Episode 405 – Robb and Nicki Q&A #9

We’re back with Q&A #9 with Robb and Nicki.
Remember to submit your own questions for Robb and Nicki to answer on a future show here: https://robbwolf.com/contact/submit-a-question-for-the-podcast/

Show Notes:

 

1. [2:06] Kidney Stones

Krisztian says:
I’ve been mostly Paleo for about 5 years now based on one of your piror books.  Overall, it has worked well for me, with one exception.  I started to develop kidney stones on a regular basis.  I finally had them analyzed and they turned out to be calcium oxalate stones.  Upon reading up on this condition, it stems from a high amount of oxalate in the diet.  Unfortunatley, most of the foods I liked on Paleo happen to be super high in oxalate… spinach, nuts, seeds, dark chocolate, sweet potatoes.  The other wammy here is that I was initially avoiding dairy on Paleo which turns out to be worse for stones because one way to counteract high oxalate intake is to match it with high calcium to avoid stone formation.  I’ve since gone back to eating plenty of cheese and high fat dairy in my diet.

I’m curious if this is a common issue that you’ve seen and I’m wondering if this is something that might be helped by going to a keto diet.

 

2. [5:33] Sugar addiction

Kathryn says:
Hey Robb,
I am really hoping you can give me some insight into why I can’t seem to fully recover from sugar addiction. I have had a sweet tooth my whole life, but in recent years I have learned that I have a true addiction to sugar. In the last four years or so, I have studied a lot of nutrition, functional medicine and ancestral health perspectives and gone on a strict paleo diet for months at a time. In almost every way, a clean diet of whole foods makes me feel amazing (better sleep, clearer skin, joints and movement feels better, etc.), except, I become very depressed. It’s not a mopey, weepy kind of depressed, it’s literally a depression of all feeling, like I feel very little at all. But I do sometimes feel really, really irritable, or sometimes bouts of rage that don’t match the situations they arise in. But most of the time, I just feel blah. I thought this would go away after a couple of weeks or even a month or two of eating clean, but it didn’t. In happy or exciting moments, it was like I just couldn’t feel those emotions fully. I also noticed that I didn’t crack jokes like I usually do or feel like being social. All my feelings were dulled. Even sad ones. And when I did fall off the diet, and eat sugar, I immediately felt cheerful again. To me, it seems that the years of sugar abuse have altered my brain enough that without sugar, I can’t feel normal emotions anymore. So my question is concerning healing my brain. Is it possible to reverse these effects? The longest I have gone on a strict paleo diet is three months. I admit it was hard to keep going when I just didn’t see myself ever feeling happy again. If it’s possible to heal my brain and increase its capacity for proper dopamine signaling again, are there certain therapies or supplements that can precipitate and accelerate that healing? Perhaps I am ignorant of some other factor or mechanism at work here. I would be grateful for any insight or help you can give. Thanks for the incredible work you do to bring to light the truth about human health and nutrition.

Notes:

Carb 22: https://carbsyndrome.com/nutraceuticals-new/

STEM Talk Episode 69 (David LeMay): https://www.ihmc.us/stemtalk/episode-69/

 

3. [11:32] Metabolic Flexibility and Weight Loss/Maintenance

Julia says:
Robb and Nicki,
I am very interested in the concept of metabolic flexibility and eagerly waiting to hear your upcoming lecture on this topic. Intuitively it makes sense that given variation in season and climate that humans would have relied on a menu of macronutrient combinations. My question is: how can developing metabolic flexibility be used as tool for weight loss/maintenance? I have been about 90% ketogenic for the past 28 months; the other 10% would be high carb meals which I have allowed as a metabolically flexible person. I can swing in and out of ketosis with ease; however, I have noticed that if I go through periods of higher carb, it does result in weight gain which is tough to lose even when reentering ketosis. I do crossfit almost daily and practice the 18:6 IF schedule, and I don’t notice either of those things affecting my performance. Thanks!

 

4. [16:31] Low afternoon energy

Laura says:
Hi Robb and Nicki,
Thank you both for all you do! I’ve been a huge fan since 2010 and admire your relentless pursuit of the truth when it comes to health and nutrition.

My question is about my extremely low energy in the early afternoons. I know it is a common complaint, but I feel like I’ve done everything I can to fix the common mistakes  that lead to the afternoon slump, and I also feel like my exhaustion is too extreme to be normal for my age and health status.

I’m 32 years old, I eat low carbish (75-100g most days), have toyed with keto, eat mostly paleo with the addition of some dairy and occasional non gluten grains. I do crossfit 3x/week and spend most of my time chasing my 2 year old around. My sleep is good most of the time, and I do not have any major life stressors that effect me currently. No diagnosed health conditions, no rx meds.

I had bloodwork done recently, and my doctor was very impressed with the results, especially my blood lipids. A1c was 4.8, C-reactive protein 0.8, no thyroid antibodies present. Fasting blood sugar 78. The only things that were slightly out of range were homocysteine (slightly low at 4.6), Uric acid low at 2.4, serum iron slightly high at 148, and my free T3 was a little low at 2.5. Another Doctor years ago prescribed me naturethroid but I never took it.

