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.

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

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. Look at who she is.

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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

Read more

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.

Read more

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.

Read more

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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Recently, I was asked to provide our newly graduating trainees with a lecture on job-selection. Most of the time, lectures on this topic concern themselves with:

• Academic vs Private Practice

• Salary + Benefits

• Vacation Time

Of course, this is in the context of medicine…but many of these considerations translate to other industries. Just replace Academic with “public” and Private Practice with “corporate.”

Regardless of where any of us choose to work, if there is an HR department…we will be inundated with information about burnout and techniques that can be used to mitigate it.

Often times, these techniques involve things that are to be done outside of work.

• Meditative practices

• Social connection

• Time away from work

Don’t get me wrong, these things are incredibly important.

In some industries, they’ve even tried a combination of reducing work hours or increasing pay.

Unfortunately, this has not been very successful. Burnout continues to be a leading cause of attrition in the workplace. Most recent statistics suggest that even radiologists (previously one of the most satisfying specialties in medicine) have a 50% chance of leaving their current job within a 2-year span.

On the face of it, this article is about burnout at work.

But on a deeper level, this is about blowing the fuse in your head - both physiologically and psychologically. In fact, the term burn-out is quite appropriate here…as is the idea of a blown out fuse.

There is another visual that we can keep in mind whilst we discuss the cause and nature of burnout.

Rising load → Compensatory mechanism → Instability → Crash.

Let’s use a couple of common experiences to illustrate.

Have you ever run a graphic-intensive software on a computer? At first it seems like the rendering is going fine, but at some point…things start getting choppy, pixels glitch out here and there. Until eventually…the computer crashes.

Or…you ever found your internet browser has 100+ tabs, and you opened that insanely large spreadsheet from work…only to find that your system is becoming less responsive? All that memory and processing bandwidth has been clogged up. The computer tries to compensate…heats up…and…crashes.

I think you get the picture. But, there is something deeper in these examples that hauntingly echoes what happens to humans under stress.

I emphasize ‘stress’ because often it’s understood from 2 seemingly distinct perspectives. Either physiologic stress (e.g. adrenaline, stress hormones) or psychologic stress (the subjective experience of being ‘stressed’).

What the above examples should hint at…is that there is a direct connection between these phenomenon.

Broadly speaking, depending on how you run your software…you can burn out your hardware.

Before we get into how this manifests, it’s important to understand a few basic concepts about routing and transformation of energy.

First, all of life is the movement and transformation of energy. This energy is used to order the material of our organs and bodies. It’s used to carry out the functions of our body parts. And it’s used to perform the actions or outcomes we desire.

Second, the movement of energy is optimal when it occurs in pulses synchronized to its use and eventual loss. That is to say, if you pump too much electricity through a circuit into a light bulb…the filament can overheat and break. The input was not matched to use and output.

Since energy can neither be created nor destroyed, this synchrony is of great importance.

Finally, we need to avoid recursive traps of energy expenditure for two reasons:

1. We will eventually starve other parts of the system from the energy input.

2. We will overwork the upstream input mechanism.

For example, if I run a bitcoin-mining algorithm or heavy 3D rendering software…I cannot use my computer for any other function. At least not without getting annoyed. Furthermore, if this process runs for too long (and without appropriate cooling off) the computer will crash…and maybe even the hardware will burn out completely. Like a blown fuse.

Let’s take this back to the burnt out human to understand how and why burnout manifests, what it signifies, and how we can hope to prevent it.

Humans In Action

Let’s continue this discussion with the industry I’m most familiar with - medicine.

There are several trends in the medical field that are worth considering, at least in the USA.

For instance, there has been decades long trend of reducing reimbursements for medical services rendered. It’s only a few percent per year, but even across a short 10-year career…that’s a lot. For instance, a 3% reduction per year results in a net loss of 15% by year 10. This loss is also amplified by annual inflation and increased costs of goods/services. But, this article isn’t about finance.

This is one pressure on the job market.

Another pressure on the market is increasing rates of chronic disease and dependence on healthcare services.

Yet another is increasing use of technologies which depersonalize the human interaction (e.g. electronic health records, tele-medicine), and attempt to automate/scale an industry that is inherently unscalable.

What are we left with?

Doctors who:

• Are pressured to make more money to stay still in life

• See more patients because of the above and market demand for healthcare services

• Less-and-less human interaction

Both the increased workload and decreased human interaction are really important.

When workload goes up a few things happen:

1. Doctors spend less time with a patient → less likely to figure out the real problem → even less likely to affect the appropriate change needed to heal

2. This increased likelihood to make an error hangs in their mind for days and weeks to follow

   • “What if I made a mistake? What if I missed something? I hope the patient didn’t get worse…or hurt.”

When human interaction goes down, the doctor also gets hurt.

Whether you are a primary care doctor or someone more introverted (like a radiologist or pathologist)…what is most predictive of work satisfaction?

Meaningful interactions with colleagues and patients. Direct feedback reinforcing the notion that you played a positive role in someone’s life today.

This is simultaneously a reward and a moment to relax - cool off.

Your work has made a positive impact. It has been felt. You can take a moment to breathe it in.

I think you can start to see the picture we are painting.

Recursive Pattern

Remember the analogy with recursive and high-demand software burdening the hardware to failure?

It’s important to understand just how energy demanding the brain is. At approximately 2% of body weight the brain consumes about 20% of available oxygen and requires a similar amount of blood perfusion.

The synaptic transmissions between the nodes of the brain are very energy intensive. It’s not just the autonomic biologic drive to survive and process information which consumes energy.

The landscape of conscious imagery, thoughts, fears, and emotions also drive up energy demands.

Now, imagine you are constantly thinking about:

1. How little time you have for your family

2. How little time you have to take care of yourself

3. Whether or not you missed something with last the patient you saw, because you were rushed.

4. What about the patient before them? And so on?

5. Did you spend all this time and money on education and training so you can satisfy the absurd demands of administrators?

These psychological phenomena and imagery (software) are running recursively in your head (hardware), constantly depleting you of precious energy and bandwidth.

You start losing sleep.

Getting irritable.

Making even more mistakes.

(You are starting to glitch).

And, eventually…you crash.

Welcome to burnout.

Your fuse has blown.

Unfortunately, humans are not a fuse box. You cannot simply replace a blown fuse and continue like everything is ok.

Even the humanoid robots in Westworld had remnants of their traumas haunt them with each new system reset.

Preventing Burnout

Preventing burnout isn’t that complicated.

The problem is that the answer is contradictory to the demands of our employers. Which is why you are constantly being bombarded by HR about the ultimately unsuccessful strategies they recommend.

The solution requires us to approach one of the 4 Pillars of Health: meaning.

Remember, the factor which doctors value most in their jobs?

Meaningful interactions with their colleagues and patients.

Meaning. Depth. Significance.

Not case volume. Not how they got paid.

It is long overdue to tend to the garden of our Souls.

A person’s dynamic with their workplace and employer will be unique to them.

But the common thread is they need to put the value of their soul, and the meaning of their work above all else.

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This may be the perfect opportunity to plug my last interview in which we discuss this very topic: Tending to the Garden of the Soul.

Background

If you are active in the health space, atherosclerosis is the talk of the town. Rightfully so.

How it comes about…and, indeed the downstream consequences is up for debate. But, one thing is for certain. Where there is chronic illness, there is almost always…atherosclerosis.

Like most aspects of the human body, atherosclerosis is also misunderstood.

First, some definitions.

• Atherosclerosis is a subset of arterio-sclerosis.

• Arterio-sclerosis simply means stiffening of the arteries.

• Athero- is Greek for “gruel” or “paste” and refers to “fatty plaque”

Thus, atherosclerosis is the stiffening of arteries in the presence of “fatty plaque” otherwise known as an atheroma.

