The Arrow #136

Hello everyone.

Greetings from Montecito, where it is pouring rain. In August. So much for the good weather holding.

Since I whined so much about my email burden last week, let’s jump into the mail first thing.

Low-Carbs and Low-Thyroid

I received this email from a lady wondering about whether or not low-carb or ketogenic dieting could damage one’s thyroid.

I got this email in my inbox this week from Dr Paul Saladino as I have been looking into animal based ketogenic diets for autoimmune conditions. There is a lot of hype online about ketogenic diets being bad for the thyroid and you will see he mentions this in the email below. Having looked into it a little in the past I couldn't find any good evidence for this and of course we all know we can make the glucose we need via gluconeogenesis anyway. But I did wonder if it was something you have ever looked into and whether you found any evidence.

She attached a subscription email she had received from Dr. Saladino, a noted promoter of the Carnivore diet. She also posted a link to a Virta Health blog by Dr. Steve Phinney, who is a friend of mine.

In his email, Dr. Saladino, whom I do not know personally, writes about some issues he started experiencing with his carnivorous diet.

For about 1.5 years I ate a strict carnivore diet of meat, organs, animal fat and salt… this put me in ketosis because I was eating essentially zero carbohydrates, and I ended up with some pretty bad muscle cramps, palpitations, sleep and hormone issues.

He then apparently started adding honey and other plant sources of carbohydrate to his diet. And felt a lot better.

In his email, he included links to a few studies that I found to be pretty weak gruel, so I’m not going to bother to discuss them.

He goes on to discuss how a ketogenic diet has been shown to be harmful to the thyroid.

Another huge concern I have with ketogenic diets is the impact on hormonal health. Because something that happens to essentially everyone I've seen on a ketogenic diet is that their thyroid hormones go a little bit wonky and their T3 goes low.

And you don’t want low T3 guys. It negatively impacts your basal metabolic rate and your hormones.

And we see this with ketogenic diets in the research…if you look at the thyroid labs of anyone who’s done long term ketosis, you will see that they are typically out of whack and their T3 is low.

It happened to me on my carnivore diet but resolved when I included carbohydrates back in my diet.

Steve Phinney has been doing experimental and clinical work with patients on low-carb and ketogenic diets since back in the 1980s, which is when I began putting my own patients on such diets. He and his team did some of the very first work on low-carb adaptation of athletes. He discovered in treating his patients—as I discovered in treating mine—that increasing sodium intake eliminates most, if not all, of the symptoms Dr. Saladino describes above.

When people go on low-carb or ketogenic diets, insulin falls quickly. When that happens, the kidneys release a lot of fluid. An experience all of us who have been on such diets have had. When this fluid gets released, a lot of sodium goes along with it. If the sodium level falls enough, people experience symptoms. Cramping, fatigue, and heart palpitations among them. These symptoms can almost always be alleviated by the addition of sodium to the diet.

I encouraged my patients to drink broth or bouillon as often as they wanted. I also suggested they increase their salt intake. Especially sea salt, which contains iodine. I always gave them a bit of potassium as well, since it also goes out with the sodium during the big fluid dump.

Another researcher who has written on thyroid hormones and ketogenic diets is Dr. Ben Bikman from Brigham Young University. He covers the issues nicely and provides references.

I didn’t notice a big change in thyroid hormones in my own patients, but I looked at the overall thyroid picture. Not just T3. More about which in a bit.

Before we get into it in depth, let’s take a quick look at how the thyroid works.

The above graphic is not the best, but it will do. There are several hormones involved in making the thyroid work properly. The hypothalamus is a part of the brain positioned above the pituitary gland. The hypothalamus more or less links the nervous system (the brain) to the endocrine system (of which the pituitary is a part). One of the many actions of the hypothalamus-pituitary combo is to regulate the release of thyroid hormone.

Let’s look at it from the bottom up.

When the body runs low on thyroid hormone, it sends a help signal to both the pituitary gland and the hypothalamus. The hypothalamus then releases thyroid releasing hormone (TRH), which signals to the pituitary that more thyroid hormone is needed. The pituitary gets the signal from both directions: from the hypothalamus above and the low thyroid hormone below.

The pituitary then releases thyroid stimulating hormone (TSH), which kicks the thyroid into gear and drives it to make more thyroid hormone.

Doctors used to be able to measure only the end product, the thyroid hormone. Sometime in the 1970s, some clever folks figured out how to measure TSH, which was a major game changer in terms of being better able to accurately determine what was going on with the thyroid.

