Paleo --> Peat --> Nutrigenetic Diet

That's right, I'm moving on... After trying Paleo and losing on it, besides a few kilos, lots of energy and precious thyroid tissue , I embarked on the Peat style diet and kept that up for eight months. I gained a lot of energy back, I increased my metabolic rate as reflected in my daily calories intake, I stuck to my pre-Paleo weight and I acquired a superior understanding of how my body works. ("Superior", as compared to the blissfully ignorant lifestyle I used to have before my health failed me, but I am sure many of you are way more in tune with their bodies than I can ever hope to be.)

I have been fascinated by deciphering the results of my genetic testing for a few weeks now and I am mesmerized by the potential answers that lie within the field of Nutrigenetics. 

I know, this is still in its infancy and there are no "gurus" around to make "following" a nutrigenetic diet an easier journey. Not that I paid attention to the "Peat practitioners" previously as I had been too burned with the Paleo "practitioners" to ever trust any of these folks again, but there is not even a Ray Peat in this emerging field. 

So much the better, no noise. These "practitioners" are all self-experimenters who gathered a bit of  knowledge, largely from extensive internet browsing, and who have superior online marketing skills. In Peatdom that is so obvious: Peat is making way less money than the astute "practitioners" who "translate" his work for their patients, whom I guess must be people too busy to bother reading all the Peat articles for themselves. The fact that these highly questionable "practitioners" do not only dispense nutritional information without qualification, but they also dabble in hormone supplementation, using a few intuitions of Peat's as "the science behind them" makes me shudder.

But enough of that. I never linked directly to them and if you used them, good luck to you, I hope no harm will ever come your way and I am the one who exaggerates here.

NUTRIGENETICS!

Just like I did not throw away many of the Paleo recommendations when I moved to Peat dieting (as a matter of fact, the valid parts of these diets tend to overlap, see the broth and/or gelatin example, which is carried forward from Paleo to PHD to Peat, in the order in which I discovered them or, rather, from Peat to Paleo to PHD, in their chronological order), I will preserve from the Peat lifestyle whatever worked for me in this self-tailored Nutrigenetic diet.

So, my Nutrigenetic diet will consist of cross-referencing my genetic risks and predispositions with the Peat style diet and adjusting everything so that I may not, well, succumb too early to the diseases that my genes "destined" me to encounter, should I not pay attention to my lifestyle and awaken any of the monsters laying dormant for now.

You see, I have already managed to disturb the Hashimoto monster during my Paleo/ketogenic experiment, and that was a second-rate one, hidden in the background, on the innocuous list of "typical risk factors".

Between "Scleroderma" and "Essential Tremor" there were a bunch of other conditions. Source: 23andme.com

Thus, believe me, I don't want to step on the Type 2 Diabetes or Coronary Heart Disease dragons, which reign supreme on top of my list of high risk, unlucky genetic combinations:

And the list goes on and on and on, unfortunately.. Source: 23andme, I hope they don't mind...:)

At some point on the same scary list, Hypothyroidism is mentioned, with 3 out of 5 markers indicative of higher risk...:(

Alas, it was in the (three) stars... Source: 23andme.com.

It will be a bit awkward to blog about this because that would mean revealing a lot of my genetic make-up.  On the other had, so what if I reveal too much information, who is tracking this down and what can they do about it? 

The risks associated with that are amply overshadowed by the chance that someone else might benefit, one way or another, from the story of my journey...

Dr. Raymond Peat's Books



They are thin and easy to carry around, at least..:)

If you are hoping for authoritative tomes that would once and for all put to rest your doubts regarding Dr. Peat's views, don't buy his books.

Buy them if you are on the market for more skepticism.

I must admit, I had expected books published by a publishing house specialized in scientific works, texts with a clear structure, fully edited and with a comprehensive index. I was hoping that Ray Peat's books will further my knowledge and enlighten me on the topics that his articles and radio interventions had only touched upon.

Alas, there is (let's say "almost") nothing in the books that you couldn't have found on the net already if you followed the excellent collections put together by his followers which include articles, radio shows and even published emails.

The books are self-published collections of articles.