There are some things you should understand about the terminology used that is already misleading.

First, atherosclerosis is not a disease in itself. Similar to hypertension, atherosclerosis is a consequence.

But, here’s the real kicker. Atherosclerotic plaques (atheromas), are almost entirely blood products, not fat. Not cholesterol. Not lipids.

I know what you are thinking, the above image from the Cleveland Clinic shows atherosclerosis as slow growing fat-deposition, which eventually gets clogged by a small blood clot.

Incorrect.

This is part of the marketing (so to speak), to get both the public and physicians to buy into the framework that athero-sclerosis is the result of fat deposition.

Even a simple Google or PubMed search will reveal the following about atheromas.

• The primary component of these plaque is “fibrous” tissue, ranging from 50-87% depending on the plaque that is sampled

• “Fibrous” tissue is yet another term that can be confusing

  • Fundamentally, this refers to breakdown and long-term clot evolution of blood products

  • In fact, the consequences of hemorrhage account for about 30-35% of the plaque’s volume

• Another 1-15% of plaques are calcium/minerals

• 1-5% are inflammatory cells (yes, there is inflammation here…and we will soon reveal why that is important)

• the Lipid (or fatty) core can range from 5-20% depending on plaque stability - another important concept

  • Furthermore, a lot of the lipids come from broken down cells (20 - 40%)

How much is left to be accounted for by circulating lipids? Very little.

An unstable lesion is one that is actively and rapidly changing. These are usually seen in patients with extremely poor metabolic health, very high inflammatory stress, and very poor vascular health overall.

Thus, it is no surprise that lipid content is higher in this population…as the body is vigorously trying to heal the damage being done to the blood vessel.

The Modern Discourse

If you keep up with the work of the most verbose and public figures in the realm of cardiovascular disease and “lipidology,” you will find a couple of common themes.

First, for these figures it is a bygone conclusion that elevated cholesterol (e.g. LDL, ApoB, or lipoprotein A) is the causative agent of atherosclerosis.

That is to say, it is the necessary and sufficient factor to cause atherosclerotic narrowing of blood vessels.

Every new development in the field of cardiology and lipidology is finding a new canary to blame the plaque on. First it cholesterol, then it was LDL cholesterol, now its ApoB (a part of the LDL cholesterol particle) and Lipoprotein(a) (intrinsically tied to ApoB).

Until you ask some simple questions:

Then, behold as the explanations commence.

The explanations which underscore the truth: that atherosclerotic plaques are not caused by cholesterol or any constituent thereof.

These two facts should slowly but surely shake your confidence in the cholesterol hypothesis:

1. Atheromas are by and large composed of breakdown products of the blood, not fat.

2. Atheromas do not form in veins.

Now we can start answering the question: what is causing atherosclerosis?

A Little History

The idea that dietary fat and blood cholesterol causes atherosclerosis is almost 100 years old now. Starting with the fraudulent work of Ancel Keys, the focus on inflammatory stress shifted toward dietary fats. The basic premise that if you eat saturated fats (like butter, lard, and animal meat) you would increase your chances of atherosclerotic heart disease.

Eventually, even the American Heart Association realized that dietary fat intake does not correlate with blood cholesterol levels.

People could now eat more than 1 egg per day. Hurray!

Then, the focus shifted toward blood cholesterol panels and serum cholesterol profiles. Including things like triglycerides, LDL, and HDL cholesterol.

LDL became the new boogieman. This paved the way for a new class of drugs called HMG-CoA reductase inhibitors - AKA, Statins.

If you don’t know why Statins suck, you can find out here:

Then, as more pointless and circular research was done…people started to realize a few things

1. LDL levels do not predict cardiac mortality as well as we’d like.

2. People who live the longest tend to have the highest cholesterol and LDL.

3. Contributors to atherosclerosis are far more varied than just blood cholesterol

4. Despite the public health and drug campaigns, more and more people still develop atherosclerotic heart disease…

The cholesterol levels of the oldest people on earth:

Invariably, the same old problem was repeatedly presenting itself as a thorn in the side of the a cholesterol hypothesis folk.

Inflammatory and biomechanical stress.

Thus, the formation of atheromas is a response to injury…aptly termd the “response-to-injury” hypothesis. The critics of this hypothesis will state that “there is no definitive evidence in vivo that endothelial injury or desquamation is necessary or sufficient for lesion formation.

In some ways, this statement is true.

In the presence of “injury,” without any blood products to lay down at the site of injury (to heal)…then no atheroma can form.

These critics will also point to evidence that atheromas can form in the absence of visible injury to the endothelium. They often mean tears, or ulcers, or “desquamation” which refers to loss of the lining of the vessel. Which is also true.

Because of these observations, they felt the need to introduce a new framework. Which is Lipid retention. That is…there are some low-grade, not consequentially definitive changes to the nature of the blood vessel…that increase permeability to lipids (and other blood products)…which allows lipids to move through the vessel lining…and maybe, sometimes form atheromas.

The term “leak” is used here. As if it’s purely by accident that the vessel is changing its conformation to allow fats and blood products to move through these walls, even in the absence of clear discontinuity (tear, ulcer, desquamation).

The ultimate explanatory framework they have come up with is the Response-to-Retention model. Their conclusion is:

“…subendothelial retention of atherogenic lipoproteins as the central pathogenic process in atherogenesis.”

In their conclusion they state:

“Although atherosclerosis is a complex and multifactorial process, we conclude that there exists a key pathogenic event, namely, lipoprotein retention, that is both necessary and sufficient to provoke lesion initiation in an otherwise-normal artery.”

To translate, they conclude that “retention” is both necessary and sufficient to explain the presence of an atheromatous lesion, in an “otherwise-normal” artery.

Retention leads to retention. Absolute genius.

What they don’t discuss in their article…as almost all articles on this topic that I have encountered is the following.

In all the in vivo studies they cite, they find that these lipid plaques form in 2 specific locations:

1. Only in arteries.

2. In specific locations in the artery.

Number 2 is where there is some sleight-of-hand used to obscure the truth.

All these studies discussing the Response-to-Retention model cite the work of Schwenke and Carew, who demonstrated the following:

• accumulation of atherogenic lipoproteins within the arterial wall is focally concentrated at certain sites

The field has since termed these sites atheroma “prone” and other locations where atheromas do not form they termed atheroma “resistant.”

That’s it. That’s how they brush this conundrum aside, and why most don’t notice.

This is the part nobody talks about.

If the rate of lipid entry into the prone vs resistant sites is the same…then how are the lipids the problem?

Do you see?

Lipids are needed by all cells of the body…at all times.

So if the same amount is moving into the atheroma prone and atheroma resistant locations…then, why is one retaining the lipid but not the other?

Clearly, the causative agent is not the lipoprotein itself.

The real question is: why is one site prone and one site resistant?

Ultimately, the answer lies in a combination of electrodynamics, circulatory stress, systemic inflammation, and Poiseuille’s Law.

The modifiable factors in this Law that are relevant to our physiology are:

1. Viscosity of blood

2. Change in pressure

3. Vessel diameter

Closely related to all three of these factors, especially viscosity are the contours of our circulatory system, and the charge separation between blood vessel wall and the viscous/non-newtownian blood contained within.

Digging Into The Real Factors

In the near future, I will be hosting a Seminar and Q&A on the nature of circulation, circulatory stress, and all of its consequences including blood pressure, brain aneurysms and atherosclerosis.

If you want the opportunity to partake in the Seminar, submit questions, or just watch segments of the Seminar, hit subscribe and you’ll be among the first to know!

