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Jun 28, 2021•20 min
Question: Do some people do well on ketosis because they have defective glucose metabolism?I doubt that that's the majority of people that feel good in ketosis, but certainly people with GLUT1 defects need to be on a low-glycemic index diet at least, if not a keto diet in order to not have seizures, and that's the best example of what would fit with that. People who do poorly with glucose, maybe in more moderate ways are going to do better on fat. If you would like to be part of the next live As...
Mar 17, 2021•4 min
Question: What to do when different folate markers don't line upYou know, if you have high figlu on the NutrEval, which is Formiminoglutamic acid, which rises when there is Tetrahydrofolate THF, unmethylated folate, to metabolize figlu, and in that case, I would be thinking about maybe you have a B12 deficiency that is leading to the trapping of folate as the methylfolate form, so that THF isn't regenerated for that reaction. So I would absolutely never use figlu as the only marker of folate. I ...
Mar 16, 2021•5 min
Question: Can sulforaphane hurt the thyroid?What I can say is that sulforaphane does generate thiocyanate ions, which do inhibit uptake of iodine into the thyroid and mammary glands. Although that is a matter of the ratio between isothiocyanate, or between thiocyanate ions and iodine. And so in principle, most uses of sulforaphane, in the context of adequate iodine shouldn't be an issue. I believe at some dose you're going to run into a problem with balancing with iodine, especially in people wh...
Mar 15, 2021•5 min
Question: Are the PUFAs in phosphatidylcholine supplements a concern?I don't think so. I think that you're looking at fairly low levels of PUFAs in there, but the way that I see it is yes, we want to restrict PUFA beyond what's needed, but what's needed is defined by what do we need to get our essential nutrients in. If you would like to be part of the next live Ask Me Anything About Nutrition, sign up for the CMJ Masterpass, which includes access to these live Zoom sessions, a private discussio...
Mar 12, 2021•3 min
Question: Is dairy safe for overmethylators?There's so little methylcobalamin in milk that I think that it is totally insignificant with regards to methyl groups, coming into the methylation cycle. Generally, if you're experiencing over-methylation symptoms from methylcobalamin or methylfolate, I think the big issue is partly that you don't have enough glycine in the system, very likely, and partly that your body is over-accustomed to low methyl supply and putting more suddenly into it leading i...
Mar 11, 2021•5 min
Question: Should different macronutrients be eaten at different times of day?No, I don't agree with the principle. I think you want protein spaced out at every meal. And that's because your efficiency in extracting protein for muscle synthesis is limited in any given hour or any given unit time. And so you need a lot more protein if you're going to put all your protein in one meal, then you are not going to get optimal body composition results from that. Body composition plays into every other m...
Mar 10, 2021•5 min
Question: Is it OK to take two milligrams a day of MK-4?Two milligrams, I don't have major safety concerns over, but I would prefer for most people who aren't dealing with a clinical soft-tissue calcification issue take more like 200 micrograms. If you would like to be part of the next live Ask Me Anything About Nutrition, sign up for the CMJ Masterpass, which includes access to these live Zoom sessions, a private discussion group, premium features on all my content, and hundreds of dollars of e...
Mar 09, 2021•3 min
Question: How to feel great on a poor night's sleep?I would say get rid of the poor night's sleep. And so that's go through the checklist of two to four hours of blue light blocking before bed, up to two to four hour, depending on your needs, psychological winding down routine, in which you clear everything off your to-do list, everything off your problem-solving list, focus on a paperback fiction, TV, video games, movies, et cetera. Deal with all those things first, because I don't think there ...
Mar 08, 2021•8 min
Question: What supplements should be taken by someone on PPIs?I would first consider what you should do to get off the PPI. And so PPIs Are targeting stomach acid. And so I would first and foremost be thinking of excess histamine might be leading to excess stomach acid. You should probably try to eat a higher-protein diet, unless you're getting negative consequences from poor protein digestion. But if you're poorly digesting your protein, you are going to need more protein to nourish yourself. S...
Mar 05, 2021•6 min
Question: Could methylglyoxal be causing elevated fasting glucose in low-carbers?Yes. I did my doctoral dissertation on methylglyoxal so I've covered it in a lot of different contexts, and the basic story is we know that diabetics have high methylglyoxal levels. We know that diabetics have high methylglyoxal-derived advanced glycation endproducts. And we know that this is true even when they're treated. Now that raises the question, does diabetes cause methylglyoxal to increase, or does methylgl...
