PPNF Journal: Fall 2019 - Volume 43 Number 2

Price -Pottenger Journal of Health and Healing Vol. 43 / No. 2 ~ Fall 2019

BEAT PAIN WITH THE GOKHALE METHOD When It’s Not Actually Depression Is the Ketogenic Diet Right for You?

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Price-Pottenger Journal of Health & Healing Vol. 43, No. 2

Fall 2019

Editor in Chief

Edward Bennett

Managing Editor

Roberta Louis

Contributing Editor

Mark Bielsky

Proofreaders

Rachel Ramsey Cathy Lombardi

The Price-Pottenger Journal of Health and Healing is published quarterly by the Price-Pottenger Nutrition Foundation, Inc. ISSN# 1553-1090 Copyright Š 2019 by the Price-Pottenger Nutrition Foundation, Inc. All rights reserved.

Office and mailing address: 7890 Broadway Lemon Grove, CA 91945 Email: info@price-pottenger.org; Article submissions: editor@price-pottenger.org

IN THIS ISSUE FEATURES Living Pain-Free with the Gokhale Method: An Interview with Esther Gokhale.........................4 Ryan Kennedy, CCN, CFMP, CTN Psychiatric Pretenders: Physical Imbalances that Mimic Mental Health Disorders......................................13 Kelly Brogan, MD

DEPARTMENTS Clinical Perspective: The Ketogenic Diet and Your Health...................23 Sherry A. Rogers, MD In the News............................................................27

The information in this publication is for educational purposes only and is not intended as medical advice. Always consult with your physician or other qualified healthcare provider with any concerns you may have regarding a medical condition.

Price-Pottenger assumes no responsibility for errors in, or applicability of, any statements contained herein. All opinions expressed are those of the respective authors and do not necessarily reflect those of Price-Pottenger.

Family-Favorite Recipes......................................30 Sarah R. Smith

Price-Pottenger assumes no liability for products and services advertised by third parties.

Photo courtesy of gokhalemethod.com.

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Marketplace........................................................... 34 Calendar of Events............................................... 40

ON THE COVER Esther Gokhale demonstrates proper sitting position.

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Fall 2019 / Vol. 43, No. 2

Weston A. Price, DDS

Francis M. Pottenger, Jr., MD

Executive Director - Joel Dauteuil ACTIVE BOARD President - Mark Bielsky Vice President - David J. Getoff, CCN, CTN, FAAIM Treasurer - Andrew J. Zakarian, DDS Secretary - Mary Ann Sowards, MA Curator - Edward Bennett Heather Dane, MEd, CPC Nora Gedgaudas, CNS, NTP, BCHN Neil Hirschenbein, MD, PhD, CCN ADVISORY BOARD

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Annie Dru Allshouse, CCE Mark Anderson Lauren Barbrey, LAc Vivian Blackstone Kelly Brogan, MD Mary Ann Brummer, PhD Lee Clifford, MS, CCN Sean Croxton, FDN Helena S. Fischer Gray Graham, NTP Joan Grinzi, RN Julia Irons Patricia Kane, PhD Hollis H. King, DO, PhD Joseph Mercola, DO Sylvia Onusic, PhD, CNS Richard Pooley, MD David Richard Carol B. Simon, JD Bruce West, DC William L. Wolcott

Koushikai (Japan) Olympio F. Pinto, CD, MSC (Brazil) Vicki Poulter (Australia)

Vol. 43, No. 2 / Fall 2019

HONORARY Kim Bechthold Walter Jess Clifford, PhD John Diamond, MD Ann Louise Gittleman, PhD Norman Goldfind David C. Kennedy, DDS Sherry Rogers, MD Fred Walters Jonathan V. Wright, MD

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The mission of Price-Pottenger is to educate people on the remarkable benefits of a natural plant- and animal-based diet and inspire individuals to live a healthy lifestyle.

We are a leading resource for practical and current information on nutrition, food preparation, disease prevention, natural medicine, environmental influences on health, and more.

Founded in 1952 and known early on as the Weston A. Price Memorial Foundation, the organization later became the PricePottenger Nutrition Foundation to honor the invaluable contributions made by Weston A. Price, DDS, and Francis M. Pottenger, Jr., MD, to our understanding of diet and disease. Price-Pottenger is the repository for their work and that of other prominent researchers in the health and nutrition field. The Foundation continues to publish Dr. Price’s Nutrition and Physical Degeneration as well as Pottenger’s Cats: A Study in Nutrition, the book documenting Dr. Pottenger’s classic experiment.

Price-Pottenger is a nonprofit 501(c)(3) public education corporation supported by membership, donations, and sales of educational materials. Members have access to video courses, online tools and tips, and current and past articles, and are entitled to discounts on select lectures and bookstore purchases. Professional members also receive a free listing on our website to help them connect with clients.

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FROM THE EDITOR Dear Members and Friends, It is not news that our modern society has lost its way when it comes to using our ancestral knowledge in choosing foods that are nutritionally dense, such as those our healthy forbearers thrived on; one can readily see the tragic results from the proliferation of refined and “fast” foods. But something else we have lost, and an issue of perhaps equal importance, is our awareness of how the biomechanics of our bodies affects us. Backaches and other musculoskeletal problems are accepted as normal parts of daily living, and, all too often, our response is to find relief through over-the-counter and prescription drugs.

In this issue, Esther Gokhale, creator of the Gokhale Method, points out that we can learn much from observing people in pre-industrialized societies who avoid many of these problems by maintaining proper posture, even when carrying heavy loads or lifting heavy objects. In a fascinating interview, she explains the basics and benefits of her systematic approach to relieving pain and correcting dysfunction, using exercises and practices that can be easily done by most anyone. By teaching us how to move correctly as we go about our everyday activities, such as walking and even sitting, Esther shows how it is possible to change not only how we look, but how we think and feel.

Our state of mind is, of course, also influenced by other aspects of our physiology. In fact, various medical conditions have been incorrectly diagnosed as depression or other mood or mental disorders.

Holistic psychiatrist Kelly Brogan, MD, has shown in her new book, Own Your Self, that many issues may be successfully addressed by identifying what she calls “psychiatric pretenders.” In an excerpt from the book, presented here, Dr. Brogan points out five pretenders that are routinely undiagnosed and explains how to correct them with the help of natural methods.

The ketogenic diet and its variants have become among the most popular regimens of recent years.

Because its basic premises fly in the face of established dietary thought, one might well ask if the ketogenic diet is suitable for everyone. In another article in this issue, health expert Sherry Rogers, MD, publisher of the Total Wellness newsletter, explains the fallacy behind the fear of high-fat foods, and discusses who might benefit from the diet and how best to go about it. To determine if one’s current biochemistry can utilize it properly, she recommends looking at one’s total health history and getting specific laboratory tests, making needed corrections before starting a ketogenic diet.

Enjoy this issue of the Journal and share it with your friends. Your comments, as always, are welcome.

We can be reached at editor@price-pottenger.org.

Yours in good health,

Edward Bennett Editor in Chief

At this time of year, we are reminded of how much we have to be grateful for, in spite of the many troubles throughout the world. Our board of directors, editorial committee, and office staff wish you and your family and friends a joyous holiday season and thank you for your continuing support.

Price-Pottenger Journal

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Fall 2019 / Vol. 43, No. 2

Living Pain-Free with the Gokhale Method An Interview with Esther Gokhale

by Ryan Kennedy, CCN, CFMP, CTN

In today’s modern world, the majority of people have lost connection with the proper biomechanics and physical functioning of their bodies. As a result, many individuals suffer from chronic pain and dysfunction. Yet rather than trying to correct the structural issues that are the root cause, many fall into the trap of masking their symptoms with pain medication and other means just to get through the day. The amazing thing is that this physical dysfunction is often reversible. With the right practices, you can improve your posture and alleviate your musculoskeletal pain.

Esther Gokhale (pronounced “GO-clay”) is the creator of the Gokhale Method, a unique, systematic approach that helps people find their way back to painfree living. Esther is the author of the book 8 Steps to a Pain-Free Back, which has sold over 200,000 copies and has been translated into 10 languages. In 2010, she hosted the nationally televised program Back Pain: The Primal Posture Solution (now available on DVD). She has taught at many corporations, including Google and Facebook, and she’s been a speaker at numerous conferences, including TEDx. ●●● Ryan Kennedy: Let’s start by diving into your backstory. What got you interested in the field of posture and proper biomechanics?

RK: What led you to believe that posture was the solution to your back pain?

Esther Gokhale: I came to it the hard way, like many people come to their passions. I had a series of back pain episodes in college, and then the pain really hit me hard during my first pregnancy. At month nine, I had a herniated L5-S1 disc at the lumbosacral joint, as well as sciatic Vol. 43, No. 2 / Fall 2019

pain shooting down my left leg. I was told that the baby could be sitting on a nerve, and it might be okay after childbirth. It wasn’t. The pain just got worse and worse, and it got to the point where I couldn’t carry my baby around.

I couldn’t even carry a cooking pot. At night, I would wake up every two hours with a back spasm and have to walk around the neighborhood to relieve it.

I tried all sorts of things, from the usual conservative approaches, such as physical therapy and strengthening exercises, to complementary medicine, including acupuncture and massage.

Nothing worked. I ended up with back surgery— a laminectomy-discectomy. That helped for a while, but a year later, I had a reherniation of the same disc, and the doctors proposed another surgery. There I was in my mid-20s, having always thought of myself as super healthy—I was even a yoga model in Bombay—and suddenly I was facing lifelong disability. It wasn’t until I looked at the problem very differently that I found a solution.

EG: All the interventions I had tried were more or less like band-aids. Even acupuncture, which helped relieve my symptoms for a while, didn’t get to the root of the problem. Only when I tried methodologies that really addressed the way I moved and the way my spine was structured did I find sustained relief. That made me realize that

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RK: I find that a lot of people underestimate the importance of posture and don’t identify it as a possible culprit for their dysfunction and pain. But how does posture affect one’s overall health?

EG: The most obvious repercussions of bad posture are on our nuts and bolts—our joints, muscles, and bones. The human body has components that need to be used in a certain way, and if you misuse them, there will be wear and tear. But when you change your musculoskeletal system, you’re also influencing the way your organs orient, the space you give them, and their blood and nerve supply. Posture affects your circulation, your breathing, the functioning of your organs, and your overall physiology.

What’s recently being seen in the literature is the connection that posture has with emotional well-being. Increasingly, there are studies showing a relationship between posture and depression, or posture and confidence and mindset. That’s not so surprising if we think about the way we know how an animal is feeling. For example, if a dog has its tail between its legs (the equivalent in the human animal is a tucked pelvis), we know that that dog is depressed, submissive, or fearful. If that dog has its head high and is standing very erect with its tail out behind it, we know that it is well and happy. So, it is Price-Pottenger Journal

not surprising that in the human animal as well, there is a correlation between mental health, mind state, wellness, and posture.

RK: Often, when you see someone slouched over, you can tell that they’re down or upset about something. When you see someone standing straight, with their shoulders back and great posture, they appear to be happier and have more energy and vitality.

EG: They actually do have more energy and vitality, and the research is beginning to show this. Although people in our culture are not trained to read these cues, we subconsciously pick them up. Sometimes, our students come back with reports on how a friend asked them if they had lost weight or changed their hairstyle.

Although the friend didn’t consciously identify a postural change, they recognized that something was different.

There’s a book called Emotional Contagion in which the claim is made that when we have mind shifts, they register in our bodies. Then, because human beings are mimics, we copy each

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Courtesy of gokhalemethod.com

posture and proper movement were key parts of the solution.

Also, I had grown up in India, and I’d seen people who carried very large loads while selling their wares or doing construction work fare very well under impressive challenges. In addition, my mother would point out various people, such as the sweeper in our home and the fruit seller, and marvel at how amazing their carriage was and how functional they were. All that had registered in my awareness from childhood, so it made sense to me that there was some systematic error in the way I was using my body.

I started delving into the medical literature and into anthropological and historical data and finding proof that there is something different about how the people in nonindustrial cultures use their bodies and how their spines are shaped.

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other’s body cues and posture. This loop is completed when we scan our own body for cues on how we’re feeling. If, for example, we find our mouth in the shape of a smile, we conclude that we must be happy, and that, in turn, elevates our mood. If we scan our body and find confident, happy posture, we conclude that we must be happy, and then we become happy.

It has been scientifically demonstrated that mindset can register as posture and get picked up by other people who copy that posture. Their minds then identify that posture and pick up the corresponding mood or mind state.

RK: You’ve visited many parts of the world in your research. How common is back pain in other countries that you have visited, relative to the United States?