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Key Topics:

• The dichotomy in healthcare: short appointments vs. emergency demands

• Managing nervous system dysregulation after intense shifts

• Practices for recovery and maintaining emotional resilience, including breathwork and boundaries

• The importance of spiritual hygiene to metabolize stress

• The role of purpose and meaning in sustaining healthcare providers

• How to set effective personal boundaries to preserve vitality

• The impact of societal and systemic influences on medical practice and ego

• The dangers of over-reliance on pharmaceuticals and peptides as shortcuts

• The importance of understanding oneself to foster health and happiness

• The cultural shift needed for medicine to serve with compassion and humility

Timestamps:

02:26 - The focus on human connection and personal transformation in healthcare
06:23 - The systemic limits of time in primary care vs. emergency rooms
09:20 - Internal nervous system regulation and spiritual hygiene practices
12:00 - Developing awareness through breath and behavioral tools
15:26 - The garden analogy: tending to different aspects of the self
16:51 - The importance of recognizing and nurturing the soul in health
22:34 - Societal influences, information overload, and seeking truth
29:24 - The impact of systemic and industry incentives on healthcare practice
33:47 - Conspiracy, trust, and the power of collective intention
43:05 - The systemic issues around medical training, ego, and professional identity
49:58 - The risks of pharmaceuticals, peptides, and short cuts in health
66:30 - Balancing modern medicine with foundational lifestyle and spiritual principles
74:38 - The significance of personal sovereignty and understanding one’s true self
78:43 - Embracing the universe within and the importance of self-compassion

Connect with Kaveh:

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This episode underscores the importance of integrating self-awareness, spiritual hygiene, and a grounded purpose into healthcare to foster resilience and genuine healing—for ourselves and our patients.

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UPDATE:

As our paid-supporters know, we have published our first episode of the Foundational Health podcast. Now, it is also available in audio form on podcast platforms like Spotify.

On the morning of March 21st, the full video will be available for everyone to watch on our Youtube Channel.

Background

Ever since encountering the work of Jack Kruse, I’ve been enamored by the relationship between light and life. It’s not simply the contrarian in me gravitating towards another perspective which runs counter to medical dogma.

No.

There’s something about the Sun that I’ve always had a positive relationship with. That is until I started listening to the mainstream and avoiding it.

When I was young, I would be outdoors as much as possible. Under the Sun, playing any and all sports…until it set. Never encountered a problem. That is until our family fell victim to mainstream dogma.

Like most families in the developed West, we started using sunscreen. As I got older, it became “cool” to wear sunglasses. That’s when things took an unpleasant turn.

I started getting sunburns. My eyes were more sensitive to sunlight.

But, ever since I encountered Jack Kruse’ work…my relationship with the Sun was renewed. I realized it isn’t something to fear. If anything, to embrace. Ever since this renewal, I have been sunscreen and sunglass free for over 4 years. No sunburns.

Deeper Than Skin

As I dug deeper into Kruse’ work, I learned that the Sun plays a much larger role than simply regulating sleep and tanning our skin.

As Kruse likes to state, light is more important than diet.

Many, including myself, not only found this hard to believe…but, I suspect do not fully grasp what he is trying to say.

Recently, I picked up a copy of Roeland Van Wijk’s latest book:

In this book, Van Wijk reviews some of the earlier work on the role of photons (more accurately than light) in effecting and regulating metabolic functions. After digging into the basics of the biophysics, I think I have a decent grasp of what Kruse is trying to convey.

That’s what I want to share with you.

From the Basics

I’m talking really basic.

‘What is life?’ basic.

Life is the process by which energy is harvested and transformed to create order from the chaotic potential of the world around us. This is true of plants, single-celled organisms, and humans.

Further, living beings have the ability to harvest and transform energy at will. Not necessarily by conscious will, but by physiologic need.

This is a really important point to consider, because according to the Law of Conservation of Energy…energy cannot be created nor destroyed.

It can only be transformed.

When we talk about health in the modern era, we often talk about things like

• Metabolic syndrome

• Oxidative stress

• Insulin resistance

Essentially, chronic illnesses which are a manifestation of inefficient/ineffective energy flow and transformation.

So the question is…where does all terrestrial energy ultimately come from?

Turns out, this is a bit of complicated question.

On the one hand, all mammalian life ultimately comes from the consumption of plants. Whether you consider the cow grazing on the field, or the wolf eating that cow.

On the other hand, we need to consider all of the metabolic processes that occur in the plant, the cow, as well as the wolf.

For the plant, our dogma already has the answer baked in. Plants undergo photo-synthesis, to make the “foods” (aka energy stores) they need to live and grow.

But, what about the cow and wolf?

What is Food?

Foods, at minimum, have a dual purpose.

1. Foods are a store of energy - think sugars, fats (and even proteins).

2. Foods provide the building blocks of our tissue - lipids/fats, proteins, and amino acids.

It’s not just food that has stored energy. Our own body has stored energy, in the form of complex macromolecules.

So foods are a store of energy, right? Problem solved.

Not so fast.

I give you an orange, packed with energy. Can you just spontaneously assimilate this into your body and use its energy stores?

No. It needs to be transformed. This requires energy.

However, using that explanation to explain the primacy of photonic energy would not only be “cheating,” but it would be incorrect.

Every metabolic reaction requires an interaction between substrates (ingredients) to make something new (product)…with a shift in energy. Either energy is put into this reaction, or energy comes out of this reaction. Often, both happens…with a net shift of energy from one side of the reaction to the other.

Biochemical reactions depend on the ability of electrons to be exchanged between molecules, or used in the creation or destruction of bonds between the ingredients and products.

This is where we enter some basic quantum physiology.

If all life is the ability to harvest and transform energy…then, we must necessarily focus on the fate of energy flow…or electron flow. Because, it is the movement of these electrons which allow for chemical bonds to be formed and destroyed.

Everything from vision, to nerve conduction, to ATP generation by the mitochondria using the electron transport chain. It’s right there in the name. Whether you want to think of it as electron flow, energy flow, or current…it’s all really the same.

The importance is in realizing that a healthy and robust metabolism is one in which energy is transformed, used, and stored with optimal efficiency.

Once you take this perspective on life and energy…you can start to see proteins (the molecules encoded by our genome) in a new light. That proteins are semi-conductors.

Conductors allow energy (electrons) to flow freely through the material, such as a copper wire.

Semi-conductors (like Silicon) introduce an “energy gap” that needs to be bridged before the electron can move from the static (non-conductive) band to the conductive band.

Thus, semi-conductors enable the selective movement of electrons in a tissue/material. Depending on the purpose of the reaction (and protein), the energy-gap that the electron needs to cross varies.

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That is to say, the excitation energy the electron needs to jump from the non-conductive state to the conductive state, is specific to the protein/enzyme involved in the biochemical reaction.

The great insight about proteins in the last couple of decades is that proteins (perfectly encapsulated in the function of enzymes) are semi-conductors.

As such, every protein has a specific band gap that needs to be bridged. This bridging occurs by the excitation of the electrons in the corresponding molecules/atoms involved in the reactions.

Thus, it isn’t enough that I give you an orange.

I need to give you electromagnetic packets of energy - AKA photons, to activate the electrons in the relevant proteins involved in the digestion, harvest, transformation, and storage of energy from that orange.

Once You See It…

Once you grasp the importance and relationship between photonics and electrophysiology, you will appreciate its role in metabolism.

Everything from receptors on your skin, under your skin…in the fat below your skin, in your retina….in your bloodstream…in your mitochondria…it is all photon-dependent.

