Functional Medicine Costa Rica https://functionalmedicinecostarica.com Jungle Anti-Fragility Tue, 09 Jul 2019 13:37:02 +0000 en-US hourly 1 https://wordpress.org/?v=5.1.1 Lifetime Natty – Does It Matter? https://functionalmedicinecostarica.com/lifetime-natty-does-it-matter/ Wed, 04 Jul 2018 18:19:13 +0000 https://fmcrprod.wpengine.com/?p=5582 Does lifetime natty really matter?

Probably.

Is there a threshold of anabolic steroid use that alters myogenic potential forever?

It looks like Yes, but forever is a long time.

Does resistance training and anabolic steroid use have an additive or even synergistic effect on myogenic potential?

Likely, but we do not have the data in humans, nor do we know if this is a threshold or a gradient-like effect.

 

To begin to delve into this somewhat esoteric BRO topic let’s hit 5 or so intertwining points.

 

  1. “Testosterone-induced muscle fiber hypertrophy is associated with a dose-dependent increase in myonuclear number…Muscle growth during postnatal development or hypertrophy is dependent on the addition of myonuclei to muscle fibers”

-Sinha-Hikim et al. 2003

 

  1. “Satellite cells appear to be crucial to maximizing the hypertrophic response to resistance training. The primary role of satellite cells appears to be their ability to retain a muscle’s mitotic capacity by donating nuclei to existing myofibers.
  2. Satellite cell function might be particularly important in well-trained people because the size of myofibers would necessarily reach the upper limits of their myonuclear domain (maybe a threshold of 26%).
  3. Myonuclei are maintained over time even after long periods of detraining and the corresponding muscle atrophy.”

-Dr. Brad Schoenfeld – Science and Development of Muscle Hypertrophy

 

  1. “Prior steroid exposure conferred a distinct advantage to the muscles, with a 44% increase in CSA rather than the 17% increase observed in controls. These benefits were not transient. When the muscles were induced to hypertrophy 3 months after steroid treatments had ended (the mouse equivalent of 10 years of human lifespan), the steroid-treated group displayed a 31% increase in CSA compared to a modest 6% in placebo controls. Taken together, these data suggest that: (1) once you acquire a myonucleus, it is essentially permanent; and (2) more nuclei translate into greater capacity for regrowth, which presumably translates into enhanced muscle strength and/or speed.”

-Schwartz 2013 The Journal of Physiology

 

Now that we have that we have covered those topics we can start to look at the data we have in humans, unfortunately all untrained which is a huge asterisk.

“Significant increases in satellite cell number were observed only in men who were treated with supraphysiological doses of testosterone enanthate.”

-Sinha-Hikim et al. 2003

However, this was WITHOUT resistance training and the 125 mg per week group (around a TRT dose) did not see a significant hypertrophic response, nor did they see changes in satellite cell number.

Which leads us to two intersecting pretty big questions that I can only speculate about in humans.

  1. Does lower dose anabolic steroid use combined with resistance training increase myonuclei and satellite cell number more so than resistance training alone? Given the animal data I would guess there is an additive, maybe even synergistic effect (we do see an additive effect on muscle hypertrophy). I don’t believe we have this study in humans, but if someone knows about it please send it my way.
  2. The next jump is where things get really interesting to me. We know guys get more jacked when they get on higher doses of gear (average bodybuilder dose is 1100 mg per week) and lift weights. That is a duh. Maybe not so duh is that they have also likely raised the ceiling on their muscle building potential forever (through increased myonuclear potential and perhaps also through epigenetic memory). This may ruffle your feathers if you are an anti-doping purist. BUT, if we do see an additive/synergistic effect of testosterone on myonuclear potential at the higher end of physiological, when combined with resistance training this all of a sudden makes the time frame of the mid-teens to early twenties where testosterone tends to top out really really important. You don’t lift hard in that age range and you potentially miss out on laying down the myogenic potential for later in your training career. Maybe, but a lot of us do see this anecdotally in trainees who find resistance training much later in life, some of them just can’t seem to put on the same degree of muscle we would expect, granted there are a tons of factors involved here the biggest likely being effort over time and a lack of grit, but this idea of critical period of myogenic potential is extremely interesting to me.

