Category Archives: 24.Basic Physiology

Are You a Food Addict? Take the Susceptibity Test

FReferences: Bright Line EatingSusan P Thompson’s Susceptibility ScaleValidation of Yale Food Addiction Score in ChildrenPhilos Trans R SocWheat FactsCornAm J Physiology56 names of sugar,

There is a growing science of measuring addiction susceptibility in humans. Criteria for being an addict include developing tolerance to a substance, withdrawal when use is stopped, needing larger and larger doses, persistent desire coupled with the inability to stop using, spending increased time to access the substance, continuing use of the substance even though you know it causes harm and giving up social or recreational activities to use the substance. Sounds dour and threatening, doesn’t it? Could this be chocolate? Or just plain sugar? 
The body of research supporting human food addiction is actually getting more robust as we look at our obesity epidemic and ponder what is driving it. Animal models of addictive eating show that rats given access to sugar or highly processed foods exhibit the classic behavioral and biological signs of addiction (e.g., withdrawal, tolerance, dopaminergic downgrading). Hmmm… For example, get rats addicted to cocaine, then expose them to a choice of cocaine or sugar, and they go for the sugar instead of the cocaine. Hmmm….. 
More to the point, functional MRI scanning of active circuits in the human brain show pretty remarkable overlap between sugar, white flour, and heroin. 
And processed food appears to be at the forefront of this addictive behavior. What’s in processed food? 80% of American food has sugar or high fructose corn syrup added to it. Often it is given a different name hoping you are willing to let dehydrated cane juice, agave, or honey trick you into thinking it’s not sugar. Some foods even boast that they have no, underline NO high fructose corn syrup, and then have pure beet sugar instead. The difference between the two is subtle, at best.

What is processing? It’s actually very simple. Take a whole grain with the surface area of the grain, and grind it into talcum powder. We call that flour – whether it be from wheat, or corn, or rye, it’s still talcum powder. 10-100 fold increase in surface area, with the encasing protective fiber also gone. When you eat it, your enzymes can get to that greater surface area faster. A whole grain will have a glycemic index below 30% of pure glucose. A grain that has been broken in half, like steel cut oats, will have a glycemic index of 50% of glucose. Just cracking the grain in half increases the ability of your enzymes to access the glucose packed in that grain. But crush the grain flat and call it “Quick Oats” and you increase the surface area enough to increase the glycemic index to 70-80, depending on how finely you crush it. You put out insulin in an increasingly rapid fashion in response to the rapid glucose rise. Insulin blocks leptin in your brain stem, making you want to eat more. And there you have it. Any grain will do the same. Corn is just about the foundationof everything we eat because of its use in animal feed.

But wheat occupies a special place in addiction. Not only is it made into talcum powder but that talcum powder is put into about every package or processed food, be it pasta, gravy, bread, crackers, cookies, or any other form that leads to the 6 oz of wheat flourwe each eat every day. And wheat has wheat germ agglutinin (WGA) in it and that is a special devil. It is an insulin agonist/antagonist, leading to more insulin binding to fat cells, less to muscle cells and more leptin blocking, all of which engineer weight gain and more addictive consumption.

With all that hitting you when you eat processed foods, is it any wonder that you act like an addict? It’s almost amazing we all aren’t.

Do you want to take Susan Thompson’s quiz? This is the link. I’m not sure it’s the final word in understanding why we overeat, but it sure gives you some insight into why we all have so much trouble losing weight. She claims that about a third of us are not affected by addictive tendencies, about a third are modestly affected, and a third are rabidly vulnerable. That would be me. All of us can act with addictive tendencies, given constant exposure and reinforcement.

WWW: What will work for me. I took her quiz and scored an eight. Ha! That explains just why it is so easy for me to start with 8 chocolate chips, then return for 45 more, then finish off the bag. And that done only when there are no human witnesses. The dog, fortunately, doesn’t tell. And I know I won’t sleep well when I do it. And I’m fully aware it’s awful for me. But, but, but……

Pop Quiz

  1. What percent of humans are vulnerable to food addiction? Answer: All of us, given enough exposure though only about a third show a particular penchant for it.
  2. What are some of the features of addictive behavior? Answer: developing tolerance to a substance, withdrawal when use is stopped, needing larger and larger doses, persistent desire coupled with the inability to stop using, spending increased time to access the substance, continuing use of the substance even though you know it causes harm and giving up social or recreational activities to use the substance.
  3. What is the link with flour products to addiction? Answer: the more a grain is ground up, that easier it is to digest, and the faster blood sugar goes up. That results in greater insulin release, resulting in more leptin blockade and fat storage
  4. Explain to me what WGA is? Answer. Wheat germ agglutinin is a small protein in wheat germ that messes with your insulin receptors, pushing calories into fat but starving muscles. This results in disordered glucose management, and makes for your gaining weight and developing diabetes.
  5. Dehydrated cane juice is safe to use as it is a dryer form of sugar. T or F Answer: Please, please, please tell me that you didn’t fall for that. There are over 56 names for sugar. If you answered yes, click this link and learn the other names.

ChronoNutrition – What you eat is as important as WHEN you eat it!

