With Patrick Coles, we dove into a thought-provoking discussion about the nature of disease and its relationship with toxins in the body. The dialogue unravels the complexities surrounding tumors and how they might not just be signs of disease, but rather protective adaptations by the body.

Disease as Damage and Dysfunction

Remnant begins by challenging the notion that disease strictly equates to end-stage damage. He suggests that conditions like ulcerative colitis, while serious, can still exhibit signs of reversibility. This perspective leads to a broader discussion on how the body responds to various toxins.

Tumors: Symptoms or Protective Adaptations?

Patrick introduces the concept that tumors, particularly brain tumors, might serve as protective adaptations rather than mere indicators of disease. He notes a fascinating statistical anti-correlation between brain tumors and Alzheimer’s—indicating that individuals who have had brain tumors may actually have a reduced risk of developing Alzheimer’s. This assertion opens up a new way of viewing tumors, as potential protective mechanisms.

The Role of Toxins in Cancer

The conversation deepens as they explore how tumors may actually be sequestering harmful toxins. Patrick shares insights that brain tumors contain lipid droplets, which are storage sites for fat-soluble toxins. He argues that this may reflect the body’s strategic response to manage toxin overload, especially given the brain’s protective blood-brain barrier.

Rethinking Tumor Removal

The discussion also touches on the implications of tumor removal. In early-stage cancers, removing a tumor might yield positive outcomes, as these tumors might primarily serve as storage for toxins. However, in late-stage cases, the narrative shifts. Tumors may play a critical role in detoxification, leading to the complex question of whether surgical removal is beneficial or detrimental.

Early releases of podcast episodes are available to all paid subscribers. Stay tuned for the public release on our Youtube Channel.

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Given that the peptide market is in the “hysteria” phase of its trajectory, I thought it would be appropriate to conduct a sober investigation. So, I did.

And, I decided to start it with one of the most widely discussed peptides: BPC-157. You are about to see just how fundamental an investigation I am talking about. Because as it turns out, the hype around BPC-157 doesn’t even pass the most basic questions.

Since the rise of GLP-1 (e.g. Ozempic), I’ve encountered more questions about peptides broadly. To be transparent with you, my bias and instinct is to be skeptical of all them all. Take that however you want, but I’ve been around the block enough times to know that things are rarely as they seem. It was this instinct which led me to thoroughly investigate and analyze the covid injections. And…I’d be a fool to think that the hysteria over peptides is any different.

the story we are fed

If you tune into any podcast, a wellness social media channel, or any vendor website…you will see some variation of this sentence:

You may not know it, but the marketing has already begun.

Because the two claims naturally occurring “protein” and “found in human gastric juice” have never been confirmed. When I discovered this, I decided to go full Michael Burry on this peptide.

This may shock you. Because it shocked me. Not because some pharmaceutical vendor or conflicted lab made the claim. No.

I was shocked because voices in the health community whom I respect and trust have parroted this same line. Maybe they did it unknowingly, but that’s precisely the point. They bought into the hype without doing their due diligence.

During the process of this investigation, I had an epiphany that I’m still working through:

That the original protein BPC (which was never confirmed), may have been masking the effects of another molecule which we know exists and have been using for decades.

Which means there is a better understood, proven, safer, and effective alternative to BPC-157.

Here is how this article breaks down:

1. How BPC was discovered: Is BPC a naturally occurring human protein?

2. What BPC-157 is and is not, and what it does therapeutically.

3. What the patents reveal.

4. What else behaves exactly like BPC-157?

5. What this tells us about the peptide market broadly.

the idea that came first

In 1975, a second year Croatian medical student named Predrag Sikirić had an idea: if stress can damage the stomach, then surely the stomach must make a compound that protects itself.

He gave this hypothetical compound a name, Substancija Bože Pomozi - God Help Me Substance.

In 1981 his team began collecting gastric juice from clinics, hospitals and emergency rooms locally and as far as Bosnia. But it wasn’t just humans, they also collected the juice from animals including pigs from slaughterhouses.

From US Patent US5288708A:

They go on to list a number of disease-inducing experiments conducted on these animals with BPC used as the therapy. We will go into all the specific diseases a little later.

But, this is really important to keep in mind: they did NOT inject these animals with BPC-157. Their patent clearly states they gave the animals BPC - i.e. whatever substance they extracted from the stomach.

the elusive protein

Now, the really important question is did they really isolate one protein?

Because here is what they did with that pooled gastric juice:

1. They homogenized and centrifuged the solution.

2. 200 mL of whatever was left on top was extracted and processed through various fancy sounding terms. (details can be found in the patent)

3. Then they’d dried out and obtained a very minute amount of substance, which was then distilled in 10 mL of water.

4. Then this solution was placed in a gel chromatography column.

Based on what came out the other end, they claim that BPC is a single protein about 40 kDa in size. Here is the problem with that statement:

• The process they use allows them to approximate the size of the substance that passes through the column

• molecular weight is inferred - not measured.

And, most importantly: it does not confirm that it is one single protein.

Right after describing this process, they immediately claim that they only sequenced 15 amino acids out of the whole protein. A 40 kDa protein has up to 400 amino acids. But they simply claim a 15 amino acid sequence, followed by an ellipsis (…)

Again, this is all in patent filings. Not published research.

Anna Mapp (chair of the American Peptide Society) reviewed the patents and stated quite clearly:

What’s more, in a subsequent patent that the group filed in 1993, they make the following admission after describing the wide therapeutic benefit of this so called BPC:

Do you understand? The people who harvested BPC and designed the synthetic sequence BPC-157, admitted from day 1 (and to this day)…that it’s possible they never isolated a single protein.

To this day, there is still no full protein sequence, no gene, no discrete mechanism or receptor interaction that has been identified.

Just to recap, we have so far established the following:

1. Sikirić was looking for a compound that responds to stress and can survive the hostile conditions of the stomach

2. They isolated something from pooled gastric juice from humans and animals

3. All the tests on disease models were conducted using BPC (NOT BPC-157)

4. They admit in their own patent, the variety of therapeutic effects could be because the compound was not pure.

That is to say, there could be other things in the isolate other than one protein (ie. BPC).

what about BPC-157?

Now, according to their patents they only sequenced a 15-amino acid chain on one of the protein…and just…stopped there. Or, at least they never reported anything other than this 15-amino acid chain.

For starters, this means that no other lab can check the validity of their claims.

The claim that:

• BPC is a single protein

• This single protein exists in humans

• and is made in the stomach

All of the above were merely asserted in patents.

It’s important to note that both in the European and US Patent, they make the following assertion about BPC-157:

And, of course their evidence for these claims are their own patents.

Which brings up another question:

Why did they only study and produce to this 15-amino acid chain?

Even Sikirić et al admit that the original protein is actually quite hard for them to isolate, and they were worried about virus contamination.

At this point it’s important to understand that the BPC-157 is not naturally derived. It is a sequence with no confirmed origin (other than the patent claim). Which means that BPC-157:

• it is an artificial sequence

• produced by synthetic means

• using modified (unnatural) amino acids and other such processes

The vast majority of the published research on BPC-157 (last I check around 80%) was produced by the lab of Sikirić and collaborators.

Now, in full transparency it should be mentioned that a few unrelated research groups have demonstrated some findings. For example, Chang et al found that BPC-157 increases growth hormone receptor expression in tendon cells of lab rats tested in vitro.

As a quick summary, this is what has been tested on humans and published:

1. Lee & Padget (2021) compared knee injections of BPC-157 alone against BPC-157 and Thymosin Beta-4.

   1. 12 received BPC-157 only and 11 of those people reported improvement in knee pain.

   2. 4 received a combination of BPC-157 and TB4, and 3 reported improvement.

2. Ayadi et al (2024) tested BPC-157 in women suffering from chronic bladder inflammation. 12 women total had BPC-157 instilled directly into their bladder.

   1. 10 women reported complete relief of symptoms

   2. 2 women reported relief of most symptoms

3. Lee & Burgess (2025) tested to see if it is safe to inject BPC-157 directly into the veins. Tested in 2 (TWO) people.

   1. On day 3 after injection, they report no lab markers to suggest side-effects.

The take-home summary is this:

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what is still uncertain

First, it is still unconfirmed that BPC-157 is a naturally occurring fragment of a single protein.

So this claim you see on marketing, podcasts, and everywhere else is total BS. But, most of the parties involved don’t seem to care, because as long as there are benefits without side-effects - who cares?

So, let’s talk about the benefits.

Currently, there is still no receptor interaction that has been identified for BPC-157. Proponents will claim that this peptide can interact by some other means. Which is completely plausible…that is until you look at the dosages used.

As far as we can tell from their patents, the inventors used doses of BPC-157 as low as 10 nanograms per kilogram (of animal weight) and as high as 10 micrograms per kilogram. That is a 1000-fold difference in dosage.

Very importantly, they never tested anything lower - so they have no clue what is the minimum necessary dose to achieve an effect.

But, despite the vast difference in dosing…they observed the same effects…with no adverse effects or toxicity.

In a 250 gram rat, the lowest dose used is about 2.5 nanograms - which puts us in the picomole concentration for effects. For reference, 12 picomoles/L is an expected concentration for a potent signaling molecule. For example, Free T3 (active thyroid hormone) circulates at around 5 picomoles/L. Similar magnitude for oxytocin and estradiol.

But there’s an important distinction here. Thyroid hormone, oxytocin and estradiol have effects at this low dose because they have receptors which amplify their effects. Without this amplification mechanism (and short half-life ~30 minutes), it’s hard to make sense of this mysterious peptide (BPC-157).

If you never run a dose low enough to get no effect, how can you know that it’s the peptide that’s causing the effect? If the effect and risk-profile is the same no matter how much you tested…this adds another layer of confusion.

So the question to ponder is…if BPC-157 has all of these amazing effects, and at such a low dose…how does it do this?!

what Sikirić didn’t know to look for

When I was listening to a recent episode of Andrew Huberman’s podcast, he and his guest Abud Bakri were discussing all of the alleged benefits of BPC-157. In reality, they were discussing the benefits published by the same authors who synthesized BPC-157. Very few of these effects have been replicated by anyone else.

The inventors merely claimed that the effects of BPC-157 are the same as purified gastric juice. They never published any tests comparing BPC to BPC-157.

In any case, Huberman and Bakri were discussing everything from gastric problems to tendon and ligament injury, to neurological problems. They even described a case of rats being less drunk when given BPC, and mitigating the effects of alcohol.

While doing my research for The Peptide Dossier, I realized something strange…

BPC-157 does not just have benefits throughout the body, but also in opposite directions. BPC-157 counteracts L-NAME, but also L-Arginine (two drugs). It prevents clotting…but also prevents bleeding. It lowers high blood pressure, and raises low blood pressure. It grows blood vessels for healing…but not for tumors.

A miracle drug.

It’s not like these sorts of substances don’t exist…but the fact that there is no confirmed mechanism to account for this behavior is strange.

As I was listening to them discuss this…it dawned on me all at once.

It occurred to me that there is one other molecule which has all of the claimed features of BPC-157, including:

• made in the stomach in response to stress/inflammation

• resistant to degradation by stomach acid

• has a whole variety of beneficial effects from the gut, to joints, to brain, to liver…

• …and yes, even mitigating the effects of alcohol

And, as far as we know it truly is a miracle compound.

The only difference is we’ve characterized it, know its structure, and its interactions.

Melatonin and the great masquerade

Around the same time that Sikirić was dreaming of a stress-responsive compound released by the stomach, a research group in Moscow identified something very interesting.

Whereas in the past it was thought that melatonin is only made and released by the pineal gland, Raikhlin & Kvetnoy discovered that cells of the gut (enterochromaffin) make melatonin (1975).

Here is a shortened summary chart of all of the claimed benefits of BPC-157 compared to the observe/known benefits of melatonin. The real list is longer than this, but the overlap is nearly complete.

At the same time that Sikirić was claiming all the benefits of BPC-157, his contemporaries had demonstrated the same benefits in known melatonin…including the effects on alcohol consumption.

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Once I confirmed this overlap, my next question is…why did the Sikirić group observe the benefits they did from purified gastric juice? How come BPC had the same therapeutic profile as melatonin?

Turns out the answer to this lies in the only thing they sequenced: BPC-157.

Let’s take a look at this 15-mer sequence:

It’s especially interesting to note what Sikirić’s parent company (Diagen) states about this sequence

What is interesting about this proline-rich motif?

Proline-rich proteins bind small aromatic molecules, using the proline-amino acid chain. The first proline in that proline-rich chain is the preferred binding spot. When researchers compared the aromatic compounds, it seems that this proline motif has the greatest affinity for indole aromatics.

As it turns out, melatonin is an indole aromatic.

Which raises a possibility that nobody has tested.

The gastric juice Sikirić et al purified and isolated was a mixture of proline-rich proteins bound to melatonin. Which is why the vast majority of their tested effects were observed with BPC (the gastric juice isolate).

My assertion here, is that depending on where BPC-157 is administered…it can bind and stabilize melatonin - which has a very short half-life when unbound.

The effect this would have is to prolong the period of time over which melatonin can have its wide and known beneficial effects.

But, the benefit would be observed in places where melatonin production is abundant - for example, in the upper gastrointestinal tract (like the stomach - which produces 400x more compared to the pineal gland).

Now, I can’t prove that this is the case, but let’s just review what we know for certain and you decide what the most likely explanation is.

Sikirić et al identified a gastric juice isolate that:

• is produced by the gut

• stable under acidic conditions

• has diverse effects across the entire body

• incredibly potent anti-oxidant

• mitigates harms of many substances including alcohol

• has never been isolated since

• protein sequence, gene, and interactions still unknown

• has a proline-rich motif that binds melatonin

All the while, melatonin does everything BPC has in its favor and more.

