How to Reset Your Metabolism: Repairing Metabolic Damage After Dieting

All right, we're live. Look at that. Thanks for everyone. Welcome in, welcome in. Got 13 people here. Thanks for joining everybody. We're going to just kind of wait for like probably 30 seconds a minute. Let everyone roll in here. While we're doing that, let's do some introductions. My name's Cole Steeley, from one of the co-founders of MedMatrix, and I'm here with the brilliant Dr. Rose. Dr. Rose, how are you doing? I'm great. Really good. Awesome. So, for those who live under a rock and don't know who you are, [laughter] could you just give an introduction of, you know, kind of your background and functional medicine and yeah, what you do as a like a functional medicine provider at MedMatrix. Yeah, I'm a naturopathic doctor and I'm one of the lead providers here at MedMatrix. So, what that means is that like what we're talking about today in terms of metabolism, metabolic damage, these are conversations that I have with my patients every day, different aspects of it, different pieces of it, um depending on that individual's specific health concerns, health history, etc. So, yeah, I mean, the way that we're going to kind of dive into that today is really pretty much what I do in some shape or form every day with my patients. Fantastic. Yeah, today's going to be a really exciting episode. We're talking about metabolic health and what that actually means cuz a lot of people say, "Hey, my metabolic health is messed up." But they don't really know. Right, there's ways to fix it, there's ways to figure it out. So, we're going to be talking about all of that today. If this is your first time joining us, you should know that none of this is medical advice. If you want medical advice, welcome to come see us as a patient. But also, even more importantly, is we like to have fun on these live webinars. So, let us know where you're joining live from, and feel free to drop questions. We love to do Q&A. Hey, what's going on, Jess? We love to do Q&A at the end. Um, it's really fun. Um Um, if you're thinking it, other people are probably thinking it. So, as questions come up, make sure to drop them in the comments and we'll we'll get to as many as we possibly can. So, um, with that said, let's let's jump right into it. So, Dr. Rose, what is metabolic health? Good question. So, metabolic health is really um it's it's essentially kind of how your body or really how each cell um creates and uses energy. Um, you know, circling back to biology 101 in high school, we all learned that there's, you know, these uh pathways in the cell um and that we really the end product is ATP, which is energy. So, metabolism is essentially how the body generates and utilizes ATP or energy and it is very much influenced by uh hormones, nervous system, uh mitochondria, which are those um small organelles within each cell, kind of the engine of the cell. Um, so yeah, it's basically like energy production and utilization and all of these kind of influencing factors. Okay, great. Um that's an awesome explanation. Thank you. Um, and thank you Gary, Becca, Robin, Jess, everyone, Brenda. Um, so, okay. Why is that important? Why does that matter? Why should people care? Well, we again on a cellular level, um on, you know, everywhere from the micro to the macro level, so the cellular level to like literally how we're feeling um and how we're moving our bodies and how our brains are working, we need energy. So, that's why metabolism matters. Um, and I would say that, you know, eight or nine out of 10 every patient of the patients that come to see us, fatigue, um, brain fog, difficulty losing weight, uh, those are like, again, eight or nine out of 10 people have those concerns. And it's like at the top of the list of why they're coming in. So, um, you know, clearly there's something that's out of balance for most people when we're talking about metabolism. Got you. And what are the things that affect your metabolic health? So, one thing is that it's like uh, what I like to A lot of people come in and they kind of feel like my metabolism isn't working. Like my metabolism is broken. And I I think a reframe is sometimes important in that that it's really I think the human body is very intelligent and we it it's always trying to to adapt and adapt to the current situation and survive, basically. And so, it's trying to kind of adapt to the current environment to what is being put into the body, to how much rest, I.E. sleep, the body's, you know, all of all of these different factors. The body's always trying to kind of adapt to that so that it can survive. And so, things like how you're handling stress, how you're sleeping, what your nutrition level of nutrition is, um, both like what you're eating and amount of calories, um, physical activity, um, all of these things, and then, like I mentioned before, you know, this your home where your hormones are, if those are kind of in check, if those are balanced or not, those are all going to influence it. Mhm. Got you. So, we talk a lot about we talk a lot about hormones, right, men and women. Uh, and obviously that's something that declines with age. So, as your hormones decline with age, it's also affecting your metabolic health. Is that what you're saying? Yes. I would say almost inherently that your metabolism is going to adjust, change along with the natural hormonal shifts that happen I mean, honestly, as early as your early 30s. Your metabolism is inherently going to change because of that, because it's such a hormonal status is such a big influence on metabolism. Mhm. Got [clears throat] you. And what is the traditional approach to kind of metabolic health? Like you go to a conventional doctor, like in what lens are they looking at your