This episode of the podcast we have guest Mikhaila Peterson. Mikhaila has become well known for putting her severe Rheumatoid Arthritis into remission by using a carnivore diet after trying everything else under the sun.
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Listen in as we chat about the carnivore diet and the results of her new blood work she had done recently (or read full transcript of the episode below):
[0:53] – Summary and pre-intro
[2:18] – Introduction, and Mikhaila’s previous carnivore bloodwork
[3:15] – Last ditch effort to manage autoimmune disease (RA)
[3:50] – Pregnancy affecting autoimmune disease
[6:50] – Inventing the autoimmune paleo diet protocol
[9:08] – How the carnivore diet got on Mikhaila’s radar
[15:50] – Mikhaila’s first round of blood work on carnivore
[17:38] – Advanced testing blood work results (second round)
[24:50] – Mikhaila’s takeaway from her recent bloodwork
[27:40] – Robb’s great experience with loperamide (Imodium)
[31:14] – How people are doing the carnivore diet
[33:11] – Paleomedicina experience in Hungary
[35:15] – Case studies reversing Type-1 diabetes when caught early
[40:0] – Robb’s 6-week carnivore diet experience
[45:30] – What Mikhaila has coming up
Mikhaila’s blood work while Carnivore:
First round: http://mikhailapeterson.com/2018/08/07/blood-work/
Second round (more in depth): PDF Download
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Download a copy of this transcript here (PDF)
Robb Wolf: 00:52 Hey folks. Welcome back to the show, another edition of the Paleo Solution podcast, really jazzed for today’s show. Mikhaila Peterson, really wonderful girl, huge fan of her dad. If that makes me incompetent in your eyes, then that’s fine. Just turn off the podcast. Now you don’t have to listen to the rest of the stuff.
Robb Wolf: 01:12 But anyway, Mikhaila has become reasonably famous for putting what has been a lifelong condition, a very, very severe rheumatoid arthritis, effectively into remission. She’s had this condition since she was two. At the age of 17, she had both an ankle and a hip replaced and she did everything. She did low carb, she did keto, she did autoimmune, paleo, and then out of somewhat of an act of desperation and just doing some diligence, she stumbled onto this idea of a carnivore diet and the therapeutic potential that it held for conditions like hers, severe autoimmunity and also gut issues.
Robb Wolf: 01:53 Back in mid-2018, Mikhaila did some blood work. It was really interesting. But it was not as comprehensive as what I like to see. So we had her do some advanced testing through our clinic, and we unpack all that stuff. It’s very interesting. So check this out, Mikhaila Petersen and her advanced testing blood work.
Robb Wolf: 02:18 Mikhaila, how are you doing?
Mikhaila P.: 02:19 I’m fantastic. How are you?
Robb Wolf: 02:21 Good, good. Sorry, Mikhaila Petersen on the show. We were just jabbering about her trip to Budapest, Hungary and I realized we should be recording a bunch of this stuff. Hey, thank you for coming on this show. You posted some blood work earlier. It was kind of mid-2018, if I recall correctly.
Mikhaila P.: 02:47 Yeah, I think I had the blood work done in May. I don’t think I posted it until August. But sometime in the summer.
Robb Wolf: 02:53 Cool. Yeah, yeah, and it was remarkably unremarkable, given that you’ve been eating a carnivore diet and from whether you’re in the vegan camp or certain camps within the paleo sphere, you should be dead, you should have exploded into a fiery ball of something and shouldn’t be here. But in fact, this has been kind of like the last-ditch effort, and correct me if I’m wrong, in addressing what has been effectively a lifelong and very, very severe situation of trying to manage an autoimmune condition.
Mikhaila P.: 03:32 Yeah, this was definitely a last-ditch effort. I started the diet, I started a meat diet last December, after about three years of a very, very, very restricted paleo keto diet, dairy free, kind of like the autoimmune protocol, but way more restrictive. It worked really well at the beginning, and then it stopped working when I got pregnant. As soon as I got pregnant, all my food sensitivities came back and then it took me a year, a bit more than a year after that, to just drop plants entirely, because I was eating salad and I was reacting to organic lettuce and olive oil and apple cider vinegar. Eventually, I dropped that and went on this all meat diet.
Robb Wolf: 04:18 Which just as an aside, is so interesting, because in the literature, usually if a woman becomes pregnant and she has something like rheumatoid arthritis, usually it improves during that period.
Mikhaila P.: 04:30 Mm-hmm (affirmative).
Robb Wolf: 04:30 That is so crazy.
Mikhaila P.: 04:31 It was really interesting. I have distant cousins with autoimmune disorders, and a lot of them went into remission during their pregnancy. But I don’t know what happened to me, but yeah, it was instantly my arthritis was back and I don’t know if that’s because I had been playing around with foods, and so having flare ups intermittently, which was already weird, but my rheumatologist was surprised, yeah, he was surprised as well that I wasn’t feeling better. I definitely felt worse.
Robb Wolf: 05:03 It’s super perplexing. I mean, literally, it just doesn’t happen in the literature. My wife’s mom had rheumatoid arthritis and that was the only time in her life, the two pregnancies, when she was able to get back and ski and do tennis, because apparently she was a super stud athlete in her youth. And then they’ve traced this back to, potentially, like a mold exposure. They were in a house that had a wall that got mold on it. They pulled the bed away [inaudible 00:05:39]. But this was ages ago. But they kind of trace it back to that. But there was basically when Nicki and then her sister [Chrissy 00:05:46] were in utero, that was a time that Candy got back on the skis. Apparently there’s some video of a giant bellied Nicki’s mom-
Mikhaila P.: 06:00 She’s like, “I can finally ski.”
Robb Wolf: 06:01 … bombing down the slopes, because she’s like, “Hey, I got to get it in while I can.”
Mikhaila P.: 06:05 That’s really interesting.
