Eating alaPeat without gaining weight ?

[neu4]

I want to start an approved Peat diet. Last time I tried to reintroduce milk (skim) and sugar I gained.
Do you have recommandations ?

 

[Peatness]

From my notes - taken from forum posts

This might be helpful. I learnt this after making so many mistakes. If I had to start over I would remove pufa, keep overall fat really low, go very slowing on increasing carbs. I would also think twice about milk due to being intolerant to it for years (I'm not suggesting you avoid milk if you tolerate it). Study the forum!!!!!!!

RP Says Glucose Helps T4 To T3, Then Why Fructose?

So, assuming one keeps a steady dietary supply of sucrose (or some other type of sugar), wouldn't the constant presence of glucose in the blood stream keep insulin chronically elevated too? I have read various, and often contradictory, statements from Peat about the whole blood sugar and insulin thing. Often, he says that it is important to always keep blood glucose up to keep cortisol at bay and metabolism high. Of course, this means insulin would be elevated chronically too. On insulin, Ray sometimes says it is a good hormone responsible for anabolism and keeping tumor growth under control. At other times he has said that elevated insulin is not a good thing. So, I am bit confused about the overall dietary guidelines. Should we try to keep blood sugar elevated all the time but at a certain stable (and reasonable) level, which would imply higher (but stable insulin), or should we do pulse feeds which would temporarily bring insulin up to shuttle the glucose to the muscles and then insulin goes down and the body runs on glycogen from the liver?
I suspect a number of people on the forum struggle with this issue as evidenced by several posts of rapid weight gain, elevated blood glucose and insulin on blood tests and worried doctors making recommendations to cut down on sugar, blood pressure rising in people who did not have blood pressure issues before, etc. Some of these things could be beneficial, but there was a post by one person who said her blood pressure went from 120/80 to 150/90 after adopting the higher sugar diet and after some back and forth with her doctor she decided to quit the Peat diet. Then she reported her blood pressure normalizing after reducing sugar intake. Btw, it is well known in the bodybuilding community that cutting carbs works just like diuretics. I am not an advocate of this, but wouldn't people prone to edema and having thyroid problems get their water-retention problems exacerbated if they increase sugar/carbs intake? I guess that would happen at least initially and the theory is that as their metabolism normalizes they should be able to better utilize glucose and then lose all the excess water. So, the million dollar question is how long does one have to re-feed higher carbs diet (and suppress fatty acid oxidation through the Randle effect) until their insulin sensitivity is restored?
Finally, there have been a number of reports on Peatarian and occasionally on this forum of people experiencing proteinuria (protein in the urine) when increasing sugar intake above 200g daily. If you are eating 80g+ of protein then you probably strive to eat at least as many carbs. Peat has said that this proteinuria is due to people burning PUFA, which makes albumin leak in the urine and show up on the tests but as far as I can tell, these people were actually burning fat before adopting the higher sugar diet and only experienced proteinuria after increasing sugar intake. Of course, they could have had this issue all along and only realized it after switching and measuring their urine but there are several reports of this so I doubt it's a random thing. Somebody also posted a study on thousands of university employees and those who consumes the most sugary drinks reported the highest incidence of proteinuria.
It would be nice if we can get some guidelines on this. Personally, I use caffeine to increase the utilization of sugar and don't really have issues with it, but in theory there should be a way to handle sugar from diet without relying on sugar burning aids like caffeine and/or thyroid. Thyroid does not seem to be a good option for me, and I have tried all kinds of supplementing schedules and dosages. As I have posted on other threads, my experience with sugar only improved after I took serious measures to "normalize" my liver function through caffeine and vitamin K2, BUT my liver enzymes were NORMAL according to the standard lab ranges. If the stats are true and over 80% of people over 30 have some degree of fatty liver, which is the real cause behind type II diabetes, then I think many people adopting the Peat diet will likely experience stress reduction through the lower cortisol, but may end up making their fatty liver worse, especially is supplementing niacinamide and aspirin. Such_Saturation and I posted about this in another thread.
So, my main point is that burning sugar is definitely preferable to burning fat based on both Peat's writings and all the studies I have seen about liver disease being caused by increased lipid peroxidation by products, and cirrhosis (in alcoholic rats) being easily and succesfully treated by feeding about 60g-70g of saturated fat like butter or coconut oil for a week, while the rats kept drinking alcohol at the same time! So, on the point of burning sugar I think the question is settled that it is preferable to burning fat.
However, the point is to actually BURN the sugar rather than simply feeding ourselves more of it. For people with sluggish livers, many of whom also take niacinamide and aspirin, this is likely to make the metabolism situation worse by fattening the liver even more, even though admittedly the fat synthesized will be saturated since it is made from sugar. But fatty liver will increase your estrogen no matter how saturated the fat is that you are synthesizing. So, fattening up the liver even more probably won't do much good for metabolism. Another suggestion from Peat would be to increase protein intake to at least 80g a day which should support liver function, lower estrogen and increase conversion of T4 into T3. However, that will likely also not work very well in people with sluggish and fatty livers since underperforming liver will convert a lot of that extra protein into ammonia. Even Peat is clear on this point in one of his articles where he says that "hyperammonemia can be caused by exhaustive exercise or hypothyroidism". This is also evidenced by a number of studies showing that people in their late 30s, 40s, and 50s experience chronic fatigue issues that are greatly helped by giving them ammonia-reducing agents like ornithine or sodium benzoate. And those people consume nowhere near the 80g of protein Peat recommends. So, if they are having ammonia issues imagine how would the people loading up on extra protein would feel.
Which brings us to the point that for many people over the age of 30, simply increasing sugar and/or protein will likely not solve the metabolic issues. Thus, the Peat diet, while the correct way to eat, may not be a solution to the issues of hypothyroidism, but rather a way to avoid the worse option of running on cortisol and adrenalin, which while energizing in the short run will ruin you in the longer run.
Considering the Barnes book "Hypoglycemia: It's not your brain, it's your liver", which I read, it seems that restoring optimal liver function is also a key to improving metabolism. Yes, thyroid function is important too, but I think Peat's recommendation on supplementing thyroid even in the presence of normal thyroid labs may cause issues for a number of people. Charlie, and at least 20 other people have posted on struggling with supplementing thyroid. If they take it, they develop teeth issues, skin issues, anxiety or some other unpleasant symptoms. If they don't take it, their digestion slows down to a crawl or they start getting hypothyroid symptoms like brain fog or muscle issues, etc.
So, if the stats are true and the evidence I have seen is legit, then eating according to the peat guidelines is a great strategy AFTER metabolism is fixed. But if 80% of people over 30 are having liver issues or some other problems with metabolism, then the diet will be certainly supportive, but likely not "curative". And for some people with particularly bad liver problems the situation may end up getting worse in a way due to even more fatty liver issues or higher ammonia levels. Just ask anybody over the age of 40 if they are having trouble maintaining (let alone building) muscle mass.
Then the question becomes, what will aid metabolic recovery, other than blindly supplementing thyroid even in the presence of normal thyroid labs? I guess the answer Peat will give is that one needs to wait at least 4 years and get rid of the PUFA before starting to see solid results. There is some solid evidence in favor of lower PUFA fixing metabolic issues. But I wonder if working on liver health or trying to build more muscle will also help while waiting out the PUFA detox period? Uncoupling agents are probably also key, but they should probably be other than aspirin since it may make fatty liver issues worse for many people if used in the doses needed for mitochondrial uncoupling. Finally, increasing CO2 production or intake somehow will also likely have a key role. Just throwing things out there that seem to be cardinal methods for improving metabolism.
Sorry about the long rant, I just felt like this deserves some attention since a number of threads pop on the forum asking the same questions and I have been thinking about this for some time. If someone knows about Peat's definitive opinion on this issue please share it. Maybe I missed it in his articles. IMHO, after reading pretty much all of his published stuff, reading people's testimonies/complaints, cross-referencing this with studies, and my own experience,

