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Obesity, Anxiety and The Divided Mind

In past posts, we’ve discussed how to effectively and efficiently lose weight and open the gates of the fat cells.  We’ve talked about the keys to the back doors of the fat cells that must be opened to create effective lipolysis (releasing of fat from the fat cells) and weight reduction.

I want to focus, today, on another key found in the brain.  The brain neuropeptides play a huge role in metabolic balance of the body and have direct relationships to anxiety, stress and post-traumatic stress disorder (PTSD).  In the last few years, research into the hormones of the brain (neuropeptides) and body demonstrates that the “autonomic nervous system” plays a very significant roll in losing weight.

The autonomic nervous system is the part of the nervous system responsible for “fight or flight responses.”  If a bear rises up in front of you while you are strolling in the woods, and begins to chase you, the autonomic nervous system kicks in to speed up the heart rate, shunt blood to the muscles and turn down the processing of food in the gut while you run from or fight the bear.  This autonomic nervous system is also the system that links emotions (like happiness, sadness, stress, anger, depression) between the conscious and subconscious mind and creates the attachments of these emotions to specific memories.

The Divided Mind and Disease

A disconnect or poor communication between our conscious mind and subconscious mind wreaks havoc in the balance between memory, emotion, cognitive function, endocrine glands and immune system.  One example of this is the onset of panic attacks for no reason.  Another example is chronic fatigue and many symptoms found in autoimmune diseases.  This same autonomic nervous system, when malfunctioning, plays a significant roll in our ability to lose weight.   The subconscious mind triggers the autonomic nervous system without the conscious mind’s involvement.

Thanks to the work of John E Sarno, MD, and Candace B. Pert, PhD, the link between our subconscious mind and the autonomic nervous system is much more clear.  This opens the door to our understanding how the subconscious mind can have a profound effect on obesity.

This field of research requires one to understand a concept about the psyche initially outlined by Dr. Sigmund Freud and his colleague Dr. Josef Breuer (the Father of Psychoanalysis) in the 1880’s.  Misconceptions regarding the basic drives of the human psyche aside, they identified through their clinical evaluations that the human psyche is made up of three parts, the subconscious (the id), conscious (the ego), and the super-conscious (the superego).  They identified an essential concept that the subconscious is a more primitive and childish component of the mind functioning much more instinctually,  and that the ego and super-ego house the intelligent, ethical, and moral consciousness.  They also identified that a split or division can arise between these two partitions causing physiological conflict to arise (i.e. – onset of a panic attack for no reason).

Autonomic Nervous System is made up of two parts: Sympathetic and Parasympathetic divisions. These divisions act like a gas pedal or brake for various organs and functions.

It is important to understand, as Freud pointed out, that you cannot divide the mind into neat compartments suggested by these three divisions.  The mind acts as a single unit.  However, understanding the “id” and it’s instinctual functions being tied to the autonomic nervous system is central to understanding how subconscious can derail weight loss.

Freud and Breuer identified in their Studies on Hysteria that a simple subconscious idea or instinct could be strong enough to exert powerful physical responses without  sufficient intensity to become conscious thought recognized by the individual. This means that a physiologic motor response in the body could be stimulated without being conscious of the reason for the stimulus.  They, along with Jean-Martin Caharcot, Alfred Alder, Franz Alexander and Allan Walters, witnessed this multiple times clinically.  They came to the conclusions that pain and other nervous functions could originate and could actually be created by the mind.

The Mind has the Power to Create Disease

Dr. Pert’s research over the last 40 years has been able to clearly identify a communication system between the brain, the endocrine system and the immune system.  Dr. Pert’s research identified that memory and/or subconscious idea is directly tied to emotion through the brain hormones called neuropeptides that, when triggered, reproduce stored memory, emotion physical autonomic responses (like changes in heart rate, dry mouth, dilation or constriction of the pupils, sweating of the palms or trunk, chest pressure, etc) and even auto-immunity.

Memory, Emotion & Storage Controlled by Neuropeptides

Neuropeptides also participate in memory sorting, storage and recall .   In his recent book, Beyond Order, the clinical psychologist and professor Dr. Jordon Peterson explains that the miracle of memory is not that we remember, the miracle of memory is that we forget and that we only remember what is necessary.  The miracle of memory is that we only remember those things that are important and teach us meaning.  Because we can forget, we don’t drag the horrible details of the past along with us.  Our memories allow us to get free of the past.  All you need is three sleepless nights in which you cannot dispense with the past and you would understand that life would be a literal hell if we cannot dispense with the day, the memory and the emotions of each day. We must renew ourselves in this cyclical unconsciousness we call sleep and resetting of the memory.   It is during this time that memory, emotion and neurohormones are tied together.

Our memories are tied to emotions through neurochemical synapses created in the brain by the neuropeptides.  Forgetting and remembering are very complex and sophisticated cognitive processes.  Our subconscious reduces the memory, emotion and experience to it’s significance.  The significance is then recorded as memory with it’s associated emotion, then our brain lets go of the details.
If you think about it, we boil our lives down to the “jest” of the story and then we remember only the significance of that story with attached emotion.  This process saves us from being crushed by days, years and decades of the gory details of day to day experience.

Anxiety Provoking Memories are Experiences that Still Need Unpacking

If memories from 18 months or older are still bothering you, if they produce negative emotions, that is a sign that that memory has not been correctly or completely unpacked by the complex processes of the brain. It is essential that the brain unpack wisdom from the past that learning can occur and it can be applied to the future.  This process occurs so that you don’t do the same stupid thing over and over again.  Or, it is there so that you can repeat things that worked well.  That is the purpose of memory.  Not recollection, our memory is the extraction of wisdom for the lesson of life from vast experience.
If you have a memory that is still hurting you, making you anxious, causing, fear, guilt or shame, you have not undertaken the complex process of analyzing that memory, pulling out from it the moral, and dispensing with the details.   This is why writing down these specific memories is so very important.
You must write the bad memory out.  You must write out all of the details you remember and the emotions of that experience.  It allows the mind to do the complex processing of identifying wisdom and social moral barriers of uncertainty, anxiety, threat, fear and panic that are bothering you.  This is what therapy does when talking about and discussing the past.
If journaling and writing out the memory is not effective in resolving the anxiety or if you are unable to identify the memory causing the anxiety, you may want to consider hypnotherapy and directed meditation.  This has been very effective with many of my patients having anxiety relating to childhood experiences improperly tied to strong emotions.
W. Dennis Parker does a wonderful job in his book, Spiritual Mind Management, elucidating how our subconscious mind inappropriately ties emotion to simple experiences and memory, and how these can cause anxiety. For those with resistant anxiety to journaling and therapy, hypnotherapy has been very effective.

