The Battle of the Diets: Is Anyone Winning (At Losing?)

On Mon, 4 Jun 2012 16:46:03 +0000 (UTC), Doug Freyburger
wrote:

Dogman wrote:
" wrote:

I'm not arguing with Doug. I'm arguing with
you and it has nothing to do with the above. Capiche?
...
Doug appears to be smart enough to hedge his bet, by saying he would
try to avoid the risk factors noted by Duesberg.

You will note that I also follow the advice of others to avoid exposure
to HIV.

Yes, as I acknowledged earlier.

Both sets of advice are good public health policy issues. The
fact that I follow good public health policy is not the same thing as
hedging my bets on the topic.

Yeah, it pretty much is.

I think it nearly certain that AIDS is
triggered by HIV infection. I think other illnesses with AIDS symptoms
are probably what is being observed.

Those other illnesses, in the presence of HIV antibodies, or without
the presence of HIV antibodies, are all the same illnesses.

One cohort gets treated with AIDS drugs, which will eventually kill
them, the other cohort gets traditional treatment for those particular
diseases and generally survive, if their illness is treatable.

I avoid HIV infection for one of
those reasons. I follow good public heath policy for a lot more reasons
than the second one.

Following good public health policy will not prevent you from possibly
testing positive for HIV antibodies (sometimes they do it without even
telling you). And then you will be put on AIDS drugs which will
eventually kill you. Slowly, but ever so surely.

There are approximately 90 known conditions that can cause a person to
test positive on an HIV test, even pregnancy, which might be the only
condition that you, as a man, are not able to experience.

Asshole.

I review my kill file and ask myself if it is time to add Dogman to it.

A man's gotta do what a man's gotta do.

At this point I could trade him for someone else and reduce the noise.

Feel free to trade me for two Mickey Mantles and a Sandy Koufax!

I'm worth at least that much.

Then I check the total amount of traffic that would be left if I did
that. It's close. I ask that you read your own posts and decide to not
play the abuse game. Don't be a troll by reacting. It's a process that
gets worse and worse over time.

It might get worse, yes, but that's mostly up to Trader.

Life is all about making choices, Doug.

Which way you choose will not affect me in the least.

--
Dogman

"I have approximate answers and possible beliefs in different degrees of certainty
about different things, but I'm not absolutely sure of anything" - Richard Feynman

James Warren wrote:
Doug Freyburger wrote:
James Warren wrote:

Depending on the plan at least tabular data. Dr Atkins tried to get his
tabular data published and was refused because it was not double blind.
You have stated that you will accept nothing less than double blind
studies. As such I suspect you will call any amount of tabluar data
anecodotal.

A diet cannot be double blind using real food. Was the assignment to
diet random? This would be a minimum requirement for a controlled
trial.

It is theoretically possible to randomly assign diets without the
dispensing technician knowing. It would require confinement and food
made to look identical. Maybe even tube feeding. Completely
impractical. Will probably never happen. But ...

Selling millions is not a good scientific criterion for anything though.

It's an extremely effective method for finding out what does not work.
Which is what most folks want rather than scientific studies. You are
by far the exception on that.

What can be known is the non-obvious parts gave results successful
enough for an person to notice them and study the field long enough to
become established as an expert, publish a book, and for the book to
survive the culling process to become well known.

What are non-obvious parts?

You already know the obvious parts and you are already doing it. If low
is good then lower must be better. If human bodies worked like that
every single low carb plan out there would have us go as close to zero
as we can. Human bodies do not work like that. Perhaps you're even
reducing fat grams in addition to reducing carb grams.

How was success defined?

By group loss. By reduction in group stalls. By better group
adherence. By longer group membership. By better group health results.
Those are how plans become popular. In the end it's about individual
results aggregated. Popular is a herd attribute. Consider that
you're currently stalled. Not knowing what your stats are others can't
estimate if you've already lost to ideal weight and you're done or if
you're stalled for hormonal reasons aka starvation modes.

What does success
of a diet book have to do with anything. Many diet books have been
highly successful in selling copies and making money. Surely they
didn't all contain good advice, did they?

