Monthly Archives: October 2014

Low Free T3 in the “Normal” Range Predicts Death in Elderly Patients

Low Free T3 in the “Normal” Range Predicts Death in Elderly Patients

Reference: JCEM Iglesias Oct 2013 PubMed Abstract Reverse T3 and Mortality

There is lot’s of talk about thyroid and how important it is for your general well-being. It acts as the idle on your engine, generating power for your body to turn into energy and vitality.   Just how important it is?   Well, this study gives us a clue.   404 patients, over age 65 were admitted into the study when they were admitted into the hospital. They didn’t necessarily stay in the hospital but their overall survival was followed for the next 7years. Their TSH, T4 and T3 were measured. (Not reverse T3).   In that time period, 303 of those patients died (80%). Low free T3 on admission was highly predictive of death in the hospital. The lowest quarter of patients with low free T3 lived only 3 months when their free T3 was less than 3.1 pmols. In the US we use picograms and the conversion is to less than 2.1 pgms. That is low, even in the USA, and is just below the normal range.   But folks in the next third were in what we call normal and their mortality was still greater than the folks in the top third. They only lived 13 months compared to 19 months for folks at the top.

About a third of the patients died of heart disease and they too fit the pattern of predictive deaths with low free T3.   In fact, low free T3 appeared to by particularly important for predicting cardiac mortality.

Now, confounding all this is that the same pattern also matched low TSH. Remember, TSH works inversely to T3.   A low TSH would suggest that your body thinks you are getting more than you need of thyroid. TSH is usually high if free T3 is low. If free T3, T4 and TSH are all low, and predictive of mortality, it may mean your whole system is just giving up and shutting down. If free T3 was low, and your natural systems were working, your TSH should be climbing to raise up your T3 and subsequent free T3.   This particular pattern may be identifying those folks whose whole integrated system of checks and balances is going down.

The conundrum could have been explained by measuring the REVERSE T3.   Remember the adage, “Reverse T3 reverses T3”? This study may be a confirmation that reverse T3 is not an inactive metabolite but rather an active blocker of free T3.   We believe that reverse T3 is induced with stress. Being sick and hospitalized is a great way to induce stress.

The best explanation of the “big picture” would be as follows.   The older you are, the less you can deal with stress. Your mechanisms for adjusting to it are less robust than when you are younger. (Surprised?) If you are sick, you want to have energy available for immune function and repair, so it would be helpful to shift fuel from metabolism to immune function. Reverse T3 would help do that. Makes perfect sense when you are doing things like hibernating, or dealing with infections. But it becomes counterproductive when your body is tasked with a new sort of stress like heart attacks. Then, you just spiral down into a gyre of self-reinforcing trouble. You can’t even make TSH to stimulate your thyroid any more. Without that basic hormone to sustain life, you spiral into death.

The authors of this study warn that this does not prove that treatment prolongs life. We just see an interesting association.   But what would you do?

WWW. What will work for me.   I’m really interested in this. I believe the Free T3 should be monitored in all of us and we should aim to keep it in an optimal range. That may be even more important for us as we age.   That optimal range may be a little higher than we thought. The lower half of our “normal range” may still have higher mortality.   Is treating it helpful? The jury is still out on that one.

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Pop Quiz

  1. Elderly folks with low free T3 have a much higher mortality than those with normal free T3.   T or F

Yup. In a nutshell

  1. Treatment with T3 will reverse that, T or F

Nope. Not proven at all, but intriguing and maybe.

  1. TSH, thyroid stimulating hormone, also can predict mortality. T or F

True – but in contradictory pattern – backwards

  1. Reverse T3 is induced by stress. T or F


  1. Understanding reverse T3 and free T3 might be useful

Seems to be a good argument for that.