Ive tried changing my diet in every way imaginable to try to combat a possible hypoglycemic or food sensitivity related slump after lunch.  I’ve eliminated various foods that people can be sensitive to,and ive even tried more carbs in the morning, but that leads to blood sugar imbalance and cravings all day. As a result, my breakfasts and lunches would fall under the keto umbrella, as I feel better when I eat carbs later in the day.

The only thing that seems to slightly help is not eating at all, but I just get so hungry! My activity level is fairly high and I don’t feel like I’m a great candidate for intermittent fasting at this point.

My mom, who has had MS for about 30 years, does not eat all day and only eats dinner because she’s says eating makes her tired. I just can’t handle not eating at all, and I do feel fatigued and hypoglycemic if I try to skip meals.

Thanks for reading and for all you do!!

 

5. [23:08] Carb test and ketosis

Carl says:
Hey Robb,

I read Wired to Eat while I was pretty deep into a ketotic cycle, so I didn’t immediately get to the 7-day carb test. Years of self-experimentation have led me to a relatively low carb (<50g/day) Paleo diet with an occasional 48 hour fast, an occasional ketotic cycle, and a very occasional carb re-feed. Genetic testing revealed some SNPs that predispose me to insulin resistance, and others that positively affect my fat metabolism, reinforcing the fact that I look, feel, and perform better eating in this fashion. I do enjoy my occasional carb binges, so I’d like to perform the carb test in order to whittle my food selections down to those least damaging to my metabolism; but I’m concerned that my postprandial blood glucose readings will be skewed upward because I don’t regularly eat more than ten or fifteen grams of effective carbs at a time. Should I bring my daily and per-meal carb intake up for a certain period of time before starting the carb test, or is a 50 gram bolus of carbs small enough to give me a true measure of glucose tolerance for the purpose of food selection? Thanks in advance.

6. [27:30] Creativity and Writing Process

Peter says:
Robb,

I hope all is well. I’m a big fan of the Podcast and excited about the Q & A return.  I have a two-parter both within the same general idea.

FIRSTLY:
I’m a writer and I am alway curious about how others approach the creative process.  I was curious if you could elaborate on how you approach writing and creativity in regards to balancing an active lifestyle? And how a typical day when writing might look.

For example — Do you do things like meditate? What time of the day do you write? Where do you write? If you write in the morning how do you reconcile with hanging outside first thing in the morning to get some sun?  If you do Jujutsu around noon and roll for 2 hours how do you write around it?  You’ve mentioned eating big meals in the morning, if you’re in a heavy writing period, is this a habit you stick with? Oh by the way, you have a wife and kids… how do you balance it all?

Do you still do caffeine?  Do you force yourself to take breaks during writing?  How do you avoid sitting for 5/6 hours straight?

Sorry for all the questions, I’ve just been thinking about this a lot lately as I enter into a career pursuing my passion as a writer while trying to balance and prioritize my health.  As I am sure you can attest, writing can be all consuming if you let it and setting boundaries is vital — though difficult, especially if you’re in “the zone.”  So I’d love to hear your thoughts.

[33:18] SECONDLY:
I’d love to get your thoughts on the mechanisms at play when writing or doing anything else that requires intense mental focus in regards to willpower.  Correct me if I am wrong, but it feels like for me, many aspects of writing and maintaining a healthy lifestyle (choosing healthy food over shitty stuff, hitting the gym, walking, etc.) can drain from the same willpower tank (if not just psychologically, and physically — physiologically as well).  This isn’t to say that both can’t exist — rather does one need to be given priority based on ordering of events throughout the day?

For example, I feel my creativity comes to me first thing in the morning.  If I were to wake up and hit a Metcon first thing, I feel my creativity gets depleted from the shared willpower tank.  I feel this to be true with little things that chip away at my early morning start time as well.  For example, taking the time to make a big healthy breakfast, sitting in the sun, even a short walk, all delay me tapping into when I feel I am creatively primed — but is it worth the sacrifice of my health?

I was curious if you have any thoughts on when or how you prioritize creativity.  Or maybe this is all just a bunch of bullshit like Robert Rodriguez says — and our creativity is totally out of our control.

Anyways, love the show and everything you do.  If I had more time, I would have written a shorter letter.

Regards,

Peter

 

Transcript:

Download a transcript of this episode here (PDF)

Paleo Solution – 405

[0:00:45]

Robb: Hey, folks, welcome back to another edition of Paleo Solution Podcast. I’m sitting here with my incredible wife, Nicki Violetti. Wife, what’s going on?

Nicki: I’m good, honey. Just laughing at your–

Robb: It’s a little warm in my office. The air conditioning is not working that well so I pulled my shirt off and then I looked at her and said, “Hey, I encourage you to pull your shirt off too.”

Nicki: And I’m just chuckling.