metabolic health through, if that makes sense? Well, that's a good question. So, when you go to a conventional provider, what are they Like, are they considering your metabolic health? Are they How are they How are they looking at it? Basic labs. So, that can sometimes include what we what's called a CBC, a complete blood count. It might be a comprehensive More often than that, actually, it's more a comprehensive metabolic panel. So, that's going to look at, you know, initial screening, and we include that as part of our much larger comprehensive panel. We do have that included. Um but a CMP looks at your liver health, looks at your kidney health, looks at your It doesn't have your cholesterol on there. It your fasting blood sugar. That's kind of that's that's pretty much like a basic lab. If you If you come to your doctor and you feel like, "I think something's off with my metabolism." they'll they might run some basic labs, and they if if everything kind of falls within the labs' normal range, they might say you're fine. If they feel like you weigh too much, they might say, eat less, move more, um maybe give you some medications, maybe depending on if it's like a high cholesterol thing, a weight thing. The I think the crux of the issue here is that as we've talked about in several other podcasts is the limitation in the length of those visits with your primary care doctor. And those are, you know, averaging probably 5 to 12 minutes. And so, it's literally impossible to dive deeper into where is the metabolic imbalance, what is contributing to the metabolic imbalance, why are you fatigued, why do you have brain fog, why are you um cutting your caloric intake, working out 6 days a week hard, and you're not losing weight. There's just literally not the time um because it that model, again, as discussed in the past on other episodes, um the is not designed around assessing root causes. It's not that an individual provider doesn't want the best for you um and doesn't want you to be healthy and doesn't want you to feel your best. They do. They just either don't have the tools, uh the training, and or they're literally limited by these really, honestly, ridiculously quick visits. Right. Okay, that makes sense. So, how much is metabolic health like a chicken and an egg thing? Where it's like, okay, I'm feeling fatigued and I'm not losing weight. I am metabolically unhealthy. How much of that is like they need to fix their metabolic health first, but the only way to fix their health is to move more and eat better foods, essentially. Does that make sense? Like, how much of this is like you're kind of predisposed to just having poor metabolic health and you know, there's nothing you can do about it. Um What do you have to fix metabolic health before you can start losing weight and having more energy, or you just have to actually start working out and um eating better and then your metabolic health improves. Um Mhm. That makes sense. Yeah. So, right. So, you're basically asking like uh what comes first? Like the the lifestyle pieces, like the new the nutrition and the exercise piece or the fixing the underlying metabolic imbalance. Right. Um and I think different providers might take different We all We all have a slightly different style. My style, I can only speak for myself and I I think met most of the other providers here at Men's Matrix, but definitely for me, um I'm a big proponent of treating of doing things in parallel. I feel like you can start doing that that more investigative work, that root cause work of what is going on with your metabolism? What kind of testing do we need to do? Do we need to look at your thyroid? Do we need to look at your insulin levels? Do we need to look at your other hormonal levels? Um do we need to kind of do some look at genetic testing, look at how well you're actually methylating, you know, uh your your supplements and your food. I feel like we can do all of that and we can start asking the questions. Again, we have the gift of um really I think nice long visits. Um and but I'm also a fan of starting to give people tools so that they can start to feel better sooner than later. And so, and I'm a big fan of meeting people where they're at. So, I'm not telling every patient that you need to start training for a marathon. Like that's the key. Um I'm meeting somebody where they where they're at in terms of their level of fitness, their exercise, their age, their level of mobility. Same with nutrition, right? Like there's not a one diet There's not a one diet for every person. But I feel like those things, those adjustments um and you know, and we have a health coach that is a great resource as well. Um those things can and should happen kind of at the same time as we're figuring out, well, you know, how much of it is how much is it what you're doing or not doing and how much is it that there's really these underlying metabolic issues that really need to be solved. I think you can do it at the same time. Yeah, got you. And obviously with functional medicine like the lifestyle component is one of the first things we look at. Totally. That's not Yeah, if that's not addressed, then we're not doing our job. Yeah. So other other than the lifestyle component, which is pretty obvious, I think most people already know, what are like the top three things that you see um kind of wrecking or um ruining patients' metabolic health that's not related to um diet and exercise. So [snorts] I would say um nerve like nervous system um dysregulation. So somebody who has been kind of surviving on um suboptimal sleep for years. Um so that could be anything from somebody who has shift work, um night shifts, uh to other reasons for poor sleep. Um and that more often than not I would say goes along with