Mark Sisson's Blog, page 75

All About NAC: Supplement Benefits, Side Effects, Dosages

Our understanding of how antioxidant supplementation works has changed in the last decade. Rather than act directly as antioxidants, most of these compounds stimulate the body’s own production of endogenous antioxidants. That’s right—most of the popular and beneficial “antioxidant” supplements work by provoking a mild hormetic stress response that activates our own antioxidant defenses.

But homegrown antioxidants aren’t made out of thin air. They are material substances that require physical building-blocks. Probably the most important antioxidant is glutathione, and its most important building block is NAC.

What is NAC?

N-acetyl-cysteine, or NAC, is the stable, supplement form of the amino acid cysteine. Cysteine provides one of the most crucial backbones undergirding the body’s premier antioxidant: Glutathione.

In the conventional medical world, NAC is mainly used to rescue people from acetaminophen toxicity. If you overdose on Tylenol and get to a doctor within 8 hours, they’ll give you a big dose of NAC to save your liver and your life. But how does it work? How does NAC beat Tylenol toxicity?

By increasing glutathione stores in the liver. Glutathione binds to the toxic Tylenol metabolite and makes it harmless, but it doesn’t last forever. A big dose of a major toxin like Tylenol is enough to deplete glutathione stores and increase acute glutathione requirements. NAC provides the raw material for glutathione production, allowing it to commence and get to protecting.

Might this have other effects? Does glutathione do anything else?

It reduces reactive oxygen species down to less damaging metabolites.

It is the master detoxifier, a major line of defense against invading mutagenic, carcinogenic, and inflammatory agents.

It defends against glycation.

It controls hundreds of proteins in the body.

Instantly access our FREE download: Guide to a Healthy Gut

It protects against lung damage and maintains respiratory function, especially in the context of infectious respiratory diseases.1

It regulates glutamate levels in the brain, reducing over-excitation.

In other words, it does a lot. We should probably try to keep our levels up. If we don’t?

Well…

Low levels of glutathione have been linked to such disparate conditions as diabetes, tuberculosis, cancer, HIV, and aging.2 Heart failure patients tend to have low glutathione.3 Low glutathione levels are generally associated with elevated markers of inflammation, like CRP.

Okay, so glutathione is important, low levels are linked to many different diseases and health conditions, it’s a good idea to have adequate levels for general health, and NAC is one of the better ways to replenish glutathione.4 At normal doses of Tylenol, taking NAC along with it prevents glutathione depletion without negatively affecting the therapeutic effect of the drug.5

NAC helps the liver metabolize alcohol, too, by speeding up the clearance of its most toxic metabolite—acetaldehyde. In rats, NAC even mitigates the hypertensive effect of drinking alcohol, suggesting general detoxification effects.6

Detoxification with NAC

All those “experts” who say detox is a myth and your body is perfectly able to detoxify everything it needs to without fancy supplements and therapies are half-right. The body is able to detoxify a wide range of toxins, provided we give it the substrates it requires. NAC is one such substrate that seems to help us deal with incoming toxins.

In workers with chronic lead exposure, NAC increases antioxidant capacity in red blood cells, reduces oxidative stress, and lowers blood levels of lead.7

In adults with acute pesticide poisoning, NAC (600 mg 3 times per day) reduces inflammatory markers and the need for atropine (a pharmaceutical that treats pesticide poisoning).8

After exposure to diesel fumes, taking NAC reduces blood vessel damage and, in asthmatic patients, lowers the airway responsiveness.910

NAC even reduces the toxic effects in people who eat poison mushrooms or get dosed with mustard gas.1112

If large doses of NAC can help people deal with serious toxin loads, moderate doses of NAC can probably help people deal with normal loads.

NAC and Lung Health

In bronchitis and Chronic Pulmonary Obstructive Disease (COPD), the lungs lose glutathione and accumulate too much thick mucus, reducing their function and making it harder to breathe. When you take NAC in this situation, it replenishes lung glutathione and thins out the mucus.

The result is that bronchitis patients who take NAC over the course of 3-6 months experience lower rates of “exacerbations” (worsening episodes) and see their symptoms improve.13 Same goes for COPD patients on a year-long course of NAC; they enjoy improved lung capacity.14

Flu Resistance

One study in older adults had some remarkable results.15 Subjects were randomized to one of two groups. The first group got placebo. The second group got 600 mg of NAC, twice a day, for 6 months. Over the course of the study, they tracked “influenza-like” symptoms, finding that the NAC group had far fewer than the placebo group. Then they tested the subjects for influenza antibodies and found that both groups had equal seroconversion rates. Both groups were equally likely to have gotten the flu over the 6 months, but just 25% of the infected NAC group ever showed symptoms versus 79% of the infected placebo group who showed symptoms.

NAC Reduces Inflammation and Oxidative Stress

The modern world is a stressful place. We have long commutes to jobs we often dislike. We’re stuck indoors when we’d rather be outside in the fresh air and sunlight. We have to closely read labels—or avoid them altogether—to make sure we’re eating healthy fare. The air is polluted, we’re disconnected from nature, we sit too much and move too little. I’m not saying this to be a downer or alarmist—the world remains a beautiful place full of joy and wonder—but a realist. Life is good but our bodies are under constant, chronic low-level assault from evolutionarily novel physiological and psychological stressors.

Increased oxidative stress is the baseline for too many people, and NAC has been shown to be one of the best “all-purpose” supplements for reducing it.16

Mental and Psychological Health

NAC checks off a few important boxes for mental health. It crosses the blood brain barrier, reduces oxidative stress, and regulates glutamate levels in the brain. Now, glutamate isn’t “bad,” but too much glutamate in the wrong places can lead to over-excitation. That’s often what we see in mental and psychological disorders—over-excitation, excessive activity.

NAC smoothes that out. It sticks glutamate where it belongs in the right concentrations. It provides the right amount of inhibition to counter the excitation.17

This is probably why NAC supplementation has shown preliminary promise in treating a number of disorders, including autism, Alzheimer’s disease, cocaine and cannabis addiction, bipolar disorder, depression, trichotillomania, nail biting, skin picking, obsessive-compulsive disorder, schizophrenia, anxiety, attention deficit hyperactivity disorder and even mild traumatic brain injury.18

NAC and Fertility

Both male and female infertility often come down to elevated oxidative stress. Can NAC reduce stress? Yes. Can NAC improve fertility? Yes.

In men visiting a fertility clinic, an NAC supplement (600 mg/day for 3 months) increased serum antioxidant capacity, reduced oxidative stress, and improved sperm quality, motility, and consistency.19

A combo of selenium and NAC was also able to improve semen quality in men with fertility issues.20

As for women’s fertility, NAC seems to be most effective in women with PCOS already taking clomiphene citrate (a PCOS drug meant to stimulate fertility). A pair of studies found that NAC increased both ovulation and pregnancy rate in women with PCOS who had proven resistant to clomiphene citrate alone.2122

Should Everyone Take NAC?

Not necessarily. Most of its benefits occur in people with depleted glutathione levels and/or elevated inflammatory status.

One paper found that NAC was only helpful in patients with depleted glutathione levels.23 Those with low glutathione saw platelet function improvements, while those patients with normal glutathione levels saw no improvements in their platelet function.

Another paper found similar results with depression. Only those patients with elevated CRP levels at baseline experienced a reduction in depressive symptoms after taking NAC.24

And most of the studied health conditions are quite serious and, relatively speaking, rare. What draws me in is the fact that glutathione is upstream of so many different physiological processes. It’s not some specific compound with very limited application or relevance. It’s a specific compound with broad applications.

You may not have the glutamate over-excitation issues of someone with full-blown schizophrenia or social anxiety disorder, but a little NAC might help you focus or improve your internal self-talk.

You may not have COPD, but making sure your lung glutathione stores are replete isn’t a bad idea.

You’re probably not completely infertile, but reducing oxidative stress and improving sperm or endometrial quality never hurt anyone’s chances.

All that said, NAC is one of the safer supplements available. It probably won’t hurt to try a small dose whether you have elevated inflammation or depleted glutathione or not—and many people do have suboptimal glutathione status without knowing it.

What’s a Good NAC Dosage?

Many of the therapeutic effects used in the studies I referenced today were in the 500-600 mg range. Sometimes higher, but not necessarily.

I included 500 mg of it in my broad-spectrum micronutrient supplement, Primal Master Formula, because that is a well-tolerated, well-attested dose that’s safe to use and quite effective at glutathione maintenance.

I am a very light/moderate drinker these days, but whenever I do have more than usual, I’ll take 500 mg of NAC and 500 mg of vitamin C about an hour before drinking. This dose seems to improve the positive effects and reduce any negative side effects, probably by increasing glutathione, enhancing ethanol metabolism, and clearing acetaldehyde more quickly.

That’s it for NAC, folks. If you have any questions or comments, drop them down below.

References https://www.ncbi.nlm.nih.gov/pmc/arti... But does taking a NAC supplement actually improve health?

Let’s look at the evidence.

NAC Benefits

What areas of health can you expect to benefit from NAC supplementation?

Liver support
Detoxification
Lung health
Flu resistance
Inflammation and oxidative stress
Mental and psychological health
Fertility

NAC and Liver Support

NAC protects the liver against acetaminophen (Tylenol) toxicity, keeping liver enzyme levels down.[ref]https://www.ncbi.nlm.nih.gov/pubmed/3...

The post All About NAC: Supplement Benefits, Side Effects, Dosages appeared first on Mark's Daily Apple.

