Your VAP = Brain Gut Axis Function

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Reader Summary

  1. What can we use a VAP test for? And WHY you should ask your doc for it instead of a regular lipid test?
  2. Should our diet be static or dynamic endeavor?
  3. How does the brain gut axis function and sustain health or promote disease?
  4. How do hormones tie this all together?
  5. How does HS CRP, thyroid and the brain all make love and not war?

When most people get a VAP they think heart and lipid study. I do not. I use this test to assess levee 5. Most people in the paleo world associate a leaky gut with a gluten problem. I do not. The VAP test is the best test to use to assess the function of our gut and how leaky it is based upon the fuels we are feeding it now. If you really dissect your VAP you can learn a lot about what you should be eating and you should not be eating based upon your current cellular homeostasis. Most people think a diet is static. I believe a diet must be dynamically altered based upon the testing feedback we receive from our body. As most of you know I use a quarterly lab draw system to assess my own health to make dynamic changes as I see fit. So today let’s talk about the uses of a VAP test.

The basis of the brain gut axis is the protective effects of great liver function. I think the real defender of “leaky gut” is not the brush border of the intestine but it is the liver. Why? All humans are subject to direct assault of inflammation via our intestines because it is the most common way the environment reacts with our body. This is also why the immune system is ready for defense right behind the brush border. We already know that diseases like celiac destroy this first line immunity. Well, a good liver will protect a leaky gut and the brain. Most endotoxins gain access to our portal circulation but they rarely ever get to our general circulation to cause the real damage because our liver won’t allow it to occur based upon its design. In fact, endotoxin binding in the liver is increased by exercise, testosterone, estrogen and even occasional alcohol use. These things all increase our HDL particles too. A high HDL is a sign of good liver function. Remember that HDL particles actually bind inflammatory endotoxin particles to increase our immunity from oxidation from many sources. This is why a high HDL level confers general health and well being across the board. Moreover, VLDL and chylomicrons also protect us from inflammatory damage as well. This biologic process is at the seat of why we see higher cholesterol levels in the face of cellular stress or infection.

Cholesterol production is the bodies natural response to clean up this kind of mess if the brush border is overwhelmed. We also need to be mindful that any stressor can increase the permeability of the gut to endotoxic damage. This includes cortisol, malabsorption, or frank infections. The liver is backed up in its protection by the action of thyroid hormone. If your thyroid is working well, when you get a serious gut insult that causes “leakage”, your thyroid responds by increasing production of its own hormone to allow the the upregulation of cholesterol turnover. How it does this is by acting as a co-factor (thyroid hormone) with vitamin A to allow the conversion of cholesterol to pregnenlone. Remember that pregnenolone is the basic building block of all the steroid hormones that our brain uses to signal our 20 trillion cells of exactly what is going on in our bodies. You may begin to understand why I believe lowering your cholesterol makes zero sense from a biologic stand point. Its formation is critical to a positive response from our brain to a direct cellular stressor from many different insults.

If this system is not working properly we have a major communication breakdown between the brain and our cells. This is how I globally define Leptin Resistance. LR does not allow the brain to understand the current situation as it exists in the periphery or in the liver. In essence, it is blind to the bodies needs. It should be clear now, thyroid hormones help regulate the and control the inflammatory processes in our bodies. When we lose control of our thyroid hormone production ( hypothyroidism by any cause) we effectively lose control of how the brain sends its message to our peripheral cells. We can no longer make steroid hormones effectively from pregnenolone. This is the basis of the pregnenolone steal syndrome. It also helps explain why we see a pandemic in low vitamin D levels and low testosterone and estrogen levels in people clinically today.

So we need to think about the thyroid some more. Here is another biochemical fact few of us talk about. 20% of the conversion of T4 to T3 occurs directly in the gut but outside the liver. Why is that? It is because the thyroid works in unison to also help protect our portal circulation from gut inflammation. This is a key point. Its stimulatory protein is TSH and it is released from the brain at the anterior pituitary site. In hypothyroidism, TSH is high because the brain is trying to nudge the thyroid gland to make more active hormone (T4). Remember that T4 has to be converted to the active form of thyroid hormone called T3, guess where? The answer is in the liver for the remainder of the 80%! So the liver and thyroid is critical to how this brain gut axis system works.

