Do You Have a Grain Brain?


READERS SUMMARY:

1. WHO IS DR. PETER UNGAR AND WHY ARE OUR TEETH A BIG DEAL?

2. WHAT DID GRAINS DO TO OUR BRAIN AND SKULL?

3. WHAT IS A CHIARI MALFORMATION AND HOW MIGHT IT BE TEETH RELATED?

4.. WHAT MIGHT BE THE REAL CURE OF SIDS (sudden infant death syndrome)?

5. WHY PHYSICIANS NEED TO ASK QUESTIONS ABOUT YOUR DIET IN A HISTORY AND PHYSICAL EXAM?

I saw a very interesting case in the clinic last week, and I decided I had to write a short blog on it because I think it makes and elegant point of some of the evolutionary changes we have seen in Hunter Gather skulls and modern skulls as we have continued to eat grains. If you are not aware of the work of Dr. Peter Ungar, you should read some of his work. My fourth cite is his masterpiece book on mammalian teeth. It is quite interesting and helps tie what our diets have done to shape our skulls and our occlusions. He is an expert on the study paleolithic teeth. Since I am a past dentist, and a present neurosurgeon, his work really resonates with me. It has allowed me to think about current diseases in neurosurgery that have no known etiology using an evolutionary prism. I bet even he would not see the cross-connectivity in this clinical case I just saw in clinic last week. It was a great case for us to consider. He holds a PhD in Anthropology, and is the current chairman of the University of Arkansas department of Anthropology. There are several major things that have occurred to the human skull over the last 15,000 years that we should be mindful of when we consider some neolithic diseases that are tied to them in for today’s healthcare practitioner.

The first one, it appears as agriculture became more prominent, the skull case shrunk in the occipital area as the jaws shortened. This means the entire posterior skull base has been facing constant natural selection pressures with the advent of agriculture. The effects of these things have left modern man with changes that can cause a smaller posterior cranial fossa where our cerebellum now sits. This is a part of our brain that allows us to perform coordinated complex movements of our motor and sensory tracts. It allows you to track and catch a ball in the air as you run for example. As this part of brain has gotten smaller, we lost the ability as a species, to climb trees well and do some of the things that our ancestors were masters of. Those of us who retain these capabilities usually are athletically quite gifted.

Another thing that has happened is that our teeth had to shrink to fit our smaller jaws as our skull base shrank. This has left modern man with a neolithic disease many do not often consider a disease. That is impacted wisdom teeth! This neolithic disease used to help support me in my former life as an Oral and Maxillofacial Surgeon. Today, it helps most orthodontists making them very effective at separating you from your dollar to get your kids teeth straight. If you follow the paleolithic occlusal records of Dr. Ungar, you will find straight and worn down teeth were very normal on an ancestral diet. Crooked teeth in the human skull was a very rare finding in the fossil records. This should make you wonder why this happens, but that will be another blog down the road. It also changed the mechanics around the tempro-mandibular joint as well, that used to keep me quite busy. This is another neolithic disease we face as a species.

The most interesting consequence to present day neurosurgeons is the consequence of what a shortened occipital bone might cause clinically. So I decided that I wanted to share with you another new neolithic disease that I see today as a neurosurgeon. That is called I call GRAIN BRAIN. That disease is called Chiari malformation by medicine today. You can see a picture of the MRI of a person with Chiari on the link provided.

This is a situation where the posterior cranial fossa is too small to accommodate the size of our cerebellum. It can cause headaches, fatigue, muscle weakness in the head and face, difficulty swallowing, dizziness, nausea, impaired coordination, and, in severe cases, paralysis. The most common feature, however, is the presence of a headache that has some special features. Headaches aggravated by Valsalva maneuvers, such as yawning, laughing, crying, coughing, sneezing or straining, makes a physician think that maybe there is a congenital skull base abnormality present.

What happens as the person grows into adult hood is that the cerebellum actually tries to push itself out of the skull and into the foramen magnum, which is the hole in the skull base where the spinal cord exits the skull. Part of the cerebellum, called the cerebellar tonsils, push down and try to exit with the spinal cord. This begins to put pressure on the spinal cord, and can cause some significant symptoms that bring the patient to see a physician. Most people do not realize that this condition is tied to a smaller and flatter occipital bone. There does not seem to be much evidence that this condition occurred much before the dawn of agriculture in the paleolithic fossil record. So this is another neolithic disease that rarely gets a lot of press.

I decided to post this blog because of a case I saw last week had a very unusual presentation. Generally most neurosurgeons believe this is a congenital defect that a child inherits from their parents. I do not. I believe this is a nutritional disease that humans get from the transgenerational epigenetic signals from our maternal blood lines. It means that grandmother and mother likely ate some things during their respective pregnancies that foreshortened the occipital bone of my patient who came to see me in clinic with this problem.

The cerebellum grows very late in human gestation. So the epigenetics of a foreshortened occitipal bone predisposes modern humans to this malformation. Since the bone growth is stalled due to dietary factors and the underlying brain grows until late in gestation. This is not well appreciated by my own specialty, even today. Recent pediatric data suggests that the growth of the immature fetal cerebellum is particularly rapid during late gestation in the third trimester. However, this accelerated growth seems to be impeded by a premature birth and associated brain injury. Prematurity is also associated with vegan and vegetarian diets. Future mothers need to be made aware of this to prevent future Chiari’s in offspring. The long-term neurodevelopmental disabilities seen in survivors of premature birth may be attributable in part to impaired cerebellar development. The reason I want to touch on this case is because we do not have a true etiology for Sudden Infant Death Syndrome. I have often thought that this might be the real cause. If the child is born with a large cerebellum and small brain space, it can increase intracranial pressures transiently in children while they sleep. If they retain enough CO2, this cause an increase of cerebellar blood flow and the child can immediately stop breathing and die. I think if you’re a vegan, vegetarian, and female of child bearing age you better think to ask your pediatrician this. I doubt any of them know about this proposed mechanism but it makes too much evolutionary medical sense not to consider it. Moreover, since modern medicine has no good reasons for SIDS it is something that should be studied in my view. My patient last week got me motivated to write about it for you all to consider. We might save a few lives?