Other Hormones associated with Anxiety and Obesity

Over the last two decades, I’ve found that two other hormones play a huge role in handling stress, anxiety, brain repair and play a very large role in sleep.  Both of these hormones are derived directly from cholesterol.  Low fat, vegan and vegetarian diets lead to low cholesterol availability and I commonly see low levels of the following hormones in both men and women.
The first of these is Pregnenolone.  Pregnenolone is the precursor sex hormone derived from cholesterol in the blood stream.  When serum pregnenolone level is lower than 50 mg/dL anxiety, insomnia, hair loss, poor recovery from exercise and difficulty with concentration become chronic.  The cognitive cloudiness that occurs with low pregnenolone levels make the unpacking of traumatic experiences and the sorting of wisdom from day to day experience difficult due to poor sleep.  I have been amazed that just the simple supplementation of pregnenolone nightly reverses anxiety, improves sleep, stops chronic migraine headaches, increases cognition and frequently allows people to “feel normal again.”
The second hormone is Progesterone.  Interestingly progesterone is derived directly from pregnenolone.  If large amounts of mental or physical stress are occurring, pregnenolone is used to make DHEA, Cortisol and Cortisone.  Little is left to make progesterone which is necessary for further hair growth, sleep, focus, memory, the healing effects from stress and trauma in the brain.  Progesterone often acts like a “brain steroid” healing both brain and spinal cord from stress and trauma.
Any evaluation for anxiety, insomnia, PTSD or stress must include screening both of these hormones, because without them, I’ve seen patients suffer for years with failure of the standard approaches.
One other molecule that has hormonal activities in the arena of anxiety and weight loss is that of methylated folic acid.  Folic acid is converted into L-Methyl Folate within every cell of the body.  This is accomplished by and enzyme called methytetrahydrofolate reductase (MTHFR).  About 60-65% of the patients I see in my office with insulin resistance, impaired fasting glucose or diabetes have a deficiency in one or both of the MTHFR genes leading to poor conversion of folic acid to the methylated form.   This is detrimental as methylated folic acid is essential in using Vitamin B12 within every cell of the body.
Lack of effective MTHFR enzymes leads to neuropathy, anxiety, depression, obesity and in severe cases elevated homocysteine levels and schizophrenias.  You can learn more about that by reading my blog article on Folic Acid here and a youtube video on it here.

The Search for Individual Meaning is The Deepest of Human Instincts

The human psyche is stabilized by the search for and the experience of individual meaning within life. The subconscious instinct for understanding our individual meaning is the deepest thing about us as humans.  It is innate and is part of our survival instinct.  What if the instinct understanding or experiencing meaning meaning goes wrong?  Pathologizing or lying about that individual meaning causes one to become “lost.”  Understanding that the instinct for meaning can be distorted or lied about is the most frightening thing upon this planet.  If you pathologize that individual meaning with deceit, you will be in the hands of things you do not want to contemplate.  If you have no theory of good and evil, if you’ve never been exposed to malevolence and someone malevolent touches you, you’re done for.
Being true to one’s self or truthful with your understanding of individual meaning helps to properly orient a person in the world, and find middle ground between complete chaos on one side of life and rigid totalitarianism on the other.   Finding and living in that middle ground requires one to rely upon individual instincts founded in truth.   If you want to live in harmony with yourself and your instincts, and live in a middle ground between a life of chaos and one of totalitarianism, don’t feed yourself or surround yourself with indigestible lies, half-truths and deceit.  You certainly shouldn’t try to warp the world around you by intentionally sharing deceitful meaning.

Anxiety Arises from Naivete

The sheltered soul or naive person is raised with the mindset that “all people are innately good.”  The thought or concept that people are “fundamentally good” is a complete misconception.  Being “good” is very difficult.  It is by no means the default position of the natural man and the subconscious mind. Entropy, catastrophe, tragedy, malevolence and death is the default position of human nature and the subconscious mind.  Good struggles up against this continually.
The people who are most prone to post-traumatic stress disorder (PTSD) are usually naïve people who have been sheltered from malevolence – sheltered from those who are truly spiteful, hostile, vicious, malicious, malignant, vindictive, pernicious, vengeful, hateful, rancorous, and evil-minded.  This is a well known clinical fact and can be found throughout the psychology literature.  There is nothing about this fact that is questionable.  The naïve world view is that you believe the world is fundamentally good – you believe that good behavior is rewarded with good in return – and you don’t really believe that there is any such thing as evil, and you encounter someone who is malevolent (and often you encounter this in yourself).  That sheltering is general throughout our society.  Death no longer occurs at home, it usually occurs in a hospital.  People live in cities and are rarely exposed to the death of animals and the cycle of life seen 100 years ago in farm and ranch life.
Often in those with PTSD, people who have been sheltered from these things, do something, or are required to do something, so morally reprehensible that it damages them psycho-physiologically. Until their psychological framework of good and evil changes, it is very difficult to recover.   These people have no framework in which to conceptualize violent death, evil or the reprehensible act.  They are unable to balance the conscious and subconscious memories and emotions attached to reprehensible emotional guilt, and it destroys them.  This is very common among soldiers.  It’s not always what they saw, it’s what they did or what they were a part of.
Telling and teaching people that humans are innately good (which has been part of our school system teaching for decades) and that evil doesn’t really exist makes them ripe picking for the malevolent and there is nothing about that which is positive.  It leaves tremendous anxiety and psycho-physiological scars in the wake.  This sheltered outlook is cowardice masquerading as virtue.  We see it more and more in our society.
This is why a teenage boy or girl in a traditional Christian or Jewish school is wiser and happier than the 50 year old professor of philosophy in a secular college.  The person who innately understand that good and evil exist within the world have a much easier time coping with and handling stress and trauma that will cross all of our paths.

What does anxiety, chronic stress and PTSD have to do with obesity and weight gain?