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what this tells us about the peptide market broadly

I didn’t start with BPC-157 because it’s unusual. I started with it because it’s representative.

Go back to that opening sentence: a 15-amino acid fragment of a naturally occurring protein found in human gastric juice.

That sentence isn’t describing a molecule. It’s moving a compound out of the drug aisle and into the supplement aisle.

“Naturally occurring” does that heavy lifting.

“Peptide” does the rest.

What I discovered about BPC-157 when asking such basic questions led me to realize that I need to ask more penetrating questions about the whole market.

Which led to the production of The Peptide Dossier.

The Peptide Dossier

The above is the result of an investigation that was carried out in an effort to inform people of the validity, safety, and benefits of BPC-157.

What started as an investigation into 1 peptide, quickly turned into my own personal research project about several other peptides.

The Peptide Dossier is a live and quarterly updated research summary that I created to share with people who are interested in this space.

The guiding principle for this research summary is very simple, but telling:

Currently, The Dossier is available as a complementary Perk to paid subscribers.

If you would like to purchase The Dossier without having to become a paid subscriber, let me know in the comments below or shoot me an e-mail at peptidedossier@pm.me

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At one point or another, the vast majority of adults in the industrialized world have experienced heartburn. Some more frequently than others. Many people I know approach taking antacids and PPIs (like Nexium and Prilosec) like it’s a daily multi-vitamin.

It is such a regular practice, I think some people just assume heartburn is a feature of normal life. That the pills they are popping are like brushing their teeth.

This is wrong.

In fact, the entire mainstream framework for understanding and treating heartburn is wrong. This is precisely why it seems to persist, no matter how many PPIs or antibiotics people take. Sure, they may provide some temporary relief…but eventually, it comes back. And then, gets worse.

This article is intended to function as a complete guide to stopping heartburn and reversing the damage it has caused. Therefore, I cannot spend real estate explaining all the manner in which the mainstream medical paradigm is wrong. I’ve already written several articles doing just that.

Instead, let us focus on what this article entails:

Chapter 1 - Heartburn and its consequences.

Chapter 2 - The many causes of heartburn.

Chapter 3 - Immediate relief of symptoms.

Chapter 4 - Reversing the damage.

Chapter 5 - Preventing the return.

Chapter 6 - A new experimental protocol.

Chapter 1 - Heartburn and its consequences

Simply put, heartburn is a sensation. That nagging feeling of burning or irritation in your chest and up along your throat. Sometimes that includes a poor or metallic taste in your mouth.

By using the term heartburn, we presume that it is associated with “acid reflux” - which is the movement of stomach acid up into the esophagus. But, this is incomplete. Some of these symptoms could just as easily be manifestations of a heart attack. In fact, many heart attacks are undiagnosed because people mistake the symptoms for something else.

Near the top of the stomach is a band of muscle called the lower esophageal sphincter (LES), which regulates passage of food between the esophagus and stomach. At the other end is the pyloric sphincter, which serves the same function between the stomach and duodenum. These sphincters are regulated by a combination of neural, hormonal and mechanical signals.

The highly acidic environment of the stomach helps break down the large and complex macromolecules that you swallow. The stomach is extremely acidic (low pH), almost to the degree of battery acid.

With respect to digestion, the acidity is ideal for breaking down food and activation of the digestive enzyme pepsin. It is likely that the reflux of stomach acid into the esophagus causes damage not on its own, but by activation of pepsin. The pepsin then proceeds to digest the lining of the esophagus.

When the stomach is digesting and releasing more acid, this low pH is a signal that keeps the LES closed - so that the contents of the stomach do not move up into the esophagus.

Which brings us to an critical point: acidic content in the esophagus is bad…but, it does not mean that ‘high stomach acid’ is the cause of the reflux.

In fact, it is low stomach acid (high pH) that leads the LES to remain open and reflux the contents of the stomach - including pepsin.

The constant irritation of the esophagus can cause many consequences, including:

• a change in the mucosal cells that is not ideal for its function

• a transformation of the mucosal cells to some other kind (dysplasia)

• continued degeneration of the cells to something that is cancerous

• inflammation and eventually ulcers, which bleed

• Ulcers can ultimately perforate, which can be fatal

But, heartburn is also part of a spectrum called peptic ulcer disease, which can also impact the duodenum - a part of the tract that comes after the stomach, past the pyloric sphincter.

At this point, people will be screaming in their heads “he didn’t mention H. Pylori! The cause of peptic ulcer disease!”

Quite right. Because after many years, I am more inclined to believe that the proliferation of H. Pylori is a symptom, rather than a cause.

That is to say, the chronic dysfunctional environment of the stomach leads to growth of the H. Pylori population - which in many people is present in small amounts, normally. For H. Pylori to proliferate, the stomach pH has to go up above its normal level. So, to target H. Pylori as a “root” cause is misguided.

Chapter 2 - The Many Causes of Heartburn

Heartburn does not have one cause. It doesn’t even have a few causes.

It’s got a boatload of causes. Many of which converge on a couple of common pathologic mechanisms. To get a good sense of the causes, I would highly recommend reading the Root Cause essay linked above.

Suffice it to say, digestion is an incredibly involved and complex process. And so, the causes are appropriately vast.

Digestion begins before we even take a bite of the food we desire. Digestion is impacted by the food itself. Highly processed and unnatural foods can be harder on the stomach or intestines to digest. Not to mention the inflammation that processed foods cause.

A lifestyle that includes poor scheduling of meals can cause heartburn. Similarly, the environment we eat in can cause heartburn. Overfilling the stomach with food causes heartburn. Inappropriate mixing of foods and drink also contributes.

Other disease, like diabetes, can cause heartburn by slowing the movement of food through the gastrointestinal tract.

Herniated discs in specific locations in the spine can cause heartburn. Similarly, poor breathing habits can cause heartburn due to their impact on certain nerves (e.g. Vagus or Phrenic) in the back of the chest and abdomen. A mass in these areas can cause heartburn.

Inflammation, weakening or thinning of the diaphragm can cause heartburn by causing a hernia involving the stomach and esophagus. Relatedly, poor breathing habits can cause heartburn.

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Vitamin and mineral deficiencies can cause heartburn. Famously, B-vitamins and salt deficiencies. Especially if your only salt intake is iodized table salt - the worst option for your health, including blood pressure, circulation, and…heartburn.

Seed oils, which are highly inflammatory, cause heartburn.

Eating shortly before sleeping, or exposure to blue-light before sleeping can cause heartburn. In part, this can be due to suppression of melatonin production.

We can keep going. But, I think you get the point.

And the reason it is important to get this point, is because if you want to be successful in preventing chronic recurrence (and complications) of heartburn…you have to put in the time and effort of figuring out what is causing your heartburn.

There is no one cause. Therefore, there is no universal solution.

Chapter 3 - Immediate relief of symptoms

Before we can hope to solve the long-term problem, we have to get immediate relief. Heartburn is just such a nagging and insidious syndrome, that immediate relief is a reasonable first step.

As with all the solutions presented in this guide, there is no solution that will work for everyone. You have to experiment.

Luckily for you, there isn’t a single prescription or over-the-counter drug in this guide.

First, we need to address one of the most incredible discoveries as it relates to gut health and particularly heartburn and reflux: melatonin.

In addition to melatonin’s many anti-inflammatory properties, recent research reveals it also seems to inhibit the activity of pepsin. The enzyme that eats up the lining of the esophagus after reflux.

I’ve used this on myself, family, and other patients for various syndromes of gut inflammation, including heartburn.

Start with 3 mg, and work your way up for effect…and as tolerated. Some people get groggy on low doses, others on high doses. Rarely have I seen someone need more than 6 mg. The relief from this can be very quick, but it’s not instantaneous.

For fast relief, there are many options that involve drinking of acidic or soothing formulations. These include:

• Pickle brine/juice

• Apple cider vinegar

• Slippery elm bark

Alternatively, you can try Betaine HCl tablets or licorice root.

To address salt/mineral imbalance, a pinch of natural sea salt with diverse minerals in a small glass of water can do wonders. You can also just put the pinch of salt right in your mouth if you want.

For some, simple breathing exercises also can help. Diaphragmatic belly breathing or pursed-lip breathing 5-10 minutes, before or 30 minutes after meals can be helpful.

I did say that there is no single solution that will work for everyone. But, if any of the above doesn’t work for 99% of people reading this, I will eat my hat.

And if you are wondering why I haven’t included PPIs like Prilosec or Nexium, you should read this:

Chapter 4 - Reversing the damage

Many people who have heartburn experience it for extended periods of time. This chronic syndrome causes a lot of damage to the esophagus, the stomach as well as the duodenum.

So, the next phase of treatment should concern reversing the damage and allowing the gut to heal.

One of the first pieces of research I discovered on melatonin was its use for reversing a grade 4 ulcer to a grade 1 erosion. This was in the span of a month, and accompanied by all sorts of improvements in the patient’s condition. A remarkable achievement using only 2.5 mg of melatonin + a vitamin stack.

In my experience, even an intensive 2 week program using 3-6 mg of melatonin only is incredibly effective. But, I’d still suggest using it for a month.

HUGE Caveat: Do not consume spices (capsaicin) - this will significantly limit the healing effects of melatonin.

But, healing is not a one-trick approach.

In addition to promoting healing, we want to prevent more damage. For a time horizon like weeks to months, it is prudent to implement other strategies. Not only to accelerate the healing, but also the degree to which the healing occurs.

In the ideal circumstance, the goal is healing as fast as possible, and ideally with return to normal gut lining. A few scars here or there are tolerable.

With that in mind, we also need to implement habit and dietary changes. Including:

1. Chew food thoroughly.

2. Do not overeat (stomach should be 1/3 food, 1/3 water, and 1/3 air).

3. Do not eat at night.

4. Consume digestives with your meals, like fermented foods.

5. Avoid processed foods and vegetable/seed oils. Full stop.

6. Tablespoon of coconut oil before meals.

If you want to target a gut dysbiosis (such as H. Pylori proliferation, but others as well), approach it from a naturalistic perspective. Pick herbal remedies which are anti-bacterial, such as oregano oil.

Complement the oil by promoting the establishment of healthy gut bacteria using things like yogurt, kefir, and fermented vegetables.

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Chapter 5 - Preventing the Return

Many of the habits mentioned in Chapter 4 apply to Chapter 5 as well. Quite simply because the good habits that prevent continued damage also prevent recurrence long-term.

These habits include:

• Eating the right food, at the right time, and in the right way.

• Breathing exercises to improve the nervous system regulation of the muscles (gut and diaphragm), as well as digestion.

• Avoiding inflammatory and highly processed “foods.”

• Appropriate mineral intake.

• Incorporating digestive and bitters.

• Chewing Mastic Gum, which promotes early digestion and chewing habits

• Avoiding diets heavy in hard to digest foods.

• Improving other aspects of your health, such as insulin resistance

• Identifying possible spinal contributions, such as disc herniations, and embarking on approaches to heal these.

For those of you with a hiatal hernia, it was brought to my attention that Eric Karrfalt had developed a protocol for improving the tone of his diaphragm:

Eventually, I devised the following regimen with the intent of providing the LES with some resistance training. The resistance was provided by positioning my head below my stomach in a kneeling posture. This required food being swallowed to be pushed up an incline. I began eating part of each breakfast (oatmeal) and sometimes lunch (a sandwich) in the exercise position. I would kneel on a platform (which happened to be 6 ½” high), take a normal mouthful, chew it as needed, and prepare to swallow. I would then lay my forearms and the backs of my hands on the floor, rest my head on my hands, and complete the swallowing process.

From my research, people have had mixed results with this approach. I have a suspicion it’s because the causes are not universal (as already mentioned), and probably because of misapplication of technique.

Another aspect of this is avoiding medications which can cause damage to the gut, most commonly NSAIDs.

Alcohol and coffee consumption also have an impact.

Circadian dysregulation is an important consideration: avoid poor night-time habits, near-infrared exposure and circadian alignment that comes with greeting the sunrise and sunset.

Chapter 6 - A New Protocol

After discovering the role of melatonin in this disease process, I developed a simple protocol.

This protocol was based on the knowledge that near-infrared light promotes the production of melatonin in our cells.

If that is true…then we can generate the incredibly potent effects of melatonin without ever taking the supplement. Simply using light to our advantage.

Many readers were interested in this and decided to embark on a self-experiment using infrared light panels, many of whom continue to use it for their whole family to this day.

One of the readers experienced a remarkable improvement in their symptoms that was associated with a hiatal hernia. A result that shocked even me:

Now, it wasn’t a perfect protocol…as we discovered some caveats along the way. My research now shows that these findings are corroborated by the late Edwin Babbitt who wrote a book on using color and light for healing.

Although it doesn’t work for everyone (because not everyone has the same cause of heartburn)…it’s truly miraculous to witness the power of light.

I’ve been thinking about making a new version of this light protocol, this time more comprehensive, and targeted at heartburn, indigestion and gastritis - which I believe are related phenomena. I will also include a strategy to use light without having to buy an infrared light panel.

If you are interested in purchasing such a guide, comment “light” below.

Alternatively, if you are interested in a webinar going through heartburn in more detail with Q&As, I’m open to this as well.

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Error in Reductivism

A grievous error in modern medicine is the belief that we can understand an infinitely complex human by focusing on the microscopic. The genes, the proteins, the mutations.

Reductivism at its finest.

Of course, for academic and scientific purposes this has its benefits. But for understanding and improving the wellbeing of a human, its got tremendous limitations.

