People with kidney disease end up with GFR levels below 60 and creatinine levels above 1.35: https://www.mayoclinic.org/tests-procedures/creatinine-test/about/pac-20384646. Imagine my horror when my GFR came in below 40 and my creatinine above 1.76 at the beginning of November 2021.
The general belief in medicine is no one is coming back after a GFR of 30. Time to sign up for the donor list and dialysis, get your affairs in order, and hope the life insurance policy pays out for your family like it says it will. People who are down to a single kinda-functioning kidney routinely pull creatinine levels at 1.8 and up. Needless to say, it was pretty jarring to see my own lab values similar to those of dying people.
“Defeated” doesn’t really encapsulate the experience. Some people might have this happen, and think, “well, at least I can start exercising, cut out the sugar, stop drinking, etc.”. But for me… what’s there to clean up? I routinely fast. I do lengthy raw juice fasts quarterly. I exercise. I’m on whole food as my baseline. I haven’t really had any alcohol in years. I attend to my sleep and stress management. I’m on no medications. I supplement vitamin d, c, omegas, occasional minerals. From a practical perspective, what else could I do?
Trying to figure out what risk factors I even had was dicey. Sure, I’d been vaccinated AND had breakthrough Covid infection after vaccine; and there is a growing body of evidence that healthy males under 40 in particular have higher risk of myocarditis after vaccination. There is more ACE2 expression in the kidneys than in the lungs and heart combined. So, it stands to reason that vaccine plus infection plus something about my unique genetics made my kidneys specifically vulnerable. But again, what practical takeaway did that really afford me? What could I actually DO?
I could blame it on vaccine or infection or genes or both or all or some combination or something else entirely. But so what? What was I going to DO?
After feeling sorry for myself and accepting that I may be dying, I tried to get some clarity. I have walked clients through reversal of diabetes, reversal of bone density loss, reversal of joint deterioration, clearance of fatty liver, reversal of autoimmune diseases, and a whole host of “impossible” situations. I’ve watched people with “irreparably” destroyed spines recover fully to athleticism; and the natural healing of bulged discs is now a clinically-verified fact: https://pubmed.ncbi.nlm.nih.gov/30610984/ . I’ve coached clients with Parkinson’s who improve in fitness. I’ve watched those with muscular dystrophy gain muscle size and strength. I currently have clients who USED to have high blood pressure, high cholesterol, atherosclerotic plaque build-up and USED to take medication for it. Even for myself, I once was debilitated with Lyme disease and nerve damage. I couldn’t reliably bend my right knee without issue from 2015 to 2017 while I can now deep squat over 600lbs. “Snap out of it!”, I kept telling myself.
The difference with kidney damage, of course, is that NO ONE really believed kidneys could regenerate… prior to 2014: https://med.stanford.edu/news/all-news/2014/06/adult-kidneys-constantly-grow.html. In fact, ask any kidney specialists or nephrologists who graduated before 2015, and they still don’t know this unless they stay on top of the literature. To this day, the current OFFICIAL position for organizations is that kidney damage CANNOT be reversed: https://www.cdc.gov/kidneydisease/publications-resources/live-well-with-chronic-kidney-disease.html. Not just the CDC, but all authoritative organizations in medicine state the same thing: kidney health goes one direction. The most hopeful sentiment you’ll find in mainstream medicine is that we may slow the deterioration of kidneys: https://www.mayoclinic.org/diseases-conditions/end-stage-renal-disease/symptoms-causes/syc-20354532
The only thing I could even think to do was drop body weight and lower my protein intake (and I wasn’t even sold on this idea, because it’s promulgated by the same organizations who don’t believe you can heal the kidneys). Nonetheless, between those and complete abstinence from any NSAIDs, I just couldn’t even think of another thing to actually DO.
The first retest, shown on the left, was a small improvement, but still VERY concerning. There are people with numbers like that who are essentially actively dying.