The increased secretion of TSH from the pituitary has a major effect on out liver too. It is pro inflammatory because it causes the liver to make HS-CRP. HS-CRP is what we used to measure baseline inflammation in patients. It is called an acute phase reactant protein. High CRP levels are known to walk hand and hand with the development of atherosclerosis. The increased CRP produces multitudes or pro inflammatory chemicals body wide, because they activate immune cells like Mast cells. Mast cells and other immune cells, are the factories of pro inflammatory chemicals and they stimulate more inflammation in the plaques of atheromas in blood vessels to rupture and cause disease.

High TSH levels are not good signs. This is why hypothyroidism is correlated with heart disease and many autoimmune conditions. Hashimoto’s thyroiditis is an epidemic in America and in my view is a sign of a constant assault of the intestinal brush border of our gut that eventually overwhelms it and then floods the portal circulation with inflammation. This results in a liver response that over time goes from favorable (particle A LDL size with high HDL) to a very unfavorable particle B size dominated by sdLDL and low HDL and a high HS CRP. This then sets the stage for disease propagation in many sites of the body.

This is how the physiology of the brain gut axis works from a biochemical standpoint. Once the inflammation markers are present in the general circulation they head to the two most prominent organs based upon blood flow . The brain and the heart are those targets. In the brain the first effect is to overwhelm the parts that are not protected by the brain blood barrier. These places are called the circumventricular organs. The most important of these is in hypothalamus where the leptin receptors are. The receptors become over whelmed with these inflammatory cytokines and lead to leptin resistance. Leptin resistance basically makes the brain completely blind to the energy needs and status of our 20 trillion cells. It also no longer allows us to have tight control over how calories are partitioned to our peripheries. Remember also, that the pituitary gland is where TSH is made. The portal circulation of the pituitary also has no brain blood barrier so it too is at the mercy of inflammation from the gut if it is leaky. This is another way your thyroid gland can be shut down and cause a problem allowing the conversion of cholesterol to pregnenolone to help heal the body. This complex disorder results in multitudes of breakdowns of cellular homeostasis in many organs leading to disease development in many organ systems over the years it occurs. You can now begin to see how the brain is totally dependent upon leptin to make hormones that respond in kind based upon cellular homeostasis.

In the heart the HS CRP fosters the development of atheroma generation in the coronary arteries and stiffens the leaflets of our heart valves. Given longer time it also causes huge changes to the hearts electrical system leading to arrhythmia generation. This is why atrial fibrillation is so common in America today. Eventually the atheroma collects oxLDL and grows and when it is matched with a the persistently elevated HS CRP causes a plaque to explode and causes a heart attack or death. The plaque is the “dynamite” and the HS-CRP is the “lit match”. Neither one is dangerous unless they are present together.

The brain gut axis is vitally important to all of us. Understanding how it basically functions is really a study in how our liver protects us. Our liver is the last line of defense before the brain is assaulted. Once the brain is involved , hormonal disruption ensues first with leptin resistance and then cascades to every other hormone in some fashion. Once this occurs the brain loses its control over cellular homeostasis and neolithic diseases become prevalent. We can understand this process dynamically when we look out our VAP profiles. They really don’t measure lipids in my view. It is a test that tells us how good or bad our brain gut axis is functioning to protect the 20 trillion cells in our body from disease propagation.

For more information on what a VAP can do, click here.

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  1. Resurgent says:

    If one wishes to do quarterly blood work, without going to a physician, as one is otherwise healthy, what would be the tests that you would advise be done.

  2. @Resurg…..that post is coming. I have to make my readers understand why it is even worthwhile to do. If you dont quantify yourself youre flying blind. You have no way of gaining feedback on what youre doing and it if makes sense or not. Just go to PH or MDA and see how many questions are asked because they just dont know how to assess this. Im giving the secret sauce here for people to understand the WHY.