References: The Big Breakfast StudyCenter for Health ResearchWhat to Eat When by Roizen , FASEBInt Jr Obesity,

It’s the first of the year. You have resolved to do a little better this year and lose weight. Humpf! Good luck! Nice try! You’ve done this before. Well, here is another piece of science to put in your pipe and think about. Michael Roizen, chief wellness officer for the Cleveland Clinic and Dr Oz show advisor and frequent guest has a book to help you while you are at it. Just published this week. 
Here’s the skinny you want to know. First, basic physiology of how you work. At 7 in the morning your cortisol surges by about 7-10 fold from a level of 2 at 4 in the morning to a level of 18-20 at 8. Cortisol helps you mobilize energy and makes your brain feel alert and awake. It’s your natural wake up, git up and git hormone. You can get stuff done when you have cortisol surging. If you don’t have it, you can’t. Under circumstances of high stress, you can stimulate yourself to put out more cortisol. Sweaty exercise stimulates you to put out more cortisol. Hot saunas alternating with freezing showers does the same. Cortisol last 5-6 hours and with a great sauna or a good run, you feel pumped up, alert and alive for the next 4-6 hours.

In the evening, your cortisol falls off, your melatonin starts to rise as it gets dark. Your body temperature falls off. Your immune response weakens and allows your fever to rise. You are slowing down and cooling off. You can’t burn energy as easily. The only thing that feels good is lots of extra carbohydrates as that raises your blood glucose, and also turns on fat production. (Just look at night shift workers. The easiest way to deal with night shift is to eat all night. Doing that gets you through the night, but at the cost of storing half the calories as fat.) 
What did nature design us to do? For most of human history, we didn’t have light bulbs and electricity, much less ipads, TVs, computers or even books and magazines. We ate when the sun was up and went to bed when it got dark to stay warm. 
Now, all of this biological clock stuff is managed by this tiny little 20,000 cell area of the brain called the suprachiasmatic nucleus that mediates more than just your cortisol. It also impacts your sensitivity to insulin, which rises and falls with the day as well. You are naturally more sensitive to insulin in the morning and some fat cells show 50% difference in insulin sensitivity between noon and 8 pm. 
The exact same pattern has been shown with experimental mice. Given carbs during their normal inactive time, they get fat and eat more (just like humans on night shift). What you eat, when really matters. In fact, it might be argued that it’s the whole ball game. We are pretty certain you can lose weight when you compress your calories down to under 10 hours a day. That’s true. And we are pretty sure you need to get away from sugar. That’s true. And we are pretty sure that vegetables are, in fact, a back door ketosis food (just ask the gorillas) because your gut bacteria turns the cell walls of green veges into beta-hydroxybutyrate.

So now, think about timing your eating and what you eat when. Read Roizen’s book and think about training yourself for a hearty breakfast, during sunlight hours and a smaller dinner.

WWW: What will work for me. Well, I’m gradually prying myself off any eating after 6 pm. I know it’s dark at 5 now but I don’t get home till then anyway. I’m pretty good with the sugar and the vegetables. I’m having bigger spinach breakfasts of late. Hope I can stick with that. I want to see if other folks can make Roisin’s ideas work for them. I think there is truth to it.

Pop Quiz

  1. Your biology runs on a clock driven by….what? Answer: Light affecting your brain.
  2. What part of your brain registers that? Answer: Ok, this is an honors answer – the suprachiasmatic nucleus with it’s teeny little 20,000 cells.
  3. What hormone surges the most at 7 am? Answer: That would be cortisol.
  4. What hormone has its sensitivity altered throughout the day, with a peak at noon and a 50% drop by 8 pm? Answer: Insulin
  5. Is chononutrition easy to understand? Answer: Not yet. It’s a new idea that needs to settle in with more research. But what promise it has!

Cancer Free? Get the “Ivy Gene” Test

Cancer Free? Get the “Ivy Gene” Test

References: Jenny Hrbacek’s Cancer FreeProceed Natl Acad Sci USA,

This might be the best test of them all, so please concentrate on this week’s cancer test: The IvyGene. The science if a bit dense, but not incomprehensible. The core function that is being measured is the patterns of signaling placed on DNA in cells. Your body attaches a carbon atom, with three hydrogens on it, called a methyl group, to DNA as a marker for something to happen. The proteins that read your DNA are designed to be able to interpret what those little nubbins of carbon and hydrogen mean when they are present, or absent.

Here is the rub. Cancer cells have a reliable pattern of methylation that differs from regular cells. If we have a sample of cancer cells in a blood test, we can measure their DNA and now find that those patterns are present, or absent, as the case may be to indicate either cancer is there, or no. And we can do that all years and years before the cancer is large enough to be detected on a CT scan or a physical exam.
Remember, go back to cancer physiology. A cancer colony that you can feel or see is often 1 cm in size, which is a billion cells. And a billion cells represents 30 doublings or generations of cancer. We want to catch those little buggers when they are at the 10 generation stage, not the 29 generation stage. And that’s what the IvyGene test does.

How accurate is it? The sensitivity is said to be 86% and the specificity is 88%. This is amazing for a medical test that is now allowing us a sneak peek years before our current testing methods.

What does it cost? Well, it has been $ 400 in the past but depending on where you get it drawn, the draw and shipping fee can add a bit to that. It has to be ordered by a physician, but to date insurance doesn’t pay for it. It should
www.What will work for me. I think this is the best test with the best science for managing the success of therapy. It has only been scientifically validated for colon, breast, liver and lung but others are on the list to become validated, so it’s worth asking about. I’ve got it in my office.