Robb Wolf: 06:05 So interesting, yeah.
Mikhaila P.: 06:08 I was in a pregnancy study for arthritis, because they said … I was basically in remission during the pregnancy because I could vaguely control my symptoms with diet, and I was still doing very low carb, so my symptoms, I could feel it in my joints, but they weren’t visibly swollen. So I never had a huge flare up or anything. But then this pregnancy study was … I was doing blood tests periodically after I actually gave birth to my daughter, because my rheumatologist was waiting for the flare up that inevitably happens to pregnant women with arthritis. Then that never happened, because I managed to keep it under control with diet. So he was also surprised by that. But it’s been very strange.
Robb Wolf: 06:49 It’s interesting for me, and perplexing in many ways, because, not to pay myself on the back, but I’m going to both pat myself on the back and thrown myself under a bus here pretty quickly. I’m the person that came up with the term autoimmune paleo.
Mikhaila P.: 07:05 That was you?
Robb Wolf: 07:06 I’m the first person to put it together into a book. I had very, very little space in the original Paleo Solution, but myself, Mat Lalonde, and some other people, we kind of put our heads together and we were like, “Okay, as a base line, paleo works for a lot of people.” But we were noticing that there was a whole other cross section of folks for whom the basic paleo prescription wasn’t working. So we looked at tomatoes, potatoes, the peels, seeds. So it became much more restrictive. That’s where that, honestly, was birthed from. I would say it’s had a modicum of success. It’s always been one of those things that felt like a bit of a dead end cul-de-sac. Like if people got on it, they never really got off of it. Sometimes it helped, but it didn’t …
Robb Wolf: 08:01 So I’ve had really mixed feelings about the whole thing. Then as I started following your story and some other folks’ stories and Paleomedicina, Hungary, which you went and talked to those folks, and maybe we can circle back around and talk about what the methodology is with them, but what I was seeing was legit, therapeutic potential from this dietary approach that just absolutely crushed anything that I had seen within the autoimmune paleo sphere. There are some people that have built their name, built their brand around the autoimmune paleo thing, which is all well and good, but they’ve been really, really critical of this carnivore approach. Which I find fascinating, because the same stuff in criticizing grains and legumes can extend to really any plant material. If it’s immunogenic for the individual, then it’s going to be a problem and maybe you need to delete it. That’s been kind of interesting.
Robb Wolf: 09:08 How did the carnivore idea initially get on your radar?
Mikhaila P.: 09:18 It was kind of by chance. What happened was, I didn’t know, I had no food background, so when I first started cutting out groups of food, I didn’t know about … I don’t even know if I’d heard of keto. I’d heard of paleo, but I didn’t know anything about anything other than being gluten free. Then, I got better and then I got way worse after pregnancy and then I was reacted … So a couple of things happened. I was down to, like I said, lettuce and olive oil and apple cider vinegar and salt and pepper and meat and olives, and everything organic. I was down to that and I was still having days where I would wake up and my whole body would be itchy. I knew that that was a food reaction. So I was like, “Okay, my wrists hurt, I have a new baby,” that is really annoying, arthritis in your wrists with a newborn. And, “Why am I itchy, more itchy on some days and less itchy on other days? What’s going on?”
Mikhaila P.: 10:10 I noticed I was eating, some days I would eat a lot of salad. I’d have big salads at every meal. Some days, I would only eat chicken wings. So I was like, “Okay, that’s weird, but I need vegetables, or I’m going to die.” I’m already like, “I don’t know how my vitamins are okay still, only eating lettuce, basically.”
Mikhaila P.: 10:30 Then I Googled. A couple of things happened. First, I Googled. I did a whole bunch of Googling. I came across Charlene Andersen’s story, so the woman with Lyme disease, yeah. So there was her story about how she’d been on meat for decades and was totally fine. I was like, “Oh, okay.” Then one of my friends, who’s like a Navy Seal, had been listening to Joe Rogan and was like, “Oh,” because I was talking to him about it and he was like, “Oh, this doctor went on Joe Rogan, and all he eats is meat.” I was like, “What?”
Mikhaila P.: 11:04 I saw Shawn Baker’s episode with Joe Rogan and then that night, I stopped eating salad. I was like, “If it doesn’t kill you, I’m going to try it,” because I was like, “I can’t. I can’t go back to having an autoimmune disorder.” Once it’s gone and then comes back, that was just too much.
Robb Wolf: 11:20 Right. Man, it’s so interesting. I’ve been in and around this stuff for a long time and have tinkered with different things. I actually have been working on, I’m not sure what I’m going to call it, like carnivore in context, or carnivore 101. But I really got in and started digging around on both what do we have in the scientific literature and also the anecdotal state of affairs?
Robb Wolf: 11:49 Because again, there is some folks in the paleo scene, low carb scene, that have built a pretty good name, pretty good following, and they’ve put on a pretty big pair of pants, like they’re pretty big for their britches, when they start talking about different things. Some people’ve leveled some slings and arrows at the carnivore concept, saying that there’s no scientific validation on it, it’s all anecdotal. The irony of irony about this is that these people have built a name on a platform that 10 years ago was purely anecdotal and had no scientific backing. So it fucking pisses me off, to be completely honest.
Robb Wolf: 12:28 It’s like, now we don’t have to run pell-mell into this thing and … Because I see, I’ve warned some people online within the carnivore community, I’m like, “Dude, chill out. You’re becoming the raw vegan of low carb. Just-“
Mikhaila P.: 12:43 Yeah, it’s just scary. It’s scary that as soon as you figure something out, and then the paleo diet was a huge solution to a lot of people, but then it blows your mind and then you get stuck in whatever ideals you are then.
Robb Wolf: 12:54 Right, right.