The interesting part of my patient’s story was that she had not had these headaches since she was a child and her sutures on her skull had fused. For the occipital bone the key sutures close and ossify by age 6. In the occipital bone at birth, there are three primary sutures that can be identified. At the age of 0-3 years, occipital and innominate sutures started to fuse. These two then ossify completely by 4 years of age. The last occipital suture is the mendosal suture and it persists until 6 years of age, and this is when most brain growth is also complete in this area, after which no primary sutures can be seen in the human skull. So technically, if this was going to be a problem for her, we might have expected her to have headaches from the age of 6 years and onward. This however was not what she reported. Her headaches were at age 29, about a year ago. That bit of history was perplexing to me, so I knew I had to dig a bit deeper.

I asked her what happened to her a year ago that coincided with the headaches. I thought maybe a trauma, a pregnancy, or a medication might have exacerbated the situation to start her symptoms. I got no real answers from her initial history to help me. Then for shits and giggles I asked her about her diet. She told me she recently changed her diet due a church recommendation and had started a fasting diet with use of juices. She reminded me that this just occurred just in the last month, so it likely had nothing to do with her headaches. She then told me a year ago she moved from a standard American diet to a 100% vegan diet and I just smiled widely, because I knew I just hit oil!

I told her to stop the history and I had a handle on what had happened to her a year ago. When she began to eat a 100% vegan diet she increaseh her inflammatory cytokines in her blood, and this registered by bombarding her posterior fossa circumventicular organs in her “already tight” posterior fossa. That organ is called the area postrema, and is covered extensively by afferent neurologic input from the vagus nerve. This nerve makes up part of the fifth levee in my Quilt called the brain gut axis. It is a portal that will allow a leaky gut to completely bombard our cerebellum with inflammation. I had no labs sent with her. Just a CT scan, my history, and physical exam. That inflammation likely caused her cerebellum to swell at age 29, when she became a vegan. Then her headaches began. I told her that I did not think she needed surgery at all. She instead, needed to test my hypothesis, with an immediate fuel change to a paleolithic diet for 30-45 days to see if her symptoms went away without any surgery. She was shocked and clearly thinking I was nuts based upon the look on her face. This is how I look at medical problems using a Paleo Prism now. You name the disease and I have a new unique way of hacking it and testing it now. I told her that she should go get another opinion but she should be aware that neurosurgeons make money by cutting, not watching. I was strongly advocating a conservative plan of changing her diet and monitoring her symptoms to see what happened. It made the most sense, because she had none of the more serious findings we see in Chiari patients.

Her husband really seemed to be very interested because it made too much sense…so we will see how the story ends I guess in the next few months.

CITES:

1. http://www.pediatricsdigest.mobi/content/115/3/688.full

2.http://en.wikipedia.org/wiki/Circumventricular_organs

3.occipital.pdf

4.http://www.amazon.com/Mammal-Teeth-Origin-Evolution-Diversity/dp/0801896681

 

Comments

  1. Jack,

    You Rock – "neurosurgeons make money by cutting not watching" The truth in that statement only exemplifies your own compassion.

  2. She was very lucky to have found you. With all the unnecessary surgeries in the country you just saved one I hope.

    • @Pam M She certainly did not react that way. I think she was rather shocked that her problem actually began in her maternal family and was diet related. I am fine with her doing her due diligence because I know down the road when she meets problems in her history she wont forget what I told her. That is the beauty of this evolutionary science, it is so powerful that it has its own gravity that will eventually bring you back at some point when you do not meet the results you want. Most humans are socialized to swim against our biology for most of their lives. When they finally realize why they must become a salmon, and swim against the social pressures and follow their "biologic wave" to surf to shore their results will speak volumes in the mirror and in less trips made to people like me.

  3. Wow very eye opening read!!

  4. Another amazing post! +10000 on Resurgent's comment! You're in a class all your own Jack!

  5. Excellent post. My son had chronic headaches in his mid-teen years, and we never even consider such angles (even though consulted wide array of specialists). Wish more Dr's even thought to ask questions like you. He's fine now, but fascinating to think of implications of such things. He's also in undergrad now, loves evolutionary biology, and is heading towards combined MD/PhD, so I share your work with him often. Keep it up and maybe you can affect others in the next generation of care-givers!

  6. On Sudden Infant Death Syndrome, what about the plasticity of the skull in infants? Is there a difference or a lack of plasticity in the actual bone of the babies that get or die of SID? Could not diet play a role here, too or the timing of the closing of sutures?

    • @John S I think it has to do more with differential growth's John of the occipital bone (slower due to the use of grains) and the late explosive growth that occurs of the cerebellum in the third trimester. This leaves the modern human infant with too large a post hindbrain with a shortened occipital bone. If the child is not breast fed and feed formula and grains, which most are this further favors the development of SIDS going forward. Remember too that in SIDS there is a heavy male predilection for death, bu tI think this can be easily explained because androgen hormones tend to favor enlargement of the circumventricular organs in the developing brain. In this case it would be the area postrema.

  7. John, babies still have *bone* skulls. The "plasticity" is only due to the fact that the joined sutures we see in adults are not yet joined all the way in infants, so when they are born it's possible for the head to flatten somewhat to get through the vaginal canal. But most of the skull is still hard, as anyone who's ever been hit in the nose by a young baby's forehead will attest.

    Those sutures only occur in so many places in the skull. But if a part of the brain's up against bony plate it doesn't have many places to go.

  8. majkinetor says:

    While connection between teeth and brain is really great info, I think you are probably off the line about SID. There are other, more promising and already tested ideas as to why is it happening.

    http://goo.gl/zeczL http://goo.gl/tkn8f

  9. Dr Kruse, hello from sunny New Zealand! I have followed your information with huge interest and an even bigger dose of gratitude. I find the conversation about SIDS to be especially interesting (I work primarily with infants and their mothers). I learned many years ago about the role of leptin in protecting infants from the neurological changes experienced when a mother has depression. Nancy Jones' research (rarely discussed in mainstream due to political incorrectness) showed that exclusively breastfed infants of depressed mums didn't show the neurological changes that formula fed babies did (in which their brain mirrors mum's depression). One of them main vehicles for this protective effect is thought to be leptin (as well as the mechanisms of oxytocin and soothing/regulation/reduced cortisol via both the breastmilk and the interaction itself). I am AMAZED at where leptin leads us.