The next study is an RCT by Kvorning et al. which is pretty much the complete opposite of the study above. These researchers suppressed endogenous testosterone production and then put participants through eight-weeks of strength training (pretty high volume bodybuilding program).

Yea…I am not signing up to have my testosterone floored to less than a tenth of what it was, BUT interestingly, these untrained (20ish% body fat) dudes still saw lean muscle mass gains even with testosterone smashed at or below 50 ng/dL and they also showed the same improvement in 10RMs as the group that had un altered testosterone concentrations that held in the mid-physiologic range.

The suppressed testosterone group did gain fat while the placebo lost fat, but we cannot conclusively say that this was all the result of testosterone, as estrogen, thyroid, and energy balance all come into play (this study did not have any dietary controls in place which is a huge red flag when looking at the body comp data). However, the seminal data from Bhasin et al. (without a resistance training arm) showed similar increases in body fat changes at the lower doses of testosterone while combined muscle loss (Data Below) which looked to be not only attenuated, but increased by resistance training in the current study.

Kvorning et al. also analyzed satellite cell number in these subjects and BOTH groups significantly increased their satellite cell pool with no significant differences between groups.

However, only the placebo group showed a significant increase in myonuclear number in Type II fibers with no change in either group for type 1 fibers.

It is very interesting to read both of these papers because they are written in very a positive light towards testosterone, when the findings are in fact somewhat lackluster, and definitely not blow out wins especially inside of physiologic ranges.

If you put this together with the research on hypertrophy rates and hypertrophy potential of males vs. females it doesn’t really appear that changes in testosterone within the physiologic range have that big of an effect size on the ability to put on muscle at least in untrained subjects. We also do not know if this effect is independently additive (1+1=2) or synergistic (1+1=10). I would guess IF there is a synergistic effect on muscle hypertrophy between testosterone and resistance training it lies in myonuclear potential and the increase in the ceiling of which someone can hit, BUT we still need more research. And we desperately need research in trained subjects where all these annoyingly meticulous details likely have a more pronounced effect in wringing out the last percentage points of one’s genetic potential.

Until then LIFT because regardless of your gender, age, or sex hormone status it just WORKS. And with an estimated 91% of Americans being overfat and severely under-muscled we evidently have a lot of WORK to do.

References:

  1. Bellamy LM, Joanisse S, Grubb A, et al. The acute satellite cell response and skeletal muscle hypertrophy following resistance training. PLoS One. 2014;9(10):e109739.
  2. Egner IM, Bruusgaard JC, Eftestol E, Gundersen K. A cellular memory mechanism aids overload hypertrophy in muscle long after an episodic exposure to anabolic steroids. J Physiol. 2013;591(24):6221-6230.
  3. Kvorning T, Andersen M, Brixen K, Madsen K. Suppression of endogenous testosterone production attenuates the response to strength training: a randomized, placebo-controlled, and blinded intervention study. Am J Physiol Endocrinol Metab. 2006;291(6):E1325-1332.
  4. Kvorning T, Kadi F, Schjerling P, et al. The activity of satellite cells and myonuclei following 8 weeks of strength training in young men with suppressed testosterone levels. Acta Physiol (Oxf). 2015;213(3):676-687.
  5. MacKrell JG, Yaden BC, Bullock H, et al. Molecular targets of androgen signaling that characterize skeletal muscle recovery and regeneration. Nucl Recept Signal. 2015;13:e005.
  6. Murach KA, Englund DA, Dupont-Versteegden EE, McCarthy JJ, Peterson CA. Myonuclear Domain Flexibility Challenges Rigid Assumptions on Satellite Cell Contribution to Skeletal Muscle Fiber Hypertrophy. Frontiers in physiology. 2018;9:635.
  7. Schwartz LM. Muscle nuclei remember to cheat death. J Physiol. 2013;591(24):6133-6134.
  8. Serra C, Tangherlini F, Rudy S, et al. Testosterone improves the regeneration of old and young mouse skeletal muscle. The journals of gerontology Series A, Biological sciences and medical sciences. 2013;68(1):17-26.
  9. Sinha-Hikim I, Roth SM, Lee MI, Bhasin S. Testosterone-induced muscle hypertrophy is associated with an increase in satellite cell number in healthy, young men. Am J Physiol Endocrinol Metab. 2003;285(1):E197-205.
  10. Thorley M, Malatras A, Duddy W, et al. Changes in Communication between Muscle Stem Cells and their Environment with Aging. J Neuromuscul Dis. 2015;2(3):205-217.
  11. Yu JG, Bonnerud P, Eriksson A, Stal PS, Tegner Y, Malm C. Effects of long term supplementation of anabolic androgen steroids on human skeletal muscle. PLoS One. 2014;9(9):e105330.
  12. Zeng F, Zhao H, Liao J. Androgen interacts with exercise through the mTOR pathway to induce skeletal muscle hypertrophy. Biol Sport. 2017;34(4):313-321.
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Intermittent Fasting – How I Really Feel. https://functionalmedicinecostarica.com/intermittent-fasting-how-i-really-feel/ Mon, 04 Jun 2018 20:56:13 +0000 http://fmcr.wpengine.com/?p=5515