  3. di pawlik says:

    does the above in any way have an impact on an irritable bowel problem? negative for celiac.

  4. Awesome info. I find it funny that I am only the second person my GP has ever ordered a VAP for. I tried to explain it to him and saw that he was interested in hearing it from an uneducated non MD. It is too bad he didn't believe me when I said the lipid hypotheses was a false correlation and cherry picked data. Thanks for the info Dr. Kruse it is really eye opening the way things tie together.

  5. WOW, I am definitely going to ask my Dr for a VAP lab in August. I posted earlier that I am on a LC Paleo diet and my last lipid panel showed TC 348, TG 49 HDL 86, & calculated LDL of 252. This way of eating has really helped my IBS and over all energy. The ldl 252 reading caused my Dr some serious concern. I think at this point in my life (age 70 ) I would rather stay on this diet, feeling much better, and just roll the dice on heart plaque. However it would be nice to know that the VAP test showed large fluffy ldl particles. I will let all know in August.

    Dr Kruse your posts really help me know that I am on the right path for me. Keep up the good work and thank you.

  6. Adriana G says:

    Is there any advantage to VAP over the NMR Lipoprotein test? When I had mine done last year the NMR was cheaper. Insurance did not cover most of it.

  7. I was diagnosed hypothyroid and fatty liver 6 years ago. Lost a lot of weight and eating paleo for 1 year now. Fatty liver gone, doc still wants me on 150mcg Synthroid 'just because'. 30 days ago I started cutting my Synthroid dose in half. So far so good. I think I have my leptin under control. Will retest TSH in 60 days and go from there. Sound reasonable?

  8. nmr and VAP can hack a leaky gut equally well.

  9. @TIM……most docs and endo's use the TSH alone as the "test" for thyroid dysfunction. I dont. I think it gives you a small view of the larger clinical picture. As for synthroid I have no qualms with people using it but I think many docs with CW use it and never use other options. I think if youre having stalls you need to react with a different bullet.

  10. DrMommyN says:

    Wow – I have been searching for a long time for how the liver connects various issues I've had. I knew it was the common denominator in my low cholesterol (total 93), hypothyroidism, and fructose malabsorption. But HOW does one correct the inflammation in the liver? I've come upon the same basic diet because of eliminating fructose and fructans (wheat, fructose & sugar, certain fruits and vegetables, soy.) So I lost weight, but this only caused my rT3 to INCREASE! What do you think of using T3 only to suppress TSH and T4 production to allow rT3 to "clear out"?

    The sleep article was great, too, but I'm afraid your website is not helping me get to bed on time!

  11. Not to push the envelope, Dr. Kruse, but if you have time some podcasts covering the material in these blogs would be very helpful to those of us trying to learn the science.

    Thanks for your great work.

  12. Im toying with many ideas right now to get more info out. Because my ideas are rooted in deep biochemistry I need to lay out basic premises and give you the biochemistry and physiology behind it. This is how I intended the quilt being built out. I need to add to more levees so you can see how things you think are not interconnected really are. I guess my blog is more like a synthesis project for humans?

  13. Jack Kronk says:

    Dr. K – This is great stuff. I have been devouring information on Ray Peat's site. He has a lot of info on there about how interconnected the thyroid is to so much. The more I learn, including what you've put here, the more I am really beginning to think I may have an a thyroid issue, possibly hypothyroidism. Here's what I wonder… (even after everything I've read so far) How do I test my thyroid health? This is totally new ground for me so I am very wet behind the ears on this topic.

  14. @jack. That will come. But here is the thing about thyroid fxn……it is completely dependent upon leptin status, diet, and omega six content at the time in question. The labs most docs use to assess its fxn never tell the real story. The clinical history does. I listen intently to patients symptoms. When I hear they have at least three I realize they have a receptor protein folding problem on their thyroid. Cause is usually high cortisol or high omega six level. Go to MDA and read page 163 to 164 on that long thread there. You will see me lay it out there. I think this is where you need to start your hack. But your hack I think is going to require a doc to help you. Copy stuff and bring it to them. The VAP post should be an eye opener for you. My advice is get your cortisol and omega six level done and then retool the diet to limit carbs but up the coconut oil and fermented carbs to high levels. Then retest. Good luck and keep me informed of what you find. I told you your VAP would help thousands and it will.

