The Leptin Rx: FAQs

The Leptin Rx: FAQs

Readers Summary

  1. What questions do you have about The Leptin Rx?
  2. What questions would you like to see added to the FAQs?
  3. Post your experience with The Leptin Reset in the comments

What should I do before I start The Leptin Reset?

Before you start, take a picture of yourself from all angles. Don’t be bashful or you’ll be sorry in 18-24 months. Next, weigh yourself naked. Let your significant other or a family member take this picture. Go to the store and buy a piece of clothing that does not fit you now, but will when you have met your goal. Remember, calories are important when you’re LR (leptin resistant) and mean nothing once you are LS (leptin sensitive). Macronutirents count when you’re LR and mean nothing when you’re LS.

How do I determine if I am leptin resistant?

Remember, you can be LR (leptin resistant) if you’re fat or skinny. If you’re overweight by more than 30lbs, it is a lock you have some degree of LR. If you’re underweight by 20 lbs, you are likely LR, too. If you had an eating disorder, you’re likely suffering from a serious leptin issue.

The easiest test is to look in the mirror. The mirror does not lie and it is really cheap. For those people who still can’t be sure after peeking in the mirror, you can order some blood tests. My favorite is the HS CRP (highly sensitive C-Reactive protein) and the reverse T3 tests (but there are others). They are accurate in over 90% of cases.

My next favorite test is the salivary cortisol test, along with at least two of the following: HDL level, serum ferritin, homocysteine, fasting triglycerides, fasting insulin, or post-prandial glucose readings done every 15 minutes for one hour after eating. (Read my Hormone 101 blog for details.)

How do I restore leptin sensitivity?

If you’re overweight, eat a low carb version of the paleo or primal diet.  You’d be wise to read my book, The Epi-paleo Rx.    If you’re really obese, eat a ketogenic version of this diet. If you’re underweight, you need to eat a regular paleo or primal diet using leptin reset principles found in the Leptin Rx.  You probably need to eat more protein and exercise more than you would expect.  Exercise when your leptin resistant will make you gain weight.  And the more protein you eat the less you should exercise because of the AMPK pathways.  This seem counterintuitive but you will gain weight.  You must be careful when you do it.  Most people who eat a paleo diet who exercise too much will gain weight.

How long does it take to restore leptin sensitivity?

This step depends upon how badly damaged your metabolism is. It also depends upon how willing you are to adapt your diet and your exercise routine. My standard answer is 6-8 weeks for most people. “Most people” refers to those within one standard deviation on either side of the mean, and that includes about 68% of people.

How do I know when I am no longer leptin resistant?

Changes in appearance: Your hair and nails will improve in color and presentation. Your pedicurist will notice you have less dead skin on your feet. Your face will look a lot better, with softer skin and better color, especially if you use olive oil or coconut oil on your skin.

Changes in mood, personality, and thoughts: You will become more thoughtful, more mindful, and less explosive in explosive environments. If you decide to add mindfulness to your reset, (you should) you will notice tremendous changes in your thinking and your ability to learn and comprehend things. Your insight, intuition, and mental acuity will be sharper. Also, your sexual desires will change and your libido will awaken. Your spouse will begin to notice things and treat you differently.

Changes in appetite: Your carbohydrate cravings will go away. You’ll feel full and not really need to eat three meals a day. You’ll notice your taste and smell change.

Changes in energy and sleep: Over 6-12 months, expect your energy to gradually improve. You will feel warmer and exude body heat, but your body temperature will actually be lower. It will continue to trend lower over the next 18-24 months while you thyroid settles into its new biologic groove. Dramatic improvements will be made in your sleep. Both migraines and muscle soreness from exercise will decrease.

After leptin sensitivity is restored, what practices should I follow?

Once you realize things have changed, you need to immediately begin HIIT (high intensity interval training) exercise. I am a huge believer in lifting heavy weights at low reps. At this stage, I want most people lifting at 85-95% of their maximum weight, 2-3 times a week. The exercise rotation can be simple. A good resource is the Body for Life workout found at the end of the book in the weight lifting section. You do not need anything but a good set of dumbbells. You should do this for about three weeks.

Women especially need to regularly lift weights. Women never listen to me about this, but they should! Ladies, you will never get huge muscles doing this, I promise. The reason that weight lifting is so important for women is because their pregnenolone level declines fast after the age of 30. This causes steep declines in the sex steroids (known asperimenopause), in growth hormone secretion, and in vitamin D status. The muscle strain from weight lifting is the best way to stimulate the pituitary gland to say, “We are not aging yet, and we need to continue to make these hormones.” Leptin sensitivity controls that switch. And ladies, your body composition is directly tied to this action! If you lift, your curves will be maintained until you’re ninety or greater.

Both men and women need to consider their HS CRP levels. High levels indicate a person you have entered perimenopause or andropause at a much faster pace than others. This means your time to a total reset and optimization will take longer. It does not mean it is not possible! Do not compare yourself to others. Compare yourself to how bad your own labs were when you began. The worse your labs were, the longer it will take you to get to optimal. Do not forget this biologic fact, you can’t run away from it!

After three weeks of lifting, you should add two days of running sprints. The sprints should be no longer than 40 yards and you should not exceed 20 sprints. If you can’t do twenty, work up slowly and steadily. Walking in the beginning is fine. Do not stress about this. If you do you, will raise your cortisol and the rest will take longer. Your thoughts will drive your cortisol.

As for your diet, you can begin to increase or decrease macronutrients slowly to see if it affects your cravings, weight, and your moods. If your symptoms start to return, return to your original diet.

Why should I avoid aerobic exercise during the reset?

This will require some explanation. If you’re LR, you are a sugar burner, not a fat burner. That means you can not do glycolytic exercise until your muscles and lever become completely LS as well. Your brain being LS is not enough. If your muscles are still LR, they can’t properly use the glucose or the fat delivered to them. This is detailed in the post Why is Oprah Still Obese? Leptin Part 3.

Another to avoid aerobic exercise at this stage is because the AMPk pathways are not working well yet. (This will be the focus of an upcoming blog post.) AMPk is stimulated by re-teaching your muscles and liver how to deplete glycogen and metabolically respond to hypoxia and cellular stressors. AMPk is directly stimulated by chronic cold environments to limit the effects of IGF 1 and mTOR activation.  This is why cold thermogenesis is not hormetic and provides all eutherian mammals with longevity when they use this strategy.  Any time metabolism is stressed, AMPk should respond in kind with big results.  In LR, AMPk does not, and cannot work well at all.  This is why body composition is trashed in LR states. If you do aerobic exercise when you are still leptin resistant, you send signals to the mitochondria that conditions are really bad. Instead of making new mitochondria to help out, you wind up killing your cells via apoptosis. New stems cells are recruited to replace the suicidal cells. Sounds good? The problem is those stem cells were going to help extend your life span, and, well, you just shortened it! This is why NFL players, bodybuilders, and marathoners don’t live long as group, and why they get many disease early.  They sustain things like heart attacks, Alzheimer’s disease, and cancer. No of it is good.  Longevity always mandates we protect our stem cells.  Cold exposure is the best way to stimulate AMPk to provide a long life.  We only want to use them when we really need them. If you use them early in life, you’re subtracting years from the end of your life.

Why do you need to eat within 30 minutes of waking?

When you’re LR, your diurnal clocks in the brain, the liver, and muscles are all disordered. This is how we will reset those organs to once again act in unison, like an orchestra. If you break this rule, you can still find success, but it will make your reset take longer.

What exercise can I do during the LR Protocol?

My personal advice it to do none. If you must, swim, walk, or have a lot of sex right before bed. Yes, timing of sex is important, too, in the reset. Oxytocin is released at climax and it is the best chemical a brain can have prior to sleep. It jump-starts the conversion of serotonin to melatonin without the four hours of complete darkness it usually takes. This is why orgasm can make you sleepy, and why moms and babies fall asleep in a rocking chair after breastfeeding.

Does everybody need 50 grams of protein at breakfast during the LR Protocol, regardless of size or sex?

My answer is yes, 50 grams is the minimum for success. The reason is tied to our modern microwaved world we live in.  It was not true in 1930.  If you’re bigger and more obese, you can go past 70 grams, truthfully. If you can’t eat that much protein, add fat to make up the rest.  Fat replacement in the leptin Rx helps with eating disorders but it requires yoking it to light because of an up-regulated ubiquitination cycle.

If you are obese, add coconut oil to your coffee or tea, or eat a tablespoon of it. I use Nutiva brand and love it. If you’re underweight, eat more hashbrowns cooked in pastured butter. Eat breakfast until you’re stuffed. If you don’t get to 50 grams of protein, don’t sweat it – I don’t want the stress to raise your cortisol! Just make sure your hunger is killed. If you get hungry before, during, or after lunch, you need to eat more protein or fat at breakfast.

What are examples of a 50 gram protein breakfast? If you can’t figure this out, you have bigger problems than the reset can fix. Use the internet or go read my book or read brain gut 6 blog post. You could also contact grassfedgirl – she’ll tell you to just eat a shit-load of  seafood and bacon. She has my stamp of approval. Her new Epi-paleo cookbook can help teach you to cook Epi-paleoliciously.

Does breakfast need to be just protein, or can there be vegetables or fruit? What about fat?

If you are overweight, avoid fruit. Veggies are fine as long as they are not nightshades and have a low glycemic index. If you are underweight, you can eat fruit, and I suggest blueberrries, blackberries, and grapes over all others.

Fat is great. The obese can use coconut oil as their “number one diesel.” If you don’t like coconut oil or Nutiva coconut manna, you can use heavy cream, but you won’t lose weight as quickly.

For the thinner LR crowd, I recommend pastured raw heavy cream. Get some saturated fat raw cheeses from France. If you must use pasteurized stuff, go ahead, but it’s not my top choice.

What if I can’t eat a big breakfast?

Don’t complain about your leptin problems then. To get where you want to be, you must do things you have not done before.  The leptin Rx is all about light and not food, but would would not expect this.

How strict is the 50 grams of carbohydrates per day limit?

It is strict for the overweight and not strict for the underweight. How should they be spread out over the day? The most carbs should be eaten when cortisol is the highest, in the morning. Dinner should be the meal with the least amount of carbs. Eat the most food in the morning, with decreasing amounts as the day goes on. As you progress, you will notice yourself naturally falling into this pattern.

Can I use whey as a protein source during the LR Protocol?

Can you? Sure, but you should have asked, “Should I?” The answer is no. It is too insulinogenic and raises NPY. (If you are underweight, however, you can do so without any restriction.)

Can I have coffee or tea between meals, with cream?

You can have them plain, without cream. But again, should you? Nope. No snacks are allowed at all, just three meals a day. Drinks without calories don’t count as a snack and don’t even ask me about artificial sweeteners because the answer is “no freaking way.” (Stevia is allowed as long as it doesn’t have any fillers such as maltodextrin. Generally the liquid forms are fine.) The really obese or metabolically broken (such as people with fibromyalgia) may need four meals a day, but most people who eat a BAB (Big Ass Breakfast) will do fine with three meals.

Can I skip lunch during the LR Protocol if I’m not hungry?

Yes, it is good if you can make it until dinner without being hungry. Then, you can eat more at dinner if need be.

Can you do IF (Intermittent Fasting) in conjunction with the LR Protocol?

No way. I love IFing, but don’t try it until you are leptin sensitive again. IFing requires the AMPk pathways to be working optimally.

What if we can’t eat dinner before 7 p.m.?

Drink water, have sex, and go to bed early. Turn the lights off early, too.

What if my family isn’t participating in the reset?

You’re not here to save them yet. Focus on you. You are worthless to them and the world if you’re not working optimally. Trust me, when they see where you are going, they will all change. Just ask my wife how that road goes.

What should I do about meal timing if I work night shift?

This one will piss you off. You will never be optimal until you quit your job and work normal hours. I have no answer for you here. Do your best, but you’re screwed. You can’t fight circadian rhythm biology.

If I fall off the wagon on the LR Protocol do I need to restart the clock?

Yes and kick yourself in the ass. If you’re not ready to change your life, keep doing what you’ve been doing. During the initial reset period, there is a 10-14 day setback each time you fall off the wagon.

Will the Leptin Reset fix insulin resistance?

It is designed to eradicate it completely, if you do it correctly.

Will the Leptin Reset fix thyroid problems?

If you read the Hormone 101 blog,you’d know this answer already. Anyone with a leptin problem has a thyroid problem by definition. So if you fix leptin, you can easily fix the thyroid. If you have an extreme case, you may need a doctor to help guide you back to optimal.

Will the Leptin Reset fix adrenal problems?

It depends on the severity of the condition, as most are tied to cortisol issues. High cortisol levels are harder to treat than low cortisol levels. If they are really bad, I treat both the same time. Most often though, with fixing your light cycles, occasional adaptogenic support and some good doctoring of your envionment, you can fix most adrenal problems.  For adrenal fatigue read the brain gut 16 blog.

How do you handle cravings and headaches from the initial carb withdrawal, or the urge to snack?

Magnesium is the answer, and lots of it, but avoid supplements with magnesium oxide. Start with doses of 400 mg and then increase the dose.

Your cravings will go away in a few weeks, if you don’t give in. If you read the Leptin Reset thread at the Mark’s Daily Apple forum, you’ll see that some people who gave in to their cravings had to start the process over. It takes two weeks to regain what you lost from breaking the rules. (If it’s a minor issue like only eating 49 grams of protein or eating 55 grams of carbs, you’re fine.)

If you drink a twelve pack of beer or soda and eat Domino’s, you’re cooked. Family gatherings or Chinese dinners should just be handled with beef jerky and nuts in your pocket, and tell them you have a virus. If your spouse rolls their eyes, no happy ending for a week. And make sure you announce that the public embarrassment will alter their behavior going forward.

Can I drink alcohol or wine on the reset?

Norcal Margaritas? Can you? Sure. Would I? Nope, not even Malbec!

Will this have any affect on my pee or poop?

Yes it will. With time, your pee may smell like cat pee. If this occurs, increase your B complex vitamins to 2-4 a day, and your vitamin C intake to 2000 mg a day. Your poop should be followed using the Bristol stool chart. Yes, I even evaluate poop.

What’s Dr. Kruse’s personal story?

You can listen to my podcast on Jimmy Moore’s site (episode 474) or read my story here. Here is an edited version of post #206 from the monster Leptin Reset thread from Mark’s Daily Apple.

I have had a lot of requests for my personal story and how I lost weight and improved my health. You need to understand that this was my game plan and it can’t be used as a “plug and play” game plan. As I evolved, I adapted my eating and my exercise plan.

I began as a “fat ass” at 6 feet 2 inches and 351 lbs. Most of you need to hear how bad I was – I was B. A. D., bad. I was dying ever so slowly, but I could still lie to myself about my condition. As I stood in Orlando, FL, in a mall, I knew a change was coming to me; no one around me did, however. As a neurosurgeon, I knew I was a bright guy, but I also realized I was not too bright to get this fat and ruin my health and my life.  My life really changed at the foot of a statue in Italy.

So I started to listen to people who had already overcome this health trap. I also began to read about both basic science and the latest scientific discoveries. As I read, I found out that everything I had learned in medical school was based upon “faulty opinion-based science”. I then took a leap of faith and did what the real science told me to do. I ate a high fat, high protein diet. I ate very few carbs and loaded up on saturated fats.

A funny thing happened after three months – my fat began to melt away! The more I lost, the more I experimented with this new diet, changing it as my blood test results changed. (I am a big tester. Sometimes I run labs every few weeks.) I began to take more supplements and do more exercise that was complementary to my new way of eating. I shunned aerobics for heavy weight lifting and running sprints. If I worked out too hard, my cortisol levels went up and fried my sleep and my weight loss. I began to monitor my blood levels for general biochemistry and lipids. I also began to include hormone levels. I checked vitamin D, HS CRP, reverse T3, and salivary cortisol levels.

I fired my primary care doctor three times back then. I had a torn knee meniscus and I needed surgery, but none of the surgeons I saw really understood why my meniscus had torn. None of them understood why I shunned what I had learned in medical school in favor of what I had found by reading about my injury.

I distinctly remember one orthopedic surgeon I saw in consultation. I told him that my plan was to eat a ton of saturated fat and protein, get my knee repaired, and never see another doctor for the rest of my life. He laughed, and I left him. I was dead serious and I still feel this way.

Next, I went to see a guy who was an old acquaintance. He remarked about my early transformation and he never critiqued me. He listened, even though he was a skeptic. I was fine with that. He told me regardless of my new way of living, I needed surgery on my knee. As a surgeon myself, I knew he was correct. I decided to let him do it because he was non-judgmental.

I had my surgery in May 2009. I operated on my own patients the next day. I never filled the Rx I was given for Percocet. I never, to this day, even went back to my surgeon for any follow up. I took my own sutures out and have never looked back. I optimized my labs and retooled my supplements and my meds based upon my N=1 and my own medical theories.

I lost a total of 133 lbs during my surgical recovery.  I discovered how altered light cycles caused leptin resistance and how to treat it. I discovered that the timing of when I eat,  was more important than what I ate. I found out that I can’t get away with snacking. At the time, I ate a fairly low-carb diet, seasonal diet, loaded with seafood for most days below 50 or even 25 grams of carbs.

These days, I can eat anything I want. After I became leptin sensitive again, I also began IF (intermittent fasting). When I had previously tried it, when I was still leptin resistant, it caused plateaus in my weight.

I found that many things changed about me. The first change was my mind. Every morning at wakefulness I jumped in the hot tub and thought about three things to make my life better that day. I posted the best thought to my Facebook wall. I still do this, even today. (I also make it a personal task to view every sunrise and sunset.) I then got out of the tub and made a monster breakfast (BAB) with 50-70 grams of protein to start my day. Next, I did yoga or stretching, before heading off to work.

I usually was able to skip lunch (IF) or eat nothing but rabbit food at lunch. I came home and loaded protein and fat again, and I worked out with HIIT and sprints. I did everything consistently and my family and wife kept commenting on my dedication. I went from a 48″ waist to a 32″ waist in 11 months. Everyone asked “How? What? Why?” and I remained silent. I would only say, “I am not close to done yet. Talk to me when I get there.”

Later, I told people about the speedo bet. I told them about the Thanksgiving dinner speech to my family. I told them about buying new wardrobes when I was fat – 6 different wardrobes. I told them what I told the salespeople when I shopped. For example, I distinctly remember going into a Nordstrom Brioni store and buying a size 42 R royal blue blazer for $5,000 when I was currently wearing a 50 L sports coat. The person I bought it from thought I was out of my mind that day. Her name was Sara and she was from Croatia. I told her what I told everyone else. It is not crazy when you know what is coming.

Eleven months later, I flew to Orlando and took my kids to Disney World. I walked into the Nordstrom’s where I bought the Brioni jacket. It was still in the plastic when I purchased it. I walked up to the salesman and asked to see Sara. I was told she was busy. I said I’d wait for her. I had a very big smile inside of me. Sara approached me from behind. I asked her if she remembered me as I handed them a picture of me as a fat ass buying the jacket for 5K on my iPhone. She stood there with her mouth open wide and could not believe her eyes. I was now 6’2″ and 197 lbs.

I dropped my jeans, pulled off my sweat shirt, and pulled the plastic off the Brioni jacket I had bought from Sara. I stood there in my Speedo underwear as I asked Sara to get me a pair of Brioni pants to match my current attire. She quickly obliged. I distinctly remember Seal was playing in the background, and acoustic version of “Crazy.”

I put the pants and put the jacket on over my bare chest. I saw about 35 people watching the whole miracle unfold for Sara. I put my shoes on, threw Sara my AMEX card, and left her a tip. After I checked out, I left all my clothes on the floor, right there. Sara called to me and asked my if I wanted my old clothes. I told her, “No, this new guy thinks a new way on this brand new day.”

I walked out of there and knew my thoughts of eleven months earlier had dictated every move I made that day in Nordstrom’s. I hope you go get yourself some of what you know you can have, if you want it badly enough.

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  • If you have any other questions that I deem FAQ worthy, I will add them.

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  1. Shijin13 September 1, 2011 at 1:18 pm - Reply

    Dr. Kruse

    Can you be LS if your adrenals aren't functioning properly (low cortisol in the am, high at night)?

    If you are LS and have wonky cortisol – should you be doing HIITs at all?

    I'm on week 12 and I've got most of the signs of LS – Thanks so much for opening my eyes, you've changed my perspective on optimal health

  2. Jack September 1, 2011 at 2:25 pm - Reply

    @Shijin13. It's possible.

  3. cancerclasses September 1, 2011 at 3:14 pm - Reply

    You rock brother, you seriously rock. In your podcast with Jimmy Moore you allude to the cause of your meniscus tear, I've read every word on your site at least once, did I miss your explanation of that somewhere or is it still coming? Leptin? Wine?

  4. Shannon September 1, 2011 at 3:21 pm - Reply

    Thank you so much for the FAQs! Finishing up week 7 and feeling great. My husband likes the changes, especially the bedtime workouts. I've lost 11 pounds since starting and my glucose numbers are great! My second favorite change is the ability to go to sleep at a decent hour and wake up refreshed. You are awesome Dr. Kruse!

  5. Tim September 1, 2011 at 3:40 pm - Reply

    What would it take to turn you, Dr. Kruse, once again into a 350lbs 'fat ass'? This is a serious question. What would it take to lose your sensitivity to leptin? How long do you suppose it would take? Once fully LS, what are the warning signs you are screwing up?


    • Jack September 1, 2011 at 4:04 pm - Reply

      I think if I went back to eating Wheat, grains, fructose and omega six oils……about a year. That is not going to happen. Now that I know what causes the problems we can avoid them and do the correct things. It took a long time to reverse the things. This is not a "drive through" Rx writing medical condition. It takes time and the diligence of a doctor and a patient with a good relationship to get well. But it can happen. I am proof of it. If I did it anyone can. Many of my spine patients have also benefited greatly from this as well. It all depends upon the degree that people go to get the result they want. Me personally I am still not done with my transformation but my family and patient think that sounds crazy but my doctor does not. Optimal is what I am shooting for.

  6. Chris September 1, 2011 at 3:43 pm - Reply

    @cancerclasses I believe it was leptin resistance:

    • Jack September 1, 2011 at 4:00 pm - Reply

      Leptin plays a major role in DDD and DJD that I see in spine patients.

  7. Chris Tamme September 1, 2011 at 3:49 pm - Reply

    Rock on Doc. I have been using this site to answer lots of questions for people. People hear my story and want to know more. Everyone has to keep questioning the things that aren't working.

    • Jack September 1, 2011 at 3:59 pm - Reply

      Chris if I can help I will. Leptin is an issue for most humans at some point.

  8. steve September 1, 2011 at 3:56 pm - Reply

    Dr. Kruse: How does Histamine tie in to the Leptin story, if at all? I am 5'6", 142LB, 61 yr old male who has suffered with the atopic variety of allergies- brother and father have them, me worse specifically with eczema. Diet is good: good proteins, fats, carbs are only potato and rice- no wheat, junk or sugar. Interestingly enough i find if i eat very light for dinner, i cannot go to sleeep. Doc says i am a huge histamine releaser. Thyroid ok, D level ok, no carb cravings, Trgs low, HDL 62.

    Fantastic personal accomplishment by you, and aprreciate your dealing with the science of how to get ourselves optimal. Thanks,

    • Jack September 1, 2011 at 3:59 pm - Reply

      It does play a role but a minor one that I have not touched on as yet.

  9. NDF September 1, 2011 at 4:00 pm - Reply

    What is the carb limit for those who have 10lbs or less to lose?

    • Jack September 1, 2011 at 4:07 pm - Reply

      @NDF it would depend upon testing. But with just ten pounds to lose I think cleaning up the neolithic foods, optimizing workouts and leptin and making sure your hormones are in good working order you should be able to drop that weight fairly quick.

  10. NDF September 1, 2011 at 4:10 pm - Reply


    I have been diagnosed with functional hypothalamic amenorrhea so hormones are not in working order and leptin is most likely a mess. It's not really the weight loss I'm worried about as it is straightening the hormones out.

    I do eat a primal diet. Just not sure if I should limit carbs – which I eat in the form of low GI fruit(berries, apples, peaches)

    • Jack September 1, 2011 at 4:56 pm - Reply

      @ NDF The basic defect in women with functional hypothalamic amenorrhea is the failure of the hypothalamus to increase GnRH output in the presence of severe hypoestrogenism. Usually the pituitary responds to the LH surge but in your case you do not.

      Most investigators believe that there is a slowing of the GnRH pulse generator as reflected by a decrease in peripheral pulsatile LH secretion in these women. secretion of endogenous GnRH is difficult to assess in the human because this peptide is rapidly metabolized within 2 to 4 minutes in the peripheral circulation. Thus, it is not possible to directly assess GnRH secretion, and the majority of clinical investigations utilize frequent measurements of LH concentrations as the surrogate marker for hypothalamic GnRH secretion. In women with regular menstrual cycles, clinical studies have demonstrated a characteristic pulsatile secretion of LH at a frequency of 90-120 minutes during the follicular phase and a frequency of 180-240 minutes during the luteal phase . Small alterations in LH pulsatile frequency and or amplitude can result in a range of disorders including luteal phase defects, oligo-ovulation and anovulation. Thus, most studies have examined for changes in LH pulsatile frequency and amplitude as the major endpoint in studies to investigate functional hypothalamic amenorrhea.

      In these patients, after a period of priming with intravenous pulsatile GnRH (1-2 mg/90 minutes), normal levels of LH and FSH can be restored and responses to exogenous GnRH become normal. Considering both, these observations suggest that endogenous GnRH secretion is deficient and gonadotropin secretion and ovarian function can be normalized with physiologic replacement of exogenous, pulsatile GnRH. Endogenous GnRH is controlled by leptin so the leptin reset could help you even though your weight is fine. But often some patients with leptin issues need their pituitary primed with exogenous steroids to get them working again.

      Excitatory amino acids such as glutamate and aspartate have been shown to be localized to the arcuate nucleus in the media basal hypothalamus adjacent to GnRH neurons and have been implicated in a regulatory role for GnRH secretion primarily during puberty so you might consider supplementing them.

      Cortisol is the biggest cause of this syndrome in my eyes. CRH directly inhibits GnRH so if you remember my Hormone 101 post I said that LR generally leads to hypercortisolism…….and this blocks the sex steroids……GnRH. So I definitely think you need the salivary cortisol testing done. This can be fixed if the endocrinologist opens their minds.

  11. livinlite September 1, 2011 at 4:54 pm - Reply

    Bikram/Hot Yoga: Yes or No? I'm only 10-15lbs over my optimal weight (at 6'4") and am doing the LR and Adrenal Fatigue prescriptions to improve my energy levels and overall health. Is a PM hot-yoga practice in the cards for me at this point or should I stick to "no exercise" for the full 6-8wks? It gets my heart-rate up, but its mostly a medium-hard strength effort with great relaxation benefits. My concern is the heat and the intensity counteracting the leptin reset and over-taxing my adrenals. My cortisol is still out of whack and my sleep is not great. I'm ~4wks into the reset.

  12. Bobbie September 1, 2011 at 4:57 pm - Reply

    I believe you mentioned that following the Primal philosophy is acceptable during the reset. Dairy is part of a Primal diet assuming you have no allergies, but I've seen comments from others in various places suggesting that dairy is not okay on the reset. I think I know the answer, but I'm hoping to hear it from the horse's mouth… is dairy considered optimal or another one of those foods that will slow progress?


  13. EMT September 1, 2011 at 5:03 pm - Reply

    What's with the jerky attitude? If you don't like being asked questions, why make yourself so available to people? No one is making you do this. It's really a turn off.

    • Jack September 2, 2011 at 7:55 am - Reply

      @EMT I post not to make you feel good just to make you feel optimal. No one can turn every person on. I know that I am only responsible to turn myself on. You may need that level of introspection too. It may be the first step you need to make to change your life.

  14. NDF September 1, 2011 at 5:06 pm - Reply


    Thank you so much for your feed back!

    I have read many studies about FHA – the causes and treatment. I don't want to use steroids at this point. If FHA is still an issue when I want to have children, I will consider it, but I'd like to try to correct the matter naturally if I can.

    My gynecologist (no endocrinologist at this point yet), also suggested that my cortisol is most likely high and to help elevated it has advise I not exercise (cardio or weight training). She suggested yoga or pilates and meditation. She didn't give me any dietary advice only to say "Don't lose weight". I don't intend to lose weight using the leptin reset, I was just hoping resting my leptin might help the issue.

    So are carbs a non issue then? Or is there a limit I should put on them?

    Thanks again.

    @NDF I dont think carbs are a big deal for you but you should monitor that yourself. It should be an easy pick up. In HA you get the following…..Neuroendocrine Abnormalities

    1. Increased daytime cortisol secretion

    2. Increased amplitude and duration of nocturnal melatonin secretion

    3. Increased nocturnal secretion of GH

    4. Elevated CRH levels in cerebral spinal fluid

    5. Blunted elevation of PRL, ACTH, and cortisol during the noon meal

    Dr. K

  15. jkc September 1, 2011 at 5:07 pm - Reply

    Very informative post. I liked what you had to say about exercise, and I have to say that it dovetailed very nicely with what felt like the right exercise once I became leptin sensitive. I have been putting off sprints, but you have convinced me to start them today. I also appreciated hearing a timeline for how long you think some of the healing issues would take.

  16. AW September 1, 2011 at 7:49 pm - Reply

    You might have some interesting theories and information, but when it's masked by grammar errors that you should have corrected in third grade, you lose all semblance of professionalism. Please hire a proof reader or copy editor; consider it an investment in your credibility.

    @ AW Thanks for the advice. Since it bothers you so much are you volunteering by any chance? This site offers free advice and most people seem to not have a major issue with this. I don't have great typing skills and I do this as a hobby. If you want to start a donation to hire an editor you can send the donations to me. My office number is 615 871 4113 ask for Beth. Since this is such a major issue for you I will be expecting to hear from you quite fast.

  17. Pat Palmese September 1, 2011 at 8:47 pm - Reply

    Dr.Jack just a side note on past subjects..changing how Doctors treat us as patients..I had a physical today and my Doctor (from Europe)asked me what I was doing differently to get in the shape he now sees me in after a year, I said Paleo! He was excited and he whole heartily wanted to learn more from me as he feels this is the way we should be eating and getting healthy, he asked what books to read, what kind of supplements I am taking and generally about the "diet" He felt this would be wonderful to traet his Diabetic and obese patients thiis way! Patient teaching the doctor! I hope you don't mind but I would like to give him your web site and phone number so he can contact you.

    @Pat This is awesome. I'd love to hear more patients doing this. This is precisely how we can change medicine.

    Dr. K

  18. Egrammy September 1, 2011 at 8:58 pm - Reply

    Dr. Kruse, I am doing it. I will be going to visit my granddaughter who has Chron's and had a baby 10 months ago. Should I share this program with her and encourage her to do it?

  19. indigogirl September 1, 2011 at 9:25 pm - Reply

    Dr. K,

    Thank you so much for posting this! It crosses all the t's and dots all the i's in the Leptin Reset for me. So much clearer now.

    Thank you also for sharing your story.

    You are a breath of fresh air in our sick medical community.

  20. Jim September 1, 2011 at 10:12 pm - Reply

    Dr Kruse,

    really nice information, I am not sure if I am LR, a little obese at the waist and a very bad case of adrenal fatigue, its like I need to take a nap early in the evening to beat the days stress, always having low energy. I am trying to shift to the protocol you recommend and already see some signs of energy, some progress and I am going to stick to this. One question though, what would you recommend for supplements when beginning the leptin reset protocol

  21. Dan H September 2, 2011 at 12:41 am - Reply

    This is the best post so far! I am bookmarking this and sending it to everyone I know on a Paleo diet.

    Wait so why would LR cause you to have dead skin on your feet?

    @Dan when your LR you have higher levels of inflammation and it leads to increased O6 oils in the dermis that causes increased stem cell recruitment and more layers of dead skin to be placed on your heels, palms, and elbows. You will also notice more skin tags and red splotchy skin areas.

    Dr. K

  22. Jenny September 2, 2011 at 12:42 am - Reply

    awesome FAQ! Thank you! Any chance you could list out all the supplements you recommend taking? It would be REALLY helpful! Thanks again!

  23. Marcela September 2, 2011 at 6:16 am - Reply

    Dr. Jack,

    Thanks so much for your blog. I finally hear some science from someone that had to lose a lot of weight. I love Mark Sisson and Robb Wolf, and the rest, but I think many of their suggestions will be great when I am LS and my system is functioning well… Mark especially is great for long term health. I feel fantastic with paleo/primal/phd but the weight doesn't come off like it seems to for other people.

    Reading your blog I see that yes, it may take me 6-8 weeks just to turn things around.

    I am female, 5'3", 41 yrs old, and around 60-70lbs overweight. When you say calories and macro nutrients matter for the overweight LR, could you give some concrete targets to hit as a short person accustomed to eating like a 6'2" man? I like to journal my food intake for a few days until I get a good idea of how much to eat at each meal.

    Second, does ghrelin hunger, grumbling stomach, matter much? I usually have breakfast and dinner and the only thing is sometimes I get a grumbly stomach at work. I don't get cravings and don't think about food… just the grumbling.

    Thanks so much and appreciate the work you are doing.

  24. Resurgent September 2, 2011 at 6:44 am - Reply

    Fantastic.! Fantastic..!!

    Jack, you just made a difference to another life – I had my co-passenger in the plane read this. He is hooked.!

    What a post.. Grok On.!!

  25. indigogirl September 2, 2011 at 7:22 am - Reply

    Dr. K,

    I'm having arthroscopic surgery for a torn meniscus late next week. Any suggestions for healing besides eating Paleo? I've started taking arnica and bromelain.

  26. Sheila September 2, 2011 at 9:02 am - Reply

    Thank you so much for all the great, scientific information. It really helps me to understand my experiences, i.e., struggles, with weight loss over the past couple of years and helps me to determine how to continue with the optimizing process.

  27. EMT September 2, 2011 at 10:23 am - Reply

    Your suggestions are greatly appreciated.

  28. steve September 2, 2011 at 10:41 am - Reply

    Hi Dr. Kruse: Thanks for the reply on Leptin/Histamine connection. Any thoughts on how best to deal with Histamine issues? Thanks.

  29. Exceptionally Brash September 2, 2011 at 10:57 am - Reply

    My intrigued vegetarian friends want to know….Is it possible to regain leptin sensitivity on a vegetarian diet or without eating "red" meat?

    • Jack September 2, 2011 at 12:10 pm - Reply

      @ exceptionally brash. They could but they will never reach optimal due to the leaky gut they will have from the lectins and phytates and the omega six profile of a veggie life. Most veggies are surprised to learn that their diet has a huge bad affect on their omega six to three ratio. Vegetables have an unfavorable O6/3 ratio. Plus their hormones will never be optimal because our hormones are made from cholesterol and not plants. Cholesterol can be made by us humans but on a plant diet not enough for optimal. This is why vegan body comp is rarely optimal. They have to do a ton of supplementing to get it done. But to answer you…..the best they could get is a B. Not an A or A+ because of their diet. I have some vegans patients but most have eventually changed after a few years of seeing their hormones never budge.

  30. Valtsu September 2, 2011 at 11:16 am - Reply

    Hi Dr. Kruse,

    What is the physiological reason why you are recommending so high amounts of protein (on breakfast)?

    • Jack September 2, 2011 at 12:06 pm - Reply

      @valtsu. Great question. Two major reasons. The first has to do with the gut incretin hormones. When someone is LR they not only have a metabolic derangement at the brain level but also at the muscle and liver levels. You can read about both in my first two leptin posts back from June of 2011. When one eats a high protein and fat breakfast it allows proper signaling to be reestablished between the small intestine, liver and the brain. We actually have circadian rythmns in for sleep and food in our gut organs and our brains. The major appetite incretin is gherlin. The satiety incretin is NYY Prtein and fat in the AM increase satiety very fast. The goal is to eliminate cravings and improve satiety. Cravings are controlled by NPY in the brain and carbs restriction and satiety by NYY and use of high dose protein and fat.

      The second reason is is when you eat higher protein it is thermogenic and stimulates the thyroid and uncoupling proteins to begin to function again. Kinda like priming the pump. But the real reason is one needs protein synthesis to stimulate muscle growth to eventually burn fat and not sugar. This is how the weight loss comes. For the anorexic they add muscle bulk with the protein and carb eating. The more muscles that are active the more fat can be burned and the more carbs can be tolerated in the diet and by the brain. Those are the physiologic reasons

  31. Todd September 2, 2011 at 12:37 pm - Reply

    Thank you for all the interesting and informative material you put on this blog! I have been on a lowcarb diet, with various permutations, for the past year, but after losing 40 lbs fairly steadily, weight loss stopped, about 20 lbs away from what I take to be a desirable weight for myself.

    I started reading about leptin, read the long Byron Richards book, and found this web site. Although your recommendations are not identical to BR's, there is a fair amount of overlap. You both emphasize the importance of no snacking, ever, and getting plenty of protein at breakfast, and not eating too soon before going to bed. I started with BR's rule of three meals, at least five hours apart, etc., and found that after months of being stalled, I started losing weight again. After finding your site, I tweaked the plan and loaded more protein into breakfast, to get to the 50g, and added a bit of coconut oil. I continue to lose weight and found, to my astonishment, that I have no desire at all to eat lunch. Breakfast and dinner get the job done.

    This, I take it, is at least a sign of increased LS.

  32. Mallory September 2, 2011 at 12:50 pm - Reply

    awesome response to MDF, very helpful. WHen you want people to be fat burners to become LS I got confused. If a LR is a sugar burner, and one with HA is LR and a sugar burner, what help would excitatory amino acids do. it seems like they would enhance the sugar burning ability.

    i think my personal big take away is i am going to have to learn to sit still. i think i am to active for my body to gain back fertility. i 'seem' very LS, however i also meet all the LR criteria- i get confused

    what's your opinion on ray peats stuff?

    also, reading the perfect health diet series, i am a bit more confused as it seems starch is what theyre advocating for thyroid/leptin 'reseting'

  33. Jack September 2, 2011 at 12:53 pm - Reply

    @Todd. I think it's a great sign for you. I don't think his book goes into the clinical detail I do. He is about selling supplements and it's geared to that. I think much can be done by a good paleo diet. But the real issue with stalls are the hormone cascade and understanding why it happens. I don't think he has that info or the clinical experience I do. He is a nutritionist who can not follow or test labs unless the doctor does them. His book is solid for sure but I don't buy a lot of what he has to say about some disease processes.

  34. Cameron House September 2, 2011 at 12:53 pm - Reply

    Doc I just saw your answer to Valtsu and it made me think of a problem I have been having. I usually have no problem falling asleep and when I sleep I sleep like a log but about half the time I wake up like an hour and a half early. When I do I go ahead and get up and fix breakfast but would my circadian rhythms get in sync better if I just waited and ate breakfast at the same time everyday?

  35. Jack September 2, 2011 at 12:55 pm - Reply

    @Mallory on that phd series they are not distinguishing who is LR from who is LS and that is why it is confusing. My comments there said that in a tactful way.

  36. Mallory September 2, 2011 at 12:56 pm - Reply

    is l glutamine and glutamate the same things?

    Here ya go……. .

  37. Mallory September 2, 2011 at 1:01 pm - Reply

    one more, doesnt elevated plasma LH result in a rise of GnRH caused by lactate?

    @Mallory For patients with HA, most studies report a decrease in total circulating leptin with a loss of the normal diurnal rhythm. This lower leptin level is a common characteristic of several energy-deficient conditions and is associated with a decrease of the LH pulse frequency. The decrease seems to be related to damage of the hypothalamus in some fashion and this is why most with HA need exogenous steroids to reset their hypothalamus. A reset can help but I doubt it will do it 100% of the time. Most need a priming to get the LH urge back. Lactate can help this in a normally functioning hypothalamus but a women with HA are not NORMAL!

  38. livinlite September 2, 2011 at 1:14 pm - Reply

    I have the same problem as Cameron. I've been "waking up" at 5:00a every morning and trying to get back to sleep until when I should be getting up…7:30-8:00a.

    Will this pass as the LR becomes LS? Should I keep trying to stay asleep instead of getting up?

    Also – nevermind on the Hot-Yoga question. I'm going to stick to more restorative and classic hatha/anusara yoga until I'm able to do HIIT in another month or two.

    Thanks again!

  39. CMHFFEMT September 2, 2011 at 2:32 pm - Reply

    IMO forget the grammar nazi's. Id much rather you spend your FREE TIME answering questions and producing informative content then editing. If they cant read past a few grammatical errors their loss. or is it there loss. or the're loss……….

  40. Renfrew September 2, 2011 at 3:02 pm - Reply


    you should WRITE A BOOK about all this. I think a bestseller would be assured. You already coverd so much ground. A good editor could even produce a book out of your work so far.




    @Renfrew……kinda cool this has reached Germany! Not sure how they will like it considering how much they like Beer…

  41. Renfrew September 2, 2011 at 3:05 pm - Reply


    if you don't like WHEY protein, what other protein are you recommending?

    And along the same line: Which fats/oils are your recommending?