Here is a list you can use to guide your research:

1. Flavoproteins (FAD/FMN-containing enzymes)

• Example: Cryptochrome

• Blue-light absorbers (~450 nm)

• Central to redox metabolism (NADH/FADH₂ handling)

• Light → circadian gene expression + mitochondrial signaling

2. Cytochromes (heme-based ETC proteins)

• Example: Cytochrome c oxidase

• Absorb red/NIR light (600–1000 nm)

• Directly modulate electron transport and ATP production

• Photon input can displace nitric oxide → increase respiration

3. Opsins (retinal-binding GPCRs)

• Example: Melanopsin

• Use vitamin A–derived retinal as chromophore

• Convert photons → GPCR signaling cascades

• Regulate circadian rhythm, hormones, and possibly peripheral metabolism (skin, fat)

4. Heme-containing enzymes (beyond ETC)

• Example: Catalase

• Heme absorbs visible light → alters redox state

• Involved in ROS handling and oxidative stress

• Light can shift peroxide metabolism

5. Nitric oxide–associated proteins

• Example: Nitric oxide synthase

• Not directly photoactivated, but light liberates NO from heme sites

• Couples photons → vasodilation + mitochondrial efficiency

• Acts as a bridge between light exposure and perfusion

6. DNA repair photoproteins

• Example: Photolyase

• Use light energy to reverse UV-induced DNA damage

• More prominent in non-mammals, but conceptually key

• Tie light → genomic stability → downstream metabolic integrity

7. Ion channels with photomodulation (indirect in humans)

• Example: Channelrhodopsin

• Direct in microbes; indirect analogs in humans

• Light → ROS or chromophore effects → Ca²⁺ flux

• Ca²⁺ shifts strongly influence mitochondrial activity

8. Iron–sulfur cluster proteins

• Example: Aconitase

• Light-sensitive via Fe–S cluster oxidation

• Core to TCA cycle + electron flow

• Vulnerable to photon-induced redox perturbation

It’s Not Just the Proteins…

If that weren’t enough to punctuate the importance of photons in metabolism…we haven’t even talked about the biological molecules which are not proteins.

These molecules are equally as important as the proteins, and are also photon-dependent.

Broadly speaking, these molecules cluster into:

• Conjugated π-electron systems → absorb light (flavins, porphyrins, indoles)

• Isomerizable bonds → structural switching (retinoids, urocanic acid)

• Redox flexibility → electron transfer shifts (NADH, CoQ10, bilirubin)

• Highly unsaturated chains → electron mobility (DHA)

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Here is another list to whet your research appetite:

1. Retinal (retinoids)

• Photon → cis–trans isomerization

• Initiates neuroendocrine signaling cascades

• Drives circadian entrainment, hormonal rhythms, autonomic tone

2. Melatonin (tryptophan-derived)

• Light suppresses its synthesis (not direct activation, but tightly photon-coupled)

• Governs sleep, mitochondrial function, antioxidant status

• System-wide timing signal (“darkness hormone”)

3. Serotonin (tryptophan-derived)

• Light exposure increases synthesis (retina/brain axis)

• Regulates mood, gut motility, vascular tone

• Precursor pool for melatonin → links day ↔ night physiology

4. Nitric oxide

• Photolabile → released by UV/red light

• Rapid systemic effects: vasodilation, blood flow, mitochondrial respiration

• One of the fastest ways photons affect whole-body physiology

5. FAD / FMN

• Blue-light responsive redox cofactors

• Control electron flux through metabolism

• Systemic impact via mitochondrial output + ROS signaling

6. Coenzyme Q10

• Lipid-phase electron carrier

• Interfaces with photon-sensitive ETC components

• Influences ATP production across all tissues

7. NADH / NAD+

• Central redox currency

• Light shifts balance indirectly via upstream chromophores

• Governs metabolic rate, repair, and signaling (e.g., sirtuins)

Is Light More Important Than Food?

Look, food is obviously an important contributor to our tissue and health.

No question.

But, which is more important?

Think about your standard combustion-engine vehicle.

You can think of gasoline and engine oil as the foods of your car.

But…how are you going to drive that car without an ignition?

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As you may be able to tell, this is still a work in progress with respect to recording, editing, and preparation of the videos.

I’m looking forward to hearing all of your feedback, positive and negative. I’ve got a lot to learn about this medium and how to best approach it. So, please let me know in the comments below, private message, or by e-mail at rmdllc@proton.me

Full episode will be available for all to view on our Youtube Channel (@ Found-Health) in about a weeks time.

Dr. Ahmad Ammous is an internal medicine physician based in Boston, who is trying to escape his hospitalist job by taking his interests, discoveries, and non-mainstream treatment approaches to those who seek to truly improve their health without the use of prescription drugs.

I’ve known him for quite a number of years, and am grateful that he wanted to be the first guest on the new podcast.

We discussed Dr. Ammous’ journey through diet, quantum biology, and spirituality. We also touched on the problems with medical education, the broader contributions of society to the decline of medicine, and the role of AI in our own research.

Dr. Ammous can be found on X (@AmmousMD) and Instagram (@Ammous_MD), as well as on his website https://ammousmd.com/

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For those of you who have been with me since the beginning will recall that this publication started as a way to research and write about my findings during the covid hysteria.

For the newer readers, I haven’t written much about covid or viruses in years. The reasons are pretty straightforward.

• I don’t find covid relevant to helping people understand their body and health

• Virology is like a religion…maybe a cult is more appropriate

• Helping people cultivate a vibrant foundation of health is my goal

However, there is a debate that continues to this day…with opposing sides arguing over one another.

This debate is what I call the “No Virus” debate.

On one side of the argument there are people arguing that no viruses have ever been properly isolated, and therefore viruses as obligate parasitic infectious organisms do not exist…at least empirically.

On the other side, you have people straw-manning this argument and accusing the side of being crazy to suggest “viruses don’t exist.” This side tends to believe that “of course, viruses exist. What are you, crazy?”

As you may have intuited, these people are not arguing about the same thing.

In reality, they are both right.

It is true that the process by which viruses are “isolated” is full of holes, and does not hold up to scrutiny. However, this does not mean that viruses do not exist.

For example, there is no Hepatitis C virus out there, somewhere, waiting to infect you. "Hepatitis C” is the label we give a genetic transcription profile most commonly observed in people with chronic alcohol and drug abuse.

But, it came from within.

Can you “isolate” a computer virus? A psychologic virus?

All of these are simply packets of information, parceled and transmitted by different means via different mediums.

Does it mean these things do not exist? Of course not.

Many many months ago, I brought up this nuance and distinction to someone I respect greatly for his humility and courage, Dr. Mike Yeadon.

As I expected, he understood the distinction and agreed it is real. However, as he described it, that is not the battle he is in. He is debunking Virology, as an academic enterprise. Which is a totally valid perspective and argument.

I’m just not interested in that game, any longer.

I want to know how we can use this information to steward our minds and bodies through life in a healthy manner.

I’ll give you the punchline right now: viruses (and virality) exist, because genetic instructions exist.

But, are viruses parasitic or infectious organisms? No.

The real question is, WHAT ARE VIRUSES?

Let’s unpack the following:

1. Basics of cellular information storage and transmission

2. What is the definition of a Virus?

3. How are the #1 and #2 related?

4. The case of a simplest known ‘virus’

5. Clinical significance of viruses

Cellular Information

To understand viruses, we first have to understand how biologic information is stored, expressed and transported.

This is where knowledge of the “central dogma” of molecular biology is important.

You can think of DNA as a long-term biologic information storage system. DNA stores two types of information.

1. The code needed to produce proteins.

2. The code needed to produce various forms of RNA, which in and of themselves can have molecular consequences, without needing to be translated into proteins.

However, the environment of the nucleus, cytoplasm and extra-cellular space is so chaotic and volatile that simple nucleic acid strings (DNA and RNA) cannot exist without some sort of vehicle, or protection.

Thus, cellular life needs a mechanism that protects and accompanies RNA strands until they meet their end-use (either translation into proteins, or interaction with its final target).

