Heart attack and stroke: why you should care

It’s simple: most people in the world die of heart disease or stroke. Cardiovascular and cerebrovascular disease are the top 2 causes of death (Ref1). Approximately one out of three in the US and in most industrialised countries, dies from heart attack or stroke (Ref2). It is strange, however, that not many people seem to care about this. Or at least not until it actually happens, either to them or to someone close. Have you ever thought about it? Did you even know that you and everyone you know are more likely to die from heart attack or stroke than anything else? Are you surprised that your doctor hasn’t mentioned anything about this to you? Well, you really shouldn’t be, because they also die primarily of heart attack and stroke and cancer, like everyone else, and they have no idea why.

To be fair, though, some people do care, and some people do know. But those that do, are usually not those that need to, and those that really do need to, usually don’t. Funny how that is. And funny how this seems to be the case for so many things. Anyway, it is important to realise and remember that heart attack and stroke are together the single most important cause of death in most of the world, and are responsible for about a third of all deaths in industrialised countries. That is a lot.

Something else which is important to appreciate, is that heart attack and stroke are two manifestations of exactly the same problem: damage to the arteries. Moreover, and rather unbeknownst to most, Alzheimer’s disease, responsible for about 5% of deaths in the US (but 7% in the UK and 10% in Australia, by the way), as well as dementia and senility, are yet a third manifestation of the same problem. In this case, it is the accumulation of plaques in the smaller arteries of the brain that gradually obstruct or block the flow of blood to specific areas, causing the gradual withering and eventual death of these brain cells.

Now somehow, because all of these conditions manifest themselves in older folks, usually in their sixties, seventies or eighties, we all just tend to ignore this, pretending it has nothing to do with us. Do you find this sensible? It’s not, really. So, what do we need to know, and what do we need to do?  Let us paint as clear a picture as we can by asking a few simple questions, answering them, and looking at the various connections and relationships between the factors that emerge from this process.

Why do plaques develop and accumulate in the arteries? Because the cells and tissues that are part of the artery get injured, and the body’s repair systems are activated to patch up and heal the injured tissue. The plaque, just like a scab that allows the skin wound underneath it to heal, protects and provides the necessary constituents for the healing and repair of the artery wall. And just like a scab falls off on its own when the wound has healed, there are specific mechanisms to deconstruct the plaque, and recycle its constituents when the injury has healed. If, however, damage to the artery occurs faster than the time it takes to heal and repair, the plaques accumulate. This is exactly what happens in most of us.

Where do plaques develop? In the places where the blood pressure and blood flow are greatest, and particularly at arterial junctions where there is an important change in the angle of the blood flow from one arterial branch to another. This is very important. Moreover, plaques form inside the artery wall, not on its surface. This is also very important. Why are these two little facts so very important? Because they are completely contrary to the standard picture held by practically everyone about the development of arterial disease.

We have been taught, and hence absurdly believe, that plaques are made up of cholesterol and saturated fat that circulate in the blood, stick to our arteries, and that over time, grow into large bulges of cholesterol and fat that block the arteries. Nothing could be further from the truth, and it is hard to imagine how a thinking person could have come up with a total failure of a pedagogical scenario as idiotic and absurd as this one. Still, this is what we believe. Isn’t this what you thought, at least at some point in the past, or actually even still think?

Firstly, neither cholesterol nor fats are water-soluble. Blood is 50% water and the plasma in which everything other than red and white blood cells is transported is 90% water. Therefore, neither cholesterol nor fats can circulate in the bloodstream on their own. They are carried around by lipoproteins of various sizes and densities that can be imagined as little spheres with a protein shell that hold fat and cholesterol on the inside (read more on this in What about cholesterol). These lipoproteins only open up and transfer their contents when they correctly latch onto a receiving gatekeeper on the surface of the cell, and this is so important that every cell has a lot of these ports to receive fat and cholesterol from the carrier lipoproteins.

Secondly, if it were the case that somehow fat and cholesterol floated and just stuck to the blood vessels, we would naturally expect to see a gradual appearance and accumulation of an evenly distributed layer of fat and cholesterol in all the arteries, as well as in all the veins. And this is not at all what we see: we see plaques in specific places and not anywhere else.

And thirdly, how in the world would the cholesterol and fat stuck to the blood vessel, somehow, magically, move from the outside to the inside of the artery wall without losing its structure or disintegrating? There is just no way. So please eradicate this erroneous notion from your conscious intellect, and spread the word to your family, friends and especially to your family doctor!

What causes injury to arteries? This is the million, or rather, the multi-billion dollar question, isn’t it? Because if we can answer this question, we can do what is needed to avoid arterial injury and damage. And no, it’s not cholesterol!  (I know, I know, you’ve gotten that point by now). Well, fortunately, we know what causes injury to arteries, and get to that very soon. Unfortunately, there are several causes, and they are intertwined into vines of interdependent factors, each of which must be considered in the context of the overall picture. It is through this second point that I distinguish myself from most experts whose books I’ve read on the topic, that almost inevitably focus on one particular underlying cause or problem at the expense of the others, and more importantly, the relationship between them. Here we go:

Chronic dehydration  is the most fundamental of all causes of arterial injury. Unfortunately, this is not generally recognised. But fortunately, it is the easiest to address and correct. Blood pressure is absolutely fundamental to all bodily processes and functions. The body has evolved an extremely finely tuned system for continuous control and refined adjustments of blood pressure, because everything depends on it. Since the circulatory system is pretty much a closed system (blood doesn’t go in or out), the pressure in the entire system is primarily a function of its water content (50%). Therefore, even a slight decrease in this water content, immediately translates to a drop in volume and thus pressure. This drop is sensed by many different types of cells in blood vessels, in some glands and organs, and in parts of the brain that continuously monitor the pressure in the system. This triggers a series of hormonal responses whose ultimate purpose is to raise the blood pressure back up to its optimal level, and maintain the precious balance that the organism and all of its parts require and strive for incessantly during every instant of their existence. And by the way, remember that none of these care about you, what you want, or what you like. They strive for optimal function and survival independently of you, for their own sake.

You can read more about this in The kidney: evolutionary marvel and in How much water, how much salt, and our amazing kidneys, but basically, it goes like this: drop in water content, drop in blood pressure: secretion of renin by the kidney, secretion of angiotensinogen by the liver, conversion to angiotensin I  by renin, conversion to angiotensin II  in the lungs, contraction of blood vessels in order to raise blood pressure; secretion of stress-response hormone vasopressin by the pituitary gland, more contraction of blood vessels, reabsorption of water and salt in kidney to raise blood pressure, secretion of glucose from the liver, secretion of blood clotting factors and platelets to thicken blood, secretion of stress hormone ACTH  to reinforce all of the above. Bad news. All of it. Don’t you think?

The solution is very simple, drink more water and eat more salt to maintain sodium concentration in the blood; always drink on an empty stomach: up to 30-45 minutes before meals (at the very least 500 ml 30 minutes before), and then wait at least 2-3 hours after meals. Simple, easy and inexpensive, but highly effective and absolutely fundamental.

Magnesium deficiency  is the second most fundamental cause of arterial injury. But once more, this is unfortunately not generally recognised either. Magnesium experts, (most probably unaware of the underlying problems caused by chronic dehydration), estimate that about 60% of all cardio-cerebro vascular events are attributable to magnesium deficiency. Why? Because magnesium is what allows muscles fibres to relax. It is quite straight forward: without enough available magnesium, muscle cells cannot relax; they contract and just stay contracted. This prolonged involuntary contraction is what we feel in the foot, calf or hamstring when we get a cramp. But the smooth muscle cells that line all of the blood vessels are much more sensitive to magnesium, extremely sensitive, in fact, because they are the mechanical means by which blood pressure is continuously regulated, moment to moment, in order to best adapt to the physiological conditions and needs in any given instant.

This function is far more important than the use of an arm or a leg, because it is vital to the survival of the organism as a whole, and therefore takes precedence in the body’s physiological hierarchy. Imagine if you experienced arterial spasms, and consequently, little heart attacks, as frequently as some of us experience muscle cramps in a foot, hamstring or calf? How disastrous! So the body’s physiological hierarchy definitely serves us also very well indeed. Nonetheless, even a slight deficiency in magnesium will cause dysfunction in blood pressure regulation by those smooth blood vessel muscle cells. Since the primary effect of magnesium deficiency is stiffening of muscle fibres, this will manifest in higher blood pressure, generally and in all circumstances, when relaxed or asleep, when exercising intensely or feeling stressed. Naturally, this does not get any better with time. Instead, degradation and dysfunction increase in severity at a faster rate with each passing day. The vicious cycle goes just like this: less magnesium, more stiffness; more stiffness, higher pressure, more arterial damage; more arterial damage, more plaques, more stiffness, higher pressure; and down and around it goes. Bad, bad news.

The solution in this case is also very simple: daily supplementation. You can read more about magnesium in Why you should start taking magnesium today. My updated recommendations for supplementation are as follows: use concentrated trace minerals in your drinking water, 20 drops per litre, which is just like drinking natural, mineral-rich water. This will result in 40 to 80 drops per day, and will provide 250 to 500 mg of magnesium, but also all the other trace minerals in their most natural ratio as found in sea salt (minus the sodium which is taken out). This is perfectly adequate, and over time will replenish magnesium in addition to all other mineral deficiencies that are usually just as bad but not as important or noticeable. This can take years, but that’s not a problem. Be patient and consistent.

Two or three times per week, (probably mostly in the winter), take baths with 2/3 to 1 cup of nigari (magnesium chloride) flakes. You have to soak for at least 30 minutes, and do not wash with soap or rinse off before coming out. In the summer, if you want to hasten the replenishing of your magnesium levels, you should use “magnesium oil” (concentrated solution of magnesium chloride and water; I recommend 20%, not more), and spray it on your arms, legs and body, avoiding sensitive areas because it stings a bit. In this case also, you must wait at least 30 minutes before having a shower to allow the skin to absorb the magnesium. I don’t recommend taking nigari solution orally because it irritates the intestines in the long run, especially the colon.

That’s it. And just like with good water intake, magnesium supplementation, especially using concentrated trace minerals in your drinking water, is also simple, easy and inexpensive, but highly effective and absolutely fundamental. We simply cannot be in good health without it, let alone in optimal health.

Simple and starchy carbohydrates  that stimulate the secretion of insulin from the pancreas, are without any doubt the most damaging and dangerous substances that we call and consider to be food. And once more, and again unfortunately, this is not generally recognised. Now, I know that the above statement about carbs is a very strong one which, in fact, can be interpreted to imply that simple and starchy carbohydrates should not be considered food, per se. But I hold to this, because I believe we should only consider as food those substances that are, on the one hand, essential for survival, and thus also for optimal health, and on the other, health-promoting and not the opposite. And whether you know this already or not, whether you chose to ignore this fact, or even whether you believe it or not, simple and starchy carbohydrates fail on both counts: we do not need any whatsoever for survival and certainly not for optimal health, and the ingestion of even the smallest amount causes damage to the body, its systems and its metabolism. The less is consumed, the lesser the damage; the more is consumed, the greater the damage. But there is a threshold effect, so that above a given amount, the damage that is sustained by the tissues and organs increases rapidly.