    • Jack September 3, 2011 at 10:38 am - Reply

      @Renfrew……I did not say I don't like Whey. For some people its context is critical to avoid. Protein for me is all grass fed meat and wild fish and pastured eggs. Oils I am a huge fan of Coconut oil, Palm Oil, ghee, Pastured butter, beef tallow, lard that is non hydrogenated. For cold oils for salad……Macadamia nut oil, avacado oil, or olive oil.

  42. SteveO September 2, 2011 at 5:25 pm - Reply

    Doc… THANKS for the faq it is awesome, and so much handier to look up key points

  43. Colleen September 2, 2011 at 5:25 pm - Reply

    I second the suggestion to write a book!

  44. Colleen September 2, 2011 at 6:10 pm - Reply

    Doc, what is the deal with nightshade veggies? I'm at my weight goal but want to make sure leptin is reset. You said no fruit or nightshade up above for the overweight so I assume I can eat them. But why the ban on peppers and onions for the overweight? Cortisol spikes?

  45. Jack September 2, 2011 at 6:18 pm - Reply

    @colleen and renfrew. I stopped writing the book to start this blog. One of my fellow MDs told me I needed to stop it and help people now with this info. That is why I started blogging. I know it's not my niche but when you come talk with me you will see my real niche.

  46. Jack September 2, 2011 at 6:22 pm - Reply

    @Mallory I have never really read a lot of Mr Peat's work because you have to buy his stuff. Basic science should be shared. The reengineering of humans is how I get paid. How the information makes sense from the clinical history and the labs. That is the Rosetta Stone of optimal to me. If you have any of his stuff you'd like to forward to me I would be happy to peruse it and tell you what I think. Let me know and I will give you my office address.

  47. Tina September 2, 2011 at 6:25 pm - Reply

    Dr. Kruse, I'd like to volunteer to edit this post for you. I've already started working on it and can send it in the next day or two. I appreciate all the time you've taken to help everyone here, and think that this could be my way of giving back and helping others.

  48. steve September 2, 2011 at 10:55 pm - Reply

    Dr K: It might be beneficial if you could list of books you believe might be helpful to your readers in working towards optimizing their health. Thanks.

    • Jack September 3, 2011 at 10:33 am - Reply

      @Steve I may do this when I come out with my supplement blog.

  49. Mike September 3, 2011 at 1:03 am - Reply

    Hello Dr. Kruse, Since calories matter for the LR how calorie restricted should the leptin reset be? I am in a constant struggle to figure this out. When following a strict paleo diet I find it hard to get enough calories and end up freaking out and binging by the end of the week. Adding heavy cream solves this problem but having no access to raw cream leaves me with ultra-pasteurized which I know is not optimal or part of the paleo diet. I have a history of anorexia but once that was cleared up my weight almost doubled and I can't get it off now. A quick note on this would be so helpful. Thanks for all your great work!

    • Jack September 3, 2011 at 10:33 am - Reply

      This one is an easy answer. If you eat a BAB within 30 minutes of rising it is impossible for you to over eat calories. Try it. You will see I am using your brains' wiring to my advantage. This is why calories dont matter and and you should not worry about them. If you get hungry during the day and you overeat it means you did not eat enough at the BAB stage. Alter that and proceed on. You wont have to worry about it…….regards of how rewarding the food is too.

  50. Primal Mama September 3, 2011 at 2:50 am - Reply

    Dr. K,

    What an awesome post!


  51. Baba September 3, 2011 at 4:15 am - Reply

    Dr. Kruse, would you care to explain the physiological reason why nightshades should be avoided?

    • Jack September 3, 2011 at 10:29 am - Reply

      @Baba If you read about night shades they cause issues similar to a leaky gut. So if you re read my VAP= Leaky gut post you will see that I use the VAP as a proxy to see if the gut is leaky. Most people doing a reset all have really bad HDL levels. This means the liver is not as good a filter as it could be. IE the gut is leaky to more inflammation than it need be. This is also why the HS CRP is higher. It tells us that the plasma is more oxidative to our systems. And this fosters leptin resistance. Therefore, during the reset we want to do everything possible to eliminate inflammation and that is why you should avoid the nightshades. And if you happen to get a lipid panel on your reset……and as a female your HDL is above 60, or as a male above 70, then I say you can eat nightshades on the reset. In my six years of doing this I have not seen a LR person who fit that bill as yet.

  52. Outsider September 3, 2011 at 6:18 am - Reply

    @EMT@Jack – Sarcasm and god complex on the part of Dr's are reasons Dr's need some good introspection. Great advice for feeling optimal, it just needs to be concise and not confusing or contradictory – otherwise we stupid sheeple keep asking clarifying questions, and apparently deserve sarcasm from the beautiful people who are responsible and able to turn themselves on.

  53. CMHFFEMT September 3, 2011 at 7:37 am - Reply

    Doc, I second the book list idea.

    • Jack September 3, 2011 at 10:24 am - Reply

      I am writing a book on spine surgery…….and how to do it without a blade.

  54. Owl September 3, 2011 at 8:02 am - Reply

    I'm confused. In your original Leptin Prescription, you say to have the 50+ grams of protein, and "Make sure that breakfast has little to no carbs ."

    In these FAQ's, you say, "Carbs should always be eaten Cortisol is highest… the AM. And the least amount at dinner. "

    I have been on the reset for 6 weeks eating zero carbs for breakfast. Should I now try to eat most of my carbs for breakfast?

    @Owl 0-50 grams is very inconsequential for a human. The point I am making if your going to eat carbs eat them earlier than later. This advice seems contrary because none of you are my patients and have labs. When a patient comes to me I know what part of the day their cortisol is high and we suggest that they eat their carbs when the cortisol is highest. That often varies tremendously. So here on the net when we have no clue where you really are, I use the normal diurnal rhythmn as the default answer.

    Dr. K

    • Jack September 3, 2011 at 10:23 am - Reply

      @ Owl. You should not be confused. No where did I say zero carbs…..although I have no problem with it for the reset period. Just stay below 50 grams during the reset if your overweight. If you stay on zero carb you will eventually have a problem with T3 and Vitamin A (cofactors for steroid production) and with a rising LDL on your lipid panel and you will feel bad because you can no longer convert that good surge of Particle A LDL to the hormones that make you feel rockstarish. This is why you need to ask questions and rely on your doc who gets this. Its all in any endocrine text that any doc should have read at some point before they got corrupted by a drug rep to use a statin instead.

  55. NDF September 3, 2011 at 3:10 pm - Reply

    Why is it okay to skip lunch or dinner but not breakfast?

  56. Jack September 3, 2011 at 4:35 pm - Reply

    @NDF. In the AM humans have diurnal cortisol pattern. It's high in the morning and lowest at night. The evolutionary biologic function is to one, wake up the brain from sleep and two to get us up to feed. So when cortisol is highest we should be waking up eating. When cortisol is lowest we should be eating less and getting ready to sleep. It's lowest from 6 to 9 pm. When you eat late at night you are destroying the normal diurnal rhythms of how cortisol and leptin are designed to work. Do this long enough you screw up the diurnal clocks in the liver and muscle too. Not just the brain. And that is how LR insidiously takes over. Neolithic foods are but one part of e obesity story. Reading Taubes, Guyenet, Dr. Lustig or Dr Davis you'd be led to believe "some theory" of obesity. Mine is a pretty simple top down look. Everything begins in the brain. Macronutrients are partioned based upon energy needs and by diurnal releases of hormones that ironically the brain also releases. Everything is dictated by the brain. This is why leptin is King of the Hill.

  57. Embyr42 September 3, 2011 at 8:47 pm - Reply

    I've seen others ask this elsewhere but can't recall seeing a clear answer.

    Can you please address what adjustments (if any) need to be made for children to the protein and/or carb limits?

    Perhaps age groups such as 1-6, 7-12 and Teen years.

    Or perhaps a minimum age for this type of protocol.

    I can't imagine trying to get 50g of protein down a 5 year old with that tiny stomach… but my friend's niece is 5 and obese and she would like to suggest this to her sister.

  58. steve September 3, 2011 at 10:35 pm - Reply

    Dr K: What are acceptable carb sources to you, and which ones do you eat? For those of us with CAD, how, if at all, would you modify your recommendations? Some out there are hyper absorbers of fat; do you see this as related to Leptin, Thyroid, or just genetics of under performing LDL receptors? Thoughts on how to correct? Are statins ever advisable to anyone?

    I realize that was a boatload of ?'s. Thanks

  59. Jack September 3, 2011 at 10:59 pm - Reply

    @Steve. All natural carb sources are fine. I dont count HFCS as natural. I eat anything I want now, but what I eat seems inconsequential to the discussion. I dont buy any assertion of hyper absorbers. We partititon calories based upon our machinery and how good its working at all levels. Statins in my view are chemotherapy and not fit for human consumption at any time.

  60. LSseeker September 4, 2011 at 7:21 am - Reply

    My HDL is 77 and I'm a female. As far as I know, I'm becoming LS as I'm in my 8th week. Nightshades for me.

  61. Adriana G September 4, 2011 at 7:35 am - Reply

    "NDF. In the AM humans have diurnal cortisol pattern. It's high in the evening and lowest at night"

    Shouldn't this read " high in the morning"?

    It should and I fixed that error. Thanks

    The management.

  62. Shijin13 September 4, 2011 at 7:55 am - Reply

    Dr Kruse

    I think I'm LS (have all the signs) But my cortisol levels are low in the am, and high at night…

    Can I still push the HIIT – or do I need to fix the adrenals first?

    Thanks so much for putting this out there…

  63. Jack September 4, 2011 at 8:32 am - Reply

    If your cortisol is up at night you are not yet LS. Read my comment above about diurnal clocks. Yours is set 180 degrees the wrong way yet.

  64. LabLover September 4, 2011 at 9:23 am - Reply

    My father was diagnosed with early onset Alzheimer's when he was 61. I have been reading your blog and was telling my stepmother about what you had written regarding cholesterol and brain function. She said no doctor that they had seen in all these years (there have been many) has ever mentioned diet or nutrition to them. Why is this something that is not being explored by more neuro docs? They really offer nothing for treatment – only assessments.

  65. vkiernan September 4, 2011 at 10:59 am - Reply

    Dr. K, I have shared this with my boss and he says he cannot do this because when he eats before 9 or 10 in the morning it gives him diahhrea not long after. Why would this be? He would like to be healthy but that really gets in the way of life. Thanks so much.

  66. Jim September 4, 2011 at 11:10 am - Reply

    What is the reasoning for the perceived increase in body heat?

  67. Shijin13 September 4, 2011 at 12:50 pm - Reply

    Thanks Dr Kruse

    What do think about my LABs (I think I've got some serious work to do ahead of me):

    I dont think it is wise to post labs and even less wise for me to answer this here. So I have edited it.

  68. sally September 4, 2011 at 4:28 pm - Reply

    How does pregnancy, breastfeeding, and/or hormonal birth control play in the LR?

    I have learned so much from you, Thank You!

  69. Pam September 4, 2011 at 8:27 pm - Reply

    For anyone who wants to see what foods have highest protein check this one out. I thought it was interesting that eggs have the lowest amount of protein per 100g serving. It only looks like you need about 6 oz of chicken, meat or fish for 50g, maybe even 5oz.

  70. Baba September 5, 2011 at 12:35 am - Reply

    Dr. Kruse, in the context of leptin reset, what does an overactive liver signify? The less carbs I eat, the more sugar it dumps into my blood – or at least that's how I read it.

    Can anything be done about it?

    • Jack September 5, 2011 at 10:40 am - Reply

      @Baba That is liver leptin resistance and a remaining defect in gluconeogenesis. Read Leptin Part deux once again. With the reset it will fix this with time.

  71. moreporkplease September 5, 2011 at 12:45 am - Reply

    My experience so far on week 4 – I'm crashing at 10:30pm and waking up at 6am no matter what. I feel very hot in the mornings – my face actually get sweaty just strolling to the store. I have started Superslow because I found a female trainer. I'm a 5'7", 40 y.o. female. In fact I sweat so much for no particular reason my makeup sometimes smears. Is this good or am I having the world's earliest hot flashes?!?!? Losing about a pound a week.

    • Jack September 5, 2011 at 10:38 am - Reply

      @More pork Its early on…..i bet its normal If it stick around several months you need to see the OB/GYN for the perimenopause check

  72. marcia harmon September 5, 2011 at 10:16 am - Reply

    Is it normal to have low energy in the first few weeks of the diet? Thank you.

    • Jack September 5, 2011 at 10:30 am - Reply

      @Marcia This is a mixed bag for patients. Some do some dont. I think it depends upon how your epigenetic switches are set.

  73. Jack September 5, 2011 at 10:51 am - Reply

    @Sally I have hit on pregnancy and leptin all throughout my blog. If is critical in my view for a woman to be LS before she ever contemplates pregnancy. If she does not she is not giving her child the best chance she could to begin life.

  74. Jack September 5, 2011 at 11:00 am - Reply

    @Jim the reason for the body heat is two fold. First, is since we are priming the gut with a huge protein load in the AM you get a thermogenic effect of protein on mitochondria. This signal affects the incretin signaling to the brain to affect satiety and appetite. Once this is established the brain begins to send metabolic signals to the muscles UCP to burn calories as heat as well. This however requires thyroid hormone to become active as well. This is the second reason you will feel the heat so to speak. People with Hashimoto's of bad thyroid function (low T3) will struggle with this for a while and may need a doctor to help jump start it. Eventually it can be repaired and this step is critical to lowering the LDL that will occur in some who eat a paleo diet who have poor T3. Remember the conversion of LDL cholesterol to the steroids the brain uses for signaling requires T3 and vitamin A. Once someone is LS for a long period of time 12-24 months you will notice the heat go away and your body temp will actually lower with time. This is a long term sign that LS has set in. You will also note that you can eat anything you want without gaining weight. There are many LS people who experience this and others wonder aloud how they can eat whatever they want and not gain weight. This is how it happens.

  75. Jack September 5, 2011 at 11:02 am - Reply

    @vkiernan …….hearing that tells me he has a real low HDL and his gut is real leaky. He needs that repaired ASAP. It predicts weight gain, low testosterone levels and a higher risk of cardiac disease and can be predicted from his HS CRP. This guy needs a doctor stat.

  76. Jack September 5, 2011 at 11:06 am - Reply

    @Lablover The answer is reading and lack of communication of the research data to clinical medicine. That is my opinion.

  77. steve September 5, 2011 at 9:18 pm - Reply

    Dr. Kruse: Are you going to post on how to use the NMR results in a way simalar to your VAP post? Perhaps suggestions for how we can best understand these results in the context of LR/LS. Also, any specific recommendations on how best to deal with CAD and keep plaque stable? I know to minimize 06 Pufa and eat 03Pufa, but anything else in terms of carb specific maximums and how you would measure the success of your diet? I know that was a lot. Thanks

    • Jack September 6, 2011 at 7:42 am - Reply

      eventually yes……probably when I get to heart failure and autophagy levee. Most people dont realize that the human heart fails due to autophagy and apoptosis. And some of the science of the NMR analysis is pretty instructive there.

  78. David September 6, 2011 at 12:51 pm - Reply

    Jack, can you tell me why you recommend sprints for no longer than 40 yards? I had always thought sprints up to 400-800 yards were great for good hormone stimulation. Thanks

    • Jack September 6, 2011 at 12:58 pm - Reply

      The reason is because when your LR severe cardio exercise can hurt you. Read my blog on why Oprah is still fat to see why. Also when your LR you are not able ot make your hormones optimally so it makes zero sense to push cardio which raises your cortisol even higher making you more likely to be LR and adrenally fatigues. Fix Leptin first and then add in the exercise.

  79. Kelly C September 6, 2011 at 1:07 pm - Reply

    Since hcg I have been zero to low carb and my T3s continue to decrease. (I take 30mg of Armour thyroid & BHRT). My DO suggests my low carb diet is causing my thyroid to decrease to try to prevent gluconeogenesis. He is suggesting I take in more carbs to help correct this. I am about 5 pounds from my goal weight. But happy to stabilize and get LS going at this point. I have not added exercise to my routine yet – waiting on the leptin reset.

    My fasting blood glucose level is 85. I just took it after having a whey protein drink (jay robb made with unsweetened almond milk) at 15 minute intervals – went to 93, 93, (30 minutes later) 87 and finally (30 minutes later) 87. Is this too much of a spike to continue with the whey protein drink. I'm not sure what he determines is too much of a spike. Suggestions?

    Also, sweet potatoes seem like a great option to get some healthy carbs into this plan – but since that is a risk in P3 not sure I can go that route. My HDL is under 60 so I need to stay away from nightshades right now. I know I cannot eat enough green veggies to get the 25 grams of carbs…

    • Jack September 6, 2011 at 3:09 pm - Reply

      Sounds like you do need more carbs to up the T3. I think your doc is spot on

  80. Kelly C September 6, 2011 at 1:12 pm - Reply

    Also, I have read about HGH and curious to know if you use that or are your benefits strictly from the HIIT once you're LS? Is there a supplement that helps us produce more HGH?

  81. Laney September 6, 2011 at 3:38 pm - Reply


    Thanks for taking the time to educate us with your blog. I only found you out this weekend and it took one pass through your posts to have my (very positive) paleo experience set on a theoretical basis; Heck, I your site was the science shock I really needed to rock my MD sister's boat. Now she understands how paleo worked on me…. And I understand why my work stress and late-night IF-style eating won't let these last 20 pounds go away (5 feet 11' 200 lbs, four month plateau).

    Got a question regarding the best of the worst choices as regards the type of protein one should adopt on hectic mornings while attempting the reset; whey is out due to the insulin response. Egg white proteins are supposed to be slower to absorb, and casein even slower, although it's milk-derived so it's probably

    • Jack September 6, 2011 at 5:50 pm - Reply

      @Laney For me protein is a simple issue. When I was fat I used a glucometer to see if proteins altered my BG level. I found Whey did that too me. So I used raw eggs in smoothies to replace that for quick breakfast. Most of the time protein for me in the AM is meat. Bacon, sausage, or left overs from the night before. But my quick staple is raw eggs.

  82. Laney September 6, 2011 at 3:41 pm - Reply

    …insulinogenic too. Should I try the glucometer… Or do you have a clear cut protein origin suggestion? I am referring to solely to powders when there is no time for a proper breakfast.

  83. Kelly C September 6, 2011 at 5:55 pm - Reply

    Dr. K – My fasting blood glucose level is 85. I just took it after having a whey protein drink (jay robb made with unsweetened almond milk) at 15 minute intervals – went to 93, 93, (30 minutes later) 87 and finally (30 minutes later) 87. Is this too much of a spike to continue with the whey protein drink. I'm not sure what he determines is too much of a spike. Since I'm close to goal weight hoping I can tolerate the whey.

    • Jack September 6, 2011 at 6:23 pm - Reply

      I think those numbers are superb. No issues at all.

  84. Valerie September 7, 2011 at 12:48 pm - Reply

    i've been on the leptin reset for the past 3 to 4 weeks. i've noticed the past few days that my bile production has slowed or even stopped (very pale stools). no jaundice, a little tiny bit of back pain. this has never happened to me before (and i extreme-low-carbed for 10 years) so i feel it's related to the reset. i'm consuming less than 25 carbs per day along with copious amounts of allowed fats. is this normal, should i be concerned?

    • Jack September 7, 2011 at 4:35 pm - Reply

      @Valerie. Stool that is pale or grey may be caused by insufficient bile output due to conditions such as cholecystitis, gallstones, giardia parasitic infection, hepatitis, chronic pancreatitis, or cirrhosis. Bile salts from the liver give stool its brownish color. If there is decreased bile output, stool is much lighter in color. Some other causes of pale stool is the use of antacids that contain aluminum hydroxide. Stool may also temporarily become pale after a barium enema test.

  85. zion September 7, 2011 at 3:52 pm - Reply

    Can you comment on the Warrior Diet and how Ori indicated that we only need one meal at the end of the day, a very big one, a BAD if you will? Is this a formula one could not follow after completing the LR? Also, when you comment on being fit, can you speak more about those who might be otherwise fit and not need to lose more than 10-15 lbs?

    • Jack September 7, 2011 at 8:24 pm - Reply

      @Zion I am not familiar with that diet so I can not comment on it.

  86. Raylynn September 8, 2011 at 9:29 am - Reply

    Dr. Kruse, I am 5 weeks into my reset, and sleeping like a log. Don't even turn over much anymore. I will be going to my doc for annual in a few weeks and would like to know which thyroid test to ask for. My hair has been falling out for about a year, but last labs did not show a thyroid problem. Should I ask for T3?

    Also, which type of magnesium should we supplement with? I already take a multi-vitamin and 1000 of vit C. I read your blog about mag, but am confused about which one to take.

    Love your blog, and thanks for discussing all of this. Can't wait to buy your book when you are able to finish it.

    • Jack September 8, 2011 at 10:40 am - Reply

      Usually when hair is falling out and your eyebrows are involved its a hormonal issue related to the thyroid and sex steroid issues and leptin. Continue the reset and get your labs done. Look at the blog post for optimal labs I just did the last few weeks.

  87. crystal September 8, 2011 at 3:57 pm - Reply

    Hi Dr. Kruse! I am really excited to try your Leptin RX. I have had a really hard time with carbs and sugar cravings, it's only gotten worse with age. I was wondering about coffee. I saw that you say to not drink it in between meals. Am I correct in assuming that it's okay to have with a meal, like my BAB?

    Also, I have been using Stevia Extract in powder form. The ingredients only show the stevia plant and inulin. Is that okay, or should I only use the liquid version?

    Thank you!

    • Jack September 8, 2011 at 4:50 pm - Reply

      @crystal look at the package. If it has maltodextrin in the stevia toss it. If it does not use it.

  88. Nicole September 8, 2011 at 5:16 pm - Reply

    I currently use and love Nutiva's coconut oil, but what about their hemp oil? Can LR people use it? I can't wait to try the manna!

  89. JimG September 8, 2011 at 6:43 pm - Reply

    Hello Dr Kruse,

    I previously mentioned on this blog that I am trying out the leptin reset protocol, but I am convinced from the posts that I need to get myself tested first, as to how stressed I am, my main problems are really low energy/motivation and not loosing weight after exercising for more than a year, I am overweight by 6-8 pounds. I do have a very mild psoriasis of scalp. What are the comprehensive tests you would recommend, I am not even sure if my doctor will agree with me for getting tested


  90. Adriana G September 9, 2011 at 9:07 am - Reply

    How about putting the Leptin FAQs into a tab? As you add more posts to your blog it's going to get buried…a lot of people will come here to learn about leptin, and whoops! Before they know it, they are on track to optimize their bodies. We'll just call you te Trojan Kruse.

  91. Kami September 9, 2011 at 6:14 pm - Reply

    HI Dr. K, how about adding your post WHAT ARE THE OPTIMIZING LABS? in the popular posts section so it can be easily found. Thank you.

    • Jack September 10, 2011 at 2:41 pm - Reply

      @Kami I will have to ask the management.

  92. April September 10, 2011 at 4:44 am - Reply

    Hi Dr. Kruse, wanted to let you know that you actually got quite some fans here in Germany!

    Love your blog, it s a great inspiration to kick off further reflection of my own. Unfortunately we currently haven t got any experienced medical scientists who are writing about Paleo/Primal/Archevore/… in a free blog in German. I m sure a lot of people around here would be highly interested in your findings – but most of them probably haven t got the language skills to understand scientific posts in English.

    As soon as my next university semester in biochemistry starts, I ll hence, every now and then, write in different German Paleo Blogs about some basic, medical topics that might help people understand why Paleo really does make sense. Also hoping, to tie the community a bit together & strengthen the paleo movement in Germany. Already talking about it with the people I encounter everyday arouses their interest a lot (in a way that quite some of them are now as well switching to Paleo).

    PS: By the way – I m female, 25 years old now and on week 5 of strict paleo. After 13 years of vegetarianism & lots of abuse to my body like running marathons, inappropriate junk like birth control pills with a high dose of hormones at the age of 14 already (eventually thus developing eating disorders), becoming anaemic (my MCV dropping with every year, MCHC always being a hint to high according to "medical norms") etc.

    As far as I m able to remember, I ve never felt better in this life than right now! And it was your blog that pulled the trigger in my head and gave me the knowledge and the tools, I was looking for all the time.

    Thank you!

    • Jack September 10, 2011 at 2:39 pm - Reply

      @April Thanks for the kind words. I have some German in me but I dont know a lick of German. Maybe google translator can help the Germans get this info? Let me know if I can help in any way

  93. Jack September 10, 2011 at 11:32 am - Reply

    @Judy in response to your email about loose skin and stretch marks and how to deal with them. I responded to this in the MDA monster thread around page 83 on my iPad. Here is the response. Some one asked about loose skin post weight loss too……here are my thoughts.

    after my patients lose their weight we use a few things to tighten skin over about 12 months…..high dose Vit K2 and teprenone (Oral and topical), caprylic acid (oral and topical) and high dose dietary palm and coconut oil. It does amazing things to adipocytes and the skin once the weight is gone.

    I also add a couple of high dose supplements too….NAC and R-lipoic acid and resveratrol. This is not for a leptin reset…….this is when you are looking to lose the last twenty pounds after your weight loss.

    If there is a lot of cellulite marks I also ask patients to consider high dose super curcumin as well.

  94. golooraam September 10, 2011 at 11:48 am - Reply

    Thanks Dr. Kruse

    I have recently started my morning with a mess of pastured scrambled eggs, bacon, and a can of coconut milk and feel pretty great – no hunger during the day

  95. Adriana G September 11, 2011 at 10:52 am - Reply

    A question from a new thread on MDA…. :

    These two statements conflict eachother:

    15. Can I skip lunch during the LR Protocol if I'm not hungry? Yes, and that is good if you can get to dinner without hunger. And you can eat more at dinner if need be then.

    16. Can you do IF ( Intermittent Fasting) in conjunction with the LR Protocol? No way. I love IFing, but not until you are leptin sensitive. IFing requires the AMPk pathways to be working optimally before you do this.

    if you're skipping lunch, isn't that IF'ing?

  96. Kelly C September 13, 2011 at 8:39 am - Reply

    Jack says… likely not the right thyroid med then……. (from MDA thread)

    Doc, many of us are taking Armour or Nature thyroid that requires waiting an hour before we can eat in the morning, are you suggesting you prefer another type of thyroid medication (low free T3s is the common problem)…

  97. Beth September 13, 2011 at 11:54 am - Reply

    Why is pastured butter/raw cream suggested for underweight people with LR instead of coconut oil?

    • Jack September 13, 2011 at 12:03 pm - Reply

      @Beth Raw dairy is anabolic and stimulates insulin. Coconut oil does not. If you want to use butter use ghee. Ghee has all the animal proteins removed and leaves the fat. Ghee= clarified butter and it rocks

  98. Beth September 13, 2011 at 12:19 pm - Reply

    Thanks! The closest to raw dairy milk I can get is grass-fed, non-homogenized, pasteurized at the lowest temperature legal. Or would raw (homemade) almond milk be better?

  99. Kelly C September 16, 2011 at 2:43 pm - Reply

    Good Morning, Doc. Have a friend on a beta blocker – any special considerations for her on this plan? Supplement suggestions? Many blessings to you for your hard work here!

  100. Jack September 16, 2011 at 3:12 pm - Reply

    Kelly beta blockage will slow the heart rate down and decrease the stroke volume. It will limit the ability to do many HIIT exercises by time or what we call a tabata protocol. Should have zero effect on a primal diet with a leptin reset.

  101. Jack September 17, 2011 at 3:58 pm - Reply

    @Janel Thank you for the kind words and allowing me to publish your comments.

    Hi Jack,

    Thanks for 'friending' me.I'm a friend of Jodi, one of your spine patients. She introduced me to Paleo. About the same time she started, I was going strict Atkins again. I was frustrated after training for and running a half marathon – and not losing ANY weight – I knew something had to give. I only wanted to lose 10-12 lbs. I had effortlessly lost 40 lbs on Atkins after having my second child and knew it was the easiest way for me to lose weight. I had maintained that wt loss for 10 years maybe swaying 5 lbs on the scale. I thought I was eating healthy – lean protein, fruits and veggies, and only whole grain complex carbs – no "white stuff". Why was my weight creeping up when I was eating this way and running my butt off??!!! After reading a few of Jodi's fb posts I read Robb Wolf's book. I made the adjustments from Atkins and went strict Paleo. I lost 11 lbs in 2 weeks…now down a total of 18 lbs and 4 sizes!! I'll turn 40 in Dec. and feel better than I did in my 20's!

    I also got my parents on board – my dad lost 27 lbs, my mom lost 25 lbs. My mom no longer suffers with reflux and has decreased her thyroid med. My dad's arthritis pain is gone and his lipid panel looks fabulous- better than it has in 25 years. You'll love this… On his visit to his cardiologist last week his doc kept quizzically flipping pages, then asked, "Do you have any blood in your urine or stool?" Dad said no. "How much alcohol do you drink?" He answered not much. So finally the doc says, "Well you've lost 27 lbs since your last visit 6 months ago. You weren't a large man to begin with. What have you been doing?" Dad explained he gave up wheat/grains and dairy, just made 63 but has the energy he had in his 30's, and his arthritis is gone. The doc said he'd not heard of this new 'fad diet' but to keep doing whatever he's doing since his lipid panel looked fantastic. Brilliant doc…lipid panel looks terrific, pt now has a normal BMI, and your first thought is maybe he's got cancer or is an alcoholic. Seriously?! Not to mention no further questions about this "fad diet" that produced such incredible resuts! I'm an RN and hate where healthcare is headed.

    However, I am encouraged that Jodi inspired me, I got my husband, kids, parents, sister, brother in law, and dentist on board. My dad has inspired 2 employees and a couple of customers at his business to go Paleo as well. Success and results make people notice.

    Thanks for your informative posts…love learning all I can to share!


  102. Jack September 17, 2011 at 4:00 pm - Reply

    @Janel…….I love posts like this. It is proof that a thought can change our DNA forever. Now we have to work on your Dad's doc. Send him the blog link. I am not kidding. I would even be glad to speak with him if he has questions. Its that important to change medicine.

  103. ATL_Paleo September 17, 2011 at 4:47 pm - Reply

    Thanks for all wisdom Dr. Kruse. Been on the reset for 3 months. I am so happy to have broken my snacking habit. Been grainfree for 18 months (thanks to Marks Daily Apple) with no weight loss needed. I am eating 3 meals a day, and male w/ 9% body fat, so I gather I am now LS.

    Question: in item 4 above, you state "your body temp will actually be lower". Using a digital thermometer under my tongue, I get a reading of 97.0. How much lower might my body temp go if I remain LS?

    • Jack September 17, 2011 at 9:29 pm - Reply

      My body temp has gotten to 96.0 last Dec. That is my lowest. I think when your thryoid is maximally firing out T3 to convert LDL cholesterol to hormone cascade and simultaneously turning on the uncoupling proteins I mentioned in the Leptin post on oprah…….that is how you know youre cooking with gas. When I see a patient their I tell them go lift real heavy things and have sex and sleep a lot. They generally are so happy then I never see them…….except by email and their pictures on FB.

  104. Dan September 18, 2011 at 3:59 pm - Reply

    Dr. Kruse,

    Do you have any thoughts about the hypothesis that the formerly-obese have too many adipocytes, leading to insufficient production of leptin at low body-fat percentages? If true, this seems problematic, given that I am not aware of any any strategies for reducing the number of adipocytes other than liposuction.

    I've read your entire site, but if I've missed a discussion of this issue, my apologies.

    • Jack September 18, 2011 at 6:17 pm - Reply

      @Dan. It actually is on the site but I did not get into too much. Amgen synthetic trials showed that people who lost massive amounts of weight needed synthetic leptin to keep the weight off. No one knows precisely why but most of the researchers I have spoken to believe that the leptin receptor itself may become damaged by long term obesity due to sustained high levels of TNF alpha or IL-6. Some others think there may be a problem at the adipocyte itself. Still others I spoke to think that when a patient is extremely LR there is a big energy mismatch at the hypocretin neurons and this sensitizes them to neurotoxic damage of glutamate, aspartate and cysteine that accumulates in the energy deficient neurons over years of obesity. Simultaneously as these collect around the Hypocretin neurons, the astrocytic footplates that should absorb them, become sluggish further increasing their concentration creating more free radicals that destroy the neurons. There is only 50K of these neurons and they are not replaced once lost. When the numbers decline it means that leptin signaling is forever damaged and the person becomes dependent upon the synthetic leptin to sustain weight. The same researchers are also looking at how gliaden from wheat also causes an autoimmune reaction at this area to cause the same problem. I personally believe the data is best now for hypocretin neuron loss over receptor damage or over a problem at the adipocytes for release. It also maybe a combination of all these mechanisms. This will be known pretty soon considering how many people are working on it now. Great question and I should have made this a bigger point in the blog.

  105. Colleen September 19, 2011 at 1:58 am - Reply

    the entire body temp thing confuses me. When I was at my sickest with fibromyalgia, my body temp was 96, sometimes less. When i got on bioidentical thyroid after reading dr lowe's site about undertreated thyroid being the base cause of fibro, the fibro went away as my body temp came up. So I'm pretty leery of even thinking that it might crash that low again. I just don't understand how that can be good.

  106. Flip September 19, 2011 at 8:33 pm - Reply

    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.

    Lastly, I do have a beef allergy (red meat only). (it started about 9 years ago) I actually go into anaphylactic shock, hives and heart rate drops. Should I try and reintroduce or would it be okay to stick with all the white (fish, chicken, turkey ,etc.)?

  107. Phoenix September 20, 2011 at 1:55 pm - Reply

    After many years of severe dieting and exercising, in which I lost over 100 lbs, I'm left with low T3 levels (currently on sustained T3), goiter and 60 lbs of regain with an inability to lose no matter WHAT I do! I'm wondering about total calories. If I don't get enough calories I get bloated, tired, temps drop more, etc. I do eat a low carb paleo diet (100-150g), but where do calories fall in returning LR back to normal? And is there still hope for a reversal of my hypothyroidism or am I stuck relying on T3 supplementation forever?

  108. Rachelle M September 20, 2011 at 8:52 pm - Reply

    Because I'm not overweight or underweight, how many carbs should I eat? And can I eat dairy?

  109. Jack September 20, 2011 at 9:18 pm - Reply

    @Rachelle how are your cravings, sleep and body composition? IF all are good you have no limits. IF they are not you might need to cap them What are your goals if your at ideal weight? are you even sure you are leptin resistant? if you are not sure you need to get testing done to check that out.

  110. Jack September 20, 2011 at 9:19 pm - Reply

    @Flip read everything on here about leptin. There is a lot. I am sure this will help you.

  111. Jack September 20, 2011 at 9:21 pm - Reply

    @colleen not all causes of low temp are bad like FM. When your completely reset and the hypothalamus is working well with everything else you normal body temp will 96-98 degrees. But you will feel warm and wont sweat until you really exert yourself.

  112. Rachelle M September 20, 2011 at 10:08 pm - Reply

    I dont really crave carbs per se, more like yogurt, fruit. I lost half of my weight on the HCG diet (the homeopathic version)and the other half on Atkins My goals are to be able to eat more carbs, I'm not talking about a whole chocolate cake worth but maybe an occasional extra carb here and there. I also would like my body to shape up.

    What tests would those be?

  113. Heather September 20, 2011 at 11:58 pm - Reply

    Hi Jack and everyone,

    Been on the reset now for 3 weeks, and no cravings (though I have been off fructose since mid June which I think has helped), no hunger, great sleep and 4 kgs has melted away, the first weightloss since the Birth of my middle son 18 years ago. Thank you! This has been an amazing journey, can't wait to get stuck into the weights, the book Paleo Solution has a great section on weights, though he advocates early morning exercise rather than evening.

    One thing I have noticed is no more hay fever! It's spring here in Australia, and I normally start all the medication, puffers and pills, but no need, while everyone else is whinging!

    Feeling very positive, and want to encourage everyone to stick to the program,

    Thanks again, cheers Heather

  114. Jack September 21, 2011 at 12:14 am - Reply

    @Heather. Awesome. Summer is ending here. Maybe I should come down under. I love summer. Great to hear this working for you! Keep us informed!

    I hope others post their results here too! Lots of my patients post it on their FB walls.

  115. Jack September 21, 2011 at 12:20 am - Reply

    @pheonix. Calories dont matter when your LS. They do when you LR. Sounds like you are. So start with primal/paleo fuels and eat them following the leptin rx blog. If that fails you you likely need the help of a medical professional to see if your metabolism is hormonally broken.

  116. Jack September 21, 2011 at 12:17 am - Reply

    @rachelle Read this link….. . You'd be wise to read all the links under leptin. There are lots. I also have a blog on testing that you can look at too

  117. JimG September 21, 2011 at 4:56 pm - Reply

    Hi Dr.Kruse,

    I have been following your leptin rx for a few weeks now, but all my muscles feel really fatigued throughout the day a bit crampy, my fingers get a bit shaky, is this normal?

    • Jack September 22, 2011 at 1:45 am - Reply

      @JimG this is pretty common because you are going from a sugar burner to a fat burner. In the MDA monster thread Georgette had this problem. I suggested to her that she eat straight coconut oil off a tablespoon to combat this. You should read her response. Most people think yuck……until they try Nutiva coconut oil or coconut manna. Then their problems fade to black. Try it.

  118. Bev September 21, 2011 at 8:06 pm - Reply

    Dr Kruse – you mentioned changes in urine oder similar to cat pee and that means one needs to supplement with B and C vitamins. Does this mean I am becoming LS? How long will the supplements be needed for?

    • Jack September 22, 2011 at 1:34 am - Reply

      @ Bev it does. It shows that your body needs more methyl transfers substrates. THe increased Vitamin C is also from the increased reaction in the stress and glycolytic pathways. All good stuff.

  119. Jen September 22, 2011 at 5:10 pm - Reply

    Dr. Kruse,

    I'm on day 8 of Leptin Reset. Starting day 6 I've been feeling lousy in the morning. Kind of nauseous/headachy. Not horrible, but not pleasant by any stretch The period about 1.5-3 hours after breakfast is the worst.

    I have woken up not hungry each day so far, and put down my 50g protein breakfast anyway (500-600 cal. usually 3 eggs, 3-4 oz meat and sometimes vegetables)

    Is this expected and/or any ideas what I could do to avoid this semi-nauseous feeling?

    Also, my heart feels like it's pounding (not faster, just pounding) from time to time. What's the implication?

    I'm at an ideal bodyweight & doing the reset for mood stabilization & Seasonal Affective Disorder avoidance and because I was experiencing voracious hunger on a more free-form paleo diet. I've been mostly paleo for about 10 months and sugar-free, fairly low carb for 18 months. Before Leptin reset I've tended to skip breakfast a lot, sometimes lunch and have included snacks like fruit and cold salads.

    Thank you.

  120. Jen September 22, 2011 at 6:37 pm - Reply

    One more thing – I'm consistently sleepy right after lunch. Not like the afternoon blahs of the carb roller-coaster, but just sleepy. Any thoughts?

  121. Heather September 23, 2011 at 9:49 am - Reply

    Hi Jen,

    I felt lousy around those times in the early stages, but am fine now, suspect it's just an adjustment we have to make. I also found a tea I was drinking was making things worse. It was a rose hip/ginger/lemongrass concoction, pretty pink, but it laid me low. Once I cut it out I was much better. Just my experience, hang in there,



  122. sara z. September 24, 2011 at 5:20 pm - Reply

    I would love, some day, a post about how the Leptin RX can benefit those of us with TYPE 1 (or 1.5/LADA) diabetes. I find much of the paleo and primal guidelines so helpful in managing my LADA (though I still have to take a little bit of basal insulin), but I know that diabetic (esp T1 types) followers of paleo are not exactly the same as non-diabetics and the advice must differ somewhat? Thanks.

    • Jack September 24, 2011 at 6:38 pm - Reply

      The Leptin Rx actually helps you a ton. The only issue is that anyone with autoimmune Diabetes (LADA or type 1.5) needs to not only avoid neolithic agents like fructose, grains and omega 6's as in any standard paleo regimen but you also need strict avoidance of all dairy. Raw or otherwise because of the the leaky gut. I would strongly recommend you read my tab to the right on my home page on brain gut axis and read every blog under that tab. Those all pertain to LADA for sure. LADA is a disease caused by a leaky gut and it needs to be treated aggressively simultaneous to the leptin Rx protocol.

  123. JimG September 26, 2011 at 8:32 pm - Reply

    thanks for the suggestion Jack, I now take few teaspoons of coconut oil straight up before breakfast & dinner, shakiness has been less over the past week though I experience this only in the mornings. I use the spectrum organic's virgin coconut oil.

    I was reading up on you brain gut axis post for leaky gut manifestations on the skin, I do have a very mild psoriasis on my scalp and have also started taking glutamine supplement. Thanks!

    • Jack September 26, 2011 at 11:34 pm - Reply

      @JimG glad to help

  124. Baba September 27, 2011 at 5:54 am - Reply

    Dr. Kruse, could you kindly elaborate on the muscle soreness?

