My Leptin Prescription

Readers Summary

  1. How do I start?
  2. What are the guidelines to remain mindful of?
  3. The fuel is the food, but how you eat that fuel is more important
  4. How does Leptin tie into the quilt survivability index?

I have been asked by many to put a short post out about how I reverse Leptin resistance in my own clinic for my patients.  After reading all of the comments left here, my forum, and on twitter,   I decided that it was a good idea.

1.  First make sure you really are Leptin resistant (LR) to begin with.

The easiest way to do this if you are heavy is to look in the mirror.  If you’re overweight you definitely are Leptin resistant.  If you still have a large appetite and crave carbohydrates, especially at night, these are also signs that you are likely Leptin resistant.  If you are fit or in decent shape and not sure based upon the above symptoms, I would tell you to go get a blood test and check your reverse T3.  It will be elevated.  I also recommend simultaneously checking a salivary cortisol level.  With LR, you will always see higher cortisol levels later in the day.

2.  To regain Leptin Sensitivity (LS) follow a strict Epi-Paleolithic diet.

To see an outline of a strict Epi-Paleolithic diet, read Brain Gut 6: Epi-Paleo Rx. The type of fuel you eat is important initially in eliminating the foods that cause Leptin receptors to become nonfunctional.

  • Try to eat as soon as possible upon rising in the morning, ideally within 30 minutes of waking.  Make sure that breakfast has little to no carbs (less than 50 grams), and has a lot of protein and fat.  I use as a general rule 50-75 grams of protein with most patients.  Some patients can use less and some need more.  The key point of knowing how much is right for you is your hunger later in the day.  If you remain ravenous throughout the day, you need to eat more protein in the morning.  If you can hold off eating until dinner you probably are at homeostasis for you.  If you can skip both meals you likely are overdoing it at breakfast.  As for sources, I suggest pastured or organic eggs first, served with left over dinner scraps of grass fed meats, poultry, or fish. A third option, although less ideal, would be whey protein or protein shakes.
  • Try to limit carb intake to 25 grams if you are overweight by more than 30 lbs.  If you are fit and have a small amount of weight to lose, (less than 30 lbs.) you can titrate up your carb loads.  Even then, I do not advocate potatoes or rice as some Paleo diets allow for.  You will be able to eat them eventually, but try to avoid starches until you have mastered your cravings and hunger.  Do not count calories; it is not needed at this point.  Any time I eat carbs, I use liberal amounts of butter, heavy cream, coconut or palm oil.  I do not recommend other oils initially such as olive oils or industrial seed oils.  I would also avoid nut oils at the initial stages.  My personal favorite is coconut oil because of the great metabolic effects of MCT, and how it helps heal the guts of LR folks.

3.  How and when you eat your fuel is more important than any other factor, including the food itself.

  • Never snack at all.  This is meant initially and forever.  Snacking completely stresses the liver’s metabolism and is just not recommended.  Your liver needs to re-learn how to use gluconeogenesis normally again when you are asleep and awake.  Snacking just destroys the timing and circadian clocks that work in unison with Leptin.
  • Try to eat three meals a day initially; but as your hunger and cravings fade you can adapt to two a day.
  • Try to eat breakfast as early as possible from rising.
  • Do not work out before or after breakfast.
  • Try to allow 4-5 hours between dinners and sleep time.
  • If you decide to incorporate working out, do it after 5 PM.
  • Within an hour of sunset try to make your surroundings as dark as possible.
  • If you have trouble falling asleep I suggest 3-5 minutes of body weight exercises right before bed (pushups or air squats are fine, but avoid this if your evening cortisol is high).
  • If you’re inclined to, try becoming mindful when you first lay down.  I use transcendental meditation techniques to help me clear my mind and concentrate on improving my thinking.  (Optional; but this is awesome if your eveningcortisol is high).

4.  Most people will notice a change in their cravings and hunger within 4-6 weeks.

Other changes I advise of my patients, is to supplement with prescription grade fish oils.  The dose depends upon their HS CRP and salivary cortisol levels.

5.  Signs that you are becoming Leptin Sensitive (LS) again

  • Men will notice quick weight loss.
  • Women will notice mood changes first (calmer/sleepy) and their sleep will improve (huge clue).  Their clothes will fit differently but weight may not change drastically initially because of effects on the pituitary.  This will change too if they continue moving forward.
  • You will notice a change in your sweating pattern.
  • You will notice you have better recovery from exercise and your energy levels seem to have risen.
  • Your hunger is gone and so are your cravings.
  • When you awaken you will feel very refreshed like you slept well.
  • Generally when the signs are all present, I then really push HIIT exercise with heavy weights.

6.  (Quilt Survivability) = (Total Energy – Growth and Immunity Expense) x (Resources) x (Efficiency) x (Awareness of our Environment).

You wont understand this until we pass the following blogs:

Stated in levee form where:

Cell longevity = LS – IGF-1 + Immunity x Food Quality x Leakiness of Mitochondria x Environmental Cues

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Comments

  1. patricia knigge says:

    Thanks!

  2. Can you explain the problem with exercising in the morning. I find that many people don't sleep well if they exercise in the evening.

  3. Based on previous posts I pieced together a lot of this and to my surprise I am able to get by without snacking this week for the first time in probably 12 or 15 years. In my 20's I was doing a lot of weightlifting and got into the habit of many small meals. It is a little hard for me to get in the 50-75 at breakfast but doing so has allowed me to cut out the snacking. Looking forward to the longer term benefits. Thanks for the info on this site.

  4. Once someone has regained leptin sensitivity, would you advise skipping breakfast to practice Intermittant Fasting, ie. no eating from 6pm to 12pm? Or should the high protein breakfast remain a staple?

    Thanks for your informative posts!

  5. meredith says:

    Question about potato. Since potassium helps convert glucose to glycogen without having to use insulin to do so, wouldn't foods high in this mineral be good to consume? Potatoes with skin on are one of the highest in potassium. Am I wrong in what I have read about this? If not, wouldn't potassium be a natural nutrient partitioning agent that would make potato a good choice for carbs?

  6. David Porter says:

    What is you're opinion on zero carb? I eat bacon and eggs for breakfast, salmon or sardines for lunch, steak or lamb for dinner. Is this ok, or must I have some vegetable?

    Also, do you count cream in decaff coffee as snacking?

  7. @ Lisa…LR folks need to extend fat burning. Once one eats it immediately turns off fat burning. So the best time to exercise when you are getting your "Ferrari" optimized again is to work out after your last meal. If your already fit you dont need to pay heed to this issue.

  8. Thanks for the kind words Jim and Patricia. Im trying to do my part help people understand how to get optimal.

  9. @Tim…..Regardless of fitness or LR or LS……I never advocate skipping breakfast ever. If you IF skip lunch and dinner. If you want to do a multi day IF run I would wait until you are fit and completely LS. I like IFing but I dont advocate any IFing if you're LR.

  10. Thank you dr. kruse. after i lost a lot of weight and putting on muscle, i find that i sweat less. this is a change, but i seem to remember you saying before that leptin-sensitive people sweat more.

    i also wonder why it is not a good idea to work out in the morning. if it is not a good time, then when is? i'm going to guess that in the morning most leptin-resistant people have elevated cortisol, and exercising at that time will elevate it further thus interfering with fat burning?

    finally, in the future if possible, could you put up some general observations you have seen in patterns of weight loss by not just gender, but age as well? i am perimenopausal, and my experience is going to be different from a 20 something. also, i saw on PH that you have prescribed bioidenticals for bone loss. have you prescribed them for other reasons as well? if so, would it be possible to do a post on hrt/bhrt? thanks for your energy.

  11. @meredith I have no issues with your reasons but big issues with the context in this post. If you're LR potatoes should be shunned until your LS and working out. That is when you can add back in your starchy carbs.

  12. @David Porter I am ok with zero carb for a period of time. But I base it on the cortisol issues. I have some patients who are zero carbers and when they start exercising they go into mild adrenal fatigue. I have others who are zero carbers who have awesome adrenals and great livers and they live in this zone well. Some of them are the most cut people you might ever see. Some are professional athletes. When they go into adrenal fatigue, sometimes I have to dig them out of that hole. I have a future blog about how we treat adrenal fatigue. Hope this helps.

  13. @V…..I can do this. I am going to ask some of my patients to consider posting their stories on here. As for the sweating issue its a question of adaptation. elite athletes who are leptin sensitive hardly sweat at all. They usually sweat post exercise to cool down. But the people we are talking about are LR to LS folks. When you restart the furnace you will see some physiologic changes. The sweating issue is evidence that UCP 1 and 3 are now beginning to function once again. Its kinda like a when you clean out a boat engine and fires out some black smoke and then it resolves as the engine runs more efficiently. Its a clinical sign that a doctor uses to follow his patients. Many researchers and non clinicians do not appreciate these things because they don't see patients and treat this condition

  14. I do use BHRT for some of my patients and I also offer a complete anti aging service for some of my older patients who want to be optimized outside of neurosurgery. This is part of my quantified self program that I used to recreate me and many other patients.

  15. Georgette says:

    I'm more than 30 lbs overweight but have noticed as of late that I have a lot of weakness if I eat under 30g of carbs a day. Would it be ok if I eat half a sweet potato or a baked potato when I get like this. It was so bad the other day, I literally felt depressed all day and then ate a little bit of a potato and felt better almost immediately. I even had sexual desire again.

  16. If a patient strictly follows these recommendations, how long would you say it takes the average patient to regain leptin resistance? And once someone regains leptin resistance, what changes about the recommendations – anything? Thanks!

  17. Is that 25g carb limit daily or for the first meal of the day?

    If exercising after dinner how long should one wait – 30 mins, 1 hr?

  18. Thanks. This post is very helpful.

    One short question, what is wrong with olive oil if you are assured that it is high quality?

  19. After 6 months Paleo and 8 weeks of Crossfit, I can proudly say I'm in the BEST shape of my life at 39 years old. The transformation is nothing short of AMAZING. I'm wearing a bikini again, which I didn't think I could EVER do again after having kids, and thanks to your advice, encouragement and resource recommendations, I FEEL better and healthier than I have in my whole life. More energy, more stamina, more strength, and less inflammation, headaches, fatigue. An all-around profound improvement, and I owe you a HUGE thanks for getting to this point. You really have done a great thing by sharing your knowledge and personal testimony with the world. I'm sure there are many "inspirees" out there like me who will live longer and better because of you. My husband thanks you, and one day my kids will too!

  20. This is a big help especially to pass on to friends who may be less willing to read all the denser material.

    I’m feeling better every day; this leptin reset is remarkable.

  21. Hi Jack –

    I'm not sure where to ask this, so I hope I'm okay to post here. I appreciate your work.

    Do you think bulimia is associated with leptin? I've been trying to cure myself for 11 years now of late-night binge/purge. The rest of the day I'm okay. I've done all the medical things and feel like my diet plays a role – so if you have any research you can send me, I'd really like that.

    Thank you!

  22. Hi again, Dr. Kruse. I don't mean to be greedy, but I had another idea for a blog post that i hope you might have time to do when convenient. i have talked to quite a number of perimenopausal and post menopausal women who say that getting a good night sleep is there biggest quality of life issue. i you have experience with this, i think a post on this problem would be invaluable.

    i am mostly have good sleeps- the colder the room in the summer the better. in the transition months before winter and summer, i use a fan to keep things on the already cool side.

    i have found melatonin to give me uninterrupted sleep, but i wake up feeling like a zombie.

    i have read that light therapy (light boxes) have been used effectively with alzheimer patients to reset their body clocks in that they go from being active during the night hours to going to a more normal schedule of being active in the daytime.

    anyway, just some thoughts. this sleep issue among older women is really huge for quality of life. thanks again.

  23. Diane S says:

    Ok in week five and have absolutely seen all of the LS signs, can I ask what is HIIT & how much weight are we talkin? You know I have a weight limit cause of my stomach (10lbs) is the limit, is that ok? Jack I can’t believe how good I feel (physically) the boys too. It’s amazing. Even Eli isnt on 2 blood pressure pills, down to one! Thanks for helping us with this :)

  24. In doing my due diligence to study levees 1&2, I have come across a medicinal mushroom used in Russia and Asia for thousands of years. This mushroom called, Inonotus obliquus, contains secondary metabolites including phenolic compounds, melanins, and lanostane-type triterpenoids. Among these are the active components for antioxidant, antitumoral, and antiviral activities and thought to improve human immunity against infection of pathogenic microbes.

    From Wikipedia:

    "The biologic properties of crude preparations of these specific β-glucans have been studied since the 1960s. Although these molecules exhibit a wide range of biologic functions, including anti tumor activity, their ability to prevent a range of experimental infectious diseases has been studied in the greatest detail. Recent scientific research in Japan and China has been focused more on the anti-cancer potential and showed the effects of these specific polysaccharides to be comparable to chemo therapy and radiation, but without the side effects.[5] [6] Further research indicated these polysaccharides have strong anti-inflammatory [7] and immune balancing properties, [8] stimulating the body to produce NK (natural killer) cells to battle infections and tumor growth, instead of showing a direct toxidity against pathogens. This property makes polysaccharide-based supplements stand out from standard pharmaceuticals – no side effects will occur / develop; the body is healing itself."

    A quick search on PubMed for Inonotus obliquus turns up dozens of studies for it's anti-diabetic, anti-tumor, and insulin sensitivity restoring properties.

    My question to you, are the anti-oxidants and polysaccharides present in the typical paleo diet sufficient to provide the cellular homeostasis that levees 1 and 2 demand?

  25. Scarlett.Lilly says:

    Thank you!!!

  26. At Jill……6-8 weeks is avg

  27. @Sue……the daily limit. I know. But it works.

  28. @Ruth……in the beginning I want to limit your omega six’s. They cause leptin resistance themselves. Later you can add back olive oil. In the beginning stick with coconut oil and palm oil and pastured butter.

  29. @katie……eating disorders are coming. Too early now in the process cause I need to lay out more science before i confuse too many. Stay Tuned.

  30. @Tim…….not where levee one or two were going.

  31. I got up today at 5am, right away I ate 6oz cooked chicken salad. Just went all morning until 11:30am before being hungry for lunch. FIRST TIME EVER.

  32. I'm a 46yo male. I was overweight as a child, overweight as an adult. I have been eating right and exercising about a year (a la Primal Blueprint) now and am finally close to an ideal weight for my height and age. Have I been LR my whole life? Are all fat kids LR? My brothers ate way more than me and they were both skinny as rails. Thanks for sharing your thoughts!

  33. One other comment/question. Are there any supplement recommendations that you believe help speed along the process of restoring leptin sensitivity? I'm taking some fish oil, I also take some pantethine based on some evidence of helping remove fat from the liver and visceral fat stores (PMID: 11425046). I am not aware of what types of supplements, if any, are available for specifically helping with LS.

  34. @Akman Most overweight children today are LR. NHAHNES curves for kids since the 1980's support my belief. As for you you might have been. Its hard to know without labs or seeing you.

  35. @Jim…..great question and I was gonna save this for a blog. But if you are LR is highly recommend NAC, Resveratrol,PQQ, Curcumin, very high dose omega 3 (prescription grade) and optimization of your vitamin D level with D3. There are others but I will be saving them for the blog.

  36. Brittany says:

    Do we go about managing Leptin the same way if we are trying to maintain a recent weight loss? I've lost about 25lbs over the last year but I'm finding it hard to maintain. I'm at a healthy weight for my bone structure and height 5'4 – 120lbs but I feel like if I don't keep myself in check, I could out eat everyone around me. I just never seem to get that "full" feeling. I actually lost down to 115 but I've gained back 5lbs from carb cravings/binges (I've also skipped a period and am late for another)…. It seems like this is a leptin issue…. Any thoughts?

  37. 25g carbs – is this total or net? Thank you.

  38. Jack – Is it the foods themselves causing LR? If someone is eating 100% according to a paleo diet as outlned in Primal Blueprint or Paleo Solution, but still LR, could it be a certain (albeit paleo) food causing the problem? Which would you suspect?

  39. Is there a daily limit of protein – I understand that too much protein can be counter-productive? Thanks.

  40. Melissa says:

    I'm 55, post-menopausal and have quite a few pounds to lose. I'm 5'1". I've been trying to get as close as I can to a 50 gm. breakfast but I'm finding it impossible since I'm used to nothing but coffee till about noon.

    I manage a hard boiled egg within the half hour, then about 15 minutes or 30 minutes later, I'm able to eat more, but still barely hitting 30 gm. within an hour of waking. Even this small amount makes me feel heavy and generally bad – almost puking.

    Of course I'll keep trying to increase the amount I can stomach in the morning, but my question is this. Is 30 gm. of protein within an hour helping in any way, or should I just give up if I can't do 50 gm. in half an hour?

    Thanks

  41. More questions :)

    Background : I've been on Atkins for 18 months now, 60lbs lost, gained back 15lb and stuck. I recently modified protein down to around 85g, upped fat to 175g and net carbs 30g. No processed foods (ie bars with soy), fat is coconut oil/olive oil/pastured butter. Age 47, possibly peri-meri but I don't like excuses like being female and age to get in my way! 5'7", currently 180lb, goal 150 and below if it happens (was 225+).

    Since increasing fat, I'm finding I don't need to snack, is it ok to keep fat at this level? Is there a daily protein limit? My breakfast this morning was hard – 4 eggs, 4 bacon, 2oz chicken, I'm assuming because I had a coffee/cream before so won't do that again.

    Drinks – it's mainly water but do other drinks like tea/coffee have to be milk/cream free or would they be considered snacks?

    Thank you so much for sharing your knowledge with us, you are a truly fascinating and ground-braking guy! And thank you for spending the time answering our many questions – maybe there could be a forum in the future??

  42. Poisonguy says:

    Hi Jack,

    Making my way through your website. Very enlightening. Keep up the great work.

    Quick question: Like Dave, I wondered about the cream in one's morning coffee. I guess if it's part of the morning breakfast ritual, it's no big deal. But if it's outside of mealtime (like I'm doing now–I'm IF without breakfast), I imagine the cream is just like a snack; a liquid snack.

    Do you advise against coffee? Decaff, maybe? Does it contribute to LR (or other obesogenic processes)?

  43. Just a note – I don't believe cream or butter are allowed on a Paleo diet. Will you please clarify?

  44. @ Katie If you have an autoimmune disease you need to cut it out period. If you don't you can use them.

    @PhilT there is no limit on protein intake but the person usually gets satiated quick with high protein meals and this is really what limits intake. Hormones are a huge issue with women and weight loss…….They generally need to be really understood by the treating physician.

    @Tim…….LR is different animal for Paleo. Paleo allows for high carbs in tubers and potatoes. When youre trying to lose weight you need to go a low carb Paleo lifestyle. This is a special situation and should not be generalized to all people eating paleo.

  45. @Poisonguy Cream outside meal time is a snack and a no no. When youre losing weight I think coffee should be limited. Caffeine is something that has a different effect on different biochemistries. When I was losing weight I stayed away from coffee and caffeine. I drank a ton of green tea but I steeped it to limit caffeine.

  46. Why no working out before/after breakfast? My wife and I like to take a walk of 30-45 mins in morning before work. Is that OK?

  47. efaitch says:

    I'm unsure whether I'm LR or LS now. I have type II diabetes and have been eating LC (ish) paleo for sometime now (80% ish)- I'm also a breastfeeding mother (2 year old). I am around 7lb overweight for my height (4ft 10in), but know that I my body composition needs to change (abdominal fat).

    I don't get cravings anymore, but know that LR comes prior to IR. Is it possible to reverse LR before reversing IR? I sleep well (even with two toddlers), I wake up better than I ever did (ever, even as a kid) and although don't get much organised exercise, I do a lot of incidental exercise.

    I am finding that my weight loss has slowed, but can see that my abdominal fat is receding very slowly without a change in weight (I'm 35 btw :-).

  48. Mike that rule is specifically for those who are LR and who have weight to drop. If you exercise before eating it immediately turns off all fat burning. So you want to exercise after your last meal to extend fat burning into sleep until you eat the next morning.

  49. @ efaitch It is possible to reverse LR before IR and that is precisely how I suggest type two DM should consider their treatment. Standard medical treatment in the USA is to treat IR and ignore LR. I do not advocate that at all because in essence you become and annuity for the healthcare system and have no hope of a cure. You must reverse LR and slowly IR will reverse. Eventually you can get off all your meds provided you have not destroyed all your beta cells in your pancreas.

  50. efaitch says:

    Thank you for that. It certainly seems that I've regained sensitivity – the clinical signs/symptoms that you refer to definitely seem to be non-existent.

    I also have another question about whether metformin would lead to IS quicker than without? FWIW, my diabetes is controlled on LC paleo without needing to take metformin, but my fasting BG is raised still. My concern is nutritient deficiencies that can be caused by long term use.

    BTW, I'm in the UK, so our healthcare system is slightly different.

  51. http://jcem.endojournals.org/content/85/12/4511.f

    Jack – Is leptin resistance defined in the context of high leptin or low? I've read the linked article and suffered with bulimia for 12+ years. It has gotten better on low-carb, but it is not gone yet and I'm trying. I've tried all other measures over the years with no success.

  52. I'm just confused because if leptin resistance is defined with lots of leptin circulating in the blood, why would those in the study with bulimics show low/normal levels? thanks for any insight.

  53. @katie it can be in both…..obese =high leptin, anorexia, bulemia are low leptin states but both are leptin resistant because they have high rev T3 and turned off their thyroids and have high cortisol levels. It depends upon the clinical scenario. It gets more complicated in those who were morbidly obese and those who were anorexic…….they may need leptin infusions to offset the loss of hypocretin neurons in the hypothalamus from years of damage.

    But here is the key point most miss. LR is not about the leptin levels at all. Its about a non functioning receptor that this protocol bypasses using circadian rythmns.

  54. GOOD luck with leptin injections. they dont get prescribed, and they cost a ton, and no doctor understands eating disorders

  55. You cant get leptin injections unless your in a research group…..so no worries there.

  56. I have a question: My reverse T3 is elevated, but my cortisol is not elevated in the evening, by blood and saliva tests recently. I have 15 pounds to lose that just won't budge even after eating low carb for 2 years and Paleo for the past year. My body fat is 35%. I am a 55 year old female, peri-menopausal and on bio-identical thyroid, progesterone and testosterone. With elevated T3 and normal cortisol, could it still be LR?

  57. The 25 carbs per day – does that include carbs from fiber? In other words, is it 25 total carbs or 25 net/effective carbs? Thanks!

  58. @ Reb…..If your reverse T 3 is up and you have 35% BF no doubt your LR. i bet you likely have pregnenolone steal at the same time……to get that result. 25 Grams is it until your Rev T3 falls and weight loss starts.

  59. Thank you so much! I guess that 25 carbs is total carbs and not net carbs. Lately, I have only been eating 80 grams of protein per day, split evenly between lunch and dinner – I have been skipping breakfast all together. I see that you say not to do that.

    I have been thinking that it was too much protein that was causing the high body fat, and that is why I have cut it down to 80 grams. (I am only 5'3" tall). I have never eaten more than 25 net carbs per day. I noticed that you said that people should eat 50 grams of protein within 30 minutes of waking, but that some people need less than that. I'm afraid that if I start eating higher protein, I will gain weight. By the way, I do not have carb cravings. I do, however have a huge appetite for a woman my size. I always feel like I want more to eat. I do not snack – I only eat at meals. I do not eat after dinner.

    I already lift weights (HIT), but I only do it once a week and I will start doing that after dinner per your suggestion.

    I guess my main concern is that if I increase my protein I will start gaining again. How is a person to know if they are one of the ones who needs less than 50 grams of protein at breakfast? Do you suggest that I just jump in and give it a try with the 50 at breakfast and then lunch and dinner without counting grams except for carbs to keep it under 25?

    Thank you again for your help!

  60. Stephanie Alexander says:

    I would be interested in your thoughts on this post by Dr. Sharma: http://www.drsharma.ca/obesity-why-hyperleptinaem

  61. Cameron House says:

    First I wanted to say thanks for a great and informative website.

    Second I was curious about the importance of eating first thing in the morning. Because of my work schedule this is kind of difficult. If I continuing eating breakfast approx one to two hours after waking and followed the other recomendations would I eventually get my leptin under control?

  62. @ Cameron House If you're trying to lose weight and want to regain your sensitivity this is how you do it. You cant try your way but if you dont see results I suggest you change your schedule. Leptin wont work around your schedule. It only takes a few weeks to start your weight loss program on the correct footing. This is said not to be harsh but I have gotten this question a lot. The reason so many are LR to begin with is because they let life dictate to them and instead people doing the things that are optimal for your health. This is a choice you have to make but there are no other options to get LS from a biologic stand point. Thanks for the kind words.

  63. Cameron House says:

    Thanks for the rapid reply and it didnt seem harsh at all.

  64. Thank you for sharing your hard work and passion. My son had a near fatal TBI and now has DI and has become severly overweight with tryglicerides in the 500's. He also lost a chunk of frontal lobe. He has great intentions but seems to have lost all self control. I am st a loss for how to help him lose this weight. I have had him on double dose omega three since two days after the accident. Any ideas?

  65. Shari that is unfortunate. Sorry to hear that. The injury you describe is an injury to the hypothalamus. The evidence is the diagnosis of the DI and the fact that his weight has gone up. He will need the help of neurologist who specializes in these injuries. Most often they are in academic centers in big cities. Most of what we recommend here wont help him much because it requires a functioning hypothalamus. You son may have to consider more aggressive options. You may want to consider putting him on a ketogenic paleo diet low in carbs until you get in to see someone.

  66. Poisonguy says:

    Hi Jack. I've been on your protocol for a week now and I feel good (and I'm losing weight, despite putting on muscle). Love the big breakfasts (was IFing before with lunch and dinner, and I'm finding two meals a day with breakfast and dinner more satiating despite the apparent lesser intake of calories). So, so far, so good. I've only got about 7-8 kg to lose to be at an "ideal" weight, but I'm wondering how long it typically takes to regain as much of one's leptin sensitivity as one can?

    As well, do you mind elaborating on the type of HIIT exercise you recommend? I've been alternating days of weights (body by science-type) and tabata sprints (in the pool). Both take about 10-12 minutes to complete. Is this sufficient, in your opinion?

  67. Thanks. My son is on long island about 20 min from NYC. Can you recommend a neurologist who thinks like you do? Thank you again.

  68. Shari I do not. Sorry. @ poison guy. If you only have to lose that little weight doubtful your leptin resistant. But eating with leptin principles will help you. What your doing HIIT wise seems good to me. I would not change unless you hit a stall.

  69. Cameron, I also have a difficult time with breakfast because I have to be at work at 5 am and my body absolutely does not want a lot of food that early. I also don't want to have to get up any earlier than I have to. What I have been doing on work days is to make a shake with 3 eggs, about 80g of half and half (I can't get heavy cream without carageenan, which I am sensitive to) and 45 g of whey powder (from trueprotein.com). This comes out to about 60g of protein with only 4 carbs (from the eggs).

    This only takes about 5 minutes to mix up and down so it's super quick. It tends to last me from 5ish to about noon.

    On non-work days, I get up later so I eat real food for breakfast on those days (eggs and tuna mostly).

    I've been a long time IF'er but feel absolutely amazing doing this. I haven't lost much weight yet but my energy level really went up, which is worth it in itself. It's actually a little embarrassing because I have been a "breakfast isn't that important" person for years.

  70. Cameron House says:

    A shake might be the best solution for me. Thanks for the idea Frosty.

  71. DrMommyN says:

    Dear Jack,

    A friend of mine sent me the link to your site as we both share a love of information on metabolism, thyroid, leptin, and gut issues. (She has celiacs and I have fructose malabsorption, and both of us hypothyroid). She was so excited because you seem to be the first to link all of this together. This has been fascinating reading, even though some of it will require multiple readings on my part.

    In this past year I have lost almost 70 pounds getting me to my desired goal weight. Before I lost the weight I had rather normal hunger and satiety signals. Now, however, I cannot feel satiety. I tested leptin levels myself recently (since my doctor said it wasn't useful information as there was nothing I could do about it) and it was 5.6 (normal range 1.1-27.5.) So this does not show LR (right?), yet my reverse T3 is high out of range which I thought was due to my thyroid meds. Everything I'm reading here is talking about high leptin levels, and I wondered about low normal levels and high rT3 and if it relates to my lack of satiety. Thanks for any insight.

  72. callaway7259 says:

    I started this week, trying to reset my leptin. I'm 41, 5'5"ish and 186lbs. I am also type 2. I've been following Atkins since Sept. 2011 and recently have started following a more paleo style of eating.

    I am able to get breakfast within 30 minutes of waking and I don't have trouble getting the 50 grams protein. However, I'm noticing that my glucose goes up or stays up from my fasting readings. I take no meds, just control the glucose with my diet.

    My breakfasts are usually sausages that we make at home from scratch or a shake made from coconut milk (unsweetened, a bit of splenda, and vanilla protein powder from Whole Foods (their brand). Is this to be expected? I had been told that too much protein would cause my glucose to go up and to keep my proteins at the lower end for my range (I try to keep it to below 100, but I find that I go over by the end of the day.

    Thanks for sharing this and your willingness to help so many people.

  73. @callaway First…….never use splenda ever. Change to Stevia ASAP. The protein will spike your glucose but that will change as your LR goes away. In someone like you I strongly rec you add MCT in coconut oils to your coffee. You really need to add more fat to your protein meal. Also Whey is incredibly insulinogenic. You need to avoid it. Dont worry about your proteins when youre resetting things. Eventually all will come down.

  74. Dr K – so whey or soy protein shakes are out? I know diddly-squat about these as I can't stand the sweetness but they do keep him full and off the snacks (a miracle in itself).

  75. SOY? Not fit for any human consumption. It is the most processed food and the planet has a huge effect on liver metabolism because it is a phytoestrogen. Whey is OK if you dont have excess weight to lose and dont have diabetes. It stimulates insulin release and I am not a fan of anything that spikes insulin. People who have great leptin function and good liver function and glucose utilization at their muscles can tolerate whey well.

  76. walter ebden says:

    jack can you explain why whey induces a blood sugar response when its just protein.Is it because it gets broken down quickly into amino s, believe egg powder is better or mixed cassenen ect. thanks wally

  77. walter ebden says:

    jack adding a half a cup of cream or coconut to say 50 grams of whey be ok for someone with say bf 6 percent that has lost 70 kg low carbing and is six foot six, thanks walter

  78. @walter. Whey is highy processed and allows for very fast AA breakdown. Most whey has a lot of BCCA and these cause huge spikes in most people. To test yourself use what I do for my patients. I have them eat a whey shake and then we check their BG with a glucometer at 15 min intervals up to 90 mins. In 6 yrs not one person has not showed a spike. Check your own and be a skeptic of my data. If your leptin sensitive and very fit you may not see this. I see very few people like this in my clinic. That tells me if you are fit you wont get degenerative spine disease. One of my core beliefs. I think at 6% BF you can eat anything really. But I think you should test your BG spike post eating. It maybe a wake up call for your N – 1. If you do please post what you found.

  79. walter ebden says:

    Thanks jack only using low carb over the last two has allowed me to loose 71kg life changing Jack never thought i was fat until i looked at photos lol. And Resistance training, I now keep carbs at about 40 grams max a day and start the day with whey and cream. Just didn't want to be spiking insulin with to much whey, thanks j will post results.

  80. DrMommyN says:

    Hi Jack,

    I've enjoyed reading your website, and comments you make on other low-carb forums. Three questions I'd love to have your comments on:

    1. Does a low/normal leptin blood test number rule out leptin resistance?

    2. Can you have a high rT3 blood test (ratio of 8 to free T3) from a different cause than leptin resistance? or is it more common to be associated with leptin resistance?

    3. Is lack of satiety tied to leptin resistance?

    Thanks so much! Looking forward to your comments.

  81. callaway7259 says:

    Jack, you were so right on with the whey…I stopped that, added coconut oil to my coffee, added butter to my meats and switched to stevia and the last two days I've had much better glucose levels. Is the stevia that's mixed with erythritol (sp?) okay. It's what I had on hand. Is liquid better than the crystallized stuff?

    • @ callaway Glad you tested for yourself to see why I say what I said. Congrats. PS not a fan of erythritol……use raw stevia. I buy it at Trader Joe's

  82. @ Dr Mom 1. Nope 2. Yes and it is more commonly seen with LR. 3. Yes……but insulin plays a huge role in disrupting nutrient partitioning at peripheral tissues. But to get insulin resistant you first must screw up leptin!

  83. I know you have offered a lot of advice/clarification on your recommendations, but can you be a little more specific about the ratio of protein:fat that you view as "ideal" for the 50-75 g. protein meal in the morning? Also, are you of the opinion that protein should be limited at all? In other words, as a short (62") female, if I eat 50 g. of protein for breakfast, should I make a conscious effort to keep the protein in remaining meals (yes, there is an "s" because I have extreme trouble with satiety) to a specific amount? Thank you in advance for your assistance.

    • 50 to 70 grams is a range for most people to use as a gauge. The key is if you are hungry you may need to go higher…..if your satiated you go lower. It's based upon your results. Everyone is different

  84. I've been searching without any luck to get a handle on what an "insulin spike" looks like. Is it 10-20-30points above fasting bg level? I was testing variious protein shakes to figure ou their effects. If my fasting bg is say 90, then goes up to 105, is that normal or a spike?

  85. Insulin has two post prandial spikes so it is possible this is your first one. The more fit you are from a leptin perspective the lower your insulin spikes will be.

  86. Will following the Leptin Prescription (and taking ample RX Omega3, leaving out O6 as much as possible) eventually end chronic pain and allow a full night's sleep? Since sleep is essential to regaining Leptin Sensitivity, will chronic pain prevent getting LS?

  87. Kaleein says:

    I'm getting it, Dr. K! I'm getting it! Keep writing!

    For 20 years, from age 8 to age 28 I was on 1 grain a day of desicated thyroid, based on symptoms my mother and my family doctor saw in me as a child. When my family doctor died in the late 70's I could no longer get thyroid prescribed, based on the "new" lab tests for TSH that all "good doctors" using "common wisdom" use. After all, my THS was in the "normal range" at 4, consistently. Over the years, after thyroid meds I became lethargic, isolated, and continually fatter despite many attempts at various diets. Over the past 7 years I developed extreme pain in various parts of my body, but mainly focusing in a painful hip that prevented good sleep and more movement throughout the day than was healthy.

    I've been eating Primal since March, turning Paleo, dropping dairy in June. I also finally was able to get desicated thyroid again to begin healing that part of me … I found an enzyme to help with the inflamation, and I'm almost PAIN FREE for the first time in at least 7 years! I discovered YOU and have been reading and reading and reading and applying your timing for food consumption. I even related when you said if you did NOT have insurance while beginning to suffer from many of the problems listed from Leptin Resistance! I've often thanked God for this, myself, as I forced me to take charge and research to figure out how I might "naturally" regain my health! Doctors who refused to listen to me and would prescribe anti-depressants and heart meds, but not the thyroid I knew I needed frustrated me and kept me away even the few times I worked where I had good insurance!

    Today at the age of 64 I have more energy and optimism as I feel healthier every day … moreso than I've experienced in such a long time I can hardly remember!

    I'm so thrilled God placed you where you are and has led you to "expose" the world to the biochemistry of optimal living!! Today's blog is really tying things together for me! THANK YOU!! Don't even stop pulling together your QUILT for us! I'm spreading the word for people I know who have physical challenges to come here and read, read, read!!! I get it!!

  88. Well you need to read the july 22 2011 post then because more of the leptin and interconnectedness is laid out there!

  89. Kaleein says:

    I've read that, Dr. K, several times and it's a little cloudy to me. That's why I asked twice about how a person who can't get enough sleep due to chronic pain is supposed to actually heal and get into Leptin Sensitivity. My eating habits and thyroid med, along with anti-inflamatory nutrients have relieved may pain, but I'm still not sleeping restfully every night … and I don't think sleeping pills are the answer. Moreover, I have a friend who is in chronic pain from nerve damage that she cannot get a handle on who never gets into REM. So until the cloud is lifted on what you are saying in that June 22 post, we wait patiently for more of your writings to help clarify. THANKS!

  90. Dr Kruse,

    My husband and I recently started the Primal Diet. He has lost 15 lbs since July 4th and I have lost nothing.

    We were told about your blog and the great information here.

    I am an E.R. Nurse and work nights, given that my work schedule is that I work every Thursday/Friday and every other Saturday/Sunday. How do I adapt the first meal eating schedule? Do I eat the big meal every morning regardless, or wait until I wake up that evening? I understand that my cortisol levels are messed up because of my schedule and that will effect my progress, etc. .

    I look forward to your advice.

    • @Liz. You won't like my reply. Quit your shift. You will never get optimal on a shifted schedule. Read my posts on sleep and leptin being yoked. Also on marks daily apples forum under nutrition there is a thread that has over 45000 hits and you would do well to read it and all my comments!

  91. Dr. Kruse,

    I would love to quit my shift, but it's just not possible at this time. I will read the nutrition thread there.

    Other than that, what other advice do you have in regard to becoming LS again?

    Thank You.

    • @LIZ If that is the case you should not expect maximum effects no matter your behavior. It will still help you but when sleep is not coupled to your metabolism bad things happen

  92. Kay Keister says:

    My question is it ok to use sf hazelnut torani syrup with cream in my coffee at meal times? Will that affect anything? This is my favorite way to have coffee. I used to drink throughtout the day but now just at meals.

  93. Kay Keister says:

    I am 5'3 110 pounds. I have small arms,lower legs,bony shoulders,hands,feet but I have belly,hip and thigh fat areas. My middle body I struggle with. I am 45,perimenopausal. Am I LR? I have beeen doing atkins eating for 1 year today. I am tweaking it to your way. Will that be safe for me? I am not over weight or diabetic.

  94. @KAy…….can you do it. Sure. But the question you need to start with all the time is SHOULD I do this. That answer is no. Use STEVIA. If you eat a paleolithic low carb diet using my leptin prescription you will see amazing changes. And Kay I would suggest you head over to Mark's Daily Apple forum under the primal nutrition part and read the thread over there people have started using my leptin reset. It has 350,000 hits and you will find huge amounts of real time data. Keep me updated to how you do. I want you to be a rockstar. I did it and so can you. But you must change the way you think and act to get there.

  95. Dr. Jack, when you say all nut oils are really not good, are you saying don't eat any nuts themselves except for macadamia nuts too? I had been buying mayo made with canola oil because I feel the same way you do about soybean oil but I didn't know that about canola oil too. Is there any safe mayo? I wish there was one made from coconut oil! I go through tons of the stuff. :)

  96. @ Colleen only nut oil that is OK is macadamia nut oil. Its so expensive most people pass on it. But it is great to make mayo. I think you use EVOO to make your own mayo. Homemade mayo is too easy to make not to make it. If you are eating canola mayo you are filling your brain and body with PUFA's which are one of the main causes of all neolithic disease. It must be cut out. Also PUFA's cause leptin resistance over time because they are pro inflammatory and lead to an increase of TNF alpha. Not good at all. Now as for nuts I only eat macadamia's or pistachios…….and this is only done when I cant eat a meal for any reason. Nuts have too high a PUFA content for my money.

  97. I recently started the leptin prescription but have noticed after lunch i get cravings for snacking

    what do i do? thank you much love your program!!!!

  98. Great info, thanks so much!

  99. Dr. Kruse, I have been eating paleo for a year now. I had been on low calorie diets since I was 15 years old because I had gained 40 pounds for no apparent reason. I have low thyroid with high reverse T3. High night/morning cortisol. I like what I am reading and thought that this would be a good thing to follow. Since starting the leptin way of eating, I have gained 2 pounds. I would rather loose body fat, but my clothes are getting tighter. I feel better on 3 meals a day and I don't always think about food eating this way. Can you explain why I am gaining weight and what should be my plan of action. I like to know where I am going so I can have a vision. I have been wondering if it could be the ratios of protein/fat or too many/too few calories causing this weight gain?

  100. @Maria Means you're not eating enough fat or protein at breakfast. Load it up until cravings and hunger go bye bye. It will happen.

  101. @KAmi…..give it time. It took you decades to get this way. The Leptin Rx takes 6-8 weeks. Stay on it and follow all the rules and prepare for change.

  102. walter ebden says:

    Dear jack I am 44 male have been over weigt most of the time prob by 50 kg or so six foot six, Have over the last two years lost 70 kg and bf now 5 percent. At my heaviest never had high blood sugars ect and hn1c was always very good. I would now think I have leptin sensitivity, I have neropthey in both feet whats your best bet that caused that as huge people fat people don't always get it do they. Apart from continuing at 5 percent body fat is they anything i can take medicine or natural to stop this progression. Thanks Jack wally in Australia

  103. Dr. Jack, on the MDA forum you said someone with cancer should eat tons of broccoli and certain spices. What spices? My best friend has ovarian cancer and my husband just had his prostate removed from aggressive prostate cancer.

    I'm following you everywhere. :) I think I'm going to blog about this. I'm telling everyone. I'm a romantic suspense author and have some healthy social media numbers. We've been talking about it over on the hcg forum as well and many of us are big fans of yours.

  104. Dr. Jack my question is while doing the leptin Rx what foods should we refrain from? What about cheese? and nuts? thank you much!!!

  105. LSSeeker says:

    Dr. Kruse:

    Thank you for being a trail blazer! I've read lots of your blog and have been following here. I have some specific questions I hope you have time to answer.

    Myself: 39, overweight since a child, yo-yo dieter, currently 132lbs (5'5), medium build/bones, "apple" shape, three months ago started Atkins and down 10 pounds. Had been up to 180lbs, but managed to keep atleast 20 pounds off in the last 15 years. Had always been experiencing nighttime cravings and later poor sleep. It seems to me, without testing, that I'm leptin resisitant. 17 days ago started only the timing/no snack aspects of your protocol. 11 days ago started the 50g at breakfast and low carb paleo (25+total carbs and no dairy/legumes). I'm enjoying the clairity and freedom from no snacking. I just started heavy lifting two nights ago. Had been active running and lifting previously.

    Husband: lean, 6', 170lbs, carb man, nighttime snacker, during time of stress up to 185/190lbs, hair thinning, 37 years old. He has also been working on getting in more protein and no snacks. He's feeling better and dropped a couple of pounds.

    Questions:

    1. We haven't done any tests. We've decided to start the protocol anyway. If we were already LS and were following the protocol, what would be the symptoms/experiences we would have? What would happen to tell us to stop and just eat a low carb Paleo diet?

    2. When we become LS, we should eat a low carb Paleo diet. What aspects of the protocol should we incorporate once LS, if any? I know you continue to follow the protocol by choice b/c of decreased hunger, etc.

    I am so ready for good sleep, firm body, freedom from food cravings, and all of the other great aspects that have been mentioned in this blog. Can't wait!

  106. @Maria……I would try to refrain from both for the first six to eight weeks. Both are partially ok but if you have an issue with leptin both foods can slow the reset

  107. If you're LS already you would have no hunger or cravings at all and you would sleep 7.5 hours soundly and arise without an alarm clock. I have lived this way everyday for five yrs now. You're husband does not fit the bill based upon what you described and I'd be willing to bet you his DHEA level free and total testosterone and vitamin d levels all would show it. When you get LS you can eat any style paleo diet you want but it should be a Paleolithic diet. My personal choice is a vlc paleo diet but that is what works best for my epigenetic switches.