Robb: That would make me want to do a podcast every single day, not that I don’t want to do them anyway, but that would definitely align incentives properly for getting work done.

Nicki: There we go. Good thing these aren’t video podcasts.

Robb: No. Nobody wants to see us naked. What’s new? How are you doing? You had a little bit of a back dinger recently?

Nicki: Yeah. I was pulling some weeds and, yeah, after three hard days of rolling, which puts you in a pretty hip flexor dominant position, I guess, for those three days and I didn’t do adequate back extension work and then went out and did a serious weed session and–

Robb: Pulling weeds.

Nicki: Pulling weeds not smoking weed.

Robb: Yes.

Nicki: Anyway, I’m 95%. I’m doing good, yeah.

Robb: Cool. Well, should we jump into this? We’ve got a whole bunch of a lot here today.

Nicki: Yeah. Okay. Let’s see. Our first question has to do with kidney stones. Christian says: I’ve been mostly Paleo for about five years now based on one of your prior books. Overall, it just worked well for me with one exception. I started to develop kidney stones on a regular basis. I finally had them analyzed and they turned out to be calcium oxalate stones. Upon reading up on this condition, it stems from high amount of oxalate in the diet. Unfortunately, most of the foods I like on Paleo happen to be super high in oxalates, spinach, nuts, seeds, dark chocolate and sweet potatoes.

The other whammy here is that I was initially avoiding dairy on Paleo, which turns out to be worst for stones because one way to counteract high oxalate intake is to match it with high calcium to avoid stone formation. I’ve since gone back to eating plenty of cheese and high fat dairy in my diet. I’m curious if this is a common issue that you’ve seen and I’m wondering if this is something that might be helped by going to a keto diet.

Robb: Oh, man, it’s a really good question. I guess, that main piece — I guess, two questions here. Is this common and would a keto diet fix this? One, it is a bit common. One of the unfortunate things that has happened with our change in our gut microbiome is that a lot of the bacteria that degrade oxalates are absent in the modern western gut.

When some research had been done on the Hadza, it’s interesting, they eat a remarkably high oxalate diet but the oxalate tends to get processed in the gut by bacteria. It doesn’t really have a metabolic effect for people. What do you with that? Some strains of probiotics may help with that. Off the top of my head, I have no idea what the specific strains are that you would want to approach from trying to improve your oxalate clearance capacity. Some people have reported improvements with a fecal transplant, but that’s a last resort deal. The turkey baster of doom.

Nicki: That’s not going to be a popular option.

Robb: Right. I think that what you’ve done here is a really slick way to navigate this. If you don’t have problems with dairy like a proinflammatory response or what have you, then I really — It’s again one of those things. Have as much variety in the diet as you can up to the point that we start seeing some deleterious effects. I think that that’s a great way to handle it.

The shifting to a keto diet, I wouldn’t really see being much of a viable option because it’s still a lot of the same stuff. Dark chocolate can still be in there. You’re not doing sweet potatoes but you’re doing some nuts, you’re doing some seeds, you’re doing some greens potentially. I mean, you could shift things around and find some low oxalate options. I’m pretty sure jicama is a low oxalate option, varieties of squash are low oxalates and then others are higher oxalates. You could just go and create yourself a general food list and pull that down. But just simply shifting to a ketogenic diet is not really going to be the solution there.

[0:05:17]

Nicki: Sorry.

Robb: Nicki is wanting to take some notes.

Nicki: I’m wanting to take some notes. Okay.

Robb: Along the sugar addiction?

Nicki: Is that all you have to say?

Robb: That’s all I have to say on that.

Nicki: Okay. Question number two is from Catherine: Hey, Robb. I’m really hoping you can give me some insight into why I can’t seem to fully recover from sugar addiction. I’ve had a sweet tooth my whole life but in recent years have learned that I have a true addiction to sugar. In the last four years or so I have studied a lot of nutrition, functional medicine, and ancestral health perspectives and gone on a strict Paleo diet for months at a time.

In almost every way, a clean diet of whole foods makes me feel amazing, better sleep, clearer skin, joints and movement feels better, et cetera, except I become very depressed. It’s not a mopey weepy kind of depressed. It’s literally a depression of all feeling. I feel very little at all. But I do sometimes feel really irritable or sometimes bouts of rage that don’t match the situations they arise in. Most of the time I just feel blah.

I thought this would go away after a couple of weeks or even a month or two of eating clean but it didn’t and happy or exciting moments, it was like I just couldn’t feel those emotions fully. I also noticed that I didn’t crack jokes like I usually do or feel like being social. All my feelings were dulled, even sad ones. And when I did fall off the diet and eat sugar, I immediately felt cheerful again.

To me, it seems that the years of sugar abuse have altered my brain enough that without sugar I can’t feel normal emotions anymore. My question is concerning healing my brain. Is it possible to reverse these effects? The longest I’ve gone on a strict Paleo diet is three months and I admit it was hard to keep going when I just didn’t see myself ever feeling happy again.

