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Circadian biology is so fundamental to sleep and metabolism but few people realize just how important it really is.  It is more important than your macro or micronutrients.  Most of you reading this really do not buy this because of the questions I get asked and all the comments I have seen made on FB, twitter, blogs, and on internet forums.  The blogosphere is tied to macronutrient ratios.  It is a fact that our neolithic mind has burned into our conscious beliefs.  This post is about showing you why you might want to consider changing your perspective on things related to what you eat.  What you feel like eating does not mean it should be what you are designed to eat.  What you can eat safely, does not mean it should be what we are designed to eat either.  What we are designed to eat is the answer to where our ultimate health really lies.  When we choose to eat in spite of our biologic directives this is when illness, disease, or bad feelings tend to crop up and cause confusion to the patient.  The best way for you to solve this situation is to think.  I want you to think about the message your neolithic mind is capable of delivering to your paleolithic genome on a daily basis.  Most of us are completely unaware of this biologic mismatch.  It is my belief that it underlies much of what currently ails most of mankind today.

It is very easy to blame the USDA, SAD, and my profession for sure.  And believe me, we all deserve all the criticisms we get.  But the fact remains, even on a solid paleo/primal template there are many people who hit major plateaus that continue to confound them.  This post is about those experiences we all have faced whether we want to admit it publicly or not.  I think we can control for it as long as we think about what we are doing first.  The reason I decided to write this post is because of a thread on Facebook that just came out of the blue and someone asked for my two cents on it.  I thought what I wrote needed to be said here, because it applies to many of the the complexities I see discussed daily in the blogosphere about micro or macro nutrients.  I believe, often, many of these arguments detract from the success that can come to each of us if we just stop and think about the perspective of how our metabolism is designed to work for us.  It seems carbohydrates have been under the biggest attack the last six months so I am going to use them as the example macronutrient of why this method of thinking may be toxic to your optimal life.

There is a role for carbohydrates,  but calling them safe to me is a misnomer. The reason we all might need some carbs is that the occasional glycogen replenishment made in our liver is stimulatory to the conversion of T4-T3 in the gut (20{a7b724a0454d92c70890dedf5ec22a026af4df067c7b55aa6009b4d34d5da3c6}) and in the liver (80{a7b724a0454d92c70890dedf5ec22a026af4df067c7b55aa6009b4d34d5da3c6}).  The actual pathways that really replenishes glycogen is not carb based, it is fat based.  See this link.   The real interesting paradox of this biologic truth, is that all wild animals are at the mercy of the light cycles and seasonal variations of temperature of their own eco-systems.  We are the only animal that can reverse engineer our environment to improve upon what we might feel is “right or correct” for us.  My point here,  is that this feeling we have is a neolithic problem brought about by our brain that has evolved far faster as an organ in our species than the rest of our organs have to support it.  Some in this community feel we should eat carbs because they are essentially safe for our paleolithic genes.  They are safe when they are used in the context that evolution planned for them to be found in. This is independent of what we think or feel is best for us. That is being appropriately yoked to the light and temperature cycles.  These factors are hard wired into our genes.  Where we live generally allows for the biologic congruency of those genes expression.  This means that some of us who have epigenetics that favor long light cycles and high temperatures can do things that people who are naturally adapted to in Patagonia cannot do.  Ironically at the same time, both of these humans may “feel or think” that they can eat carbohydrates, protein, and fats as they chose regardless of the circadian cycles because this is what their brain is telling them.  These foods may, in fact be “safe”,  but we are not designed to eat them year round form an evolutionary biologic perspective. Even in the tropics, there is a seasonal variation to what foods are made available to wild animals.  That is evolutionary biology at work  and not my opinion.  I am just reminding you of this constant environmental mismatch the most humans allow themselves to fall into because of our neolithic brain.  In fall and winter,  we are meant to have a lower conversion of T4-T3 because it confers longevity and optimal health.  This is true of wild animal even in Africa. It is not a principle that we should consider altering because of how we may feel about. That biologic mismatch is however what happens over and over again and our paleolithic genes pay the price for it. The result is found in how we respond, what our mirrors reflect to us and how many times we need to go see the doctor and get pissed off by their conventional wisdom advice that never solves this simple biologic mismatch.

The role of food and diet has to be placed into the context of what the light cycle and temperature cycles  are based upon where and what you are best adapted to and not where you currently live. That means you scientifically need to understand that what the epigenetic expression is of your genome currently SHOULD match t how you employ your current paleo template………WHY?  Because when it does not this is where neolithic illness or disease spring form. Most only believe that the micro or macro-nutirents can generate inflammation. That is a neolithic thought that needs to be studied before you fall into that dogma.

Many people arguing about this issue (arguing over diet, carbs or thyroid levels) are missing the greatest points that biology is teaching us,  because they do not realize the perspective of how our metabolisms have always been set……..by circadian cycles and not much else.  In fact, the photoperiodicity in humans is codified by Vitamin A cycling in the brain independent of DNA or RNA.

The local environment forces natural adaptation and this rewires our brain via neuroplasticity and it turn effects our epigenetic responses to our diet. Illness occurs when there is a mismatch between these “tight biologic connections”.  The human mind does not appreciate this disconnect because they are not aware of it. Much like you are not aware of the perspective that the earth is revolving about its axis now at 25,000 mph……….but, in fact it is.

I hope people really begin to see how profound these thoughts are,  because the most common reason we see disease and illness as a species, is because our brain allows us to daily disconnect the “tight biologic connections” that are hardwired into our paleolithic genes. When you become consciously aware that your brain can do this all the time………you begin to think about what your actions may do to you’re underlying paleolithic genome. This allows you to really determine what is safe and what is not for you today in the present.

The funny thing to me is this might be why even today, people struggle with Einstein’s theory of relativity.  It is because they just cannot fathom the change in perspective of time is completely relative to the observer and the body in action. Moreover, when you think about it, it just plain makes primal sense.  And when you begin to realize that the earth is moving at an incredible speed daily, but  you can’t feel or perceive it every minute of every day, you begin to understand that this biologic and physical truth is revealed to your consciousness every day the sun rises and sets.  Maybe, It can then allow you to begin to think about your metabolism from this new perspective as well.  When I fell upon these thoughts it changed everything about my perspective in medicine and it allowed my brain to see different worm hole in how I might look at all neolithic diseases differently than I was taught too.  At first it was scary and daunting but as I ventured out on that limb of risk I found more answers to neolithic disease than questions.  I found solace in that for the first time in my professional life.

It also made me realize that the way I think is far more important than the knowledge I have collected over my life.  It has allowed me to make connections that before I was previously blind too.  And when my brain became aware of just how much of this was connected, it took all that data I knew, and made a lot of sense of it to give me a new insight and wisdom about diseases.  Most of those diseases today,  I still do not treat.  So I employed this new found insight first to me and then to my family.  When it worked on them I knew that these new concepts were not so new at all.  This was the work of evolutionary biology and medicine at work.  I became aware that I was now able to decipher how we were designed to work from the perspective of the owners manual that we were all born with hardwired into our DNA.


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  1. Amanda January 20, 2012 at 11:04 am - Reply


    Great post, once again. Your QUILT has changed my life. I'm down 61 lbs. since going paleo. I sleep like a rock. I don't snack or get sugar cravings. However, I think my thyroid is still out of rhythm. Every 5th day or so, I crash and burn…feel tired, heavy legs and depression. I have tried to increase and decrease my macros, but I haven't found the sweet spot yet.

    I live in the extreme temps (hot and cold) of SD. What should I be shooting for this time of year? I know you said in the weeks leading up to winter solstice, you go zero-carb, but what about as the days get longer? Any advice you have would be greatly appreciated.


    Amanda in SD

    • Jack January 20, 2012 at 12:18 pm - Reply

      @Amanda After Jan 15th I start adding carbs back in. Right now I am about 25 grams of carbs, but I'm just guessing because I no longer count. I stopped about 3 years ago when I found how my body best responded to my own circadian biology by trial an error over 5 years.. I have recently did a major bio-hack on myself that was all about altering my circadian biology so this year will not be representative to what I usually do…….but I had to prove a clinical point that I found to be true and I designed an experiment to do just that.

  2. Jonathan Goins January 20, 2012 at 11:12 am - Reply

    Well written. This parallels things I have been saying for over a year. Man is too smart for his own good. In this environment in which we find ourselves, how can we tel real from fake good from bad and even if we can see past all that how do we acclimate ourselves or alter our personal space to improve our own lives.

    Thanks for all you do. you are the greatest.

    • Jack January 20, 2012 at 12:14 pm - Reply

      @Jon Goins
      No Jon, I am not the greatest. I am searching for the greatest in me, as you are in you……..and we are helping one another to get there. To me the latter is the greatest of human endeavors.

