The Dr. Hedberg Show

One of my all-time favorite healthy foods is definitely sardines.  This was certainly an acquired taste and I had to learn the hard way that some brands are absolutely disgusting and others taste great.  The picture above shows the three brands of sardines I eat the most.

Why are sardines so great?

Sardines are nutritional powerhouses containing healthy omega-3 fatty acids, selenium, high-quality protein, potassium, calcium, phosphorous, vitamin A, vitamin D, vitamin B12, folate, thiamin, riboflavin, vitamin B5, niacin, vitamin E, vitamin K, magnesium, choline, CoQ10, zinc and iron. They’re really stacked to the gills!

Sardines are also extremely low in mercury so you don’t have to worry about toxic metals like from other types of fish.

Sardines are perfect if you are following a ketogenic diet, paleo diet, low carb diet, modified vegetarian diet or just want to add a lot of nutrition to your diet.  If you are following a ketogenic diet then go for the sardines packed in olive oil for extra fat.

How could eating sardines benefit you?

Based on their nutritional content including protein, fatty acids, vitamins and minerals, the health benefits of sardines may include:

Enhance immune system function

Improve cardiovascular health

Prevent macular degeneration

Reduce the symptoms of autoimmune thyroid disease

Improve insulin resistance

Reduce inflammation

Build lean muscle mass

Burn fat

Prevent certain types of cancer

Strengthen bones

Reduce the risk of blood clots

Improve skin and hair quality

In fact, if you have a dog or cat and you want to improve their coat, let them eat the leftover oil in the can and after just a few days you’ll notice a serious shine and silkiness on their coat.

What are the best kinds of sardines?

Sardines usually come in a variety of options including in spring water, olive oil, olive oil with lemon, salted or unsalted and some brands offer some kind of tomato or mustard base.  I usually get a variety of spring water and olive oil with or without lemon since I’m not into tomato or mustard on my sardines.

Always go for “wild caught” sardines packaged in BPA-free containers when you can.  Also look for “sustainably harvested” meaning that the fishermen do their best not to harm the environment or other sea animals to the best of their abilities.

How do you eat sardines?

Sardines are great because they don’t require any cooking or much prep at all.  They’re also convenient to carry and travel with when you need a healthy snack.  I usually make a large salad and put the sardines on top with some lemon or lime squeezed on top of the sardines.

Usually just some salt, pepper, vinegar, olive oil and lemon or lime in some combination is enough to enhance their flavor.  I almost always eat sardines raw but they can be sauted in olive oil if you prefer cooked fish.

Don’t go overboard!

A few things to note about sardines that everyone should know.  Eating too much of anything is a bad thing so don’t go crazy.

There is no reason to take a fish oil supplement on the days you eat sardines because they are already loaded with omega-3 fatty acids.  Also, if you are dealing with too much iron in your body then you may want to limit your sardine intake until your ferritin levels look healthy.

Sardines also contain purines which could cause a flare-up of gout if you suffer from that condition.  Additionally, in rare cases some people may have an allergic reaction to compounds called vasoactive amines which are found in sardines.

Other than that, enjoy sardines in moderation just like any other food but they are hard to beat when it comes to convenience and nutritional quality.

In order to understand how to beat depression naturally, we must understand what causes depression.

Inflammation and depression

For many years there has been a generally accepted cause of depression with the treatment revolving around neurotransmitter manipulation through antidepressant medications.  It has become quite clear however that inflammation is at the core of depression, anxiety, insomnia  and other mood disorders in many people. And, you can beat depression naturally!

Antidepressants have helped many people and are definitely required for certain individuals in order to function. These medications manipulate neurotransmitter levels but they also have anti-inflammatory properties which can additionally explain why they help people.

Studies are showing that patients with increased levels of inflammatory markers such as C-reactive protein, interleukin-6 and tumor necrosis factor alpha suffer from depression and other mood disorders.

Why does inflammation cause depression?

Normally, the amino acid tryptophan is converted into serotonin and melatonin which are important for mood balance and sleep. However, if you are inflamed, tryptophan will travel down the inflammatory kynurenine pathway.  Kynurenic acid and quinolinic acid cause imbalances of your neurotransmitters as well as robbing you of healthy serotonin and melatonin levels.

How does chronic stress create inflammation?

A dysfunctional HPA-axis (hypothalamic-pituitary-adrenal-axis) due to chronic stress will create more and more inflammation.  Cortisol produced by your adrenal glands is an excellent natural anti-inflammatory produced by your body.  If you are stressed for long periods of time then you will develop resistance to cortisol and inflammation will increase.

Your adrenals also produce norepinephrine and epinephrine commonly known as “adrenaline” which increases inflammation.  Your autonomic nervous system is composed of the sympathetic and parasympathetic branches.  The sympathetic nervous system is the “fight or flight” branch that is activated during stress and adrenaline is pumped out of the adrenal gland.  The parasympathetic branch is the “rest and digest” branch which is important for digestion, repair and relaxation.

Many people are stuck in a vicious cycle of cortisol resistance and sympathetic dominance due to chronic stress resulting in chronic inflammation.

Traumatic physical and emotional experiences can create a low-grade, post-traumatic stress disorder type biochemistry that is a recipe for inflammation.   Our brains can be affected for long periods of time after traumatic stressful events and they don’t return to normal without treatment.   Many people never seek therapy or truly deal with these traumatic events and never really get better.  It is virtually impossible to get well if you are inflamed.

Some of the most common causes of chronic stress are:

Worrying all the time

Ruminating about people and things that upset you

Lack of physical affection from your partner

Staying in an unhealthy relationship

Anger

Social isolation

Poor diet

Lack of exercise or too much exercise

Chronic infections such as viruses, bacteria, parasites and fungi anywhere in the body (gut, urinary tract, mouth, blood etc.)

