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Mastering Nutrition

Hi, I'm Chris Masterjohn and I have a PhD in Nutritional Sciences. I am an entrepreneur in all things fitness, health, and nutrition. In this show I combine my scientific expertise with my out-of-the-box thinking to translate complex science into new, practical ideas that you can use to help yourself on your journey to vibrant health. This show will allow you to master the science of nutrition and apply it to your own life like a pro.
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Now displaying: 2019
Dec 30, 2019

Question: Does mixing carbohydrate with fat cause people to get fat because of the Randle cycle?

 

There's a theory floating around on the internet that mixed diets are more fattening than low-carb or low-fat diets because of the metabolic competition between glucose and fatty acids. 

 

I don't believe this to be true because, in the context of isocaloric diets, mixed diets don’t seem to be more fattening than low-carb or low-fat diets.

 

Isocaloric diets are important for understanding physiological cause and effect, but they interfere with the real-life practical understanding of something. We want to use isocaloric science to study the academic question of, physiologically, are carbs and fat more fattening when combined than not combined. But, in real life, people eat more food on a mixed diet than they eat on a low-fat or low-carb diet.

 

I think someone who says mixed diets are more fattening because of the Randle Cycle is totally misunderstanding this. They are more fattening because of the hyperpalatability factors that Stephan Guyenet has explained. 

 

Also, they probably are more likely to cause metabolic harm because of what Alex Leaf has explained about the Randle Cycle in his post, “Why you may reconsider buttering your potato” at Superhumanradio. He was arguing that you don't want to put butter on your potato because you have substrate competition between glucose and fatty acids, which makes it more difficult to clear the glucose from your blood and causes a compensatory higher insulin response.

 

I'm not so insulin-centric that I believe that you necessarily always want to be minimizing your insulin response, and I definitely know that I have friends and colleagues who disagree with me on that, but I just don't view any disease, including type-2 diabetes, as a problem with hyperinsulinemia.

 

The short of it is that the more you mix carbs and fat in your diet, the more likely you are to overeat. You don't necessarily overeat, but it's way more probable because it's hyperpalatable. The more you mix carbs and fat, the more you don't specialize in one or the other. What's the most efficient thing to do?

 

If you eat a high-carb, low-fat diet your body specializes in burning carbs, you eat a high-fat, low-carb diet your body specializes in burning fat — and you're not going to do either of those as good if you're eating a mixed diet. Can you do them good enough? Often times, but if you have metabolic problems you might want to try a low-carb or a low-fat diet so you can specialize and be more efficient with your metabolism, because if you have metabolic problems whatever you're doing isn't working for you right now.



Dec 27, 2019

Question: What to do if gamma-tocopherol levels are low-normal while taking 100 IU/d of alpha-tocopherol.  

 

My initial impression is that there is nothing wrong because I don't care that much about gamma tocopherol. My doctoral research specialized in gamma tocopherol and there is some evidence that gamma tocopherol does some things that alpha tocopherol doesn't do. It’s likely that people who take high-dose alpha tocopherol supplements are suppressing their gamma tocopherol levels.

 

But you don’t have to be in the middle of the green for gamma tocopherol on the ION test. So if you are taking a 100 IU of alpha tocopherol at the time of test, then stop taking that and replace it with TocoSorb, or take a lower dose. I think a reasonable dose of vitamin E for the average person is 20 IU.



This Q&A can also be found as part of a much longer episode, here: https://chrismasterjohnphd.com/podcast/2019/02/24/ask-anything-nutrition-feb-17-2019/

 

If you would like to be part of the next live Ask Me Anything About Nutrition, sign up for the CMJ Masterpass, which includes access to these live Zoom sessions, premium features on all my content, and hundreds of dollars of exclusive discounts. You can sign up with a 10% lifetime discount here: https://chrismasterjohnphd.com/q&a



Dec 26, 2019

Question: What to do if taking biotin and yet beta-hydroxyisovalerate is elevated.

 

Well in theory that's a marker of biotin deficiency, but you might have a defect in a biotin-dependent enzyme so you can try 5 milligrams, but if you still have high beta hydroxy isovaleric you need to start looking at a metabolic disorder, providing there are symptoms. You might have a 20% decrease in that enzyme activity.

 

This Q&A can also be found as part of a much longer episode, here: https://chrismasterjohnphd.com/podcast/2019/02/24/ask-anything-nutrition-feb-17-2019/

 

If you would like to be part of the next live Ask Me Anything About Nutrition, sign up for the CMJ Masterpass, which includes access to these live Zoom sessions, premium features on all my content, and hundreds of dollars of exclusive discounts. You can sign up with a 10% lifetime discount here: https://chrismasterjohnphd.com/q&a



Dec 24, 2019

Question: For someone who is taking 45 mg of vitamin B6 as P5P but has xanthurenate, kynurenate, and quinolinate high in the urine as markers of vitamin B6 deficiency, and who is a man with high estrogen, what should they do?

 

If you have xanthurenate and kynurenate spilling into your urine, it means that quinolinate would be building up. Quinolinate is usually the last thing to rise in B6 deficiency. 

 

Quinolinate is an excitotoxin: it both can cause neurotoxicity like glutamate does and it can also make you hypersensitive to glutamate, effectively giving you a glutamate sensitivity.

 

You clarified that quinolinate is in the fourth quintile. So you're kind of in the zone quinolinate might be a problem, particularly if you have trouble sleeping, or if you have trouble with anxiety, or you have anything that would be related to glutamate sensitivity, like headaches

 

If you have any of those symptoms, they could be from quinolinate buildup. In that case, I recommend increasing B6. I would titrate it up to 100 mg. I'd be very cautious going higher than that. Don't take any pyridoxine hydrochloride ever.

 

Second course of action is look at iron and riboflavin levels. If there's any things wrong with those fix them, since they are needed to properly convert tryptophan alongside B6.

 

Third course of action is to reduce protein intake, if necessary, or search for low tryptophan proteins and focus on those to meet your protein needs. You need at least a few hundred milligrams of tryptophan in your diet to be okay.