  3. Jack January 20, 2012 at 12:11 pm - Reply

    @Christine if you are in Quebec now you should not be eating fruits in the dead of winter…….do you see any fresh berry bushes blooming? Banana tress? You are designed to eat meat, fish and fat in winter. I suggest you do just that. Read this blog right now. Maybe this will further make the point of why the grandmothers tale was correct? http://jackkruse.com/so-you-completed-the-leptin-

  4. Amanda January 20, 2012 at 12:51 pm - Reply

    Thanks, Dr. K. I mostly keep between 10-25 grams of carbs. My question is, what should these carbs consist of this time of year? I've been favoring onions, cauliflower, pumpkin, with occasional broccoli, green beans and kale.

    Also, even though my thyroid has been shown to wax and wane, I'm convinced I don't need thyroid meds to fix the problem. If I continue on the reset, will the foods I'm eating, the sleep I'm getting an the supplements I'm taking help to correct my issues?

    Thanks in advance for your time.

    • Jack January 20, 2012 at 12:56 pm - Reply

      @Amanda…..those carbs are just fine. I usually use mushrooms as my first carb back in because it is the one food that has not changed much in 2 million yrs according to the literature. Then I add some tubers that have been around……and I gradually increase it. You might be very interested in my new e cookbook that is coming out in two weeks on this site. It will have four seasons to it and it will follow circadian biology as the year adjusts. It will show you exactly what I eat as the light and temp cycle change. The e book is designed to evolve as circadian biology changes. I am starting out with Winter recipes and will be adding spring and summer and fall as the year progresses.

  5. LSSeeker January 20, 2012 at 1:06 pm - Reply

    Dr. Kruse,

    I'm in Maine so for the ecookbook, would I just stay in the winter section longer because of the climate? I saw that you've suggested a Canadian to still be eating protein and fat while you're up to 25 carbs an TN.

    • Jack January 20, 2012 at 1:34 pm - Reply

      @LSS Since my ancestry is northern European I stay lower carb into April. that is what I learned about me from all the testing I did 5 years ago. So what I do is not totally accurate to you. but I do agree with you that where you live should push you further out on the carb window in Maine and Canada. It also means that you can eat many of those tubers however in October-Dec 21 too.

  6. Norma January 20, 2012 at 1:23 pm - Reply

    Dr. Kruse, first thank you for all you have done and doing. The reset is already doing great things for my husband and I.

    I do have a question. I was born and lived in s.c. For 20 years. The last 18 years I have been living in Indiana. Before that moved around due to hubby being in the Navy. I don't even pretend to understand epigenetic switches etc. I lived in a hot and humid climate, for we were on the coast. My family had a huge truck farm. Very little came from the grocery store. We were up at sunrise and usually in bed by nine. We were so tired from working, there was really no other option.

    How am I suppose to incorporate above article? My first thought is to eat and do as I was growing up. Do I now eat for this area because I have been here for so long?

    I am a female without my ovaries or uterus and taking no hormones until I can get tested and put on bio-identical, hypothyroid and medicine is just keeping me going. I had gall bladder surgery before I found you. Dumb, I know.



    • Jack January 20, 2012 at 1:36 pm - Reply

      @norma what is your ancestory and tell me a bit about your maternal family and I may be able to save you thousands of dollars in testing to figure it out like I had to do. No one knew this stuff in 2006.

  7. Russ January 20, 2012 at 1:38 pm - Reply

    Doc, Another excellent post. Makes me think though that it becomes not only important to recognize where we do live, but in a mobile world where we have and are always moving, where our own personal genes were originally best adapted to live.

    For examples, I previously had my genes sequenced at 23andme (just for fun at the time), and by learning that I was APOE4, then connecting with your blog among many others, I learned that my genes are best adapted to the interiors/mountainous areas of northern climates (which is where my family came from). One attribute of that gene is that I actually don't make vitamin D well from sunlight, but do absorb it well from food (why the gene was advantaged in some areas). So even though I get quite a bit of sun (even at this time of year), now I have increased D food intake (e.g. kale), and am also supplementing D3 to see what effects I observe.

    But the only reason I knew that is because there is so much research on APOE4 due to Alzheimer's connection. I can only imagine how much other useful information is out there waiting to be discovered on the connection between personal genetics?

    Seems like the supposed direction of 'personalized medicine' has more to do with eating/living than matching drugs. Don't know how you feel, but I feel the cost of getting my genes sequenced (now only $100), has not only payed back many times already, but will do even more-so in the coming years.

    I really look forward to your book as I expect to get many more clues about creating a diet/lifestyle that optimizes my own health.

    • Jack January 20, 2012 at 2:09 pm - Reply

      @Russ APOe4 is a gret adaptation that allowed us to migrate and inhabit the extremes…….I am of the personally belief that this is our primordial genetic set as eutherian creatures. And there is a huge reason for this tied to leptin. That will come in 2012. It is at the seat of why me and Dr. Rosedale do not see eye to eye. And I will promise I will show you why it is a huge issue.
      Your key is to keep your HDL up and keep your sdLDL low and you do that by keeping your plasma low in oxidative potential. There are great ways of doing all that and I get into this in detail in my book.

  8. LSSeeker January 20, 2012 at 1:45 pm - Reply

    My ancestors were from Lebanon and Scandanavia. What a combination, I know.

    • Jack January 20, 2012 at 2:00 pm - Reply

      @LSS maternal side?

  9. Jayelle January 20, 2012 at 1:53 pm - Reply

    It's nice reading things like this because it's one of the few times I don't feel like an oddball. My ancestry is Mediterranean on one side, northern European on the other, but I live where it's cold now. Everyone around me is trying to 'eat healthy' which means salads and all kinds of fruit abound. My body says it's January, it's dark and cold and there is snow on the ground and it's not interested in salads. For now it's soups and stews, roasts and root vegetables roasted in bacon fat. It will tell me when it's time to change to salads and fruits. It always does. The difference is, now I listen.

    • Jack January 20, 2012 at 2:03 pm - Reply

      @Jayelle do not have all your data but my guess would be 3/15-4/15 is when your carb curve can steepen.

  10. LSSeeker January 20, 2012 at 2:10 pm - Reply

    Maternal side is scandanavian/english. Dad's side Lebanon.

    • Jack January 20, 2012 at 2:42 pm - Reply

      @LSS. I would then follow a steepened carb refers like march 15 to April 15 as mentioned earlier. I also bet that you you need to support your D levels to in winter with lineage!

  11. Russ January 20, 2012 at 2:53 pm - Reply

    That's basically what I'm working on already, so glad I'm still on the right course overall. This month I focused on raising HDL with Vit D3, coconut oil, fermented foods. Drew blood for VAP this morning so will see if I have expected effect.

    Meanwhile, I'm assuming APOE4 is but one example of matching food/lifestyle to my genes. So I will look forward to the book even more now with more ideas on how to shape.

  12. Erin January 20, 2012 at 2:56 pm - Reply

    The genetic component is SO interesting! I'm pretty much northern Euro descent with a little potential Ashkenazi Jewish (central Asian/Khazar) on my mom's side (though she is heavily English/Dutch/Prussian/German). I really don't crave fruit this time of year, nor many veggies.

    Question: what bearing does it have on genetics when you very strongly physically resemble one of your parents (in my case, I look a lot like my dad, who is half Scottish and half French but looks very Celtic)?

  13. Norma January 20, 2012 at 3:45 pm - Reply

    Just checked with my aunt. I am Scottish and Irish maternally and German paternally. My maternal grandmothers people came a little after the Mayflower or just before. Little hazy on that. Depression is very common on my mothers side of the family. Glaucoma in most of my aunts and of course my mother. I have three sisters and we all have glaucoma including one of my nieces. Gall bladder problems galore as well. My sister had to have a thyroidectomy due to cancer. Myself and my youngest sister is hypothyroid. High blood pressure is a problem and was for a lot of my aunts and uncles. My son is also hypothyroid. I know my great grandmother died at an early age. My grandmother was 13 and she had already had that many children. They say she died of the flu. Other than that that is all I know. Depression and it's other problems with it was kept away from children. I grew up children were to be seen not heard. We were a labor force. Harsh I know but I never doubted I was loved by my grandparents.

    Anyway, I hope this helps. I told my aunt that I wanted this year to be the healthier ever. Another aunt had breast cancer and underwent chemo and is on other drugs. I saw her in Oct. And she was not even close to what she use to be. She use to be full of laughter etc. I miss her and I do not want to be that person when I get to her age. She is only 70 maybe. My mother will be 80 this July and up until a fool of a doctor put her on statins she could outworn me at 75.

    Thanks Dr. Kruse. Without finding you I would still be wallowing in bad health, bad thoughts and a fort closer to death. I will never be able to thank you enough. I am passing everything to people that I know.


  14. Norma January 20, 2012 at 3:51 pm - Reply

    Forgot to add, I come from a long line of farmers. Tobacco farmers who sharecropped.



