Dr. Jack Kruse - Neurosurgeon


The Living Force
FOTCM Member
This is a thread I'm starting on the information collected on Dr. Jack Kruse's (neurosurgeon) website. There's quite a bit of interesting info, so I'll probably be adding more posts as I read the material. He seems to advise a Paleo/Primal/Low Carb diet approach overall and is very adamant about diet (and other influences) - epigenetics - and health / longevity. This first post seems to be the overview for many other things he covers in more detail (will take a while to go through). There are many links in the original blog post article (including the comments at the end) that are not active in this post - some you can't even tell that they're links here. (There's also a graphic of the Quilt Matrices layout at the top before this text.)

LIVING AN OPTIMIZED LIFE Dr. Jack Kruse Neurosurgeon


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The Quilt

A document that will evolve as science eliminates past dogma

This document is a compilation of three decades of “thought secretions” on medicine as a science and an art form. Healing is not axiomatic, yet you would never know that if you opened a new text book or current journal. Medicine today is all about evidence-based findings. Evidence-based medicine is a great idea if you the underlying dogma is correct and based upon fact that we know to be undeniably true. I think you will find that I do not accept many of the foundations that evidence based medicine now currently rests upon. For me, biochemistry or physiology are absolute knowns about how humans work. Practice standards and evidence-based medicine are based upon prevailing opinion. For example, evidence-based medicine believes that everyone with a total cholesterol over 200 should be treated with a statin medication. After many years of studying this, I realize that we may need to question that kind of advice. Practice standards in the United States are based upon what a large group of physicians believe are good practices based upon the current science. But the science that is published and in the media today is not based upon truths like biochemistry or physiology. Sadly, evidence-based medicine founded on data paid for by a corporation or branch of government that is subject to the influence of many biases. Several years ago I read an article that changed my thoughts on this. It was called “Lies, Damned Lies, and Medical Science” in the Atlantic. Shortly after, I read “Good Calories and Bad Calories” by Gary Taubes, and this confirmed much of what my intuition was telling me. What I saw, and was doing as a surgeon, often felt incongruent to what the reality was for the patient. Many good doctors practice medicine today. I honestly believe that they think they are doing good work. I know this, because I was one of them. I honestly believed everything I was taught was based upon solid scientific facts. I allowed my medical and dental educators the intellectual leeway of trusting the facts they told me were true. Good intentions, however, are not congruent with longevity, or with health for that matter. Good doctors were a dime a dozen, I found out… However, great doctors were few and far between. I no longer wanted to be good; I wanted to be great. To be great you have to reject being just good. Good is not optimal. That was my initial thought after reading the Atlantic article. Yet the current system rewards only good doctors. This document will help you, the reader, differentiate between the great healers and the good ones. Your life actually depends upon it, so I strongly suggest you begin to think as you read.

Today, medicine is dominated by doctrine and dogma that caused us some serious missteps in thinking. These missteps have made us advocate for treatments, behaviors, and thoughts that have become ingrained within our society. With science, the truth always updates itself. Moreover, one must realize that every mile that we think we have conquered that puts us in the wrong direction will require us to walk two miles back just to return us to ground zero and a new beginning.

This document is not about our species becoming successful in creating a new generation… It is about making the current living humans all they can become with respect to the aging cell and where they are now. It is about increasing our life span while we simultaneously expand our health span. I suspect we are going to explore subjects in the future that none of us our thinking about now, because that is the nature of science. Living long without intervention of conventional medicine is the goal. Pointing out the good and bad in medical care will also be helpful to the lay person and healer alike I suspect. We should begin to rely on our physicians to guide us to pathways that attain that goal. I believe that my profession will evolve into taking care of healthy humans, and leave behind the old paradigm of trying to repair people after they have already been damaged by disease.

I believe this expertise will become the currency of the new paradigm, and I believe the change will be an obstacle course for many. Patients already know that we do not know everything — just ask them. But I believe we lose our credibility when we do not act congruently with the knowns of biochemistry and physiology. We cannot use treatment algorithms that promote data sets that are in fact not factual or are incredibly flawed. We have all read what has been said by the medical and nutritional gurus about the current beliefs on diet… yet we have the world’s worst weight problem and a massive public health dilemma facing us. Maybe we need to stop making excuses for what we believe to be true, and understand what really is true regardless of the implications it draws?

Accepting the proposition that randomized control trial (RCT) is the golden goose of research has given my profession a slow steady decline in reputation. It is not because a RCT is a bad thing. It is the best thing we have if it’s based upon real facts. Therein lies our real problem. When the underlying science is faulty, the randomized trials become worthless. Do we need a RCT to tell us that a potassium level of 4.0 is good? No we do not. Do we need a RCT to tell us that a potassium level of 3.1 is bad and requires treatment? No we do not. The current thinking in medicine is that we need a RCT for everything we do. The reality is that we do not if we practice using the biochemistry and physiology found in humans. We can no longer allow a drug company to tell us that a cholesterol level of 200 is bad when it is not. That is a great opinion when you are selling a statin, for sure. But if it was good for humans then why is heart disease still the number one killer in the US after 50 years of actively lowering LDL cholesterol? At some point you must ask this question if you are a patient or a doctor.

We will not need to have the support of big pharma or medical implant companies to run trials because our new focus will be on promoting health longevity and not treating disease. The transition of the healthcare economy is already occurring. Industry has a vested interest in treating sick people and not the healthy. Patients want to be healthy, but struggle to find physicians or insurance coverage who offer those services. Our government makes it easy for the current paradigm to exist, because they advocate for agriculture policy that makes us ill with diets laden with omega 6 fats, fructose, and grains. We all understand why they do it. It’s because processed food stuffs can be stored and shipped to feed the world population cheaply and for profit. They are not doctors or researchers so they can’t know unless we tell them. But they also are now beginning to feel the pain of that decision made at the industrial revolution and continued currently by their incongruity in intellect. The current healthcare crisis is ground zero for this epic battle to be fought.

I, however, choose to think my way out of this predicament. Instead of focusing on what I cannot do, (ie: change Washington DC thinking), I will instead focus my attention on what I can achieve and teach the lay public how to remain healthy so they can cure themselves. So we need to start that trend here together. This is what my blog is about.

My primary weapon in this battle?…… It is thinking. The greatest of humans are deep thinkers. Show me a success and I will show you a thinker. A human is the only animal that can actually change its DNA just by thinking. Moreover, what we really think is just a biologic secretion. No different than any hormone released by the pituitary gland. Thinking is… well it is a meme that hijacks our brain’s chemistry. Any one thought can alter our genetic and biologic purpose in life. No other animal has evolved this ability. Yes — thinking well or badly becomes a vector that changes us all in some fashion. It can alter us. This thought experiment occurs daily in our country on TV, radio, and on video games and computer screens. In fact, I believe it is the one thing that is speeding up the evolutionary pressures that we currently face. I think it is a real problem behind many health issues we will explore in the document.

The pathways I have identified over my thirty years in healthcare I call “Longevity Levees.” Remember that a levee is a protective barrier from flooding and devastation. These levees are biologic protectors of our cellular machinery . My goal is to share it with the lay public and my colleagues. As new data emerges, blogs will be added to the quilt by me and I’ll bet by you. This document should be a collaborative effort.

The longevity levees are as follows and in order of importance. .

Each one of these will be expanded upon in blog form. I will attempt to go through each one until I begin assembling the quilt in other dimensions. The quilt will link together in hypertext format to allow ease of navigation. I am open to comments and suggestion to make this platform to your liking but I will remove and edit comments I think our counterproductive to the goal of the levee. I hope you enjoy, and we can stimulate some thinking.


Levee number 1:

Current cellular homeostasis determines cellular fates all of the time. This is the cornerstone of my theory of longevity. We must stop focusing in on disease states and instead think about what happens to the cell’s environment that dictates its fate. The cellular terroir are what cause the disease states. This is my cellular theory of relativity. My theory of aging is that the environment the cell finds itself in is directly proportional to outcomes the cell may face.
In my mind, these levees will uncover a new paradigm that requires the “patient” and physician to forget about the disease states and think first about the normal cell. This theory will require you, the reader, to embrace paradox and ambiguity at every turn.

Levee 2:

Leptin sensitivity and resistance determines all energy balance. This levee is all about energy. No life can sustain itself without controlling energy metabolism. A body without energy is called a cadaver! Leptin is a hormone secreted by fat that signals the hypothalamus as to what the 20 trillion cells in our body need. Leptin is obtained through breast milk at birth. This immediately loads the hypothalamus with data, much like a disk drive with a Power Point presentation on it would do for your laptop. Leptin receptors are very specific in how they work, and they are found concentrated in the lateral hypothalamus. This hormone regulates all aspects of energy metabolism, hormonal status, fecundity, and eventual cellular generation. Simply put, the leptin axis is akin to the relationship the sun and plants have in energy generation. Plants use sunlight to convert carbon dioxide and water into sugar which supports their life via energy generation. Photosynthesis is effective for plant life but it may not have been an efficient mechanism to support animal ascent in the evolutionary development to humans. To continue to allow complexity of life, evolution had to come up with a new mechanism of energy metabolism and a way to control it, and it did. It incorporated the plant-like mitochondria into a cell and modified it to use it to generate energy. It appears that quantum biology is critical to this step based upon recent scientific developments. The amount of energy generation was quite impressive and this gave life the power to evolve further into more complex organ structures and eventually into complex organisms like humans.
Leptin controls all of this machinery of energy generation for humans. It is our photosynthesis. The sun still plays a huge role in oxidative phosphorylation. Sleep obviously plays an enormous role in here as well. This will also be explored. Sunlight and leptin signals remain tied together by the hypocretin neurons in the lateral hypothalamus of the brain. Both hypocretin neurons and leptin neurons are small in number and found in few areas of the mammalian brain. Humans have only 50,000 hypocretin neurons in their brains. Mice have but 3000. Moreover, these neuronal tracts appears very new in evolutionary times. And, because of that “newness” they are subject to signaling errors, receptor single nucleotide polymorphisms (SNP’s) and errors, neuropeptide modification, and out of sequence firing due to signaling issues at many steps. So, in humans, it appears obesity has many causes and features that confuse researchers. Because of the youth of this system of control in mammals, it is subject to several potential problems that can tremendously affect energy generation in the animal. This levee will have many blogs pointing out the various forms obesity can take due to problems in this system. To fully understand the gravity of this hormone, consider this analogy: What would happen to life on earth if, all at once, we eliminated all coal, oil, nuclear fuel, and all sunlight from our planet? I believe life would surely be changed dramatically and quickly. When leptin is not working correctly this is precisely the fate the cell has to deal with and it can dramatically alter how the cell or organ system responds when fuel demands cannot pace needs.

Levee: 3

Cellular inflammation is critical. It is akin to the fire in a burning house. The more of it your cell possesses, the more chance bad outcomes will come to the cell. Cellular inflammation comes in many different forms. It tends to flow down in certain biochemical pathways and cause havoc. (link) It also now appears that inflammation is the base cause of obesity, diseases of aging and the cause of cellular death. There are many pathways it uses to achieve this signaling and this part of The Quilt will delve into matters more deeply and show how they tie concepts together that lead to problems we humans face as we live our lives.

Levee: 4

Dietary principles of longevity. We have already seen that energy metabolism is critical to life and why Leptin holds position two in The Quilt. This levee concerns itself with the substrates that give us that energy. That energy comes from the diet we eat. This levee will explore diet and nutrition optimization. We have adapted to many environments on earth but this levee is not concerned about what we can do in adaptation. It is about how long we can live in our own current dietary edicts. The key principles here will be eating to satisfy the true knowns and not the opinions of the day. Our biochemistry and physiology have been carved by millions of years of natural selection and have not failed us yet. It is now becoming clear that biologic systems have for many millions of years used quantum mechanics to do some of the amazing things animals can do. It appears energy generation is one of them. We will explore quantum biology in this levee many times over the next few years to open the discussion of this brand new frontier.
The foundational cornerstones of this levee will be limitation of inflammation, low levels of omega 6 foodstuffs, limited fructose, limited carbohydrate intake, concentration of omega 3 laden protein sources, limited uses of foods known to cause nutrient depletion or nutrient loss in the gut. The balance of this levee will have many blogs tied to the nuances of paleolithic eating and whether micro or macro nutrient issues should dominate or not. The key points here will be how foods affect telomere lengths and what the research is pointing to, and how food may affect quantum biology.