Cholesterol Explained – A Unified Theory – 18 Wheelers and You

Cholesterol Explained – A Unified Theory

Reference:   The Art and Science of Low Carb Living by Volek and Phinney

You don’t understand how cholesterol works. It seems so complicated. Your doctor has so many urgent, compelling reasons why you should take statins, but you don’t feel bad and you don’t get any information about how to fix it on your own. Here is that fix. I want you to understand it in just 250 words.

One key, indisputable principle. Your body can only store 1,500 calories as carbs. After that, you make fat with extra carbs. Now, presume that your carb storage tank is full – all 1,500 calories. You eat another bowl of pasta, or rice or potatoes. Now what happens? Your blood glucose goes up. You make insulin in response to the higher blood glucose. You have to start making fat. You do that to a large part in your liver. That’s the factory. Your turn on that factory by making insulin that rises in response to those extra carbs you ate that filled your tank over the top. But your liver is in your stomach and your fat tissue is ….where___________(fill in the blank).   How do you get from the liver to the fat tissue? You have to transport the fat in your blood system. Your blood is largely made up of water.   Does fat dissolve in water? NO! So, our bodies have developed an ingenious packaging system that takes a globule of fat and wraps a coat around it that makes it water-soluble. We call that globule an LDL. Onto that LDL, we add a protein called Apo-B that is essentially the docking station for the little transporter to attach to a fat cell and empty itself into a fat cell. Just like the space shuttle, we have to transport stuff from our liver to our fat cells, and we need a docking mechanism.

Now, another clear set of principles. Big fat LDLs are safe and don’t cause trouble. Little small, dense ones cause a heap of hurt. They are the ones that get into blood vessels and start making stiff arteries and filled with plaque. That happens particularly when glucose sticks to them- called glycation, and makes them act like inflammatory signals. What is the fastest, most efficient way to make a big, safe LDL? Eat bacon (or butter, or other saturated animal fat). What’s the fastest way to make a dangerous little LDL? Eat cookies, bread, cereal, pasta, rice, potatoes, donuts, bagels, sugared sodas……all the isles in the grocery store filled with packaged food. You want big, fluffy LDLs.

So, here is my simple analogy. Your LDL is really just a delivery truck, an 18 wheeler, bringing its manufactured product (fat) from the liver where it was made (the factory) to your fat cell where it is stored (the warehouse). Your blood is the free way system.

HDLs, the good cholesterol, is the stuff that is supposedly safer for you. Do you know the fastest way to raise your HDLs and keep them up?   Bacon and saturated animal fat. And a diet with less than 20 grams of carbs in it. By one year, a person on that diet will have an HDL of 100 and a total cholesterol/HDL ratio of about 2.0 – making them ridiculously safe and unable to make a heart attack.   What’s the analogy for HDLs? They are empty 18 wheelers, waiting for you to eat some carbs so they can fill up and turn back into LDLs. But when you are on a high fat, low carb diet, you don’t have anything to transport so the 18 wheelers just hang out, parked, with nothing to do.

WWW. What will work for me. Buy Eric Westmans book. But summarize the analogy again.   Understanding cholesterol is simple. If you have high LDLs, it is simply a marker that you are overwhelming your bodies ability to process and digest carbs. Same message if your HDLs are low. If you want to change that, stop eating carbs and start eating saturated fat from animals. This is exactly opposite, diametrically opposite, completely and utterly opposite to the teaching of the American Heart Association and the American Diabetes Association. And they have had 50 years to get it right, and continue to be diametrically, astoundingly, utterly wrong. That’s why you have failed, and they have failed. Our health authorities keep telling your to eat with carbohydrates.   We didn’t evolve eating carbs. We discovered them only 5,000 years ago with the advent of agriculture.   Prior to that, we had carbs only at the end of the growing season, just before the starvation season (winter in Asia, dry season in Africa).   Carbs are your internal bodily signal that starvation is coming, you better eat up, gain weight and get ready for winter.


Pop Quiz

  1. The fastest way to make big, safe LDLs is to eat what kind of food?

Saturated animal fat – bacon and butter – while eating NO carbs.