  108. Colleen…….I wrote a blog a while back dedicated to a good friend named Mary……..about what to do with a newly diagnosed cancer. Search the archives for it under oncogenesis levee on the front page. I think this will be what youre looking for

    Here is the link….. .http://jackkruse.com/what-to-do-with-new-cancer-diagnosis/

  109. THanks so much!

  110. LSSeeker says:

    Thank you for your response.

    The 84 year old patient with a six pack has a way of being memorable. I want optimal and the six pack. If anyone can reach that, I need to do what? I'm following the protocal, not eating dairy (except cream), legumes, nuts (except pistacios/macacdamian), and fruit. Just started heavy lifting. Once I get LS, start the sprinting? If I don't run into any hormone issues, is there anything else? VLC equals how many total carbs? I want what I haven't had all my life.

  111. @LS. You can titrate up carbs and sprinting to see how they effect you. I find that the more active one is the more carbs one can tolerate but let me give you a side of the story few in the paleo world have considered. If you begin you quest fat or thin and you have an unknown high 6/3 ratio the more you exercise the more turnover of cell membranes occur. This liberates your current sixes in those membranes and can make you feel bad when you change your life style. Many call it the low carb flu……I don't. I find this happens for two major reasons…..one I just mentioned. Two is because the abrupt change in carb reduction effects the serotonin production in the gut and the storage in the brain that can lead to serious mood changes. When this occurs I usually add 5 HTP to their regime and serially monitor them. There is also the simultaneous issue of RER due to sugar and lipid oxidation in our bodies. Most of my patients get a start off omega six three ratio to see where they are now……and most can't believe how bad their numbers are even eating paleo. It takes three to four years to reverse a bad 6/3 ratio and you must be diligent. Your health however changes dramatically then!

  112. LSSeeker says:

    Lots to consider. Thanks a bunch. Time to look into the lab test for 6/3 ratio.

  113. I am so glad you decided to blog about this really important topic. I am quickly improving by following your advice.

    My own experience with thyroid troubles led me to a long search that finally ended up in the low carbosphere. With the majority of my questions answered through Jimmy Moore's podcast. I am still in shock and sometimes still have a hard time reconciling all this new information. Your writing is piecing it all together for me.

    I was diagnosed with hypothyroidism a few years ago. I did not have many of the classic symptoms, but my TSH was through the roof, and the endocrinologist I was using was somewhat puzzled with me. One of my most debilitating symptoms was/is insomnia. As far as the doctor was concerned my insomnia had nothing to do with my thyroid condition. He put me on synthetic replacement and I had a really hard time with it. I was on the lowest available dosage and quickly became extremely skinny, sick and hyperthyroid.

    I am not currently medicated and still have a few symptoms, insomnia being the worst, but many other symptoms have balanced out or disappeared. Because I am not medicated I can quickly assess how correct dietary advice is because my sleep pattern responds positively or negatively really quickly.

    The low carb lifestyle, that I now truly embrace, just did not work well for me. Now I know it wasn't the food, it was the timing. So I am easing my way into all your recommendations. The one rule that I don't deviate from is the timing of 3 meals a day. I might start blogging about my experience following your advice

  114. Misty Williams says:

    Hi Jack,

    Love your work here; very exciting to see you weave so many areas together.

    I am a runner … I run half marathons and have been running for about three years. I have watched my body completely reshape itself and have become pretty fit at 36. While most people would characterize my body type as "average," I carry weight along my lower abdomen (and have my whole life). I've been fortunate to enjoy good health all of my life, though I recently had surgery for removal of an endometrial cyst on my left ovary (ovary was removed, too), which has heightened my "focus" on being as healthy as I can be.

    I had a bunch of tests done after the surgery, and it appears my liver and adrenals are both fatigued. Been taking supplements to improve their health … of course, this seems to tie in to the Leptin challenges you've described. Your eating program sounds fantastic and resonates with me on a lot of different levels (not the least of which, I HATE trying to eat 5-6 meals a day, which has worked for me in the past … who wants to think about food that much?!) I'm starting your program tomorrow (which is keeping me up late tonight! :) ).

    The main concern I have is about my running. I love it. I don't want to give it up. Long training runs are always done in the mornings (8-15 miles). I have traditionally run in the evenings mostly, but about a month ago, I started making an effort to get to bed between 9:30 and 10:30 pm to align better with nature, wake earlier, etc. Now, I'm doing all runs in the morning (3x a week now, 4x a week in the fall).

    Do you have recommendations for runners re: incorporating training runs into your program? Are morning runs couner-productive? Tolerable? Any useful thoughts? I really want to to be as healthy as I can be … LOVE your blog!

  115. @misty. You may not like what I am going to say! You need to find a new exercise than endurance running. It's likely the cause of the liver adrenal issues. Endurance exercise increases cellular stress so I only advocate sprinting distances. I do twenty forty yard dashes and tell my runners not to go over four hundred yards atma time. So I think you love of running is a problem. You need to get involved in more HIIT training in my view

  116. Misty Williams says:

    ACK! You're right. I don't like what you said. LOL! BUT … I'm going to explore this with my doctor, have him run some tests around this. Are you suggesting there aren't ways to provide extra support to liver / adrenals so one can keep running? I've noticed SO many improvements physically and in the quality of my life (improved sleep, stress relief, athletic endurance to enjoy a lot of other activities, mental clarity, etc); I don't want to throw out the baby with the bath water.

    • @Misty…….Let me be clear……I will never advocate endurance training of any kind period. When I get to stem cell depots you will understand why. You can still run but you need to change distance and intensity to sprints in my opinion. You also need to add short heavy lifting to your routine with some resistance stretching or yoga. That is optimal for long term health especially when we age. It will also get rid of that pooch you complained about…….while long distance running never will.

  117. Cameron House says:

    Jack, another question

    What level of Omega Three supplementation do you recommend? Currently I am doing a .25G Per 10 Lbs ala Robb Wolf.

    Thanks

    Cameron

  118. @Cameron……depends upon many factors. Weight, body comp, and omega six three profile and the HS CRP level. I don't advocate a one size fits all dose. It must be done in context with the clinical picture of the patient.

  119. Hi Dr. Jack, i weigh 165 am currently on day 6 of leptin rx can i do pilates or what form of excercise do you suggest, i still can't answer yes to all the question you ask. thanks Doc have a great weekend :)

  120. Kay Keister says:

    I bought stevia packets today. Going to try the switch. I also bought Lipton green tea bags Orange,Passion fruit & Jasmine. Are the flavored green tea bags ok and can I drink this between meals too? Do I limit 3 stevia packets per day? As sweet as stevia sounds I doubt I would use 1 per day. I will try to drink the tea plain but if not will add small amt stevia. I have not had this before. Should I do this is my question?

  121. Stephanie says:

    Jack – thanks for all the great info you are making available. I have been applying your prescription but am noticing a rise in my fasting blood glucose. It was generally between 88 and 94 and now is regularly over 100 but below 110. This has happened to me before when I changed my diet to such a low carb diet. My fasting blood glucose seems better when I am consuming 70-80 grams of carb per day (no grain, limited fruit, etc.)

    Do you have any suggestions or potential explanations why lowing my carbs raises my blood glucose?

    Thanks!

    (FYI – still obese at 200lb, 5'7" female, 45 years old, down from 264 following primal eating)

  122. Kay Keister says:

    Can I drink this flavored green tea with stevia between meals?

  123. Grammasmitty says:

    You made 2 comments above that I would like clarified if you would please. In one place you said "Once one eats it immediately turns off fat burning" then later you said "If you exercise before eating it immediately turns off all fat burning" and therefore exercise should be done in the evening. I am wondering, which is it, or is it both?

    THANK YOU for ALL the information! It is helping me restore my health!!

    • @Grandma. It is both. THe real point is you don't want to exercise in between daily meals so that is why does the exercise post dinner. The reason after dinner eating is preferred is you have 12-14 hours to go until your next meal so it extends night time fat burning if your liver is working well. And eating like this repeatedly it will begin to work well.

  124. Cameron House says:

    Thanks for the answer even if it wasnt what I was looking for. I know you are anti chronic cardio but what do you think of a lot of long slow like Mark recommends?

    Thanks again

    Cameron

    • long and slow is better…….than long and fast. But long is the bigger issue. Long allows the guardian of the genome, p53 gene, to become "lax" and it allows us to use our stem cell depots quickly. Once you use the reserves you have no triple A team to go get replacements and you die early healthy with organ failure due to autophagic failure. Not my idea of optimal. Elite athletes think only of performance and not of longevity. People pay me to think six steps ahead. That is why I post this stuff…….to get you to think maybe even conventional paleo advice is not too bright at times………

  125. Cameron says:

    Cool Thanks

  126. @kay- sweeteners trigger sugar/food cravings for most people. I've had great success with this leptin protocol, but don't add any sweet taste between meals. I talk about it at sugaraholics.com, for more detail.

    I'll weigh in here. The reason cravings comeback is because we have leptin receptors on our tastebuds. So when you use an artificial sweetener it cause an insulin spike even when no carbs are present. Not good.

    Dr. K

  127. Jack, I am overweight by more than 30 lbs. Have been diagnosed with Hashimotos and dealing with menopause. I noted that you indicated no butter if dealing with auto-immune disorder. Are you suggesting no dairy at all if dealing with auto immune? If so, can it be added back in once the LR is resolved?

  128. Dr. Kruse do you have any comments about adding large amounts of gelatin/glycine to the LS regimen? I currently take between 30-45 grams of powdered gelatin with 40 grams of powdered glycine divided throughout the day. I make sure one of my drinks is an hour before bed in a hot drink. I think I have been sleeping more deeply since I started this and so don't want to remove this from whatever plan I do. I believe that bone broths(high gelatin and relatively high glycine are pretty good Paleo food?

    I'll make sure there is no cream added from now on except for mealtimes. I feel good on this but I would like to fit it into the LR Prescription, which BTW, was how I was raised to eat as a child. Especially rules # 2a, 3a,b,c,e and g. I wish I had kept to that pattern for the last 20 years, I could have avoided gaining these 70 pounds. BTW, would the glycine supplementation reduce the insulin spikes from insulinogenic proteins like whey and eggs? I had read a research article where it mentioned "glycine supplementation reduced the total increase in blood glucose by a remarkable 50%. Importantly, this channeling of the glucose surge was not accompanied by any increase in insulin levels, nor did it push fasting glucose levels down into hypoglycemia". The link to the article is broken so am unable to link for you. Thanks for any thoughts you may have on this.

  129. Q1: Can you use rice protein for a shake?

    Q2: My labs only show TSH, T4 Free, T3 Free, T3 Total. There's no reverse T3. Is this something special that needs to be ordered separately.

  130. I don't understand. All I've read online about leptin resistance relate it to high fat diets. Can you explain?

  131. You seem to relate it to carbs. Also, doesn't fasting shoot up leptin, inducing resistance?

  132. Thanks for answering Q2.

    Another question: Q1: Can you use rice protein for a shake?

  133. Thank you – I'm trying to search your site for recommendations for ingredients for protein shakes. I'm staying away from soy and whey due to allergies. What other options do you recommend?

  134. Dear Jack,
    Nine days ago I began eating more protein at breakfast. On the third day I was able to not snack and lost all cravings and hunger! Terrific! I am also sleeping very soundly. Unfortunately, I’ve gained more than 5 pounds in this past week (after losing 70 pounds this past year), but I decided not to weigh for now as I realize unless I become sensitive to leptin my weight maintenance will not work long term. I am VERY HAPPY to not be hungry for the first time since February when I reached my goal weight. However, I have no sense of satiety or fullness.
    Even after eating 50, 60, or 70 grams of protein, I feel -unlike everyone else I’ve read— NO satiety or fullness, as if I could eat the same breakfast all over again. I have only ran across one other person who has this problem, and she has not figured out an answer either. I’ve tried drinking several glasses of water 15 minutes before my meal, not drinking during or 1 hour after a meal, chewing very slowly and thoroughly, taking 45 minutes to eat, taking 9 g of fish oil over the day, eating high volume foods, etc. I still cannot feel satisfied. So the questions:
    1.) Is leptin responsible for satiety as well as hunger? Or is that the function of CCK?
    2.) Is it likely that some satiety will come at a later point during the 8-week reset?

    The simple solution is just to eat what I’ve planned and be done. However, even after months and months I frequently find myself eating too much at a meal because there is still a real drive to feel satiety. All said, I am counting my blessings that I no longer have hunger or cravings between meals!

  135. Thanks for everything on this site.

    I’m three days in to this LS recovery program. I’ve been lower carb for six months. I’ve noticed several times in my life changes in sweating associated with decreased mood and weight gain. I’m hopeful the is my answer.

    In the past when I would LC diet, my sweating would change and my mood improve. Along with this my nose would itch and I sneeze periodically. Interestingly I noticed the itchy nose/sneezing thing beginning last night. This (oddly) always happens in association with improving mood.

    Any idea if a histamine response could be associated with LS recovery?

  136. Jack: First, thank you for all of your work. It is outstanding and I bow to your compassion for people.

    My question: how do you feel about yoga during the leptin reset? I'm not more than 10lbs over being 6% BF. My main thing is trying to fix my energy levels after working a few years of rotating shift working and still not feeling right; and also recovering from 5+ years of intense endurance training.

    When I say yoga, I sometimes do Bikram yoga, and sometimes more gentle, classic hatha yoga. Do you recommend quitting even that for a while until the energy levels return to where they should be and I'm not waking up tired?

    I'm working on the protocol you laid out. Prior to that I was doing more of the IntFasting type…eating paleo-ish, but only from 12p-8p each day.

    • For you case I don't think you need a reset. I bet instead your problem may lie elsewhere. At six percent BF you can do yoga. You are the kind of guy I bet has a minor hormone issue or a transmitter issue. My next blog post will be on transmitters……I was going to load it today but the comments at SG site forced me to post today's blog! Thanks for the kind words.

  137. Thanks Jack. As it turns out, last year I had a cortisol saliva test done when I was working with a naturopath. I looked up the results and I had low-cortisol in the AM and above range cortisol starting at 4pm and getting worse into the evening. I also had problems with my melatonin, serotonin, epinepherine, and norepinepherine…basically all my hormones/transmitters were out of whack. At the time I was still running 40+ mpw and eating a vegetarian/vegan diet. I somewhat dismissed the doc's recommendation to eat more protein and stop endurance activity. I eventually did both in the fall, but I never connected it to the tests…until now. Really looking forward to your next posts.

    For me, it's all about my energy levels and better health. I feel like a worn out shoe most days.

    BTW – I'm probably 8-10% BF. 6'4", 180lbs. Recovering runner, so I'm not that muscular…getting there tho ;)

  138. Leelannee says:

    "Whey is OK if you don't have excess weight to lose and don't have diabetes."

    I'm reading over this thread and am wondering, since soy and whey are out, what is a good protein shake if one is diabetic/overweight? Do you recommend egg protein powder…or only fresh raw eggs? Or plant protein, like hemp or pea?

    Another non-whey, non-soy protein that comes to mind is gelatin. It is considered to be an incomplete protein but I have also read that it is helps with satiety and lacks the amino acids that may contribute to aging. I sometimes add a spoonful of unflavored gelatin to my shakes or soups.

    Thanks!

  139. Leelannee says:

    Hi, quick update–I've been on Metformin for about 3 months and have had the famed side effects the whole time–including very painful intestinal cramps(just for a few seconds per day). I started the big protein breakfasts last week and on the very first day, both the pain and the frantic running to the bathroom 10 times a day STOPPED. ENTIRELY. Just wanted to let any other Metformin users know!

  140. @LeeLannee Thanks for adding this for others to read.

  141. Dr K, Thank you for your dedication to allow us to make changes for optimum health. You are a godsend!

    I have some questions for you about transitioning into the leptin reset and beyond.

    About me, I am 40 year old female, 5'6" athletic build. Average weight over past 10 years has been 145ish. Generally healthy, I was diagnosed with hypertension 8 years ago and take Diovan 80mg which controls it well. I also take Loestrin birth control pills continuously which suppresses my periods.

    Family history, brother died 3 years ago of a brain tumor at 41. Sister has type 1 diabetes since age 9. Mother had noncancerous esophogeal tumor which resulted in her esophagus being removed.

    I am presently doing HCG to take off 10-15 pounds (again). I will be beginning the LR immediately upon cessation of HCG. I have read your comments about HCG and transitioning into paleo style eating after HCG.

    I don't know if I am leptin resistant but I love the philosophy behind your recommended style of nutrition and timing. It makes sense to me. (Not that I understand everything-but I will continue to read, read, read!) I feel like the reason I continually regain those last 10 pounds is due to snacking and excess carbs.

    One comment that you made was about avoiding dairy when transitioning from HCG. Does that include heavy cream and butter? What about greek yogurt? Fruit?

    How many carbs should I aim for during the leptin reset if I am at my goal weight?

    What about beyond the LR once I have confirmed signs of becoming leptin sensitive?

    In regard to exercise, should I wait until leptin sensitive or can I begin right away if I don't need to lose more weight? I am already a fan of HIIT and short heavy lifting sessions. How many times per week for each?

    I had blood work done last in December. My total cholestorol was 214 ratio 2.5, Triglycerides 78, TSH 1.550, leptin, serum 2.8, bun/creatine ration 20, vitamin D 34.1.

    What kind of labs should I get moving forward?

    Any suggestions for supplements?

    Anything else you would recommend?

    Again, thank you so much for all you do. I will be anxiously awaiting the inclusion of any resources that you may make available in the future that may allow for more intimate consultation with you such as the ones you had mentioned you were working on.

    I will be happy to share my experiences. Thank you!

    • @AKgirl. If your at your goal weight eat carbs. But I would do it post work out. Do I put a limit on carbs in this case? No I dont. Every person is different. I have some patients on 800 grams of carbs a day and others on zero carbs. It depends upon labs and condition. If your LS you can push the HIIT huge as long as you dont overtrain to raise your cortisol. You ask me how I do it……i test. I know I sound like a broken record but I am a tester. I will have many blogs coming that will answer some of the others.

  142. Leelannee says:

    PS–After months on a high fat/mod protein/low carb diet I get full on a smaller amount of food. Eating enough eggs & meat to reach 50g protein leaves me uncomfortable and lethargic for hours. I can eat enough food to get 30-40g, then I take liver tablets to make up the difference–5 (of the brand I'm taking) have 8g protein, equivalent to a jumbo egg.

    Still hoping someone can get back to me on a non-whey/non-soy protein powder or shake…thank you…

    • @LeeLannee you can use whey as long as it does not make your insulin go thru the roof. Buy a glucometer, eat whey and check you blood every 15 minutes after the whey for an hour. You will then know if you can eat it.

  143. Leelannee says:

    Whey DOES make my blood sugar go up.

    I read through this thread and you recommend against using it, especially if diabetic or overweight. "Whey is incredibly insulinogenic. You need to avoid it." Re. your patients: "In 6 yrs not one person has not showed a spike."

    Sorry; I don't mean to be a pain or take up too much of your time, but a few other people on this thread asked what you recommend for protein shakes besides whey, soy or rice and if you answered, I can't seem to find it. Thanks again.

  144. Thanks Dr K. I look forward to your upcoming blogs.

    No special advice for coming off of HCG?

    Still do the 50 grams of protein within 30 minutes though right?

    Exercise ok in the am if I am at goal?

    Cortisol test? Any others?

    Can I get on your waiting list for up coming long distance out patient services?:)

  145. Leelannee says:

    Thanks so much!

  146. I'm confused. The protein intake for breakfast is like 2 oz. That hardly seems like enough for an adult. It's less than a quarter pound hamburger. It's 2 eggs. Did I miss something? Is there anywhere to go for menu suggestions? Are there any guidelines for amount of protein at any other meals? Thanks for your help.

  147. Sorry for the previous post. I was weighing the egg not considering the other components besides protein. I retract part of my comment. But I would like to know what others are eating at breakfast and if there are any guidelines for protein for other meals. I have a ton of weight to lose; have carried extra weight for over 20 years so I know it will take a while to come off. So far have shed 20 pounds but it took about a year. I started Crossfit training yesterday. I want to be in shape to keep up with my husband when we retire and begin to do more traveling and adventuring. Thanks for your help in advance.

  148. Leelannee says:

    There are a few threads on MDA w/people who have been doing the "Leptin Reset" for a while, with suggestions for breakfast…Dr Kruse answers a lot of questions over there, too.

    http://www.marksdailyapple.com/forum/thread32345…. http://www.marksdailyapple.com/forum/thread32655….

  149. Dr. Kruse,

    I've asked a question about our son and what should he be eating. One important part I left out and now want to know if it changes your previous advice. You suggested paleo diet with 150gms and lower it by 20gms until he feels good. He was breastfed close to a year, I have two brothers with schizophrenia, and my mother was sick most of her pregnancy with me. He's ten now, but when he was three, he had three grand mal seizures in a day. He went on the lowest dose of Depakote and after a year, his EEG was normal. No problems since then. Does he have a "bad brain" and need the ketogenic diet or does the 150gm/day and lower it as necessary still apply? Thanks.

  150. Dr. Kruse

    Firstly what you are doing is amazing, your knowledge base is truly vast.

    Secondly I have history of anorexia, bulimia and overexercise. I am overweight slightly now with a soft body and cellulite. Should someone like me try this leptin reset or do i need further help. I went to a dr. and had low testosterone, vit d and iron. I am supplementing them and i am seeing a hormone specialist tomorrow who suspects i have adrenal fatugue and leaky gut. Do you have any recommendations for me? This is costing me a bit of money to see these people but i am desperate to get better. I also over the last 3 years and dry brittle hair and nails, poor wound healing, headaches and fatigue.

    i really hope you can offer me some advice – i have always resisted seeking advice but now i know i need it and am determined to get on the right track and have a fit, toned, energetic and healthy body.

    Thanks!

  151. Dr. K, if weight loss is not a need for me, but resetting the leptin is, can I get away with working out in the morning 3x a week, eating after that workout on those same days?

    • You can certainly try it given your specific situation……but remember fat burning is turned off as soon as you eat because insulin spikes and turns burning off at the muscles. This was made clear in my why is Oprah fat blog. Since you don't need to shred weight I think you can do this and evaluate it.

  152. So should I just not eat until lunch on those days I exercise extremely early?

  153. Scratch that. I answered my own question. :) Thanks!

  154. Dr. Jack – I've read where you've stated PCOS is 100% reversible after becoming LS for 12-18 months. We just need to find a doc that u/s the way hormones work with the metabolism… Do you have a specific regimen you use for PCOS patients, i.e., recommend Metformin, Omega 3 fish oil supplement, progesterone, Armour thyroid and how do you monitor, balance these with the leptin plan. As one becomes more LS – should the Metformin be reduced. There are no words adequate to express my gratitude for your work!

    • @ Kelly C I treat PCOS in many spine patients because most have serious spine issues like bad discs or DJD and osteopenia. This is why they come to see me. I don't see regular PCOS people unless they come into to my Optimized Life program which is completely separate from my spine practice and quite steep cost wise.

  155. Dr. Jack – Thanks for your reply. We've been through several doctors in the area and are quite discouraged with the standard health care treatments. You have seen PCOS symptoms reversed after a patient stays LS for that period of time? Your Leptin Rx lifestyle would be a much improved life over the PCOS symptoms brought on by the SAD!

  156. Also, do you have a recommendation for a 9 year old boy – to improve leptin sensitivity – does your Leptin Rx work for kids too? (He was not breastfed.)

    • @ Kelly C My 9 year old daughter started this last yr. She is now ten and she is fine. We don't even bother telling the pediatrician about it because its not worth the time to argue.

  157. Dr. Jack – Great, thanks so much for the information – love to have the whole family on the same plan. Both my daughter and I have done 3 rounds of hcg. While we have been successful on it, we know it is not long term. The more I read your information the more I am convinced it is the leptin that catapulted our weight losses (and as you say, the hcg uncoupled the leptin). Which gets me excited to thinking about the long term lifestyle benefits of your leptin rx. A big bonus is we get to eat this time :) (This is oversimplified I'm sure, but the way I'm thinking about it now.)

  158. Dr Jack, Thank you for this website, it is extraordinary! I am a severely type 2 diabetic taking insulin (large amounts daily of fast acting, the long acting does nothing) and of course obese, 64 yo female. My question is that I need to take around 30-40 units insulin at bed-time to have any possibility of control over waking glucose, so does this completely negate any possiblity of improving leptin resistance. How does someone taking so much insulin daily ever overcome the leptin/insulin resistance problem. It would seem that there is probably exogenous insulin circulating in my body all throughout the day as it is the only way I can keep any semblance of glucose control, even on a very low carb diet. Your website is giving me some fresh hope.

    • You need to do two things. Eat a VLC paleolithic diet and follow the leptin Rx. Go buy Robb Wolf's The Paleo Solution or Mark Sisson's Primal Blueprint. This details the foods you should eat. The Leptin Rx documents how you eat those foods. I can not stress to you enough that you need to stop eating all carbs especially wheat and fructose ASAP. And you need to make coconut oil your number one diesel fuel in your diet. If you do this you will reverse your diabetes. But you can no longer afford to listen to the dietary advice given by the UK authorities. We have the same problem here in the US but your healthcare system puts your health at a premium because it rations care.

  159. Hi Jack,

    thank you for the great post, I am definitely going to try this. I am doing a strength biased CrossFit type training and normally work out midday. You say that this should be done after 5 pm, which is fine. But that would mean I should eat dinner before that (due to the 5h before going to sleep). Is this what you are getting at or should I use the higher tolerance for glucose in post training and eat my dinner then?

    Keep up the great work and warm regards from Cape Town,

    Roland

    P.s. I am happy to share my experiences should you be interested.

  160. thanks Doc, I know what you say to be true. Its turned me from a 275 pound fat man into a 171 pound healthy man with visible abs muscle.

  161. Hello Dr. K,

    We (Hubby and I) are going to start your Leptin rx next week and I have a few questions before starting:

    1) Do you feel that it is OK to have raw kefir (that is fermented for 24-48 hours to get rid of the lactose/carbs in the raw milk) during the Leptin rx?

    2) What about raw cottage cheese?

    3) What about raw cheese in general?

    4) Is NO FRUIT allowed during the Leptin rx even if it part of your 25-50 carbs for each day?

    5) How do you feel about incorporating raw milk back into your diet after your regain LS and begin lifting weights and doing HIIT?

    6) Once you achieve LS and you are regularly lifting weights and doing HIIT, can you EVER "splurge" or have have dessert/high carb food for a holiday, special occasion, vacation? Not trying to be a rebel, just curious because I want to be able to live life too…but healthily.

    Thank you so much for all of your information. Your story is very impressive. I appreciate your scientific approach. I am sure I will have more questions…Take care!!!

  162. I work overnights, and find working out and eating patterns to be difficult to work out for the paleo lifestyle. Any suggestions? I am eating now at 1700 before work, then again at 0200, but not sure if I should be eating the same amounts as i normally would for a meal at 0200. Also, when is the best time to workout on those nights? I'm off work at 0730. Thanks for any info you can give me!

    • @Jaime and @ M&M…….You need to read the Leptin FAQ blog post to see why your in trouble. The answers to your questions are in that post. And Jaime, Its not going to change until you change your hours. Raw dairy usually spikes insuloin way too high for a reset.

  163. Kay Keister says:

    Sunday Sept.11 will be 8 weeks doing LR. I have increased energy, calmness with dealing with people/stresses,sleeping well,no water retention,my body has heated up. Nails and hair growing/appear healthier. Skin improved. I have a tightness/achiness in legs. I have gotten a few cramps at night. Do you recommend magnesium supplement for this? If so what dose. I do drink chicken or beef broth when I get the cramps–an Atkins recommendation. I bought Primal Blueprint and eating more wholesome foods. I have given up sf items and artificial sweetners except stevia with green tea and lemon juice. I am drinking coffee with cream/coconut oil 1-2 times daily. I am not sure what supplement I should take. I am taking a multiple vitamin that supports glucose metabolism, I am taking fish oil capsules after my 3 meals. I have cut out snacking and sometimes have skipped lunch about 4 times. I always eat breakfast. Not eating or drinkinng after dinner. So easy does not seem to be a problem. Does this mean my Leptin has been reset? I actually don't crave sweets as much as good meat,veggies or fruit. I think I really where the sweets will end up. This is an update on how I am doing. Any further advice. I also read Mastering Leptin by Byron Richards. I am doing some weight exercises for arms, walking alot and quad exercises. Thanks for any additional assistance you can give me.

    • @Kay no way to know for sure without testing. I do think you could consider adding some Magnesium malate at night time. 400-800 mgs would be the range to shoot for

  164. Kay Keister says:

    Just wanted to add I am 5'3,105 lbs. I lost 5 lbs since July 24. I am not wanting to lose more weight but get lean muscle mass. What exercises would you recommend? I will do them after dinner meal. Thanks again,Kay

  165. Kay Keister says:

    I have 23% body fat. Fat mass 24.5 lbs. Fat free mass 81 lbs. 56% water. BMI 18.7. Are these good numbers? We have a wellness coach where I work that comes monthly and will give numbers to me. Total body water 59.5 lbs=56% water. These numbers are from 8/29/2011. Are these good numbers??? I would like to have even less body fat esp. hips/buttocks/thighs but hopefully increase in exercise will help with that. What is the lowest safest body fat % for ME?

  166. Hello Dr. Kruse, what can i take if I have candida? I am on the reset going on my 8th week now, I cant take this itchness any more help please. Thank you Dr. for your time.

  167. Silver Angel says:

    Maria, I did the reset for 5 days (fully) then 90% for another 10 days. I lost 3 kilos, and my candida is much improved, no itching, have had it for at least 20 years. I gave up mushrooms. Here is an excellent site to see if you are eating any of the things you shouldn't. I am going back on the reset full time when I organise my financials!

    I was having 4 – 5 egg omelette with avocado, ham or bacon or chicken breast. Kept me full for 5 -6 hours. Chicken breast for lunch with steamed veg,same for dinner. Only thing I missed was cheese/nuts. link here for site:-
    http://www.candida-albicans-cure.com/natural-cand
    I love Dr Kruse……feel better than I have done for years. Looking forward to going full time again.(when I have some money!)

    Thanks Dr K for all the time you spend answering the same questions over & over!! You are the best….

    Blessings

  168. Silver Angel says:

    Maria, also foods to avoid, see this link here:-
    http://www.thecandidadiet.com/foodstoavoid.htm
    Good luck, I feel great, no more Itching!!

    Blessings

  169. I did the HCG program 2 different rounds and lost a total of 40 lbs. Then I did the 3 week maintenance stage and then found you and the whole Leptin thing and the reset program. I've been on the reset now for 9 days. My sleep has gone haywire, I wake up several times a night, sometimes having a hard time going back to sleep. I also get the night "heat" not sweat necessarily but major heat turns on and I can't sleep.

    Is it possibly a switching of all these hormonal things that are causing this? Is there something I can do about it? I'm 51 and pre menopausal I would say but this lack of sleep is annoying and I'd like to fix it.

    I'm eating a BAB, light lunch and light dinner with not much carbs at all. Would adding some carbs help with this problem?

    • HCG can cause a lot of hormonal rebound for sure. That is why many people have trouble coming off of it. Without testing there is no way to be sure. Go back to the doc who put you on it and ask these questions. If they advocate it for you they should have some answers.

  170. Question about working out – please confirm my understanding;

    – Work out in the evening, after eating dinner (i.e. the last meal of the day)

    What in this situation constitutes "working out"? HIIT? Some other intense effort? Is gentle yoga, walking, or other easy and slow-ish cardio "working out" in this context? I find exercise in the evening very difficult.

    Thanks!

  171. Do you think the leptin prescription and a paleo diet could help someone with Achalasia who is on a liquid diet because they only have a 2mm opening to the stomach? From what I read it does seem to be inflammation related, but then there is talk of nerve damage…..

  172. So, if one is narcoleptic is one completely screwed?

  173. Does the program have to be modified for narcoleptics? Do I need to do more or other stuff?
    My hypothalamus took a major hit after general anesthesia some years ago, resulting in narcolepsy, PLMD, memory/focus issues, and now T2DM. =[ I want to get better!

  174. Thanks for the brilliant info.

    I have always been very fit and active, but struggled with weight. (Stopping the exercise for reset has been my biggest challenge).Paleo (low carb) for 8 months now. Dropped good weight for four months 18kg then it just stopped. I'm still at 24% bf so have some way to go. Read Richards and changed timing of eating. I've been following the reset now for 4 weeks and fairly certain I am LS. I have to workout in the afternoons (cant do evenings) should I eat lunch, workout and skip dinner or skip lunch, workout and eat dinner? Once you are LS does the no working out pre breakfast still apply. ( even if it's a HIIT workout?)

  175. WOW! I was directed over here through Paleohacks. I am 41, not menopausal but have had amenorrhea and virtually no hormone production (bloodwork history) for 10 years as a result of overtraining and undereating. My body seemed to be functioning well on the outside (fit/lean) but I had no idea of the metabolic derangement going on inside. Though I stopped the overtraining, gained some body fat, currently take bioidentical estrogen and progesterone I still haven't got a period. Very frustrating and scary. It's as if my hypothalamus has shut down for good, which basically means other things are shutting down too.

    I am very very interested what I am reading on your site and am thankful Dr.Kruse is providing so much of his time providing scientific evidence. In addition, I am seriously contemplating on experimenting on myself with the Leptin RX. Science has provided a great deal of data on amenorrhea recovery but the gals seem to have had it for less then 2 years and are under the age of 30. My only hesitation with the Leptin RX is the possibility of a another BIG disappointment. Being infertile has been the biggest disappointment even with clomid, estrogen, progesterone etc on top of having osteoporosis as an athlete.

    Feel free to provide any feedback. I will keep reading and will follow up.

  176. Hi, so I've been reading on here for awhile but I wanted your opinion. I'm a 17 year old girl, I have lost 117 pounds in the last 20 months. I'm down to my goal weight (well 10 pounds short but in the normal range) and I was wondering if I would benefit from this diet?

  177. Dumb question, but what do you mean by "body composition"?

  178. @rachelle. Body comp is how much fat muscle and bone constitutes your body. Generally for a normal girl you want your body fat % 20-24%. If you want to be ripped up you go for more muscle but at your age you could turn off your hypothalamus and it could effect your fertility as you grow up. If you follow the paleo solution or primal blueprint books and eat using this protocol you will be rockstarish compared to your girlfriends.

  179. Alrighty thanks for answering :) Do I buy a book telling me how to eat exactly? And how many carbs a day total should I eat?

    • @ Rachelle I recommend "The Primal Blueprint" by Mark Sisson or "The Paleo Solution" by Robb Wolf. Those provide the foods you should eat. The manner in which you eat them is located in my blog post called the Leptin Rx.

  180. Oh wait nevermind

  181. I'd just like to say thanks for your awesome and simple advice regarding doing a leptin reset. After hearing your interview with Jimmy moore I tried it. I'm still amazed that I don't need to eat, not something I've ever experienced before despite being low carb for a few years now. I ate breakfast at about 6.30am and still don't really need to eat at 6pm, such a novel experience for me. I love it. Thanks so much.

  182. Hi Dr Jack,

    Sorry if I sound a little dumb but I'm a little confused on how much carbohydrate I should be eating. I read that:

    From Para A:

    "Make sure that breakfast has little to no carbs (less than 50), and has a lot of protein and fat."

    From Para B:

    "Try to limit carb intake to 25 grams if you overweight by more than 30 lbs. If you are fit and have a small amount of weight to lose, (less than 30 lbs.) you can titrate up your carb loads.

    Is it <50g carbs for breakfast and then <25g for lunch and <25g for supper? Or am I misunderstanding what you are saying?

    Also do I count total carbohydrate or do I deduct fiber counting net or effective carbohydrate?

    A rough idea of how much fat? 100g a day?

    Thank you for your help

    PS I'm an older female who is a regular exerciser

  183. Great post – thanks Doc! Being that this ends up being pretty strongly low-carb, wondering if you see any benefit to a cyclic high-carb day, a.k.a. a cheat day, to get the t3 / t4 function improving?

  184. Lea I believe that is 25g for the whole day if you are overweight by more than 30 lbs and you can go higher based on your improvement and its not including fiber I think. Correct me if I'm wrong someone.

  185. Insomnia and low carb question:

    First of all, thank you for writing this blog. I've just discovered it today and have only read a couple of articles so far, but I'll rectify that with a weekend full of reading.

    I've read a few low cab/weight loss books and there seems to be some correlation with those diets and my getting insomnia. I'm prone to insomnia anyway (perimenopausal and the insomnia appears to be cyclic associated with ovulation and onset of menstruation). In the past when I ate below 30 grams of carbs in a day, for the first few days I felt energetic, but then the high energy just never went away and I moved into exhaustion. It also prevented sleep. After those few energetic days, I was begging the universe to "pull the battery". I was a zombie, mentally and physically. I never made it past 2 weeks on low carb because I just couldn't stand it. (I tried the VLC experiment twice) Once I started eating about 80 grams of carbs per day (about 50 net grams), after a few days, I started sleeping again.

    So my question is, will the recipe for regaining LS still work if I eat the minimum carbs I seem to need in order to sleep?

    FWIW, I've lost 60 pounds, but it's taken me 2 years. I messed up early on and didn't eat enough protein and fats and didn't lower my carbs enough. (I average about 80 grams of protein per day now, but obviously that will go up if I follow your recipe to increase LS) Presently, I have about 20 pounds to go to get to my ideal weight, but I'm only losing about 1-2 pounds per month and that's with eating only 1200 calories per day! (I'm not fudging the numbers either, I literally eat meat, a whey drink in the morning, veggies and 2 servings of fruit with one rice tortilla per day)

    Like I said, I tried not counting calories and eating VLC, but the insomnia and burn out were miserable. Ergo, I added some carbs back and I count calories again. Any advice on how to combat the attack of the zombies and exhaustion on VLC would be greatly appreciated. I have ambien, and valerian that I use to help with insomnia, but they don't help with the exhaustion.

    Thanks again for your blog!

  186. Thanks for the info. I'm buried deep in the comments on those pages and it looks like I've got way more than a weekend worth of reading to do both here and on MDA. :)

    I've often wondered if my overweight state, mild hirsutism (face arms and legs), tendency toward insomnia (since purberty), and even my keratosis pilaris (also started after puberty along with getting fat) were somehow connected. It's always seemed that when I read about each one individually, they seem to point toward systems that have to work together and regulate each other.

    Anyway, lots to learn…I live in "nowhere MS" and am poor, so getting information to help myself is going to be up to me. But I guess it's a case of better late than never (hopefully, 47 isn't "too old".)

    Thanks so much for the copious information on your blog and the pointers to other sites that are also discussing these ideas.

  187. I hope this works for me. I was pretty strict zero carb for nearly 2 years. Went from 130 to 118. Then for no apparent reason gained 20. I add back some low carb veggies when I started taking probiotics in the hopes that that might have something to do with my inability to loose weight. Currently at about 145, female, 60 years of age, 5' short. Doc said my thyroid is fine. Is there a minimum amount of carbohydrate one should eat on this RX? After being zero carb it is a bit challenging to get very much in the way of carbohydrate back in the diet. Many foods give me indigestion if I eat them. Even a salad can set it off. I never get indigestion on fatty meat or eggs and water, which is mainly what I eat. 2 cups of coffee with heavy cream in the am.

    • @Deb Read the Leptin FAQ blog. Then if you want a real leptin education read the monster thread at Mark's Daily Apple under nutrition tab. You will find it. No thread on the site is bigger. Close to 300,000 posts.

  188. Just an update, in case there is someone else on this planet who could not feel any satiety with a 75 protein-gram breakfast: Dr. K suggested adding Betaine HCl (over at the massive MDA thread), and it has given me back some feelings of satiety! Additional benefits from this are relief from acid reflux and constipation – lifelong battles. Amazing! Thanks, Dr. Kruse!

    • @DrMommyN I would hope many would head over and peek at the MDA thread. There is a lot of practical advice for someone making the Leptin Rx and reset part of their lifestyle.

  189. Welp, I'm only 4 days into my leptin reset. I was concerned about insomnia and exhaustion happening and it already reared it's head after only 2 days. It's like I'm burning the candle on both ends…high energy + insomnia = exhaustion and extreme foggy headed/unable to think issues.

    I'm waiting for some supplements to come in that might help me get through this transition metabolically. What's strange though, is that I "upped" my carbohydrate from 25 grams (total not net) to 42/day and my sleep returned last night. I'm still not eating wheat, but I have tossed in a clementine and a 1/2 a rice tortilla into my day so that my carb count is high enough to allow me to sleep for now. Even though 42-45 grams of carbs isn't much by typical SAD standards, it seems apparent that metabolically, my body seems to still want carbs for energy. Even so, I don't eat carbs at breakfast and it is indeed nice that I'm not even hungry by lunch time.

    • @Ceci Ingestion of carbohydrate leads to the preferential uptake of the rare amino acid, tryptophan, into the brain. Since tryptophan is the precursor to serotonin, and serotonin is converted to melatonin by absence of light, eating carbohydrates will presumably make one more serene, sleepier, and more sated. You might have low cerebrospinal fluid (CSF) serotonin level. And this is also associated with many other behavioral adaptations like violence, insomnia, hunger, and suicide. So you can up the carbs or choose to supplement with 5 HTP for a couple of weeks or consider getting your DHEA-s level drawn. Most people with bad sleep have terribly low DHEA. That is why it is on my top ten Paleo Supplement list Written Sept 26th 2011

  190. Thanks Dr. K.

    I have 5-HTP and DHEA on the way. Perhaps I messed up when I opted to get the 7 keto version of DHEA because I was leery of the hormonal effects of DHEA (since it's a precursor to testosterone and estrogen). I'm already fighting chin hairs during this peri-menopausal stage of life. :) I also don't know if I've become misdirected by reading about something called estrogen dominance. My doc prescribed me premarin once and talk about a miserable experience. I took myself off that ASAP. I tried an herbal supplement called Vitex which supposedly helps the progesterone side of the equation and I began sleeping pretty well again except for 2 short stages in my monthly cycle. Until the Vitex though, I was literally one of the walking dead.

    I have to admit that at the moment I'm rather flying blind. My current GP isn't keen on anything like this. Heck it seems that as long as a patient my age has a BP until 150/95 and glucose below 100, he's happy. Eventually I'll get the money put together to get the blood work I need done …whether he's interested or not though. :)

    Anyway, sorry for rambling again. I plan to stay at the minimum carbs it takes me to sleep until my supplements get in, then I'll see about dropping things back down to under 25 grams.

    Thanks again for making all of this information available. I feel like I'm making progress again.

  191. This is a comment I left on the Leptin thread going on over at Mark's Daily Apple, Dr. K asked that I share it with everyone here and I'm more than happy to share my experience:

    Hello Everyone!

    I stumbled across this thread on Sept. 12th and immediately started the reset. From the start my hunger and cravings have been under control. I feel like I've found the key to unlock the future that up until now I've only dreamed of. I always thought it was failure on my part when I would cave in to the cravings, closet eat my way through a bag of chocolates or feel totally deprived when I was able to avoid the chocolate birthday cake. I have to thank Dr. K for giving me the hope of a bright future, no more binges, no more caving. I can do this because food no longer holds that much interest for me, still amazed that I can make a statement like that and it's totally true and I know how to keep it that way…BAB!