It does not matter that they all contain conflicting advice, yes they do
all contain good advice. Each for some segment of the population. Be
clear - Some people do great on any one diet plan. Different diet plans
have different percentages they work for. The key is to start with a
plan with a good percentage, then eventually migrate to other plans
based on what has been working for you. Or to pick a plan that is a
fully customized process that could conceivably take you to a point with
little resemblence to your starting point. The reason I'm an Atkins fan
is Atkins is such a process. There exist people eating low fat because
that is where the process led them.

My results were pretty good but not as good as I had hoped.

How much motivation do you have to acheive better results? Only you can
answer that. It tells how much motivation you have to try one of the
well known plans complete with the parts that are not obvious. Was your
success good enough that your hopes were unrealistic? That's extremely
common. Are you motivated enough to start trying the non-obvious parts?

It would be hard to get lower carb than I now do. I think I may have
asymptoted or have entered a phase of slow decline which is inevitable
eventually.

That or you think "if low is good lower must be better". It's obvious.
Obvious does not equal true. T3 thyroid output drops when eating too
low carbs causing stalls once leptin issues no longer force loss. Body
fat plus liver produce versions of leptin driving loss rates. There are
several interlocking hormones involved in the metabolism. You haven't
yet asked about these biochemical drivers that I have noticed. The
biochemical driver explanations are at the hypothesis level through the
estabolished fact level depending on the idea but justification aside
they do work.

James Warren wrote:

I was on three diabetes drugs and control was still not as good as
I wanted. A few months after starting LC I dropped a drug and am
considering reducing another because control is very good.

I'll chant some litanies. Let's see how many of the chants you already
knew.

Dietary ketosis is not ketoacidosis. Reading on the test sticks show
whether ketosis is present and a very inaccurate view of how much.
Because ketoacidosis shows as almost black, darker is NOT better on
the sticks. Dietary ketosis is limited and reflects a successful
predator diet. Ketoacidosis is unlimited and reflects a broken
metabolism. Blood sugar is low while in dietary ketosis. Blood sugar
is high going into ketoacidosis. Lower carb does not drive the sticks
darker no matter that a lot of newbies want it to work that way. The
sticks naturally show dark in the first week or two so test that
blood. The sticks naturally get lighter after a week or two so expect
that to happen and consider it a goal. Rate of loss is proportional to
amount to lose so expect to start fast and end slow. Immunity to stalls
is also proportional to amount to lose so expect to start steady and end
bursty.

Heavy exercise depletes glycogen so there is a bonk earlier. Mild
exercise uses fatty acids so the bonk is farther out. Where the bonk is
depends on physical conditioning. Get in good enough shape and keep the
intensity low enough and there is no bonk - This is how marathoners
survive the distance. On a smaller scale this says that once
established in a low carb regime you can expect better endurance at the
price of worse intensity. Early on the metabolism takes a bit to adjust
so early on the exercise regime suffers a temporary large set back.
Walking is good. Jogging is better once you're in mediocre shape.
Saying faster running is better than jogging is a sign that someone is
competitive not that they are interested in loss or weight. Both
aerobic and resistance exercise are good. Do whichever you will keep
doing and try to end up doing both.

A marathon run to finish is a pound of fat. This is why diet is better
to trigger loss than is exercise. A 5K run is a few hundred calories.
This is one of several reasons why exercise is very good at preventing
regain even though it is poor at driving loss. So start walking and
build up to jogging. Go faster if you like it but jogging is plenty
good for you.

Less is not better no matter that it's not obvious. For the same total
calories most low carb dieters can drop protein calories and add a
matching number of fat calories and end up losing better all the way
down to some minimum number of protein calories. See the glucagon chant
below for why that works.

Tuning carb quotas across the weeks is a part of some programs. In this
part of the process more carbs generally mean more filling so they are
approximately offset by less fat keeping protein grams and total
calories the same week to week. If you also cut your total calories
across the weeks that's a separate process that is done by cutting fat
grams (maybe also protein grams depending on your current protein gram
level).

Insulin drives fat into storage. Glucagon pulls fat out of storage.
Insulin is released in direct response to dietary carbs. Glucagon is
released in indiect response to dietary fat. Together this is why low
carb is medium protein, high fat not medium fat high protein. It's also
why in the original fat fast experiment the group eating 1000 calories
of 90% fat lost more than the control roup eating 0 calories. No matter
that it is not obvious eating more fat grams at the low end leads to
more loss because of the glucago released. It's easy to eat so much fat
this effect is overwhelmed if you mix carbs into the fat. Picture
yourself mixing a stick of butter with the same amount of flour and
making a cookie out f it. It's not easy to eat so much fat this effect
is overwhelmed if you stay low carb. Picture yourself eating that stick
of butter straight. Excess protein is burned for fuel by using the
energy to create glucose, yet another reason why more protein is not
better once over some minimum.