This Q&A can also be found as part of a much longer episode, here: https://chrismasterjohnphd.com/podcast/2019/02/24/ask-anything-nutrition-feb-17-2019/

 

If you would like to be part of the next live Ask Me Anything About Nutrition, sign up for the CMJ Masterpass, which includes access to these live Zoom sessions, premium features on all my content, and hundreds of dollars of exclusive discounts. You can sign up with a 10% lifetime discount here: https://chrismasterjohnphd.com/q&a



Dec 23, 2019

Question: For someone who is homozygous for the H63D allele of the iron- and hemochromatosis-related HFE gene, if ferritin is low but transferrin saturation is high, should they still donate blood?

 

H63D is one of the genes that predisposes to hemochromatosis, a condition of iron overload. Most clinicians who work in this area do not consider the H63D allele to be a concern because it's less severe. With that said, most people who are progressive on the iron research front do believe it's a concern. There is literature showing that people can get clinical hemochromatosis from it and you don't have to get clinically hemochromatosis to be worried about iron overload. 

  

My opinion on this is going to be different than someone who is an expert clinician, but is not immersing themselves deeply in the physiological literature about how this works.

 

I don't have the skills that they have in triaging and filtering who’s ideal for what treatment and looking at large numbers of people that do one or another treatment and knowing intuitively what happens in those — but what I do have is I have immersed myself very deeply in the physiology. 

 

So the way that I look at this is as follows: iron saturation is an estimate of your transferrin saturation. It's a cheaper way to estimate it than to actually measure transferrin saturation, so it's much more common to get iron saturation.

 

But let's assume that we're talking about actual transferrin saturation or that iron saturation is a good metric of it. That's your short-term iron storage. Ferritin is your long-term iron storage. The defect in the H63D allele, same for the C282Y allele of the HFE gene, the two moderate and severe hemochromatosis alleles. Allele is a variant of the gene.

 

In normal physiology what happens is transferrin acts as a gauge of your iron status. The normal physiological levels are between 30 and 40 percent. Now being 41 percent doesn't mean you have a disease, we're not talking about diagnosis here, we're talking about understanding the physiology.

 

Mechanistically this is designed so that as you go from 30 to 40 percent and especially as you go over 40 percent that communicates the signal to a hormonal system that says you have more iron than you need. So you ramp down iron absorption and you ramp up ferritin. Why do you ramp up ferritin? Because you have more than you need in your short-term storage, so that's when you put it into your long-term storage. Also, because ferritin is a protective response that prevents you from having free iron.

 

Free iron is bad because it feeds pathogens and it makes infections worse. Free iron is bad because it causes oxidative stress and causes wear and damage on your tissues. And so to avoid free iron you ramp up ferritin while you take down your absorption from food at the same time.

 

And now is that a problem at all?  You could debate that, but if you're just talking, if you're not talking about diagnosis and you're talking about wellness, and you're talking about health management then… What I would want to do myself in that situation is I would first of all not let the ferritin go under 20, and if it's going near there I

would be getting a CBC to make sure I'm not making myself anemic.

  

And so I would not stop donating blood just because the ferritin is going down 60, 50, 40, I would consider it a gray area, it would be my preference to focus on the transferrin saturation and get it consistently under 40%. You get the pinprick to look at your serum iron levels, they're not going to let you donate blood if you're actually in the danger zone of anemia.

 

So I would get the CBC to be proactive about it.

 

This Q&A can also be found as part of a much longer episode, here: https://chrismasterjohnphd.com/podcast/2019/02/24/ask-anything-nutrition-feb-17-2019/

 

If you would like to be part of the next live Ask Me Anything About Nutrition, sign up for the CMJ Masterpass, which includes access to these live Zoom sessions, premium features on all my content, and hundreds of dollars of exclusive discounts. You can sign up with a 10% lifetime discount here: https://chrismasterjohnphd.com/q&a



Dec 20, 2019

Question: Thoughts on lowering my resting heart rate. It's often in the high 80s or low 90s once I'm up for the day.

 

I wish I knew the answer to that. I'd use it for my heart rate. I don't even measure my heart rate because my whole life it's been kind of high. I think breathing and meditation are probably the best things that you can do.

 

I've typically had a white coat syndrome response to getting my blood pressure taken, and because as soon as I feel the pressure, I start to get

anxiety and I'm like, “oh no it feels like it's high” and I get an adrenaline rush.

 

A couple of years ago I got rejected from giving blood three times in a year because either my blood pressure, or my pulse was too high when they measured it, both because of the adrenaline surge.

 

I was not able to donate blood until I started using Headspace, the meditation app, in particular the visualizations of the happiness portion.

 

The first time I was able to donate blood was when I went in to get my blood pressure and pulse taken and I imagined that bright light in the middle of my chest I just did the visualization and "boom" my heart rate and my pulse, just went straight into normal zone because I was able to create an association between that visualization and the state that the meditation produced. 

 

So that would be the first thing that I'd try. If I find out that I have a medical condition with a physiological solution I'll let you know, because I have the same thing.



This Q&A can also be found as part of a much longer episode, here: https://chrismasterjohnphd.com/podcast/2019/02/24/ask-anything-nutrition-feb-17-2019/

 

If you would like to be part of the next live Ask Me Anything About Nutrition, sign up for the CMJ Masterpass, which includes access to these live Zoom sessions, premium features on all my content, and hundreds of dollars of exclusive discounts. You can sign up with a 10% lifetime discount here: https://chrismasterjohnphd.com/q&a



Dec 19, 2019

Question:  How to manage the zinc-to-copper ratio and what to do if zinc and copper are both low-normal when supplementing with 15 mg of zinc and 1 mg of copper.

 

I don't recommend looking at the zinc-to-copper ratio. Although there are studies correlating health endpoints with the zinc-to-copper ratio, I do not believe that it is a causal factor in disease. 

 

I believe the zinc-to-copper ratio is often associated with disease because inflammation raises plasma copper and lowers plasma zinc, based on taking zinc up in the cells and mobilizing stored copper out of the liver. You want zinc and copper at the right levels; the ratios are less important. You want both around the middle of the reference range; the bottom of the range is not adequate.

 

If you are taking a supplement, then the simplest thing to do would be to take it twice per day instead of once per day and to make sure you are taking it on an empty stomach. Up to 50 mg of zinc will not cause nausea on an empty stomach in most people if you take it with a full glass of water.

