November 20, 2013

Mental models


What do passion, persistence, and deliberate practice have to do with our health?

Read Time 8 minutes

One of my readers posted a link to this short talk from TED Talks Education. (You’ll want to watch it to understand the rest of the post.)

I found the talk interesting, and in the talk Ms. Duckworth makes a reference to a Stanford psychologist, Carol Dweck, who has been very influential in my thinking about children and childhood learning.  In fact, when I became a father one of the first books I read (and have since recommended to every parent I know and even my daughter’s kindergarten teacher) is a book by Dr. Dweck, Mindset.

Now, I don’t know if everything Ms. Duckworth says or suggests is correct.  Her work is well outside of my area of knowledge.  But it’s a topic I think about so much, and since watching this video I’ve been reflecting on my life and the implications of this idea to our health.

First, some background

Shortly after my twelfth birthday, boxing fans around the world were given a gift unlike anything before or since, the showdown between Marvelous Marvin Hagler and Tommy Hearns (don’t watch this unless you can handle a violent boxing match). To this day most boxing experts agree the first round of that 3 round war remains one of the — if not the — greatest round in boxing history.  I was a huge Hagler fan, and this fight galvanized in me two things:

  1. I wanted to be a professional boxer (something I pursued relentlessly enough to nearly forgo college), and
  2. I wanted to be just like Marvin Hagler, the grittiest fighter of my generation.

You see, I was not the fastest when it came to hand speed or foot speed.  My punching power was good, but not George Foreman or Sonny Liston good.  There was no special “gift” or talent I had that was ever going to make me the next Mohammed Ali or Mike Tyson.  But, Hagler didn’t seem to possess any God-given ability and, in my 12-year-old opinion, he was the greatest fighter on Earth.  Sure, Sugar Ray Leonard was the media darling and wealthiest fighter of the era, but Hagler was the grittiest. (Anyone tempted to point out that Leonard was awarded the split-decision over Hagler when they met in 1987 need not bother.  In my mind – and the mind of many — Hagler won 115-113.  If you want to read more, here’s a great summary.) He out-trained everyone.  He never got out of shape between fights. He was always ready for combat.  He was pure grit.

So, this became the defining feature and mantra of my youth.  No one was going to out-grit me. I would run 6 to 10 miles at 4:30 in the morning (imagine how dark and cold that was in Canada) because I knew the other guy was still sleeping.  I did 400 push-ups every single night (except one night in 11th grade when I was too sick to move) before bed from age 13 to 18 because I knew the other guy would not.

When I did decide, ultimately, to go to college instead of pursuing a career as a professional fighter (something I attribute to the most influential teacher in my life), it was such an easy transition, because I had already built a mental and emotional infrastructure of grit.

Perhaps because of some deep insecurity I always felt the need to out-grit everyone at everything, even surgery.  In residency, while my peers would (rationally) try to catch a nap any time there was a free moment during call nights, I would practice anastomosing 3 mm Dacron grafts together with 8-0 proline, over and over again. I even built a model heart with a deep mitral valve to practice – a hundred times a day – one of the most difficult stitches in surgery, the “A-to-V” and “V-to-A” sutures through the mitral annulus.

You get the picture.  I was (and remain) a freak.  The ‘why’ is beyond me, though I’ve never stopped trying to understand it. Even when my daughter was only 5, I spent a lot of time talking with her about ‘mastery’ and the joy that comes from the journey of mastering a skill (versus the need to seek pleasure in the outcome or final result).  This is not a natural phenomenon and I think, unfortunately, most of our education is based on the result and not the process.

I’ve read countless books on this, both out of desire to better myself and out of a desire to ignite this spirit in my children, and to date the best one I’ve read is The Talent Code, by Daniel Coyle. It’s the only book I’ve ever read where the moment I finished it, I turned to the first page to read it again.   In this book, Coyle argues that grit – practice – may not be enough.  It’s necessary, but not sufficient for mastery. The other component essential for mastery is the right kind of practice — deliberate practice.  This topic is worthy of a book, of course, and not just a few sentences, but suffice it to say, deliberate practice is a very specific type of practice that leads to change. Mastery. While I disagree with this writer’s view that the book, Talent Is Overrated does a better job explaining the concept than The Talent Code, he provides a quick overview for those not familiar with the concept.

