Jay Feldman 0:04
Welcome to episode 74 of the energy balance podcast, where we teach you how to live without constant hunger and cravings, fatigue, brain fog, poor sleep and all sorts of other low energy symptoms by maximizing your cellular energy. I'm Jay Feldman. I'm a health coach and independent health researcher, and joining me again today is my good friend Mike Fave. Mike and I have been studying health and nutrition together for a long time now, and Mike also draws on his experiences from working within the healthcare industry. Today's episode is part two, the second and final part of our series refuting nutrition with Judy's article titled thoughts on the repeat diet a review, and in today's episode, we'll be discussing why low carb diets are inherently stressful, how carbohydrates oppose stress and decrease the stress hormones, why carbohydrates are essential, and why their intake plays a vital role in our endocrine systems, whether most people have hypothyroidism, and how carnivore diets can cause hypothyroidism, why carnivore diets are not ideal for gut health, even if they improve symptoms in the short term, and the real reason why people are moving from a carnivore diet toward a quote, diet. This episode was inspired by a listener question. If you have any questions that you'd like us to answer on a future episode, you can send those into Jay at JayFeldmanwellness.com that's j, A, y at Jay Feldman wellness.com or you can leave those in the comments if you're watching on YouTube. To check out the show notes for today's episode, head over to Jay Feldman wellness.com/podcast where you can take a look at the studies and articles and anything else that we referenced throughout today's episode, and if you are struggling with any low energy symptoms, maybe you're coming from a low carb or carnivore diet, and you're struggling with chronic cravings and hunger, low energy or fatigue, chronic pain, digestive symptoms, brain fog, poor sleep or Insomnia, hormonal imbalances, low libido. Maybe you're dealing with body composition issues, either having trouble putting on muscle or getting rid of stern body fat. Or if you're dealing with any other chronic health issues, again, whether you're coming from a low carb carnivore diet or any other lifestyle or diet, these chronic health issues could be autoimmune conditions or heart disease, diabetes, whatever it is, if you are dealing with any of these symptoms or conditions, then head over to Jay Feldman wellness.com/energy, where you can sign up for a free energy balance mini course, where I'll explain how these different symptoms and conditions are really caused by lack of energy. And I'll also walk you through the main things that you can do from a diet and lifestyle perspective to maximize your cellular energy and resolve these symptoms and conditions. So to sign up for that free energy balance mini course, head over to Jay Feldman wellness.com/energy, and with that, let's get started.

Moving on to another piece here, discussing, because this is, again, crucially important, is understanding the relationship between carbohydrates and energy and stress, and how blood sugar fits in there. And so a couple or another quote that she mentioned in this regard. She says, and so this is in and I guess, a response to this idea that, from the bioenergetic view, that a low carb diet would drive stress. And so she says, If low carb dieters had chronically high stress, and then in parentheses, in cellular energy, the impact would be on Hormonal Health, adrenals, and possibly even some inflammation. We just don't see this unless a person is consistently under eating or over exercising. So again, this is there's kind of some tactics here to get away from actual any discussion of the physiology. And just saying that we don't see this, but we've discussed this in depth, and these are kind of extensions from this difference that occurs between sugar and fat oxidation, and because sugar is so crucial for our brain and is necessary for a high rate of ATP production without oxidative stress, and because we do need so much on a regular basis when we don't, and our blood sugar is the direct kind of mediator of regulator determining whether we do or don't, it does directly cause physiological stress. So in other words, if you go, if your body is using carbohydrates, because you're on a carbohydrate containing diet, and then you don't eat carbohydrates for long enough, your blood sugar drops. And if there is no stress, like no stress hormones produced. These stress hormones being glucagon, cortisol, epinephrine, growth hormone, epinephrine is not necessarily in that order, but those being the four main ones. If none of those are produced, your blood sugar keeps going down and then you die because you don't have enough sugar to fuel your brain.

Mike 4:57
So you don't even need all of. Those, if you don't have adequate amounts of cortisol, you would, you could die. And that you see that in Addison's disease,

Jay Feldman 5:06
Right. Great. Yeah, exactly. So instead, our bodies are better than that, and what they do is, as our blood sugar starts dropping, they activate these stress symptom systems that cause the release of stored glucose as you know, into the bloodstream to raise the blood sugar, or beyond that, if that's not enough, then they'll start to convert protein to to sugar. And along the way to there, there's some other mechanisms going on, where they shift toward more fat oxidation, and eventually they'll shift to our ketone oxidation, or production and oxidation. And so these, so the this is stress, this is like, this is the direct release of stress hormones. And again, the category of stress hormones here, I guess, is rather, rather arbitrary in a way. But in general, when most people are thinking of stress, they just think of cortisol. But our, what we're kind of defining here is stress is the hormones that are produced when we are lacking energy. And that drop in blood sugar is a is a signal that we're lacking energy, because we can't be producing enough energy in our brain without that glucose and elsewhere as well. And so then we are forced to to create these backup or to activate these backup pathways, which we are calling stress pathways, as backup pathways, because they because stress is a situation where we have to dive into these pathways so they get activated in response. And so again, this is coming from the fact that this is what happens anytime we are in a physiological stressful situation where we have an increase in energy demands or a lack of energy supply. So this means we're exercising and we aren't constantly taking in fuel, or we're starving and we're not taking in fuel, or we're working really hard mentally on some assignment and we're not taking fuel. These things. I mean, at least the exercising and the mental work increase our usage of fuel. That will also drop our blood sugar. It will also lead to, basically, yeah, a low fuel state, because we're using the energy. And so it activates these stress pathways. If you don't eat or don't eat carbohydrates, that'll do the same thing.

Mike 7:11
So and they recognize, she recognizes this specifically, because she's like, if you're over exercising, right? She already she has or under eating exactly she has the concept understood, but it's just, I get the sense it's not applied to the idea that not having adequate amounts of carbohydrates in general is is putting you in a state. Here you are under you're essentially not providing the energy that you need to meet whatever the excess demands are, which is why it's so much easier for you to crash in stressful situations, which she actually suggests in the beginning of the article.

Jay Feldman 7:46
Yeah. And we can pull that quote in a moment, yeah. And again, as you're kind of alluding to, under eating is like mild starvation and starvation and low carb, like, there's that direct connection, showing that low carb diets create the same effects as starvation. So in her saying that under eating will cause stress is basically the same as saying that not eating enough carbohydrates will cause stress. And I've got a couple quotes here that are from a study looking at the role of glucocorticoids the stress the stress hormones, specifically cortisol, in relation to carbohydrate oxidation and energy availability and blood sugar. And so they say, a major function of the steroids, or these steroids, and thus, the HPA axis, or stress axis, is to ensure energy homeostasis. As such, this neuroendocrine system is highly responsive to states of energy balance, and in turn, modulates energy acquisition and deposition. And this, again, is just pointing to the fact that the stress hormones, and our HPA axis is responding to the energetic state. Then the next quote they say is that consumption of carbohydrates and other palatable foods blunts the neuroendocrine, metabolic and behavioral responses to stress. And there are a few others in there as well. But as you're saying, she did relatively acknowledge this early on in the article, and she was talking about the people in the carnivore space who are, who have been transitioning away and moving away from carnivore, and a lot of them moving toward a bioenergetic perspective, or things that reflect that, whether they're acknowledging it or not, some are and some aren't. And she was blaming that on a couple of things. So the first one thing that she said was that it's very normal during a highly stressful state to crave sugar and carbohydrates. And she this was in regard she was discussing covid, and saying that the stress of covid over the last year and a half is causing people to be under a lot of stress and then crave carbohydrates, and that's why they're moving away from carnivore. And for one, I mean, it's, I mean, there's a lot to to pull apart there. I mean, for one, it's interesting that you would have a diet that doesn't, that isn't very compatible with dealing with stress. It doesn't help to oppose stress. There's also this assumption built into that, that quotes, which is the idea that carbohydrates are. Uh, oppose high stress, and that we crave carbohydrates when that happens. And that's true. And that's what that study that I was referencing is talking exactly about, is, is, and there's, there's many of these showing that carbohydrates directly oppose stress. And so in the same like we were kind of talking about this in reverse, when you don't have enough carbohydrates, it causes these stress hormones to be released. And then the opposite happens too. Is the best way to stop stress hormone release is by taking in carbohydrates that you are able to efficiently use to produce energy. So of course, in someone who is diabetic or insulin resistant, when they take those carbohydrates in, they still have high stress hormones. And that is this, that is the pathology, that is the difference, as opposed to somebody who is using carbs. Well, when they take carbs in those stress hormones all go down, and Insulin helps with that too. And insulin and the stress hormones tend to have opposing effects. So yeah, there's a couple other quotes I know she had in that intro part. I don't know if you wanted to mention those.

