Kurt G. Harris MD

The PāNu approach to nutrition is grounded on clinical medicine and basic sciences disciplined by knowledge of evolutionary biology and paleoanthropology. The best evidence from multiple disciplines supports eating an animal-based diet high in fat, low in cereal grains and relatively low in carbohydrate.

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Friday
Feb052010

180 + 180 = 360

Reader Jeff writes in with a comment about Matt Stone of 180 Health.

Matt is the subtle attention-shy guy who poses shirtless holding a pig’s head on his blog.

Matt doesn’t really need any attention from me, he is busy commenting in a “contrarian” fashion all over the blogosphere right now. However, enough readers are asking me what I think that I should say something, I suppose.

Jeff writes regarding Matt Stone's guest post on Tom Naughton's blog:

re colton osborn's question- i just went over and read the post at the link.  i think the key section is:

And therein lies the true danger of uber-low-carbohydrate diets. All my experience tells me that, the first few years aside, a low-carbohydrate diet and certainly a full-blown ketogenic diet exacerbates a low metabolism. It is not a matter of having a genetically-doomed dysfunctional thyroid gland; it is fixable, and it lies at the core of the health problems we’ve seen explode over the last century. This is why all prolonged restricted diets, low-carb included, in the words of Robert Atkins himself (from page 303 of Dr. Atkins’ New Diet Revolution):

“…tend to shut down thyroid function. This is usually not a problem with the thyroid gland but with the liver, which fails to convert T4 into the more active thyroid principle, T3. The diagnosis is made on clinical grounds with the presence of fatigue, sluggishness, dry skin, coarse or falling hair, an elevation in cholesterol, or a low body temperature.”

To that I will add constipation, bad moods, heartburn, cold hands and feet, and a whole host of other minor but significant health problems. To get an idea of how “shutting down the thyroid” can manifest, Mark Starr’s chapter on Hypothyroidism symptoms is 83 pages long.

Jeff here- most of what is in the post is fully compatible with PaNu.  But Matt Stone asserts that once you've been on zero carb or very low carb for a while [several years] you'll run into problems as specified above.  The carbs he recommends sound like potatoes and rice, not clear what he thinks about whole grains, but the bottom line question seems to be about thyroid function over the long term.

 

I read the post and it starts out reasonably. Matt's hyping a pseudo -contrarian position that has some truth to it, but reading him later he goes off the rails when he starts talking about cortisol and thyroid function.

His first target is really a straw man. PaNu, Wholehealthsource and Peter at Hyperlipid all target fructose and linoleic acid as the main causes of metabolic disturbance in the western diet. Even Gary Taubes in his recent lectures has said "it may indeed all be fructose". None of us, read carefully, claims that "carbohydrates = disease".

His observation that some people may not feel good, even "hypometabolic" on VLC I don't take issue with. It seems like common sense that you might feel better eating more or less of just about anything. As long as you are avoiding the neolithic agents, tinker away! (That's for Brett and Nassim)

My blog with 60 or so main posts and pushing 3000 comments does not have any content from me prescribing precise ratios of anything, except for when advising how to lose weight. I respect the Optimal diet and Peter but I think any tightly defined macro ratio is rather artificial, including Kwasniewski's. I am sure that bias shows in my irritation at the bodybuilding questions :  )


At the same time, Stone's statement that long term ketogenic eating per se ruins your metabolism is much less supportable than the "all carbs are metabolic poison" straw man he is attacking. Again, even Taubes does not really say this in GCBC.

My own view on the ratio of carbs in the diet should be pretty clear by now.

1) I think a wide range is tolerable for those with normal metabolism. For those about to ask "how wide" - OK, let's say 5% to 40% or even more if you can tolerate it and the rest of your food is very high quality. If your metabolism is damaged (you know who you are - type II or obesity prone) or you don't tolerate starches well like me, you should probably stay on the low end of carb intake. 

2) I think the paleolithic principle itself argues against LC and VLC being damaging the same way it argues against plants and all carbs as being poison. It just makes no sense, as it implies that humans in any given econiche, even one rich in a huge variety of animal foods, would have been at risk of metabolic damage from being in long term mild ketosis if they were not able to find enough starchy tubers and fruit in season. (We've agreed that grains like white rice are a recent food, I hope).

Enough nonstarchy greens to choke a gorilla with an otherwise all animal diet will not keep you totally out of ketosis, I guarantee. If it did, I wouldn't want to share your bathroom.

Of course, you can start eating a lot of coconuts like the Tokelauans or Kitavans and you can elevate your B-hydroxybutyrate even with a normal carb intake. Uh-oh - now our thyroid glands will die!

3) I suppose it is a corollary of my own paleo principle that I don't like approaches that require "seeking" behavior for something that provides only calories. "I'd better eat some carbs or my thyroid and adrenal glands will be screwed up". Really? HGs had to consciously think about whether they were getting enough starch? Or is starch just something that we eat because it helps us not starve? 

4) On the other hand, avoidance behavior is totally compatible with the paleolithic principle. "Avoid that, as it is outside of our evolutionary experience or causes metabolic effects that are outside our experience in the amounts that are available". This is my template. Fructose, wheat and excess linoleic acid.

5) It is true that being in negative energy balance – losing weight -generates an energy conserving response. That is not surprising. Once you are at equilibrium though, does a lower free T3 with normal TSH and T4 on lower carbs mean something pathologic? What if you had cold hands and a low basal temperature when even you ate 50% of calories as carbs? Are you now supposed to go from 10% to 70% to "restart your thyroid" or are you rather still hypothyroid because you have always been hypothyroid and you are just no longer euphoric now that you have stopped losing weight? Remembering your mood or body sensations one hour ago is hard enough. We are supposed to remember what they were years ago?

6) In answer to the idea that we need to carefully regulate macronutrient ratios to control the function of our thyroid and adrenal glands I have only one comment for now:

Lacks biological and evolutionary plausibility.

To summarize, Matt is a clever and entertaining writer, but his main target is a straw man, as most of the science oriented paleonutrition blogs are not really "low carb" blogs at all. His observation that starch per se need not be unhealthy is not really that controversial.

Matt's claims about his own serum BG after meals should be published as a case report in a medical journal. They are at odds with clinical studies I have read on glucose metabolism in normal highly insulin sensitive young people (can you say "superhuman"?).

Matt's got some good observations, but is over or mis-interpreting the literature in the realm of endocrinology. I did not notice if he has any medical or scientific credentials, but his views of hormonal action lack nuance, to say the least. He is also avidly mining the "I feel like shite, it must be my thyroid or adrenal glands" meme.

 

Well, back to the real post. Thank you all for your patience

Reader Comments (107)

Wow! Nice way to strawman what Matt has actually said. It is easy to argue against someone and declare that they have no nuance when you have taken all the nuance out of their approach and added your own BS.

I well have a more detailed response later, but for now I just wanted to declare exactly what I think about your ad hoc argument.

KGH: Gee, I can hardly wait for the minions to arrive.

February 5, 2010 | Unregistered CommenterDML

Dr. Harris-great to see a new post!! I've been checking back often and look forward to what's upcoming. Interesting post as I have recently been looking up info on low carb and cortisol response. My conclusion so far is, even though low carbohydrate diets tend to increase cortisol generally, it is not the muscle destroying/adrenal exhausting cortisol response seen with starvation and chronic or acute high stress states. As for someone who already has adrenal of thyroid issues, I don't know. What I do know is that your argument on fructose, wheat and excess Omega 6's is right on-very hard to dispute!!

February 5, 2010 | Unregistered CommenterThomas

"I did not notice if he has any medical or scientific credentials..."

