This week we’re glad to welcome Chris Masterjohn back to the show. Chris joined us on Episode 11 to discuss the role of cholesterol in heart disease, and to dispel the many myths associated with those subjects. There was so much to cover, we had to have Chris back for part 2 (and in fact, we still didn’t cover all of the material so he’s going to come back for part 3 in the future!)

In this episode, we discuss (among other things):

• what is a “normal” cholesterol? what can anthropological studies tell us about this?
• are lipoprotein particle size tests accurate? what’s the best way of determining particle size?
• why do some people have high cholesterol (TC & LDL) after adopting a Paleo/WAPF diet? is this something to be concerned about?

Enjoy the show!

One of the most contentious issues in the Paleo nutrition community is whether dairy products are health-promoting or disease-causing.

On one end of the spectrum you have Loren Cordain and his group, who claim that dairy is not fit for human consumption for two reasons: 1) because it’s a neolithic food and not part of our evolutionary heritage, and 2) because of proposed physiological mechanisms by which dairy causes harm when consumed. On the other end of the spectrum you’ve got folks like Kurt Harris, Stephan Guyenet, Chris Masterjohn and the Weston A. Price Foundation who have pointed out the many health benefits of dairy and are generally in favor of its consumption.

My answer to the question of whether dairy is healthy are harmful is, in short: it depends. But before we get into the factors I think the answer depends on, I want to briefly address why I don’t take the evidence against dairy very seriously at this point.

Paleo re-enactment isn’t the goal

I agree with Dr. Kurt Harris on this one. We can look to the Paleo era to determine what was evolutionarily normal for humans, but it doesn’t follow that anything that falls outside of that norm is automatically harmful. The argument that we shouldn’t eat dairy now because we didn’t eat it 2 million years ago – without supporting clinical evidence – is not convincing.

There’s also the inconvenient (for the anti-dairy set) matter of people like the Masai and Loetschental Swiss that Weston A. Price studied, who were free of modern, degenerative disease despite receiving a large percentage of calories from dairy products.

Human evidence is more convincing than proposed mechanisms

Cordain’s group has published and reviewed several papers proposing various physiological mechanisms by which dairy causes harm. One recent example is a paper by Melnik called Milk Signalling in the Pathogenesis of Type 2 Diabetes. The theory presented is that milk consumption beyond the weaning period may overstimulate pancreatic beta-cells and promote beta-cell apoptosis. Since proliferation and apoptosis of beta-cells are hallmarks of type 2 diabetes (T2DM), it follows that milk consumption must contribute to T2DM.

Or does it?

If that theory were true, we might expect to see increased rates of T2DM in people consuming dairy products. But in fact we see just the opposite.

This study looked at serum levels of trans-palmitoleic acid, a fatty acid found in milk, cheese, yogurt and butter, and correlated them with risk factors for diabetes. Here’s what they found:

At baseline, higher circulating levels of trans-palmitoleic acid were associated with healthier levels of blood cholesterol, inflammatory markers, insulin levels, and insulin sensitivity, after adjustment for other risk factors. During follow-up, individuals with higher circulating levels of trans-palmitoleic acid had a much lower risk of developing diabetes, with about a 60% lower risk among participants in the highest quintile (fifth) of trans-palmitoleic acid levels, compared to individuals in the lowest quintile.

Translation: people with the highest trans-palmitoleate levels had 1/3 the risk of developing diabetes over the three years volunteers were followed. Not only that, after adjusting for confounding factors trans-palmitoleate levels were associated with smaller waist circumfrence, lower triglycerides, higher HDL and lower C-reactive protein.

Since trans-palmitoleic acid is a fatty acid found in the – you guessed it – fat of milk, the study also supports the idea that full-fat, whole dairy products are beneficial. This directly contradicts the low-fat hysteria we’ve been brainwashed with for so many years. But I digress.

