Monthly Archives: August 2019

Fasting: Part 1: Why?

References: Fuhrman: Fasting and Eating for HealthShelton: Fine Art of FastingCurr Opin Onco., Longo, , HVMN,

If I told you to not eat a thing for a week or two, would you think I was nuts? Would you feel afraid and say, “I can’t do that!”. Those were my thoughts. I write this column for me to learn and to share with you. Prepare for a mind-bending trip of discovery. This idea works. I want to do a deep dive and learn it.

Joel Fuhrman is one of America’s most respected functional medicine doctors. He is widely read with his many books and has a very active research and clinical practice. With that in mind, did you know that he was a world-caliber ice skater? In that career, he had a “career-ending injury” and had an orthopedic surgeon give up on him, telling him he would never skate again. He refused to take part in a program of experimental, unproven surgery opting instead to follow Dr. Shelton’s idea of fasting. He embarked on a 40 day fast, got better, came in 3rd in the World’s Men’s figure skating. Not bad for fasting. That intrigued him so much, he went to medical school. He found medical school all about giving drugs, not healing. Fasting? You kidding? So, what goes on in fasting? 
We’ve learned from Longo in prior columns that your body turns on two sets of genes when you reduce calories: RAS and PKA. You can call them your vacuum cleaner and your stem cell engine if you want to understand their function. It’s primarily glucose and protein that cause trouble, in part because they turn on insulin.

Aha! Turning off insulin. How do you do that? In essence, you have to stop stimulating its production. You have to stop eating glucose and protein sources. Longo does that by cleverly making an 800 calorie diet based on nuts and green vegetables. That is an 80-90% fat diet when you consider that green vegetables get converted into fat (beta-hydroxybutyrate is the short-chain fatty acid made by the bacteria in your colon when you eat green, leafy vegetables.) You can get beta-hydroxybutyrate (BHB) from eating greens or coconut oil, or by burning your own fat. How much fat have you got to burn? Well, most of us are at least 20% fat if we are slender and up to 50% fat if we aren’t. Take me at 210 pounds: 20% is equal to 40 pounds of fat. Forty pounds at 3500 calories per pound is 140,000 calories. At 1800 calories a day in fasting mode, that’s 77 days worth of calories. 
But why the fast need? Ah! Here’s the rub. Most of our modern diseases are caused by the immune response to our food. 70% of our immune system is around our gut. Our immune system has to spend most of its energy policing what we eat and the effect it has on us. Our gut interface is the primary boundary between us and the outside world. When we eat food that sets off our immune system, we make immune responses that are often dysfunctional, attacking us. We call those diseases “auto-immune”. When we fast, we first of all remove the foreign proteins that are setting off the immune response. But more importantly, we give our system a chance to turn on your “vacuum cleaner”. Our system has to clean up old, unused stuff, and knock off dysfunctional, sulking, bad-assed immune cells that are causing trouble. That’s effectively what you do when you fast. 
Let’s just summarize that and then move on to other topics like exactly what can fasting do for you. When you fast, you switch off the engine of foreign proteins that drive your immune system to distraction with an overload of wicked things. You switch your metabolism from running on glucose to running on your own BHB (the ketone beta-hydroxybutyrate). Your brain can’t run on fat, but it can run on BHB so you don’t have to have carbs or glucose for your brain to function just fine. Fasting can give you a giant reset button to push. 
At the 30,000 foot level, you turn on the conversation between your nucleus and your mitochondria when you fast. Exercise does that too. And growth hormone naturally does that. Being young is nice because you made growth hormone for free then. Over 40 and you simply aren’t making it any more growth hormone that isn’t suppressed by somatostatin. But this column is about fasting. Yes indeed, you are waking up the vibrant conversation between your nucleus and your mitochondria to get into shape when you fast.

It’s not starving. It’s fasting. Yes, you lose weight. Yes, you reduce calories. Yes, you feel hungry for the first two days. But then you have a period of time in which your body heals, resets, rejuvenates. Next week, just what!

WWW: What will work for me. I’ve been doing the fast mimicking diet for 18 months now. Every month I go 5 days at 800 calories. I am used to it now and confident that I switch into ketosis in 48 hours. I measure my BHB and can prove it. I also am confident that it only takes a tiny dose of glucose or protein to subvert that. I’m curious about what else is possible. I’ve ordered Shelton’s book and am going to read that too.

Pop Quiz

  1.  An average skinny person can fast for how many days before they use up all their fat stores? Answer: Probably at least 40
  2. What good things happen when you fast? Answer: You turn on your internal stem cell engine, your internal vacuum cleaner and you fit into your old jeans. Your immune system has the time and energy to fight the right fight instead of being distracted by all that stupid food you eat.
  3. Do you feel hungry when you fast? Answer: Well, yes, for the first day or two but then you slip into ketosis and run on your internal fat stores, which your body loves to do.
  4. Most of our modern diseases are caused by? Answer: the wrong foods we so cheerfully eat.
  5. What single thing can I learn from this column? Answer: start by eating more vegetables every day. Cut one serving of meat and one serving of bread in exchange for a real food grown in real soil.

Leaky gut and LDL-Particle Number

References: PLOS OneWikipediaInfection and ImmunityScience DirectJr of Immunology,

Feel tired and run down? No energy? Ever thought of where that might be coming from? Might you have lipopolysaccharides circulating in your body because you have leaky gut? Does that sound like gobble-di-gook? You suspected it could be your thyroid? I’ve been going down the mold rabbit hole. But there are other causes of fatigue. One of the main causes is explained by one of the main “triads” in your body’s function: the brain-gut-immune triad. And it is inflammation. Here is how it works.

Most of your immune system is around your gut. Some 70% of it is there, as that is the main interface between you and the outside world. Most alien stuff gets into you through your gut by what you eat. Your gut lining is only one cell thick so if the tight junction of your gut is loosened, you allow large particles with foreign antigens in them to leak into your blood. If your gut is leaky, your immune system gets stimulated. Now, the kicker. Half your brain cells are immune responsive and react to the inflammatory messages put forth by your immune system. The triad.

This is where lipopolysaccharides (LPS) come in. LPS is part of the coating of many bacteria and certainly something your immune system gets all in a bother about. You have to get rid of it. Well, you do. You clear it from your blood via your LDL particles. Your LDL particles are essentially taxis carrying the fat you have manufactured in your liver to your fat cells and muscles. But they also function as Uber’s carrying LPS particles back to your liver which is your central laundry. Your liver cells can process and detoxify the LPS particles. You have to get your LPS particles out of circulation where they are setting off all sorts of fire alarms. That’s what LDLs do.

Now, if you are septic (the number one cause of death in American hospitals) you certainly have a lot of circulating LPS particles. But just everyday run of the mill living with “leaky gut” and you have some LPS in you, messing with you. Your HDL particles suck it up and bind it. They transfer it to other white cells, notably your LDLs. The more LPS you have, the more LDL particles you have to make.

So, did you get that slight slip of the tongue? Your cholesterol count goes up, not because you didn’t take a statin, but because you had leaky gut. The more LPS particles you have the more LDL particles you need to carry them. LDLs get smaller and more dangerous. On your LDL particle count, the more small dense particles you have, the worse your heart disease not from the cholesterol effect but really from the lipopolysaccharides.

Ok, you mean my cholesterol may be more dangerous because I have leaky gut? Yup, because it, leaky gut, releases more LPS which then changes your big fluffy, harmless LDLs into small dense, dangerous ones, all with the same total cholesterol. This is why total cholesterol is a simplistic, incomplete picture because the same total can be associated with large, safe LDLs or small, dense LDLs that aren’t safe at all.

How did I get leaky gut? Taking ibuprofen (or any NSAID), too much sugar, too much alcohol, lack of Vitamin D or A, lack of zinc, stress, chronic disease of any kind are all on the common list.

How do you fix leaky gut? First and foremost, stop the above, and throw in wheat. Gluten stimulates zonulin which unzips your gut. Then, feed your gut the food it wants to be healthy. Most importantly, prebiotics and fiber. Aim for 25 grams a day. Glutamine, zinc, inulin, omega fats, fiber, fiber, bifer. Measure your particle number of LDLs, not your total. Measure your zonulin, your LPS, your, CRP. There is a whole raft of newer labs that allow you to see your progress.

WWW: What will work for me. Well, this sounds gross but let’s get down and dirty. Start thinking of your stool as a precious commodity. When your gut is happy and not “leaky”, your LPS goes down, your particle count goes down, your LDLs get bigger and safer. You can tell if your gut is happy with a very simple test. Do you have soft, easily passed bowel movements daily? If you are consitpated, you aren’t getting enough fiber. Make your breakfast cereal from the following: a cut of berries with a cup of almond milk. Add 1-2 T of chia seeds and 1-2 T of freshly ground flax seed. Every week add another T of freshly ground flax. Within twoo-three weeks you will have a happy gut. And a happier LDL particle count. And a happier brain.

Pop Quiz

  1. What is LPS? Answer: Lipopolysaccharide – the coating of many dangerous bacteria which our immune system responds to. Too much of it causes septic shock and collapse. Just a little makes you feel like you do when you feel “crummy”.
  2. How does LPS get into you? Answer: It’s there in your gut all the time but can’t penetrate past your single-cell layer lining, until you damage the lining by eating NSAIDs of all kinds. Motrin is the biggest offender but they are all wicked. Antibiotics, steroids, acid blockers, chemotherapy all do it too. Wheat and milk do it to a variable degree in folks. (Note: read the Canadian GI Societywhich says there is no such thing as leaky gut. They see the world through the eyes of diseases, not function. In time we’ll convert them.)
  3. What does LPS do inside you? Answer: your immune system goes nuts. We call it septic shock and collapse if there is enough. But a small amount makes you feel crummy. Sets off all your internal fire alarms.)
  4. How do you get rid of LPS? Answer: You have to carry it back go your body’s central clearinghouse, your liver.
  5. And to do all that, what happens to your particle number? Answer: It goes up. (I’m looking for stronger research on this. Many functional medicine doctors swear it happens and the see it “all the time” but the published literature is thin. It’s the new frontier and I intend to see if I can prove it. Let me test you and show you.). In the meantime, don’t ruin the test by starting to eat more fiber. You’ll get fixed before I can test you. (Kidding: eat more fiber.)

Peptide Primer: LL-37, Super Antibiotic You Make on Your Own

References: WikipediaScience DirectCritical CareFront ImmunolFuture Microbiol., ScienceCell PhysJr Biomed SciDermatoendocrinology,

Did you know you make an antibiotic called Cathelicidin? Yup! It’s a peptide otherwise known as LL-37. It makes a circular pore that basically binds to the cell wall of bacteria and then makes all their guts leak out. You don’t make it until your Vitamin D level is 32. Now, in Wisconsin, our D levels get to around 20 in the winter if you are Caucasian and less if you have any pigment in your skin. In summer, Wisconsin Caucasians get to 45 and make Vitamin D in response to sunlight. More skin pigment, less Vitamin D production (but better folate protection). Consequence: we get more flu and colds in winter because of less Vitamin D, resulting in lower cathelicidin. We used to treat tuberculosis by sending folks off to the mountains where they got fresh mountain air and sat in the sun. (So, they were actually getting more UVB radiation at high altitude, making more Vitamin D – raising their cathelicidin levels: LL-37) 
Ok, so you tell me what you think would happen with patients in an ICU with sepsis, systemic infection in their blood when you study Vitamin D and cathelicidin levels. You got it. In 121 ICU patients, those with the top third of Vitamin D levels had 4.5 times LESS mortality than those in the bottom third, which also correlated with their LL-37 levels. Know any antibiotic that works that well? Hmmm. How about looking at over 10,000 patients starting dialysis and examining mortality from infection over the next year. Again, the lowest third of Vitamin D and LL-37 have double the mortality from infection. 
Let’s expand our view of our immune system and look at cancer. What role does LL-37 play here? Once again, we find that Vitamin D turns on cathelicidin/LL-37 and that kills cancer cells. The mechanism in cancer doesn’t appear to be quite as simple as in bacteria where LL-37 just punctures a hole in the wall. In cancer, LL-37 binds to the surface of the cancer cell and mucks up its reproduction. But it works, on almost every kind of cancer.

Any human studies with LL-37 given in sepsis? Not that I can find. Lot’s of mice and rat studies, where it shows it helps. But we are getting a little far off the reservation when we jump to humans.

The theory is good. The toxicity is low. The activity is there. Would you do it?

WWW: What will work for me. This is the dilemma we are in. We can now purchase these powerful chemicals on the gray market. Not super cheap but not unattainable. The ability to manufacture them allows a new frontier of medical exploration. Am I ready for using it? Not really sure until you get into the right circumstance. If all else is failing, would you add this to your armamentarium? What I would do is make dead certain my Vitamin D level is sufficient. We are now nearing fall when the angle of the sun becomes such that we don’t make enough Vitamin D. 100,000 a month, 20,000 a week, 5,000 a day are doses that work. Do one of them.

Pop Quiz

  1. LL-37 is what? Answer: a peptide we mammals make that kills bacteria and viruses.
  2. How does it do it? Answer: It burrows into the cell wall of the bacteria and all their contents leak out.
  3. What Vitamin induces you to make your own LL-37? Answer: Vitamin D
  4. What blood level do you need to have to make your own LL-37/cathelicidin? Answer: 32
  5. Do we get more cancer in winter than in summer? (Just like more flu). Answer: Yup!