He worked at GNC!

KGH: You said it, not me.

February 5, 2010 | Unregistered CommenterChris

Whenever someone says anything about long term VLC, I like to ask them to explain Lex Rooker. I wonder if Matt is aware of him or not.

February 5, 2010 | Unregistered Commenterpfw

Thanks for the rational thought on Matt Stone's post. Literature search does not constitute research, nor does limited self study of ones personal health.

KGH: And sometimes a medical background actually can help you evaluate what you read. Not a politically correct view in the blogosphere, I suppose.

February 5, 2010 | Unregistered CommenterDr David Marcon

Glad you addressed Mr. Stone. He doesn't pass the smell test for me. I remember an instance where an avid 180 health follower came after Dr. Eades on his blog and claimed to be eating just about anything he wanted (while avoiding fructose and other Matt unapproved food) and lost a ridiculous amount of weight. It was silly.

Matt also managed to find me on twitter. I don't post very much of my own content and generally retweet. Didn't see why he would be interested in following me, unless of course...

He's selling something. I think this is what a lot of people forget. And what better crowd to espouse a pro-carb stance to than people who are trying to keep their carbs down? As most of us know, it aint always easy.

My guess is that a lot of the long term problems people might experience from a low carb or paleo-style diet are a result of eating too much protein and junk low-carb foods, not enough fat and organ meat, not enough seafood, omega 3's etc. I definitely had problems when I first tried paleo and was unaware of how much fat I needed.

I hope you are ready for your blog to get blown up. You are a brave man :)

KGH: It had to be done. Nasty responses will be instantly deleted. I am fully prepared.

February 5, 2010 | Unregistered CommenterRick

Thanks for taking him on, and being so polite in the process. I would have found that difficult. As I commented on Richard's blog, I don’t appreciate Matt’s trying to make people doubt themselves, and his “listen to me cuz I know everything” attitude. I know enough to know he's BS'ing much of the time, and generally avoid his blog because of it. I think there is an awful lot we still don't know about endocrinology, what's truly normal for humans and what is pathological. I'm keeping an open mind until more of the picture becomes clear. That said, my husband and I are fairly typical people I would say, and started out on the "HED" eating mostly the healthy stuff, and it didn't work so well for us over the years. It might have been better if we'd cut fructose alone, but I doubt it. Going paleo/low carb-ish has much improved our health. And I don't have any issues with low body temps and feeling cold either (quite the opposite!).

February 5, 2010 | Unregistered CommenterCynthia

@ Rick

I remember the guy well who came on my blog and pushed the high everything diet (I'm assuming that's the guy you're speaking about).

A few months ago I got another comment from the same guy telling me that he had regretted going on the high-everything diet and that his health had been compromised as a consequence. And he apologized for what the many comments he had written. His comment was so heartfelt and sincere that I never approved it simply because I wanted to save him the embarrassment of having it out in his own words where everyone could see.

February 5, 2010 | Unregistered CommenterMichael Eades

Mr. 180's views, some of them, never seemed right. I have done so well on Real Food. My glucose tolerance used to be 198, (and since like a good RN, fully indoctrinated in Conventional Wisdom, I was eating like the American Diabetes Association told me to that's no surprise). Once I dumped grains and all other process pretend food, not only did my glucose tolerance test drop to 100, but I dropped 30 lbs from my gut and lost 20-25 points off of my blood pressure.

So my question to him would be, "why in the world would I go back to eating lots of carbs and starch"? 3 years on paleo have been good to me!

People make eating so difficult. I don't understand what's so hard about just eating things that you can either pick or kill. Nothing to keep track of. And it's amazing how the body will find the perfect homeostatic weight and just stay there...

One day, take on the ADA and their ridiculous dietary advice to diabetics.

And thanks for being a doc that's gotten wise to conventional wisdom. May there be many more of you to come.

February 5, 2010 | Unregistered CommenterDave, RN

Some people can tolerate carbs more than others, and after seeing his post on Fathead, followed by Free The Animal and this response, I think I will continue to follow your advice and Hyperlipid, and Eades, and the other great blogs that provide data. He got me thinking about glucose differently, and how I might change my advice about starchy carbs like potatoes and rice, but that's about it. Avoid frutose (HFCS, fruit, sugar), cereal grains, vegetable oils, and eat real food that doesn't come in a package. Self-experiment with carbs, and enjoy life. I think there are a lot of great low carb recipes for goodies if that is what you like. I cannot eat too many carbs. I feel it instantly. It's starts with water retention and dehydration. Unsatisfactory bowel movements, and after the rise and drop in insulin I become tired. I eat a lot of eggs, meat, cheese, creme fraiche, cacao, coconut, butter, half n half and nuts. I feel great all the time.

February 5, 2010 | Unregistered CommenterJeromie

KGH

"but his main target is a straw man, as most of the science oriented paleonutrition blogs are not really "low carb" blogs at all"

I thought his main target was the low-carb crowd, the article doesn't mention "paleo" once.

KGH: I wonder why he posts comments on every single paleo blog, then. Which are the "low carb" blogs, anyway?

February 5, 2010 | Unregistered CommenterColldén

"Yet there is something more that needs to be said about this. However studiously and conscientiously the bullshitter proceeds, it remains true that he is also trying to get away with something . . . "
-- Harry G. Frankfurt, On Bullshit.

February 5, 2010 | Unregistered Commentercaphuff

Dr Eades:

I know who you are talking about. At least I think I do, based on deduction, because he was about the only one commenting about HED with any great frequency on your blog. Also, he showed up on Matt's blog a few months later saying pretty much the same thing. However, a couple things must be observed: 1.) This fellow has psychological problems pre-dating HED, as he later acknowledged, both on Matt's blog, and on his own yahoo group; 2.) It is not uncommon for people with his problem to be really for an idea or concept and then to flip-flop completely on the issue; and 3.) He now has his own blog, called Forget About Diets, where he supports the HED concept.

HED is not causing anybody health problems, go and follow along at Matt's blog. He does not censor or even actively "moderate" comments.

Following Matt's advice, my own health has drastically improved. I don't know if it works for everybody, but it definitely did for me and many following HED.

February 5, 2010 | Unregistered CommenterDML

Typical nutritional fundamentalist. A young one, with a lot of hot air to blow. Funny, so much of his energy and health today is probably attributed to his three year healing with carb restriction. Where a persons individual chemistries end up is a toss up, but why shred realities that work for so many others? Lex Rooker is one shining example he needs to look up. Whether you post my comment or not, thanks for calling Stone on his hype.

February 5, 2010 | Unregistered CommenterRachel Allen

I still think your two eating approaches have more commonalities than differences, especially compared to the SAD.

KGH: They share much in practice, but theoretical differences can matter when someone like Stone starts making endocrinologic diagnoses of people he has never met over the internet.

February 5, 2010 | Unregistered CommenterKelly A.

Some clarification: when I said "saying pretty much the same thing" I meant he was claiming that the high everything diet (HED) had compromised his health.

But as I observed, he has apparently changed his mind again, given his support of it on his blog.

February 5, 2010 | Unregistered CommenterDML

@Dr. Eades

The same fellow showed up on Hyperlipid, where Peter (correctly it sounds like) suggested a diagnosis of Bipolar Disorder.

February 5, 2010 | Registered CommenterKurt G. Harris MD

Do you really think low thyroid is a fad? Anecdotally, it seems to be quite rampant.

Good article, I was going to respond to Matt, but you did a much better job.

Danny

KGH:

Actual hypothyroidism is indeed highly prevalent and of course, not at all prevented by eating huge amounts of carbs.