 

Some people do have digestive issues when supplementing on an empty stomach, and if you need to take it with food, do not supplement anywhere near phytate, which is the principal inhibitor of zinc absorption and is found in whole grains, nuts, seeds, and legumes.

 

I recommend Jarrow’s zinc balance, which has the exact ratio that you’re talking about. It’s a convenient way to have the copper in the zinc supplement already. But if you are low in copper, this isn’t an adequate source for two reasons: (1) the amount of copper is too low, and (2) the form of copper isn’t ideal (it has lower bioavailability because it’s not the oxidation state that you get in food).

 

For a copper supplement, I would want to use food first, and liver capsules if you want a supplement. For foods, check out the tiers of copper-rich foods that I recommend, which includes liver, cocoa powder, and certain mushrooms.



Dec 18, 2019

Question: What nutrients are needed to break down old, damaged bone and build new, healthy bone?

 

So you are breaking down bone all the time throughout every second of your life. 

 

We are always breaking down bone, we are always building up new bone, and if you had any kind of defect in the ability to break down old bone, then you would have problems manifesting elsewhere. 

 

Bone breakdown is necessary to maintain your serum calcium levels. You would probably be having severe hypocalcemic attacks if you were not breaking down your old bone — and you probably also would have exercise intolerance and/or poor exercise performance as a result of the undercarboxylated osteocalcin released from bone, which acts as a hormone to improve energy utilization during exercise. 

 

In fact the overwhelming problem in the general population is that people are breaking down too much bone and not building it back up enough. 

 

So if you just look at the course of someone's life over time when we are young we are building more bone than we're breaking down and that, somewhere around 25 years old depending on male and female — we reach peak bone mass and then we spend the entire rest of our lives declining in bone mass.

 

To some degree when you're building bone you need everything. So eating a nutrient-dense diet across the board is important, but things that are extremely important that kind of stand out from building other tissues when you're building bone is collagen.

 

Half your bone is protein — about 95 percent of the protein in your bone is collagen. The limiting factor for collagen synthesis is glycine. Collagen peptides provide glycine and they also are better at stimulating collagen synthesis than just powdered glycine. So collagen peptides, bone broth, edible bones from canned fish or from the ends of small chicken bones, would all probably be helpful. Then clearly calcium and phosphorus are the overwhelming minerals in bones.

 

So you need enough calcium and enough phosphorus — between the two of those in the population most people do not get enough calcium and get too much phosphorus. People get phosphorus from processed foods and from soda, and in addition to the natural phosphorus in meat and other foods. If you are not eating junk food you probably don't get too much phosphorus, but you still probably get enough.

 

If you're not eating junk food, and you're not eating dairy, and you're not eating bones, you probably do not get enough calcium and in particular many people in the natural health community have read a lot of anti-calcium supplementation stuff.

 

I want to emphasize over and over again that it's better to get calcium from food than to get calcium from supplements, but it's better to get calcium from supplements and then not get calcium. 



Dec 17, 2019

Question: What are my thoughts on detoxing heavy metals?

 

My thoughts are first you need to look at how bad the heavy metal is and if it is even at a level that a conventional practitioner would say you have toxicity; for example lead. 

 

If this is your situation then I don’t feel comfortable advising anyone here, but if your levels are slightly high and you would like to reduce them, then my suggestion would be zinc supplementation on the basis that most heavy metals produce a metallothionein increase. 

 

Metallothionein is your endogenous chelatior. 

 

The ability of the heavy metal to provoke that protective response is completely dependent on zinc concentrations inside your cell even across the range of deficiency through normal status through more zinc than you need, and there's no evidence for a threshold or cutoff.

 

So I think if your zinc status is fine and you boost your zinc status a little, without causing any zinc toxicity, or copper deficiency -- I think that's a very gentle and safe way to reduce your load of heavy metals.

 

Unless what you're seeing is arsenic, in which case methylation would be my focus because methylation plays a specific role in addressing arsenic. For anyone who hasn't seen that I have a comprehensive methylation resource at chrismasterjohnphd.com/methylation.

 

This Q&A can also be found as part of a much longer episode, here: https://chrismasterjohnphd.com/podcast/2019/02/24/ask-anything-nutrition-feb-17-2019/

 

If you would like to be part of the next live Ask Me Anything About Nutrition, sign up for the CMJ Masterpass, which includes access to these live Zoom sessions, premium features on all my content, and hundreds of dollars of exclusive discounts. You can sign up with a 10% lifetime discount here: https://chrismasterjohnphd.com/q&a



Dec 16, 2019

Question: What to do about elevated morning blood glucose in the mid 90s.

 

I think usually your morning glucose is primarily impacted by your hormones and very rarely impacted by what you ate the night before, unless you are severely glucose intolerant.

 

So the overwhelming probability is that if your blood glucose is elevated in the morning and mid-90s is not tremendously high; it is most likely cortisol. 

 

If there are other signs of slipping into pre-diabetes then I might come up with another explanation, but I don't think waking up in the morning and often having mid-90s glucose — with everything else being fine, is likely to be a sign other than cortisol levels. 

 

It's not necessarily a bad thing because you're supposed to have a cortisol spike in the morning. You may want to look at your cortisol levels over time. The DUTCH test can do that. It happens to look at a lot of other things that I think are useful so that might be my first go-to. 

 

First you want to know if that's actually the issue. 

 

If cortisol is out of range then you probably want to look at stress reduction as a first step, and there's some evidence for using phosphatidylserine to lower cortisol. 



If you would like to be part of the next live Ask Me Anything About Nutrition, sign up for the CMJ Masterpass, which includes access to these live Zoom sessions, premium features on all my content, and hundreds of dollars of exclusive discounts. You can sign up with a 10% lifetime discount here: https://chrismasterjohnphd.com/q&a



Dec 13, 2019

Question: neither my mother nor myself respond to T3 supplementation (cytomel; up to 140 mcg/d). Body temp remains low and reverse T3 stays normal. Could you discuss the factors that might interfere with thermogenesis in response to T3, and offer considerations how to improve this?

 

Having normal levels of reverse T3 tells you that the body isn’t deliberately getting rid of the thyroid hormone. High reverse T3 would be a sign that your body just doesn't want the thyroid hormone around.

 

That doesn't seem to be happening and so that makes me wonder if there could be a problem with taking up the thyroid into the cells. In which case I would expect thyroid hormone levels to be higher in the blood then you would otherwise expect them to be.