Below, we see one such mechanism by which this occurs. In this image, we can see little bubbles (vesicles) which shuttle biologic matter (including RNA) from the Nucleus to other organelles, and out into the extra-cellular space.

Notice the shape and structure of these vesicles. Do they remind you of anything? Below is a diagram of a virus. This virus has a genetic code at the core (RNA or DNA) and is surrounded by some combination of lipid/protein capsules/envelopes. The nature of the “capsomer” and envelope vary from virus to virus. Some have one layer of protection. Some have two. And all manner of combinations.

This is a critical point to understand. But, before we dig a little deeper into this relationship, let’s clear up a few things.

First of all, viruses are not organisms.

Viruses do not autonomously reproduce, grow, and do not have a metabolism. Therefore, viruses are not organisms.

If they are not organisms, then the rest of the commonly used words when discussing viruses are mostly null and void. For instance, viruses are not parasites. Parasites are living organisms.

A virus has two fundamental components:

1. Genetic code.

2. A transport vehicle.

That is it.

The discovery of the simplest virus (Narnaviridae) is very helpful for our discussion. For our purpose, we will stick with one genera of narnavirus found in Saccharomyces cerevisiae.

S. Cerevisiae (SCN23 or 20S) is the simplest RNA virus and it only encodes and RNA-dependent RNA polymerase. This is an enzyme which uses a string of RNA code to generate another string of RNA code. Essentially, a process by which an RNA code can be duplicated.

The authors of this chapter, however, rather liberally use the word ‘infection’ in the above description. Because, when you or I think of infection, we think of something from the outside contaminating the cell.

However, this is not how S. cerevisiae was discovered.

Pay really close attention to what is being said here. Commercial yeast strains were exposed to conditions of high stress. These yeast cells subsequently demonstrated aggregates of “cytoplasmic elements.”

Meaning, when yeast are placed in high stress conditions, they began expressing certain strings of genetic code (RNA). These “cytoplasmic elements” were then identified as 20S and 23S RNA strands, and used to give the “virus” it’s correspond names: SCNV23S or SCNV20S, i.e. S. Cerevisiae Narnavirus 23S.

Do you see the sleight-of-hand here?

The experiments induce the yeast to produce unnatural quantities of a string of genetic code, because of unnatural conditions…and then called the result of this…a virus.

They aren’t wrong, technically. But, this depends on the framework.

If your framework is that “viruses are pathologic parasitic infectious agents,” then this is stupid.

But, if you use the framework that viruses are simply packets of genetic instructions…then, it works. Because, that is what they are.

This case of the simplest RNA virus is, in my opinion, a canonical demonstration of a) what viruses are, and b) how they are discovered and labeled.

I guess what I’m trying to get across here is just how banal it is that something is called a virus. You may as well just call them genes, or gene fragments.

But, we don’t. Because often times a viral particle contains more than one gene or fragments.

Once you realize that this is what viruses truly are, it becomes much easier to understand how biologic viruses are very similar to viruses of other mediums (e.g. computer or “mind” viruses).

Furthermore, you also start to realize how futile efforts to vaccinate against viruses are. Because…well…how do you vaccinate against information?

Why do you think people who receive polio vaccines develop paralysis?

Or, those who receive a flu shot get the flu?

Or, those who get shingles from the shingles vaccine?

Because the vaccines contain the instructions!

This is why viral vaccines have proven to be such astounding failures, decade after decade, and billions after billions spent on their development.

Clinical Relevance

Circling back to why all this matters.

How does this knowledge and understanding of viruses help us make informed decisions about our health? When should we be concerned about viruses?

To a large extent, viruses matter because they activate exaggerated or novel response mechanisms. All life has co-existed with viruses since the beginning of time. This is why a large proportion of our DNA are viral gene fragments.

So, what are we to do about viruses?

We must have a robust health, for several reasons.

1. It’s good to be in good health, duh.

2. When we encounter a novel virus, our bodies know how to process this new information without overloading ourselves.

3. We feel confident in exploring and encountering new conditions in our environment, so that we can continue to update our repository of viral information.

Thus, the solution is not to live in a bubble, sterilize every surface, and receive every injection manufactured by Big Pharma. This is a surefire way to get sick.

The solution is building a robust foundation of health.

Foundational Health is where it all starts.

As a final remark, I’m sure some of you are scrambling to let me know that viruses cause cancer.

No, viruses don’t cause cancer.

Just like the yeast that were under high stress…and started focusing on pumping out 1 gene over and over (in oncology terms this is analogous to a monoclonal expansion)…it’s the environment.

If your environment is stressing you to the point that your genetic machinery is singularly focused on making one thing, and replicating/replenishing in one direction. You develop cancer.

But, the response to the stress is not the proximate cause of the cancer.

Background

In our modern industrialized world, thyroid dysfunction is one of the most common health problems. Far more than “data” suggests.

Data can only reflect people who have been diagnosed with thyroid dysfunction. What about people who are not diagnosed? What about people who cannot be diagnosed by standard testing.

What do I mean?

Let’s take low thyroid function (hypothyroidism) as an example. The vast majority of diagnosed hypothyroidism is clinched with a panel of tests looking at various thyroid related molecules, primarily Thyroid-stimulating hormone (TSH) and Free T4 (a thyroid hormone).

Thyroid Panel Normal Range

TSH: 0.4 - 4.5 mIU/L

Free T4: 0.8 - 1.8 ng/dL

In reality, these tests can be useful for overt cases of hypothyroidism.

Then, there is subclinical hypothyroidism. Which is diagnosed with a High TSH but normal Free T4.

Now, what about people with one or a few symptoms of hypothyroidism, but normal lab results? This would require the work of an astute physician who truly understands thyroid function.

But, let’s say you’ve accurately diagnosed low thyroid function.

In the person with abnormal lab tests, the treatment approach seems straightforward…right?

Treatment will be guided by normalizing lab tests. Often, TSH is what is used to guide treatment.

But, what value should you target? A TSH closer to 0.4? 4.5? Right down the middle?

To add more complexity to the situation, what do you target if your lab test are normal?

Understanding the Thyroid Gland

The standard education states that the thyroid is a hormone-secreting gland in the neck, whose function is to regulate the body’s metabolic rate, heart rate, temperature, and overall energy levels.

To carry out its role, the thyroid needs many things not limited to:

• Tyrosine (amino acid)

• Iodine

• Selenium

• Zinc

• Sunlight

That last one is really important.

This article is not about specific treatment of low thyroid function. This article is about temperament and its relationship to both thyroid function as well as using it as a guide for thyroid treatment.

Granted, there are other ways to guide treatment of hypothyroidism. Chief amongst them will be alleviation of symptoms, and a normal heart rate and body temperature.

Infamous endocrinologist and thyroid specialist Broda Barnes makes a strong case for using heart rate and body temperature as a way to guide treatment. They do not recommend using lab tests. The reasons are plentiful. First, these lab tests do not reflect what we believe.

Second, there is no “correct” lab value…since there is a broad range. Ranges of data are great for population analysis, but we are talking about treating a particular person.

Of course, you can get quite far using Barnes’ recommendation - using heart rate and body temperature.

But, this approach misses an important distinction.

If your particular temperament is cold (or hot)…what do you do?

What do I mean by this?

Let’s dig in.

Temperament and the Thyroid

In Unani medicine, temperament is fundamental quality of all things. Including a person, their organs, and even the food they eat.

Temperament is a dynamic balance of two fundamental qualities of all things: heat and moisture. That is, things can tend towards being hot (or cold) and wet (or dry). It gets a bit more complicated than that, with degrees and divisions of various qualities But, this is the basic concept.

As you may have intuited, the thyroid is temperamentally hot. This is its balanced temperament. Similarly, when thyroid function gets weaker, the gland is said to be deranged towards a cold dystemperament.