Food sensitivities such as gluten and dairy

Insulin resistance

Weight gain

Not having a purpose in life

Stressful work environment or job dissatisfaction

Inflammatory bowel

Do women have it worse than men?

Yes.  The research is clear that women suffer from depression more than men, with about a twofold higher risk. Why are women more prone to depression than men?

Women are affected more by relationship issues than men.  Lack of physical affection, emotional support, childcare stress, disagreements etc. affect women more significantly than men resulting in increased inflammation.

When women gain body fat they become more inflamed than men who gain body fat.  Men can gain weight and not become as inflamed as women.

Hormonal fluctuations during the menstrual can increase inflammation.  Estrogen is anti-inflammatory and as levels drop too low due to a variety of factors, inflammation can increase.

Women exposed to the same endotoxin as men that triggers inflammation experienced more depression than men. Endotoxin-induced inflammation also caused women to become more lonely and socially disconnected compared to men receiving the same dose.

Women were found to have greater levels of inflammation than men after sleep deprivation.

Women experience more fatigue than men if they are inflamed.  Men can be inflamed and not notice fatigue the same way women will.

Women who are socially disconnected show higher levels of inflammation. The lack of connection with friends and family significantly increases inflammation in women.

Women are more likely to have experienced physical or verbal abuse as a child compared to men.

The more body fat you have, the more inflammation you experience when under stress.  Globally, women suffer from obesity more than men.

People who experience adverse childhood events actually show higher levels of inflammation as adults than those who did not experience similar levels of trauma.

What can you do to reduce inflammation that is causing depression?

The first thing you have to do is figure out what is causing the inflammation.  You may need a stool test to identify chronic infections in the gut for example.  You may need an adrenal profile to identify cortisol imbalances or an organic acids profile to identify issues with amino acids and neurotransmitter metabolism.  Or it could be subclinical hypothyroidism that has been overlooked.  These are a few examples of areas that could be causing your depression. The investigation begins with your functional medicine practitioner to uncover the root causes of the inflammation.

You may need to seek therapy to work on any traumatic events you have experienced in your life or go to counseling with your partner to resolve relationship issues.  Cognitive behavioral therapy is highly effective for dealing with post traumatic stress and ongoing psychological problems.

What about social isolation?

If you are disconnected from friends and family then you will experience more inflammation and mood problems.  This can be difficult for some people because of the way they feel, so set the bar low and start with just one person to spend time with.  It’s important, especially for women, to spend time with other women.

Is there a genetic component to depression?

In some cases your genes may be part of your mood imbalances.  The way your body produces and metabolizes serotonin, dopamine and adrenaline may be altered by what are called genetic polymorphisms. Your receptors to the above neurotransmitters may also have genetic defects which results in a need for higher levels of these chemicals to be effective because of poor binding to the receptor.

Other factors involve methylation defects, especially the MTHFR defect.  If you have the MTHFR defect then your body won’t optimally metabolize folate which is important for your mood.  Some people notice big improvements in their mood when they supplement with methylated folate if they have this polymorphism.

How can gut bacteria cause depression?

There are profound connections between imbalances in your gut bacteria and many diseases including depression and anxiety.  The more antibiotics you have taken throughout your life the greater chances you have abnormal gut bacterial colonies known as dysbiosis.  Additionally, chronic consumption of refined carbohydrates and sugar will created dysbiosis.  Dysbiosis creates inflammation as well as problems with digestion and absorption of the food you eat and supplements you take.

In some cases, addressing dysbiosis and gut infections can result in less inflammation and a better mood.  The gut-brain connection runs deep and it must not be overlooked in cases of depression.

How does exercise play a role?

It has been very clear for a long time that exercise works just as well as antidepressants for depression.  However, too much exercise increases cortisol and adrenaline which will only make you more inflamed.  You’re going to have to find the right balance because exercise is one of the best things you can do to reduce inflammation.  Use this rule of thumb:  If you feel energized at the end of your routine and you could easily do the entire workout over again, then you are probably exercising with the right intensity.  If you feel wiped out like you couldn’t easily keep going then you’re probably overtraining.

Many people need to take it easy and just do some light yoga, walking or something fun for a while and stop putting extra stress on their bodies through excessive exercise.

Can meditation help to beat depression naturally?

Meditation has been shown to improve depression, anxiety, memory problems and much more.  It’s free, easy to do, and you don’t need anything to do it other than yourself.  You only need to do 10 minutes a day to reap the benefits of meditation.  Read my article here on meditation and how it can really help you improve your mood and overall health.

Journaling can really help

Start journaling about all the things that are stressing you out.  Write down how these things make you feel.  Write about the absolute worst case scenario of everything you are stressed about.  Journaling has been shown to really help with mood disorders after just a few weeks of doing it.  Putting things down on paper has a way of “dumping” all those things you are ruminating about and makes you feel better.

Will supplements and diet help?

Yes and no.  Clearly, eating a healthy diet will reduce inflammation however this can actually create more stress and anxiety if you aren’t eating perfectly all the time....

The rate of osteoporosis continues to increase despite new drugs and an increase in vitamin D and calcium supplementation.  Could it be that the focus on building bone has been going down the wrong path of drugs, supplements and hormone replacement?  Although all of these can potentially help build bone, the key really lies in building lean muscle mass.

As we age, we also lose muscle mass (known as sarcopenia) which results in the following health problems:

Frequent falls resulting in bone fracture

Depression

Increased inflammation

Increased mortality (dying earlier than you should)

Physical disability

Nursing home admissions earlier than necessary

Increased hospitalizations

Obesity

Loss of cartilage

Slow gait speed (walking slowly)

Osteopenia ⇒ Osteoporosis

You see, there is an intricate connection between your bones and your muscles known as the “bone-muscle unit”.  This unit shares many characteristics including important hormones, chemical messengers and loading connections.  Whenever a muscle and it’s connecting bone are loaded by physical stress, they adapt together and change their structure together.  If you break a bone, it is the muscles that attach to that bone that aid in healing the fracture.  The same goes for cartilage in your joints that rely on healthy muscles to keep cartilage from breaking down.  This perfectly explains why you lose bone density and cartilage while you lose muscle mass in aging.  When you think of osteoporosis and sarcopenia (loss of muscle mass), you should think of the same condition.

