Transcription
So this is kind of the gist of what we want to do in terms of solutions. Um, the way that I like to run these programs ideally is to have a lab-based protocol, and that's, you know, as a functional medicine practitioner, just makes the most sense to me. So we're starting with healing the metabolism, right? With the diet. We we're talking about people getting better and feeling better, and then at the end of this process, getting to the weight loss portion. So starting with a systemized approach where you're addressing the root causes of the problem, and then adding in a lab-based model. We'll show you some lab work right now, lab lab testing right now, and then figuring out the supplement protocols that are going to work. Okay? And we're going to do a case study today too, so we can go through all this.
So number one, in terms of weight gain, we're really kind of struggling with these steps and the action steps that we want to do. We want to number one, repair the fat-burning metabolism. Get the fat-burning metabolism working. It doesn't mean people are going to lose weight though, in the very beginning. That's the problem.
Next step is using the right lab tests so you can get an accurate picture of the patient's physiological status. That means you're like, okay, well, why is their fat-burning mechanism not working in the first place? I'm going to run these labs and figure out why. There's three basic reasons. I'll show you all three of them tonight in the case study. Um, I think maybe she even has all three of them. We can look at that. Okay.
So the the last step then is implementing an eating plan that's going to be appropriate for the body. First, in the healing phase. And this could be a completely different diet in the healing phase when you're healing metabolisms than it is when you want to get them on an eating plan plan to burn fat. So in other words, you've got to get the metabolism working well first. And there's certain specific diets that do that. Those are going to be rich in protein and fat because you need the protein and fat for cellular repair, to repair all the enzyme systems and all the things that are damaged. We heal using protein and fat. Once the body is healed and repaired, then you can put them on an eating plan to burn up all the body fat. But if you try to do it the other way, in the other order, it doesn't work very well, and people will lose weight and then of course, they'll put it all back on rather quickly.
So again, if we're going to keep this simple, three basic causes of weight gain based on body systems. First would be the hormonal system. Second would be digestive-related problems. And third would be toxins and detox-related issues.
So within the hormonal system itself, we're talking about a breakdown from increased cortisol causing the person to be in a catabolic or breakdown state. So when you're breaking tissues down excessively, one of the first things that you do is go into catabolic physiology, and you start to store body fat and you start to break down protein or amino acids for fuel. The more that you do this breaking down of amino acids or protein for fuel, the more tired you get because it's very inefficient to run these cycles where we're burning up protein and amino acids for fuel, and the fatter you get because your body's just doing everything they can to store body fat. Soon as we're stressed, as soon as we're unhappy in our marriage, unhappy in our job, as soon as we're skipping meals, as soon as we're doing anything that's going to provoke a stress response, you're going to start to store body fat. So we have to stop that first, or you're never going to lose weight. Right? And we'll talk a little bit later about even sleep can cause people to get fat, which and lack of sleep.
Second would be digestive system. Obviously, if there's inflammation, tissue damage in your gut, you're not absorbing well, you're not going to be able to lose weight. If you don't have nutrients in your system.
And then toxins in the liver will break out and prevent the liver from being able to metabolize fat and do all the normal fat-burning stuff that your liver should be doing. So the more toxic a person is, the more fat that they'll put on their body, and the harder it is going to be for them to burn body fat. Okay.
So if we're going to then break it down into how the metabolism can get damaged most easily. Emotional stress, dietary stress, pain, and inflammation. All three of these are going to drive cortisol up and drive body fat storage up. Second big issue is toxins. We're not going to talk too much about gut-related stuff tonight because I talk about that a lot. I want to talk more about toxins and and catabolic physiology. So the more toxic that the person is, the more blocked that detox pathways are, the more unable the liver is to handle the normal mechanisms that it needs to handle to burn body fat. Okay. And there's a lab test for this. You can measure all this stuff with an organic acids profile. And then here on this test, you can see that the section says toxicant and detoxification. Very simple way to measure how well detox pathways are working. You can also measure oxidative stress, which is also going to be implicated in damage to fat-burning metabolism, damage to your insulin levels.
So a little bit of a breakdown on the the different phases of detoxification. So the first phase, we're using these cytochrome P450 enzymes to flush the toxin out into an intermediary stage. Then we're going to run phase two on the toxin and try to break it down with amino acids, with sulfur-containing amino acids. And then eventually, you're going to dump it out through the sweat, the stool, or the urine. And so the your body can do this, the more stress you relieve from the liver, the easier it is to burn body fat. If you're toxic, a couple of things are going to happen. One is that your liver will be scrambling just to deal with toxins and won't be able to burn fat. The other is that your body's going to store toxins in body fat because many of these toxins, most of the ones we're talking about right now, are fat-soluble. And so your body stores them in the fat tissue, which is another reason why it makes it even harder and harder to break down the fat tissue because they're full of toxins.