Levee: 5

The Brain Gut axis is critical to organizational health. The major route into and out of the human body is via the gut. The brain senses this axis before food even touches the palate via the five senses. When food touches any part of the tongue, signals are immediately made on leptin receptors on the tongue to begin digestion and assess the dietary values of what we are eating to see how it will affect our energy balance. Almost the entire gut is innervated by one nerve that provides this feedback. That nerve is not a somatic (peripheral or body) nerve; that nerve is a cranial nerve called the vagus nerve. It is extremely specialized and carries many special fibers to and fro the brain and its targets. It originates in the floor of the fourth ventricle of the brainstem and the nerve covers every cell down to the transverse mesocolon of the large intestine to give the brain constant feedback on the energy coming into the animal. The incretin system is monitored directly by this nerve. If this axis is disturbed in the time it takes for food to pass through, or in the integrity of its lining, it can have drastic effects upon energy utilization and in some cases it can open the blood-brain barrier to direct assault and cause brain damage quite quickly to kill the animal. The immune system plays a monster role in regulation of this levee and the autonomic nervous system has over a billion cells in the wall of the gut to monitor progress of how this axis continues to function as the human ages. If this axis fails in some fashion, disease usually follows quickly thereafter. Major diseases like MS, ALS and autism are affected by this axis, as are the neurodegenerative disorders. Depression and Alzheimer’s also are greatly affected by a defect in this axis. IBS and Crohn’s disease are common diseases that cause massive leaky gut scenarios. A disease I treat as a neurosurgeon also plays a role in this levee. That is cerebral aneursymal rupture and the development of vasospasm. To date no theory in neurosurgery has been able to find the cause of this deadly phenomena. My theories point to the leaky gut as the conduit to it rise.

Levee: 6

Immunity affects regulation. This levee is critical because it is the major protective arm of the body. It contains two major parts, cell mediated immunity and humoral immunity. We will delve into both of these systems to show you how they are imperative for protection of organ systems, integrating development of the organism as it grows from a fetus to an adult, and how the system adapts to pathogens it faces as it grows and ages. Moreover, this system has so much complexity that is can also be turned back upon itself and cause huge issues for the organism with autoimmune diseases. These can wreck havoc and cause early death and disease if not kept in check. This system works in tight balance and is built with many redundancies to protect from malfunction but it does happen if the cell faces the wrong environments with a mismatch. Examples would be the effect of HIV on cell mediated immunity, the lack of a functioning brain-gut axis, graft versus host disease, molecular mimicry, low vitamin D levels, or failures of the complement system in humoral immune response.

Levee: 7

ROS generation. ROS stands for Reactive Oxygen Species generation. We all know our life is based upon energy production from the use of oxygen. This process is called oxidative phosphorylation. Examples include oxygen ions and peroxides. Reactive oxygen species are highly reactive due to the presence of unpaired outer shell electrons. ROS forms as a natural byproduct of the normal metabolism of oxygen and has important roles in cell signaling and homeostasis. This process occurs in the mitochondria. When we generate energy packages adenosine triphosphate (ATP) from nutrients we also generate free radicals of oxygen that leak from the cytochromes of our mitochondria. Cytochromes are the furnaces in mitochondria where ATP is made. This “leakiness” is critical to life and to the death programs inside our cell. The more “leaky” our mitochondria the more ROS we generate. Generally ROS is a bad omen for the cell but it can also signal the cell to lengthen its telomeres at times or to recruit the formation of new mitochondria to make energy. ROS generation is a measure of cellular stress, and that stress can be so great that is can damage cellular structures so that they no longer work properly. Examples are UV exposure or radiation exposure.
In general, lower ROS is better for longevity of the cell and for it to function optimally. A simple example of this fact is coenzyme Q10. Most people have heard of this cofactor, and this protein is used up to a great degree when you are making energy or the cell is stressed. Statin drugs cause depletion of this protein because of their mode of action on enzymes in blocking the building blocks of cholesterol, so they cause the cell to be more inefficient making energy as the CoEnQ10 is depleted. It is also used up when we are under stress due to long term insulin or cortisol secretion. Depletion of CoEq10 is why people can get cognitive change and muscle cramping when they are on statins too long or the dose becomes too high. The cause is because the cells in that part of the body can’t make the energy they require because of the side effect of the drug. Therefore many patients are told to add CoEnQ10 to their supplement list daily if they are on a statin.

Levee: 8

ALE’s. ALEs are short for advanced lipoxidation end-products. These are proteins that are modified in our body after we assimilate the nutrient and it becomes harmful to us. Most of us know about AGEs — advanced glycation products from excessive sugar intake. Well ALEs are far more damaging. Estimates have put the oxidative stress of ALE’s at four to six times as great as AGEs. Clearly, both are bad and our levee here will deal with how to limit the collateral damage of ALEs. These proteins are made from PUFAs (polyunsaturated fats) and become malondialdehyde (MDA for short). MDA is a biomarker for ALE stress in the cell. Malonaldehyde reacts with deoxyadenosine and deoxyguanosine in DNA, forming DNA adducts, the primary one being M1G, which is mutagenic. The guanidine group of arginine residues condense with MDA to give 2-aminopyrimidines. Two diseases where MDA plays a big role is in the development of keratoconus in the eyes or osteoarthritis of the joints of the body. One clinical measure we use of ALE toxicity in the body is presence of skin tags in folds of the skin. This finding seems to correlate with the omega 6/3 ratio in plasma. Generally we want a diet that approaches a 1 to 1 balance of omega 6 (PUFA) to omega 3 fats but in the standard American diet (SAD) that ratio can be up to 40 to 1 with heavy intake of processed foods. This is the reason we have seen tremendous increases in orthopedic joint replacement and degenerative spinal conditions in the American population. I believe it is a great contributing factor to the tremendous increases we have seen in osteoporosis and metabolic bone disease caused by hormonal disruption of bone metabolism. It leads to damage and early aging of all tissues. ALEs also generate carboxymethyllysine (CML). These can be seen in foods with added ascorbate and PUFA enrichments, such as salad dressings and Similac. Many baked wheat products are particularly prone to CML formation. Since I am a clinician who treats neurodegenerative diseases and complex spine conditions this levee will contain many entries over the years. Moreover, it will be the levee that stimulates me to write a book about my thoughts on spine disease in the modern world.

Levee: 9

AGEs. AGEs stands for Advanced Glycation Products. This is the levee that concerns itself with how high levels of all sugars we eat cause disease. The disease process is mediated through a receptor system. Activation of the receptor for advanced glycation end products (RAGE) by its specific ligand N(epsilon)-carboxymethyllysine (CML) results in the activation of NF-kappaB (the 911 system for the cell) and the production of proinflammatory cytokines. This is the mechanism of how degenerative disease begins and progresses. Moreover, it is now clear that this process feeds forward if the stressor is present chronically, as it is in diabetes. For the lay person a good way to understand what glycation by glucose, sucrose, or fructose do to our organs and proteins over time is to think of this analogy: Imagine pouring maple syrup on your granite counter top and leaving it there for three months then trying to remove it on month four. It becomes rock hard and does not allow you to use the counter top like it was designed to. That is what an AGE does. Limiting AGE generation is a clear levee of protection and we will examine many areas here for study and prevention. Damage by AGEs is common in diabetic neuropathy, Alzheimer’s, high blood pressure, stroke, atherosclerosis, osteopenia, and generation of epithelial cancers.

Levee 10:

Mitochondrial Signaling is Pleotrophic and adaptable. Pleotrophic means the process can move in multiple directions both good and bad in this context. It depends upon the amount of cellular stress. We have already seen examples in cellular stressors in the above levees. Mitochondria are the cells’ power plant to make energy. Cells use ATP as their fuel and they generate this from multiple pathways of biochemistry. Mitochondrial signaling is a pathway of communication from mitochondria to the nucleus and cytoplasm that influences many cellular and organismal activities under both normal and pathophysiological conditions. In animal cells, retrograde signaling is linked to mTOR signaling, which directly affects the cells next biologic step in its life. In mammalian cells, mitochondrial dysfunction sets off signaling cascades through altered Calcium concentration reactions, which activate factors such as NFκB, NFAT, and ATF. Retrograde signaling also induces invasive behavior in otherwise non-tumorigenic cells implying a role in tumor progression. Anterograde signaling appears to be significant in mitochondrial biogenesis and in activation of telomerase to lengthen the cell’s telomeres to allow it to divide and the tissue to live longer. This levee has many unknowns but is vitally important to understanding how we avoid disease and live longer. It should be clear to any reader that life, healthy or not, is all about energy generation and utilization. The mitochondria are the engine within our Ferrari and we need to keep that engine working efficiently if we are to remain fit long-term.

Levee 11:

mTOR pathway is life or death. We just mentioned mTOR in levee 10. I did not describe it because it is a levee by itself. mTOR stands for mammalian target of rapamycin pathway. This pathway is a giant factor for the cell. Signaling through mTOR is activated by amino acids, insulin, and growth factors, and impaired by nutrient or energy deficiency. mTOR plays key roles in cell physiology and disease states. mTOR regulates numerous components involved in protein synthesis, including initiation and elongation factors, and the biogenesis of ribosomes themselves. Oncogenesis uses mTOR pathways to make parts for the immortal cell when mTOR is biochemically linked to phosphatidylinositide 3-kinase (PI3K)-AKT. Insulin and leptin play huge roles in PI3K as well. Strategies are being developed and used now involving horizontal and vertical blockade of the pathway, as well as the use of biomarkers to select appropriate patients for certain treatments. Moreover, this pathway is being used to provide proof of target modulation. Curcumin, cacao chocolate, and ECCG have been found to give some of their clinical effects by interrupting this pathway.
The mTOR pathway integrates signals from nutrients, energy status and growth factors to regulate many processes, including autophagy, ribosome biogenesis and metabolism. The pathway has two major components call Rictor and Raptor. Rictor is involved in protein–protein interactions and is not as well conserved in all animals as is Raptor. Ironically, Rictor is also not blocked by Rapamycin either, as science found out as more data was uncovered. The rapamycin-insensitive rictor–mTOR pathway regulates Akt/PKB, PKCa, Rho/Rac to control cell survival, proliferation, metabolism and the cytoskeleton. Raptor complex of mTOR is highly conserved in animals and is blocked by Rapamyin. Raptor is a cellular kinase protein that has wide ranging effects. Long term research has shown that raptor mTOR positively regulates cell growth and that its inhibition causes a large decrease in cell size. The mitochondria signal through mTOR raptor directly. This pathway is worked out fully and can be seen in most biochemistry textbooks today. Most research has focused on Rictor and Raptor inhibitors but it’s a pathway that has vexed scientists. Most recently, research in this pathway has focused on the dual nature of mTOR that is integrated by the mTOR complex 1 and complex 2. These two complexes are formed and regulated by different proteins and are also driven by multiple different compensatory feedback loops making understanding them very complex.