EG: It’s a changing landscape. In modern Western cultures, for a while now, we have suffered greatly from musculoskeletal problems, back pain being the leading one. But that is now also becoming the case in other cultures as they get urbanized, Westernized, and industrialized.

What’s particularly sad is that in village-based, nonindustrial cultures, which historically have very low back pain rates—only about 5 percent in some cultures—industrialization leads to problems worse than what we have in the Western world. In nonindustrial cultures, if you lose your healthy traditional systems, you don’t have all the buffers that we have developed in modern Western societies. Here, if you have back pain, you can take ibuprofen. You can take a day off or even change your job. There are all sorts of hacks and semi-solutions that we can use to temporarily assuage the problem.

But in these cultures, when people are sent into the gold mines or are forced into concrete factories to carry inordinately large loads, they are really vulnerable. They have been sent away from their families, so they don’t have all the traditional checks and balances in place. They don’t have access to the modern solutions or semi-solutions either, so they become worse off than we are.

However, if you search for the traditional places that are not yet modernized, that still have Vol. 43, No. 2 / Fall 2019

their kinesthetic traditions handed down from the grandparents, who are still living in the same village as the parents and the children, you see these amazing, functional, beautiful carriages and systems. It’s really something to behold.

RK: You have developed a whole system of posture training that you’ve termed the Gokhale Method. Would you explain what this is exactly?

EG: It’s a methodology. It’s a whole bag of tools, a philosophy, and a journey that is crafted to help people get from where they are to where they want to go, architecturally speaking. If we want to sculpt our bodies and restore them to the healthy functionality we used to have when we were two years old and that our We’ve discovered ancestors had, there are many ways to get that you can use there. your everyday The Gokhale Method provides a life activities as particularly efficient your exercise— and effective pathand your therapy. way to make these necessary changes.

This pathway has a lot of unique characteristics. One is that we use everyday activities as our primary toolkit.

What’s much more common in other programs is to give people exercises that must be added to their daily routine. But we’ve discovered that you can use your everyday life activities as your exercise—and your therapy.

For example, when you bend over, that can be your hamstring stretch as well as your rhomboid strengthening exercise, your erector spinae strengthening exercise, and your external hip rotator stretch. This is the way traditional societies get their strengthening exercises and stretches taken care of.

We’re restoring the length and strength of the muscles in a way that is very natural, rather than contrived, time consuming, and expensive. There is some investment in learning, but then you are empowered to be your own healer and to have your everyday life become your tool. Daily life becomes your gym and your therapy.

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RK: How does your method compare to other ways of treating back pain, such as chiropractic care or Rolfing?

EG: One of the big differences is that chiropractic care and Rolfing are done to you, and this is something you do to yourself. It’s an educational process where you are learning intellectually, kinesthetically, and visually. That’s also a difference from some of the other techniques, such as Alexander Technique, which I respect a great deal. But the main tool there is kinesthetic learning, which is a particularly slow way of learning for most people today. We have greatly developed our intellect, and we have a huge visual cortex, so why not use them? One of the important features of the Gokhale Method is that it’s multichannel. It looks right, it feels right, and it makes sense, so the changes happen more quickly and are more sustained.

In addition, we keep adding arrows to our quiver. Our program has started using technology a great deal. We connect our students via their mobile devices and computers because part of our goal is to populate the landscape with healthy concepts, terminology, and observations. Most people’s notions of posture are really flawed. They have been told to sit up straight, stand up straight, tuck their pelvis, keep an S-shaped spine—a lot of notions that are not only nonhelpful but actually counterproductive. We help people pull out these weeds, so to speak, and plant some useful verbiage, notions, and images.

We also email our students and newsletter subscribers. Every two weeks, they get some really useful education as well as invitations to our online teleseminars. We provide a lot of free offerings that help educate the general population, because our goal also includes helping whole communities develop better posture tools.

People constantly learn from each other. In the villages, they copy each other and learn healthy ways. Here, we copy each other slouching and thrusting out our chests, thinking that’s good posture. So, our program is trying to seed the entire planet with healthy posture teachings.

We’ve also recently invented a wearable, the Gokhale SpineTracker™, that we use in our Price-Pottenger Journal

classrooms. This is cutting-edge, and it took a lot of work and dedication on our part. It has five sensors that go on the back, and a mobile app that shows the shape of the spine. We help students record their baseline shapes when they are sitting, standing, and bending. Then, we mark targets for them, and they learn what body movements enable them to get to those targets.

All those targets and shapes of the spine get recorded on the students’ profiles, and they can watch themselves change over time as well. All of this helps them make changes as quickly and in as sustained a way as possible.

RK: You mentioned a few common recommendations that are misleading people when it comes to good posture. What does good posture actually look like, and what do we need to do to achieve it?

EG: One of the key paradigm shifts that people need to make is to focus on the J-shaped spine, or J-spine, rather than an S-spine. In modern times, we’ve come to think of the S-spine as being the right template for the human structure, and I think that concept is flawed.

My book, 8 Steps to a Pain-Free Back, contains a picture of a spine from a 1911 anatomy text.

This picture shows a J-spine, as opposed to the S-spine that you see in chiropractic charts and modern anatomy books. The J-spine is similar in shape to a hockey stick. The behind is angled back, and the rest of the spine is stacked relatively straight.

The J-spine makes a lot more sense because it has all the upper lumbar discs, which are cylindrical in shape, fit into cylindrical spaces. In the S-spine, they’re all squished into wedge-shaped spaces. No wonder we have degenerated discs, arthritic spines, and back pain—we’re putting load on the edges of the vertebrae. It is important to change the paradigm so that we can move forward and have a theory and template for designing things such as furniture and clothing.

Most ergonomic chairs, for example, are built to S-spine specifications. People were always asking me, “How should I change my chair?” We used to fit them with towels and bungee cords.

After a while, we designed the Stretchsit® Cushion

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to make bad chairs into good ones. Finally, we designed a really good chair, the Gokhale Pain Free™ Chair, that helps stretch and stack people’s spines.

RK: Your book describes eight steps people can take to eliminate back pain. Would you briefly explain what those steps are?

EG: We list these steps in the book in an order that is desirable. We begin with stretchsitting and stretchlying on the back. These methods entail gentle traction on the back while people are sitting and lying down. They are the simplest techniques to learn as well as the best beginning techniques.

It’s similar to preparing the clay for a remodel.

Before we start moving the parts around, because discs may already be compressed and nerves may already be impinged upon, we want to prepare the clay. We like to soften the muscles and lengthen the whole spine as a first measure to prepare for the remodel.

Stretchsitting is one of the things I teach in our free online workshops because it is good for everybody. As long as it’s done gently, there’s no downside. I don’t have to worry that if someone has a herniated disc, this might not be good for them.

In brief, stretchsitting involves leaning forwards, away from a backrest, and then lengthening your spine in a couple of ways before hooking yourself back to our Stretchsit Cushion, which has some sticky nubs on it. A frictiony towel can also work, if you have a fabric chair that will hold it sufficiently. The problem with towels is that they often slip around. If you do use a towel, it should be placed under the shoulder blades. The point is not to reinforce a big lumbar curve but rather to reduce that curve and elongate your spine.

With stretchlying on the back, no products are necessary. You basically prop yourself up on your elbows, dig them in, and then gradually lengthen your back as you unroll onto the bed.

There are some important details, such as where your pillow goes, why you should put a pillow under your knees, and how to lengthen your neck. However, the most important thing is that Vol. 43, No. 2 / Fall 2019

the back is in gentle traction for at least the first five minutes of the night. We tell people not to discipline themselves for too long but just to create familiarity with this very comfortable position, which often helps them fall asleep. Students frequently tell me: “Wow, I woke up in the same position I went to sleep in. I’m shocked because I never sleep on my back. I’ve always found that uncomfortable, but here I was feeling really good.”

So, that’s a nice first measure. It often leads to very good results, and that encourages people to invest a little more time and effort in the other techniques, such as stacksitting. In stacksitting, the pelvis is tipped forward, which allows the rest of the spine to stack without tension.

Here, the J-spine is very important. We like to use a wedge when people aren’t used to having their behinds out behind them and the rest of the spine stacked pretty straight. We teach that posture in stacksitting, which then opens up to all kinds of sitting, whether you’re on a horse, a bench, a stool, or a meditation cushion on the floor.

Then, we teach stretchlying on the side, which reinforces the concept of the J-spine. If you have good length and good shape to the spine, it doesn’t really matter whether you sleep on your back or your side. There are even ways to sleep healthily on your belly, but I discourage that for beginners because it takes more props and good habits to do that well. The main thing is the length and the shape of your spine as you sleep.

Next, we go on to using what I call the inner corset. This is very different from what most people are doing to improve what is commonly known as core strength. It is a natural way of moving that you see in people in nonindustrial cultures when they carry weight. They engage a particular set of deep abdominal and deep back muscles to basically cinch the body and make it taller and more slender. This protects the discs and nerves from wear and tear and impact.

This is extremely important if someone is running or carrying a heavy weight, if they’re in a bumpy bus, or if they’re going to distort their spine in something like yoga or dance that requires the spine to change its position. Then, that extra length is very important to avoid wear and tear.

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Next, we teach tallstanding, which allows you to stand well and maintain a J-spine and a stacked spine. In tallstanding, most of the muscles in the body are in a resting position, with the weight-bearing bones vertically stacked over the heels.

After that, we teach hip-hinging, which is the natural way of bending with a very flat back.

This has to be done precisely—kind of flat is not good enough. That can put load on discs and lead to a lot of problems. So, hip-hinging is not a beginning technique. We like people to have lengthened, strengthened, and reshaped their backs before they learn hip-hinging.

In addition, all along the way, we teach glidewalking, which is really the natural way of walking. It’s low impact, with the posterior chain (muscles along the back of the body and legs) used a lot. The glutes propel you forward with every step, and then you land like a hunter-gatherer, very softly, so there’s not a rattling of the joints and precipitation of arthritic changes and tight muscles.

The program progresses through all these natural ways of moving the body. In the process, the body becomes longer and stronger, and the person increasingly thrives.

RK: For people who may not be suffering from back pain, what other benefits would be gained by using your method?

EG: We’ve talked about improved physiology, mental health, and mindset, but there’s also improved performance if you’re an athlete. If you are glidewalking all day, and every step is a rep, you are going to be a better athlete. You are going to run faster, jump higher, and change direction with more power.

You’re also going to look a lot better. Good posture correlates with improved appearance.

You are able to look your best self in addition to being your best self. You become a better negotiator and a better leader. If you have more confidence, people have more confidence in you, and that reinforces your sense of self and really makes the whole world a more functional place.

I think if we all had this combination of being well-anchored in ourselves as well as available Price-Pottenger Journal

to the world, we would have a nicer planet to live on.

RK: What would you tell people who may be thinking that they’re a lost cause or that there’s no hope for them to reverse their chronic back pain? Is it ever too late for posture re-education?

EG: You’re never a lost cause. You can always improve on what you have. That’s not to say there’s a guarantee that you will get rid of 100 percent of your pain. However, in my experience, only a tiny percentage of the population—perhaps 2 or 3 percent— has some genetic condition or has had a suffiIf you have a ciently damaging acciserious health dent that obliges them condition, all to have some ongoing the more reason pain. However, even these people will see to not have benefit, because while improving your posthe additional burden of poor ture, you are improving your circulation and posture habits. your breathing. And if you have a serious health condition, all the more reason to not have the additional burden of poor posture habits. You need to have posture work for you, instead of against you.

So, everybody benefits, most people to the point that they completely get rid of their aches and pains and are pleasantly surprised by other positive changes. I often hear comments such as: “Hey, I don’t have my constipation anymore”; “My periods don’t hurt”; “I feel more vibrant”; and “I have a lot more energy.”

RK: I want to elaborate a little more on sitting, because many people consider it a major cause of back pain and a big problem with our current work environments. Based on what you have said, it’s not that sitting is inherently bad, but that people have to sit in the right position.

Would you go into that in more depth?

EG: Certainly. It’s not just that we need to be sitting well. We also need to sit in moderation. Just

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sitting like a lump for eight hours straight is not good for anyone. We have to change it up, and we also need to do each of the other positions well.

Right now, it’s a fashion to call sitting “the new smoking.” It used to be that standing was the bad guy. In the days when a lot of people worked on assembly lines and suffered from varicose veins and other ailments that come from standing too long in one position, that was the culprit. Now, sitting is the bad guy. However, I think the truth of the matter is that you need to sit well, stand well, and move around regularly.