Mike 10:55
I just wanted to touch on that specific that that quote that you had, there was, was perfect. Mine was the same. It said it's very normal during a highly stressful state to create sugar and carbohydrates. If low carb dieters had chronically high stress, the impact would be on on hormone health adrenals, possibly even some inflammation. So this was talking about the first quote is really talking about, like, the idea that you crave carbohydrates during stress. I like she recognizes that, and I think that's great, but I don't think I don't get the sense from her quote. And this is me, my interpretation of her statements, that she understands that you craving like you're craving for carbohydrates during stress is a physiologic craving to help manage the stress. I think inside the carnivore low carb spheres, it's like, oh, and you're just addicted to sugar, and you just like, want comfort foods without, without a recognition and understanding that the comfort foods and the cravings during stress are literally to help your body meet the stress. Like, it's a it's an inborn craving that we all have because it it's effective. It's that providing carbohydrate during stress decreases stress and allows you to handle stress better or or more appropriately. So to I tried to find a study here that was specific to like the coronavirus pandemic, lockdown, whatever stuff like that was analogous situation. So this the study that I have here is healthy male volunteers attending survival training. This is a quote, by the way, healthy male volunteers attending survival training were recruited for participation in the study at the conclusion of the mock captivity phase of survival training, before recovery night of sleep, subjects participated in cognitive testing. So this was a mock captivity test in survival training, where the recruits were essentially like held in captivity during their survival training, and they weren't, I don't think. They were given food, and they also weren't. They weren't allowed to sleep so and they did cognitive testing on them, and so then it says after this, subjects were randomly assigned to one of three treatments. Subjects either received a 6% carbohydrate drink, 12% carbohydrate drink, or placebo beverage in four isovolumic doses, so same volume, the placebo beverage had no carbohydrates, and then in the morning of the following day, all subjects participated in a second assessment of cognitive functioning. So these participants were held in some type of mock captivity. This is like a military setting. So they're literally captive, and then they are they do this, this type of computer testing to see what, how their intellectual functions are going, and before they get any sleep, and then they have carbohydrates, and they're allowed to sleep, and then they test them again the next morning. And so some have carbohydrates, some don't. So then what they say compared to subjects who received placebo, the placebo was no carbohydrates. Those who received supplemental carbohydrate beverages exhibited significantly improved performance on complex tasks involving concentration effectiveness associated with selective attention and response inhibition. No differences were observed on a variety of cognitive tax tasks of lesser complexity. So what they're showing here is that during stressful periods, if for these people, for these individuals, when they were put under stress and they did cognitive testing, the one who were provided carbohydrates scored better in the cognitive testing for complex mental functions and compared to those who didn't have carbohydrate. So it's the carbohydrate in the scenario of mock captivity. Keep that in mind. This is like analogous to the lockdown, the lockdowns for stuff. To some extent, the ones who had carbohydrates were better, had better complex mental functioning in this study. Then the second study here, this one, I tried to get close to it as well. What they did, this is in college students. So as a double blind placebo controlled design, subjects were instructed to fast overnight, then they arrived to a lab, like a research lab, and their baseline salivary cortisol. Was taken, the subjects were then seated in front of a computer screen and were exposed to computer like a bunch of tasks on the computer. So after doing this baseline performance on the computer, they the participants were given to two mil 200 milliliter glasses of orange juice. I think they were 20 grams of carbohydrate each, and then the placebo group, or the control group, was given one that didn't have any of the carbohydrate in it, so a glass of the juice without carbohydrate, or it wasn't it was still orange flavored the juice, it wasn't orange juices, like orange flavored juice with glucose, so that they could all have the only variable that they were changing was the glucose, so the placebo group didn't get or the control group didn't get any glucose. So then after, then after, like a rest period, they were then seated in front of the computer screen again, and they were to run the same test, but this time, when they ran the test, what they had to do was they had to keep their hand in ice cold water that the non dominant hand at random periods of time. So it was like a, it was a, whenever the researchers would tell them to do it, they'd have to put their hand in the cold water and hold it for as long as possible. So it was like a, what's it called? It's, um, I'm forgetting the term off the top of my head. It, it you don't know when the stress is going to occur. It's kind of it's a random stress, so you have to put the hand in cold water while you're doing this, this computer test. So then it says after or unpredictable stress. There we go. Approximately 15 minutes after the stress performance, they took a third salivary cortisol sample, and then the subjects filled out questionnaires on their mood. And so basically, what they showed here is repeated this is a quote of the results, repeated measures, analysis of variance with diet and time as within subject, factors on cell on salivary cortisol Concentration. Concentration revealed a significant interaction of that interaction effect of diet and time, meaning that cortisol concentration changes dependent on dietary condition, as demonstrated, after intake of carbohydrate, there was a slight but significant decline in cortisol that was not found in the placebo group. So essentially, the groups that even on this small test, even on doing computer games while having to keep your hand in ice cold water, they the cortisol level was lower in the group that had, that had carbohydrate, versus the group that didn't. So, number one, there's, there's two assumptions that I want to draw from these, this study specifically. Or two, I guess, my take my my interpretations. Number one, it wasn't that hard to increase salivary cortisol people to increase their cortisol response and create a stress system by or a semi stress state, because it's not like you're in stress or not. That's obviously a spectrum. But it wasn't very difficult to create the state. And then, second of all, having carbohydrate still blunted the state in such a small degree. And there's only 20 grams, so it's just showing the importance overall of carbohydrate in because if the way I think both of us tend to look at it, and I don't want to speak for you, so correct me if I'm wrong, but it's essentially carbohydrate is the we see it as, like the primary fuel source, and to to a large extent, for a bunch of different tissues in the body and any of the external forces, if they're increasing that demand on your carbohydrate utilization, your body has to meet that need by releasing hormones that mobilize carbohydrate from your own tissue stores and to be able to provide energy to those tissues to meet the demand, if you are taking the carbohydrate exogenously, there's no need anymore to mobilize your own body's tissues, because you have the carbohydrate coming exogenously, so the response gets blunted. And that's essentially what the research shows as well. And that also validates people's craving for various carbohydrates, or like, you know, it's usually like a sweet, salty, fatty food they crave during times of stress, because you're providing literally, a whole host of factors that your body doesn't have to liberate them from its own tissues. It's an intelligent design. It's a beautiful design, and it makes sense, and it's in line, and it gets rid of this idea, again, of the paradoxes that I was talking about up front, where it's like, oh, during stress, you crave carbohydrates, but carbohydrates are bad for you. That is a paradox that doesn't make any sense. It's like, why would you crave something that is bad for you? And it's like, because it's not actually bad for you. And this is why.

Jay Feldman 19:26
Yeah, yeah. And another piece here, just in talking about the stress, and we're we're kind of talking around it and using all these examples that support it, but I want to make sure that it's clear that that the stress is caused by a lack of energy, and that is something that seems to be very much missed in this article, where there's this assumption that stress is just caused by outside factors and there's no interaction with the physiology. But what happens when there are outside factors that are stressors is that they use energy. They require the use of energy, whether they're cycle. Logically stressful things that use, you know, require a brain to use energy, or it's exercising that requires usage of energy by our muscles. And when there's that lack of energy, and we don't, as you said, Have enough readily available fuel, then we either have to pull it from our stores, or we can take it in. And if we pull it from our stores, it signals stress. And I'm going to explain why that's so important and makes sense evolutionarily and in a larger context as well. But it's really key here to acknowledge, to recognize this point, that the stress is caused by the lack of energy there, and it's not just something that's psychological, like, you know, Jody had mentioned, it's caused by, in this case, like a covid pandemic. And then she also suggested that a better way to deal with stress, then to taking carbohydrates would be to do some sort of breathing exercises or taking magnesium.

Mike 20:46
That's why I was laughing before, because I was just thinking about, like the breathing exercise recommendation. It's just such a weird perspective on managing some of these stressors, especially if you're already putting yourself in a state that increases your stability to stress. It's like, don't fix the actual problem, just do breathing exercises.

Jay Feldman 21:06
Yeah which, which, in that case, you're not actually going to be doing anything to reduce the stress at the time. All that's happening, really, is that a you might be reducing the the stressor. You might be reducing the psychological stressor that is causing the stress, and you're also giving your body enough time for those stress hormones to liberate enough fuel to produce enough energy to bring the stress down. You know, that's why you don't have chronic, chronically elevated cortisol. When you just exercise for an hour, it doesn't stay elevated forever, just long enough until you replenish your energy stores or your energy availability and then it stopped. You don't need it anymore. Serves its purpose. Breathing exercises and magnesium do not directly help increase your energy production and stop the stress hormones at all. So yeah, there's there's definitely that missed concept there, which is in talking about the bioenergetic view is absolutely key to having a larger perspective of all of these things. And we're going to talk in a moment. We're going to dive into how this then directly relates to almost every other argument that's made in this article in regard to the endocrine system and thyroid and gut health and all of that. And so there's this one piece that I want to show this next quote, because it directly ties into this concept. And so she poses a question, do you think our body makes carbohydrates non essential, but then expects organs and a whole endocrine system, adrenals, thyroid hormones, etc, to depend on a non essential macronutrient for proper function? First, just to get this essentiality idea out of the way, carbohydrates are absolutely essential. Dietary carbohydrates are not but if you don't need the dietary carbohydrates, you still have to produce a lot of carbohydrates. So your body is always using carbohydrates that are absolutely essential to life as humans and function, and you cannot live without those carbohydrates.

Mike 22:53
They are so essential that your tissue, your body, will break down its own structure by breaking down the proteinish tissues of your body,

Jay Feldman 23:01
your muscles, your bones, your organs.

Mike 23:03
Yeah, exactly. It'll literally break down whatever it can get, as far as protein structure, to turn amino acids into glucose, and also, while doing so, produce large amounts of ammonia that have to be detox, detoxified, or maybe not, maybe perhaps not large amounts, but a decent enough amount of ammonia to cause an issue, and this is specifically why. This is one of the reasons you can't just live on protein. If you're going to go on a low carb diet, you need to have fat because the ammonia production of trying to turn the protein into glucose, because it is that effective, can poison you from producing excess ammonia and then overwhelm your body's ability, your energy availability to deal with the ammonia overall.

