Acne, Long-Term Imodium, Salt and Diarrhea | THRR047

Acne for Pre-Teen Boy, Imodium – Brain Related Issues, Water Consumption Goal, Protein Preferred Metabolism, Salt and Diarrhea

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Show Notes:

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News topic du jour:

Beyond Meat turns children’s food educator

In partnership with digital education innovator Everfi, the platform will be launched in October 2020, aimed at teachers and 10–14-year-old pupils in the US. The course will cover topics such as finite natural resources, the importance of biodiversity and the effects of climate change, alongside the necessity to minimise personal carbon footprints.

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1. Acne for Pre-Teen Boy [14:28]

Heather says:

Hi Robb & Nicki,

Thanks so much for your podcast. I’ve been a follower for years.

My son has eaten a mostly primal diet (he drinks organic milk and eats organic cheese & butter) since he was in preschool, but I do allow him to cheat once a week on school pizza or at birthday parties. (He’s the only one in our family that does not show a sensitivity to gluten). However, he is twelve, going on thirteen and he is beginning to show acne, which of course is natural at this age.

My husband suffered from bad acne during his teenage years and believes that anti-bacterial soap is the best solution. But that goes against every cell in my body. I see this as a hormone issue and wonder if you know of a better solution (doesn’t antibacterial soap kill our good bacteria, too?). I did mention to my son that he might think about giving up the dairy (even though its organic), but he did not like that idea. Do you have any other solutions that could make my son happy (and possibly keep my marriage together? 😉 )

Thanks for any insights!

Heather

2. Imodium – Brain Related Issues [21:51]

John says:

Hi Robb!

I’ve heard you mention that using immodium has helped you with your BMs. I’ve always been a person on the “loose” side of things. I’ve experimented with 2mg of immodium in the morning and 2mg in the evening. This has been a game changer for me. There’s less “urge” to go, and more consistent and satisfying poops. I also feel like I’m absorbing my nutrients and have put on muscle mass as a results.

I also take Microbiome Labs’ MegaSpore and MegaMucosa… They’re incredible supplements for gut health. But even then, nothing has worked like immodium for slowing transit time in the gut.

I’ve heard that immodium acts similarly to an opiate, but in the intestines. Is there a danger with long term use? From what I know, opiates can have negative effects on the brain, mood, depression, etc. I’m wondering if you have any insight into this topic?

P.S. It was awesome to meet you at Paleo FX. You’re one of my heroes and The Paleo Solution changed my life.

3. Water Consumption Goal? [27:59]

Stephanie says:

Hi Robb! I listened to your podcast with Dr. Ruscio and you mentioned that we are told to drink too much water and that there is no data that actually supports drinking half your weight on ounces of water. What is sufficient for hydration? I do drink coffee in the mornings so I’m not sure if that changes anything.

4. Protein Preferred Metabolism [35:06]

Jeff says:

Robb,

Assuming a metabolically healthy individual, is it possible for someone to have a metabolism that runs best on a very high protein and very low fat and very low carbohydrate diet? I’m talking 2 to 3 times body weight in grams of protein and near PSMF levels of carbs and fats.

My 30 second life story if it helps. I weighed 300 pounds as a teenager, lost 60 of those pounds through unhealthy pursuits in Slimfast and vegan land, and continued to lose another 75 pounds over the past ten years through various forms of Paleo/Primal/ancestral approved protocols. I’ve done every variation of macronutrient setup one can concoct, but always feel my best when consuming obscene amounts of lean protein only.

Is this nutritional preference viable and metabolically sustainable? Did I break myself so badly as a teenager that this is the only remaining option? Am I morally obliged to offset my sins as a roughage humping vegan from decades past? I’m aware of the possible pitfalls this type of diet presents, but can’t seem to sustain other protocols that support my Look/Feel/Perform objectives.

Speaking of which, mine are:

-Look: lean and muscular

-Feel: steady physical and mental energy

-Perform: build muscle and be awesome

Thank you so much for your wisdom. You have and continue to be such an impactful influence in my life. Keep up the good fight!

-Jeff

PS – Sacred Cow is a triumph!

5. Salt and Diarrhea [41:48]

Shaun says:

I have been Keto for 3 years and strict carnivore now for 18 months. As of today I am 40KG lighter than I was at the start of this journey. After lots of experimenting I have found that my tolerance for salt is much less than it use to be. In short, if I don’t get enough salt (~6-9g a day, although I have gone as high as 12g) I feel lethargic, light headed etc – the general malaise you get with low sodium. However, more recently I have found even 6gs of salt will cause a flushing effect and give me fairly instant diarrhoea. Titrating my salt intake down stops the diarrhoea but I seem to be constantly walking this tight rope between Orthostatic hypotension and disaster pants when I get a bit too friendly with the salt shaker. Do you think this lower tolerance could be my body trying regulate the balance of sodium and potassium or something else? do you have any tips on managing salt intake and mitigating the flushing effect? I.e. would it be better to space the sodium intake out rather than larger boluses? is it better to take salt with water or without water? etc. for background I have found as I have got leaner and leaner I require much more fat for satiety and currently hit 1.6g/kg of protein and fill up the rest of my calories with lots of animal fat. I also eat a tonne of liver, kidney and heart. Since March I have been doing a summer cut so I am currently in a fairly deep calorie deficit which could be a confounder. currently 65kg ~10% BF (Ketogains calculator puts me at 8%). Thanks for your time and all your efforts. Btw I loved the sacred cow book! Kind Regards Shaun

 

Sponsor:

This episode of The Healthy Rebellion Radio is sponsored by White Oak Pastures. White Oak Pastures is a six-generation, 154-year-old family farm in Bluffton, GA. They pasture-raise 10 species of livestock and practice regenerative agriculture that improves the land. Their cattle and sheep are grassfed, their pork and poultry are pasture-raised and given non-GMO feed. All their meats are raised, slaughtered, and butchered on the farm. They also sell organic vegetables, pasture-raised eggs, honey, pet chews, leather items, tallow goods, and more artisan products that they make on the farm. They are committed to animal welfare, land regeneration, and rural revival. Check them out at http://whiteoakpastures.com/robbwolf and enter code REBEL10 to get 10% off product total ($100 max discount) for first-time customers.