  15. @ di pawlik…….it has everything to do with it!

  16. McCloud says:

    Thank you for this very informative website.

    I'm Apo E4/E4 and also have very low hs-CRP (from what I've read a low hs-CRP is common among Apo E4's but doesn't imply low atherosclerosis risk).

    Do you have any thoughts on Apo E4/E4 carriers diet's and any other suggestions that may be of assistance?

    Keep up the good work here!

  17. Jack Kronk says:

    Dr Kruse – I will look into the high cortisol level, but I wonder, is it possibly chronic high cortisol? Or is it only sometimes, like maybe a fasting state? The reason I ask is because I generally feel best and 100% tip top health wise right after my weight lifting sessions. I feel zero ailments, but at other times, I have a heartburn like sensation and even at times a different type of unsettling feeling in my chest, right where my heart is and I hate it. I've been battling that ever since I went VLC back in Aug 2010, so 1 year ago now. But I was only VLC for 2 months and then LC for 2 months and then Lacto-Paleo since December.

    Here is what I gather so far:

    I need to check my cortisol levels, ApoE status, omega6 levels tested, and possibly retest in a fasted state.

    Since my VAP, I have completely eliminated bananas and reduced heavy cream intake by about 70% as a knee jerk reaction. I am also eating more virgin coconut oil, have been taking 2 spoons of virgin red palm oil daily, and I've been getting a lot of sun lately here in San Diego so I'm sure my VitD status is pretty good right now.

  18. Dr. Kruse,

    I had my cholesterol checked about a month ago (fasting lipid panel). This was about 6 weeks into Atkins.


    TRI= 48

    HDL= 77

    LDL= 178

    Height 5'5 1/2


    Weight= 128

    I asked my doc for a VAP test. She said what I just had was a VAP test. I mentioned the NMP Lipoprofile test Jimmy talks about. She said that she'd order the test, but regardless of the test results, she'd tell me the same advice. Retest in 6 mos and "seriously consider my diet and exercise."

    Any thoughts?

    • The panel looks good to me……but you need some other data to see if more can be done. But this VAP to me is pretty solid and your gut is not that bad with an HDL of 77. I bet it could be even better with tweeking.

  19. I will retest in January. Should be interesting to see how that is after 6 months of paleo and doing the reset. I'll post those then. Thanks.

  20. Dr. Kruse,

    It would be helpful if, at some point, you would dissect the results from a sample VAP to assess the brain/gut axis…

    • I did this with a persons VAP. That was the point of this blog. One of the posters on posted his labs and it lead to a huge discussion and I posted this blog just for him.

  21. mike cobble says:

    Dr. Kruse, excellent article. You make a great point about abnormal endocrine/brain, gut/liver/pancreas, poor diet choice interactions which can be pointed out nicely by the VAP lipid test. Those people who show elevated remnant lipoproteins (VLDL3 and IDL) along with abnormal HDL (HDL2-3), ApoA1 metabolism are in trouble. For many it is dietary/lifestyle, others genetic or hormonal. Whenever I see high NHDL (VLDL, IDL, LDL, Lpa-c) and high ApoB I worry and even moreso when the ApoB (bad protein on NHDLc)/ApoA1 ratio (good protein on HDL) is over 0.5. High Lpa-c is genetic but also driven by high sugar carb diets and independendently predicts heart attacks and strokes (being both atherogenic and thrombogenic). With the VAP lipid test you have a comprehensive picture into such metabolism and lifestyle issues and can make targeted choices for change. Thanks

  22. What about people like me (hetero familial hypercholesterolemia) whose VAP shows low IDL(14) and VDL3(9), high normal HDL2-3 (22, 58), yet high apob100(165-calc) and very high LDL-R(Real)-C (263). Pattern A
    Plus now thanks to Dr. Kruse, I had my new thyroid results and all seem to be normal- thyroid antibodies (TPO Ab 6. antithyroglulin <20), T4 Free (1.32), TSH (2.62), Endomysial antibody (negative), glucose (98), insulin (3.6)
    I am still waiting for the salivary cortisol results to arrive.