Why Do I Feel Tired All the Time?

“I’m tired all the time.”

“I have no energy.”

“I’m too tired to go to the gym.”

“I need a nap.”

Walking around in a fog seems like standard operating procedure nowadays. No matter how common it is, though, feeling exhausted, low energy, or sleepy all the time is not normal. It’s always a sign that something else is going on.

Tiredness, Sleepiness, Fatigue: What’s the Difference?

What does it mean when someone says, “I’m tired all the time?” Are they falling asleep at their desk? Do they need to take an afternoon nap in order to function in the evening? Perhaps they feel too wiped out to exercise or even get off the couch?

Colloquially, we use the word “tired” to describe the subjective experiences of both sleepiness and fatigue. “Sleepiness” is the familiar experience of needing sleep due to sleep debt. We all know what this feels like.

“Fatigue” can mean a few things. There is the tiredness you experience after overwork or exertion, which is usually temporary. Then there are the chronic feeling of exhaustion, low motivation, physical weakness, or inability to function.

From a medical perspective, sleepiness and fatigue are different. The boundaries are fuzzy, though, and there is a lack of agreement about the best ways to assess and differentiate the two.1

Sometimes sleepiness or fatigue are easy to explain. You get a few bad night’s sleep in a row. Yesterday’s CrossFit WOD was particularly brutal. An important and stressful work project is wearing you down. Situations like these, in which there is an obvious, short-term cause for your tiredness, are generally not a problem. Assuming you give yourself appropriate rest, you should recover just fine.

Chronic tiredness—whether sleepiness or fatigue—can make it impossible to participate fully in life. Everyday activities such as driving may become dangerous. It interferes with work, physical activity, relationships, and general quality of life.

Persistent tiredness that interferes with day-to-day functioning and quality of life is not normal. In today’s post, I’ll discuss some of the common causes of feeling tired all the time and provide tips for troubleshooting.

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“I’m Sleepy All the Time”

We all need a minimum of seven to nine hours per night. Yet, survey after survey shows that most adults and even many children chronically get less sleep than they need. It’s no surprise that in studies, around 20 percent of the population experiences excessive daytime sleepiness.2

Obviously, the first question you should ask yourself is, “Am I getting at least seven hours of sleep per night?” Really, I’d say at least eight for most people. That doesn’t mean seven hours in bed. It takes a while to fall asleep, and most people wake up at least a couple times per night. An analysis of over 10 million users’ Fitbit data revealed that the average person is awake or restless for 25.5 minutes per night.3 If you’re aiming for seven hours of sleep, you should be in bed for eight. Want eight? Commit to being in bed for nine.

Here are a few sleep tracking methods to help you understand where you are starting.

What You Can Do to Get Better Sleep
Sleep Timing

If you believe you’re getting the requisite amount of ZZZs, the next question is whether you are getting it at the right time. Daytime sleepiness can be caused by inconsistent sleep and wake times.4 If you are maintaining one sleep schedule during the week and a completely different one on the weekends, stop. Make a concerted effort to maintain the same sleep and wake times for a few weeks and see if that helps.

Sleepiness is also a sign of circadian rhythm misalignment.5 This is when your sleep doesn’t align with your body’s natural biological clock. Shift workers, who are up at night and asleep during the day, are the classic example, but it need not be so extreme. One theory holds that some of us are “larks” (early to bed, early to rise) while others are “night owls.” Not all sleep experts agree, but it’s worth considering whether your current sleep schedule feels natural to you.

In any case, you should be sleeping when it’s dark and awake when it’s light. If you’re staying up late binge watching shows and struggling to wake up in the morning, that’s the first thing to fix.

Sleep Hygiene

Make sure you are practicing good sleep hygiene. That means:

Proper amount of time in bed
Appropriate sleep timing
Minimizing blue light at night
Cool, dark, uncluttered room

I’ve written often about sleep hygiene. I’ll link to related posts at the bottom.

Sleep Disorders

If you believe that you have all the obvious sleep boxes checked, yet you feel excessively sleepy during the day, talk to your doctor. They can test to see if you are suffering from a sleep disorder. Sleep apnea is a common one, but there are dozens more.6

Consider keeping a sleep-wake diary or using a sleep tracker such as an Oura Ring or Fitbit. This can provide some initial insight into what’s going on.

Can Your Diet Cause You to Feel Tired All the Time?

Possibly. There are certainly links between certain vitamin and mineral deficiencies and fatigue. Low iron (even without anemia),7 vitamin D,8 B vitamins (especially B129), vitamin C, magnesium, sodium, zinc, L-tryptophan, L-carnitine, coenzyme Q10, and essential fatty acids are among the most commonly implicated.10 Vitamin D in particular seems to be associated with sleep disorders.11

Food intolerances can also contribute to tiredness. The majority of patients with celiac disease12 and non-celiac gluten sensitivity13 complain of fatigue. Food allergies and intolerances are common among people diagnosed with chronic fatigue syndrome, and supplements are frequently used as part of treatment protocols. If you haven’t already, simply eliminating gluten from your diet for a few weeks is an easy at-home experiment. Even if it doesn’t help your tiredness, I’m willing to bet you’ll see other benefits.

Especially if you’re experiencing other digestive symptoms, you should work with a practitioner who can help determine if you suffer from allergies or intolerances. They should also test for underlying gut issues that might be exacerbating the problem.

If you’re not eating enough food to fuel your daily activities, that can make you feel fatigued as well. Some folks who practice intermittent fasting or follow a keto diet find they accidentally undereat. Ketones can suppress appetite, and when you’re eating in a restricted window, it can be hard to get in enough calories. If this rings a bell, track your food for a few days to make sure your calorie intake is adequate.

Is It What You’re Drinking?

Research shows a correlation between caffeine consumption, daytime sleepiness, and nighttime sleep issues.14,15,16 Of course, it’s entirely possible that sleepiness leads people to consume more caffeine, not the other way around. Experimental tests on the effects of caffeine consumption are mixed, suggesting individual differences in the degree to which caffeine affects sleep.17

And then, there’s alcohol, which can cause sleep disturbances.18 It’s counter-intuitive, because a lot of people like to have a glass of wine or other beverage to help them sleep. While it may help you fall asleep, alcohol has a tendency to disrupt sleep phases in a way that renders your sleep incomplete.

On the other hand, maybe it’s what you’re not drinking—enough water. Dehydration, perhaps even mild dehydration, can cause fatigue.19,20 You don’t have to force yourself to drink a certain amount each day, but consider adding a glass of water or two, perhaps with a pinch of sea salt, if you’re feeling somewhat fatigued.

Lifestyle Factors That Affect Tiredness
Leading a sedentary, indoor lifestyle

Being sedentary is associated with experiencing greater fatigue.21 It’s hard to get moving when you’re tired, but low-intensity exercise has been repeatedly shown to alleviate fatigue, including in chronic fatigue syndrome.22,23,24 Exercise can also improve sleep.25

Of course, you can have too much of a good thing. Overtraining can cause persistent fatigue.26 I don’t think I need to tell you how I feel about chronic cardio, do I?

Taken as a whole, the evidence suggests that low-level aerobic activity is particularly effective for helping to relieve tiredness. If you’re feeling tired all the time, try going for a daily walk. Walking is by far my favorite low-intensity activity. Plus, you get the added bonus of sun exposure, weather permitting. Get that vitamin D boost! One study found that three-quarters of patients who complained of fatigue were deficient in vitamin D27, while another showed that supplementing with vitamin D can improve symptoms.28

Stress

Experiencing extreme and/or chronic stress can also lead to fatigue and sleep problems. Mindfulness Based Stress Reduction interventions have been shown in many studies to reduce symptoms of fatigue in individuals with a wide range of chronic health problems.29,30,31 You can also experiment with supplements in this article that help your body process stress.

Is Your Tiredness a Sign of Underlying Medical Issues?

If you are experiencing fatigue that isn’t obviously related to sleep or lifestyle factors, you should talk to your doctor. There are many underlying medical issues for which fatigue is a noted symptom. Some of the most frequently cited are:

Anemia32
Type 2 diabetes33,34
Hypothyroid35, including subclinical hypothyroidism36
Heart disease37,38
Perimenopause and menopause39
Depression40

These are just some of the many issues that are associated with otherwise unexplained sleepiness or fatigue. There are others, namely chronic fatigue syndrome and fibromyalgia, for which fatigue is a defining characteristic, not just a symptom.

When you talk to your doctor, try to be as specific as possible about what you are experiencing. Is it fatigue that manifests as physical exhaustion, weakness, or lack of desire or ability to do daily activities? Persistent sleepiness despite apparently good sleep habits? Make a note of frequency and patterns, such as if you experience fatigue more at certain times of day, after meals, or, if applicable, at specific times of your menstrual cycle. Track your sleep for a few nights at least. Your doctor will ask.

Tell your doctor about any other symptoms you are also experiencing, even if they seem unrelated. Your doctor might spot a pattern that leads to a diagnosis. Finally, make sure you tell your doctor about any medications you are taking, as fatigue might be a side effect.

Getting to the Root of Your Issues

As you see, there are lots of possible causes for tiredness. If your sleepiness or fatigue is significantly affecting your quality of life—you have trouble completing your daily tasks, your memory is impaired, your mood is affected or you feel depressed—a doctor’s visit is absolutely in order.

