Keto and the Menstrual Cycle: Is There Reason To Worry?

It seems every “keto for women” forum abounds with stories about menstrual cycles gone wild in the first few months of keto. Irregular cycles, breakthrough bleeding, and periods lasting much longer than normal are common complaints. Sometimes these stories are cited as evidence that keto isn’t good for women, at least not premenopausal women, and that we need carbs for healthy hormones. Yet, many women don’t notice any changes in their menstrual cycles at all, while others report improvement in PMS symptoms and cycle regularity from the get-go.

What gives? Why do some women’s cycles apparently become wacky when they start keto, while others feel like keto is the key to period bliss? Can keto “mess up” the menstrual cycle?

We know that diet—what and how much we eat—can profoundly affect our hormones. This is true for both women and men. One of the reasons people are so excited about ketogenic diets is specifically because keto shows promise for helping to regulate hormones and improve cellular sensitivity to hormones such as insulin and leptin.

At the same time, women’s hormones are especially sensitive not only to dietary changes but also to downstream effects such as body fat loss. Furthermore, one of the ways women’s bodies respond to stressors is by turning down the dial on our reproductive systems. It’s reasonable to hypothesize, then, that women might have a tougher time adapting to or sustaining a ketogenic diet. Keto can be stressful depending on one’s approach, and that might negatively impact women’s reproductive health. But do the data actually bear that out, or is so-called “keto period” more misplaced hype than genuine fact?

Note that throughout this post, I’m going to use the term “reproductive health” to refer to all aspects of women’s menstrual cycle, reproductive hormones, and fertility. Even if you aren’t interested in reproducing right now, your body’s willingness to reproduce is an important indicator of overall health. When your reproductive health goes awry—irregular or absent periods (amenorrhea) or hormone imbalances—that’s a big red flag. Of course, post-menopausal women can also experience hormone imbalances that affect their health and quality of life (and low-carb and keto diets can be a great option for them).

Menstrual Cycle 101

Let’s briefly review what constitutes a normal, healthy menstrual cycle, understanding that everybody’s “normal” will be a little different. A typical cycle lasts from 21 to 24 days on the short end to 31 to 35 days on the long end, with 28 days being the median. Day 1 is the first day of your period and begins the follicular phase, which lasts until ovulation. Just before ovulation, levels of luteinizing hormone (LH), follicle stimulating hormone (FSH), and estradiol (a form of estrogen) spike. Next comes the luteal phase covering the approximately 14 days from ovulation to menses. LH, FSH, and estradiol drop, while progesterone rises. Estradiol bumps up again in the middle of the luteal phase. If a fertilized egg is not implanted, menstruation commences, and the whole cycles starts over again. All this is regulated by a complex communication network under the hypothalamic–pituitary–gonadal (HPG) axis, which is closely tied to the actions of the adrenal (the A in HPA axis) and thyroid glands.

Across the cycle, fluctuations in body weight are common as fluid is retained and then released along with shifts in estrogen and progesterone. Changes in blood glucose are also normal, and insulin-dependent diabetics often find that they need to adjust their dose at different times of their cycles to keep their blood sugar in check. The most common pattern is higher blood glucose readings in the pre-menstrual period (the second half of the luteal phase), and lower readings after starting your period and before ovulation. This is generally attributed to the fact that progesterone, which is highest during the luteal phase, is known to reduce insulin sensitivity. However, different women experience different patterns, which can also be affected by other factors such as oral contraceptive use.

Normal fluctuations in insulin resistance and blood glucose can mean that women get lower ketone readings at certain times of the month than others. When these occur premenstrually—and so they tend to coincide with a period of (transient) weight gain and food/carbohydrate cravings—women often feel as though they are doing something wrong. Rest assured that these variations reflect normal physiology.

The many factors that affect your cycle and the levels of your sex hormones include: other hormones, gut health and microbiome, metabolic health (e.g., insulin sensitivity), environmental toxins, stress, sleep, immune health, nutrient deficiencies, activity level and energy expenditure, and age. Each affects the others, and all (except age of course) can be affected by diet. It’s no surprise, then, that it can be extremely difficult to pin down a root cause of menstrual changes or reproductive issues.

What the Research Tells Us About Keto and Menstruation

As I said at the outset, there are lots of anecdotes, both positive and negative. In my experience, most women whose cycles seem to go crazy when they start keto find that things get back to normal—and often a better version of normal—after a few months.

First, it’s tricky to determine the effects of keto per se, since many people combine a ketogenic diet with calorie restriction (intentionally to lose weight or unintentionally due to the appetite suppressing effects of keto) and with fasting (intermittent and/or extended). Each of these can independently impact the factors listed above, lead to weight loss, and affect the menstrual cycle and reproductive health.

So, is there any evidence that keto itself causes changes to menstruation?

The scientific evidence is scant….

The one statistic you’ll see floating around the interwebs is “45% of (adolescent) females experience irregular menstrual cycles on keto.” This statistic comes from one small study of adolescent girls using a therapeutic ketogenic diet to treat epilepsy. Six of the twenty girls reported amenorrhea (loss of period) and three were diagnosed with delayed puberty. However, the ketogenic diet used for epilepsy is different and usually much stricter than an “everyday” keto diet needs to be, and epilepsy is frequently associated with menstrual dysfunction regardless of diet.

To extrapolate the findings of this study and argue that nearly half of teenage girls (or women generally) are likely to experience menstrual problems from going keto is a huge leap.

The fact is, I’m unable to find any studies done in healthy human females (or mice for that matter) demonstrating that otherwise normal menstrual cycles are disturbed by going keto.

5 Ways Keto-Related Factors *Might* Affect Your Menstrual Cycle

With the limited amount of research looking directly at keto and menstruation, let’s look first at whether there are direct effects of carbohydrate restriction or elevated ketone production on the menstrual cycle. Those are the defining characteristics of keto and what differentiates keto from other ways of eating. Then we can examine indirect effects that occur due to factors such as weight loss. These are not unique to keto, though they might be more likely on a ketogenic diet compared to other ways of eating.

Carbohydrate Restriction

There is no real body of evidence that looks at ketogenic levels of carb restriction and menstruation, but there are some clues. In this small study, functional hypothalamic amenorrhea (FHA) was associated with dietary fat restriction; women with FHA actually ate non-significantly more carbs than matched controls and nearly identical total calories. Likewise, in this small study, FHA was associated with lower fat intake but no significant difference in carb intake.

This meta-analysis looked at the effect of low-carb (not keto) diets on markers of reproductive health among overweight women. The researchers found four studies that examined effects on menstruation; all showed improved menstrual regularity and/or ovulation rates. Of six studies that looked at levels of reproductive hormones, five reported significant improvements.

Carb restriction also results in decreased insulin production. Hyperinsulinemia and insulin resistance are frequently associated with polycystic ovarian syndrome (PCOS), one of the leading causes of female infertility and a frequent cause of menstrual irregularity. There is currently a lot of interest in using keto to treat PCOS, but only one small study has so far directly tested the effectiveness of a ketogenic diet to treat PCOS, with positive results.

Ketones

No studies have looked at the direct effects of ketones on menstruation.

Weight Loss

Of course weight loss is not unique to keto, but keto can be very effective for weight loss. Some women experience rapid weight loss when first starting a keto diet. Weight loss in and of itself can impact menstruation through a variety of pathways (and, of course, keto isn’t the only way people lose weight). A key way is by reducing the hormone leptin. Leptin’s main job is to communicate energy availability to the hypothalamus—high levels of leptin tell the hypothalamus that we have enough energy on board, which also means we can reproduce. Low leptin can disrupt the menstrual cycle and is linked to hypothalamic amenorrhea.

Body fat loss can also affect estrogen levels since estrogen is both stored and produced in adipocytes (fat cells). While fat loss in the long term will decrease estrogen production, it is possible that rapid fat loss might temporarily raise estrogen levels and can also affect estrogen-progesterone balance. These transient changes in estrogen levels might underlie some of the menstrual irregularities women report.

