For today’s edition of Dear Mark, I’ll be answering your CBD questions from the past few weeks. CBD, or cannabidiol, is exploding in popularity, but there are many unknowns. People have a lot of questions and there aren’t many definitive or comprehensive guides, so today I’ll do my best to make sense of it. We’re all piecing things together based on limited data—which, I suppose, is the fundamental human experience.

Let’s go:

What’s the difference between hemp and CBD?

Hemp is a (recently legalized) industrial form of cannabis used in the production of paper, textiles, clothing, biodegradable plastics, and overpriced Bob Marley shirts sold along Venice Beach. Hemp seed can be eaten (and is a fantastic source of magnesium, one of the best). Hemp is the plant.

CBD is cannabidiol, a non-psychoactive cannabinoid found in both hemp and cannabis. Unlike THC, CBD won’t get you high.

Due to legal issues, most big name online retailers won’t allow sellers to list “CBD oil” or “CBD” products, let alone CBD content. Descriptions like “full spectrum hemp extract” often mean CBD is present in the hemp oil, but it’s tough to know exactly how much. I recommend investigating the product, searching for the company that makes it, and seeing if they give more explicit details on their website. Even then, make sure the company is the actual seller on Amazon or else you may end up with a counterfeit product sold by wholesalers.

The best bet is to buy directly from the product website.

Is there oil for diabetics??

Although there aren’t any human trials that give CBD to diabetics to see what happens, there are some reasons to think it could be helpful:

Lowering stress. As stated in previous posts, CBD is an effective anti-stress agent. Stress is awful for anyone with diabetes. It increases blood sugar levels. It induces insulin resistance. And if you’re a stress eater, it can increase cravings for high-carb junk food that you really shouldn’t be eating in the first place. In other words, stress exacerbates all the physiological conditions a diabetic is already experiencing.

Improving sleep. Perhaps the most popular use of CBD is to improve poor sleep. Just about the best way to induce some serious glucose intolerance is to get a bad night’s sleep. A diabetic already has poor glucose tolerance; it’s pretty much the defining characteristic of diabetes. What’s worse, a bad night’s sleep has been shown to make a person more susceptible to the allure of junk food.

Inadequate sleep is a strong and independent predictor of type 2 diabetes risk. The less sleep you get, the higher your chance of developing diabetes.

Anything that reduces stress and improves sleep will improve a diabetic’s health. If CBD does that for you, it’ll probably help someone with diabetes. So in a roundabout, not direct way, CBD oil has the potential to help reduce the risk of diabetes and improve the symptoms.

Good MDA folks … does anyone have any experience using CBD oil in lieu of an SSRI to help with anxiety and panic? I’m using CBT techniques to deal with anxiety and panic episodes, and cutting back on my dosage of my SSRI with the intent to eliminate over the next couple of months. I was considering giving CBT oil a try (organic, full spectrum), starting out with just a drop or two and building up to a therapeutic dosage. Also, does CBT oil cause fatigue for anyone? It’s the last thing I want to happen as it’s a big reason I want to eliminate taking the SSRI?

Give it a try, making sure you keep your doctor in the loop.

There are several parallels between anti-depressants and CBD. Both antidepressants and CBD interact with the endocannabinoid receptor systems in the brain. Both antidepressants and CBD can stimulate neurogenesis and counter the depression-related reduction in brain-derived neurotrophic factor.

Any compound that’s used for sleep has the potential to increase fatigue. Sleep is fatigue at the right time. Fatigue is sleep at the wrong time. In an Israeli study of 74 pediatric epilepsy patients using CBD to quell their seizures, 22% reported unwanted levels of fatigue, so it’s a common complaint. Just consider that these were kids taking fairly high dose CBD to quell seizure activity, and that you may not have the same issue taking lower doses at a higher body weight.

Does CBD oil break my fast?

The dosages involved in most CBD oils include at most 1/8 teaspoon of carrier oils, so that’s not enough calories to impact your fast in any meaningful sense.

I haven’t seen any evidence that CBD itself inhibits or impedes ketosis, autophagy, or fat-burning. So, no, there is no indication that CBD oil breaks your fast.

How do I figure out how much cbd is in hemp oil?

As I indicated earlier, it’s impossible to know unless you buy a hemp oil that explicitly states the CBD content.

CBD oil is so expensive. Are there any other options for getting CBD?

You could make your own. It’s actually legal to buy “CBD flower,” which basically looks exactly like the cannabis or weed you’d buy on the street or at a legal dispensary, only it contains little to no THC and tons of CBD. One recipe I saw involved slow-cooking an ounce of the CBD flower in a cup of coconut oil for 8 hours, then straining out the solids. Whatever method you use to cook it, it requires fat, as cannabinoids are fat-soluble.

Here’s a place you can buy CBD flower online. (Note: I don’t have any experience with that company or any other that markets CBD flower or CBD products, so buyer beware.) There are many such places. Just search for them.