  23. mike cobble says:

    Het FH is usually very high risk and ApoB goals based on risk and family history are usually under 110-90-80 with DLDLc goals under 130-100-70 based again on risk. I do have some very rare and lucky pts with HFH with no family history of CVDz but those are very rare. Likely they don't have binding arterial proteins or macrophage activators or just 'silicone' arteries. Yes it does not look like you have a glucose or metabolic based issue but rather and LDL receptor defect. All the best. mc

  24. ok so lower hdl = more leaky gut, is that what i am seeing here?

    these were my last numbers

    Cholesterol, Total 50 34

    LDL <100 105

  25. Hi Jack, thnx for this amazing information… I have been eating paleo for couple of years, plenty of fat from coconut, avocados, meat, whole milk yoghurt, occasional cheese, some nuts, no vegetable oil, and lately trying to limit fruit as much as possible… Have been eating 3 meals a day after I found your blog, with occasional snacks of a bit of fruit (summer cantaloupes are divine!). I am not looking to loose weight as I am 5'4 and currently 104 Ib. Just received my VAP blood test results and am FREAKING OUT: Can you PLS comment?

    Glucose 85


    LDL Cholesterol 149!

    HDL 130

    VLDL 14

    CHOLESTEROL, Total 293!

    Triglycerides 48

    Non HDL Col (LDL+VLDL) 163!

    apoB100-calc 96

    IDL Cholest 4

    Remnant Lipo. (IDL+VLDL3) 12

    Sub-Class Information:

    HDL-2 35

    HDL-3 95

    VLDL-3 8

    LDL1 Pattern A 3.1

    LDL2 Pattern A 26.0

    LDL3 Pattern B 71.0

    LDL 4 Pattern B 31.4

    The ordinary, non-VAP Lipid panel shows:

    Cholest TOTAL 279 !

    Triglycerides 48

    HDL Cholest 144

    VLDL Cholest Cal 10

    LDL Cholest Calc 125 !

    Also, even though I live in California and have been sun tanning all these summer months, my vit. D is low: 29.0. I guess I should start supplementing…

    Thnx for any comment that you may spare your time on. I am terrified of going on some kind of low fat fasting diet, and of course can"t show this info to my physician…

  26. Dr. Kruse, do you believe depression is linked/caused by damage to the gut and chronic gut issues? Would you recommend healing the gut via dietary intervention as a first step in treating someone with mild depressive symptoms?

    • @DanH I do think this is a major issue. I think fixing the leaky gut and getting a person to a ketogenic paleo diet are critical to success. Sadly, I see too few psychiatrists even recommending this things. It is more disconcerting that many seem to know about the GAPS and paleo diets science in these areas but they are afraid to recommend it to patients because they don't know how their medical friends will view them.

  27. After re-touching up my endocrinology from M1 last year and re-reading your older articles, things make so much more sense. I now understand you're saying due to hypothyroidism, the anterior pituitary is releasing high amounts of TSH in order to compensate, which causes actions i.e. inflammatory effects on other organs, producing the universally recognized hs-CRP.

    I fully understand just how important gut/liver function is. due to lack of BBB at the hypothalamus/pituitary, any inflammation or chemicals that get past the GI can damage the brain. I can assume this implies aspartame/MSG and other toxins too?

    Endocrinology is a beautiful nightmare, the ultimate connect-the-dot exercise.

    • @DanH youre doing it correctly…..most of my readers need to keep going back and re reading blogs because you will begin to make the links I have made in the Quilt. Once you make enough you will see how easy optimal is. It is a thought experiment that can save your life.

  28. Useful information. Fortunate me I found your site by accident, and I am shocked why this twist of fate didn't happened earlier! I bookmarked it.