Stephan Guyenet blogged about this study and re-wrote the authors’ conclusion in more straightforward terms:

Our findings support eating as much butter as possible****. Don’t waste your money on low-fat cream, either (half-n-half). We’re sorry that public health authorities have spent 30 years telling you to eat low-fat dairy when most studies are actually more consistent with the idea that dairy fat reduces the risk obesity and chronic disease.

Since this was an observational study, it doesn’t prove that dairy fat reduces the risk of T2DM. But it does suggest that the converse isn’t true.

Another study found that people with the highest levels of milk fat biomarkers, suggesting they consumed the most dairy fat, were actually at lower risk of heart attack; for women, the risk was reduced by 26 percent, while for men risk was 9 percent lower.

Another study showed that people who ate the most full-fat dairy had a 69% lower risk of cardiovascular death than those who ate the least.

Finally, this literature review of 10 studies found that milk drinking is associated with a small but significant reduction in heart disease and stroke risk.

I could go on, but I think you get the point. Which is this: evidence of what happens when people actually consume dairy products is a lot more convincing to me than proposed mechanisms of how dairy may effect humans.

The problem with isolating certain effects of a nutrient or food, and then making predictions based on those effects, is that we might miss some other quality about that food that negates the proposed effect. That’s a mouthful, so let me explain.

T. Colin Campbell is (in)famous for his research linking casein, a protein in dairy products, with cancer. He then made the huge and unsupportable leap to concluding that all animal proteins cause cancer and should be avoided. Most of you know the rest of that story.

However, what Campbell neglected to notice, or mention, is that whey, another protein found in dairy, has anti-cancer effects that completely cancel out the cancer-promoting effects of casein. Oops! This is why it’s so important to study whole foods, not just nutrients.

So let me finish this section by saying that I believe the weight of the evidence on dairy consumption suggests that it is not only not harmful, but quite beneficial.

When dairy may not be beneficial

However, as in most things, there are exceptions. Many of you reading this are probably sensitive to dairy and don’t tolerate it well. I certainly have patients that this is true for, and it’s not at all uncommon.

What’s the deal? Why does it seem to benefit some, but cause problems for others? In my opinion the answer boils down to the health of the gut. If someone has compromised intestinal permeability, or “leaky gut”, it’s more likely that their immune system will respond to potentially allergenic components in milk such as alpha- and beta-casein, casomorphin and butyrophillin.

This is especially true for people who are gluten intolerant, because it has been shown that milk proteins commonly cross-react with gluten. Put another way, if you react to gluten, it’s more likely that you’ll also react to milk.

Along these same lines, people with small intestine bacterial overgrowth (SIBO) – which is one of the major causes of irritable bowel syndrome (IBS) – may be more likely to react to milk because the bacteria in their small intestine aggressively ferments lactose, the sugar in milk, causing gas, bloating and other G.I. symptoms.

Not all milk is created equal

Something that irritates me is that raw and pasteurized dairy is often discussed as if it’s the same thing. It’s not. Raw dairy is a whole food, and pasteurized dairy is a processed food.

While it’s true that some people (described above) react to the proteins in milk, most who are sensitive are reacting to the sugar in milk: lactose. The enzyme lactase must be present to hydrolyze lactose into its constituent compounds, glucose and galactose. Somewhere between 1% – 95% of people don’t produce lactase on their own, depending on race and ethnicity.

In a sign of nature’s wisdom, raw milk contains lactase, the enzyme needed to digest lactose. Pasteurization, however, kills lactase. So if you don’t produce your own lactase, you’ll have a hard time digesting pasteurized milk. But that doesn’t mean you can’t tolerate raw milk. I can’t tolerate pasteurized dairy myself, but I don’t seem to have any problems with raw dairy.

So the answer to the question I posed in the title of this article isn’t so simple, and it depends on several factors:

• The status of your gut barrier
• Whether or not you have SIBO or IBS
• Whether or not you’re gluten intolerant
• Whether you’re eating raw or pasteurized dairy

If you’re not sure where you stand with dairy, the best approach is to remove it for 30 days and then reintroduce and see what happens. Elimination/reintroduction is still the gold-standard for determining sensitivity to a particular food.