The fad is self- diagnosis with body temperature, non-specific symptoms and no labs.

February 5, 2010 | Unregistered CommenterDanny Roddy

As someone who takes thyroid medication for hypothyroidism, I am extremely interested in the topic of the impact of low carb diets on the thyroid gland. I have read and highly recommend Broda Barnes' excellent book on hypothyroidism ("Hypothyroidism: The Unsuspected Illness") and can say that the following quote from Mr. Stone's posting is innacurate and misleading.

"Most importantly, people are overcoming hypothyroid symptoms and a low body temperature very quickly, and without medication, by following some of my ideas. I think this is key, as the most successful doctor in history at preventing type 2 diabetes and heart disease (Broda Barnes) did so by keeping the metabolism high, but had to use medication to do it."

Broda Barnes specifically advocated a low-carb, moderate protein, high (but not unlimited) fat diet for his hypothyroid patients. What Barnes states is that in experimenting with protein ratios -- he found that eating too much lean protein with low carb and too little fat quickly produced hypothyroid symptoms in himself and his patients necessitating increase in med doses. Think rabbit starvation. On pages 273 and 274, Barnes states that a diet "quite high in protein utilizes available thyroid hormone. " He then explains that this is why some physicians who specialize in weight reducltion use very high protein diets along with added thyroid hormone without apparant harm to their patients. The supplemental thyroid hormone makes up for the lowering of metabolism and hypothyroid symptoms caused by high protein diets. When Barnes experimented on himself by eating low carb , low fat and mostly lean meat -- he needed to raise his own thyroid diets. But Barnes found that this problem disappeared by merely lowering dietary protein and raising fat. He concludes: "It would appear that a rational and natural approach to overcoming obesity should employ a slightly modified diet containing approximately one gram of protein for each kilo (2.2 pounds) of body weighr and a minimum of fifty grams of carbohydrate to avoid ketosis. Enough fat should then be added to keep the appetite satisfied and still not quite enough to satisfy the body needs, thus allowing a weight loss of one or two pounds a week."

Lest anyone think that Barnes thinks ketosis is dangerous - not so. The diet he recommends in the book avoids ketosis but he makes it clear repeatedly throughout the book that ketogenic diets can be effective and not harmful. The book has one particularly interesting such section on ketosis (pages 270-273) where he describes a NY cardiologist's success on slimming his patients with "one-half pound of fat meat three times a day." He concludes: "Not only did his patients lose wieght successfully but they suffered no deleterious effects and their heart function improved. Personal experience has confirmed that it is possible to lose weight on this quantity of meat and, of course, with no carbohydrate in the diet, ketosis will occur. If this is not harmful to people with failing hearts, one would not expect any trouble in people with normal hearts."

So there appear to be several low-carb ways to skin the obesity cat. If someone is experiencing hypothyroid symptoms while low-carbing, I would suggest trying to cut back on protein -- not low protein -- just gradually cut back a bit and fill in calories with fat. But nowhere have I seen any credible study or indication that a properly conducted low-carb diet which contains sufficient fat and not excessive amounts of protein would cause hypothyroidism. Not everyone starts out with the same metabolic rate. I am starting on the slow side so perhaps I should monitor my protein a tad more carefully. Then there are the genetically blessed who have naturally higher metabolisms to start with so perhaps they can get away with higher amounts of protein.

One last point on Barnes and the Stone (mis)quote. Barnes didn't use thyroid hormone to keep metabolisms high to prevent diabetes or heart disease. What he explains is that untreated hypothyroidism can 1) be mistaken for diabetes; 2) exacorbate diabetic complications; and 3) cause heart disease. He explains that hypothyroidism can cause slow digestion and delayed stomach emptying which can give high blood glucose readings during a two-hour post-prandial blood test. So a hypothyroid person may be miscategorized as a diabetic. Barnes gives a fascinating example of a study done on Eskimos (The Canadian Medical Association Journal in 1968) who glucose tolerance tests indicated diabetes in over 50% of the cases. Yet the investigators knew that that diabetes is very rare in Eskimos. So they repeated the test but injected the glucose directly into the Eskimos' veins rather than giving it to them orally. This bypassed delayed stomach emptying. During this second test, in no case was there a diabetic response. Bottom line is that Mr. Stone states that Broda Barnes had to use medication to keep metabolisms high in order to prevent diabetes and heart disease and this is not a correct interpretation of what Barnes actually wrote.

Sorry to write and paraphrase so much but I feel Barnes' book is the very best on the subject and didn't want to let the misinterpretations of Mr. Stone go unanswered. I also highly recommend Dr. Mark Starr's book on hypothyroidism as well.

KGH:

There are problems with both of those books I may blog about in the future, but I do agree with you that Barnes was misread.

As far as:

"Barnes gives a fascinating example of a study done on Eskimos (The Canadian Medical Association Journal in 1968) who glucose tolerance tests indicated diabetes in over 50% of the cases.'

A substantial number (25% or so) of VLC eaters will fail OGTT simply due to the adaptation of physiologic insulin resistance.

February 5, 2010 | Unregistered CommenterAnnie

I enjoyed your posting, Dr. H. I'm a long time participant of a popular low carb forum and the fads come and go with regularity. Sometimes I get swept up in them. Last one, Dr. Kawleski (sp?), resulted in a 10 pound gain from putting more carbs and dairy back in my diet.

Anyway, I try to avoid these brash young men who are convinced they have the answer to everyone's problem. As a pre-menopausal woman I can guarantee you NO young man has a solution that works for women my age with a stubborn, intractable inability to lose weight. These young testosteronies can look cross-eyed at the moon and lose 10 pounds. They need to spend some time as a middle-aged woman and they'd lose some of that conceit.

February 5, 2010 | Unregistered CommenterNancy LC

re rick,

Undoubtedly a problem with long term low carb for some people is deficiency. Some problems are bound to show up if all one eats is conventionally raised muscle meats and eggs. A lot of people who start Atkins just to lose weight end up concluding that a low carb diet is not sustainable for this reason. I don't remember Atkins talking about the quality and source of the fat/protein in the early editions of his book Add some pastured eggs or dairy, or even ground beef and I think a lot of problems would go away. Buy local or grass fed if you can afford it and support organizations like WAPF and Farm to consumer legal defense fund.

And then, there are indeed people out there who just don't do well on low carb, who do best just avoiding sugars and grains but having lots of vegetables and starches, but I know your feelings on joseph mercola and his nutritional typing, kurt:)

KGH:

There are certainly some differences in nutritional tolerance that are genetic or epigenetic but not in the sense of Mercola's metabolic typing.

As far as deficiency, you cannot possibly become deficient by eating less of something that has nothing you need and more of things that are real food. Decreasing carb sources like bread and sugar can only make you less deficient, even if you are still deficient.

Conventionally raised muscle meat and eggs is zero carb, not low carb.

February 5, 2010 | Unregistered Commenterzach

@Collden

"...the article doesn't mention "paleo" once."

Actually, it does:

"What their diet does consist of, in contrast to the American Pima, is EVEN MORE high-glycemic carbohydrates. Their staples are corn (gasp), potatoes (shriek), beans (Holy Lectins, Paleo Man!), and other grains and tubers, along with primarily game meats."

@DML

"HED is not causing anybody health problems, go and follow along at Matt's blog. He does not censor or even actively "moderate" comments."