    Anyway, I wanted to share my experience so far for others and maybe get some help and support. I started the morning of Sept. 12th while reading this post in the AM, with 7 deviled eggs sitting in front of me. I had been eating 3 for breakfast and the other four for lunch. The BAB just made sense to me when I look back at my best attempts at low carb I was eating a hearty breakfast, I just never tied it to my binges or lack there of. So I shoved all seven eggs down and I was off and running. By the end of the first week my belt was one notch tighter and I was down 2 pounds. Second week I was down another 2.5 pounds, my hair was look better and I have a much easier time styling it. Oh, and my belt was yet another notch tighter, this is crazy I've never been able to lose so easily and with such a nice variety of food. Survived 2 parties without craving, caving for feeling deprived. The real test on this will come when I go to my Mother's house for a party, don't know why but that's where I usually lose it. I have not been doing any exercise. I would love to walk, but it's just been non stop rain for days. I don't thing I'm ready for HIIT yet. I'm not sure about the body heat, I feel warm from the inside at times, like the fire is inside me. I also had very loose BM's the whole second week and when I say loose I mean watery! TOTM came this week and the watery BM's went away, but 1.5 of the pounds I lost are back, I'm hoping just some water retention due to TOTM.

    Sorry this turned into a short novel but I know I hung on everyone's words while reading this so I feel obligated to contribute for those that are reading and finding hope. I didn't want to post until I had read through the whole thread and I finished it yesterday, there is an absolute wealth of good info in here. I am hoping someone can help me or point me in the right direction, my eczema is bad, I have patches on my belly, arm and legs. I also think that is part of my flaky scalp problem. it seems to be getting worse, my scalp anyway. Looking for some relief, anyone?

    Lori

  192. Hello everyone,

    Rain here as well! into the 5th week of reset, and starting to loose weight after the end of my cycle, where I put on a kilo for a few days. I have had a hysterectomy, so can not really pin point cycles as well. Hang in there everyone! My funny dermatitis has gone, hay fever gone, no dull headaches, the bottom paddock is fine (take mg which helps), weight is still going down, no hunger and no cravings, with the odd days where I only have 2 meals a day. I am not missing anything, though I am looking forward to eating a bit of cheese at some point. The dumbbells are poised, and I stroll in the evenings to check the sheep, as daylight savings has kicked in down under. Sleep well as well, though my flyin flyout hubby comes back next week, so we will see how his snoring will change that lol. I just encourage everyone who is thinking about giving this a whirl, to have a go, you have so much to loose but an incredible amount to gain in terms of health to gain!

    Cheers

  193. Hiya,

    Thank you so much for putting all this information out there.

    I started the reset about 4 weeks ago after realising I may have done some damage to myself follwing 6 months of IFing and hard (over) training for a competition. I gained about 10lbs very quickly afterwards as the training volume cut right off for several weeks as I just too exhausted to train.

    So far I think I've put on another 5-6 lbs on top of this during the reset. Is this normal?

    The extra weight I've put on is very loose, soft fat, particularly around my chest and stomach. Current stats are about 5'11, 195 lbs, probably 18% BF up from about 178 lbs in June. In that time I've also changed job and country so I guess cortisol may be an issue currently.

    I've started training again, and only feel stiff the day after (tend to have a tight posterior chain), no unexpected tiredness as a result. Usually HIIT style bodyweight work and a few sprints. Does this sound ok given my current status?

    Somebody mentioned egg powder protein above. Does this have a better insulin response than whey?

    Many thanks again,

    Jim

    • @Jim given what you posted I bet you have some serious hormone issues. To lose that amount of body comp that fast tells me a lot. You need to get tested and for sure the reset will help you. I think there are some underlying issues in your Ferrari that need to be tuned up on top of the reset. But the reset is a good place to start. I fyou dont make head way in 4-6 after your hypothalamus adjusts to the timing of your paleo foods then you must test.

  194. Adam sent me this message and I wanted to share it with all of you here:

    Dr K.

    Thank you for putting all this info out and have nothing to sell anyone. It is clear where your heart and motives are. You are quite literally saving lives and changing the world.

    I ate a paleo diet for 2 years and lost 100lbs and reversed my diabetes. Interesting things that happened were: I started to be drawn to exercise at very high intensities for short periods and not feeling hungry until dinner time.

    So for over a year, I have been eating 1 meal a day (dinner) simply following my body's hunger cues. Sometimes if I have to eat lunch for social reasons, I simply have no room for dinner. Food choices are always low carb paleo.

    Exercise includes 4 times a week of heavy lifting and 2 times a week of max sprints (my heart rate is always hits >95%). I'm in south east Asia and it's summer all year long and I make sure I take a 1/2 hour walk with as little clothing as possible at noon every single day.

    I just had my body fat measured at 8% using calipers and have a waist line of 29" at 5ft 8" (yes I have a 6-pack now). Coming from a body fat of 38% with a waist line of 42", I'm over the moon.

    What to me is mind boggling: I stay lean despite eating as much as I want, whenever I want (which is naturally once a day), have no struggle with any sort of cravings for non whole foods, spend very little time exercising, have better sleep than ever, do not remember the last time I have gotten the flu, astounded my dentist as she claims that my decayed molar has somehow magically healed itself over the course of a year, have a HDL of 90 and trigs at 30, my 25 hydroxy D level is at 75 without any supplementation…etc.

    I just feel freaking great. Friends say I look like one of their atheletic college students now despite being in my 40's. I even lost my man boobs that have been one of the major sources of insecurity in my life. This is huge cos I had them since I was 5.

    I just want to thank you for explaining to me why with all your writings. I finally have an idea. Although I never followed your protocols to begin with (you weren't blogging then), I did them all correctly and am experiencing the best health of my life.

    For people who are wondering, try Dr K's advice and just watch yourself change. And do it right without half-assing.

  195. Are bubbles in the urine meaningful while I am eating the BAB and a high protein Paleo dinner or should it be ignored?

    • @Rozi……could be from a lot of different things. I experience the same thing but I believe it is inconsequential because I test. IF your were a T2D I would be concerned enough to check your urine with a dipstick to see if you were spilling a ton of protein. But other than that I would not be too concerned. If you are spilling protein that tells us you got pretty big medical problems cooking due to AGE's and ALE's all over your body.

  196. After seeing Lori's post, I wanted to pipe in on how things are going for me even though it's probably still too early to tell much (not quite 2 weeks on the reset yet). I'm not sure if it's due to the supplements, but I'm starting to be able to sleep now when I eat less than 50 grams of carbs per day. So far, I've managed to ramp things down to 30 grams yesterday and I slept *hard* last night. My brain still seems a bit foggy/slow thinking though, but I figure if my body's managed to adjust, eventually my brain will catch up too.

    I haven't lost any weight perse, but I'd been doing a conventional diet for almost 2 years and had just gotten off wheat 3 weeks before starting the leptin reset (so I've had long plateaus in the past). But I can already tell that things seems to be "shifting" and I have a feeling that once my "monthly moment" is over, I may end up being a pound or so lighter because unlike every other month, my weight didn't go up when my flow started this month.

    One that that has definitely changed is that I have more even moods. It used to be that when I got home from work, I was ravenous. I'm talking that I'd mow over your grandma and kick your puppy to get to the refrigerator…ASAP! Now, I have no trouble cooking and it doesn't bother me one bit to have to run an errand after work. I used to go into a rage if something "popped up" out of the blue that interrupted getting home for supper.

    So far, i feel like I'm making progress and I'm definitely getting enough positive feedback to want to stay the course.

  197. DR KRUSE, I AM DAZED I HAVE BEEN DOING THE RESET FOR 8 WEEKS TODAY I JUSY GOT MY TEST RESULTS BACK EVERYTHING GOOD EXCEPT MY TOTAL CHOLESTROL TOO HIGH, MY HOLISITCS DR WANTS ME TO CUT BACK ON MEAT AND HE SAID EAT FISH, TURKEY BACON, TURKEY GROUND BEEF, AND ONE APPLE A DAY TO LOWER MY NUMBERS, SO FAR ON THE RESET THIS IS HOW I AM, MY SLEEP SO SO I HAVE TO TAKE MELATION BUT STILL WAKE UP A FEW TIMES AT NIGHT BUT FALL ASLEEP EASILY, NO CRAVINGS, GET WARM SENSATIONS AFTER EATING, MY CLOTHES FIT BETTER, BUT LOSING WEIGHT STILL SLOW, I FOLLOW THE RESET AS YOU STATED, SO NOW WHAT DR IS ALL LOST FOR ME DOING THE RESET? PLEASE RESPOND THANK YOU DR. KRUSE.

  198. So you like the raw eggs for your protein shakes. May I ask what you add to improve the flavor? Raw eggs by themselves in a shake seems yucky.

    Many Thanks,
    Grizz

    • @ Grizz It changes with the seasons. In the summer I use Nutiva Coconut manna, stevia, 100% pure cacao chocolate powder, some blueberries, 4-6 eggs, and so delicious coconut unsweetened milk. I add cinnamon too. Occassionally I will add some whey protein in lieu of some of the eggs if my labs dictate it.

      Right now I am doing fall smoothies with lots of nutmeg pumpkin heavy cream eggs cinnamon ginger and some raspberries or a splash of real vanilla or almond

  199. Background: I'm a 38yo woman, and a mother of 2. I've had migraines since the age of 10, I have a history of PCOS symptoms (just recently diagnosed), I worked high stress jobs in the military to include working graves and swings, I've worked emergency response to national disasters, I've been diagnosed w/bipolar disorder, fibromyalgia, I've been in a severe car accident which most likely caused a concussion. At one point I went vegetarian for two years back in the late 90's and I've been fighting to loose 20-30lbs of weight for the past 10 years w/o success. Fast fwd to November 2010 when I stumbled upon the Primal Blue Print, MDA, and this past May I found Dr K's blog and my life changed.

    I started the LR back in June… by July I had most of the LS indicators – except I wasn't loosing weight… so In August I ran *most* of the tests Dr K recommends…and discovered I was Still LR – and was experiencing Pregnalone Steal syndrome & my HPA was out of whack -as a result of wonky cortisol level (depressed in the AM, and elevated at night), and a low Free T3/Reverse T3 ratio, and HIGH LDL – which is another indicator of pregnalone steal (where as my HDL almost doubled, my Trigs are very low & my LDL is patter A)

    so once I got all my labs – I restarted the Leptin Reset on 3 September (LR Redux Day Zero)- adding adaptogens (Maca, Ltheanine, Rohidial, and PS at night), I also eliminated all caffeine, and have limited diary. I also only walked for my exercises… this past Monday was my first LHT in 1 month. So far I've lost 10lbs, I haven't done my measurements yet – but I now can fit into my Ann Taylor business suits in the 12P, and my 12 regular suits I don't need to unbutton or unzip them to take them off… Tomorrow will be my first HIIT!

    Since I tested back in August, and started back at 0 for my Leptin Reset Redux – my over all mood/well being has been very stable… my frustration level w/my kids has all but disappeared… holy moly! I can't believe I'm just now realizing this… this means my stress level must be way down (even though work is quite volatile right now!) I'm handling my kids much better and not yelling at them any more… wow! Yet another positive thing the Leptin Reset has brought to my life…

    Dr K – say if you don't test it will take longer…and he's right… once I got my labs and knew where I needed to focus… I realized the man is 100% right and it works… if you follow the plan to the T. While right now I could easily get away w/skipping lunch… knowing I have to slog through a few things… I'm still eating lunch b/c I want the A+, though I will admit sometimes I do dumb ass shit that holds me back – like not engaging my brain and Dr K says changing your thoughts change your DNA…. the more I follow the protocol the more I *KNOW* I'm changing myself for the better… and to hell w/my doctors that won't work w/me…

  200. Dr K

    Would you explain the relationship between Leptin and Ghrelin? What is the balance needed for optimal health?

    Thank you DL

  201. As a physician treating many like that on this blog, i have found the information very useful. I too am LR based on the mirror test. I have gone from 252 lbs to 188 over the last 6 years, struggling all the way. I started LR reset Sunday, down to 184 this am. Carb intake around 25-30 grams a day. I must say i feel AMAZING. Basically no carb craving in the evening.

    Dr. K, at what level of ketosis should be achieved (lets say on urine dipstick testing) and for how long should one stay in ketosis?

  202. Dr. Kruse,

    IMO, your Web Site needs an index to the many fantastic articles you have in your blog. I have made up an index for you, and it can be placed in the top menu, or in the side menu. Ideally it should be placed under each months selection on the right. So Click August & all the August article headers will appear. I've also included references to MDA message links which all reference your work. I must also say that you are the best thing that has happened to the Paleo Movement. You are fantastic, and I have sent your web page to everyone on my Email List. My son & I were fighting with plateaus for many months, and your Leptin Reset has the weight falling like a rock.

    Next page for my index. Use it as you see fit.

    Grizz

    Grizz

  203. Dr. Kruse,

    My listing won't take. Where should I send it? You can contact me offline if you want.

    Grizz

  204. One of the goals of the early big protein breakfast is to get cortisol down quickly.

    I use prednisolone for adrenal support. 5 mg at waking and 2,5 mg at noon. Does this inhibit the leptin reset?

    • @Niels That is a goal but the real reason for using protein is because it really shuts down hunger and allows the brain the to see the incretin gut hormone signals at the hypothalamic level to allow for proper signaling. This can also be done with fat. I use a lot of fat leptin resets in neurologic diseases. I think being on prednisone is a problem, but not an insurmountable one. The reset will just take longer. Stick with it.

  205. Dr. K, can someone whose had gastric bypass surgery partake in a leptin reset? I am a 30 year old female and underwent RNY surgery 10 years ago. I lost 100 lbs in a year but never actually got to my goal weight. I slowly regained weight, but brushed it off thinking it was the "normal" 15-30 lbs gastric patients regained. But it kept going and I was addicted to carbs like oatmeal and bread, and also sugary Starbucks drinks (for some reason I could handle the sugar in the drinks but not if I ate a piece of cake). I also had 2 kids in that time period. I have been desperately trying to lose 50 lbs I gained back but nothing has been working. I have been low carb Primal for about a month (Starbucks free for a year)and keep gaining and losing the same 5 lbs. My cycles are now every two weeks WHILE being on birth control pills. I want to try to do a leptin reset but I can't get that much food into my stomach at one time at breakfast(my pouch may have streched a little but it is still smaller the then the average human's stomach). I'm pretty sure having the surgery has damaged my body in ways I can't even comprehend. Any thoughts or tips?

    • @Erin This is a loaded question. I have had to deal with this one more than I care to admit. Gastric bypass surgery is very common now and I have to tell you that I am not a fan of any bypass surgery at all. That all being said it can be done but it requires a very specialized plan of action depending upon what type of bypass one has had. The meal size and frequency have to be altered to fit the bypass. I tend to use a lot of coconut oil in those patients to stimulate the alternative pathways to the hypothalamus.

  206. Dr.K: Thanks for sharing your work…i feel hopeful for the first time in longer than I care to admit. I started on Monday, Oct. 3 and have been following your program precisely. I have already lost 7 pounds and for the most part feel better than ever..calm and happy and NOT hungry. One issue: I typically go to bed around 10 pm and wake up at 6 a.m., so your schedule fit in nicely. However, since day 3 of the Rx my sleep has deteriorated–got worse each night. Saturday night I woke up at 1 a.m. and the last time I looked at the clock is was 4:25 a.m. I then woke up for the day at 7:45 a.m., which threw my whole schedule off for the day…sigh. Last night I crashed at 9 p.m. and woke this morning at 5:15 a.m. and went down and had breakfast..off schedule again. Today I am tired and have brain fog. I am concerned because I thought the exact opposite would happen–is this to be expected as my body resets? Thanks, JeaniB

    • @JeaniB always be optimistic! If you read the Leptin FAQ's some take longer than others because of the inflammation. One must be patient when you are going from a sugar burner to a fat burner.

  207. My testimonial: I did multiple rounds of HCG dieting, albeit I was considered "rogue" because I mixed veggies and upped my protein intake. I've lost 38 lbs over the last 8 months. I transitioned to Primal in between rounds, until I found the Kruse Leptin Reset Rx. It has been so successful for my maintenance. I have virtually no hunger after my BAB. In between previous hcg rounds, I was constantly battling the urge to nibble day and night, and so fearful I would regain the weight. I'm not fearful anymore. This works! Thanks!

  208. Dr. Kruse & ALL,

    The NEW INDEX to Dr. Kruse Blog Articles & Related Links are now located on the internet here:
    http://tinyurl.com/Dr-Kruse-References

    Makes it REALLY easy to find all of Jacks excellent articles. Give it a try.

    Available to all. This should work well until Dr. Kruse can get his Website updated with an index.

    Grizz

  209. @Erin I will be tackling gastric bypass soon. Quite complicated.

  210. Dr. Kruse,

    Would you be so kind as to review this for accuracy before I post it? & edit as required? "Leptin for Dummies"

    "Here is the bottom line in as few words as possible. Humans are either sugar burners or they are fat burners as determined by diet. The High Carb – Low Fat Diet insures that we are sugar burners, and store fat. The High Carb diet also dulls the brain's sensitivity to LEPTIN. The following skips all the scientific mumbo jumbo to explain a very complex & confusing subject for Dummies.

    Leptin For Dummies

    =========================================================

    * Leptin = Hormone that comes from fat and is sent to the brain & all other cells to control energy

    * Leptin is the MASTER Hormone that controls all other body hormones including insulin

    * Leptin is the feedback loop between fat cells & the brain and all systems that use energy.

    * Leptin Sensors in the brain are the "Gas Tank" that measures fat stores

    * Leptin HELPS tells the Brain when to eat, when to stop eating with the incretin hormones

    * Anything that uses Energy in the body is therefore tied to leptin status.

    * The more energy dependent the physiologic process the more coupled it is to proper leptin function.

    * Leptin allow the body to burn fat very efficiently even when sugar/carbs are plentiful

    * Leptin allows the brain to live through "Starvation Mode"

    * Leptin signaling can be blocked in the brain = High Leptin levels = Leptin Resistant = Starvation Mode/Obesity

    * Starvation Mode = body told to burn sugar, then eventually it causes osteoporosis and fatty muscles

    * Leptin sensors in the brain OK = Low leptin levels = Leptin receptor Sensitive = body is able burn fat well.

    * We can train our bodies to be a fat burner by a special diet to restore Leptin sensitivity

    * IF the leptin receptor is permanently damaged we can train our brain to re read leptin signal with the Leptin Rx.

    * Blood testing can measure Leptin levels, but they are rather useless clinically.

    * The Liver makes energy for use between meals and is our metabolic engine, the thyroid is the gas pedal, and leptin is the computer who modulates control over both using hormone signals.

    Characteristics of the Sugar Burner = High levels of leptin = Brain Leptin Resistant (LR)

    =========================================================

    – – A lifetime of eating high PUFA containing foods, High Carb foods, a life of elevated cortisol with poor sleep damages the Leptin Receptors in the brain

    * Brain receptors that are blocked, do not detect Leptin well any longer, and in some cases may be damaged

    * When the Leptin receptor is blocked the brain sees the body as in "Starvation Mode" to store even more fat with every meal.

    * In obese, you are hungry even when overweight, urges to snack, no signals to stop eating when full

    * In anorexia no hunger, thyroid shut down and you consume your own bodies protein, bone, and fat.

    * Dieting wont work when LR; exercise is highly inflammatory when your are LR and wont help because you still won't burn fat well at muscle level until you become LS.

    * Blood sugar can become out of control, leading to diabetes: Intracellular loss of Magnesium is the first step in LR.

    * Thyroid Gland is no longer under control of brain in LR, and basically not functioning well regardless of lab findings

    * Thyroid shuts down, preventing muscles from burning fat

    *A nation of Obese People are walking around in "Starvation Mode" because their brain is blind to their fat stores.

    * Liver gets overloaded with energy, becomes fatty and sluggish causing our Ferrari's engine to become inefficient

    * Belly fat accumulates as LR continues for the obese and waistline increases. Anorexics waste away and die.

    Characteristics of the Fat Burner = Low levels of Leptin = Brain Leptin Sensitive (LS)

    ==========================================================

    * Satisfied after eating, can even skip meals without getting hungry, no desire for snacks,

    * Body burns fat instead of sugar

    – – Exercise & Dieting results in burning stored energy, then fat cells and NOT muscle & bone

    * Blood sugar under tight control because your liver will be optimized once again to run like a Ferrari engine

    * Thyroid functioning normally because leptin will allow the brain to control its gas pedal once again.

    * Body no longer in "Starvation Mode," healthy weight controlled for the obese or the anorexic

    *The reset can use Low Carb Diet high protein or high fat diet timed correctly to reset how our neurons work once again and allow us to once again become effective fat burners.

    – – Hormone levels are properly controlled and normal levels will eventually return as leptin function normalizes

    – – You will be able to eventually eat anything you want & not gain weight once your brain is retrained.

    So bottom line, people who can't lose weight or who have diabetes- can blame it on their epigenetic switches that are set to partition calories differently than a normal persons metabolism because the are likely to be Leptin Resistant. No amount of dieting will work until Leptin Receptors get trained to function properly again. This normally takes 6 to 8 weeks of the "Leptin Reset" protocol which use adaptive neuroplasticity to allow our brain to once again be sensitive to our fat stores and restore us to energy efficient again. The LEPTIN RESET IS RETRAINING LEPTIN NEURONS TO RESIGNAL TO APPROPRIATE SIGNS USING TIMING OF THE MEALS AND AND FUELS AND GUT SENSATIONS TO REORGANIZE HYPOTHALAMIC FUNCTION IN THE HYPOCRETIN NEURONS. The more systemic inflammation one has the longer the reset can take. This means the timing of return of the leptin reset is dependent upon variables in each one of us. Patience is the key.

    For more details, refer to Dr. Kruse's Blog Articles & message threads on Leptin here:
    http://tinyurl.com/Dr-Kruse-References

  211. My testimonial Part 2: Prior to adopting this new way of eating, I was hypothyroid on Rx T4 and T3 replacement, had fatty liver disease, chronic intestinal problems (IBS), anemia, high blood pressure, constant fungal infections, rashes, migraines, and on and on. I was working out like a demon and restricting calories to 1200/day or less and could not lose weight or get the health issues under control. I have not been in for my yearly physical yet, but will let you know how that goes. However, I haven't have headaches, rashes, or fungus in months. I home test my BP and it's been very good, my muscles and joints don't ache all the time, my IBS is gone and my energy level feels good most days. Even the "age spots" that were beginning to appear on my hands and cheeks are gone or fading. My hair, which had gone dry and frizzy the last 10 years, is soft and wavy again like it was in my younger days. I just can't say enough about how much better I feel! I still have 25 or so lbs to lose, but now I am so hopeful that it will happen.

  212. @dr. patel honestly i dont use ketostix at all. They are completely useless in the mechanism of how this reset works. I promise i will soon make a post on the neurologic reasons a leptin reset works. It has very little to do with ketones. Thanks for your kind words.

  213. @jeani B. Stick with it. Restting your hypothalamus takes time when you have hier levels of inflammation. It will come if you keep making all the correct baby steps

  214. Dr. Kruse, thank you so much for your work. I am a 5'4" 46 year old and have gone up and down in weight since I started college. My highest was a couple years ago at 206 and I'm down to 162. I did a round of HCG and lost 30 lbs and am doing a second round, 9 days into my low calorie diet. I used homeopathic HCG. When I read your info it became clear to me I am LR. I actually have been struggling on the HCG diet this round and am thinking about not completing the round (supposed to go at least 23 days) and moving straight into your prescription. So, my question is, if you are willing to answer it, do you think I should just stop the HCG diet and move straight into your prescription or would that be a bad idea? HCG is an unforgiving diet and don't want to gain back what I've lost, but I feel like your prescription is exactly what I need to not just lose weight but optimize my well-being long term. Thanks for your help!

  215. Rachelle M says:

    Dr I was wondering what the simplest blood tests I could get done that would tell me if I'm LR? I live in an small town and dont have medical insurance. Also what exactly im looking for :)

    • @Rachelle the simplest one is not a blood test. It is a look in the mirror. If you are not heavy and thin then you could get a reverse T3 and a full thyroid panel HS cRP and a serum leptin level.

  216. Splenda & Crystal Light are my crack. I better make a change asap.

    I am all for using coconut oil to cook my breakfast eggs in but don't like it in my coffee at all. Would it be ok to keep using coconut milk? The brand I use (aroy-d in the green carton) has 2 ingredients … coconut & water. I drink way too much coffee right now but would love to keep one morning cup (sans splenda)

    I feel like I won the lottery with having your blog recommended to me! Thanks for the win!

  217. Dr. K, thanks for this site and all that you are doing to help others! Understanding the whole LR issue has explained thyroid/inflammation (high CRP/ESR)/weight gain/energy/sleep issues that rheumatologists finally gave up on as unanswerable. Following LR reset has handled them all within weeks after years of no answers.

    A question though — I know that whey powder is not recommended because of stimulating insulin production. Is it the same with casein powder?

  218. Rachelle M says:

    I'm 132 lbs and 5'6 so I'm smack dab in the normal range :)

  219. @Rachelle M I doubt that you are LR if that is the case. But testing would confirm it.

  220. I have thyroid cancer (the 4th time) so should I be staying away from ALL dairy?

    I've recently been eating: greek yogurt, 10% cream, butter, ghee, whey protein & cottage cheese.

    Should I stop all of it? I don't mean just for the reset but for life?

    Thanks, Dr. K.

  221. Rachelle M says:

    Okay. I've also been told I'm insulin resistant before, but I have family on both sides with type 1 diabetes.

  222. Dr K.

    Would you please tell me what you recommend to use for salad dressing.

    Thanks

    Maria

    • @Maria I make all my own using paleo oils. In order of use……macademia nut oil, avacado oil, and olive oil with organic herbs and spices in a small bottle and I use it til its gone. My wife is not the maker of them since she became part of the transition too so I no longer have to make them. I taught her how to do it and she loves being creative with it now.

  223. Hi Dr K,

    Thank you for your informative posts and vast patience with all of your readers' many questions, as well as a few of mine.

    How much time do we have to eat our big breakfast? Does sipping coffee upon awakening start the leptin respponse and does it continue while preparing and eating how ever long it takes to finish a meal? If I want to finish my 2nd cup of coffee (I use half caffiene and half non caffiene coffee beans) with the coconut oil at my desk after my breakfast is it considered a "snack"? I take all my vitamins with the coffee and cream, etc. at that time right after breakfast. I find that I remain full for at least five hours. I have a light lunch and dinner. If I have wine in evening can I have a glass before dinner and one after or is the one "after" considered a "snack". I really want to know how much time does one have to finish a meal? Is a tablespoon of coconut manna considered a snack if you have it before going to sleep? What is your opinion of Xylitol-made from birch trees? I use it in coffee and sometimes in cooking when stevia won't do well in a recipe.

    Thank you for the extensive information you are sharing. This is truly enlightening and enabling people to have deeper levels of knowledge to help them find the keys to optimum health. I look forward to reading all the updated posts every night. Sincerely, Myrna

  224. Okay.. I'm gonna do this!! I struggle with fat loss–hashimotos/adrenal fatigue prevent it..What is the carb count? 25 total? Or 25net(subtracting fiber from total carbs?) also.. I take armour thyroid upon waking and I have to wait 30 mins to eat. Can I exercise then? I'm fairly fit- 5"4' 139 pounds and I stand and walk around all day for a living– had taken a break from exercise due to adrenal fatigue. I work till 9 at night so exercising at five isn't an option.. Thanks!!

  225. Dr. K,

    I've noticed a lot of people eating beef with eggs for their daily BAB. Conventional nutrition advice says not to eat beef daily for a healthy heart. What do you say?

    • @Linda CW is total bullshit. Is that clear enough? If you follow CW you will be obese and come down with T2D. Eat like the USDA and you will look like one too.

  226. Yes, that's clear enough. LOL. Thank you.

    Once someone hits LS, do you still have to eat a BAB? Or can you scale down the protein level? Does it still need to be within 30 min after LS?

  227. I meant "Does it still need to be within 30 min after breakfast, once LS?"

  228. I'm very confused Jack. In comment #111 here you say "My personal choice is a vlc paleo diet but that is what works best for my epigenetic switches."

    Over on my blog about a month after that you said: I guarrantee you I eat more carbs than Carb sane…….and less protein too. The people who ate with me at AHS were a bit shocked.

    I just now listened to your Jimmy podcast and you came off very pro-Taubes, pro-LC. And yet on PaleoHacks recently you accuse me of accusing you of being LC and assured me you are not. WTF Jack?

    • @LCC Confused? Evelyn you obviously dont follow how I make changes to my own diet. I test every three months to see where I am at and what the response of my brain is based upon those labs. IE how I partition calories. I have been doing this now for some years. In the summer, my labs have shown that I can eat much higher carb levels from April through Sept. When I hit low light levels I usually face a drop in pregnenolone, DHEA and testoterone. I back off the carbs in early Sept and become ketogenic through our low light months using a ketogenic paleo diet. I use labs to dictate how I eat. You however think carbs are fine no matter what. This is where you an d I dont see eye to eye. I feel macronutirent discussions are a complete waste of time and effort because how we partition calories and account for them at the hypothalamus are what really matters. When I treat people clinically this is how I view the problem. I put diet recommendations into the proper context based upon testing. These are my words of how I see it. I will not let someone with an agenda (YOU) tell me what you think your perception of reality is. I understand your biases and I enjoy reading your thoughts because they are at the border of many people's comfort zone. I think you are genuine in your quest of knowledge and on many topics I think you are correct. But on others I think you let your biases color other people's reality. I said that on PH too. I dont let what others say about you color my perception of what you say and how you conduct yourself. We all have opinions on things good, bad, or indifferent. I could care less what anyone thinks because ultimately I am the final arbiter of what matters for me. Some people value what I have to say. Others, like you, like to label things with pro Taubes or Moore and Anti Harris and PHD. Me, I don't think I am pro-Taubes at all. I think my readers and patients can figure out where I coming from. This is not a game to me. This is about helping people get back to optimal from hell. There are many roads to Optimal but to get there we have to know first where we stand now and how food effects our biochemistry. I think most people who know me personally and professional would attest to that. I think GT has his own set of issues. Taubes never mentions Leptin in either of his books much at all. Its all about insulin for him. I don't think I have a blog post here that hundreds of people follow called the Insulin RX do I? So I clearly am not pro-Taubes. Reading your comment that I am so pro-Taubes tells me about your optic. It says more about you than me. I don't think you are even aware of this. This is why so many people are turned off by your methods. It is sad because this is why people wont pay attention to some of the things you say that bring a lot to the table. They throw the baby out with the bath water. My take on this is you dont seem to care about that. I have zero problems with that too. Will this change how I view your posts or blogs on things. Nope. I like chaos and different ways to look at things. That is one of the things I like about you. But liking some things about someone is not a rubber stamp of everything they say.

      I think VLC living is good for many people who require it. I think carbs can be good for some people in the correct context. I also think they can be harmful in other context. As for Jimmy Moore……I am very pro Jimmy because he is a maven for part of this paleo community that tries to tie loose ends together. He also very effectively brings people together and is a nice man. The more we all talk and understand one another the better we all become for it.

  229. Dr. Kruse…First, thank you for taking the time away from your family and practice to share your expertise and passion for personal wellness. The foundational and instrumental knowledge you offer on your site is truly refreshing and enlightening.

    After Weeks of perusing your site, I'm finally going to take the leap into the leptin protocol. Its been quite the debate in mind because I've had success following a 16/8 IF schedule using a paleo/perfect health diet template — eating bw 11 thru 7pm.

    I currently take combo t4/t3 (synthroid/cytomel) and LDN to treat hashimotos and likely other autoimmune issues.

    T4 in the am upon waking. T3 around 9am then second dose at 3ish. Then LDN before bed. Should I adjust this protocol if I move forward with the leptin prescription? Especially since T4 is recommended on an empty stomach. Breakfast right away may affect absorption.

    Also, I'm lean and in good shape so is it not necessary I lift after my last meal?

    Thank you. Keep up the prolific and inspiring work!

    Adam

    • @adam. I think you can lift anytime but i am a huge fan of lifting after food. Now if youre lean trying to get ripped you can change it up. I think you should also read hardwired for fitness. Great exercise physiology book.

  230. hi, Dr. Kruse. I've been doing the leptin reset for several weeks now. Last week, i experienced excruciating pain in the abdomen area and it was discovered through ultrasound that I had multiple tiny (0.4 cm ) gall stones in my bladder. I don't want my bladder removed which is of course what my doctor wants. Is there anything I can do that actually works to eliminate the stones without surgery? I've seen several cleanses but I'm also apprehensive because of the size of my stones. What would you recommend? Thanks very much.

    • @belle there is a lot of literature supporting a high fat diet to reduce gallstones. The fastest way to get your gallbladder removed is a high carb low fat diet.

  231. Just wondering if you think there will be negative hormonal consequences to changing my IF routine from eating b/w 1130am thru 730am (which I've been doing for over a year) to eating my biggest meal in the morning within 30 minutes (Leptin RX-style) then a second meal 8 hours later (usually around 2pm with my schedule).

    I lift late afternoon after my last meal then fast until the morning.

    I'm only a few days into this schedule and haven't been hungry at all really b/c of my big breakfasts. I'm mainly concerned that such a dramatic change could have adverse consequences.

    Lastly, if one is LS, have you ever given any thought to rotating eating styles every month or so, similar to how lifters cycle training programs. Since the formula for progress is stress the body, it adapts, then sleep, eat, and recover. Would cycling your eating patterns potentially lead to a similar outcome? I know you mentioned in another post how you adjust your food choices throughout the year based up lab testing, etc, so I was wondering if this ideas is similar.

    Appreciate it.

    Take care

  232. I asked about the last part because I want to give my body a month on this new Leptin RX/IF hybrid protocol and see how it responds, then maybe switch back to my 1130-7pm leangains approach.

  233. Hi Jack, I am very new to all of this Lepitin info and have been reading quite a bit. I have two questions. First, I have done 5 rounds of HCG over the last 2 years with a total of 90 pounds gone. I am 5'5", 38 years old and ended at 143 lbs- Yup I started at 233. Here is my question- I can't stabilize at all. I gain and have to do HCG again, it has become a vicious cycle. I have tried everything short of blood work to try to figure out why I gain. Right now I have added an extra 15 pounds back on since Aug 1st. I am miserable. I had planned on doing yet another round to get this off but I am wondering if I am truly LR?

    I have been heavy since puberty and my daughter who is 14 is having the same issue. She is my other question- She has IBS and fairly severely. There aren't too many foods that she can eat in the mornings, eggs cause her pain for hours. The list is daunting and we are heading to the PGI again on Thursday for a check up on the meds they have her on. All of her tests and labs have come back fine but Doc noticed as well that she is having unexplained weight gain. We eat almost nothing processed, no splenda, no soda's, none of that garbage. So we are not too far off of the eating that you outline. My question regarding her is how do you live this diet out with IBS like this? And can she do this being only 14? She is 5'2" and about 130.

    Thank you in advance for your insight!

    April

  234. Dr. Kruse, thank you so much for being a generous and caring person! This Leptin Reset has been a miracle for me!

    For years I've suffered from debilitating hip pain. I've needed a cane to stand or walk even during times of relative relief from flare ups.

    Among the many health benefits of the reset I've been working since July 11, (the higher energy, positive outlook, healthy skin, hair and nails, fading age spots, to name a few) I am very nearly PAIN FREE now!!! This is an awesome benefit of strictly limiting my Omega 6s and increasing my Omega 3s and vitamin d3 intake expotentially!

    I am so very thankful!!! You are awesome!!

  235. How do you go about healing the gut? Me or my daughter?

  236. I guess I should have expanded my response a bit to ask who are you referring to when you say that about healing the gut, me or my daughter? and how can we do that?

    I would love any ideas that you have!

    Thanks, APril

  237. Why do hasimoto suffers need to stay away from cream and butter? Is pasture butter okay? Thanks!

    • @ Sarah Hashimoto's is an autoimmune thyroid condition and the casein protein's in dairy can be a major trigger to making the inflammasomes and up regulating Toll receptor proteins that increase our IL-1 B secretion in our gut to make more antibodies. I wrote about this stuff in my autoimmune and MS posts…….go check them out.

  238. Rakesh Patel says:

    Dr. K,

    i started leptin reset and had labs drawn 2 weeks after (that might be my first mistake) needless to say my lipids were very hi, pattern density went from A to A/B, HDL went down (despite low carbing prior to reset), TG slightly higher, low normal testosterone, but despite the numbers all markers in inflammation were squashed (hscrp, Lp-PLA2, and mpo). Could this be pregnenolone steal? One would think the hdl and Tg would have changed for the better. Any thoughts? (AM cortisol and reverse T3 are pending)

    • @Rakesh When we begin this fuel source change the first set of labs is used as a baseline trend. I am not too surprised but what you posted but you do need the others done as well. When you retest in 3 months I bet you see a reversal and an increase in your HDL. Make sure you pay attn to your gut! Read my blog post on the leaky gut Rx. Anyone with a low HDL needs to be mindful of this.

  239. Dr Kruse,

    I am sorry to be such a dunce, but I am seeing my doctor soon and I want to get this right so I know what to ask for:

    I am 41 years old, female. I have had severe bulimia for 24 years. No therapy, drugs or anything else has ever curbed it.

    Concurrently I have also been diagnosed with clinical depression, ADD and PTSD and severe insomnia.

    Ritalin, antidepressants etc have always made me feel rotten and made the bulimia worse if anything.

    I stopped taking them all years ago.

    My doc however recently got me to try the latest sleep aid/antidepressant, Valdoxan (based on Melatonin I think) and, while it helped me sleep, after a couple of months I felt the depression get markedly worse so I have stopped that too. Felt very odd and horrid mood swings on them too.

    My backgorund is that I became obese by the age of 15 (only 5 ft 1 and I weighed around 190 pounds)and stayed that way until I was 22 years old until I lost all the weight in around 18 months by alternately staving myself then binging and purging. I ended up weighing around 100-108 pounds and have stayed that way for these 20 odd years since.

    However, I know something is very wrong with me because I still have severe bulimia, inflammation issues such as periodic joint pain, eczema flare-ups, rashes, acne, terrible fatigue, mood-swings, ear-infections and other infections such as cysts, periodic blurred vision, weakness, depression, and I'm sure other things that just don't come to mind as I write this.

    I start having cravings for fruit as the day progresses and they often become unbearable by the evening. Even when I eat a high fat, high protein meal in the afternoon or evening, even when it's 2000 cals, I just want to keep eating and eating and eventually I end up bingeing and then, of course the urge to purge is often too much for me. I never feel satisfied even if I'm stuffed.

    Do these symptoms sound to you like I might be leptin resistant even though I am thin?

    I have been to so very many doctors, specialists and psychs over the years and no one has been able to help me and I am so tired and so desperate for a solution to this nightmare.

    I tried eating low carb, very low carb and zero carb (ie less than 5g per day) but I can never sustain any of them because whether they are 1500 cals 2000 cals or 3000 cals or more (I have tried everything) the drive to eat, especially after 4pm is relentless. Even if I am stuffed full of meat and fat I want MORE. It drives me insane and eventually I give in and end up eating so much that my body seems to reject it and I end up purging.

    I have no hunger at all in the morning and all I drink is coffee (black no sugar). In fact eating makes me feel nauseous so for more than 20 years I have avoided eating breakfast and even lunch because even lunch makes me feel sick and bloated if I eat before 4pm. Even if it's a small amount.

    Could this history have caused leptin resistance? Could these problems that I have been having for so long really be so easily fixed, even the bulimia because leptin resistance is linked to bulimia?

    Do I need to just FORCE myself to eat breakfast and lunch for 6-8 weeks even though I am nauseated and bloated by them, until my body finally resets itself?

    If that is so then I will start immediately! I would rather 6-8 weeks of pain than to continue to live in this hell.

    Anything else I should tell my doc I wish to have tested besides rT3 and a salivary cortisol test?

    A million million thanks for any advice you can offer.

    • @Circe Eating disorders are directly tied to the the incretin hormone system not being yoked to the leptin system and in many ways models narcolepsy for sleep. I personally think Ghrelin, agouti and NPY are the keys for bulemia and I think the Leptin Rx will help that……but you must eat the massive breakfast and it will definitely take longer for your hypothalamus to re organize to these signals. I think it can be overcome but I have no idea if anyone is treating eating disorders in this fashion. They should consider it because the conventional psychiatric treatments for these disorders is woeful. More people die of eating disorders in psychiatry than all other mental illnesses combined. Its funny we never hear the psychiatrist talking about why this happens.

  240. I have read most of these posts and have not seen any reference to the Whole 30 program. (I apologize if I missed it) Do you see anything wrong with the portion size of their recommended carbs? If I can modify what I know from that program, i.e. pre-workout snack and post-workout snack, I would love to bring my husband on board with me on this. He had a heartattack a year and a half ago and for the past two months, he has been trying very hard to lose weight(his version of Paleo) and it has not budged. 3 months before his heart attack the Dr. put him on Thyroid medication and he has been on cholesterol medication for at least 5 years before the attack. He is 42yrs. My gut feeling has always told me there was something turned off in his body. Your post has given me proof and real hope to help him. Thank you, Kelly

  241. Dr K, thank you so much for replying despite my long post :)

    Actually this at least gives me hope. I will start the Leptin Rx tomorrow, hell, if it stops me purging I am willing to stay on it for life because it will have saved my life.

    I will let you know how I go, and thank you again for your kindness in responding.

  242. Hi Jack, I need to lose 70lbs. I'm on Day 4, really struggling to eat the breakfast, I'm only managing 30g of protein but am not hungry all day and can easily go till 6pm. Is this ok?

    Also I am really really tired all day after breakfast, no energy at all and I'm doing no exercise. I wasn't this tired before I started, is this normal?

    Last one, if I eat a bit of cheese will this slow down the process?

    Love the site, hopefully this will be answer for me!!

    • @Joanne you can dial the protein down if your craving are controlled. Sounds like yours are. The sleepiness is definitely a sign that your hypothalamus is remapping. Keep going.

  243. Is there a time limit in the morning to get in BAB, tea with coconut milk/oil and fish oil supplements? It normally takes me about an hour to get it all in. Then to I start counting the hours till the next meal? Thanks!