CBD is everywhere these days. Should I definitely use it?

Not necessarily. Like anything, it has its uses, there’s great potential, and as new research comes out I foresee the discovery of new modes of action and new applications. However, in all fairness, it’s being overhyped when promoted as a cure-all or panacea.

For what it’s worth, I’m not using it myself. I don’t feel the need, haven’t felt a “CBD deficit.” Don’t assume it’s yet another essential supplement that you simply must have. The basics are the important things—sleep, food, exercise, community, love, micronutrients.

CBD is best used for people who have an established need for it. Chronic pain patient who wants to stop using so many opioids? Great candidate. Kid with epilepsy for whom keto and meds aren’t working? Give it a try. Anxiety and insomnia? Better than just going with narcotics right off the bat. (But as always, work with a physician for any medical issue.)

That’s it for today, folks. If you have any more CBD questions, write them down below and I’ll be sure to answer them!

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References:

Rudnicka AR, Nightingale CM, Donin AS, et al. Sleep Duration and Risk of Type 2 Diabetes. Pediatrics. 2017;140(3)

Mcneil J, Forest G, Hintze LJ, et al. The effects of partial sleep restriction and altered sleep timing on appetite and food reward. Appetite. 2017;109:48-56.

Fogaça MV, Galve-roperh I, Guimarães FS, Campos AC. Cannabinoids, Neurogenesis and Antidepressant Drugs: Is there a Link?. Curr Neuropharmacol. 2013;11(3):263-75.

Tzadok M, Uliel-siboni S, Linder I, et al. CBD-enriched medical cannabis for intractable pediatric epilepsy: The current Israeli experience. Seizure. 2016;35:41-4.

The post Dear Mark: CBD Edition appeared first on Mark’s Daily Apple.

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I left the pro athlete world a long time ago. I no longer compete. I don’t train with the intensity and volume it’d take to win races. But I do pay attention to what’s going on in that world, and I still have a lot of friends who never left it. Developments there often foreshadow developments in the rest of the health world. And after things like keto, MCT oil/ketones, and collagen, the performance hack that’s blowing up among elite athletes is CBD oil. Almost everyone I talk to who puts in serious training and competing time (in a variety of sports and pursuits) is dabbling with CBD.

What are they using it for?

There are two main claims when it comes to CBD and fitness.

  • That it improves sleep.
  • That it reduces pain, improves workout recovery, and helps you get back to training and competition.

Do their claims have any scientific support?

CBD and Sleep

A big review of CBD and sleep found that CBD increased sleep time and reduced the number of times people woke up during the night, improved sleep quality, reduced REM-related behavioral disorder (where you act out your dreams in your sleep), and improved sleep in anxiety patients.

Sleep is one of the biggest weak spots for many athletes. They sacrifice sleep for gym time. They train late at night under bright lights and come home energized and unable to get to bed. They focus on the workouts rather than the recovery. But here’s the thing: the more you train, the more sleep you need. The more performance you need to wring out of your body, the higher your sleep requirements are going to stack. There’s no getting around it. Sleep is one of the most important things to get right if you want to improve performance and make your hard work count for something.

But let’s get more granular. You want details?

Sleep deprivation ruins your posture and makes you more liable to make technique mistakes, get injured, and compromise movement quality and power. If you can’t coordinate your limbs, you won’t succeed in the gym or on the field (and you’ll probably make a critical mistake that gets you hurt).

Sleep deprivation kills your judgment. If you’re not thinking clearly, you’ll make silly mistakes and dangerous choices. Go for the last rep on the deadlift when your back’s about to give out, that sort of thing.

Sleep deprivation squanders your adaptation to training. Enjoy the insulin sensitivity and improved energy utilization training provides? Sleep loss blunts both. Like gaining muscle in response to lifting heavy things? Sleep loss inhibits muscle protein synthesis.

Sleep deprivation makes eating well harder. If you’re training for fat loss and body composition, you know that eating is well over half the battle. A single night of bad sleep makes you more vulnerable to the rewarding effects of junk food. It becomes harder to resist and more addictive.

Sleep deprivation causes muscle loss. A lack of sleep increases urinary nitrogen, a sign that the body is breaking down lean muscle mass.

So, is there a connection between sleep, CBD, and performance?

That hasn’t been directly tested. We know two things:

  1. CBD can help people who are having trouble sleeping get more sleep.
  2. Sleep is ergogenic. If you aren’t sleeping, you aren’t maximizing your performance in the gym and adaptation to your training.

That’s not to say you can’t get good sleep without CBD. It’s not a requirement for good sleep. But if CBD is helping athletes get better sleep than they would otherwise, it’s also giving them a performance and training boost.

CBD and Pain, Adaptation, and Recovery

One of the biggest quandaries an athlete faces is how to balance pain management, training adaptation, and workout recovery.

You can use ice baths to get back in the game quicker, but you might reduce training adaptations.

You can take two days off after a really tough workout and maximize the training effect, but you won’t be able to compete in the interim.