Pop Quiz:

  1. How does the IVYGENE test work?                                                  Answer: It measures unique to cancer methylation patterns on DNA.
  2. What on earth is methylation?                                                         Answer: How DNA is marked so that cells know how and when to copy genes. Cancer cells do dysfunctional growth which is visible on the methylation pattern seen on their DNA. Nifty. Gets right to the heart of the problem with cancer.
  3. How early can it be positive?                                                             Answer: We believe as much as 7 years before clinically visible cancer shows up
  4. Why is it useful?                                                                                   Answer: Two reasons. It rises and falls as a cancer grows or recedes, and it tells you if the cancer is even there. With that information you can make decisions about whether you think your therapy decisions are working or not.
  5. The IVG Gene is widely available? T or F                                         Answer: Well, you can get it anywhere you can find a doctor to order it for you. The traditional oncology system hasn’t used it widely yet.



Cancer Free? Check Your Circulating Tumor Cells

Cancer Free? Check Your Circulating Tumor Cells

References: Jenny Hrbacek Cancer FreeWikipediaTherapeutic Adv Med Onco,

Circulating tumor cells are not rare. Hang on. You may have them. Right now. Yup, everyone one of us may have circulating tumor cells that are being shed off a cancer. Your immune system may handle them and you may never get disease. Or, they may represent hidden disease that is still years away from presentation.
What they represent is that shedding and spreading of an original clone of cancer cells to distant places. The thought is that metasteses are what kill the majority of people with cancer by causing the disease to spread to so many sites that surgical control, or radiation therapy, can no longer keep up. When you hit about 1 kg of cancer total, your burden is so great your body cannot maintain itself and you succumb to the illness.
From our prior week’s newsletters, you should now understand that a visible 1 cm cancer lesion has a billion cells in it, which represent about 7-10 years worth of growth, or 30 generations of doubling. As the cancer grows, it sheds cells into the lymph system, or into the blood system and those cells float away. Generally, they don’t stick and survive. Most are filtered out and are gobbled up by your immune system. We think that the majority of them are able to successfully spread only when they travel in bunches or groups. But there they are, and that’s what will do you in. Your lung, your liver, your bones and occasionally your brain tend to be where the cells are captured and then establish a new colony. Cancers in the bowel tend to then spread to the liver, as that is the next upstream filter. Breast can go almost anywhere. Prostate is commonly in bone. On and on.

Hmmm. So, you may have circulating cancer cells floating around from a cancer that is only 13 generations into its growth, so is so tiny you can’t see it. You can’t feel it. You can’t find it to biopsy it. But with antibody technology, you can find it, bind it, measure it and know it is there. Just not exactly where. We can even find fragments of circulating DNA (ctDNA) from destroyed cancer cells that indicate something amiss; either the cancer cells dying and disintegrating from your immune attack. And all 5-7 years before it shows up clinically. At that stage, the cancer is likely to be more mature than a cancer at the 23 generation stage. Or more mature than the 27th generation stage, when it is still too small to be seen but is now even less mature and more aggressive and out of control. Earlier generations are more prone to be vulnerable to lifestyle changes: diet, supplements like curcumin, mushrooms, alkalinity, polyphenols.
And here is the kicker. What happens if you change your diet and exercise and after three months, your CTCs go down? Would you continue to eat the way you are eating with lots of vegetables and no animal protein? Would your fast mimicking diet not seem so onerous? You betcha.
The test is from Biocept in San Diego. They can also test for some specific markers of specific cancers like HER2, ER, EGFR, BRAF, ALK, PD-L1, KRAS, NRAS, PR, AR, ROS1, RET, MET, and FGFR1. And if you understood one word of that sentence, you are way ahead of the fame. The test needs to be done at least two weeks away from any prior treatment and requires a courier service to ship it. The company claims their validated biomarkers are 83-90 percent sensitive and 92-99 percent specific. Some insurance companies pay for it, and Biocept is willing to give it a try. But you can get it for around $ 700.

WWW: What will work for me. Goodness. This is a roadmap to allow folks with disease the opportunity to monitor how they are doing. It’s a bit pricey, but the data is pretty powerful. Knowing that you may be getting a 7-10 year jumpstart is pretty cool if you want to know. Would you get chemotherapy for a specific cancer before you could even see the cancer? It raises many issues, to be discussed by you and your oncologist/doctor. I’m doing it.

Pop Quiz

  1. Most people with cancer die from the size of their primary cancer? T or F         Answer: False. Most people die from the accumulated mass and disruption caused by the original cancer spreading to distant sites by cancer cells floating around and taking root in distant places. It’s still breast cancer if it started in your breast and is now mostly in bones. And it will very likely have protein markers you can measure on it.
  2. How big does a cancer have to be to show up on a physical exam?                   Answer: Usually in the range of 1 cm, which is a billion cells, which is 30 generations.
  3. What happens to circulating cancer cells when you start a lifestyle strategy change that is successful?                                                                                                                    Answer: The CTCs (circulating cancer cells) go down. Success!
  4. Which would you rather have, surgery on your lung to biopsy a cancer ($ 25,000 and 3 days in the hospital) or a blood test ($ 700 in 5 a minute blood draw)?                    Answer: Your choice
  5. The blood test for circulating cancer cells becomes? What?                               Answer: A liquid, affordable biopsy.