All the same, it WAS an improvement. So… patiently I kept on. The following month I had another small improvement. And February I had another. By March I was in “normal” range and I had begun to add some days of higher protein intake. VERY HIGH. In part, I wanted to see if high protein intake would worsen my numbers back to where I was in February or earlier. In part, I was tired of feeling like I was getting weaker and less athletic.
Not a big surprise, but the numbers improved again, confirming my suspicion that dietary protein is likely a red herring for people with compromised kidneys. After all, WHAT are you going to use to regrow the cells in the kidneys if you’re going to regenerate them? It sure as hell ain’t carbs. Moreover, carbs are going to reinforce insulin resistance, which damages all tissue, kidneys included.
Also, I have to add that the GFR is a calculation from creatinine based in part on body mass. Technically, my GFR is even better than the picture on the right because no one updated my weight since November (all visits since have been “lab only” blood draws); and I’m down 20lbs.
1.) The uncommon is always possible when we think and behave in an uncommon manner.
Be wary of bleak opinions, especially expert ones, when the opinion is coming from people who don’t think or act in uncommon and exceptional ways.
I don’t care for toxic positivity or effusive can-do attitudes. But we have to be on the lookout for the can’t-do experts who seem to be in endless supply.
2.) Less body mass is less work for all systems and organs.
This is incontestable. Among the average populace, this is a bit of a Catch-22, because they need to gain 30lbs of muscle to be somewhat healthy. At the same time, the average American adult is walking around with 60lbs to 150lbs of excess body fat.
In my case, I can pretty much be whatever weight at whatever percent composition whenever I want within 6 months. For this particular process of healing, I didn’t take great pains to save muscle mass so much as just clock in lighter. I prefer NOT to do things this way; but I was genuinely sick and needed to give the kidneys a fighting chance. This is NOT the best course of action for all people, because most don’t have a lot of extra muscle and strength they can afford to lose, nor do they really know how to rebuild it.
Long story short: learn to fast. Learn to do medically-strict ketogenic nutrition from time to time. Protein intake will eventually be a necessity. Thus, although I acknowledge the benefits of fasting and low-protein keto diets, healing is eventually going to require moderate to high protein intake (and oftentimes not much else), if only periodically.
3.) Gain some real understanding of lab testing.
One test is ONE DATUM. Diagnosis and prognosis off of even several tests is logically fallacious and a critical-thinking no-no. I’ve actually witnessed several people get “good” A1C readings WHILE their diabetes was worsening. And, when you understand how physiology works and what the test can and can’t evaluate, this makes perfect sense.
This always shocks people, but I know how to change cholesterol test outcomes in the same day. In fact, most chronic disease diagnoses are based on a single test which you can alter the very next day. I know. I’ve done it. And I’ve helped clients successfully contest their employers’ health care premium evaluation by retesting an improved blood lipid panel one to two weeks later.
4.) Keep reminding yourself that “average” outcomes are MOSTLY self-fulfilling prophecy. Look around. You can see people don’t try hard. As such, when you’re consulting statistics, be starkly aware that you’re observing trash behavior, garbage choices, uneducated and willfully self-sabotaging lifestyle.
When you perform even modest or moderate effort at anything, you’re immediately shifting into an outlier percentile. I don’t care at all to learn from the best of the best UNLESS they came from a severe disadvantage. We need to learn more from people who’ve achieved “the impossible” against all odds. We can’t learn anything valuable from people who have an aptitude, a knack, an inherent talent, a prodigious start, or an outrageously privileged beginning. What we need to know is how someone who “shouldn’t have been able to” employed an uncommon tactic to exceed all expectations.
I never once studied a success story who came from a wealthy family. I prefer a Fredrick Douglas, or a Mark Mathabane. I want to know how someone with less than I had has done more than I’ve done. In fitness, I don’t care at all what a lifelong super athlete has to say. I want to hear from the sedentary person who was on death’s door and transformed her life at the age of 60, 70, 80.
In health, don’t look at average outcomes or exceptional backgrounds. Look at exceptional outcomes that come from average or below-average backgrounds.
5.) Hate Dogma And Conventional Thinking.