The human genome contains roughly 20,000 protein-coding genes. Through multiple layers of molecularly wizardry, these genes are estimated to produce up to (and over) a million different proteins (depending on who you ask).

No doctor, nor patient, is going to be able to juggle all that information. No practical advice can be meaningfully derived from this gargantuan network of genes and proteins.

Human beings are simply incomprehensible at this resolution.

Not Just Medicine

Several fields of science run into this problem: the raw data is real, but it is useless at the same time. And every field that has actually solved this problem has solved it the same way. Not by ignoring the granular reality, but by finding the right layer of comprehension.

Even in physics this is necessary.

Start with a single molecule of air in the room around you. It has a position and velocity that will change in the next instant when it collides with its neighbor. There are roughly 10,000,000,000,000,000,000,000,000 such molecules in this room, each one moving along its own path.

There exists no instrument nor computer that could track them individually.

And yet you know the temperature of this room. You knew it the moment you walked in, without needing to know anything about a single molecule.

Temperature is not a lie told to hide the complexity underneath it. It is the correct level of description. It is what you get when you take an incomprehensible swarm of particles and ask “what is this swarm doing as a whole?”

The molecules are still there, still colliding. But, we are wise enough to describe the swarm without describing the particles.

Climate science makes the same move on a different level. A single location on Earth has a temperature reading for every hour of every day, a rainfall measurement for every storm, and a humidity curve. But, nobody understands climates this way.

Instead we say: this is a tropical climate, this is arid, this is temperate.

The Köppen system takes years of granular meteorological data and compresses it into a handful of categories. Once you know which category a place belongs to, you know something real and actionable about it. What grows there. What to build. What to wear. The category doesn’t diminish the variation within it; it makes this data usable.

How Psychology Solved the Problem

Personality psychology ran an analogous procedure on the human mind. The lexical hypothesis behind the Big Five Traits started from thousands of trait-words that language has generated to describe people (stubborn, warm, anxious, curious, meticulous), and looked for overlap. Factor analysis collapsed the language cloud down to five principle axes. Not because people are simple. But because the space of human variation, however vast it looks at a granular scale, has a comprehensible structure to it.

Notice what’s happened across these three domains: particle to temperature, weather to climate, word-cloud to trait-axes.

In each case, a highly specific and individually irreducible observation gets compressed into a smaller set of categories that are comprehensible and therefore useful.

How medicine solved it 2000 years ago

This process also applies to biology and metabolism.

There are hundreds of thousands of proteins in the human body by conservative estimates. Tens of thousands of genes governing their expression. And an incomprehensible number of interacting pathways that govern the functions of our body:

• determining how you turn food into heat,

• how you store fat,

• how you respond to cold,

• how quickly you tire.

Trying to understand a person by an inventory of their proteome one molecule at a time is as hopeless as trying to understand a room by tracking one air molecule at a time. And yet, a swarm of metabolic processes has a character.

A tendency toward heat or cold, dryness or moisture, quickness or sluggishness. Furthermore, these tendencies are consistent enough across human beings that they can be named and be acted upon with sufficient accuracy.

This is what temperament (what I call metabolic personality) claims to be. It’s not some woo-woo impression of biology, but the metabolic equivalent of what temperature is to particles and what the Big Five traits are to behavior.

Why Temperaments Exist.

Temperaments are a cluster. A usable unit of information sitting above the chaos.

To continue on our personality analogy, two fundamental questions arise when we discuss personality.

Where does personality come from, and why does it exist at all?

Where it comes from is still unknown. Genes contribute. Developmental environment contributes. Geolocation contributes. Even the cosmological time-point which governs the spirit that may embody your body at the time of conception. This may sound crazy to some of you, as it did to me many years ago…but the parallels are uncanny.

Why personality exists is a more answerable question, and the answer matters.

If one personality type were simply the best one, evolution should have eliminated the others long ago. The fact that boldness and caution, sociability and solitude, all persist stably across generations means none of them wins outright. Each comes with a trade-off. The bold, exploratory animal eats more, mates more, and dies younger. The cautious one reproduces less, and lives longer. Which strategy pays off depends on the environment. Predation pressure, population density, resource scarcity. There is no personality that is best for all circumstances.

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Metabolic Personality.

And here is where metabolism and personality turn out to be entangled.

Behavioral ecologists have found that an animal’s personality and its metabolic rate are related: the bold, fast-exploring individual tends to run a faster metabolism, grow quicker, reproduce earlier, and die sooner. In broad terms, this is the choleric individual.

The cautious, slow individual runs cooler, grows slower, and lives longer. Personality and metabolic temperament are not two separate systems that happen to resemble each other. In many organisms they appear to be two expressions of the same underlying adaptation strategy.

Which means the question “why does personality exist” and the question “why does temperament exist” are the same question. These are the same question, asked along two different dimensions of the organism.

And the answer looks like this: because temperaments are adaptation strategies across a landscape of variable existence. Different circumstances, origins, and goals of existence require different adaptation strategies - each of which come with their own trade-offs.

And if you want to address the source question (where personality comes from), these different temperaments are appropriately suited for the arc of the spirit that embodies the human. From the spiritual perspective, the human is a vessel for the journey of the spirit that enlivens it. From the moment of conception, the point in which the spirit imbues itself into the human, the temperament and purpose of the spirit impacts the physiologic and psychologic temperament which develops in the human.

The Variations in Temperament

Classically and psychologically, temperament is divided into the main four: Sanguine, Choleric, Phlegmatic and Melancholic. But, as you can see from the graph below, there are different degrees for each axis. It isn’t the case that everyone maps cleanly onto Sanguine or Phlegmatic alone. You can think of each person as a dot somewhere along the cartesian map below. And, the position of this dot determines your sanguine-ness or melancholic-ness.

The same is true with metabolism. In fact, Avicenna and the Galenic tradition describe that pure temperaments (e.g. Sanguine) are quite rare, and that most people have a compound temperament; e.g. Sanguine-phlegmatic.

Unfortunately, the practice of identifying and applying the insights of temperament have been lost to time. I have seen some new practitioners who are applying this lost art to psychology (i.e. BioType) and helping people evolve spiritually. But, for the purpose of understanding and optimizing metabolic health…there remains a huge gap.

In fact, unless you are able to find a Unani physician in your local area…you’re probably out of luck. The available temperament quizzes leave a lot to be desired. Almost all of them suffer from the same problems:

• Only categorize into 1 of 4 temperaments

• The language they use is archaic or difficult to understand

• The inventory of question is insufficient to assess compound-temperament

• and more…

This is why I’ve spent the last year developing a temperament self-assessment that works for the vast majority of people. Of course, there will be rare temperamental combinations that will require deeper personal work with a trained Unani physician. But by my calculations…about 98% of the population will be captured by this assessment.

Subscribers know that we ran a pilot test of the quiz over a year ago, with good results. But, there was a lot to improve.

Version 2 of the self-assessment

The good news is that I’ve finished constructing the questions and answers, as well as the scoring logic which will determine the temperament report. But I still have to figure out how to code that scoring logic into an assessment that anyone can take online.

Let me know what you think about temperament, the quiz, and how it can inform your daily life. To find out when the quiz is released, subscribe below!

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Further Reading

You find yourself at a “heart-healthy” screening event. You have no symptoms. No history of heart attack or stroke.

The doctor asks you a few questions, then recommends a coronary calcium scan - an imaging test that estimates how much hardened plaque sits in the arteries of your heart. The result is very distressing to the doctor, and so it becomes distressing to you.

From that single test, a cascade begins.

First, you are reclassified from healthy to being “at-risk.” Because now, you have “heart disease.” The doctor probably starts you on a statin that you will need for the rest of your life. He may also put you on aspirin. The high calcium score also invites progressively more invasive imaging. First, a coronary CT angiogram. Then, heart catheterization so they can personally inject your coronary arteries with contrast.

Doctor says something like “you have 3-vessel disease. Total blockage. You need a bypass.”

Remember, before all of this testing…you had no symptoms. Despite the fact that all your major coronary arteries were blocked.

Coronary Artery Plaque vs Heart Disease

When you look up “heart disease” you will find a few usual culprits.

• Heart attacks

• Heart Failure

• Coronary Artery Disease (plaque)

• Arrhythmia

Heart attacks, heart failure, and arrhythmias are all clinical syndromes. That is to say: these are things that patients experience and bring to medical attention.

Plaque, on the other hand, is not. The smuggling of plaque into the category of “heart disease” is something that most likely began as a misunderstanding…but persists because the vast majority of cardiovascular testing and treatment hinges on plaque. A billion dollar industry.

My argument is that plaque is simply a marker of heart disease…and in fact, an unreliable marker.

A marker is an indirect measurement that is hoped to predict the real outcome, in this case a heart attack. There is nothing wrong with markers in principle. The trouble begins when the marker that was meant to hint at the disease is treated as the disease.

And, as you can see from the contemporary definition of heart disease…plaque is considered to be heart disease.

But, the two are not the same.

Where This Hits Home.

My friend (in his sixties) experienced a scenario like the one above. In fact, his experience was almost identical.

The first question you may ask is:

if all his arteries are blocked…how come he didn’t have any symptoms? That’s a good question.

The next question is:

if his arteries are already blocked…then what was the cardiologist trying to prevent?

Because the entire premise around opening narrow arteries is that you want to prevent a plaque rupture from causing a blockage of the vessel.

But…if all the major coronary arteries are already blocked…how could a plaque rupture possibly make it worse? In my friend, the reality is that the circulation had already rerouted itself through hundreds (if not thousands) of tiny collateral vessels the body grew on its own.

His body already bypassed the blockage. To suggest they need to bypass the blockage with 1 large vessel…is creating a scenario in which a clot could cause a heart attack. Because with this new bypass…you reroute heart perfusion through one failure point.

But, it doesn’t matter. Because plaque is “heart disease.” So, now we are in the business of treating the plaque.

But, Is Plaque Heart Disease?

In 1953, William Enos examined the hearts of 300 young American soldiers killed in Korea. Average age 22. No cardiac history. Died in combat.

He found plaque in 77% of them.

Later, the PDAY study found plaque already building in trauma victims aged 15 to 34. Further, an autopsy study of people who died of non-cardiac causes showed plaque in 46% of those in their forties, 65% in their fifties, 82% in their sixties, and 88% of those over seventy.

A marker present in 88% of people dying of an unrelated cause, without history of heart attack or stroke, is measuring something else. Maybe it’s simply a function of age. Plaque may be closer to grey hair. The marker is nearly everywhere. The disease is not.

Now, the argument that cardiologists will make is something like this:

“If these people only lived long enough, they would eventually die of a heart attack.”

Is this true? It’s a hard thing to refute, though it’s certainly a convenient assertion.

Let’s see…

One study looked at the rate of plaque in 3 elderly age groups: 80-89, 90-99, and >100 years of age. This study consisted of autopsy results from over 400 people.

These people had various causes of death, but the important thing to note here is that the third column (>100 years old) had a similar proportion of coronary artery disease as those in their 80s and 90s.

None of the centenarians died of heart disease. And, those in their 90s were less likely to die of heart disease than those in their 80s (~30% vs 50%).

The pattern here is worth noting: despite the fact that all 3 groups had a similar degree of coronary artery plaque…heart disease was less and less likely to be their cause of death as they lived longer.

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So the cardiologists argument doesn’t really hold up.

What it does support is the argument that plaque is merely a marker of aging. Aging means tissue has undergone stress and healing cycles. And the body lays down plaque as a way to heal.

Even amyloid plaque in the brain (alleged cause of Alzheimer’s) is seen in cognitively healthy and functional people who lived beyond the age of 100.

In fact, 35% of healthy centenarians had Amyloid-beta plaque in quantities similar to those with clinical Alzheimer’s Disease.

What Plaque Tells Us Beyond Aging

Another argument you may hear from people in the pro-plaque camp is that there are such things as unstable plaque. Which is true. An unstable plaque is one with characteristics which suggest this plaque can rupture at any moment.

A small unstable plaque can kill. A large stable one does not. Here we have yet another piece of evidence showing us why plaque burden (or volume) is not what we should be worried about. Plaque volume says nothing about the stability, and the calcium score is even worse because calcium is what makes a plaque hard and stable.

So the real question is: What makes a plaque unstable? More on this later.

Consider this paradox, which is the clearest sign that the field is protecting its premise. Two people with calcified coronary arteries. The first is untreated and asymptomatic, just like my friend. His calcium is interpreted as a risk, a reason to start treatment, and even operate.

The second has been on a statin for years, and his coronaries have gotten more calcified during this period. That rising calcium is interpreted as success: the drug is working, the plaque is stabilizing! Same substance, same artery, same measurement, but its meaning flips depending on treatment status.

There is a real physiologic story for that second person. Statins can subdue the hot, inflamed, dangerous plaque. As the plaque cools down, it hardens and mineralizes. Rising calcium alongside a falling inflammatory signal is the picture of a lesion converting from dangerous to safe. That is a perfectly coherent mechanism.

But notice what it does to the marker. If rising calcium can mean a patient is getting better, then calcified coronaries does not = heart disease. At this point, you should start to see the cracks in their reasoning. And we’ve only just gotten started.

When We Treat By Plaque Burden

What happens when you treat the marker directly? If plaque volume were the disease, clearing it should save lives. Two of the largest trials ever run, COURAGE and ISCHEMIA, took thousands of stable patients with narrowed arteries and gave half of them stents and half medication. The stented patients did not live longer or have fewer heart attacks.

You can remove the blockage, lower the plaque burden, and survival does not change. My friend got a procedure that does not extend the lives of stable patients like him.

Then there are cases of heart attacks with barely any plaque present.

