Mastering Nutrition

Question: Menstrual Migraines, Pregnancy, and HRT What I think is happening is the estrogen is probably suppressing DAO when it's higher, but because it's staying suppressed, there's compensation that's happening for it to help minimize the histamine level. Whereas when the estrogen is cyclical, it's suppressing DAO when the body hasn't made any adaptations to low DAO. And that's sort of like some...

Question: How do I know if biotin deficiency is causing my hair loss and fungal rashes? The plasma or serum biotin level is not a good marker of biotin status because it's not very sensitive. And so, if you're in the bottom 10% of it, I would definitely take that as a red flag that you might have biotin deficiency, the best test for biotin, well, the gold standard for biotin deficiency is beta-hyd...

Question: How do you know if skin problems are from zinc deficiency? I would measure plasma zinc and if the plasma zinc, the sweet spot is around 120. If the plasma zinc is in the 70 to 90 range, that's borderline and if it's below 70, that's very clearly potentially related to skin problems. I think you have your answer right there. If your zinc's at 120, your skin problems, are not due to the zi...

Question: Anxiety, Neurotransmitters, and Nutrition So there's a few trans neurotransmitters that are particularly relevant. Histamine is a key anxiety neurotransmitter. Another neuro-transmitter that's relevant is dopamine and I don't see dopamine as primarily actually causing baseline anxiety. Measurement of neuro-transmitters is very difficult but you can get some hints and make some inferences...

Question: What are the best ways to stabilize blood sugar? I would definitely be trying to lower the glucose response. And what I would do in such a situation would be to run a series of experiments on the type of carbohydrate, as well as the amount of carbohydrate, as well as the context of the meal to see. I would use that as the maximum and so define the carbohydrate load of the specific foods...

Question: What are the best natural ways to lower cholesterol? The top things that I would think of to lower cholesterol levels are number one, I'd get thyroid status thoroughly checked out. Number two, I would consider experimenting with a diet low in saturated fat or diet low in cholesterol to see how responsive your levels are to those things. Number three, I would experiment with some fiber su...

Question: Does high B12 mean it's not getting into the cell? The right way to address that would be to measure serum or urine or both methylmalonic acid MMA, and that's a functional marker that's very specific to B12. If B12 was not getting into the cell, then methylmalonic acid is going to be high. If you would like to be part of the next live Ask Me Anything About Nutrition, sign up for the CMJ...

Question: What range of folate and homocysteine are good for MTHFR? So 18 to 22 nanograms per milliliter for serum folate and then for homocysteine, I would say seven to nine, I think eight is right smack in the middle and it's fine. No harm in getting down to five, if you can get there but I wouldn't, if you're in the seven to nine range, I wouldn't worry about it. If you would like to be part of...

Question: Do Ketogenic Diets Lower Glutathione? And so what a ketogenic diet does is put you in a low insulin to glucagon ratio longterm and the insulin to glucagon ratio is what is used for the body to perceive whether it has enough energy to invest in making glutathione. And so the reason the liver's glutathione is going to go down on a ketogenic diet is because you're in the fasting state. Glut...

Question: Why do I have a high LDL-C when my diet is on point? Generally in the presence of insulin sensitivity, more carbohydrates, less fat will lower LDL, but in the presence of insulin resistance, more carbohydrate will sometimes raise LDL. And if the LDL is only a little bit out of range and the HDL is good, I wouldn't worry too much about it. If the total to HDL cholesterol ratio is under fo...

Question: Can protein replete glycogen on a low-carb diet? Yes, it's possible. And I don't know exactly what the dosing is, but I think it's totally possible. It comes at the risk, I don't want to say risk, but at the downside of creating a lot more ammonia. But I think it's quite possible. I think it was Master Nutrition, Energy Metabolism, Lesson 17, it was the one on the evidence around low-car...

Question: Creatine: do the benefits outweigh the risks for a mid-30s male? I think that there are borderline no risks to creatine supplementation. I know some people get bloated from it that usually passes. Anecdotally, some people get insomnia. I think if nutrients are balanced and you just stick with it, that'll go away. There's speculation that it could aggravate male pattern baldness, but ther...