Why do people lose muscle and bone as they age?

The more body fat you have, the more inflammation you will have and inflammation causes muscle and bone loss.  As many people age, they become less active so they lose muscle mass and gain weight.  The stresses of daily life combined with convenience foods that are high in refined carbohydrates is a perfect recipe for muscle and bone loss.  A vicious cycle is created with decreased activity ⇒ weight gain ⇒ refined carbohydrates ⇒ inflammation ⇒ muscle and bone loss.

An additional consequence is impaired absorption and utilization of vitamin D for healthy bones.  The more body fat and inflammation you have, the less likely you are to optimally utilize vitamin D.

What are the most important supplements to build bone?

A quick refresher includes calcium, magnesium, vitamin D, essential fatty acids from fish oil, vitamin K, Zinc, copper, manganese, boron, and potassium.  None of these will work unless you are building muscle, reducing inflammation, maintaining an alkaline pH and if your hormones in balance.

What about supplements for building muscle?

The most important thing to build muscle is consuming enough protein in your diet.  You can add protein supplements such as whey protein, hemp protein or pea protein for additional support.  You can give your protein supplements a muscle building boost by adding leucine powder to your protein shake.  Leucine is the most anabolic amino acid meaning it builds muscle the best.  Magnesium and potassium supplements may be necessary if your pH is too acidic which leads to the loss of muscle and bone.

Why is acid-alkaline balance important?

Your growth hormone levels will decrease if you become too acidic and growth hormone is important for building muscle and bone.  When you eat a highly acidic meal, your bones release calcium to buffer the acids from the food you eat.  You’ll also excrete more magnesium, Zinc and potassium if you are consuming an acid-forming diet.

What are the most important steps to reverse osteoporosis?

A good general guideline for exercise is to do resistance exercise with weights, bands or machines 2 days a week for 20-30 minutes as a minimum.  You should exercise all of your muscle groups including the upper body, but with a special emphasis on the largest muscle groups which are the glutes, hamstrings, quads, and back muscles.  Additionally, focus on flexibility by performing yoga 2 days a week for 20-30 minutes or a similar stretching routine.  *Always consult your doctor before beginning an exercise program.

Eat plenty of protein as outlined above and reduce your carbohydrate intake to lose body fat.

Keep your pH in the alkaline range as outlined above.

Get your hormones in balance including your thyroid, adrenal hormones and your sex hormones.  Too much or too little of any of these can contribute to bone loss.

Supplement with vitamin D and if you are osteoporotic then it may be beneficial to use a good bone-building support formula with the supplements outlined above.

If you suffer from inflammation, then it’s important to get evaluated by a functional medicine practitioner to find out the underlying causes of the inflammation.  Some common causes of chronic inflammation are infections like viruses and bacteria, poor dental health, gut infections such as parasites, yeast and bacterial dysbiosis, food sensitivities like gluten and dairy, physical and psychological stress, insulin resistance and many more.  If you are doing everything right as outlined above but you are still inflamed, it will be very difficult to build muscle and bone so get a thorough check-up.

The connection between building muscle and building bone may surprise you, but it just may be one of the best long-term approaches to preventing and reversing osteoporosis.

Have you ever wondered what causes hypothyroidism?

Are you suffering from any of the following symptoms?

Fatigue

Weight Gain and difficulty losing weight

Hair Loss

Depression

Cold Hands & Feet

Constipation

Insomnia

Dry Brittle Nails

Lack of Motivation

Muscle pain

Your thyroid could be a major contributing factor to these symptoms. Your thyroid may have been checked by your physician, but were you evaluated for autoimmune thyroid disease?  What causes hypothyroidism?  The number one cause of hypothyroidism in the world is Hashimoto’s thyroiditis.  This is a condition in which the body produces antibodies that attack the thyroid gland.  This results in slow destruction of the thyroid gland leading to hypothyroidism.

What should everyone know about Hashimoto’s disease?

Hashimoto’s disease is the most common undiagnosed autoimmune disease in the world. More women are diagnosed with this condition than men.  Many patients do not receive a thorough evaluation of their thyroid gland and are put on thyroid medication without adequate testing for autoimmune thyroid disease.  Patients with autoimmune thyroid disease sometimes do not respond to medication and their doctors are continually adjusting their medication based on lab tests.  The autoimmune attack on the thyroid gland creates inflammation so there are a lot of ups and downs of thyroid hormone production.

This results in inconsistent blood tests, symptoms and frustration for the doctor and the patient.  Since medication is the only tool conventional doctors have to treat Hashimoto's disease, many patients are left without answers.  The key is finding out what is causing the autoimmunity and addressing those root causes because the problem is with the immune system, not the thyroid gland.

Is the TSH test enough?

The TSH test can significantly fluctuate in autoimmune thyroid disease due to the immune system’s attack on the thyroid gland.  Traditional medicine does not check for autoimmune thyroid disease routinely which leaves patients in limbo for months and even years before their doctor finally decides to run tests for autoimmunity.  Even in these cases the only treatment for autoimmune thyroid disease is medication.  That’s right, the treatment is the same for you whether you have autoimmune thyroid disease or thyroid dysfunction that is not autoimmune in nature.  Since only 10% of hypothyroid cases do not involve autoimmunity, millions of people are still not feeling well.

Is autoimmune thyroid disease genetic?

