Excerpt from The book Love Lessons by Terry McDonald. Available on Amazon, Kindle and Audible.

Love Lesson Fifteen

Get On the Same Page and Stay There

Early in our relationship we started to take one vacation a year in a place that provided peace and solitude and not too many distractions. Lean years meant a Spartan location, prosperous years meant more comfortable surroundings. Both work well. We devised a strategy for these vacations that we found very powerful.

For each vacation we purchase a notebook. On day one of the vacation we take a long walk, usually on a beach and we talk about what we liked about the last year. This review of the positives helps us to remember how much fun and love we enjoy together. Concentrating a year of these memories is a boost that creates something of an emotional high. At the end of the walk we return to our room and write out all the things that we like and then set the book aside and spent the day in play and relaxation.

On the second day of the vacation we walk and talk about the things we did not like about the last year. We do this without criticism or rancor. We both try to hear and understand the things we each found unpleasant and why. As with day one we return to the room write down the things we did not like and then enjoy the rest of the day.

On the third day we talk about where we want our life to be in one, five and ten years. By now you know the pattern, at the end of the walk we write the results of the conversation down and then play.

On the fourth day we talk about ways to make the good things we discussed on day one happen more often and we also talk about new positive things we would like to incorporate going forward.

On the fifth day we talk about ways to reduce the frequency and severity of the negatives we captured on day two. The ideal of course is to totally eliminate the negatives.

On the sixth and seventh days we plan how we will incorporate the ideas from the previous days into the next year so that we enjoy more positives, fewer negatives and move our life to our one year vision and a year closer to our five and ten year visions.

This process has been immensely powerful for us. The sequence of the dialog helps to keep it productive and open. Doing it in a place that is peaceful and free of distractions is a plus but I’m sure it could be done on a series of Saturday mornings at home or in some other creative format that works for you and your life. The key is that we are on the same page, trying to attain the same things. We are attaining those things in a way that makes life better now and in the future and we both have “skin in the game”.

 Because we create the plan together we hold ourselves and one another accountable. If we get off track, we problem solve together. When we are successful we celebrate together as co-creators of the success.

Where do you want to be 1, 5, 10 years from now? Are there things you would like to happen more often next year? Less often? What is stopping you from getting and staying on the same page with your partner in life?

Crispy Whole Snapper Burmese Style

Since this is the first recipe I am posting under the “Cooking With Ter” name, I want to provide a little background. I decided to start this blog, vlog, Facebook page, website, YouTube channel thingy so that I could promote cooking at home. I believe there are huge benefits to making your kitchen your happy place. I am pretty sure you and your loved ones cannot enjoy robust health without home cooking. I also believe that making food for each other is an act of love that is good for all parties. Cooking brings me so much joy that I want to share that joy with you in the hope you will share it with others.

I have a belief that comfort and enjoyment in the kitchen comes from mastery of three things:

Tools, Techniques and Ingredients. Notice what is missing here. There is no mention of recipes. I think it is very easy to become “recipe bound”.  I believe that if you know your tools, techniques and ingredients you can be free to create. I am not against recipes. I have read hundreds of cookbooks and I have searched the internet to read thousands of recipes there, too. I will provide recipes that I create because they are a useful tool for learning about new ingredients and the tools and techniques used to prepare them. The crispy fish recipe that follows is an original recipe I created last night that is a variation on an old Burmese recipe I read in a cookbook about 35 years ago. I will warn you that I did not measure anything I used in the recipe. The written recipe below is my best guess.

The recipe started with a request from my better half for a crispy whole fish. We had our first fish this way in a Chinese restaurant on the lower Chesapeake Bay and have loved fish prepared this way ever since. We were in a nearby town with a world class fishmonger so I looked over the fresh whole fish offerings and selected a red snapper. The fish was larger than I wanted but it was too perfect to pass up. The next stop was the Asian grocery where a tray of perfect shiitake mushrooms was on display along with fresh mung bean sprouts, Thai or holy basil and green leafy vegetables I was unable to identify but they looked so good I bought some. While there I picked up a big hunk of fresh ginger, a jar of pickled ginger and a jar of fermented black bean and garlic paste. I knew I had rice, peppers, garlic, soy sauce, sesame oil, fish sauce, rice vinegar and some other Asian goodies in the pantry so we were good to go.

