Pregnancy Toes – What Sugar Does to Feet


Pregnancy toes are really swollen feet and swollen toes. The name stuck in my mind because one of my daughter-in-laws is pregnant and I was sent a photo from her winter vacation in her flip flops in the snow and winter coat—she was not able to put her boots on because of her swollen feet (swollen even in the cold!).

I did not think much about it until she came to visit me yesterday and I noticed the flip flops and her chubby toes. She had “pregnancy toes” again she said. It then suddenly all became clear. I asked her: did you by any chance have any sugar today? And she said “as a matter of fact, yes!”

I reached for my salt pills that I use for my migraines as do all members in my migraine group on Facebook and handed her one. I really should have photographed what happened but I did not think the effect was going to be so fast and so big. Less than 15 minutes after she took the salt pill and a glass of water, her toes went back to normal. We ended up laughing it away. Had she known this, she could have worn her boots in the snow after all!

So what did her pregnancy toes have to do with sugar and salt you may ask? Previously, I quoted from the Harrison’s Manual of Medicine an important paragraph that I repeat here:

…serum Na+ falls by 1.4 mM for every 100-mg/dL increase in glucose, due to glucose-induced H2O efflux from cells. (page 4)

The above means glucose (part of sugar) and sodium (part of salt) are in inverse relationship. As you increase sugar, salt drops and water is sucked out of your cells by sugar like a giant Slurpee machine. The water then collects on the outside of your cells rather than the inside, thereby dehydrating your cells and at the same time make your body swell. Edema is often associated with too much salt, but in fact, it is too much sugar. Being always thirsty is associated with Type 2 Diabetes but it is also associated with not having enough salt in the body since without salt the cells cannot get hydrated.

In light of this fragile balance between sodium and glucose in the blood, are we treating pregnancy edema, gestational diabetes, and other maternity complications, the way we should? Consider that with pre-eclampsia (gestational hypertension), women are told not to eat salt. You can see what happens when we reduce sodium: glucose increases and we also induce an ionic imbalance. This ionic level imbalance is visible (like the swollen toes) and may lead to further complications. There are two problems that we are facing here: first if she does not eat salt, her sodium-potassium pumps cannot work–this may cause migraines and headaches as I often see in my migraine group. Secondly, as you saw the fragile balance between the see-saw action of glucose and sodium, if she stops eating sodium her glucose may increase, causing swelling. This is an interesting theory to ponder – one that merits research.

Sodium and Glucose Work Together

Salt breaks up in the body into sodium and chloride. Sodium attracts water and holds onto it inside the cells. It keeps chloride outside of the cells to ensure proper voltage and electrolyte balance with the aid of potassium. When you eat sugar, the glucose part of it removes the water from the cells via osmotic channels that are too narrow for the sodium ions to exit. Thus, one ends up with a ton of water outside the cells with sodium inside hugging a tiny amount of water. Swelling occurs as the water leaves the cells but remains between cells.

Given the inverse nature of glucose and sodium in the blood, if one is swollen as a result of too much sugar, eating salt will take the water back from sugar and move it back into the cells–as it did for my daughter-in-law’s pregnancy toes. What is important in this information is this:

  1. If you feel swollen after eating sweets, you need to eat salt and drink a bit of water to reduce your swelling.
  2. If you have Type 2 Diabetes or are hypoglycemic, eating a salty meal can give you a major sugar crash and land you in the hospital!
  3. Eating sugar of any quantity will dehydrate your cells and you and make you run to the toilet every 30 minutes.

Because glucose takes water out of the cells, the edema that follows increases extra-cellular water and causes swelling in the body. This extra-cellular water needs to be reabsorbed into the circulation for the kidneys to be eliminated. To be reabsorbed, sodium is necessary since without sodium, the cells cannot operate their voltage gated sodium pumps and so the gates cannot open to grab glucose to take it into the cells and to get the water back into the cells. I think you can already see the contradictions in the logic of reduced salt: the mom-to-be is told to not eat salt, this causes extra-cellular water and swelling, which needs salt to be reabsorbed into her cells for clearance by the kidneys but which she is not allowed to eat. This way ionic level balance is not possible and chain reactions may occur with negative consequences. She may have protein leaching into her urine, extra hard kidney work, and a whole other long chain of complex events may kick in to make pregnancy a rather unpleasant experience risking the health of the fetus.

The amount of extra-cellular water is very hard for the body to get back into circulation without salt and may take days, taxing the kidneys with the volume of water leaving and increasing pressure on the blood vessels from the outside, causing high BP. However, as the volume of water is leaving the body finally, this reduces blood pressure. When a pregnant woman’s blood pressure drops as a result of all that water leaving, the dehydrated blood cells carry less oxygen. This indicates reduced oxygen for both her and the baby.

By telling mothers to reduce salt intake, glucose increases, which increases blood pressure (BP) rather than reduces it. The similar phenomenon happens in gestational diabetes. In gestational diabetes (and gestational hypoglycemia as well) the sugar level is unstable and is either too high or too low, respectively. Should the mother-to-be eat a salty pickle (as cravings always dictate pickles), she may end up in a major sugar crash and in the hospital for immediate treatment.

The balance between sodium and glucose is very fragile and extremely quick changing as you could see on my daughter-in-law’s foot. Interestingly we now also know that salt does not increase blood pressure but sugar does and so a reduced salt diet automatically increases blood pressure because of the glucose and sodium inverse connection and sugar’s dehydrating properties. Reduced salt also increases triglycerides (Graudal, 2011), causing a lot of problems for people with preexisting heart conditions. So by reducing the salt intake of the mothers to be, are we creating diabetic mothers and/or babies? Babies have been born with diabetes 2!

Is it possible that we are giving the wrong advise to pregnant women about salt and sugar? It’s an interesting question to pose and further research is badly needed. Knowing that salt and sugar are in inverse proportion in the blood, one may suggest eating them together. In fact, eating them together is a much better idea than eating sugar alone. It is best to not eat sugar at all but if you must eat sugar, consider eating salt too.


Effects of low sodium diet versus high sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterol, and triglyceride. Graudal et al., Cochrane Database Syst Rev. 2011 Nov 9; (11).

This article was published originally on Hormones Matter on February 15, 2015. 

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Hydration, Thirst, and Drinking Water


Most of us equate the expression “hydrate extra” with drinking more water but – unfortunately – this is incorrect. In any online dictionary “to hydrate” means to create “…a substance that is formed when water combines with another substance…” In other words, water alone is not a hydrating fluid but it must be combined with something to become one. We do not have water in our body on its own; we have a substance we call electrolyte. I wrote substantially on the topic of hydration, mixing water with minerals, as part of the protocol that prevents migraines. However, a new problem has surfaced: when to drink water? Several articles have recently published water drinking instructions on the internet. Most of these articles consider it bad practice to drink water when one is not thirsty and recommend drinking water only when thirsty. There are several serious flaws with this argument.


The first flaw is that most research is aimed at athletes; but athletes are not representative of the majority of the population. Furthermore, athletes should not be drinking “water” to hydrate. Drinking water cannot be absorbed by cells without adequate sodium to hold onto it. When athletes sweat, the content of sweat is not water but electrolyte. Many sport drinks aim at re-hydrating athletes but their problem is their sugar or sugar substitute content, defeating the purpose — see how much sport drink one needs to drink to make up the content of sweat for an athlete. Then add up the sugar in a typical sports drink: 1 teaspoon of sugar is 4 grams of carbs. An average serving of a typical sport drink provides between 14 grams to 54 grams of carbs, all sugar, which converts to 3.5 to 13.5 teaspoons of sugar per serving. Drinking sugar substitutes is even worse because sugar substitutes fool the body like it is receiving glucose so insulin spikes but there is no glucose. This creates insulin overflow in the blood causing you to become hungry! Sugar substitutes may lead to obesity and metabolic syndrome. Drinking sport drinks with sugar substitutes actually reduce muscle energy.