T3 thyriod is released based on some detection of deitary carbs plus
total calories in the last two weeks. One of dozens of reasons phase
one lasts two weeks in most plans and the main reason lower is not
better. Leptin is released based on amount of excess body fat plus most
recent peak dietary carbs. One of several reasons why plans mention
six months and why cheats tend to trigger wooshes. Leptin is why lower
longer is not better.

Cortisosol is lower when very low carb. One of several reasons why lower
is not better and why staying very low tends to trigger crash and burn.
I think there are not enough studies on how to effect the cortisol
levels by controlling carb levels. I just know that there are plenty of
studis that say that cortisol levels drop if too low in carbs too long.

Ghrelin is released in the stomach. Work to shrink your stomach and it
helps to not fell hungry. This is one of those arguments for lower carb
because lower carb is smaller bulk. Not all of the hormone chants point
the same direction.

And a partiridge on a dairy cow. Until maintenance when pears are okay
for some people! I bet pear wood would rock for smoking BBQ slow and
moist all night for the best Q. Pear grows too slow though. Better to
make those pears into brandy. You know what brandy is? Magic wine with
the carbs distilled out. Just add water to reconstitute back to the
original wine strength without the carbs. You know what whiskey is?
Magic beer with the carbs distilled out. Just add water to reconstitute
back to beer strength without the carbs. The five golden rings are
actually shot glass sized stains on the wooden table. Six geese a
laying sounds good until you've tried a sour goose egg side by side with
a chicken egg.

On 6/4/2012 4:49 PM, Doug Freyburger wrote:
James Warren wrote:
Doug Freyburger wrote:
James Warren wrote:

Depending on the plan at least tabular data. Dr Atkins tried to get his
tabular data published and was refused because it was not double blind.
You have stated that you will accept nothing less than double blind
studies. As such I suspect you will call any amount of tabluar data
anecodotal.

A diet cannot be double blind using real food. Was the assignment to
diet random? This would be a minimum requirement for a controlled
trial.

It is theoretically possible to randomly assign diets without the
dispensing technician knowing. It would require confinement and food
made to look identical. Maybe even tube feeding. Completely
impractical. Will probably never happen. But ...

That would be only single blind. The subject knows what diet he is on.


Selling millions is not a good scientific criterion for anything though.

It's an extremely effective method for finding out what does not work.
Which is what most folks want rather than scientific studies. You are
by far the exception on that.

Selling many copies is not the same thing as being a successful diet.


What can be known is the non-obvious parts gave results successful
enough for an person to notice them and study the field long enough to
become established as an expert, publish a book, and for the book to
survive the culling process to become well known.

What are non-obvious parts?

You already know the obvious parts and you are already doing it. If low
is good then lower must be better. If human bodies worked like that
every single low carb plan out there would have us go as close to zero
as we can. Human bodies do not work like that. Perhaps you're even
reducing fat grams in addition to reducing carb grams.

How was success defined?

By group loss. By reduction in group stalls. By better group
adherence. By longer group membership. By better group health results.
Those are how plans become popular. In the end it's about individual
results aggregated. Popular is a herd attribute. Consider that
you're currently stalled. Not knowing what your stats are others can't
estimate if you've already lost to ideal weight and you're done or if
you're stalled for hormonal reasons aka starvation modes.

What does success
of a diet book have to do with anything. Many diet books have been
highly successful in selling copies and making money. Surely they
didn't all contain good advice, did they?

It does not matter that they all contain conflicting advice, yes they do
all contain good advice. Each for some segment of the population. Be
clear - Some people do great on any one diet plan. Different diet plans
have different percentages they work for. The key is to start with a
plan with a good percentage, then eventually migrate to other plans
based on what has been working for you. Or to pick a plan that is a
fully customized process that could conceivably take you to a point with
little resemblence to your starting point. The reason I'm an Atkins fan
is Atkins is such a process. There exist people eating low fat because
that is where the process led them.

My results were pretty good but not as good as I had hoped.