If one more person asks me about intermittent fasting, I may never eat again.

If someone comes up to me at a conference and asks, “Hey, have you heard about intermittent fasting?” I might just stare at them until they walk away, or I’ll play dumb…“What’s that? Please tell me all about your confirmation bias and the magic of not eating.”

I guess if you are after weight-loss, not eating could be magic. Some really, really big Scottish dude did it for over a year, lost two of himselves, and took a shit once per month. Sounds like a great time.

In all honesty, I like when I get emotional about topics. I don’t try to sugar coat anything. So let’s go for the jugular of intermittent fasting even though I really don’t care what they hell you eat or when you eat it.

If you are after weight-loss in a complex obesogenic food environment, then perhaps encountering food less often is a good idea. BUT, if anything, the eating frequency research (this was my dissertation topic so please don’t try to argue with me on this) tends to lean in the direction of higher eating occasions for weight loss in the general population (albeit not strongly). If intermittent fasting had such powerful food voodoo, we would not expect this out of those useless meta-analyses. In the equally useless RCTs, IF and Alternate Day fasting do not seem to outperform continuous caloric restriction for weight loss or changes in insulin sensitivity.

That’s not to say that not eating sometimes does not work; it just doesn’t work any better than eating less, most of the time.

Not sure what I am talking about – read Why Your Stupid Diet Is Stupid. The trump card for metabolics in unhealthy humans is pulling energy through the system and getting out of a state of over-nutrition.

Also, we have to take into account that fasting looks a lot like disordering eating, and what I have found is that people don’t have time to eat, and all of sudden they start justifying their fucked up schedule with cherry picked intermittent fasting google searches.

“I wake up, drink some coffee, drive to work, pound away at my computer, and then eat spoonful of almond butter at 3 pm. It’s delightful. I then eat a piece of lettuce at 5. I am so happy. Have you tried intermittent fasting? I’m pretty sure it would work perfectly for you…and HIIT – have you tried that? Together they are extra magicful.”

Fuck you. You forgot about all the times you accidently fell into a pool of queso…I just couldn’t say no…yeah, because you are literally starving.

If you are an untrained sedentary human, it honestly doesn’t really matter what you choose to do with food quantity, quality, or timing, if you are not going to lift and get off your ass. Humans just can’t seem to regulate low energy intake and low energy expenditure. We aren’t wired that way.

But But… intermittent fasting is related to increased longevity!

Yes, cells and animal models tend to live a little longer when they don’t eat enough, and I am not against the occasional fast to increase metabolic flexibility, but why would you think not eating would turn you into Wolverine? Talk to Dr. Mike T Nelson about this topic. He is loaded with great ideas.

Still not buying it? Please send me a 50-year longitudinal trial on fasting and all-cause mortality in humans. Yes, Longo’s studies are cool, and I enjoy reading them. But, long-term human trials don’t exist, and the idea that a 10% caloric restriction will increase lifespan in humans has been dug into by Dr. Brad Dieter at length. Besides not eating enough forever sounding terrible and being a giant unknown, it seems to be directly inverse to putting on muscle and being strong; two of the most important factors determining longevity.

To this end, I am unaware of any study in trained subjects (like really trained) showing positive muscle gain while intermittent fasting (if you have one, please send it to me; I would love to read it – maintaining LBM 100% possible). (Again not to be a dick, but I just don’t really find research in baby humans becoming less baby that interesting as everything seems to work in that population.)