Every cuisine has a set of signature flavors created by a set of standard ingredients. A lot of Pacific rim cuisine uses garlic, ginger, sesame oil, green onions, citrus, soy sauce and fish sauce. The perfect balance of sweet, salty, spicy, bitter, sour and umami thus created is like a musical chord.

Back home I laid out all the ingredients on the kitchen counter both those purchased and those foraged from the pantry and fridge.

When I formulate a plan of attack for a meal, I consider what can be cooked ahead and held and what must be cooked right before serving. I also consider all the ways I can be “mise en place”. Mise en place is a French term for having everything organized and ready to go. Being mise en place is a great stress reducer. If you have all ingredients prepped and at hand, all utensils and equipment sorted out and ready, things go much more smoothly than looking for the hot pads when you are trying to get a screaming hot pan out of the oven. I often begin by getting out the knives I will be using and giving them a couple of swipes on the sharpener and then getting out a cutting board, a small waste bowl and a salad spinner.

I began prep by chopping the greens and rinsing and soaking them in the salad spinner. I then sliced the peppers and green onions and peeled and chopped the garlic and ginger. I cleaned, destemmed and sliced the mushrooms and I chopped the pickled ginger coarsely. Each veg thus prepared was placed in a container of some kind, so it was ready to go. I often use thin flexible cutting boards so I can leave the vegetable on the board, set it aside and get another board. The flexible boards can be bent into a funnel to transfer the veg to the pan.

I next mixed cornstarch with water. I had no idea how much would be needed to thicken my sauce, but I knew having it mixed would allow me to add a little at a time when needed until I attained the thickness I wanted. I also prepared a pan with rice and cooking water so it could be turned on about 25 minutes before serving.

With prep complete I decided the sauce for the fish was next since when it was finished it could hold a long time without a problem. I knew the mushrooms would have to give up a lot of moisture to attain the texture I wanted so I put the sliced mushrooms in a wok with some sesame oil to get them started. I added a little water and placed a lid on the wok so steam would cook the mushrooms and then I used high heat with the lid off to reduce the liquid to almost nothing. At this point I added the pickled ginger and a few ounces of the liquid in the jar the pickled ginger was packed in. To this I added some lite soy sauce and a splash of rice wine. I thickened this mixture with the cornstarch mixture and then adjusted liquid and spices. I did not add sugar of any kind. The pickled ginger liquid tasted sweet enough for me but a little brown sugar would work if desired. When I had the thickness and taste I wanted I added a lot of holy basil leaves. They wilt down but add a lot of great flavor. If I were making this again today, I would also add some chili paste.

I planned to fry the fish and then finish it in the oven. The vegetables I knew would stir fry quickly, so I planned to cook them while the fish was in the oven.

To prep the fish, I rubbed it with salt inside and out and then rinsed it thoroughly. This cleansing process takes away any fishiness in fresh, properly handled fish. I keep plastic cafeteria trays handy in the kitchen (I bought them at a restaurant supply store). The fish was patted dry on one of these trays and then the flesh was scored deeply in a decorative pattern. I then dusted the fish with a mixture of salt, pepper and Wondra flour. Wondra does not clump or cake and it forms a nice very thin coating. I had to use a roasting pan to fry the fish. The pan spanned two burners and the frying took quite a lot of oil because of the size of the pan. Fish cooking times vary with the thickness of the fish. A good rule of thumb is 10 minutes for each inch of thickness at the thickest point. After browning the fish on both sides, about six minutes per side, I transferred the fish to a rack in a sheet pan in a preheated 400-degree oven. I set a time for ten minutes and placed my digital meat thermometer at the ready.

Back on the stovetop I heated the wok with a splash of sesame oil and a splash of peanut oil and quickly stir-fried garlic, ginger and peppers until the garlic was tan in color. I added the greens to the wok along with a splash of fish sauce. The moisture in the greens kept the garlic and ginger from burning when the greens wilted, I added green onions and bean sprouts. The sprouts were thoroughly rinsed and spun in a salad spinner. Two tablespoons of black bean paste were stirred in along with a bit of the cornstarch water mix. After a quick taste I performed final adjustments with soy and fish sauce.

The stir-fried veggies were placed around the perimeter of a serving platter with the crispy fish from the oven in the center. The sauce with the mushrooms, pickled ginger and basil went over the fish along with strips of the tops of green onions. Uncooked bean sprouts added a little crunch to the veggies. Some shredded carrot and chopped peanuts would be a good accent to add if desired.