  15. v January 20, 2012 at 4:47 pm - Reply

    i love the individualization. i am one who reached my present weight 3 months into paleo and have pretty much stayed there. i have a belly still, although it is smaller than it used to be. since my grandmother died of stroke and my mother has cancer, diabetes, high blood pressure, etc, i am very motivated to get rid of the belly and the underlying conditions causing it. you have said before i should investigate bioidenticals, but i will wait til more women jump on that band wagon so i can see what happens to them first.

    my maternal side is 100% very northern latitude grey-eyed russian woman with humpty dumpty body. any advice on carb level and how i could find it myself through testing?

    thx as always.

  16. Coriander January 20, 2012 at 5:06 pm - Reply

    Hi Jack, I have been so looking forward to your recipe book, and here you've said it will be released seasonally! Would you consider an early release of your autumn recipes for those of us in the southern hemisphere? Please? Although I'm sure, after reading this blog, that I can figure it out. So, thankyou.

    • Jack January 22, 2012 at 8:23 pm - Reply

      @Coriander Not likely because the way the the book is going to be rolled out is based upon how I cook right now and send the recipes to the my web publisher. Since I live up here it will be how how cook now and take pics of the recipes. The book will grow as the seasons grow. So after a year of recipes you will be OK. I plan on continuing to add recipes over the years so the book may be filled with thousands of recipes as time evolves. I also will gauge it based upon interest in the e-cookbook this year.

  17. Joe Branca January 20, 2012 at 5:56 pm - Reply

    hm, this is really interesting. we should look mostly at maternal descent? my father is Sicilian, my mother German (her and her mom grew up in northern midwest, their lineage going to a region near the French and Swiss borders). So presumably the carb allowance is different between the German/northern European lineage and the Sicilian/Mediterranean lineage, and the divergent seasonal climates need to be considered as well? Or the climate of the last two generations? (midwest vs coastal NE) And then I myself was raised and still live in Southern California, which factors carry the most weight?

    • Jack January 22, 2012 at 8:18 pm - Reply

      @Joe maternal lineage, then your diet and how it has affected your labs. If there was confusion than I would tell you to to get your SNP's checked at 23and me too.

  18. Robineka January 20, 2012 at 6:25 pm - Reply

    What about the tropics? Living in Miami for the past 16 years, before that the Caribbean and the Mediteranean. Russian, German, Polish & Spanish ancestry? Grew up in New England, left about 30 years ago and since then always warm climes.

    Try to eat as much local as possible to avoid confusion, any recommendations?

    • Jack January 22, 2012 at 8:16 pm - Reply

      @Robineka……you need to assess your maternal ancestry……since you have eaten locally that means you altered your epigenome for 30 yrs. Your labs should show if that is healthy of not. And you really should consider 23andme SNP testing……it would answer most of these issues for you when you marry it to your labs and current diet.

  19. Alexandra January 20, 2012 at 6:43 pm - Reply

    I have same concerns as Cavemom regarding coconut oil and the macadamia nuts I love so much. I've used coconut oil for around 10 years after I'd read Peat and Enig. But back then, I merely low carbed but still included dairy. As I transitioned to paleo, I've rely on coconut oil to add fats and replace butter/cream. My lipids don't seem to change yet I wonder if there could be some other issue with relying so much on a tropical oil when my ancestery is 3/4 Russian/Polish 1/4 Italian/Spanish. Ditto for the macadamia nuts I down by the boatload.

    PS: Your encore interview on Jimmy's site was outstanding. Thanks Dr. K for all your insights. Can't wait for the book.

    • Jack January 22, 2012 at 8:14 pm - Reply

      @Alexandra you could try to see if you get better results from Ghee but I bet CO is the better choice.

  20. Glamorama January 20, 2012 at 6:45 pm - Reply

    Very interesting post, my fav so far!! Thanks. 🙂

    As you might know by now, I was born and raised in Norway, but my family is South-Indian (tropical climate) back by thousands of years. I have moved back to a southern climate, although Melbourne is not tropical- we do indeed have seasons, but it's by far warmer than good old Norway is!

    What I get from your post is that I tolerate a higher amount of carbs from starchy sources (not fructose) without ruining my weightloss, and that palm- and coconut-oil is my fats of choice biologically. Fish is preferred over meats. Funnily enough, I've noticed a natural change towards fish/shellfish over ruminants in the last 2 months. I feel great on 40-50 gr carbs daily. Being of darker skin, I know I need more time in the sun in order to get enough D3. And I have also learnt that I have an issue with lactose. It's all linked back to my ancestors. South-Indians only changed their diets very recently, so it's easy to assess what I should be eating. Before they all went crazy with rice and roti, it was all about coconuts and fish!

  21. Meghan January 20, 2012 at 9:01 pm - Reply

    thanks Dr. Kruse…I live in Pennsylvania and hubby and I are both starting Leptin Rx this week after being on GAps diet for a year. We both developed high RT3, in the mid-summer my ratio was 4.2, optimal being 20. Using adrenal support(Isocort and adaptogens, taking Iron as I was seriously anemic) and now on T3. No adverse reactions yet, but does the Reset help me to eventually not need T3? I know some say RT3 may be "healthier", but since I could barely get through the day with this level, I certainly see no benefit to it. I am avoiding carbs other than say broccoli, spinach(cooked) or sauerkraut. My mom and hubby's both are of Austrian/Irish/Scottish descent.

    • Jack January 22, 2012 at 8:10 pm - Reply

      @Meghan I would tell you optimize your diet and follow your results and labs closely. You will then be able to tell how to modify your treatment from there.

  22. Lauren January 20, 2012 at 11:10 pm - Reply

    Do I have this right? The main forces here are maternal lineage linked with current season/light-dark cycles? The former dictates the food groups you're suited for and the latter dictates what you should eat and when (and how much in terms of carbs)? Is coconut oil still best for all of us (my mother's entire family for eons is Greek/Turkish). You sure do stretch my brain – but in a good way! Thank you.

    • Jack January 22, 2012 at 8:07 pm - Reply

      @Lauren Your own SNP's also matter because your diet has altered how your genes have adapted……that is how natural selection works but if you figure out how you are wired sand you eat this way you will see a synergy come together because you will feel great and your results will blossom. I figured me out with testing and tweaking my diet over 5 years.

  23. Owl January 20, 2012 at 11:25 pm - Reply

    My maternal ancestors are English, Irish, and American Indian (tribe from Pennsylvania), and I live in Arizona. Does where I live change the ancestral carb recommendations?

    • Jack January 22, 2012 at 8:05 pm - Reply

      @Owl It could be you'd have to follow it with results of your diet and your symptoms.

  24. Paul January 21, 2012 at 1:41 am - Reply


    "best adapted to and not where you currently live" I was bought up in England & have moved to NZ ( 10 years ago ), do you foresee any problems.


    • Jack January 22, 2012 at 8:04 pm - Reply

      @Paul……your maternal lineage matters most.

  25. Cú Chul January 21, 2012 at 3:14 am - Reply

    I read Hardwired for Fitness and, if I understand, it looks like humans really out to be going to sleep soon after sunset and getting up at 3:30-4:30 when cortisol levels rise.

    • Jack January 22, 2012 at 8:04 pm - Reply

      @Cu That is not precisely how we are wired. We are designed to have a small awaken spell around 2 AM but we usually fall back to a deep sleep. It seems that natural selection for humans has altered us off this cycle over the last 1 million years so you just need to see how you do best with sleep and with IL- 6 levels.

  26. Todd January 21, 2012 at 7:13 am - Reply

    This is a very interesting article that makes a lot of sense. Our bodies will always be playing catchup to our brains, but it'll never get there.

    I've lived in the Midwest all my life. My ancestry (both sides) comes from Germany. As far as I know, other than one Swiss gal on my mom's side, we're German heritage all the way through. It shows because I was a really blonde, blue eyed baby. My hair has darkened, but I still have the blue eyes and the fairer skin. I seem to tolerate the cooler months better than the warmer ones.. I guess that's all in the genes.

    • Jack January 22, 2012 at 8:01 pm - Reply

      @Todd it does get there if you are aware of the mismatch and you alter your environment to suit your primal genes. That is the core of how I eat now. Go read the blog post dedicated to how I eat after the Leptin Rx is complete. This is how I do it now.

  27. LSSeeker January 21, 2012 at 7:18 am - Reply

    "I became aware that I was now able to decipher how we were designed to work from the perspective of the owners manual that we were all born with hardwired into our DNA."

    I love this!

    In light of this blog and my recent question to you about the red blisters on my hands and feet in the winter, I'm considering lowering my carb count even more. I've been around 20 since Christmas, but now interested in doing a test of zero carb (scandanavian/english maternal lineage and living in Maine) to see if the skin condition improves. This winter I am paleo, however for the two previous years I was SAD. I'm wondering if my genetics are expressing the stress of the incongruency of my diet, light cycles, and epigenetics. I am lifting and sprinting in the cold and will continue to do that. It might be a little on the late side to do zero carb, but if I can figure out the cause of the blisters and see how I'm best designed to work, it would be worth it.