um what I call um sub par stress resilience. And so we all there's stressors in life we all stressors, life is full of stressors or stress, but the issue is how well do you kind of internally handle those stressors? How do you you know, how how is it affecting your nervous system? Um and then there's also, you know, a lot of for a lot of people, a lot of our patients, there's layers of past trauma, childhood trauma. So all of those things are going to feed into nervous system dysregulation. The body, the nervous system on some level, and this brings in the hormone cortisol, um the body thinks it's in is in fight or flight. The body thinks it's in survival mode. And so, for example, that's going to make it difficult to lose weight cuz the body doesn't know the difference between stress at work and there's a famine coming up and I have to conserve, you know, I have to hold on to my fat cuz I don't know, you know, when my next meal is going to be here. Right. So, there's So, there's I would say nervous system, I would say hormonal status, and again, that can be anything from um it it really could be a person of any age. Definitely in the, you know, for women, the perimenopausal years, the postmenopausal years, that's big. Um for men, it's like often just a very you know, it's even starting in uh the 20s for some men, there's a loss of testosterone. That's going to impact all of that. Um and then I would also say, and this does, I guess, somewhat bring in nutrition, but kind of blood sugar issues. So, fluctuations in blood sugar, um uh you know, chronically elevated blood sugar, just unstable. And so, all of those things are really big with um impacting metabolism. Got you. Okay. Well said. Um I see good job with the comments, guys. We love interacting with you, so keep the comments coming. I don't want you to have a question then forget it. So, I want to mention thyroid and how thyroid's very important and how thyroid um So, how does thyroid relate to your metabolic health? Yeah, so thyroid is um kind of the gland that is maybe most known for um um playing a role in metabolism. So, in terms of energy production. Um thyroid the kind of the pituitary is kind of the mother um gland that tells the thyroid whether how much thy uh thyroid hormone to actually produce. And a lot of people don't have an issue with that part of the pathway. They have an issue with further down uh the pathway, which is this conversion of T4, which is an inactive form of thyroid hormone, that needs to get converted to T3, which is the one that actually locks into the thyroid receptor and again does things like give you energy, burns fat, um helps with cognitive abilities. Um really we have those thyroid receptors throughout the body. So, a lot of people have an issue with the conversion of that T4 to T3. A lot of that has to do with nutrient depletion, not having the right nutrients. Um so, that if the thyroid is not working optimally in any of this any stage in that kind of that whole pathway, then things are going to be sluggish. Things are going to be harder. It's basically like walking around with weights around your ankles and you don't really know why. And it can affect everything from joint health to um bowel regularity to weight loss. Wow. So, everything is pretty connected, you're saying? Yes, I am saying everything's pretty connected. Right. Um what are some other things that are connected to metabolism that you might not expect? Um what are some things connected to metabolism that people don't on uh like um well, I guess one way to look at it is you know, when I have somebody come into my office, if I'm wondering if you know, again, it's not just a lifestyle piece. It's not just a how are they eating or what are they doing for exercise, but is somebody's metabolism kind of not functioning optimally? What are some of the questions that I am asking them? So, some things I'm asking is like are you sleeping? You you know, you either feel like you got a good night's sleep or you're you know, your your watch, your Fitbit, your Aura Ring told you that you slept well, but you wake up and you still don't feel rested. I'm asking kind of what we said earlier, someone's like doing all the right things, but they're still not losing weight. Um I'm asking about sugar cravings, carb consumption, um not just are you tired, but like how stable is your energy throughout the day? So, is it that you wake up pretty good, but then 2:00 hits and you crash? Um brain fog, which is often kind of referred to as like that word recall or I can't remember what I was in the middle of doing, that's kind of a brain what brain fog is. Overall low motivation, and then this people often I think know that this is these symptoms are um signs are often connected to thyroid health, but feeling cold even in like the middle of summer or you just feel like your hands and feet can never warm up. Um and then the whole questions that we ask about hormonal health, you know, everything from libido to what are your menstrual cycles like to um you know, yeah, you know, are you having hot flashes or night sweats? So, all of that is kind of you have to collectively put that all together to start to assess that not that it's an either or, but how much is it lifestyle, how much is it metabolism? Mhm, okay. So, you said you said something um kind of on the topic, you said something about tools earlier. You said I have like tools that I like to kind of do both, like lifestyle but also some tools. Like, what are What are your favorite tools for helping uh patients kind of get better results with their metabolic health? So, in addition Right, in addition to kind of the education piece around um lifestyle. You're asking kind of in addition to those, what are some good tools to help