 

Or if there's a problem with the thyroid actually carrying out its functions inside the cell to regulate gene expression. This could be a zinc deficiency issue, since zinc is necessary to allow the thyroid receptor to bind to the DNA. In fact, zinc is necessary for everything that has a nuclear receptor that alters gene expression by binding to a nuclear receptor. This includes receptors for vitamin A and vitamin D, receptors for the sex hormones, and for thyroid hormones; all require zinc to act.

 

But, you seem to be saying that your issue is a specific thermogenic response, which makes me ask, are you seeing every other thing that you would expect from thyroid  hormone and not thermogenesis? 

 

If that's the case, I have no idea. But, if you're not seeing any of the effects from thyroid hormone that you would expect, then I would say maybe some kind of resistance to getting into the cell if blood levels are elevated. If blood levels are normal, then maybe it’s not acting on the nuclear receptor, which I'd think zinc deficiency. 

 

I don't know what else you could do with the exception of measuring the free fatty acids, which would be high if you had a zinc deficiency. They might not be if you're taking insulin and you're eating moderate to high carb. Get free fatty acids measured, which would often be called NEFA, for non-esterified fatty acids.

 

You know you can't have everything. I would rather your pancreas just start making all the insulin it needs, but options are limited, right? so I don't know if you can fix the temperature issue. If you can with fixing it at the root problem great, but if you can't then absolutely I would I would manage your temperature with clothing. 

 

This Q&A can also be found as part of a much longer episode, here:https://chrismasterjohnphd.com/podcast/2019/02/09/ask-anything-nutrition-feb-1-2019/ 

 

If you would like to be part of the next live Ask Me Anything About Nutrition, sign up for the CMJ Masterpass, which includes access to these live Zoom sessions, premium features on all my content, and hundreds of dollars of exclusive discounts. You can sign up with a 10% lifetime discount here: https://chrismasterjohnphd.com/q&a



Dec 12, 2019

Question: "What are your top three non-nutrient factors that prevent someone from entering beta-oxidation or ketogenesis? I mean like sleep disruption."

 

Top three non-nutrient factors? Unless you are taking a drug that prevents lipolysis, then they aren't non-nutrient. 

 

The overwhelming things that govern those are carbohydrate and fat intake. You eat more fat, you have more beta-oxidation. You eat less fat, you have less beta-oxidation. You eat less carbohydrate beyond a threshold.

 

==I don't think sleep disruption is going to do that. Sleep disruption is going to increase your stress hormones — so with sleep disruption, your cortisol is going to spike, and it's going to increase your appetite for junk food —  so you're probably more likely to eat things that are anti-ketogenic when you're sleep-deprived because you're eating more junk food, which has more carbs. You probably are not going to have lower beta-oxidation. You're probably going to have higher oxidation because you're going to eat more fat.

 

But most people do not have impairments in beta-oxidation. 

 

If you have a riboflavin deficiency, you can have an impairment in beta-oxidation, but even in disease states, beta-oxidation is higher. If you have a fatty liver, beta-oxidation is increased because your liver is trying to get rid of fat.

 

The overwhelming thing governing beta-oxidation is the relative balance of fat going into your tissues versus out. To the extent carbs displace the fat from being burned, carbohydrate is going to decrease beta-oxidation —  but if you're eating carbohydrate, and you're eating more fat, versus less fat, you're going to have more beta-oxidation when you eat more fat. 

So, yes, sleep disruption will disrupt the appropriate way of handling those things, but I don't think it's going to block ketogenesis or beta-oxidation, except by messing up your appetite.

 

This Q&A can also be found as part of a much longer episode, here:https://chrismasterjohnphd.com/podcast/2019/02/09/ask-anything-nutrition-feb-1-2019/ 

 

If you would like to be part of the next live Ask Me Anything About Nutrition, sign up for the CMJ Masterpass, which includes access to these live Zoom sessions, premium features on all my content, and hundreds of dollars of exclusive discounts. You can sign up with a 10% lifetime discount here: https://chrismasterjohnphd.com/q&a



Dec 11, 2019

Question: "Any recommendations for peripheral neuropathy? Testing vitamin B, lion's mane?"

 

First of all, there is no such thing as vitamin B. I'm not trying to be a nitpick, but there's literally almost a dozen B vitamins, with different tests, that do different things. So, I think it's important to establish a habit of never saying vitamin B because, not to be a grammar nitpick, but I just think it's misleading to think about the concept of vitamin B. 

 

There are quite a few B vitamin deficiencies that can cause peripheral neuropathy. 

 

You can also cause peripheral neuropathy by taking vitamin B6 in too high doses, and that's one of the reasons why you have to separate them out because B6 is unique among the other B vitamins in that respect. 

 

In Testing Nutritional Status: The Ultimate Cheat Sheet; I have an index of signs, and if we go into peripheral neuropathy, I have listed here deficiencies of thiamin, riboflavin, and vitamin E — toxicity of selenium and B6. 

 

This Q&A can also be found as part of a much longer episode, here:https://chrismasterjohnphd.com/podcast/2019/02/09/ask-anything-nutrition-feb-1-2019/ 

 

If you would like to be part of the next live Ask Me Anything About Nutrition, sign up for the CMJ Masterpass, which includes access to these live Zoom sessions, premium features on all my content, and hundreds of dollars of exclusive discounts. You can sign up with a 10% lifetime discount here: https://chrismasterjohnphd.com/q&a



Dec 10, 2019

Question: "If cholesterol, LDL-P, and oxidized LDL are high, the sterol panel is normal, and TGs are great, would you suspect clearance of the particles driven by LDL receptor in the liver is the issue, and what would you recommend to boost LDL-R?"

 

Yes, it sounds like you should target LDL-R. 

 

The big regulators of LDL-R function are thyroid hormone, and the amount of cholesterol in the liver cell, and anything that brings bile acids into the feces, and that's generally a high-fiber diet; psyllium husk would be a fiber you could add.

 

Thyroid hormone is the other piece of that, and that you target with higher carbohydrate intake. Higher carbohydrate intake also acts on PCSK9 to boost LDL receptor activity. 

