Marks Daily Apple
Serving up health and fitness insights (daily, of course) with a side of irreverence.
14 Sep

A Doctor Finds Primal Balance

It’s Friday, everyone! And that means another Primal Blueprint Real Life Story from a Mark’s Daily Apple reader. If you have your own success story and would like to share it with me and the Mark’s Daily Apple community please contact me here. I’ll continue to publish these each Friday as long as they keep coming in. Thank you for reading!

Dear Mark,

I’m a physician and budding blogger, and I’ve been a fan of MDA for a few years now. You are my blog-crush, always combining the perfect blend of serious scientific information with colloquial content. Primal living is about much more than just what we eat and how we exercise, and your posts always reflect that!

My story begins around the time I found your site and your book, The Primal Blueprint. A bit of background: I’m a very tall (over six feet) woman who was raised on Conventional Wisdom and the Standard American Diet, replete with Oreos for breakfast, bologna sandwiches for lunch, and spaghetti for dinner with Cheetos and Hostess snack cakes thrown in between! In high school, I was heavily recruited for athletics due to my height but was never courageous or confident enough to learn how to play sports. I focused more on my schoolwork and music studies, and I couldn’t have cared less about what was going on with my body. This all changed when I met my husband in my freshman year of college: a very tall and athletic rock climber who inspired me to exercise and learn more about health and fitness. My newfound love of fitness grew through our climbing adventures around the world, and it eventually prompted me to pursue a career as a physician.

Fast forward to 2007 and the transition from medical school to Anesthesiology residency, where I felt the healthiest and fittest I had ever been. The future was bright with possibilities in all sorts of outdoor athletics and my budding career as a physician. As many MD trainees do, I had developed some bad habits related to food – like eating junk because it was free and available at the time you encountered it, as you never know when you’ll again have time for your another meal. Ironically, the medical establishment perpetuates these habits by providing the unhealthiest food free for the taking during our required lectures and call shifts… doughnuts, cookies, pizza, you name it. But for a year or so, this poor eating style failed to affect me much and I was able to keep a semblance of fitness. The Chronic Cardio queen that I had become kept slogging through post-call runs, group exercise classes, or rides in an effort to “stay fit” and counteract my poor nutrition with the math of “Calories In, Calories Out”.

When I started my specialty training in Anesthesiology, I began to feel the effects of chronic stress on my body and mind. While I couldn’t put a finger on it at the time, in retrospect I was not myself. I began to suffer depression, sleep disturbance, and a general lack of vigor that affected my work and relationships. I suddenly hated going rock climbing. My poor eating habits worsened in a vicious cycle of treat/reward and overexercise/remorse, and my then 35 year-old body started to show the effects. My previously “toned” (read: skinny-fat) body that could handle eating a half box of Lucky Charms after each step class was slowly becoming fat-fat. Being tall, this wasn’t too noticeable to the outside world, but I fell into an even deeper pit of self-loathing.

And yet… I continued to chow down on free hospital doughnuts, cookies, and cake at all hours of the day or night. I tried severe calorie restriction with “cheat days”, but the cheats turned into huge binges and the frequency increased from once a week to every other day! My cravings for sugar became insatiable. Any exercise I did in attempts to counteract this out of control situation was deteriorating in quality. In fact, I began to suffer an incredible fatigue that left me needing a nap after even a short walk. Getting up for an early morning cases in the OR became a daunting task.

I knew deep down that something was seriously wrong, but I chocked all of these changes up to my stress level and the general process of aging. The only “medical” manifestation I could report to a doctor was the absence of my period for the past several months. After much laboratory testing, it was decided that I had stress-induced amenorrhea, which was basically akin to saying that I had self-inflicted menopause at age 35. I was devastated! My estrogen levels were so severely low that I had started to show the signs of osteopenia on a bone density scan. A 24-hour urine study revealed high levels of calcium in my urine. My thyroid labs were out of whack. There was talk of scanning my head for tumors, which I immediately shirked. At the time, it all seemed like a ridiculous, far-fetched Zebra chase!