For instance, if you get a lab result showing thyroid hormone to be low and TSH to be high, you know the thyroid is the problem. The TSH is sending a strong signal to make and release thyroid hormone, but the thyroid can’t do it.

There are all kinds of possibilities given the TSH and thyroid hormone level lab readings. It’s beyond the scope of this newsletter to go over all of the different readings and what they mean, so I’m just going to stick to what happens sometimes on low-carb and ketogenic diets.

Before we get into any depth into making sense of thyroid labs and diet, I want to explain a bit about lab work in general. I always like to look at everything through an evolutionary lens, lab values included.

Most of the techniques used to determine blood levels of just about everything were developed in the 20th century. At the time the various measuring technologies were invented, no one knew what the ‘normal’ levels of whatever was being measured were. After numerous measurements on hundreds or thousands of subjects, the folks running the labs would chart these values and end up with a normal distribution looking like the graphic below.

A normal distribution of lab values was then calculated as being two standard deviations from the mean. That set the high and low ends of what was supposedly normal.

Which is why when I was in medical school an upper level of 300+ mg/dl was considered normal for cholesterol. Then the drug companies got into the act and decided that an upper level of 300+ might be within two standard deviations from the mean, but it certainly wasn’t healthful. So, at the urging of the drug companies, the upper level kept getting pushed lower and lower until it is where it is now. If the drug companies could totally get their way, it would probably go down to 100 mg/dl.

When pretty much all of these lab values were derived, we were all eating a lot of processed carbohydrates. Yet when we cut our evolutionary teeth, so to speak, there weren’t any processed carbs. In fact, there weren’t a lot of carbs at all. For millennia our ancestors ate primarily fat and protein. And in those times, there were no labs to measure thyroid hormone or anything else. So we are clueless as to what two standard deviations from the mean would be in blood drawn from our ancient ancestors, whose genes still whisper to us through the ages.

Maybe our Paleolithic ancestors would have blood work showing the exact same thing we see today in people eating high-carb diets, but I doubt it. If I had to guess, I would guess that in terms of thyroid hormones and TSH, their lab work would look about like the lab work of someone today following a diet similar to theirs.

What do I think these labs would show? Probably thyroid hormone levels that might be a little low along with a normal TSH. It’s the normal TSH that is important to note. If the hypothalamus and the pituitary are not worried about the slightly low thyroid hormone levels, then why should you be worried? The hypothalamus and pituitary gland are monitoring the thyroid hormone levels second by second. If there were an issue, the pituitary gland would be pouring out TSH, whipping the thyroid to get busy making more thyroid hormone. But it isn’t. Which tells me the slightly low thyroid hormone levels are probably normal for people on a low-carb/ketogenic diet.

In these subjects with lowered thyroid hormone levels there are typically no symptoms of hypothyroidism. They don’t have brittle hair, dry skin issues, cold intolerance, or really any other signs of hypothyroidism. Consequently, I believe that the lowered thyroid hormone levels are simply normal in the face of our ancestral diet. What medicine now views as ‘normal’ may well be the aberration.

In 2004 Wolfgang Kopp, an Austrian researcher, wrote a nice paper on the phenomenon that pretty much accords with my take on it. He looked at it from an evolutionary perspective as well.

He views the high-carb diet as a problem for people who live in iodine-deficient areas.

When the thyroid is stimulated by TSH to make thyroid hormone, the thyroid hormone itself requires iodine for its synthesis. As far as I know, it’s the only hormone requiring iodine. If there is not sufficient iodine available, the thyroid can’t make a lot of thyroid hormone no matter how strong the TSH signal is from above. This constant whipping of the thyroid by TSH in the face of a lack of iodine can stimulate the tissue of the thyroid to enlarge. If it goes on long enough, the small butterfly-like gland right under the Adam’s apple can enlarge to a great whopping thing that pushes the neck out and becomes what is called a goiter. These aren’t seen much any more, but in the old days there were areas in the United States deficient in iodine in the soil. These areas were called the goiter belt.

The image below shows a woman, believed to be from central Norway, with an enormous goiter. Believe it or not, these were common—probably not that large—not all that long ago in certain areas of the United States. Iodine fortification of food staples and salt have pretty much done away with it here, but have created other problems in its stead.

According to the paper by Kopp, a high-carbohydrate intake significantly increases T3, the most active thyroid hormone. If people eat a lot of carbs from iodine poor soil, they can’t meet their iodine needs and so are at risk for iodine deficiency disorders, with goiter being one.

He writes

Serum levels of thyroid hormones, especially of triiodothyronine (T3), are dietary dependent, or more precisely, they are dependent on the amount of dietary carbohydrate.