    I also just wanted to send a word of deep thanks for the time and energy you spend getting this info out. 18 months ago I had stage 1 breast cancer and was only ever advised an alkaline diet by my doctor (who is quite forward thinking). I have gone paleo and am eating heaps of coconut oil. I feel so much better – no anxiety/depression, tons more energy, a bit of weight loss – and I feel very grateful to you and others who are spreading the word.

    I have one question re: the meditation/mindfulness connection. I am a long-time meditator and Buddhist practitioner. I now eat copious amounts of organic eggs and fish as well as the coconut oil and organic/home made veggies, pestos, etc. I have resisted adding chicken and mammal meat to my diet for spiritual reasons. I am open minded and trying to determine if it's integral now that I've added the eggs and fish/seafood. I also have access to organic raw milk which I have used both plain and to make yogurt and low-temp cheeses. If you have an opinion on this that would be great. No worries if not.

    Thanks again.

    Cheers,

    Lauren

    • @Lauren I am well aware of her work. And if you think this is a big move where leptin is headed I promise you that where its heading is going to blow your mind.

      As for your spirtual leanings……you must decide what is best for you now and I would never try to sway you, but I can promise you this, the answer to your request is right under your nose buried in your DNA…….after my book comes out your intuition about animals/mammals might be altered from here on out.

  10. I have a patient who, a few years ago while living in Japan, developed vasculitis. She has seen several specialists, none of whom can identify a cause. She moved back to the U.S. a few years ago and resumed her S.A.D. and lifestyle of working crazy hours with lots of travel. During this time, she gained 70 lbs. She came to me for relief of her neck, back and knee pain so that she could return to running. She planned to start a vegan diet to lose the 70 lbs starting on 1/1/12. I warned her of my concerns with a vegan diet (to no avail) and began treating her with very light (activator technique) to the spine and knee while beginning to educate her about the importance of omega3/6 balance, fat and protein intake, etc. Jan 1 came around and she commenced her vegan diet. One week later, she called to cancel her appts as her vasculitis had returned in the lower leg below the knee I had every so gently adjusted with the activator instrument. Her Dr. felt that the adjustment caused the flare of the vasculitis and told her to cease chiro care. I did some online research and found no correlation with chiropractic manipulation and vasculitis, but several articles documenting food allergy with vasculitis.

    Comments? Ideas?

    • @Lisa her diet predisposed her to this…….And I bet if you had of tested her blood your would have found a lit up cytokine panel array……..Sadly I bet her allopathic docs still are acratching their heads too.

  11. Very exciting! When is your book coming out????? Can't wait. Thanks again, Lauren

  12. I just stumbled across your work and am very interested in it. The SIDs info is fascinating–my brother-in-law had a little sister who died of SIDs. She was a preemie, but her mother was also a vegetarian, and she died a few days after they brought her home for the hospital at about 3 months old. It was tragic.

    I have a few questions for you about fetal development and primal/paleo. I am 28 weeks pregnant and have been thinking about going low carb (haven't decided if I should try to do low-carb paleo, paleo without the low-carb, or simple low-carb without the paleo restrictions) and have the blessing of my OB with any of the options. To this point, my diet has been full of "healthy" and not so healthy grains and carbs. I find it hard to eat protein, probably because I'm filling up with the other stuff. I am obese (BMI around 45), but I'm interested in this for my health and the health of the baby.

    My question is–what modifications, if any, would you make to your Leptin RX, or would you recommend skipping it all together until after I am finished with gestation and/or breastfeeding?

    Another question … one Maternal Fetal Medicine doctor told me that ketones were not good for a fetus because "ketones have a predilection for the developing neurons" of the baby's brain. What exactly does this mean and do you agree? Also, my neurologist (I have a very mild form of epilepsy) said he didn't think that ketones were a problem while breastfeeding because the baby's stomach would digest them before they got to the baby's brain. What is your opinion?

    For the next 12 weeks, since brain growth is so explosive, as you've said, I'd like to nourish the baby's brain as best I can.

    • @Amberly Your story fits many of my theories. First off the CW advice youre getting might hurt or kill you and might harm your baby in my opinion. You should consider going at once to a low carb paleo template because at your BMI you're are extremely obese and LR by definition. This means that your pregnancy is high risk by definition.

      To show the safety and science around this advice go buy Dr. Loren Cordain's new book called The Paleo Answer and read about pregnancy in there. Your epilepsy is likely nutritional based, and due to your heavy dietary use of carbs and glucose. Once you begin to eat correctly, I bet it goes away completely. Your fetus might be at deep risk for gestational diabetes and many neurologic problems as it begins life. You need prenatal vitamins but you must supplement high dose Vitamin D3 at a bare minimum for sure. Your Vitamin D levels are probably woeful because of your obesity, which means that your child's vitamin levels might be even worse. This could mean the fetus's brain might be at huge risk in its future development. It also predicts a poor progesterone level from your placenta and this too can effect fetal brain growth.

      You must immediately consider changing your lifestyle now, to save you and your child from potentially serious consequences. I would strongly recommend you adopting a high fat, moderate protein and very low carb diet from the next two yrs of your life. You might consider not wanting to have any more children until you fix your Leptin problem. My belief is that via your current epigenetic dietary signaling you might have already imprinted this fetus with some suboptimal epigenetic signaling. I am sorry to tell you this here, but this is what the new science of epigenetics leads one to suspect given your history. There is still a great chance you can radically help your child if you consider instituting change now……..and I mean right now.

      Your child stands to be epileptic too because if you currently are because you have taught your own neurons to use only glucose for fuel and not ketones. Your fetus is in you and is getting the same signals to its developing brain. The brain works more efficiently when it runs on ketones all the time. The advice you have gotten from others does not fit what this neurosurgeon knows is best for optimal neurologic function. This is also why you suffer epilepsy ironically!!!! This set of circumstances puts you at extreme risks for post partum depression too because when your are leptin resistant you have extremely low levels of pregnenolone and progesterone that help limit your risks for depression. You need to be aware of this link now.