These are both corroborated by our modern understanding of thyroid, as one that increases energy output, and literal body temperature when functioning normally…and getting colder when its function goes down.

This is why thyroid function is the perfect vehicle by which to understand the importance and role of temperament.

Hypothyroidism is described to be a cold dystemperament. A phlegmatic temperament is one that is cold and moist. Which tracks perfectly with common clinical features of hypothyroidism:

• cold intolerance

• Weight gain

• sluggishness

• Swelling/edema

• excess phlegm

Now, we need to explore the most important consequence of this understanding of thyroid function.

If a person has a cold (or hot) temperament at their normal baseline…how does this guide treatment of thyroid function?

If you don’t want to rely on ancient top-down understanding of physiology…there are some modern studies which shed light on this interaction, and ultimately can guide treatment.

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In recent weeks, there’s been a lot going on in our personal lives and I’ve felt the squeeze on all the things I’m trying to accomplish.

• New baby

• Home renovations and construction projects

• Research and writing for Foundational Health

• Hosting and tending to extended family

• Serving my local hospital

I’d like to think I have these things handled, but one of the first signs that I’m spread too thin is when my body begins to pay the price. One of the benefits of caring for your health is that you also reset the homeostatic barometer which tells you when things are going wrong.

A sore joint. A headache. A runny nose.

All of these are signs. My body is telling me something.

It’s telling me I need to re-prioritize my time, at least for the moment. Which reminded me of another time I had to re-prioritize, but not for the moment…for the rest of my career.

Before the covid episode, I was on a career path that looked very different to today. One in which I would commit more of my time, resources and effort to the industry of academic medicine.

Mercifully, covid happened…and woke me up to the mistake I was about to make. The commitment I was about to embark on. A commitment to an industry that has little regard for both its practitioners and its ‘customers,’ so to speak - the patient.

That’s when I started this Substack. To focus my time, research and continued education on material that really moves the needle in people’s lives and their health. Material based on a framework that really understands the nature of being, and how and why disease manifests. Heck, even what disease is.

This shift in my focus had to be accompanied by a desire to move away from all the corrupt practices of my profession. To stop giving the institution more of my time. To be involved in cases I truly believed will help a patient.

People often say modern medicine is terrible when it comes to chronic disease, but excels at acute and surgical care. To some extent that is true, those are definitely where its strengths lie, if indeed these are traits unique to modern medicine. We won’t argue about that here.

But, this means that if I want to have a conscience while still working in this industry…then I had to shift my focus towards practices which do indeed have a positive impact in peoples lives. Or, at least with the potential to do so.

Enter the emergency department.

In a hospital, the ED isn’t only the ED. The acutely ill and trauma patients which come through the ED are also served by trauma surgeons and critical care specialists.

So, I figured…that’s who I will help. Those patients and those clinicians.

Now, granted…not every patient that walks into the ED and gets some imaging needs my help. There are a lot of wasteful practices, for sure. But, that’s beyond the point.

In the ED, the cases which have the potential for positive impact are far more frequent than in any other clinical setting.

Especially cases in which you can make a real difference in a person’s life, right now. I’m talking about the kind of cases where nobody else but the radiologist can know something of critical importance.

Let me explain what I mean.

This story is from the time that I was a trainee (resident) in a busy NYC hospital. I was on call…and the only radiologist in the hospital. An elderly lady came into the ED with vague abdominal pain. The doctor ordered a CT scan of their abdomen, and so I took a look.

I diagnosed an imminent closed loop obstruction.

What’s that? Glad you asked.

We have a very long small intestine (bowel) that is jumbled up onto itself in many loops.

For a myriad of reasons, most commonly from scarring, one of these loops of small bowel can twist around a neck. This point can serve as a “bottleneck” which prevents the movement of blood into and out of that loop of bowel, putting it at risk of ischemia and infarction. AKA dead bowel.

Because of this twisted loop orientation, and compromised blood supply, the loop can start swelling…and the swelling just makes the strangulation and risk of bowel death even worse.

If left untreated, this can lead to dead bowel…which even in the young and healthy can be fatal.

As I like to tell my trainees, even a monkey can identify a closed loop obstruction/dead bowel after it’s already happened. The way that a radiologist can make a difference is to help clinicians identify these anatomic orientations which are at risk of becoming full-blown closed loop obstructions.

What I saw that night in that elderly woman’s abdomen was not a “textbook” presentation of a closed loop obstruction. What I saw were bowels that were oriented in such a fashion that the swelling and bowel death was imminent…though nothing had happened yet.

So…that’s what I told the team taking care of the patient.

Shortly after, the on-call surgeon walked into my reading room and disagreed with my diagnosis.

“Those findings aren’t convincing. The patient seems fine clinically. Just some vague abdominal pain.”

I walked him through the images and made my cases a little more thoroughly.

He still disagreed…and demanded that an attending (faculty physician) provide a second opinion. Unfortunately, I was only a trainee at the time…and the only radiologist present. But, I knew an attending at a neighboring hospital, and asked him to come by.

Once he arrived, I didn’t tell him anything. He just turned to the surgeon and asked why the patient was here. Then, he started looking at the images himself.

“That’s a closed loop,” he says to the surgeon.

looks at me

What did you tell them?”

“Closed loop,” I said.

Next evening I come in for my night shift, and immediately open up the medical records to see what happened to this patient.

I see a note from that night around 4AM, the patient started feeling a bit worse, and immediately the surgeon realized I was right, and took her to the operating room.

By his report, there was scar tissue everywhere in her abdomen. Which, as a side note…we can’t see on imaging. We can only see the consequences of this scarring.

He found the closed loop I was talking about, and fixed it. There was no dead bowel…surgeon had gotten their in time. Patient went home a few days later.

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Although experiences like this are considered stressful and confrontational by many of my colleagues…it felt natural. More importantly, it set pieces in motion that I realized years later.

For those of you wondering what I do in my day-job…that is it. I help emergency teams identify and care for patients in dire circumstances. It’s fun, rewarding, and helps me sleep at night.

Even if our newborn doesn’t.

So, as much as I would like to spend all my time reading more ancient and medieval medical texts, writing, and experimenting with health protocols…I have a responsibility to some hospitals and their acutely ill.

As this digital business grows, one day I can do this full-time…and leave the modern medical industry entirely.

On that note, you may have noticed some changes to this website. I’ve received the final design package for the logo of Foundational Health. Hope you like the logo.

Things are slowly, but surely, moving in the right direction.

This holiday season has been a bit of a roller coaster for my family. With our third child expected to arrive in the middle of January, we purchased and moved into our first house a mid-December.

Moving in, unpacking, settling, and making the home comfortable for my wife was a time-sensitive matter. In large part because we were planning to deliver at home, with our midwife. This would be our second home birth.

I’m happy to report that the delivery went beautifully and smoothly, thank God.

But, leading up to this we were in an “all hands on deck” scenario. My parents flew in to help, and shortly thereafter so did my grandfather-in-law.

To provide a little context about grandpa, he is one of the most active and fit people I know, especially when you consider he’s pushing octogenarian status. His help would definitely be felt.

The only chronic and serious health concern I know about him, other than his gout, is his hypothyroid status.

A Little History

For as long as I’ve know grandpa, he has avoided red meat quite strictly and alcohol to a lesser extent. In large part to avoid a gout flare-up.

This is the standard recommendation. Avoid these triggers, and take something like colchicine to alleviate flareups.

One of the increasingly appreciated and understood contributors to gout is overconsumption of fructose. But, this starts to beg the question…what is gout?

Is it the red meat? Is it the uric acid? Maybe there’s something more to this story.

Fast-forward to this visit, and we see a somewhat different and more lax grandpa. He is consuming meat, drinking beer, and enjoying the holidays.