Signals in our environment from very stressful life experiences on a daily basis, chronic underlying stress, chronic anxiety, radiation exposure, infectious organisms (such as bacteria and viruses), xenobiotic chemicals, allergens, intestinal bacterial metabolites and food-derived bioactive substances (including phytochemicals), all have influence on messages received by our genes that then influences their expression. Gene expression can turn on and off neuropeptides.  This can effect the autonomic nervous system turning the metabolism up or down.  The expression of our genes in turn controls our health and disease outcomes.  This is one of the reasons COVID-19 seems to effect some people more dramatically than others.

The hormonal counterbalance of blood sugar is regulated, in part, by the autonomic nervous system.  Changes to this system increase or decrease cortisol & glucose production, thereby affecting production of insulin and other weight mediating hormones.  Changes in neuropeptides from stress or anxiety can act just like eating a meal.

As blood sugar falls, the autonomic nervous system responds to balance the blood sugar.  If this system is dysfunctional or under chronic stress, cortisol and adrenalin will cause higher blood sugars due to the stress response and can trigger increased hunger inappropriately.

This is why chronic stress, poor sleep, or even getting cut off while driving in traffic is the equivalent of eating a donut to your hormone responses.  If you’re not exercising, theses hormones will cause weight gain without any change in your diet, and even with caloric restriction.

How Do You Combat Chronic Stress or Anxiety?

  1. Exercise – Because these hormones are released subconsciously, the only way to help control them is regular and consistent physical activity or exercise.  Exercise, 20-40 minutes 3-6 days per week, is often the only way my patients have been able to combat the weight gain from chronic stress, anxiety and PTSD.
  2. Adequate Protein – Recent studies have demonstrated that hitting protein thresholds in men ( > 150 grams per day) and women ( > 90 grams per day) increased growth hormone and decrease insulin, helping to offset the negative effect of stress and anxiety.  This is a key component of a ketogenic or carnivorous lifestyle.
  3. Sleep -Lack of sleep has been implicated in difficulty with weight loss and weight gain.  Lack of sleep places the body into a state of chronic stress. This elevates cortisol, lowers testosterone, increases insulin (there’s that insulin problem, again) and increases the other inflammatory hormones. This perfect storm of stress, driven by lack of restful sleep, plays a big role in fat loss. My average patient needs at a minimum of 6-7 hours of restful sleep to maintain and lose weight. This is where untreated sleep disorders like sleep apnea play a big role. If you have sleep apnea, get it treated. What else can you do to help improve sleep?
    • Remove the computer, iPad and cell phones from the room.
    • Lower the room temperature. Men sleep better around 68-70 degrees F and women sleep better when the temperature is <70 degrees F.
    • Close the blinds or shades to add or darken the room.
    • Don’t study or watch TV in the same room you sleep in. Your body gets used to doing certain activities in certain rooms of the house. The bedroom should be reserved for sleep.
    • Go to bed at the same time
    • Get up at the same time. 
  4. Journaling – Daily journaling of experiences is one of the most powerful keys to helping the brain sort powerful emotions related to anxiety and memory.
  5. Meditation – I’ve created a 23 minute relaxation/meditation audio file that you can listen to for 30 days to help change your subconscious script on weight loss.  You can find it here.
  6. Some people need additional help through hypnosis.  Talk to your doctor about a certified hypnotherapist near you.  If you are a patient of Dr. Nally’s, he offers these services. Set an appointment today.
  7. Additional Resources – If this information is helpful, you may find additional interest in the following books:
  • “Loving What Is ” by Byron Katie
  • “Overcoming Worry and Fear” by Paul A Hauck
  • “The Joys of Living” by Orison Swett Marden

What to Expect

It may take your body and body’s biorhythm 3-4 weeks to adjust to changes you make around exercise, journaling, protein & sleep habits. Be patient with yourself.

Knowing that these challenges plague people on and off throughout the year, and, seeing people get hung up on these issues, I’ve created the Ketogenic Lifestyle 101 Course.  This program gets you jump-started into ketosis and gives you the tools to overcome the individual hurtles you will experience on your health journey.

 

High Fat? High Protein? Low Protein? What is really ketogenic?

The daily question that I get asked by my patients, and from those around the internet, relates to burning one’s own fat. “Don’t you have to limit the calories and limit fat you eat to burn your own body fat?”

It seems everyone has a differing opinion on this question and a few of them have two opinions (you know who you are).  Very few of these opinions are grounded in the actual science of weight loss.

I hear coaches, trainers and even a number physicians argue, name call and rant about the need to cut calories to lose fat.  Yet, most of my patients “cut their calories” 200-1000 per day without successful fat reduction.  They may increase their exercise by 400-600 calories per day and still no weight loss.  This is the same crazy ineffective instruction we’ve been given for the last 50 years.

To be honest, there is a percentage of those in the fitness and modeling worlds upon which this dogma is effective and that is because of normal insulin levels and significant exercise. However, for the other 85% of the world who work over 40-80 hours a week, have children and families, serve in our churches and occasionally have a social life, myself included, it doesn’t work.  If we were all paid to exercise 2 hours a day and take “butt selfies” on Instagram, it might be easier.

Yes, you will probably lose 20 lbs. with calorie restriction, but your testosterone will drop by up to 50%, sex hormone binding globulin will double, and over time your basal metabolic rate will slow due to dramatic and often permeant reduction in thyroid function.  This makes it nearly impossible to lose more than that 20 lbs, and then you will regain the weight once calorie levels return to normal within 18-24 months.  (No one ever talks about that little problem, do they?)

For those of you that want to see success in weight loss, let’s outline a few essential principles that the trainers, keto-coaches and social media talking heads aren’t mentioning.

First, insulin has to be kept at a baseline.  The reason that 85% of people don’t, won’t and can’t see effective weight loss beyond 20-30 lbs long term (greater than 2 years) with calorie restriction is that 85% of the population has some degree of insulin resistance.  It’s not a disease, it’s a syndrome associated with the effect of the standard American diet.  I wrote a whole book about it called The Keto Cure.  We know that insulin and catecholamines increase the rate by which fat is stored.

Second, glucacon is a counter active hormone to keep your blood sugar from bottoming out.  The presence of glucagon stimulates fat burning.  Intermittent fasting and ketogenic dietary intake allow blood sugar to drop below 70 mg/dL (3.9 mmol/L) causing glucagon release and stimulate increased release of free fatty acids from the fat cells.