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Diets that heal the metabolism versus diets that lead to weight loss. So there's, we don't have time to get into all the different healing diets. I, in my practice, generally, they use a gluten, dairy, soy-free diet, no sugar, no alcohol, no tobacco, no caffeine, no firearms, all that kind of stuff, right? The, um, that was a joke. But, um, other cases, and, you know, I'm not against doing this, I just don't do it a whole lot. Might need a GAPS diet, a FODMAP diet, an autoimmune diet. I do some food allergy testing, not a lot. You know, I used to do a lot more of that, an SCD diet. So, you know, depending on the level of severity of the case, you know, you may need to escalate to a more complicated healing diet. Whatever it is, once that part of the program is done, and you feel like, okay, this person is not so inflamed anymore, their metabolism is kind of repairing, then we start to get into weight loss diets after. Okay, you've got a healing metabolism, the metabolism metabolism is working now. Now you're going to get into the weight loss. And I'll go over that in the next slide. If you try the weight loss diet too fast, you're going to know right away because when they start to eat normally, they're going to put all the weight back on. And that's what everyone in the United States is doing. They're trying to lose weight by doing a ton of exercise or by doing ridiculously low-calorie things, and it backfires in the long run.
Now, this is a big assumption, but we're assuming you're at that point where the metabolism has healed and repaired, and they're no longer massively inflamed in their gut, and their toxic burden is somewhat under control. Okay? So you may be three months, six months into a program, something like that. Once you get to that point, you can follow a series of different programs and you can pick one of these and vary it. Some doctors will do a couple days of the week for each one of these. That's represented really well in a book called The Fast Metabolism Diet. And The Fast Metabolism Diet is by Hayley Pomroy. She talks about doing each of these diets for a couple days during the week. There are other doctors that'll do an adrenal, a liver, and a repair diet, maybe a week or even as much as long as a month of each one of these and rotate them through. The idea is that we're mixing it up. Each one of these diets is going to be lower calorie than the person needs to burn. So you were probably looking at 1,500 calories a day, something like that. Now, remember, if you try a 1,500 calorie a day diet with somebody before their metabolism is healed, it's going to damage their metabolism, and they're going to gain all the weight back. So we're working with someone who's already repaired their metabolism. Now we're just lowering the overall calories so they can shred the body fat and get rid of it. Six months into a program, that's where we're at right now. So, 1,500, maybe 2,000 calories, somewhere in that range, but it's obviously going to be less calories than they're burning up so that they're going to lose weight. Clearly. And so the three different phases include an adrenal support phase where there's a little bit of starchy carb. There's a liver support phase where you're really honing in on all the detox capacity of the liver, using protein and green veggies. And then there's a repair phase with a little bit of carb and a tiny little bit of fat. So some salmon, some almonds, some walnuts, some avocado, just enough fat to get a little more repair going, not a ton of fat. And in the adrenal and liver portions of the diet, there's very, very little fat. So again, you could do each one of these diets a couple days a week. That's what Hayley Pomroy talks about in her book, The Fast Metabolism Diet. Some other practitioners prefer to do a month, as long as maybe two weeks or a month on each one of these diets. You're rotating the person through. The liver support diet is kind of like a paleo diet, basically, because there's zero carbs, but it's a little different than paleo because there's very little fat. Now, how can we get a, now you're saying, how can you get away without using fat? Because you need fat to repair. Where there's fat in the repair phase, but remember, this person's already mostly done most of their repair. This is this is a diet that you would do with a healthy patient, not a sick patient. So when they've gotten to that point where you've run the healthy diet on them, they've had tons of healthy fat, they've been slathering themselves in coconut oil and even avoc and doing all kinds of olive oil, so they've already got the healthy fats back in their system. Once we've achieved that, then we use this diet, and this is a way to peel off the pounds pretty quickly.
All right, I just wanted to talk about sleep for a minute because I think sleep's really important. And I have this whole thing about sleep where I go to bed, you know, on a good night between 9, 9:00, 9:30. Last night I was staying up kind of late last night, but there's reasons why this makes a really big difference. And in terms of weight loss, this is absolutely essential. And there's just a couple of studies that, um, I kind of think are fascinating. And you can Google this later and read about them in more detail if you want, but just losing a couple hours of sleep in a night can lead to almost immediate weight gain. So University of Colorado, they got a group of healthy men and women for this two-week experiment tracking metabolism, eating habits to figure out how much sleep deprivation you need in order to mess up your your weight loss. And this is like fascinating that they could do this. It's pretty cool. So the first week of the study, half the people could sleep nine hours a night. The other half stayed up until midnight. Does that sound familiar? Stayed up until midnight and then could sleep up to five hours. Everyone got unlimited access to food. And the second week, they restricted the nine-hour sleepers to five hours of sleep. Bottom line is what they found is that getting five hours of sleep increased the person's metabolism. So that's a good thing, right? If you want to lose weight, because now you're sleep-deprived, but you're burning an extra 111 calories a day. The problem is that when people are deprived of sleep, they eat more. And they eat a lot more than 111 calories worth of stuff. So by the end of the first week, the sleep-deprived people gained two pounds. Two pounds. That's just in a week of not enough sleep. Imagine doing something insane called being a parent and having a child. Okay? And you're not sleeping for five or six years through the night. Imagine how much, you know, body fat you're going to pack on just from losing sleep from having a baby. Serious stuff right there. There's more detail on here. You can read the slides later, but you get the point that these, anything that's going to cause stress, lack of sleep, over exercise, is going to have the same basic result as what we just saw with the sleep study. It's going to speed up your metabolic rate a little bit, so you burn another 100 to 200 calories a day, but it's going to make you massively overeat. So you're going to put on weight. Okay? And this could be lack of sleep, this could be over exercise. Anyone who works out really hard knows on a day you work out really hard, you eat more. You might burn 500 calories in the gym, but you're going to eat an extra 800 calories. There's very few people who can lose weight long-term by doing excessive exercise because again, the more you exercise, the hungrier you're going to get. You may be able to starve yourself and exercise for a while, but eventually your calorie consumption is just going to go up. So it's pretty hard to exercise your way out of this, right? And, um, just think about any one of the variables that can stress you, including sleep.