Fundamentally, the process of arterial damage, the subsequent plaque formation and the entire genesis of cardio-cerebro vascular disease is an inflammatory process. This means that anything which causes inflammation will make it worse, but also that inflammation is at the root of the problem. So, what does this have to do with carbohydrates? Absolutely everything! Volek and Phinney write in The Art and Science of Low Carbohydrate Living:

Inflammation causes our cells (specifically our mitochondria) to increase production of free radicals. Free radicals are like mini roadside bombs that interfere with normal cellular functions. So … : 1) dietary carbohydrate raises serum insulin; 2) insulin promotes inflammation … ; 3) inflammation increases cellular free radical generation; 4) free radicals attack any convenient nearby target; 5) ideal targets for free radicals are [cell] membrane polyunsaturated fats; 6) membrane polyunsaturated fats are important determinants of cellular function … (p. 82). Carbohydrate ingestion and … hyperglycemia activate a host of inflammatory and free radical-generating pathways. Some of these include: … activation of NF-kB which regulates the transcriptional activity of over 100 pro-inflammatory genes (p.186).

And to reinforce the case against insulin, Rosedale couldn’t be clearer on this in Insulin and Its Metabolic Effects:

If you drip insulin into the femoral artery of a dog, … , the artery will become almost totally occluded with plaque after about three months. The contra lateral side was totally clear, just contact of insulin in the artery caused it to fill up with plaque. That has been known since the 70s and has been repeated in chickens and in dogs; it is really a well-known fact that insulin floating around in the blood causes a plaque build-up. They didn’t know why, but we know that insulin causes endothelial proliferation. This is the first step as it causes a tumor, an endothelial tumor.

Insulin also causes the blood to clot … and causes the conversion of macrophages into foam cells, which are the cells that accumulate the fatty deposits. Every step of the way, insulin is causing cardiovascular disease. It fills the body with plaque, it constricts the arteries, it stimulates the sympathetic nervous system, it increases platelet adhesiveness and coaguability of the blood. (p. 7)

There we have it. Although tons more could be said, and indeed, has been said, tried and demonstrated many times during the last half century, the only thing that we really need to understand and remember, is that both insulin and glucose in the bloodstream are like corrosive agents that both cause direct damage to tissues and fuel inflammation throughout the circulatory system and the organism as a whole. We didn’t even mention glycation, but you can read more about carbohydrates if you wish by browsing the articles in that category.

The solution in this case is also very simple: just eliminate simple and starchy carbohydrates from your diet. This one, however, is definitely much more easily said than done. However you look at it, there are no alternatives. It is just a question of time and motivation, understanding and determination. At least until it becomes a question of necessity, and in the extreme, a choice not just between health and disease, but between life and death. Plainly said, it is impossible to gain and maintain optimal health without eliminating insulin-stimulating carbohydrates from the diet. It is important to emphasise that fibrous vegetables (everything except for starchy and potato-like) do not stimulate insulin secretion. These should constitute the bulk in volume of what we eat every day.

Polyunsaturated vegetable oils  are the other “food” substance that should be eliminated simply because they also promote inflammation and free radical damage. This includes all vegetable oils from seeds (sunflower, safflower, rape, etc), pulses (soya) and grains (corn) that are liquid at room temperature and in the fridge. You didn’t know that? Well, this is another one of those well established and demonstrated facts that most of us are unaware of. What else can I say? You can read about this in The Skinny on Fats by Mary Enig, but also in the books by Taubes, Volek & Phinney, Kendrick, Colpo and Ravnskov among others (see Readings).

Solution? Simple: olive oil is monounsaturated (you will notice that it solidifies in the fridge), and is the only one you should use in salads and dips; get high quality and use less. Otherwise, cold pressed, extra virgin, organic coconut oil and organic butter (unpasteurized is is much better if you can find it) are by far the best options for everything else.

Stress,  negative physical, psychological and emotional stress, especially if it is chronic, is probably the worst assault that can be imposed upon the organism. In fact, many health and stress experts maintain that stress is definitely the most potent poison with the most immediate and most deleterious effects on all bodily functions and systems. Kendrick makes this the main thesis of his book on cholesterol and heart disease, and he does make a very convincing case of it. Other medical scientist have shown how psychological stress increases all disease markers, from the propensity to catching colds and flus, to the increased probability to develop degenerative diseases like diabetes, heart disease, stroke, cancer, arthritis and multiple sclerosis. This seems amazing at first, but when we look into the details of what stress actually means, how stress manifests itself in our biochemistry, it becomes completely clear and obvious why it is so damaging. In addition, this is where we see how everything ties in together, and very explicitly at that.

One thing that should be clear is that any kind of negative stress induces the release of stress hormones. As we saw earlier, this triggers a bunch of reactions: contraction of blood vessels and rise of blood pressure, increased clotting, thickening and stickiness of blood, redirection of blood from digestive system, internal organs and brain, to large muscles in outer limbs, conversion in the liver of stored glycogen into glucose and subsequent release into the bloodstream, temporary insulin-resistance and thus inability to burn fat that also causes both blood sugar and insulin to remain in the bloodstream much longer than it rightly should. Temporary suspension and suppression of essential immune functions, increased magnesium needs as well as magnesium wasting are other really important immediate consequences of the presence of stress hormones in the system. Even though these biochemically mediated reactions are all very important when we need to fight or run for our lives, it is really bad in every other possible circumstance we may find ourselves in. And I am pretty confident that most of you rarely find yourselves facing a tiger or raging bull, but frequently feel that characteristic tightening of the breath, those butterflies in the stomach, the rush of blood to head, the wave of heat that seems to come out of nowhere, and all the other sensations associated with the surge of stress hormones through the body. In fact, you probably feel this much too often.

Now imagine this state of psychological and emotional stress, with all of its biochemical effects and metabolic consequences, as chronic: as how we live our life from one day to the next. What a disaster! We simultaneously induce and exacerbate all of the effects of chronic dehydration, of magnesium deficiency, of eating simple carbohydrates, and this, throughout the day, from morning to night. What an incredible disaster! So, no wonder we find that the more stress we feel, the more colds and flus we catch, the fatter we get, the more metabolic syndrome and diabetes we develop, the more heart attacks and strokes we suffer, the more cancers we grow and die from. And if that isn’t enough, sustaining such daily stress over an extended period will inevitably lead to adrenal fatigue, because the adrenal gland sitting on top of the kidneys that are continuously stimulated to secrete ever increasing amounts of stress hormones, just get exhausted. And then our cortisol and insulin levels are all screwed up, we can’t sleep at night, we can’t get up in the morning, we can’t concentrate, we cry for no reason, we forget things we shouldn’t and don’t want to, we are confused about everything and everything confuses us. Is that enough? Is that black enough a picture?

Is there a solution? Of course there is. First and foremost, it is crucial to recognise that the bulk of the stress that we impose on the bodymind is caused by the physiological assault at the cellular, metabolic and hormonal levels of the previous four factors: chronic dehydration, magnesium deficiency, insulin-stimulating carbs and polyunsaturated oils. Therefore, the most important thing to do to reduce our overall stress, is to do what is needed to take care of the first four factors, and to stop drinking coffee which always induces a stress response by stimulating the adrenal glands directly. Doing this will go a very long way in reducing and maybe eliminating stress almost completely. The first thing that everyone who adopts the green, mostly raw, alkalising ketogenic diet I promote, is how calm they feel after just a few days. And this calm becomes how you are in general. Why? Because stress hormone levels drop dramatically and quite quickly. And note that this is solely due to the biochemical and hormonal effects of this type of diet. Therefore, the importance of what we eat and drink on the overall stress levels cannot be understated: it is the most important! Unfortunately, as with many things I point out and underline, this is not generally recognised either.

Once you have done that, you will feel an entirely different person. Then, secondarily, for the psychological aspects, you really have to relax, take it easy, and take it slow. This may sound silly: telling someone who is stressed out to relax is almost as useful as telling someone who’s clothes are on fire that they should put out the fire before they get burnt. But, in many ways it is hard to say anything else: almost all the emotional and psychological stress we feel is self-induced. We simply work ourselves up. And that’s a fact.

We might very well invoke and attribute our stress to a thousand and one external circumstances and people and places and things to do and family problems and on and on, but in the end, the fact is that stress is self-induced. It is our response to all these things, these events, these circumstances, all of these things that are just our life, nothing more and nothing less. And it is our response that is either highly stressful, mildly stressful or not stressful at all. In other words, it is our attitude, our disposition towards what happens, that determines if we will feel stressed or not.

As soon as you understand and recognise this, the stress will ease up on its own: you will relax. You really have to just let go and relax. Change your attitude towards things. Just be cool and things will cool down for you. Just be calm and things will be calm. Take your time: walk slowly when you are going somewhere, speak slowly and listen to the person that is talking, leave early so that you don’t have to rush, just take your time in everything you do. This will help enormously. And you really have to do this, not just sometimes or for a while, but as the way you do things from now onwards. You will really feel the difference.

Biochemically, it is absolutely essential to optimise your B12 (aim for 600-800 pg/ml) and D3 levels (aim for 80 ng/ml). Both are really important for everything physiological and everything psychological. You can also use some natural helpers like tulsi (holy basil) as a tea (we start each day with that), or in extract; it is very effective at helping to calm down and it directly supports the adrenal glands, those that secrete the stress hormones. Valerian and melatonin are excellent non-addictive aids to sleeping soundly without side effects.

Maybe what is worth underlining at this point is the relationship that all of these variables have with each other, and particularly with stress. What I mean by this is that stress stimulates the release of glucose from the liver and leads to hyperglycaemia followed by insulin secretion, but ingesting sugar that directly causes hyperglycaemia and insulin secretion, induces stress on the system. Stress wastes and depletes magnesium, but magnesium supplementation reduces stress. Chronic dehydration triggers a comprehensive and full blown stress response, but a plentiful intake of high quality mineralised water and salt puts a stop to all of this and naturally suppresses the stress response. And although I haven’t mentioned this yet, it’s the same for food: all food that is eaten that induces stress on the digestive system—processed, chemical-laden, refined, overcooked or otherwise dead food—induces stress on the organism, a lot of stress. On the contrary, all food that instead provides enzymes, minerals and other phyto- and micro-nutrients—all raw veggies, nuts, seeds, coconut milk, superfoods—nourishes the body and its systems, and very effectively eases the stress on the organism as a whole. This is very important.

Free radicals,  regardless of how they come to be in circulation in the first place, are the source of a lot of damage, and this to all cells, tissues and organs, and also naturally the cause of accelerated ageing and naturally with that, the appearance of degenerative diseases. We now know that free radicals abound with high blood glucose, high insulin, high polyunsaturated oil intake, and stress which combines and exacerbates all problems. So, in addition to implementing all previous solutions comprehensively, especially loading up on raw fresh vegetables and green juices every day, it is also really good to supplement with anti-oxidants. Obviously, it is intelligent to find and take only the best ones. In this regard, what I take and recommend is astaxanthin (Bio-Astin from Nutrex I think is the best on the market) and turmeric in capsules (from Organic India), at night after dinner.