Third, two hormones, epinephrine and norepinephrine, are produced when blood sugar drops below 67 mg/dL (3.7 mmol/L).  Exercise lowers blood sugar to this level and stimulates additional burning of fat by engaging the release of glucagon and epinephrine and norepinephrine.  Exercise, also, has three other myokine hormonal effects making weight loss more successful when the diet is correctly balanced.

The fourth principle that is essential to understand relates to growth hormone.  Growth hormone stimulates and preserves muscle tissue, has a suppressive effect on insulin. Growth hormone increases with exercise, sleep, intermittent fasting and when protein intake is at least greater than 90 grams per day in women and around 1 gram of protein per body weight in men.  This is notably higher than previous calculations on protein that I have written about in the past.  Recent research, also found here, here and here, demonstrates that increased protein above 90-100 grams per day enhances muscle growth and stabilization and further suppresses insulin production beyond what we previously understood.
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Contrary to what the media has been saying about protein sources, not all protein is absorbed in the same way.  When it comes to absorption in the human gut and use by the human metabolism, protein sources differ in their effectiveness:

    • Egg protein utilization – 50%
    • Meat protein utilization – 40%
    • Cheese protein utilization 35-40%
    • Whey protein utilization – 18%
    • Vegetable protein utilization – 14%

Lastly, release of fat from the fat cell is mediated by natriuretic peptides and cGMP through the release of catecholamines, prostaglandins and nicotinic acid.  Interestingly, the major positive regulators of human lipolysis are catecholamines and natriuretic peptides (NPs). Fatty acid release from fat cells triples when catecholamines and natriuretic peptides are released.  Catecholamines are produced by exercise, stimulants and stress, and natriuretic peptides are stimulated by short change fatty acids (ketones).

For the science geeks in who follow my blog, I’ve included the following picture that summarizes the effects of these hormones on the fat cell.  The figure below shows the major pathways by which insulin, thyroid, catecholamines, testosterone and sympathomimetics effect fatty acid release from adipose tissue.

Primary signaling pathways in human lipolysis. Black and red lines indicate pro-lipolytic and anti-lipolytic signaling events, respectively. Arrows indicate stimulation and/or translocation and blunt lines indicate inhibition. Stimulation of lipolysis is dependent on PKA- or PKG-mediated phosphorylation of HSL and PLIN1. PKG is activated by cGMP, which is increased in response to activation of the GC-coupled NPR-A. Similarly, stimulation of the Gs-protein-coupled β1/2-ARs activates AC, which generates cAMP and activates PKA. Conversely, activation of Gi-protein-coupled α2-ARs inhibits AC and thereby reduces cAMP-dependent signaling to lipolysis. Stimulation of the insulin signaling pathway through the IR increases the activity of PDE3B, which converts cAMP to 5′-AMP, thus decreasing PKA activity and suppressing lipolysis. PKG activity is reduced by PDE5-mediated conversion of cGMP to 5′-GMP, although the upstream signals regulating this process are currently unknown. The dashed line indicates a putative Akt-independent insulin pathway acting selectively on PLIN1. α2-ARs, α2-adrenergic receptors; AC, adenylyl cyclase; TG, triglyceride; ATGL, adipose TG lipase; β1/2-ARs, β1- and β2-adrenergic receptors; CGI-58, comparative gene identification-58; DG, diacylglycerol; FFA, free fatty acid; GC, guanylyl cyclase; HSL, hormone-sensitive lipase; IR, insulin receptor; IRS1/2, IR substrates 1 and 2; MG, monoacylglycerol; MGL, monoglyceride lipase; NPR-A, type-A natriuretic peptide receptor; PDE3B, phosphodiesterase 3B; PDK, phosphoinositide-dependent kinase; PI3K, phosphatidylinositol 3-kinase; PKA, protein kinase A; PKB/Akt, protein kinase B; PLIN1, perilipin 1. (Journal of Molecular Endocrinology 52, 3; 10.1530/JME-13-0277)

The take home message from this information is this, effective long term weight loss cannot be achieved by calorie restriction.  Effective weight loss (specifically fat loss and muscle gain) is most effectively achieved when carbohydrates are restricted, protein is optimized, and proper exercise adequately triggers the release of fat burning hormones.

Click HERE and get a copy of my ketogenic diet.

Get a copy of my diet and 13 learning modules with coaching and online assistance by becoming a member of Dr. Nally’s KetoClan.

I’d like to know, what combination has been most effective for you?

Have a great day!

Adam (eat your bacon) Nally, DO

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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Estrogen Dominance – The Dead Man’s Curve on the Road to Ketogenic Happiness

Over the last 18 years of my practice, I’ve seen tremendous success in helping people improve their health when low-carbohydrate dietary changes are anchored as the foundation of treatment.  However, there is still a group of people that struggle with seeing success.  Even with the most effective ketogenic dietary control, there are those that see abnormal weight gain, inability to lose weight, poor libido, fatigue, foggy thinking, mood swings, persisting depression, headaches, bloating, breast tenderness, fibro-cystic breast changes, hair loss, and hot flashes.  They may not experience all these symptoms, however, many are often present.  If you have been following a ketogenic lifestyle and are still experiencing any of these symptoms, you are probably suffering from estrogen dominance.

Estrogen dominance is a condition that elusively effects thousands of women (and men) and your doctor probably doesn’t even know about it.  I didn’t know about it.  I, like all of my physician colleagues, were trained in school that the symptoms above are related to fluctuations of estrogen as a woman ages (or dropping of testosterone as a man ages).  We were, and still are, taught that they are fixed by giving more powerful doses of estrogen or testosterone.

Over the years of my clinical experience, giving more estrogen frequently didn’t work.  And, giving men more testosterone didn’t work either.  What I found very effective, for many, was changing the diet.  And, for about 85% of people, the symptoms list above resolved.  However, the cause of the symptoms above in that last 15% of patients I see was still elusive.  Examinations, blood tests, and even psychological evaluations never revealed the answer.  Giving synthetic estrogen, progestin or testosterone when the blood work showed abnormality partially alleviated some of the symptoms for a few months, but then the patients would end up back in my office with the symptoms having returned.

I’ve found a number of problems following the “standard” medical approach to using synthetic sex hormones.

The first problem is that estrogen, progesterone and testosterone are heavily bound to proteins in the blood. It is only the free component of the three forms of estrogen and progesterone in the body and the free testosterone that acts upon the delicate cells located throughout the body.  Blood testing does not account for the levels of free estrogen forms and progesterone effectively.  These can only be tested through salivary testing.