    Why did I get atrocious DOMS (plus a bad temper) after a high-intensity workout when leptin-resistant? And why is ist so much better after two months on the reset? Curious mind wants to know…

  125. MikeM September 29, 2011 at 12:34 pm - Reply

    Dr. Kruse, I would appreciate any wisdom you might have on Berberine. Three grams / day along with the paleodiet and I have an absence of all cravings, have no blood sugar spikes and feel energized.

    • Jack September 29, 2011 at 1:33 pm - Reply

      @MikeM I have no experience with it clinically but I have read some interesting new things about it. I would wait for more data before I could get behind it. Several studies have shown berberine has various beneficial effects on the cardiovascular system and significant anti-inflammatory activities. A Canadian report suggested berberine can effectively reduce intracellular superoxide levels in LPS-stimulated macrophages. Such a restoration of cellular redox by berberine is mediated by its selective inhibition of gp91phox expression and enhancement of SOD activity.
      Berberine exerts up-regulating activity on both the low-density-lipoprotein receptor (LDLR) and the insulin receptor (InsR). This one-drug-multiple-target characteristic might be suitable for the treatment of metabolic syndrome. If yiu decide to use it for an N-1 let me know how it goes. I'd be interested.

    • Amy July 29, 2015 at 3:11 pm - Reply

      woops! here it is:

      Berberine might be a “natural alternative” to metformin. Like metformin, berberine can activate AMPK, lower blood sugar and improve blood sugar control, and enhance short chain fatty acid production by gut bacteria. Being a whole plant extract, berberine isn’t identical to metformin, so I wouldn’t suggest diabetics switch without consulting their doctor, but it is a promising alternative that doesn’t require a prescription.

  126. andrea September 29, 2011 at 4:21 pm - Reply

    Dr. Kruse, I've posted some numbers here before and am fairly certain I'm LR. The Dr I've been getting scripts for tests for is actually an APRN, so not necessarily the right person to work with to fix this. Do you have any recommendations for selecting the right kind of medical professional to work with? I've had nothing but overloaded GP's in the past, they want to write a script and not see you again.


  127. Anju October 4, 2011 at 6:15 am - Reply

    Dear Dr.Kruse,

    I have been eating primal for the past 6 months and have lost 25 lbs so far. I am 5'8" and weigh 185 lbs. I want to get to about 165 lbs. Thats another 20 lbs to go. But I have hit the plateau in the last couple of months. I have never been a breakfast kind of person, so been skipping bfast all these days and believing that IF will help me to lose the fat.Been reading your site and I get the logic of reversing Leptin resistance that will drive your whole system to your optimal weight and how important bfast is to put us in sync with our circadian rhythm and hormone balance. I would like to give the Leptin Rx protocol a try but facing the following difficulties

    1. I have been a vegetarian all 27 yrs of my life born in a south indian home. I am trying to eat eggs and occasionally taste eating meat and seafood, but am still not used to the taste, smell and texture of the meat and preparing them in the home is a strict no-no for my family. So in this case can I start off with 3 eggs and a scoop of whey to hit the 50gms protein? or should I just take eggs and dont have the whey? is the whey more detrimental to the LR rest?

    2. If I were a vegetarian diabetic [I am not, just a scenario], am I screwed? or do I stand a chance with Whey? I know I cant get an A/A+ but will I be able to get out of meds this way? Cos there are no low carb protein sources in a vegetarian diet.

    Please please reply to my questions. It will immensely help me.



    • Jack October 5, 2011 at 2:56 pm - Reply

      @Anju Great questions. I think if protein is that big a deal to you Id be fine with eggs. As for the whey here is my answer. In Southern India we have more diabetics and autoimmune diseases than in the US due to the vegan diet common place there. So if you family has no diabetes Id say OK to the whey. Why? I am thinking about your own epigenetic signaling you got from your mom and grandmother. If they are diabetic or had gestational diabetes with your pregnancy then I would suggest you buy a glucomete and see what whey does to your BG at 15 min intervals after you eat it. If your BG goes above 150 at any time I would say no to whey.

      I think you need the Leptin Rx for sure. And yes I think any vegan diabetic is asking for neolithic disease and death. This is lifestyle is the most biologically incongruent decision a mind can make. The reason it occurs is because we fall prey to our emotions and dogma and politics over what our body knows it needs.

      Thirdly…….you need meat and fish more than you can imagine to lose that last 20. That last twenty depends upon optimal hormonal status. Read my post Hormone 101 and see why the cholesterol and protein is vital to body composition.

  128. Bruno October 4, 2011 at 11:25 am - Reply

    Hi Dr. Kruse, I'm a 20 yo guy, not overweight not underweight, but I do have skin issues. Would the leptin reset help, or is it really only for people with weight problems?

    My vitamin D level was 9, I'm now taking 5000 IU a day. Is that enough?

    Currently I'm eating an all-meat diet, but my stool is extremely loose.

    Apart from that : is eating pork/chicken a bad idea on the leptin reset. I mean, you do say omega 3 is very important during the reset, so wouldn't pork or chicken make the progress much, much slower?

    • Jack October 5, 2011 at 2:50 pm - Reply

      @Bruno. Skin issues mean a few things to me…..first I think grains……totally eliminate all. Second Vitamin D has to be optimal For me that is above 70 and with correct Vitamin K2 and D3 levels. Third issue is a serious lack of good fats in the skin… this i am thinking the O6/3 ratio. I correct this by using caprylic acid (found in coconut oil and K2 foods). I eat a ton of coconut oil and I use coconut oil and olive oil directly on my skin. I also use epsom salts baths to get my sulfur levels up. My blog post today (October 5, 2011) will tell you why.

  129. Holly October 5, 2011 at 10:32 pm - Reply


    I am very overweight, 36 years old and just gave birth to my sixth baby 5 weeks ago whom I am breastfeeding. Is it possible for me to do this program while breastfeeding? Do I still need to keep it under 50 grams of carbs per day? I'm just hoping my milk supply doesn't tank. I'd love to hear comments from other ladies who have done this diet whi

  130. Holly October 5, 2011 at 10:33 pm - Reply


    I am very overweight, 36 years old and just gave birth to my sixth baby 5 weeks ago whom I am breastfeeding. Is it possible for me to do this program while breastfeeding? Do I still need to keep it under 50 grams of carbs per day? I'm just hoping my milk supply doesn't tank. I'd love to hear comments from other ladies who have done this diet while nursing a newborn.


    • Jack October 5, 2011 at 10:44 pm - Reply

      @Holly congrats on the baby. Absolutely you can do this while breastfeeding. You will actually help yourself and your baby. You need to head over to the MDA site and look for the monster 750 page thread and look for Shinjin . She has been doing the Leptin Rx for 12 weeks while she breast fed and her comments over there will make you very happy.….

  131. JimG October 5, 2011 at 11:00 pm - Reply

    Hello Jack,

    I am struggling with the same problems as Anju, being an vegetarian, I try to get to the 50g protein by adding whey to the breakfast, still can't get to meat or fish. so you are saying that without adding meat and fish, becoming leptin sensitive is impossible or just not enough to loose extra few pounds, I know that its sort of all connected.

    • Jack October 5, 2011 at 11:30 pm - Reply

      @JimG there is another way……the ketogenic leptin Rx. Use coconut oil to add to the breakfast to make up your deficit. Its tough to do but it can be done. I use this with my real obese patients or my brain injury patients. The problem is the satiety and cravings are not as good as with protein……but it works too.

  132. Anju October 6, 2011 at 2:52 am - Reply

    Dear Dr. Kruse,

    Thank you for that insightful reply. I will try the glucose meter. I have been having a tbsp of coconut oil on my avacado for breakfast with three eggs for the past three days. Had a scoop of whey in milk as well. Not feeling hungry until 3pm. I have some coffee or more avacado and go straight to dinner at 7pm, where i eat coconut oil sauted vegetables with some coconut milk or cream and a handful of berries. that keeps me full through the night. do you think this is good enuf?

    Also when you say meat and fish – i know grass fed and wild caught is better – that will work if am able to go to the grocers myself buy it and prepare it – that aint gonna happen for sometime now. so do you think i can eat some meat and fish from restaurants/ food courts where i cant know the source? or stick to the eggs for the last 20lbs weight loss?

    Thanks a ton for answering my questions.

    Keep up the awesome work..


  133. Shijin13 October 6, 2011 at 3:34 am - Reply

    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…

  134. Shijin13 October 6, 2011 at 3:42 am - Reply

    @ Holly

    I went Paleo/Primal last Nov 2010 and ds was 6mth old. He's now 18mths and I'm still nursing…When I switched to eatin Paleo/Primal – my milk supply increased – I think mostly from the increased fat & protein consumption. If your concerned about supply Coconut Oil will boost your calories! Really the BAB + the Leptin principles = easy and successful nursing and resetting your hormones. make sure you follow it to a T. Keep your exercise to walking only, until you get your LS signaling. Also – read Dr K's sleep series

    Dr K outlines how prolactin is linked to Leptin, melatonin and sleep. your prolactin levels are the highest at night – so the more your new baby nurses btwn midnight and 4am – the more milk you'll make… For me the best way to take advantage of this was safe co-sleeping, and nursing ds through out the night. DS still wakes several times a night to nurse – since doing the LR the night wakings no longer wipe me out for the day….

  135. JimG October 6, 2011 at 8:28 pm - Reply

    Hi Jack,

    if I understand correctly from you suggestion, you are still saying to remove whey and add more coconut oil to make up the deficit, but i am supplementing whey in the breakfast to add another 18-20 g of protein to achieve 50g protein,coconut oil won't help with that right? sorry if I am being naive about something here

  136. JimG October 6, 2011 at 8:29 pm - Reply

    and currently my breakfast is loaded with eggs , around 4 and 4-5 tablespoons of coconut oil, some tea and the controversial whey!

  137. Grizz October 8, 2011 at 6:38 pm - Reply

    Dr. Jack,

    I too am confused about Coconut Oil with JimG. How many tablespoons per day of Coconut should we be taking? I know you said more is better. But how many tablespoons of CO are too much? I am taking about 3 tbsp per day mostly in the morning before & after breakfast. Should we also take some with lunch & dinner? I also ordered 3 jars of Coconut Manna on your suggestion. I never heard of it before.

    PS) Testimonial:

    Since starting the Leptin Reset, my Insomnia Sleeping problems are GONE in the 1st week! Also lost 4 lbs in the 1st week.

    Many thanks for your expert opinion,


    • Jack October 8, 2011 at 10:53 pm - Reply

      @Grizz the amount of CO is done until hunger and cravings are gone. My personal view is if you are doing this to lose weight then as much as you can tolerate. I have several patients who are bodybuilders who use it to shred fat as well when they limit their carbs and BCCA.

  138. Anju October 10, 2011 at 1:15 am - Reply

    Dear Dr. Kruse,

    I purchased the blood glucose meter and tested my fasting BG [70 mg/dl] and after two scoops of whey in 1/2 cup milk only [15 mins: 104.4 mg/dl; 1 hr: 108 mg/dl; 3hrs: 97.2 mg/dl]. But if I only have whey, I feel light headed in an hour and quite hungry in 3 hours. but if i have it along with egg, avocado and coconut oil I start feeling hungry by 7-8 hrs. My BG is not shooting beyond 150 so I think I will have a scoop of whey with my bfast. Next weekend I plan to test my fasting and pp BG with the complete bfast and not only whey, and will let you know the results..

    Thanks doc for your help!!



  139. franks October 10, 2011 at 4:06 pm - Reply

    Dr. K, My husband is starting the leptin reset after gaining back 60lbs when we fell off the paleo wagon. Just so happened that he had a physical shortly thereafter and his doc put him on meds for HBP and want to put him on a statin. He is in full blown metabolic syndrome and he is determined not to go on a statin.

    In the begining you note that Calories and Macros are improtant for someone who is LR..How do I determine what his cals and macros should be each day?

    • Jack October 11, 2011 at 3:27 am - Reply

      @franks. you dont. You eat until the cravings and hunger stop. So if his BAB is 50 gms and he is still hungry go up to 75gms. If it is still there he can add MCT to the protein load in the AM breakfasts. Everyone thinks they cant do it in the beginning and then magically they realize they can and things begin to happen.

  140. J October 10, 2011 at 4:17 pm - Reply

    Quick question for you Dr. Kruse-

    Teas won't mess up my LR protocol, correct? I'm talking about unsweetened herbal blends with things like cinnamon, rooibus, etc. I so enjoy a cup of tea midmorning but don't want to jeopardize my success.


    • Jack October 11, 2011 at 3:25 am - Reply

      @J no they should not.

  141. Holly October 10, 2011 at 8:39 pm - Reply

    Thanks to Dr. Jack and Shinjin for answering my questions about breastfeeding and the Leptin RX. 🙂 Giving it a try…currently on Day 2. Coming off the GAPS diet (have been on that for 6 months) and hoping that makes things easier.

    • Jack October 11, 2011 at 3:17 am - Reply

      @Holly keep us in the loop.

  142. Prue October 11, 2011 at 6:25 pm - Reply

    The leptin reset has been going really well for me and I was able to move to just 2 meals a day after a couple of days. But I've hit a problem with low blood pressure. Any suggestions Jack?

    • Jack October 12, 2011 at 12:59 am - Reply

      @prue. Not uncommon. The reset has major affects on the renin angiotensin system and this is likely an aldosterone effect. Just up you use of sea salt…..not table salt which often has dextrose added as a filler. Think i am kidding? Go look at your Morton salt in the cubbard. You must be a label reader.

  143. andrea October 11, 2011 at 7:52 pm - Reply

    Question on timing the BAB- I eat at 6 am during the week and like to sleep more on the weekends. My bf is LS and fasts until lunch, which on saturdays is a special meal.

    If I naturally wake up at 6 am, have my 50 g protein and then go back to sleep for a an hour or two, does that defeat the purpose of breakfast first thing?


    • Jack October 12, 2011 at 1:01 am - Reply

      @andrea…..probably not but it may take you longer to reset. This is a very uncommon question for me. I dont think anyone has asked this of me before.

  144. Marsha October 12, 2011 at 4:00 pm - Reply

    I had a gastric bypass two and a half years ago. I lost about 50 pounds of fat before the surgery, another 70 pounds of fat since. I need to lose 40 more pounds of fat. I get body fat measurements taken about once every two months. I work out with (for me) heavy weights 3 times a week and engage in strenuous cardio 2-3 times a week. I have gained muscle mass (which I want to do).

    I've been unable to lose fat for the past 6 months. I've been shifting my diet around, watching carb counts (I used to follow Atkins and then Dr. Richard Bernstein) and calorie counts. I've been all over the map trying to find something that works that I can actually eat.

    I read about eating 50 grams of protein in 30 minutes and can't figure out how on earth I could do that as I have done my utmost not to stretch out the stomach pouch. I do drink a lot of my protein (unjury brand) because I don't digest meat protein very well. I was also advised to eat 100 grams of protein a day, which I do through drinking 3 servings of almond milk and protein powder and then eating solid food.

    Before I send off for a book on your method (which I heard about through Wheat Belly) I'd like to know if it could work for someone who is post gastric bypass.

    • Jack October 13, 2011 at 2:02 am - Reply

      @marsha……i think given all the emails i have gotten….now over 500 on gastric bypasses……i will do a leptin rx for bypass patients. Be patient!

  145. andrea October 12, 2011 at 7:22 pm - Reply

    So does that mean that taking a nap is counter productive as well?

    When I eat the early weekend breakfast, it's typically an hour awake eating and then cleaning etc, before I go back to bed for an hour or two. Same problem with an afternoon nap?

    Thanks for response! I'm seeing some changes in my chronic parotid swelling I've had for years. I'll be sure to email once I get to 7-8 weeks.

    • Jack October 13, 2011 at 2:01 am - Reply

      @ andrea …..nope. Sleep is tantamount for success… is good sex. The sad part is our community needs to tlak more about real food , real sleep, and real sex a lot more often. Why? Optimal is why.

  146. Grizz October 15, 2011 at 11:57 am - Reply

    Dr. Kruse,

    What are your thoughts on Sciatica? I have a friend in church suffering from this.

    Many thanks,


    • Jack October 15, 2011 at 11:00 pm - Reply

      @ Grizz I have lots of thoughts. I operate on this condition quite often. The causes are vast……some surgical and some not.

  147. darius sohei October 15, 2011 at 7:06 pm - Reply

    its f*cking ludicrous saying that people who work night shifts are screwed. it's unrealistic. people have to cope the best they can and anyone posting on the net with credentials needs to understand this.

    • Jack October 15, 2011 at 10:58 pm - Reply

      Darius the most common email I get is from the shift worker or sleep deprived who struggles with sleep and metabolic issues. When it comes to light and time…….evolution is pretty hard wired because we have found nothing that solves the problem. If you call that Fing ludicrous so be it.

    • Jack October 15, 2011 at 10:58 pm - Reply

      @Darius the most common email I get is from the shift worker or sleep deprived who struggles with sleep and metabolic issues. When it comes to light and time…….evolution is pretty hard wired because we have found nothing that solves the problem. If you call that Fing ludicrous so be it.

  148. Karen October 16, 2011 at 4:47 am - Reply

    I'm dealing with my 4th bout of thyroid cancer. I've had a complete thyroidectomy. The cancer is in a lymph node in my neck.

    I've been on .175 & .2 mg dose of Synthroid (alternating days) and I'm now hyperthyroid so my doc just adjusted my dose down to .175 with a retest scheduled in one month.

    Is it safe for me to do a reset? Should I ask my doc to retest my TH levels more often while I do this? I imagine they'll change as I lose weight.

    I'm a 51 yr old female … morbidly obese … 5'7" and 222 lbs to give you an idea. A LOT of abdominal fat.

    My cholesterol levels just came back. (these are Canadian figures) Overall is 5.93.

    HDL is 1.5, trigs are .89 (!) and LDL is 4.03 and the ratio is 3.95.

    I've been *trying* to lose this excess weight for decades but just manage to get fatter and fatter and more and more frustrated.

    Your article about why Oprah is still fat just lit up the teeny bulb in my head! That's me every time I try to lose this excess fat!

    I've been successful this year at somewhat changing my diet but suffer from what many trying to lose weight do … impatience and focusing on a number on the scale rather than restoring health. Consequently, I fall off the wagon all the time and binge and never reach my goals.

    From the bit of reading I've done here tonight though, I can see that it hasn't been entirely my fault. I've just followed some bad ideas on the best way to lose weight. I've never heard of LR before and now it all makes some sense to me.

    Sorry this is so long but I'm just super excited to perhaps have the golden key in my hand … finally!

  149. Chris October 19, 2011 at 6:02 am - Reply

    Dr. Kruse why would coconut oil cause insatiable appetite? Particularly coconut manna – I can easily eat half a jar (200g) or more in one sitting! However, pastured butter seems to provide much better appetite control.

  150. andrea October 19, 2011 at 7:47 pm - Reply

    Chris, I know what you mean! I was going to ask Dr. Kruse if coconut manna is still a good idea considering the carb content. I could easily substitute a meal with it.

  151. sarah October 20, 2011 at 2:56 pm - Reply

    Hi. Just a few questions! Im starting the protocol today!

    I am 22 years old, 140 pounds, 5 foot 4. I have hashimotos/adrenal fatigue.

    Was wondering if I could/should/want to … work out in the first 30 mins I wake up? I have been taking a lot of time off due to the adrenal fatigue and want to get back in.. I have been paleo for the last year. fat loss is a struggle. I work until 9pm so I can't work out after 5pm.

    Also can we eat goat cheese? raw cheese? grass fed sour cream? coco powder? flax seed?

    and are the carb counts 25 total carbs or 25 net carbs (carbs minus fiber?)

    • Jack October 20, 2011 at 4:07 pm - Reply

      @sarah… can work out for 10 minutes right before bed……And no I would not recommend W/U within th efirst thirty of waking up. Great way to further kill your adrenals. Follow the Leptin Rx.

  152. sarah October 20, 2011 at 5:12 pm - Reply

    Thanks!!Also can we eat goat cheese? raw cheese? grass fed sour cream? coco powder? flax seed?

    and are the carb counts 25 total carbs or 25 net carbs (carbs minus fiber?)

    • Jack October 21, 2011 at 11:02 pm - Reply

      @Sarah can you? sure. The question should have been should I eat those things though?

  153. Perdita October 21, 2011 at 4:43 pm - Reply

    Dr. Kruse, what are your thoughts on ground flaxseeds and grapeseed oil?

    • Jack October 21, 2011 at 10:32 pm - Reply

      @Perdita Good question. I think flax is close to useless. I would rather see you eat Krill oil or marine fish oil. Flax provides us with a vegetarian source of omega threes that we are ill equipped to convert well. Grapeseed oil is an oil I rarely use or recommend but it does have a place in treating some who have already repaired their O6/3 imbalance. I have a few patients who have went too far on the omega three train and it has caused them some issues. Grapeseed oil can be a help in very selective cases. In people who are trying to restore oral health grape seed is very important. Grapeseed extract suppresses lipopolysaccharide-induced matrix metalloproteinase (MMP) secretion by macrophages and inhibits human MMP-1 and -9 and can be helpful in dental decay and restoring periodontal height. Many newer toothpastes are beginning to come out with green tea and grapeseed extracts because of this. I usually recommend that diabetics change from a fluoride toothpaste to one of these newer ones that uses antioxidants to block MMP's.

  154. Perdita October 22, 2011 at 2:44 am - Reply

    Thank you, Dr. K.

    About the 50g protein BAB. Would you say a petite (5'0") woman, 24 BMI, 6 lbs from goal, be able to get by with a lower protein amount?

    • Jack October 22, 2011 at 3:29 am - Reply

      @Perdita You can try to back it down……..but given your info you posted here I doubt you are truly leptin resistant now and you may not require the reset if that is the case. If you are an HCG user and you are worried about gaining after using the HCG to get down…….the reset may help you maintain until you transition to a full paleo or primal template to completely retrain your hypothalamus to optimal

  155. Perdita October 22, 2011 at 4:46 am - Reply

    Yes, I am an HCG user. I wondered if I was still leptin resistant…or if maybe the HCG made me resistant. This is my 2nd round of HCG…after my 1st round (lost 18 lbs), my weight was stable for 2 months, but then I started eating poorly again and gained 8 of it back. I gain very easily on the SAD, especially as a petite, and still have some belly fat. I was hoping the LR would help me to maintain or even slim down more. Thank you.

  156. Imma October 22, 2011 at 7:52 pm - Reply

    Dr Kruse

    Question: I have a BMI of 18.2. You mentioned on a MDA thread that you've never seen anyone who is LR with a BMI under 20. Would I still get any benefit out of following the LR protocol? I would love to have more energy and feel less hungry during the day (without gaining weight).

  157. sarah October 22, 2011 at 9:37 pm - Reply

    Okay.. Should I eat goat cheese? raw cheese? grass fed sour cream? coco powder? flax seed? Im a "thinner" LR … 5'4 140 pounds.. but I have the symptoms of LR

  158. Jack October 22, 2011 at 10:47 pm - Reply

    @ sarah. I cant say for sure. You can figure it out with a cheap glucometer from walmart.. Its not that hard

  159. Jack October 22, 2011 at 10:48 pm - Reply

    @imma. You could try it because it wont hurt you. But doing some IFing might help too.

  160. sarah October 24, 2011 at 1:50 am - Reply

    Okay. So it is 25 carbs period. Or 25 NET carbs..? Or 50 carbs…. Confused!

    • Jack October 25, 2011 at 2:09 am - Reply

      @Sarah depends……on the reset we want it to be as low as possible so NET or TOTAL matter little.

  161. sarah October 25, 2011 at 12:59 pm - Reply

    Okay. Thank you. Do some people experience constipation? I feel its because im not eating as many veggies as I was on "paleo with snacking" an suggestions?

  162. Jack October 25, 2011 at 4:16 pm - Reply

    @sarah. Yes it happens but rarely lasts long. I use magnesium and coconut oil in the transition period. I also try to optimize vitamin D at this point as well.

  163. sarah October 25, 2011 at 4:39 pm - Reply

    Okay, Thank you SO much for all the responses!! What kinda of Magnesium? I feel it gives me a stomach ache!

  164. Perdita October 25, 2011 at 5:51 pm - Reply

    Dr. Kruse, with fish oil/krill oil for Omega 3–what levels of EPH & DHA are we aiming for? Some capsules have a high EPA/low DHA, others are opposite. Are there any specific brands you recommend?

  165. Maria October 26, 2011 at 2:57 pm - Reply

    Hi Dr. Kruse:

    I have started your leptin reset regime and after 1 week it has made a bigger difference in my sleep than anything else I have tried over the past 3 years. I am hoping that this will help reset my thyroid. Here is my story.

    After my second pregnancy I found a thyroid lump about the size of a golf ball. I was 39 years old. The doctors told me they would watch it for the time being since all the thyroid test results were perfect, with an excellent TSH of 1.5. Subsequently I stumbled upon a story about the Atkins diet and how it improved blood lipids. My family has a high incidence of cardiac death, to I tried it, and as reported, my triglycerides were normal for the first time in my life. I've never been obese. I did need to loose about 30 lbs after the pregnancy, and this came off easily on Atkins. I was back to my high school weight of 103 lbs on a 5' 1" frame. Over the next year I was healthier than I had been since I was a child. I also started working out and felt great. In the mean time I had a biopsy for the lump and was told it was inconclusive. The awful endocrinologist told me that she could send me to a surgeon who would say take it out, or one who would say leave it in, it was my choice. I was shocked, and decided to go with a surgeon who I knew to be very skilled. He unfortunately turned out to be of the "take it out" variety. So out came half of my healthy thyroid. The path report showed that the lump was an unremarkable neoplasm. And here my ordeal begins.

    The surgeon put me on synthroid. But, I was never able to find a dose that made me feel as well as before surgery. I would limp through the fall until I realized that maybe I needed a top up, and then in the spring feel hyper and need a dose reduction. This went on for 3 years and then in the fall of 2007 I felt like I needed a top up and ended up with frightening palpitations. I then went to my family doc and asked her if perhaps I should go off the synthroid completely to see if my own thyroid could recover, since I had read that many people with a hemithyroidectomy are able to make enough t4 with the remaining half. She agreed and I went off of it. I felt not too bad for the next 8 months, and then in September I started having severe hypo symptoms. Mental fog, feeling cold, constant hunger, weight gain, colds that lasted 4 months at a time, and worst of all insomnia. I tried going back on synthroid, but even the smallest dose caused palpitations and other symptoms of hyperthyroidism. The past 3 years have been misery. I tried everything in the way of diet and supplements. I tried increasing carbohydrate, that resulted in a quick weight gain and no improvement in symptoms. In fact, I suspect my excellent low carb diet is the only thing standing between me and morbid obesity at present. I tried iodine, minerals, etc. The only thing that gave me a small edge was the addition of vit D at a dose of 10-20 000 IU per day in the non summer months. Instead of getting by on 2-3 hours of sleep, I was able to get 4-5 hours of interrupted sleep. This at least allowed me to keep my job. My TSH 8 months after going off synthroid was 12, it has slowly come down to 4. Incidentally, I went to see an alternative doc 2 years ago, who ran salivary cortisol levels and they were very low. So I suspect that the problem is endocrine disruption from going off the synthroid cold turkey. My gut tells me that a simple reset is required which is why I was intrigued by your site.

    The biggest change I have made so far, based on your recommendations, is to eat most of my calories in the morning. I get my protein from 3 eggs, with sausages, or bacon, cooked in generous amounts of lard and butter, and a scoop of whey containing about 25 g of protein. I don't have any sugar cravings so I'm not worried about using whey. I avoid carbs until lunch and then only eat small amounts low glycemic fruits and veggies. I don't expect that I exceed 40 g of carbs on most days. After being on the Atkins diet for the past 9 years, carb cravings are a thing of the distant past. The last 3 nights I have been able to sleep 8 hours per night with only 1 or 2 interruptions. This is a huge improvement.

    So my question is, do you think your protocol may eventually reset my thyroid function as it does in your leptin resistant patients (given my inability to eat carbs at present I'm sure I'm leptin resistant), and given my history, is there anything that you think I need to do in addition to your recommendations that might help? Also, should I try to do weight training and a little cardio, or should I hold off. Any suggestions to speed up the process would be greatly appreciated. I thank you for sharing your wealth of information. And please excuse the very long letter.

    • Jack October 27, 2011 at 12:10 am - Reply

      @Maria I think the ketogenic Leptin Rx would work well for you. Try it out for three months and check your labs and see how you do. If it works you found your answer…..if you have to tweek it a bit your labs will tell you that as well.

  166. Grizz October 26, 2011 at 6:13 pm - Reply

    For those interested in WHY Dr. Kruse talks up Coconut Oil so much, here are the answers:


  167. Regina October 27, 2011 at 2:05 am - Reply

    I have been following your Leptin Reset Protocol for my phase 3 (hcg diet). I just found out I am pregnant, should I continue with the Leptin Reset or pick it back up after the baby is born.

  168. Regina October 27, 2011 at 2:06 am - Reply

    I am in phase 3 of the hcg diet following your protocol. I just found out I'm pregnant, can i do the Leptin Reset while pregnant?

    • Jack October 27, 2011 at 2:20 am - Reply

      @Regina I see no reason why not and I have had several friends and family do it when pregnant. I think you need to stop HCG if your pregnant……just my two cents. Good Luck on the baby and make sure you get your Vitamin D up!!!

  169. Maria October 27, 2011 at 11:52 am - Reply

    Thanks Dr. Kruse,

    Do you recommend any exercise over the next 3 months or should I hold off until my TSH normalizes? And if so, what kind of exercise?

    • Jack October 27, 2011 at 2:50 pm - Reply

      @Maria I dont have enough info to make that call. You can try it and see the result and draw inferences to those results. I make it pretty clear that exercise is a no no until you start to see some clinical markers that leptin fxn is back in the game.

  170. sarah October 27, 2011 at 6:21 pm - Reply

    Is egg white protein powder (jay robb brand) acceptable for consumption on leptin reset? Or for someone with hashimotos?

    • Jack October 27, 2011 at 6:47 pm - Reply

      @Sarah OK for you maybe, but its not optimal for me and therefore I would not eat it.

  171. sarah October 27, 2011 at 7:23 pm - Reply

    Okay. Thanks! Also.. is coconut flour OK? Im thinking more about after the reset for the egg protein and coconut flour 🙂

    • Jack October 27, 2011 at 10:21 pm - Reply

      Sarah….no to coconut flour during reset. I have eaten it twice and i just see the point so i cut it oit totally.

  172. sarah October 28, 2011 at 1:36 am - Reply

    Thank you!

  173. Kristina October 30, 2011 at 9:13 pm - Reply

    Hi Dr. Kruse,

    Are you saying that reverse T3 issues are always and only caused by LR? Or can one have RT3 issues but not be LR or the other way around?



  174. Jenna October 31, 2011 at 6:16 pm - Reply

    Dr. Kruse,

    I have Grave's disease, and I had a total thyroidectomy 6 months ago. Since then, I have been fighting my weight. I have gained about 20 lbs since the surgery. Recent labs show that I am not converting well from T4 to T3. I fired my endocrinologist because he said that with a TSH of 4.41 (range .45-4.5), none of my symptoms could possibly be thyroid related because my TSH is "in range." I am now seeing a family doc who will consider Armour or Cytomel but wants to wait and see how my new dose of Synthroid works out. Anyway, I am definitely LR, and I am wondering if becoming LS will help convert T4 to T3. Is there anything else I can do to help that conversion? Or should I just push for a thyroid hormone replacement that contains T3?



  175. Maria October 31, 2011 at 8:28 pm - Reply

    Hi Dr. Kruse,

    You mention that anaerobic excercise just before going to bed at night helps you fall asleep. My problem isn't falling asleep, it's staying asleep. Would weight lifting just before bed help with night waking as well?

  176. Starlene October 31, 2011 at 9:42 pm - Reply

    Dr. Kruse, are we supposed to count net carbs (total carbs minus fiber carbs) for the day's total? I'm trying to stay under 25 grams and with 1.5 cups broccoli am already at 20 unless I figured the net carbs. Thank you!

  177. Lexi November 2, 2011 at 1:32 am - Reply

    hi Dr. K, some people are using lipodrene to lose weight fast. Is this going to hurt my thyroid or adrenals if I take it for just 30 days? I'd like to get the last 10-15 lbs off fast and then do the reset. thanks.

    • Jack November 3, 2011 at 12:33 am - Reply

      @Lexi I have no experience with lipodrene but I would suggest you do some due diligence and search them out with www.

  178. Jenna November 4, 2011 at 5:40 pm - Reply

    Dr. Kruse,

    One more question. I am a mom of young children who don't sleep well at night. I am about 2 weeks into the leptin reset, but I am wondering if getting up at night with them is making it more difficult to reset. Along the same lines, I have talked to many other moms of young kids who say that for years after their kids start sleeping through the night, they continue to wake up overnight. Is this cortisol disregulation, possibly from years of having interrupted sleep?



  179. Linda November 6, 2011 at 11:43 pm - Reply

    Dr. Kruse, what are your thoughts on ph levels (alkaline vs acidic), and how it relates to diet and optimal LS?

    • Jack November 6, 2011 at 11:56 pm - Reply

      @Linda These processes biochemically are tightly regulated and it rarely a cause of suboptimal. The acidic/basic argument is a big myth.

  180. Fara November 7, 2011 at 1:18 am - Reply

    Dr. kruse,

    I have been diagnosed with delayed gastric emptying. Is there anything I can do to speed things up? I have terrible trouble with bloating.

    Thank you

    • Jack November 7, 2011 at 2:14 am - Reply

      @Fara have you and your doctor spoken about CCK? IF not you might want to google it and discuss it with them. You might consider some replacement bile salts and pancreatic enzymes too.

  181. Jamey November 7, 2011 at 5:26 am - Reply

    Dr. Kruse is it imperitive to quit smoking? I smoke organic cigarettes and I don't smoke huge amounts but I really like to smoke half a cigarette and put it out. It makes me feel good. How important is quitting smoking for leptin resistance reseting? I have quit for 3 years at a time and 2 years another time. I can quit fairly easily but I come back for the feeling.

  182. Fara November 7, 2011 at 2:35 pm - Reply

    Dr, Kruse,

    No we have not discussed CCK, but will now. He has ordered a Hida Scan. Useful?

  183. Jack November 7, 2011 at 3:28 pm - Reply

    @fara if they are talking hida scan beware…….i see a missing gallbladder coming.

  184. Jack November 7, 2011 at 3:31 pm - Reply

    @jamey yes it is. I wont even talk optimization until smoking is eliminated from the clinical picture. Changing your diet is a waste of time if you are smoking.

  185. Fara November 7, 2011 at 7:26 pm - Reply

    Oh oh. Dr. kruse. Nothing is going to be extracted from this body. I like to keep all my parts and pieces. Thank you for your response.

  186. Luke November 7, 2011 at 8:55 pm - Reply

    Dr Kruse,

    Thank you so much for your website and for the research you have done into this topic, and for sharing it so freely – you are a true champion of good health.

    I have been on the Leptin Rx for since Friday last week (this is my 5th day).

    So far so good on most fronts, and whilst a challenge to get all of the BAB down, I have managed a couple of days with over 60gms of protein – the first time I did this with ~67gm protein at ~6am , I didn't have to eat until 4.30pm – and I made that a combined dinner and lunch.

    I do have a couple of questions/concerns so far, and was hoping you may be able to assist? I have read the FAQ section and other posts, but couldn't find the answers I need (hopefully I haven't missed some important post – if so – my apologies)

    First issue is sleep. I used to struggle to get to sleep, but then struggle to wake up – needing to set two alarms, and even then being so lethargic that I hating getting out of bed. My issue now is I seem to be falling to sleep OK, but then waking in the middle of the night, well before my 8 hours. I usually fall asleep again, and then wake up pretty refreshed – and no issues getting out of bed – and this was after only 2 days! I'm obviously happy about the energy levels I have, but would like to sort out the waking in the middle of the night. The last two days I have been trying to watch the sunset, turn out all lights after sunset (with noTV/PC time after sunset) and also getting up and going to my rooftop to watch the sun rise (I live in Australia – so we have summer time approaching now – so early sunrises and very late sunsets). Problem is I am still waking, last night I woke after only 3 hours sleep. Any tips? Or is this just a matter of time? If it is a matter of time, when should I expect to see this resolved, as you indicate that sleep is one of the first things to resolve during the Leptin Rx?

    Big question about breakfast – you say to "east breakfast within 30 minutes of waking" – sorry to be pedantic – but does that mean "start to eat breakfast within 30 minutes" or FINISH eating breakfast within 30 minutes? Also – does waking mean out of bed – or first awareness of not being asleep – as sometimes 5-10 minutes can go there?

    At the moment – getting 60gm+ into me is taking about 20 minutes to eat – and I'm a slow cook, so overall, it can be 25-35 minutes from when I first realise I am awake – to getting up, cooking and starting to eat. With the 20 odd minutes to eat – that is taking me to 45 -55 minutes since first realising I'm awake. Am I taking you advice TOO literally – or is this sort of variance OK?

    Finally, how strict is the 4-5 hours between dinner and sleep? I am finding that turning out all my lights after sunset, I don't want to do much other than go to bed (the bedroom is the only place to do anything in total darkness). Again, am I taking the turn the lights out too seriously? Is it OK to use a reading light for a book, or is candle light OK?

    Once again – apologies if I have missed these answers, or if I am taking things to literally – I have tried to read all the posts I thought were relevant, and as many answers as I could. I feel amazing after only a few days, and despite the fact I know it is mostly water weight so far, I have lost 3.7kg (8.2lbs) in the last 4 days and as such I am trying to maximise this experience and perform the best possible Leptin reset I can – so your advice, if you have the time to respond, would be appreciated.

    Thank you once again.

    From your Number #1 fan in Australia.


    • Jack November 8, 2011 at 2:30 am - Reply

      @Luke regarding sleep……give it some time for your hypothalamus to under go some neuroplasticity. Regarding the breakfast timing. Try to eat and finish it in the window if possible. If you fall outside it by ten minutes or so you wont screw the reset up. The 4-5 five hours before sleep is as important as the BAB. It should be axiomatic during the reset.

  187. Jamey November 8, 2011 at 1:01 am - Reply

    Can you elaborate? Why is changing your diet if you smoke a waste of time? Certainly it must make a difference.

    • Jack November 8, 2011 at 2:27 am - Reply

      @Jamey All disease is based upon inflammation generation. Smoking generates massive amounts of inflammation and this is why smokers have some of the lowest levels of anti oxidants measured in the body. It is also precisely why smokers have higher risks of most of the neolithic diseases we see in humans. Generally, when you have a problem you go after the most significant risk factor first before tackling choices two and three. Smoking is the number one risk factor in neolithic disease in my opinion and should be dealt with first.

  188. Luke November 8, 2011 at 7:26 am - Reply

    Hi Dr Kruse,

    Thanks for the reply – I really appreciate it. I will definitely try and finish my BAB within 30minutes, but as per your advice won't stress if a few minutes over – as that would just raise my cortisol levels!

    I will also ensure my last meal is 4-5 hours before sleep.

    If you don't mind me asking some follow up questions – both out of curiosity regarding the science and in terms of practical implementation?

    1) Is the 4-5 hour between last meal and sleep related to the 4 hours of darkness needed to allow the conversion of serotonin to melatonin? Or are they separate processes?


    2) On the making the room as dark as possible post sunset, when you say "as dark as possible" – is it still possible to have some light in order to facilitate staying up for the 4-5 hours between the last meal and sleep (as staying up for 4-5 hours in complete darkness is tough).

    Whilst this second question is related to practical implementation, for me it is more out of curiosity as I am lucky that I am starting my reset as the days are getting longer in Australia. Hence I could eat at 6.30pm, sun would set at ~8.00-8.30pm, and then wouldn't need to darken my room for another hour at ~9.00-9.30pm (as per your Leptin Rx), and that would only leave 1-2 hours in darkness before sleep.

    I guess I am wondering for others, and I'm curious – IF I had started your Leptin Rx in winter, when the sun may already be down by the time I eat, would the Leptin Rx require someone to spend the 4-5 hours post meal in darkness (without any other light source) before sleep?

    Thanks once again.


  189. André November 9, 2011 at 6:36 pm - Reply

    Dr Kruse,

    A question on the protein. I once read that the body can take up max 30 grams per meal. So I thought it was best to spread my protein intake over 3 meals. I can go without lunch; no cravings. But is a 2 meals a day protocol optimal for building/maintaining muscle mass?

    Btw; I love this site. And I am mailing it to all my friends here in Holland.

    • Jack November 11, 2011 at 2:13 am - Reply

      @Andre Honestly I have never heard this and it is utter nonsense.

  190. MimiDiet November 10, 2011 at 6:44 pm - Reply

    Dr. Kruse–AWESOME stuff. Just shared your website with my natural (tho board-certified) dr's assistant, who is all excited. I THANK YOU for your ground-breaking, body-healing work.

    That said, I noted EMT's comments regarding your need for a basic proofreader, and would be very happy to help (of course, for free).

    My email is listed (concealed) with this post; if you're interested, please contact me. I can provide either simple correction (spelling, punctuation, wrong-word-right-spelling corrections), or something deeper (e.g., you used a new term you didn't define–can you explain?).

