Low Stress = Happy

I think most people (particularly non-Peat folks) would see the title of this post and think that by “stress” I mean emotional stress.  I don’t mean that, although emotional stress certainly is a joy killer.  I mean stress hormones, which can be caused by emotional and environmental factors, as well as biological processes that aren’t functioning optimally for one reason or another.

I’m still taking niacinamide and aspirin, 100mg of each, 3 times a day to inhibit fatty acid release (and thus to inhibit cortisol/stress).  I can really tell a difference in my mood now when I don’t take them.  I feel ok, but there’s definitely a more *happy* feeling when I do take them.  I think it’s stress hormones that have kept me from feeling that sense of happiness, and when I do the things that inhibit them I feel pretty great.

So to inhibit cortisol, here’s what I’ve been doing:

  • Every time I eat I make sure there’s some kind of fruit/juice/sugar involved, some kind of fat, and some kind of protein.  If I don’t overdo it on the carbohydrate I don’t have any blood sugar issues.  Previously when I was eating fruit/sugar I was drinking 8 oz of orange juice at a time – now I only drink 2-3 oz at a time, and it’s always paired with protein/fat.
  • Eating frequent small meals.
  • I’m keeping lights on at night until I go to sleep, rather than spending time awake in the dark.
  • Taking niacinamide/aspirin 3x a day.  I’ve also started taking cynomel (T3) once a day, just 1 mcg.  I actually cut up a single 25mcg tablet into 25 pieces and I take one itsy bitsy piece of it a day.  I took 2 the first couple days and my heart was pounding after the second one.  So going very….very….slowly.
  • Eating before bed and right when I wake up in the AM (the opposite of intermittent fasting, really).
  • Eating raw garlic to inhibit the proliferation of bad gut bacteria, minimizing the endotoxin –> inflammation –> cortisol cascade. At least 1 clove per day, sometimes as much as 4.
  • Minimizing PUFA (of course…this goes without saying now, really.  And yet, I said it.)
  • Red light/sunlight – as much as possible.

An interesting thing about garlic – I can’t stop eating it.  I’m completely addicted to raw garlic now.  I’ve been cutting it up and putting it in my food…and now I really like how it tastes when I chew it – it no longer tastes too strong, provided there’s other food in my mouth at the same time.

Here’s what else I’m doing these days (and I’m writing this as much for me as for anyone reading this….one day if the *happy* goes away again, I want to be able to refer to this page to determine where I may have gone off track):

  • Beef liver 1x/week (about 5 oz)
  • Shellfish (shrimp, crab, or smoked oysters) – 2-3x per week
  • Vitamin A 10,000 IU (on days I don’t have liver)
  • Vitamin D 5,000 IU/day
  • Vitamin K 4mg/day
  • Vitamin E 400 IU 2-3 days/week
  • Progest E – 3 drops/day during second half of my cycle
  • Magnesium Glycinate 200mg/day
  • Pregnenolone 1000mg 1x/week (or every 2 weeks)
  • Diet of milk, cheese, eggs, OJ, fruit, coconut oil, butter, raw carrots, chocolate, beef, lean chicken/ham, spinach, kale, bone broth, and sometimes starches (rice, potatoes, or gluten-free bread)

I feel really good these days.  Happy.

Update (forgot a couple things):

I’m also taking:

  • A probiotic and prebiotic supplement once per day, first thing in the AM before eating
  • Hydrochlorothiazide (HTZ) for my high blood pressure.  I notice my blood pressure is higher when I miss a dose of my magnesium than a dose of the HTZ though.  Hope to be phasing this out soon.  I’ll be experimenting soon with taking more magnesium.

My Boy’s Wicked Smart

Research I’ve done in the last 24 hours as well as a couple more emails exchanged with Dr. Peat have resulted in me completely understanding everything Peat does.  It kind of crashed over my head like a big wave today.  I want to write it all down so I don’t forget it, but my head is swimming so I’m pretty sure it would just be in bits and pieces anyway.