You can pound NSAIDs to reduce pain, but it might slow down your recovery and impair your adaptation to the exercise.

Everything has a tradeoff. And if you lean too far in one direction, you’ll pay the price. Back when I was competing, I leaned hard toward “getting back out there.” I ate ice cream and grains by the gallon to replenish the energy I expended, popped Tylenol like candy to dull the pain long enough to let me get through the next workout. It all worked out in the end (I wouldn’t be doing this if I hadn’t messed up so badly), but boy if I didn’t cut it close.

Where Does CBD Fit In?

CBD is a potent antioxidant and anti-inflammatory. It can block neurotoxicity from oxidative stress. It lowers inflammatory cytokines and raises anti-inflammatory cytokines. It may reduce a person’s reliance on opioids for pain control. It can even synergize with NSAIDs, reducing the amount you need to get the same effect. And it can do all this without causing liver damage. Sounds uniformly beneficial, right?

Be careful. Anti-inflammation can be a double-edged sword. After all, inflammation isn’t wholly pathogenic:

The inflammatory response is the healing response.

Training adaptations occur in response to the inflammatory effect of exercise.

The inflammatory reactive oxygen species that we’re all so worried about also serve as cellular messengers that provoke the creation of new mitochondria and the production of endogenous antioxidants like glutathione.

This is hormesis—the application of good stressors to make us healthier, stronger, and more resilient.

NSAIDs have many of the same effects, like blocking inflammatory cytokines, and have been used by athletes for decades to reduce pain, improve acute performance, and hasten the return to competition. They’ve also been shown to reduce muscle adaptations to resistance training and impair healing even as they reduce pain.

One of CBD’s anti-inflammatory effects is to blunt the release of interleukin 6 (IL-6), an inflammatory cytokine. This isn’t always helpful, as studies show. A hard training session spikes IL-6, and, at least in animal studies using IL-6 knockouts (mice who produce no IL-6 at all), lack of an IL-6 response tends to reduce muscle and adipose tissue adaptations to exercise. NSAIDs are another anti-inflammatory drug that block IL-6 and have been shown to impair muscle adaptations to resistance training in the young and improve them in the elderly. In other words, NSAIDs impair the hormetic stress effect of exercise in the young (who tend to have a lower stress burden and higher stress resilience) and enable it in the elderly (who tend to have lower stress resilience).

What Does This Mean For You?

Well, it depends on who you are and your situation.

High stress lifestyle? CBD can probably help you blunt some of your underlying stress to give the training a bigger effect. Low stress lifestyle? CBD might blunt it too much and render your training less adaptive.

As for CBD’s effect on pain means, there are a lot of unanswered questions that I trust will be answered in due time.

CBD may help mask the pain from injuries by exerting anti-inflammatory effects while slowing down healing. However, if your baseline inflammatory status is high, reducing inflammation may be just what you need to improve healing.

CBD may help reduce pain by speeding up the healing process. There’s even some evidence in rodents that CBD can speed up the healing process of a fractured bone. Does that happen in humans? Does that happen in other types of injuries? Maybe.

That said, if taking CBD before a workout is the only thing that lets you actually get through the workout without pain, it’s going to be better than not taking it. I know of a few people who swear by CBD for joint relief; they couldn’t do what they love without it.

We have a lot more to learn about CBD and training. The benefits for athletes who need help with sleep are clear and well-established. The benefits for athletes who need help with pain and recovery are murkier—we simply don’t know the details yet. It’s likely that CBD will help athletes recover in some situations and not in others. But for the most part, it’s relatively low-risk. Give it a shot and see what you notice. The beauty of it all is that even if CBD impairs your training adaptation, it’s not set in stone. The safety profile is good. The research is only growing. You can always drop it and keep training and regain your gains.

That’s it for today, folks. Have you used CBD to enhance your training? Did it work? Did it hurt? Tell us all about it down below!

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References:

Kozela E, Juknat A, Kaushansky N, Rimmerman N, Ben-nun A, Vogel Z. Cannabinoids decrease the th17 inflammatory autoimmune phenotype. J Neuroimmune Pharmacol. 2013;8(5):1265-76.

Lundberg TR, Howatson G. Analgesic and anti-inflammatory drugs in sports: Implications for exercise performance and training adaptations. Scand J Med Sci Sports. 2018;28(11):2252-2262.

Kogan NM, Melamed E, Wasserman E, et al. Cannabidiol, a Major Non-Psychotropic Cannabis Constituent Enhances Fracture Healing and Stimulates Lysyl Hydroxylase Activity in Osteoblasts. J Bone Miner Res. 2015;30(10):1905-13.

The post CBD For Performance: What We Know So Far appeared first on Mark’s Daily Apple.

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Anxiety is normal. It’s something we all have experience with—to one degree or another. Most people are anxious about something that hangs over them and follows them around like a personal rain cloud. Then there’s the deeper but still familiar anxiety many of us carry. The anxiety about our self-worth. The anxiety of performance, of social situations. This type can grip us in an uncomfortable, but hopefully not chronic, way.