    It would be an honor to help with your wonderful site.

    • Jack November 11, 2011 at 1:59 am - Reply

      @MimiDiet several of my readers have edited the content but I have been too busy to put up the corrected copies. I am a busy guy. Im sorry to hear that the spelling and grammar really bother you so much. I post these as I write them and maybe some of you are correct that I should not do this and proof them. I post them to get the info out. All will be edited eventually.

  191. MimiDiet November 10, 2011 at 6:49 pm - Reply

    (E.g., you do the science, & let someone else worry about the minutia.) 🙂

  192. Maria November 11, 2011 at 2:08 pm - Reply

    Hi Dr. Kruse:

    I wrote you a couple of weeks ago. (please see post #223 above). After 1 week my sleep had improved greatly, and for 2 weeks I slept better than I had in 3 years, but this past week has been awful. I wake up around 2 am and can't get back to sleep unless I eat carbs. It is the only thing that works. When the sleep deteriorated, I started experiencing quick weight gain. Also I think the reason I wake up is due to hot flashes which have started this past week both during the day and more frequently at night. Is it possible that this is still all part of the adjustment? I am optomistic since one great improvement has been that my joint pain is lessend. Is it possible that this is a serotonin deficiency. You mentioned taking 5HTP. How much and at what time of the day should I take it? Also, are there any other supplements specifically recommended for sleep. I am also having trouble with not eating 4 hours before bed. By the time I get to bed I am so hungry that I can't fall asleep, let alone stay asleep. It doesn't seem to matter how much I eat during the day. Thanks again for your help.

    • Jack November 12, 2011 at 5:36 am - Reply

      @Maria the hypothalamus does not reset in a straight line. Give it some time. You did not get out of whack in a few weeks nor will you get to optimal in a few weeks.

  193. MimiDiet November 11, 2011 at 4:09 pm - Reply

    Jack…I am so grateful for the posts and am not "bothered" by them at all. If some others are, I would have been glad to help, but I see that you already have help. You are so busy!!! and we only appreciate that you would take the time to blog & help us. Perhaps someday you will have an assistant who can do all those things that you don't need to or have time to do. 🙂 Till then, I'm happy reading your posts & learning a lot. THANK YOU for all you do, in spite of your busyiness.

  194. MimiDiet November 11, 2011 at 4:10 pm - Reply

    I mean busy-ness. lol, I need a proofreader.

  195. Maria November 11, 2011 at 4:29 pm - Reply

    Hi Dr. Kruse,

    One more question. Would it be possible for you to post a typical 24 hr meal plan that you would put one of your patients on when they are first starting the leptin reistance reset, both the 3 meal and the 2 meal version, for us to get a better idea of what we should be aiming for. I understand that as the program progresses that this will be individalized for each person by their own dietary needs, but I presume that to start off, we will have to eat exaggerated meals until our leptin levels rest. Thanks.

    • Jack November 11, 2011 at 11:08 pm - Reply

      @Maria I would tell you to contact @grassfedgirlsf on twitter…….she has done this and she is a rockstar.

  196. carmelite November 11, 2011 at 6:56 pm - Reply

    Dr. Kruse,

    I have been attempting the Primal diet, a la Mark Sisson, on and off for several weeks now. I also made a brief attempt to do your Leptin Reset. I have had major problems with both due to symptoms of hypoglycemia.

    About me, briefly: I have had hypoglycemia symptoms for as long as I can remember (dizziness, emotional crashes, nightmares, sudden intense hunger, sweats and chills, nausea). Symptoms generally onset rather quickly 1-5 hours after my last meal, and resolve only when I eat again. Symptoms have always been worse a week prior to my period. I have been an athlete (martial arts) and at a healthy weight most of my life, but since having my son 15 months ago, I am still about 30 pounds overweight. I have always been able to manage my hypoglycemia symptoms in the past by making sure to get fat and protein at every meal, and by eating frequently (usually every 3-4 hours). Since becoming pregnant, though, the symptoms have worsened. I now have to eat 1-2 times in the night or else I will wake up from a nightmare in a cold sweat, dizzy, and feeling sick and paradoxically foggy brained and hyper-alert. All symptoms go away as soon as I eat, and I am able to sleep again. All attempts to go low-carb have worsened my symptoms somewhat, and doing the reset was impossible. I just couldn't last between lunch and dinner or through the night without severe crashes. Right now I am eating a higher carb version of Primal, consuming only squash, sweet potato, berries and veggies as carb sources. This works for me, but I still have to eat in the night, and I'm worried about whether I will be able to lose weight this way, and also whether there is something going on hormonally that I should be examining more closely. Other details that may be important:

    1) I have had irregular menstrual cycles for much of my adult life. They are regular now since giving birth.

    2) I have had extreme menstrual pain until giving birth (menstrual pain almost as severe as labor pain). This was controllable if I took Naproxen at very first onset of symptoms.

    3)I have low blood pressure.

    4) Tracked my menstrual cycles for awhile and took my basal body temp. It was consistently low.

    5) Even though I am 30 pounds overweight (5'4" and 165 pounds), my body fat is only 28%. I have always been densely muscular and found it easy to build muscle (made my male friends envious).

    6) I am still breastfeeding my son.

    7) My son still wakes me at least once in the night. I've tried every possible method to change this, so far, it is intractable (it's better than the 8 times/night he used to do, though). I nap most days in the afternoon with him to try to make up the sleep. Still, I haven't had a full night's sleep in 15 months.

    8) I have been eating the diet recommended by the Weston A. Price Foundation for about 6 years now. More carbs than Primal, but plenty of good fats, high quality proteins, and very little sugar, fruit or junk.

    9) I have great skin, hair and nails, no overgrowth of body hair, and generally good mood unless I am sleep deprived or in the middle of a blood sugar crash.

    10) I am a full time student (nursing) and my husband is a massage therapist. Money is tight and I have no health insurance. I would love to see and endo, but don't think I can afford to.

    I imagine you would recommend a number of tests. Is there a way to narrow down what I might need so that I can try to pay for it? Is there a least expensive way to go with this? I realize this is important, but right now I'm choosing between tests for me and winter clothes for my son and a working vehicle for my husband to get to work.

    Sorry this is long. Thanks you.

    • Jack November 11, 2011 at 11:19 pm - Reply

      @carmelite I think since you are still nursing just keep doing what your doing. I think you should eat primal and not WAPF exclusively. I think Raw Dairy is OK but I doubt you can get it. When you get in a better position I think then testing is where you need to go but your not that far off based upon what you posted. I think you need some tinkering both nothing too major. I am getting ready to launch a post next week on what someone might consider after the Leptin Rx reset. I think this maybe right up your alley based upon your question so stay tuned.

  197. carmelite November 11, 2011 at 6:59 pm - Reply

    Oh, also, other than needing to eat in the middle of the night for the past two years, I have never had problems with sleep, and generally wake up refreshed. My chronotype tends towards night owl (I feel most alert in the evenings and prefer to sleep a bit later), but not intractably so. I wake up with the dawn now with my son, and have gotten used to it, although I still often get a burst of evening energy.

  198. carmelite November 11, 2011 at 7:14 pm - Reply

    Oops! Also, I'm 31 years old, female, married with one son.

  199. MimiDiet November 11, 2011 at 10:25 pm - Reply

    I get it, I get it!! This is a doctor's BLOG, not a doctor's official website, per se. (That changes the unconscious expectation completely.) This is a presentation in process, public while still taking form, in order to get the information out to the most people in fastest possible way. 🙂

    Some would leave it private until completely done, then put it into a book that costs $$$…BOTH of which would limit the scope of those this information touches. That would decrease its ability to reach both doctors and the patients who direct their doctors here (I have), directly limiting its impact by keeping it off the net until "perfect!" While your thoroughbred-racing mind leaves us in the dust at times (and I do have a science background, but it's been a while), you do a great job of answering questions re: application and various particulars. It still amazes me that a brain surgeon takes the time to personally answer so many questions.

    Kudos to you for blogging it all out there, Dr. Kruse, free of charge, to challenge both medical professionals and patients alike.

    I do expect (& hope) that a book is coming, but the internet is such an immediate and available source that I hope you keep these posts coming online, too.

    • Jack November 11, 2011 at 11:21 pm - Reply

      @MimiDiet People need help and my job is to help. I offer what I can do here to answer people in the hope that they will pay it forward to other people. I also am hoping people who get help from me will turn their doctors on to my blog so we can slowly change healthcare for the better. That is my ultimate goal. I need people like you to help me do this. Copy a blog and give it to your doctor when they don't appear to get something and its connection to your case. I have been contacted by over 150 doctors since I began blogging 4 months ago. This one fact makes me very happy. That is my goal. It is my contribution to the paleo/primal community. One doc at a time. These docs will then be able to help a lot of people. I can only do so much. We need more docs to realize how deep the science is behind evolutionary medicine.

      For people who want more I will be available for private consultation on a very limited availability that will be scheduled in advance. My time is at a premium and I know some people want more but I will have to charge for that kind of personal time.

  200. Dave November 14, 2011 at 1:11 pm - Reply

    …another "thanks Doc!" story here.

    So I'm approximately two, well maybe closer to three months into my own LeptinRx here (down with some slight personal modifications). Started noticing some real changes about three/four weeks back. Medications that I've been using suddenly started becoming too strong.

    Some background, I've suffered from some sort of 'unlabeled' hypothalamus/pituitary dysfunction for the last twenty years or more. Things got really bad around the time I hit age 30 (bulimia/binging — over-exercising/dieting…).

    After ten years of countless medical testing and trials, I started taking Cortef at age 40. Did that for about 15 months, switched to pregnenolone, added some thyroid (T3 and T4), added some DHEA, a bunch of supps, etc…Things were functional but not great.

    Anyways, about a month back I started noticing the meds were getting increasingly strong. October 30th I decided to take a gamble and stop the pregnenolone use. After a bit of a rocky week making the initial adjustment, my body (ACTH) seemed to stabilize and things really improved.

    Then suddenly I started feeling really hyperT from the thyroid meds. Partly attributed to the lower cortisol (from removing the preg) I'm sure, but it was a drastic change none the less. The feelings got increasingly stronger last week, so Saturday I decided to roll the dice again and drop the thyroid meds too (2.5 grains ERFA and 30mcg T3).

    The result, well it's only been two days, but I really feel fantastic! Almost like I had never needed the meds in the first place. Blood pressure is holding steady at 115/60 — 55bpm (compared to readings like 90/50 — 40bpm three years ago). Blood sugar is a tad higher than some would like (fasting is usually 5.1), but I've had none of the reactive hypoglycemia episodes, no post-meal/post-exercise dips down into that 'shaky' 3.5 range. Moods are stable, my outlook is bright — thanks Dr.K!!


    Another happy LeptinRx'er that's looking forward to more of your blogging…Dave

    • Jack November 15, 2011 at 12:02 am - Reply

      @Dave These are the kind of comments that tell me I am doing something correct. I am quite happy to hear this. Stay tuned for tomorrow or Wednesday blog on the Leptin Rx postscript…..what to do after a successful Leptin Rx reset.

  201. Cowboy November 14, 2011 at 3:15 pm - Reply

    How long should it take for the leptin reset to have an effect on weight loss? I have been doing it strict for three weeks (no screw ups) and fairly strict for the previous 3 weeks (some late evening dinners (8:00 PM)) and some tea with cream a few times between meals. Before starting the leptin reset I was ZC to VLC for approx 8 months and lost 60 pounds. I stil have 50-60 to go, but I have dropped not a pound in the last 5 weeks. Eating too much??? Eating too little fat??? I don't think either. Will something happen soon? I assume I am not the only one with some concerns about the lack of results scale wise. I do feel god with no cravings, good energy, and good sleeping, although my wife complains about the dark room. Is there something that should be done differently for some of us>

    • Jack November 14, 2011 at 11:49 pm - Reply

      @Cowboy It all depends upon your inflammatory levels and how bad your hormones are disordered. Most (68% of population) take 6-8 weeks. If you fall outside them it can take longer. This was covered in the Leptin FAQ's blog.

  202. Kristina November 14, 2011 at 6:20 pm - Reply

    Hi Dr. Kruse,

    Sorry for posting this again. I wasn't sure if you saw my question or not. Are you saying that reverse T3 issues are always and only caused by LR? Or can one have RT3 issues but not be LR or the other way around?



    • Jack November 14, 2011 at 11:36 pm - Reply

      @Kristina……. no I am not saying that. Many other conditions can drive a reverse T3 higher. This is why a doctor and testing are required for more confounding clinical presentations. The most common cause of Rev T3 in America today by far is LR due to Obesity.

  203. hanna November 14, 2011 at 7:12 pm - Reply

    I started the LR on the 2nd this month of November. I am so impressed that I finally got a hold of my hypoglycemia! Before that I'd have to eat all the time and then crash. Eating primal and doing the LR has stopped my hypoglycemia! Yayyy!!

    I am not overweight, but would love to shed some fat from my thighs. Yesterday I stepped on the scale and my weight which had been down to 154 was up again to 156. I was mad! Got frustrated and ate half of a cheesecake… after dinner had popcorn and a coke. I was not even hungry! OMG, I paid for my mistake! Immediately got insomnia! I remember when started LR that I'd get sleepy early at night. Is there a connection? I think so. Eating bad, between meals = bad night of sleep. But where is my weight loss?????

    • Jack November 14, 2011 at 11:35 pm - Reply

      @Hanna Of course sleep and metabolism are yoked. I have written blogs about this on this very site. Search them out. As for your weight loss the Leptin Rx is clear on this…… depends upon how much underlying inflammation or hormonal issues underlie the problem. Without testing there is no way to guesstimate. This is why I advocate testing. I will say this though…….if you cant afford to test stay on the Leptin Rx until you see all the things I mentioned in the Leptin FAQ's. Once you reach them………Read my next post on how one should consider eating the rest of your life after the Leptin Rx reset. I will be posting it tomorrow or Wednesday before I go on a much needed vacation.

  204. Luke November 15, 2011 at 1:13 am - Reply

    Hi Dr Kruse,

    I understand you are busy, and doing this in addition to your regular work. I also noticed you are about to take some well earned vacation time.

    I did post a couple of curiosity questions earlier – but no biggy if you cannot address those.

    I am now on my 12th day of my Leptin reset. I have been pretty damned strict with it, even attending a wedding on the weekend, and not drinkning a sip of alcohol and ensuring even ensuring I only ate the protein and fats and green vegetables etc, leaving the potatoes and not even touching the desserts. Only issue that evening was I was not able to be in darkness within one hour of sunset.

    My issue is you say not to worry about calories, but I have been using a calorie tracking website to ensure I am getting at least 50gms of protein in my morning meals as well as ensuring I am staying low carb (as I am more than 30lbs overweight – and new to the primal/paleo diet, so need to get my bearings).

    Issue is – according to this site, the total calories I am eating is only about 1500-1700 (one day was 1900 – but I forced it). I am not hungry per se, but I am feeling hungry at around the 5 hour mark between meals, and it is far from unconfortable.

    Now I am currently 104kgs/229lbs (down from 109kgs/240lbs when I started)… which is great, but according to most BMR calculators, I need at least 2500 calories per day (sedentary) – 2950 calories per day (light activity 1-3 days per week).

    I am worried – will eating such a low amount of calories impact my Leptin Reset?

    My first week loss was 4.2kgs/9lbs, but this week the breaks have slammed on so to speak, and I have lost only 0.8kgs/1.8lbs so far… is this due to the too low calories? Is this sending signals that I am in starvation mode?

    I do have some ketones in my urine, which would suggest my body has more than enough energy, and is excreting excess – but this may be independant of the hormonal signals occuring?

    Hopefully you get a chance to answer this? Can you eat too few calories during the reset, even if you are not hungry and seem to be in ketosis?



    • Jack November 15, 2011 at 1:31 am - Reply

      @Luke……great question. I suggest you immediately go read the blog how does the leptin Rx work. It works because I am using visceral exercises of your mouth, gut, eyes, and your incretin hormones to force neuroplastic change onto your hypothalamus. YOu said your self you are about 2 weeks in. In anything in life when you are trying to change…….do you see optimal results when you are in the process of change? No. Why? Because adaptation occurs slowly. Think about evolution……does it happen fast or slow to a humans consciousness? Slow……correct. But what if I was to tell you that the higher we go on the phyllogenetic chain of life evolution actually works faster than it does on say yeast. Its true. I promise you just stay on the reset. All those BMI calcualtors are based upon real faulty assumptions. If you are not hungry on 1500-1700 calories why are you caring? The reset is meant a temporary reset to your hypothalamus. Go read The blog post again……its not about a permanent way to eat. That permanent way to eat……once a reset is done and complete…… my next blog that I will release right before I go away. I promise you it will open your eyes wide and you will understand better at how the brain can be reset using neuroplastic change. Most physicians and researchers have no clue about neuroplastic change. Neurosurgeons use it all the time in several operations. The Leptin Rx is brain surgery without a blade………or a co-pay or insurance. I want you to learn how to become optimal and share it with your friends and family and your doc. I want you to show the doctor how you did it. And then we can change medicine for real.

      You said, "Can you eat too few calories during the reset, even if you are not hungry and seem to be in ketosis?"

      This is the essence of the reset. These conditions must be met to allow neuroplastic change. You just got a big clue.

  205. hanna November 15, 2011 at 8:04 pm - Reply

    Yayyyyy!!! Doctor Kruse replied my post!!! (doing the happy dance!)

    Doc, I have printed about 50 pages of all your posts here on your website and am devouring them! I am just impressed that by going back to my LR in just one day my sleep pattern is back! Awesome!

    And I don't feel my hypoglycemia anymore! Free of all those thousand meal a day and crashing afterwards! I feel like I've found the fountain of youth!

    Thanks doc! I probably have a lot of inflammation going on, but I want to stay on LR for a life time!


  206. hanna November 15, 2011 at 8:11 pm - Reply

    Is anyone doing the LR here interested in keeping in touch (email or facebook) to encourage each other? I'd love to have a leptin buddy!

  207. CrystalM November 15, 2011 at 8:33 pm - Reply

    Dr. K – I was diagnosed with diabetes back in September 2011 and made it a point to tell my doctor I did not want to go on medication, but rather get rid of the problem. Not only does diabetes run in my family, but I am obese. I knew it was not only genetics that got me here, but my lifestyle. He put me on a low carb, high fat/protein diet. My sugar levels immediately got better, but I was not losing weight. When I expressed my frustration he gave me your Leptin Rx. Since then I've noticed a major difference in the way my clothes fit at lost 10 lbs in one month. So I am a definite believer. I have made your website a daily habit and am beginning to comprehend (although slowly as I am a newbie to the science)how all of this works.

    My question is, if I follow the leptin rx to the end, will this assist in eradicating my diabetes without the need for medication? My sugar/glucose levels are usually under 120 and often in the low 100s.

    Can't thank you enough for opening my mind to a new way of living.



    • Jack November 16, 2011 at 2:31 am - Reply

      @CrystalM your post made my day and its been a long one! May I ask you your doctors name and city? I think that is way cool and shows that docs are reading and liking what they are seeing. Regarding your main question after you successfully complete the Leptin Rx you should move on the Leptin Rx postscript blog. I should have it loaded later tonight or tomorrow in the AM.

  208. Elle November 15, 2011 at 9:36 pm - Reply

    I am going to try the leptin reset, and I think you have answered this somewhere but i cannot find it. I currently exercise in the mornings, i am female and as of late, i have been doing heavy weight lifting. Will this completely negate my efforts if I follow everything else? I do not want to stop exercising if I do not have to, and evening is not ideal as it is less likely that I will do it. But if I need to stop for now in order to make progress, or if i absolutely must switch to evening, I will. Please advise or point me to where you have answered this. Thank you very much.

    • Jack November 16, 2011 at 2:27 am - Reply

      @elle If you are going to do the Leptin Rx you can do exercises when you start to see the small positive wins outlined in the Leptin FAQs blog. IF you are already LS you might want to read my next blog post……..because it may really change the way you look at life and exercise timing.

  209. Luke November 16, 2011 at 9:43 am - Reply

    Dr Kruse,

    Thanks for your reply. You are correct – I am being impatient… I want to reverse what tools years in a better of weeks damn it!!! haha

    Thanks for pointing out the big clue… I read the post you pointed me to, which I had "read" before, but obviously in my haste to devour as much as I could, I did not comprehend last time (2 days after finding your site I started on the Leptin Rx).

    I definitely want to stick to this, and I know I will be successful with it (change your thoughts as you say).

    By the way, on telling my doctor (or other doctors), I USED to work in the Pharma industry in sales, and most recently in marketing – in fact in my last role I was responsible for launching the DPP4 inhibitor sitagliptin (I won't post the brand name) in the Australian market, so I have some familiarity with the incretin system and it's function… anyway I am starting to digress…. What I wanted to say is, I know a thing or two about communicating and promoting concepts/ideas and information to medical professionals, and I would LOVE to assist you if you have any need or desire now or in the future to actively promote your theory and the Leptin Rx to other medical professionals, in particular primary carers at the front line.

    The reason I joined the pharma industry is I truly believe good health is a fundamental human right, and the reason I left is I got the feeling that whilst the industry started with that mission, along the way, a large swathe of it has lost that focus and mission. Don't get me wrong… the industry still does great things, and I am sure a decent amount of the science you have referenced for your quilt was funded by pharma, so it isn't all bad… just not as good as it could/should be… I guess it may be like the feeling you have for the medical profession in some way?

    Anyway – Your aim to change the medical profession is needed, and it is not just the profession, but the related industry around the profession, like pharma, insurers and even regulators. I was trained and coached within an inch of my life to be the best I could be at influencing the opinions, beliefs and attitudes of medical professionals, with the aim to turn that into a behaviour – i.e. a certain treatment choice for their patients. If you are interested, I would be honoured to use those skills, knowledge and experience for the betterment of human health (which is why I learnt them in the first place) in any way I can.

    Of course I fully understand, appreciate and respect if this is not the sort of approach you wish to take to spread the word about your work and to encourage others to use it in their practice, and I also recognise you may in no way need my assistance, even if you did want to take that sort of approach. It is simply an offer.

    I absolutely looking forward to your next post on what to do AFTER the Leptin Rx.



    • Jack November 16, 2011 at 2:13 pm - Reply

      @Luke much like you perceived I learned a lot from the work of many big pharma trials. Amgen's synthetic leptin trials being point one. And I think you would be wise to use your skills in helping others learn to help themselves. I was invited to collaborate with the founders of the AHS to come up with a talk on how to build a new paleo healthcare delivery system. SO if you have any ideas…….lets collaborate. Contact me at I would also love for you to participate in AHS 2012 or consider coming to PaleoFx in Austin, Tx in March of 2012. Contact my friend Kevin Cottrell here or on FB to get the hook up. We need people who want to help others change our world.

  210. Luke November 16, 2011 at 9:46 am - Reply

    wow – "I want to reverse what took years in a matter of weeks damn it!!!"

  211. CrystalM November 16, 2011 at 10:52 am - Reply

    Dr. K – I'm glad to have brought a little happiness to your day. My doctor is Dr. Rakesh Patel out of Gilbert, AZ.

    So if I continue with the leptin rx until the end and then start the postscript my diabetes should be on it's way out of my body (so to speak)? That is my ultimate goal. I can't wait to read it!

    Thanks again!

  212. Kristina November 16, 2011 at 12:14 pm - Reply

    Thank you for clarifying. I am not obese but have chronic Lyme disease. I was under the impression that chronic infections can drive up RT3. Mine is ok right now because I am on Cytomel but would eventually like to switch back to Naturethroid (or get off thyroid medication completely).

  213. LSseeker November 17, 2011 at 6:47 pm - Reply

    Hi Dr. K,

    From what you've said about adrenal fatigue "it depends on the severity of the condition, as most are tied to cortisol issues." What kind of cortisol numbers would you consider severe? What adaptogens do you use for your patients? Thanks.

    • Jack November 18, 2011 at 7:33 am - Reply

      @LSS Salivary cortisol levels are assessed and I also use the DHEA to cortisol ratios. In people who are really off sometimes DHEA is so low I have to use their sex steroid to help. Everything is customized to the patients labs and symptoms.

  214. Sarb November 18, 2011 at 2:24 pm - Reply

    Hi, Thank you so much for sharing all your knowledge with us all, Its really nice of you. I have been reading about fitness/fatloss/health for the last 10 years and what you have written has really taken me back, it makes so much sense!!! Thank you again. I've been sharing this information with anyone that can put up with me talking about it!

    I have a few questions though.

    1) Is it ok for me to eat 2 meals per day. I eat the first at about 8-30am and the second at 7pm, i go to bed around midnight.

    2) I've got to go out drinking 3 weeks into the reset, do i start again, i really don't want to but it's my friends stag do and he would kill me dead if i didn't!

    3) Can i eat cheese or does the lactose count as carbs.

    4) I use a SAD light around 5pm when i get home from work, does that affect the circadian rhythm?

    Thank you so much again for everything.

  215. Lauren November 20, 2011 at 9:25 pm - Reply

    I've been reading up on your Leptin RX for over 7 weeks now, and was very excited to try it when I went into yet another P3 of the HCG Diet. I have had difficulties stabilizing my weight after each round (3 times)…therefore, I keep losing and gaining the same weight over and over. Each time, I have reached my goal weight, but can never keep it there even though I have followed the protocol to a "T" and have stayed away from all starches and sugars. So, I was super excited to hear about your Leptin RX because I felt that this might be just what I needed to fix my leptin resistance, which I'm assuming is my problem. I have been overweight all of my life…diets never seemed to work, and then finally was able to drop 75 pounds through a doctor-run medical fast about 7 years ago (which I'm sure probably screwed up my metabolism even more). I was basically able to maintain that weight through obsessive exercise, calorie counting, and eating healthy, but was never able to drop the final 15-20 pounds to get me at my goal weight. That's when I tried HCG. I dropped the weight with no problems, but keeping it off has been practically impossible. This last round I decided to start your Leptin RX on day 1 of P3 to see how I would do this time with stabilization. I'm completely frustrated and feel like a freak-of-nature because instead of maintaining or even possibly losing, I'm gaining the weight back again! I have been on your plan for 4 1/2 weeks now. On a positive note, I have experienced less hunger throughout the day eating the 50g or more of protein in my BAB each morning…being able to skip lunch and just have dinner around 6pm. I also seem to wake up without my alarm clock and feel more refreshed and not as tired. I've been keeping my carbs below 25g(veggies & coconut manna…but no fruits,starchy veggies, or night shades)and eating plenty of Nutiva's coconut oil. I've already gained back about 10 out of the 15 lbs. I lost. After reading most of everyone's posts on here, I haven't seen anyone else gaining like I have been. The stress is obviously causing my cortisol levels to go up which doesn't help matters. I did not have any lab work done before starting because I was almost certain I was LR and had a feeling my doctor wouldn't allow the testing I needed, but now I'm going to really push my doctor on it. If that doesn't work, I guess I'm going to have to find the money to get the tests done on my own. I'm going to be asking for the Reverse T3, HS-CRP, Saliva Cortisol Levels, and cholesterol (LDL, HDL, Tri). Given how my body is reacting so far, do you have any other tests that you'd recommend me ask my doctor to run? Or, if my doctor won't run the lab work on the above tests, which ones are crucial for me to get done if I have to pay for them out of my own pocket and can't afford them all? I'm a 5'3" 39 year old female. I was diagnosed with hypothyroidism at the age of 21 and went on synthroid. About 2 years ago, I convinced my doctor at the time to put me on Armor Thyroid instead because I felt like even though my ranges were in the "normal" range, I had a feeling something was still off. My menses is very erratic…sometimes months go by without getting it (it's been that way for 7 years (ever since I lost the initial 75 lbs.). I'm sorry I have written a novel here, I am just so boggled by my body and I thought maybe you'd have some good advice for me. I'm so glad that your work is helping so many people out there and I hope that I can be someone to help spread your work to the many doctors out there that need to be enlightened by all of this great research you've done. Thank you.

    • Jack November 26, 2011 at 9:13 pm - Reply

      @Lauren it is pretty common post HCG to gain……on a reset but it will go away if you remain persistent with it.

  216. Algomagirl November 20, 2011 at 10:11 pm - Reply

    I am psyched to begin my reset tomorrow but am wondering if I need to modify anything due to my 'pacemaker' I received two years ago? My BFF is a huge successful fan of LR and I'm next !!

  217. Owl November 21, 2011 at 9:03 am - Reply

    Hanna, a bunch of us have a leptin reset thread on Mark's Daily Apple site:….

    It's huge, but has lots of good info. Join us.

  218. LSSeeker November 26, 2011 at 10:50 am - Reply

    Dr. Kruse,

    I just listened to the Joanne podcast. So good.

    You've mentioned "My favorite is the HS CRP (highly sensitive C-Reactive protein) and the reverse T3 tests (but there are others)." What numbers do you look for to determine LR with those two tests?

    I'm getting empowered to use my doctor to get what I need done. She works for me. So what if she doesn't like it. Hopefully as I change, I'll be one of those patients she keeps thinking about.

    • Jack November 26, 2011 at 8:30 pm - Reply

      @LSSeeker Honestly it depends upon the clinical context of the patient and what I am treating and what other testing has been done. Generally speaking I want the rev T3 levels and HS CRP as low as possible,

  219. kim November 26, 2011 at 11:15 pm - Reply

    Hi Dr. Kruse

    I posted about a month ago and I have some questions that are probably pretty basic, so Im happy to be steered to places if you have already written about this. So here goes.

    How can eating bigger meals and only 2 myb 3 meals, help restore metabolism. Im not a professional in this field at all so Im sorry this is so basic, but all the history and trainers/nutritionists say to eat like 4-6 smaller meals throughout the day? And then there's the whole thermogenic industry and green tea etc. Its kinda crazy out here knowing what to believe. I know thats probably so old school but thats what is still being talked about.

    Also, Im someone who did Hcg and wish that I hadnt, luckily I only did 1 short round, but Im wondering should I get lab work done, like thyroid or these other tests you talk about or just go by some of your guidelines. I lost weight with hcg, 10-15 lbs and gained it back. I have not started your reset yet, I tried one day about 3 weeks ago and had a horrible reaction to coconut oil, and got terribly sick for a few days because I didnt know that was what was causing the problem. So Ive been kinda wary and just eating mostly primal/paleo but also eating about 4x a day. Just trying to sort through this body stuff and feeling frustrated. I love to exercise, love to run and do yoga and so Ive recently tried to incorporate HIIT sprints and weight training. I know if Im LR then Im not supposed to exercise yet, but it does feel good to my body, so Im learning and trying to be open. Thx for any thoughts you have

  220. Lauren November 27, 2011 at 1:13 am - Reply

    Hi Dr. Kruse,

    Thanks so much for answering my post. I hope you enjoyed you well-earned time away. I'm going to keep the faith and continue on with the reset even though the weight gain is causing some major panic. I really want to be one of the many people that your plan has already helped to turn unhealthy, unbalanced bodies back into the healthy and well-working machines that they were meant to be! I know there is no exact time frame you can give me, especially given you don't have any lab results on me, but do you have any insight of when I might see the gaining stop and begin dropping it again? I've been on the reset for a little over 5 weeks now. Is there a point when the weight gain has just gone way too far and I will need to take another approach?

    After my doctor read my lab requests she sent me an email telling me she is sending my requests to an endocrinologist for review to see if they think these labs are something I should receive. Not sure if that's a good sign or not…what do you think? I'm really hoping it's not just a way they plan on turning me down. If she feels I should make an appointment with an endocrinologist, would they have more insight and the ability to recognize the red lights from labs that you recommend? Thanks for any thoughts you might have.

  221. Nico November 29, 2011 at 1:28 pm - Reply

    Dr.Kruse i'm allready paleo for some time now and i want to start LR restart program, but one thing i'm concerned about is ph balance. LR diet seems to be very acid forming(high protein, high fat, no fruits, litlle veggies), so i'm affraid, that this may deplet body's ph buffering minerals like calcium and this may lead to osteoporosis in the long run. i don't eat dairy, except butter(ghee). so maybe one on LR diet should add some calcium or drink distilated water with lemon juice? i think ph meter also would be useful for monitoring salivary and urine ph. or do you think there is nothing to worry about? thank you very much.

    p.s. sorry, my english is far from perfect.

    • Jack November 29, 2011 at 4:03 pm - Reply

      @Nico I have zero worries about Ph balances unless you have kidney disease with a paleo diet or a leptin reset

  222. Jack November 30, 2011 at 8:52 pm - Reply

    @Holly awesome……keep me informed of how the journey goes.

  223. Jack November 30, 2011 at 8:56 pm - Reply

    @Holly If you have not dove deep into my blog you wont know that Mg is coupled to ATP production. Without energy biology breaks down tremendously. It is the master key to understanding the entire process. The leptin hormone is the proxy for how energy efficient we are. If Mg is low you likely have a leptin issue. Since you have a collagen vascular disorder I would suggest you begin baths three times a week with epsom salts and supplement with magnesium malate every night. It will help a lot.

  224. holly December 1, 2011 at 9:19 am - Reply

    hi jack!! i am trying to absorb, no pun intended! all of this information, it is a wealth of info. for awhile i couldn't think or read more than a paragraph at a time, im still struggling. my serum magnesium is the 2.0 range and has been for awhile but my rbc magnesium is still low, not out of range low. i will try the baths. thank you

  225. Lauren December 4, 2011 at 1:12 am - Reply

    Dr. Kruse,

    I apologize for bothering you again, but I wanted to get your feedback on some of the lab results I got back. My doctor would not do the Reverse T3 or the Salivary Cortisol test (only the morning blood test after taking steroid pill the night before), and was only willing to do TSH, Free T4, T3, Glucose (fasting), Lipid panel, Calcium, and HS-CRP. I'm hoping it's ok to share my numbers with you because I'm quite taken back by a few of them. The most jaw-dropping is my Cholesterol. My TC has always been under 200, my HDL usually in the 50's & 60's, & my Triglycerides would from 62-97, but my latest numbers have gone extremely high (or low w/tri). Now my Total cholesterol is 367, HDL is 198, LDL is 163, and Triglyceride is 28. What in the world is going on?! My good "HDL" is crazy high, my bad "LDL" is high, and my triglycerides are really low. I've been eating BAB (often a form of red meat) and lots of coconut oil & coconut butter. My carbs are usually under 25g coming from vegetables (no fruit). Eating 2 meals a day…still gaining. I've finished my 6th week on the reset.

    My TSH is 3.03, Free T4 0.8, T3 (true) 44, HS-CRP 0.9, glucose fasting 92, and I haven't gotten my cortisol results back yet. Given what I've already told you in posts #295 & #305, do these numbers raise any red flags for you? I know I'm probably going to have to go to an outside lab to pay for additional testing, so what do you see being the crucial ones that I get done first? I appreciate any thoughts you might have.

  226. Lauren December 4, 2011 at 1:37 am - Reply

    So sorry…it double posted. Whoops!

    • Jack December 4, 2011 at 8:06 am - Reply

      @Lauren First things first……paleo patients do not get biohacked with CW medicine. That is an epic fail. Your Lipid profile is ridiculously great for a paleo girl. In fact one of the better ones I have seen. Now for the some tongue lashing, (LOL) YOU DONT NEED A DICTOR TO GET REV T3 OR SALIVARY CORTISOL LEVELS!!! you can get the Rev T3 from and the salivary cortisol levels from

  227. […] can be followed by the clinician or the patient.  Those clinical signs are outlined in the Leptin FAQ blog post.  In doing this,  we force the neurons to see neurochemical signals that radically confuse the […]

  228. MzTiny December 4, 2011 at 11:16 am - Reply

    Dr. Kruse,
    Thanks for this fascinating info, which I am devouring and digesting with my first BAB this morning. I do have a question that I haven’t seen answered here: I had Graves disease 26 years ago, and had my thyroid completely ablated with radioactive iodine. Since then I’ve been on varying doses of Synthroid (.75 to 1.25), depending on the current status of my yo-yo dieting. Over the past couple of years I’ve dropped 70 pounds through low-glycemic dieting under 1500 calories, with no carbs except veg, fruits, oatmeal and Ezekiel bread, and have kept it off for several months. My lipids are good (HDL 74, triglycerides 64, LDL 160 but extremely “fluffy” per a special test I requested my doctor get when she wanted to put me on statins, which I refused to take), and I’m within 7 pounds of my goal weight. For the past several months my weight has been absolutely STUCK, and I can’t budge it even with a VLCD (on homeopathic HCG). I’m wondering whether this relates to my thyroid condition, and whether I can ever hope to again eat a “normal” number of calories for my 67 yr old, 5′ 8″ female body? Or have I completely ruined what’s left of my metabolism with all this low calorie, low carb stuff? I am tired of dieting!! I want to relax and enjoy food, even if it’s limited to Paleo, which I don’t have a problem with. I’m terrified that if I increase my calories per your Leptin RX I’ll start climbing right back up in weight, which would really suck! Many thanks for any insights.

  229. MimiDiet December 6, 2011 at 12:29 pm - Reply

    Dr Kruse…what about urine changes that are more like you've been eating asparagus (but haven't) with an unpleasant twist? I've been half expecting a bladder infection to become evident from this, but it's been weeks and no change. Is this typical? I assist the SPCA so am quite familiar with a litter box smell & this isn't it. 🙂

  230. MimiDiet December 6, 2011 at 12:32 pm - Reply

    (So odd to post something so personal!! lol…but in the quest for answers & in the hope it clarifies something for others, too.)

  231. MimiDiet December 6, 2011 at 4:10 pm - Reply

    I suppose it could also be any of the supplements I take…pretty much everything on your paleo supplement list, plus B complex & extra B5 & probiotics.

  232. Syl December 7, 2011 at 10:38 pm - Reply

    i love flax seed oil on my raw veggies, I can live without thou if i have to, Dr. Kruse, is flax seed a no no?

    • Jack December 7, 2011 at 11:11 pm - Reply

      @Syl Its not a no no……its just useless to humans because we dont not convert the parent omega 3 ALA well. You do better with DHA and EPA as we have that machinery and use it well. If you rely on ALA from flax like most vegetarians do they should also know that the rate of conversion is directly tied to dietary omega six consumption. The higher it is the less ALA you convert. And the vegan/veggie diet has a high omega six ratio……6-10-1 is usual. It makes no sense when you understand the biochemistry. Flax can increase estrone production and this can help estrogen dominant women but there are better treatments. Flax wont hurt you but taking flax is like making expensive urine to me.

  233. Syl December 8, 2011 at 11:07 pm - Reply

    thank you so much Dr. Jack. you rock!

  234. PattyLA December 13, 2011 at 10:04 pm - Reply

    I've got two questions.

    I started following the leptin reset a couple of weeks ago. I have been on T3 only medication for a few months for a reverse T3 problem. Prior to that I was on naturethroid for several years. I am finding that I need more T3 now than I did before I started the reset. Is this common? I'm also having lots of detox symptoms which I wasn't expecting. Esp after 2 years of the GAPS diet.

    Also my 7 year old is hypothyroid and has adrenal fatigue both are being treated with hormone replacement (naturethroid and isocort). I have started to offer her as much protein as she will eat first thing in the morning and when she eats a good big breakfast, she stays full and isn't constantly asking for snacks. But she won't do it every day. We already follow a very low carb paleo type diet (GAPS) and have for 2 years. She (and I) have chronic Lyme disease making everything a bit more complicated. Anyhow I'm wondering how to make this work for a child. She is at a very healthy weight and is very strong and solid but still needs to be on thyroid medication and adrenal support. She seems to benefit from the BAB but I'm not sure what else from the proticol might be beneficial. I'm not sure about insisting on only 3 meals a day, for example, for a child her age.

    Thanks for making this info available for all of us to learn from and apply so generously.

  235. suncountry December 14, 2011 at 5:24 pm - Reply

    On RX for 2 full days. Eliminated Dairy, Nuts, and Nightshades from my Paleo diet. Where can I go to find out what to cook? I'm looking for recipes for things I typically use to spice them up – cheese, tomato based sauce, sour cream etc.

    My eggs are bland without my nightshades. And I'm missing my paleo pizza and chili…

    Many thanks!

    • Jack December 14, 2011 at 5:53 pm - Reply

      @Suncountry there are tons of great paleo cookbooks. Soon I will have them all on my site and I will have my own e cookbook of my concoctions. I cook like a primal madman.

  236. suncountry December 14, 2011 at 6:06 pm - Reply

    @Jack It seems each recipe I have calls for Dairy, cheese or tomatoes of some kind. : (

  237. Chris December 16, 2011 at 11:51 am - Reply


    Thanks for the time and energy you put into this and every other forum you monitor and post on.

    I've been on your reset for about a month and am noticing a definite INCREASE in abdominal fat. I wasn't in bad shape when I started (5'9", 168 lbs, maybe 20+% BF), but it's all about becoming optimal. I was a low-carb paleo IFer before and like some of the changes I'm seeing – new ability to eat BAB, no hunger until well into the afternoon, great sleep. I am, however, worried about the fat gain. I've gained nearly 10 lb, much of which is lean body mass but I can definitely see the love handles getting bigger.

    Should I stop or keep on keeping on?