Moreover, anything that converts to glucose in the body removes both water and sodium from the cells1 so drinking/eating sugar with sodium (salt is the form in which sodium is available to us) and water is worse than not drinking anything at all. Many athletes have smartened up and drink pickle brine rather than water. Pickle brine is great, assuming the brine is of salt and water and not vinegar. Vinegar is fermented ethanol (alcohol). Thus, drinking vinegar-processed pickles will actually dehydrate further. Look for pickles made with salt rather than vinegar.

Best Hydrating Fluid

Whole milk is an ideal hydrating fluid because it has perfect electrolyte balance in sodium, potassium, water, blood sugar (lactose), calcium, phosphorus, magnesium, and protein. Whole milk is THE perfect electrolyte. Some athletes drink water and take salt pills (also called electrolyte pills). That is also a great option, particularly since they are easy to carry around and take one when needed.

The second flaw in the argument of “drink water when thirsty” is that many people feel thirst after eating sugar when it is the least advisable to drink water. Since about half of sugar converts to glucose, and glucose pulls water and sodium out of the cells1, if one is thirsty after eating sugar and drinks water, the metabolic process will remove more water from the cells. This can cause edema. Although most articles today blame salt for causing edema, the opposite is true.

While sodium retains water inside the cell, glucose removes water and sodium from the cell and forcing the water to be retained in extracellular space2. Eating salt when one has edema actually reduces edema by the sodium bringing water back into the cell. This was easily demonstrated by a previous article showing how this works.

The problem with most studies that blame salt on retaining water is that no studies have ever controlled for both salt and sugar at the same time in the same experiment. All studies I could find only looked at the effects of salt on the body regardless of the amount of sugar, water, or protein the subjects had consumed before the experiment. Since the body can easily be tipped out of balance and is never in a vacuum for a pristine controlled experiment, one cannot say with certainty that one element makes a particular change without looking at what else is affecting the body. No such studies exist except in my migraine group where we control for all variables. We found that being thirsty often means the person does not have enough salt to keep water where it belongs3. A migraineur should never drink water when she is thirsty, particularly not if carbohydrates were consumed.

The final problem with only drinking water when thirsty is the population of people who have diabetes 2; they are always thirsty. Being thirsty can be a sign of diabetes mellitus and not the need for more water.

Should you wait until you are thirsty before you drink?

Absolutely not, and for sure drinking water alone will not get you hydrated. How much water you should drink is a question I will address in another article. Drinking the minimum 8 glasses of water is a myth; people vary in size, age,and activity, implying that each person needs a different amount of water. There are many online water calculators that go into detail of weight, climate, activity, altitude, your health, pregnancy, nursing, etc. For each person the amount of water and thus hydration need (not just water) will differ and for that hydration level you need to make sure you drink adequate amounts of water as part of your hydration protocol.


  1. Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J. Harrison’s Manual of Medicine 18th Edition. New York: McGraw Hill Medical; 2013.
  2. Millar T. Biochemistry Explained: A Practical Guide to Learning Biochemistry.Vol reprint edition: CRC Press; 2002.
  3. Stanton, Angela A. Fighting The Migraine Epidemic: A Complete Guide: How To Treat & Prevent Migraines Without Medicine

This article was published previously on Hormones Matter in July 2015. Minor updates were added.


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More people than ever are reading Hormones Matter, a testament to the need for independent voices in health and medicine. We are not funded and accept limited advertising. Unlike many health sites, we don’t force you to purchase a subscription. We believe health information should be open to all. If you read Hormones Matter, like it, please help support it. Contribute now.

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Topamax: The Drug with 9 Lives


Is Topamax a Wonder Drug?

Over the past week alone, I have talked to several people about their doctor visits. Each one of them had a different illness and each one of them was prescribed the drug Topamax.  I cannot help but wondering, how it is possible that one medication can treat so many disparate illnesses. I suspect it cannot and the overreach is driven more by marketing than medicine. This led me to do some digging into Topamax.

What I found is not good. Topamax is prescribed for a broad scope of illnesses for which there is likely little evidence of its efficacy. Take a look at the list below.

Illnesses or Conditions for which Topamax is Prescribed

  1. Obesity1. Medicine: Topamax
  2. Seizures1. Medicine: Topamax
  3. Migraine1,2. Medicine: Topamax
  4. Impulsivity3. Medicine: Topamax
  5. Diabetes with nerve damage4. Medicine: Topamax
  6. Bipolar disorder5. Medicine: Topamax
  7. Depression6. Medicine: Topamax
  8. Alcohol addiction7: Topamax
  9. Fibromyalgia8. Medicine: Topamax

I would like to add a 10th to that: I have broken a nail…can I get Topamax?

Honestly, off-label prescribing has gone too far! Does Topamax really treat so many disparate conditions that doctors prescribe it for everything, even when it is not FDA approved for these conditions? I must add that Topamax is one of the most dangerous drugs in the prescription market today. Not only is it a diet pill made from sugar derivatives  (actually a sugar substitute) but it uses two dangerous methods (blocking both voltage dependent calcium and voltage gated sodium channels at once) to achieve what several classes of drugs normally do separately; and thus, with one medicine it affects and potentially damages the two circuits that are critical for brain function. Topamax (an anticonvulsant under additional name Topiramate (generic) and in time release Trokendi XR) is important to discuss because it was initially formulated as a diet pill. Yet over 50% of the new members who join my migraine group arrive with Topamax on their prescription list.

I have yet to find a single person on this drug who is not seriously considering dropping it due to its adverse effects, not to mention that it does not appear to work as a pain killer. Unfortunately, Topamax is difficult to quit. The most difficult problem is that doctors are under the false impression that a drug that blocks the voltage dependent calcium and potassium channels can just be easily stopped by a few days of reduction. However, since the voltage dependent calcium channel is a high voltage channel, for some people the discontinuation may end in seizures.

Evidence is also accumulating that Topamax can cause brain damage 4. Personally, I have heard of many cases where it in fact has done just that.

Topamax is a sugar substitute that failed as a diet pill but is somehow permitted by the FDA to be used for epileptic seizures. It also received approval for use against migraines. The reasons for such a turn of events is unclear; how can a drug that fails approval for a diet pill suddenly be a perfect match for seizures and migraines? Don’t we all wish for sugar pill to be a pain killer? Unfortunately, sugar or sugar substitutes do not have such serious adverse effects  as Topamax (they happen to have different ones).

Adverse effects of Topamax

If we look at the list of adverse effects associated with this drug (as provided by Wikipedia – Topamax), it is clear that Topamax is not very safe. Indeed, the list is very long.