Mikhaila P.: 12:54 And so some of the people can’t change their mind [crosstalk 00:12:57]-
Robb Wolf: 12:57 So I’m in this kind of funny spot where I’m kind of doing kidney shots to some of the people in the paleo scene, where it’s like, “Hey, maybe you should shut the fuck up and listen, instead of running your mouth, and just see what’s going on.” Then there’s other people that I’m like, “Hey this may be such an effective modality, don’t turn it into a religion so that it takes longer for science to take it seriously.” I find myself in a really interesting spot with that, because I’m incredibly intrigued. I could make a case for doing all manner of stuff prior to going carnivore, including things like fecal transplants, move to the tropics so you’re in the sun. I mean, there’s all this stuff that one could do.
Robb Wolf: 13:46 But at the end of the day, it was really hard for me to find any evidence that people are going to end up with long-term nutrient deficiencies when I looked at things like folks who have had ileoileostomies, they’ve had either all or some of their large intestine removed, so they can’t even deal with fiber. These people do fine. They live normal lives, they have no curtailment in their life and so I’m kind of like, “Okay, what’s up with the fiber? What’s up with the vitamins?” And I started digging around.
Robb Wolf: 14:21 There’s some fascinating history around that, like in Victorian era naval warfare. Like some of these navies relied more on dried meat and dried fish and they had no scurvy or [burberry 00:14:36]. And then other navies relied on rice and biscuits and their navy was so sick that they virtually could not field a military. Again, this stuff’s all anecdotal, it’s all observational, but it’s something that again, I’m like, “Hey, folks, just shut up, listen, think about this.” Then also, then we get the real example of you and now many, many other folks that had conditions that the best of modern medicine could do nothing for, like everything had been thrown at this and then you really …
Robb Wolf: 15:14 I loved it, I think, when you described it, that it was like your beverage experience is water, hot, cold or warm, bubbly or not bubbly and then really bubbly and then, like that’s the … When you narrow your … I think the Inuit have something like 50 different terms for snow. And so if your environment is really, really limited, like you’d become very nuanced in the stuff that you’re exposed to. But arguably, this has really transformed your life. So I’ve been pretty passionate about trying to get this stuff out there. So your first round of blood work, could you talk a little bit about that and then we’ll dig into, like I roped you into getting some blood work ordered through our clinic to look at some other stuff. But I mean, the first round of blood work was, like vanilla.
Mikhaila P.: 16:05 I will pull it up. Oh yeah, it was not nearly as in-depth as what you got me to go do. But total cholesterol was 132 milligrams per deciliter. LDL cholesterol was 68 milligrams per deciliter. HGL was 53 milligrams and triglycerides were 58. So it was totally normal. And my vitamin C was normal, I mean, we tested that. Everything was totally normal-
Robb Wolf: 16:35 Your B12 was normal.
Mikhaila P.: 16:36 … in that first blood work.
Robb Wolf: 16:37 I mean, but it was-
Mikhaila P.: 16:38 My B vitamin [inaudible 00:16:40] looked better than they had before.
Robb Wolf: 16:42 Right.
Mikhaila P.: 16:42 Quite a bit better.
Robb Wolf: 16:44 Right, but what was interesting to me was like, “Dude, that’s as vanilla a blood work as you could get.” It’s so unremarkable that it should be perplexing, given how remarkable your dietary intake was. Not just carnivore, but correct me if I’m wrong, you’ve been doing what I’ve called one cut carnivore. It’s been pretty constrained even within the carnivore world. Because some people’ll have some cheese, some people’ll have some bacon and-
Mikhaila P.: 17:13 Oh yeah, no. No, no, no. I don’t think the whole … I’m not a fan of dairy at all. It made me so ill. So I have no eggs, yeah, no dairy. I don’t even eat butter. I’m literally eating beef. I had some lamb, lamb is fine. I eat a lot of tallow. I’m actually getting quite a bit of fat. But yeah, beef. Beef, mainly; beef or lamb.
Robb Wolf: 17:37 Okay, beef and lamb, mainly. Okay. I saw this initial round of blood work, which I thought was, again, remarkable in how unremarkable it was. So I shot you an email. I’m like, “Hey would you like to do some advanced testing?” You were game to do that. We had to wait until we got you back down in the states to be able to dig into that. But the advanced testing that we do in our clinic is very lipidology based. We look beyond just the HDL cholesterol and LDL cholesterol. We look at some particle counts, particle sizes, and then also calculate this thing called the LPIR score.
Robb Wolf: 18:17 What was so interesting, your LDLP, which is the marker of your total low-density lipoproteins and what’s being carried around in that, which is your LDLC, your LDL cholesterol, your LDL cholesterol was 67 milligrams per deciliter. Your LDL particle count was 684, which, anything below a thousand is considered both a low and super low risk from a cardio vascular disease standpoint. Your HDLC, HDL cholesterol, was 58, which is high and generally regarded as good. Your triglycerides were 41, which is rock bottom, super low. Your total cholesterol was 133. If you don’t mind, I’ll x out all of your personal information, then I’ll put a copy of this stuff up on the website when we’re-
Mikhaila P.: 19:14 Yeah, yeah, yeah. I’m going to put it up on my blog too.
Robb Wolf: 19:17 Perfect. Cool. Cool.
Mikhaila P.: 19:21 That’s totally fine.
Robb Wolf: 19:21 HDLP the HDL particle count was 40, which is phenomenal. So if there was anything, if someone wanted to nitpick something, your small dense LDL particles, you’re not at the absolute bottom, but you’re in the lower one-third with that. So I’m sure the vegan folks’ll absolutely lose their minds, because you’re only in about the 28th percentile on that instead of the zero percentile. But I mean, it’s-
Mikhaila P.: 19:55 I think too, I think that runs in my family. I think my mom has the same. I’m going to get her, because she’s been on the carnivore diet for a year too, and she’s 57. So it’s be interesting to see what she had. Because she always had high cholesterol. So I think I’m genetically predisposed to having high cholesterol. I don’t-
Robb Wolf: 20:15 And here’s a really interesting thing with that that people forget. The lipoproteins are a critical feature of our innate immune response and in individuals with rheumatoid arthritis in particular, but autoimmunity in general, a higher cholesterol level, a higher lipoprotein level, reduces the disease severity and extends life. People with low lipoproteins, low cholesterol and rheumatoid arthritis don’t live long. And this is-
Mikhaila P.: 20:44 Yeah, especially if they’re women, right?