A high-carbohydrate nutrition is associated with significantly higher levels of T3, compared with very low-carbohydrate diets.

Our Paleolithic ancestors subsisted on a very low-carbohydrate/high-protein diet during a long period of human evolution, a diet that is associated with significantly lower T3 levels.

Beginning with the agricultural revolution about 10,000 years ago, a dramatic increase in dietary carbohydrate has occurred.

The addition of considerable amounts of carbohydrate to a low-carbohydrate diet is associated with a significant increase in T3 concentrations.

Increased T3 concentrations are associated with a higher iodine requirement, that — in many regions of the world — exceeds the availability of sufficient amounts of iodine from environmental sources.

He goes on to write later in the paper

Significant changes in human nutrition have occurred during human evolution. While in our primate ancestors, carbohydrates in the form of fruits and berries were an important part of their diet, the diet of bipedal hominids became increasingly carnivorous. Early hominids like the Australopi- thecines, who lived between 3 and 4 million years ago as well as Homo habilis, who appeared about 2.5 million years ago, were scavengers. They sub- sisted on a mixed diet, consisting of vegetable materials as well as meat from carcasses that were left by true predators. Homo erectus, who appeared about 1.5 million years ago and Homo sapiens who appeared about 500,000 years ago were hunters, who consumed large amounts of meat, and some amounts of carbohydrate in the forms of roots, fruits, tubers, nuts, grains and seeds. Especially during the ice ages when large parts of the world had little vegetation, our ancestors lived on an abundance of animal protein and only minimal amounts of carbohydrates. Most of the wild plants such as roots, berries, nuts, tubers, and leafy vegetables were fibrous and contained small amounts of glucose only. The amount of carbohydrate eaten may have been as little as 10 g a day, especially during the ice ages.

Thus, during a very long period of human evolution, our ancestors subsisted on a diet high in protein and very low in carbohydrate. In consideration of the relation between dietary carbohydrate and thyroid hormone concentrations, this Palaeolithic nutrition must have been associated with T3 levels significantly lower than those associated with later high-carbohydrate diets.

In this context, the seemingly “inappropriate” association of low T3 values and normal or even decreased TSH levels becomes quite understandable: these are levels associated with a diet our ancestors had genetically adapted to during a very long period of human evolution. Thus, these levels must be regarded as “normal” from an evolutionary point of view.

Which, in my view, is a pretty accurate summary of what’s going on.

The take home message is that if you are following a low-carb or ketogenic diet and your T3 is running a little low and your TSH is normal, or even a bit low, you have nothing to worry about. Especially if you have no symptoms to go along with it.

And if you do have symptoms, try drinking a cup of bouillon a time or two a day. And add some extra sea salt to your meat. In my experience, that fixes things fairly quickly.

One last thing…

T3 tends to drive the breakdown of protein into amino acids. And it suppresses protein synthesis, so if you are wanting to build and maintain muscle mass, you probably want just enough T3 hanging around to keep you out of trouble, but no more than that.

The Whole Foods Halo Effect

Since MD and I shop at Whole Foods occasionally, and since I’m a liberal user of Amazon Prime, I’m on the Whole Foods mailing list. This arrived in my inbox yesterday.

The impression is, of course, that highly-processed-wheat-flour pretzels dripping with some kind of high-pure-cane-sugar chocolate coating are somehow healthful because they don’t contain artificial sweeteners, trans fats, etc. Don’t fall for it. Just one of these babies would probably run your insulin and glucose through the roof.

The WHO and other entities that are supposedly looking out for us have come out in the last couple of months bashing all kinds of artificial sweeteners. Each entity apparently gets to bash one, so all together they’ve bashed them all.

The studies are garbage. Not even worth dissecting.

Here is my take on artificial sweeteners. Virtually all of them are intensely sweet. Maybe 600 times sweeter than sugar by mass. So if you want the sweetness of one teaspoon of sugar, you can get it with 1/600 of a teaspoon of one of these artificial sweeteners. Which is a barely visible amount. The rest of what you get in packages of these artificial sweeteners is filler. Otherwise you would think the packet was empty.

I can tell you with a high degree of certainty that you will incur less damage from a minuscule amount of one of these sweeteners than you will with an amount of sugar that provides the same degree of sweetness.

Whenever you hear that something is bad for you, always ask: Compared to what?

My preference is to avoid artificial sweeteners altogether. I do it not because I’m worried they’ll give me cancer or somehow damage me, but because I like to keep my sweet receptors sensitive so that I can taste the sweetness of regular food. If you’re constantly bombarding your taste receptors with sugars or intense sweeteners, you get sweet receptor resistance just like you get insulin resistance when your insulin levels are chronically high.