Levee 12:

PPAR gamma is the confluent gate. PPAR (peroxisome proliferator-activated receptor) gamma is regarded as the master regulator of the adipocyte and of lipid metabolism in the cell. It is under the direct control of leptin and its receptors. There are three total PPAR, alpha, delta and gamma. PPAR gamma are nuclear proteins that function as transcription factors regulating gene expression from all aspects of dietary metabolism. PPAR gamma’s role is essential in cellular proliferation, energy generation, cellular differentiation, and tumorogenesis.
γ (gamma) – although transcribed by the same gene, this PPAR through alternative splicing is expressed in three forms:
γ1 – expressed in virtually all tissues, including heart, muscle, colon, kidney, pancreas, and spleen
γ2 – expressed mainly in adipose tissue (30 amino acids longer)
γ3 – expressed in macrophages, large intestine, and white adipose tissue.
So why do I call this the confluent gate? Because all metabolism goes through this path to directly affect DNA activity. This is precisely how epigenetics occurs. Diet directly affects our DNA function.
All PPARs heterodimerize with the retinoid X receptor (RXR) and bind to specific regions on the DNA of target genes. Lipids transformed into free fatty acids (FFA’s) play a huge role in the physiologic function of PPAR gamma. Endogenous ligands for the PPARs include free fatty acids and eicosanoids. PPARγ is activated by PGJ2 (a prostaglandin).


Defective signaling responses can wreck havoc. All cellular homeostasis is based upon this principle. If you have no control over the systems that govern how a cell works, then you have chaos. Cancer in my way of thinking is a complete loss of signaling. The most vital signal in a cell is that of energy homeostasis. This is dominated by leptin sensitivity. If one is leptin resistant there is no way to control cellular biology and disease processes begin. This levee is acts much like a conductor does over an orchestra. If we look at the New York Symphony ensemble individually we all know they are expert musicians and can play extraordinarily well independently. But it is the conductor who brings these 300 musicians together and coordinates their activities so well that the music sounds magical. Now think about what the music would sound like if there were no direction. The trombones and flutes would no longer be synched to the drums or violins. In essence we would have noise, not music. This is what a lack of signaling can do to the cell. Bad signaling can cause cell death, cell senescence, diabetes, neuro degenerations, autoimmunity, or cancer. Understanding how to maximize this levee is a study in maintenance of your cellular machinery to make sure it functions long term.

Levee 14:

Epigenetic modifications is quick and dynamic. We saw in the PPAR gamma levee that dietary forces can force immediate gene transcription on the cell in question. Not only does diet induce immediate changes in DNA activation but so does the organism’s hormonal status. Moreover, humans are the only animals that can induce DNA changes just by the way we think. We know that DNA activation occurs with thoughts from functional MRI data and PET scans on brain function. Many call this area the mind/body connection but I find this to be a misnomer. The mind is the sum total function of the central nervous system (CNS) and its endocrine secretion is called a thought. That secretion can directly up regulate DNA and RNA activity with gene expression and protein formation. This happens within nanoseconds according to functional MRI data, and EEG strips. It’s nothing short of amazing to think evolution can move that fast on a micro level but still not affect the phenotype of the organism in any great macro way. Another paradox of life revealed I guess. (link)
We also know that epigenetic modifications usually involve activation of NF kappa beta at some point in the pathway. Therefore we must, in this levee, consider inhibitors to NFkappa beta in future additions to “The Quilt”

Levee 15:

Autophagy. In cell biology, autophagy, or autophagocytosis, is a catabolic process involving the degradation of a cell’s own components through the lysosomal machinery. Why, you ask, is this so important? Well, the leading cause of death in humans is cardiac death from heart disease. Autophagy is the mechanism that cardiomyocytes die from. Therefore if we can understand this pathway in detail and how to protect ourselves from it we may finally do something meaningful to stop cardiac death. All of the cardiologists in the world believe in the lipid hypothesis of heart disease. I think the data is overwhelming that is it not, and understanding how autophagy occurs will help you understand why this levee may be extremely useful to us as humans. Autophagy was first described in the 1960’s but it took a back seat for the last twenty years to apoptosis. That was the new darling find in cell biology.
Autophagy is best described to the non-scientist as a mechanism the cell uses to auto digest cellular components. This is called microautophagy because it involves parts of the cell. Chaperone mediated autophagy (CMA) is a process of selective autophagy. Entire cells can be engulfed and taken out. The tissue then has more stroma/scars and less cells. This is precisely what occurs in heart disease. A dying heart loses heart muscle cells and it is replaced with scar stroma. The remaining cells have to hypertrophy to compensate but they never can get back to the baseline. So the heart’s function slowly wanes with time. Autophagy is heavily influenced by mTOR signaling. So we know that what activates mTOR affects cardiac death. One of the major players in mTOR is the polyphenols of cacao. If you Google search the MARS Corporation and see what they are up to in the Amazon basin you might become very interested in slowing your own cardiac autophagy down. This topic will surely interest many people because it really affects all of us with a heart.

Levee 16:

Oncogenesis. I bet most of you thought this one would have been higher on the list? Most people really fear cancer. I think once we develop this part of the The Quilt it may move down in importance. Cancer incidence and prevalence has risen dramatically in the last 125 years in our country. I do not believe that something magically has changed in the world to cause this. Instead, I think our focus on curing cancer is completely backwards. I think we need to prevent it and not worry about curing it. Once cancer occurs we have a cellular mutant that is made immortal by altering normal cellular pathways to make it resistant to normal cellular death pathways. I doubt we ever get a chance to reverse it. I do however think once we know how cancer begins we can avoid it. This document has over thirty ways to do just that. If we control the cellular environment and limit damage to it, the cell will never have to make the choice to become immortal due to the chaos we are causing it. The factors causing cancer are all multifactorial. Metabolic, dietary, environmental, genetic, senescent etc……..are some.
The key is to focus on the cell and not the cancer.
If we do many things correctly over long periods of time we will not face cancer, and I believe the incidence and prevalence will fall. Let me give you this scenario: In 1900 colon cancer was the 37th leading cause of death in the USA. Today, it is the second. So what exactly happened to us in this country in the last 111 years? There will be many theories after some read this. But my theory is simple: To have a huge short-term shift in a disease prevalence and incidence in an entire population ties it to a common source. That source is the introduction of cereal fibers and grains into our diet in massive forms. I think if you go back and read about how grains came to dominate American politics and culture, you will see several trends that begin with Mr. Kellogg, growing population that needed cheap food, a large plot of land that was underutilized for years (the bread basket) and the political decisions that monetized the agriculture complex to cheaply feed the masses during a great economic downturn. Couple that with the false hypothesis (See Ancel Keyes) made about animal products and proteins and fats. The promulgation of industrial seed oils loaded in omega 6 PUFAs (see Eisenhower’s cardiac issues) and then further expanded in the 1960’s by the increase of soybean oil. In the 1970’s we took Japan’s worst idea ever, high fructose corn syrup (HFCS), and tried to use it to replace all fats in everything that was food. From the 1980’s on we have gotten fatter and sicker and suffered from increased colon cancer. Simultaneously, our government pushed USDA foods because they realized we could make lots of it dirt cheap and export it all over the world while making tons of money doing so. The only part Senator McGovern did not foresee was the current healthcare nightmare that the US now faces. Let’s not even talk about the demographic nightmare that makes it doubly worse. Our diet depletes the distal colon of omega 3’s from butyric acid (butter) and limited use of fermented carbs that convert to protective omega 3’s. This leads to ROS chronically in the face of constant glycation and lipoxidation. Are you starting to see how we went 37th to 2nd in 111 years? Moreover, the explosion in the use of grains caused massive changes in our gut biology, breaking down our immunity to allow the guts toxins to see the gut-associated lymphatic tissue (GALT) and directly affect oncogenesis production through loss of p53 gene control. P53 gene is the guardian gene of our entire genome. Once it goes south, chaos ensues at the cellular level and oncogenesis occurs with amazing regularity.
If we change what we do to our cells, we avoid what we fear. It’s that simple.

Levee 17:

Stem Cell depots. This one, I bet, will move up as I age. I think what we are learning now is nothing short of amazing. As autophagy and apoptosis take out cells as they age, get infected with vectors, eliminated by ROS, ALEs, AGEs, and many other things, they get replaced with new cells that are not differentiated as yet that are hiding in our stroma as “soldiers in waiting.” The real issue is we do not appear to have an unlimited supply of them. Science now is challenging that assertion and I hope they are right, because if they are, we all might start living a long time.
The key to this levee is time and context. My theory holds that if you deplete your depot too early in life, your lifespan is shortened tremendously. In fact, I will be less tactful: If you abuse your body from ages 0-40, I think it has greater effects than if you abuse your body from 40-80. The reason is simple: The less we need to replace early in life allows us to have many more as we age when the effects of time and cellular damage accumulate. This is why the major diseases in humans all get more common as we age. We no longer have the reserves we once had. If science proves that we can go back and create pluripotential cells and reengineer our stem cell depot then this risk certainly lessens. Right now this option does not exist. Damaging your depot includes poor dietary choices, trauma, cellular and emotional stress, and endurance exercise. We need to protect our stem cells at every age but we tend to lose most of them when we are young because we do not employ a levee strategy until we get to the back half of life.

Levee: 18

Sirtuins as a black box. Sirtuins have been described as guardians of the cell. They hit the scene in the early 2000’s with the discovery of resveratrol and its effect on lifespan. In people, for example, they seem to halt the normal cellular cycle that ends with old cells committing suicide, and instead help rejuvenate them by beefing up their DNA repair processes and stimulating production of protective antioxidants. It appears that if a cell is at a point of deciding whether to live or to die, these sirtuins push toward the survival mode and allow the cell the option to survive longer to rejuvenate itself.
Sirtuin, or Sir2 proteins, are a class of proteins that possess either histone deacetylase or mono-ribosyltransferase activity and are found in organisms ranging from bacteria to humans. Sirtuins work in calorie restricted states to improve cellular stress response and regulate transcription. Their main effect however is on energy generation by improving the NAD/NADH ratio to decrease mitochondrial “leakiness” at the first cytochrome. This generates less ROS than we would normally see. Resveratrol works with quercetin and is generally found in certain wines, grapes, and cacao chocolates. Quercetin is found in grapes and apples.
Sirtuins bring about the effects of calorie restriction in the brain’s IGF axis, known as the somatotropic signaling axis, which controls growth and influences lifespan and lengthens telomeres.

Levee 19:

Apoptosis. Apoptosis is the preprogrammed cell death in animal cells. Apoptosis has certain biochemical features that characterize it. These changes include blebbing, loss of cell membrane asymmetry and attachment, cell shrinkage, nuclear fragmentation, chromatin condensation, and chromosomal DNA fragmentation. Excessive tissue apoptosis is seen in atrophy and insufficient amounts occur in cancer generation.
Apoptosis is controlled by both intracellular and extracellular signals to affect the cell. Some of those extracellular processes are toxins, growth factors, nitric oxide, cytokines, and hormones. These signals can both positively or negatively regulate cell suicide. Intracellular signals come from glucocorticoids, heat, radiation, nutrient depletion, viral infection, and hypoxia.
Before the actual process of cell death is precipitated by enzymes, apoptotic signals must cause regulatory proteins to initiate the apoptosis pathway. This step allows apoptotic signals to cause cell death, or the process to be stopped, should the cell no longer need to die. Several proteins are involved, but two main methods of regulation have been identified: targeting mitochondria functionality, or directly transducing the signal via adaptor proteins to the apoptotic mechanisms. Another extrinsic pathway for initiation identified in several toxin studies is an increase in calcium concentration within a cell caused by drug activity, which also can cause apoptosis via a calcium binding protease, calpain. The process involves increasing mitochondrial permeability and induces swelling and eventual cell death.

Levee 20:

Supply side stability. Clearly, if an organism doesn’t survive the early stages, then genes that promote survival in later life are meaningless. Supply side stability is important in the later stages of life to increase lifespan. It is becoming clear that the guardian of the genome gene P53 executes this function. P53’s main function seems to be inducing cell cycle arrest in somatic cells, the cells that currently make up our organs. They do not include stem cells or the cells of reproduction. If the cell cycle is arrested that cell cannot go on to form a cancer because it cannot divide. Loss of P53 control, however, can and does lead to chaos many times. Ironically, it also appears that P53 controls the stem cell supply of many organs as well. This appears to be true in the mammalian brain based upon current research. It also appears that the cellular machinery used to go from stem cell to a somatic cell is present in human aging but the supply of stem cell is now the rate-limiting factor for longevity. This points to two areas of thinking: One, we must look to youth to keep the supply vibrant as we age, or two, we must figure out a way to reverse engineer the somatic cells in our organs today back to the pluripotential cells that we had as a child to redivide and replenish our diminished stock of stem cells. Sounds idealistic, no? Guess what… it appears it’s possible based upon what we now know. This levee will explore this area.