If it is possible to heal my brain and increase its capacity for proper dopamine signaling again, are there certain types of therapies or supplements that can precipitate and accelerate that healing? Perhaps I’m ignorant of some other factor, mechanism at work. I would be grateful for any insight you could help or give. Thanks for the incredible work you do to bring light to the truth about human health and nutrition.

Robb: Man, that’s a lot to unpack. This is one of the interesting things that we’ve seen with a ketogenic diet, is that some people do seem to suffer what would effectively be some sort of brain damage, brain alternation specifically in the hippocampus. This is one of the reasons why people that have struggled and failed with every other approach they end up succeeding on a ketogenic diet because if we know that there’s one area of efficacy for ketones and a ketogenic diet, it’s generally with neurological issues.

This gets stronger and stronger every day and this runs from epilepsy to Parkinson’s, Alzheimer’s, dementia and even extends into traumatic brain injury. It’s tough because on the one hand clearly you seem to feel better in some ways eating some sugar but I’m guessing, what’s not stated here, but I’m guessing that sugar maybe turns into a feed forward mechanism and there might be some weight problems and some other health problems. If there’s none then maybe we just try to find some sort of a middle ground there where–

Nicki: Like if you feel healthy and you’re happy with your body composition–

Robb: Yeah, yeah, then we don’t really need to mess with this. But if that’s not the case, which I’m assuming that that’s what we’re talking about here, then I would recommend exploring something that looks like a ketogenic diet. It could even be a low glycemic load diet that is supplemented with MCT oil, which would be called an MCT ketogenic diet. There’s a lot of different things that you could do there.

A good friend of mine, Dr. William Wilson, he developed a product. I have no financial ties to this thing whatsoever, but it’s called CARB-22. I will put a link to that in the show notes. That thing is interesting in that it provides a bunch of cofactors to help with sugar metabolism but on this dopamine and neurotransmitter side it provides all of the substrates that lead in to the primary neurotransmitter. It helps to support normal neurotransmitter function. It’s a pretty slick product.

Finally, there’s a recent podcast, episode 69 of STEM Talk. My good friends Dawn Kernagis and Ken Ford, they interviewed Dr. David LeMay and he’s talking about inflammation and SPMs, which are — I’m blanking on — pro-resolving mediators called SPMs.

[0:10:00]

This is really interesting stuff. I’ll put a link to that in the show notes as well. They are using these products to help with traumatic brain injury and a host of other issues. That might be a direction that you could go. In that podcast, Dr. LeMay talks about using fish oil and even a very low dose aspirin, taking a baby aspirin and cutting it in half, doing it a couple of times a week.

What that does is in the inflammatory response — and this is part of the reason why NSAIDS or anti-inflammatories are problematic for injuries and end up being problematic for cardiovascular disease. We have a front end of the inflammatory response and then a back end. The back end is the resolution phase. You need that resolution phase. But some of the things that we use generally like NSAIDS, it blocks both the front and the back end. We don’t really get the total improvements that we would like to see.

You have to have that resolving phase to deal with brain inflammation and normal neurotransmitter function. It’s a really interesting episode. That might also be some areas to poke around. Think about a ketogenic diet, perhaps check out this supplement called CARB-22, which we’ll have a link to that in the show notes, and then check out STEM Talk episode 69 to learn about inflammation and SPM.

Nicki: Okay. All right. So, our next question is from Julia. It has to do with metabolic flexibility and weight loss and maintenance. Robb and Nicki, I’m very interested in the concept of metabolic flexibility and eagerly awaiting to hear your upcoming lecture on this topic. Intuitively, it makes sense that given variation in season and climate that humans would have relied on a menu of macronutrient combinations.

My question is: How can developing metabolic flexibility be used as a tool for weight loss or maintenance? I have been about 90% ketogenic for the past 28 months. The other 10% would be high carb meals which I have allowed as a metabolically flexible person. I can swing in and out of ketosis with ease. However, I have noticed that if I go through periods of higher carb it does result in weight gain, which is tough to lose even when reentering ketosis. I do CrossFit almost daily and practice the 18-6 intermittent fasting schedule. I don’t notice either of those things affecting my performance. Thanks.

Robb: Man, it’s interesting. The main argument that I would have with pursuing some of these metabolic flexibility pieces, and a very simple illustration of this would be during the spring and summer maybe May through August or something like that. You’re a lot more flexible with the carb intake although I would still generally steer people towards largely whole unprocessed foods. We’re talking maybe a shift between Paleo, in quotations, during the spring, summer, beginning of the fall, and then maybe in the depths of winter we go with more of a ketogenic state. There’s some arguments for shifting back and forth around that.

The concerning feature here is that you’re gaining, Julia is gaining body fat when she does these swings. I don’t know if we just have some really highly processed foods and maybe we’re getting some–

Nicki: How high is high? Are we going from keto levels, 25 grams a day, to 100 or are we going to 400? Does that look like it?