      You also likely might face needing to deliver this child via a C- section because of your BMI. Your BMI puts you in morbidly obese territory which means you and your child are at the highest risks one can find themselves at for a C-section delvery. Your leptin levels will drive the childs cells to gain tremendous size in the last trimester of its gestation and the child will likely become larger than you might expect. This situation might make it very likely that the child physically can not fit out of your birth canal. This may create a problem for you the child and your doctors. The doctors might have to cut the child out of your abdomen for both your sakes!! This child will also carry many health risks because of this abnormal physiology. This puts you both at more risks. They grow exponentially greater as this process goes on and do not lessen I am afraid to say. If this happens your child might not ever get its initial innoculum of bacteria for its gut as evolution designed and its gut will be leaky. Because your leptin resistant your breast milk likely wont come in so you will then default to feeding this child formula which be a major neolithic error that compounds the rest. You maybe shocked to find out this is how an infant gets leptin to hardwire it hypothalamus for the rest of its life. I have written about this effect elsewhere in this blog. Your child might not ever get this chance because mothers who are LR rarely get breast milk to come in due to poor prolactin and hormone levels.

      This also might mean your child can become hardwired for obesity as well now because its hypothalamus is not getting the appropriate signals of how to account for food. You might consider after realizing this information, to never feed this child dairy, soy or any grains because of how this fetus brain was programmed in utero based upon what you shared here with me. You need to consider feeding this child a strict paleo template as outlined in the Dr. Cordain's The Paleo Answer. I can not stress to you enough that you should consider a radical lifestyle change immediately now to not only help you out but help your fetus try to live a normal life…….these decisions you now face likely might likely decide most of that child's fate the rest of its life…….based upon what we now know about all this new epigenetic science. I pray that you might consider this information if not for your sake but the sake of that fetus in you now! Good Luck, Amberly and please consider a lifestyle change now……..!!!!!!

  13. Glamorama says:

    @Amberley, I was mildly epileptic. Since dialing in my sleep and running on ketones, my epilepsy is gone. 4.5 years since my last seizure. Without being LR and running on glucose, my seizures never ever surface anymore- not even slightly.

    I was LR when my very big baby was born last year. She was a big 9.4 lbs and was not nice to push out. I always had plenty of breast milk, but you really need to make sure you're on a high dose of omega 3 wild fish oil both now and post-patrum. It should reduce the chances of post-natal depression. Eating liver should also help. Really focus on getting the breastfeeding right. Drink lots of water and feed on demand to encourage supply. My baby has been fed a 85/15% paleo-template since starting solids, and at 14 months she can best be described as very tall for her age, unlike her brothers who were fed CW till they were 4. I worry she'll have the health-issues I've had but I believe feeding her primal food has set her up for a better start. Good luck. :)

  14. What Dr Kruse is saying is not conventional wisdom. But for us who follow paleo/primal eating, our lives have been drastically changed to the better. Not only will Dr Cordain's book help you understand the primal template, there are other books…such as Robb Wolf' book The Paleo Solution or Mark Sisson's book, Primal Blueprint. Those of us who have rejected conventional wisdom are reaping huge rewards in renewed health. We are no longer risking our health status. We have taken charge of our own health and Dr Kruse has provided us a roadmap to health…just as he has provided you and your baby with a roadmap to optimum health. Here is the story of a primalo/paleo baby raised in Hawaii by a family that adheres to paleo real food eating. http://hawaiianlibertarian.blogspot.com/2011/05/p
    I encourage you to start now…today…to nourish yourself and therefore your baby following the tenets Dr Kruse has laid out in his Leptin Prescription. Read the FAQs on Leptin. Do it today as every day delayed is a day missed in the proper nourishment of you and your child.

    If you wish you can ask questions to people who are in the process of retraining their bodies in the Leptin Reset Protocol at http://www.marksdailyapple.com/forum/thread32345-
    The people who are posting are made up of very helpful people who can talk to you via posting about any questions you may have. Some are breastfeeding ladies and some are posters are obese. But we are all there because we know that Dr Kruse has given us a roadmap to optimal health and we help each other over challenges. Visit us and we can assist you.

    Do not delay.

    Hugs to you.

  15. I had past surgery for chiari malformation and have 2 children (grown) with it also. It took many years for me to figure out, by myself, the connection with diet. I need to eat a very low carb, natural paleo diet in order to function normally. Otherwise I will experience increased intracranial pressure and then will lose mental function. A natural ketogenic diet is the only thing that keeps me from disability. Dr. Kruse, thank you for your brilliant work.

  16. @Lauren sometime in august 2012-nov 2012

  17. @Keli thanks for the kind words but I do not think what I am doing is brilliant……I am just making the connection between information we all know and tying it to an owners manual that comes in each one of us……our evolutionary blueprint. That is how we should live………not by the way we think we should. The evolutionary blueprint has navigated our ancestors thru more trials, tribulations, diseases, and pathology than any of us can imagine. Just by virtue of being here today alive is proof positive that maybe this owners manual knows a bit more than we do about what can make us optimal based upon the gauntlet it put our gene through over the eons.

  18. This sounds all too much like some of the research done by Weston A Price. You're a great man to help someone have OPTIMAL health instead of slapping a bandaid on the issue.

  19. @Elle M. V. Ugramov studied the permeability of the curcumventricular organs back in 1983 I believe.

  20. @Amberly

    My life changed when I went primal/paleo. The most amazing thing happened my milk supply increased around 6 months! I had an oversupply to the point I was able to donate milk to another mother in need! With my 1st child I most likely had post partym depression b/c my daughter was physically unable to nurse. I exclusively pumped breast milk for her for 14month, but I never made enough milk for her so we had to supplement with for formula, much to my disappointment event with taking RX grade galactagoues. With my son I was close to 230lbs at delivery, I'm 5'3"! DS ended up being delivered via C-Section, much to my dismay, b/c I was having problems ( he was just chilling having a good old time!). DS was 9lbs 5oz!. Fortunately he was able to nurse but initially I neede the RX galactagoues to help with bringing in and establishing my milk supply.

