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Hello everyone.

Greetings from Dallas where the weather is quite beautiful but windy.

Comments from Readers

I received a vaccine comment from a lady that I thought was extremely pertinent. Here it is in part.

I’ve spent most of my time writing and researching on childhood vaccines and mRNA Covid vaccines. No one taking the former would be reading this newsletters (thought their parents might), and I doubt many (with good sense at least) are taking the later.

So this lady’s suggestion is a terrific one. Let’s start out with shingles.

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Shingrix for Shingles

For those who don’t know, shingles is a disorder fairly common to elderly people who have had chicken pox in their youth (which means almost everybody). After their spots fade, the chicken pox virus migrates up the nerves and hides out in the nerve roots and ganglia. The virus hangs out there held in check by the immune system.

As our patient ages, he/she has a fall off in immune function that, sadly, is a part of aging. Everything functions a little less well over time, the immune system included. Sickness, stress, aging itself, cancer, and any number of stresses can allow the virus to migrate back up the nerve and cause a breakout.

The pattern of the blisters runs from the center of the body toward the side, which is the distribution of the nerve. If the blisters stretch across the centerline of the body, it probably isn’t shingles.

I did a pretty deep dive on the Shingrix, the shingles vaccine available now. The first thing I wanted to know about it was, of course, was it tested under placebo-controlled conditions. As it turned out, the test was placebo controlled with a real placebo. According to the paper describing the study

The vaccine does have an adjuvant.

Along with the Recombinant Varicella Zoster Virus Glycoprotein E (gE) Antigen (the active ingredient), the injection contains the AS01B Adjuvant System. Here’s what it says about it.

This adjuvant enhances the immune response to the gE antigen. It contains Monophosphoryl Lipid A (MPL): A detoxified derivative of lipopolysaccharide from Salmonella minnesota, which activates innate immunity through Toll-like receptor 4 (TLR4) signaling. QS-21: A saponin extracted from the bark of the Quillaja saponaria tree, which boosts both humoral and cellular immune responses by stimulating antigen-presenting cells. And liposomes: Composed of dioleoyl phosphatidylcholine (DOPC) and cholesterol, these serve as a delivery system for MPL and QS-21, ensuring their stability and effectiveness.

The adjuvant more or less fires up the immune system to react against the antigen, the Varicella Zoster (chicken pox) virus.

How safe is Shingrix?

Within the first few days after the vaccine, recipients experience the following mild reactions:

• Local reactions: Pain (78%), redness (38%), and swelling (26%) at the injection site.

• Systemic reactions: Fatigue (44%), muscle pain (45%), headache (38%), shivering (27%), fever (21%), and gastrointestinal symptoms like nausea (14%).

Some had worse side effects.

• Grade 3 reactions: About 17% of recipients experienced severe side effects that temporarily interfered with daily activities, such as intense fatigue or muscle pain.

• Guillain-Barré Syndrome (GBS): Post-marketing studies identified an increased but rare risk of GBS, with an estimated 3–6 excess cases per million doses administered.

• Severe allergic reactions: Rare but possible, including hives, facial swelling, difficulty breathing, or dizziness.

According to the literature, subjects taking Shingrix or placebo suffered the same degree of Serious Adverse Effects.

• 2.3% for Shingrix vs. 2.2% for placebo within 30 days of vaccination.

• Over one year, SAEs occurred in 10.1% of Shingrix recipients compared to 10.4% in placebo recipients, consistent with the general population's health conditions.

I couldn’t find the specific serious adverse events in the paper containing the above, so I went to the package insert.

I looked up the effectiveness of the vaccine, and based on the numbers I found, I figured they were listing the relative risk and not the absolute risk. But, have no fear, I found the absolute risk.

Here is what they want you to see.

Effectiveness in Healthy Adults:

• Ages 50–69: Shingrix is 97% effective in preventing shingles and 91% effective in preventing PHN.

• Ages 70 and older: It remains 91% effective in preventing shingles and 89% effective in preventing PHN

  (PHN is postherpatic neuralgia, which is pain after the blisters are gone.)

The numbers above are relative rates of effectiveness. I looked up the absolute rates in the paper linked above.

