least restrictive means of protecting health. With regard to the novel coronavirus, this may not be the case.

A Change of American Values

There are those on the left who have a profound dislike for what you and I see as the traditional American culture and political mores of the United States. Remember Barack Obama’s words about those who “cling to Bibles and guns,” Hillary Clinton’s labeling of Trump supporters as “deplorable,” and the recent emphasis across the nation by many to get “transformational change?”  Understand that it is not just mere reform or improvement the Democrats desire, they want a wholesale difference in the way Americans interact with each other, think and operate day-to-day.

Fear of your neighbor, because of unseen illness or skin color, makes you and I more likely to accept governmental regulation and vote for help at the ballot box.  History has demonstrated this fact for hundreds of years. When the government appears smarter than your doctor, you’re more likely to vote for single payer health care.   Think about it.

 

Ten Reasons Why I Will Never Support Black Lives Matters

I have been very vocal this week about the new narrative for racism that permeates every air-wave and smartphone across the country, “The criminal justice system is to blame.”  The logic states that Black men are being rounded up for little reason by a White-run criminal justice system dedicated to the eradication of a burgeoning minority middle class.  If it weren’t for the dastardly system, all would be well.  All is to blame on “white privilege” they claim.  And, the narrative is being driving by the organization called Black Lives Matters.

Phoenix, Arizona May 31, 2020 – CNN

A significant number of the ketogenic and carnivore world “elites” have significant buy in to this narrative and have come down hard on my position during the last week.  I’ve been called a white racial supremacist, a bigot, a fanatic, and I’ve even had a few death threats arise in my “in-box” because I disagree with the agenda of this organization. But those of you who know me, know that I don’t make statements lightly.  Any time I take a position, it will be based in scientific fact.

All of this has occurred as protests, riots, looting and murder have flooded the news, social media feeds and airwaves of the world.  Anger that justice has not been served was the initial outcry.  True it is that any life unjustly taken deserves restitution.  Yet, in the attempt to make things right, I refuse to join with a movement that stands for nearly everything wrong and evil in this world.

As of today, more innocent lives have been taken (20 as of today’s count) since these violent protests began over the horrible death of George Floyd.  But what about the other black lives that have been lost in the chaos.  What about the Black business owners that lost their businesses?  What about the families of those that lost fathers and mothers to this violence in response to violence?

Minneapolis Minnesota, May 31, 2020 – FoxNews.com

“Dr. Nally, you don’t have to agree with everything.  Just because it’s on their website, doesn’t make them bad.  Just agree with the good things this movement is doing.  Just drop to a knee with your sign and show your support for the good parts,” I’ve been told by quite a few people I used to admire.

Let’s apply that logic to other examples.  Would you hold your church social on the lawn of the Playboy Mansion because Hugh Hefner was a Methodist who believed in God and had a copy of “The Purpose Driven Life” on his nightstand table?

I am not a racist. Just because I disagree with your position on social justice does not make me a racist either.  The definition of racism is the belief that race is the primary determinant of human traits and capacities, and that racial differences produce an inherent prejudicial superiority of a particular race.  I do not view, interact with or treat anyone of a different skin color any differently than I would treat my own family.

This may offend you, but according to scientific evidence, “white privilege” isn’t real.   If it were a real issue, you would not see statistical success of the Asian populations in the United States.  Just look at the graph of ethnic incomes below.

And, it’s not just income.  Asian students score higher on educational testing like the SAT.  How does the argument of “white privilege” explain this anomaly? It doesn’t.  If race provided privilege, then these graphs would be notably different.

Those of us that have been raised to abide the law, pay our taxes, set aside our instinctual urge to provide justice by allowing for due process in the civilization we’ve contributed to, act with civility toward leadership, give honor to the experience of our parents and our elders, follow basic civil instructions, provide for our families, protect them and serve our neighbor are horrified that someone would claim we are “subconsciously racist.”  This is an attack on and an attempt to verbally disarm the good men and women of this country by creating guilt, claiming that because of your heritage, a part of you is unwilling to protect your neighbor.

Because of this, I cannot sit idly by and watch this country spiral down the drain without making my position  loud and clear.  Based upon additional thoughts I contemplated after reading Ryan Bomberger’s article in TownHall this morning, here are:

Ten Reasons I Will Never Support #BlackLivesMatters (BLM)

  1. Their Premise Isn’t True.  I despise racism.  It is never appropriate.  It is even worse when racism is used as a political weapon like is has been this week. According to the FBI’s latest homicide statistics, a black man is 11 times more likely to be killed by another black man than by a white man.  The comprehensive 2019 study by PNAS, “White officers are not more likely to shoot minority civilians than non-White officers.”  Even the Washington Post’s database on police-involved deaths put this into perspective.  In 2020, among those killed by police officers (all male):
      • 2 Native Americans
      • 9 Asians
      • 46 Hispanics
      • 76 Blacks (Incidentally only 9 of those 76 Blacks were unarmed)
      • 149 unlabeled individuals
      • 149 Whites (whose deaths are never reported by national mainstream media.)
“White Privilege” – @AmyDC – (Satire Image)

2. Goals for Forgiveness or Reconciliation are not Present. On none of the Black Lives Matters websites are there any mention of healing wounds, forgiveness or moving forward.  You cannot talk about the sins of distant past and expect to move forward if there is no intention of forgiveness.  Ask any counselor, psychiatrist or physician, when your spouse brings up old wounds or grievances with every argument, does the marriage get better?  Absolutely not.  They’ve never forgiven you and neither will Black Lives Matters.  Their paradigm is not centered in any gospel of forgiveness.  It is a prejudicial oppressor/oppressed race theory paradigm that is completely flawed.  This seems strange when the majority of Blacks in the U.S. are Christian (79%) and profess a belief in Jesus Christ. 

Most Christians believe that we are individually responsible for our own actions and, not Adam’s transgression from the fall (that was the whole point of the atonement of Christ).  Yet, belief that white people living today are responsible for the slavery their for-bearers participated in is diametrically opposed to Judaeo-Christian philosophy.  I am not responsible for my father’s transgressions and neither are you.  You can’t stand on both sides of the fence.

What is the solution? Whether you are a believer or not, Jesus Christ taught an inspired model that leads to peace and harmony — to love God first, and then to love our neighbors as ourselves. I don’t pretend that either of these pursuits is easy, but in the 50 years I have been upon this earth, it is the only action that yields the promised fruit.

3. The Focus is 100% Black Power.  That’s all you’ll ever see on their websites at M4BL and BLM.  Both of these organizations focus on “organizing and building Black power across the country.”  This is not what Martin Luther King promoted.  He promoted “God’s power and human power.” That’s dramatically different.  I agree with Dr. Martin Luther King, Jr.’s statement, that “hate cannot drive out hate. Only love can do that.”  Only this kind of love and empathy can inspire us to do the rigorous work of rebuilding bridges of cooperation instead of walls of segregation and alienation.  I will happily stand and march with the principles outlined by Dr. King.

4. Both Organizations Heavily Promote Homosexuality and Transgenderism.    “We foster a queer-affirming network. When we gather, we do so with the intention of freeing ourselves from the tight grip of heteronormative thinking.”  Any group that claims normative thoughts and attractions as a heterosexual male or female are abnormal is embracing confusion, dubiety and promotes chaos.  These are the last people I want my children associating with.  Loving every human being is NOT the same as loving every human action.  Teaching from this platform is teaching half-truths and is devious and vile.

5. Black Lives Matters Intentionally Ignores and Suppresses the Importance of Fatherhood.  From their own website: “We disrupt the Western-prescribed nuclear family structure requirement by supporting each other as extended families and ‘villages’ that collectively care for one another, especially our children, to the degree that mothers, parents, and children are comfortable.”  Notice “fathers” is intentionally missing from that statement.   We know from years of research that every “village” that has fatherless families is a village that suffers higher crime rates, higher drug usage, higher abortion rates, higher drop-out rates, higher poverty rates, and so much more.

Prejudice, hate and discrimination are learned behaviors.  We are not born with them. This is why parents, family members, and teachers must be the first line of defense. Teaching children to love all, and find the good in others, is more crucial than ever. Oneness is not sameness in America. We must all learn to value the differences.

How does the absence of a father play a role in this? Isn’t it interesting that the ethnicity that is the most successful at income and education is also the group that has the lowest number of fatherless homes.

6. They Demand Reparations.  On the same BLM website above, they demand, “Reparations for . . . full and free access for all Black people (including undocumented and currently and formerly incarcerated people) to lifetime education . . . retroactive forgiveness of student loans, and support for lifetime learning programs.

Ummmm, question?  What about the mixed racial peoples?  Will the white half of their bodies have to pay the Black half of themselves?

7. Complete Abolition of Police Forces.  These people assert that complete abolition of prisons, police and any other institution related to civil safety is their goal.  Across 30 cities this week you’ve heard the cry, “Defund the police!”  This would leave total anarchy in any community. Yet, police chief’s and commissioners around the county have begun to stand with these groups at the behest of their officers.  Reforming department codes to control use of force, continued training in use of aggressive force and monitoring systems that identify officers who abuse these policies have been show to be effective and are essential, but abolishing police forces is utter insanity.

To paraphrase Winston Churchill, people who buy this mindset are guilty “Of not understanding the difference between the fire department and the fire.”

8. BLM IS Anti-Capitalistic. They declare  “We are anti-capitalist. We believe and understand that Black people will never achieve liberation under the current global racialized capitalist system.” The video and recordings that identify incidences of police brutality and misuse of force are captured on phones and body-cameras that were made possible by capitalism.  We have known for over 100 years that the best way to raise people out of poverty is capitalism.  Capitalism is what makes the United States of America the most charitable nation on the earth and the nation with the most freedom.

9. Collin Kaepernick Supports It.  I want nothing to do with a man who idolizes Fidel Castro and Che Guevara and worships Malcom X (check out his social media feeds and you see all the proof you need).  Malcom X was an anti-integration, pro-violence member of the Nation of Islam (virulently racist).  Interesting that this #SocialJusticeWarrior is absolutely silent about the fact that he makes millions from Nike whose entire Executive Leadership Team is White, and according to Kaepernick makes its shoes in the most “murderous regime in the world.”

Colin Kaepernick – NYTimes.com

10. Not All Black Lives “Really” Matter. The pro-abortion Black Lives Matter further declares: “We deserve and thus we demand reproductive justice [aka abortion] that gives us autonomy over our bodies and our identities while ensuring that our children and families are supported, safe, and able to thrive.”  Aborted children don’t thrive.

Many even argue that Planned Parenthood’s founder Margaret Sanger, a strong believer in eugenics, intentionally used abortion to lower the Black birth rate.  Something is amiss when over one-third of all abortions occur in Black mothers.

BLM has claimed solidarity with “reproductive justice” groups since February 2015 and have been officially adopted into the Democratic National Convention platform since August 2015.  Sorry folks, you cannot simultaneously fight violence while all the while celebrating it by destroying lives before they take their first breath.

Will I be ostracized from the keto/carnivore community for my position?  Probably, but my conscience is clear, and I can sleep at night.

Why You Shouldn’t Worry About COVID-19 Any Longer

(Note: Author Updated this article on January 31, 2021)

I’ve been accused of writing this article because of my personal political motivation.  That is not the case. I write this article because my patient’s expect me to treat them based on the actual science that exists, not the interpretative politics and non-evidence based health mandates that so many have recently cowered under, or used as a virtue signaling security blanket.  A number of my patients, and potential patients, have notified me since I first published this article that I upset or angered them, because I haven’t conformed to “everyone else’s opinions.”  My intent in writing this is not to anger anyone, agree with your opinion or to put forth a political agenda.  Just because the media, politicians or city bureaucrats repeat something over and over doesn’t make it true. I share with you the actual science that has been recently made available so that you and I can make an educated judgement on how to act.  Without an understanding of the actual evidence how are you and I to respond when there are so many voices sharing so many differing opinions? If you can’t trust your doctor to follow updated scientific evidence, then who can you trust?