But not all anxiety is run-of-the-mill—or manageable. People with Generalized Anxiety Disorder, for instance, might have trouble leaving the house, ordering a coffee from Starbucks, going to work. Anxious thoughts cycling through their brains often keep them up at night. When untreated, people with this level of anxiety can end up living in a state of perpetual fear.

The conventional approach is to take anti-anxiety meds, which can be genuinely life-saving for some people. Nonetheless, these can come with downsides that vary depending on an individual’s dosage and reactions—and the nature of the particular medication itself. Some meds result in few side effects, but others’ effects can be heavy. For instance, there are the benzodiazepines, highly-addictive tranquilizers with the potential for abuse. They make driving unsafe. They lower productivity. They sedate you. When necessary for the severity of the condition, these side effects may be worth it.

In other cases, a person might have more space to experiment and want to explore a different route.

In some cases, people choose to try natural anxiety aids. These are supplements, nutrients, and herbs that have been designed across millennia by nature (and maybe some input from green-thumbed healers). They might not always be enough for something as serious as a clinical anxiety disorder (please talk to your doctor before making any adjustment or addition to your medication), but at least some may be important complements to a prescribed regimen.

For those who want or need an alternative strategy for anxiety beyond meditative practices and general good health, these natural remedies may be worth a try.

First, the NUTRIENTS….

These are basic vitamins, minerals, and amino acids that your body needs to work. They are non-negotiable. You don’t have to get them through supplements—in fact, that should be a last resort after food—and I wouldn’t expect “drug-level” effects, but you do need to get them.

1. Long Chained Omega-3 Fatty Acids

Some human evolution experts maintain that the human brain wouldn’t be the human brain without steady and early access to coastal food resources—fish and shellfish rich in long chain omega-3s. If the long-chained omega-3s found in fatty fish and other sea creatures made our brains what they are today, it’s safe to assume that our brains work better when we eat them today. And if we’re talking about anxiety, that appears to be the case:

Studies in substance abusers find that supplementing with enough fish oil (and, yes, here’s what I use regularly) to raise serum levels of the long chain omega-3 fatty acid EPA reduces anxiety, while increases in DHA (the other long chain omega-3) reduce anger. Rising EPA levels after supplementation predicted the reduction in anxiety.

In healthy young medical students, omega-3 supplementation (2 grams EPA, 350 mg DHA) lowered inflammation and anxiety. Follow-up analyses revealed that reducing the serum omega-6:omega-3 ratio also reduced anxiety scores.

And in early pregnancy, high DHA levels predict low anxiety scores.

2. Magnesium

Magnesium deficiency is a risk factor for anxiety. The evidence, considered by some to be low quality, nonetheless suggests that supplementing with magnesium can reduce subjective anxiety. The mechanistic evidence is stronger, as magnesium is one of those minerals that plays a role in hundreds of very basic and essential physiological processes—including the generation of ATP, the body’s energy currency. Without adequate energy production, nothing works well. One’s mental health is no exception.

Magnesium supplementation reduces subjective anxiety (the only kind that matters) in the “mildly anxious” and in women with premenstrual syndrome.

Magnesium L-threonate, a form particularly good at getting into the brain, is worth trying for more immediate, noticeable effects.

3. Zinc

Zinc deficiency is common in people with anxiety, including Chinese males and Americans. And although mainlining oyster smoothies probably won’t fix serious anxiety, a follow-up in the group of Americans with low zinc levels found that zinc supplementation did reduce anxiety levels.

4. Vitamin B6

Vitamin B6, or pyridoxine, helps regulate production of serotonin and GABA—two neurotransmitters that control depression and anxiety. In mice exposed to anxiety-producing situations, pyridoxine increases GABA, reduces glutamate, and reduces anxiety. In humans, correcting a magnesium deficiency with magnesium and vitamin B6 has a stronger effect on anxiety than magnesium alone. (Good to note: women on hormonal birth control may be depleted of vitamin B6 as well as other vitamins and minerals.)

The best sources of vitamin B6 are turkey, beef, liver, pistachios, and tuna.

Now, the NATURAL INTERVENTIONS….

These aren’t essential nutrients. Rather, they’re plant compounds with pharmacological effects and, in most cases, hundreds of years of traditional usage for dampening, inhibiting, or resolving anxiety.

5. Kanna

Kanna comes from a succulent plant native to South Africa. The story goes that an anthropologist noticed elderly San Bushmen nibbling on a particular type of succulent plant while displaying incredible cognitive ability and remaining calm, cool, and collected. The fact that they weren’t dealing with daily commutes, traffic jams, annoying bosses, and mounting bills probably had something to do with it, but it turns out that the succulent plant wasn’t hurting the cause.

Kanna has been shown to dampen the subcortical threat response, which is normally heightened in anxious states. It also increased well-being and resistance to stress in health adults who took it in a safety study.