I reviewed a recent 2016 study on IF here in trained subjects in which no one really gained muscle, and training volume was pretty damn low. Even then, the authors spun these lackluster findings into pure fasting gold.

For putting on muscle, I am with the majority of the nutrition community who really lifts and advocate four eating occasions per day with adequate protein at each eating occasion (at least 0.2ish g/lb). Three eating occasions might cut it, and two is probably less better. I also think this probably becomes even more important as you get further along the training continuum.

Again, if you are 30% body fat, strap your pedometer to your dog, and still buy Cheez-Itz, I don’t care what you can do with nutrition as long as you can do it forever.

Now, if you are a jacked human trying to get more jacked, I am into you. There is no reason to beat around the bush; I think you are verrrry nice. I dig your Christmas tree and your effort. Thank you.

So let’s play out what 3,300 kcals looks like in “Clean Food” at macros no one will put up a hissy fit about.for a 190ish pound jacked male at a healthy 9-14% body fat.

Macros: ~190-200 PRO ~375 CHO ~115 FAT

Total Food for the Day:

15 ounces of Lean Protein (Chicken Breast, Turkey Breast, or Fish – Steak one to two times per week.)
1.5 Scoops Protein Powder
45 oz of Sweet Potato, 35 oz White Potato or Brown Rice, 28 oz of White Rice or Plantains, or 21 oz of Yucca
4 Servings of Fruit
7 TBS of Oil
10 to 12 serving of Vegetables (at least 1.5lbs)

Just try to fucking eat that in two eating occasions. Seriously try.

Three. No problem.

Four. Easy work.

So why would you make it harder on yourself for literally no reasons?!

Intermittent fasting will likely make you undereat (especially if you eat well), and 3,300 kcals isn’t even that high for dudes I deal with. If you are an advanced or working on being advanced trainee, being in a kcal excess is likely a necessity for putting on more muscle mass, so intermittent fasting is likely in direct opposition to your ultimate goal. Being more bigger.

Again, if you want to get better at spinning around in the park on one leg, I don’t fucking care, please don’t eat.

But, I’m Keto…

Make it stop.

Well, now you are playing with multiple unknowns. Can one put on muscle on extremely low carbohydrate intakes? I would actually guess it is possible, and I am not really averse to Keto at all. I just again don’t think there is any magic there, and the majority of the population doesn’t seem to be able to adhere long-term, and it is insanely socially isolating for most.

Also, carbs are delicious, and if you don’t have them, you may not eat enough food/energy, again shooting yourself in the foot. Besides not having delicious carbohydrates, Keto may have an appetite suppressing effect. Just look below, I don’t want to eat that, so an attribute that might be helpful in the gen pop is shooting you in the foot…again.

Macros: ~150-160 PRO ~50 CHO ~275 FAT

Total Food for the Day:

15 ounces of Lean Protein (Chicken Breast, Turkey Breast, or Fish – Steak one to two times per week.)
20 TBS of Oil or 3 pounds of Avocado
Vegetables 1.5lbs of Non-starchy Vegetables

Sounds amazing, doesn’t it? Yes, I understand you could take out the oil and get all YOLO with fattier meats.

But, bro you don’t understand me. I am a Keto-Vegan Intermittent Faster because life isn’t hard enough as it is.

Macros: ~150-160 PRO ~50 CHO ~275 FAT

Total Food for the Day:

6 Scoops of some Chalky Ass Vegan Protein Powder
20 TBS of Oil or 3 pounds of Avocado
Vegetables 1.5lbs of Non-starchy Vegetables

You could probably fit a few ounces of beans in there somehow, but I just can’t appease you.

Humans love to be martyrs with their diets. The harder it is, the better that diet must be!

Just keep stacking fad dietary rigidities on top of each other, eventually you will be so micronutrient and calorie deficient you will likely believe your own bullshit. (If someone was really about it, I could probably make all of these scenarios work with supplements)

Focus on the fundamentals. Eat real food. Move. Sleep. Lift. And groom other humans you care about, and stop asking other people about what and when they are not going to eat.

