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TrueNorth Health
Alan Goldhamer, D.C.
www.TrueNorthHealth.com
(707) 586-5555
Everyone wants a long-life
But no one wants to get old
Aging is associated with
pain, debility, and
dependence
Adults today live little longer than
adults did in 1900.
LIFE EXPECTANCY
White Men
At Birth At Age 65 At Age 85
Life
Expectancy
Years left Years left
1900 47 12 4 1910 49 12 4
1920 54 12 4
1930 60 12 4
1940 62 12 4
1950 67 13 4
1960 67 13 4
1970 68 13 5
1980 71 14 5
1990 73 15 5
2000 75 16 6
2014 78 19 6 INCREASE 31 7 22
MIRACLES OF MODERN
MEDICINE
1911 INTRAVENOUS FLUIDS
1937 SULFONAMIDE
1940 PENICILLIN
HYGIENE
• Improved water and food sanitation
• Less Mal-nutrition
• Reduced over-crowding
• Less deadly medical care
Total Humans Ever Born
109 Billion
Humans Alive Today
7.3 billion
Total well documented that lived to 117+
5
Odds of living to 117:
1/20 billion
HEALTHY
LIFE EXPECTANCY
The major causes of health loss include ischemic heart
disease, respiratory disorders, stroke, spinal pain,
injuries and depression
Life expectancy 78.7 Health life expectancy 69.3
9.4 years of debility
The World Health Report
Ultimate Causes of Death
Metabolic Syndrome
• Abdominal Obesity
• High Cholesterol and Low HDL
• High TG
• High Blood Pressure
• High Blood Sugar with Insulin Resistance
Obesity Trends* Among U.S. Adults
BRFSS, 1986 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14%
Obesity Trends* Among U.S. Adults
BRFSS, 1997 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% ≥20%
Obesity Trends* Among U.S. Adults
BRFSS, 1999 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% ≥20%
Obesity Trends* Among U.S. Adults
BRFSS, 2001 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
Obesity Trends* Among U.S. Adults BRFSS, 2002
No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
Obesity Trends* Among U.S. Adults
BRFSS, 2003 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
Obesity Trends* Among U.S. Adults
BRFSS, 2004 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
Obesity Trends* Among U.S. Adults
BRFSS, 2005 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
Obesity Trends* Among U.S. Adults
BRFSS, 2010 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
Prevalence* of Self-Reported Obesity Among U.S. Adults BRFSS, 2012
15%–<20 20%–<25% 25%–<30% 30%–<35% ≥35%
Prevalence* of Self-Reported Obesity Among U.S. Adults
BRFSS, 2013
Prevalence of Self-Reported Obesity Among Black Adults,
2013
Data not reported <20% 0%–<25% 25%–<30% 30%–<35% ≥35%
0
5
10
15
20
25
0
1
2
3
4
5
6
7
8
1958 61 64 67 70 73 76 79 82 85 88 91 94 97 00 03 06 09
Nu
mb
er
wit
h D
iab
ete
s (
Millio
ns)
Perc
en
tag
e w
ith
Dia
bete
s
Year
Percentage with Diabetes
Number with Diabetes
Number and Percentage of U.S. Population with Diagnosed Diabetes,
1958–2010
CDC’s Division of Diabetes Translation. National Diabetes Surveillance System
available at http://www.cdc.gov/diabetes/statistics
Age-adjusted Prevalence of Obesity and Diagnosed Diabetes
Among U.S. Adults Aged 18 Years or Older
Obesity (BMI ≥30 kg/m2)
Diabetes
1994
1994
2000
2000
No Data <14.0% 14.0%–17.9% 18.0%–21.9% 22.0%–25.9% 26.0%
No Data <4.5% 4.5%–5.9% 6.0%–7.4% 7.5%–8.9% >9.0%
CDC’s Division of Diabetes Translation. National Diabetes Surveillance System available at
http://www.cdc.gov/diabetes/statistics
2010
2010
“Health Food” vs Healthy Food
• Olive Oil
• Red Wine
• Dark Chocolate
• Coffee
• Energy Drinks
• Granola Bars
• Meat and Fish
• Dairy products
• Fresh Whole Fruit
• Fresh Raw
Vegetables
• Fresh cooked
vegetables
• Whole grains
• Beans
• Nuts, Seeds
• Water
Modern Brain versus Ancient Brain
Our brains are designed
for an environment of
scarcity.
