Paleo Doc

Living Our Life Through Filters: What's Yours

We all know the phrase, seeing through rose colored glasses and understand that it means a way of viewing life but I do not think most of us realize the many different filters we see through each day.  Life circumstances contrary to these filters have been referred to in psychology as cognitive dissonance.  We find these filters pervasive in our everyday lives but we really pay little attention to their presence.  They tend to only allow in info that resonates with our deeply held beliefs or personal attitudes.  Do you know people that are extremely lucky and find yourself wondering why they always seem to be fortunate?  Well, there is science behind this; studies have found that "lucky" people have a very acute filter for identifying subtle opportunities that not so lucky people tend to filter out.  To better understand these filters in practice, watch the video below:

Lets look at some of these filters in everyday life;

1. The nutrition and fitness filters:  We all have our own ideas of what constitutes healthy nutrition or the ideal fitness routine but what happens is we set up filters for these ideas.  We tend to latch onto and promote any study or article that supports our beliefs while quickly dismissing anything that states otherwise.  In doing so our brain tells us that we are well supported in our views.  I like to refer to this as cherry picking data and studies.  We also tend to rally around others that share our beliefs thus further reinforcing that filter.  The key is to recognize these filters and understand where they come from.  Being a physician in the primal/paleo community, I see these filters often.  When presented with these views, I step back and ask myself if I am truly being objective in my reviews or whether my filter is setting me up for denial.

2. Health & medicine filters:  As a practicing physician, I am inundated with conflicting medical studies on a daily basis.  From hormones, to statins, to nutrition, there is little consensus.  I believe there is no such thing as an unbiased study; just asking the question to begin with will influence the outcome.  Because of this, I try to read as many articles supporting my belief as I read that deny my belief and then see which resonate with my medical observations of my clients.  Many researchers may not have much clinical experience or their clinical experience is lived through the filter of their belief.  Here is a TED talk that covers bias in statistics:

Here is one of my favorite articles from The Atlantic: Lies, Damned Lies, and Medical Science.

3. Life filters: These are the most pervasive of the filters and the ones that make you who you are.  Filters are the way we interpret the objective world, what I mean by this is that multiple people can take a situation and interpret it very differently.  As an example; two people stand on the edge of a cliff overlooking the Grand Canyon and one person is full of exhilaration and wonder while the other person is paralyzed by fear or the same two people are in the presence of a crying baby; one feels empathy and the other annoyance.  In both of these, the objective situations are the same for each individual but the interpretation of that data is altered by the filters they apply.  I have also heard the example of two people who walk out to a warm sunny day,  one says, "what a beautiful day," while the other states, "it's too hot out here."  Same situation but one chooses to see the day through a filter that is more optimistic.  Some may refer to this as PollyAnna but studies show that people with this filter tend to be happier and have less health issues.  The other group we refer to as possessing the "Eeyore filter."  The Eeyore filter is a difficult one for us in our medical practice.  Eeyore types tend to be people that have developed such a strong filter over the years that it is truly a part of their identity.  We all know these people, the ones that have to have some sort of drama going on in their lives.  They must tell you about how difficult their lives are and when one drama ends, there has to be another to replace it.  Despite saying that they do not want to feel that way, they tend to thrive on it.  Most people avoid asking them how they are doing or feeling because they know they are in for a spilling of misery.  The challenging part is that after seeing through this filter for so long, many of them do not want to get better.  They sit in fear as they begin to see improvements in their health and will often begin to sabotage their progress to stay in the comfort zone of their Eeyore filter.

Filters are not permanant, they can be changed but it takes practice and over time,  it becomes second nature.  Just like learning to juggle, when you start, you have to focus on all the intricate movements and concentrate all your efforts on making it work but after many hours of practice, you do it without thinking.

Think about the people you surround yourself with and understand that filters can be contagious.  We all know that being around people that whine and complain about things can influence us to do the same.  The flip side is also true and certainly attractive, being around happy optimistic people feels good and many are drawn to that energy. What filter do you prefer to see through?  

Understanding Thyroid Labs and Hypothyroidism

Many people are confused when it comes to understanding their lab values of thyroid function.  I frequently find clients with full blown symptoms yet have thyroid numbers which they have been told are "normal."  When you truly grasp the complexity of the thyroid function and interactions you can get to the real root of the problem and threat the cause rather than the symptom.