The most developed of them is called "From PMS to Menopause. Female Hormones in Context". 189 pages ending with the following note:

 

Added to the artisanal publishing, this rather aggressive promotion of Progest-E places a serious question mark over the book's contents. I cannot see a good reason not to name Dr. Peat's patented product here and I honestly do not see why Dr. Peat does not name it as well, since he so obviously refers to it in the note above. Is this name omission business intended to not make the entire book appear like a "companion" to Progest-E? Be that as it may, even without the name of the patented product, the book still reads like an extensive effort to persuade Progest-E users that the progesterone product they bought is good for them and to persuade readers that the mysteriously unnamed but obviously referred to Progest-E should be bought and used.

 

It is all about context, right?

 

I did read the book carefully. I underlined many things. Sometimes, these were just interesting tidbits I did not know. For instance, the fact that "a male runner's estrogen is often doubled after a race" or that "Estrogen and insulin lower blood sugar, progesterone and thyroid sustain it". Sometimes, I noted snippets of speculation that sound pretty cool, stuff I tend to believe in or that I have seen elsewhere information about: "Antibodies to joint material are found after even a mechanical or thermal injury to the joint; twisting cartilage makes it antigenic; autoimmune disease is probably nothing very special" but I would stop underlining when things went off in directions I didn't find convincing, like the estrogen-demonization pathway, very present in the book. The above sentence goes on with: "estrogen is now known to be responsible for many forms of it, including osteoarthritis".

 

But many times I underlined things that were unsubstantiated in a major way. Key elements of the "progesterone is good for women" theory are left hanging, simply things we should trust Ray Peat on.

 

For instance, on page 68, there is this paragraph that had me pull my hair in frustration (my reactions are in red):  

"Progesterone and DHEA are the precursors for the other more specialized steroid hormones, including cortisol, aldosterone (sodium retaining hormone), estrogen and testosterone. The formation of these other hormones is tightly regulated (by what?), so that taking a precursor will correct a deficiency (but why would that unnamed "regulatory authority" ever allow a deficiency to begin with?) of the specialized hormone, but will not create an excess (if 'it' allowed it to be deficient, how can we trust 'it' that it will a) increase b) not overly increase the deficient hormone?). At least in the case of progesterone (why suddenly ditch the other precursors, then? Are they less likely to be properly used by the unnamed "regulatory authority" and if so, why?), an excess tends to balance or neutralize an excess of the specialized hormone, so it has been described as having anti-androgenic, anti-estrogen, anti-aldosterone and anti-cortisol functions (I find it so easy to believe all this, especially that it totally contradicts my own horrible experience of attempted progesterone supplementation!)".  

WHAT? Is that IT? I mean, the paragraph above establishes a whole universe and places progesterone on a position that is incredibly powerful, a god among hormones. No reference is given, however, Ray Peat merrily goes on to other things. That is often the feeling I get reading his books and/or articles: he drops bombs and then pretends nothing has happened and keeps on gathering pretty flowers and spreading references/explanations for THOSE!

 

Even so, I believe that the paragraph unequivocally implies that, should someone be in need of estrogen, the supplemental progesterone, its precursor, might just oblige. However, although half the book is about how estrogen is the work of the devil, this obvious pathway is never explored and the idea that women who are low in estrogen should not touch progesterone is never even mentioned, not a fleeting remark, nada! Besides, what a can of worms that is, given how a woman's hormones fluctuate throughout most of her adult life.

 

Besides the variations on the "progesterone=good/estrogen=bad" theme, the book is also replete with the usual believable advice Dr. Peat has extended for a long time and for which he has gathered his current following.  Sunlight, red light, coconut oil, saturated fat, the benefits of milk and OJ, the malediction of PUFAs are all there.  Honestly, were it not for the hormonal exaggerations, I would recommend it to my friends.

 

However, tall tales of progesterone wondrousness had me roll my eyes too many times in regret that Dr. Peat ever embarked on his progesterone-worship journey. Too many formulations like "I suspect", "probably", "seems to be", "appears", "from my observations", "x suggests y" "indicate that" we are not on solid scientific ground.

 

I will end this review with another one of Ray Peat's optimistic speculations, one that might entice you to take advantage of the summer season better, instead of embarking on unsafe hormonal supplementation. I don't know about you, but I'd rather be cured (or harmed) by some good old sun exposure than by rubbing on my skin powerful substances recognized as carcinogenic by the scientific community and labeled as such by the authorities: 

"I suspect that light on the skin directly increases the skin's production of steroids, without depending on other organs. Different steroids probably involve different frequencies of light, but orange and red light seem to be important frequencies."