Infectious viruses, bacteria and pathogenic microforms  that circulate in the bloodstream have also very clearly been found to cause direct damage to blood vessel tissues. Ravnskov makes this his primary thesis in his book on cholesterol, fats and heart disease. And even though he does make a convincing case of it, with plenty of evidence and logical deductions, I am of the opinion that the terrain—the internal environment of the body—is ultimately what matter most, and in fact, if it is in optimal balance and health, then pathogens simply cannot either exist there, or if they do, cannot cause any harm. So, instead of looking for ways to kill and eradicate these, my focus is on attaining and maintaining a perfectly healthy and alkaline terrain such that there is no need to worry about pathogenic microforms, almost all of which thrive in acidic, oxygen-deprived environments. And this without saying anything about the Bechamp’s, Enderlein’s, Rife’s and Nassens’ observations and theories of the pleomorphic nature of microzymas or somatids, and their metamorphic cycle with three health-promoting and thirteen disease-promoting states. This fascinating story will be for another time.

High free iron levels  are very tightly correlated with increased incidence of cardiovascular events. It is well established that men tend to die about 5-10 years earlier than women. The fact is, though, that they tend get a lot more heart attacks with rates increasing with age up to about 50. But following menopause, women’s rates of heart attack steadily grow to reach those of men by the time they are 65-70.

This is due to excess free iron that is always much lower in women during their reproductive period, but that grows steadily after menopause. And it is well established that iron is definitely essential and actually also works as a potent antioxidant when it it in optimal concentrations, but that it switches to being a potent oxidant and irritant in the blood vessels in high concentrations. For men who do not exercise, iron concentration just grows with time, just as their risk and rates of heart attack. If you exercise, iron is used up and therefore stays around optimal levels naturally. For women who love blood every month, iron tends to be ok, although sometimes too low. So this needs to be monitored.

Closing words

Is there a need for a conclusion? I don’t really think so: you have everything you need. But if I were asked to summarise everything I wrote in this article, or better still, everything I know that relates to artery disease in a few recommendations, I would then say this:

1. Drink plenty of water with trace minerals (2 litres/day), fresh and/or powdered green juices (1-2 litres/day), freshly pressed lemon water (1-2 litres/day), always on an empty stomach away from meals, at least 30-45 minutes before and 2-3 hours after, for a total of 3-4 litres each day and every day.
2. Eat as many raw fresh veggies as you can (celery, cucumber, fennel bulb, red and yellow peppers, etc), and tons of salads with greens of all kinds, (you can never eat too much of any of these things), with unrefined sea salt. Eat plenty of raw nuts and seeds of all kinds (soaked overnight in water is better).
3. Do not eat simple or starchy carbohydrate.
4. Do not eat polyunsaturated vegetable oils.
5. Minimise stress: first physiological and then psychological, and sleep long and well. Do everything you can to make this happen.
6. Eat lots coconut milk and coconut oil, of the highest quality, fresh, raw, whole and organic.
7. Eat small amounts of animal protein from eggs, fish and/or meat, and unpasteurized cheese, always in the evening.
8. Do not drink alcohol  (it is fermented sugar and so has all of its detrimental metabolic effects in addition to its highly acidifying, poisonous effects due to the alcohol and high concentration in toxins excreted by the microforms that actually inverted the sugar into alcohol.)
9. Do not drink coffee (caffein is a neuro-toxin produced by the plant to deter insects and birds. Why would you want to drink a neuro-toxin? In addition, given that we already have plenty of natural stress, way too much, in fact, from our fast, busy, noisy, overstimulating city lifestyle, why would we consciously drink something that will strongly push our already overworked and tired adrenal glands to pump out even more stress hormones, and thereby trigger all of the devastating biochemical and physiological responses discussed earlier? It’s just more bad news. So just don’t drink coffee.)
10. Always supplement with the highest quality B12, D3 and maintain optimal levels. Take astaxanthin and turmeric, krill oil, and optionally probiotics (until your digestion is perfect), ubiquinol, spirulina, chlorella and chlorophyll, and maybe  iron and zinc once in a while (especially if you are vegetarian or simply don’t eat much meat).
11. Go outside and exercise in the fresh air and under the sun’s rays. Do heavy weights with very few reps, and short high-intensity intervals. Do some Pilates (or yoga) regularly to strengthen, align and balance the core, the posture, the body as a whole, and do lots of stretching and self-massage to release accumulated tensions.

If you do all these things, and you are not exposed to some dangerous environmental toxin, you will never have to worry about cardio-cerebral vascular disease, or any other degenerative disease or immune or metabolic dysfunction, for that matter. And mark my words: I’m willing to bet my life on it.

Heart surgeon sees the light after 25 years

One of this blog’s readers commented on my article Six eggs per day for six days: cholesterol?, by pasting a statement made in March 2012 by an experienced and apparently well-known heart surgeon, Dr. Dwight Lundell, about heart disease. I think it is worth posting not because there is anything new in it, (if you’ve been reading this blog, you will already know all the stuff he says and much more), but just because it is comforting to be reminded that there are some high-profile doctors such as him that are not ignorant and incompetent, and that actually care about people enough to try to make a difference.

Nonetheless, it is also important to point out, firstly, that he is certainly not the first one to have been shaken out of his trance, understood the truth about heart disease and started speaking about it, and secondly, that his and everyone else’s efforts in this direction have unfortunately not yet had much impact. This is particularly and painfully obvious in light of the fact that the best selling and most lucrative drugs in 2012 are still cholesterol-lowering and blood-thinning drugs, with profit margins in the several tens of billions. So, we’re still at least a couple of decades away from large-scale changes in mindset but it will come. Here is what Dr Lundell is reported to have said in the article that was published under the title World Renown Heart Surgeon Speaks Out On What Really Causes Heart Disease:

We physicians with all our training, knowledge and authority often acquire a rather large ego that tends to make it difficult to admit we are wrong. So, here it is. I freely admit to being wrong. As a heart surgeon with 25 years experience, having performed over 5,000 open-heart surgeries, today is my day to right the wrong with medical and scientific fact.

I trained for many years with other prominent physicians labelled “opinion makers.” Bombarded with scientific literature, continually attending education seminars, we opinion makers insisted heart disease resulted from the simple fact of elevated blood cholesterol. The only accepted therapy was prescribing medications to lower cholesterol and a diet that severely restricted fat intake. The latter of course we insisted would lower cholesterol and heart disease. Deviations from these recommendations were considered heresy and could quite possibly result in malpractice.

These recommendations are no longer scientifically or morally defensible. The discovery a few years ago that inflammation in the artery wall is the real cause of heart disease is slowly leading to a paradigm shift in how heart disease and other chronic ailments will be treated. The long-established dietary recommendations have created epidemics of obesity and diabetes, the consequences of which dwarf any historical plague in terms of mortality, human suffering and dire economic consequences. …continue reading the original article.

Detoxification

Do you know why all cattle raised industrially, either for meat or for dairy, need to be on various drugs and antibiotics? Because they are all sick. Do you know why all these cattle are sick with viruses, bacteria, infections, tendonitis, chronic inflammation, arthritis, atherosclerosis, diabetes and cancer? (By the way, doesn’t that sound familiar?) Because their intestines are chronically acidic. Do you know why their intestines are chronically acidic? Because they are fed a high-carbohydrate diet based on corn. Do most people know this? No, they don’t. But is this a well-known problem in the industry? Of course it is. And is the cause of this problem also well-know? Of course it is. Industrial veterinarians say so themselves: “If these animals grazed on grass, we would be out of our jobs!” (from The Omnivore’s Dilemma).

And why is that: why is it that if cattle were to eat grass—as they always have, not just for the last ten thousand years since our ancestors domesticated them, but for millions of years along the slow evolutionary path—they would not get sick? Because they are meant to eat grass: they are herbivores. Yes, but that’s not the underlying reason. They would not get sick because their intestinal tract and their blood would be alkaline. Now, the most important question is the following: why is a chronically acidic intestinal tract the root cause of so much sickness and disease in cattle? The answer is simple, relatively speaking:

Cattle are herbivores. This means they have evolved eating grass. Dark green, chlorophyll-rich, fibrous grass loaded with minerals is not only excellently nutritious for them (and for us), but it yields in the intestines an alkaline residue after digestion, sometimes referred to as ash in analogy to something that has been consumed by fire. The pH of the entire length of the intestines is meant to be and remain alkaline. (Recall: 7 is neutral, below that is acidic and above is alkaline.) Unlike the stomach in which the environment must be acidic (from mildly to greatly depending on its contents) in order to break down proteins into their constituent amino acids, and that for this reason has cells that secrete mucus to form a thick layer that protects the lining from the corrosive acid also secreted by cells in the stomach in response to the presence of proteins, the delicate lining of the intestines does not have such a protective coating of mucus. The mechanism intended to protect it is the secretion by the pancreas of a strongly alkaline bicarbonate solution into the small intestine in order to neutralise the acid following the transfer of the contents of the stomach into the duodenum.

However, even though this process does take place more or less efficiently depending on many factors like pancreatic and kidney function but especially on hydration status (see Why you should drink water before meals), the final stages of digestion and breakdown of the foodstuff—the now pH-neutralised chyme that came from the stomach—leave either an alkaline or an acidic ash depending on what it is and on how well this entire digestive process takes place. Now, if you didn’t already know this, this final digestion and breakdown process is not done by “us” or by the intestine itself: it is done by the trillions of bacteria, yeasts and fungi that live in our gut. These microscopic inhabitants that make up our intestinal flora depend on us for their survival and we depend on them for ours. But as you will maybe have guessed, some are beneficial and essential; others, detrimental and pathogenic. What is it that regulates the proliferation and lifecycle of all these microscopic inhabitants of our intestines, different kinds throughout depending on the section and specificity of the cells and nutrients that are absorbed in that particular stretch of the long tube that is our gut? It is the environment, the surroundings, the medium in which they live. And what determines the characteristics of that medium? The foods we eat and when we eat them; the drinks we drink and when we drink them. Makes perfect sense, doesn’t it?

When the intestines are chronically acidic, the pathogenic yeasts, fungi and bacteria thrive and proliferate, their metabolic by-products (their eliminations) that are all acidic, make the environment increasingly more acidic, the lining of the intestinal wall is gradually corroded and eaten away by the acid, once it is thin enough the yeasts’ and fungi’s tentacles and outgrowths pierce through the intestinal wall and spill out their toxins and themselves into the bloodstream and outside the gut, spreading throughout the body, multiplying and proliferating in every other place where the environment is suitable, and given that in the crushing majority most tissues are totally acidic, this is not hard to find. The result? Inflammation, yeast infections, urinary tract infections, vaginal infections, fungal overgrowth, generalised candida all over the place, inside and out. This is what causes the cattle to be sick. This is what causes all of the diseases from which they suffer, from which they need to be treated with drugs and antibiotics, from which they need to be treated by the vets. Why? Simply because they eat corn instead of grass. Once more: is this known by most people who gingerly go to the supermarket to get a their meat for dinner? Sadly, no, it isn’t. But is this known by the vets in the meat industry? Sadly, yes, it is.