Levee 21:

Adaptogens. These are plant derivatives that can affect the neuroendocrine and immune systems to bring back a sense of balance to those systems when they are deregulated by cellular stressors. These plants have been used for thousands of years in Chinese Medicine and Ayurveda medicine. Their longevity and safety is clearly documented by time, but western medicine often does not support their use because they have not been subjected to RCT’s. It is ironic that most of the chemotherapeutic drugs western medicine uses are also used without a RCT but we seem to overlook this fact easily. The real interesting point about adaptogens is that they have really begun to be looked at by research scientists recently because most of the adaptogens used for thousands of years have been shown to contain heat shock proteins that are very important in the biologic system. Licorice is very common in candies yet most Americans do not know that this is an adaptogen. So are Maca, Rhodiola, Resveratrol, Quercetin, Ginseng, Holy Basil, and astralagus. The interesting factor is that astralagus extracts are now commercially being developed by major biotech companies and being sold as telomere lengthening devices. TA-65 is one such example that was developed from Geron Corp. in the last 15 years. This is a levee that I think will grow in importance as we learn more about how adaptogens effect the biologic system.

Levee 22:

Cellular Depletions. It appears that cellular damaging and aging can occur from depletion of certain co-factors to cause havoc. For example, the depletion of ATP in cells causes them to lose their cytoskeleton architecture very quickly. The cell can no longer function and undergoes apoptosis rapidly. This is most commonly seen in lack of oxygen or blockage of blood flow. (link) We have known in medicine for years that dialysis leads to early heart disease. For many years it was not well established why this occurred. We now know that dialysis membranes remove water-soluble proteins, and the B-complex vitamins are water soluble. This is why we see very high homocysteine levels in renal patients on dialysis. And the depletion of the B vitamins leads to early heart disease. Chronic Coumadin use depletes cells of vitamin K analogues. This leads to earlier osteoporosis and calcification in the blood vessels all over the body.
High levels of glucose, and fructose in the diet, causes cells to use massive amounts of B6 and Magnesium in the production of energy, leading to cellular depletion over time. This is clearly seen in diabetics and is being looked at in the development of neuropathy and nephropathy by those patients. B6 and Magnesium are also co-factors in the production of serotonin from 5HTP. This might explain why depression is more common in diabetics than in those who are not diabetic. Beta blockers and diuretics also deplete Magnesium and B6. Recently, the anesthesia literature has begun questioning the higher complications seen in those treated with beta blockers. See how depletion can hurt a cell or animal? Magnesium depletion is very common these days due to the diet being loaded with fructose. Drugs like Digoxin and Nexium are commonly used in older Americans and also deplete magnesium. These all cause restless leg syndrome in older people. This problem is endemic because of a wide variety of ways Magnesium is depleted in our diets.
HIV cocktails contain several antiviral meds that all deplete zinc. Zinc is vital for testosterone production and for wound healing. Certain legumes contain lecthins and phytic acid that block absorption of minerals from the gut, worsening the cellular environment. This levee will cover how cellular depletions can cause disease and rapidly increase aging.

Levee 23:

Iatrogenic effects. This levee will concern itself with the negative outcomes we get from trying to heal or help the human live longer. Estimates have reported that close to 100,000 deaths a year are caused by medical errors. This created quite a stir when the study came out. I believe this number is actually too low because we are not realizing how many things that we advocate for today are bad medicine in disguise. For example, an iatrogenic effect may be the use of mammography (X-rays) to detect breast cancers from 1 mm to 1 cm in size. We know X-rays are oncogenic. Since it takes decades to develop cancer there clearly is an iatrogenic risk here. We now have new technology being developed that can detect breast cancer much sooner, like thermography. When I was in residency, thermography was looked at as quackery, but this technology uses angiogenesis and heat to detect changes in cells that are quite small in breast tissue. This technology was recently used to find and kill Osama Bin Laden in Pakistan and is currently deployed in all our smart weapons in our missile systems. It likely will make a huge impact in medicine, and change the standard of care, once it is realized how much more sensitive this technology is compared to the mammograms of today. It can detect cancers much smaller than 1 mm in size when they can easily be eradicated by today’s conventional treatments.
This levee will cover numerous areas of iatrogenic errors in dentistry, medicine, alternative medicine, denial, drug interactions, and in failing to diagnosis or treat issues. Many specialties will be discussed in this section as well as potential problems that can arise from complications.

Levee 24:

DNA/RNA alterations. Over the last decade, the human genome project has allowed us to sequence our entire genome. This has allowed researchers to study genomic alterations and the mRNA they lead to. Those mRNAs tend to lead to genes that alter the DNA to force certain cellular biochemical pathways to become operational or to shut down completely. Genome-wide studies are now routine for diseases using arrays based on hybridization techniques. These studies have shown us much about how certain diseases begin and propagate, and how the biochemical pathways influence decision pathways in the cell. It allows us to identify genes that are expressed by certain stimuli in cells to cause disease propagation quite efficiently.
This levee will explore the complexities in DNA and RNA function and how both can affect the human or animal in aging and disease. For example we now realize that fat lipodystrophy that occurs in HIV-positive patients is caused by the effects of antiretroviral drugs on depletion of mitochondrial DNA and RNA, and it leads to interactions that alter fat biology in these patients. This also explains why Growth Hormone treatment in HIV patients is quite effective in also restoring their normal body composition.

Levee 25:

Hypoxia. Hypoxia is a cellular state that disrupts normal oxygen supply to the tissue, causing cellular dysfunction. An example is altitude sickness at high elevations. Another example would be a clot in a blocked artery causing an organ to fail and die. Apoptosis and autophagy allow cells to adapt over their lifespan in many situations. Hypoxia is directly toxic to mitochondrial energy production. In humans, when oxygen is in short supply we can shift to anaerobic energy production, but it is not as efficient as mitochondrial energy production. Athletes with proper training can perform well in anaerobic conditions but it does appear that they pay a steep price for this adaptation by depleting their stem cell supply.
Hypoxia plays a role in aging because as one ages the amount of blood to organs declines as the heart fails to deliver the same amount of blood through a stiffened arterial tree throughout the body. This allows cellular oxygen levels to fall and usually is a signal to mitochondrial biogenesis to offset the deficits. As one ages this signaling system is not as accurate in sensing changes to the oxygen level. Low oxygen tension is a signal to autophagic pathways that normally help repair cells. If this gets impaired signaling autophagy become less effective as we age and results in more organ failure and diseases of aging. Hypoxia is a critical signaling in the cell for repair processes. This is disordered in heart disease and in sleep abnormalities such as sleep apnea.

Levee 26:

Organizational failure of structure. This levee will deal with organs and tissues and how they sustain failures as we age and what we can do to prevent this. All organs have different rates of failure and some organs fail in typical patterns. We look at ways to stop this from happening and in strategies designed to prevent it from occurring.
A simple tissue failure to understand is that of a bone fracture. This is well understood and rather straight forward to deal with. Osteoporosis is another type of failure of bone that is much more complex to deal with and is a result of failure of multiple systems acting upon the bone. Heart failure is very common and occurs under autophagic control. The causes vary but we understand how the heart fails. What we do not understand well yet is how to modify the process to facilitate health as one ages.
For the brain, we now believe that most degeneration occurs by autophagic processes but it is clear that the interaction with other systems plays a huge role on its ability to stave off functional decline. We have already seen this in the brain-gut axis but it is clear that the brain is impacted by most other organ systems in some fashion once they begin to decline. The brain must compensate to offset that loss of efficiency.
In this levee we will look at organ systems and see how they fail both acutely and chronically over time, and see how these failures can be impacted by strategies to lessen their effects to increase longevity.

Levee 27:

Heat shock proteins (HSP). HSPs are proteins that are only expressed when the cell is faced with higher temperatures or other cellular stress. It appears that heat shock proteins origins come from direct transcriptional processes once the stressor is encountered. Most heat shock proteins are named by their weight, but the more important ones have names. One such example is ubiquitin, which is a HSP that marks proteins for degradation. Most HSP can be thought of as cellular pathway chaperones that help the cell do the business of homeostasis more effectively. They are very active in infection, trauma, burns, inflammation, exercise, hypoxia, starvation, nitrogen depletion, alcohol use, UV radiation, and heavy metal poisoning.
The interesting thing about these proteins is that they seem to affect tertiary and quaternary structural folding of proteins in our bodies. This effect seems to be lost as we age so we see a defect in protein folding in aging related diseases. They also are critical in transporting proteins across cell membranes in all tissues. HSP are also vital in maintenance of steroid receptor function.
Folding issues are thought to play major roles in Mad Cow disease, Alzheimer’s disease and Parkinson’s disease.

Levee 28:

Sleep. Why we sleep is currently unknown. This sounds crazy considering we spend one third of our life sleeping, but it is factual. We do have some theories that are plausible. It appears sleep is vital for auto repair processes to occur in the body and brain. It also appears that sleep, and energy metabolism, are tightly regulated in the hypothalamus. Cognitive decline is obvious with sleep deprivation, and learning is impaired. Sleep apnea is a known killer in humans and generally appears in those with obesity, again linking energy metabolism to sleep. It appears that less than 5.5 hours of sleep or more than 9 hours of sleep seem to predict a shorter longevity. So sleep is clearly critical to longevity.
This process is quite complicated but incredibly fascinating, and we will explore many facets of how sleep and obesity are likely close relatives, and we will introduce you to concepts that you may not have ever heard of. I think sleep will turn out to be a top ten levee before too long, but there is so much we don’t know about it at this time it is hard to make a claim to put it there now. With energy metabolism at position two and sleep clearly tied to it… I guess you could say this is this documents quantum entanglement!

Levee 29:

Hormesis. Hormesis is the biologic process that allows for a favorable biologic response on a cellular level to a small or low-dose exposure of the hormetic agent. A good example of hormesis is exercise. In the right amount, it confers longevity and lengthens our telomeres. In excess, it will hurt us by causing high cortisol levels and generating ROS to deplete our stem cells and cause us to use anaerobic energy production which does not suit our biochemistry long term.
When cells are faced with mild stressors this seems to confer an increase in function and longevity. This occurs in all organs of the body that have been tested, but we do not know if this effect has a floor or a ceiling in some cases. In others it is obvious. Too much exercise or alcohol can kill a human. This is true of stress and certain drugs as well. Cardiac hypoxia without cell death has been shown to increase cardiac output and stroke volume and improve heart function.
Curcumin and Ginger are examples of spices with hormetic effects. Resveratrol and Quercetin are plant polyphenols that have similar effects on humans. This levee will discuss this biologic process and its role in aging.