Dizziness, Weight loss, Paraesthesia (pins and needles), Somnolence, Nausea, Diarrhea, Fatigue, Nasopharyngitis – common cold, Depression, Weight gain, Anaemia, Disturbance in attention, Memory impairment, Amnesia, Cognitive disorder, Mental impairment, Psychomotor skills impaired, Convulsion, Coordination abnormal, Tremor, Lethargy, Hypoaesthesia, Nystagmus, Dysgeusia, Balance disorder, Dysarthria, Intention tremor, Sedation, Vision blurred, Diplopia, Visual disturbance, Vertigo, Tinnitus, Ear pain, Dyspnoea, Epistaxis, Nasal congestion, Rhinorrhoea, Vomiting, Constipation, Abdominal pain, Dyspepsia, Dry mouth, Stomach discomfort, Paraesthesia oral, Gastritis, Abdominal discomfort, Nephrolithiasis, Pollakisuria, Dysuria, Alopecia (hair loss), Rash, Pruritus, Arthralgia, Muscle spasms, Myalgia, Muscle twitching, Muscular weakness, Musculoskeletal chest pain, Anorexia, Decreased appetite, Pyrexia, Asthenia, Irritability, Gait disturbance, Feeling abnormal, Malaise, Hypersensitivity, Bradyphrenia, Insomnia, Expressive language disorder, Anxiety, Confusional state, Disorientation, Aggression, Mood altered, Agitation, Mood swings, Anger, Abnormal behavior, Crystal urine present, Tandem gait test abnormal, White blood cell count decreased, Bradycardia, Sinus bradycardia, Palpitations, Leucopenia, Thrombocytopenia, Lymphadenopathy, Eosinophilia, Depressed level of consciousness, Grand mal convulsion, Visual field defect, Complex partial seizures, Speech disorder, Psychomotor hyperactivity, Syncope, sensory disturbance, Drooling, Hypersomnia, Aphasia, Repetitive speech (stuttering), Hypokinesia, Dyskinesia, Dizziness postural, Poor quality sleep, Burning sensation, Sensory loss, Parosmia, Cerebellar syndrome, Dysaesthesia, Hypogeusia, Stupor, Clumsiness, Aura, Ageusia, Dysgraphia, Dysphasia, Neuropathy peripheral, Presyncope, Dystonia, Formication (the sensation of insects crawling under the skin), Visual acuity reduced, Scotoma, Myopia, Abnormal sensation in eye, Dry eye, Photophobia, Blepharospasm, Lacrimation increased, Photopsia, Mydriasis, Presbyopia, Deafness, Deafness unilateral, Deafness neurosensory, Ear discomfort, Hearing impaired, Dyspnoea exertional, Paranasal sinus hypersecretion, Dysphonia, Pancreatitis, Flatulence, Gastrooesophageal reflux disease, Hypoaesthesia oral gingival bleeding, Abdominal distension, Epigastric discomfort, Abdominal tenderness, Salivary hypersecretion, Oral pain, Breath odour, Glossodynia, Calculus urinary, Urinary incontinence, Haematuria (blood in urine), Incontinence, Micturition urgency, Renal colic, Renal pain, Anhidrosis, Hypoaesthesia facial, Urticaria, Erythema, Pruritus generalized, Rash macular, Skin discolouration, Allergic dermatitis, Swelling face, Joint swelling, Musculoskeletal stiffness, Flank pain, Muscle fatigue, Metabolic acidosis, Hypokalaemia, Increased appetite, Polydipsia, Hypotension, Orthostatic hypotension flushing, Hot flush, Hyperthermia, Thirst, Influenza like illness, Sluggishness, Peripheral coldness, Feeling drunk, Feeling jittery, Learning disability, Erectile dysfunction, Sexual dysfunction, Suicidal ideation, Suicide attempt, Hallucination, Psychotic disorder, Apathy, Lack of spontaneous speech, Sleep disorder, Affect lability, Libido decreased, Restlessness, Crying, Dysphemia, Euphoric mood, Paranoia, Perseveration, Panic attack, Tearfulness, Reading disorder, Initial insomnia, Flat affect, Thinking abnormal, Loss of libido, Listless, Middle insomnia, Distractibility, Early morning awakening, Panic reaction, Elevated mood, Blood bicarbonate decreased, Neutropaenia, Apraxia, Circadian rhythm sleep disorder, Hyperaesthesia, Hyposmia, Anosmia, Essential tremor, Akinesia, Unresponsive to stimuli, Blindness unilateral, Blindness transient, Glaucoma, Accommodation disorder, Altered visual depth perception, Scintillating scotoma, Eyelid edema, Night blindness, Amblyopia, Calculus ureteric, Renal tubular acidosis, Stevens-Johnson syndrome, Erythema multiforme, Skin odour abnormal, Periorbital oedema, Urticaria localized, Limb discomfort, Acidosis hyperchloraemic, Raynaud’s phenomenon, Face edema, Calcinosis, Mania, Anorgasmia, Panic disorder, Disturbance in sexual arousal, Feeling of despair, Orgasm abnormal, Hypomania, Orgasmic sensation decreased.

The FDA Black Box on Topamax

According to the FDA and their listed label update in 2014, Topomax includes a black-box warning that has the following known adverse effects:

  • Acute myopia and secondary angle closure glaucoma: Untreated elevated intraocular pressure can lead to permanent visual loss. The primary treatment to reverse symptoms is discontinuation of TOPAMAX as rapidly as possible (5.1)
  • Visual field defects: These have been reported independent of elevated intraocular pressure. Consider discontinuation of TOPAMAX (5.2)
  • Oligohidrosis and hyperthermia: Monitor decreased sweating and increased body temperature, especially in pediatric patients (5.3)
  • Metabolic acidosis: Baseline and periodic measurement of serum bicarbonate is recommended. Consider dose reduction or discontinuation of TOPAMAX if clinically appropriate (5.4)
  • Suicidal behavior and ideation: Antiepileptic drugs increase the risk of suicidal behavior or ideation (5.5)
  • Cognitive/neuropsychiatric: TOPAMAX may cause cognitive dysfunction. Patients should use caution when operating machinery including automobiles. Depression and mood problems may occur in epilepsy and migraine populations (5.6)
  • Fetal Toxicity: TOPAMAX use during pregnancy can cause cleft lip and/or palate (5.7)
  • Withdrawal of AEDs: Withdrawal of TOPAMAX should be done gradually (5.8)
  • Hyperammonemia and encephalopathy associated with or without concomitant valproic acid use: Patients with inborn errors of metabolism or reduced mitochondrial activity may have an increased risk of hyperammonemia. Measure ammonia if encephalopathic symptoms occur (5.10)
  • Kidney stones: Use with other carbonic anhydrase inhibitors, other drugs causing metabolic acidosis, or in patients on a ketogenic diet should be avoided (5.11)
  • Hypothermia has been reported with and without hyperammonemia during topiramate treatment with concomitant valproic acid use (5.12) (FDA Topamax Label)

According to the label, Topamax is only indicated for seizures as a secondary medication in support of a primary kind and for migraines and nothing else (not even for diet anymore). Yet, I see people being prescribed this drug for all types of off-label use that are unrelated to either seizures or migraines. The large migraine group I run on Facebook grown to over 4000 migraineurs in the past two years.

Because I have found that Topamax is the #1 prescribed medicine to migraineurs when they join the group in despair and hopelessness, I have decided to designate Topamax also as the #1 medicine discussed on the series titled drugs of shame. This is apt because it affects (and often damages) the neurotransmitters (hormones of the brain) and thereby puts the whole hormonal structure of the body in chaos.

The Problem: Brain Slowing

Topamax may cause brain function slowing. Why? Topamax is a voltage dependent calcium channel blocker (also called voltage-gated calcium channel blocker), which is a key channel for neuron communication via neurotransmitter release. Topamax is systemic, meaning it doesn’t just act on a particular type of neurons but all neurons. This means that neurons that are responsible to organize how the heart beats, how the lungs function, how you blink, and how you digest are all affected by Topamax in a negative way: the neurons cannot release neurotransmitters and so the communication between hormones of the brain and the hormones of the body are broken. Many of the side effects of Topamax are so strong that migraineurs who start Topamax stop within weeks (some on day 3) of initiating this medication. The drawing below shows how voltage dependent calcium channels work and what happens when they cannot work because they are blocked.

Voltage Dependent Calcium Channel Blockers

Voltage gated calcium channels plugged and unplugged
Voltage gated calcium channels plugged and unplugged.

Figure 1. How Voltage Dependent Calcium Channels Work


In figure 1 you see a simplified neuron on the left and the axons of another neuron on the right. In the synaptic cleft normally neurotransmitters work like a domino effect. One neuron receives a signal from a sensory organ that stimulates the release of neurotransmitters that are specific to the type of stimulus. The neurotransmitters then get to be picked up by the neuron connected to the releasing neuron and pass the signal along. When the signal volume, intensity, frequency reaches a particular threshold, the brain sends a command to the body: wipe nose, for example.

Blocking the voltage dependent calcium channels from firing means that no neurotransmitters can be released and thus no message is passed on to the necessary number of neurons to reach the threshold. Since Topamax is systemic, every function of the body is hampered to some degree.