    I began the leptin reset when my son was 14 mths old, I'm on my way to optimal and I'm changing his potential epigenetics because he's still nursing! I positive that if I had found primal/paleo way of life 6 years ago when I went gluten free my pregnancies, deliveries, nursing relationships with my children would have been much different!

    Go paleo/primal. You won't regret it! It will be the best thing you've ever done.

  21. I just read this blog post and am wondering if my son might be suffering from Chiari malformation. He is presently 13 years old, and has had chronic headaches since the age of 6. I was a vegetarian for the 8 years preceding and including my pregnancy and I can't help but wonder if his headaches may be a result of gestational defects due to my diet! So far, with only "migraine" diagnoses to go on from pediatricians and pediatric neurologist, he continues to have headaches several times a week.

    I have adopted the paleo diet for the last several months and my son has (mostly) as well. Is there any way to tell if his headaches may be caused by Chiari malformation? If so, is there any way to treat the problem if it is truly a malformation? Will diet affect it?

    I've been looking for clues to help him, as his headaches are often debilitating.

    Thank you for any suggestions!!

  22. Jack, what about lack of vitamin K2 as another dietary factor contributing to skull malformations? I've read that K2 appears to be a critical component of a nutrient dense diet to produce optimal bone growth in children and health in adults and lack of K2 can have profound effects on skull formation (from work by Weston Price, Chris Masterjohn, and Stephan Guyenet).

  23. Amberly, good for you for wanting to make your baby as healthy as he or she can be! I too am doing the Leptin Reset, and highly recommend it. Paleo is the natural way to eat – it's how our bodies get the best nutrition. We've been brainwashed for decades that fat is bad, and complex carbs are good. And as a culture, we've gotten fatter and sicker. It's time to go back to what works best for our bodies. I sure hope you'll take Dr. Kruse's recommendations to heart.

  24. William Trumbower MD says:

    Jack I have always thought that the chiari malformation must have a nutritional cause. I think you are right on! Do you think that vitK2 deficiency is part of the problem? It causes a mid-face hypoplasia and maybe other bone malformations too. For Amberly, I am an obstetrician and recommend a paleo diet for all my patients with outstanding results. Look at Chris Kresser's blog and his advice for pregnant women. Good Luck!

  25. Hello Amberly, welcome to THE most important blog you will ever encounter. And VERY, VERY, VERY WELL DONE on reaching out for help. Listen to what Dr. Kruse is saying. Thanks to Dr. Kruse's love and knowledge, I have been able to switch from a lacto-vegetarian diet to a diet that has NO grains (sorry, there are absolutely NO healthy grains on this planet). I have much more energy and ambition now and robust health now. Read every word of Dr. Cruse's blog…it shall enlighten you like nothing else will! Much love.

  26. @Amberly – Since last summer my husband and son have started eating paleo/primal. Both of them have dealt with chronic excess mucus. My husband since he was a kid has been clearing his throat. My MIL said she could always tell where he was in the outfield b/c she could hear him clearing his throat. He's 37 now and has done it all his life. Our son had been doing the same thing, but as soon as we stopped eating grains, it's been very quiet around our home.

    My husband did the leptin reset, even though he may not have been LR and ended up losing 15 pounds without even trying. He has been an at least two desserts a day kind of guy. For eight months he's been craving free and has totally changed his way of thinking and eating. Our son's disposition has seemed to change as well. He's happier, more focused and content. For me, I have lost about 15 pounds, eat according to the post leptin RX and enjoy the freedom from the cravings. I sleep better, sex is better, and taking charge of my health. There is so much life available after eating this way. I thought it was all a spiritual condtion like a lack of self-control and being gluttonous. There is definitely a mental component to this, but once I took out the biochemical reactants of the grain and sugar, I had control that I've never had before. One of the greatest pieces is the loss of shame. That has been the greatest loss of all.

    Whatever you do, I pray for wisdom and courage for you.

  27. I have been reading Loren Cordain's info after reading your response to Amberly. I am now thoroughly confused – he has a large article about acid/base foods and recommends only lean meats and huge amounts of fruit and veg (keeping the high sugar fruit for when one's metabolism is set correctly) and says we must have an overall alkaline/base diet for bone health. As I now contemplate moving into adding meat (as well as fish and eggs) and keeping carbs low, it seems this is in conflict with his recommendations. Help?

    • @Lauren…..read the new book the paleo answer……it is an awesome book. Remember he is making global diet recs while i treat disease…….context is critical.

  28. PS In addition to Omega 3s as a suppplement, I was recommended regular intake of Evening Primrose Oil by a Primal/Paleo nutritionist. She said this: "Evening Primrose Oil (500mg at each meal: 3 times/day): EPO

    features pure evening primrose oil, a natural source of

    gamma-linolenic acid (GLA). As a precursor of the important

    prostaglandin E1 series (PGE1), GLA helps to support healthy eicosanoid balance. Eicosanoids (including prostaglandins) are natural, hormone-like compounds produced within the body. Proper eicosanoid balance plays an important role in the maintenance of good health." But in reading and re-reading many articles on your site, I wonder about the adding of Omega 6's to anyone's diet. Thoughts?

  29. @Bryan I think it can play a huge factor because K2 is very deficient in vegan or veggie diet users. People know about the B12 and Vit D issues but too few know about K2. I have written about the K2 issues for bone in my osteoporosis series so I was not compelled to re write it here. I guess I need to link more past blogs to new ones huh bryan?

  30. @ william T Thank you for stepping in here. Its good to see an OB giving this advice too. Im glad to see some in my profession have my back. Evolutionary medicine is going to save us eventually.

  31. @Seri This is an easy diagnosis. Just get him a MRI. I bet with his history he may have had one already. If not ask for one. Even if he does not have it I bet with your history he was born with both a leaky gut and a leaky blood brain barrier. If you move him to a paleo template I bet he improves faster than you can imagine. My son had headaches too…….and now there are gone. My son before and after shots likely will make my book since he was the first person other than me to do the reset. His pictures are truly stunning.