  29. What is a 'good' HDL number, Dr. Jack? Does this allow me any benefit on what foods to eat if HDL is good enough or do I need to remain vigilant on the no-nos (grains, eggs, dairy, nightshades)?

    Here are October 2011 results:

    Tests: (3) TSH (2835)

    TSH 0.8 UIU/ML

    Tests: (4) LIPID PANEL (173)






    P.S. Diagnosed with Multiple Sclerosis, 1990

    • @LinD it must be placed in a patients proper context. So there is no correct answer to this question. I will say this. You want a higher HDL than not. In women I like 60 and above and in men 70 and above for optimal health. I do use the HDL level as a proxy of gut health because it directly tells the doctor how efficient endocytosis clearance is int he liver and portal circulation. This means the plasma is more reduced and less oxidized and this is a highly prized clinical finding in a patient. It is pretty rare in SAD folks and very common in paleo/primal patients. Im interested in getting all patients understanding how they can improve their HDL view lifestyle changes and thinking changes to lead to DNA changes.

  30. Hi Jack, I dare to ask again – doesn't hurt to keep trying:-) Can you pls look at my question on September 19th and comment on my situation when you get a chance?

  31. @Kira This is a place to ask questions not to play doctor. When you post labs you're crossing a line a I won't cross. The disclaimer on the site is pretty clear. You definitely have some interesting numbers and you should be seeking the help of a healthcare practitioner for help making sense of them.

  32. Mark Sisson's post on Daily Apple Today had this to say "

    Recent evidence shows and commentary from researchers concludes that the various advanced lipoprotein particle classification tests can produce wildly disparate results on the same samples to the point of rendering them unreliable." If you read this blog, I'l like to hear what you think about it's content.

    • @Suzanne I will be hitting this in my book. And Mark and I are on the same page. But there is more to this story from a clinicians perspective that you might consider.

  33. Dr. K, Could very high HDL levels ever be a problem, and if so, what would in your opinion would that signify?

  34. Is it true that LP (a) Cholesterol is an inherited coronary risk factor that is the most toxic component of the blood? Is it also true that it almost impossible to lower? Mine is high (14.2 mg/dL range <10).

  35. Is there any scenario in which a single high hs-CRP reading (say mid 3's) would not be cause for concern, assuming individual is not on a SAD diet??

    • @Jared yes. often it can be artifactual. this is why I draw other labs in a panel to decrease the risk of an over call.

      • Could you elaborate on when you would rely less on a one-time high hsCRP and what else you would look at to give more context? I scored 4.4 on hsCRP and had a calcium index test which came out at 0. I’m trying to figure out whether my chronically low levels of hormones (due to loss of ovaries) could have initially created the liver inflammation that would cause high hsCRP. I have been off the SAD diet for 2+ years but was eating a fair amount of nut butter prior to the labs.

  36. It seems like we focus a lot on HDL and I see you say it should be above 60 for females. What is going on with an individual who has an acceptable HDL level, but very high LDL, total chol, apoB100?

  37. Bridgette says:

    Dr. Kruse –

    I've always assumed I had leaky gut, but after reading this blog and your VAP blog I'm beginning to reconsider. I'm sure I have hormonal issues and perhaps that's my main issue.

    My hsCRP is low (0.05), vitamin D levels are good (70), good HDL (76) and particle A LDL size. I have hypothyroidism, but I don't believe it's Hashi's as 2 separate antibody tests were negative.

    Am I on the right track here thinking that perhaps it's not leaky gut based on these tests? Is there another test I should consider to find out for sure?

  38. Bridgette says:

    Does the bad hormone panel also indicate leaky gut or should I be looking to treat it as a separate issue? Just trying to figure out if I should be following the leaky gut protocol or zeroing in more on the low hormones/pregnenolone steal.

  39. Bridgette says:

    Wishful thinking. After seeing 6 doctors in the last 2 years I thought I found a keeper . . . until he offered me "natural" cholesterol lowering supplements last week! I've given up on doctors. Is this an issue we'd be able to work through when you get your membership website up?