Neurons have five types of voltage dependent calcium channels based on voltage requirements:

  1. L-type that directs skeletal muscles, cardiac related muscle cells, endocrine cells, adrenal, etc., associated with contraction, hormone release and synaptic integration (neurons working together)
  2. P/Q-type that activate neurons and neurotransmitter and hormone release
  3. N-type works at the nerve terminals similarly to P/Q for neurotransmitter and hormone release
  4. T-type think of it as the pacemaker of the brain for firing with a particular frequency
  5. R-type that works with cerebral cells and some neurons

For each of these, the current required is different so fine-tuning is necessary. The calcium channel must go through all stages of voltage levels to be able to perform all five types of actions, as the body requires all of them. Note that when the voltage gated calcium channels are blocked, none of these 5 types of actions can properly function. The body will utilize its reserves to maintain vital functions. People who take Topamax can still breathe and their hearts beat – but they have serious issues, for example, with body cooling, which is a pretty basic, built-in automatic motor function. People who take Topamax overheat and cannot cool themselves. Most interestingly Topamax prevents the very functions a migraine brain needs for relief the most because it blocks those channels that would instruct the brain to cool the body.

In addition, Topamax blocks both voltage dependent sodium-potassium channels. I have written extensively on voltage dependent sodium-potassium channels in previous articles so here I just present a short summary. Voltage dependent (or gated) sodium-potassium channels have the critical function of sodium and potassium exchange in the cell to ensure that proper voltage is created in the cell membrane. Proper voltage is required so that the channels can open and close their gates, nutrients can enter and waste products can leave. Neurons cannot manufacture neurotransmitters without the availability of various minerals, many of which must be able to enter the neuron via voltage gated sodium-potassium channels. When these channels are not able to generate the proper action potential, nothing moves in or out of the neuron. By blocking voltage dependent channels, the high voltage needed to release the neurotransmitters is dulled as well.

Topamax robs the brain from its most important vital roles: making neurotransmitters that transmit messages and regulate brain and important autonomic body functions such as, cooling the body when it is too hot,  maintaining and appropriate heart beat, or simply making a decision1.  I think, Topamax is one of the more dangerous drugs on the market. From what I can gather from the research and my work with migraineurs, Topamax does not appear to work for pain. It only slows brain function. I would not be surprised to see researchers soon showing a connection between Topamax use and dementia. Until then, proceed with caution.

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More people than ever are reading Hormones Matter, a testament to the need for independent voices in health and medicine. We are not funded and accept limited advertising. Unlike many health sites, we don’t force you to purchase a subscription. We believe health information should be open to all. If you read Hormones Matter, like it, please help support it. Contribute now.

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1          Sommer, B. R., Mitchell, E. L. & Wroolie, T. E. Topiramate: Effects on cognition in patients with epilepsy, migraine headache and obesity. Therapeutic Advances in Neurological Disorders 6, 211-227, doi:10.1177/1756285613481257 (2013).

2          Nelles, G. et al. Prevention of episodic migraines with topiramate: results from a non-interventional study in a general practice setting. The Journal of Headache and Pain 11, 33-44, doi:10.1007/s10194-009-0163-x (2010).

3          Navarrete, F., Pérez-Ortiz, J. M. & Manzanares, J. Pregabalin- and topiramate-mediated regulation of cognitive and motor impulsivity in DBA/2 mice. British Journal of Pharmacology 167, 183-195, doi:10.1111/j.1476-5381.2012.01981.x (2012).

4          Garvey, W. T. Phentermine and topiramate extended-release: a new treatment for obesity and its role in a complications-centric approach to obesity medical management. Expert Opinion on Drug Safety 12, 741-756, doi:10.1517/14740338.2013.806481 (2013).

5          Geddes, J. R. & Miklowitz, D. J. Treatment of bipolar disorder. Lancet 381, 10.1016/S0140-6736(1013)60857-60850, doi:10.1016/S0140-6736(13)60857-0 (2013).

6          Campayo, J. G. et al. Effectiveness of topiramate for tobacco dependence in patients with depression; a randomised, controlled trial. BMC Family Practice 9, 28-28, doi:10.1186/1471-2296-9-28 (2008).

7          Johnson, B. A. & Ait-Daoud, N. Topiramate in the New Generations of Drugs: Efficacy in the Treatment of Alcoholic Patients. Current pharmaceutical design 16, 2103-2112 (2010).

8          Pereira, A. G., Michael J.; Gross, Robert A.; Posner, Kelly; Dworkin, Robert H. Suicidality associated with anti-epileptic drugs: implications for the treatment of neuropathic pain and fibromyalgia. Pain 154, 345-349 (2013).

This article was first published on September 10, 2015.


Why Are We So Scared of Salt?


Over the past several decades, the general consensus of health professionals has been to recommend that all people lower their salt intake. Without the recognition of the effects of lifestyle and dietary choice differences, this avalanche of low salt advice hit the general public and as a direct result many became ill. Differences in individual genetic, lifestyle, and dietary factors have completely been ignored in the broad-brush campaign for lowering salt intake. Today, it is unmistakably obvious that a large segment of the population followed the low salt regimen with disastrous consequences.

The professionals who first introduced and propagated the low salt diets had good intentions. They did not know any better. Now we do know better and there is no excuse for not revising a failed treatment regimen in the face of new countervailing evidence. The process of correction needs to begin on a large scale. My work is part of this very much needed correction.

Why Are We Scared of Salt?

In the 1960’s, scientific studies linked salt consumption to hypertension and obesity. I am not quite sure why it was salt they picked on as “enemy number one.” I suspect the reason was the proliferation of precooked and canned food, all of which were salt preserved. To me, it was not logical that only salt was picked on. There were many other dangerous food items that could have been singled out: sugar, margarine, preservatives, pesticides, etc. The American Heart Association still has some of these salt reduction articles on their website. Even today, when waiting for an appointment at my medical institution, the forever-on TV was showing how to cut salt out of kids’ daily lunch to be “healthy.” Indeed, once something is ingrained in our brains, it is habit forming. Habits are very hard to break, particularly when the medical research relied upon showed that salt is something dangerous that may kill you.

Is Salt or Sugar the Enemy?

The problem is that hypertension and obesity are not and have never ever been caused by salt! They are caused by sugar—I am saving the sugar discussion for my next article.

Why not salt? Consider: human fetuses are floating in salt water and are typically not born with heart attack or hypertension. Our bodies are made of over 7% salt, our brains, heart, and all of our cells use salt to function. Humans have always consumed salt. Do they all have hypertension and heart attacks? No, they don’t. In fact, for some time now, studies have been surfacing suggesting that reduced salt does not eliminate the chances for hypertension and heart attack but may even contribute to the problem.

It is scientifically irresponsible to analyze biological processes in the human body involving salt without accounting for the effects of sugar and sugar substitutes and the amount of water consumed.

Probably not many of you have the handbook “Harrison’s Manual of Medicine” (18th edition McGraw Hill Medical by Longo et al.,) but I do. Page 4

…serum Na+ [sodium] falls by 1.4 mM for every 100-mg.dL increase in glucose, due to glucose-induced H2O efflux from cells.

Let me explain this sentence for you: Sodium is part of salt. Salt is Sodium (Na+) and Chloride (Cl-) where the + and – represent the ionic state in which there is either one extra or one fewer electron (electrons have negative charge) and so the atom is looking for another atom it can attach to and form a bond creating a molecule. According to the medical handbook, Na+ drops if glucose, which is blood sugar, increases. If you eat glucose, it causes “H2O efflux from cells” which means that sugar attracts water to the point that it pulls it out of the cells, thereby emptying the cells of sodium, and thus, the cells are dehydrated.

Sugar causes a very serious problem that can result in hypertension and heart attack. The volume of blood inside the cells reduces by dehydration of the sugar and higher pressure is required to pass the dehydrated blood to traverse the same route and be able to oxygenate organs at the same rate as hydrated blood cells. Think of a water hose when suddenly the pressure drops (unfortunately we cannot replicate reduced water molecule size the same way dehydrated cells become smaller). You instinctively squeeze the hose end to increase pressure so the water can continue to reach to the same distance. You have just given a hypertension to your water hose!

