Ask The Low-Carb Experts
Jimmy Moore Presents his latest podcast, Ask The Low-Carb Experts. Listeners like YOU can call in LIVE every thursday evening at 7PM US Eastern time. Just call (712) 432-0900 and use the access code 848908 or you can Skype the show for FREE by calling the username freeconferencing.7124320900.

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AIR DATE: March 29, 2012 at 7PM ET
FEATURED EXPERT: Dr. Jeff Volek
FEATURED TOPIC:“Saturated Fat Is Good For You?”

Researcher and associate professor of kinesiology at the University of Connecticut Dr. Jeff Volek is one of the world's renowned experts in exercise, nutrition, weight loss and low-carb diets today. He is the author of a number of popular books addressing these subjects, including Men's Health TNT Diet, co-author of The New Atkins For A New You with Dr. Stephen Phinney and Dr. Eric Westman and most recently The Art and Science of Low Carbohydrate Living in 2011 with Dr. Phinney. I interviewed Dr. Volek in Episode 236 of "The Livin' La Vida Low-Carb Show" podcast and I've personally heard him lecture at various obesity conferences over the years. He will be joining us on The 5th Annual Low-Carb Cruise in May 2012, but we are pleased to have him joining us to discuss a subject he has studied thoroughly over the past few years. Saturated fat is arguably the most misunderstood and maligned real food in the history of mankind and Dr. Volek can answer any and all questions you may have about how it impacts you metabolically. He is a real expert that we are privileged to have addressing this very important topic!

If you have any questions about saturated fat that you would like Dr. Jeff Volek to address, then feel free to send it to me by 3PM ET this Thursday afternoon at AskTheLowCarbExperts@gmail.com. Or you can ask your question LIVE on my show by calling (712) 432-0900 or Skype the show for FREE by calling the username freeconferencing.7124320900. Whether you call or Skype, be sure to use the access code 848908. Listen LIVE and leave us a review at iTunes if you like what you hear. This is your chance to interact with the best nutritional health experts in the world, so don't be bashful.

For those of you using the Windows version of Skype to call into the show on Thursday night, you can locate the dial pad by selecting the Call tab at the top of the page, then click Show Dial Pad. Please see the image below for reference:

And if you use the Mac version of Skype, here's how to call in:


http://youtu.be/bp5Z_rxj_C0

Direct download: atlcx-11-dr-jeff-volek.mp3
Category:general -- posted at: 1:00am EDT

AIR DATE: March 22, 2012 at 7PM ET
FEATURED EXPERT: Chris Kresser
FEATURED TOPIC: “All Things Thyroid (Thyroid 101)”

Licensed acupuncturist and integrative medicine practitioner Chris Kresser is one of the most highly-sought after voices of reason in the realm of health on the Internet today. He has personally been through the wringer with the traditional medical system as he shared with me in Episode 464 of "The Livin' La Vida Low-Carb Show." But that set him on a quest to discover more about his own health by gathering and analyzing the medical research staying up-to-date on everything he could get his hands on. There are a lot of health myths that unfortunately pervade in the realm of health and Chris regularly addresses these on his highly popular ChrisKresser.com web site and wildly-popular Revolution Health Radio podcast. One area of specific interest to him is the subject of thyroid. Around 20 million Americans deal with some form of thyroid disease and yet it is left undiagnosed due to a variety of reasons. Yet there is a lot of confusion about thyroid conditions that we will hopefully have Chris help bring clarity to in this episode!

LOW-CARB, GLUTEN-FREE CONDIMENTS MADE WITH STEVIVA

NOTICE OF DISCLOSURE: http://cmp.ly/3

Here are some of the questions we addressed in this podcast:

Are there any dietary changes that will "treat" hypothyroid?

There is a meme that has spread quickly to Paleo sites that low carb causes low T3, and is a cause of hypothyroidism. How can this be? My doc who treats hypothyroidism and insulin resistance had me do low carb, and it worked. How can low carb be both the cause and part of the solution? Someone has this wrong. What is going on?