  28. Souldanzer January 21, 2012 at 10:08 am - Reply

    I need to re-read this post but for now – thank you for explaining why I was feeling SO much better living in a minimalist cabin in the Rocky Mountains at 8,500 feet with sparse neighbors and NO city lights around!

    I started sleeping like a rock within days of moving there, exactly in congruence with seasonal light cycles, I felt awake during the day and ditched the coffee entirely, and my hormones started to regulate themselves back into balance (NO PMS, no moodiness, no bloating, no sore breasts, no cramps… I felt like it was any other day of the month!).

    And that was with a very screwed up diet years before paleo/primal and heavily living off grains and artificial sweeteners.

    I'm also thinking that the pure, well-mineralized well water I was drinking heaps of might have played a role…. thinking tons of mag and trace minerals…

    I've always wanted to go back b/c I just felt so good up there in the mountains 🙂

  29. Jack January 21, 2012 at 3:57 pm - Reply

    @souldanzer. I believe this is your body in tune to its quantum biologic needs intrinsically. Cool stuff

  30. Cú Chul January 21, 2012 at 4:20 pm - Reply


    interesting discussion of _Hardwired for Fitness_

  31. Kevin January 21, 2012 at 5:44 pm - Reply

    Great perspective Jack on things – I'm a firm believer in Circadian Biology and agree 100% that observing all these discussions on Facebook and Twitter the real issue of alignment for optimization around longevity gets lost in all the noise surrounding micro and macro nutrients and the desire to fit one size into all solutions.

    Looking forward to the e-book – especially since it will have a seasonal/circadian alignment and adjusts to meals.

    • Jack January 22, 2012 at 7:58 pm - Reply

      @Kev Thanks!

  32. Primal Dream January 21, 2012 at 6:11 pm - Reply

    This is so very interesting.

    I'm of northern european lineage — Norwegian and Swiss on my mother's side. I grew up in the northeastern US (and live there now) but have lived in 13 states, including CA and Hawaii.

    I've never felt at home in other parts of the country. I prefer mountains to sea shore. And in the winter I have no appetite for salads or fruit. This season I'm loving liver and onions, and today cooked a lovely leg of lamb in my crock pot with a bit of leek and celeriac.

    But I'm going to the southwest for a couple of months beginning next week. I guess I should stay as much as I can with lower carbs?

    Thanks for sharing your insights and knowledge with us. You have made a huge difference in my health and how I look at life.

    • Jack January 22, 2012 at 7:57 pm - Reply

      @Primal Dream. With your history I would limit my carbs until the light cycle favors it.

  33. Cú Chul January 21, 2012 at 6:26 pm - Reply

    why don't you do a real book? cannot really give an ebook as a gift to those who would benefit

    • Jack January 22, 2012 at 7:56 pm - Reply

      @Cu if the e cookbook does well I might. several publishers have contacted me about doing just that already but none are willing to do it my way so……I procrastinate.

  34. suejeanne January 22, 2012 at 2:33 am - Reply

    To remember how to swim out of a riptide – stop fighting the riptide and trying fruitlessly to swim back to shore – instead, swim parallel to the shore until you are out of the riptide and then swim to shore – maybe even the normal tide will help bring you in without too much effort, really. Your blog is like learning how to swim out of a riptide.

    • Jack January 22, 2012 at 7:40 pm - Reply

      @suejeanne I like this analogy.

  35. Marijke January 22, 2012 at 7:19 am - Reply

    Funny, I recently increased my carbs somewhat and found out that it does not work for me now. I am of Dutch/German ancestry living in the Netherlands. So I should wait.

    I tried coconut oil several times in the last few years because of all the good things I read about it. Every time I try I have to stop becuase it speeds up my thyroid and I get heart palpitations after eating. So should I give it up entirely? What is the best replacement for me?

    • Jack January 22, 2012 at 7:40 pm - Reply

      @Marijke Ghee is choice two.

  36. Xena January 22, 2012 at 12:40 pm - Reply

    Thanks Dr. Kruse,

    This is fascinating reading. I am somewhat new to Paleo, live in Colorado (now Front Range area but grew up at 9,000 ft of elevation on the Western Slope). My maternal ancestry is Mescalero Apache (New Mexico and Arizona) with maybe a quarter Welsh and my paternal is 100% Irish. Cancer, heart disease, alcoholism, glaucoma, diabetes, macular degeneration, arthritis and early death on both sides, and my mom died at 53 of breast cancer. I fortunately have been sober since I was 25 and at 23 and 24 had a couple of internists tell me I had a "pre-cirrhotic liver." While mother was dark with black hair and green eyes and I'm extremely fair with light brown/red hair. 6'1" tall.

    I've struggled with polycystic ovaries, hypothyroidism and severe adrenal fatigue, weight gain up to 250, etc. From 2005 to 2010 I ran-walked marathons, half marathons and some insane high altitude races, and never lost any weight-did all that at 225-235 lbs. Between that and being a litigator, it's no wonder I fried myself. Now I've slowed down and work for myself so the work part has calmed considerably in the last 12 months. Also, Mom was a well-meaning hippie who had us living on beans, rice and tofu, with occasionally some elk someone would give us, dandelion greens and whatever would grow out of our garden at 9000 feet for the 10-minute growing season. Up until about 10 or so years ago I was still vegetarian. Now that I'm 48 and have a doc who tests adrenals, etc., I'm on a different path (she pushes Paleo and is a walking testament).

    Carb-wise, I know I don't need much fruit this time of year, usually have an apple and veggie-wise it's been sauteed dark greens, cukes in apple cider vinegar and salad greens but now rethinking that until maybe further in the spring. Maybe lose the apple too. Have done several rounds of HCG and am finishing one now, my last one for sure. Starting reading your take on that in the middle of this round . Have read your supplement list for that, and am taking everything but pregnelone because I haven't been tested to see what I need. I'll start the leptin reset shortly. Thanks for all that you do. Wondering if I should lose the fruit until later in the spring. I'm down 18 lbs but still weigh 229 at 6'1". Stopped exercising per the doc except for walking the dog a few times a day for 30-45 minutes and will wait for the reset to kick in before I do more (WON'T be doing any endurance run-walking).

    Looking forward to the e-book and learning more.

  37. CitizenfothePlanet January 22, 2012 at 5:40 pm - Reply

    This blog entry, brimming with logic. Your website so full of useful sensible educational information was a welcomed discovery. Thanks!

  38. Brenner January 22, 2012 at 7:39 pm - Reply

    Dr. K,

    Journal of Science Feb 2, 2011 * 31(5) : 1885-1894

    Rescue of Progranulin Deficiency Associated w/ FTLD by Alkalizing Reagents

    and Inhibiition of Vacuolar ATPase

    I think I can prevent further disease progression with this (chloroquine)

    But I cannot find a neurologist to try it …what can I do …I want to try it

    but I need a script to get it …is there any other place?


    • Jack January 22, 2012 at 7:54 pm - Reply

      @Brenner I think you might try an academic center neurologist.

  39. Jack January 22, 2012 at 8:13 pm - Reply

    @Amanda both are partially correct. I don't worry about a high total cholesterol unless the HS CRP is up……then you do need to worry about T3 and Vitamin A levels to convert the LDL cholesterol to pregnenolone…….but there is a ton of other things could help. This is something I will be hitting upon in my book too.

  40. Norma January 22, 2012 at 8:46 pm - Reply

    Hi dr. Kruse, I have posted above about my maternal ancestry. Comment #24, it was rather lengthy. I think the more someone knows the better they are able to help you.

    Thanks again for your time and help.


  41. akman January 23, 2012 at 12:20 am - Reply

    I have a nagging inconsistency in my mind with all this. I spent 21 years in the Armed Forces. We took hundreds of thousands of young men and women from all walks of life and inducted them into the military during those years. We worked them hard all day, fed them whatever they wanted to eat–never discussed macros or micros–just fed them. They drank, smoked, stayed up late, yet still became and stayed lean and healthy. We placed great stressors on them and still they stayed healthy. No one ever gave thought to circadian rythms, leptin, primal, paleo, cortisol, or supplementing. Approximately 1% of the thousands brought in each year couldn't maintain health and fitness and were drummed out.

    Upon exiting the services, many quit exercising but still eat and drink like a 20 year old and within a few years are in the throes of metabolic syndrome.

    How have the militaries of the world maintained great armies since iniquity without the knowledge you are now supplying? What did they do right? What can we learn from this?

    • Jack January 23, 2012 at 9:26 am - Reply

      @Akman your story assume that what they did to them was ideal…….what happened to them is exactly what happens to endurance athletes…….on the facade they look good but they are dying slowly inside. This is why we see endurance athletes drop left and right from 45-60 yrs old. It is also why the military is now experiencing unprecedented claims for medical care in the VA system and in the last 15 yrs is facing unbelievable amounts of PTSD related illnesses. Today we look for this and in years past we could not see what we did not look for.