How does this apply to our health?

First, if you don’t practice correctly, no amount of practice is going to achieve mastery, whether it’s swimming the 200 IM or playing the piano.  A disciplined approach to eating the wrong foods may be better than an undisciplined approach to eating the wrong foods, but it’s no substitute for the correct approach to eating the correct foods.

In 2009, when I was at the height of my unhealthiness – I was overweight, insulin resistant, and had Metabolic Syndrome – it was not because I was not ‘trying hard enough’ to eat well.  I had all the grit in the world when it came to eating. I wanted so desperately to be lean and healthy. The problem, of course, was that I was not eating the right foods. It’s the difference between gritty practice and gritty deliberate practice.

Second, let’s posit you figure out what the ‘right’ foods are.  Is this sufficient to achieve your health?  Well, here I have to include not just my experience, but the experience of my friends, family, and clients. Some people, once introduced to the ‘right’ foods, experience almost an immediate change.  The pounds melt off. Their biomarkers improve seemingly overnight. They feel rejuvenated and renewed.

Let me assure you, these folks are the exception and not the rule. For most people the pattern of going from metabolically broken to fixed, which often includes a loss of fat mass, is very slow; slow enough that on a day-to-day and even week-to-week basis it seems negligible.

To explain this, I’ll use fat mass as an example, since it’s the metric most people understand best.  In my experience, outside of profound caloric restriction or outright starvation, the typical amount of fat loss I see in a person is about one pound per week, or about 60 g per day.  That might not sound like much, and over a week or day, it’s not. (Though, hold 60 g of almonds in your hand and imagine a net loss of this much fat every day from your collective fat cells, and you can start to appreciate how impressive it is physiologically!)

But, we can’t track fat mass directly, at least not on our bathroom scales, and frankly not even with DEXA scans unless they are really spaced out.  Certainly not at the level of a few hundred grams. Furthermore, our bodyweight – what we typically do track – fluctuates a lot.  In me, for example, it fluctuates by 5 pounds per day.  How, you ask? Water. Not just the difference between what I drink and what leaves my body (urine, perspiration, respiration), but also interstitial accumulation, which manifests as minute amounts of swelling, typically in muscles, and elsewhere, too, often in response to exercise, travel, stress, and even foods I eat.

So, if your bodyweight can fluctuate 5 pounds in a day, is it possible to track 60 g per day of net fat loss? It’s like me blindfolding you and putting 50 pennies in your hand and asking you if there are 49, 50, or 51 there.  No chance.  Furthermore, 60 g is so far outside of the measurement spec of a bathroom scale that even if your weight did not fluctuate much due to fluid shifts, you would never be able to appreciate the net fat loss over the course of a few days and barely over a week.

What does this look like in real life? Consider the graph, below, which shows the actual (and completely achievable) weight loss of a person over 7 months. This person went from 227 lb to 195 lb in 7 months, which represents an average of about 4.6 lb per month, or about 69 g of net fat loss per day (as confirmed by DEXA).  This was not a starvation diet or something radical. This was a change in macronutrients – from a standard American diet to a ketogenic diet — that led to a change in net fat flux. But, the change is subtle over any short period of time.  It’s only over months that the change becomes life-changing.


Now, imagine the day-to-day frustration this person (I know, because I was working with this person) experienced with the fluctuations in scale readings!  It was tempting on many occasions to say, “Forget it, I’m going back to what I was doing before.”  Just like there were many days I didn’t feel like going to swim practice, or days I didn’t feel like deliberately practicing my surgical technique.

If you remember nothing else, remember this: the game is won – or lost – not by the infrequent big changes, but by the frequent, deliberate, and repeatable small ones. This is where grit comes in.