  244. Dr. Kruse, I've been reading your site and likely need to do the leptin reset. I have markers for LR: Overweight, High reverse T3: 329, range 90-350. Free T3: 4.4. FT3/rT3 ratio: 13.4. I have low Vit D: 31, range 32-100. Although instead of high cortisol mine is low, proved by saliva testing (6x/24hr). I'm on hydrocortisone to support my adrenals, with stable average daily temps. My naturopathic doctor dx. Graves' since my Free T4 is 1.85, range .82-1.77, but we ruled out w/ antibody test Thyrotropin Receptor Ab which comes back <0.51 range 0.00-1.75. Negative for Hashi's also. ND doesn't know about rT3 "problem" – will attempt to educate. My understanding is I need Cytomel (T3) but since my ND is on vacation for 3 more weeks I was thinking about getting started on the leptin reset. I've been on the GAPS diet since Dec. '09 to address fatigue and depression (my only "digestive" issue was intermittent constipation), GAPS helped tremendously the first year (lost 50 pounds in '10, mental health improved, many little physical discomforts disappeared) but this year I've had constant chronic stress, adrenals crashed in August, started the HC Aug.29. My weight has remained 180-184 this year. I'm 5'4", 48yo, my LH and FSH indicate I'm in menopause (no menses since May). I have high ferritin 195, range 13-150. Low UIBC 130, range 150-375, which I know can indicate inflammation and will get more tests done once ND gets back. I've had symptoms of hypothyroidism and adrenal fatigue for a decade or more (maybe my entire life?) but finally getting worse enough to do something about it. I'm doing what I can to reduce stress including cutting my workdays to 6 hours. Should I get on T3 and then do your leptin reset, or try the leptin reset for 6-8 weeks, then reassess? In the last month I am feeling more and more hypothyroid symptoms, much exhaustion. I recall reading somewhere on your site that my being in menopause may complicate my reset, it may take longer? Should I start the leptin reset, then get on T3? I know lights out by 10pm, but is 5:30 too early for waking? Would 6 be better? Thank you very much for your suggestions.

    • @Starlene. The journey begins one step at a time. Do the reset ASAP. Stop worrying about all the other crap. Focus only on the big things…..and the little things will vanish.

  245. Its clear now, haha. I over think things!

  246. Dr. Kruse, did you mean to say do the "reset" ASAP? And if yes, is 5:30 too early for waking? I normally have to get up at 4am but I switched my hours at work because I got the impression waking at 4am might be considered shift work. I only need to be up at 5:30am three days a week, I work from home the other day. Thanks!!

  247. Dr. Kruse, can you explain about the hypotalamus remapping. I can hardly keep my eyes open since starting the leptin reset. Also interested in the mechanisim that is involved in inch loss but not weight loss. I am definitely losing inches but not so many pounds. Thank you.

  248. Hi Jack, could you please explain what is happening that I am so sleepy and why I am losing inches but very few pounds.

    Also, I'm trying to help my office manager with this program (first guinea pig, besides me) and while she is quite overweight (80 pounds or so) she says she is never hungry, doesn't know what if feels like to be hungry so how will she gauge when she is no longer hungry? I tried her on the HCG but she had debilitating headaches. She is also hypoglycemic.

    What do you put on salads?

    I am a practitioner using functional medicine in my office. Are you planning on doing any training?Would love to do some with you.

    Best,

    Kate

  249. In this page, you say to eat little to no carbs at breakfast but on the Leptin RX FAQ page, you say to eat most of your carbs for breakfast when cortisol is highest and little to none at dinner.

  250. I have been on armour thyroid for over ten years without any need to change the dosage. I think if I had Hashimotos it is long gone in it's acute inflammatory form. Shortly after I got on thyroid meds I went gluten free and started working on fixing leaky gut issues that I knew were going on.I think those were big factors in keeping the autoimmune monsters quiet.

    So I have a few questions:

    I just lost 38 lbs on the HCG protocol. I started the Leptin reset about 3 weeks ago and am feeling better but not losing the weight that came back on after stopping HCG.

    I know it can take time and it is only about 6 or so lbs.

    1) I am used to taking my meds in the am on an empty stomach. That is what I have thought is best with thyroid meds. If I eat within 30 minutes of waking , is that enough time? It sort of doesnt feel like it is.

    2) Last year when armour stopped making their 15mg tablets my doc gave me levoxyl to make up the 15 that I added to my 60 mg armour. I insisted on getting some cytomel in case I noticed a need for it but I never really took it. But since the reset I have actually noticed that I am able to lose when adding in some cytomel in the middle of the day. Any advice as to dosing of T3 to optimise losses? My losses have been almost nonexistent even tho my carbs are under 20g.

    3) do I need always to avoid eggs and cheese / dairy due to my thyroid status? Right now I am eating eggs and small amount of cream but no other dairy.

    thanks

  251. Thanks Dr. Kruse. I plan on eating only about 25g. of carbs and the timing clarification helps. Thanks for this site and for helping all of us with our questions.

  252. Can someone tell me why we can't have nightshades? I apologize about asking. I had everything copied down on a word document but my computer crashed and I lost it. I don't want to have to go back through everything since I'm already on the reset.

  253. Sarah,

    Just wanted you to know you're not alone. I too suffer from hashis/adrenal fatigue and have just started the reset. I'm finding it difficult not to have any dairy (I am eating eggs) or night shades. It seems like there is not a whole lot left that we "can" have. I'm trying to stay positive and stick with this, so maybe I should really get out and try new things. Any ideas?

  254. Dr. Kruse,

    Thank you so much for this blog and your time!

    In the Erin Chamerlik podcast you discussed that you change your eating habits in the winter months. I am 4 weeks into the leptin reset and coming off of my third round of homeopathic hcg. I eat my BAB within 30 minutes of rising and then I get hungry and eat again around 3pm. I know you say the timing is very important so in the winter should I just eat some coconut oil at 3 and then eat later when the sun is going down like when I get home from work at 5:30?

    • @Sonia In this case I would not snack at 3PM. Im assuming you are in the northern hemisphere, Instead I would chose one of the following. Eat an early dinner at 3PM and not eat anything after it or I would just wait til 6 to eat and use cold water or green tea to quell your ghrelin response from your gut that is driving the hunger.

  255. Nevermind…I looked it all up again. My only question now is where to concentrate more….leaky gut or autoimmune. I am on day 3 of reset and need to order supplements, but not sure what is most important. I lost weight with hCG, so looking at that list, also looking at leaky gut list. I can't afford it all, so just curious where I should start.

  256. Dr. Kruse,

    I'm on phase 2 of HCG right now, and have a couple of questions. First of all, I'm 5'6, female, not overweight, athletic (but haven't been able to work out for about 6 months because of injury), highest weight was at 162, currently at 137, goal of 130. I obviously can't use the mirror test to see if I'm leptin resistant, but I don't have the money to get the tests done. Any other cheap way to find out if I'm LR?

    Also, can I start the Leptin Reset on P2? Eat one serving of protein upon waking, eat veggies/fruit in the middle of the day, and final meal at night?

    Does the Reset work without the supplements? I'm planning on just taking a multi, C, B complex, co-Q10, and resveratrol. Do I really need the rest?

    Lastly, if I want to work out, should I do resistance training as long as it's not a cardio workout during the reset, or will that extend the time of the Reset as well?

    Thanks in advance!!

    ~ninja

    • @ninja I am not even sure why you would still being HCG with those numbers. What is your body comp like? Your sleep? I think you are playing with fire right now. You are telling me you need to use HCG to shred 7 lbs? I am telling you that I think once you finish you are going to have a brutal time staying at 130. I would tell you to do the reset as soon as possible. You dont need supplements unless you have a ton of underlying issues like inflammation and if you modulated your hypothalamus. In your case, I 'd be seriously concerned about both issues.

  257. I'm at about 21-22% bodyfat right now, but I'm also in the middle of round 2 of phase 2. I was at 150 when I started (round 1). Do you think I have to finish up the 3 weeks of HCG or can I start the reset asap? is 130 too much of an expectation for me? the "ideal weights" that i've been looking up say i should be around 125. I thought 130 was ok with muscle. When I was in my competition days, working out for a living, and not watching what i ate (and also younger), I was a comfortable 136.

    • @Ninja…..at your numbers I think your body comp is not close to optimal. I think you need to rethink why and how your doing it. you are close to an ideal body weight with 22% BF. That tells me your body comp is off and I am wonder aloud if you have ever consider picking up a real heavy weight and maybe sprinting? I think those two things are the ideal things to be doing eating a solid paleo diet with the Leptin RX rules. I think you might get to 120 or 125 with a six pack and be kicking some butt soon. I think your settling for less than optimal really. I just don't see the HCG angle at all for you here. As a doc I just don't get it. And who ever sold this stuff to you has to be in it for the cash alone. Id love to hear how the doctor signing your chart can sleep at night well.

  258. i'm worried that stopping the HCG before the 3 weeks is up will make my stabilization even harder and mess things up even more.

    • @ninja I can understand that but I am at a loss why you would try to finish with HCG at your current weight and height and I am even more at loss to explain who would allow you to do that? To each their own. I think you better have a good plan in place when you come off. You are going to need it I think.

  259. I was informed that if I don’t do at least 21 days of the HCG, that stabilization is basically out the window and the weight I lost will come back pretty much in a few days. The reset was going to be my plan. That’s why I’m trying to get it (the reset) right before I start. What do you mean by “modulated my hypothalamus”? How do I find out if it’s modulated, and if I have underlying issues with inflammation?

  260. So I should stop the HCG before the 21 days are up?

    • @ninja…….Im perplexed why you thought it was a good way to finish your seven pounds with your body comp? I think now that you have jumped in you might as well finish it but my bet is you will not be able to stay their because your hypothalamus is a wreck

  261. I started when I was at 150, so I had 20 lbs back then to lose. and I didn't know about the Lrx. Now I'm kicking myself in the ass. Wish I had known about this before.

    • @ninja. Dont beat yourself up because it will raise your cortisol! Just pick and realize you learned something continue on to optimal. You are lacking the final piece. Body composition. That comes with heavy lifting short reps and running sprints with no cardio and eating a paleo template.

  262. Thanks for all your help. Lifting heavy and doing sprints is allowed for me, right? I'm planning on incorporating that, starting tonight (putting on shorts and t shirt as i type).

  263. So when I start it, should I see it as a reset (no working out, if I cheat, i have to start over, darkness at night), or should i just see it as starting the new lifestyle (paleo, HIIT, heavy lifting, no snacking)?

  264. thank you :) started with the workout out last night. feel awesome about it today. i'm assuming standup martial arts (muy thai, taekwondo, boxing) counts as HIIT.

  265. Rachelle M says:

    Hi doctor, I got some labs sone and I was wondering if you could look at them really quick and tell me what you think?

    Cholesterol: 204 (yikes!)

    Triglycerides: 65

    HDL: 70

    LDL, calculated: 121.4

    CHOL/HDL Ratio: 2.9

    t4,thyroxine:7.7

    T uptake:34

    TSH: 1.58

  266. wait, what's the difference between the reset and the rx?

  267. terecita60 says:

    Dr. Kruse i have been on reset for twelve weeks now, but my energy is no good my body aches, could it be cause i eat nightshade veggies? or is my body still healing? I did alot damage to my body in the past, dieted all my life and i also struggled with bulima before, i am determine to still continue the reset.

  268. nevermind. i got it. i found the MDA leptin forum. very helpful, thanks :) I'm in the same boat as Theresa (post #256), and am stopping the drops today. reset officially begins with the BAB on Sunday. can't wait!

    ps, any word on how Theresa is doing so far?

  269. @ ninja last i heard, quite well.

  270. @ Michele, I am struggling with my "everything free" diet, but its just raising my cortisol! Not fun! goat cheese/ goat yogurt and butter were the last things I wanted to give up. Check out my adrenal/thyroid health blog .. healthfaithlove.com, you can contact me on there as well!

  271. Dr K, I am in week three Leptin RX, still hungry inbetween meals… Im sleeping better, and feel fuller longer, but the hunger hasn't gone away. I really want to start exercising as I am 5'4 140lbs and it seems the weight wont budge…and it STRESSES me out! :( adrenal fatigue/hashimotos are my battle right now. I've been paleo for about a year now and the only way I lost the first 20 was HCG. Suggestions? Thanks, you are a ROCKSTAR!

    • @sarah if you still hungry between meals you are not getting enough protein or fat at breakfast. That is clear in the Leptin Rx and the leptin FAQ's . Make some adjustments. If you want to try exercise you can see how it goes. DO HIIT with weights and sprints only. No cardio!

  272. I have a quick question Dr. K. If my HS CRP is down to .7 was 8) and my ratio of FT3 to RT3 is now 48 (was 9), does this mean that I am now leptin sensitive?

  273. Ok, not sure how the smiley face happened…..my CRP not too long ago was 8.

  274. I've been doing between 50-60 grams of protein, but I will up the fat, with come coconut oil.

    HIIT/weights after the last meal of the day?

    @ninja, I was wondering the same, but I was wondering about the "just like sugar" product :)

  275. I've seen all the signs of the reset working to various degrees and am now considering myself finished with the reset! Thanks everyone for contributing to a great resource here as well as Dr K of course. Here are my stats from when I switched from vegan to Primal as well as more recently starting the LR:

    date lbs. body fat waist size notes

    ========== === ===== === ==================

    04/10/2011 192 22.5% 38" started Primal lifestyle

    09/04/2011 170 19.6% 34" started LR

    09/12/2011 168 19.2% 33"

    09/27/2011 162 18.2% 32" more strict LR, less exercise

    11/05/2011 156 16.6% 31" finished LR

    While switching from vegan to Primal was certainly effective, my fat loss really accelerated to more than twice the rate once I switched to LR. I made about as much progress the 2 months I've been on LR as the 5 months before that I was on primal (not to mention it is more typical for progress to get slower and slower the closer you get to optimal body fat %).

    Keep up the great work everyone! :)

  276. People are saying the just like sugar is really good, especially in cooking.

  277. I know I saw it mentioned somewhere…. Calories from a TBS of coconut oil is less than the amount of calories that it will burn, thus promoting weight loss. My doc of course believes that it has it's place in helping some childhood diseases, but in adults, it's use will just make us fat. I would love to have an actual study to show him otherwise. Anyone?

  278. quick followup after 48 hours following the paleo diet with LRx rules….stayed same weight first day (which was technically only half a day on the Rx), and second day i lost 1.8 lbs!! BAB was close to 60g of protein each day with an added T of CO (didn't even drain the bacon grease!), and lunch yesterday was an ahi steak, asparagus, and probably about 3 T of CO (2 of which got mixed with some cocoa powder and stevia/rubiana). I think i'm ok having just 2 meals a day. Yesterday, my last meal was at 2:30 (not even hungry, but i was aiming for 3 meals), and i didnt' get hungry till about 11pm…which is when i just drank some water, and the hunger went away. and i went to bed. No cravings, energy's good, didn't work out this weekend, but I did a short heavy lifting session on Friday (before the LRx) and felt fine. I'm assuming I'm not LR….does that mean I'm totally LS? What should I do about nightshades and dairy? Do i have to get a cholesterol screening for the nightshades, or should they be ok because i'm LS? And do i have to do the glucometer for the dairy or should that be ok, too? ps, THANK YOU SO MUCH :D best part of the whole thing…i really like the freedom from snacking and thinking about food all day (being a recovering food addict)….crazy how it works SO well, and (in my case) SO QUICKLY!!

  279. how long should i reset for? i'm already showing signs of LS…no cravings, no hunger between meals, feeling warm, sweating easily, sleep is good, energy is good…weight loss i won't comment on quite yet because i think it's too soon. is there any way to test HDL at home? or as close to free as possible?

  280. and now waking up way before my alarm clock….

  281. Hi Dr. Kruse

    Im another Hcg patient for you. I feel like I never should have been prescribed it but thats another story. First off I will say that Ive struggled with insomnia, anxiety and depression for years. BIggest symptom is the insomnia. And a history of an eating disorder. Been in recovery for about 6 years, but still struggle with emotional eating.

    So, I started Hcg at 130 lbs, Im 5'5" but I had about 27% body fat. I lost 12 lbs in about 26 days and got to about 21 % body fat, and I actually slept well on the hcg. But the weight loss was strange, dont get me wrong, I lost everywhere,but I also lost a lot in my face and breasts and then when I got out of Phase 2 and started eating again, the weight came back on in strange places. I stabilized very well at about 120 but even though I had only gained 2 lbs, my legs seemed so much bigger and my proportions were just off. I felt very depressed and confused. Ended Hcg in June of this year and did the follow up stabilization phases. I only did the one round.

    So after about 2 months of struggling with insomnia still and discomfort in my body, I fell back into the anxiety/depression and had a tough 2 months…. Gained most if not all of the weight back. On a bright note :) about 2 wks ago, I crawled my way out of it :) and back to eating healthy and exercising. Since then I've lost about 1.5 lbs. But my weight is still up and so is my body fat. My scale says 128, and for body fat, one test said 22 and caliper test said 27….. I am really struggling with the gain, cant fit into most of my clothes. Im not doing any more hcg and have just been trying to eat well, and exercise (tried Hiit ystrdy) but my body is definately confused.

    So…. Im wondering if you think this would be a good option for me? Im a little gunshy to try another diet, so I may need to start off slowly, but Im wondering if this will help me. This morning I woke up and Ive been at the same weight now for over a week and so I did a BAB, thougth I would give it a try. Made me a little nervous tho… My biggest goals are to lose the lbs/body fat and help with the insomnia. These are what "weigh" on me the most. Thank you so much! Btw Im 42 female

    P.S. Is there a way to tell if I messed up my hypothalamus? I read a little about that in an earlier post.

    • @Kim I am not sure why you tried HCG either? Let me be clear, the reset is not a diet. I do not advocate any diet. I tell people to eat an ancestral diet but I focus on timing and light cycles. Once these basics are reset in the brain then we go about trying to rewire how your hypothalamus works permanently. That post is coming this month. It is what one should consider after the reset has worked. The Leptin Rx is meant to reset people……its not a permanent way to eat. Eating a primal/paleo template is best for optimal longevity and that is my primary focus.

  282. ok, thx. So do u think this is a good option? With what I have told you? Do you see any big concerns etc?

    Diet, food plan, template… etc, new way of eating… I just meant that Im a little hesitant, because of what Ive been thru.

  283. p.s. How Ive been eating, is fairly paleo, I do have yogurt which I think Sisson says is ok in moderation and lots of fruits and veggies and organic meat… Coconut oil and occasionally almonds and almond butter. thx :)

  284. Dr. Kruse,

    If someone is LS, would they benefit from following the Leptin Rx? Or just from eating Paleo/primal and the timing and snacking?

  285. So question…..should we count coconut oil into our daily calories for those of us who are LR and watching caloric intake?

  286. "Should" we count calories if we are LR?

    • @Sarah…….I never count calories no matter my Leptin status. When I was LR I did not and I dont now. They are not material to weight loss or optimal for that matter in my opinion and only serve to drive a patient's cortisol higher if they do count them.

  287. Correct me if I'm wrong anyone, but I remember Dr. Kruse saying that if you're LR, calories absolutely count, but once you're LS they don't.

    • @Michelle…….true but I could care less about calories period. They seem to matter to many bloggers and researchers who pin their theories on the first law of thermodynamics and who don't seem to really "get" how hormones and the brain control counting electrons.

  288. Hi,

    I am in the 5th week of the Leptin Reset and I have combined it with phase 3 of my 3rd round of homeopathic hcg. I have stabilized perfectly but I haven't lost any weight. I would like to use the Leptin Reset along with a Paleo lifestyle to lose the last 30 pounds that I have to lose instead of doing any further rounds of hcg. Do you think it is odd that I haven't lost any weight?

    Also, I am doing the BAB on time and paleo for my other meal except I have not completely given up dairy. Is this a major roadblock? I have purchased a blood glucose meter and don't see any major spikes after eating it.

    Thank You!!

  289. Can the body go into starvation mode if one is leptin sensitive? From a weightloss perspective, there are tons of articles that tell people that eating under 1200 calories will put our bodies into starvation mode. If one is simply not hungry enough to eat 1200 calories, is that okay? Thanks

    • @Maria…….I never talk calories…….why? Once your LS they don't matter. Of course the body can go into starvation mode if one is LS. someone who is normal will eat north of 1200 calories. If you do not feel you need to eat 1200 calories something is really wrong or you are doing a diet that is not congruent with evolutionary medicine.

  290. Hi Jack, thank you so much for all you are doing.

    I am a 60 year old woman LR, with no physical restricitons. What should I be doing for exercise? Do you recommend fit for life?

    • @Kate. Exercise should also be done within the proper evolutionary context. That is coming in the Postscript post for the Leptin Rx. As for what to do I have been pretty clear on that……..I recommend HIIT with heavy lifts (90% max) for short reps 3 X a week……core, upper ext, and lower ext with two days of 40 yd wind sprints in between. I dont recommend anything else. If you do cardio just put me down as a beneficiary on your will! ;)

  291. Hey Jack- it has been 8 days now that I have been following this protocol- not perfectly but I am getting closer every day. I wanted to tell you that I am thrilled with my results so far. I have lost 7 pounds now. Most of which have come off in the last 4 days since I really have been adhering to your protocol. I have a ways to go but this is a great start.

    Thank you so much. I have hope again!!

  292. Hello, Jack. I am tempted to try this, but I am not sure it is really for me. I have been primal for 5 months and have lost 35 pounds. I should lose an additional 50 pounds to reach my ideal weight (that would be around 160 pounds). I am overweight, so I am probably leptin resistant. Nevertheless, I am wondering whether your plan makes sense for me. It seems to be designed for people who have cravings and find it hard to resist binges. That is not my case at all. I eat twice or three times a day, without snacking. I do not crave anything "prohibited". I think I am safely under 50 g of carbs per day. Would the reset be beneficial for me? I like eating my breakfast about 90 minutes upon getting up. Eating immediately would be a change I would not exactly enjoy, but if you think it would help, I might give it a try.

  293. hi Dr. Kruse. thank you for your info on leptin. i am still working through your blog but i, like everyone else, have a couple of questions.

    i am female, almost 5'9" and hover around 178 lbs. i have of course been exercise consistently for about 9 months and i went up to 182 but with a few weeks of hard workouts (INSANITY program) 6 days a week and way less carbs, i dropped to 175. after that, i never dropped lower, but i felt i had lower energy and did not see muscular progress in my workouts, that's when i found your site, and i decided to stop the hard workouts. i switched to walking for 2 weeks, and then started weight training for 3 weeks. my body fat percentage has gone down from 30% to 28% i work out in the mornings and only ingest BCAA powder right before and after. i eat 3-4 hours before bedtime, 3 meals a day spaced about 4-5 hours apart. i have dropped most cravings for carbs and sugar and i'm not hungry between meals. in July i had an A1C done and it was 6.2 in October it was 7.2 despite eating less carbs and exercising. i started taking cinnamon and suddenly in november it was 5.3 i had a history of graves disease but have been symptom free and tested normal for 3 years, but on Nov 1 my TSH was 0.31. my T4 was normal. my doctor did not test T3, and it's difficutlt to get her to test what i ask her to test (such as cortisol). i need to change doctors because she recently told me that for me to lose weight i may need to drop down to 800 calories and exercise a lot. not good.

    i used to take diphenhydramine to sleep for over a year but was able to stop after i started allowing at least 3 hours after eating before going to sleep. i sleep pretty well now. i cannot lose the 12-15 lbs i feel i need to lose to get to a normal body fat percentage or bmi. i sweat fine and recover from exercise fine. however i don't usually feel all that refreshed when i wake up. i get 7-8 hours of sleep nightly.

    i have no idea if i am leptin resistant, i had assumed i was insulin resistant but switching all my carbs to things like sprouted wheat grain bread, and lowering them, etc, did not seem to help for any length of time.

    do you think i am leptin resistant based on what i have said? also, how can i find a decent doctor in my area that will do some of the tests you suggest? i hope this wasn't too long, it seems long. but i am very confused.

  294. I am new to all of this, but have been reading in order to educate myself. I am just now starting the intro to the gaps diet and would like to know if incorporating your leptin protocol, along with eating the GAPs way would be beneficial. I am pretty sick and tired of being 30-40 lbs too heavy, with inflamation problems and constipation so it's time. I recently moved to a Senior Co-op high rise and seeing the problems all these people have has scared the living daylights out of me. I don't want to end up with problems I can no longer reverse. Please let me know if starting out with your Leptin reset protocol would be the best way to go.

    • @Susan with limited info there is no way to say…….I think paleo template laid out in Robb Wolf's book or Mark Sisson's book married to my Leptin Rx far exceeds the Gaps diet. I think the Gaps diet is used more for certain conditions that I doubt you have.

  295. Dr, K. I apologize about saying according to you calories count for those that are LR. I went back and re-read what you said and I get it now. They do count, but not the way I was thinking you meant.

  296. Thanks, now I will have to look into these books. I just read "Wheat Belly" and I have always felt that it was wheat that caused much of my problems. That along with most dairy. Infact, animal protein and starchy food will give me an acid reflux situation. I try never to eat them together. I don't go to doctors, so obviously, I do not have numbers, and diagnosis to refer to. I also do not take allopathic medicine. All I know is that all my life I have had constipation problems, and as i got older, into my 40's, weight problems, along with inflamation which causes pain in my ankles and sometimes eleswhere. I might sound a bit wishy washy, but I want to give something a try that makes sense to me.

  297. I'm 4 weeks in and still experiencing hunger… I'm eating 75-85 grams of protein and lots of fat at BAB… Between lunch and dinner I get really hungry and i feel like it makes me over eat. I'm still not loosing any weight and I'm very very thirsty. I'm 23 5f4inches 140 pounds. I haven't started HIIT because I'm waiting for the hunger to go away. I have hashimotos and adrenal fatigue and ive been paleo for about a year. Thanks!!

  298. I eat so much in the morning I feel nauseous! It just doesn't last long.. Should I eat a big lunch too? I eat lots of coconut oil and milk.

  299. are we supposed to do HIIT AND lift heavy weights or get a HIIT workout in WHILE lifting heavy?

  300. I'm reading someones(a female like me) blog who is doing your Leptin RX.

    I thought I understood your leptin reset food rules:

    Eat 50g of protein (little to no carbs) within 30 minutes of waking

    Limit carbs to 50g a day

    Eat 3 meals a day, no snacking especially past 7:30pm

    the blogger is eating 50 gm of protein at each of 3 meals per day for 150gm+ of daily protein! Is this how the Leptin reset is to be understood?

    I was figuring to start with 50 gm at BAB and not eat again until I felt hungry which I estimate will be early evening. 5:30 pm or so. Does the Leptin RX really mean I have to eat such gargantuan amounts of protein throughout the day? I don't think I can eat that much protein without throwing up. in fact I KNOW I can't.

    Thanks for clarification.

  301. After reading through all the comments here and elsewhere, I get the feeling that some folks are confusing the amount of protein they are consuming versus what the protein source weighs.

    As an example, a piece of chicken breast that WEIGHS 50g, only contains about 15g of protein.

    I bet that many of you who are saying that you are still hungry after consuming a BAB of 50g or 70g of protein are using the weight of the protein source and not the actual amount of protein found in the source.

    I have the ability to "eat big" and I cannot fathom anyone not being totally stuffed for hours after consuming 70g of protein. Just sayin'.

  302. Jack I was wondering how detrimental it is to workout in the early morning? I have about 5-7lbs of fat that I would like to lose but my biggest blocker is my schedule. Thanks! Your articles are awesome!

  303. What about nuts? I crave them and eat them almost every meal. Why do you say no cardio?

    • @ Tracy nuts are just OK…..I use them only for meal replacement when in a pinch or in my paleo bark chocolate. The only nuts I eat are macadamia and pistachios nuts raw. Nothing else because the omega 6 content is too high. If my Selenium levels are dropping (thyroid panel) then I may eat a brazil nut every other day for a couple of weeks.

  304. Ashley Smith says:

    I apologize if you've answered this before somewhere else, but will this reset help with the hormones estrogen and progesterone? I went Paleo back in Jan. 2011 the month after (Feb.) I skipped my cycle then it came back in March…after that nothing. It never returned, and I've been annovulatory ever since. My doctor eventually put me on three rounds of Clomid to try and have me ovulate. Not much success there either except a lot of mood swings and weight gain. We want to have a family, so I'm looking for every angle I can to get my hormones balanced again. Thank you for your help.

  305. @jleslietx – thanks, that's kind of what my question was about too. I can barely eat 30-40 gm protein(the macro-nutrient) and couldn't fathom people(women) eating 150+ gms in a day. glad to know that's not what the reset means.

  306. why no cardio?

    • @tracy Cardio depletes stem cell supplies by increasing the amount of ROS from our mitochondria. This is why people who marathon race often die. You dont see this with sprinters or weight lifters.

  307. So, Dr. Kruse, you are saying that if I sprint and weight lift, I will never die, in comparison to marathon runner who "often die?"

    • @Lynn No I did not say that. I said your chances are much higher that you could die if you do endurance exercising as a routine chronically. Everyone will die. It just a question of when and how sick or healthy.

  308. Is there a reason why this way of eating would bring out a fairly dormant eating disorder? I have had my weight off for 3 years now (hCG) and have worked constantly on binge eating, but finally got it under control about 90%. With IFing and paleo I have kept my weight down. For some reason, eating the leptin reset has caused me to want to binge at night again. I feel like I'm on a rollercoaster and going backwards.

  309. I'm at my wits ends and not sure where to go from here. I am taking vitamin k2, but think I will up it.

    Any other supplements you recommend?

  310. Hi Jack

    A question for athletes (not that I consider myself one but it's a similar situation)

    You say not to work out till after 5pm. This is impossible for me – my life/work runs as follows;

    breakfast (can do within 30 mins of rising so now worries there and can probably manage the 50g of protein)

    9am-4pm – downhill skiing (it's my job as a ski guide) every day for 5 months.

    8pm – Dinner.

    How would one deal with this issue of HAVING to exercise all day in one of the highest calorie burning sports known to man(this is how I knew I had serious problems when I worked doing this job last year I didn't lose a single inch. All the fat was still there! (I was snacking and carbing)

    Any recs?

    take care

    • @Sarah professional athletes use timing all the time to optimize their performance. There is no way around this. My latest blog on on when to exercise shows why this must be followed. And it you dont you can not expect optimal soon…….it will take years.

  311. Oh ps – it may help (after reading all these comments) that the downhill isn't chronic much – it's much more like HIIT – you ski straight down, high intensity then stop for a bit, wait for everyone else, tell them where we are going to next – then high intensity again, then maybe a slow, easy run, a few chairlifts in between (great resting phases)

    I also have a smidge of narcolepsy (I don't fall asleep unwarned – I usually feel it coming. I rarely feel tired out skiing) and my t4 is borderline low (not low enough for docs to consider meds..bought my own Armour and they refused point blank at the lab to do t3)

    Hopefully this will help with sleeping through the night, I awake at least 2 or 3 times and you can imagine low thyroid combined with narcolepsy and broken sleep!

    I will be able to start the plan now before I commence my job on or around 19th December.

    take care!

  312. I've been thinking about this and wondering something The past few days I have been feeling very anxious and like I want to kill someone. I am normally laid back so this is very different for me. I feel like I want to jump out of my skin. This is the only way to explain it. Is it possible that my adrenals are starting to kick back in (addisons)and this is what I'm experiencing? Maybe I am feeding the anxiety that I'm feeling.

    • @Michele Those are not things I usually hear from patients and I doubt have much to do with the reset. I would suggest you discuss this issue at once with your PCP

  313. Jack, I started the Reset RX a few days ago. So far so good. My main issue is I have had chronic insomnia since I was a young teenager. I rarely get more than 6 hours of sleep a night and wake up frequently. I also have sleep apnea and use a CPAP machine.

    I take Lunesta 3mg to help put me to sleep but I nearly always wake up a couple of hours later and then have a difficult time getting back to sleep and staying asleep. I have tried Melatonin (various doses) without much success.

    Is it hopeless for me to reset with this sleep problem? Is there anything else I can do to resolve the insomnia? I went to a "sleep doctor" for a year to see if any of the usual techniques would help but none made much of a difference so she ended the therapy and referred me back to my GP for meds. control.

    Thanks for your input.

    • @SteveR……ask your doc to order a DHEA level on both your blood and serum. And be ready to be shocked. Yours wont be pretty. But then you can repair it and your sleep will improve. You must control light levels after sunset. it is critical.

  314. Very interesting site! Apologies if you've answered this question elsewhere: considering how early the sun sets at this time of year (4:18pm today!), is this a bad time of year to start the Reset? It would be pretty hard to make my surroundings as dark as possible by 5:15: how would I cook dinner? I have another month of shortening days before things turn around. Are there lighting tricks to help with this situation, e.g., or should I just wait until Spring? (I don't really want to wait until Spring!) Thanks for your time.

  315. Newby here with a situation not yet published:WF, 49, 5'5,186(started paleo 6mos ago @202#). started LpR 4 days ago. Always ate healthy/clean &natural food. No chips, chocolate but love my dairy. Weightlifer/Active in my 20's, started child bearing @33-38. Type A, work aholic, VERY stressful past 10 yrs. Heart rate always low but got to 31 which I ended up w pacemaker 2 yrs ago. Blood/oxygen NOW gets thru my body regularly….so I should/could be the six million dollar woman other than my 30+lbs overweight. I'm on no meds of any kind and want to stay that way w/healthy eating. What measures should I follow or stay away from due to my pacemaker? My cholesterol has gone up from previous 140 to 190 w all my new fat eating choices :(. Thx for providing this outlet!!

  316. Extra thoughts-don't have hunger or snacking issues but I can't remember if and when I've ever slept more than 6 hours at night in past 20 years.

  317. Jack, I've seen all the signs of LS except for the feeling full while I eat (enough to make me want to stop eating), and the increase in libido. When are these supposed to kick in? I've had issues with binge eating/purging in the past (handful of times), and my sex drive all of the sudden took a dump this March. As a 29/f who used to have a sex drive of a teenage boy, this is quite alarming. When are these two things going to kick in? Also, I was holding steady weight-wise for the first 2 weeks of the reset, and I gained a quick 4.2 lbs in the 3rd week. We'll see what happens this week, but I thought I'd throw that in there in case it means anything.

  318. I have been on Paleo since July with no weight lose at all .. I also have Adrenal Fatigue due to Mold exposure with Hypoglycemic symptoms… The Paleo diet has helped but I have gained 35 pds due this Mold Illness sickness and not a pound of it has come off …. :(

  319. I didnt know that .. Thanks !!! I am on Cholesytramine for the Mold Illness and I know its going to take time to heal my body..

  320. I am 7 1/2 weeks into the reset but am not seeing any of the signs of leptin sensitivity other than being able to skip lunch and snacks. I might be sweating a tiny bit more but I have gained a little weight and I am definitely not refreshed when I wake up (generally because someone or a pet wakes me up in the middle of the night and I can't fall back asleep).

    I am 40 yrs old on 75 mcg synthroid with ten pounds of pot belly that refuse to budge no matter how much I exercise or eat well (prior to the reset).

    I finally clued in to the fact that I should be taking the top ten supplements and started them today. I also have not been able to make my house dark in the evenings because of young children. Also my cortisol is probably really high every night when I have trouble getting my kids to go to sleep. I have followed the other rules: 50 gm protein upon rising (although I have been waiting 45-60 minutes for the synthroid), no exercise, no snacks, 25-50 gm carbs, paleo diet.

    I was hoping with the reset I could heal my thyroid and get off the synthroid since I still don't feel great even with the medicine.

    Any recommendations and would the supplements make that much of a difference? Any ideas on how much longer? I have to wear a swimsuit over the Christmas holidays! Thanks for all you do.

  321. How do you test for Leptin levelsand where can you have it done ?????

  322. terecita60 says:

    Dr.Kruse what can i do when my cholesterol test came back too high, I am a 51 yr old female, have been tested on everything all good numbers except this, total cholesterol 357,Triglycerides265, LDL-cholesterol236,I have been on reset since june of 2011 I am quite not there yet but I was a bad eater and suffered with bulima, any advice from you dr. I am deeply grateful…

  323. Hello Dr Kruse,

    Throughout my life I have often struggled with constipation. Since dropping sugar and grains (wheat in particular), I have not had that problem until now following your Leptin Reset Rx. I have been doing this for the last 4 weeks and can't believe I have completely lost interest in food. I practically gag at every meal now, whereas I used to eat everything in sight. Looking forward to my weight dropping off. When I went to my GP to order all my tests, I mentioned my constipation and she told me to eat more fiber, drink more water and get plenty of roughage. Apart from the water, I know this is not advisable and would like to know what you would recommend to get my bowel working properly with a more thorough elimination. Thank you very much for your time Dr Kruse.

    • @ Lee I would not recommend that at all. I think you should consider three things. One……use epsom salt baths or pedicures 2 X a week, I would consider Magnesium malate of citrate 800 mgs 2-3 hrs prior to sleep, but the the best one to consider is adding Betaine HCL to your AM supplement list to improve your ability to absorb protein to repair your gut. Constipation is a clear sign of a gut issue. I also am a big fan of using Coconut oil orally to your meals to help this too. Fiber is a waste of time in my primal opinion.

  324. Wow, thanks for your prompt response Jack. My doctor says my HDL is unusually high – 2.29 mmol/L Range (>1.20). My LDL 4.9 mmol/L Range (<3.5). Why would that be? Thank you Jack.

    • @Lee you can have a good HDL level but still have a gut issue die to motility issues or due to absorption issues. Nothing is static in biology except the way a human often thinks about complex problems.

  325. Dr Kruse-

    Started the leptin rx only a few days ago and am feeling great. I'm able to eat a BAB at 8am and am not hungry until 2 or 3 pm. Would you recommend that I just eat another big meal at that point and make it dinner? Is there any drawbacks to just eating twice per day? I'm a little afraid of consuming too few calories and a lowered metabolism. I'm a nursing mom so I know I need to get sufficient calories.

    Thanks!

    • @MarieZ the quantity of calories is immaterial but the quality of what you are eating is quite material to the issue. Two meals is fine if that is all your brain is telling you you need.

  326. What are "prescription grade fish oils," and are they necessary since I have found fish oil at Walmart that says it is screened & purified of mercury? How are they better? (I'll make the switch if needed but want to understand.) :)

  327. Michelle, when you say you've "had your weight off for 3 years (HCG)" does that mean you've been on the 500 cal/day regimen for all or most of that time? If so it would be my guess that's what your problem is. I only ask because I know several people who have been cycling on this starvation routine for the last 2 years because "it's the only way" they can keep their weight down.

  328. Hello Dr Kruse, following on from my post yesterday regarding constipation and you saying it's a gut issue. Do you mean leaky gut? and if so, can I leptin reset at the same time as heal my gut? Thank you.

  329. So any gut issue would be healed following the leaky gut protocol? And … can I still leptin reset at the same time?

  330. I am medium build, 5'5 1/2 and have just surpased my goal weight of 127.5. I'm still on the reset due to slightly elevated cortisol in the evening and very depressed in the AM. I just started adaptogenic treatment about two weeks ago. Just started to lift heavy the other night with some soreness yesterday and today. My body comp is better than it's has ever been, but all but two sex hormones and thyroid are not optimal, hence the need for improvement. Eating 30/35 carbs a day. How do I stop losing? Should I just titrate up the carbs to where I stop losing, but stop if cravings/hunger increases and then increasee fat? Thanks.

  331. General question to anybody who might know this. when i'm doing the leptin reset is the amount of carbs net or total, i know the least carbs the better but I'm just wondering and a lot of people on other website want to know as well.

  332. It's total carbs.

  333. Thank you LSSeeker

  334. Hello Dr Kruse, I have just been diagnosed with bacterial pneumonia and have been prescribed penicillin and another anti-biotic. I was told there was no other option. What would you recommend to minimize the impact on my gut flora, apart from increasing pro-biotics please?

    • @Lee Lots of fermented carbohydrates like Kimchee, Kombucha, sauerkraut, Dill Pickles, Kefir, Raw Milk greek yogurt all come to mind………and a much higher dose of Vitamin D daily.

  335. Doc, above you mention,". First make sure you really are Leptin resistant (LR) to begin with."

    Then," … I would tell you to go get a blood test and check your reverse T3. It will be elevated. I also recommend simultaneously checking a salivary cortisol level. With LR, you will always see higher cortisol levels later in the day.

    By "higher levels", is it higher than the AM level, or, higher in the PM range than it was in the AM range?

    Example: On the saliva test chart, AM cortisol is at bottom of normal range. As day goes on, level rises to nearly the top of the range. But it's still lower than the start of the cycle. Am I clear enough?

    And "reverse T3 will be elevated" does not mean the ratio, just elevated according to the limits on the lab sheet. Correct?

    I try and do my own lab interpretations but sometimes I can't be sure of simple things. I really helps us learn and do for ourselves when we get help with what we are looking for. Thank you for the gift of guidance!

  336. What an eye-opener, whoa.

    Been LC for several years, went paleo in 01/10. Then I was very fit (bf% 15%). In 04/10 started to gain weight plus other hypothyroidism symptoms. Cortisol (daytime) is mile high.

    Situation now: on T3 only meds, currently 80mg/day. DHEA and other sex hormones low. Suspect of a hypothalamic disorder. Trying to get better by eating T3 only until "clearing" and then starting T4 as well.

    Gained altogether 28 pounds and still almost gaining. Exercised a LOT whole my life, still do. Crossfit (weightlifting, metabolic conditioning etc.) and some other stuff.

    Probably I'm leptin resistant too? I just thought that I caused my situation by eating zero carb, exercising too much and eating also too little. Is the cure still the same: minimal carbs, three meals a day?

    A HUGE thank you for your work! Would appreciate a response. Will start the diet immediately. (Ps. Been paleo the whole time since 01/10).

  337. Oh, also: my hypothyroidism was diagnosed as subclinical and my RT3 is high. First tried to treat it with T4, then Thyroid and now I'm on the T3 only bandwagon.

    One more question: if I am to start this tomorrow there shall be Christmas in two weeks. Does eating "bad" on one day ruin all the efforts? Talking about the 24th. It'll be extremely hard to explain to our families…

  338. Some personal observations. And I'm aiming this at you hcg users.

    I have been borderline anorexic since my teens. When I was in my early 30's I got my weight down to 135 (I'm 5'9.5" and med frame) by living on 750 calories a day. And that wasn't unusual. I think that pretty much says it all.

    In the last 30 years I gained 100 pounds, lost 59 on the Jenny Craig (near starvation) diet about 5 years ago, gained 20 back, starved some more for 9 months using hcg and lost that 20, gained that 20 back, read Why we get Fat and what to do about it, went strict no-low carb in January of this year and gained another 20 pounds.

    huh.

    Read Wheat Belly in September and completely ditched all grains. Found this blog in October and started the leptin reset mid month. Lost 10 pounds in 2 weeks while choking down 50g of protein every morning. Here's the interesting part.

    the first 2 weeks I would FORCE myself to eat all that food. I would feel nauseous for hours and wouldn't feel hungry until about 6pm. Then just barely. So naturally I dropped 10 pounds because I wasn't eating much.

    The next few weeks were really difficult. I couldn't stick with the program. I'd toss at least a third of my breakfast in the garbage because I JUST COULDN'T CHOKE IT DOWN. Then I'd find myself sneaking a cup of coffee with cream about mid day because I "wanted" it. I kept trying to stick to the no-lunch thing but it was not working.

    A couple of weeks ago I began to notice that eating all that food at breakfast wasn't nearly as difficult as it had been. And I was getting hungry earlier and earlier. About the time I noticed that I was hungry around 2pm (yet suppressed it) I also found that after I ate dinner I'd get REALLY hungry again in about an hour.

    hmmm. So last week I started having a 60g protein shake (made with plenty of coconut milk) at midday. Eating a normal dinner about 6pm but SHEESH I'm HUNGRY HUNGRY HUNGRY again in a couple of hours.