Robb Wolf: 20:47 Yes. So this is another part of this nuance that is really underappreciated. What’s particularly interesting in all of that is that smaller, more dense lipoproteins are more effective at mitigating the inflammatory response associated with the disease itself, but are also really important in mitigating gut derived toxins, like lipopolysachrides. The whole profile makes a lot of sense, but you’ve got to kind of pull back and look at the thing from a bigger picture.
Robb Wolf: 21:21 The LPIR score, the lipoprotein insulin resistant score, which is really where the rubber hits the road in our clinic when we’re working with people and we’re trying to assess their metabolic health, it’s 27 out of 100, which is outstanding. It is just freaking outstanding. It means that you are super metabolically healthy. You are super insulin sensitive, which again, is one of these things that I think is really underappreciated and is interesting to me. Do you track ketones at all, or have, have not?
Mikhaila P.: 22:01 I was badly, because I was using the urine test, which wasn’t great. I did do a breath test, and it was incredibly high at five, five whatever they … Yeah. So I did that for a number of days and it stayed pretty consistent around five, which they told me was extremely high. I haven’t tested recently. But I think I’m going to get a breath tester, just out of curiosity, or a blood one.
Robb Wolf: 22:29 It’s really interesting because some folks will, particularly in the, well a whole host of places, but kind of like the vegan world, they will get cranky about low carb diets, because they talk about physiological insulin resistance and saving glucose for the brain and that this is somehow a bad thing.
Mikhaila P.: 22:51 Yeah.
Robb Wolf: 22:51 But what’s interesting is this LPIR score shows that at a physiological level, kind of like a lock and key level, at the cellular level, you’re actually quite insulin sensitive, remarkably insulin sensitive. Again, I’ll throw out there, I don’t know that everybody eating a carnivore diet is going to get the same type of results, and this is where doing a little bit of blood work and a little bit of assessment is really valuable. But this looks really good. We battle to get people to look this good when they come into our clinic, particularly police, military, firefighters, folks on shift work. Their LPIR score will be in the 80s and they’re frankly kind of fucked up. They’re really sick, they’re dyslipidemic, they’re inflamed, and so this is really impressive stuff.
Robb Wolf: 23:44 I guess if there was, again, if there were anything that was a little bit, we could raise a little bit of an eyebrow, your hemoglobin A1C was 5.2, which is honestly a smidge higher than what I would want to see. But what we didn’t do is run a fructosamine on this, to see if this is an artifact of red blood cells that live longer than normal or if you’re legitimately running a little bit higher on the blood glucose level. But we saw this in Shawn Baker. I think that if you’re running hard on gluconeogenesis, which would make sense, because you’re going to convert a decent amount of this protein into glucose, there may be a little bit of an error. Then also, if people are exercising at a pretty vigorous clip, then that in and of itself can push up the A1C.
Mikhaila P.: 24:41 Mm-hmm (affirmative).
Robb Wolf: 24:44 So that’s most of the blood work. Again, we’ll post this stuff online. But I mean, what was your takeaway from looking at this stuff? I know it was a ton of information to unpack, and we probably actually should have actually sat down and gone over this stuff before running the podcast itself. But what was your takeaway from looking at this, given that you’ve been tinkering with this stuff for so long?
Mikhaila P.: 25:09 I’m a bit surprised, I guess, because I’ve been following Dave Feldman. His guess was my total cholesterol, anyways, going to go up. It hasn’t changed. Well, it doesn’t look like it’s really changed since May. The only thing I’ve been trying to figure out how to get under control is, I’m deficient in Vitamin D. I’ve been deficient in Vitamin D since I was a kid. I’ve never been able to raise my levels. I would think that after a year of being on this diet, I was hoping that would change. I went to talk to the people in Hungary, the doctors at Paleomedicina, and their theory was, I need more organ meat. Who knows who has the right information about this, because it’s so new? But I’m going to start doing what they suggested, which was, I think, about a pound of liver a week.
Robb Wolf: 26:03 Mm-hmm (affirmative).
Mikhaila P.: 26:03 Which I hadn’t been doing, because it kind of upsets my digestion. So I figured that wasn’t a good idea. But I’m going to incorporate that in, because it doesn’t give me any symptoms, and see if that finally raises my vitamin D, because I haven’t been able to get that up.
Robb Wolf: 26:17 Got you.
Mikhaila P.: 26:19 Other than that though, I don’t know. I don’t really believe anything any more about what people think they know. My initial thought was, I went on low carb and I was like, “Okay, low carb is the way.” And then the low carb just randomly stopped working when I got pregnant. So it was like, “What?” So then my entire world shifted again, and it was like, “Okay, maybe people are only supposed to eat meat. This seems to be working really well for me.” But who knows? There’s just so much we don’t know. The next thing I’m going to try, actually, is FMT, so I’m going to the Taymount Clinic in, I think in Canada and trying to do, they do a gut flora transplant.
Robb Wolf: 27:01 Okay.
Mikhaila P.: 27:02 That’s actually, I’m going to be doing that in February or March, and then seeing what happens after that. I might try and see … Well, first I’ll try and vary my meat. Because I can’t tolerate chicken, I can’t tolerate a whole bunch of meats. So I’ll vary my meat, see how that goes, and then slowly try and re-introduce super-safe foods like a teaspoon of a sweet potato and see how much of this has to do with microbiome problems. So that’s where I’m headed now, but I have no idea what’s going to happen.