 

This Q&A can also be found as part of a much longer episode, here:https://chrismasterjohnphd.com/podcast/2019/02/09/ask-anything-nutrition-feb-1-2019/ 

 

If you would like to be part of the next live Ask Me Anything About Nutrition, sign up for the CMJ Masterpass, which includes access to these live Zoom sessions, premium features on all my content, and hundreds of dollars of exclusive discounts. You can sign up with a 10% lifetime discount here: https://chrismasterjohnphd.com/q&a



Dec 9, 2019

Question: "What are your recommendations on magnesium supplements and dosage?”

 

My opinion is that most people shouldn't be supplementing with high doses of magnesium. I think if you're going to supplement with more than 400 milligrams a day, you should be testing your magnesium status, and you should be making decisions on that. I think there's way too many people throwing really high doses of magnesium into their system. 

 

The topical stuff makes sense if you're absorbing poorly, but hey, maybe you're absorbing poorly because you don't need it, and so I think you really have to judge it against real metrics of results.

 

So, in terms of types, I would not recommend magnesium oxide for anything. It's poorly absorbed, so maybe you could argue that magnesium oxide is going to help act as a laxative better, but that's not bowel function, that's pharmacologically modulating your bowel transit time. So, I don't think it makes sense to deliberately take a poorly absorbed magnesium to have that effect.

 

The good sources of magnesium are: magnesium citrate is okay, glycinate is okay, malate is okay, across the board, I genuinely don't believe that the form is that important. It's just that oxides of minerals including magnesium are generally poorly absorbed. There isn’t much difference in the other forms. As always tailor it to the individual. I wouldn't give blanket recommendations there.



This Q&A can also be found as part of a much longer episode, here:https://chrismasterjohnphd.com/podcast/2019/02/09/ask-anything-nutrition-feb-1-2019/ 

 

If you would like to be part of the next live Ask Me Anything About Nutrition, sign up for the CMJ Masterpass, which includes access to these live Zoom sessions, premium features on all my content, and hundreds of dollars of exclusive discounts. You can sign up with a 10% lifetime discount here: https://chrismasterjohnphd.com/q&a



Dec 6, 2019

Question: "Calcium score, is there a way to treat one's calcium score and get it to zero?"

 

⇒ No, you don't treat the calcium score. You take the calcium score as indicative of what's going on in atherosclerosis, and you treat that.

 

The goal, I think, is calcium score equals zero. No, that's a bad goal because that's like saying my goal this year is to be a billionaire. Is that going to make me harder and get closer to it? I don't know. You set somewhere what the ideal is, but then you don't think about that, you think about — okay — what's the next step right now in front of me. What you focus on is the thing that's right in front of you. So, maybe you want to be a billionaire -- but your goal is, how do I increase my revenue this month? Not how do I be a billionaire this year.

 

If you want a calcium score of zero, fine, but you don't think about that; you think about how do I lower my calcium score, because then when you lower your calcium score, you do more of that. When you do something that raises your calcium score, you do less of that.

 

In atherosclerosis, calcium is super driven by the atherosclerotic progress. So, ideally it would be nice if you had ultrasound imaging of your carotid IMT. If you have advanced plaque formation, you probably will be able to see that on the IMT, like you can see how the plaque is developing and whether the actual atherosclerotic plaque is.

 

K2 is relevant there, but a general deficiency of K2 is more likely to manifest as diffuse calcium deposits everywhere in the artery. So, it might be that your LDL is high, and then that's what you should be focusing on. 

 

You really have to start from point A through B through C, and K2 is one of those things, but you need to look at all the factors that can be contributing to atherosclerosis.

This Q&A can also be found as part of a much longer episode, here:https://chrismasterjohnphd.com/podcast/2019/02/09/ask-anything-nutrition-feb-1-2019/ 

 

If you would like to be part of the next live Ask Me Anything About Nutrition, sign up for the CMJ Masterpass, which includes access to these live Zoom sessions, premium features on all my content, and hundreds of dollars of exclusive discounts. You can sign up with a 10% lifetime discount here: https://chrismasterjohnphd.com/q&a



Dec 5, 2019

Question: "What do you think of alternative testing like hair mineral analysis or SpectraCell?"

 

I'm against SpectraCell on the basis of, it's not validated. I gave more details in a podcast episode "What Makes a Good Marker of Nutritional Status?" and you can find that at chrismasterjohnphd.com/marker.

 

Hair mineral analysis; I like hair mineral analysis when there is nothing better and more validated. For a lot of the trace minerals where we don't have good, validated markers of nutritional status, so I think hair mineral analysis is good. I also think hair mineral analysis is good if you don't have the money to do something comprehensive with all the best markers, and you want something that can clue you in when something might be off. So, the nice thing about it is, with less money, you cover all the minerals. The less nice thing about it is, it's not very well validated quantitatively. 

 

Even where there's data, like for example — it is validated that your iron in your hair tends to be higher when your iron in your body is higher, and vice versa. But it's not validated to say, when hair is X amount, this is when you need more iron, and when hair is Y amount, this is when you need less. The way that the blood markers are — like transferrin saturation, ferritin, hemoglobin, all these more validated markers. We have tons of quantitative data saying — the normal range is this — the optimal range is this.

 

You lose the precision when you go back to the hair mineral analysis. I wouldn't use it — the thing is, if you spend $200 on a hair mineral analysis, that's $200 that you can't put towards your Genova ION Panel, or you could have gotten four iron panels with that, right? 

So, you have to be careful that if your financial resources are constrained, you might want to do the hair mineral analysis on that basis, but it might be a better financial decision long-term to hold onto that money and do free stuff.

 

In Testing Nutrition Status: The Ultimate Cheat Sheet, what I say is, if you don't have the money for the comprehensive testing, you focus on the things that are free. 

 

You do the dietary and lifestyle analysis. 

 

You do the symptom analysis. 

 

Then you go to the things that that indicates is most probable, and then you do the best validated test. Maybe this diet and symptom analysis all points you to iron, and you spend $60 on the iron panel, and that gives you more payoff than $200 on a hair mineral analysis. 

 

So, it's not an obvious choice about when to get the suboptimal test. It's something you have to think about carefully.