What does any of this have to do with us? It has everything to do with us because exactly the same thing happens in our own gut (see Sick and Tired). You’ve certainly heard of the so-called leaky gut syndrome. Well, this is it. But what you probably haven’t heard is that this is what is happening in your intestines and in those of almost everyone you know, and, in fact, almost everyone everywhere to a greater or lesser extent. Why? Because we all eat lots of simple and starchy carbohydrates, because all simple and starchy carbohydrates make the intestines acidic, and because all the pathogenic inhabitants of our gut thrives on the sugar and starch it is fed and the increasingly acidic environment this promotes.

What does any of this have to do with detoxification? It has everything to do with detoxification because the metabolic by-products and eliminations of the pathogenic yeasts, fungi and bacteria thriving in our gut are by far the most important source of toxins from which the body is sickened, but also of which it is desperately trying to detoxify itself. Furthermore, all toxins resulting from the natural and normal digestion and metabolism of proteins are also highly acidic. And what is generally the case for most of us, here again, almost everyone everywhere, is that every tissue in the body is overly acidic, every cell that needs an alkaline environment to function properly is desperately trying to survive in this acidic medium. And so, exactly like the cattle, we are all sick, we suffer from viruses, bacteria, infections, tendonitis, chronic inflammation, atherosclerosis, arthritis, diabetes and cancer, and everything else you care to add to this list.

What happens when we stop eating simple and starchy carbohydrates? It’s simple: the pathogenic micro-organisms in the intestines are starved because they cannot survive without a constant supply of sugar, and consequently begin to die off, massively. The beneficial ones do not. In addition, there is a quick metabolic adaptation and shift to using fat instead of sugar as the primary source of cellular fuel: nutritional ketosis is triggered within about 48 hours, takes about 4 weeks to be well established, and about 8 weeks to be completely established (from The Rosedale Diet and The Art and Science of Low Carbohydrate Living). This keto-adaptation causes a fast and sudden activation of fat-burning stimulated by the drop in blood sugar and insulin levels, thus releasing into the bloodstream the heavy metals and chemical contaminants stored in the fat cells. This causes the spilling out of toxins all at once and from all directions that can manifest in a large variety of ways: headaches, stomach aches, diarrhea, vomiting, boils, rashes, anxiety, insomnia, as well as asthma-like or other allergy-like reactions, to mention the most common. But all of these are signs of detoxification and are therefore good, very good, extremely good. The only thing is that depending on the initial state of the body, the process may be more or less extreme, more or less painful, more or less prolonged, and more or less stressful. In some cases, we may want to do it more gradually in order to avoid an extremely fast and thus intense detox phase that can sometimes actually make us sick for a while. But no matter what everything that manifests is a positive and encouraging sign that we are moving towards a healthier state of body and of mind, for sure.

There are several things that help in the process of detoxification. The first, that you will have read or heard about anywhere you encounter mention of detoxification, is to drink a lot of water. What you will not have read or heard about, however, and that I will add to this recommendation, is that it is essential to take plenty of unrefined sea salt to accompany all the water. Without the salt, you will quickly dilute your blood sodium and chloride concentrations and consequently dehydrate instead of hydrating. The ratio is 1/2 to 1 teaspoon of salt per litre of water. The more you drink, the more salt you need, and it is particularly important if you don’t eat for an extended period of time. Drops to make the water alkaline is extremely helpful.

The second is that since you can consider all the toxins being released as acidic waste, it is extremely helpful to alkalise as much as you can to neutralise as much of the acidity as possible. So, drink green juices and chlorophyll, either fresh or in powdered form, and eat cucumbers, celery, kohlrabi and huge dark green salads with avocados and lots of fresh arugula, parsley and basil whenever you can find them. But this is also true every day and always.

Third and also crucial are psyllium husks to help clear out the toxins from the intestines as efficiently as possible. The very best way to take them is to dissolve in a 1 litre bottle of water, 1 heaping teaspoon of green juice powder, 1/2 teaspoon of unrefined Atlantic salt, and two teaspoons of psyllium husks (aloe vera juice to enhance cleansing and a tiny bit of stevia to sweeten and counter the salty taste are optional). Make sure you let it sit for some time so that the psyllium husks are well hydrated before you start drinking, and shake well every time before drinking. You should have at least 1 litre per day (I do this every day, drank relatively slowly typically between 10:30 and 14:30, always on an empty stomach), and 2 litres during the acute detox phase would be excellent. This will clean out the entire length of the intestines very effectively but also very gently. But remember to always start the day with a litre of plain, room temperature, alkaline water, drank over the course of at least 30 minutes. Or, alternatively or in combination, you can also start with a litre of tulsi herbal tea. Tulsi or Holy Basil is a powerful anti-stress and thus adrenal support that is soothing and relaxing without inducing sleepiness, and that over time helps the adrenal system recover from the very commonly encountered state of partial or nearly complete adrenal exhaustion. I usually to do both the water (between 1/2 and 1 litre) and tulsi tea (also from 1/2 to 1 litre) for a total that is always between 1 and 1.5 litres, typically taken over the period from 7 to 9, first thing in the morning.

Finally, it is very useful to soak in a hot bath with 2 to 4 cups of baking soda or epson salts (magnesium sulphate), or even better, 2/3 cup of nigari flakes (magnesium chloride). This will help relax the muscles, alkalise by pulling out acids from the tissues, and promote maximum detoxification through the skin. Magnesium chloride is also a powerful detoxifying and metal-chelating agent on its own. Make sure to supplement with it both orally and through the skin (see Why you should start taking magnesium today). Putting food-grade, virgin coconut oil, scented with a little essential oil of lavender or geranium on the skin is excellent. (Melt the coconut oil at low temperature, add the essential oils in the ratio of 10 ml per litre, seal, shake well and put in the fridge cool quickly. Then let is sit and keep it a room temperature.)

The acute phase can be hard to get through, but it is relatively short (days), and you will really start to feel a lot better after all these toxins have been cleared out of the body: all the pathogenic micro-organisms starved off and eliminated together with their acidic metabolic byproducts. The process of healing the intestines, the blood and the tissues takes a long time, but on the way there, you will feel better with every passing day. Regular green juice fasts are an excellent way to accelerate the process of healing and then to maintain health. It is essential to remember, however, that beyond the initial acute detox phase, optimal health depends entirely on a continual process and perpetual cycle of cleansing, detoxification and alkalisation followed by nourishing, repairing and rebuilding, carried out every day, and day after day. The profound systemic detoxification and healing process that results from the complete elimination of sugars and starches from the diet is without any doubt the most important and powerfully healthful change you could ever make.

The kidney: evolutionary marvel

Kidney stones appear at all ages. They are common in older people, but also in the middle aged. They are seen in infants and toddlers, but also in teens and young adults. About 80% of them are calcium stones, 10% struvite stones (from urinary tract infections), and 10% crystallised uric acid, but uric acid ‘seeds’ also promote the formation of calcium stones. That this is so naturally implies that chronic kidney dysfunction must also be common.

Pain associated with a kidney stone can be sharp or dull, mostly depending on the size of the stone either partially blocking or passing through a calix in the kidney or the ureter from the kidney to the bladder, and usually expresses itself as pain in the back or side (easily mistaken for muscular strain), in the abdominal area (easily mistaken for indigestion) or in the groin above which sits the bladder. That such a pain should appear and persist when there are no reasons to suspect either muscle soreness or indigestion indicates that the problem may well be with one or both of the kidneys.

We take almost everything for granted. That we should have air that is not toxic to breathe, water that is not polluted to drink, food that is not contaminated to eat. That we should have a comfortable and warm place to live and work, hot water to shower and bathe whenever we wish, running water wherever find ourselves. That there should be living plants, insects and animals; soils in which can be planted seeds that will grow; rivers, lakes, seas and oceans in which fish can live, thrive and multiply; mountains, forests and plains in which trees, bushes and grass, beasts, birds and bugs, and every living thing can also not just survive, but thrive. We take these for granted, maybe all the time, and if not, probably most of the time. It is, unfortunately, more than obvious that we should not.

That we take almost everything for granted is even more remarkable when we consider this bodymind (that we customarily and mistakenly call ours), with its countless numbers of specialised cells and tissues, its amazingly intricate organs and systems, and its multitude of facets and functions. What happens when we breathe in, and then when we breathe out? What happens when we drink a glass of water or when instead we drink a glass of juice? What happens when we drink a glass of Coke or a glass of wine? What happens when we eat something: when we eat a an apple or a cucumber, a carrot or a celery stick, a potato or an avocado; when we eat an almond or a walnut, pumpkin or sunflower seeds; when we eat meat or fish, eggs or cheese, olive oil, fresh butter or coconut oil; and what happens when we eat burgers and fries, doughnuts, cookies, cake and candy? What happens in the stomach, in the pancreas, in the liver, in the gall bladder, in the small intestine and in the colon? What happens during the process of digestion? How does digestion take place? What happens in the kidneys? What happens in the bloodstream? What happens in the brain?

Most of us have no idea. But we should, should we not? We take it all for granted: that everything will just work; everything will take care of itself; the body will take care of us. Although this can happen, sometimes, in general it doesn’t. But it should, shouldn’t it? Why does it escape us so thoroughly that this bodymind—every single cell in it—is entirely made from what we eat, drink and breathe? It is so obvious and yet it eludes us. And so, we must consciously come back to this again and again.

When we begin to explore the physiology of the body to find out how things work, we find that both the complexity with which we can appreciate, and the understanding of the various functions and interactions, arrange themselves in layers from coarse and superficial to more subtle and profound. Inevitably, as appreciation and understanding deepen, it becomes impossible to find all of it anything less than amazing. And although this can be said for many, maybe even for all organs, it is particularly true in this case: the kidney is an evolutionary marvel, a true jewel of physiological evolution in animals. It is without any doubt one of, if not the most refined organ both in architecture and function. To pack together so many tiny, delicate structures, working both independently and in unison in an array of such intricate, complex and subtle functions and interactions is truly mind boggling and awe inspiring. This fact is totally under-appreciated. And for this very reason, I feel it extremely important to raise the point now and bring it to your attention before moving on, so that it can remain in attention throughout your reading of this article. I hope that with an understanding of what the kidneys do, how they function and what they need, this appreciation will become permanent for you, coming up on its own every time you drink a glass of water, and every time you remember that you should have.

What we need to know

The kidneys are two bean shaped organs typically 11 cm in height, 6 cm across and 3 cm thick, on top of which sit the suprarenal (as in: above-the-kidney) or adrenal glands. They are located deep in the abdomen close to the spine, one on either side, in the area of the lower back, just below the rib cage, protected in part by the last couple of ribs but mostly by the tick muscles of back. The kidney has four main components: a thin layer that covers it like a thick skin called the capsule; a thicker layer just beneath the capsule called the cortex (outer layer), in which are most of the arteries and veins; the inner layer called the medulla (middle layer) constituted by conical structures called the pyramids (there are usually 7 of them in humans) with their wide part or base in the cortex and their tips pointing inwards towards the innermost  part of the kidney; and finally the pelvis (base) with its calyces connecting to the ureter.

As for everything that relates to health, understanding how to promote optimal function of a cell, tissue, organ or system requires understanding how it works. It is important to remember that every living cell and organelle does what it does not for our sake, but to maximise its own prospects for survival. When we understand what an organ is trying to do, then we can understand what is needed to make sure that it can do it with ease and efficiency. And when the organ functions with ease and efficiency, it functions optimally. This is the approach to use to maximise our prospects for living a long, healthy and happy life.