In about a third of the most serious heart attacks, the culprit plaque does not rupture. Instead, the artery’s delicate inner lining simply wears through and the raw surface beneath it triggers a clot.

There is another mechanism known as spontaneous coronary artery dissection. This mechanism is estimated to cause anywhere between 25-50% of heart attacks in women under 50.

Another path to a heart attack is by coronary artery aneurysm. The artery can balloon and let blood stagnate and clot. Or, an aneurysm can also lead to a dissection.

Yet another is a heart being stunned into failure by a flood of stress hormones while the arteries are entirely clean. This is a syndrome known by many names including broken heart syndrome, Tako-tsubo cardiomyopathy, and apical ballooning. I mention this because it’s an example of catastrophic neuro-hormonal stress overload, and leads to the next cause of plaque-independent heart attacks.

Modern life is an endless cascade of stimulation and stress, which puts chronic high stress (sympathetic) on the heart. This prevents it from resting and recovering (parasympathetic). In fact, many of our traditional preventative plant medicines (such as ouabain and galangal) have been successfully used to prevent heart attacks by promoting parasympathetic rest.

Which brings us to the crux of it all.

What does unstable plaque, coronary dissection, and coronary aneurysm all have in common?

You guessed it.

Inflammatory stress.

Inflammation can be measured with a blood test called hsCRP.

In a landmark trial called JUPITER, over 17,000 people with high hsCRP but without high cholesterol were given a statin to see if it would impact their risk of heart attacks. This was given to people who are otherwise healthy, to see if they experienced a first major cardiovascular event.

PET imaging that lights up inflamed, metabolically active plaque shows that statins reduce the inflammation within weeks, and often before the plaque changed at all. Thus, even the flagship plaque drug is working on inflammation.

Furthermore, if you block inflammation directly with a drug that does nothing to cholesterol or plaque…we see a reduction in heart attacks. This is what the CANTOS trial showed using an anti-inflammatory monoclonal antibody, given once every 3 months!

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Another trial was conducted using a cheap gout medication called colchicine, given to people who already had a heart attack.

And, guess what? Reduced risk of a repeat cardiac event. Keep in mind, this study was sampled from a patient population in which the vast majority were already on a statin. So, the colchicine is impacting the people who had heart attacks despite use of a cholesterol-lowering drug.

What’s fascinating and even more telling about this industry, is that when statins turned out to help patients with normal cholesterol but high inflammation, they conclude that hsCRP should be used to decide who should get the statin!

Think about what that means. Because in all of medicine, patient selection is everything.

By checking for inflammation, they select for people who respond to reduced inflammation. The net effect of this will be to magnify the perceived efficacy of a cholesterol-lowering drug. Further justifying the use of plaque targeting drugs. When in reality, it is the inflammation and stress which is the culprit.

Because as history has shown us, whether its regarding atherosclerosis or hypertension…the guidelines shift to include more people in the treatment paradigm, not less.

Thus, they are selective in the clinical trials when they want to give the impression that the treatment is effective. But, they use this magnified efficacy to prescribe the treatment to a wider band of the population.

Alas, this industry has a lot of capital behind it…and it seems that the practice of cardiology is pot-committed to this assertion about plaque.

From decades of observational studies, autopsies and clinical trials…it is clear that plaque is a marker of heart disease.

Frankly, it’s not even a good marker.

The word plaque conveys judgement.

When you hear the word “plaque” what comes to mind? Gunk on your teeth that need to be scraped off? Sediment in some piping that needs to be cleared?

The word “plaque” is evidence of a lifetime of bad choices. It comes loaded with guilt. So when someone tells you “you have plaque,” it comes off as a verdict against how you’ve lived. This motivates you to accept whatever intervention reduces it. The fear is entangled with shame, and shame makes you compliant.

But, what if we called it something else?

Why not, a scar?

After all, plaque is the end-result of damage being healed. Frankly, without the ability to lay down plaque your blood vessels would be a disaster. A hellscape. Constantly throwing clots or hemorrhaging.

What happens as we get older and get cuts and scrapes? We develop scars.

Of course, in the wrong environment (one that is toxic and inflammatory) even a skin scar can ulcerate and eventually become cancerous. But, under healthy conditions the scar simply remains.

So next time you hear someone say plaque…remember, it’s just a scar.

A marker of getting older and having experienced life. For better or for worse.

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The only complaint I heard was that there was a lag in the video feed, but exiting and rejoining the livestream fixed that problem for most.

Moving forward live Q&As will occur on the last Sunday of every month at 10AM CST/CDT. Thus, our next one will be on August 30th at 10AM.

If you can attend live, awesome!

If not, there is a chat thread in which you can leave a question. I will try to get through as many of the questions as possible.

Especially useful if you don’t want to forget the question in the weeks leading up to the livestream.

Either way, bring your questions! I certainly enjoyed thinking through them in real-time and being in direct service to those who make Foundational Health possible.

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A couple of months ago, a friend of mine reached out about pain he’s had in his neck for several years. The pain was centered in the back, with radiating symptoms along his shoulders and arms.

For years this had only worsened…relieved intermittently by pain medication. He had tried physiotherapy, gone to several doctors including spine surgeons.

They had done all usual imaging: x-rays, CAT scans, MRI.

The conclusion from the doctors was unanimous: there were disc herniations in his neck (cervical spine), and the problem would keep getting worse…until eventually he would need spinal fusion surgery.

This is an incredibly common problem, especially in the modern, sedentary, and tech-heavy world. I could write up a long list of all of the factors contributing to neck pain, herniated discs, and tech neck. But words alone would pale in comparison to understanding and visualizing the mechanics of our spine…and ultimately the axis of our being.

The first thing you want to appreciate is that between every bone in the spine (vertebra) there are several joints. The disc between the vertebra are just one of these joints. There are also facet joints, which are smaller joints along the back of the vertebra. And, in the neck there are also uncovertebral joints, which are smaller specialized joints aimed at stabilizing the neck while facilitating flexion and extension (forward and backward bending of the head/neck).

Just like your hip or your knee, these spinal joints have ligaments and muscles which stabilize the balance of the joint and facilitate movement. Without these, your neck would just flop down forward, or backward, and even a little to the side.

Now, it’s important to keep in mind that each spinal level in the neck has 3-4 joints. Which means there isn’t just one joint that we have to concern ourselves with.

In the neck alone, the balance of tension and relaxation between the front, back and side muscles are responsible for the stability of over 20 joints simultaneously!

The stability and harmony across all these joints is what leads to the postural curvature of the spine. Furthermore, the joints and muscles of the neck are stabilizing a hefty head (>10 pounds).

Which means that even the slightest imbalance in muscle tone (and therefore neck posture) will lead to chronic aggravation of at least one spinal joint. But here’s the kicker. Because these joints exist in sequential chain across the entirety of the spine, a small imbalance at one joint can have consequences on the entire spinal axis.

From this picture, you can start to visualize all of the factors which can impact the health of your neck:

• Work conditions

• Exercise regimen

• Stretching

• Even the direction that your eyes are looking for extended periods of time

  • For instance, if your computer or phone screen is below eye level…you head and neck will start to drift and compensate for this

Now, the common theme across the conditions of daily modern life is that it is heavily biased towards flexion. That is, head forward/down orientation.

If you stop and think about this…when was the last time you habitually and consistently favored neck extension/head backward movements?

Across time this leads to tightening and shortening of flexor muscles, and laxity/atrophy of extensor muscles. Further aggravating the muscle tone and joint imbalance.

Which is exactly what I saw in my friend’s neck…and see in the vast majority of back pain cases I am consulted on.

To further complicate matters…it isn’t just the force of gravity acting down upon our spine which can lead to spinal imbalance. But, the complementary force upward from walking.

The shape that our foot conforms to as a result of the intricate balance of the tiny joints within it. This impacts how we walk and the force transmitted upwards.

But, this is a topic for another day.

Back to Basics

When I looked at my friend’s neck MRI, there were many things which were clear to me…that were not mentioned in the report from the radiologist.

As you can see from the sample image blow, human anatomy is incredibly complex.

You may think that when a radiologist looks at something like this, they would discuss every abnormality…and have an idea of why it is abnormal. But, this is far from the truth.

Reading a spine MRI has become incredibly systematized and cookie-cutter. In fact, most radiology practices incorporate reporting templates, which they use during interpretation…and simply fill in the blanks.

I’m sure many of you have seen a report like this, and it’s not all that different for other parts of the spine. To be honest, structured reporting improves efficiency for the radiologist…but as far as the patient is concerned…it leaves a lot to be desired.

I digress.

You can see that the vast complexity of everything we just discussed is not described in a standard report.

Why am I bringing all this up?

Imagine you are engaging with life in a manner that is leading to imbalance in your core axis (the spine). This engagement is leading to various forms of stress:

• Inflammation

• Joint imbalance

• Dehydration (yes, joints and discs can dehydrate)

• Posture

Then, you develop some pain and discomfort.

So you go to the doctor. They order some imaging and they all conclude that the problem is that you have a disc herniation.

Think of this disc herniation as the outcome or physical manifestation/symptom of the deeper problem. But, none of the doctors see past these manifestations.

They simply target their therapy to the “symptom.”

This is what happened to my friend.

Even worse then that, they led him to believe that this is inevitably going to get worse…until one day he’d need surgery.

Before we dig into how we fixed his neck, I want to provide you with some snippets of his experience along the way.

The first time I checked in on his progress he said:

One month after, he said:

At the end, I asked him a question that deep down I knew the answer to. But, I wanted to get his perspective on it.

Before that, let’s dig into how we fixed his neck…

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I invited Dr. Nathan Riley onto the podcast with the initial intent of discussing obstetrics and home birth. As a complement to the conversation I had with Dr. Stuart Fischbein - an Ob/Gyn who practiced hospitalized birth for decades before conducting home births.

But, it quickly became a conversation between two doctors who walked away from institutional medicine after being fired by an industry that doesn’t seem to care about the people it serves, nor the providers which do the serving. Neither of us planned to end up here. But we are both grateful we did.

What follows is a more philosophically rich conversation ranging from Howard Gardner’s theory of multiple intelligences and what it reveals about who we select into medicine, to the three traits that might actually make someone a good doctor: humility, curiosity, and courage. The conversation ends on a nuanced discussion on the value of giving newborns vitamin K.

Beneath all of it is a shared conviction: that medicine has become a discipline of technicians operating on behalf of administrators, and that recovering the art of medicine requires doctors who are willing to say ‘I don’t know.’

This was my first conversation with Nathan, but certainly will not be the last! We have so much more to discuss…

Topics Covered

• How pregnant women and couples find physicians like Nathan Riley

• The difference between home birth, free birth, and what Nathan actually advocates: listening to what the woman wants

• Howard Gardner’s theory of multiple intelligences and what it reveals about who gets selected into medicine

• The type of intelligence medicine selects for

• Descartes, Bacon, and the separation of body from soul: how the pendulum swung and never came back

• Newton as alchemist, Paracelsus as philosopher

• The three traits of a good doctor: humility, curiosity, courage

• Paul Farmer, and the physician who brought a dying patient a six-pack of beer

• Saying ‘I don’t know’ in medicine

• Doctors in the home birth space

• COVID as a proof of concept for medicine’s failure of courage

• The physician fired for prioritizing patient autonomy in a vaginal breech birth

• Nathan Riley fired for removing his mask to sit with a dying man who hadn’t seen a face in 18 months

• The physician as partner, guide, and fellow traveler — not source of healing

• Vitamin K for newborns: why we give it, what the actual risk numbers are, and the argument that neonatal blood may be thin for a reason

Nathan can be found here:

Instagram

Substack

Website: www.bornfreemethod.com/

There is no paid content below the paywall, it is simply here so people can read what this podcast is about (above). The conversation will be available for everyone in a week’s time.

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Whenever a baby is born in a hospital in North America, within 6 hours they are given a vitamin K injection. This is to prevent Vitamin K Deficiency Bleeding.

Remember the choice of words used to describe this phenomenon.

We give vitamin K not because we are concerned about any little bleeding that can happen in a newborn. We are worried about the type of bleeding that can end the life of a baby or leave them severely disabled.

In up to 60% of cases, this is related to a brain bleed.

Before we get into the framework used to describe this problem, as well as the real benefit of this intervention…let’s give the devil its due.

This is one of the longest articles I’ve written, so an overview:

1. The data in favor of vitamin K injection

2. What the stats hide

3. The population of newborns that benefit from vitamin K

4. What the above means for the true value of vitamin K injections

5. Why are babies born with low vitamin K?

   1. My Hypothesis

   2. what can happen if we “correct” low vitamin K

6. The data supporting the hypothesis

Those last 2 points are important, because as far as I can tell…there is no published literature making this hypothesis, and linking the hypothesis to vitamin K and the observed trends in childhood disease.

Which makes this article completely novel, and invites (even requires) immediate feedback to improve the hypothesis.

We begin with the strongest possible argument in favor of giving every newborn a vitamin K injection at birth. We’re going to present the numbers as favorably as the evidence allows. We’re going to assume the best-case scenario. And we’re going to be honest about what those numbers actually mean.

The Numbers Supporting Vitamin K Injections

First, a description of Vitamin K deficiency bleeding (VKDB) straight from the CDC.

Vitamin K is a substance that our body needs to form clots and to stop bleeding. We get vitamin K from the food we eat. Some vitamin K is also made by the good bacteria that live in our intestines. Babies are born with very small amounts of vitamin K stored in their bodies, which can lead to serious bleeding problems if not supplemented.

VKDB occurs when babies cannot stop bleeding because their blood does not have enough vitamin K to form a clot.