    • Jack December 16, 2011 at 9:53 pm - Reply

      @Chris It is quite normal to gain some weight on the reset initially. If you go on the monster MDA thread you will find that some of the biggest supporters and eventual losers had the same experience. It will come off once you reset your hypothalamus. I gained 19 lbs in the first ten days and then lost 77 lbs in 3 months during my own reset. And if you are gaining that much belly fat you might have an underlying cortisol issue that is causing a sex steroid problem…….because the sex steroids control LPL the enzyme that dictates where fat is laid down in certain body areas. YOu might look into getting a salivary test done soon……

  238. Mart December 18, 2011 at 5:33 am - Reply

    I have been on a LC diet for 10 weeks and LR for 2 weeks. A few weeks into the LC diet my fasting blood sugar started rising. At the beginning of the LC diet it was between 90-104, now it is consistently 110-114.

    I googled this and not sure how to interpret that. Should I lower the diet fat content?

    Cardiovascular and Hormonal Aspects of Very-Low-Carbohydrate Ketogenic Diets. Jeff S. Volek* and Matthew J. Sharman. Obesity Research (2004) 12, 115S-123S; doi: 10.1038/oby.2004.276

    The very slight and short-lived rise in LDL–and it is very slight–12 mg/dl in the study described by Diabetes in control–is nothing to be afraid of. By six months into the diet it will be gone in most people, replaced by a better cholesterol profile.

    The only people who may not experience this improvement are the very small number of people with diabetes who, because of some specific genetic issue, are very fat sensitive. You can tell if you are one of them because if you are, when you eat a low carb diet for six weeks your blood sugar will go up, not down. This is very rare. I have heard from two people over the past five years who experienced it.

    • Jack December 18, 2011 at 6:52 am - Reply

      @ Mart I went through the same thing 5 yrs ago and by 12 months it was gone. we must allow the liver time to adapt to the new hormonal response. Once this response is set it will alter epigenetic switches in our genes that respond to diet we eat consistently

  239. Mart December 18, 2011 at 10:41 am - Reply

    I am glad I asked. It reminded me that my body doesn't come with a switch :-). It will take some time to get optimal!

  240. Jackie December 21, 2011 at 3:42 pm - Reply

    I had many early wins on the reset – improved skin, return of dreaming, less hunger, no more carb cravings. Now, after 8 weeks:

    + I am now waking up before the alarm goes off and am ready to get out of bed. Instead of dragging and feeling like I need to have a cup of coffee to perk up, I'm just ready to go. I think making the effort to go catch the sunrise has been the biggest thing that has helped me in this regard. I think the adaptogens are making a big difference the rest of the day.

    + My fasting blood glucose level has dropped to 80s (I started the reset in the low 100s). I return to fasting level 1 hour after eating low carb meal. I return to fasting level 2 hours after eating meal with small sweet potato covered in fat.

    + Mood has improved significantly. I am a different person in stress and when dealing with other people's B.S. Even after hours of one or both 2 year olds doing that terrible two thing I dont' lose my cool.

    + Sex drive is back. YIPPEE!!! And even though my cycles were regular before the reset I can tell that the way my hormones are working through the month are changing.

    + Before starting the reset the week before menses I would run a fever and have flu-like symptoms – that didn't happen this time.

    + Mental clarity is improving and I have much more energy through the day.

    + I've lost 30 lbs

    + I have done 3 sessions of body weight exercises with no soreness…

    Sounds like it's time for the HIIT.

    But I still feel like I have a lot of improvement – homones, energy level, weight (still need to drop 90lbs), possibly still some gut healing.

    My understanding from going back and re-reading (blog and thread on MDA) is that at this stage one should begin transition to the Post Leptin Rx. For me, that would mean adding in the carbs in the morning as we move away from winter solstice and getting the exercise in during the afternoon. As one continues the 'lifestyle', hormones, energy level, weight loss, etc. will continue to improve over the next 1 to 2 years?

    Do I have this right?

    Oh, and correcting meal timing for my son who is almost 3 allowed me to get him out of our bed and sleeping through the night in his own bed. Amazing! It took about a week but now he's been sleeping in his bed with no problem for weeks.

  241. Mart December 23, 2011 at 9:46 am - Reply

    Dr. K! I started sweating with a light physical activity like never before. This is a good thing, right?

    Merry Christmas to you and your family! God bless you!

  242. becky December 26, 2011 at 11:11 am - Reply

    i have decades of exerperience with no carb, low carb, high protein, ketogenic, gaps, etc.

    i have to do very low carb, cause i'm very insulin resistant and overweight.

    they r great! but i am always VERY constipated on them. does the coconut manna help that?

  243. becky December 26, 2011 at 11:26 am - Reply

    thank you for sharing your amazing knowledge.

    i oil pull for 20 minutes as soon as i wake. during which i will be preparing breakfast. so i will start to eat 20 minutes after waking. do i need to stop eating in 10 minutes? in order to be finished eating in 30 minutes of waking? or maybe i should skip the oil pulling til after my leptin is reset?

    happy holidays to u and your's

    • Jack December 26, 2011 at 5:44 pm - Reply

      @becky Its hard to say without more info but without any data I would say I would oil pull after breakfast because of the effect of CD36 in the mouth as a leptin sensor for fats.

  244. Sass December 27, 2011 at 2:45 pm - Reply

    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.

    • Jack December 28, 2011 at 6:15 pm - Reply

      @Sass this is covered in the Leptin FAQ's blog.

  245. Sammi December 27, 2011 at 4:14 pm - Reply

    Ok…New Year's approaching….hubby is doing LR & is "pretty strict" with himself. Is a half glass of champagne ok for LR? Also, I'm doing a more slower LR as I'm not overweight and a vegetarian. I have nuts,eggs,cheese at breakfast for protein. Is there hope for doing LR as a vegetarian? We are GAPS diet duo also and trying to combine the two…it's pretty challenging. Thanks!

    • Jack December 28, 2011 at 6:15 pm - Reply

      @Sammi sure its OK……its just not Optimal. If you're a vegetarian/vegan you have hope that one day you will realize that you can change and become the optimal person you were born to be. On vegetables alone a human is by definition sub optimal. I have so many patients that used to be vegan and vegetarians for the wrong reasons. One of them used to watch me buy 50 lbs of meat routinely at Whole Foods and try to council me. Then after 5 times I handed her my card and she came to see me as a patient. She is not part of the Dr. Kruse's Krewe of Karnivore………and she looks and feels amazing. Its your choice what to eat. But the science is crystal clear on what constitutes optimal.

  246. Evalinda December 28, 2011 at 4:06 pm - Reply

    Dr. Kruse,

    I started to take coconut oil a week ago and getting stomach pain. As I'm not allergic to anything and have no diseases whatsoever this kind of reaction was really upsetting me.

    I also experienced a little headache, cold and hot flushes. Could this be Herxheimer's reaction (I so hope it is…not intolerance to coconut oil) ?

    • Jack December 28, 2011 at 6:00 pm - Reply

      @Evalinda yes or it could be a bad CO loaded with an aflatoxin. I only used Nutiva or TT for this reason.

  247. Evalinda December 29, 2011 at 4:07 pm - Reply

    I'm using organic unrefined cold pressed extra virgin co from but will try Nutiva. Thanks a lot.

  248. Kristina December 30, 2011 at 6:57 am - Reply

    Hi Dr. Kruse,

    I am about to get some blood tests and the doctor said I could add to the lab slip what I want in addition to what she ordered. On the lab slip there is a test called "hsCardiac C-Reactive Protein (CRP)". Is this the one you recommend. Wasn't sure since it says hsCardiac and not just HS.

    Thank you,


    • Jack December 30, 2011 at 4:27 pm - Reply

      @Krisitna It is the one.

  249. thomasina December 30, 2011 at 12:41 pm - Reply

    i am on day 50 of the reset. having most of the markers for the reset having been successful except sweating. i am reluctant to change my reset eating pattern since i have had no hunger or craving for anything since day one. what will happen if i continue eating this way? if i have to change my pattern to the post reset plan can i go back to the other style once in a while?

    • Jack December 30, 2011 at 4:23 pm - Reply

      @Thomassina Not sure but if you stick with it let me know! I'd be interested in the results.

  250. thomasina December 30, 2011 at 12:43 pm - Reply

    Becky, i continued oil pulling i just dont do it first thing. i do it whenever i can find the time and it still seems to have to great benefit on gums, etc.

  251. hanna December 30, 2011 at 1:05 pm - Reply


    I've been on Lexapro for many years now. After starting my paleo way of living, I'd love to be able to get off the antidepressant but I am truly scared! I am starting menopause what could make things trickier. I stopped the meds once and it came back with a vengance! Instead of 10 mg I needed then 20!

    MY QUESTION: I've heard about vitamins that can aid depression. What should I take to help me with this problem? If there is blood work that I should do, I'll do it. Please, just guide me on this.

    Thanks so much!

  252. Kristina December 30, 2011 at 7:09 pm - Reply

    Thank you.

  253. thomasina December 31, 2011 at 10:34 am - Reply

    thank you. i will soldier on. and let you know. i just love this. i will mention that my weight has started to drop. almost 5 lbs since Nov 10 but included 2 major holidays and some holiday parties wherein i did eat some carbs. i am an ex-hcg user thinking was going to do another hcg round this month but now i would rather continue this.

  254. Emilie January 1, 2012 at 8:45 am - Reply

    Hi Dr K,

    I have been reading your blog over the holidays, started the MAD monster thread, and just listened to your podcast with docfermento. Wow!

    I started the leptin reset yesterday. I am also doing GAPS/Paleo/LCHF eating. I can't thank-you enough. You are bringing so much good to the world.

    I have a few questions. First, I do amazing meditation CD's for an hour every morning right when I wake up. I am a single mom w/my 87 yr-old dad living w/me so I am extremely busy. So, I find if I do them right off before I get busy it is best for me. You say to eat within 30 min of "rising." If I wake up, get up to pee, then lay back down for an hour and deeply meditate (alpha-theta-delta brainwaves) will I mess up the circadian rhythms of the reset? I am certainly willing to do reschedule the CD's if need be while I do the reset but I would love to not need to.

    Second, is it okay to drink carbonated water/sparkling mineral/club soda w/or w/o lime/lemon between meals?

    Third, you say you now eat whatever you want. I'm assuming you are still eating pretty low carb or paleo or grain free, correct?

    Thanks so much for everything you've done and Happy New Year to you and your family!

    You are a wonder.



    • Jack January 1, 2012 at 7:52 pm - Reply

      @Emilie I would do the reset as I wrote it. USe the CDs some other time. As for how I eat now there is a full blog on that called After the rest how should one eat. Its the Leptin Rx post script. It is very detailed. I dont eat low carb all the time. When you read the blog you will see why this is the case.

  255. Johanna January 4, 2012 at 1:21 pm - Reply

    Hello Dr. Kruse,

    Before I started doing the reset I was on another weight loss protocol, I've lost 60 lbs and never regained. Part of it was a paleo type diet so it was perfect to lead into the reset. I started the reset on 12/24, and while I have trouble some mornings with the BAB I suck it up and have my BAB. I have some questions about all of it, bare with me 🙂

    I have found the protein intake I need to not get hungry at lunch time, it's 60g. Is it ok to get 24 of those 60g from Egg White Powder? The ingredients are egg whites, lecithin, stevia, aminogen, acesulfame. How about Meat Powder for shakes? Neither contain any whey protein or soy.

    If not, if I don't get my 60g and feel hungry for lunch, can I have lunch on a day like that, or would that throw off the reset if it's only once or twice a week?

    Also, I haven't gained any weight, which I read is normal for woman, but I have lost 1-3 lbs, gained them, lost them again. Is that normal?

    I've had trouble with bowel movements. It just seems like I'm not going enough for the amount of food I'm eating. Should I be going a certain amount of times during the week?

    I read that it usually takes between 6-8 weeks to become LS again, can you become LR again? Is it something that can easily happen?

    Those are my questions, sorry if you've answered them before, it's hard to read through 354 comments 🙂

    Thank you!

    Also, I enjoy your daily sunrise pics on FB, great way to start the day since I don't have that view.


    • Jack January 4, 2012 at 6:19 pm - Reply

      @Johanna How do you know your LR? what are you basing this on?

  256. Johanna January 5, 2012 at 8:08 am - Reply

    I wish I could say it's because my wonderful endocrinologists told me but sadly it's not. Process of elimination. I struggled with my weight and a variety of hormonal issues for about 10 years. Always been a healthy eater, exercised and continued to gain weight. In 09 my OBGYN told me I had PCOS and insulin resistance, which he said because I had cysts in my ovaries, amenorrhea, thinning hair and abnormal hair growth. Metformin and birth control didn't help. I went to an endocrinologist who after running blood work and telling me to eat 1500 cal/day and 2 hrs of exercise finally said "I'm sorry, you just have bad genes maybe you should try liposuction". The next endocrinologist found my testosterone, estrogen and ketosteroids were within normal range but my cortisol levels were high so he thought it was Cushing's disease then after more tests said it wasn't. He just kept ordering blood work and I never got an answer, to be honest I got tired of looking for doctors (went to 6 different specialists in 1 year).

    As a last resort since I figured I can't mess myself up any more than I currently am I did the HCG protocol to lose the weight. I finished my 2nd round on the 22nd and had been reading about leptin, the signs exhibited when someone is LR, problems associated with it and it all seemed to fit.

    I'd be more than willing to go to a doctor and have blood work done, etc., but it's just been such a disappointing experience that I figured I'd take my health into my own hands since I care more.

  257. JRW January 5, 2012 at 9:45 am - Reply

    I was diagnosed with sarcoidosis 20 yrs ago. Have had several flares over the past 3 years. Primarily pulmonary and arthritic issues but one bout of 6 kidney stones also. I have some CAD, 20-40% diffuse disease. They have me on lipitor which I am considering stopping.Have been reading Dr. Terry Wahls book, "Minding my Mitochondria" and Mark Sisson. I eat organic, wild and grass fed for about a month. I have noticed some improvement but would like further direction. Any suggestions? I find your work very interesting.

  258. Bob January 5, 2012 at 5:14 pm - Reply


    Forgive me if this has been asked… but does the Leptin Reset work for those who are, so to speak, "diet f*cked". I am a young, 20 year old male who was at a skinny fat weight in my mid teens… did alot of running, low fat whole grain diet, and lost a ton of weight (from 135 to 105 in a year… yeah, and I'm 5'7). One day it hit me how thin I was and I went on a binge eat everything in sight diet… gained all the way back up to 135 over the course of 6 months, mostly fat, a small amount muscle. I found paleo a year later and lost some fat and gained some muscle, now at 133 although less chubby and more musclar but not by a whole lot. Testoterone is higher now but still weak (300,400,500's depending on sleep really). I did low carb paleo for a year and it seemed to make things worse although I leaned out a tad. High carb paleo now, and I go through days where I feel and look way better but I still have some chub that is very apparent, yet still very little muscle… I think leptin is an issue for me since I hardly ever have a real appetite.. I just eat anyway. Is this wrong? Not really sure where to go but I know crash dieting is associated with low leptin levels.

    • Jack January 5, 2012 at 5:32 pm - Reply

      @Bob The Leptin Rx is not for you but the Leptin Rx postRx is.

  259. Carole Tallant January 5, 2012 at 12:06 pm - Reply

    You are a rare person indeed–brilliant, yet full of common sense! I hope you can help me with a problem that has plagued me for 10 years. I have a Morton’s Neuroma in my left foot that sometimes keeps me from day hiking in the mountains (my and my husband’s favorite vacation)and from wearing most shoes. It has gotten bad enough lately that I am reluctantly contemplating surgery even though I have read AWFUL things about the outcome. Do you have any suggestions other than the typical things such as wear shoes with wide toe boxes (which are impossibly hideous for a woman), low heeled shoes (which I’ve worn all my life), icing, and Advil (which I hate taking, along with any other meds.)? Thank you with your help with this problem.
    I SINCERELY hope you will write a book for laypeople. It is so vital.

    • Jack January 5, 2012 at 12:27 pm - Reply

      @Carol Tallant You will need to discuss one with your doc and one you can start alone…….The one you can start is 500 mgs of krill oil three times a day with 900 mg of curcumin twice a day. If you really want to step it up get your doctor to write a Rx for trental 400 mg twice a day. Trental destroys several inflammatory cytokines in our body that make nerve pain worse. You also need to get your 06/3 ratio below 3 to 1

    • Jack January 5, 2012 at 12:32 pm - Reply

      @Carol… confident that real people will like this book. Its written for you and not in spite of you

  260. Carole T. January 5, 2012 at 7:17 pm - Reply

    Dear Jack,

    Thank you so much for your suggestions for krill oil and curcumin for my Morton's Neuroma. I currently take 4 Carlson's fish oil capsules a day, plus I eat seafood fairly weekly. Should I stop the fish oil once I begin the krill oil?

    I will discuss the Trental with my surgeon and podiatrist. Just out of curiosity if those measures don't help, what do you think about the surgery for morton's neuroma?

    • Jack January 5, 2012 at 9:01 pm - Reply

      @Carole T It works best if you use the Krill oil in combination with the fish oil. I am no fan of Morton Neuroma surgery.

  261. Carole T. January 5, 2012 at 10:07 pm - Reply

    Dear Jack,

    Thank you so much for your invaluable help, not just for me, but for all the other people on this blog thread. I only recently discovered your website, so I'm just starting to read and absorb all your incisive information.

    • Jack January 6, 2012 at 7:09 am - Reply

      @CaroleT This is my job. Spreading real health answers using evolutionary medicine. Its the new paradigm of healthcare even if healthcare does not see it yet. I do and many of you seem to as well.

  262. sarb January 6, 2012 at 8:29 am - Reply

    Hi Jack, thank you for all the work you have put in this leptin diet, im spreading the word to everyone I know!!

    My issue is that I started leptin rx 3 days again and now i can't sleep. What can i do? I'm tired but can't nod off. I usually sleep like a log.

    Also I know i can't do cardio but what about lifting really heavy weights? I normally do 3 reps of 5 sets. Can i do this with the leptin reset?

    Thank you so much again.


    • Jack January 6, 2012 at 8:38 am - Reply

      @sarb can you yes……should you? You immediately need to go read the blog post why is oprah too fat and see if you can answer the should you question.

  263. sarb January 6, 2012 at 8:45 am - Reply

    Thanks, I will re-read it. But what about my lack of sleep? I normally sleep really well. Will it subside once i get used to leptin rx.

    Also i plan on using a SAD light in the morning to sync light levels to my BAB, its dark here in the morning in the UK.



    • Jack January 6, 2012 at 9:49 am - Reply

      @sarb go get your IL-6 or DHEA tested and you'll realize why you sleep sucks……DHEA correlates to poor sleep. Inflammation is why your DHEA craters and why you cant sleep……DHEA is linked ot leptin via the light cycles. Its all tied to together. Once you fix it it will get better. You want it yesterday but first you must take three steps backward to get back on to your optimal life path.

  264. Sarb January 6, 2012 at 1:35 pm - Reply

    Thank you again Jack, i will look into it.

  265. Nicky January 6, 2012 at 4:17 pm - Reply

    I am following the Leptin Reset perfectly. I just got off of my 5th round of HCG and lost over 60 pounds. I bought all of the supplements that you recommended and am taking them diligently. However, I am gaining weight. I have gained 10-15 pounds. What is my next step? Do I need to go get lab work done? My last blood tests showed that my hormones were normal; although, I do have PCOS. I would greatly appreciate your help. I love the schedule, eating and sleeping on the Leptin Reset. I know that I am not Leptin Sensitive as I still have many of the symptoms and have my entire life.

    • Jack January 6, 2012 at 11:36 pm - Reply

      @Nicky If you have PCOS I promise your hormones are not normal. I would tell you to stick with it.

  266. Carole T. January 7, 2012 at 8:57 am - Reply

    Dear Jack,

    If you have time, I have two follow up questions about the Trental, krill oil and curcumin you suggested I take for my Morton's Neuroma. 1) Should I continue to take them indefintely or should I stop taking some or all of them if the pain abates? (You should know I have taken most of your suggested supplements for years, including the Carlson's fish oil caps.)

    2) If they don't cause a lessening of the pain, should I consider the alcohol injections that I've read about? My podiatrist wasn't pushing them, but told me using them has resulted in him cutting WAY back on the MN surgery. By the way, he was most receptive and supportive of your advice about the Trental.

    Thank you again for your unselfish devotion to all your virtual patients. You are a gem!

    • Jack January 7, 2012 at 9:09 am - Reply

      @Carole T……I personally do not use alcohol injections any longer for peripheral nerves issues so you would have to lean on the podiatrist experience with that. You would need to stay on this stuff until you HS CRP falls below .2 and stays there.

  267. Nicky January 7, 2012 at 12:46 pm - Reply

    Thank you, I will stick with it; because as I stated previously I love the Leptin Reset schedule. Should I take your list of recommended labs and get those done with my physician? Do I continue taking Metformin? I know that I must have thyroid issues, because I am freezing constantly. I drink hot tea all day long to keep me semi-warm and I wear a ton of clothes (layers). Thank you so much! I appreciate your help and response to many of us that need fixing 🙂

  268. Renata January 7, 2012 at 3:02 pm - Reply

    Hi Dr. Kruse.

    Thank you for putting out this wealth of information for the world to see.

    I (female, 2 kids, 5,2'', 175 lbs) started the LR Rx 5 days ago. I eat what for me is a BAB, but photocalorie says I don't get to the 50 grams of protein. I don't get hungry until dinner and I don't snack either, so I think all is good.

    I have a question about your recommendation to shut all lights down 1 hour after sunset. Well, it's winter and here in Munich the sun is down at 5 pm these days. My kids go to bed at 7:30, my husband and I around 10:30 pm. Well, I can't turn all lights off at 6 pm, nor I would know what to do to stay awake in complete darkness between 7:30 and 9:30 pm. Is the LR Rx thought to be done during summertime? Any thoughts on that?

    BTW, I read all comments 🙂

    • Jack January 7, 2012 at 3:42 pm - Reply

      @Renata Its meant for every season. If you pay attn to the light cycles it will be the wind behind your sails. It's your choice.

    • Amy July 29, 2015 at 6:53 pm - Reply

      This is why many recommend using amber/orange bulbs on lamps you use frequently once the sun sets. You can also wear orange goggles and use only candle light after sunset too…
      I believe once you become fully LS you will naturally be tired when you’re supposed to regardless of the season and wake up when you should regardless of the season 🙂

  269. John Rhoades January 7, 2012 at 6:32 pm - Reply

    I guess I did my leptin reset before I ever heard of Dr. Kruse or leptin reset. 26 months ago at age 64 I was an overweight 245 lbs, 6'1'' male, with diabetes, high triglycerides and cholesterol, and general low energy. I decided Something Had to be Done.

    I cut calories to 1800/day and started slow jogging 3 miles/day, and studied the exercise and nutrition literature and blogs. This did indeed start lowering my weight but it took a lot of will power. It didn't take me long to run across convincing evidence that walking/sprinting was better than jogging, high intensity/low reps was best for resistance training (I had already been doing weight training to help fight diabetes), and that I should cut out grains, and replace most carbs with healthy fats. So my reset started in March 2010, at age 65, coincident with retiring from my job. The transition wasn't hard, although I had some minor problems with leg cramps that went away in a few months. My weight continued on down to 192 lbs but now without effort or calorie counting. My body fat percentage came down from 30% to 18%. I'm now stronger than ever in my life. After a year, I cut out the diabetes meds and Lipitor, and added a 5000 IU daily vitamin D tablet. I have no more signs of diabetes. Although my cholesterol measures don't please my doc, I think they are fine. My LDL cholesterol went from 46 (with Lipitor) to 130, but my small LDL-P is a satisfactory but not great 409, and still decreasing. My HDL went from 42 to 68. My fasting insulin is 3 (bottom of the scale), hs-CRP is 0.3, A1C is 5.7.

    I don't get hungry anymore and I seem to have boundless energy. I recently played poker with some buddies through the night till 8 am the next day. When the others broke for snacks at 2 am, I just had a splash of bourbon on ice. I was still alert and sharp when we finally quit. When I got home, I did a keto strip check and got a reading of 40 mg/dl (moderate according to the package label), and I still wasn't hungry. I won money, too. Not bad for a 66 year old fart playing with several 30/40 somethings.

  270. darc January 8, 2012 at 9:43 am - Reply

    Hi, Jack,

    I am a 53-year-old woman, 5'4", 195 lbs. In 2008 I started working out (women's bootcamp, gym classes like spinning, etc). I lost about 8 lbs that first year and that was in the first 3 months.

    In June 2009 I was introduced to Crossfit and, a few months later, I started eating Paleo. I went to the CF gym 5 days a week and from June to October I did not lose a single pound, though there were body composition changes…smaller belly and waistline slimming mostly. I never gained any true strength, though, I just got more skilled at moving (weights and myself).

    In early Oct '09 I injured my back (not at the gym) so my workouts came to an abrupt end, though I continued eating about 85-90% Paleo and, lo and behold, I started losing weight,1-2 pounds every 2-3 weeks. Mind-numingly slow compared to others I'd encountered at CF, but consistent. This continued through Dec, but by Jan, '10, the weight loss stopped. By then I was into the mid-to-high 170s.

    Since then my working out has been sporadic, at best, mostly at home, while my eating has fluctuated between "I'm gonna do this!" strict Paleo to "eff this I want pizza" and, of course, the weight crept back on. The only thing I can say is that if I hadn't been eating mostly Paleo I would probably weigh a lot more by now. Small comfort.

    In summer 2011 I read Taubes', Why We Get Fat and What to Do About It. Good stuff, I read it twice. The only thing missing was an actual plan of action. While it is a good read and nice to understand the mechanics, the biology of the process, I already knew how to eat that way and, even when I did it strict I didn't lose weight. I knew something had to be missing, at least for me.

    I found your site and FB page about a month ago. The main differences are that you focus on leptin instead of insulin (arguably a chicken/egg conversation) AND your direction about eating 50 grams of protien within 30 minutes of waking. This was something completely new to me and, I thought, might be the key…well, that and not working out in the mornings which is always when I did it (when I did).

    I started the very next day, and ever since have had pre-portioned servings of protien in my fridge ready for my early meal. But that presents its own problem and this is why I'm writing today.

    My sleep patterns are horrendeous. I sleep through the night not more than 1-2 days per week. The other days I awaken at least once and sometimes up to 5 times a night (restless leg syndrome is the biggest culprit but also racing thoughts), and most often struggle to get back to sleep.

    My concern is this: how meaningful can it be for me to eat that 50gs of protien 30 minutes after getting out of bed, when I've awoken several times previous to that? Have you encountered this situation and, if so, do you have any tips for overcoming it? I've suspected for some time that my sleep pattern may be at least part of the reason my body holds so stubbornly onto fat. Would you agree?

    I really need help with this but, please note, I do not want to resort to taking sleeping medication. I do sometimes take herbs (valerian, et al) and they work for a few nights but then the effect wears off, so I use them only about once or twice every few weeks. I've also used a homeopathic for the restless legs, which worked very well for several years, but just in the last 2 months seems to not work at all anymore.

    I'm exhausted and getting really miserable, and fat, in spite of sticking to Paleo. Can you help?

    • Jack January 8, 2012 at 11:26 am - Reply

      @darc…….read my latest post… might see a light bulb go off.

  271. darc January 8, 2012 at 11:31 am - Reply

    Jack, is that your latest blog post? date & title?

    • Jack January 8, 2012 at 11:41 am - Reply

      @Darc I just loaded it up today…….it may wake you up to a possible answer.

  272. darc January 8, 2012 at 1:20 pm - Reply

    Ok, I read it, thanks.

    It's very technical but I will reread it again because, guess what, I'm extremely allergic to mold…to the point that, in my recent (and first ever) skin scratch test the mold spot was about half the size of a golfball and my upper arm was sore and stiff for several weeks. When I expressed concern the allergist simply said, "yep, you're allergic to mold." I've had reactions to mold for at least 20 years, in the form of severe respiratory reactions up to and including pnuemonia. I'm still not sure how to go about remediating all of this but at least I have a few more clues now. Thanks a lot.

  273. Kath January 8, 2012 at 4:53 pm - Reply

    I am soon to be 59. Last year had blood work done and outcome was less than stellar. 5'3", 110lbs. around 29% body fat. Homocysteine:8, CRP:.23, LDL:191, HDL:130, Tri:65. Adrenals: flatlined. Thought I had maintained good health until all of this. I'm low carb but hardly consistent as should be. Not as much energy as I'd like and wake around 3AM for couple hours. Not always, but enough that I find lack of energy often. Always had issues with snacking. Have tested glucose with meals and find that ANY grain-type food sends it up quickly. I have sugar addiction. With this information can you get an idea if I'm LR or not? Am ready for action to make changes and take blood again in 3 months. I want that wonderful health and glow back!

    Dr. Kruse thank you for all you do, the motivation and inspiration.

    • Jack January 8, 2012 at 5:17 pm - Reply

      @Kath you are likely not leptin resistant. YOu need testing to figure it out but with bad cortisol my bet it is your gut. Read my leaky gut Rx and follow it.

  274. Kath January 8, 2012 at 8:41 pm - Reply

    Thank you Dr. Kruse. I read and see to be true but don't have any physical pain or any discomfort. (do have spinal stenosis) I will follow your leaky gut RX along with Robb Wolf paleo solution. Coffee throws day off so will eliminate my two cups in AM. I've heard about L-Glutamine good for gut health but did have dark spot biopsied from toe 3 months ago and it came back atypia. (scary) Read that L-Glutamine is questionable if any cancer present? Have noticed in ONE year skin is changing and a little too quickly. I need to get this turned around and am willing to adhere to program.

    There's a lot here on your Blog. I appreciate much.

  275. Southern_Momma January 10, 2012 at 9:54 am - Reply

    I have searched through the site several times and am having a hard time finding what I need right now. I am LR… confirmed by my doctor… I am on day two of this program. Is there one page where I can see listed… approved and disapproved foods (without jumping blog to blog… there is so much here I can't remember where I saw stuff). I did check with the two diet programs you recommended… but neither support ketosis… which you recommended with the amount I'm overweight. Sorry if I have missed this somewhere… I'm suffering from carb and caffine withdrawl! 🙂 THANKS!!

    • Jack January 10, 2012 at 10:07 am - Reply

      @southern Momma… there is not. I tell my patients to by Robb Wolf's book (the Paleo Solution) or Mark Sisson's ( Primal Blueprint) book to get the details on the fuels.

  276. Vadim January 10, 2012 at 10:02 am - Reply

    Hi Dr Kruse! It could take me a whole day to introduce myself as far as my weight loss efforts are concerned. I read every single book ever written on diet and followed them all as well. The best lifestyle plan for me was always a modified low carb plan. I know people in the low carb community dispose that word… Modified … When it comes to low carb lifestyle. However if I am to implement a strict version of low carb I am always fatigued and moody. Anyway, I was itching to ask you a question and this is the first time I am actually asking after reading your blog… A friend of mine is a devoted vegetarian and he only eats fish. No meat of any kind, but he does eat eggs and occasional dairy. He is overweight though and after many years of yo yo dieting he finally decided xto embark on the low carb lifestyle. But I am concerned about his chocies of food given the fact that he doesn't eat meat. He attempts to stay away from processed soy but does it fermented soy, edamamame and lots of seaweed. However he eats tons of canned Alaskan salmon every single day…… He buys tons of cans of Alaskan salmon from trader joes. He claims, which I recently found out, was true that Alaska is the only state in the union to ban farmed salmon so anything that comes from Alaska even canned is real wild salmon.

    Here is his diet 95 percent of the time .

    Canned salmon patty which he bakes in the oven. He takes canned salmon out and mixes it with a tablespoon of flax seed, one egg and lots of spies and bakes it for twenty minutes.


    Seaweed and fermented soy and edamame

    Almond milk and diet Arizona black tea

    Occasional buttermilk and Greek yogurt and frozen berries

    Daily sunflower seeds and occasional nuts

    What worries me is his daily consumption of canned salmon. So since I persuaded him to undergo low carb route I feel kind of responsible now for his choices, lol.. In your opinion would a daily consumption of wild canned salmon be beneficial, neutral or detrimental in the long run if a person to consume a lot of omega 3 fatty acid? He does consume omega 6 as well through seeds . I will patiently await your answers.thanks!

    • Jack January 10, 2012 at 10:05 am - Reply

      @Vadim The salmon is fine…..I'd cut the sixes and the flax and all the soy. I like the seaweed

  277. Southern_Momma January 10, 2012 at 10:25 am - Reply

    Ok… thanks. I did buy Primal Blueprint… but not supportive of ketogenic diet… Will double check Paleo Solution. It is a lot to wrap your mind around LS (I like to know details not just "I'm LS"), chasing the kids, etc… so was looking for a quick "cheat sheet" as I head out for a grocery run! 🙂 But I have enjoyed reading your work… I LIKE well thought out reasonings!!

  278. Vadim January 10, 2012 at 10:36 am - Reply

    Thanks! You said that you would cut sixes. I assume you meant seeds. I know that sunflower seeds have omega 6 in them but I find that at times they are beneficial to kill boredom or cravings. I see a lot of baseball people spitting them out for hours during the game, lol. But what makes sunflower seeds unhealthy? Or is it unhealthy in larger amount?

  279. Nicky January 10, 2012 at 2:26 pm - Reply

    I see that your top 10 supplements include melatonin, but I thought that inhibited fertility for those of us wanting to get pregnant?

  280. Renata January 11, 2012 at 2:47 am - Reply

    Hi there Dr. Kruse!

    Day 8 of the prescription. Doing really good. 5 Lbs gone, gums not bleeding anymore, clothes fitting a lot better. Looking forward to the mood changes 🙂

    Take care,


  281. Liz January 11, 2012 at 12:56 pm - Reply

    Dr. Kruse–

    Why no nightshades during breakfast? What about for the other meals of the day?

    Thanks in advance–Liz

    • Jack January 11, 2012 at 3:55 pm - Reply

      @Liz……read a paleo 1.0 book, like the Paleo Answer, paleo solution, or primal blueprint. Nightshades have a toxin in them that causes a leaky gut. No way on the nightshades!

  282. Suzanne January 12, 2012 at 2:39 pm - Reply

    In post #313 – How can those lipid numbers be great (TC 367, HDL is 198, LDL is 163)? I get confused.

    • Jack January 12, 2012 at 5:28 pm - Reply

      @Suzanne higher is better than lower……and I believe those numbers artifacts from measuring and not calculating.

  283. Suzanne January 13, 2012 at 9:09 am - Reply

    Higher is better than lower? Well, you once wrote that your readers should "be prepared to embrace paradox at every turn." It's confusing because we are told constantly that we need to lower our cholesterol.

  284. Jack January 13, 2012 at 9:20 am - Reply

    @ Suzanne You wont hear that from me. I would suggest you go buy Anthony Colpo's book the great Cholesterol Con and read it. What others tell you may bother you a lot less about cholesterol once you read it

  285. Suzanne January 13, 2012 at 11:44 am - Reply

    Thanks, I will buy the Colpo book.

    With regard to coconut oil, I use Nutiva oil and Manna. Delicious! What do you think about their Hemp Protein?

  286. Mike R January 13, 2012 at 2:00 pm - Reply

    Southern_Momma – Here are a couple of links that shows food lists. look under the Free Printable Downloads section… look under the Is it Primal? section

    • Jack January 13, 2012 at 2:09 pm - Reply

      @MikeR thank you!

  287. amy January 15, 2012 at 8:28 pm - Reply

    Can I send you a private email with my health questions Dr. Kruse or do I have to post them publicly here?

    • Jack January 16, 2012 at 10:34 am - Reply

      @Amy no need too. I don't answer private questions. I do not have time.

  288. MzTiny January 16, 2012 at 5:39 pm - Reply

    Please give us a small primer on the role of the B vitamins in this whole metabolic process. I recently had a complete vitamin scan blood test, and my B vitamins were off the chart low, especially B12. I'm on complete thyroid replacement after Graves disease/radioactive iodine, and wonder whether I will ever have the sort of normal metabolic process you are promoting, especially with the apparent low absorption I now have. I've also been on very low carbs for over a year. Thanks for any insights.

  289. Lauren January 16, 2012 at 9:55 pm - Reply

    If, in doing the Leptin RX, I am unsure if I have all the signs that I'm LS (I'm maybe missing one – which is feeling warmer – but it is summer here in NZ and I'm not sure if it's me or the rising outside temp) is it better to continue with the Leptin RX diet for a bit longer or to switch to the post-RX recommendations? Many thanks.

    • Jack January 16, 2012 at 10:01 pm - Reply

      @Lauren…..Id say since it summer there go for the change and leave the leptin Rx behind and tell us how it goes.

  290. Lauren January 16, 2012 at 10:12 pm - Reply

    Great, thanks!

  291. amy January 16, 2012 at 10:56 pm - Reply

    Hi Dr. Kruse,

    I am 40 yr old female, 5"4, 115 lbs. My leptin lvls in May tested at 3.5 ng/ml. My endo doctor had me tested for his curiosity and told nothing can be done to fix leptin, but just wanted to feed his curiosity. Now, I am learning more about it through your site and book.

    Anyway, I want to lose 5 lbs..I know I am at a good weight according to the charts but I feel my best at 108-110. I carry my weight in my waist in hips, muffin top and pooch. But mainly, I want to heal my hormones, I have hpypo, very low estrogen, digestive issues and suffer bloating and constipation. For the past 6 mths I haven't had an urge for pass a BM, I am addicted to laxatives/enemas and have no idea how to break the cycle. I have suffered constipation since my late teens but in the last year I have had 2 "bandings" down there with more internal ones now. My story goes on but I just wanted to ask you if doing the LR would be beneficial for me? TO heal my hormones? Will all the protein cause more constipation..not sure anything could get it worse than what it is but…. Thank you for your time!

    • Jack January 17, 2012 at 8:56 am - Reply

      @Amy you dont the reset. You need the Leptin RX post Rx for eating and you absolutely must fix your gut. The constipation is a critical sign that your gut is why you body is not where it should be. YOu need to look into a Metametrix GI fx test or a Spectracell work up. You should really consider coming over to on the nutrition tab and look for the leptin reset monster thread…….you will get lots of answers if you read the entire thread. We cover these issues there is big time detail.

  292. amy January 16, 2012 at 11:05 pm - Reply

    I should also add….sorry to have this in two posts…

    I spent 20 yrs with an eating disorder.

    Have done several rounds of HCG.

    Crave sweets and carbs.

    I am a fat, thin person…meaning, no muscle tone, very soft and mushy feeling.

    Not sure if this helps my question above.. 🙂

  293. Heather January 16, 2012 at 11:28 pm - Reply

    Dr. Kruse,

    I am nursing a 3mo and would really like to do the leptin reset. However, is there any concern with detoxing that can occur with the resent and this getting into the milk and to the newborn? Thanks!

    • Jack January 17, 2012 at 8:52 am - Reply

      @Heather there are no issues at all.

  294. amy January 17, 2012 at 11:49 am - Reply

    "You need the Leptin RX" – I thought I was posting there, thus I read it which brought me to asking you questions, thinking I would benefit.

    I understand more than anyone that I HAVE to heal my gut…I live with it daily, I live in fear, stress and pain because of it…I have to eat, I have to poop, but I can't find a way of eating and I can't poop.

    I realize you can't really help me…..I am growing deep in fear and depression these days and so confused as to where to turn.

    I have seen aturalpathic doctors, endocrine specialists, GI specialists, colon specialists, crainal doctors, rekie practitioners, chiropractors, therapists, acupuncture, colonic therapies. I stopped eating gluten, dairy, and grains years ago. I hardly eat any processed foods. Animal protein is the only food that doesn't cause massive bloating and pain. Regardless of any of these changes, my bowels remain the same, if not getting worse since I now have no urge to ever go.

    I have been to so many doctors, have had colonoscopies, endoscopes, barium tests, we can't get my estrogen levels to get in normal range, I have been below normal for the past 2 yrs.

    Are you suggesting that I eat the primal way that Mark has outlined, rather than following the leptin plan? I am sorry to keep asking all these questions but as you well know, 95% of the doctors are not even aware of leptin…so I don't have anyone else to turn to see if this program could help me. I am at the end of my rope.

  295. Jack January 17, 2012 at 1:11 pm - Reply

    @Amy I say clearly in comment 417 to you, I say YOU DONT NEED IT!


    and you need to fix the gut.

    You will need a doctor who gets how to do it. If you want to learn more on your own and you should in my opinion come over and read the MDA thread. The information in it is better than any medical textbook I know.

    I bet you will find that your have very low levels of intracellular glutathione and that is why you are spinning your wheels with docs and your diet. You need to dig deeper. But you have to invest in your own thinking and thoughts to get to optimal. Do rely on my profession because they don't have the answers either. They will just make money off your symptoms.

  296. MzTiny January 17, 2012 at 5:26 pm - Reply

    You're right, I apparently overlooked the B vitamin blog. I have just read it, and still am wondering whether my extreme deficiency of B's might explain the fact that I seem unable to lose weight, even on very low calorie diet. I am a-thyroid after Graves disease. Thanks.