——————————-

After graduation from medical residency, I served for four years as my AirForce Reserve unit’s biological/chemical weapons expert & physician. My job was to understand the risks of all the known biologic and chemical weapons that could be used on a human being, including severe viral and bacterial diseases that could pose a threat. My training was specifically focused on how to prevent and treat the effects of these illnesses in those under my care, military or otherwise.

I spent four years reading and researching where and when various types of masks, respirators and protective equipment would and should be used. Never once was a surgical or cloth mask ever found to be effective. Even N95 masks failed the rigors of these encounters.

 

This week our fearless Dr. Fauci says it’s “common sense” to wear two masks. So, my question to him and all of the other emperors of medicine is, what about three masks?

Even better yet, 10 masks makes even more “common sense!!” Where does this stop? (‘Cause my ears flop over at 11 masks.)

I’m thinking that 100 masks is 100% effective right?

I guess those filtered gas masks really aren’t essential then?!

One surgical mask decreases risk by 1-2% (yes, that’s the benefit of a mask that we’ve been required to wear). You’re more likely to have a 40% COVID risk reduction by throwing salt over your shoulder when you leave the house . . . (that’s the actual placebo effect).

The whole reason for mask wearing is to decrease “asymptomatic” transmission of COVID-19. That means, masks are supposed to decrease your risk of spreading or inhaling this virus when you or the person near you have no symptoms. Initially, we recommended wearing masks, because we did not know how infective the COVID-19 virus was to humans. We also knew that there was limited access to the N95 masks used in the hospital setting.

However, in the last 12 months, we’ve learned a great deal and we have a tremendous amount of data about treating this virus in the outpatient setting.

How Contagious is COVID-19?

What’s the actual risk of spreading the virus when you have no symptoms? It’s about 0.06% if you have prolonged contact (3 hours continuous face-to-face) with a person within six hours of that person having onset of symptoms (i.e. – fever, sore throat, fatigue, headache, loss of taste or smell, or runny nose). It is very rare to be infected at all with COVID-19 asymptomatically if you contact a person 6-9 hours before they have symptoms.

In fact, a recent study revealed there were no positive tests (or asymptomatic spread) among 1,174 close contacts of asymptomatic cases.  So, why are we still wearing masks? Because it is politically convenient, increases fear, and increases your likelihood of getting a vaccine.

Are There Unintended Consequences of Mask Wearing?

Is wearing a mask to decrease a minimal risk by 1% more worth the risk? Increased bacterial and fungal infections that are on the rise as a consequence of chronic and continued daily mask wearing.

I’m seeing patients with increased frequency of facial rashes, fungal infections, non COVID-19 induced bacterial infections. Reports are coming from my colleagues, all over the world, that suggest bacterial pneumonias are on the rise.

Why? Because we are wearing and re-wearing of dirty masks. Untrained members of the public are wearing medical masks, repeatedly… in a non-sterile fashion… They’re becoming contaminated. They’re pulling them off of their car seat, off the rearview mirror, out of their pocket, from their countertop, and they’re reapplying a mask that should be worn fresh and sterile every single time. And, there is no way around this when 330 million people are required to wear a mask to go to Wal-Mart or Costco.

In a recent report in Emerging Infectious Diseases, the U.S. Centers for Disease Control and Prevention (CDC) suggests what experts have stated all along: There is no conclusive evidence that cloth masks protects users from coronavirus, especially since most people do not use them correctly and do not keep them clean.

The report actually says, “To our knowledge, only 1 randomized controlled trial has been conducted to examine the efficacy of cloth masks in healthcare settings, and the results do not favor use of cloth masks. More randomized controlled trials should be conducted in community settings to test the efficacy of cloth masks against respiratory infections.”

So, why, again, are we wearing these masks?

Should We Still Be Hiding In Our Homes?

Six months after the the largest variant of the five coronavirus sub-types appeared with it’s ugly little glycoprotein envelope and infective RNA fusion peptide coating, many states and countries are still in a quarantine or lock-down.  Initially, because of the rapid infection rate that was seen in Italy and China, health experts recommended quarantine of the general population in order to keep hospital systems and medical providers from being overwhelmed.  However, the “overwhelm” has been quite underwhelming.  This begs answer to four very important questions:

  • Should we still be quarantined?
  • Should we still be wearing a mask when in public?
  • Should businesses still be shut down?
  • Should we wait for a vaccine?

This is the first time in history that large scale quarantine of the healthy across the country was ever used.  The sole purpose was to control the number of severe cases requiring intensive care and ventilator use.    Multiple mathematical models predicted that hundreds of thousands would die based upon statistics seen in Italy and China.

Source: https://commons.wikimedia.org/wiki/File:3D_medical_animation_corona_virus.jpg

In early February, 2020, we were concerned that risk of death as high as 5.5% in our initial data from Italy and China.  Limited N95 masks and protective equipment was available.  In agreement with the CDC and WHO, I recommended everyone wear a mask, take drastic infection precautions and quarantine to prevent risk of transmission (Davies A, et al., Aug 2013).

Because viruses like COVID-19 and influenza are so small, a single layer cloth mask and or surgical mask has only been shown to decrease your risk of viral infection or transmission to others by 1-2%.  Triple layer cloth masks with central interfacing layer give 3% – 20% reduction of infection risk based on the studies we have in the medical literature (Disaster Med Public Health Preparedness. 2013;7:413-418).  At the time we learned about this virus, our understanding was that any protection was better than no protection.

Underwhelming

Yet, as this virus crossed our shores, traveled over the amber waves of grain and ascended the majestic purple mountains of majesty, the overwhelming number of patients hitting the hospital in droves isn’t what we saw.  A few areas like New York and Washington State were hit hard, but not nearly as predicted.  The large numbers of deaths seen in these states is because of their decision to send thousands of recovering COVID-19 patients into nursing homes, exposing those over 65 at greatest risk for death, to this virus.

The ONLY reason to quarantine an entire population was to decrease the load on hospitals and medical providers.  Since the corona-virus entered the US, only 2% of those who actually get infected have required hospitalization.  Our fears never came to fruition. The hospitalization load never even reached full capacity in 99% of hospital facilities across the country and many facilities began furloughing employees in April 2020.  In fact, this weeks estimate by the CDC is that the fatality ratio for COVID-19 is 0.004.  That means if you get the infection, you have a 0.4% chance of dying from coronavirus.  Remember, influenza has a fatality ratio that fluctuates between 0.002-0.005 depending on the year (0.2%-0.5% fatality risk).  In layman’s terms, your risk of death from a coronavirus infection is no greater than the flu.
The population with the greatest risk for death with any infection is that group over 65 years old.  Your overall risk of getting this infection in the United States and dying, if you are over 65 years old, is 0.04% based on our current population and fatality rates. Your overall risk of getting the flu and dying, if you are over 65 years old, is between 0.03%-0.05% depending on the severity of the year.

Some claim that this is because we quarantined the healthy, yet if this were the case, infections would begin to rise as soon as lock-downs were lifted.  Yet, no surge has come in the last three to four weeks, not even a blip.  And Sweden, who only quarantined the sick and the elderly at high risk, has not seen the overwhelming surge of death so many predicted.

Arizona Department of Health Services COVID-19 Dashboard – June 18,2020

As of June 18th, eight weeks from the time we began opening up businesses, elective surgeries and letting people go back to work, the death count from COVID-19 continued to fall.  If social distancing and mask wearing was really effective, significant rise in infections and COVID-19 deaths should have escalated in mid-May (5-6 days after exposure).  Yet, in states like Arizona COVID-19 death counts continued to fall.

Quarantine of the Healthy

In all of history, we have never seen any benefit to quarantining the healthy.  In fact, quarantine of the healthy has been demonstrated to be unhealthy for a “well population” (Brooks SK, et al., Lancet, Feb 2020).  Based on scientific evidences we have today, despite what our politicians say, there is no reason to quarantine those that are not ill.  Seeing all this data over the last two weeks dramatically changed my perspective on this virus.

Asymptomatic Transmission

“Oh no, Dr. Nally!  You can’t say that, because this virus can be transmitted when you’re not symptomatic!”  Yes. I’ve heard that argument for the last three months. And it is unfounded.

The main reason for quarantine was the fear of asymptomatic transmission.  Early editorial reports (these were not actually controlled studies, they were opinion reports based on a case review) showed that the virus “may” be spread prior to a person showing symptoms via respiratory secretions.  Initial data in seven very small presumptive editorial case reports out of China, Singapore and Germany postulated that this could occur in 40-50% of those infected (1,2,3,4,5,6,7).   Yet all of these articles were case reports of 1-10 people and the exact mechanism of transmission was observational only and is still unknown.

The CDC made its recommendations on wearing masks based on these seven presumptive editorial cases between January and May, 2020. Recent nursing home case report data from April and May looked at 76 people in two nursing homes, 50% of those with positive infections were asymptomatic for the first 5-6 days.  The report implies that those with COVID-19 must have had the potential to spread the disease 3-4 days before onset of symptoms.  All of our social distancing and mask wearing has been based on upon these seven very small presumptive case reports and/or medical editorials.  Never in medical history has sweeping health recommendations or mandates been made on editorial reports alone.

It is very important to note a recent larger population study of 455 patients was performed looking at infected members of families and those living in close quarters over 2-4 weeks. The researchers findings were opposite that of the seven small case reports above and concluded that the likely hood of asymptomatic SARS-CoV-2 transmission was “weak.”

The assumption that viral infections can be transmitted in the asymptomatic state comes from the Ghandi study, and others, that 30-50% of asymptomatic influenza patients can spread the flu a full 3-4 days prior to showing any symptoms, and in some cases up to 7 days prior to symptom onset.  We’ve assumed that is the case with COVID-19, but that isn’t what the larger study demonstrated.

Have we or do we currently quarantine the healthy or institute social distance because of asymptomatic influenza spreading risk?  No.

Do we quarantine the healthy or social distance because of the highly contagious croup or whooping cough (that is still prevalent on our southern border)?  No.

But, these are the same editors and journals that have been telling us for the last 50 years that eating fat makes us fat. So, we must trust them, right?  Wait, didn’t the New England Journal of Medicine and the Lancet both just retract “ground breaking” articles on COVID-19 because of falsified data that was never peer reviewed?

The fear of asymptomatic spread is therefore a mute point, as it is roughly identical to the flu.  And it has infectious similarities to other infectious diseases like whooping cough (pertussis) and the croup (para-influenza virus).  If the only actual large study of COVID-19 demonstrates that asymptomatic droplet based spread is weak, then why have we created fear and economic collapse for a virus that is less likely to spread in the asymptomatic person than the flu, croup, or whooping cough?

Risk Factor for Disease Severity

These three maladies (hypertensiondiabetes & coronary artery disease) are the three most common medical problems that I see in my clinic, and they affect 85% of the people in my practice.  All three are caused and driven by hyperinsulinemia.

Hyperinsulinemia is defined as an elevated insulin production (2-30 times normal) when ingesting any form of carbohydrate or starch.  It starts 15-20 years before the onset of diabetes and is the cause of hypoglycemia, elevated fasting blood sugar, pre-diabetes, metabolic syndrome, chronic kidney disease, idiopathic neuropathy, hypertension and coronary artery disease.