If you read that last sentence again, you will notice that VKDB is a disease in which something doesn’t stop. That is, when bleeding doesn’t stop.

Unlike the name suggests, it’s not a form of bleeding…it’s just bleeding in the setting of low vitamin K.

Simply: if bleeding doesn’t stop and you have low vitamin K = VKDB.

Even more circularly, VKDB is the condition vitamin K prophylaxis is designed to prevent. It has three forms: early (within 24 hours), classical (days 2–7), and late (weeks 2–12). The severe form we are worried about is late VKDB, which presents as intracranial hemorrhage in 30–60% of cases.

In high-income countries, among infants who receive no vitamin K prophylaxis, the rate of late VKDB is approximately 8.8 per 100,000 births. This is the median figure from a systematic review; the upper bound of the interquartile range reaches 17.8 per 100,000.

A single intramuscular injection of vitamin K at birth reduces this rate to less than 0.2 per 100,000. The relative risk reduction is approximately 98%.

The relative risk of developing late VKDB without prophylaxis is 81 times higher than with it.

These are the numbers you will find in every public health document, every AAP guideline, every CDC fact sheet. They are accurate. They are also, in isolation, profoundly misleading.

What the Relative Risk Conceals

When a relative risk of 81 appears in a policy document, it implies a large and urgent effect. It does not tell you how large the baseline risk is.

The absolute risk reduction from vitamin K prophylaxis in a healthy, term infant born in a high-income country is approximately 8.6 cases of late VKDB per 100,000 births. (8.8 - 0.2 = 8.6 per 100,000)

Not all of those cases result in death or permanent disability. Intracranial hemorrhage occurs in approximately 50% of late VKDB cases. Of those, in high-income settings with immediate NICU access, approximately 20–25% die and approximately 50–70% of survivors sustain permanent neurological injury. When you account for these figures, it’s less than 8.6 per 100K.

Optimistic scenario: number of newborns needed to inject (NNT) to prevent one death or case of permanent disability is between 27,000 and 33,000.

Using the upper bound of the risk estimate — 17.8 per 100,000 instead of 8.8 — the NNT improves to roughly 15,000 to 18,000.

Let’s grant this more favorable figure for the remainder of the argument.

This is not a criticism of vitamin K prophylaxis per se. An NNT of 15,000–33,000 can be entirely justified for a cheap, safe intervention with no downside.

But the question I pose, is whether the cost of mass-injection is zero…

The Population This NNT Applies To

Before examining the other side of the ledger, we need to be precise about which infants the best-case scenario actually describes.

The figure of 8.8–17.8 late VKDB cases per 100,000 in high-income countries without prophylaxis is a population-level estimate. It includes every birth in those surveillance populations — medicated and unmedicated, instrumental and spontaneous, induced and physiological. It is not the rate in the lowest-risk population. It is the average.

The lowest-risk infant for VKDB looks something like this:

• Term gestation. Premature birth increases hemorrhagic risk substantially.

• Healthy mother, no medications. Maternal anticoagulants, anticonvulsants, and antibiotics all increase neonatal VKDB risk.

• Spontaneous, unmedicated vaginal delivery. Instrumental delivery and induced labor create specific risk factors for hemorrhage.

• Exclusive breastfeeding from a nutritionally replete mother. Formula-fed infants receive supplemental vitamin K in formula and have substantially lower late VKDB rates.

• No underlying liver disorder. A Dutch nationwide study found that the majority of late VKDB cases in their well-nourished population occurred in infants with underlying bile-static liver disease. Not in healthy infants.

Strip out the iatrogenic (caused by healthcare) and pathological risk factors, and the residual VKDB rate in a genuinely healthy term infant born via unmedicated natural delivery to a nutritionally strong mother approaches the lower end of the risk estimate. Maybe even less.

The Hospital Birth Environment as a VKDB Risk Factor

Here is what is almost never acknowledged in discussions of vitamin K prophylaxis: the modern hospital birth environment is itself a source of bleeding risk that does not exist under natural birth conditions.

The NNT figures cited above are derived from populations born in an unfamiliar and often times harmful environment. Just ask any doctor that works in a hospital: is a hospital a benign environment for a patient?

You cannot apply the same risk factors to natural births without accounting for the risks the hospital introduces:

Artificial, short range, constant light exposure. Vitamin K is degraded by ultraviolet and blue-spectrum light. Hospital lighting, particularly in NICUs and delivery rooms, delivers continuous artificial light exposure to a neonate whose plasma vitamin K levels are already low. The photo-degradation of vitamin K under clinical lighting conditions is documented in pharmacy literature. This is why vitamin K solutions are stored in amber vials. The effect of continuous blue-light exposure on an already low neonatal vitamin K reserve is not zero.

Cold environment and thermoregulatory stress. Hospital delivery rooms are maintained at temperatures comfortable for staff, not for newborns transitioning from 37°C intrauterine environment. Cold stress activates the sympathetic nervous system, increases catecholamine release, and alters peripheral vascular tone and coagulation dynamics in the neonate. Natural births in warm environments do not impose this stress.

Lithotomy position during delivery. The dorsal lithotomy position (on your lower back, legs elevated) is bio-mechanically awful for the delivering mother and infant. It prolongs labor, increases risk of tearing, and alters the pressure dynamics of delivery in ways that increase mechanical stress on the fetal head. Head trauma during delivery is a direct risk factor for intracranial hemorrhage.

Synthetic oxytocin (Pitocin) induction and augmentation. Synthetic oxytocin produces uterine contractions that differ from normal contractions: longer, more frequent, and lack the natural relaxation phase that allows fetal recovery of cerebral perfusion between contractions. The synthetic hyper-stimulation increases risk of unnatural cranial stress during delivery. Both hypoxia and cranial compression are independent risk factors for neonatal intracranial hemorrhage.

Instrumental delivery: forceps and vacuum extraction. Forceps and vacuum extraction apply direct mechanical force to the fetal skull. Both instruments are associated with increased rates of cephalohematoma, subgaleal hemorrhage, and intracranial hemorrhage independent of vitamin K status. It may not be as commonly used today as it was in the past, but that suggests that these older practices caused inflation of newborn hemorrhage rates, altering the apparent efficacy of vitamin K administration.

Maternal nutritional depletion. Extended hospital admissions, fasting policies during labor, and the absence of nutritional support during prolonged periods of induced labor leave mothers depleted of multiple micronutrients including vitamin K at the time of delivery and in the early postpartum period. Breast milk vitamin K content, already low, is further reduced by maternal depletion. This is not a feature of a well-nourished mother delivering spontaneously at term.

What This Means for the NNT

The honest interpretation of the available data is this:

The NNT of 15,000–33,000 to prevent one death or permanent disability from VKDB describes a mixed population that includes infants exposed to the iatrogenic (healthcare-caused) risk factors above. Many of the VKDB cases captured in surveillance data occurred in infants exposed to one or more of these iatrogenic or environmental risk factors.

In a term infant born via natural spontaneous vaginal delivery to a nutritionally replete mother, in a warm environment, without synthetic oxytocin, without instrumental delivery, the baseline late VKDB rate is almost certainly lower than the population-level figure. The NNT (number needed to treat) in this population is probably way higher than 33,000.

We do not have the data to calculate the precise figure, because no surveillance study has been performed with these factors considered.

This is not an argument that vitamin K prophylaxis should be withheld from all infant. It is an argument that the risk it addresses is not uniform across the population, that the NNT in the lowest-risk population is unknown and likely way higher than cited figures. A policy of universal prophylaxis is treating a problem that modern obstetric practice substantially creates…without examining whether the treatment introduces problems of its own.

That examination is what the rest of this article is about.

Is there a downside to vitamin K injection?

With an NNT that high, the downside does not have to be huge to warrant deeper consideration.

So…what is the downside?

I think we missed something.

Why are Babies Born with Low Vitamin K?

Doctors have assumed for decades that this is a mistake of nature, a design flaw that needs to be fixed with an injection. This paper argues the opposite: nature made this choice on purpose. Nature intended that a newborn’s blood stays thin during the first hours and days of life because the baby’s body is doing something extraordinary: opening new and developing existing networks of blood vessels that have never had blood flowing through them before. Or had very little blood flow through them in the past.

If the blood clots too easily during this process, it could damage the very organs that are trying to develop with the vascular bed. When we give every baby a vitamin K shot, we may be interfering with a protective system that nature designed. And the evidence suggests we’ve been unknowingly paying a price for it.

Newborn babies are born with almost no vitamin K. This happens three separate ways:

• Vitamin K does not cross the placenta in any significant quantity.

• Breast milk barely contains it. A breastfeeding mother can take vitamin K supplements every day and it still barely appears in her milk.

• Newborn guts can’t make it. Adults make some of their vitamin K through bacteria in their intestines. Newborn intestines don’t have this bacteria.

Three completely separate systems all pointing in the same direction: keep vitamin K away from the newborn.

Doctors look at this situation and say:

“This is a deficiency. The baby is vulnerable to bleeding. We need to fix it.”

But here’s a different question: Why? Why is it low?

If one biological process leads to low vitamin K, you might call it an accident. If two systems did it, you’d start wondering.

But, when three independent systems all converge on the same outcome, the probability that it’s an accident becomes very low.

And, as far as we know from the veterinary literature, it is not uncommon among mammals with a placenta:

So what would be the reason?

THE BIRTH EVENT

Think about what happens the moment a baby is born.

For nine months, the baby’s lungs were filled with amniotic fluid. Not air. The placenta was doing the breathing. Less than 10% of the heart’s output went to the lungs. In adults its 100% except for the blood that goes into the coronary arteries.

At the first breath:

• The lungs expand for the first time

• Blood rushes into the lung circulation: the full output of the heart.

• The liver, which had been getting blood from the placenta through a shortcut, now has to process all the blood through tiny internal channels for the first time.

• Shunts that bypassed organs in the fetus begin to close.

This is the most extreme cardiovascular event in human life, compressed into seconds, minutes, hours, days.

The Problem: Opening Up Empty Pipes

When blood first rushes into a system of vessels that has never had flow before, there’s a problem:

Slow-moving, low resistance blood flow tends to clot.

This is a direct consequence of Virchow’s Triad, named after a 19th-century German doctor who figured out the three things that cause blood clots:

1. Blood moving too slowly (or not at all)

2. Damage to the vessel wall

3. Blood that clots too easily (e.g. too many clotting factors)

The new blood vessels being recruited in a newborn’s lungs, liver, and brain satisfy at least the first condition automatically: there’s a window of time before normal flow is established where the blood is sluggish. And in these same vessels, the walls haven’t yet been trained to resist clotting (more on that below).

If the blood clots too easily during this recruitment window, the developing vessels get blocked. Not catastrophically, this is a developing organ. It mostly disrupts/changes the architecture. But it can have effects in severe cases. As we will discuss below.

Blood Vessel Walls Need to Learn to Resist Clotting

Here’s something remarkable about blood vessel linings: they only become anti-clotting once blood is flowing through them.

The inner lining of blood vessels (endothelium) responds to the physical force of blood flowing past it. When blood flows steadily, the vessel wall releases signals that actively prevent clotting.

But that’s after laminar (not turbulent) blood flow has been established.

So in the critical window when new vessels are opening up and trying to recruit flow, the walls of those vessels are pro-clotting until they learn otherwise.

The only systemic protection available during this window is: blood that doesn’t clot easily.

Which is exactly what low vitamin K provides.

THE THREE PLACES THIS MATTERS MOST

1. The Lungs

The lungs don’t finish developing at birth. The tiny air sacs (alveoli) and their surrounding blood vessels continue forming in the first weeks and months of life. Specialized cells in the lung’s capillary network are actively dividing and building new exchange surfaces after birth.

If tiny clots form in the capillaries being recruited into this new architecture, the alveoli don’t get the blood supply they need to develop properly. The result: simplified lung structure, reduced gas exchange capacity, structural vulnerability.

This is essentially what bronchopulmonary dysplasia (BPD) looks like.

Look at what BPD manifests as. The sac are malformed, and dysplastic. To me, these lungs look like they may be quite reactive to irritants or toxins.

These hypersensitive lungs can manifest as something like asthma.

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2. The Liver

Before birth, the liver had a shortcut: blood from the placenta could bypass most of the liver’s internal filtering system through a vessel called the ductus venosus. At birth, this shortcut closes. All the blood that enters the liver must now flow through a vast network of tiny channels for the first time.

These sinusoidal channels are still developing their final structure when birth occurs. Subtle thrombosis here during first recruitment could disrupt architecture in ways that manifest years later as metabolic dysfunction, elevated liver enzymes, or portal hypertension.

3. The Brain. Yes.

The area around the brain’s ventricles (periventricular region) is fed by tiny end-arteries with no backup blood supply. This region is actively being built when a baby is born, populated by the cells that will eventually form the brain’s white matter: the information highway. Defects here lead to slowing in information transfer, at the very least.

This network is part of a matrix (germinal matrix) that are the most fragile cells in the developing brain. They are exquisitely sensitive to being cut off from blood supply, even briefly.

If the periventricular capillaries experience even minor disruption (clots) during development, these precursor cells die or fail to mature. The result: white matter never gets properly developed. Brain circuits don’t connect properly. This is called periventricular leukomalacia.

This is the architecture and imaging finding associated with cerebral palsy, and increasingly, autism.

Evidence 1: The Lung Numbers

Doctors have been giving vitamin K to all newborns since 1961 in the United States. Adoption was gradual, reaching near-universal coverage by the late 1960s to early 1970s.

The first generation of fully prophylaxed babies started generating neonatal and childhood outcomes data in the 1970s and 1980s.