With the blessing of my residency directors, I took a leave of absence from my training program to embark on a mission: to fix my body through effective stress management and self-care. That’s when I embraced MDA, The Primal Blueprint, and other primal teachings from people like Nora Gedgoudas and Robb Wolf. My husband, being the early adopter that he is, was already fully on board with Primal eating… but I loved me some baked goods that I had not been able to part with! I learned meditation, completed a silent yoga retreat, internet/phone fasts, and a Primal 30-day Challenge during this time. I vowed to share what I had learned about the under-addressed areas of stress management and self-care with other professionals through a blog, now dubbed

After sufficient time for rest and learning these self-care techniques, I returned to work feeling (mostly) rejuvenated. My mind felt much calmer, but my body still continued to battle cravings, fatigue, and weight gain. My period still hadn’t returned, and some of the medical procedures that I perform as part administering anesthesia (especially those that involved visual-spatial skills) seemed to be lacking. I ran into my own doctor one day at work, who upon hearing my persistent troubles, insisted that I finally get a brain MRI. There it was… larger than a marble, a tumor shaped like a little octopus with its head pushing up into my midbrain and its tentacles wrapping around my optic nerve! I was both devastated and elated… maybe this was the key linking my strange, nonspecific chain of problems!

It’s been a little over a year since I had brain surgery to remove the tumor, which turned out to be a benign pituitary adenoma. After a long hospital stay with horrible headaches and even a re-admission for dangerously low blood sodium levels, I was left weak, bloated, and at my heaviest weight ever. My pituitary gland is still unable to signal the correct amount of cortisol production, resulting in the need to take steroid medications, and I have permanent peripheral vision loss in one eye. However, I am so grateful to be cancer-free and have essentially normal function. Being a patient in an ICU is an experience that I will never forget, and it has shaped my practice as a physician. I slowly became stronger while trying to take care to not get sick while finishing the final months of my residency program.

(Before and After pics above. Hover for caption.)

Since graduating from residency and transitioning to Anesthesiology practice, I have renewed my pledges to stress-management and self-care by embracing the Primal lifestyle. My high-protein, moderate carbohydrate Primal Blueprint diet leaves me satisfied and without insatiable sugar cravings, I lift heavy things 2-3 times per week, sleep an average of 8 hours a night, and take long walks with my husband and dog. I started rock climbing again this spring, and I recently completed my hardest climbing level in years! provides me with a creative outlet and a means to share my experiences with others. My weight is down 35 pounds from my heaviest point, my pants are two sizes smaller, and my body fat has decreased by almost 10%. I don’t just feel like my “old self” again; I feel stronger and better than I ever have!

You want comments? We got comments:

Imagine you’re George Clooney. Take a moment to admire your grooming and wit. Okay, now imagine someone walks up to you and asks, “What’s your name?” You say, “I’m George Clooney.” Or maybe you say, “I’m the Clooninator!” You don’t say “I’m George of George Clooney Sells Movies Blog” and you certainly don’t say, “I’m Clooney Weight Loss Plan”. So while spam is technically meat, it ain’t anywhere near Primal. Please nickname yourself something your friends would call you.

  1. WOW what a fantastic story I’m so glad you have made a full recovery from your brain tumour operation.

    Best of luck in the future

    Best wishes


    kim wrote on September 17th, 2012
  2. Go on a ketogenic diet if you want to keep your cancer from growing back.

    Read Nick Lane’s Power, Sex, Suicide if you want to know why (and if you want to geek out on mitochondria); also read Gary Taubes’ modern classic, Good Calories, Bad Calories – chapter 13 he talks about IGF (Insulin-like Growth Factor).
    Taubes is something every MD and health researcher (and every nerd) should read.

    Fruit flies are often studied for their genetic resemblance to humans. Ever heard of a fruitfly getting childhood leukemia? Ever seen a thousands-years-old tree get leaf cancer? Why is it that humans are the only multi-cellular organisms that can die of cancer? How does cancer even manage to kill a multi-cellular organism when making sure cells don’t rebel is a primary function of being multi-cellular?

    Answer: cancers plant the seeds of their own destruction when they deactivate their mitochondria to block programmed cell death. Without the ability to burn fat or ketones… or even sugar at an efficient rate since they only use sugar fermentation (& eat the by-products for a little extra energy), they are doomed to failure and destruction by well-fed white blood cells that use cellular respiration.
    UNLESS… said cancer becomes ultra insulin sensitive by building large amounts of insulin receptors & you eat a shit-ton of carbs and fuck up your carb metabolism, and in the process generate insulin that will degrade IGF-binding protein, ensuring that cancers get enough growth hormones to not die, AND that said cancer is now getting the only energy source it can eat, in spades. This is especially true if, like I said, your carb metabolism is messed up and your non-cancerous tissues are already insulin resistant… because cancers don’t get insulin resistant.

