Yesterday Steve Jobs floated a description of his personal health problems into the public; calling them “a hormone imbalance that has been ‘robbing’ me of the proteins my body needs to be healthy. Sophisticated blood tests have confirmed this diagnosis. The remedy for this nutritional problem is relatively simple and straightforward, and I’ve already begun treatment.” His press release describing his health issue was timed to quell market concern and Apple’s stock price, as Jobs failed to appear today to deliver his almost cult-like yearly Macworld keynote speech.
In response to his announcement Apple stock rose, as investors were apparently encouraged by the near-meaningless description of Jobs’ very serious health condition. There are two headline stories here. One is about Steve Jobs’ health, which he has now held out for public discussion and holds many important lessons for others struggling to maintain weight in the face of some type of health problem. The other is about risk and investing.
Wall Street, in the past year, has shot itself in both feet while wiping out over 30% of the investment wealth in the stock market. In no small part this was due to the greed-driven use of computerized risk models that were unethically and unintelligently applied -- with the net result of wiping out hundreds of billions in wealth -- while putting taxpayers on the hook to keep these reckless companies in business. Starting 2009 with a jaundiced eye; no investor is interested in being further snookered on the subject of risk.
When one man is the brand his personal health takes on significant importance. On a personal basis, his health problems are and should be protected by privacy laws. However, once he starts making announcements about his health that are designed to quell investor concern, then he is forsaking privacy rights to build investor confidence and in my opinion should make his health records public.
Portraying his problems as a hormone imbalance and a nutritional problem, compared to having a recurrence of his pancreatic cancer, has the net result of lessening investor concern about the risk in an Apple stock investment. However, such a description of his health problems is vague and potentially misleading, as it downplays their severity.
Body-Wasting Health Problems
It may be somewhat difficult to understand, considering the ever expanding waistlines of most Americans, that inappropriate weight loss is a far more serious health problem than obesity. This problem is typically triggered by an intense level of stress such as divorce, loss of a loved one, illness, accident, or injury. During the intense period of such a stressor inflammation is out of control, appetite is suppressed, and weight loss can get out of hand. For many people, as the acute nature of the stress subsides, their body bounces back and they can then regain their weight and recover. The common cause of all body wasting problems is excessive inflammation.
This problem can also be self-inflicted, as with anorexics who don’t eat enough food. What starts out as a desire to be thin gets locked in place as an inflammatory problem -- setting the stage for chronic body wasting. Also, as any serious cancer progresses this body-wasting malnutrition sets in and is often the cause of death.
Steve Jobs problems are far from simple and by no means easy to fix. In 2004 he was successfully treated for an islet cell neuroendocrine tumor, a slow-growing form of pancreatic cancer. While his treatment was considered successful from the point of view of surgically removing the tumor, his pancreas became a war zone. Even a successful treatment causes bridges and building to be knocked down, in this case affecting cells in his pancreas that produce the hormones insulin and glucagon, key regulators of his nutritional status.
Over the last year he has lost considerable weight. Considering his health history, this is not good news at all. It means his body is locked in an inflammatory pattern of unknown cause, but likely the result of his pancreatic problems. When a person gets stuck in an inflammatory-driven body wasting trend, the longer they are in it the more serious the nature of the problem. It is like a forest fire burning out of control. During this process proteins are broken down and lost, as protein-containing body structures are “burned.” This not only includes the loss of muscle and bone, but eventually the loss of structural integrity of key body organs such as the heart, kidneys, pancreas, and liver. A year of inappropriate weight loss is like 15 years of aging.
Unlike getting over the inflammatory trauma of a bad divorce in a period of months, the nature of Jobs’ health problems is harder to define. The source of the problem is not clear. Is it actually the return of his cancer? Is it a consequence of his previous treatment? Is it another problem altogether? Answering these questions may help doctors settle on the appropriate medical treatment, but this is clearly a situation where Jobs would benefit from a comprehensive nutritional program to support whatever medical treatment is appropriate.
Here are the key factors that he can nutritionally improve:
1) Overall protein status.
2) His inflammatory condition and cortisol levels.
3) A low leptin, de-energized condition.
4) A thyroid system on the brink of conking out.
5) Disturbed insulin function.
6) Growth hormone and appetite issues.
7) Any other digestive problems.
These issues apply to any person stuck in an inappropriate trend of weight loss -- so it is worth taking some time to explain how to fix them.
Overall Protein Status
If one wishes to view Jobs’ problem as a simple nutritional issue, then the explanation is that he has negative nitrogen balance. This means that he does not have enough dietary protein (which contains nitrogen) to sustain the structure of his body, thus he is in a trend of body wasting. The simple solution is to increase protein intake to at least three-fourths of his ideal weight in grams of protein per day -- especially glutamine and the branch chain amino acids. If he is very lucky, then that would work -- and it would be a simple solution.
Since Jobs has questionable ability to digest and absorb protein, he needs some of his protein intake in easier to use supplemental forms. I would suggest up to 10 grams of glutamine per day, along with another 60-70 grams of high quality whey protein that is rich in branch chain amino acids. Glutamine is the single most important amino acid to protect against body tissue break down. Branch chain amino acids are needed to fuel insulin signaling and muscle metabolism once basic nitrogen balance has been obtained. In other words, once his liver gets enough protein to meet nitrogen balance, then it is vital that he has a surplus of proteins that are metabolized in muscle so as to fuel muscle regeneration, which is the value of the branch chain amino acids.