How much motivation do you have to acheive better results? Only you can
answer that. It tells how much motivation you have to try one of the
well known plans complete with the parts that are not obvious. Was your
success good enough that your hopes were unrealistic? That's extremely
common. Are you motivated enough to start trying the non-obvious parts?

It would be hard to get lower carb than I now do. I think I may have
asymptoted or have entered a phase of slow decline which is inevitable
eventually.

That or you think "if low is good lower must be better". It's obvious.
Obvious does not equal true. T3 thyroid output drops when eating too
low carbs causing stalls once leptin issues no longer force loss. Body
fat plus liver produce versions of leptin driving loss rates. There are
several interlocking hormones involved in the metabolism. You haven't
yet asked about these biochemical drivers that I have noticed. The
biochemical driver explanations are at the hypothesis level through the
estabolished fact level depending on the idea but justification aside
they do work.

I have nothing about this. DO you have a reference?

James Warren wrote:
Doug Freyburger wrote:

It is theoretically possible to randomly assign diets without the
dispensing technician knowing. It would require confinement and food
made to look identical. Maybe even tube feeding. Completely
impractical. Will probably never happen. But ...

That would be only single blind. The subject knows what diet he is on.

Not with tube feeding or food encapsulated in tablets. Will probably
never happen.

Selling millions is not a good scientific criterion for anything though.

It's an extremely effective method for finding out what does not work.
Which is what most folks want rather than scientific studies. You are
by far the exception on that.

Selling many copies is not the same thing as being a successful diet.

Diet books sell because people who follow the magazine article summary
lose weight. Any plan that fails to trigger good loss will not sell.
Any plan not already of a popular type that fails to exceed current ones
will not sell. Successful in their begining stages does not equal
successful to those of us around for years, but popularity ensures that
a simple read of the directions work for a lot of people.

That or you think "if low is good lower must be better". It's obvious.
Obvious does not equal true. T3 thyroid output drops when eating too
low carbs causing stalls once leptin issues no longer force loss. Body
fat plus liver produce versions of leptin driving loss rates. There are
several interlocking hormones involved in the metabolism. You haven't
yet asked about these biochemical drivers that I have noticed. The
biochemical driver explanations are at the hypothesis level through the
estabolished fact level depending on the idea but justification aside
they do work.

I have nothing about this. DO you have a reference?

Dozens or hundreds for the parts of it. As I wrote it there it's an
integration of many studies and many anecdotal reports. Hypothesis by
me. Incomplete in that paragraph. Easy to check any one part of it.
would need studies to check the integration. When I first started
writing that authors spent 10+ years studying and learning it was 1999.
An integration of this sort is the result of my doing that. Would need
more study for me to write it in more than postings.

On 04/06/2012 9:29 PM, Doug Freyburger wrote:
James Warren wrote:
Doug Freyburger wrote:

It is theoretically possible to randomly assign diets without the
dispensing technician knowing. It would require confinement and food
made to look identical. Maybe even tube feeding. Completely
impractical. Will probably never happen. But ...

That would be only single blind. The subject knows what diet he is on.

Not with tube feeding or food encapsulated in tablets. Will probably
never happen.

Selling millions is not a good scientific criterion for anything though.

It's an extremely effective method for finding out what does not work.
Which is what most folks want rather than scientific studies. You are
by far the exception on that.

Selling many copies is not the same thing as being a successful diet.

Diet books sell because people who follow the magazine article summary
lose weight. Any plan that fails to trigger good loss will not sell.
Any plan not already of a popular type that fails to exceed current ones
will not sell. Successful in their begining stages does not equal
successful to those of us around for years, but popularity ensures that
a simple read of the directions work for a lot of people.

Any diet that has calorie reduction will work short term. The success rate
after a year or so is about 5%. Then a new diet book comes out. Repeat cycle.


That or you think "if low is good lower must be better". It's obvious.
Obvious does not equal true. T3 thyroid output drops when eating too
low carbs causing stalls once leptin issues no longer force loss. Body
fat plus liver produce versions of leptin driving loss rates. There are
several interlocking hormones involved in the metabolism. You haven't
yet asked about these biochemical drivers that I have noticed. The
biochemical driver explanations are at the hypothesis level through the
estabolished fact level depending on the idea but justification aside
they do work.

I have read nothing about this. DO you have a reference?

