The Trouble with Iron Part III Diabetes

The Trouble with Iron Part III Diabetes

References: Cell MetabolismJ of Diabetes Research,

You were trained to think of iron as absolutely necessary to help fatigue. “Build up your blood!” and other such phrases are deep in our subconscious. We see blood and know it is the red of iron. Iron is critical for life, because it’s the key to carrying oxygen to the tissue so that we can make energy. No doubt, iron is important. But carrying oxygen is no mean feat, as it is such a reactive chemical, it needs the strong chemical bond of iron in heme to transport it. What happens when you get too much iron?

Two conditions of too much iron are thalassemia and hemochromatosis. Guess what happens to those folks? Hemochromatosis is also known as bronze diabetes. They fill up the islet cells of their pancreas with iron, and their insulin producing capacity fails. This can be reversed with removal of the iron.

And what happens to normal folks? Well, here again we find that the tendency to being diabetic goes along with the tendency to be iron overloaded. And the devil is in the details. It’s not just the total load of iron that causes damage. It’s not just the accumulation of iron in the islets of your pancreas. It’s the whole ecosystem effect of iron. Iron plays a role in every tissue that mediates energy metabolism, particularly the fat cell. There is a whole host of signaling that occurs when iron is present with intracellular and extracellular messaging. The nuance of it is still not anywhere close to being understood, but you can get a sense for its complexity by the review in Cell Metabolism.
And what have we done, with all of our good intentions, in America. We have devised guidelines for iron supplementation that serve young, pregnant women, well. We add iron to all our grains. It is the fortification you see on the label of every kind of flour product. When you eat most breakfast cereals, particularly the ones that claim to have you supplemented with great vitamins and minerals, you will find 18 mg of iron added to each serving. But it will also be in the flour of your bagel, your hotdog bun, your Danish, your french toast. And it interferes with your metabolism of carbs, immediately. On the spot.

This raises a fascinating conjecture. Is it the iron added to carbs that makes them so problematic for weight gain, insulin resistance and diabetes? Hmmm. There is enough evidence around iron to make it a perfectly reasonable hypothesis. That also explains a few conundrums that the pure carbohydrate hypothesis doesn’t solve. For example, why is red meat so insulogenic? You eat a large bloody red steak, dripping with heme, and you get a huge spike in insulin. And it may not be just the red meat per se, because we see a stronger effect with processed meats. The evidence seems to lean towards more complicated and nuanced reasons, like the amount of AGE’s and ALEs. (If you knew what those were before you read this: you are a star. AGE’s are Advanced Glycation End Products – made by roasting meat with sugared sauces and ALEs are Advanced Lipo-oxidation Products, that occur with food preparation of meats with protein and high fat content.) However it occurs, iron is in the middle of it.
Here are some tests this hypothesis. First, one must look for high ferritin in folks who have high cholesterol, moderate blood glucose and elevated insulin: all the people we thought were overindulging in carbs. So far, I’m three for three. The last one had a ferritin over 600. Another test…..why can’t women lost weight after menopause? Answer: They stop losing iron with menses after menopause, accumulate iron and have their insulin go up. That makes them gain weight. Hmmm. Ever seen that happen? They go carb free and eat more meat, and don’t lose weight. Hmmm. I’m about 400 for 400 on that one.

WWW: What Will Work for Me. I’ve paid a lot of attention to this topic in my own life. Right now I’m reading labels and finding secret iron everywhere. At the picnic last night, I avoided the hamburger offering and had two olive oil salads instead. I had just read that the iron in spinach is tightly bound by oxalates. And what about Vitamin C? It increases iron absorption 400%. Complex, isn’t it?


Pop Quiz

  1. Too much iron in you can cause you to become insulin resistant, thereby leading to diabetes risk and obesity? T or F                                                                              Answer: Bingo. True
  2. The mechanism for this cause is well known. T or F                            Answer: Well, it’s well known now but the mechanism is still murky. Too complex. The phenomenon has been observed. And ferritin is deposited into insulin cells in the pancreas, but the cellular mechanism is much more nuanced, probably because iron is so tightly regulated and bound.
  3. You should know your iron level and it should be?                              Answer:  Ferritin of 40 or so.
  4. If your ferritin is too high, you can reduce it by?                                   Answer: giving blood to the Red Cross. Come on in and we will phlebotomize for you if the Blood Donor Center won’t or can’t do it.  (Leaches.  Blood letting.  Hand to hand combat.)
  5. This iron topic is a whole new way of interpreting the problem with carbohydrates, because………..?                                                                                           Answer: we added iron to virtually all carbs in Western societies. It may be the iron, and not the carbs.  This is conjecture for now, but it sure fits.