I just read this today in the comments from the Feb 4 post on Matt's site:

"I am still gaining weight and on a small person 11 pounds is a lot, I feel very, very uncomfortable at a weight i haven't seen in 25 years.... I am not really seeing changes and don't know how much longer I can continue psychologically with the weight gain and no improvements. I do understand this can take months but I was hoping to see some sign of positive change after three months and I never expected to gain so much on calories around 1900. I want to give it at least 6 months because i much prefer eating in a more relaxed way and including carbs again but it would seem my maintenance level for calories is around 1500 if I am gaining so much. I already take thyroid meds after having half my thyroid removed last May, so I don't know what else i can do now. iodine may help a bit of course. I think one of our challenges here is we are in the midst of a trial and unlike the low carbers for whom they can cite 100s of people for whom it has worked, HED hasn't been going long enough to be able to cite lots of people who have improved their metabolism and lost the weight they gained. hopefully within the next year or so we will have many more examples we can cite to encourage others :)"

If you go to my site, on the other hand and search "Paleo Problems" you'll see that we have no issue honestly addressing problems or perceived problems.

The surest sign of utter quackery is seeing people report that a single approach is working fine & dandy for everyone at all times.

KGH:

HED? Sounds like the idea is to go 6 months or until you have an MI, whichever comes first.

February 5, 2010 | Unregistered CommenterRichard Nikoley

Dr. Harris, a sentiment I've seen floating around is that saturated fat interferes with the beneficial effects of omega-3 fats. Is this based on any evidence or is it just falling back on saturated fat as a scapegoat?

February 5, 2010 | Unregistered CommenterBen

Richard:

There was not any mention of HED causing health problems in that quote was there? Weight gain, yes.
Weight gain, however, is not the same thing as health problems. Weight gain and increased appetite can sometime be a sign that an organism is healing. Veterinarians and farmers know this very well: animals that are healing from a disease or health problem often go through a period of rapid weight gain. Sometimes they end up quite a bit above there previous (or species average) set point. However, as they heal, the weight comes back off, there appetite comes back down, and the become more active. I saw this a few time when I used to be a veterinarians assistant.

Moreover, observe that many of the tribes that Weston A. Price studied that had good health were not exactly lean. Many of them had (shudder, gasp) love handles.

When I first started HED, I also experienced weight gain, but then my temperature came up, my appetite decreased, and the weight came off. This is a consequence of metabolic healing, which is exactly what Matt is trying to achieve.

By the way, HED does not mean continuos, indefinite overfeeding. As Matt himself has stated:

"180 doesn't advocate indefinite overfeeding. It's a temporary measure taken to achieve a specific goal, which is a reduction in insulin resistance and a rise in basal metabolism. This is due to both caloric and nutritional superabundance. Eventually, appetite comes to a standstill."

This has actually occurred for many people that have stuck with it, myself included.

Richard said:

"If you go to my site, on the other hand and search "Paleo Problems" you'll see that we have no issue honestly addressing problems or perceived problems."

Yeah, and neither does Matt, just and spend some time reading his comments to people that address concerns.

Is it possible that HED could cause problems for some people, just like Paleo, low-carb, veganism, etc? Perhaps...that remains to be seen.

To put things in perspective, here is a quote from Matt this morning under the "Count the Obese Starch Eater Game" post:

"Welcome. I've done extensive research that has given me some of these ideas. We're not trying to convince anyone of anything really, just trying to achieve what could be considered the optimal metabolism.

There are people losing weight, and there are people gaining weight. There are people feeling better, there are people feeling worse.

There's not a real discoure about any "optimal human diet" here, figuring out how to counterbalance our imbalances through diet.

And there is strong evidence that getting hardly any omega 6 or omega 3 is better than getting a lot of either.

I can't describe exactly what the idea is here in a paragraph or two. You'll have to snoop around a bit. But stick around and decide for yourself whether we're getting into something good or not. Others will gladly fire off answers to your questions as well."

Wow! What a brash young man! How dogmatic he is! What a shyster! Look at how he is trying to force his ideas off on everybody! Look at how he is making money by scaring people! Etc, Ect, (fill in preferred hyperbolic, ad hoc statement).

I agree that exactly what an "optimal metabolism" is remains open to interpretation and discussion, and moreover, probably depends on context.

KGH:

"Veterinarians and farmers know this very well"

I have many farmers as relatives and I know many farmers. They have a similar interest in weight gain - the goal is pounds added per unit time so they can sell the animal for slaughter. I'll bet their animals have "healthy" temperatures right up to the point where they get a bolt through the head ; )

February 5, 2010 | Unregistered CommenterDML

Oops, I see I typed "there" when I should have typed "their" a couple of times.

KGH said:

"I have many farmers as relatives and I know many farmers. They have a similar interest in weight gain - the goal is pounds added per unit time so they can sell the animal for slaughter. I'll bet their animals have "healthy" temperatures right up to the point where they get a bolt through the head ; )"

I can't tell if: 1) You are trying to be amusing; 2) You are setting up a strawman; or 3) Perhaps I did not explain myself very well.

Not all farmers, and even vets , are cognizant of my above discussion(=1). Some perhaps more than I know actually think that when the animal is not very active, and standing around eating and gaining weight that it is still ill. Indeed, sometimes that can be the case, but it is rare. However, a better general sign that an animal is ill is if is lethargic and lacks appetite. (Note: on the other hand, hyperactivity and "moodiness" are also signs that something is wrong. In very, very rare cases, overfeeding can be a sign of illness, but a vast majority of those cases, the animal is overfeeding on a poisonous plant to the exclusion of all other feed).

In addition, I was not talking about "feeding out" an animal for sale or slaughter. No, I was talking about something that can be observed in many animal species used for many purposes, ranging from the trusty saddle horse to the family milk cow to the family pet.

(=1): I guess I was engaging in my own hyperbole when I said "Veterinarians and farmers know this very well..." It is much more accurate to say "SOME Veterinarians and farmers know this very well..."

KGH: You are reading way too much into it. My point was farmers don't really have the same idea of optimal animal health that we should have for ourselves.

February 5, 2010 | Unregistered CommenterDML

KH said: "The fad is self- diagnosis with body temperature, non-specific symptoms and no labs."

Just for the sake of clarity, since I've probably blogged more about hypothyroidism lately than anyone else in the paleo community, I don't recommend that.

Then again, I don't see that any such "fad" exists -- unless it's in comments on blogs that I'm not reading. Of course, I've seen some increased discussion about hypothyroidism lately -- mostly by myself and Richard Nikoley. But we're two people with clear hypothyroidism (as diagnosed by regular doctors, using lab tests, a slew of symptoms, etc.) I've also seen some worry about the issue -- some reasonable, some overblown. That seems to be settling down, I think. That's good: blind panic isn't helpful.

Overall though, I'm happy to see that discussion of hypothyroidism. Given the prevalence of hypothyroidism, people should be familiar with its symptoms. That way, if they see such symptoms in themselves, they can speak to their doctor, order the relevant lab tests, review how they're feeling, etc. In my own case, I wouldn't have had the slightest clue what my problem was if a friend hadn't alerted me to the possibility of hypothyroidism and I'd not read Dr. Davis' blog posts on the topic. As it was, I caught it fairly early -- and I was able to ask for a thyroid panel before I saw my doctor. Yet it was still quite debilitating and frustrating, and I'd rather not have anyone else suffer the same.

KGH: I was not referring to your posts as I have not read them.

February 5, 2010 | Unregistered CommenterDiana Hsieh

It seems clear to me after reading a few of Matt Stone's posts, and listening to his podcasts that his guru is Diana Schwarzbien, an MD specializing in endocrinology. He quotes her quite a bit. In her books she claims that if you do not eat enough carbohydrate, you will secrete adrenaline to convert protein into sugar for brain fuel. She believes that nonstarchy carbohydrates are not enough to keep adrenaline levels from getting too high. When adrenaline/cortisol levels are too high, you will store fat and further damage your metabolism; so will eating too much carbohydrate due to increased insulin production. She claims that too low of an insulin level has the same outcome of too much adrenaline/cortisol. Therefore, everything needs to be in balance and as metabolism corrects itself, a gradual increase in carbohydrates should be added. Obviously, Matt has tremendous respect for Schwarzbien and perhaps he feels her views need representation.