Jay Feldman 23:44
Yeah. And if you want to talk about wasting nutrients for energy production, the conversion from protein to usable carbohydrate for energy wastes about 30% of potential, like of the fuel, it's like 30% less efficient than just using carbohydrates for energy. So you're losing a huge amount there, not to mention the protein that was either already built into your muscle, for example, or was going to be used for something like that. And because of that, that is not our primary way to produce carbohydrates. It's our one of our backup ways to do so, because it's so costly, and you could say wasteful, if you want to make that argument, and along those lines as well. I think that if we want to make some conjecture, which we don't even have to do, because people explain it, as far as why so many prominent carnivore advocates have moved away and started incorporating a lot of carbohydrates and have have been shifting toward a more bioenergetic approach, is because a carnivore diet is really effective at creating that stress, because you have to rely on converting protein to carbohydrates for that necessary, essential glucose and carbohydrate that your body does need, even though it doesn't have to take it in. So that's what happens when you're considering things from this perspective that carbohydrates are not essential. Now, the other piece here is that the only reason that you can say, and I'll let you talk about this later on. Yeah, but the only reason that you can say that fats are essential and carbohydrates are not is because of this idea of essential fatty acids, which are omega threes and Omega sixes that we cannot produce ourselves. So you can say that fats are essential because carbohydrates aren't, because we can produce the carbs ourselves, but we can't produce omega threes and Omega sixes, so those are essential. But in reality, fats are not essential. You could just say that, like a couple grams, and we'll talk about the specifics of omega threes or omega sixes are essential. But fats are not essential really, either. We produce saturated and monounsaturated fats ourselves in large amounts, and that's really like, it's, again, this is kind of like a complete straw man argument, argument here. But then I wanted there is an important question that, like, there is a legitimate question that is posed here, which is that, which is that, why would carbohydrates be so essential and be so tightly regulated for proper function? Why is it that if we go, let's say, five hours, four hours depending or two hours, depending on how active we are and on why is it that if we go that long without taking carbohydrates, that we immediately switch into stress, and that this stress then directly has effects on our thyroid activity or hormone, on your reproductive hormones? It's a good question, and one that we have discussed, and so I'll link to that episode where we talked about kind of the ancestral diet idea and evolutionary perspective here, but a short answer here is that the amount of carbohydrate, because carbohydrates are so effective at producing energy relative to fats, and we can't, if like, efficiently produce them ourselves from other things, it's way more efficient to get them from our diet. Because of that, we are very tightly regulated in terms of our energetic capacity in relation to what our environment can provide, and that really in many ways, depends on carbohydrates, because if we don't have those carbohydrates available, we're going to have to make do with much less quality fuel, so to speak. And because of that, we need to be able to sense very closely how much carbohydrate is available. So that if we don't have enough for an extended period of time, we know to turn down our thermostat. We know not to we know to start conserving the glucose, which we don't have that much of, we can't store that much of, and we use so much, you know, like relative to the amount that we can store, we use a lot. So we need to have a very tightly regulated thermostat there. And if we're not getting enough carbs, we have to decrease our metabolism, decrease our thyroid activity, move away from things like reproduction, because we need to, in reality. And she said, life or death earlier, but we do actually need to prioritize survival when that when it comes to lower energy availability. And so that's again, in short, and I'll link back to that other episode, but that's why these things are so tightly regulated around carbohydrate intake, and why they have such a direct effect on something like stress hormones, and why they're also in the same vein, so potent at raising our metabolism and getting those stress hormones down and supporting testosterone production and other hormone production and supporting thyroid activity, and why It does make such a big difference whether you are getting enough of them on a regular basis or not.

Mike 28:05
Yeah, and I think this directly ties in with the the entire thyroid piece as well, because essentially, if a great way to lower your thyroid hormone production. and just to put this perspective for people, I'm pretty sure there's a study that I was reading in the past, when I was doing a thyroid episode going over thyroid thyroid, essentially saying that about 40% when they removed, when they removed people's thyroids and they didn't replace thyroid hormone, upwards of 40% of the metabolic rate was was decreased because of the lack of the thyroid. So when you look at something and you start saying, Okay, if thyroid is the main controller of what's going on metabolically, and I decrease my carbohydrate consumption, and it has with like, direct effects on what's going on with the thyroid and active thyroid hormone and whatnot, and inside the body, it's, you're literally seeing that relationship where it's like carbohydrate and thought is the sin, the stimulus, the signal to increase the metabolic state overall. And this ties in. I don't know if you wanted to go into this or there's something else you wanted to get into before we discuss the whole hypothyroid piece that she discusses in the article, but it's a perfect transition to that.

Jay Feldman 29:19
So Judy has a section discussing thyroid and hypothyroidism, and I think one of the main reasons why she felt it important to include this was because it's something that's discussed a lot by by Ray and in the community, but the, you know, the ideas from which it's discussed, or the place the lens from which it's discussed doesn't really seem to be grasped as much based on the section because so here are the few points that that are made in that section, and we'll kind of build from there. But her first point here is basically that most people don't have hypothyroidism, even if they think that they do. The second point is that hypothyroidism is not. Issue. And then the third is that carnivore diets don't cause hypothyroidism. So in terms of this first idea that most people don't have hypothyroidism, the reason why I think she's making this point is because, from the bioenergetic perspective, hypothyroid hypothyroidism is extraordinarily common. And everything that's used in terms of reference ranges and typical markers has been way skewed due to the history of hypothyroidism and medications for hypothyroidism and all sorts of of things that have changed in the medical industry throughout the last 100 plus years. In that regard, that has led to it to be a very low percentage diagnosis, even though it could be rather widespread. But, you know, we, we don't typically talk about things too much in terms of hypothyroidism, because I think sometimes that does give this idea that hypothyroidism is kind of the root issue, and encapsulates the larger issue when reality it's it is just a depiction of what's going on, which is low metabolism.

Mike 31:01
What's causing the hypothyroidism? What's underlying it?

Jay Feldman 31:06
Exactly. Our thyroid is our main metabolic regulator. It turns that thermostat up and down, and there's tons of things that can cause it to be turned down or turned up. But the larger idea is that when we're not producing a lot of energy, when we're under a lot of stress, we end up with a lower metabolism, and that shows as hypothyroidism and comes with a ton of issues. So that's why this, you know, she's including this piece saying that most people don't have hypothyroidism, as if that you know, that this kind of negates that idea. And she cites a study. Well, she mentions a study. She doesn't actually cite it. So I don't actually know where this study is coming from, but she says there was a European study with nearly 300 hypothyroid patients with ambiguous hypothyroid diagnoses. They were all on hypothyroid medications. The doctor, the doctor, took them off medications and found that 60, 60% were misdiagnosed. And there's not really much more behind that that's said in regard to the study, and there's no reference to the study, so I don't really know what it's referring to and what really any of that means, as far as what the ambiguous hypothyroid diagnoses were, what the hypothyroid medications were, or what the misdiagnosis like, how 60% were misdiagnosed, I don't know how that was determined, what that was determined based on, but what it sounds like is that, well, I don't know about the ambiguous hypothyroid diagnoses, but I'm all being on hypothyroid medications. I'm assuming was the t4 only medication, and we've discussed why this can be extremely problematic, because many people have issues converting the inactive thyroid hormone, which is t4 into the active thyroid hormone, which is t3 and so if you administer t4 to someone who's not converting those very well, and we'll discuss things that can inhibit that conversion. One of them is a low carb diet, if you're not converting those well, and then you add in a bunch of t4 not only will it not solve the issue, but it will actually make it worse, right? Because it's it acts as a further signal of lower metabolism when you have a very high amount of t4 especially relative to t3 so if you had people who were actually legitimately hypothyroid, and you give them t4 which I've seen this numerous times with clients, they feel way better off that medication because they were never converting it to the active hormone in the first place. It doesn't mean that they weren't hypothyroid or they didn't have a low metabolism. Just means that the medication that was used that's supposed to be the solution is not very effective at that solution. And again, we talked a little bit about the history there too, where the only reason why they started giving just t4 was because it was shown to be equivalent when it was given in 20 to 25 year old men who don't typically have these conversion issues and and on from there. But regardless, I don't know exactly what, what the studies that she's referring to, but it's certainly not a good or, yeah, substantial refutation to the idea that a lot of people don't have legitimate hypothyroidism or legitimately low metabolisms, and that that wouldn't account for tons of symptoms that are and issues that people experience all the time. And we've talked about this virtually every single chronic health issue or symptom, whether it is like a metabolic condition, diabetes, heart disease, cancer, on from there, or you're just looking at particular symptoms, like particular digestive symptoms, low stomach acid, low gut motility, low reproductive function, low fertility, just on and on and on, are all directly tied with hypothyroidism.