Elevated insulin, even small elevations, puts a load on the immune system.  The higher your insulin response to starches or sugars, the more likely you are to have hypertension, diabetes and heart disease.  We found that those with elevated insulin levels and those over 45 years old with stressed immune systems are the most susceptible to severe COVID-19 infection.

We know that those who do get severely ill are those over 45 with immune system compromise and/or hyperinsulinemia. A very interesting fact was published in The Lancet. The authors found that the highest rates of death occurred in those with current hypertension, diabetes and/or coronary artery disease (heart disease or atherosclerosis of the arteries).

Interestingly, Italy, Spain and Portugal have the highest incidence of metabolic syndrome (hyperinsulinemia) across all of Europe.  It stands to reason that they have also been hit the hardest with a virus that is focused on this form of immune-compromise.

Corona-Virus is Quite Common

The corona-virus, traditionally, causes a simple common cold.  In fact, 2% of the population are asymptomatic carriers of the six corona-virus strains that are known to infect humans.  And this class of virus is responsible for 10% of respiratory infections yearly around the world (Cascella M, et al. 2020 Apr 6. In: StatPearls.).

Should We Still Be In Quarantine?

Should we still be in quarantine? The answer is therefore “no.”

What we should be focused on is limiting exposure to those with the greatest risk like those in nursing homes, care centers, populations of elderly (over 65 years old), and those with known risk for suppressed immunity.  Our focus, efforts and funds should be spend keeping these populations from exposure to COVID-19.

Should we still be wearing masks in public?

As noted above, cloth masks provide only very minimal (20-40%) protection from bacteria and almost no protection (1-2.3%) from viral infections.   The two studies that do exist about effectiveness of mask wearing during viral infections to prevent spread demonstrate that adherence is very difficult and that transmission of viral infections is not statistically different between those wearing masks and those not wearing masks (MacIntyre CR et al., Cowling BJ et al.).  Because we now know that this virus is similar to influenza in risk for death, general healthy populations should have no need to wear masks.  Wearing of a mask actually increases the likely-hood of infection by increased frequency of touching your face.  It also perpetuates a climate of risk and fear.  It, also, implies that if required, mask should be a covered cost of medical provision at the State and Federal levels.  As you can see, even the NIH director over NIAID, Anthony Fauci, MD, the one person in the country with the most experience in pandemic infectious disease, has trouble wearing a mask in public.

Second, there are a number of other medical problems including exacerbation of headache and migraines that occurs with chronic use of both surgical and N95 masks.  For those who have COPD, mask wearing can exacerbate hypercapnia (increased carbon dioxide levels causing slowed respiration, confusion and fatigue). Mask wearing can also cause chronic hypoxia (reduced oxygenation) which has been shown to increase risk of cancer growth.  In cases where patients with pulmonary fibrosis or impaired lung function wear masks for prolonged periods, syncope or loss of consciousness has been documented.

Therefore, wearing a mask for prolonged periods of time when it is not medically justified is not recommended and in many cases dangerous to your health.

Despite this, and the fact that there is significant doubt as to asymptomatic transmission of this virus, mandates to wear face masks in public were decreed across Arizona today.

Should businesses be shut down?

If our ultimate goal was to “flatten the curve,” and protect hospitals from being overwhelmed, then we were successful at doing that in mid-April.  Some communities rightfully extended that quarantine to the end of April.  However, there has been no justifiable evidence to suggest that healthy people cannot go back to work, feed their families, pay their mortgages and provide for themselves.  In fact, multiple states including Wisconsin, Kansas, & Michigan have had Federal courts overturn draconian quarantine measures enacted by over-reaching emergency gubernatorial orders.

How accurate are the tests anyway?

The accuracy and predictive values of SARS-CoV-2 tests have not been systematically evaluated, and the sensitivity of testing likely depends on the precise RT-PCR assay, the type of specimen obtained, the quality of the specimen, and duration of illness at the time of testing.

In a study of 51 hospitalized patients in China with positive SARS-CoV-2 RT-PCR test (mainly on throat swabs), 15 patients (29 percent) had a negative initial test and only were diagnosed by serial testing [Fang Y, et al., Radiology 2020]. In a similar study of 70 patients in Singapore, initial nasopharyngeal testing was negative in 8 patients (11 percent) [Lee TH, et al. Clin Inf Dis 2020]. In both studies, rare patients were repeatedly negative and only tested positive after four or more tests.

Seven additional studies (including two unpublished reports) that evaluated RT-PCR performance, the estimated rates of false-negative results were 100 percent on the day of exposure, 38 percent on day 5 (estimated as the first day of symptoms), 20 percent at day 8, and 66 percent at day 21 [Kucirka LM, et al., Ann Int Med 2020].

And even though manufacturers are pushing the new antibody testing, antibody testing with IgG and/or IgM tests are frequently falsely positive [Guo L, et al., Clin Infect Dis 2020] and have been shown to be erroneous 20-30% of the time.  The accuracy and time to antibody detection vary with the particular test used. Studies evaluating the specificity of serologic tests in a broad population are lacking; in particular, the rate of cross-reactivity with other coronaviruses is a potential concern, and IgM tests are prone to false-positive results.

In the first week since symptom onset, fewer than 40 percent had detectable antibodies; by day 15, IgM and IgG were detectable in 94 and 80 percent, respectively.

In the United States, several serologic tests have been granted emergency use authorization by the FDA for use by laboratories certified to perform moderate- and high-complexity tests [FDA.gov]. The FDA highlights that serologic tests should not be used as the sole test to diagnose or exclude active SARS-CoV-2 infection. The sensitivity and specificity of many of these serologic tests are uncertain.

Should We Wait For A Vaccine?

As a preface to this section, please be aware that I am a very strong proponent of safe and effective vaccine use.  Because the RNA vaccines are so new, long-term efficacy, safety and adverse reaction studies are essential before these vaccines can be recommended across the board.  It takes at least 4-5 years to 1) bring a vaccine to market and 2) complete adequate safety studies.

Let’s start by looking at the effectiveness of current RNA viral vaccines. The most common RNA vaccine currently in use is the influenza vaccine, quadravalent (four flu strains) and high dose (five flu strains) versions.  Over the last 20 years, the percentage of seniors getting flu shots increased sharply from 15% to 65%. It stands to reason that flu deaths among the elderly should have taken a dramatic dip due to increased flu vaccination each year.

Instead, as you can see above, influenza deaths among the elderly continued to climb. It was hard to believe, so researchers at the National Institutes of Health set out to do a study adjusting for all kinds of factors that could be masking the true benefits of the shots. But no matter how they crunched the numbers, they got the same disappointing result: flu shots had not reduced deaths among the elderly.

It’s not what health officials hoped to find.  I was shocked when I read these studies.  Two studies, here and here, demonstrate that yearly flu vaccine for those over age 65 does nothing to decrease influenza related death. These studies funded by the government in 2005 and 2006 were suppressed and I never heard about them. Yet the CDC still emphasizes to the elderly, “Get your flu shot.”

One reason these vaccines are ineffective is that viruses like influenza and corona-viruses are highly antigenic.  That means that there are hundreds of strains and the virus is changing rapidly.  Influenza has over 600 strains.  Our current high dose vaccine only covers five of these strains.

SARs-CoV-2 (COVID-19) is known to have over 160 strains. “There are too many rapid mutations to neatly trace a COVID-19 family tree.” Said Peter Forster, geneticist at the University of Cambridge.  “We used a mathematical network algorithm to visualize all the plausible trees simultaneously.” (Proceedings of the National Academy of Sciences, 2020).  Dr. Forster’s research identifies 160 genomes within the hundreds of additional variants of the three central COVID-19 strain variants.

The other very fascinating concern found when making RNA virus vaccines is the potential to increase susceptibility to other viruses.  In a Department of Defense study, looking at 6000 military personal vaccinated in the 2017-2018 season, those who got the influenza vaccine demonstrated an increases susceptibility to corona-viruses by 36%. Those who were vaccinated with the flu vaccine had additional increased susceptibility to non-influenza viruses by 15%, and increased susceptibility to human metapneumovirus by 59%.

A second influenza study demonstrated an increased risk of para-influenza virus in adults (increased by 4.6% of vaccinated adults and only 2.6% of unvaccinated adults.)  Though the researchers dismissed it as calculation error, the p value reflects that the vaccine played some roll (P=0.04) in the increased susceptibility.

Herd Immunity? Maybe in 200 Years

Do the math on a vaccine that covers only four out of 600+ strains like the quadravalent influenza vaccine.  For a vaccine to create “herd immunity,” currently being touted across the airwaves as the way to return to normal, it would require the average human to be vaccinated every year for 100 years, and would take 200-400 years to create any semblance of herd immunity.  And, that’s after 4-5 years studying the safety of a vaccine in large populations.

Influenza and HPV, the two most widely used RNA vaccines, still have a number of post-market adverse reactions including: Guillain-Barré syndrome (GBS), convulsions, febrile convulsions, myelitis (including encephalomyelitis and transverse myelitis), facial palsy (Bell’s palsy), optic neuritis/neuropathy, brachial neuritis, syncope (shortly after vaccination), dizziness, and paresthesia (tingling of the extremities) (Package-Insert—Gardasil.pdf; Package-Insert—Fluzone High Dose.pdf).  Though these adverse events occur more rarely, it is essential you and I understand the risks of these newer RNA vaccines.

Conclusion

In summary, our focus should be shifting to protecting our elderly and immune-compromised.  The evidence does not support quarantine of the healthy.  Evidence does not support general public mask wearing.  And there is no evidence that continued business closure is beneficial.

What can you and I do?

  • Reduce your risk of hyperinsulinemia.  Follow a carbohydrate restricted diet, exercise, control blood sugar, blood pressure, cholesterol and limit risk factors that suppress your immune system. Quit smoking, vaping, etc.
  • Actively engage your congressman or congresswoman.  What are they are doing to assist/protect the seniors, nursing home patients, and shut-in’s in your area?
  • Let your governor or mayor hear your voice. What damage has quarantine has done to your livelihood and those of your family?
  • Get educated about your civil liberties and do not let anyone take them under the guise of an emergency.
  • Ensure your loved ones, especially the elderly and immune suppressed, understand the truth about their risk of infection.

Don’t be afraid to go outside and be a human being again.

Fork In The Road

I woke today seeing a large fork in the road of life.  It was more prominent that other forks I’ve seen in my 50 years of navigating life’s highways.

Everyone eventually comes upon this fork. Yet, this morning, because of the crisis created in life, it loomed bigger and beckoned prompt decision.

The road separated to the left and to the right.

The road to the left was paved in the color of dole.  People followed neatly in line.  They donned their masks.  They carried their subsidy checks in freshly hand sanitized hands.  Neatly packaged rations of toilet paper, and chicken under their arms.  The path was smooth, well-trodden, the evidence of thousands passing down this fork.  The road sign pointing to the left said “Victim.”

The road to the right was not nearly as smooth.  It was rocky, and in some areas, not well marked.  A small sign, barely visible, hidden in the shadows of overgrowth pointed to the right and said “Victor.”

When you look back on your life, and you remember today and the decision before you at the fork in the road, will you have merely survived?  Or will you have thrived?

Has the experience of the first few months of 2020 softened you or hardened you?  Have you even noticed?  Did you even see the signs at the fork in the road?

The road you chose is up to you and you alone.

When you feel stuck, when your life is stagnating, it takes courage to turn down a different path.  It takes effort and resolve to break free and walk a different path.   Traveling a different road gives you a new perspective, an interlude to the mundane, and forces you to be alert and to learn.

Stop waiting for the instructions.  You already know what to do.