The second obstacle is that the synthetic forms of progesterone (progestin), cannot effectively enter the brain. When synthetic forms are used, a person only gets half the benefits of progesterone found in the human body.  This is why so many women have depression, anxiety and foggy brain feelings when using the synthetic versions.

The third challenge is that pharmaceutical companies cannot patent a drug that is identical to your human hormones.  The chemical structure of the synthetic estrogen, progestin or testosterone must be slightly different. Hormones effectively work on certain aspects of various cells throughout the body, however, progesterone and progestin (the synthetic version found in medroxyProgesterone) DO NOT have the same hormonal effect on each cell.  Natural progesterone is broken down by the stomach when ingested. That’s why progestin was invented, however, it doesn’t act the same in the body and only does half the job.

The fourth dilema is that much of our food in the standard American Diet stimulates increased estrogen production or inhibits clearance of estrogen excess through the gut and digestive tract.  This happens in men and women.  We can get excess estrogen from animals treated with hormones in meats, milk and dairy products.  Hydrogenated oils in processed foods change the way estrogen and progesterone are handled in the body.  These unstable fats increase the effects of estrogen on the body and amplify the risk for cancers.  Excessive omega-6 fatty acids in the diet magnify estrogen receptor response to estrogen.

Estrogen metabolism in the liver and removal in the gut are dependent on vitamins B & E, magnesium  and idol-3-carbinol (IC3).  Diets without adequate IC3 from glucobrassicin found in leafy green and crucirferous vegetables allow re-uptake of estrogen in the gut leading to high estrogen levels and estrogen dominance.  This is where gut health is even more important, and where I see failure in the “carnivore” approach to a ketogenic lifestyle.

The fifth problem is that the more estrogen I give a person, the more estrogen receptors are unregulated to the surfaces of the cells in the body.  When that happens, more estrogen is required.  Excess estrogen can actually cause many of the same symptoms present in progesterone deficiency including:

  • Irregular or heavy bleeding
  • Breast tenderness
  • Depression
  • Fatigue
  • Poor concentration
  • Fibrocystic breast changes
  • Decreased libido
  • Fibroid growth on the uterus
  • Endometriosis
  • Water retention and bloating
  • Fat gain around hips and thighs
  • Bone mineral loss (osteoporosis)
  • Hair loss
  • Skin thinning
  • Disturbed sleep
  • Breast and uterine cancer

More estrogen isn’t needed. Balancing natural progesterone with the current estrogen the body is already making is the solution in most cases.  This can only be effectively assessed through a salivary hormone test.

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.

The treatment to this issue isn’t difficult.  For that reason, much more is to come on this subject.  I will address each of the points above in future blogs. However, the first step is get your hormones checked by someone who understand this problem.  And, then knows how to interpret it and treat it.

Fixing Habit-Loop Cycle of Weight Gain #DocMuscles #KetonianKing

Fixing the Habit-Loop of Obesity

(Fixing the habit-loop cycle of obesity is the third article in a series on habits relating to obesity and weight gain: Willpower & Self-Discipline and Habit-Loop Cycle of Obesity)

“I want you to increase your fat to 70-80% of your total food intake . . .” I stated, before I was cut off by a loud gasp, followed by a chortle.  The 300 lbs male sitting on the exam table in front of me looked at me with a very skeptical smirk.

“You want me to eat fat to lose weight?!” he said after catching his breath.  “You’re the first doctor who’s openly blown smoke up my a** . . . ,” chided the rotund 42 year old male shaking his index finger at me as we discussed weight loss treatments.

“Although that was standard medical treatment of the Royal Humane Society for drowning victims in 1774, . . . .” I responded.  “No. I’m actually trying to help you lose weight by shifting the hormone signal in your body with food.” I replied as I recalled that the medical thought of the time was that a tobacco enema dried out the insides , warmed the body and increased the heart rate of the drowning patient.  I informed my patient that the use of tobacco smoke enemas fell out of favor around  1811 when its use for drowning, typhoid, headache and stomach cramping was found to actually be cardio-toxic and ineffective.

Tobacco Smoke Enema DocMuscles #KetonianKing

“So, . . . blowing smoke into your rectum won’t help you lose weight, nor will it help you maintain ketosis.  In fact, it might actually kill you.”  I added with a smile.

Eating fat is, however, one of the keys to hormone manipulation used to fix the Habit-Loop Cycle of Obesity.  So, how do we fix or alter the habit-loop of obesity discussed in the last two blog posts?

Four Part Habit-Loop of Obesity

The habit-cycle cycle of obesity consists of four parts:

Habit-Loop of Obesity DocMuscles #KetonianKing Adam Nally @DocMuscles
Habit-loops can be identified by a routine that satisfies a craving
  1. Trigger
  2. Response
  3. Reward
  4. Hormone Response

In my last blog post, we discussed how the trigger and the response are driven by or focused on a craving that may or may not be consciously perceived.  We also learned that breaking this habit-loop cycle takes willpower we talked about in my first article, and willpower can fatigue.  It has a daily shelf-life.

Fixing habits and creating new powerful habits requires identifying the components of your individual habits.  That means, first, identify the routine that occurs in a habit you want to change.  We want to identify a habit that drives you to eat carbohydrates when you really rather wouldn’t.  You’ve tried to stop, but you struggle and when fatigued, ignore your previous thoughts and imbibe on cookies.

Identify the Routine

Weight gain, fat entering and staying in the fat cells, is stimulated by the production of insulin.  Many of us who are insulin resistant, produce 2-15 times the normal amount of insulin when we indulge in carbohydrates.  That’s the master hormone part of weight gain. There are 29 other hormones that play a role in weight gain, however, turning them all on or off is driven by the routine you follow in your daily habits.

In my journey to understand my weight challenges, I found a pattern that was causing my middle to grow.  After a long day at work and returning home to have dinner with the family, I would often sit down to work on my charts, billing codes, labs and dictation from that day.  (Thanks to the wonders of the Affordable Care Act, this immense amount of work added 3-5 hours of “home work” to my already 10 hour day at the office, only to be completed late in the evenings.)