Robb Wolf: 27:37 Interesting. Interesting. Each year, I do my yearly training and food update and I’m working through that in the last, man, six months, nine months. Are you familiar with the anti diarrhea, over the counter medication, loperamide, Immodium?
Mikhaila P.: 27:59 Yeah, yeah.
Robb Wolf: 28:00 Yeah, yeah. In traveling, I had gotten waylaid a couple of times with some sort of food borne illness and I would need to pile onto a plane. And the idea of getting up and down 30 times during a six hour flight to dash back there wasn’t appealing, so I would eat half a bottle of Immodium and then just listen to my gut rumble on the plane. But what was weird, these two or three times that I did this, for a day or two after this catastrophic event, I pooed like a teenager. Everything was great, everything was on point, I actually felt really good. Then as time went on, things went back to their normal … I’ve always been a little on the loose side in the IBS spectrum and I started … One day, it popped into my head, like, “I wonder what the deal is with Immodium?”
Robb Wolf: 28:55 So I started poking around, and it’s, oh, Immodium, in addition to slowing gut transit, it decreases gut permeability, it alters lipoprotein fractions it’s [crosstalk 00:29:08]-
Mikhaila P.: 29:08 It decreases gut permeability?
Robb Wolf: 29:11 It decreases gut permeability.
Mikhaila P.: 29:11 What?
Robb Wolf: 29:12 It increases autophagy. So I started taking two to four milligrams of this stuff in the morning and in the evening. It changed everything for me, I mean, everything. I would eat a salad, because I’m supposed to eat a salad. The next day, it was like everything came out the same way it went in.
Mikhaila P.: 29:34 Yeah.
Robb Wolf: 29:36 I felt horrible. And it has changed everything. So now, I’m still not super carb tolerant, but I can eat way more carbs than what I did previously. I still cycle between keto, because I just feel good with that, but my tolerance to foods in general and my tolerance to carbs specifically is shockingly altered.
Robb Wolf: 30:04 Interesting thing about Immodium, it is technically an opiate. You have to do all kinds of crazy chemistry to it to get it to go through both the gut barrier and the blood brain barrier. If people take huge, I mean, ridiculous amounts of it, it won’t make you high, but it will suppress your respiratory function and you’ll die in your sleep. So there are a few caveats to it. But I’m literally taking two two-milligram tablets in the morning, two two-milligram tablets in the evening, and it has transformed my life. I’ve been sitting on it, because I’m like, “I don’t even known how to roll this out.” So this’ll be the first time I’ve mentioned all this stuff and I wanted to put it on your radar, in case you were interested in tinkering with this.
Robb Wolf: 30:53 But I guess, the big takeaway with that is, if you’re sick, it’s worth turning over just about every damn stone, even if it seems-
Mikhaila P.: 31:02 Everything, yeah.
Robb Wolf: 31:04 To go with an all meat diet or a largely meat diet or something like that, again, when we look into the epidemiology and the small but compelling number of people that we have from an anecdotal story, we’re not seeing wanton nutrient deficiencies. We’re not seeing massive problems with people. In poking around some of the carnivore forums, you see some people that it doesn’t really seem to be working for them. They’re like, “My hair’s falling out. I don’t feel good.” It’s like, “Okay, do something else, man.” Don’t-
Mikhaila P.: 31:39 But also, are they just surviving off of cheese? Because a lot of people I’ve talked to, they’re like, “Why isn’t the carnivore diet working?”
Mikhaila P.: 31:45 “What are you eating?”
Mikhaila P.: 31:46 “Bacon and cheese and I’m drinking cream.”
Robb Wolf: 31:48 See, now I haven’t gotten into that.
Mikhaila P.: 31:48 I’m like, “Well, I can’t do eggs or dairy.”
Robb Wolf: 31:49 Oh, okay, okay.
Mikhaila P.: 31:52 Yeah, so that’s the problem with the popularized carnivore diet. What they’re doing in Hungary isn’t the popularized carnivore diet. It’s a very high fat meat diet. They don’t eat butter. They eat some eggs, carefully, depending on the person. But for people with autoimmune disorders, I don’t think dairy’s in the cards. I don’t think eggs are a good place to start, either. It might be worth going down to meat. So those forums are a little problematic, because not everyone is actually on the same diet.
Robb Wolf: 32:21 And I did not do my due diligence in asking that question. So that really, that helps a ton. That makes a lot of sense. So two pieces to that. Are people actually doing this thing in a reasonable way, in a way that was intended and has been vetted out to be helpful? Then also, within the spectrum of human experience, there’s going to be some people for whom carnivore isn’t going to work for them, maybe vegan does, but even if we just say that, so that we don’t sound like we’re going to dis salads. It’s good, just from a marketing perspective. So it’s like, “Okay, those people are reasonable. They’re not crazy.”
Mikhaila P.: 33:06 Yeah.
Robb Wolf: 33:08 Talk more about your experience with the Paleomedicina folks. I’ve been really intrigued by them and then I have a little bit of a cautionary story that I got from some friends in the type one diabetes world, around those folks. But give some of your experience in working with these people.
Mikhaila P.: 33:28 So I only went out there once to visit them. I’ve been communicating a bit across social media. But I haven’t talked to them a lot. But what I got was, they delved into treating autoimmune disorders with paleo, the paleo diet. They did that for eight years, up until 2012. And then, they weren’t seeing the results that they wanted to see and they weren’t really seeing very many results. They were seeing weight loss, but they weren’t really seeing autoimmune problems that-
Robb Wolf: 34:01 Improvement.
Mikhaila P.: 34:02 Improvement, yeah. So then they switched over, just … I asked them, “How did you come to a diet of just meat?” They said they basically monitored patients. So they kept having patients that were saying, “Well, you know, I’m reacting to nuts,” or, “I’m reacting to certain vegetables.” Eventually, they were like, “Okay, well maybe we just get rid of the vegetables.” So they got rid of the vegetables and then they saw, obviously it’s just case studies, they’ve seen a lot of benefit from a very high fat carnivorous diet.