  1. The fastest way to raise your good cholesterol, your HDL, is how?

Eat bacon and butter – while eating NO carbs..

  1. The fastest way to make deadly, dangerous small LDLs is to eat?

Bread, donuts, cake, potatoes, rice – easily digested carbs

  1. So, LDLs sensibly represent your body’s equivalent of 18 wheelers delivering fat from the factory to the warehouse (liver to fat cell). T or F

Yup. That simple

  1. And your HDLs are simply the equivalent of empty 18 wheelers with nothing to do, sitting around on empty parking lots. Indicating you must have not eating any carbs for months (must be January in hunter gatherer season)! T or F

Yup again

  1. Knowing all this, it makes perfect sense for you to take a statin to lower your cholesterol? T or F

Are you insane. You can fix it completely if you want. Get your cholesterol checked at AnyLabTestNow. Go on the Atkins Diet. Go back in two weeks and do it again. Prove it to yourself.   Don’t pay any attention to anyone who tells you otherwise. They are all in the pocket of big pharma that wants to sell you junk and big medicine that is perfectly happy to keep you sick.

Cleveland Clinic Leads American Health Care the Right Way

Cleveland Clinic Leads America Again – Adds Functional Medicine Clinic

Reference:   Cleveland Plain Dealer Sept 22, 2014

The Cleveland Clinic has been one of the most admired clinics in America. It was the birthplace of open heart surgery and for many years has been one of if not the premier destination for open heart surgery for international clients. But it has also always fostered a climate of innovation and creativity.

For example, Dr Roizen has been intimately involved in the Wellness Institute at the Cleveland Clinic. He was the best selling author of many wellness books but the most well known is probably You, The Owner’s Manual. (At least that’s the one I have). With that, the climate was created for Dr Esselstyn to start innovation. With his diet, he established the first study to show that coronary artery disease could be reversed!   Reversed! Imagine, a clinic that makes the most money in the country from open heart surgery nourishes and helps develop a physician who undercuts their most lucrative income source. You can come to the Cleveland Clinic and find a “Disease Reversal Program” and not only reverse coronary artery disease, but sign up for a variety of programs to help reverse other chronic disease.   Why would the Cleveland Clinic invest in technologies that undercut it’s most lucrative lines of business? Because it’s the right thing to do.

Now, the clinic has moved another step forward to make itself a leader in American health thinking. Mark Hyman is the chairman of the board of the Functional Medicine Institute. Patrick Hanaway, another blockbuster leading advocate for functional care. Dr Hanaway will be the actual “boots on the ground” medical director, as Mark Hyman will only be spending three days a month in Cleveland.

To quote the Plain Dealer: Hyman first broached the idea of functional medicine to Cosgrove a few years ago.

Hyman’s pitch to Cosgrove: “What would you say if I created a program that would cut the number of angioplasties and bypass operations in half, and cut hospital admissions in half?”

To Hyman’s surprise, Cosgrove was receptive to the idea. In turn, Cosgrove reached out to Hyman with an offer to join the Clinic and help launch a center for functional medicine.

“You probably don’t want me there,” was Hyman’s initial reluctant response. After all, functional medicine is a paradigm that challenges the traditional practice of medicine, he said.

“Instead of where the symptom is in the body, we’re looking at underlying mechanisms,” Hyman said. “It’s the difference between treating the soil and treating the plant, which is what functional medicine does.”

WWW. What will work for me. This is what I want for me. I want doctors who address and help me reverse my illnesses. Don’t treat my diabetes, show me how to reverse it. Don’t push a statin on me, help me eat differently so that I don’t even need one. Don’t encourage me to have open heart surgery, show me Esselstyn’s diet.

What incredible bravery! Can you imagine this happening in Milwaukee?