KGH: That would explain a lot.

February 5, 2010 | Unregistered Commenterkb

Matt Stone has done exactly what he wanted to do. He now has everyone who reads any paleo blog looking at his.

KGH: Think Boyz 2 men, not Neil Young. Let him have his 15 minutes. Value will out.

February 5, 2010 | Unregistered CommenterSJH

"Matt has tremendous respect for Schwarzbien and perhaps he feels her views need representation."

Either that or we're smelling the marketing genius of a metabolically challenged rat. ☺

February 5, 2010 | Unregistered Commenterkb

There may be some truth to the "too low carb might promote hypometabolism". But perhaps only when combined with calorie restriction ?

http://www.thyroidmanager.org/Chapter5/5a-frame.htm

Interesting parts in between >>>> <<<<

"Multiple alterations in thyroid hormone regulation and metabolism have been noted
during caloric restriction. The most dramatic effect is a decrease in the serum TT3
within 24-48 hours of the initiation of fasting.[36-40b] Because changes in the free T3
fraction are usually small, the absolute concentration of FT3 is also reduced, clearly
into the hypothyroid range The marked reduction in serum T3 is caused by a reduc-
tion in its generation from T4 rather than by an acceleration in itsmetabolic clearance
rate.[41,42] >>>>The decline in T3 concentration is accompanied by a concomitant and re-
ciprocal change in the concentration of total and free rT3.<<<< The increase in the serum
rT3 concentration tends to begin later and to return to normal at the time serum T3
is being maintained at a low level with continuous calorie deprivation.[38,39] Little
change occurs in the concentrations of TT4 and FT4 and the production andmetabolic
clearance rates of T4.[38,39,41,42]... "

"...Composition of the diet rather than reduction in the total calorie intake seems to de-
termine the occurrence of decreased T3 generation in peripheral tissues during food
deprivation. The dietary content of carbohydrate appears to be the key ingredient
since as little as 50 g glucose reverses toward normal the fast-induced changes in T3
and rT3.52 >>>>Replacement of dietary carbohydrate with fat results in changes typi-
cal of starvation.<<<<[39,53] Refeeding of protein may partially improve the rate of T3
generation, but the protein may be acting as a source of glucose through gluconeo-
genesis.54 Yet, dietary glucose is not the sole agent responsible for all changes in
iodothyronine metabolism associated with starvation. For example, the increase in
serum rT3 concentration may not be solely dependent on carbohydrate deprivation
since >>>>a pure protein diet partially restores the level of rT3 but not that of T3<<<<39 (Fig.
5-1)... "

"Starvation has a profound effect on thyroid function, causing a decrease in serum
T3 concentration and a reciprocal increase in rT3 level. These changes are due to a
selective inhibition of the 5’-monodeiodination of iodothyronines by peripheral tis-
sues. >>>>Reduction in carbohydrate intake rather than total calorie deprivation appears
to be the determinant factor.<<<< These alterations in thyroid function are believed to re-
duce the catabolic activity of the organism and thus to conserve energy in the face
of decreased calorie intake. Chronic malnutrition is accompanied by similar changes.
Overfeeding has opposite although transient effects. "

Dr Harris, I would appreciate it very much if you could comment on this part from the last quote : "Reduction in carbohydrate intake rather than total calorie deprivation appears to be the determinant factor."

Thanks,

Patrick

KGH:

Hi Patrik

I have that paper (or the paper it came from) along with a whole stack of others on thyroid function and actually read it just a few weeks ago. I am not exactly sure what your question is, though. They are saying that macronutrient amounts affect their T3 observations independent of caloric deprivation. This is a short term study as I recall.

I definitely disagree that this one short term study of non-steady-state starvation and which factors mediate metabolic parameters means "too low carb = hypometabolism". For one thing, I am not aware of any consistent medical definition of the term "hypometabolism". What does that mean, exactly?
Is it a clinical diagnosis? Is it just hypothyroidism or something different from that? Is it feeling tired? Is it anything other than having a fever? I honestly do not know what is meant by "hypometabolism" other than it's literal translation, which tells me nothing at all.

February 5, 2010 | Unregistered CommenterPatrick

"You are reading way too much into it. My point was farmers don't really have the same idea of optimal animal health that we do."

I will concede that is sometimes the case but not always. For instance, organic farmers and people people who pasture animals with the view of working with nature, unlike many "conventional" farmers and "conventional" feedlot managers, know that an animals optimal health is very important. This stems from the fact that they know that keeping animals healthy and disease-resistant is crucial if they want to avoid using chemical/pharmaceutical inputs and engage in "emergency" intervention. As a consequence of this approach, they know that food - i.e. nutrition- is the key to health, and that "food is medicine" indeed. Thus, when they see an animal that has been ill in cool, quite corner resting and leaving only to drink and eat abundantly that it is on the road back to health.

In other words, given that organic farmers are trying limit disease by optimizing nutrition and eliminating emergency intervention, it is arguable that they do indeed share the same idea of optimum animal health that we do. After all, to reduce disease, animals need to be in optimal health, and not just viewed as machines that must gain maximum poundage per unit time.

Lest we get lost in the details, it behooves me to to summarize what my points are. First of all, as I have stated, weight gain and eating vigorously is not unhealthy in and of itself, as one can note by observing animals recovering from illness. (I also pointed out the love-handles on the healthy tribes).

I further stated the fact that these animals returned to their normal weights and health after the period of rest and weight gain.

KGH then declared that farmers don't have the same idea of optimal animal health that we do. I responded with a discussion attempting to show that it is arguable that they actually do.

KGH: Now you are beating a dead horse. I don't buy your analogical reasoning about "overfeeding". But you already know that.

February 6, 2010 | Unregistered CommenterDML

Annie

"If someone is experiencing hypothyroid symptoms while low-carbing, I would suggest trying to cut back on protein -- not low protein -- just gradually cut back a bit and fill in calories with fat. But nowhere have I seen any credible study or indication that a properly conducted low-carb diet which contains sufficient fat and not excessive amounts of protein would cause hypothyroidism."

There are at least two studies that I'm aware of which suggest that substituting carbs for fat has a positive effect on thyroid function, and vice versa.

http://www.ncbi.nlm.nih.gov/pubmed/500814?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=134

http://www.ncbi.nlm.nih.gov/pubmed/7064875?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=19

KGH

Both studies I have already seen and read.

They are both 20 years old and do not measure free T4 or free T3, the much more sensitive and meaningful measures of thyroid hormone on vivo.

They describe homeostatic adaptation to changes in diet, including possibly a relatively lower T3 requirement, at least short to intermediate term. As this has it's effect on the deiodination step and not on T4 (or TSH) levels, it obviously does not represent some kind of damage to the thyroid gland. Neither study mentions symptoms or signs of hypothyroidism.

The idea that this lower T3 level means "overfeeding" can "treat" clinical hypothyroidism as a long term solution is totally unfounded, as these experiments are demonstrating a homeostatic or allostatic phenomenon, not the cure for a disease.

It should be obvious as well that T3 normal ranges are based on subjects who eat the SAD. Why not conclude that the average SAD eater, who clearly eats an unhealthy diet is hyperthyroid or hypermetabolic and needs to be cured by cutting their carbs rather than the reverse?

