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Craig Cooper
11-07-2006, 11:00 AM
So I have a client with Rheumatoid Arthritis who's doctor put her on an experimental drug a couple of years ago called MEHTATREXATE. She was on an ungodly dose, which caused her to gain weight, rapidly. She's been off the drug for about a year and a half now, but is unable to lose the weight she gained, despite exercise and diet intervention. I was wondering if anyone has heard of the drug and what it's specific action is that would cause weight gain.

Robb Wolf
11-07-2006, 01:14 PM
It is usually used as a cancer drug. Blocks folate metabolism. Nasty stuff but I have no idea why the weight gain unless it messes with insulin sens due to folate deficiency. It's also interesting to note that folate is integral in apoptosis, the process whereby our body disposes of abnormal cells via programmed cell death. Methotrexate is "trying" to kill cancer by removing folate from the equation while preventing some of our best machinery from dealing with abnormal cells. Odd approach to killing something.

Actually, Methotrexate may improve insulin resistance:
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=153842

Brad Hirakawa
11-07-2006, 01:50 PM
Craig,

Methotrexate has been around for quite a while, since well before I was born anyway. :) I believe the doses used for treating arthritis are relatively low compared to the dose used for cancer, and it's often co-administered with another drug (I forget which one). Although it may still affect folate metabolism at these relatively low doses, I don't think that is what the doctors are shooting for in the case of arthritis. Methotrexate appears to knock down certain components of the immune system, and that is what is believed to alleviate some of the arthitic symptoms... but I'm digging way back in my education on this one.

Thumbing through the literature.... I don't see any common side effects related to weight gain. But, there are always idiosyncratic toxicities out there.

Sorry I could not help more.
Brad

Craig Cooper
11-07-2006, 02:28 PM
So I need to get the exact dosage from my client, but she said that cancer patients usually take 6 pills/week, where as she was taking 10! Again, will have to find out dosage before that makes any sense.

Robb Wolf
11-08-2006, 01:51 PM
I think you may just need to approach the whole situation with caution. Get a DETAILED food log for 3-7days. Sleep patterns etc. Delving deeply into the pharmacology of a chemotherapeutic she took 2 eyars ago is dicey ground.

So I need to get the exact dosage from my client, but she said that cancer patients usually take 6 pills/week, where as she was taking 10! Again, will have to find out dosage before that makes any sense.

Craig Cooper
11-08-2006, 03:09 PM
Robb - thanks, I know. I'm drawing at straws, but I can't figure out what else it might be. She gained 40lbs while on the drug, and hasn't been able to lose ANY weight since. I've had her give me a 7 day food log, which was decent. She's scared of saturated fat, there are traces of wheat in her diet, and she's a cottage cheese/yogourt fan. My first intervention will be trying to eliminate dairy from her diet, see if that works. She's doing 3 Metcon workouts/week + 2 30-45min cardio sessions. I'm just frustrated, I'm sure you can relate.

Robb Wolf
11-09-2006, 11:27 AM
Fer-shizzle...I feel like instituting a metabolic ward as part of our training. One month of what we feed you, lights out at 20:00 and daily fanny kicking. Hmmm...

Yael Grauer
11-09-2006, 01:16 PM
Fer-shizzle...I feel like instituting a metabolic ward as part of our training. One month of what we feed you, lights out at 20:00 and daily fanny kicking. Hmmm...

OMG, you should do it! You can call it Paleo Boot Camp! You'd make bank, too--they charge over six THOUSAND bucks a week for that at the place one of my friends works at...and Fitness Vacation charges 13,000 a month...and this one is 2500 for eight days... http://www.swatfitness.com/vacations.htm

Scott Kustes
11-09-2006, 01:22 PM
Robb, that's actually a good idea. 6 weeks of Paleo eating (have Scotty cook up some of his recipes), completely darkened rooms for 10 hours/day. I'd come work there. We'd have "Robb Wolf - Chief Science Guy, Assistant A$$ Kicker", "Greg Everett - Chief A$$ Kicker", "Scotty Hagnas - The Paleo Cooker Guy", and me..."Chief Turn Off The Lights Guy". Anyone else wanna volunteer for a position?

We'll make you rich before it's over! Then you can quit training people and just buy a private island, kick back, drink mai-tais and smoke cigars.

Ken Urakawa
11-09-2006, 02:15 PM
I'll be the "shout slogans at you while you sweat" guy...Oh, and the "I think he's down at the Sierra Nevada brewpub again" guy...

Yael Grauer
11-09-2006, 03:15 PM
I could work in the Paleo bookstore, making sure everyone has the appropriate books to complete their required reading assignments for Robb's mandatory Evolutionary Science classes. And I could get everyone signed in, check their gym bags to make sure they're not sneaking in any soy milk or anything and take their car keys away from them, like they do on those 10-day meditation retreats.