Even though I enjoyed a late low-carb dinner with my family when I got home, I’d find myself getting hungry 2-3 hours later.  While working on charts and trying to “push through” the pile of work in front of me, I’d start getting “hungry” around 10 pm.  I would find myself rummaging through the fridge and freezer looking for something to eat.  The problem was that I would find myself eating things that I normally wouldn’t, and I’d even find myself finishing off the quart of ice-cream in the back of the freezer left over from a birthday.  No matter how much I tried to avoid this behavior, I would frequently cave to cravings between 10 pm and 1 am.  (Yes, I heard the gasps from the ketogenic blogosphere, but I’m human, too.)  I knew that if I, an obesity specialist, was having these challenges, you probably are, too.

So, how does one change this kind of behavior?  The solution is found in the habit-loop cycle.

I started drawing out the loop.  Trigger –> Go to kitchen fridge/freezer —> Reward.

What is the Trigger?

I had to ask myself some questions.  What is the Trigger or Cue?

Was it actually hunger? Boredom? Stress? Fatigue?

What is the Reward?

What was the reward? Was it actually food? Change of scenery?  A temporary distraction? Energy from the food?

So, I had to experiment with my reward to find out.  Rewards are powerful because they satisfy cravings.  However, you and I are often not aware or conscious of the craving that actually drives our behavior or routine.  As Charles Duhigg states, “Most cravings are hiding in plain site. . . They are obvious in retrospect, but incredibly hard to see when we are under their sway” (1).

To figure out which craving drives which reward, I had to run a few experiments on rewards.  I asked my wife to make extra fat bombs and some of her low-carb cheese cake to have in the fridge.

The next few evenings I recorded what happened.  When I felt the urge to get up and go eat, I ate a few fat bombs.  But that didn’t take away the craving.  I tried going out and walking around the back patio and petting the dogs for a bit.  I tried drinking something different instead of my routine water, Diet Dr. Pepper or exogenous ketones.  No matter what I did, some of the evenings I still found myself rummaging the back of the freezer for something sugary.

What Action Eliminated the Craving?

My point here was to see which of these activities took away the cravings.  I wrote down how I felt after each activity, as well as what happened after I’d cheat late at night with ice cream or chocolate.  Just the action of journaling how I felt, my thoughts, emotions or words that came to mind was the key.  After waiting for 15 minutes, I wrote down three words or phrases that came to mind.

I found myself journaling: “Sleepy,” “Anxious,” “Tired,” “Still Hungry”

I found that eating something I should be avoiding, like ice cream, chocolate, or sweets (Even in a low-carb home you can still find some of these things), caused me to feel short term euphoria, more relaxed and suddenly more tired.

The brain will record the scribbled words as recollections attached to emotions.  It is easier to see patterns if you will actually write it down with pen and paper.  The goal is to isolate what you are actually craving.  The words and emotions attached to those words will give you an idea about your cravings and the cue driving it.

Five Categories of Habitual Triggers

Scientists have shown that almost all habitual triggers fit into one of five categories:

  • Location
  • Time
  • Emotional State
  • Other People
  • Immediately Preceding Action

So, in trying to identify the cue driving me to the back of the freezer, I write down five things that happen the moment the urge hits (I’ve included some of my actual notes in bold from my experiment):

  • Where am I? – Sitting in front of my computer at my desk in my home office.
  • What time is it? – 11:32 pm
  • What is my emotional state? – Tired, anxious, and overwhelmed by the volume of work
  • Who else is around? – No, one.  Everyone else is in bed
  • What action preceded the urge? – I looked at the clock while finishing a patient’s chart

I repeated these notes and the repetitive pattern I identified was that it was late (between 10 pm – 1am) and I felt very tired and anxious.

Look at the Pattern

I realized that I wasn’t actually hungry.  I was exhausted, anxious & tired.  My willpower was gone for the day.  Eating the sugary food has always caused me to have a huge insulin surge and when that happened, I always got more sleepy.  When I ate the sugary food, I got more tired – tired enough that I would start falling asleep at my desk and end up going to bed.

I found that the craving was not for sugar at all, but for sleep.  The cue was not hunger or boredom, but for time of day coupled with the emotions of fatigue and stress.  The combination of time of day with these emotions were the trigger that would kick in a routine of rummaging through the pantry or freezer for something sweet, leading to an insulin response (hormone) driving me to bed.  This routine had has a negative aspect, it kicked me out of ketosis causing weight gain and further cravings for the next 72 hours.

Make a Plan

So, I wrote out my plan:  Go to bed at 10 pm.

I actually found that I could get up earlier, exercise and my ability to focus in the morning was much more crisp, alert and I was more effective at getting my charting and labs done in the morning and throughout the day.  I haven’t rummaged the pantry for the last month and I dropped the inch off my waist that had crept back over the last year.

Now, I realize that some habits are much more difficult to break.  I expect that, but hopefully this will be a starting point for you and I to begin looking at some of the hundreds of habit-loops that affect us for good or bad throughout the day.

Sometime New Habits are Required Before Bad Ones Can Be Broken

Your ability to break some of the stronger habits occurs when you set other good habits (2, 3). Habits like regular daily exercise increase the likely-hood of changing or breaking other bad habits.  People get better at regulating impulses and avoiding temptations when they strengthen willpower with habits like exercise. Research shows that simply establishing a habit of exercise actually increased peoples ability to drink less, smoke less, eat better, and learn more effectively (3).

The key to change is repetition of an activity, thought statement associated with physical or emotional feeling.  The repetitive action of exercise 3-6 times per week when willpower is strong increases the emotion of excitement, joy and happiness.  The combination of the repetitive action physically with the emotions experienced by the accomplishment actually strengthens willpower and allows for naturally identifying and changing the triggers and cravings of other habits (3, 4).  It takes at least 3-4 weeks for people to experience the effects of forming a new habit, so be patient with yourself.

Using Hormones and Your Journal to Bridge the Habit-Loop Cycle Faster

This is where journaling and fat come into the equation.  The ingestion of an increased amount of fat in the diet stimulates three hormones: GLP-1, Protein YY, and Oxyntomodulin.  These three hormones suppress hunger cravings by turning down the effects of hunger hormones in the hypothalamus.  When we use fat as a fuel and as a reward, we can change the cravings and the weight at the same time.