I also think that lying down while you work is a missing piece of the conversation. From time to time, people Every kid on the should recline to give planet, every the musculoskeletal system a break. In nonindustrial Silicon Valley, some of indigenous the companies have person, and every napping pods, which I strongly support ancestral statue both as a good respite has this elongated and as a posture reprieve to let all the lumbar spine. discs rehydrate and the spine lengthen.

It also turns out that hunter-gatherers do a lot of sitting. There was a recent study on the Hadza tribal people in Tanzania, and the researchers put wearables on them to see how much of the time they were sitting. It turned out to be very similar to how long we sit in modern Western culture— about nine hours a day. However, they do just fine with their sitting. I think the key differences are that they sit well and that they engage in vigorous activity daily. For about two hours each day, they are up and around, being very active. I think it’s that combination that we want to head for. Sit well, but also exercise and move around— and whatever positions you’re using, do those skillfully. That takes an education.

RK: Many people I’ve worked with are standing and walking incorrectly, and they’re not resolving a lot of their issues. At the end of the day, they’re still very stationary.

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EG: There’s a crowdsourcing website called healthoutcome.org that rates treatments for various orthopedic injuries and conditions. It has a huge amount of data on lower back pain, with over 165,000 ratings, and walking is rated as one of the least effective measures for relieving it.

Only surgery has a worse rating.

If you look at how badly people rate walking, it might be a little shocking, unless you realize that most people these days have tight psoas muscles. Thus, when they walk, they’re yanking on their backs and arching them. So, it’s how they’re walking, not that they’re walking, that’s the big problem. The missing piece is education on how to walk well—and that’s what we teach.

We teach people how to walk well, sit well, and stand well.

Interestingly, on that website, we’re the number one-rated intervention by an extremely wide margin.

RK: I was taught by many chiropractors, and even in school, that we want to bring the curvature back to the spine. Your work is basically the opposite of many things I’ve learned, and it’s really enlightening. By having less curvature, we have more space for the vertebrae, and there is less compression.

EG: Every kid on the planet, every nonindustrial indigenous person, and every ancestral statue has this elongated lumbar spine. It’s pretty flat.

There’s not a lot of curve there. So, who do we want to copy? Shouldn’t it be people who actually function well?

It’s crazy how wrong we got it. Just about every lay guideline on posture is wrong: “An ideal spine is S-shaped.” No, it’s J-shaped.

“Tuck your pelvis.” No, leave your “behind” behind. It’s called a “behind” for a reason.

“Keep your chin up and your chest out.”

Wrong. Keeping your chin up will squish your cervical spine. Thrusting your chest out will squish your lumbar spine.

“Do crunches to strengthen your abs.”

Crunches focus on the wrong abdominal muscle. The rectus abdominus is actually the least important of them. The three deeper layers are

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more important. So, you want to use the inner corset in daily activities or in exercises in order to strengthen the correct abdominal muscles without compromising the discs and nerves. I think crunches are very well named. They crunch the nerves and the discs, and they should be thrown out. However, they are still the most popular abs exercise among the general population.

RK: What types of abdominal exercises do you like to strengthen the inner corset? If people have been doing crunches, what should they do instead?

EG: The best way to strengthen the inner corset is on the job. Anytime you’re carrying something, you would use this particular set of muscles. In Chapter 5 of my book, you can learn about the inner corset and how to use it every time your back would otherwise be compromised. That chapter is available as a free offering on our website, gokhalemethod.com.

You can also work on your inner corset throughout the day for a minute or so as a contrived exercise. You don’t have to stop what you’re doing—you can do it while cutting your vegetables, for example, or you can incorporate it into things like swimming, dancing, and running.

In addition, there are exercises you can do in the gym, including anything asymmetric. For example, if you’re pulling a band across your body, you’re using half of your obliques. Then, you do the other side, and you’ve strengthened some key components of the inner corset.

RK: A lot of people like to have set exercise routines in addition to their day-to-day activities. Would an exercise like a plank help to strengthen the inner corset?

EG: Absolutely. Anytime you’re preserving the shape of your torso against some external force— and in the plank, it’s gravity—that’s a good exercise. Some people like going to the gym, taking exercise classes, and so on. If you like that, by all means, incorporate the inner corset into those activities. If you prefer to hike, dance, or do another kind of vigorous activity, that’s fine, too.

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There are a lot of opportunities to use the inner corset there.

RK: People lately are talking a lot about “text neck,” a painful condition caused by frequently tilting the chin towards the chest while looking at one’s phone. Since this repetitive behavior flattens the curvature of the cervical vertebrae, why is it not beneficial?

EG: I think when people are getting text neck, the place that distorts the most is the upper thoracic spine. It starts curving forward and becoming rigid. Then, their head is facing the ground, and they have to extend their neck to look ahead of them. I find that causes things to go wrong.

What we want is to straighten and flatten the entire spine above the sacrum. In the neck, we need to focus on stability and strength in the muscles, and in the thoracic spine, we need to preserve mobility. If it gets too rigid in there, hunching or a hump can develop.

Many people have come to me from chiropractors who told them that they have military neck and that they need to get the curvature back in there. Sometimes, these chiropractors use a pretty violent approach, such as hanging the head off the bed and using devices and extreme manipulations.

In my book, there are many photographs of people with perfectly erect, straight necks and not much curvature to be seen. These are people who carry large loads on their heads all day and have no arthritic changes in their spines. They are functional and healthy, with no pain and no changes in their bones and discs—and medical literature documents this.

It’s quite shocking for a lot of people that I’m teaching them the opposite of what they’ve been told before. I always tell our students, as long as you’re training with me, empty your cup and immerse yourself in what I’m teaching.

Sometimes, they may only be in training for one day. We teach a one-day Pop-up Course with a half-hour online follow-up. There’s a lot to teach in that day or in the six-lesson course offered by our teachers all over the world. Immerse yourself in it, and then you can decide what feels right, looks right, and makes sense for you.

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RK: What is the most difficult thing for people to change as they learn your method and start to incorporate the eight steps?

EG: The way we have broken it down, it’s remarkably doable. Some of the steps are not easy, but they’re all doable. The people who tend to have the most difficulty are those who have been heavily trained in some other methodology.

For example, if they have been trained in walking, leading with their pelvis like models, there’s a lot of unlearning to do. However, they still get it, because the body remembers how it used to be when they were two years old. Even if it feels strange in the beginning, it feels strangely familiar.

We’re teaching natural things that are written into their DNA, that are written into their personal memory and their ancestral memory.

Sometimes, to make the change a little smoother, I ask people to dig up old photographs of their great-grandfathers—if such pictures exist—or of their grandfathers and use them as a reminder and an inspiration.

RK: This valuable information is very important for people to hear. Where can they go to connect with you and learn more about your work?

EG: The best place is our website, gokhalemethod. com, which is quite a rich ecosystem. It has all kinds of free offerings, including the PDF of the chapter on the inner corset and invitations to free online workshops. It also lists all the offerings of our teachers. We have over 50 teachers, all of whom are incredibly dedicated, capable people trained personally by me. They teach our courses and provide initial consultations all over the world. You can type in your zip code, and the website will show which of our teachers are close

to you. If there aren’t any, you can request that a teacher come to your area or you can travel to one of our intensive courses. I’m going on tour with our one-day Pop-up Course all over the country, so you are sure to be able to find something that suits you.

You can also see my book 8 Steps to a Pain-Free Back. It’s another great way to start. In addition, you can sign up for our newsletter, which contains a lot of valuable information. We’re here on a mission to educate the planet on how to get back to what we used to have. & ABOUT ESTHER GOKHALE

Esther Gokhale, author of the award-winning book 8 Steps to a Pain-Free Back, was educated at Harvard, Princeton (BA in biochemistry), and San Francisco College of Acupuncture and Medicine, as well as by people in nonindustrial cultures worldwide. She founded her Palo Alto, California-based center, the Gokhale Method Institute, over 20 years ago and has helped thousands of people get pain-free through her application of the Gokhale Method. For more information, see gokhalemethod.com.

ABOUT RYAN KENNEDY

Ryan Kennedy, CCN, CFMP, CTN, is a Functional Medicine Practitioner and Board-Certified Clinical Nutritionist who takes a holistic approach to helping his patients improve their health. He has helped thousands of people break free from fad diets and feelings of discouragement with the conventional approach. To learn more about his work, find him on instagram@ryanckennedy or on his website thrivingwellness.co.

Price-Pottenger members: Read hundreds of present and past articles from our Journal at price-pottenger.org/journal-articles.

Vol. 43, No. 2 / Fall 2019

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Psychiatric Pretenders Physical Imbalances that Mimic Mental Health Disorders

by Kelly Brogan, MD

Textbook psychiatric disorders can actually represent some very ordinary physical imbalances that are routinely undiagnosed. They are what I call the psychiatric pretenders, five physiologic conditions that can leave you with symptoms that are indistinguishable from depression and other so-called mental disorders.

For example, an unbalanced thyroid—not unbalanced brain chemicals—is among the most common “pretenders” in women today. In fact, hypothyroidism (an overwhelmed and thus underperforming thyroid) is one of the most underdiagnosed conditions in America.

Four other pretenders round out the picture of why you shouldn’t accept a diagnosis of a mood or mental disorder without investigating the source of your symptoms. These are 1) gluten (and dairy) sensitivity, 2) blood sugar instability, 3) vitamin B12 deficiency, and 4) medication effects. Because of this complexity, the psychiatric diagnosis handed to you could have you taking Zoloft for an endocrine condition or Lamictal for a B12 deficiency—not intelligent medicine.

Hypothyroidism occurs when the thyroid gland is underactive because of nutrient deficiency or inflammation and doesn’t produce enough thyroid hormone.

Specifically, the thyroid is responsible for producing hormones called T0, Tl, T2, T3, and T4.

The two most active thyroid hormones are T3 and T4. Most of the T4, the storage form of thyroid hormone, is converted into its active form, T3, in tissues around the body including the brain. This conversion to active thyroid hormone is dependent on specialized enzymes, optimal cortisol (your stress hormone), and certain nutrients such as iron, iodine, zinc, magnesium, selenium, B vitamins, vitamin C, and vitamin D. In our fast-paced, nutrient-depleted world filled with toxic substances, this one hormonal conversion step alone can be easily impaired.

And while you may not feel the attack in your thyroid per se, you’ll definitely feel it in your mood, energy, and cognition. When the thyroid

The vast majority of symptoms that occur with a thyroid disorder could easily come under a “depression” diagnosis. Most of us never think about our thyroid, but this butterflyshaped gland located at the base of the neck has important functions, including playing a key role in metabolism, digestion, elimination, appetite, energy, temperature, sleep, and mood.

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PRETENDER #1: THYROID DYSFUNCTION

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is responding to stressors, you can experience an array of depression-like symptoms, including fatigue, constipation, hair loss, low mood, foggy thinking, feeling cold all the time, low metabolism, weight gain, dry skin, muscle aches, and an intolerance for exercise. You’re wearing socks to bed, pooping only once a week, and penciling in your eyebrows because the hair has gone missing.

And then there’s the special consideration of postpartum thyroiditis, a condition that 10 percent of women develop after delivery. It’s a condition that I was diagnosed with nine months after the birth of my first child, and one that invited me to reexamine my lifestyle, and then later my entire life. This is whole-person medicine.

Interestingly, a recent study demonstrated that treatment with synthetic prescription hormone (levothyroxine or Synthroid) did not actually resolve associated depression, arguing for root cause resolution and whole body treatment over symptom management.1 PRETENDER #2: GLUTEN AND CASEIN SENSITIVITY

© Adobe Stock | luciepeclova

It’s estimated that up to 80 percent of the population has some sort of intestinal permeability and gut microbe deficiency, which can make digesting the proteins found in wheat especially problematic. With a growing body of research linking gluten to various inflammatory disorders, “non-celiac gluten sensitivity” is on the rise.

Through the gut-brain axis, symptoms can include brain fog, fatigue, depression, migraines, and a host of other psychiatric symptoms. This

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is in addition to skin rashes, bone or joint pain, bloating, and/or weight loss. Over time, this can cause antibodies to be formed against brain and other tissues.

Gluten, from the Latin word for “glue,” is a composite of proteins consisting of gliadin and glutenin, both found in wheat. When I suggest eliminating gluten to patients, they sometimes tell me that they have already been tested and “don’t have celiac.” The limitations of conventional testing are very real, as most physicians who do a “celiac panel” are only testing for a small portion of the potential immune responses to this food. In one preliminary study, inflammatory response was noted in healthy volunteers, suggesting that gluten may cause reactions in everyone.2 If you’re skeptical about the benefit of going gluten free, but open to it, a case reported in the New England Journal of Medicine suggests that, yes, gluten is an issue and not a wellness fad.3 It goes so far as to say that dietary elimination of gluten may very well be the key to resolving what would otherwise be a chronic and disabling psychiatric condition, offering the following case report.