I don’t think it’s enough to challenge the status quo. We must revile it. Odium is the only appropriate response to self-proclaimed fonts of authority. Only through extensive self-experimentation and genetic testing did I discover that plant-based nutrition is harmful for me. You can find lots of opinions on this and controversial gurus who say one thing or another. But I KNOW with total certainty through REPEATED testing that my labs worsen and risks of heart disease go up dramatically with vegan eating while labs improve and risk of heart disease plummets with animal-based dieting FOR ME.
The only high blood pressure reading at rest I ever had in my entire life was during a plant-based eating experiment.
6.) “What’s the plan if you’re wrong?”
I like this question, both for myself and for other experts. It helps to move people into their thinking brains and out of their ideology shields. It’s like an Occam’s Razor meets Pascal’s Wager. I’ve heard it rephrased by clients, one in particular I really enjoy, “what is your plan to get me OFF of this medication after I begin taking it?”
Imagine a person who feels motivated to learn guitar but has no guitar, learning system, teacher, time to practice, or plan to rectify that landscape. That person feels something, sure. But she isn’t ready.
Imagine a person who feels motivated to do anything else. Any skill. Any subject. Any language. Any change. Visualize what happens when he doesn’t make his environment include the tools to get there. I don’t question his emotions. He may feel incredible motivation. I just KNOW he isn’t ready.
Emotions are beautiful.
Emotions are not concretely who you are.
Emotions do often choose for you who you’ll be in the next millisecond. And indeed who you are is always becoming and never fixed. Some milliseconds you are motivated. Most you aren’t.
Healthy lifestyle readiness is not that. Ready is painful self-awareness. What WILL you do on your least motivated weeks of your life? How WILL you stay disciplined WHEN YOU DON’T WANT to do this? If you have brilliant answers for this, you’re getting close to ready.
Nearly every weight loss or fitness program in existence capitalizes on buyers feeling motivated. One of the largest, WW, after tens of millions of members, only has a few thousand long-term successes: https://www.calpoly.edu/.../weight-over-two-cal-poly....
That’s a success rate of bout 1 in 10,000, or 0.01%. This is worse than the unguided general populace. In the general populace, 10% of resolutioners keep going after week 6 (when all initial feelings of motivation wear off): https://d25d2506sfb94s.cloudfront.net/.../Results%20for.... Around 4% keep up what they say for a year, mostly, sort of.
Ready is not like that. Once you are ready, your discipline supersedes wavering emotions and feelings. When you are ready to change, you will continue to walk the steps of change WHEN you don’t feel like it.
Motivated is not ready. Motivated is not close to ready. Motivated is shorter than the blink of an eye. Ready persists.
As such, I DIScourage people who aren’t ready. I don’t want motivated. I want ready. Trust me: I’ve met many motivated people. I’ve met incredibly high net worth, famous, business owners, execs, well-known speakers, and self-proclaimed “A-type”s and “driven”s. That’s nice. Cool. But are you READY?
And mostly they aren’t. People will peak in emotion and confuse that with readiness. That isn’t readiness. It’s the opposite. You can see this with people who have near-death experiences, survive car crashes, cancer, near fatal surgeries and brushes with disaster and THEN DON’T CHANGE LIFESTYLE. They get a new lease on life and continue to eat, act, and think precisely the same way that caused their brush with death.
Wake up calls work for a moment. They’re highly emotional. They will invoke all kinds of feelings. And you WILL FEEL MOTIVATED. To quit smoking. To quit drinking. To quit various addictions and counter-productive behaviors.
That’s a flit of a heartbeat. It’s nothingness in the vast cosmos of reality. We don’t need that. We don’t even want that. We need ready.
More than in exercise or nutrition, I encounter this confusion with executive coaching clients and their professional journeys or career paths. A bad moment makes them feel motivated to leave. Lack of readiness keeps them there. A hopeful moment makes people feel ready to launch a business. They never launch, no matter how motivated they get, because they never ready themselves.