I think Ray recognizes that there are many cases where antibiotics and/or charcoal won't solve the problem but our knowledge on the issues causing microbiome disbalance is probably limited at the moment so he refrains from making more definitive statements. Finally, people with good liver and kidney function can also have ammonia issues if they have slow digestion of things like IBS/IBD, which allows for the food to stay longer in the colon and the ammonia to get reabsorbed. The antibiotic rifaximin, used for treating SIBO, is also used for ammonia encephalopathy precisely for that reason - otherwise healthy people with ammonia buildup issues. I wonder if there is a case for chronically increasing salt intake simply for the purpose of controlling ammonia levels, given how toxic to the metabolilsm it is and how closely related it is with serotonin and histamine. Ray wrote in one of his articles about this toxic trio of amines and how important it is to control their levels. Or maybe taking 5mg of lithium every night, which is close to the levels people ingested daily about 100 years ago in some parts of the US and it was shown that this resulted in increased longevity and decreased illness incidence.

Caffeine mainly forces the liver to flush its fat out into the bloodstream, so it's a great treatment for NAFLD and I posted a study on that. I believe vitamin K2 works by stabilizing the so-called Kuppfer cells in the liver: Kupffer cell - Wikipedia
At least that's what the studies I have seen on PubMed say. Also, we know that quinones like K2 makes mitochondria work better, so that's probably another mechanism behind K2 effects. Glycine's mechanism of action has not been definitively pinpointed yet but it is a potent antiinflammatory and Peat gives many explanations about its effects - antiestrogenic, antiserotonin, antiexcitotoxic, etc. All of these effects will be beneficial for liver.
Finally, taurine is also a big of an enigma for liver health but some of its good effects have to do with protecting the liver from lipid peroxidation effect, and in fact one study compared it to vitamin E and found their effects to be virtually identical. Taurine also forces bile release and that may "cleanse" the gallbladder and liver in a way.
So, if you are willing to ingest all of those I would recommend combining them for a week and then maybe falling back on caffeine and K2 as I believe they specifically target the liver and are not sedative unlike glycine and taurine. There are studies showing benefit for NAFLD from coq10. The doses were in the range of 300mg-500mg daily. Also, there are studies using 1,200mg and 2,400mg of coq10 for diabetes type II, which some people believe to be just another name for liver disease. Finally, 1,200mg-2,400mg of coq10 are currently in humans trials for Parkinson disease, so there must be something to the quinones like coq10 and K2. Coq10 won't match the effectiveness of K2 as far as I know. In doses of 2,400mg per day it may be as effective for mitochondrial health as K2 but won't be as effective for liver health. I just suggested it for alternative for people that absolutely cannot get their hands on K2 at doses of 15mg or more.


How to improve protein utilization

Moderate doses of protein, combined with some sugar and keeping fat low should form the basis of your diet. How much protein? Well, maybe you can start with 50g which is what most sick people in the hospital get and seems to be the minimum to ensure organ function without burdening liver or kidneys too much. Try to ingest at least twice as many carbs as the grams of protein in each meal. Then you track temperature and pulse and monitor health signs like fatigue, brain fog, thirst, etc. Increase in any of these probably means increase of ammonia and/or lactate so you need to adjust thing. If is lactate, your muscles would feel sore and limbs would feel heavy and you may start panting from the reduction in CO2. If that is the case, you are probably not processing carbs well so adding things like thiamine and biotin should help. If you get sudden brain fog or your pee smells of ammonia too strongly then either ammonia in blood is too high or you got dehydrated. Adding more carbs and/or sweetened fluids may resolve this. Also, things like zinc or ceylon cinnamon or biotin or thiamine would reduce ammonia in blood. So, now we have two supplements that seem like they would work for both ammonia and lactate - thiamine and biotin. However, if even 50g of protein gives you ammonia symptoms consistently then I'd get some tests done for liver and kidney function as it should not be happening. Another reason for ammonia build up from small amounts of protein would be extreme hypothyroidism and/or strenuous exercise. Peat said that in one of his articles. But I'd get liver and kidneys checked anyways.
Once you get to a basic diet that does not cause you a stress reaction or symptoms of toxic metabolite buildup you can (if needed) add some metabolic boosting agents like caffeine or thyroid (if needed). Monitor temperature and pulse and if any of these extra substances gives you a stress reaction then either back down or increase nutrients. Overall, the body is very good at regenerating. If you get to a diet that does not harm you (in terms of ratio of protein, carbs, and fat) it takes about 2-3 weeks to get to a much healthier level where you can expand on your success and change nutrient ratios or amounts, add different supplements, etc. Initially I gained more than 30 lbs on the Ray Peat "diet" until I finally figured it out, and for me it was liver function that had to improved with caffeine and vitamin K2 before things got better. That does NOT mean that this is what will work for you since your situation/context is almost certainly different from mine. But that's why you start with something common in all people - smaller meals of basic nutrients that can be controlled and adjusted and once you get to a working version of a diet that does not affect you badly you build up from there. Again, Peat write about many things that are useful IN ISOLATION, but in order for them to be working for you context will have to be taken into account. If your current context (it changes over time like everything else) is such that a supplement or recommendation from Peat stresses you out then it better to work on changing the context instead of forcing that supplement or recommendation on yourself.
Enough ranting, on to controlling serotonin. I can't directly recommend drugs but people have had good responses to small dose cyproheptadine (1mg-4mg daily) and it should be fairly safe UNLESS you have liver disease in which case I'd get that checked first (like I said above). Ondansetron has some great studies behind it in terms of being a very potent anti-depressant in low doses (4mg daily), cognitive enhancer, libido booster, etc. but it seems to have some bad effects on the heart rhythm so if you take it then it should be fairly short-term (less than month). Some of the legal LSD derivatives are (mostly) dopaminergic drugs and include drugs like Bromocriptine, cabergoline, lisuride, etc. They all have very good effects on metabolism and in fact bromocriptine has been approved for the treatment of diabetes type II. See link below.
Bromocriptine - Wikipedia
Bromocriptine: a novel approach to the treatment of type 2 diabetes - PubMed

 

[frannybananny]

From my notes - taken from forum posts

This might be helpful. I learnt this after making so many mistakes. If I had to start over I would remove pufa, keep overall fat really low, go very slowing on increasing carbs. I would also think twice about milk due to being intolerant to it for years (I'm not suggesting you avoid milk if you tolerate it). Study the forum!!!!!!!

RP Says Glucose Helps T4 To T3, Then Why Fructose?