Plating included cooked basmati rice, a big scoop of the veggies and large hunks of fish that lifted easily off the bones. I reserved most of the ginger, basil, mushroom sauce to serve at the table. The textures and flavors were fab. The sensory musical chord played brilliantly.


1 Cup basmati rice

1 Red snapper about three pounds, gutted and scaled.

1 Pound fresh shitake mushrooms

1 bunch holy basil (Thai basil)

1 large bunch Asian greens

1 pound fresh mung bean sprouts

1 Large pepper

1 bunch green onions

5 tablespoons pickled ginger

6 cloves garlic

1 two-inch piece of fresh ginger

2 Tablespoons black bean and garlic sauce

Peanut oil for frying

Sesame oil for stir frying

Fish sauce

Soy sauce


Rice wine

Getting the Body You Want in 2020 in 10 hard steps.

  1. Decide what you want. A vague “I want to lose weight” won’t get it Specificity is key. Your brain cannot help you get what you want if you only have a fuzzy notion. Describe the result you seek in terms you can quantify and visualize and then state the goal in the present tense with a specific date for attainment. For example; My body is lean, strong and flexible with a bodyfat percentage of XX% on XX date.
  2. Be very clear about why you want the result described above. If it is for health reasons, why do you care about your health? Get specific. Why is health important to you. Do you want aesthetic results? Why? Do you want to improve your ability to do things like having the energy, strength and athletic ability to play with your children, grandchildren or great-grandchildren? Are their activities you used to really enjoy but are incapable of today because of the state of your body. Are the activities you enjoy today that you would like to enjoy for decades to come? Just about any “what” can be achieved if you have a powerful enough “why”.
  3. Determine your baseline caloric needs and desired macronutrient mix. A calorie is a unit of energy. You need energy just to breathe, digest food and keep your body at 98.6. More energy is needed to perform normal daily tasks such as bathing, going to work etc. etc. etc. Additional calories are needed if you exert yourself through exercise. A solid exercise program can burn several hundred extra calories per day which will allow you to enjoy a bit more food while you are losing bodyfat. Jenny Ruhl has posted a calculator that can help you with this. Here is a link to her calculator. http://www.jennybrown.net/Calculators/DietMakeupCalcNew.htm Any calculator is at best an estimating tool. Mileage varies from human to human. Your metabolism may be more or less active than most people and as a consequence, you may have to make some adjustments. We will cover that later. Beware of any diet that is too restrictive. Keto, carnivore and vegetarian are all popular these days. Each leaves out a lot of things that will make it difficult to get all of your nutritional needs met. Extreme diets may be necessary for certain circumstances but they should be studied carefully. get input from proponents and critics. A vegetarian diet can be incredibly healthful as long as it is highly disciplined, carbohydrates are kept within limits and supplements are used to provide the missing critical nutrients. Failure to do this can have major health consequences. Fasting can also be powerful as a way of reducing body fat and promoting health. Doing a fast correctly and safely is beyond the scope of this article but I encourage you to study this subject further.
  4. Quantify yourself. I use a Fitbit Versa 2 to track activity and sleep, a Fitbit Aria 2, wifi connected scale to track weight and bodyfat and a diet tracking program called Lose-it. It is possible to connect the devices and programs to create a dashboard that tracks calories in and out along with weight and bodyfat percentage. My steps during the day are tracked by the watch. My walks, yoga sessions or gym workouts are all tracked. I start each day by entering the food I plan to eat in Lose-it. I have entered my goal and desired nutrition profile into Lose-it so it can compare my planned intake for the day with the goals I and make adjustments as needed. If I deviate from the eating plan I set in the morning, I need to go to Lose-it and make the adjustments to see where I am for the day.
  5. Work the program. Set your daily food plan and activity plan and weigh in at the same time every day. Each day notice how you did. If you did not follow the eating or activity plan you set, what got in the way? What will you do differently tomorrow to prevent another disappointment? The mindful awareness provided by tracking food and activity is powerful. I have found that a diet containing a pound of non-starchy vegetables has the advantage of being a lot of food with lots of nutrients and fiber but not a lot of calories. Add some good proteins and tasty and healthy fats up to your budget levels and hunger should not be much of a problem as the bodyfat melts away. Protein and fat are very important for satiety. Protein is particularly important to prevent muscle loss. Muscle builds slowly (slower with each decade) but it can be lost quickly. Muscle burns fat. Losing muscle can lower your metabolism and make you susceptible to a number of problems. In seniors loss of muscle mass results in loss of function that can have serious quality of life and health consequences.
  6. Prepare as much of your food as possible in your own kitchen. Factory and restaurant made food contains a lot of things you do not want and is missing a lot of things you do want. Manufactured food can be made to appeal to the senses through the addition of salt fat and sugar. Loading up on fresh and frozen vegetables. Frozen vegetables and berries are great. They are picked at their prime and put into suspended animation until thawed or cooked. Avoid frozen vegetables with sauces etc. They will be loaded with salt, fat, and sugar.
  7. Exercise is great for burning a few more calories and for a wide range of health benefits but you cannot out-exercise your mouth unless you are prepared to train at the level of the Tour de France cyclists. Body composition is 80% diet and 20% exercise. Go for 150 minutes a week of light cardio, whole-body resistance training 3-4 times a week and balance and flexibility work such as yoga as close to daily as possible. The list of benefits from this regime is way too long to cover here. Health, longevity and quality of life are all dramatically impacted. It is imperative that you ease into exercise a little at a time and that you do it correctly to avoid injuries that will set back your efforts.
  8. Sleep is an important component in changing body composition. Poor sleep or not enough sleep can seriously impair success. We use our Fitbit watches to track sleep and to assess the effects of things we do to improve sleep quality.
  9. Drink lots of pure, plain water. It is ok to add tea and coffee to the mix but still get plenty of plain water. A few packets of stevia a day are OK but artificially sweetened drinks increase appetite and should be avoided. All sugar should be avoided.
  10. Hunker down for the long term and be patient. Make adjustments as necessary so you are enjoying food and your life as you are improving your health, wellbeing, and appearance. Analyze setbacks as they occur and look for simple hacks to make sticking to the plan easier. Rinse and repeat.