  42. JanSz January 23, 2012 at 10:37 am - Reply

    Jack Says:

    This is why we see endurance athletes drop left and right from 45-60 yrs old.


    how many months of combat a soldier can, or should, handle

    PTSD was was not a catastrophic problem during World War II, Korea and Vietnam, because troops tended to get badly wounded and killed before they hit the 200 day mark

  43. ATL_Paleo January 23, 2012 at 12:12 pm - Reply

    @ akman … In addition to Dr K's valid points, there appears to be another big factor in play; Selection Bias.

    Below are 2 quotes from http://criticalmas.com/2012/01/the-problem-with-b

    When you take a bunch of healthy men and women that are mostly 18-20 years old and subject them to high levels of training, they tend to respond positively. Young people have a greater window of recoverability. To further ensure success, the Armed Forces does extensive physicals on all enlistees. If you are overweight, you are instructed to "make weight" on your own before you can even start Basic Training.

    In other words, the military stacks the deck in their favor by selecting the candidates that can best respond to military training.

  44. polarpaleo January 23, 2012 at 1:27 pm - Reply

    I would love to see 'survival guides' for people living in the far north, equatorial, shift workers, etc…

    • Jack January 23, 2012 at 3:25 pm - Reply

      @polar I will get into this area big time later this year because it holds huge promise for several conditions.

  45. Kami January 23, 2012 at 1:33 pm - Reply

    Dr. Kruse, I found out my Great Grandmother came from Ireland. I now Live in SD. What does this mean for me as far as carbs? Paternal side is Sweedish.

  46. Sage~~ January 23, 2012 at 4:04 pm - Reply

    I decided to do the haplogroup test I referenced above (number 20)–I've been curious about it for other reasons for quite awhile. Just knowing that I have a lot of German and English ancestry doesn't tell me what family of genes I have…. It's pricey, and an indulgence on my part. But, oh, so fun!

    • Jack January 23, 2012 at 5:48 pm - Reply

      @sage I think you're wise…….honestly.

  47. Coriander January 23, 2012 at 4:11 pm - Reply

    How far back is relevant Jack? Since reading this blog, I've traced my maternal line back 10 generations. While I don't think that the diet in 17thC Wiltshire, England holds many clues for optimization, I will continue to enjoy the wild blackberries! Is the Haplogroup info that Sage posted @ #20 worth following through?

    • Jack January 23, 2012 at 5:48 pm - Reply

      @Coriander it is very relevant……and after you do what you are doing what I would do is then consider going to 23andme and getting your SNP's tested. I also think the haplotypes are very helpful in figuring out how your epigenetic switches are set currently. I know how we are best adapted based upon our common bottleneck ancestor that we come from……but that discussion will come later this year int he book.

  48. Sage~~ January 23, 2012 at 7:29 pm - Reply

    Tnx, Jack. I think it's amazing that there are only 7 haplogroups! We're all so closely related…. The second link in #20, though, goes to a wiki that shows a bazillion subgroups within the various major types, and shows continental subgroups, too; so we're far apart, also. I show my ignorance when I try to get into it all there, though; even though science is one of my passions, I have very little experience in biology. So glad this topic has come up for discussion 🙂

    • Jack January 23, 2012 at 7:54 pm - Reply

      @sage this is why the what we eat is critical……but few realize today right now that it is the one thing that binds us all. And when my book comes out you will see where that bottle neck comes from and just how tied it is to the leptin receptor biology. It is incredible.

  49. Sage~~ January 24, 2012 at 4:19 am - Reply

    Jack, I'm salivating in anticipation (analogy intended Hehee)!

  50. Coriander January 24, 2012 at 6:02 am - Reply

    hahaha Sage.

  51. Rodney January 24, 2012 at 11:47 am - Reply


    Please keep us posted on your test results and overall experience!

    My mother was adopted and has no interest in knowing about her biological family. I would love to know at least where I came from and am therefore interested in the testing you referenced. I wonder how detailed the results are, and if that answer would satisfy my curiosity.

    • Jack January 24, 2012 at 1:35 pm - Reply

      @Rodney if you do 23andme you can surely find out where your genomic ancestry is for about 200 bucks. Its the best deal in healthcare today.

  52. DermDeb January 24, 2012 at 7:37 pm - Reply

    Just a quick thank you for all you are doing. I have been a dermatology physician assistant for 34 years and this already has affected how I am practicing dermatology. My husband and I have started the leptin prescription and I have sent many of my patients to your website, particularly ones with eczema and psoriasis. I have always suspected grains may be a problem for all inflammatory skin disorders..everyone who practices derm knows about the link between dermatitis herpetiformis and gluten sensitivity..but you are the first to explain how this may affect so many other skin disorders. I am still absorbing so much you have written…thankfully I was checking in on Jimmy Moore's podcasts and listened to both of your segments, and the light went on!

    • Jack January 24, 2012 at 8:51 pm - Reply

      @Derm Deb I will take it further……if you have a skin disease you have a leaky gut by definition. We must get derms into the gut physiology and away from the sun…….We cant live without the sun but you'd never know it from modern dermatology. Thanks for the kind words too!

  53. Sage~~ January 24, 2012 at 9:18 pm - Reply

    Jack, I sent you an email a day or two ago re the BioHack. If I'm in your Spam folder, is that legal on the Reset? :::ducking::: If my note doesn't show up in your mailbox, please let me out of the Spam can and into the pastured area. Hehee.

    I await your reply,

    Tnx, SageQZ

  54. Sage~~ January 25, 2012 at 6:46 am - Reply

    All joking aside, I certainly wish I had been more aware of what's available in genetic testing. I'd have chosen 23andme over National Geographic…. I guess it's part of the perils of being immersed in Alzheimer's — my mother's, that is. Being one of her caregivers over the past 5 years has certainly been isolating from other interests/inputs. I wonder if I can get a refund from NG?? Hmmm…..

  55. Sage~~ January 25, 2012 at 6:53 am - Reply

    oops–doubled up on the blog and left out the youtube channel:


  56. akman January 25, 2012 at 4:32 pm - Reply

    You mention that lower conversion of T4 to T3 is a normal process in the winter. Wouldn't this make T4-only treatment for hypothyroid better than T4+T3? (assuming you have normal conversion ability) Should those on thyroid replacement drugs do anything differently in the winter?

    • Jack January 25, 2012 at 5:25 pm - Reply

      @akman……? Why? I see no need for it if you are eating the diet we are best adapted to. In your case in the arctic circle you should be eating the ancestral Inuit diet. Lots of fish, protein and blubber. It might be hard to recreated but if I was you I would damn well try and you can bet your ass I'd be out exercising in the the frigid cold as they do too.

  57. Coriander January 25, 2012 at 5:04 pm - Reply

    Great question akman. I have no thyroid, and have been taking the same dose of synthetic T4 and T3 for 22 years, with no problems, even through pregnancy. I've read that synthetic is not ideal, and now I wonder if this constant dose is optimal. Is there anything I should be looking out for Jack?

    • Jack January 25, 2012 at 5:26 pm - Reply

      @Coriander If youre fine I'd say no……as you age if you see your LDL rise and your get symptoms of hypothyroidism you might consider bioidentical replacement. I am not a T4 only fan like conventional medicine is.

  58. Coriander January 25, 2012 at 5:29 pm - Reply

    Thanks Jack.

  59. Lee January 25, 2012 at 5:44 pm - Reply

    I am 5' 8 weigh 127 lbs, have 18 per cent body fat with calipers, BMI 19 ish, 49 years old female, I have it all. Sleep apnea, heart palpitations,ridiculous cholesterol, fat deposits around my eyes. A year at the gym was like a wall, inflammation was an issue, and strict calories did nothing. I am now paleo and see the redistribution, my pants have gone up a size, whilst losing weight, and it s flattering. I have the heavy plaque on my back teeth and my fronts are nice and white, even at my age. Do you think I should kick it up to i/f and get the fat gone? Or do you think if I stick with it it should iron itself out? I freeze when I'm too thin and now see I need a reset to fix it. The sweat pattern has changed and I can breathe full breaths, I though I was short winded, but I think it was swelling. Its been since a week before Christmas.

    • Jack January 25, 2012 at 6:44 pm - Reply

      @Lee I would stay the course……and If you still hit the wall then testing is a smart move to see how bad the inflammation is.

  60. Lee January 25, 2012 at 5:46 pm - Reply

    I have a big handful of belly fat that folks poopoo, but that's gotta be my devil. I had high cholesterol the first time I weighed 125. Never trouble at the 118/119, weights, which is what I weighed in high school and when I stepped on the scales after delivering my babies.

  61. Jonathan schwartz January 26, 2012 at 11:17 am - Reply

    Dr kruse.