Transcript:

Download a copy of this transcript here (PDF)

Nicki: It’s time to make your health an act of rebellion. We’re tackling personalized nutrition, metabolic flexibility, resilient aging, and answering your diet and lifestyle questions. This is the only show with the bold aim to help 1 million people liberate themselves from the sick care system. You’re listening to The Healthy Rebellion Radio.

Nicki: The contents of this show are for entertainment and educational purposes only. Nothing in this podcast should be considered medical advice. Please consult your licensed and credentialed functional medicine practitioner before embarking on any health dietary or fitness change.

Nicki: Warning, when Robb gets passionate, he’s been known to use the occasional expletive. If foul language is not your thing, if it gets your britches in a bunch, well, there’s always Disney+.

Robb: Howdy, rebels?

Nicki: Hello, everyone.

Robb: You’re waiting for me to kick this one off.

Nicki: Well.

Robb: You’ve been kicking them off lately.

Nicki: I’ve been kicking them off and then, what was the line that you used and overused a few times? It’s not coming to me right now. So, I decided to-

Robb: Well, clearly, I didn’t overuse it.

Nicki: I decided to wait.

Robb: If you can’t even remember it, then it’s not overused.

Nicki: Oh, it was, “Look at you grabbing the bull by the… Or grabbing the-

Robb: The short hair-

Nicki: … short hair by the bull.” I decided to sit back and let you do that.

Robb: Similar to dinner prep.

Nicki: Oh, shit. Are we going to get feisty this morning?

Robb: It’s not a Salty Talk so you have to keep the salt.

Nicki: Oh, you, who needs a haircut?

Robb: Yeah. And why do I need a haircut? Because my hairstylist has fallen down on the job horrifically.

Nicki: Well, I became your backup hairstylist during the-

Robb: Oh, I can go back to my other hairstylist if you want me to piss away that much money for somebody to run a number one.

Nicki: Over your head.

Robb: Yeah, it’s the easiest. And when I was doing that, they’re like, “What do you need?” and I’m like, “It’s the easiest haircut of the day.”

Nicki: Pretty much.

Robb: But I suspect people are not here for that. I’m still not sure why people are here at all, but thank you for being here. I hope you’re all doing well. Do we have anything? The 7-Day Carb Test is in full carby flight.

Nicki: It’s in flight, so that’s been fun to watch. People are seeing what their blood glucose responses to certain carbs.

Robb: It’s so interesting that we had tons of people do this as a consequence of Wired To Eat. And we’ve done this four times now-

Nicki: This is our third reset.

Robb: Err, third within the rebellion. I’ll be jiggered, but people still come up with new questions all the time, and it’s cool. One of the takeaways that we had yesterday, we had a live chat unpacking all this stuff. We had a number of people that were old hats at this stuff and a good number of people that were brand new. And what was interesting is just that testing is really cool, really informative, and similar to the piece in like Zen and the Art of Motorcycle Maintenance where you ask one question and do the research to try to answer it and it spawns two or four or six more questions. It’s just this infinite process.

Robb: But it is really cool and I think it helps people understand why buttoning up health once you leave the real macro level and start getting in to these details and out in the weeds, it’s really a lot of nuance and it’s cool. It’s cool.

Nicki: Mm-hmm (affirmative). Yeah, I think people are enjoying it and enjoying seeing how their body is responding to the different carbs. We actually had a really interesting question. One of our rebel members, Nicki, in Spain, she’s doing it as a homeschool project with her kids. So, she has two boys. I believe they’re either 10 and 14, or 12 and 14. And so, she was asking, “My husband and I were going to do the 50 grams of effective carbohydrates. My boys weigh about half of what my husband weighs. What amount of carbohydrates should they be testing?” So, she’s going to go ahead and test them with 25 grams of effective carbs. Anyway, it’s just a lot of fun. Interesting stuff going on in there, right, Robb?

Robb: Yeah, yeah. I wish we could have tested Zoe the other day after Thai food because she had smashed some rice.

Nicki: A lot. She had two large servings of rice.

Robb: But the only thing she complained about, she was like, “Oh, my tummy hurts.” She ate a lot of food. We have a long day and we were kind of underfed, but I got to say even though both kids are such an interesting mix of us, I feel like Zoe is more carb tolerant like you because I don’t feel like she gets the same kind of blood sugar dips even after doing-

Nicki: She felt uncomfortable because she ate a lot of food in total. She did eat a lot of rice, but I didn’t notice any-

Robb: Kind of blood sugar squirreliness, and generally don’t. Whereas Sagan, who, again, interesting mix of both of us, but I feel like she leans a little bit more my direction. I feel like she’s a little more sensitive to not getting enough protein and stuff like that. But it’s interesting.

Nicki: Yeah. What do you got for us for a news topic today?

Robb: Well, you’ve got to scroll up so I can see there. Thank you. I stole this one from Diana Rodgers two-piece Beyond Meat turns children’s food educator, and I have a link to this in the show notes. In partnership with the digital education innovator, Everfi, the platform will be launched in October 2020 aimed at teachers and 10- to 14-year-old pupils in the U.S. The course will cover topics such as finite natural resources, the importance of biodiversity, and the effects of climate change alongside the necessity to minimize personal carbon footprints.

Nicki: Gosh, I wonder how you minimize the personal carbon footprint. Do you just eat Beyond Meat?

Robb: Well, that’s an ironic thing where it’s been well-established that pastured meat actually is net carbon negative, whereas Beyond Meat is not. There’s just… I can’t turn this into a Salty Talk. I do want to dig into this more because I’ve followed some people like Bjorn Lomborg and Matt Ridley, some of these people out of maybe you would call them like the rational optimist camp. Who’s the guy, the author of Apocalypse Never?