with metabolism? Is that what you're asking? Yeah, so um uh you know, again, if anybody's ever heard any of these podcasts, I always seem to come I always seem to end up talking about hormonal health. So, yes, I'm a big fan of kind of assessing someone's metabolic status and making sure that things are optimal, not just normal, and that is going to be very personalized for the individual, um but we I just can't tell you how many times, you know, helping with a little bit of hormonal support seems to really kind of jump-start overall metabolism. Um and that would also include, you know, we've done a whole podcast or two on thyroid um optimization, and definitely that's a big part of it for some of the reasons that I just mentioned. Um and those those influence each other. So, um you know, maybe it's thyroid replacement, maybe it's um nutrient um tweaking to kind of help support the thyroid, maybe it's some botanical support. Um as I mentioned, oftentimes a nerve nervous system dysregulation is off, and so, you know, whether I'm using certain um peptides, um maybe I'm referring somebody for counseling, right? Maybe they've never had that kind of support, and it seems like that would be a good idea to help regulate their nervous system. Sometimes I'm recommending certain apps to help um bring somebody into what's called the parasym part of the nervous system to help them relax more on a regular basis. So, different tools for different people. Um but that nervous system balance um or recommending yoga or acupuncture, something like that, some other modalities. And then there's lots of botanicals and nutraceuticals that are also um really beneficial for the nervous system. Um and then, you know, for things like inflammation, weight loss, um helping with some of these uh signs and symptoms that we think of as uh metabolic syndrome. And that is like high cholesterol, uh blood pressure, elevated blood sugar, sometimes fatty liver, almost always inflammation, we do have the GLP-1 peptides. And those um I really can be can be really awesome when dosed appropriately for, you know, for the right person. Yeah, let's dive into GLP-1s a little bit more because it's pretty still a hot topic. It's been a hot topic for Still a hot topic. Yeah. Very like polar on each side. Some people love them, some people hate them. What's the truth? So, like what's your opinion on GLP-1s and um fixing people's metabolic health? Like when like how do you use it right? And kind of also where do people go wrong with GLP-1s? Yeah, so GLP-1s um just for some definitions, GLP-1 it's technically GLP-1 class of medication is GLP-1 agonists. And they are a class of peptides, which means that it's a sequence of amino acids. These and the the medication specifically that um are the ones that are used the most, um the the generic names would be tirzepatide and semaglutide. Some of the brand names that people that our viewers are probably familiar with would include Ozempic, Wegovy, Zepbound, Mounjaro. Um so so they basically work by mimicking hormones. Um somewhat produced in the stomach, some in the pancreas, even somewhat in um the brain. So they mimic these hormones and they have a lot of um a lot of benefits. Some that were part of the original design and some that have are only now being discovered and even some influence again on brain chemistry that nobody really understands how or why they're working yet. Um but they're working if they work they for example, they really help with cravings. So people who have different kinds of addictions, they work in a way in ways that other medications have not been able to work. So basically these GLP-1 medications were originally designed for people with diabetes. Then they discovered that they help with they help people eat less and therefore lose weight. Now we know that they have what I think of as kind of like a holistic benefits in that they help with weight, they help with blood sugar regulation, they help uh again with fatty liver, they help lower your blood pressure a little bit. Um and this is significant with inflammation. And so they just kind of touch on a lot of things and again when dosed in the right way, um can you know, can have very few side effects and really kind of really help with that piece to metabolism that someone's been struggling with. Um the stories that you and I probably both hear a lot of people one having really bad side effects, usually GI related. Those are usually on people on pretty large doses. They're most likely not getting the kind of support that I think they need, like the nutritional support, even something like vitamin B6 or B12 is going to help with some of that. They're not really given the the support around the GLP-1. They're not given the tools to help with the constipation. Um and the dose might be too high for that individual. So, the other thing that I hear about is, oh well yeah, my sister lost all this weight, it was great, and then her insurance stopped covering it, and she had to stop the medication overnight, and she gained all the weight back. So, those are like the most common things that I'm hearing about. And again, when kind of dosed appropriately and when done with support, we're not seeing that because we're able to kind of bring people down really slowly. We're able to, you know, at that point, the lifestyle changes have been kind of established, ingrained, and um there's other tools that we can use to kind of, you know, we've gotten the metabolism to this new set point. We have other tools that we can bring in to kind of maintain that. Um so, that's my GLP spiel in a nutshell. Okay, gotcha. Um so, the biggest place where people go wrong is the lifestyle component. Um dosing and support around it. I mean, I you know, cuz everyone's