    I wanted to ask you a question on another note but didn't see a direct email for u. My true love is nutrition and I spend many hours reading all the info with this extended community and live it myself. I want to pursue a career in this field at some level but am unsure where I could fit in and what training I should seek. I have a liberal arts BA and have also taken courses the entry level course work in anatomy and physiology. I really don't think conventional dietician training is for me as I think much of it is way off base. I lean more towards the holistic side of things but am not to far left on that side either. I want to find a degree program or certifications that would be attainable within around 2 years or so that would get me an entry level position in the field. I just want to help people and share all this groundbreaking info . Any ideas or people I would best suited to contact within this community would be much appreciated.

  62. Meghan January 27, 2012 at 6:07 am - Reply

    @Jonathan, did you check out Hawthorn University or Nutritional Therapy? I am planning on doing the Hawthorn program for Nutritional Consultant, they have several up to Masters.

    @Jack question about waking up. If my spoiled dog wakes me at 5:30, do I need to get up because I now have to eat by 6:00? or can i lay around awhile. Also, we use timers on our bedside lamps to start coming on around 15-30 minutes before the alarm, the amount of light gradually increases. Does this mess up the reset, would I be better to skip the lights and just set the alarm?

    • Jack January 27, 2012 at 8:16 am - Reply

      @Meghan…….lock the dog up. Your health should not be marginalized by the dog. We had the same problem and we solved it. Sounds harsh but it had to be done.

  63. Lee January 27, 2012 at 11:07 am - Reply

    Dr. Kruse,

    Thank you so much for the quick response abut the Bipolar deficiencies. I had only been told folic acid and the depletion symptoms for the B6 align with my daughters episodic behavior, along with bizarre guilt. Anyway, last night at dinner, my daughter asked her brother if he had to shave less since he was eating this way. It reminded me that my daughters episodes corresponded with her menstrual cycle and she would get unstable sometimes after each episode at the same time. The doctors just said it was normal. He gp put her on depo and it made her sicker than a dog. So anyway, I found this article about dhea and dheas and I can't figure if he is saying it mutates or it gets depleted like a sucker punch or if its just low. I am trying to understand what he is saying. if you could kind of translate or tell me your thoughts. He says its an addiction of sorts, and I know it must feel pretty amazing on the way up.


  64. Lee January 27, 2012 at 2:45 pm - Reply

    Sorry to keep bothering you. I reread it and I think the gyst is that mania is just like pcos. They suggest some rough med to take. I see the naturopath treatment is minimum 6 weeks of no carbs to reset the adrenals along with chromium. That would explain why less hairy armpits. She's already decided that things are going so right, so fast, that this is a lifestyle. What kind of doctor would measure her hormones for this? Is this the sort of thing bioidenticals would be used for after an extended period?

    • Jack January 27, 2012 at 4:43 pm - Reply

      @Lee she should be able to do it…….and if she refuses I would look for a progressive anti aging doc. Going to endocrinologist is an exercise in futility in my opinion.

  65. Lee January 27, 2012 at 2:52 pm - Reply

    I stopped beating my self up years ago for being on the pill while I was pregnant for 6 months, after getting negative pregnancy test after test. Maybe imprinting or over something…IDK

  66. Lee January 27, 2012 at 5:39 pm - Reply

    Thanks again so much. We're just gonna tool along a couple of cycles and concurrently search for a doc. I know someone gets it somewhere. Its the mental illness diagnosis that makes her a hot potato. I guess if we just go in for hormone imbalance, at least they will talk to us.

  67. grokker January 27, 2012 at 6:09 pm - Reply

    First off, you changed my life! 50y/o male here. I started PB last year at 75lbs overweight, stalled, found you…Did the entire Leptin Reset, stalled. Got tested by a good doc who is into paleo. He found my thyroid out-of-whack, but everything else pretty good. No auto-immune, just low T3 and T4 with normal rT3 and high TSH. My Vit D is 69, trigs 45, HDL 69, LDL 125. Iodine level OK.

    My doc wants me to try Synthroid as he thinks I have no conversion issues. I said OK. How long does it take get back to normal with Synthroid? What should I look for as we determine proper dose? There is not much written on people with sluggish thyroids w/o Hashi or Graves.

    • Jack January 27, 2012 at 6:28 pm - Reply

      @grokker you should see results with quickly but I am no fan of any synthetic hormone replacement. That is my bias and you should re listen to Matt LaLonde AHS talk to understand why. Synthetic never equals the biologic hormone……..it was the one talk at AHS that I fully bought 100%.

  68. Russ January 28, 2012 at 8:05 am - Reply

    Following up on my earlier comment re hacking VAP profile w D3, Coconut Oil and fermented foods. Unfortunately, had really no effect at all on HDL – up from 47 to 48 in 30 days. But LDL went up from 170 to 200, with size actually declining a bit and still mostly sdLDL (from 60% to 65% sdLDL).

    Per comment on your FB page this week, I had not picked up earlier on potential extreme sensitivity of APOE4's to dairy. I still use butter liberally (eggs, veggies), and occasional cheese. So will cut dairy out completely this month and test again.

    Any other bloods tests that you might suggest (hormones, vitamins, minerals, …) to look for clues to help hack out an optimum?

    • Jack January 28, 2012 at 8:47 am - Reply

      @Russ when this happens do not fret…….the rise in LDL could be a normal variance. The other possibility is that you could have a small pregnenolone steal going on where you cant convert LDL cholesterol to pregnenolone. This conversion requires T3 and Vitamin A. I would cut the dairy…..butter and cheese. Use Ghee or coconut oil. Stay with the eggs…….I think you should read my Leaky gut Rx…….This will help you cut the sdLDL for sure. and if your sdLDL fraction stays high it means carbs are the problem or BCCA from protein……..it also means that your sex steroid hormones might be critically low. So that woul be something to check too. When you are tinkering you need to stay the course and keep thinking how evoltuion has built you and keep digging. Optimal is buried in our DNA and hardwired into each one of us.

  69. Cú Chul January 28, 2012 at 9:18 am - Reply

    Dr Kruse, lately I have a sleep problem that disrupts my work and makes the Leptin reset impossible. I sleep at a normal time (ca, 10 pm) and then wake up about 2 or 2:30 in the morning, cannot get back to sleep, and then I end up falling asleep ca. 6 am and sleeping til 10 am. Any suggestions would be appreciated.

    • Jack January 28, 2012 at 9:24 am - Reply

      @Cu go read what I just posted on comment 671 on the Leptin Rx comment section.

  70. vadoc January 28, 2012 at 11:32 am - Reply

    Greetings Dr. Kruse – I was 'turned-on' to your site by a patient last summer and have been a constant lurker ever since. I have used your Leptin Rx on several folks to great success, my only challenge is getting them to believe it will work…"Perspective Matters". Some get it, some don't, but they will all read this blog when the next come in!

    Regarding Synthroid. Thyroxine Sodium has been our go-to treatment for hypothyroidism for decades. Most respond well to it. I recommend testing every 6 weeks, to ensure it is converting to T3 at the proper rate during intial dosing. If not, I will prescribe a T4/T3 mixture. I have always felt that it's best to let the body make it's own T3 rather than force feeding. but, as you know, it's all in the context and one size surely does not fit all, but perspective matters!

    • Jack January 28, 2012 at 12:33 pm - Reply

      @VAdoc I do not believe that most respond well to T4 synthetic hormones…….not at all. I think that is CW advice our profession deals out daily. Let me give you a perfect example…….Most physicians know a little bit about stero isomers. For example racemic epinephrine is a 1:1 mixture of the dextrorotatory (d) and levorotatory (l) isomers of adrenaline. The l- form is the active component and D form has a totally different biologic activity.

      Racemic adrenaline works by stimulation of the αadrenergic receptors in the airway, with resultant mucosal vasoconstriction and decreased subglottic edema, and by stimulation of the β-adrenergic receptors, with resultant relaxation of the bronchial smooth muscle. In local anesthetics, Adrenaline is added to injectable forms of a number of local anesthetics, such as bupivacaine and lidocaine, as a vasoconstrictor to retard the absorption and, therefore, prolong the action of the anesthetic agent. Some of the adverse effects of local anesthetic use, such as apprehension, tachycardia, and tremor, may be caused by adrenaline.

      Most physicians know this biologic fact……….that the chirality of these two enantiomers have equal and opposite specific rotations have different biologic effects at the receptor………but yet we believe that synthetic hormones are somehow allowed to not follow the same laws of physics and chemistry that adrenaline does?????????

      Synthroid does not equal our own thyroid hormone!!!!! EVER. that is why so many patients have so many problems. Our profession has made this error more than I care to admit. It does the same thing with BCP and most other synthetic hormones. We as a species need to run the other way from all synthetic hormones. We have no idea how the changes a drug company made to patent a drug will do after we get. To see just how shocking one hydroxyl group replacement might be lets go back and read the Women's Health Initiative study.

      It is also why the flawed WHI on hormone replacement is toilet paper in my eyes. Medroxy-progesterone does not equal real human progesterone that is found in bioidentical prometrium. Most MD's and patients today think what links the WHI found are cross reactive with prometrium use……..TOTAL BULLSHIT TO THIS DOC. WHY?………evolution requires a lock and key for its steroids and its receptor. When a drug company adds a hydroxy group to the 17 position to patent a drug, we in the profession have to KNOW that this drug is not the same drug that our body makes and it will have dramatic down field effects that are likely long lasting. Food and steroids are the only two things we know that alter our epigenetic switches so this is a huge deal for our patients.