Stress

Stress can impact the menstrual cycle in myriad ways. Cortisol acts on the hypothalamus and pituitary glands, affecting hormone levels, sleep, immune function, and gut health, to name a few. Diets can be a source of stress, both at the physiological and psychological levels. Keto has a reputation for being especially stressful because it is more restrictive than other low-carb diets, but this can be mitigated by following the Keto Reset tips for women.

Thyroid Function

Thyroid dysregulation is another common cause of menstrual irregularities, and there remains a pervasive belief that keto is bad for thyroid health. Indeed, the thyroid is sensitive to nutrient deficiencies and caloric restriction, and thyroid hormones, especially T3, do frequently decline on keto. However, as Mark has discussed in a previous post, changes in T3 levels might not be a problem, especially in the absence of other problematic symptoms. Moreover, many practitioners now use keto as a cornerstone in their treatment of thyroid disorders.

What Should I Take From These Findings?

The first takeaway: there just isn’t much direct evidence about how keto might affect your menstrual cycle, positively or negatively. We have some studies suggesting that low-carb diets improve some aspects of menstruation and reproductive health, but keto is more than just another low-carb diet. Ketones themselves have important physiological properties, such as being directly anti-inflammatory, which might positively impact women’s reproductive health.

Second, the ways that keto is likely to (negatively) affect menstruation aren’t unique to keto, they’re common to any diet: hormone shifts mediated by energy balance, stress, and weight loss.

Furthermore, since keto is so often combined with caloric restriction, time-restricted eating, and fasting, even the anecdotal evidence might not be able to tell us all that much. If a woman is eating ketogenically, in a big caloric deficit, and doing OMAD (one meal a day), and her leptin plummets, how are we to know what really caused it? We don’t have good evidence that otherwise healthy women start a well-executed ketogenic diet and end up messing up their menstrual cycles.

That said, women do need to be cognizant of the sum total of the signals they are sending their bodies when it comes to energy availability and stress. A lot of women come to the keto diet with a history of adrenal, thyroid, metabolic, and reproductive issues. It’s important that they’re extra careful about how they approach keto. Done correctly, it might be just what the doctor ordered. I encourage any woman who’s dealing with other hormonal issues to work with a medical practitioner to tailor a keto diet to her unique needs.

But I’m Telling You, Keto Made My Period Go Haywire!

Ok, I believe you, really! But changes do not necessarily equal dysfunction. It is normal to experience hormone fluctuations when you make a massive—or even a relatively small but important—shift in your nutrition. Sometimes those fluctuations are unpleasant or unwanted, such as a period that lasts 14 days or one that arrives a week before you planned while you’re on vacation. However, that doesn’t make them bad from a health perspective. We need to respect that our bodies are dynamic systems. Changing the input will invariably change the output, and the system might need a few months to adapt to a new normal.

If your cycle goes wonky but you’re otherwise feeling good, give it a few months to sort itself out. If after a few months it’s still all over the place (or definitely if you’re having other disruptive symptoms), enlist help. In the meantime, check to make sure you’re not short-changing yourself nutritionally or calorically. Scale back on fasting efforts, and consider shifting more toward a traditional Primal way of eating.

At the end of the day, if you go keto and experience negative effects, stop. Keto is super hyped right now, but if your body is sending you clear signals that keto is not a good approach for you at this time, don’t do it. You can always try again later. It might be that your first attempt at keto didn’t work, but with a few adjustments and some experimentation over time you can find a version of keto that works for you.

Thanks for reading, everyone. Do you have comments, questions, or feedback? Let me know below.

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References:

Comninos AN, Jayasena CN, Dhillo WS. The relationship between gut and adipose hormones, and reproduction. Human Reproduction Update 2014; 20(2): 153–174.

Fontana R, Della Torre S. The Deep Correlation between Energy Metabolism and Reproduction: A View on the Effects of Nutrition for Women Fertility. Nutrients. 2016;8(2):87.

Klok MD, Jakobsdottir S, Drent ML. The role of leptin and ghrelin in the regulation of food intake and body weight in humans: a review. Obesity Reviews 2007;8(1):21-34.

Meczekalski B, Katulski K, Czyzyk A, Podfigurna-Stopa A, Maciejewska-Jeske M. Functional hypothalamic amenorrhea and its influence on women’s health. J Endocrinol Invest. 2014;37(11):1049–1056.  

Tena-Sempere M. Roles of Ghrelin and Leptin in the Control of Reproductive Function. Neuroendocrinology 2007;86:229-241.

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Success Story Follow-Up: Finding My Passion Through Healing

It’s Friday, everyone! And that means another Primal Blueprint Real Life Story from a Mark’s Daily Apple reader. If you have your own success story and would like to share it with me and the Mark’s Daily Apple community please contact me here. I’ll continue to publish these each Friday as long as they keep coming in. Thank you for reading!

This is a follow-up post from a former MDA success story, Andy Hnilo. In response to his original story, a number of readers had questions about Andy’s routine he used for healing and the ingredients his research showed were effective for various skin repair and restoration purposes. He’s answered those questions in this follow-up post. Enjoy, everyone!

After a car accident left me with seven broken ribs, a collapsed lung and “the worst compound fracture’ the maxillofacial specialist at the hospital had ever seen, my body was wrecked and my confidence not far behind. For any person, this would be a traumatic experience, but as a 30-year-old working actor and model, my future was suddenly completely unsure. As easy as it would have been to give up, my near-fatal accident turned out to be the ultimate blessing in disguise — that experience sparked the fire in my soul’s purpose. A walking ball of inflammation, I began researching ingredients for how I was going to accelerate my healing both internally and externally. Along the way, I shared everything I had learned about nutrition, natural healing, skincare and how to feel better about the reflection in the mirror with the rest of the world.

There came a point in my accident recovery where new passion, fun and hobby displaced my previous worry and intermittent pain. Researching and experimenting with various therapeutic ingredients became a creative outlet for me. While many of my friends found my new ‘hobby’ a bit crazy at times; I never let that stop me. In addition to the obvious results, I found a sense of encouragement for my recovery in researching and learning about certain studies and ingredients that helped others heal their scarring. It gave me hope and further validated the physiological capabilities of my ‘crazy’ concoctions.

For those of you like me, who share in the joy of science, biology and nature’s magic, I would love to share with you some of the most impressive research on the ingredients that accelerated the healing of my skin after my accident.

Skin Restorative Ingredients: What My Research Revealed

Medicinal Clays

It turns out, clays have been used therapeutically throughout various cultures. While one might be quick to discredit someone with mud on their face, the fact of the matter is there are many scientific discoveries associated with use of hydrated clays. There are 2500 scientific articles published in PubMed to sort the scientific works have been done on the effects of this clay on body function.

For example, Illite and Kaolin have ionic properties that affect antibacterial activity. In fact, studies have found that the natural and ion-exchanged illite clays significantly decrease bacterial load, skin inflammation and gross wound morphology. There’s even research that dives deeper into the chemistry of clay’s antibacterial effects, providing evidence that suggest some antibacterial clays can promote similar bactericidal (bacterial death inducing) reactions as effect as synthetic antibiotics. 1,2

Pearl Powder

Pearl Powder is perhaps the most sophisticated exfoliates created by Mother Nature. If you’re unfamiliar, Pearl is one of the well-known traditional Chinese medicine (TCM) tonics used for treating various skin disorders and beautifying the skin, mostly due to its abundant antioxidant, protein and mineral contents.

In one study, pearl powder supplemented people showed a substantial increase in total antioxidant capacity. Tests done found a significant increase in master antioxidants glutathione and SOD (superoxide dismutase) content and activity. It was also found that pearl considerably suppressed lipid peroxidation, which is the oxidative degradation of fats in the body. These outcomes sum up to one clear fact about pearl, it is a supremely potent antioxidant and thereby makes a novel, natural remedy for treating various age-related degenerative disorders. For me, this is the kind of data that helps me make sense of why pearl powder makes my skin soft and smooth. 3

Colostrum

Colostrum is yet another power-house ingredient backed by science. In short, it is a natural source of many important vitamins, minerals, enzymes, and amino acids. However, perhaps the most impressive part of colostrum is its unique content of insulin-like growth factor (IGF-1).