So, assuming one keeps a steady dietary supply of sucrose (or some other type of sugar), wouldn't the constant presence of glucose in the blood stream keep insulin chronically elevated too? I have read various, and often contradictory, statements from Peat about the whole blood sugar and insulin thing. Often, he says that it is important to always keep blood glucose up to keep cortisol at bay and metabolism high. Of course, this means insulin would be elevated chronically too. On insulin, Ray sometimes says it is a good hormone responsible for anabolism and keeping tumor growth under control. At other times he has said that elevated insulin is not a good thing. So, I am bit confused about the overall dietary guidelines. Should we try to keep blood sugar elevated all the time but at a certain stable (and reasonable) level, which would imply higher (but stable insulin), or should we do pulse feeds which would temporarily bring insulin up to shuttle the glucose to the muscles and then insulin goes down and the body runs on glycogen from the liver?
I suspect a number of people on the forum struggle with this issue as evidenced by several posts of rapid weight gain, elevated blood glucose and insulin on blood tests and worried doctors making recommendations to cut down on sugar, blood pressure rising in people who did not have blood pressure issues before, etc. Some of these things could be beneficial, but there was a post by one person who said her blood pressure went from 120/80 to 150/90 after adopting the higher sugar diet and after some back and forth with her doctor she decided to quit the Peat diet. Then she reported her blood pressure normalizing after reducing sugar intake. Btw, it is well known in the bodybuilding community that cutting carbs works just like diuretics. I am not an advocate of this, but wouldn't people prone to edema and having thyroid problems get their water-retention problems exacerbated if they increase sugar/carbs intake? I guess that would happen at least initially and the theory is that as their metabolism normalizes they should be able to better utilize glucose and then lose all the excess water. So, the million dollar question is how long does one have to re-feed higher carbs diet (and suppress fatty acid oxidation through the Randle effect) until their insulin sensitivity is restored?
Finally, there have been a number of reports on Peatarian and occasionally on this forum of people experiencing proteinuria (protein in the urine) when increasing sugar intake above 200g daily. If you are eating 80g+ of protein then you probably strive to eat at least as many carbs. Peat has said that this proteinuria is due to people burning PUFA, which makes albumin leak in the urine and show up on the tests but as far as I can tell, these people were actually burning fat before adopting the higher sugar diet and only experienced proteinuria after increasing sugar intake. Of course, they could have had this issue all along and only realized it after switching and measuring their urine but there are several reports of this so I doubt it's a random thing. Somebody also posted a study on thousands of university employees and those who consumes the most sugary drinks reported the highest incidence of proteinuria.
It would be nice if we can get some guidelines on this. Personally, I use caffeine to increase the utilization of sugar and don't really have issues with it, but in theory there should be a way to handle sugar from diet without relying on sugar burning aids like caffeine and/or thyroid. Thyroid does not seem to be a good option for me, and I have tried all kinds of supplementing schedules and dosages. As I have posted on other threads, my experience with sugar only improved after I took serious measures to "normalize" my liver function through caffeine and vitamin K2, BUT my liver enzymes were NORMAL according to the standard lab ranges. If the stats are true and over 80% of people over 30 have some degree of fatty liver, which is the real cause behind type II diabetes, then I think many people adopting the Peat diet will likely experience stress reduction through the lower cortisol, but may end up making their fatty liver worse, especially is supplementing niacinamide and aspirin. Such_Saturation and I posted about this in another thread.
So, my main point is that burning sugar is definitely preferable to burning fat based on both Peat's writings and all the studies I have seen about liver disease being caused by increased lipid peroxidation by products, and cirrhosis (in alcoholic rats) being easily and succesfully treated by feeding about 60g-70g of saturated fat like butter or coconut oil for a week, while the rats kept drinking alcohol at the same time! So, on the point of burning sugar I think the question is settled that it is preferable to burning fat.
However, the point is to actually BURN the sugar rather than simply feeding ourselves more of it. For people with sluggish livers, many of whom also take niacinamide and aspirin, this is likely to make the metabolism situation worse by fattening the liver even more, even though admittedly the fat synthesized will be saturated since it is made from sugar. But fatty liver will increase your estrogen no matter how saturated the fat is that you are synthesizing. So, fattening up the liver even more probably won't do much good for metabolism. Another suggestion from Peat would be to increase protein intake to at least 80g a day which should support liver function, lower estrogen and increase conversion of T4 into T3. However, that will likely also not work very well in people with sluggish and fatty livers since underperforming liver will convert a lot of that extra protein into ammonia. Even Peat is clear on this point in one of his articles where he says that "hyperammonemia can be caused by exhaustive exercise or hypothyroidism". This is also evidenced by a number of studies showing that people in their late 30s, 40s, and 50s experience chronic fatigue issues that are greatly helped by giving them ammonia-reducing agents like ornithine or sodium benzoate. And those people consume nowhere near the 80g of protein Peat recommends. So, if they are having ammonia issues imagine how would the people loading up on extra protein would feel.
Which brings us to the point that for many people over the age of 30, simply increasing sugar and/or protein will likely not solve the metabolic issues. Thus, the Peat diet, while the correct way to eat, may not be a solution to the issues of hypothyroidism, but rather a way to avoid the worse option of running on cortisol and adrenalin, which while energizing in the short run will ruin you in the longer run.
Considering the Barnes book "Hypoglycemia: It's not your brain, it's your liver", which I read, it seems that restoring optimal liver function is also a key to improving metabolism. Yes, thyroid function is important too, but I think Peat's recommendation on supplementing thyroid even in the presence of normal thyroid labs may cause issues for a number of people. Charlie, and at least 20 other people have posted on struggling with supplementing thyroid. If they take it, they develop teeth issues, skin issues, anxiety or some other unpleasant symptoms. If they don't take it, their digestion slows down to a crawl or they start getting hypothyroid symptoms like brain fog or muscle issues, etc.
So, if the stats are true and the evidence I have seen is legit, then eating according to the peat guidelines is a great strategy AFTER metabolism is fixed. But if 80% of people over 30 are having liver issues or some other problems with metabolism, then the diet will be certainly supportive, but likely not "curative". And for some people with particularly bad liver problems the situation may end up getting worse in a way due to even more fatty liver issues or higher ammonia levels. Just ask anybody over the age of 40 if they are having trouble maintaining (let alone building) muscle mass.
Then the question becomes, what will aid metabolic recovery, other than blindly supplementing thyroid even in the presence of normal thyroid labs? I guess the answer Peat will give is that one needs to wait at least 4 years and get rid of the PUFA before starting to see solid results. There is some solid evidence in favor of lower PUFA fixing metabolic issues. But I wonder if working on liver health or trying to build more muscle will also help while waiting out the PUFA detox period? Uncoupling agents are probably also key, but they should probably be other than aspirin since it may make fatty liver issues worse for many people if used in the doses needed for mitochondrial uncoupling. Finally, increasing CO2 production or intake somehow will also likely have a key role. Just throwing things out there that seem to be cardinal methods for improving metabolism.
Sorry about the long rant, I just felt like this deserves some attention since a number of threads pop on the forum asking the same questions and I have been thinking about this for some time. If someone knows about Peat's definitive opinion on this issue please share it. Maybe I missed it in his articles. IMHO, after reading pretty much all of his published stuff, reading people's testimonies/complaints, cross-referencing this with studies, and my own experience,

I think Ray recognizes that there are many cases where antibiotics and/or charcoal won't solve the problem but our knowledge on the issues causing microbiome disbalance is probably limited at the moment so he refrains from making more definitive statements. Finally, people with good liver and kidney function can also have ammonia issues if they have slow digestion of things like IBS/IBD, which allows for the food to stay longer in the colon and the ammonia to get reabsorbed. The antibiotic rifaximin, used for treating SIBO, is also used for ammonia encephalopathy precisely for that reason - otherwise healthy people with ammonia buildup issues. I wonder if there is a case for chronically increasing salt intake simply for the purpose of controlling ammonia levels, given how toxic to the metabolilsm it is and how closely related it is with serotonin and histamine. Ray wrote in one of his articles about this toxic trio of amines and how important it is to control their levels. Or maybe taking 5mg of lithium every night, which is close to the levels people ingested daily about 100 years ago in some parts of the US and it was shown that this resulted in increased longevity and decreased illness incidence.