  297. Jilann January 17, 2012 at 6:21 pm - Reply

    Dear Dr. Kruse,

    Firstly, thank you SO much for donating your time and expertise. I have been struggling with my thyroid for 3 yrs (although it was much longer but not diagnosed, docs just kept pushing anti depressants instead)…to keep it short i have a very important question as I'm getting nervous that maybe somethings terribly wrong with me>>>

    I've been following you Leptin Rx and am on Day 9. I have had my menstrual cycle this week and also been drinking heavy cream in my coffee….THE ISSUE IS…i have not had a solid elimination at all. As a matter of fact it's just liquid, like water.

    I want to take the 3 main tests you recommend but have no insurance and am currently unemployed so money is an issue. Can you give me any ideas as what this runny elimination is about. I'm concerned there's a greater issue. THANK YOU SO MUCH!!

    • Jack January 17, 2012 at 7:39 pm - Reply

      @Jilann stick with it. Day 9 is not too far in and many times bowel habits take a hit while the gut flora adapts.

  298. Jilann January 17, 2012 at 9:13 pm - Reply

    Thank you so much for your reply! I have never felt so committed to truly changing my habits to change my health! I'm 12 yrs sober so it's about time, ha!

    I just went to you Leaky Gut Rx and I've suspected some possible intestinal/gut issues for awhile so looks like I'll stop coffee and cream. Maybe that will help.

    Have you heard of Julia Ross? She works with Amino Acids therapies. I had started using the aminos about a month ago and Aloe. Would you recommend me following you supplements for Leaky Gut too…but without Aloe because I don't know if I have Chrons etc.?

    I guess my question is…does the Leptin Reset Rx on it's own heal leaky gut or are those separate issues and I should follow that protocol too?

    Again, THANK YOU SO INCREDIBLY MUCH! I am inspired and so grateful Whole, True Health will maybe finally start to be addressed! Sincerely, Jilann

    • Jack January 17, 2012 at 9:22 pm - Reply

      @Jilann you can do both……at same time…….but a word of advice you need to supplement pretty high doses of NAC when your doing both……because you likely also have depleted glutathione. You also need adequate B12, folate and Zn levels when your adding NAC to your armentarium.

  299. Yolanda January 18, 2012 at 1:01 pm - Reply


    I started the leptin reset Monday (this week) and I have noticed a spike in my weight (ala 3lbs per day/3 days thus far). I am 44yrs old with low Vitamin D/high morning cortisol/hormone issues (recurring fibroids),gastric bypass patient (10+yrs/-150lbs loss/currently 45lbs overweight).

    Anything that would cause fluid retention and a spike in weight when beginning the reset? Also, currently taking all supplement recommended. Vitamin D (5000iu) dosing began over 30 days ago.

    • Jack January 18, 2012 at 1:17 pm - Reply

      @yolanda the Leptin RX is very difficult for bypass patients……if you read the blog of how it works it requires an intact vagus nerve which you do not have. There is another way to deal with it that will be published in my book.

  300. Yolanda January 18, 2012 at 2:32 pm - Reply


    Thanks for your reply. Should I abandon the reset immediately? How soon before your book is published? I'm alarmed at the gain in the recent days. I have worked out 5-6 days for years and recently have gone down to 0 days in an effort to get hormones and cravings in control.

    • Jack January 18, 2012 at 4:21 pm - Reply

      @Yolanda Book should be out late summer 2012 according to Mark

  301. Yolanda January 18, 2012 at 5:51 pm - Reply

    @Jack— trying to do my due diligence on this matter. It appears that I'm at a crossroad. My immediate response is to "RUN" to what I've done in the past but not sure if that is the right thing. Perhaps I'll revisit other options until then. I'm available for experiments/trials if there are any on the subject.

    • Jack January 18, 2012 at 11:07 pm - Reply

      @yolanda……if you run back to what you did before……..and you expect a different result do you know what Einstein called this?

      INSANITY. Your choice.

  302. Lauren January 18, 2012 at 7:09 pm - Reply

    Hi Dr Kruse. I am one who wrote and asked about being able to live optimally with only eggs/fish/seafood on board (no other meat). You were gracious in telling me it is my decision and that I should continue to investigate. So I have. I've read (and re-read) your postings, read heaps on Sisson's site and read Taube's book. I am now convinced of the need for animal meat. So… we began eating chicken (first step…) last night. I ate a cooked organic chicken meal for dinner, had scraps with my eggs for breakfast and had some bone broth (cooked for 12 hours overnight) for lunch. Here is my question: you have mentioned that you've had many vegetarian/vegan patients. Is it common to have digestive disturbance when taking up meat again (which I now do since post-lunch (diarrhea). I have been grain/sugar free for 3 months, began the Leptin RX 6 weeks ago (with eggs, fish and shellfish as my proteins and coconut oil as my main fat) and now have all the symptoms of being LS so am moving to the post-Rx Rx protocol. Prior to last night, I had not eaten meat for 25 years. This is the first sign of any unhappy digestion through the whole process. I am really fine with persisting if this is normal and temporary. Also, if it is something you see regularly, any suggestions of supplements at this time (I already take a broad spectrum probiotic each morning). Many thanks! Lauren

    • Jack January 18, 2012 at 11:06 pm - Reply

      @Lauren…….very common. Think about this……is you put crappy gas in Ferrari for ten yrs and then put the right gas in your car…… you think it would go 220mph right away or might your need a tune or cleaning before you hit 220 mph like you were built to?

  303. Eleanor January 18, 2012 at 10:21 pm - Reply

    Hello Dr. Kruse, just wanted to thank you for all your information, I've been learning alot and have had more then my share of…"omg that's why that is happening" 🙂 I've been overweight my whole life, since I was 11 to be exact, I'm thinking now that the weight gain had to do with hormones somehow, as it was at this time my husband also started to gain weight and only kept it off when he was in the army as a young man.

    I am now on Day 10 of the Leptin Reset and am totally amazed at the 15lbs I've lost so far. I've been on a fairly low carb way of eating for a couple of years now but never lost at a consistent rate like I am now. Since I've started the reset, my blood sugar has gone down 10 points and is at normal levels most days.

    I look forward to finally getting down to a healthy weight, I'm walking a bit every day like you suggest and it's crazy but I actually feel like exercising and am looking forward to starting the low volume HIIT exercise.

    Thanks for all your hard work and the benefit we all get from your research. Tomorrow I'm taking your list of tests you suggest into my doctor and will see how many she will go with. The rest I'll get done somewhere else if I have to 🙂

    thanks again and keep up the great work. ~Eleanor

  304. Lauren January 18, 2012 at 11:44 pm - Reply

    Thank you! The reassurance is great. Even greater to know I am unlocking my hidden Ferrari 🙂

  305. Yolanda January 19, 2012 at 10:44 am - Reply

    @Jack…. I know. Yesterday, I was in a PANIC. Weight gain at this rate is a brand new experience. I'm just really not sure what to do(INSANITY isn't an option). Considering Atkins but the water retention is severly discomforting. This week feels like the time when my weight was 352 lbs. If Leptin Rx isn't….what are my choices?

    • Jack January 19, 2012 at 2:01 pm - Reply

      @Yolanda just stick with the plan…….put the scale away permanently

  306. Eleanor January 19, 2012 at 12:52 pm - Reply

    Oops, I wrote down the wrong day, I've on the reset since Jan 2, so that makes it 17 days today, still pretty impressive. Also went to my doc today and she was very willing to take the tests I asked from, she wasn't able to do them all as the cost was very prohibitive so as I go along I will get those as well as I can afford them. Interesting to note, she hadn't heard of Leptin, but she does now 🙂

  307. Yolanda January 19, 2012 at 1:38 pm - Reply


    So I need an external Vagus stimulator?? I plan to modify my eating to a strict low carb diet. I am considering a visit to my doctor for updated labs and a diuretic. I will start back strength training today and use short bursts of cardio accordingly. Perhaps HCG should be reconsidered.

  308. Lauren January 20, 2012 at 2:33 am - Reply

    OK, so this former vegetarian (now Ferrari-in-waiting) has roasted a chicken, cooked bacon and made bone broth. Before I move my thoughts (thoughts before feelings on this one) onto offal, one question. I've always heard that eating liver is only OK if you know the animal was healthy because the liver would hold all the toxins. Is this true? Does one need to get liver from an organic/grass fed cow or organic/free range chickens? Thanks!

    • Jack January 20, 2012 at 8:08 am - Reply

      @Lauren not true, just more urban myth. Soak the liver in milk before you cook it. You'll thank me.

  309. Suzanne January 20, 2012 at 8:14 am - Reply

    Has anyone experienced intestinal distress, i.e. diarrhea, from eating coconut oil? I've been trying to work up to 3 tablespoons per day but I am having problems that began when I began ingesting CO. Or should I be considering another cause?

    • Jack January 20, 2012 at 9:31 am - Reply

      @Suzanne It is completely normal and called the Herxheimer reaction. Google it. The CO is killing off all your bad gut flora and it will take weeks to months to work and you will feel works as it occurs but then the sun will shine on your gut. Stop focusing in on how you feel……..just keep doing what is correct for your paleolithic genes. My next blog post likely will help you understand this perspective well.

  310. Jojo January 20, 2012 at 2:47 pm - Reply

    Dr. Kruse,

    I'm a 28 yr old female, 5'9 1/4, 197 lbs. I've done two rounds of hCG, I started at 255.8 lbs. I doing a 3rd round but only 30 days to lose another 20 lbs and intend on doing the Leptin Reset if I am in fact Leptin Resistant. I'm having some blood work done on Monday, but I have no idea what to do with the results. I'd need to know what range they should be in which I'm sure varies from person to person. Below is what I'm having done…what do I do with it after I have the results? Could you provide me with some advice.


    Complete Blood Count (CBC) With Differential CPT Code: 85025

    Metabolic Panel (14), Comprehensive CPT Code: 80053

    Osmolality,serum CPT Code: 83930

    Osmolality, Body Fluid CPT Code: 84999

    Urinalysis, Complete With Microscopic Examination CPT Code: 81001


    Hepatic Function Panel (7) CPT Code: 80076

    C-Reactive Protein (CRP), High Sensitivity (Cardiac Risk Assessment) CPT Code: 86141

    Vitamin D, 25-Hydroxy CPT Code: 82306

    Insulin, Free and Total, Serum CPT Code: 83525; 83527

    C-Peptide, Serum CPT Code: 84681

    Hemoglobin (Hb) A1c CPT Code: 83036


    Ferritin, Serum CPT Code: 82728

    Iron and Total Iron-binding Capacity (TIBC) CPT Code: 83540; 83550


    Homocyst(e)ine, Plasma CPT Code: 83090

    Lipoprotein Subfractionation Profile CPT Code: 83701; 84478


    Cortisol CPT Code: 82533

    Dehydroepiandrosterone (DHEA) Sulfate CPT Code: 82627

    Dihydrotestosterone (DHT) CPT Code: 82651

    Estradiol CPT Code: 82670

    Estrogens, Total CPT Code: 82672

    Follicle-stimulating Hormone (FSH), Serum CPT Code: 83001

    Growth Hormone-binding Protein CPT Code: 83519

    Insulin-like Growth Factor 1 (IGF-1) CPT Code: 84305

    Luteinizing Hormone (LH), Serum CPT Code: 83002

    Pregnenolone, Mass Spectrometry CPT Code: 84140

    Progesterone CPT Code: 84144

    Prostate-specific Antigen (PSA), Serum CPT Code: 84153

    Sex Hormone-binding Globulin, Serum CPT Code: 84270

    Testosterone, Free (Direct), Serum With Total Testosterone CPT Code: 84402; 84403

    Prolactin CPT Code: 84146


    Thytropin Releasing Hormone CPT Code: 83519; 84999

    Thyroid-stimulating Hormone (TSH) CPT Code: 84443

    Thyroxine (T4) CPT Code: 84436

    Triiodothyronine (T3) CPT Code: 84480

    T3 Uptake CPT Code: 84479

    Reverse T3 CPT Code: 84482

    Thyroxine-binding Globulin (TBG), Serum CPT Code: 84442

    Thyroid Peroxidase (TPO) Antibodies CPT Code: 86376

    Thyroid Antithyroglobulin Antibody CPT Code: 86800

  311. Dynnette January 20, 2012 at 8:53 pm - Reply

    Thank-you I did read your blog and it did send up signs! and rereading "the liptin-rx-Faqs" Helped also. I am ready to get going because what you said about gaining 20lbs on top of what I lost, is what I have been dealing with my whole 44yrs! and lets just say "THAT SUCKS"

    So Thank-you

    and FYI I found your site because of people on sparkpeople web site.


  312. Sharon January 22, 2012 at 8:23 am - Reply

    I have a hernia that is going to be repaired soon, and I have arthritis. So I can't do weights and I can't run. I've been swimming and walking regularly throughout a year and a half on Atkins, 19 kg lost and now am at a stall (now 105 kg, BMI 41.8). Any exercise suggestions during and after the leptin reset?

    • Jack January 22, 2012 at 7:39 pm - Reply

      @Sharon you need to lift weights. And once you heal and our cleared by your surgeon you can and should do it. If you can't sprint then you need to swim.

  313. Nichole J January 23, 2012 at 10:10 am - Reply

    Hi Doc,

    I started the Leptin RX late Nov. and seemed to be showing all the LS signs the 2nd wk of Jan. However, I learned many months ago that I have a (physical and facial) allergic reaction to coconut oil. I have a large container of a (1) good-quality brand CO, (2) Coconut manna and (3)coconut capsules in my cabinet right now and have tried several times unsuccessfully. So I used other fats instead (butter, bacon oil, olive oil, and avocados for my BAB and 2 other meals. With the large consumption of protein and fats, I seem to have BLOWN UP like a balloon in the bottom half of my body. I now feel the signs of LS but my weight is and has been going upwards rather than lower. I think it is from the large amounts of protein with little exercise for weeks or the inability to have the preferred slimming CO. Either way, I am strongly leaning toward abandoning ship with this and Mark's (MDA) primal eating regimen (perhaps vegetarianism or a soup diet), since my clothes rarely fit anymore. Help. What do you suggest I do? So many have lost weight. Not me. :-/

    • Jack January 23, 2012 at 10:52 am - Reply

      @Nicole J this tells me something is going on and it requires testing. You abandoning paleo is among the worse things you can do but it is your life. It took you years to break yourself and it may take time to get you right. This is how we are designed to eat. My bet is you have major gut issues and major hormone issues. Moreover, if you had all the LS signs why are you still doing the reset and why have not you migrated to the Leptin Rx postscript way of eating that I outlined here…. .

  314. Nichole J January 23, 2012 at 10:22 am - Reply

    In addition post #447 above…

    PS: I read your post #442 where you suggested googling Herxheimer reaction. I read wikipedia. This allergic reaction makes sense to me, since I am also allergic to penicillin. :-/

  315. Nichole J January 23, 2012 at 11:54 am - Reply

    Thanks Doc for responding,

    I guess I sort of did switch over. I am not as hungry. My body is just accustomed to the meal schedule and wake and sleep patterns now. 🙂 I am also writing the final chapter of my book (Ph.D. dissertation). Even though I have my heavy adjustable weights here at home, I have been spending more time at the computer typing than in the past. Once I am done in week or so and can submit the chapters for approval, I can REALLY hit the gym & sprints HARD. Thanks Doc! You made my day to know that I could still be on track with a bit less typing activity. (lol) I will look further into all of your suggestions. You're the best! 😉

  316. Jack January 24, 2012 at 9:03 am - Reply

    @Leiha if you have a disc make sure you get HS CRP and Vitamin D level drawn……if they are low you need to up the supplementation pre-op because you might find that you may not need the surgery

  317. Amanda D. January 26, 2012 at 7:46 pm - Reply

    This is all very excellent information; thank you, Dr. K! I do have one question about excersize, which I never thought I'd care much about. I wanted to start hula hooping for the exercize and for the creativity and artistry involved, but after reading this I'm wondering if that is a good idea. I am a 5'4" 303 lb. female who is finally ready to change my life for good. Where – if at all – do you think hula hooping with a 2 lb hoop could fit in with all this?

    • Jack January 26, 2012 at 8:07 pm - Reply

      @Amanda D knock yourself out. It will likely reduce your cortisol.

  318. Amanda D. January 27, 2012 at 11:09 am - Reply

    Awesome! Thank you!

  319. Evalinda January 28, 2012 at 4:03 pm - Reply

    Hello Doc,

    I have now decided to start Leptin Reset after losing 3 stone on hHCG. I don't have any diseases, as a matter of fact I have never had any (not even flu or cold) but I still reckon I'm leptin resistant as I crave cherries and grapes. I'm 5'6 154 lbs body fat 25.6 – would like to get it down to 18-20 %. I'm in a quite good shape but would like to become optimal like you. I sleep well, wake up without alarm. Any suggestions what would be the best plan in my case and what to pay attention to? Thank you.

  320. Tim Lundeen January 29, 2012 at 1:11 pm - Reply

    What do you think about protein cycling up-regulating autophagy? (Per Ron Mignery's book at… If the after-reset eating protocol has protein at breakfast and at dinner, wouldn't that reduce autophagy?

    • Jack January 29, 2012 at 1:58 pm - Reply

      @Tim…..autophagy is tightly regulated to the sleep circadian cycle. To date no other biologic mechanism seems to undermine its power. I am working on a monster series now tying all the circadian biology together to this level. Failure of autophagy is how the human heart most commonly fails. The link is from high circulating leptin levels, high IL-6 levels, extremely low DHEA levels and the presence of sleep apnea. The time of the day where protein synthesis is highest is when we are awake 4PM to 6PM…….but when autophagy is most important is in in stage 2-4 sleep when GH secretion occurs. Ironically this happens when the cerebral cortex is chemically disconnected from our motor systems. If you do not get this type of cycled sleep it means that autographic failure has occured. It is so powerful that in some animals it completely causes sepsis and can kill them. It appears in humans that this is also true. When we see see declining sleep in the older humans or in the sick younger ones we always see co morbid development of atherosclerosis that is due to activation of the macrophages due to failure of mTOR during activation of autophagy during sleep. It is a part of mTOR that is completely separate from mTOR signaling that is linked to protein or carbohydrate intake. The role of leptin in the activation of mTOR function is an important factor in the ability of leptin to activate macrophages. An interesting aspect of the role of leptin in mTOR function is that within mature adipocytes leptin synthesis itself is dependent on mTOR activation. Given that leptin levels rise in the serum of obese individuals and that leptin interaction with macrophages leads to increased macrophage inflammatory processes, it is not surprising that there is a direct correlation between leptin levels and the development of atherosclerosis. This is another link why AD and CVD are tied together and both tied to poor sleep.

      It is incredibly interesting and of course critical to circadian cycles. Many today do not believe that leptin answers to circadian biology. In 2012…….I will show just how much it does. There are so many connections its mind boggling.

  321. george January 29, 2012 at 8:52 pm - Reply

    Great information! 50 grams of protien for breakfast without whey is a lot of food. I still don't understand how bacon can be healthy…

  322. Amanda D. January 29, 2012 at 11:11 pm - Reply

    Hello, again, Dr. K. So far I have found the BAB to be difficult but incredibly useful for my cravings, which are still tough – and I have fallen off the wagon this weekend; I think I was not taking it seriously enough yet.

    Anyway, my concern right now is that this Thursday I am having my wisdom teeth taken out, and the doctor who is performing the surgery said I would be miserable for about a week since one is attached to the jaw, and one is attached to a nerve. Great! So do you have any suggestions about how to eat properly while my mouth is healing? Or should I drink broth and tea with coconut oil until I am able to eat solid food?

    Also, will putting red wine vinegar (0g carbs) on my beef affect the leptin reset at all?

    • Jack January 30, 2012 at 6:59 am - Reply

      @Amanda D make a lot of bone broth and eat it twice a day. Use grass fed bones.

  323. Amanda D. January 30, 2012 at 7:13 am - Reply

    Awesome, thank you!

  324. TheKid February 1, 2012 at 1:21 am - Reply

    Dr. Jack,

    I suffer from Antiphospholipid Syndrome (APS) and take Coumadin daily (12.5 mg). I found out I have APS in 2003 when a thrombosis in my iliac vein nearly killed me. That episode led to an insult to both of my kidneys and I ended up on dialysis for 4 days until kidney function returned. I have been told that I am borderline for Chronic Kidney Disease (CKD). My creatine has been stable for 2 years, but is elevated slightly and my nephrologist is concerned about maintaining renal function.

    I am taking 10 mg of an ACE inhibitor (Coversyl) to protect my kidneys and I have been advised to eat only about 100g of protein daily, spacing it out over the course of the day.

    What I would like to know is whether 50g of protein all at once has the potential to have a negative impact on the kidneys. Additionally, is the leptin reset so important that a risk to the kidneys is worth it? You know, 8 weeks of stress with a lifetime of health on the other side.

    I am also interested in what you know of the any link between APS (which is an autoimmune disease) and leptin and other metabolic problems.

    For background, I am a 41-year-old male. I ballooned to 305 lbs. in 2009 after fighting weight and diet for about 10 years. Lost 50 lbs. by banging my head against the wall at the gym. Lost 30 lbs. more by going Paleo. Now plateaued at 225 lbs. and struggling to maintain that weight. I often creep back to 230. I think my ideal weight should be just under 200. I am 6 foot 1 and a half inches.


    • Jack February 1, 2012 at 7:47 am - Reply

      @TheKid I know a bit about this syndrome because a family member has it. It was related to her leaky gut from a carbohydrate laden diet that lead to her getting the autoimmune disease called lupus. She became morbidly obese and then she developed APS. Her physicians had no clue why. I knew and tried to help but she could not fathom that I was correct. Today she has begun to heal with my leaky gut protocol and Leptin Rx protocol. She has married the two together. She has a nephrologist and he was very concerned with her protein intakes. She did it inspite of his advice because she said if this would kill her she was fine with it because it was no way for a human to live anyway. So far she has dropped about 77 lbs and has not had one lupus flare up. Her kidney function has improve 27%. Her nephrologist I am told is quite shocked by this turn of events. He clearly does not get it. She asked him to read the blog and call me………he is not that interested in becoming a better doc than he already is. As for your case…… will have to take what you nephrologist says and look at your own primal instincts and make the decision in your own mind after fully informing yourself of the pro's and cons. One thing that clinched the choice for my family member was that her docs told her even with the best medical care her life would be limited and her lifespan likely reduced because no one knew how to stop the AI destruction. They also told her they felt no matter what she did she would be on dialysis at some point…….I think that really opened her eyes that CW was not a game changer. A change to her lifestyle with the leaky gut Rx and the Leptin Rx however would afford her control of inflammation in her body without any drugs. She knew the risks from conventional medicine……..and she chose. Remember her N-1 cant be generalized to all people with this condition……..but all AI disease battle begin at the intestinal brush border. At the very least you must eat a strict AI paleo diet………and I would suggest you look up Dr. Terry Wahl's protocol and her story. It may give you a lot more hope……because the odds she faced were even greater than yours. I wish I could give you answers here……but I cant. I can share with you the biology and how I think about these conditions. You will have to evaluate things with your own docs and then make an informed decision on what to employ. Godd Luck and keep us informed of what you do and how you do no matter what.

  325. TheKid February 1, 2012 at 8:07 am - Reply

    Dr. Jack,

    Thanks for the encouraging words. I will definitely talk with my nephrologist, who actually IS open-minded. Will also let you know how it goes.

    I actually posted in the comments on your Oprah thread, but am not sure if you saw this question, so I'd like to ask it here as well:

    Thanks so much for your time and effort. This stuff is transformative.

    I have been eating Paleo and doing HIIT, weightlifting and long walks on a 3-day rotation. When I started, I was abuot 255 lbs. Now I'm down to 225 lbs. but have plateaued. (my heaviest was 305 in 2009)

    I started low-carb Paleo because I was diagnosed as a reactive hypoglycemic. I would eat and get horrible fatigue, vision disturbances and headaches. The first 6-8 weeks were great and I gained energy and things were going well. But as I passed the 8-week mark, added some cheat days and more consistent Paleo carbs back into my diet, things started going south.

    Now I'm stuck at 225 lbs. and have been getting awful hypoglycemic symptoms again. My questions are as follows:

    1. Once you damage you metabolism as I surely have, is there no going back? Will even cheat days cause a return to insulin and leptin resistance?

    2. When I'm experiencing hypoglycemic symptoms, what exactly is going haywire in my body? And will your leptin protocol fix that?

    3. I found it very hard to stay low carb after 8 weeks? Is there a safe carb consumptions protocol (types and timing) that will prevent returning to insulin and letpin resistance?

    Thank you so much.

    • Jack February 1, 2012 at 8:10 am - Reply

      @The Kid I will answer fully later……i have to fix a fractured back. But I will tell you this. There are no safe starches in my view until you regain control of your fasting BG. It is controlled by PEPCK which is the enzyme that controls gluconeogenesis. When your fBG is below 87 you then can employ PHD theory of safe starches.

  326. TheKid February 1, 2012 at 8:14 am - Reply

    Sorry, one last question.

    Ever since my last Antiphosphospholipid Syndrome flare, I have had persistent and sometimes intense GERD. Symptoms slowly developed since September 2011, exploded in Nov. with my APS flare and continue up to today.

    Is there a GERD-leptin relationship? Will balancing out all my hormones impact my GERD positively?

    I ask, because, to be honest, I feel that the sticter low-carb Paleo I eat, the more GERD I seem to get along with painful loose stool. I thought it would be the opposite.

    Another practitioner suggested I add more Paleo-safe starchy carbs back in so as to give my "good" gut flora something to eat and thrive on. But if I do that, how can I reset my leptin?

    Should I just suffer for 2 months until leptin is reset and THEN tackle the GERD? I'm concerned about risks for esophageal cancer, since this has been a problem for some time now. Any advice?

    • Jack February 1, 2012 at 4:49 pm - Reply

      @the kid…..GERD is not a disease of acid reflux. It is an autoimmune disease related to a leaky gut that foster high tissue omega 6 levels in the stomach fundus and in the distal esophagus. The chronic inflammation is what forces the Barrett's Metaplasia and eventual cancer. The key is not to take proton pump inhibitors. All that does is reduce symptoms. Modern medicine is focused on treating those symptoms and not the disease because they remian blind to the fact a leaky gut and chronic inflammation from high series two level prostaglandins are what causes the problem. You the patient, can have a bigger impact on your gut than your doc can because you are closer to the etiology of the disease then they are now. It is putting spackle on a big dent. You must consider re tooling your diet to an AI paleo diet to eradicate it. That means you might have live with some symptoms until you re tool your gut inflammation and reduce your tissue omega 6. That can take 1-2 yrs depending upon your current O6/3 ratio and your HS CRP levels. When you have GERD you likely will never have good hormones because good hormone profiles require low inflammatory levels. You can not have one without the other.

  327. TheKid February 1, 2012 at 8:17 am - Reply

    Fasting BG actually did hit 87 and below consistently. I also hit the ball out of the park on a glucose tolerance test. It was at this point that I added in carbs and cheat days once a week. But this resulted in those hypoglycemic symptoms coming back and me getting almost a nervous addiction feeling with reference to carbs and sweets again. Don't know where that came from.

    I figured I must not have actually reset my Leptin properly, causing the symptoms and some weight gain. That's why I'm starting your Rx.

  328. Jill February 1, 2012 at 1:05 pm - Reply

    Thank you so much for all of your great info. I'm seeing my doc tomorrow and hoping she'll order the tests you suggest. May I ask a question about my son, who is 16? He has been an extremely picky eater and severely underweight since soon after starting solid food. (He was healthy/chubby while just breastfeeding.) He's a true carb addict now but doesn't seem to feel hunger like most people, never has. He also has issues with food texture. Could this be hormone-related? You mention the Leptin Rx will help with underweight folks, but I'd like to ask what tests you suggest specifically. Thank you so much for any help you can give us. We've worried about him for such a long time.

    • Jack February 1, 2012 at 2:20 pm - Reply

      @Jill if he is a carb addict I promise you he will face some serious issue down the road. Any hypothalamus that is wired to the effect NPY will have a huge problem with hormones eventually. If his diet is bad now it will be magnified as he ages. I cant comment on testing because without a history and physical exam there is no way to predict. YOur doc should do these things. If they cant help you then you need to start reading…….yourself and get your kids on a primal template. The only way the follow it is if you and Dad do too. I know. I had two kids that I had to retrain. Both with success because they followed our lead after we set the example. We never bought any food that we used. Everything changed. We did not care about their complaints. It is amazing what happens when you force your kids environment to be be a certain way. It forces them to eat just like wild animals have to ………they can not change their environment therefore they adapt to it. Parents do not realize how much control they cede to children.

  329. Eric February 1, 2012 at 6:00 pm - Reply

    Dr. Jack,

    I'm on day 7 of a Paleo diet plan and day 2 of your Leptin restart. I'm at 307 lbs and 64 years, taking Metformin and glipizide twice a day. For the first time in over 20 years my blood glucose numbers are around 100 fasting and 110 1 hour post the BAB. My question is, what is the process for reducing the amount of meds I'm taking? Do I need to wait for the fasting numbers to come down lower first?

    I can't thank you enough for all you are doing here Jack. You have changed my future.

    • Jack February 1, 2012 at 9:58 pm - Reply

      @Eric……give it some time. You will know when because you are following your numbers. The reset causes the exact same affect that bariabtric surgery does. Most diabetics are taken off their meds right after the surgery. The reset dies the same thing……but it could take up to 7-10 days. You are observing the same effect. If you ask any bariatric surgeon they stop their meds Post op day 1 because they uncoupling the incretin hormones from the leptin receptor……the connection is the vagus nerve. The reset does the same thing without the surgery

  330. Eric February 1, 2012 at 11:20 pm - Reply

    Thank you for your reply. I'll watch for a dip in the numbers then and drop both meds when I see it.

  331. Jill February 2, 2012 at 5:42 pm - Reply

    Thank you, Jack. I am determined to get us all up that hill, even if I have to break some crowns 🙂

  332. cgk February 4, 2012 at 7:20 am - Reply

    Dr. K,

    Thank you for your website. I've invested hours reading it and feel empowered and overwhelmed all at once. One thing I have not been able to figure out is will you see non surgical patients F2F?

    • Jack February 4, 2012 at 8:39 am - Reply

      @cgk I am working on that as we speak. In 2012 I will add a way for people to interact with me if they choose as a health coach. I can not dispense medical care over the internet without a physical exam. And coming to see me in Nashville for non neurosurgical issues is possible but it is non insurance based and costly. It takes a lot of my time to help them and is labor intensive that is why it costs. Most people can not swing it and I keep that group small because of the time factor it takes.

  333. cgk February 4, 2012 at 10:14 am - Reply

    Dr K,

    Thank you. I know you have lots of murky waters to wade to be able to help all of us, and your efforts are appreciated!

  334. cgk February 6, 2012 at 1:37 pm - Reply

    Another question that I hope is truly novel and not a duplicate. It surrounds the fasting between meals. How long should one be at table eating? In other words, is it okay to be tasting food as you are cooking. To me it seems very natural to be tasting ingredients as you cook, season to taste, etc. So my perhaps 1/2hr at table is really an hour dinner that started with the 1/2 hour preparing it. I ask also too because I often eat my breakfast almost in stages – getting the protein eaten in peace and then the carbs more on the go as I'm preparing youngsters breakfasts and school lunches.

    • Jack February 6, 2012 at 7:29 pm - Reply

      @cgk…….I think eating slower is better than chowing it all down but honestly I saw no difference between eating speeds on the Reset. When you go to the post Leptin Rx then you should slow yourself down. I had to do this because I used to eat super fast because of my job……now I eat a meal over 30-45 minutes because I read and listen to pandora.

  335. wmg February 9, 2012 at 9:42 am - Reply

    I've been doing the reset now for two and half weeks. I have a feeling I need to bump up my carbohydrate intake. I've been waking up the last few mornings at 3:30 am with my heart racing and cannot get back to sleep. I think what's happening is my blood sugar is going too low and my adrenals are dumping a bunch of adrenaline in my system and waking me up with my heart POUNDING in my chest. I've been dealing with adrenal fatigue for a while, so I guess it's back to the drawing board and carbs.

    Frustrating, as I know I'm leptin resistant. Any suggestions as to what I might eat in the evening to prevent this from happening?

    • Jack February 9, 2012 at 11:53 am - Reply

      @wmg more protein would be my action.

  336. NinaJ February 9, 2012 at 10:32 pm - Reply

    Dr. K, Thanks for all your great info! Four weeks into Leptin reset I got pretty foggy headed due to low BP, but luckily found a previous post and followed your suggestion to up the sea salt. It worked like a charm, but my husband who has high blood pressure wondered if the sea salt would raise his blood pressure more than table salt. I also have experienced menstrual cycle regulation, from random almost no periods (peri) to 2 periods exactly 28 days apart right after starting Leptin reset. Is this a side effect of the leptin reset, random coincidence or too soon to tell? Take care!

    • Jack February 10, 2012 at 7:09 am - Reply

      @Ninaj CW is the salt is bad for those with higher BP. You can tell hubby to discuss this one with his doc but I think if you both do your homework and due diligence you will find out yourself the link between sodium intake and BP is among the weakest in medicine.

  337. MaMiaGirl February 10, 2012 at 10:41 am - Reply

    Hi Jack, great info here, for sure a lot to ruminate about in the brain.I have Reactive Hypoglycemia, and have done Atkins for years, but now it seems Ive slowly put on 15 lbs.My RH is fine as long as I dont drink alcohol, I had severe nocturnal episodes.My Dr thought I had panic disorder and also menopause(Im 53 and had a late life baby at 45) but I didnt buy that, and I insisted on some tests.Sure enough RH.. ok with that said,Can this WOE cure the RH over time, OR will it just keep it in check as eating low cabr, low or no sugar has.Im 100% as long as no sugar,pasta such and alcohol(beyond one glass of wine and of course eating with a sweet is double trouble)


  338. Mamagrok February 10, 2012 at 2:03 pm - Reply

    I've seen the cravings go, slight sleep & energy improvement, end to binge eating. Still wake groggy every day & feel I'm running on 40%, at best, during the day. I'm down to needing to lose less than 25lb, but still have leaky gut and subsequent low thyroid, sex hormone, etc., issues. 100% compliance with the LR & GAPS (including circadian guidelines).

    Question: I tallied my carb average. It's about 10-15g carb/day. Lots of very, very low carb veggies. Should someone close to goal weight try to get closer to 25 or 50? Would that benefit fatigue/thyroid issues, or cause other problems? (I admit I'm worried about triggering cravings again.)

    Since sweet potato is causing bloating, it seems winter squash is the only remaining option. Is that correct?

    • Jack February 10, 2012 at 6:10 pm - Reply

      @Momagrok You can help this situation by adding cold to yoru regime as it will raise your adrenal function, raise immunity, decrease the cravings to binge. you need to stay up on the blog. Cold thermogenesis can markedly help you.

  339. Mamagrok February 10, 2012 at 8:53 pm - Reply

    I'm adding cold, lol; but still wondering about my question! 🙂 Thx for the encouragement!

  340. […] of which is alteration in skin blood flow in humans.  My version of cold thermogenesis for the Leptin Rx reset is the process where we generalize these effects for the entire bodies fat mass to force the brain […]

  341. Jean February 12, 2012 at 9:58 am - Reply

    Dr. K ~

    First I want to say thanks so much for all you do!

    I started the leptin Rx 2 months ago and on the very first day I found I could easily skip lunch. Continued for a few days, but then life got in the way and I had to stop.

    Just started again 10 days ago and am doing 50-55 gm protein at BF, but am still hungry 5 hours later for lunch. I also find that sometimes the big breakfast makes me very tired and I feel weak down to my bones! Any idea why?

    I have noticed improvements in hair, skin, sleep, even sweat patterns. I'm noticing though that I'm gaining weight now. I'm 5'5 and ~118 lbs, so not overweight, but I don't want to gain either. What could be causing the weight gain? Possible insulin resistance?

    Little history: I have low vitamin D, high reverse T3, low ferritin (other iron levels ok), low triglycerides, high LDL, HDL has been relatively high, but dropping lately (from 84 last year to 63 currently) and high total cholesterol.

    I've been on various low-carb and anti-candida diets for the last 2 years. I'm currently on GAPS, so no grains, sugars, processed foods at all. My carbs are generally around 50 gm per day.

    I'm beginning to wonder if I truly am leptin resistant. Can't afford to do all the labs right now. Do the results I put above plus the history give you any idea of whether or not I should be following the Rx?

    • Jack February 12, 2012 at 10:30 am - Reply

      @Jean it is designed to make you sleepier because it is inducing some biochemical changes in the hypothalamus. The bigger question is why did you stop when you were doing well?

  342. Jean February 12, 2012 at 10:36 am - Reply

    I think I just started feeling better overall and got busy with life events and backed off on the big breakfast. I was still following the other rules of no snacking/only 3 meals, no processed junk, etc. It was just the big breakfast I cut back on without even really thinking about it. My main concern right now is this weight gain. I'm not even positive it's fat gain so much as it is water. My face gets extremely puffy as well as my thighs, hips and abdomen. It's only been 10 days and none of my pants are fitting me! What's going on?!?!

    • Jack February 12, 2012 at 11:04 am - Reply

      @jean without testing hard to say…….but you clearly need to reassess how you think and what you do because your methods are not working. Maybe its time to change it up a bit an try a new way?

  343. Jean February 12, 2012 at 1:17 pm - Reply

    Any specific testing you'd suggest Dr. K?

    • Jack February 12, 2012 at 2:54 pm - Reply

      @Jean no……..specific comes when I know what is going on during a visit or a hack. I have a post on the Optimizing labs. Take a look there.

  344. Jean February 12, 2012 at 5:11 pm - Reply

    In that case, I'm anxiously awaiting a phone consult with you when you have that up and running!

  345. Judie February 12, 2012 at 5:29 pm - Reply

    Thanks Dr Kruse for all the great information. Your site is magnificent and I love to see how you are so open to learning and getting better! I need to lose at least 30lbs and have tried low carb previously but this time have noticed a big difference in my energy and hunger because of the big breakfast—that is the key. My husband and I are starting week 6 of the leptin reset. I have been having a problem with extreme thirst. No matter how much I drink, I feel thirsty and my tongue feels thick and sour. I've been drinking a couple bottles of coconut water a day along with tons of water and it seems to help but only for a bit. At night I take 2 qts of water to bed with me and I'm up drinking water and going to the bathroom all night. This wasn't like this in the beginning but seems to be getting worse. I'm taking magnesium (transdermally), l-carnitine, coq10. Any ideas what would help? Thanks.

    • Jack February 12, 2012 at 6:04 pm - Reply

      @judie big thirst not satisfied by drinking is tied to Mg and or Zn issues……I'd suggest you add those in. The biggest issue is your water is not cold enough…….see to it your drinks are at 40 degrees and I bet when you start drinking cold water your thirst will go away. Why? Cold induces ADH a hormone in the posterior pituitary that controls water balance. If your BP is also low it could be a salt deficiency too.

  346. BenG February 13, 2012 at 7:37 am - Reply

    Dr Kruse,

    I also (week two) and noticed that I get sleepy in the late morning. It's ok to nap? and how long should the hypothalamus take to get past the late morning tiredness?

    • Jack February 13, 2012 at 8:36 am - Reply

      @Ben G give your hypothalamus time to adjust. Napping is fine.

  347. Sara February 13, 2012 at 10:59 am - Reply

    Dr. Kruse,

    I was following the leptin rx forum on MDA and just recently jumped in with the BAB a few days ago. I was planning on posting my questions over there, but it's been down all weekend.

    A few of the days I did the BAB I got a lot of lower back pain afterwards and seemed to swell all over. My face got puffy, thighs, abdomen and hips all seemed swollen. Is this normal?

    Also, I remember reading a few posts where people immediately were able to skip lunch. I've had a few times where I could go 6 hours without eating, but have yet to actually skip lunch. I can eat the exact same breakfast – ~ 55g protein and be hungry in 4 hours one day, but not hungry for 6 hours the next day. Is that typical?

    • Jack February 13, 2012 at 11:59 am - Reply

      @Sara all normal…….you're adapting. It's not supposed to be smooth sailing in the beginning. Is going to the gym a pain free experience in the beginning? Same thing here.

  348. Sara February 13, 2012 at 12:01 pm - Reply

    Gotcha Doc! Thanks for the reassurance!

  349. claudia rowe February 13, 2012 at 4:11 pm - Reply

    Hi Dr Kruse. This may be a question too big for this forum so completely understand if you can't answer it here:

    1. I've been doing mostly your principles for about 8 years without really knowing it – most cals from fat, mod protein, carbs <30 per day. I've now tweaked my regime to be purely yours to optimise the outcome – added more coconut oil and more protein at breakfast.

    2. I've been diagnosed with Hashis, DB2, MS, lupus, coelliac. I take compounded T3, DHEA, Pregnenalone (sp), estrogen cream, progesterone cream. Good labs in general but shows every increasing and high serum leptin levels and rT3 is always high. The MS (I think) is causing an ever worsening Katherine Hepburn style palsy in my neck which is now noticable.

    Here's the thing: Since 2002 I've inexplicably been unable to control my weight. I've just followed your principles for ten days and all the extra cals from the coconut oil and breakfast protein has put on 7kg in ten days.