Nicki: Michael Shellenberger or something similar.

Robb: Shellenberger. It’s really interesting stuff. And climate change is a really big, important topic, but it’s big and important as much for the way that I think people are inappropriately contemplating how we should tackle things as outright denialism and whatnot. I saw some remarkable virtue signaling on Instagram the other day from a do-not-be-named individual from the ancestral health scene. The individual was lamenting the California fires and all this stuff is horrible, but the individual made the comment, “Well, you really need to vote properly this next election cycle so that we don’t have climate change deniers running amok,” and it’s like, “Okay, that’s a possibly valid point.”

Robb: But I would really like to ask a lot of these folks, “So, what do you think should be the primary driver in the way that we tackle this stuff? Is reducing total greenhouse gas emissions the most important thing? Is raising the rest of humanity out of abject poverty and providing them the infrastructure and resources to better handle the challenges that are coming with climate change?” These are things that folks just literally do not talk about. It doesn’t exist in their worldview and it might be worthwhile to get in and educate oneself about some of these nuances.

Robb: It’s mind-blowing that Michael Shellenberger was speaking before the House of Representatives, and he got interrupted and basically blown off the stage by the folks there when he started talking about some of these very nuanced topics. There was an online mass-

Nicki: You wrote an article about it, and then apparently was invited back.

Robb: And had 40 minutes to talk. At the end of it, some of these folks that are typically very vocal about climate change, and again, rightfully so, it’s an important topic, but they literally said, “I had never heard of stuff like this before.” And these are people that are in these positions to make huge policy, allocate massive amounts of resources. And even if what Shellenberger is saying is wrong, let’s just say it’s wrong, but if you don’t even know what the null hypothesis is, if you don’t even know what the full spectrum of what people are contemplating these things, then you are not well-educated on this topic. And I don’t know that these folks are really in a good position to make good decisions about what we should do.

Robb: This circles back around with this Beyond Meat thing. The irony with this is that it’s okay and this would be acceptable for this platform to go into public schools, and it will be roundly welcomed and accepted because it falls within all the USDA guidelines and FDA guidelines and all that stuff. Whereas if we put together some sort of an ancestral eating template, it wasn’t keto, it wasn’t carnivores, it just includes meat sources and all that, it wouldn’t go. It would be nuked from the beginning. So, there’s some real asymmetries in all this stuff.

Robb: This is, again, where I just get very prickly about people being lackadaisical with the way that government in media embrace some of these things, and these lies get spoken again and again and again to the point that they just become accepted and written as accepted truths.

Nicki: And then, you have these students that are being taught this in school and maybe they believe it as truth if they don’t have parents at home. One, if parents at home aren’t actively interested in and asking about what you’re learning, and there’s no there’s no dialogue there, then they believe it as truth and then they grow up to forever be Beyond Meat consumers. And with the whole, “How many ingredients are in their product?” and it’s a lot.

Robb: It’s a lot more ingredients than grass-fed meat, which is- And again, I don’t want to turn this into a Salty Talk episode, but this stuff is really important and, again, I would throw out there. We’re noodling on some ways to maybe dig into some of these more nuanced topics and we’re going to continue to noodle in.

Nicki: A couple ideas to make sure that they make sense.

Robb: They make sense. Yeah, so check that stuff out.

Nicki: We’ll have a link to this in the show notes. Yeah.

Robb: Cool.

Nicki: Cool. Let’s see our T-shirt winner for this week goes to Navy Dock Wife, “Come for all things ancestral, stay for the salty. Stumbled upon this podcast when I went through a major health change via Paleo diet. Fast forward, marriage and three kids later, I’m still tuning in to this amazing resource. Robb and Nicki are basically my life coaches at this point, and I look forward to carving out time each week to listen. The past few episodes have been so on-point and I wanted to show my support, so I ordered Wired To Eat, Sacred Cow, and a pack of LMNT all in one night. Add in this review, and I’m basically a superfan. Keep up the good work, you two.”

Robb: That’s awesome.

Nicki: Navy Dock Wife, thank you so much. Send us an email to [email protected] with your T-shirt size and your mailing address and we’ll send you a Healthy Rebellion Radio T-shirt.

Robb: Cool.

Nicki: All right. This episode of The Healthy Rebellion Radio is sponsored by White Oak Pastures. White Oak Pastures is a six-generation, 154-year-old family farm in Bluffton, Georgia. They pasture-raise 10 species of livestock and practice regenerative agriculture that improves the land. Their cattle and sheep are grass-fed, their pork and poultry are pasture-raised and given non-GMO feed. And White Oak Pastures meats are raised, slaughtered, and butchered right on the farm. They operate two on-farm USDA inspected abattoirs to process and butcher their meats. And their nose-to-tail production uses trim, fat, bones, height, etc. They make dog treats, leather products, and tallow good. So, I mean, they use the whole animal, and everything happens right on site, so it’s like the dream of regenerative agriculture production situation.

Nicki: And we talk a fair amount about regenerative agriculture on this show. And if you’ve read Sacred Cow, you also know that White Oak Pastures beef specifically has been shown by a third-party life cycle and assessment to be carbon negative, which goes back into our news topic today. Beyond Meat certainly is not in effect. Was it Impossible Burger or Beyond Meat that they compared to-

Robb: I believe it was Impossible Burger, yeah.

Nicki: In that? Okay. Similar.

Robb: Yeah, same thing.

Nicki: Same thing.

Robb: Yeah. At the end of the day, you’re probably not going to beat sunlight grass and herbivores and an ecosystem that’s been here either 6,000 years or 4.5 billion years. Yeah.

Nicki: Well, folks, check them out at whiteoakpastures.com/robbwolf, that’s R-O-B-B W-O-L-F, and enter code REBEL10 to get 10% off your product total for first time customers. That’s up to $100 max discount. Again, that’s whiteoakpastures.com/robbwolf and the code is REBEL10.

Robb: Cool.

Nicki: Hubs, you ready for questions?