Levee 30:

Geopathic stressors and Quantum biology. Geopathic stress is a natural phenomenon affecting certain places and can be damaging to our health. In some cases it may actually help us. Birds use geopathic stressors to map their flights during migrations. It relates to irregularities in the earth’s magnetic field, which can be aggravated by a variety of features. One way humans may be affected by this is from cell phones. The EMF signal appears to be a geopathic stressor. It also appears to be the root cause in the death of honey bees. Electric power grids, earth transitions in agriculture are well known geopathic stressors that can affect cellular function. Signs of geopathic stress are areas in the earth prone to mold or lichen formation. Many animals will avoid these areas because they function sub-optimally. Many in conventional medicine do not believe this is a factor, but quantum biology may help answer why this occurs. Many new exciting research areas are pointing to no-locality factors in the earth that dramatically affect the way biologic systems operate. This levee will examine this fascinating frontier of disease and see how it can affect our longevity.
55 Responses to “THE QUILT”

1. avatar Leptin part deux………..the Liver. - Jack Kruse Says:
June 5th, 2011 at 3:20 pm

[...] The Quilt [...]
2. avatar consequences of calorie restriction | Mark's Daily Apple Health and Fitness Forum page 2 Says:
June 20th, 2011 at 8:34 pm

[...] Kruse of Nashville is writing some really good stuff in his new web feature, "The Quilt," THE QUILT | Jack Kruse It's hard to find a lot of good articles on rT3 since so few people understand it. Other things [...]
3. avatar Tracy Says:
July 24th, 2011 at 2:46 am

I was just wondering how the paleo diet would work for someone with sleep apnea and severe obesity? I am currently on a surgeons wait list for VSG. I have tried bootcamps and eating “proper” to what my dietician told me to do, and all i feel is more tired and exhausted than ever before. Please help.
4. avatar Jack Says:
July 24th, 2011 at 4:57 am

@Tracy. It would be ideal!
5. avatar Mia Harrod Says:
August 15th, 2011 at 4:49 am

Jack Kruse, are you on Facebook yet?
6. avatar This, or that | Mark's Daily Apple Health and Fitness Forum page Says:
August 17th, 2011 at 2:58 pm

[...] pretty ironed out by now. But I suppose, it IS all fairly complex. This thing almost killed me. THE QUILT | Jack Kruse Reply With Quote + Reply to Thread « Previous Thread | [...]
7. avatar Francie Workman Says:
August 21st, 2011 at 8:50 pm

I have a question?
I was reading what you wrote about ketosis and MCT.
Why would a ketogenic diet high in MCT [the medium-chain fatty acids that compose 50% of coconut oil] do something radically different to brain metabolism and Cerebral Blood Flow that carbs and protein do not?? Thanks so much>

Continued in next post...


The Living Force
FOTCM Member
Continued from previous post...

8. avatar Jack Says:
August 21st, 2011 at 9:11 pm

This answer may hurt your head a bit…….it based upon two major issues. One is quantum biology and the other based in organic chemistry. The organic chemistry answer is best to answer your question. I discussed this with Matt LaLonde (Harvard Trained Organic chemist) and this is the consensus answer. During oxidative phosphorylation, almost all of the reducing equivalents produced by glucose metabolism in the Krebs cycle are in the form of NADH with the exception of the succinate dehydrogenase step, which takes place in mitochondrial complex II and makes FADH2. Metabolism of one molecule of glucose produces an NADH:FADH2 ratio of 5:1 whereas fatty acid metabolism in beta oxidation and the Krebs cycle will produce a ratio of ≤3:1 depending on the length of the fatty acid.
NADH is oxidized only in mitochondrial complex I whereas FADH2 is oxidized only in complex II. Complex I produces more reactive oxygen species than complex II.
As such, production of a specific number of ATP molecules from glucose has the potential to generate more reactive oxygen species compared to the generation of the same number of ATP molecules from fatty acids.
So in english this means that metabolism of MCT does not allow for as much leakiness at the mitochondrial inner membrane so it is more energy efficient and that energy efficiency is translated in uncoupling CBF from CRMO2. I hope that helps. I know its technical…..but it is factual.
9. avatar Michelle Says:
August 23rd, 2011 at 5:38 am

What is your opinion/thoughts on Multiple Chemical Sensitivity?
10. avatar Jack Says:
August 23rd, 2011 at 12:12 pm

I have no experience in treat this at all.
11. avatar Jen Says:
August 25th, 2011 at 12:48 am

If leptin is delivered to the body via breast milk, what if you were not breast fed? I have chronic fatigue, something even the Paleo/Primal diet doesn’t seem to touch. Is there a possibility that if you weren’t breast fed, you could be doomed to never get on track energy-wise?
12. avatar Jack Says:
August 25th, 2011 at 2:11 am

Its a problem for sure. Be sure to watch my blog for more on the leptin story. I am not close to done with leptin. It is that important. The central leptin story will be unleased here shortly. And the breast feeding issue comes in there.
13. avatar JMichael Wood Says:
October 12th, 2011 at 9:04 pm

Hello Jack,
We have a mutual friend (CPA) in Richard Garrett, and he sent me your website as he thought we might have thoughts to share.
I am here in Nashville, and if you are able, please call me at: 615-366-8940 (best in the mornings).
In the meantime, please see my website for a bit about what I do, and please feel free to call Richard to confirm who I am.
Thank you.
14. avatar Things That Interested Me This Week: 10-20-11 « Bare 5 Says:
October 20th, 2011 at 1:23 pm

[...] The Quilt A new way of looking at longevity and health in “quilt” form by Dr. Jack Kruse. [...]
15. avatar Top 10 Low-Carb Movers & Shakers Of 2011 « Liberation Wellness Says:
November 4th, 2011 at 6:28 pm

[...] the most thought-provoking and compelling information about health and longevity online through his “Quilt” concept. And if you’re not already reading Dr. Kruse’s blog, then you’re missing out on [...]
16. avatar TO B OR NOT TO B THAT IS THE PALEO QUESTION? | Jack Kruse Says:
November 18th, 2011 at 3:21 pm

[...] about why protein and B Vitamins are critical components to a paleo template. This is covered in levee 14 and 24 of the QUILT. One of the facets of this lifestyle is becoming active again. To become active [...]
November 18th, 2011 at 4:04 pm

[...] lipid metabolism repair mechanisms become so unbalanced that it induces the nerve cells to undergo apoptosis! This ties another levee to the AD and Parkinson’s disease [...]
18. avatar WHY SLEEP APNEA KILLS | Jack Kruse Says:
November 18th, 2011 at 4:05 pm

[...] sleep is rebuilding our cellular terroir (think levee one), the immune system is also undergoing autophagic repair……that is another reason why the temperature has to fall. Usually, temperature rises [...]
November 18th, 2011 at 4:07 pm

[...] Adaptogens Maca, Rhodiola, Holy Basil, Black cohosh root, licorice, Fo-ti root Supplements: CoEnQ10 [...]
20. avatar Leaky Gut, causes of autoimmune diseases, | Jack Kruse Says:
November 18th, 2011 at 4:08 pm

[...] with the type of chronic disease they will face in their life time. It appears the key in this levee 5 is to keep inflammation at low level as possible to retain your health. The types of food we eat [...]
21. avatar Why exercise can kill you, How to exercise when your fat, | Jack Kruse Says:
November 18th, 2011 at 4:11 pm

[...] optimization we should shoot for exercises that are hormetic and do not constantly cause leakiness at the mitochondria. What does that mean? It means that [...]
November 18th, 2011 at 4:14 pm

[...] areas. The public and business sectors adapted for the betterment of citizens. I believe my QUILT allows for the same change. My question is will you join me in that thought experiment? Will you [...]
23. avatar kathleen Says:
December 13th, 2011 at 11:15 am

I just found your website, poked around a bit, ran out of time. I can’t wait to explore the Quilt–not so much for the information, which may save my life yet, but because of the informational structuring. It’s how I think, and the hunger to be fed information in a way that fits my brain is acute and usually unmet. People who think in a more linear fashion refer to it as `random and non-sequential’, but it is anything but. Matrices-based thinking makes perfect sense for those who engage in it. I am impressed by the simple elegance of this solution for communication.

Just ran across a phrase a few days ago: positive deviants. I think that an argument could be made for a human `quantum brain’, supported by the phenomenon of ideas, once introduced, spreading geometrically at rates that exceed logic, when people see them and intuitively grasp the power of a solution before they even know all the details. When you are deeply familiar with a problem, the glimpse of a fractal of the solution will be recognized on a deep level.

To me, a positive deviant is like the first molecule to crystalize in a super-saturated solution. You, sir, appear to be one of these people. Can’t wait to come back and read more.

One more thought: I once taught a group of struggling readers who had been through different teachers and approaches with little success. As I got to know them, I realized they hadn’t been taught in a way that made sense to them. Instead of starting with an abstract concept (“letters make sounds”) in a random order (alphabetic), they taught me to teach them based on something they knew (some speech sounds). I helped them distinguish between them more clearly (hand on throat, hand in front of mouth, so they could feel the production process) and taught them grouped on a place-and-manner of articulation approach (stop consonants from front of mouth back: p/b; t/d; k/g; then nasals, then fricatives). By the time we’d worked our way through them, with me showing them a structured way of organizing that information, they were off and reading. I tried to persuade them to come back and let me teach them the rest of the consonants and the vowels, but they cheerfully, politely, firmly refused–they were too busy doing what they had been struggling to do for several months. They knew their problem so well that the solution was very recognizable to them when they encountered it.

Don’t be deeply surprised if the same thing happens to you.
24. avatar Carole Holcombe Says:
January 5th, 2012 at 7:26 am

Good Morning Dr. Jack -

Didn’t know where to jump in to post my question, but I must say from the outset that I absolutely agree with all you are saying. I have read the quilt (although a bit scholarly for me! lol) and every one of your blogs. I joined “The Quilt” Leptin Re-set group on Spark People. No doubt at 205 lbs. and 5’5″, I am Leptin Resistant!! I have been stuck for some time.

Here is my question: I am having difficulty with the level of protein/fat. I do not have my gallbladder.
I am Celiac and Dairy Allergic (casein) and have been 100% compliant since 10/05. I keep on top of my food sensitivities via Genova Labs. I eat a very clean diet and no junk! Still can’t lose.

I also am being treated for adrenal exhaustion. I am on a 2 month stint of Cortef. I had a hysterectomy in June 2010. Doc is trying to balance out my hormones (bio-identical). Her orders are “light walking only 1-3 miles per day, no lifting for now.”

My D3 is excellent (78)
My Reverse T3 is excellent (102)
My blood lipids are fantastic (combined = 160)
Blood sugar is elevated slightly with morning readings around 110 (on 500 mg. metforim 2x daily).

It’s my digestion that is suffering on day 4 and getting in all that protein in the a.m. I hate eggs (sorry). I could “try” but would have to slowly work up to such a high volume. I understand there are other sources of protein.

Any words of wisdom for me, especially in the realm of digestion/protein and consumption without gallbladder? I take Theralac probiotic daily, 1 T flaxseed in unsweetened applesauce, and Enzalaze (Master Supplements) digestive enzymes with each meal.

Lastly, been searching your site for info on the volume of protein and it’s impact on kidney function.

Keep up the good work. I just wish I felt better doing it!! I WANT TO!!!! Maybe some additional direction would help.