Robb Wolf
11-10-2006, 12:28 PM
Ok..., I'm sold. Let's do it. List of speakers:
1-Art Devany
2-Loren Cordain
3-Dr's Eades

Location:
California Wine country. Easy flight into SFO, limo ride to the retreat. Optional retreat in Baja.

Topics:
Food, Fun, fanny-kicking

Thoughts?

Jeremy Jones
11-10-2006, 04:05 PM
I'll be the guy who temps everyone by walking around eating bad stuff and drinking beer.


This would be to teach them how to live with temptation.



(I can also teach some MA classes).

Yael Grauer
11-10-2006, 04:28 PM
You should be careful. This is Paleo boot camp! http://members.tripod.com/~tiki_21/cartoon/bam.gif

Scott Kustes
11-11-2006, 05:43 AM
I can probably deliver food too....if I'm not too busy flipping the lights off at 8pm and flipping them back on at 7am. Don't forget, I also have to yell "Lights out!" and "Get your a$$es up!" Tough job, but somebody's gotta do it.

Ken Urakawa
11-11-2006, 06:18 AM
Can I bang the garbage can lids together in the morning?

Yael Grauer
11-11-2006, 06:47 AM
Don't forget to turn all the lights off and light little candles by 7:00PM! I could find the best flights for all the guest speakers, and of course tape and transcribe all the lectures. I could also keep meticulous notes on everyone's progress, putting together little booklets with bar charts at the end of the month. I could also fill out detailed complaint forms which nobody would ever look at, which I do all the time at one of my jobs anyway. :) Oh!! And I could help build debris huts for people who decide they want to do Paleo boot camp very primitively. Kitchen staff is on their own for finding substitutes for store-bought fermented food.

Scotty Hagnas
11-11-2006, 08:22 AM
You know, I've actually been thinking about this for a while. My "mountaintop compound" and everyone always wanting me to fix food for them had got me to thinking.... I do think that this could be doable.

The other idea I have kicked around is a Paleo restaraunt in Portland. Maybe when I get the 30 hr day perfected.

Scotty Hagnas
CrossFit Portland

Yael Grauer
11-11-2006, 06:16 PM
The other idea I have kicked around is a Paleo restaraunt in Portland. Maybe when I get the 30 hr day perfected.

That would be awesome!!! There is a local cafe opening here with wheat alternatives (maca flour scones with goji berries, mesquite flour scones with cacao nibs) and the owner said I could help develop almond flour recipes which I've been playing with all week, to try to make them my own... The cafe will have no soy, almost all the ingredients will be organic or wild, sweeteners will include only agave nectar and yacon (possibly honey) and there will be Butte Creek and Nimbus Brewery drinks! (No preservatives or additives from Nimbus...) She wants to have raw cheese and milk (instantly pasteurized at the steamer) but I don't think the Health department will let it fly...

Back to the Paleo boot camp idea, I was thinking a really good draw would be offering continuing education credits. They did that at a conference I went to and they had so many people signing up that they ran out of meal tickets! So it could be a three-pronged approach to appeal to different crowds--the weight loss crowd, diehard athletes and science geeks. Also if there are CE credits you can change the lecture topics slightly and get a return crowd year after year... They could stay in hotels if they don't want to go to bed at 8. Also I would love to see debates there, like Cordain versus McDougal or something. And then their followers would arrive by the hundreds and pay to watch the debate. :D

Scott Kustes
11-12-2006, 07:32 AM
The other idea I have kicked around is a Paleo restaraunt in Portland. Maybe when I get the 30 hr day perfected.
I've kicked this idea around for Louisville. Perhaps not totally Paleo as that is difficult to market, but mostly Paleo...no pasta, any bread would be non-gluten, etc. I've gone so far as to start on a menu, but I don't think I would want to work the kind of hours that restaurant owners work. Which is why I'm leaning more towards Paleo-ish packaged goods.

Scotty Hagnas
11-12-2006, 02:50 PM
Yael-

Is the cafe in Tucson? I am down to visit the area periodically, as some of my fiance's family lives in the area. I'd like to check out the cafe when I'm in town.

There is a similar restaraunt here in Portland, but unfortunately the only meat they serve is seafood. The owners are clients of mine, and they buy memberships for all of their employees as a health benefit.

Scotty Hagnas
CrossFit Portlanf

Yael Grauer
11-12-2006, 09:49 PM
Scotty,
It is in Tucson and it'll be opening in a few months. I'm not sure if there'll be meat or not as it is mostly breakfast food, but we'll see. If you want, I can e-mail you the sample menu!! You should check out Seven Cups too next time you're in town if you like a damn good cup o' tea.

Scotty Hagnas
11-13-2006, 04:57 PM
Thanks! If you get a chance, that would be fun to check out the menu.

Scotty Hagnas
CrossFit Portland
flatland@teleport.com