Back Clinic Metabolic Syndrome Functional Medicine Team. This is a group of conditions that include increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels. These occur together, increasing an individual’s risk of heart disease, stroke, and diabetes. Having just one of these conditions doesn’t mean an individual has metabolic syndrome. However, any of these conditions increase the risk of serious disease. Having more than one of these might increase the risk even more. Most of the disorders associated with metabolic syndrome have no symptoms.
However, a large waist circumference is a visible sign. In addition, if an individual’s blood sugar is very high, they might have signs and symptoms of diabetes, including increased thirst, urination, fatigue, and blurred vision. This syndrome is closely linked to overweight/obesity and inactivity. It’s also linked to a condition called insulin resistance. Normally, the digestive system breaks down foods into sugar (glucose). Insulin is a hormone made by the pancreas that helps sugar enter the cells to fuel. People with insulin resistance their cells don’t normally respond to insulin, and glucose can’t enter the cells as easily. As a result, glucose levels in the blood rise despite the body’s attempt to control the glucose by churning out more and more insulin.
Dr. Alex Jimenez, D.C., presents how adrenal insufficiencies can affect the hormone levels in the body. Hormones play a vital part in regulating body temperature and help function the vital organs and muscles. This 2-part series will examine how adrenal insufficiencies affect the body and its symptoms. In part 2, we will look at the treatment for adrenal insufficiencies and how many people can incorporate these treatments into their health and wellness. We refer patients to certified providers that include hormone treatments that relieve various issues affecting the body while ensuring optimal health and wellness for the patient. We appreciate each patient by referring them to associated medical providers based on their diagnosis when it’s appropriate to understand better what they are feeling. We understand that education is an excellent and inquisitive way to ask our providers various intricated questions at the patient’s request and knowledge. Dr. Alex Jimenez, D.C., utilizes this information as an educational service. Disclaimer
What Are Adrenal Insufficiencies?
Dr. Alex Jimenez, D.C., presents: Many factors can affect the body, whether eating habits, mental health, or lifestyle habits all play a role in maintaining hormone function in the body. Today, we will apply these common dysfunctional cortisol patterns that patients present when they go in for a daily examination. Most patients often come in and explain to their doctors that they are suffering from adrenal dysfunction because different symptoms are associated with various stages of adrenal dysfunction or HPA dysfunction. Now adrenal dysfunction or hypothalamic pituitary adrenal (HPA) dysfunction is when the adrenal glands are not producing enough hormone to regulate the body. This causes the body to go through different stages of adrenal dysfunction if it is not treated right this way, causing the body to deal with muscle and joint pain that a person hasn’t dealt with throughout their life.
Many doctors and healthcare providers use a systematic approach that can help many people address whether or not they have adrenal dysfunction in their bodies. Today, we will discuss the relationship between female hormones and mood disorders associated with adrenal dysfunction. When it comes to adrenal dysfunction associated with hormones, many people will often get medicated for mental illnesses like bipolar disease or depression when their hormones are imbalanced. When hormonal imbalances begin to affect women in their early fifties due to premenopause, the mental disorder would often worsens and cause many other overlapping issues that can affect their hormones and their bodies.
Adrenal Dysfunction Affect The Body
Dr. Alex Jimenez, D.C., presents: Many women would have healthy diets, take yoga, be involved in spiritual practices, and hang out with their friends; however, when their hormone levels are imbalanced, they are dealing with other issues associated with HPA imbalances or adrenal dysfunction. By looking at the 24-hour corticotropic activity and determining how the circadian rhythm controls it, many doctors can look at the data presented to the patient. The way the data is being presented to the patient on how their hormone levels fluctuate in the body in the morning and how they rise or decrease throughout the entire day until they go to sleep.
With this information, many doctors can diagnose why this individual is having trouble going to sleep, constantly waking up early in the night, or not getting enough rest, making them exhausted throughout the day. So how is adrenal dysfunction associated with 24-hour corticotropic activity? Many factors can cause adrenal dysfunction in the body and affect hormone levels. When the body begins to over or underproduces hormones from the adrenal glands or the thyroids, it can cause cortisol and insulin levels to lose control in the body and cause various issues that result in muscle and joint pain. Sometimes hormonal dysfunction can cause somato-visceral or visceral-somatic pain by affecting the vital organs like the gut and the brain and start to cause issues to the surrounding muscles and joints. When the surrounding muscles and joints are causing pain in the body, they could be causing overlapping issues that can affect a person’s mobility and make them miserable.
