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Language warning on question #3 (F-bombs worse than usual)
News topic du jour
1. Banning Nutrition Advice Without A License? [10:38]
Hi Robb & Nikki —
Longtime follower, podcast listener, and fellow libertarian here. Thanks for all you do!
My question/comment is regarding the recent decision out of FL that upholds a ban on providing individual nutrition advice without a state-sanctioned license — have you heard about this? I’m a recent Nutritional Therapy Practitioner (NTP) graduate and have already helped clients in my home state of Virginia make ancestral-type changes and seen speedy benefits. If I lived in FL this would be illegal. I’m trying to start a coalition of some of the big guns in the nutrition space (you!) to spread awareness (state legislatures across the country are trying these bogus regulations to squash small business and anything that goes against conventional wisdom) and maybe help this particular case while there is still change. I’m hopeful bigger platforms can come together and make a big deal about this — it is an important freedom of speech issue with public health ramifications.
The post below from IJ explains the case, and I’d be happy to help in any way possible connecting you to people in that world (I work at a public policy think tank in DC and have lots of connections through my network I can put you in touch with).
2. Keto For Autoimmune & Thyroid Dysfunction? [18:43]
Hi Robb! Your podcast is one of my favorites among all of the health and fitness voices out there.
I have a question regarding something my nutritionist said to me the other day. I have SIBO, Celiac and Hashimoto’s and was discussing treatment protocols with her for the SIBO. I’ve done a 2-3 week elemental diet before and it was pretty rough – two years later I still can’t look at a spoonful of coconut oil the same…
This time I suggested trying a zero carb diet like Shawn Baker’s carnivore diet for the 2-3 week therapeutic period then transition to keto as a long term way of eating. I’ve heard that some people with SIBO get drastically better this way. However, my nutritionist specifically objected to the lack of carbohydrates that would, in her opinion, cause my thyroid dysfunction to get worse. She said something about not having insulin spikes means my thyroid hormones would drop. She prefers something like Integrative Therapeutics Elemental Diet formula which is 69% carbohydrate (dextrose and maltodextrin), 17% fat, and 14% protein.
What is your opinion on me as a woman eating a keto/carnivore diet with autoimmune/thyroid conditions? Thanks!
Efficacy of the Autoimmune Protocol Diet as Part of a Multi-disciplinary, Supported Lifestyle Intervention for Hashimoto’s Thyroiditis
A-Online health coaching pilot study looking at AIP in Hashi’s
B-Antibody titer did not change much, but quality of life, symptom reporting improved, CRP reduced
C-If on meds, thyroid is not really an issue
3. Antibiotic Prophylaxis? [25:35] (F-bomb Warning on this question)
Hi Robb, I’m a huge fan of all you do! I’m a dental hygienist and I love combining my passion for health with my dental career (thank you for introducing me to Dr. Steven Lin through your podcast by the way). For a long time it was recommended that patients take an antibiotic before there dental appointments if they had a joint replacement, due to the risk of bacteria entering the blood stream at those appointments and causing infection in the new joint. In recent years the rules have changed and it is no longer required. However many orthopedic surgeons are still advising some of my patients to take this before all appointments for life! I try to educate them on risks of altering their gut microbiome as well as creating resistant bacteria strains. But of course most people side with their surgeon and not their dental hygienist. I don’t have a lot of time to spend with them on the topic and I’m not well versed in this enough to educate appropriately. What can be my “elevator pitch”, so to speak, to explain this thoroughly, quickly, and effectively? Or maybe I’m overreacting? Should I recommend a probiotic if they insist on pre-medicating? You have a way of putting things so I always understand them so I thought you could help. I know this isn’t your typical question but I would appreciate your input.
Thank you so much if you even read this long rant 🙂
Antibiotic prophylaxis for dental treatment after prosthetic joint replacement: exploring the orthopaedic surgeon’s opinion
A-PJI….can easily be fatal
B-but, antibiotics can have a host of problems ranging from anaphalaxis, to unforeseen gut alterations.
C-BUT, reviews of this topic paint a picture that for dental treatment, this may be overkill
From the paper:
“There is limited evidence demonstrating an association between dental treatment and PJI . Case reports and retrospective studies that suggest a relationship between dental treatment and PJI are usually cited as justification for continuing to use antibiotic prophylaxis , , , . Current international guidelines do not support the use of antibiotic prophylaxis to prevent PJI , , , , . The Australian Therapeutic Guidelines recommend reducing the risk of infection by comprehensive medical management perioperatively . Despite these recommendations, some dental and orthopaedic surgeons continue to prescribe antibiotic prophylaxis hoping to protect patients from the dire consequences of PJI , .”
D-Quick note to the Evidence Based Medicine crowd:
The recommendation were once to do X, upon review, they are now Y, yet many practitioners still rec X. NONE of this is writ in stone and it’s ridiculous to hide behind the evidence based moniker…this current recommendation may modify with time!
4. Moms, Lack of sleep, Exercise [33:56]
Hi Robb and Nicki,
As a new mom to a 4.5mo old I’m curious to know your thoughts, experience, etc on exercise and diet after a night of very little sleep. I used to love working out through walking, lifting weights/swinging a kettle bell, however life changes when you have a baby. Around 3mo postpartum I started doing some body weight exercise and built back into swinging a 15-20# kettle bell for 15-30min in the morning. Diet wise, I tend to follow a lower carb paleo template (50-80g/day) and yes I’m breastfeeding. My goal is simply to maintain health and support hormone levels for fertility. My weight is fine, but I also want to support good insulin sensitivity and keep some muscle mass since I lost quite a bit right after the baby was born. However, after a night or two or three… of little sleep <5hr is it even a good idea to try and exercise due to higher cortisol levels. Could adding in short bursts of exercise spike cortisol further and increase insulin resistance, or would trying to get in a few burpees be supportive of reducing insulin resistance brought on by the lack of sleep? I live in Minnesota so going for a walk with baby right now is very hit/miss due to weather. Are there any diet recommendations that you