Case Studies

****these pages are no longer hosted on the main site because I have since discovered new, important biological science such as the solution to the Warburg Effect, which underlies cancer, and other nutritional strategies to getting well that are not reflected in these past consultation examples. While they can still contain valuable information they are not up to date, and relying on them excessively can cause missed information as discussed in the latest version of Fuck Portion Control.****

Presented here is a record of my interactions with several people I have coached (with their permission), to demonstrate the kinds of issues commonly experienced by those needing assistance with their health, and how I personally chose to address issues or ones which are similar. I only provide insight from how I dealt with these things myself and this is not and should not be a substitute for professional medical assistance—It is meant to inform, educate, and entertain, as a supplement to and not substitute for proper medical care and attention from capable medical professionals. Please discuss all pertinent information and decisions with your doctor or provider and only attempt presented suggestions and therapies under the supervision of a properly trained, licensed, and capable medical professional. I have absolutely no training, certification, or association with any medical institution, board, or regulatory agency. Each coaching course begins with a questionnaire as shown below. Some editing of the interactions was necessary to clarify, contextualize, or update information as I would now present it as indicated by the use of brackets. I do not endorse products, so please don’t ask.

Case 1 + 2: Females aged 39 and 9 Case 3: Male aged 45 Case 4: Female aged 45 Case 5: Male aged 30

 Case Study #1 and #2 Age: 39 Sex: Female Child Age: 9 Sex: Female

Nathan:

Hey ********,

Thanks again for signing up. Here is the questionnaire I have people fill out so we can get started. Remember that it's your job to manage the subscription to this coaching, so when you feel like we've accomplished enough you can log in to cancel it whenever you like, otherwise it will continue to charge you indefinitely. I saw that you also ordered my book, which means you haven't read any of it yet. Most of the coaching I do refers you to the book, which is the most efficient way to explain things. When you get it I would ask that you immediately read up to chapter eight so you can understand a lot of the foundational requirements to accomplish the stuff I will be suggesting for your personal situation. Looking forward to your reply,

Questionnaire:
1) What are your current symptoms and how would you like to improve? What are your health challenges?
2) Please list everything you might eat in a day.
3) List everything you might eat in a week.
4) Times of day you eat.
5) All supplements you are currently taking.
6) All medications you are currently taking as well as those you've taken in the past, including drugs and alcohol.
7) Times and frequency of physical activity, if any.

******** :

1.) I am 39, I have ***** children, I’m married, I work part time as a therapist for young children. I have a regular cycle although it seems to be shorter 24/25 days than it used to be (28 days). My main symptoms- unrefreshing sleep (dreaming, moving, waking up to pee, not feeling rested in the morning, easily awoken), body/belly fat—excessive fat in abdomen, hips, butt area. I feel stressed out with my kids (especially by the end of the day). I have social anxiety which comes out as excessive “niceness” and people pleasing, freezing up in group conversations, forgetting words, unable to be funny/witty. I also have very little joy or feelings of happiness in my life. I had a traumatic childhood with an abusive mother who has bipolar disorder and put a lot of her dietary restrictions on me. She was very concerned with my appearance and weight. She started restricting my food at 12 and put me on Slim Fast. I have always been about 10-20 lbs overweight with a few times in my life that I lost significant weight due to extreme stress, or dieting/diet pills, or digestion issues.

In January of 2014, I experimented with resistant starch (potato starch) and it screwed up my gut health and led to fungal issues in my feet. I soon after became pregnant in feb 2014 (unplanned) and had a tremendously difficult pregnancy since my gut was wrecked from the potato starch. I developed severe insomnia, weight loss, hair loss, depression/anxiety during the pregnancy. It was probably the worst time in my life since I knew the impact it was having on my baby but could not break out of the cycle. Prior to this health decline I had been improving my health through the paleo diet, various herbs, vitamins, and homeopathy. My first child (born in *******) was diagnosed with autism at 22 months old and I was learning so much about diet and gut health between the years of 2010-2014. I recovered my oldest son through intense dietary changes, homeopathy, and some herbs/vitamins. I was so devastated with what occurred in my last pregnancy. In fact, I still feel that I am dealing with low level problems the resistant starch caused (toe nail and foot fungus, hormonal imbalances, stress, anxiety/depression). My main priority is improving my sleep and reducing my stress/anxiety. I also want to feel joyful for myself and family. I want to improve my body composition by losing belly fat.

2.) Coffee with 1% milk and honey or sugar. Orange juice with gelatin. Chocolate milk. Oysters. Applesauce. Cottage cheese. Low fat Swiss cheese. Orange. Pineapple. Mango. Peach/pear fruit cups. Raw carrot. Hard boiled or scrambled egg

3.) Same as above plus Coconut oil. Shrimp. Mussels. Chicken. Beef. Prosciutto. Ice cream. Banana. String cheese. If I am at a party I will eat anything- pizza, hotdog, cake etc.

4.) 7:30, 11:00, 2:00, 4:30, 6:00, maybe 9:00

5.) Nothing regularly, but I have experimented with thyroid glandular, desiccated liver, magnesium lotion, progesterone cream, homeopathic medicine as needed, trace minerals, potassium/magnesium powder, magnesium bicarb, natrabio thyroid support. I also take homeopathic cell salts frequently depending on what I need or I use Bioplasma which is all the minerals in one.

6.) No medications currently. I have taken Ativan twice (2010 and 2014) due to unrelenting insomnia. I took it for about 5 days each time. In 2002 I took a weight loss supplement called Herbalife that had ephedrine in it. It is no longer sold due to it being dangerous. I believe this supplement caused long term damage to my nervous system and metabolism. I lost about 30 lbs on it but developed my first experience with anxiety and insomnia. I have taken antibiotics for various things but not in about 11 years. I was prescribed Vicodin when I had my wisdom teeth removed. I have never smoked or have done an illegal drug.

7.) 3-4 days a week in the morning around 9:00/10:00 o’clock. I was doing hot yoga for about a year, then started spin classes, now I do light weights and have stopped intense aerobic exercise.

—Questionnaire response for daughter, age: 9–

********* 9 years old. She is the middle child. She was small at birth, had a calcium deposit on her heart, did not move much in uterine. Her right side appeared weaker than her left. Her right eye wanders outward and her right eyelid doesn’t open as wide as the left. Short stature, had failure to thrive as a baby, had “anemia” that was unresolved by iron supplements. Has had digestion issues on/off since birth. Bloated tummy, back arched, low energy, low motivation for school related things. We’ve done every special diet you can think of. We’ve seen naturopaths, an Ayurvedic doctor, several homeopaths, and mainstream doctors. The best she has done is with a chiropractic doctor who did “muscle testing” and found small intestine gut issues with candida overgrowth and treated her with a variety of herbal supplements. We had to move and lost contact with this doctor.

1.) Her current symptoms- slow growth, 15 lb weight gain over last 12 months, disinterested in most things including school, sports, playing with friends. Receives special support at school because she is behind in reading, math, and writing. Received speech therapy until last year due to articulation errors. Has anxiety at night about sleeping alone- always worried robbers will come in the house. Sucks her thumb (has done this since birth). Has pain in her legs and heels at night. Her general health and learning abilities at school decline in the winter months. Since moving to NJ we get much less sun than in California where she was born and lived until 5 years old. I would like for her to have better energy, growth, and engagement at school. I would like her to stop gaining weight (unless this is needed) as she is gaining fat in her mid section and not growing in height.

2.) 3.) 4.) same as mother but more starches

5.) Nothing regularly, mostly homeopathic remedies as needed. When I remember I give her desiccated liver capsules. Arnica lotion at night for her legs. She has had strong negative reactions to epsom salt baths in the past so I avoid magnesium usually with her.
6.) None
7.) ********** walks or rides her bike to/from school. It takes about 15 minutes waking and less than 10 minutes biking. She plays soccer three times a week (this just started). Two practices at 6:00pm for 1 hr and a game midday on the weekend for 1 hr. She generally does not like to be active. We have a large trampoline, play set, other backyard equipment but she wants to sit and watch TV whenever possible.

Thank you for your time! I look forward to working with you.

Nathan:

Hey ********,

Thanks again for signing up. So first off there are several issues with your diet which must be addressed. You appear to have a deficit of calories—this is very common nowadays as people believe that calories cause weight gain—but calories are a measurement of fuel, and our body needs fuel in order to maintain a healthy metabolic rate, retain minerals, and support metabolic processes like sleep, libido, and to slow the aging process. Additionally, you also have a glucose deficiency which comes from not eating any starch, although you could perhaps be getting enough from bananas, though that's unlikely, a deficiency of glucose prevents many healthy metabolic pathways from functioning correctly, least of all being able to get your pulse and temperature up to the appropriate levels required for metabolic regeneration. You are also missing vitamin K foods, which means you are not producing some of the most important nutrients for maintaining a healthy gut microbiome, losing weight, and controlling calcium metabolism. All these issues are discussed in the first several chapters of my book in more detail.

Social anxiety and end-day fatigue are primary signs of pregnenolone deficiency. Pregnenolone is our master hormone from which all others are made, and if you are not making enough your body does not have the resources to cope with the simple stresses of even just being awake and doing things. For some reason social anxiety is a more acute symptom of pregnenolone, probably because we are deficient in all the other hormones which help us navigate social interaction such as the sex hormones or oxytocin. I would then recommend one of the first things you do is take a supplement of pregnenolone. Typically most of these supplements are good, just avoid any which contain silica as an ingredient because this can cause agitation. Pregnenolone does not usually have side effects [for women], and taking 50 mg every morning and in advance of social gatherings will help to eliminate your fatigue, anxiety, as well as support numerous metabolic pathways, so long as your diet also changes for the better.

Next we must discuss your weight. Not losing it, but your attitude surrounding it. Fat storage is a protective biological mechanism which prevents our death by shoring up calories against many sources of stress, most commonly gut pathogens but also environmental and social stresses. For instance, people who do not feel safe emotionally with a healthy social support network will gain weight as the organism detects instability and uncertainty in their environment. We are highly social creatures by design, and when our need for interconnectedness and cooperation is impeded our body responds to the potential loss of social cooperation by storing up fat [as if we were wild humans this would indicate an increased risk of demise through lack of strategic resources]. Typically though this is also compounded by a poor diet and dietary behaviors like fasting, calorie counting, low-carb, excessive exercise, or exposure to harmful chemicals which impact the gastrointestinal system and alter a healthy microbiome. Fat is what has kept you alive in the face of all these stresses. It is your friend and your body is actively protecting you against the problems in your life. In order to lose extra fat you must come to terms with this realty, respect and appreciate your body for the service it has performed for you, and respect and cherish food as a source of comfort, joy, ritual, and not as a necessary evil simply meant to satiate your basic hunger instincts. Particularly in your situation, with a history of abuse and emotional manipulation it is helpful to practice the personal inventory therapy which is discussed in chapter 31. This therapy helps us to diagram and understand the pain and trauma of our past in order that we may be properly done with it. It affects the subconscious in very real ways which will help your mind to understand the parameters of your challenges and in turn will receive you of the stresses which contribute to weight gain and exhaustion, and even bring increased joy and satisfaction to your life which in turn will lower the adrenaline response which is one of the biggest promoters of weight gain as adrenaline is most highly stimulated by emotional response and not diet or environment as all the other stress hormones are. This will also help you find an increase in compassion and love for yourself and your body and free you of the chains imposed upon you by your childhood and society's misunderstanding of the human body, and the coping mechanisms you have developed which end up compromising your own best interests.

In addition to that practice, the absence of feelings of a positive nature also reflect high stress hormones which will be reduced as you take care of your physical health and use generous amounts of calories and nutrients to raise the metabolic rate. Our feelings are hormones, and the harmful ones are lowered by an abundance of carbs, B vitamins, vitamin C, minerals, and sunlight as discussed throughout my book which in turn makes room for the healthy, stimulating hormones which bring with them the higher emotions. Your body just has not had the resources to make them in the past, but they are easy to restore using these guidelines, and taking pregnenolone and other foods which support the natural synthesis of pregnenolone and the other hormones will bring them back in a relatively short amount of time.