6. Theanine

Theanine, an amino acid found in green tea and available as a supplement, isn’t going to obliterate your nerves before a big performance. One study showed that it (along with the benzodiazepine Xanax) reduced resting state anxiety but not experimentally-induced anxiety. Then again, neither did Xanax.

Theanine is instead a mild anxiolytic. If you get anxiety from caffeine, take 200 mg of theanine with your coffee. It will smooth out the experience, reduce/remove the anxiety, and leave the stimulation.

7. Kava

Kava is a plant native to the South Pacific. Traditionally, its roots were chewed fresh with the resultant liquid often spit into communal bowls for consumption, pounded to release the moisture, or sun-dried, ground, and steeped in water to make an intoxicating, relaxing mild sedative. Nowadays, the active kavalactones are also extracted and pressed into capsules.

I don’t use kava, but I have tried it a couple times in the past. For what it’s worth, I don’t have anxiety issues but it did seem to pair well with caffeine (similar to theanine).

8. Rhodiola Rosea

Rhodiola rosea is a longtime favorite adaptogen of mine. It hails from the barren wastes of Siberia, where for millennia people from all over the ancient world coveted it. There’s something about the harsh environment of the northern tundra that made rhodiola rosea incredibly resilient—and bestows upon those who consume it a similar type of mental resilience.

2015 study sought to determine the impact of rhodiola on self-reported anxiety, stress, cognition, and a host of other mental parameters. Eighty subjects were divided into either a twice-daily commercial formula (containing 200 mg rhodiola) group or a control group. Compared to the controls, the rhodiola group showed notable improvements in mood and significant reductions in anxiety, stress, anger, confusion and depression after 14 days.

Rhodiola rosea, along with theanine, features prominently in my anti-stress (and anti-anxiety) supplement Adaptogenic Calm. (If you’re interested, here’s a video of me talking about how I use it.)

9. Lavender

There’s a great lavender farm on the island of Maui. One of the favorite memories from that trip is strolling through the fields of lavender, brushing against the leaves and flowers, just basking in the relaxing scent that permeated the entire property. A very low-stress environment, to be sure.

One study gave lavender oil capsules to major depressive disorder patients suffering from anxiety who were already taking antidepressants. Not only did adding the lavender reduce anxiety, it also improved sleep.

Perhaps the most impressive study is this one, where generalized anxiety disorder patients either received lavender oil or a benzodiazepine anti-anxiety drug. Patients receiving the lavender had the same beneficial effects as the benzo patients without the sedation.

Lavender oil aromatherapy also seems to reduce anxiety, at least in cancer patients. One weakness of aromatherapy research is the difficulty of giving a “placebo smell.” Essential oil scents are quite distinct.

10. CBD Oil

As I wrote a couple weeks ago, CBD is the non-psychoactive cannabinoid found in cannabis.

Most recently, a large case series (big bunch of case studies done at once) was performed giving CBD to anxiety patients who had trouble sleeping. Almost 80% had improvements in anxiety and 66% had improvements in sleep (although the sleep improvements fluctuated over time).

In a five-year-old girl with PTSD (a category of patient that just shouldn’t exist) in whom pharmaceutical anxiety medications did not work, CBD oil provided lasting relief from anxiety.

Here’s how to find a good CBD oil.

What do you folks like for anxiety? What’s worked? What hasn’t? What did I miss?

Thanks for reading, everyone. Take care.

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References:

Cunnane SC, Crawford MA. Energetic and nutritional constraints on infant brain development: implications for brain expansion during human evolution. J Hum Evol. 2014;77:88-98.

Boyle NB, Lawton CL, Dye L. The effects of magnesium supplementation on subjective anxiety. Magnes Res. 2016;29(3):120-125.

Mccarty MF. High-dose pyridoxine as an ‘anti-stress’ strategy. Med Hypotheses. 2000;54(5):803-7.

Walia V, Garg C, Garg M. Anxiolytic-like effect of pyridoxine in mice by elevated plus maze and light and dark box: Evidence for the involvement of GABAergic and NO-sGC-cGMP pathway. Pharmacol Biochem Behav. 2018;173:96-106.

De souza MC, Walker AF, Robinson PA, Bolland K. A synergistic effect of a daily supplement for 1 month of 200 mg magnesium plus 50 mg vitamin B6 for the relief of anxiety-related premenstrual symptoms: a randomized, double-blind, crossover study. J Womens Health Gend Based Med. 2000;9(2):131-9.

Lu K, Gray MA, Oliver C, et al. The acute effects of L-theanine in comparison with alprazolam on anticipatory anxiety in humans. Hum Psychopharmacol. 2004;19(7):457-65.

Terburg D, Syal S, Rosenberger LA, et al. Acute effects of Sceletium tortuosum (Zembrin), a dual 5-HT reuptake and PDE4 inhibitor, in the human amygdala and its connection to the hypothalamus. Neuropsychopharmacology. 2013;38(13):2708-16.