Cancer Free? Check your Metabolic Profile

Cancer Free? Check your Metabolic Profile

References: Cancer Free HrbacekWikipediaCancer ResearchBr J CancerOncotargetWorld Jr Biol ChemJournal of Cancer,

When cancers start they tend to become “less mature” in an increasing fashion. It shouldn’t be surprising that cancers have immature fetal proteins in them. Humans start as immature fetuses. Your first marker of being pregnant as a woman is having HCG (human chorionic gonadotropin) in your urine. That’s the little line that shows up on the pregnancy test you bought at Walgreen’s. It logically follows that the immature cells of cancers might make HCG, a fetal protein. Indeed, some unique cancers that start in the placenta skyrocket their HCG levels, but a lot of cancers have a little bit of HCG. By itself, that little bit might merit a shrug. The core idea of the American Metabolic Profile is to combine all the markers that show up in small amounts in various cancers into a panel of tests. Each one of them is not so remarkable. However, all of them put together combine to make a uniquely sensitive test. This may not tell you what you have, but it’s quantity may be useful in expressing how much you are progressing or regressing.

Here are the separate markers in the test.
1. HCG. As mentioned, the pregnancy test. Normal is less than 1 mIU/ml. 1-3 is a gray zone. Anything above 3 is something to be concerned about and monitor. This can show up as early as 10 years before an x-ray or physical exam will find the cancer. How does it relate to pregnancy? Less than 5 is “not pregnant” and greater than 25 is “pregnant”. It doubles every couple of days in pregnancy. Cancer is a different beast. A level of 2.2 might not merit a fire alarm. When it changes to 2.6 in this profile, it does!
2. PHI, Phosphohexose isomerase. Funny little protein that helps glucose shift back and forth with fructose. No big deal. But somehow it also ends up playing a role in helping cancers spread, metastasize. That’s exactly what you want to know. Normal is under 34 and the gray zone is 34-40. But any change is meaningful.

3. CEA: Carcinoembryonic Antigen. This has been found to be present in many folks with cancer, and rises and falls with the amount of the cancer. It shows up early. It is another of those embryonic ones we mentioned. Normal is under 3 and gray is 3.1-5 ng/ml.

4. GGTP: Gamma-glutamyltranspeptidase. This enzyme is bound to membranes in the liver and reflects damage to the liver. Its action is to break down glutathione into its individual amino acids. We like glutathione. Losing it is bad. Why cancer does this might be in part because cancers don’t like glutathione. So they try to make more GGTP to get rid of it. So let’s measure it and see how much you have. It’s part of that early detection thing.

5. TSH. Thyroid stimulating hormone. Go figure! For whatever reason, many folks with cancer have high TSH because their thyroid just poops out. Again, not dramatic, but combined with the others, makes for a red flag. Could this be why some folks advocate for more iodine to lower cancer risk?

6. DHEA-S. Dehydroepiandrosterone. It’s sort of thought of as the anti-stress hormone but curiously, again, it’s oddly low in many folks with cancer. You don’t want to be low. It’s a predictor of trouble. By itself, not certain, but nevertheless, a yellow caution sign. Normal ranges are: Females 35.0 – 430.0 µg/dL, Males 80.0 – 560.0 µg/dL.
That’s the list. Not remarkable in itself with its individual test, but combined has a close to 90% predictive accuracy. Its changes with therapy are useful. It is not specific to what type of cancer, but it helps to tell if you if your diet is helping you, your supplements, your IV Vitamin C etc.

WWW: What will work for me. I’m going to get this one on myself. I’ve just ordered a bunch of tests for my office. It’s going to be on the list of tests I offer my new clients who want to get a screening test just to know. Its cost of $ 549 is a slightly sobering fact.

Pop Quiz

  1. A high TSH means you have cancer. T or F                                      Answer: Heck no. It means your thyroid is struggling and not keeping up. But combined with the other tests in this screen, it may indicate you are at some risk. Consider taking some iodine just on general principles. Go for about 1 mg a day. Sea weed in any form. (Hurray, Sushi tonight!)
  2. Taking DHEA as a supplement will help prevent cancer. T or F Answer: We don’t know that. We do know that folks with cancer almost always have a low DHEA. Taking a supplement? Well, I do and I prescribe it to virtually all my clients. Evidence of rock solid proof is thin.
  3. Which one of these is the enzyme that encourages cancers to spread?            Answer: PHI
  4. Cancers all tend to be pretty mature cells? T or F                         Answer; Oops. Backwards. Pretty immature. Which is why CEA or carcino-EMBRYONIC-antigen is an indicator of a very immature cell.
  5. The validity of this test comes from what?                                     Answer: No individual one but the combination of all of them and their mutually supporting snap shot. To be used to measure the success of your efforts to bring the wicked disease to heal.




Are You DEAD Certain You are Free of Cancer?

References: Cancer Free

You had a breast lump and your surgeon did a lumpectomy. Your oncologist gave you six months of chemo and you lost your hair. Folks from church brought over casseroles and you wore a scarf for 4 months while your hair grew back. Are you cancer free? Are you safe? You had a mass in your ovary and had a hysterectomy? You had a melanoma on your thigh and had a 2-inch margin incision. Are you safe? You had your prostate taken out. Are you safe? Your PSA is 0.05. Is that good enough? Are you safe? What’s it worth to you?
Here is the dilemma. There are huge numbers of us living with this awful uncertainty and the answer isn’t as clear as we would like. We all hear about cancers coming back. You get emails from dear friends with comments like, “They found a hot spot on my PET scan in my pelvis”. “The CT of my lung showed a mass.” My sore elbow has a hole in the bone and the doctor wants a biopsy.”
Here are some facts about how cancer behaves. First of all, visible cancer by eyeball techniques is a centimeter or so in size. That comes to about 1 billion cells. One billion is about 30 generations or 30 doublings of cells. Each generation takes about 3-6 months, so you have a 7-15 year time frame for that to have happened. You can’t “see” generation 25 and earlier. They are too little by eyeball techniques.