There are a lot of people out there who love sweets. Many of them, when they go on low-carb diets, want to replicate their sweet laden diet with low-carb sweets. It’s the road to hell. It doesn’t work. Maybe for an occasional treat or snack, but I would rather have the real thing for an occasional snack. With emphasis on the word “occasional.”

That’s my two cents on it.

The Carrot Problem

I read a brilliant short essay on the Carrot Problem a few days ago and thought I would pass it along.

During the early days of WWII, the Germans were flying across the channel at night and bombing England. About the only defense the Brits had against the air assault was the blackout. Turn off all the lights, so the German planes can’t see what to bomb.

The Brits ultimately invented what they called Airborne Interception Radar, called AI at the time. The AI allowed the Brit fighter pilots to locate the German bombers and shoot them down before they could reach England and do any damage.

Problem was that once the Germans figured out what was going on, it wouldn’t be long before they would come up with a defense against the AI. According to legend as described in the Smithsonian Magazine the Brits started a propaganda campaign about how their pilots had exceptional vision because they binged on carrots.

The real problem for the Germans was that they were up against AI. Their perceived problem was that the vision of their bomber pilots wasn’t up to that of the carrot-eating Brits. If the Germans believed the propaganda, they would have their pilots face down in carrots in an effort to improve their vision to at least match the superior vision of the British pilots. In other words, they were spending effort doing something that had no chance of success because they didn’t know the real reason—the AI—for the mismatch.

I don’t know if the story is true or not, but it’s a great setup for the Carrot Problem, which, once you see it, can’t be unseen.

The short essay was written by someone named Uri on a blog called Atoms vs Bits. He writes:

Once you look for Carrot Problems, you see them everywhere. Essentially, any time someone achieves success in a way they don't want to admit publicly, they have to come up with an excuse for their abilities. And that means misleading a bunch of people into (potentially) wasting their time, or worse.

He gives a few examples, which I encourage you to read about in the link above. Here is one.

Many companies basically distribute their jobs to friends and insiders, but don't want to admit that publicly. So they set up public application processes, which cause outsiders to waste time and effort applying through a channel that has 0 chance of landing them the job.

I remember reading a great book years ago by John Malloy, who was a business consultant. He helped companies solve problems, and he helped executives inside companies solve problems to get ahead. He wrote that anytime he asked a C-level exec what he (they were all he back then—this was years ago) looked for in someone coming up the ladder, they always said they looked for people who were bold and not afraid to confront the boss when he was wrong. And they should always put the business first, even if it meant clashing with the top brass. Based on his own observations in many companies, Malloy wrote that despite what these top execs said, what they wanted was someone to suck up to them and be a yes man.

If you were a young guy back then trying to make it up the corporate ladder based on what the CEO said he looked for in a leader, you had a Carrot Problem.

I suspect there will be a lot of Carrot Problems generated by Ozempic, Wegovy, Mounjaro, and any other semaglutide-like drugs that come along. I’m sure many people will be losing a lot of weight, but won’t want to admit they’re on the drugs. They’ll tell people who ask that they are just cutting calories, or they decided to start working out, or whatever. Those listening will try to do the same based on faulty information.

Ancel Keys, Butter, and Omega-6 Fats

A reader sent me the video below. It’s really worth watching.

The kid doing the video is great. He gets into the whole Ancel Keys situation and explains how he (Keys) promoted the diet-heart hypothesis. He talks about different kinds of studies. It’s obvious he is familiar with searching the literature. He provides a lot of information in a clever, funny way that maintains your attention. And most of it is accurate. I have only one quibble, and it’s with an issue I run into all the time. At around 10:55, he begins talking about the quality of the fat in the butter as a function of how the cow is fed.

He tries to make the case that grass-fed cows produce butter with less omega-6 fat and more omega-3 fat than do cows fed on grain. He shows this chart from what he calls a truly accurate study.

All kinds of people make this mistake. And the mistake isn’t in the accuracy. The mistake is that the difference between the omega-6/omega-3 ratio is meaningless in terms of butter and even the meat from cows that are grass fed vs those fed grains.

Let’s take a look, and you’ll see what I mean.

First, let’s look at grass-fed vs grain-fed beef. Take a look at this table from a recent article I pulled on fat in various cuts of beef as a function of feed.