    Here's what *I* think is happening. and please Doc, your input is definitely wanted here. I think that my body is slowly becoming leptin sensitive again but still "reads" my leptin levels as insufficient. I recently watched an interesting explanation of how leptin works at Underground Wellness and that's what got me thinking about this ridiculous hunger. I mean I JUST ATE for pete's sake! Last night it was a pork chop, steamed asparagus and about 1/2 cup of steamed sweet potato with butter. And a mug of decaf with cream. That wasn't enough?! I mean I went to bed HUNGRY! 50g protein at breakfast, 60g at lunch and probably another 20 at dinner. geez.

    I will say that since starting the leptin reset I am sleeping like a log. for well over 8 hours every night. This is unbelievable since I've suffered with insomnia for 30 years. Hormone replacement has helped a lot but the reset seems to have fixed something. I start yawning now about 6pm (it's dark here by then) and am ready for sleep by 9. No more melatonin to help me sleep, no more waking up in the middle of the night and then have trouble falling asleep again. I mean I'm SLEEPING! YAY!

    But this hunger thing is bugging me. Any suggestions? Other than to keep on doing what I've been doing?

  339. Are there special things to consider if I want to do a leptin reset using fat instead of protein? Or should I just eat a big load of fat at breakfast so I stay satiated until dinner?

    Reason: Coconut oil is cheaper than pasturized meat and I have a very small budget.

    I did the protein reset for 2 months, but I felt very lethargic and got fatter. I ate up to 150g of protein a day and near zero carbs.

    (btw, I am not very overweight, just some 15 to 20 pounds I guess. I have elevated HS CRP and chronic fatigue syndrome.)

    Thanks!

  340. David Cole says:

    Help. I am about 10 pounds over weight. Meaning that if I lost 10 pounds I would actually have definition. I can lose weight if I get up to 180 and then work my way to 160. I am primal and will never have issues gaining weight again HOWEVER i simply can't lost those last 10 pounds. I really don't know if I should try a reset. I suspect not as it seems unlikely that I would be LR only when I reach 160. But I also would like to know ways to get that last bit of love handles, belly fat etc off and really start "cutting up". Maybe working with my leptin cycles more? I think I saw someone with a similar post as this you wrote about hormonal imbalances etc. but I can't find where you address it in your blog. thanks for all the work.

    • @David Cole. Resistant belly fat is usually a hormonal problem on multiple levels. Way more complex than most think. I would suggest you get tested to see how you fair in this department. For this issue you can do it without a doc yourself with a salivary assay from zrtlabs.com include all sex steroid hormones cortisol pregnenolone progesterone and dhea.

  341. Jack How can you say "SOY? Not fit for any human consumption"

    Isn't Tofu Soy?

    • @Jan……you eat Tofu you die early…….simple. Enjoy your decline. This is a choice you have to make and there is no way any soy would touch my body ever even under extreme starvation.

  342. Hi Dr. Kruse,

    How do tell if someone is underweight?

    After starting to eat low carb style Paleo 8 months ago I went from 150lbs to 120lbs. I am 6' and have a slight build (e.g. the circumference of my wrists are 6 3/4"). BMI says I am anorexic but I do not feel it takes into account body type.

    I have also not slept well since changing my eating habits and after reading your blog am starting to entertain the thought that I am LR.

    I look forward to your future posts.

    • @Andrew There are many ways but the most accurate way is to get a formal body comp scan done and then plug the numbers into a calculator to check it. One then can also draw simultaneous labs and plug them in to see if there are the labs data to support your belief. At your height and weight by any measure you are "SEVERELY" underweight and you need to re think how you think about body types if you are to get well. Please talk to a physician about this.

  343. Jack, Can you explain to me why soy is so bad for us? The Asians eat this stuff every day and live long lives. I'm just trying to understand. I certainly can give it up if it declines my health. Thank you

    • @Jan……here is your primer link below. After you finish it read the cites and then google "Why is soy bad for you." You will be busy for months with this homework. After your realize why it is I hope you share it with your friends and family. Soy is the most processed food on our planet and a major endocrine disruptor. Just because a lot of people eat it does not mean it is good. Lots of people eat McDonald's too in this country, does that make it right?
      http://www.mercola.com/article/soy/avoid_soy.htm

  344. OMG! I just read the article for 10 minutes and I'm sold. I occasionaly throw up. I take Synthroid to keep a small goiter in check. I've been eating this stuff for years. Gross. I'm disgusted with myself and have prided myself on eating something I thought was good for me and to help hot flashes and bone growth. I will be changing that immediately. I drink the soy milk too b/c I am lactase intolerant. Thank you Jack for providing the link.

  345. Hi, I am 47, male, 180 lbs., and I've been eating paleo for about a year. I usually rock-climb at the gym once a day (the only exercise that I truly enjoy doing). Since starting paleo/climbing, my body fat has dropped from 29 to 20% and weight from 196 to about 180. My fasting insulin has dropped from 8 to 4. I test my fasting BG every morning. Sometimes it's in the 80s, sometimes around 100 (seems to run high for a few weeks, then drop to normal). A1c is about 5.1. I'm serious stuck on a plateau. Would like to get down to 165 and get leaner, but I just cannot seem to lose any more fat.

    I had radiation therapy to my neck (HD) about 20 years ago, so I'm worried about my thyroid–my TSH is usually about 3.0–in the past I've used Naturethroid to get it down to 0.03 and T3 up to 490, but it made almost no difference in terms of my energy level or mood, so I don't think I have a thyroid problem.

    Any advice or suggestions?

    Thanks!

    • @Jerry radiation is a game changer. Testing for you would likely be extensive and expensive because neck irradiation can involve PTH, and the thymus so your immune system and you calcium and magnesium balance are clearly at risk. This will require a really good endocrinologist that you likely will only find in an academic tower. the problem you will find is that most are not very approachable unless you travel to a national endocrine meeting and tell them your story and hand them your labs and workup and ask them to review it all and email you when they can collect their thoughts. I bet your case would challenge them.

  346. Thank you.

    Can you tell me which tests I should order? I would like to do as much background learning as possible before approaching doctors at a conference.

    One thing I forgot to mention: a few years before and several years after the radiation, I was a very strict macrobiotic vegetarian. Grains, beans, veggies, vegetable oils, and seaweeds for about 10 years. That's an excellent way to mess up your health, I assure you.

    Another thing: I went gluten-free about a year ago, and it made an amazing difference in my mood. (Took about 3 weeks to take effect.) It also dropped my anti-thyroid antibody levels to zero. No more Hashimoto's. That made me wonder what other low-level autoimmune problems might be lurking in my system. Heck, HD could well be an autoimmune disorder, for all that the oncologists know.

    I really appreciate the work you're doing on this blog, doctor. Thanks a million.

    • @jerry my blog on optimizing labs would be a place to start but I have an endocrine friend and a radiation oncologist who visits here often who I'd love to see chime in on your case.

  347. Your blogs are excellent. I'm still reading and exploring it all. There are tons of good info and experience here. Please write a book.

    I would love to hear what your endocrine and rad. oncologist friends have to say; I'll be happy to provide lab reports, etc. (I must admit, however, I have learned from bitter experience to be quite skeptical of radiation oncologists).

    Thank you so much for your web pages and blog.

  348. Hi Dr. Kruse,

    I am trying to determine if I should try the leptin reset. My RT3 was elevated so I was put on T3 medication. This keeps my RT3 low of course, but if I go off and switch to a T4/T3 medication it goes back up. However, my fasting insulin and triglycerides are both low, never had an HS CRP but my regular CRP and other inflammation markers are always low normal, I am not overweight, and considering I don't work out anymore due to lack of energy I am in decent shape. I AM constantly hungry but don't crave carbs. Been on a low carb/Paleo diet for years. I have Lyme disease and Babesia, possibly other fungal/parasitic/bacterial overgrowth.

    I know you cannot diagnose me, but at first glance reading this, does it sound like LR to you? I can't decide if I should try it or now.

    Thanks,

    Adalina

    • @Adalina Without more info there is no way to tell for sure but one thing you said is important. If you have been paleo for a time and you are not hitting goals then for sure inflammation and hormones are at the origin of why. Your history of lyme also makes me think your immune system is far from optimal and maybe the reason you are struggling. Testing will help you for sure.

  349. Hi, I have been reading a lot of posts and comments here and Mark's Daily Apple monster post on the leptin reset. I really feel that I need to do the leptin reset.

    Facts about me:

    I am a 44 yo female, 155 pounds, 5'3" tall

    have been on synthroid (actually generic version Levothyroxin) 125mcg for 14 years.

    I am about 25 pounds overweight. I have been struggling to lose weight for a long time, discovered primal/ paleo eating a year ago, I love eating this way and feel better, but have seen very little success with weight loss or increased energy. (I have lost 5 pounds, don't sleep well, don't wake up refreshed). Typically eating only good fat, protein and vegetables and limited fruit and dark chocolate.

    I believe if I do the leptin reset, it will be my answer. However, I have a couple of questions that I can't seem to find the answer to. I can't figure out how to search Mark's forum for the answer, although it has probably been covered there. But if anyone has some insight or if Dr. Kruse would be kind enough to answer this, it would be awesome!

    more background:14 years ago, I complained to the doctor of being fatigued, they did a TSH test and started me on synthroid. Have been getting annual TSH test and kept on medication. I don't know if I really have hypothyroidism, I could have just been fatigued from the diet of high sugar high carbs I was eating at the time. I have an appointment with an endocrinologist in 2 months (first available appointment). I have not been able to get any information from his staff on which blood tests he will be using for assessment, but hope that it will be the ones you recommend (free T4, free T3, reverse T3, cortisol).

    OK, here is the QUESTION: Should I stop taking the synthroid, and do the reset to see if I can reset the leptin and fix the thyroid at the same time. Then when I go to the endo appointment, I will be at a good starting point? Or should I continue on my synthroid while doing the Leptin Reset, then get the blood tests done? (if so, are people taking their synthroid and eating immediately, instead of waiting an hour, bit confused by the timing with the medication).

    thanks so much for reading the long comment (first time I have done this!) and look forward to any help that is out there.

    Lea

    • @Lea…I answered this in the Hormone 101 post and the why is oprah fat post. If you are LR and I think you are given your story here then your thyroid panel is useless really. I bet inflammation and hormonal disruption are at the seat of your issues. I think the Leptin Rx rest could help you big time.

  350. Hi again Dr. Jack,

    I'm educating myself by reading your amazing website and listening to your podcasts.

    Here's an interesting observation. I occasionally take Allegra-D when I visit someone who has cats in the house (Allegra is the only allergy medication that works at all for me, and it works amazingly well). A few months ago, I was on it for about 7 days straight. During this time, I suddenly started losing weight. Lost about 1 lb./day, in fact. When I went off the Allegra, about half of the weight came back.

    Is it possible that this indicates that I am LR at the receptor level because of inflammation? Maybe the Allegra temporarily blocked the inflammatory response and allowed normal leptin signaling to occur. Have you ever observed a similar situation?

    Thanks,

    Jerry

  351. Yes, I really have high hopes for the Leptin Reset, I think it is the answer to this long time issue. It seems to explain so much.

    I guess I missed the part about whether to continue thyroid medications while doing the reset, I will re-read the posts.

    Lea

  352. Dr. Kruse, you should get the Noble prize for your work. This is changing so many lives. I have severe fibromyalgia, exteme chronic fatigue, sleep apnea (with CPAP nightly), 120 lbs. overweight.

    I have struggled with this for over 20 years. I have had 4 "flare ups". Each time I crashed it took me longer to recover function (several years) and this time at approaching 50 yrs old everything that worked in the past has failed me. I think final straw was the adrenal fatigue (I blew out my adrenals pushing myself "through the fatigue and pain" to go to my very stressful desk job until I literally collapsed. Plus, I had to have an emergency hysterectomy during the last episode because I would not stop bleeding no matter what they tried. They left my ovaries, but my blood tests say I am post-menopausal.

    I have no ability at the current time to lead anything near a normal life. Self care is even difficult. Though I am willing to do anything to get healthy again and regain the ability to participate joyfully in life. Movement is often like trying to walk through peanut butter.

    I have been eating primal for 1 month. I found the leptin prescription through a link from MDA forum. I started the leptin reset 4 days ago and have read many, many of your blog posts.

    I understand you believe fibromyalgia is a complete breakdown of the metabolic function and that many things need to be addressed at once. I couldn't agree more since whenever this comes on I have gone from a normal weight of 130 at 5'3" to almost 250 pounds in only 7 months. It is always as if something short-circuits. Before I followed a gluten-free diet (not primal) and was able to recover. Clearly it did not work this time, though the shift to primal was easy for me since I am HIGHLY motivated to get well.

    I have already reached the markers for leptin reset(I was unknowingly following the reset almost identically the way I was eating primal for the four weeks prior) except for the markers for energy and sex drive (I have none or either). I am on Amour Thyroid 60 mgs currently only started on 30 mg back in October (my doctor decided to treat my symptoms regardless of the labs). I am sleeping much deeper at last when I can finally get to sleep. Am taking Progesterone at night 100mg, mmethocarbamol and 400 mg of magnesium to help me get to sleep.

    I bought your top 10 supplement recommendations(those I wasn't already on). Just started those 2 days ago. I also take a probiotic by MD Perscriptives.

    I saw the PA in my doctors office this month and he ordered a few of the tests you suggest based on having already done many of them in the recent past.

    I avoid a long list of vegetables and foods (or severely limit if cooked to 3 times a week)that may interfere with my thyroid (broccoli, cabbage, rutabaga, cauliflower, cassava, kale, etc.)

    I have some questions if you would be so kind to answer them:

    1. I was diagnosed with leaky gut in '09 by another doctor, however I have no idea if the greek yogurt I was eating was sufficient with the on and off use of the probiotics to cure it, nor if it is cured. I can't seem to find where you indicate how we know if it is cured. Is there a test?

    2. With fibro patients do you recommend excluding dairy, eggs, butter and nightshades too, or only if you have leaky gut? Once the gut is definitively cured can I add back in the organic omega 3 eggs and greek yogurt, grass fed butter? I mostly do not eat any dairy except the grass fed butter and greek yogurt ever after going primal in mid-November.

    3. I can only eat two meals a day after having the 50g protein at breakfast (usually eggs now) with onions, garlic and mushrooms sauteed in coconut oil (sulfur containing carbs) for breakfast and leafy green and colorful carb veggies for my evening meal. I'm trying to ensure sufficient micro-nutrients in the veggies I do eat. My carbs are always no more than 50mg. I eat wild alaskan salmon patties (2) for one of my meals – 40 g protein and add either turkey bacon or macadamia nuts to equal the extra 10 grams if I eat the patties for breakfast. Should I maintain the carbs at 50 to keep up the micronutrient loading, or not worry about that and focus on keeping the carbs lowers during the reset?

    4. I have the most trouble with the sleep cycle as the pain levels are so bad that the fatigue doesn't overcome the pain until 2 or 3 a.m. sometimes and it is really random and unpredictable. I know how important the sleep cycle is so I have made many changes to try to fix this. Do you think the giving up wheat/processed foods will eventually give me pain relief at some point so I can regulate the sleep cycle, or is there something else that will help speed this?

    5. I have with high inflammation in my body. Based on your blog posts that goes without saying. I am taking the supplements recommended, I'm just not sure, should I take the high end of them all to combat the inflammation or not necessarily? Are there any additional ones I should definitely add because of the fibro?

    6. I know I need to focus on a lot of things at once, can you give me an idea of what all those are so I can work on fixing them? I have also just added eating LOW oxalates.

    i.e. I know based on reading your blog:

    – Do the Leptin Prescription (check)

    – Take the top 10 supplements (check)

    – Support the thyroid with Armour (check)

    – Walk 30 min. day 5 – 6 days a week (check)

    – Eat low oxalate foods

    – ANYTHING else??

    Thank you for being the messenger of the miracle I've been seeking for over 20 years, through dozens of doctors and thousands of hours of sifting through medical information (most of which is just bad science and theory it turned out). I am so relieved to have REAL hope and a promising direction to head in at last.

    Paula

    P.S. My rheumatologist told me this condition would likely never improve. I choose not to believe that.

  353. Hi Dr. Kruse,

    Thank you for such an informative website. I wanted to ask a question about leptin resistance in non-obese populations, and the connection to hypothalamic amenorrhea. I am a 33 year old female of normal weight, with a history of eating disorders. I was on stimulant medication for years, and stopped taking it about 6 months ago. A few months ago (august) I started eating a paleo diet (eliminated processed foods, sugar, etc), but I have struggled with it (I am a pescetarian, so am limited to fish and eggs). I have found that I am having a lot of issues controlling my portions (I can eat 500 g of protein a day– not food weight, actual macronutrient amount–and i weigh about 55 kg). My appetite is insatiable and once I start eating I feel I can't stop. I do eat enough fat and end up eating 4000-5000 calories a day of "paleo" food. I have lost my periods since august, and after reading your posts and listening to the podcasts on which you were a guest, I am convinced my issues are connected to leptin resistance.

    I wanted to know your opinion on this, and any advice you might have.

    Thank you for your time,

    -J

  354. I forgot to mention above, I also have DDD as shown by my MRIs which is why I have been loading up on the eggs and am not anxious to eliminate them. I'm adding offal this week (not excited about this, but excited for the results). I also of course have metabolic syndrome. However, my blood pressure dropped from 135/82 to 114/68 in just the 4 weeks I was on the Primal Blueprint before I added your leptin prescription. So I can immediately see eating this way is extremely good for the body since that is a significant drop. Luckily I was never put on blood pressure meds (I refused since my father died while on Avandia of a massive heart attack at the age of 73).

  355. Dr. Kruse, Can you please explain why it's not necessary to eat after working out (i.e., lifting weights)? I know you said eating stops fat burning and that's the reason, but I've always read that it's important to eat protein and carbs within one hour after strengthtraining for muscle restoration or something like that.

  356. Ever hear of anyone alergic to coconut? ;-( Think that must be the case with me because everytime I eat anything with coconut oil or coconut flour my left ankle swells and left eye gets dark with a line underneath. No biggie, I can improvise. Been doing it all my life. Also, the only vitamin I have not ordered out of the 10 you recommend in your article is PQQ and will do that this week. Melatonin is the only one I will not use because it does the opposite of what it is suppose to do for me. I should have known better then to try it again, but I did and did not sleep well. Goes to show me that everyone is different.

    I also read the article "Find your Primal Sense". What a post to spur someone on to take control of their lives. That single article did that for me and now even without the energy I once had, I will pull this off. Again, Thank you Dr. Kruse for all the encouragement.

    • @Susan Thanks for the kind words……Most people who have CO issues are due to the Herxheimer Reaction or aflatoxins in bad CO. Allergy is possible but pretty rare in my experience. I stick to two brands…..Nutiva and TT.

  357. Here are my labs from October 2010, a little over a year ago. I will be going in for new labs in March when my insurance kicks in. I'm sure I'll see improvements! Hack away. I felt really, really crummy back then which led me to…where I am today, getting better all the time. I've lost 40 lbs and feel pretty darn good most of the time. I think my Dr. is going to be amazed, or at least puzzled, and I will refer her to you Jack, for some education. She might be a little miffed at first because I went against advice and ditched all pharmaceuticals except my T3, ditched all those "healthy whole grains and cereals", and increased my fat and meat content considerably.

    From Oct 2010:

    WBC, 4.4 rg=4.5-10

    RBC, 3.2 rg=4.2-5.2

    Hgb, 10.8 rg=12.0-16.1

    Hct, 30.5 rg=37.0-47.1

    MCV, 95.4 rg=81.3-94.2

    MCH, 33.6 rg=27.0-32.5

    MCHC, 35.3 rg=32.0-36.1

    RDW, 15.2 rg=10.5-16

    PLATELET, 237 rg=150.-450

    NEUTROPHIL, 29 rg=30.-80

    LYMPHOCYTE, 60 rg=20.-40

    MONOCYTE, 7 rg=0.-12

    EOSINPHIL, 1 rg=0.-7

    ABS NEUTROPHIL, 1.3 rg=1.5-8.0

    Triglycerides, 381

    Cholesteral, 163

    HDL Cholesteral, 26

    HDL Normal >49mgldl

    LDL Cholesteral, 81

    Chol/HDL, 6.3

    LDL/HDL, 2.3

    Vit D, 25.4

    ALT (SGPT), 84 rg= 6-44

    AST (SGOT), 82 rg=5-33

    Albumin, 3.9 rg=3.4-4.8

    Glucose, 95 rg=65-99

    Potassium, 3.6 rg =3.5-5.3

    Taken a few months later, February 2011:

    TSH, 1.4, rg-1.-5.5

    Free T4, .65 rg= .82-1.77

    rT3, 192 rg=90-350

    Free T3, 1.8 rg=2.0-4.4

    Insulin, 24.0 rg = 0-24.9

    Ferritin, 111 rg=13-150

    Leptin, 13.0 rg=1.1-27.5

    HA1c, 4.8, rg = 4.8-6.4

    I know I am missing some crucial labs, and hopefully I can remember to get everything when I go in a few months. What else should I ask for?

  358. I'm type 2 diabetic (and on dessicated thyroid) and I've been doing the leptin reset for about 2 weeks, the weight has steadily crept off, and I'm nearly off the BP meds! I stopped my metformin after the first week when my blood sugar numbers came down so well, but now they've suddenly taken a 2-3 mmol/L jump (fasting reading of 9.6 this morning). Should I be concerned, or will it come down? Thanks!

  359. Hi Dr. Kruse,

    Thank you for your reply and all the time you spend helping people. I truly appreciate it.

    I will get further testing done but in the meantime, I am thinking doing the leptin reset can't hurt in any way. Can it?

    I do have one question and one concern. I currently don't eat breakfast, just lunch and dinner. My concern is that by adding breakfast and therefore calories, I will gain weight. I am not sure that my hunger will go away immediately so that I can skip lunch. Any thoughts on this?

    Re eating within 30 minutes of waking. Does that mean the meal has to be "completed" within 30 minutes or as long as I start my meal within 30 minutes I am ok?

    Thank you again,

    Adalina

  360. Okay, on the Herxheimer Reaction making sense. I thought, later on, I was over-reacting. I use the TT, as I do worry about the quality of any oil and do not want to be poisoned! Will address this left ankle swelling when I see the doctor next Friday. I am even excited to see her and tell her the treasure I found with your blog. I will read from now til then so I can be sure to ask for the right labs-as long is it does not cost me an arm and a leg. ;)

  361. I am diabetic and a dialysis patient. I am allowed to eat high amounts of protein but only 1/2 cup of vegetable a day. If I shouldn't eat rice, does that mean I can not eat pasta. I am not allowed to eat whole wheat, nuts, beans, milk products (I use Rice Milk occasionally when I have cereal like Old Fashioned Oatmeal. Do you feel that I will be able to go on your meal plan and be successful. Thank you so much.

    • @Gail you have to discuss this with your nephrologist but I would use a high fat lower protein paleo diet for you. A very ketogenic version of the diet in fact.

  362. I am recovering from severe adrenal burnout. I am sure that I am LR. Should I really exercise after 5? That is when my energy comes back then I can't sleep. My cortisol is normal at 6 but flatlined by 9am and starts climbing again at around 6-7pm. I usually workout pretty hard for 2 weeks and then am too tired to workout for a week or so. I understand that you want us to walk at a slower pace as well. I walk about 3.5mph is that slow enough? Also, I notice potatoes make me feel happy. Are they completely out of the question? Should I freeze my gym membership?

    • @ TJ I am OK with potatoes but don't eat the skins. This is where the glycoalkaloid is located. Make sure they are organic and I also advocate organic sweet potatoes for your issue too.

  363. Dr. Kruse, I just want to say once again that your website is truly excellent.

  364. Dr. Kruse,

    Do you see patients for LR and other issues or just for neurosurgery? I live in Nashville and sure could use some help from a doctor who doesn't tell me to just eat grains.

    Thanks,

    Kristina

  365. Hi again, Dr. Kruse do you have any insight to my posts of comments 475 and 477?

    I know you must be busy, and I'd really appreciate any help or direction you could give regarding my conditions: fibromyalgia. I also have sleep apnea, adrenal fatigue (low cortisol), hypothryroid, low estrogen, low testosterone, and low progresterone, low ferritin (just discovered), and DDD. I just want to be sure I'm covering everything with my doctor. We've been working at this for over a year (since I changed to him). He is a longevity specialist, but hasn't read your work yet. I'm hoping to get him to investigate it and open his eyes soon. So far no luck (He is overworked like you :).

    I'm thinking I need to add Pregnenolone, based on the pregnenolone steal, but I cannot find where I can get just that lab test done. I went to ZRTlabs and Spectracell, is there somewhere to get that test done alone? I have all the others, but I don't have the results from the doctor yet.

    If you have answered elsewhere about the way to tackle fibro I have not been able to find it and would be happy with the URLs if you already have. I have found solutions for most other conditions and they all do tie together.

    Was just struck by your saying that with fibro there is so much to tackle at once.

    Thank you for all you do.

  366. From Jackie Wu to Jack Kruse via FB:

    I'd like to thank you for for your reset, and allowing my hormones to get back to normal. i can now feel full, and actually stop eating when i am full. even after a salad (i used to feel hungrier after eating a salad than i did before i ate it). i find that i also feel better, and without aches and pains (including an early onset of arthritis in some small joints) than before. this is very important to me, because i had a severe L2 compression fracture a few years ago, complete with bulging disc and complete destruction of another disc, so if i don't take care of my back, it's very annoying all the time. i was able to sit on an airplane for hours in a very upright position (which usually would have my back crying after 30 minutes), and i was absolutely fine! so thank you for restoring my hormone balance as well as allowing me to regain a pain-free existence! all without low fat bullshit :)

  367. Oh that is excellent news. I am going to see one of Dr. Klinghardt's doctors in Seattle in a couple of weeks, but would like someone local for ongoing support. Looking forward to it…

  368. Hi Dr Kruse,

    I am not sure if you read my post (#476), but I'm hoping you have insight into my dilemma. I seem to be one of very few people who don't seem to get satiated or full after even 120 g protein for breakfast. I am not sure whether this is a problem with leptin, or if you have encountered patients with this issue. For the past six months I have eaten a paleo pescetarian diet. I lost my periods about 4 months ago, which, along with my lack of satiety, led me to believe I might be leptin resistant. I am not underweight or particulartly overweight (163 cm, ~55kg). I started doing your leptin rx by eating breakfast within 30 minutes of waking, eating lunch 5 hours later, and dinner 5 hours after lunch, about 4 hours before bedtime. However I find that I still have trouble feeling satisfied and have a constant appetite. By the end of the day, I end up consuming an extreme amount of protein (~400-500 g). I eat mostly fatty fish, and eggs, so I feel I get adequate fat.

    Do you believe this is a leptin problem? I look forward to any advice you can offer.

    Thank you for your time, and best wishes for the New Year!

    -J

  369. PS: I wanted to add that when I mentioned the amount of protein I eat, it is not the weight of the food itself, it is the actual macronutrient amount (I track on myfitnesspal). I easily consume about 7 pounds of fish a day. I know this is highly abnormal.

    • @j no one i dont think this represents a major issue. you are not eating a congruent primal diet. I think when absolve your self to do so things will change. Until then I doubt you will see Optimal. There is a reason your getting these results. You need to adapt your actions to get somewhere new from where you are now.

  370. Hi Dr. Kruse,

    Thank you so much for your response! Do you mean I need to eat meat to be optimal? I have been lacto-ovo vegetarian for 20 years, and recently added fish, but I am aiming to try to eat meat eventually.

    Thanks again, and best wishes!

    -J

  371. Hi Dr. Kruse,

    I am starting the leptin reset on Wednesday and I am excited. The thing I am disappointed about is that I will have to stop eating butter and homemade kefir (from raw/pastured dairy) again since I have Hashi's. However, I was wondering if ghee would be ok since to my knowledge most if not all of the casein should be removed.

    Thank you and happy new year.

    Kristina

  372. So I am still going back and forth re whether I am LR or not. Here's a little bit more history and maybe you have some thoughts Dr. Kruse. Getting blood tests on Tuesday but would like to start on Wednesday rather than wait for the results.

    I am 45, history of anorexia starting around age 10, later also bulimia starting around age 22, into my late 30s. Still a lot of restricting since then, skipping meals, overexercising, etc. Wasn't breast fed, grew up eating a fairly high carb diet but a lot of fat, too, from my 20s to about age 30 ate high carb, low to no fat. In 1996 switched to Atkins, in 2003 switched to Paleo with occasional cheats/splurges. Also did chronic cardio (running, biking, aerobics, etc. daily) up until 1996 at which point I added weights three times a week.

    Was put on Armour thyroid around 1996 as well. Around 2000 started having reactions to food, was found to have fungal overgrowth, leaky gut, hormonal imbalance, etc. Hysterectomy (due to endo, adenomyosis) and removal of one ovary in 2003.

    In 2008 gained about 20 lbs without any changes in diet/exercise, started having a permanently distended belly (pregnant looking 24/7), and just felt miserable. Prior to that I noticed I was getting a small layer of fat on my belly. Early 2009 was switched to Cytomel due to high RT3 and was put on hydrocortisone due to adrenal issues. Summer 2009 switched to zero carb with IF – no breakfast, just lunch and dinner.

    Prior to getting sick I had about 18% body fat with a flat stomach and felt great. Now I have roughly 25% body fat and while I am the same size I was back before getting sick, I weigh about 8 lbs less now which to me translates to less muscle and more fat.

    No amount of LC, VLC, or ZC or IFing is changing anything for me. I continue to feel sick, fatigued, achy, etc. While I slim, I consider myself skinny fat and don't like it. In July I was diagnosed with chronic Lyme and Babesia, and possibly other co-infections. I am seeing a doctor in Seattle for treatment next week.

    Soooo…given all this I would think I am LR. Oh, I forgot to mention that I do not crave sweets, but I am constantly and non-stop hungry and every day is a struggle. Making it through the day without snacking is sheer torture and I hate it.

    Other symptoms are left eye lid extremely swollen upon waking, right cheek bigger than left cheek, tons of white spots on fingernails on right hand only (liver issues??), fatigue, not sleeping well, hormonal imbalance, depression/negativity (5-HTP helps), severe digestive issues, food intolerances, fluid retetion – especially after eating in my hips, butt, thighs, belly – red/burning eyes daily, anger, nausea, POTS, and more.

    Thank you!!!

    Kristina

  373. That should have been right eye lid extremely swollen upon waking, not left eye lid. So I have a lot of right side issues which one doctor felt is a liver issue.

  374. Dr Jack.. Your LR suggestions have completely turned the quality of my life around. I recently, Xmas eve had appendicitis, and had an appendectomy. I was had bowel movements everytime I ate before starting the Leptin Rx, but I found for the first time, I was constipated regularly. I eat as close to the food source as possible, pasture eggs, organic meats, very low carbs. keeping it to 25grams a day. I stopped teaching my indoor spinning class. I meditate and use a infra red FIR sauna daily. I do not use caffeine. I try to get up with and wind down with the sun. I drink plenty of water. I eat a tbls of extra virgin coconut oil twice a day. I am in recovery with the surgery. I started the program to fight what I sense it inflammation due to adrenal fatigue and hormone imbalances my whole life. I have always been an avid athlete and followed a strict diet but- my lifestyle unfortunately was vegetarian and very low fat. I see now with research why my PCOS was such a problem since I was a teen needing fat and animal protein. Now I wish anxiously to continue but am wondering how I can continue with the Leptin Rx, but be more gentle with my intestines? I had a funny intuition about my constipation and my appendix. Of course, I am not sure, but it felt connected. I would certainly not blame it in anyway, but wish to continue in the most optimal way. Any suggestions? ( PS- You have changed my life, doc… your generosity- wealth of knowledge- and consideration towards giving us your expertise is such a gift to each of us searching for a better way. Blessings to you, may your kindness be returned to you 1000 fold.)

  375. Hi Dr. Kruse,

    Thank you for the reply about ghee. Glad I will be able to eat it. Any thoughts on whether I am LR or LS based on my post above?

    Kristina

  376. Hi again… Important to note I added HCL & pancreatic enzymes early on as I was having difficulty digesting the meat. So my main concern is minimizing the constipation as I heal from the surgery– creating a more gentle environment for elimination. Also, I take therapeutic enzymes to assist in reducing inflammation. I don't want to over do it as I see wobezyme is a pancreatic enzyme mix. I also experiment with nattokinase and serapeptase for the same reason of addressing inflammation… I have a high RBC and I believe the nattokinase has reduced my RBC & hemocrit levels down into a high normal range which conventional medicine had urged me there was no way to do it naturally– There is not a lot of research on enzymes, at least nattokinase & serapeptase- except for the fact it has been used for hundreds of years in Japan & around 30 yrs in Europe- however its short on research knowledge so far-the combination has reduced the cystic growth on my ovaries to almost nothing which I found out days ago in the exploratory ultrasound. I have had really positive results bc I am a massage therapist for the last 17 years doing physically intense types of bodywork therapy but virtually have very little repetitive to none pain where other therapists working with me seem to suffer from work related pain. I just want to be mindful on the dose & it's relationship to my pancreas in the long term. I want to make digestion as easy as possible on my system while honoring the delicate balance of my organs. I also take glandulars from Standard Process- Drenamin for Adrenal support, I no longer take Armour thyroid but switched to Thytropin for thyroid, and Symplex F for ovarian support. I feel the three help my HPA axis & I am starting to feel my hormone issues beginning to normalize- oh with the support of a great product too, end fatigue by integrative medicine which as far as I can tell supports the adrenals through B's and what appears to be a great liver cycle support. So, everything in this combo combined with your dietary suggestions are healing me up pretty quick after many years of trying so hard to feel better with inflammation getting out of hand. Your Leptin RX tipped the scales & really seemed to compliment my other therapies to a point I believe I am on the mend just have to solve the constipation piece… My system was adapting a bit but any hints to assist would be so welcomed… Thank you for shining your light so bright into our concerns.

    • @Ali constipation is a sure sign on gut dysbiosis. I dont have a problem with nattokinase, serapeptase, ox bile acids, or pancreatic enzymes but they are all worthless unless you get to the core issue. Its your gut flora!!!!! I bet this is from your surgery, prophyllatic antibiotics they gave you and your continued use of fake protein powder and dairy your eating!!!! This crap is all quickly absorbed into your intestines and set you up for a major bacterial issue in your distal gut, namely, your colon and this is the source of why you are constipated. A SAD cause a shift of our bacterial flora from a complex collection of bacteria that works in symbiosis with us to a simpliefied one. the reason for this ecologic change is that when one eats a diet high in processed fats, protein, and carbs the digestion occurs in the first two feet of our GI tract and not the back end by the colon. This forces or naturally selects for bacteria to evolve to adapt to the new environment. The major change is to decrease the ability in our colon to support stool forming bacteria that support the formation of short chain fatty acids (SCFA) like butyric acid. Taking the things your taking is OK but the most important factor is changing the quality of the foot to a paleo template. This effects the normal circadian cycle of how the gut hormones called incretins are released in relation to meal timing. This is becoming a clear issue in many eating disorders hypothesis these days. I think when the incretin system is mismatched to the central nervous system (hypocretin or orexogenic system ) we allow for the development of eating disorders much more easily.

  377. Yikes forgot to say post surgery digestion/elimination back to optimal but I am not recovering on the Leptin RX protocol- You probably need that piece before you make any suggestions…I have stayed as close as possible to high protein low carb- but did use a gluten free raw protein powder (3gram carb per serving) mixed with organic yogurt at almost every meal… Only small amounts of chicken and lots of eggs- it's time today to start back towards the Leptin RX- so feeling iffy about the potential constipation while mending a healing intestinal surgery…

  378. Interesting… No dairy, no fake protein powder! Bacteria in the distal gut- ok this makes such good sense… Appreciative of your expedient and thorough reply… I did slip on the dairy right before I had a problem- back to quality paleo template here I come–thx so much!

  379. Hi Dr. Kruse,

    Sorry to bug you again. I am thinking about starting the leptin reset on Wednesday, but I am still undecided whether I am LR or not. Looking at my posts above (#504, 505) I would think I am. What throws me off is that all my inflammation markers are normal. I have not had the hs CRP, but my CRP, ESR, and all cytokines have come back at normal levels.

    Any thoughts on all this? I am currently IFing with lunch and dinner only and don't want to do the leptin reset unless I really need to.

    Thank you,

    Kristina

  380. Thanks Dr. Kruse…I am getting the hs CRP tomorrow. I will wait for the results and go from there.

    Any chance the inflammation markers are wrong because I have chronic Lyme? I have heard/read that there are often false positives on anti-body blood tests in people with a chronic infection, could this be an issue with testing inflammation markers?

    With all the symptoms I have, almost daily pain, and elevated RT3 unless I take T3, it's hard to believe I am leptin sensitive.

    Thanks,

    Kristina

  381. I have PCOS and this is apparently caused by insulin resistance (glucophage treats it well.) However, I didn't "cause" the PCOS, I've always had it since my teens when I was a healthy weight (5'11", 150 lbs.) I suspect I'm LR as well because I have some serious issues where I'm unable to feel full, in spite of eating. This continues, however, in spite of my 75 lb weight loss. I am still overweight, with a BMI of 30. I'm working to lose the rest. I've been eating low carb to lose, eggs and low fat bacon or sausage every morning. I've found that I cannot do they recommended treatment for hypoglycemia, I MUST eat 3 decent meals per day, eating frequently is a recipe for constant hunger. I'm hypoglycemic as a part of the PCOS. I just wondered what you thought of someone like me. The main changes I can make are eating sooner (I eat about an hour after getting up), eating more protein at breakfast, I have about 30 g now, and cutting out snacking completely, as I have one in the evening usually now. I exercise and weight lift as well.

  382. Thank you Dr. Kruse. I guess it would be best to at least wait for the hs CRP before starting the leptin reset.

  383. I really enjoy reading your blog. Just out of curiosity, what have you heard or John McDougall, M.D. and, if so, what do you think of his work, e.g. below? Obviuosly, this is almost the opposite of what you think.

    "The "Eat More Starch" Challenge:

    Eat 12 Slices of Bread Daily to Lose 10 Pounds Monthly

    In 1979, researchers from the Food Science and Human Nutrition Department at Michigan State University (my alma mater) reported the results from asking 16 moderately overweight college-age men to add 12 slices of white bread (at 70 calories a slice) or high-fiber bread (at 50 calories a slice) to their diet daily.1 On average, subjects eating the extra white bread lost 14 pounds (6.26 Kg) and those adding the high-fiber bread lost 19 pounds (8.77 Kg) over the next eight weeks. There was no change in their physical activity or exercise. "Thus, weight loss of both groups of subjects occurred without alteration in life-style except for the supplementation of food intake with breads," according to these investigators. (You might want to read this entire study right now for free.)

    The health of these college students also improved as reflected by the very rapid reduction in blood cholesterol levels by an average of 60 and 80 mg/dL in the first few days of eating bread. (From 223.6 to 172.3 mg/dL with the high-fiber bread addition and from 231.4 to 155.3 mg/dL on the white bread diet. The reason for a greater reduction in cholesterol on the white bread was not explained.) The students on the high-fiber bread, as expected, had more frequent and larger bowel movements than those on the white-bread diet. (If this single article had been given deserved attention the world and its inhabitants would be in a much better condition today.)

    A Time for Positive Action

    Okay, I get it after 43 years in medicine; I, John McDougall, MD, can't convert everyone to a healthier diet with my recommendations to abandon all animal foods and oils at the dinner table. Perhaps people do not respond to negative comments such as "don't eat this or that." Maybe a better answer is to give positive instructions to eat more of their favorite foods. Starches, like rice, corn, potatoes, beans, pastas, and breads are so universally cherished that they are individually and collectively referred to as "comfort foods." However, most people are unaware of the power of starches to cause them effortless loss of excess weight and to restore their health. Even after becoming fully informed, many "true believers" are still unwilling to fully pledge to the McDougall Diet at this time. But that does not change the obvious: that they would benefit from eating healthier. As a dedicated doctor, I will not abandon the sick and needy.

    In this context, my recommendation to help people who are gaining more weight and losing more health is to not intentionally give up any of the foods that they currently love: do not stop eating eggs Benedict, hot dogs topped with beef chili, pepperoni pizza, fried chicken, or ice cream sundaes. Instead, I ask them to pledge to make one—and only one—addition to their diet: Eat more starch. Just add an extra 600 to 900 calories of starchy comfort foods daily, like the college-men in the study did, in order to see similar remarkable benefits.

    This commitment means adding any one of the following to your regular diet:

    3 to 4 cups of steamed rice

    3 to 4 cups of boiled corn

    3 to 4 mashed potatoes

    3 to 4 baked sweet potatoes

    2 to 4 cups of cooked beans, peas, or lentils

    3 to 4 cups of boiled spaghetti noodles

    6 to 12 slices of fresh bread

    You can mix and match any kind of whole grains, legumes, or starchy vegetables to make up these additional 600 to 900 calories daily. The effect of adding these appetite-satisfying, nutritious choices will be to displace fattening and sickening foods (meats, dairy products, and oils). Spontaneously, without any conscious thought, your intake of calories, fat, cholesterol, and chemical contaminants will diminish and fiber, vitamins, minerals, and carbohydrate will increase.

    Starches Satisfy Our Appetite

    The authors of this landmark study wrote, "Reasonable amounts of bread consumed with the meal provided an increased quantity of bulk before the individual has a chance to consume his usual intake of calories. High-fiber bread may be more effective in this regard since one characteristic of cellulose is its ability to absorb water with a consequent increase in volume. This may explain the ability of the subjects receiving the reduced-calorie bread to consume only two-thirds of their usual calorie intake without experiencing any severe hunger pains." By adding the bread, the college students were able to spontaneously reduce their average daily intake by 850 calories (3,200 to 2,350) for white bread and 1,325 calories (3,200 to 1,975) for high-fiber bread.

    Appetite satisfaction begins with physically filling the stomach. Compared to cheese (four calories per gram), meat (four calories per gram), and oils (nine calories per gram), starches (at only one calorie per gram) are very calorie dilute. In the simplest terms, starches will physically fill you up with a fraction of the calories.2 Furthermore, research comparing the impact of eating carbohydrates and fats on the appeasement of our appetite shows carbohydrates lead to long-term satiety, enduring for hours between meals, whereas the fats in a meal have little impact on satiety. People are left wanting more food when they eat fats and oils.3,4

    The authors of this study concluded, "Bread itself is not high in calories. It can be reasoned that it curbs hunger pangs, enabling the dieter to resist foods that otherwise would cause excessive caloric intake." There was some adjustment during the eight-week study. At the beginning, even though they were allowed to continue to eat their usual food choices in unlimited quantities, almost all subjects felt hungry. However, by completion at eight weeks, the subjects consuming the high-fiber bread indicated that they were not hungry at any time.

    White vs. Brown Rice and Brown Bread

    Whole foods are healthier than refined foods for people in most circumstances. The extra dietary fiber has many benefits, including improved bowel function, greater reduction in cholesterol, triglycerides, and blood sugars, and better weight loss (as this study showed). However, the fear of "white" is overrated and has caused experts to overstate the role of refined foods in the current epidemics of obesity, type-2 diabetes, and heart disease. Consider this undeniable observation: There are 1.73 billion Asians living on polished white rice worldwide and they are not overweight or obese. However, most lose this immunity with their immigration and assimilation into western societies and the replacement of rice for meat and dairy foods.

