Corrective Diets for Weight Loss & Issues with Insulin

In the medical community we don’t offer “diets” as solutions, we guide people on lifestyle changes — and adopting a healthier diet is a large part of that lifestyle change. But it’s important to understand the different meanings of the word “diet.” Diets that are marketed to people on TV and through books are rarely positioned as actual lifestyle changes based on science and what your body needs. “Diets,” let’s call them “fad diets,” often offer unhealthy short term solutions in the hopes that you see and feel some sort of results — and continue to spend money on the fad diet. 

We do not condone short term diets, except in extreme circumstances — and we come to that decision after extensive lab work. Sometimes people have metabolic irregularities, and we need to give them short term corrective diets. Those are very specialized moments. Let’s look at some of the reasons we’d change a person’s dietary lifestyle. And then we’ll close by looking at when and why we use short-term diets with patients.

Someone may eat perfectly, but whenever they get on the scale they see weight-gain no matter what they eat or how much they eat. This situation most likely hinges on blood sugar levels.

Let’s say you go out to lunch. When the average person eats, they bring their blood sugar up to a normal level. Your pancreas should sense that blood sugar increase and then release insulin to match your blood sugar levels. The insulin escorts the sugar to your cells to be used as an energy source. Your blood sugar starts to go down because it’s being taken up by your cells, and your insulin goes down with it as well. This is ideal. This is healthy.

Sometimes we see patients who have type 2 diabetes or are pre-diabetic. Chances are they regularly eat too much, causing their blood sugar to soar too high. These people may be over indulging on a regular basis, resulting in high blood sugar levels. Their pancreas is likely responding with a lot of insulin. They have high insulin and high blood sugar. The insulin will still escort sugar into the cells to be used for energy, and the insulin levels will drop. But this person is setting themselves up to for diabetes, if they aren’t diabetic already.

Now let’s look at someone with type 1 diabetes. They don’t produce insulin, their pancreas doesn’t make it. That person can eat a salad, or an orange, (something small), and their blood sugar will start to go up. But since their pancreas isn’t secreting insulin, the blood sugar is not escorted to the cell to be used for energy. Blood sugar levels continue to soar. These people will have a level of blood sugar that is three to four times higher than normal. You may think this person should be overweight, but they usually aren’t. People like this are usually under weight. 

Sometimes we have a patient who has trouble loosing weight no matter how hard they try. We do a hemoglobin a1c test, that shows what their average blood sugar is over the course of three months. Their blood sugar is very low, we know that from lab work. They calorie restrict, but it doesn’t matter — their body is trying to gain weight. So in our labs we also test their insulin, and we find that their insulin is astronomically high.

Basic physiology shows that insulin preferentially takes whatever you eat and does everything it can to store it as fat. it’s like living with a hoarder who takes part of your paycheck every time you get paid. Instead of using that money for the upkeep of the house, they’re hoarding it away. This person’s blood sugar isn’t being used as an energy source, it’s being stored and held onto, as fat. These people are now left with a small amount of energy. They’re fatigued and gaining weight. And perhaps eating a low calorie diet. A lot of times these people are also exercising — they want to lose weight.

A low calorie diet will not help this person. She wouldn’t loose any weight and she’d feel worse. We have to address the insulin issue.

The standard american diet has a bit of fat, a good amount of protein and a lot of carbs. This could be a healthy diet, but most of the time it isn’t. Most of the time we load up on carbs by eating junk food. We just do. But you could do this healthily, carbs can be found in fruits and vegetables. But low calorie diets simply change the volume of fats, proteins and carbs. As soon as this person eats carbs, it stimulates the pancreas to produce insulin. They are over responding to carbs with too much insulin. So what’s our solution for that? There’s a few and we’re going to talk about the ones that work best for us.

Let’s look at the standard American diet. Your protein will be moderate, your carbs will be high and your fats will be low. The problem is high carbs lead to high insulin. This diet will not help, even the lower calorie version of it.

What about a high protein diet, like paleo or Atkins? That type of diet is high in protein, low in carbs and has a little bit of fat. That could work, but the problem is you only need so much protein in your diet. As soon as you exceed a certain point, your body will bioconvert protein into carbs using gluconeogenesis. And that’s when high protein diets no longer work. These people are eating too much protein, the protein gets turned into carbs, and the carbs stimulate the pancreas to create more insulin.