One thing I love about Ray Peat is that he’s just so…smart.  I mean, if his IQ was an animal it would be a whale.  If it was an international conflict, it would be the Middle East.  If it was a baby it’s mother would have had gestational diabetes.  He’s like this:

 

“My boy’s wicked smaaht.”

Anyway, what I like is how when you write to Peat, you tell him why your writing, of course, maybe give a little context.  And he’s no fool – he knows that he can’t just go ahead and give medical advice over the internet – the liability would be too great, plus he doesn’t really know much about the person on the other end, so doing so would be irresponsible.  So what does he do?  First of all, he completely ignores the question you ask, because inevitably, unless you’ve been at this a LONG TIME, you’re probably asking the wrong question.  Instead, he tells you what you need to hear.  And he’s REALLY GOOD at determining what it is you need to hear from these few sentences of context you’ve given him.  But HOW he tells you is pretty brilliant too.  He doesn’t just say, “You should really take some aspirin.”  No, he states what he knows about physiology (as it pertains to your issue) and then cites a bunch of research that tells you what he thinks you should do, without overtly saying it in so many words.  In other words you have to do your own work and draw your own conclusions, but he makes it clear what direction he thinks you should look.

Brilliant.

Anyway, what I’m looking at now is reducing cortisol.  Here’s what Ray said to me in an email today.

Free unsaturated fatty acids turn on the stress hormones, and cortisol blocks oxidation of sugar and turns it into fatty acids and triglycerides. Keeping cortisol and stress low is the main thing. Keeping a high ratio of calcium to phosphate helps to oppose the stress metabolism.

And he listed a bunch of research on high cortisol causing metabolic problems, and on the use of niacinamide for reducing triglycerides.

Ray Medina would say that my gut health – specifically reducing gut leakiness – is key for reducing cortisol.  Peat seems to be leaning toward PUFAs causing high cortisol.  In any case, mine is high, and I’m going to do everything I can to lower it.  More red light, more sugar, more sleep, better macronutrient balance at meals.

Today I ate 4 meals, and each had protein/fat/carbohydrates.  In most cases the carbs were fruit or OJ – at dinner I had some rice.  I also took niacinamide and aspirin, 100mg of each, 3 times throughout the day.  Lastly I took a couple mcg of T3 at 2 different times today.  I felt really good all day – good energy, good mood, good blood sugar control.  I even felt really happy for a while there.

This way of eating and supplementing feels right and I’m going to continue it.

Cortisol, Inflammation, and New Garlic

I started with a new brand of organic garlic a few days ago.  It’s like the experiment is starting over again!  Another round of swollen, tender lymph nodes, some minor GI issues, and re-enlargement of my spleen (or whatever).  Ray Medina has mentioned somewhere in his blog that different brands of garlic resulted in different bodily responses for him.  Targeting different bacteria?  More/less effective?  I’m just gonna go with it.  Currently doing the garlic only twice a day.  Mostly because it’s not such a big deal anymore and I tend to forget sometimes.  Yesterday I actually craved garlic.  Weird huh?  I chopped it up and put it all over something I ate.  Raw.  Maybe my new happy bugs are hungry and are looking for the prebiotic inulin in the garlic.  Quite a bacterial fantasy life I have now.

I’ve been reading a lot over at Ray Medina’s site.  He’s really got my situation nailed with his Inflammatory-Cortisol Ballet series.  I’ve only read it once (so far), but it’s like he’s talking about me.  It makes a lot of sense – gut dysbiosis leads to inflammation (um….hs-CRP of over 8?), and the body produces cortisol to cope with the inflammation.  I do have the classic metabolic syndrome/high cortisol body.  A nurse I knew once used to call it the “diabetic body shape”.  Fat accumulation around the waist, skinny arms and legs.  Anyway, because the inflammation is chronic, the high cortisol becomes chronic, which leads to a crap-ton of symptoms, many of which I have, including weight gain, obesity, high insulin level, insulin resistance and diabetes, high blood pressure…basically all the metabolic syndrome stuff.