Dopamine
• Molecular Formula: C8H11NO2 Formula
Weight: 153.18
FOOD and SEX
SEX and FOOD
DOPAMINE SECRETION
SEX VERSUS COCAINE
0
10
20
30
40
50
60
70
80
90
100
ORGASM COCAINE
THE DIETARY PLEASURE TRAP
• SPECIFIC CHEMICALS ADDED TO
FOOD TO IMPROVE APPEAL AND
INCREASE CONSUMPTION
Total sugar consumption exceeds
150 pounds per year per person
• HFCS use increased by
1,060%
CH3(CH2)7CH=CH(CH2)7CO
OH
What do we eat?
Fruits/Vegetables
7%
Animal/Processed
93%
Current Treatment for HBP
Treatment Duration?
For the rest of
your life$
FOREVER!
SYSTOLIC BLOOD
PRESSURE
The top number when blood pressure is
reported.
Represents the blood pressure during heart
contraction.
DIASTOLIC BLOOD
PRESSURE
The bottom number when blood pressure is reported.
Represents the blood pressure during heart relaxation.
HIGH BLOOD PRESSURE FACTS
High Blood Pressure related conditions are the
leading cause of death and disability in
industrialized societies
287,000 die from congestive heart failure each
year in the U.S. and HBP is the major preventable
factor
790,000 people have strokes and HBP is the
major cause.
HIGH BLOOD PRESSURE FACTS
Most people will develop HBP in their lifetime.
38 million office visits to physicians and a
leading reason for prescription drugs.
Drug intervention is largely disappointing with
improved outcomes only in those with highest
BP.
The majority of heart attacks and strokes from
HBP occur in the masses of patients with BP
that is not elevated enough to justify the risks
of drugs.
HIGH BLOOD PRESSURE
BP of 138/88 increases risk of heart attack
5 fold compared to a healthier BP of
110/70
Each point reduction in BP reduces all
cause mortality by 1 percent.
Risk reduction continues all the way down
to at least 90/60.
Training is our #1
Priority
August's featured site: Local 701 Training
Clinical Effects of Participating in the TNH Residential Health
Education Program Including Fasting.
After TNH Follow-up (2-12 month)
Weight Loss -26 pounds -28 pounds
Systolic BP
reduction
-30 points -27.6 points
Diastolic BP
reduction
-11 points -10.6 points
Effect of the TNH residential health education program on the cost of medical
treatment and drug costs in the year after participation versus the year
prior to program participation in members of the IUOE with diabetes or high
blood pressure.
Average Costs Per
Year Prior to TNH
Program
Average Costs Per Year
After the TNH Program
Savings in the First
Year After the TNH
Program
Medical Costs
$3,912
Medical Costs
$2,016
Medical Savings
$1,896
Drug Costs
$1872
Drug Costs
$984
Drug Savings
$888
Total Costs
$5,784
Total Costs
$3,000
TOTAL SAVINGS
$2,784
Types of Fasting
CR: Calorie restriction
IF: Intermittent fasting: (reduced feeding
window or alternate day fasting)
PF: Periodic fasting: 3-5 days multiple times
WOF: Water-only fasting: (5-40+ days of total
fasting)
Fasting Definition:
The complete abstinence from
all substances except pure
water in an environment of
complete rest
Starvation Definition:
Abstinence from nourishment beyond the point where the bodies nutritional reserves are exhausted and impairment of vital organ function and structure ensues.
The average 70 Kg. male has 12.6 Kg. of fat reserves.
This represents 18% of body weight and = 117,000 calories.
BMR of 1 cal/Kg/hr equals a 70 day supply of fuel.
Moderate activity will double energy expenditure.
Fasting is NOT Starving!