Robb: Yeah. One of the things that I’ve learned from Tyler and Luis over at Ketogains is although they have variation within what they’re doing, if somebody reaches a level of leanness and athletic performance where they feel like they just need some more carbs then they just titrate the carbs. They have a lot of small females over there and it’s funny because the name is Ketogains. People assume that every single thing that they do is all ketogenic diet related.

They have a number of small females that are really active and they just seem to do better at 100-120 grams of carbohydrate a day. They recommend largely whole unprocessed Paleo type diet to fit that bill. Although this metabolic flexibility idea I think is really powerful and it’s something that we should keep an eye on, I think that the really dramatic changes day to day could be problematic.

If you look at the approaches of doing a cyclic ketogenic diet, that seems to be really problematic for people. This is where you usually have a meal a week or two days out of the week that you do a carb refeed and you’re low carb the rest of the time. That approach really doesn’t seem to work that well.

[0:15:00]

What seems to work better is either generally staying in ketosis or generally having something that is in that moderate carb intake and that really big punctuated change doesn’t seem to work that well for folks other than certain situations where like they’re doing a marathon or an adventure race or something like that and they really need to fuel appropriately. I would think about just generally rounding those edges a little bit.

If you’re going to do a ketogenic block, do a ketogenic block. And then if you want to do some more carbs, slowly titrate those carbs up and find a maintenance level. Clearly, when you titrate those carbs up, you got to titrate the fat down commensurately and just rule of thumb is every two grams of carbs that you add you delete one gram of fat. It’s not perfect but it’s pretty damn close. We’re talking eight calories versus nine calories. That’s a way to tackle this.

Nicki: That could be what’s going on too, the calories are shifting up. If she’s not deleting the fat then the calorie content could be….

Robb: It’s really easy to do because you get comfortable eating these higher fat meals which are – It’s generally okay but if you throw high fat plus carbs, appetite increases, the total caloric load increases. Whether it’s Paleo or vegan or what have you, it’s that middle ground of fat-carb combos that are the killer and it’s going to those edges where most people find that they can actually make some headway.

Nicki: Okay. Our next question is on low afternoon energy and it’s from Laura. She says: Hi, Robb and Nicki. Thank you both for all you do. I’ve been a huge fan since 2010 and admire your relentless pursuit of the truth when it comes to health and nutrition.

Robb: Got her fooled.

Nicki: My question is about my extremely low energy in the early afternoons. I notice a common complaint but I feel like I’ve done everything I can to fix the common mistakes that lead to the afternoon slump. And I also feel like my exhaustion is too extreme to be normal for my age and health status. I’m 32 years old. I eat low carb-ish, 75 to 100 grams most days, I’ve toyed with keto, eat mostly Paleo with the addition of some dairy and occasional non-gluten grains.

I do CrossFit three times a week and spend most of my time chasing my two-year old around. My sleep is good most of the time and I do not have any major life stressors that affect me currently, no diagnosed health conditions and no prescription meds. I had blood work done recently and my doctor was very impressed with the results especially my blood lipids. A1C was 4.8, C-reactive protein was 0.8, no thyroid antibodies present, and fasting blood sugar 78.

The only things that were slightly out of range were homocysteine, slightly low at 4.6, uric acid was low at 2.4, serum iron slightly high at 148 and my free T3 was a little low at 2.5. Another doctor years ago prescribed me Nature-Throid but I never took it. I’ve tried changing my diet in every way imaginable to try to combat a possible hypoglycemic or food sensitivity related slump after lunch.

I’ve eliminated various foods that people can be sensitive to and I’ve even tried more carbs in the morning but that leads to blood sugar imbalance and cravings all day. As a result, my breakfast and lunches would fall under the keto umbrella as I feel better when I eat carbs later in the day. The only thing that seems to slightly help is not eating at all but I just get so hungry. My activity level is fairly high and I don’t feel like I’m a great candidate for intermittent fasting at this point.

My mom, who has had MS for about 30 years does not eat all day and only eats dinner because she says eating makes her tired. I just can’t handle not eating at all and I do feel fatigued and hypoglycemic if I try to skip meals. Thanks for reading and for all you do.

Robb: Man, when I first read through this I was thinking thyroid and then the fact that one healthcare provider has recommended some thyroid, the Nature-Throid specifically, that’s the direction that I would nose around this and maybe this is something that we need to do a little tear sheet on like similar to the blood lipid testing. People go and get a standard lipid panel and it just doesn’t tell us a damn thing.

It’s more confusing than not 90% of the time. They really need to get an LPIR score that includes an LDLP. We want to check Lp(a) at least once. And then similarly with thyroid testing, just looking at T3, just looking at TSH doesn’t tell us the whole story. It would be really good to see reversed T3. It would be really good to see a total thyroid uptake, to see the iodine status. There’s this process of triangulation, when you’re trying to find where you are in a map or something like that and you need three vectors going in. I find that when we’re dealing with blood sugar issues, if somebody is eating low carb and they have an elevated morning fasting blood glucose, that might be concerning or it might not matter.