How To Diagnose Adrenal Insufficiencies?
Dr. Alex Jimenez, D.C., presents: When doctors diagnose a patient suffering from adrenal dysfunction will begin to look at the patient’s medical history. Many patients will start filling out a long, extensive questionnaire, and doctors will begin to look at the anthropometrics, biomarkers, and clinical indicators found in physical exams. Doctors must obtain the patient’s history to look for the signs and symptoms of HPA dysfunction and adrenal dysfunction to determine the issue affecting the individual. After the examination, doctors would use functional medicine to look at where the dysfunction lies in the body and how the symptoms are connected. The numerous factors causing adrenal dysfunction in the body could be how a person’s eating habits are causing these issues, how much exercise they are incorporating in their daily lives, or how stress impacts them.
Functional medicine provides a holistic approach that considers lifestyle components causing issues in the person’s body. By connecting the dots on what the patient is saying and how these factors are causing adrenal insufficiencies, it is important to get the whole story from the patient to devise a treatment plan catered to the individual. They would appreciate that someone finally understands what they are going through and will begin to restore their health and wellness. By looking for the root causes, triggers, and mediators causing adrenal dysfunction, we can look at the expanded history that the patient is telling us, whether it be their family history, their hobbies, or what they like to do for fun. All these things are important to consider to try and connect the dots of the underlying cause of adrenal insufficiencies in the body affecting a person’s hormone levels.
Adrenal Insufficiencies Affect Cortisol
Dr. Alex Jimenez, D.C., presents: Now, do adrenal insufficiencies correlate with increased DHEA and cortisol hormone levels? Well, DHEA is a hormone that is produced by the adrenal glands naturally. DHEA’s main function is to make other hormones like estrogen and testosterone to regulate the male and female body. Cortisol is a stress hormone that increases the glucose levels in the bloodstream. Cortisol’s main function is to allow the brain to use glucose in the body while repairing the affected muscle tissues. When the body begins to over or underproduces hormones from the adrenal glands, it can raise the cortisol levels to cause resilience to the body, and the HPA axis begins to decrease. When this happens, the body starts to feel sluggish, which can cause you to feel exhausted throughout the entire day, even though you may have gotten a good night’s sleep.
Adrenal Insufficiency Symptoms
Dr. Alex Jimenez, D.C., presents: This is known as adrenal fatigue and can be associated with various symptoms that affect the hormone balance in the body. This can include non-specific symptoms like sleep disturbances, digestive issues, fatigue, and body aches can affect the hormone levels inside the body. This causes many individuals to feel miserable due to feeling low energy. Adrenal fatigue can also be associated with the different stages of HPA axis dysfunction. These can include:
Trauma
Food allergies and sensitivities
Dysbiosis
Changes in the gut microbiota
Toxins
Stress
Insulin resistance
Metabolic syndrome
All these issues can affect a person’s hormone levels and cause elevated cortisol to overlap many factors that cause somato-visceral problems. An example would be someone having gut issues associated with chronic stress who can start to feel pain in their joints from the knees, back, and hips which cause their hormone levels can fluctuate.
Dr. Alex Jimenez, D.C., presents an insightful overview of how hormonal dysfunction can affect the body, increase cortisol levels, and be associated with PTSD in this 3-part series. This presentation provides important information to many individuals dealing with hormonal dysfunction associated with PTSD. The presentation also offers different treatment options to reduce the effects of hormonal dysfunction and PTSD through functional medicine. Part 1 looks at the overview of hormonal dysfunction. Part 2 will look at how various hormones in the body contribute to body functionality and how overproduction or underproduction can cause drastic effects on a person’s health. We refer patients to certified providers that incorporate various hormone treatments to ensure optimal health and wellness for the patient. We appreciate each patient by referring them to associated medical providers based on their diagnosis when it is appropriate to have a better understanding. We understand that education is an excellent and inquisitive way to ask our providers various intricated questions at the patient’s request and knowledge. Dr. Alex Jimenez, D.C., utilizes this information as an educational service. Disclaimer
A Look Into Hormonal Dysfunction
Dr. Alex Jimenez, D.C., presents: Now, looking into the exciting didactic here, we will discuss something rare but important to understand when looking at these steroid pathways. And this is something called congenital adrenal hyperplasia. Now, congenital adrenal hyperplasia can occur in the body through an inherited enzyme defect or 21 hydroxylases that can cause a severe decrease in the adrenal production of glucocorticoids. When the body is suffering from congenital adrenal hyperplasia, it can cause an increase in ACTH to make more cortisol.