While he needs to eat this much protein regardless of whatever else he does, it is quite likely that he will need to do more in order to get anywhere. That is because protein is a structural raw material like 2 x 4s and plywood, not the carpenter. He needs to stop the inflammatory demo crew that has gone wild while getting his remodeling crew into action -- in addition to increasing protein intake. Otherwise, his inflammatory forest fire will keep burning down his protein-containing trees.
Inflammation and Cortisol Levels
Body wasting is always a problem of excess inflammation. Your adrenal glands make higher amounts of cortisol to deal with any increase in inflammatory stress, as a defense mechanism to cool off the inflammation. Cortisol is like oil in a car engine -- it is needed to keep it running with less friction. Since Mr. Jobs is overheating, excess cortisol is constantly produced unless his adrenal glands run out of gas, at which point cortisol drops and even more serious problems set in (like driving a car with no oil).
The problem with cortisol being released in high amounts is that cortisol is actually a catabolic hormone that, in excess, actually helps fuel the break down of his body proteins. The best way to stop this problem is to drastically increase anti-inflammatory nutrients, which helps address the actual source of the problem.
Nutrients that reduce inflammation while at the same time assisting tissue recovery are the key to turning this problem around. Top choices include grape seed extract, fish oil, bromelain, papain, curcumin, quercetin, silymarin, and r-alpha lipoic acid. These nutrients not only help his physical structure they directly help turn down the inflammatory gene signaling, which then enables cortisol production to diminish.
A Low Leptin, De-energized Condition
Unlike many Americans with expanding waistlines and high levels of leptin (leptin resistance), Jobs has low leptin. Leptin is made in body fat and his body fat levels have been reduced to dangerously low levels. Leptin is needed so that his energetic systems can come on. Leptin is also a primary anti-inflammatory nutrient, especially in the brain. And he needs normal leptin levels to support proper insulin signaling in his struggling pancreas.
Two key nutrients that support both leptin status and insulin function are zinc and vitamin D. Zinc is also needed to help him make his own pancreatic digestive enzymes. He’ll need 75 mg to 100 mg of zinc per day, in the form of zinc picolinate and/or zinc citrate (the two biologically active forms of zinc). He will need at least 2000 IU of vitamin D per day, and possibly more if a blood test shows him lacking.
It is vital that he prop up his failing leptin system or he will have no energy to function, no creative drive, and feel like he has worked 12 hours a day when he has only worked 10 minutes. Maybe that’s the real reason he didn’t want to give the keynote at Macworld -- he didn’t have the energy to make anything that excited him this year.
A Thyroid System on the Brink of Conking Out
Inflammatory problems are a major jolt to healthy thyroid function. T3 is the biologically active form of thyroid hormone. Reverse T3 is the brakes that slow down thyroid function. A thyroid lab test that measures free T3 is actually a score of both active T3 and reverse T3. Ongoing inflammation causes reverse T3 levels to rise. Steve Jobs is in a situation where he really needs to know his actual reverse T3 score -- as it will directly predict the likelihood of any recovery. As reverse T3 elevates one’s ability to recover dwindles.
He can also use nutrition to help make thyroid hormone as well as to activate it. By boosting his own T3 levels, reverse T3 will lesson. Nutrients such as iodine, selenium, and manganese can be key to maintaining thyroid status in the face of inflammatory stress.
Insulin and Growth Hormone
The bottom line for Jobs is that he must get thyroid hormone, insulin, and growth hormone all acting in harmony to facilitate body tissue repair. These hormones are the managers within his body that will use the protein and mild exercise to form new body tissue.
As I mentioned above, zinc and vitamin D are essential for his insulin system to work well. He also needs to rest his pancreas between meals so that he can build up insulin to release correctly when he eats. Thus, snacking is out of the question as are meals that are too large. He is best eating four meals spaced four hours apart.
His growth hormone status is reflected by his appetite as well as his ability to improve muscle strength from mild resistance exercise. The appetite signal is called ghrelin, which also acts to stimulate growth hormone activation. Thus, if there is no appetite, then there is no growth hormone release from the food that is ingested -- and little ability to build body structure from the food that is eaten.
If this is the case he should drink some warm vegetable broth ½ hour before eating, in an effort to stimulate an appetite signal by bringing warmth to his inflamed digestive tract. He can also take an herb like ginger or slippery elm, which soothes and promotes blood flow to the digestive system. He can also take digestive enzymes ½ hour before eating. He should also do some form of relaxation before eating. His goal is to get an appetite signal and when he gets it to eat.
If these strategies do not produce an appetite signal then he should consume fairly large amounts of first milk colostrum, which contains IGF1, the growth hormone signaling molecule.
He may have other digestive problems that need to be addressed, and these can vary considerably.
I have used the above tips many times to help individuals recover from weakened physical states, regardless of the cause. These tips do not interfere with any needed medical treatment for any problem that can be identified. Rather, they help turn the tide so that any needed medical treatment can work better.
While Jobs’ problems are not simple, they are solvable. However, the longer he stays in an inflammatory wasting condition the more damage that is caused, the faster he ages, and the higher the risk for cancer to return. If doctors better understood how to use nutrition to improve difficult health situations an awful lot of hardship could be spared and the odds for success could be improved for many health problems.
It will be interesting to see how the Steve Jobs story unfolds. Will he rise above his own health problems and a medical profession that pretends to be the authority on health but often falls short? If I were a risk taker, I’d bet on Jobs.