Mikhaila P.: 34:30 The way they do it is a little bit … I mean, not that I necessarily know what I’m talking about when I’m talking about the carnivore diet, because I’ve only been doing it for a year, but from my experience, the way they go about it would have been really hard on me, I think. What they do is they put you immediately onto a very, very high fat meat diet. For me, whatever damage was going on, I had a very difficult time digesting that amount of fat at the beginning. That would have been rough.
Mikhaila P.: 34:59 So they put people right onto that and then they monitor how much they eat and they add a little bit of salt and then you go out there. If you want to go to their retreat, they have a five day retreat where they teach you how to cook and how you should be feeling and telling you what’s normal. But they showed me a number of case studies that I thought were really interesting and a couple of them, like speaking about type one diabetes anyway, at least what they showed me was, or what they told me was, if you have someone who’s just been diagnosed and they’re not totally reliant on insulin yet, if you-
Robb Wolf: 35:37 They’re in that honeymoon phase.
Mikhaila P.: 35:38 Yeah, they said the honeymoon, that honeymoon phase lasts for about a year, and after that year, they’re on insulin forever and there isn’t anything you can do about it. You can’t get those cells that died back. But if you catch those people before they’re totally screwed and put them on this really high, this pure meat diet, you can reverse that. So they had, I think, three case studies of teenagers who had just been diagnosed and they’d managed to get them back to normal-
Robb Wolf: 36:08 Interesting. Okay.
Mikhaila P.: 36:09 … as long as it was within the first year. So the one woman, the one doctor, Dr. Zsófia Clemens that I was talking to, was really adamant about, like, “We’re not giving people an option and this option exists.” She really wants, at least these case studies, to be known so that people can at least give it a shot, because maybe they have a chance at not being screwed forever.
Robb Wolf: 36:38 Just in the mainstream literature, there are case reports of low carb, gluten free, dairy free-
Mikhaila P.: 36:46 And that being enough.
Robb Wolf: 36:49 And that being enough.
Mikhaila P.: 36:49 Yeah.
Robb Wolf: 36:49 Now, there’s not a ton of them, but there’s stuff out there, and it’s compelling. You could make the case that it should at least be something that is-
Mikhaila P.: 36:57 Tried pretty quickly.
Robb Wolf: 36:58 … floated by folks. Yeah, yeah.
Mikhaila P.: 37:00 Yeah, yeah.
Robb Wolf: 37:03 Very good friends of mine, they run the Type I Grit Facebook group. It’s dedicated to managing type one diabetes. They use the Bernstein diabetes approach, which is not carnivore, but it’s low-carb, not specifically high fat. They actually fuel things more via gluconeogenesis than they do specifically trying to be in a high fat environment. But some of the folks there had some concerns around what they saw in the Paleomedicina recommendations. But I wonder if the way that those recommendations … The thing that’s getting missed here is the Paleomedicina people are really focusing on trying to catch people in the honeymoon phase, where we could potentially reverse it, versus their protocol may be different once the person has gone beyond that year and it’s kind of like, “Okay, this is just the situation that we have.”
Mikhaila P.: 38:00 Yeah, they said once you’ve gone beyond that year, then they can’t really do anything for you. They said, I mean, obviously changing your diet is going to make you healthier, but there isn’t a going back.
Robb Wolf: 38:13 Right, right, right, right. Because the program they describe online, they don’t do post-meal insulin. It really, it was kind of wacky and the … But again, this may be, again, something lost, potentially in translation, where they’re really trying to get after this early and intervene in that honeymoon stage, so that the kid may potentially not fully become type one diabetic, that we may get some recovery off that.
Mikhaila P.: 38:45 Yeah, yeah.
Robb Wolf: 38:46 So that’s super interesting.
Mikhaila P.: 38:46 They’re-
Robb Wolf: 38:47 Keep going. Sorry, I didn’t mean to interrupt you.
Mikhaila P.: 38:49 Oh, no problem at all. They’re pretty intense with their protocol. The popularized carnivore diet, which like I said, I don’t think being heavy dairy is a good idea for sick people, but the popularized one isn’t similar, yeah, because they go right into, you measure your meals. So it’s kind of like the super serious ketogenic diet, where they do all the measurements. These guys do that. So it’s more difficult for people to follow, I think, because you have to start measuring your food, and you’re only eating meat. I think there are probably ways to make it easier for people. But I think what they’re doing is strangely effective, if people can follow it through.
Mikhaila P.: 39:36 I asked, “How many people do you see that are then cured that then … or not cured, treated, that then stay on this diet?” They said 50 percent. So 50 percent of the people will follow through with it. They said a lot of people will follow through and then they’ll feel so much better that they’ll just go back to eating other things again. Fifty percent isn’t that high. Whereas I feel like if you switch over to paleo, that’s a lot easier to [inaudible 00:40:03] with.
Robb Wolf: 40:05 I did a six week carnivore experiment. I really tried to follow what my understand of their methodology, from the material they have online and the podcasts that they’ve done and whatnot and I was kind of crazy. I was a little bit crazy. I wanted a fucking avocado so bad.
Mikhaila P.: 40:29 Oh, yeah.
Robb Wolf: 40:30 I never have food cravings. I’ve eaten low carb, paleo … But it was so funny. I was, “I just want a fucking almond.” I was kind of going a little crazy. It was interesting because for most of the world, me eating low carb, paleo, keto is crazy and neurotic, but I’m totally cool with it. I will do this the rest of my life, there’s no drama. But just the notion of, “What? I can’t have a handful of almonds? I can’t have any avocado?” It made me a little crazy. So that was a challenging piece. Then, my lipoproteins went to the moon. Like it went from 1,100 to 2,800-
Mikhaila P.: 41:13 Oh, wow.