There is definitely a familial factor in autoimmune thyroiditis but not necessarily a genetic factor in everyone. Habits of living tend to run in families such as food choices, lifestyle, environment, location, and stress, all of which can contribute to the development of autoimmune disease.

How does Hashimoto’s cause hypothyroidism?

In autoimmune thyroiditis, thyroid cells are attacked by the body’s own immune system causing destruction of the thyroid gland and chronic inflammation. It can cause an overactive thyroid initially or underactive thyroid – the latter being the most common.  Most frequently, the thyroid is slowly attacked over time leading to hypothyroidism with an elevated TSH (thyroid-stimulating hormone).

How is it treated?

Traditional medicine treats Hashimoto’s with synthetic T4 (thyroxine) and when the TSH is in the normal range, the patient is considered to be treated successfully. The autoimmune component is rarely addressed which does the patient a great disservice because the body’s attack can be greatly reduced sparing the thyroid gland for a much longer period than without treatment.  Many of these patients continue to take synthetic thyroid hormone but still have symptoms of hypothyroidism.

What should you know about vitamin B12?

It has been shown that patients who have autoimmune thyroid disease also have pernicious anemia (vitamin B12 deficiency). Pernicious anemia can occur when the body is producing antibodies to intrinsic factor which is required for vitamin B12 utilization.

Should you avoid gluten?

Many studies have linked gluten intolerance to autoimmune thyroid disease.  Gluten contributes to leaky gut syndrome which can be an important player in Hashimoto's disease.  Gluten is more of an irritant to Hashimoto's disease and the vast majority of people feel much better not eating it.

Destruction of the thyroid cells in the early stages of Hashimoto’s can lead to increased amounts of thyroid hormone circulation leading to symptoms such as anxiety, tremors, hot flashes and rapid heart rate. These symptoms can significantly improve on a gluten-free diet.

Is there a connection with vitamin D?

Vitamin D deficiency has been linked to autoimmune disease including Hashimoto's disease.  Vitamin D influences the immune system by keeping immune cells in balance that may become overactive and attack tissue cells.  In addition to having low vitamin D levels, Hashimoto's patients also have a defect in the vitamin D receptor requiring much greater amounts of supplementation.  Lack of sunshine, decreased absorption due to inflammatory bowel, high cortisol due to stress, obesity and aging can all effect vitamin D levels.

Should you avoid iodine?

Iodine is a major factor in thyroid health but too much of it is not recommended for patients with autoimmune thyroid disease.  Iodine stimulates the enzyme that is under attack from Hashimoto’s disease.  Supplemental iodine will increase this immune response leading to further inflammation and destruction of the thyroid gland.

What about environmental chemicals?

Toxicity can also be a major player in thyroid disease. Compounds known as thyroid disrupting chemicals or “TDC's” are rampant in our environment.  The thyroid gland is very sensitive to chemicals which can not only cause imbalances in thyroid hormone production, but can also affect thyroid hormone receptors.  This can lead to a scenario of normal thyroid hormone on your blood tests, but it is not able to bind to receptors therefore causing hypothyroid symptoms.  Examples of TDC's are pthalates and Bisphenol-A from plastics, triclosan which is found in anti-bacterial soaps and fluoride found in our water supply.

Should you worry about mercury?

Mercury is also a major thyroid disruptor and can potentially trigger autoimmunity.  Mercury is found in dental amalgams and is also a product of coal-burning.  Here in North Carolina, we are exposed to large amounts of mercury from the coal-burning plants in Tennessee.  It ends up on our crops, water and some is inhaled.  Mercury can have the same effects as TDC's by disrupting hormone production as well as damaging receptors.

Are there any infections connected to autoimmune thyroid disease?

Infections such as Lyme disease, Epstein-barr virus (causes “mono”), Hepatitis-C, Yersinia (a gut bacterial infection), the flu virus, Helicobacter pylori and rickettsia (tick-borne) can all trigger autoimmune thyroid disease as well.  As long as these infections are active, the autoimmunity will be driven to attack the thyroid gland.

How do the adrenal glands and blood sugar affect thyroid function?

Other glands in the body such as the adrenals and pancreas are also major players in thyroid disease.  The adrenals produce cortisol which is a stress hormone that can either inhibit thyroid hormone production or decrease it's ability to bind to receptors.  Blood sugar swings from sugar and processed carbohydrates cause surges of insulin from the pancreas further inhibiting thyroid hormone production.  Your blood sugar levels and adrenal function are intimately connected and must be in balance for proper thyroid hormone production.

What about nutrient deficiencies?

The most common nutrient deficiencies that cause hypothyroidism are Zinc, Iron, Vitamin A, Selenium and Iodine.  Zinc is important for the activation of thyroid hormone as well as healthy binding of thyroid hormone to it's receptors in the cell.  Iron deficiency is very common in women but you should have a ferritin test to get the most accurate picture of your iron status.  Low ferritin levels will lead to hypothyroidism.  Vitamin A is important for healthy utilization of thyroid hormone in the cell.  Iodine is one of the main components of thyroid hormone itself.  T4 is one part tyrosine and four parts iodine.  T3 is one part tyrosine and three parts iodine.  Selenium is required for the activation of thyroid hormone and it has also been shown to decrease thyroid antibodies.

So as you can see, there are many potential causes of thyroid dysfunction that may require more than just taking a pill. I have written extensively about this in my new book, The Complete Thyroid Health and Diet Guide, which is now available on Amazon.  If you know you have a thyroid problem and are still not getting the results you want, there may be an underlying cause that hasn't been uncovered.

When I was bodybuilding in the 1990’s, we used to use the ketogenic diet to burn off that extra bit of stubborn fat.  We would only do it for about 3-4 days however and would then cycle the diet for 2-3 weeks maximum.

The ketogenic diet works well to burn fat while preserving muscle mass which is extremely important when you are dieting because lean muscle mass is vital for good health.