What happened to bronchopulmonary dysplasia rates in that exact period? They tripled. From 10.6% to 32.9% of very low birth weight babies over a single decade. With the same diagnostic criteria. With known risk factors analyzed and ruled out as explanations.

Nobody has adequately explained this.

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Evidence 2: The Same Pattern in Brain

Cerebral palsy rates rose from 1.68 per 1,000 babies in 1964–1968 to 2.45 per 1,000 in 1989–1993. This rise was documented not just in premature babies, but also in full-term babies. That’s the important part.

Full-term babies have no prematurity to blame.

Nine separate international registries all showed the same trend: rising cerebral palsy through the 1970s and 1980s.

Evidence 3: The Smoking Gun

Here’s the most striking finding.

Brain bleeds in premature babies has dropped from 50% of very premature infants in the 1970s to 15–25% today. Vitamin K prophylaxis is partly credited for this. Less bleeding. Good.

But here’s the problem: neurodevelopmental outcomes didn’t improve in proportion. The babies stopped bleeding, but the brain damage didn’t stop.

The type of damage changed.

Instead of obvious hemorrhage, there is an increasing trend of white matter lesions likely due to non-bleeding, ischemia/clot related damage that’s harder to see on traditional scans and that directly causes myelination failure and connectivity deficits.

Less hemorrhagic damage. More thrombotic damage. Still brain damage.

This is exactly what we’d predict would happen if you suppress the thin-blood phenotype (by normalizing vitamin K), without addressing the underlying vulnerability of newly recruited blood vessel networks.

Evidence 4: The Autism Connection

Children with autism spectrum disorder consistently show abnormalities in the white matter of the periventricular region, precisely the area most vulnerable to the mechanism described above. Studies using advanced MRI have found:

• Elevated periventricular white matter injury markers in ASD vs. typically developing children

• The amount of white matter injury correlates with the severity of ASD symptoms (specifically repetitive behaviors)

• White matter abnormalities detectable in ASD children as young as six months old — meaning they were present at or near birth

Diffuse white matter injury is now recognized in the scientific literature as a risk factor for autism, ADHD, cerebral palsy, and learning disabilities. What nobody has proposed is what causes the white matter injury in the first place in babies who weren’t premature.

This hypothesis proposes a new answer: normalized coagulation during the blood vessel recruitment window.

To summarize: to prevent 1 catastrophic bleed after treating at least 20,000 infants…we are risking increasing rates of cerebral palsy (severe disability) and a spectrum of autistic disorders…at the very least.

There are probably other connections I haven’t yet looked for because this theory has only just been developed.

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The Evidence Was Never Collected

Once vitamin K became universal in 1961, the comparison group was gone. You can’t study what doesn’t happen in a population where everyone gets the intervention.

The harms being proposed here are:

• Delayed: injury at birth; consequences appear over years

• Invisible at the time: you can’t see a tiny clot in a periventricular capillary in a newborn in 1965 (hard to see even today).

• Diffuse: not one dramatic event, but architectural disruption across millions of tiny vessels.

• Attributed elsewhere: the child with cerebral palsy or autism gets their diagnosis years later, with no connection drawn back to what happened in their first hours of life

In 60+ years of vitamin K literature, I don’t think anyone has proposed that neonatal vitamin K deficiency might protect newly developing blood vessels. The literature only describes the deficiency, characterizes it as a problem, and studies how to correct it.

THE BOTTOM LINE

Nature arranged for every newborn to have low vitamin K. Three separate biological systems cooperate to ensure this. The most extreme cardiovascular event in human life (when the lungs, liver, and brain all open their blood vessels for the first time) happens in this low-vitamin-K window.

We have overridden this arrangement for 60 years, universally, for every baby born in the developed world.

The epidemiological record (rising rates of lung disease, brain injury, and neuro-developmental disorders in the first generation of universally prophylaxed babies) is consistent with the possibility that vitamin K is low for a reason.

Not deficient.

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References

Sankar MJ, Chandrasekaran A, Kumar P, Thukral A, Agarwal R, Paul VK. “Vitamin K prophylaxis for prevention of vitamin K deficiency bleeding: a systematic review.” Journal of Perinatology. 2016.

Sinkin RA, Cox C, Phelps DL. "Predicting risk for bronchopulmonary dysplasia: selection criteria for clinical trials." Pediatrics. 1990.

Jobe AH, Bancalari E. "Bronchopulmonary dysplasia." Am J Respir Crit Care Med. 2001.

Colver AF, Gibson M, Hey EN, Jarvis SN, Mackie PC, Richmond S; North of England Collaborative Cerebral Palsy Survey. "Increasing rates of cerebral palsy across the severity spectrum in north-east England 1964–1993." Archives of Disease in Childhood — Fetal and Neonatal Edition. 2000.

Scheller JM, Nelson KB. "Timed relation of a single seizure to perinatal factors in neonates." American Journal of Obstetrics and Gynecology. 2003.

Georgiadis P, et al. "White matter injury in infants with intraventricular haemorrhage: mechanisms and therapies." Nature Reviews Neurology. 2022.

Blackmon K, Ben-Avi E, Wang X, Pardoe HR, Di Martino A, Halgren E, Devinsky O, Thesen T, Kuzniecky R. "Periventricular white matter abnormalities and restricted repetitive behavior in autism spectrum disorder." NeuroImage: Clinical. 2015.

Bronchopulmonary dysplasia as a risk factor for asthma in school children and adolescents: A systematic review." Allergologia et Immunopathologia. 2017

disease is distance from creation and the creator.

This is the conversation that followed.

Liev is a former therapist who left the mental health profession after recognizing that the system was structural…

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A medical student can tell you what homeostasis is. What the autonomic nervous system does. What heart rate variability measures. What spontaneous remission means, and why the placebo effect is real and clinically relevant.

Ask the same student “what is health?” and you’ll get an interesting response.

It used to be the case that health was defined as merely the absence of disease.

Nowadays, you will find something like this:

Health is a state of complete physical, mental, and social well-being…

Read incisively: “Health is a state of…well-being.”

Brilliant.

Modernity continues to stumble in the direction of what has been known about health for thousands of years, as a consequence of its frame of reference.

Because health is not the absence of disease. Not a lab value within a “normal” range. Not a Framingham score below a threshold.

Health is not the absence of something negative.

Being healthy is a positive phenomenon.

Unfortunately, asking what is healthy is tantamount to asking what is the sound of silence?

Every school of medicine that has survived across time had a language to capture this positive aspect of health.

• The Arabs have ruh, the animating spirit that organizes the body’s faculties and determines its vitality.

• Ayurveda has prana, the life force that precedes and underlies all biological function.

• Traditional Chinese medicine is structured around qi, the circulating vital energy whose balance or disruption determines health and dis-ease.

• The Hippocratic tradition (which modern medicine claims as its ancestor) centered on pneuma and the vis medicatrix naturae, the healing power of nature.

All of these schools of thought are centered around what you might call the vital force.

The force which facilitates growth, healing, and life. The force that is necessary and sufficient for health, and animates life itself.

This frame has come to be known as vitalism - the position that living systems are organized by something that cannot be fully reduced to their material components.

Modern medicine does not have a term for this. Not because it has been disproven. It’s just inconvenient for its worldview.

It was a philosophical commitment that began in the 17th century, when Descartes separated res cogitans from res extensa: mind from body. Separated the animating principle from mechanical substrate.

Modern Medicine chose machine over life-force. The living body became a modular system of parts. In part a hangover from the industrial revolution.

Disease became a malfunction of parts. Treatment became intervention in these parts. The force that organized and gave life to these parts was ignored

Vitalism had defenders through the 18th and 19th century. The vital force was still in active clinical use as late as 1850. In fact, it is in the “alternative” schools that we continue to see reference to it.

When germ theory arrived. When pharmaceuticals began producing measurable results. When the American Medical Association began professionalizing medicine as a scientific discipline. When the Flexner Report became the guiding principle for medical education…this is when modern medicine began to distinguish itself from the “alternative” practices.

These alternatives were naturopathy, homeopathy, osteopathy, chiropracty, etc. All of these schools grew in protest against allopathic medicine, and partly as a defense of the idea that the body had an inherent healing capacity worth supporting rather than suppressing.

The response from allopathy was not to refute the vital force, but to abandon it entirely.

To invoke a healing force was to sound like a naturopath. The phrase was surrendered…and with it the idea that living systems have a direction, a telos. An intrinsic intelligence that exceeds what can be described in reductive terms.

This left a void.

A series of phenomenon that needed a new explanation.

• Wound Healing

• Spontaneous Remission

• Watchful Waiting

• Placebo Effect

These are all a manifestation of the vital force, without the name.

The phenomenon didn’t disappear…it was just abandoned. Which is arguably worse.

The modern doctor observing two patients with identical diagnoses, identical labs, and wildly different clinical trajectories has no vocabulary for what they are seeing. They reach for concepts like compliance, psychology, chance, the will to live. A phrase they use informally but, never write in a chart. A half-thought.

The closest approximations in the modern lexicon only illustrate this gap.

Homeostasis captures the self-regulating tendency toward equilibrium: the body as thermostat. It describes the functional dimension of the vital force. But it still lacks purpose. There is no telos. No organizing principle.

No drive toward flourishing. No way to distinguish between a set-point that is adequate, and one that is optimal.

Autonomic nervous system tone is another useful clinical approximation. Vagal tone, sympatho-vagal balance, heart rate variability(HRV).

High HRV correlates with resilience, adaptability, physiological reserve. Low HRV predicts adverse outcomes across nearly every disease category examined. The measurement is real. But it is a proxy metric for a concept that has not been properly described.

The result is a school of medicine that can sequence your genome but says nothing about how you should lead your life.

Every school that Foundational Health draws from opens with a positive description of health. They are descriptions of the animating principle whose presence constitutes health and whose depletion contributes to dis-ease. Pathology is a loss of vitality. Treatment is guided by support for its return.

Modern medicine inverted this. It defined health as the absence of disease. Built its entire diagnostic apparatus around detecting pathology without consideration for the positive state it seeks to revive.

This is not a knowledge gap. This is a framing problem.

But, the vital force was always here. It organized Western medical thought from Hippocrates through the 19th century.

And, no…it was not superseded by “better science.”

It was surrendered to preserve an industry boundary.

This is the missing ingredient most doctors can feel without being able to name.

This is why you feel the contradiction when you see a doctor. Everything about you is measured and reported with great precision. Yet the one thing in the room that is alive (you), remains unknown.

Know Thyself. Flourish.

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In this conversation, Remnant and Dr. Stu trace the full anatomy of a system that has turned a normal biological function into a medical event - and in doing so, has made outcomes worse, not better. They cover the cowardice and economic incentives that drive obstetric decision-making, the use of fear as a management tool, the difference between relative risk and actual risk, and the specific claims made about breech delivery, twin birth, VBAC, and routine hospital interventions that do not survive scrutiny.

RemnantMD also shares his own experience: his first child born in a hospital, his wife depleted and hollowed out after; his next two born at home, the midwife arriving too late, his wife radiant immediately after. And what that contrast taught him about what birth is supposed to be — and what medicine has taken from it.

Topics Covered

• First do no harm — and the paradox that the medical license exists to cover harm, not prevent it

• How cowardice is manufactured in medicine: managed care, hospital employment, and the removal of physician leverage

• Medical schools recruiting sheep, not shepherds

• The Essure device, intrauterine metal coils, and the absence of basic precautionary thinking

• Birth control pills, statins, and SSRIs as lifetime patient creation

• The C-section rate: from 5% in 1970 to 35% today

• Why hospitals cannot afford to let normal births be normal

• How fear is weaponized against pregnant women

• Fetal growth restriction: the definition changed and generated more business

• Twin growth charts vs. singleton growth charts

• Breech delivery: the actual risk numbers

• The Term Breech Trial: no quality control on practitioner skill

• How to correctly perform a breech birth

• Twin birth: actual stillbirth statistics by week

• Pregnancy as preparatory medicine: the system programs fear before conception and monetizes it through delivery

• Midwives as the torchbearers of breech and twin skills

• Stillbirth and the limits of surveillance

Dr. Stu can be found at Birthing Instincts: the website, the podcast, the instagram account.

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Part I: The Wrong Framework

There are two questions that every patient asks themselves as they walk into a doctor’s office.

What do I have?

What do I need to fix it?

Unfortunately, these are the wrong questions.

It’s not because patients are unsophisticated. It is because medicine has spent decades teaching people (including doctors) to ask them. The entire architecture of modern healthcare (diagnostic codes, treatment algorithms, and pharmaceuticals) is built on this framework. Several of the core clinical reference manuals (e.g. Merck Manual) are based on this framing.. That is not a coincidence. It’s an entire profession encoded in industry pairings.

The framework goes like this. Your body has malfunctioned. Name the malfunction. Correct the malfunction. Move on.

The problem is that the body doesn’t malfunction.

It responds. Every symptom, every sign, every number your doctor circles in red is the body’s attempt to compensate for something that came before. It is not broken. It is communicating.

The body is trying to tell you something.

Which begs the question…are you listening?

This question asks you to adopt a different position. On in which you try to understand, to reflect, to hear what the body is telling you. Instead of you telling the body it is malfunctioning and the doctor has just the prescription it needs.

Once you lock in on that…the solution follows naturally.

There is no better example of this than blood pressure.

Because it is the most aggressively treated, the most casually diagnosed, and the most misunderstood. It demonstrates the pipeline I described above perfectly.

Number → Label → Prescription

Without taking a moment to understand what the body is telling us.

And it is trying to tell us something.

I’m going to use the example of my mother’s insanely high blood pressure over the holidays to illustrate this guide, but if you want to read the dedicated article about the experience/process of getting her blood pressure as low as its ever been without medications - here it is:

The point is that she didn’t have hypertension. Her blood pressure was dysregulated.