Most chemotherapies will kill the 90% of rapidly dividing cells of a cancer, but not the slow-growing cancer stem cells that learn from each sequence of chemo to be resistant. So, chemo doesn’t really work on most solid tumors and has the price of making you feel sick, reducing your remaining quality of life with all its side effects. You die when the total mass of cancer is about a kilogram.
Cancer cells have some vulnerabilities. First of all, all cancers have broken mitochondrial membranes as their core defect. They have lost the ordered structure of their “energy factories” with their membranes effectively looking like curdled milk instead of orderly sequenced proteins. They can only burn glucose by making lactate, and the acidic quality of lactate drives the growth of high flow blood vessels. They need acid to encourage blood flow. All this translates into needing lots of glucose, being unable to burn fat, and hating alkaline foods. (Vegetables.)
More intriguing, cancer cells hide from the immune system by coating themselves with a bunch of novel proteins that have no business being on the surface of the cancer cell. And they generate all sorts of genetic defects we are learning how to interpret. Their DNA markers on histone proteins get characteristic patterns that reflect these changes. These “methylation” defects can be identified.
Finally, cancer cells don’t hold together as healthy tissues do. They break loose and spread like Viking raiders, spreading mayhem and carnage. Now, single cells aren’t able to establish a colony but bundles of cells can. We all have a certain level of “circulating cancer cells”. Yes. All of us. All the time. (Terrifying, isn’t it?) But folks with active cancers have more. If you have 20 cells make a colony, how long will that colony have to grow before it is visible? (Answer, 26 generations or 7-13 years).

Would you like to know that? Can you imagine counting your circulating cancer cells, then changing your diet, getting more IV Vitamin C, adding IV Ozone, taking more curcumin, adding tetrathiolmolybdate, eating a pure ketogenic diet, doing some fast mimicking…….then recount your circulating cancer cells. What would you think if your CTCs went down when you did that? Would you feel encouraged?

Your nascent cancer is vulnerable to lifestyle manipulations when it is in its first 15 generations, less so in the last 15. Can you imagine a sure and steady hand to help you through that frightening thicket of fear and uncertainty?

Next three-four weeks, we are going to explore the new and emerging tools of cancer biology testing to look at tests that help you do just that. Read the next four for five weeks of blogs and learn this material. Get good at it. Show these blogs to your oncologist. Read the book Cancer Free. Celebrate your life.

WWW: What will work for me. Well, I’m a cancer survivor times two. I’ve had two types of minor skin cancer but I had a lung APUDoma (rare endocrine tumor of the lung) that surgery fixed. But I had to wait for 10 years to be sure I was cancer free and never knew for sure. I’ve lived with that uncertainty all through my forties. Not so fun. I’m doing these tests because I’m running them all on myself just for starters. Join me. Want to know if you are cancer free?

Pop Quiz

  1.  A typical 1 cm cancer has been around for how long?                     Answer : At least 7-10 years
  2. Why?                                                                                                          Answer: because a cancer you can detect on exam or x-ray ( 1 cm) is about a billion cells big, which is 2 to the 30th power, or 30 doublings. Each doubling takes 3-6 months.
  3. Chemotherapy for most solid cancers fails in what fashion and why? Answer: It appears to succeed as it shrinks the cancer to so small you can’t see it anymore. But that is only killing the rapidly dividing cells (90%) but not the stem cells which subsequently learn from the chemotherapy how to be resistant to it. 10-15 doublings, generations, later, the cancer is back, meaner and more resistant than ever.
  4. Would you do something different if you knew you had cancer still inside you? Answer: It’s your life, your choice, but lifestyle changes are more likely to be effective when the cancer colony is tiny than when it’s big.
  5. Can you think of one test you just read about that will give you a measure of your cancer, and the effectiveness of your lifestyle changes?                                    Answer; Circulating cancer cells, for one.

Vitamin D and the Risk of Cancer – “Disappoints” 

Vitamin D and the Risk of Cancer – “Disappoints” 

References: NEJMScienceAJCNPLOSVitamin D Council,

It was all over the news last week, “Vitamin D Doesn’t Help Reduce Your Risk of Cancer”. Published in the prestigious New England Journal, (lead article, no less) this smacks of credibility. It was randomized with 25,871 Americans from all over the country and intentionally designed to include 20 percent African-Americans. Folks were given 2,000 IU of Vitamin D or placebo for a median range of 5.6 years. The results were “disappointing” in that there was no statistical reduction in cancer.
What’s my take on this? Wow, there are so many flaws, I’m just stunned that this made it into the NEJM. This reflects all the classical problems of nutritional research. Let me give it a try to see if I can convince you with a reasonable argument.
First, cancer is not a 5 year disease. It is a 15-20 year disease. Here is why. A 1 cm nodule, big enough to be seen on an x-ray is about 1 billion cells. That is about 2 to the 30th power, or 30 generations, or 30 doublings. If a doubling takes 6 months, you have 15 years for that cancer to grow from one cell to its current size. The time you want to be affecting cells is at the very beginning of their life. Vitamin D’s core function is to tell immature cells to mature. A mature cell is programmed to die at the end of its “time”. Cancer cells don’t grow wildly as much as they don’t die. A five year study is way too short. And if I were to do the study, I would first do the new generation blood testing studies that can show cancer cells circulating 5-7 years before clinically apparent. We’ll talk about those next week.
The key problem with this study is then that the cancers that do show up in 5 years will already be 10 years down the road from getting started and no longer modulated by vitamin D levels. As cancers progress from generation 1 to generation 30, they add more mutations to allow them to grow with their primary genetic defect in their mitochondria. They are now autonomous and on the road to aggressive disease. Any study that looks at generation 22-30 is looking at inevitable disease. Vitamin D is going to work at generation 1-10.