 

This Q&A can also be found as part of a much longer episode, here:https://chrismasterjohnphd.com/podcast/2019/02/09/ask-anything-nutrition-feb-1-2019/ 

 

If you would like to be part of the next live Ask Me Anything About Nutrition, sign up for the CMJ Masterpass, which includes access to these live Zoom sessions, premium features on all my content, and hundreds of dollars of exclusive discounts. You can sign up with a 10% lifetime discount here: https://chrismasterjohnphd.com/q&a



Dec 4, 2019

Question: How do I address edema? 

 

Edema is basically going to be caused by excess salt retention in the body. The reason is that with the exception of very extreme scenarios, your body is going to tightly regulate the sodium concentration of the water in your body, and sodium draws water. 

 

Now, that's not to say that the cause is eating salt. And there are cases where eating salt might remove edema. But generally salt retention of total water volume is going to be a big factor. In hypothyroidism it becomes I believe at least partly about glycoproteins in those spaces that are holding onto water. 

 

If it's thyroid-related, you're not really talking about nutritional support, you're talking about fixing your thyroid. Maybe that means nutritional support, but it might mean other things. But the nutrition is aimed at the thyroid, not the edema.

 

Maybe manganese would help modulate those glycoproteins in hypothyroidism the same way that it does in regulating the stickiness of the arterial wall. I'm totally guessing on that.

 

Edema in the menstrual cycle is caused by high aldosterone, which is probably caused by high progesterone. I know that everyone in alternative health thinks that progesterone is the good hormone, and estrogen is the bad hormone — but in PMS water retention, I believe progesterone is just accumulating so much that it's spilling into aldosterone. I genuinely don't know what to do about the high progesterone, but about the high aldosterone. Magnesium and B6 have been shown to help with that. I did an episode about that, so I would Google "Masterjohn what to do about menstrual weight gain" for more details on thata. Then I would play around with salt and potassium. So, generally less salt during that time and more potassium in the diet are potentially going to be helpful.

 

I think the principles are going to be similar elsewhere. It doesn't have to be in the menstrual cycle. You are generally going to find that salt is increasing extracellular water, and potassium is increasing intracellular water, and that's often going to be a factor in edema that can't be tied to thyroid hormone.

 

This Q&A can also be found as part of a much longer episode, here:https://chrismasterjohnphd.com/podcast/2019/02/09/ask-anything-nutrition-feb-1-2019/ 

 

If you would like to be part of the next live Ask Me Anything About Nutrition, sign up for the CMJ Masterpass, which includes access to these live Zoom sessions, premium features on all my content, and hundreds of dollars of exclusive discounts. You can sign up with a 10% lifetime discount here: https://chrismasterjohnphd.com/q&a



Dec 3, 2019

Question: "How do you determine if you're getting enough protein? I heard Dr. Stephen Phinney say, for those on a keto diet, if ketones are greater than 3 on a regular basis, then it's a sign you're not getting enough protein."

 

First of all, why are you on a ketogenic diet? 

 

If your purpose is to get the ketones, why wouldn't you want your ketones higher than 3? The ketogenic diet is, regardless of what people are doing it for, it's best tested in terms of epilepsy, and the classical ketogenic diet gets ketone levels up to 3 or 4 millimoles per liter… sometimes higher.

 

Then the question is, you're not doing it for medical therapy, why are you doing it? 

 

If you're doing it to lose weight, who cares what your ketones are? 

 

There's a ton of people out there who are on a "ketogenic diet" who don't care what their ketones are because they're doing it for weight loss, for body composition, or to feel better. If those are what your goals are, your metrics should just be whether you're losing weight, whether you're getting better body composition, or whether you're feeling better. There's no data backing up the fact that you can measure your blood ketones and determine what any of those outcomes are going to be.

 

That has nothing to do with why you need protein. Yes, too much protein is probably going to lower your ketones. Protein is anti-ketogenic. It's not as anti-ketogenic as carbs are, so I get the kernel of truth that Phinney is getting at. The higher your protein is, the lower your ketones are going to be, and maybe there's some general correlation to be seen across people that the people who tend to have ketones that high tend to not be eating enough protein, but that's a correlation that has nothing to do with the underlying reason of why you eat protein. 

 

You eat protein because you need protein to optimize your neurotransmitters, you need protein to optimize your metabolism, and you need protein to optimize your body composition. The number one metric that we have on protein intakes and quantifying them is on body composition, and you want a half a gram, to a gram of protein for every pound of target body weight. So, if you're trying to gain muscle, use what you want to have at the end of gaining muscle. If you are overweight, use what your ideal weight would be. And the more you care about your body composition, the more you should aim for the top of that range instead of the bottom. It doesn't matter if you're keto or not.

 

This Q&A can also be found as part of a much longer episode, here:https://chrismasterjohnphd.com/podcast/2019/02/09/ask-anything-nutrition-feb-1-2019/ 

 

If you would like to be part of the next live Ask Me Anything About Nutrition, sign up for the CMJ Masterpass, which includes access to these live Zoom sessions, premium features on all my content, and hundreds of dollars of exclusive discounts. You can sign up with a 10% lifetime discount here: https://chrismasterjohnphd.com/q&a



Dec 2, 2019

Question: What supplements would you recommend for a ketogenic diet? Any concerns with carbs being that low? 

 

If someone's on a keto diet and they have 80 grams total carbs, the first question I have is where are the carbs coming from? 

 

That's really going to determine whether the person needs supplements. So, on a keto diet in general and protein, too? If you're eating a lot of fat instead of protein, then you're going to need supplements of the things found in protein foods. If your carbs are all coming from honey, then you're going to need things that are found in vegetables.

 

==>You just can't tailor nutrient needs based on carb total data alone. 

 

The biggest things would be make sure you're getting a gram of protein per pound of body weight if your ketones and goals can handle that load of protein. That'll protect you from a lot of nutrient deficiencies right there. Try to cook your proteins in ways that recapture the juices. That will help conserve the electrolytes. 

 

You also probably want salt and either a lot of low-net carb vegetables, or you're probably going to need more potassium in your diet. Those are the big things that I'd look at.

 

This Q&A can also be found as part of a much longer episode, here:https://chrismasterjohnphd.com/podcast/2019/02/09/ask-anything-nutrition-feb-1-2019/ 

 

If you would like to be part of the next live Ask Me Anything About Nutrition, sign up for the CMJ Masterpass, which includes access to these live Zoom sessions, premium features on all my content, and hundreds of dollars of exclusive discounts. You can sign up with a 10% lifetime discount here: https://chrismasterjohnphd.com/q&a



Nov 29, 2019

Question: "Why would a male be low in calcium?"