Caffeine mainly forces the liver to flush its fat out into the bloodstream, so it's a great treatment for NAFLD and I posted a study on that. I believe vitamin K2 works by stabilizing the so-called Kuppfer cells in the liver: Kupffer cell - Wikipedia
At least that's what the studies I have seen on PubMed say. Also, we know that quinones like K2 makes mitochondria work better, so that's probably another mechanism behind K2 effects. Glycine's mechanism of action has not been definitively pinpointed yet but it is a potent antiinflammatory and Peat gives many explanations about its effects - antiestrogenic, antiserotonin, antiexcitotoxic, etc. All of these effects will be beneficial for liver.
Finally, taurine is also a big of an enigma for liver health but some of its good effects have to do with protecting the liver from lipid peroxidation effect, and in fact one study compared it to vitamin E and found their effects to be virtually identical. Taurine also forces bile release and that may "cleanse" the gallbladder and liver in a way.
So, if you are willing to ingest all of those I would recommend combining them for a week and then maybe falling back on caffeine and K2 as I believe they specifically target the liver and are not sedative unlike glycine and taurine. There are studies showing benefit for NAFLD from coq10. The doses were in the range of 300mg-500mg daily. Also, there are studies using 1,200mg and 2,400mg of coq10 for diabetes type II, which some people believe to be just another name for liver disease. Finally, 1,200mg-2,400mg of coq10 are currently in humans trials for Parkinson disease, so there must be something to the quinones like coq10 and K2. Coq10 won't match the effectiveness of K2 as far as I know. In doses of 2,400mg per day it may be as effective for mitochondrial health as K2 but won't be as effective for liver health. I just suggested it for alternative for people that absolutely cannot get their hands on K2 at doses of 15mg or more.


How to improve protein utilization

Moderate doses of protein, combined with some sugar and keeping fat low should form the basis of your diet. How much protein? Well, maybe you can start with 50g which is what most sick people in the hospital get and seems to be the minimum to ensure organ function without burdening liver or kidneys too much. Try to ingest at least twice as many carbs as the grams of protein in each meal. Then you track temperature and pulse and monitor health signs like fatigue, brain fog, thirst, etc. Increase in any of these probably means increase of ammonia and/or lactate so you need to adjust thing. If is lactate, your muscles would feel sore and limbs would feel heavy and you may start panting from the reduction in CO2. If that is the case, you are probably not processing carbs well so adding things like thiamine and biotin should help. If you get sudden brain fog or your pee smells of ammonia too strongly then either ammonia in blood is too high or you got dehydrated. Adding more carbs and/or sweetened fluids may resolve this. Also, things like zinc or ceylon cinnamon or biotin or thiamine would reduce ammonia in blood. So, now we have two supplements that seem like they would work for both ammonia and lactate - thiamine and biotin. However, if even 50g of protein gives you ammonia symptoms consistently then I'd get some tests done for liver and kidney function as it should not be happening. Another reason for ammonia build up from small amounts of protein would be extreme hypothyroidism and/or strenuous exercise. Peat said that in one of his articles. But I'd get liver and kidneys checked anyways.
Once you get to a basic diet that does not cause you a stress reaction or symptoms of toxic metabolite buildup you can (if needed) add some metabolic boosting agents like caffeine or thyroid (if needed). Monitor temperature and pulse and if any of these extra substances gives you a stress reaction then either back down or increase nutrients. Overall, the body is very good at regenerating. If you get to a diet that does not harm you (in terms of ratio of protein, carbs, and fat) it takes about 2-3 weeks to get to a much healthier level where you can expand on your success and change nutrient ratios or amounts, add different supplements, etc. Initially I gained more than 30 lbs on the Ray Peat "diet" until I finally figured it out, and for me it was liver function that had to improved with caffeine and vitamin K2 before things got better. That does NOT mean that this is what will work for you since your situation/context is almost certainly different from mine. But that's why you start with something common in all people - smaller meals of basic nutrients that can be controlled and adjusted and once you get to a working version of a diet that does not affect you badly you build up from there. Again, Peat write about many things that are useful IN ISOLATION, but in order for them to be working for you context will have to be taken into account. If your current context (it changes over time like everything else) is such that a supplement or recommendation from Peat stresses you out then it better to work on changing the context instead of forcing that supplement or recommendation on yourself.
Enough ranting, on to controlling serotonin. I can't directly recommend drugs but people have had good responses to small dose cyproheptadine (1mg-4mg daily) and it should be fairly safe UNLESS you have liver disease in which case I'd get that checked first (like I said above). Ondansetron has some great studies behind it in terms of being a very potent anti-depressant in low doses (4mg daily), cognitive enhancer, libido booster, etc. but it seems to have some bad effects on the heart rhythm so if you take it then it should be fairly short-term (less than month). Some of the legal LSD derivatives are (mostly) dopaminergic drugs and include drugs like Bromocriptine, cabergoline, lisuride, etc. They all have very good effects on metabolism and in fact bromocriptine has been approved for the treatment of diabetes type II. See link below.
Bromocriptine - Wikipedia
Bromocriptine: a novel approach to the treatment of type 2 diabetes - PubMed

Wow! Thanks for taking the time to provide all of this valuable info.... it is much appreciated!

 

[Peatness]

Wow! Thanks for taking the time to provide all of this valuable info.... it is much appreciated!

It was no trouble, I keep these notes for my own use anyway. These are mostly haiduts posts. So, thanks to him.

 

[LadyRae]

@Peatness I love this! My experience exactly! Low fat, smaller meals, easy to digest foods, no processed foods!

And nobody talks about this but a huge huge thing everyone can do is quit drinking alcohol.

 

[L_C]

From my notes - taken from forum posts

This might be helpful. I learnt this after making so many mistakes. If I had to start over I would remove pufa, keep overall fat really low, go very slowing on increasing carbs. I would also think twice about milk due to being intolerant to it for years (I'm not suggesting you avoid milk if you tolerate it). Study the forum!!!!!!!

RP Says Glucose Helps T4 To T3, Then Why Fructose?