Great job on treating your autistic son yourself. That is difficult to do. I have [information in the most recent version of my book] for treating autism, no doubt you achieved this through your own intuition and determination. Unfortunately the treatments used early in your daughter's life, most specifically the iron supplements, probably contributed to her issues. The medical industry does not properly understand the nature of iron—a child is not supposed to have large amounts of iron exposure, in order to prevent bacterial ingress to the gut which can disrupt development. That is why milk is so low in iron (iron is still necessary for growth but it's stored in large amounts in the liver during gestation). Your daughter's condition developed probably because your own body was metabolically ill while you were pregnant with her, so it wasn't able to grow a robustly healthy fetus and you wouldn't have been able to do anything about it. But the good news is that you definitely can improve her condition too, and rather rapidly too as children, who have not yet gone through puberty, are less susceptible to the factors which contribute to metabolic decline. For instance, the increase in estrogen which comes to both women and men during adolescence causes an increase in iron absorption to support adulthood and the increase in sex hormones and metabolic function, but this iron is also a liability which burdens tissues and increases the risk of bacterial infections. Children don't yet have this so they can respond much more quickly to changes of diet and an increase in metabolic health. Your daughter likely has chronic thyroid dysfunction which in turn prevents her body from developing normally, but where a medical professional would merely prescribe thyroid medication and cliche dietary changes, the information on diet in my book can be used to help her body naturally recovery and develop the thyroid function she has not yet had. Just like you, your daughter is also missing important nutrients which are required to be healthy, although she probably does appear to get a bit more glucose than you are, she is getting it from unhelpful sources as the pasta and flour you are using is likely common wheat, the gluten of which is a complex hybrid that is difficult for our bodies to break down and causes a host of metabolic problems, and even worse is fortified with additional iron which feeds pathogenic gastrointestinal microbes which are constantly blocking her body's attempts at getting well. Rice is also slightly estrogenic, though it can be delicious and useful I would not consume rice more than twice a week. Switching to safe grains for things like pasta and pancakes, grains [like spelt, einkorn, and kamut] which have gentle gluten which is easy to digest, will help to reverse her gastrointestinal symptoms, reduce the inflammation caused by common wheat, which will in turn promote regeneration of the thyroid.

The key to fixing the diet is NOT to just cut things out but to REPLACE them with healthier options. That way you do not get frustrated by a deficient diet and are instead satiated and hedonistic. One of my favorite brands for healthy grains is **********. They carry many einkorn pasta and flour options which are delicious and make for great pancakes, cookies, and cakes, which you should make in abundance. The joy of eating these foods made from healthy ingredients will not only bring your family relief but will actually be health promoting indulgences. A cookie made of real butter and safe flours is just as healthy as an apple, packed full of good nutrients the body can use to run a hot metabolic rate, whereas a cookie made of cheap flours, vegetable oils, and chemical products is poisonous and toxic. Yogurt is absolutely not allowed for children. Thyroid function requires the hormone to react with acetic acid in the gut, and lactic acid from yogurt interferes with this reaction and can thus sustain thyroid dysfunction. Introducing root vegetables into your family's diet is going to make significant improvements for all of you (roots like sweet potatoes, yams, yuca, etc.), and you should have root vegetables at least four times a week and those with vitamin K (spinach, collard greens, lettuce) at least three times.

Nighttime anxiety and thumb sucking is a sign of similar hormonal stress to what I discussed earlier in this email, which for children is supported by a proper diet free from things like common wheat which causes inflammation and thus impairs neurological health—but it is also likely that you unintentionally bring her stress yourself due to your defensive mechanisms gleaned from your abusive childhood. Finger sucking is a substitute for close physical contact with one's parent's, and if you objectively analyze your own behavior toward your children you may realize that you do not hug and hold them as much as you should, since you are probably afraid of close emotional ties on account of your treatment by your own mother. But this has the unfortunate effect of perpetuating the pain and trauma she inflicted and passing it down from one generation to the next. These reactions to pain and abuse are not our fault—they are the defensive mechanisms of our human biology meant to support survival as a species in the face of environmental stress. The practice of personal inventory will help relieve you of these burdens and find the kind of loving, integrated and emotionally sound family that you never had. None of us are more powerful than our biology, and this often includes our reactions to pain and trauma, and the only solution to address it is to face those problems head on. The practice of personal inventory is simple and straightforward, only requiring a few minutes of each day, and rewires the subconscious as to affect the most profound change in humans that is physical possible, and if you complete it you will know such a bliss as is only written about in books and known by a spare few of humanity. Best of all you will be able to pass that bliss on to your own children and positively affect generations of human beings.

It is keen of you to notice that your daughter's symptoms increase during the winter. In this case it is helpful to get some cheap, artificial, bright lights to supplement light for her (and yourself) during the wintertime. One of the best for this is a simple red heat lamp as you can find at any hardware store. The addition of infrared heat will supplement metabolic heat and the bright light will help to reduce the stress hormones which rise in its absence. She can sit under it whenever she feels poorly, not too close as we don't want to cause further discomfort from too much heat and light, and the bulb is hot and comes with a risk of burning if touched so take precautions to ensure safe operation. You can also buy a warm LED light, but those are more expensive and not necessarily better. The dietary changes you will make are also going to lessen the severity of winter symptoms, and more rapid healing will occur at the onset of summer next year after this long foundation of good eating.

You personally will benefit from using a general B vitamin supplement such as brewer's yeast as discussed in my book. I personally like *********** brand which is grown on sugar beets, mixed with milk. It's not tasty but it's very effective. Additionally, the use of a separate supplement of niacinamide once a day or when symptoms present will help raise the metabolic rate. I have an update for my book coming soon which includes a suggestion of using some salt water to help set gut function which also addresses a lot of metabolic issues as sodium is very important for metabolic health, adding about 2 tablespoons of good salt to a whole gallon of water and drinking off that as you feel thirsty. Other strategies in the chapter on gut health, especially the dietary ones, will help restore a normal gut microflora which will in turn help you address the symptoms you are dealing with.

The most important thing you can do right now is also to perform the temperature and pulse diagnostic as discussed in the chapter on self therapy (just for yourself). This data will help me better understand the state of your endocrine system and will show you how to measure and monitor your metabolic health and progress (or lack thereof). After you have completed four days of data please share it with me.

Looking forward to your numbers,

Nathan

******** :

Wow, thank you for such a detailed and thorough response. I am thankful you have such a unique eye for what is going on in my life. I received your book today and plan to get started on it tonight. I will take my temps and pulse and get back to you. I have one question. I have a digital ear thermometer. Is this ok for me to use or do you have a specific thermometer that you use? I am not certain of the reliability of mine. Thanks, ********

Nathan:

Sounds great. I think you should use an oral thermometer, other locations tend to be less accurate, or at least not oriented the same as what the mouth can do. It doesn't have to be an expensive one either, just a normal cheap grocery store variety will do just fine.

******** :

Thank you! I just wanted to share that my temps are already up. It could be the new thermometer that I purchased, but I was getting readings for weeks in the 96.7-97.5 range with my old thermometer (I didn’t take the temps routinely, though). Today I woke up at 98.2 and now I’m 98.5 at night. This is after two days of niacinamide, brewers yeast, b-1, pregnenolone, and vitamin C. You did not recommend vit c, but I added it. I also have been eating root vegetables - potato, sweet potato, beets, and taro root. A little Pasta made from Einkorn wheat. I’ve been hot today, but it was 90 degrees and several of my client’s homes do not have air conditioning. I am very close to my period starting so my sleep hasn’t been great. I really hope that improves eventually. Thanks for all your help and I will send you more data soon. I need to do my pulse readings!

Nathan:

Oh hey that's great. Yes, it could have been your thermometer but I do often see immediate increases when people make changes, so it's probably that. I should not have forgotten to mention vitamin C, which is very important, so I'm glad you picked up on that! Stay cool.

******** :

Actually, you did mention it I just reread it.

******** :

Hi Nathan!

Just wanted to check in and let you know how things are going. I have consistently had good temps (98.2-99.2) for the past week. I’m not as good at checking my pulse but I did buy a pulse oximeter and when I remember to check it, my pulse is somewhere around 80-90 bpm. Overall, I feel SO good— motivated to get things done, making lists, handling stress. The biggest change has been my ability to stay calm and not flip out on my kids 🤦🏼‍♀️. I feel like everything isn’t as big of a deal and I’m able to check myself when my mind starts going down the anxious/depressed pathway. So THANK YOU 🏻 ️️️!!!

As a reminder, I’m taking these things 1x/day in the morning:
- 500 mg Niacinamide
- 50 mg B1 (I was getting headaches from something and decided to try cutting 100 mg to 50 mg)
- 2 scoops Brewers Yeast in 12 oz of water
- 50 mg Pregnenolone
- coffee with milk and sugar
- sometimes I take a Potassium powder called Keto K 1000 (it contains Mg and trace minerals, too). My electrolyte balance is difficult for me to figure out, but usually the powder makes me feel better (calmer heart, relaxed).

I am eating a high carb diet- lots of whole fruits, low fat dairy, starches, vegetable juice (Lakewood organic from Whole Foods) because it’s easier for me when I work to get the nutrients in that way. Seafood and gelatin mostly for protein. To be honest, my digestion hasn’t been great (some bloating and burping) so I thought maybe adding in the salt water you suggested. I just hesitate because I feel like salt tends to throw off other minerals (Not sure if this is just in my head 🤷🏼‍♀️).

As for my daughter, I’ve switched out the wheat products for Einkorn brand. I’m adding more fruit, starchy veggies, and low fat dairy (is this ok?). We go on walks at night together- about 1 mile. My mom is doing a 5k in October with my daughter and we are preparing for it slowly. She and I enjoy the walks and it gives us a chance to hang out together and talk. In the past, I would have been too stressed and tired/wired to walk at night, so that’s been a nice change for me in being able to support her better.

I also give her the Brewers Yeast (one scoop) with breakfast. Is this ok? You didn’t recommend any supplements for her, but after seeing how it made me feel and noticing her low energy levels, I thought she could benefit. Please let me know if you don’t think it’s a good idea. She had been coming home from school in a good mood and I’ve noticed fewer errors on her homework.

I do have a few questions:

1. Is there a way to support my husband? He is a type-A, high achiever, high stress type. It worked for him until recently (around when he turned 40). Now he is tired a lot, grouchy, over weight, and has become more introverted. He is a big guy- comes from a big family. He eats very little and still has quite a bit of excess weight (I tell him all the time to eat more). He also started balding early in life. I was thinking maybe he needs the same things I am taking? He is open to any suggestions.

2. I’m confused with [Ray Peat’s] recommendations verses what research shows regarding dietary fiber. I was avoiding it, but now I am not limiting it because it seems as though you are in favor.

3. Any advice for better sleep? I’m waking up to pee at least once a night and having very vivid (somewhat anxious) dreams—like not being prepared to go on stage for a performance. Stuff like that. Not feeling very rested in the morning (like I didn’t have deep sleep).

Thank you for all your help! It’s been a wonderful change for me to feel more calm and capable of adulting .

Nathan:

Hey ********,

That's really great stuff. I'm glad you have been able to sustain high temps and pulse so easily. Great job. Your improvements in other areas are very encouraging as well. Yes, it's great that you've given your daughter brewer's yeast, it's a great source of B vitamins and will help, especially since you are doing other important things like replacing common wheat with heirloom grains. I would caution though against doing a 5K—when you have metabolic problems it's not a good idea to do much exercise, but more especially cardio. Strength training can be okay if you are not very ill, but engaging in cardio exercise can have a negative effect if your body is not healthy enough to do it. Walking is great, and exercise is okay as long as it is fun. As soon as it turns into something you feel like you have to do or have to push yourself to do it's a sign that your metabolic health is suffering and you should stop. This also goes for kids as well.

Your husband needs to do a lot of the same heavy lifting which is discussed in my book. Taking some vitamins and supplements may help, but unless there is a total overhaul on ideas about nutrition, physical activity, and stress he will not be able to reverse those developments. I'd just recommend he read my book too to get started.

We get plenty of fiber in food, there's no need to focus on getting more or avoiding it. I'm not in favor of fiber, it just isn't as big of an issue good or bad as people make it out to be. Just eat normally and it is a non-issue.

Waking up to pee is a sign of high estrogen. Was this occurring before? I don't remember you mentioning it. As your metabolic health continues to improve it should also improve as well. You could use a natural vitamin E supplement to try to help with that, as vitamin E blocks the aromatization of hormones into excess estrogen. Sleep quality is also determined by levels of our endogenous antioxidant and thiol, glutathione, which is limited primarily by your supply of glycine, which means that consuming gelatin, which is high in glycine, is helpful for this issue. Gelatin is made from the skin and other leftover organs of animals, and cooking meals which utilize the entire carcass of a animal such as the chicken soup recipe on my blog is a great way to get lots of glycine into the diet through normal food. You can also add gelatin to any sauce, soup, gravies, and other dishes it can dissolve into to feed your whole family. It can be bought in larger cost saving sizes online than what you can get in stores. Glutathione also requires sunlight exposure, and this is discussed in depth in the chapter on gut health in the portion on candida.