Dozens or hundreds for the parts of it. As I wrote it there it's an
integration of many studies and many anecdotal reports. Hypothesis by
me. Incomplete in that paragraph. Easy to check any one part of it.
would need studies to check the integration. When I first started
writing that authors spent 10+ years studying and learning it was 1999.
An integration of this sort is the result of my doing that. Would need
more study for me to write it in more than postings.

I am not convinced that LC affects any hormones other than insulin. If you
can show me affects on leptin or ghrelin or others I'd be interested.

--
-jw

James Warren wrote:

I am not convinced that LC affects any hormones other than insulin. If you
can show me affects on leptin or ghrelin or others I'd be interested.

I've already posted that the regulars have spent years citing study
after study so we've seen many. Were I to try to get a book published
I'd need to gather together references for everything. I'm not doing
that. Not what you want to read but I'm not going to dig through the
archives to repeat references.

On 05/06/2012 12:22 AM, Doug Freyburger wrote:
James Warren wrote:

I am not convinced that LC affects any hormones other than insulin. If you
can show me affects on leptin or ghrelin or others I'd be interested.

I've already posted that the regulars have spent years citing study
after study so we've seen many. Were I to try to get a book published
I'd need to gather together references for everything. I'm not doing
that. Not what you want to read but I'm not going to dig through the
archives to repeat references.

I have read a couple of books and the only hormone I remember being discussed
is insulin. Were those studies cited on leptin and ghrelin?

--
-jw

On Jun 4, 1:26*pm, Dogman wrote:
On Mon, 4 Jun 2012 16:46:03 +0000 (UTC), Doug Freyburger

wrote:
Dogman wrote:
" wrote:

I'm not arguing with Doug. *I'm arguing with
you and it has nothing to do with the above. *Capiche?
...
Doug appears to be smart enough to hedge his bet, by saying he would
try to avoid the risk factors noted by Duesberg.

You will note that I also follow the advice of others to avoid exposure
to HIV.

Yes, as I acknowledged earlier.

Both sets of advice are good public health policy issues. *The
fact that I follow good public health policy is not the same thing as
hedging my bets on the topic.

Yeah, it pretty much is.

I think it nearly certain that AIDS is
triggered by HIV infection. *I think other illnesses with AIDS symptoms
are probably what is being observed.

Those other illnesses, in the presence of HIV antibodies, or without
the presence of HIV antibodies, are all the same illnesses.

One cohort gets treated with AIDS drugs, which will eventually kill
them, the other cohort gets traditional treatment for those particular
diseases and generally survive, if their illness is treatable.

You claim to believe in "the scientific method". So, show us
the peer reviewed study that shows the above. Of course
it won't be forthcoming because it does not exist.

If you knew anything about HIV and AIDS you would know
how it began. There were patients, mostly young gay men
showing up at major hospitals in NY, LA with mysterious infections,
like PCP pneumonia. This pneumonia is never seen in
people with normal immune systems, because it's a common
fungus that any functioning immune system simply eliminates
with out us even getting sick. Yet you had 20 year
olds coming down with it and other opportunistic infections
that those with normal immune systems would never get.

The point here is there were no AIDS/HIV drugs back when
this was occuring, in 1982.
For the first 5 years or so, all they did was treat these
patients with conventional drugs, eg antibiotics, that they
would use to treat anyone suffering from PCP pneumonia
or the other infections they had. They started with the most
basic antibiotics and when those did not work, they moved
on to the next. And despite heroic efforts, those patients ALL
died within months or a few years. None recovered. So
it's just nonsense to claim that those treated for the particular
opportunistic infection survive. They died. End of story.

Now, I saw that occuring and everyone else in
this discussion should have too. It was all over the news.
It's what lead the CDC
and worldwide health authorities to begin the investigation
to find out what was wiping out the T cells in these
patients. That search lead directly to indentifying HIV.

Today we have effective HIV drugs and patients are
living for decades. We can measure the amount of HIV
virus in these patients. With the drugs the level is very
low or undetectable. These patients aren't dying of
opportunistic infectons. They don't have any infections,
they are healthy.
In parts of the world where the
drugs are not available, people are still dying early
deaths from AIDS, soon after diagnosis, just like here
in 1982.
Dying again from these very specific opportunistic diseases
that only those with no immune system contract.