Case study. A 37-year-old woman who was studying for an advanced degree and who was under a lot of stress began expressing the belief that people were talking about her. This belief progressed to paranoia when, a few months later, her home was burglarized, and she accused her parents of conspiring to rob her.

The woman was hospitalized at a state psychiatric facility where she was labeled with psychotic disorder. She was treated with the drugs risperidone and sertraline and then discharged after one month. She was ultimately diagnosed with Hashimoto’s as well as celiac disease, which accounted for her multiple nutrient deficiencies, weight loss, and inability to absorb thyroid hormone medication.

After receiving the diagnosis of celiac disease, she thought her practitioners were being deceitful regarding the diagnosis and refused to adhere to a gluten-free diet. Psychotic symptoms and paranoia persisted, and she continued to “find clues” of conspiracy against her. She lost her job, became homeless, and attempted suicide;

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her family had to take out a restraining order against her. Eventually, she was rehospitalized at an inpatient psychiatric facility, where she was placed on a strict gluten-free diet.

After three months, her delusions resolved completely and were associated with remission of celiac. At the time of the case write-up, she had relapsed psychiatrically after an inadvertent exposure to gluten.

From this report showing the gluten-brain connection, it would seem that a trial of a strict gluten-free diet for anyone presenting with symptoms of psychiatric and neurologic illness would be a good idea. Especially in light of increasing acknowledgment of non-celiac gluten sensitivity, not just celiac disease, having a very real psychiatric manifestation including depression and psychosis.

Why and how would these foods cause the problems that they do? A fascinating study helps elucidate just how wheat/gluten grains can promote intestinal permeability or “leaky gut,” allowing peptides through this precious barrier where they go on to stimulate the brain and immune system.4 A concept referred to as “molecular mimicry” underlies the direct relationship between these peptides and immune response agents that end up attacking tissues that share amino acid sequences with the offending intruder (e.g., a bagel).

Furthermore, digested proteins from cow dairy and gluten, termed exorphins, interact with opiate receptors in the brain, which accounts for the potentially addictive quality of these foods and the associated withdrawal when they are taken off the menu. Sayer Ji of greenmedinfo.com details the history dating back to 1951 of gluten in psychiatric and specifically psychotic illness.5 More recent data has demonstrated that patients with a diagnosis of schizophrenia are two to three times as likely to have immune reactivity to wheat.6 Essentially, going gluten free should mean eliminating processed food from your life, which is why I also recommend elimination of co-reactive foods like corn, soy, and in some cases legumes (including peanuts), and gluten-free grains like rice and millet. I also recommend elimination of dairy to include all milk-based foods and products Price-Pottenger Journal

including yogurt, cheese, and ice cream, due to the protein casein.

Casein is the name for a family of proteins found in mammalian milk. It is possible that our modern, post-industrial foods—gluten and processed dairy, as well as sugar and genetically modified soy and corn—are conspiring with nutrient deficiencies in an incendiary collaboration that gives rise to gut/brain pathology.

The molecular similarity between gluten and casein makes them coconspirators. However, dairy immune provocation appears to be more variable from person to person. In cow dairy, there are six types of protein: four casein, making up 80 percent, and two whey. Within the casein category, A1-beta casein is most commonly present in American cows (Holstein) and is thought to represent a mutated form of the protein, only 5,000 years old. Casomorphin, an opiate-stimulating compound, is released from A1-beta casein.

A2-beta casein is found in the milk of sheep, goats, and Jersey cows.

Researchers have also identified elevated antibodies to alpha, kappa, and whole casein in new-onset and treated schizophrenic patients.7 In patients with casein antibodies, there was a seven to eight times increase in the diagnosis of schizophrenia, and they have similarly demonstrated a three to five times increased risk of bipolar disorder in patients with casein antibodies (lgG).

Beyond direct brain stimulation and poor digestion with local inflammation, cow dairy may also be a source of folate antibodies, which can gum up receptors responsible for transporting this critical nutrient to the brain.

It is my firm conviction that diet—both what it may be deficient in and its potential toxicity— can cause what we label as mental illness. My strongest mandate as a psychiatrist is that of a gluten- and casein-free dietary trial. Only then can these pretenders be unmasked and not diagnosed as mental illness.

PRETENDER #3: BLOOD SUGAR INSTABILITY

One of the most effective ways to heal a dysfunctional immune system and thyroid gland— and their effect on your mental health—is by

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eliminating processed sugar to get your blood sugar under control. You read that right: the secret to ending your mood, behavioral, and cognitive symptoms could very well be in stopping the highs and lows (the sugar roller coaster) that are taking place in your bloodstream and, by implication, your brain.

Reactive hypoglycemia is a blood sugar imbalance that occurs after eating. When a person consumes high amounts of sugar (either through obvious forms like soda, or non-obvious forms like pasta), blood sugar increases quickly. This fast increase then spikes insulin, and blood sugar crashes. This forces cortisol to compensate and try to move sugar out of storage and back into the bloodstream.

Over time, this process is responsible for carb and sugar cravings (since in the non-breatharians among us, the brain needs a steady supply of sugar to function), which can frequently result in feeling “hangry” after skipping a meal. This can also lead to anxiety, irritability, headaches, dizzy spells, and trouble sleeping. Balancing blood sugar chaos may also save you from a diagnosis of panic disorder, generalized anxiety, symptoms associated with ADHD diagnoses, and even bipolar disorder, and keep you from relying on medication that can inflict harm on your mind and body.

Here’s a typical scenario. You wake up, have a glass of orange juice and a bagel (or a bowl of “healthy” cereal, or a Special K bar), and your pancreas is confronted with a wave of sugar that it does not react kindly to. It puts out a counterwave of insulin, charged with sweeping that sugar into cells for energy production. The resul-

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tant dip in blood sugar can alarm the body and the adrenal glands, making them work overtime.

These glands are charged with producing cortisol (which ultimately promotes insulin resistance or the lack of cellular response to insulin) and fight-or-flight chemicals that can get your heart racing and ratchet up anxiety. The solution to this agitated slump is often a follow-up serving of refined carbohydrate and/or caffeine and sugar—midmorning cookie with coffee.

The more days of your life you engage in this pattern of sugar and refined carb consumption, the more your brain suffers, potentially putting you at risk for Alzheimer’s dementia down the line, according to my esteemed colleague Dr. David Perlmutter.8,9 The solution is to restore sugar balance by eliminating sugar and refined flours from the diet and incorporating more protein and natural fats, particularly for breakfast. It’s also a good idea to eat every two and a half hours—sometimes for a period of months or even years— until this response has had a chance to correct itself.

PRETENDER #4: B12 DEFICIENCY

Vitamin B12 plays a critical role throughout the body and is associated with improved energy levels, improved moods, and healthy nervous system function. A deficiency of this key nutrient is extremely common, however, especially for those with compromised gut health, small bowel inflammation, and/or autoimmune disease.

Vitamin B12 is among the most important vitamins when it comes to depression and mental health. Here are some of the reasons that vitamin B12 is so important: B12 supports myelin, the sheath around nerve fibers that allows nerve impulses to conduct. So when this vitamin is deficient, it’s suspected of driving symptoms such as an impaired gait, loss of sensation, signs of dementia, and even multiple sclerosis. But what about B12’s role in psychiatric symptoms such as depression, anxiety, fatigue, and even psychosis?

The role of vitamin B12 in neuropsychiatric syndromes can best be explained by two basic biological mechanisms:

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Methylation. Methylation is the process of taking a single carbon and three hydrogens, known as a methyl group, and applying that group to countless critical functions in your body, such as thinking, repairing DNA, turning on and off genes, building and metabolizing neurotransmitters, producing energy and cell membranes, and getting rid of environmental toxins, to name a few. DNA methylation in particular is the process of marking genes for expression rather than silencing them.

Homocysteine recycling. Vitamin B12 is a primary player in the recycling of a compound that can be inflammatory when it builds up: homocysteine. In other words, vitamin B12 is necessary to keep homocysteine in check. High homocysteine levels are typically found in those who suffer from depression. High levels are also a marker for heart disease and stroke risk.

One of the most remarkable papers I have read in the psychiatric literature was about a 57-year-old woman who was treated for months with both antipsychotic and antidepressant medications and given two rounds of electroconvulsive treatment before anyone bothered to check her vitamin B12 level.10 Her symptoms, years in the making, included tearfulness, anxiety, movement abnormalities, constipation, lethargy, and eventually perceptual disturbances (hearing her name called) and the ultimate in severe psychiatric pathology: catatonia. Despite her inpatient treatment, she remained suicidal, depressed, and lethargic. Within two months of identifying her deficiency, and subsequent B12 treatment, she reverted to her baseline of 14 years previous, and remained stable with no additional treatment.

PRETENDER #5: MEDICATION REACTIONS

This bears repeating: there’s no free lunch with medications. We’ve all listened to the ticker tape of side effects—including blindness and death— reported by TV commercials for pharmaceuticals, but how many medications have been causally linked (with known mechanisms) to entirely reversible psychiatric diagnoses and symptoms?

More than you’ve been told. It may very well be Price-Pottenger Journal

that symptoms of anxiety, depression, inattention, fatigue, insomnia, and worse are actually means of the body saying no to a given medication exposure.

Polypharmacy and Depression

A Mayo Clinic study found that 7 out of 10 Americans take at least one prescription drug,11 and a 2017 Consumer Reports survey found that over 55 percent of Americans regularly take four prescriptions on average.12 This means that more than half of us are existing daily under the influence of polypharmacy—that is, simultaneously using multiple medications, day after day.

Here’s what makes all this very bad news: a common polypharmacy side effect is depression.

A 2018 University of Chicago study was the first to demonstrate that simultaneous use of prescription medications is associated with a greater likelihood of experiencing depression.13 In fact, researchers found that more than one-third of US adults are taking at least one medication that can trigger depression.

And worse, they probably don’t even know it.

Many may be surprised to learn that the medications they’re currently taking, despite having nothing to do with mood disturbance or any other condition associated with depression, can increase their risk of experiencing depression.

The three I’ll examine here are birth control pills, statins, and common painkillers such as Tylenol and Advil.

Birth control pills. When patients come to me with complaints of low libido, low or flat mood, weight gain, hair loss, and cloudy thinking, one of my first questions is, Are you on the Pill?

When they complain about premenstrual irritability, insomnia, tearfulness, bloating, and breast tenderness, requesting that I sanction a course of oral contraceptives combined with an antidepressant, I tell them there’s a better way.

Since the 1960s, there has been controversy surrounding the potential mood effects of oral contraceptives, but more than 50 years of use has not settled this question. There are pilot studies that demonstrate women using the oral contraceptive pill are significantly more depressed

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than a matched group who do not—something I see firsthand, most notably in those who begin contraception (hormonal IUD, progestin only, or combined) postpartum.14 And we know that depression is the most common reason for discontinuation of use. The data suggests overall that there is a subset of women for whom oral contraceptives represent a major risk factor for depression and/or related mood disturbance. Who might these women be? From 13 prospective trials, it appears that these are younger women who have a personal or family history of having been psychiatrically diagnosed, particularly related to pregnancy/ postpartum.15 We now have the largest epidemiologic study of its kind, published in JAMA, in which one million women ages 15 to 34 were followed for 13 years.16 Here’s what they found: • Women who were prescribed the combined pill (progestin and estrogen) were 23 percent more likely to be treated with antidepressants.

• Women treated with progestin only (sometimes called the “mini pill”) were 34 percent more likely.

• Teens were 80 percent more likely if prescribed the combined pill and twice as likely with the progestin-only pill.

While the mood risks of hormonal contraceptives are well known, little attention has been paid to the life-threatening potential side effect of suicide. A 17-year Danish study published in 2017 has revealed a startling association between hormonal contraception and the risk of suicide and suicide attempts in women from ages 15 to 33.17 These previously mentally healthy women had no prior history of suicide attempts, psychiatric diagnoses, or antidepressant use.

One of the most startling revelations from the Copenhagen research was that the relative risk of suicide attempt doubled just one month after first use of hormonal contraceptives. What could so quickly tum a nonsuicidal person into a suicidal one? The Copenhagen researchers suggest that one explanation for the increased risk in suicidal behaviors is that hormonal contraceptives Vol. 43, No. 2 / Fall 2019

likely have a direct influence on brain structures involved in stress regulation and the neurobiology of suicidal behaviors.18 Interestingly, a Mayo Clinic study found that the rate of suicide in the general population was less than .05 percent for those with no previous history of mental illness, much lower than the statistical risk of suicide for women who use hormonal contraceptives.19 Statins: cholesterol-lowering drugs. Chances are you or someone you know takes a cholesterollowering drug such as Crestor, Lipitor, or Zocor, assuming it will help prevent a fatal heart attack.