“All of The Above” Fast

Ketogenic Diet…. Check

Intermittent Fasting…. Check

Time Restricted Eating…. Check

Calorie Restricted Diet…. Check

Prolonged Fasting…. Check

Fast Mimicking Diet …. Check


Serving as your dietary crash dummy is one small service I render freely. Following my experience with water fasting for five days, I became convinced of the value of the practice and pledged to do it quarterly or more often. I had planned and was mentally preparing to do my next one early in January. Unfortunately, marathon vacationing, dinner parties and gourmet excesses cause me to hit the upper limit of clothing’s capacity last week. Not ready for the asceticism of water fasting yet, I decided to try an experiment by drawing inspiration from all of the buzzwords above. Here are the essential elements.

  1. Coffee with heavy cream in the morning followed by supplemental exogenous ketones (Keto Ca-Na) and electrolyte replacement (Lime Juice, Morton’s lite salt, stevia and water).
  2. No food with the exception of bone broth until dinner. Bone broth is 35 calories per cup which I count as negligible. A few times I boosted the broth with a tablespoon of coconut cream as well as a half teaspoon of turmeric and a grind of black pepper. This version was delicious, satisfying and anti-inflammatory as well.
  3. Dinner was fish (Smoked trout, smoked salmon, seared grouper) and a half avocado.
  4. Vodka with dinner with a squeeze of lemon and a bourbon after.
  5. A few ounces of mixed nuts (not more than two oz. a day) to provide something crunchy whenever willpower waned.


  1. The program was easily tolerated as compared with the water fast.
  2. I lost 10 lbs in five days. I lost 12 lbs on water only in the same timeframe. Historically four pounds come back when eating begins. My first normal meal will be dinner tonight.
  3. The pants that were uncomfortably tight five days ago are now comfortably loose.
  4. My energy level was extremely high for the five days. This makes evolutionary sense. When your body senses almost no food coming in, it wants you to get into high gear and go kill something. If fasting goes on too long, your body concludes there must be a famine and so it dials your metabolism way down to conserve.
  5. My experience with fasting shows that there is a huge boost to growth hormone when feeding resumes and thereby muscle is packed on.
  6. The work of  Dr. Valter Longo on the fast mimicking diet suggests that I should enjoy most of the biological benefits conferred by water fasting. The list is a long one. Google Valter Longo and the fast Mimicking Diet to see the full list.


I have no idea how safe this way of eating (not eating?) is. I tolerated it fine but you may not. I would suggest being under the care of a good functional medicine doctor before trying it. I also suggest getting before and after lab work done to see how any personal risk factors are changed by doing this. I have labs schedules. if the numbers move in the right direction, I will put this plan on my calendar several times a year.

