Doctor's Note

Here are links to some of the videos I mentioned:

Here’s some videos unearthing the IGF-1 story:

NeuGc is what opened up this whole can of worms:

I wonder if alpha gal is playing a role in the improvements in arthritis and Crohn’s on plant-based diets: Dietary Treatment of Crohn’s Disease and Diet & Rheumatoid Arthritis.

In my next video, Tick Bites, Meat Allergies, and Chronic Urticaria, I explore the role these tick-bite induced allergies may play in the development of chronic hives and other allergic skin reactions in children.

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  • Adrien

    There is a typo in the transcript : “The reason NeuGc triggers inflammation is because humans lost the ability to make it two million years agE” age instead of ago.

    • Tommasina

      Thanks Adrien, I just fixed it!

  • not in the choir

    If you really want to reach more people it would be good to have a second voice on here presenting data that isn’t so strongly anti meat. a more balanced website would have more reach.

    i’d like to see what is the best meat? what is the best (animal) milk?

    this website has worked well in making mine and my family’s lives far healthier but a balanced view for those attempting to change may be more useful than preaching to the choir.

    your voice is a trusted one with lots of logic. the people you want to save the most will be the most resistant to change – give them some baby steps.

    Ive watched all your videos. from a general perception on your presentations i no longer eat meat and eggs but still enjoy an organic beef steak once in a while. is this the best idea? i have no idea.

    • me again

      typo. I no longer eat chicken

    • Thea

      “not in the choir”: I appreciate your post in that I think it is an understandable and respectfully submitted opinion even if I disagree with it.

      You may be interested to know that there *is* a video on this site covering the healthiest meat. And there is even a video on how to reduce cancer risk for meat eaters. So, in my opinion, it is not fair to say that Dr. Greger leaves meat eaters “out to dry” or is unbalanced.

      I don’t consider it a bad thing that Dr. Greger is also honest about what meat consumption does to your risks – even low meat eating:

      Balance is a false concept when it comes to health. To me, your request would be like saying on another site, “You should really give a ballanced view of eating sugar. You are being too biased talking about the problems with sugar. You are not going to reach as many people that way.” If I went to a site to learn about sugar, I would want to know the expert’s honest opinion. I would not want it sugar (ha, ha) coated. After absorbing the honest information about sugar, it would be up to me to decide what to do with that information. Personally, I understand that sugar is bad for me. I still eat it, but I limit how much I eat. (FYI: I think the evidence against meat, dairy and eggs show those products to be way than sugar health-wise, not mention unethical, and so I chose to simply remove them from my diet rather than try to limit them.)

      The same is true on this site. Dr. Greger can’t tell you what the healthiest dairy is if he doesn’t believe it is healthy. Period. My take is: This site is not a popularity contest. It is a place to learn the truth (at least one person’s truth – shared by many) about nutrition. Then, as you have already chosen, you can decide which pieces of advice you will follow and which ones you will ignore. At least you will be educated on the topic and know what you are doing / knowingly take on the risks.

      I like your idea of baby steps. Cold turkey (ha, ha again) just doesn’t work for everyone. Sometimes ‘baby steps’ is exactly what people need. But, again, it is not up to Dr. Greger to change his health message. Instead, I hope that people who are looking for baby steps will ask those kinds of questions and people like me and other (better) comments on this site will provide useful suggestions.

      It sounds like you yourself have made a series of baby steps that are likely to add to you and your family’s health. That’s very cool. You are on a path. Hopefully you are not stuck. Hopefully you will be able to continue down the path of good health. I’m glad you visit this site. I hope this site continues to help you, and I wish you all the best health in future.

      • Daniel Wagle

        I guess over the last four years, I, too, have taken baby steps to being Vegan. First I eliminated meat and then over time, I stopped eating eggs, and greatly reduced dairy in my diet. I am in the last phase now of eliminating foods that have traces of dairy in them, such as chocolates and coffee creamers. I now buy the So Delicious coconut milk creamer as well as Silk soy creamer. Just like you, I limit sugar for prudence sake, but from an ethical point view, meat, dairy and eggs are a complete no no, even though I haven’t completely gotten there, but I have improved a lot. Writing down everything I eat everyday does help in that it makes me think about everything I put in my mouth. I lost a lot of weight before I became plant based by exercise and writing down what I eat, but after becoming plant based, I lost even more weight. I still place a high priority on exercise as well- I commute to work by bicycle. It is important to be plant based, but also to do it correctly. Some ex “vegans” say this diet created so and so deficiency, but that is their fault that they didn’t make sure they got these vitamins from the beginning. I have been drinking fortified Soymilk from the beginning to get enough B12 and calcium. I now also eat Red Star nutritional yeast to add even more B12, as well as the other B vitamins. I eat greens every single day, as well as ground flaxseeds and lots of nuts as well. I think I get enough vitamin D from being out in the sun bicycling, but I should get a test.