Robb: Lay them on me, wife.

Nicki: I’ll lay them on you? Okay. So, we’ve got one from Heather, and she’s asking about acne for a 12 turning 13-year-old boy. She says, “Hi, Robb and Nicki, thank you so much for the podcast. I’ve been a follower for years. My son has eaten a mostly primal diet. He drinks organic milk and eats organic cheese and butter since he was in preschool, but I do allow him to cheat once a week on school pizza or at birthday parties. He’s the only one in our family that does not show a sensitivity to gluten.

Nicki: However, he is 12 going on 13 and he’s beginning to show acne which, of course, is natural at this age. My husband suffered from bad acne during his teenage years and believes that antibacterial soap is the best solution, but that goes against every cell in my body. I see this as a hormone issue and wonder if you know of a better solution, doesn’t antibacterial soap kill our good bacteria too? I did mention to my son that he might think about giving up the dairy even though it’s organic, but he did not like that idea. Do you have any other solutions that could make my son happy and possibly keep my marriage together? Thanks for any insights. Heather.”

Robb: Man, this is a tough one. Both you and I have noticed dairy can be a significant problem. We’ve had innumerable clients that dairy was the thing. It gets into some of the IGF, insulin-like growth factors, and EGF, epithelial growth factors, that get upregulated in the consumption of dairy, and dairy is great at making small mammals into larger mammals. And then, there may be some other potential challenges with it. It’s interesting for myself since I’ve shifted more carnivore-ish, where I’m only focusing on plant materials that don’t give me GI problems. I noticed that I don’t really get acne from dairy now, after really eat a lot of it in lower quality dairy-

Nicki: But you’re not doing milk. You’re doing some specific cheat types of cheese.

Robb: I’m doing some very specific types of cheeses, some Greek yogurt, and honestly, of the mix, I would say milk is probably the most challenging potentially. And I get that he’s maybe reticent or resistant to the notion of dropping the milk, but if you could look at some of these longer-aged cheeses, looking either sheep or goat cheese, those things seemed to be less problematic.

Robb: A good friend of mine, Pedro Passos, did this presentation on dairying from an ancestral perspective, and it was fascinating. These dairying cultures ceased. There are other considerations at certain points in the… It’s almost like the bovine menstrual cycle. I’m not an expert on this stuff, and this was eight years ago probably that I saw this, but it really struck me. There are changes in the hormone profile within the milk naturally. And it’s fascinating that both the processing methods like the fermentation tend to mitigate these problems and then also these pre-Westernized cultures just somehow knew to not harvest milk at these certain times when the hormone levels could have been high enough that potentially were injurious to human consumption and we have nothing like that in the way that we collect milk now, and this is true whether it’s organic or like the Weston A. Price people:, “Have you tried pastured milk?” That pastured milk milked by the hands of the Dalai Lama. These folks are funny.

Robb: But there are historical examples of people figuring out, not dissimilarly to say like the way that people figured out how to eat or processed cassava or acorns or what have you, they just, over the course of time, figured out that there were some challenging elements there and they figured out ways to navigate around it. And at the end of the day, if the acne gets bad enough, Heather’s son is going to have to make a decision like, “Do you want to deal with that, or do you want to deal with it with something like antibacterial soap or Accutane or tetracycline?” I was on tetracycline for years and looking back, I really think that that was one of the big factors in in my lifelong gut issues.

Nicki: I would agree. I had a good friend in high school. Her name was Heather and she was on tetracycline, and she actually got lupus from it. When she went off of it, it thankfully subsided. And so, it contributed in some way to her having an autoimmune condition.

Robb: Yeah. So, Heather, I wish I had… What are the two boys like?

Nicki: Let’s maybe pose it to him if he would be willing to just do an experiment and like we say with everybody, “Try for 30 days,” and give up all dairy entirely. The butter is probably not bad.

Robb: Butter is probably fine.

Nicki: He could probably keep the butter and just see. And to Robb’s point… When I was in high school, I had pretty bad acne. Everybody on my dad’s side of the family still has pockmarked scarring on their face from terrible acne. I had pretty bad acne as a teenager as well. And if I knew then what I know now, the dairy would just go out the window because, also, at this age, you’re also really concerned about how you look and you’ve got friends, and all this stuff. I guess maybe wearing masks makes it a little bit easier but still you don’t want it going on. So, maybe see if he’s open to an experiment in eliminating it for 30 days.

Robb: And then if it improves, then we can do some tinkering. Is goat milk okay? Are goat and sheep cheeses and/or yogurts and stuff okay? And I guess you could tackle it the other way around, which is just shift the height of dairy first. Yeah.

Nicki: Shift to goat and sheep sources and see if it-

Robb: But that elimination can be powerful because if it all goes away, then you really have a…

Nicki: And then, he knows and he can make those choices for himself. If he breaks out, he knows, “Okay, gosh, I had a bunch of pizza and ice cream at Bobby’s birthday last week.”

Robb: And at a minimum, if there’s some social event coming up, he’s like, “Okay, I’m not having that this week because there’s a school dance,” although I don’t know if they do those anymore, particularly in the age of COVID, but whatever. At least, he’s gotten some options around that. And again, I think this and also just the general GI-related stuff is part of the reason why the Paleo solution did as well as it did, reached as many people as it did, because we just said, “Hey, for 30 days, pull all this stuff out, reintroduce it, and see how you do,” and it’s just shockingly effective. Yeah.

Nicki: Mm-hmm (affirmative). Okay, let’s move on to our next question from John. He has a question about Imodium, “Hi, Robb. I heard you mentioned that using Imodium has helped you with your bowel movements. I’ve always been a person on the loose side of things. I’ve experimented with 2 milligrams of Imodium in the morning and 2 milligrams in the evening. This has been a game changer for me. There’s less urge to go and more consistent and satisfying poops. I also feel like I’m absorbing my nutrients and have put on muscle mass as a result.