different, right? We always say that like it's a personalized medicine, and it really is. I mean, every person has a different level of sensitivity to all medications. And so, you can't do a one-size-fits-all, maybe especially with the GLP with peptides with these GLP-1s, but um you really have to realize that people are going to respond differently. And um so, it's personalized, and it I think it requires personalization, support, education. Yeah, totally. Um and for the little side tangent there, for those who don't know what peptides are or maybe they've heard the name peptide or the name GLP-1, can you classify what peptides mean, how GLP-1s are actually also peptides, um for those who just might not know? Yeah. So, peptides are a class of medications. They've been around for about 40 years. A peptide is a short protein, and so therefore it's a sequence of amino acids. They mimic, um proteins that we that the body already makes. Um they are synthesized in a lab, but they basically mimic things that the body kind of knows and recognizes. So, the And one key aspect of that is that that means that they that in general, the safety profile is really high because the body It's not something foreign. The body recognizes it, is able to kind of break it down easily. We don't see toxic buildup of peptides. We don't have to monitor your liver, your kidneys when you're on a peptide. Um So, basically depending on the sequence of amino acids, we can target um a peptide can target a different tissue or a different, um organ system in the body. So, we have peptides that specifically help with neurotransmitter balance. We have other peptides that specifically help with fat metabolism. The GLP-1 and other one, and then one of my favorite ones, which is, um inflammation, joint inflammation, and gut inflammation. So, and there's I don't know pep call how many peptides are there? Maybe I don't know if there's hundreds, but there's a lot, right? Yeah, there's a lot. I mean, there's only so many like that have been tested and used regularly, yeah. Yeah. But there's a handful that were just And there's a hand Yeah, there's a handful that were just, um FDA approved, but, um So, the GLP-1s are people don't know often know this, but that they too are peptides. They're just kind of their own, you know, kind of, um their own category within peptides. One thing I will say about peptides is that where you get them matters. So, where they're sourced matters and there's I read an article not too long ago about there's a there's a company that's kind of there I think their sole focus is assessing the um peptides. They basically get sent from all over the place and they have a lab and they're looking at the actual content and seeing if there's contamination, seeing if there's like actually, you know, they're like if it's a viable product, you know, all of this and it's honestly like the the statistics are not we're not great on what they were finding. You know, except for play except for these peptides that were basically going through like reputable compounding pharmacies. you explain that real quick cuz a lot of people don't know the difference between like research pharmacies and kind of the peptides that we get as like an actual established medical practice? Yeah, so you can go online and kind of get all get it you know, just kind of because they're not for the most part they're not like, you know, regulated by the FDA that you can just kind of buy whatever peptide you want on the black market and you just don't really know where it's coming from. And so um so those are I don't know what those are. It's all over the map what those are. Um when we when we recommend and prescribe peptides we only get them through um specific compounding pharmacies that have really tight kind of quality control and standards built in to their process. They as a compounding pharmacy they kind of have to abide by these certain standards and so we kind of we know what we're getting from them. Okay. Gosh, I hope that If you guys have any questions about kind of like how that works or peptides, drop them in. We love to answer them. Um okay, so got a little question here. So, like what about inflammation and histamine um intolerance um when it comes to I imagine this question is in relation to um GLP-1s maybe? Do you want to pop that question up on the screen? There we go. So, the question is what about um inflammation and histamine intolerance both at the same time? Good question. So, I would say that inflammation is a very broad category. Yes, I mean I I don't know if we're talking about this in the context of metabolism or metabolic damage, but um inflammation is a very broad term. It's something that the body needs to do. It's a reaction to something. It's a way to kind of um honestly kind of fight something, kill off some kind of pathogen. Um but we all know that in you know that inflammatory process can kind of get out of hand in a lot of different ways. Histamine intolerance, I would say, is kind of a type of inflammation. It specifically has to do with a specific part of the immune system, which is the mast cells. They produce histamine. And um a lot of people do have a histamine intolerance, and that too is that type of inflammation, that histamine production kind of being a little bit out of control in somebody and/or somebody not being able to tolerate a natural level of histamine within their body. Yes, you can have them at the same time, but I would say histamine intolerance is almost a subset of inflammation. Gotcha. I hope that uh helped imaginative arc. Um okay, cool. So, let's dive into one of the more um kind of problem parts of being a functional medicine practice, which is the testing. What are like some tests that you like to use for metabolic