One Year Later

My father will not be a centenarian. May he rest in peace...

***

I spent some time last autumn in the Neurology section, with him. All those elderly people trying to still function, battling it out, and the nurses and doctors assisting them in Purgatory, matter-of-factly... My respect for the medical establishment, imperfect as it may be, has increased even more. They have not saved my father, but they did extend his life by a few months...

***

A neurologist thought I may suffer from a subclinical case of vasculitis. She had me try "Lyrica", which I could not endure. My pain, at its worst, is not worth the side effects and the zoning out. I tried "Gabaran" as well -- much easier on me: I composed many songs on the one and only pill I tried. I am glad to know there are such powerful painkillers out there, but I hope I will never have to use them consistently.

The neurologist also suspected an incipient diabetic neuropathy. Given my high genetic risk of diabetes, over 40%, I figured my following Dr. Peat's recommendations for almost a year must have been quite unfortunate. Luckily for me, her suggestion to help with this one worked wonders: "Milgamma" (B1 as a benfotiamine and B12). It was literally like growing back a bunch of nervous endings... I had come to accept that my right big toe had left the system for some idiosyncratic reason and I was not too worried (I should have been!) Well, I was overwhelmed to feel it return to me! Regeneration after degeneration, so there is hope!

So... I dropped my sugar consumption to almost zero. Peat was definitely wrong for me on this front!

No more weird numbness for me. That is a winner! And no, I don't miss OJ. I see it now, for myself, as the orange specter of diabetes.

Another huge improvement was the disappearance of the CA-125 marker.  I cannot be sure what brought that about. Except giving up sugar, I did not do any other spectacular diet changes.

One small thing I can think of is that I increased garlic consumption. My body was craving it. If it turns out this new garlic habit got rid of some incipient tumor, hey... The stench is a small price to pay. I also brought a bunch of PUFA back into my life in the form of potato chips -- I have to have them at least once or twice a week, dipped in my garlic salsa...

Thyroid function -- I am still at 25 mcg T4, but with my free T4 bumped up into a mid-range of normalcy (it used to hover to the lowest normal and even under that), with a rather high TSH by US standards (2.6). I think this is a pretty reasonable spot, I am sleeping well, I no longer experience those "hit by a truck" moments... Some days are better than others, energy-wise.  My weight is pretty much the same and nobody guesses my age, so I am alright. Actually, I look much better than I feel and people look confused and rather skeptical when they hear about my troubles.

I stopped measuring all the other hormones, I will let my body deal with them. I experimented with supplementation of most and I didn't like it one bit. Maybe I am oversensitive, or maybe I have a low tolerance -- my 23andme results show me as a slow metabolizer for many substances (including coffee, yet another reason for me to not follow Peat), so perhaps I should stay away from any "bio-hacking" that involves hormones. Nobody knows for sure how they work, anyway, so why be a guinea pig, life is too short even without self-experimentation.

In my search for the perfect seaside, I visited Cyprus and loved the taste of their produce... I hated the pollution, though...

I hope you are all doing well and staying healthy and gorgeous.

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."

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.

Aspirin Will Cost Us In the Long Run. Low Estrogen/High Progesterone Exists!

The Peatian news of the day has to be Noah Buhayar's article on Bloomberg.com about aspirin becoming such a burden to the cost of healthcare... because it protects so many from cancer!

I have not started supplementing with aspirin. The idea that then I would have to add K2 to my regimen and balance these guys out is truly not something I look forward to (especially that both can do some damage, in the wrong dose, they are not harmless little substances).

***
Yesterday I started reading Dr. Sara Gottfried's "The Hormone Cure", because I had read the reviews and many raved about how well she explains their interplay.

I took her hormone quizz online and the results hit pretty much where I expected.  So, to all the women out there who think there is no such thing as progesterone dominance or women who are not in need of progesterone, because they would instantly turn it into the evil estrogen, check out my results:

High Cortisol.  It sounds like you are unlikely to have high cortisol at this point, which is great (...)

Low Thyroid.  There’s a good chance you are low in thyroid hormone (...)

Low Estrogen.  There’s a good chance you are low in estrogen (...)

Low Cortisol.  There’s a good chance you are low in cortisol. (...)

Low Progesterone.  You are unlikely to have low progesterone. Congratulations! (...)

High Estrogen.  You are unlikely to have estrogen dominance. (...)

High Androgens.  You are unlikely to have high androgens. (...)

For whatever this is worth, my recommendation for any woman out there considering hormone therapy is to take Dr. Gottfried's test or, better yet, to check your hormone levels before you decide you are "estrogen dominant" and start the "bioidentical hormone" supplementation, be it with pregnenolone or progesterone. Reading Ray Peat's and others' fabulous experiences is one thing, taking the decision to go that route on one's own is another.

Balance the time you spend on forums with time you spend with doctors or reading their books and using their free online resources. Just because you run on a discussion group into a woman who seems smart and knowledgeable and who did some things that worked for her and then she went out of her way to recommend them using Ray Peat's work and quoting his instructions to her as endorsements doesn't mean you have found YOUR answer! Nobody is evil in this equation, everyone is being super nice and tries to be helpful -- but hormone supplementation can have serious consequences and you need all the qualified, personalized help you can get when you do it.

I learned this the hard way, unfortunately!