If the mean carb fraction eaten during our evolutionary past were closer to 30% than 60% (for example) then shouldn't we be content to have the T3 value of whatever diet our body more likely evolved with?

These studies are not wrong, they are just being misinterpreted and inappropriately extrapolated from.

At minimum, it is unfounded to equate "experimental change in T3 level" with "positive effect on thyroid function".

"I wonder why he posts comments on every single paleo blog, then. Which are the "low carb" blogs, anyway?"

Possibly because most paleo blogs have a large low-carb following. Stephan may not be a low-carber, but many who reads and posts in his comment sections sure are. I'd say a "low carb blog" is any blog with an obvious bias against carbohydrates, regardless of whether they explicitly argue that any and all carbohydrates causes disease.

KGH:

If you think Stephan has an unfounded bias against carbohydrate, then you have not read his blog.
The point remains he clearly is addressing the paleo blogs and readers, that is undeniable.

February 6, 2010 | Unregistered CommenterColldén

To be fair, the 180health dude did sneak in the following clever stab at Andrew Weil:

"Dr. Santa has some kind of boner for soy products and eats enough fructose and polyunsaturated fat to, well, be fat."

KGH: Yes, he is clever sometimes and an entertaining writer.

February 6, 2010 | Unregistered CommenterJeff

And what if T3 was meant to be lower in H-Gs as designed by nature? I am just going through "Primal Body - Primal Mind" by Nora Gedgaudas, who though not being a medic seems to have done her research on Paleo nutrition. She observes that reduced thyroid function is associated with longevity (I'd like to see some reference for that) and argues, that higher fat intake (if indeed characteristic of H-Gs) improves metabolic efficiency and that "as long as thangs are operating efficiently, higher metabolism isn't necessary or even desirable. Your internal engine runs less hot, and the engine therefore lasts longer".

Quite possibly, lower T3 and insulin are the two most symptomatic Paleo markers, and possibly even predictors of better health and longevity. I would argue that seasonally, increased availability of carbohydrates would mean faster metabolism, storing fat, and reproduction, but this would be only few months of the year - late summer/early autumn. This would also assure that years long continuous VLC diet would not be an exception to the rule.

In any case, this is still a learning curve for me and I am curious what your opinion is.

And thanks for the effort you have made in putting it all together and providing your clinical insights.

PaleoDoc @PaleoClinic

KGH : Hi paleodoc, you can see my comments in response to Collden.

February 6, 2010 | Unregistered CommenterPaleoDoc

Thank you for your reply Dr Harris.

We can find this definition for hypometabolism: "An abnormal decrease in metabolic rate.". Which you probably already knew about :) It is indeed a very broad definition.

So of course hypothyroidism results in hypometabolism, but hypometabolism could have a whole hosts of other causes.

The cause of hypometabolism that I am personally interested in, is when peripheral tissue (mainly the liver) starts converting T4 to Reverse T3 instead of T3. ReverseT3 takes the place of T3 in your cells but is inactive. This seems to be the normal way the body slows down when it wants to. But, it looks like we can reach a point where RT3 is too high and stimulates all by itself conversion of T4 to RT3.

Maybe I'm just following on the hypometabolism fad?! :) But I have followed something close to the Wilson Temperature Syndrome protocol in the near past. My temperature was hovering in between 95.2 and 96.5. My TSH was 0.95 and there seemed to be no problem with my thyroid. So I took T3 (Cytomel) for 3 months. Since I recently had an abdominoplasty (I maintained a fat loss of 80 pounds for the past 4 years and thought I was due for this :) and even though I do not take Cytomel anymore, my temp is now hovering a full degree higher than before. Was I able to clear some excess of RT3 with an intake of pure T3? I don't know, but it worked for me. Unfortunately, if I believe what I read on hypometabolism, I would still be in an hypometabolic state, since my temp is still lower than 98.6.

Do you believe that low body temperature is automatically a sign of "An abnormal decrease in metabolic rate"?

Thank you,

Patrick

KGH:

I am on the fence about body temperature but some of its use looks like quackery. Wilson himself (what kind of ass names a disease after himself?) had his medical license revoked and was sanctioned for causing a cardiac event by treating a patient solely with T3.

I emphatically do not recommend T3-only treatment for hypothyroidism, and especially not for the non-existent disease of "wilson's temperature syndrome"

If you are or were clinically hypothyroid, see a real doctor and get a prescription for dessicated thyroid or T4 plus cytomel.

February 6, 2010 | Unregistered CommenterPatrick

I like Matt Stone even though I don't get the results everyone else is getting from HED. I get severe hypoglycemia from it instead or should I say that it comes back in full force.

KGH: Maybe that should be a clue that it's not good for you?

My take on the Dr.Schwarzbein theory that too low in carbohydrate makes the body secrete too much adrenaline.......

KGH: Quite obviously before ketoadaptation there is more epinephrine to keep blood glucose normal. Once you have some muscle insulin resistance however (days to weeks) this is not necessary and epinephrine should actually be more normal. I've seen no evidence of a hyper-catecholaminergic state long term.

See I have had SEVERE insomnia for good part of my life. Searching the net over the years I come to find that its adrenaline and norepherine that is the cause of my insomnia. When I fall asleep,an hour later my blood sugar drops so low that my body secretes these hormones to up my blood sugar.All good but these hormones are used by the body to basically wake it up.When your body is now using these adrenaline hormones to manage blood sugar then your basically screwed.You have gone past the insulin/glucagon balancing act and are running on emergency hormones IMO.

Then over yrs of this which I had you will get adrenaline burnout. Sluggish doppy feelings thruout the day that are only cured with tons of caffeine which keeps the cycle going.

Now here we have LC diets that when done right will manage to stabalize BS to amazing extent. So I am asking you Dr.Harris.......If BS stays constant throughout the day then wouldn't adrenaline be kept very low??

KGH:

That is exactly why VLC eaters can fast with no discomfort whatsoever - serum BG is stable because you are burning fatty acids and B- Hydroxybutyrate. You have not said what you are eating, but in my experience hypoglycemia and the resultant adrenaline surge is a response to too much carbohydrate in the diet - it goes away with VLC eating.

Kind of the reverse of Schwarzbein?

February 6, 2010 | Unregistered Commenterwolfstriked

The straw man style of rhetoric is very common. Politicians use it all the time – “To those who obviously want to destroy democracy, I say …”

Style issues aside, I think he may be correct regarding leptin resistance preceding insulin resistance. And you are obviously right about individual variations.

Open debate is good. If he is contributing to it, pig head in hand or not, then the final outcome is positive.

KGH:

I have not said a word about Leptin resistance preceding Insulin resistance as it has nothing to do with my objections to his theorizing. It may precede it or not. So what?

I would go to Stephan's blog or email him if I have a question about Leptin, as he is a PhD and dong a post-doc in this very area.

Leptin certainly is the hormone du jour. Just look on Amazon for the number of books with Leptin in the title. I smell some BS marketing.

Leptin does not explain the whole metabolic universe any more than insulin does. The idea that HED or some such is needed to "cure" leptin resistance in those who have normal or totally unknown leptin resistance is what I take issue with.

Also, Stone fails to mention the critical difference between physiologic (peripheral or muscle) insulin resistance and liver insulin resistance. You can "improve" your OGTT glucose handling by overeating carbs for a while, yet without changing or "improving" your liver insulin sensitivity one bit. This is just a normal physiologic adaptation. You are not "curing" anything at all.

It is the LIVER that is broken with metabolic syndrome, not global glucose handling on OGTT.