Question: How important are MAT1A SNPs to methylation? These in principle, could reduce the activation of methionine, but I don't know that there are any studies that have looked at whether that's the case. And so, just because a SNP isn't a gene doesn't mean that it reduces the activity of that gene. In fact, it doesn't mean it does anything even to the protein sequence of a gene because a lot of...

Question: How to increase red blood cell magnesium content? Well, the first thing you want to do is look at your serum levels. And if your serum levels are low, you want to look at your urinary levels. And if your serum levels are not low or especially, if your serum are high, then you want to focus on promoting magnesium absorbed into the cell. If your serum levels are low, then you probably don'...

Question: Why would ferritin rise on a low-carb diet when iron status is stable? Well, they sound copper deficient because copper is needed to mobilize iron out of ferritin. Copper is most abundant in plant foods, except that it's also very rich in liver. And it's pretty decent in a number of shellfish, but on a low carb, steak and cheese diet, not only are you deficient in copper, but you are als...

Question: What are the best practices for nutrient absorption? Large meals and fat soluble vitamins. Large meals are the ally of fat soluble vitamin absorption. Fat absorption from poor fat digestion, is the enemy of not only the absorption of fat soluble nutrients, but also the absorption positively charged minerals. There might a few of them missing, but those are the ones that really stand out...

Question: What's the best prenatal nutrition? The things that sort of stick out to me are, you don't want to be Vitamin A deficient or Vitamin A toxic, so you're right in the middle of the range. You really don't want to be deficient in anything. Everyone knows about folic iron which is really important, but there's not really a good nutritional status test for choline. Biotin is very important. O...

Question: Supplement Timing and Food Combining for Zinc? So for zinc and food, the main issue is that, my guess is that a carnivore meat based meal would probably enhance zinc absorption, but that's never really been tested. There's some controversy in the field over whether you should take zinc on an empty stomach or not. So my position is basically like if it's practical for me to take the zinc...

Question: How to approach chronic joint pain? You definitely want to move the joints that are affected. So the movement must target the joints that are affected. And you definitely want like 30 minutes a day of just moderate movement, even walking would be great. But then you also want movement aimed at actually supporting the muscles and the proper joint motions and stuff like that. And so that's...

Question: How should I break a 36-hour fast? The two things that I would think about are your digestion, it's probably going to take a little bit of time to ramp itself up. I don't think you're going to do any harm by eating things that are difficult to digest, probably not great for your microbiome, but probably something that would just adapt to you. And so I would take that very subjectively. I...

Question: What are optimal levels of B12? So there's a paper called the Pathophysiology of Elevated Vitamin B12 in clinical practice that PM Schoenfeld, another Masterpass member, had given me. And this paper is very interesting because it identifies a bunch of things that high B12 can be an indicator of, not a causal factor in but an indicator of problems. And it also disputes the low end of the...

Question: Are GABA or methylation support useful for panic attacks? I think anything that increases GABA activity is probably going to slow down anxiety and panic. I think that's clear just from the drugs that are used to treat an anxiety, or panic disorder. Xanax is used for that purpose. So I do think that working on nutritional support around GABA makes sense, but I also would look at histamine...

Question: Is increasing reactive oxygen species a good strategy for appetite control? Is that going to cause satiety in the brain? Maybe. I haven't studied that. I think Stephan Guyenet would be a great person to talk to about that. It wouldn't surprise me in the sense that if you want to shut down energy coming into the cell, why wouldn't you also want, at some bigger level, to shut down energy i...

Question: What's the best way to increase ferritin? If you're taking an iron chelate supplement then you should probably take it with a carnivore meal. Vitamin C and a few other ones, folate, are not really vegan nutrients but they're very plant-oriented nutrients in terms of what's the thing you're probably going to add to your diet that's going to help. And so I really feel like if I had iron de...

Question: What to eat for a 35-year-old vegan woman with hypothyroidism and low zinc levels? I think a vegan with poor zinc levels should supplement with zinc. You know, it's one thing if you have a vegan whose diet just happens to provide good zinc status, despite the fact that their diet is dramatically lower in total zinc than an omnivore who eats a lot of red meat or seafood, particularly oyst...