Sure, there are genetic freaks and lucky ones out there, for whom none of this matters. But for the rest of us – because we live in, and are surrounded by, a food environment that is chronically toxic to about two-thirds of us – re-building our bodies requires consistent and deliberate change.

Are there people with all the grit in the world who can’t achieve health? Absolutely. And I put them into two categories:

  1. Those who are not eating the ‘right’ foods for them (recall: I was in this camp until 2009).
  2. Those who have underlying issues – usually hormonal – which are working against them and preventing their fat cells from liberating fat.

I will not get into these categories in great detail, because the topic is beyond the scope of this post and, frankly, it takes me months to diagnose this in people I work with weekly.  So I can’t responsibly spout out blanket statements about ‘fix this’ or ‘fix that.’  However, far and away the most common causes I encounter in my practice for persistent metabolic derangement, often but not always accompanied by adiposity (excess fat), in the presence of seemingly correct eating and true grit are as follows:

  1. An insulin resistant and/or hyperinsulinemic person eating foods that stimulate significant amounts of insulin;
  2. Hypothyroidism (in my book, TSH > 2 accompanied by basal morning axillary temperature below about 97.8 F);
  3. Hypogonadism in men (which I diagnose with not only total testosterone, but also free testosterone, DHEA, and estradiol), or PCOS in women;
  4. Disruption of the HPA axis, most commonly manifested by “adrenal fatigue” and/or elevated cortisol levels.

Again, I’m not going to get into the nuance of these, but I list these to give those folks who believe they are A) eating the ‘right’ foods, and B) full of grit, yet not seeing results, some hope. These issues are fixable, but you need to see a doctor who knows how to fix them.

Fortunately, such situations are very rare! Most people, with the correct dietary intervention, armed with sufficient grit, and the confidence to stay the course, despite the day-to-day and week-to-week fluctuations, will emerge as renewed people.

Parting shot

Unfortunately, as long we live in a world where (i) the conventional wisdom, (ii) dietary recommendations, and (iii) the market forces enabled by them create an eating environment that is not suited to what most of us should eat, we need to guard against the desire to give up when the results are not what we expect in the timeframe we expected.  As a result, about 90% of people who make a dietary change – and even see results – end up gaining the weight back.  Why? I suspect it’s a bit of what I’ve written about here, and two other phenomena:

  1. The fall-off-the-wagon-and-get-discouraged issue, and;
  2. The I’m-better-now-I-don’t-need-to-do-this-anymore issue.

In the former, folks get very discouraged when they make a ‘mistake.’ Rather than immediately getting back on the program, they get frustrated, and over time – sometimes quickly, sometimes slowly – revert back to their old eating habits.

In the case of the latter, there is this belief that once the goal is achieved, one need not continue the practice. It’s like me training for a year to win a time-trial race on my bike, winning the race, and then deciding I don’t need to train anymore and I can still compete successfully. Not going to happen.  If I want to win, I need to train.  If I’m going to train, I need to train deliberately and persistently. Even on the days I don’t want to.  When I miss a workout or have a bad one, I can’t beat myself up over it. I have to let it go and remember that tomorrow is a new day.  The sum of my days determines my success.

Grit by Crystian Cruz is licensed under CC by 2.0

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    • I don’t know, Dan. No time soon. A blog is easy to write, but a book — a really, really, good book — would be very difficult for me, given the other things in life I need to juggle.

    • Just found your blog and am bleary-eyed from reading all. Didn’t see how to post a question.

      Hypothetical only. Suppose one had hyperaldosteronism with mild Stage 2 CKD and taking eplerenone and supposed to avoid Na & Monitor K. Would such a one be able to be on nutritional ketosis? Would one have to take increased Na?

      Just scientific, hypothetical inquiry!

  1. what is your take on HRV ? grit is one thing BUT if the body says you have NOT recover yet from your previous training then rest before doing another challenging session.

    sometimes subjective feeling that you feel fine is NOT enough because HRV will have subtle indication that one has NOT recovered yet.