CRIS ASKS:
I am a 53 year old female who had a Total Thyroidectomy four years ago due to thyroid cancer. My doctor keeps me just a smidgen "hyper" with Synthroid replacement medication to help the cancer not grow back. I have lost 50 pounds. In one year on a low carb diet, I feel great. But I have been stalled for two months now. I can't seem to lose any more weight. I need to lose 50 more. I know I need thyroid replacement meds but could this be the reason I can't seem to lose anymore?

JENNIFER ASKS:
Which is better--natural or synthetic thyroid hormone (like Synthroid) or a combination?

PAUL ASKS:
When I went zero carb Paleo, my T3 dropped out of the range and I needed to take antibiotics for a mouth abscess. I resumed carbs and gained back the weight I lost. I am now trying to drive down the carbs again. What can I do to ensure that my T3 remains ok. I am hypothyroid (take 100T4 + 20T3) and I was assessed a few years back by a former family doctor as having low adrenal function. Are adrenal and thyroid metabolism related and can a low adrenal state lead to a low T3?

REGINA ASKS:
What is your opinion of Jack Kruse's Leptin Reset Rx and Cold Thermogenesis on the thyroid?

LAUREN ASKS:
I underwent a total thyroidectomy in January of 2006 following a thyroid cancer diagnosis and will be on replacement T4 (Synthroid) for the rest of my life. Are there any modifications that those of us without a thyroid need to keep in mind when following a Paleo diet?

JOSH ASKS:
My wife had about 90% of her thyroid removed several years ago after undergoing a thyroid storm and goiter. She's on levothyroxin and we've switched over to a Paleo diet about two years ago, and she's pretty good with adherence, especially when it comes to avoiding wheat and grains. One of my real concerns is with her long term bone health due to the thyroid removal. She currently takes anywhere from 2000mg to 3500 mg of calcium each day to combat calcium loss from her bones. She takes 5000 IU of D3 daily, as well as K2 to help with proper absorption. Her blood calcium levels are usually high, but if she doesn't take the oral supplements she gets pain in her hands, wrists, and other joints. What supplements would you recommend for proper calcium absorption? What are some good blood markers you'd like to to indicate proper function?

SHARON ASKS:
Can you discuss the role of antibodies (AB), both blocking and stimulating, on thyroid health? When the typical thyroid labs appear "normal", could there be an AB issue occurring, causing the autoimmune response?

DONNA ASKS:
Since giving up soy milk and grains (including daily wheat germ) when I started on a low-carb regimen about a year ago, my arthritis symptoms have virtually disappeared, and my thyroid started working better (I was able to lower my dosage of levothyroxine slightly). During the same period, my osteopenia has progressed to osteoporosis. The latter may just be age, but what I want to know is, could the same root cause underlie co-existing hypothyroidism, osteoarthritis and osteoporosis?

PAUL ASKS:
My TSH increased from 3.86 a year ago to 5.23 last month. I have no hypothyroid symptoms but my doctor want to put me on levothyroxine. Does this make sense?

Other relevant blood values
T4 free 1.09
T4 total 5.9
T3 uptake 38
TPO antibody: 19
Total cholesterol increased from 197 to 215 over last year.
T total 417
T free 45
Free T% - 1.1%
SHBG 79.6

LAURA ASKS:
I am a 42-year-old female who has been eating Primal/Paleo (low to moderate carb) for over one year now (after being a vegetarian and vegan for almost my ENTIRE life). I had my one and only child almost three years ago and lost all my baby weight (and then some) by changing my eating habits. I looked so much better after changing my lifestyle, but still had low thyroid symptoms (FREEZING cold, tired, digestion issues, etc) AND it was discovered I had near zero sex hormone production (estrogen, progesterone, and testosterone). Also, I had BEYOND low Free T3 and Free T4 (TSH was all over the place, but is now quite low). I was diagnosed with hypothyroid due to a pituitary disorder. I have been put on Estradiol, Prometrium, and a small amount of topical Androgel (testosterone). I have also been taking Armour. I have gained 30 pounds thus far. I am miserable.