******** :

Hello! Thank you for your response. I added in vit e and more gelatin this past week due to your recommendations.

Today on Facebook, someone who runs a Ray Peat group posted this link regarding starch: [link to an article which uses out of context quotes by Dr. Ray Peat to discourage the eating of starch] I wanted to get your take on it. I have been trying to incorporate a lot more starch and I have had bloating, backache, and overall discomfort. I am not completely sure it’s the starch, could be a supplement I’m reacting badly to or maybe it’s the combination of foods. I used to be careful with consuming fruit apart from anything else but lately I’ve thrown all caution to the wind including eating fruit and drinking milk at the same time. If you could clarify why you recommend starches, that would be helpful. Right now I’m eating sweet potato, regular potato, yuca (not much because it’s hard to find). The info regarding endotoxins is confusing to me because I know it’s important to create SCFA for metabolism.
Hope you have a great weekend!

…

Oh, and one more thing. Do you know if there is a connection with vision issues and hypothyroidism? I recently met with staff members from my daughter’s school due to her very low standardized test scores. Several staff members want my daughter to be evaluated by a pediatric optometrist for what they believe are visual spatial issues (knowing left from right, organizing words on a page, sizing of letters, constructing puzzles, etc). They believe this is factoring into her significant difficulty with reading, as well. I am going to have her evaluated, but I am wondering if you know of a connection to visual spatial issues and underlying metabolic disorder. Thank you!

Nathan:

Hey ********,

So yes—and I think I discuss this a lot in my book, foods can feed pathogenic bacteria and reveal their presence in the gut. This is not really a problem with foods but instead with the bacteria itself. There is a flush of misinformation about starch currently circulating [and every other macro]. If you read that article more closely you will see that the compiler's summary of the issues are at best misleading—for instance, in the first section which he summarizes the glycemic effect of starch Peat actually says more things about amino acids and polyunsaturated fats [affecting glycemic levels and insulin] than he does about starch. This is a common problem in forums and groups online, is that people pick and choose what they want to focus on in regard to things Dr. Peat has said, filtered through their own biases, and strip away a lot of the context too, which is often more important than the actual things being said, for instance the context between advice which considers healthy people rather than those with severe metabolic diseases, or visa versa. There are many times when Peat talks about glucose deficiency and problems related to that, which aren't mentioned there as I can tell, and it is extremely difficult to get sufficient glucose to raise the metabolic rate without the use of [safe] starches.

My chapter on gut health explains in detail how the different macros can reveal the presence of pathogenic or unhelpful gut microbes and how to deal with them. I am emphatic about how cutting out each macro can cause its own problems and does not work to address the presence of these microbes or the root of the problems. Yes, your symptoms are being caused by bacteria, which is why I recommend things like using apple pectin, sun exposure, [iodine], vitamin K and A foods, horseradish, sodium acetate, and other strategies to address them, since cutting out macros does nothing of permanence for the presence of these harmful invaders, even if it might give you temporary relief.

Yes, hypothyroidism strongly affects visual acuity. It's very common. Improving her [metabolic health will] also improve her eyesight and related brain pathways.

Case Study #3 Age: 45 Sex: Male

Nathan:

Hey ********,

Thanks for signing up. Here is the questionnaire to get us started. For all but the first question please answer only with simple lists, as explanations make it difficult to take in the data..

Questionnaire:
1) What are your current symptoms and how would you like to improve? What are your health challenges?
2) Please list everything you might eat in a day.
3) List everything you might eat in a week.
4) Times of day you eat.
5) All supplements you are currently taking.
6) All medications you are currently taking as well as those you've taken in the past, including drugs and alcohol.
7) Times and frequency of physical activity, if any.

******** :

Looking forward to it, Nathan :)

1.) Some hair loss the last year or so in the front, along with getting more gray hairs. I have varying energy levels throughout the day, and generally lack motivation, drive and passion for things these days. Some of this can probably be resolved through a Personal Inventory, so I plan to book that after this coaching (he’s referring to the therapy in chapter 31 of my book) - but I have spent the last 10 years on self-development ranging from classical techniques such as NLP, EFT and CBT all the way to Soulspring Masterclass which is a very spiritual approach. I used to be a powerlifter and then a bodybuilder, but my strength is about half of what it used to be. I have poor connective tissue health and have had 2 shoulder surgeries on the left side, and have a torn supraspinatus on the right side and lots of clicking noises. Hips have osteoarthritic symptoms, most likely inherited from my mom. I have had high LDL cholesterol for a while now, most likely cause both by my diet but also subclinical hypothyroidism. My thyroid health has improved tremendously these last 2-3 months since I started implementing more milk, fruits, honey etc. My daily oral temp is now 97.8-98.3F. I struggle to get and stay lean unless I calorie restrict and use the stress-based model, I reached single digit bf% but needed to go down to 2200kcals which isn’t a lot of food for a guy weighing 220lbs at 6´1." Most symptoms likely related to being on a low-carb diet for a couple of years now, in the most extreme case eating meat-only in various ratios of fat vs. lean (all the way into the PKD ratios of ***************** when I worked with them). I have been on TRT (topical gel) for 25 years. I have tried twice to restart my HPTA with medical interventions but I have given that up and will rely on it for life.

2.) 3 out of 4 meals is usually a combination of various fruits (apples, pears, strawberries, blueberries, banana, melon, cherries etc etc), honey, cottage cheese, milk and cream, butter (organic, low-pasteurized, non-homogenized), coconut oil, hydrolysed collagen, eggs (in the breakfast meal). Dark chocolate for snacks if still hungry. 20g or so of milk protein isolate per day mixed with the cottage cheese and cream or milk. Sometimes ice cream for the evening snack. Coffee with cream and honey 1-2 cups/day. 1 out of 4 meals is ground beef or fish, some type of veggie (asparagus, cucumber, tomato), cheese, butter, and once in a while potato but most often just more fruit.

3.) Variations of the above. Saturdays we have pizza with ground beef and sausage, crust made with spelt flour.

4.) 7-8am, noon, 3-4pm, 7-8pm.

5.) Hydrolysed collagen. Milk protein isolate. Used liver capsules but stopped that fearing too much iron (after reading your book). Pregnenolone 20mg in the morning. Sodium Acetate morning and evening. 250ml can of Monster Energy Drink (with Vitamin B, Taurine, Caffeine). On the way, after reading your book: Boron. Natural Vitamin C. Chelated Molybdenum. Niacinamide. Brewers Yeast. Jarrosil activated Silicon (unsure about this, though). Iodine. Taurine

6.) Testavan - topical testosterone gel + recently testosterone enanthate injection subcutaneous 2x/week. Ephedrine for workout energy boost, or fat loss - 10mg. Nicotine gum 2mg 2-3x/day - but have stopped this the last couple of weeks. Very moderate alcohol consumption (my dad was an alcoholic), 2 units per week at the most (beer), but I went from New Years to May without drinking anything. I have tried cocaine, amphetamine and Attentin (methylamphetamine) reacreationally, but I tend to get rebound depression and low energy so don’t really like it. I don’t tend to addiction at all, I would have friends that would be binge drinking, smoking and doing drugs - I could take it or leave it at any time…perhaps except for when I was going through some depressive episodes, but then again the effects wouldn’t last so it wouldn’t be worth it to me.

7.) Weight training 3x/week or so, 30min workouts. Some easy walking here and there, have a ******* year old boy so walk him in the stroller with my gf. :)

Let me know if anything is unclear.

Nathan:

Hey ********,

Thanks for your answers, and thanks again for signing up.

So I know you've read my book, and some of the symptoms you've brought up are discussed in specific chapters. Energy overall is complicated, such as you can have motivation but not have much energy to actually do anything. Motivation specifically is stimulated by sex hormones as discussed in the chapters on erectile dysfunction and depression. It is possible to get your motivation back but not also have a ton of energy, because motivation can be pretty easy to restore but energy not so much. That being said, it is possible to improve everything you've listed as symptoms, though they are unlikely to return 100% the way they were when you were younger, they will certain reach a level that will make you feel better and enjoy life again.

Specifically for "motivation" you will need to focus on restoring robust testosterone production as discussed in the chapter on erectile dysfunction. Because this is pretty straight forward I will just refer you to that chapter, although I'm not sure which version of the book you have so I am attaching the latest eBook file, which also includes some updated information that is going to be released in the upcoming book update, although since it's not an official release please still get that copy when it comes out as there may still be other additions forthcoming.

I'm really glad to hear you've already started making changes and seen improvements. It's amazing what simply having fruit every day can do to the body. Berries for instance are potent erectile support, almost more than anything else I've ever tried (next to sunlight [and nectarines]).

It is often impossible to both get lean and be healthy after a person has already begun exhibiting metabolic problems, especially because this reflects changes in the gut microbiome in response to stress which can be difficult to reverse. That being said, zinc is one of the best supports for both managing the gut microbiome and promoting a lean figure (as well as many other things including hair restoration and a healthy libido). But most people are not aware that zinc is incredibly difficult to absorb, and if you have metabolic issues you are likely not producing sufficient gastric acid to properly digest and absorb dietary zinc or many of the supplement forms, such as those chelated to amino acids. Zinc sulfate is one of the best and doesn't require gastric acid for absorption, so I would recommend getting on it right away. There aren't many products available. Right now I am using ********** zinc sulfate. You will want to use this [just about] every day for the rest of your life. You could start with two or three capsules a day for a week, then cut back to just one a day thereafter. Zinc is slow to absorb as a natural mechanism to prevent overdose in our bodies, so it takes 1-2 weeks to start seeing real benefits of using it.

So, your TRT medicine is actually one of the bigger contributors to a lot of your problems. Two things happen when you supplement testosterone in a biological male (or anyone really). The first is that our own production of testosterone drops, because it is a self regulating system, and since you're adding extra the body turns down its own production. Second is that more aromatization of testosterone occurs. This is a process which converts testosterone into estrogen, and this is also the mechanism by which our own T is downregulated, because the body knows that elevated estrogen means excess aromatization so it slows the production of testosterone to prevent excess estrogen. Because you're using supplemental testosterone, the body can't control how much is produced and thus how much is aromatized (a process which is also increased during metabolic insufficiency), and you are in essence pumping your body full of estrogen, not testosterone, and this is in turn causing your joints and connective tissue to stiffen, your morale to drop, hair to fall out, and promotes hypothyroidism, etc. You will also need to stop taking the ephedrine and nicotine (good job on stopping) in order to get your body to regenerate. The body does not take well to forceful stimulants, which instead cause stress hormone release and in a metabolically compromised person these stress hormones, which are normally meant to only bridge gaps during acute deficiencies, instead catabolize your organs and increase your symptoms. In order to see improvements you will need to completely stop TRT. Not to worry, you can turn your own production on pretty quickly specifically by following the instructions in the chapter on erectile dysfunction—specifically promoting mitochondrial respiration by liberating it from the influence of nitric oxide through the use of sunlight, dietary thiols, and foods high in anthocyanins (don't forget zinc and dietary carotenes, though). Instead of TRT you can safely use a supplement of pregnenolone instead. You will mostly likely lose all libido functions in the week or two after stopping TRT, but normal function should return shortly after, depending on your age. If you are a bit older it might take more effort in raising the metabolic rate as well, which we will discuss below.

Your diet isn't awful but it's also not yet great. Good job getting in fruit and using spelt flour. I want to make sure you are avoiding all normal wheat, because even one serving a week can be enough to cause systemic inflammation and stop healing. One thing you are desperately missing are foods high in vitamin K. Without vitamin K our healthy gut microbes cannot remain in the gut, and they require it even more than we do. For this reason you need to have foods high in vitamin K every day for a while, then afterward at least every two or three days (dark lettuce, spinach, collard greens, etc.) The less difficult ones can be had raw, like lettuce, or baby spinach, and a lunchtime salad with carrots, cucumber, onions, cheese, berries or raisins, etc, and homemade vinaigrette (to avoid harmful, cheap, store bought brands) is a great way to do this. Because they have enough of the worst types of PUFA, eggs unfortunately can interfere with recovery [in those with metabolic illnesses] if having them every day. For this reason I would relegate them to the weekends as a treat. You can have them a little more often if you are eating pastured eggs, or if they are included in some dish where they are buffered by other good sources of fat (such as a fried egg on a salad which has coconut oil dressing). Don't have them every day though. For protein use cheese, milk, nuts, or protein supplement [nuts contain some PUFA but they also have lots of vitamin E which protects the PUFA from oxidation]. Remember the key to cutting out bad foods is [not to focus on cutting them out but ] to replace them [with options that you enjoy just as much]. Otherwise you will just end up craving them and give in eventually.