This graphic shows just the first few entries in this much longer table. (You can click the link above and see the entire table.) The area I have enclosed by the red box shows the amounts of omega-6, omega-3, and the ratio of the two in both grass fed and grain fed beef. These are the results of measurements published in the studies listed to the left. (The n-6 and n-3 are simply another way to say omega-6 and omega-3.) You can see the omega-6/omega-3 ratio is much higher in the grain-fed than in the grass-fed beef, just as the guy on the video said.

But let’s look a bit deeper.

Here is a chart of the different fats in nuts. The kinds of nuts we eat all the time. The kinds of nuts everyone tells us are a health food.

Take a look at Macadamia nuts, the second in the list above. It has the lowest amount of omega-6 fats by far of any nut in the chart. (I couldn’t screenshot the entire chart on my laptop, but the top part says the chart shows the grams of the various fats per 100 grams of nuts. (Here is the link to the full chart.)

You can see that 100 grams (about 3.5 ounces) of Macadamia nuts contain 1.3 grams of omega-6.

Let’s compare it to the worst of the grain-fed beef. Going back to the beef chart, take a look at the second entry from the top. Ground beef from an Angus grain-fed steer. The chart shows 623.9 omega-6 per 100 grams. That’s 500 times the amount in the Macadamia nuts, right?

No, it’s not. I’ve led you astray. You’ve got to look at the units. The various fats in the nuts are measured in grams/100 grams of nuts whereas the fats in beef are measured in milligrams/100 grams of beef. A gram is 1000 times a milligram.

So, the omega-6 fat in beef is only one third the omega-6 fat you would find in an equivalent weight of Macadamia nuts, which are prized because they are so low in omega-6 fats.

If you look at the lowly peanut, which people throw back like a chicken eating corn, you see that there is almost 28 times (27.6 to be exact) as much omega-6 as there would be in an equivalent amount of grain-fed beef.

If you’re worried about getting too much omega-6 fat in grain fed beef, well, you had better avoid nuts of all kinds.

Granted, the omega-6 to omega-3 ratio in grain-fed beef is high, but the absolute amounts of the two fats are tiny. In other words, you’re not getting enough of them to matter irrespective of what the ratio is. If you compare the amounts of omega-6 fat in grain-fed vs grass fed (I’m using the first listing for this), you’ll see that although there is an almost doubling of the omega-6/omega-3 ratio, the absolute difference in omega-6 is only 0.172 grams, a tiny, tiny difference.

But, wait… The guy in the video was talking about butter, not beef.

I know, but I was using it to get my point across about how little difference there is in omega-6 fats in grain-fed vs grass-fed beef.

Okay, on to the butter.

It’s really the same thing. I tracked down the butter study he was talking about, and the graphic below shows the difference in omega-6 and omega-3 fats in the butter from the grass fed vs conventionally fed cows. I have to do it in two parts, because I can’t get the entire chart on one screenshot. (I’m sure there is a way to do it, but it’s beyond me.) Here is a link to the full chart.

Okay, I’ve put a box around the omega-6 and omega-3 fats.

From this USDA chart about the nutritional content of butter, we know that fat makes up 81 percent of the weight in butter. In the chart right above, the amounts are listed as percent of total fat, so multiplying 0.81 times 0.018 gives us 1.46 grams of omega-6 fat in 100 g of butter, which is almost a stick. The omega-3 number calculates to 1.2 g.

Not a lot, in any case. Not worth worrying about.

In terms of what the study found, the kid in the video is bullshitting. He picked out one small segment of the study that ended up being meaningless and implied it made a big difference. There were these minor differences in the fats in butter, but when the researchers fed these fats to 38 subjects for 12 weeks in a randomized, controlled fashion and tested them for any changes in cardiovascular and inflammatory risk factors, they found basically no difference.

From the study conclusion

Lack of effects on blood lipids and inflammation indicates that dairy products from mountain-pasture grazing cows are not healthier than products from high-input conventional systems.

Having said all this, I’ve got to admit that I much prefer Kerrygold butter to others. I suppose it has to do with taste. But, in truth, I probably see the bright yellow color and it makes me think it tastes better. And in fact, that pretty gold color may indicate its being richer in some good things, like Vitamin K.

The take home message here is eat the beef you like and the butter you prefer. Or can afford. Don’t spend a lot of time worrying about the omega-6 to omega-3 ratios. If you do worry about them, never eat nuts again for the rest of your life.

I hope this dissolved a few illusions.

Speaking of dissolving illusions…

Dissolving Illusions

I’m deep into the book Dissolving Illusions, and I really recommend that you read it. It is a total eye opener. If it is true. Which is what I’m going about trying to figure out.