Now, there's always these, always these four factors I think about. You know, there's diet, exercise, meditation, and sleep. Those are the four major lifestyle factors. And so if we can get those under control for the average patient, we're doing pretty well. Then there's another factor which is outside the realm of our usual patient that we're working with, and this is when you're struggling with addiction. When the person has an addiction problem. So I was in practice for maybe five years, four years, five years before I even realized that addiction was a big problem in my pain patients. And, um, it was a real revelation to me to understand this. And I want to tell the story because I think it's really important. And some of you may not work with addiction, and I think, um, it's one of these sort of mission-critical things that we should know about, but not something that they really teach us in school or even talk about in school.
So glutomorphins are morphine-like compounds from the breakdown of gluten. And they trigger a feel-good reaction in your brain. They're also casomorphins, which are opiate-like compounds that are a breakdown product of dairy. And so for people that have this kind of a reaction, they're eating a piece of bread, they eat another piece of bread, and all of a sudden they eat the whole loaf of bread. They eat one cookie, all of a sudden they eat two cookies, all of a sudden they eat a bag of cookies. And the next day, do they feel like, oh, I'm not going to eat cookies for a while because I had a bag last night? No, they start to eat cookies again. It's exactly the same behavior that a heroin addict would have or an alcoholic would have. And it's almost impossible for people with food addiction to stop eating the food that they're addicted to. It's a very strong draw because you're getting a morphine-like high from eating this gluten or dairy. Now, if I ate gluten today, did I eat gluten today? No, I didn't. I don't think I did. No. Uh, but if I did eat gluten today, you know, I'd feel kind of crappy tomorrow and I probably wouldn't eat it for a while because it always makes me feel sick. But when you're gluten-sensitive and you have this glutomorphin problem, you eat the gluten one day, you wake up the next day, and the first thing you're thinking about is, you know, should I have pancakes or should I have French toast today? So I learned all of this from Lynn Elliot Harding. She's my absolute hero in terms of eating disorders, food addiction, alcohol addiction. She taught me everything I know about all this. I was very fortunate to meet Lynn about 20 years ago, and we're still close friends. And she's just an amazing, amazing person. If you have, you're struggling with food addiction yourself or you have patients that are, you know, look up Lynn Harding. She's, um, a pretty amazing person. And if you don't have her contact information, you can email my office, I'll give it to you. I always want to support her as much as possible.
And so a lot of the things that she taught me about food is that foods have chemical properties, just like heroin and cocaine and alcohol. And, you know, one of the first things Lynn taught me when, this is a great story, is that, you know, if she's doing a counseling session with an alcoholic, and they come into her office drunk, she's not going to say, okay, John, let's sit down and talk for an hour while you're drunk about your alcohol problem. She's going to say, hey, go away, go to some meetings, let's try next week at the same time. If you can show up drunk, we can talk. You wouldn't even consider talking to an alcoholic who's drunk at the moment because you know their brain is under the influence of the chemical alcohol, and they're not going to have a normal affect and a normal response and be able to have a normal conversation. Well, a lot of the patients that we're working with have that exact same chemical reaction to food. And what do we hear it as? Brain fog, migraines, confusion, memory problems, depression, anxiety. Their brains are being controlled and dictated by the chemical reactions that they have to food, just like an alcoholic would. So to sit down and talk to a food addict and say, hey, I want you to get off gluten, dairy, and soy, and do this lab, and I'll see you in three weeks, is absolutely useless because they're not going to be able to make those changes in their food unless you really confront the addiction component of the problem.
So what addicts all need to do, they need to recover. They need to abstain from the food. So if you have an addiction to gluten, it's no gluten, never, forever, one day at a time. If you're like me and you're just mildly sensitive to it, you can get away with eating it once in a while. And honestly, if I eat gluten today, it doesn't cause me to eat more of it later. It makes me feel kind of sick. And so it's sort of self-limiting in that way. For an addict, if they eat gluten or dairy, they can't not eat it the next day. It compels them to keep eating it. And this is one of the really sad things is they keep eating the food that they're reacting to. Now, you can figure out through lab testing, you can figure out through common sense, figure out how you react to a food. But the real solution here, as, um, is true for all addiction, is a, it's a spiritual solution, right? Because we use addictive substances because of spiritual disconnection. And of course, or, you know, 12-step programs are kind of both best known for dealing with addicts in this way. But I think it's something that we could all learn from, that there is a solution, but it's about getting spiritually connected.