    Switching to unrefined foods, like brown rice, is impractical for many people because these choices are less available and sometimes costlier. In the past eating refined foods has defined social class. Traditionally in Asian countries, wealthier people could afford white rice, but the poor people had to eat the less expensive brown rice. Many of my Japanese, Chinese, and Filipino patients have refused to eat brown rice because of bigotry. My solution has been a trade-off: Stick with your favorite white rice, but eliminate the most damaging culprits: meats, dairy products, and oils.

    The most effective diet ever reported for obesity and recovery from failing hearts and kidneys is based on white rice.5 The Kempner Diet, associated with Duke University for the past seventy years, has also cured thousands of people with severe hypertension, type-2 diabetes, and inflammatory arthritis. White rice was preferred because of familiarity and palatability among patients.

    Perfection Is Not the Only Answer

    If you are still struggling to follow my recommendations, for now take a pledge to do nothing more than eat more starch. Buy a loaf of whole wheat bread (with no added fat, milk, or eggs in the ingredients) every day and eat it all. What could be simpler? Tired of bread, then buy rice. Although not ideal, even white rice will work. Frozen, already cooked rice, corn, and peas are available in plastic bags. Just reheat in the microwave. Uncooked, shredded potatoes can be quickly "fried up" in a non-stick pan. Canned and bottled beans make a quick meal. With the rules of the "Eat More Starch" challenge, you could pour bacon grease, butter, cheese, and baby back ribs over your hash browns and still be better off than you were without the 600 to 900 calories of additional starch. After all, these college men lost considerable weight and reduced their cholesterol by simply adding more bread to their standard American diets.

    The McDougall Diet is a tool, not a religion—the benefits are not "all or nothing." However, I hope that once you experience the healing power of starches you will become greedy and want all the good health you can get. With undeniable proof from a couple of months of additional rice and potatoes, you should eventually make starches 75 to 85 percent of your diet, with the remainder coming from fruits and vegetables—and one day soon, forgo all the meat, dairy, and vegetable oils. Your adjustment will be quicker and easier than you ever imagined, you will enjoy your foods, and you will be thrilled with the results.

    References:

    1) Mickelsen O, Makdani DD, Cotton RH, Titcomb ST, Colmey JC, Gatty R. Effects of a high fiber bread diet on weight loss in college-age males. Am J Clin Nutr. 1979 Aug;32(8):1703-9.

    2) Rolls BJ. The role of energy density in the overconsumption of fat. J Nutr. 2000 Feb;130(2S Suppl):268S-271S.

    3) Blundell JE, Lawton CL, Cotton JR, Macdiarmid JI. Control of human appetite: implications for the intake of dietary fat. Annu Rev Nutr. 1996;16:285-319.

    4) Rolls BJ, Kim-Harris S, Fischman MW, Foltin RW, Moran TH, Stoner SA. Satiety after preloads with different amounts of fat and carbohydrate: implications for obesity. Am J Clin Nutr. 1994 Oct;60(4):476-87. Annu Rev Nutr. 1996;16:285-319.

    5) Kempner W, Newborg BC, Peschel RL, Skyler JS. Treatment of massive obesity with rice/reduction diet program. An analysis of 106 patients with at least a 45-kg weight loss. Arch Intern Med. 1975 Dec;135(12):1575-84."

    • @Pat I am familiar and I have three patients who followed his diet and are a mess. Their body comp studies are among the worst I have seen. Two need surgery and I wont operate on them until they eat via an evolutionary prism……Dr. McDougall's 43 years of experience do not trump nor come close to the 2 million years of the randomized control trials done by evolution of stressing the human genome the manner it was designed.

      Let the data drive your decisions, not someone's opinion. I use and evolutionary paradigm to drive mine now. The next decision is yours.

  384. Thank you for all the wonderful info. I have ran out an bought the books you suggested and am now devouring them both. One question for you pls- why do you suggest working out after 5pm? The Paleo book you recommended said working out in the morning will burn fat very effectively the rest of the day (as is conventional thought) I'm sure you have a good reason, so please help. Thank you for your time.

  385. Nevermind, I found one of your replies from a prior post

  386. i'm a 40 year old who has been eating a GAPS diet for 1.5 years (paleo + bone broths + ferments). most of my health issues are resolved except the following: eczema, severe sugar cravings at night, and i have a bit of a belly, but am thin otherwise (123lbs and 5' 5" tall). i could use a bit more energy, too.

    i haven't eaten breakfast for a long time…usually eat between 12p and 7p, and that's it. perhaps that is part of what's causing the problem with sugar cravings and belly fat? also, i don't do any strength exercises. do you have any opinion on whether i should do the leptin reset or just proceed with the leptin sensitive diet and start doing strength training?

    thank you!!

  387. re: msg 525, seems i need to do lab tests to know whether i am leptin sensitive or not.

    wanted to add another issue: bloating after every meal. i started taking hcl betaine and digestive enzymes but they haven't helped.

    so my new questions is, would it hurt to do the leptin reset even if i don't need to?

  388. Jack, I started my first LR yesterday. My stats: 5 ft 7 in, 201 pounds. My first LR day was accidentally nearly zero carb so I entered in ketosis right away and lost 2 pounds in a single day. It is great because my weight loss has been really sluggish lately (about 2 pounds a month). But my main goal at the moment is leptin reset, not rapid weight loss. Should I up my carbs a bit in order not to jeopardize the reset? My main hopes in relation to LR are getting rid of my eternally cold feet and hands and upping my sex drive. I do not have cravings and binging attacks. Thank you.

  389. Actually, I have another question. I have an appointment with my allergist next week, day 10 of LR. She wants to draw my blood and make some tests (including CRP; I forgot about the others but they are probably inflammation-related). Some of the tests require fasting so I would not have breakfast on that day, but I guess that's not a big problem. However, I am worried that my results could be somehow influenced by my LR and ketosis. The appointment is not urgent. I could reschedule it and go by the end of February. Thank you for your great work!

  390. Thank you for taking the time to reply. If I gave the impression that I supported Dr. McDougall's diet, I assure you that was not my intent. In reality, I read out of interest because I essentially have no choice in how to structure my diet. Since I was seriously injured and disabled in combat at age 20, I have been institutionalized in a VA facility. My food is chosen for me be by nutritionists. It is uniformly poor quality. Things are better now at the VA than they were 40 years ago but there are so many of us here that one can certainly understand that a wide variety of choices in not feasible. Ironically, I could probably easily follow Dr. McDougall's or any other vegetarian or vegan diet but a strict primal approach would be difficult. I haven't seen a sunrise in 40 years and I probably never will.

    But I am alive and I can read the ideas of men and women such as you and I applaud the hope and direction you offer so many. On so many of these "diet" blogs, I notice an almost messianic tone among the author and his/her readers. I suppose it is natural for people to become passionate about something that offers hope and promise. Your blog, so far, seems devoid of this and I note that you encourage critical thinking. I hope you continue. And I wish you success.

  391. Ok, so confusing the hypothalamus by eating protein in the morning, sleeping in complete darkness etc., trains the hypothalamus to regulate metabolism using circadian cycles. But does doing this actually restore sensitivity of the leptin receptor? Or are we permanently bypassing the leptin receptor? Thanks in advance.

  392. They can and do.

    Just curious, but isn't it true that for a diet to be paleo the eggs would have to be omega-3 and the bacon free range, grass fed? Otherwise, wouldn't one be getting too much omega-6? I thought that is why the Adkins-type diets don't work as well as paleo for long term health.

  393. Have you heard of Irvingia Gabonensis (African Mango)? According to Life Extension Magazine, it can reverse leptin resistance.

  394. Hi Dr. Kruse,

    I finally got my lab results and was wondering if you could give me your input regarding starting the leptin reset.

    First some history:

    -I am 45

    -history of anorexia and bulmia since age 10 roughly

    -chronic cardio person until roughly 6 years ago

    -yo yo dieting

    -rarely crave sweets but am constantly hungry no matter how much I eat

    -in 2009 had elevated RT3 and was switched from Armour Thyroid to Cytomel; this keeps RT3 down but if I try to switch back to Armour or just reduce Cytomel, RT3 goes back up

    -on hydrocortisone for adrenal insufficiency since 2009

    -chronic illness since roughly 2008 (leaky gut, 24/7 abdominal distention, fatigue, trouble sleeping, too overwhelmed to work, muscle loss, skinny fat, fluid retention, POTS, chronic Lyme and Babesia, and more and I am just not getting better despite all my efforts)

    All this would lead me to think I am leptin resistant but here are my labs. These are fasting but I did take my normal dose of 10 mg hydrocortisone before getting blood drawn.

    Glucose 92 (65 to 99)

    Insulin 3.1 (2.6 to 24.9)

    Homocysteine 6.5 (0.0 to 15.0)

    Ferritin 158 (13 to 150) High

    WBC 2.8 (4.0 to 10.5) Low (has been low for years)

    Neutrophils 37 (40 to 74) Low

    Lymphs 49 (14 to 46) High

    Neutrophils Absolute 1.0 (1.8 to 7.8)

    Creatinine 0.43 (0.57 to 1.00) Low

    BUN/Creat Ratio 37 (9 to 23)

    Cholesterol, Total 193 (100 to 199)

    Triglycerides 57 (0 to 149)

    HDL Cholesterol 76 (>39)

    VLDL Cholesterol 11 (5 to 40)

    LDL Cholesterol Calc 106 (0 to 99) High

    Iron Bind. Cap. (TIBC) 240 (250 to 450) Low

    UIBC 92 (150 to 375) Low

    Iron, Serum 148 (35 to 155)

    Iron Saturation 62 (15 to 55) High

    Hemoglobin A1c 5.4 (4.8 to 5.6)

    hsCRP 0.20 (0.00 to 3.00)

    Given my history and these labs, as well as the fact that Lyme can cause lab errors, do you think I should try the leptin reset? My main concern with starting is that the abdominal distention I have 24/7 gets much, much worse after eating to the point that I feel very uncomfortable. I also get a lot of fluid retention after eating. This is one of the main reasons I start skipping breakfast in 2009 so that I could have at least part of the day with feeling so miserable.

    However, if I am leptin resistant I would be willing to deal with this discomfort given that the LR could be part of the reason I am not healing??

    I would really love your input and thoughts on all this.

    Thank you,

    Kristina

    • @Kristina……still not sure but your history of a high rev T3 knocked down with drugs and a elevated ferritin indicate a possibility that you might be. It does point to inflammation. You really need a HS CRP And vitamin D level done at same time. I think with the partial labs the more likely issue is a chronic leaky gut…….I bet we would see a cytokine panel show elevate IL1-B and IL-8 . There is no way to tell with this data though.

  395. Rachelle M says:

    I'm big on percentages, and I was wondering what my protein/fat/carb ratio should be? I feel like ever since I added in more carbs I've gained fat. I'm at goal so I should be eating some healthy carbs right?

  396. Rachelle M says:

    My testing?

  397. Hi Dr. Kruse,

    I forgot to mention I had cytokines tested last year and all came back normal. I wish I had gotten a D but forgot. However, since supplementing with D3 drops my levels have been in the high normal range.

    Thank you for replying.

    Kristina

  398. Rachelle M says:

    Oh wait I got it. Sorry :P

  399. Actually, I just looked at my cytokine results and IL-1B and IL-8 were not tested. Only IL 2, 4, 6, 10, 12, and l7 as well as IFN-gamma, TNF-alpha, and TGF-beta. All those were normal.

  400. Would eating a badass breakfast with a good artificial sweetener (stevia, say) fool the hypothalamus even more? It it's expecting carbs that time of day, but gets mostly protein but with a carb taste, isn't that an even more confusing signal?

    • @Jerry there is nothing in the literature I know of that stevia alters mRNA of the hormones and peptides in the hypothalamus yet. It wont surprise me if it does but I am unaware of this now.

  401. Hi Jack. What do you recommend to folks on thyroid medication who have to take it first thing in the morning and wait an hour before having breakfast (hard to get that protein in within 30 minutes of waking)? Thanks.

  402. I'm allergic to eggs (and soy and cow-based dairy, so no protein powder, either) … what do you recommend for a BAB? Just various meats?

  403. I'm not referring to stevia per se, but rather to the sweet stimulus acting in combination with (conflicting) signals from the vegas nerve indicating consumption of protein. Greater confusion going into the hypothalamus –> faster changes in mRNA there. Just a guess. I'm currently testing this theory by eating a badass breakfast with home-made stevia soda water.

  404. What's an N-1?

  405. Hi Dr.Kruse

    I was wondering if a vegan can do the reset as well. I use the sun warrior protein, which is raw sprouted Rice protein. One spoon has 17g Protein 3g carbs. 70cals. My cravings are normal, and I have about 12lbs to loose. Thank you, J

  406. Hi Jack!

    Just started the Leptin Protocol~ I have Hashimotos Thyroditis with elevated TSH levels as well as adrenals increasing in the 10+ p.m. levels. So, just started and just calculated my protein numbers for the breakfast in the 40's range..but, didn't eat until 8 hours later. Should I decrease the protein or should I just leave it? I have used HCG in the past and not too sure how you feel I should proceed. Also, another thing that I have noticed is that I do better on a bit lower fat as far as cellulite and fat on my woman bits; should I lower my fat and stay protein high? Or just stick with the high fat?? I want to ask you too, should I workout, I feel pretty energetic and antsy already but, maybe I should wait a few more days to a week?

  407. Ahhh, you mean N=1, not N-1. Ok, that makes sense. Can't wait to hear what your experiment is, the one you just completed. Progress report: so far (about 2 weeks) my weight is holding steady, the badass breakfasts are extremely effective and enjoyable, I don't think about food very much, and sleeping in total darkness is making me feel great.

  408. Thank you for your reply, did you ever heard of a vegan who did it successfully?

  409. I had been following your plan for about 6 weeks and I found myself in a full blown gout attack. Every joint and soft tissue was inflamed. I completely stopped the plan for a few weeks until I felt better, and once I resumed the plan, within 48 hours I was back in full gout again. What can I do to reset my metabolism, and not set off this very painful attack which seems to be activated by a high purine diet?

    • @Roshann what you did not say is that you did not test. If you did you would have found that your HS CRP and Vitamin D levels and ferritin were really bad but your omega 6/3 ratio is horrible. That is why this happened. You are going to have to modualte your immune response when you do the reset. Generally this does not happen unless your 06/3 ratio is over 30/1. That puts you in some rare air. It also would precict you have high blood pressure and sky high sdLDL on your blood work.

  410. Thank you!! :)

  411. Dear Jack,

    Could you please give us clear instructions on nightshades during LR? You almost always write that everyone should avoid them, but once you linked it to HDL below 70. We are having a discussion about it in the forum. Thank you.

  412. Dr. Kruse,

    What do you feel are the downsides to a grass-fed whey protein concentrate from raw milk to use for the big protein breakfast?

  413. About my question above (552): What do you recommend to folks on thyroid medication who have to take it first thing in the morning and wait an hour before having breakfast (hard to get that protein in within 30 minutes of waking)?

    To clarify: is it best to not take the thyroid pill upon waking, have breakfast ASAP and then take the pill an hour later OR is it better to take the pill, wait an hour and then have breakfast or will the circadian rhythm kick in no matter which option is chosen? I'm asking because I'm planning on putting someone on the leptin Rx. Thanks again.

  414. Dr. K. –

    I found your site through MDA. Thanks for the great information.

    I'm trying to understand the relationship between exercise, LR, and stem cells. I have to lose about 25 pounds, but I sweat easily, have no carb cravings, and respond well to exercise, so I'm wondering if the whole "Primal" take on exercise – keeping it between 55% and 75% (while doing weekly HIIT and lifting) will cannibalize my stem cells.

    Thanks again.

    • @Don Stem cells get depleted by excess inflammation and too much replacement…….if you limit apoptosis and autophagy you can increase the lifespan of your stem cells. BEst way to tell is your inflammation level and your telomere lengths. Telomere measurements are still too expensive to recommend but soon they will be the gold standard in my view.

  415. I just spent a good part of the afternoon reading everything in this thread, and have two additional questions.

    You recommend 40-yard sprints – how many sets, and how much rest in between sets?

    And at what point do you start considering physical exercise to be "cardio"? Is it a measure of heart rate or of being winded? Or is it a matter of how long you do the exercise? Thanks again – I'm finding this site to be very interesting!

    • @Don I say work up to 20 40 yd sprints…..i run them all and walk back 40 yds and run again. avg break time is 7-10 secs.

      The cardio issue is a time based and how my HR responds on my watch.

  416. @Jack the links aren't working for me. Does the article say anything about a problem with sleep if you take Levothyroxine at night? I thought that was why I shouldn't do it. If that is not the case, then it is a perfect solution!!!! yay!!

  417. Did I see that folks with autoimmune disease should avoid butter and cream? Are other dairy products ok?

    Is whole goat milk yogurt ok with autoimmune disease?

  418. Is it possible to be overweight and LS? I ask because the only time in the last 20 years I gained weight was due to steroid use. My weight was stable before, and has been stable since – just 30 pounds higher. It never changes regardless of how much or how little I eat. I don't get hungry in the evening. My hungriest time of day is approx 11am-4 pm. Before or after that my hunger levels (and interest in food) are much lower.

    My HCL is high, TG and LDL are low, fasting BS is right where it should be. My cortisol follows the proper pattern, though it is on the low end of normal. TSH is 'normal', but fT3 and fT4 were low, so I take natural thyroid – which is something I hope to improve. I haven't had a HS-CRP done, but I have one ordered. I am 50+, sleep in a dark room (read TS Wiley years ago) and have followed a 'mostly' WAPF diet for about a decade. Thanks.

    • @Jayelle it is but it is rare. The reason is that fat alone contains leptin and leptin is an IL-6 analogue that causes inflammation by itself. But one can cover that IL-6 effect with certain natural anti inflammatories.

  419. @Cavemom…….there is a solution for you I believe but I have not written or talked about it just yet. I am planning to unleash it on Jimmy Moore's cruise or possibly in my book. I promise that just because your vagus nerve has been severed does not mean all is lost. The answer I think is going to shock you.

    Here is a preview for you…….

    1. Acute spinal cord damage, nerve compression data, SCI Injury data Miami project, chronic pain, inflammatory cytokines
    2. Leptin, IL6, people with spine disorderswho are LR have pain? MRI findings? Having DDD?, paradox spine surgeons and radiologists see daily, inter-body fusions that have high levels of failures documented in the literature…….unreal amount of joint replacements, neolithic diseases all tied to aging
    3. NASA data, frost bite data from kids, Sherpa findings, Mount Everest, eating grass fed butter/lard to maintain weight, pulmonary edema, great white sharks, dinosaurs, asteroids hitting earth, Amgen's synthetic leptin trials, Einstein, Michelangelo, Da Vinci, Kevin Everrett situation.
    4. environmental stimuli, Zeltiq data, insensate body, principles of dorsal column stimulator, overstimulation confuse's brain. lowered cytokine response by severely lowering cortisol levels, using sympathetic nervous system while lowering the total local cytokine response, using a paleolithic diet in a new way to get a new result. lowers acute tissue 06/3 levels……. cold urticaria, 06/IL6 levels increased, IL-8 amplifies cytokine response, acutely and chronically change things to make it a feed forward chemical response, can the brain be shut off acutely when the vagus nerve is cut, brain damage, nerve damage, partial nerve injuries, SCI and Bracken Protocol mechanisms, acute or chronic pregnenolone steal syndromes, how does hormone levels matter?, progesterone, BDNF, modulation of nerve growth, shutting down secondary damages

    That is all the data points I had before I figured it out……..now you can try until I lay it all out.

  420. Hi Dr.,

    Ever since I was young Ive had a weight problem. Even the past 12 years, where I have been a competitive swimmer and water polo player and train between 2-4 hours a day, and eating very low carb and high protein I could never lose weight. I eat a few low- sugar fruit, but mostly veggies, meat, eggs, and am very keen on nutrition. I'm 22, have been a college athlete for the past 3.5 years and just got diagnosed with hypothyroidsm about 3 months ago. My doctor started me on armour thyroid and prescribed 2 rounds of the hcg diet, where I lost 30 lbs. The weight no matter how I try has been trying to come back however and its been incredibly frustrating. I read your research and was just wondering if you think I am leptin resistant, even if Ive basically eaten paleo the past 2 years. Not a gram of sugar, and barely any carbs, the worst was an occasional bowl of oatmeal but ive cut that out as well for the psat 3 months. Please tell me your thoughts about my situation. Ill try the 50 grams of protein 30 mins after taking my armourthyroid pill in the morning, and keeping meals 2-3 times a day like i have been. Im 5'7, 140 lb now (but used to be 170+ even with eating superbly and rigorous exercise) , and a 22 female. I know Im not insulin resistant, my cortisol is pretty normal, and a blood food intolerance test was also done tome, so I try to work around foods it doesnt allow. Any thoughts would be appreciated,do you think I'm LR, and could I do you protocol exercising, or would that not allow it work. I am in dire need of help. Thank you dearly

  421. @Jack regarding Cavemom, even if the vegus nerve is severed in the gut, can't a stimulator still be used? Also, can turning on a vegus nerve stimulator for only, say, for 3 or 4 hours after each meal extend the (~3 wk.) time before the hypothalamus figures it out and rewires?

    • @Jerry it can…..but here is the big anatomical problem…….the tip has to be in the hypothalamus and that is physically impossible to do in 2012 by modern neurosurgery. So , realizing this short coming I came up with a hypothesis in 2010 that i have fine tuned. I think I have now found the answer. And That answer will be unleashed in 2012.

  422. Thanks Jack- have some ideas – researching.

    If anybody else has input let me know.

    So Jack – it might be useful for you to be able to test the hypothesis. Although hardly publishable it may help as far as not succumbing to a confirmation bias. I haven't gone to a physician in years, but I've recently found a paleo friendly one and thinking of testing and optimizing. I'm willing to test a protocol.

    Keep up the good work.

  423. @Jack @Cavemom Ok, but I thought a vegus nerve stimulator is connected to a coil that wraps around the nerve (not an embedded electrode)and that it's placed near the shoulder. My guess is that you're confusing the hypothalamus using only hormones. Can't wait to hear what your idea is.

  424. I ate a tuna steak and 4 eggs cooked in butter with a banana and almond butter for breakfast around 6 am. It's 2pm and I'm not hungry, but I have a sharp pain in my upper abdomen. I'm not normally a breakfast eater. Its not unbearable but very uncomfortable. Advice? I also dont think i need more protein for the day…no hunger at all after 7 hrs, should I still try for three meals or can i just do two? I guess if hunger comes before 5 that will just be dinner? or can lunch and dinner both be very small and close together?

    21 y/o f, 125 lb, 5'2", but my body fat% seems really high in contrast to my lean body mass. hoping to turn that around with the primal diet. used to be active and have done calorie restriction before, but am now quite sedentary which might explain the muscle loss. my guess is too much protein today but ill keep going. my sleep schedule has been bad but i plan on walking after 5 today and being in bed by 10.

    • @Sarah you may not be LR……so you need to test it before you do the reset because the Post Leptin Rx postscript method of eating…….I think you might be making an error in judgement.

  425. I am new here. Did I see that folks with autoimmune disease should avoid butter and cream? Are other dairy products ok?

    Is whole goat milk yogurt ok with autoimmune disease?

  426. I am following a new T3 only protocol while supporting adrenals and iron. It has been six months on this protocol to clear Rt3 that has been blocking T3 absorption in cells. I was chronically low iron most of my life, very anemic. My Hashimoto's Thyroiditis was not diagnosed until age 40, though I am certain it was there from at least puberty, likely birth considering my poor health since birth.

    Clearly T3 only or natural thyroid is the best way to go. So many folks who have been treated with levothyroxine (T4) are suffering from poorly treated hypothyroid.

    Stop the Thyroid Madness by Janie Bowthorpe and other websites listed below have educated and guided me to where my temp is now averaging 98.2 instead of 97.9. The goal is to have 98.6 avg temps which will fight off pathogens/disease and raise metabolism. Iron is now optimal and I have cleared Rt3. Iron and thyroid need each other to work properly. Low thyroid causes fatigued adrenals. These sites give great guidance on optimal values necessary for iron/adrenals/thyroid.
    http://www.adrenalsweb.org/ http://health.groups.yahoo.com/group/NaturalThyrohttp://faqhelp.webs.com/ http://health.groups.yahoo.com/group/NTHA-Chat/ http://health.groups.yahoo.com/group/RT3_T3/ http://www.thyroid-rt3.com/

  427. Alright, I just did the mirror test and I could grab onto some fat with my hands which is bad.. Thank you for replying. I ended up eating around 6pm which does seem like quite a stretch. I felt no difference in energy levels and felt very full throughout the day not even ravenous 12 hours later, more like an "i could eat" sensation and I just had a salad of spinach, cucumber, grapefruit, celery, seaweed and some flaxseed. filling but im done eating today. I will just start on with the guidelines prescribed in the Primal blueprint and get to working out on a regular basis.

    Just out of curiosity what would the dangers of doing the leptin reset be if you are not LR?

    • @Sarah the LEptin Rx is designed to confuse your hypothalamus…….that is the last thing you need if your hypothalamus is working well. This is why there is a Leptin Rx postscript and it is precisely how I eat today. It is very much like the Primal Blueprint but I focus more on timing and light cycles. I think if you go read that post you may see why its that important.

  428. Sorry for the delay thanking you, Jack (was on business in London). I'll have my wife give the bedtime thyroxine dosing a go and report back at a later date. Take care.

  429. How to eat post leptin is a good guide then? I will study it for sure. However, I think I may have some biochemistry issues in the area of PCOS, though I don't know how related that is to the hypothalamus. I am going to make an appt to go see and endocrinologist bc I am suffering from some low mood swings/anxiety and facial hair and as I mentioned, change in body comp. Thank you for generosity. I have not had the best sleep record but I am getting it under control with close to 8 hrs a night. Really need to invest in a sleep mask and some earplugs haha.

  430. Jack – you gave me your card in Barnes & Noble a couple weeks ago as I was looking at "Wheat Belly". I've been researching paleo for quite a while, and have loved reading over your work. I'm currently reading The Perfect Health diet as well which is also very interesting. I'm interested in doing your Leptin reset program, before doing a paleo like program for life, but had a question. Back in June I had emergency removal of my gallbladder so I am curious if this "throws a wrench" into the process at all? Anything different I need to do? I currently don't have any real problems eating any fatty foods, my digestion has definitely evened out since the surgery. Have read about digestive enzymes, lecithin, bile salts, but I don't know what's really necessary and what's not.

    • @Erin I do remember you! Im glad you like the blog. The Perfect Health diet book is a paleo 1.0 book that is just fine. I do not think the GB removal would stop you. I would tell you however to supplement with K2 which you can down in rivergate at the vitamin Shoppe. Read my blog on the Vitamin K2 recycle system and you'll be sure to understand why.

  431. Dr. Kruse,

    With regard to post #570 above, you state that "You are going to have to modulate your immune response when you do the reset." How does one do that? I don't have gout but I do have osteoporosis, osteoarthritis and history of traumatic joint problems. My mother is Portuguese so I have eaten pretty much a Mediterranean diet my whole life. Based on your recommendation in another post, I switched to a ketogenic paleo diet with plenty of coconut oil a few months ago. Even since I have had very inflamed joints. My D levels are in the 70s and ferritin 244 mg/dL (200-400). My HS CRP is normally around 0.07 but recently spiked to 3.0 which you thought was due to my excessive testosterone levels at the time of testing. I need to get tested for O6/)O3 ratio,

    • @Paul you modulate the immune response by increasing your D, checking your intracellular glutathione level, intracellular uric acids levels, modulating the endogenous endorphin system with LDN, and strict protection of the intestinal brush border with your diet…..using bone broths and certain foods. There is a ton one can do to modulate your own immunity.

  432. Hi Jack. I'm wondering if you might have any helpful thoughts for me. I am 54 yrs old, and was at 420 lbs in January of last year. I dropped 40 lbs in 6 weeks eating low-carb, then 20 more lbs in the 4 months thereafter…then completely hit a wall and haven't lost anything since (though I was eating exactly the same as I had in previous months). I had given up grains and sweets (although, to be honest, I've been indulging occasionally in them in recent weeks and have reactivated my sweet tooth…need to tamp down on that again), and eat primarily homemade beef jerky (5-7 sticks per meal), chicken breasts (6-8 ozs) and hot dogs (3-4)…some hard-boiled eggs, celery with peanut butter or regular blue-cheese dressing…and every once in awhile some berries. I do mostly drink diet pop, which I know is bad…but even when I gave it up for 3 weeks, I saw no benefit in the area of weight loss, so I kind of backslid. I also think I probably eat too much peanut butter (all-natural), so I am backing that down. In the past couple months, I seem to have regained about 15 of the 60 lbs I lost originally. I am also doing 60 minutes of cardio a day on a recumbent bike. I don't mind eating this way…but it's terribly disheartening, because I don't see where I'm making any progress. I heard your interview on Jimmy's podcast yesterday and it sounded so hopeful…but in reading the Leptin RX (and then skimming Mark and Robb's eating plans) it sounds mostly like what I'm already doing (other than not eating as many veggies as they would prescribe). I'm planning on eating sooner when I get up in the morning…and not eating for 5 hours before bedtime…neither of which I had been doing before. And I know I need to get off diet pop and back on water. But do you have any other thoughts about things I might try? Thanks!

    • @Chuck if you're eating any grains, dairy, chicken,hotdogs you are not eating paleo…..the quality of your food is important too. You cant eat garbage and expect to get superior results. I think you need to buy a paleo 1.0 book and follw the Leptin Rx to a T. You will win.

  433. Thanks for the quick response, Jack. You're referring to grain-fed animals regarding hot dogs and chicken, then? Can you refer me to a Paleo 1.0 book (or are you referring to Mark/Robb's stuff)? Also, I listened to your interview today with Dr. Fermento and you mentioned apnea and DHEA. I do have apnea and my sleep quality is TERRIBLE (basically, I have to drug myself with Ambien and Vicodin just to get to sleep and through the night with back pain). I haven't had the saliva test you referenced, but does it seem wise to experiment with 50mg of DHEA to see if it helps my sleep quality? Thanks!

    • @Chuck…..let me be crystal clear. Hot Dogs and Chicken are not optimal foods in my view. And 50 mgs of DHEA for someone with apnea wont touch you. You need to test the DHEA-s level. its dirt cheap to get done. I bet you will find the dise you need to take is very much higher and it will require some pregnenolone too to maintain.

  434. Thanks so much for your help. I'll get the saliva test and phase out the hot dogs/chicken. I need to get this thing done.

  435. @Jack – thanks for the quick response, will definitely check out your K2 posts.

  436. An update for you, doc… after restarting the LR many times (b/c of binge eating disorder – amazingly, each time I restarted, it became easier and easier, till finally I am able to stick to the precepts of the LR protocol with little or no problem) Here's my first post here: http://jackkruse.com/why-is-oprah-still-obese-lep

    And here's my update:

    Signs of LS

    – skin very, very soft

    – occasional improvements in energy, not consistent

    – NO desire to snack, ever

    – No need to eat lunch, ever

    – NO BINGES IN OVER TWO MONTHS, including all the fall & winter holidays, and not missing any of it

    – Cravings almost completely absent. What little exist are negligible and easily ignorable.

    – Stopped weight gain and started losing – 10lb so far, and from a size 12 to an easy 8. My lowest weight in 6 years.

    – Bloating has started decreasing slowly, but this is more attributable to finally learning I have to be 100% dairy- and wheat-abstinent than the LR itself

    – Sleeping solidly almost every night. No longer take an hour to fall asleep, and//or waking in wee hours and unable to return to sleep

    Remaining

    – still pretty bad energy, feel like I'm running on 30% most of the time

    – haven't had warm flashes in many months

    – still foggy much of the time, absent-minded, etc.

    – still wake up feeling like I need ten more hours of sleep, every day. Still needing 8.5-9.5 hours simply to function, every day. Have regularly needed naps for most of the last year, for the first time in my non-pregnant life.

  437. Hi, Dr. Kruse

    My Question to you is being in a college lecture with the head of 2 hospitals here in MN. He said basicly that any "just protein diet" is very bad for you. So is it just bad on a long term? and I have been doing 1100 cal diet 90 protein, 35 fat,100 carb. am over weight by 100 or more.

    • @Dynnette You can listen to CW……and see where it gets you. Or you can use the 2.5 million years of evolutionary biology that sculpted us from our ancestors. I know what I have chosen. Evolution is a bit smarter than some CW ass in a college.

  438. I have lost 36lbs doing this but its going very slow now and I do not work out yet. am seeing a Nurse P. for this and she said not to work out yet more then just get up and move. also have you hear of Ideal Protein Diet.. I have clients and friends that started the same time I did and are way past me.. in just 3 mo. for loosing weight that is..thanks

    • @Dynnette if you compare yourself to others you wont make headway. You are changing your biology based upon the way it is designed to work by evolution. If you want to short cut it like them do so. You will suffer the same fate most humans do on diets and gain back what you lost plus 20. Leptin is tied into our DNA. Your choice what to do……..I don't compare myself to anyone. I am striving for my own biologic optimal. You should too. And you really need to read my blog post written today because it is at the crux of your real problem.

  439. Hi Jack you stated this in reference to # 570

    @Roshann what you did not say is that you did not test. If you did you would have found that your HS CRP and Vitamin D levels and ferritin were really bad but your omega 6/3 ratio is horrible. That is why this happened. You are going to have to modualte your immune response when you do the reset. Generally this does not happen unless your 06/3 ratio is over 30/1. That puts you in some rare air. It also would precict you have high blood pressure and sky high sdLDL on your blood work.

    Yes I have high CRP 15

    Low D

    Low Ferritin (32)

    Not sure how to measure my 6/3 ratio.

    I do not however have high blood pressure (110/78)

    And my sdLDL is in range.

    So how do I go about doing this – "Generally this does not happen unless your 06/3 ratio is over 30/1" "You are going to have to modualte your immune response when you do the reset. Generally this does not happen unless your 06/3 ratio is over 30/1."

    Your help is appreciated!

    Roshann

  440. Julie Mccarthy says:

    Dr Kruse: I sure could use your help. First off, I have become unemployed and have no health insurance and no income beyond that which can barely cover my bills (cortisol, anyone?) so testing is out of the question. I am a 5ft 6in 195 lb- 55 year old post menopausal female that is still recovering from 4 major surgeries in 2 years. First was a triple cervical fusion (Jan 09) then I had a complete rotator cuff tear repair (August 09), then in May 2010 I had surgery to have a plate put in to my lumbar spine–unfortunately, that plate failed and I had to go back in in Aug 2010 to fuse the lumbar in the one place and place rods on either side of my spine. Needless to say, I have had enormous pain to deal with both before and after the surgeries and probably was on pain meds for at least 4 years (I no longer take anything except for ibuprofin or aspirin occasionally, thanks to being mostly paleo for the last 6 months) On top of that, I had successfully lost 65 lbs in 2006 by calorie restriction but now I have gained most of it back. I had hoped to lose weight on the paleo diet and so decided to be very strict with the anti-inflam paleo (gluten, sugar, grain, legume, nightshade free-only heavy cream and ghee for dairy) for the last 40 days but I have not lost a pound and my measurements have not changed. I do sleep well and I get all my meat at a local farm that has pastured animals. (I do trades with the farmer) I am so frustrated. I would like to try the leptin reset but also wonder about my adrenals and thyroid because of the surgeries. I know you can't really do any "doctoring" over the Internet but if you have any advice beyond getting tested–anything I could try on top of the reset or foods to look at adding or avoiding I would be thankful. I have to say, I DO feel much better so far but I want to take this to the next level. I plan to begin the reset next week once I stockpile some good meat! Thanks so much for all your hard work.

  441. Kristin Walters says:

    Hi Jack,

    My 12 year old son had clear sticky discharge coming from his nipples. I attributed it to puberty. The Doc thought so to but wanted to check his leptin levels and do a CT scan in order to rule out a rare tumor in the pituitary gland. Ct Scan came back fine but the Leptin levels are high. we are going to do another blood test in 2 weeks to determine if an MRI is necessary. Can you tell me if patience with Leptin Resistance have ever had this kind of symptom and if so did the reformation in their diet help?

  442. Hello,

    I had a few questions regarding your Leptin prescription, mostly to evaluate my progress and manage expectations to avoid frustration.

    What I feel I've done right so far: I'm a 32 yr-old male, dedicated to getting rid of the ~20 pounds I seem to be hoarding behind my abdominal wall. For the past 2 weeks, I have been eating 50g of protein, usually around 30 min. of waking, but not more than 45 mins. (I have a handicapped son and sometimes he requires attention before I can get to eating ) I never snack between meals. I eat almost nothing but protein, fats and vegetables.

    However I have a few questions about expectations (and possible mistakes):

    1-How much weight–if any–should one expect to lose in the first few weeks? If this is only about restoring Leptin sensitivity, should we only expect weight-loss only after 6-8 weeks?

    2-Should I be avoiding ALL sugar? Even in marinades and/or salad dressing? (One of my favourite meals is roasted pork tenderloin with a tblsp. or two of barbecue sauce) You mention in the comments of your post that Leptin receptors in the tongue are sensitive to sweets. Does that mean nothing sweet, ever?

    3-To staunch any hunger after lunch and dinner I usually have 5-10 lightly-salted dry roasted peanuts or almonds. Is this advisable?

    I appreciate any insight you could provide on these topics.

    Thanks for your time,

    Sebastien Rolland

  443. Seb Rolland says:

    Well, I'm 5'9", 200lbs, and should probably weigh 165-170. ( a lot of that is visceral fat) Until I started the Leptin RX I was constantly ravenous for anything, mostly in the evening, though not specifically for carbs. I was constantly eating. The RX was like flipping a switch on my hunger Also, I didn't have much luck with Tim Ferriss's slow carb diet.

    That's what I've got to go on. :)

  444. Hallo Dr,

    My question: When pregnant, should you also not snack? Should you stick to only 2 to 3 meals? I had HELLP syndrome twice with my first and third pregnancy and read the late Dr. Brewers book on Toxemia in pregnancy and he prescribes eating proteien every waking hour. HELLP is a liver problem — what is best for the liver then in pregnancy — eating often or eating 2-3times per day? Do you think HELLP could be linked to Leptin problems?

    Thank you so much for your time.

  445. Ok I will as for that test. In the meantime can you clarify what you mean when you said that I will need to modulate my immune response when reseting?

  446. Hi Jack,

    My husband and I are trying to conceive, but I am also wanting to get my weight down as much as possible before I get pregnant. Is there any problem with following your plan if I happen to be pregnant? Once it's confirmed, should I make modifications? Add tubers and starchy carbs? Thanks!

    • @jessica…..you won't like my answer. I think you need to become LS before you get pregnant because it has tremendous effects on the fetus if you do not. That all being said It is very safe to eat this way if you are pregnant. You should discuss it with your OB but you might not get the insight from them.

  447. Doctor, I have to get foot surgery next month and I was wondering what I need to do to prep. my body, and what to do about the pain afterwards?

    • @Rachelle Here is what I discuss with patients before surgery. You should not use this without discussing it first with your own surgeon before surgery. All surgeons have different thoughts and regimen's they feel comfortable with before and after surgery.

      Dr Kruse's Recommendations to be discussed with your surgeon pre op!!!! ( I use these with my patients)

      In an ideal situation, patients undergoing surgery will have adequate time before the operation to prepare themselves emotionally and physically. This preparation will likely include dietary supplementation, as well as mental and emotional preparation. The healthier patients are when they go into surgery, the healthier they are likely to be during the postoperative phase.

      I also recommends that patients with poor glucose control discuss intensive insulin therapy with the surgeon before surgery. Specifically adding 500 mgs of reservatrol for 2 weeks prior to and after the surgery can cut insulin needs as well. Studies indicate that surgery-induced insulin resistance, leading to elevated glucose levels during surgery, raises the risk of complications and death. Intensive insulin therapy, a procedure in which glucose levels are closely monitored during surgery, can help reduce complications and lower the risk of death (van den Berghe et al 2001). The recommended glucose range is between 80 mg/dL and 120 mg/dL. However, this practice is not standard in hospitals and requires intensive administration from nurses and other members of the surgical team. Nevertheless, because of the benefits, patients may want to discuss intensive insulin therapy with their surgical team to see if it is warranted. Ironically, my own hospital wont follow through with my recommendations via the pharmacy so I have to do this for each one of my patients individually as we talk about peri operative care. I handle this best by trying to solve their diabetes before I operate on them if they are willing to do the things needed for success.
      I also advocate bagging the body part that is going to be physically cut by the surgeon with ice packs for 45min to an hour a day two weeks prior to surgery.
      I also think you need to turn off all lights in your environment as soon as the sun sets two weeks prior to surgery and not use LED or artificial light products at all. I asked them to consider using eye masks when they sleep. Extra steps are to consider cooling mattress pads to sleep on pre and post op are great ideas. I also advocate using sleep domes that produce calming sounds to bring upon the onset of sleep faster. I also want them to bring it to the hospital if they buy it to use. I tell them all that I want them out of the hospital fast because it is among the worst environments to sleep in because of the artificial lights, noises, and constant waking up from the staff to do vitals and other things that the hospital makes the nurses perform upon patients.

      I also asked them to double there use of Vitamin D# and DHEA two weeks prior to surgery, if they are on these meds. If they are going to be an in patient in the hospital more than one night, I want them to bring their DHEA, Vitamin D3, pregnenolone, progesterone and estrogen with them in case I decide to dose it post op. We do not need testosterone because we can dose that IM for men. FOr women with patches we ask them to bring them to the hospital. IF there are other regimens they are on I tell them to bring their supplements to the hospital. I also tell the family to bring good food from home and avoid the hospital food like the plague!!! If you eat it you wil have more pain and your will be more likely to come back to the hospital for some other neolithic disease in the future.
      Patients may also want to discuss aspirin therapy before surgery. Aspirin is a well-known antiplatelet that is used for prevention of heart attack and to mitigate the damage of ongoing heart attacks. Me, I like the combo of fish oils and reservatol better because most of the surgeries I do use bone and grafts and aspirin inhibits the formation of bone post op. So I dont recommend any NSAIDs or aspirin for that reason. If however I am not doing bone grafting or brain surgery I am OK with aspirin. Some studies have suggested that aspirin therapy may benefit certain patients before surgery, especially heart patients and those undergoing carotid endarterectomy (Mangano DT 2002). However, because aspirin affects the blood's ability to clot, no surgery patients should begin aspirin therapy unless under the direct supervision of their surgical team.