  2. This is a great article. Thank you so much. Have you read Mastery by Robert Greene? All of my life I have been trying to “get there” in every which way possible. It wasn’t until I became process oriented that I discovered that Mastery is the way, not the designation. The sky has been the limit ever since… Thank you for speaking to this! We always enjoy your posts, insights, and the time you take in sharing them.

  3. Heh, “fix you” by Coldplay has been probably my favorite motivation song since 2007 when I was fully into trying to get Ron Paul elected as president and someone made a motivational video of him using that song. I go back to that song all the time.

    I have a group that seems to be ever expanding here in Louisville that I have tried to tell this to as well. Some fall off the bandwagon as you say while others have gotten to their goal weight over a longer time period (and got rid of their PCOS symptoms).

    Great post. Love reading you stuff.

    • I have seen similar criticisms before. I think there is merit to this around the lack of scientific evidence. For me, the myelination aspect of his theory is mechanistic. It may or may not be the mechanism by which the phenomenon he (and others) describes. I think the criticism that ‘nothing in his book is new’ is not relevant. I don’t think Coyle claims (maybe I’m wrong) to be the guy who thought of this. I just find he explanation the best.

  4. The journey is far more interesting, insightful, and enjoyable (if I’m not too audacious) than the outcome. Most of us expect to see results right after jumping on a diet, like you pointed out. Unfortunately, bliss comes for those who persevere no matter the external or internal factors.

    I started a ketogenic diet as an experiment to lose the stubborn remaining belly fat I had. I ended up with a lifestyle thanks to Tim Ferris which pointed me to your amazing work. From you doc, I found out about Steve Phinney, Gary Taubes, Jeff Volek and other great individuals.

    It will take several years (possibly decades) until the paradigm shifts, but I know that we (the society) have the greatest founding fathers we could have.

    Thanks for everything you do Peter. Always inspiring!

  5. Another amazing post Peter!

    Im in the second year of med school and studying for an exam on inflammation, innate/adaptive immunity and immunological disorders.

    Whenever I need a little extra push to keep studying I go to your blog/the NuSI-website and get inspired.

    Thanks alot!
    Greetings from Sweden.

    • Immunology was one of my favorite subjects in med school. It’s such a remarkable system, especially the adaptive (vs. humoral) system. Now get back to studying!

  6. Interested to see your take on the new recommendations for increasing statin Rx in the healthy population based on this “formula” which says that if you have a “7% chance of a heart attack or stroke in the next TEN years,” you need to be on statins.

    How can they still be pushing this, to such a ridiculously low threshold, when it’s been so thoroughly debunked?
    How long will it be before MD’s are FORCING people to take these unwanted, unnecessary drugs?

    • Thank you for an ispiring post for those of us frustrated and disappointed by slow progress. I am really looking forward to part X. I hope you will please give us your thoughts on topics I see everywhere, such as the dangers of statins for women, and the ideas presented by the experts in Cholesterol Clarity (by Jimmy Moore) on the dangers of low cholesterol and the statistics that those with the highest cholesterol live the longest and healthiest lives. When treating LDL-P with statins, is the body able to thrive and achieve optimal health when the drug drives the total cholesterol down to 130-150?

  7. Dr. Attia:

    Another great post! I can most definitely relate to your psychological mindset. Have you ever read the book “The Way of the Peaceful Warrior” by Dan Millman? I read it when I was 14 and it permanently changed my view on life from how I wrestled at practice to how studied for school to how I treated friends and family. There are so many great quotes from the book that I live by everyday. And while some people think I’m crazy for referring to the “Peaceful Warrior” mindset with everything I do, it is absolutely relevant. In regards to taking control of your health, the psychological strength seems to be more difficult then the lifestyle changes themselves. If only there were more people out their with the mental focus and drive to take control of their lives, this would be a very different world. In the meantime, it’s caring, dedicated Doctors like yourself that WILL impact our current state of health, so thank you. Please keep the posts coming, I look forward to what is to come next! Especially your Cholesterol Part X !!!!