So again, the appropriate diagnosis for this kind of problem would be substance dependence. We think of this in the, in terms of a drug, but it's the same with food. You have to need more. You have to keep eating more to get the same effect. One piece of bread isn't enough. Now you eat the whole bag of bread. The fear of being without it. If you look in a, in a food addict's eyes and you say, hey, I want you to do a gluten-free diet for two weeks, they'll look at you like, are you insane? You know, my, I had this one couple once that came to see me in my old office in San Diego, and they had flown out from the Midwest to see me, this married couple. And I told them that they had to get up, they were going to have to give up gluten to do the program with me. They literally together looked at each other, got up, and walked out of the room. And I never saw them again. I mean, that's an addict. You can't conceptualize of your life without gluten. Of course, you have consistent hunger, persistent cravings, all this kind of stuff. So you look at this list. This is true for heroin. You need more to achieve the same effect. You're pretty scared to not get your heroin that day, and you have persistent cravings for heroin. It's the exact same thing for apparently, uh, sprinkled covered donuts. For, um, as a matter of fact, I mean, I gotta talk to my staff about this because, um, on a deeply personal level, I think sprinkles are stupid. And I don't like chocolate on my donuts. I'm like, straight up glazed old-fashioned guy. So we're going to have to change that for later. They don't take me seriously anyway. So, s back back to seriousness. It's really, really almost impossible for people to do this on their own. They're going to go through withdrawal symptoms. It's going to be a nightmare. So just be prepared when you're working with people with food addiction, it's going to be a lot harder. They're going to feel like you're pulling away their most essential aspect of their being. They're going to feel defensive. They're going to have shame and guilt feelings. It's going to be a really hard road. It takes, according to Lynn, five to seven years for a food addict to really get over the addiction. It's not something that's going to happen in 30 days. But I'm really dedicated to this group of folks because they need our help. And, you know, I think that we can do a good job to help them using functional medicine.
So as extreme manifestation, we're talking about anorexia, bulimia, overeating. Really, it's all the same constellation of a problem. It's all centered around dependence on food. And it's not a moral problem, it's a chemical imbalance and an addictive disease. It's not, I mean, if she tells someone to go off gluten and they go off gluten and they feel better, and then they start eating it again, and they can't figure out how to stop it permanently, that's an addiction, right? They're doing something over and over again that's harmful to them. That's an addiction. And before you can really get into the depth of the food changes, you have to refer out, you know, for psychological counseling and help. And then we on our side can deal initially with a physical and biochemical solution, which is the lab testing that we do. So abstinence, cutting the food out, eating the foods that are going to work for your body, and then of course, doing, um, all the right things with blood sugar, figuring out how to separate your food from your feelings, and having your peace, you know, developing over time, peace around your food. As we're doing the lab work, getting these sort of parallel tracks going. Okay.
And so there's some pretty straightforward ways that we work with people who have food addiction problems. And we have these slides available. I also have a talk that I did called Double Trouble. And it's Lynn Harding and I together. It's maybe a three-hour talk that we did. And if you're really interested in food addiction, I can send you a link to that. You can listen to it, no charge. Okay.
Allergies are another reason why people can react to foods really strongly. So food allergy testing can can help a lot. And then I want to talk a little bit about, uh, eating patterns before we get into the case study. So in terms of patterns, and we're going to see some of this on the lab that we're going to look at in a minute here. We've got low brain chemicals that can cause overeating. We've got the ability to use 5HTP and tyrosine and an herb called Mucuna for cravings. These products are available by most for most of the companies. We've got the issue with serotonin suppressing carbohydrate cravings. Low, low serotonin levels associated with carb craving. So it can be a brain chemistry related issue in some people. We got the pathogens we've talked about. We toxins we talked about. And one that I, I mention all the time when I'm working with patients is hydration. So I'm going to have a sip of water here, but most people, most people, most every patient I've ever had is dehydrated. Pretty rare to get a, a patient who's well hydrated. Everybody always says they drink enough water, but it's, I mean, in my clinic, maybe it's a couple times a year I'll have a person that's actually hydrated properly. Um, and when people get dehydrated, they get hungry all the time. And so they'll just continue to eat and eat and eat and not realize that the real problem is the dehydration. So that's a whole other issue.