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Moderation is Death Part 2 https://functionalmedicinecostarica.com/moderation-is-death-part-2/ Mon, 28 May 2018 23:59:01 +0000 http://fmcr.wpengine.com/?p=5483 “Moderation is death.”
-Dan Millman

“Everything in moderation, including moderation.”
-Oscar Wilde

The only thing that yells at me in these sentences is Alcohol. I have an extremely addictive personality so when people try to tell me moderation is the key to nutrition and life, I throw up in my mouth and swallow it down, instead of hack it on the sidewalk. We wouldn’t want anyone in our band of 7 billion crazies to get too uncomfortable.

My wife can moderate everything. It just works for her.

Me not so much, especially in certain environments. I can moderate food pretty well even in the worst of circumstances, but exercise and drugs…no chance. I’ve swallowed painkillers to work out more times than most people have worked out. I’ve been drunk for days across different city skylines, trying to keep it all going on a Tuesday just because I was afraid of the silence at the end.

I don’t regret either and if it weren’t for Steph, The Puppies, Zazen, Training, and a Purpose bigger than myself I would likely be perpetually pinballing around in the flashing lights of the mesolimbic dopamine system.

It’s one of the reasons we live in the Jungle. It is 15 minutes down a jagged mountain road to get anything. And that anything is hella limited. The environment makes us plan.

And…”You are always smarter in advance.”

Thus, if you get to the weekend without a plan and you end up at a bar mindlessly eating food you don’t need with people you don’t like AND you use the excuse, “Well, moderation is the key to whatever I WANT right now.” I get it. 100%. No judgement. I’ve been there.

It will forever be the easier choice and you aren’t going to make a better one if you keep putting yourself in the same environments, where you have the same thoughts and inevitably make the same decisions, and justify it with the same bullshit internal monologue of moderation.

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Adrenal Burnout…Ha https://functionalmedicinecostarica.com/adrenal-burnout-ha/ Mon, 28 May 2018 23:53:28 +0000 http://fmcr.wpengine.com/?p=5480 Adrenal Burnout/Exhaustion is a laughably simple explanation for fatigue, but go head keep spitting in tubes and pounding those unregulated cattle glandulars because utilizing an imprecise marker that doesn’t even correlate with your outcome, and then adding more cortisol to an insanely complex system that might just want low cortisol sounds like a great idea.

Even giving hydrocortisone isn’t recommended or supported by the peer-reviewed literature.

However, initial RCTs involving Rituximab, a B-cell depleting agent and fecal microbiome transplants have resulted in highly positive findings and are both undergoing larger trials.

Hmmm, go figure targeting the immune system likely works better than just trying to replace what might or might not be low.

“The stress crash theory that HPA axis hypofunction drives the activation of immune-inflammatory pathways in chronic fatigue syndrome cannot be validated…

Findings show that activation of immune-inflammatory and oxidative and nitrosative pathways in chronic fatigue syndrome are probably not secondary to HPA axis hypoactivity…

The downregulation of the HPA axis in the face of a chronic inflammatory environment is well documented. The HPA axis becomes hyporesponsive following prolonged exposure to the cytokines, and this adaptation occurs relatively quickly. There is now considerable evidence supporting the view that the hypofunction of the HPA axis seen in these diseases is driven by chronic inflammation caused by systemically elevated levels of pro-inflammatory cytokines.”
-Morris et al. 2017

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Practice? https://functionalmedicinecostarica.com/practice/ Mon, 28 May 2018 23:44:38 +0000 http://fmcr.wpengine.com/?p=5477 Like school, lifting can turn into endless practice and most humans are dying for the bell to ring.

Endurance exercise has games. They have competitions. They have social events with other humans that result in running across a finish line and feeling a sense of pride and accomplishment. The Couch to 5k ideology has play.

What do we have in weightlifting?

We have Powerlifting, Oly, and Strongman competitions which are actually generally extremely uplifting, supportive, and powerful.

But, most of the general public isn’t really interested in 1RMs and if we are playing the risk vs. reward game this probably shouldn’t be our first choice unless they fall in love with either of these sports.

We have bodybuilding which is an absolutely amazing and courageous feat of effort and will. Having the grit to walk on stage, almost naked and be judged by others. Damn. But, getting that low in body fat percentages brings with it a host of hormonal compensations and perhaps eating behaviors that the gen pop and coaches should not take flippantly.

We have CrossFit which can be done really really well or can be done grotesquely with graveyards full of caring mothers and fathers that just couldn’t cut it. It is a social structure in a world that has never felt so alone. It has its own language and is the most addictive substance next to black tar heroin.

