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

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

If you can attend live, awesome!

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

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

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

Live Q&As are available to paid subscribers only.

Additional benefits include access to the entire archive of almost 200 articles on health and disease, and early access to new podcast episodes.

Paid supporters can also recommend podcast guests for the show. You can do so in this chat thread:

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

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

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

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

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

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

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

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

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

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

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

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

• Work conditions

• Exercise regimen

• Stretching

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

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

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

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

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

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

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

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

But, this is a topic for another day.

Back to Basics

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

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

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

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

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

I digress.

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

Why am I bringing all this up?

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

• Inflammation

• Joint imbalance

• Dehydration (yes, joints and discs can dehydrate)

• Posture

Then, you develop some pain and discomfort.

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

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

They simply target their therapy to the “symptom.”

This is what happened to my friend.

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

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

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

One month after, he said:

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

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

Read more

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

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

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

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

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

Topics Covered

• How pregnant women and couples find physicians like Nathan Riley

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

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

• The type of intelligence medicine selects for

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

• Newton as alchemist, Paracelsus as philosopher

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

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

• Saying ‘I don’t know’ in medicine

• Doctors in the home birth space

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

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

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

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

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

Nathan can be found here:

Instagram

Substack

Website: www.bornfreemethod.com/

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

Read more

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

Remember the choice of words used to describe this phenomenon.

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

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

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

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

1. The data in favor of vitamin K injection

2. What the stats hide

3. The population of newborns that benefit from vitamin K

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

5. Why are babies born with low vitamin K?

   1. My Hypothesis

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

6. The data supporting the hypothesis

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

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

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

The Numbers Supporting Vitamin K Injections

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

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

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

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

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

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

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

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

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

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

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

What the Relative Risk Conceals

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

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

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

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

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

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

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

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

The Population This NNT Applies To

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

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

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

• Term gestation. Premature birth increases hemorrhagic risk substantially.

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

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

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

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

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

The Hospital Birth Environment as a VKDB Risk Factor

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

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

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

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

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

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

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

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

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

What This Means for the NNT

The honest interpretation of the available data is this:

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

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

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

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

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

Is there a downside to vitamin K injection?

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

So…what is the downside?

I think we missed something.

Why are Babies Born with Low Vitamin K?

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

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

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

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

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

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

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

Doctors look at this situation and say:

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

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

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

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

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

So what would be the reason?

THE BIRTH EVENT

Think about what happens the moment a baby is born.

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

At the first breath:

• The lungs expand for the first time

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

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

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

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

The Problem: Opening Up Empty Pipes

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

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

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

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

2. Damage to the vessel wall

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

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

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

Blood Vessel Walls Need to Learn to Resist Clotting

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

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

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

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

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

Which is exactly what low vitamin K provides.

THE THREE PLACES THIS MATTERS MOST

1. The Lungs

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

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

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

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

These hypersensitive lungs can manifest as something like asthma.

Subscribe now

2. The Liver

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

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

3. The Brain. Yes.

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

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

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

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

Evidence 1: The Lung Numbers

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

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

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

Nobody has adequately explained this.

Subscribe now

Evidence 2: The Same Pattern in Brain

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

Full-term babies have no prematurity to blame.

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

Evidence 3: The Smoking Gun

Here’s the most striking finding.

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

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

The type of damage changed.

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

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

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

Evidence 4: The Autism Connection

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

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

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

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

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

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

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

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

Subscribe now

The Evidence Was Never Collected

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

The harms being proposed here are:

• Delayed: injury at birth; consequences appear over years

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

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

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

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

THE BOTTOM LINE

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

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

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

Not deficient.

Share

References

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

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

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

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

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

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

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

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

disease is distance from creation and the creator.

This is the conversation that followed.

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

Read more

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

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

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

Nowadays, you will find something like this:

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

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

Brilliant.

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

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

Health is not the absence of something negative.

Being healthy is a positive phenomenon.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

This left a void.

A series of phenomenon that needed a new explanation.

• Wound Healing

• Spontaneous Remission

• Watchful Waiting

• Placebo Effect

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

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

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

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

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

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

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

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

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

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

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

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

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

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

It was surrendered to preserve an industry boundary.

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

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

Know Thyself. Flourish.

Share

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.

Read more

Part I: The Wrong Framework

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

What do I have?

What do I need to fix it?

Unfortunately, these are the wrong questions.

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

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

The problem is that the body doesn’t malfunction.

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

The body is trying to tell you something.

Which begs the question…are you listening?

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

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

There is no better example of this than blood pressure.

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

Number → Label → Prescription

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

And it is trying to tell us something.

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

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

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

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

Part II: What Blood Actually Is

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

This picture is wrong.

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

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

Let that sink in.

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

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

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

The whole path looks like this:

1. Food provides electrons.

2. Light excites the electrons.

3. Oxygen closes the circuit and draws electron flow.

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

Think of it this way.

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

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

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

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

Part III: How Blood Actually Flows

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

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

Dr. Francisco Torrent-Guasp changed that picture.

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

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

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

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

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

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

The blood moves, in part, because of light.

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

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

What happens when a branch is no longer used?

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

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

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

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

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

Part III: The Diagnosis Dilemma

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

Let’s start with the number.

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

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

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

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

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

It doesn’t. Not reliably.

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

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

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

And about those medications.

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

1. medicated and controlled (blood pressure),

2. medicated and uncontrolled,

3. unmedicated and uncontrolled, and

4. normotensive

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

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

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

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

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

You do not *have* hypertension.

Your blood pressure is elevated.

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

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

Part IV: The Case Study

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

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

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

She’s getting better at that though.

If you were to ask the right questions:

• who is she, and

• why would her body manifest elevated blood pressure?

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

Read more

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

Read more

• 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.

Read more

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.

Share

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!

Subscribe now

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:

• Twitter

• Instagram

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.

Read more

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.

Subscribe now

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)

  Subscribe now

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?

Share

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/

Read more