health that aren't typical in uh conventional medicine. What are some tests that we like to use that aren't Yeah, that people might not have heard of that are not part of kind of conventional medicine. Well, even even a comprehensive hormone panel, even a comprehensive thyroid panel, I would say is above and beyond what is standard, you know, offered most of the time. Other metabolic markers, we do kind of get a baseline and then we monitor several inflammatory markers and that can be a sign of metabolic imbalance. So, we're looking at There's one called HS-CRP, which is high sensitivity CRP. There's, you know, some other ones. There's ESR or sed rate. There's other kind of inflammatory markers that are general. They're not telling us what part of the body might have inflammation, but they do tell us, you know, what the level of inflammation is. We also have lots of different panels that can look at kind of nutrient level and even nutrient absorption, like how well you're actually absorbing nutrients. So, that too is going to as as we've said multiple times, how well you're eating, how much you're eating, those lifestyle factors are going to greatly influence your metabolism. And I people all the time are saying, well, I eat really healthy I have such a healthy diet and that means like, you know, 100 different things what healthy means. And they might be eating a healthy diet, it just might not be what that body needs at that time for that person. So, we're looking at thyroid, we're looking at insulin levels, we're looking at cortisol levels, we're looking at the sex hormones. Again, we're looking at some of those genetic tests, the ones that that some of the ones that people might have heard of would be um MTHFR or COMT. Those are some common genetic tests to see again how it can give us clues into your nervous system regulation. It can give us clues into um you know, levels of inflammation like homocysteine. So, those are some examples I think of tests that are not standard in conventional medicine. Okay. Awesome. Um guys who are live with us, if uh we're going to we're about to go into Q&A pretty soon, so start uh putting some comments have any. Um you said something that was interesting and I wish I wrote it down um because I want to ask it the way you said it. You said um some people think that they're eating healthy and they may be, but it's not what's right for them at that time. Can you give an example as far as like when it comes to nutrition and metabolic health, like what what diets do you see working for patients versus diets that are are maybe not working as well? Um again, it the diet, you know, diet the diets, there's not a one-size-fits-all and it's and kind of I think what you're alluding to or what I said and you're picking up on is that a diet that maybe worked for somebody 10 years ago is not working for them right now. Um so, I have people who say a woman is you know, when she was 30, she did she did the carnivore diet and she lost 20 lb and she was just like convinced that that you know, that's like her diet and that that is you know, magical. Life happens, COVID, the pandemic happens, she kind of falls away from the diet. It's 10 years later and she um has gained weight and she goes back to the carnivore diet and it's not working. Right? So, yes, it worked for her at that point, but her hormonal status, her stress level, um everything's not everything. Some things are different. Maybe she's got stress in her life that she didn't have, you know, maybe she didn't have kids back then, now she has kids. Like things are different and her body is again trying to adapt and it's she that's not working for her anymore. And so that maybe she needs to have more fiber and more vegetables and not solely focus on meat, you know, so I think that answers your question about and again, some people real do really well on like, you know, all you know, largely carnivore, largely keto. And then I have other people who honestly like they do really well on a healthy balanced vegetarian diet. Like they know how to get enough protein and not carb out on a vegetarian diet, which is not easy, but they know how to do it and not a lot of, you know, weird textured textured vegetable protein and too much soy. They've figured out a good balance and they their their lab work looks great and they feel great. Great. Okay. So we have two interesting questions here. We want we have one that says how significant of an impact of metabolic health is chronic stress versus anxiety and then a great follow-up question that says any secrets for lowering cortisol. So maybe you're just joining us. Uh I might I think it's Teresa. We did talk about it a little bit, but let's talk about it again. How like how significant is kind of that mind-body connection stress to your metabolic health and then how can we fix it? Or how what are some strategies that you use with patients to fix it? Yeah, so we were talking earlier about the biggest impacts on what are the biggest influencing factors on metabolism and I feel that nervous system dysregulation is a huge one. So under that category of nervous system dysregulation, I would put chronic stress, I would put anxiety, I would put depression, I would put Just cortisol, right? Like under the hood of all that, like the that's all that's cortisol that's being produced. Potentially, I'll get into that. Yeah. Um anxiety, depression, early you know, trauma, all of that is going to definitely impact your metabolic health because your Yes, and this is where cortisol comes in. Your body basically thinks it's in it's it is in fight or flight mode. It doesn't again know the difference between the tiger that's chasing you and the chronic um work stress that you deal with on top of taking care of