But, what can you do for your clients as a coach if they and you have no interest in these type of competitions?

Enter the 1 and 3 Round Cajuns from MASS2 by Dr. Pat Davidson

20 sec On 40 sec Off with the goal of 10 reps per Round.

5 exercises with 4 min rest between rounds (if someone is new new they won’t need this much rest and it might bore them).

We generally use:

TB DL
Barbell Bench
Strict PullUp
Back Squat
Incline DB Bench

But, there are so many other combinations you could play with, another pull instead of two pushes, Front Squats, Belt Squats, Bulgarian split squats, etc.

Make it as safe as possible with exercise selection.

Let them walk out to their favorite music and just let it rip.

Track how much weight they lift each time so they can watch it climb.

Make it as much like game day as possible. Buy them eye black or set the weights up in a ring and have a real bell. There are so many ways to elevate the moment and break up the beautiful monotony that is training.

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Thyroid and Iron Status https://functionalmedicinecostarica.com/thyroid-and-iron-status/ Mon, 28 May 2018 23:40:48 +0000 http://fmcr.wpengine.com/?p=5475 The addition of iodine to tyrosine residues on the thyroglobulin protein is catalyzed by a heme-containing enzyme called TPO which utilizes H2O2 in the oxidation reaction.

What that means in English…slapping iodines on the backbone of thyroid hormone requires an enzyme that needs iron (heme) and involves playing with fire (H202 = Free radical). Thus, anemia or low iron and low thyroid hormone status is an absolute mess that is going to spin out into every system.

Combine the above mess with chronic inflammation which dysregulates pretty much every step of thyroid synthesis/conversion and a beat up antioxidant system and you are going to induce a tidal wave of compensations over time.

The antioxidant system needs adequate vitamin C and E, and also zinc, copper, manganese, iron (again), selenium, magnesium, and amino acids (protein) to synthesize glutathione and then a bunch of the former to recycle it effectively.

So if you are flippantly vegan and low on damn near every nutrient that humans need to spin these biochemical cycles, it isn’t a matter of if you are going to have problems, it is just a question of when they will become so bad that you notice them.

The thing is you don’t need any fancy expensive nutrient tests (that probably don’t measure anything of worth anyways) to act and you don’t have to be vegan or vegetarian to be low in any of the above nutrients.

To start, just put your average dietary intake into chronometer and see what happens.

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Maybe we are evolved to laugh. https://functionalmedicinecostarica.com/5472-2/ Mon, 28 May 2018 23:38:18 +0000 http://fmcr.wpengine.com/?p=5472 Maybe we are evolved to laugh.

“The evolution of bipedal locomotion freed the respiration system of its support function during running, permitting greater breath control and the selection for human-type laughter (a parsed exhalation), and subsequently the virtuosic, sustained, expiratory vocalization of speech. This is the basis of the bipedal theory of speech evolution.”
-Provine et al. 2017

Laughter is contagious within a group and seems to be a vitally important social means of communicating. It bonds groups, breaks down barriers, and generally signifies safety. It also feels good. We crave it from somewhere old and deep inside.

“Social laughter increased pleasurable sensations and triggered endogenous opioid release in thalamus, caudate nucleus, and anterior insula.”
-Manninen et al 2017

You hopefully didn’t need science to tell you that it is enjoyable and addictive to laugh with friends.

But, what about when laughter seems to have the opposite effect?

Insecure, anxious, fear-based laughter.

My face hardens just thinking about it. Awkward laughter filling silence visibly irks me. If a stranger does this, I won’t even smile, as I want to end the conversation as quickly as possible. I tend to be gruff, curt, maybe even crotchety, and generally won’t partake in empty conversations that aren’t hilarious. Take it or leave it. I am direct. That does not mean I do not care immensely about those within my band, quite the opposite. Being able to curtail relationships I know will be one-sided and drain me allows for more effort in win-win relationships.

If I am in a consult and a human does this repeatedly, I know they are starved for a social group. They are starved for real connection with other humans. I will generally smile, but am much more cautious with this human in the tone and amount in which I converse with them, as they have the potential to cling.

Remember high school?

Nothing kills a relationship like desperation.