Mike 34:18
The other piece here is that the quote is talking about doctors referring to like a misdiagnosis. In the modern medical model, most of diagnoses are made off of TSH, and the TSS, TSH range goes up to four, and that was just adjusted downward, I think, from being at eight or 10. So first of all the you can't diagnose hypothyroidism off of TSH. This is like, this is this is not the only, the only diagnosis for hypothyroidism that you can do just off TSH is that if your TSH is elevated, you are most likely hypothyroid. Now, if your TSH is low, it doesn't mean that you don't. Have hypothyroidism. And the reason for this is because your pituitary reacts differently to the thyroid hormone that you have going on in a regular basis. And so you're like your TSH will basically have your will basically signal your thyroid to produce t4 now, t4 thyroxine is a pro hormone, essentially, and it has to be converted into the active t3 which will is very important to keep in mind when we get to some of her other points. But the t3 is the active hormone, and then that t3 has to be able to have an effect at the cell. And so there's multiple factors that can that can adjust the conversion of that t4 into t3 including liver health, including metabolic state of the cell. And there's, there's the one I'm speaking about is directly from a research article which we will cite, but essentially the doctor. The first piece there is number one, the TSH that the doctors may be diagnosing from if it's according to there's quite a few articles on this. If your TSH is greater than two, then you most likely are having a thyroid problem like that. Is that is pathology, especially in people who are younger. So if your doctor is saying that you're that you're not hypothyroid because your TSH is in range in it's greater than two, like that, that's not reality that they haven't looked into the research. Then the next piece to keep in mind is that even if your TSH is less than two, which I've seen with people that I have been working with coming from a carnivore diet, their TSH is is less than two. Some of them are ones, some of them are less than one. But it's, it's exactly as you mentioned. It's suppressed, and it can be affected by stress hormones, so you can't diagnose them for hypothyroidism, from that TSH level, you have to then look, okay, what's their t4 what's their t3 what's their cholesterol, what's their temperature, what's their symptom profile. And if, if I'm going to be looking at all these pieces, and it's in like, you have high cholesterol, which some this, you have higher cholesterol from what you had before. You have low t3 you have low t4 you have low free t3 and t4 you have a high reverse t3. You have a cold hands, cold feet. Your temperature is low. All of these indicate hypothyroidism, regardless of what the TSH is. So this study, I would and I haven't read the study because it hasn't been cited. So I just want to be clear on that this study largely doesn't tell us anything, even if we went read through and it's like, oh, the doctors removed these thyroid patients off of their thyroid medications, and all of a sudden they're like, they were they they weren't actually hypothyroid. It's like, okay, what were you diagnosing on TSH, like, What else were you looking at? And considering the modern medical point of view, there's a very good chance that they were just looking at TSH, and then I would even be surprised if they were looking at t4 and even if they were looking at t4 that still doesn't tell us anything. If your t4 is high, even if your t4 is high, if your t3 is low, or your reverse t3 is high, then you still can be hypothyroid. And I've had people who've come to me who have high t4 but they also have high antibodies, even though their TSH isn't super high, and then their t3 and the reverse the reverse t3 is high, and their t3 is low, and then their temperature is cold, and they have a whole host of hypothyroid symptoms. And the there's an article basically discussing this, but essentially the problem with like, even with taking t4 by itself, is the pituitary reacts differently than the rest of the tissues of the body to the t4 medication. So if your blood t4 is high and you're not converting into t3 then your patoot, then that will signal to your pituitary, oh, we have a lot of we have enough thyroid hormone, and then your pituitary will down regulate all of the signaling cascades for your thyroid, and then you're essentially left with nothing, because now you have t4 you're not converting it, and then you're the little t3 that your thyroid was producing from the signal from your from your pituitary gland. It there's no signal anymore. So now you don't have t3 and you don't have teeth, you don't and you just have a whole bunch of t4 that you're not converting and you feel worse, because regardless of how much t4 you have it, what really matters is, is that t4 being converted to t3 and is that t4 or t3 getting to the cell and doing its job if it's not doing that? And the only way to measure those things at the cellular level, unless you want to do like biopsies, which none of us are recommending, is to look at your symptom profile, you need to see what's going on with your symptoms, your function and your symptoms are the biggest indication as to where you're at physiologically. If you're freezing cold, if your hands and feet are cold, if you're still having like, a litany of these issues, if your cholesterol profile is elevated, those are indications of a hypothyroid state. And that's why there's that's why you have to look at more, like the entire picture. And the other thing you can look at too is like, if you're, if your TSH is low and your or your TSH is low and your t4 is fine, but you have sky high cortisol and you have hypothyroid symptoms, like, that's a problem as well. Like, you're not, you're not going to have a good thyroid panel. And then also. Have high stress hormones as well. It's you have to look at the whole picture. That's symptoms, that's labs, that's everything altogether. And so this one study is largely from my perspective, based on how it was described, even though I haven't read it, is probably going to be useless. And then, even if we did read it, and they did test more than TSH, I think it would be unlikely that they did test t4 but if they did test t4 it still won't tell us enough information for what we need to know. And in my experience, most people have hypothyroid symptoms, and using the correct thyroid medication does make a huge difference for people, and that is either natural, desiccated or mix of t4 t3 and those are some of the reasons why we would use it.

Jay Feldman 40:42
Right? And again, just to clarify two things. One, we can't read the study because it's not referenced or cited. And two, again, it just said that they were on hypothyroid medications. And as we mentioned, being feeling better when somebody goes off of a t4 medication is not evidence that they did not have hypothyroidism.

Mike 40:59
So yeah, and it doesn't The thing is, is it says that the doctor, doctor took them off medications and found that 60% were misdiagnosed. So what that means is, it's not even that they were feeling better. It was probably just that their lab values, like their TSH, was not super elevated out of the reference range. And again, the current reference range is skewed. If your TSH is over than two, there's quite a large probability that you are having that there's, like, some dysfunction. Thyroid wise, it should be lower than that, according to some of the studies that we've that, that I've been looking at and that I think that you've been looking.

Jay Feldman 41:34
Well. So yeah, and, and, as you said, also, just because it someone's TSH is below two, that does not mean they don't have hypothyroidism. It's just that if it's above that does address that it is. And as you said, that's because it can be suppressed. And in a moment, we'll talk about some things that could suppress TSH without, without moving someone into a non hypothyroid state.

Mike 41:55
Exactly, and the other piece I want to recommend, or I want to mention really quick, is that they just adjusted the thyroid ranges down the TSH TSH ranges, because previous TSH ranges were way too high. So there's still haven't narrowed down the TSH range, and there is research to indicate that that the TSH range that they currently have is still too high. And so yeah, just just things to keep in mind about, like, the context of this study, especially, like, if we knew the year that this was put out, and, like, what they did and whatnot, we could, you know, go into it, but there's no citation, so we have to conjecture. So this, this is conjecture, like, blatantly, I'm saying that for everyone to know.

Jay Feldman 42:34
Right about that study, yeah, about the study specifically, yeah, yeah. And again, not to get into this whole separate conversation, but it is pretty insane how much they're dialing down that reference range for for TSH, where, when you consider how many people were not diagnosed due to that range being so far off, and just this whole idea that we're treating lab values as opposed to people and their symptoms and what they're actually experiencing, and not Looking at the lab work together in a more quote, unquote holistic way, where you're comparing, you know, considering what different parameters mean when, when combined together, yeah, it's, it's a pretty insane way to go about improving someone's health. But anyway.

Mike 43:17
You have, you have personal experience with this, with family members being misdiagnosed with with thyroid disease and then subsequently developing heart issues after the misdiagnosis, not directly after. But if you look in Broda Barnes book, essentially, he showed that the people who were put on thyroid medication, their risk of heart disease was severely decreased. And there's multiple mechanisms for this. So having doctors or or having these doctors in this study misdiagnosed people because they don't understand full thyroid physiology, which, again, is my conjecture of this is Act there's actually danger to that. Um, and if you read so brota Barnes book, hypothyroidism, the unsuspected illness, has a graph in there showing his experience with his patients over the years and their their cardiac events can and so the ones who took thyroid medications and the ones who didn't. And then for you it, you have your those specific family member who had hadn't super elevated TSH that was still in that particular range, which we they then subsequently adjusted down, and then a couple years later, had had some some issues go on with the heart, so just interesting pieces to keep in mind in the overall picture. And yeah, I don't know if you want to, I don't want to talk for you on any of that.

Jay Feldman 44:32
So no yeah I mean, you're definitely right in all those things. But I want to move on to some of these other points. So her next point is basically that hypothyroidism is not ever a root problem, it's ever the root issue. And so you don't want to be treating the thyroid directly. And she goes on she discusses this endocrine cascade, this waterfall, where she talks about all the possible things that can drive imbalance in the hormones and how that will eventually affect the thyroid. And this is supposed to be evidence that you don't want to be. Right doing anything on the thyroid side in particular, and that hypothyroidism is never the cause of your issues. And this isn't like, I we don't disagree with this. As we mentioned, every single thing in our environment is going to be affecting our hormonal state, and absolutely, is going to be affecting our thyroid state or thyroid status. And so it's rather, I mean, I guess it's rather just a straw man, this idea that the bioenergic, energetic perspective is just suggesting that all you need to do is take thyroid hormones, or that everything is just caused by the thyroid as opposed to being caused by other things, other factors in your environment, food, stress, whatever else that are then having effects through the thyroid system. And so, I mean, I guess we don't, we wouldn't really disagree with any of these things, other than, and we say this all the time, right, that you want to be able to get those foundational pieces of your environment in place, in order to, in order to fix your hormonal state, and that the hormones are levels above, more surface level compared to those foundational pieces of diet and stress and sleep and movement and all of those things. So there's no real disagreement there, other than the one that I would mention is just that there. That doesn't mean that using thyroid hormones can't also do the reverse, it can't also support the healing process and lead to a lot of regeneration and help to drop stress down, basically as a way to speed up or shortcut that adaptive process to a better environment. And that is a situation where I think it can be really beneficial to use, as you mentioned, a proper, balanced thyroid hormone supplementation regimen that includes t4 and t3 maybe a desiccated thyroid. So that's the part I would disagree on. But as far as the larger concept, I mean, it's just rather a straw man that no one is saying that this, that this is only a thyroid issue and it's not affected by everything else. That's why, from the bioenergetic perspective, and from Ray's perspective, he's always talking about various things you can do, dietary and otherwise that will affect your thyroid.