But if you tolerate it well, I haven’t seen any evidence in the literature that convinces me you shouldn’t be eating liberal amounts of full-fat dairy.

Over the last several years I’ve come to believe that chronic stress – and the cascade of changes it causes in the body – is second only to diet as the primary cause of modern disease. This isn’t just my opinion. It’s supported by mountains of scientific evidence as well as a basic understanding of evolutionary biology and human physiology.

The problem is, nobody wants to hear this. I think it, um, stresses us out to know that stress is so harmful. It’s interesting to note that whenever I write an article about stress, like this one about how stress makes you fat and diabetic, the response is decidedly lukewarm – especially compared to the popularity of articles about diet.

Diet is important. I think you all know how I feel about that. But here’s the thing: it’s not enough. Even if your diet is perfect, stress can still destroy your health.

In fact, I see this in almost all of my patients. Most people I work with already have pretty good diets. Sure, there’s almost always room for some tweaks, but overall they’re doing better than 99% of the population. Yet they are still struggling with chronic health problems – some of them quite severe.

Without exception, these folks have cortisol problems. Either their cortisol is high, low, or the rhythm is out of whack. Remember that cortisol is a hormone that is released during the stress response. Like insulin, we need it in small amounts to function properly, but too much of it can wreak havoc on the body.

Why? Because our bodies aren’t set up for chronic stress. We evolved to deal with a series of acute, short-term stressors. Stress causes the release of cortisol and other hormones. The purpose of these hormones is to prepare our bodies for either fight, or flight. This involves mobilizing stores of fat, protein and glucose to give us the energy we need to deal with the threat.

This all works well if we actually do fight, or run away, because these activities discharge the hormones and the extra energy produced by the stress response.

But these days, we don’t have the chance to do that. The stress we experience is chronic, not acute, and more often than not it’s not something we can fight or run away from. One of the disadvantages of our big brains is that we’ve developed the capacity to stress ourselves out simply by imagining potential threats. Worrying about our financial future or driving in traffic produce a similar hormonal response to what getting chased by a lion would have triggered for our ancestors.

But in our case, those hormones just keep pumping out and building up, and fat, protein and glucose keep getting mobilized without any discharge. And what happens when cortisol builds up and fat and sugar are too abundant? Modern disease happens. Obesity, diabetes, heart disease, depression, anxiety, insomnia, gut disorders, autoimmune diseases, allergies and nearly every chronic, modern health problem is directly related to the changes in our body caused by stress.

I’m sure you don’t need me to tell you that stress is harmful. Duh. The question you’re probably more interested in is, “what can I do about it?”

It’s pretty clear that for most of us, reducing stress isn’t a viable option. At the simplest level, stress is what happens when the demands of life exceed our ability to deal with them. Those demands can be physical, emotional or psychological.

Raise your hand if you ever feel the demands of modern life exceed your capacity to deal with them. Yeah, that’s what I thought. That’s probably why people feel disempowered when they read articles like this. But that doesn’t mean we can’t take steps to mitigate the harmful effects of stress. Stress management – not stress reduction – is where we need to focus.

Stress management may very well be the most important thing you can do to improve your health and prevent disease. Yet most of us don’t do it anything about it.

When I talk to people about the importance of stress management, I usually get a nod of the head and an answer like “yeah, I know I’m really stressed out and I need to relax more.” But I can tell they’re not taking it seriously. It’s almost like I suggested they put up their Christmas decorations a little earlier, or they wash their car more often, or something like that. “Yeah, I know I should, but…”

Yet these are the same people that are taking 23 different supplements, following a strict diet and exercising every day at 6:00am. Clearly lack of motivation isn’t the issue.

So why are we so resistant to managing stress? Because the truth is, it’s far easier to change our diet and take some pills than it is to manage stress and transform the way we live.