  32. Doc I was wondering if you had any insight into A nutritional link to Bruxism. I have gotten some pretty significant wear from it but I believe that it is something that has started in the last few years. I kind of feel like it has gotten worse since I went paleo which makes no sense to me. Thanks

    • @Cmhffemt yes I have a theory about it. I think it is a small symptom that is tied to ephaptic damage due to dairy/grains (autoantibiodies) that cause movement disorders. This is something I may hit down the road but we will see. I see it as the same disease process that causes Tourette's Syndrome but as the first stop in the symptomotology.

  33. Daniel Han says:

    fascinating stuff. Point of the story. Grains suck.

  34. How can eating right do anything if the space inside the skull is too small…did I read that wrong? Eating right won't make the skull grow bigger will it?…Confused about how a structural problem is helped by something like that.

    I can see how it would help lessen the headaches/other symptoms as the inflammation goes down there is more space but what if there isn't enough room even with low amounts of inflammation? Also she mentioned that her son was already eating mostly Paleo already so is he not better yet because it takes time or the he just needs to be more strict?

    • @jon I have not given you all my thoughts on it on purpose. But the reason is this……..the area postrema is vital to leptin neurobiology. If one has damage there for any reason it is like getting a central vagotomy. This means it completely alters your brains ability to sense what is going on in your gut…….If you remember I have said many times the Leptin Rx does not work for whom well? Those morbidly obese who opted for bariatric surgery……..it completely damages the vagus nerve afferents to the brain. Go re read the blog right now about how the leptin Rx works……..I think you get why the area postrema is critical to the entire biology of leptin and how it ties it to the gut. This is how the brain gut axis is wired together to fire together. People with eating disorders have this precise issue…….they do not wire and fire together correctly. This is very very complex neurobiology that modern science is just opening their eyes too……I have realized since 2007 this biology is critical to a lot more than just weight gain or loss. I think its key that tie food and circadian biology to longevity. I will be touching upon this in my book.

  35. @Seri @Jack the last comment was about Seri's situation since I forgot to post that.

  36. @Myree If you want to check my hypothesis……you can do a simple test at home. It will be easy to do but hard to perform. Place you legs and botton in ice water consistently over the next few weeks slowly increasing the times of exposure. If I am right you will notice pretty amazing changes in several systems. I am not going to tell you what to expect but I would love for you to post your results.

  37. I'm 33 yrs old with three children and I was diagnosed with a chari 1 malformation at age 30. I had headaches as a child and during my teen years but it wasn't a chronic problem. Before age 30, I was in good health. I was active and full of "life." I rarely had any issues with pain. Before my kids, I weighed 114 pounds and after my last child, I went up to 174 pounds. I was 28 yrs old at the time.

    I decided to change my entire diet in an effort to lose weight. I stopped eating fried foods and tried to stick to a regimen of fruits and veggies. I also started taking supplements for the first time such as calcium. I didn't eat much meat and when I did, it was grilled or baked.

    In one year, I lost 20 pounds but shortly after that, I started experiencing "random" symptoms. First, it started with awful burning in my throat and a lump in the throat feeling. I was told it was acid reflux and given meds for that. Second, when the first symptom disappeared, I suddenly started having VERY painful muscle spasms in my chest that eventually radiated to my neck. I was given prednisone (made it worse) and then a muscle relaxant which worked well for the muscle spasms. Later, I started having the sensation of a "vibrating" feeling in my chest. It was on/off and eventually I started feeling it in neck and head. I still have that symptom today which feels like a pounding heartbeat or pulse in my head and I get relief from it when taking naproxen and flexeril.

    I've had blood work done many times and the only thing that was shown is high blood calcium and a slightly low vit D levels. I've seen countless specialists including a neurosurgeon and they aren't convinced that the chiari is the cause of all my symptoms. They think it's anxiety and a muscle problem.

    I always look back to the year when I changed my eating habits and wonder if there is a connection my health issues. It seemed strange that a year of healthy eating and losing weight would suddenly, out of nowhere bring on a host of symptoms. Do you think there is a link in my case? Should I change my diet once again?

    • @Elise here provides us with a rare opportunity…….for my theories to be tested by someone who has not been helped by conventional medicine. Neither one of us has much to lose………so I say to you…….I think the reason you have all those symptoms is because they fit a Chiari compression phenomena……..meaning something is making it worse. In my view that something is your diet. Your diet is very inflammatory and it is being transmitted to your area postrema in your fourth venticle……this causes minor swelling and ironically low vitamin D levels…….If you buy the Paleo Answer, or the Paleo Solution, or Primal Blueprint my bet is your symptoms will vanish………….completely. Do it and let us know. I would tell you one thing. Krill oil is a great way to get an anti inflammtory into your area postrema fast so I would tell you you need to supplement 500 mgs a krill three times a day and I would suggest 10,000 IU of D3 a day during your experiment if you choose to do it. Also I would tell you with a Chiari you should avoid all NSAID's since they cause a leaky gut………and will make your symptoms often worse several days later.

  38. Hello Dr. Kruse

    I just want to follow-up on the comment: avoid all NSAID's since they cause a leaky gut

    This does not include aspirin right?

    I remember you recommending this in a prior blog to help with cell leakiness if one is not living perfectly (sleep, paleo diet tied to the light cycle, proper exercise).

    Thank You.

    Mark

    • @Mark All NSAID's including aspirin cause a leaky gut. So if you suffer from one it makes more sense not to use any thing to make it worse until it is repaired. Now you are correct that long ago in my original mitochondrial series I mentioned that ASA has a unique ability to be an uncoupler of oxidative phosphorylation. I think as a human gets older but is in optimal shape that using 81 mgs of ASA is not a bad idea assuming the remainder of their health is great. The reason is that ASA uncouple their mitochondrial's inner membrane and this decreases leakiness at our first cytochrome of our electron chain. This slows aging. It lengthens telomeres. It is generally good. But a leaky gut increases inflammation that causes aging to increase and shortens your telomeres. It is a definite balance. You always must consider your personal context when you decide to act…….and this is why I spent this time discussing this with you. It is important that I give you that context. ASA is not all good or all bad just like anything else.