Recent guidelines have expanded the number of potential statin users, adding 13 million new people to the pool of candidates for statin treatment.20 But you may not know how statins can affect your brain. New research reveals that statins may lessen brain function and increase risk for diabetes, heart disease, and depression. The reason is simple: the body and brain both need cholesterol in order to thrive. Reams of scientific data show time and time again that extremely low cholesterol levels are linked to depression, memory loss, and even violence toward oneself and others.21 Furthermore, it has been known for almost 30 years that low levels are associated with habitually violent tendencies of homicidal offenders under the influence of alcohol.22 Since then, many studies have either confirmed or explored the cholesterol-violence link, including violence toward both self and others.23

A review article called “Neuropsychiatric Adverse Events Associated with Statins” discusses the state of the literature around the intersection between mental health and cholesterol control and concludes that severe irritability, homicidal impulses, threats, road rage, depression and violence, paranoia, alienation, and antisocial behavior have all been reported in registries of those taking statin medications.24 The signal for certain statins—simvastatin and atorvastatin—was stronger. These medications penetrate the brain, and brain cholesterol deficiency has been implicated in bipolar disorder, major depression, and schizophrenia.

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Common pain killers: Tylenol and other NSAIDs. Prescription meds are not the only culprits in the polypharmacy-depression link, according to the previously cited 2018 study.26 A 2017 Consumer Reports survey found that 75 percent of people taking prescription medication also take at least one over-the-counter drug regularly, which further increases the risk of adverse drug effects.27 Just take a Tylenol. This might as well be the American mantra. It’s the perspective that we have been indoctrinated to adopt—that our bodies are full of annoying symptoms that can be suppressed by drugs.

The main ingredient in Tylenol is acetaminophen, which has been used in the United States for more than 70 years. It’s considered a benign over-the-counter medication, used reflexively for aches, pains, and fever, and is widely thought of as safe for pregnancy. About 23 percent of American adults (about 52 million people) use a medicine containing acetaminophen each week.

It’s the most common drug ingredient in the United States, found in more than 600 medicines, but this “harmless drug” is linked to over 110,000 injuries and deaths per year.28 How can Tylenol, which is doled out like candy, be bad for you? Amazingly, no one really knows how acetaminophen works,29 but people do know that this drug gets to your brain.

Tylenol in your brain is concerning because it depletes glutathione, an antioxidant that is especially necessary for brain health.30 Our bodies depend on antioxidants to balance oxidative damage and inflammation.

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Fat-slamming and brain health. Since the 1950s, we’ve been told that eating fat makes you fat and that avoiding traditional fats (butter, meats, and eggs) in lieu of industrialized, man-made fats (margarine) is highly recommended. As a result, we have suffered ever-escalating rates of chronic inflammatory diseases like diabetes and the very heart disease we were aiming to prevent.

But if you are struggling with hormonal imbalance and mood symptoms, you might want to know that cholesterol is a vital nutrient for brain health, a fact that has gotten lost amid all the fat-slamming. It turns out that 25 percent of the cholesterol found in the human body is localized in the brain, 70 percent of it in the myelin sheath that coats and insulates the nerves. By extension, behavioral and cognitive adverse effects may be the manifestation of this fat-based interference.

In a powerful expert review, researchers Diamond and Ravnskov state: “A low serum cholesterol level has also been found to serve as a biological marker of major depression and suicidal behavior, whereas high cholesterol is protective.” In their review, they decimate any plausible indication for cholesterol-lowering agents, giving full consideration to the above-mentioned side effects. They plainly state: “Overall, our goal in this review is to explain how the war on cholesterol has been fought by advocates that have used statistical deception to create the appearance that statins are wonder drugs, when the reality is that their trivial benefit is more than offset by their adverse effects.”25 As my patients’ lab results come in, I often note that those with mood symptoms invariably have a fasting cholesterol below 160. Their internists may be impressed and pleased with their low-fat diets, but I’m not.

The body also recruits cholesterol to produce pregnenolone, a molecule that’s a precursor to sex hormones such as testosterone and estrogen, so without it our reproductive and endocrine systems go awry. Think libido, harmonious menstrual cycle, clear skin, balanced metabolism, and cognition. Additionally, vitamin D, a steroid-like wonder hormone, is produced from cholesterol precursors, and its deficiency appears to be correlated with maladies too numerous to mention (but, yes, including depression).

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Most people have heard that Tylenol can damage the liver (has anyone ever drunkenly warned you to take a Motrin, not a Tylenol, to prevent a hangover?). But since everything in your body is connected, it’s not surprising that Tylenol can do damage beyond your liver. After swallowing 1,000 mg of Tylenol, people exhibited less empathy and blunted positive emotions.31 For reference, 1,000 mg is two extra-strength Tylenol tablets, and the “safe” range is 3,000 mg per day.

This means that popping two Tylenols can affect you physically and emotionally in ways that are just starting to be elucidated.

Hopefully you’re convinced to think twice before taking a Tylenol, but what about other pain relievers like Motrin, Aleve, or Advil? These nonsteroidal anti-inflammatory drugs (NSAIDs) must be safe, since 30 million people take them every day! Not so fast...

Women who recognize the importance of hormonal balance should be wary. NSAIDs can mess with ovulation, especially progesterone levels, after only 10 days of use.32

Additionally, NSAIDs injure the small intestine; in one study, 71 percent of NSAID users showed small intestinal damage, compared to 10 percent of nonusers.33 Damaged intestines can lead to intestinal permeability, or “leaky gut” or gut permeability, which is linked to depression, ADHD, and allergies. NSAIDs can induce leaky gut and harm your microbiome, the inner ecology of organisms you rely on for wellness.34 PSYCHIATRIC SIDE EFFECTS OF ANTIBIOTICS AND VACCINES

Antibiotics. We are just beginning to unravel the hows and whys of antibiotic effects on the brain. Invented and studied before our knowledge of the microbiome and the role of mitochondrial dysfunction in chronic disease, antibiotics have long been reported to have psychiatric side effects but have never been adequately studied for safety.35 We are learning that the effects of exposure to antibiotics on gut bacteria can persist for months after treatment and sometimes result in permanent disability.

An excellent 2017 review by Zareifopoulos and Panayiotakopoulos suggests that patients Vol. 43, No. 2 / Fall 2019

should be told of risks including irritability, confusion, encephalopathy, suicidality, psychosis, and mania.36 In fact, the term antibiomania has been coined around the potential for antibiotics to induce manic symptoms. In a recent review, two-thirds of the mania inductions were in male subjects.37

The resolution of acute-onset mania with charcoal, which binds foreign toxicants and bacterial byproducts in the gut, suggests that these psychiatric risks may be both microbiome dependent and independent.38 Relatedly, data suggests that there is a dose-dependent risk of new-onset depression; the higher the antibiotic exposure, the higher the risk of depression.39 In a large case-control study conducted from 1995 to 2013, antibiotic usage was found to precede diagnosis and treatment for depression with recurrent courses of penicillin antibiotics resulting in a two- to five-fold increase in depression diagnosis.

Vaccines. It might surprise you to know that vaccines are potential drivers of psychiatric struggles like depression. According to several studies, depression, stress, and dysbiosis can load the gun while vaccines pull the trigger on prolonged inflammatory responses and adverse reactions.40 On the other hand, some studies indicate that depression and other psychiatric phenomena may result from vaccination effects.41

How do you know if you will suffer psychiatric consequences from a routine vaccine such as Gardasil, a booster shot for tetanus, or the annual flu shot? You don’t.

Vaccines were designed before we knew about DNA, viruses that contaminate cells used to produce them, the microbiome, or how toxic one chemical can be to one person while leaving another unscathed. One-size-fits-all medicine is no longer appropriate, and we just don’t know how to determine who might be at risk for adverse effects ranging from psychiatric conditions to death.42 For further scientific exploration of vaccines and brain health, you can download a free ebook from kellybroganmd.com. & Excerpted with permission from Own Your Self

by Kelly Brogan, MD, with Nancy Marriott (Hay House, 2019).

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ABOUT THE AUTHOR Kelly Brogan, MD, is a Manhattan-based holistic women’s health psychiatrist, author of the New York Times bestselling book A Mind of Your Own and co-editor of the landmark textbook Integrative Therapies for Depression. Her latest book is Own Your Self. She completed her psychiatric training and fellowship at NYU Medical Center after graduating from Cornell University Medical College, and has a BS from MIT in Systems Neuroscience. She is board certified in psychiatry, psychosomatic medicine, and integrative holistic medicine, and specializes in a root-cause resolution approach to psychiatric syndromes and symptoms.

Dr. Brogan is on the advisory board of Price-Pottenger. Her website is kellybroganmd.com.

REFERENCES 1. H. H. Loh et al., “Association between Subclinical Hypothyroidism and Depression: An Updated Systematic Review and Meta-Analysis,” BMC Psychiatry 19 (January 8, 2019): 12. doi: 10.1186/s12888-018-2006-2.

2. D. Bernardo et al., “Is Gliadin Really Safe for Non-Coeliac Individuals?” Gut 56, no. 6 (June 2007): 889-90. doi: 10.1136/ gut.2006.118265.

3. H. K. Delichatsios et al., “Case 14-2016­—A 37-Year-Old Woman with Adult-Onset Psychosis,” New England Journal of Medicine 374 (May 12, 2016): 1875-83. doi: 10.1056/ NEJMcpc1514473.

4. A. Fasano, “Leaky Gut and Autoimmune Diseases,” Clinical Reviews in Allergy and Immunology 42, no. 1 (February 2012): 71-8. doi: 10.1007/s12016-011-8291-x.

5. S. Ji, “60 Years of Research Links Gluten Grains to Schizophrenia,” GreenMedlnfo, August 27, 2018. http://www. greenmedinfo.com/blog/60-years-research-links-glutengrains-schizophrenia.

6. O. Olaoluwa et al., “Elevated Gliadin Antibody Levels in Individuals with Schizophrenia,” World Journal of Biological Psychiatry 14, no. 7 (September 2013): 509-15. doi: 10.3109/15622975.2012.747699.

7. E. G. Severance et al., “Subunit and Whole Molecule Specificity of the Anti-Bovine Casein Immune Response in Recent Onset Psychosis and Schizophrenia,” Schizophrenia Research 118, no. 1-3 (May 2010): 240-47. doi: 10.1016/j. schres.2009.12.030. Epub 2010 Jan 13.

8. S. M. de Ia Monte and J. R. Wands, “Alzheimer’s Disease Is Type 3 Diabetes—Evidence Reviewed,” Journal of Diabetes Science and Technology 2, no. 6 (November 2008): 1101-13. doi: 10.1177/193229680800200619.

9. M. A. Fishel et al., “Hyperinsulinemia Provokes Synchronous

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Increases in Central Inflammation and Beta-Amyloid in Normal Adults,” Archives of Neurology 62, no.10 (October 2005): 1539-44. doi: 10.1001/archneur.62.10.noc50112.

10. N. Berry et al., “Catatonia and Other Psychiatric Symptoms with Vitamin B12 Deficiency,” Acta Psychiatrica Scandinavica 108, no. 2 (August 2003): 156-59. PMID: 12823174.

11. Mayo News Releases, “Nearly 7 in 10 Americans Take Prescription Drugs, Mayo Clinic, Olmsted Medical Center Find,” Mayo News Network, June 19, 2013, https://newsnetwork. mayoclinic.org/discussion/nearly-7-in-10-americans-takeprescription-drugs-mayo-clinic-olmsted-medical-center-find.

12. T. Carr, “Too Many Meds? America’s Love Affair With Prescription Medication,” Consumer Reports, October 3, 2017, https://www.consumerreports.org/prescription-drugs/too-manymeds-americas-love-affair-with-prescription-medication/.

13. D. M. Qato et al., “Prevalence of Prescription Medications with Depression as a Potential Adverse Effect Among Adults in the United States,” Journal of the American Medical Association 319, no. 22 (June 12, 2018): 2289. doi: 10.1001/ jama.2018.6741.

14. J. Kulkarni, “Depression as a Side Effect of the Contraceptive Pill,” Expert Opinion on Drug Safety 6, no. 4 (July 2007): 371-74. doi: 10.1517/14740338.6.4.371.