      Other nutrients might also be helpful before and after surgery that I use often depending upon the case:

      ■EPA/DHA—1400 milligrams (mg) EPA and 1000 mg DHA daily
      ■Arginine—3000 to 12,000 mg daily (in three divided doses)
      ■Glutamine—1000 to 3000 mg daily
      ■Vitamin C—2000 to 3000 mg daily
      ■Vitamin E—400 international units (IU) daily (with at least 200 mg gamma tocopherol)
      ■Vitamin A—25,000 IU daily
      ■Lipoic acid—150 to 300 mg daily
      ■CoQ10—300 mg daily
      ■Zinc—30 mg daily
      ■Melatonin—300 mcg to 10 mg, usually taken before bedtime; begin with the smallest possible dose
      ■Curcumin—800 to 1600 mg daily
      ■Protein (derived from whey)—up to 60 grams (g) daily

      Importantly, the surgeon should be aware of any dietary supplements that are consumed. Some supplements, such as vitamin E, Krill and Fish oil, Ginkgo biloba, increase the risk of bleeding during surgery. Many physicians will recommend that patients discontinue these supplements up to 14 days before surgery. Some surgeons will not because of their experience with the supplements.

  448. P.S. During pregnancy, I believe sprints and HIIT are generally not advised? Is it then best to opt for slow exercise, light weight training, or none at all?

    • @Jessica This is something to ask your OB but I think you might be hear a CW answer from them. I think you need to do your due diligence because my personal feeling is that you can do HIIT safely until a certain point in the pregnancy.

  449. can you clarify what you mean when you said that I will need to modulate my immune response when reseting? #570

    • @Roshann it means you need to limit the inflammation that is slowing your immune systems down regulation. For example a simple way is upping your D3, K2 and astaxthin levels. Another way would be fixing you leaky gut. Another way would be up regulating your alpha MSH to increase the endogenous endorphin axis that activates your Tcells……….the possibilities are endless. The real goal is to have an optimal immune system. The best way to ensure this is to eat a Primal template constantly.
      The cost of dietary distraction is the unfulfillment of your optimal potential.

  450. Hello, D.K! Thanks and congratulations for your work! I have a question, please: I am a 35 year old woman, 13 kg overweight, have ulcerative colitis with ocasional flares, breastfeeding a 4mo daugther, had hypoglycemia for most my life before switching to a primal diet in the middle of this pregnancy, 7 or 8 mounths ago. Although eating primal, I still very hungry between meals, so I eat 3 main meals a day and usualy snack between lunch and diner and before bed. I am very tired constantly and have very bad mood swings. I think I am LR but I wonder if it's safe to make LRx while breastfeeding( I want to breastfeed for a long, long time).

    Thanks and regards.

  451. Dr. Kruse:
    http://www.lipidworld.com/content/7/1/12 This study found that a combination of Irvingia gabonensis and cissus quadrangularis led to a 2.2lb/week weight reduction, significantly more than placebo. Do you recommend the latter supplement, as well (the group taking c. quad alone also lost more than the control group, but less than the combo group)?

    Any comments on dosage for both or either?

    This study doesn't mention leptin, so I don't know if the c. quad's effects are from improved leptin sensitivity as the irvingia, or not.

    • @MommaGrok if you want to use it go ahead……..me and my patients fix it the real way with food and we use it and the vagus nerve to rewire our brain back to optimal. There is so much fluctuation in the Irvingia and Cissus they can't control for it. Doctors who push this are usually supplement sellers trying to create a revenue stream. Id rather see you do it with food you already must eat to fix yourself. It is cheaper and how we are designed to eat.

  452. Dr. Kruse,

    Although not overweight, I was concerned that I was leptin resistant. In the last year or so of being on a low-carb GAPS diet I have found that I gain weight anytime my carb intake goes above 40 gm per day. I started on your protocol about 8 weeks ago. I do believe it has made a positive difference in my sleep/sweat/hunger patterns.

    I believe I may have restored my leptin sensitivity as I can now easily go 5 hours between meals. However, I still find myself gaining weight INSTANTLY if I even go a hair above 40 gm of carbs in a day. Because I'm on the GAPS diet I do not eat any grains, sugar or other processed foods. My diet consists only of high quality, grassfed animal fats and meats and a few veggies. I eat no fruits, nuts or seeds. The only carbs I consume are from veggies.

    Any ideas on why I have such problems with weight gain from even what I would consider to still be a low carb intake? Thanks!

    • @Jean…..my bet is that it is an underlying inflammatory issue causing a hormone issue. I think testing would help. I also think you should look into the Metametrix go fx testing for the gut…….because I bet that is the source. GAPS is not a good diet for those with infections of eukaryotic organisms and would not surprise me in the least that is your underlying problem. When in doubt TEST!!!!!

  453. Thx, Doc! I was wondering if it would be helpful when done *combined with* what we're already doing via food & circadian rhythms on the Leptin Rx. Or just superfluous at that point?

  454. Thanks Dr. K! I did have the Great Plains comprehensive stool test done and really the only abnormality that showed up was a lack of beneficial bacteria. No harmful bacteria, yeast, fungi, etc was identified. I actually had the test done twice within 4 months and similar results both times. Do you still think it would be worthwhile to do the metametrix test?

  455. Doc – You mentioned an underlying inflammatory condition causing a hormone problem. I did recently test very Estrogen dominant and am planning to start supp'ing with a progesterone cream. You've got me wondering if that could be the culprit? Any correlation between low progesterone and carb intolerance that you're aware of?

    • @Jean if that is the case you should have your doc draw your labs on day 3-4 of your cycle to see the ratio's of estrogen to progesterone…..also check your pregnenolone and DHEA levels. Many women (most) have estrogen dominance and need both progesterone patches and some need oral supplementation. It just depends upon you labs. Women in menopause also have a serious lack of prolactin/dopamine that further makes their weight loss tougher because they lose control of their releasing hormone mechanism at the pituitary. Leptin become uncoupled from the releasing hormones essentially. This uncoupling is obvious and most physicians don't realize it……..because we don't look for it. I look for it in my post menopausal women who have bad bone and when I fix it for them other medical problems magically go away too.

  456. Thanks again Doc. I'm only 34 and not menopausal yet, but I will have my estrogen/progesterone ratio, pregnenolone and DHEA checked. Do you suggest testing with blood or saliva? I've read contradictory info on which is the most accurate. Planning to start the progesterone cream in a few days when I'm at day 12 of my cycle and hoping to see some improvement with it.

    • @jean That is up to person you see…….in your case I would do it yourself with saliva from ZRTlabs.com I also will tell ya the higher the inflammation the quicker you enter menopause and the earlier peri-menopause hits……..your chronological age means nothing these days because your neolithic environment is what cooks your goose.

  457. Hello Doc,

    Thank you for your responses. Although I am a Holistic Health Practitioner, some of your terms are new to me.

    I just found out that I have Mycoplasma Pneumoniae, which I have more then likely had for over 20 years. Subsequently my NK cells are very low.

    I am currently on antibiotic/plaquenil treatment for the mycoplasma, as well as doing many supporting agents for the immune system.

    The problem when I eat Paleo style, which I truly prefer, I get such a Gout flare up that I am unable to even walk, as my entire body feels like I have been run over by a concrete paver. The minute I stop eating that way, the inflammation goes back down.

    So with that said, how can I eat Paleo style, build up my immune response, and insure that I do not gout again?

    Do I need to wait until my immune system is regulated before I begin?

    Why does the immune system respond negatively to this type of eating?

    I appreciate all of your support, I have sent many of my clients to you for guidance.

    Roshann

  458. Question Doc I am doing the reset following primal. Meat is my primary food not big on veggies or salads. After two weeks weight is down 9 lbs and blood sugar is 110 now where is use to bounce 30 to 50 pnts higher. The only problem I am having is the infrequent stool movements, sometimes three days any help would be greatly appreciated.

  459. Hello Dr.Kruse,

    Yes I will move forward with curing the M.Pneumonia first.

    However I was hoping that you would still elaborate for me, as well as others who may be reading this, why this diet causes a negative immune response if it is supposed to be healthy for us? Why would it cause such inflammation in the body, if this diet is designed to create wellness and healing?

    I am trying to educate myself the best I can, as well as to use this information to help guide my clients whom many of them suffer with immune challenges as well..

    Thanks!

    Roshann

  460. KathleenM says:

    Mamagrok, I just read your update above and it has encouraged me to no end. I'm having a hard time sticking with the reset due to horrible sugar cravings from systemic candida overgrowth. Can go a few days without having the need to binge on any type of sugar and I feel great on those days. I'm slowly beginning to associate a few bad habits to the sugar-filled days. For instance, I have to make sure I get enough water. I actually set my computer calendar to chime every hour to remind me! If I don't, then by evening I'm ravenous for sugar. I think the key for me is to be as consistent with the reset as possible, know why I'm binging and then be kind to myself when I do binge. Thanks for sharing your update!

  461. Hi, Dr. Kruse

    I started this past Sunday and it is now Wed. and I have lost 5lbs. Yahh!! Just wanted to say thank-you!

    Been feeling a little headache, and tired but sleep well. Diff. sweat more. And thanks so much for the coconut oil. I cook with it and I know it makes the diff. Because I have used butter and still was hungry. something about the coconut oil stays with you but doesn't make me feel heavy.

    thanks again,

    Dynnette

  462. Jack, when you say "You will notice a change in your sweating pattern" as an indication of returned leptin sensitivity, what are referring to? Do you mean while exercising or in general? I am 42 and one of the problems I've had for the last year or so, increasingly worse, is sweating. I feel like I sweat all the time. I'm guessing it's an estrogen issue and have an appointment with a naturopath coming up but I was wondering how sweating pattern changes one way or the other. Thanks so much!

  463. Thank you, one more question. How do liquids such as unsweetened tea, coffee without sugar etc affect leptin or insulin response?

    Thank you

    Shannon

  464. Hi Jack,

    I have been Paleo for a while but

  465. Hi Jack,

    Do you know much about prostatitis and eating paleo? I am insulin resistant (I have the belly to prove it despite being slim everywhere else)and am hoping your leptin protocol will help me.

    Also, can I just clarify, when you say about exercising after 5pm are you saying that I should NOT have a post workout meal?

    Thank you for all this information.

    Best wishes,

    Andy

  466. Dr. Kruse,

    My husband and I started the reset 9 days ago and I am feeling so much better. We are also on T3 for the time being, but just a few days into this I felt so much beyond that, I am feeling less pain and more happy than I have for over two years. So unfortunately for husband, who probably has insulin resistance too (a big belly) and glucose around 100, weight has not budged but worst thing is he is feeling very acidic, painful urination, will retest ketones with test strip in a.m. but p.m. urine ph is 5.0 or lower. Can he drink a green juice with his breakfast(celery, lettuce, mustard greens) or even drink baking soda on an empty stomach? it is very uncomfortable for him. Thanks,

    Meghan

  467. okay, well that' frustrating, we will try baking soda, he really doesn't want to give up

  468. Thanks Dr. k for your quick answer!*636/637* Thanks for your kindness and generosity! I will certanly follow your advice! Meanwhile, I have a doubt that came up while reading the comments on leaky gut prescription blog: Can I eat eggs, macadamia and brazil nuts and greek yogurt? Wish you the best!

  469. Jack, sorry if you've already answered this somewhere but do you include your veggies as part of your carbs and if not what carbs do you eat? i.e. can you eat bread?

    • @Jo I do eat veggies, but no nightshade veggies, and when I do they are covered in coconut oil, pastured butter, or Ghee. I eat no grains. And Jo you need to buy the book on fuels……The Paleo Answer by Loren Cordain, The Paleo Solution by Robb Wolf, of Primal Blueprint by Mark Sisson You wont get to optimal if you do not understand what fuels are ideal for the Leptin Rx.

  470. Dr. Kruse,

    Thank you for the response (#456). My GP was not concerned about my weight. We ordered some labs because I have not been able to sleep.

    I have low bioavailable testosterone (1.52 nmol/L) and relatively low total (9.8 nmol/L) for a 22 year old. My hematology was off (low RBC, low Hgb, low Hct, high MCH, Low Neut, High Lymph). Also, B12 was low despite having eaten a strict paleo diet for the past 8 months. Many of the labs you recommend were not available.

    I feel great, have good energy, my teeth, hair and nails look good and I recover quickly from high intensity training. I have a healthy appetite (I eat upwards of 100g protein a day) and never have cravings between meals.

    The issue is, I cannot sleep without melatonin, and even then, at doses of 6mg, I wake up at 3am-4am and lie awake until falling back asleep for an hour at 6:30-7am.

    My GP does not have any ideas as to what might be the underlying cause.

    Taking melatonin for extended periods of time (it has been a month so far) concerns me.

    What do you think of what I've laid out?

    • @Andrew the clue you gave me was the low B12. If youre strict paleo your B12 should be rockstarish and your not. That means that you have a leaky gut and this is allowing inflammation into your body. Many people do not realize this, but melatonin and DHEA are the number one and two antioxidants of the brain. So you need melatonin to sleep because you are using it up to fight off the inflammation from your gut. The other problem is that because of the gut issue you wont be able to assimilate all that great food youre eating and it will lead to changes in your circadian sleep cycle because your DHEA will be off compared to the leptin cycle. I bet if you check your DHEA-S you will find it real low……..so you can prove me right. Ask your doc to run it on you. Its cheap and all the big labs run this. My recommendation to you would be to start high dose NAC, re read my leaky gut Rx (honestly its one of the best blogs I think I have written) and you need to consider IV glutathione replacement if it does not get better in two months. In the last 40 pages of the monster MDA thread we have just talked extensively about this gltathione issue if you are interested in it. I think it is on pages 1475-1505 over their. PS if you take high dose NAC you must add 50-100 mgs of Zn when you do it too……….I mentioned that at MDA.

  471. Cheers Doctor.

    The leaky gut prescription starts today.

    It's time to heal my gut.

  472. Cú Chul says:

    thanks Doc, 671 sounds like me–DHEA-SULFATE 116 was my most recent result

  473. I suspect I am LR, even though I am not overweight. 59 yrs before I discovered I was coeliac, I haven't (voluntarily) eaten wheat for 6.5 years, and no longer eat grains or legumes. I gained weight from borderline underweight, to a BMI of 25, but most of it around my middle. I am also fibromyalgic, and have been ever since I first had M.E. aged 12 (they thought I had TB). I got M.E. the second time when I was 22, and had it for 25 years.I am currently the healthist I can remember, but feel there is more to come – but it has got 'stuck'. I eat a protein breakfast, low carbs in the day – but they are in the evening – can change that, and have lunch and dinner. Dinner is usually too late, but I am trying to train my husband. I take the usual coeliac supplements, but also extra Mg and D3. I am low on Zinc (still can't taste it) but can't get that up even with extra. I have a GP who does not believe in testing really, and live in a village so not much choice of GP, so I need to notice things for myself. Any suggestions – other than on the main 'sheet'?

  474. I forgot to say, I also have hypertension – had it 23 years since I noticed wheat made me ill (but I didn't know about coeliac). Although I have eaten paleo for 6 years, the BP hasn't shifted. I take lisinopril and felodipine, and all the others – bar the most expensive drugs either make me ill, are not allowed or no longer work! Grateful for any suggestions.

  475. Thankyou. I have just been reading a large part of your site, thoroughly enjoying it and will read the rest tomorrow. I got here because I had been reading 'Mastering leptin' and getting rather frustrated with it – explained the bits I already knew and leeping into the new bits. Years ago I was a neuro-physiologist, but sad to say with no interest in nutrition until I found out about the coeliac – and that my kids are too. Is there anything special I can post their way to make sure they keep healthy? They too both got ME following glandular fever, but have had a better outcome because I knew more about supplements to help.

  476. Hi Dr. Kruse

    I started the leptin rx almost three weeks ago. I am 5'11" and started at 363 lbs. I eat my BAB every morning and take magnesium and vitamin d. Breakfast is eggs and bacon and leftover steak. I'm down to 352 today and feel good. This morning I noticed my ankle was swollen and my wife (ex RN) told me I have edema in my calves and left ankle. Could this be related to what I'm eating? Why the swelling all of a sudden? Do I need to lower my salt intake?

    Thanks

    Dave

    • @Dave I doubt it unless you have an undiagnosed kidney or heart problem. Since you mentioned it's only on one side I do not think it would concern me that much. When you reset the hypothalamus it can effect our serum and urine osmolarity too for period. Most people usually complain of higher thirst.

  477. Dr. Jack, what do you think of hookworm therapy for allergies? I've been reading about it, and a small infestation of 10 to 15 worms seems to work well for allergies by modulating the IgE response. Might the worms also be useful for reducing chronic inflammation and thus restoring leptin sensitivity? I have been living with severe seasonal ragweed/hayfever and cat/dog allergies my whole life, and this cannot possibly be helping leptin signaling. Would love to get your opinion on this. Sincere thanks.

    • @jerry there is a lot of work on this being done for autoimmune conditions. I also think that that there is something to eating dirt off our organic veggies somehow provides our guts with protection from the same mechanism. It believe it helps select out for a proper gut microbiota that is loaded with bacteroides species.

  478. Dr. Kruse,

    I've been diagnosed with Hashimoto's. My latest lab work is as follows:

    TSH+T4F+T3Free

    TSH:  0.005

    Triiodothyronine ,Free,serum. 3.4

    T4 Free direct 0.63

    Reverse T3: 203

    Cortisol: 10.5 (taken at noon)

    Vitamin B12: 428

    thyroid antibodies: 336

    The thyroid antibodies have gotten worse in the last 6 mos. 6 months ago they were at 270. 

    Somewhere on one of your blogs I read that autoimmune diseases are caused by leaky gut. Do I need to switch to your leaky gut RX before following your lepton resistance RX or can I do both at the same time? Any thoughts on the lab work?

    I just happened to stumble on your web site two weeks ago and I'm so thankful to you for all the time and energy you put into getting this word out. I believe you are helping out so many people! So my hats off to you Doc!

    • @Cathy I would suggest you head over to MDA on the monster thread and post your data. We do not practice medicine on the net here. At MDA the comments become invaluable teaching tools for you.

  479. I've already been following your leptin resistance RX two weeks ago. I've already dropped 8 pounds. Woohoo! May not seem like much but I have trouble getting the scale to ever move in the downward direction.

  480. Hi Jack,

    I know that you cannot give medical advice, but I am searching desperately for even SOME bit of direction on what to do. Can you let me know if you find any information that pertains to my situation?

    I am 17 weeks pregnant with my third child; I am 32, was in "good health" (not overweight, good energy, etc.) prior to pregnancy, have been following a very-low-sugar/starch GAPS-style diet for two years, and was very happy to be pregnant.

    Three months ago, I hit a wall, and am dealing with incredible carb cravings (like nothing I've ever experienced), nausea and food repulsions…and absolutely debilitating depression, high anxiety, and panic attacks. We are living with my parents because I cannot cope. My midwife can offer me antidepressants, but before I try these, I want to try EVERYTHING else.

    Thank you so much for reading; I would be so grateful for any information (everything I'm finding concerns hormones as they affect non-pregnant people).

    Regards,

    Sarabeth

  481. SteveH,RN says:

    @Dave, if it is still swollen on only one side, I might worry about a DVT, a clot in the leg, might want to get it checked out.

    @ Dr. K, Just want to say WOW!!! As a ICU rn, I know how busy you must be, and the time you take to answert questions on here is just amazing to me. I wish there was a way to have you and some of the other Paleo oriented MD's out there go preach the word to your fellow doc's. Paleo revivals! Better yet, a list of Paleo oriented doc's, so it would be easier to find one close to me for my own primary. Just wanted to say thanks, I am learning SO much, and so much more to learn. I need to pull out my old A&P, nursing school books and study up, because this site, and some others out there, are definate gold mines of information. Thanks you for your dedication to learning and sharing the fruits of your labors.

  482. Hi, Jack. Thanks for all the great info. Wanted to ask you about my situation.

    I am a 47 yr old male. I was 373 lbs when I went on a 60-day HCG phase back in October. By the end, I was down to right around 300. I decided to do the Leptin Reset for my "Phase 3" as it sounded like a great idea as I knew I was big-time LR. I started the reset on 12/1 and it's been going great. My weight has stabilized and I've lost about 5 additional pounds. However, I was certainly hoping to see more loss by now. I've been quite faithful to the plan as far as meal timings, no snacking, very minimal carbs/sugars, huge breakfast, etc. I've been taking probiotics to keep my gut healthy (I hope). Recently I've begun working in some fairly brisk walking as a way to hopefully get some more fat burning started. But my weight refuses to budge. Some days it's up a couple pounds, some days down a couple. I can't seem to get it on a nice, gradual downward trend. I feel like I'm on the right track: no cravings, my clothes seem to fit a bit looser than they did, I feel good. But the weight won't move and I'm getting frustrated. After two months of the reset, I was hoping for somewhat better weight loss results. I eat 3 meals . . . a big breakfast and then two small-to-moderate meals about 6 hours apart. What am I doing wrong? Any ideas? Thanks!

  483. Hi – just finished reading all the comments and searching the website, but could not find anything about birth control pills affecting the leptin prescription.

    I am obese, and taking continuous bcp for stage for endometriosis – they keep the pain at bay. However, every time I go on a low carb diet, I have serious breakthrough bleeding, and cramping/pain. So really no point in continuing but just wondering if the bcp have an adverse affect on doing the leptin reset.

    Also was wondering if endo can be reversed with this like PCOS?

    thanks!

    • @Percy BCP are synthetic steroids so they cause a leaky gut. If you read my leaky gut Rx you will see that in the blog. I am no fan of BCPs because they block women from getting to optimal. The reason you re experiencing these issues is because your underlying leptin resistance and upside down omega 6 to 3 ratio is not good. This destroys your estrogen to progesterone ratio's. This is your real problem. A good anti aging doc or an OB/GYN who does not follow convention wisdom advice and can help you. In atlanta Ga there is a great doc named Eldrick Taylor who gives seminars and talks about this very issue. You might consider contacting him.

  484. Sorry, one more question. If you are obese, would you need to do the leptin prescription until you are not?

  485. Thanks so much, I really appreciate it. I just finished reading the leaky gut rx – didn't look before as I didn't think it applied to me.

  486. Doing great on leptin rx, 2nd week no hunger. I’m about 25# overweight. Had a small amount of bulgur & potato w/ my lamb tonight. Shame on me. Am I essentially starting over or will once not reverse all I’ve accomplished so far? I’ve been so good otherwise. Thanks!

  487. Dr. Kruse,

    I basically am in a similar level to 36 yo/male BMI around 45, last blood test in December showed TC: 193, LDL 126, HDL 34, Trig. 167, FastGluc: 94, TSH 7.87, Free T4 15.3, (GP says I'm subclinical hypo), Estradiol 123, Testos 7.4 nmol/l, DHEA-S 2.71, VitD – 7 ng/dl, (terrible!), CRP 0.5

    I was diagnosed with PDD-NOS (Autistic Spectrum disorder [leaky gut?]), and I have DPSD (Delayed phase sleep disorder)…my natural rhythm is go to bed around 3-4am and get up at 12-1pm. If I force normal times, I feel like cr*p all day, moody, carb cravings etc.

    I went to the ER for a possible MI…had this recurring chest pain in the winter months over the last 10 years…radiated to arm, neck. Did EKG, Blood, Stress test…all normal, no signs of MI. Doctor thinks it's costochondritis. When it is really bad it seems like fibromyalgia. Was depressed, weak, didn't want to get out chair, felt like absolute inflamed cr*p

    Started supping with B-50 complex x2 day, w3 oil, and 20,000 IU of D3 drops a day (overweight so take 2x the upper limit for). 5 weeks later feeling a ton better. Started doing HIIT/Sprints 2-3x a week within 2 weeks of D3 supplementation. I generally was eating an IF pattern…light breakfast, medium lunch, rarely ate much after 11pm (till my 3-4am "bedtime"). Once in a while had a carb craving at night…a single piece of fruit was enough to get rid of it. Also eating around 1600-1800 kcal/day, lost a pant size already. Days I do HIIT have no carb craving for that day and day after (third day I usually get). (Also I didn't gain weight till I started eating wheat around pre-teen years…use to be allergic, never ate, was thin until then and I "outgrew" my allergy).

    Two Questions:

    1-To do the leptin reset, do I need to go back to a "normal" daytime schedule, or with DPSD, can I follow my DPSD circadian rhythm.

    2-The D3 seems to have made a *ton* of difference in energy. The HIIT too. *Most* of the LR symptoms are gone. Do you thing vitD in serverely deficient people can reverese LR…i.e. the minnesota study showing for every ng of D, people on a hypocaloric diet lost an extra 0.2kg of weight over 12 weeks.

    Thanks

    • @Ben your cortisol is the seat of your problem no doubt It is what is driving your inflammation and making you feel bad and the CP. I think you need to eat and sleep by your current biologic settings but I would suggest you start to re create your environment to change your circadian clocks. You do this with light, Leptin Rx, and thinking. This is a huge bio hack and I do think you will need a doc to get you thru it. Your chronobiology is so screwed up it is the seat of of your cortisol issues.

  488. Hey doc do you know of any doctor in NYC that follows and believes in the reset and primal way of life?

    • @Timc Try Eric Braverman at Cornell Weil center.. I know some others but they take no insurance and cost ridiculous money. I would not pay it to go to them honestly. Your better off getting on a plane and seeing someone…….for a day trip It'd be cheaper.

  489. I have a question about exercise during the rest. Two days out of the week (off days) I can lift heavy during the daylight hours like you say. On the other days my only option is to workout after work between 10 and 11 pm and then immediately go to sleep. I know this is not optimal. My question is, it detrimental?

    What type of exercise would you prefer in this situation?

    Thank You.

  490. Thanks Dr. Kruse. One other question I just thought of…the recent studies show that people with PDD/ASD have lower cortisol levels in the morning and higher levels in the evening than neurotypicals. (They are theorizing the lower cortsol levels explain obsession with routine and avoidance of/inability to adapte to new experiences, etc. Theoretically, would that indicate any adjustments to the Leptin Rx for such users?

    • BenG great point about the good effect of cortisol here. Cortisol is needed for us to become motivated to explore or environment. This motion is wired to our hippocampus that codes for the making of memories and it helps humans learn. Humans with bad circadian rhythm for cortisol can not learn well and also to not adapt to changes well like the Leptin Rx. The reason is because they can not think as well with a disordered hippocampus from poor cortisol levels in the AM. This is why salivary testing yields more results than blood testing for this hormone. The human with your problem however still has the ability to overcome this deficit when they become aware of it and begin to think differently about how to recreate their environment to help. The best way to increase your AM cortisol is to eat and see the sunlight hit your retina every morning. This is why I am in the hot tub every AM waiting for the sun as I meditate and think of the best thought I have in my mind. I then post that thought on my FB wall or on twitter for the world to see.

  491. My husband and I have been working on our fasting blood sugar for years, and after 7 days of following your protocol – SUCCESS! 80 and 83 this morning! You're a GENIUS!

    Can't thank you enough!

  492. I am having great results after two weeks on the leptin Rx. However, I seem to be getting hemorrhoids, despite efforts to stay hydrated and eat plenty of vegetables and fats, some fruit in addition to the increased grass-fed proteins. I'm having daily BM but they are harder and sometimes more difficult to pass. Any advice?

    • @Jean I would tell you add 1200 mgs of Magnesium malate or citrate 2 hours prior to bed and increase your daily intake of coconut oil until your poop is softer. If these maneuvers fail use the plain Kevita coconut probiotic drinks once a day until poop is optimal by the Bristol stool chart that you can google in the net to check yourself.

  493. Thank you so much. Is the supplement safe for pregnancy? I forgot to mention I'm 4 wks.

  494. Reposting this from a Mark's Daily Apple thread, on the urging of some forum members.

    A little more background, I've been doing the LR since early December, it's coming up on 8 weeks, and I plan to move on to the post-LR phase in a couple days.

    ——————————————————-

    [QUOTE]Awesome, may I ask what changes you achieved in your health? Were you primal before?[/QUOTE]

    No, I was not primal. SAD, and mostly fast food or quick food SAD, 47 years worth of SAD.

    Changes:

    Waking up automatically at around 5:30 every morning, not groggy. I used to need two alarms to get me out of bed to be at work at 10:00AM.

    I feel "warm" quite often now (not hot, just a feeling of heat radiating off of me).

    Joint pain is gone, what I used to think were "shot" rotator cuffs that have been a chronic source of pain for years are now healed. I have full shoulder mobility now. That's an artifact of what I'm eating, not the reset timing, most likely, but it's just one more good thing.

    The flaky "elephant skin" on my elbows is gone, healthy supple skin there now. Same with the dead skin on my feet.

    For the first time in years my feet and toenails don't embarrass me.

    Weight has been fairly stable with only a 10 pound loss. Then again, you don't do this for weight loss, that comes AFTER…if it happens during, well, that's a bonus. However, my measurements have improved more than ten pounds could account for, measurable in inches and well as how my clothes fit. And I put the BIG in Big Ass Breakfast, trust me.

    I don't snack. I don't feel the need to snack. Snacks have no power over me now. To put that in perspective, it wouldn't be unusual for me to eat a whole tall can of Pringles, or an entire big bag of Doritos as a "snack" before I started the LR.

    I can go grocery shopping hungry in the evening, after skipping lunch, and still make good choices…and it's not an exercise in willpower, it just happens.

    I've kicked a 30 year six-pack/day Diet Pepsi habit with no stress, replaced with two cups of coffee and water.

    I have energy all day long. No crashes. I'm not hyper, just have steady "I can do this" energy.

    Not. One. Single. Headache.

    No depression, no irritability, I'm calm and collected and often actually happy. I could be a real bear in the past, and my subordinates would tiptoe around me at work when I got a certain look on my face, a look that's been absent for two months now.

    My libido is almost embarrassing. :o

    I can walk away from food on my plate, because I can tell when I'm full now, [I]during [/I]the meal, not an hour or two later. That's a big deal for me. I now savor my food, instead of wolfing it down, which helps, but even being able to do that is a huge improvement.

    Overall, I'm very *expectant* about the future thanks to the LR. I look forward to starting real exercising next week, and expect really good results in regards to body comp changes and overall health.

    —————————————————–

  495. @alex @Jack Same thing happened to me! About 1 week into the Leptin Reset, my waking BS stabilized in the low 80s. Formerly it was anywhere from 95 to 120, and I just couldn't figure out to get to get it down. Also, I get really tired between 9 to 10 PM now. Getting to bed early, sleeping in total darkness, and eating a badass breakfast are the only way to live.

  496. Jack, I listened to Jimmy Moore's podcast that featured you today, and came on the website to get some more information. I have been wondering whether Reverse T3 and insulin resistance are related, and based the relationship of RT3 and leptin, I would assume that is the case. I am currently on metformin for insulin resistance, and Armour for hypothyroid, but confirmed that I do have an RT3 issue and am planning to switch to Cytomel. I have been on a low carb/primal diet for 9 months, and have not lost weight, which I am assuming is due to the RT3 and insulin resistance. My question is- am I still leptin resistant if I have already gotten to the point where I have eliminated my cravings and hunger? I eat only two meals per day and snack very rarely (usually nuts). However, I eat my first meal of the day around 10-12, and wake up at 7. Is this okay at this point, or do I still need to worry about leptin resistance and eat my first meal earlier?

  497. Julie Mccarthy says:

    Hi–I was the poster for #619 on this page but never got a response. I'm thinking that I must not have been clear with my question(s) so here is what I posted on the Peripheral Neuropathy page:

    Hi Doc,

    Wondering if you ever posted a blog on the affect of opiates on leaky gut. I took many pain meds for years before, during and after spinal surgeries. I don't take them now but they recently prescribed Neurotin again because I still have nerve pain and burning creepy crawlies-does Neurotin affect leaky gut? Also, I have the classic physique of someone with Cushings and had several shots of cortisone in my time-that, with the stress of the surgeries and losing my job, I think my cortisol levels may be through the roof. Is there an inexpensive test for cortisol? Have you had experience with patients that have experienced these things and were able to improve their health? How did they do it? I have changed my diet to Paleo- should I address leaky gut first and then do the leptin reset? I have so many questions…

    • @Julie…..I have not hit on this yet but exogenous opioids reduces endogenous opioids and that cause weight gain via the MCR system. The best way to treat it is radical and something I am now testing clinically. Cold thermogenesis. I call it Factor X and will be giving a talk about it on Jimmy Moore's cruise meeting in May

  498. Julie Mccarthy says:

    Oi! I feel a cold shower coming on! Now, about my other question concerning if I should address leaky gut first or LR? AND if Neurotin (and muscle relaxers) will cause trouble with those protocols?? Thank you so much. I have learned so much from your blogs!

  499. Julie Mccarthy says:

    I look forward to it! Thank you, Dr. K! I'll just keep drinking my homemade bone broth and eat my homemade sauerkraut until you update.

  500. My 21 yo son has very high egg sensitivity. What's the alternative for him on this diet. He is overweight and struggles with fatigue and anxiety. Thanks.

  501. Hi Dr Kruse,

    I need help…

    32 y/o female, 15 lbs to lose that I gained in the last year with binge eating- sugar cravings, trouble sleeping that has improved a lot in the past months but rarely feeling refresh as I wake up. Mild bulimia for 3 years, with lots of stress, that stopped a little more than a year ago. I suspect adrenal fatigue, but feeling it has improved a lot. No medication. Supplement: magnesium, calcium, Vit A,B,D,E, fish oil.

    With low carb, sleep gets worst. Eating your way makes wonder with cravings, but that last night I woke up at 1, and hungry. Couldn't go back to sleep at all. Is it gonna get better or I just need to increase carbs? Pretty difficult to do it with veggies….Should I use fruits, dairies or starch? What would be better without compromising results with leptin reset?

    Thank you so much for your input and for all your amazing work!

    • @kathie I will get better but if you woke up at one AM i think you need to increase protein or fat during BAB or even at dinner time. Stick with it. And make sure you read my last blog on eating disorders.

  502. Dr Kruse,

    Could celiac disease cause LR from chronic, low grade inflammation in the gut? I kind of mentioned it earlier, but I told my GP about my history with a wheat "allergy" as a kid. My mother told me when I started eating wheat, I bloated up with edema and started gaining weight, etc.

  503. addendum: forgot to mention—just got the GP to order a celiac blood panel.

    Thanks.

  504. Will do. Thank you very much!

  505. Hi Jack,

    I posted above (#686), concerning my seemingly-hormonally-driven depression/anxiety (I'm almost 19 weeks pregnant, and while I used to have moderate mood fluctuations during the luteal phase of my cycle, pregnancy just slammed me into a wall).

    I'm on day #7 of a modified leptin reset (i.e. I'm eating the huge protein breakfast, not snacking, not eating late, but am also not limiting carbs from veggies, fruit, etc., especially because I was not overweight to start).

    I am hoping against hope (and believe me, my husband is too!) that this will not only help with the terrible moods, but also reduce the likelihood of me "stealing" cortisol from the baby during the last trimester, and getting post-partum-depression.

    But is this enough? Many people are telling me that I should try to supplement cortizone, and a pharmacist yesterday suggested instead that I supplement DHEA, pregnenolone, and progesterone for "adrenal support." My biggest challenge is that most labs don't seem to have any standardized, clinically useful ranges for pregnancy for cortisol testing, and since my midwife can't authorize testing for anything beyond very basic thyroid tests (TSH, free T3, and free T4, which were "within normal ranges"), I am stuck without any useful labwork. I would need to pay for any tests I get and interpret them myself, which I am not qualified to do and everywhere I look online I get just _slightly_ conflicting information.

    I have been dealing with chronic stress (raising a very high-needs child for 8 years) for a long time, and the problem is that this isn't going away any time soon. And I am functioning so poorly right now, and feeling so terrible with the anxiety, that I am hoping against hope that it isn't too late to turn things around with this pregnancy and the unexpected mood issues.

    Are there any tests or supplements or "extras" that you would recommend?

    Thank you very much for any thoughts.

    Regards,

    Sarabeth

    • @Sarabeth Low progesterone and low vitamin D are the big risks of post partum. Both are higher in older or sicker mom's. You could have assessed your risks best before you got pregnant with testing. Its hard to say where you are now. I would tell you to eat a heavy fat and protein diet with lots of good veggies and you are doing all you can for your child. HCG and leptin are master hormones for fat burning which are critical in pregnancy. If you moods are bad my bet is you have a leaky gut and are not assimilating the good nutrients from your gut.

  506. Thank you, Jack, for responding so quickly. Are you saying, basically, that eating good foods is about the best I can do for now? This has been my philosophy for a long time now…it's just that I've honestly never felt so bad in my life, and am worried that if I ignore a Problem now, things will be even worse later. (I was eating a very-low-sugar GAPS diet for 1.5 years before I got pregnant, and naively thought I was in the best shape of my life…)

    From what I'm reading, I can't tell if I'd harm myself more by taking cortisone for possible adrenal issues, or harm the baby more by NOT taking it… And thus I am paralyzed! And of course, I don't even know if my cortisol is low except for my very extreme mood symptoms. Get tests, or don't do any tests, or take glandulars, or take supplements…at this point every single doctor or pharmacist or person with hypothyroid/adrenal issues has an opinion that at least slightly conflicts with everyone elses', and meanwhile my body feels like it is running on empty as it tries to build a baby. :(

    The breakfast this morning made me so nauseous that I wanted to cry…but am certainly not hungry afterward!!

    Are there any physicians you'd recommend for a consultation, or would it just make everything even more murky?

    I guess one of my biggest questions is also: are there ever cases of severe anxiety/depression/panic that do NOT involve the adrenals? And can acute cases be treated without supplements, but just with food?

    Thanks again for your time,

    Sarabeth

    • @Sarabeth there is a lot you can do……more than I can recommend because I can not practice medicine over the net. But eating high quality food is one of the best things you can do. I always recommend to young women that before they get pregnant they should test to see just how fit they really are hormonally……that usually falls on deaf ears.

      As for physicians……OB?GYN by and large are CW because of CYA and legal issues.

      Can you have central mediated stress without a major adrenal response…….yes you can its rare but that is the basis of PTSD ironically.

  507. Do you ever offer phone consultations, and if so, do you think you could help me with recommendations if I presented you with a list of symptoms? I totally understand if not, or if my lack of pre-pregnancy labwork would make it impossible…but I am so desperate to be functional, and SO confused by the (lack of) testing options during pregnancy.

    (Eight years spent parenting a very high needs child has definitely put us on the road to PTSD….it's just that now, adding in this pregnancy for me, it's "D"TSD (D=during)…)

    Thanks again,

    Sarabeth

  508. Okay…does that mean "not yet"? I am happy to pay for your services in the meantime if you might be able to help, though, so please let me know.

  509. Hey Dr. K –

    Thank you so much for compiling all this info. Honestly, I can't wait for my round of HCG to be over just so I can get started on my own Leptin Reset. I do have a question, though, about your opinion on those of us dealing with psychological issues that "require" (still not convinced, but, again, I'm not a doctor) medication. I was diagnosed as bipolar recently, and unlike when it was just depression and anxiety that I thought I was dealing with, this time, I couldn't opt out of medication (at first, that is – I'm just now getting my mania under control, and for awhile there it was touch and go, but I'm still hoping there will be a time when I won't need medication).

    Anyway, my question is – how should I go about dealing with my bipolarity (mostly in reference to medication management) with regard to the Leptin RX and living a paleo life? And do you think it's possible to potentially live a med-free life with this issue? This is still a relatively new diagnosis for me, even though I'm no stranger to psychiatric issues – but now, without medication, I am a legit crazy person. It's annoying cause it's like a catch 22: I would like to get my diet under control and eat fully paleo so I have a chance of controlling this sh*t without meds, but at this point, if I don't take medication, I'm not functional.

    Seriously, any comment you could give on this would be truly, truly helpful. And thanks again for all your generosity, both in sharing this with us and in continuing the conversation.

    -Lindsey

  510. Hi Dr. Kruse,

    My daughter is 25 years old and on the hCG diet. She's been visiting home for a week, and she just found your site through one of their forums; I'm grateful for this because you just might be the one person who can convince her that this diet is ridiculous. I've been convinced it's not healthy just by virtue of the fact that she eats NO fat, barely 50g of protein a day, and hardly ever gets up to the 500 calorie protocol it apparently calls for because it's impossible for her to eat enough by following the guidelines listed in the hcg book (which I've since read). She also doesn't eat breakfast, eats a very low calorie diet, and only very specific kinds of carbs…apples and strawberries…and that's it. I'm worried for all the above reasons, but also because she has a history of eating disorders, and this seems to be triggering those same impulses in her. In truth, she can't be more than 5-10 pounds overweight, anyway.

    I've read elsewhere on your blog that you're not a fan of this diet, either, but I was wondering if you could elaborate on why it is this is so unhealthy? I don't have the medical or scientific background to understand why, but it seems to go against everything listed in your blog, and everything else I've known to be true about healthy eating habits. I'm worried she's going to do long-term damage that won't be able to be reversed.

    Thanks for your help,

    Howard

    • @Howard…….I might dissapoint you with my answer. I do not advocate the HCG diet because it is an incomplete way to activate proper leptin signaling and institute permanent fat burning. But HCG has some amazing effects on human biochemistry. It is a hormone of pregnancy that allows the fetus and placenta the ability to use fats extremely well to burn for fuel to fuel the massive energy requirements required to make a child. That all being said, it is not a sustainable method to lose weight because it requires that you be constantly on the protocol until the weight is gone…….and here is the big problem. It does nothing to solve the real problem. Leptin resistance. This is why so many people regain their weight as soon as they come off protocol. This is why I tell all people when they come off HCG protocol they shuld immediately jump to the Leptin Rx. But they also need to do one more big thing. They need to learn about my new addition to the reset I am laying out over the next few months. How to use cold.

      But here is why I cant dismiss it totally. The people who use this has stumbled upon a metabolic trap door in our physiology that actually is quite effective for fat burning and abolishment of appetite to maintain a low calorie diet. Many people poo- poo the diet because they wrongly believe that people lose the weight because of the calorie restriction only. That is not true. This level of calorie restriction normally would immediately turn off TSH and TRH in the brain. On HCG that does not happen. Moreover there is an initial surge of some other peptide hormones that we see released in an ancient metabolic pathway we rarely use any longer in human physiology. It is called the leptin-melanocortical pathway. If you read my latest blog you will find that it is directly tied to cold thermogenesis from our environment. It is my belief now that if a person on HCG uses cold thermogenesis while on the protocol they may actually lose even more weight than if they did not use it. And this weight loss might be sustainable because they are now inducing the other epigenetic changes that HCG can not do on its own. Even the doctor who came up with the HCG diet had no earthy idea how his diet plan worked up until his death. The diet has perplexed many a scientist. It perplexed me too for a long time because it was counterintuitive. That was all true until I stumbled on data from NASA astronauts and Sherpa's from Everest and Michael Phelps. I think your job as a mom is not to pound your daughter about HCG and further raise her cortisol……..support her unconditionally. Then get her to use the Leptin RX and cold thermogenesis to make her weight loss transition permanent, easy and sustainable. Your daughter needs your support and love now. She is trying to make herself better than before. Support her and help her. She wont kill herself or hurt herself by experimenting with the HCG diet. You just need her to have a plan with how to use it best.

  511. Dr K.

    I just read your blog on REWIRING THE LEPTIN RESET…

    Do people with thyroid issues always feel cold because maybe the body is trying to correct itself with cold thermogenesis itself?

    • @Cathy…….when you feel cold its usually because your TRH is shut off at the brain level by CRH or cortisol. That is the normal default path for humans in most of environments. When you induce cold it force a new epigenetic program to become active that reverses the central and peripheral effects of cortisol in the thyroid and TRH. And it happens fast.