So when the ACTH increases to make more cortisol in the body, it could lead to muscle and joint pain if it is not treated immediately. We also often think cortisol is bad, but you must have some congenital adrenal hyperplasia when you have the 21 hydroxide deficiency. To that point, your body is not making enough glucocorticoids, causing you to have a high level of ACTH. When there is hormone dysfunction from various environmental triggers, it can cause the hormones in the body to overproduce unnecessary hormones. For example, if you have too much progesterone, it can’t go down to the pathway to make cortisol due to those missing enzymes. It can be converted into androstenedione, causing people to become virilized.
What Happens When The Body Doesn’t Create Enough Hormones?
Dr. Alex Jimenez, D.C., presents: So when patients become virilized, they’re not making any cortisol; it is important to do hormonal therapy to decrease the ACTH stimulation to get the hormone levels back to normal When this happens, it diminishes the stress inside the body system to make more androgens. In the female body, however, progesterone has no peripheral conversion of steroids to be produced except during pregnancy. Progesterone comes from the ovaries and doesn’t get to be produced in the adrenal glands. Progesterone is excreted mostly in urine as many different breakdown products tend to be higher than normal due to that 21 hydroxide deficiency.
So now, let’s talk about androgens in premenopausal women. So the major androgens come from the ovary, the DHEA, androstenedione, and testosterone. At the same time, the adrenal cortex produces glucocorticoids, mineralocorticoids, and sex steroids to make some testosterone and about half of the DHEA hormone. The body also has peripheral conversion responsible for DHEA and testosterone production to normalizing hormone levels. This is due to all the different tissues that have these enzymes to make these various hormones in different concentrations. Premenopausal women are most likely to lose more estrogen after removing their ovaries. This causes them to lose DHEA, androstenedione, and testosterone production in their bodies.
PTSD & Hormonal Dysfunction
Dr. Alex Jimenez, D.C., presents: Now testosterone is carried by SHBG just like estrogen, and many factors that change SHBG are important to testosterone and estrogen. Interestingly, testosterone can decrease SHBG in small amounts to allow the body to have free testosterone, which causes a physiological effect. When it comes to testing for testosterone levels, many people don’t release that when their testosterone levels are elevated, it could be due to low SHBG. By measuring total testosterone in the body, many doctors can determine if their patients are producing too much androgen, which is causing excessive hair growth in their bodies, or they may have low SHBG levels due to hypothyroidism associated with obesity or elevated insulin.
Now when it comes to PTSD, how does it correlate to hormonal dysfunction and affect the body? PTSD is a common disorder many individuals suffer from when they have been through a traumatic experience. When traumatic forces begin to affect the individual, it can cause the cortisol levels to rise and cause the body to be in a state of tension. PTSD symptoms can vary for many individuals; thankfully, various therapies can help lower the symptoms while bringing the hormone levels back to normal. Many healthcare professionals will develop a treatment plan that can help reduce the symptoms of PTSD and help hormone levels function in the body properly.
Treatments To Regulate Hormone
Dr. Alex Jimenez, D.C., presents: Stress in the body can affect the musculoskeletal system by causing the muscle to lock up, leading to issues in the hips, legs, shoulders, neck, and back. Various treatments like meditation and yoga can help lower the cortisol levels from fluctuating higher, causing the body to deal with muscle tension that could overlap with joint pain. Another way to reduce stress in the body is by working out with an exercise regime. Exercising or participating in an exercise class can help loosen up the stiff muscles in the body, and keeping a workout routine can exert any pent-up energy to relieve stress. However, treatments to balance out hormones associated with PTSD can only go so far for many individuals. Eating nutritional, whole foods with vitamins and minerals can help regulate hormone production and provide energy to the body. Dark leafy greens, fruits, whole grains, and proteins can not only help with regulating hormone production. Eating these nutritional foods can also lower inflammatory cytokines that are causing more harm to vital organs like the gut.