McDonald Family Rx Lucky Part 13 Self Imposed Starvation

Why the heck would someone who loves food as much as I do stop eating for almost a week? The answer has to be a really good one because I have done it twice and I’m “fixing” to do it again.

The answer(s) to that question came from a lot of reading/listening and studying I have done. Three researchers I will point you to are Dominic D’Agostino, Peter Atilla and Valter Longo. These are all serious researchers not lightweight dilettantes like me. You can go to the actual medical literature as I have. As an intro, I have placed links below to podcasts and YouTube videos as a more accessible form of study.

Dom D’Agostino on Fasting, Ketosis, and the End of Cancer


Dr. Rhonda Patrick Is the person who interviews Valter Longo.  She is maybe my favorite geek on earth. I watch every video she produces, I read every blog she writes and I listen to every podcast she produces and every interview she gives.

If you study all of the resources above, you might find reasons to fast that are different from mine. Here are mine:

  1. I like losing 12 pounds in 5 days. I regain 4 pounds when I start eating again but the other eight stay off if I eat and exercise normally. I do not, however, remain on my normal eating and exercise program. We just vacationed for 21 days during which we had access to food we cannot get in Alabama. In Nova Scotia, we had Lobster Rolls for breakfast and a Lobster dinner that night. We had craft-brewed beer, great croissants, fabulous bread, banquets with family and friends. We ate and drank everything and put on a few pounds that will come off with the next fast.
  2. I like knowing that eating is optional. Not eating is like a super-power. If you spend your whole life thinking about the next meal, it is liberating to think that there does not need to be a meal today. I can see how some people can end up with a severe eating disorder when they feel this power so be careful. Observing the world of food without eating is an incredible mindfulness exercise also.
  3. I like the long list of health benefits from improved lipids, improved insulin sensitivity, new stem cells, clean up of senescent cells and the boost of growth hormone that occurs when you start eating again. The fat loss combined with the GH boost changes body composition in the right direction. There is even reason to believe that fasting delays or prevents age-related mental decline and cancer.

There is no free non-lunch however. Fasting may be risky for some people. Find a doctor who will help you to decide if fasting is for you. Fasting causes you to burn your own fat for fuel. In essence, you will be going on the highest fat diet ever invented. Human fat is the place we store all sorts of nasty things like heavy metals so you may get sick from consuming your own fat. I routinely eat a low carb diet so I shift easily into the “butter burner” mode. Others struggle the first two to three days making the shift. I am mildly uncomfortable just the first day.

Not eating is a pain in the neck for other people. When I am not eating I cannot cook for others. The act of cooking with all of the sights and smells makes me hungry. I can sit with others while they eat. You might not be able to comfortably do that.

Food is a major source of entertainment for me. Everything from menu planning to shopping and cooking is fun for me not to mention eating wonderful food. As the fast goes on, I miss the whole process a lot.

I call my fasts “water fasts” but I do consume other things. In the morning I have coffee with heavy cream. The heavy cream is pure fat so I do not interfere with the butter burner mode my body is in and it is a treat that I look forward to each day. I also drink flavored seltzer form La Croix. I allow myself one diet coke a day and I drink tea occasionally. I also have slipped in a cup of bone broth on occasion.

I use two supplements that I would not attempt the fast without. The first is KetoCaNa. I have one scoop in a large glass of water in the morning and a second in the afternoon. This boosts my ketones immediately which kills my appetite and keeps my energy level high. The second is an electrolyte replacement drink I make using the juice of one lime, 24 ounces of water and a quarter teaspoon of Morton’s lite salt. I have two of these a day also. I also drink plenty of water in addition to everything above. You will be flushing out a lot of toxins so pushing the water is key.

Dierdre asked if fasting kills metabolism. The answer is no if limited in duration. What does kill metabolism is calorie restriction long-term. Think about this from the perspective of our hunter-gatherer ancestors. If food is cut off suddenly it means you need more energy immediately to go on a successful hunt or to relocate to a place with food to gather. 12 pounds is equal to 42,000 calories or 8,400 calories a day for five days. Or take the net eight pounds lost. That still works out to 5,600 calories a day. Those burn rates are in lumberjack territory. My normal metabolism is in the 3,000 calorie range.