So, what is the kidney trying to do?

One: Take out of the blood metabolic wastes and toxins, primarily urea, uric acid and creatinine all resulting from protein metabolism, while keeping as much as possible of the useful stuff, especially water, minerals and amino acids. Two: Maintain blood electrolyte balance (sodium, chloride and potassium; calcium, magnesium and phosphate), pH (bicarbonate and hydrogen) and osmolarity (concentration of solutes in general). Three: Regulate body fluid content and blood volume and pressure. Sodium is the most important electrolyte and blood pressure regulator and therefore most closely monitored by the kidney.

What are the main metabolic waste products?

Urea results primarily from the breakdown (oxidation) of amino acids that are not used to build tissue, i.e., protein intake in excess of what can be used at any given time to build and repair cells, (but also from our own tissues). Urea also result from the conversion of ammonia, another byproduct of protein digestion which is so acidic that in high concentration it can cause cell death. The kidney, therefore, tries to eliminate as much as possible of the urea, recycling only what it must depending on the body’s needs, especially to increase water re-absorption when there is dehydration.

Uric acid comes from the breakdown of purines. Some are present in our own cells, and so the natural recycling of the components of dead ones produces uric acid on a more or less continual basis and at a more or less elevated rate depending on how quickly cells are dying (the rate of ageing). Purines are also present in foods we eat and drink: mostly protein-rich foods and alcohol containing drinks like wine and beer. The more purines are present, the more uric acid is produced. All the uric acid needs to be eliminated. When the urine is too concentrated and acidic, however, uric acid cannot be dissolved and thus crystallises.

Creatinine is a breakdown by-product of creatine phosphate, an energy storage molecule used mostly in cells with fluctuating energy needs like those in the muscles and brain. Creatine is made from three amino acids in two steps: the kidney combines the arginine and glycine, and then the liver binds on methionine. Creatine is then transported in the bloodstream to muscles where it is made into creatine phosphate and back to creatine as needed. In the first few seconds of an intense muscular effort or brain activity, creatine phosphate can lend a phosphate group to ADP (adenosine di-phosphate) to form ATP (adenosine tri-phosphate, the energy currency of cells), and help supply the needed energy. Very conveniently, if later there is extra ATP floating around not being used, creatine will take back a phosphate group from the ATP molecule, leaving the latter as ADP, and storing the former for future needs as creatine phosphate once more. Creatine is eventually broken down to creatinine and must be completely eliminated by the kidneys. The need for and use of creatine phosphate depends primarily on muscle mass and level of activity.  Therefore, so does production of creatinine.

How does the kidney do what it does?

By filtering the blood. And the kidneys filter a lot of blood. About 25% of all the blood coming out of the heart flows through them. This is on average 1.2 litres per minute, which amounts to more than 1700 litres per day! Since there are 4-5 litres of blood in the body, it means that every drop goes through the kidneys about 400 times each day! Since the overall flow and pressure of the system must be maintained, only around 20% of the blood flowing through the kidney is filtered (that’s 240 ml/min and 340 l/day). The renal artery supplies the blood, and branches out into smaller arteries that also branch out into smaller arterioles all the way to the filtering unit. Because half of the blood volume is water, this amounts to 850 (1700/2) litres per day flowing through the kidneys. Filtering 20% means that 170 litres of water are filtered each day. Therefore, if one litre of urine is produced and excreted over the course of 24 hours (that’s pretty typical, unfortunately), it means that 169 out of 170 of these litres of water are reabsorbed: a reabsorption efficiency of 99.4% (169/170)! Producing two litres of urine eases this down to an efficiency of merely 98.8% (168/170). Now, that’s what we call high running efficiency.

But what does ‘filtering the blood’ actually mean and how is this done exactly? In each kidney there are about 1 million miniature filters called nephrons; they run from the lower part of the cortex deep into the pyramids. It is in the nephron that the blood is filtered and the urine produced in five main stages, first through Bowman’s capsule (1) and into the proximal convoluted tubule (2), then along the loop of Henle (3) and into the distal convoluted tubule (4), and finally out through the collecting duct (5) and into the ureter to the bladder. The filtrate and the concentrated blood course separately through the nephron only once on a one-way trip through the interstitial medium in which it is embedded in distinct but intertwined vessels. Along this winding course take place the delicate regulation of blood pressure, the filtration, the reabsorption of water and useful substances, the concentration of wastes into the filtrate that will become urine, and the regulation of water content and electrolyte balance. Here’s a description of how it works:

Stage one: Bowman’s Capsule    The blood coming into the nephron first enters a little spheroidal structure 0.3 mm in diameter (Bowman’s capsule) where about 20% of it is mechanically filtered to separate the fluid part called the plasma from the solids. It is ‘mechanical’ in the sense that it is pressure driven and based on particle size: smaller stuff like water, minerals, glucose and amino acids, together with the metabolic waste like urea and uric acid pass through, whereas large stuff like blood cells, proteins and fats do not. This is similar to how a water filter works: the water goes through the porous but densely packed carbon or ceramic block that stops most of the large particles like chemicals and metals, but allows the water to pass. And just as the filtering efficiency of a given filter depends on the pressure of the water supply, the filtering through the glomerulus in Bowman’s capsule depends intimately on the pressure of the blood supply. If the pressure is too low, the filtering is inefficient. But if the pressure is too high the delicate filtering structures are damaged. The pressure must therefore be just right for the circumstances, (the conditions being obviously very different when we are running and when we are sleeping).

Stage two: The Proximal Convoluted Tubule    The fluid moves from the capsule into the proximal (as in: close-by) tubule. The blood moves from the larger afferent (as in: towards) arteriole where the pressure is monitored before entering Bowman’s capsule, into the smaller efferent (as in: away-from) arteriole after passing through the glomerulus. It is now much thicker and more concentrated. Here, most of the water (about 65%) and almost all sodium are reabsorbed from the filtrate back into the blood, in addition to all of the glucose and amino acids, (none should end up in the urine), and some urea. If the pressure is even slightly lower than it should, the juxtaglomerular (as in: next-to-the-glomerulus) pressure-sensing cells in the afferent and efferent arterioles, secrete renin that flows into the bloodstream, and stimulates the release of angiotensin I from the liver, which is then converted in the lungs to angiotensin II, a powerful vasoconstrictor that promotes the contraction of the blood vessels to raise blood pressure, but also triggers the secretion of aldosterone in the adrenal glands, which in turn stimulates more reabsorption of water and salt in the nephron, also for the purpose of raising blood volume and pressure.

Stage three: The Loop of Henle    Most of the water and salt, and all the organic molecules like glucose and amino acids are reabsorbed from the filtrate back into the blood through a network of tiny blood vessels (capillaries) in the first part of the proximal convoluted tubule, straight after its emerging from Bowman’s capsule. From there, the vessel changes in shape and direction, and becomes what is named the Loop of Henle: a crucial element of the nephron that has a water-permeable descending limb and a water-impermeable ascending limb. As the filtrate travels down, water moves out because of the higher concentration of sodium in the embedding interstitial medium, and is reabsorbed by tiny capillaries back into the blood. The deeper it descends, the higher the sodium concentration grows, the more water comes out of the filtrate, and thus the more concentrated it becomes. As the concentrated filtrate travels back up along the ascending limb of the loop, it is sodium that is now pulled out, but this time by active transport through little pumps instead of by osmosis as for the water in the descending limb. This is necessary to recover as much sodium as possible and maintain the gradient of concentration of the interstitial medium in which the loop of Henle is embedded.

Stage four: The Distal Convoluted Tubule   The next leg of the trip—a very important one indeed—is through the distal (as in: distant) tubule. It is here that pH and electrolyte levels are regulated. It is also here that we find the chemo-sensing macula densa cells tucked in between the afferent and efferent arterioles, next to their pressure-sensing juxtaglomerular cells. Blood pH is regulated by either absorbing bicarbonate and secreting protons to increase acidity, or vice versa, (without a doubt the much more common alternative), by secreting bicarbonate and absorbing protons to make the blood more alkaline.  Sodium can be left to be excreted or it can be reabsorbed and potassium secreted into the bloodstream under the influence of the hormone aldosterone, and calcium can also be excreted or reabsorbed but in this case under the influence of parathyroid hormone or PTH.

Stage five: The Collecting Duct   The distal convoluted tubule is endowed with a system of collecting tubules to which is delivered the filtrate, (now practically urine), and that merge into the main collecting duct that carries the liquid to the ureter into the bladder. On this final stretch in the collecting duct through the interstitial medium of the nephron, a little more water can be squeeze out of the already concentrated urine. This, however, only happens in the presence of the very important hormone vasopressin (also called anti diuretic hormone or ADH), which is secreted when the body is dehydrated.

This amazing process takes place in millions of nephrons tightly packed and organised in each of the two kidneys, continuously throughout the day and night, from the moment the kidney starts to work in the not yet born child, to the moment we die, either from kidney failure or something else. And to appreciate just how amazing it really is, consider this back-of-the-envelope calculation: 1 million nephrons are packed into 7 pyramids makes about 150 000 per pyramid. Taking a pyramid to be a cone with a base of 2 cm in diameter gives a surface area for the base of about 3 cm squared (Pi*R^2, and R=1). Dividing 150 000 nephrons by this surface area in which all of them must be packed gives a density of 50 000 nephrons per squared cm. Since there are 100 squared mm in 1 squared cm, this makes a density of 500 nephrons in every square mm over the surface of the base of each pyramid, and remember that they must all squeeze in together even more as they penetrate towards the tip of the pyramid and its collecting calyx. Can you even imagine how small this is, without even considering the incredible complexity with which it all works? Gray’s Anatomy states that the thin part of the Loop of Henle is 30 microns in diameter, whereas its thick part is 60 microns, and it is safe to assume that most tubular parts of the nephron are probably also in this range. This is truly amazing. But appreciating this, we can also appreciate how incredibly fragile each nephron must be. And by the way, once a nephron is dead, it’s dead forever.

Now, blood pressure is intimately related to blood volume (amount of water in it) and blood osmolarity (the concentration of solutes, mostly sodium, and to a lesser extent the other electrolytes as well as glucose). Maintaining these in balance is essential to the functioning of everything in the body. For this reason, there are pressure sensors throughout every blood vessel, and osmolarity sensors in the hypothalamus of the brain, as well as highly sensitive sensors of both kinds in the kidney itself. A drop in volume sensed by the pressure sensors in the blood vessels, or a rise in solute concentration sensed in the hypothalamus, will trigger the release of vasopressin from the pituitary gland. Vasopressin will signal the kidney (the collecting duct) to release more water for reabsorption into the blood stream, in order to counter the drop in blood volume and rise in solute concentration. Vasopressin, just as angiotensin, will make the blood vessels constrict and tighten to maintain the blood pressure constant. It will also stimulate the secretion of glucose from the liver in case fast reaction times become necessary, as well as clotting factors and platelets to make the blood thicker and stickier, and prevent excessive blood losses in case of injury. All of these are part of the standard stress response. Vasopressin will also stimulate the secretion of the stress-induced adrenocorticoprotic hormone or ACTH that will act to reinforce all of the above in what will amount to a heightened stress response.