There are several authors, but the overall thesis of the book is that all the diseases that were a scourge to humanity for the last few hundred years were not necessarily brought on by, but were exacerbated by filth, lack of clean water, ignorance, and poor diet.

The authors go on at nauseating length about the squalor in which the great mass of humanity lived not all that long ago. The book is clotted with references throughout. So many so that I ended up buying the softcover version. I love the Kindle app, because I can carry a thousand books with me everywhere I go in my iPad (I just checked and the number is a little over 1,200 right now). I love reading on the Kindle app, but it is a major pain when I’m trying to track down citations. The soft cover is much, much better for that. In fact, it’s great because I don’t even have to flip to the back. The citations are listed at the bottom of the page on which they appear.

The story in the book is so awful that I’m checking citations to make sure they’re accurate. So far, they are.

The horrible conditions that most people lived in were simply unimaginable to people today. Raw sewage running in the streets, horse shit everywhere, multiple families living cheek by jowl in tenement housing with no bathrooms. Kids actually playing in the shit in the streets. It’s no wonder people were ripe to any infectious agents that came along.

For those of you who have spent time in New York, think about the area in front of the Plaza Hotel. You can hire horse-drawn carriages there to take you around that end of Central Park. I don’t know how many there are of these—maybe a dozen. And when the horses take a dump on the street, as horses are wont to do, if they miss the canvas trough behind their tails, someone cleans it up quickly. Imagine if all the cars you see going up and down 5th Avenue and the side streets were all various types of carriages drawn by horses. Which they were 120 years ago. Imagine the enormous amount of horse waste that would have to be dealt with.

Add to that the fact that there weren’t a lot of indoor toilets for people. Where did that waste go? And what about dogs, cats, rats, pigeons, and all the rest. The streets must have been nasty. I came across a letter to the editor of Scientific American in 1900 complaining about how the big hoop-skirted dresses worn by women at the time dragged this filth into the homes.

The streets of our great cities are not kept as clean as they should be, and probably they will not be kept scrupulously clean until automobiles have entirely replaced horse-drawn vehicles. The pavement is also subjected to pollution in many ways, as from expectoration, etc. Enough has been said to indicate the source and nature of some of the most prevalent of nuisances of the streets and pavements, and it will be generally admitted that under the present conditions of life a certain amount of such pollution must exist, but it does not necessarily follow that this shall be brought indoors. At the present time a large number of women sweep through the streets with their skirts and bring with them, wherever they go, the abominable filth which they have taken up, which is by courtesy called “dust.” Various devices have been tried to keep dresses from dragging, but most of them have been unsuccessful. The management of a long gown is a difficult matter, and the habit has arisen of seizing the upper part of the skirt and holding it in a bunch. This practice can be commended neither from a physiological nor from an artistic point of view. Fortunately, the short skirt is coming into fashion, and the medical journals especially commend the sensible walking gown which is now being quite generally adopted. These skirts will prevent the importation into private houses of pathogenic microbes. [Bold emphasis]

h/t to Roots of Progress for the quote

I love how the writer uses the term “dust” for this “abominable filth,” which would have been impolite at that time to call what it really is.

After discussing the revolting conditions in which most people lived prior to the age of sanitation, the authors go into the various diseases of those times that killed scads and scads of people.

As those of you who have been readers of The Arrow for awhile know, I’ve written a number of times about how the evolutionary life cycle of various infectious agents attenuate over time. These agents are just like us. They want to live long and prosper. And the best way to do that is to evolve over the course of time into being less virulent and more infectious. A truly virulent infectious agent kills its host. Without a host, the agent dies. So over time, mutations that are less virulent end up being spread more because their hosts don’t die so quickly. At the same time, the mutations that make the agent more infectious infect more people. The end result of this cycle is an agent that is vastly less deadly yet more infectious.

I’ve known this for years—I learned it in medical school—but I never applied it to older, more deadly infectious agents. I never really asked myself why small pox didn’t attenuate. I assumed it hadn’t, and that if it weren’t for the vaccines, we would all still be getting it.

The authors of Dissolving Illusions pointed out that small pox did indeed attenuate over time. When I come across things like this, I always like to see what the other side has to say. It took me some checking, but I came across the graph below in a number of publications.

As you can see, from the blue line I added going down and toward the right, the deaths from small pox had already started falling before Edward Jenner came up with the vaccine. The implication from the graph is that it was in 1796 that the deaths started falling as a consequence of the vaccine. The vaccine didn’t become mandatory in England until the early to mid-1850s, which I have marked with the red arrow.