If water alone is too much to ask, you might want to try Dr. Valter Longo’s fast mimicking diet (FMD). It is about 600 calories per day so at least you get something to eat and drink. He claims to produce all of the same health benefits without going to near zero calories.

McDonald Family Rx Part 12 The Good Stuff

When buying supplements you are trusting a supplier to provide what the label says. the FDA is way too focused on other things to crack down on supplement sellers so brand names become our first line of defense.

Fish Oil: The best bet is to get a prescription for Lovaza or its generic equivalent. prescriptions are much more tightly regulated. If you must buy OTC fish oil, Krill oil is a good bet because Krill live in the cold southern oceans which are relatively pure.

Amazon is a new brand name in supplements. They provide a copy of independent lab analysis of their products. In addition, they are very competitively priced. They are my new go-to source if they make the product I am looking for.

Qunol is the brand of CoQ10 I buy

Sports Research is the brand of K2 + D3 I buy

Pure Encapsulations is recommended by my doctor. Their formula for MTHFR (Homocysteine factors)has a great combo that would take five pills to replicate.

Thorne, Now Foods and Life Extension are all good brands as far as I can tell.

Olive oil quality is something to be as concerned about as supplements. I just finished a book titled Extra Virginity The Sublime and Scandalous World of Olive Oil. This book details the worldwide organized crime network that sells counterfeit Extra Virgin Olive oil (EVOO). Genuine EVOO has major health benefits that include reducing inflammation, reducing bad and increasing good cholesterol. EVOO is the basis for the Mediterranean diet that is best for McDonald genes. EVOO is also darn delicious and it produces satiety. Satiety is the sensation of having enough to eat. EVOO keeps hunger away for hours. If you learn to taste olive oil, you will be able to tell junk from the good stuff. Go to one of these shops that sells nothing but vinegar and oils where they have little cubes of bread for tasting. Taste unflavored EVOO. The good stuff has a distinctive sharp taste that also produces a little catch in the back of the throat. Color is meaningless. great oil can be a rich green or a pale amber.

You should also know that olives are harvested once a year. This means that at some point you will be consuming oil that is at least a year old unless you buy oil from both the northern and southern hemispheres. Keeping oil from deteriorating means keeping it away from heat, oxygen, and light. I have found an importer in Pensacola Florida who buys shipping containers full of oil from Crete. He has it packed either in cans or in the same packing device as box wine. I buy the box wine packaging because it is opaque and as the oil is consumed the bag inside collapses and allows no air to enter. I buy five-liter boxes and I buy three at a time to get a case discount. To my taste this oil is pristine. He ships. Shipping is free on orders over $100. Buy three five-liter boxes and you will get free shipping. The website is below.


McDonald Family Rx Part 11 Pills and Shots (Cont.)

Just a practical note before I continue the list. I use pill sorters that have seven days with AM and PM. I have four of these so I only need to sort pills once a month. After I fill them I wrap them in plastic wrap and store them in plastic bags because the humidity in Alabama can be absorbed by pills ruining them and making a mess.

Homocysteine Factors by Pure Encapsulations 1 Capsule Daily

This capsule contains four ingredients for dealing with the MTHFR defect and it is from a reputable supplier. You get an active form of B6, Methylfolate, methylcobolamin, and trimethylglycine.

Red Rice Yeast 1200 mg, two capsules morning and two evening

I am taking this instead of a prescription statin. I had a classic reaction to statins in the form of muscle pain, lack of exercise tolerance and brain fog so the doctor switched me to red Rice Yeast. I am ready to test statins again using a different drug and a smaller dose. When I do the Red rice Yeast will go away. I think our family history warrants statins but they should be used int he context of all of the other recommendations for max effect.

Beta Sitosterol 800mg

Lowers LDL and has a rather long list of other possible benefits.

Fenofobrate 160mg (Prescription Drug)

Cuts risk of heart attack in half. Reduced bad cholesterol and triglycerides while raising HDL.

Levothyroxine 150mcg (Prescription)

Thyroid hormone replacement for a thyroid gland gone missing.

Omega 3 Acid Ethyl Esters 1 Gram 2X a day (Prescription kept refrigerated)

Omega 3 fatty acids are extremely important for brain nerve and heart health. Eating small fatty fish harvested in the wild from cold waters could provide all you need. If like most people you are not eating sardines daily and you can get your doctor to prescribe Omega 3s, you will be getting many benefits. These gelcaps have cut my triglycerides in half and they serve to reduce platelet adhesion and therefore the formation of clots that cause heart attack and stroke.