If you want to try to self-experiment at home first, start with the obvious and easy steps:

Optimizing sleep hygiene
Staying in bed for eight to nine hours every night at the same time
Eliminating gluten if you haven’t already
Removing caffeine in the afternoon
Making sure you’re hydrated
Avoiding long periods of being sedentary
Getting outside and getting plenty of sunlight
Taking steps to alleviate stress

You can also try tracking your food for a week using Cronometer to see if you are consistently low on any vitamins or minerals. Up your intake of foods rich in the vitamins or minerals you need. If you’re not already eating a serving of liver each week (for iron and other nutrients) and small, oily fish (for essential fatty acids) on the regular, do that. If you think you’re clinically deficient in one or more areas, get tested before supplementing willy nilly.

Is Inflammation the Key?

What do poor sleep, chronic illness, sedentary lifestyles, poor gut health, chronic stress, and nutrient-poor diets all have in common? Inflammation.

It’s perhaps no surprise, then, that some scientists believe that inflammation is a key feature in fatigue of various etiologies.41 Luckily for you, everything about the Primal diet and lifestyle is aimed at avoiding the big offenders when it comes to inflammation. Still, if you see your doctor, ask them to test your inflammatory markers.

Be Persistent

Don’t let anyone write off your tiredness as normal. Yes, you might be busy or have young children or train for endurance events. We all have a lot of reasons to be “feeling down” right now. Still, you know when something is wrong. You deserve to feel vibrant and energetic.

More from Mark’s Daily Apple

The Definitive Guide to Sleep

17 Ways to Improve Your Sleep

How Light Affects Our Sleep

How to Manufacture the Best Night of Sleep in Your Life

References https://pubmed.ncbi.nlm.nih.gov/20514923/https://www.sleepfoundation.org/sleep-disorders/excessive-sleepinesshttps://blog.fitbit.com/how-do-your-sleep-habits-stack-up/https://pubmed.ncbi.nlm.nih.gov/8843535/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4677771/https://pubmed.ncbi.nlm.nih.gov/25367475/https://pubmed.ncbi.nlm.nih.gov/28625177/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5207540/https://www.bmj.com/content/349/bmj.g5226/https://pubmed.ncbi.nlm.nih.gov/10767667/https://pubmed.ncbi.nlm.nih.gov/22583560/https://pubmed.ncbi.nlm.nih.gov/12741468/https://pubmed.ncbi.nlm.nih.gov/24885375/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3280075/https://pubmed.ncbi.nlm.nih.gov/27527212/https://pubmed.ncbi.nlm.nih.gov/16549311/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6292246/https://www.sciencedirect.com/science/article/abs/pii/S1087079201901625https://www.mayoclinic.org/diseases-conditions/dehydration/symptoms-causes/syc-20354086https://pubmed.ncbi.nlm.nih.gov/26290294/https://pubmed.ncbi.nlm.nih.gov/23783259/https://pubmed.ncbi.nlm.nih.gov/18277063/https://pubmed.ncbi.nlm.nih.gov/27031610/https://pubmed.ncbi.nlm.nih.gov/27995604/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3317043/https://bjsm.bmj.com/content/32/2/107https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4158648/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5207540/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4431452/https://pubmed.ncbi.nlm.nih.gov/26519614/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5187553/https://www.sciencedirect.com/science/article/abs/pii/S0093775401902076https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2905388/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6064586/https://pubmed.ncbi.nlm.nih.gov/22989469/https://www.aafp.org/afp/1998/0215/p776.htmlhttps://pubmed.ncbi.nlm.nih.gov/24589645/https://pubmed.ncbi.nlm.nih.gov/3169045/https://pubmed.ncbi.nlm.nih.gov/10851573/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3225130/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5247454/

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How to Get Back into Ketosis After a Carb Binge

A little planning and motivation will help you start a low-carb, keto, or Primal lifestyle, and under normal circumstances, keeping your carbs on the low side is easy. But let’s not create the illusion that it is easy all the time. From time to time, you may get stressed and eat mindlessly. Or, your aunt drops off her blue-ribbon cake that you’ve loved since you were in preschool, and you give in, just this once. Or, you had a jam-packed day and all you can muster to make for dinner is that package of gluten-free noodles in the back of your pantry. The next thing you know, you’ve eaten enough carbs for a week, and you wonder how you’ll get back into ketosis after a carb binge.

The short answer is, yes you will recover from a carb binge. Yes, you will get back into ketosis. As far as how long it will take to get back into ketosis – that depends on numerous factors, that we’ll dive into here. The important thing to remember is, you did not obliterate your goals with one misstep. Especially after you’ve spent some amount of time in ketosis, your body will allow for fluctuations in carb consumption here and there. That’s called metabolic flexibility, which we’ll go into shortly.

Instantly download the Keto Reset Diet Recipe Sampler

Can You Have a Cheat Day on Keto or a Primal Diet?

Admittedly, I’m not a fan of calling them “cheat days,” for a few reasons:

“Cheating” implies that you did something wrong and should feel guilty about it.
Earmarking “cheat days” sends the message that you can eat whatever you want that day with abandon. You’d be surprised how much you can backpedal on your goals in a 24-hour period.

I prefer to frame higher carb meals or snacks as carb cycling or carb refeeding, which is an intentional higher carb meal to enhance your results; or, frame them as treats, which are planned. That way, the extra carbs are enjoyable, planned in advance, and come with limitations so you don’t go overboard. And, there’s no guilt involved.

So, can you have high-carb days on keto? If you are in ketosis and have a sudden surge in sugar or carbs, your body will burn glucose instead of producing ketones. In order to get back into ketosis, you have to use up the glucose you just consumed, and the glycogen your body just stored.

The concern is whether the transition back into ketosis will be as difficult as you remember from those first days cutting carbs. If you have been in and out of ketosis for a while, you may slip back into ketosis fairly easily because you’ve developed metabolic flexibility. If you’re just starting, you may go through some of the discomfort of transitioning between fueling with sugar vs. fueling with ketones. Your body “remembers” though, and most likely, it will not last as long or be as severe. This article contains some things you can do if you experience “low-carb flu.”

What Happens to Your Body After a Carb Binge?

So, you decided to give in. First, don’t beat yourself up. It happens. What does your metabolism do with the surge of insulin and carbs? Even a few quick forkfuls can shift you from small doses of quality carbs wisely spread throughout the day to possibly 100 or more grams of pure sugar in one sitting. It’s likely you’ll experience some effects, but you can get past it.

First off, the good news. There’s no carb police coming to take away your keto card. Nor is there any other permanent fate awaiting you. You’ll go about your day a live, generally functional human being. There is no truly long-term risk elevation for that matter. Nonetheless, you’ll likely experience a fair amount of regret for cheating on keto.

Your Pancreas Kicks Into Overdrive. Within a few minutes, your pancreas starts pumping out a flood of insulin to try to sop up all the excess glucose that’s suddenly rushing through your bloodstream. Remember, while glucose is muscle fuel when it’s in the muscles, it’s toxic sludge when it stays in your bloodstream. Your body knows that and does everything it can to get it out of there. Perhaps you’re feeling flushed, a little high, spastic, anxious, or nauseous depending on how much you ate, how big you are, what your normal carb load is, and how acutely you tend to “feel” the effects of sugar and other substances. Ironically, if you were insulin resistant, you might not even notice these sensations.
Excess glucose converts into body fat. The gush of insulin now creates a see-saw effect. If your glycogen stores have room, some of the sugar goes into muscles. If there’s no more room, the excess goes into fat cells, where it is stored as fat. In reaction to this quasi-emergency that your brain perceives as a life-threatening stress, the body steps up its efforts to achieve homeostasis by releasing both epinephrine (adrenaline) and cortisol from your adrenals. Your heart starts racing, and you’re starting to feel uncomfortable, maybe even sweating. And we’re still likely within the first hour after you finished off that cake!
Sugar crash. After a bit more time passes, burnout settles in? That’s called a sugar crash – when all the glucose is gone from the bloodstream and you start to feel sluggish, off-kilter, like the internal circuits are all fried after sparking in a heap of now smoldering wires.
Your immune system slows down. The havoc that sugar rush set off – the swing of glucose and insulin, the cortisol and adrenaline – they’ve sent your immune system into a tailspin. Research1 has shown that the function of immunity-related phagocytes, the cells that surround and engulf pathogens, is impaired for at least five hours after intake of simple sugars. Free radicals, or damaging oxygen atoms, have their heyday as well within the first few hours after sugar increases oxidative stress2 on the body. Your blood even thickens as a response to the stressors. A hefty dose of sugar can compromise the immune system3 for more than 24 hours.
Your sleep is disrupted. At the end of the day, you try to sleep it off, but you toss and turn as your heart continues to beat faster than normal. Little surprise there – the old hormonal system is confounding in its interconnectedness. You lay there cursing not just that cake but the entire cultural custom of birthday celebration. As the sun comes up and you roll out of bed, you think you should be done with this sugar business by now. Maybe, maybe not.

How to Recover From a Carb Binge

As bad as this sounds, it could be worse. If you follow a Primal or keto lifestyle and the carb overload was just a detour, you’ll come out of this generally as healthy as you were before the flub. You’ll experience the effects, and you may feel them more acutely than you did before you chose the low-carb path. This isn’t a bad thing. Nonetheless, after the dust settles, the worst thing you can end up with is maybe a cold you wouldn’t have gotten otherwise. Your system will realign itself pretty readily. After spending a couple days back on your regularly scheduled program, you’ll be as good as new.