Nicki: I also take Microbiome Labs’ MegaSpore and MegaMucosa. They’re incredible supplements for gut health. But even then, nothing has worked like Imodium for slowing transit time in the gut. I’ve heard that Imodium acts similarly to an opiate, but in the intestines. Is there a danger with long term use? From what I know opiates can have negative effects on the brain, mood, depression, etc., and I’m wondering if you have any insight into this topic?”

Robb: Yes, Imodium is a type of opiate and its effects are almost exclusively expressed at the gut level. The bugger here though is that some people in our opiate crisis world will take massive amounts of Imodium and not only does it back you up as if you were on heroin, it will not get you high in any way. You will not have any type of euphoric effect at all, but it can and will suppress your respiratory function and you can die from it. As a consequence, I can no longer find the 200-count bottles of this stuff because similar to what they did with the Sudafed years ago, it’s becoming this ever more regulated kind of thing. Now, it’s only blister packs and I can only get 24 of them at a time, and it makes me want to cry.

Robb: So, yeah, John, again, I’m not a physician, but I mean, the science on this is pretty crystal clear, the toxicology, all of that type of stuff. And it’s interesting because if you dig into the literature on irritable bowel syndrome, maybe 10, 15 years old, maybe a little older than that, Imodium was used all the time for folks that had the looser side of the irritable bowel spectrum because you can be either constipated or loose or go back and forth. And so long as the dosing is not significant and that two milligrams twice a day seems completely reasonable, this was a standard of care use for Imodium for quite a long time.

Robb: I’m stunned that now… I’ve talked to a couple of GI docs, asked about this, and they’re like, “Oh, I wouldn’t recommend it long-term at all.” And then, I pull up these papers and they’re like, “Oh, that’s kind of interesting.” And then, the anecdotal reports that we’ve had, where people have just had this, like he mentioned that he gained some muscle mass because that decreased transit time allows you to get the nutrients out of your food.

Robb: There’s something weird about this too, and I think I’ve mentioned it in the past, before I started using the Imodium when I would get ready to do my business first thing in the morning, I usually felt fine until I went poo. And then, I just had this weird… If I was on the loose side, then immediately after this, I don’t know maybe it’s an electrolyte deal or something, but I would feel bad after that. It was like a neurological type stuff. And if I happen to have one of those rare days where the poo was well-formed and everything was good, then I felt great and that’s what was so striking about putting the Imodium.

Robb: And then, I noticed it when I had some food poisoning, used the Imodium to deal with food poisoning because I had to take a six-hour flight back from Boston and barely got on the plane. I actually probably consumed more Imodium than I should have. But at that point, I was like, “I don’t care if I die on the plane.” So, I’d rather that than crapping my pants. And I just noticed for days afterwards, my digestion was great, it was all formed, and I felt generally better. And so, that was the thing that got me thinking about all this stuff.

Robb: So, again, I think it’s completely reasonable so long as the dosing is kept within these parameters. I also think that the warnings on the Imodium packages, most people do use it in response to traveler’s diarrhea or something like that, and they don’t want you suppressing the symptoms of a bacterial or parasite infection. So, if you have loose stools from an infection, they don’t want you wallpapering over that with the Imodium and hiding it. But this is again, it doesn’t have to be an all-or-nothing thing on this. Man, that’s a lot about poo.

Nicki: Yeah. Well, we haven’t had a poo question in a while.

Robb: We haven’t. Yeah.

Nicki: Thanks, John, for that.

Robb: I still got my mojo though. I still have my poo mojo.

Nicki: Okay, we have a question from Stephanie on water consumption. She says, “Hi, Robb. I listened to your podcast with Dr. Ruscio and you mentioned that we are told to drink too much water and that there’s no data that actually supports drinking half your weight on ounces of water. What is sufficient for hydration? I do drink coffee in the mornings so I’m not sure if that changes anything.”

Robb: Well, this is possibly self-serving because of LMNT and all that, but when you… This is one of the things that gets missed on the hydration topic is that when you look in a textbook of medical physiology, and you look up the term “hydration,” it’s not just water. It’s water and electrolytes, calcium, magnesium, potassium, and also the negative anions or negative cations with the chloride and bicarbonate and stuff like that. All of those things play a factor in this electrical signaling and ion gradients and whatnot.

Robb: And so, it’s not so much about just water or fluid volume, it’s about getting adequate electrolytes with that and maintaining an osmotic level of both the liquid water and the dissolved constituents in our blood. And there’s no singular answer. It’s like, “Well, how much should I drink?” Well, do you live in South Dakota? Is it cool and mild all year and freezing cold at certain times? Your demands are going to be shockingly different than somebody that lives in Central Texas or, God forbid, even like Houston or something like that where it’s both hot as the surface of the sun and humid as like a Wookie’s armpit.

Nicki: And then, make you an HVAC installer that’s in attics all day long.

Robb: Yeah. We have a friend and she also have a pest control service that she does and she gets up into the attics of the houses in Central Texas, and she said that she will go up to do what she does in an attic and she’ll be 10 pounds lighter coming out of that. She’s brought a scale before. Her needs are shockingly different. So, Stephanie, I’m not dodging this thing but it really depends on what your-

Nicki: Your activity level.

Robb: … overall situation is, activity level.

Nicki: Heat, humidity.

Robb: Thirst is a pretty good gauge to go by. And I will make the case that I would not be surprised that the need for using something like LMNT is there in part because people are drinking 16-ounce cups of coffee, like my little cup of diminishing freedoms that I’m sipping from, that are absent any electrolytes and I don’t get enough from my food and even salting it. It’s just not really enough. Whereas if we mainly relied on both the fluid volume and the electrolytes mainly from our food and then had a bit of water on top of that, we would probably be at an OK spot. But because we do have this tendency to consume these fluids, this is pure speculation, there are no randomized control trials on this, but I think that that actually drives the need for something like LMNT or just more aggressively salting our food. And clearly, we also know that fasting and ketosis and stuff like that also increases the need for things. So, that’s another factor in this whole story.