So if you are one of these humans who is afraid of silence and craves real connection, you need to do some serious internal work. That could be meditation, it could be therapy, or both, but until you make this happen, you are subconsciously communicating distress, neediness, and damage to the group.

Humans recognize sleep deprivation and physical ill-health subcortically within milliseconds, and the instinct is stay away. My guess is the same goes for those bumbling, shaky, half giggles to needlessly punctuate a perfectly normal question.

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Because they all died. https://functionalmedicinecostarica.com/because-they-all-died/ Mon, 28 May 2018 23:37:23 +0000 http://fmcr.wpengine.com/?p=5470 My grandfather was a marine. He was drafted when he was 18. His platoon was on the frontline of the Korean War, fire fights back and forth over the 38th parallel. I only know bits and pieces of the horror my grandfather saw, and nothing from his own words.

I remember being a small child and staring up at the flags flapping in the wind. They were everywhere. Stuck to trucks, thermoses; they lined the lawn. His car horn could play the marine corp hymn and my little fingers loved to push that magical button. I remember the way he sat on his bar stool and sipped coffee and vodka. I also remember that he didn’t have any marine friends.

Because they all died.

My grandfather and four other marines piled their fallen friend’s dead bodies on top of themselves and hid under them for two days until the allied troops retook the line.

My grandfather re-integrated into society, but he had gone through the hardest ordeal a warrior can – to survive the death of all of his brothers. Faces forever burned into the back of his mind. Only 5 lived out of his entire battalion. He had night terrors and lost his temper. He had long-term PTSD, never sought treatment, and his stoic nature is something I will always admire.

But, therein lies the problem for many vets. We have Memorial day because we don’t really want to hear about war the other 364 days out of the year.

We have quarantined death to assisted living centers, and quarantined our wars to faraway lands against terrorists, rebels, insurgents, radicals, sub-humans. We are thankful for their service against these forces we don’t want to understand, but hesitant to reintegrate these humans back into our modern, comfortable, civilized society, to give them meaning instead of thanks.

My grandpa was lucky. He became an electrician and he was almost never alone. He was on the job and he fished through the silence on the weekends. He provided for his family and he loved the best he could.

And he won the hardest battle of them all, finding some semblance of meaning after war.

“Shared public meaning gives soldiers a context for their losses and their sacrifice that is acknowledged by most of the society. That helps keep at bay the sense of futility and rage that can develop among soldiers during a war that doesn’t seem to end. Such public meaning is probably not generated by the kinds of formulaic phrases, such as “Thank you for your service, ” that many Americans now feel compelled to offer soldiers and vets. Neither is it generated by honoring vets at sporting events, allowing them to board planes first, or giving them minor discounts at stores. If anything, these token acts only deepen the chasm between the military and civilian populations by highlighting the fact that some people serve their country but the vast majority don’t.”

-Sebastian Junger – Tribe – Read it Today.

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Sweating Out Toxins? https://functionalmedicinecostarica.com/sweating-out-toxins/ Mon, 09 Apr 2018 22:22:31 +0000 http://fmcr.wpengine.com/?p=5303 We are all toxic. Period. Breast milk, fetal core blood, meconium all contain toxins, and lots of them.

“Commercial chemical production has risen from 1 million tons in 1930 to 400 million tons in 2001. As of 2012 the number of industrial chemicals on the global market was estimated to be around 143,835.”
-Bijlsma et al. 2016

Think it is all pseudoscience bullshit and that the cumulative effect of these compounds doesn’t matter, read the 150 page report from the Endocrine Society’s 2015 Scientific Statement on Endocrine-Disrupting Chemicals.

“Significant mixture effects are observed when chemicals are combined at concentrations that individually do not induce observable androgen receptor antagonistic effects.”
-Otron et al. 2014

Saunas seem to have spiked in popularity of late and I really really love when people do science math and argue in peer-reviewed journals.