How to Get Back Into Ketosis After Cheating on Keto

So, you want to get back into fighting shape as soon as possible. Here’s what to do:

Scale back your carbs to where you were before you found yourself off-track.
Make sure you are getting the correct balance of electrolytes. Read this article to understand why electrolytes are important while transitioning to ketosis and how to make sure you are getting adequate electrolytes.
Consume sufficient high-quality fats, especially at first.
Don’t overdo the cardio. You can ease back into more intense aerobic exercise once you’re fully transitioned.
Consider intermittent fasting. You may have an easier time getting into ketosis for the long haul if you time-restrict food intake, which gets your body used to producing ketones.

How Long Does it Take to Get Back Into Ketosis?

You may wonder how long it will take to get back into ketosis after falling off. The answer is, it varies. It depends on how metabolically flexible you were before you started, how insulin-sensitive you are currently, how many carbs you were accustomed to consuming before you increased your carb intake… there are a lot of factors. The vague answer is, it won’t take long to get back. Start now, and you’ll get to where you want to be before you know it.

References http://www.ajcn.org/cgi/content/abstract/26/11/1180http://jcem.endojournals.org/cgi/content/abstract/85/8/2970?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=1&andorexacttitle=and&andorexacttitleabs=and&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&sortspec=relevance&volume=85&firstpage=2970&resourcetype=HWCIThttp://www.ncbi.nlm.nih.gov/pubmed/18469239?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_Discovery_RA&linkpos=2&log$=relatedarticles&logdbfrom=pubmed

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Keto Hawaiian BBQ Meatza Pizza Recipe

Have you ever heard of a meatza? It’s the low-carb, grain-free answer to pizza cravings once you’ve adopted a keto, paleo, Primal, or Whole 30® way of living.

Meatzas are just as versatile as pizza. You can use virtually any ground meat as the “crust” base, and top it with endless combinations of pizza toppings. From traditional sauce and uncured pepperoni, to veggie lovers’, to caramelized onions and herbs, anything goes. We tapped into some tropical inspiration for this Keto Hawaiian BBQ Meatza. It’s flavorful and spicy, with a touch of sweet. To cool the kick and take a flavor journey to the islands, add some chopped mango or pineapple right before serving.

The best part is, they’re easy to make! If you’ve ever tried to make a grain-free or cauliflower pizza crust from scratch, you’ll appreciate how simple these are.

Keto Hawaiian BBQ Meatza Pizza Recipe

Serves: 2 as a main, up to 6 as a snack

Time in the kitchen: 30 minutes, including 20 minutes bake time

Ingredients

Meatza Base

1.5 lbs ground chicken thigh
1/3 cup + 2 tbsp fine almond flour
1/2 tbsp coconut flour
1 tsp Primal Kitchen® Olive Oil or Avocado Oil
1/2 tsp salt
½ tsp black pepper
½ tsp chili powder
½ tsp garlic powder
½ tsp onion powder
½ tsp paprika
1 egg

Toppings

1/4 cup Primal Kitchen Mango Jalapeno BBQ Sauce
1/4 cup sliced onion
1 jalapeño, thinly sliced
3/4 cup shredded mozzarella cheese
Optional additional toppings: avocado, pineapple, mango, cilantro

Directions

Preheat your oven to 400 degrees Fahrenheit. Mix all of the meatza ingredients together in a bowl until well combined.

Line a large sheet pan with parchment paper. Divide the meat mixture into two and make two round flattened patties about 1/2” thick. Bake for 10 minutes, then flip the meatzas over and bake for an additional 5-10 minutes, or until their internal temperature is at least 165 degrees Fahrenheit and they are browned on the outside. Allow the meatzas to cool for a few minutes.

Spread the Primal Kitchen Mango Jalapeno BBQ Sauce on the meatzas. Arrange half of the sliced onion and jalapeno on top, then sprinkle with cheese.

Top with the remaining onion and jalapeno. Turn on your broiler and place the meatzas under the broiler until the cheese is melted.

Top with any additional of your favorite toppings and slice the meatzas up!

Nutrition Information (1/6 of recipe):

Calories: 264

Total Carbs: 6 grams

Net Carbs: 5 grams

Fat: 14 grams

Protein: 29 grams

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Weekly Link Love – Edition 78

Research of the Week

New study says exercise may prevent severe respiratory complications of COVID-19.

About 50% of food sold in Britain is ultra-processed. In France, it’s around 14%.

“The majority of studies, and especially the higher quality studies, showed that those who avoided meat consumption had significantly higher rates or risk of depression, anxiety, and/or self-harm behaviors.” From a new paper on meat and mental health.

New Primal Blueprint Podcasts

Episode 419: Helen Marshall: Host Elle Russ chats with Helen Marshall, a Primal Health Coach and founder of the grain-free line of foods called Primal Alternative.

Primal Health Coach Radio, Episode 57: Laura and Erin chat with Drew Manning, who understands the importance of empathy when coaching.

Media, Schmedia

Coronavirus is hitting the meat industry hard.

Coffee is healthy unless it’s not.

Interesting Blog Posts

On the carbon footprint of various foods.

How risky is outdoor transmission of the coronavirus, asks the amusement park industry.

Social Notes

My favorite movies.

Everything Else

The more meat the better.

Superspreading happens “wherever and whenever people are up in each other’s faces, laughing, shouting, cheering, sobbing, singing, greeting, and praying.”

Things I’m Up to and Interested In

Important new paper: “From barefoot hunter gathering to shod pavement pounding. Where to from here? A narrative review.”

Question I’m asking: So it’s not the meat and dairy causing all the pollution?

Another question I’m asking: Are seed oils even worse than trans-fats?

Interesting discussion: On fat:protein ratios in carnivore diets.

I’ve seen this stuff somewhere before…: Twitter’s Jack Dorsey starts his day with meditation, salt water with lemon juice, ice baths, sauna sessions, hour long walks, short but intense workouts.

Question I’m Asking

How has your diet changed (if at all) the last month?

Recipe Corner

Sometimes, you want a treat. Look no further than paleo cinnamon rolls.
Red Thai curry with cauliflower gnocchi.

Time Capsule

One year ago (Apr 19– Apr 25)

What Breaks a Fast: Supplement Edition – What supplements break the fast?
Keto and the Menstrual Cycle: Is There Reason to Worry?– Well, is there?

Comment of the Week

“The link titled “Outdoor transmission of coronavirus is very rare, according to new research.” is misleading if you don’t review the linked article carefully. This research only studied infection points for 3 or more. Thus we can only conclude that “Outdoor transmission to 3 or more at once” is very rare, according to this research.

It would be premature to conclude that since group transmission hardly occurs outdoors that you or I have little chance of infection outdoors. The data is not present in that study (there may be others) to draw such a conclusion and doing so before we know might be dangerous.”

– That’s a fair point, Steve. I think outdoor transmission will be much rarer—group or otherwise—especially with increased sun and humidity, but you are right that the link doesn’t account for single 1-to-1 transmissions.

The post Weekly Link Love – Edition 78 appeared first on Mark's Daily Apple.

The Secret to Achieving Any Health Goal is All in Your Mind

Around here, we talk a lot about the stories we tell ourselves. You know, the limiting beliefs and thoughts that constantly dance around in our brains, preventing us from achieving our health goals. “I’m a terrible cook.” “I never have time to exercise.” “I’ll always be heavy.” Or, “I’m too lazy to stick to a plan.”

Why do you create limiting beliefs?

As humans, we’re wired to create narratives that string together the picked-apart aspects of our lives in a way that rings true for us. It might be things we heard our parents say or experiences we had growing up. Or even interpretations of those things and experiences. According to psychologists at Northwestern University, the narratives we create become a form of our identity — an identity that not only reflects who we think we are, but also what we believe we’re capable of achieving.

Just FYI, these are the false narratives and limiting beliefs you tell yourself and anyone else who will listen. As a veteran health coach, I know this drill firsthand.

Limiting Beliefs List: Examples of Common Narratives People Tell Themselves

When you have a goal in mind, it’s natural, almost reflexive to come up with reasons why you can’t achieve it. Here are some of the more common false narratives that I hear in my practice:

I don’t deserve it

I don’t have the willpower to accomplish this

I’m not disciplined enough

My body type is genetic

Any change I make will be minor, and barely noticeable

I have a tendency to fail at things like this

I don’t have the time

This is going to be just like the last time I tried and failed

I’m lazy

I’m selfish if I focus on improving myself like this

I’m too old

These are all made up – every last one of them. I get it though. You probably have decades of proof that you’ll never lose weight. Or that everyone in your family has thick thighs or has an awful sweet tooth. But let me ask you this…

What if you could change your beliefs?

Your mind is one of the most powerful resources you have. If you can believe you can do it, you have a better chance of actually doing it. It’s sort of a believing is seeing mentality. And there are loads of studies to back up this phenomenon. Research by psychologist, Alia Crum shows that how you think about your health can influence the outcome. She adds that you can actually change your reality just by changing your thoughts.

Studies on mindset and limiting beliefs

In a 2007 study 1, Crum and her associate Ellen Langer looked at hotel room attendants whose work involved strenuous physical activity. Two-thirds of the participants believed that they weren’t exercising enough because they weren’t doing typical exercises. Once it was pointed out that pushing heavy carts, pushing a vacuum, and lifting mattresses qualified as exercise, they showed improvements in their weight, blood pressure, and body fat over the course of four weeks.

Researchers conducted another study 2 where participants were given a 380-calorie milkshake, but were told that it was either an indulgent 620-calorie shake or a more sensible 140-calorie shake. When participants drank the milkshake they thought was indulgent, they had a steeper decline in the hunger-inducing hormone, ghrelin than when they drank the milkshake they were told was sensible. Basically, their bodies had a physical response based on what they believed.

