Monthly Archives: April 2014

My “Total Fat Loss Solution” Talk

Seth Roberts died on Saturday, while hiking near his home in Berkeley. Aaron Blaisdell and others have written eloquently of this untimely loss. I’ll write my own appreciation of Seth soon. For now, my prayers and condolences to Seth and his family.

That news dampened my spirits, but some aspects of life go on. For those who are interested in weight loss, today is the day when my discussion of weight loss with Katherine Watkins goes live at her Total Fat Loss Solution summit. Today’s schedule:

Dr Datis Kharrazian:  The Role of the Immune System in Weight Loss Resistance

  • How the balance of bacteria in our gut affects our weight
  • How leaky gut makes it difficult for us to lose fat
  • The contribution of inflammation to weight gain
  • How foods we eat may be causing immune reactions and weight gain

Paul Jaminet:  A Perfect Health Approach to Weight Loss

  • How circadian rhythm disruption may be sabotaging our weight loss attempts
  • The benefits of intermittent fasting for weight loss
  • The optimal amount of exercise for losing fat
  • FREE GIFT – Perfect Health Diet Weight Loss Tips

Sarah Ballantyne:  Paleo, Weight Loss and Health

  • Sarah’s amazing story of how she lost 100llbs twice – the unhealthy and the healthy way!
  • Why the Paleo diet is so good for weight loss
  • How to follow a Paleo diet for healthy and sustainable fat loss
  • FREE GIFT – Paleo Quickstart Guide

This is an all-star lineup. Sarah is the author of the fantastic book The Paleo Approach: Reverse Autoimmune Disease and Heal Your Body. She’s a Ph.D. scientist and one of the smartest and most careful people in Paleo. Datis Kharrazian is the well-known endocrine doctor and author of a popular thyroid book, Why Do I Still Have Thyroid Symptoms? When My Lab Tests Are Normal.

All three talks are free today! To listen, click the image:

Total Fat Loss Solution

A Tale of Two Summits: Weight Loss & Diabetes

I’m delighted to announce I’m a part of two upcoming summits: The Total Fat Loss Solution and The Diabetes Summit. Obesity and diabetes are conditions I’ve been thinking about a great deal in the last year, and also conditions we’ve had great results fighting at the Perfect Health Retreats. So I’m happy to be able to speak about them to a wider audience.

The 11-day 30-presentation Total Fat Loss Solution hosted by Katherine Watkins features me, Dr. Datis Kharrazian, Sarah Ballantyne, Amber “GoKaleo” Rogers, Dr. Johnny Bowden, and many others. There are free presentations each day from April 28 through May 8. My presentation is on the first day, April 28. That’s Monday!

The 12-day 50-presentation Diabetes Summit hosted by Dr. Brian Mowll and Jimmy Moore features me, Dr. Mark Hyman, Dr. David Perlmutter, JJ Virgin, Chris Kresser, Mark Sisson, Jenny Ruhl, and many others. There are free presentations each day from May 5 through May 16. Mine will be the keynote presentation on Tuesday, May 13.

Here is Katherine’s promotional video for the Total Fat Loss Solution:

And here is Dr. Brian Mowll’s promotional video for the Diabetes Summit:

Incidentally, I’ve written an ebook on how to lose weight healthfully, and that will be offered as a free giveaway to those signing up for our newsletter, which is coming soon. Keep an eye out for it!

Happy Easter!

On the third day the friends of Christ coming at daybreak to the place found the grave empty and the stone rolled away…. [T]hey hardly realised that the world had died in the night. What they were looking at was the first day of a new creation … and in a semblance of the gardener God walked again in the garden, in the cool not of the evening but the dawn.

~ G.K. Chesterton, The Everlasting Man

In honor of the dawn, Bach’s Easter Oratorio:

Vitamin C: Should you take it before and after surgery? Part 2

In Part 1, we found that taking vitamin C after orthopedic surgery is a good idea, and that vitamin C could help in other surgical situations as well. But that’s only half the story. Here’s the other half.

Vitamin C as a prooxidant?

The world of vitamin C was tipped upside down in 1998, with the publication of a controversial paper in the prestigous journal Nature entitled “Vitamin C exhibits pro-oxidant properties”. News media was all over it, predictably warning readers to be afraid…very afraid of taking vitamin C supplements. But the paper had a lot of holes, to put it mildly.

The study showed that some DNA was oxidized by vitamin C, but some DNA was also protected from oxidation by vitamin C (with the protection being around ten times greater in magnitude! A fact that was conveniently left out of the paper.). Plus the experimental technique may have oxidized some DNA by itself. So what happens when throngs of angry vitamin C supporters wrote in to the journal? The primary author backtracked, and his reply concluded “our study shows an overall profound protective effect of this vitamin.” Case closed. Or is it?

IRONing out the details…

Vitamin C is neither always an anti-oxidant or always a pro-oxidant, and not all studies are applicable to what goes on in your body. Take lab mice for example. Unlike humans, mice can synthesize vitamin C, and supplementation can paradoxically reduce their vitamin C levels. In humans, study results are mixed, with most showing either an anti-oxidant effect or no effect, and some showing both anti and pro-oxidant effects. Timing could also be an issue. In a study where vitamin C was added before LDL was experimentally oxidized, it displayed antioxidant properties. But vitamin C actually showed prooxidant properties when added AFTER the LDL was mildly oxidized. So what does this mean for surgery?