Robb: So, Stephanie, I don’t have a… It is virtually impossible to give you anything other than some kind of bracketed guidelines on this stuff. And even that, I’m like… When you look at the literature, it’s just kind of goofy. I would really go largely by thirst. I would be cognizant, like if you’re not feeling great, if you have some kind of brain fog, certainly, if you’re having any type of cramps, then you need to pay more attention to the electrolyte side of that story, specifically the sodium, but also the potassium and magnesium and the rest of that.

Nicki: And if your urine is really dark yellow, that’s another indicator that people-

Robb: Can be.

Nicki: You don’t like that one?

Robb: The whole pee pale thing, I think that that’s a little bit of what gets folks in problems. It’s like doing squarely things so that you get a higher ketone reading and-

Nicki: Make my urine so clear that you can’t even see it. People go like that, they get really-

Robb: Invisible urine?

Nicki: … invisible urine.

Robb: Oh. I have many thoughts around that. I’m going to keep them all inside my head for once. So yeah, can we beat this one to death anymore? It’s an interesting question, but there’s-

Nicki: There’s no hard and fast rules.

Robb: There’s no hard and fast rules on this stuff. And I would go out on a limb and say that if you enjoy drinking things like coffee or tea and you’re just sipping on that stuff throughout the day, if you’re not actively stacking the electrolytes or if you’re eating a pretty carb-centric diet, you may end up retaining enough sodium and electrolytes naturally that it may be less of a factor. But if you eat a little bit on the lower carb side of things, I just don’t think you need as much fluid volume going through you. And again, that sounds absolutely crazy, but it’s a defensible position. I think over time, we’ll get more information on that.

Nicki: Okay. It’s trivia time. Our episode sponsor, White Oak Pastures, is giving away their beef sample kit. This is a bundle of amazing stuff. It’s going to one winner this episode. It includes two boneless rib-eyes, two fillets, three pounds of ground beef, three snack sticks, spicy, herb, and original. Again, to one lucky winner, selected at random, who answers the following question correctly.

Robb: I want to win this.

Nicki: But first, I have to say these prizes…

Robb: I want to win this.

Nicki: The last episode that White Oak sponsored, I think we had the most trivia submissions of all time because clearly this is-

Robb: Because it totally kicks ass.

Nicki: … a highly coveted trivia prize. So, Robb, I wanted to ask, is there one supplement that you think everyone should take? If there’s only one supplement that you would recommend, what might that be?

Robb: I think a D3K2 combo in probably a dropper form. There’s a zillion different supplement. Some people might say like methylated B vitamins, but for the MTHFR genotypes, not everybody has MTHFR and just supplementing B vitamins doesn’t always address that. But I would say the D3K2. And if I really wanted to get squarely on this, it’d be like a D3K2 and then a Vitamin A with that, although that’s hard to find in combination now. They used to have all those but now they’re separate. So, as a moving target, my final answer, a D3K2 combo.

Nicki: Okay. All right, folks, you heard it. To play, go to robbwolf.com/trivia and enter your answer. We’ll randomly select one extremely lucky person with the correct answer-

Robb: They’re not too damn random. I want to win this.

Nicki: … to win a White Oak Pastures beef sample kit. The cutoff to answer this week’s trivia and be eligible to win is Thursday, September 24th at midnight. Winner will be notified via email, we also announce it on Instagram as well, and this is open to residents of the U.S. only. I could say the super fast thing that if you are Robb Wolf, you will not be eligible to win.

Robb: Dammit, I quit. This podcast is over. We’re done.

Nicki: All right. Our fourth question this week is from Jeff on protein-preferred metabolism, “Robb, assuming a metabolically healthy individual, is it possible for someone to have a metabolism that runs best on a very high protein and very low fat and very low carbohydrate diet? I’m talking two to three times body weight in grams of protein and near protein-sparing modified fasting levels of carbs and fats.

Nicki: My 30-second life story if it helps. I weighed 300 pounds as a teenager, lost 60 of those pounds through unhealthy pursuits in Slimfast and vegan land, and continued to lose another 75 pounds over the past 10 years through various forms of paleo, primal, ancestral approved protocols. I’ve done every variation of macronutrient setup one can concoct, but I always feel my best when consuming obscene amounts of lean protein only.

Nicki: Is this nutritional preference viable and metabolically sustainable? Did I break myself so badly as a teenager that this is the only remaining option? Am I morally obliged to offset my sins as a roughage humping vegan from decades past? I’m aware of the possible pitfalls this type of diet presents but can’t seem to sustain other protocols that support my Look/Feel/Perform objectives. Speaking of which, mine are Look, lean and muscular, Feel, steady physical and mental energy, Perform, build muscle and be awesome.

Nicki: Thank you so much for your wisdom. You have and continue to be such an impactful influence in my life. Keep up the good fight.”

Robb: P.S. Sacred cow is a triumph. Thank you. This is really interesting. In general, when you… Something that would have been super helpful here is if Jeff had really weighed and measured his food for a couple of days and we would have seen exactly what the macro breakdown was. In general, humans tend to top out at about 30% to 35% of protein as a primary fuel source. And once we get much beyond that for any length of time, we can end up in like a rabbit starvation scenario. We need co-factors either carbohydrate or fat to aid in the metabolism and removal of ammonia products as a consequence of protein metabolism.

Robb: There’s some thought that some people can adapt up to about 40%, like the liver actually enlarges a little bit. There’s some thought that some Inuit populations may have some tendency in this direction where they can handle, say, like 40% of protein as a percentage of total calories. In general, though, if the numbers are much above 30 with protein, people just start having problems. They get diarrhea, they have blood sugar, or not really blood sugar, but more electrolyte abnormalities because of the body trying to deal with this situation, so he might be like a total outlier. I mean, it sounds like he’s been doing this for a while.