I see this in my clients too. For one reason or another, they were programmed to believe that walking wasn’t a good form of exercise or they couldn’t go a single day without eating chocolate or that they’re flat out lazy.

They believed these thoughts until I helped them see things differently. And you can too.

You can always work with a health coach, but I think you’ll be surprised at how simple it can be to start to rewrite the limiting beliefs that have been holding you back for maybe, forever.

How to Change your Limiting Beliefs in 4 Steps and Reach any Health Goal

Here’s a snapshot of my 4-step action plan to shift your mindset so you can reach all of your health goals:

Visualize your new identity
Think about what qualities that person has
Describe the specific actions they take
Prove it to yourself with small wins

1. Visualize your new identity (and really feel it)

As I mentioned, your identity is based on your limiting beliefs, so instead of putting all of your effort into the behavior you want to change, focus on the person you want to become.

EXAMPLE: You’re trying to be healthier and your spouse comes in the kitchen with a drive-through burger and fries. Instead of saying, “no thanks, I’m on a diet,” try “no thanks, I don’t eat fast food.”

See the difference? In the first response, you still believe you’re a fast food eater (or soda drinker or whatever) but are trying to act differently. In the second response, you believe you’re the kind of person who doesn’t eat fast food. The more you associate with that person, the more your brain starts to automatically believe it.

ACTION STEP: Describe the type of person you want to be. The more specific, the better.

2. Think about what qualities that person has

What are the qualities you’d associate with someone who is healthy? Really visualize a person in that situation — it could even be someone you know. What traits do they have that make them so successful?

EXAMPLE: You’d probably say that they’re mindful and patient. They might also be excellent planners, respect themselves and have a good sense of self-esteem.

Remember, you’re not listing out your own traits, you’re imagining yourself as a person who is mindful, patient, and a good planner. You’re laying the groundwork for becoming the person you want to be so that you can reach the health goal you want to achieve.

ACTION STEP: List out the positive qualities of the person you want to become.

3. Describe the specific actions they take

How does the person you’re becoming act? What’s the first thing they do in the morning when they wake up? What do they do at mealtimes? How do they organize their fridge?

EXAMPLE: A healthy person eats according to their hunger level and recognizes when they have an emotional need (like boredom or fear) versus actual physical hunger. They also fill their kitchen with fresh veggies and good protein sources, making it easy for them to eat healthy.

Your interpretation of what this person does is completely up to you. There’s no right or wrong answer. The key is to visualize the specific actions this person takes, so you can follow suit.

ACTION STEP: Write down the types of things a healthy person does on a daily basis.

4. Prove it to yourself with small wins

Once you’ve visualized your new identity, brainstormed what qualities they have, and figured out the actions they take, your subconscious will start associating with that type of person. Now is the time to take note of all the small wins you’ll be racking up.

EXAMPLE: I’m a healthy eater because I planned out my grocery list for the week. Or, I took 15 minutes to cook a meal of scrambled eggs and bacon instead of grabbing a breakfast sandwich at the nearest drive-through.

Making a grocery list or cooking breakfast one day may not feel like a big deal on its own, but as you see these wins add up, your brain starts to get onboard with your new way of being. And before you know it, you’ll be proving it to yourself with bigger and more consistent wins for the long-term.

ACTION STEP: Keep a record of all the small wins you experience and add to it regularly.

The idea isn’t to become someone else entirely. It’s about reframing your narrative to include all the possibilities you hadn’t yet allowed yourself to believe, then giving yourself the evidence that the life (and awesome health) you want really is available to you.

References https://mbl.stanford.edu/sites/g/file...

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Fasting with a Cold: How Does Fasting Impact Viral and Bacterial Infections

Fasting is a great tool for so many things. You can use it to regulate food intake and lose body fat. Fasting can help you shift body composition, normalize your appetite, and gain control over your relationship to food. Many people report cognitive enhancements from fasting, and it’s a surefire way to speed up the transition into ketosis and full-blown fat adaptation. There’s strong evidence that we look, feel, and perform best skipping the occasional meal—that it’s the evolutionary norm for humans not to have constant, unceasing access to food. After all, we didn’t always have 24 hour grocery stores and fast food restaurants. But what about fasting with a cold?

And what about intermittent fasting and the immune system? Should you fast at all when you’re sick? What about fasting with the flu? Or how about bacterial infections—can fasting help with those? These are actually some of the most common questions I receive. Because intermittent fasting seems to help with so many other conditions, it makes sense to wonder about its relationship to the immune response.

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There are two main types of infections that most people worry over: viral infections and bacterial infections.

Viral infections include influenza (flu), the common cold, viral gastroenteritis, and the various coronaviruses. There are also things like measles, chickenpox, and viral meningitis, but most people aren’t very worried about catching those these days.
Bacterial infections include pneumonia (most pneumonias are bacterial in origin, though some can be viral), bacterial gastroenteritis, food poisoning, and bacterial sinus infections.

Fasting With a Cold – Viral Infections

In general, fasting doesn’t look like a great idea if you’re dealing with a viral infection like the flu or common cold. Why?

Studies on Fasting and Viruses

Animal studies show that mice who fast have a worse response to subsequent viral infections. In one paper, mice were either fasted every other day or placed a normal diet, then exposed to a “viral mimetic” (a type of chemical that replicates a viral infection). The mice who fasted ended up with higher cortisol, a more inflammatory immune response, more severe symptoms, and acted sicker than the mice who ate.1

Another mouse study found that in animals exposed to an infectious virus, a fat-based (fasting) metabolism was detrimental to survival and a glucose-based (fed) metabolism was beneficial.2

Viruses Deplete Nutrients

Viruses are much smaller than bacteria and generally cause trouble by hijacking cells and using your body’s machinery to replicate. To do so, they often steal nutrients from the host. One example is selenium, a crucial nutrient for viral replication. Studies show that viral infections can induce selenium deficiencies and that correcting those deficiencies by, well, eating selenium-rich foods can improve the outcome of infections.3

Most viruses will deplete nutrients and you need to eat to replenish them.

Fasting Inhibits MTOR, Which is Good and Bad

Blocking MTOR (mammalian target of rapamycin) through fasting reduces expression of another major immune component: the interferon-inducible transmembrane protein (IFITM). 4 Think of the IFITM as a barrier preventing some viruses from gaining a foothold in your body, including influenza, Ebola, SARS, MERS, Marburg, Dengue, and hepatitis C. These are IFITM-sensitive viruses, but there are also IFITM-resistant viruses, like the common cold.

In fact, one study found that increasing IFITM levels increased vulnerability to infection by the common cold virus.5 Using fasting to reduce mTOR and lower IFITM expression could conceivably increase resistance to the common cold while increasing vulnerability to flu (and the others like Ebola and so on). Double edged-blade.

Or perhaps it’s triple-edged.

Part of dealing with an infection is learning from it. Our immune systems have to seroconvert antibodies so that when we encounter the infection again, our immune system is better equipped to head it off at the pass. This is the concept behind vaccination—a measured dose of the infective agent that trains our immune system to defeat the real thing in the future. As it turns out, inhibiting mTOR through fasting could affect our ability to seroconvert antibodies in response to viral infections.

In studies of older adults, higher levels of mTOR predict lower rates of seroconversion, and giving them an mTOR inhibitor improves seroconversion after a flu vaccine. If fasting reduces mTOR (and it does), it should in theory improve the antibody response to a vaccine or infection.

Weird, right? Fasting reduces mTOR, which could impair your short term response to an infectious insult (or improve it if it’s the common cold) while improving your long term response. You might still get sick but at least your chances of developing longterm immunity should increase.

Fasting With a Cold – Bacterial Infections

In general, fasting looks like a better idea when you’re sick with a bacterial infection.

Research on Fasting and Bacteria

Animal models of bacterial infections find that mice tolerate them much better in a fasted, ketogenic state. In fact, the ketone body beta-hydroxybutyrate is able to directly nullify some of the oxidative stress associated with bacterial infections;6 while “ketogenesis was required for survival in bacterial inflammation, it was dispensable in the case of viral inflammation.”

Bacterial Infections Reduce Appetite Naturally

One indicator is that your appetite often falls off a cliff when you have a bacterial infection. The last you want to do when you’re dealing a bout of food poisoning is eat. This doesn’t usually happen with viral infections, and I believe that’s important. In those “base” states of survival, what you crave is a good indicator of what you need.

Fasting Improves Phagocytosis (and Sugar Inhibits It)

A key component of the innate immune system’s ability to deal with bacterial infections is phagocytosis: When a class of immune cells called neutrophils surrounds, engulfs, and destroys individual bacteria. The phagocytic index describes the number of bacterial cells a neutrophil is able to engulf and nullify in a set time. Generally speaking, higher phagocytic activity means you have a better response to bacterial infections.

Luckily, we know pretty well how to increase and decrease phagocytic activity in people. To decrease phagocytic activity (make neutrophils worse at engulfing and destroying pathogenic bacterial cells), you simply feed a person sugar.7 It could be orange juice, honey, sucrose, fructose, or glucose—any simple source of sugars—and if you give 100 grams to a person, their phagocytic capacity drops for at least five hours. Give the person nothing—let them fast—and their phagocytic capacity climbs. Even at 5 hours after eating the sugar, the phagocytosis still hasn’t caught up to that of the fasting person.