What changed?

He tells us that he has started a combination of a B-vitamin complex and morning caffeine. This, he claims, prevents his flare-ups.

Interesting.

One final component we need to consider here, before we build a broader understanding of gout, is that grandpa also has low thyroid function for which he has taken levothyroxine.

Before we dig in, let’s summarize the factors:

1. Diet and alcohol

2. Vitamins and Caffeine

3. Fructose

4. Hypothyroidism

5. Joint pain

At first glance, it’s very hard to unify all of these factors.

So, let’s get started.

A Krusian Perspective

During my many attempts to try and understand Gout, I stumbled upon a couple of articles written by Dr. Jack Kruse on this topic. For those of you familiar, he’s a very large proponent of Solar and Circadian health.

Personally, I find his work astounding and informative. In the past his writing has been very hard to penetrate, and his ego on podcasts difficult to stomach. But, he has been improving.

In any case, this is Kruse’s basic assertion about Gout:

Gout is a marker of impaired mitochondrial energy flow caused primarily by light deficiency, with uric acid rising as a downstream signal and nitric oxide (NO) being chronically inhibited.

Like many aspects of health and disease, Gout (which is commonly understood as a joint problem) is a symptom of a biochemical impairment which is marked by uric acid elevation.

From Kruse’s perspective, the pathway to gout looks like this:

Sunlight → energy flow → mitochondria → waste handling → repair

Without appropriate Solar signals (UV and infrared), the ability of your body to produce and move energy, recycle nitrogen waste, and repair the body becomes impaired.

High uric acid is a warning sign that these energy processing systems are not functioning properly.

Thus, all of the various things which contribute to elevation of uric acid (waste) without recycling of nitrogenous amino acids and compounds…can contribute to gout flare-ups.

This includes factors like:

1. Vitamin deficiency for recycling nitrogenous compounds

2. Fructose overconsumption (relative to sunlight exposure)

3. Purine and hypoxanthine rich foods

4. Factors which modulate xanthine oxidase (an enzyme).

Kruse’s core beliefs are in alignment with this model, including:

• All energy ultimately comes from the Sun

• Food is simply a secondary storage form of Sunlight

Nitric oxide is one of the core players in circulatory health, energy production, and redox balance. In the presence of high uric acid, we enter a low nitric oxide state.

Low nitric oxide → poor energy and poor tissue repair.

Why does fructose matter? It’s not simply that Fructose is producing uric acid.

In nature, fructose is most abundant in tropical fruits. Tropical fruits get a ton of sunlight. If you are consuming tropical fruit, you should typically be under the exposure of the Sunlight. However, if you consume tropical fruit (grandpa is from Colombia) without getting adequate sunlight (as in modernity and in cities)….well, that’s a mismatch that leads to metabolic trouble.

More Than Joint Disease

The natural question you should be asking is, if gout is really a manifestation of something so systemic, then why does everyone complain of joint disease?

Well, this is one of the few felt symptoms of gout.

In reality, gout has several systemic manifestations:

• Hypertension - can’t feel it.

• Atherosclerosis - can’t feel it.

• Chronic Kidney disease - can’t feel it.

• Insulin resistance - can’t feel it.

• Non-alcoholic Fatty liver - can’t feel it.

What can you feel?

• Joint pain

• Fatigue/Sleepiness

• Peripheral neuropathy

Now, if I think back to all of the people I know who have Gout…these association are confirmed. Other’s I know who have gout flare-ups have pretty bad metabolic disease, including insulin resistance, hypertension, and atherosclerosis.

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During This Visit

This visit was unlike others.

We’ve done a lot of work around the house, the yard, and the workshop. Grandpa has been helping as much as anyone else.

Everyone had some sort of soreness, pain or exhaustion from all the work we got done in a short period of time.

One day, grandpa told us his foot hurts. “It’s the gout.”

I thought to myself…are you sure?

I mean…my foot hurts too. So does my shoulder, my forearm, my hands…a lot of soreness. Why is this gout?

Maybe because he’s been consuming meat and imbibing during festivities, he thinks it must be the gout?

Then, it dawned on me.

B-vitamins…thyroid…overworking…exhaustion.

Kruse was right.

It is an energy problem.

Let me ask you, the reader, something.

Imagine you are healthy and fit. You decide to embark on extended period of strenuous activity, in the cold winter, with short periods of daylight. You keep doing it for weeks.

What is the first pain you expect to experience?

If you are like me, the answer to this will be obvious. Musculoskeletal…and most likely joints first.

These parts of our body are constantly in motion, under strain, requiring lubrication and clearance of waste/damaged tissue.

If we overload these processes, we get joint pain.

How B-Vitamins and Caffeine Help

Purines (which are nitrogen containing biological compounds) can either be recycled or degraded.

Uric acid rises when these purines are degraded.

To recycle purines, and prevent uric acid build-up, we need B vitamins, including B2, B3, B9/B12.

Furthermore, other B vitamins helps with inflammation, including B6 and B1.

Thus, a B-vitamin complex is precisely what a person with this energy dysregulation needs.

Caffeine also plays a role. Caffeine acts like a methylxanthine which binds to a mildly inhibits the activity of xanthine oxidase. Furthermore, caffeine is a natural diuretics, which promotes the clearance of nitrogens via urate in the urine.

This account fits perfectly into Kruse’s model. From his perspective, B-vitamins do not fix the problem, they improve metabolic efficiency when the light signal is weak. B-vitamins improve electron flow (via oxidative phosphorylation), improve recycling of NAD/FAD, and overall improve our redox balance.

In the absence of appropriate solar signals, the B-vitamins help minimize the consequences.

Even the caffeine fits into his model, but caffeine somewhat increase nitric oxide signaling (which the uric acid worsens).

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What About Thyroid Hormone?

From the energy balance perspective, this fits in perfectly.

Let’s take Kruse’s perspective here, to keep things consistent.

He would assert that metabolic rate of our body is not created by thyroid hormone. Instead, it is created by sunlight. Thyroid hormone simply acts as the facilitator/conductor of this energy throughput.

So, when light signals are weaker, the thyroid will turn down its rate…adaptively.

Morning UV light lead to nitric oxide production/release. Infrared activated cytochrome C (a critical protein in production of ATP).

When these signals are missing…energy flux slows down. This leads to reduced demand on the thyroid gland.

As is the theme with most of medicine, low thyroid hormone production in this case is yet another symptom. Because of the impact of thyroid hormone on electron flow and energy coupling…since the light inputs are impaired, the body turns down thyroid hormone production to protect itself.

This state also feeds back into gout.

Low thyroid function → Slow ATP turnover → increased uric acid production.

This is the tradeoff. Uric acid production goes up to reduce oxidative stress.

This is why thyroid supplementation temporarily helps reduce gout flares. This is not without its risks. Without getting lost in the weeds of quantum electrodynamics…let’s put it this way.

You can’t crank up thyroid hormones without the appropriate light signals required to drive this higher metabolic state. If the underlying light deficiency is not addressed…

Solar light sets the ceiling on metabolic activity. Thyroid hormone modulates the throttle.

How Do We Fix This Problem?

We return to foundational health.

Step 1: Address morning UV light exposure.

• More exposed skin

• No Sunglasses

• Within an hour of waking up

Step 2: Near-infrared to mitochondria from any source

• Sunlight

• Fire

• Incandescent light bulbs

• Infrared panels

Step 3: Circadian Alignment

• Eat during daylight

• Sleep when its dark outside

• Avoid blue light at night

Step 4: Cold exposure

Step 5: Diet

• Eat during daylight

• Pair fructose consumption with sunlight exposure

• Avoid seed oils

  ---

Since sharing my initial Note regarding grandpa’s gout status, I got ton of feedback with many stories about how people fixed their gout.