Note that if sodium (page 3 in same book) falls below 135 mmol/L, it is an electrolyte abnormality whose symptoms include “nausea, vomiting, confusion, lethargy, and disorientation”; if Na+ falls below 120 mmol/L it is a life threatening emergency that may cause “seizures, central herniation, coma, or death.” Not having enough salt (sodium) in the body is called hyponatremia and is “primarily a disorder of H2O homeostasis” meaning too much water and not enough salt. In common parlance, this is called water toxicity. Water toxicity can be caused by drinking too much water—e.g. drinking only water.

Interestingly, in the same book under the section of hypertension (page 834-835), the causes of hypertension are listed. Increased salt (or sodium) is not mentioned at all, but glucose intolerance is. However, under treatment, on page 836, it recommends lifestyle modifications that include lowering salt intake. So increased salt did not cause hypertension but lowering will cure it? I do not understand. Do you? Seems the authors of even this highly respected medical reference book could not escape the fallacy of the low salt campaign. Hypertension is clearly listed to be caused by sugar under the causes. So for heaven’s sake, if something is caused by sugar, treat it with removing sugar from our diet and not salt.

Confusion in the Ranks

In recent years a major fight started between the academic groups, not-for-profit organizations, and the government. Test after test shows that earlier hypotheses were all wrong about salt. Not only is added salt not hurting us, reduced salt does. Even the American Heart Association (AHA) and other heart organizations are in complete confusion. Next to the article of “lower your salt for health” are articles saying “that is all wrong and increase your salt.” I find this kind of funny. Here is an article from the AHA suggesting to increase salt. Here is another from the HealthAffairs organization; one from the American Journal of Hypertension, one from the Journal of the Association of American Medical Colleges, and there are now dozens more proving that indeed, reduced salt is actually bad for you.

How Bad is Reduced Salt on Health?

This particular article is my favorite because it shows how bad reduced salt diets really are on the heart. In detail, for a healthy individual reduced salt diet reduces BP by 1% (that means your systolic BP of 120 just dropped to oh my 118.5!!! gasp) and in patients with hypertension it reduced their BP by 3.5% (that is if it is say 160 systolic, which is high, it is reduced by a whopping 5.6 to 154.4! gasp again) but at the same time triglycerides, which contains the accurate measure of the sticky type of bad cholesterol in the LDL increased by 7% in people with hypertension (triglyceride should be less than 149). So if an individual with hypertension and triglyceride levels at 150 went on a low salt diet, that low salt diet would increase their triglycerides by 10.5 to 160.5, which is a significant jump for bad cholesterol. In a healthy individuals, the triglycerides jumped by 2.5%. Armed with such details, do you still believe that salt is bad for you?

Which Would You Rather Eat?

If I handed you 2 teaspoons: one was full of table sugar and the other full of table salt, which would you chose? For taste, we all would choose the sugar. What happens to our salt levels when we eat sugar? Refer back to the Harrison’s Medical Manual I mentioned earlier: eating glucose drops salt in our body because it sucks up all water and dehydrates. Eating a teaspoon of sugar will effectively dehydrate you and put you at risk of hyponatremia. By contrast, what will happen if you chose the teaspoon of salt? You will be thirsty, drink a couple of glasses of water and will feel like you are on top of the world.

My Recommendation

Stop being scared of salt and start being scared of sugar!


Longo et al., Harrison’s Manual of Medicine; 18th Edition, 2013; McGraw Hill Medicine

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This article was first published on June 13, 2015.


Popping the Obesity Balloon


It is well known that obesity in the United States is in epidemic proportions. It is also well known that it presents a risk for metabolic disease, the most common being diabetes. Books have been written about various diets and appetite curbing pills are legion. It is, of course, obvious that the type of diet consumed by so many people is responsible. What has not been understood is the exact mechanism.

Obesity and the Brain

Fat is stored in cells called adipocytes (from Latin adep, fat) these cells are capable of producing a hormone called leptin. This circulates in the blood until it comes to the part of the brain known as the hypothalamus. The message that leptin delivers to this organ tells it that the fat stores in the body are full and food intake should be curtailed. It is an important mechanism of appetite control. It is not generally appreciated that it is the brain, not the stomach, that is responsible for the sensations of hunger and satiety, thus controlling appetite.

As usual in basic science research, leptin was discovered in mice. By injecting it into fat mice that were made to be leptin deficient experimentally, appetite control resulted in reduction in body weight to normal proportions. It was concluded that this would be the obvious treatment for obese humans. Clinical trials with leptin treatment in obese humans failed to make any difference. It was then found that these humans already had plenty of circulating leptin but the hypothalamus was insensitive to its message. Adipocytes were doing their part but the hypothalamus was unresponsive. The question then was why the hypothalamus was insensitive and not responding to this important mechanism. The next phase of research was published in a scientific journal called Cell. This is read only by a group of scientists that are studying the properties of the cells that make up the body. It will be a long time before this research reaches clinicians and it also has the disadvantage of having been performed in mice. The message is so transparent, I undertook to report it here because we can use it now.

Of Mice and Men

When mice were fed on a high-fat diet, a mechanism was found in the hypothalamus. A “master switch” that controls inflammation in the body was turned on. This switch normally remains inactive throughout life in healthy animals. However, with it turned on, the mice gained weight and became resistant to insulin and leptin. By using genetic engineering, the researchers were able to turn off the master switch and they were then protected from becoming obese, even on a high-fat diet. It has been known for a long time that obese people develop inflammatory disease. The mechanisms involved are extremely complex but the simple message is one that is timeless “don’t overeat, particularly high calorie junk foods”. It has also been long known that calorie restriction in experimental animals is the only way to extend their longevity. Hungry animals fed this way not only live longer than those fed with enough food to give satiety, they also remain much more active into old age. We are obviously not required to remain permanently hungry, only to reach satiety with the right food. It is therefore not surprising that “junk food” eaters are always hungry.

Diet Basics: Eat Real Food

If this research is true for humans, it may be that it is actually a protective factor as long as we obey the rules of diet that have been with us for thousands of years. It is only recently that we drive a two ton machine to a store to buy food in a variety of boxes packaged by a food industry that depends entirely on their products being purchased. We would not require anti-inflammatory drugs or even a special diet. All we would need is self discipline and a full recognition that the only food we should ingest is the natural food that I used to tell all my patients is “made by God”. The high calorie man-made foods, many of which are simple carbohydrates, should be rejected completely. This is, of course, advice that is bound to be ignored by the majority because our sense of sweet taste that provides so much pleasure is perceived by our brains. Also, natural food is expensive. Taste buds on the tongue send a sensory input signal to the brain where it is interpreted. Reducing it to first principles, so much of our diet is hedonistic. As the old saying goes, we live to eat rather than eating to live.

Sugar on the Brain

Sugar extracted from its natural source is more of a drug than a food. This is because censors on the tongue send an input message to the brain where the sensation of sweet taste is perceived and interpreted. I remember that several physicians wrote letters to medical journals to state that the sweetener, aspartame, was responsible for a number of symptoms in their patients identical to those induced by sugar, including migraine headaches. The manufacturers responded by performing a study in which aspartame was given to experimental subjects in the form of capsules that they swallowed, thus bypassing the sweet taste mechanism. The study showed that there was no evidence for migraine or any other symptoms as a result of administration of this chemical sweetener by this method, suggesting that its effects are produced by the sensory input from tongue to brain. I am personally highly sensitive to sugar. The ingestion of one cookie gives me whole-night insomnia. Since I am not unique, I wonder how many people are taking sleeping pills because of chronic insomnia induced by their innocent consumption of sugar.