In regards to skin health and regeneration, colostrum and its IGF-1 content sparked great interest for me. IGF factor 1 (IGF-I) is widely distributed in various tissues, including the skin. It turns out, IGF-I is strongly expressed in injured areas, where it plays an important role in epidermal and dermal wound healing. Repeated studies have shown the beneficial effects of topically applied IGF-I on wound healing, due to its stimulating effects on collagen synthesis in skin fibroblasts, the proliferation of fibroblasts and keratinocytes, and angiogenesis. 4,5 As collagen production starts to decline with age, it is essential to make healthy skin care a priority by choosing products with ingredients that will keep your skin functioning at its peak, no matter what age you are. 6,7

In simpler terms, colostrum promotes the regeneration of fresh skin. I greatly attribute my regular use of colostrum and its effects to a surprisingly minimal appearance of scarring after my accident.

Pracaxi/Acai Oil

After my accident, I had the worst compound jaw fracture the resident maxillofacial surgeon of Cedars Sinai had ever seen. We actually had to hire a private surgeon and he assisted him. So you can only imagine the wounds that inflicted my face, negatively affecting the integrity of my skin. Normally, intense wounds means equally intense skin scarring. Luckily, scar formation itself varies based on many factors and can be mitigated by therapeutic agents, such as the beneficial fatty acids found in pracaxi oil.

According to clinical research, the topical application pracaxi oil to injured skin led to considerable improvements in wound healing and scar attributes. Additionally, it has been found that acai oil, applied topically to diabetic ulcerations can dramatically improve healing, up to 100%. With my initial fear of scarring after my accident, discovering natural ingredients with regenerative abilities were a true saving grace. 8 9

Plant-derived Stem Cells

When I said I was willing to try anything to improve my recovery, I meant it. Somewhere along my journey, I came across compelling research on the use of plant stem cells for skin regeneration. The science and use of plant-stem cells is an interest focus for leading edge cosmetic treatment. When you consider the unique self-pairing, tissue regenerative processes of plants; it’s amazing to think that we could utilize their cells to also assist our skin cells in regeneration. That’s what plant stem-cell science is all about and it’s quite intriguing.

According to the research and experimentation, plant-stem cells contain phytohormones that have an antioxidant effect on the skin. In fact, one study found that a product derived of plant-stem cells greatly reduced wrinkles in the crow’s feet area of the face 10. It was found that the depth of face wrinkles became shallower by 8% after 2 weeks and shallower by 15% after 4 weeks. 11

Plant-Derived Vitamin A

Vitamin A plays major regulatory roles in the functioning and health of the skin matrix. Vitamin A is typically found in two forms; carotene or retinol. However, with the help of modern technology, we are capable of extracting a retinol-like plant-based vitamin A, derived of the popular superfood, Alfalfa.

Plant-derived Vitamin A has some amazing science behind it. Sourced organically from France, it contains similar beneficial polysaccharides as retinol, called galactomannans. This gives plant-derived vitamin A retinol-like-activity because it’s working on similar biological markers. Best of all, it achieves these effects without inducing irritancy on the skin like Retinol so often does. It can greatly improve the appearance and health of aged skin by significantly reducing fine lines and Crow’s feet.

In fact, study has found that topical plant-derived Vitamin A improves fine wrinkles associated with natural aging. The induction of glycosaminoglycan; beneficial mucopolysaccharides, increase collagen production and are most likely responsible for the minimization of fine lines. Additionally, plant-derived Vitamin A treated skin improves skin matrix synthesis, making it more resilient to skin injury and ulceration. 12

CoQ10

Also known as ubiquinone coenzyme q10, CoQ10 is an endogenously synthesized lipid-soluble antioxidant, which is essential for cellular energy production. However, like all aging, this precious molecule is diminished with skin aging too. Stress of all sorts all tend to decrease the antioxidant presence and activity of coQ10. Luckily, both dietary and topical Q10 treatment is incredibly beneficial with regard to effective Q10 replenishment.

In study, application of Q10-containing formulas significantly increased the levels of this particular quinone in the skin surface and even in the deeper layers of the epidermis. More importantly was the effect this had on the skin; the results founds that stressed-skin improved by reduction of free radicals and the increase in antioxidant capacity. In other words, the topical use of CoQ10 improves the skin’s resilience to oxidative stress. Considering that oxidative stress results in the well-known signs of skin aging, like the appearance of wrinkles and lines as well as loss of elasticity, CoQ10 application serves as a useful anti-aging novelty. These are just a few of the reasons I feature CoQ10 in both my Night Cream and Gold Serum. 13, 14, 15

How I Applied My Research To My Routine

Purely through self-experimentation and trial and error, what made most sense to me was combining THE best, most effective ingredients that I could source from nature along with the latest and greatest in cutting edge science. The process began by isolating carefully sourced ingredients based on texture alone, then combining them with different carrier oils then moving forward and adding essential oils and extracts that fit my creation and desired emulsion.

I knew I wanted a dense feel that would be there throughout the night, nourishing and healing the scar area through deep hydration. I tried a couple products in the beginning before making my own, and they would absorb quickly leaving me questioning its level of effectiveness if it is gone within minutes. What made the most sense to me is a rich concentrated emulsion that was thicker, therefore moisturizing the target areas for longer periods of time. Devoid of harsh, drying ingredients. In search for the perfect blend of botanicals, it was fascinating to me to learn of certain ingredients like Sea Buckthorn and find out about it’s very rare Omega-7 fatty acid capacity.

In my night cream specifically, in a cast iron pan, I would melt down thicker ingredients like Beeswax, Cacao Butter and Manuka honey then combine with cold-pressed oils to create an highly concentrated, nourishing emulsion for my skin that I would apply after rinsing off The Clay Mask. I still have that first concoction with little dimples of cacao butter strewn throughout, preserved solely by K-Factor 16 Manuka Honey. That concoction turned into what is now, our award-winning Alitura Night Cream.

As you can see, my skin-care craze isn’t as whacky as it seems—there is credible scientific evidence that backs my madness. In a culture that is quick to go under the knife or get an injection it’s imperative to remember that none of those options actually help keeping the appearance of the skin youthful and glowing. Using skincare products that are dense in topical nutrients are vital for healthy looking skin. 16,17 At this point, you’re likely wondering how to put it all to practice. So, without further ado, I’m happy to share with you my personal skincare routine…

Here’s What It Looks Like To Date:

Pearl Cleansing: I start off my skin-care routine with a traditional step; cleansing. However, I use a not-so-conventional cleanser, the Pearl Cleanser. As we discussed, this unique cleanser cleans the skin while protecting it from the stressful effects of free radicals.
*Wet your face with warm, clean water
*Apply the cleanser with your hands, gently working it into the skin
*Wash it off
*Let your face dry

Derma Rolling: Next up is Derma Rolling. Derma rolling is one of the most powerful weapons for getting the what I call the “Alitura Glow.” This is one of the many high-end medi spas best kept secrets. Microneedling, a.k.a. Collagen Induction Therapy, is exactly that: an effective way to stimulate collagen synthesis and simultaneously break down malformed tissue such as acne and surgical scars (keloid scars are the exception as Microneedling can cause more keloid scarring).18 It works by creating “micro-tears” or generating acute, inflammation, that initiates the healing or regeneration of the outer layer of the skin. It also helps open the poors up, allowing any of the medicinal ingredients in your serums or moisturizers to absorb more deeper.