Robb Wolf: 41:13 … or something like that, in six weeks. Again, I’m not totally sure what that means from a cardiovascular disease standpoint. I totally buy the notion that a high lipoprotein count in a low inflammation, low insulin environment is different than it happening in a high inflammation, high insulin environment. But it’s really kind of weird. If I can drive that up by eating, by throwing a bunch of tallow in with my meals versus drive it down by going almonds and olive oil, it’s kind of freaky. It was crazy. It made me a little nuts doing that for six weeks.
Mikhaila P.: 41:54 Yeah, I’ve seen that happen. Were you still eating dairy?
Robb Wolf: 41:58 No, no dairy-
Mikhaila P.: 41:59 … [crosstalk 00:41:59] just meat.
Robb Wolf: 41:59 I don’t do … very, very little dairy, anyway.
Mikhaila P.: 42:02 Wow.
Robb Wolf: 42:03 Yeah.
Mikhaila P.: 42:04 Yeah, well-
Robb Wolf: 42:08 I love meat. I love eating meat. It’s so funny, and it may have been mainly a psychological thing, because if I’m not, quote, eating carnivore, three meals out of five, I may just eat a steak or whatever, and I don’t bother adding anything to it. I’ve never really felt restricted. Part of this is, again, I was so sick that when I made the change, that I’ve largely been following for 20 years, I was like, “Dude, no drama. I’m so grateful not to be sick.” It may be that I’m at a comparative level of health at this point that I’m kind of like, there’s not that next level of motivation to cut out the [inaudible 00:42:51] and the coconut and, you know-
Mikhaila P.: 42:54 Yeah, if you don’t have a reason to do it, it’s much more difficult to do it. Because I had it pretty rough. Luckily I went just from eating salad to not eating salad. So my cravings weren’t that bad. But when I went from salad and apples and meat to just salad and meat, that was unbelievable, just getting rid of the apples, yeah. But the interesting thing, I find, well one of the interesting things about the carnivore diet is, you do get cravings, even if you’re coming from a, quote, healthy diet. So even if you just cut out lettuce, I was getting lettuce cravings, like sugar lettuce cravings. But now that I’ve been on it, and it took about six weeks, I have nothing. I don’t have any cravings for anything.
Robb Wolf: 43:36 Interesting.
Mikhaila P.: 43:37 It’s kind of amazing. Because when I was doing low carb, occasionally I’d be like, “Okay, I really need, I would really like an apple.” Foods popped into my head. I wouldn’t say they were cravings, but they’d pop into my head, and I’d be in the mood for a salad. Now, that part of me’s died.
Robb Wolf: 43:53 Interesting. That’s so interesting. Wow. Well, I have been a huge fan of everything that you’re doing. I think the therapeutic potential of a properly constructed carnivore diet may so eclipse the autoimmune paleo that it’s kind of staggering. This is why I really encourage people, and again, let’s not do the raw vegan gig. Let’s not turn it into a religion. Let’s keep our feet on the ground. Let’s be rational. Currently, we’re in very much a anecdotal state. But let’s collect that anecdote, because the recent autoimmune paleo studies that have been done, which have actually shown quite favorable results with some IBD, IBS type things, they’re now looking at one in Hashimoto’s, but that only happened because there was a large enough group of people that had an anecdotal experience that they had documented and they had shared and weren’t so annoying and over-the-top that researchers didn’t want to dig into the pool and do anything with it.
Robb Wolf: 45:07 For folks for whom they still have some really significant health problems that low carb or ketogenic or paleo, whatever version of it, hasn’t worked, I think that there’s a whole untapped potential within this carnivore scene. I encourage people to be open to it, but also not be complete zealots because it just slows the whole process down. But what else do you have cooking here in the upcoming weeks, months? You’re doing a gut microbiota transplant. What else do you have happening?
Mikhaila P.: 45:43 That’s most of it on the health front. I’m writing a book, just basically about my experience. I’m hoping to hand in the first draft around May. I’m really excited about that.
Robb Wolf: 45:54 Nice.
Mikhaila P.: 45:55 I started a YouTube channel that I haven’t been doing as much as I should. But yeah, I’m mostly just trying to get the word out that this diet at least exists as an option for really desperate people to give a shot. So I think it’s really helpful, too. Also, you never know when you’re wrong. You never know when you’re wrong. People do have to be careful about putting one diet forward as the only option or as the best option, because there’s so much we don’t know.
Robb Wolf: 46:30 Right, right. Yeah, cannot emphasize that enough. But the cool thing, and I think if people could just chill out a little bit, with a six week, two month experiment, okay, go try on the vegan sweater and see how you look, feel and perform. If it’s not working, then try on a different sweater and just keep trying stuff until-
Mikhaila P.: 46:51 It’s not that long of a time commitment, especially if you’ve been sick for decades. What is a month-and-a-half? It’s nothing.
Robb Wolf: 46:59 Right, because you potentially regain the rest of your life. My GI problems were so bad that I honestly don’t know if I would still be alive now. Twenty years and a wife and two kids and a very rewarding life might not have happened had I not gotten a handle on that. That was just not giving up and being willing to do some stuff that on the surface looked kind of crazy.
Mikhaila P.: 47:23 Yeah.
Robb Wolf: 47:25 Well, Mikhaila, safe travels to you and when the book is ready to be launched, will you please let me bring down your property value and have you back on the show? Maybe we’ll do a Facebook live and some other stuff, to promote that?
Mikhaila P.: 47:37 Yes, please.
Robb Wolf: 47:42 Awesome, awesome. Take care. Safe travels, and I’ll talk to you soon.
Mikhaila P.: 47:45 Thank you. Talk soon. Bye.
Don’t forget, Wired to Eat is now available!