  8. Thanks Peter you are such an awesome person. Did you ever end up reading “The Law” by Bastiat?

    • Ryan, I’m ashamed to say that it’s on my nightstand (with 8 other books in the queue). I refer to it in pieces, but have not done the cover-to-cover yet. Funny enough, I did read a section over the weekend after having a discussion about it with a friend (who is the biggest Bastiat fan I know).

  9. Thank you for this! I work w/ women who have struggled w/ weight and it’s a challenge to enable them to see that real results aren’t going to be the proverbial Lose 30 pounds in 30 days…thanks, Dr. Oz. The inflammation that most people have from a lifetime of bad oils, sugars and processed foods also increases the difficulty in moving it on out. I will share this with my frustrated clients. Thanks again!

  10. I have been thinking of this very video for at least a week, and am so glad you found it for me! It is a truly inspiring story, I wanted to share with someone. thanks a bunch, you are terrific.

  11. I take my temp once a week on the day I record my weight, body fat %, and BP/HR first thing Friday mornings. My temp is consistently 97.6°F ± .2°. Has been like this for years. Last time I had my TSH checked in Nov. 2012 it was 4.64 and temp was 98° That number had actually dropped from a previous result of 5.08 in Feb. 2012 (interesting enough the difference in my diet between the two tests was trying to lose weight with a “healthy” low-sodium diet and exercise in Feb. to giving up (no grit) after a spring and summer full of tests and hospital stays and going on meds for my AFib, the doctors insist my “healthy” diet habits had no bearing on my condition, so I started eating all kinds of junk food and had gained 22 lbs. between those two tests). I’m planning to have it checked again in a couple months, along with my lipids, etc. to see if how the numbers have changed since I started low-carb (and adding sodium, also been mixing dried seaweed into my morning eggs for the iodine) last July.

    Should I be overly worried about the low temp and TSH numbers as I don’t seem to be having any problem averaging about 1 lb./wk weight loss since I started low-carb last July? I’m perfectly happy with this weight loss rate, as I’m hoping losing it slowly with help reduce the skin-skirt effect I see on people who loose weight quickly.

    Yeah, I see fluctuations in my weight loss progress too, but since I do weigh myself every morning and night I have a pretty good idea that when I don’t eat food I cook from scratch at home I always gain a couple lbs. from food prepared by others. I also didn’t start loosing until I cut out the cheese and cut down on the nuts and stopped eating more than 3 meals a day (picked that trick up from Dr. Jason Fung’s lecture series on YouTube).

  12. Hi Peter. I love your posts and learn something new each and every time. I am studying Nutritional Medicine and Mind Body Medicine at College and one book I am currently reading is “Breaking the Habit of Being Yourself” by Dr. Joe Dispenza a neuroscientist. He explains in detail about how quantum physics works and how in order to attract or be attracted to goals and intentions in your life there is definitive mind shifts needing to happen and that the “how” a goal is achieved is not up to us. How do you think this fits in with your post? According to the book, long lasting and profound creative change happens within not from the external.
    Hope my question makes sense.

  13. Great post! I’m a 64 yr old fitness trainer certified in fitness nutrition. I work mostly with folks over 55. I can’t get people ( especially the women) off the_ ing scale. If they see daily fluctuations of a few lbs. they freak out. Maybe I’ll hand them a copy of your post.

    By the way have you reviewed Grain Brain by Dr.Perlmutter. He seems to be advocating a ketogenic diet generally. I’m not entirely convinced. Do you have any reaction?

    • Larry, I have not read his book, but am familiar with his views and the general arguments he puts forth, which I mostly agree with. I can’t speak to his recommendations.