I think it’s interesting that while Ray Peat and Ray Medina don’t agree about everything, they agree about a lot of things that no one else seems to say, mainly that chronically high stress hormones are behind the most common chronic ailments.  They disagree somewhat about how to treat this – Peat says to eat enough sugar and protein, get enough light, and eat a thyroid-friendly diet.  Medina says to eradicate gut pathogens, take probiotics, and eat a gut-friendly diet.  I don’t see why I can’t do both!

Still feeling very emotionally stable no matter what I eat, since starting the Great Garlic Experiment.  Depression seems to be gone.  My husband says he’ll believe it’s gone if a month passes without seeing it.  It’s been only a week and a half.

Stress Hormone Overnight Test

Just a quick note – I ate some sugar along with protein and fat (and a glass of wine) last night before bed and this morning my fasting blood sugar was 108!  That’s the lowest it’s been in a long time.  Plus, this morning I felt hungry when I woke up, but I don’t feel hungry all morning long despite eating, as I typically do.  Amazing!

Analysis Paralysis

Yesterday I was in the car for 4 hours, and in that time I listened to 3 or 4 podcasts featuring Ray Peat.  I think I understand now why I’m having trouble with hunger in the mornings but less so in the late afternoon and evenings.  I start each day in a state of metabolic stress.

Here’s how it works:  A healthy person can store enough glycogen in their liver to get through the night (8 hours) without running out.  I’m not healthy.  What happens overnight is I run out of glycogen (which the body uses to maintain a healthy blood sugar level).  The body’s first reaction to running out is to increase adrenaline, which “squeezes the last bit of glycogen out of the liver,” according to Peat.  That same adrenaline will sometimes wake you up in the middle of the night.  If you don’t eat when this happens the body’s next step is to increase cortisol.  Cortisol is the guy that turns protein into glucose for the body to use (gluconeogenesis).  Protein, meaning muscle.  Hmmmm…so you don’t eat enough sugar, and your body raises cortisol to turn your muscle tissue into sugar.  The appetite is suppressed (which is why I used to love low-carbing), but the thyroid is also suppressed in order to reduce the number of calories required to live. Our bodies are remarkable at shutting down important processes to keep us alive.  All about the big picture.  Anyway, yadda yadda yadda, now I have a lot of cortisol-induced abdominal fat and sub-optimal thyroid function.

Another thing I learned is that it’s the lowering of stress hormones that makes you feel tired after eating a high-carbohydrate meal when your body has been depleted of glycogen.  I’ve always wondered about that.  So you’re cruising along on the adrenaline/cortisol high of low-carb and suddenly you decide to have some orange juice or some rice…or you supplement thyroid hormone.  In an hour you’re exhausted.  Yeah, that’s because finally your body is able to rest and put the stress hormones away because you finally fed it what it needs.  So your true fatigue shows up – the fatigue resulting from pushing yourself, staying up too late, waking up too early, running on adrenaline all day long.  Suddenly you feel all of it.

So it seems I wake up with my body all saturated with cortisol from having no glycogen stores overnight.  I’m going to focus on a pure Peat-friendly diet (no starches, which I’ve been eating sporadically) and I’m going to stop measuring my blood sugar throughout the day (with the exception of fasting blood sugar in the morning).  I’m going to listen only to hunger cues.  I think all the testing and micromanaging of my blood sugar, pulse, temperature, calories, macronutrients, and weight is interfering with me actually learning to feel what I need to be healthy.  Also, I’m going to eat some fruit and/or sugar before bed and see what that does to my fasting sugar levels and my hunger the following morning.

Update:  Wow…this chick said it way better than I ever could.