My questions are:

Do you believe in supplementing with sex hormones or should the thyroid medication be sufficient?

Would daily intermittent fasting be contraindicated for someone with issues like mine (or does this stress the adrenals too much)?

I want to be HEALTHY. But I cannot lie, I am so OVER being overweight. I would love to find a healthy balance.

STEVE ASKS:
This question is about real thyroid health vs "health on paper" (good test results). I've been treated for hypothyroid, chronic fatigue, and insulin resistance since 2007, with good results. I see a top doctor that deals with all three and they use the so-called bio-identical T3, hormones like testosterone or progesterone cream, and a lot of supplements. I lost 120 pounds quickly and look much different. My blood work went from train wreck to awesome. Weight is normal enough and I feel fine, even though I have low calorie requirements now (about 1,400 a day, and I'm male 51, 5"8, 192 pounds)

My question is how do I know if I get to a point where I'm spending a lot of money on meds and supplements and maybe need to back off and let the body take over? My doc wants to keep doing what has worked. Am I broke forever, or should I think about cutting back on supplements and hormones and let the body handle more?

TIRIL FROM NORWAY ASKS:
I am wondering if thyroid problems is the cause of hair thinning in a woman? Are there any other causes that should be investigated as well? And what can you do as a first intervention?

JAN ASKS:
What thyroid tests do you recommend when weight loss has stalled? (In my case TSH is elevated but the HMO will not test T3 or rT3--is it worth paying privately for those tests to have a more complete picture of what might be going on?)

PAULA ASKS:
Do you have any insight on what might cause thyroid nodules? (I have several, and biopsies show them to be non-cancerous at this time. One doctor recommends surgery; another says they are nothing to worry about)

Direct download: atlcx-10-chris-kresser.mp3
Category:general -- posted at: 1:00am EDT

Harvard research biochemist Mat Lalonde has a rather interesting take on the Paleo diet from the role of an organic chemist. Lauded for bringing skepticism about the claims of ancestral living to light, Mat is a really smart guy who pushes the boundaries of thinking outside of our own little online communities to see the bigger picture. He was a guest in Episode 419 of my “Livin’ La Vida Low-Carb Show” podcast and we’re pleased to have him address a subject matter that he knows quite a bit about: CALORIES! Mat is a big believer in food quality over food quantity and that eating until you are full is possible on a weight loss plan. This is sure to be one of the most popular episodes we’ve aired to date!

GET BEN GREENFIELD’S ‘LOW-CARB DIET FOR TRIATHLETES’:

NOTICE OF DISCLOSURE: http://cmp.ly/3
Here’s the column on calories Jimmy referenced at the beginning of the show:
“What’s Really Making Us Fat?” by Kristin Wartman in the March 8, 2012 issue of The Atlantic

Here are some of the questions we addressed in this podcast:

ANGELA ASKS:
Is there a point where your body gets too comfortable with a low-carb diet and too used to burning fat for fuel, that you need to watch your calories as well as your carbs in order to lose weight? I had a great success on Atkins in the first months, losing 13 kgs, then nothing else since then, unless I lower my calories.

DON ASKS:
On a recent ATLCX show I heard Mark Sisson say that he believed if you are taking in enough nutrients and fat in your diet to maintain your current weight that you probably wouldn’t gain weight but that if your goal was to lose fat that you needed to create a calorie deficit. Mat, what is your take on this? There seems to be a lot of disagreement on this subject.

SUSAN ASKS:
Is it true that there’s no scientific evidence that 3500 calories = 1 lb? Where did this stat originate from? Why is it not relevant for weight loss if this stat isn’t true? I would love to have an answer for those who still regard this as the holy grail of weight loss.