        • Thea

          Daniel: Thanks for sharing your story! I really enjoyed reading it. I’m more like you than the cold-turkey-ers. I admire people who can completely change their diet in a day, but I’m not one of them.

          You sound like you are totally on the right path to me. I find that every time I feel that I have hit a plateau, I am able to make another small change to my diet that helps me be healthier. As far as I’ve come, I still have a long way way to go (in my book). I just keep with the “yet” method and find it does well for me. Instead of saying, “I don’t like leafy greens and will never eat enough of them.” I try to remember to say, “I don’t like leafy greens YET. I don’t eat enough of them YET. But I will keep trying and keep an eye out for ways that will help me move in that direction.” I find that by keeping an open mind like that, I am often able to take the next baby step — surprising myself, because I didn’t really think I would ever really do it.

          Best of luck to you!

          • Daniel Wagle

            Thanks, Thea. One thing you might try for the sake of greens is finding the right seasoning. I am from Indiana, but now live in Atlanta and one thing Southerners know how to do is to season greens to make them taste good. Of course, the fatback is a big no no, but what I have found makes greens taste good is balsamic vinegar. I eat raw turnip greens, along with a beet slice, a carrot and one half of a small tomato. I put a little nutritional yeast, turmeric, curry powder and the balsamic vinegar and blend them all up. I find I like the taste of it. The one green I don’t have too much of a taste for is Kale, mainly because it is so bitter. But I don’t think Turnip Greens have any less nutritional value. Also, getting rid of animal products to me is more inspired by the enormous cruelty involved and does not depend on it being unhealthy, even though I do think it is unhealthy. Even if they proved there was a health value to eating animal products, I am still not going to eat them, mainly because of the horrible images I have seen of animal mistreatment on factory farms. Thanks again, and good luck.

          • Thea

            Daniel: Thanks for the tips! I invested in some really good balsalmic vingear (aged 18 years), but haven’t tried it with your seasoning idea. I’m definitely going to give it a try!

          • Daniel Wagle

            I would be curious if you found the taste to be good in this. Balsamic vinegar is delicious and it seemed that once I discovered it, the price went up! I discovered it going to salad bar restaurants. Turmeric also has a nice taste, and Dr Greger also recommends it for the health value. I actually saw real turmeric roots at the farmer’s market here. I haven’t tried them yet, I mainly use the powdered form. You might also add a few walnuts (or other nuts), in order to increase absorption of the carotenoids. Mustard greens could be tried, as they are actually very spicy in taste, and not bitter. If you respond to this, I would know, because I would be emailed to know if there was a response.

          • Thea

            Daniel: The good news is that I gave it a try. And also good news is that I didn’t hate it. But I also have to report that I didn’t love it either. :-(

            But I really appreciate the suggestion! I just need to keep trying. I think that every time I try something like this, my tastes change a bit more.


          • Daniel Wagle

            I guess that is progress. I am working on adjusting my taste buds to the completely non dairy coffee creamers. Good luck!

          • DGH

            Funny, baby steps never seems to work for me. I changed my diet overnight a few times. First to Atkins. Then to pesco-lacto-vegetarianism. Then to veganism. These aren’t really baby steps. I simply decided at some point to stop eating all animal products.

            Because I am about to begin a more intensive exercise regimen with a personal trainer, I will have to add more protein and calories. Likely beans and nuts. Grain is great, but with my history of metabolic syndrome, I am trying to keep my intake to more modest levels for grain.

            It is funny that baby steps works for some people and dramatic lifestyle change works for others. When we have people who are admitted to our hospital for a heart attack who have smoked all their lives, sometimes it is a really teachable moment for them, and they literally quit smoking on the spot, never to start again, despite decades of daily tobacco consumption. I think people need to be scared to change their diets. The three things people fear are loss of their loved ones, loss of their health, and loss of financial security (getting hit in their pocketbook).

          • Toxins

            Here is a great video why baby steps in terms of environmental impact and diet are not the way to go. Via McDougall seminar.

          • Thea

            Toxins: I haven’t had a chance to watch the video, but I wanted to comment about the general topic sooner rather than later:

            If it is a choice between baby steps and no steps (status quo without any change), as was the case with me and many others, I have a hard time believing that anyone would argue that baby steps is not the way to go in some cases. I guess I’ll have to watch the video… :-)

          • Toxins

            The video is great, and very compelling. I hope you find the time to watch it.

          • Thea

            Toxins: I finally got a chance to watch this video. I completely agree that is is a *great* video. I have long internalized this information and completely agree with everything the speaker says. Except.

