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."

Reality Check Feat. Dr. Coculescu

In a posh part of Bucharest, at a luxury clinic where everyone on staff had sheer reverence towards "The Professor", I had this consultation with Dr. Mihail Coculescu, the President of the Romanian Society of Endocrinology. To my surprise, we had a rather extensive chat, by my standards, and by the looks of the still waiting patients. 

As expected, Dr. Coculescu had never heard of Dr. Peat, whose books I had brought along, in the hope that they might capture his interest. Granted, I was not given the opportunity to pitch them properly as Dr. Coculescu had interventions and pointers for me at every step. However, something tells me that he would eventually check out Dr. Peat's work and theories. 

To summarize, he recommended that I simplified my life and quit the path of excessive intellectualization I had embarked upon. Decrypting PubMed articles and becoming fluent in the theories behind Hashimoto's would accomplish nothing. I should be thankful for the easy form of the disease I experience and for its simple (perhaps not even necessary, judging from my last set of blood tests) treatment. 

I could see that Dr. Coculescu was barely registering my suffering and I cannot blame him for one second. I myself felt kind of guilty for insisting on seeing him, when other people, with far more serious problems, were waiting in line by his door. But the harm is done. Refreshingly, he didn't mind this aspect, he even indicated that he would accept my "case", if I decided to switch endocrinologists, so no discrimination there on his side. 

He laughed when I mentioned that I didn't believe Anti-TPOs and Anti-TGOs were killing thyroid tissue and mentioned the "firemen at the place of the fire" analogy. He freely admitted that the science doesn't have all the answers, but refused to admit that I should complicate my life and allow myself to be affected by THAT, i.e. the proverbial things I could not change. 

He insisted that the thyroid, no matter in what shape, whether shredded or inflamed, can still accomplish its function, and that I seemed to have been in that situation.  It is OK if I feel better under T4 treatment, it is just that I should determine the optimal amount of supplementation, because it looks like even 50 mcg is too much for me. 

As to the concept of improper nutrition undoing thyroids, he mentioned the endemic lack of iodine in some places, and how entire populations develop huge goiters -- however, all those thyroid glands do keep working... They huff and they puff but... they do their jobs. So?.. At this point in the conversation, I felt kind of ashamed -- I didn't even have a goiter to complain about... 

I felt like coming out of a tunnel.  Minor twists of perspective performed by "authoritarian figures", to use a Peatism, can work wonders. In that sense, Dr. Coculescu was a tremendous doctor -- and I am convinced that he performed knowingly his "tricks".

They were what I needed and he was too experienced a practitioner not to know it the minute I took out of my purse Dr. Peat's books and my stacks of blood test results...

What Kills A Thyroid Gland?

Today is International Thyroid Awareness Day.

I am celebrating by posting a few thoughts on the current views of Hashimoto's Thyroiditis.

Many people out there will tell you that autoimmune thyroiditis comes from the thyroid gland being attacked by antibodies. People measure those and try to evaluate their degree of thyroid health by them.

My endocrinologist advised me to stop measuring those things. "Once you have them, they're there for life. Genetics plays a big role. At some point, a stress related event may have triggered them and they would exist in your body, once in a while getting to your thyroid, until they destroy it and render it incapable of doing its job". So, according to her, there is no way to go but down and measuring antibodies levels is not constructive or conducive to any worthwhile conclusions. I have to admit, despite my continuing efforts and gluten free diet, the results of my own lab tests indicate she might have a point... Unfortunately...

Dr. Datis Kharazzian, who has a best selling book on Hashimoto's, thinks one can balance the immune system and thus stop the killing of the thyroid. He says Th1 and Th2 cells are out of balance in Hashimoto's and that all the patient has to do is bring them back into the desired equilibrium. He offers combinations of nutrients that would boost either Th1 or Th2.

Dimitry Chistiacov's study, "Immunogenetics of Hashimoto's thyroiditis", published in the "Journal of Autoimmune Diseases" in March, 2005, seems to indicate that it is only the Th1 cells that are to blame for the said destruction. So, if you believe in Dr. Kharazzian's balancing of the immune system you may combine it with the results of this study and go for increasing Th2 right off the bat.

Dr. Alexander Haskell (link to the right) thinks that autoantibodies (Anti-TPO and Anti-TGO) are not the culprits in this scenario. He says they are simply there to clean the thyroid cell debris and that lack of specific nutrients is the culprit for the destruction that does occur at the thyroid gland level. He isolates iodine among those and this has caused some serious rebuttals of his vision (as iodine deficiency is hardly a problem in the US.) If he hadn't emphasize iodine, his theory would have actually sounded a lot more credible - and it is my favorite, still...