Collagen can sometimes cause problems like headaches or contribute to gastrointestinal bloat. I'd recommend using normal gelatin or getting a glycine supplement (or both). Yes, don't use liver capsules. Increase pregnenolone to 100 mg in the morning—this will decrease the burden of stress on your body during the day. It may contribute to failure of libido but this will subside after you get your metabolic rate up and fix the nitric oxide balance in your testicles as described in the chapter on erectile dysfunction. You do not have to give up caffeine right now, but I would have you read the chapter on GABA to understand how blood volume affects metabolic recovery and erectile quality. Caffeine can often be necessary to get a robust metabolic rate going, and that should be first priority, but keep in mind that as you improve you might want to spend some time without caffeine, to increase the influence of potassium on regeneration, and thus achieve more improvements if you ever feel like you hit a wall or can't get some things to get better. This information on increasing blood volume can help increase the rate of healing as well as improve emotions and energy as it helps to increase the flow of blood and nutrients to the rest of the body, especially if using the methods to balance nitric oxide expression as discussed in the chapter on erectile dysfunction (also in the chapter on hair restoration, and another I forget at the moment).

Yes that ******** [silicic acid] product just may work. There are two ways you can tell—with about 30 minutes of taking it you should feel an increase in relaxation, every time. If it's not working you will instead feel more irritated or no effect, and after several days of use you might start to exhibit symptoms of eczema as the silica irritates skin tissue. If that happens stop taking it. I'd love to hear how it goes for you so I can have another product to recommend. Again, also get a supplement of zinc sulfate too. I don't think any of your other drug or alcohol use is getting in the way since you say you don't use them often, and none of those have serious long term effects (for instance if you had taken finasteride).

I think your physical activity should be fine, except that you will have a noticeably reduced capacity for exercise without your stimulants. This is really important though because if you continue to use stimulants to promote your workouts you will only make your problems worse. You will feel better in the future and be able to have good workouts without resorting to stimulants (coffee is fine, as long as you are not avoiding caffeine for reasons discussed earlier), but right now you need to take care of yourself, and going to the gym isn't really doing that. Mentally it might help, but physically you are hurting your body. The good news is that when your body is able to retain more amounts of minerals you actually get more more conductivity to the cells, your muscles get harder and more responsive to contraction, and so workouts will be more fun and productive in the future even without stimulants. If you also want a practice which is holistic, safe, and even more productive than the gym I would highly recommend getting the book "Muscle Control" my Maxick and giving that a go. It's really nothing short of amazing, and is a good routine to do while taking it easy.

The most important thing you need to be doing right now, though, is the temperature and pulse diagnostic as discussed in the chapter on self therapy. These are numbers at rest so if you've exercised during the day you will have to interpret those results through the knowledge that exercise, through the elicitation of stress hormones, will raise the metabolic rate but not in a way that is regenerative. It is only through diet and nutrients at rest that an increase in metabolic rate is regenerative, and it is important that you do this diagnostic because it will help me further understand exactly what is going on with your endocrine system and how better to address your health. It will also give you the tools to directly measure your progress. Most people simply hope and observe their waistline and this is not a reliable method of analysis, and leads to demoralization and distraction. Please share with me the first four days of data after you have them.

This is a great place to start, looking forward to your data.

Nathan

******** :

First, I completely understand about restoring testosterone function as a primary intervention. I reread the erectile dysfunction chapter (thanks for providing the updated e-book, I will reread it), and I think I have everything covered. It also refers to the GABA chapter, the gut health chapter, the thyroid chapter and the niacin therapy chapter - so I’m assuming that everything is important when it comes to this important hormone. As for restoring natural T production, that would be amazing…but I have tried it before without any success. The last time was in 2015-2016 and I spent a full year consulting with both Dr ************ who is one of the world’s most prominent experts on hormone restoration, as well as a specialist for getting regular labs and the prescription drugs to do it. I was diagnosed with low T levels as a teenager (6-8nmol/L with reference range 8-35), and I had high estradiol levels back then (0.20-30nmol/L with reference range below 0.18 for men), but the ********* medical system didn’t allow use of anti-aromatase for men back then.

I started self-treatment with an anti-aromatase in 2000 when I worked in the US (returned back home to ******** a few weeks before 9/11…), and I also got prescribed testosterone injections. I was finally able to build some muscle mass (was skinny as a teenager) and it lifted my depressive symptoms and brain fog I had experienced for some years. I tried to come off everything for a few months a couple of times through the years, but with no success. Then in 2015 I decided to make a proper attempt working tightly with specialists, since I had started entertaining the thought of becoming a father. My testosterone progressively got worse, and so did Estradiol. There was also very little sperm activity. I tried coming off all TRT (so no SERMs or HCG for another 6 months, and retested my testosterone levels: The result was 4 (range 8-35). FSH and LH undetectable. I lost a lot of muscle mass, gained fat, and had really low energy and was prone to depression - just like in my teens. I also think my diet was on point at the time - carb-based, not too far from how I eat today, just with rice being about half of my carb intake. Still - my girlfriend and I were able to conceive a month after I restarted TRT with Testogel - so that was an unexpected happy side effect of this story…most likely due to residual FSH activity of the HCG treatment and it just took some time to produce that one “soldier” lol. My son ****** was born ********* 2017. So to conclude - you can probably understand that I don’t have much faith in my ability to restore endogenous T production after so many failed attempts and 20 years on TRT (I turned 45 in June). I shudder at the thought of having to go several months with low T, libido and having to experience muscle loss and depressive thoughts again. If you have any convincing case studies, I am obviously willing to give it a try - as I really WANT to, I just don’t have any evidence that I CAN. Finally - my interpretation of the way of eating is to just go by hunger and intuition from the recommended foods, and measure pulse and temperature in the morning and then after every meal (so 4 times per day) and send you this data? Thanks again, I was overwhelmed and pleasantly surprised at such an extensive reply!

Nathan:

Hey ********,

There is every chance that something in your childhood caused a permanent inability to produce Testosterone, but the body is capable of remarkable healing and generally the organs which are involved in hormone production can regenerate pretty rapidly. No, you will not have to persist for months and months in those conditions, nor should you. That's not how any of this works. You should only have to spend about 2-4 weeks in a deficient metabolic state, more likely only 2-3, before you start seeing improvements in your pulse and temperature readings. When your pulse and temperature start to rise, which can occur in as little as a week of beginning this process, you will also start to experience improvements in your symptoms. Sometimes it can take as much as six months for people to get their pulse and temperature up to the ideal levels, but that is also usually due to noncompliance in measuring and promoting those numbers (eating common wheat, for instance). So it depends on how much you align to the recommendations along with some troubleshooting here and there. Generally you should see a steady and consistent increase in your resting numbers, and your resting numbers reflect the body's ability to sustain the metabolic rate without the assistance of stress hormones (or not), and when the body can sustain the metabolic rate without the assistance of stress hormones that is when metabolic regeneration occurs. Doctors don't know about this connection of the metabolic rate and regeneration, so none of them would have been able to help you permanently heal those conditions you've been suffering. This process does that (within reason). So if you get much worse after four weeks I would recommend going back on the hormones, but in my experience you will most likely find some improvement by then which will justify abstaining indefinitely.

I would advise you not to use any new products or anything that I have not recommended—the reason being that those things are not part of the natural body. They may have effects, good or bad, but they will not directly address the metabolic pathways which naturally support human health. The foundations of human health are based on vitamins, minerals, and environmental stimuli like sunshine exposure. Healthy people don't need geopeptides to function properly, and neither do you. Of course, we encounter things like glyphosate, and you may very well have been exposed to something in your youth which caused all these health problems, but the persistence of the condition is not caused by that exposure but instead other factors which inhibited healing and regeneration.

Only use one aspirin a day, or one every other day. You're not ill enough to use it in those amounts and overuse can cause depletion of glycine and vitamin K. Of course, take one whenever you feel poorly though.

Also, try using the brewer's yeast in the morning and 30 minutes before any sun exposure. There are proteins which use riboflavin to sense sunlight and regulate circadian rhythms and this process will benefit from that.

Looks great. Looking forward to getting your temp and pulse readings.

******** :

Ok, so the general idea is that restoring metabolic health and thyroid function will increase regenerative capabilities and thus improve the chances of recovering the HPTA function?Previous use of testosterone and its derivatives have a pretty horrible recovery statistic depending on length of use: [provided links to stats of hormone recovery] A lot of these being athletes, is the assumption that the combination of stress from training and diet deficiencies is the reason why they are still not fully recovered after 6-12 months after stopping all exogenous hormones? I have done a handful of “cycles” of AAS in my 20s and 30s when I competed, 10-20 weeks in duration, and then “normal” levels with TRT in between just to provide context.

Ok, so based on these last two days it seems like the metabolic issues isn’t all that bad? Yesterday - morning temp 97.4F, pulse 75 - the next 3 measurements had me at 98.6F and pulse 78-82. Today - morning temp 97.7F, pulse 82 - the next 3 measurements had me at 98.8F and pulse 88, 92, 80 - and the last (just going to bed now) - 99F and pulse 80. All pulse readings are strong. I will provide pulse and temp in another 2 days.

I have gained 10lbs of weight the last 3-4 weeks. I sometimes eat before I’m hungry and sometimes eat beyond fullness (I finish my plate instead of leaving leftovers for later), as I’m intent on restoring metabolic health moreso than staying lean - but I guess I could listen more to my hunger cues and go a little easier on the butter, cream and coconut oil unless you think this is all important for my recovery. I still tend to analyze and concern myself with food choices and macros for each meal, but mostly I’m able to just eat according to instinct.

When everything I ordered from iHerb and eBay has arrived I will give your advice about stopping TRT an honest try, do a blood test in 4 weeks and determine what to do based on that.

Nathan:

Yes exactly.

The reason those states exist [low sex hormones] is because the same factors which caused the condition in the first place don't get addressed (exposure to glyphosate or endocrine disrupting chemicals, lack of sunlight and calories, consumption of common wheat, etc.) so the person stays in a state of perpetual inhibition, and doesn't really have anything to do with the medication.

No, those aren't terrible numbers but they're not great either. Also, they need to be taken into context, it's great that you hit 99 but did you do any physical activity today? How did you get to that number, was it just through food or did you also use anything like aspirin, coffee, or exercise? Are you still on any of your meds/stimulants or are they still circulating in your body? The problem is that if your temps were elevated through the elicitation of cortisol or adrenaline as a result of exercise or stimulants it doesn't [really] help, because stress hormones have a catabolic effect on the body which stimulates the rise in numbers, and this catabolism tears down your organs or promotes calcification, etc,—to your thyroid, your thymus, testicles, pituitary, etc. The numbers have to be from the rested state, which means no [manual] elicitation of stress hormones and only facilitated through food and nutrition.

Yes good fats like butter and coconut oil are important for recovery, but there are also bacteria which feed on our bile which is expressed during the presence of these fats, and those bacteria are some of the strongest stimulators of weight gain. This is a protective mechanism from the body to prevent malnutrition caused by these microbes, so the solution is to get rid of them rather than avoid fat—you do that through the use of apple pectin, iodine, and restoring proper vitamin D function in the body as discussed in the chapter on gut health.

Yeah don't worry at all about macros or count calories. Just eat to prevent hunger and whatever you enjoy, as long as its from the safe choices of food.

Sounds good. We should probably wait to do the numbers until you are completely off all the meds, as that will be artificially skewing the data—or you can still take numbers until then and they should actually drop after you go off the meds, it would be good for you to see so you can correlate those results with the state of your health. It's a great tool for managing your own health in the future.

…

Oh I just had another thought, you could also probably benefit from a lithium supplement. I'd add that to your list too, and take every day. The effect of lithium is a little hard to pinpoint, but generally results in improvements in mood, cognitive function, sleep, and it [strongly] benefits gut health [as it binds to ammonia—I recommend lithium orotate as the other commonly available form lithium aspartate can be excessively stimulating].