Kasey Dungan says
I would like to check it out.
Holly Panter says
the podcast is not here
Ben miller says
Has anyone else tried Imodium? Let me know if I understood rob right in that it helps with gut strength and carb tolerance.
Janel Hopper says
Dre Ramirez says
Why not include in the description how long she was on the diet at both points of testing? Thanks!
Her autoimmune symptoms are probably related to her low vitamin D status.
Vitamin D modulates immune response and is now routinely prescribed for several autoimmune conditions. https://pubmed.gov/23857223
The US government recommendations for vitamin D are based on a statistical error. It should have been 9000 IU per day, not 600 IU. https://pubmed.gov/25333201
And that’s the minimum dose to achieve a serum value of 50 nmol/L, which is also too low.
“People with traditional lifestyles, living in the cradle of mankind, have a mean circulating 25(OH)D concentration of 115 nmol/L.” https://pubmed.gov/22264449
Reindeer herders in the Russian Arctic have an average serum vitamin D level of 68 nmol/L. https://pubmed.gov/25472642
The single biggest difference between us and paleolithic peoples is vitamin D. I hope the paleo community learns more about the importance of vitamin D.
Matthew Batchelor says
Has Mikaila tried sun exposure 5 min a side to largest body surface areas to correct Vit D deficiency? Applying magnesium topicaly morning and night with 10 mins exposure to large body surface are has corrected a life long Vit D deficiency with me after recent blood mineral test.
Doing Carnivore diet grass feed beef only, black coffee, pink salt flakes and water
Robb seems to use the word “fan” very liberally or is he an idiot? I see how someone would be a fan of a stupid hollywood star like Willis or Stallone. When it comes to a scientist how on earth could a human be objective about the arguments and logic when they are fanatic about the person making those.
Wobb Rolf says
Frits, shut the fuck up.
Kamala Wolf says
That Imodium thing? Fascinating.
Wish someone would chime in about it. Out of curiosity, I started taking 2mg a day since the podcast.
Jetro Kangas says
Let her talk lmao
My experience, very relevant to what Mikhaila is doing with regards to her Vit D levels, I took the same approach, thinking I can normalize my vit D levels on the PKD diet, without any supplementation, well I failed miserably. I am full carnivore since 07.2018, pkd consulting with Zsofia from paleomedicina 09.2018-12.2018. I was doing it for one of the autoimmune disease (in the liver bile ducts) I was not able to fix with other approaches (>100k usd in treatments, analysis and consultation, years of studies, third party and self studies). I can honestly write an assay, I will limit myself to say: 1. paleomedicina has an outspoken dogmatic belief pkd is the only diet for everyone, I do not subscribe. 2. paleomedicina has little to no understanding of the role of extradietary environmental components on gut microbiota, immune system regulation 3. They will tell you if you do not improve on pkd you are doing the diet wrong. This can be frustrating. It is your fault if they’re diet does not work 4. I am a chemist and Zsofia’s recommendations did not make sense to me, you should drink surface water according to her it is less mineralized, absolutely no sense, I live in Switzerland, mineralization varies greatly and has nothing to do with the extraction point of water. 5. I do not agree with them that microbiota is a direct result of your diet, complete BS., that is the focus of my work actually. This is a major point as it is very clinically relevant for them 6. I am not convinced by her telling me low free Testosterone is a sign of health and not otherwise 7. There is no proof their test for leaky gut is superior to the usual mannitol/lactulose challenge. 8. While I know I require 10k iu of vit D to keep my serum levels constant, I decided to follow the advice and kick my low allergenic vit D in MCT 3 months ago. In 3 months I have gone from normal levels to deficiency. Well after 3 years of solving or improving my autoimmune conditions I have at the end of Dec developed yet another autoimmune component against my inner ear, after a viral infection losing part of my hearing and part of my sense of balance. I was very deficient in Vit D at that point evidently and I do believe and I am an example of it that vit D is essential to avoid and control cross reactions. For me carnivory was always like walking on a thin layer of ice, still it improved my life from where I was before. PKD as per paleomedicina is not ideal for me, I am better of with less fat, enough to have decent ketone levels, with their recommendation I cannot control proteobacteria levels and will just have diarrhea (…I have some inflammation in my stomach and bile ducts, so fat/protein digestion is somewhat affected). I have stopped working with them, I continue to make the same mistake, all my progresses came from my own analysis and therapies, practitioners usually at best teach me what I should avoid. Now I focus on normalizing my Vit D levels, HBOT and antivirals to recuperate my hearing and balance. Then I will move on to continue working on the bile duct autoimmunity, possibly introducing extra animal foods. They are doing important work, and I believe their diet can have a strong therapeutic effect, and it can help people, it is the dogmatic approach that I cannot agree with.
Interesting, thanks for sharing.
I think Michaela Peterson has a gut biome issue. How Are we going to find out what the outcome of the fecal matter transplant is?
Why has not this ever been addressed in the past?
Holly Champaign says
Podcast link disappeared again!
Not sure what the deal with that is, added it back again.
Really interesting bit on Imodium – would be good to hear more about Robb’s experience/research into it.
I have IBS and have been using Imodium anytime I need to ‘reset’ (i.e. I take a couple of pills, it stops all problems, I don’t go to the bathroom for around 36 hours, then when I start again I’m pooping normally again – for the next few days anyway.) Like Robb said, it really is like going back to being a teenager.
And as well as improving bowel movements, the days after taking it just feel ‘better’ all round. I think part of it is a reduction in anxiety – you know that for the next few hours/couple of days you won’t need to worry about gut issues.
I’ve always thought that using it on a longer-term, continuous basis is not a good idea, but when I seek out research for why this would be, I can’t find much. It seems plenty of gastro docs recommend ongoing use for lots of people with gut issues too.
The only thing I notice is my tolerance builds up if I use it too much in a short period of time.