What this means is that of each 1,000 people getting the vaccine, 0.3 ended up with shingles whereas in each 1,000 receiving the placebo, 9.1 ended up with shingles. What it really means is out of every 1,000 people, 9.1 are going to get shingles. That’s what you’re odds are of getting the disease. That’s the figure you should use to determine whether or not you want to take the jabs. Your odds are ~991 out of a thousand of not getting shingles if you don’t take the vaccine.

Long-Term Effectiveness Shingrix maintains high efficacy over time:

• It remains 73% effective after four years, based on real-world studies.

• Long-term data show that its efficacy can stay above 79.7% for up to 11 years after vaccination.

Single vs. Two Doses

• A single dose is less effective, providing only 64–76% protection, with significant waning over time.

• Completing the recommended two-dose series ensures maximum and prolonged protection.

Now there is a new twist to the Shingrix story.

Yet another study has been done which is a clever take on a randomized-controlled trial. It’s about as close as you can come. The study was done at Stanford and the researchers looked at how many people developed dementia after taking the Shingrix shots compared to those who don’t.

As it turned out, fewer of those who took the Shingrix vaccine developed dementia than those who didn’t. A fifth more, in fact. The researchers involved made an nice video about the research.

Much more needs to be done to figure out where this effect comes from. One thing the researchers do know, is that is it much stronger in women than men. Given the strength of the showing, I’m positive much more will be coming forth on this in due course. Here is the Nature paper on the study for your review.

You may ask whether I’m going to take the vaccine or not. My vote right now is no. I’ve got a zillion elderly relatives and none, as far as I know, have come down with shingles. So I think my odds are pretty good.

But if this dementia prevention work turns out to be as good as it’s looking, I may take the shots just for that.

Let’s take a look at another adult vaccine. This one will be short and sweet.

The Latest Flu Shot

This year’s flu vaccine should be avoided, unless it’s a case of the flu you want. Then, by all means, take the shot.

The Cleveland Clinic volunteered its many employees to determine the effectiveness of this year’s flu vaccine.

A vaccine effectiveness of -26.9 percent, means that 26.9 percent of those vaccinated ended up with the flu. In my view, it would best be avoided.

More on Dr. Peter Marks

I have a reader who has worked (or tried to work) with Dr Peter Marks, whom RFK, Jr. just canned. I’ve read multiple articles recently about how Dr. Marks refused to let RFK, Jr. look at the Vaccine Adverse Events Reporting System (VAERS) records. I would have fired him on the spot, too.

Although I don’t know Dr. Peter Marks, one of your fellow readers does. Here is the comment he posted about having to work with him:

Dale, the author of this comment is an ex-marine helicopter pilot who shifted careers in the military from flying helicopters to being a lawyer. He’s since retired from the Marines, but is suing the military on behalf of many personnel from all the services who were issued the vaccine mandate and refused to comply. They were all discharged and lost considerable in terms of retirement and other benefits.

Based on Dale’s work with soldiers forced to take the experimental anthrax vaccine from years before, he was sought out for Covid.

I told him I thought Trump had executed TROs to give all those folks their bennies back. But apparently that wasn’t the case.

He ended up our back-and-forth with this.

I’m fervently hope we’ll be seeing people prosecuted over all this. It will have taken a while, but revenge is a dish served best cold.

Years ago when Dale was working as a lawyer for the military he was assigned a case in which a handful of military from the various services were either in the brig or headed for the brig for refusing to take an experimental anthrax vaccine. He ended up defending these guys against Uncle Sam.

He wrote a book about it that I loved. He gets into all the chicanery involved in suing the government—I’m surprised more people don’t off themselves when they get stuck so deeply in that tar baby. Give his book a read. It is really good.

I also put a link down by my recommended newsletters for Dale’s Substack, which is wonderful. Please take a look.

Thyroid and Low-Carb, Ketogenic Diet

I’ve gotten a bunch of emails over the past few weeks about thyroid and thought I would write a bit about it. A year or so ago, I got a flurry of emails on the same subject and intended to write on it then, but had other things on my mind. Then the thyroid emails dried up, so I kind of forgot about it until this new bunch of emails came in.

People are concerned when they go on a low-carb or ketogenic diet and discover their thyroid hormone levels have suddenly fallen off. There is a pretty simple explanation for it, but there is also a different variation on the typical explanation. I’ll go through both and also explain why you might find your thyroid stimulating hormone (TSH) level go up as you age. And I’ll clue you in to how my own doctor might have come close to doing me in on thyroid medications.