******** :

I only have 2 cups of coffee with honey and cream spread between waking and about 2pm. No other stimulants, no exercise, didn’t get the Aspirin or all the other supplements listed in the previous e-mail yet (I only have a few 10mg Pregnenolone left so take 20mg/day until my order is here) and the Testavan (testosterone gel) is the newest type which provides a physiological release curve - so high T in the morning, tapering off towards almost zero in the evening. But alright, I will keep monitoring and then see what happens when I go off the testosterone :)

I eat a lot of ice cream now that the temperatures are so high, but how concerned should one be about ingredients that aren’t whole foods - such as things with E-numbers (I know to avoid soy lecithin) like emulsifiers, guar gum, carrageenan etc? There is also egg yolk in most ice cream.
Perhaps just make my own with cream, milk, sugar and fruit?

A slightly sensitive question…but my girlfriend and I have been together for almost 5 years so sex frequency is down to perhaps once/week and sometimes less frequent. But during the transition period when I’m off TRT, if the occasion should arise - and provided that I even have the desire to - would some Cialis be ok or would it suppress GABA too much?

Nathan:

No you should absolutely avoid those drugs. They will completely stop all progress for several days.

******** :

Ok, so here’s 4 days of data, with 5 days of no TRT and with the supplements we have discussed earlier. I will list temperature in C, if you want the F conversion let me know.

Tuesday:
36.5 - 83 - after waking
37.0 - 98 - after breakfast
Short workout - 20mins taking it easy, 2 sets of 2-3 exercises
37.0 - 95 - after lunch
37.0 - 84 - after dinner
36.8 - 90 - before bedtime

Remaining measurements are taken at approx the same times.

Wednesday:
36.8 - 80
36.7 - 92
37.0 - 82
36.6 - 70
37.0 - 72

Thursday:
36.6 - 79
36.8 - 82
Short workout (also 20mins easy stuff)
37.3 - 88 (added lots of extra sugar to a fruit bowl with cottage cheese…)36.9 - 75
37.0 - 78

Today/Friday:
36.6 - 77
36.9 - 85
36.6 - 75 - I missed my lunch and had to grab a protein bar instead, immediately reflected in a lowered temp
37.0 - 76
Had a beer (first in 3 weeks)
37.0 - 78

Libido was surprisingly good, at least for the first few days - but we will see if that changes (I expect it will). There is even some morning wood going on. I have been kinda moody today, though - short-tempered and quick to anger…which is very unlike me, and I hope this will pass. Notice some water retention in my face and ankles, but then again - I’m eating a lot now, adding unrefined sugar and honey to a lot of my foods, drinking sugary drinks and juices, and having ice cream most evenings. If I don’t eat as soon as I start to notice the slightest hunger, like today when I missed lunch due to unforeseen circumstances, my temperature drops and I feel low on energy. I am attending a wedding next Saturday, and there will be some alcohol involved - as usual - but my recovery is the most important and I’ll only have a couple of glasses of wine, at the most. Let me know if you need any other information.

Nathan:

Hey ********,

So it does look like your pulse was being sustained by the TRT, it appears the longer you are going without it the more your pulse is dropping. I'm not sure exactly why that would be, but probably the T was aromatizing into estrogen which in turn could have been promoting excess adrenaline, and as adrenaline depletes dopamine and tyrosine contributes to depression and other mental health issues. The excess stress hormones would have given you a boost, kind of like using drugs, and made you feel a bit energetic, but now that you are lowering those stress hormones you aren't getting that high from them, and probably why you were feeling irritable. What's really strange is that your temps all stay within a very, very tight range. I haven't seen that before. They don't get high enough but they also don't drop very far at all—this might indicate very, very high levels of cortisol which can also be very aggravating. Normally when waking temps are that high in someone (who is healthy) their peak easily gets up to 37.2 to 37.5. But now that the effect of TRT is wearing off we can more directly address your foundational metabolic health. Have you begun using niacinamide or any other supplements? Those will show you effects on your temp and pulse which you can then use to promote healthy resting heart rate and temperature, which in turn will translate into improvements in mood and symptoms (assuming your diet is also sufficient).

******** :

Thanks, it does make a lot of sense. Fortunately, it was just that one day, though - yesterday and today I’ve been in a really good mood. I did a couple of days of 150mg of pregnenolone (overzealous) and that may have been too much, so yesterday and today I just did 100mg and that seems to be a good dose for well-being and mood. Or it could be something else, hard to tell nowadays with so many supplements involved. I notice libido being reduced now - but I expected that. I plan to get blood tests of testosterone, estradiol, FSH, LH - and possibly also TSH, FT3 and FT4 in about 3 weeks if you think that is a good idea, to see if there is any hope of recovery.

Today’s temp readings, if still relevant:
36.4 - 70
37.0 - 90
37.0 - 82
37.2 - 81
37.3 - 85

Mostly sedentary today. I try to measure within 30-60mins after eating a meal, but it was somewhat inconsistent during those 4 days for various practical reasons. Measuring just before eating shows a lowered temp some of the time (36.6-36.7).

I have focused on eating lots of fruits/berries and added sugar/honey, and have lowered my fat intake to facilitate that (still at probably 70-80g/day of fat) - as I don’t want to feel like I’m force-feeding (getting in enough calories from fruits is hard), and since sugars seem to be driving my temp/pulse the most I sacrifice some fats for that. I recall reading that you were using 4lbs of unrefined sugar per week during your healing phase, and 2lbs for “maintenance”? I guess I’m around 70-100g of added sugar per day right now, just to give you an idea.

Nathan:

You can't really overdose on pregnenolone, so that's just fine and if taking more makes you feel even better, then do it. The one side effect of using lots of pregnenolone is to actually suppress the libido, because that amount of pregnenolone lowers the stress hormones which have been sustaining what libido you do have, so it's actually a good thing even though it might be a bit frustrating.

Yes your numbers are still relevant, and that's great that they are already coming up very well. Do you see how your pulse jumped really high after breakfast? This occurs because of high adrenaline during sleep, then you eat some food which allows the high adrenaline to have a larger effect, but the introduction of food then allows the stress hormones to subside so the numbers drop, but then they begin to rise again later in the day due to high metabolic rate facilitated by the food and not by stress hormones—this is the point where healing occurs, because the stress hormones are not interrupting the healing process and with sufficient nutrients and calories the body is able to run the primary metabolic pathways which regenerate the body. That is what you want to have occur every day. Ideally your pulse would get back to 85-100 bpm at some point by the end of the day, but you're already on your way to great results.

******** :

So the way forward from now is simply to follow the plan with the supplements, and eat good food and sugars to maintain my temp+pulse readings? And take a blood test in another 3 weeks or so, as mentioned in the previous e-mail? How often should I check in with you?

Nathan:

Yes but as your temps and pulse stabilize you then move on to the more specific therapies of the relevant chapters, such as using thiols and sunlight for erectile dysfunction, and light therapy to the dorsal raphe nucleus for depression, etc. You can update me if you ever have issues, questions, or to share developments. Yes you can get blood tests but they need to be interpreted in context, so share them with me when you do.

******** :

I’ve been having some pretty massive water retention the last week or so, to the point where my eyes are really swollen when I wake in the morning and I can press a finger into my ankle and it leaves an indentation in the skin. My left thumb just starting swelling up and becoming very painful for the last couple of days for whatever reason, as I haven’t injured it - nor can I find any insect bites that may have caused an inflammatory reaction. Perhaps it is due to the heat wave we’ve been experiencing here, 30C+ is 5-8 degrees above the norm here in ******** and it affects both energy and sleep quality, or maybe my body is converting some pregnenolone into cortisol? I have stepped it down to 100mg again, just to see what happens.

Libido is still fine - meaning that it’s pretty much the same as it has been, considering I have been with my gf for 5 years. I was almost expecting erectile dysfunction, which I suffered from last time I tried going off TRT (with HCG and Clomid, where libido was also much lower), but no such issues which makes me optimistic for recovery now going on the 3rd week without the gel.

I seem to still be gaining weight (close to 99kg now - and waist has increased a total of 2.5 inches), but my appetite has been dropping noticeably lately so maybe that will regulate itself now that my body temp/pulse readings are staying consistently high? I still have confidence in this strategy being a better idea, but I also find it hard to reconcile with the mounting evidence of time-restricted feeding being so great for health [link to a study which showed time-restricted eating to alleviate certain metabolic markers]...not to mention the various metabolic and auto-immune issues being resolved with a meat-and-fat based diet: [link to an all-meat promoting diet program]

Maybe it’s more a function of the removal of various processed foods that are in most people’s diets (and even the exclusion of excessive amounts of phytate, oxalate etc from eating too much vegetables all the time?), and not necessarily the restricted feeding windows or eating meat? And that long-term it will backfire? I just see people having success eating like this for several years when their previous dietary approaches failed them, and lack a good explanation for it.

Nathan:

Hey ********,

That's not a good sign, but yes heat stress does cause that in people with compromised metabolic health. Normally pregnenolone will help with it a bit, but I think it just shows how sensitive your health is at the moment. I think if you took thiamine with every meal, some niacinamide, and magnesium chloride it might help it go down. Let me know if you do this and it doesn't help. You can take magnesium chloride internally, but too much will only act as a laxative, so smaller doses are better (measure to taste by putting some in a glass of water until you can just barely taste it) and it's sometimes more helpful to apply to the skin, making a more concentrated solution in a little bit of water that tastes more strongly, but not too much which can irritate the skin, and applying it to the areas which are swollen.

I'm glad to hear you've not had any lapse in libido. That's really great.

Like I mentioned in a previous email, weight gain is a common development when the body is under so much physical stress. That being said, [the more you address your gut health as discussed in that chapter, such as addressing excess histamine, ammonia, and biotin deficiency, the less weight gain will occur. Also, the therapies in the chapter on GABA can also help reduce or reverse weight gain].

Studies on dietary restriction are not accurate because the indicators they measure to decide if it's successful are woefully misunderstood. For instance they might show reductions in cholesterol and so claim it to be healthy, but the body cannot make cholesterol under enough dietary stress and cholesterol is the foundation of all our hormones and steroids. If you read that page on the meat diet you will also see that those people have a history of extreme eating behaviors, dieting, veganism—yes people who eat meat and fat are eating foods which actually have lots of nutrition in them and also tend to be avoiding the other kinds of foods which cause problems, like excess PUFA and processed foods with additives and agricultural chemicals, but that doesn't mean that you should or even can limit your diet to that, and the people doing this are all suffering psychologically with no real experience in human biology and are not the kind of people who can help you heal from metabolic disease. If you look at anyone on a long term meat diet they have horribly weird skin and features, like one of the biggest proponents of it https://www.shawn-baker.com/about he's not even in his sixties but he has the skin and hair of a seventy-year old. Sure he's muscular but he looks like that, probably has no libido and probably can't sleep without pills and is probably an emotional nightmare. All you need to pay attention to is your temp, pulse, and symptoms.

******** :

Attaching a screenshot of the blood tests, with units and reference ranges. I once tried converting the units into the commonly used in the US, and it was a giant hassle, so I hope you can make sense of it anyway. I also think the names of the values should be intelligible.

Now, these tests were done approx 09:30 after waking at 7:00 and having breakfast, so I was pleasantly surprised…no, strike that…positively ecstatic about seeing LH/FSH and testosterone at those levels after only 5,5 weeks of no TRT!!! I had lower values than this using upwards of 2500IU of HCG twice weekly, using 25mg/day Clomid, and even after using a GnRH stimulation test back in 2016 and 2017! And since I have getting some morning wood lately, my mood is 200% more stable and positive, and I lost a ton of water weight in my face. My gf has commented on me looking several years younger - and she likes the less muscular look as well, so even if I just manage to stay at 8 and the very lower threshold of normal T, I will NOT be going back on TRT. TSH, FT3 and FT4 also looks good, but maybe you’d like to see it even higher? TSH of 1,3 seems to be a good indicator, though. My only concern is ferritin being so high, I can’t understand why when I have lowered my meat intake significantly to only 150g a few times per week, and my main protein sources are cheese and protein powders. Could it be my high vitamin C intake? Another concern is that I found a small nodule on the left testicle. The doctor said it was most likely nothing to be concerned about, but ordered an ultrasound just to be safe.

Nathan:

[we had a phone call on which we discussed his test results—the node turned out to be benign—and discussed using light therapy to increase the metabolic rate further as discussed in the chapters on depression, leanness, etc.]