Okay, now let's take a look at a case study and do a little program design stuff here, which is the fun part. And let me see. All right. So I'm going to show you a case and then let's solve it. And so in the training program, which we all going to sign up for at the end of the call, this is what we do every week. Doctors submit their cases, we look at the labs, and then we figure out how to solve the problems. You're in class three to five hours a week, looking at all the lectures, reading all the case study material, practicing on your patients from the get-go. And then you get on this call once a week, 10 or 12 other doctors. You got your acupuncturist, naturopaths, couple medical docs, maybe a physical therapist, bunch of chiropractors like myself. And it's just a really amazing experience. People love it. I, I can't even say. And, you know, people love it because I'm great, but people love it now even more because we have a community. You know, it used to be years ago, it was just me teaching the class, and that was kind of what you were stuck with. But seriously, now you're, you're on this call with a dozen other people, and then you're in this community with a couple hundred other people, all of whom you can ask questions. You may have a pediatric question. Okay, we have a couple of pediatricians in the group. You may have a question related to breastfeeding and, uh, pregnancy. We've got a couple of OBGYNs in the group that'll answer that. You got a question about Chinese medicine. We've got a whole flock, or I think if acupuncturists are not flock, I think they use the term gaggle for a group of acupuncturists, but we've got a gaggle of acupuncturists. We've got chiropractors use the word crowd. We've got crowds of chiropractors. You've got a structural problem. Okay. So all these people are working together, but we're all doing functional medicine. And it's, um, to me, it's my absolute dream come true because when I was, um, first starting my practice, I didn't have a community of functional medicine people, let alone ones that had positions from, you know, psychiatry and a major hospital to running a podiatry clinic to running a nutritional practice. Right. It's an amazing group. And anyways, this is really cool. So you got to imagine there's 10 or 12 of us on the line, and we're looking at this case because that's how it would be if this was a real class.
Now let's take a look at here. 44-year-old woman, single, overweight, oh, craves sweets, breads, pizza, and cake. Um, sounds familiar. And then we ran some labs on her. So first of all, and again, three body systems, right? Hormones, gut, detox. Always run an adrenal panel. We're really looking at her metabolism, in a sense here, that's really the goal. So in her case, um, we've got extremely low cortisol in the morning, noon, and afternoon. Total cortisol is 18. DHEA is down at a one. So when I'm showing these to patients, I would say, you know, uh, what's her name? Let me go back up here. Oh, we don't know her name. Let's call her Carol. So I'd say, Carol, in a perfect world, you would have around 40 units of cortisol per day, 30 to 40 units. You're making 18. So I think of cortisol like units of energy. You have 18 units of energy. You should have about twice that. That's why you're tired. But also cortisol is a fat-burning hormone. So if cortisol levels are abnormal, your body's going to store fat because it thinks that you're starving. We need to break this cycle. We need to heal your metabolism, which is represented on this cortisol test. And if I can heal your metabolism, get your cortisol into the normal range, then we can start the weight loss program with you. And I promise the weight will come off. We'll do some special dietary changes around that time, but it'll work really well. If we start you on any kind of calorie-restricted diet, now your metabolism will become more and more damaged, and these numbers will get worse and worse, and it'll be harder and harder to correct later. And then you have to kind of invoke their past history and just remind them that every time they tried to do calorie restriction, when they stopped, the weight would come back plus a little, which is why the metabolism is damaged in the first place because they were doing these kind of diets. So then we'll set up an elaborate adrenal program to fix the adrenals. And I'll show you that in a minute.
On the GI-MAP, D enterococcus on the lab. Nothing too too bad except for that. And here on the organic acids profile, she's got problems with fatty acid metabolism, problems with carbohydrate metabolism, and problems with energy production. So how is she going to burn fat if all of her fatty acid metabolism markers are elevated? That's not going to happen. How is she going to burn carbs or keep her blood sugar stable if her pyruvate's all high like that? So let me show you. Oh, and she's got some intestinal bacterial overgrowth, which probably isn't helping the situation either. So let me show you the breakdown on these. So if you look under fatty acid metabolism, in parentheses, it says carnitine. Carnitine is the shuttle that helps you pull fat from storage so you can burn it up for fuel in the mitochondria. And that whole mechanism for her is shut down. Adipate, succinate, ethylmalonate, those are all not functioning, which means that she can't burn stored fat efficiently for fuel. Pyruvate is also elevated. That indicates that she can't burn carbs either. When pyruvate elevates, it implies that the person is catabolic. So in catabolic physiology, it's this pretty complicated, but if you remember back to biochemistry, this is exactly what happens. It's worth telling patients this because it's pretty important. So if you're stressed, and remember the sleep study, you stress someone out for a week, they gain two pounds. Okay? If you're stressed because you're not sleeping, if you're stressed because you don't like your spouse, if