Methylcobolamin 5mg injection One shot IM weekly (Prescription compounding pharmacy, must be refrigerated and kept in the dark)

Call it placebo effect if you wish but I feel so much better when I get my shot weekly. If I run out and have to wait a few days for a shipment, I experience a noticeable decline in wellbeing. Sub-lingual forms of methylcobolamin may work just as well. I have no way of converting my dose to oral because I am not sure how the rate of absorption of oral forms. Injection into a muscle means 100% absorption. Some people cannot bring themselves to self-administer injections. The inconvenience of refrigeration and injection paraphernalia might be enough to motivate most to seek other forms of delivery.

I am considering adding some things to this list when I drop the red rice yeast and go back to statins. Right now my pill sorters are maxed. I am conducting what is known as an “N of One” experiment constantly. The “N” refers to the number of subjects in an experiment. The more you have the more confidently you can generalize to a larger population. N of One experimental results apply to one person and no generalizations are scientifically possible. I generally change something with my doctor’s concurrence about a month before my next round of blood tests. that way I can see if I am moving in the right direction of not with the change. One challenge I am struggling with is competition between treatments for lipid problems and treatments for elevated homocysteine. The two tend to fight each other. For example, high dose Niacin is great for cholesterol by bad for homocysteine. I’ll keep tweaking and tuning and let you know what works for me.

N of one experiments also do nothing to control for dumb luck. Have I lived 14 more years than my dad and 18 more years than my brother because of all the crazy supplement, exercise and diet things I have done? Who knows? Joe is the one who should be writing this blog since he has me beat by 15 years and he still plays a mean game of tennis.

McDonald Family Rx Part 11 Pills and Shots

This is probably the only post you will read. I probably could have written this first and skipped the rest. The reason this is so far into the posts is that the basics need to be in place. No fistful of pills will compensate for lack of activity and a crap diet, a life filled with stress and lack of relaxation etc.

Caveat Emptor: Because I use it does not mean that you should. What works well for me may not for you. Interactions with other things you are taking can cause problems. I have based my choice of what to take on my best understanding of the best current science. My understanding could improve tomorrow and I may change my mind. Science may improve tomorrow and change my mind. There is no substitute for the personalized medicine approach taken by a functional medicine practitioner that knows how to use both prescription and nonprescription substances in an integrated fashion.

For each of the substances below, I will list the substance and dose in bold and below it, I will describe why I take it and what it does. I take a lot of stuff so I will probably break this into multiple days of writing.

K2 100 mcg + D3 125 mcg

If you are young and spend an hour a day buck naked in full sunlight you do not need to take vitamin D. If you wear clothes and sunscreen and spend a lot of time indoors your ability to produce Vitamin D naturally is severely impaired. If you are over 50 your ability is reduced to half that of a younger person. D3 is actually a hormone that is involved in too many biological processes to list but they are all important. Two of note are immunity and calcium absorption. The immune system requires D to function properly. Your immune system not only deals with the common cold but also with the job of killing mutated cells that can grow out of control (cancer). K2 is important for directing calcium to the proper location in your body (bones) and away from the wrong places (artery lining). A blood test for vitamin D levels should be part of your annual checkup so that supplementation can be adjusted up or down as needed. Too much can be bad.

Magnesium Citrate 400mg

Just about everyone is magnesium deficient because they do not eat abundant quantities of green leafy vegetables and because the vegetables they do eat are grown in magnesium depleted soil.  Magnesium promotes regular bowel movements and relaxed muscles throughout the body. Muscle cramps are a common indication of deficiency.

High Absorption Curcumin 500mg twice a day

Lowering inflammation is a daily challenge. I leave nothing out in this battle. Curcumin is a derivative of the turmeric root. Absorption is improved by consuming it with a substance found in black pepper. the form I take includes this substance.

Alpha Lipoic Acid 600 mg

Powerful antioxidant that supports metabolism and cardiovascular health.


This substance is important to cardiovascular health. Supplementation can have a significant impact on your lipid profile. Everyone taking statins must take CoQ10 because the same mechanism that reduces cholesterol production inhibits CoQ10 production.

To be continued tomorrow.

McDonald Family Rx Part 10 Chill Out on Labor Day

A degree of physical, mental and emotional challenge is necessary for life and the development and preservation of function but there is a limit. Once that limit is crossed you move from stress to distress. Distress has significant deleterious effects on all aspects of health and needs to be avoided.