 

You either have something wrong with parathyroid hormone governing your calcium levels, in which case you would want to see a doctor about that, or you have a long-going deficiency of related nutrients. 

 

Not enough calcium and not enough vitamin D should not cause low serum calcium unless the deficiency has been going on for a very long time and is very bad.

 

Then again, I don't know what measurement you're referring to. So, maybe the calcium was a tiny bit low, and you remeasure it, and it's not low anymore; it was a fluke. 

 

But if you're talking about confirmed low serum calcium, then nutritionally, I would look at long-standing severe deficiencies of calcium and vitamin D. I'd follow it up with measurements of PTH and calcitriol to better assess the situation.

 

This Q&A can also be found as part of a much longer episode, here:https://chrismasterjohnphd.com/podcast/2019/02/09/ask-anything-nutrition-feb-1-2019/ 

 

If you would like to be part of the next live Ask Me Anything About Nutrition, sign up for the CMJ Masterpass, which includes access to these live Zoom sessions, premium features on all my content, and hundreds of dollars of exclusive discounts. You can sign up with a 10% lifetime discount here: https://chrismasterjohnphd.com/q&a






Nov 28, 2019

Question: "I keep waking up in the middle of the night and stay awake for hours. Would low carb make it worse?"

 

It definitely could. 

 

Your brain will consume 120 grams of carbohydrate every day, just your brain. There's got to be another 30 grams or so that would be used no matter what obligately by red blood cells, certain cells in the testes, the kidney, and the lens of the eye. Then the rest of your body if you're eating not a ketogenic diet, the rest of your body is not really trying to burn fat, so it's going to burn through carbohydrate.

 

Your liver stores about 90 grams of carbohydrate to be able to stabilize your blood sugar between meals, and overnight is the biggest time where it has to do that because overnight is the longest period of time that you go without meals.

 

If you add that up, you're looking at like 250 grams of carbohydrate a day — and remember we haven't gotten to high-intensity exercise yet.

 

Now, if you go on a ketogenic diet, what happens? 

 

Well, your brain glucose consumption goes down from 120 grams a day to like 30 or 35 grams a day. You cannot and will not ever, ever, ever, ever, ever go to zero. That's one thing. You still have another 20, 30 grams of carbohydrate that you're burning through by cells that cannot burn anything else. You still have a minimum probably 60 or 70 grams of carbs per day that you need even when you're maximally keto-adapted. I'm not saying you need to eat those carbs. You'll make them through gluconeogenesis if you don't eat them.

 

But the rest of the body where the needs were flexible, has mostly shifted to burning fat for fuel on a long-term ketogenic diet. So, the real big problem is if you're not low-carb enough to be keto, but you're way under 200, 250 grams of carbs a day. Like, probably 100 grams of carbs a day is like, if it works for you, great, but if you have symptoms of low blood sugar at night, you shouldn't be spending a lot of time guessing why, because you're in this gray area where you are not keto-adapted, your brain is still burning through 120 grams a day, your liver still stores 90 grams a day, and the rest of your body still probably is preferentially burning carbs for energy instead of storing them for the most part because the carbs are there. So, your body is not deliberately, intensively reorganizing to conserve the carbohydrate in that gray area.

 

==If you are eating 50 or 100 grams of carbs, and you are in this place, then you absolutely should connect the two and see if increasing your carbs helps.

 

Low-carb is not the best solution to high fasting glucose. There's a lot of people on low-carb who have high fasting glucose. There's a ton of people who go low-carb and develop high fasting glucose. That’s because a low carb diet alters the hormonal environment in two main ways:

 

1.) Increases the morning glucagon response. 

 

2.) Increases adrenal hormones. 

 

Both of these are early and late-stage adaptations to low glucose supply. 

 

This Q&A can also be found as part of a much longer episode, here:https://chrismasterjohnphd.com/podcast/2019/02/09/ask-anything-nutrition-feb-1-2019/ 

 

If you would like to be part of the next live Ask Me Anything About Nutrition, sign up for the CMJ Masterpass, which includes access to these live Zoom sessions, premium features on all my content, and hundreds of dollars of exclusive discounts. You can sign up with a 10% lifetime discount here: https://chrismasterjohnphd.com/q&a



Nov 27, 2019

Question: "Which brand and dosage of no-carb electrolytes would you take at night to optimize sleep, especially after sauna use?"

 

I would drink a bottle of Gerolsteiner, and I would add to it 100 milligrams of any kind of magnesium: citrate, glycinate, malate, those three are fine. And I would add to it 400 milligrams of potassium citrate, or bicarbonate if it's an empty stomach.

 

You say no-carb. Because of the potassium, I personally would take maybe like a teaspoon of honey with this. I would also take some salt. Let's say a half a teaspoon, to a teaspoon of salt with it. The caveat being if you’re sodium sensitive you should be mindful not to overdo it. If you know you don't have a problem with salt and blood pressure, then I would recommend adding the sodium to the mix. 

 

This Q&A can also be found as part of a much longer episode, here:https://chrismasterjohnphd.com/podcast/2019/02/09/ask-anything-nutrition-feb-1-2019/ 

 

If you would like to be part of the next live Ask Me Anything About Nutrition, sign up for the CMJ Masterpass, which includes access to these live Zoom sessions, premium features on all my content, and hundreds of dollars of exclusive discounts. You can sign up with a 10% lifetime discount here: https://chrismasterjohnphd.com/q&a



Nov 26, 2019

Question: "Vitamin K2, MK-4 and MK-7, might have caused prolonged heart palpitations. Upon stopping it, symptoms mostly resolved after a week or so. Does that mean that the body is better off without it? Might increasing calcium intake mitigate this?" 

 

I would say, the calcium is really interesting. I genuinely hadn't thought of that until you mentioned it. Even though I've heard other people ask this question, I haven't had time to look into it, but you raise a good point.

 

So, it is conceivable, for example, that your bone density has been very low because you have not had the K2 you needed to get the minerals into the bone. So when you get the K2, you start loading the calcium into the bone, but maybe because your whole body is programmed to assume things were the way they were before you started taking the K2, then it doesn't adapt fast enough to normalize your blood calcium, which, by the way, how do you normalize your blood calcium? You take calcium out of the bone.