“We have previously reported that the total POPs concentration derived from the sum of PCBs and organochlorine pesticides in individuals with obesity is approximately of 600 μg/kg lipids. Knowing that clean sweat, e.g. with no epidermal contamination, contained 0.08 μg/mL of lipids, it is estimated that 4.8 × 10−8 μg of POPs would be contained per ml of clean sweat. An individual losing 1 L of sweat per day (double the mean rate of insensible or perceived perspiration) would eliminate approximately 4.8 × 10−5 μg of POPs. Based on the occurrence of non-dioxin-like PCBs in food products consumed in The Netherlands that were collected in measurement programs carried out during 1998 and 1999, reported that the estimated median lifelong-averaged intake of the measured PCBs was 5.6 ng per kilogram body weight per day. This would correspond to an estimated daily ingestion of 0.392 μg of PCBs for an individual of 70 kg. If one assumes an additional 1 L per day of sweat loss during physical activity, the total amount of POPs excretion via sweating would amount to 9.6 × 10−5 μg per day; corresponding to less than 0.024% of daily PCBs intake…based on our estimates, POPs excretion via sweat is negligible.”
-Imbeault et al. 2018

“Induced perspiration does not seem to hasten the clearance of any of the common PFCs (perfluorinated compounds)—PFHxS (perfluorohexane sulfonate), PFOS (perfluorooctane sulfonate), or PFOA (perfluorooctanoic acid)—from the human body. Induced perspiration does appear to hasten the elimination of some, but not all, PCB (polychlorinated biphenyls) congeners from the human body.”
-Genius et al. 2013

So are saunas bullshit?

Maybe for lipophilic POPs, but before we drop the hammer, it looks like there is a lot more math to do.

“Sweating deserves consideration for toxic element detoxification.”
Sears et al. 2012

“DDT, DDE, DDD, methoxychlor, endosulfan sulfate, and endrin appear to be readily excreted into sweat, induced perspiration appears to be a potential clinical tool to diminish the body burden of these agents.”
-Genius et al. 2016

“Some parent phthalate compounds and metabolites appear to be readily excreted in sweat; others do not.”
-Genius et al. 2012

“Induced sweating appears to be a clinically useful tool to facilitate the release of BPA through the skin in order to eliminate this toxicant from the human body.”
-Genius et al. 2011

A lot of these resources were pulled from Dr. Bryan Walsh’s detox presentation last month in the Jungle. He has an online course on the topic as well.

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The Anecdotal Bro-on-Bro Sewer World https://functionalmedicinecostarica.com/the-anecdotal-bro-on-bro-sewer-world/ Wed, 04 Apr 2018 12:48:43 +0000 http://fmcr.wpengine.com/?p=5265

Yesterday, there were guys working on the pool pump before Steph’s retreat got into full swing. Jed asked, “Is that an eco-friendly pool without chlorine? I replied, “Yea, they use salt instead.”

“Dope…I heard that with the sunlight the sodium chloride just turns into chlorine anyways.”

As I sat with this conversation, it struck me that this is the epitome of our industry.

A lead in question followed up with unsure anecdotal “evidence”.

“Yo, how many reps are you doing over there?”

“3 sets of 21”

“I heard that if you can do over 20 it isn’t doing anything anymore.”

“Oh shit, I meant 3 sets of 19.”

Other than being total passive aggressive bullshit, the problem with this whole interaction sequence is rarely do people ever look things up from reliable peer-reviewed sources. They live in this bro-on-bro sewer world of Iron Lore and Norse Muscle Myths.

High-rep low-load training (when volume is somewhat equated) works just as well for hypertrophy, but not nearly as well for strength.

Where is this from? Type Schoenfeld, Low Load, and Pubmed into your search bar and you might find a peer-reviewed meta-analysis on the subject.

I had no idea if the sun causes the dissassociation of sodium chloride (bullshit meter was going off though) or what dilution the pool is set at. Well the sun doesn’t do it, the chlorine generator does through electrophoresis via titanium plates. Which explains what the hell that beeping gadget hooked up right in line with the pump is. Next line of action, message the pool guys and ask them how many ppm of chlorine the pool is set at.

“The chlorine level recommended for swimming pools by the CDC is 1–3 ppm, and the recommended level for bromine is 2–5 ppm.12 Most germs are actually killed at the lower ends of these ranges, but extra disinfectant often is needed to accommodate the organic matter—such as urine, sweat, and dirt—that is brought in by swimmers. That’s because all the contaminants and compounds on an unshowered body react with the free disinfectant in the pool, reducing the amount available to kill pathogens.”
-Spivey 2010

“CDC recommends pH 7.2–7.8 and a free available chlorine concentration of at least 2 ppm in pools.”
– CDC 2018

Don’t urinate in pools or on the gym floor. Thank you.

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