15. K. A. Oinonen et al., “To What Extent Do Oral Contraceptives Influence Mood and Affect?” Journal of Affective Disorders 70, no. 3 (August 2002): 229-40. PMID: 12128235.

16. C. W. Skovlundet et al., “Association of Hormonal Contraception with Depression,” JAMA Psychiatry 73 (November 1, 2016): 1154-62. doi: 10.1001/jamapsychiatry.2016.2387.

17. C. W. Skovlund et al., “Association of Hormonal Contraception with Suicide Attempts and Suicides,” Psychiatry 175, no.

4 (April 2018): 336-42. doi: 10.1176/appi.ajp.2017.17060616.

18. M. Sokolowski et al., “An Overview of the Neurobiology of Suicidal Behaviors as One Meta-System,” Molecular Psychiatry 20, no. 1 (February 2015): 56-71. doi: 10.1038/ mp.2014.101.

19. J. M. Bostwick and V. S. Pankratz, “Affective Disorders and Suicide Risk: A Reexamination,” American Journal of Psychiatry 157, no. 12 (December 1, 2000): 1925-32. https://doi. org/10.1176/appi.ajp.157.12.1925.

20. H. Zhang et al., “Discontinuation of Statins in Routine Care Settings: Cohort Study,” Annals of lnternal Medicine 158, no.

7 (April 2, 2013): 526-34. doi: 10.7326/0003-4819-158-7201304020-00004.

21. Z. Vesza et al., “Statin-Related Lichenoid Dermatosis: An Uncommon Adverse Reaction to a Common Treatment,” European Journal of Case Reports in Internal Medicine 5, no. 5 (May 2018): 000844. doi: 10.12890/2018_000844.

22. M. Virkkunen, “Serum cholesterol levels in homicidal offenders. A low cholesterol level is connected with a habitually violent tendency under the influence of alcohol,” Neuropsychobiology 10, no. 2-3 (1983): 65-69. doi: 10.1159/000117987.

23. See numerous studies as reported on greenmed.com, http:// www.greenmedinfo.com/greenmed/topic/47443/focus/856/ page.

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24. M. Tuccori et al., “Neuropsychiatric Adverse Events Associated with Statins: Epidemiology, Pathophysiology, Prevention and Management,” CNS Drugs 28, no. 3 (March 2014): 249-72. doi: 10.1007/s40263-013-0135-1.

25. D. M. Diamond and U. Ravnskov, “How Statistical Deception Created the Appearance That Statins Are Safe and Effective in Primary and Secondary Prevention of Cardiovascular Disease,” Expert Review of Clinical Pharmacology 8, no. 2 (March 2015): 201. doi: 10.1586/17512433.2015.1012494 .

26. Qato et al., “Prevalence of Prescription Medications with Depression as a Potential Adverse Effect Among Adults in the United States.” Some of those 200-plus medications are also available over the counter (OTC).

27. Carr, “Too Many Meds? America’s Love Affair with Prescription Medication.”

28. T. C. Miller and J. Gerth, “Behind the Numbers: We Explore the Data Behind Figures Showing How Many People Die from Overdosing on Acetaminophen, the Active Ingredient in Tylenol,” ProPublica, September 20, 2013. https://www. propublica.org/article/tylenol-mcneil-fda-behind-the-numbers.

29. C. Drahl, “How Does Acetaminophen Work? Researchers Still Aren’t Sure,” Chemical and Engineering News 92, Issue 29 (July 21, 2014). https://cen.acs.org/articles/92/i29/DoesAcetaminophen-Work-Researchers-Still.html.

30. J. T. Slattery et al., “Dose-Dependent Pharmacokinetics of Acetaminophen: Evidence of Glutathione Depletion in Humans,” Clinical Pharmacology and Therapeutics 41, no. 4 (April 1987): 413-18. doi:10.1038/clpt.1987.50.

31. R.O. Geoffrey et al., “Over-the-Counter Relief from Pains and Pleasures Alike: Acetaminophen Blunts Evaluation Sensitivity to Both Negative and Positive Stimuli,” Psychological Science 26, no. 6 (April 10, 2015): 750-58. doi: 10.1177/0956797615570366.

32. European League Against Rheumatism, “Non-Steroidal Anti-Inflammatory Drugs Inhibit Ovulation after Just 10 Days,” ScienceDaily, June 11, 2015. http://www.sciencedaily. com/releases/2015/06/150611082124.htm.

33. D. Y. Graham et al., “Visible Small-Intestinal Mucosal Injury in Chronic NSAID Users,” Clinical Gastroenterology and Hepa-

tology 3, no. 1 (January 2005): 55-59. PMID: 15645405.

34. G. Sigthorsson et al., “Intestinal Permeability and Inflammation in Patients on NSAIDs,” Gut 43, no. 4 (October 1998): 506-11. PMID: 9824578.

35. H. Sternbach and R. State, “Antibiotics: Neuropsychiatric Effects and Psychotropic Interactions,” Harvard Review of Psychiatry 5, no. 4 (November-December 1997): 214-26. https://www.ncbi.nlm.nih.gov/pubmed/9427014.

36. N. Zareifopoulos and G. Panayiotakopoulos, “Neuropsychiatric Effects of Antimicrobial Agents,” Clinical Drug Investigation 37 (May 2017): 423. https://www.ncbi.nlm.nih.gov/ pubmed/28197902.

37. S. Lambrichts et al., “Antibiotics and Mania: A Systematic Review,” Journal of Affective Disorders 219 (September 2017): 149-56. doi: 10.1016/ j.jad.2017.05.029.

38. Nora Hamdani et al., “Resolution of a Manic Episode Treated with Activated Charcoal: Evidence for a Brain-Gut Axis in Bipolar Disorder,” Australian and New Zealand Journal of Psychiatry 49, no. 12 (December 2015): 1221-13. doi: 10.1177/0004867415595873.

39. I. Lurie et al., “Antibiotic Exposure and the Risk for Depression, Anxiety, or Psychosis: A Nested Case-Control Study,” Journal of Clinical Psychiatry 76, no. 11 (November 2015): 1522-28. doi: 10.4088/JCP.15m09961.

40. To access a user-friendly, comprehensive resource center on the effects of vaccines and, in particular, the reporting of adverse reactions, visit the National Vaccine Information Center at http://medalerts.org/. I have written extensively on my concerns about vaccines, especially in vulnerable populations. I invite you to visit my website and use its search function to read more about my stand on vaccines and the supporting studies.

41. See my post “A Scientist Speaks: Senate Bill 277 in California” at www.kellybroganmd.com, May 7, 2015. https:// kellybroganmd.com/article/scientist-speaks-senate-bill-277california/.

42. For more information about dangers of vaccines, see my e-book Special Report: Vaccines and Brain Health, available from my website.

Have You Moved … Or Do You Plan To? The Post Office charges us for each issue of the Journal that is returned because of an incorrect address. Please let us know of any changes, so we can keep your Journal coming!

Call 619-462-7600 or email us at info@price-pottenger.org.

Vol. 43, No. 2 / Fall 2019

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IN THE NEWS CLINICAL PERSPECTIVE

The Ketogenic Diet and Your Health with Sherry A. Rogers, MD How did someone like you who has been a strong proponent of the macrobiotic diet get interested in the ketogenic diet?

I’d like to make sure that your readers know that I’m not any smarter than any other physician; I was just sicker than most. This not only forced me into four medical specialties but also led me to devote my life to researching the molecular biochemistry of God’s healing— which, by the way, has been designed into every human body. For everything I say, we have the scientific proof or evidence somewhere in our 15 books and the 30 years of our monthly, referenced newsletter, Total Wellness (all available at prestigepublishing.com).

You are right that I have long been a proponent of the macrobiotic diet, which is largely focused on whole grains, vegetables, and beans.

It is the only diet that I have seen to actually cure metastatic cancers in folks who were given mere weeks to live by their oncologists. Since these people were not my patients, they kindly sent me all of their records and let me examine them for confirmation.

In spite of the benefits of the macrobiotic diet, there were several factors that led me to question the validity of our medical system’s emphasis on reducing dietary fat. For one, I consult with people in the Ornish Lifestyle Medicine program—which includes a low-fat, high carbohydrate diet—who have continued to make arterial plaque. This is in spite of the fact that I have examined all 34 of their fatty acids and can verify that they have been following the diet perfectly.

So, what’s wrong?

For starters, we have in the United States the most expensive healthcare system in the world, but we only ranked an abysmal 43rd in Price-Pottenger Journal

life expectancy in 2014.1 Obviously, we are doing something very wrong. The incidences of heart disease, obesity, diabetes, and cancer have all more than doubled in less than four decades, and we lead the world in chronic diseases. We also have new diseases, such as fatty liver and sleep apnea, as well as our opioid epidemic, which stems from the large number of people who are experiencing chronic pain or depression or both. In fact, we know how to cure all of these, but conventional medicine turns a blind eye and offers merely drugs, devices, or surgery. Clearly, dietary guidelines that stress the fear of fat have been a failure.

How can anyone advocate a high-fat diet, low in meats and vegetables?

The fear of fat was based on an entirely unscientific association. Decades ago, when it was realized that folks dying of heart attacks had plugged coronaries, pathologists looked at what was in those arteries. When they found cholesterol, the war on cholesterol began. But association does not mean causation; in fact, that is a blatant error in science. It is like blaming firefighters for fires because they show up to fight them or blaming police for crimes because they are found at the scene.

The fear of saturated fat fostered the popularity of hydrogenated corn oil (containing trans fats), Crisco, and margarines. Then, the cholesterol-lowering drugs came on the scene. Pretty soon, reputation and ego—not to mention profits— trumped science even more. It seemed as though there was no way out.

Fortunately, however, there is a mountain of evidence showing that insulin should be a main focus in restoring cardiovascular health.2

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Even the American Heart Association’s main journal, Circulation, featured an article in 2002 entitled “Insulin creates endothelial dysfunction in humans.”3 Regardless of what your disease title is, from high blood pressure to coronary plaque to osteoarthritis, fatty liver, sleep apnea, Alzheimer’s, mitochondrial dysfunction, or cancer, if the blood vessels are not healthy, no organ downstream can be. Our medical system creates disease titles so that specific drugs can be used.

But, in essence, all disease is linked to the same mechanisms. It is just that folks have different target organs, depending upon their personal nutrient deficiencies and toxicities.

How does anyone know if they would benefit from the ketogenic diet?

If you have diabetes, fatty liver, hypertension, arrhythmia, coronary plaque, cancer, Alzheimer’s, or any other health condition that you have been struggling with for a long time, the ketogenic diet bears investigating. First of all, you can determine whether you have insulin resistance. Merely ask your doctor to let you see your last metabolic profile, and divide your HDL into your triglyceride level. If your triglyceride/HDL score is greater than 1.5, you already have insulin resistance. If it is 1.0, you don’t have insulin resistance, but that doesn’t mean you couldn’t benefit from the diet.

The next step is to get a Cardio/ION profile.* You also want to get a free T3 and reverse T3 (rT3) thyroid hormone test, as well as a thyroid autoantibodies test and a coronary calcium score. Depending on your personal history, other tests—such as D-dimer, NT-proBNP, N-telopeptide, and MMP—may also be important.

Clearly, where you start depends on your weight, your diagnoses, and whether or not you have insulin resistance or serious undiagnosed nutrient deficiencies—not to mention your total past history of antibiotics, other medications,

surgeries, dental repairs, pesticide and other xenobiotic exposures, etc. I go through all of this in a phone consult when I help people interpret their Cardio/IONs. Of course, if you have any diagnoses—from fatty liver, mitochondrial dysfunction, coronary plaque, or diabetes to cancer—those determine your individual organ propensities. Remember, a hundred people can have the same disease, but they all have different deficiencies and toxicities, hence different causes and cures. We don’t all merely look different. We have different composite chemistries as well.

If it has so many benefits, what are the problems that you see with the ketogenic diet?

There are a dozen cardiologists who have written up their versions of the ketogenic diet, but they all have one glaring failure. They are all working totally blindly, as they do not measure the myriad nutrient deficiencies that can keep many people forever sick. There are only two causes for all disease: the nutrient levels go down, and the toxicity levels go up.

For example, you can’t heal insulin resistance— or, for that matter, any health condition—if you have subclinical hypothyroidism or are still eating high-fructose corn syrup, which secretly carries mercury throughout your body. Likewise, you cannot heal if you have an overgrowth of fungi in your gut from antibiotic use (which can lead to autoimmune thyroiditis), high reverse T3 (which suppresses thyroid-stimulating hormone and poisons the thyroid hormone receptors), or hidden nutrient deficiencies, such as magnesium, zinc, or copper. You will not get well if your cell membranes are starving due to low levels of vitamins A, D, and E8, the complete form of vitamin E containing all four tocopherols and all four tocotrienols.