[0:20:03]

What we need to do to figure that out is we need to look at A1C also. If A1C is normal then we’re not super concerned but we’ll maybe do some additional follow-up with a fructosamine and if both A1C and fructosamine are low then we know that that elevated morning blood glucose is some dawn phenomenon. We don’t need to freak out about it. But if A1C is high then we need to make sure that we have the fructosamine to validate whether or not the A1C is elevated due to red blood cells living longer or elevated blood glucose levels.

This is similar with regards to the thyroid again. I would circle back around and try to get a more comprehensive thyroid panel done. Nicki took a note. We’re going to do a little tear sheet on this and help people get the better recommended thyroid testing and then you will be able to triangulate in on that. The only other thought here is that there might be something gut related where we’re getting a proinflammatory response.

It may be both of these. This is one of the challenges of tracking this stuff down. If we have an elevation in inflammation then we oftentimes get a suppression in the conversion of T4 to T3 and an elevation in reversed T3. I had Dr. Bryan Walsh on a podcast two years ago and I thought I knew this stuff reasonably well and he absolutely blew me out of the water. He talked about the fact that there are both benefits and challenges to that immune suppression that comes about via elevated cortisol and how the body is trying to manage all of this by suppressing some thyroid function.

It’s good on the one hand but ends up being bad on the other and it still ultimately is not addressing the fundamental issue. We’ll put a link to the Bryan Walsh podcast and then I would do some nosing around on the thyroid and we will also put out a thyroid testing cheat sheet so that people go get the complete package. Sometimes it’s a bugger. Even in our clinic Specialty Health, I’ve had to bludgeon the doctors and the nurses a time or two because it is very non standard of care, it’s quite comprehensive, it can be a little bit more expensive.

But you really just don’t know what’s going on. You’re just operating in the dark. If there is a thyroid issue then using something like the Nature-Throid would make a lot of sense. Oftentimes people go on like a half a grain, a quarter grain. They do that for six months and then they titrate off and then everything is fine. The body is able to normalize and get ahead of that inflammatory cycle.

Nicki: It’s not like she would have to take it forever?

Robb: She might. Some people do. I would say maybe 50% of folks, they just need an intervention to get them over the hump and then the body recovers.

Nicki: Got you. Okay. Let’s see. Our next question is from Carl on carb test and ketosis. Hey, Robb. I read Wired to Eat while I was pretty deep into a ketotic cycle so I didn’t immediately get to the seven day carb test. Years of self experimentation have led me to a relatively low carb, less than 50 grams a day, Paleo diet with an occasional 48-hour fast and occasional ketotic cycle and a very occasional carb re-feed.

Genetic testing revealed some snips that predisposed me to insulin resistance and others that positively affect my fat metabolism reinforcing the fact that I look, feel and perform better eating in this fashion. I do enjoy my occasional carb binges so I’d like to perform the carb test in order to wheedle away my food selection down to those least damaging to my metabolism but I’m concerned that my postprandial blood glucose readings will be skewed upward because I don’t regularly eat more than ten or 15 grams of effective carbs at a time.

Should I bring my daily and per meal carb intake up for a certain period of time before starting the carb test or is a 50-gram bolus of carbs small enough to give me a true measure of glucose tolerance for the purpose of food selection? Thanks in advance.

Robb: Man, Carl, given that this appears to be just kind of like – what I’m taking from this is Carl’s asking, “Hey, man, how do I figure out which variety of cookie I can eat and have it be the least impactful?” In that case, I really don’t see the benefit of doing the carb test. What’s your recommended – If you wanted to kick the tires on this and really vet it out the, yeah, you would probably want to increase your daily carbohydrate intake to 75 to 100 grams a day, reestablish a baseline of more normalized carb tolerance. We would likely reverse any type of physiological insulin resistance that’s sparing glucose for the brain.

[0:25:00]

But at the end of the day, what you’re describing is a lot like the way that I look. My genetics suggest that I’m not well primed to handle carbs. I am a little bit unique or there are people out here that I should probably do more monounsaturated fats than tons of saturated fats. Bulletproof coffee with butter is not really a great idea for me. But otherwise, I’m really we’ll set up for low carb and a ketogenic diet and a minimum just be more fat fueled than carb fueled.

But I too will occasionally will go out and have some Vietnamese food. If I’ve done a really hard jiu-jitsu day I’ll do a bowl of pho, I’ll do double meat, like one quarter of the noodles and then I may not even eat all those noodles. I just let that stuff pop up as it happens. I don’t make it a super regular thing because if I do I start feeling really bad. I would lean towards just let this stuff pop up when it does. I try to do it after a workout, try to take a walk after having the meal. All of those things will help you to mitigate the blood glucose response and then I wouldn’t really worry about it that much.

Nicki: But if he wants to test it and see if he tolerates rice – I mean, I don’t know what he does when he does his carb binges but maybe he wants to see if rice is a better fit for him than sweet potatoes or beans.