Mar 04, 2021•8 min
Question: Is it important to hit the AI for total omega-6?I think it's totally normal to not meet the AI for Omega-6 and to exceed the AI for Omega-3. Question is really, if you have systemic inflammation going on, you frame this as, should I strive to at least meet the AI for Omega-6 if I have chronic disease/inflammation? Well, if you have chronic disease/inflammation, you might be depleting your Omega-6, which means depleting arachidonic acid, which means you might need more arachidonic acid....
Mar 03, 2021•8 min
Question: How 30 minutes on the elliptical helps my head and neck tensionSo what the elliptical does is, it doesn't do a whole lot for moving my neck one way or another, but it does a lot for moving my thoracic spine and my shoulders through a pretty defined range of motion, not full range of motion going like this is, but it's a lot of movement through a considerable amount of that range of motion, and I think it's sufficient to give my thoracic spine and my shoulders a lot of circulation of fl...
Mar 02, 2021•11 min
Question: Why does it take time to be fat-adapted when our body already knows how to burn fat?So the body does need time to get fat-adapted because yeah, the body knows how to burn fat, but fat adaptation is not about the body knowing how to burn fat, it's about the body increasing the expression of enzymes involved in burning fat. So everything that you do in the body requires enzymes. Enzymes are proteins that need to be made. It's going to increase enzymes involved in fat digestion and metabo...
Mar 01, 2021•5 min
Question: What should someone with FH eat if they also have prediabetes?So first of all, it's a separable component of the diet so you need a low-saturated fat, low-cholesterol diet without necessarily eating a low-fat diet. Then second of all, the effect of that on blood lipids is dependent on the healthfulness of your insulin pathway. And so over time, that's something where you can play the balance between those two things and as you improve your blood glucose handling, you can fit in more ca...
Feb 26, 2021•14 min
Question: How should I take zinc if it makes me nauseous?As far as I know, there's no relationship between the nausea and zinc deficiency. I could be wrong, maybe there's research on it I haven't seen or it could be not researched but I don't think there's a connection. My guess would be that that is either related to her ionizing it faster in the GI tract than you, or something else related to her nausea impulse that might be nutritional, it might be genetic, it might be male/female. You could ...
Feb 25, 2021•7 min
Question: Can familial hypercholesterolemia be managed without statins? I think there's the general perspective that there's no point in having LDL-C be any higher than 50; therefore, since it doesn't matter, let's provide a sufficient margin of error where we're real confident that getting it down to 100 is great and so why not get it down to 50? If there is any extra protection we get it and we don't lose it. So my point of view would be, I would personally rather use a more conservative targe...
Feb 24, 2021•15 min
Question: Is this a biotin deficiency? Beta-hydroxyisovaleric acid is well-established to be the most sensitive marker of biotin status. And actually typically it's done after leucine challenge, which is, no one does that. And so, generally in my experience, the way they have the reference ranges set on that should, on the ones that do have it, so the ION panel has it, the Genova panel has it, and the way they set the reference ranges, I think it works without the leucine challenge. But, I prefe...
Feb 23, 2021•13 min
Question: Why do vitamin E requirements stay elevated for four years when we stop eating PUFA? None of this really proves that long-term vitamin E status is compromised, and that will make the clinical effect of PUFA be net negative after four or five years. But it does show you that the general relationship between the fact that you get more vitamin E when you eat PUFA oils, right? Because in the plant, the plant doesn't have this turnover problem, the plant makes vitamin E whenever it wants. A...
Feb 22, 2021•20 min
Question: How long should our fasting windows be?I think someone who eats three meals a day and no snacking is doing a form of intermittent fasting that most people aren't doing. And I don't even have a basis for believing whether that is superior, inferior, or the same as one meal a day in a 20 hour, four-hour feeding window. And so I think it's very clear that you want to cycle through the fed and fasted states. I think exactly how you do that is all trial and error and anecdotal accumulation ...