February 6, 2010 | Unregistered CommenterNed Kock

I think Matt has some interesting ideas, but if low carb caused thyroid issues then the Inuit, Sami, Yupik, and numerous cultures that ate almost zero carbs until the recent introduction of Western foods would have been sick sick people. Hmm, what else do those cultures have in common? Well, they live in areas where they can eat marine foods rich in iodine, among other important nutrients.

I bet if most low carbers added just an 89 cent can of sardines to their daily diets, they would prevent almost all the problems Matt Stone blames on not having enough carbs. Low carbers, ditch the steak and chicken breast and start eating more things like seaweed, whole fish (not just the salmon filet!), and oysters.

February 6, 2010 | Unregistered CommenterMelissa

KGH

"They are both 20 years old and do not measure free T4 or free T3, the much more sensitive and meaningful measures of thyroid hormone on vivo."

Fair enough, do you then know of any more recent study which contradicts these results? Of course my judgement that it is a "positive effect" assumes that it is desirable to have a high metabolism.

"If you think Stephan has an unfounded bias against carbohydrate, then you have not read his blog.
The point remains he clearly is addressing the paleo blogs and readers, that is undeniable."

No I don't think so, that's why I said he's not a low carber. Many who read his posts and participate in the comment sections are low carbers though.

KGH:

You said .."my judgement that it is a "positive effect" assumes that it is desirable to have a high metabolism."

My criticism is that I have no idea what "high metabolism" means. Why does "high" mean good in your mind, because the word "high" sounds better than the word "low"?

If high is intrinsically better than low, would you like to run a fever all the time with body temperature of 101 F?

Subjectively, I feel both more energetic and much calmer on VLC than high carb.

So is that high or low?

I have no idea as the term is just thrown around without a definition. Or am I supposed to base everything on my T3 or body temperature and ignore how I feel and function? Can you see the difficulty with trying to achieve a "high" metabolism without even knowing what it means?

My other point was, once again, it that it is clear that Stone is targeting his message to readers and writers of paleo blogs.

February 6, 2010 | Unregistered CommenterCollden

Dr. Harris,

If I may ask you a question pertaining to the subject of insulin resistance or metabolic syndrome, is there a way that one can improve insulin sensitivity or reverse metabolic syndrome? I have been struggling with this ever since being diagnosed as pre-diabetic. I've read Schwarzbein's book, which basically states that you can indeed heal your metabolism and reverse insulin resistance by balancing your hormones (insulin, adrenaline, cortisol, etc), but she never really cited any data to back up her claims, and that left me a little unsure as to whether her claims have any merit. I've also followed Matt's blog, and it has all just left me more confused than ever. If one's metabolism is "broken," is the only answer to reduce carbs for the rest of one's life or can the metabolism indeed be "healed?"

KGH:

The chance for healing is dependent on removing the things that damaged you in the first place.

First, understand that it is liver insulin resistance we are trying to restore. Insulin is the way the pancreas talks to liver (hat tip Peter for that)

The liver is the principal damaged organ, and the knock-on effects to other organs, including the brain. etc follows from that.

The liver may heal if you stop damaging it with things that screw it up and cause inflammation.

Like:

1) Excess PUFAs especially (but not only) excess n-6 linoleic acid. Eat zero plant based vegetable oils (not counting coconut) No more than 1g n-3s per day as well as fish oil or CLO

2) The hepatoxin called fructose. I advocate a ZF (zero fructose) diet if you have Type II or metsyn.

3) The hepatotoxin called ethanol. Zero that out, too.

4) A fail-dafe approach to leaky gut. Endotoxin that leaks into your blood stream through your gut causes inflammation. Eliminate all gluten grains like wheat and all wheat flour. Eliminate all excess PUFA (step one). Consider a casein free diet until you have healed.

Eat as low or high a fraction of carbs as you feel like, unless you feel like losing weight and then you can read "how to lose weight" - that post is free and works as well as any book you can read.

I think the whole issue is more about stopping metabolic damage and consequent inflammation than it is about "managing" your hormones.

February 6, 2010 | Unregistered CommenterChristy

Hi there,
I just wanted to chime in and clarify some things which are not necessarily correct in my opinion:
There's a lot of talk about Hypothyroidism going on here. However, one should also keep in mind that when Matt talks about a low basal metabolsim that might be induced through dieting (which does include low-carbing in his opinion) he also states that this does not necessarily have to be Hypothyroidism, but might just mimick Hypothyroidism even though the thyroid glands itself are pretty healthy. So it's not necessarily that he says that low-carb leads to hypothyroidism, but rather that low-carb could lead to a slow metabolism. He might or might not have said something about Hypothyroidism before, but as everyone with an open mind should also be, he is willing to change his opinions, when confronted with new discoveries that shake his current hypothesis. He talks about the whole Hypothyroidism issue quite in detail on his latest podcast ( http://180degreehealth.blogspot.com/2010/02/rethinking-hypothyroidism-podcast.html ).
Note: This is not necessarily an encouragement to click on that link or listen to the podcast. I'm also not trying to do some advertising here or something. But it's really hard to argue about someone's opinion, if you don't even really know what somebody's opinion really is. This is the reason why I feel there are many unjustified claims made here about Matt Stone's opinion of low-carb and hypothyroidism.

Also I find it quite silly to discredit his opinion, just because he is selling something. I mean Jimmy Moore and Mark Sisson definitely do some much more aggressive promoting. And while Matt shows up on a lot of blogs, he usually does not menton his eBooks. No, I don't want to deny that he probably is also trying to sell something with those comments, but godammit, even PaNu has got a PayPal button. Just the fact that someone tries to sell something does not automatically lessen the value of that someone's opinion.

February 6, 2010 | Unregistered CommenterMatthias

How to be a successful charlatan:

(Note: if you have a hypothisis that is based on solid science and that is likely to stand up well to review by knowlegable critics, you don't need this guide.)

Rule # 1........
Self-promotion is all important! As the great Anthony Colpo has pointed out, if hundreds of thoughtful, science-based writers are on record talking about how silly you are, that means you're famous! Being famous sells books!

Rule # 2........
Allways remember that, like any leader, your constitiancy is a subset of the population, not the whole.
It is very difficult to convince knowlegable people of a radical hypothisis - and worse yet you might falsify your argument. Don't waste time and energy that might be better spent on self-agrandizement. There is a significant proportion of the population that is enthusiastic and uncritical; 10% of a million people is one hundred thousand potential buyers!

Rule # 3.....
Be witty and entertaining. Work hard on appearing to be just one of the guys, but vastly smarter and more knowlegeable. Talk about how most Asians are slender and fit. (Some people will point out that most Asians tend to be hungry - ignore them. They are not your target audience.) Don't hesitate to diagnose prominent bloggers from their pictures. Most people will see that behavior as nonsense, but your target audience will be enthralled by your brilliance. Say things like "Most people wouldn't notice the visual signs of hypothyroid problems, but to someone as smart and knowlegeable as me, it's obvious." They'll eat it up!

So in conclusion:
Keep busy -- there's no such thing as "bad" publicity.
Be entertaining - sell those carbs and circuses.
Be sincere, whether you mean it or not. And always remember: there's a sucker born every minuite!

February 6, 2010 | Unregistered Commenterdjinn

Dr Harris: "...It should be obvious as well that T3 normal ranges are based on subjects who eat the SAD. Why not conclude that the average SAD eater, who clearly eats an unhealthy diet is hyperthyroid or hypermetabolic and needs to be cured by cutting their carbs rather than the reverse?"

That's an interesting angle indeed. I have been wondering the same thing lately. :) Also, low body temp is associated with longevity. Maybe this is something crucial that should be kept in mind by researchers on human metabolism.