******** :

The halogen lamp gives off quite a lot of heat, so I’m concerned about using them on my testicles. They have experimented with something like 45 degree C heat exposure as a male contraceptive, and maybe it’s just a nocebo effect but I think my libido has been dropping these last few days. I’m considering using something like this, although way more expensive it seems to have more research behind those specific wavelengths: [links to red lights] This one is cheaper, both literally speaking and how it looks and probably performs: [links to red lights]

I will use the halogen light on the rest of my body, though. It really revvs up my metabolism! On a positive note, the ultrasound showed a small “water cyst” about 3mm, so nothing cancerous and quite normal :)

Nathan:

[another phone call–advised not to heat up the testicles excessively and any discomfort is a sign of heat stress and should stop]

******** :

I’m observing that I’m eating less even though I eat and snack regularly, I just get full quicker - but my body temp is still staying consistently high at 37.0-37.2 thoughout the day. The coconut oil swish has definitely helped my joint/tendon pains, and it even seems like it is what is driving my metabolism higher (or spontaneously reducing my overall calorie intake). It is another 500kcals per day, after all. I’m still interested to know about the light therapy - i.e. getting some UV light once in a while since the winters here are so cold and dark.

Nathan:

Yes you can use a UV light, although it's not always necessary and isn't much if at all more effective than just a normal bright light. Or at least, a normal bright light will do more good than a UV, since we can't be exposed to UV lights for too long a time without getting burned. I'd primarily use a normal bright light (perhaps with some red in it too, like those infrared heat lamps) and then add a UV bulb on top of that occasionally. I just a cheap Exo Terra brand UVB bulb when I do (mostly just get sunlight). You must use caution if using a UV light as the risk of burning is far greater than sunlight and the burn from these bulbs is more painful than a normal sunburn.

That's fine if your appetite has dropped. It might mean that your gut is balancing out better. Just don't let yourself go hungry.

******** :

Hey, just got new blood tests yesterday, at 8:30 - fasted (awake since 7am). Doctor only wanted to look at hormones since those were the most important (thyroid must be good according to temp/pulse).

Not great, but still a doubling and both estradiol and SHBG seems good.

Nathan:

That is a really great testosterone level for someone who has been on TRT for so long! Your body is producing all of that on its own. Things are looking so great.

You will likely see a plateau or stall now as we go into wintertime, though, as the body downregulates the metabolic rate. It's normal. You can still make progress during the wintertime but it won't be reflected in obvious ways. Wintertime improvements are more about regeneration and restoration of nutrients, and when summer rolls around next year your body will restart all its active pathways and you'll make even more progress than you did this year.

******** :

Thanks, I was pleasantly surprised myself - at least it’s moving up :) Still not where I want to be in terms of strength, it actually feels like when you have a fit of laughing and feel really weak, but maybe I should just take a week or two of rest and do some light walking and stretching instead…it’s not very motivating to go to the gym and lose strength every time (even though it’s a minimalist program that only takes 20-30mins).

Nathan:

Strength has a lot to do with nitric oxide levels, and also electrolyte balance. When you're replete with both potassium and sodium your muscles are both more responsive to contractile stimulus and able to sustain the stress from physical exertion. The effect of electrolytes on muscle function can be demonstrated in the way preworkout and coffee promote an increase in workout performance, but in a negative, stress based way, because the dumping of potassium and thus exaggeration of sodium makes cells respond more strongly to contractile stimulus. But this also causes sodium loss after the effect of those stimulants wear off, and over time a person has such reduced levels of both potassium and sodium they are in a constant state of stress. To do it in a healthy way which doesn't involve potassium loss requires promoting both sodium and potassium retention by reducing stress hormone levels and stress itself, which you are doing, but it can be a bit tricky to get to the point where your body successfully holds on to the minerals consistently. This involves reducing excess nitric oxide and other techniques as discussed in the chapters Free Muscle, Hair Loss, and Erectile Dysfunction. Also, this may actually be a sign of experiencing positive benefits of the work you have been doing, which are reflected in the reduction of stress hormones, which may have made you feel strong but at the expense of your physical health, and this may actually be a positive development and reflects tissues which are actually restoring their potassium levels due to a decrease in stress hormones but thus reducing the contractile response of sodium. Physical strength and endurance is not a sign of health—but one which is a sign is muscle bulk and muscle retention. If you are retaining muscle bulk, even and especially if you're not working hard, that is a great sign of low stress hormones and an increase in metabolic health. If you see muscle bulk deteriorating rapidly or requiring strenuous effort to maintain, that is a sign of very high muscle catabolism due to high stress hormones. Even if you feel strong during the stress state it's actually very deleterious to your physical health, and in fact it's this very mechanism which has been responsible for your hair loss, erectile dysfunction, and other metabolic decline (including emotional), because these hormones also catabolize your other organs such as the testes, thyroid, thymus, etc. So I would evaluate your physical development by muscle size and ease of muscle retention, not actual strength and ability, which will fluctuate depending on the state of sodium/potassium balance and whether or not you have high stress hormones which manipulate it.

 Case Study #4. Age: 45 Sex: Female

******** :

Hello Nathan. I have been following you for some time now. But some how lost track of you a few months ago. Then I heard you wrote a book. Which I im loving. You really go deep into your personal story. Which has made me think about how i deal with my son. So wow. Thanks for that. I really like your approach. Im still reading your book and have implemented many things in it.
I should say, I have been working on healing my metabolism for about 2 and half yrs. I have seen many problems go away. But at this point I need help with personalizing it all. I’m still fat. I started at 134lbs under intermitted dieting. Now im at 155lbs so I have gained about 20 lbs trying to fix it all. LOL. I will be turning 45 this fall but i know it can be done. So when u get ready send me your questionnaire and see where this takes us.

Nathan:

Thanks I'm really glad to hear that, and thank you for supporting my work. To be honest, weight loss is not something I can guarantee, since it's highly dependent on some factors which are sometimes difficult to address, [and the body stores fat as a protective response to stress], but we can see where you are and what we can possibly do about it. For all but the first question please answer only with simple lists as long explanations make it difficult to take in the data.

Questionnaire:
1) What are your current symptoms and how would you like to improve? What are your health challenges?
2) Please list everything you might eat in a day.
3) List everything you might eat in a week.
4) Times of day you eat.
5) All supplements you are currently taking.
6) All medications you are currently taking as well as those you've taken in the past, including drugs and alcohol.
7) Times and frequency of physical activity, if any.

******** :

1) I have always been constipated, it got better for a while, but last month I did a potato hack, I regret so much, now, I vent been able to be regular again. I have done enemas, which I don’t think are good, but its a relieve for now. My main problem I would say is my gut is not working properly. I used to get heartburn all the time, that has healed, but not enough to make me regular.. so that would be number one.

2) OJ with salt collagen. 12 oz home made latte. eggs in butter or coconut oil. 2 % milk with honey. Grass fed steak, or ground beef stew. Apples, pears. Hot cocoa with sugar and 2% milk. Sweet potatoes fries, baked with butter. Ice cream. Cheese, and bread.

3) 2 times a month grass fed cow liver. Watermelon. Mexican coke. Chipotle take out/ steak. 2 times a month some kind of chicken

4) Within 1/2 hr of getting up, 6:30 am. 9 am snack. 12 pm lunch. 3-4 pm dinner. 7 pm snack

5) At night if I remember cascara sacrada. Aspirin 2 times a day. B3 some times. Vitamin E if I eat something I shouldn’t

6) In my 30’s I took heartburn meds, the purple pill, I can’t remember the name. In the past I have taken asthma meds. I have a pump, I use about 3 times a yr. haven’t taken asthma meds in 4 yrs. Pot and heavy drinking in my 20’s

7) I try to hit 8,000 steps a day, at work, I have free time by my self I just walk in the office. On Sundays, its heavy cleaning at home, working on the garden, always running around. I may do some kettlebell lifting for about 5-10 mins 3 times a day, yoga if I can 15mins. Never too early usually after 10 am

Great, hope it wasn’t too much.

Nathan:

Hi ********,

Thanks for that info. Okay, you only [really] listed one health problem, and I'm assuming that's not the only one you're dealing with, so can you please be more specific about all your health issues as all symptoms help to establish what is going wrong? Meanwhile, I will give you some advice on the information you have provided.

Chronic constipation is often associated with SIBO, because the bacterial products of from populations of unhelpful bacteria cause the muscles of the intestinal system [to become inflamed and bloated with water retention, which causes them] to slow down. You can temporarily treat constipation by taking in more salt in addition to using vitamin C (I prefer a non-corn source like ******** brand from tapioca). Getting enough salt throughout the day is important not only for your gut function but your overall metabolic rate. I see that you get some salt when you take your orange juice, so repairing this problem is also going to require you to get your metabolic rate up. Have you ever measured your pulse and temperature? The chapter on Self Therapy I advise people to take their pulse and temp at specific times of the day in order to measure their metabolic rate. I will need you to do this in order to fully understand the nature of your metabolism and how to best approach it.

What strikes me about your diet most is the lack of whole meals and a variety of foods. I think you have the classic forum induced mania about foods and the limitation of your choices does not seem to be providing you with a broad enough diet, lacking in glucose and foods which our gut bacteria can make into short chain fatty acids. I would prefer that you include other breakfast choices like whole fruit, cheeses, sprouted oat meal, etc. In my experience, having eggs every day can be enough PUFA to prevent healing, so I would relegate them to the weekend. The problem is that the type of PUFA in eggs is the most harmful variety, so even though other foods might have more PUFA the ones in eggs are more powerful in their detrimental effects. Also, types of bacteria which ferment proteins and give off large amounts of ammonia easily cause constipation, so sometimes it's helpful to only have carbs such as fruit for breakfast, in large quantities. Not all the time but just occasionally to suppress those bacteria. Collagen products can also sometimes be harmful in that they have poorly decomposed protein peptides and I prefer the use of normal gelatin. Migraines and headaches are often symptoms of a bad collagen product. Getting in lots of well cooked vegetables is also helpful. If you cook, I would highly recommend making the homemade spelt bread recipe on my blog, as it can greatly improve the amounts of helpful vitamins (from the yeast) and glucose. Normal bread you get from the grocery store is not acceptable as a food source, especially when dealing with constipation, because common wheat is extremely inflammatory. Heirloom breads made only with grains like spelt, kamut, or einkorn are acceptable though.

If cascara isn't helping your gut I would stop taking it, long term it can exacerbate gut issues, unless you really like taking it. Your vitamin use is fine, but if you don't make spelt bread I'd recommend using brewer's yeast for more B vitamins. The most important thing I get people to do is take their pulse and temperature, so if you can do that for me and share those numbers with me it would really help us fix what you're dealing with.

******** :

Hi Nathan,

Ok, u r right, I’m thinking constipation may be my main. let me get in deeper, plus what stresses me. –low labido, this is not just low, but the fear of getting pregnant at my age. i dont use birth control anymore, its not only low labido, but the though of having sex stresses me to think of pregnancy. i would love to find a birth control that does not effect by body other than condoms any thoughts???? - bad eye sight/ bad hearing...- dry skin, the bottom of my feet are so dry, i remember you saying something like this, and i stated using more butter instead of coconut oil. about SIBO, i did read your advice in your book about it, i need to be more consistent with the sodium acetate, im taking it ones a day, but should take it 3 times a day, i do better on it when im home, if this is the best way, i will keep on it, or if you think that the apple cider vinegar is just as good, i can do that, i dont mind the taste. about pulse and temp-- i used to take it for years i have stopped, here are the current one—last night, bedtime 71/ 97.9. this morning in bed 62/ 97.4. at noon 1/2 hr after lunch 63/ 98.4. yup my pulse is low, it used to be lower, and my morning temp used to be 96.9 so its better, but not there. i dont know if it matters but im at the end of my monthly cycle. i notice my temps change as the month goes, i used to use temp as birth control.

about my food, ohhh yes classic forum induced mania, so sad, but true. this is where i must need most help. i get so black /and white about what to have and not to have. my dayly schedule is crazy each day, i work 12 hrs mon. and tues. weds and thus. i dont get home till 6pm so i dont cook those days. i have in the pass, made beef stew, or fried rice with steak , then i was told i eat too much beef. i stopped having so many eggs after i got your book.( i really dint know how bad the eggs where) but maybe keep this once a week. so you say have fruit in the am, which is fine, i would mix oj and milk, and have a latte for breakfast, some how thats not enough , i cook fruit all the time, like pears,blackberries and apples and now peaches, and have that also, some how i feel i need more protein. i was putting collagen in the milk, but i rand out and waiting to see which one you may recommend, because i was using the Great lakes hydrolysate one, which i think you dont think is good. would the regular collagen from Great Lakes be ok, the one in the orange can??? also, when you say eat sprouted oaks, which is fine, not every day right??? and yes, i made your sprouted bread monday, i messed it up. but like you said, need to practice how to put it in the bowl. this is the second sunday i have the sprouted spelt flour pancakes, omg, i love them, is it ok to have the spelt bread eveyday?? i make sweet potatoes often, few times a week, but i can make veg more often, like this weekend i took a lb. ground beef and cooked it with about 6 chopped well cooked zucchinis and divided this in 4 bowls, for 4 days lunch, i had them with cooked peaches. whats your take on the carrot salad?? what other foods would you recommend. ok this makes me sound stupid, because of the forum induced mania, it really makes me sound silly, but until i get out of this bad idea of some food, help he out here PLEASE :) im actually a real good cook, but this way of avoiding some foods is making me sound crazy.

about cascara, i have only used it 3-4 times in a row, it taste horrible, but who cares, if it works i will use it. but now i know not to use it too much. i also take Progest-E some times, im not sure of what im doing with it though. Also, should mention that i have a vitamin D lamp, it may be in my head, but i think it works. also the red light, someone said that if you pointed at tour thyroid, its like taking thyroid meds. i dont use it as much any more, usually just for muscle pain. im sure im forgetting other stuff, but hopefully this will help
thanks again for all your work

Nathan:

Ah I see... well, I don't have advice for contraceptives, but progesterone can help to improve your health in the event of a pregnancy. A woman I worked with used progesterone but stopped taking it once she got pregnant and she had a miscarriage because her body was not able to make enough progesterone to support a pregnancy, and she stopped before the term when the placenta takes over making the hormone. It could be that you don't produce enough progesterone to get pregnant anyway, in which case you would not get pregnant. But taking progesterone is quite supportive of women's health, and you could benefit from doing so, though if you do it would make you more susceptible to pregnancy and you should definitely use a contraceptive in that case [you can read more about this in my article “How to Get Pregnant If You Can’t”]. Pregnenolone is also really helpful for restoring health and has similar properties.