      We have models to prove what I am saying is true. Medicine just ignores it to our patients detriment. I just gave you one in the chirality of epinephrine!!!!…….and that one change to progesterone can have far reaching biologic effects when it is introduced to the biologic system that never was adapted by natural selection of evolution to see the hydroxy group at this position!!!!………This error in modern medical thinking is why people today think progesterone cause breast cancer and all other kinds of things……….total bullshit and our profession just allows drug companies to propagate this bullshit to the determent of patient care. BIOIDENTICAL HORMONES SHOULD BE ADVOCATED BY OUR ENTIRE PROFESSION JUST because of this little chemistry lesson I have posted here.

      I am not trying to call you out…….at all. I am pointing this out because your belief about synthryoid is what we had drummed into our heads in training and it is just plumb wrong. And that has allowed us to make other errors of commission in how we think and treat people. The WHI studying being case study one of how a a flawed thought could hurt millions of people based upon bullshit science. The same errors happened with cholesterol……..but I am not going there now……..That will be in the book I am writing. We have a duty to patients to advocate medicine based upon how our body is designed to work and not what we were taught to believe in my humble opinion. That is the perspective that should matter to our entire profession and sadly it falls on deaf ears. I'm going to change that if I can.

      Thaks for the kind words about the Leptin Rx………but I had to point out I do not share your view about fake T4 at all.

  71. Russ January 28, 2012 at 12:11 pm - Reply

    Dr K, Thanks. No fret here. I am having fun learning and tweaking. I started hacking to get tips to help my Dad's health, and found big leaps in my own. I feel incredibly healthy so feel I am on the right path. Will definitely cut dairy (except ghee) and go back and read the Leak Gut Rx again. I'll look into options for thyroid and sex hormone panels for other clues.

    My wife and I are coming to PaleoFX in Austin. I'll look forward to listening to you more there and hopefully getting a chance to meet.

    Meanwhile. Thanks tons. Just keep writing – I learn a lot from every post.

  72. Cú Chul January 28, 2012 at 1:23 pm - Reply

    bingo, thank you Doc– do you know this book–?


    • Jack January 28, 2012 at 1:31 pm - Reply

      @Cu I do.

  73. Colleen January 28, 2012 at 4:45 pm - Reply

    vadoc, most women in particular do not convert T4 to T3 well. I've seen it over and over again. Fibromyalgia is a relatively "new" disease but quite often it's simply the result under optimized thyroid. I see so much of it on women who are taking Synthroid. Switch it to Cytomel or a compounded version of Armour and the pain, brain fog and depression lift immediately. I am always urging people to talk to their doctors about switching. If you have any patients who are complaining of short term memory, hair loss, joint pain, etc. switch them off of Synthroid and see for yourself. And get their free T3 and Free T4 tested and ignore the TSH. You'll have happy patients. 🙂

    • Jack January 28, 2012 at 5:30 pm - Reply

      @Colleen thanks for weigh in and letting the good doc know about these issues you have faced. Your story is going to help so many other people. We have much to do getting good info out.

  74. vadoc January 28, 2012 at 8:24 pm - Reply

    I am going to start asking my Synthroid pats if they want to try Cytomel or Armour, after showing them this blog. I do use both, but have really good success with Synthroid, also. I'm one of the few that runs full thyroid panels, I never liked TSH alone, and esp after reading The Quilt last summer. I have been convinced that the T3 produced by the body from synthetic T4 is the same as T3 produced from the body's own T4. My paleo patients are awesome! If I could convert them all I'd be out of a job.

    • Jack January 28, 2012 at 8:38 pm - Reply

      @VAdoc…….glad to hear it. I think if patients migrate to this lifestyle it free us to go from being just good doctors to great ones. We can stop treating disease and we can teach people how to stay well. And trust me in this country we will be busy for 100 yrs teaching people that.

  75. Shijin13 January 29, 2012 at 9:16 am - Reply

    @VADoc… As a veteran who uses the VAMC system I'm encouraged by your willingness to step outside the current paradigm the VAMC uses for medical care/treatment. My current PCP at the VAMC has been very open to the Paleo/Primal WOL and she's been open to looking at other treatment options for me. When we discussed my concerns about my inability to loose weight, as well as my PCOS; she willingly sent me to see a VAMC Endo.

    The Endo in both of my visits, and 2 phone consults tried to placate me by running tests, and told me point blank that nothing was wrong, and I should be happy that I'm healthy, even though my weight and BMI places me squarely in the obese category.

    Its about Perspective and the context of that perspective. For me its not just about loosing weight, its about optimal health so I'm able to interact and be active in my children's lives. Its about setting an example of wellness for my children. Unfortunately, the VAMC Endo did not get this, and felt mediocracy is acceptable. Its not.

    Last August, after being on the Leptin Reset for 3mths, my TSH was 2.77 mUI/mL, free T3 was 2.5pg/mL, RT3 was 256pg/mL. In Jan 2012, after 6mths on the reset, and 18mths of Primal/Paleo WOL, my TSH is 4.12uIU/mL, my free T3 is 2.7pg/mL,& I'm still waiting on my RT3. Something is going on…with my thryroid as well as my hormones, as my testosterone and estradiol is HIGH, and my progesterone is in the basement through out my cycle. I'm now pursuing a way to fix this, now that I know what's going on.

    If I had accepted the VAMC endo's assessment, I wouldn't be on my way to optimal, I'd be stuck in the same cycle I've been in for the past 10yrs. I now question everything a doctor tells me. I want verification and validation that the recommendation I'm being given is right for me, not just the "party line". That might make a difficult patient, but if I'm an active participant in the management of my health, I'm a better patient b/c I understand the treatments being recommended, and I'm more likely to buy in 100% vs just doing something b/c my Doc says I should. This is just one more aspect of perspective and context that should be occurring within the doctor-patient relationship.

    I've known something has been wrong for years, but it seemed no one will listen. Thanks to Dr Kruse, I've been able to figure out what's going on, and now I'm trying to find a doc who is both willing and able to think outside the box the system has placed them in, to address my issues. I'd love to be able to use the VAMC to do this, but it seems the current climate of health management is one of mediocrity, so I'm looking elsewhere.

    VADoc keep pushing for change, while your efforts may not help me solve my problems, you can change the health management of your patients from the status quo to optimal, and hopefully, the next patient who walks in with problems like mine won't have to jump through hoops for 10 years to figure out what the problem is and how to solve it. Thanks for serving our veterans, keep pushing for optimal for them, and they'll have the best health of any Vet who walks in to your VAMC.

    • Jack January 29, 2012 at 10:40 am - Reply

      @Shijin…….just gorgeous reply and I think you just tapped your Primal Sense. I hope your vision becomes infectious to those in my profession who read this. We all need it.

  76. Lee January 29, 2012 at 3:06 pm - Reply

    Dr. Kruse,

    I have been searching the internet for the progressive anti-aging docs and they all hype thyroid and seem like beauty parlors (I live in Southern California). My daughter is 25 and was diagnosed at 19. We had a talk and she remembered even being so radical as to use a razor on her upper lip before her last episode. And her eyebrows get Frankensteinian. We thought it was the meds doing it. Anyway…The naturopaths say just what you do, it will never be right if the thyroid gets dabbled with and I think in spite of all the "medicine", she's got a lot of bounce in her. we've been through three episodes that had her hospitalized for 21, 22, and 23 days. The only thing that worked was zyprexa and lithium… The only thing. There is no direction to go with the bipolar meds. Can you recommend a school maybe? (anywhere in the US) I'm starting to get confused about the vitamin deficiencies. I think the B6 is the vitamin that put a morning smile on her face or maybe the diet… but if the deficiency is caused by the episode and then, and the deficiency is starting after ovulation…and then dhea is good one part of the month and bad the other, and, and, and. My hope is the adrenals get fixed and stay fixed, then the ovaries fix themselves, then so does everything else. Is there any other kind of doctor that can monitor and compound as necessary and write her a prescription for vitamins in case she ever does have to be hospitalized again?

    • Jack January 29, 2012 at 5:17 pm - Reply

      @Lee conventional medicine has no answers for these problems because they refuse to see the links and connections between them all. We are taught to put them into neat diagnosis packages and come up with cook book algorithms that is called evidence based medicine. I would tell you to go to functionalmedicine.org or even look in Suzanne Sommers books. She has a link to some of the best anti aging dics and most are in southern california. I do not know anyone out there.

  77. Lee January 29, 2012 at 5:26 pm - Reply

    Thank you, I guess we will find someone that will leave the thyroid alone and try to fix what can't fix itself with a little beginning of the cycle fasting. Thanks for everything so much.