    The radiologists that scanned your cancer injected you with a radioactive glucose molecule… because they know the glucose will be taken up in excessive amounts by your cancer, and the radiation will show them exactly where it is.

    mm wrote on September 18th, 2012
    • Don’t forget to look up at the ceiling, wave your fist in the air and yell, “Damn you, Warburg Effect!”

      mm wrote on September 18th, 2012
    • Googling “do fruit flies get cancer” will yield this as first result:

      “[…] but fruit flies — which in nature actually never get cancer themselves […]”

      mm wrote on September 18th, 2012
      • Thanks for your comment. I have been thinking about this, and I’m going to try starting with cycling in ketogenic days.

        PracticeBalance wrote on September 19th, 2012
  3. Awesome story, love your blog too. I am curious- I very similar symptoms to you and I had prolactin levels tested that came back normal…but you said your results were also “normal” and it was only the insistence of another doctor to get an MRI that detected the tumor? Did you have headaches along with lacking visual spacial skills?

    Michelle Bunderson wrote on September 21st, 2012
    • Thanks for your comment! I did not have headaches, and you are correct I had normal prolactin. So keep vigilance if your symptoms persist!

      PracticeBalance wrote on September 21st, 2012
      • Thanks for replying- appreciate it. I am still having symptoms so I am going for an MRI next week.

        I feel a bit paranoid but I had some lab tests done and found out the my TSH is back up despite being on meds(I have hypothyroid) and my estrogen levels are low as well as elevated testosterone. My hair has been falling out like crazy, I am SO fatigued and I have gained significant weight in the past few weeks- and still no period for 7 months. I am just beside myself with anxiety which doesn’t help.

        Did you have any of these types of issues? The problem is that I live in Africa where the medical system is severely lacking-so I am going back to the States at the end of the month for more testing.

        I really want to get the most out of my trip back so do you have any other recommendations for me- who to see, what types of tests to have my doctor order etc.? I am going to see a Paleo Doctor and also signed up with a Certified Holistic Nutritionist- but she basically doesn’t think that is is very diet related as I have been extremely clean with my eating, but she wants me to do an Adrenal Stress test as well as GI Analysis.

        Any help or advice on what to look for would be so helpful, thanks again.

        Michelle Bunderson wrote on October 18th, 2012
        • Michelle, I recommend you schedule an appointment with an endocrinologist while you’re here, and don’t be afraid to get a second opinion. I hope your trip to the US brings you the answers you are looking for!

          PracticeBalance wrote on October 19th, 2012
  4. I am a night shift nurse for the last 17 years. I gave up gluten, dairy and soy. Due to health problems. I lost 40lbs and have kept it off for four years. I am trying to give up coffee and sugar. I do exercise couple times a week. I practice meditation and go to Unity church. Most nurses are over weight and have a lot of health problems. I made a diet change. I didn’t go on a diet. Gluten made me sick.

    Lori Bernardo wrote on September 24th, 2012
  5. An interesting and inspiring story for sure. I’m going to read your blog now. I just heard about the paleo diet this week so I’m brand new at it. I was pretty much a vegetarian most of my adult life, but my guts were always bothering me. I had sore joints plus I need to lose a few pounds.

    Over the years, I’ve been told by naturopaths and chiropratics to eat meat, but I’ve resisted because of the fat, and the animal cruelty involved. I really didn’t believe that eating meat was healthy, but I’m starting to. The poor little animals though. It’s so sad. But whadda do?

    I think your little belly looks great in both pictures. I wish mine was as pretty as yours! Maybe some day it will be as my carb consumption is almost nil now, except for what I get from vegetables. I’ve been working out with free weights too and in just three weeks I’ve noticed a big change.

    I do crave bread, cheese, ice cream, caramel, you name it, anything that’s sweet and gooey. Thank you

    Sienna wrote on September 29th, 2012
  6. Great article! Very inspiring! I love how you thrived in a difficult situation

    womens fitness program wrote on November 30th, 2012

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