We now know that the use of hormone stimulus, emotion and repetition of an action allow for parallel learning about and expecting the reward in the basal ganglia.  The basal ganglia is the region of the brain that streamlines complex learning. It is the part of the brain that allows you back up a car, or riding a bike without deeply thinking about steering, pedaling and balancing.  Shifting the food type to predominantly fat and lowering the carbohydrates changes the hormones in the brain.  When we add journaling, by physically writing and recording our emotions, the basal ganglia learns about this reward system faster (5).

If you are ready to change your life, feel more energy, have improved concentration, better sleep and lose weight, I want to help.  I’ve created a 30 Day Keto Kickstart Challenge Program starting October 1st.   Click on Kickstart Challenge to join this exclusive group of Ketonians as we use the principles in these articles to successfully improve health, lose weight and feel more energy.

And, to answer your burning question, “No! Adding tobacco smoke rectally . . . doesn’t help the habit-loop cycle.”

References:

  1. Duhigg, Charles. The Power of Habit. Random House, New York. 2014. p. 290.
  2. Oaten M, Cheng K. Longitudinal Gains in Self-Regulation from Regular Physical Exercise. Journal of Health Psychology. 2006.; 11: p 717-733.
  3. Baumeister RP, Gailliot M, DeWall CN, Oaten M. Self-regulation and personality: How interventions increase regulatory success, and how depletion moderates the effects of traits on behavior. Journal of Personality. 2006; 74: p 1773–1801.
  4. Oaten M, Cheng K. “Improvements in Self-Control from Financial Monitoring,” Journal of Economic Psychology. 28 (2007): p 487-501.
  5. Brown J, et al., How the Basal Ganglia Use Parallel Excitatory and Inhibitory Learning Pathways to Selectively Respond to Unexpected Rewarding Cues. Journal of Neuroscience. 1999. Online OpenBU edition: https://open.bu.edu/bitstream/handle/2144/2228/99.011.pdf?sequence=1
Basal Ganglia Fat DocMuscles #KetonianKing Adam Nally

Habit-Loop Cycle of Weight Gain & Obesity

In my last blog post about willpower, I described habits being neural impulse channels in our brain stimulated by a cue following a path leading to the same outcome each and every time – without exerting much effort. Researchers call the formation of these impulse channels habit-loop cycles.  Much of the original obesity research of the 19th century was conducted by psychiatrists and psychologists recognizing that people had habitual eating patterns.  Because of this, gluttony became the perceived influence of obesity.  This underlying philosophy still permeates the obesity research, treatment and low-carb dietary world today.  Yet, over the last 15 years, I’ve found that the habit-loop cycle is tied to powerful hormone responses. These responses to very subtle and often unknown triggers or cues powerfully drive weight gain, obesity and struggles with willpower.   How does the habit-loop cycle effect you?  Before we can change these habit-loop cycles, we have to understand what they are, and how they were created.

It’s All About That Basal Ganglia

All About That Bass (All About That Basal Ganglia) DocMuscles #KetonianKing

Meghan Trainor tells us that “It’s all about that bass . .  .” However, it’s really all about that basal ganglia. Deep inside our brains, close to the brain stem, at the location where the brain meets the spinal cord, is a little “nub” of neurological tissue called the basal ganglia.  This little nubbin of tissues was identified by the really smart scientists at MIT in the 1990’s as the location where habits are formed and executed.  The brain is – to take a quote from my favorite ogre, Shrek – “like an onion – it has layers!”

The Brain Is Like an Onion

If you picture the outer layers of the brain tissue, those closest to the hair and scalp, you can create a mental image of where our most complex thoughts occur.  When you think up a new invention, create a new way to cook with bacon, laugh at a friend’s joke, or link two complex thoughts about how habits form, you are using these outer layers of the brain.

Brain is like and onion DocMuscles #KetonianKing Habit-Loop Cycle
Like an Onion – It Has Layers! (DreamWork’s Shrek, 2001)

However, our interest today is deeper . . . much, much deeper.  Deep within the center of the brain at the basal ganglia is the location where our automatic behavior originates.  Swallowing, breathing and the startle responses are housed in this little nubbin of brain tissue.  It is this area of the brain that learns to recall and record patterns of neurological thought and stimulating action. This part of the brain has the ability, like the water drops on the mound we discussed last week, to record neural pathways and tracks leading to reduced mental effort and habit.  The basal ganglia even has the ability to store habits while the rest of the brain is asleep.  It is in this location, the basal ganglia, where the habit-loop cycle occurs.

Habits Created by Chunking

The habit-loop cycle is the process where the brain converts a sequence of actions into an automatic routine.  The really smart guys at MIT call this “chunking,” and it is the root of habit formation.  There are hundreds of behavioral chunking activities that you and I rely upon every day.  Some of these are as simple as the process you use to squirt toothpaste on your toothbrush before brushing your teeth.  Others are more complex like getting dressed or making a lunch box for the kids.

The Habit-Loop Cycle in Your Car

A habit-loop cycle is performed by this little nubbin of tissue by millions of people every morning.  Take, for example, backing your car out of the garage.  When you first learned to do this, it required huge amounts of concentration – and for very good reason. You’re steering 3000-5000 lbs of steel between a 16 foot garage-door opening into oncoming traffic.  Basal Ganglia DocMuscles #KetonianKing Habit-Loop Cycle

Safely backing your car requires you to open the garage door, unlock the car, adjust the seat, insert the key into the ignition, turn it clockwise, move the rear-view mirror and the side mirrors to visualize any obstacles, put your foot on the brake, put the car into reverse, gently remove your foot from the brake, mentally estimate the distance between the garage and the street while keeping the wheels straight and looking over your shoulder, applying a slight pressure between the gas pedal and the brake, and in some cases, slapping your teenagers hand while they fiddle with the radio dial.

But think about it . . . did you actually put any thought into these actions this morning?  You and I probably did this once or twice today without any additional thought.  It happened because the basal ganglia took over and created a habit-loop out of it.  This routine, repeated hundreds of times, became a habit, requiring very little mental effort.

Your Basal Ganglia Makes You Fat

The habit-loop cycle occurs hundreds and maybe thousands of times throughout our day. It is the cycle that drives hundreds of our activities.  In fact, it is this same cycle, in combination with 30 different hormones, that drives our weight gain or weight loss.  Yes, I said it, your basal ganglia can make you fat.