Second problem. Way too low a dose. We know that you have Toll Receptor Proteins that are sensitive to Vitamin D and they are not activated until your D level is 32. Since that research study by Liu in Science came out there has been an explosion of research all linking low Vitamin D to a sluggish immune response to TB and just about everything else. You need enough Vitamin D to fight cancer, or anything else. 2,000 IU of Vitamin D will get you to a blood level of 30. Just. We’ve shown that with a study in Antarctica over winter where you get NO Vitamin D for 6 months, guaranteed. Worse, African Americans have pigment which keeps Vitamin D out. They start with levels of 5.5 ng – 15 ng, whereas Caucasians start with 20. This study didn’t get blood levels. Arrghhh. Two thousand units of D is what a healthy young Caucasian will make in 2 minutes of sun exposure in June. Get their blood level to 50, for goodness sakes! And go read Garland’s study in PLOS1, that showed a 67% reduction in cancer when your blood level gets closer to 50 than 20. This study likely had folks D levels around 25, way, way, way too low. If you look at folks who live on the Equator in Africa, the Masai and the Hadzabe, both who are very dark skinned, wear very little clothing and have abundant sunshine, you find a D level of 45-55 range. That’s what we should aim for. And by the way, they have very little cancer.
I can go on….finally. Any new dose of D takes about a year to reach a new homeostasis without a starting loading dose. This wasn’t a four-year study at a stable dose, it was a three-year study. Your body thinks of D’s “volume of distribution” of D as about 1,000 gallons, not the 20 gallons you think of yourself representing. That is because D dissolves into fat.
And D isn’t a vitamin in isolation. It is critically linked to K2. You can’t do foods in isolation. You need ecosystems……I can rant on and on. But this study doesn’t help me much. It just gets me steamed up.

WWW: What will work for me. Just out of pique, I went and took my monthly dose of 100,000 a few days early. My blood level runs around 50 ish when I take 100,000 a month. But the war on cancer is just getting wound up. I want to learn all the technology of advance warnings on cancer and show that lifestyle can reduce your risk when we catch those early cancer cells when they are still capable of being modulated.

Pop Quiz

  1. Cancer cells that you find by physical exam are usually at least 1 cm in size. How many cells does that represent?                                                                Answer: about a billion, which is 30 generations of cancer cells, which is about 7-15 years of disease.
  2. Humans have toll receptor proteins on immune cells regulated by Vitamin D. They are activated by what level of D? n                                                Answer: above 32
  3. Two thousand units of D is the equivalent of how much sunshine in a middle European young person?                                                                           Answer: 2 minutes. (Africans need 12 minutes to get the same amount. Arabs and South Asians need about 6 minutes to make that much D. Finns, Russians and Celts need less than a minute, and then they burn.
  4. A study of Vitamin D and cancer should run for how long? Answer: At least 15 years and then you are just getting started. And throw in some K2 while you are at it.
  5. It’s possible to weed out folks who might be getting cancer in the next 7 years by what?            Answer: read next week. The science of circulating cancer cells is coming soon.


The Trouble With Flavor

The Trouble with Flavor

References: Yale Food Addiction ScaleThe Dorrito EffectEur Eat Dis Review,

If I were to ask you a delicate question…bear with me…..why do you have sex? Is it procreate and have children? Or do you have this deep urge to seek intimacy with someone you really like and just have fun with them? Of course, it’s fun and satisfying and connecting. Oh yeah, and you had one kid while you were at it. Now, extend that analogy to food. Why do you eat your food? Is it to get enough Vitamin A and B1, iron, and protein? Do you sit down at the table and ask, “What calories do I need today?” Come on…… you open the fridge and say, “What looks good to me?”. Do you look at the table in front of you and reach for what looks tasty?   Yup!  that’s it.  Sex and food are both deeply primal functions that we have to have to survive. And both derive their power from the satisfaction of those drives, and the pleasure they invoke. Pleasure. With food, that’s all about flavor.
Here’s the problem. As brilliantly explained by the author Mark Schatzker in his book, The Dorrito Effect, The Surprising New Truth about Food and Flavor, it’s all about flavor. We humans evolved to have specific flavors on our tongues and in our noses that represented rare and very valuable foods. It was greatly to our advantage to stuff ourselves silly when fruit season came around so that we put on weight and stored enough calories to make it through the next lean period, whether it be dry in Africa or cold in Asia. Hence, sweet is smack dab in the middle of your tongue. Along with about 5 or 6 others on your tongue. Then there is your nose, with 50,000 different flavors and trillions of combinations.
You are hard-wired to seek some flavors. In fact, good science shows it is the anticipation that drives your behavior more than the flavor. That is all about prior exposure, memory, and emotion. It’s that interplay of emotion, happiness, pleasure, memory, all hardwired to get you to eat abundantly when you find those flavors. Guess what the food industry has found out! Yup. Exactly what those flavors, memories, feelings and vulnerabilities are. Much of the drive to discover those flavors has been the inadvertant “blanding” of food. What used to be tasty chicken is now blah tasting white meat. What used to be delicious……name almost any food and its flavor has declined with industrial farming, yield improvements, genetic manipulation and long-distance shipping, storage, and mass marketing. Getting a chicken to grow to maturity in just 6 weeks, with just 4 pounds of food, with giant breasts,,,,has resulted in a very bland chicken.
No problem! We can fix bland food by adding more flavor to it of a very specific nature…and you will obediently eat it. Not one serving, but two or three.