First things first: if you have iron overload (for example, due to hereditary haemochromatosis), be careful with high doses of vitamin C, especially during times of surgery. Unbound iron can interact with vitamin C to produce oxidative stress. Iron is typically bound to transfer proteins and largely safe from vitamin C, but a portion of iron stores may be released when tissue is injured and blood vessels are compromised. And when is a large mass of tissue injured? Surgery!

For people without iron overload, the implications of iron and vitamin C interactions are not so clear. There doesn’t seem to be much data about the interaction of vitamin C and iron during the surgical and post-surgical period. In vitro and trial evidence conflicts on whether vitamin C protects or chemically reduces (i.e. harms) iron in humans, and evidence is also mixed on whether vitamin C protects or occasionally causes protein glycation. Vitamin C can have differing effects on oxidation of depending on the target (lipids, proteins, or DNA) as well.

So the takeaway here may simply be: avoid taking supplements that contain iron and too many iron-enriched foods around surgery time (unless you are advised to by your doctor), and don’t go much beyond the PHD-recommended vitamin C intake. If you have a crappy diet and think vitamin C will save you, be careful. Overloading on vitamin C after tissue components are already oxidized could theoretically lead to further oxidation.

Crohn’s and Ulcerative Colitis

Crohn’s and ulcerative colitis patients often take vitamin C in combination with iron for anemia. That might be a bad idea, as high doses of iron worsen symptoms in Crohn’s patients. Even a single high dose of iron can cause intestinal lining oxidative damage in healthy individuals, and supplementing with quite small amounts of vitamin C and iron together leads to oxidative damage. Iron-enriched diets increase colon cancer in mice and injected vitamin C combined with iron causes ulcers in rats.

The combination of vitamin C, certain metals, and hydrogen peroxide makes up a free-radical generating process called the “Udenfriend system”. Diseased tissue, such as the intestinal tissue in bowel disorders, may contain higher levels of these components. While some in vitro studies show that the Udenfriend system is NOT your friend, others show that it doesn’t cause lipid or protein oxidation in vivo. Without a conclusive answer, it might be prudent to avoid going overboard with vitamin C and iron if you have Crohn’s or UC, especially around surgery.

Other surgeries

There are many different surgeries for many different conditions, and vitamin C hasn’t been studied for most specific examples. One type of surgery that there is evidence for is vascular surgery. In a randomized trial of vascular surgery patients, 2 grams of prophylactic vitamin C was tested for the purpose of decreasing inflammation and tissue damage. It ended up actually increasing oxidative lipid damage, which can lead to further vascular damage. Cardiac surgery can cause tissue injury when blood supply returns after a period of low oxygen. And guess what else happens when blood returns? Extra iron is released from storage, and this iron can theoretically be reduced (damaged) by vitamin C.

Conversely, vitamin C has shown promise for other surgeries. In a study of GI surgery, post-surgical oxidative stress was reduced by taking 500 mg/d of IV vitamin C. Note that IV vitamin C can lead to more than six times higher blood levels than oral intake. Since vitamin C is consumed at high rates during some surgeries, this effect seems logical, and certain patients may be very low in vitamin C before surgery and hence really need a vitamin C boost. Most often, studies combine a few antioxidants rather than testing just one, which makes singling out the effect of vitamin C difficult.

Physical therapy

In some surgeries (e.g. orthopedic surgery), surgery is only the beginning of the treatment. The rest of the treatment comes in the form of grueling, sometimes scream-inducing physical therapy that can last for weeks or months. Since muscles atrophy if a body part isn’t used much before surgery, the post-surgical period is important for muscle growth.

While vitamin C is important for joint healing, there is a small amount of evidence that vitamin C supplementation can interfere with muscle growth. And physical therapy is a combination of growing muscle, healing joints, and re-training the nervous system.

Reactive oxygen species (ROS) are not universally bad, and one of their important functions is to signal the body to increase protein synthesis as part of the mTOR pathway. Vitamin C in extremely large doses inhibits muscle growth (in rats) by quenching not just bad ROS, but helpful ROS as well. In humans the effect is uncertain, as the impact of supplemental vitamin C varies widely by study. Given the importance of vitamin C in wound healing and collagen formation, it’s likely unwise to avoid vitamin C in the post-surgical period. The takeaway may be to avoid massively overloading on antioxidants in general — large amounts of antioxidants other than vitamin C may impair muscle adaptation to exercise. And taking vitamin C to bowel tolerance directly after physical therapy may be both uncomfortable and unwise.


A healthy diet should support the entire endogenous oxidative system, as antioxidants often work together. So as usual, focus on getting a balance of nutrients from your diet, especially before and after surgery when nutrition is critical for healing tissue.

Vitamin C intake should be at least 500 mg/d after surgery in order to avoid the terrible pain condition RSD/CRPS. Moderate doses of vitamin C typically show benefit for oxidation, and are likely helpful before and after surgery. Only very high doses over extended periods or extremely high IV doses have been linked to adverse events like renal failure, and vitamin C studies typically only show prooxidative effects when combined with iron supplementation or in higher doses.