If stress is what happens when life’s demands exceed our body’s capacity to deal with them, then we have two options. The first is to reduce the demands. In today’s world, this just isn’t practical for most people. The second option is to increase our body’s ability to deal with the stressors we face. Everyone can – and should – do this.

How? There are two ways, both important. First, we can learn stress management techniques and make lifestyle changes that increase our buffer against stress. Second, we can use supplements and herbs to support the hypothalamic-pituitary axis (HPA), which governs our stress response. I’ll discuss specific strategies for both in a future article.

An estimated 20 million Americans have some form of thyroid disease. Up to 60 percent of these people are unaware of their condition. One in eight women will develop a thyroid disorder during her lifetime. Levothyroxine, a synthetic form of thyroid hormone, is the 4th highest selling drug in the U.S. 13 of the top 50 selling drugs are either directly or indirectly related to hypothyroidism. The number of people suffering from thyroid disorders continues to rise each year.

Hypothyroidism is one of the most common thyroid disorders. One recent analysis suggested up to 10% of women over 60 have clinical or subclinical hypothyroidism. It is characterized by mental slowing, depression, dementia, weight gain, constipation, dry skin, hair loss, cold intolerance, hoarse voice, irregular menstruation, infertility, muscle stiffness and pain, and a wide range of other not-so-fun symptoms.

Every cell in the body has receptors for thyroid hormone. These hormones are responsible for the most basic aspects of body function, impacting all major systems of the body.

Thyroid hormone directly acts on the brain, the G.I. tract, the cardiovascular system, bone metabolism, red blood cell metabolism, gall bladder and liver function, steroid hormone production, glucose metabolism, lipid and cholesterol metabolism, protein metabolism and body temperature regulation. For starters.

You can think of the thyroid as the central gear in a sophisticated engine. If that gear breaks, the entire engine goes down with it.

That’s why people with hypothyroidism experience everything from weight gain and depression to infertility, bone fractures and hair loss.

One of the biggest challenges facing those with hypothyroidism is that the standard of care for thyroid disorders in both conventional and alternative medicine is hopelessly inadequate.

The dream of patients with thyroid disorders and the practitioners who treat them is to find that single substance that will magically reverse the course of the disease. For doctors, this is either synthetic or bio-identical thyroid hormone. For the alternative types, this is iodine.

Unfortunately, in the vast majority of cases neither approach is effective. Patients may get relief for a short period of time, but inevitably symptoms return or the disease progresses.

So what’s the problem? Why have replacement hormones and supplemental iodine been such dismal failures?

Because hypothyroidism is caused by an autoimmune disease.

Studies show that 90% of people with hypothyroidism are producing antibodies to thyroid tissue. This causes the immune system to attack and destroy the thyroid, which over time causes a decline in thyroid hormone levels.

This autoimmune form of hypothyroidism is called Hashimoto’s disease. Hashimoto’s is the most common autoimmune disorder in the U.S., affecting between 7-8% of the population. While not all people with Hashimoto’s have hypothyroid symptoms, thyroid antibodies have been found to be a marker for future thyroid disease.

Most doctors know hypothyroidism is an autoimmune disease. But most patients don’t. The reason doctors don’t tell their patients is simple: it doesn’t affect their treatment plan.

Conventional medicine doesn’t have effective treatments for autoimmune disease. They use steroids and other medications to suppress the immune system in certain conditions with more potentially damaging effects, such as multiple sclerosis, rheumatoid arthritis and Crohn’s disease.

But in the case of Hashimoto’s, the consequences – i.e. side effects and complications – of using immunosuppressive drugs are believed to outweigh the potential benefits. (Thanks to conventional medicine for a relative moment of sanity here.)

So the standard of care for a Hashimoto’s patient is to simply wait until the immune system has destroyed enough thyroid tissue to classify them as hypothyroid, and then give them thyroid hormone replacement. If they start to exhibit other symptoms commonly associated with their condition, like depression or insulin resistance, they’ll get additional drugs for those problems.