Mike 47:06
So he literally gives lists in his art at the end of like every article, it's like this list of like progesterone and aspirin and red light and low Sartin and all these different like, protective substances that you can use, not just for the not just for the thyroid, but for like this, the whole system in general. And it's, it's because it's not no one is like, the perspective is never just that. It's, oh, it's the thyroid. Like the you have a problem specifically with your thyroid, you there's always a piece like, what is causing the problem with your thyroid? How can we address that? And that's why, that's why the bioenergetic perspective isn't this in depth approach of figuring out how to use thyroid hormone. That's like, that's like, one area of the perspective, because the and again, this comes out the perspective of like, energy and structure are interdependent on every single level, and thyroid hormone is one of the main determinants of energy production, energy metabolism in the body. So increasing providing could provide your body with basically a stimulus to increase energy production can help kick start it in the right direction, if used appropriately. And if used appropriately is the most important stipulation there, because that's in in the perspective of providing all the adequate micro macronutrients and lifestyle factors to allow your body to properly use the thyroid hormone. There's never been a point in the bioenergetic perspective, like, I don't even think we've even done a podcast on just, you need to just take thyroid like, there's it's always been this culmination of multiple factors that can be used and implemented, like, not simultaneously, but like, you want to implement them all together, and perhaps in a step wise, kind of organized, logical factions, you can figure out what's working and what's not working, and if you're responding to something poorly, so like a controlled manner, essentially. But this, it's always, it's always, and raise perspective from his work, like if you actually read Ray's work, which is one of the things you talked about in the beginning when, and she says she does. She hasn't really read the the entirety of it, but Ray is addressing so many different pieces and talking about the interplay of serotonin and estrogen and cortisol and prolactin and all these different hormones and and with and their effects on thyroid and on energy metabolism and on the steroids, and in the steroids, like testosterone and progesterone, effect on the body overall, and like looking at the entire picture. So this is a huge, huge straw man of the of the body of work to just and the thing is, is not even like, it's not even a well constructed straw man, because it doesn't, it's like a straw man against how to use thyroid in the and understanding thyroid in general as well. Like none of these pieces is like that one study, as we said, which was incited so we had to conjecture on a bit, doesn't really mean anything in the whole context of of of understanding thyroid physiology, especially when you. Look at a lot of the prescribing information and information around thyroid in the modern medical model, like is completely misunderstood. So just looking at a doctor's perspective of of these thyroid patients doesn't really tell us much of anything. And then, like trying to straw man, oh, there's so many other pieces underlying thyroid doesn't to like to that causes a thyroid issue, doesn't preclude the fact that using thyroid can help rectify some of those pieces overall. And so it's like, if you have the resources available and you have the ability to make these differences and have these compounds used to improve your situation with massive risk and minimal minimal or massive benefit and minimal risk. Why would you not use it? And that's the entire point is, why would you not use it? That like, there's, there's so much benefit to using it and again. So you have the two straw mans, and then you also have, like, the perspective overarching the straw man's, of like, there's no point not to use thyroid in these situations.

Jay Feldman 50:59
Yeah? One, yeah. In that larger context, of course, there's so many dependent factors there. But as you said, also a major piece here is this large, intricate web of all the how all the hormones interact and the entire endocrine system, and how that also interacts with diet and everything that we do in our environment, sunlight, whatever it is. And when you look at this waterfall cascade, for example, which is just showing causes a endocanna disruption, which then affects blood sugar, which then affects the adrenals, the pituitary, the thyroid and the hormones in that direct order is really not accurate at all. Like it is a very intricate web where all of these things are affecting each other. It's not just a one way, like downward cascade, and it's also not really in that order either, necessarily there there are, there is a piece of it that goes in that order, but they're all directly affecting each other in multitude, various ways. Yeah, various ways. And, for example, the hormones and the adrenals don't just affect the pituitary. They also directly affect the thyroid. They also directly affect the hormones and on from there. So yeah, it there's just a lot missed in that point.

Mike 52:03
The thing that's essentially her model of things is extremely poor compared to Ray's model. Like, Ray's model of these systems is much closer, I think, to the reality of how these systems work in their Interplay than this very basic linear waterfall model. So, like, it's just like you have to use the right model if you want to understand these things appropriately. And she's essentially trying to compare, like, the model that she's trying to compare, just it. It's like a fiction. It's the same thing as some of the other like fiction pieces that are discussed, that we discussed previously, like they're just their stories. To a large extent, it's her interpretation of how things work from her limited set of knowledge. And this isn't a knock on her, but it's just like, it's, it's hard to make a critique of Ray's body of work without reading it, and then try to offer your own models against Ray's body of work without reading it, because then you're just creating straw man's and it's, it's like, kind of silly, because the model that she created is so much less intricate and so much less nuanced and so much less closer to reality than Ray's model is of things that it's just like, it's kind of an absurd comparison the the waterfall model, it doesn't, it's like, it's literally one piece within side Ray's model based on a particular nuance if you were having blood sugar issues. So it's there's a lot more to it overall.

Jay Feldman 53:28
And so speaking, even if we want to use her waterfall model. So her next point is that carnivore diets don't cause hypothyroidism. And so her quote is that she poses a question. She says, Could a meat based diet now reveal underlying issues you've been having because you're no longer eating carbs, maybe going zero carbs is a step closer to revealing root cause issues and not the actual issue. So she's getting at this idea that, for one meat based diets, which I'm gonna say, a low carb carnivore diet, doesn't cause doesn't cause hypothyroidism. And then she's talking about this idea that's revealing root cause issues. She doesn't really give any explanation for how it could reveal anything. But the the piece here is that we already discussed this a little bit in terms of the effects on blood sugar and how low carb diets directly cause stress through that whole cascade of of the effects on blood sugar and the lack of carbohydrates, and the the lower efficiency of using carbohydrates as a fuel, and the less energy that results and on from there. And so, because of that, low carb diets and and we've discussed this ad nauseam will directly cause increases in the stress hormones. And I'll link back to to some articles regarding this and those stress hormones, as she acknowledges directly, then affect the other endocrine systems, including the thyroid and including the hormones. And they have direct effects there, where they decrease thyroid hormone activity, or well, they decrease thyroid hormone production. They also decrease the conversion from the inactive. Of t4 to the active t3 and they also reduce the production of the steroid hormones, and these are all hormones that are relatively pro metabolic. They raise our metabolism, and they do basically the opposite of hypothyroidism. They increase thyroid activity. And so she's saying that, I mean, she just kind of says that a low carb diet wouldn't do this, or carnivore diet wouldn't do this, but based on all these things, it would well under studies showing that, yeah, yeah and yeah, there's a lot showing that that ketogenic diets will directly cause the presentation of hypothyroidism, yeah, yeah.

Mike 55:37
I mean in low carb diet, yeah, the low so the low carb diets are like, semi akin to starvation on the function of the thyroid gland. And then the thing is, is like, in some, I think, based on the what she said, in some portion of her mind, she actually recognizes this, because she winds up saying, she winds up talking about how her t3 was low, and then she conjures this mechanism where she says, Well, in the book, and in this, this YouTube video, I talk with Dr Jamie Seaman about how we have t3 in our peripheral tissues that cannot be detected with blood work. So maybe I have sufficient t3 levels. And this is the new norm for carnivores. So it's like there's this understanding that the carnivore diet on her. And this is this. The reason I say the understanding is there is because implicit in this, in her, in her statement. The implicit nature of the statement is that the her carnivore diet has lowered her serum t3 levels. And she knows her serum t3 levels are low because she she specifically states it and discusses that in the article directly. And then she also talks about an article how her cholesterol has increased. It's not super high. And again, this is not to directly talk about about Judy's specific profile, like we're not. It's to talk about the principles behind the profile.

Jay Feldman 56:55
But yeah, and she's using this as evidence for her for her argument.