    This is in no way unusual. Feel fantastic and even look forward to swigging coconut oil first thing in the morning!

    My usual response to weight gain is water fasting and IF. I tried an experiment where I ate ketogenically and did not fast for 3 months and put on….are you ready…35kgs!!!!!

    I'm getting kind of desperate. I seem to be doing what works but I'm getting fatter and fatter and more and more palsied.

    Any idea of my next port of call? Like you when you strated out, I'm absolutely determined to solve whatever "this" is but, short of painting a pentagram on the floor and chanting 3 times, I'm stumped.

    • Jack February 13, 2012 at 5:52 pm - Reply

      @claudia. 8 yrs is not a reset. That is a lifestyle choice. I clearly say that the reset is a temporary situation. When you have some small clinical wins as outlined you move to the Post leptin Rx mode of eating. Here is that link. This is how I eat now.… It is quite normal in a reset to add weight initially as you adapt. I strongly recommend you visit the monster reset thread at MDA and you will find many people who had the same issue. You will also find many people who have successfully used this protocol to improve dramatically.
      You are not close to desperate…….you wasted 8 yrs doing something that got you no where. It is time to do something different to get you to optimal. My bet is your gut is a train wreck and you need a great gut hack. Dont not be stumped…….always question when you hit a plateau…….because your failures will lead to your road to optimal.

  350. Eleanor February 14, 2012 at 8:22 am - Reply

    I'm thinking I'm LS but don't have all the markings,

    1. changes in appearance – yes

    2. changes in mood, personality and thoughts – hmm maybe

    3. changes in appetite – yes, have only been eating 2 meals a day and am amazed that I'm not hungry, can take my time when I eat. This morning I had no appetite, I didn't eat the usual 50gms of protein, just couldn't get it down, we'll see how the day goes.

    4. changes in energy and sleep – The sleep is definitely better, I wake up before my alarm but if I don't go to bed early enough, I'm dragging the next day and could sleep during the day. I do have more energy if I get enough sleep.

    5. libido – it's getting better but not great

    I've always felt warmer and exumed body heat, how much lower should my body temp be? It's always been normal even when very hot. I sleep with a fan on me at night because I get so hot, even before the reset I did this.

    6.Exercise still sore but I do recover a bit better..

    I'm going to start the HIIT exercise today. as well as the ice water protocol with the face in the water to start. I've also been using a cold pack between my scapulas at night until I notice it getting warmer, might need to actually use ice since it isn't staying warm as long as I think it should.

    Am I starting the HIIT to early? since I'm not seeing all the markers for being LS?

    • Jack February 14, 2012 at 12:15 pm - Reply

      @Eleanor…… will know best. If HIIT makes you feel horrible you will have your answer. Try it and experiment…….it wont kill you and you might learn something about your body

  351. Eleanor February 14, 2012 at 1:24 pm - Reply

    gotcha thanks, I tried the first part of the ice water protocol this morning and was so frustrated, I couldn't even put my face in the water, I felt like I was smothering, I don't have a problem putting ice on my face or even putting a cold shower on my face, but actually putting it in the bowl of water, I couldn't do it.

  352. Leptin Rx: Week 2, Day 1 | Sans Carbs February 14, 2012 at 8:37 am - Reply

    […] doing this Leptin Rx program: Be sure you read the comments following his Leptin Rx post and his Leptin Rx FAQ post.  There’s a lot of good Q and A in there on what is and what isn’t appropriate to eat […]

  353. Gladina February 14, 2012 at 3:38 pm - Reply

    @Eleanor: I bet Dr. K wouldn't have a problem with you using cold water from the shower on your face w/ the ice packs applied instead of submerging your face in the [essentially the same condition]. It's about the cold and in water…not submersion itself. The ice bath should still be OK for you, since it seems a problem with your face being 'smothered'.

    I'm not the doc, but hope this helps.

  354. BenG February 15, 2012 at 1:16 am - Reply

    Dr Kruse,

    Yesterday on Leptin reset (end of week 2), ate low carb, was fine all day. Around 5pm did HIIT at 95-100% and ate low carb for dinner right after. Felt fine. Went to bed around 9-10pm. Around 12am, woke up with most likely high cortisol/adrenaline. Mildly hypoglycemic. Took me about 30-60 minutes to get back to sleep (did some breathing/mediation to calm down). I was torn whether to eat some carbs to address the hypoglycemia/high cortisol or wait until BAB. I decided on the latter…didn't want to screw up the circadian pattern. Woke up an hour later than normal. Took morning glucose…it was 66. Should I just eat more carbs at night after HIIT session? Also if this were to happen again, would you say it is better to eat at hypoglycemia in middle of night, or suck it up till BAB?


    • Jack February 15, 2012 at 7:50 am - Reply

      @BenG you need to remain hypoglycemic. This is how leptin regains control of PEPCK to control gluconeogenesis.

  355. BenG February 15, 2012 at 11:27 am - Reply

    Dr Kruse,

    You wrote on the Mg article: "If it is large and sustain and colored by an emotional stressor the obesity is more likely to damage the hypothalamus. If it is due to heavy fructose and PUFA intake it is likely reversible with a leptin reset protocol"

    Are you basically saying if you take two people. One sips on cola loaded with HFCS all day and eats french fries everyday, and the second is a woman who everytime she get's stressed out, emotional and she becomes a carbaholic, the former is likely to correct with a Leptin reset. The latter is permanently screwed unless they use the cold therapy you are advocating?

    • Jack February 15, 2012 at 11:55 am - Reply

      @BenG I am saying both risk LR……..both maybe treated with the reset…….the response depends upon the confirmational changes that could have epigenetically altered the six binding sites on the leptin receptor or possibly even altered their adipocytes themselves via activation of a leptin SNP……..or crazier yet……..alter protein protein interactions that cause a quantum biologic shift that alters the binding affinity of the hormone and receptor to lead to a different expected biologic outcome………in essence……inflamamtion alters the normal biochemistry in a printed textbook……..the one we all expect normally. There are too many clinical scenario's I have observed to explain this simply……..therefore the best explanation to me is the one that the master organ uses…….neuroplastic change. If the brain can undergo plasticity that means that evolution has an ability to make organic chemistry plastically change when certain variables are altered. If the end organ, (the Brain) exhibits these plastic changes in a 30,000 ft view of our understanding………then it means that the pieces and parts that make up this organ………also must exhibit the same plastic ability. I know this is tough science……..but in July I contacted a quantum biologist with my ideas……….and this is what I proposed to him……..and told him I thought I had a way to prove this clinically. He told me what I proposed was not only biologically plausible but it was already proven mathematically in quantum mechanics. But no one had thought to marry the concepts together yet in a a directed evolutionary experiment. I told him about my idea about the quantum effects of electrons………that I mentioned here….

      I realized that the biochemistry had to adapt to different thermal coefficients to explain my clinical observations…… own thought experiment so to speak. He sat me down and told me what he thought I had to do to show that biochemistry had a different reality based upon some variables added to the biologic system. That is what I did. To answer you fully now that I have your mind twisted………..those two people can be in the same place but travel a different path and their biochemistry can be radically different to get there but the end clinical result is the same……………..This is a quantum biologic effect. Life makes order from the complete disorder of matter. These biologic adaptations are based upon environmental and epigenetic signals changes that force conformational changes in molecules and bonds of enzymes and proteins to restore that order for ideal biologic function. Evolutionary design is based upon fractal geometry that has an ability to alter chemistry and physics to suit its requirements for survival. Survival is at the basis of all natural selection pressures. The Paleo world seems blind that biochemistry can be altered to an environmental change like light or temperature or many others I am exploring……….this is why macro nutrients matter little on the surface. What matters is what is the best plan for survival in any system. Evolution has a fractal plan in place for each variable it has faced. The ones it has not faced…….we have no plan for. For example…….refined carbohydrates with PUFA's on Dec 31, at midnight during a rock concert. That is a complete mismatch for biology. That takes order out of the system and allows disorder. Disorder results in disease.

      What matters is how biology alters chemistry and physics to suit its needs. When you begin to understand the nature of organ function you begin to realize that the same architecture is used at protein binding level, an atomic level, even a subatomic level. Einstein was right……….there are many realities for us…….it appears biology and evolution use it……..but we are clueless to that trap door.

  356. BenG February 15, 2012 at 12:35 pm - Reply

    Wow, thanks for that explanation..and much thanks for your help to me and all your readers.

  357. Eleanor February 15, 2012 at 7:09 pm - Reply

    Thanks Gladina, I'll keep working on it, I use a cold pack between my shoulder blades that BenG suggested, but I'm thinking I need to get better ones as it doesn't last long.

  358. TheKid February 16, 2012 at 3:30 am - Reply

    Question about blood glucose (BG) levels. I just finished week 2 of your leptin reset. I am concerned because my BG levels have climbed. I am tracking them daily right when I wake up. When I started I was around 88. And prior to the reset, I would test periodically in the morning and would be 88 or 89. I had been Paleo and lower carb (100g/day) since May, but stalled in weight loss, started carb craving and started getting hypoglycemic symptoms again. That's why I've started the Leptin Reset. But over the past 2 weeks I've watched my fasting BG go from 88 to 93 to 95 and then this morning it was 100. I figured maybe my machine was off so I tested again and got 95. Either way, I was expecting BG to trend lower, not higher. I feel good, and cravings are gone as well as hypo symptoms, but I am concerned about the BG numbers. Any thoughts?

    • Jack February 16, 2012 at 7:18 am - Reply

      @The Kid its called adaptation.. Do you adapt to lifting 500 lbs you first day in the gym?

  359. BenG February 16, 2012 at 7:41 am - Reply

    Dr Kruse.

    As you said earlier, a person with a high BMI can't get leptin sensitive. If you take a yo-yo dieter with a screwed up metabolism, high reverse T3, LR,, etc. etc. like an obese woman who has so screwed up her metabolism from yo-yo dieting that she eats 900 calories a day and gains weight….Will the leptin reset work on her…if she keeps at it? Or does she have to eat 500 calories a day to get her BMI down to a level before the reset is able to fix it?

    • Jack February 16, 2012 at 7:52 am - Reply

      @BenG is she eats 500 calories or 900 calories she wont lose any weight…….you are not resetting anything with the same signal thru the vagus nerve. You must eat……….and rewire by timing and light………then if rev T3 is still resistant………cold thermogenesis.

      Here is the key to transformational change…… anything. You must think differently about the problem today if you are to get to the place you have buried in your minds eye right now

      Your present day thoughts must change. If you think the same way you did yesterday your results will be a different version of the same old condition.

      Neuroplasticity is a function of subatomic quantum physics……….evolution follows the same plan as transformational thinking.

      GET SOME and learn how to constantly upgrade your mind to get you where you want to be.

  360. TheKid February 16, 2012 at 7:51 am - Reply

    Dr. Kruse, I did indeed expect adaptation to be a bit bumpy for sure. I suppose I just didn't expect my BG, which appeared to have righted itself, to start climbing. If this is normal, I'm cool with being patient and waiting for the full adaptation to take hold. I was just concerned that an increase in BG might signal some problem, cause I don't know where the BG is coming from if I'm eating less than 50g carbs per day.

  361. BenG February 16, 2012 at 8:29 am - Reply

    I understand you saying that the calories take a back seat to the reset. I'm just trying to understand the catch-22..i.e.

    a. You can't become LS as long as you're obese.

    b. As long as you aren't LS, you won't lose weight and can't lower your BMI (except temporarily through hypo-caloric dieting).

  362. Eleanor February 16, 2012 at 2:16 pm - Reply

    BenG I can tell you it works, I'm morbidly obese, have fought weight problems my whole life, I started the leptin reset on Jan 2, lose weight immediately and then the weight bounced back and forth 4 pounds since then. I did not eat a calorie restricted diet, I ate what Dr K suggests, I also am taking all the supplements he suggests as well. It seemed like the weight was going to stall and stay there, then he came out with the cold protocol to help those of us that keep stalling. Only been a couple of days using this cold method in whatever way I can until I can get the supplies I need, and this morning was down 3 pounds. I also started the HIIT as well and maybe that helped not sure, I might not need the cold protocol but hey it's working, I sleep better, everything else is falling into place. Was a bit hungry once I started on the post leptin rx with a smaller breakfast, but noticed at lunch today, even though I was ready to eat when the time came along, I wasn't able to finish what I had prepared. 🙂 BenG it may look like a catch-22 but hey, I was LR, am now LS, and am doing it without starving myself or exercising til I drop. All I can say is thank you Dr. K 🙂

    • Jack February 16, 2012 at 2:21 pm - Reply

      @Eleanor and BenG I have never told anyone this but when I did my reset…….my wife used to constantly say this, Jack, you really need to cut your portions back! If you meet her someday ask her. She could not fathom the meat pounding I could muster back then. I'd finish up with a cup off black coffee with two scoops of Nutiva coconut oil and jump in the ice. Back then she thought what I was doing was completely psychotic. After 3 months and 77 lbs I became awfully smart and all her girlfriends wanted to come over and see my madness in action.

  363. Eleanor February 16, 2012 at 7:45 pm - Reply

    Love the story 🙂 yeah I bet they thought you were the smartest man on the planet lol, way to go Dr. I love the fact that I can now eat until I'm satisfied and can stop, I don't snack, that in itself is astounds me 🙂 I don't need to eat until I'm too full, I will eat this way the rest of my life.

    • Jack February 16, 2012 at 8:04 pm - Reply

      @eleanor…….I am not close to done yet sharing what is in my mind. Let's just say from unconventional thoughts lead to stunning results!

      In biology we find that the truths are stranger than anyone can imagine. The paradox is this…….all the universe is filled with entropy and total disorder. Einstein taught me this. Evolution is the giant maid who came in and made order from total chaos…… she did it……no one really has it all together but what she did is the most amazing thing my mind can fathom. Total order from disorder. It catches my attention. I need to learn all I can from the owners manual we all came packed with in our DNA.

      Americans need to begin to help themselves to avoid my profession as much as they can……otherwise they subjugate themselves to the machinations of a brutal system that will enslave them in illness and not shine the rays of wellness on their DNA because they are blind to how to read that owners manual

  364. […] not until they restore the balance and signalling.  I’ve been particularly interested in reading Dr Jack Kruses Leptin Reset ideas in this […]

  365. cgk February 17, 2012 at 9:35 am - Reply

    Dr. K, Ben and Elanor,

    Thanks for the posts/comments about the different paths to LR. I guess the question really is how to determine if the hypothalmic damage is irreversible? Is it enough to rewire the leptin receptor elsewhere through the protocol? Is that enough to put the hormonal cascade to rights? Even if with the cold protocols are used to aid the fat loss and gain LS, will hypothalmic damage (which I understand is permanent) continue to erode the situation? Should that recovering stressaholic pretty much need to expect to supplement a Paleo diet (PQQ, CoQ10, etc) beyond completion of the L Rx – if they ever do get LS?

    And yes I'm asking because I had one of those cataclysmic life events in a post partum state in my 40's and surprise, not exactly feeling "optimal". This all makes me wish I had been really "fat and happy" instead of " just dumpy and miserable".

    • Jack February 17, 2012 at 1:20 pm - Reply

      @cgk some people are completely fried but that number is low. Some people can be restarted again too…….When the mechanisms are laid out you will see there is a way to sensitize a receptor to biologic action without have a normal physiologic level of a specific hormone or enzyme

  366. TheKid February 19, 2012 at 1:45 am - Reply

    Dr. K, I am wondering about the difference in approach to the Leptin Reset that might need to be taken by those who start life at a deficit. I ask because I was not breast fed and for as long I can remember, I have had unhealthy cravings for sweets. Strangely, I remember that even as a child, I would put weight VERY easily. I was a seriously competitive swimmer from the age of 8-27, and I had the mysterious problem of putting on belly fat whenever we came to the end of a competitive season (periodization in training mandates work overload earlier in the season and reduced work late in the season in the hopes of a supercompensation and uptick in peak performance). All my teammates would be just fine. I would immediately start to feel a little soft around the midsection and would also not be able to naturally reduce my caloric intake. I would still have the same cravings, especially for carbs.

    It's no wonder I jumped from a healthy 190 lbs. at the age of 27 to 235 at the age of 28 to 250 before my 30th birthday. I have never understood how the hell that happened. And when I reached 305 lbs. all seemed lost.

    Could it be that my personal issues with leptin far outstrip the challenges facing others? Is it a function of not being breast fed alone? Or is there some other confounding causal element that made me always have these cravings and always gain weight so easily? And will the standard protocol fix me, or am I looking at needing something extra to heal properly, if that is indeed possible. Thanks for all you do.

    • Jack February 19, 2012 at 4:04 am - Reply

      @TheKid you are touching on some core issues here to my quilt document The short answer is yes you are describing living an incongruent life to how the leptin receptor was adapted in you. Your story from 8-27 is classic severe LR. And the fuel that caused the weight gain was likely the excessive spikes in cortisol you added to this doing your swimming while you were LR. In essence you over trained while LR and made the short term situation fine at the expense of your long term situation. Immediately go back right now and read the blog Why is Oprah fat you may begin to gain see insight as to why this all happened.

  367. BenG February 19, 2012 at 11:26 am - Reply

    Dr Kruse,

    Are you ok with the anti-inflammatory "superfood" juices like pomegranate either during or after the reset?

    • Jack February 19, 2012 at 1:11 pm - Reply

      @BenG Am I OK with it……….sure. Would I ever consider eating it? No. The name of my site is Optimizing Life…… can be optimal and eat foods we are not designed to eat. Eat the fruit and never the juice.

  368. TheKid February 19, 2012 at 12:54 pm - Reply

    Wow doc. You've hit the nail on the head. Because another feature of my career as a swimmer was my persistent penchant to fatigue quickly. Everyone always had that extra Oomph. I was nearly always flat. Never reached my potential. Coaches were always puzzled. But after reading the Oprah post again, it all makes sense. My muscles simply couldn't use energy properly and I was chronically overstrained and over stressed.

    So what do I do now? If I am a classic case the way Oprah is, do I just continue on the Leptin Rx as you have generally described it? Or is the road to normalcy for people like me and Oprah different?

    • Jack February 19, 2012 at 1:08 pm - Reply

      @TheKid Now that you had an aha moment…… todays post and see what I just did to you. I led you to a place where you could learn something on your own……..and it would make a bigger impact on you than If I just told it to you. This is how my Quilt is designed. You are becoming both a student and soon to be a teacher in my war of change. I build real transformations because they lead to creative destructions. Telling you something allows for procrastination…….and real change rarely comes from this learning. In brain architecture, change is not transformative. Change brings a different version of the same old same old………Im looking to bring you to a place you have not imagined existed. To do it……I need you to discover on your own

  369. Coburn February 20, 2012 at 12:13 pm - Reply

    Jack, I am immensely grateful for your taking the time to share your amazing insights! You are truly an original thinker. I am 5 weeks into my Leptin reset and have started to see some of the signs of LS that you mention. I can hardly believe how rested I have been feeling in the mornings for the last week! And I am fast running out of holes in my belts despite only a modest (less than two punds per week) weight loss.

    Question: You often use sunset as a reference point for the timing of eating, training etc. I live on 59 degrees north (Norway) and sunsets here vary between 4pm in the winter and 11pm in the summer. It would be great if you say a few words about how people far away from the equator should interpret for example "Within an hour of sunset try to make your surroundings as dark as possible" and similar advice.

    • Jack February 20, 2012 at 8:31 pm - Reply

      @Coburn When I release the next blog on the cold thermogenesis series pay attn to it…….at your longitude and latitude biology uses a curve ball no one saw coming. I uncovered it 4 yrs ago and I have been using it ever since. It is why I developed my post Leptin Rx plan. It is based upon what I found after the reset and I have tested it on several of my patients and it is nothing short of amazing.

  370. shirley raab February 20, 2012 at 6:43 am - Reply

    Jack, I am due for anterioir cervical fusion next week due to herniated discs pressing on the c7 nerve and causing pain and moter problems in right arm.I have been trying to implement the leptin reset to fight inflamation .It has been a short time but I had already limited grains and nightshades. I have been experiencing definately less pain and am wondering if I should postpone the surgery to see if I can take care of this in a natural way?If I should continue and have the surgery what are your recemendations for this next week. Thanks for you time.

    • Jack February 20, 2012 at 8:28 am - Reply

      @Shirley I am in surgery right now…….when I get out I will post a blog just for you……it is what I give all my patients before they consider surgery…….I think it could help you. I actually have to go do a cervical fusion as we speak!

  371. Sharon February 20, 2012 at 12:56 pm - Reply

    I posted this on another thread…The Leptin Rx until I saw where there was FAQ thread so I am posting here as well in case the other one is out-dated.

    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.

  372. shirley raab February 20, 2012 at 7:33 am - Reply

    Jack,Thought I had better add a little more inf on myself. I am 51 postmenopausal.

    I have some reumatisim but the flare ups have decreased due I think to not eating grains.My body comp is poor , about 13 pounds overweight.Poor sleeping habits inpart from the neck pain.The disc c5,6 ,7 show degeneration from arthritis and there are ostephyte build up on the c6,7.Will eating the diet help with the return of strength in my arm due to less pressure , inflamation? And will I be able to workout with weights at some point in the future.

    • Jack February 20, 2012 at 8:32 am - Reply

      @Shirley Get your surgery done……..its important to limit your pain but you need to consider some things peri operatively to make things go optimal.

  373. BenG February 20, 2012 at 2:14 pm - Reply

    Dr Kruse…How much do poor oral hygeand inflammation like gingiivitis contribute to LR and CVD?

    • Jack February 20, 2012 at 8:24 pm - Reply

      @BenG oral health is huge. You need to treat your mouth like you treat a leaky gut. It is the beginning or your "optimal life" tube.

  374. shirley raab February 20, 2012 at 2:07 pm - Reply

    Thanks Jack for an answer. I will be watching for your blog

    • Jack February 20, 2012 at 6:43 pm - Reply

      @Shirley Rabb is is up for you now.

  375. Coburn February 21, 2012 at 2:41 am - Reply

    Thankyou for answering, Dr. Kruse! Very much appreciated. I will definately continue to follow you blog very, very closely.

  376. BenG February 21, 2012 at 6:29 am - Reply

    Dr Kruse,

    Does an increase in NEAT (i.e. fidgeting) suggest LS improving? UCP1 activity? I've noticed I'm fidgeting a lot more..arms, legs, neck rocking etc near end of week 3 on reset.

    • Jack February 21, 2012 at 6:49 am - Reply

      @BenG it does

  377. Nic4health February 21, 2012 at 9:17 am - Reply

    Hi there! Wow this has been so enlightening. I actually teared up when I got to the bottom and read about your Nordstrom purchase / miracle. What a day that must have been! You have really inspired me and I have been in a very dark place due to a divorce and many other things stressing me, but i remain grateful that i still have a job and now this great info! A quick summary: I was a very sucessful low carber during the 2000's during and after college. I maintained 130's at 5'4" not too bad. Even self published a low c cookbook! The past 2 years I made a shift to a raw diet, was on and off a raw vegan first dong really well then rapidly seeing major health issues (hair, teeth issues, belly fat etc) which pretty much led me to a miserable place health wise. Going back to low carb diets, acid/alkaline vegan diets, finally to paleo, and now here, i feel like i have seen the "light" in a big way! (I also fell back into old Eating disorder ways out of total desperation and stress/changes happening the past few months which thankfully i have a handle on over the past few weeks, but i did see a HUGE weight gain from 150 to at present day 175lbs! It is shocking how fast it came on, and also how none of my wardrobe fits me at the moment. Depressing isn't even the word. It is amazing I am staying as positive as I am. So my first question is: I am really curious to know if you have any insights as to why my body would put on soooo much weight sooo fast!? I would say I was bulemic on/off, mainly at night for apx 3 months, and gained about 25lbs in that period! What a harsh lesson to learn there. Sorry if this is TMI but I am very interested to know hormonally what could be happening. I have a scientific brain and find this info useful and helpful in healing. Thankfully, low carb and the promise to myself that life will and can only get better are helping me to heal.

    Just a few other q's: I am a few days on low carb, officially starting leptin reset today. Had a BAB, feel really full. I did have a coffee this morning with a little splenda and almond milk – and like to have a cup or two through the day: is this considered a "snack"? Will 40 extra calories spread through my day cause an inturruption with the liver? If so, I'll give it up.

    Excercize: I sit ALL DAY at a desk, virtually motionless :/ … Is it ok to start walking for 20-30 minutes after work around the neighborhood? Can I jump on my rebounder (mini-trampoline)? Or is this too "aerobic"? I Like it to stay flexible. And lastly, I was quite literally today going to start a new core workout routine: upper and lower body ie: abs, squats with 5lb weights, 4x/week. Should I hold off on starting this routine for a few weeks? I do sweat quite easily once I start to work out. But I dont want to take any years off of my life for a quick result! I am more then happy to just be in very sexy shape by the summer, which gives me a few months.

    Lastly: Is it possible to be overweight and NOT LR? Like in my case – with a ED. Could it be something else (starvation mode) causing my gain?

    Thank you so much. I have a wonderful feeling about this new discovery! Again, I feel I have "seen the light". ^.^

  378. Shilohman February 21, 2012 at 12:26 pm - Reply

    Dr. Kruse, I have been lurking on your website for several weeks now and find your site very informative. You Dr., are a very unusual breath-of-fresh air in a society where everyone is hawking their views for $money. You obviously, are not blogging for $money or promoting your supplements or hawking any books you have authored, bravo for you. You obviously are very passionate in your views and some might say excessive. Well that just is the way it is with someone who has walked-the-walk and lives what they preach. Again bravo for you.

    Reading the calls for you to write a book are interesting, but how do you condense the QUILT down to where it fits into a two to three hundred page book? Not sure you can, maybe several volumes? You mentioned writing a book for Doctors regarding surgery without the blade, well when you are done with that book, how about one for the patient, you know one that shows the patient how to use their diet so they don't get to the stage where they need to see a surgeon. Volumes could probably be written on doing the Leptin Reset along with the comments of those who reflect real life examples of different problems that must overcome to become Leptin Sensitive. Your personal research into extending telomeres and longevity could be another book. Just some ideas to think about, since the

    whole QUILT concept probably needs to be segmented and broken up piecemeal for different audiences.

    You are the poster child for Leptin, since you have lived the Leptin resistant life and have been healed. Surely, the phrase, physician heal thyself, is very apropos and gives you not only insight, but also authority to write/speak about Leptin and the whole leptin lifestyle.

    Notice I didn't say, Paleo lifestyle, because that conjures up something totally different. Who wants to live in a cave 🙂

    Doc, whatever you write, write to be true to whatever you want to communicate and whatever way you want to communicate. Ignore what the publishers want, they are no different than car salesmen. They only want you to write what will maximize their profits in the shortest amount of time possible. Past that, they don't really give a squat about your life's passion. Be true to yourself and let them be your servants, not the other way around.

    Rationed health care appears to be where our society is headed and there has never been a more appropriate time than now for someone with your credentials, personal experience, research and insight into healthy living, so that we can take control of our health. In the future, we may only have limited access to medical help for our health problems, your Leptin Rx will only gain in importance and acceptance.

    Keep up the good work Doc, you are spot on.

    P.S. in your blog you mention N-1, but I can not find anywhere on your site where you define N-1, what does that stand for?

    • Jack February 21, 2012 at 12:36 pm - Reply

      @Shilohman N-1 is a self experiment……..i have many on myself but the last two are about the deepest. And show why you might want to really pay attention to the QUILT. Read todays post for a flavor of where I am heading.

  379. BenG February 22, 2012 at 5:21 am - Reply

    Dr Kruse:

    On the TED video linked on your sleep essay, the speaker said the normal pattern of sleep in a natural environment (I'm assuming the sun went down around 6pm and they weren't exposed to artificial light) was to go to bed around 8, wake up around 12am, then one would typically mediate for two hours till 2am and go back to sleep until around 6am–or 2x4hour cycles. This seems different than 1×7.5-8 hour cycle in your Rx, etc..

    • Jack February 22, 2012 at 8:07 am - Reply

      @BenG she is correct…….but she also was quick to point out that this ability has been lost in modern humans in her estimation because of artificial light has been a huge game changer. Since Paris France became the first city in our world that used fake light in 1924. I think most humans are not really ambiently aware of how how circadian mismatches destroy our biology. Moreover, when one looks at the biology and biochemistry of sleep and truly understands the power of autophagy for longevity it becomes apparent to me that we may want to consider that maybe sleep is our primordial conditon and not wakefulness. Maybe we evolve consciousness over time. This theory I have follows the thoughts i have developed in cold thermogenesis because in extreme cold environments the process of autophagy becomes super sensitized to save energy. In fact in cold sleep is heavily selected for in terms of how mammalian nervous systems respond to the stimulus. This is why mammals sleep so long underground in sub zero conditions and survive. You are beginning to ask great questions and I think you might begin to see where there is a convergence of scientific findings that occur in this biology to explain many effects we observe in humans and all mammals. Radical Rule #3: Sleep and cold environments were our ancestors primordial condtion and as such, this was evolutions starting point for life on our planet. I think this thought maybe why epigenetics has become to be found as the major player in genetics too. Because anything that promotes survival and reproductive fitness has to be passed to the next generations. I think evolution found this to be true and it became a backbone law of genomics functioning. Life was likely static at this time and to get the nutrients it needed it had to evolve wakefulness to obtain them. To do this it yoked metabolism to sleep early on so it could account for things. I believe the timing became an easy solution because of the ryhthmicity of the sun and the freezing cold could control these cycles for the cells.
      I believe this fractal organization of sleep and metabolism remains in every organism studied. Because of this I believe that sleep, autophagy are extremely highly conserved across all species on our planet. We still have yet to find a species who does not sleep some. I think as life evolved wakefulness it had to account for it environments and as such evolution then moved from a static model to a dynamic one and then a whole new set of environmental problems had to be navigated to make life persist. This is where movement was first coupled to memory or actions. Even today all learning in higher order animals is directly coupled to movement in their environment. The more one moves the more intelligent one becomes. We can prove this today because if we just get an Alzheimer's patient with a demolished brain, when we introduce exercise we can increase their cognitive function in a completely broken organ. That tells me a lot of how evolutionary design is constructed. I hope this helps you understand how I think about life and how it all began. It is a foundational concept behind my QUILT document. When you see my point of reference you begin to see a new reality that you might have not anticipated before you thought about what I just explained to you.

  380. BenG February 22, 2012 at 5:26 am - Reply

    Pardon me, the video was on the "How the Leptin Rx works" essay.

  381. BenG February 22, 2012 at 10:27 am - Reply

    Actually, it was recognizing an occurrence when people lived more naturally regarding rising at midnight to meditate that rang the bell which is when I connected the dots. I think it all points to how unnatural urbanization really is. Thanks.

    • Jack February 22, 2012 at 10:53 am - Reply

      @Ben G in a few minutes when CT part two gets posted…… going to connect a few more dots for you.

  382. Dee February 24, 2012 at 11:28 am - Reply

    Great website! Glad I came across it.

    I've lost a significant amount of weight and learned a lot about my body in the process. I agree with much of your information from my personal experience—high protein breakfast is a must for me. I've been researching Leptin over the past many months and would like to try to incorporate what I've learned with some of your recommendations. I will def make a point to read your site. Tried searching for some important things but since this site doesn't have a search function I wasn't able to find some answers. I def have leptin resistance, though I believe it has improved, I still don't have the hunger of a normal person yet. I probably have 25lbs of fat to lose and would like to gain 5-10lbs of muscle—-Most of all I would love to feel satisfied on 3 meals a day with no snacking.

    A FEW QUESTIONS—for Dr. Kruse and anyone else who may be able to help!

    1. If we were NOT BREAST FED, I'm assuming this may be a contributing factor if we have experienced leptin resistance since childhood, is there a supplement we can take to activate leptin, or whatever we didn't get from breast milk that we should have gotten?

    2. COCONUT OIL and MCT OIL. I use mct for salad dressing, and use both mct oil and coconut oil to cook with extensively, however, I recently attended a seminar at my health club that said if I cook with it, it turns it into a "TRANS FAT" since it is not stable under heat and converts it to an unhealthy fat. They said we should only use butter for cooking, only add coconut oil or mct oil to warmed dishes? Is this true? Also, should we not heat coconut oil at all? Have I been consuming trans fats all this time cooking with it?

    3. PALEO DIET or INUIT DIET? Ok. Seems the Leptin Reset says Paleo Diet but then Im reading Inuit diet? Not familiar with Inuit diet, but does that mean no vegetables- meat and fat only? If so how do we get the nutrients contained in those vegetables.

    4. I recently purchased a book MINDING MY MITOCHONDRIA: How I overcame Secondary Progressive Multiple Sclerosis—- a Paleo type diet created by doctor who came up with her own diet to feed her brain and was able to reverse her MS condition from being wheel chair bound, to riding a bicycle again, in under a year. Pretty remarkable story. Is her version of the paleo diet acceptable. I never thought I could do paleo bc it seemed to not emphasize meat, and I know for sure red meat helps me so much with hunger and feeling satiated. Her diet is hunter-gatherer with meat but emphasizes the nutrients needed by the brain. As a brain surgeon, I'd love to hear your views. If not which book do you recommend we use as our diet guide, in light of your recent articles suggesting and intuit diet for the Leptin Reset? Here is a link to her YOUTUBE VIDEO STORY which chronicles Dr. Wahls journey and diet basics , Here is a link the BOOK Minding My Mitochondria: How I overcame secondary progressive multiple sclerosis (MS) and got out of my wheelchair… , Here is a link to her FACEBOOK page!/Dr.Terry.Wahls .

    5. SWIMMING, I've been swimming 5-6days a week for 20-30min for a couple months—about 40 laps of 25 meter pool in about 20min, sometimes I use fins. I was a competitive swimmer growing up, but when I swim I aim for a "refreshed feeling" when finished as recommended in the book Mastering Leptin, not heavy yardage, lower heart rate "fat zone" 120avg heart rate max. Seems this should be eliminated during Leptin Reset until all sugar cravings are gone? And other measures you menti oned. I think swimming helps a lot with stress management for me and suppresses my appetite, so I'm not sure what I will do with this aspect bc I really enjoy it again, but would like to get rid of sugar cravings. I will def stop swimming first thing in the morning and change it to 5pm, prior to dinner, but will try to stop altogether if I have to for awhile.

    6. STRESS MANAGEMENT, what do you recommend for stress management during the Leptin Reset since we are not able to exercise? I take Omega 3's, but know swimming helps a lot with stress for me.

    7. COLD PROTOCOL, Read your articles on COLD THERMOGENISIS, but people seem to be talking about daily regimens of cold bathing, but I couldn't find anywhere where is stated your regimen and how often/when it should be done. Could you direct me to the thread that discusses what you do daily to capitalize on the principle? If I walk outside in the cold for exercise, should I stop wearing my Under Armour cold gear clothing and let my body be cold? Or is it bathing in cold but not exercising at the same time? Is there a difference?

    8. ANTIOXIDANT SUPPLEMENT. I take an antioxidant supplement called Go Greens since I don't eat much in the way of fruit when Im trying to lose since fruit triggers carb cravings. Any thoughts on the usefulness of this supplement? Says is has the antioxidants of 6 servings of fruits and veggies. Is it a good thing to take each day? I take all my regular vitamins Multi, C, D3, B Complex… and resveratrol too. Here's a link to the supplement… I usually take it when I finish swimming in case I create any oxidative stress when I am working out.

    I'd appreciate any input from you and the followers of this site. All input is welcome! Thank you in advance for your help!

    • Jack February 24, 2012 at 11:47 am - Reply

      I am friends with Dr. Wahls and will be speaking with her at Paleo Fx in Austin.

  383. Dee February 24, 2012 at 12:23 pm - Reply

    Great! So far I really like the diet recommendations in her book, but I don't follow 100%. Chicken gives me insatiable nasal itching (brother is allergic- throat swelling) and whitefish gives me migraines so I'm a little more limited in what works. Salmon and lean red meat, and eggs are staples for me. I do still eat Greek Yogurt which she doesn't mention. It wasn't hard to adjust to most of her recs bc I was eating most of these things already but I like that she gives guidance as to amounts. I just cut most all fruit now, with some occasional blueberries until I get to my goal. anything high glycemic, or even sweeteners like stevia seem to still cause carb cravings, so I'm trying to go cold turkey. If her method is acceptable for Leptin reset I will stick with it—minus fruits and other things that aren't consistent with the rules. The hardest part is the under 25g of carbs. I had adopted that from my readings on Atkins, so I have to watch my quantity if I have things like brussel sprouts or other higher carb veggies, so I try to go with salad and mct oil/ACVinegar dressing for my other meal that day. I look forward to reading your site and buying your books when they are published! Thanks for your hard work!

    • Jack February 24, 2012 at 12:29 pm - Reply

      @Dee CT helps AI huge. Problem is it is hard to apply for those with severe MS…….when you use her diet to get better then you can add the CT. CT is amazing for adrenal fatigue and Hashimoto's

  384. Dee February 24, 2012 at 12:40 pm - Reply

    What is CT? And I don't have MS! I'm healthy, just overfat, and major Leptin issues. I just striving for great health for a lifetime. I was attracted to her book when she talked hunter-gatherer but she also talked about red meat being ok. I always thought paleo was very against red meat in favor of lentils, nuts, etc. My biggest problem is not having normal hunger, too many carb cravings. I've probably read over a hundred diet/health books—Oz,Atkins, … but seems now science finally has the key root to the problem esp. Leptin, cellular health, and all the great things you are educating us about. Great that the low fat, low calorie diet recommendations of the past are debunked—since they left us hungry for a decade! Thanks again for your great work. Can't wait to learn more from you!


    • Jack February 24, 2012 at 12:43 pm - Reply

      @Dee Cold Thermogenesis

  385. Dee February 24, 2012 at 12:51 pm - Reply

    Oh! Yep. I read your articles on CT! Very interesting. I once did an ice bath after a triathlon several years ago—-and survived it. I look forward to learning more about CT, and developing a daily regimen. Not sure what everyone is doing or the timing of it all. I live in chicago, so if walking in the cold is a good thing—-we have plenty of cold here. I ordered the book 4 hour Body that you had a link too. hoping to see the author's regimen. If you have your regimen on this site, please let me know where to find it. if you haven't shared it yet, I will look forward to your future posting! good luck at the Paleo conference, I look forward to watching. Hopefully they will have podcasts we can watch if we aren't able to watch live during the day!


  386. Dee February 24, 2012 at 12:54 pm - Reply

    PS I have a friend with Hashimoto's! She drastically changed her diet and lost 50lbs post pregnancy, and recently was able to reduce her medication. I will definitely refer her to this site!

  387. BenG February 26, 2012 at 10:58 am - Reply

    Dr Kruse,

    At week 3, day 5 on reset, I felt almost like hyperthyroid..was jittery, hyper, and my pulse was 95 sitting down (though my BP dropped to 116/66 from 120/85 in Dec.), almost felt anxious–sometimes like a panic attack, but no reason to feel paniced. Could this be a sign of Leptin regaining control of thyroid? (Similar to how I was hypoglycemic a few weeks ago and it was Leptin gaining control of PECK) I was subclinical-hypo in December (High TSH, mean T4). The only two sups I've added in last two weeks (was already taking w3, B,C, Mag, etc) is a kelp and green tea extract capsules). Maybe the simultaneous uptick of T3 and supplemental Iodine from Kelp overcompensated thyroid output?


    • Jack February 26, 2012 at 4:57 pm - Reply

      @BenG could be adaptation or maybe that you do not need your meds. The DHEA levels will rise after you really start fat burning…….way to tell is sleep should improve and that tells you may back off DHEA.

  388. BenG February 26, 2012 at 11:04 am - Reply

    forgot to mention…added DHEA at night too.

  389. BenG February 27, 2012 at 7:04 am - Reply

    @Dr Kruse, Thanks. One other new "symptom". I get sleepy as soon as it gets dark. I guess this is normal? I'm showing all the signs I think of LS, but still have a lot of weight to lose. Should I switch to post-leptin rx now or wait after my weight gets down to a normal BMI despite showing the signs (sleeping better, waking up refreshed, disinterested on carbohydrates, no appetite till dinner, libido, etc). My C-RP was low, to start — 0.5 — even when I started, but I don't have much visceral fat…just a lot of subcutaneous (gained weight in puberty..have more adipocytes to store outside visceral area).


    • Jack February 27, 2012 at 7:44 am - Reply

      @Ben G great sign. Means your hypothalamus is rewiring.

  390. BenG February 27, 2012 at 8:21 am - Reply

    should I switch to post-reset or stay on reset till my weight gets to the normal ranger (despite the signs showing)?

    • Jack February 27, 2012 at 9:41 am - Reply

      @BenG without labs hard to say

  391. Rick R February 27, 2012 at 10:59 am - Reply

    Hey, Dr. Kruse

    Just heard your talk at Paleosummit. Great stuff.