you're stressed because you, you don't like your job, if you're stressed because you're eating too many carbs, if you're stressed for whatever reason, your cortisol is going to become abnormal. That's going to make you catabolic because cortisol is a catabolic hormone. When you start to become catabolic, the very definition of catabolic is that you're breaking stuff down. And what people do when they're stressed is they break down amino acids to use them for fuel. And that's what this marker is showing is that you're catabolic. You're breaking down amino acids for fuel rather than using them for cellular repair, for enzyme production, and all the good things. So if you're catabolic and inflamed and breaking down amino acids for fuel, you're also going to be hanging on to every gram of fat that you can because your body's in an emergency mode and it's going to try to store body fat for survival purposes. So now we've got a situation where you're burning up amino acids, breaking down your gut lining, breaking down lean muscle mass tissue to try to get glucose. Your cortisol is abnormal, so you're tired, you're inflamed, you're catabolic, you're breaking things down. We want to stop that process. We want to get your blood sugar stable, help you build up, get you the carnitine and the blood sugar support that you need so you can start to flip this around and instead of breaking down, you can start to build up and repair. What are we going to repair? We're going to repair your metabolism because you want to burn fat. Your metabolism is breaking down right now. Catabolic physiology means your body is chewing up and breaking down things, not building them up. And we want to repair. Now, as a side effect of this, this particular patient, Carol, has also got all these energy production markers. So let me just show you a couple quick graphics on that in case you forgot all your physiology from school. Here's here's a little model, right? Here we've got the, uh, the little doohickey thing they call the mitochondria down here. See the mitochondria? And here's your carnitine shuttle, and your body's trying to grab the fat and burn it up for fuel. But when we see these markers, adipate and succinate elevated, it's like, oh no, oh no, my fat is not going to be burned up for fuel. It's going to adipate and succinate. That's bad. That's bad. Okay. And that's what happens with this patient. You want to be able to burn fat for fuel. She can't do that. And then again, another graphic here, real quick, little physiology review. She had an elevated pyruvate, right? Pyruvate's up here. So remember, we also want to be able to burn carbohydrate for fuel, very efficient mechanism. If pyruvate is elevated, it means the carbs are not coming into the Krebs cycle, they're not coming down there. And what does that imply? Well, if you're not burning carbs for fuel, you're going to be burning up amino acids for fuel. And that is very inefficient in the Krebs cycle. When you burn up energy, you get like 30-plus units of ATP in the Krebs cycle. When you're burning amino acids, you get minus four. How bad is that? In other words, it takes more energy than you make to burn amino acids for fuel. But that's what we do in catabolic physiology. So if I was sitting here right now and someone burst through the door and they had a spear, you know, and they were going to start chasing me and who knows what could happen. This is Northern California. There could be some guy with a spear up front. And I'm like, I'm freaking out. And I think, oh, wait a minute, I'm in Northern California. I have my own spear. I could grab my own spear and throw it at him, or I could try to run. Either way, I'm going to go into catabolic physiology. Boom, just like that, because I'm going to need quick access to muscle glycogen to burn, to burn, right? I need quick fuel to burn. So the fact that I'm burning up four ATPs for every two ATPs I'm getting, it doesn't really matter because I'm going to either be dead or not. But most of our patients are stuck in this catabolic physiology all the time, day in and day out. They're just not running away from crazy Northern Californians with spears. They're sitting in traffic, stressed out. They're dealing with family situations, they're stressed out. But the physiology is exactly the same. Okay? And that's the disturbing part in all this. And the lab just showed that, right? This whole citric acid cycle component is shut down. They're not burning energy. They're not burning carbs. Double, double problem. And let's see if we can make this whole thing go away.
Now, um, let's get to the punchline about solutions. And that's probably enough bad things for this patient. We could harp on this lab for a while, but this is kind of stick with the fat part, the fat-burning part. So now, if we're going to design a protocol, and this is what I would call a weight loss protocol. We're going to want to address the adrenal component that we saw in the beginning. And this is kind of a lot of stuff, so you might not want to give them this many supplements. Let's say this may chop a few things out, but I'll show you. And when we do this in the class, we always start with the most important products. So I'm going to trim this back a little bit. So the red products are for adrenals. And again, I'm cutting back a few things just to make this a little easier to see. Um, and again, the red products for adrenals. Let's blow this up a little bit, you guys can see. So we would use DHEA, pregnenolone, some licorice root, multipacks, and then something like support glucose. Um, uh, depending what brand you use, you might have a different blood sugar support product. But remember, they had a carb metabolism problem. So we want to really address that so we can get the adrenals working well, we can get the fat-burning mechanism going well. So this is a way to start healing their metabolism by fixing their adrenals based on a lab.