  14. Hi Peter,

    Long time reader, first time poster from Australia. I loved the subject of this blog. I read Mastery by Robert Greene and it changed my life by inspiring me to get passionate about finding my passion. (I will now certainly be ordering The Talent Code too; any book you think that highly of is worth reading!) I stumbled upon Mastery around my third year of struggling with constant low energy, nausea and anxiety attacks. It’s like something always felt wrong, even when nothing was, and that made me miserable. At 25, I knew I was too young to feel so old, but I had no idea how to fix it. Doctors only gave me pills. But through my exhaustion and only thanks to my natural curiosity, I kept fighting for answers, kept researching, and somehow or another, I discovered Paleo, then low carb, and then this incredible blog. I completely turned my diet and health around nearly overnight (with a lot of help from your informative and insightful posts). As it turns out, I’m severely affected mentally by gluten. I had resigned to living out a life of negativity and fear, without any idea that these weren’t my personality traits, but side effects of neurotoxicity! I wish I’d known years ago, but better late than never. The change in me since removing gluten (and all the other processed crap I was eating) has been almost too ridiculous to be true – For the first time I’m clearheaded, focused, energised, excited for the future and VERY passionate about nutrition and health. I see many people suffering the same way I did, knowing there’s every possibility that it’s the bread they’re chowing down on daily causing the problem. But they’re too tired to care, something I completely relate to. So I am heading back to university next year and it’s my goal to make a change to the conventional wisdom that’s out there today. In particular, I’m passionate about the link between mental health and diet, something that currently seems very underemphasised within the medical field. Basically, I’ve realised the point of life is to make a difference to others, and one day I hope to (something your blog is doing every day – how fantastic it must feel to know you’re positively changing people’s lives, and by extension, the world!)
    You’ve heard this a million times, but the level of detail and craftsmanship you put into your posts is second to none and truly appreciated. I especially love the non-biased way you approach the subjects you discuss – carefully dissecting all the available scientific data instead of blindly supporting only what you believe is right. It inspired me to follow that kind of thinking whenever I am researching a topic. It’s certainly not natural to try and see evidence in something that goes against what you believe, but thanks to you, I’m training myself to think that way.
    In summary, I cannot thank you enough for the time you put into your posts and for all I’ve learned from them. Now if only I was as naturally talented as you at maths/formulas etc, I’d be set! But I guess I will just have to push through my chemistry classes with plain old practice and grit instead 😉

  15. Hi Peter,

    I completely agree with you on grit. I studied with so many people who never finished college because they only cared about being big shots, making a lot of money after graduation instead of realising that studying is a long process. On the flipside of that, I’ll argue (and you briefly mention it) that that is also what got me into an exercise addiction followed by anorexia and orthorexia when I was too fatigued to run anymore. Its a bit like your ‘Is sugar toxic?’ post – there is a limit to how much you can take of any ‘drug’.
    I was a little surprised that you say that TSH >2 could indicate thyroid issues. I recently had mine done and it had gone up to 2.2. That concerns me a little as I’m still recovering from anoxeria. I know you have no chance of diagnosing anything via the internet but I’m pretty curious to hear if you think that ocean swimming (8C water now with only trunks, no wetsuit) followed by HIIT body weight exercises three times/week in addition to commuting by bike 10k each day is too much exercise for me at the moment? I do have some of the symptoms for hypothyroidism.

    Thank you for another great post,


    • “TSH > 2 is just suggestive. If not accompanied by low basal AM temperature, probably not an issue.”

      My endo, a real trailblazer in hypothyroidism treatment, has found over many years that *no* test, even TSH, can reliably rule out hypothyroidism (unless of course TSH clearly suggests hyperthyroidism).

      If a patient presents to him with signs and symptoms consistent with hypothyroidism he does a trial of low dose T4. It quickly becomes apparent if supplementation is beneficial. Many patients of his who were refused treatment by other docs based on lab tests have had amazing turnarounds of longstanding health issues. The ones who don’t have lost nothing to the experiment and can confidently look elsewhere for answers.

      During treatment, he only uses lab tests (TSH and free T4) to provide hints about how to adjust doses. The patient’s sense of well being is always the much more important guide, and practical experimentation is the primary method.