In our experience the diet that works in this case isn’t a diet that’s sustainable — to be honest. This is why it is one of the rare times we implement a short term diet solution. the diet is: you eat as much protein as your body needs, as low a level of carbs as we can get away with, and we level it out with fat. This is a crazy diet, it is not good long term. it isn’t safe. But after a period of time this diet leads to a regression in insulin. At this point we pivot and take the patient off this potentially detrimental diet, now that it’s done its job.

Every decision we make is based on extensive and continual lab work — whether we are offering a short-term diet to mitigate the dangers of metabolic irregularities, or we are changing a patient’s lifestyle long-term. We base all decisions on lab work that pertains to each individual patient of ours. No two people are alike, and no two plans are alike. 

Women & Testosterone

Most people go through life thinking estrogen is for women and testosterone is for men, but things aren’t that simple. For example, men need estrogen. And when men lack estrogen there is a genetic irregularity. This leads to health problems. There’s a lot of good research on men and estrogen. But there hasn’t been much research done on women and testosterone. But that’s changed over the last 10-15 years.

At Protea, we run lab work to figure out why women may need testosterone. In this blog we’re going to cover why we treat some women with testosterone, symptoms of low testosterone in women, and the risk and benefits associated with testosterone in women.

In women, testosterone is produced in the ovaries. Testosterone is produced all month long, with a little spike sometime around ovulation. Testosterone binds to muscle tissue to help fortify muscle tissue, including your heart.

Currently, the most common use of testosterone in women has been for anti cancer treatments. Testosterone helps mitigate the pain caused by breast cancer, and inhibit breast cancer growth. But testosterone also has a profound effect on brain chemistry.

In the brain there is the limbic system. It’s a deeper part of the brain, and it has centers associated with confidence, assertiveness, aggressiveness, libido, risk taking and boundary setting. These are deep drives within the human brain. Then there is the cortex, the upper part of the brain.

A young man (around 17/18 years old) may exhibit a lot of these traits: abnormal libido, they take too many risks, and they have over abundant confidence. This is because a young man has a very thin cortex. I.e., he doesn’t have a lot of judgement. If you have a thin cortex you feel those drives more intensely, this is only compounded by the amount of testosterone a young man has.

Women have much thicker cortexes than men. Especially adult women. Adult men have tick cortexes as well, but cortexes develop slower in men. Your cortex is where your experiences live: your upbringing, your values, friends, beliefs, spirituality and etc.

Healthy amounts of testosterone filtered through a woman’s thicker cortex means they have a healthy level of risk taking/risk management. They don’t act aggressively in a harmful way, but they are aggressive in regard to pursuing their dreams and what matters to them. Women with healthy levels of testosterone can more easily set emotional boundaries and adhere to them. This all allows women with healthy testosterone to be able to be more confident, more assertive and also have an increased libido.

A lot of women want these traits. A lot of books are written telling women how to be more assertive and take more risks in their lives. But the issue with being told “how” to be more confident and assertive is that it’s an external “solution.” When you read a book and intellectually process that information it lives in your cortex. The info you just absorbed is not rooted deep within your limbic system. So you may be aware of these concepts, but it’s harder to act on them because they are merely concepts in your cortex. We want to stimulate the actual centers of confidence and assertiveness which live deep within your limbic system. Testosterone in women helps to do that. Let’s look into this some more.

Why would women have low testosterone? Well, women aren’t supposed to have a lot of testosterone. A man’s level of free testosterone is at 20-25, for women it’s four. Four is a good number. Now, when we say “free testosterone” we mean testosterone that is unattached to anything in your blood. One of the reasons women can have low testosterone is because of sex hormone binding globulin — a protein made by the liver.

Sex hormone binding globulin is like a magnet. It looks for testosterone that’s in circulation and binds it to the protein. Any testosterone bound to that protein becomes inert. Anytime a woman has too much sex hormone binding globulin, she won’t have any free testosterone available to do anything in her body. Well, what could increase sex hormone binding globulin? Oral contraceptives.

So when a female patient comes and says she lacks confidence, assertiveness and drive and etc, we look at what her sex hormone binding globulin level is. We then ask if she have a history of oral contraceptives? We gauge what her testosterone levels are. We measure what amount of testosterone is bound to the sex hormone binding globulin protein. And then we look at what is her amount of free testosterone.

Giving a woman dosages of testosterone is not our ultimate goal. Our goal is to find a woman’s free testosterone that isn’t bound to the sex hormone binding globulin, and bring that testosterone to a healthy level — naturally.