What is ketosis?

The ketogenic diet converts the body into a fat-burning metabolism known as ketosis which basically means that your body is producing energy from ketones rather than glucose.  Ketones are made from fat and your body has no problem running on ketones instead of glucose.

Ketosis is not to be confused with the serious condition known as diabetic ketoacidosis which occurs in type 1 diabetes and is a life-threatening condition.  Sometimes nurses and doctors confuse these two which are completely separate physiological states.

Ketosis has been used in conventional medicine for epilepsy but it also has been found to be effective for the following:

Type 2 diabetes

Polycystic ovarian syndrome (PCOS)

Acne (often caused by growth hormone in milk, excess androgens and too much sugar in the diet)

Insomnia

Fatigue

Difficulty losing weight

Headaches

Insulin resistance

Metabolic syndrome

Alzheimer’s

Parkinson’s

Neuropathy

Lowers cholesterol and triglycerides

Increases HDL

Increases the size of LDL particles making them less prone to stick to blood vessels

Obesity

Cancer

Improves fasting glucose and hemoglobin A1c levels

Autism

Multiple sclerosis

Brain trauma

ALS (Lou Gehrig’s disease)

How do you achieve a ketogenic state?

Ketosis is fairly simple to achieve.  All you have to do is keep your carbohydrate intake less than 50 grams a day and after 3-4 days you will be in ketosis.  Some individuals must keep their carbohydrate intake less than 30 grams a day to shift into ketosis.  The way to find out if you are in ketosis is to use ketone test strips that you dip in your urine and use the color chart that comes with the strips.  These can be purchased at any drugstore or online.

There are also electronic ketone monitors that require blood and they are much more precise than the urine strips. However, the urine strips are just fine if you want to see if you are in ketosis or not.

Is this just the Atkins Diet?

Dr. Atkins made ketosis popular because it was extremely effective in losing weight however his work was misunderstood and misrepresented.  His diet was erroneously thought to just be a bunch of bacon, eggs and butter which really wasn’t his method.  Yes, these foods were acceptable in the initial phase but most people consumed too much and didn’t transition out of ketosis correctly.

Diets always have a beginning and an end so when people would stop they would just gain the weight back.  This is because the underlying reasons for weight gain were not corrected such as psychological and lifestyle factors.

Why does ketosis work?

Decreased appetite.  You just won’t really feel all that hungry in ketosis.

Increased fat-burning and decreased fat storage

Greater efficiency in burning fat

Increased thermic effect from protein consumption

Increases glutathione levels in the brain which repairs memory problems

Reduces inflammation

Restores mitochondrial function

Reduces oxidative stress

Additionally, if your brain is insulin resistant then it won’t burn glucose very well so your brain function may be sluggish. Your brain however can burn ketones efficiently even if you are insulin resistant.  This is why it is a promising diet for those with Alzheimer’s and dementia.

A ketogenic diet also just tends be lower in calories so most people lose weight without feeling hungry.  This can definitely provide an advantage for those with food cravings and blood sugar problems.

Ketosis mimics fasting and calorie restriction, both of which significantly reduce inflammation.  The advantage with ketosis is that you actually get to eat rather than cutting calories and dealing with hunger.

What foods can you eat?

Basically, anything that has little to no carbohydrates such as meat, fish, eggs, oils, salad vegetables, non-starchy vegetables and small amounts of cheese.  Certain dairy products are low in carbohydrates such as cream cheese, cottage cheese, sour cream and butter.  Your plate will have some sort of protein source such as meat or eggs and some vegetables on it.

You don’t have to hold back on fat so you can use plenty of olive oil on your salads or cook your food in butter or coconut oil.  Nuts and seeds are ok but they must be consumed in extremely low quantities so that your carbohydrate intake doesn't kick you out of ketosis.

Red wine and distilled spirits are ok as well as coffee and tea.  85%+ dark chocolate in small amounts is another acceptable food for ketosis.

What foods should you avoid?

Any food with moderate to high carbohydrate content such as grains, legumes, fruit (berries in small quantities may be ok), potatoes etc.  If your carbohydrate intake increases above 50 grams you will shift out of ketosis.  It’s also extremely important to stay away from sugar even if your carbohydrate intake is low.

Small amounts of berries, nuts and seeds may be okay, but just be sure you are monitoring your carbohydrate intake so you don't go above 50 grams a day.  I like to use the free app LoseIt to track all of my food intake which tells you exactly how many carbohydrates, fat and protein I am eating.

Are there different types of ketogenic diets?

As long as the basic guidelines are followed of keeping carbohydrate intake under 50 grams a day then a variety of different foods can be eaten.  However, there is a promising variation known as the Spanish Ketogenic Mediterranean Diet.  It has a few specific guidelines which tend to emphasize olive and fish with red wine as a staple of this variation.

You can read about this variation in it’s entirety here.

Are there any supplements required for ketosis?

Ketogenic diets can lead to a few deficiencies such as potassium and magnesium.  I usually recommend a good multiple vitamin, potassium bicarbonate, magnesium glycinate, fish oil, and MCT oil is useful for accelerating the ketogenic state.  Some people need to use a fiber supplement if they become constipated.  1-2 tablespoons of ground flax seeds provides a lot of high quality fiber as well and anti-inflammatory omega-3 fatty acids.

How long should one do ketosis?

This is to be determined by your doctor however there are a few important points to note.  Ketogenic diets do begin to show signs of lower thyroid function if you stay in it for too long.  This is because our bodies are designed to conserve fat for energy if food is scarce.  A ketogenic diet over time can tell your brain that food may be scarce so it slows your metabolism to conserve energy.