 

Female Testosterone Replacement

Many women that come to see me are surprised when I tell them that they have a testosterone deficiency or infufficiency.  Mostly they are surprised that women actually need testosterone.  When they hear this they immediately think of the body builder muscle, or acne, or facial hair.  Unfortunately this is the bias that our society has placed on testosterone and it really is unfortunate because this hormone is the key to female vitalitly.  It is also surprising to women to find out that the amount of testosterone circulating in a healthy reproductive female is actually 10x the amount of estrogen yet we focus on the loss of estrogen - because it is the "female" hormone.  Please watch this video to at least understand the truth about the role of testosterone in females.

 

Health Risks of GMO's and Modernized Foods

What are GMO's and hybridized foods and how do they affect our health and physiology.  As a physician, I wanted to really understand these risks, truths, and myths.  This is my perspective.

The slides were are a little difficult to see so I have included a pdf of the slides if you would like to see them as you watch and listen:  Download Understanding the Risks GMO's and Modernized Foods or get the file at imgur: http://imgur.com/18UYmuG. Or you can follow the slides below with Slideshare.

 

Understanding the risks gmo's and modernized foods from PaleoDoc

Testosterone Replacement Dangerous? Not Really.

The internet has been reproducing the sensational headlines that an article in JAMA produced last month when they published, "Association of Testosterone Therapy with Mortality, Myocardial Infarction, and Stroke in Men with Low Testosterone Levels."  The study proclaimed that the risk of death, heart attack and stroke was 30% higher in men taking testosterone replacement than men not using replacement for low levels.  Wow! would really make me think about avoiding it.  The problem with this finding is that it flies in the face of much of the other data that has been produced over the past 10-15 years on testosterone replacement.  Two studies in particular were published in the Journal of Clinical Endocrinology and Metabolism in 2007 and 2012 both of which showed an approximate 40% reduction in overall mortality in men with the upper quartile levels of testosterone vs. those with the lowest quartile.  The 2012 study specifically looked at men being treated for low levels vs. those not treated.  So why is this study indicating that these other studies were wrong? Or could it be that this study was flawed?  This study reminds me of the WHI study that took all the women off their hormones.

The first issue that I came across is the proclamation that there was a 30% increase in death, MI, and stroke.  Here are the actual study participant numbers as reported in the article: "Of the 1710 outcome events, 748 men died, 443 had MIs, and 519 had strokes. Of 7486 patients not receiving testosterone therapy, 681 died, 420 had MIs, and 486 had strokes. Among 1223 patients receiving testosterone therapy, 67 died, 23 had MIs, and 33 had strokes."  I'm not a statistician but these numbers don't quite fit the conclusions - those not getting testosterone had a 9% mortality rate, 5.6% rate of MI, and a 6.5% stroke rate, now those that received testosterone therapy had a 5.5% mortality, 1.8% rate of MI, and a 2.7% stroke rate based on the reported numbers. What????  Here is what happened, it's called manipulation of raw data to fit your desired outcome.  The study authors calculated in more than 50 variables and gave different weighting to the variables in order to come up with the desired statistical data.  Can they really do that?  Yes, and JAMA is more than happy to scare the public with this type of misinformation.

The data manipulation is not my only issue with this study.  First, it is a retrospective study which is fine but it is also not the type of study that should ever produce sensational headlines, retrospective studies are only of value as a guide to further investigate through prospective evaluation.  Another problem, only 60% of those receiving therapy had follow-up testosterone levels checked to even know if their levels were therapeutic or supra-physiologic - I prescribe replacement therapy and would never assume that levels are ideal, there is way too much variability in the levels achieved in each individual.  Also, there was no attempt to look at estrogen or DHT (dihydrotestosterone) levels, both of which are potential conversions from testosterone and can have profound consequences to mortality, MI, and stroke.  No male should ever be put on testosterone without having at least estradiol levels measured once or twice a year.  Estradiol should not be too high and not too low for optimal health.  High levels of estrogen alone can increase risk of MI and mortality.  DHT can increase atherosclerosis and it is usually very high in persons using any form of topical testosterone therapy and 65% of the men were using topical forms in the study.  Finally, there was no report of the monitoring of the hemoglobin and hematocrit, this is important because testosterone can increase the concentration of the blood which can lead to adverse cardiac outcomes if not monitored and managed appropriately.

I have been treating men and women with testosterone replacement therapy for many years and have seen amazing health improvements: improved cardiovascular risks, improved mood, improved cognitive function, decreased fatigue, increased muscle mass, decreased body fat, improved libido and sexual function - overall improved vitality.  This therapy does have to be monitored and should be part of an overall lifestyle of good health habits.  When combined with paleo/primal nutrition, functional fitness, and mind/body practice, health optimization is outstanding.