Conclusion
Incorporating a healthy diet, an exercise routine, and getting treatment can help many individuals dealing with hormonal dysfunction associated with PTSD. Each person is different, and the symptoms overlap with hormonal dysfunction associated with PTSD and vary from person to person. When doctors work with associated medical providers, it allows them to develop a treatment plan catered to the individual and enables them to regulate their hormone production. Once the hormone production in their bodies is regulated, the symptoms causing the person pain will get better slowly but surely. This will allow the individual to continue on their wellness journey.
Dr. Alex Jimenez, D.C., presents an overview of hormonal dysfunction can affect the various hormones in the body that can increase cortisol levels in this 3-part series. This presentation provides valuable information to many individuals dealing with hormonal dysfunction and how to know the signs and utilize holistic approaches toward their health wellness. Part 1 will look at the overview of hormonal dysfunction. Part 3 will look at various holistic treatments that are available for hormonal dysfunction. We refer patients to certified providers incorporating various hormone therapies to ensure optimal health. We encourage and appreciate each patient by referring them to associated medical providers based on their diagnosis when it is appropriate. We understand that education is an excellent way when asking our providers intricated questions at the patient’s request and understanding. Dr. Alex Jimenez, D.C., only utilizes this information as an educational service. Disclaimer
An Overview Of Hormonal Expression
Dr. Alex Jimenez, D.C., presents: So the classic teaching about hormones is that they’re produced in an endocrine gland and then transported to the cells where the body will utilize them. But things are a little bit more complex. So every cell contains the genes necessary for hormone expression and functionality in the body.
And we know this because when de-differentiated from the late stage, unfortunately, cancer cells uncover gene expression. Those cells make hormones in inappropriate locations and at inconvenient times. So that means that any cell can make any hormones in the body. Still, the hormonal expression of certain genes indicates the presence of certain enzymes, which determines what hormones will reproduce. So, for example, you need to have the right precursors and enzymes. So in a reproductive female, the granulosa cells, the luteinize, and the corpus luteum are produced in the body. The granulosa cells are follicles, while the corpus odium is after ovulation. And these cells start the formation of the steroid hormones in response to FSH and LH. So FSH and LH come from the pituitary glands and stimulate the granulosa cells to start making estrogen. Steroid production will begin if the messaging from FSH and LH gets to the part of the cell that makes estrogen. This allows the body to regulate hormonal production and keep it functional. When issues disrupt hormonal regulation, the body can over or underproduce hormonal production, leading to metabolic issues associated with muscle and joint pain.
So this is a complex process, and there are many areas where this can go wrong. So you can have the right amounts of the hormone, but you’re not getting hormone production. So the messages must get into the cell first, and FSH and LH are too large to get into the cellular structure. So, they have to activate a membrane-based enzyme called adenylate cyclase to produce cyclic AMP to enter the cellular network and start hormonal formation in the body. This is the P, or the production of hormones. So by thinking about cellular membrane health, if a doctor does an essential fatty acid analysis, the patients may be very low in omega-3s; therefore, their cell membranes are more rigid and affect the body’s hormonal process. When patients are not taking their omega-3s, it could cause the inflammatory cytokines to cause more joint pain issues when various factors affect the body internally. Since inflammation can be good or bad in the body, it can cause hormonal dysfunction when they attack healthy cellular structures. That will affect this hormonal production process.