Yes [the fats in] butter cure dry heals. Yes your pulse is low which to me speaks of high cortisol [and adrenaline deficiency], which means you probably need to be taking in more protein (make sure to get plenty of carbs too) [and improve your protein digestion as discussed in the chapter on gut health], and yes temps fluctuate, but should always be within range if healthy. Your goal should be to raise your temps at or above 99 F once a day and to get your pulse up above 85. The milk tonic as described in my [chapter on self therapy] is a great way to do this, especially if accompanied by an aspirin, coffee, or niacinamide. If you don't have time to cook then just keep whole foods around that you can snack on—fruit, chocolate, macadamia nuts, marshmallows, cheese, carrots, anything that is safe, and make enough cooked food for leftovers when you can. Yes you could use protein for breakfast so I would use cheese, a protein supplement, milk, or safe heirloom bread if you can. The ************ brand is fine. Sprouted oats are great because the sprouting destroys some phytic acid and makes it more edible. I have never gotten a stomach ache from eating them. Also, cooking them in milk instead of water not only makes them delicious but the calcium breaks down the oat even more. You can have this two or three times a week so long as your other breakfasts are good choices too. You can have sprouted spelt pancakes every day if they are yeast-risen. If not, limit them the same way you would oats. You should not have grain every day, unless it's yeast-prepared. The carrot salad never did [much] for me, but I find carrots to be beneficial for the action of carotene on the mucosal layer of the gut where it helps to squelch free oxygen species, [not to mention promoting vitamin A synthesis]. My version of a carrot salad is shredded carrots and grated cheese sprinkled with some sea salt and lime [or part of a fully salad]. It's much tastier and includes tons of calcium and protein from the cheese. Stews are great—squashes, cabbage in stew cooked well, dark leafy greens cooked in cream or butter, mushrooms, roots. Lots of french food is safe because of the preparation methods and large amounts of good fats. The only two things you really need to avoid are: common wheat and PUFA [and industrial contaminants].
Red light can help a little but isn't powerful enough to fix problems. Yes it can activate your thyroid [as discussed in the chapter on immune system]. Are you in the northern hemisphere? If you are you should be out getting natural sun. Save the lamps for the winter time. To use [progesterone] properly you must take it every day at least once [for women at this age, with these issues]. In the morning is best because it helps turn on the metabolic rate. You can use it again throughout the day if you feel sluggish, cold, or achy.

******** :

Hi Nathan

Thanks for the advice. So I get it. When it comes to pregnancy. I may be worrying about nothing because i may not be producing enough progesterone to get pregnant. But at the same time as I start to take progesterone to heal other issues I may be more prone to pregnancy. Lol. Ok i just repeated what u said. Point being i get it.

So i started to add more protein into my diet. Mostly in the form of cheese. But will implement more milk. I also added more vegs. Like squash and onions, cabbage and garlic. Cut up and slow baked. Omg. So good i could eat this all day. Which buy the way. I think im eating too much. Im making the yeasted pancakes and the bread. Having g a few pieces of the bread everyday with cheese and cooked apples. Im not really doing the mic of vinegar and baking soda( should i be doing it??) i do a Tbs. of coconut oil and keep it in my mouth for 10 mins [the coconut oil swish]. But is that enough

Im not sure if its my imagination. But the top of my stomach is not that pronounces anymore. Wondering if all the goodness from the bread is working on my bad bacteria.

About [cortisol]. U said that it may be do to not enough protein. Would i be hurting matters if i exercise ??? I haven't. Not sure if the stress produced from exercise may prolong healing. What else can be done about [cortisol]??? And what else can I do to raise pulse. Would more CO2 help. If so how do i add more CO2. Goodness i have never really understood that.

Lastly, Great Lakes collagen, only the regular one is good to use correct. Not the hydrygenised one ???

Nathan:

Vinegar or sodium acetate will help if you have digestive problems or energy/hormonal issues. It's not really necessary so if you're improving without then that's just fine. Exercise can prolong stress. You don't have to stop exercising, just take it easy. You can't just "add" CO2. It's a gas so it's got a mind of its own, and a lot of people do extreme and even dangerous things to manually raise it. The more effective way is just to turn on the metabolic rate by using healthy foods and strategies like that milk tonic, aspirin, niacinamide, coffee, etc., as an increased metabolic rate will automatically translate into elevated CO2. Sodium acetate does help raise tissue CO2 as well. I would use the gelatin, not the collagen.

******** :

Hi Nathan

Ok. The milk tonic is so nice to drink. I usually use aspirin. I notice that i have been using aspirin only. And forgotten all about the B3. I will like to incorporate it. Would it be better to use it at bed time or can i also use it at the same time as i use the aspirin??

About bread, so km only eating the wild yeast spelt bread im making. But i have made it 3 times now. On a different note. About cannabis oil. It that stuff safe for metabolic health. ? I was once told its smoking pot which is bad. For health. I dont think i have any health concerns to use it. But my mom has back pain. And my sis brought it to my attention. What r your thoughts on it.

On another note. Sometimes i get itchy from milk. And sometimes my deodorant burns. Its natural. What could that be. Could it be hormonal.

Nathan:

Cannabis is very helpful for pain, but because it increases cortisol it can also cause muscle wasting, although I wouldn't stop for this reason if it is helping [the increase in cortisol is why some people get agitated or paranoid from its use, but cortisol is a steroid which is also why it can be helpful for pain]. Back pain is actually caused by gut bacterial problems, where the metabolic effects of pathogenic species prevents the regeneration of the psoas muscles where they connect to the spine, causing them to tighten. This can be addressed by improving the gut as discussed in the chapters on [gut health]. [The “itchy” feeling from milk you’re describing is histamine from the activity of histamine producing bacteria and other microbes like candida, which are addressed in the latest update of my book]. Candida is especially obvious with any thick white tongue coating, or large cracks in the tongue, bloating and weight gain, or yeast infections. [One of the biggest contributors is the consumption of foods high in the amino acid histidine, which is the precursor to histamine, which in turn promotes the activity of histamine producing microbes, but is also related to your ability to digest proteins, since undigested protein in turn supplies those microbes with the amino acids they need, all issues which are addressed in the updated chapter on gut health].

******** :

Wow. Thats crazy. I thought i have my candida under control. But i do have all those symptoms.
I have been taking the sodium acetate 3 times a day after meals since this monday. I feel my belly is bloated. Hoping its the beginnings of my body getting rid of bad bacteria.
Of course your bread advice worked great. My bread is coming out better and better.
Thanks Nathan

******** :

Hi Nathan
I may sound like a broken record. Or maybe im missing something. I feel good. But as i was 15 lbs over weight. Im now more like 23 lbs. im doing the vinegar and baking soda. I dont think its working. Im eating more fats. In the form of cheese. And butter. Also loving the bread recipe. But my stomach is huge. Of what else i can do. I am taking in more protein. In milk form. And less beef im trying for beef 2 times a week. Any ideas what i can do next

Nathan:

Hi ********,

Not at all. That is a common experience [with this kind of diet] because the problems caused by gut dysbiosis [can be exacerbated by] adding more carbohydrates and nutrients [if you don’t address the microbes at the root of the problem]. I don't think I effectively helped you to resolve your digestive issues. [The heart of the problem is] insufficient digestion of food, particularly proteins and fats, which is in turn supplying the unhelpful microbes in your gut with the nutrition that should instead be going to your own body. You earlier used a supplement of extra gastric acid (the betaine HCL). I think it worked for you somewhat, [but you still are not properly breaking down nutrients and this is causing you to have malnutrition while also strongly feeding the microbes in your gut]. [Temporarily you can use digestive enzymes to improve your digestion. Enzymes are far more important for digestion than stomach acid. While acid breaks down food it does not break down molecules, which is what enzymes do. Healthy people can produce plenty of enzymes, but those with major gut and metabolic problems have lost this ability for some reason or another, and may require a supplemental source to properly digest food. Using more of the therapies to address the harmful gut microbes such as the use of horseradish, which you haven’t done yet, will help eliminate the bacteria which are at the root of the problem].

Case Study #5 Age: 30 Sex: Male

******** :

Nate, I want to thank you for writing all your experiences with your health through your blog. I have read all your articles and I first came across you [on a forum]. You seem to have one of the biggest success stories and it is very encouraging. I have been moderately Peating for the last 8 months after trying the slew of diets out there including Paleo, Atkins, intermittent fasting etc. None worked. And when you write about insomnia, it really hits home. I have had insomnia since high school (28 right now) and I am so darn sick of it. Recently in the past few months it has gotten to the point of just 2-3 hours a night, which is really interfering with daily life and increasing depression, as you already know through personal experience. I hit up my doctor who did several thyroid tests including free t3, free, t4, tsh, and testosterone. What's funny is everything turned out normal, though I have the hallmark symptoms of hypothyroidism including fatigue, dry skin, insomnia, dandruff, lower body temp and pulse, you name it. He didn't give me the time of day and sent me away after 10 minutes on an SSRI. Go figure. Obviously I don't want to take it as the negative effects are highlighted time and time again. Anyways, your experiences are positive and I am implementing them as much as possible. This is just a personal thanks for your blog, and I know there are probably plenty out there benefiting from your journey as well. Much appreciated, man.

Nathan:

Hey thanks for the nice words. Yeah, test "ranges" are so broad these days they don't do much good for diagnoses. The good news is you don't need thyroid to fix your insomnia. Are you going to follow the strategies I talk about in the insomnia [chapter]? Let me know how it goes.

******** :

Yes, I'm starting your plan. I'm curious Nate did your body not metabolize milk properly and thus the need for the casein? Or were you just trying to lower tryptophan? My body does okay with milk but I'm gonna definitely give that a shot. Funny thing is I read all of your blog besides the weight loss article lol because it was not a high priority on my desired outcomes nutritionally. I'm going right over to read it. Have you ever noticed feeling better right after Ray's carrot salad with olive oil and vinegar? I always do, maybe it is having a quick effect on seretonin.

Nathan:

Milk was a problem for me but I figured out why. My metabolism was always low when I took it. Even with sugar, the milk would digest before the sugar had a chance to raise my metabolic rate. So the tryptophan would convert to serotonin and keep the cycle low. Now I raise my metabolic rate FIRST, with sugar, aspirin, fruit, veggies and THEN once my pulse is up a bit have milk. It works great. You should also read my [chapter] on [gut health] because it details how to prevent stomach fermentation of food, which is one of the worst causes of serotonin and endotoxin. The carrot salad was [only] moderately helpful, I think because my bacterial issues were so severe. I do often have a carrot salad but with lettuce, cheese, and cucumbers, sans olive oil (not many brands are very good, and I have found success from being very strict about my fat sources being only saturated ones).