So, assuming one keeps a steady dietary supply of sucrose (or some other type of sugar), wouldn't the constant presence of glucose in the blood stream keep insulin chronically elevated too? I have read various, and often contradictory, statements from Peat about the whole blood sugar and insulin thing. Often, he says that it is important to always keep blood glucose up to keep cortisol at bay and metabolism high. Of course, this means insulin would be elevated chronically too. On insulin, Ray sometimes says it is a good hormone responsible for anabolism and keeping tumor growth under control. At other times he has said that elevated insulin is not a good thing. So, I am bit confused about the overall dietary guidelines. Should we try to keep blood sugar elevated all the time but at a certain stable (and reasonable) level, which would imply higher (but stable insulin), or should we do pulse feeds which would temporarily bring insulin up to shuttle the glucose to the muscles and then insulin goes down and the body runs on glycogen from the liver?
I suspect a number of people on the forum struggle with this issue as evidenced by several posts of rapid weight gain, elevated blood glucose and insulin on blood tests and worried doctors making recommendations to cut down on sugar, blood pressure rising in people who did not have blood pressure issues before, etc. Some of these things could be beneficial, but there was a post by one person who said her blood pressure went from 120/80 to 150/90 after adopting the higher sugar diet and after some back and forth with her doctor she decided to quit the Peat diet. Then she reported her blood pressure normalizing after reducing sugar intake. Btw, it is well known in the bodybuilding community that cutting carbs works just like diuretics. I am not an advocate of this, but wouldn't people prone to edema and having thyroid problems get their water-retention problems exacerbated if they increase sugar/carbs intake? I guess that would happen at least initially and the theory is that as their metabolism normalizes they should be able to better utilize glucose and then lose all the excess water. So, the million dollar question is how long does one have to re-feed higher carbs diet (and suppress fatty acid oxidation through the Randle effect) until their insulin sensitivity is restored?
Finally, there have been a number of reports on Peatarian and occasionally on this forum of people experiencing proteinuria (protein in the urine) when increasing sugar intake above 200g daily. If you are eating 80g+ of protein then you probably strive to eat at least as many carbs. Peat has said that this proteinuria is due to people burning PUFA, which makes albumin leak in the urine and show up on the tests but as far as I can tell, these people were actually burning fat before adopting the higher sugar diet and only experienced proteinuria after increasing sugar intake. Of course, they could have had this issue all along and only realized it after switching and measuring their urine but there are several reports of this so I doubt it's a random thing. Somebody also posted a study on thousands of university employees and those who consumes the most sugary drinks reported the highest incidence of proteinuria.
It would be nice if we can get some guidelines on this. Personally, I use caffeine to increase the utilization of sugar and don't really have issues with it, but in theory there should be a way to handle sugar from diet without relying on sugar burning aids like caffeine and/or thyroid. Thyroid does not seem to be a good option for me, and I have tried all kinds of supplementing schedules and dosages. As I have posted on other threads, my experience with sugar only improved after I took serious measures to "normalize" my liver function through caffeine and vitamin K2, BUT my liver enzymes were NORMAL according to the standard lab ranges. If the stats are true and over 80% of people over 30 have some degree of fatty liver, which is the real cause behind type II diabetes, then I think many people adopting the Peat diet will likely experience stress reduction through the lower cortisol, but may end up making their fatty liver worse, especially is supplementing niacinamide and aspirin. Such_Saturation and I posted about this in another thread.
So, my main point is that burning sugar is definitely preferable to burning fat based on both Peat's writings and all the studies I have seen about liver disease being caused by increased lipid peroxidation by products, and cirrhosis (in alcoholic rats) being easily and succesfully treated by feeding about 60g-70g of saturated fat like butter or coconut oil for a week, while the rats kept drinking alcohol at the same time! So, on the point of burning sugar I think the question is settled that it is preferable to burning fat.
However, the point is to actually BURN the sugar rather than simply feeding ourselves more of it. For people with sluggish livers, many of whom also take niacinamide and aspirin, this is likely to make the metabolism situation worse by fattening the liver even more, even though admittedly the fat synthesized will be saturated since it is made from sugar. But fatty liver will increase your estrogen no matter how saturated the fat is that you are synthesizing. So, fattening up the liver even more probably won't do much good for metabolism. Another suggestion from Peat would be to increase protein intake to at least 80g a day which should support liver function, lower estrogen and increase conversion of T4 into T3. However, that will likely also not work very well in people with sluggish and fatty livers since underperforming liver will convert a lot of that extra protein into ammonia. Even Peat is clear on this point in one of his articles where he says that "hyperammonemia can be caused by exhaustive exercise or hypothyroidism". This is also evidenced by a number of studies showing that people in their late 30s, 40s, and 50s experience chronic fatigue issues that are greatly helped by giving them ammonia-reducing agents like ornithine or sodium benzoate. And those people consume nowhere near the 80g of protein Peat recommends. So, if they are having ammonia issues imagine how would the people loading up on extra protein would feel.
Which brings us to the point that for many people over the age of 30, simply increasing sugar and/or protein will likely not solve the metabolic issues. Thus, the Peat diet, while the correct way to eat, may not be a solution to the issues of hypothyroidism, but rather a way to avoid the worse option of running on cortisol and adrenalin, which while energizing in the short run will ruin you in the longer run.
Considering the Barnes book "Hypoglycemia: It's not your brain, it's your liver", which I read, it seems that restoring optimal liver function is also a key to improving metabolism. Yes, thyroid function is important too, but I think Peat's recommendation on supplementing thyroid even in the presence of normal thyroid labs may cause issues for a number of people. Charlie, and at least 20 other people have posted on struggling with supplementing thyroid. If they take it, they develop teeth issues, skin issues, anxiety or some other unpleasant symptoms. If they don't take it, their digestion slows down to a crawl or they start getting hypothyroid symptoms like brain fog or muscle issues, etc.
So, if the stats are true and the evidence I have seen is legit, then eating according to the peat guidelines is a great strategy AFTER metabolism is fixed. But if 80% of people over 30 are having liver issues or some other problems with metabolism, then the diet will be certainly supportive, but likely not "curative". And for some people with particularly bad liver problems the situation may end up getting worse in a way due to even more fatty liver issues or higher ammonia levels. Just ask anybody over the age of 40 if they are having trouble maintaining (let alone building) muscle mass.
Then the question becomes, what will aid metabolic recovery, other than blindly supplementing thyroid even in the presence of normal thyroid labs? I guess the answer Peat will give is that one needs to wait at least 4 years and get rid of the PUFA before starting to see solid results. There is some solid evidence in favor of lower PUFA fixing metabolic issues. But I wonder if working on liver health or trying to build more muscle will also help while waiting out the PUFA detox period? Uncoupling agents are probably also key, but they should probably be other than aspirin since it may make fatty liver issues worse for many people if used in the doses needed for mitochondrial uncoupling. Finally, increasing CO2 production or intake somehow will also likely have a key role. Just throwing things out there that seem to be cardinal methods for improving metabolism.
Sorry about the long rant, I just felt like this deserves some attention since a number of threads pop on the forum asking the same questions and I have been thinking about this for some time. If someone knows about Peat's definitive opinion on this issue please share it. Maybe I missed it in his articles. IMHO, after reading pretty much all of his published stuff, reading people's testimonies/complaints, cross-referencing this with studies, and my own experience,

I think Ray recognizes that there are many cases where antibiotics and/or charcoal won't solve the problem but our knowledge on the issues causing microbiome disbalance is probably limited at the moment so he refrains from making more definitive statements. Finally, people with good liver and kidney function can also have ammonia issues if they have slow digestion of things like IBS/IBD, which allows for the food to stay longer in the colon and the ammonia to get reabsorbed. The antibiotic rifaximin, used for treating SIBO, is also used for ammonia encephalopathy precisely for that reason - otherwise healthy people with ammonia buildup issues. I wonder if there is a case for chronically increasing salt intake simply for the purpose of controlling ammonia levels, given how toxic to the metabolilsm it is and how closely related it is with serotonin and histamine. Ray wrote in one of his articles about this toxic trio of amines and how important it is to control their levels. Or maybe taking 5mg of lithium every night, which is close to the levels people ingested daily about 100 years ago in some parts of the US and it was shown that this resulted in increased longevity and decreased illness incidence.