Home-use vs. Medical Microneedling has everything to do with needle size. The Alitura Dermaroller comes in .25 mm, .5 mm, and 1 mm needle sizes making it ideal for safe home use. Within just a few treatments over the course of 6-8 weeks you will notice visible changes in the texture of your skin at the surface level and plumpness and contour since your dermis has more collagen giving the understructure a firmer foundation for a more youthful contour to the jawline and cheekbones.

In addition to these benefits, derma-rolling can improve collagen synthesis, heal scars, prevents premature skin aging, reduces stretch marks and helps balance skin tone. 19

Clay Mask: My third step is to follow up Derma Rolling with The Alitura Clay Mask. As we’ve discussed, the mask on its own is a wonder treatment that thoroughly purifies, exfoliates, detoxifies and revitalizes the skin by stimulating blood flow. Combined with the Derma Roller; however, the benefits are increased exponentially!

Check this article out for full instructions on how to use the Clay Mask.

Alitura Night Cream: I ‘stack’ my Night Cream and Gold Serum before bed. I apply a thin layer of The Gold Serum all over my face, neck and eye area and then follow with thin layer of The Night Cream as a protective, ultra-hydrating barrier that deeply conditions the dermal layer of my skin which is the most important time to do so, while you are in one position for hours. Wake up looking renewed, refreshed and with a plump, radiant complexion. Great way to start the day if you ask me! Enjoy 🙂

To me, there truly is nothing better than feeling good with your what you see in the mirror. One thing I don’t touch on enough is that my journey into skincare really started in college where I became insecure to take my shirt off because of bad back acne that I had. Growing into my body, hormones racing, using poor products and consuming inflammatory dormitory food at UC Berkeley led to it. It was a bit deflating to wake up and see some type of irritation on my face and body and it really bugged me. Made me self conscious. It was then and there that I started to pinpoint the problem. I was a scrawny freshman athlete at Cal, and needed to gain weight quickly as a Division 1 Pac-10 athlete, so I was always scouring the back of food labels for the big three: 1) Protein 2) Calories 3) Fat. That attention to detail on labels led me to look down into ingredients on skin and hair-care as well. Tossing the heavily marketed, big brand name skincare for a better, cleaner ingredient deck yielded results and my knowledge grew year after year.

After my accident that knowledge grew quickly as I voraciously read and researched ingredients and topical remedies to heal myself. It has been said that ‘necessity is the mother of invention,’ and I couldn’t agree more. My accident not only led to me finding my passion through healing myself, but I found my purpose along the way. To be able to share what I have created with people all over the world in an effort to make people feel better about what THEY see in the mirror… it gives me goosebumps as I type this. I am grateful.

I want to give a HUGE thank you to the incredible people at Mark’s Daily Apple, Primal Blueprint, Primal Kitchen, and of course Mark Sisson for letting me share a piece of my journey. Thank you for reading.

All the best,
Andy Hnilo
CEO & Founder
Alitura Naturals

The readers featured in our success stories share their experiences in their own words. The Primal Blueprint and Keto Reset diets are not intended as medical intervention or diagnosis. Nor are they replacements for working with a qualified healthcare practitioner. It’s important to speak with your doctor before beginning any new dietary or lifestyle program, and please consult your physician before making any changes to medication or treatment protocols. Each individual’s results may vary.

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References:

  1. https://www.ncbi.nlm.nih.gov/pubmed/26508716
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3126108/
  3. https://www.ncbi.nlm.nih.gov/pubmed/29389568
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4184407/#b5-ijn-9-4551
  5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4184407/#b6-ijn-9-4551
  6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4089350/
  7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1606623/
  8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4257951/
  9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4857298/
  10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5674215/#B11
  11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5674215/
  12. https://www.ncbi.nlm.nih.gov/pubmed/17515510
  13. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4737275/#biof1239-bib-0004
  14. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4737275/#biof1239-bib-0003
  15. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4737275/
  16. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4428712/
  17. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3583891/
  18. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4976400/

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Top 12 Keto Blogs

With the explosion of keto, there’s an ever growing constant stream of new information about the significant benefits, supposed risks, and varying “rules” for how to adopt a keto diet. As with most things, it’s easy to get sucked into information overload. (And that doesn’t even take into account the hype that unfortunately gets distributed like wildfire around the Internet.) You want sources you can count on for facts, reason, and utility. Here are twelve solid sources I’d recommend for intelligent commentary, sound science, and useful ideas.

1) Mark’s Daily Apple

Sure, this isn’t an exclusively keto blog. It’s a Primal living blog—with attention to all the components that figure into a healthy lifestyle and fulfilling life. But keto is a powerful tool I use within the Primal Blueprint template. As most of you already know, I approach keto specifically through a Primal lens—what I call a Primal-keto approach to keto living that prioritizes optimum nutrition with the least amount of pain, suffering and sacrifice. I know it’s been working for a lot of people, and I’ll continue to to write on it as well as all the other elements of a healthy life. Four particular resources I’d suggest to folks new to keto: the MDA Keto Hub, our Keto Recipes, the Primal Blueprint Keto Podcast, and our private Keto Reset Facebook Group. They’re all free resources for anyone to use and enjoy. For those who want to receive an additional Mark’s Daily Apple monthly email with exclusive information and commentary on keto, you can sign up below for the Keto Reset Digest (also free).

2) Virta Blog

Virta is a groundbreaking health organization using keto to treat—even reverse—type 2 diabetes and associated metabolic disorders. The Virta Blog is an must-read, providing a mix of cutting edge science, easy to understand articles regarding practical aspects of going keto, and inspiring success stories.

3) Tuit Nutrition

I love Amy Berger’s common sense approach to keto on Tuit Nutrition. She calls her approach Keto Without the Crazy, and that about sums it up. Her articles are long but very worth reading.

4) Ruled.me

At Ruled.me you’ll find mostly long-form articles that contain a ton of information about the keto diet. The site also provides an extensive recipe collection and other resources.

5) Healthful Pursuit

Healthful Pursuit is the home of Nutrition Educator and keto guru Leanne Vogel. Leanne provides a blend of blog posts, videos, and recipes to help you go keto in a healthy way. Much of the content is focused on keto for women, but men and women alike can benefit from the info provided.

6) Calories Proper

At Calories Proper, Dr. Bill Lagakos covers a wide range of topics related to nutrition, fasting, circadian biology, and much more. While it’s not a keto blog per se, keto is a frequent topic. In any case, you’re sure to learn a lot from the content here, which is heavily focused on reviewing and critiquing empirical research studies in an understandable way.

7) Ketogenic Athlete

Ketogenic Athlete is a well-rounded blog for strength and endurance athletes who are interested in using keto for training and performance.

8) The MAF Files at philmaffetone.com

Dr. Phil Maffetone has been using low-carb and keto diets to help athletes achieve breakthrough athletic performance for decades. His 180-age formula is a cornerstone of my Primal Endurance approach to become and fat- and keto-adapted athlete. The MAF Files covers a variety of topics that will be of interest to Primal and keto athletes.

9) HVMN

HVMN offers the only commercially available ketone ester supplement. The blog reflects their target audience: athletes and other high performers who are interested in using diet and lifestyle modifications—and possibly exogenous supplementation, of course—to harness the power of ketones.

10) Elana’s Pantry

Elana Amsterdam has long been one of my go-to sources for healthy, delicious paleo recipes, but more recently she has been using keto as part of her strategy to address her MS. I’ve never made an Elana’s Pantry recipe that wasn’t excellent. She also writes about a variety of topics related to health.

11) Castaway Kitchen

Christina Kurp shares how she used a combination of AIP and keto to fix her own health issues. Part wellness blog, part scrumptious recipe collection, Castaway Kitchen is a great resource for anyone looking for food inspo, especially if you have dietary restrictions.

12) Cast Iron Keto

Plainly put, Cast Iron Keto has food I like to eat: simple, delicious, keto-friendly. You’ll find lots of keto-fied classics here suitable for kids and non-keto types (making dinner that much easier).

Thanks for stopping in today, everyone. Have a favorite you didn’t see here? Share down below. Take care.