  39. Thank you very much for the detailed response. While I don't think that I'm LR, I also don't think that my gut is 100% perfect either. I'll hold off on the Aspirin. Thanks again

  40. Jack – for 19 years I've been in 'blissful' ignorance that having my gallbladder removed would cause no problems. I'm now understanding that ignorance is indeed not bliss – what can I do to optimize myself? I already follow a low-carb, wholefood (grass fed/pastured meats/fish), primal way of eating (still have dairy) – am I able to absorb all I need from my food and supplements (D3, fish oil, multi, VitK, VitB). Is not having an "off switch" one of the problems of no gallbladder? I'm not without willpower, especially when there's a very good reason, but especially in the evening, I am capable of eating myself sick :(

    Thank you and can't wait for the book!

  41. My story involves brain inflammation too, albeit in a different way. I had a stroke at the age of 12. I had headaches in the months previous to the stroke and lots of TIAs in which I lost control of my left side. I was told by the Drs that it was caused by an inflamed blood vessel in my brain and they didn't know why it happened. Up until then, I was normal/slim.

    After the stroke I started having a weight problem which was chalked up to being on steriods to help with the recovery of the stroke plus enough residual weakness and spasticity on my left side to make it difficult to move around.

    I'm now 47 and still struggle with my weight. I've low carbed for years but just recently went gluten free and I've started to feel better. I'm working on the other stuff you recommend but I was hoping you'd comment.

    • @Heidi……I have such a long answer for you……but its all in my book. LOL I promise to lay out a Gut brain axis post that explains it all…….but the main factor is the leaky gut from your diet. The stroke just opened your brain wide open to the inflammation that caused your leptin resistance and weight gain.

  42. Vilho Ahola, M.D. says:

    Greetings from a fellow paleo doc in Finland. Keep fighting the good fight! :)

  43. hi Dr. K. this is slightly off topic, but I did not know where else to post this. Short story is I found paleo, then your blogs, then Nora Gedgaudas' book. She mentions a condition called pyroluria – body leaches all zinc and B6. I feel like I have most of the symptoms – and getting worse. Just sent out for my test kit. Have you ever run across this? Do you know the long-term implications? Will supplementing with zinc and B6 also help the leptin issue? or just make other things go squirrley? Have been doing the rest for 2 months, but not there yet and I gained. Thanks.

    • @Lexi yes I have and testing can work it out but often this is seen in patients who have terrible intracellular glutathione. Spectracell's nutritional panel is quite good.

  44. thanks. ok so i was just diagnosed with hashimotos…. remembered reading something about glutathione…. here is one thing: http://sarah-tomley.suite101.com/how-nac-and-glut…. now i am getting confirmation all this is connected. my thinking is to try and treat the pyro then retest to see if that cures the hashis….. are my instincts correct? or should i try and do everything at once – meaning the thyroid hormones + zinc + B6. thanks. wow. finally some answers after feeling sub-par since i was 10.

  45. Jack – thank you for the referral – so K2, some ox bile and (from other reading), coconut oil?

  46. @Judith all good.

  47. Jack, what is about Frontal Sinus Aplasia?

    Is it also related to malnutrition of mother or child or epigenetic traumata during pregnancy? Any dangers from that?

    Or can it be an effect of contergan (sleeping pill with Thalidomide)

    • @Andrea I know that sinus aplasia is tied to disease like cystic fibrosis and epigenetic modifications but in neurosurgery we consider the present or absence of sinus's a normal variant in the population. It could create a problem in trauma or with certain surgeries but honestly this is not a major problem for most who have it. Could it be a nutritional disease…….possible but I am not aware of any data to support it.

  48. This is really helpful Doc. And nice to hear. :-)

    So nothing to worry about. Thanks for taking your time. :-)

  49. Thanks to everyone who took the time to respond to my questions. My computer got a virus and I've spent the last three days trying to deal with it.

    Yes—I'm high risk, but luckily have an amazing hospital-based midwife who takes care of things but doesn't overreact. This is my 4th (and last) baby. My three boys' birth weights have all increased as my weight (and, theoretically my leptin level) has gone up (6lb 13oz, 7lb 3oz, and 9lb 2oz) and this one (girl) is measuring at 75th to 90th percentiles on the ultrasounds, so yes, I am concerned about the birth weights. I'm hoping that I have enough time to change things between now and the delivery. And I do feel bad about the epigenetic signaling, and hope that by changing things now and being consistent I'll be able to reverse some of the damage. How long does it take for the leptin levels to come down? i.e. can these things (birth weight, milk supply) be improved at this point?

    I didn't realize that there was a link between glucose and seizures. I had heard some link but my neurologist dismissed it when I asked him. (I have a new neurologist because there were several things we disagreed on). And I haven't done a ton of research because I have such a mild case of simple partial seizures (the main thing that triggers them is aspartame, which I have stopped using, obviously). Where can I find more about this?

    I've always had a good milk supply at the very beginning which starts dropping off after a month or two and the only way to keep it up is by eating a LOT. (I even worked with a pediatrician and her breastfeeding clinic to try to figure out the issues.) I have ended up gaining 15-20 pounds with each of my kids, and never was able to get it off. I was able to bf my last one until 11 months because he was allergic to dairy and I didn't want to put him on soy formula, but it took a lot of effort (and galactagoues). I've always hoped that if I was able to change my hormone issues so that my body could access my fat stores that I would actually lose weight breastfeeding.

    So thank you Dr. Kruse, and I did order the Paleo Answer and it should be here tomorrow.

    @Glamorama—And I will have to keep this one paleo once she starts solids. It makes so much sense.

    @Shijin13—That's great about the milk supply! Being able to donate milk would be awesome! Oh, and it sounds like we have a lot in common—I was 230 and 5'3" with my last, and almost ended up with a c-section because he was chillin too—transverse until the last moment and then had to be induced for 4 days before he finally decided to come out at 9 lb 2 oz!)

  50. Thanks for the suggestions Dr. Kruse. I'm going to buy the necessary supplements and learn more about the Paleolithic diet so I can start on that. I will let you know how it goes! By the way, I don't know if it has any relevance but I use to tell various doctors that my symptoms tend to flare up or get worse after eating. I mean, I do feel weak of course if I go without eating but the other symptoms aren't as bad. Someone once told me that if I fast for awhile and my symptoms decrease or stop, it means the chiari is the cause of the symptoms.