I know you want to hear it.  I know you need to hear it.  But, no one is going to tell you it’s finally “safe.”  It will never be completely safe. That’s the whole point of life.  Growth does not occur in restraints.  When you’re not feeling safe, remember, you’re growing.

Many voices can be heard beckoning you down the well beaten path of ease.  Sure, you could live out your life on the couch.  It’s softer and safer there, quarantined upon your familiar couch.

Stop waiting for someone to re-train you, re-hire you or even reassure you.  Reassurance is only momentary.  Stop waiting for the next “expert” to change your life with an enlightened YouTube video.  The herd will never be immunized.   That’s why you were given you own immune system.  Stop waiting for a vaccine, a magic pill, or the sound of “all clear.”  It will never be all clear.  Lean into the challenge.

Stop waiting for someone to re-open your life.  No one is coming to save you.  The sad but honest truth is no one really cares.  So, stand up, step out, work a bit harder.

It’s up to you to protect, provide and steer your carriage down the road.  Do not give up that greatest of all your gifts, your ability to chose.  Yes, you must chose.  If your ability to chose is taken, you’ll never see it again in your lifetime.

The road will never be the same, it never is.  The road you chose today determines the level to which you just survive or thrive.  Chose to thrive.

Let me help you thrive.  My membership program and concierge program is designed just for that purpose.

 

What’s the One Difference that Increases Likelyhood of COVID-19 Survival?

I’ve taken a tremendous interest in the recent deaths caused by the corona-virus infection.  The reason for my interest is high C-reactive protein (CRP), high interleukin-1 (IL-1), high interlukin-33 (IL-33) and high interleukin-6 (IL-6) levels in patients with this illness.  Recent data, literally hot off the press, demonstrates that those with the greatest risk of death had the highest CRP, IL-6 and IL-33 levels.

I have a large population of metabolic syndrome, hyperinsulinemia and diabetic patients in my practice. About 85% of my practice has hyperinsulinemia.  They over produce insulin between 2-30 times normal in response to any form of ingested carbohydrate (simple and complex sugars, fruit, pasta, cereal, oatmeal, etc.) High insulin causes elevated CRP, IL-6 and IL-33.

Why is this a problem?

A very interesting fact was published four days ago in The Lancet. They published a study looking at 191 patients in two hospital centers in China. The authors found that the highest rates of death occurred in those with current hypertension, diabetes, elevated cholesterol (high triglycerides and LDL) and/or coronary artery disease (heart disease or atherosclerosis of the arteries).  This virus traditionally causes a simple common cold.  Seeing this data in this particular viral strain dramatically changed my perspective on this virus.

These maladies (hypertensiondiabetes, elevated cholesterol & coronary artery disease) are the four most common medical problems that I seen in my clinic, and they affect 85% of my practice population. All four are caused and driven by hyperinsulinemia.  The higher your insulin response to starches or sugars, the more likely you are to have hypertension, diabetes, elevated cholesterol and heart disease.

Insulin Raises Cytokine Levels

This elevated insulin in response to eating any starch or sugar, hyperinsulinemia, causes a rise in molecules called cytokines.  C-Reactive Protein (CRP), Interleukin-1 (IL-1), Interleukin-6 (IL-6) and Interleukin-33 (IL-33) are the cytokines that are abnormally and chronically elevated in hyperinsulinemia.  These cytokines are responsible for mediating the inflammatory response to illness, injury and stress in the body.  They control how your body responds with release of white blood cells, macophages, and other immune cells.   These molecular hormones are ALWAYS chronically elevated in patients with hypertension (elevated blood pressure), pre-diabetes, diabetes, elevated cholesterol, coronary heart disease and obesity.

C-Reactive Protein

CRP is a reactive protein produced by the liver in response to inflammation.  It is an “acute phase reactant” signaling the body’s immune system to respond to stress, inflammation or infection.  The presence of insulin directly raises CRP.  In my clinical experience, CRP normalizes within about three days of insulin returning to a normal level.

Interleukins (1,6, & 33)

IL-1,IL-6 & IL-33 are all cytokines.  They stimulate increased body temperature, regulate fevers, modulate macrophages and stimulate other immune cells to function in various parts of the body when infection or inflammation occurs.   These dual acting hormones are produced by a number of cells, but predominantly by the adipocytes (fat cells) and pneumocytes (lung cells).

IL-6 has a negative feedback on the liver’s ability to sense the presence of insulin.  Elevated insulin levels over time cause increased size of fat cells.  This causes abnormally high levels of IL-6 production from the adipocytes and decreases the signal of insulin on the liver – leading to insulin resistance, pre-diabetes and diabetes.  Elevation of IL-6 often persists until the fat cells shrink back down to a non-obese size.  IL-6 can also stimulate elevated CRP as well.

Elevated insulin on top of the presence of a viral infection in the lungs stimulates additional increase in IL-33.  A normal rise in IL-33 increases fluid and cells like macrophages around the lungs causing a normal immune response. This is part of the healing process, but if IL-33 is already chronically elevated in hyperinsulinemia, then a burst of IL-33 leads to the pneumonia, hypoxia and blood clotting that commonly occurs in those with severe coronavirus infections.  IL-33 has been implicated as one of the drivers in the “cytokine storm”  found in severe coronavirus infection patients.  The presence of IL-33 increases production of IL-6 leading to a “storm of hormones” (cytokine storm) being overproduced from the lungs and fat cells.

Risk of Death

Patients with elevated IL-1,IL-6, IL-33 and CRP were at much greater risk of mortality when exposed to COVID-19.  Those that died, all of them, from this viral infection had IL-6, IL-33 and CRP levels twice as high as those who recovered from the illness. That is profound.

Temporal changes in laboratory markers from illness onset in patients hospitalized with COVID-19.

Temporal changes in lab markers from illness onset in Chinese patients hospitalized with COVID-19

What does this mean?

What does this mean to you and me?  It means that those with elevated interleukin levels are more likely to experience a severe complication if exposed to this virus.  That means that 85% of my practice, if not controlling hyperinsulinemia, is at higher risk of mortality.  That’s what got my attention.  Hopefully, it gets your attention.

But, don’t stress out. As of the writing of this post, 9-10% of the population may get sick (that is the current statistical data we have over the last three months).  Relax , because 92% of people who get the virus won’t be severe enough to warrant hospitalization.  And, only 0.4% of people will die from COVID-19.  That’s actually lower than the current influenza numbers of 0.43% mortality. (Statistics taken from https://www.worldometers.info/coronavirus/) .

A recent paper written by Qasim Bukhari and Yusuf Jameel, both from the Massachusetts Institute of Technology, analyzed global cases of the disease caused by the virus, COVID-19.  They found that 90% of the infections occurred in areas that are between 37.4 and 62.6 degrees Fahrenheit (3 to 17 degrees Celsius), and in areas with an absolute humidity of 4 to 9 grams per cubic meter (g/m3).  Absolute humidity is defined by how much moisture is in the air, regardless of temperature. (https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3556998)

Arizona just hit temperatures of 100 degrees Fahrenheit this week, the last week in April. This means, if the research is correct, there should be a notable decline in the transmission and number of infections in hot and/or humid areas of the country like the south and south west regions.

What can you and I do?

What can be done about it?  Follow a ketogenic lifestyle.  Studies published in November, 2019, reveal that a ketogenic lifestyle has an enhancing effect on immunity by suppressing viral replication and barrier effect through γδ T cells in the lung.

This dietary approach is, also, the only one that I have seen clinically lowering CRP and IL-6 when using it long term.  Ketosis may be the perfect prevention.  Over the last 16 years of using ketogenic lifestyles, I have seen this pattern improve thousands of times.  The presence of ketones immediately suppresses the production of IL-6 and improves the stimulus for CPR production at the liver.  Cutting out carbohydrates lowers insulin back to a normal baseline within 3-7 days for most people.  CRP returns to normal within three days of fixing your diet.  And, IL-6 begins to decline immediately.  In my obese patients, it can take 18-24 months for IL-6 to return back to normal.

Additional Measures

Don’t stress.  The overly hyped fear mongering produced in the media in the last two weeks raises your stress level.  Turn off the T.V. and stop listening to the 24 hour news cycles.  Over the next couple of weeks, while the risk of viral exposure is the highest, the following precautions are essential:

  1. Follow good hand washing practices
  2. Limit exposure to those who may be carrying this illness through social distancing.  If you have a fever, stay home. If you are ill, wear a mask out in public.
  3. Get good sleep (six or more hours of restful sleep)
  4. Use a complete pharmaceutical grade vitamin
  5. Spend 20-30 minutes outside
  6. Do something physical for 20-30 minutes 5-6 days per week

Taiwan and Hong Kong have instituted strict quarantines and you can see their effect in the graph below.

Above all, enjoy some bacon.  Seriously.

You can’t eat bacon?  Have a nice rib eye.  Either way, based on the data above, your ketogenic lifestyle is the very best thing you can do to avoid serious infections, including COVID-19.

I talk about this an much more here on my YouTube video:

Eight Steps to Help You, Your Children & Your Family Thrive In Quarantine

Some of you are doing well.  Some of you aren’t.   There is a twisted part of some of you that actually like this “shut-down.”  Because, you’ve been in a mental/emotional shut down for years.  The pain of past failures punched holes in your heart.  You feel it and re-experience it when you try.  Your family sees it (they just don’t say anything).  Your friends see it. But, they are tactful and just smile.

With each failure, you lowered the fence.  With each betrayal, you widened the moat around your soul.

And now, life has caught up to you.

Part of you wants to double down and float corpse-like in the misery of the past.  Quarantine is an easy excuse to kill the last spark of your ambition, binge on Netflix and pop bon-bons on the couch.

But, COVID-19 just kicked over the game-board.  Life’s dice have just been changed.

Pull back the curtain of chaos around your life and the life of your family.  Realize that you actually set the rules.

The Eight Rules

There are eight rules that, if applied, will stabilize you and your family.  And, if you teach them to your children, you will solidify a generation.

Give your life and your children some structure.

We as humans have always needed guard rails, or banisters, especially the little humans.  A simple list of the top three things you and your children need to do today will make the day go so much smoother. Start at the top and go to work.  You don’t have to accomplish all three, but, just knowing the three most important things to accomplish today, gives you and your ” miniature carbon copies” satisfying direction.  If you don’t finish number 2 or 3, then put them on the top of the list tomorrow.

Delayed gratification is your true best friend.

This is a perfect time to place strategic rewards on pleasurable activities. I realize that spending the day in your pajamas watching TV, Netflix binge’ng, or playing video games can be very easy.  These activities are fine after the structure has been addressed.  Clean your room, then reward yourself with a video game. Fold the laundry, then surf the internet.  Mow the lawn, then watch Netflix.  Pay the bills, then reward yourself.

People, grown and those still growing, always respond better and gain self-confidence when experiencing delayed gratification.

Teach your family the how and why of working together.

Yes, the shutdown causes problems.  But, make lemon-aid out of lemons.  Teach your family to cook, plan and make meals together (I know a great book with 60 wonderful ketogenic recipes). Young children can clean up, feed the dog, take out the garbage and even do their own laundry.

My wife had our children doing their own laundry at seven years old.  Umm, yes, they actually can, and are capable of some complex chores at that age.  Anyone that can “Call of Duty,” “Super-Mario” or dress a Barbie can sort clothes and turn on a washing machine.  This is a perfect time to teach them and supervise.

Exercise as a family.

Daily family walks, runs, or weight lifting (body-weight exercises if you don’t have weights) will shake out the cobwebs.  Teach your kids great health habits and you fatigue them for bedtime sooner in the process.