Let me know how the above jives with your experiences in a comment below.

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Brief Update:

I’ve been a bit MIA recently, but wanted to share that 6 days ago we welcomed our first baby girl into the world. We had the birth at home in our bath. Everything went beautifully well.

I’ve written about our choice to go with a home birth in the past, and this was our second time.

Everything went even more smoothly this time.

Background

A couple of weeks ago I wrote about how we cured my mother’s “essential” hypertension using a combination of minerals, vitamins, and self-care routines.

Not only was the “treatment” (which I like to call caring for yourself) successful, but so too was the article. So, I think it’s worth approaching this from a whole new perspective.

One person who was pleased by my mom’s success was my father. He was very worried for his wife, with how high her blood pressure had gotten. Greater than 190/120 mmHg.

Dad asked me to help put together a supplement stack they could take home with them.

I showed him how to responsibly use ChatGPT, and think of it more like an extension of a Google search, but with more sophisticated language processing and working memory.

Now, I had never done this before myself.

I’ve only recently started using ChatGPT and other LLMs like Manus, to save time in finding the research I want to explore. It has been very helpful when used in this manner. So much so that I am now applying it to other aspects of life for which I have problems that need solving.

In this article, I will use my exchange with ChatGPT to convey two things:

1. Share the supplement stack, and how we went about selecting it.

2. Show how you can use ChatGPT responsibly and to your advantage.

At the end, I will share what I’m currently testing as a daily replenishment drink.

I’ll tell you the secret to #2 right now.

The biggest benefit of AI, ChatGPT or large language models (LLMs), is to save you time. Not exercise judgement or make decisions.

It’s not good at anything creative or spontaneous.

Imitation, on the other hand, it can do great.

You have to understand this about LLMs in general. This also applies to any Google search.

These tools save time.

With that in the record, let’s set up the premise of this supplement stack.

Rationale of Supplement Stack

First, we should clarify that the purpose of this stack is not to provide a source of everything we need. It is to fill dietary gaps.

Food first principle applies.

The difference between which micronutrients you will get from food vs a pill will vary by geography and budget.

The supplement stack I created for my family is based on context specific to my family. There are some things I know we get sufficiently from our diet. Certain fats, and its derived products. Other products that are stored in fat or protein.

I actually had a whole exchange with ChatGPT about this very point, and corrected its interpretation of this first prompt we used on this experiment:

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People love posting the ideal health transformation, the best “bio-hacking” strategy, or sharing the fruits of their own journey.

Perfect labs. Perfect abs.

Perfect skin.

Beautiful bowel movements.

You get the picture.

But, if you cannot afford some of these tests or “hacks” with time, money, or motivation…it can all start to seem a bit unattainable or discouraging.

The truth is we all stumble. We all have constraints on our lives that either make things more difficult or distract us from our goals.

Myself included.

I try to do a lot, and often wear myself out. My wife notices and will remind me that I need to take time for myself. She’s right.

Full-time hospital job. Part-time side-gig (this publication). Two boy toddlers. Third baby any day now. House work and renovations. Hunting and staying active. Plus all the other tedious things that populate our lives.

Today, I want to talk about all my health mistakes/oversight to help keep myself accountable.

1. Getting enough sleep.

People will tell you that you absolutely need to get 8 hours of sleep. Others will say 7 is enough. Some will say they can run on 4.

My belief is that the answer is more nuanced than that.

For example, the amount of sleep you need depends on your temperament (physiologic constitution). This has been known for thousands of years, and is reflected in several traditional medical arts.

From the Unani perspective, sleep is not simply a time to rest. Sleep is an essential pillar of health. During the day, the brain is ON. I mean, really on. Despite having 2% of body weight, it consumes 20% of total energy.

Unani teaches us that this activity generates heat, which makes things dry. During sleep, moist vapors (of the humors) rise to the brain and provide a cooling, moistening restorative effect.

Furthermore, Unani teaches us that the optimal sleep duration depends on your temperament.

Some days, I do not get enough sleep. I should be getting 7-8, but would be lucky to hit 7. Luckily, it’s very easy to remedy this and it’s something I actively try to consider when I’m burning the midnight oil. If I know what time I need to wake up the next day, I just go to bed earlier.

The benefit of staying active and busy (especially with 2 young boys), is that I can fall asleep whenever I decide to hit the bed.

2. Slowing down.

This may be a function of my temperament, or having been raised in a huge city…but I’m always trying to do something. The more productive and harder, the better.

Go, go, go.

One of the things I love about life in some European countries is the daily focus on slowing down, taking time to pause and reflect on life. Interact with neighbors. Let your mind and body walk slowly through the events of life.

This is one of the things I learned from my Uncle as well. Every day he takes long walks. He says it allows his mind to process information and problem solve, at its own pace, while he concerns himself with his steps.

Last night I was speaking with my wife. We have finally settled into our home. I said something along the lines of:

Look at all this. We have wonderful kids, a beautiful home, and the will and resources to achieve anything we like. And, as much as I like the grind and climbing the mountain…right now may be a good moment to stop and enjoy this plateau.

This isn’t just an opportunity to “rest,” whatever that means.

It’s an opportunity to be grateful, to savor, to debrief, to reflect and to re-orient.

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3. Stay hydrated.

Yes, I know. But, as you can probably tell from the above…I often forget about staying hydrated.

And I don’t just mean drinking water. I mean getting appropriate and adequate electrolytes. Magnesium, potassium, and sodium.

Not much more to it. Just remember to make the mix, keep it on hand, and drink.

4. Breathe and stretch.

Whether you want to unravel this from the perspective of modern science and vagus nerve activity, or from a traditional medical perspective…the answer is the same.

Stretch and joint strength improves mobility and posture.

Good posture + deep breathing exercises → optimized energy flow.

As every medical discipline knows (either explicitly or implicitly), stagnant or blocked energy flow is the basis of many diseases.

At this point, both you and I are starting to see a pattern with the mistakes I keep making.

Don’t let my wife see this, but I think she was right about Yoga.

5. Moisturize.

Don’t tell her about this one either.

This is another big for me. When I was young, I knew kids who would regularly use moisturizing creams. But, it never occurred to me. Not because it wasn’t practiced in my household…my parents had all sorts of skin creams in our home.

After learning about the pitfalls of modern skincare and makeup products, maybe it was for the best. However, that doesn’t mean there are not good moisturizing options on the market.

In my case, it’s particularly important for my hands and face. As someone who does a lot with their hands, they tend to get cuts and scrapes, and generally worn out.

On my face, I have recently developed something that apparently my father suffers from as well. A red hot patch of skin between my eyebrows. Looks fired up, and often dry.

I haven’t yet figured out what it is. People will tell me all sorts of things about it, often about how it’s some manifestation of disease.

But, I have a sneaking suspicion it has something to do with an energy center of my body.

The space between the eyebrows is the seat of the sixth energy center, the Ajna (or third eye) Chakra.

The Ajna chakra is associated with intuition, inner wisdom, clarity and spiritual insight. Furthermore, this patch of skin started getting fired up just as my life completely changed course.

A change that started with discarding the grip that modern academic medicine had on my life. When my wife and I both welcomed a new way of living centered on our family, values, and tradition.

It would be foolish to think that this is merely a coincidence. The moment I decide to live a more considered, spiritual and sovereign life…the energy center associated with these functions suddenly revs up.

With skin care we try to keep it simple.

For skin in general, we use a tallow-based balm/cream. We like the products from White Oak pastures, very affordable and consistent quality.

For the face, we add a copper-based serum and infrared light. Bonus points on wrinkles when you combine infrared light with green tea on the face.

What are some of the mistakes you’ve made that you want to avoid?