  51. 49 yr old female 5'9" 150lbs, 15lbs I'd like to lose as was really thin naturally until 40's…hypothyroid (continuing with hair & eyebrows lost) in spite of Synthroid for a year and metabolism that has screeched to a halt. Always had very fibrocystic breasts and major seasonal allergies. New is psoriasis. Endocrinologist suspects unknown "autoimmune disease" & says monitor on current dosage 50mcg Synthroid. Interesting to me? Reading your articles!!! I became vegan 13 years ago for about 3 years–I thought I did it very well with really good grains, nuts, soy & beans, etc. I knew I had some tree nut sensitivities…but became extreme with me having major "irritable bowel", hair loss, anemia and finally full blown allergy to peanut and soy at age 39 (which abruptly ended my being vegan)…and in the midst of it all? Two nocturnal seizures. I had temporal lobe craniotomy to clarify no glioma. So the endocrinologist isn't sure what to do with me…I'm still on 200mg Tegretol XR 1xday at night for maintenance & 50mcg Synthroid. I'm still losing my hair…but my energy level is good. I don't feel like just waiting to see what's next & wondering if diet has done all of this to me….

    • @Carolyn You previous history is a big issue for you. My bet is you need to eat a ketogenic version of the paleolithic diet to offset the brain issue and the loss of the temporal lobe. My bet is you also have serious underlying hormonal issues because of the brain/vegan issue. You really need to focus in on your gut. Strongly recommend you read my leaky gut Rx to help you! Coconut oil needs to be your number one diesel fuel.

  52. Thank you!! I just arranged testing for coconut oil at my allergist as I'm so allergic to soy/peanut/tree nuts/sesame/kiwi. For what it's worth he is also very anti-MSG. Splenda sweetener for my one a day latte will be finished forever now as well. With my case complicated by L temporal lobe craniotomy & hypothyroid are you able to consult & make specific recommendations for me as patient? No one seems to be able to tie all this together & give specific direction for me. I want to be proactive!

  53. @Carolyn – you should read up on Dr. Brownstein's work with hashimoto's, low thyroid, iodine, fibrocystic breasts and fluoride, chloride&bromide.

    Dr. Mark Starr, Dr. David Brownstein, Dr. Abrahams and Dr Flechas are names to look for regarding information about the connection between low thyroid, fibrocystic breasts and iodine.

  54. Hello Dr. Kruse. You mentioned Krill oil is a great way to get an anti inflammtory into my area postrema fast. Is evening primrose oil good for this as well? Also, you suggested 10,000 IU of D3 per day. Did you mean 1000 IU? Any thoughts on taking liquid stabilized oxygen daily for those with a Chiari? I heard it can help with Intracranial pressure.

  55. @elise…..i meant 10000 IU a day of D3. Evening primose is good for menstrual pain but it not as good as krill oil. No opinion on the other as I have no experience with it.

  56. Thank you! I will do the reading. I'm booked with Dr. Starr. I read his book too :-)

  57. NEW YORK TIMES

    Getting Back to Basics After Brain Surgery

    On Sept. 1, Holmes, 29, underwent brain surgery at Johns Hopkins Hospital in Baltimore to relieve symptoms of Chiari malformations, which caused vertigo-like dizziness. A piece of his skull, about the size of the core of a golf ball, was removed to relieve pressure on his cerebellum, and a titanium mesh plate was affixed to its base.

    http://www.nytimes.com/2012/01/27/sports/golf/aft

    • @Paul……..thanks for this and very nice read. This could help many with this condition. I do this operation myself and it does make a big difference. If the patient goes on a gluten free gliadin free diet the results are even better.

  58. Anyone tried ratfish oil? Sounds like a real paleo food: http://ratfishoil.org/

  59. Thanks Dr. Kruse

    I'm not getting notifications if I get responses here. I can do cold water via removable shower head but don't have a tub at the new house. I'll try anything you tell me to since your advice has paid off so far! I just am getting over either a really bad stomach flu or food poisoning… still can't get my 50+ g protein in yet eating protein even in the form of whey is causing severe cramping and gastric distress! I actually had to revert to Graham crackers and oatmeal to just get food down and now I'm red bumps all over my chest and back and my flippen feet are REALLY dry and cracked just from a few days of grains EEK! I look pregnant as well!

    I did have a question though since my hysterectomy I can't strain at all without urinating. I literally can't pass gas without laying on my left side or sitting on the toilet… so this gastric distress has been horribly painful! I've cut out my flax seed oil since I read about the omega 6 here and increased coconut oil. I'm drinking hot chamomile tea trying to calm my tummy and get things moving properly and also doubled my dose of probiotics.

    I'm exhausted and now the Psychiatrist has put me on Doxepin to make me sleep. I'm getting to sleep now but waking up in 5-6 hours still exhausted but not being able to go back to sleep…URGH

    Going to get up in the morning and try the cold shower…with the hypothyroidism I really hate the cold because it's so hard to get warm if I get chilled.

    I just got a letter from my doctor saying she's leaving my HMO and I've been assigned a new doctor…hopefully this one will be more open to doing the proper testing and treatment you recommend!

  60. I was wondering about calcium overload in the brain and vitamin K2. Is that a proper supplement for this?

  61. I guess I am asking if it is the same mechanism for getting it out of your arteries?

  62. hockleyj says:

    It seems a lot of people forget evolution is still happening so as we go from environmental pressure based evolution to society led evolution, effectively playing god. Then we will have god level problems to deal with, worst case scenario we die out, and we will only have our selves to blame. Rather then nature who for all intensive purposes will fill our void after we’re gone with other species, and some healing from what we have done to nature.

    All that aside the lazy way also known as efficient when used in medicine really has never been long term effective.

    I.e any pill to treat a problem is long term in-effective in almost all cases, even good old aspirin has a poor long term effectiveness compared back to evolutions way of doing things

    Mineral vitamin supplements are excluded from the above pill example as they are more about nutrient balance I.e human version of salt licks for cattle.

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