  512. @Jack. Thank you for your honesty. I do want to support my daughter, but I admit it's hard considering her past. It does ease my mind a bit, though, that you say it's not triggering the same negative reaction in her brain that eating 500 calories (or less) would without the hCG. You're right, too – I want to help her, but it's difficult to do so while also accepting that she's an adult now and ultimately what she does is her decision. I need to remember that. It's just hard because our culture conditions all of us to eat in a way and treat our bodies in a way that's different from our evolutionary blueprint. I've been reading your site all morning, and I'm certain you really have something here. I'm happy that once she's done with the hCG she is going to follow your plan.

    With regard to your answer – how do I get her to do this right and use the Leptin Rx with cold thermogenesis? What do I tell her to do? She tells me not to worry, that she only has two more weeks left on hCG – but with this new information you've given me, what do I suggest she do during the remaining two weeks?

    I'm sorry for all the questions. I'm just a concerned parent, and ultimately my daughter's health is most important to me. That being said, your information does a lot to quell my fears, and for that I'm grateful.

    Thanks again,

    Howard

    • @Howard……..one thought can change our DNA. Remember that society and our neolithic creations are always looked at as better our situation now as opposed to yester years. I always look at how these things might undermine our paleolithic genes. Most of the mismatches we can fix easily are all circadian biology repairs……..they key is becoming aware of them and then reinvent yoru environment to support your paleolithic genome instead of undercutting it. Modern life is the ultimate neolithic challenge to our paleolithic biology in my view.

      When she comes off print up the Leptin Rx and tell her to follow it. Tell her to go find Colleen Coble on an HCG forum or over at MDA's monster thread to be her mentor. She is the Queen Bee of HCG and how to incorporate the Leptin Rx. I have yet to outline the cold thermogenesis protocol to the Leptin Rx but it will be coming soon enough here in a blog.

  513. If you take a cold bath how cold should your water be?

    • Cathy it is coming…….if you want to begin first buy a compression shirt……very tight. Then begin by placing 20-40lbs of ice on your chest and abd for an hour a day say for a week……then begin cold showers…..you will notice you can tolerate them better. As time goes on you will be better able to adapt to them…….when you get real serious you will see what I do. I can make it 18 hours packed in solid ice with no problem. But it took my 18 months to get there. Do not try this at home!

  514. Do you think I should try the cold baths first before I start taking LDN?

  515. Christa Whiteman D.C says:

    Curious about this correlation between reverse T3 levels, cortisol rhythm and leptin resistance. I have one patient, very thin, almost too thin, and when tested had very high reverse T3 levels. She also had low TSH and low T4, suggesting poor functioning of serotonergic and dopaminergic hypothalamic pathways. She did on the fit the clinical picture for someone with leptin resistance at all, so my question is what is the mechanism that links reverse T3 and leptin resistance?

    There is another patient of mine who would seem to be obviously leptin resistant- Hx of Type II diabetes, FM, endometreosis and I suspect PCOS as well with a body habitus that includes a lot of mid section adipose accumulation. A recent ASI showed a normal, though very slightly depressed cortisol rhythm. Definitely no increased cortisol at night as you suggest is the case with leptin resistance. Can you shed more light on this as well?

    • @Christa This is detailed in my Hormone 101 blog. When you are LR you have high cortisol levels in the brain. This leads to high hypothalamic CRH. This CRH blocks TRH/TSH release. It also is a competitive inhibitor of T4 and T3 and causes both hormones to form reverse T3. This is why high cortisol levels immediately shut down all thyroid function at the brain and thyroid levels. It can no tbe reversed unless the underlying problem is reversed……or you use cold thermogenesis to unlock this epigenetic pathway. Most people do not even know that cold can do this directly without any drugs.

      Your second patient is also a classic…….PCOS is underpinned by inflammation that leads to estrogen dominance progesterone collapse and high testosterone from aromatization……..it also in its has in its initial stages of the disease a higher cortisol level due to excessive ACTH from the POMC protein…….as this proceeds chronically the brain no longer makes a ton of POMC due to the chronic stress. So ACTH levels fall……….so does alpha MSH levels. This leads to other issues. So does DHEA levels……which destroy their sleep and allow IL-6 to rise. PEople with PCOS has much more major diurnal cortisol problems than an over all measure and this is why salivary testing trumps serum testing in these patients in my opinion. The other possible cause in a case like hers might be a CAH due to a 21 hydroxylase deficiency…….very doubtful that she has this but not impossible.

  516. Dr. Jack, once you notice the "small wins" on the leptin reset diet, should the transition to a maintenance diet be sudden, or gradual?

  517. Can the L Rx result in weight loss that is too fast? 10 days in and down 6lbs? (47 female @68" starting at 171#)supplementing w/ C, D, E, Omegas, ALA, NAC, CoQ10, Magnesium (Natural Calm at night). (Haven't sourced PQQ yet) Definitely not hungry between meals, albeit definitely ready to eat dinner on time. Carbs have been in the 50-75 range. Sleep is way better 6.5-7.0hrs To borrow from the Wicked Witch of the West… I'm melting!

  518. definitely think I'm LR – the chronic low vit D, amennorhea – although my NFP charts still show LH surge and and all the other sympto thermo signs over a 26ish day cycle; crappy sleep, muscle soreness w/in 2 hrs of exercise. All the usual thyroids tests within normal limits; female hormones tending age appropriately toward menopause. Dead libido. PMS/ PMDD Fuzzy thinking/attn of a lab rat on cocaine at times – mid cycle/end cycle are peaks. Definitely sugar addict over holidays, although anotherwise low – no grain eater. Dairy has waxed and waned. So doing the LR Rx has been mostly tighten the diet back to Primal/Paleo and add the timing mechanisms of when to eat. Sleep and thinking are better. PMS/PMDD too early to tell. I forgot to list the Kelp – every third day, which is the only thing I can think might be excessive, since I'm a fish at least once a week person – usually twice. Sorry for posting all this here but MDA is down :( otherwise I would bother someone in the forums there to help me tweak this. Don't get me wrong. More than happy to see the numbers go down each morning, but I don't ever want to see them come up again.

  519. will do.

  520. claudia rowe says:

    Hi Dr Kruse. Thank you for your website and taking the time to answer so many questions.

    I "cured" myself of PCOS about 3 years using paleo-ish principles. My left ovary was so cystic that it was close to twice its normal size. I now have almost no cysts, with only one chocolate cyst present at the last scan 3 months ago. I changed my diet to lots of salmon, eggs, avocados, macadamia nuts and homemade brocolli soup.

    I also upped the oils, mainly omega 3 and coconut, which not only my ovaries seemed to love but my skin and eyes seemed to gobble up happily.

    I can highly recommend your prescription for PCOS. It realy worked for me.

    Now, if only I could be less high rT3/high leptin level girl and more Leptin Sensitive girl. No matter what I eat – Paleo, Atkins, Rosedale, South Beach, You – I cannot seem to crack that!

  521. Hi Dr Kruse, I just found your website and have been reading through this post and the comments. Fascinating stuff. In a nutshell, I had some major stress about 6 years ago now, when I was 43 (female) and went from 123lbs to about 100 in six months. I had initially dieted the first 10lbs then the rest I couldnt keep on from stress, lack of calories and sleep and too much exercise. I was at that time very lean. Of course I had a rebound, binging, until I realized my body was trying to regain lost nutrients and dealt with that. In there was a long period of eating canned tuna every day and being diagnosed with mercury poisoning and given an oral challenge of DLPA which sent my energy levels into a huge hole. Early in 2009 I want to an anti aging specialist just to get someone to take my problems seriously. Because I LOOKED healthy no one believed me on how I couldnt sleep, gained weight by looking at food, even if I was paleo at that time and had no control over my body comp, despite regular sessions on the bike and practicing ashtanga yoga regularly. I was put on porcine thyroid compounded, it helped some, but by late 2010 it wasnt doing anything. I had happened to ask for a RT3 test and it was highish (280) and talked my doc into putting me onto SR T3 about a year ago. BBT have been higher since, but still I have NO control over my body comp. Energy levels are better, and I sleep better since I upped my carbs. I dont do well on high fat, it makes me gain weight, even in the absence of carbs, and my energy levels plunge on high fat, I cannot move my legs go to walk up stairs. I havent tried that for a couple of years now because it was so unpleasant for me to be VLC. I also get very dizzy on standing if my carbs are too low. I am currently gluten and mostly dairy free, the dairy free also seems to be improving my sleep. My cortisol was tested high in the am two years ago, I havent had it tested since. Stress levels are generally much lower now. I am at a loss at how to dig myself out of this hole. Is it just time? I am about 120lbs now but feel best around 110lb. I still ovulate and have a very regular period. Thank you :)

    • @Shelley Read all you can here on Leptin……in fact my post from yesterday 2/11/12 is perfect for your specific issue but you might not like the solution. It is the best way I know of in 2012 to reverse a high rev T3

  522. Dr Jack,

    As you've been LS for a while….As a point of reference of learning "what not to do"…If you wanted to gain weight and become LR as quick as possible and screw everything up as soon as possible, what would you eat and how would you eat, activities, etc?

    • @Ben G……I would add back grains and dairy with PUFA's especially in the AM and I would cut most of the protein. I would cut all the CO and saturated fat and I would graze at all hours of the day and night. I would use endurance exercise if I exercised at all. I would also go back to juices and soda for my drinks

  523. Or another way of putting it, how long could you go back to a SAD and expect to remain LS?

  524. Following the Leptin Rx can one drink coffee and tea between meals? Would homemade beef or chicken broth be acceptable between meals? Thank you.

  525. 2 quick questions I'm hoping someone can help me with.

    1. Does anyone else get headaches from their BAB? I've only been doing this for a week now, and I've been eating 4 eggs and 3.5 oz beef w/ about a tablespoon of butter. Every morning i end up w/ a headache shortly after eating.

    2. I was trying to add in coconut oil to help w/ mid-afternoon blood sugar crashes, but i think it's causing constipation in me. I've eaten the other foods w/ no problem. Since that's the only new thing, i think that must be the culprit.

    • @Marisa both these symptoms tell me you have a leaky gut for sure. You should consider adding betaine HCL acid to your BAB and you need to read my leaky gut RX and implement it with your reset.

  526. Thanks Doc. I just read your leaky gut info and I follow some of that already since I've been on the GAPS diet for over a year. I thought i would have had more healing by now, but I can't handle the broth for some reason. Are there any other options for getting in the healing collagen?

  527. Dr K, regarding comment #773, does that include liquid stevia?

    • @J you can use liquid Stevia without maltodextrin as long as it is for a transition move…..but you need to adapt to life without it. Evolution has no plan for artificial sweeteners so I cut them. We may adapt well to them or even tolerate them but that takes time. Epigenetics does not work fast when there is no previous history in our biology for something.

  528. I was just talking to a friend who is a dietician. We rarely agree on health or nutrition ideas and the leptin rx is no exception! She "warned" me that I'll stretch my stomach by eating such a big breakfast and that I'm forcing my liver to work too hard to process that much food.

    I'd like to get her on board w/ this. How do I respond to her concerns?

    • @Marisa tell her for me she should begin to find new work and a career…….because I will put her out of business in 5 yrs. Do not bother trying to convert her. Become the change she cant fathom……..prove it to her with your presence. Her science is based upon flawed Dogma……..and here is the beautiful thing about science…….It remains quite true whether they believe it or not. Her adivce kills people daily and she is ignorant about it……..my advice is saving people from her ignorance. You do what you should and make her eat her cheerios……..

  529. Ha! Got it Doc! I'll pass your message on ;)

  530. Thanks Dr K!

  531. Felt like a failure as I've now done the leptin reset twice: first for 8 weeks then back to hCG, second time for 4 months. Went back to hCG again a week ago – rather ashamed, but it is the only thing that causes weight loss. I've tried the low calories without it (even leptin "style"), no success. So your recent ice-bath post was what I needed to hear. I had started doing this myself, but had a few things wrong (empty stomach, not long enough.) I also stopped my thyroid meds this round of hCG — as Simeons suggested — I am NOT suggesting anyone else do this! However, it was like they were doing nothing — I'm feeling actually better without them (but on hCG). Now, I finally get it based on your comments here: high cortisol, shut off TSH/TRH in the brain – shunts to high rT3: this fits me to a tee, and even explains why no amount of thyroid hormone helps the hypo symptoms nor causes any hyper symptoms. So I'll be the guinea pig for hCG + icing. And if it somehow helps my lack of satiety along the way – I'll call you a miracle worker!

    Dr Kruse, 1. you mention ice on the stomach, is the back area between shoulder blades not important? My bath wasn't hitting this area, so was considering the ice idea. But you say the bath is more effective. 2. So is a 20-minute bath less effective than laying/wearing ice for longer?

  532. Hi Dr. Kruse,

    I'm a little embarrassed to post here but Lord knows I need help and I'm feeling confused/overwhelmed. I would email privately but I couldn't find where to email you and you post here often so I figured I'd give it a shot.

    My whole life I've been "sickly" and I have so many problems that I KNOW must be inter-related but I've never found a doc that could help with the puzzle. I'm in my mid thirties but my health issues started at age 5. I will say that my mother had a horrific "mind blowing" tragedy happen during her early pregnancy with me to the point that she never ate, cried non-stop, and actually weighed less when I was born than where she started. She attributes my health issues to the pregnancy but who knows… at any rate, I want to do the Reset but I'm wondering if you see patients if someone wanted to travel from out of state to you? My problems have culminated in what seem to be two separate MS like episodes, the first of which resembled Guillain-Barre syndrome, although the local guys say they have "no idea" what's happening because the MRI's are normal.

    I have seen many docs (even alternative guys)and been diagnosed with many things:

    Stage IV endometriosis with adhesive disease and a frozen pelvis

    T2D

    PCOS

    multi-nodular thyroid tumor and goiter

    Fibroadenoma of the breast

    colon polyps

    severe vitamin D deficiency

    TMJ

    chronic sinusitis

    chronic fatigue

    orthostatic hypotension

    female hair loss

    … the list goes on and on yet my blood work in the past seems "normal."

    I KNOW the reset would help me but I'm worried I can't figure this out on my own and I need more help than just the reset. I'm currently on HCG (it's how I found you) trying to peel off some more weight but I'm ready/willing to jump off, get any blood work, travel anywhere if I could finally find a doc willing to connect the dots.

    Thanks and I'm sorry if this is inappropriate to post here.

    JDW

    • @JDW contact Colleen Coble at the MDA site or your HCG forum and she can tell you where to go to get the help you need. I am just a doc posting my thoughts and rumination of human biology and evolution for others to toy with

  533. Thanks, Doc. I tried to find Colleen at MDA but she must have a different user name than her real name. Do you happen to know what it is?

    Will you still hack blood work if I wanted to try and go it alone?

  534. Hi Dr. Kruse,

    I'm curious what you would say in response to this podcast transcription (interview by Chris Kresser, of Chris Masterjohn): http://chriskresser.com/chris-masterjohn-on-chole

    They discuss thyroid hormones in particular (later in the interview), and why symptoms of thyroid problems sometimes warrant the consumption of more carbohydrates. Chris M. quotes from Weston Price, who writes that natives in the Far North who plan to get pregnant in the winter (i.e. when their carbohydrate consumption is virtually nonexistent) must consume moose thyroid in order to maintain their own health and fertility.

    I am confused by their ensuing leap to the conclusion that more carbs can boost thyroid function…but I am curious how you would respond to their thoughtful comments. What happens to those of us who are consuming only a semi-nutrient-dense diet, and eat much more muscle meat than organ meat? Is it possible to heal our hormones?

    Thanks for any insight,

    Sarabeth

    • @Sarabeth you're confused because it is their dogma and bias that is confusing you. This is an example of where youre primal instinct is signaling you that someone is telling you something that just does not jive on some level. You want to believe what they say because your perceive that they might know more than you but never buy that. I would tell you the same if you go the gut feeling from something I said. QUESTION EVERYTHING!

      You do not need carbs to get pregnant in the polar regions……mammals excel in these environments and have excellent fecundity. Human lifespan and fecundity in Sweden and Norway (arctic) are awesome…..Neither are aware that NASA proved thirty years ago that cold increase GNRH that increases the sex steroid hormones while also increasing TRH but no worries………….But If you are part of an organization with an agenda you must tow the line at times. I laughed out loud several times in this podcast because of some of the rather amazing leaps of science made but I will point out their glaring lack of understanding of how cold actually influences the thyroid. It is actually up regulated in arctic peoples and those adapted to cold environments. NASA studies on the Sherpa's are exhaustive in this area but they fail to mention it because their agenda is to push the safe starches point of view. In cold, TRH and TSH are elevated without any carbs because carbs do not grow in these environments 10 months out of the year. Iodine is low in polar environments but it is found in abundance in the offal these people ate. There is no evidence of epidemic hypothyroid polar people anywhere on the planet. I do believe CM when he says Weston Price mentioned the Indians eating moose thyroid ritualistically to get pregnant…….but I believe this was a ritualistic belief of those arctic Indians but it has nothing to do with needing to eat carbs to up their TRH/TSH. CM did use the word PERHAPS so I will give him the benefit of the doubt………..But this blurred the line for me……..and I am surprised Kresser went there and did not edit it. This was blatant disregard for the differences in biochemistry from equatorial Africa and the polar regions. The biochemistry is completely different at the hypothalamic level. Again, this is why my cold thermogenesis series is being unleashed now. This nonsense about safe starches and thyroid function needs to be put in its proper context which here to for it has not.

      All that being said, I think the world of CM because I think his thoughts are generally excellent. He is one of my favorite bloggers and I like to hear him speak. His depth is impressive. But he is not a clinician and his experience in these areas are quite limited to what Weston A Price has written. There are pretty strict limits on ethnographic data but they are great things to know. There are some things he says, that I do not agree fully, and I am quite sure there are many things I say that ruffles his feathers as well…….But I still find enjoyment in his efforts and thoughts. I look at CM like this quote from Ann Rynd: When I disagree with a rational man, I let reality be our final arbiter; if I am right, he will learn; if I am wrong, I will; one of us will win, but both will profit.

      With CM I find there is much to profit and ponder.

  535. Oh… I figured out who she is; I know her.

  536. Ok, maybe a dumb question but where are the answers to the questions asked here? I am particularly interested in why no exercise in the a.m. as this is really the only time I can exercise. Thanx

  537. One more thing… On the blood work you recommend, is it important to do it before you start or does the reset not really change in specifications no matter what the numbers show? Would it be advisable to just take them after 6 weeks or would finding out the numbers help me tweak the reset?

  538. Hi Dr. Kruse,

    Thanks for your response. I get that you definitely don't think carbs are necessary for hormonal re-balancing. But do you think there are any other things (aside from moose thyroid :) ) which ARE necessary for healing/fertility/stable moods, in addition to a good diet and eating food at the right times, practicing stress management techniques, followed by correct exercise when/if physical condition improves (i.e. a leptin reset)?

    I know that you very rarely suggest cortisol (or other hormone) supplementation…but I am very curious at what point you DO think that this or other interventions are necessary, and what these treatments might be in various cases. I do recognize that this is probably too complex of a question for you to answer here, but I'm searching and searching for ideas, hoping against hope to finish this pregnancy in better shape than I evidently was when I began, and am curious about your thoughts.

    (I just read "Safe Uses of Cortisol", by Jeffries, and by golly if it doesn't sound FANTASTIC to take a pill and get some energy, get rid of some of my anxiety/panic, and not sap my baby's rising cortisol production as I head into my third trimester of pregnancy! I kept reading his case studies and thinking, Gosh, how much better those patients might be if they ALSO ate well!! I sent my salivary cortisol test to the lab yesterday, and although I am unsure how I will interpret the results since I'm pregnant, I am definitely wondering if cortisol supplementation would be a good idea in my case.)

    (It's been two weeks today on my modified (no carb restriction) leptin reset. The noticeable effects are a large reduction in hypoglycemic symptoms, and just in the past few days, some faint color in my cheeks (after months of pallor!) after some meals. Do you think my body will get more benefit as time goes by, despite the apparently large demands of this third pregnancy?)

    Thanks for your time,

    Regards,

    Sarabeth

  539. Hi Dr. Kruse,

    I sent you an e-mail with further details. Thank you.

    Regards,

    Sarabeth

  540. Brandon Jones says:

    Hey Jack,

    You said above that when LS was re-established, that men would notice rapid weight loss. I have been losing about one pound every two days. Would that qualify as rapid to you? (In my past dieting experiences, radid would have qualified as 20lbs in 10 days on low carbs with walking as exercise.)

    For reference, I am 23, male, 5'8", 237lbs, large build. My highest weight was at age 19, and I was 300lbs. Got down to 255 the summer after my freshman year, and then intermittently low-carbed and IF'ed for a few years down to 220lbs and held it, but after a rough holiday season I was up to 247lbs again.

    Thanks!

    • @Brandon To gain FDA approval a weight loss drug only has to show a 5% total loss in 6 months. You're cooking with gas. I think you're perspective is a bit skewed on what you call fast. I had massive weight loss quick but I was doing everything correctly like a mad man………do not use me as a barometer.

  541. Dr. Jack,

    Today marks 1 Month on a paleo lifestyle and your Leptin Rx. My weight loss has been gradual and inconsistent. I'm down 17 lbs since starting the program. In general I think I may have been eating to much and drinking to much water. I have been drinking a full large glass of water with every meal plus more in between. I have had the impression from past diets such as Adkins that extra water was important. Mark Sisson makes a point of saying to drink when you are thirsty. My bs numbers have been in the 90-120 range 2 hours post meal time which is a huge improvement for me. I'm still taking the glucophage and glipizide twice daily. The plan is to watch the numbers and cut back as warranted. I feel better than I have in 20 years and my energy level is much improved.

    Today at the 1 Month point, I decided to test my conversion to being a fat burner. I awoke at 6AM as usual and wasn't particularly hungry, so I had a T of coconut oil and skipped my usual BAB. Now it's 1PM and I'm still not feeling hungry. I took another T of CO and 5 minutes later checked my bs levels again. I was surprised to see 165. Can you tell me what is going on here?

    My lack of feeling starved tells me I am getting energy from burning stored fat. That's the first time in my life I can say this was possible. Quite remarkable. It has been 30 days since the last bite of grain or sugar or processed food. I feel like I have done something remarkable here.

    Thanks for all you are doing here Jack. I am enjoying learning the science of the biology involved.

    • @Eric Liver is not optimal yet. That is what is going on……and you need to drink water at 40 degrees…….all the time. Drink as much as you like. You can read about liver and leptin on my Leptin Part Deux blog

  542. I lost three pounds this week but have what I think is a liver stitch. I am on broth and paleo and can't quit craving grapefruit. I thought it was a sugar craving but I used to smoke and have brown spots to the point of ridiculousness and high triglycerides. I know the fructose is bad, but the stuff is dripping off my neighbors trees and I keep seeing it on liver cleanse sites. It seems harmless enough to try and get rid of a stitch. I also remember this brown skin and apple/grapefruit craving hit when I busted my ribs full weight a couple of years ago, in front of my liver. I am just wondering if the apple/grapefruit no protein for a day and shot of walnut oil at bedtime would screw up a reset any worse than waking up with a gurgling sound on my right side and a stitch? I am confused about priority.

  543. Dr. Jack – just wondering if you think "no snacking" should really be followed by everyone or just those with leptin resistance? It seems everyone is pushing this snacking thing to keep your "metabolism burning fat" all day and I was wondering, do they have it all wrong or is it on a case by case basis?

    • @Erin good question. I think on this one I have thoughts in evolution. I believe that modern humans need a small protein laden breakfast to prime the circadian rhythm for acid production in the gut………but that is for optimal function. We are a very adaptable kind of mammal because our brain allows for more axis of control and introduction of variables than any other animal on the planet. I think modern humans can live and live well on one large meal every dinner………but I do not believe that is the optimal manner in which we are best adapted because of the evolution of our gut. Out gut an brain are the two things that we need to pay attention to when thinking about this issue. My thoughts 5 yrs ago were more dogmatic on snacking……..now I think snacking is only important for those who are LR. I think LR is a human biologic novelty that evolution has has not long enough time to deal with just yet. I believe the same thing about aging………but ironically longevity does have an evolutionary answer……..because we have been called to use that plan once in our history already. And that one thing………has huge implications for us all. As generation continue that effect lessens……but today the Western diet is proof that this program exists for some reason……figuring out why……..is the complex and cool part. FACTOR X is what I call it.

  544. Hi Dr., is there any hope making this work for a fellow physician (my wife) who cannot choose her own hours yet. Limited sleep, and workouts in the morning (military physician, meaning she has to pass regular pfts with lots of cardio)

    • @Marco yes……..if she eats well.sleeps well and use ice and cold water to her benefit. Any day she does cardio I would pack her in ice for a period of time. Read my 2/11/12 blog on why.

  545. I decided not to do that liver cleanse because of the fruit. I just thought that since I'm thin and have an ab fat blob and the long hitt in the pool makes falling sleep very welcoming, I didn't want to risk it. I did think about the past thirty years of dry crappy toast and thought that even though my omega 3-6 ratios must be off, I still must be short of fat because I was using atkins protein weights for the past dozen years. I took the shot of walnut oil with no drama and no night time gurgling. I hope it doesn't trip up anything because it was bed time.( Which I guess I had better follow up on, now that I read up.) But I am wondering if its possible to be short of fat? I weigh 124 now, am 5'8" and fine boned, so I should weigh ten percent less than others. Do you think extra cod liver oil might be reasonable? or should I just try to cram down more fish? I eat about a pound of brie a week also. I feel that I am eating large volumes.

    • @Lee you are doing so much that is sub optimal there is no use pointing you anywhere until you read the Paleo Answer……..and realize walnut oil and brie is like Kirk Cobain gun shopping and looking at bullets. You must improve your thoughts to improve your decisions……..you will never make gains until you get your own problems straight. Your thinking is a major problem.

  546. Dr. Kruse,

    Now I'm curious if I've been LR even with losing a lot of weight/fat. A bit of my story:

    In 2009 I started exercising heavily. I always yo-yo a bit, especially in the fall months leading into Christmas (seems like I begin a craving for sweets. Last summer I got down to 160 pounds as a 5'10" male of 31 years. I should be seeing a lot of muscle definition.

    However, I still carried a 34.75" waistline and had a lot of fat in my back, chest, and lower abdomen. I never could get past this point.

    I just did some recent reading and found some people who are insulin resistant seem to store fat in back and love handles more than others. All of this lead me back to your site. Could leptin resistance all this time be what was keeping my fat stores so high?

    • @Brent Yes…….and my people at MDA just learn why in the last 50 pages of the monster thread. YOu should go there too and ask Glamorama why it happens. After you complete that come back and read todays post……..in that order. And you will see why I wanted you to do it this way.

  547. Dr Kruse,

    I have a few questions regarding mostly timing.

    1. You recommend Resveratrol, Curcumin, PQQ, etc. Resveratrol seems to influence or reset the circadian clock. The Leptin RX also seems to be based on the circadian clock (eat a lot of protein immediately or in up to 30 minutes after eating).

    When is the best time to take resveratrol? It is ok to take it with food?

    Also, what about Curcumin and PQQ? What are the best times to take the supplements?

    2. What if I'm an insomniac with highly irregular sleep patters? When should I eat the protein-loaded breakfast?

    For example, if I can't sleep the entire night (which happens more often since I take Resveratrol), do I still eat the BAB in the morning?

    3. Resveratrol, Curcumin and cold exposure all seem to lower the leptin level. Doesn't this produce extreme hunger?

    Also, if lowering the leptin level is good for very overweight people like me (300+ lbs), by that logic being an insomniac should also be good, because during sleep the leptin level raises a lot, and not sleeping keeps it lower (I read a study on this, unfortunately I can't find the link again).

    4. When is the best time (morning/afternoon/evening) to do the cold exposure?

    Thank you.

    • @Dan I think if you use the supplements you should use them with food. If you have a sleep problem you have a metabolic one as well. Neither will get better unless you address both. They are both tied to leptin. To get a handle on it you need a sleep and metabolic functional assessment. Regarding hunger…..Not in someone who is LR. Remember the Leptin Rx is a reset not a lifestyle. It is meant to be a temporary plan to get your leptin receptor yoked back to proper signaling. There is only one way to lower it fast……..that is laid out in the 2/11/12 blog. If you LR anytime is a good time for cold. Cold is the primal Rx for all IR issues. This is how biochemistry evolved in mammalian design. Its the primordial blueprint and the reason why no cure will be found…….the cure is living to our normal cycles. T1D likely are epigenetic due to the generations of decisions by humans not to live congruently or due to SNP or defect. Although I seriously doubt that given what we are learning about epigenetics

  548. Hi Dr. K!

    I am a 42 y/o female, 5'3" 252 lbs. I was initially diagnosed with PCOS w/ insulin resistance several years ago after undergoing fertility treatments with no success (even though I did not have polycystic ovaries and my blood glucose levels were fine). As a person with a biology degree and some level of knowledge of cellular activities, I found this to be highly suspicious so I went to an endocrinologist. After several rounds of blood tests, it was found that my leptin levels were around 110, and I was indeed menopausal with non-measurable estradiol (<25) and progesterone levels (0.2). My thyroid levels were normal and blood glucose around 84 each time I had blood tests. The endocrinologist las month started me on a regimen of 1000 mg of metformin 2x/day, 2 mg estradiol/day, and progestin 10 days every 3rd month. This last bloodwork indicated that my estradiol levels were now at 131 – a level he says is now considered to be therapeutic. He explained the relationship between the estradiol and leptin resistance and said it would take anywhere from 12 to 18 months to begin seeing any results towards gaining back leptin sensitivity. Here is one question: I haven't found any significant research on the relationship between estradiol and LR in humans – is there any or can you provide any insight? And my second question is this: would it be safe to follow your diet protocol along with the medications and do you think it would play a more significant part in regaining LS than just the meds alone? Thank you in advance for your input.

  549. Dr. Kruse,

    What do you suggest for people who are hypoglycemic? I've been on the rx for 2 weeks now and find some days where I think I could easily go longer without eating as far as hunger goes, but I get this terrible nausea and sometimes a headache. I assume this is low blood sugar? When I eat it goes away, but I'm trying to push through and not eat for at least 5 hours between meals.

    On the flipside, I'm concerned that by pushing through and allowing myself to have low blood sugar I'm actually causing problems for my adrenals. Thoughts? Thanks!

  550. Dr Kruse, went back and read the thread, read your post, and I guess I'm still a bit confused at how all this answers my question about possible insulin sensitivity, leptin levels, and how fat storage works. Maybe I missed something?

  551. Dr. Kruse,

    I've been following the reset protocol for about 2 weeks and the whole time have had no trouble packing away ~75g of protein for breakfast (I'm 6'1", 230lbs, ~15% BF – so i upped the protein a bit) plus some coconut oil (3-4T). All of the sudden, the past 2 days I now feel so full after I eat the BAB that I feel very naseous…like if I ate anymore, I would puke. I've NEVER felt this sick from big meals and have always been a big eater…even ones twice the size of my BAB were no problem in the past. I am eating exactly the same breakfast every day.

    I was almost certainly LR to some extent upon starting…is this 'adjustment' to meal size normal? Will the reset make you fuller sooner as a benefit and is there any harm in cutting down to 50g at my size (esp while lifting heavy weights)?

    Thanks for all the info you've provided…love the articles!

    Michael W

  552. Awesome…Thanks Doc!

    You might consider adding that to the FAQs as something to be anticipated, as when it occured so suddenly two days in a row, I was pretty shocked/confused. Up until this point, I could have EASILY eaten more at every BAB so far without any trouble and felt fine afterwards with nothing like this "full" feeling I have had the past 2 days. Being a T1D for 25+ years, I've never really felt "full" from meals unless my stomach was literally stretched out (at my size, this takes a LOT of food/liquids). I could always eat more after any 'normal' sized meal…common for T1Ds.

    Anyway, I've absolutely NEVER felt so full on so little food in my life. If this is a continued benefit, my brain is going to have to totally re-learn appropriate portions…lol…exciting stuff! Thanks again!

    • @Michael W I dont always put everything in because I want you to experience you own epiphanies or sparks of insight I talked about in the Primal sense blog. The reason is by design. This is how the human brain works best for learning.

  553. Hey Dr Kruse,

    Quick question about fatigue:

    I just finished my first round of hCG (within 10-15 pounds of my goal weight) and for the last two days I've been eating a BAB within 30 mins of waking and staying under 25 carbs a day (only from vegetables and from whatever carbs are in the coconut manna). The problem is, even though I've been getting around 8-9 hours of sleep every night and waking up without an alarm clock around 6:45, I get so incredibly tired after eating my breakfast that I fall asleep within 30 minutes of eating it (and don't wake up for several hours). If I DO wake up within an hour or so, I feel too heavy and sleepy to stay awake.

    What could this indicate?

    Thanks for all your continued support,

    LD

  554. Will do…thanks for the response.

  555. Dear Dr. Kruse;

    I am 43 years old and I have Hashimoto's thyroiditis, my fasting blood sugar is 105 & sometimes it's much higher 126, I test my blood often after meals 1 hr. and 2 hrs. and I can handle carbs much better when I eat them, when I low carb diet my blood sugar level rises a lot higher when I eat even a little carbs. I was also told low carb diets slow your metabolisim and is why I stopped my low carb diet. I was eating 25 grams of carbs a day, but I never lost weight that way, because I still ate a lot of food, calories in and out still matter! I was only able to loose 100 pounds after being diagnosed with ADHD, because the meds make me not hungry and so I lost 100 pounds by only eating dinner. I am so hungry at night I eat everything and then want desert, so I save all my calories for dinner. So I pig out one day and fast the next and have managed to keep the weight off this way. I want to be cured of my leptin problem & I need to lose 20 more pounds. I am currently on t3 only time release 100 mcg to lower my reverse t3 (it did lower it, now I'm 63, but my SHBG is high, so are my thyroid antibodies) and I'm also on low dose Naltrexone 4.5 mg at night before bed. Should I follow your normal protocol, is the Naltrexone going to interfere with it? I see my doc on the 28th and I may change to a T3/T4 combo any thoughts on this? By night time when I get so hungry I think my time release T3 is worn off. I worry that any t4 will cause me to have high reverse t3 again and for the 1st time in 10 years my hair finally stopped falling out (I HATED Synthroid). I feel like the Naltrexone helps me with cravings during the day when I don't take my ADHD meds (Adderall), but not at night. I do not take ADHD meds everyday, because I want to sleep sometimes, so I take it like 3-4 days a week and if I didn't I would gain all my weight back. I want to be able to get off the ADHD meds. My temps change sometimes it's 97.4 and sometimes it's 98.4, which seems low? And my cortisol by a blood test taken at 4 pm was 9.7, normal range is 2.3-11.9 (LabCorp). Can you help me, should I book an appointment with you via the phone, is this possible? If yes, then how much will it cost? Thanks, Lisa

  556. Dr. Kruse;

    P.S. I was referred to your site by a lady I met at Dr. Freidman's office in L.A. and I've only had time to read a few pages, I plan to read it all, but just got on it today for the 1st time and I started your diet today, but had those questions above, due to my circumstances, with my meds and my thyroid. Just wanted to clarify that I did start your diet today, thanks, Lisa

  557. Hey Dr. Kruse,

    I can't afford testing and I don't have insurance (much to my chagrin). I'm within a normal weight for my height, though at the high end. I'm genuinely not sure if I'm leptin resistant or not. Is there any harm in doing the reset if you're not leptin resistant? Also, if I'm not leptin resistant, should I start showing the signs of leptin sensitivity if I do begin the reset?

    Thanks,

    Jessie

    • @Jessie You dont need money. You need the Leptin Rx reset. Follow it. Then add the CT protocol to it here . Make sure you read along about the Cold Thermogenesis protocol as I roll along the series. It will rid you of PCOS and much more.

  558. I should maybe add that my hands are always freezing, I sometimes get very cold after I eat, I was diagnosed with PCOS and IR as a teen (I was also very overweight then) but I've been symptom free for about 4 years now (I'm 25), and I've just recently finished the hCG diet.

    Thanks again.

  559. Dr, Kruse,

    maybe you can help. My mother (56 years old, 150lb, 5'3") had a portion of her intestines removed about 15 years ago, than had several more surgeries including removal of gall bladder and one related to acute pancteatitis. Right now she is on GAPS Intro diet and has lost about 10lb in three months. Her blood work is normal except her triglycerides that are over 500 (they were 3000 a year ago, she was taking trilipix and Lovaza, now just fish oil). She also has some nodes in her thyroid, but haven't done hormone test. She is a complete and some days feel extremely bad, have headaches and feels like her blood is not circulating properly. Do you think she can benefit from Leptin Reset? Is it save to do in her condition? The source of her high triglycerides is still unknown.

  560. Yesterday when I woke up, its seemed like my lungs reached down to my belly button. My chest was really expanding and I could feel cold air way down deep. I had to think for a second to get my breathing not so consumptive. Anyway , I thought more inflammation or something was gone. Early this morning I woke up and felt like I wasn't going to be able to get around very well, like I had a huge workout on my trunk, inside and out and nothing was gonna fit. I think I was breathing crazy deep a lot the night before, that the deep breathing is what woke me up. I had some fat and went back to sleep and feel like I can get around and get the kinks out easily enough. Is the change in breathing normal? Will my posture get easier to maintain? I need to stretch or hang or something in the afternoon. Should I expect more surprises?

  561. Hi Jack,

    I'm curious; I wonder if you've seen or looked into any correlation between diet and dreaming? Since I started the reset five days ago, I've noticed that I'm not sleeping as deeply, and I've been having very vivid dreams…not quite lucid, but very vivid, nonetheless. I also notice I have many of them within a short period of time, and I often feel like my body is buzzing with energy throughout the day and into the night, even though I'm physically tired when it's time for bed.

    I'd be interested to hear your thoughts on this – and the potential correlation, if any.

    Best,

    Jenna

    • @Jenna The reset will affect dreaming. Not as you described however. During the first few weeks of the reset you will notice some things differently because your hypothalamus is rewiring. Once you fat burn long enough on the reset most people will report more vivid dreaming and they will begin to remember the dreams for the first time in a while. The reason is simple. Your progesterone is rising and this increases BDNF which improves autophagy…….autophagy improves sleep in all mammals. All mammals are designed to be fat burners. As this progresses you will begin to see memory improvements during wakeful hours and more energy……..your brain works a lot better on ketones than on carbs despite what many tell you in this community. It is not close. Fat adaptations actually improves muscular performance on VO2 max testing too in 24-36 months. It takes a while ot show up and most want results yesterday so they default to the easy of doing it with carbs because they "feel" better. This feeling could be costing them down the road………but most unaware of it.

  562. Hi Dr. K, I'm now about 5 weeks into the leptin reset. Decided to get a blood test to check my progress, and discuss results with my endo (going to give him mp3's of your interview at Joanne Unleashed while I'm there tomorrow). (Had to skip BAB that one morning to get fasting levels, but otherwise I've been pretty strict about doing the reset.)

    Anyway, just got the results. HDL went up from low 40's to 55 (I've been using coconut oil in my BAB). BUT LDL is way up, too (188). Total cholesterol shot up from 200 to 261. What's going on? Previously, it was coming down (233 to 200).

    RT3 is 24 ng/dL, FT3 is 3 pg/mL, and cardio CRP is 1.1 mg/L. Do these numbers indicate inflammation?

    What am I doing wrong? Thanks!

  563. Re post #669 and your response #671

    22 year old with low B12 and probable leaky gut who lost the ability to sleep in December.

    I have been following the leaky gut prescription for about a month. Until last week I was having some success. With melatonin I was sleeping at least 6 hours a night.

    Your recent blogs on cold thermogenesis aroused my interest and on Thursday I gave my head a good soak in 48 degree water before bed. WOAH!!! I did not take any melatonin and was out like a light. Aside from a few inter-dream wakings I slept straight through the night. I have since moved to bathtub soakings at night and cold showers in the morning. The past three nights I have slept from 10:00pm-7am.

    I'm blown away. Last month it honestly felt as though I would never sleep again.

    I am not sure how to make the connection between the success of cold exposure and my leaky gut. Is the cold triggering my body to better fight the inflammation from m stomach?

    I have read that BAT exposure increases glutathione production. Perhaps the NAC, kimchi and probiotics have done their job and I no longer have a leaky gut.

  564. I have RA. I started eating paleo about 5 weeks ago and have had an enormous change as far as inflammation in my joints and my energy level has skyrocketed. However, I have only lost 4 pounds. I have been having a bit of cream in my breakfast coffee and was still eating some of the nightshade veggies as well as using EVOO along with coconut oil and butter; do I need to cut these at least for a few weeks? Also was eating some almonds, am now thinking this is not ok? Thank you!

    • @Cheryl you need to read my Cold thermogenesis series. And the new evolution to the Leptin Rx blog. Its a must for you. Anyone with a AI needs to eat a strict ketogenic non dairy paleo diet.

  565. I came across GAPS gut healing protocol and thought my mother should try it. I haven't researched Paleo much.

  566. Post #848 refers to post 841.

    I also have a question about myself. I am 26, 130lb 5'6", breastfeeding my 10 moths old son. I gained 30lb during pregnancy and lost 25 without any effort. About a months ago I noticed that I was constantly snacking after lunch even though I was full up to my ears. And after dinner around 9pm I would have a whole load of fruits. I never had that problem before. I always used to each small meals but often and it seamed to be working because I lost 30lb that way. Now I do fine after breakfast (usually 2 eggs or a bowl of oatmeal with heavy cream and blueberries) which keeps me going from 8am till 1pm, but after I have lunch, I just can't stop eating. I eliminated all the sugar and eat pretty much no grains with the exception of a piece of gluten free bread and/or oatmeal at breakfast. I do eat a lot of fruits, though. Yesterday I tried following LR protocol, and was able to go without lunch, but my stomach hurt after breakfast and dinner because I definitely overate. Today I had to have lunch at 2pm after BAB at 8am. I am sure I should continue. My stomach just doesn't feel right (I have gastritis) Btw, is LR safe to do while breastfeeding?

  567. Hi Jack :)

    I recently lost weight doing hcg and no gluten no sugar for maintenance (which I am struggling with). I don't need to lose weight right now but I find myself to be still struggling with low blood sugar symptoms-mostly extreme irritability and dizziness. And I am even more sensitive to natural sugar then before (a strawberry can make me feel dizzy). And I still crave carbs, chocolate and dairy (Greek yogurt) I also have Hashimotos thyroiditis. Could your leptin reset help? Thank you for your time and input.

  568. What is your feeling on adding a vegetable protein powder drink for those rushed morning. I have seen a couple out there that have no added sugar and 40-45 grams of protein per serving.

  569. sepianbounce says:

    Holy Shit! Information jackpot! This is such an incredible resource. I've been up and down with my weight (20-30lbs) since puberty and unable to keep it down without eliminating carbs and drastically limiting calories (900-1200). I'm 30 now, 5'4", 164. I was doing well for a couple years (between 26 and 28yrs, 130 lbs) weightlifting/working out a ton, and eating very low carb pescetarian diet. Then I started gaining weight out of nowhere and experiencing severe bloating and disabling depression (when I quit nuvaring after 2 yrs), and no amount of exercise or dieting could reverse it (