MIKE ASKS:
What are your thoughts on the food reward theory and the idea that weight and health management is really “all about the calories.” I think it’s rubbish but I’d like to hear Mat’s take. It seems that many Paleo folks are abandoning low-carb as a legitimate nutritional approach.

LISA ASKS:
If you eat too low of calories, will that send you into “starvation mode” and stall your weight loss?

JAMIE ASKS:
One of the biggest chains of women’s workout centers is Curves and they claim you will “Burn up to 500 calories in 30 minutes.” Just how accurate would you say calorie estimates are for exercise machines and programs?

WALLY ASKS:
You have made the remark that the human body is not a calorimeter. In what ways, if any, are food kilo-calories relevant to optimal health?

SUSAN ASKS:
Is there an ideal percentage of your calories that should come from carbs, fats and proteins?

BEN ASKS:
Mat once mentioned how intermittent fasting causes an increase in the “fight of flight” response. Is this still true for a person that is well adapted to intermittent fasting and can go 16+ hours without any desire or hunger for food? And if it’s still true, would something like a piece of fruit be enough to negate the stress issue?

MICHAEL ASKS:
Before I ran across Paleo, I was looking into calorie restriction, which naturally I didn’t even attempt to comply with. In your estimation, do you think the science shows there is an advantage to modest calorie restriction when already eating cleanly? Do you believe all the benefit of calorie restriction can be retained by clean eating and intermittent fasting? Where does protein sparing fasting fit in?

Direct download: atlcx-9-mat-lalonde.mp3
Category:general -- posted at: 9:00pm EDT

AIR DATE: March 1, 2012 at 7PM ET
FEATURED EXPERT: Dr. Mary Vernon
FEATURED TOPIC: “What Questions Should I Ask My (Non-Low-Carb Friendly) Doc?”

Famed low-carb clinician Dr. Mary Vernon, MD is the co-author of Atkins Diabetes Revolution with Jackie Eberstein, RN (who was our very first guest in Episode 1 of ATLCX). She is a Past President of the American Society of Bariatric Physicians. Dr. Vernon is well-known amongst her medical professional peers as an expert on the therapeutic use of low-carb ketogenic diets on patients to treat a variety of health issues, including diabetes and metabolic syndrome. She is the CEO of Innovative Metabolic Solutions which seeks to educate her fellow physicians and medical professionals on how to use science-based modalities with patients. Dr. Vernon has a heart for arming doctors with practical ways to implement low-carb diets where they are necessary for improving key health markers. What better expert could we have to address what questions you should be asking your (non-low-carb friendly) doctor than her!

Here are some of the questions we addressed in this podcast:

KELLY ASKS:
My frustration with doctors is they spout the conventional “wisdom” of the food pyramid or MyPlate or whatever it is now, but yet when it doesn’t work for me they say I’m just not trying hard enough – which is without a doubt not true. So I guess my question would be – If something isn’t working, wouldn’t it be smart to try something else? And really – where are the medical studies that back up that a low fat diet is better for my health? Where are the studies that correlate fat = heart disease? If I lose weight (even if it’s a small amount) and feel better and have lower blood sugar on a low-carb diet, then shouldn’t I stick to something that’s working? And is it so wrong that I want to be personally involved in my health enough that I HAVE done research and have looked up the studies and that I might actually have a working knowledge of what is best for my body?

CONRAD ASKS:
I am currently in the process of looking for a new Doctor (already checked http://lowcarbdoctors.blogspot.com/) What questions can I ask before visiting to find out if they might support a low carb lifestyle, other than the obvious “Do you support low-carb, high-fat diets?” I have read that I should make sure they perform and understand a VAP instead of standard cholesterol test. Are there any other tests or procedures I should be aware of and ask for?