  40. Just got lab results back after 1 year of Paleo. This is why I don’t trust any other doctors – she said I need to see my PCP b/c my Cholesterol went from 185 to 247, but HDL went from 58 to 84!
    LDL from 116 to 153.
    LDL/HDL from 2.01 to 1.8.
    TG same at 51.
    What is BUN? She had concerns about this too b/c it went from 15 to 28.
    FSH is 5.4.
    She also wants to up my Synthroid b/c TSH is 5.24, T4=8.4, T3 uptake is 35%.
    Should I just ignore all this and focus on the HDL being great and continue with my CT protocol or do you think there are valid reasons to be concerned? I don’t want to increase my Synthroid, but you said high TSH levels are not good in your blog. I must be doing something wrong.

  41. Lauren Porter says:

    So we want high HDL and as low as possible hs-CRP. Since hs-CRP is one of the diagnostics for leptin sensitivity, is there a threshold to cross where a person is entering LS after being LR? Under 1.0?

    • @Lauren under 1.0 we need to correlate it with clinical exam and/or other labs like T3 conversion, LDL level or serum leptin level. Personally, I think if you just keeping eating well you can do well.

  42. Hey Jack!

    My name is Lara and about four years ago I had a serious eating disorder and went from 5’9 150 lbs to lowest weight 105. I did not have my period for 3 years either. Now I am doing AIP paleo and have gotten back to my starting weight 146 but my all of my weight seems to be going to my stomach! I’m certain I have leptin resistance and am planning to do the leptin RX you have here. I’m trying to find the place on this website to purchase a version of the leptin RX because I’m someone who needs specifics (carb intake, etc.)! Thank you!

  43. Joanna Wong says:

    Hi Dr Kruse, can I say that for a Hashimoto Hypothyroid patient (me) that when my T3 goes up, it is then logical for my total cholesterol and LDL to come down? Because that’s my experience. My C-RP (sorry, not HS C-RP, as my GP didn’t do that) came down slightly and my total cholesterol came down from 247 in Dec 2015 (start of my Hypo) to 216 in Jan 2017 (after more than 1 year of NDT+T3 combi)


  1. […] It appears when your plasma HDL is low, so is your level of paraoxonase. So HDL is a type of a clinical marker for paraoxanase (and perhaps Vitamin K2 levels by extrapolation). This should explain to you why I use HDL as a measure of how leaky our gut is (and why your Vitamin K2 is likely low too) to endotoxins that then are able to oxidize our LDL molecules. The absolute level of LDL is of little consequence to me in clinical evaluation. The level of oxidation of the plasma, however, is hugely important. So when one has a low HDL, high HS-CRP and a high ferritin level you have the “trifecta of a highly inflammatory serum plasma” and one that causes all kinds of neolithic diseases. This was explained in detail in my VAP and leaky gut posts here. […]

  2. […] In the June 2010 American Journal of Pathology published a study that caught my eye. It reviewed at the Vitamin D Receptor (VDR) and the generation of inflammation in the large intestine in a mice model. The paper looked at gut inflammation in the presence of a Salmonella infection. Salmonella is a bacterial infection. Mice which lacked VDRs seemed to have higher states of gut inflammation and worse outcomes than control groups. They key difference however was the high levels of IL-6, and inflammatory cytokine. IL-6 is a bad actor in cellular homeostasis. It is seen in most cancers and all inflammatory conditions in humans to some degree. Most gut absorption is done via the transcellular pathway. (90% through gut cells) The remainder of gut transport occurs via intracellular methods (tight gut junctions) that are controlled by vitamin D status. The less Vitamin D you have the more leaky your tight junctions will be and this exposes you immune system to direct assault. This assault is then aimed directly at our liver for detoxification. And our liver has to defend the rest of our body as I laid out in the VAP blog. […]

  3. […] A levels they can accumulate higher sdLDLox and this lowers the HDL level. Remember from the VAP post that a lower HDL means less filtering ability (endocytosis clearing by the liver) in the […]

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