God bless –

25. avatar Jack Says:
January 5th, 2012 at 12:34 pm

@Carole After reading your question I think leptin resistance is a big deal but I thnk the biggest issue is a leaky gut…….re read my leaky gut Rx. Its critical.
26. avatar HEY LYME DISEASE, MEET LEPTIN! - Jack Kruse Says:
January 8th, 2012 at 11:19 am

[...] hope you found this interesting. It is another piece in the Quilt that shows you that everything is connected at some level and that we should to continue to solve [...]
27. avatar William Trumbower MD Says:
January 10th, 2012 at 5:44 pm

Jack Have you read Earthing? I now use a grounded bedsheet and feel better! My wife says it is placebo effect and laughs at me. She always laughs at me, but it is OK cause I love her.
28. avatar Jack Says:
January 10th, 2012 at 6:13 pm

@ william no I have not.
29. avatar Krissy Says:
January 20th, 2012 at 2:42 pm

Hi Dr Jack,
I went low carb about 2 years ago and, long story short, I lost just over 100 lbs. I am still however about 30 lbs away from my goal. I have PCOS and a funny thing happened, once I lost the weight my cycle became “normal”.
I hit the 150lbs mark I couldn’t budge that number. I worked out, ate less..I am even ashamed to say that I took diet pills for awhile but 148 was as low as I could get.
I discovered The Primal Diet which I started about a month ago and I loved it but still no weight loss. Then a friend introduced me to your Leptin Rx which I started following immediately.But I ran into a problem, which has been a problem in the past and have been tracking, and I wanted your opinion on it. My blood sugar levels drop every time I ovulate. I have been tracking this for 3 months and I don’t know how to handle it. It happened yesterday at the store and I felt faint. I have a meter, checked my level and it was at 42. I drank OJ immediately and started to feel better although I never brought it up past 70 (and failed my reset!). Today, I am fine! So, my question is, should I be doing a leptin Rx? If I need blood work, What should I be checking? And, one last question..can I do yoga during the reset?
30. avatar Jack Says:
January 25th, 2012 at 7:49 pm

@Krissy no way to say based upon what you gave me here. I think the reactive hypoglycemia tells me you likely are not LS at the liver level. I suggest you read Leptin part Deux. It might help you get why.
31. avatar Jack Says:
January 25th, 2012 at 7:50 pm

@ Levee 15 autophagy: Interesting study out today.http://www.sciencedaily.com/releases/2012/01/120120184528.htm
January 28th, 2012 at 1:22 pm

[...] brainstem but I think the connections we make in this blog will help you really understand why the brain/gut axis is the fifth levee in my Quilt. A leaky gut can cause tremendous problems for our species whether conventional medicine believes [...]
33. avatar Bev Says:
February 6th, 2012 at 11:47 am

I am 62, female 5’2″ 172 lbs, have various ailments, had melanoma surgery Dec of 2011, now getting ready to have tendon repair in the same foot. Would like to know what is a good diet for before surgery and after. Will not be able to walk for 6 weeks and then physical therapy for 6 weeks. Doing toning exercising,per Dr.but, not able to use foot much at all.Any suggestions?
34. avatar Jack Says:
February 6th, 2012 at 7:33 pm

@ Bev the best diet for pre and post surgery is a high protein paleo diet with lots of goods fats and few carbohydrates to support your hormones as you heal. I would suggest you get The Paleo Answer by Loren Cordain, The Paleo Solution by Robb Wolf or The Primal Blueprint by Mark Sisson
35. avatar REWIRING THE LEPTIN RX RESET........... - Jack Kruse Says:
February 8th, 2012 at 6:50 pm

[...] mitochondrial series). During a low redox time cells are usually recycling their components using autophagy during sleep. During the day while energy is being made to explore the environment the cell is [...]
36. avatar THE EVOLUTION OF THE LEPTIN RX - Jack Kruse Says:
February 11th, 2012 at 7:10 pm

[...] cooling can induce selective “damage” and increased hypothalamic signaling by forcing adipocyte apoptosis and subsequent loss of subcutaneous fat, without damaging the overlying skin or the underlying [...]
37. avatar Ted Says:
February 13th, 2012 at 7:51 am

Dr. Kruse. I am a Urologist in Indiana who stubmled into Paleo about six months ago. I still have the enthusiastic zealotry of the newly converted. There is a large body of information that I am still working my way through. I have incorporated Paleo principles in my patient care, as off topic as this may seem to some of my patients (tell and infertile guy to quit grain and you’ll know what I mean). I agree that conventional wisdom, anchored to “data”, should be viewed with suspiscion and I think the volume of flatly contradictory data on any given medical topic should be the first indicator of this. I believe Big Pharma cares about honesty as much as Big Tobacco. I also believe that my role, currently, is to fix what I can, when I can on an individual basis. I am not sure what it will take for a sea-change to occur in this country in the area of nutrition and health. I applaud your efforts and I very much look forward to delving into your site and its content.

BTW where are you on the subject of potatos. Kidding…
38. avatar Jack Says:
February 13th, 2012 at 8:36 am

@Ted I think we as a profession have to do more because we have failed the public with much of our advice. Perfect example look at what you and I learned in med school and residency about testosterone and prostate cancer…….before avoid it…….now your meta analysis says the exact opposite. We have failed the public and we need close that divide. This is how I plan on doing it……slowly but steadily. We owe it to them. We must stop the madness of giving CW when we have no clue if its true and act as if it is always
39. avatar Ted Says:
February 13th, 2012 at 9:32 am

Agreed, but I think it is bigger than just physicians. We have government that aggressively promotes and subsidizes corn, soy, and wheat (26 billion in direct farm subsidies in 2010) and then there is this completely phoney national health care debate on why we are plagued with obesity, diabetes, CAD, HTN, cancer, etc.

With regard to CW, it takes a certain type of person to stand up and openly refuse the “evidence based” recommendations that get handed down from on high. Admittedly, there is a lot of safety, on multiple levels (professional, career, medico-legal, reputation, etc) in following those recommendations and not rocking the boat. I don’t rock the boat so much as jump out of it alltogeter, but I am in the minority. As an example, I just got out of a room with an 83 year old who was referred to me for a PSA of 4.3. I mean, there is CW and then there is that.

I also think that people need to approach their lives and their health with much more educated interest and skepticism because a lot of folks who are willing to sell you something are willing to sell you anything, even poison. If you don’t have a plan, they do and it is not in your best interest.
40. avatar Jack Says:
February 13th, 2012 at 11:57 am

@Ted all true……but my job is now to teach people how to avoid the snake oil…….and its not that hard. We need to legislate from our owners manual…..our DNA and epigenetic biology. When we begin to treat people this way……much of crap falls away and people magically get better across the board. We need medicine to get that loud and clear. They don’t and often do not want to hear it…….and until they do we have work to do.

And Ted…….we agree patients have to have skin in the game. And in this community…….the beauty for you and me…….they are already in. We just need to teach more how to transform. And I view that is my main goal now.
41. avatar Ted Says:
February 13th, 2012 at 12:46 pm

You know, there is an undercurrent of distrust for the medical community, and I wonder if some of this is just people’s common sense kicking in. Maybe its wondering if financial incentive is at play when the doc recommends treatment X. Maybe they are medication weary and really don’t think another branded pill will help. Maybe what has been said doesn’t reconcile with their experience. Have you had the experience of talking to a patient about evolutionary nutrition and they suddenly become much more engaged? I think they are so relieved to to hear someone say that the answer is not a pill or scalpel. I think they feel, like I do, that they do have the power to make themselves healthy, but they just didn’t know how. It is VERY gratifying to help these people and I hope the word spreads like fire.
42. avatar Jack Says:
February 13th, 2012 at 12:51 pm

@Ted…….you might like the first four chapters of my book. Cause it is about this issue. Patients love my approach. The real problem is other doctors and the hospital. My message is directly opposite theirs and patients get better with me. Their results tell me more than anything I learned in training at any level. I question everything now. And our profession does little of that because the system punishes you if you do.
43. avatar Ted Says:
February 13th, 2012 at 2:13 pm

Alright, so you are a neurosurgeon and I am full time urologist. If you leave Robb Wolf’s Norcal Fitness eating a 4 egg omelet and travelling 60 MPH and I leave Mark Sisson’s place in Malibu eating meatza and going 57 MPH, when do we meet at the hopital? Kidding. Sort of. Are you dealing directly with patient’s IDDM, HTN, CAD, and obesity and doing full time neurosurgery? I would have to do some major restructuring, to the chagrin on my 6 partners, to REALLY address all the non-urologic pathology that walks through my door fully expecting focused medical expertise as opposed to a complete paradigm shift in fitness and nutrition. Do you have separate office hours? If all this is in your book, don’t waste your time reiterating it here. I’ll get the book. Thanks.
44. avatar Jack Says:
February 13th, 2012 at 5:44 pm

@Ted I will lay it all out. But I would love to see you come to Paleo fx in Austin in a month and go have dinner with me and I will tell you how I take the theory of the Primal Rx to the clinical practice of paleo medicine I have been using for 6 yrs now. I do not treat chronic diseases outside my practice……by incorporating it within neurosurgery their co morbid neolithic disease vanish…….to the amazement of their referral docs.
45. avatar COLD THERMOGENESIS TWO - Jack Kruse Says:
February 22nd, 2012 at 5:54 pm

[...] There is one larger problem with her assumptions in this TED talk. She said light is the big deal. And I know it is not true any longer incold. This means that if evolutionary biology gave up on light and uses cold what else may happen to our metabolism in cold? Evolution does not do these things for no reason. She was quick to point out that this ability has been lost in modern humans in her estimation because of our discovery and widespread use of artificial light has become a huge game changer. We know Paris, France became the first city in our world that used fake light in 1924. I think most humans are not really ambiently aware of how how basic circadian mismatches destroy our biology slowly via the “slow erosion of metabolic function.” We know that humans die most from heart disease and heart failure. Heart failure is the number on cause of admission according to Medicare data. After this blog is through you might know why this makes complete sense. The reason has to with a slow erosion of the process of autophagy in humans due to the circadian mismatches created by our choices in life when they are married to the rapidity to the development of our neolithic brain. In essence, we got so smart so fast we became able to control too much of our environment for our own epigenetic and genetic good. The smarter we got the more mismatches we created for our biology and the less efficient autophagy became to fix and recyle proteins for repair. Reduced autophagy leads to heart failure. So this means that biologic mismatches are best measured in animals by looking at their rates of heart failure. For humans the rates are staggering. That is a big clue that what we all believe to be true could be what is actually killing us slowly. Remember autophagy occurs when we sleep. [...]
46. avatar COLD THERMOGENESIS THREE - Jack Kruse Says:
February 26th, 2012 at 10:05 am

[...] knockout show a significant increase in tumor development and a significant decrease in apoptosis (levee 19). It should be clear because of these links that just a simple mismatch in circadian cycles can [...]
47. avatar Stephanie Says:
February 27th, 2012 at 1:37 pm

Was listening to your talk on the Paleo Summit today. You said something that I found here verbatim: “A human is the only animal that can actually change its DNA just by thinking.” I’ve got to say I have no idea what you mean by that. Could you expand this or point me to a place where you have already cashed this idea out? From my schooling (degree in biology), I can’t make sense of this, but I’d LOVE to hear how this can be. Please convince me. :D
48. avatar Jack Says:
February 27th, 2012 at 4:25 pm

@Stepanie I am not sure what to make of this question? Humans an can control their environment. Wild animals cant. In winter when we are hungry we go to the grocery store and eat. A mountain lion has to starve…….in the winter. If you have to be convinced of this basic an ability……..my blog is going to blow your mind. And tonight I am going to blow many minds with a new blog that ties the entire Quilt together called together called the Holy Trinity.
49. avatar Stephanie Says:
February 27th, 2012 at 5:28 pm

I think we may have a language barrier. :D I agree that we can control our environment, but I don’t call that “changing my DNA”. It seems to me that if I have DNA testing done when I’m 20 and then I go through 10-15 years, I’ll still have the same DNA whether I’ve thought positive or negatively, eaten well or not, etc. Do you perhaps mean “gene expression”? I’m really trying to understand this. Not meaning to attack.
50. avatar THE HOLY TRINITY: CT-4 - Jack Kruse Says:
February 27th, 2012 at 5:39 pm

[...] implications. All longevity research currently says that high levels of activity in IGF-1 and mTOR pathways cause premature aging and all the diseases of aging. After 2006, I never bought that [...]
51. avatar Jack Says:
February 27th, 2012 at 5:57 pm

@Stephanie Food changes your DNA via your epigenetic switches. It appears you do not realize that. If you badly out of your circadian rhythm long enough it changes your hormones too which also change your epigenetic switches. Read the blog I just post tonight. your epigenetic switches are way more important than your DNA……recent science shows that. Read about trans-generational epigenetics. In fact I have a blog post about that too. My blog could keep you busy for months.
52. avatar Stephanie Says:
February 27th, 2012 at 7:35 pm

Thanks, Jack! Looks like I have a lot of reading to do.
53. avatar Jack Says:
February 27th, 2012 at 7:40 pm

@Stephanie…….yep. I write a lot…….and it will make you’re head hurt at times because of the technical aspects of the post.
54. avatar Paleo Summit Musings | Northwest Cavegirls Says:
February 28th, 2012 at 4:58 pm

[...] The Quilt by Jack Kruse. I’m unsure of what to make of this. I’m quite puzzled by it but am doing [...]
55. avatar linda keeper rn Says:
February 29th, 2012 at 3:52 am

dear dr kruse.
i think if you put the information you’ve gathered , the missing pieces can be put together with dr. howard loomis’s system of enzymes. it will esp help with explaining #29 krissy’s sx as hers is not a reactive hypoglycemia (based on info here)but a functional one and yes the liver/adrenal are involvd as it can’t convert glycogen to glucose to maintain homeostasis.
it will also help ted the urologist (if he can step out of medicine/disease model) to address digestion and possible structural issues to alleviate urinary leakage,urinary stones , use of half the reasons young women are using catheters these days and being able to see and feel the problem without medical testing to start with.
my background is critical care and i can’t tell how excited i was to finally identify the “extra pulse” i used to feel on pts that didn’t appear on the monitors (the cranial sacral rhythm). Can’t wait for your book and i’m glad you are a neurosurgeon to put this all together with the ANS, CNS . dr loomis can really help you put together the sympathetic and parasympathetic and the major role played with nutrition and muscle contraction. it will make you look at stroke pts and handicap pts in a whole new light, including “whiplash” and the impediment of the vagus nerve. thanks for describing that better in your talk. and if you are involved in stroke pts, look up “oral motor exercises”
for speech involvement, makes all the diffence in recovery, sorry to wander, feel free to email and thank you!