The obvious shortcoming of this approach is that it doesn’t address the underlying cause of the problem, which is the immune system attacking the thyroid gland. And if the underlying cause isn’t addressed, the treatment isn’t going to work very well – or for very long.

If you’re in a leaky rowboat, bailing water will only get you so far. If you want to stop the boat from sinking, you’ve got to plug the leaks.

Extending this metaphor to Hashimoto’s disease, thyroid hormones are like bailing water. They may be a necessary part of the treatment. But unless the immune dysregulation is addressed (plugging the leaks), whoever is in that boat will be fighting a losing battle to keep it from sinking.

What the vast majority of hypothyroidism patients need to understand is that they don’t have a problem with their thyroid, they have a problem with their immune system attacking the thyroid. This is crucial to understand, because when the immune system is out of control, it’s not only the thyroid that will be affected.

Hashimoto’s often manifests as a “polyendocrine autoimmune pattern”. This means that in addition to having antibodies to thyroid tissue, it’s not uncommon for Hashimoto’s patients to have antibodies to other tissues or enzymes as well. The most common are transglutaminase (Celiac disease), the cerebellum (neurological disorders), intrinsic factor (pernicious anemia), glutamic acid decarboxylase (anxiety/panic attacks and late onset type 1 diabetes).

In the next post we’ll look more closely at why Hashimoto’s can’t be treated successfully without addressing the autoimmune component, and why both the conventional and alternative approaches to treating hypothyroidism are destined to fail from the start.

In a recent post, The Myth of Evidence Based Medicine, I explained that conventional medicine is based not on evidence, but on profit.

So how’s this working out for us?

The U.S. spends far more than any other country in the world on healthcare – a whopping $2 trillion per year. ¹

Considering this enormous expenditure, we should have the best medicine in the world. We should be reversing disease, preventing disease, and doing minimal harm.

But that’s not what’s happening at all. The U.S. ranks just 34th in the world in life expectancy and 29th for infant mortality. Of 13 countries in a recent comparison, the United States ranks an average of 12th (second from bottom) for 16 available health indicators. ²

Even worse, a study published a few years back in JAMA suggested that medical care may be the leading cause of death in the US. (For more on this, read my article The Failure of U.S. Healthcare).

Yes, you read that right. Medical care kills more people than heart disease, strokes or cancer.

How can it be that we spend nearly 16% of our GDP on healthcare, but have one of the worst health care systems in the industrial world?

The answer, in short, is that we don’t have healthcare in the U.S.. We have disease management. And there’s a world of difference between the two:

Wellness care is what we need. Disease management is what we have.

Wellness care would save insurance companies billions of dollars each year. But it would devastate the bottom lines of the pharmaceutical industry.

Wellness care is what I will offer my patients. And it’s the vision I have for what medicine could be here in the U.S. and elsewhere.

I’m just not holding my breath. Until we can lessen the influence of Big Pharma, disease management will rule.

I just came across a website called Modern Paleo, put together by Diana Hsieh. It has a section called “modern paleo principles” with a list of 30 nutritional and lifestyle recommendations for staying healthy and avoiding disease.

If you’re looking for a good “blueprint” for health to follow, this is it. It’s one of the bests lists of this kind that I’ve seen. I agree with Diana on every point, with the exception of #30 (which is more about politics than nutrition). I also have some minor quibbles on #2/#6 (I think grains and legumes are okay in moderation when properly prepared/soaked, and I definitely think refined grains are worse than whole grains), #15 (although some nuts are high in omega-6, they are nutrient-dense whole foods with antioxidants to minimize oxidative damage), and #19 (I don’t recommend most commercial fish and cod liver oils, which are rancid, contain synthetic nutrients, or are not high enough in DHA/EPA to have a therapeutic effect).

I’m re-posting the first ten principles here with Diana’s permission. Visit this page on the Modern Paleo website to read the remaining 20 principles. Even better, Diana has included links to additional information for each principle that you can access by clicking on the “+/-” sign.