            Except that the reality is that we live in a world where the vast majority of people Just Don’t Get It. When surrounded by family, friends, doctors, government agencies, media, and our own long history all telling us to do unhealthy things (unhealthy for our current selves and the planet and the survival of humanity), it can be extremely difficult for some people (like myself) to change dramatically from one day to the next. If, in that context, it takes someone say 6 to 12 months to make a change, that’s pretty darn good in my opinion. (Took me about 6-7 months to wean myself off dairy and eggs.)

            Perhaps one of the issues here is really our understanding of “baby steps”. As the speaker defines them, I agree that “baby steps” is just not going to work. If Meetout Monday were the sole level of (type of) change people are able to make for the foreseeable future, we are doomed. But if “baby steps” means more what I am thinking, in terms of a concerted effort that takes someone from SAD to WFPB in a few months to a year, I think that is reasonable and the best of what you can expect with some types of people.

            If I were the ruler of the world, I would force a massive world-wide phase out of human consumption of meat, dairy and eggs. In that context, everyone would be working to make that happen. And in that context, the idea of “baby steps” would not be necessary – because even people like me would find it easy to make such a change in that context. But given where the world is right now, I just don’t think we can expect everyone to be able to drastically change their diet from one day to the next.

            That’s just my current thinking/response to the video and this discussion. I greatly appreciate you bringing this video to my attention! I will definitely be sharing it with other people and I think it is a great high-level summary of one of the most important issues of our time.

          • Thea

            DGH: Thanks for your comments. I totally agree with you concerning, “It is funny that…” It really is funny. While I admire people who work the way you do, I personally just do not seem to work that way.

            I also appreciate your comment about “teachable moment”. Those kinds of life events really can make a difference for people. (For those who survive and wish to avoid future events…)

            Thanks again for piping in. Good luck with your new exercise routine! Sounds awesome.

    • L Charles

      Well, he’s doing more than preaching to the choir for those of us who are Vegan. I appreciated being scientifically educated so that I may teach others as well.

    • robert

      You might not be in the choir, but it sounds like you are in the congregation. I sympathize with your point of view to a certain extent, but there are some difficulties with pursuing the second voice. Can you think of someone who would present that view? It is a pretty polarized discussion paleo vs vegan. The science on both sides is a bit cherry picked. One of the problems is that if you ask most people they will tell you that they have a good diet. Reading comments section in NYTimes on a Mark Bittman article one sees moderation being stressed as the most important factor in dietary judgement. Clearly with all the health problems in this country I think that moderate needs to be reset much further in the direction of whole plant foods. I haven’t seen much science to convince me that at best animal products should play more than a tiny part of anyone’s diet. I continue to thank and support Dr. Greger and his team for their work.

    • Editor d

      So you’re basically asking the Dr. to give you a reason to eat animal products. But the truth is that you shouldn’t. “Baby steps” are not what he’s going for. There is no better meat. No not even grass fed organic. There is no better milk. He not here to baby people, he’s doing this to provide facts. It’s science not therapy.

    • Toxins

      There are no studies that show that animal products increase lifespan and reduce chronic disease risk, they do the opposite as the abundance of evidence shows. Dr. Greger is not creating these studies, he’s drawing them from journals and showing them. The whole point of NF is to show people the evidence to prevent chronic disease and increase the quality of their health. Dr. Greger constantly brings about counter evidence, or evidence of the old paradigm, and shows how it is flawed in a very key way. 2 of the best examples of this are the BOLD study and how the renal acid load of meat does not affect bone health.

  • Jonathan

    FYI – Broken Link:

    Your link to the video “Higher Quality May Mean Higher Risk” in the “Doctor’s Note” needs to be revised from:


    • Tommasina

      Thanks Jonathan! I just fixed it.

  • Darryl

    Interesting fact: we have more circulating antibodies against alpha-Gal and Neu5gc conjugated proteins (20 μg/mL) than we have against A/B blood types (10 μg/mL).

    • guest

      Do even vegans have a similar concentrations of these two compounds? I would assume than long term vegans would have little to no alpha gal since it would have been a long time since they last ate pork.

      • Darryl

        Antibody concentrations in vegans are little studied. One study of gluten-free vegan diets in rheumatoid arthritis patients found ~35% reduction in antibodies against β-lactoglobulin (from dairy), and 30 to 65% reduction in antibodies against gliadin (from wheat). So perhaps vegans have fewer of the anti-α galactose and anti-Neu5Gc antibodies as well.

    • Well, that’s a fascinating statistic.