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I don't think we need to reproduce the entire site here...

ADDED: He's got these categories of topics in this first essay. Maybe you should track each one down and synopsize his findings on each. I printed the essay out and he's got some real interesting ideas.


FOTCM Member
I’ve been going through Dr. Kruse’s blog and there are two big ideas that stood out for me. The first is the information about leptin – the master hormone -- and how it is very important regarding energy, metabolism. I didn't know any of this stuff. He lays out what he calls his Leptin Rx which is a way to get one’s body back to being leptin sensitive. (Leptin is a hormone released from white adipose tissue WAT that signals to the hypothalamus that fat is available to be burned as energy. The problem is that the more WAT you have the more leptin you produce and your hypothalamus becomes desensitized therefore causing leptin resistance and the inability to burn existing fat stores.) One way to find out if you are leptin resistant is to have a Reverse T3 test or HS CRP done. (not sure of the normal values yet). The other way is the “mirror test”. Just look in the mirror and if you are overweight by 30lbs, obese, or underweight by 20lbs, and have excess fat then you are likely leptin resistant. This could be the cause of limited weight/fat loss and lack of body composition change despite exercise or eating paleo diet.

His Leptin Rx is a way to bypass the hypothalamus and regain leptin sensitivity through a paleo diet (Paleo Solution or Primal Blueprint listed as sources) and living by circadian rhythms. Here it is:( Comments in italics are mine which were gleaned from going through his blog)
A. Never snack at all. This is meant initially and forever. Snacking completely stresses the liver’s metabolism and is just not recommended. Your liver needs to re-learn how to use gluconeogenesis normally again when you are asleep and awake. Snacking just destroys the timing and circadian clocks that work in unison with Leptin.
B. Try to eat three meals a day initially; but as your hunger and cravings fade you can adapt to two a day.
C. Try to eat breakfast as early as possible from rising. – eat no later than 30mins after waking; eat a big ass breakfast (BAB) with few carbs, lots of fat and 50-70grams of protein
D. Do not work out before or after breakfast. – due to cortisol levels being high in the am, exercise will only contribute to the high cortisol level
E. Try to allow 4-5 hours between dinners and sleep time.
F. If you decide to incorporate working out, do it after 5 PM. – this is the best time for protein metabolism
G. Within an hour of sunset try to make your surroundings as dark as possible. – cut out all artificial sources of light, use flux on your computer, sleep in a dark room
H. If you have trouble falling asleep I suggest 3-5 minutes of body weight exercises right before bed (pushups or air squats are fine, but avoid this if your PM cortisol is high).
I. If you’re inclined to, try becoming mindful when you first lay down. I use transcendental meditation techniques to help me clear my mind and concentrate on improving my thinking. (Optional; but this is awesome if your PM cortisol is high). – do POTS ( :lol:)

He says it should take 6-8 weeks to regain leptin sensitivity.
For more details see these links:
On the Leptin Rx, how to tell that you are leptin resistant and how to tell if you have regain leptin sensitivity after completing the reset

More on leptin

The other big idea that caught my attention is Cold Thermogenesis (CT) or adapting to the cold to influence epigenetic changes in DNA. We still carry around cold adapted DNA from our paleo ancestors who were cold adapted. This DNA has been turned off due to poor diets, living outside circadian rhythms, living in a perpetual summer due to heavy clothing and climate control as well as eating loads of carbs all year long.

An interesting bit: http://jackkruse.com/cold-thermogenesis-two/
Lets continue on now to metabolism from the light and temperature story. There was a recent paper done that showed mammals may have another unique ability that is thermoplastic that we are also not aware of. It is currently assumed by researchers and scientists that the only way a mammal can change its fatty acid concentration is by its diet. This article showed us that assumption might also not be true. In “changes in ‘Good’ Fatty Acid Concentration of Inner Organs Might Be Largely Independent of Diet” In this article they state the following, “it is generally believed that mammals are unable to alter the proportions of essential fatty acids in their cell membranes except by changing their diets.
Amazingly, the amount of so-called “n-6″ polyunsaturated fatty acids (those with the final double bond at the sixth position) in the membranes was found to increase dramatically before the start of hibernation, apparently to prepare the body, and particularly the heart, for operation at very low temperatures. Consistent with this idea, the transition to a higher content of n-6 fatty acids in membranes takes place extremely rapidly just before the animals enter their hibernation chambers. The changes are reversed, again over a short time, around the termination of hibernation in spring, when the animals return to a life at high body temperatures.
The fatty acids incorporated in the membranes probably stem from the marmots’ white adipose tissue. Surprisingly, however, fatty acids are not simply taken from the fat stores at random but n-6 polyunsaturated fatty acids are transported preferentially, although the mechanism remains a mystery.
These new and unexpected findings show that mammals can make highly significant and rapid seasonal changes to the lipid composition of their cell membranes. But the results go far beyond this. During and immediately after hibernation marmots are unable to eat anything — their food is under a thick layer of snow — so the changes cannot be related to immediate dietary influences.

And because the animals hibernate underground, isolated from any external signals, the changes are probably controlled by an endogenous clock as part of an annual cycle.”
This article implies some more evidence for my theory on thermoplastic change is really not a theory but an evolutionary dictum in all eutherian mammals. Lets examine why evolution may allow mammals to do this.
The critical points for us to consider in this article are two fold: 1. the stimulus for hibernation in eutherian mammals and their descendants are tied to high dietary carbohydrate intake (proven fact already in science and not controversial) and high placement of omega six intake into their cell membrane prior to hiberantion begins. This was not known until this article came out. It did not escape my view because it makes total sense of why mammals in particular would do this. The dietary stimulus of plentiful carbohydrate availability is a metabolic sign that they should soon den (fat and happy) and this seems to change what happens to the fatty acid synthetase enzyme in the mammalian gut lining. In this new research, scientists studied mice that are unable to make fatty acid synthase (FAS) in the intestine. FAS, an enzyme crucial for the production of lipids, is regulated by insulin, and people with diabetes or insulin resistance have defects in FAS. Mice without the enzyme in the intestines develop chronic inflammation in the gut, which is a powerful predictor of insulin resistance. This is how mammals used to signal their body that it was time to lay down under ground and avoid the harsh arctic winters. This biology is now coming to light in humans and you can read about it in my second cite. It appears all the biology is lining up quite well with my theory.
This signal is likely tied to signaling that the mammal should begin to replace its own cell membranes with PUFA’s. Why would evolution do that?. Why should we pay attention to it? We should pay attention to it because it has major implications for modern humans who are direct descendents of these animals. Moreover, this evolutionary design feature allows for an interesting conudrum to potentially develop for us. It appears incorporation of PUFA’s into cell membranes are a “normal signal” in mammalian hibernation for them to den. I also found out from organic chemistry that high cell membrane concentrations of PUFA’s make the cell membrane of our cells very fluid in cold environments. This explains why mammals need this adaptation to sleep and not freeze their cells. It is a cellular anti freeze. I also found out from canadian frog biology that high glucose levels also act as an antifreeze fro animals in extreme environments. This information was nothing short of shocking. Maybe diabetes is an ancient epigenetic program for survival and not a disease at all? When I found this out I realized immediately why evolution needed to plan for this. In cold environments, if our cell membranes are filled with MUFA’s and saturated fats they become to stiff to work. All cellular functioning in organ systems depend upon proper cellular signaling. Mother Nature knew it, so it designed a system to incorporate PUFA’s normally into all mammals cell membranes to get optimal functioning in cold environments. Any organic chemistist can verify that this is a complete and factual statement. Here is another example of how biologic thermoplasticity occurs in nature.
So it appears that dietary carbohydrates, which are only present in long light cycles in the summer in cold places, induce mammals to add PUFA’s to our cells to become fluid so we can function as we hibernate. Makes complete logical sense when viewed from an evolutionary stand point. I asked several mammalian vertebrate physiologist if this is how carbohydrates work for hibernating mammals and their answer was yes.
This implied to me that maybe if this is how mammalian physiology was designed to work to begin with. After all they evolved in the polar environments on earth. This implied something even bigger to me……why would we need diabetes to survive. Then the answer occurred to me. I called it Factor X. I checked my facts and continued to connect more dots. Diabetes is required in mammals who are designed to work for optimal adaptation in cold environments.
Maybe, just maybe, it has become thought of as a neolithic disease in humans because we we have simultaneously lost the ability to hibernate because we evolved the ability to control our environment completely? After all we know evolution is moving today faster than our genome can adapt Cordain and LaLonde have pointed out many times.
Remember, we still have our mammalian paleolithic genes that control our use of dietary carbohydrates and the up-regulation of PUFA’s in our cell membranes in us today. These biochemical pathways remain in us. This is another well known fact in the paleosphere. What is not so obvious to most however, is that the rapidity of our brains evolution created the ultimate mismatch in this system. I believe some perceive this mismatch but no one has explained this as yet. So it then follows that when we create a biologic mismatch with our neolithic thoughts………we get something we have been socialized to believe is a disease. When after all it is not at all……it is an evolutionary novelty created by our own rapid evolution secondary to our brain amazing development in the same time period?
This is how I view it from a 30,000 foot level today. The skeptics will immediately jump down my throat and point out that type one diabetics and use CW that says it is a genetic disease! I don’t and never have. I think Type 1 and 1.5 diabetes are decidely epigenetic phenomena of this mismatch that has been passed from every eutherian mammal to us today, and we remain unaware of this possibility either! Epigenetics has also speed up if evolution has. This is why humans have no ability to stop diabetes once it stops…….unless they get in a cold environment. And this is why we assume that these two conditions are diseases, rather than consequences of a “relative time frame shift” in evolutionary time, due to how fast our brains developed. This also explains why we have a paucity of hominid skeletons in the fossil record. This time disruption is part of levee one which I called the “cellular theory of relativity.” Time is something we failed to consider in how our species maybe its own missing link to this puzzle!
Several of my friends have asked me, if this is not a disease then how does nature cure diabetes on its own? The answer should be intuitive now to you. When you began this post you might have thought where I was headed was counter intuitive and frankly insane. Well, now you see how I think about it from a new perspective. The biology we know to be true today lines up completely with this theory. But how is IR and DM cured? Well, can you really cure a disease that is not a disease to begin with?
In IR, we get expansion of the fat mass to increase storage from carbohydrates we ate during long light cycles. So that implies to reverse this process there has to be a system. There is…….its called hibernation in freezing cold. It means the cure is to live by your descendants biologic directs and in congruency with our evolved biology. Since we no longer hibernate……..maybe you need to consider how you eat carbohydrates within the circadian controls? Maybe what you thought was safe………really is not?
Final point in part two of this series….…..Doc, how does evolution eliminate these fat cells normally. What is the biologic process? The reason diabetic researchers can’t find a cure is because their manner of looking at the problem is skewed and dead wrong. When you put on your evolutionary glasses you see a different view of a perplexing issue. Cold environments are found as mammals hibernate in normal circadian biology…….this completely reverses IR in mammals and wakes them up when conditions are better for life. Humans extinguished this ability rapidly in our evolutionary history because we are fully capable of controlling our environment. There is no need to den any longer because we control our environment regardless of the temperature but we still have the machinery that acts within us. If we eat outside that directive we get modern day diabetes. We can forage and succeed all the time. We can obtain Chilean banana’s on Dec 31 in the Arctic circle. Do you think evolution has a plan for this set of circumstances yet? Nope.
The modern result is that we have created a world where carbohydrates and PUFA’s are available 24/7 while we no longer can access to evolutions solution for Insulin resistance. It also makes sense why we have no built in hard wired metabolic pathways for fat removal. But Cold thermogenesis does it and dies it remarkably well. That implies that our ancestors paleo genes remain dominant as we evolved out of the Savana……..or it could even mean that maybe other assumptions we have made are also wrong?……..Realize that because our brains development was so rapid it allowed evolution to extinguish the ability to hibernate. But there is a lot more to this story yet to be told…………as added biologic plausibility and maybe ultimate proof as to what is the optimal diet and what is just good enough