Tell your children stories.

Share stories around the dinner table of your adventures, successes and failures.  They want to hear the how and why, it is educational for them and it is therapeutic for you.  Read to your kids before bed.  We worked through the entire Narnia series over a couple years and my kids still talk about it.

Or, better yet, tell them a bedtime story.  The crazier the better. You will never regret it, and it will be some of the most memorable things your family may experience.

Find a project that you and they can tackle.

My daughter loves to collect Medieval swords and loves to sword-fight (Probably because of the bedtime stories we read.)  We had this collection of swords that was hard to keep in a closet.  So, we made a wooden sword rack together.  My daughter found that she “loves to build stuff,” and this  brought out a creative side of her that my wife and I had never seen.

Carve out some adult time. 

You need time for yourself.  You also need time with your spouse.  Kids need to see that adults need some time for themselves.

I can still remember the time when my daughter called me at work in tears.  When I asked what was wrong, she told me, “Mom put herself in time-out, she locked herself in the bedroom and she won’t come out.”

My wife was homeschooling the kids, it had been a difficult year and didn’t give herself time to regroup.  She was frazzled.   To this day, my grown children and I have learned that each of us needs some personal time.  Or, we end up putting ourselves in “time-out.”

Learn and teach your family independence. 

If your family, your spouse, or those you are responsible for come to you with every little unmet need and want, this quarantine is going to  feel like it “lasts for years!” Train your family, and yourself, up front what they can do for themselves. And, teach them how to decide when they can do it on their own.  Help them be independent.  Tears and whining will probably occur, initially (probably, from your husband the most.) But, it is our job to take completely dependent infants and turn them into independent self-starting adults within 18 years.

So, dream big, take your white knuckles off the steering wheel, pull over and re-imagine your life.  These eight rules are the alchemy of the soul.

Using Quinine to Prevent Coronavirus is Really BAD Advice

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I’ve had multiple people send me links to people and/or “supposed experts” recommending the use of quinine to prevent coronavirus or COVID-19.  In my perspective, this is really bad advice and borders on malpractice.

Quinine was and still is used for the treatment of malaria. Yet, there are some significant reasons using quinine is, and should continue to be, limited.  Anyone recommending liberal daily use of quinine does not have any grasp of the potential for harm and death that can arise with the use of this substance.  I have seen quinine toxicity on a number of occasions in my 20 years of medical practice, and it ain’t pretty.

There is NO Evidence that Quinine Prevents COVID-19

There is absolutely no evidence that using quinine prevents infection from coronaviruses or COVID-19.  Quinine differs in its mechanism of action from hydroxychloroquine, one of the drugs currently under investigation for use with COVID-19.  Please, DO NOT confuse the two.

Even Small Amounts of Quinine Can be Deadly

Quinine use is the most common cause of immune-mediated drug induced thrombotic microangiopaty (DITMA), a life threatening condition caused by small-vessel platelet clots.  In a systematic review of all published reports describing drugs and other substances as a suspected cause of thrombotic microangiopathy (TMA), quinine was responsible for 34 of 104 cases in which there was definite evidence for a causal association (33 percent) [1].

The Oklahoma Thrombotic Thrombocytopenic Purpura-Hemolytic Uremic Syndrome (TTP-HUS) Registry found quinine-associated TMA in 19 of 509 patients (4 percent) referred for a possible TMA over a 25-year period and found quinine as the cause of DITMA in 20 of 23 patients (87 percent) for whom a drug could be implicated as having a definite or probable causal association with the TMA [2, 3].

A 2017 report describing the 19 individuals included in this registry found the following features [3]:

  • All were white. This is distinctly different from Thrombotic Thrombocytopenic Purpura (TTP), in which approximately one-third are black (seven-fold higher than the reference population).
  • Eighteen (95 percent) were women. This is greater than the increased frequency of women (75 percent) among patients with TTP.
  • Eight (42 percent) had a prior history of quinine-related symptoms (nausea, vomiting, fever, chills, headache, confusion, ataxia).
  • Thirteen (68 percent) could recall the precise timing between quinine ingestion and symptom onset (all ≤4 hours).
  • Eighteen (95 percent) were caused by a quinine tablet; one was caused by quinine in tonic water of a vodka/tonic drink.
  • Eighteen (95 percent) had evidence of quinine-dependent antiplatelet (or antineutrophil) antibodies.
  • All had acute kidney injury; 17 of 18 required dialysis; three developed end-stage renal disease; and two underwent kidney transplantation.
  • One died from complications of central venous catheter insertion. Of the remaining 18, eight died a median of nine years following diagnosis, five from cardiovascular disease or stroke that may have been related to the TMA.

Quinine is implicated in causing neutropenia (decrease of white blood cells in the immune system). When it occurs, neutropenia is often accompanied by other organ-system findings that may include thrombocytopenia (low platelet count), microangiopathic hemolytic anemia (the most common being DITMA referenced above), rash, acute kidney injury, fever/chills, and others.  The mechanism in many cases appears to be an acute, immune-mediated reaction to the drug.  Evidence to support these associations was evaluated in a 2016 systematic review of published reports, which found neutropenia in 24 (17 percent) of the 142 patients who had an immune-mediated quinine reaction.

Quinine + Sugar is A Perfect Storm

The problem that many physicians find is that quinine tablets may be borrowed from a friend or family member, or the exposure may occur from a beverage like Schwepps (eg, tonic water, bitter lemon).  And tonic water is loaded with sugar or high fructose corn syrup.   This high carbohydrate content, in combination with quinine is a perfect storm for kidney failure.

Schwepps Tonic Water

In the United States, the only available quinine tablet (Qualaquin) requires a prescription, and the only approved indication is for malaria treatment. This restricted availability of quinine tablets may explain why we have not seen a patient with quinine-induced TMA since 2009 [3]. There are also several over-the-counter tablets and herbal remedies for leg cramps available in the United States that may contain quinine, and quinine tablets can be purchased over-the-counter in Canada and other countries. Quinine may also be added to drugs of abuse such as cocaine.

Just One Dose of Quinine Can Be A Trigger

Importantly, TMA from quinine can be triggered either by a single ingestion (eg, one quinine tablet, one quinine-containing beverage) occurring many months or years after a previous exposure, up to 10 years in our experience. This is because the drug-dependent antibodies can persist for many years, but they cannot react with target cells in the absence of the drug. Acute immune-mediated tissue damage can occur within hours of re-exposure. It is not known whether the homeopathic doses of quinine present in remedies for leg cramps in the United States can trigger TMA, but in principle, immune-mediated DITMA can occur with extremely low levels of re-exposure.

Chronic kidney disease is common following quinine-induced TMA [3].

So, please, don’t follow bad advice about using quinine from people who have no concept of what these drugs can really do.

Please see my Coronavirus Page for information and recommendations on prevention and treatment.

References:

  1. Al-Nouri ZL, Reese JA, Terrell DR, et al. Drug-induced thrombotic microangiopathy: a systematic review of published reports. Blood 2015; 125:616.
  2. Reese JA, Bougie DW, Curtis BR, et al. Drug-induced thrombotic microangiopathy: Experience of the Oklahoma Registry and the Blood Center of Wisconsin. Am J Hematol 2015; 90:406.
  3. Page EE, Little DJ, Vesely SK, George JN. Quinine-Induced Thrombotic Microangiopathy: A Report of 19 Patients. Am J Kidney Dis 2017; 70:686.

What Can You & I Do To Prevent Viral Infections?

The following general measures are recommended to reduce transmission of infection:

  • Diligent hand washing, particularly after touching surfaces in public. Use of hand sanitizer that contains at least 60 percent alcohol is a reasonable alternative if the hands are not visibly dirty.
  • Respiratory hygiene (for example – covering the cough or sneeze).
  • Avoiding touching the face (in particular eyes, nose, and mouth).
  • Avoiding crowds (particularly in poorly ventilated spaces) if possible and avoiding close contact with ill individuals.
  • Cleaning and disinfecting objects and surfaces that are frequently touched. The CDC has issued guidance on disinfection in the home setting; a list of EPA-registered products can be found here.

Dr. Nally talks about each of these in his latest YouTube video below:

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“Keep the carbs low and the fat high.”

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For more information about any of the things mention above and in other videos, you can find the links below:

#JustKeepEsterifying #LeadFolloworGetOutOrMyWay.
#Ketogenic #Keto #KetogenicLifestyle #Carnivore #DrAdamNally #DocMuscles #DocMusclesLive #DocTalk #DocsWhoLift #LiftRunShoot #DocMusclesLife YouTube.com/drnally/.
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Should You Be Wearing A Face Mask To Prevent Coronavirus?

Should You Wear A Mask?

Source: @jperla (Twitter)

Should you and your family members be wearing a mask to slow the spread of coronavirus (COVID-19)?   This is a hotly debated topic and one that may not soon be agreed upon by everyone.  Over the last few weeks, a number of voices are saying “Yes.”

I am, also, one of those proponents of dawning a mask.  And, that’s no April Fool’s joke.

Dr. Nally in the office

The head of the Chinese Center for Disease Control and Prevention, Dr. George Gao, is also one who has been very vocal about using a mask.  “The big mistake in the US and Europe, in my opinion, is that people aren’t wearing masks. This virus is transmitted by droplets and close contact. Droplets play a very important role — you’ve got to wear a mask, because when you speak, there are always droplets coming out of your mouth.” Gao said in his interview in Science.

Because coronavirus is a droplet based infection, and not an aerosolized infection, wearing a face mask can more effectively prevent the droplets that carry the virus from escaping and infecting other people.  However, I don’t recommend using the medical grade masks. Save those for those that must have face to face contact with COVID-19 positive patients and persons with direct exposures.  For the lay person in the grocery store who must get essentials and may have brief contact, I recommend using a specially designed homemade mask.

Masks Actually Help

Recent research shows that some people infected with the COVID-19 virus who don’t have any acute symptoms can still spread the virus.  This means that the person in line with you to buy toilet paper, might just be infected and not know it.  Research also shows that even wearing a proper homemade mask can reduce silent transmissions of bacteria and viruses in these situations.

In fact, this has been the recent topic of discussion at the CDC, and the use of homemade masks were reviewed in great detail in yesterday’s Washington Post article here.

Homemade Masks Make a Dent in Viral Spread

Wearing a homemade mask has become the norm in Czechia.  The government of Czechia mandated the wearing of masks on March 18th, 2020.   Jeremy Howard of #Masks4all has collected and summarized 40 published scientific research papers that show wearing masks actually does work.  One 2011 meta-analysis shows, when coupled with strict hand washing, masks have the greatest impact on reducing virus spread.

Mr. Howard states that this action of the Czechian government has flattened the curve of the pandemic in his country.  You can read the article in Prague Morning.

What Kind of Mask Should I Wear?

So, what kind of mask should I wear?  The what, where and how of homemade masks that I am recommending to my patients can by found in my youtube video below.

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The source for the pattern that I am wearing and recommend using can be found here:  http://tianascloset.com/index.php/2020/02/06/face-mask-against-the-coronavirus-epidemic/

How can you avoid contaminating the mask and yourself?

The main objection of the mask naysayers is that the mask itself becomes contaminated.  Carelessly using the mask and not cleaning it can become of source of viral transmission.  The benefit of a homemade mask is that it is cheap, washable and re-usable.