 

MK-4 has been studied in high-milligram doses as an osteoporosis drug because it inhibits bone resorption. If you inhibit bone resorption, you will definitely interfere with your ability to maintain normal serum calcium levels because bone resorption is how you do that.

 

So, either you're giving the nutrients needed to get the calcium into the bone and the body is just prioritizing that because it's been missing them for so long, and your serum calcium drops — or you're actually creating signaling stopping bone resorption, and so your blood calcium drops because of that.

 

Either way; taking calcium might impact that, and I would love to have some anecdotal data on that because there's no studies on K2and heart palpitations. So, I would love it if we have some anecdotes of people saying whether the calcium helps, especially since so much of the K2 stuff is so skeptical of calcium. 

 

Kate Rheaume-Bleue's book Vitamin K2 and the Calcium Paradox, I think it's a great book. Basically, what that book is, is an enormous elaboration of my 2007 article on Activator X and Weston Price. 

 

If I had written that book, I would have done things a little bit differently. The whole idea of the calcium paradox that's in the title, I think it has merit. There is some data indicating that calcium supplements might worsen the risk of heart disease, but I think that the conclusions are way too anti-calcium, and I think there's too many people out there taking K2 who have it in their heads that calcium supplements are bad. 

 

Calcium supplements are bad compared to getting enough calcium from food. A huge portion of those people are not getting enough calcium from food, and getting calcium is more important than where it comes from.

 

This Q&A can also be found as part of a much longer episode, here:https://chrismasterjohnphd.com/podcast/2019/02/09/ask-anything-nutrition-feb-1-2019/ 

 

If you would like to be part of the next live Ask Me Anything About Nutrition, sign up for the CMJ Masterpass, which includes access to these live Zoom sessions, premium features on all my content, and hundreds of dollars of exclusive discounts. You can sign up with a 10% lifetime discount here: https://chrismasterjohnphd.com/q&a



Nov 25, 2019

Question, part 1: "Bovine colostrum from New Zealand cows. Yea or nay for those with dairy sensitivities? If nay, what would you recommend instead?"

 

What is your goal? If you have a dairy sensitivity, your problem could be with casein, with the whey proteins, or with something more specific like certain antibodies. It's very complicated. You're less likely to tolerate colostrum if you have a known dairy sensitivity, but you can't really know without testing the colostrum.

 

Question, part 2: "to settle a client's overactive immune system down."

 

What, specifically, about the overactive immune system are we looking at? I would think maybe this is chronic inflammation that's not resolving, and then I'm thinking more about arachidonic acid and DHA.

 

Question, part 3: "She can take a supplement one time and then the next time it throws her over. Same with food."

 

Okay, that sounds to me like an oral tolerance issue. When you put something in your mouth, it goes to your gut, and then your immune system decides whether it's safe or whether it's not safe. Your immune system doesn't know anything when you're born; it is more or less a blank slate. You do have predispositions because you have genetics that impact categories of protein fragments that you have the potential to make a decision about, but you are never born having a tolerance or intolerance to something. You are born with very broad genetics that say, “I will make decisions about this category, I can't recognize this category, I will make decisions about this category.”

 

So, you eat food or take supplements, you put something in your mouth, you swallow it. In your gut, your immune system says, “This might be something important, I'm going to take it back to my home base and decide what to do about it.” That home base is called the gut-associated lymphoid tissue, or GALT. Your immune system is deliberately taking things into that lymph tissue, purposefully taking fragments that are not completely digested for the purpose of making decisions about it.

 

In the gut, how does it make that decision? Overwhelmingly, there are two pro-tolerance factors. They are prostaglandin E2, which is made from arachidonic acid, the omega-6 fatty acid that's found most abundantly in egg yolks and liver, and that is the direct target of anti-inflammatory drugs, acetaminophen (Tylenol), aspirin, high doses of EPA from fish oil, and probably a lot of herbal anti-inflammatories. They will lower prostaglandin E2, and prostaglandin E2 is critical for oral tolerance in the gut.

 

So, any potential anti-inflammatory is a potential contributor to this. You need prostaglandin E2, made from COX-2 from arachidonic acid, made from everything that everyone believes is inflammatory. All the anti-inflammatory drugs, the Zone diet, almost everything written about inflammation says prostaglandin E2 is inflammatory. It is one of the two central causes of oral tolerance, of the immune system recognizing that something is safe.

 

The other is retinoic acid made from vitamin A. So, to create a pro-tolerance environment, you want no COX inhibitors being taken, you want sufficient arachidonic acid in the diet, and you want sufficient vitamin A in the diet.

 

Then what are the factors that tell the immune system, this is not safe, and that is tissue damage. So, the immune system is basically saying, "I will make a decision about this. To make this decision, I need data." So, what are the data that things are okay? Retinoic acid, prostaglandin E2. What are the data that say this is not okay? All the factors released during tissue damage because tissue damage is the number one sign that something is harmful.

 

So, if the thing comes in and they're fine, then the next time they take it, they don't tolerate it. That sounds like they are programmed to decide that everything that comes in is a threat. And so they take it, and it gets into their system and it doesn't do anything, but meanwhile the immune system took a piece of that into gut-associated lymphoid tissue, and said, "We need to program to make an army against this threat," and so it's the second time that they took it that they have the reaction.

 

And so that means, again, get the arachidonic acid, get rid of the anti-inflammatories, get the retinoic acid from the vitamin A, and thoroughly investigate any possible sources of tissue damage in the gut. I don't know if it's necessarily the gut. It could be tissue damage somewhere else that then the things circulate into the gut, but it's probably the gut because that's what's closest to the situation. So, those are the things that I would be looking at.

 

This Q&A can also be found as part of a much longer episode, here:https://chrismasterjohnphd.com/podcast/2019/02/09/ask-anything-nutrition-feb-1-2019/ 

 

If you would like to be part of the next live Ask Me Anything About Nutrition, sign up for the CMJ Masterpass, which includes access to these live Zoom sessions, premium features on all my content, and hundreds of dollars of exclusive discounts. You can sign up with a 10% lifetime discount here: https://chrismasterjohnphd.com/q&a



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