Feb 16, 2021•4 min
Question: What is the value of third party genetic reports?There are very, very few genes where we have really good information on how they impact nutritional requirements, but we have many, many, many genes where we have decent information on what they do mechanistically and where we can speculate things that might be helpful. So genome analysis is very useful as a brainstorming mechanism. And of course, there's genome sequencing in a clinical context to identify rare metabolic diseases, a tota...
Feb 15, 2021•5 min
Question: What is the value of the oxidized phospholipids test?It's interesting to measure, but we don't have real strong data on its correlation to disease risk. And we also don't really know how much it reflects the oxidation of lipoproteins in the subendothelial space, which is what matters.If you would like to be part of the next live Ask Me Anything About Nutrition, sign up for the CMJ Masterpass, which includes access to these live Zoom sessions, a private discussion group, premium feature...
Feb 12, 2021•3 min
Question: Can NADH supplements cram more NADH into the system?The NADH will be hydrolyzed to something along the lines of nicotinamide riboside, it will be absorbed and it will act like nicotinamide riboside does, which will increase the amount of nicotinamide stored in the liver for release to the tissues. And that will help increase their NADH levels.If you would like to be part of the next live Ask Me Anything About Nutrition, sign up for the CMJ Masterpass, which includes access to these liv...
Feb 11, 2021•3 min
Question: How to avoid losing nutrients in fat thrown out from an organ meat blendI don't think you're going to lose that many nutrients because the 25% fat, 75% lean ground beef mixed with those organs, most of that fat is coming from the marbling of the beef. That's not coming from the organ meats. Most of the nutrients in the organ meats, and they're not in marbled fat they're in cells and stuff.If you would like to be part of the next live Ask Me Anything About Nutrition, sign up for the CMJ...
Feb 10, 2021•3 min
Question: How to manage the zinc-to-copper ratio?I don't agree with using the zinc/copper ratio in testing. So it is the case that zinc and copper need to be in a very loose range of ratios. So you don't want your dietary zinc to be more than 15 times your dietary copper, and you don't want your dietary zinc to be less than two times your dietary copper. But other than that, you're really looking at them individually, and you're looking at, do I have enough zinc? Do I have enough copper? Do I ha...
Feb 09, 2021•4 min
Question: Milk thistle, sulforaphane, and blood donation for iron overloadIf it's an uptrend, you probably want to do something about it. Someone in that situation could try the Nrf2 stimulators, like milk thistle and sulforaphane. But if it is a genuine uptrend in early stage iron overload, that might be a situation that giving blood once a year would be the best solution.If you would like to be part of the next live Ask Me Anything About Nutrition, sign up for the CMJ Masterpass, which include...
Feb 08, 2021•9 min
Question: Why would methylated vitamins increase pain sensitization?I'm not sure. Just to throw out some random threads that may or may not be of use. I think methylation in some people is going to lead to increased synthesis of dopamine. But in general, the effect is going to be to decrease the tonic pool of dopamine. There's going to be some degree to which it decreases other neuro-transmitters. And it's possible that if, particularly, if glycine is not stabilized, that you're going to lose th...
Feb 05, 2021•7 min
Question: Why would ferritin and B12 increase on a low-calorie keto diet?Ferritin is very strongly influenced by inflammation, oxidative stress. And so if the iron status is not changing and the ferritin is going up and then down, to me that suggests that oxidative stress or inflammation is increasing in the hypocaloric state. I was thinking maybe there's more PUFAs and stronger favoring of oxidative stress when there's more PUFAs released from adipose tissue during the hypercaloric during a hyp...
Feb 04, 2021•7 min
Question: Why are polyunsaturated fats more easily burned for energy than saturated fats?I don't know in detail the mechanism, but I do know that it's been shown in human cells and in live animal experiments. And it presumably is related to the affinity of the enzyme for the fatty acid. And that's not something that's biochemically difficult. It's normal if there are enzymes that work with any fatty acid, for them to have different affinities for some fatty acids versus others.If you would like ...
Feb 03, 2021•10 min
Question: Why zinc deficiency causes resistance to thyroid and sex hormones and vitamins A and DThe answer to that is because the, because all of those things carry out their gene expression function by binding to nuclear receptors. And all of the nuclear receptors to DNA using zinc finger motifs. Zinc finger motif means that in the nuclear receptor, there's a zinc ion that coordinates the primary structure of the protein, which is a long string of amino acids into a finger shape.If you would li...
Feb 02, 2021•6 min