Later studies confirm that low fasting blood glucose is a strong predictor of a strong neutrophil:leukocyte ratio8. Lower glucose, more neutrophils available to take on bacterial pathogens. Fasting is a reliable way to drop your blood glucose.

Phagocytosis doesn’t work so well against viral infections because a virus sequesters itself in the host’s cells. Neutrophils can’t engulf and kill the host cells; that’d just be counterproductive and probably quite dangerous. However, there’s evidence both ways: that neutrophils can enhance the immune response to viral infections but they can also exacerbate the damage done to host tissues. It isn’t clear what role they play so I’d advise against consciously manipulating them through fasting.

Intermittent Fasting While Sick: Making Sense of it All

There are no easy, straightforward rules governing the optimal fasting strategy for infections, whether viral or bacterial. Each virus is different. Every bacteria is separate. Nothing in biology is simple. What we do know:

If fasting stresses you out, it will be bad for your immunity. Cortisol depresses the immune system.
If fasting ruins your sleep, it will be bad for your immunity. Proper sleep is absolutely essential for an optimal immune response.
If you’re hungry, let that be your guide. Eat. Don’t force the issue.
If you’re not hungry, skip the meal. Again, let your body’s signals be your guide.
When faced with an immune insult, or if something’s “going around,” cut back on the fasting or at least keep it shorter than normal. 16 hours instead of 30. 20 instead of 48.
Realize that fasting is not a panacea. It’s not the answer to everything.
Understand that bacterial and viral infections often tag along with each other. A virus will weaken the host enough to allow bacterial pathogens to flourish. You’ll often be dealing with both at once. I’d imagine that something that allows you to stay fed while also enjoying a fat-based metabolism—like a lazy ketogenic diet—could work well here.
Fasting can prune damaged parts of your immune system and replace them with renewed components.9 This is good for long term immune health, but if an infectious agent happens to catch you in the middle of an extended fast while you’re doing the pruning, your risk of infection probably goes up. There’s always a give and a take.

There are no magic bullets, but it cuts both ways. You are resilient. While most of the humans throughout history didn’t make it through hundreds of thousands of years of death, destruction, famine, and disease, your gene line did. So don’t think you have to pick one or the other—fasting or feeding—in response to illness. Go with what feels best, don’t get dogmatic, and just take it easy.

What’s your go-to feeding strategy for dealing with sickness? Do you differentiate between viral and bacterial illnesses? Let me know down below!

References https://www.ncbi.nlm.nih.gov/pmc/arti...

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Carb Refeeds for Women: Do They Help With Fat Loss?

One of the more common questions we get in the Keto Reset Facebook community is, “How do I break through a weight-loss plateau?”

Stalls are frustrating. You’re cruising along on your Primal or Primal + keto diet, and then wham—you hit a wall. It’s all a totally normal and expected part of the weight loss process. Weight loss is never linear. There are always downs, ups, and flat spots.

In fact, if you’ve been losing weight for a while, and then you stall out for a week or two, I wouldn’t even consider that a plateau necessarily. Your body might keep losing weight on its own if you give it time and don’t stress about it. Still, I get it, you’re eager to kick-start the weight loss again.

One strategy that gets tossed around is trying a carb refeed or “carb up.” Carb refeeds are touted as plateau busters and also, more generally, as a strategy to support weight loss. In today’s post, I’ll explain the logic behind this idea and explain why it might be effective, especially for women following a generally low-carb approach.

 

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What Is a Carb Refeed?

Let’s get some terminology out of the way. Strategically adding carbs to a low-carb diet is variously called a “carb refeed,” “carb up,” or “carb cycle.” These terms don’t have standardized definitions. In general, carb cycling usually refers to eating low carb for a certain number of days, then higher carb for a certain number of days, and repeating.

“Carb refeed” and “carb up” can mean the same thing, or they can mean adding carbs more intuitively when you feel like you need them.

Carb cycling strategies have long been used to promote leanness, especially by physique and other athletes trying to achieve low body fat percentages. In this context, carb cycling involves specific protocols, usually 5-6 days of very low carb eating combined with 1-2 days of higher carb eating. They may include exercise and fasting regimens, too.

The carb cycling protocols used for getting super lean aren’t the same as what we’ll be talking about for general weight loss and breaking out of a stall. For one thing, they usually involve more carbs than you probably need. We’ll get to that later. Also, although some of the mechanisms are probably the same, they focus specifically on depleting and refilling glycogen stores. For our purposes, that’s not so important.

How Do Carb Refeeds Work?

First let me say that the evidence for carb cycling strategies, especially with regard to weight loss and plateaus, is mostly anecdotal. There is pretty good data to support the pieces, but the whole picture has not been rigorously tested.

So what do we think is happening? There are a few (not mutually exclusive) hypotheses here:

Carb refeeds work by boosting leptin
Carb refeeds work by relieving the stress of dieting
Dieting is hard, and carb refeeds help us stick to them

Carb Refeeds Work by Boosting Leptin

Leptin is sometimes called the “satiation hormone,” but it’s probably more accurate to think of it as a starvation sensor.1 Its main role is to tell the brain whether we have sufficient energy on board, either in fat cells, which secrete leptin, or because we have recently eaten (especially carbs).

It’s well established that leptin levels drop both when we lose body fat and when we eat in a caloric deficit2 for even a short period. Remember, from an evolutionary perspective, weight loss signals that we are in a time of food insecurity and stress. Low leptin signals to the hypothalamus that we might be facing an energy shortage. In turn, the hypothalamus kicks on the processes collectively known as adaptive thermogenesis,3 or energy conservation. These include down-regulating thyroid activity and slowing metabolic rate, decreasing energy expenditure, and increasing hunger and appetite.

Premenopausal women’s bodies are especially sensitive to anything that sets off the “Danger! Starvation possible!” alarms. (Postmenopausal women are generally more resilient.) Leptin is a key player in that system. It is also involved in the regulation of insulin sensitivity and glucose metabolism, the female reproductive and immune systems, and skeletal and cardiovascular health. Basically, leptin is really important if we want to feel good and achieve optimal hormonal balance.

Leptin levels rise in response to eating carbohydrates specifically.4 Thus, one rationale behind carb refeeds is that by boosting leptin, we can reset the system. Basically, it tells the brain, “Hey, it’s cool, we have food around. It’s safe to let go of some of this body fat.”

Carb Refeeds Work by Relieving the Stress of Dieting

A related hypothesis is that dieting is physiologically stressful on the body. After periods of energy restriction, we see a decrease in thyroid hormones and an increase in cortisol (which may be related to falling leptin). These are part of the adaptive response that aims to restore energy balance. Carb refeeds alleviate the stress of being in a constant state of energy restriction.

Dieting Is Hard, and Carb Refeeds Help Us Stick to Them

One of the main reasons dieting hard is because of hormonal changes (ahem, leptin5) that increase hunger and appetite. Besides feeling unpleasant, this leads many dieters to eat more than they realize, undermining fat loss. Multiple studies also suggest that low leptin levels increase reward-seeking behavior. Basically, food becomes more appealing and harder to resist.

Low leptin is also related to depression6, anxiety, and perceived stress, all of which can make it harder to stick to your diet goals.

For all these reasons, periodically boosting your leptin via carb refeeds should make dieting feel less challenging. Beyond that, there’s also the psychological factor of knowing that you don’t have to strictly adhere to a diet indefinitely. Although it might seem counterintuitive, research confirms 78that giving yourself planned breaks can help relive the doldrums of dieting and actually increase your adherence in the long term.

Who Should and Should Not Consider Incorporating Carb Refeeds

There’s no evidence that carb refeeds are necessary or optimal if weight loss is your goal. Like so many things, this is going to be an n=1 situation. They might help, hurt, or be neutral depending on the individual.

First and foremost, if it ain’t broke, don’t fix it. If your current diet is working just fine, you feel great, and you’re losing weight, you don’t need carb refeeds. (By the way, if you’re impatient because you’re losing slowly, I haven’t seen any evidence that they will speed up weight loss.)

Likewise, they generally aren’t recommended for people who still carry a significant amount of body fat. There’s no real guidance as to what constitutes “significant amount,” unfortunately. As a rule, though, leaner individuals are more likely to benefit from the hit of leptin because they have less adipose tissue to produce it on a day-to-day basis.

DO: Reasons to experiment with carb refeeds include:

You’re experiencing a weight loss plateau. This means several weeks of no change in weight or body measurements despite nothing else changing. This isn’t a guaranteed strategy, of course. There are lots of reasons weight loss can stall, not all of them related to leptin or diet adherence. It’s certainly worth a try, though.
You’ve been low-carb and/or calorie restricted for a while, and you’re experiencing other signs of hormone dysregulation. These include menstrual irregularity and sleep9 disruptions, among others. Depending on how severe your symptoms, you might need more than the occasional carb refeed. For mild symptoms, an occasional refeed might help.
You’re sick of dieting. Mixing it up with carb refeeds (which are not the same as “cheat days”) can relieve the dieting fatigue.

DON’T: Other instances when carb refeeds are not advised are:

For people who are using low-carb or keto therapeutically, such as for epilepsy or Parkinson’s, unless advised by their health care practitioners.
For people who are extremely insulin resistant.

How to Implement Carb Refeeds

No matter what strategy you use, you want to refeed with nutrient-dense, Primal-aligned foods. We’re talking sweet potatoes, potatoes, beets, baked goods made with almond or coconut flour if you want, in-season fruit, quinoa, maybe legumes if they work for you. If you want to eat some rice (sushi!), no judgement here.