That’s why I’ve created the acronym THINK, which stands for toxins and teeth, hormone deficiencies, intestines and interference fields, nutrient

* The Cardio/ION is a combination of nutritional tests that identifies risk factors for cardiovascular disease. It measures levels of fatty acids, amino acids, vitamins, minerals, antioxidants, and organic acids. Directions on how to order your own test if your doctor is not knowledgeable about it can be found in my book How to Cure Diabetes.

Vol. 43, No. 2 / Fall 2019

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deficiencies, and knowledge gaps. I guarantee you will find the cause for any disease if you address all these factors. For example, within category T, for toxins, look at the 7Ms: 1. Medications: Statins prescribed for high cholesterol can cause Alzheimer’s, diabetes, and other diseases. ACE inhibitors for high blood pressure can also lead to Alzheimer’s. Proton pump inhibitors such as Nexium, used to reduce acid stomach, can induce Alzheimer’s and any other disease by inhibiting nutrient absorption.

2. Mercury: High-fructose corn syrup, contaminated with mercury during the manufacturing process, can induce any disease.

3. Mangled fats: Hydrogenated trans fats or, even worse, hidden esterification—which isn’t even listed on nutrition labels—can also produce any disease. In fact, through use of these FDA-approved food additives, we have, in the last few decades, changed the chemistry of the human cell membrane dramatically.

4. Manipulated GMO foods: Genetically modified foods and their related herbicides can cause symptoms that mimic any disease, from autism to chemical sensitivity.

5. Mycotoxins: These toxic metabolites produced by molds and other fungi can masquerade as anything—including cancer. In fact, some mycotoxins are among the most potent carcinogens known. Antibiotic use can lead to an overgrowth of Candida and other bad fungi in the gut, increasing the mycotoxin load.

6. Manufactured toxins: Chemicals such as phthalates from plastic and PFOA from nonstick cookware and stain-resistant furnishings contribute to the reasons why we lead the world in chronic diseases. In fact, the polar bears in the Arctic now have human diseases, such as hypothyroidism and osteoporosis, from the plastics (phthalates) in their environment—and they don’t even drink out of plastic water and infant formula bottles and Styrofoam coffee cups.

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7. Managed care: Our medical delivery systems guarantee that each specialty has a very narrow focus on disease mechanisms and is limited to drugs, devices, and surgery. Consider psychiatrists who prescribe Prozac or other serotonin reuptake inhibitors for depression and do not examine the gut. If they did their job properly, they would know that 95 percent of our serotonin is made in the gut, not the brain.

That’s why the gut is called the “second brain.”

Because their specialty does not involve the gut, their patients may never get rid of their depression.

And, of course, rare is any specialty that looks at nutrients, depite their critical importance. For example, folks with insulin resistance, diabetes, prediabetes, or metabolic syndrome cannot heal without adequate levels of vitamin D, but checking this is not in the practice guidelines.4,5 In addition, the standard cutoffs for vitamin D deficiency are out of date by four decades. The “norms” were obtained from blood samples from sick people who were already in the lab—not from healthy people. As result, many norms, even in commercial labs, are not normal. You want your vitamin D level to be over 80 ng/mL, not the dangerous and antiquated 30 ng/mL that is on commercial lab reports. You can’t heal any disease without adequate levels of D, and that goes for anything from arthritis to high blood pressure to cancer.

Even more dangerous are the blood levels of nutrients that I see in some folks who are thinking of going on the ketogenic diet and fortunately have held off until they have determined if they are in optimal biochemical shape to do so. Many of them have RBC magnesium levels so low that they could have a sudden cardiac arrest that no amount of cardioversion can rescue, since they don’t have enough magnesium to make the heart continue to beat. Others have cell membranes that are literally starving for the right fatty acids (such as EPA and DHA, found in cod liver oil). This damages the function of the cell membranes, which are like the computer keyboard for the entire body. However, if they don’t have enough of the substances such as phosphatidylcholine and phosphatidylserine that

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anchor the fatty acids, taking these essential fats is meaningless.

The bottom line is: There is no substitute for finding the underlying biochemical causes and cures of a disease. Any time you have the opportunity to avoid working totally blindly, your chances of success are magnified enormously. & BIOGRAPHICAL NOTE

Sherry A. Rogers, MD, is board certified by the American Board of Environmental Medicine and the American Board of Family Practice. She is a Fellow of the American College of Allergy, Asthma and Immunology and a Fellow of the American College of Nutrition. Dr. Rogers has been practicing medicine for 50 years, and has taught well over 100 physician courses in six countries, including lectures at Oxford. She has written fifteen books, including the landmark book Detoxify or Die; numerous scientific papers; textbook chapters; and the

monthly, referenced newsletter Total Wellness, which she has published for 30 years. In addition, Dr. Rogers maintains a non-patient phone consulting service, where she consults with readers in two dozen countries. She is also a long-time honorary member of Price-Pottenger’s Advisory Board. For more information, see prestigepublishing.com.

REFERENCES 1. US Burden of Disease Collaborators, Mokdad AH, Ballestros K, et al. The state of US health, 1990-2016: burden of diseases, injuries, and risk factors among US states. JAMA. 2018; 319(14):1444-72.

2. Kahn SE, Hull RL, Utzschneider KM. Mechanisms linking obesity to insulin resistance and type 2 diabetes. Nature.

2006; 444(7121):840-46.

3. Arcaro G, Cretti A, Balzano S, et al. Insulin causes endothelial dysfunction in humans: sites and mechanisms. Circulation. 2002; 105(5):576-82.

4. Al-Shoumer KAS, Al-Essa TM. Is there a relationship between vitamin D with insulin resistance and diabetes mellitus? World J Diabetes. 2015; 6(8):1057-64.

5. Chiu KC, Shu A, Go VL, Saad MF. Hypovitaminosis D is associated with insulin resistance and beta cell dysfunction.

Am J Clin Nutr. 2004; 79(5):820-25.

23RD PRINTING OF OUR ALL TIME BEST SELLER First published in 1939, this monumental and highly readable book is designed to preserve Dr. Price’s classic studies of nutrition among indigenous populations. His worldwide investigations expose the deleterious effects of processed foods and synthetic farming methods on human health and hold the promise of regeneration through sound nutrition.

Nutrition and Physical Degeneration contains guidelines for approaching optimum health and reproduction the way traditional peoples did. Dr. Price has been universally accepted as one of the foremost authorities on the role of natural foods in our overall health. His work chronicles the development of degenerative illnesses as a result of replacing whole foods with processed ones.

528 pages, includes 196 photos and 6 maps Regular price: $27.95; member price: $25.15

To order: price-pottenger.org/store 619-462-7600 • 800-366-3748 (in U.S.) Calendula Vol. 43, No. 2 / Fall 2019

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© Adobe Stock | Africa Studio

IN THE NEWS FISH OIL SUPPLEMENTS REDUCE HEART DISEASE RISK Daily supplementation with omega-3 fish oil can reduce risk of heart attack and other cardiovascular disease (CVD) events, according to a new study published in the Journal of the American Heart Association.

The researchers analyzed data from more than 120,000 people in 13 randomized trials worldwide and found that those who took daily fish oil supplements had an 8 percent lower risk of heart attack and of death from coronary heart disease (CHD) than those who took a placebo. Incidences of total CHD events, total CVD events, and death from CVD were also lower with fish oil use, but no benefit was seen for stroke.

Because millions of people experience CVD events each year, even small reductions in risk can mean the avoidance of hundreds of thousands of heart attacks and CVD deaths, the researchers state.

Moreover, the protective effects of fish oil were found to increase linearly with dosage. This suggests that supplementation at above the 840 mg/day dosage (indicating the combined amount of the omega-3 fats EPA and DHA) used in most of the clinical trials might lead to even greater benefit.

SOURCES: Harvard TH Chan School of Public Health. Omega-3 fish oil supplements linked with lower cardiovascular disease risk. ScienceDaily, September 30, 2019. sciencedaily.com/releases/2019/09/190930161922.htm.

Hu Y, Hu FB, Manson JE. Marine omega-3 supplementation and cardiovascular disease: an updated meta-analysis of 13 randomized controlled trials involving 127,477 participants. Journal of the American Heart Association, 2019; 8(19). doi.org/10.1161/JAHA.119.013543.

GUM DISEASE AND HIGH BLOOD PRESSURE

Researchers in the United Kingdom have found a link between periodontitis (gum disease) and risk of hypertension. In a meta-analysis of 81 studies from 26 countries, moderate-to-severe periodontitis was associated with a 22 percent increase in likelihood of hypertension, and severe periodontitis was associated with a 49 percent increase. These associations were found to be linear—the more severe the periodontitis, the greater the probability of high blood pressure.

One reason for the link could be the fact that gum disease, and the oral bacteria associated with it, can lead to inflammation throughout the body, and this inflammation may affect the health of the blood vessels.

In 5 of the 12 interventional studies analyzed in the review, blood pressure was reduced when periodontitis was treated. Although further research is needed to determine the impact of periodontal therapy on blood pressure, the researchers note that providing oral health advice to people with hypertension would seem prudent.

Conversely, according to senior author Professor Franceso D’Aiuto, “The findings suggest that patients with gum disease should be informed of their risk and given advice on lifestyle changes to prevent high blood pressure such as exercise and a healthy diet.”

SOURCES: Gum disease linked with higher risk of hypertension. European Society of Cardiology, September 24, 2019. escardio.org/The-ESC/Press-Office/Press-releases/Gum-disease-linked-with-higher-risk-of-hypertension.

Aguilera EM, Suvan J, Buti J, et al. Periodontitis is associated with hypertension: a systematic review and meta-analysis. Cardiovascular Research, September 24, 2019. doi.org/10.1093/cvr/cvz201.

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IN THE NEWS

© Adobe Stock | kaliantye

PRENATAL EXPOSURE TO BPA MAY AFFECT LUNG FUNCTION

Children who were exposed to higher levels of bisphenol A (BPA) while in the womb tend to have smaller lung capacities and are more likely to suffer from wheezing, research presented at the European Respiratory Society International Congress indicates.

Alicia Abellan, of the Barcelona Institute for Global Health, and her colleagues looked at data from 2,685 mother-child pairs participating in eight large European studies. The mothers’ urine had been tested during pregnancy, and the children had their lung function measured between ages six and ten. Questionnaires ascertained whether the children wheezed.

BPA was detected in the urine of 79 percent of the pregnant women. Those with higher levels of BPA were 13 percent more likely to have children who suffered from wheezing. In addition, a doubling of the amount of BPA in the mother’s urine corresponded to an approximately 5 ml decrease in the child’s lung capacity.

Daiana Stolz, chair of the European Respiratory Society Education Council, observed: “This research suggests that exposure to BPA in the womb may lead to small but measurable differences in children’s lung function. These effects might not have much impact on children who are otherwise healthy, but they are very important when we consider the health of a whole population.… We know that having lower lung function in early life makes people more prone to developing chronic lung diseases like COPD.” SOURCE: Exposure to BPA in the womb linked to wheezing and poorer lung function in children. European Lung Foundation, January 10, 2019. europeanlung.org/en/news-and-events/media-centre/press-releases/exposure-to-bpain-the-womb-linked-to-wheezing-and-poorer-lung-function-in-children.

BONE HEALTH AND UNDIAGNOSED CELIAC DISEASE

Adults with probable undiagnosed celiac disease (UCD) were found to have lower bone density than those without celiac despite consuming more calcium and phosphorus, researchers from George Mason University College of Health and Human Services report.

The study, recently published online in the Journal of the American College of Nutrition, used data on over 13,000 people who participated in the National Health and Nutrition Examination Survey (NHANES) from 2009-2014 and who were not pregnant or on a gluten-free diet. Analysis revealed that those with probable UCD had higher dairy consumption and higher combined dietary and supplemental intake of both calcium and phosphorus. Nonetheless, this group had lower bone mineral density in the thigh bones and in the femur necks, the most common site for hip fractures.

Researcher Lara H. Sattgast explained: “Our findings suggest that lower bone density among adults with UCD is not a result of their diets, and in fact, they took in more calories and nutrients than the control group. This may mean that these adults are not correctly absorbing nutrients.”

SOURCES: Adults with undiagnosed celiac disease have lower bone density, says first study on topic. George Mason University, October 17, 2019. chhs.gmu.edu/news/580296

Sattgast LH, Gallo S, Frankenfeld CL, et al. Nutritional intake and bone health among adults with probable undiagnosed, untreated celiac disease: What We Eat in America and NHANES 2009–2014. Journal of the American College of Nutrition, July 19, 2019. DOI: 10.1080/07315724.2019.1616003.