Nicki: I’m wondering what… He’s saying lean protein, but I’m wondering, does he have… Maybe it’s not as lean-

Robb: Lean as he thinks. When we say PSMF levels… I was talking to Luis Villasenor about this and I will do my version of PSMF, which is just basically whatever protein I’m eating, which usually like ground beef or whatever, and they just don’t add any extra fat to it. And that’s my version of it. Luis is horrified by that. He’s like, “No, you don’t do it that way.” He gets a chicken breast or the leanest cuts of beef and you trim any visible fat. And when you look at that, it’s really goddamn lean. It’s no joke, lean. That’s also part of the reason why when people like Luis do a PSMF for a block of time, man, they just shrink wrap down.

Robb: So, I think that one can get the perspective that they’re eating comparatively low fat when in fact if the meat isn’t trimmed and if you’re doing chicken thigh versus chicken breast and stuff like that, or you’re even doing the skin versus not skin, there ends up being a decent amount of fat there and you can get… Maybe what’s happening is Jeff is just writing right at that edge where he’s keeping the protein intake right about 30% or something. So, I don’t know if this is going to be a problem long-term. My gut sense is that, Jeff, you’re getting more fat, and I assume not much in the way of carbs, but you’re getting more of something somewhere, I suspect.

Robb: And this is, again, something that I just learned from watching Tyler and Luis interact with their folks. Somebody would say, “I’m not losing weight,” and they’re like, “You’re overeating.” “No, no, no. I’m doing X, Y, Z,” and they’re like, “No, you’re overeating.” It was like watching a doctor filled or they just broke the person down. And eventually they’re like, “Okay, I was lying about this,” and I was like, “Are you shitting me? I can’t believe this,” because I would have been inclined to just say, “I don’t know, maybe your metabolism doesn’t work.” I gave people many more outs, whereas like Tyler and Luis would hold their feet to the fire and they’re like, “No, I know you’re lying or something else is going on.” And every damn time, they ended up… They were right.

Robb: So, my gut sense here is there’s more calories sneaking in from non-protein sources, Jeff, than what you think. And so, I would maybe weigh and measure everything, stick it in chronometer, and see what you’re really getting. And if you want to circle back around and even just a quick email update, and be like, “Oh, yeah. Actually, this is the macro breakdown,” that would be super helpful. The only other thought I have is that you’re literally one of these genetic outliers. And for some reason, you’ve got a polymorphism or a situation where you’re able to handle a higher than normal protein intake. Because usually, once people get down to what a reasonable, it’s not even that lean, but I mean, just reasonable leanness, you will start having deleterious effects from this pretty quickly because your body knows that the protein toxicity story is a real deal problem.

Nicki: Okay. Let us know, Jeff. We’re curious now. All right, we’ve got our final question from Shaun on salt and diarrhea. Oh, we got two poop-

Robb: Two poops.

Nicki: … questions this week.

Robb: More for your money.

Nicki: So, Shaun says, “I have been keto for 3 years and strict carnivore now for 18 months. As of today, I’m 40 kilos lighter than I was at the start of this journey. After lots of experimenting, I have found that my tolerance for salt is much less than it used to be. In short, if I don’t get enough salt, about 6 to 9 grams a day, although I have gone as high as 12 grams, I feel lethargic, light-headed, etc., the general malaise you get with low sodium. However, more recently I’ve found even 6 grams of salt will cause a flushing effect and give me fairly instant diarrhea.

Nicki: Titrating my salt intake down stops the diarrhea, but I seem to be constantly walking this tight tightrope between orthostatic hypotension and disaster pants when I get a bit too friendly with the saltshaker. Do you think this lower tolerance could be my body trying to regulate the balance of sodium and potassium or something else? Do you have any tips on managing salt intake and mitigating the flushing effect? I.e. would it be better to space the sodium intake out rather than do large boluses? Is it better to take salt with water or without water, etc.?

Nicki: For background, I’ve found as I’ve gotten leaner and leaner, I require much more fat for satiety and I currently hit 1.6 grams per kilogram of protein and fill up the rest of my calories with lots of animal fat. I also eat a ton of liver, kidney, and heart. Since March, I’ve been doing a summer cut so I’m currently in a fairly deep caloric deficit, which could be a confounder. I’m currently 65 kilos, 10% body fat, and the KetoGains calculator puts me at 8%. Thanks for your time and all your efforts. By the way, I loved Sacred Cow. Kind regards, Shaun.”

Robb: So, this is a game where someday we will have a phone-in show again when we figure out the technical because he mentioned the bolus intake, which is making me think he’s maybe doing sodium in a bolus intake. And definitely, if we’ve seen one scenario in which people can get disaster pants, it’s trying to hammer a big-

Nicki: Too much at once.

Robb: … dose of sodium. It’s interesting in that regard where I tend to be kind of the canary in the coal mine and have problems with everything. I am one of these people that I could have it real concentrated even though I don’t like it that way or I can have it more dilute. But either way, I can hammer the stuff. I don’t really get much problem from it. But that is one of these, yes, sip it throughout the day, spread it out.

Robb: I’ve also noticed that it gets old drinking all of my sodium and electrolytes in some ways. And so, I do pickles, I do a quite a bit of olives. And olives, if you do, I don’t know, 12, 15 olives or something like that, I think you get a gram of sodium out of that. Olives actually have a remarkable amount of sodium, potassium, and magnesium, and stuff too, and good monounsaturated fats, and even within the carnivore land thing like Paul Saladino, they’re a fruit, and so they get a wink, wink, nod, nod on that.

Robb: I like trying to find food sources of significant sodium, and this is where I’ll even in. Like when we’re eating lunch, if I’m doing some ground beef or something, I’ll get a little bit of pepperoni or something that has a fair amount of sodium with it, and then I will… It just takes the pressure off of getting all of it from a liquid source. So, I definitely like doing that. Not chugging it is a good idea. Did we miss… Can you think of anything else?

Nicki: Yeah. He mentioned something about taking it with or without water. I’m assuming when he says, “without water,” he means salting food because you can’t swallow a teaspoon of salt.