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I Saw the Extra Weight I’d Carried My Whole Life Slip Away

It’s Monday, everyone! And that means another Primal Blueprint Real Life Story from a Mark’s Daily Apple reader. If you have your own success story and would like to share it with me and the Mark’s Daily Apple community please contact me here. I’ll continue to publish these each Monday as long as they keep coming in. Thank you for reading!

My visual transformation isn’t all that impressive. In fact, despite having a completely different body composition, I weigh more or less the same that I did six years ago.

My real transformation has occurred on the inside and in the way that I try to embody the Primal Blueprint principles in the way I live my life.

Before Primal Living:

  • Out of shape
  • Abysmal self-esteem
  • Without a clear life path

6 Years Since Discovering Mark’s Daily Apple:

  • Owns a Health & Fitness blog and coaching business
  • Inspires others to find their self-esteem through leading by example
  • Recreational athlete in Powerlifting, Strongman and Highland Games
  • Loving life every day

I first heard of Mark and his message about primal health back in 2013. At the time, my husband and I were living in a modest cabin in the woods of Northern Maine and the extent of my fitness routine was the obligatory jog now and then or some exercise videos that mostly involved bodyweight training. Our cabin had no electricity or running water which meant that we were gathering, cutting and stacking firewood by hand so that we could stay warm during the long winters. Turning manure, bending over in the garden, hauling hay for our goats and clearing woods for future pasture were serious back killing chores and we knew we needed to find a way to get stronger in order to support our active lifestyle. Coupled with this was my husband’s chronic GI distress and autoimmune condition, Reactive Arthritis, which led us down the road of research into how a grain-free, sugar free diet could improve those ailments.

As is often the case, primal nutrition and heavy lifting principles were deeply entwined from the very beginning of our journey towards optimal health. And as we cut out wheat and sugar, we also began learning the functional movements of the squat, deadlift and pull-up. With a manual treadmill we found in the barn, we regularly blasted ourselves with intervals after reading from you the importance of sprinting. Your fitness principles of walk far, run fast, lift heavy came so naturally to us and in the setting of the lush, Maine woods, it felt that much more primal to get in tune with our ancestral physiques.

You might imagine that the stronger and more fit we became, the more we wanted to eat better to support that. Before long, our backs felt bulletproof chopping and stacking piles of firewood. My husband’s arthritis improved. I was seeing the extra weight I had carried my whole life slip away. We had gone to the woods to seek a lifestyle where we could call the shots and pursue our healthiest existence. But in the process, we had the rude awakening that our bodies were the weakest link in the chain of health. Our minds were strong and our homestead was strong, but our bodies were not. And so when we saw the benefits of the Primal Blueprint massively improve our existence, it was like coming out of a bad dream and I woke up one morning thinking “hey, this is really something to live for.”

While I graduated college with a degree in writing, I never really had found my purpose or a career I was passionate about giving my 9 to 5 energy to. I always believed that I had a lot to share with the world, but couldn’t conceive of what avenue to take, but with this new primal lifestyle, I discovered a completely unexpected passion. Always the chubby book nerd my whole life, taking on sports in school out of social pressure and obligation but never out of true interest, here I was, suddenly wanting to pursue fitness and wellness as a career.

We ended up leaving our little homestead for my husband to travel down the long (and still not complete) road of becoming a Dentist. He studied for biochemistry and tests and I studied strength and conditioning in between my long hours at Starbucks. (Side note: I managed to make it 2 years working there without consuming sugar and my coworkers would always marvel at my dedication of turning down a free Frappuccino. I explained to them that eating primal, my energy was consistent throughout the day and better than ever and seeing the positive effects of my nutrition in my day to day life was all the motivation I needed to persist.) The years we spent studying for our individual pursuits, we also spend wrecking ourselves on the barbell and on the field doing sprints and without following any strict program, we simply tried to remember to walk far, run fast, lift heavy. Slowly and surely, our body composition improved and I took on my first personal training clients.

Now living in Salt Lake City, I think of myself more as a Strength Coach than a personal trainer and before walking that road I didn’t even realize there was a difference. I see my colleagues often get wrapped up in ideal programming principles and I try to remember the basics: pick up heavy stuff and put it overhead using good technique, train for explosive speed and go on long hikes outdoors.

I use my personal experience to help guide my athletes on the emotional journey of becoming strong and realizing their physical potential. I have so many people, primarily women, come to me saying they want to lose weight. But as we begin working together, they quickly see that in fact their goal is much more complex that a number on the scale. They learn that it feels good to get strong and learn how to move in ways they never thought possible. I see the look of fear in their eyes at approaching a back squat for the first time and I recognize that look of fear because it’s the same one I felt when I started my journey. I see timid women who hate their bodies do a pull-up for the first time after working hard for a year and then it’s like poof… now they love their bodies because they unlocked this talent for strength they never knew they had. When that happens, the number on the scale matters so much less to them because now they have a performance goal. Now they are pursuing health rather than weight loss.

Although I am not strictly a Primal Blueprint coach, I still hold onto those principles while I teach other people how to lift and what strategies they can use to build balanced nutrition. I encourage them to seek nutrient-dense foods rather than counting macros or calories and to eat when hunger ensues naturally rather than adhering to six small meals a day. I feel confident coaching strategies like Keto and Intermittent Fasting because I have done the research on the health benefits and have the anecdotal evidence to back it up from my own experience. I am always trying to do what your blog did for me, which is to teach them ways they can figure out what health uniquely means to them. I still try to embody the idea that you instilled in me: study how our ancestors thrived to learn how to seek our healthy existence in a world that can often be toxic.

My transformation doesn’t come through in a before and after photo, but I believe I have gained a million times more than if I had lost 100 lbs and cured 10 autoimmune conditions. I discovered my life’s path and spend every day trying to guide others to do the same.

Thank you,
Hill

primalpillarsstrength.com
Instagram @primalpillars

The readers featured in our success stories share their experiences in their own words. The Primal Blueprint and Keto Reset diets are not intended as medical intervention or diagnosis. Nor are they replacements for working with a qualified healthcare practitioner. It’s important to speak with your doctor before beginning any new dietary or lifestyle program, and please consult your physician before making any changes to medication or treatment protocols. Each individual’s results may vary.

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5 Hemp Oil Benefits For Health and Wellness

Have you tried hemp oil?

After almost a century of being outlawed, hemp—a form of cannabis with extremely low levels of psychoactive THC—is now legal in the United States. This is big news for people interested in the therapeutic effects of cannabidiol (or CBD) because—while hemp doesn’t contain enough THC, the compound that provides the “high” of cannabis, or any other psychoactive compounds—it does contain cannabidiol (CBD).

For years, all anyone talked about when they talked about cannabis was the THC content. Breeders focused on driving THC levels as high as possible and ignored the other compounds. Even pharmaceutical companies interested in the medical applications of cannabis focused on the THC, producing synthetic THC-only drugs that performed poorly compared to the real thing. It turns out that all the other components of cannabis matter, too, and foremost among them is CBD.

CBD doesn’t get you high, but it does have big physiological impacts. These days, researchers are exploring CBD as a treatment for epilepsy, anxiety, and insomnia. They’ve uncovered potential anti-inflammatory, anxiolytic, and immunomodulatory properties. And now that it’s quasi legal, hundreds of CBD-rich hemp oil products are appearing on the market.

What are the purported benefits of using CBD-rich hemp oil, and what does the evidence say?

Although CBD research is growing, it’s still understudied and I expect I’ll have to update this post in the near future with more information. But for now, here’s a rundown of what the research says.

The Health Benefits of CBD In Hemp Oil

CBD For Anxiety Reduction

Anxiety can be crippling. I don’t have generalized social anxiety, but I, like anyone else, know what it feels like to be anxious about something. It happens to everyone. Now imagine feeling that all the time, particularly when it matters most—around other people. The average person doesn’t consider the import and impact of anxiety on a person’s well-being. If CBD can reduce anxiety, that might just be its most important feature. Does it?