T4 Trials & Tribulations

Ten days ago I treated myself to yet another round of blood tests.

TSH shot up to 2.88 from 0.11, so definitely 25 mcg is too little daily T4 supplementation for me. If 50 mcg was too much, then I guess I need 37.5? I’ll be cutting up pills every night then. Fine.

Magnesium was at the bottom of the acceptable range and calcium was at the top! That’s got to be bad news, right? Maybe that plays a role in the return of my pain and tiredness?

Estrogen doubled yet again. Progesterone increased as well, four times the amount I had when I wrote the “Perfect Ten Progesterone” posting,  however, it is now only twice as much as my estrogen, from ten times the amount. So that’s another piece of bad news.

Anti-TPO’s are falling again, 611 from over 700 (so, still a heck of a lot, they should be below 6!), so moderately good news there, although… I’m not even sure I should bother checking them anymore.

The CA-125 (an ovarian cancer marker) is higher than last year, 45 instead of <35.  I don’t like seeing it progress, needless to say, the more so as my estrogen is rising as well, steadily, if you catch my drift…

Total cholesterol at an all time high: 225, with an LDL of 67. So, still good ratio, but it was 190 five weeks ago… Vacationing in Eastern Europe increases cholesterol, who knew…

For the first time, I did Free T4, Free T3, Total T4, Total T3 and TSH, like so:

The real downer was Total T4, which was under the lower limit! Not by a whole lot, but still! What was that supposed to mean? Lab proof of hypothyroidism?  Or was my body adjusting to the lower dose of supplementation? I can't wait to check it again and to talk to someone about this.

Well, on the other hand, I just read today "Levothyroxine And Lung Cancer In Females: The Importance Of Oxidative Stress", by Umberto Cornelli, Gianni Belcaro, Martino Recchia and Annarosa Finco a very credible study suggesting that too much T4 can cause serious issues as well and that one cannot monitor its amounts carefully enough. I see lots of people living with undetectable TSH levels and that cannot be right either. Inducing hyperthyroidism iatrogenically apparently can cause lung cancer in women.

"During the therapy with LT4 even at the steady state condition a peak of the hormone is evident a couple of hours after the administration and may cause a temporary condition of hyperthyroidism and a further increase of oxidative stress.

Oxidative stress is well documented in hypothyroidism [22-24] and is even worsened through treatment with LT4 [1,2]. The difference between the two conditions is that, in case of hypothyroidisms, oxidative stress is due to the reduction of AO [4], whereas, after the LT4 treatment it stems from overproduction of ROS from mitochondria [5,6].

A very simple method that can be used to measure oxidative stress is related to hydroperoxides content in plasma which is considered a very reliable test compared to other common methods since it shows very limited coefficient of variation [25].

An inverse association with fruit and vegetables consumption and lung cancer recently has been documented recently in the EPIC study for 50 to 59 age group, without an effect on specific histological subtypes [26]."

 So I should start measuring the hydroperoxide levels as well while I fiddle with this dangerous stuff. Also, increase antioxidants intake. I am not so sure about vegetables, finding clean veggies is an ordeal in itself.  I will look into supplements.

How to decrease calcium and estrogen and increase progesterone, magnesium and T4, make CA-125 and Anti-TPOs go away and be happy?

That’s all I’d like to know.

P.S. on August 17, 2013: Actually, the above sounds outdated. Just an old Peatian "reflex".  I no longer believe progesterone is good and estrogen is bad, so I take that back.  I will stop caring about the progesterone/estrogen ratio and worry instead about the level of hydroperoxide in my blood. It sounds like a fair trade-off..:)

Plus, the study I mention gave me a nightmare last night. So maybe I should withdraw a bit from worrying about these things altogether, like the doctor said. Just find the time and organize another seaside session...

P.P.S. I just came across a study that supports my decision to stop considering progesterone such a good guy, a study linking it to the emission of hydrogen peroxide: "Progesterone increases skeletal muscle mitochondrial H2O2 emission in nonmenopausal women". Yep. :( And guess what, estrogen is counteracting it, according to the authors. That makes progesterone less than a hypothyroid woman's best friend, because it promotes oxidative stress. Taking this one step further: maybe it was an excess of my natural progesterone which launched the H2O2 destructive festival which may have brought about my Hashimoto's.