You might be wondering, “what if we do have to use testosterone?” “What are the risks?” “What are the benefits?” Testosterone in women is probably one of the hardest things we deal with in our office. Because the way it’s naturally secreted by the ovaries is very slow and gentle. When we give a women an injection of testosterone, her levels shoot up, but then harshly drop after seven days. Meaning the process needs to be repeated. Which means the patient is on a tumultuous cycle of hormone dosing. That’s a roller coaster. Some women don’t notice that roller coaster, and everything is fine. But some women do notice it, and that roller coaster ride of testosterone can be immensely difficult to deal with.

In most cases we’ll insert a sub-dermal pellet that lasts for four months, and releases very slowly and steadily. This is our preferred method of treatment. This does not spike testosterone levels. After the four months, it dissolves and leaves the body. This is far gentler on the endocrine system than injecting testosterone into the body.

It’s important to note that side effects of testosterone can be mitigated as long as you’re receiving a healthy dosage. As long as the dosing is healthy, any side effects can be managed and reversed. We view testosterone as a subordinate to progesterone in women. Testosterone helps progesterone do its job. Progesterone is your body’s natural anti-anxiety agent. And finding natural solutions to your health problems is what we’re passionate about at Protea.

We want to work in concert with your body, not against your body. That is our philosophy at Protea, and it has lead us to success with our patients. We invite you to contact us to learn more about how we can help you live a healthier and happier life — naturally. That is the Protea promise.

Deconstructing Patterns

I wanted to talk a bit about patterns this week. Patterns of behavior are usually learned, not innate, and can take a while to take hold.

As a baby, you learned patterns of language by mimicking and copying until eventually you made your own words and phrases. As a kid, you learn how to act and behave through trial and error: in school, at home, with your friends. You don’t grow up automatically understanding that you must say “please” and “thank you” or where to put your homework when you unpack your backpack in the classroom.

We learn social patterns, how to drive a car, how to study for a midterm, how to give and receive gifts. We are taught how to cook by watching and then helping our parents until the patterns become ingrained.

Patterns become a part of the tapestry of our days so much that we forget the work involved in the process.

I am currently teaching my kids a pattern on how to snack after school. How to eat the rainbow on their plates, to include a protein, a healthy fat, a carb and a fruit or veggie. I show them how to read labels to look for sugar grams, make a list for a recipe, shop for the ingredients, and put everything away when they get home.

Patterns become a part of the tapestry of our days so much that we forget the work involved in the process. When we learn patterns, our frontal cortexes are engaged: our powers of concentration, forming new neural pathways, and repetition fire up until we “get it.” Once this happens, we can’t imagine not knowing.

Unlearning patterns of eating is a tricky process. It can be discouraging, starting to understand that how you ate at 20, 30, 40 does not work for your metabolism right now. For those of us who were children/teenagers in the 80s, learning that eating “fat free” didn’t deliver on the promise of “thin” can be disheartening. We were programmed to believe something so deeply that it can be daunting to unlearn it.

Daunting, yet incredibly empowering.

Once you start to understand macronutrients and eating for your particular biochemistry, the hard work begins. We begin to deprogram our brains with knowledge that makes sense to how our bodies feel now – not at the moment years before when the first patterns formed. At the same time we deprogram, we learn new ways of thinking about food and our bodies.

Our brains love to hold onto established patterns and resist the shift we towards eating a new way. We feel better, and get excited by less inflammation and bloating or brain fog. But our brain patterns and memories can sabotage our newfound knowledge, because food is so much more than just nutrition.

Don’t forget the hard work you are doing in deprogramming a set of patterns and learning new ones. Take heart knowing that when you “mess up” on a diet, you are still doing great work. Creating a new nutrition plan deserves success and celebration as much as it does discipline and dedication.

If you have a craving, know that your body is sending you a signal. If you indulge the craving, do it mindfully and then notice how you feel afterwards. Be easy on yourself. If you choose to replace the craving with something that aligns with your new eating pattern, celebrate the win.

We encourage eating for life rather than “dieting” at Protea. Understanding the process in creating a new pattern not only keeps you from going crazy with “fails,” but also helps you stay the course.

It can be a delicate balance, but an encouraging one, as you eat for your body now rather than who you were before, or based on what popular culture tells you. Diet books are tools, but only one part of the pattern you make for yourself.

We believe in the body’s wisdom and the power of your brain to create a successful nutrition pattern that allows you to thrive.  One step, one meal, one day at a time.