Mike 57:00
So it's like so implicit is that carnivore lowered her t3 levels, which are low, as stated by her, and then her cholesterol is also increased. And then to conjure mechanisms to to to basically rationalize the low t3 which would be indicative of low thyroid function. She She Connect. She solves the paradox in her article by saying that perhaps her cellular t3 is actually adequate. Now, even though her serum t3 is low, and this is considering the high cholesterol, the higher cholesterol level, this is just with that lab value alone is kind of a weak argument, although multiple things can increase cholesterol. And then overall, like in the research, it is there's directly shown the low carbohydrate diets cause a hypothyroid state, and then they can cause a hypothyroid state in something known as euthyroid sick syndrome, where your TSH and your t4 levels are fine, but your t3 levels are low. And then there's pathology that is associated with that. And you see this in stress, you see this in starvation, you see this in traumatic injuries. And it's literally, you're it like her mechanism could have been plausible if it hadn't already been proven to be false. That's the thing. It's like she's made. She's conjuring up a mechanism, and like rationalizing an idea that's already been, already been discovered, and it's it's already well known that t3 and thyroid require carbohydrate specifically. So trying to conjure like an intracellular thyroid mechanism doesn't make any sense, especially when you consider when they there are studies looking at conversion factors for t3 from t4 and it shows that low carbohydrates, decrease that conversion. So you're you can conjure whatever mechanism that you want, but if that mechanism has already been discovered and and addressed, then there's like you need to conjure. You either need to conjure a new mechanism, or you need to rectify that. The the information has already been like, it's already uncovered. The other thing too is like, this is also her N equals one on her rationalizations with herself. So even just on a N equals one, from my perspective, or n equals, you know, 10s of people that are carnivores, the people who are carnivores, who've come over have had similar thyroid hormone profiles that I've worked with, where their TSH isn't high, but their t3 is low, and they have all of the symptoms of hypothyroidism and multitude of symptoms of hypothyroidism. And while carnivore addressed their gut issues, it didn't solve the subsequent hormonal problems that they developed while they were on the carnivore diet as a function of not having enough carbohydrate. So it's and the car what bringing carbohydrate in address those, those effects made a difference. It was just which carbohydrate they use that didn't lead to issues with their gut. They were sensitive to things beforehand. You know, we're not bringing, I think both of us aren't bringing people on soybean oil breads and, you know, like trickery. Like, like, fiber, one, brownies and stuff like that, or any it was like, the carbohydrate sources were juice and fruit. And the other thing I want to add in here is that people adding in juice and fruit into their diet. In my experience, I know this has been some of a issue or worry for some people is, like, the idea that they would get insulin resistant or gain a lot of weight. And that hasn't been the case. If anything, they went to a normal weight, because most people came underweight and from a catabolic state and then went to a normal weight and then maintained it would drastically increase in their carbs in one month's period of time. I'm not even talking about like, like, you know, like, like, for in one month, drastically increased their carbs from like, I had one individual go from like 25 grams of carbs a day to 250 grams of carbs a day, without gaining massive amount of weights or be or becoming insulin resistant, and without having significant amount of gut issues, which the gut issues still take time to resolve. Not saying that's an instant success. So just some some personal examples to counter her individual. Personal example.

Jay Feldman 1:01:02
Yeah, yeah, definitely. We've both seen quite a few instances like that. And along with that, too, definitely seen people having blood sugar regulation issues on carnivores, seeing their fasting blood sugar go up and up and Yeah, and just general blood sugar going up, and then being incredibly surprised when they're adding in hundreds of grams more of carbohydrates. And if anything, their fasting blood sugar comes down and so and they're, you know, a 1c goes down or stays the same, things like that. So, yeah, it's a something we both seen quite a bit. But in talking about the the next piece that she discusses here, beyond the thyroid is she talks about the other aspects of the endocrine system. And here she's kind of referring to Ray's high regard for progesterone and pregnenolone and other DHEA metabolic hormones. Yeah, yeah. So she says you can take progesterone and pregnenolone exogenous hormone creams or medications hoping to help your hormones. But instead of making the hormones like pregnenolone going down to make estradiol, these exogenous hormones get rooted to make more cortisol. And she's referring here to cortisol steel, or pregnenolone steel, which is the idea that basically because so when you're looking at the steroid hormone pathways, they all start with, well, first it's cholesterol. Cholesterol gets converted to pregnenolone, and then you've got this whole web of hormones after that. And if you follow down some of those pathways, especially the farther down you go, you start hitting some of the stress hormones like cortisol and estrogens and aldosterone. And there's this relatively pervasive idea that she's suggesting here, which is that, yeah, so you can, you can see, you can see that here. You can see the cholesterol on the top left, coming from cholesterol. And then if you look all the way on the right, you see the glucocorticoids, cortisol, corticosterone. At the top right, you've got the aldosterone, and then the bottom right you've got the Estro estrogens. And so there's this idea that if you take those earlier hormones, whether it's pregnenolone or progesterone or anything else, they're just automatically going to get converted to the downstream ones, and that is just going to lead to an increase in cortisol and increase in estrogens. And she was actually talking about an increase in estradiol being a good thing. It's one of the hormones. We won't dig into that, but the but this is basically a very common misconception, but the reality is actually often the opposite where when you take these earlier hormones, like pregnenolone or like progesterone, you actually tend to decrease the conversion to those farther down steroids, to cortisol and to the estrogens. And again, this is seen very clearly, where you see an inhibition of aromatase, for example, as you mentioned, or as you're highlighting there, from pregnenolone and progesterone. And you also tend to see an opposition of the effects of the glucocorticoids where they, you know, their their ability to affect the cellular activity is diminished because you have increased levels of things like pregnenolone and progesterone. And, yeah, it's, there's this. It's just based on this faux idea that everything will keep getting converted farther down. And part of the reason for that, I think, is because of a lack of understanding of what like, what the purpose is of those downstream hormones. And I think an easy way to describe them, we've kind of talked about this before, where there are layers to responses to stress, and in general, we want to be having a lot of those, a lot higher amounts of those precursor type hormones, like, let's say pregnenolone and or progesterone. Yep. And if they're not able to have their prometabolic effects, or, I guess, another way to say it is if their pro metabolic effects are not enough to support the health of the organism, and the organism is is getting pushed. Into a stress state, then they'll start to convert toward those downstream hormones to make up for that state. So we all like it's very well known that glucocorticoids, for example, are anti inflammatory, like people use cortisone as a medication, as an anti inflammatory medication, and they are in the short term. We also know that in the long term, they cause pretty dramatically negative effects, and that's because it's that classic stress hormone that's produced when the current hormonal state and energetic state is not capable of maintaining the structure of the organism, basically maintaining the health of the organism, and so and adding in those earlier hormones actually helps to correct the energetic and structural state so that you don't need those stress hormones anymore. That's why they tend to decrease the production of those downstream stress hormones. So it's essentially the opposite of of what she's describing.

Mike 1:05:53
And the thing, the thing I the way I like to look at the the hormones, is that depending on the state of the body, there's kind of a switch where different states or different contexts of the body move the hormones into different directions. So if you don't have adequate amount of sugar available, you've gone through your glycogen or whatnot, the state of the body switches the for the production of cortisol and for the movement of cortisol in these different directions. However, if you have some of these other hormones inside the system, like pregnenolone or progesterone, that are altering the state of the body, then the need for cortisol is decreased. There's no need to upregulate the some of the cortisol function and production. If you if you have some of these hormones being produced, or if you're taking them exogenous, exogenously, and they also, or if you have, like, adequate sugar on board. So that's why the entire idea is about bringing all of the factors and adjusting the context of the body by providing adequate nutrition, adjusting stress, making sure you have adequate micronutrients, macronutrients, whatever that is, light exposure, movement, and then also using some of these other supplements to bolster that, to provide adequate amounts of progesterone and adequate amounts of pregnenolone, and a lot of like the progesterone and pregnenolone, which Ray discusses, are like general anti stress factors. They're they're endogenous anti stress factors. You're just bolstering your body's endogenous systems. And especially because there's not really much of a negative feedback from these to a large extent, where you can use progesterone appropriately. As a female, it, if you stop taking it, it doesn't completely shut down your whole system, like some of the further downstream hormones are, or some of the further downstream hormones do same thing with pregnant alone and DHEA. And so it's like, again, you have this massive beneficial effect of being able to adjust the system out of the stress state using these compounds with minimal risk. So using them, it's just like, it just makes sense. It just it's just the in the context of thing with all the information given like there's such a broad protective effect. By adjusting all these inputs into the system, you can adjust the output on the system. And that's that's the overall perspective. That's the idea. The idea is providing enough energy allows you to build more structure. And as you build more structure, you can harness more energy. That is literally the the view with which Ray is looking at things. And these are compounds that allow for the building of more structure through the harnessing of more energy.

Jay Feldman 1:08:25
Yeah, exactly, yeah.

Mike 1:08:28
So yeah. And I just want to just for your point, specifically these hormones, like through research based on research studies, lower cortisol signaling, help balance out estrogen, help deal with the stress hormones, progesterone, pregnenolone, DHEA, DHEA. DHEA directly opposes many of the actions of cortisol, particularly some of the immunosuppression functions of cortisol and the catabolic functions of cortisol, and the body releases DHEA simultaneously with cortisol to minimize or blunt some of the negative effects of course, all so it's like they're, they're there for a reason. And it, it's, how can we harness these systems that are existing regularly to optimize our own function? Like, if we know that these things have an effect and we know how to use them appropriately, why not implement them appropriately for the desired outcome, instead of build kind of straw man arguments, like, oh, we shouldn't be using these because of XYZ. Like, again, that hasn't been shown to happen. Like, it hasn't been shown that people take a whole bunch of pregnenolone and just their cortisol goes up, or DHEA or progesterone. It's, can they, can they convert down those pathways? Sure. But is that what we see happen? Like, all of it just goes down that pathway? No. Especially in the context, again, of adjusting the body's context overall, putting in all these other inputs.

Jay Feldman 1:09:48
Right? And by that argument that she's making, you shouldn't eat anything with cholesterol in it, because that cholesterol is just going to become cortisol, you know, and you shouldn't eat anything that can be converted to cholesterol, like, you know, any sort of saturated fats. Those will just become cholesterol, which will then become cortisol. So all this meat that you're eating is just basically pre cortisol, and so, you know, that's worse, or just as bad as taking these, these other cortisol precursors as they all are. In reality, there is kind of a legitimate point here, which we kind of talked about the thyroid, which, again, is that we don't want to, you know, these these hormones are not necessarily fixing the issue. If you are experiencing a low metabolic state, you don't want to just throw pro metabolic hormones on top of it. It can help. But in reality, you want to make sure that you're doing it in the proper context where it's not going to drive stress, which it can do, for example, if you're not eating enough carbohydrates or or you're not getting enough calories, and then adding something like a thyroid hormone or pregnenolone or progesterone or DHEA can make things worse. So it is something to to consider in that regard, but that's not really the way that she's describing it, yeah.