Before a simulated public speaking event, people with generalized social anxiety disorder were either given 600 mg of CBD or a placebo. Those who received CBD reported less anxiety, reduced cognitive impairment, and more comfort while giving the speech. Seeing as how people without social anxiety disorder claim public speaking as their biggest fear, that CBD helped people with social anxiety disorder give a speech is a huge effect.

This appears to be legit. A placebo-controlled trial is nothing to sniff at.

CBD For Sleep

A 2017 review provides a nice summary of the effects of CBD on sleep:

In insomnia patients, 160 mg/day of CBD increased sleep time and reduced the number of arousals (not that kind) during the night.

Lower doses are linked to increased arousals and greater wakefulness.

High dose CBD improved sleep; adding THC reduced slow wave sleep.

In preliminary research with Parkinson’s patients, CBD reduced REM-related behavioral disorder—which is when you basically act out your dreams as they’re happening.

More recently, a large case series (big bunch of case studies done at once) was performed giving CBD to anxiety patients who had trouble sleeping. Almost 80% had improvements in anxiety and 66% had improvements in sleep (although the sleep improvements fluctuated over time).

Mental Health

While its psychoactive counterpart THC has been embroiled in controversial links with psychosis and schizophrenia for decades, CBD may be an effective counterbalancing force for mental health.

In patients with schizophrenia, six weeks of adjunct treatment with cannabidiol resulted in lower rates of psychotic symptoms and made clinicians more likely to rate them as “improved” and made researchers more likely to rate them as “improved” and not “severely unwell.” There were also improvements in cognitive performance and overall function. It seems the “adjunct” part of this study was key, as other studies using cannabidiol as the only treatment mostly failed to note improvements.

This was placebo controlled, so it makes a good case for CBD hemp oil as adjunct treatment (in addition to regular therapy) in people with schizophrenia.

Among 11 PTSD patients who took an average of 50 mg of CBD per day for 8 weeks, 10 (90%) experienced a 28% improvement in symptoms. No one dropped out or complained about side effects. CBD seemed to particularly benefit those patients who had issues with nightmares.

This is promising but preliminary. This was an 11-person case study, not a placebo-controlled trial.

Epilepsy

A recent review of four human trials lays out the evidence: More than a third of all epilepsy patients experienced 50% or greater seizure reductions with just 20 mg of CBD. The effect of CBD on seizure activity is so widely acknowledged and understood that the only FDA-approved CBD-based product is Epidiolex, a plant-based CBD extract used to treat seizures in patients with Dravet syndrome and Lennox-Gastaut syndrome.

CBD for epilepsy is legit. Side note: I wonder how CBD would combine with ketogenic dieting for epilepsy control.

Pain

By far the biggest draw for medical consumers of CBD is its supposed ability to nullify pain.

In one study, researchers induced arthritis in rats with intra-articular injections, then gave them CBD. Rats given CBD were able to put more weight on their joints and handle a heavier load before withdrawing. Local CBD reduced nerve damage.

That’s great for pet rats. What about people?

There actually isn’t a lot of strong data on pain management using CBD by itself. Far more robust is the evidence for using CBD with THC for pain. According to this group of researchers, the two compounds exert “constituent synergy” against neuropathic pain. One study found that low doses of each were more effective combined than high doses of either alone in neuropathic cancer-related pain. Another gave a THC/CBD oromucosal spray to otherwise treatment-resistant neuropathy patients, finding that the spray reduced pain, improved sleep, and lessened the severity of symptoms.

Anything Else?

Anecdotal evidence for pain relief and other benefits with CBD is vast. Chris Kresser, a practitioner and researcher I trust, swears by it. I have employees who use it quite frequently, reporting that it improves their sleep, hones their focus, reduces pain, speeds recovery, and reduces anxiety. These things are always hard to evaluate, but I can say that my people do great work, and I have zero reason to distrust them.

In later posts, I’ll probably revisit some of these other, more theoretical or anecdotal potential benefits to see if there’s any evidence in support.

Is It Safe?

A recent study gave up to 6000 mg of CBD to healthy subjects, finding it well tolerated and the side effects mild and limited to gastrointestinal distress, nausea, somnolence, headaches, and diarrhea. For comparison’s sake, keep in mind that a typical dose of CBD is 20 mg.

Mouse research indicate that extended high-dose CBD (15-30 mg/kg of bodyweight, or 1200-2400 mg per day for an 80 kg man) might impair fertility. Male mice who took high-dose CBD for 34 days straight experienced a 76% reduction in testosterone, reduced sperm production, and had dysfunctional weird-looking sperm. In the 30 mg/kg group, the number of Sertoli cells—testicular cells where sperm production takes place and sperm is incubated—actually dropped. Male mice taking CBD also were worse at mounting females and had fewer litters.

Those are really high doses. For epilepsy, a common dose is 600 mg/day, and that’s for a severe condition. Most other CBD therapies use much smaller doses in the range of 20-50 mg/day. Long term safety may still be an issue at these lower doses, but we don’t have any good evidence that this is the case.

There’s some evidence that the dosages of CBD required to achieve anti-inflammatory effects are also high enough to induce cytotoxicity in healthy cells, though that’s preliminary in vitro (petri dish) research and as of yet not applicable to real world applications. Time will tell, though, as the legal environment opens up and we accumulate more research.

Is Isolated CBD the Same As Whole Plant Extracts?

As we’ve learned over the past dozen years of reading about nutrition and human health, whole foods tend to be more effective than isolated components. Whole foods have several advantages:

  • They contain all the components related to the compound, especially the ones we haven’t discovered and isolated. Supplements only contain the isolated compounds we’ve been able to quantify.
  • They capture all the synergistic effects of the multiple components working together. Isolated supplements miss that synergy unless they specifically add it back in, and even then they’ll probably miss something.

It’s likely that whole plant hemp extracts high in CBD are superior to isolated synthetic CBD for the same reason. Is there any evidence of that?

A high-CBD cannabis whole plant extract reduces gut inflammation and damage in a mouse model of inflammatory bowel disease. Purified CBD does not.

Even at a 2:1 CBD:THC ratio, co-ingesting isolated CBD with isolated THC using a vaporizer fails to reduce the psychotic and memory-impairing effects of THC. In another study, however, smoking cannabis naturally rich in both CBD and THC completely prevented the memory impairment.

And as we saw in the pain section above, THC combined with CBD seems more effective against pain than either alone.

That’s not to say isolated (even synthetic in some cases—see note below) CBD isn’t helpful. We saw it improve joint pain and reduce nerve damage in arthritic rats. It’s just that full-spectrum hemp oil containing multiple naturally-occurring compounds is probably ideal for general health applications. Specific conditions requiring high doses may be another question entirely. Again, we’ll find out as more research comes out.

A word about synthetics: this is fodder for a follow-up, but it appears there may be additional concerns with synthetic CBD, and even supposedly “natural” CBD companies have in some cases allegedly added ingredients to their formulas without letting consumers know.

Is It Legal?

CBD-rich hemp oil lies in a legal grey area. The recently passed Farm Bill allows people to grow and make products from industrial hemp, as long as it contains less than 0.3% THC. That means CBD derived from industrial hemp is legal at a federal level. But because the Farm Bill has provisions that allow states to set their own rules, legality at a state level is more complicated.

States where hemp is still illegal—South Dakota, Idaho, and Nebraska—do not permit the sale or use of hemp-derived CBD oil.

In states that permit recreational cannabis—California, Vermont, Massachusetts, Maine, Oregon, Colorado, Washington, Nevada, Michigan, and Alaska—CBD derived from both hemp and psychoactive cannabis is legal.

In all other states, hemp-derived CBD is legal.

The FDA has yet to approve of CBD, so most of the big online retailers like Amazon and Walmart don’t allow CBD products to be advertised. However, Amazon sells a ton of “hemp extract” tinctures and oils with “hemp extract content” listed in milligram dosages—a workaround for listing the CBD content.