One last thing. As the saying goes, “don’t let the perfect be the enemy of the good.” Embrace the 80/20 rule with these principles. If you follow them 80% of the time, you’ll be on the fast track to vibrant health. An occasional ice cream or piece of bread isn’t going to kill you or reverse the positive effects of this approach. (Of course this isn’t true for those with true intolerances to dairy and gluten. In that case, 100% avoidance is the rule.)

Modern Paleo Principles: A Work-In-Progress

These principles are in a rough order of importance. If you’re overwhelmed by them, try working your way down the list slowly.

1. Eat real foods, prepared well. Prepare your own food as much as you can. Beware the junk ubiquitous in convenience and restaurant foods.
2. Don’t eat wheat, corn, rice, or other grains. If you choose to eat some grains, eat them sparingly and prepare them to minimize toxins, such as by sprouting and soaking. Wheat seems to be the worst of all the grains, while rice seems to be the most benign. Whole grains are not better than refined grains.
3. Don’t eat sweets: avoid sugar, corn syrup, agave nectar, honey, maple syrup, and artificial sweeteners. If you must have some sweetener for a dish, you might try a bit of stevia. With time, your tastes will adjust: ordinary sweets will taste cloying, but formerly bland vegetables will seem delightfully sweet.
4. Don’t eat modern oils derived from grains and seeds — such as canola oil, corn oil, or soy oil. Make your own mayonnaise and salad dressing. Don’t eat fried foods in restaurants: rancid vegetable oils are standard for frying. Avoid all hydrogenated fats; they contain damaging artificial transfats. Instead, use liberal amounts of animal fats — like butter, ghee, lard, and tallow — as well as unrefined coconut oil and olive oil. (Reserve your bacon grease: it’s delicious rendered lard!) Do not fear saturated fat: it’s healthy, including for your heart.
5. Don’t eat soy. Some fermented soy might be okay, if tolerated. However, all soy is goitrogenic and contains estrogen-mimicking hormones.
6. Don’t eat beans and other legumes. If you choose to eat some legumes, eat them sparingly and prepare them to minimize toxins, such as by soaking them.
7. Watch your ratio of omega-6 to omega-3 polyunsaturated fats, as well as your total omega-6 intake. Most people eat far too much omega-6, both absolutely and relatively. Today, the average ratio of omega-6 to omega-3 in Western diets is 17:1, but the ideal ratio looks to be between 2:1 and 1:4. To achieve that you’ll need to limit omega-6 intake by eliminating modern vegetable oils and eating high-omega-6 nuts sparingly. You’ll likely need to supplement with high omega-3 fish oil too.
8. Eat plenty of high-quality meat, preferably from pastured animals. Grass-fed meats have a better ratio of omega-6 to omega-3 polyunsaturated fats than grain-fed meats. Avoid meats treated with antibiotics and hormones, if feasible: the animals are likely treated better, and they taste better. Enjoy plenty of red meat. Try uncured bacon and other breakfast meats. They might not be any healthier, but they taste so much better!
9. Eat eggs, preferably from pastured chickens. Eggs enriched with omega-3s are a good option too. Prefer nutrient-dense egg yolks to nutrient-poor egg whites.
10. Eat fish and shellfish periodically, preferably caught wild rather than farm-raised.

Don’t forget to click here to read the remaining 20 principles!

A recent study published in the American Journal of Pathology adds to the already considerable body of evidence which suggests that inflammation is a primary cause of heart attacks and strokes.

In an article I wrote last year, Preventing Heart Disease Without Drugs, I reviewed the current scientific understanding of what causes heart disease. If you’ve been following this blog, you know that inflammation and oxidative damage – not saturated fat and cholesterol – are the primary causes of heart disease.

I wrote:

The data from this study provide further support for the “oxidative response to inflammation” hypothesis described above. The researchers found that inflammation leads to a reduction of mature collagen in atherosclerotic plaques, leading to thinner caps that are more likely to rupture. This is important because other studies have shown that it is not atherosclerosis alone, but the rupture of the atherosclerotic plaques, that causes heart attacks and strokes.