Then we had the scenario with hemophiliacs being
infected with HIV from blood products. They came
down with the same opportunisitc infections, again
T cells gone, no immune system. Once we had a
test for HIV and used it to screen blood, that scenario
stopped. Hemophiliacs are no longer acquiring HIV/AIDS.
Dogman's answer: Hemophiliacs don't live long anyway.

Also, it's curious that Dogman lists hemophiliacs as
if they were a major component of the AIDS epidemic.
They were not. But they were an important part of
the proof of HIV causing AIDS. Receiving blood
products that are made from the combined blood of
many people, they are exactly where you would
expect a new virus that can be transmitted via
blood to show up.

We also had people who went in for routine surgery
and had blood transfusions. They got infected with
HIV, came down with AIDS and died. Arthur Ash,
Isaac Assimov are examples. As soon as we had
the test for HIV, that infection route stopped.
Dogman's explanation: People who get transfusions
are all very sick and dying anyway.



Following good public health policy will not prevent you from possibly
testing positive for HIV antibodies (sometimes they do it without even
telling you). And then you will be put on AIDS drugs which will
eventually kill you. Slowly, but ever so surely.

The lie repeated. The rest of us know that exactly the
opposite is true. In the 80s we had AIDS patients dying right
and left. Now with effective drugs, they are living. At least those
on drugs are. The foolish few that follow Dogman's thinking
are still dying.




There are approximately 90 known conditions that can cause a person to
test positive on an HIV test, even pregnancy, which might be the only
condition that you, as a man, are not able to experience.

The current tests for HIV are recognized as among the most
accurate tests there are.





Asshole.

I review my kill file and ask myself if it is time to add Dogman to it.

A man's gotta do what a man's gotta do.

At this point I could trade him for someone else and reduce the noise.

Feel free to trade me for two Mickey Mantles and a Sandy Koufax!

I'm worth at least that much.

Then I check the total amount of traffic that would be left if I did
that. *It's close. *I ask that you read your own posts and decide to not
play the abuse game. *Don't be a troll by reacting. *It's a process that
gets worse and worse over time.

It might get worse, yes, but that's mostly up to Trader.

I'm not the one that's started several totally new and unrelated
threads where you attack me with the very first post.

James Warren wrote:

I have read a couple of books and the only hormone I remember being discussed
is insulin. Were those studies cited on leptin and ghrelin?

I'll only discuss Atkins because that's what I know best in the field.
With ghrelin and cortisol I move on to where I think post-Atkins
advances should be made. Other low carb experts have plenty of good
material on other topics.

Atkins discusses glucagon some. In the 1972 DADR he called in "fat
mobilizing substance" because glucagon had not been discovered yet. He
realized very early on that higher fat led to higher loss. In my
untested integrative hypothesis insulin and glucagon form a pair at
level 1 - Why low carb works (insulin) and why low carb is high fat
(glucagon) not high protein.

Atkins discusses T3 thyroxine some. He suggests getting tested for
hypothyroid. I have not seen in any of his writings signs that he
understood that T3 is the reason lower is not better on a time scale
starting at two weeks. His core plan starts phase 2 in two weeks but I
can't see that he understood the correlation. He started out doing
tabular studies so he knew what happened when so he did not start out
knowing why . In a sense he did not need to know the underlying hormone
biochemistry beyond the TV debate level. TV debates never need to get
to this second level.

With insulin, glucagon and T3 you mostly run up to the end of studies
that are directly about low carb because studies tend to be short. The
rest are longer term issues where doing low carb studies gets very
expensive.

Google "leptin reset" and you'll find how to do it plus citations of
studies that describe leptin release. The reversal diet does appear in
the 1993 and 1999 editions and it does acheive a leptin reset. The
hormone was not discovered until he was old. I don't know if he no
longer kept up with new science at the time but I can't see that he
understood the correlation. His process works fine without needing to
understand it.

Ghrelin is a fairly new hormone on the radar of low carbers. I've read
about it in the summaries of some studies and in reports of bariatric
surgeries.

Cortisol is a fairly old hormone on the radar of low carbers. It's
mostly used to argue against low carb because very low carb changes its
levels and causes irritability. To me that's just one more point in the
list of non-obvious reasons why lower is not better. Not understanding
the role of cortisol folks seem to think it's like the weather. I think
something can be done about it, but other than not staying lower without
overwhelming reasons I'm not sure what.