If you’re looking for CBD-rich hemp oil, watch out for culinary hemp oil, which comes in larger quantities and has no discernible CBD content. CBD-rich hemp oil will come in dropper bottles, not liters.

You can also buy directly from manufacturers online who proudly advertise their CBD content. I’ve heard good things about Ojai Energetics and Sabaidee, though I haven’t used either.

Many health food stores sell it. Surprisingly, I’ve seen it in every pet store I’ve entered in the last half year.

Word of Caution: Because it isn’t regulated by the FDA yet, there’s no telling exactly what you’re getting. Choose a product with verifiable lab tests. Many CBD hemp oil products have far less CBD than advertised. In addition to CBD content, the most reputable manufacturers also test for pesticides, heavy metals, mycotoxins, and bacteria and advertise their results.

CBD-rich hemp oil is a hot topic these days, and it’s only going to get hotter. I think the compound shows great promise in promoting health and wellness, and I’ll look forward to doing more research as it unfolds.

For now, what about you? Do you use CBD? Have you noticed any benefits? Any downsides? Share your questions and feedback down below.

Thanks for reading, everyone. Take care.

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References:

Bergamaschi MM, Queiroz RH, Chagas MH, et al. Cannabidiol reduces the anxiety induced by simulated public speaking in treatment-naïve social phobia patients. Neuropsychopharmacology. 2011;36(6):1219-26.

Lattanzi S, Brigo F, Trinka E, et al. Efficacy and Safety of Cannabidiol in Epilepsy: A Systematic Review and Meta-Analysis. Drugs. 2018;78(17):1791-1804.

Elms L, Shannon S, Hughes S, Lewis N. Cannabidiol in the Treatment of Post-Traumatic Stress Disorder: A Case Series. J Altern Complement Med. 2018;

Serpell M, Ratcliffe S, Hovorka J, et al. A double-blind, randomized, placebo-controlled, parallel group study of THC/CBD spray in peripheral neuropathic pain treatment. Eur J Pain. 2014;18(7):999-1012.

Silva RL, Silveira GT, Wanderlei CW, et al. DMH-CBD, a cannabidiol analog with reduced cytotoxicity, inhibits TNF production by targeting NF-kB activity dependent on A receptor. Toxicol Appl Pharmacol. 2019;368:63-71.

Carvalho RK, Souza MR, Santos ML, et al. Chronic cannabidiol exposure promotes functional impairment in sexual behavior and fertility of male mice. Reprod Toxicol. 2018;81:34-40.

Morgan CJA, Freeman TP, Hindocha C, Schafer G, Gardner C, Curran HV. Individual and combined effects of acute delta-9-tetrahydrocannabinol and cannabidiol on psychotomimetic symptoms and memory function. Transl Psychiatry. 2018;8(1):181.

Morgan CJ, Schafer G, Freeman TP, Curran HV. Impact of cannabidiol on the acute memory and psychotomimetic effects of smoked cannabis: naturalistic study: naturalistic study [corrected]. Br J Psychiatry. 2010;197(4):285-90.

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I Feel Strong and Powerful In My Own Body

It’s Monday, everyone! And that means another Primal Blueprint Real Life Story from a Mark’s Daily Apple reader. If you have your own success story and would like to share it with me and the Mark’s Daily Apple community please contact me here. I’ll continue to publish these each Monday as long as they keep coming in. Thank you for reading!

Growing up, I was very bookish and avoided all forms of exercise despite my parents’ best efforts to get me involved in some sort of sport. I was also a very picky eater, especially when it came to veggies, so my diet wasn’t the greatest.

Throughout high school, I always carried an extra 10-15 lbs and my lunch consisted of stuffed crust pizza, strawberry milk and fries swimming in ranch dressing.

My weight yo-yoed in college depending on how excited I was about the gym and whether I was on a salad bar or buffalo chicken wrap kick. I did gain a lot of weight after I got married and hit my all time high of 170 lbs. I was able to lose most of the weight through a low carb diet, though I still avoided the gym.

My first experience with primal eating came in 2014 when my husband came home talking about this paleo diet he’d heard about from a colleague. I started doing a lot of research and decided to start this new way of eating. We weren’t super strict about, using dressings and condiments that were not ideal and I refused to give up cheese (I now know that including dairy is more aligned with the primal way of eating). My husband lost a bunch of weight, and I felt really good even though the scale didn’t move.

Unfortunately, after only about two months, we went on vacation and fell back into our SAD eating habits even after we returned. Fast forward to 2016 and I had moved to another state, finally gotten a full-time job after a year of under employment/unemployment and was steadily gaining weight again. I didn’t realize how lucky I’d been to have been able to walk or bike to work before moving to a bike and pedestrian unfriendly area! I started calorie restricting, but that just left me feeling hungry all the time and my pants were too tight. I weighed in at 155 lbs.

In January, I finally gave in and let my husband sign me up for a gym membership. As much as I disliked exercise, I knew that I had to get my body moving if I didn’t want to look like a lot of the people in my office when I got to middle age. I started strength training which was way more fun than cardio and lost 5 lbs in the first month. But despite hitting the gym 3 times and week and participating in a Crossfit style workout once a week, my weight loss stalled after that. I knew I was building up muscle mass that I’d never had before, but I was mostly motivated to not have to buy new, bigger pants at this point.

By the end of March, I realized that I had to make some serious diet changes if I wanted to get my health completely under control, so I decided to do my first Whole30. It was hard but amazing! I felt great, finally kicked my diet soda habit, reset my taste buds and learned that dairy gives me migraines and makes my seasonal allergies go crazy. I also rediscovered MDA during this time and read years of primal success stories which gave me the courage to keep up this style of eating long term using the 80/20 principle. I also made it a point to try every (primal) food I thought I hated one more time and now I eat many of them regularly. Hello onions, peppers, brussels sprouts, squash, zucchini, fish, nuts, carrots, pineapples, sweet potatoes, tea, and so many more. I’m still working up the nerve to try sardines but there’s a tin of them in my pantry for the day I’m feeling brave!

For the first time in my life, I felt fit and strong. My body learned to love and crave veggies, even at breakfast. I was empowered to make better food choices. I still get anxious about food in social situations sometimes when my social anxiety combines with my fear of accidentally eating dairy and getting really sick, which has, unfortunately, happened. Now if I don’t feel comfortable with my food options, I eat beforehand or bring my own food. My health is totally worth being that weird person for. I have also learned that most people have no idea what is in their food or what is actually good for their bodies. I am so glad to have come upon this way of eating while I’m still young.

My next big health change occurred in the fall of 2018 when I started getting into long distance running. I came into running knowing that I wanted to do it in a way that aligned with my health and nutritional values that I’d worked so hard to get straight. This led me to using the run walk run method to decrease risk of running injuries and to primal keto to avoid all of the sugary fuel and recovery products aimed at endurance athletes. I do all my training runs fasted and eat a bit more carbs right before and after races. I also make sure to focus on keeping up my strength training by incorporating the Primal Essential Movements, even the two I dread-pushups and planks. There is something awesome about being able to take yourself 13 miles on your own two feet, but nothing makes me feel as badass as using the assisted pullup machine.

Doing keto while staying dairy free, maintaining a high veggie intake and properly fueling my athlete body has taken some extra effort but the benefits are amazing. I no longer get hangry if a meal is delayed. I feel strong and powerful in my own body. I weigh less than I did in high school. I have way fewer migraines. I even have abs. I have learned so much about my body and my personal nutrition needs. I still ended up needing to buy new pants twice but smaller rather than larger. I have so much more energy to do the things I love. Most importantly, I now know how to take care of my body properly for a long and healthy life.

Stephanie

The readers featured in our success stories share their experiences in their own words. The Primal Blueprint and Keto Reset diets are not intended as medical intervention or diagnosis. Nor are they replacements for working with a qualified healthcare practitioner. It’s important to speak with your doctor before beginning any new dietary or lifestyle program, and please consult your physician before making any changes to medication or treatment protocols. Each individual’s results may vary.