Mike 1:11:01
It's, it's, it's a foundational pyramid. To a large extent, you have to have the bottom foundation properly built in order for the next layers to to be to build upon that. If you have a weak foundation, then you can't, you can't build on top. And I think that's the kind of the easiest way to see it. It's not exactly like that, but it's that's kind of how I go. You got to have your nutrition and your sleep and your stress dialed in, or, at the minimum, have your nutrition dialed in. And for anybody that that I've worked with, or I think that you worked with as well, like, those are our primary pieces to address first and then. Like, while these different hormones and supplements can aid that process there. In addition to having building out these other pieces and then using again, it's about using them very like, appropriately. We're not none. There's never been an argument here to just throw DHEA and progesterone and pregnenolone on everything. It's like, let's use them the right way. Let's use them appropriately. Let's figure out the most optimal way to get the outcome that we want from them. And again, when you don't fully read Ray's work, and then you make arguments against it, then you don't catch on to the nuance of these pieces, and then you make straw man arguments against it, like, like, what we have continuously at this point.

Jay Feldman 1:12:19
Yeah. And so in talking about those, you know, addressing those foundational pieces first, that is one of her next arguments, which is basically saying that we should be focusing on gut health over thyroid health. And so she has, you know, a couple of quotes here. She says, One, if her first quote is that, if you're suffering from thyroid issues, I suggest checking your gut health first, which, again, we kind of already have acknowledged this. This is, you know, really just a straw man, and we don't really disagree with with this, that obviously gut health is a major factor. And also Ray, like so much of what Ray suggests has to do with gut health. You know, as far as the types of foods he suggests, the types of foods he suggests avoiding. So he, you know, and if you if he talks about thyroid and thyroid activity and hypothyroidism. A lot of times, he'll ask what someone's gut motility is like, and on from there. So that's the first piece. The second thing that she mentions is, if you have ever suffered from leaky gut, SIBO or IBS, you probably don't want to consume all those carbohydrates. And we'll all I'll let you touch on this in a little bit more detail, but it's, again, kind of one of those wide, sweeping statements that's not really founded in anything specifically, and I think in this part in particular, and we'll talk about this with the carrots as well. As she discusses, it becomes clear that this is more of an anti plant based argument that at least this piece of it is more of an anti plant based as opposed to an anti bioenergetic view argument, because the bioenergetic viewing incorporates a lot of what she discusses as a problem as far as anti nutrients go, or having something, yeah, endotoxin, having something like SIBO, that is going to be a problem depending on the type of carbohydrates you're consuming. This is something that that is discussed all the time. So again, these are things that, in some ways, were relatively in agreement, you know, on other than the idea that all carbohydrates are going to cause an issue here, and that carbohydrates won't help, actually, to heal the gut, which we would argue that they definitely do. And we've discussed that in the past, and I'll link to some some research supporting that, and I'll let you talk in a little more detail about some of the other things that she mentioned here.

Mike 1:14:28
I just, I think it's quite interesting that she has this focus on gut health, but then she goes and makes a recommendation for an all meat carnivore diet, and then she talks about like she also has. And I'm going to just tie all these pieces together here. But she says things. She says things like, we consume carbohydrates, and the bacteria in our body for men's carbohydrates to make gas, methane. So make gas, and then in quote, in parentheses, methane, hydrogen, sulfur, etc. The more bloating and pain you feel after eating, the higher. Likelihood you have these gut issues. And then she talks about, like a low FODMAP diet. And she says, Well, the goal of of the diet is to cut fruits and vegetables that feed these bacteria. Since it doesn't remove all plant based foods, it doesn't remove all the culprits. And yes, a lot of these plant based foods that Ray peat recommends are on the do not eat list. And then, so it's like all of this, all of these pieces are quite interesting to me to make an argument about the microbiome and then go and recommend an all meat diet as a solution to fix microbio microbial issues in the intestine, when it's known that all meat diets increase endotoxin producing species inside the gut. And then also, I'm going to read a quote here. And the quote is, is that high protein, reduced carbohydrate diets alter the colonic microbiome, favoring a potentially pathogenic and pro inflammatory microbiota profile, decreased short chain fatty acid production, increased ammonia, phenols and hydrogen sulfide concentrations. These metabolites largely compromise the colonic epithelium structure, causing mucosal inflammation, but may also directly modulate the enteric nervous system and intestinal motility. Increased protein fermentation as a result of a high protein intake can be attenuated by the addition of oligosaturides, resistant starch and non starch polysaccharides, and a reduction in total protein, or specifically aromatic sulfur containing amino acids. So the carnivore diet, which is high in protein, low in any other types of fiber, actually causes dysbiosis inside the gut. And I've seen this on GI maps that I have from people coming from carnivore with increased they didn't have increased cow protectant, which is an inflammatory mediator the gut, meaning the gut is inflamed. But they had increased Zonulin, which means an increased Secretory IgA. So the Zonulin indicates that the gut barrier is actually being disturbed and being leaky, and then the increased Secretory IgA indicates like pathogenic species inside the gut, and the immune system reacting and trying to decrease their binding to the intestinal epithelium. So you have that going on in the carnivore perspective. And then it's also known that high amounts of protein, and this is something that you can ask anybody about in the bodybuilding sphere. When you have you take too much protein powder, you get super constipated, but the protein ferments in the or actually putrefies in the gut, which is, this is a vegan thing, and this is reality, and this isn't a This isn't to say that we're supporting veganism, but there is some tenants of veganism that do make sense, and the idea that meat does putrefy in the colon is a legitimate piece, and that meat produces the same compounds that she suggested that fruits do, including methane, hydrogen and hydrogen and sulfur are the hydrogen sulfide is one of the main bacterias produced by meat putrefaction, which is directly inflammatory to the gut lining, as our phenols, as our pre presol, which is a mediator created by putrefaction or fermentation, of cholesterol compounds. And then, as are the ammonia that's produced, which is also liver toxin. So the carnivore diet can produce gut dysbiosis. And I've seen this in carnivores that I have worked with. They come show me their GI map that they got with another practitioner, and they have a dysbiosis. And then it's like, oh, I need to take this list of antimicrobials and whatnot to fix my dysbiosis. And it's kind of like, No, you need to adjust. Your diet, because your diet is leading to the dysbiosis. And then the second piece that I want to address here is that carbohydrates are extremely necessary for producing mucus and mucin, which is the underlying component of mucus that lines the gut and protects the gut from endotoxin. And then the carbohydrates are important for the gut to utilize as an energy source in order to maintain adequate function. And thyroid hormone itself is a pro kinetic and it also enhances digestive enzyme and output so that you can absorb and digest and not have SIBO. So going on a hype, becoming in a Hypo metabolic state, impairs digestive function and leads to a predisposition towards SIBO. And then on top of that, only eating meat, while you may not be fermenting heavily inside inside your small intestine, with the meat, there's a large chance that you could be ferment putrefying the meat inside your colon and causing issues with LiPos, polysaturide production. Then the other piece that I wanted to discuss here just that she talks about foods on the repeat diet that that cause any type of like a FODMAP problem. So this is a picture. Let me get down here. This is a picture of the from a research article talking about foods high in FODMAPs versus the suitable alternatives that are low in FODMAPs. So these are plant foods that you can eat on a carnivore diet and not have, you know, a ton of bloating and issues because they have, because they don't have their high in FODMAPs. And so a lot of these are actually fruits recommended by peat. And then there's a lot of fruits over here that PEAT doesn't. Necessarily discuss, and I just want to point out here, and it's not because, oh, what does Pete say? What does Pete Not say about these but the idea overall is that not all plant foods cause the issues that she's discussing. And if anything, in most of the microbiome studies that we see, the the the polyphenol, polyphenol compounds from a lot of the fruits that Pete recommends eating are extremely helpful for the microbiome. So if you want to address your microbiome issue, then eating carbohydrates is important, not only from a thyroid perspective and a gut energy perspective, but from modulating the bacteria that you house in your guts. You don't have endotoxin producers. So yes, the gut is extremely important in thyroid production, which means that a carnivore diet is probably not what you want to be eating if you want to modulate your gut appropriately.

Jay Feldman 1:20:52
Yeah, yeah, I agree. There's a lot of points there, and we've discussed gut health in detail throughout our podcast episodes. I'll link to those in the past. So I'll link to those previous episodes, so that if somebody does want to listen a little bit further about those, they can but yeah, the general idea here, I think, is, you know, is is clear, which is that we agree that the gut health is a huge, huge factor affecting thyroid health, affecting our overall health. And definitely are not suggesting to ignore it. And a pro metabolic, bioenergetic diet, we would argue, is the best way to support gut health, as opposed to a carnivore diet.

Mike 1:21:30
And that's documented. The having excessive amounts of meat is documented to cause microbial like disturbances inside the intestine with especially without having the it doesn't even have to be fibers, but having the adequate polyphenols and some of those components.