Habits Make for a Smaller Brain

Your brain will try to turn any regular routine into a habit, because habits allow our minds to slow down and conserve effort, energy and fuel. The efficient brain allows us to stop thinking about basic behaviors like walking, breathing and eating. This effort-saving effect of the brain is a major advantage, otherwise our brains would be huge, requiring heads the size of watermelons, or even the size of a water tower, causing their own weather systems.  Your wife will thank you for an efficient brain that is smaller and requires less room. Can you imaging giving birth to a watermelon or a small Chevy?  (Did you notice the size of Shrek and the Donkey’s head? Just say’n . . . )

Habits Are The Root of Behavior

What all this leads to is this – habits, as much as memory and reason, are the root of our behavior.  We often don’t remember the experiences that create our habits. However, once they are created, they influence our action without our own realization. Charles Duhigg’s book, The Power of Habit is a great resource for further information on how habits drive our behavior.

The Habit-Loop of Obesity

So, how does all this affect obesity and weight gain?  Let’s, first, look at the habit-loop cycle.  Researcher, Larry Squire, documented the habit-loop through three decades of research.  He and others published numerous articles showing that habits have a cue or trigger that stimulates a routine.  The routine leads to an outcome or reward.  The reward usually satisfies a craving.  Cue-> Routine -> Reward.  What we learn through our studies in obesity is that the reward often stimulates a hormonal response of 1-30 different hormones in brain and body leading to repeat cues or triggers.  The cravings are hormonally driven.  I call it the Habit-Loop of Obesity.

Habit-Loop of Obesity DocMuscles #KetonianKing Adam Nally

 

The Craving is the Key

Human psychology and emotion is the key behind habit creation.  First, there must be a trigger or cue.  Second, the trigger is attached to  a previously experienced emotion or craving tied to the cue.  The key to habit formation is the craving.  The craving is what stimulates the physical routine to occur.  It is an emotion or craving that drives the brain to create the habit. Third, there must be a clearly defined outcome or reward that satisfy the emotion or the craving. The emotion or craving doesn’t have to be associated with hormones, however, in the relm of obesity, it is usually tied together.

I am all about making things easier.  Your brain does it. We all do it.   And, I’m all about trying to help you lose fat and get healthy more easily. Let food be your medicine, let medicine be your food. That’s my mantra and that is as easy and natural as it gets.  But, in our day and age, we don’t always have access to growing and raising our own food.  That’s why my second mantra is – better living through chemistry.  So, I created the KetoKart.  Over the last 15 years of medical practice, I’ve found products and supplements that aid in letting food be your medicine, changing triggers, modifying hormones, and help to satisfy cravings in a healthy way to make your decisions easier.  Go to the KetoKart, see which package works for you and order it.  You’ll thank me.

How do  we change our obesity habits?  Stay tuned for the third part in this series: Fixing the Habit-Loop of Obesity.

So, I want to know . . . which package did you choose?

 

Why Be In Ketosis – Part XII (Thyroid)

There is a pattern that I’ve noticed on every live-stream that I’ve appeared on talking about ketosis that someone always asks the question: “What about the thyroid?”  That’s literally how it’s asked. . . someone I am unfamiliar with keys in the question, “What about the thyroid?”

The blunt sarcastic response in my head is usually, “Well, what about it?”

Buried within the vague periscope or twitter question above is the real question that is on the minds of thousands of people,  “Does ketosis effect the thyroid . . . ?”

There’s loads of information about the thyroid on the internet.  Much of it is garbage.   Seriously.  Ask Google about “thyroid,” and you’ll see thousands of articles, posts and comments on WebMD, Women’s Health, and Wikipedia all across the “interwebby.”  Everyone, and I mean everyone, seems to have a “thyroid opinion.”  Much of the “wikopinion” out there is here-say, conjecture and anecdotal. It doesn’t really give people any foundational understanding of what their thyroid is doing, or more importantly for that matter – what their thyroid isn’t doing.

Of late, the Paleo and Vegetarian thought leaders seem to decry nutritional ketosis because they claim that this dietary approach suppresses thyroid function. This wiki-theory (yes, it is just a theory) was extrapolated from a single study where the T4 level dropped in the first few weeks after ketosis was entered.  But just because T4 drops, doesn’t mean the diet suppresses the thyroid.  Using T4 as a screening test alone for assessment of thyroid function is 1987 thinking (1987 brought us the Kia Concord and the Subaru Justy just so you get the mental picture).  T4 fluctuates with a number of binding proteins and following this number alone is really bad medicine.  Taking thyroid advise from the Paleo people is like asking your Fed Ex driver about the correct lift on your 4×4 truck.  Really?

Excessive insulin, the hormone produced when you eat sugar, starch and some proteins, actually stimulates thyroid peroxidase antibodies and can cause exacerbation of thyroiditis (causing over-production or under-production of thyroid hormone).  Because 85% of the people I see in my office over-produce insulin (this is referred to as insulin-resistance), in response to starches, there is a significant flux in thyroid function due to  this pre-diabetes state (insulin over-production) on high carbohydrate based diets.

Leptin, the hormone produced by fats cells when they are “full,” actually stimulates the conversion of T4 to T3.  At least 40% of my obese, insulin-resistant patients are also leptin-resistant, meaning they over-produce leptin as well.  This has a suppression effect on T4 (by converting it to T3) and is the usual cause of the T4 levels being lower when initially staring a ketogenic diet.  It is also the reason that some people feel anxious or “activated” when changing to nutritional ketosis.  Leptin-resistance is driven by a high level of fructose in the diet and the presence of high triglycerides, inhibiting the leptin signal from crossing the blood-brain barrier.  As a person follows a ketogenic diet and lifestyle, leptin returns to normal over 3-6 months and T4 levels normalize.  The Paleo and Vegetarian nay-sayers never mention that . . . do they?  What they won’t tell you is that calorie restriction, which is a must for weight loss, on the DASH, Mediterranean, Paleo or Vegetarian diet causes suppression of testosterone, leucine, and thyroid function, causing worsening T4 suppression over time.  Hmmm . . .  put that in your low-fat green vegetarian taco, and smoke it.

Wait . . . I don’t advocate smoking so, ignore that.

The point is, a ketogenic lifestyle stabilizes thyroid function and improves auto-immune thyroiditis. I’ve seen it happen clinically for over 12 years.  It, also, dramatically helps stabilize the other 30 hormones involved with the diseases of civilization including obesity, insulin resistance and diabetes.

Watch my live-stream recording below to find out more about the thyroid.