Here are some steps to follow to ensure that you and your family remain healthy while using a homemade mask:

  • Wash with soap and water, or sanitize your hands well, before making any mask.
  • Wash and sanitize your hands before putting the mask on.
  • When removing the mask, do not touch the front of the mask with your hands; take it off by the ties or elastics. Then wash your hands.
  • Immediately after use, do not put the mask on any surface. Put the mask into the washing machine or a sink of hot soapy water and clean well.  Some data shows that you can also bake fabric masks. However, the temperature must reach 180F° (82C°) for 20 minutes to cleans it.
  • If you have made a disposable mask out of paper towels or coffee filters, throw it out into a plastic-lined waste bin with a lid.
  • After discarding, or sanitizing the mask, sanitize your hands again.
  • Any time you are wearing a mask, do not touch the mask, your face or rub your eyes.

Wearing any mask over the next 3-4 weeks will help protect you from passing the virus on to others at greater risk.  It may also decrease your risk of someone else passing the virus on to you.

This will help reduce the number of infected people from overwhelming our healthcare system, first responders, and healthcare workers.

Check out my dedicated coronavirus page that is regularly updated for further information about this virus at https://www.docmuscles.com/coronavirus/.

Should We Be Wearing A Mask to Protect Ourselves From COVID-19 Exposure?

There are a number of confusion and mixed messages in the community about wearing or using protective masks while out and about in the community while getting your essentials.  Dr. Nally talks about the pro’s and con’s of wearing masks, the type of mask he recommends using currently and where you can find a pattern to make one.  Check out his latest YouTube video below:

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Keto Misconceptions – Have You Heard Any Of These?

The keto misconceptions abound and this week is no different.  A popular health website recently published an article warning people about the “dangers” of a ketogenic diet, including the keto-flu, kidney disease, gut bacteria, nutritional deficiency, bone health and low blood sugar.  They claimed these dangers are “evidence based.”  Dr. Nally very quickly debunks these dangers, explains how the naysayers “spin” the science and talks about why these misconceptions are false.

Check it out:

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I Can’t Do Keto Because . . .

I hear this all the time.  “I can’t eat keto because. . . ”

What is your excuse?

I am amazed at how tightly people cling to these excuses. They are just that excuses.  In the 16 years I’ve been training people how to use these diets to treat disease, I have yet to find one that is not just an excuse that covers up the real reason . . .

Check out my video on this:

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Food Storage, Emergency Preparedness & The Ketogenic Lifestyle

In the light of the recent coronavirus toilet paper shortage, the proxy war with Ukraine, the attack on domestic energy by our Administration, the possibility of nuclear war, and the crash of the Silicon Valley Bank, I started thinking about how I could effectively follow a ketogenic or carnivore lifestyle in an emergency.

What it would take to maintain a ketogenic diet through a natural disaster or crisis?  Those of you that know me, know that my wife and I have, for the last 30 years of our marriage, tried to keep a year’s supply of essentials in storage for emergencies, a life crisis or catastrophes.

Some of you may call me a “prepper.”  And, I’m very happy to wear that hat. (But, I will remember that when you show up on my doorstep and you’re not prepared.)

My wife and I try to follow the principle of “prepare every needful thing,” so that, if adversity, illness, or calamity arise, we can appropriately care for ourselves, our neighbors and lend support to those around us.  That preparation has been life-saving and budget saving on a number of occasions through the course of our marriage.

Principles of Food Storage

Before I dive into this too far, lets define the basic concept of emergency preparedness when it comes to food storage. There are really three main components you need to think about:

  1. Food Supply
    1. Start with a three-month supply that is easy to rotate through your daily meals
    2. Expand as you can to a year’s supply of food
    3. Rotate through these foods using some of them regularly in your meal preparation and replacing them as you go along.
  2. Water Supply
    1. Storage
    2. Filtration
  3. Financial Reserves
    1. Essential (A whole topic for a different blog post and we won’t delve into it here)

The recommendation is to store foods that are part of your normal diet in a three-month supply.  As you develop a longer-term storage, focus on other staples that can last for years.   Most information that surrounds food storage revolves around food and other items that preserve well over time.  The challenge is that these usually come in the form of complex carbohydrates. These longer-term supplies are easiest to store in the form of wheat, rice, pasta, oats, beans and potatoes.

“But, wait a minute,” you say.  “Aren’t you a keto/carnivore doctor? You’re suddenly going to eat carbs in an emergency?”

The answer is “no.”  I am dramatically healthier and I feel much better when eating a ketogenic/carnivore lifestyle.  In an emergency or time of crisis, suddenly changing my diet will make me and my family feel and perform even worse throughout the day.  That’s not what someone needs when they are trying to live through a crisis.

Those that know me, know that I have a very strong family history of diabetes, heart disease, hypertension, kidney failure, gout, thyroid disease, and cerebral vascular disease (strokes) that sit upon the branches of my family tree.  Suddenly “carbing-up” and switching my diet isn’t a wise thing for me or my family.

So, how does one build a long-term food supply and rotation without resorting to carbs? 

Currently, the majority of my ketogenic/carnivore food is stored in my freezers and refrigerator. (Yes, I have three freezers).   Part of my emergency plan for food if I needed to stay in place involves keep those freezers running.  It, also, involves the ability to cook that food.

Over time, I have acquired a generator and stored fuel that I can get running immediately allowing me to keep the freezers cold.  I’ve built two sets of solar arrays, separate from my home’s electrical grid, that allow me to harness power from the sun and recharge battery packs to operate other appliances as necessary.  I even have the ability to power appliances with my vehicles/camping trailer.

Stored propane or other gas to run stoves or grills is essential.  These need to be rotated and canisters need to be checked for leaks and safety.

One of the greatest lessons I learned was that near-by local ranchers and farmers are happy to sell me half a cow if I’d just ask.  This literally provides me meat for months at a time.  However, you’ll need an entire freezer to store all this meat.  And, a new freezer, plus half a cow, can be a large expense up front.

Locally, here in Arizona, I use Arizona Grass Raised Beef Company to provide me frozen grass fed meats.  I know the owners personally, and they produce some of the best steaks in the country.

Hunting is another way of bringing home large quantities of meat.  If you are a hunter, bringing home a deer or elk also provides months of good quality grass-fed food for you and the family.  I am a bow hunter.  Learning to hunt and staying prepared for hunting season keeps me in shape, and it is also a way to provide meat on the table if the grocery stores are empty.

The challenge with this strategy alone, is that it relies upon our staying in and around our home in time of an emergency.  If, for some reason, we had to leave our home, it wouldn’t be practical to haul freezers and refrigerators around.  So, doing some re-thinking for those types of emergencies is also essential.

Over the years, the members of my family have followed low-carb, ketogenic or strict carnivorous diets depending on their needs and goals.  I may be doing a stricter keto/carnivore diet, where my children are following lower carbohydrate diets.  The information I list below are there to help you come up with ideas that may fit your personal needs and dietary requirements.

How much food do I actually need?

Start simply.  Begin with a week’s supply of food. I am always amazed at how many people have less than two days of food in their homes.

The amount of food you would need to purchase to feed your family for a day multiplied by seven is the amount of food you need for a one-week supply.  Once you have a week’s supply, you can gradually expand that to a month, then three months.  Eventually, that will expand to a year’s supply.

Where do I store all this food & water?

Dry & canned foods need to be stored in cool dry places.  Short term perishables will need refrigeration or freezing.

If you have water from a good, pre-treated source, then no purification will be needed.  Otherwise, water will need to be purified before you can use it.  Store water in sturdy, leak proof, breakage resistant containers.  Keep water away from heat sources and direct sunlight.  Water storage and purification is a whole topic in and of itself.  You can find simple straight forward information about water storage and purification here.

Start with Canned Foods

We don’t use a large amount of canned foods in our current day-to-day diet, but we do have a fairly large selection of canned foods in our storage.  These range from canned proteins like beef, chicken, seafood, freshwater fish and Vienna sausages to Spam and canned bacon (Yes, I love a good slice of fried spam. Seriously. My wife will vehemently disagree.)  You may want to learn to do some home canning and stock preparation.  It’s pretty invigorating when you know how to store and preserve your own food.

Lower carbohydrate canned vegetables can also be used.  Artichoke hearts, asparagus, spinach, mushrooms, green chilies, and even canned tomatoes could be used to stretch protein and fat stores.  These can also be used to add variety to meals.

Canned cream and coconut milk can also be an important piece of your food storage.  These can be found at any grocery store. Though, they may be a little more expensive, we’ve found that picking up a can or two when we are at the grocery store allows one to build a supply over time that doesn’t break the budget.

Dry Goods

When people think about dry goods, they often think of only jerky, trail mix and nuts.  These are nice to have, but they don’t store for long periods of time and they shouldn’t be the basis of a food storage plan.  Carbs in trail mix and nuts add up really fast. And the oils in the nuts expire quickly.  If you ever eaten a old rancid nut, you’ll know why this can be a problem.   My brilliant wife actually keeps all of our stores of nuts in the freezer.  They actually preserve longer that way.

Dry goods that we use and cycle through our storage almost daily (other than nuts and dried meats) include things like protein powders like ISO-100 and KetoChow meal replacement proteins (these will last for two years or more).  KetoChow changed our ability to store meals.  Chris Bair, and his wife Miriam, created the KetoChow product and this has been a wonderful and needed addition to our food storage.  Simply adding water, avocado oil, butter or cream to the KetoChow powder creates and instant, and very healthy ketogenic meal.

Don’t forget salt, sea salt, pink salts (like Redmond Salt), pepper & peppercorns, other herbs & spices, and chocolate are other essential dry goods you will want to include on your list.

Powdered creams and fats are also an option that can be stored; however, you’ll want to look closely at how long these can be adequately stored.  These are also a little more expensive and do have a little more bulk in regards to meal preparation.  Also, be mindful that many “powdered fats” use maltodextrin or dextrose to powder them.  These “covert sugars” are not keto friendly so beware.

There are some great keto bars made by Quest Nutrition and KetoBrick. These have a 1-2 year shelf life, and would work well for shorter-term food storage. Remember that these dry goods may have different storage lives, so adequately planning storage rotation is something you will need to keep your eye on.

Storing Your Own Seeds & Simple Garden Growbeds

If you are able to stay around your home in an emergency, the ability to plant your own lettuce or kale can be pretty handy.   Having the seeds to do this is an essential part of a good food storage program.  You don’t have to have a large space or garden to do it either.   There are many companies offering seeds for storage; however, be aware that heirloom seeds are necessary to be regenerative and not genetically modified.

Alfalfa sprouts will grow in 5-7 days.  Having something fresh in an emergency can be a game changer for morale.

Simple aquaponics garden – 2015

I’ve been experimenting with aquaponics systems for years.  We were able to live off of our own lettuce, kale and strawberries for a full year using three 4’x4’ grow beds and a 50-gallon water-trough with our own koi.   If you haven’t looked into aquaponics, this is a great way to provide the leafy greens you need and a great source of live fish.

I’ve since expanded this to a 14,000 gallon pond with 20 + koi.

Designer Dry Goods

Freeze dried eggs, meat and vegetables are available, and we use these for backpacking and short term camping.  However, they are expensive.  These work well in a three-day emergency kit or pack as well, but you’ll need to see if they fit into your budget.

Fats

Fats are usually what we worry about most when following a ketogenic diet.  Many people following a ketogenic lifestyle use butter, A LOT of butter.  However, butter doesn’t last indefinitely at room temperature.   Canned butter does exist, but it is really expensive.

There are other options.  MCT oil, coconut oil, ghee, lard, avocado oil and olive oil are used in my home regularly and are on a regular rotation with the butter in the refrigerator.  Avocado oil is higher in omega-6 fatty acids and can be inflammatory for some people, and it is also more fragile, meaning it doesn’t store as long as other oils.  Olive oil also has a shorter preservation life.   We have some stored coconut oil that has been good for 8-9 years.  Others have shared with me that they have MCT oil that stored for 7-8 years without problem.  Your nose will know.