Cortisol and Weight Loss: Questions

In my post yesterday, I wrote the following:

The problem with low-carb diets is the following:  The body releases insulin to process the amino acids in proteins.  When insulin rises, the body needs to raise blood sugar to avoid hypoglycemia.  If there’s no glycogen (sugar) stored in the liver cortisol is released instead, which increases blood sugar.  Cortisol suppresses thyroid function and immune function, and lowers metabolism.

I was paraphrasing what I heard Ray Peat say in an interview about sugar and carbohydrates.

But over the last 24 hours I’ve been thinking about this.  If this is the case, then why do so many people have success losing weight with low carb diets?  I decided to go back and listen again to make sure I really understood what he was saying about cortisol being released when you don’t eat carbs.  Here’s an actual transcript:

Several of the amino acids in proteins are powerful insulin stimulants, and when you eat protein by itself, you stimulate insulin secretion which is needed to metabolize the amino acids. But in reaction to the insulin, your liver has to put out glucose to keep your blood sugar going so your brain and blood cells and kidneys and so on can keep working.  And if your liver is somewhat low on glycogen, then every time you eat protein and have an insulin secretion, your body secretes a compensating amount of cortisol to bring your blood sugar back up.  But the cortisol brings your blood sugar up at the expense of protein.

[…] The first tissues that cortisol breaks down are the thymus gland and other immune cells and the muscles and if you eat lots of protein in spite of the high cortisol, you can keep your balance so you are replacing your muscles and thymus gland but you are running on a constantly high cortisol secretion.

Yeah, I heard him right.  So given this, how come people are able to lose weight on low-carb diets?  Is he saying that weight loss from low-carbing is all loss of lean tissue?  How about people who lose LOTS of weight eating low carb?

He goes on to say:

[…] I’ve seen that doctors simply neglect to measure hormones that were related to blood sugar when they would prescribe insulin, calling a person a diabetic, they said they needed to take insulin the rest of their life.  But, having some of these people test their cortisol, we saw that very many of these so-called diabetics just had very high cortisol.  Sugar happens to be the best thing for lowering cortisol to normal, and since high cortisol gives the impression of diabetes, causing high blood sugar, you get the unexpected effect of when you eat sugar you lower the cortisol, and some of these people had a very quick recovery from their so-called diabetes.

This explains why a lot of low-carbers have what they like to call “Physiological insulin resistance,” (as opposed to “Pathological Insulin Resistance”, I think).  It’s not real insulin resistance – it’s just the effect of high cortisol secondary to low-carb intake.

Which leads me to another question – when I was low carb, how come my cortisol didn’t test high(Update: The answer to this question is in the comments of this post.)

Adrenal Stress Index Results

Here are my current cortisol lab results:
Hormone Test 3/23/2012 11/14/2012 6/30/2013   Units Range
DHEAS (saliva)
15.4
5.3 8   ng/ml 2-23 (Age Dependent)
Cortisol Morning (saliva) 9.6 7.6 5.8   ng/ml 3.7-9.5
Cortisol Noon (saliva) 1.3 1.3 1.5   ng/ml 1.2-3.0
Cortisol Evening (saliva) 0.9 1.3 1.4   ng/ml 0.6-1.9
Cortisol Night (saliva)
0.5
1.6
0.3
  ng/ml 0.4-1.0
Current results are in bold, and are shown compared to the last 2 times I had this test done (about a year ago and about 6 months ago).  According to Dr. Myhill, I’m recovering, as evidenced by normal DHEAS  and low cortisol.  Great.  Well, most things are in range – night time cortisol is a bit low, but I’m not sure I care about that, except that suggests overall low cortisol production.  I’d like morning and noon levels to be higher.  I guess I’ll be looking into adaptogens and supplements.  We’re all moved in to the new place.  I’m looking forward to things.  I have been sleeping well and don’t feel completely tired.  I think I just need to go to bed at a reasonable time.

Virgin Diet – Day 4

For the first time this week I really wanted carbs today.  I suspect this is related to drinking wine last night.  Didn’t give in though – still adhering closely to the rules of the Virgin Diet.  I have learned a couple of things about myself in the last few days.