Robb: Right. He could certainly do that. In that case, I would give yourself maybe a two-week period of just eating at that baseline of 75 to 120 grams of carbs, dial the fat down appropriately and then test with that, yeah.

Nicki: Unless once you start dialing it up and you start feeling like crap. It’s maybe not worth the test.

Robb: That’s what my experience always was. I love Paul Jaminet, brilliant guy, but when the safe starches were all the rage, god, man, I tried and tried and wanted to believe but I felt like shit on that. It just didn’t work for me. And even though all the boogeyman, my penis falling off and my gut lining degrading if I was in ketosis long term, it was like, okay, I feel like shit so that I avoid these problems. That just didn’t make sense.

Nicki: Right. Okay. Next question is from Peter. I think it’s a two-part question.

Robb: Yes, and a long one.

Nicki: A long one on creativity and the writing process. Okay. He says: Firstly, I’m a writer and I’m always curious about how others approach the creative process. Could you elaborate on how you approached writing and creativity in regards to balancing an active lifestyle and how a typical day when writing might look? For example, do you do things like meditate? What time of the day do you write? Where do you write?

If you write in the morning, how do you reconcile with hanging outside first thing in the morning to get some sun? If you do jiu-jitsu around noon and roll for two hours, how do you write around it? You’ve mentioned eating big meals in the morning if you’re in a heavy writing period. Is this a habit you stick it? By the way, you have wife and kids? How do you balance it all?

Do you still do caffeine? Do you force yourself to take breaks during writing? How do you avoid sitting for five to six hours straight? Sorry for all the questions. I’ve just been thinking about this a lot lately as I enter into a career pursuing my passion as a writer while trying to balance and prioritize my health. As I’m sure you can attest, writing can be all consuming if you let it and setting boundaries is vital though difficult especially if you’re in the zone. I’d love to hear your thoughts.

Robb: That’s the first chunk which has 50 sub-questions in here. When I’ve been writing a book or when we put together the Keto Masterclass and I’m really in a focused chunk, I generally prep my food the night before. I grab my coffee, although I’m in a tea mode right now.

Nicki: You’re a tea in the summer guy.

Robb: Yeah, it’s funny. In the summer, coffee just doesn’t work for me. It’s really funny. Generally, I will get all my stuff squared away. I’ll get up, shower, grab my caffeinated beverage of choice, have my food ready, and then I get out of the house. We tend to go to bed pretty early and I get up pretty early.

Nicki: You wake up pretty early.

Robb: I wake up pretty early. Man, if I can get to the office by 5:30 or 6:00 a.m. and write for three hours, I can smash it. I am just on point. That is definitely when my best writing occurs. And then doing physical activity a little bit later in the day, doing a bit more mundane low CPU necessitating stuff.

Nicki: Email.

Robb: Email, all that stuff. That’s when I would prefer doing that. I have a little bit been getting outside and doing my morning writing outside and that’s actually been really legit. It’s a little challenging because we have two kids out of school right now and once they get underfoot then the ability to focus goes out the window.

[0:30:06]

I do do that. I am doing — On a general creativity side, I don’t do anything like meditation. I will use occasionally an app called BrainWave. We’ll plug that in. I’ll do a little caffeine. I’ll do a little nicotine gum. I will maybe do some of the racetams, some of these things that are nootropics. But on really what I would consider creative side, I try to read a really broad cross section material.

I read science fiction. I read history. I try to check out different blogs and podcasts. I listen to History on Fire. I listen to Dan Carlin’s Hardcore History. I find listening to and consuming things from economics, physics, thermodynamics, just getting out and listening to other things. I try to take in some stuff around game theory. I try to consume material that is focused on these really big picture topics that govern the world.

I find that I get some really big inspiration from that. I would say that if I’m uniquely gifted in this area at all, it’s synthesis. I’m able to take some stuff from economics and evolutionary biology and thermodynamics and kind of plug it in and make it germane to a ketogenic diet. So, that’s a critical piece for me. If I get bogged down in just reading papers on metabolic pathways and stuff like that, I really don’t have much of a creative process going.

So, consuming a wide variety of material not directly in my domain is really helpful but I always need to be peppering in the latest updates in what’s hot and happening. I just referenced that podcast on SPMs from STEM Talk and that thing is just mind-blowing. It connected a ton of dots for me.

Nicki: And then one of the questions is: How do you avoid sitting for five to six hours straight?

Robb: I do tend to do pomodoros from Barbara Oakley. Was she the one that recommended that?

Nicki: She made it more popular but it’s a pretty popular technique.

Robb: Yeah. I set a timer at about 25 minutes, 25 minutes happens, I get up, do some active mobility work, stretch my hip flexors, maybe I’ll even do some squats, hip bridges, push-ups, something like that. I’ll do a five-minute mobility break occasionally. If I’m really on a tear and I’m really focused I will skip it and then I’ll program the thing in and go again.