    I'm a 53yo Male about 50lbs overweight. I'm at about week 7 on paleo. Grain-free, legume-free. The only fruit I'm eating is Rader's Farms 3-berry mix, (every other day.) Only dairy is some hard cheeses, plain greek yogurt, and a splash of milk in my coffee. I drink Scotch a couple times a week and have been off beer for a month now. I'm eating just under 1600 cal/day. Generally I get about 50-6-% of cal from fat, 25-35% from Protein, and the remainder from carbs. I walk or bicycle 30 minutes/min a day and do 90min of yoga once a week. All of the above has been very consistent with zero "cheating."

    Here's the thing — Though I've had a total 6lb loss (down to 214lbs) I spike up 3-4lbs during the week. Generally, wednesday is the day I will see a big drop in weight. (I've linked this to what is my busiest.most active day of the week (Tuesday).)

    Above you stated that recovering from LR takes "6-8 weeks for most people." I get the whole most people bit. My question is, (assuming I'm 'most people') would I expect that once I've regained sensitivity that the weight loss should improve/become consistent? Is this, so to speak, the sign that LS has resumed?

  392. BenG February 27, 2012 at 12:36 pm - Reply

    Dr Kruse,

    What would caused increase thirst on the reset?…I find I'm guzzling twice the water I use too before I started the reset.

    • Jack February 27, 2012 at 12:39 pm - Reply

      @BenG rewiring of the posterior hypothalamus.

  393. Lindsey February 27, 2012 at 1:19 pm - Reply

    Thanks Jack, I look forward to reading it. Just a quick follow up question: even though I'm experiencing significant and constant heartburn/burning in the back of my throa throughout the day (worse than I can remember having, honestly), should I deal with it and continue with the reset? Will it heal itself? Like I said, otherwise, my response has been phenomenal.

    Thanks again.

  394. Lindsey February 27, 2012 at 11:03 am - Reply

    Hey Dr. Kruse,

    I’m in the middle of your interview for the paleo summit, and I’m riveted (as I have been to your work since I first discovered it through the hCG forums). I recently finished a 35 day round on hCG where I lost a total of 13lbs…but in the last 5 days of your reset, I’ve not been counting calories, eating strictly paleo and in strict accordance with your prescription (along with your recommended supplements for both the prescription and hCG users), and have begun cold-adapting. I can’t believe it when I get on the scale in the morning, but I feel like I eat to capacity at every meal, I’m now within a normal weight for my height, and yet I’ve still lost over 4 lbs in the last 5 days. My goal at this point is not weight loss, but taking control of my life and my health – and yet I can’t help but be floored by the changes I’m already seeing in my body. I could go on about how thankful I am to have found your blog and paleo living – but I should get to the real reason for this post.

    As I said, I’m trying to take control of my health. Last year, in early December, I lost my voice completely…and quite randomly. I woke up one morning not being able to talk, and after a visit to several doctors, was told I have severe acid reflux and “probably” a cyst or nodes. I was told not to tax my voice, as it would make it worse, and to eat a “low acid” diet in accordance with the book “Dropping Acid.” When my reflux and voice did not significantly improve after months following their directions perfectly, and when the doctors STILL did not know what was up, I sought out Dr. Jamie Kaufman – the author of “Dropping Acid.” Upon seeing Dr. Kaufman, she immediately ordered a 24 hour pH test and an ecg test that measured the electrical impulses of my vocal cords. As it turned out, according her, “lightening struck twice” and partially paralyzed my vocal chords, twice, via my vegus nerve. Dr. Kaufmann is at the forefront of acid reflux and voice issue research, and I felt lucky we were in the same city. However, after another three months of working with her and eating exactly as she prescribed in her book, in addition to being put on neurontin to attempt to stimulate my vegus nerve to heal my vocal cords – my reflux still did not improve. It became clear to me that Kaufman, while brilliant in her own way, was a sort of Dr. House with regard to my case. She was increasingly interested – and stumped – by my situation, and eventually I realized that her prescription was not helping me, and like so many other doctors, was missing something integral. Her low pH diet was not my cure-all, and my reflux remained as bad as ever.

    Fastforward a year and a bit to today. Until I went on Dr. Kaufman’s low acid diet, I had never had heartburn or the sensation of a burning esophagus in my life. After switching back to a SAD (I should say, though, SAD that consisted of organic foods and whole grains – never anything like diet coke, refined sugars, or fast food – but grains and a lot of carbs, nonetheless) I suddenly found that I not only got heartburn from all the foods that were on her “do not eat” list, but that I was experiencing heartburn on a fairly regular basis. For the last few months on hCG, I have not felt any heartburn, but I assume I still have reflux issues.

    As I said, I started your reset five days ago and have been having spectacular results with regard to weight loss and my overall disposition…and yet, though I’m following it perfectly and supplementing, it seems my reflux is back with a vengeance. I ate my BAB around 6:30am (2 eggs, 5oz turkey, 1oz grassfed beef liverwurst, 2tbsp coconut manna, 1 tbsp coconut oil, spinach and raw kraut)…and I am STILL hurting from it. I’ve also been getting really bad headaches. Prior to this reset, I never had any sensitivity to these particular foods…but over the last few days, I’ve become increasingly intolerant. I am absolutely stumped, of course. What could this possibly mean?

    I realize that this is an incredibly long post and your time is so valuable, so I appreciate any attention you give to this. I want to take control of my life and my health, because in spite of my best efforts, and an attempt to be healthy for most of my life, I’ve still not managed to accomplish this goal. I think finding you and the paleo diet will allow me to finally change my life forever…but something is up. I should also say that in the past, I’ve been diagnosed with PCOS (no cysts, but I continue to have severe hirsutism on my face and neck that has been unresponsive to testosterone blockers and other medications, along with hyperhydrosis), hypothyroidism (though I’ve been within the normal range for 4 years without any medication, so my doctors said I no longer have it), bipolar disorder as of 3 months ago (currently the only medication I take is an atypical antipsychotic in order to control the mania), as well as depression and anxiety. My blood work is normal aside from elevated overall testosterone (though the free t3, t4, and other testosterone panels were normal); I just checked it again, and they didn’t test my reverse t3, but my assumption is that it would most likely be abnormal because of my hirsutism and hyperhydrosis. My tsh is currently 1.9.

    Thank you, again, for the work your doing and your generosity in sharing it with us. You are an inspiration to me, and I only hope I can eventually be another case of living proof to support all your research.

    All my best,

    • Jack February 27, 2012 at 12:31 pm - Reply

      @Linsdey the blog tonight will be illuminating to you.

  395. Bud T February 28, 2012 at 1:37 am - Reply

    Dr. Kruse, I only learned about you today on the Paleo Summit. Fascinating and encouraging! I weigh 450 lbs and am 6 ft 1 in tall and 55 years of age. I am scheduled to begin a "pancreatic protocol" next week called the Ideal Protein Diet that has been quite popular in France for over 23 years. This program is medically supervised and is 0.5g protein per lb of lean body mass daily and less than 25 carbs per day. They say that the program rests the pancreas and resets it in such a way that there is no muscle loss and the body is forced to burn the stored fat.

    I'm sure that I'm LR. Do you feel that this type of ketogenic protocol will reset my leptin? My goal is to lose at least 200 lbs.

    Thank you so much for your contribution to all of us who desperately need to know what you've learned. Please feel free to share any advice you feel will benefit me.

    Thanks again.

    • Jack February 28, 2012 at 6:20 am - Reply

      @Bud T. save your money and use my Leptin Rx reset married with my CT protocol in this site. Do it for six months and then see if I am nuts. YOu must cold adapt. Its critical without cold youre wasting your telomeres and your stem cells……'re dying slowly. You are an hourglass……..who has seen its sand get lower daily for 55 yrs………as you have aged the glass is now clearer because their is no sand left……… this clarity you should realize the impact my news has for you today. It should make your vision sharp for your future because I have made it crystal clear to you here that time is your most valuable asset. You cant afford to waste it any longer. your life depends upon it. I faced your situation my self 6.5 yrs ago. You see me now. You know what you must do now.

  396. Stirling Gardner February 28, 2012 at 5:00 pm - Reply

    I have no words for how grateful I am for finding this site.

    Can you offer any resources online as to where to get the various LR tests you recommend?

    1) The HS CRP (highly sensitive C-Reactive protein)

    2) The reverse T3 tests

    3) The salivary cortisol test

    4) HDL level, serum ferritin, homocysteine, fasting triglycerides, fasting insulin, or post-prandial glucose readings done every 15 minutes for one hour after eating.

    Thank you.

    • Jack February 28, 2012 at 6:17 pm - Reply

      @Stirling Head over to MDA and ask for the help there…….there is an army of people traveling the road to optimal there under the nutrition tab.

  397. Stirling Gardner February 28, 2012 at 5:02 pm - Reply

    As well as what the numbers should be for healthy Leptin levels.

  398. Dineen February 28, 2012 at 5:08 pm - Reply

    While doing the LR, what's the best way to eat while recovering from gastroenteritis (commonly called "stomach flu")? CW is the BRAT diet which is of course not at all appropriate. Total fasting seems to aggravate nausea, while the typical high fat, high protein meal seems to promote indigestion. What I have done and seems to work is lower fat content and size of meals, while not out-right fasting.

    • Jack February 28, 2012 at 6:18 pm - Reply

      @Dineen its temporary so I would not worry about this in the grand scale of things.

  399. Bud T February 28, 2012 at 6:48 pm - Reply

    Thank you, sir. Since I do not believe I found your information by coincidence, I've chosen to accept your counsel and follow your lead. One simple question. I have a hip issue that was diagnosed a few years ago with a "arthritic hip joint" that has progressed from me walking with a limp to now requiring 2 canes. I believe that when I lose more than a hundred pounds, I will be more mobile and able to rehab the major muscles that have weakened from lack of mobility. A replacement was recommended, but I did not have health insurance at the time and I would rather not go that route until I've reduced my weight significantly.

    I've heard you talk about LR being linked to causing osteoporosis…could the reset and exercise when I'm more mobile due to weight loss possibly reverse this hip issue?

    Thank you.

    • Jack February 28, 2012 at 6:57 pm - Reply

      @BudT we have a funny saying in my house when this happens out of the blue…….quantum biology. Me and the wife are entangled for sure. BudT get your Testosterone and DHEA levels tested……it can help your issue huge. Yes you can reverse a lot…..but you need to go strict ketogenic lots of seafood and coconut oil

  400. Susan February 28, 2012 at 10:03 pm - Reply

    Your wonderful blog explains all my lifelong symptoms, starting with inflammation under my kneecaps at age 16 (chondromalacia patellae), very easily torn ankle ligaments,obesity despite strict adherence to WWatchers, osteopenia at age 53.

    Two days onto your program, going great.

    I have a mild egg allergy.

    Can I eat a small amt of high fat cheese in the morning with perhaps an apple? Can I use half and half in the morning in my coffee?

    Bless you!

  401. Bev March 1, 2012 at 8:09 am - Reply

    Jack – what are next signs to look for after the warmth following meals and while sleeping?

    • Jack March 1, 2012 at 9:31 am - Reply

      @Bev not sure what signs your talking about?

  402. Mamagrok March 1, 2012 at 4:01 pm - Reply

    Stirling – try or (I think they’re running a sale today!). They carry all of that except for 4-part salivary cortisol, which you can get from

    I think that leptin #s are irrelevant, IIRC – it’s the sensitivity of the *receptor* that counts, not how much you have.

  403. Ginastarke March 2, 2012 at 4:36 am - Reply

    Should I avoid unsweetened tea completely until LS is restored, or should it only be avoided between meals?

    • Jack March 2, 2012 at 5:45 am - Reply

      @Gina you can drink unsweetened tea anytime

  404. Helen March 3, 2012 at 3:08 am - Reply

    Hi Jack, I've tried cold training for the last few days. I managed to get up to 45 minutes in an ice bath after the second day as I found it really very easy. My bath is cold water, plus extra large packets of ice. Does this mean I am already leptin sensitive? Thanks.

    • Jack March 3, 2012 at 6:34 am - Reply

      @Helen without testing you cant assume anything.

  405. […] is based upon timing from circadian cycles and food signals. As I said in the Leptin Rx and the FAQ’s blog timing is as important to us as what we eat. This is why. to regain control you first have to […]

  406. Gina March 4, 2012 at 7:05 pm - Reply

    I am in the 4th week of the leptin reset. My goal is to heal my non-hashi's hypothryroidism. I would not mind losing 5-10 pounds. I am having some good signs: regained my sense of thirst, decreased appetite, much warmer all the time, very calm, great sleep and wake up about 6 without an alarm. However, sometimes I wake up feeling anxious with a pounding heart. I am wondering if I am now overmedicated with Armour. Could that confound how I feel? Do you have any guidance on when I should consider a getting a new thyroid panel? Are there any other signs I should look for? Your Paleo Summit talk was terrific.Thank you!

    • Jack March 4, 2012 at 7:10 pm - Reply

      @Gina add my CT protocol and watch you need for Armour go away.

  407. Judy March 5, 2012 at 7:56 am - Reply

    Hi Jack,

    Can you send me a link for instructions on the cold therapy?

  408. BenG March 5, 2012 at 9:25 am - Reply

    Dr Kruse, Is it normal for LBM/FFM to increase on the reset even without resistance exercise?

  409. Susan March 5, 2012 at 10:27 pm - Reply


    I have been on the reset for a little over a month, and for the past 10 days have been experiencing constipation. I haven't dealt with it since my pregnancies many years ago. Up until the reset I have been three years low-carb/primal.

    The only thing I have changed in my diet that I can think of, is that I have given up nuts and cheese and I am drinking a lot more water.

    Any ideas would be appreciated.


    Susan M.

    • Jack March 6, 2012 at 5:58 am - Reply

      @Susan you need Mg malate 1200 mgs a day, 99% dark chocolate and lots of coconut oil!

  410. Susan March 6, 2012 at 11:27 am - Reply

    Thanks Dr. Kruse,

    I drink about 1.5 tbls. of Hershey's cooking cocoa in about 6 oz. of hot water in the evenings, with no sweetner. Not sure if that is enough cocoa. I will up the Mg malate and the coconut oil.


    • Jack March 6, 2012 at 12:28 pm - Reply

      @Susan……Hersheys is crap. You need 99% pure real chocolate. Not fake chocolate loaded with mycotoxins.

  411. lioness7 March 6, 2012 at 11:52 am - Reply

    Dr. Kruse, is there a link between LR and nicotine addiction? What recommendations would you have for people trying to quit in order to 1. minimize withdrawl, 2. stay smoke free? As well, for those that are LR, would it be better to quit before, during or after the reset? It would be great for people to know if there is a way to rewire the brain from all the various dependencies.

    • Jack March 6, 2012 at 12:26 pm - Reply

      @lioness yes there is…..nicotine make us more LR. And when you see tonights post it make make you want to quit yesterday.

  412. Susan March 6, 2012 at 12:49 pm - Reply

    Dr. Kruse,'s

    Thanks for the heads up on Hershey's.

  413. chase March 7, 2012 at 8:13 am - Reply

    Doc I have asked this before on here but I just want to make sure my thought process is clear. If someone is experiencing jitteriness, forgetfulness, easily agitated, and lightheaded between meals it could be an imbalance/problem with the circadian rhythm. This would mean they would want to check the HPA axis by having a look at cortisol levels because high cortisol levels prevent insulin from allowing glucose into the cell. It could also be inflammation/leptin resistance at the liver, because this is what provides the body glucose between meals when it's functioning properly. I'm assuming as well that when the liver is inflamed and releasing inflammatory cytokines, it drives up that HPA axis creating cortisol imbalances. So addressing the liver would start to modulate the HPA axis. I'm also assuming that this person would be experiencing some leptin resistance, or is this a case where reducing systemic inflammation/HPA activity is preventing proper glucose absorption?

    • Jack March 7, 2012 at 9:34 am - Reply

      @Chase it could be anything. Modern humans are so screwed up they have no idea until I do a hack on them. After that they begin to realize just how off their behavior really is.

  414. chase March 7, 2012 at 8:49 am - Reply

    I also saw where you replied to BenG that an increase in fidgeting could mean increased leptin sensitivity. How does this differ from seeing more ticks found with touretts as you talked about in a previous blog?

    • Jack March 7, 2012 at 9:23 am - Reply

      @chase Tic in the grain brain blog are baout short circuits from myelin defects……once they are remyelinated often they can improve.

  415. Susan March 7, 2012 at 3:45 pm - Reply

    Dr. Kruse,

    Other than keeping inflammation down, would following the Leptin RX and CT have much of an impact on existing heel spurs? What about cold sores?

    Susan M.

    • Jack March 7, 2012 at 3:48 pm - Reply

      @Susan both are caused by cytokines so the answer is yes.

  416. Steven Wright March 7, 2012 at 5:55 pm - Reply

    Hey Jack what brand 99% chocolate do you use? Scharffen Berger? Thanks!

    • Jack March 7, 2012 at 6:19 pm - Reply

      @Steven Lindt and World Market brands are my go too’s

  417. Deidrefrom March 7, 2012 at 6:02 pm - Reply

    Hi Dr. Kruse,

    I have been Paleo for a couple of years, I don’t lose weight (likely have about 20 to lose). I have an HDL of 116, low FT3 and high RT3 at last check (from too much Armour), and low am cortisol, high pm. Since my HDL is so high, I am thinking that I do not have Leptin resistance. I am sure that I have other details that could be important, but I figured these were the most important. Thoughts? Thanks so much for all you do! I posted your site to my page today, because I do believe that you are changing lives.

    • Jack March 7, 2012 at 6:40 pm - Reply

      @deidrefrom search the optimizing labs blog……and the Hormone 101 blog. I think your issue is likely a bad hormone panel. Love your HDL. It is not your gut that is for sure.

  418. Deidre March 7, 2012 at 6:26 pm - Reply

    Oh – and I started CT. I can sit in a cold (45 degree) bath for about 15 minutes, almost to belly. I could go longer, but I have time limits.

  419. Lacey March 8, 2012 at 3:09 pm - Reply

    Hi Dr K.

    I have two questions I was hoping you'd be able to help me with. I apologize if they've already been answered in this forum or your other ones, but with over 500-1000 comments to get through, it's a bit hard.

    I'm in week 3 of the LR and I'm doing well.

    1) I've noticed in this website and Mark's Daily Apple that some people (some on the slimmer side, but most who need to lose more than 30lbs) who are in the LR stage are saying that they're eating/using certain cheeses (gouda, cottage), almond flour, almond milk, heavy cream, butter, sweet potatoes, cocoa powder etc. for baking/making meals. Is this allowed in the LR stage and I just missed something? I thought the LR Stage was a strict Paleo diet. Could you let me know if I can have the above mentioned foods?

    I think a page saying what products are DEFINITE NO's in LR would be helpful.

    2) What do you think about using Symlin or Byetta to help along with the Leptin Resistance? I've been reading some articles that they've been helpful. What are your thoughts?

    Thanks Dr. K

    Much appreciated.

  420. Evo Mama March 9, 2012 at 4:41 am - Reply

    Dr. K – thank you for sharing your amazing work through your blog and fb. I read your inspirational thoughts nearly every morning. Great way to start my day.

    I'm doing the CT your recommmend (was actually turned onto this a while ago reading Todd Becker's blog.

    Anyway, I've been reading more about the Leptin Rx as well, but I'm having difficulty determining if I am LR. My HDL is 64, and my FBG is usually in the mid80s. My sleep is decent (though I cosleep with my toddler son, so we have some occasional wake-ups), I'm maybe 15lbs. of fat away from ideal body comp. No cravings and can usually skip meals without any hunger. I feel like I'm in a LR/LS grey area. Maybe I should just do the protocol and see what happens.

    Your thoughts on this would be greatly apprecitated. 🙂

    • Jack March 9, 2012 at 7:08 am - Reply

      @Evo Mamm You need to get labs done if your not sure. read my Hormone 101 blog.

  421. Evo Mama March 9, 2012 at 8:04 am - Reply

    Thanks, Doc. Will do. This blog is abundant with wonderful information and I’m still working my way through it. I’ll read the Hormone blog right away and then talk to my doc about getting the labs done.

  422. Susan March 9, 2012 at 6:49 pm - Reply

    Dr. Kruse,

    I just finished sitting in my tub in 54 degree water that covered me to my waist and upper thighs for the past 40 minutes. I find it doable, if I don’t move around. If I continue with this along with the leptin rx, what is the possibility that it might assist in reversing osteopenia in my lower spine, as I am not fully immersed? I realize that I need to invest in a thermometer that will read my skin temperature, but until I can get one am I doing myself any good in this regard?

    Thank you.

    Susan M.

    • Jack March 9, 2012 at 6:54 pm - Reply

      @Susan the chance are outstanding as long as you eat lots of protein and fats with it…….and stay as far away from carbohydrates as possible.

  423. Susan March 9, 2012 at 8:27 pm - Reply

    Thank you for your response Dr. Kruse. With your encouragement, I will continue to keep on doing the doable!

    Susan M. 🙂

  424. Susan March 10, 2012 at 12:04 pm - Reply

    Sorry, but I forgot to ask, what do you recommend the minimum about of soaks I should get in for a one week period to start with, and how quickly should I add to that minimum, if at all? Is there a maximum number of soaks I should aim for in a week’s period? I should be getting a DEXA scan sometime in the next six months, so I will let you know the results.

    Thanks again,

    Susan M.

    • Jack March 10, 2012 at 12:08 pm - Reply

      @Susan the more you do the better off you are.

  425. Susan March 10, 2012 at 12:31 pm - Reply

    Oh Heck! And here I was praying that you were going to tell me that there was, at least, a maximum amount of soaks for the best benefit! Oh well, there is a price for health just like there is a price for not taking care of yourself. I choose health! 🙂

    Thank you Dr. Kruse. You truly are a gem.

    Susan M.

  426. Margeaux March 10, 2012 at 2:24 pm - Reply

    I on my first week of the leptin Rx …can you tell me if I can chew sugar free gum or is that a considered a snack if I do?

    • Jack March 10, 2012 at 3:15 pm - Reply

      @Margeaux you can but it has artificial sweeteners in them……i have written about them here extensively and I doubt you would want to chew gum once you read those blogs.

  427. Kathy March 10, 2012 at 8:28 pm - Reply

    I have Hashimotos and take synthroid daily upon waking, and wait at least one hour before eating. How do I reconcile this with eating within 30 minutes of waking??

  428. Jack March 12, 2012 at 4:00 pm - Reply

    @Leiha I have not hit that yet.

  429. Coriander March 12, 2012 at 10:13 pm - Reply

    @Kathy I have been taking synthroid since 1986. I take it when I go to bed, which is 3 hours from eating.

  430. christi March 13, 2012 at 9:29 am - Reply

    hi Dr. Kruse, I have been on a healing quest for 3 yrs now. Massive diet changes, all organic, gluten free (sometimes) have recovered from Lyme disease and Babesiosis, Fibromyalgia-gone, CFS-gone. Neruo symptoms-speech/memory-gone. Migraines-gone. Thought I was going to be wheelchair bound and not know who I was and with 18months ABX and tons of supplements and major diet change I am getting my second chance at life. So grateful.

    That said I am still walking around at 250lbs. I eat so healthy. I have a son that developed Tourette Like symptoms so we went Paleo/grain free. Cured his tics and the stutter he had his whole life. Powerful stuff.

    My question is bowel related…I am on day seven ketogenic diet…almost no carbs. Feel great, nagging knee pain gone. Sleep hasnt come yet, but am expecting it. Only eating breakfast and dinner…no afternoon appetite since day 3. First cold shower last night! Exhilarating!

    My bowels are crazy…like pure fat. Sorry to be gross but they are like congealed poultry drippings. I dont mind. Glad to see it go….just wanted to be sure this is ok for my body/health?? Thanks so much!


    • Jack March 13, 2012 at 10:12 am - Reply

      @Christi sopunds like fat malabsorption…….and a leaky gut. Ox bile salts…..first off would help if it continues you need a fat absorptions study.

  431. christi March 13, 2012 at 10:14 am - Reply

    Ah! I have no gallbladder! Ox bile salts indeed.
    Thank you!

  432. Melinda March 15, 2012 at 2:12 pm - Reply

    You say no aerobics (You’re my hero!) What about some strength training while you are trying to reset, using your own body weight and resistance bands. I am doing a dvd series that really gets my heart rate up, a circuit training I guess.

    • Jack March 17, 2012 at 7:16 am - Reply

      @Melinda You can give it a try.

  433. john March 15, 2012 at 9:42 pm - Reply

    Hi Dr. Kruse, thanks for the website. I wanted to ask if you have ever worked with anyone with familial hyperlipidemia in this was. Forty five, 6’1″, 260. Did HCG last year, lost fifty pounds and gained it back over 4 months. I tried HCG again, but couldnt make it through the first week. So utterly exhausted all of the time sleep is terrible. Diagnosed with EBV/Chronic Fatigue-If i do exercise, like golf or over exert for too long, I cant function or digest the following day. I feel that most of this has been brought on by statin use. I was in the original trial for lovistatin in the 80’s, went on Liptor at 80 with zetia, and got fatter, weaker and dumber as the years went by. My calcuim score is 11, have st depression, although EKG was OK. I feel so brainwashed by the AMA, and fear fats. I am going to give it a try anyway. I read the monk and loved it, I must make the change to get my life back.

  434. PaleoDentist March 17, 2012 at 4:42 pm - Reply

    Is there any harm in doing a leptin reset if one is leptin sensitive as I am not sure my level of sensitivity/resistance. I have been on a low carb Paleo Diet for 13 months , and pretty close to my goal weight. I am thinking of following the Leptin Reset protocol for 8 weeks just to make sure. Just wondering if its OK as I may be Leptin sensitive by now. Thanks!

    • Jack March 18, 2012 at 5:12 pm - Reply

      @Paleo dentist…….no your just wasting your time.

  435. Stuart March 18, 2012 at 2:32 am - Reply

    Hi Dr Kruse, appreciate all the help your providing! After reading around your site, I’m still wondering if I’m LR or not –

    – I’m 38, 5’10”, c 154 pounds, and I’ve been on a Paleo diet for 2.5 years and for the last three weeks I’ve cut out all dairy (cheese), chocolate and tea/coffee (just drinking water). Today I’ve cut out nightshades so I think I’m now on the ‘auto-immune’ version of the diet. I’ve also adopted the ‘reset’ meal times. I’m not exercising much at all due to weakness poor health, however from experience I have a good athletic base and am only 2 weeks of activity away from being fully ripped.

    – Have had worsening ‘CFS’ & Fibro symptoms for the past 15-20 years, including recurring viral infections and have recently been found to have Mycoplasma & Chlamydia infections. I’ve been on antibiotics for 3 months + for that.

    – My sleep is not great – can take 2-3 hours to get to sleep and then start waking at 5am, meaning for many nights I’m getting around 5-6 hours. I often wake in pain & with nausea.

    – I have high RT3 (just above range) and a T3 ratio of 7.2. Vitamin D is above range (I think due to over supplementation + summer in Australia), CRP is very low (0.6), 24 hr cortisol is good / close to target and DHEAS is mid-range. Testosterone is upper mid range, however Free Testosterone is down at the low end.

    My Doc has just started me on T3 however am keen to avoid meds if possible. Question – Should I give a Leptin Reset a go for 6 weeks – before my next blood tests – before starting T3, or could the RT3 itself be a consequence of long term chronic infection/poor health (and would T3 help to lift immune function & break the cycle?)?


    • Jack March 18, 2012 at 5:04 pm - Reply

      @Stuart LR and CT would be a good play here.

  436. JD March 18, 2012 at 2:38 pm - Reply

    I am so depressed right now – I can’t believe I’m writing this post. So, I have a question about cheating (cringe). During my slip-up today, I have not strayed at all from any of the allowed foods on a strict paleo diet (no dairy, carbs/starches of any kind, alcohol, sugars, processed foods,etc). I have, however, been eating all day since my BAB, not waiting the usual 4-5 hours between meals, and have probably consumed enough fat and protein for three days – coconut oil, grass-fed burgers, lard, bacon…the works.

    I don’t know. I got some bad news today and kind of just snapped for a few hours. Trust me, I’m beating myself up for it. Anyway, I’m not planning on eating for the rest of the day, and I know I’ll pay sorely for this tomorrow on the scale – I’m just curious about the implications of my particular lapse on the reset. Considering the things I ate, will this slip up still be the same 10-14 day back track?

    • Jack March 18, 2012 at 4:48 pm - Reply

      @Jd dust yourself off and consider it a learning lesson.

  437. Kundalini Bennett March 22, 2012 at 10:23 am - Reply

    Dear Dr. Kruse,
    I have just finished a round of HCG and I am starting leptin reset in conjunction with P3 & P4. I prefer to use minimally processed foods in the most whole and natural state possible, so I would really like to get my coconut fat/oil from whole young thai coconuts (instead of oil separated from the whole coconut). My preference is to blend the spoon meat and the coconut water together in the vitamix, but I would also be willing to discard the coconut water (too sweet??) and just eat the coconut spoon meat. Is coconut spoon meat, or blended whole young coconut okay on LR, or does it contain too many carbs or too much natural sugar?

    • Jack March 22, 2012 at 10:28 am - Reply

      @Kundalini Most people do not do well on coconut with HCG from what I have read. I do not prescribe HCG nor do I advocate it. I just understand it.

  438. Kundalini March 22, 2012 at 10:33 am - Reply

    Thank you. I am no longer on HCG. Perhaps that was too much information. I really want to know if whole young coconut or young coconut spoon meat is significantly less desirable than pure coconut oil for your leptin reset program.

    • Jack March 22, 2012 at 10:53 am - Reply

      @Kundalini I have not tested the differences in coconut so I cant say for sure.

  439. Kathleen March 23, 2012 at 9:45 am - Reply

    Dr. Kruse, I am currently on day 32 of vlcd with rxhcg. I will be going into the next phase on thursday. I really feel I need to do the leptin reset, my concerns are this: It states above that after the reset to begin interval training. I had a spinal fusion L4-S1 8 months ago and tailbone removed 5 months ago. I also have DDD and already show signs of substantial degeneration in 4 other discs (i am 37 years old, 5’5″ and am currently 167lbs). I am not cleared for more than 20 lbs. lifting and can not run, ride bike, or even eliptical from pulling at my incision site from tailbone removal or due to restrictions on back. Basically all I can do is use resistive tubing, walk, and pool therapy. What would you suggest for someone like me? will this still be successful even though I am unable to do any type of strenuous exercise anymore? I desperately want to feel healthy again and enjoy life as I did before all of my back and tailbone problems. thank you for any suggestions or help you can give me! i am way to young to not enjoy my life do to so many physical limitations and pain.

    • Jack March 23, 2012 at 10:10 am - Reply

      @KAthleen Swimming is probably best for you to do with that history.

  440. Tim Lundeed March 23, 2012 at 1:53 pm - Reply

    Should I eat coconut oil while I’m doing leptin reset and cold adapting? I was trying to phase it out until cold adapted, because it is a tropical fat…

    • Jack March 23, 2012 at 2:38 pm - Reply

      @Tim Lundeed Depends….if youre obese then yes you can use it. If youre just Cold adapting then stay with animal fat.

  441. alisa March 28, 2012 at 1:17 pm - Reply

    Dr Kruze, quick question, what is yout take on HGH for weight loss ? Im 27 yr old female, tried hcg it doesn’t really work for me. I’ve been on paleo for a while now and still not loosing any weight. My naturopath suggested HGH she swears by it. it you recomend using it what dose should i be using.

    Also im thinking that maybe my hcg was not succesfull because i was using mct oil ? what’s your take on that.

    I really appreciate everything you do, i work in the health care and alot of our docs really don’t know their stuff, brainwashed on whole grains and low fat. it’s nice to have someone like you to get opinion from. Huge respect.

    • Jack March 28, 2012 at 9:30 pm - Reply

      @Alisa I do nto advocate HCG or HGH for weight loss at all. I use the Leptin Rx reset and CT and the paleo diet.

  442. Linda March 28, 2012 at 10:23 pm - Reply

    Dr. Kruze, Have been 95% LR/Paleo for 8 weeks now. CT in the shower for 2 weeks. In the last few weeks, I have noticed a rather rapid change in my vision. I have had to purchase a stronger set of reading glasses. Before I only needed them for small print, now I need them constantly all day at my desk. Could my diet changes be affecting my vision in a bad way?? Or, is it possible my vision is improving and I need a different contact prescription? The only reason I am concerned is that the change has happened quite quickly… Any ideas? Thanks for all you do.

  443. KiwiLauren March 30, 2012 at 10:22 pm - Reply

    Finally got some labs done (all I could in NZ), 3 months on strict Leptin Rx, Leaky Gut Rx and doing CT for past month. Doc is saying my ‘cholesterol is too high’ (among other things). Having trouble interpreting after reading blogs/forum… hsCRP 1.20 mg/L; cholesterol 8.1 mmol/L; trigs 0.7 mmol/L; Cholesterol (HDL) 2.17 mmol/L; Cholesterol (total/HDL) 3.7 mmol/L; Cholesterol (LDL calc) 5.6 mmol/L along with 4.9 mmol/L fasting blood glucose (and HbA1c of 32 mmol/mol). DHEAS is 4.3 umol/L (range is 0.5 – 12.0). T4 free is 15 pmol/L, T3 free is 3.6 pmol/L and TSH is 1.51 mIU/L. I’m not doing supplements (except in food form – liver 3+ times per week, teaspoon of tumeric with one meal per day, lots of 100% chocolate, fermented veggies, etc). Should I be worried? (And if so, in what way?) Thanks.

  444. Kelly Phillipson March 31, 2012 at 8:21 pm - Reply

    Dr Kruse,
    I’ve merged the GAPS diet with the leptin reset, and am starting CT (hx of EDs). Am wondering if I can take l-tryptophan, l-aspartic acid, l-glutamic acid between meals and natural calm before bed? They don’t seem to have any calories but I’m not sure if they stimulate insulin. And THANK YOU for all of your blogs – they are just amazing 🙂

    • Jack March 31, 2012 at 8:47 pm - Reply

      @Kelly I would not take them between meals…….take them at meals

  445. Kelly Phillipson April 1, 2012 at 7:53 pm - Reply

    Will do – thank you!!

  446. Meghan Miller April 2, 2012 at 4:17 pm - Reply

    Hi Jack
    I have been on Leptin RX for 5 weeks now and have seen some changes in belly fat visually. Also been doing CT for 5 weeks and worked up to 45 min in 50 degree water for 3 weeks now. I had all my blood work done and would like you to look at with any recommendations.

    Leptin 4.0


    T3,TOTAL 88
    REVERSE T3 401

    GLUCOSE 83
    TSH 1.99

    CRP 0.50
    URIC ACID 4.4

    Thanks so much for all your hard work!!

    • Jack April 2, 2012 at 5:41 pm - Reply

      @Meghan Looks like DHEA is light……means turn off the lights and improve your sleep efficiency. Pregnenolone can vary depends upon day of cycle drawn. CRP is worthless. HS CRP is the one you need. Rest looks good……

  447. Lauren Porter April 2, 2012 at 6:11 pm - Reply

    OK, I think I found Americanised values for my cholesterol. My testing doc is worried, I am not particularly (keepin on with diet, light cycles, CT). I’ve love your thoughts.

    HDL 84
    Chol/HDL Ratio 3.7
    LDL 216

    hsCRP 1.20

    GLUCOSE 88.2

    T4 (free) 15
    T3 (free) 3.6
    TSH 1.51

    DHEA 4.3 umol/L (range 0.5-12.0)

    • Jack April 2, 2012 at 7:07 pm - Reply

      @Lauren HS CRP is too high. DHEA too low. The cholesterol number solid……but I would want you to work on inflammation.

  448. Body Mission: Significantly Reduce Body Fat | Mind. Body. Soul. April 2, 2012 at 7:40 pm - Reply

    […] and what to do about it. In addition to his Leptin Prescription post, you should also check out the Leptin RX FAQs post for more information. The post is good, but Jack’s own words, the real […]

  449. Lauren Porter April 2, 2012 at 9:34 pm - Reply

    Thanks! I am definitely working on inflammation… lots of CT, turmeric, resveratrol, seafood, CO, etc. Thanks again for commenting.

  450. Meghan Miller April 3, 2012 at 10:31 am - Reply

    Thanks Dr. for the information but do my numbers still show I’m LR? I don’t know at what point I start the after Leptin RX protocol or do I just go the full 8 weeks to be sure??

  451. Jesse Brause April 4, 2012 at 6:36 am - Reply

    Hi Doc!!
    Thank you so much for this information!! I found you via Jimmy Moore’s podcast 😉
    I’m a 33 y/o male, 5’9″ currently @ 157 pounds (I guess one would call it skinny fat) down from 185. I had childhood asthma, allergy shots and was over weight since I can remember. No longer asthmatic and no longer on the shots going on 20+ years now. I take no supplements of any kind.

    I’ve been working in Australia for 2 months and since my arrival, I decided to go full primal/paleo and low carb. I return to the US in a week and plan on getting some test’s run – I *think* I know what I need to have tested from this post.

    I do have a questions about my energy levels since going full primal/paleo that I was hoping you might be able to help me out with:

    I get lots of good sleep 6-7 hours. However, since going P/P, I’ve been experiencing an increase in vivid, lucid ‘nightmares’, 2-3 a week.

    I am active all. day. long. Literally. I work ~10-12 hour days if not more.
    Breakfast is my biggest meal and I eat till I am full. I now eat a HFHP BAB; I’ve cut out the veg that was part of my P/P diet with the exception of a small bowl of mixed blueberries and raspberries topped with 2 spoon fulls of double cream, washed down with 1 cup of coffee and CO first thing ~5am. I am able to make it without eating to noon with just a slight hunger around 10.30 or so.

    Lunch, regularly consists of a BAS [big ass salad] consisting of mixed leafy greens with some shredded carrots and cabbage (white and red), with a half pound or so of meat (grass fed when I can make it to the butcher) drenched in a mix of EVOO and avocado oil with some balsamic or Bragg’s apple cider vinegar drizzled on top. However, around 3pm, I get what almost feels like a crash and I start to get really hungry again. If I don’t eat my energy levels drop, lethargy kicks in and the cravings begin. You say no snacking – I get that. So…
    – Is this crash “normal” or something to be expected going LC?
    – Am I too active to do your leptin Rx? Should I even do it??
    – Am I eating the “best” type of lunch for my activity level?

    Thank you so much!

    • Jack April 4, 2012 at 8:57 am - Reply

      @Jesse 1. 6-7 hours sleep is not good. 8-8.5 is ideal for humans……dont believe it…..check your DHEA level…..good sleep it should be ideal levels. Second test that shows poor sleep is bad diurnal cortisol levels on salivary assays. With time you will migrate to two meals a day and then one big one as you become very leptin sensitive. USe the Leptin Rx only if you are LR on testing……if not use how to eat post Leptin Rx blog I have on site and use CT protocol of 2/11/2012.

  452. EvalindaLange April 4, 2012 at 1:09 pm - Reply

    Dear Doc,
    Would a person with Spinal Muscle Artrophy Type 1  ( weighs 70,2 lbs, diagnosed at birth and sent home to die basically, but now she is 52 , uses ventilator to breathe at night ) benefit of anything (leptin reset, paleo diet, co)? Thank you.  

    • Jack April 4, 2012 at 2:56 pm - Reply

      @Evalinda Lange that is a genetic disease of the SMN1 gene. Most type 1’s are dead in two years. So if this person is 52 I doubt the diagnosis is correct. I have no idea how it would work because I doubt the diagnosis is correct.

  453. Evalinda April 6, 2012 at 3:58 am - Reply

    IIII That’s exactly what I thought ! Thank you.

  454. Jesse Brause April 6, 2012 at 4:16 am - Reply

    Thanks for the reply, doc!! Other than the first few days, I’ve been feeling really good since implementing the LeptinRx- REALLY GOOD!! I’ve skipped dinner the past 2 nights and I’ve found that I’m just not hungry!! Working on the sleep now 😉 Not looking forward to the jet lag when I get back. Thank you so much!!

  455. Larry April 6, 2012 at 1:27 pm - Reply

    Jack, will testosterone supplementation either by gel or injection effect or damage Leptin Rx results in any way?

    • Jack April 6, 2012 at 10:11 pm - Reply

      @Larry nope

  456. Lauren Porter April 6, 2012 at 2:14 pm - Reply

    Dr K. Any thoughts on Chris Kresser’s recommendation that cocoa/chocolate (in any form) is too high in phytic acid to be included in the diet regularly?

    • Jack April 6, 2012 at 10:13 pm - Reply

      @Lauren maybe his chocolate…….but not mine.

  457. Lauren Porter April 6, 2012 at 10:52 pm - Reply

    🙂 Thanks.

  458. Tita April 8, 2012 at 3:49 am - Reply

    Hi, dr.Kruse!

    In my country there’s only blood test option.
    Any comment on my labs?
    I am signing up for the consultation with you, but would like to know if there’s anything I can do until then.
    I am still not 100% sure I’m LR (we don’t have all the tests possible here – no rT3, …)

    According to doctors I have hypothalamic amenorrhea (probably due to stress & dieting; never anorexia or bulimia, just lots of dieting and exercise). I’m 34, 5’5’’ and 128 pounds.

    I sleep good (always did) – 8 h (9.30pm-5.30 am), I dream a lot, no headaches.