Nell H, Siebert M, Chellan P, Gericke N. A randomized, double-blind, parallel-group, placebo-controlled trial of Extract Sceletium tortuosum (Zembrin) in healthy adults. J Altern Complement Med. 2013;19(11):898-904.

Fißler M, Quante A. A case series on the use of lavendula oil capsules in patients suffering from major depressive disorder and symptoms of psychomotor agitation, insomnia and anxiety. Complement Ther Med. 2014;22(1):63-9.

Woelk H, Schläfke S. A multi-center, double-blind, randomised study of the Lavender oil preparation Silexan in comparison to Lorazepam for generalized anxiety disorder. Phytomedicine. 2010;17(2):94-9.

Shannon S, Opila-lehman J. Effectiveness of Cannabidiol Oil for Pediatric Anxiety and Insomnia as Part of Posttraumatic Stress Disorder: A Case Report. Perm J. 2016;20(4):16-005.

The post 10 Natural Anxiety Remedies appeared first on Mark’s Daily Apple.

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Last week, I explored the impact of all the various foods, beverages, and food-like substances people consume while fasting—and hoping to maintain a functionally fasted state in the post, “The Definitive Guide To What Breaks a Fast.” Does MCT oil break the fast? What about coffee, tea, or bone broth?

There were more than a dozen, and I even did a follow-up. Today I’m going to discuss whether commonly-consumed supplements break the fast.

Let’s go:

Fish Oil

Fish oil is pure fat. If you’re taking the average supplemental dose of 1-2 grams of fish oil, it’s not a problem. That’s not even a teaspoon. It’s about 9-18 calories.

You may burn slightly less fat than you would otherwise, but in the grand scheme of things, a few grams of fish oil won’t break the fast.

Cod Liver Oil

Cod liver oil is fish oil with extra vitamin D and vitamin A. As long as you keep the doses low enough, cod liver oil won’t break the fast.

Multivitamin/Multimineral

Multivitamins do not break a fast. They are usually non-caloric. However, not all of their components will be absorbed very well on an empty stomach, so keep that in mind.

If you’re still not on board, note that in the older studies with really overweight people who fasted for upwards of a year straight, they usually supplemented with a multivitamin.

Food-Based Multivitamin

A popular one I’ve seen around—Alive, made from kale and raspberries—has just 2 grams of carbs per dosing. It’s not ideal, but it’s not a deal breaker—or a fast-breaker.

Gummy Vitamins

Gummy vitamins have the potential to be about 5-6 grams of sugar, a gram of protein (from gelatin), and a gram of fat (if including omega-3s) per serving, so they’d arguably break the fast. Plus, they taste like candy and are likely to stimulate cravings and make fasting harder.

Gummy vitamins break the fast.

Potassium

Potassium is non-caloric and does not break the fast. In fact, it can help you handle the fast better by replenishing electrolytes.

Potassium doesn’t break the fast.

Creatine

Creatine contains no calories and has no effect on insulin secretion (or glucose in the absence of calories).

Creatine does not break the fast.

Protein Powder

Protein powder provokes an insulin response, which opposes autophagy, which means you’re breaking your fast. Plus, protein powder contains calories.

I’m going to say “yes, protein powder breaks the fast.

Collagen

If you’re strict and technical, then yes, collagen breaks a fast. There’s evidence that glycine—the most prominent amino acid in collagen—can inhibit autophagy, but it was a convoluted animal study where inhibiting autophagy with large doses of glycine after brain injury actually improved outcomes. It probably doesn’t apply to someone adding a scoop of collagen to their coffee. Besides, even if it slightly reduces autophagy, a little collagen won’t negatively impact ketosis, fat-burning, or energy intake.

I’m going to say “technically yes,” but “realistically no, collagen doesn’t break the fast.” Avoid if your main focus is autophagy, however.

Branch Chain Amino Acids (BCAAs)

BCAAs trigger an insulin response and thus stop autophagy…and the fast. That said, many proponents of fasted training recommend using BCAAs before a workout to help preserve muscle and improve the post-workout anabolic response.

I’m going to say “yes, BCAAs break the fast.”

Vitamin D

Vitamin D is fat soluble and thus comes packaged in an oil carrier, but the dosage is so small that it won’t affect your fast.

Unless you find that 1/8 teaspoon of olive oil ruins your fast, vitamin D won’t break a fast.

Probiotics

Probiotics contain no calories and will not break a fast. However, they are best absorbed in the presence of food—the food protects them as they travel through the digestive system, and most probiotics occur naturally in food—so taking them during a fast is probably, mostly useless.

Probiotics don’t break a fast, but why take them during one?

Prebiotics

Pure prebiotics will not break a fast, as they contain no digestible carbohydrates. Prebiotic-enriched foods will break a fast, as they do contain calories.