      He has also developed a novel and (I can attest) most superior approach to treatment, which combines T4 with very small physiological doses of T3 or thyroid extract. He’s found that neither conventional (T4 only) or “alternative” (T3 only or thyroid extract only) therapy is optimal. The first fails to provide much-needed T3; the latter has too much T3. Everything he’s leaned is detailed in his latest book:

      • Yes, this is what I mean… most docs (myself included) don’t really understand how to manage hypothyroidism. I’m getting better, but I have a lot to learn, which is why I try to work very closely with excellent clinicians on this topic. Symptoms matter most, but temp needs to be included as a sign, even if not a symptom.

    • For me at least, temp is not a useful sign of thyroid status. Mine is a rock solid 96.9 (not a typo) regardless of thyroid status, including wide TSH differences from quite hypo to quite hyper. IIRC, Ron Rosedale has commented about low carb diets lowering body temp in a very positive way, and I’m sure there are many other factors.

      My endo has never found body temp (or anything else) to add anything to measuring TSH and T4 and, above all, listening to patients talk about how they feel. But he’d be the first to say that other practitioners, using different methods, might not find the same thing.

      BTW, I achieved an almost 50% reduction in my T4 dose requirement via iodine supplementation with Dr. Guy Abraham’s protocol. None of my docs, including my endo, who treats hypothyroidism exclusively, has ever seen anyone reduce their dose like that. I’ve had docs tell me it’s impossible in Hashimoto’s, but my medical records don’t lie. The iodine doses are enormous compared to the RDA, but many others have experienced similar results. If used early enough in the course of the disease, it can apparently completely eliminate the need for thyroid supplementation, which would otherwise likely be lifelong.

      Peter, I know you don’t need more book suggestions, but I’m sure you’d love Dr. Blanchard’s book on hypothyroidism. He’s a true iconoclast, and a doc who wants to help people even if it means discarding standard protocols, suffering the ire of the bigshot Harvard endos, and potentially threatening his career. You will particularly enjoy his commentary about the “quaduple blind” studies in his field used to justify extremely poor standards of care (in addition to the usual double blind, the investigators are blind to the phenomenon they’re studying, and the journal editors and reviewers are, too, and therefore publish the junk). Sound familiar? 🙂

      As an example, several widely heralded clinical trials have supposedly disproven the value of adding T3 to the standard T4 therapy for hypothyroidism. But those studies used T3 doses about 10x higher than those Dr. Blanchard has found to be optimal in decades of practice. If one studied the use of insulin in diabetes in such a fashion, all the dead bodies would be quite inconvenient.

      • I’ve seen him speak and have notes from his lectures. Impressive fellow, no doubt. Hard to make sense of all the competing views, many of which make sense, but with such a paucity of really good research.

    • I think Dr. Blanchard’s new book might convince you to try his methods 🙂

      It’s what he begs other doctors to do, since his methods are obviously safe (his doses of T3 are minuscule compared to those long used in endocrinology and psychiatry) and the benefits quite obvious. I’ve experienced them, and so have others I’ve sent to see him. I felt like a 900 lb. weight was lifted from my head.

      To me, it’s not unlike low carb diets. Open minded practitioners quickly realized how miraculous they could be once they experimented with them. It’ll take NuSi to prove it with research! Not optimistic the endo establishment, or anyone else with the requisite resources, will do the same for all us poor thyroid cases. But any physician can easily find out for him or herself, just like with diet. I have the advantage of having experienced the benefits, I know, and I understand the skepticism of trying controversial things way outside the standard of care. There are professional risks. But this stuff works.

  16. Thanks Peter for sharing this inspiring post, and for revealing a little of your true grit, always enjoy your blog posts and now see where your energy and drive comes from.
    Makes me think of the process and journey more so than the destination.

  17. My wife has just recently been diagnosed with Hypothyroidism and she always has body temperature below 97.8, adrenal fatigue syndrome and obese. We were wondering what type of specialist would be the best to treat her and or is there a clinic or hospital that specializes in this?

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