If you read the history of the vaccine, you’ll realize how horrible it was in the early stages. It probably killed more people than it saved. When it did get mandated in England in the mid 1850s, it was left to the local governments to enforce. People could still avoid the vaccine if they paid a fine.

The governing fathers in the city of Leicester decided they weren’t going to enforce the mandate. Instead, they were going to provide pure water and keep the city clean. And anyone who came down with smallpox had to be quarantined. The papers of the day were just like they were here during the Covid panic-demic. They foretold stories of mass deaths in Leicester and told people to avoid the city at all costs. In the end, Leicester came out with way fewer deaths than in those cities that had enforced strict vaccine mandates.

Some things never change.

I read a paper about the drop in mortality in the US over time. It showed the chart below:

As you can see, deaths from all these infectious diseases were dropping off rapidly before the vaccines for them came into existence. And the introduction of the vaccines didn’t even change the angle of the downward trajectory. It just kept drifting on down. There was no sharp drop-off after the vaccine entered the picture.

The maker of this graph was a little disingenuous in that he/she made a different scale for polio on the right vertical axis, which makes it look more life-threatening than it was. Probably because it’s really the only serious nation-wide media disease scare a lot of us alive today lived through. Until Covid, of course.

I’ve added it to the same graph below in red to compare to the rest of these diseases on the same scale.

Doesn’t look nearly so impressive, does it?

Let’s take a look at what happened to a disease for which there were no vaccines. Tuberculosis. Here is the decline in deaths over time. This is from the same study the above chart came from.

As you can see, TB deaths were on their way down dramatically before any meds became available for them. I’m sure this fall off was due to a combination of agent attenuation and improvements in sanitation. Once the squalor issues are remediated and the drinking water is pure, there is a huge infectious burden removed from people. Room in their immune systems’s capacity is freed up to better fight off disease.

Let’s look at one more. This one from Dissolving Illusions. Deaths from Scarlet Fever.

Just for comparison, I added a horizontal dotted line to this chart to show the upper limit of the chart two above on the various diseases for which vaccines have been developed. As you can see, scarlet fever was a major killer of people, especially kids, in earlier days.

Both MD and I got it when we were about 4-5 years old. My mother was a registered nurse, so she acquired penicillin and gave me a shot in the butt every day for ten days. The experience has put me off of shots since. I can let people practice starting IVs in me. I can give blood all day long. I can deal with finger pricks to get blood ketones. None of that bothers me, and all of it hurts more than shots today with razor-sharp single-use needles. My mother sterilized the needle over a pan of boiling water and used it each time on my hind end. God only knows how many rears it had pierced before it got to mine. If anyone tells you childhood experiences can’t scar you, don’t believe it.

When MD was diagnosed with scarlet fever, and the doctor told her grandmother what it was, her grandmother swooned. Literally swooned. She thought MD was going to die, because that’s what happened to kids in her day.

Everything I’ve read in Dissolving Illusions that I’ve looked up to confirm is accurate. If you’re at all interested in this subject, I would encourage you to read it.

Let’s take a humorous break from all this.

Scared Stupid

I came across an article in the Financial Times from a while back that was a hit piece on Dr. Simone Gold and America’s Frontline Doctors.

I almost had to quit reading when I came across this admission by the author of the piece, who, by all appearances is a normal American male.

He had called Dr. Gold to interview her. She asked him if they could continue the interview in person. Here’s what he wrote:

Gold wanted to continue our interview in person, but I was nervous. It was August 2020, the week Boris Johnson delayed easing lockdown restrictions in the UK and the mayor of New York City set up checkpoints to turn away people coming from other states. My wife, son and I hadn’t seen anyone we knew, even outdoors, for more than four months. Gold agreed to meet outside but wouldn’t wear a mask. I considered it, but ultimately was too afraid.

Wow!

Later he writes—totally devoid of any idea of what has actually gone on—the following:

Gold’s sad about the sacrifices I — and probably you — made during the pandemic. She says this with such sympathy and sincerity that I want her to be right, that the many vaccines I took, the masks, the sheltering in place — it was all a trick.

He, of course, “knows” it wasn’t a trick, despite all evidence to the contrary. He is one of the mainstream journalists who decided to follow Fauci, the CDC, and all the rest instead of digging in and hunting for the truth.

Then I came across the video below. It was on Twitter, but since Elon is apparently in a perpetual feud with the founder of Substack, he isn’t allowing the videos to embed in Substacks. Which is one of the reasons I want to switch platforms. I just haven’t had time yet.

But I did find a way to pull the videos from Twitter, so I can embed them myself.