Adaptogens

Adaptogens are compounds, usually herbs or herb derivatives, that modulate your stress response. They improve your ability to tolerate and respond to stressful situations; they don’t blindly inhibit the stress response if the stress response is warranted. They keep you honest and counter unnecessary stress responses. They contain no calories, unless you’re chowing down on a big hunk of maca or ashwagandha root. In fact, most adaptogens have traditionally been consumed in tea form, extracting the active compounds and leaving behind any calories. Have at ’em.

Adaptogens do not break the fast.

Mushroom Extracts

Medicinal mushroom extracts come from mushrooms, which are technically food. But the amounts you take are so low—usually no more than a teaspoon—that they won’t impact your fast or provide any significant amount of caloric energy. Four Sigmatic has those “mushroom coffee” blends you add to hot water. They can get up to about 30 calories per serving, but even that’s going to let you maintain most of the fasting benefits.

Mushroom extracts don’t break the fast.

Melatonin

I used to keep the old Trader Joe’s melatonin on hand because it was half a milligram, whereas most other melatonin supplements are in the 3-5 mg range. It was also sweet, tasting like those white Valentine’s Day mint hearts you used to get back in the day. I haven’t come across any sweetened melatonin supplements since Trader Joe’s phased those out, but that’s the only thing I’d worry about on a fast.

Melatonin does not break a fast.

Final Note: Most supplements are okay to take on a fast, though the lack of food may make absorption more difficult. If you have any other questions about supplements on a fast, drop them down below. Thanks for reading, everybody.

On a related note, with supplements on my mind this week I thought it would be a good time to offer one of my favorite deals—just for the MDA community: 20% off my full supplement line, plus Primal Fuel and Collagen Fuel. It’s a great time to stock up on favorites or to try something new. Offer ends 4/24/19 midnight PDT. Use code WELLNESS20 at checkout. (Offer doesn’t apply for autoship orders.)

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The post What Breaks a Fast: Supplement Edition appeared first on Mark’s Daily Apple.

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For today’s edition of Dear Mark, I’m answering three questions. First up, what can a person do to help their gut recover its barrier function after too many antibiotics? Are there any foods, supplements, or dietary strategies? Second, what can explain rapid fatigue during sprint sessions on a keto diet? Is this simply part of the deal, or are there modifications you can make? And finally, what do I do when I know I’m going to get a bad night’s sleep?

Let’s go:

Mark – any idea how to cure leaky gut caused by overuse of antibiotics. Tried raw dairy for a month to no avail.

First of all, check out my post on leaky gut. Read through it and follow my suggestions for preventing and treating intestinal permeability. It’s a great place to start.

Then, let’s look at some other interventions that have been shown to improve recovery from antibiotic therapy. While most of the studies referenced don’t explicitly describe antibiotic-induced leaky gut, anything that improves gut function and restores healthy gut bacteria will also normalize leaky gut—since it’s the eradication of native gut bacteria that causes antibiotic-induced leaky gut.

Fermented dairy. You tried raw dairy. What about fermented dairy? While raw dairy has its merits, it’s fermented dairy that just works for recovery from antibiotics. Yogurt is a good option to try, although the evidence is a bit inconsistentKefir is probably better; it’s been shown to improve patients’ tolerance to triple antibiotic therapy during treatment for H. pylori infection. This is even worth consuming during antibiotic therapy, as many of the probiotic bacteria found in fermented dairy show resistance to common antibiotics.

Fermented vegetables like sauerkraut are also must-eats. The fermented cabbage contains ample amounts of L. plantarum, a bacteria strain that’s been shown to prevent antibiotic-related diarrhea in piglets (another omnivorous mammal). Good options exist in stores (check the refrigerated section; shelf-stable pickles and kraut aren’t lactofermented), and even more are available in farmer’s markets, but the best way to get the most bacteria-rich vegetable ferments is to make your own.

Supplemental probiotics are fantastic here, too: large doses of the desired microorganisms delivered directly to your gut. Some of the strains used in Primal Probiotics, like B. clausii and S. boulardii, have been shown to be effective against antibiotic-related diarrhea, so that could be a good choice.

Don’t forget the food for your gut bugs: prebiotics. You need to eat fermentable fibers and other prebiotics like resistant starch to support the growth and maintenance of the helpful bacteria that improve gut barrier function. Consider eating cooked and cooled potatoes, unheated potato starch, leeks, garlic, onions, green bananas, apples, pears, berries, and pretty much any fruit or vegetable you can get your hands on. Plenty of them are low-carb enough to work on a keto diet, if that’s your desire. Oh, and dark chocolate is a great source of fiber and polyphenols, which have prebiotic effects in the gut.

Incorporate intermittent fasting. Going without food for a spell gives your gut a break and induces autophagy, which can help with tissue healing.

Get dirty, too, to introduce potentially helpful bacteria. Go out and garden. Go barefoot at the park (do your due/doo diligence, of course) and practice tumbling, or roughhouse with your kids (or friends). Don’t immediately rush to wash your hands all the time (unless you’ve been handling raw meat and/or dog poop).