I’ve always loved sushi – today I found out it’s not nearly as delicious when it’s not drenched in soy sauce (which is made of wheat and soy – 2 items banned by this diet).  Still good though, but not head-exploding good as it usually is for me.  Also, I learned that when I accidentally let my blood sugar get too low it takes me a long time to recover and for the next several hours – even after eating and after feeling relatively full – my appetite stays high.  A couple days ago it was 5 or 6 hours after breakfast – I was enjoying not thinking much about food and just sort of let it ride and skipped lunch.  Then around 3PM my blood sugar dropped quickly and I felt ravenous.  I was at a store and there was nothing on-plan to eat with me or in my car.  I was feeling pretty bad by the time I actually got to eat – my blood sugar had dropped further and I was really irritable.  I ate shrimp and vegetables and a broth-based soup – enough that I should have been full…but I just wanted to keep eating.  I ate probably the equivalent of another dinner over the next several hours – I just felt driven to keep eating.  It was like my body was programmed to stock up to avoid the inevitable next famine.   Anyway, I stayed on plan with everything I ate, and the next day the scale was the same.  If I had eaten even one piece of bread though, I know it would have all been stored as fat.

The scale today was down another pound – so that’s 2 pounds since I started this, and I’m not attempting to eat low carb/ketogenic/low salt – I’m just avoiding those 7 foods.  I’m eating rice and potatoes and drinking wine.  The loss today could be dehydration from drinking wine last night, so we’ll see what happens tomorrow.

So far it’s a tentative thumbs up for the Virgin Diet.

What I’ve eaten today:

Breakfast: Wild-caught salmon fillet sauteed in coconut oil and 1/2 of an avocado.

Lunch: 2 grass-fed hot dogs with dijon mustard

Snack: sushi (minus soy sauce but with rice and wasabi)

All I drink is water.  I do use caffeine pills – not the greatest thing ever if you have adrenal fatigue, but I don’t care.  I take in the equivalent most days of one cup of coffee.  I actually think my adrenal fatigue is getting better.  When I was in California and for the first few weeks after getting back here I had a very hard time getting out of bed in the morning.  Now it’s much easier – closer to how it was before we went West. I also get tired earlier at night.  This indicates to me that my cortisol is higher in the morning and lower at night again.  So things seem to be turning around for the better.

Updates and Psychological Challenges

I had an ultrasound yesterday as a preventative measure to detect ovarian cancer.  In order to get the test covered by insurance, my PCP had to write on the form that she “couldn’t find” my ovaries during my pelvic exam last week, making an ultrasound necessary.  This tells me that my insurance would rather pay to treat cancer than pay to prevent it.  Health care is not best served by Capitalism.  Anyway…had the ultrasound.  Don’t have results yet.  I don’t expect anything to be wrong, but you know…Dr. K. said I was at high risk, and typically ovarian cancer is well advanced by the time it’s detected.

Got some blue-blocker glasses to wear at night.  It’s so not a big deal…not sure why I waited this long.  I used them last night.  Slept well, but then I usually do.

About every other day or so my appetite is really low these days…like I can go 8 hours between breakfast and lunch.  Some days though I’m still getting hungry at (or before) regular meal times.  Yesterday I was starving and it was still an hour or so before lunch.  Ate all the kid-snacks I happened to have in my purse, which are all Paleo-friendly but higher in carbs than I typically eat.  Oh well.  It’s hard to plan snacks on the go when one doesn’t eat any snack foods.   I suppose I could bring meat and vegetables for a snack.  Not. Convenient.