What steps WILL you take WHEN you have no time, kids are sick, work is crazy, you’re defeated, demotivated, and it all seems hopeless?
WHEN you have SOME good, honest, realistic answers to this, you are almost ready. When you are fully prepared to shoot down all of your own valid excuses and victim narratives, THEN, and ONLY then, are you ready.
Motivated is not ready.
December 2012: developed virtual template
April 2020: 50 virtual sessions/wk
June 2020: had to take most the month off to get a break, RV out West
August 2020: scrambling influencers, “sign up for my virtual coaching courses”
2010: I’m putting butter/ghee in coffee for extended fasts
2012: Bulletproof launches
2008: credit market imploded and sinks 100k on our business venture outright
2009-present: zero-overhead hobbyists, shooting YouTube fitness videos out of their moms’ basements, “this fitness business thing is hard”
2011: wearing masks on flights for our immune-compromised child
2006/07: purposely gained 100lbs, cut 70
2016: Fit to Fat to Fat show “first of its kind”
99/00: developed concept to take labs/blood tests BEFORE heart disease, diabetes, stroke, etc.
2010: WellnessFX startup
1998: implementing foam roll, muscle balance, mobility drills
2004-2008: NASM popularizes foam roll and imbalance protocols
1989: taking notes on periodization from exercise science and nutrition science text books
2000: Glassman incorporated Crossfit, LLC
2007: split/lost left knee cartilage and rebuilt high level athleticism
2014: Lyme disease right knee dislocations/severe locking/joint damage and rebuilt HIGHER athleticism
2021: people, “hey, have you heard of knees over toes guy?”
And that’s the short list. I can think of a lot more, like shoulder dislocates, food scale for if-it-fits-your-macros, glucometer testing, heart rate variability, and ketone strips 20 years ago. And I’m a young guy. Imagine what the genuine old dogs feel like.
Shockingly, the American Heart Association let one slide through their filters; and they featured this published research showing protein benefit to lowered heart disease risk EVEN WHEN SOME PROTEIN COMES FROM PROCESSED RED MEAT: https://www.ahajournals.org/.../HYPERTENSIONAHA.121.18222. What I find a little laughable is that in the journal of publication meat is mentioned first. In the AHA’s summary on their website, whole grains (which are a terrible and incomplete source of protein) are mentioned first.
As I covered previously, the AHA has outrageously questionable ties to financial interests which drive their recommendations. As such, you’re going to observe really weird and conflicting messages anyway. But, like I’ve covered previously with any health topic and varied research outcomes, we have to find WHY seemingly-conflicting messages exist.
Protein is the driving mechanism in biochemistry. All immunity, bone matrix, and DNA replication relies on an abundance of available protein. Also, the pressure of the circulatory system is managed via nitric oxide whose synthesis is totally reliant on protein as precursor. Thus, as completely expected, we see a U-shaped relationship EVEN WITH HIGHLY PROCESSED RED MEAT. Why? Because it is STILL a complete source of amino acids. Too low, and it’s likely representative of the person eating too little protein altogether. Too high, and it’s clearly too much of the processed byproduct affecting the person. There’s a sweet spot, even for this vilified food.
The irritation remains, however, as grains don’t contain the most usable protein or an amount which is usable. Double negative.
Nevertheless, MECHANISM is where we can understand seemingly-conflicting findings.
This research explains why.
Moreover, fundamentally, people who set up their weeks with lots of growth are going to see vacation as a partly negative interruption. There’s no need to “get away” from what you’re looking forward to.
I first noticed this in my teens, when the idea of going on even a short trip without bringing my guitar was unconscionable. I loved playing; and I was consistently every day becoming better. The thought of going a single day without practicing was intolerable. I mean this precisely and literally. It’s not hyperbole. It’s not exaggeration. It’s not a rhetorical device. I would have just as soon skipped a dream vacation if I couldn’t pack at least one guitar. A single day without it was agony. I mean it. I can’t even narrow down the time frame of the photo included above, because it could’ve been any given day of any year, any trip, home or away, from ‘96-‘99.