******** :

Nate, I reached out to you about my insomnia two years ago and safe starches a year ago. I purchased your book and read it cover-to-cover; I also have a pretty good background of Peat principles. 3 years ago I discovered Peat/Danny Roddy and have been experimenting with food/supplements ever since. There definitely has been some progress, however, I still seem to struggle with consistency and my lingering, nagging problems deal with weight loss, some insomnia issues, and less than ideal temps/pulse. Now that it's the springtime and the summer is right around the corner (good helpful sun), I figure it is as good of a time as any to obtain coaching. I'm reaching out to see about your options and how your coaching process works. Thanks.

Nathan:

Yes you did. Here you go. For all but the first question please answer only with simple lists as long explanations make it difficult to take in the data.

Questionnaire:
1) What are your current symptoms and how would you like to improve? What are your health challenges?
2) Please list everything you might eat in a day.
3) List everything you might eat in a week.
4) Times of day you eat.
5) All supplements you are currently taking.
6) All medications you are currently taking as well as those you've taken in the past, including drugs and alcohol.
7) Times and frequency of physical activity, if any.

******** :

1) Poor sleep (I usually sleep 3-4 hours a night, but then I'm tired the next day so I get 8-9.... then it goes back to 3-4 and the cycle starts again). I have tendencies to gain weight and I suspect poor sugar metabolism as part of it.... I feel bigger/heavier after carbohydrate consumption. I'm probably 15 pounds over where I would like to be. Most likely some sort of gut problem because I do have white tongue (and two years ago I had an infestation of canker sores in my mouth for weeks at a time, and it was probably thrush. But I started Peat's carrot salad daily and it luckily took that away). I do notice that whenever I go on a drinking bout (like St. Patrick's day) the sores come back after a day or two, not many of them but they come back. I don't really have consistent energy levels; I fatigue somewhat easily. I have dandruff. Low body temps currently, however, with your recommendation of iodine/pectin I'm able to get into the mid 98's afterwards with lots of sugar. But in the morning I have 96ish body temp. I'm able to consistently get into the 97's by the end of the day. Pulse is usually in the 70's. High blood pressure right now (135/89). I don't know about other health tests because I haven't gotten them done. Hair greying and thinning (I'm 30).

2) Carrot salad- Gelatin- Rice- Bread (I try for Whole Foods One Degree Brand)- Sometimes pasta- Tilapia (helps me sleep before bed.... weird)- Tuna- Sometimes pizza- Sometimes hot dogs- Chicken- OJ- Milk- Eggs- Oranges/Pineapple/Apples- Spinach- Cheese- Fast food probably every other day (I have bad influences around me like my roommates and boss who eat for speed/convenience). - Pork - Steak- Ice Cream- Coconut Oil Chips- Potato - Soda

3) Basically everything I just mentioned above for the sake of simplicity.

4) Immediately upon waking up OJ/Milk/Coffee 7am- Drink milk throughout the day in a thermos- Lunch 12pm- Dinner 5pm- Bedtime/snack 9pm

5) Iodine- Apple Pectin- Brewer's Yeast B Vitamins- Sodium Acetate- Lithium - Sometimes Biotin/Molydenum

6) None. I don't drink/do drugs (if I drink it is for a big occasion).

7) I am a ************* so I have a pretty physical job all day with bending, kneeling, ladder climbing etc. On feet all day.- Every other day I will do compound resistance moves like squats, deadlifts, and bench press for 20 minutes. Some pull ups/dips.- No aerobics/running

Nathan:

Hi ********,

Thanks again for signing up and providing your information.

Okay, so the biggest factor in sleep quality are vitamin D and our supplies of our endogenous antioxidant glutathione. Have you tried the sulfate/sun therapy as discussed in the chapter on gut health to restore your vitamin D status? This also addresses the presence of candida which thrive when we lose our stores of vitamin D. When we run out of vitamin D (and not supplemental vitamin D either but endogenous only) our body releases increasing amounts of parathyroid hormone to compensate, but this hormone leeches calcium from our bones rather than getting it from our digestive tract and this also causes soft tissues to absorb too much calcium which in turn supports the presence of candida. Endogenous vitamin D helps lower parathyroid hormone and reverses tissue calcification, but the increase in sulfate from dietary sulfur and sunlight exposure also helps to run the immune system and evict harmful microbes. Since releasing the last version of the book I've also discovered [foods like] asparagus to be a great source of sulfur for the sunlight therapy. The stuff in [the chapter on gut health] about biotin and streptavidin producing bacteria are also relevant for this if the state of your gut is very severely disturbed and the sun/sulfate therapy doesn't work, but you also must avoid all potential sources of glyphosate, which means eating only organic foods which are more likely to contain glyphosate—most importantly any grains and most vegetables which tend to be soaked with glyphosate more than other foods. The other factor, glutathione, is made from glycine, selenium, and B vitamins (mostly vitamin B2) [and sunlight] so if you are getting those your body will make glutathione. It wont' be enough on its own to cure you, but in combination with sulfate and sunlight it will [improve the restorative quality of your sleep].

The weight gain/canker sores yes are related to candida (although canker sores can be viral as well) and alcohol destroys healthy gut bacteria, especially if you're already only marginally well to be begin with, and in turn promotes yeast and pathogenic microbes. You will need to avoid alcohol for now until you get fully better, but there are also ways you can protect against the negative effects of it once you are well, but we'll get to that later (this info is also in the chapter on alcoholism).

Yes, your numbers aren't great. I usually have people start on the temp and pulse diagnostic [as discussed in the chapter on self therapy] but since you've already used that to an effect and understand the state of your metabolic rate you've already accomplished that. But we do need to work on getting your numbers up! The higher they go the faster you will get better.

Your diet is going to be the major thing which is working against you here. It's both good and really bad. Especially if you're eating fast food you are being exposed to a lot of glyphosate, and glyphosate strongly blocks sulfate and vitamin D synthesis and also destroys the gut microbiome, and it's not something you can balance with better choices—any big bad choices like fast food is going to completely negate any good choices you're making, as they are more strongly destructive than the better ones are helpful. Rice is slightly estrogenic, which is fine if you're healthy but if you're not this is going to contribute to your problems if you have it more than once a week. Is the pasta you have gluten free, organic, or heirloom grain? If not you should get a product like this from ********* They sometimes have sales which can bring the price down even more than if you buy in bulk (a bit of a discount for buying 5 or more). Don't get the whole grain products on there, just the traditional ones as whole grain needs to be processed by yeast or bacteria in fermentation to remove antinutrients like phytate. THE KEY to achieving a strictly healthy diet is in staying ahead of your hunger and replacing the harmful foods you like with ones that are not, rather than simply eliminating them. If you just eliminate foods that are bad you are left with few choices, get bored (rightfully so), and are more likely to get hungry and then reach for the bad ones when you are at your last straw. Keeping lots of healthy foods on hand to take up the empty space, searching for new guilty indulgences, and actively eating lots of calories from a wide variety of foods that are safe will make it a fun and satisfying endeavor and thus successful. Instead of fast food have a homemade taco night with organic corn tortillas, lots of salsas, meats, cheese, and organic vegetables. You can even fry your own shells or chips in coconut oil for really good food that is also going to fix your health rather than be a liability, and you can eat as much as you want.

In the info on biotin and streptavidin in the chapter on [gut health] I recommend a protein fast. You should try this out if the sulfate/glutathione stuff doesn't really make a big difference right away. You don't have to do this right away but try it if you don't get much progress from the above mentioned changes. Also, [you can use things like the use of lipase enzymes and dietary fats as discussed in the chapter on gut health to reduce the activity of these bacteria, and other gut health therapies to decrease the opportunity for these microbes to use the nutrients for their own benefit].

Your symptoms must be that much more frustrating since you have such a physically demanding job (I grew up doing [physically demanding work] so I know what you're doing every day. So it's going to do you a lot of good to get better). Since it's hard to take your temp and pulse during this kind of a job you really only need to measure your morning and late afternoon/evening temps, and the most important is your highest temp which usually occurs in the late afternoon/early evening after lunch or dinner when the metabolism is finally fully awake, benefited from all the nutrients and sunlight you've gotten. When your high temp starts to reach or exceed 99 F your lowest temp will automatically come up as you start to heal as well. But actively promoting and pushing your high temp will require strict adherence to avoiding glyphosate and consuming sufficient calories, so plan ahead, stay ahead of your hunger, supply yourself with enough good and indulgent food that your metabolic rate can actively heal itself, otherwise you will never see results. When I was really sick I bought a large thermos and made a fruit/sugar/casein or milk shake in the morning and took it with me and nursed on it all day long in addition to the normal meals and snacks I was eating as well. As some casein can promote high histamine, it's good to use a safe A2 milk. My favorite [shake] was a bag of frozen strawberries, 1 cup of sugar, and enough milk to fill the blender. Pretty much strawberry ice cream all day long. Addressing your gut as described in the first [part of this email] will prevent such food from exacerbating your weight and sleep issues, and the use of things like horseradish and sodium acetate [as discussed in the chapter on gut health] will also directly challenge the unhelpful microbes (it appears you haven't used horseradish yet—I would give this a try right away as it can help dismantle biofilm and dislodge gut microbes. Don't use too much at first as this can make you nauseous, and extended use can make your throat scratchy and irritate the stomach, so if this happens back off for a bit and try again later). And you need to be getting more fruit and vegetables than you are—I would especially recommend [things like] microgreens (there's a great recipe on my blog) as well as things like squashes, sweet potatoes, zucchini, cucumbers, etc

Let me know what your progress is like as you incorporate all this stuff, especially your peak temps.

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Hi, Nate. I've had a interesting last 7 days. A lot of positives compared to negatives. I slept deeper on days where I obtained sunlight and kept everything very strict (I only waivered away from the outlined eating for probably 2 meals because I didn't have a choice, and I limited the damage by avoiding food I suspected high in pufa/glyphosate). I journal and in my journal I noted that I reached 99.1 temp in the afternoon one day and the day before I reached 98.9, and I have never observed over 98.4 before. However, both times were after working out and sitting directly in front of my bright light, in addition to large carb meals. But I still have never seen temps this high, which is great. I also just note a greater feeling of wellness after adding in more squash, yams, beets, asparagus, etc. Vegetables were almost non-existent before. I gather together questions, sometimes every day but I like to accumulate them and have a list. So if you don't mind I'll ask those below.
What do you feel about microwaving stuff? What do you feel about Matt Stone's liquid/salt argument, saying that liquids can be very detrimental (I notice i'm just colder if i don't have solid foods) This brings me to my next point. Should I first eat solid foods, which seem to increase my temps quicker.... and then eat colder, liquid foods if my temp has increased from the solid foods?Should bright light be used right up to bedtime or will that have a stimulation effect on me so I won't sleep as well? (I noticed days in the last week where I slept better with light right before bed, and then days worse.... but the worse days could be anything like not eating properly that day)Should I cut off supplements sometime during the day or can I take them right up til bedtime? I’ve also noticed that on days when I get sun.... it seems I have less bloating going on. Like it happens when I have a lot of milk or big bowl of ice cream... but when I got sun that day the bloating is reduced and I don’t feel fat lol. It’s subtle but it’s definitely there

Nathan:

Hey ********,
That's really great. I'm glad to hear you're already having progress, and that you're enjoying your food, which is really important. Normally workout temperatures are not really a good indication of progress, but because you were also using a light and carbs and food to support it [and weren’t able to get there with exercise anyway], then yes these are great numbers. I hate microwaves because they make everything soft and soggy. As far as health though, I don't think there's anything very harmful with using them. I'm not familiar with Matt Stone but in some cases liquids can be a problem, but that also leads people to force themselves to some regimen when it comes to liquids and for that you should always just listen to your body. If you're thirsty or craving orange juice or milk—go for it. If you're not, then don't worry about it. Mostly the liquid/minerals balance is determined by our stress hormones rather than what [liquids] you specifically take in, although you should always be getting generous supplies of minerals, mostly through food. Yes when light stays on it keeps your melatonin low, and melatonin does not trigger sleep, GABA does and melatonin inhibits GABA as melatonin is a stress backup for GABA, so keeping it low improves sleep. Sometimes supplements can cause your body to stay metabolically active during the night and then you use up glycogen quickly and either wake up too often or too early, or you feel really crappy in the morning. If this happens, then you can worry about it, but typically it is more helpful to keep the metabolic rate going with things like niacinamide or aspirin, which will actually help with sleep. The one exception is B2, which can sometimes directly interfere with sleep [because most B2 supplements are derived from corn and as such can be allergenic], so it's best to take in the morning or afternoon. [Strategies which increase dopamine as discussed in the chapter on depression can also help to further improve your sleep].