The way around this is to eat a large amount of carbohydrates one day a week which tells the brain that plenty of food is available.  This will pull you out of ketosis but you will be back in it after a few days eating low carbohydrates again.  Your thyroid function will increase after eating this large bolus of carbohydrates.  Some people just like eating like this because they get the benefits of ketosis during the week and then they get one day on the weekend where they can enjoy carbohydrate-rich foods without gaining weight.

All diets end eventually so think of this more as a lifestyle change if it works for you.  If you notice tremendous benefits then it may be worth discussing with your doctor how this can work as a lifelong strategy.

You should always do the ketogenic diet under medical supervision due to the risks of ketosis and eating extremely low amounts of carbohydrates.

Ketosis can produce a rapid improvement in those with insulin resistance so we are fortunate to have this mechanism built into our own bodies.  I think you’ll see ketosis become more and more popular as our rates of obesity and diabetes continue to explode.

My favorite ketogenic diet resources:

Ketogenic Diet Resource

Dr. D'Agostino's Keto Nutrition Site

Dr. D'Agostino Interview with Tim Ferriss

What are FODMAPs and how do I follow a low FODMAP diet?

FODMAPs or Fermentable Oligo-Di-Monosaccharides and Polyols are a specific type of carbohydrate found in certain foods that you must avoid if you are following a low FODMAP diet.  The family of FODMAPs include:

Lactose from dairy products.

Fructans:  garlic, onions, wheat etc.

Galactans:  legumes such as lentils, beans, soybeans etc.

Fructose:  honey, certain fruits, high fructose corn syrup etc.

Polyols:  stone fruits such as avocados, peaches, plums, cherries, apricots, nectarines etc. and sweeteners such as xylitol, sorbitol, mannitol.

 

Why should you follow a low FODMAP diet?

FODMAPs create a few problems for your intestines that lead to Irritable Bowel Syndrome (IBS) and digestive system problems.  The following symptoms can be caused by FODMAPs:

Gas

Bloating

Abdominal pain & discomfort

Abdominal cramps

Fatigue

Weight gain with difficulty losing weight

Feeling like you don’t completely empty your bowel when you have a movement

Alternating constipation and diarrhea

Inconsistently formed stools such as random changes in size, shape and color

Passing mucus

Sometimes feeling hungry shortly after meals

Fatigue after meals

Brain fog

How does this happen?

FODMAPs draw a lot of water into your intestine which contributes to some of the symptoms listed above.  Additionally, FODMAPs are not digested well and poorly absorbed which results in fermentation of the food that you eat.  When your food ferments in the intestine, it causes the above symptoms as well.

Why can’t you digest them well?

If you have taken a lot of antibiotics throughout your life then you may have too many bacteria in your small intestine or abnormal bacterial colonies in your large intestine.  Normally, the large intestine has a lot more bacteria than the small intestine; but if this shifts due to antibiotics and poor diet then you won’t be able to tolerate FODMAPs very well.  If there is bacterial overgrowth in your small intestine known as SIBO (small intestinal bacterial overgrowth), then there will be rapid digestion and fermentation of the food you eat which leads to your digestive system problems.  This can be compounded by yeast overgrowth and/or intestinal parasites.

Beans are a classic example of a FODMAP that has had many jokes made about their connection with gas.  The gas produced by beans is a result of their fermentation in the bowels due to problems with gut bacteria.  Not everyone gets gas from beans which means they are a great indicator of healthy gut bacteria.

How long should you follow the low FODMAP diet?

This depends on your current situation and what your doctor prescribes.  Most individuals stay on it for approximately 2-6 weeks and then begin restoring healthy gut bacteria with specific prebiotic and probiotic-rich foods.  The great thing about the low FODMAP diet is that you don’t need to be on it for very long to restore healthy digestive system function.

Your doctor may prescribe an antibiotic or herbal medicines to suppress the growth of bacteria in the small intestine during this diet.  If your stool analysis shows yeast overgrowth or parasites then this diet will be extremely helpful for that as well.  The healthier your gut bacteria, the better you will be at fighting infections in the intestine.

Can I combine the ketogenic diet with the Low FODMAP Diet?

Yes.  All you have to do is follow the ketogenic diet and eliminate any FODMAPs that are listed on the ketogenic diet.  The purpose of combining the two would be to burn more fat, reduce inflammation and to reverse insulin resistance.

How do I get started?

Simply start eating low FODMAP foods and small amounts of moderate FODMAPs.  I have found a number of excellent resources for you to help with your low FODMAP diet.

You can download this free handout provided by Ohio State University which should get you started right away.

Kate Scarlata, a registered dietician, has some excellent resources to help you including a shopping list, recipes and more on her website.

All of this material was founded by the Monash University Department of Gastroenterology where the research was done on FODMAPs.  They are an excellent resource for FODMAP information and they even offer a mobile app to help you with a low FODMAP diet.

Remember to always consult with your doctor, nutritionist or registered dietician before trying the low FODMAP diet.  If you aren't getting the results you expect on a low FODMAP diet, then there may be other factors involved such as an intestinal parasite or yeast overgrowth that is holding you back.  Be sure to be evaluated by a functional medicine practitioner to find the underlying causes of what may be impairing your progress.

In this interview with Dr. Jeff Moss I discussed all of the health benefits and uses of monolaurin which is one of my favorite supplements for infections and healthy immune system function.  The interview is about twenty minutes but it is packed with great information.

What is Monolaurin?

Monolaurin is a "monoester" formed from lauric acid which is a medium chain fatty acid.  Monolaurin is the main antiviral and antibacterial found in human breast milk as well as in coconut.  Monlaurin works well against certain viruses, bacteria, fungi and parasites.  Monolaurin has also been shown to improve immune system function in addition to its ability to target infections.