The Trouble with Iron – Part II – Your Brain on Iron

The Trouble with Iron – Part II Iron and Your Brain

References: The MindSpan DietNeuromolecular Medicine, Nature CommunicationsJournal Biol ChemUCLA Newsroom,

Ok you got it. You know the “AP” rule, antagonistic pleiotropy, from last week: what’s good for you at one age isn’t so good later. Young women need lots of iron to have babies. Young men need iron for their brains to develop. Young. As we get older, that changes and becomes “ANTAGONISTIC”.

What’s the trouble with iron? First of all, epidemiology. Men accumulate iron faster than women, and get Alzheimer’s younger than women. Women who have hysterectomies start accumulating iron sooner, and get dementia sooner.

Then there is pathology. All major brain diseases (Parkinson’sALSAlzheimer’s) are shown to accumulate iron in their region of damage. Iron is very reactive. With oxygen it’s a deadly combo. On our cars, we call it rust. In our brains, it wreaks havoc.
There are many mechanisms now being understood wherein iron is a problem in the brain. In essence, beta amyloid accumulates as a net effect of excess iron. And chelating that iron, in animal models, reduces the damage.

What do we see in human populations who have very little Alzheimer’s disease and who live to be 100 with healthy brains? First, they eat foods low in iron and live in parts of the world where there aren’t “fortified” grains (added iron). Their average serum ferritin is 20. In America, we call that deficient. More and more research is showing that ferritin in spinal fluid and blood predicts risk for AD. This is the perfect example of Estep’s “AP” rule. The iron we needed in youth to make babies isn’t so good for us as we age. Those, whose scales are tipped to eating more iron by intention or serendipity, are at greater risk.

The question arises, how do I get rid of excess iron? Rule #1: when in a deep hole, the first thing you do is stop digging. Stop eating iron rich foods. That included fortified wheat products. Cereals like Total contain 18 mg of iron per serving. Don’t. Steak. Don’t. Find flour that is not fortified. Find bread that is not fortified. Consider taking supplements that deplete iron. Wheat grass juice is uniquely good. Go to the Blood Center and give a pint. Often. Let them have double red cells. Get your serum ferritin to 20. AKA: KNOW YOUR FERRITIN.

www.What Will Work for Me. I’m changing my meat eating. I’m looking for unenriched flour. I just measured my ferritin and I’m over 100. Hmmm. I just might give some blood away. I threw out our red colored ibuprofen (iron coating).


Pop Quiz


  1. Iron is good for your brain. True or false                                    Answer: Ha, Trick question. It appears to be important for you when you are young, but too much is a deadly toxin as you get old. That is the AP Rule: Antagonistic Pleiotropy.


  1. We have added iron to many of our foods on the belief that it is good for us. T or F        Answer: True.


  1. People around the world who have the best functioning brains, the longest, have much lower blood iron in the form of ferritin than we have thought was safe. T or F                  Answer: Yup. Average ferritin of 20


  1. Beta amyloid in the brain might be accumulating as a side effect of our brain’s attempt to get rid of extra iron. T or F                                                        Answer: Again. Yup


  1. Getting rid of excess iron might be the only way to reduce our risk for the dangers of iron. The easiest way to do that is……?                                 Answer: Donate blood.




The Trouble with Iron

The Trouble with Iron

References: The Mindspan DietEndocrine Society MeetingHow Much Iron in My CerealJr of Nutrition,

Ready to blow your mind with a whole new set of ideas? Want to live a lot longer and have your brain survive with you? Want to have an organizing principle that explains much of the trouble with modern nutrition, that is a complete curve ball from anything you have ever heard before? Here goes. Please read the next couple of weeks of The News with great attention to the details in this column.
Dr Person Estep is not am MD, he’s the smart kind, a PhD at Harvard Medical School, in Genetics and Health Science. HIs research is into those populations of people whose brain survives into their later years, and why. I’ve just devoured his book, and if you want to preserve your brain, you should too. This is a must read.
Let me start with a few core principles and ideas that he presents. First, the concept of MIND SPAN. I want my brain to survive longer than my body. My LIFE span makes me nervous, if it’s longer than my brain span. That’s Alzheimer’s (AD). Get that? Of course your do. We all do, and right now 50% of are getting it if we have the “good fortune” of living to 85. That’s idea #1.
Concept #2 for us to all know is the idea of Antagonistic Pleitropy. (Wow, if you get this, you can skip medical school.) It’s actually a simple idea. What it means is that your bodies needs change as you age. What was good for you once, becomes bad for you later. Biology works by natural selection, and reproduction is the driving force. If you can’t pass on your genes, they can’t change. So, natural selection works only until you stop reproducing. Nature is not interested in you once the pressure of natural selection is over. Get it? What is good for you before passing on your genes, may be bad for you later. Women have to give iron to their babies. The human body needs iron for it’s blood making. And through most of human history, our guts were filled with tiny worms that made us lose iron. In this mix, men have to make sperm. Trillions of them. But sperm doesn’t involve the losing of iron. Making babies does. Lots of iron. The human species has resulted in a model that generally, in both genders, accumulates iron easily. That’s good for women, while they are making babies. And its good for all of us when we keep losing iron from intestinal parasites. What happens to us after we stop reproducing? Well, nature has no way of repairing or changing that tendency to accumulate iron after our reproductive years. What happens if we keep accumulating iron? What happens when we get good plumbing and sanitation and stop getting pin worm? Our iron leak stops.
What happens, if we decide that our society is across the board iron deficient and we add iron to all of our grains? (Look at your breakfast cereal and see how much iron you are getting. Look at your “fortified bread” and see how much iron you are getting. Consider that the USDA says that we need 18 mg of iron a day, and good science shows that actually you probably need much less, like 4 mg a day, once you hit 50. What’s happened is that in America, we have added abundant iron to our diet, to our baby formula, to our grains, our breakfast cerealsour rice, to our whole food chain. And that may be a big problem.
What if I told you that accumulating ferritin in your pancreas pushes you into diabetes? What if I told you that amyloid plaque in your brain may be a side effect of a desperate attempt to get that toxic iron out of your brain. We’ll get to that in the coming weeks.
For now, think about these two core ideas and please, look at your “fortified” flour on your shelf and read the labels for your source of iron. Think about how red meat provides you lots of iron. And next week, we’ll have more details.