Jay Feldman 1:21:47
Yeah, yeah. And as you mentioned in the past, previously in this episode, people can have a lot of relief from symptoms, gut wise, from a low carb carnivore type diet, which is generally accounts for a lot of the benefits from those diets. So that is worth mentioning, but it is not actually solving the issue. And over time, a, the stress will catch up and start to cause problems. And B, A lot of times, the gut issues start to come back. People become more and more sensitive to more and more foods, and anytime they try to reintroduce any foods, it's even worse. We discussed the intricacies of bringing carbohydrates back in from a carnivore diet in the previous episodes. I'll link to that. I'm sure we'll talk about it again in the future. But yeah, that's it's definitely an episode I'll listen to if someone's trying to transition from a carnivore diet toward a more bioenergetic approach. Yeah.

Mike 1:22:38
And the point being here is that eliminating some of these problematic like plant foods that cause bloating and intestinal issues is an excellent idea, and carnivores get that right. But that doesn't mean that all plant foods and all carbohydrate sources are going to cause gut issues. The nuanced, and I think better strategy overall, is let's find the carbohydrate sources that you can tolerate and digest well, in conjunction with eating meat and and fish and all these other foods to construct a nutrient dense, a toxin poor, very easily digested diet to support your metabolism. That's the perspective that I would come from. And it's not about just like, dogmatically saying it's all plant foods, which was a statement that she had in that quote. So let, like, let's go to the nuance. Let's figure it out instead of just all plant foods gone.

Jay Feldman 1:23:28
Yeah, yeah, absolutely. And that's, you know, I want to kind of conclude this episode, because there's a lot of other pieces that we didn't touch on in this article. She kind of will just throw little bits in about things like dairy, fish, oil, carrots, a Lemon Detox drink that Ray Pete has never talked about, things like that, and many others. A lot of you know further kind of surface level type arguments that I think aren't really worth spending too much more time on, and it would just take a long time, because it's like trying to fully explain these concepts in response to a very minimal surface level kind of argument that something is is just bad because it is and so I don't want to spend, yeah, I'd want to kind of wrap up considering those things. There are a couple things she mentioned in her conclusion to her article that I think are worth touching on real quick, which the first which we talked, talked about a little bit, but she says that many of the people that have moved from carnivore to repeat are, frankly, chronic dieters. They need an identity with a diet or group to belong to, and I'm not going to say that that doesn't exist at all within the repeat sphere, however, above diet and lifestyle and anything else one of one of the things that Ray talks the most about is anti authoritarianism and moving away from ideology and dogmatism. And that's something that I think is pretty universally discussed. And point that's that's really touched on a lot throughout the bioenergetic community and and you see a lot of. Variety between people within that within the community. And so I think, you know, speaking of strawmans, I think this is definitely one of them. I don't think that this is actually a reason why people, why a substantial amount of people, have moved from carnivore to repeat, and they've discussed why they feel so much better with carbohydrates and all those things and with all this, not to be not to also touch on the extreme amount of dogmatism and ideology that also comes in the carnivore community. Or, I would say, is, is there much more than it is in the bioenergetic but kind of doesn't really matter. I don't want to, like, there's no point in saying you guys are more dramatic dogmatic than us, or anything like that. I just don't think that that actually accounts for somebody switching, especially considering that the carnivore community diet, whatever is certainly not free from those things.

Mike 1:25:48
So I think the largest reason is people are switching is because it's not working for them. And that's really what it comes down to. It's like people continuously switch diets and move in different directions until they find something that works for them. And so it's there's with most, quite a few people that I've worked with, it's kind of like this, oh, I found out that gluten and dairy don't do well with me, and I removed them from my diet, and then I got sucked into paleo. And then after paleo, I got sucked into low carb and keto and intermittent fasting, and then carnivore, or somebody got sucked into veganism, and then went into paleo and then went into carnivore. So it's like, it's it's not that people are dogmatists. It's that people are looking for something that works for them, and they're going through all these different phases. And part of going through these phases involves mindset shifts around figuring out what works, versus being attached to a dogma. And so, like, I think there's an element with a lot of these communities create dogmatism in them, and and then you get attached via conflating the ideas with the dogmatism. And then eventually it's like, it doesn't you get to the point where it's just not working for you. So then you move to the next one, and then you still kind of get, you still kind of start to conflate, and you're a part of the community, so like, there's an element of, like the group think of the community that comes in, and you have to part of, like going through this process is getting out of the group think model, as well as figuring out what works. And then the ultimate point is, I think my perspective on things is coming to a point where it's like, let's take what works and let's throw out what doesn't. But let's do that from like, an intelligent perspective. Let's start with like, what is our was our philosophical understanding or baseline for what we're doing and and as far as like, rather than trying to align ourselves with the dogma, we're going to align ourselves with ourselves, and we're going to align ourselves with what's working for us, and move into that, move into that space, and not have to be a part of this idea of, oh, I'm a carnivore, oh I'm a Pete tarian, oh, I'm a vegan, whatever it is that's and going through that's all part of the process. Like that is an evolution of of of of growth. And I think it's a great thing, and I think it's necessary. And I think the sooner people can hop, like, make that evolution, hop out of the dogma, the sooner they can start to move into their into figuring out, actually, like, figuring out their problems and and solving and figuring out what works for them. But that's a that's a necessary step of the process. So you have to understand and be a part of a dogma to what, in order to understand what a dogma is not, right? It's kind of that type of perspective.

Jay Feldman 1:28:23
Yeah. It's definitely a step on that evolution for for a lot of people, and we've discussed our history with that as well. And it's a Yeah, a pretty common place to go when you're looking for answers. Yeah. And another thing that she mentioned again in her conclusion I wanted to touch on as we wrap up here is she mentions that a lot of the people that preach these things also don't see any meat based clients or patients. Things are great in theory, but I see real life clients for months. I see what works and what doesn't. And we've discussed a lot of how we not only work with clients, but also quite a few coming from carnivore and low carb, who have quite a lot of negative like results from them, despite, you know, doing everything right and understanding it, and being people who really do understand the physiology more so than was discussed in this article, at least. And, and you know, or are, as you said, not coming at it from a dogmatic perspective, but rather are open to looking at the physiology and understanding it and perceiving, thinking and acting, which, as you said, perceive, Think, Act, is really raise only prescription, so to speak. And this is what's led them to this place, rather than it, I don't know, being stressed from covid or or that they're looking for new identity or something. And again, I also wanted to mention, we kind of talked about this, that we also see a lot of people who are already coming from the quote, unquote repeat diet, you know, coming from within the bioenergetic space, who are struggling, to some extent, they've had some really great results, and maybe also some things aren't working as well. And. So I'm not trying to say that anything is as simple as you just like, here are the perfect foods for you, and on from there. You're not saying that either. Obviously, everything we've discussed here is not that. But yeah, I just wanted to to kind of mention that I don't know, yeah, just to kind of close with with those kinds of thoughts and ideas.

Mike 1:30:18
Yeah. And I think the covid piece overall just show was showed people that carnivore wasn't working for them. That's literally what the covid piece does. It wasn't that they jumped ship. It was like the stress of covid indicated to them that the carnivore diet wasn't the answer for them. I think that that they made an intelligent decision.

Jay Feldman 1:30:34
Right? Yeah. What did you want a diet that helps you to feel better when you're under stress, as opposed to one that makes it much harder to handle stress, yeah, or just leaves you in a constant state of stress.

Mike 1:30:44
We're not doing breathing exercises every day. Just, I just want to put that out there.

Jay Feldman 1:30:48
Not that there's necessarily anything wrong with that. I do think, depending on the type of breathing exercises, they can be really helpful. But, uh, I mean, we, I mean, no, I've like, I'll reference back that episode talking about the Wim Hof breathing, just in, talking about things that just drive constant states of stress, that's that's a good one, and often it's paired with low carb diets. And I don't think that's, uh, a coincidence either.

Mike 1:31:09
Yeah depends on why you're doing the breathing right. Like, there's different reasons for which you're going to be doing the breathing exercise.

Jay Feldman 1:31:15
Yeah, yeah. All right. I hope you enjoyed that episode. If you did, please leave a like or comment. If you're watching on YouTube and if you're listening elsewhere, please leave a review or five star rating on iTunes. All of those things really do a lot to help support the podcast and are very much appreciated. This series was inspired by a listener question. If you have any questions that you'd like us to answer on a future episode, then you can send those into Jay at Jay Feldman wellness.com that's j, A, y, at Jay Feldman wellness.com or if you're watching on YouTube, feel free to leave those questions in the comments to check out the show notes for today's episode. You can head over to Jay Feldman wellness.com/podcast you can take a look at the studies and articles and anything else that we referenced throughout today's episode. And if you are dealing with any low energy symptoms, whether those are related to the various symptoms that we discussed today, maybe related to hypothyroidism or gut issues, or if there are various other low energy symptoms, like chronic cravings or hunger or chronic pain or weight gain or brain fog or poor sleep or mono imbalances, Whatever it is, or if you're dealing with any other chronic health issues, like an autoimmune condition or diabetes, heart disease, or anything along those lines, then head over to Jay Feldman wellness.com/energy where you can sign up for a free energy balance mini course, where I'll explain how these different symptoms and conditions are really caused by lack of Energy, and I'll also walk you through the main things that you can do from a diet and lifestyle perspective to maximize your cellular energy and resolve these symptoms and conditions. So to sign up for that free energy balance mini course, head over to Jay Feldman wellness.com/energy, and with that, I'll see you in the next episode.