Primal carb refeeds aren’t just an excuse to “cheat” (a term that I hate). You’ll see carb cycling protocols that allow, even advocate, eating copious amounts of junk food (another term I don’t love) on refeed days. Since our goal here is metabolic health and hormone balance, stick to the same Primal foods that support those goals, just with more carbs.

How Many Carbs Should I Add?

If you look at the literature on carb cycling, you’ll find various opinions. Depending on who you ask, it can be upwards of 300+ grams per day. Again, though, these come mostly from protocols aimed at physique and other athletes, and these high carb recommendations are for men who are already quite lean. It’s not clear how they apply to the average woman looking to kickstart their weight loss.

As usual, it’s also hard to find research on people who follow a low-carb Primal or paleo approach. In this oft-cited study,10 for example, the control diet was a mainly liquid diet supplemented with orange juice, yogurt, and cream that came in at an average of 224 grams of carbs per day. In the carb overfeeding condition, which was shown to boost leptin, the average daily carb intake was 394 grams—way more than the average Primal eater probably consumes.

In the absence of solid research-based recommendations, you’ll have to experiment. A good place to start is bumping up to twice your normal daily intake by adding nutrient-dense carbs to one or two of your meals, and increasing as necessary. If you want to be scientific about it, log your food and also keep track of metrics like weight, sleep, and energy. Play around with the frequency of carb-ups, as well as the amount of carb you add, and see what works best.

Should You Increase Carbs, Calories, or Both?

Technically, carb refeeds don’t have to involve more calories. Some protocols state that you should reduce fat on carb-up days so that your total caloric intake stays the same. Others specifically recommend adding carbs and increasing calories by a fixed amount.

Unfortunately, we don’t have enough studies to break down the separate effects of carbs and calories here. In theory, both should signal to the body that energy is available, but carb intake uniquely boosts leptin. Once again, experiment to see what works for you. To start, I’d recommend allowing your calories to increase on refeed days. You might dial back your fat a little, but I wouldn’t overthink it, especially if you’re already low-carb or keto. Adding 50 or 75 grams of carbs is 200 to 300 calories. That might be less than your typical caloric deficit. Even if you add more, it’s unlikely to negatively effect weight loss if we’re talking occasional refeeds.

I know that many dieters are afraid to increase their calories for fear of “undoing” their progress. That fear seems to be unfounded. Multiple studies confirm that intermittent dieting—mixing periods of caloric restriction with eating around your maintenance calories—is no worse11 for losing weight than continuous calorie restriction. It may even be advantageous12 for weight loss, and fat loss specifically.

How Often Should I Refeed?

In terms of how often to refeed, you have some options:

Add in carbs whenever you plateau
Carb cycling on a schedule
Carb cycling around your menstrual cycle
Eating carbs intuitively

Add in Carbs Whenever You Plateau

If you’re actively trying to lose weight, one option is to wait until you hit a plateau—at least a couple weeks when the scale stops moving—then add a day or two of higher-carb Primal meals to see if that moves the needle.

Carb Cycling on a Schedule

As I said up top, some carb cycling strategies involve fixed periods of lower- and higher-carb eating. Often this looks like eating low-carb during the week and then doing one or two higher-carb days on the weekend. This is more convenience than science though. There’s no reason you can’t do 9/1 or 12/2 or any other pattern that works for you. You don’t even need to take a whole day. Some people just do one high-carb meal per week and feel great.

Obviously this strategy is more of a lifestyle than an acute tool for breaking through a weight-loss plateau. This is for people who don’t do well with continuous dieting or who find it easier to stick to their goals when they have planned deviations. It is akin to the idea of a cyclical ketogenic diet, although you don’t have to be keto to use carb cycling.

Carb Cycling Around Your Menstrual Cycle

Another carb cycling strategy is timing carbs strategically around your menstrual cycle.

This strategy isn’t specifically geared at weight loss but rather supporting the whole hormonal system, but it potentially allows you to kill two birds with one stone. There are different approaches here, but a common one is increasing carbs 4 to 5 days post-ovulation (around days 19 and 20 of your cycle) and on the first couple days of your period. These are times when your leptin levels naturally dip, so you could possibly benefit from the boost. Some women prefer instead to add carbs around ovulation, days 13 to 15. Again, see what works be for you.

Eating Carbs Intuitively

Finally, you can wait until your body starts calling out for carbs and respond appropriately. In my opinion, intuitive eating is one of the goals of a Primal diet and lifestyle. When we improve hormone balance and tap into how good it feels to nourish ourselves with nutrient-dense foods, we should be able to trust when our inner voice says, “Hey, I could use some starchy vegetables here!”

Eating carbs intuitively isn’t the same responding to sugar cravings or eating something off plan just because it “sounds good.” I think we can all recognize the difference between listening to our bodies and eating purely for pleasure. (You’re more than welcome to do that too, but it’s not what we’re talking about here.)

Intuitive carb refeeds are probably going to work best for people who have been on the Primal train for a while and who generally feel pretty in tune with their bodies. Women who are dealing with chronic health issues or hormone imbalances might need something more structured.

Note that this is a different question than carb timing, which Mark covered recently. Carb timing is about when to eat your carbs during the day.

Don’t Be Afraid to Experiment

I’m a big fan of experimenting with your diet. There is so much bioindividuality, it’s impossible to find a one-size-fits-all approach. The best strategy for you is the one that hits that sweet spot where you to feel your best and also enjoy how you eat.

Moreover, I’m going to go out on a limb and say if you’ve been low-carb for so long that you’re afraid to consider eating even nutrient-dense, Primal-aligned carb-y foods like sweet potatoes, you should challenge yourself to try a carb refeed and see what happens. I’m not talking about people who know they feel better eating very-low-carb and simply don’t have the desire to switch it up. I’m talking about people who have a mental block around the very idea of carbs. We don’t want people to get “stuck” in a low-carb paradigm to the point where they feel unable to enjoy otherwise nutritious foods just because they have more carbs than, say, broccoli.

Finally, although their are good reasons to try carb refeeds if your current low-carb diet isn’t working the way you want, it’s only one of many things you might try. In particular, if you haven’t also gotten your sleep and stress in order, make those priorities as well. Carb refeeds can only do so much if you don’t have a solid foundation of healthy habits in place.

Tell us: Have you had success implementing a carb cycling approach? What works for you? What are your favorite foods to use to increase carb intake?

Related posts from Mark’s Daily Apple

Does Carb Cycling Work? It Depends.

Dear Mark: Should I Increase Carb Intake for Weight Loss?

Carb Refeeding and Weight Loss

References https://onlinelibrary.wiley.com/doi/f...

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How to Make Pemmican

If you’ve ever had a meat or jerky bar made of finely chopped dried meat and perhaps berries, you may be familiar with pemmican. Pemmican consists of lean, dried meat – usually beef nowadays, but bison, deer, and elk were common back in the day) which is crushed to a powder and mixed with an equal amount of hot, rendered fat, usually beef tallow. Sometimes crushed, dried berries are added as well. For long periods of time, people can subsist entirely on pemmican, drawing on the fat for energy and the protein for strength, and glucose, when needed.

Vihljamur Stefansson, eminent anthropologist and arctic explorer, went on three expeditions into the Alaskan tundra during the first quarter of the 20th century. His discoveries – including the “blond” Inuit and previously uncharted Arctic lands – brought him renown on the world stage. People were fascinated by his approach to travel and exploration, the way he thrust himself fully into the native Inuit cultures he encountered. Stefansson studied their language, adopted their ways, and ate the same food they ate. In fact, it was the diet of the Inuit – fish, marine mammals, and other animals, with almost no vegetables or carbohydrates – that most intrigued him. He noted that, though their diet would be considered nutritionally bereft by most “experts” (hey, nothing’s changed in a hundred years!), the Inuit seemed to be in excellent health, with strong teeth, bones, and muscles. He was particularly interested pemmican.

The Inuit, Stefansson noted, spent weeks away from camp with nothing but pemmican to eat and snow to drink to no ill effect. Stefansson, a Canadian of Icelandic origin, often accompanied them on these treks and also lived off of pemmican quite happily, so its sustaining powers weren’t due to some specific genetic adaptation unique to the Inuit. In fact, when Stefansson returned home, he and colleague adopted a meat-only diet for a year, interested in its long-term effects. A controlled examination of their experience confirmed that both men remained healthy throughout.

So, pemmican has a reputation as a sort of superfood. While I’m usually leery of such claims, the fact that the stuff is essentially pure fat and protein (plus Stefansson’s accounts) made me think that maybe there was something to it. I set out to make my own batch.

 

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How to Make Pemmican

What you need:

1 1/2 lbs I got about a pound and a half of lean, grass-fed shoulder roast,
Salt and pepper
Fresh or frozen wild blueberries
Grass-fed bison or beef kidney fat, leaf fat, suet, or tallow

Let the meat firm up in the freezer, then slice it thin. After adding liberal amounts of salt and pepper, set the oven to the lowest possible temperature (around 150 degrees) and lay out the strips of meat directly onto a rack. Keep the oven door slightly open to prevent moisture buildup.

Put a handful of frozen wild blueberries on a small oven pan to dry out with the meat.

Let the meat dry out for about 15 hours, or until it takes on a crispy jerky characteristic that breaks apart easily. Pulverize the jerky in the food processor or blender until it becomes powder.

After the meat, repeat the process for the blueberries. No need to wash the blender in between – you’ll mix the dried meat and dried berries together anyway. Again, you want a powder.