WWW.What will work for me. My mind is being totally turned upside down. I can’t wait to tell you the rest. This is a whole new way of exploring the metabolic problems we face with aging. But for now, stop taking any iron in your diet. STOP. Trust me. Stop. Stop your vitamin pill with iron. Stop your fortified cereal. Get skeptical about red meat. I’ll prove it to you. Or else buy the book. Next week.


Pop Quiz

  1. The human body accumulates iron easily, too easily. When is that good, and when is it bad?                                                                        Answer: It’s good if you are a young female, having lots of babies and with lots of intestinal parasites – like humans were until 100 years ago when we cleaned up our toilets, our guts and stopped having so many babies. It’s bad when you are male, have a clean gut, live longer than 35 years.
  2. What is this effect called?                                     Answer: Antagonistic Pleiotropy. (Go straight to your third year in medical school.) What’s good for you at one age or circumstance, becomes bad for you later.
  3. We decided, as a society, that every one should have how many milligrams of iron a day?                                                                             Answer: 18
  4. How many milligrams do mature adults, past the age of child bearing need? Answer: Probably around 4.   Certainly no more than 8.
  5. Should I worry about the red color of my ibuprofen pill?                              Answer: Yes, that is actually oxidized iron. Buy another brand. The ibuprofen is good for your brain. The Iron is not.

Nine Risks for Cognitive Decline

Nine Risks for Cognitive Decline

References: The Lancet, July 2017BBC News

This week, in London, the Alzheimer’s Association International Congress, just met. One of their presentations was a publication in the Lancet detailing the current best evidence of risk factors for developing cognitive decline. The over arching principle is that the brain does show changes with time that eventually lead to withdrawal and loss of cognitive function. It shows up as short term memory loss, but starts with other risks. Prevention should be focused on building a “cognitive reserve” earlier in life. If there is to be an inevitable downward slope, change the grade of the slope.
Your brain is constantly tasked with decided what to keep and what to throw away. It is not a hoarder. It repeatedly questions what memories to discard, what are important, and which are less important. The stop sign you passed on the way to work may not be all that important to remember. It gets tossed. Where you put your keys is important, only in the short term, but can be forgotten. Your spouses birthday, now, that is important. Your brain has to sort those out. Routine and repetition can lead to letting go.

In order to do all that sorting, your brain needs data. It needs to be exercised, flexed, challenged, used. Knowing that, the list presented at the meeting makes sense. They estimated that approximately one third of dementia was amenable to prevention by early intervention. That starts with mid life hearing loss. This is the first paper that I have seen with a meta- analysis of multiple high quality studies of hearing loss as a risk for cognitive decline. It accounted for 9% of the risk. Following that was lack of a completed high school eduction (8% risk), smoking (5% risk), failure to seek early treatment for depression, (4%), physical inactivity, 3%, social isolation (2%), high blood pressure (2%), obesity (1%), Type II diabetes (1%). These all add up to the 35% percent of modifiable risk factors.
Continuing life long learning keeps your brain working with new data. Doing something “hard” every day, keeps your brain solving problems. Staying socially engaged with humans keeps all your filters of human interaction functioning. These factors appear to be important, and make sense. They flatten the slope of decline.
What is quite new in this examination is the consideration that diabetes accounts for only 1% of risk, obesity 1%, smoking 5% and physical inactivity 3%. These are far lower than prior estimates and suggest that there was no attempt or discussion about reduction and change of lifestyle risk factors. That is likely because the prior model of weight loss is all about low fat, which doesn’t work. Hence, no one has been able to succeed with weight loss, diabetes reversal, high blood pressure reversal etc. With the proper use of low carb for weight loss, modifiable risks for cognitive decline will appear to be more meaningful and effective.
WWW.what will work for me. I’m paying attention to the hearing loss concern. This is the first study that shows it to be so high on the list. It’s never been so high in any prior study. I’m going to find a time to get myself checked. I haven’t seen any other study like this, so this could be a statistical blip, but it sure catches my eye. Pay attention.