This book is exceedingly insightful into the battle for your taste. This is a battle not of your conscious brain but of your very primal, survival-based brain stem. It tiptoes along the edge of creating out of control eating. Addiction? In fact, the Yale Food Addiction Scale was recently developed because so many of us are showing eating behaviors that look a lot like drug addiction. Take the test yourself. You may not be totally addicted, yet. You can’t chose not to eat, thus avoiding the addictive exposure to flavors. But if you can’t lose weight and feel utterly stuck, you might want to consider thinking how you can insert your conscious, rational, logical forebrain into the discussion and avoid the overwhelming power of flavor. Start with sweet. Avoiding sugar means you don’t purchase 80% of American food products that have sugar added to them. Consider peanut butter.
Next week gets even more interesting. Flavor is very, very important.
WWW. What will work for me. I can’t have ice cream in the house. It took me about a year to wean myself off it. The only way I can escape is to not purchase it. I haven’t succeeded with Indian All-You-Can-Eat Buffets yet. Fortunately, they are remote and not so easily brought home. And if I give in and have one heaping tablespoon of peanut butter….well, odds are, I have more.

Pop Quiz

  1. The flavor sweet was present through most of human history when?         Answer: With ripe plants that show up briefly at the end of the growing season, right before the starvation season.
  2. Where does sweet flavor fit?                                                                                Answer: Right in the middle of our tongues. Front and center.
  3. What is the most important driver of flavor choices?                                      Answer: The anticipation based on prior memory and feelings.
  4. What percent of food in America have some sugar in them?                        Answer: 80
  5. How much you eat may be based most on what feature of food?               Answer: It’s flavor.


Mitochondrial Primer 5: Beta-hydroxybutyrate, The King of Ketones

References: Front Mol MedWikipediaPerfect KetoAm J PrimatologyPeer JBiochemical Journal,

When you burn fat (the stuff that’s in your belly and cellulite and second chin) you produce two ketones primarily. Ketones are what we make from fat burning as we break down stored energy and ship it around the body. The primary one is called beta-hydroxybutyrate, or BHB. The other is called acetoacetate (ACAC). ACAC is what you measure in your urine to show ketones but can be changed to BHB, and thereby not show up in urine. Hence, measuring urine for ketones is iffy and can have false negatives. BHB takes a blood test and is more reliable.
Now, what I find interesting is the enzyme that switches ACAC to BHB and thence into the electron transport chain is actually in the wall of mitochondria. Ketones are such an important part of normal metabolism that mitochondria have all the normal enzymes to incorporate ketones into our energy flow. Did you get that? Our body has all the tools to burn ketones, all the time. It is built in. Through all of human history, ketones were our main fuel source to fall back on in lean times.

What happened in our rich, 21st-century environment? We never, ever run on ketones. There are no lean times. We always run on carbs. We store up what and corn in giant silos, formulate them into delicious foods and provide them to ourselves three times a day in exquisitely flavored recipes. And our body has a default switch that has us burning and running on carbs preferentially. It’s the universal signal to turn on fat making, storage.
This is the key to weight gain and weight loss. Our natural tank of carbs is only 1500 calories. That’s it. Anything over that and we signal our hormones that we have too many carbs. That means it must be September or October when carbs ripen – at the end of the growing season. Our blood sugar rises. We turn on insulin. Insulin switches everything into storage mode. We make triglycerides in our liver and ship those extra fats all over our body in little lipid bundles called LDLs. LDLs then deliver that newly manufactured fat to storage warehouses called your butt, your chin, your muffin top.

Think this through teleologically. We had to be designed like this to survive in a world where carbs show up suddenly, just before the starvation season. We would then evolve a hormone to store those calories when they showed up in abundance. (That’s where insulin comes in.) And we would be favored to have sweet flavor in the middle of our tongue so that we seek carbs avidly, whenever we find them.
But most of the year, we should be running on ketones. Normally. When you are surviving through winter, you are meant to be burning your fat stores. That’s ketones. When you eat green vegetables (present from April till August), your colon turns spinach into ketones. Gorillas, eating 15 pounds of green leaves a day turn those into 70% ketones.
Now there is a whole raft of websites touting the increased performance of athletes on ketogenic diets, how to induce ketogenesis etc. But most importantly, we are proving that inducing ketosis turns on stem cells. It’s so important to run on ketones, Bredesen is insisting we all do it every day for 12 hours and every month for 5 days. Gundry has jumped on board. The tide is changing.