Occasionally I will delay them and occasionally I will end up sitting on my ass for two hours straight or three hours straight. But on those days, I’m just so focused and the writing is going so well, I’ll get 3000, 3500 words of writing done which it ends up being really good writing. If the process is a little more fragmented then I’ll get up and wiggle around and move and do all that type of stuff.

Nicki: Okay. So, the second part of the question is: I’d love to get your thoughts on the mechanisms at play when writing or doing anything else that requires intense mental focus in regards to willpower. Correct me if I’m wrong but it feels like for me many aspects of writing and maintaining a healthy lifestyle, choosing healthy food over shitty stuff, hitting the gym, walking, et cetera can drain from the same willpower tank, if not just psychologically and physically, physiologically as well.

This isn’t to say that both can’t exist, rather does one need to be given priority based on ordering of events throughout the day. For example, I feel my creativity comes to me first thing in the morning. If I were to wake up and hit a metcon first thing, I feel my creativity gets depleted from the shared willpower tank. I feel this to be true with little things that chip away at my early morning start time as well.

For example, taking the time to make a big healthy breakfast, sitting in the sun, even a short walk, all delay me tapping into when I’m feeling I’m creatively primed. But is it worth the sacrifice of my health? I was curious if you have any thoughts on when and how you prioritize creativity or maybe this is all just a bunch of bullshit like Robert Rodriguez says and our creativity is totally out of our control? Anyways, love the show and everything you do. If I had more time I would have written you a shorter letter.

Robb: It’s funny how more time creates more concisity in some ways. This Peter, I’m pretty similar and that’s why I do pack the food ahead of time when I’m really on a writing mode.

Nicki: Yeah. On days where Robb stays and helps with the kids in the morning, helps get them ready for school, breakfast, all of that, he definitely is not as productive, doesn’t get–

[0:35:00]

Robb: A fraction of work done.

Nicki: If you’re working on a book or you’re working on some kind of big project with a deadline, you’re always out early. That’s just kind of the balance that we do. And you help a ton in the house, anyway. But you’re so focused. You do your best work in the morning and so then you’re — after you do your work, you do your jiu-jitsu, get some exercise in, and then you’re free to play and be with the family in the evening.

Robb: Yeah. So, whether it’s putting together slide deck for my metabolic flexibility talk or doing some writing, we’re doing a bunch of work with the Chickasaw Nation right now and there’s some really interesting stuff going with that that I need to generate material and be on point with. I just have to prep my food ahead of time, get out the door and literally every — I wish that I had like the firefighter pull the slide down and on the way down my clothes just like on to my body and I could just zip out the door.

Because 5:30 to 9:00 a.m., 5:30 to 10:00 a.m. I’m five times more productive in that window of time. During those blocks of time I don’t work out first thing in the morning. I don’t do other things first thing in the morning. That creativity piece is huge. To the motivation part, I would say that when I’ve got a project, I’m very fortunate in that I get to work on projects mainly that I’m excited about and that’s mainly what drives all this stuff.

It’s pretty easy. That is the one thing I want to do. It’s cool. It’s not like, “Oh, man, I have to go sit down and write.” It’s actually something that I really want to do, when I had an idea around the metabolic flexibility talk. I was hair on fire for that because it was really fun and it was learning a ton of stuff in the process of doing it. Just as an aside, this is what’s always totally fucking hilarious to me. When people write book reviews, they’re like, “There was nothing new in here. I already knew all this shit.”

It’s like I learned a ton of stuff writing a book and then why didn’t that asshole write the book then? Total aside. Most of the projects I do, I’m excited to do on the night. Again, I’m very fortunate to be able to have that be my current reality but this is 20 years of working in this area. You finally built a little bit of momentum that way. Anything else you could think of that touched on it?

It’s a great topic. Just throwing this out there, related to writing, I get tons of questions about should I write a book, how should I write a book, what are the ins and outs of that? I’ve stopped and started on podcast multiple times and what I’m going to do is have three different people that are in my world and very tied into the book publishing industry. I’m going to bring them on and we’re going to ask a bunch of these questions.

It’s either going to be one mega podcast or it’s going to be a three-podcast series about should you write a book or not, what are the pluses and minuses, what should you think about that, what’s the publishing process like, when do you get an agent, when do you go at it alone, when do you do self publishing, and all that type of jazz. Just related to that, we will have that popping up here at some point in the next three to six months. Was that it?

Nicki: I think that was our final question for today.

Robb: Awesome. Okay, wife, anything else you want to wrap up with?

Nicki: No. I think we’re good.

Robb: Cool. All right, guys, thank you so much for the best questions ever. The questions are better than the answers but, I guess, that’s the way life is. Thank you, guys.

[0:38:00] End of Audio

 

 

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Robb Wolf

Robb Wolf, author of The Paleo Solution and Wired to Eat, is a former research biochemist and one of the world’s leading experts in Paleolithic nutrition. Wolf has transformed the lives of tens of thousands of people around the world via his top ranked iTunes podcast and wildly popular seminar series.