FOUR PHASES OF FASTING
1. GASTROINTESTINAL (to 6 hours)
2. GLYCOGENOLYSIS (to 24-48 hours)
3. GLUCONEOGENESIS (minimized after 2 weeks)
4. KETOSIS (from 72 hours on)
By the end of the 2nd week of fasting, the majority of
energy is derived from the metabolism of ketone bodies.
Even the brain converts to burning predominately ketones rather than exclusively glucose
BIOCHEMISTRY
OF FASTING
Fasting induces metabolic and
hormonal changes to:
1. Draw upon supply of fat
2. Spare vital protein reserves
3. Conserve nutrient resources
INDICATIONS FOR FASTING
1. Loss of appetite
2. Acute illness
3. Chronic illness
4. Accelerate healing
5. Change behaviors
6. Psycho-spiritual
PATIENT SELECTION
Complete medical history
Physical examination
Laboratory evaluation
Chemistry Panel including:
lipids -- electrolytes -- kidney function – glucose -- liver enzymes
total protein and albumin
urinalysis
CBC and CRP
Specialized tests as indicated
GENERAL EXPERIENCE DURING FASTING
FOUL TASTE IN MOUTH
INCREASED BODY ODOR
FATIGUE
SLEEP DISTURBANCE
RESTLESSNESS
IRRITABLILITY
DIZZINESS (OH)
ACHES AND PAINS
NAUSEA AND VOMITING
RASHES AND DISCHARGES
HEIGHTENED SENSES
HEALING CRISIS
Determining Fasting
Duration
Minor acute problem 1-7 days
Major acute problem 5-14 days
Minor chronic problem 1-4 weeks
Major chronic problem 2-6 weeks
Some patients require multiple fasts
FASTING MECHANISMS
1. WEIGHT LOSS
2. NATURESIS
3. DETOXIFICATION
4. ENZYMATIC INDUCTION
5. INSULIN RESISTANCE
6. GUT LEAKAGE
7. NORMALIZE SYMPATHETIC TONE
8. PSYCHO-SPIRITUAL IMPACT
9. IMMUNE SYSTEM ENHANCEMENT
10. TASTE NEUROADAPTATION
FASTING MECHANISMS
1. WEIGHT LOSS
Weight loss averages one pound per day.
FASTING MECHANISMS
1. WEIGHT LOSS
2. NATURESIS
During fasting the body eliminates excess salt much more rapidly than when feeding.
Even small amounts of carbohydrate, even a single juice slows this process dramatically.
FASTING MECHANISMS
1. WEIGHT LOSS
2. NATURESIS
3. DETOXIFICATION / AUTOPHAGY
Fasting facilitates the elimination of both exogenous (external) toxins and endogenous (internal) toxins
Hematopoietic Stem Cells
HSC function, a major source of morbidity and mortality
and was thought to be irreversibly damaged by aging.
The sensitivity of HSC to toxic effects of chemotherapy is
a major roadblock to cancer therapy.
Recent research shows that prolonged fasting can
rejuvenate old HSC and protect HSC from the toxic
effects of chemotherapy.
Prolonged fasting represents a profound way to reverse
aging of the immune system and enhance cancer
treatment.
Cancer Theories
DSR (differential stress resistance)
enhanced during fasting as oncogenes
negatively regulate stress resistance.
Healthy cells are protected during
fasting.
DSS (differential stress sensitization)
with cancer cells less effective at
adapting to extreme environments or
substances.
Fasting protects normal cells
Combination of fasting and
chemotherapy results in dramatically
higher cancer-free survival than
chemotherapy alone.
Mitochondrial benefits
bHB (beta-hydroxybutyrate ) increased
in fasting provides antioxidant and
rejuvenative benefits to mitochondrial
function and results in efficient ATP
production enhancing antiviral immunity.
Fasting and Longevity
In lower eukaryotes, fasting extends longevity
by reprogramming metabolic stress resistance
pathways
In rodents, protects against diabetes, cancer,
heart disease and neurodegeneration
In humans, reduces obesity, hypertension,
asthma and RA
Delay aging by protecting against the diseases
of dietary excess
Case Report: Lymphoma We report the case of a 42 year-old female diagnosed with follicular
lymphoma stage 3 by excisional biopsy. Stage 3 Lymphoma is an
advanced stage of the disease.