Dehydration—especially chronic dehydration—is probably the greatest source of physical stress in most of us. We, unfortunately, tend to live our lives completely oblivious to this fact, and therefore suffer the consequences a little more acutely with each day that passes.

What we need to do

Although all of this is in many ways awfully complicated, what we need to do to make sure the kidneys function properly is quite simple: drink more water, take more magnesium and less calcium, alkalise the body and its tissues.

More water   This is by far the most important: proper hydration by drinking plenty of water—not fluids in general, just plain water—especially in the morning when the body is most dehydrated, before eating anything, and then before each meal.

Imagine what would happen to a water filter if the incoming water were just slightly cloudy with dissolved clay particles? It would work, but over time, (obviously faster than it would in the absence of clay), it would get clogged up. Now, what if there were more fine clay particles? The filter would get clogged up faster given that its role is to stop and store the particles so that the water coming out can be clean and clear. But in addition to that, because the incoming water would necessarily be thicker and more viscous, the filter would not work as well under the same pressure. To work properly it would need a higher pressure to help push through the more viscous water, but this higher pressure (if it could be adjusted upwards) would inevitably stress the filtration system as a whole and thus shorten its ‘life’. What if, in the extreme, the incoming water were really thick, brown and muddy? It’s pretty simple: no water would make it out of the filter because it would instantly clog up.

This analogy is definitely not exact but it is clear and adequately illustrative. To function well, the kidney needs the right blood pressure, blood flow, blood volume, blood viscosity and osmolarity (concentration). As soon as either pressure, volume or sodium concentration drops, the renin-angiotensin-aldosterone is activated and reinforced by the stress response related to secretion of vasopressin (anti diuretic hormone), all acting to constrict the blood vessels, make the blood more viscous and increase reabsorption of both water and sodium to re-establish a functional equilibrium. Imagine now this thick, viscous, sticky blood going through the exceedingly fine arterioles and capillaries in the nephron, and the difficulty with which wastes would be filtered out and dissolved in the water that should be available but isn’t. Now, picture this happening throughout the 24 hours of the day, week after week and year after year. It’s no wonder kidney problems are so common!

So, at the very least we should drink one litre before breakfast and 500 ml before each of the other two meals, allowing each time 30 minutes for the water to be absorbed into the digestive system and then into the blood before eating. It is better to drink more than this, always on an empty stomach, and to take enough unrefined sea salt to match our water intake. Doing this is already enough to ensure proper kidney function and elimination of the bulk of the metabolic wastes through the urine, preventing in this way the formation of kidney stones.

More magnesium and less calcium   The formation of calcium stones is more than obviously related to the fact that we are all in general over-calcified, consuming way more calcium than the magnesium needed to keep that calcium dissolved and flowing instead of settling and crystallising in our tissues, blood vessels, joints and kidneys. Therefore, to avoid calcification we must avoid over-consuming calcium (in fact, minimising calcium intake), and we must supplement with magnesium. This will also, over time, dissolve existing calcium stones and deposits in arteries and other tissues throughout the body.

More alkaline and less acidic   The kidney’s main purpose is to excrete acidic wastes by dissolving them in water. But all digestive and metabolic wastes are acidic, and there are many sources and forms of acid wastes that all contribute to increase the overall acid load on the body. In particular, refined sugars and protein. The heavier the load, the more acidic the blood becomes. Since the blood must remain alkaline, the acid can be eliminated, neutralised or stored in tissues. All three lines of defence are used: the kidneys try to eliminate as much as possible, alkaline minerals like calcium, magnesium and potassium are pulled out of the bones to neutralise blood acidity, and excess acid is stored away in tissues. Everything is done to take it out of circulation. The more acid is stored, the more acidic the tissues become. And the more acidic the body is, the less is its alkalising potential and the harder it is for the kidneys to dissolve and eliminate the acid that should be eliminated on a continual basis. There are fundamental physiological arguments that explain how tissue acidosis is at the root of literally every health problem and disease, (I will write about this more specifically on other occasions), but even without any further considerations, the only sensible conclusion is that the less acid-forming foods and drinks we ingest, the healthier the tissues, the kidneys and the body will be.

The most strongly acid-forming foods are refined sugars. Next are meats, eggs and milk products, then flours, grains and starches. The most strongly alkaline-forming (acid-neutralising) foods are raw and green vegetables, especially salads and leafy greens, as well as watery vegetables like cucumbers and celery. The more chlorophyl, the more alkalising. Parsley, basil, cilantro and all grasses are therefore alkalising and cleansing superstars.

Looking beyond single foods we find that certain combinations make the results indigestible and thus promoting of either putrefaction (protein with sugars or starches) or fermentation (simple sugars with most everything else). Both of these lead to the formation of a lot more acid waste in the digestive system a great part of which ends up the bloodstream. Adopting an alkaline diet will very quickly help balance blood pH and promote maximum excretion of acid wastes. Over time, this will allow the body to not only recover proper digestion and elimination on a meal-per-meal and daily basis, but also to eliminate acidic wastes stored in our tissues throughout the body, thus ridding it of aches and pains, the potential for chronic inflammation or infection, as well as for more serious degenerative diseases like arthritis, cancer and multiple sclerosis, for example.

Last words

And finally, to stop taking so many things for granted is simple. We just need to pay attention to the details of our life and allow ourselves to be surprised, intrigued, inspired and amazed by what we encounter. Nothing more. We need to open to how things present themselves and just feel sensations with the actual feeling of the hands and fingers, of the feet and toes, of the belly, the chest, the back and neck. Really feel what is felt: the glass in the hand, the water in the mouth and then flowing in the throat and into the stomach. Actually see what the eyes are seeing: not things but forms and colours, light and dark, space and expansiveness in all directions. Actually hear what is heard in the whole space of hearing. This is how we can stop taking things for granted. Just paying attention to our life with our life. That’s all.

(If you want to read more about water, salt and kidney function you can read How much salt or how much water? For more information about the importance of water in digestion and health read Why we should drink water before meals and Water, ageing and disease. For more on calcification, the importance of minerals in general and magnesium in particular, you can read Minerals and bones, calcium and heart attacks and Why you should start taking magnesium today. For more on the importance of proper hydration in treating chronic inflammation read Treating arthritis I: super-hydration, alkalisation and magnesium. Please feel free to write your comments or send me questions about anything you encounter in articles on this blog.)

Blood analysis II: understanding a few essential numbers

In a previous post, Blood analysis I: important numbers, I made a list of tests that would give a good idea of the state of health of the body. Many of them are part of standard or routine blood work, others are not. I personally find it both interesting and useful for everyone to monitor health in this objective, quantified manner by getting regular blood analysis once per year under normal circumstances, and more frequently if we are either critically ill or simply interested in documenting the evolution of the numbers that reflect the state of our health, especially during a transition period of metabolic adaptation such as a switch from a regular high carb diet to the ketogenic/alkalising diet. Either way, there are a few tests that I would argue are more useful than others, and therefore more important—essential even—for the purpose of monitoring your health.

Having these tests done and getting the results back is of little use if we don’t understand what they mean. So, I first list a minimal set of fasting blood tests to do either by themselves or in addition to those commonly done, and explain their relationship to the state of our metabolism and physiology.

1. Insulin to be as low as possible (mine is ~2 mU/l)
2. Glucose to be as low as possible (mine is ~75 mg/dl, and I don’t eat carbs)
3. Triglycerides to be as low as possible (mine are ~35 mg/dl)
4. Urea and Uric Acid to be as low as possible  (mine are ~18 and ~4 mg/dl)
5. C-Reactive Protein to be as low as possible (mine is <0.03 mg/l)
6. Creatinine to be between 0.5 and 1 mg/dl (mine is ~ 0.8 mg/dl, and I do weights)
7. Vitamin D3 25OH to be above 50 and below 100 ng/ml
8. Vitamin B12 to be above 400, and 600-800 pg/ml is best

The first three—insulin, glucose and triglycerides—give you a very clear picture of metabolic efficiency: of how well your cells use glucose and fat. Optimal metabolic efficiency is when cells use fat as their primary source of fuel. But when stress hormone levels rise while lifting a heavy weight or sprinting, and glucose is synthesised from the glycogen in the muscle or/and in the liver and released into the bloodstream, then cells use it very efficiently. If under certain circumstances glucose levels rise and remain somewhat higher for a while, a very small amount of insulin is needed, and therefore secreted, because all cells, especially those in the liver, muscle and fatty tissues, have exquisite insulin sensitivity.

It is important to measure both glucose and insulin because in most normally “healthy” people, as insulin resistance grows over time, the pancreas adapts and secretes more and more insulin. Levels of glucose can remain relatively low, i.e.,  in the “normal” range < 110 mg/dl, but only because insulin levels are higher. Higher insulin levels cause further and faster increase in insulin resistance, which continues to require greater amounts of insulin from the pancreas.

Since insulin concentration is probably the best indicator of health and longevity in practically all living creatures, simple and complex, obviously including humans, you want to have it as low as possible. To have insulin as low as possible, glucose needs to be as low as possible. And for glucose to be as low as possible, we need to eliminate simple and starchy carbs from our diet, and establish and maintain nutritional ketosis in which fat is used continuously as the cellular fuel of choice, which it is. (For more details you can read my earlier posts We were never meant to eat simple or starchy carbohydrates, and When you eliminate insulin-stimulating carbohydrates).

Triglycerides are fats: three fatty acids attached to a backbone of glycerol. When metabolic efficiency is high and fat utilisation good, triglycerides are low because they are easily used by the cells. If, on the contrary, metabolic efficiency is low and fat utilisation poor, then triglyceride concentrations will be high. The lower their concentration, the higher the metabolic efficiency and fat utilisation. That’s what we want for optimal health and long life, and keep in mind that fats cannot be used while insulin levels are high.

Urea and Uric Acid give you a good idea how much acidity is circulating in the blood in relation to how much protein you eat, because they are both bi-products of protein metabolism and digestion, and are both excreted by the kidneys into the urine as waste. Urea results from the oxidation of animo acids ingested from food and not used for the synthesis of proteins and other biological substances; in other words, from a surplus of ingested protein. It is the primary metabolic waste that finds its way out of the body through the urine. Urea is also used by the kidneys in order to increase reabsorption of water in case of dehydration. Uric acid results from the final oxidation (breakdown) of purine, which is found mostly in protein-rich animal foods, and, like urea, is excreted in urine. Both need to be as low because unexcreted excesses of either will force the body to store them as urate crystals in the tissues, preferentially in the joints but also throughout the body. This leads to the gradual growth of tissue acidosis, which is the root cause of a very wide spectrum of problems. Keeping these acidic waste products low is done through consuming only the minimum required amounts of protein (0.5-0.75 g/kg/lean mass/day), eating and drinking to alkalise—not acidify—in order to maximise their excretion through the urine, which cannot be done without excellent hydration and adequate salt intake. (More details in How much salt or how much water? and in Treating arthritis I).

C-Reactive Protein is one of the best indicator of systemic inflammation, and systemic inflammation is common and maybe even at the root of all degenerative diseases, including atherosclerosis and heart attack, stroke and Alzheimer’s, arthritis and multiple sclerosis, and on and on and on. Therefore it is very simple: you want the minimum amount of inflammation in your body, and obviously, the minimum amount of the tracers of inflammation, of which C-Reactive Protein is very reliable. (Interleukin-6 is another good one.)