Caffeine mainly forces the liver to flush its fat out into the bloodstream, so it's a great treatment for NAFLD and I posted a study on that. I believe vitamin K2 works by stabilizing the so-called Kuppfer cells in the liver: Kupffer cell - Wikipedia
At least that's what the studies I have seen on PubMed say. Also, we know that quinones like K2 makes mitochondria work better, so that's probably another mechanism behind K2 effects. Glycine's mechanism of action has not been definitively pinpointed yet but it is a potent antiinflammatory and Peat gives many explanations about its effects - antiestrogenic, antiserotonin, antiexcitotoxic, etc. All of these effects will be beneficial for liver.
Finally, taurine is also a big of an enigma for liver health but some of its good effects have to do with protecting the liver from lipid peroxidation effect, and in fact one study compared it to vitamin E and found their effects to be virtually identical. Taurine also forces bile release and that may "cleanse" the gallbladder and liver in a way.
So, if you are willing to ingest all of those I would recommend combining them for a week and then maybe falling back on caffeine and K2 as I believe they specifically target the liver and are not sedative unlike glycine and taurine. There are studies showing benefit for NAFLD from coq10. The doses were in the range of 300mg-500mg daily. Also, there are studies using 1,200mg and 2,400mg of coq10 for diabetes type II, which some people believe to be just another name for liver disease. Finally, 1,200mg-2,400mg of coq10 are currently in humans trials for Parkinson disease, so there must be something to the quinones like coq10 and K2. Coq10 won't match the effectiveness of K2 as far as I know. In doses of 2,400mg per day it may be as effective for mitochondrial health as K2 but won't be as effective for liver health. I just suggested it for alternative for people that absolutely cannot get their hands on K2 at doses of 15mg or more.


How to improve protein utilization

Moderate doses of protein, combined with some sugar and keeping fat low should form the basis of your diet. How much protein? Well, maybe you can start with 50g which is what most sick people in the hospital get and seems to be the minimum to ensure organ function without burdening liver or kidneys too much. Try to ingest at least twice as many carbs as the grams of protein in each meal. Then you track temperature and pulse and monitor health signs like fatigue, brain fog, thirst, etc. Increase in any of these probably means increase of ammonia and/or lactate so you need to adjust thing. If is lactate, your muscles would feel sore and limbs would feel heavy and you may start panting from the reduction in CO2. If that is the case, you are probably not processing carbs well so adding things like thiamine and biotin should help. If you get sudden brain fog or your pee smells of ammonia too strongly then either ammonia in blood is too high or you got dehydrated. Adding more carbs and/or sweetened fluids may resolve this. Also, things like zinc or ceylon cinnamon or biotin or thiamine would reduce ammonia in blood. So, now we have two supplements that seem like they would work for both ammonia and lactate - thiamine and biotin. However, if even 50g of protein gives you ammonia symptoms consistently then I'd get some tests done for liver and kidney function as it should not be happening. Another reason for ammonia build up from small amounts of protein would be extreme hypothyroidism and/or strenuous exercise. Peat said that in one of his articles. But I'd get liver and kidneys checked anyways.
Once you get to a basic diet that does not cause you a stress reaction or symptoms of toxic metabolite buildup you can (if needed) add some metabolic boosting agents like caffeine or thyroid (if needed). Monitor temperature and pulse and if any of these extra substances gives you a stress reaction then either back down or increase nutrients. Overall, the body is very good at regenerating. If you get to a diet that does not harm you (in terms of ratio of protein, carbs, and fat) it takes about 2-3 weeks to get to a much healthier level where you can expand on your success and change nutrient ratios or amounts, add different supplements, etc. Initially I gained more than 30 lbs on the Ray Peat "diet" until I finally figured it out, and for me it was liver function that had to improved with caffeine and vitamin K2 before things got better. That does NOT mean that this is what will work for you since your situation/context is almost certainly different from mine. But that's why you start with something common in all people - smaller meals of basic nutrients that can be controlled and adjusted and once you get to a working version of a diet that does not affect you badly you build up from there. Again, Peat write about many things that are useful IN ISOLATION, but in order for them to be working for you context will have to be taken into account. If your current context (it changes over time like everything else) is such that a supplement or recommendation from Peat stresses you out then it better to work on changing the context instead of forcing that supplement or recommendation on yourself.
Enough ranting, on to controlling serotonin. I can't directly recommend drugs but people have had good responses to small dose cyproheptadine (1mg-4mg daily) and it should be fairly safe UNLESS you have liver disease in which case I'd get that checked first (like I said above). Ondansetron has some great studies behind it in terms of being a very potent anti-depressant in low doses (4mg daily), cognitive enhancer, libido booster, etc. but it seems to have some bad effects on the heart rhythm so if you take it then it should be fairly short-term (less than month). Some of the legal LSD derivatives are (mostly) dopaminergic drugs and include drugs like Bromocriptine, cabergoline, lisuride, etc. They all have very good effects on metabolism and in fact bromocriptine has been approved for the treatment of diabetes type II. See link below.
Bromocriptine - Wikipedia
Bromocriptine: a novel approach to the treatment of type 2 diabetes - PubMed

Thank you for the post. Nicely explained.

What would you recommend for uncoupling except aspirin? Aspirin is literally my go to these days. Thanks.

 

[Ritchie]

From my notes - taken from forum posts

This might be helpful. I learnt this after making so many mistakes. If I had to start over I would remove pufa, keep overall fat really low, go very slowing on increasing carbs. I would also think twice about milk due to being intolerant to it for years (I'm not suggesting you avoid milk if you tolerate it). Study the forum!!!!!!!

RP Says Glucose Helps T4 To T3, Then Why Fructose?