Artificial Sweeteners: Chemical Cocktails

Aspartame breaks down in the body to formaldehyde (used to pickle bodies), formic acid (used by bees to sting) and wood alcohol (that makes people go blind). Irrespective of the chemical content of artificial sweeteners, however, they are no substitute for sugar since they are likely to do the same thing. The only escape is to break the sweet taste craving by “cold turkey” withdrawal. I have seen many people get well by doing this. Sometimes it only takes a very small intake of sweet taste to cause relapse and reappearance of the previous symptoms. To back up my conclusion that this is a drug effect, I have seen many people that cannot resist sugar, even though they know perfectly well that they will suffer for it. In fact, animal studies have shown that sugar is more addictive than cocaine.

Doctors and Self-Discipline

Doctors therefore have the responsibility to educate patients about how their God-given health can be maintained. We know now that our genes are drastically changed by poor diet and lifestyle and we therefore can produce diseases in ourselves. The choice is ours to make.

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Aspartame: A History of Controversy, but is it Safe?


Pink, Yellow or Blue? Which Low-Calorie Sweetener are You?!

I’m sure somewhere in a women’s magazine there is a quiz that associates the reader’s personality, or the type of man she should date, or some other unassociated trait with random questions playing up on the fact that women have been trained like Pavlov’s dogs to diet. In recent years, beverage companies have started rolling out campaigns that appeal to the other 50% of the population. Most notably, Dr. Pepper Ten is advertised as the “manliest low-calorie soda in the history of mankind.” This soda is also advertised as “not for women.”

Yet, in spite of million dollar marketing campaigns, consumers are making better choices. According to Beverage Digest, the sales volume for Coke fell 1% last year, but Diet Coke sales dropped by 3%. Similarly, Pepsi fell by 3.4% and Diet Pepsi fell by 6.2%. Diet sports beverages also dropped in sales compared to their regular product.

Due to these declines, Coca-Cola is rolling out a set of advertisements about the safety of aspartame, a low-calorie sweetener with a controversial history. There is as much “evidence” that this artificial food additive is safe as there is evidence that it causes health problems including brain tumors, seizures, blindness, the auto-immune disease Lupus, and much more. I’ll let the history of this product speak for itself on the controversy of consumer safety, but first what is it?

Aspartame Ingredients

Aspartame is a man-made chemical that is approximately 50% phenylalanine, 40% aspartic acid, and 10% methanol. Today, it is made using genetically modified bacteria developed by none other than Monsanto, of course. The ingredients occur naturally, so they are safe, right?

Phenylalanine is a neurotoxin and can build up in the blood due to the high levels in aspartame. Phenylalanine causes serotonin levels to decrease leading to depression. It can also cause behavioral symptoms in kids including ADD and ADHD. Individuals who have the genetic disorder Phenylketonuric (PKU) cannot metabolize phenylalanine and the high levels in aspartame can cause death (overtime the chemicals in aspartame can build up in the body and cause death even if an individual does not have PKU).

Aspartic Acid is an excito-toxin, which means it over stimulates certain neurons in the body until they die. When aspartic acid is in its free form, or unbound to proteins (as it occurs naturally in food), it leads to a high level of neurotransmitters in certain areas of the brain which kills neurons and leads to numerous neurological disorders including, but not limited to: multiple sclerosis, Parkinson’s disease, hypoglycemia, memory loss, hormonal problems, epilepsy, dementia, Alzheimer’s disease, and more.

The argument that phenylalanine and aspartic acid are safe is based on the fact that they are amino acids, the building blocks of protein that both occur in regular foods. In nature, however, these amino acids are consumed in more natural quantities and different combinations (oh, and they aren’t made in a lab).

Methanol – this is wood alcohol and when ingested becomes formaldehyde or embalming fluid. While there is naturally occurring methanol in fruits, it binds with the pectin in fruit, which the body cannot digest, and is excreted through the body’s natural waste process without doing damage. We do not digest high levels of methanol when eating organic, whole foods. Methanol is a neurotoxin and known carcinogen. The EPA recommends limiting consumption of methanol to 7.8 milligrams per day. One liter of an aspartame-sweetened beverage contains over 50 mg of methanol.

A Long History of Controversy

The history of getting FDA approval of this product is rich in corruption and deceit.

  • 1965 – James Schlatter, a chemist at G. D. Searle was researching an ulcer drug and accidentally discovers a zero calorie sweetener that is 180 times sweeter than sugar.
  • 1967 – G. D. Searle starts conducting tests on the new potential product. These are tests required by the FDA. In the first test conducted on 7 monkeys, 1 died and 5 suffer from grand mal seizures.
  • 1971 – Neuroscientist Dr. John Olney conducts a study and discovers that aspartame causes brain tumors. Previously Dr. Olney conducted safety tests on MSG and successfully had the food additive removed from baby food. He concludes that aspartic acid, one of the key ingredients of aspartame, causes holes in the brains of infant mice. One of Searle’s scientists makes the same conclusion during his testing.
  • February 1973 – After spending tens of millions of dollars testing the safety of aspartame, G. D. Searle submits over 100 studies to the FDA requesting approval for consumer consumption.
  • March 1973 – One of the first FDA scientists to review the aspartame safety data states that “the information provided (by Searle) is inadequate to permit an evaluation of the potential toxicity of aspartame”. Notes in her report that further clinical tests are needed.
  • July 1974 – FDA approves use of aspartame in dry food products.
  • August 1974 – Attorney Jim Turner, consumer advocate who worked helped get the previous reigning artificial sweetener, Cyclamate, off the market for its links to cancer, and Dr. Olney file objections of the approval of aspartame in dry foods.
  • 1976 – An investigation reveals that the required studies conducted by the G. D. Searle company and reported to the FDA were not conducted or reported properly. The investigators report they “had never seen anything as bad as Searle’s testing.”
  • January 1977 – The FDA requests the US Attorney’s Office to begin grand jury proceedings to investigate whether indictments should be filed against G. D. Searle for submitting false test results on the product. This is the first time the FDA requested a criminal investigation on a manufacturer.
  • March 1977 – G. D. Searle hires Donald Rumsfield as CEO. Donald Rumsfield hires numerous former politicians in order to save the company.
  • July 1977 – Samuel Skinner resigns from his position in the US Attorney’s Office to take a job with G. D. Searle’s representing law firm, Sidley & Austin. Skinner was the US Attorney in charge of the investigation. Due to Skinner’s resignation the grand jury investigation is postponed and it reaches its statute of limitations and the case is dropped.
  • August 1977 – The FDA releases the Bressler Report. The report finds that 98 of the 196 animals died during one of Searle’s studies weren’t autopsied until later dates, in some cases over one year after death. The report released many more inconsistencies. You can read the FDA’s findings here.
  • 1980 – The Public Board of Inquiry (PBOI) voted unanimously to reject the use of aspartame until further studies could be conducted. They were concerned with the high rate of brain tumors in animals used in studies.
  • January 1981 – The day after his inauguration, Ronald Reagan appoints Dr. Arthur Hull Hayes as FDA commissioner. His advisor for this decision was Donald Rumsfield, CEO of G. D. Searle, at that time.
  • March 1981 – Hayes establishes a commissioner’s panel to review issues brought up by the PBOI. During this review, three of the six FDA scientists reviewing the data on brain tumors advise against the approval of aspartame due to the unreliability of G. D. Searle’s tests.
  • July 1981 – Hayes overrules the PBOI, ignoring the recommendation of his appointed FDA Commissioner’s panel.
  • 1982 – Searle files a petition that aspartame be approved in beverages.
  • July 1983 – The National Soft Drink Association drafts an objection to the final ruling to permit the use of aspartame in beverages due to its questionable safety.
  • September 1983 – FDA Commissioner Hayes resigns and accepts a position as a senior scientific consultant at Burson-Marsteller, Searle’s public relation firm.
  • Fall 1983 – First beverages using aspartame as ingredient are sold.
  • 1985 – Monsanto buys G. D. Searle in spite of the controversy over aspartame.