Robb: Yeah. I will say this, if you’re just putting sodium directly on your mouth, this doesn’t mean that you can’t eat like chicharrones or salt on your food. But a significant amount of just raw sodium on a mucosal membrane is very irritating, so you don’t really want to do that, yeah.

Nicki: Yeah. So, main takeaways, try to get some more from food. Definitely don’t do a big bolus at once. Try to spread it out throughout the day.

Robb: Maybe dilute it more. Yeah.

Nicki: Mm-hmm (affirmative). Okay. And Shaun, let us know if that helps. I think that was our final question this week.

Robb: It was so easy, and I cursed so little.

Nicki: You did. This was not salty at all.

Robb: It can be such a blasé podcast, yeah.

Nicki: I know. We have to do double time next Salty Talk.

Robb: Just really quickly on that. It’s ironic, I noticed this ages ago, I mean, just early internet back in those-

Nicki: The Wild West.

Robb: … blogging. Yeah, the Wild West of the blogging days. But it’s so interesting and you could see this when… Even when I was on Twitter, I virtually never go on there, but you could get these little reports where the engagement and you would say something and you would see both what people liked and then what people unliked, like the positive and the negative. And the funny thing is if something is popular, it is popular in both directions. People both love it and hate it symmetrically.

Robb: Now, sometimes people would like it more and whatnot. Like, I did my best job to answer a question on masks a while back, and I lost my mind and cursed. I think there were some words in there that were non-profanity, but not many. And it had a ton of people that really enjoyed it and appreciated it, and similar number of people that were not down with various elements of it, whether it was the profanity itself or the content of the topic. But it’s just really fascinating to me the way that that plays out.

Robb: It’s also a little bit of an insight into why our world is this like over-the-top circus freak show because the incentives here… We’re trying to reach people, and so I will just about to guarantee you, even though I think quality of content… Today’s show was probably better than that other show. As far as reach, it’s going to be less. And so, if I didn’t have ethics or a soul, I would just go back in and… Well, okay, so in a Pavlovian dog type of deals like, “Well, that shit worked really well so we just need to double down on all of that.”

Nicki: That’s what mainstream media does with all of their headlines and clickbait and only showing negative topics and polarizing topics because that’s what gets people in a fizz and gets more clicks and more shares.

Robb: More shares.

Nicki: So, that’s why we’re in… We haven’t watched it yet, but there’s a new movie out called The Social Dilemma. We’ve been hearing from members in the Rebellion-

Robb: We started it, but we both pulled the ripcord on it because like, “I don’t know if I want to watch it.”

Nicki: It was late in the evening and for me, I don’t think it’s the thing to watch right before bed. Spin me up a little bit.

Robb: You barely can look at me right before I stress you out.

Nicki: But it’s definitely on our list to watch, but just highlights how all of these algorithms, the way that they get the most engagement and the most time on the platform is by making people angry and frustrated and pitting them against each other. And so, then they’re like just… People want to stay online to fight.

Robb: And again, I don’t know, maybe this is trite stuff, but it’s been interesting to me that recognizing… Now, in that response, I was honestly passionate about the topic and sometimes when I get spun up like that, I just get potty mouth. Anything COVID-related masks, it’s just super controversial. It’s virtually impossible to have any type of the discussion around it and whatnot, but I’m still just stunned by the weird incentives that come out of that. I’ve just been tripping out on it, and it’s honestly been this thing where I’m like, “Do I even want to do this anymore? If that’s where the incentives are, if that’s where one achieves success in this brave new world, is this even what I want to do?”

Robb: I don’t know. I enjoy helping people and we get positive feedback all the time, but I’ve got to say that the way that the incentives are set up now, there’s so many difficulties to it. Cry me a river, we get to work from home, we have a great life, my privilege is just showing everywhere, but on the one hand, if I try to have a conversation around something that I feel like is an important topic and least bit controversial, you face the potential just getting your head lopped off by cancel culture.

Robb: And then, the other side of this is that we mainly get rewarded for being over-the-top and being controversial, where it’s just like a journeyman, like, “Well, let’s get in and help the good people of the world.” We just have like a vanilla-flavored show, but there’s good material in it. It’s like a fart while alone. It’s like, okay, that was satisfying for you and no one else. It has no greater impact, no greater significance. It’s just interesting and there’s some element of it that is just modestly disgusting, too, and I’m processing it.

Nicki: We live in a very interesting time.

Robb: It’s a very interesting time for sure. So, I don’t know if any of that was valuable to you folks, if people are still listening, but it’s just an interesting observation.

Nicki: Mm-hmm (affirmative). Folks, thank you so much for joining us with this episode.

Robb: Indeed, we do. I do want to say that. I sincerely appreciate the people, tons of people, particularly the folks in the Rebellion, the folks that follow the podcast. There are a lot of days where I’m just like, “I don’t know if what I’m doing matters at all.” It just so feels like pissing into a hurricane force wind and getting it all blown back on us, but we do get folks that are like, “Hey, this really helped. It helped me. It helped my family or whatever.” And so, we stay in the fight for that.

Robb: So, if this stuff helps you, guys, let us know. We are sometimes operating in a vacuum. And it’s just from a self-preservation, there’s an evolutionary biology piece to this. If somebody is ragging on you or showing ill intent, it’s more important evolutionarily for you to pay attention to that than if somebody is giving you love and props, because if somebody is ragging on you, there’s potential that it’s a threat. So, it just impacts disproportionately, and you take it away disproportionately. So, we really do appreciate you all and stay engaged with us. Let us know what we’re doing well, what things we can improve on.

Nicki: Yeah. And remember to check out our show sponsor, White Oak Pastures, for all your pasture-raised meats. Check them out at whiteoakpastures.com/robbwolf and enter code, REBEL10. You’ll get 10% off your product total for first-time customers up to $100 max discount. Again, that’s whiteoakpastures.com/robbwolf and the code is REBEL10.

Robb: Cool. Thanks, everybody. Thank you, wife.

Nicki: Thanks, hubs.

Robb: Bye.

Nicki: All right. Bye.

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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.