Whatever you do, don’t stress too much about the antibiotics you had to takeStress is awful for gut health and you’ve already taken the antibiotics—which were probably necessary—so that ship has sailed.

If probiotics with prebiotics aren’t helping (or making things worse), you might want to try going the opposite direction—removing all plant foods and doing a carnivore diet for a few weeks. While I have doubts about the long term viability and safety of eschewing all plant foods, enough people have written to me about their great experiences resolving gut issues with a bout of carnivory that it’s worth trying.

When on a strict keto plan, why do I become so quickly fatigued while attempting a HIT sprint workout?

The first five seconds of a sprint are primarily powered by phosphocreatine (or creatine phosphate), a “quick burst” energy source that burns hot but disappears quickly. This is the stuff used to perform max effort Olympic lifts, short sprints, and other rapid expressions of maximum power. It doesn’t last very long and takes a couple minutes to replenish itself. A keto diet doesn’t affect our creatine phosphate levels. If anything, it should improve them if we’re eating meat.

After five seconds, anaerobic metabolism of muscle glycogen provides the lion’s share of your energy needs. The longer your sprint, the more glycogen you’ll burn. The less glycogen you carry in your muscles, the shorter your sprint. Because once you run out of creatine phosphate and glycogen, you’re left with aerobic metabolism—great for longer distances, not so great for max effort sprints.

Keto dieters tend to walk around with less glycogen in their muscles. If that’s the case, longer sprints will be harder.

If you want to keep sprinting:

Do shorter sprints. Try a 10-second hill sprint rather than a 20-second one. Really go hard. Heck, you can even do 5-second sprints and derive major benefits; just do more of them and make sure to recover in between. There’s no rule saying you have to sprint for 20-30 seconds.

Take longer rest periods. Give your muscles a chance to replenish more creatine phosphate (and take creatine or eat red meat and fish, which are the best sources of dietary creatine).

Eat 20-30 grams of carbs 30 minutes before a sprint session. See if it helps. Alternatively, you can eat the 20-30 grams of carbs after the sprint session to replenish lost glycogen stores (without really impacting your ketone adaptation, by the way).

Most people figure out their sprinting sweet spot while doing keto. They may have to play around with the dosages, durations, and rest periods, but you can usually make it work. Be open to trying new permutations.

If you knew you were going to have a poor nights sleep, what measures would you take to reduce some of the damage?

I would exercise hard that night. Normally, a bad night’s sleep tanks your insulin sensitivity the next day, giving you the insulin resistance and glucose tolerance of a diabetic. A good hard interval session the night before a bad night’s sleep, however, counters the next-day insulin resistance.

I would make the most of it. Don’t dawdle. Don’t beat yourself up because of the impending sleep deprivation. It’s going to happen. You have to accept it, not let it destroy you.

Enjoy it. A little-known acute treatment for depression is sleep deprivation. That’s right: a single night of sleep deprivation has been shown to ameliorate depression in patients with clinical depression. Sometimes the effect lasts up to several weeks. It’s not a long term or sustainable fix for clinical depression, obviously, and you can’t do it every single night—chronic sleep deprivation is a major risk factor for developing depression—but it can improve your mood if you give in to it.

I would set out a jar of cassia cinnamon. I always add cassia cinnamon to my coffee in the morning after bad sleep; cassia cinnamon the day after a bad night’s sleep attenuates the loss of insulin sensitivity and glucose tolerance.

That’s it for today, folks. Thanks for writing in and reading! If you have any input on today’s round of questions, let me know down below.

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References:

De vrese M, Kristen H, Rautenberg P, Laue C, Schrezenmeir J. Probiotic lactobacilli and bifidobacteria in a fermented milk product with added fruit preparation reduce antibiotic associated diarrhea and Helicobacter pylori activity. J Dairy Res. 2011;78(4):396-403.

Bekar O, Yilmaz Y, Gulten M. Kefir improves the efficacy and tolerability of triple therapy in eradicating Helicobacter pylori. J Med Food. 2011;14(4):344-7.

Erginkaya Z, Turhan EU, Tatl? D. Determination of antibiotic resistance of lactic acid bacteria isolated from traditional Turkish fermented dairy products. Iran J Vet Res. 2018;19(1):53-56.

Yang KM, Jiang ZY, Zheng CT, Wang L, Yang XF. Effect of Lactobacillus plantarum on diarrhea and intestinal barrier function of young piglets challenged with enterotoxigenic Escherichia coli K88. J Anim Sci. 2014;92(4):1496-503.

Jitomir J, Willoughby DS. Cassia cinnamon for the attenuation of glucose intolerance and insulin resistance resulting from sleep loss. J Med Food. 2009;12(3):467-72.

The post Dear Mark: Antibiotic Recovery, Sprinting on Keto, Preparing for Bad Sleep appeared first on Mark’s Daily Apple.

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