Not surprisingly, given the above, Dr. Kruse recommends cold adaptation to transform oneself into a more energy efficient machine. This is also a good idea to prepare for an ice age. (This is what immediately came to mind when I read this which is why I find it so interesting. Plus, I can’t stand the cold but from doing the mirror test on myself my body is not so good at dipping into its own fat stores for energy.) This can be done in tandem with the Leptin reset. He recommends slowly working your way into it. First by putting your face in icewater, then using cold packs on certain areas to activate brown adipose tissue (BAT) (which in adults is usually found on the neck, back of the shoulders and above the clavicle bones. BAT can also be dispersed throughout WAT), taking cold showers and the biggie: cold immersion in a cold bath or ice bath. You can also just expose yourself to colder temperatures by turning down the heat, going outdoors not dressed for the cold weather but this takes longer. Adapting poorly to the cold could be attributed to a high omega 6:3 ratio. This ratio can be as high as 27:1 in peeps who follw the SAD. Ideally, it should be about 5:1 or less for optimal health.

There are more details but this is about the gist of it from my reading. This CT is what he says the folks in the paleo community are not really taking into account.
More links on this:

He's not always crystal clear nor succint but he presents some interesting information. He has a book coming out soon. If you scan through his blog he has information on recommended supplements as well lab tests which he strongly advocates. He also has posts on many other health issues such as sleep, leaky gut, hormones, osteoporosis etc. that are informative. I haven't made my way through all those. Most of the links I gave require multiple readings and reading the comments after each post.

I'm conducting my own experiment on these two ideas and will update on results.


FOTCM Member
Dr. Jack Kruse was on the Underground Wellness radio show recently talking about cold thermogenesis. You can listen here - http://www.blogtalkradio.com/undergroundwellness/2012/03/09/dr-jack-kruse


FOTCM Member
I had the opportunity to read his posts on thermogenesis, the holy trinity, the quilt, the leptin Rx FAQ, and downloaded some of the papers and articles that he cites. What Odyssey synthesized sums what I read pretty well. He babbles a lot, it seems he literally types as he thinks and does no editing. I think he is reviewing a ton of information in a very short time. He goes almost by instinct but also experience as he reviews the science that is available. What he is finding sounds fascinating to me, but it requires a lot of research background. I hope he writes a book soon, and I hope he has a very good editor!

It also strikes me that he points out that people who are interesting in long-term performance and longevity with a ketogenic version of the paleolithic diet (which is basically what we do) show incredible results and huge gains in their performance over 24-36 months of adaptation. He is been doing it for almost 6 years and also in his patients.

It makes me wonder what else the Ice Age will do to our bodies and brains, provided we are ready and survive it...


The Living Force
FOTCM Member
Yes, I've been thinking about this whole cold adaptation/cold thermogenisis issue and the Ice Age. I listened to the Underground Wellness podcast dugdeep linked to. It was also pretty interesting. I agree that he doesn't edit his writing AT ALL.

The other thing that keeps niggling at me in the back of my mind is that he keeps referring to cold adapted mammals being our "ancestors" and never mentions (as far as I've run into) the long periods of Ice Age humans evolved through. One other thing that surprised me on that podcast was that he talked more about eating seasonally and the whole circadian biology, etc. He said that starting from around March 15 to April 15, he started increasing his carbs, and hits from 200 to 300 grams by summer!! Why would anybody do this and then go back to being keto adapted in the fall? Sounds like something I would NOT want to do. But then he said he's no longer going to do this/no longer is doing it, but I didn't understand the reason he gave. If anybody else listened to the podcast and remembers, did you understand why he said he gave up increasing carbs so much in spring and summer?

In any case, when I have some time, I've been planning on going through more of the material on his website and I might post some summaries again in this thread.

truth seeker

The Living Force
SeekinTruth said:
He said that starting from around March 15 to April 15, he started increasing his carbs, and hits from 200 to 300 grams by summer!! Why would anybody do this and then go back to being keto adapted in the fall? Sounds like something I would NOT want to do. But then he said he's no longer going to do this/no longer is doing it, but I didn't understand the reason he gave. If anybody else listened to the podcast and remembers, did you understand why he said he gave up increasing carbs so much in spring and summer?
As I understood it, he said he's not doing it this summer because he's continuing his biohacks this summer:


The second meaning of biohacking refers to the art of managing one's own biology using a combination of medical, nutritional, electronic, and Quantified Self techniques. The term is in common use by several public figures:

Tim Ferriss wrote about biohacking in 4_Hour_Body#The_4-Hour_Body

Dave Asprey of "The Bulletproof Executive" [1] about whom the Financial Times wrote "Indeed, why not give yourself an 'upgrade', says Dave Asprey, a 'bio-hacker' who takes self-quantification to the extreme of self-experimentation. He claims to have shaved 20 years off his biochemistry and increased his IQ by as much as 40 points through 'smart pills', diet and biology-enhancing gadgets."1

Neurosurgeon Jack Kruse who writes "Our hypothalamus rewires to many stimuli and it appears that temperature is a major factor in the rewiring protocol of our brain...Our job as enquiring primal bio-hackers is to figure out why and how this might have happened.


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SeekinTruth said:
The other thing that keeps niggling at me in the back of my mind is that he keeps referring to cold adapted mammals being our "ancestors" and never mentions (as far as I've run into) the long periods of Ice Age humans evolved through. One other thing that surprised me on that podcast was that he talked more about eating seasonally and the whole circadian biology, etc. He said that starting from around March 15 to April 15, he started increasing his carbs, and hits from 200 to 300 grams by summer!! Why would anybody do this and then go back to being keto adapted in the fall? Sounds like something I would NOT want to do. But then he said he's no longer going to do this/no longer is doing it, but I didn't understand the reason he gave. If anybody else listened to the podcast and remembers, did you understand why he said he gave up increasing carbs so much in spring and summer?

I haven't heard his podcasts, I generally prefer to read. He explains the no safe starch thing on his Thermogenesis series, but probably it is elsewhere in his blog as well. He gives several explanations, but the one that stands out for me is that the cells age faster when they use carbs as energy source since there is more oxidation as a by product. He gives a link to one of his posts on the use of energy by cells, but we have also a synthesis on energy utilization in Life Without Bread showing how ketogenic energy sources are more effective.

In simple words, I would say that people are living in a "perpetual summer" and then we are no longer reading from the environment the correct signals to switch the "longevity" hormones in our bodies during winter because we have artificial means to keep warm and have light and carbs all through the year. Physiologically, we still have the capacity to switch this "longevity" hormones though.


The Living Force
FOTCM Member
Ahh, thanks truth seeker, I wasn't able to make out "biohacks" in the podcast (the audio wasn't great).

Psyche, I did get the gist of what you wrote from browsing through his site. The thing I'm questioning is: is it good to go through the switch of metabolism -- fat burning to sugar burning and back every year? You have to get knocked out of ketosis if you go up to 200 to 300 grams of carbs, right. It's probably individual, but I'm thinking the upper level to stay in ketosis will be somewhere in the range of 50 to 70 grams of carbs.

Anyway, maybe I'm missing something important like when you've been doing it for a long enough time, it's not a big deal to switch metabolism back and forth in terms of how long it takes to adapt/adjust?


FOTCM Member
T.S. Wiley talked about switching back and forth between sugar and fat burning on a seasonal basis, too. She went so far as to say that people would be ketogenic all winter and then eat enough fruit to make them insulin resistant in the summer, switching back to meat in the winter and fall. Dr. Jack Kruse said something similar in the podcast, which actually made me think maybe he got it from Wiley.

I don't plan on mimmicking it, though. I think a lot of Wiley's stuff is pure speculation. It seems to me a lot of people speculating about the paleo diet assume that if something was around, our ancestors must have eaten it. That may not be the case, however, particularly with fruit which likely would have made our ketogenic fat-adapted ancestors rather uncomfortable.


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dugdeep said:
T.S. Wiley talked about switching back and forth between sugar and fat burning on a seasonal basis, too. She went so far as to say that people would be ketogenic all winter and then eat enough fruit to make them insulin resistant in the summer, switching back to meat in the winter and fall. Dr. Jack Kruse said something similar in the podcast, which actually made me think maybe he got it from Wiley.

Kruse has talked about how he initially got interested in all this research was from reading some papers and two books, one of which was Sex Lies and Menopause, so I bet it is the case that he did get that info from Wiley.


FOTCM Member
SeekinTruth said:
Ahh, thanks truth seeker, I wasn't able to make out "biohacks" in the podcast (the audio wasn't great).

Psyche, I did get the gist of what you wrote from browsing through his site. The thing I'm questioning is: is it good to go through the switch of metabolism -- fat burning to sugar burning and back every year? You have to get knocked out of ketosis if you go up to 200 to 300 grams of carbs, right. It's probably individual, but I'm thinking the upper level to stay in ketosis will be somewhere in the range of 50 to 70 grams of carbs.

Anyway, maybe I'm missing something important like when you've been doing it for a long enough time, it's not a big deal to switch metabolism back and forth in terms of how long it takes to adapt/adjust?

In his posts on Thermogenesis written in February and March of this year, he doesn't encourage switching back and forth between seasons which is like gorging before winter hibernation kind of thing but since we don't hibernate and expose ourselves to the crude winter, we end up creating havoc in our health. He emphasized the no safe starches thing, criticizing paleo bloggers that encourage starches and also goes into some length explaining how athletes will see great results if only they were able to stick to ketosis for a long enough period that will allow for adaptation. He reports "huge results" in athletes who have been ketoadapted for 24-36 consecutive months.


FOTCM Member
Shane said:
dugdeep said:
T.S. Wiley talked about switching back and forth between sugar and fat burning on a seasonal basis, too. She went so far as to say that people would be ketogenic all winter and then eat enough fruit to make them insulin resistant in the summer, switching back to meat in the winter and fall. Dr. Jack Kruse said something similar in the podcast, which actually made me think maybe he got it from Wiley.

Kruse has talked about how he initially got interested in all this research was from reading some papers and two books, one of which was Sex Lies and Menopause, so I bet it is the case that he did get that info from Wiley.

Iiiiiiinteresting. I only heard him mention the other book, which I think is called The Monk Who Sold His Ferrari, or something along those lines. Thanks for confirming that, Shane!


The Living Force
FOTCM Member
Yeah, he mentioned Sex, Lies and Menopause either on the Jimmy Moore Living La Vida Low Carb podcast or in his "Holy Trinity" blog post, maybe both.

Thanks for the clarification, Psyche. I'm looking forward to committing some time going back to his site and reading all his material. I need to catch up reading SOTT a bit because I've fallen behind again.

So I've been keto adapted for about a year -- I started in Feb 2011 and figure it took a few weeks to go into and stay in ketosis. Maybe after 24-36 months, we're all going to have another bump up in energy and stamina? I'm going to ease into experimenting with Dr. Kruse's cold adaptation protocol too. Let's see how many "supermen and superwomen" (as he puts it) develop out of these experiments. :)
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