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IN THE NEWS HEAVY METALS FOUND IN MOST BABY FOODS

A national investigation commissioned by Healthy Babies Bright Futures (HBBF) has detected toxic heavy metals in 95 percent of baby foods tested. Analysis of 168 commercial baby foods, from leading brands to niche products, revealed at least one of the heavy metals tested for—arsenic, lead, cadmium, and mercury—in nearly all the products. All four metals were found in 26 percent of the baby foods, with the most common one being lead, which was present in 94 percent.

Rice-based foods—including infant rice cereals, dishes, and snacks—topped the contamination list, as they were high in inorganic arsenic and almost always contained all four heavy metals. Other foods high on the list included apple and grape juice, oat ring cereal, macaroni and cheese, and puff snacks.

HBBF explains the danger: “Even in the trace amounts found in food, these contaminants can alter the developing brain and erode a child’s IQ. The impacts add up with each meal or snack a baby eats.”

The study estimates that lead and arsenic in rice-based foods alone account for one-fifth of the IQ points—over 11 million in total—that children lose due to dietary sources in the first two years of life.

Parents can lower their babies’ exposure by increasing the variety of foods served and by selecting safer alternatives, such as rice-free snacks instead of puffed rice snacks, and frozen banana or chilled cucumber instead of teething biscuits and rice rusks. For more suggestions, see the Tip Sheet for Parrents at healthybabyfood.org/#action.

© Adobe Stock | Kateryna_Kon

SOURCE: What’s in my baby’s food? Executive summary. Healthy Babies Bright Futures, October 2019. healthybabyfood.org.

COMMONLY USED DRUGS GREATLY ALTER GUT MICROBIOME

Eighteen commonly used categories of drugs profoundly affect the gut microbiome, changing the make-up of bacterial populations and altering the microbiome’s metabolic potential, according to a study presented at UEG Week 2019, in Barcelona, Spain. An additional eight categories were found to facilitate the development of antimicrobial resistance.

Researchers from the University Medical Center Groningen and the Maastricht University Medical Center, both in the Netherlands, analyzed 1,883 human fecal samples and compared those of drug users to nondrug users. The differences they observed could increase risk of intestinal infections, obesity, and other serious disorders linked with the gut microbiome.

The drugs found to have the greatest effect on the intestinal microbiome included proton pump inhibitors (PPIs), used to treat conditions such as peptic ulcers and gastroesophageal reflux; metformin, used for type 2 diabetes; antibiotics; and laxatives. PPI use was associated with greater abundance of upper GI tract bacteria in the gut, along with increased fatty acid production. Users of metformin had higher levels of E. coli in their fecal samples.

Lead researcher Arnau Vich Vila commented: “Our work highlights the importance of considering the role of the gut microbiota when designing treatments and also points to new hypotheses that could explain certain side-effects associated with medication use.”

SOURCE: UEG Week: Half of all commonly used drugs profoundly affecting the gut microbiome, warn experts. United European Gastroenterology, October 23, 2019. www.ueg.eu/press/releases/ueg-press-release/article/ueg-weekhalf-of-all-commonly-used-drugs-profoundly-affecting-the-gut-microbiome-warn-experts/.

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Family-Favorite Recipes

by Sarah R. Smith

PARMESAN FRIED CHICKEN With a crispy crust and juicy meat, this amazing recipe has quickly become a family favorite in our house.

The ingredients are simple and nutritious—the chicken is coated with a grain-free mixture of Parmesan and arrowroot and fried to perfection in a combination of butter and coconut oil.

Serves 5 5 skin-on chicken thighs 1 cup freshly grated Parmesan cheese,* lightly packed ½ cup arrowroot starch ¼ teaspoon finely ground unrefined sea salt ¼ teaspoon paprika ¼ teaspoon freshly ground pepper 1 egg, preferably from pastured hens 1 tablespoon whole milk 1 tablespoon grassfed butter 1 tablespoon refined coconut oil Directions

1. Debone the chicken thighs. (I save and freeze the bones until I have accumulated enough of them to make a pot of homemade chicken bone broth.)

2. In a pie plate (or other wide-bottomed dish), combine the Parmesan, arrowroot, salt, pepper, and paprika. Stir with a fork to combine.

3. Break the egg into a medium bowl. Add the milk and beat with a fork until well combined.

4. Set up the work-line with the chicken followed by the egg mixture and then the Parmesan mixture.

5. Dip each chicken thigh into the egg mixture and then into the Parmesan mixture. Coat all sides of the chicken with both mixtures.

6. Once all of the chicken is coated, melt the butter and coconut oil in a large, heavy-bottomed skillet over medium-high heat. I use a 12-inch stainless steel skillet for this recipe.

7. When the butter and coconut oil are shimmery-hot, add the chicken to the skillet. My skillet is large enough to cook all 5 chicken thighs at once, but if your skillet is smaller, you may need to cook a few at a time. If desired, cover the skillet with a splatter screen to cut down on the mess on the stovetop.

8. Cook the chicken for about 8-10 minutes, until it has developed a nicely browned crust. Then flip the chicken, and cook the other side for 8-10 minutes. Do not move the chicken around much once it is cooking, as that will prevent the crust from cooking properly and make the chicken more likely to stick to the skillet. You may need to reduce the heat to medium if the skillet starts to get overly hot.

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9. Use a probe thermometer to check the temperature in the thickest part of a chicken thigh. The chicken is done when the internal temperature reaches 165˚ F. This is an important step that ensures the chicken will be cooked perfectly.

10. Remove the chicken from the skillet and allow it to rest for a few minutes before serving. The rest time allows the juices to redistribute throughout the meat.

11. Serve and enjoy! I love to serve Parmesan Fried Chicken with potatoes and buttered vegetables or coleslaw. * I like to use the small holes on a box grater to grate the Parmesan.

CARAMELIZED BEETS AND CARROTS This nutritious recipe combines beets, carrots, garlic, and chicken broth for a wonderful flavor. Caramelized Beets and Carrots is a favorite side dish among the members of my family (except for my husband who has a very strong aversion to beets). Both of the kids and I just gobble this up.

Serves 4-6 4 beets, rinsed very well,* peeled, and chopped 7 medium carrots, peeled and roughly chopped 4 tablespoons butter, preferably from grassfed cows (or substitute duck fat, avocado oil, or coconut oil) 6 cloves garlic, sliced Unrefined sea salt Beet greens, rinsed very well* and chopped (optional) 1 to 1½ cups chicken broth, preferably homemade (use 1 cup if you aren’t including beet greens; use 1½ cups if you are including the greens) Optional garnishes: balsamic vinegar, sour cream, fermented bread and butter pickles Directions

1. Place the butter, beets, and carrots in a pot and season generously with salt. Cook over mediumhigh heat for about 20-25 minutes, allowing the beets and carrots to caramelize in the heated butter. Stir occasionally.

2. Reduce the heat to medium-low, add the garlic, and sauté for about a minute until the garlic is fragrant.

3. Add the broth and optional beet greens.

Season with salt. Bring to a boil and then reduce heat to low.

4. Simmer 30-40 minutes, uncovered, allowing the broth to cook down. Stir occasionally. The beets are done when they are nice and soft.

Check for degree of saltiness and turn off heat.

5. Cool slightly and serve. This is delicious on its own, or you can add either a drizzle of balsamic vinegar or a scoop of sour cream. The beets and carrots pair particularly well with fermented bread and butter pickles. Leftovers are great when served with scrambled eggs for breakfast. * If you don’t rinse the beets and beet greens very well, you may end up with sandy grit in your teeth.

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BAMYA—EGYPTIAN MEAT AND OKRA STEW Bamya is a hearty Egyptian stew made with meat and okra. When simmered in this acidic sauce, okra has little of the sliminess that it is known for. This delicious stew can be prepared with beef or lamb. The stew meat simmers until it is nicely tender, and then the flavor is kicked up with tomato, garlic, coriander, cumin, and lemon juice.

The flavor is really different than any other stew I’ve had, and super yummy! (I’ve never been to Egypt, so this dish is inspired by Egyptian Bamya rather than an exact replica of what you’d find there.)

Serves 4-6 1 large yellow or white onion, chopped 3 tablespoons butter (or other healthy fat of your choice, such as tallow, ghee, etc.)

1 pound beef or lamb stew meat 2 cups filtered water 1 bay leaf ½ pound fresh okra, stem ends and long tapered ends removed,* chopped into ½-inch chunks 5 cloves garlic, freshly minced 3 tablespoons tomato paste, preferably from a glass jar 1 tablespoon fresh lemon juice ¼ teaspoon dried coriander 1 teaspoon dried cumin 1 tablespoon salt, divided ½ teaspoon pepper 3 tablespoons white rice flour (or substitute arrowroot for a grain-free option, or leave it out entirely) Optional: Cooked white rice, to serve Directions

1. Melt the butter in a 4-quart pot over medium-high heat.

2. Add the chopped onion and ½ tablespoon salt. Sauté for about 10 minutes, allowing the onion to take on a bit of brown, caramelized color.

3. Stir the stew meat into the pot. Sprinkle with ½ tablespoon salt (or less if your tomato paste is salted) and ½ teaspoon pepper. Allow the meat to brown for about five minutes, stirring after a few minutes.

4. Add the water and bay leaf to the pot. Reduce the heat to maintain a simmer. Allow the meat to simmer for 60-80 minutes, until it is nearly tender.

5. Once the meat is nearly tender, add the okra, garlic, tomato paste, lemon juice, coriander, and cumin to the pot. Stir to combine.

6. Simmer for 20 minutes.

7. Remove ½ cup of liquid from the pot. Whisk 3 tablespoons rice flour or arrowroot into this liquid, then whisk it back into the pot. Bring to a low boil for a few minutes to allow the flour to thicken the stew liquid. Beware: arrowroot breaks down and loses its sauce-thickening ability if simmered too long, so only simmer for a few minutes if you’re using it.

8. Turn off heat and ladle into bowls. This stew can be served as it is, or over white rice as it is traditionally served in Egypt. * I prefer to remove both the stem ends and the long tapered ends, as the latter seem to contribute to okra’s reputation for sliminess. I also discard any okra pods that have brown seeds inside, as these will be tough.

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BASIC KALE CHIPS My kids and I love kale chips. What a wonderful way to eat greens! Kale chips are quite simple to make, and cook up crispy and light in the oven. When my kids were younger, I would generally send them outside with their portion because the chips are a bit delicate and little kids may make lots of little crumbs while they are eating.

Athough I have a dehydrator, I prefer to cook this recipe in the oven.

One bunch kale (curly or flat kale both work well) 1-2 tablespoons refined coconut oil (or other healthy fat such as bacon grease or duck fat), melted and cooled slightly Finely ground unrefined sea salt Directions

1. Rip or cut the tough stems off the kale. Discard the stems or save them for another purpose.

2. Wash the kale and then dry it well. I like to use either a salad spinner or a couple of towels to dry the kale. If you do not dry it well, it will steam rather than crisping in the oven.

3. Rip or cut the kale into chip-sized pieces.

4. Drizzle the melted coconut oil onto the kale.

Try to use just enough oil to coat the kale, but not too much or the chips will be overly greasy. Use your hands to thoroughly mix the oil onto the kale leaves.

5. Place the pieces of kale onto a couple of baking sheets. Make sure the kale is in a single layer, and try not to have much overlap of the pieces (else they won’t cook properly into chips).

6. Sprinkle the kale with a generous amount of salt.

7. Bake the kale chips in a 250Ëš F oven for about 30-45 minutes. To test for doneness, remove one chip from the oven and allow it to cool before eating. The kale chips are done when they are nice and crispy.

8. Store the cooled kale chips in an air-tight container at room temperature. Consume within one to two weeks.

Reprinted with permission from www.nourishedandnurturedlife.com.

ABOUT THE AUTHOR

Sarah R. Smith is a homeopath, homesteader, and homeschooling mother of two. She has been studying nutrition and health since 2005, when she was first introduced to the work of Drs. Weston A. Price and Francis M. Pottenger, Jr. Sarah has been writing about real food and health on her website (www.nourishedandnurturedlife.com) since 2011. She is the author of two eCookbooks, Nourishing Eats (2012) and Nourished Cooking (2013). Sarah also serves on the board of the Raw Milk Institute. As a homeopath, she works with children and adults to heal acute and chronic imbalances, leading to healthier, happier lives. In addition, she teaches homeopathy classes in her local community.

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Fall 2019 / Vol. 43, No. 2

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