Monolaurin has been shown to be effective for the following infections:

Viruses:

Epstein-Barr Virus

Cytomegalovirus

Herpes viruses

HIV

Measles

Influenza (The Flu)

Bacteria:

Staphylococcus aureus

Streptococcus agalactiae

Group A, B, F and G streptococci

Listeria

Helicobacter pylori

Fungi:

Candida albicans

Ringworm

Parasites:

Giardia lamblia

I use monolaurin quite a bit for these types of infections because it is extremely reliable, effective and well-tolerated by most people.  Although it is found in high concentrations in coconut, you really must supplement with it to have an effective treatment for specific infections.  You can certainly increase your monolaurin intake by consuming coconut-based products on a regular basis.

Here is a list of the lauric acid content of some foods;  monolaurin is made from lauric acid in the body (grams are per cup):

Coconut cream, raw 37 grams

Coconut cream, canned 23.3 grams

Fresh grated coconut, packed 19.4 grams

Fresh grated coconut, loose 11.9 grams

Coconut cream pudding 1.29 grams

Coconut milk contains 3.5 grams per 2 ounces.

What is the best way to take it?

The general recommended does is 1-3 grams for adults.  Monolaurin is best taken in small doses for the first week so that your body gets used to it.  The second week the dose is then increased for one week.  And then the third week it is taken at its highest dose for one week.  After that, I have patients taper down their dose for maintenance and to keep any infections from returning.

As always, supplement only under doctor supervision.  Monolaurin is a phenomenal compound from Mother Nature to help us fight infections and improve immune system function.

Curcumin is a powerful antioxidant derived from turmeric root used heavily in traditional Indian cuisine.  Turmeric is a close relative of ginger which I use quite a bit to improve digestion and reduce inflammation.

Curcumin was first used about 4,000 years ago in Chinese and Ayruvedic medicine.

Curcumin has a tremendous amount of research behind it and it is one of my favorite natural anti-inflammatories.  But it's powers don't end with inflammation.  Research has shown that curcumin has the following benefits:

Potent Antioxidant

Bile Support

Enhances bile flow and solubility which is important for fat digestion and cleansing the digestive tract

Toxic Metal Chelator

Effective chelator of copper and iron

Liver Protection

Neutralizes alcohol and aflatoxin (peanut fungus)

Digestive System Protection & Healing

Heals stomach ulcers, Crohn's disease and proctitis (inflamed anus)

Reduces leaky gut

Antimicrobial

Antiviral properties for Epstein-Barr Virus (causes autoimmune disease, “mono” and chronic fatigue syndrome) and HIV (AIDS)

Antibacterial and anti-parasitic (Staph infections, parasites and certain protozoa)

Protects the Heart

Reduces cholesterol levels and increase protective HDL

Reduces fibrinogen and platelet aggregation (prevents stickiness of blood)

Improved microcirculation (small blood vessels)

Brain Protection

Reduced brain damage after stroke

Reduces development and regression of Alzheimer's disease progression (reduces plaque formation)

Reduces brain tumors

Natural antidepressant

Immune System Regulation

Anti-inflammatory, repairs injuries and joint wear and tear (arthritis)

Reduces allergic reactions and asthma symptoms

Reduces autoimmune activity in rheumatoid arthritis and multiple sclerosis

Increases natural killer cell activity

Reduces the spread of cancer in the breast, prostate, colon, pancreas, brain and ovaries

Prostate Health

Improves prostate related symptoms

Healthy Blood Sugar

Improves insulin resistance

Nerve regeneration

Curcumin has an advantage over ibuprofen and aspirin because it does not cause bleeding in the digestive system.  In fact, one study showed that curcumin actually healed injury to the GI tract that was caused by conventional NSAIDS (non-steroidal anti-inflammatory drugs).  In combination, curcumin and resveratrol have been proven to be even stronger anti-inflammatories than ibuprofen and aspirin.

Curcumin has been studied extensively in human clinical trials at the M.D. Anderson Cancer Institute in Houston, Texas.  These studies found that curcumin was safe for patients under-going chemotherapy and does not need to be avoided.  In fact, it was found to enhance the effectiveness of chemotherapy.

Curcumin and other plant-derived compounds have been shown to work synergistically with Vitamin D3.

How should you take curcumin?

Unfortunately, curcumin is poorly absorbed however it’s absorption can be enhanced significantly if it is combined with phosphatidyl choline.  It is also very unstable but this can also be remedied by combining it with lecithin.

I recommend CurcuSelect from Moss Nutrition which is formulated to contain the phosphatidyl choline and lecithin in the patented Meriva form.

I recommend taking curcumin with a meal that contains fat or with fish oil to further support absorption.  500mg twice a day with meals is the most effective therapeutic dose which would be two capsules of CurcuSelect twice a day during acute health problems.

A maintenance dose would be 250mg twice a day with meals which would be one CurcuSelect taken twice a day.

Curcumin is not recommended during pregnancy, if you are taking blood-thinners, or with gall stones.  If you iron levels are low and you are trying to improve your ferritin levels then curcumin may inhibit your progress due to it’s chelating ability of iron.

Turmeric tea is also and excellent option for reaping the health benefits of curcumin.  I like Turmeric Ginger tea from Rishi so I get the benefits of both herbs.  You can also cook more often with the spice turmeric.

Inflammation is at the root of the vast majority of health problems so it just makes sense that curcumin works so well with so many conditions.  Curcumin is by far one of my favorite natural remedies for a variety of symptoms and health concerns.

Announcer: It's a healthy audio treat. RadioMD presents Family Food Kitchen with Ellen Briggs and Carolina Jantac.

Female 1: Hey, if you want a balanced thyroid to improve your odds of not gaining weight and of being healthy, then you ought to know which are the worst foods to avoid and the top best foods you can eat. It is such a pleasure to introduce you to the author of "The Complete Thyroid Health and Diet Guide," Dr. Nikolas Hedberg. Dr. Nik, first would you please connect the dots quickly between the food we eat and the health of our thyroid?