Pop Quiz

  1. Functional Medicine focuses on how your body functions? T or F

Perfect. It’s that simple

  1. More than 70% of what’s wrong with you comes from your lifestyle: what you eat, your stress, your sleep, your hormones, your exercise – NOT your genes. T or F

True as it can be

  1. The reason we get fat is because our health institutions have had it wrong and teach us to eat the wrong food, and we haven’t been brave enough to name it. T or F


  1. The Health Care Emperor has no clothes.

About time someone named it. Thank you Cleveland Clinic

  1. American Health Care is decidedly not the best in the world anymore. T or F


Reversal of Cognitive Decline – A Path for Alzheimer’s Care?

Reversal of Cognitive Decline – A Path for Alzheimer’s Care?

Reference: Breseden Aging Sept 2014

Can you imagine, reversal of cognitive decline? This might be a huge leap forward in this scourge called Alzheimer’s. To date, we really don’t have one treatment that has worked well. Now, Dr Breseden presents three patients (tiny study) in detail of 10 that he treated in which a 36 point integrated treatment plan was used to halt the progression of the decline, and indeed, to reverse it.   Nine of the ten showed improvement by either subjective or objective measures.

It included “comprehensive changes in diet, brain stimulation, exercise, optimization of sleep, specific pharmaceuticals and vitamins, and multiple additional steps that affect brain chemistry.” Dr Breseden in his paper posits that “Based on a combination of in vitro and in vivo studies, we have advanced a model in which AD results from an imbalance in endogenous plasticity signaling and in which the β-amyloid precursor protein (APP) is a mediator of such plasticity-related signaling.” Did you get that? Don’t worry, just read the list below and start.

Ok, ok….so what’s the program? Actually, it is individualized to each patient based on lab values and what it takes to reverse those abnormal values.   Here’s the short version from one patient in the paper.

1) eliminate all simple carbohydrates – no sugar, grains, white bread, donuts…

(2) eliminate gluten and processed food from diet, with increased vegetables, fruits, and non-farmed fish;

(3) to reduce stress, begin yoga or meditation

(4) Take melatonin each night;

(5) Increase sleep from 4-5 hours per night to 7-8 hours per night;

(6) Take methylcobalamin each day; (enough to get at least over 500)

(7) Take vitamin D3 each day; (4000)

(8) fish oil each day;

(9) CoQ10 each day;

(10) Optimized oral hygiene with flossing and electric toothbrush;

(11) Hormone replacement therapy

(12) 12 hours between dinner and breakfast, and a minimum of three hours between dinner and bedtime;

(13) Exercised for a minimum of 30 minutes, 4-6 days per week.

In his paper, he also includes a table with many other strategies that include curcumin as a supplement, NAC, blueberries, mixed tocopherols, CoQ10, pantothenic acid (B6), lead and mercury reduction, and MCT oil supplementation.

Wow! This is what we do in functional medicine. This is affirmation that the simplistic approach of giving a pill for an ill doesn’t work, but a comprehensive program that attacks all the weak points of our metabolism brought about, in part, as unintended consequences of 21st century life will work.

WWW. What will work for me? I’m using this in my practice. I’m actually thrilled. I’ve been doing many of these for my customers. Now, how about for me.? The hardest first step is that daily 12 hour fast which means no snacks after 630 pm. But that, by itself, is a potent enhancer of growth hormone and helps insulin sensitivity kick in.   If I can just remember all 36! Thank goodness I can read the paper, again and again. But I’m more determined to get my 30 minutes every day too.

Pop Quiz

  1. A woman now has a greater risk of Alzheimer’s than breast cancer. T or F

True (Not in the paper so that’s cheating), but still true

  1. As many as 50% of us will have it if we live to 85. T or F


  1. A 36 point lifestyle change can reverse cognitive decline? T or F

That’s this paper in a nutshell

  1. Key to success is the control of insulin and glucose? T or F


  1. Key to Success is daily exercise? T or F

Sad but true.