Pop Quiz

  1. The current article suggests that as much as 35% of dementia can be prevented. T or F                                              Answer: That’s there data from statistical analysis. I think the number can be much high.
  2. Mid life hearing loss can be postponed until you are on Medicare. T or F                Answer: False. It leads to social isolation.
  3. Cognitive decline is a natural process. T or F                                     Answer: Sadly true if you live long enough. Age is the strongest risk factor. What is not discussed here but is quite intriguing is that dementia may be the result of a protective or natural process going awry.
  4. Hearing loss may be far more important a risk factor than we care to acknowledge. T or F Answer: Yup
  5. The combination of diabetes, high blood pressure, obesity are all one parcel of common problems best reversed with a low fat American Heart Diet. T or F Answer: It’s true they are all one parcel, it’s false that the AHA diet will help you.


Don’t Eat Mac and Cheese

The Poison in your Mac and Cheese

References:, New York Times, CNN,

It was all over CNN, BBC, New York Times this week. “What Chemicals are in your Mac and Cheese?” Mac and Cheese. My kids were raised on it. It’s one of America’s iconic foods. The pinnacle of American comfort food. Here’s the rub. Ten years ago, we banned phthalates because they were found to be “endocrine disruptors” in children and exposure resulted in behavioral and neurodevelopmental issues. All the big retailers withdrew their children’s toys that had phthalates. Kids chewing on their rubber ducky were getting phthalates that soaked out of them.

Phthalates make kids toys soft and pliable. But phthalates are plastic chemicals that have a lot of beneficial applications. Your electrical wiring in your house is coated with phthalate plastics. Your vinyl flooring is resilient and pliable because of phthalates. And now we find in in your kids food. How did it get there? It’s not added to the food, it leaches out of the plastic tubing that is pliable and long lasting because it is made with phthalates. In manufacturing Mac and Cheese, there is plastic tubing that is made with phthalates. Voila. There you have it. The packaged Mac and Cheese had four times the level of regular cheeses, even the processed stuff in slices that comes between two layers of plastic.

What did this study show? Of thirty brands of Mac and Cheese, 29 had at least one phthalate, and some had six. The most common one, DHEP, is the one most commonly found and is the one most widely restricted. Kraft Foods made 9 of the 30 samples tested. There are 2 million packages of it sold every day in America. Hmm. So your kids are still getting it.

Your first response may be, “Give me a break. You can’t get that much out of the tubing from making the stuff.” Wrong, wrong. You get parts per billion. That doesn’t sound like much but it’s as much as four times the level of your own hormones. Therein lies the rub. Phalalates have been particularly linked to the suppression of testosterone.

The good news is that once you stop eating or ingesting them, they flush out pretty quickly.

www.What will work for me. It’s so easy to make your own mac and cheese. Just get some nice sharp cheddar and gorgonzola and make your own. Just don’t squirt it through plastic tubing. In the meantime, I’m not even buying Mac and Cheese any more when I stop at the grocery for food pantry donations. It you want to change the system, let your purchasing habits drive the market. If you want to change your testosterone, don’t buy packaged mac and cheese.


Pop Quiz

  1.  Processed foods that come in boxes are made in large, industrial sized factories, where high pressure, high heat manufacturing methods leach phthalates out of plastic tubing, enough to have detectable phthalates in the food being made. T or F Answer: If you followed all that, you got it.
  2. The concentration of phthalates in processed food is not meaningful. T or F Answer: It’s in parts per billion, some four times what your own active hormones are.
  3. Phthalates are known to suppress estrogen. T or F                       Answer: well yes, but the real damage appears to be to testosterone, needed by both men and women.
  4. If I buy organic Mac and Cheese, I can get away from phthalate contamination? T or F                                                            Answer: Nice try. False.
  5. Our kids are particularly susceptible to phthalates, which is why we banned them from kiddie toys. Makes sense to ban it from their food.                          Answer: Not if your food lobby pays your members of Congress enough to keep quiet. But we should. (Pay attention to the language – “We are going to reduce regulations that are job killing.” Might be code for not paying attention to food contamination.)



Sufficient Vitamin D Improves Vascular Health

Sufficient Vitamin D Improves Vascular Health

References: Indian Jr Endo MetabAmerican Journal of Cardiology,

I was excited last year when it was reported that Vitamin D helped folks with congestive heart failure. When 233 patients with congestive heart failure were randomly given Vitamin D, their 6 minute walk time didn’t improve, but their ejection fraction increased 23% relatively, or 6% absolutely. The dose was 4000 IU a day, with no loading dose. Note, half of us will die of congestive heart failure, so this is a big deal for older folks, particularly those with congestive failure. You may not be able to walk further, but you are still walking. Most folks with an ejection fraction (the percent of blood your heart can pump out with each stroke, where normal is 65 and dead is 18) in the low 20s die within a year or less. So, being around fora year to finish a study is cool. I added Vitamin D to my Congestive Heart Failure protocol.