I began noticing this more and more over the years as I came to love my weeks more. Even really paradise-like trips or family visits which I definitely wanted to do lost their dream-like luster when it began to dawn on me how some of my beloved growth and learning was going to be forced into a break time. NOT having access to my equipment, my rock climbing gym, my kids’ activities, my home library, etc., is not an upside. I’m gaining new skills I like every week. I’m having awesome experiences every week.
And then I started to notice that peers and clients who were in the midst of breakthrough or skill growth/learning just straight-up won’t take vacations while at that point. And they are a lot happier, healthier, and more resilient to stress.
Last week I asked about this with several of my peers in the strength coach, athletic, fitness model, bodybuilding, personal training, and nutrition communities. Some of their responses:
“There is no break during prep.”
“No.” (Answer to “can someone be taken seriously if they never go more than four consecutive weeks of on-plan?”)
A lot of the discourse centered on 16 weeks of targeted progress. What would an expert consider acceptable adherence if a person wants to see dramatic body composition improvement over the course of 16 weeks? The consensus is 16 weeks. Not just consensus. Unanimity. You didn’t misread that. Sixteen weeks of all seven days being productive. There are no off days if you want to expect to make progress. I could not find a single peer in my whole network who disagreed.
Does this mean people shouldn’t have holidays or weekends or breaks? No. But if you want to expect progress in a given time frame, regular steps backward don’t make sense. Obviously.
I was chatting about this with a client recently; and we were talking about how we just feel better when we exercise and stay active on vacation. My body feels better than when I was a teen or in my 20s, thanks to how I eat and workout. Why would I take a break from feeling good? Emotionally, likewise, I just feel better than any prior point in my life, thanks to the way my weeks are set up. Why abandon that? Seriously. Why?
One of the coaches I queried about breaks put in the caveat that if someone trains and eats on-plan during travel, that person may still expect progress, albeit possibly less. Personally, I have only tracked food tightly a few times during trips. But I think I'll start, given these recent conversations and reflections on the nature of progress/growth and breaks. I've increasingly wondered over they years, "why would I take a break from the very things which help me feel my best?" I don't have a single good reason. I just did it because that's what people do, not because it's what's best or most sensible. And as I drill down into the logic, I really don't see a good reason to discontinue anything which we find is providing benefit.
Sixteen weeks of tight consistency is rare. We all know it. Even two consecutive weeks of rigor in programming is outrageously rare. I have observed tens of thousands of members, peers, clients. I KNOW that people, as a rule, will not exert in healthy lifestyle sufficient effort. We have a chasm to face in our "all-in or all-out" narratives. But there's even more to it than that. The incessant break in consistency is paired with a second and bigger problem: the desire to look and feel virtuous. People will say things like “for how hard I worked, I would expect more progress.” Now, think about this. We've all said or thought something along these lines at some point. But really dwell on it. What is even the point of that sentiment except to look or feel virtuous? If you worked hard enough to make progress, you progressed. By definition. There’s no opinions or feelings needed.
We know that only two weeks of immobilization loses so much fitness that it takes six weeks to recover SOME of the ability: https://www.medicaljournals.se/.../10.2340/16501977-1961. Not all. SOME.
Consistent and regular investment in fitness dominates. We all know this elsewhere. No one says, “for how hard I invested in retirement last week, I should have a lot more built up.” There’s no “should”. No one cares about a few “good” days. Either your lifelong track record of retirement investment is sufficient or it isn’t. Likewise with fitness, your cumulative consistent track record is sufficient or it isn’t. There’s no place for “should.” There’s no place for virtue-signaling.
And if you’ve come to love it, there’s no reason to abandon productive structure. Skill development and growth is proven better at stress management anyway. We will certainly hit points where we have to escape overwhelm. There are places we’ll want to see and go. But there really isn’t ever a great time to repeatedly cease doing the productive things which help us learn and grow. We can and should take breaks from negative influences. But I’m not seeing a great substantiation for taking breaks from positive ones.