So, assuming one keeps a steady dietary supply of sucrose (or some other type of sugar), wouldn't the constant presence of glucose in the blood stream keep insulin chronically elevated too? I have read various, and often contradictory, statements from Peat about the whole blood sugar and insulin thing. Often, he says that it is important to always keep blood glucose up to keep cortisol at bay and metabolism high. Of course, this means insulin would be elevated chronically too. On insulin, Ray sometimes says it is a good hormone responsible for anabolism and keeping tumor growth under control. At other times he has said that elevated insulin is not a good thing. So, I am bit confused about the overall dietary guidelines. Should we try to keep blood sugar elevated all the time but at a certain stable (and reasonable) level, which would imply higher (but stable insulin), or should we do pulse feeds which would temporarily bring insulin up to shuttle the glucose to the muscles and then insulin goes down and the body runs on glycogen from the liver?
I suspect a number of people on the forum struggle with this issue as evidenced by several posts of rapid weight gain, elevated blood glucose and insulin on blood tests and worried doctors making recommendations to cut down on sugar, blood pressure rising in people who did not have blood pressure issues before, etc. Some of these things could be beneficial, but there was a post by one person who said her blood pressure went from 120/80 to 150/90 after adopting the higher sugar diet and after some back and forth with her doctor she decided to quit the Peat diet. Then she reported her blood pressure normalizing after reducing sugar intake. Btw, it is well known in the bodybuilding community that cutting carbs works just like diuretics. I am not an advocate of this, but wouldn't people prone to edema and having thyroid problems get their water-retention problems exacerbated if they increase sugar/carbs intake? I guess that would happen at least initially and the theory is that as their metabolism normalizes they should be able to better utilize glucose and then lose all the excess water. So, the million dollar question is how long does one have to re-feed higher carbs diet (and suppress fatty acid oxidation through the Randle effect) until their insulin sensitivity is restored?
Finally, there have been a number of reports on Peatarian and occasionally on this forum of people experiencing proteinuria (protein in the urine) when increasing sugar intake above 200g daily. If you are eating 80g+ of protein then you probably strive to eat at least as many carbs. Peat has said that this proteinuria is due to people burning PUFA, which makes albumin leak in the urine and show up on the tests but as far as I can tell, these people were actually burning fat before adopting the higher sugar diet and only experienced proteinuria after increasing sugar intake. Of course, they could have had this issue all along and only realized it after switching and measuring their urine but there are several reports of this so I doubt it's a random thing. Somebody also posted a study on thousands of university employees and those who consumes the most sugary drinks reported the highest incidence of proteinuria.
It would be nice if we can get some guidelines on this. Personally, I use caffeine to increase the utilization of sugar and don't really have issues with it, but in theory there should be a way to handle sugar from diet without relying on sugar burning aids like caffeine and/or thyroid. Thyroid does not seem to be a good option for me, and I have tried all kinds of supplementing schedules and dosages. As I have posted on other threads, my experience with sugar only improved after I took serious measures to "normalize" my liver function through caffeine and vitamin K2, BUT my liver enzymes were NORMAL according to the standard lab ranges. If the stats are true and over 80% of people over 30 have some degree of fatty liver, which is the real cause behind type II diabetes, then I think many people adopting the Peat diet will likely experience stress reduction through the lower cortisol, but may end up making their fatty liver worse, especially is supplementing niacinamide and aspirin. Such_Saturation and I posted about this in another thread.
So, my main point is that burning sugar is definitely preferable to burning fat based on both Peat's writings and all the studies I have seen about liver disease being caused by increased lipid peroxidation by products, and cirrhosis (in alcoholic rats) being easily and succesfully treated by feeding about 60g-70g of saturated fat like butter or coconut oil for a week, while the rats kept drinking alcohol at the same time! So, on the point of burning sugar I think the question is settled that it is preferable to burning fat.
However, the point is to actually BURN the sugar rather than simply feeding ourselves more of it. For people with sluggish livers, many of whom also take niacinamide and aspirin, this is likely to make the metabolism situation worse by fattening the liver even more, even though admittedly the fat synthesized will be saturated since it is made from sugar. But fatty liver will increase your estrogen no matter how saturated the fat is that you are synthesizing. So, fattening up the liver even more probably won't do much good for metabolism. Another suggestion from Peat would be to increase protein intake to at least 80g a day which should support liver function, lower estrogen and increase conversion of T4 into T3. However, that will likely also not work very well in people with sluggish and fatty livers since underperforming liver will convert a lot of that extra protein into ammonia. Even Peat is clear on this point in one of his articles where he says that "hyperammonemia can be caused by exhaustive exercise or hypothyroidism". This is also evidenced by a number of studies showing that people in their late 30s, 40s, and 50s experience chronic fatigue issues that are greatly helped by giving them ammonia-reducing agents like ornithine or sodium benzoate. And those people consume nowhere near the 80g of protein Peat recommends. So, if they are having ammonia issues imagine how would the people loading up on extra protein would feel.
Which brings us to the point that for many people over the age of 30, simply increasing sugar and/or protein will likely not solve the metabolic issues. Thus, the Peat diet, while the correct way to eat, may not be a solution to the issues of hypothyroidism, but rather a way to avoid the worse option of running on cortisol and adrenalin, which while energizing in the short run will ruin you in the longer run.
Considering the Barnes book "Hypoglycemia: It's not your brain, it's your liver", which I read, it seems that restoring optimal liver function is also a key to improving metabolism. Yes, thyroid function is important too, but I think Peat's recommendation on supplementing thyroid even in the presence of normal thyroid labs may cause issues for a number of people. Charlie, and at least 20 other people have posted on struggling with supplementing thyroid. If they take it, they develop teeth issues, skin issues, anxiety or some other unpleasant symptoms. If they don't take it, their digestion slows down to a crawl or they start getting hypothyroid symptoms like brain fog or muscle issues, etc.
So, if the stats are true and the evidence I have seen is legit, then eating according to the peat guidelines is a great strategy AFTER metabolism is fixed. But if 80% of people over 30 are having liver issues or some other problems with metabolism, then the diet will be certainly supportive, but likely not "curative". And for some people with particularly bad liver problems the situation may end up getting worse in a way due to even more fatty liver issues or higher ammonia levels. Just ask anybody over the age of 40 if they are having trouble maintaining (let alone building) muscle mass.
Then the question becomes, what will aid metabolic recovery, other than blindly supplementing thyroid even in the presence of normal thyroid labs? I guess the answer Peat will give is that one needs to wait at least 4 years and get rid of the PUFA before starting to see solid results. There is some solid evidence in favor of lower PUFA fixing metabolic issues. But I wonder if working on liver health or trying to build more muscle will also help while waiting out the PUFA detox period? Uncoupling agents are probably also key, but they should probably be other than aspirin since it may make fatty liver issues worse for many people if used in the doses needed for mitochondrial uncoupling. Finally, increasing CO2 production or intake somehow will also likely have a key role. Just throwing things out there that seem to be cardinal methods for improving metabolism.
Sorry about the long rant, I just felt like this deserves some attention since a number of threads pop on the forum asking the same questions and I have been thinking about this for some time. If someone knows about Peat's definitive opinion on this issue please share it. Maybe I missed it in his articles. IMHO, after reading pretty much all of his published stuff, reading people's testimonies/complaints, cross-referencing this with studies, and my own experience,

I think Ray recognizes that there are many cases where antibiotics and/or charcoal won't solve the problem but our knowledge on the issues causing microbiome disbalance is probably limited at the moment so he refrains from making more definitive statements. Finally, people with good liver and kidney function can also have ammonia issues if they have slow digestion of things like IBS/IBD, which allows for the food to stay longer in the colon and the ammonia to get reabsorbed. The antibiotic rifaximin, used for treating SIBO, is also used for ammonia encephalopathy precisely for that reason - otherwise healthy people with ammonia buildup issues. I wonder if there is a case for chronically increasing salt intake simply for the purpose of controlling ammonia levels, given how toxic to the metabolilsm it is and how closely related it is with serotonin and histamine. Ray wrote in one of his articles about this toxic trio of amines and how important it is to control their levels. Or maybe taking 5mg of lithium every night, which is close to the levels people ingested daily about 100 years ago in some parts of the US and it was shown that this resulted in increased longevity and decreased illness incidence.