For a more detailed timeline, click here for “How Aspartame Became Legal – the Timeline” on

Fast Forward Twenty Five Years to 2013

Today we are more aware and skeptical than ever about the politics and bribery involved in getting a product approved by the FDA, yet aspartame is in over 6,000 consumer products. Our diet obsessed culture has overlooked the corruption and dangers of this chemical food additive and let it poison our own bodies and our children. According to the Aspartame Information Center, “aspartame is consumed by over 200 million people around the world and is found in more than 6,000 products including carbonated soft drinks, powdered soft drinks, chewing gum, confections, gelatins, dessert mixes, puddings and fillings, frozen desserts, yogurt, tabletop sweeteners, and some pharmaceuticals such as vitamins and sugar-free cough drops.” Most consumers associate this food additive to diet drinks and products, but it is now added to most processed foods including those marketed for children. It is marketed as “safe” but as you can see in the history of the product, there have never been any properly conducted studies that conclude that this product is safe.

With the risk of obesity and type 2 diabetes on the rise, especially in children, we are looking for easy ways to cut calories. It’s much easier to reach for something labeled and advertised as “calorie-free” instead of eating healthy, whole foods low in sugar and free of chemical enhancements. However, this well marketed shortcut is not the solution to our nation’s health problems and is actually causing a rise in numerous health issues. Aspartame leads to behavioral disorders, seizures, brain tumors, auto-immune diseases, various neurological disorders, and it also causes weight gain and sugar cravings (which lead to obesity and type 2 diabetes which is what promoters argue it helps fight).

So, pink, yellow or blue? Pick your poison. Or ditch the women’s magazines’ various yo-yo DIEts and create a healthy LIFEstyle for yourself and your family so you can figuratively have your cake and eat it too.

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This article was published originally on Hormones Matter on August 20, 2013.


Thiamine Deficiency and Sugar in Diabetes


Thiamine is one of the B vitamins and I need to explain its action. To put it as simply as possible, it regulates sugar metabolism in every cell within the body and has a special importance in the brain. About four years ago a researcher in England reported that there was a mild deficiency of thiamine (vitamin B1) in diabetic patients, a disease that affects sugar metabolism. He said that all diabetics should have a supplement of thiamine because he had anticipated that it will prevent complications in this devastating disease. If that is not enough to make a diabetic sit up and take notice I would be very surprised.  I will try to explain this a little further.

A program on PBS television called “The Quiet Revolution” reported that there were 29 million patients in the United States with type two diabetes and as many as 70 million with pre-diabetes, meaning that they were on their way  to contract the disease. If we had 29 million cases of “flu” it would be called a pandemic. Most people with type 2 diabetes have no idea that their health before the onset of the disease is within their own responsibility. Our culture says “go ahead, do what you like, eat what you like, drink what you like; if you get sick, it is just bad luck and you go to one of those clever characters called Dr. who will produce the magic bullet that “cures” you because of the wonders of modern scientific medicine.

Although both types one and two have different causative factors, I want to emphasize very strongly that both types are not purely genetically determined. The genetic risk in type 1 is much greater than in type 2 and is certainly the major component as the underlying cause. Type 2 is much more clearly initiated by dietary indiscretion in a person who might be, shall we say, at genetic risk. Much of our diet today involves the consumption of man-made foods developed by the food industry. Of course, the main drive of this industry is to sell their products and so it appeals to our palatability, a sensory phenomenon that has nothing to do with good nutrition. We all know what pleasure we get from tasting anything that is sweet. Since sweetness sells, it explains why so many man-made foods are laced with sugar, so long thought to be harmless and even good for you by supplying quick energy.

Sweet and Dangerous: Sugar and Thiamine Deficiency

In 1973, John Yudkin, a professor of nutrition in a large London Hospital wrote a book with the title “Sweet and Dangerous”, the result of his many years of research into the dangers of sugar.  He reported that many diseases, including heart disease, were related to its ingestion. As so often happens, this terribly important book was ignored and cholesterol became the demon for the cause of heart disease. Now, 40 years later, many people know that the cholesterol story has been debunked. Because sugar requires vitamin B 1 to metabolize it, in much the same way as gasoline requires a spark plug to burn it, taking sugar on its own in the form of empty calories easily overwhelms the power of thiamine to carry out its function.

That means that you have an imbalance between the calories and the vitamin or a relative deficiency of thiamine. Your daily intake of thiamine may be sufficient for a good diet but not enough to take care of the overload of sugar represented as the bad diet which is so common.  It may easily be accomplished by the consumption of the stuff that we consume in our social activities.  Yes, there is no doubt that it makes the mouth water and the sweetness underlies the joy of the social event but if it is causing widespread disease, I ask you, is it worth it?

The lower part of the human brain is particularly sensitive to thiamine deficiency and because this part of the brain organizes the entire body in its performance of adapting to the environment in which we find ourselves, we easily become maladapted. For example, we may feel cold when it is hot or hot when it is cold, a mistake in sensory input and brain interpretation. The nervous system involved in this reaction is known as the autonomic nervous system and is entirely automatic.  The message from the brain to the heart causes it to accelerate when it is a necessary adaptive need as, for example, running for a bus.  But when this happens spontaneously for no apparent reason at all, we might take this to a physician and tell him that “I have palpitations of my heart”.  Unfortunately the medical focus would be on the heart not on the nervous system that caused the acceleration. For this reason one of the complications in diabetes is called “autonomic neuropathy”, meaning that the autonomic nervous system is disorganized. Thiamine protects diabetics from complications because it improves the ability of our cells to produce adequate energy for function by “burning sugar as brain fuel”.  Think of it as a change of inefficient spark plugs in a car engine.

Thiamine deficiency is sometimes referred to as pseudo (or false) hypoxia because it results in exactly the same symptoms as those from a mild to moderate deprivation of oxygen. Its effect on the lower part of the brain is to make it more reactive to all input signals. When you read a telegram giving you bad news, your eyes send a signal to the brain that has to interpret the meaning of the signal. I refer to the input signals, whether they are physical or mental, as “stress”. Your response to the stress is organized by the lower brain with “advice and consent” from the higher brain. Freud referred to the lower brain as the “id”. It reacts automatically to anything perceived as danger or self indulgence and the upper brain as the “ego” because it either permits or prevents the ensuing action. It is our moral censor.

I have studied the effects of this kind of “high calorie malnutrition” and it is responsible for a huge amount of mental illness and unpredictable bad behavior. It makes the “id” irritable and weakens the “ego” making a person much more likely to act in response to a whim or a nursed grievance.  There is much evidence that it can even affect criminal behavior.  This kind of malnutrition is widespread in America, but I have never seen it discussed in relation to whether the behavior exhibited at inexplicable school shootings is a potential factor. A recent exhibition of “road rage” projected on TV news might just be comprehensible because it was otherwise well beyond civilized behavior. Although this may sound too far-fetched, we have an epidemic of Attention Deficit Disorder, with or without hyperactivity, learning disability and obesity in our children that defies a genetically determined cause. Nature does not make that kind of mistake in so many individuals. Their young brains are irritable and disorganized because of dietary indulgence.

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Sweet Death by Sugar


We all know that sugar is bad for us but we cannot resist it. Why not? Expert Robert Lustig MD, reasoned on 60-Minutes that for humans in nature all sweet tasting things are edible and not poisonous. There are no toxins in nature that taste sweet, and thus, evolutionarily speaking, favoring sweet things is predetermined in our genes; we are born liking sweets. All of this is true with one major exception: sugar, the natural substance, can become poisonous when modified.

Sugar and Ethanol

Consider the simple modification of squeezing a fruit for its juice. The modification is not chemical: we merely separated the sugary liquid from the insoluble fiber in the fruit–some soluble fibers may remain. This little change makes no difference for most fruits or our taste buds, but it modifies how our body metabolizes sugar in it. According to Lustig’s book Fat Chance (a must read!), when we eat the fruit with insoluble fiber attached (typically the skin), the fructose in the fruit (most sugar in fruit is fructose) bypasses our metabolic digestive process (insoluble fibers are not digestible) and heads straight to the gut where the good bacteria digest the fructose as their food from the fibers, thereby producing more nutrients for us. But if we drink the juice alone without any insoluble fiber, the same amount of fructose now gets into the metabolic cycle and by a complicated process turns into ethanol and gets stuck in the liver. Ethanol is a toxin. Ethanol is an alcohol we also use to improve car mileage. Ethanol causes non-alcoholic “alcoholic” liver disease. In fact, ethanol is alcohol and those drinking apple juice (thinking of kids now) are in fact drinking alcohol in terms of the likely outcome of the metabolic process, as per Dr. Lustig.