Ketones, otherwise known as Beta-hydroxybutyrate (BHB), are your main, proper food source. BHB rules. It’s the boss! And teaching your body, encouraging your body, forcing your body, manipulating, managing, teasing…..whatever you want to call it…..but do it. Get your body to run on ketones. That means, no grains, no sugar and lots and lots and lots of green vegetables.
WWW. What will work for me. I’m wrapping my head around this technology. I’ve done the Fast Mimicking Diet 8 times and found that it jump starts me into ketosis in three days. I’m going to try taking some Beta-hydroxybutyrate supplement the next time and see if it eases me into ketosis with a little less stress. What I do believe is that this is the pathway forward. Our bodies are aching for us to break our addictive habit of carbs. It just wasn’t meant to be so. The only time we were meant to gorge on carbs was at the end of the growing season when getting ready for winter. Brings a whole new meaning to Halloween candy. Doesn’t it? So, we ended up at the Pancake House for breakfast. I ordered the Eggs Benedict with spinach on the side. Didn’t eat the English muffin. Double spinach please, no potatoes.

Pop Quiz

  1. The human primary fuel is?                                             Answer:  Beta-hydroxybutyrate. The ketone you make from burning fat, your colon digesting green vegetables, the ketone you make from digesting coconut oil, olive oil, avocado oil……
  2. Exposed to carbs, your body will switch to what fuel? Answer: Glucose. Instantly. The microsecond you put out insulin. Three french fries will do it.
  3. Running on insulin instantly is incredibly important. Why? Answer: Because through most of human history, carbs were rare, and present just before the lean, starvation system. Remember, pears and apples ripen in October; right now. So sugar is on our tongues as our preferred taste so we gorge, turn on insulin, store calories and then…survive through winter.
  4. How big is your carb fuel tank?                                                   Answer. 1500 calories, called glycogen. Fill up that tank with…….one plate of pasta, rice, flour.
  5. And what happens to green vegetables?                                 Answer. Your colon bacteria break them down into beta-hydroxybutyrate. The King (or Queen) of Ketones. BHB rules. You’ll have BHB anytime you fast 12 hours or more. You will have a blood level of 3 and more if you do the fast mimicking diet for 3+ days. The Fast Mimicking Diet: best way yet to get you in ketosis.

Mitochondrial Primer 4: Role of CoQ10

References: Mitochondria and Future of MedicineMortenson JACC Heart FailureLangsjoen Biofactors,

You should know what CoQ10 is by now. It is in every mitochondrion, in every cell in your body. Ubiquitous. It sits between Complexes 1,2 and 3 and passes on electrons, thereby playing a critical role in the electron transport chain. About 2% of electrons escape the electron transport chain, and CoQ10 soaks those escaped little electrons up before they can cause damage. You make lots of it when you are young. You make much less when you are older. It was discovered in 1957 and in 1972 the level of its deficiency was linked to congestive heart failure. Many cardiologists got interested in it and it became a widely used supplement, particularly with statins and muscle pain.

Initial studies of it were not exactly positive, perhaps because lab measurements were not as precise or available as they are today, thereby leading to inconsistent doses. But the Mortenson JACC study showed that 100 mg three times a day compared to conventional drug therapy alone reduced CV mortality by 42%, and all-cause mortality by 44%. That caught people’s attention.
Dr Sinatra has been one of its most prominent advocates and claims that the threshold of effectiveness is 2.5 ug/ml, and that one will not see much clinical benefit below that. He laughs off older studies that do not mention or measure blood levels. I personally see most folks with levels of .7 and 1.2 with very few above 1.5. Hmmm. As we age, we are all deficient.
The other controversy about CoQ10 is whether one should take the common cheap form, ubiquinone, or the fancy expensive stuff, ubiquinol. They do switch back and forth in the body quite easily, but the -ol form is a more potent anti-oxidant. The manufacturer claims that the expensive form is worth it and backs it up with a very small study of 7 people who had failed with the -one. In that study, the average ejection fraction went from 22% to 39%, and their average New York Heart Association CHF class dropped from IV to II. Very impressive. A very small study, not blinded so open to lots of problems.

The number two reason to visit a doctor is “fatigue”. If your mitochondria are weakened by low protection secondary to low CoQ10, one will have decreased heart pumping which will mean decreased delivery of blood to muscles. In muscles, the same low CoQ10 level will result in reduced muscle ability. We call that fatigue.

www.What will work for me. What I think is going on is that most folks never get to the threshold of effective therapy. With random dosing of CoQ10 from variable sources, I suspect some folks just aren’t getting enough, and some folks are getting knockoff CoQ10 that isn’t even the real drug. With the ability to measure its level, we can now really check. A starting dose should be 100 mg 3 times a day. And then ask your doctor to check the level. You are looking for a level of 2.5. Nothing less will do. If less, double your dose. Check again.

Pop Quiz

  1. What is the role of CoQ10 in the mitochondria?                      Answer: two roles. 1) Passing on electrons between complexes in the electron transport chain, and 2) catching loose ones that get away from the electron transport chain.
  2. What happens to CoQ10 levels as we age?                               Answer: Drop precipitously.
  3. How much will a heart’s ability to pump increase if you get a level above 2.5?            Answer: Mortenson’s study showed over 40% reduction in mortality and a very small study of the reduced form showed a 22-39% increase in cardiac output.
  4. What blood level of CoQ10 do you want for yourself?             Answer: 2.5 and above
  5. And what is the dose you need to get that?                               Answer: Start with 100 mg 3 times a day. Then test and then double the dose.