Those are not the same statement. The first ends at a prescription.

The second begins with a question: who is she, and why is her body working this hard?

Part II: What Blood Actually Is

Most people think of blood as a delivery service. It carries oxygen to your tissues, picks up carbon dioxide, and cycles back. Red blood cells are the vehicles. The heart is the pump. Simple.

This picture is wrong.

Start with water. Blood is mostly water, but not water the way you’d pour it from a tap. This water is adherent to biological matter. It has charge. The proteins and cells in your blood also have charge. These charges interact, attract, repel. The interactions are integral to the function of circulation.

Now consider the red blood cells themselves. They carry hemoglobin. Hemoglobin carries oxygen. This much you know. But here’s what most people don’t know: hemoglobin is built around a structure called a porphyrin - a complex cyclic organic compound whose primary function is to absorb light energy and make it available to the body. Each porphyrin is a fiber-optic node doped by iron.

Let that sink in.

These are same class of molecule that give plants the ability to perform photosynthesis (using Magnesium instead of Iron) is sitting at the core of every red blood cell in your body.

The heme in your red blood cells (heme B) is not dramatically different from chlorophyll. Plants absorb sunlight to make food. Your mitochondria run an electron transport chain that is also heme-dependent.

What this means, practically, is that the vast majority of your blood - between the structured water and the hemoglobin - is a medium that harnesses, stores, and transmits light and electrons. Oxygen is the terminal electron acceptor of the electron transport chain. Its job is to create an outlet for the electron flow that produces ATP (energy).

The whole path looks like this:

1. Food provides electrons.

2. Light excites the electrons.

3. Oxygen closes the circuit and draws electron flow.

When you understand blood this way, you begin to appreciate why sources of natural light (i.e. near-infrared) have such a profound effect on circulation. This is not alternative medicine. This is biophysics.

Think of it this way.

The lungs are a portal system where your blood exchanges gas.

The liver is a portal system where your blood exchanges nutrients and clears waste.

The skin is a portal system too. It exchanges light of all sorts of wavelengths.

Sun, air, water. When you understand the skin this way, spending time outdoors stops being a lifestyle preference and starts being a physiological requirement.

Part III: How Blood Actually Flows

The heart does not pump blood the way you imagine a hydraulic pump.

Since William Harvey described the circulatory system in the 16th century we have held a model of the heart as a four-chambered organ that passively fills with blood and forcefully contracts to push it out. This is the model taught in every medical school on earth.

Dr. Francisco Torrent-Guasp changed that picture.

Paco, as he was known, demonstrated through meticulous anatomical dissection that the heart is not four discrete chambers acting in concert. It is one long muscle twisted upon itself like a rope. This muscle undergoes something more akin to peristalsis than pumping. The same coordinated muscular wave that moves food through your intestine moves blood through your heart.

As blood moves inward, the apex contracts and ejects blood through the aorta while simultaneously drawing the basal loop back…creating a sucking force. Galen observed this and described the heart as “robbing the vena cava by violence of considerable quantity of blood” at each diastole.

It does this by creating a vortex: a tapering cone of rotating fluid that gives the blood forward momentum before the final contraction ever happens.

Gerald Pollack’s laboratory has been studying what happens to blood flow when you remove the heart from the equation entirely. In experiments using chick embryo models, blood continued to flow for hours after the embryo had been euthanized. Not from residual pressure. Not from vascular contractions.

What Pollack’s group has shown is that the inner lining of blood vessels creates what they call an exclusion zone: a structured layer of water, negatively charged. Red blood cells are also negatively charged. Like charges repel. This electrostatic interaction between the negatively charged RBCs and the negatively charged exclusion zone creates motion.

Pollack et al also observed that infrared light broadens this charged water boundary, amplifying the effect. The blood moved with more vigor in the dead animal after application of infrared light.

The blood moves, in part, because of light.

One final point on flow which connects directly to blood pressure.

Our circulation is a parallel circuit. Blood flows from the aorta into parallel pathways - arteries branching into arterioles branching into capillaries - each supplying different organs, muscles, and tissues. In a parallel circuit, the total resistance across the system depends on the resistance of each individual branch.

What happens when a branch is no longer used?

An organ that is chronically underused, or chronically diseased, reduces its blood supply. The vessels feeding that organ shrink, stiffen, or disappear. The branch closes.

KEY: in a parallel circuit, removing a branch increases total resistance.

Higher resistance requires a higher pressure to maintain the same blood flow across the circuit.

This is why chronic sedentary behavior creates the conditions for elevated blood pressure over time.

More importantly, study after study (discussed below) demonstrates that being active results in better outcomes than blood pressure medications, irrespective of whether or not blood pressure is in a “normal” range.

Part III: The Diagnosis Dilemma

Now that you understand what blood is and how it flows, I want to turn to the way we diagnose and treat high blood pressure. Because this is where I think modern medicine fails people most.

Let’s start with the number.

When I began my medical education, systolic blood pressure between 130–139 was considered pre-hypertensive. A warning, not a diagnosis. By the time I finished training, those same numbers were Stage 1 Hypertension. A formal clinical entity. A justification for prescriptions.

The threshold did not move because the biology changed. It moved because guidelines changed. And guideline committees have a complicated relationship with the industries that benefit from lower diagnostic thresholds. This is a well-known phenomenon.

The United States currently uses hypertension thresholds that are meaningfully stricter than the European guidelines and the International Society of Hypertension. The same number, in the same person, results in a different approach depending on your zip code.

Now let’s talk about what we’re actually measuring.

When you get your blood pressure taken, the cuff goes on your arm - usually over the brachial artery. This is done because the brachial artery is the closest accessible vessel to the aorta. The assumption is that brachial pressure reflects central aortic pressure.

It doesn’t. Not reliably.

The brachial artery frequently overestimates central systolic pressure. In young adults (men > women) this discrepancy is widest.

Which means a young, otherwise healthy person can walk into a clinic, have a blood pressure of 135/82 measured in their arm, be diagnosed with Stage 1 Hypertension. Crucially, their central aortic pressure may be completely normal.

This matters for millions of people being placed on medications they may not need.

And about those medications.

Two large studies are worth your attention here. The first, by Brown and colleagues in 2013, tracked over 10,000 people across groups divided by activity level:

1. medicated and controlled (blood pressure),

2. medicated and uncontrolled,

3. unmedicated and uncontrolled, and

4. normotensive

Activity was, by a wide margin, the most powerful determinant of mortality. Being active with uncontrolled hypertension produced better outcomes than being treated, controlled, and inactive. The gap between active and inactive groups dwarfed the gap between medicated and unmedicated groups at nearly every point on the curves.

One of the more disturbing findings in this study is that the worst outcomes were in people who were not active, had uncontrolled blood pressure, and were on medication.

A 2022 JAMA publication extended this picture. The investigators looked at all-cause mortality, cardiovascular mortality, and cancer mortality across different combinations of lifestyle score and medication use. Their finding: at equivalent lifestyle scores, those not taking medication tended to achieve better risk reduction than those who were. And every additional increment of lifestyle improvement produced greater benefit in the unmedicated group.

Suppression of the signal (elevated blood pressure), without any meaningful improvement in the conditions which give rise to the elevated blood pressure…has consequences.

I am not telling you to stop taking your medications. I am saying that individual circumstances are infinitely variable.

You do not *have* hypertension.

Your blood pressure is elevated.

Those are not the same thing. The question is: why.

If you’ve followed the logic this far, you already know that lowering a number isn’t the same as treating a person. What follows is how I actually think about this and what I did when it mattered most.

Part IV: The Case Study

I bring up this case again because it’s the perfect illustration of how the individual determines the path to resolving dysregulation.

So, let me tell you who my mother is before I tell you what her blood pressure was.

She is a Type A personality. A workaholic, in the truest sense - someone who works because she cannot stop. She is the kind of person who gives to everyone around her and treats her own needs as an afterthought, if she treats them at all. She runs on coffee and urgency. She doesn’t hydrate well. She doesn’t rest well. She has spent decades pouring herself out for other people and has never quite learned how to receive the same care she gives so freely.

She’s getting better at that though.

If you were to ask the right questions:

• who is she, and

• why would her body manifest elevated blood pressure?

…the answer would be obvious before you ever took her blood pressure. Of course her pressure is elevated. Just look at her.

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Each Its Strength

Every traditional form of the medical art that I have learned from seems to build upon or complement one another.

Let me give you an example.

Galenic/Humoral medicine teaches us about the interaction between the environment you inhabit and the choices you make about your life, and how that interactions impacts the balance of the substance and functions of our body.

This tells us why someone who is sanguine (more moist and hot than other temperaments) may experience “flu-like” symptoms in the spring if eating certain foods or rapid shift in climate.

Structural changes in the here and now.

Whereas, TCM tells us about the transformation of energy within and between these structures across time.

For instance, TCM tells us what response will the body manifest in the future if some disturbance in constitution occur today. So, if your summer is particular HOT or DRY…the body will undergo so-and-so transformation in the Fall or Winter.

Then, how do I apply this information?

A Case Narrative

I just came way up north to northern Ontario to visit family. I live in the Southern US. It was summer af where i came from, but it’s early spring here.

I am of the hot and moist temperament. Whereas I was in the throws of alternating dry and moist hot environment, I am now in a colder environment.

What does that do to moisture?

It condensates it.

I am now leaking fluids and feel more sluggish and congested.

So what am I focused on?

Keeping my blood flowing and fluids drying up to balance the excess moisture. Especially the food we are eating this time of year. Fatty beef. Which can shift temperament toward more hot/moist as well. Thereby amplifying the existing imbalance.

We need to dry things out.

What’s that mean? Dry sauna. Light exercise. Percussive/massaging skin and tissue manipulation. Less moistening and cooling food. Spices/pepper.

I feel better already.

Thank you, Galen and ibn Sina.

One of the other environmental shifts up here are that the days get longer.

Which I interpret as the need to adjust our life to spend more time in the Sun…we exist in this balance. Maybe we need more vitamin D? Maybe we need to accommodate to the temperature. Maybe we need more UV and IR light to improve our metabolism.

We are already doing it with artificial light lamps.

Who knows, winters here may require that much more time in the Sun.

You will need the extra boost once Fall and Winter arrive.

Soak it up.

Thank you, TCM.

The Limits

As you can see, the diagnosis and treatment are highly personal.

This is not something that can be scaled very easily.

Which plays to my strengths and desires.

To help people by empowering them with the wisdom of these medical arts using straightforward tools.

I believe one of those tools is making the wisdom of these medical arts more accessible.

Which is why this blog and the new podcast exist!

If you haven’t check out the podcast, it can be found on this youtube channel: youtube.com/@Foundational-Health

The best experience for the podcast exists on the Youtube channel, simply because the ecosystem there asks for a different experience than other platforms.

If you want to tag along the journey or support this work, consider these options:

Monthly Member:

• Complete essay archive access

• Early podcast episode releases

• Discount on future services

Founding Member (Limited spots):

• Monthly +

  • Higher discount on future services

  • Join LIVE podcast recordings and ask questions

  • Receive guest list in advance and send questions to be asked

The conversation covers a remarkable amount of ground: from why a dollar box of baking soda may outperform a $50 pre-workout supplement, to the methylation cycle and what your MTHFR gene variant actually means for your personality, your mental health, and whether you need to do anything about it.

Topics Covered

• Baking soda as a performance supplement

• Why there is no meaningful line between a supplement and a drug

• MTHFR gene variants: what the methylation cycle does, what under- and over-methylation look like in a person

• Homocysteine, histamine, and the markers that reveal your methylation status better than genetic tests

• Why multivitamins don’t reduce all-cause mortality — and the role of iron in driving that outcome

• Antioxidants as mitochondria-to-nucleus signaling disruptors — and the Vitamin E lung cancer data

• Magnesium: ATP stability, the calcium threshold mechanism, and why deficiency looks like anxiety

• Sodium, pregnancy, and the Tom Brewer protocol for preventing miscarriage

• Phosphorus from fertilizers: how its increase relative to calcium is calcifying arteries and possibly the pineal gland

• Ruminant digestion: why grass-fed cattle are essentially on a ketogenic diet, and why industrial farming reverses this

  ---

Monthly Subscriber Benefits:

• Full essay archive.

• Early podcast episode release.

• Discounts on future products.

Foundational Assembly (Limited Members):

• Advance notice of guests + submit questions before recording.

• Join podcast recordings and ask a question yourself!

• Complimentary copies:

  • Temperament Assessment Personal Constitutional Report

  • Peptide Research Dossier

  • Books

Bryce Hanna can be found here:

X: @photobiogenesis

Bryce’s website & articles: multiflora-herbs.com

Patreon: patreon.com/photobiogenesis

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A Disrupted Balancing Mechanism

Most people understand disease as an event.

Something arrives. A label is assigned. Treatment begins.

But the diagnosis is not the story. It is the moment the story became difficult to ignore.

The body is not passive. At every moment it is working to maintain internal stability against an environment that is trying to destabilize it. Temperature. Blood sugar. Inflammatory stressors. Hormonal cycling. This is called homeostasis. And health is not the absence of these stressors, but the capacity to resolve them.

Disease begins when that capacity erodes.

Not when blood sugar fails to return to range once. When it consistently returns a little more slowly, until one day it stops returning at all. When inflammation occurs and never fully resolves, leaving a residue that lowers the threshold for the next activation. The body is built for perturbation. What it requires is the capacity to recover. Most people lose that capacity over years…in ways they attribute to aging, stress, or circumstance.