Before we get into how this all works, let’s review all the working parts of the hypothalamic-pituitary-thyroid (HPT) axis. I looked at innumerable graphics on the web trying to find a simple one to show what this axis looks like. Every one I found was either was way too complex or way too simplistic. All I wanted was one showing the basics. You would think that would be an easy find. Nope. Made me realize I should have been a medical illustrator.

I ended up buying an image. It isn’t perfect, but it’s better than any other I found online.

Okay, let’s walk trough this. At the very top you see the hypothalamus identified. Hanging right below it is another gland, the pituitary gland. There is a semi-circular blue arrow with a big bubble on it containing the letters TRH that goes from the hypothalamus to the pituitary gland. TRH stands for thyrotropin releasing hormone.

The graphic is a little inaccurate as the blue arrow implies the TRH travels outside the hypothalamus to get to the pituitary gland, when it really doesn’t. It goes directly from the hypothalamus to the pituitary gland without going through the blood.

When TRH enters the pituitary gland, it stimulates the release of thyroid stimulating hormone (TSH). TSH does travel through the blood to the thyroid gland and stimulates the thyroid cells to make and release the thyroid hormones T3 and T4.

T3 is the active thyroid hormone whereas T4 is basically a reservoir for T3. T4 can convert to T3 when needed. The thyroid under stimulation by TSH releases about 13 times more T4 than it does T3, but it can convert to T3 quickly, if needed.

When T3 levels begin to decline, a signal goes back through the blood to both the hypothalamus and the pituitary gland that T3 levels are getting low. When that message is received, the hypothalamus releases TRH and the pituitary releases TSH, which tells the thyroid to make and release more T3 and T4.

Since T3 and T4 are released into the blood, we can measure them. Same with TSH, but not so much with the THR, because it doesn’t really get into the circulation.

So, we’ve got T3, T4, and TSH to measure. And we can learn a lot about what’s going on with the thyroid from just those measures.

If everything is hunky dory, we find that T3, T4, and TSH are within normal limits.

But now let’s say something goes wrong with T3. Maybe the thyroid is having a problem of some sort and isn’t able to pump out enough T3. What happens then?

The hypothalamus and the pituitary would get feedback that T3 levels are low and that the body needs more T3. They would respond by cranking out more TSH to stimulate the thyroid to make and release more thyroid hormone. Increasing the TSH under these circumstances ends up driving the thyroid to make more thyroid hormone, but it requires more than the normal amount of TSH to drive the process.

If you were to have blood drawn at this point, your thyroid hormones T3 and T4 might look normal, but your TSH would be elevated. It would tell you your thyroid gland had a problem as it requires more than a normal amount of TSH to stimulate the thyroid into action.

Now let’s say we have a situation in which the T3 is low, but the TSH is normal or even a bit low itself. What does that mean? You might think it would indicate that something is wrong with the hypothalamus and/or pituitary, because these glands aren’t cranking out enough TSH to stimulate T3 production in the thyroid.

That could indeed be an issue.

But before we go that route, we would want to see if the body were experiencing any signs of thyroid dysfunction.

We haven’t talked about what T3 does, but it is an extremely important hormone that regulates in one way or another many processes in the body. I’ve heard my friend Professor Ben Bikman say that T3 makes everything work better. Whatever tissue it stimulates just works more intensely under its provocation.

I don’t have time to get into everything T3 does, but it does a lot. For one, it increases the basal metabolic rate and enhances oxygen uptake and energy consumption by tissues. T3 is essential for normal skeletal growth and maturation. It potentiates the effects of growth hormone and other hormones involved in bone development and closure of epiphyseal plates.

T3 increases heart rate and heart muscle contractility by upregulating certain receptors in cardiac tissue. It also increases or maintains systolic blood pressure and decreases diastolic blood pressure, which improves cardiac output.

T3 promotes lipolysis—the release of fat from fat cells. It also regulates protein synthesis and degradation. Too much can end up breaking down muscle tissue.

T3 is involved in the regulation of reproductive hormones in both men and women, affecting fertility and reproductive health. It increases gut motility and helps support good digestion.

I just touched the surface of everything thyroid hormone does. I could go on and on, but let’s leave it at T3 is an incredibly important hormone for countless bodily functions. And when T3 production is too low to perform its duties properly, health declines significantly.

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