So we all thought that feeding our kids fresh fruit juices is a good thing but we also knew that they should not be getting too much sugar because their behavior changes from it. Now it is clear why their behavior changes: the part of sugar that turns into ethanol is alcohol. The other parts of the fruit juice that do turn into digestible sugars (glucose and sucrose) do something else to the body.

What is Glucose?

Glucose is “blood sugar” meaning the sugar our body can use. Sucrose converts to glucose as well. What happens to the glucose?

Some stores sell glucose in a liquid gooey form—thicker than honey—that I recommend you taste. Take a small teaspoon, fill it with glucose and swallow. The first thing you will notice (yes, I did the tasting test) is that it is not that sweet. The second thing you will notice is that the moment you swallow it, you cannot count till 5 and you are hot. So you take your sweater off. Then you have the urge to do something—paint the house? Mow the grass? If you are a kid: bounce off the walls and drive the people around you nuts. This is normal. This is what glucose feels like.

Note, however, that when you eat a teaspoon of table sugar, you will neither feel so hot, nor will you have so much energy. What is the difference? What happens when you drink a diet drink or eat sugar substitutes? You will neither be hot nor have any energy. The difference in feeling hot and having energy versus not feeling hot and not having energy represents the difference in the metabolism of glucose versus fructose and the fake sugar stuff.

The Metabolism of Glucose versus Fructose

I will not get into deep chemical equations or models; for that please watch the video below by Dr. Lustig. Rather, I will reduce all complexity and simply tell you the end of the story with as minimal of the underlying process as possible.

When food arrives into the body, insulin is released to convert the food into fat and deposit it for later use as glucose. Glucose is used by our brain and muscles for energy. After insulin has done its conversion, all insulin is used up. When the brain is hungry, it fetches the hormone leptin to get some energy. Thus, leptin grabs a hold of the available glucose and serves it to the brain (this is highly simplified!). The brain is happy and full of energy.

Now consider the situation when the only food we eat is glucose. Insulin is released but it has nothing to convert. It is already in the final form (glucose for the brain) and so the glucose goes straight to the brain, the kids are popping off the wall, and you suddenly find yourself painting the house. Note, however, that the insulin is in the blood and it is waiting for the food to arrive so it can work and convert it to fat. But there is no food; we only ate glucose and it is already being used by the brain! So what is insulin in the blood to do? Insulin stays in the blood, circles around looking for food. It finds none. By staying in the blood, over time this is a “cry wolf” scenario and the body starts ignoring insulin announcing the arrival of food that isn’t there. This is how insulin resistance starts.

Now consider that instead of glucose, you drink a glass of apple juice. It has natural sugar in it, some vitamins (very little), no fiber, no protein. The sugar of fruit is mostly fructose but a small part of it is also sucrose. So insulin releases again to match the size of the apple juice drink we just had, but again, it faces a problem. While sucrose becomes glucose in our body and can be converted and stored as fat, fructose is not seen as sugar. So once again, insulin is looking for food but finds none; it keeps on circling in our blood looking for food. It is ignored and insulin resistance begins.

The Metabolism of Glucose versus Sugar Substitutes & “Natural” Sugars like Stevia

Now consider you eat a diet something—by diet I mean sugar substitutes with reduced or zero calories. It certainly tastes sweet (very sweet indeed) but again, there is no glucose or sucrose in it and while it does not become alcohol in the liver, it certainly makes insulin run around in circles looking for food to convert to fat and deposit. Cry wolf again and the insulin is ignored. Insulin resistance begins. Why is this important? Because insulin resistance is type II diabetes!

The Famine

Now let’s continue about the peril of our non-toxic sweets. The fact that insulin is out looking for glucose also signals leptin that energy is incoming! Leptin is a hormone that is in charge of messaging the brain that glucose is available. In the case when insulin is running around in our blood in search of food it can convert to fat for later use as glucose but there is no food to be found, leptin finds no glucose. Thus, leptin tells the brain that famine is here.

Famine for the Brain is Obesity for Your Body!

The famine message to the brain means one thing: conserve energy. It reduces all non-essential activities, and literally, will not let you get up from that couch! This is highly simplified of course, but pay attention to the outcome. You are actually eating and drinking and at the same time your brain is getting the message of famine. What will that lead to? When the brain thinks it is famine time, it is famine time. The fact that you are eating and drinking sugar or sugar substitutes with lots of calories is not noticed by the brain. As far as it is concerned, there is no glucose available so it must slow your metabolism. A slow metabolism leads to obesity.

Sugar Anyone?

So, while there are many people who think nothing of having sweets or a soda, consider what it does to your body! Consider that it slows down your activity and forces you into famine state even though you are well fed! Consider that it makes you obese and sets you up for type 2 diabetes.

Now tell me if you still think that sweets are not toxic poisons for us! They are. And there is one more thing to add to the story that no one talks about. I mention this because I deal with a group of migraineurs—I was one of them until I figured things out and wrote a book about it and several articles about it on Hormones Matter.

Consider this quote from the Harrison’s Manual of Medicine:

…serum Na+ falls by 1.4 mM for every 100-mg/dL increase in glucose, due to glucose-induced H2O efflux from cells. (page 4)

Na+ is sodium ion. Sodium is part of sodium-chloride, which is salt. Glucose-induced H2O efflux from cells represents water exiting the cells as a result of an increase of glucose. Why is that, you may ask? The answer is very simple: sugar is an amazing water soak-up device. It pulls water from everywhere it can. It holds onto water like its life depended upon it. Unfortunately for the body, sugar pulls the water from the cells leaving the cells empty on the inside and a lot of fluid tied to sugar on the outside. As long as that sugar is there, the cells are not able to hydrate in any fashion until the level of Na+ is increased beyond a threshold level where Na+ can take water away from the glucose. Na+ also attracts water. In fact, all saline electrolyte liquids provided by IV or for drinking in hospitals are Na+ heavy to rehydrate the cells.

Thus, sugar not only starts and enhances diabetes II and obesity; it also shuts down cell hydration. This may cause headaches or migraines depending on your propensity.

In conclusion, if someone asks you if you would prefer to eat a teaspoon of sugar or a teaspoon of salt, while your taste buds will undoubtedly scream for sugar, you should know better!

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  1. Sugar: The Bitter Truth
  2. Longo et al., Harrison’s Manual of Medicine. 18th edition. McGraw Hill. 2013.
  3. Artificial sweeteners could cause spikes in blood sugar by By Brady Dennis September 17, 2014
  4. Washington Post:
  5. Artificial sweeteners could lead to obesity, diabetes. By Michelle Castillo CBS NEWS July 10, 2013, 4:28 PM
  6. CBS News:
  7. Artificial sweeteners may promote diabetes, claim scientists
  8. The Guardian:
  9. Do Artificial Sweeteners Really Cause Diabetes? By Published: June 7, 2013 By Jessica Chia
  10. Women’s Health Magazine:
  11. Could artificial sweetener CAUSE diabetes? Splenda ‘modifies way the body handles sugar’, increasing insulin production by 20% by Rachel Reilly Published: 12:27 Est, 30 May 2013 | Updated: 12:27 Est, 30 May 2013
  12. The Daily Mail:
  13. How To Starve Cancer To Death By Removing This One Thing From Your Diet
  14. Organic Health:
  15. Is sugar a toxin? Experts debate the role of fructose in our obesity epidemic By Tamar Haspel, September 2, 2013
  16. Washington Post:
  17. Scientific team sounds the alarm on sugar as a source of disease. By Barbara Sadick Chicago Tribune
  18. The Chicago Tribune: