The Second Force of Illness: Impaired Metabolism or Burnout

The First Force of Illness is inadequate digestion and absorption of foods (or “sludging” – as we mentioned in the previous blog) and endothelial dysfunction.  The Second Force of Illness is “burnout” due to impaired metabolic/cellular processes creating an overall lack of energy.  How many of you suffer from being “tired”.    Metabolism is the term used to describe the creation of usable energy from food – and fatigue is an indicator that you may have an impaired metabolic ability to generate this “food energy”. The main factors in impaired metabolism are:  insulin resistance, mitochondrial dysfunction and thyroid dysfunction.

A major player in “burnout” is glucose regulation and control.  There is a saying that you chargercan have “too much of a good thing” – and this applies to carbohydrates – especially glucose and sugars.  Insulin, secreted by the pancreas in response to carbohydrates in the blood, regulates the uptake of glucose into the cells.  In the current North American diet, insulin secretion is virtually constant due to the almost continual intake of sugar and carbohydrates.  The only thing the body can do is to continue to secrete insulin in the attempt to lower the blood sugar level.  The cells can only take in a certain amount of glucose at a time, so the cells, under the stress of too much insulin, will do the logical thing – change the receptors for insulin making them inactive.  The scientific term for this is Insulin Resistance.

When a cell is unresponsive to insulin, our cells become unable to get energy from the food we eat – despite the fact that we have eaten enough – and our insulin blood levels become chronically elevated.   We become tired and hungry.   The cells are crying out for energy and we crave the quickest energy source (sugar) – which only compounds the problem when we eat them.   For our ancestors, food availability was always in question, so the body adapted by being able to store away the energy that we didn’t immediately need in the moment for use later – as fat tissue.  In today’s society, however, food (especially carbohydrates) is plentiful for most of us, so the “rainy day” never comes – but we still eat as if it could.  This is the crux of our obesity epidemic.  .  High insulin levels in the blood and Insulin Resistance have not only been linked to obesity, but also to arteriosclerosis and heart disease, stroke, high blood pressure and diabetes.

Mitochondrial Dysfunction is the second major part of burnout. Mitochondria are the energy producers of the cell.  They do this by taking sugar, fatty acids or amino acids from your food and, in the presence of oxygen, burn them to create energy.  Mitochondrial dysfunction is caused by a number of factors.  Overproduction of free radicals (also known as “reactive oxygen species” or RburnoutOS) can cause mitochondrial damage.  This is why you take antioxidants like vitamin A and E.  Poisoning from heavy metals, petroleum products, pesticides and trans fats also contribute.  At the cellular level, we find mitochondrial damage or dysfunction occurring in almost every type of major illness e.g., heart disease, stroke, diabetes and cancer.

The third major factor in impaired metabolism is thyroid dysfunction.  The thyroid is like the gas pedal in your car and determines your rate of speed.  Too little thyroid hormone and your metabolism slows.  Too much and your metabolism “red-lines”.  A low-functioning thyroid – especially in women – is becoming the norm.  Symptoms of hypothyroid include:  being cold all the time, weight gain, constipation, oily skin, coarse hair, increased cholesterol and depression.  There are many possible causes which include allergic reactions (wheat allergy/celiac disease has a well-known association with autoimmune thyroid disease), toxins, infections, hormonal disturbances and low selenium or iodine levels.

In the next blog, we will explore the ways you can test for “sludge” and “burnout”.  Until then……

Dr. Gatis

Are You Suffering From Sludge?

In a previous blog, I mentioned the book “Ultraprevention” by Dr. Mark Hyman, M.D.   According to Dr. Hyman, there are Five Forces of Illness.  The First of these Forces is what he calls the “sludge” factor.  Sludge (from a process I like to call “sludging”) is a term that means the result of abnormal or incomplete digestion and absorption of food.  Many of us are deluded into thinking that eating “right” i.e., eating lean meats, fruits, vegetables and cereals while avoiding fatty foods,  means that we don’t have to consider the possibility that we are malnourished.  This is unfortunately untrue.   Diet is important, of course, but how your body processes food is as important as the food itself.

Digestion, the breakdown of food into its components is complicated and involves severalHuman internal organs key players – the most important being hydrochloric acid from the stomach, pancreatic enzymes and bile from the liver/gallbladder.  If all of these digestive factors are working well, then there should be no fats, carbohydrates or proteins in the fecal material.  If there is, then either the digestion or absorption process has gone wrong.  Many individuals, for example, say that they eat well – but have digestive problems like chronic diarrhea, constipation or abdominal pain that is unrelated to an overt pathology.

It is now known that there is a process, called endothelial dysfunction, which occurs in the lining of the stomach and digestive tract, the lining of the arteries, the lining of the bones, the skin and the blood-brain barrier .  The same factors that cause inflammation in the gut can also cause inflammation in these other areas.   When a patient presents with symptoms on the skin (like psoriasis or eczema), autoimmune reactions or demonstrated arterial disease, the first thing that an ND suspects is a problem with digestion or absorption leading to a state of malnutrition.  Malnutrition in this sense is the chronic lack of certain essential nutrients that are either not being supplied in the diet or less-then-optimally absorbed that are necessary for the optimum functioning of the system in question.

70% of our immune system is located in the gut because swallowing “germs” is one of their major entrance routes into the body.   Any protein that is not recognized as yours is considered a potential invader and attacked.  The last thing that you want is your body to react against a food component.

Incomplete digestion is the major contributor for the digestion of food sensitivities.  Food How Do You Feel Question 3d Wordssensitivities occur when a food (especially protein) is not digested fully.   These incomplete breakdown particles can enter the circulation and create an antibody response because they are seen by the body as a foreign protein.

One of the reasons food sensitivities develop is a lack of hydrochloric acid (or HCL) production by the stomach or enzymes by the pancreas.    HCL is necessary for the breakdown of proteins into single amino acids.  Single amino acids don’t trigger an immune response where tripeptides (three amino acids bound together) can.   HCL is also necessary for mineral absorption.  This is why individuals that are taking a drug like Tecta for overacid conditions on a daily basis will eventually suffer from osteopenia or soft bones – due to the reduction in mineral absorption.   It has also been related, I believe, to creating low thyroid conditions – probably for the same reason.

In summary, chronic health conditions are usually related to problems with “sludging” or abnormal digestion and absorption of foods.  This “sludge” interferes with the cell’s ability to optimally function and is one of the first signs of the beginning of illness.

In the next blog, we will talk about Force 2:  Impaired Metabolism or Burnout.

Until then……

Dr. Gatis

Blood Tests and the Naturopath

A 58-year-old male Naturopathic Doctor (myself) presented at my clinic complaining of unexplained low energy, feeling uncharacteristically emotional with a decreased of motivation to do any physical or mental beyond that required for his job. Power naps during the day did return some energy but at the end of the day he has little left to do anything other than watch television. The diagnosis could be anything from depression, to low thyroid, so blood work was requested (14 vials to be exact) In addition, a blood spot test was completed – a relatively new way to measure to measure hormones like testosterone.

The preliminary results of the blood tests have returned. Iron metabolism (Ferritin, Hemoglobin, Serum Iron and Iron Saturation) were normal. Thyroid parameters were normal – although the Free T4 was at the lower end of the range. No thyroid antibodies and the ANA was negative (which reduces the possibility of autoimmunity). In other words, low thyroid and anemia were ruled out. The Fasting Blood Glucose was normal as was the HBA1c. His waist-to-hip ratio, however, is 1.0 (and should be less than 0.9) and a previous blood insulin reading was at the top of the range, so he may have some Insulin Resistance.

The most revealing parameters have to do with cholesterol, heart and hormones. Total Cholesterol was 5.32 (which Man with conceptual spiritual body artis slightly above the upper range of normal). His total cholesterol had been around 5.4 for 20 years. Cholesterol usually is released by the liver when the body has a need to make more testosterone or when there is a low thyroid state (Both conditions are on the rise in aging males). When the cholesterol is high there is also a suspicion that plaque may be forming on the arteries. Of the blood parameters tested, the HDL was low (1.03 versus the optimal 1.5 or more) and the Apolipoprotein B was 1.13 (any value above 0.8 is associated with an increased risk of heart disease). The Total testosterone, although in the normal range was in the lower third and the Free Testosterone was so low that it was almost out of range. Testosterone in males is heart protective and anti-plaque as estrogen is in women.

From the first round of blood work, the working diagnosis is Low Testosterone – especially low Free Testosterone (some of the symptoms include fatigue, tiredness, depression and lack of motivation).
The first line of defense is to attempt to increase the testosterone naturally. In this case, moderate exercise – both interval training and strength training was prescribed which will increase the testosterone and the HDL and reduce the insulin resistance. To protect the heart by decreasing the Apo B and increasing the HDL, Niacin, Pantethine (B5), Resveratrol and Green Tea were also prescribed.

The answer to the question from the last blog is Homocysteine. Homocysteine is an indirect measure of methylation. “More than any other single test, homocysteine correctly identifies the risk of such conditions as heart attack, stroke, and dementia years before the onset of any symptoms.” (Dr. Hyman, M.D.)

In the next blog, we will track the progress of the patient, discuss the results of the blood spot analysis (if available) and investigate certain herbs that are reputed to raise testosterone naturally.

Until then…

Dr. Gatis

How Does A Naturopath Think?

I have enjoyed relatively good health over my life – with a few minor/major blips along the way.  As an aging male Naturopathic Doctor, I am acutely aware of the fact that – although I have taken care of my body and mind reasonably well over the years – my level of health has not yet achieved optimization.  In short, like the rest of you, life gets in the way.  I have decided, therefore, to use this blog as an instructional tool (how a naturopath thinks) over the next few months by using my own situation as a reference point rather than case studies.  In other words, I will assess myself as if I was one of my clients – including any naturopathypossible blood work and/or functional tests that are available – and, based on the findings, will put myself on a treatment regimen and monitor the results.

I am currently reading a book (one of many) by Dr. Mark Hyman, M.D. called “Ultraprevention”.   He is a brilliant man and far more Naturopathic Doctor than Medical Doctor, in my opinion.  I say this because he has come to the conclusion that the human body is complicated and health is a process.  There is no “magic bullet to shoot down all your health issues”.  There are “forces” that lead us down the path to illness.  When we are aware of these forces and make them personal i.e., understand that one size does not fit all when it comes to our own health, we can truly be more in control of our own well being rather than at the whim of “illness”.  These (naturopathic) factors as summarized by Dr. Hyman are:  1) Malnutrition/Mal-digestion (sludge),  2) Impaired metabolism (burnout),  3)  Inflammation (heat),  (4) Impaired detoxification (waste);  Oxidative stress (rust).  Over the next few months, we will explore these topics in more depth.

Until then, there is one crucial test (according to Dr. Hyman) that will provide you with personally with the inside track on the possibility of preventing diseases like heart attack stroke, dementia, and some forms of cancer.  This test is:

  1. Cholesterol
  2. Blood sugar
  3. Vitamin E
  4. Homocysteine

See the answer in the next blog.

Dr. Gatis

How to Naturally Increase A Man’s Testosterone Level

In the last blog, I talked about what testosterone does to maintain a man’s health (in addition to maintaining erections). Most men would probably choose to die doing the horizontal mambo – but would in their 80’s and not in their 50’s. Testosterone levels are extremely important to males. How then can we optimize these levels? To my mind, it is always better to attempt to raise levels naturally rather than initiate hormone replacement as the first therapy option – and testosterone levels fluctuate according to diet and lifestyle
testosterone-4factors.

GET ENOUGH SLEEP

Seven to Eight hours of sleep per night is extremely important to optimize testosterone
levels. A lack of sleep affects many important hormones and chemicals in your body including melatonin. Melatonin, in addition to helping you fall asleep is an extremely strong antioxidant and some researchers claim that melatonin production is somehow linked to testosterone production.

MAINTAIN A HEALTHY WEIGHT

Men who are overweight convert testosterone into estrogen in their fat cells due to an enzyme called aromatase. In other words, having abdominal fat lowers a man’s testosterone and increases estrogen. Losing the extra weight can bring the testosterone back up because the fat-cell conversion of testosterone to estrogen is reduced and the normal ratio of testosterone to estrogen is restored.

BE ACTIVE

Testosterone reacts to your body’s needs. When a man is physically active, the brain sends out the signal to increase testosterone in order to build muscles and bones. Take time to move your body. Walk, run, skate. Do Tai Chi. Remember the old adage “Use it, or lose it”. This is true whether you are using a regular muscle or the “love muscle”. Interestingly, only short intense exercise has been shown to boost testosterone while aerobics and prolonged moderate exercise do not raise testosterone levels.

REDUCE YOUR STRESS

When a man is “stressed” the hormone cortisol is produced. Chronic elevations of cortisol affect a man’s ability to create adequate levels of testosterone. Learn to relax from the brain on down. Spend an hour-a-day on an activity that isn’t work or exercise related. Learn meditation or self-hypnosis techniques.

CHECK YOUR MEDICATIONS

Many medications affect testosterone level. Discuss the drugs you are taking with your doctor or pharmacist to rule out drugs as the cause of your symptoms or low testosterone.

I value your feedback and would like to know the topics that are pertinent to you.

In Health,
Dr. Gatis

Testosterone Is Not Just For Sex

funkyicon_maleHormone Optimization Therapy is important to every man, and at every age past puberty.  It might surprise you to know that the average man in his thirties these days has less measurable testosterone than his grandfather did at the same age – which probably explains why many thirty-year-olds are still living at home!  My theory is that these lowered testosterone levels (and the availability of online pornography) are killing the desire for young males to go out and start families of their own.  In other words, “the population-level declines are greater in magnitude than the cross-sectional declines in testosterone typically associated with age.” (J. Clin. Endocrinol. Metab 2006, Oct 24)

What do optimal levels of testosterone do for a man?  If we take sexual desire and erections out of the equation for a moment, an adequate level of testosterone contributes to brain, bone, muscle and heart health – and reduces overall mortality rates.  A 2007 study had been following 800 men over the age of fifty for 18 years.  The group of men with values in the lower 1/3 testosterone level had a 33% increased rate of death from all causes than those men whose values were in the upper 1/3 testosterone level.  Another way to say this is… a higher level of testosterone that a man has as he ages reduces his risk of dying.  High free testosterone levels correlate with improved cognitive function and memory, and reduce the risk for Alzheimer’s disease.  Lower testosterone levels are associated with coronary artery disease and atherosclerosis.  Testosterone improves exercise-induced angina as it dilates coronary arteries.  High cholesterol has been associated with low testosterone and testosterone therapy has been shown to lower total cholesterol.  Testosterone therapy builds muscle mass in elderly men and increases bone strength.  These are just a few examples in current literature of the benefits of having enough testosterone.

The following is a list of symptoms indicating that a man may be low in testosterone:  decreased muscle mass and strength;  decreased sex drive;  reduced frequency and firmness of erections;  reduced ejaculate volume;  hot flushes;  excessive emotions/sensitivity to difficulty;  unnecessary worry anxiety, fear;  depression;  loss of self-confidence;  joint pains;  persistent fatigue that increases with activity; dry eyes;  reduced muscle tone;  depressed attitude;  nervous, irritable;  poor concentration and memory;  pale skin/anemia;  increased fat in breasts, abdomen and hips;  metabolic syndrome.  If you have any of these symptoms/signs on a continuing basis, please mention them to your primary health care provider and ask for testing to rule out testosterone deficiency. If, after the testing is done, your provider says that you are in the “normal” range, please ask him or her where in the normal range do your values fall?  If you are in the lower 1/3 of the range you are at risk (re-read paragraph number two above) and should consider or hormone optimization therapy.  In the next blog, I will talk about the ways to optimize testosterone levels – both naturally and by replacement.

~ Dr. Gatis

HOT & Aging Go Together

Hardly anyone would say that I need to “optimize my hormones” for good health and longevity.  In fact, many of the signs of aging can be directly related to declining amounts of major hormones.  Testosterone, DHEA, Progesterone, Estrogen, Growth Hormone all decline with age, for example.  Why are many people almost obsessed with the idea of anti-aging?  We all are going to die, right?  Well let me tell you a simple fact.  When I reach the age of sixty and beyond, when asked “How are you?”, I want to be able to look them in the eye, give them the thumbs-up sign and say “Golden” (and mean it).

That is why I am a proponent of “H.O.T.” or Hormone Optimization Therapy.  To this end, for myself and my Naturopathic patients, I have taken the training and become a Fellow and Board-Certified in Anti-Aging, Regenerative and Functional Medicine from the American Academy of Anti-Aging Medicine – and I have decided to “blog” about relevant

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issues that we all should know about when it comes to healthy aging.

H.O.T. is not just bio-identical hormone replacement therapy– as important as this can be.  Excessive hormonal levels – like insulin and cortisol – also adversely affect health.  Hormone Optimization Therapy takes into account that hormone levels and organ systems are all interactive.  Reducing stress and restoring adrenal function is absolutely necessary for individuals with low thyroid activity, for example.  Optimizing both adrenal and thyroid function is necessary to have balanced female and male hormones. A Naturopathic Doctor by virtue of his or her training is a specialist in supporting and optimizing the body’s functions.

It was a surprise to me that a high percentage of men have symptoms of and suffer from hypothyroidism and low testosterone as they get older.  The “grumpy old man” syndrome is actually the result of low T!  Maybe it is just the male in me, but there is a distinct difference between being sensitive to your female partner’s needs and being an emotionally “sensitive” male as a man ages.  One of my patient’s just today mentioned that as her father has gotten older, he cries much more often – and “that isn’t my dad”.  In my opinion, his Testosterone to Estrogen ratio has changed and he has become more hormonally like a female.   Please understand that I am not saying that there is anything wrong with a man or a woman crying.  In a man, however, inappropriate or increasing crying (or anger) may indicate a testosterone deficiency.  Optimal testosterone levels are absolutely essential to a man’s health – his mind, heart and “bone” in particular.  More on this in the next blog.

Please leave your comments below, and feel free to follow me on Twitter & Facebook.

Until next time,

Dr. Gatis