It follows, then, that if we want to prevent heart disease we need to do everything we can to minimize inflammation and oxidative damage.

By focusing on reducing or completely eliminating, when possible, the factors in our life that contribute to oxidative stress and inflammation, we can drastically lower our risk for heart disease.

For more in-depth information about each of these factors and how to minimize your risk of heart disease without drugs, please refer to Preventing Heart Disease Without Drugs.

There’s no doubt that optimal nutrition plays a significant role in supporting our health and well-being. But nutrition, as important as it is, obviously isn’t the only factor that influences our physiology.

Over the past several years, an increasing amount of research has focused on the role of emotions, behavior and beliefs in contributing to both health and disease. In fact, an entirely new discipline called “psychoneuroimmunology” (say that three times fast!) has emerged to study the connection between the mind and the body. In short, what has been revealed is that the separation we make between “the mind” and “the body” is largely an illusion. Mind and body exist in a continuous and interrelated web of connections that is only now beginning to be discovered by western science.

But though the idea that our thoughts and emotions can directly influence our physiology is new to modern biomedicine (just ten years ago it was dismissed by most physicians and researchers as so much “New Age” fluff), it has been deeply ingrained in our cultural paradigm for centuries. It is embedded in our language; consider the phrases “worried sick” or “scared to death”, and you’ll know what I mean. I’m sure all of you have had the experience of becoming ill after a particularly stressful period at work, or feeling moody and perhaps depressed while you are physically ill. These are both prime examples of how interconnected our mental and emotional health is.

In their book Feeling Good Is Good For You, researchers Carl J. Charnetski and Francis X Brennan set out to review the emerging evidence that pleasure can boost our immune systems and lengthen our lives. According to the authors,:

If stress is the antithesis of pleasure, then it follows that pleasure is the antithesis of stress. And the best way to fight stress, say Charnetski and Brennan, is with pleasure. Our bodies secrete chemicals called endorphins when we experience pleasure. Animal research has revealed, for example, that endorphin levels are up to 86 times higher after animals experience multiple orgasms! But endorphins are also released, albeit at lower levels, in more mundane daily activities such as playing with a pet, watching a funny movie, listening to our favorite music, visiting a favorite place or connecting with loved ones.

The chemicals released when we experience pleasure do more than counteract stress hormones and improve mood. Consider these additional effects:

• They improve immune function by producing an antibacterial peptide
• They enhance the killer instincts and abilities of various immune components, including B cells, T cells, NK cells, and immunoglobulins.
• They enable certain immune cells to secrete their own endorphins as a way of improving their disease-fighting capacity

Charnetski and Brennan examine several “pleasure inducing” experiences that have been scientifically proven to promote health and well-being.

• Music
• Touch
• Pets
• Humor
• Positive attitude and insight

Most of us are already aware of the healing power of those things listed above – at least on some level. But in this culture, there is also an overwhelming reliance on medicine, surgery, diet and other physiological interventions to treat disease. Though we may pay lip service to the idea that stress causes illness and pleasure can prevent it, how many of us actually attribute the same importance to listening to music or watching a funny movie as we do to taking a pill? The lesson in this book is that our thoughts, beliefs, emotions and behavior are all capable of inducing the same physiological changes in our bodies as foods, supplements, pills and even surgery are.

If you doubt that this is true, consider the placebo effect. It has been proven over and over again that pharmacologically inert substances like sugar pills can have identical or even greater therapeutic effects than drugs in certain cases. Even more impressive are the trials that have shown that sham surgery (when small incisions are made to convince the patient they have had the operation, but no surgery is performed) is at times as effective as the actual surgery.

Clearly this points to the power we all have to heal ourselves. If only the suggestion or belief that we will heal is enough to induce the physiological changes that lead to healing, without the presence of any “active” pharmacological substance or surgical intervention, then clearly our thoughts, beliefs and emotions have the potential to be powerful medicine.