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Tahini Fudge

Fudge…the creamy, rich squares of pure decadence we might associate with the holidays (or with trips to grandmother’s house). A little sure went a long way, but still…. With versions that typically call for everything from three cups of sugar to marshmallow fluff to sweetened condensed milk, fudge isn’t exactly a realistic Primal option. In fact, however much we may have loved it as kids, most of us have tastes too far adapted from this level of sweetness for it to hold the same temptation anymore. (Does anyone’s teeth hurt right about now?)

But that was then. This is now—with a whole different, Primal take on this classic. We happen to think this recipe is what fudge was always meant to be—all the rich texture and creamy feel (from healthy fats)…with a fraction of the carbs. Enjoy!

Ingredients:

  • 1 packet of Primal Kitchen® Collagen Peptides (optional for nutrition benefit)
  • 1/2 c organic tahini
  • 3/4 c organic coconut butter
  • 1/4 c SunButter (no sugar added)
  • 1/2 fresh vanilla bean
  • 3 tbsp maple syrup
  • 1/2 bar of unsweetened chocolate
  • Sea salt flakes to top

Instructions:

Melt and mix everything (except the chocolate and salt) in a double-broiler. Let cool to room temp.

Chop the chocolate into chips and stir into fudge mixture.

Pour into a silicon cube tray, sprinkle with salt flakes and let chill in the fridge until super firm.

*Store covered in the fridge.

Nutritional Information (per serving):

  • Calories—312
  • Carbs—9 grams
  • Fat—27.5 grams
  • Protein—7 grams

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Dear Mark: How Does LDL Even Penetrate the Arteries, New Zealand Farmed Salmon, Elevated Ferritin

For today’s edition of Dear Mark, I’m answering three questions. First, can LDL actually infiltrate the arteries, or is there more to the story? Malcolm Kendrick says there’s more to the story, so I dig into some literature to see if they corroborate his position. Second, is New Zealand farmed salmon good to eat? And finally, what should you do about elevated ferritin levels—and why else might they be elevated if not because of your iron?

Let’s go:

My reading of this post by Malcolm Kendrick MD is that LDL particles cannot infiltrate the endothelial lining of our arteries:
https://drmalcolmkendrick.org/2018/08/16/what-causes-heart-disease-part-52/

Great read. Malcolm Kendrick is consistently fascinating, insightful, and enlightening.

He’s basically suggesting that LDL particles can’t manhandle their way into the artery wall, which are equipped with tight junctions—the same kind that regulate passage through our gut lining. Something has to “allow” them in. The something he finds most plausible is injury, trauma, or insult to the endothelial lining (artery wall, for lack of a better phrase).

A free public textbook available on PubMed since last month called The Role of Lipids and Lipoproteins in Atherosclerosis tackles the topic head on. In the abstract, they say:

Population studies have demonstrated that elevated levels of LDL cholesterol and apolipoprotein B (apoB) 100 [note: ApoB is a stand-in for LDL particle number, as each LDL-P has an ApoB attached to it], the main structural protein of LDL, are directly associated with risk for atherosclerotic cardiovascular events (ASCVE). Indeed, infiltration and retention of apoB containing lipoproteins in the artery wall is a critical initiating event that sparks an inflammatory response and promotes the development of atherosclerosis.

This seems to posit that infiltration of the LDL particle into the artery wall is a critical initiating event. But is it the critical initiating event? Does something come before it? How does the infiltration happen, exactly? Moving on:

Arterial injury causes endothelial dysfunction promoting modification of apoB containing lipoproteins and infiltration of monocytes into the subendothelial space. Internalization of the apoB containing lipoproteins by macrophages promotes foam cell formation, which is the hallmark of the fatty streak phase of atherosclerosis. Macrophage inflammation results in enhanced oxidative stress and cytokine/chemokine secretion, causing more LDL/remnant oxidation, endothelial cell activation, monocyte recruitment, and foam cell formation.

If I’m reading this correctly, they’re saying that “arterial injury” is another critical initiating event—perhaps the critical initiating event, since the injury causes “endothelial dysfunction,” which in turn modifies (or oxidizes) the LDL particles. But wait: so they’re saying the LDL particles are already there when the arterial injury occurs. They’ve already made it into the endothelial walls, and they’re just…waiting around until the arteries get injured. Okay, okay, but, just like Malcolm Kendrick points out, nowhere in the abstract have the authors actually identified how the LDL particles enter the endothelial lining. Maybe it’s “common knowledge,” but I’d like to see it explained in full.

Moving on:

In atherosclerosis susceptible regions, reduced expression of eNOS and SOD leads to compromised endothelial barrier integrity (), leading to increased accumulation and retention of subendothelial atherogenic apolipoprotein B (apoB)-containing lipoproteins (low-density lipoproteins (LDL)) and remnants of very low-density lipoproteins (VLDL) and chylomicrons)

Ah ha! So, in regions of the arteries that are prone to atherosclerosis, low levels of nitric oxide synthase (eNOS)—the method our bodies use to make nitric oxide, a compound that improves endothelial function and makes our blood flow better—and superoxide dismutase—an important antioxidant our bodies make—compromise the integrity of the arterial lining. The compromised arterial lining allows more LDL particles to gain entry and stick around. So, are low levels of nitric oxide and impaired antioxidant activity the critical initiators? That’s pretty much what Malcolm Kendrick said in his blog post.

Still—high LDL particle numbers are a strong predictor of heart disease risk, at least in the studies we have. They clearly have something to do with the whole process. They’re necessary, but are they sufficient? And how necessary are they? And how might that necessariness (yes, a word) be modified by diet?

I’ll explore this more in the future.

In regards to the oily fish article (and more indirectly given the omega 6 concern- the Israeli Paradox) What do you think of NZ farmed salmon? I’m in Australia, & occasionally like a fresh piece of salmon- there are no wild caught available here sadly, but I am wondering how it measures up as an alternative?

Last year, I explored the health effects of eating farmed salmon and found that it’s actually a pretty decent alternative to wild-caught salmon, at least from a personal health standpoint—the environmental impact may be a different story.

I wasn’t able to pull up any nutrition data for New Zealand farmed salmon, called King or Chinook salmon. Next time you’re at the store, check out the nutritional facts on a NZ farmed salmon product, like smoked salmon. The producer will have actually had to run tests on their products to determine the omega-3 content, so it should be pretty accurate. Fresh is great but won’t have the nutritional facts available. I don’t see why NZ salmon would be any worse than the farmed salmon I discussed last year.

According to the NZ salmon folks, they don’t use any pesticides or antibiotics. That’s fantastic if true.

I used to eat a lot of King salmon over in California, and it’s fantastic stuff. Very fatty, full of omega-3s. If your farmed King salmon comes from similar stock, go for it.

ok can someone tell me how to reduce ferritin? Is is just by giving blood?

Giving blood is a reliable method for reducing ferritin. It’s quick, effective, simple, and you’re helping out another person in need. Multiple wins.

Someone in the comment board recommended avoiding cast iron pans in addition to giving blood. While using cast iron pans can increase iron intake and even change iron status in severe deficiency, most don’t have to go that far. Giving blood will cover you.

Ferritin is also an acute phase reactant, a marker of inflammation—it goes up in response to infections (bacterial or viral) and intense exercise (an Ironman will increase ferritin). In fact, in obese and overweight Pakistani adults, elevated ferritin seems to be a reliable indicator of inflammatory status rather than iron status.

Thanks for reading, everyone. Take care and be well!

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References:

Birgegård G, Hällgren R, Killander A, Strömberg A, Venge P, Wide L. Serum ferritin during infection. A longitudinal study. Scand J Haematol. 1978;21(4):333-40.

Comassi M, Vitolo E, Pratali L, et al. Acute effects of different degrees of ultra-endurance exercise on systemic inflammatory responses. Intern Med J. 2015;45(1):74-9.

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