KATHY ASKS:
I just got my lab work back from my doctor and my total cholesterol was 249 with LDL at 171 and my sugar at 103. That’s basically all he said and then of course, “I’d like to start you on a low dose statin, keep eating a low carb, low cholesterol diet”. The cholesterol is up a little and so is the LDL from 6 months ago. I am not a diabetic and have never had problem with that. I wanted him to run an NMR. My doctor called me and had absolutely no idea what the NMR Lipoprofile test was even after I gave him the CPT code. Then he went on to say “size doesn’t really matter and thats for HDL, not LDL. And if I went to any hospital they wouldn’t know what an NMR test was.” So, he is having me do a VAP profile test. He said, “elevated LDL is bad no matter what the size.” Mine isn’t horrible for a women without a risk factor, but it keeps going up. Any suggestions?

MIKE ASKS:
How do you have a conversation with your doctor about putting you on a statin drug with and HDL of 75 and triglycerides of 80 when your LDL is 225? I got these numbers in a blood test at my doctor’s office after consuming a low-carb diet.

KATHY ASKS:
How should patients deal with doctors who want to follow the guidelines put out by a group like the American Heart Association or American Diabetes Association if that association’s guidelines aren’t in keeping with our own opinions of current best evidence or even n=1 experiments we’ve done on ourselves? Sometimes doctors seem to think they have to follow those association-based guidelines to protect themselves against malpractice, do they have a point? How do we get around that if we believe those organizations aren’t up to date with their evidence or if we think the guidelines are politically motivated or otherwise flawed?

JOHN ASKS:
I’m a Type 1 diabetic and I believe I suffer from insulin resistance. I use 18.3 units for basal and my TDD on 10% carbs and 25% protein runs in the high 30’s. Whenever I fast, even for a single meal, I get a major liver dump at the next meal followed by some major cravings which seem to counter any benefits I might have seen from fasting. I’m stuck in my weight loss, and I think Metformin or a GLP-1 would help. Symlin is not an option where I live in Canada. My endocrinologist says my TDD insulin is already much lower than “normal” and refuses to consider giving me a prescription. He’s the local head of internal medicine and is known for not listening to colleagues. Any suggestions on how to proceed would be helpful.

SPARKY ASKS:
I would love to go to a doctor and find out what all my lipid numbers and thyroid numbers are. But I dread talking about my diet — I can’t defend it in terms of weight loss, because I weigh only about five pounds less than when I first started low-carbing 10 years ago. (Although a lot of women gain weight during their 40s, so maybe I’m better off than I think!)

There are no low-carb friendly doctors where I am (at least none listed on Jimmy’s List of Low-Carb Doctors blog).

I’m afraid of getting caught in the gears of the medical machinery. For example, what if my cholesterol is “high” and they want me to take statins?

Can you just go to your family practice doctor and say, “I want these tests, please have them done for me”? What exact tests should I ask for? I don’t want just a couple of numbers that don’t REALLY tell anyone anything, which seems to be what most people wind up with.

I suspect thyroid issues (20 extra pounds of fat won’t go away, cold hands and feet, dry skin). Also, one hand or the other occasionally gets a pins-and-needles feeling — I have no idea what that could mean.

I just turned 50 and am in excellent health overall. I have regular periods, no change in that regard. I haven’t had a checkup for nearly 8 years, since my last postpartum checkup. I’ve never had cholesterol tested or a glucose tolerance test. Blood pressure has always been around 90/70.

I’ve eaten mostly real, whole foods since I was a teenager (including 17 years of vegetarianism), and mostly low-carb/Paleo/Weston A. Price for the past several years. I keep the carbs to around 25-75g and rarely eat wheat or other grains.

PENNY ASKS:
While my mother’s doctor always congratulates her on her steady weight loss (and better blood sugar level control) he never fails to tell her that cutting back on her carbs is going to cause more problems in the long run. He points out that her cholesterol levels are elevated above normal, caused by eating too much saturated fat of course, and her refusing to take statins, which caused her muscle pain in the past, is leading her to a massive heart attack. She never knows how to respond to him so I thought perhaps giving him a book to read might be one solution. I was wondering if Dr. Vernon might suggest a book that she could give to her doctor that he might read? I know there are many books out there written for the average person who does not have a medical background. Is there a book that perhaps would carry more weight with an MD and not just be seen as a fad diet book? Because the doctor is probably not going to read that type of book.