    • Lawrence

      I admit almost total ignorance of glycobiology (and immunology, for that matter), but I do find it fascinating that what we are talking about here is sugar molecules, chains thereof, and their linkages to protein molecules. In particular, here’s alpha-Gal:,3-galactose
      and here’s Neu5Gc:

      For a crisp, yet approachable, introduction to chemical glycobiology, here’s a two-part lecture by Carolyn Bertozzi, a leading expert in this field. In particular, she describes the notion of blood types in relation to the chains of sugar molecules (glycans) that are attached to our red blood cells, and of the work being done to image glycans in real-time and for what purposes.
      Part 1:
      Part 2:

      • Adrien

        Just saw the two lectures, just damn interesting ! The only catch for me was when she explain how to stop white blood cell from the bloodstream to reach tissus with anti-inflammatory drugs, to stop inflammation (Part 1 at 36:58). But wait, that is a normal and healthy process we evolved to protect us ! The reason why this procress is going out of control is because of pro-inflamatory factors from our environnment, not the lack of anti-inflammatory drugs, Am I right ?

        • Lawrence

          Hi Adrien,

          What I understand Ms. Bertozzi saying is that it is normal for leukocytes to stick to the inside of the blood vessels within lymph nodes, but when this happens inside our blood vessels, it is among the first stages of atherosclerotic plaque formation, which is abnormal. Perhaps you have seen Dr. Caldwell Esselstyn present his iconic lecture on making oneself ‘heart attack proof,” by eating a low-fat WFPB diet? When he says, “Things get sticky,” what he is talking about is endothelial cell activation (bad) that begins the process of athersclerosis. Honestly, I thought about this simple phrase for weeks and really wanted to understand what was going on here. I studied the literature (as a layman and student of this material), and I attach links to papers that dig in deep (pardon the pun) and have satisfied my curiosity that I now understand what ‘sticky’ means. Also, I’ll post a link to Dr. Esselstyn’s lecture to which I refer. Have a great day!

          • Adrien

            Thank you Lawrence! I can only guess that this process is also involved in atherosclerosis but I’m not sure that was Ms Bertozzi point. She talk about leucocytes doing damage once they reach the tissus, in auto-imune/inflamatory disease. Thanks any way for your links, I guess a good reminder can’t be bad.

  • Veganrunner

    So do you have to be bitten by the tick in order to have this reaction to meat? Could some people with autoimmune diseases have this problem without the bite?

    This is a stretch, I know, but could this somehow explain why my thyroid medication dose has been cut in half since going vegan? (Autoimmune disease)

  • J

    I must say that by the title of this I thought it was going to be a cartoon of a superhero (Alpha Gal), and a cowboy (Lone Star Tick) :).

    A very close 75 yr old friend long of SAD diet was told by his oncologist that while receiving 30 days of radiation for his stage 7 prostate cancer, that he should avoid vegetables so as not to have any diarrhea of which he had a bit at the beginning of treatment. Apparently diarrhea is common with this treatment. Dr. Gregger, is this a good idea given the circumstances? The pt is a doctor, and trusts his UCSF oncologist. Since some fruit is OK, we are making pink juice and black bean brownies for him. Is there not another way to ward off diarrhea? We had planned to regale him with green smoothies, but…

    • Adrien

      Is it only to prevent diarrhea or is it because anti-oxydant can interfere with the treatment ? I think Dr Greger said that this wasn’t true, but I can’t find the video, anybody ? I think you’ll be more efficient if you email Dr Greger directly. He used to answers every question here, but that wasn’t long before the website grew huge!

      • Thank you, Adrien for looking and for responding. It is wonderful to be part of this community! How do I email Dr. Greger directly? I would be happy to pay him. He must be so overwhelmed. If I could find something in peer-review print, my dear friend, a psychiatrist married to a super-famous immunologist might pay more attention.

    • Lawrence

      Hi Gayle,

      Your friend is fortunate to have a supportive and well-meaning friend in you. My ‘gut’ tells me that soothing foods like oatmeal, rice pudding, pearled barley porridge, mashed potatoes, refined pasta and so forth with a balance of soluble fiber and water would be helpful to stabilize stool consistency and make going #2 a #1 experience. Here’s some more ideas:

      I also think that to go from SAD to green smoothies might be too disruptive to the gut microbiome and may make things worse despite your best intentions to the contrary:

      My best wishes to you and yours.

      • Thank you, very much, Lawrence. Finding the links is very kind of you.

  • Trish

    Hi, I have a question about what the best diet is when you’ve been diagnosed with Hashimoto’s? There seems to be a lot of conflicting information, particularly around iodine? I’ve been prescribed thyroxin for the rest of my life and would like to see if changing my diet could help to manage it – either to reduce my dosage or get off it completely.

  • Jordan

    I’ve been bitten by this tick while living in VA It started my vegan path by giving me a beef allergy in 2012.

  • Nathanael

    Hello there! I have a friend who recently got Lyme disease, and antibiotics haven’t been working for him. He’d like to change his diet and see if he can beat this. The only dietary guidance he’s been given so far is to keep his sugar intake below 10g.

    So my questions are:

    1) Should he be concerned about sugar in fruits, or in other whole food sources?

    2) Are there any resources or literature I should know about?