  78. Sally January 29, 2012 at 8:59 pm - Reply

    Dr. K, I could get used to this… Waking up as the sky lightens, taking some raw liver out to Primal Kitty, and feeding the chickens oatmeal, corn, rice, wheat and other grains I'm 'supposed' to be eating. I eat some boiled eggs and leftover bacon, and go sit with a happy kitty purring on my lap, listening to the pond waterfall, feeling the warmth of a small chiminea fire on my skin, as the brilliant sun finally peeks over the horizon. Kitty doesn't even mind the chickens coming up to the porch to steal some of her leftover food, as long as I keep scratching under her chin.

    Thank you for urging me to change my daily perspective.

  79. Terry Fischer February 3, 2012 at 11:46 pm - Reply

    The circadian perspective you posted was really helpful. I researched what my tribal people ate years ago and always felt better following a fish, roots, leaves and berries diet. My ancestors were Ottawa from Michigan and Canada.

    I followed your recommendations after I finished my second round of HCG. My weight has been stable, I'm feeling well and my digestion has improved eating twice a day. I've had a problem with decreased metabolism and moderate weight gain due to not eating enough in the past. I then had antibiotics due to an appendectomy which really interfered with digestion. It's taken me the better part of 5 years to fix this part of it.

    I am almost 70, an RN, and I'm wondering how much my mothers situation had to do with this. Maybe it's not only me. She was taken to an Indian school because she was starving at about 12 years old. The school wasn't that much better. When she left at age 18 she was taken in by an older woman as a maid. This woman fed her well and after age 18 she grew 4 inches and started her period at age 22. I was born when she was 28 and weighed about 5 lbs. She said she was afraid to touch me because I was so delicate. What are things I have to do extra to keep in good health as I go into my elder years? Luckily I don't have any chronic diseases but feel I am barely one step ahead of things and would appreciate any advice for me because of the difficult background I came from. Thanks for what you do and I am studying your posts.

    • Jack February 4, 2012 at 8:46 am - Reply

      @Terry Your Mom's story of anorexia epigenetically predicts for you to have a difficult life because of the way your epigenetic switches were set by your maternal lineage. If you eat aggressively to protect your own DNA you can continue to thrive. As for your own longevity I suggest you come to Paleo fx in Austin in March of 2012 and listen to our mastermind series on longevity. I will be on that panel and I have some radical ideas about longevity. My best guess based upon the science I know right now is to eat ketogenic version of the paleo diet while keeping your surrounding environment as cold as possible while you are wearing as few clothes as possible. It also would help if you have optimal LS, optimal K2 levels, optimal D levels, Low HS CRP as close to zero as possible, And consider the use of daily resveratrol, cur cumin, and coconut oil that is organic like from Nutiva or tropical traditions. You also want your TSH to fall naturally to .3-.6 as you implement this over time. Your leptin levels should never fall to negative numbers……if it does you have over done something like exercise of you have entered the territory of anorexia.

  80. Terry Fischer February 6, 2012 at 8:19 pm - Reply

    Excellent, I've been taking TRop. Trad. coconut oil for 3 years. My Vit D level was 53 last summer. I've been in ketosis since first of December 2011,and paleo since I switched over from HCG at end of December.(Good suggestion of yours by the way as I haven't gained any back). I'm just starting to consider exercise. I have not had the energy and had much joint pain. That is mostly gone now. I'm 5'4" currently at 143 lbs. I wrote out 10 meals that total 1500 calories per day so I wouldn't slide into not eating again. I've been at 1500 for the last 7 days and with digestive enzymes, HCL, pancreatin I seem to be digesting OK. the mix is fat 63%, Pro 26% and CHO 11%. I eat per your LS recommendations and am content. three things; After I lose the last 8-9 lbs, in order to maximize my energy is 1500 cals enough or is it based on how I'm doing with the energy and keeping my weight stable? Second, I have an appointment at the Indian hospital clinic this week. I am going to ask for a VAP, Homocystine level, leptin level, Vit K, D and B-12 levels, TSH, DHEA and Omega 6 to 3 level. I'll see how that goes. Any other suggestions for labs?

    Third re: cold environment. Is this to encourage my metabolism to speed up? to burn calories if I don't exercise much? How would I evaluate any issues with possible hypothermia in myself? Thanks for the assist. Terry

    • Jack February 6, 2012 at 9:13 pm - Reply

      @terry cold will increase your ACTH, thyroid and decrease your leptin levels to make you ultra sensitive. This also increases your RER and you can actually do some amazing things that most do not realize that humans are capable of doing.

  81. polarpaleo February 7, 2012 at 12:59 pm - Reply

    Hey, Jack! Have you ever had any clinical experience with heart PVC's? Any connection to PVCs and thyroid, diet, leptin?

    • Jack February 7, 2012 at 1:14 pm - Reply

      @polarpaleo yes……usually an excessive tissue omega six issue. Diet is usually very successful in reversing it. It take up to 36 months however to fully reverse a high 06/3 ratio

  82. Terry Fischer February 8, 2012 at 6:25 pm - Reply

    I just got back from the appointment at the Indian hospital. I was pleasantly surprised as the Dr. agreed to all of my requests for labs. She was curious about how I got to look so good for my age. She also took down your website information Maybe I'll have a good partner in my health quest. So you might get a note from an MD in New Mexico. I'm enthused. Thanks for being here.

    • Jack February 8, 2012 at 6:29 pm - Reply

      @Terry I am glad for you…….read tonights new blog. 2/8/2012.

  83. TheKid February 11, 2012 at 7:02 am - Reply

    Does the body ever adapt fully to a new circadian environment? For instance, I grew up (18 yrs.) in Ohio. Then I moved to California for nearly 10 years. Now for the past 9 years I have been living in the Middle East which is nearly a whole half day ahead of California and 8 hours ahead of OH.

    I happen to notice that whenever I fly home for vacation in OH, certain things get better. I usually attribute this to being on vacation and reducing stress. But could it be a return to a circadian environment that my body recognizes? Am I doing harm to myself by forcing my body to function in a foreign circadian environment?

    Interestingly, I heard from a friend that a traditional medicine text from this area of the Middle East advises that when one is very sick, in order to recover, a person should return to the place of their upbringing to convalesce. Maybe these folks were on to something.

    Additionally, to follow on regarding cold therapy and seasonal changes, what impact is there on my body now that I live in a place that is in the subtropical zone and is pretty darn hot most all the time? I mean, there is no period of cold here. Maybe we get down to the 50s overnight once in a while during winter. But its always at least int he 70s or 80s during the day. And since my body developed facing cold OH winters, am I harming myself by depriving it of the seasonal temperature shifts that I grew up with and developed in? Your thoughts?

    • Jack February 11, 2012 at 8:04 am - Reply

      @The Kid you have touched on something here that I have not got into yet. It does appears that humans have some epigenetics programs that they are best adapted too and it does appear for circadian biology that where you spend the beginning part of your life you often adapt to best. Now it is also true that circadian biology does allow for adaptation but it appears that it is far more flexible for temperature than it is for light cycles. No one quite knows why yet.

  84. Sally February 22, 2012 at 9:37 am - Reply

    Dr Kruse, I have been following your leptin reset protocol for several weeks, but I started to suspect there might be a problem. As of this morning, however, I am positive there is one. I hope you can help me. I have been making sure to be outside for each sunrise, but my neighbor is making it difficult.

    If you can believe it, my neighbor has been moving his house, just a little each day. Now part of his house blocks my view (and my kitty's view) of the sunrise. I'm afraid soon the sun will have to clear the entire ridgeline before I can behold it's full glory. I think my neighbor wants to impact my health, if you ask me. What unmitigated gall!

    I know you're only a doctor, but do you think I might have legal recourse?

    • Jack February 22, 2012 at 11:10 am - Reply

      @Sally………lol No idea but I want follow up if you win!

  85. Sally February 22, 2012 at 10:12 pm - Reply

    All kidding aside, I just today got the results of two tests I ordered. So much for patting myself on the back. My rev T3 was ok at 22.5 ng/dL, but my HS CRP was 7.39. I'll increase the krill oil and increase the fish in my diet. It's good to have the feedback, anyway.

    Makes me wonder what my HS CRP level was back when I felt miserable, and I was taking several prescriptions. My doc wouldn't order the CRP test, because I passed a cardiac stress test.

  86. Carolyn March 26, 2012 at 11:16 am - Reply

    What if you embrace the Paleo diet, are already lean, fit, healthy, but are having trouble maintaining weight on it? My husband, 49, 6 ft tall, is down to 165lbs… a 10 lb loss on someone who never wanted to lose any weight at all. (darn him!!!) He says he doesn’t desire any more protein and he’s full at meals. He does miss carbs ie. pasta but agrees it seems odd to add something unhealthy to gain weight.

    • Jack March 26, 2012 at 12:04 pm - Reply

      @Carolyn tells me his hormones are not in good shape…….especially free testosterone and maybe cortisol

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