BRIAN ASKS:
My low-carb doctor may lean even too far away from statins and other medications. When should I really think is the right time to take a pharmaceutical drug — in other words is there a risk of having too much of a low-carb friendly doc?

JOCELYN ASKS:
So, my friend went to see her doctor yesterday. Her HDL is 57, her LDL is 135. She got a heart scan a while back and got a value of 19. Her doctor prescribed a statin for her. My friend asked her Doctor to do a VAP test and the doctor said that she already knows that she is starting to have some heart disease starting, so she doesn’t need the VAP test. My friend has been starting to read Robb Wolf’s book and other Paleo people’s information, so, she’s getting wild ideas like saying no to statins. Her doctor is slightly insulted that my friend is ignoring her advice. “When you get heart disease will you go to your friends and the internet for help?” I told her to find another doctor, but she apparently wants to stay with this doctor. How would you approach this doctor? But, how would you educate a doctor who already seems to be on the defensive about learning new things about cholesterol and statins?

ROCHELLE ASKS:
I did attempt to speak with my doctor recently. I had recently gotten some blood work back and he said, for someone with such a high BMI (30) I didn’t deserve such good numbers.

Total Cholesterol 222, HDL=90, LDL=118, non-HDL=132, Triglycerides=68, Glu=84, HbA1C=5.1

I told him that I had started eating Paleo.

He did note that I still needed to lose some weight. I’ve lost about 30 lbs since starting Paleo. I asked him how he would suggest that I accomplish that.

He said he recently decided that he needed to get his BMI down. He did what he tells his patients to do. He restricted his calories and exercised more. It’s painful, but it works.

I asked him what he ate. He said a bagel in the morning. A yogurt for lunch and a regular dinner but no dessert. I asked him if he’d read “Good Calories, Bad Calories”. He said no, I don’t care about that. It doesn’t matter where the calories come from, you can eat 1200 calories of whale blubber and you’ll lose weight. I told him that I cut out the grains and sugar and it was *not* painful. He said, “Come back when you’re at your goal weight and we’ll redo all those numbers and we’ll talk.”

He is about ready to retire. Should I even bother trying to talk to him about other ways of eating and getting healthy? Or should I find a new doctor? I looked on both the Paleo physicians network and the low-carb doc site and there are a couple of oriental medicine practitioners and a chiropractor. They don’t seem to be on my insurance plan.

So…what’s a woman to do?

DAN ASKS:
I’m a type 2 diabetic who has been on low carb (Dr. Bernstein’s Plan) for about 6 years. Last year I found a low carb doc from Jimmy’s list. He favors South Beach phase 1. The only problem is that he believes in the lipid hypothesis. At my last visit, he told me that, as a diabetic, my LDL needs to be 70, even though my cholesterol would be “normal” for a non-diabetic. He said that controlling my blood sugar will not prolong my life. Only getting my LDL down to 70 will prolong my life. The strong implication is that I will die an early death unless I get my LDL down to 70. He is very pushy about statins, though I have resisted the pressure. I tried to tell him that the studies show no conclusive benefit to statins, but he won’t buy it. Do you have any suggestions on how to handle it in addition to being stubborn in refusing to take statins?

HAROLD ASKS:
I am a Type 2 diabetic. At the time of my diagnosis two years ago, my triglyceride/HDL ratio was 6 to 1. Now, after carefully watching my postprandial glucose levels (rarely, if ever over 110) my triglyceride/ HDL level is down to 1.6 to 1. My cardiologist couldn’t care less about my triglycerides and only focuses on my LDL (which were 120) and wants me on statins, I refuse them. Here’s my question, what can I use to convince her that controlling my diabetes and my trigs/HDL ratio are greater heart risk factors than LDLs.

Direct download: atlcx-5-dr-mary-vernon.mp3
Category:general -- posted at: 1:00am EDT