Current treatment protocol for stage III follicular lymphoma includes
immunotherapy-based treatments, chemotherapy, and radiation.
The CT scan revealed enlarged lymph nodes at the bilateral
inguinal regions reflecting significant change compared to a study
in 10/29/12. The largest node in the right inguinal region measured
34x20 mm and the largest on the left side measured 22x16 mm.
She underwent a CT guided core biopsy and surgical excisional
biopsy which confirmed the diagnosis. Flow cytometry showed CD
positive monotypic B cells making up 15% of the specimen.
Lymphoma continued:
21 days of water-only fasting and 10
days of refeeding at TNH
Lost 22 pounds from 174 to 152
Complete resolution of all masses in her
inguinal and axillar nodes
Follow-up 2 months later was 139 and all
physical exams are within normal limits.
Some residual mild neutropenia
Follow-up at 9 months weight was 132
and all lab values within normal limits
Before fasting After fasting
Figure 1. Radiographs of right inguinal region
Before fasting After fasting
Figure 2. Radiographs of left inguinal region
Weight and BMI
Diagnosis Start of
Fast
End of
Fast
6-Month
Follow Up
9-Month
Follow Up
Weight
(kg) 81.6 78.0 68.9 63.0 59.9 BMI
(kg/m2) 29.40 28.62 25.29 23.13 21.96
kg, kilogram; kg/m2, kilogram/square meter; BMI, Body-Mass Index
FASTING MECHANISMS
1. WEIGHT LOSS
2. NATURESIS
3. DETOXIFICATION
4. ENZYMATIC INDUCTION
Enzyme systems are used to mobilize fat, carbohydrates and protein as well as in the detoxification process.
BDNF and TrKB
Brain derived neurotrophic factor
and its receptor TrKB increase.
BDNF mediates exercise and fasting induced
enhancement of synaptic plasticity and
neuronal resistance to injury
BDNF mediates fasting responses including
regulating appetite and autonomic control of CV
system
FASTING MECHANISMS
1. WEIGHT LOSS
2. NATURESIS
3. DETOXIFICATION
4. ENZYMATIC INDUCTION
5. INSULIN RESISTANCE
Insulin drives sugar from the blood stream into the cells. If there is resistance to insulin then blood sugars rise resulting in diabetes mellitus
FASTING MECHANISMS
1. WEIGHT LOSS
2. NATURESIS
3. DETOXIFICATION
4. ENZYMATIC INDUCTION
5. INSULIN RESISTANCE
6. GUT LEAKAGE
7. The gut is a tunnel through the body
FASTING MECHANISMS
1. WEIGHT LOSS
2. NATURESIS
3. DETOXIFICATION
4. ENZYMATIC INDUCTION
5. INSULIN RESISTANCE
6. GUT LEAKAGE
7. NORMALIZE SYMPATHETIC TONE
Most natural therapies have an impact on the autonomic nervous system.
FASTING MECHANISMS
1. WEIGHT LOSS
2. NATURESIS
3. DETOXIFICATION
4. ENZYMATIC INDUCTION
5. INSULIN RESISTANCE
6. GUT LEAKAGE
7. NORMALIZE SYMPATHETIC TONE
8. PSYCHO-SPIRITUAL IMPACT
Most major religions recognize the use of fasting for physical and spiritual enhancement.
FASTING MECHANISMS
1. WEIGHT LOSS
2. NATURESIS
3. DETOXIFICATION
4. ENZYMATIC INDUCTION
5. INSULIN RESISTANCE
6. GUT LEAKAGE
7. NORMALIZE SYMPATHETIC TONE
8. PSYCHO-SPIRITUAL IMPACT
9. IMMUNE SYSTEM ENHANCEMENT
Fasting and adaptive cellular
responses:
1. Reduced oxidative damage
2. Reduced inflammation
3 Optimization of energy metabolism
4. Enhanced cellular protection
FASTING MECHANISMS
1. WEIGHT LOSS
2. NATURESIS
3. DETOXIFICATION
4. ENZYMATIC INDUCTION
5. INSULIN RESISTANCE
6. GUT LEAKAGE
7. NORMALIZE SYMPATHETIC TONE
8. PSYCHO-SPIRITUAL IMPACT
9. IMMUNE SYSTEM ENHANCEMENT
10. TASTE NEUROADAPTATION
Fasting acts similar to rebooting the hard drive of a computer. It helps to reset the “default settings”.