Medications & Supplements

I could go on and on about medications, but that could be a whole article in itself.  So, I just want to remind you that planning on having medications, supplements and electrolytes (sodium, potassium, magnesium and zinc) are essential to surviving physically and mentally stressful calamities.

Other Considerations

Emergencies may necessitate periods of fasting.  Getting used to fasting and feeling comfortable that you could go 24-48 hours without food is very confidence building.  Planned fasting periodically will help with stress, recovery and healing in many cases.  Don’t be afraid to experiment with 24-72 hour fasts so that you know how your body responds during these types of experiences.

Though, as I’ve told my patients in the past, frequent fasting longer that 24 hours has a suppressive effect on testosterone (lowering it by 50%) and suppressing thyroid function that can be permanent. This is how your body protects itself in a real famine.

Remember, preparation is the key to success.  An hour of planning and preparation can save you ten hours of doing.  And if you are living your plan, a crisis won’t set you back.  Failing to plan is just planning to fail.

There has been very little dialogue in the keto/carnivore community about following this lifestyle in a crisis or natural disaster. My hope, here, is to begin that dialogue, get you thinking about the possibilities and then planning and doing what actually matters.

My Feet Are Tingling (Polyneuropathy and Hyperinsulinemia)

One of the common complaints that I see in my office is chronic numbness and tingling of the hands, fingers, feet & toes.  There are multiple causes of these symptoms, but by far the most common cause in my practice is polyneuropathy caused by insulin resistance (hyperinsulinemia).

Before we dive into this particular type of nephropathy, it is important that we define a few terms. The terms “polyneuropathy,” “peripheral neuropathy,” and “neuropathy” are frequently used interchangeably, and although they can be easily confused, they are distinctly different.

Definitions

  • Polyneuropathy is a specific term that refers to a generalized sensation of tingling or numbness that uniformly affects many nerves at the peripheral sites (ends of the extremities like hands, fingers, lower legs, feet and toes).
  • Peripheral neuropathy is a less precise term.  It is frequently used synonymously with polyneuropathy, but can also refer to any disorder of the peripheral nervous system.  However, this term includes  pain or numbness that radiates from nerve roots like “sciatica” of the leg and “brachial plexopathy” causing symptoms in one hand and/or arm (mononeuropathies).
  • Neuropathy, which again is frequently used interchangeably with peripheral neuropathy and/or polyneuropathy, can refer even more generally to disorders of the central (brain & spinal cord) and peripheral nervous system (nerves of the arms and legs) and their connections to sensory organs, such as the eye and ear, and to other organs of the body, muscles, blood vessels, and glands.

Why spend time defining all this?  Because, neuropathy can be very confusing, even for the experienced physician.  And, because I am seeing, more and more frequently, cases of insulin resistance induced polyneuropathy. The polyneuropathies must be distinguished from other diseases of the peripheral nervous system, including the mononeuropathies and mononeuropathy multiplex (multifocal neuropathy), and from disorders of the central nervous system.

  • Mononeuropathy refers to focused involvement of a single nerve, usually due to a localized trauma, compression, or nerve entrapment. Carpal tunnel syndrome is a common example of a mononeuropathy.  Sciatica due to a lumbar disc bulge is another form of mononeuropathy.
  • Mononeuropathy multiplex refers to simultaneous involvement of non-adjoining sections of nerve trunks. Used loosely, this term can refer to multiple compressive mononeuropathies. However, in its more specific meaning, it identifies trauma, infection, auto-immunity or damage to multiple nerves outside the central nervous system.  This is often due to lack of blood supply due to disease based inflammation of blood vessels supplying blood to these peripheral nerves.
  • Diseases of the central nervous system such as a brain tumor, stroke, or spinal cord lesion occasionally present with symptoms that are difficult to distinguish from polyneuropathy.

Insulin Resistance and Neuropathy

Insulin resistance, or better defined hyperinsulinemia, begins 10-15 years before a person is considered “pre-diabetic” and 20 years before the onset of type II diabetes. This “over production of insulin” in response to carbohydrates, starches and sugars causes a subtle and progressive form of inflammation.  This excessive production of insulin will damage the smallest arteries (capillaries) carrying oxygen and fuel to the back of the eyes, the kidneys and the peripheral nerves of the hands, fingers, lower legs, feet and toes.

Often not identified until a person is actually diabetic, the mechanism underlying the development of this type of neuropathy is extremely complex.  It is driven by years of subtle and progressive damage to the blood vessels, and inability of the nerves to use essential B vitamins damaging the genetics of the cell.  This leads to inflammatory, metabolic, and ischemic effects causing the nerves to function poorly over time.

What Causes Polyneuropathy?

 

The mechanism of polyneuropathy damage in the patient with hyperinsulinemia three-fold.

    1. The presence of high insulin stimulates increased fat storage.  As fat cells begin to get filled, they begin to over-produce a number of inflammatory hormones including TNF-alpha, IL-6, IL-1, Adiponectin, Leptin and Resistin. These inflammatory hormones turn on auto-immunities and abnormal immune system function.
    2. At the same time, the high insulin levels suppress appropriate testosterone and estrogen production causing microscopic damage to the lining of the smallest arteries and capillaries of the body (found predominantly at the extremities, kidneys and back of the eyes).
    3. 65% of patients with insulin resistance (hyperinsulinemia) have a malformation of one or both genes that encode the MTHFR enzyme (methylenetetrahydrofolate reductase) that uses folic acid (Vitamin B9) inside the cells of the body.  Because this is genetic and is a process occurring inside the cell, it has been difficult to identify until recent advances in measuring genetic SNPs.  Single nucleotide polymorphisms, frequently called SNPs (pronounced “snips”), are the most common type of genetic variation among people.

Interestingly, MTHFR deficiencies are also strongly correlated with depression, anxiety and other forms of mental illness. MTHFR is a SNP that can easily be tested through a simple blood sample at your local lab or doctors office. And, nerve testing can be done through a simple sudomotor function test in the doctors office.  In fact, Medicare encourages this testing yearly through part of the Annual Wellness Exam.

The polyneuropathy that I see most commonly in my office can and will improve. In fact, polyneuropathy will completely resolve if you catch it early enough.  We treat it in two ways.

What Can I Do To Treat Polyneuropathy?

First, restrict carbohydrate intake.  A ketogenic or carnivore diet is the perfect approach to this.  If you don’t have a copy of my book, The KetoCure, please pick one up on my website or on Amazon.  if you are just looking to fine tune the nuts and bolts of your diet, you can get a copy of my diet recommendations here.  Carbohydrate restriction corrects the high insulin levels.  Within a few weeks, people start seeing improvement in inflammation, testosterone, estrogen and leptin resistance.

Second, get your MTHFR SNPs tested.  This can be ordered through a simple blood test through your doctor or nearby lab.  If you have one or both MTHFR mutations, treatment is simple. A mutation of the MTHFR SNP directly causes polyneuropathy, anxiety, depression and in severe cases, schizophrenia. It can also cause significant problems with homocysteine metabolism and is a significant risk factor in heart disease.

Third, use the correct form of folic acid.  If you have the MTHFR mutation, regular folic acid is ineffective.  Instead of using regular folic acid (Vitamin B9), 1000-5000mcg per day of L-methyl folate (premethylated Vitamin B9) solves the problem.  Within 90 days, over 50% of my patients feel dramatic improvement in their neuropathy and many have compete resolution of the numbness and tingling.  I see this so frequently, that a few years ago I had my multivitamins designed to include L-methyl folate instead of regular folic acid.  You can find them here at Ketoliving. com.  If you want more information on why I designed my own vitamin supplement a few years ago, you can read about them here.

So, restrict your carbs, use the appropriate form of folic acid for you, and pass the bacon!

If you are interested in getting more help on this issue, schedule an appointment with me in my office. Or, consider one of my membership options if seeing me in my office isn’t convenient for you.  Sign up today!

References:

  • Yigit, Serbulent et al. “Association of MTHFR gene C677T mutation with diabetic peripheral neuropathy and diabetic retinopathy.” Molecular vision 19 1626-30. 25 Jul. 2013.
  • Wan, Lin et al. “Methylenetetrahydrofolate reductase and psychiatric diseases.” Translational psychiatry 8,1 242. 5 Nov. 2018, doi:10.1038/s41398-018-0276-6.
  • Shelton, Richard C et al. “Assessing Effects of l-Methylfolate in Depression Management: Results of a Real-World Patient Experience Trial.” The primary care companion for CNS disorders 15,4 (2013): PCC.13m01520. doi:10.4088/PCC.13m01520.
  • Hughes R. Investigation of peripheral neuropathy. BMJ 2010; 341:c6100.
  • Morrison B, Chaudhry V. Medication, toxic, and vitamin-related neuropathies. Continuum (Minneap Minn) 2012; 18:139.
  • Pareyson D, Piscosquito G, Moroni I, et al. Peripheral neuropathy in mitochondrial disorders. Lancet Neurol 2013; 12:1011.
  • Rutkove SB, et al., Overview of Polyneuropathy. UpToDate.com. Online Jan 2020, https://www.uptodate.com/contents/overview-of-polyneuropathy?search=neuropathy&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1

Estrogen Excess

I’m not sure what it is about this time of year . . . maybe the post-holiday weight gain, or the fear of pulling out a swimming suit in a few months.  But I have had a number of people, both men and women, in the office with excessive estrogen levels.

Estrogen excess and estrogen dominance are two hormone abnormalities I find commonly in both men and women in my practice.  These two issues are frequently complicating factors that make feeling good and weight loss difficult.  They are, also, often the main reasons people don’t see dramatic improvement in a person’s symptoms of energy, fatigue and mental clarity when they’ve already changed their diet and lifestyle.

IMPORTANT NOTE BEFORE WE GO ON: This information applies to patient who already have normal thyroid function and corrected insulin resistance.  If your thyroid is off or if you are still significantly insulin resistant, it will affect estrogen and other male and female hormones, so follow a ketogenic diet and get your thyroid balanced FIRST!

What is Estrogen Dominance?

I’ve addressed estrogen dominance in a previous blog post.  You can find it here. Estrogen dominance is a condition where there is an abnormal estrogen/progesterone ratio.  The estrogen/progesterone ratio MUST be balanced.  Normal estrogen levels with low progesterone (this can commonly occur with the use of a synthetic progestin (HRT) in female patients) is a common scenario that  falls into the estrogen dominance pattern.

What is Estrogen Excess?

Estrogen excess is a situation where progesterone levels may be normal but estrogen is elevated (an abnormal ratio can also be present in this condition).

The symptoms of excess estrogen can be:

  • Depression
  • Fatigue
  • Poor Concentration
  • Irregular menstrual bleeding in women
  • Breast tenderness
  • Fibrocystic Breast Changes
  • PMS
  • Decreased Libido
  • Uterine Fibroids
  • Endometriosis
  • Water Retention/Bloating
  • Fat Gain around the hips and thighs
  • Breast and Uterine Cancers

Why is too much estrogen a problem?

Estrogen naturally stimulates cells to grow and multiply. Natural estrogens are essential.  But, too much estrogen increases thyroid binding globulin, inactivating the thyroid function causing abdominal weight gain. Too much estrogen changes the body’s ability to remodel bone.

Estrogen is essential to stabilize the inner lining of arteries, however, excessive estrogen doubles one’s risk for stroke and increases the risk of coronary atherosclerosis and heart attack. Too much estrogen increases the size of the prostate, increases risk of prostate cancer and increases the risk of rheumatoid arthritis.