Patrick

KGH:

High HDL, big fluffy LDL particles, low fasting triglycerides.....lower T3?

All just markers of a high fat diet?

I am not saying that it is impossible that CLINICAL hypothyroidism can be caused by a low carb intake at equilibrium, I am saying it is does not seem biologically plausible and I have not seen it proven.

February 6, 2010 | Unregistered CommenterPatrick

djinn LOL great post. That gives me some ideas, maybe I could manage to pay my house faster. ;-)

Patrick

February 6, 2010 | Unregistered CommenterPatrick

@djinn:
Now that's just silly. Of course you can make fun of him for selling something, but what you just did was trying to discredit someone's opinion by not even adressing the opinion itself. What would you say if I tried to criticize your opinion just because I think your nickname is silly (which I do not think btw ^^).
You could ceraintly argue that my comparison wasn't the best one and you also may very well have reasons to disagree with Matt. But why then, don't you adress his opinions and statements instead of just making fun of him. This is very immature if you ask me.

February 6, 2010 | Unregistered CommenterMatthias

I was just thinking this today and Patrick above posted this here....

  • Patrick said:"Also, low body temp is associated with longevity. Maybe this is something crucial that should be kept in mind by researchers on human metabolism." *

I read online that Centenarian's have been tested and show very low insulin levels. That to me shows that insulin is in fact an aging hormone in that out of control insulin will rapidly age oneself. I notice that when I eat high carbs I tend to look older and when I go VLC I actually reverse in appearance. Its not only the weightloss but also overall skin complexion. I am 40yrs old and still get proofed in a bar yet if I am eating high carb diet I never do. As silly as that sounds its actually spot on in what I notice.

So what I was thinking today relates to Matt stone's theory that high thyroid is a very healthy condition. Yet I also read that people with super fast metabolisms are known to die younger than a person with a slow metabolism. Whats your take on this? Is there anyway you can find a study linking Centenarian's and their actual thyroid readings?

February 6, 2010 | Unregistered Commenterwolfstriked

@Matthias

Of course it was silly. Actually, it was kinda like satire. I wasn't criticizing his ideas, which would take a large document to do properly. (And which has, as far as I'm concerned, already been done adequately)

Nor was I mocking him for selling something.

What I was criicizing, was his behavior...... just as you're criticizing mine, with some justification. Satire, even if well done and not just off the cuff as my post was, is never a pretty thing.

His recent activities and attitude make him a target for reactions like mine. I think my reaction was to the point.
(actually, my nickname IS kind of funny, but I'm stuck with it........ continuity, you know ;-) )

February 6, 2010 | Unregistered Commenterdjinn

I have followed Matt's blog etc. and at first it seemed exciting but now I just don't buy it. Intuition I suppose. However I will say this. I think that there are many people doing low-carb who are restricting calories because their weight won't shift and I think this is a very bad idea regarding having a 'healthy metabolism', whatever that means. So I agree with Matt that dieting can do some nasty things, but I am not sure that a good varied low carb diet high in calories (or to appetite with lots of fat) does this. It does not surprise me people are suffering after eating VLC if that is causing too low an intake of calories. Brings to mind the anecdotes by Atkins of people losing on huge calorie counts. But then again, there are people for whom nothing works for weight loss, not even low carb. I am one of those - not particularly overweight but could stand to lose a few. I for one am not willing to go down the less calories, more restriction route. Eating too little is very bad, and I agree with Matt on that one. However I think that stuffing oneself with carbs (even with lots of animal fat) won't solve things either. His answer is not an answer as far as I can see.

February 6, 2010 | Unregistered CommenterLoops

"My other point was, once again, it that it is clear that Stone is targeting his message to readers and writers of paleo blogs."

That's what I don't get. Why go after people who, for the most part, are already successful in their pursuit of a healthy diet? If Matt instead directed his energies at SADers and got them to lay off the sugars and n-6 PUFA oils, he'd actually do the world some good.

KGH: Yes and if he stuck to that there is really no disagreement, at least from where I sit.

February 6, 2010 | Unregistered CommenterAlex

Thanks Collden -- you wrote:

"There are at least two studies that I'm aware of which suggest that substituting carbs for fat has a positive effect on thyroid function, and vice versa.

I believe that increasing carbohydrate can certainly raise T3 levels. Ray Peat PHD mentions this and advocates fruit and potato consumption for that very reason . Wolfgang Lutz's book also mentions this. The problem is that I cannot tolerate much in the way of carbohydrates -- especially fruit -- which makes my blood glucose soar and crash. I also find that fruit shuts off my appetite control. I just want more more more despite the high fiber content. This is true of starchy carbs as well. I tried the Schwarzbein plan and found it increased my fat weight. No surprise because the meals and snacks she recommends contained too many carbos for me. Plans like that appeal to wheat/carbo addicts. They believe they can have their cake and eat it too -- big lie in my view. Schwarzbein even tries to cover her derriere by claiming initial fat gain is desirable and/or normal -- a sign of healing metabolism. Not true in my view and did not work for me. I also think that for most people, her plan's grazing or eating multiple meals plus snacks should not be necessary if nutrition is high (meaning sufficient animal based protein and fat) and carbs kept low.

Back to carbs and T3. If they do increase my T3 levels, it is insufficient to overide the soaring blood glucose and fat gain. I undoubtedly have metabolic damage baggage from being born to an obese hypothyroid, type 2 diabetic mother. Add to that the additional genetic component of having a skinny type 2 diabetic father and being raised on SAD in the middle of the low iodine goitre belt -- I have the perfect set up for hypothyroidism.and unless I keep carbs very low -- obesity and type 2 diabetes.

Contrary to the stereotype, hyperthyroids can be overweight. High metabolism means increased hunger. If one chooses lots of carbs to satisfy this increased hunger, I think unwanted fat gain could be the result. One of my friends is a middle aged gal like me and she has hyperthyroid yet is chubby. Her doc actually told her to cut way down on carbs but she just can't/won't. She was a gynmnast in her younger days and probably got away with eating tons of carbs because of her high activity level. Not so anymore.

Observe carb addicts -- skinny or not -- I may have posted this before but they are the ones in the store who cannot wait to get home to tear into their high carbo snacks -- usually wheat -- bread -- they actually open the bread and start ripping pieces off and furtively shoving them into their mouths like starved rodents as they continue to shop or wait in line. Today I saw another strain of carbo addict -- the cereal junkie. There's an adult woman in my building who actually carries around a baggie of cheerios for herself as well as little baggies of cereal for her young children...

Anyway, for me, substituting carbs for fat may increase T3 but would also cause too many other problems. But for someone with a different metabolism and genetic makeup -- this might work. I don't believe there is one perfect diet for everyone. So unless I see compelling reason to change, I'll stick to my VLC regime.

KGH:

Apart from your reasonable observations, we need to ask if it is justified to think that we should intend to do anything to increase T3, if we are not clinically hypthyroid and likewise to question whether if we have good clinical evidence for hypothyroidism that this will do anything at all to "fix" it. I've seen no convincing clinical evidence that is the case.

Again, T3 levels may be a marker of a particular metabolic state but not necessarily a pathologic one. If the brain and other organs are more T3 sensitive in a low carb state, the new, lower T3 level may be perfectly appropriate, in a manner analogous to a low fasting insulin level.

Shall we all overeat carbs to raise our insulin levels? Is low fasting insulin a sign of a pathologic hypometabolic state, even though it's negatively correlated with morbidity?

Think carefully, folks.

February 6, 2010 | Unregistered CommenterAnnie
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