Here are some simple things you can do to avoid distress:

  1. Recognize that distress is an inside job. it is not the reality around you but your reaction to the reality around you that determines if you chill or stress. A good cognitive behavioral therapist can teach you how to change the story you are telling yourself about the events around you and thereby produce a more functional and less distressed response. For example, when you are stuck in traffic, you could hug the bumper in front of you, grip the steering wheel until you leave indentations in is and ratchet your jaw down until you have TMJ pain while cursing drivers, road designers etc or you could say “Cool, a chance to listen to my podcasts or that audiobook I have wanted to start”. The same reality with very different outcomes.
  2. Build in opportunities for your parasympathetic nervous system to take over. The sympathetic nervous system is involved with vigilance, fight, and flight. It winds you up. Your parasympathetic nervous system winds you down. the two need to be in balance so you do not get stuck with your foot on the gas all the time. Meditation, yoga, mindfulness exercises, massage, hot tub soaks with relaxation music etc. all work to activate the parasympathetic nervous system. Regular meditation can transform your physiology and mind in profound and desirable ways. Try the phone app “Headspace” for an easy introduction to meditation. We love to use it while floating in the pool. I connect my phone to a waterproof Bluetooth speaker. Headspace is free for the first few beginner sessions and then it has an annual fee. It is cheap medicine.
  3. Spiritual practices that fit your belief system can be extremely helpful also. Sitting quietly in a place of worship. Prayer and meditation can be very powerful.
  4. Getting out into nature, walking or cycling in the woods or along a beach have been scientifically proven to have a desirable impact on stress.
  5. Quality time with people you love is one of our favorites and it needs no explanation.


McDonald Family Rx Part 9 Curing MB

The dreaded McDonald Belly (MB) is both a cause and an effect. It is insidious because you do not need to be otherwise fat to have it. Our doctor calls it being “skinny fat” because it is possible to slim down and yet hang onto visceral fat. I identify it as both a cause and effect because it is the result of insulin resistance and it is a cause of insulin resistance. It is the result of inflammation and it is a cause of inflammation. It is an effect of other out of whack hormones and it is a cause of out of whack hormones. It also has a similar relationship with high triglycerides and other lipid issues.

Because of the chicken and egg character of the problem, MB is a formidable foe. Your ability to defeat it will be determined by how committed you are to a long “healthspan”.  The war on MB will be more like trench warfare than a blitzkrieg. The MB does not form overnight and it will not go away overnight. I have not found a particular genetic anomaly you can look for on your 23 and Me results that is responsible for the MB. The MTHFR defect could certainly be a contributor if not the outright cause.

The difficulty in sorting out the problem is that close family members share both genes and experiences. We grew up eating the same foods and developing many of the same tastes and habits. Is nature or nurture responsible for the MB? The other difficulty is that we live in the United States in an era of prosperity where food is abundant and ubiquitous. Our parents lived through two world wars and a depression and only later in life did they experience McDonald’s hamburgers and convenience stores at every intersection. Our parents also expended far more physical energy to accomplish everyday tasks. Mom washed clothes in a bathtub using a scrub board and she hung them out to dry on a line. She then ironed almost everything. How many calories a week did that burn when she had four small children and our dad to care for. Mom also talked about living with no central heat. We now know that chronic exposure to cold produces “brown fat”. This fat is loaded with little energy factories called mitochondria that will provide the heat needed through a cold winter.

The reason I saved this topic until now is that MB will only be defeated by doing everything covered in the last eight posts and more. Insulin resistance and inflammation must be effectively managed. Hormones must be balanced by a skilled doctor working with you until your body is functioning correctly. You will need to be disciplined in your eating habits long term. No short-term fix will get the job done.  Fasting works wonders for me but only in the context of a healthy Mediterranean diet, day in and day out. Activity that builds muscle and causes you to sweat, stretch and breathe hard is also essential but if you go from sedentary to active too abruptly, you are likely to get injured or worse.

Age and alcohol are two additional factors that pump up the MB. Nothing can be done about the first but the second can be managed. The debate about alcohol being good or bad for you is ongoing. I prefer to believe the people who say red wine is good for you. Moderation is the challenge. We eliminated all alcohol for 21 days when we did the elimination diet. That experience forced us to seek out other adult beverages that do not contain alcohol. I now brew caffeine free kombucha that fills that slot.