Dr. Hedberg: The food that we eat and how they connect with our thyroid are really not very different from the foods that anyone would want to eat, no matter what condition they have. But there are a few caveats to that regarding some of the worst foods that can negatively affect the thyroid that you want to stay away from and then eat best foods as well.

Female 1: Well, let's stay with the three worst. Just have at it.

Dr. Hedberg: So the sugar is going to be No. 1 because that raises insulin and causes surges in blood glucose and that negatively affects the thyroid. The second is going to be Gluten, and Gluten is mainly going to be avoided if you have auto-immune thyroid disease, known as Hashimoto's, and then soy would be No. 3. Soy can be high in estrogen which affects thyroid, and it's also going to be low in sulfur containing amino acids which are really important for detoxification. If the soy is fermented, that can be okay. But any processed soy, you would definitely want to avoid.

Female 2: Okay so that's sugar, gluten, and soy, and I am assuming avoid doesn't mean you can't ever eat them but definitely keep it down to a minimum. So let's go to the positive. Which foods should we be eating to maintain good thyroid health?

Dr. Hedberg: Right. So the first category is going to be fruits and vegetables, and fruits, they need to be low glycemic fruits, meaning that they don't spike blood sugar very much. And then vegetables, pretty much all vegetables with an emphasis on cruciferous vegetables, like broccoli and cauliflower. And those are going to really help with estrogen metabolism and detoxification which is what you want if you have hypothyroidism due to too much estrogen.

Now the fruits and vegetables will ensure that your pH is in the healthy range because there are studies that have shown that if you become very acidic then that decreases thyroid hormone levels. Meat is actually a top one but it needs to be free range organic, and that is so-called, you know, natural meats and the reason why you would want to do that is because those are going to be lower in chemicals and antibiotics and estrogens. And the thyroid really needs very healthy levels of amino acids. So things like a grass fed beef, grass fed lamb, bison, things like that, fish.

Female 2: So we are eating those for the specific animal amino acid. So we are not talking about just proteins. So eating plant protein would not substitute here. You have to be looking for animal protein.

Dr. Hedberg: You can get all of your proteins from vegetables if you're a vegetarian, but meat is also going to contain a lot of other nutrients that are really important for the thyroid, especially zinc. So that's why I put that as one of the best foods.

Female 1: Gotcha. Okay and next?

Dr. Hedberg: Yeah, fish. Now with fish for the omega 3 fatty acids and the selenium, those are very important for thyroid function. Now with the fish, you definitely want to avoid farm raised fish. It should be wild caught. That's going to be a very important food for thyroid function and metabolism and tying in with the selenium in the fish, the next food would be Brazil nuts. You don't really want to eat too many of these though. Maybe only eat no more than two, maybe three a day,

Announcer: You're listening to RadioMD. What's good and good for you? Why Family Food Kitchen of course. Here they are, Ellen Briggs and Carolina Jantac.

Interviewer: I remember when my mother had my older sister, they just trotted off to the doctor because they, she wanted their thyroids checked, and boy I just didn't get it. I'd like, what's the big deal about getting your thyroid checked? It's just a little organ in your neck. I just didn't get it. But here to explain why she was really on to something is our guest, Dr. Nikolas Hedberg. He's the author of The Complete Thyroid Health and Diet Guide. Just write that down, The Complete Thyroid Health and Diet Guide, because by the time we're finished talking with him, you're gonna want to go get it. Thanks for being in our Family Food Kitchen today Dr. Nik. That's what his patients call him, so I'm calling him Dr. Nik. Please explain why were you so compelled to write about your thyroid?

Dr. Hedberg: When I started practicing, I started seeing a lot of patients taking thyroid hormones and it really wasn't helping. Then when I was out lecturing in the community on various health topics, one of the things I noticed is that every time I gave a thyroid lecture it was always standing room only. It was always a packed house. It was just such a big topic. So many people were suffering from thyroid problems, and the conventional treatment was failing them. So there was just a huge interest. And so, here's the matter of seeing a lot of it, and just seeing the real interest in it in the public who just wasn't getting answers.

Interviewer: Tell me how do you know that you have a thyroid problem? You said you had a roomful overflowing with people. How did they know they had thyroid problems?

Dr. Hedberg: Some of them were diagnosed with hypothyroidism already. They were taking medication, but it wasn't helping. And then a lot of people identify with some of the most common symptoms of hypothyroidism, which are mainly fatigue, weight gain with an inability to lose weight, constipation, cold hands and feet, hair loss, depression, all kinds of metabolic problems where the body just can't make energy, and those are really the main consequences of not being able to make energy.

Interviewer: That's a really long list of symptoms that are attached to just that one organ, just the thyroid. So I guess it would be helpful if we explained, is the thyroid's function directly related to all of those different functions you just mentioned as symptoms?

Dr. Hedberg: Right. Because basically what the thyroid does is it produces a hormone that controls metabolism. So if you're wondering what happens to the food that you eat, where's the energy made from, from the protein, carbohydrates, and fats? All of that is regulated by the thyroid hormone. So any symptoms that we would see related to a sluggish metabolism or an inability to burn and make energy from the food that you eat, we can tie those in with low thyroids. So fatigue, the weight gain, you can't burn fat, constipation. The thyroid hormone really drives the movement of food through the intestine, so that would become sluggish. Skin, hair, and nails, those are all made from proteins and various vitamins and minerals. Depression, we can tie that in with serotonin metabolism etc. So yeah, a lot to tie in there and a lot of those symptoms can overlap with other health issues, but those are very, very common symptoms.

Interviewer: Boy, it sounds like everybody needs some help with their thyroid, but I want to ask this part of question. I have a very slow metabolism, but I don't have a thyroid problem. My body functions well. I have lots of energy. I feed it right, but my metabolism does not burn a lot. Where, you've got the other people who just, their metabolisms are like furnaces that are in blaze all the time.