aging parents and teenagers. Like the body to That's physiologically there's no difference. So, the body is going to hold on to weight. It's going to kind of slow things down and just try to survive. It's going to lower the metabolic rate. It's going to basically you know, your cortisol is going to be dysregulated. I'm not going to say that it's chronically elevated cuz we don't see that. That's kind of a miss um a a cultural myth right now about cortisol, but your cortisol is going to be dysregulated to the point that it's telling the body to conserve energy and lower the metabolic rate and hold on to fat, right? Hold on to fat storage, especially in the abdomen. It's going to affect your blood sugar regulation. It's going to impact your sleep. It's going to impact that thyroid conversion. So, you're basically in this low-level of survival mode all the time and that is directly impacting your metabolism. The thing with cortisol is that we include cortisol on our um initial comprehensive panel and um it will often come back as normal and people are surprised because they say, "I am so stressed. I'm shocked that my cortisol isn't through the roof." And the fact is is that we do blood This is blood work and it's a snapshot and it can tell us somewhat, you know, if you're if that moment in time did it kind of fall into a normal range. It doesn't give us a map of what's called the diurnal rhythm of cortisol. Cortisol is supposed to have a spike in the morning and then it's supposed to kind of drop and then be at its lowest when we're sleeping. So, at its lowest cuz you're supposed to feel safe, you're supposed to be in like deep rest. You don't need high cortisol. We are physiologically wired to have the highest in the morning when the day starts, when we are out milking the cows and we are like at our most productive time of day. And so, more what I'm seeing, again, here's an example of an advanced test. It's a salivary test. You submit four samples of saliva and that maps out your cortisol um throughout the day and night. And that gives us a much better picture of, you know, you know, is your cortisol high all the time? Is it low all the time? Is it backwards when you can't get out of bed in the morning cuz your cortisol's tanked but you're wired at 3:00 a.m.? Like, is cortisol What role is cortisol in that? Um so, this person's question around about lowering cortisol Yeah, so what happens? I mean, this is a great second follow-up question cuz like, okay, you come in and you do, you know, we do a 24-hour, 12-hour cortisol test. You see your cortisol, it's not it's too high in the evening. You're getting bad sleep. We know that tanks metabolic health. What are like your favorite strategies, tools, lifestyle resources that you have in Men's Matrix that you use to actually move the needle? Yeah, I mean, it's always This is a good example of a real combination, I think, of some lifestyle uh slash behavior modifications and some additional support. So, different things work for different people, right? So, sometimes it's a meditation practice, sometimes it's certain forms of exercise, tai chi, chi gong, different things that are kind of going to work for you for whatever reason. Um sometimes it's simply um like looking at your life and cutting out the things that you that aren't necessary or the things that are draining you. So, there's those kind of aspects of things. And then, again, we have some great peptides that help kind of with stress resilience. We have some great nutraceutical um options that, you know, everything from L-theanine to GABA um that are going to kind of help the body to other kind of full-on adrenal support products that are going to help balance cortisol and help regulate the nervous system. Um and that, you know, more often than not we are looking at other things, not not just the adrenal glands or the nervous system in isolation. We're looking at the thyroid. We're looking at the sex hormones. Um you know, we're bringing in something like progesterone to help optimize sleep, which is going to help with um kind of tamp down the impact of cortisol in the middle of the night. So, we're not giving medical advice. We're this is just education, but these are just some general tools that um you know, are kind of in our toolbox. Fantastic. Um who's got Well, I guess see if you can bring it back to parasites to affect metabolic health. And then uh kind of answer the question as well. Um so, the question is it do we test for parasites? And if so, do we only test for it or when we suspect them or standard? It's not a standard test for us. Um we do have some really great comprehensive um diagnostic stool tests that um I we order quite frequently, but um it's not part of the initial panel. Um, so it's usually done when we suspect them, when the person, you know, based on um, lifestyle, history, uh, digestive signs and symptoms, um, even, you know, other signs and symptoms, they patient and or the provider, um, suspects them. We would We would order, um, we have a a handful of different ways to test for parasites, so that's usually when we would do it. Mhm. What are some of the most common like things that you would hear from a patient be like, "Oh, maybe they have parasites." Um, it's digestive symptoms, usually. I know I know there's a lot kind of on the internet right now about all sorts of symptoms and signs that can be parasites. Um, I personally have rarely had somebody, um, have a po- like have a positive uh, parasite test without any digestive symptoms. Like have completely normal digestion and have a parasite. I've just never seen that happen. So, I'm usually only going to order it when there's abdominal cramping, pain, unusual amount of, um, of gas, you know, there's kind of a a change in