Creatinine is related to muscle energy metabolism and muscle tissue breakdown. It is a metabolic waste that also needs to be excreted by the kidneys. For example, body builders have very high levels of it because they are continuously breaking down muscle fibres through weight training, but their body is also rebuilding and, in fact, building more muscle mass as a result of the training. So that is perfectly normal in their circumstances. If you are not a body builder, then your levels of creatinine should be relatively low.

It is important to point out that insulin resistance leads to muscle breakdown for the straight-forward reason that high levels of insulin prevent fat breakdown, and when glucose levels drop and glycogen stores are low, the body will break down muscle to make glucose out of it in order to supply a source of fuel to the cells. Any level of insulin resistance will cause muscle breakdown in these circumstances, which, for most people is every night, and during any period of fasting for longer than a few hours. The more insulin resistant, the more the amount of muscle breakdown. So, as the metabolic efficiency grows with time while nurturing nutritional ketosis, insulin sensitivity grows, fat utilisation grows, muscle breakdown decreases, and creatinine levels drop.

Looking a little further, we find that cholesterol lowering statin drugs have the awfully negative side-effect of causing muscle tissue breakdown. And so, people taking such medications—which absolutely nobody should—typically have much higher levels of creatinine production. At first, starting with relatively healthy kidneys, it is not noticed because most of it is cleared from the bloodstream and excreted. Over time, however, the continual stress on the kidneys causes irreparable damage to the fragile filtering nephrons, and creatinine levels in the blood start to rise. Eventually, this can—and much too often does—lead to kidney failure. If the person does not die from it, they will, for the rest of their lives, depend on regular dialysis or on a kidney transplant for long term survival; “long term” here means more than a few days. So, stay away from cholesterol-lowering drugs, no matter what your doctor says.

Vitamin D3 (25-OH-D), which must be optimised because so very many cellular, hormonal and metabolic processes depends on this fat-soluble pre-hormone, and must be monitored because there are very important differences in the needs of different individuals primarily due to their genetic background. For optimal health, it is essential to monitor vitamin D concentrations at least on a yearly basis (at the start of the winter), if not every half year.

Vitamin D is either consumed in certain fatty foods, or produced by the interaction of solar UV-B rays on the skin. Production of vitamin D strongly depends on cholesterol levels that must be optimally high (between 200 and 240 mg/dl), and once produced, requires 24-48 hours to be completely absorbed into the bloodstream. Therefore, if you wish to absorb the vitamin D produced on your skin, you should not wash with soap after sun exposure to the midday sun in the summer; it is only at midday when the sun is at the zenith that UV-B rays can pass through the atmosphere and reach the surface. Without UV-B there can be no vitamin D synthesis.

So, in the summer you expose as much of your skin as possible for 20 to 40 minutes to the midday sun, and do not wash those parts of your skin with soap for the next 24-36 hours. At the start of the winter, you test your blood levels of vitamin D, and depending on the concentration, you supplement accordingly over the course of the dark winter months. Let me  emphasise the importance of individual differences in vitamin D needs between people with this example:

My wife and I have the same diet, take the same supplements, and expose our skin in the summer to a comparable extent. However, because we have very different ancestry, different skin types and overall different physiologies, even though most of our blood test results are very similar, her levels of vitamin D are significantly higher than mine, more than twice as high, in fact: hers are 88 ng/ml, which is perfect—well above 50 and well under 100; whereas mine are 40 ng/ml, which is sub-optimal. And this in light of the fact that we have been supplementing with vitamin D during the winter months for a several years now. This means that for this winter, I need to supplement and she does not. It also goes to show that everyone interested in maintaining optimal vitamin D levels needs to monitor and supplement accordingly.

Finally, Vitamin B12 is the last on the list but maybe the most important together with Vitamin D. It is absolutely essential for everything because it is involved in the metabolism of every cell in the human body, and critically important in the function of the brain and entire nervous system. I will have to write about it in a lot more details, but for now, I will just link to an excellent blog by a psychiatrist that works with what she calls Evolutionary Psychiatry. This article is particularly revealing about the vital importance of B12. Since I don’t eat meat and fish very rarely, I always keep a close eye and most of time supplement with B12.

That’s it. I hope this will, on the one hand, encourage you to get these blood tests done, and on the other, give you a better understanding of each one’s biochemical and physiological importance in relation to your health.

Two articles that changed my life

Two days ago, on October 23, I turned 40. For me, it feels different than every other birthday I have had: it feels like the marker of the transition between what can be considered young adulthood from 20 to 40, and middle adulthood from 40 to 70, which is then simply followed by old age. Maybe this is also linked to the fact that from the time I started competing, first in running track and field, then in road cycling, duathlon (running and cycling), off-road cycling and eventually in long distance running, I have always been in the normal, standard 18-40 category (like almost everyone else, I thought). And now, starting with my first race in the first level Seniors from 40 to 50 a couple of weekends ago in Bordeaux at the Ariane Cross 2012, I am definitely, and will be for the next 10 years, in the over 40 category. So, I have been reflecting a little on the past and the future: What is really important to me, what have I done and accomplished, what do I want to do in the future and how can I get there? Simple questions whose answers are not so simple.

In this context, I want to share two articles that completely changed my life, and completely changed my state of health, in some respects, rather suddenly, and in others, gradually over the years. Interestingly, I stumbled upon and read them both in the same week almost exactly five years ago. I won’t summarise, discuss their contents, nor describe the positive effects the simple but radical changes in dietary habits they prompted me to instil have had on me, on my wife Kristin and on our son Laurent. I simply encourage you to read them for yourself, and sincerely hope they will benefit you as much as they have us, and, I am sure, everyone who has ever read and applied the information they contain to their diet.

What is clear to me now much more than it has in the past, is that no matter what information we are presented, its impact depends entirely on how receptive we are to it. And this depends on all of what we know and think we know, on how we understand the connections between everything we have been exposed to, on our habits and tendencies, on previous experiences throughout our life, and very importantly, on the circumstances that form the context in which the information is brought to our attention. Thus, let me hope that these two articles come at a time that is ripe for you to appreciate their importance in regards to your own health, that of the people you care about, and everyone else for that matter.

The two articles are Insulin and Its Metabolic Effects by Ron Rosedale, MD, and The Skinny on Fats by Mary Enig, PhD. After reading them, please consider sending this link to those you know will or even might possibly appreciate it. As you will see from the few case histories at the start of Rosedale’s presentation, it is really a matter of life or death.

Treating arthritis I: super-hydration, alkalisation and magnesium

This is entitled Treating arthritis I, because I want to highlight that it is the first phase of what I think is of the most fundamental importance for people suffering from any form of arthritis. It should really be entitled Treating and preventing any and all disease conditions in everyone I, because these measures are truly fundamental to optimal health in all respects and for everyone throughout life. So even if you don’t have arthritis, you should read on.

This first phase should be viewed as one during which you train yourself to acquire new habits. It is not a treatment per se, but rather a prescription for the basis of a new daily rhythm where hydrating and cleansing the body are of the most fundamental importance. In the end, it is really very easy and very simple. It’s just that we need to get used to it.

Arthritis is a word that means joint (arthro) inflammation (itis). There are tons of different types of arthritis (in the hundreds), but all of them are manifestations of the same thing in different joints and somewhat different ways. And the symptoms: the stiffness, the breakdown of cartilage and other tissues, the ossification or rather calcification, the crippling pain, are all related to the inflammation. But what if there were no inflammation? Would there be no arthritis?

Without inflammation there is no tendonitis where a tendon gets inflamed like in the well known tennis elbow. Without inflammation of the lining of the arteries there is no plaque and no atherosclerosis, and thus no heart disease and no stroke. Without inflammation there is no Multiple Sclerosis (MS), the inflammation of the myelin sheath that covers nerves, and no Crohn’s disease either, inflammation in the gut. We could go on and on like this because inflammation is at the heart of almost every single ailment from which we suffer. The reason is simple: inflammation is the body’s way of responding to injury in our tissues.

We sprain an ankle and it swells up by the inflammation that follows the partial tearing of ligament and tendon: this is essential for bringing plenty of blood carrying all the specialised molecules and nutrients necessary to repair the injured tissues. What is the best course of action? Just rest and allow the ankle to heal. The more we use it, the slower the healing will be, the longer the inflammation will last, and the more we will increase the chances of causing some more serious or even permanent damage to these fragile tissues. Without the body’s inflammatory response mechanisms, healing would be impossible.

In fact, repair and growth would also be impossible; muscle growth would be impossible. The process is rather simple: stress and tear (injury) followed by inflammation and repair or growth. This applies to body builders who develop enormous muscle mass over years of intense daily workouts, but it also applies to a baby’s legs kicking and tiny hands squeezing your index finger tightly. It applies to their learning to hold their head up and pulling themselves to their feet with the edge of the sofa to then take those first few steps. It applies to me, to you and to every animal. So, once again: repair and growth of tissue depends on the body’s inflammatory response mechanisms. In a well-functioning metabolism, this process takes place continuously in a daily cycle regulated by activity during the day and rest during the night: stress, tear and injury to tissues during activity; repair, growth and cleaning during the night.

Difficulties arise when inflammation becomes chronic. Either a low-grade inflammation that we can ignore completely and go about our business until it manifests in the form of a serious health concern, or a sustained, barely sub-acute state of inflammation that does indeed make if difficult to go about our business, but that we can nonetheless learn to ignore or cope with in the hopes that it will eventually disappear. Unfortunately, this is how it is for most of us to a greater or lesser extent, whether we are aware of it or not. If it weren’t the case, there wouldn’t be hundreds of millions of people suffering from arthritis the world over, and atherosclerosis-caused heart attacks and strokes would not be claiming the lives of more than one quarter of the population of industrialised countries.

As an aside, for those of you who are interested in measurements and quantifiable effects, among the best markers of chronic inflammation are C-Reactive Protein (hsCRP) and Interleukin-6 (IL-6). The number of white blood cells relate to immune response, and if elevated mean the body is fighting something. Elevated concentrations of Ferritin and Homocysteine (HcY) are also associated with chronic inflammation much elevated risks of heart attack and stroke. You can easily get a blood test to check those numbers among other important ones (see Blood analysis: important numbers).

So what is it that causes a person to develop arthritis at 50 or even 40 years of age, while another person only begins to have mild signs of it at 80? What is it that causes a teenager to develop the crippling Rheumatoid Arthritis (RA) at 16, while none of her friends do? Why does only 1 in 400 develop Ankylosing Spondylitis (AS) or bamboo spine, characterised by the chronic inflammation of the spine, the ossification and gradual fusion of the vertebrae? Who knows?

But, for example, approximately 90% of AS patients express the HLA-B27 genotype and exhibit the HLA-B27 antigen, which is also expressed by Klebsiella bacteria. Could it be the bacteria that causes the damage and injury to spinal tissues and structure, which then follows by inflammation that over time becomes chronic, and since the bacteria remains and continues its damaging activities, the inflammation continues to grow together with all the awful symptoms? Maybe. The debilitating effects of certain bacteria and viruses such as Epstein Barr or HPV for example, that persist in the bloodstream over years and decades, are well known. And the chronic inflammation that results of the activity of infectious agents such as these is also a well established effect, even claimed by some to be among the primary causes of arterial disease (see Fat and Cholesterol are Good for You in the Further Readings page.