Now, they also had this patient had, um, oh, the carnitine problem, right? So you also want to use carnitine. That's for weight loss. And usually in my clinic, I'll do that later on after metabolism completed, you know, after metabolism repaired. I find if I give the carnitine in the very beginning, it doesn't work very well anyways. Plus, if it does work, then people don't stick around to heal their metabolism. They just do the carnitine till they lose the weight, and then they start eating crappy again, and then the whole problem comes back. So I usually do the weight loss program after the metabolism is repaired. I leave that as a teaser for the next step. So I would say, Carol, come, you know, we're going to do this test, we're going to run this program, I'm going to see you once a month for the next three to six months. When your metabolism is starting to look better on the lab, we're going to throw all these fat-burning supplements at you, like the carnitine that we discovered that is on the lab. Okay? And she also had energy production markers. So I use this stuff from Designs for Health called Mitochondrial Energy. And what does that do? That gets the whole Krebs cycle going again. So again, I would probably hold back on that at least for a couple months until she's starting to, um, get the effect of the metabolism repairing. And then go for the weight loss program. And sometime around the first three or four months, if she, she's really doing well, you can start to introduce the more advanced diet. You move away from the healing diet. You'd run the healing diet with the adrenal program initially to heal the metabolism. Once you feel like that's starting to repair, then you would run run the fat-burning diet with the carnitine and the mitochondrial energy. And then you're thinking, how is that going to work? Well, look at this. Let's just talk a little physiology. All of a sudden, she's got her carnitine, so she can shuttle fat. Where can she shuttle it into the Krebs cycle? Now, remember, on the initial lab, her Krebs cycle was shut down. It was kaput. It wasn't working. You could shuttle fat to a broken Krebs cycle all day long, it's not going to burn it. That would be like, I don't know what it would be like. It would be like bringing, it'd be like waiting at a bus stop and not getting on the bus or something. You just be standing there but not going anywhere, right? Because this little thing is the bus that's spinning around. So what we want to do in her case is
Get the carnitine shuttle working so she can shuttle fat to the Kreb cycle. But then, get the Kreb cycle spinning extra, extra fast so she can burn up that fat for fuel.
And now, we go back to the lab after I've made an absolute mess of this whole thing. My grandfather, Max Kish, was a very famous artist in New York in the 1920s and 30s. And, um, you should Google him sometime. Max Kish. He's a really amazing guy. I never met him. He died before I was born. But, um, I didn't inherit any of his artistic skills at all. Although, I do have his taste in clothing, which I have learned from looking at old pictures of him.
Here's this part of the lab. That's the energy production cycle. This is, these all these H's are bad. So when you see an H, it's a bad thing. When you see like five H's in a row, that's extra bad. That means her Kreb cycle's shut down. We're going to get that going with the mitochondrial energy. That's spinning the wheel, spinning the wheel. And then we're going to crank the fat into that with the carnitine, which is, let me just show you those markers, which is up here at the top. So again, fatty acid metabolism, energy production workers. We kind of light the fire or get the fuel using the carnitine and then dump it into the Kreb cycle and crank it up with those two supplements. And that gives people energy. They start to burn off body fat. It feels fantastic and they'll do really well. Okay, that's kind of the goal.
So let's go back to the program for one second, then I'll open up for some questions. So here's the whole program right here. Forget about her liver. We deal with her liver later. Some other seminar. DHEA, pregnenolone, some multipacks, some blood sugar support. All that based on the labs. Adrenals and blood sugar. Remember, blood sugar was a problem on the lab as well. And then carnitine to get that fat from storage, the mitochondrial energy to crank up the mitochondria. And boom, you've got a happy person with a healing metabolism who's burning fat. And I do this every day of the week. It works wonderfully. And, um, it's not the easiest thing to pull off because it takes a little bit of extra time, but it's very, very effective in my experience. And so I want to share it with you now.
Summary: Your metabolism is damaged. Out of AAC, blood sugar support, adrenals. We didn't talk about thyroid. Thyroid is critical too, of course. Damaged metabolism and your liver is in crisis. Get the liver working. Fat burning master supplement. We saw in the lab, this person really needed carnitine, etc.
All right, now, next class starts in September. Sign up. You get $500 off if you've listened to this lecture. You just got to tell our sales folks that you listened to the lecture. Okay. Um, also, if you like the lecture, you can send it to friends and other people. Um, let's see. Let's open it up for some questions. Plus, you know, the class is getting better. It's very interesting. We have, it's a pretty amazing group of doctors. I think my teaching skills have gotten better over the last 10 years, but something else is happening too. In the last two years, I would say, is that we're just getting these amazing practitioners coming into the class. Like, we get top, top-notch people. It's amazing to me. And I, I'm just blown away sometimes. I'm just like listening in. You know, I feel like I'm not even teaching because someone else has got so much valuable information to go over.
Let's see here. All right, so I'm going to go through some questions here. Let me grab the first ones. Uh, yeah, we always send out the webinar recording. You'll get a copy of that for sure. Run an Organix profile, by the way. That's kind of like the take-home message on this. Run an Organix profile on someone who's overweight. Um, and email us if you want the, um, addiction information. Just email my office. It's, uh, or you can go to the website, kishinstitute.com, and and email us and I'll send you out. It's a three or four-hour talk on food addiction. I did an hour of it and then Lynn's doing like two or three hours of it. Okay. So also, if you're a eating disorders counselor or therapist, I mean, she's a therapist, so it's oriented in that way as well.
Let's see. Franka, is Dr. Kish's practitioner training for doctors only or other modalities or for anybody? Yeah, so we have, um, nutritionists, personal trainers, I'm not kidding, people with commercial real estate backgrounds taking the class. Some people take it just for their own information. Some people take it because they're thinking about a career in health. Um, we have everyone, the full spectrum of practitioners. So if you're a non-licensed person, you don't have a chiropractic, acupuncture, or medical license, you want to take the class, just talk to me first and I'll tell you what the rules are and, um, you can get signed up because we try to, if you're going to sign up for the class and you're like a nutritionist, we try to pair you up with a, a doctor that can help you order the labs. And let's see, uh, let me just make sure I've got the right thing here. Uh, sorry, there we go. Um, let's see, next question. Can you review how to interpret an organic acids lab? Our doctor did one on our 9-year-old daughter, but it didn't look like what I expected from your slides, just a black, black and white paper with text.