Like Dr. Haskell, Ray Peat does not believe in "autoimmune diseases" and the body's feasting on itself via antibodies, like those described above. He thinks that the thyroid does get destroyed (like many other organs) and that this is a process of degeneration, a result of insufficient supply of energy at the cell level. A nutrition blunder, if you will.

His view is consistent with the symptoms I have had after my Paleo time -- and, apparently, more and more people come out of their low carb experiments with damaged thyroid glands.

But let us go back to D. Chistiacov's study mentioned above, from which I have stolen the graphic above (I am giving it back if there are any complaints). His description of how things go wrong in Hashimoto's is representative for the scientific community's viewpoint. Indeed, my own doctor told me about the "strong genetic component" to Hashimoto's, to which environmental triggers are added.

Incorrect nutrition is not considered a factor in this study. However, infection and pregnancy are...

A key phrase in D. Chistiacov's paper remains:

 "The mechanisms, whereby autoreactive T cells escape deletion and anergy, and become activated, remain uncertain. "

This leaves the field still open to many interpretations, in my mind, including that of Dr. Peat and Dr. Haskell -- that the said breakdowns of cells are primarily caused by issues other than our own cells gone crazy and that we can stop or even reverse that destruction through a combination of nutrition, lifestyle and supplementation. I will attempt in full Dr. Haskell's protocol (described in his video series) once I have the necessary ingredients and let you know how it goes.

Dr. C.I. Parhon: A True Pioneer of Endocrinology

I decided to take a short trip to Romania and visit my father. He is doing great, no health issues whatsoever -- I am so proud of him!

I wanted to take advantage of being in Bucharest to check in with the endocrinologist who diagnosed my Hashimoto's last year, maybe discuss my current treatment options with her, but she was on a maternal leave.

As I was trying to find a good alternative, I made a fabulous discovery: there is an entire hospital attached to an institute devoted to endocrinology in Bucharest! The National Institute of Endocrinology was founded in 1946 by Dr. Constantin I. Parhon, who wrote, with Moise Goldstein, the very first treaty of endocrinology, over 800 pages, published in French, in 1909!

There are 42 medical doctors specializing in endocrinology working at the hospital which can host 400 patients. There is a research facility as well, which just got 10 million euros in funding, so things look quite promising... Maybe Dr. Ray Peat should be invited to test some of his theories?

The incredible Dr. Parhon also became the first president of Romania, when the King was forced to abdicate! How about THAT?

Dr. Parhon's fabulous accomplishments include founding yet another hospital, dedicated to old people this time, the first Geriatrics Hospital in the world -- as Parhon considered old age more of a disease than a natural state.

Parhon appointed a woman as director of this Institute of Gerontology and Geriatrics, presumably a former student and follower of his, Dr. Ana Aslan.   She went on to develop a line of youth promoting products that attracted quite a following (A. Onassis, J. Kennedy were among her clients). I think I will try to get a hold of these patented products, "the first medicine designed to delay human aging processes".  And I am in the process of locating a copy of Dr. Parhon's book "Old Age and Its Treatment".

I almost feel grateful to my Hashimoto's for enlarging my horizon... Um... Not really.

I figured there must be some pretty impressive endocrinologists in Bucharest, with such an outstanding school behind them, so I pursued my research.

I scheduled an appointment with none other than the Head of the Romanian Society of Endocrinology, Dr. Mihai Coculescu, whose impressive list of publications on PubMed and whose views on thyroid and estrogen went straight to my heart.  I'm thinking I should bring him Dr. Peat's books, maybe something develops... It would be worthwhile to see Dr. Peat invited to one of these mainstream congresses of endocrinologists. Anyway, the RSE publishes Acta Endocrinologica since...1938. It also publishes "The Romanian Journal of Diabetes, Nutrition and Metabolic Diseases".

I bought for five dollars, from the selection of a street vendor in Bucharest, "Clinical Endocrinology", published in 1976, authored by two of Parhon's collaborators, Stefan Milcu and Marcela Pitis, to which Dr. Coculescu, back then a young research assistant, is listed as a top contributor.

Here is Dr. Coculescu, delivering a speech at the Romanian Academy (in Romanian):

He talks about another illustrious Romanian endocrinologist I knew nothing about, Dr. Paulescu, who first discovered insulin, in 1921.  Dr. Paulescu is a controversial figure because of his antisemitic views.  Many claim that he was robbed of his Nobel prize.

Dr. Parhon is not much talked about in Romania nowadays because he was a communist. I guess Dr. Parhon was either inspired, or a student of Dr. Paulescu's. As Dr. Parhon was openly opposing antisemitism, his relationship with Paulescu must have been at least strained. Fascinating...

Back to 2013: confident that Romania boasts a mighty tradition of endocrinology, I crowned my stay in sunny Bucharest with another doctor's visit and a panel of brand new blood tests, of which I might soon write.