Now, render the fat. I used grass-fed bison kidney fat, which was already diced into tiny pieces. I put about half a pound of that into a cast iron pan and cooked it slowly over super-low heat.

I made sure to stir the fat as it rendered out, and watched closely so that it wouldn’t burn. When the fat stops bubbling, the rendering is done.

Use a strainer to avoid all the crispy bits; you just want the pure, liquid fat.

Mix the meat and berry powder together, then slowly add the hot liquid fat. Pour just enough so that the fat soaks into the powder.

If you poured in too much fat too quickly, you can add a bit of almond meal to firm it up. Once it firms, cut it into bars or roll it into balls.

Pemmican will keep almost forever. Pure, dried protein and rendered (mostly saturated) fat are highly stable, so I wouldn’t worry about it going rancid. If it does, you’ll know.

Now, my pemmican wasn’t exactly delicious. Without much spice, it comes out fairly bland. Maybe I’ll jazz it up next time with some more salt and spices, but I don’t think pemmican is meant to be eaten for pleasure. This is utilitarian food, perfect for long treks through the wilderness. It gets the job done, and I’ll probably make it again. It definitely doesn’t taste bad; in fact, the taste grows on you after awhile.

My dog certainly enjoyed cleaning up the bowl.

Has anyone else here tried pemmican? Let me know what you think!

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Learning to Love Liver (with Middle Eastern Lamb Liver and Liver Paté Recipe)

Today’s guest post is written by Dr. Terry Wahls, Institute for Functional Medicine Certified Practitioner, clinical professor of medicine at the University of Iowa and author of The Wahls Protocol: How I Beat Progressive MS Using Paleo Principles and Functional Medicine (paperback). You may be familiar with her recovery story, featured here. 

 

I heard a lot of you want to know more about liver! I’m glad you are curious. Liver is great for you, and you need only eat 6 to 8 ounces per week to gain its benefits. I limit liver because it is quite high in retinol, which is the active form of vitamin A. Retinol is involved in the management of cell differentiation and immune function. Carotenoids in colorful fruits and vegetables can be converted to retinol; however, the efficiency of these enzymes depends on the efficiency of Beta-carotene 15’-15’ oxygenase, which varies based on one’s underlying genetics. Some single nucleotide polymorphisms have a 70% reduction in the efficiency of this conversion.

Inadequate levels of vitamin A are associated with higher rates of dysplasia, infection, and autoimmunity. It is likely that patients with chronic infections, autoimmunity, dysplasia, or cancers have a higher requirement for vitamin A intake than someone who is healthy. But scientists have not determined the optimal intake for those with infection, autoimmunity, dysplasia, or cancer.

Complicating what amount of retinol to recommend is that the therapeutic range for retinol intake is relatively narrow, and excessive retinol intake also has health risks. Acute retinol intoxication is very rare (Arctic explorers died of retinol intoxication caused by eating polar bear liver). Chronic retinol intoxication is associated with serious birth defects, which is why Accutane®, an analog of retinol that is used to treat severe acne, has a black box warning advising women to have a pregnancy test before starting Accutane® and to use reliable birth control if taking Accutane®. In addition to birth defects, chronic excesses of retinol can lead to irreversible fibrosis and scarring of the liver and lungs. If you have developed fibrosis of the liver or lungs as a result of retinol intoxication, the damage is irreversible. Because vitamin A is a fat-soluble vitamin, excess vitamin A accumulates in the fat. It takes a long time for vitamin A levels to decline.

 

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The tolerable upper limit for retinol is defined as the maximum daily intake that is unlikely to be associated with the development of disease. However, an individual with high consumption of alcohol, high cholesterol, or chronic liver or lung disease may have a lower tolerable upper limit. For men older than 19 and women older than 51, the tolerable upper limit is 3,000 ?g/day of retinol. The limit for pregnant women is 2,800 ?g/day.

For all these reasons, I recommend limiting liver to 6 to 8 ounces per week. For those who consume liver regularly, I recommend taking fish oil instead of cod liver oil, which also contains retinol. The following list indicates the amount of retinol in 3 ounces of braised (simmered) liver from a variety of animals.

Beef 7,350
Lamb 6,379
Pork 5,405
Chicken 3,360
Turkey 3,360

Liver can have a strong taste. If it is overcooked, it becomes dry, leathery, and quite unpleasant. It is best cooked medium-rare. My family enjoys a Middle Eastern recipe for Lamb Liver and Parsley Onion Salad (recipe below). Other options to make liver more palatable is to pulse it in a food processor and blend it with ground meat at a ratio of 90% ground meat and 10% liver. You can use this ground meat as you would normally.

Middle Eastern Lamb Liver and Parsley Onion Salad

Excerpted from The Wahls Protocol: A Radical New Way To Treat All Chronic Autoimmune Conditions Using Paleo Principles

1 lb lamb liver, sliced
½ to 1 tsp ground cumin
1 tablespoon apple cider vinegar
1 tablespoon ghee (or extra virgin olive oil)
Sea salt and black pepper to taste
1 red onion
1 bunch of parsley
1-2 tablespoons of powdered sumac (if not available may replace with pomegranate seeds)
3 tablespoons extra virgin olive oil
1 tablespoon balsamic vinegar

Prepare the salad. Quarter red onion and slice thinly. Chop parsley leaves. Mince the stems. Add the powdered sumac, extra virgin olive oil, and balsamic vinegar and stir.

Prepare the liver. Melt ghee in the skillet. Add vinegar and heat on medium until steaming. Add cumin and stir. Add liver and cover. Cook 1 to 2 minutes, then flip and cook 1 minute to 2 minutes more. Remove from heat. Allow to sit for 5 minutes. The goal is to rare or medium-rare liver. If the liver is well done, it will be tough and taste like cardboard.

Serve liver with the parsley onion salad. If you have leftover liver, you can make Liver Paté to have later in the week.

Liver Paté Recipe

Leftover liver (cooked)
3-4 cloves of garlic (chopped)

Chop leftover liver and place in a food processor with olive oil and garlic. Pulse until blended into a smooth mixture. I serve liver paté with guacamole, raw vegetables, or rolled up in a kale leaf with hot sauce or ginger sauce.

 

My teenage children and their friends agree that liver can be delicious. The key is to not overcook it!

Liver is a superfood and an excellent source of fat-soluble vitamins such as retinol (premade vitamin A), vitamin D, vitamin K, vitamin B12, B9 (folate), B1 (thiamine), and key minerals, including zinc and copper. I urge people with any immune issues to have liver once per week for its excellent nutrient profile.

If using a supplement for your organ meat, there are several factors to consider. I do not recommend brain due the potential for prion-mediated disease being transmitted via brain tissues. I do recommend organic, grass-fed, and grass-finished organ meat. A mix of organs, including liver, heart, and kidney (but not brain), is ideal. Review the label and do not exceed 6 to 8 ounces of liver per week.

All nutrients, even water, have a u-shaped curve that determines the optimal intake for that nutrient. Too little and you develop signs and symptoms of disease. Too much, and once again, you develop signs and symptoms of disease. If we are too short on water, we become dehydrated, can have kidney damage and delirium, and can even die of dehydration. If we have too much water, we become water intoxicated, our blood sodium level falls, and we can experience delirium, severe brain damage, and even death. It is always going to be safer to consume food than take supplements. That is why I recommend eating a wide variety of organ meats – liver, heart, mussels, oysters, tongue, bone marrow, and bone broth. You will find my recipes for organ meats in my cookbook, The Wahls Protocol Cooking for Life The Revolutionary Modern Paleo Plan To Treat All Chronic Autoimmune Conditions https://terrywahls.com/wahls-protocol... and my new and expanded (with 30% new material) The Wahls Protocol A Radical New Way to Treat Chronic Autoimmune Conditions. https://terrywahls.com/the-wahls-prot...

About Dr. Terry Wahls

Photo credit Jonathan D. Sabin

Dr. Terry Wahls is an Institute for Functional Medicine Certified Practitioner and a clinical professor of medicine at the University of Iowa where she conducts clinical trials. In 2018 she was awarded the Institute for Functional Medicine’s Linus Pauling Award for her contributions in research, clinical care, and patient advocacy. She is the author of The Wahls Protocol: How I Beat Progressive MS Using Paleo Principles and Functional Medicine, The Wahls Protocol: A Radical New Way to Treat All Chronic Autoimmune Conditions Using Paleo Principles (paperback), and the cookbook The Wahls Protocol Cooking for Life: The Revolutionary Modern Paleo Plan to Treat All Chronic Autoimmune Conditions.

She hosts a Wahls Protocol Seminar every summer where anyone can learn how to implement the Protocol with ease and success. Follow her on Instagram, and on Facebook, and Twitter. Learn more about her MS clinical trials by reaching out to her team: MSDietStudy@healthcare.uiowa.edu. Pick up copies of her research papers at here.

References

Carlo dela Seña, Kenneth M. Riedl, Sureshbabu Narayanasamy, Robert W. Curley, Jr., Steven J. Schwartz,and Earl H. Harrison. The Human Enzyme That Converts Dietary Provitamin A Carotenoids to Vitamin A Is a Dioxygenase. J Biol Chem. 2014 May 9; 289(19): 13661–13666.
Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. National Academy of Sciences 2001
Terry Wahls MD, Author: The Wahls Protocol Cooking for Life: The Revolutionary Modern Paleo Plan to Treat All Chronic Autoimmune Conditions and The Wahls Protocol A Radical New Way To Treat All Chronic Autoimmune Conditions

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