But whether it is AS or arterial disease, MS or tendonitis, what is common to all is inflammation, and what needs to be addressed are the causes of the inflammation—not the inflammation itself, which is what we do with anti-inflammatory medication. The inflammation is the body’s response to the injury. What we need to do is find and stop the process causing damage to our tissues, and once the tissues have healed, the inflammation will disappear of itself.

There are many things that cause injury to our tissues, and we will look at all the most important ones in greater detail in subsequent posts, but it is fundamental to address first order issues first. Among the most fundamental issues of all are therefore those with which we concern ourselves in the first phase of treatment:  super-hydration, alkalisation and magnesium. But the truth is that these fundamental elements are what everyone concerned with optimising their health should actually concern themselves with first, before everything else.

Super-hydration

Chronic dehydration is at the root of so many health problems that it is hard to know where to begin. I’ve written a few posts on the importance of water that you can identify by their title. If you’ve read them and want to know more, you should read Your Body’s Many Cries for Water, referenced and linked in Further Readings. In relation to arthritis, however, water is not only the primary means to reduce inflammation of stressed cells and tissues, but it is also what gives our cartilage suppleness and flexibility.

Cartilage a very simple tissue. It is water, 85% in healthy cartilage, down to 70% or less in compromised cartilage and in most old people, held within a matrix of collagen and other proteins that consists of a single type of cell called chondrocyte. These cells have very special electrical properties that give cartilage its amazing resistance to friction and pressure. Without sufficient water, however, the chondrocytes cannot work correctly, cartilage dries out and breaks down, and calcification grows.

What is totally under-appreciated is that because cartilage does not have a blood supply, nerves or lymphatic system, water makes it into the cartilage through the porous end of the bone to which it is stuck, and the only way water can make it into the bone in order to get to that porous end to which the cartilage is attached is through the blood that makes it into the bone. Since there is, within the body’s functions, a definite hierarchy in water usage in which the digestive system is naturally the first served since it is through it that water enters, even the mildest dehydration can be felt in the function of the most water-sensitive tissues like those of the lungs (90% water) and muscles (85% water), (something any athlete who has drank alcohol the night before a race or even training run or ride will have noticed), it is unfortunately often the cartilage that suffer the most. Dehydration will make it such that the soft conjunctive tissues at the ends of our bones, in every joint, and that allow us to move will not get the water supply they need to remain well hydrated, supple and flexible. This is really the most important point to remember. What is also highly under-appreciated is the vital importance of silica in the form of silicic acid in the growth, maintenance, repair and regeneration of all connective tissues, including and maybe especially bones and cartilage (here is a good article about it). Silicic acid should therefore be included in all arthritis treatment programmes.

How do we super-hydrate? By drinking more, as much as possible on an empty stomach, and balancing water with salt intake. You should read How much salt or how much water? and make sure you understand the importance of a plentiful intake of water, an adequate intake of salt, and the crucial balance of these for optimal cellular hydration and function. Detailed recommendations are given below.

Alkalisation

Chronic acidosis, some would argue, is not only at the root of innumerable health complaints and problems, but that it actually is the root of all health disorders. The reading of Sick and Tired, The pH Miracle and Alkalise or Die is, I  believe, enough to convince most readers that that premise is in fact true. Not surprisingly though, it is not possible to alkalise bodily tissues without optimal hydration. And so we immediately understand that chronic dehydration is the primary cause of chronic and ever increasing tissue acidosis. Therefore we address both simultaneously, and in fact, cannot do otherwise.

Briefly, what is essential to understand is that healthy cells thrive in an alkaline environment, and indeed require an alkaline environment to thrive. Conversely, pathogens such as moulds, yeasts, fungi, viruses and bacteria thrive in acidic environments. Healthy cells thrive in well oxygenated, aerobic environments, whereas pathogens thrive in anaerobic environments, those deprived of oxygen. Since this is so, we can say, crudely speaking, that if the tissues and inner environment of the body—its terrain—is alkaline, then pathogens cannot take hold nor develop nor evolve nor survive in it. On the other hand, if the body’s terrain is acidic, then they thrive and overtake it, sometimes slowly and gradually, but sometimes quickly and suddenly, causing sickness and disease.

Everything that we eat and drink has an effect that is either alkalising, acidifying or neutral. This is after digestion and has little to do with taste. All sweet tasting foods or drinks that contain sugars, for instance, are acidifying. I will write quite a lot more about pH and alkalisation in future posts. For now, we are concerned with alkalising through super-hydration, and this involves drinking alkaline water and green drinks. By the end of phase I, drinking your 2 litres of alkaline water and 2 litres of alkaline green drink should be as second nature to you as brushing the teeth before bed.

Magnesium

As I attempted to express and make evident the importance of magnesium for every cell and cellular process in the body in Why you should start taking magnesium today, and thus show that we all need to take plenty of magnesium daily in order to both attain and maintain optimal health, for someone suffering from arthritis it is extremely important, crucial. And the reason is very simple: arthritis is characterised by inflammation, stiffening and calcification. They come together, of course, and it is useless to even wonder if one come before another. Regardless, the best, most effective, most proven treatment or antidote for inflammation, stiffening and calcification is magnesium.

Magnesium, injected directly into the bloodstream, can almost miraculously stop spasms and convulsions of muscle fibres, and release, practically instantaneously, even the most extreme muscular contraction associated with shock, heart attack and stroke. This is used routinely and very effectively in birthing wards and surgery rooms. Magnesium is the only ion that can prevent calcium from entering and flooding a cell, thereby causing it to die, and magnesium is the best at dissolving non-ionic calcium—the one that deposits throughout the body in tissues and arteries, and over bone, cartilage, tendons and ligaments—and allowing all this excess calcium to be excreted: precisely what we must do in treating arthritis.

In addition, magnesium is very effective at chelating (pulling out) both toxic heavy metals like mercury and persistent chemicals that bio-accumulate in blood, brain and other tissues. For too many unfortunately unsuspecting people, heavy metal toxicity is the cause of a plethora of various symptoms, wide-ranging in nature, hard to understand or associate with some known and easily identifiable condition, but that cause them often immense discomfort up to complete disability.

Putting all of this into practice

When you get up in the morning, you go to the bathroom, undress and spray or spread on your legs, arms chest and belly, neck and shoulders, the 20% magnesium chloride solution (4 teaspoons of nigari with 80 ml of water for a total of 20 g in 100 ml of solution). You wash your hands and face well, put your PJs back on, and head to the kitchen to prepare your water and green drinks for the day.

Line up three wide-mouth 1 litre Nalgene bottles. In each one put: 5 drops of alkalising and purifying liquid concentrate (Dr. Young’s puripHy) and 10 drops of Concentrace liquid trace minerals concentrate.

In the first bottle, add 50 ml of the 2% solution of magnesium chloride (made with 4 teaspoons of nigari dissolved in 1 litre of water), 50 ml of aloe vera juice, 1 tablespoon of Hubner’s Silicea (store locator) liquid silicic acid, fill it up with high quality filtered water, shake well to mix, and take your first glass with 1 capsule of Mercola’s Complete Probiotics. You should drink this first litre over the course of about 30 minutes, taking the third or fourth glass with an added 1-2 teaspoons of psyllium husks. (The aloe vera and psyllium husks are to help cleanse the intestines over time.)

In the second and third bottles, add a heaping teaspoon of green juice powder (Dr. Young’s Doc Brocs), 1/2 to 1 teaspoon of fine, grey, unrefined sea salt, 1/4 to 1/2 a teaspoon of finely ground Ceylon cinnamon, a heaping mini-spoonful of stevia extract powder (Now or Steweet are good brands) and a single drop of either orange, lemon, grapefruit or anise (my favourite) high quality, organic, food-grade essential oil. Shake well. One of them you will drink between about 10:00 and 12:00, the other between 15:30 and 17:30. Shake every time you serve yourself a glass or drink directly from the bottle to stir up the solutes in the water. You should take these two bottles with you to work and/or keep them in the fridge until needed: the drink is really nice when it’s cool.

Now that the magnesium has been absorbed through the skin—this takes around 30 minutes, you can go have a shower to rinse off the slight salty residue that feels like when you let sea water dry on your skin without rinsing it off. You should wait at least 30 minutes after you have finished your first litre of water before you eat anything.

By about 10 or 10:30, depending on when you finished breakfast, you should start to drink your first litre of green drink and continue until about 12:00 or 12:30. Make sure you finish drinking 30-45 minutes before you eat. Wait at least couple of hours after eating. Then start drinking the second litre of green drink by about 15:30 or 16:00 until about 17:30 or 18:00. Again, make sure you stop drinking always at least 30 minutes before eating. Depending on when you eat dinner, you should drink a half litre of plain water 30 minutes before the meal. The general rules for drinking you should follow are: 1) always drink at least 500 ml up to 30 minutes before eating, and 2) do not drink during or within 2 hours after the meal.

Before going to bed, take a small glass of water with 50 ml of 2% magnesium chloride solution. And that’s it for the day. And tomorrow and the next day and the day after that, keeping to this schedule, until it becomes perfectly natural and customary. After four weeks, you should do another blood test and see how the numbers compare to those before starting. In addition, if you are interested in this from the scientific standpoint, or just curious, or both, you should get Doppler imaging of your coronary and cerebral arteries, as well as an MRI of the joints in your body, including the spine, before you start and at then end of every phase. It will also be extremely informative to test and record the pH of at least your first urine every morning; any additional urine pH readings will be very useful and tracing the progress of the gradual de-acidification of your tissues and the days and the weeks progress. And finally, the transdermal magnesium therapy (putting the 20% solution on your skin), should last 6-8 weeks. By that time, you intracellular magnesium stores should have been replenished. We continue taking the 2% solution indefinitely, and use transdermal magnesium once in a while (once or twice per week).

The great advantage of the transdermal magnesium is that almost all of it is absorbed into your tissues and bloodstream. The oral magnesium is absorbed a level between 25 and 50%, and this depends primarily on the amount of magnesium in the blood when you take it. This is why it is very important to take it first thing in the morning when magnesium is at its lowest, and then in the latter half of the afternoon and before bed, those times when concentrations are lowest. You don’t have to worry about too much magnesium because any excess will be excrete in the urine and faeces. You should just worry about not enough: that’s the real problem. Incidentally, the fact that almost all the magnesium that you put on your skin is absorbed underlines the importance of carefully choosing what we put on our skin. Because in the same way, anything we put on it will be absorbed into our system. So putting coconut and almond oil is just as good for our skin and our health, as it is bad to put on creams and lotions with synthetic chemicals and compounds that all make their way into our blood. General rule: if you cannot eat it, don’t put it on your skin.

That’s it for the first phase: mostly drinking a lot more than you used to, with a few special tweaks to what and when you drink. I haven’t mentioned anything about food even though you can obviously know from the rest of the articles on the blog that this will come in time: in the second phase. We first deal with the first order terms, then the second order terms, and after that with the third and fourth order terms. That’s very important to grasp: what has the most and what has the least impact and thus importance.