Estrogen excess is an elusive condition.  Measuring estrogen levels is not frequently done, and most doctors were never trained to look at the three separate forms of estrogen in men and women.  I had no idea this was an issue until about five years ago.

What causes excess estrogen?

The eleven most common causes of estrogen excess are:

  1. Commercially raised meat & dairy products from animals dosed with high levels of bovine growth hormone.
  2. Insecticide or pesticide residues on fruits and vegetables.
  3. Tap water with petroleum derivatives
  4. Paraben containing shampoo, lotion, soap, toothpaste, & cosmetics. Paraben is absorbed through the skin. There is a 100% absorption that misses first pass liver detoxification
  5. Pthalates – soft plastic containing material or plastic wrapped food heated in the microwave releasing xenostrogens into the food.
  6. Artificial sweeteners including MSG (propyl-gallate and 4-hexylresorcinol are the two most common).  Canned foods that have been lined with a plastic coating called BPA (bisphenol-A). Most processed foods have some additive that you will want to avoid.
  7. Foods containing soy or soy protein isolate contain unnaturally high amounts of plant estrogens (phytoestrogens).
  8. Red dye #3 (erythrosine and phenosulfothiasize) found in food
  9. Dryer Sheets containing high levels of xenoestrogens.  Chronic skin exposure leads to permeation of the xenoestrogens into the skin.
  10. Birth control pills (conventional synthetic estrogen containing hormone replacement)
  11. Tampons and sanitary napkins containing dioxins, chlorine, fragrance, wax, surfactant, and rayon play a role in significant xenoestrogen absorption.

Other diseases can cause estrogen ratio’s to be elevated.  These include liver disease, zinc deficiency, excessive alcohol intake, obesity, calcium deficiency, insulin resistance, diabetes, and excessive testosterone therapy.

How does a person naturally decrease excess estrogen if it is present?

  • Decrease xenoestrogen exposures:
      1. Reduce use of plastics where possible
      2. Do not microwave food in plastic containers
      3. Avoid the use of plastic wrap to cover or microwave the food
      4. Use glass or ceramic containers where possible
      5. Do not leave plastic water containers, especially drinking water, in the sun
      6. If a plastic water container was heated up significantly (like a water bottle being left in the car in the Arizona sun), throw it away.
      7. Don’t refill plastic water bottles
      8. Avoid freezing water in plastic bottles for drinking later
      9. Avoid butylated hydroxyanisole (BHA) as a food preservative
      10. Limit skin care products containing xenoestrogenic substances
  • Use cruciferous vegetables like broccoli that contain indole-3carbiol (I3c).
  • Increase Omega-3 fat intake
  • Exercise
  • Use rosemary and turmeric (berberine)
  • Reduce weight
  • Use Vitamin D
  • Stop drinking alcohol
  • Stop smoking

These hormones, like estrogens, progesterone and testosterone can be easily checked by your doctor through blood or salivary testing.  The key is a balance in the ratio between progesterone and estrogens.

The two estrogens that are essential to test are:

  • Estrone (E1)
  • Estradiol (E2)

These can be ordered through your doctor.  Estrogens can take 2-3 months to balance out.  It may take some time after making changes to see your levels normalize. Don’t fret.

What if natural methods don’t fix the problem?

When natural methods of lowering estrogen levels are ineffective, then your doctor will recommend treatment.  A number of other effective medicinal approaches including:

  • Zinc Citrate
  • Quercetin
  • Grapeseed extract
  • DIM
  • Berberine
  • Resveratrol
  • Chrysin
  • Progesterone/Pregnenolone
  • Myomin
  • Vitamin K
  • Anastrazole

In my clinical experience, a ketogenic lifestyle is foundational to balancing these hormones consistently and naturally.  Carbohydrate restriction by itself corrects many of the diseases of civilization.  I addressed this in my book The Keto Cure.  For many, there are few more steps necessary to living a long, happy and healthy life.

In my office, in addition to the ketogenic or carnivorous diet, I add on Berberine Plus 500mg twice daily with meals.  This has been shown to notably improve the insulin resistance, lower estrogen and improve progesterone naturally.

Years ago, this was hard to find, so I created my own supplement line and these can be found at Ketoliving.com.  Go to Ketoliving. com and order your bottle of Berberine Plus right now, before it is too late.  I designed my own pharmaceutical grade berberine so that my patients could make sure they are getting real berberine in the doses I want you to have.

The treatment of this issue isn’t difficult.  There is much more to come on this subject.  I will address each of the progesterone, testosterone, DHEA and sex hormone binding globulin abnormalities in my future blogs.  So, keep an eye on my web page DocMuscles.com/blog/.

So, get your hormones checked by someone who understand this problem and knows how to treat it.  Second, limit estrogen stimulating sources in your diet and environment. Third, control you diet and order a bottle of Berberine Plus right away.

Just Keep Esterifying

I’ve had many of my patients and followers on social media ask about my continued use of the hashtag #JustKeepEsterifying.  Well, here is the answer.  Check out the short 4 minute video below to get the answer:

YouTube player
“Keep the carbs low and the fat high.”
#DrAdamNally #DocMuscles #DocMusclesLive #DocTalk #DocsWhoLift #LiftRunShoot #DocMusclesLife  #PicoSure #Icon #SculpSure #TempSure
Help me have time to make more great videos:  https://www.patreon.com/docmuscles
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Book: The KetoCure  https://amzn.to/2PmkPoO
Twitter: https://www.twitter.com/DocMuscles/ or @DocMuscles
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Hair Loss and the Ketogenic Diet

Hair loss is an issue that I am asked about quite frequently. With any dietary change, transient hair loss can occur in the first 2-3 months but will usually resolve. Continued hair loss is a problem with any diet and if you are experiencing hair loss it could be due to one of five issues:
1. Medication
2. Lack of protein or caloric restriction
3. Hypothyroidism
4. Iron Deficiency
5. Hormone imbalance (especially estrogen dominance or poly-cystic ovarian syndrome)

Dr. Nally discusses these and how to address them in his most recent YouTube video. Check it out below.

 

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Help Dr. Nally have time to make more great videos:  https://www.patreon.com/docmuscles
YouTube Channel: http://youtube.com/DrNally/
Book: The KetoCure  https://amzn.to/2PmkPoO
Twitter: https://www.twitter.com/DocMuscles/ or @DocMuscles
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Direct Primary Care Programs:  https://www.docmuscles.com/direct-primary-care/
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    KetoLiving:  http://ketoliving.com/

Is Your Celebration of Independence Day a Deception?

Our celebration of Independence Day is a deception.

Laying beneath the fireworks, barbecue and fun is the hard to swallow truth . . . It’s all a sham.

Are you and I really independent anymore?  No. Not anymore.

243 years ago, the British oppression was a threat. It was singular, visible and involuntary.

Now, the threat we face daily is an entirely new form of tyranny, infinitely more complex.

The scary thing is that oppression is now:

  1. Fractionated
  2. Invisible
  3. Voluntary

Fractionality of Our Millennial Tyranny

Slavery has changed.  The oppressor previously owned the slave individually. However, with time we learned that when there are multiple owners, the burden of ownership is lessened.  Joint ownership became the norm. Now we have joint ownership of our condos, boats, and jets.  The burden of slave ownership was the risk of revolt and revolution.

If ownership of debt can be spread among the masses, the individual risk is mitigated.

Our fractional oppression is spread throughout the legion, and the tyranny is masked as a principle of the great “free market.”

BIG FOOD sells cancer, diabetes, heart disease and fatigue through the FOMO of fake food.

BIG MEDIA sprinkles us with malaise, despair, anxiety and post-traumatic stress with lurid half-truths, click-bait shock value, and salty emotion all with the intent to sell us more advertisement.

BIG PHARMA peddles side-effects, addiction and false hope convincing the feeble mind, created by BIG FOOD, that a pill is necessary to prevent us from experiencing the pain, emotion and struggle of life – that same life that BIG MEDIA keeps ever present in the palms of our hands.  In bed with BIG GOVERNMENT, their evangelism recommends medicating instead the more difficult learning from struggle and failure.

BIG GOVERNMENT covers us with red tape to stop the financial bleeding and hemorrhaging of the tumor’s growth it stimulates, through greed and invasion of individual inalienable right.

BIG MONEY circles us on wings of dread and fear singing a song of doom, all the while sampling emotional cookies and Danishes of immediate gratification, while slipping the “plastic card with a security chip” shackles over the wrists of the enslaved.

BIG EDUCATION preys upon our children with glib platitudes, group-think, and participation trophies.  It teaches the weakened minds to prize test-taking, rote memorization, and fact regurgitation above problem-solving, creative thinking, and learning from failure.  They prepare our children to work as drones on the factory floor of cyberspace instead of art and enterprise.

And, that’s just the beginning.

Look no further than your bank statement to see how the oppression is itemized.  Each line item takes it’s pound of flesh round the clock each month.

Invisibility of Oppression

“None are more hopelessly enslaved than those who falsely believe that they are free.” -Goethe-

200 years ago, the shackles were visible.

Today the shackles are disguised. Independence is a deception.

We are smarter than an outright shackle.  So, they were re-tooled, re-imagined, re-formed, and hidden like landmines in cyberspace:

  • 0% APR
  • Matching contributions
  • Free Miles
  • Free Samples
  • No Money Down
  • 84 Month Installments

These are just grease on the slaughterhouse chute.

It Can’t Be Oppression if You & I Now Volunteer?

Forced slavery is no longer acceptable in our “free society.”  The dark genius of modern oppression is the creation of cultural norms, rituals and addiction that invite us to PUT ON OUR OWN CHAINS.

Modern slavery is now VOLUNTARY.

“No one put a gun to your head or forced you to buy our product or service,” is the mantra of the oppressor while billions are spent on engineering conditions that make the shackles look like icing on your cyberspace cake.

But there is an escape . . .

Massive in scale, fractional, and nearly invisible, there is still a choice.

CHOICE IS THE ESCAPE

So, this evening, as the cardboard tubes of fireworks lay discarded in the park grass, and the toy flags lay rolled up on top of the fridge, awaiting their return to the attic for storage, let your Independence Day celebration be much deeper. Choose.

Let your Independence Day stir the same indignation for oppression that our fore-fathers felt.

Cultivate within yourself the desire to fight and win a second Independence Day.

You will need every ounce of resolve and strength you can muster.

Today, there are no chains, hangman’s noose or firing squads, there is but chemistry, habit, choice and instinct.   The Oppressor will attempt to use it against you. You can still see it if you look. You can still choose.

Have the courage to flip them the bird of indignation as they present you the “standard American prepackaged life.”

Reject What Isn’t Real

Reject the drama and depletion of paycheck-to-paycheck living . . . instead, create wealth. Save a few dollars each day.

Reject the cardboard food in the grocery store and eat real food: bloody, fresh and wild. It will re-energize you.

Reject the FOMO of the dutiful consumer and become a CREATOR. Create the world you dream of by small and simple daily choices.

Reject the fake new, fake government, fake food, fake medicine, fake success, fake friendships, and fake happiness that encircles us.  Create a life that is REAL.  You’ll know it’s real because you can feel it, beyond the pain of trial and error and failure, REAL encompasses heart, mind, body and soul at the same time.

Take off the blinders so that you may see the leeches and parasites sticking to you.  Rip them from your body and warm yourself as you burn them in the fire.

Only then will you escape the clutches of the modern tyrant.

Only then will you be free.

[Adapted from Bryan Ward and his “Third Way Man” series]

 

 

Adam S. Nally, D.O. (aka DocMuscles)

 

 

 

 

 

If you enjoy my content, please checkout the links below:

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