Uh, yeah, so I mean, I have a whole four-month training program, the advanced class, we call it, right now on interpreting the Organix profile. It's pretty complicated. So I mean, it's literally a four-month class, so I can't cover that all tonight. Um, what about metabolic acidosis? I love it. It's a question. So when, when we're inflamed and catabolic, we're almost always becoming very, very acidic. What, remember organic acids? What are they measuring? Acids. So if you see organic acids elevated, like we just did on that lab, that means the person is, by definition, acidic. Okay. And so one of the big corrections is to balance out their pH.
Have I ever seen licorice drops raise blood pressure? Um, yeah, so, um, I, I don't have like a degree in herbal bloody blah stuff, but there's an herbalist in our training program. His name is John and amazing doctor. He's in, uh, Santa Fe, New Mexico, and he told me the other day that licorice root raises blood pressure in about 20% of the people that use it. So if you're going to use licorice root, you do have to be careful about blood pressure. If they either just drop it out of the program, use something else, or, you know, monitor the blood pressure. But it doesn't always happen, but it can.
I did a 12-week adrenal program with you in the past. How will this course move me forward? So I stopped doing the 12-week kind of boot camp class, because as someone said the other day, it, it would be like putting someone through the first year of medical school and then they would drop out, but then you made them a doctor. You know, it doesn't make sense to just give someone one component. So now I really, I have my advanced class and we really try to train people thoroughly on the adrenals, the gut, and the organic acids profiles, all of those. So the boot camps that I did in the past were probably maybe 15% of the content and what I do now is we, we stopped doing those, only doing the bigger classes and trying to get people. So Cynthia, if you're interested in the class, you can set up a phone call with me, um, at no charge, and we can just talk about if it's appropriate for you. Okay.
Patients get discouraged when weight loss occurs slowly. What's the best way you've found to help them consider this a marathon instead of a sprint? My new take on it is that just talk to them about the reality of the physiology. The reason why we store body fat is for survival. So for thousands of years, or hundreds of thousands of years, depending on your religious views, you know, people have been selected by evolution by dying, you know, in starvation situations. And so those of us that are alive now store fat really well. So in a way, the more damaged you are and the fatter you are, the healthier you are underneath all that, right? Because it's the fat people that survive starvation. So if you're good at storing body fat, it means that you have a core sense of really, you know, elite health in a way. It's just underneath all that body fat. And so it's not a bad thing that you're going to store your body fat. It's a survival mechanism that's allowed, you know, your genes to be passed on for a long period of time. So I try to turn it around and let people know, hey, it's really good that you're storing body fat because overall, it means that you're incredibly healthy, or you potentially could be healthy. You have the ability to store fat. We just need to heal your metabolism so it can get better.
Um, but that's kind of, let's see. So, oh, DHEA and pregnenolone. I get it from Bioh Health or BioMatrix is the name of the brand. I don't, I don't, I only sell stuff to my patients through my website. Okay.
Um, oh, Organix profile. Those are done by Genova Diagnostics. It's called a Comprehensive Organic Acids Test. There's another company that also runs them called Great Plains. Those are the two companies. Those are the only two that I know.
Um, let's see. Margo, how do you balance pH? Yeah, so, uh, you first morning pH for about a week. Make sure that they're acidic. You want them between 6.4 and 7. 6.4 and 7 is considered optimum. If they're showing that they're lower than that, give them a single pill of potassium and magnesium at bedtime. Have them keep doing their morning pH. Every night, they take an additional pill until their pH falls into the 6.4 to 7 range. All right.
And then how long is a program? So the program is six months long and about a three to five-hour a week commitment minimum. If you wanted to spend 30 hours, you could, but most everybody in the class is a working professional and they have a practice and so most of us have families too. So, you know, most people are putting in about three to five hours a week of time. They're literally hundreds and hundreds of case studies in there, so you could put in more if you had the extra time, but that's what we're looking for is about three to five hours. And most of the work that we do in the class is oriented around you doing things with your patients and your practice. So that's kind of the whole goal. There's a lot of things that you do for the class that are just going to be part of you talking to patients, you lab testing patients, that kind of thing. All right.
I think I got to all the questions unless someone's going to throw one more up on the board. We have another 60 seconds. I think we're good. All right, well, thank you guys so much for joining in on the call and, oh, there's one more question. Oh, how much is the class? Um, look online. There's a couple of different payment options. Go to the Kish Institute, okay, and you can see the different payment options there. All right, take care everyone. And if you were interested in the course, schedule a call with me. Um, it doesn't cost anything to talk to me and, um, we can go over whether it's appropriate for you to take the class or not. Okay. All right, have a good evening. Take care, y'all.