Take a look at this one and realize people like this one walk the earth. Unless, of course, it’s a huge hoax, and I’m the sucker here.

Here is the X-formerly Twitter link if you would prefer to go there.

https://twitter.com/libsoftiktok/status/1688953973493915648?s=20

If these were the kinds of people who were around in any numbers during the early days of America, the frontier wouldn’t have gotten much beyond 42nd Street in NYC.

MD just walked by and asked me if I weren’t almost finished. I said, no, I’ve still got a lot left to write. Then I checked my words, and I’m almost at 7,000. Which is sort of my limit. Plus, I’m not sure people want to read more than that.

I’ll do one more section, then save the rest for next week. By which time, of course, a thousand new things will have crossed my desk and these on it now will be forgotten.

Ketones Help Build Muscle

One of the ongoing themes of The Arrow is the importance of muscle mass as we all age. It’s kind of like a savings account or IRA. You can build it up pretty easily if you start young, then draw on it when you’re older.

But just like you can still save money when you’re old, you can build muscle, too.

It just isn’t as easy as it was in your youth, so any little help is welcomed. And any time you are sucker punched with an illness or disability, your muscle mass wastes away.

But keep heart. I just came across a paper I can’t believe I missed when it came out a few years ago. I learned about it in a review by Dom D’Agostino, who is one of the main researchers in the field of ketones. I’ll be seeing him at LowwcarbUSA in San Diego next week.

In his review paper, Dom discusses all the benefits of ketones and ketosis that we already know about.

Metabolic effects of AcAc and bHB in many organs are well established, including anticatabolic processes such as attenuation of glycolysis, hepatic glucose output, and adipose tissue lipolysis. Among more recent discoveries are the pleiotropic effects of bHB as a signaling metabolite regulating oxidative stress, inflammation, and gene expression.

He goes on to discuss how it is thought that ketones provide both anabolic (building) and anti-catabolic (anti-breakdown) action on muscle. A new study shows this quite nicely.

He goes on to talk about why this is so important.

…with aging, cancer, HIV/AIDS, chronic heart and renal failure, chronic obstructive pulmonary disease, and rheumatoid and osteoarthritis, dramatic losses in muscle mass and function are often observed. Additionally, a pathological decline in skeletal muscle health is not only a strong predictor of mortality, but also predicts a reduced ability to receive, tolerate, and respond to disease burden and/or standard of care therapies. [my bold]

The study he evaluates is one performed in Denmark in which ten healthy males were injected with lipopolysaccharide (LPS), a substance that causes inflammation. The researchers wanted to see if under this inflammatory load ketones would prevent muscle protein breakdown (MPB). Typically, inflammation in the absence of ketones does cause MPB.

There were three different experiments. One in which saline (placebo) was infused along with the LPS, another in which liquid fat was infused along with LPS, and one in which beta-hydroxybutyrate (bHB) was infused with LPS.

The researchers did this while the subjects were under an insulin clamp. This allowed the amount of insulin to be raised without driving blood sugar too low.

As it turned out, the bHB significantly decreased the amount of MPB. It was helped a bit by the addition of insulin, but the addition of insulin without the bHB did not work on its own.

The D’Agostino paper has a great graphic that shows what happens.

As shown above, the ketone bodies block the inflammatory response through the various pathways shown. They block muscle protein breakdown and have a positive but not very strong effect on muscle protein synthesis. Overall it works to keep your muscle mass intact during an infection.

The take home message here is this: When you’ve got an infection if you say to yourself ‘to hell with it, I’m eating whatever I want’, you might want to reconsider. If you eat a bunch of carbs, you’ll run your insulin up, and the study demonstrated that elevated insulin alone would not salvage your muscle tissue from certain breakdown. However, ketones will. So up your fat and protein and lower your carbs when you’re sick. [Chicken soup anyone?] You’ll be doing the best thing you can do to maintain your muscle mass.

Also, if an infection (or injury) lands you in the hospital, for God’s sake don’t eat the hospital food. Have someone bring you your low-carb, high-fat, high-protein meals. You’ll end up coming out the other end much better off.

Here are links to the review and to the actual study.

Video of the Week

This is one in which someone who should know better demonstrates either the depth of his dumbth or the nth degree of his ideology.

At a seminar I attended once, the leader said that “a public forum was no place for original thinking.” Too bad for Al that he didn’t attend that same seminar.

Here is the original Twitter link in case you can’t get the video to play.

https://twitter.com/KanekoaTheGreat/status/1687208312218210306?s=20

That’s about it for today. Keep in good cheer, and I’ll be back next Thursday.

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