Fasting Effects
Fasting decreases glucose and IGF-1 similar to exercise
Fasting decreases BP and heart rate
Fasting decreases Insulin
Fasting decreases inflammation and oxidation
Fasting decreases total microbial load
Fasting increases Leptin “the satiety hormone”
Fasting increases insulin sensitivity
Fasting increases cellular stress resistance
Fasting increases cellular stress adaptation
Fasting increases autophagy
Fasting normalizes gut microbiota and stimulates B-cell
immunity
Reverses all major abnormalities of metabolic syndrome
Preceptorship/Residency
TNH provides room and vegan board
No fees are charged to the intern
AM and PM rounds
24 hour call
Intake and exit examinations
Participate in research and case reports.
Patient education and support
Grand rounds weekly
TrueNorth Health
Alan Goldhamer, D.C.
TrueNorth Health
www.healthpromoting.com
(707) 586-5555
Patients CTCAE
Grade
Adverse Event Gender
(% male)
Avg.
Age
(years(SD))
Avg. H2O
(days (SD))
N=1171 0 None 38.6% 47.5 (21.7) 10.3 (6.9)
N=1076 1 Mild 36.7% 47.0 (22.0) 10.7 (7.1)
N=499 2 Moderate 30.0% 46.8 (22.6) 11.5 (7.6)
N=28 3 Severe 35.7% 47.8 (23.9) 8.25 (9.0)
N=0 4 Serious -- -- --
N=0 5 Death -- -- --
Tot: N=2774 0-5 All 36.3% 47.2 (22.0) 10.7 (7.1)
Case Reports
30 year follow-up
SLE
They all died years ago
No one left
16 years of cephalgia
Appendicitis
TrueNorth Health Center
• Operating our 56-bed facility for over 30 years with 15,000 patients completing the residential health education program.
• Nutritional medicine approach including medically supervised water-only fasting for up to 40 days duration
• Effective treatment for high blood pressure, diabetes and autoimmune disorders
• Internship and residency training for 30 doctors per year
• Non-profit Foundation with an active research program publishing in peer-reviewed journals.
Highly Refined “Pleasure Trap”
Foods
Foods containing added oil, salt and sugar.
(SOS)
Foods containing refined flour products
including bread, pasta, crackers and
cookies.
Foods containing dairy products including
cheese, butter and yogurt
Chemical Dose Type Target
water 8 kg inorganic nervous system
lead 500 g inorganic nervous system
alcohol 500 g organic kidney/liver
ketamine 226 g drug cardiovascular
table salt 225 g inorganic nervous system
ibuprofen (e.g.,
Advil) 30 g drug kidney/liver
caffeine 15 g biological nervous system
paracetamol
(e.g., Tylenol) 12 g drug kidney/liver
aspirin 11 g drug kidney/liver
amphetamine 9 g drug nervous system
nicotine 3.7 g biological nervous system
cocaine 3 g biological cardiovascular
methamphetamin
e 1 g drug nervous system
chlorine 1 g element cardiovascular
arsenic 975 mg element digestive system
bee sting venom 500 mg biological nervous system
cyanide 250 mg organic causes cell death
aflatoxin 180 mg biological kidney/liver
mamba venom 120 mg biological nervous system
black widow
venom 70 mg biological nervous system
formaldehyde 11 mg organic causes cell death
ricin (castor bean) 1.76 mg biological kills cells
VX (nerve gas) 189 mcg organophosphate nervous
tetrodotoxin 25 mcg biological nervous system
mercury 18 mcg element nervous system
botulinum
(botulism) 270 ng biological nervous
tetanospasmin
(tetanus) 75 ng biological nervous system
Walking point dogs
Appendicitis
Cehpalgia
SLE