Yesterday I was a little weepy toward the end of the day.  Maybe some of this estrogen is actually soaking through my skin the way it’s supposed to.  Weepy = too much estrogen.  Bitchy = not enough estrogen.  Interesting.  I’m not a jerk after all!  When I look back on my life I realize I may have never been depressed at all.  Just weepy and bitchy…which are symptoms of depression, of course…but also symptoms of screwed up hormones.  I remember as far back as age 14 being depressed.  I was terribly lonely much of my life.  Hard to separate out the emotional effects of loneliness vs. depression vs. hormone junk.  What I do know is that it was never managed well.

I read this a couple days ago:

Tension is who you think you should be.  Relaxation is who you are. – Chinese Proverb

It was actually on Dr. K’s Facebook wall.  It got me thinking, and indeed the times in my daily life that I feel tense are times that I think I need to hide who I really am in favor of who I think I should be.  I’m going to challenge this tendency to hide out, using physiological tension and relaxation as a guide.  If I find myself feeling tense, I’m going to ask myself in what way I’m not being true to myself in that moment.  And then I’m going to fix it.

I suspect a lot of my cortisol issue is related to this…to feeling like I have to be something I’m not every time I step out of the house.  To feeling like there’s something wrong with me that has to be covered up.  I find it exhausting.  I’ve felt that way ever since I was 14 and felt truly alone for the first time.  Fortunately I feel I can be myself at home, with my husband and little girl.  I just need to generalize this to the greater world.

A new challenge.

More Steps

Got my labs drawn yesterday.  I don’t know if they’ll be covered by insurance.  It doesn’t matter.  I don’t understand insurance.  If labs are drawn by the clinic I go to for my primary care but are ordered by a doctor who may or may not be covered, then are the labs covered?  I don’t know.  I figure I’ll be notified if I owe some dough.

Sorry for my extremely whiny post yesterday.  I have been feeling sick and run down this week.  I was diagnosed with Asthma 10 years ago and have had very few issues with it over the last 3 years or so…but this week I’m having a hard time breathing.  I thought I was getting sick but all it is is trouble breathing.  I brushed the dust off of my Albuterol inhaler yesterday and using it seemed to help, so I’m wondering if I’m having an allergic reaction to something.  I do live in farm country and we haven’t had much rain.  Could be lots of dust in the air.  All I know is if I can’t breathe nothing feels right.  I’ve arranged to take a day off work this week to get caught up on other things and to rest.

It occurs to me that if I start hormone therapy I won’t be able to do CT for quite a while.  The PA will be monitoring my hormone levels for 2-3 months at least, and it’s going to cloud the picture if I’m releasing extra estrogen into my system via CT.  Well, that’s ok I guess.  I miss doing it but also I suspect my cold tolerance will be better when my hormones are optimal.

In the interest of adrenal recovery, I borrowed an emWave from a friend so I can try out biofeedback.  I’ve experimented with it just a little in past years, but never with any real intention or motivation behind it.  Now that I know what my health issues are I feel very motivated to fix them.  Stress and cortisol management are clearly among them.

I’ve been reading lately that hormonal problems can lead to fatigue, as can adrenal/cortisol issues.  My energy picked up quite a bit just by doing the Leptin Reset.  Before I could barely scrape myself off the couch after work, and always needed a nap.  If I couldn’t take a nap for whatever reason I would just cry with frustration.  Now it’s better but I still wish I could just lie around a lot more than I do.  My husband thinks it’s normal to feel that way when you have  2-year old and a job.  I think it might be typical, but that doesn’t mean it’s normal.  Previous generations were busy all day long finding food, cooking, cleaning, and teaching and raising their kids instead of plopping them in front of the TV.  There’s a certain level of energy that human beings should have but don’t, and we don’t even question it.  I want to have energy all day long and feel lit up about life. I don’t want to need caffeine to function.

The PA emailed me yesterday to let me know she’ll contact me after she receives my labs.  I appreciated that, and I’m very glad she’s open to communicating via email.  I was so busy complaining yesterday that I forgot to mention, I did really like the PA.  She seems to be confident she can help me, and in fact was in the same situation when she was my age, about 5 years ago.  I’m looking forward to working with her.