Modern medicine intervenes at the threshold. It has no framework for the decade before. It recognizes the destination, gives it a name and treats it. The question of how you arrived is not a billable event, and their answer is usually a drug.

A huge flaw in the model.

Low Hanging Fruit

If disease is the progressive failure of homeostatic capacity, then the conditions that produce it are mostly ordinary:

• Sleep is when the largest share of systemic correction occurs.

• Food is the primary input that either supports or overloads the metabolic systems responsible for that correction.

• The environment is a continuous signal that either calibrates or disrupts the neuroendocrine regulation that governs all of it.

None of these are exotic. But, they are not the center of clinical practice because they are not scalable in a system built around managing threshold events.

Restoring homeostatic capacity is not generic. The intervention that helps one person return to balance will push another further from theirs. Universal protocols fail even when they are genuinely good protocols, because that balance is not the same for everyone.

This is what constitutional medicine understood…thousands of years before modern medicine dispensed the traditions from which it evolved. Before you can restore balance, you need to know what balance looks like for a given individual. Not for the non-existent average person in a clinical trial.

For you.

The first step toward health is not a protocol.

It is knowledge and understanding.

I used to think that the axiom “First do no harm,” was the correct starting point.

I now realize that’s incomplete.

First, know the patient. Know thyself.

Then, do no harm.

Or…Flourish.

Update on Temperament Assessment

Some of you took the first version of the constitutional self-assessment last year. That was a starting point: four brief outputs, just a test.

What I have been building since is completely revamped.

After analyzing the initial cohorts’ results, I have made more precise questions, written in the language of how people actually experience their bodies rather than the archaic vocabulary of most constitutional frameworks.

Now, there are thirteen possible results instead of four.

1 balanced, 4 pure and 8 compound temperaments. Enough resolution to produce guidance that is genuinely specific.

And, the output is no longer a short description.

It is a complete constitutional reference manual.

Around 60 pages specific to your temperament, organized around the Foundational Health four-pillar model: Activity, Consumption, Habitat, and Meaning. Every section calibrated to your specific type. Temporal variation throughout: time of day, season of year, stage of life, and for women, the menstrual cycle across all four pillars.

It also includes a food classification chart covering roughly 170 foods, herbs, and spices, classified by their constitutional qualities and seasonal appropriateness. This is accompanied by a seasonal meal planning template to fill in with what you know about your own nature.

The first report of this type is already done (for Pure Sanguine Temperament). I’m so pumped for you guys to see it.

I’m even thinking of offering a physical copy so you can have it sit in your kitchen, nightstand or coffee table. Returning constantly to calibrate and go deeper in your understanding of yourself.

Let me know in the comments below if a physical copy would be of interest.

Launch is coming! All subscribers will be notified when it’s ready.

Join the Journey

Monthly Subscriber Benefits:

• Full essay archive.

• Early podcast episode release.

• Discounts on future products.

Foundational Assembly (Limited Members):

• Advance notice of guests + submit questions before recording.

• Join podcast recordings and ask questions directly!

• Complimentary copies:

  • Temperament Assessment Personal Constitutional Report

  • Peptide Research Dossier

  • Books

Subscribe now

I want to show you something I’ve been working on.

A couple of weeks ago I started keeping a personal research file.

People were asking me about peptides constantly, and the more I looked at what was actually being written about them, the more troubled I was. Not because the compounds are necessarily dangerous. Because the information environment around them is almost entirely conflicted.

Vendors running “educational” blogs on the same domain as their store. Longevity clinics whose revenue depends on patients staying on protocols. Influencers presenting themselves as spokespeople for these products. Researchers with deep institutional ties to the compounds they publish on. Even the “educational resources” have a financial stake in how you perceive these products.

So I started applying a different standard. The one I use for anything I’d recommend, to anyone. The standard is simple: would I give this to my own family?

That standard has many effects:

• It disqualifies “the preclinical data looks promising.”

• It requires saying out loud when a Phase 3 trial failed.

• It requires treating a cancer signal from a mechanistically identical pathway as a risk worth identifying.

• It requires acknowledging that most endocrinologists have not been thoroughly educated or trained about the compounds their patients are injecting.

What started as a personal file quickly became a comprehensive research dossier. What I’d want to exist if I were a patient or a physician. My main thesis is that the term “peptide” is strictly marketing, and not an indicator of anything meaningful about the product.

Once you realize this, the house of cards collapses, and everything else follows including the information problem, what responsible supervision should look like, how to evaluate whether the compound you ordered is actually what it claims to be, and a full compound-by-compound analysis of the top peptides in the market - which include the following information:

1. Strength of available literature

2. Current regulatory status

3. Third party testing of contents compared to manufacturer claims

4. What is the sequence of the peptide

5. What is it most similar to in the body

6. What is the mechanism of action

7. What are risks associated with the biological pathway that is regulated by this peptide

8. What is the natural history of this peptide in the body, including as we age

9. What disease states and lifestyle factors modulate the body’s version

10. and more…

This is a glimpse into a pet project that has slowly turned into a major undertaking…and I want your honest feedback.

Here is what I’m asking: read what I’ve built so far. Tell me what’s missing, what’s wrong, what’s unclear, and what resonates. You are the people whose opinions I trust enough to show this to before it’s done. If you find a factual error, I want to know. If the standard I’m applying is too conservative, make that argument. If there are gaps — compounds I’ve missed, risks I’ve understated, questions I haven’t answered — tell me.

What you have access to here is a PDF version of the work-in-progress. The final peptide dossier will be a navigable stand-alone webpage.

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But, nobody got sick.

They ran it again with 100 different volunteers. Nothing. They ran it a third time on a different island.

Same result.

A century later, researchers tried again — this time armed with PCR machines, electron microscopes, genome sequencers, and billions of dollars in pharmaceutical infrastructure.

To the surprise of the researchers, they were unsuccessful in transmitting a cold.

This episode is probably going to ruffle some feathers. Good.

In This Episode

I sat down for over two hours with Jamie Andrews — a man who came to virology with no skin in the game, no career to protect, no grant to renew, and no patients depending on him.

What he found, by simply asking the questions will reframe how you think about every diagnosis and test result.

Topics Covered

• Challenges to contagion studies from 1917 to present

• Limitations of microscopy and laboratory methods in detecting viruses

• The influence of narrative and storytelling in scientific research

• The role of psychological effects like nocebo in disease perception

• Critical analysis of PCR testing and its implications for public health The limitations and misconceptions of PCR and genetic testing

• The concept of viruses as information rather than pathogens

• The importance of terrain and holistic health in disease prevention

• The role of charge and electromagnetism in cellular processes

• The critique of mainstream microbiology and virology

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• I am actively hiring a social media manager who can transcribe the work from Substack onto X/Instagram accounts. This seems particularly appropriate since we will be clipping podcast episodes for other platforms

  • The more I read and research, the more I want to read. I don’t want to waste time trying to figure out how to translate this important work into the formats the other platforms thrive on. Time to evolve!

• I’ve also been recording many episodes in the background, just getting around to editing them has been challenging.

  • Also in the market for someone who can edit/clip the material. If you know anyone, send them my way! Foundationalhealthllc@pm.me

• Future Podcast Guests:

  • Dr. Stu Fischbein - an Ob/Gyn of 40 years who long ago shifted his practice from the hospital to the home. Advocating for midwife-led, low-intervention and home birth approaches. He’s known for supporting spontaneous vaginal delivery of breech and twin births.

  • Dr. Nathan Riley - a young Ob/Gyn who left the standard hospital system to practice more holistic, integrative and autonomy-focused approach to birth. He collaborates with midwives and emphasizes childbirth as a natural and spiritual process, with low-intervention home birth approach.

  • Bryce Hanna - known on twitter as photobiogenesis, and I would describe him as a biochemist above anything else. But, he is unique for several reasons including a deep understanding of nutrition, pharmacology, herbalism, and naturalism. I’m drawn to his work for his attention to detail and nuance when discussing all of the above.

Early full video releases of the podcast are available to paying supporters of this venture. Episodes will be available for all to view on Youtube and Rumble, or in audio on Spotify and other platforms about a week later.

If you want to be present during the live recording as an audience member who can also ask questions of the guests at the end, let me know in a comment below, a private message or e-mail me at rmdllc@proton.me with subject line: seminar.

Conversation with Dr. Deep

On this episode we discuss how Dr. Sandeep Palakodeti transitioned from traditional healthcare to a concierge model that prioritizes patient and physician satisfaction.

Some may scoff at this, but a healthy and happy doctor = a healthy and happy patient.

In the current healthcare landscape, many patients find themselves feeling overlooked and doctors feel trapped by systemic inefficiencies. To fix this Dr. Deep created a concierge digital health confronts the challenges of healthcare professionals to restore joy and fulfillment in practice.

Dr. Deep’s journey led him to establish a nationwide concierge practice, Velocity Health, which aims to redefine patient and physician experiences.

On this episode we discuss:

• His Breaking Point: Transitioning from Traditional Medicine

Dr. Deep transition from conventional practice was driven by a profound sense of moral harm he witnessed in the healthcare system.

• Why Foundational Health Matters

The shift to foundational health emphasizes personalized care rather than generic protocols. Dr. Deep believes that healthcare should be built around the individual, focusing on holistic wellness rather than merely treating symptoms.

• Overcoming Challenges in a Concierge Model

Establishing a concierge practice presents unique challenges, especially in navigating healthcare regulations and financial models. Dr. Deep discusses the corporate practice of medicine laws that dictate how healthcare can be delivered, as well as the venture capital and private equity world that seeks to milk the healthcare cow.

• The Importance of Autonomy and Meaning

A significant theme in the discussion was the autonomy physicians gain in a concierge model. Dr. Deep emphasizes that having control over practice allows for meaningful interactions with patients, which is crucial in combating burnout.

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First, a disclaimer:

I don’t think shift-work is healthy. No matter how good your strategy is, it’s an effort to mitigate the chronic insult on your metabolism that comes with chronic or recurring circadian disruption, and exposure to modern artificial lighting.

In fact, if you can avoid it…don’t do shift-work.

But, people have different goals and priorities. Like I do. I’ll explain.

Background

Over 2 years ago, I made a bet on myself. That I would give myself 5 years to become independent of employment from the mainstream medical industry. Independent means continue to pay off my student loans, support my growing family (3 kids) as well as my extended family, and provide the type of life for them that I didn’t have.

A big ask.

A part of that bet meant taking a job that I find both fulfilling and provides me with ample time off to spend with my family. Our kids are all under 5 years old, and for now while they want me involved in all aspects of their life…I’ll take it!

As anyone who works in the Emergency Room knows, that involves shift-work.

Although I do not condone shift-work…the reality is some of us make these decisions for personal reasons.

Which means that those of us who make such questionable decisions need some help mitigating the damages.

That’s why I decided to share my person strategy that I’ve been calibrating for over 2.5 years.

The Dangers of Shift-Work

To the average person, the impact of shift-work may seem as ‘banal’ as jet-lag. The problem with these terms is that it makes it seem like it’s just fatigue setting in. But there’s more to it than that.

First and foremost, there is the circadian disruption. Which in itself should be a major consideration. Traveling or a long night out are isolated instances of circadian disruption. But shift-work is recurring and chronic circadian disruption. The negative effects compound.

• Shift work is classified as a "Group 2A probable carcinogen" by the International Agency for Research on Cancer (IARC)

• Circadian disruption suppresses melatonin secretion, dysregulates the CLOCK and BMAL1 genes, reduces natural killer (NK) cell activity, and impairs DNA repair — all of which promote tumour initiation and progression

• Shift workers face a significantly elevated risk of coronary artery disease, hypertension, stroke, and atherosclerosis

• Circadian disruption is a well-established independent risk factor for type 2 diabetes and obesity

• Circadian misalignment and decreased amplitude of circadian rhythms have been shown to predict the development of Alzheimer's disease and Parkinson's disease

• Disrupted circadian rhythms are strongly associated with major depression, bipolar disorder, PTSD, generalised anxiety disorder, and schizophrenia

A major contributor to the damages of circadian disruption is the ubiquity of modern artificial lighting. Specifically, LED and fluorescent bulbs which can be harmful even during the day, simply by virtue of their physiologic consequences. Their negative effects are magnified in the setting of circadian disruption.

Together, the physiologic consequences of just these two factors are enough to make anyone’s head spin and really reconsider the decision to take on shift-work.

In my own personal experience, I’ve noticed the encroachment of some low-grade problems that could have easily gotten out of hand had I not corrected course. These include:

• Morning crash (which I’ll explain why it is counter-productive from the perspective of my protocol)

• Irritability

• Weight gain

• Poor sleep

• Sweating and faster heart rate at night (in part due to adrenaline, adenosine cycling, and stress hormones)

• Feeling cold and low energy (Thyroid dysfunction)

To me, these are not just standard or acceptable effects of shift-work. These are indicators that I’m doing something wrong, and need to course-correct.

But in the last few months, if my protocol is executed as intended:

• No morning crash

• No irritability

• I’ve been losing weight and waist has shrunk

• I sleep much better and feel rested before my shifts

• Haven’t had any sweating or racing heart during my shifts

Sometimes, I don’t even drink caffeinated beverages throughout the shift.

This very article is being written about 14 hours after I woke up for my last shift! With less caffeine in my body than what I would drink during a normal day.

Without a doubt one of the hardest things about doing night-shift work is transitioning from day to night, and then going back from night to day. I figured out the latter pretty quickly, but the former took me some more experimentation to figure out.

My Night Shift Protocol

Alright, without further ado…let’s get into the details.

I’m going to organize this chronologically, starting from the day before my night shifts begin, and ending with the morning after my last night-shift.

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