frequency, quality of the stool. Um, obviously, um, international travel. We all know that you can get parasites domestically, so, you know, what's this person doing? Are they gardening? Do they have animals? Um, Yeah. You know, all the standard questioning, but if they have not had any extreme change in their gut health and they're not having and they're really pretty normal, I'm not as suspicious of parasites. Okay, interesting. Um, do you test test MTHFR? Um, again, MTHFR is probably the most well-known genetic test. It it it basically tests how well you are um, you know, within the cell, the methylation process. And so, it is about energy production, it is about inflammation, and there are genetic uh variants or genetic mutations to kind of the enzymes in that pathway. Um, those genetic vari- variations are pretty common. And it's a pretty simple test. It's not part of like the initial panel that we offer, um, but it is one that we do quite frequently. It can be done as a swab inside your cheek, it can be a blood test. Um, I don't know if Those are the most common ways that I know that we can test MTHFR, and we do all of that. Right. Cool. All right, um, let's wrap it up. We always like to do this with a case study. Uh, so good patient, um, with kind of their journey with um, on the topic of metabolic health. Yeah, so this is I mean, this is kind of a tough, I would say, I love case studies. I would say this is a little bit, um, it's almost like every patient fits into this category in some way or another because it's so you know, metabolism is such a big part of what we're working with, as I said at the um, start of the show. But, um, here's some Okay, here's somebody that I saw today. Um, this is a kind of a testament to lifestyle changes. So, this is somebody who She has a lot of things going on, but one of the things that we saw on her initial blood work was that her hemoglobin A1C, which is a 3-month average of your blood sugar, her She did not know this information before she came to us 3 months ago, but on our initial blood work, it showed that she was in the pre-diabetic window. So, not diabetic, but pre-diabetic. And um so, she got a little freaked out. I think she has a family history of type 2 diabetes. So, we talked about a lot of different tools, a lot of different ways to kind of help with that. Um she went home and she cut out sugar and she cut out processed carbs. She She said today that she just kind of is eating much more clean. That was her terminology. Um and despite having kind of some musculoskeletal limitations, she recommitted to working out more regularly. Those were the biggest changes that she did. She She did do some of the things that we recommended, but really in terms of that blood sugar piece, like that was what she did. And on her repeat blood work, her hemoglobin A1C has dropped. And um she's you know, we do we have an what we call an in-body scan, which is a really comprehensive way to look at the metrics, not just your weight, but your skeletal muscle mass, your water weight, um kind of your percent body fat. And she had um she'd lost 20 lb in three in 3 months just with the lifestyle pieces. So, um yes, we have great tools, but I feel like this was a really good example of the benefit of testing and her feeling like she had support. And um then, you know, repeat testing. Um you can You really only measure a hemoglobin A1C every 3 months. Um and so, her having kind of that validation that what she had done, the effort that she had put in herself without anything else really um had really moved the needle pretty significantly. So really again just a testament to for her it was the lifestyle piece and there's a lot of other things that we are working on with her but in regards to that one metabolic marker two metabolic markers the weight and the blood sugar she um she kind of did the appropriate work for what her body needed. You still there Cole? We might have lost Cole. Um so I think we might be wrapping it up. Um let me see. Um yeah I'm looking at some of these questions here. These are all really good questions. Some of these I think um some of our previous podcasts you guys might really be interested in. I see one question about or a comment about thyroid health. We have a great podcast on um thyroid health we have a couple of them that we've done that you can if you go to Apple podcast Spotify or YouTube the Matrix method you can easily look up previous episodes. Um I see a couple things about thyroid health so absolutely um and I see another question about somebody mentioning PCOS. This is a hot topic. We're about to do another podcast on this it has just renamed been renamed polyendocrine metabolic ovarian syndrome which I am super excited about PMOS. I think this is yes, absolutely Jessica a step in the right direction. I think it's finally some awareness around the different variations of PCOS that you don't need to have ovarian cysts to have this syndrome. So yes, more to come on this, but I absolutely think this is a little bit of awareness that we need personalized medicine. All right, so I think we're going to wrap it up. Um Give me 1 second. There you are. [laughter] Here's our behind the scenes. We can't hear you, Leah. I um got cut off because there was a technical issue on his side. We wrapped up. Um Dr. Rose, insightful as always. Thank you so much for all your hard work and just everything you do in general. Something amazing as always. Um and thank you all for joining. Visit our site if you Our site if you're interested in learning Bye, Dr. Rose. So I I don't know if people can hear Leah. She's um she's speaking from um uh another country right now. She she's traveling, so I think the audio was a little bit warped, but basically if you're interested