Caffeine mainly forces the liver to flush its fat out into the bloodstream, so it's a great treatment for NAFLD and I posted a study on that. I believe vitamin K2 works by stabilizing the so-called Kuppfer cells in the liver: Kupffer cell - Wikipedia
At least that's what the studies I have seen on PubMed say. Also, we know that quinones like K2 makes mitochondria work better, so that's probably another mechanism behind K2 effects. Glycine's mechanism of action has not been definitively pinpointed yet but it is a potent antiinflammatory and Peat gives many explanations about its effects - antiestrogenic, antiserotonin, antiexcitotoxic, etc. All of these effects will be beneficial for liver.
Finally, taurine is also a big of an enigma for liver health but some of its good effects have to do with protecting the liver from lipid peroxidation effect, and in fact one study compared it to vitamin E and found their effects to be virtually identical. Taurine also forces bile release and that may "cleanse" the gallbladder and liver in a way.
So, if you are willing to ingest all of those I would recommend combining them for a week and then maybe falling back on caffeine and K2 as I believe they specifically target the liver and are not sedative unlike glycine and taurine. There are studies showing benefit for NAFLD from coq10. The doses were in the range of 300mg-500mg daily. Also, there are studies using 1,200mg and 2,400mg of coq10 for diabetes type II, which some people believe to be just another name for liver disease. Finally, 1,200mg-2,400mg of coq10 are currently in humans trials for Parkinson disease, so there must be something to the quinones like coq10 and K2. Coq10 won't match the effectiveness of K2 as far as I know. In doses of 2,400mg per day it may be as effective for mitochondrial health as K2 but won't be as effective for liver health. I just suggested it for alternative for people that absolutely cannot get their hands on K2 at doses of 15mg or more.


How to improve protein utilization

Moderate doses of protein, combined with some sugar and keeping fat low should form the basis of your diet. How much protein? Well, maybe you can start with 50g which is what most sick people in the hospital get and seems to be the minimum to ensure organ function without burdening liver or kidneys too much. Try to ingest at least twice as many carbs as the grams of protein in each meal. Then you track temperature and pulse and monitor health signs like fatigue, brain fog, thirst, etc. Increase in any of these probably means increase of ammonia and/or lactate so you need to adjust thing. If is lactate, your muscles would feel sore and limbs would feel heavy and you may start panting from the reduction in CO2. If that is the case, you are probably not processing carbs well so adding things like thiamine and biotin should help. If you get sudden brain fog or your pee smells of ammonia too strongly then either ammonia in blood is too high or you got dehydrated. Adding more carbs and/or sweetened fluids may resolve this. Also, things like zinc or ceylon cinnamon or biotin or thiamine would reduce ammonia in blood. So, now we have two supplements that seem like they would work for both ammonia and lactate - thiamine and biotin. However, if even 50g of protein gives you ammonia symptoms consistently then I'd get some tests done for liver and kidney function as it should not be happening. Another reason for ammonia build up from small amounts of protein would be extreme hypothyroidism and/or strenuous exercise. Peat said that in one of his articles. But I'd get liver and kidneys checked anyways.
Once you get to a basic diet that does not cause you a stress reaction or symptoms of toxic metabolite buildup you can (if needed) add some metabolic boosting agents like caffeine or thyroid (if needed). Monitor temperature and pulse and if any of these extra substances gives you a stress reaction then either back down or increase nutrients. Overall, the body is very good at regenerating. If you get to a diet that does not harm you (in terms of ratio of protein, carbs, and fat) it takes about 2-3 weeks to get to a much healthier level where you can expand on your success and change nutrient ratios or amounts, add different supplements, etc. Initially I gained more than 30 lbs on the Ray Peat "diet" until I finally figured it out, and for me it was liver function that had to improved with caffeine and vitamin K2 before things got better. That does NOT mean that this is what will work for you since your situation/context is almost certainly different from mine. But that's why you start with something common in all people - smaller meals of basic nutrients that can be controlled and adjusted and once you get to a working version of a diet that does not affect you badly you build up from there. Again, Peat write about many things that are useful IN ISOLATION, but in order for them to be working for you context will have to be taken into account. If your current context (it changes over time like everything else) is such that a supplement or recommendation from Peat stresses you out then it better to work on changing the context instead of forcing that supplement or recommendation on yourself.
Enough ranting, on to controlling serotonin. I can't directly recommend drugs but people have had good responses to small dose cyproheptadine (1mg-4mg daily) and it should be fairly safe UNLESS you have liver disease in which case I'd get that checked first (like I said above). Ondansetron has some great studies behind it in terms of being a very potent anti-depressant in low doses (4mg daily), cognitive enhancer, libido booster, etc. but it seems to have some bad effects on the heart rhythm so if you take it then it should be fairly short-term (less than month). Some of the legal LSD derivatives are (mostly) dopaminergic drugs and include drugs like Bromocriptine, cabergoline, lisuride, etc. They all have very good effects on metabolism and in fact bromocriptine has been approved for the treatment of diabetes type II. See link below.
Bromocriptine - Wikipedia
Bromocriptine: a novel approach to the treatment of type 2 diabetes - PubMed

Interesting post, well considered...

I have a question, when you say ..

There is some solid evidence in favor of lower PUFA fixing metabolic issues.

Do you mind sharing the best evidence you've seen to this regard? I've seen some In vitro studies and animal studies, however haven't seen any comprehensive human studies showing depletion of PUFA (or that type of focus) leading to significant health/metabolic improvements and vice versa (PUFA in the context of a balanced diet being detrimental).. Now I know that the PUFA used in deep fried/shallow fried cooking oils for say french fries, burgers and so forth have been shown to be detrimental. I'm more curious about say the pufa in fish like salmon, sardines and oysters.. or olive oil and avocado, or even uncooked cold pressed seed oils...

 

[GreekDemiGod]

@Peatness Great post, but basically boils down to caffeine and K2, and I'm people sure people have already tried that...

I think NAFLD is caused by overconsumption of calories AND overconsumption of fructose. I am having good results with a more balanced starch/ fruit ratio. I eat 400h of carbs daily. Are you gonna tell me that a no starch diet is healthy and my liver should be able to process 200g of fructose/ day?

A Wish For More Energy

Update: Did blood tests for the liver today as instructed by my gastroenterologist, good news! Liver enzymes came back in normal range, they were previously high. AST 25 ALT 54 What I did: - cut back on the amount of sugar and fructose that I was eating, indirectly lowered caloric intake -...

raypeatforum.com

 

[Peatness]

I made these notes when I realised I was gaining weight Peating. As I said above these notes are compiled from forum posts mostly Haiduts. Sadly, I’m not a genius but I am working on it. I can’t emphasise enough how important it is to spend time reading – there is so much info on the forum.

@LadyRae I agree alcohol is not worth the effort. I made the mistake of not going low fat when I started.

@GreekDemiGod I've followed your thread and agree that for some high fructose is an issue. Glad you managed to lower your numbers.

@Ritchie before Peating I was a heavy nuts and seeds consumer and I had poor thyroid function. Mind you I was also supplementing pufa in the form of fish oils.