I’ve been watching for mechanisms of just how it works. Here it is! In this study, 103 folks with Vitamin D deficiency (below 20 ng) were given 60,000 IU a week for 8 weeks. Measurements were taken of vascular function like carotid-femoral pulse wave velocity, brachial-ankle pulse wave velocity, arterial stiffness index and oxidative stress markers like serum malondialdehyde levels and total antioxidant status. They demonstrated about a 10% reduction in pulse wave velocity, (996 cm.sec to 899 cm/sec) and systolic blood pressure from 115 to 106. All were statistically significant. Lowering blood pressure (996 cm.sec to 899 cm/sec) and systolic blood pressure from 115 to 106. All were statistically significant. Lowering blood pressure even 2 points reduces risk for vascular disease 4-6%.
[Now, there are any number of studies that are referenced in this article where Vitamin D didn’t help heart disease. Many of these have been highlighted in the popular press to suggest that vitamin D supplementation doesn’t work.

Cardiologists like to quote them to justify having a cath instead of taking D. Hmmm. Just about every one of those studies gave lower doses of D, in the 2000 iu range, for 6-8 weeks at a time. This is a good example of the utter stupidity of most studies that essentially don’t understand the physiology of Vitamin D. Your bodies fat tissue soaks up D and stores it. It is fat soluble. You are a big tank. If you are overweight, you are a bigger tank. When you start a new dose, it will take your body a full year before a new homeostasis is achieved. In the long run, a dose of 3-4,000 IU a day is sufficient in most folks to get to a level of 50 ng, my definition for replete.

This study effectively gives a loading dose. 60,000 IU a week gets to threshold.   I give 100,000 IU because that has been proven to raise your D level 14 ng a day. If someone is low, < 20 ng, you can give two doses in a row. They will add 14 ng a day and in two days will be at 45-50. Finally, Vitamin D works as your stem cell hormone, telling stems cells to wake up and start maturing into mature cells. Mature cells can do their function. It takes months for a mature cell to grow and start doing its function. If your D level is rising so slowly that you don’t have enough for a year, a study lasting 12 weeks, with an inadequate dose of D will never show an effect.

The final point to make about D is the clear need for it to be accompanied by K2. Weston Price highlighted this in the 1920s because that is what he observed when he documented the lifestyles and diets of “primitive” people. Like every pioneer, Weston Price didn’t get everything right, and his foundation has a few tangents that are off base, but by and large, he opened the door on omega fats, K2 and D, something we didn’t appreciate for another 70 years. When you look at D in isolation, you will often likely miss the beneficial effect if you don’t control for Vitamin K input. Increasing recognition of the complexity of our metabolism can be seen in the interplay of D and K2. They are really part of a biological partnership. Both are fat soluble.

www.What will work for me. I’m getting a better understanding of how D and K work together. Seeing a study where adequate doses of D make an impact when similar inadequately dosed folks didn’t get an impact is an important distinction. The self righteous deniers of this effect can’t explain that. Once they are ensconced in nay-saying, they keep nay-saying. As for me, I cheerfully take my D, 3500 IU a day in the form of 100,000 once a month. And I wear a hat and sun screen. Just one more skin cancer to take off my back.

Pop Quiz

  1. Vitamin D works by……….? Activating many genes, (10% of the human genome) which stimulates stem cells to become mature cells.
  2. It takes Vitamin D how long to change your blood level? Answer: If you don’t take enough, you will never get to an adequate blood level but generally you reach a new homeostasis in about a year after starting a new dose.
  3. To get to an adequate blood level Vitamin D, you need a loading dose of …..? Answer: 100,000 IU for every 14 ng you are deficient. If you want to get to a level of 50, and your level is 8, you need ………….? Answer: 3 doses of 100,000 IU, one day apart each.
  4. Your arterial blood velocity will drop when you take Vitamin D, which means your arteries have gotten stretchier and your blood pressure has dropped. T or F
  5. To prove that Vitamin D works on heart disease, you likely need to do what in terms of designing a study? Answer: It has to run longer than a year, have a loading dose, and take sufficient D to get to a level of 50. This has never been done. Any study with less, shorter, and no loading dose, no monitoring of blood level and no randomization will not show scientifically meaningful results. Meanwhile, the physiology of benefit sits right here, in this study.

Luteinizing Hormone and the Development of Alzheimer’s

Lutienizing Hormone and the Development of Alzheimer’s

References: Horm Behavior 2015PNASNeurobiolog AgingScience Daily,

Luteinizing hormone rises sharply with menopause. It is the hormonethat stimulates egg production and ovulation in women, and sperm/testosterone production in men. The ovaries no longer respond to the effect of FSH and LH, and their rise marks the definitive marker of menopause. Hormone levels fall. Hot flashes, hair loss, lousy sleep, etc all ensue. Misery. Sorting out the confusion is no mean feat, particularly because there remains widespread confusion over the elevation of breast cancer risk with post menopausal hormone replacement. This confusion stems primarily from not recognizing the adverse affects of non-human estrogen compared to the beneficial effects of bio-identical human estrogen.

There is a legitimate question in there. Is it lack of estrogen that is dangerous, or the rise in the hormones that encourage the secretion of estrogen, namely luteinizing hormone. What effect does long term LH have on the female brain? That’s the question raised here. How is the lack of Estrogen and Progesterone played out? Is it the lack of Estrogen that is the issue, or the damaging effect of too much LH?
That’s what this week’s article is about, the possible role of LH in causing Alzheimer’s. The authors carefully review the animal literature that demonstrates the damaging effect of high levels of HCG on rodent brains. HCG is very similar to LH, differing by only in the beta subunit, and is shown to have the same experimental effects on brains, namely an increase in amyloid beta proteins, neurofibrillatory tangles, and decreased problem solving ability. With menopause, LH rises sharply. With surgical menopause, it happens faster still. Epidemiological studies do link higher levels of LH in elderly women to more Alzheimer’s.

What does it take to suppress LH? You can do it with balanced hormones, which includes testosterone. Estrogen alone doesn’t do it.   It takes estrogen, testosterone and progesterone to fully suppress LH. Progesterone can be shown to do it within 90 minutes of administration, but it’s through an Estrogen dependent receptor.

Now, it’s not total Estrogen that appears to have a protective effect but rather free estrogen. That’s the nuance. There have been conflicting reports about estrogen not being protective for Alzheimer’s, at least when simple total levels are measured. But when Sex Hormone Binding Globulin (SHBG) is measured, one gets a reflection of actual free (biologically active) estrogen levels. SHBG binds 99% of estrogen, so its level strongly reflects free estrogen (the remaining 1%). Measuring total Estrogen will not give a sufficiently detailed picture of the actual hormonal milieux of the aging female brain. High SHBG has been correlated with Alzheimer’s. We do know that the use ofbirth control pills raises SHBG in women FOREVER, even after short periods of use. And we know that birth control pills alter women’s brain, changing the nature of women’s memory: emotional impact is improved, memory of details are lost. There are multiple studies showing that cognitive decline is reduced with birth control pills, which seems to suggest they are protective. What has not been done yet is a study looking at the risk of Alzheimer’s disease after using the pill in young adulthood.

So this is a real rat’s nest of conflicting issues. The bottom line appears to be that LH may be the mediating factor in cognitive decline, but that occurs in the absence of adequate normal hormonal levels. If those levels are replaced, perhaps the measurement of LH should be a consideration for proper full replacement therapy, as that is the actual causative agent for damage. The lower, the better. And for men, with low testosterone, is the use of Clomid, an LH agonist, safe? We have no information. As long as it is raising T, it probably is, but this remains an issue to watch closely.

www.What will work for me. This appears to be an issue we have to understand. There is emerging consensus that human estrogen is good for the human female brain, and testosterone for the human male brain. Is the role of that utility come from suppressing LH. Something to be closely monitored. Stay tuned.


Pop Quiz

  1. Luteinizing hormone can be shown to make the pathology of Alzheimer’s occur in rat.    T or F                                                                                                                         Answer: Probably true. Most of the rat research has been dose using HCG which is very close to LH, with very similar actions but a much longer half life.
  2. LH levels drop with menopause. T or F                                                    Answer. False, false, false. It’s the high levels of menopause that are the whole problem, and thereafter, Alzheimer’s begins to show up.
  3. This would suggest that women who go through menopause earlier, have the onset of dementia earlier. T or f                                                                                Answer: True
  4. The confusion over risks for hormone replacement therapy are mostly from the confusion over bio-identical hormones versus artificial. T or F                              Answer: repeatedly, true.
  5. Do you want to know you LH levels?                                                         Answer: I think I do.




Biotin Messes with Your Thyroid Testing

Biotin Messes with your Thyroid Testing

References: NCBIEndocrine News

Everyone needs biotin. It’s been known since the 1920s but only understood since the 1970s. It is used in 4 enzymes in the mitochondria of your cell. You can make some biotin deficient by feeding them a diet of pure raw egg white (high protein) and despite that sounding odd, folks getting IV parenteral nutrition had a lot of egg white protein given IV and thus biotin deficiency was found. Skin rashes and hair loss were prominent symptoms. Hence, the connection with hair loss. The Institute of Medicine recommends some 30 micrograms a day and that’s what’s in most OTC vitamin pills.

Now, menopause is strongly associated with hair loss, as is thyroid disease. Considering how many Americans go through menopause (rumor has it that it’s more than half), the hair loss industry was born. And biotin plunked down in the middle of it. BEST PRODUCTS to prevent hair loss! It is widely “known” that you “need” biotin to prevent hair loss. Well, is it? And are there problems with that? If you look at the ingredients in most of the hair loss products, you will find 500 mcg of biotin and above in them. That’s 20 times the Institute of Medicine guidelines.
Considering that hair loss is associated with dysfunctional thyroid, mostly low, and low progesterone, many many women are caught in this conundrum, and want to fix their hair loss. And they find themselves on biotin, in one form or another.

What’s the problem? Biotin has now been found to conflict with thyroid measurements.
This should come as a relief to many folks who can’t understand why their thyroid tests keep fluctuating wildly. The problem comes in that biotin is used as an anchor to capture antibodies. Biotin sticks nicely to streptavidin, a protein reagent on the capture surface of the test device. That makes a lot of natural biotin floating around. When someone starts taking lots of extra biotin, it’s going to interfere with that testing process. With interference, you can have falsely elevated blood tests of total T4 and T3, with normal other tests making for combinations that don’t make sense.

You see the conundrum? You have hair loss and are trying to normalize your thyroid. But you are also taking biotin, in a form you didn’t even know about because the supplement you were taking for hair loss called it something other than biotin (Vitamin H is a common misnomer).

www. What will work for me. If I didn’t know 5 people with this situation, it wouldn’t be so notable. The upshot is that it takes some 3-5 years for hair to run through its natural cycle, and up to 6 months for anyone to notice that a real change has come about. Once it has fallen out, it takes at least 3 months (the telogen phase) before it starts growing again. It’s not that biotin is bad for you. It’s that it is used as a reagent in testing thyroid, and high blood levels mess up the testing. If that leads to dose changes, you have a problem. If you are on biotin, then don’t completely trust any test about your thyroid.


Pop Quiz:

  1.  Hair loss is affected most by what two hormones?                        Answer: thyroid and progesterone

2.    Biotin is related to vitamin C? T or F                             Oh, get over it and read it again. It’s a B vitamin, B7 to be exact.

3.    The reason biotin messes up your thyroid is?                                  Answer: it doesn’t. It messes up your thyroid test leading you to look like you are in trouble, when you are just peachy.

4.     If you are worried about your hair, how often should you let yourself make dose changes of your thyroid or progesterone?                                                                 Answer: probably at least 3 months before you change anything.

5.    Your thyroid is easily understood with your thyroid tests? T or F                 Oh, my goodness. You haven’t read much about reverse T3 or de-iodinase yet.



The Triage Theory by Bruce Ames

The Triage Theory by Bruce Ames

References:  AJCN 2009 AmesPNAS,

This topic is very important. It is how “wellness” and aging intersect.  Bruce Ames, a Professor of Biology and Molecular Biochemistry at Berkeley has been the chief proponent of it and has been articulating its implications since 2006. In essence, the theory maintains that populations of mammals, or creatures, on earth allocate micronutrients on a first-come-first-served basis. This serves the animal in the short term, but creates long term consequences and problems. The body “prioritizes” short term survival over long term health.

There are about 40 critical minerals, fats, vitamins and “micronutrients” that we depend upon for optimal health. Each of them can be “optimal” or play a role in being deficient. It is not until that nutrient is critically deficient that we get a short term “deficiency” disease. But because different organ systems may require different levels of the nutrient, short term disease may not reflect the risk of long term damage that ends up causing premature aging.

One of his examples is Vitamin K. When we take coumadin to make out blood thin, we knock out a bunch of other functions that Vitamin K does. In the short term, our blood being thinner and less clot-prone might be medically life saving because we have had a blood clot in our lungs, but in the long term, we end up with arteries that have calcified and “hardened”. You will see it on X-ray. Folks who have been on Coumadin for years have all their arteries visible in calcified outline.
Another example is Iodine. In severe deficiency, you get mental retardation. Iodine insufficiency is considered the number one cause of mental retardation in the worth by the WHO. It’s terribly important to protect the brain, and heaven knows, our thyroids need iodine. What gives? Breast cancer and fibrocystic breast disease are both strongly linked to lower iodine intake. Optimal iodine intake is probably more on the order of 1-1.2 mg a day, whereas most Americans only get .250-.300 mg a day.
Alkalinity and acid give another example. Very high animal protein diets with excess protein result is “acid” biological ash, needing neutralization. The human body, evolving from plant eating backgrounds, is used to being vegetarian and only recently adopted a habit of eating meat (5 million years) so that we could get a bigger brain. Eat too much animal protein, and you have to sacrifice bone mass to neutralize the acid. American’s get an extremely high level of animal protein between meat, fish, bird and dairy and result in a uniformly acidic environment. One in eight American women breaks a hip, the disease of aging that then does 30% of them in. This raises the spector of the safety of the “Adkins Diet” to which I would suggest that one focus on the fat and not the meat.
The conundrum for wellness comes in the concept of “long term health”. It is easy to precipitate short term illness, and discover the minimal requirement to prevent a particular organ system from failing. In just weeks, you can show that a level of Vitamin D below 32 ngm in the blood results in decreased cathlicidin and lowered immune function as shown by the inability to kill tuberculosis. It takes over 10 years to show that a level of Vitamin D of 50 versus 30 results in 70% less cancer.
The web on nutrient interactions is marvelously complex and nuanced. That’s the fun of it all. We have so much more to learn. Thank you Dr Ames for opening this line of enquire. I want to live long enough to fully appreciate it.

WWW.What will work for me. I’ve referred to the triage theory several times in the past. Our column on zinc was the last one. This theoretical construct should guide our thinking on all 40 micronutrients. What is too much? Too Little? Just right? I take Vitamin D, K2, fish oil, zinc, magnesium all because of this concept. You likely should too.

Pop Quiz

1. The RDA of vitamins and minerals are well known? T or F                                                                       Unfair, trick question. They are well known only for short term disease states, not long term wellness.


2. Premature aging is precipitated by missing micronutrients? T or F                                                              True:  And that’s the Triage Theory stated backwards.


3. Vitamin B12 deficiency is key for the prevention of pernicious anemia. What else is it also critically important for?                                                                                              Not mentioned in this column, but if you have read anything in this news letter, you would have seen repeated references to its even more important role in………….brain health.


4. Taking coumadin to prevent short term blood clots results in………?                                                                       Long term arterial calcification.


5. Eating a pure cheese and meat diet (the all American fast food diet) results in what long term stressor effect on the body? Too much acid that has to be neutralized by borrowing calcium from? ……..         Bones.


LifeSpan versus HealthSpan

LifeSpan Versus Healthspan

References:  WEForum 2017Compreh Physiology 2012,  Med Sci-Fi Sport Exercise,

We are living longer. But are we living better? In the 20th century, we doubled our life expectancy with the miracle of antibiotics, clean surgical technique, X-rays, immunizations and clean water.  Babies being born today in advanced societies have a 50:50 chance of living to be 100. But living longer isn’t necessarily better. There have been some disturbing trends lately. Obesity has managed to reverse the climb to longer lifespan in some societies, namely the USA.

As we live longer, we have more choices about lifestyle, making research into factors affecting confoundingly complex. It becomes impossible to do “randomized, placebo controlled” studies over decades without limiting free choice and spending more money than could be allocated. This article, from the World Economic Forum this year, offers insight into the laboratory of fitness, namely masters athletes. I have a dozen or so men and women older than 60 in my practice who would qualify as exceptionally fit. And I see their lab results and their vitality. They are aging differently than those of us who are less active.

Sedentary behavior is being increasingly recognized as the driver of many of our modern conditions. Part of this discernment comes from the recognition that athletes, (high end performers) have a disproportionately share of good health. They don’t get in trouble. They still die, but their time of end-of-life disability is markedly compressed, compared to the majority of the sedentary population. They become a unique research cohort, one that we couldn’t duplicate with “randomized research”. In effect, what happens with athletes is that they reach their peak in their 30s, like all of us, but then don’t show much decline until close to the very end. The rest of us show inexorable, linear decline. “Patch, patch patch, after 40!,” we say.

At every age in life, starting exercise of any kind has benefit. And the risk of complications from exercise is far lower than the risk of remaining sedentary. The real risk is sitting. Considering computer games at home, TV, computers at work and cell phones in-between, we are mesmerized by electronic distractions that leave us sedentary. In fact, research in 2009 of 17,000 Canadians of all ages showed a dose relationship of sedentary behavior to all cause mortality, regardless of levels of exercise. That means 30 minutes in the gym does you no good if you are sitting the rest of the day. Bother.

The Author cites four strategies with references on each: 1) Move More (Just get started and move more), 2) Move Slow, (Aim for 10,000 steps a day) 3) Move Fast (Add some high intensity something, even for just 10 minutes) and 4) Move Heavy (Add some weights). Read those hyperlinks. It’s the best of our knowledge.

WWW.What will work for me. Sedentary behavior is the new smoking. If you want to live better, longer, you have to do it. Build it in every day. A day without exercise is as bad as a day of smoking.

Pop Quiz

1. Our grand-kids are likely to live to be 90+. T or F Answer: False if they are sedentary, but true if they get the exercise bug and take care of their diet.
2. Our society is becoming more active. T or F Answer: Mixed picture. But as a general rule, false. Bless those who make the answer slightly true.
3. 30 minutes at the gym has beneficial effects? T or F Answer: Sure, it helps. Its benefit may be completely erased by an 8 hour day of sitting.
4. There is a dose relationship between exercise and good health. T or F Bingo
5. Getting sweaty isn’t necessary. T or F Answer: False, if you want optimal results. Getting sweaty 3-4 times a week is much better for you.