Hormonal Production Process In The Body
Dr. Alex Jimenez, D.C., presents: Once made, estradiol goes directly into the blood and is not stored, but it’s bound to SHBG and albumin. And SHBG is changed by obesity and insulin associated with hypothyroidism. So when women are obese or hyperinsulinemic will have less SHBG or hypothyroidism to transport the estrogen to the cells. This tells the body that the hormones are no longer FSH or LH and cyclic AMP, but this is estrogen. And so, estradiol is sensitive since estradiol has to go in and have a cytoplasmic receptor. So the estrogen receptor is in the cytoplasm. After it binds to the receptor, it goes into the nucleus, and it’s transcribed and then goes back out and translated to allow the body to make proteins that cause cell proliferation. Estrogen is a proliferative hormone. And once it’s acted on the cell after proliferation, it’s degraded in the cell with heat shock proteins or released back into the circulation in the body’s system.
Let’s talk about some of the basics of biochemistry because the steroidogenic pathway n the body has different ways to reduce carbons in the body. The body’s system could convert it into estrone or estriol, with less estrogen in circulation. And then estradiol, estrone, estriol, everything is eliminated through the detoxification pathways. So in the Living Matrix, healthy detoxification and estrogen metabolism pathways help the body stay functional. When the body goes through detoxification, it helps reduce the issues by figuring out what is causing the problems affecting the body’s system and slowing introducing or taking away the pain that can allow normal hormonal regulation. When the body reduces excessive carbon, it can lower cholesterol from reaching dangerous levels.
Cholesterol & Hormones
Dr. Alex Jimenez, D.C., presents: So it all starts with cholesterol, and the body can’t make enough cholesterol, so we consume food to allow it to enter the body and begin to biotransform into LDL (low-density lipoprotein) to initiate steroid hormone synthesis. So we need LDL in the body to decrease the carbons since it is a union directional. When it comes to hormone deficiency cases, sometimes women can come in with extremely low LDLs because they’re on statins, underweight, or over-athletic; these are connections and pattern recognition. In a female’s body, the ovaries on the left and right side of the female reproduction system produce all three sex steroids: estrogens, progesterones, and androgens, for optimal body function. They are different than the male’s reproduction system, which includes the testicles, due to the other enzymes. They differ from the testes in many ways due to additional hormonal output in the body, which is different than adrenal hormones. For example, if the body can’t make aldosterone or cortisol in the endocrine glands, they will be shunted to make sex hormones. And since each body is diverse, male or female, some hormones can’t make glucocorticoids or mineral corticoids.
So we must think about mitochondrial health for hormone production, which is critical for producing hormones. For expecting mothers, it allows the formation of pregnancy alone in the mitochondria. So mitochondrial health energy is related to hormone health, which causes cholesterol uptake by the mitochondria in the adrenal glands and ovaries that can stimulate ACTH. So the mitochondria can make hormones as we go while enabling the enzymes in the female’s body to induce pregnenolone formation. However, getting the cholesterol to the inner membrane and LDL to the inner membrane to the mitochondria is the rate-limiting step in all steroid hormone synthesis. Now it can develop and go into two different pathways in the body. It can create DHEA, or it can include progesterone when cholesterol is forming pregnenolone and can look diagrammatically in test results.
DHEA & Hormones
Dr. Alex Jimenez, D.C., presents: So if the mitochondria can enable the body’s pregnenolone to form DHEA or progesterone, let’s start with going over things with developing progesterone since it’s hydroxylated. It creates an enzyme called 17 hydroxy progesterone, the immediate precursor of the androgens and estrogens. So the 17 hydroxy progesterone will eventually form androgens or estrogens, and androstenedione can develop testosterone, and both can become estrogens by aromatization. So what does this mean? It means you must be concerned about too many androgens being around because they can become estrogen. The best way to remember this is that androstenedione can become estrone, and testosterone can become estradiol. This can cause progesterone to be the precursor to cortisol in the body and can go in two different directions.
So progesterone is also the precursor to aldosterone, which asks what will happen when the body needs cortisol or aldosterone. The body will then produce less progesterone causing it to be shunned in hormonal production and causing cortisol to overproduce. This is known as cortisol steal, and if it is not treated at the moment, it can cause muscle and joint inflammation in the body, leading to various issues that the person is dealing with.
A decreased formation of androgens and estrogens can inhibit the DHEA pathway. So when the body makes more cortisol, it can cause the hormones to develop an estrogen-dominate shape causing the cortisol hormone to stimulate aromatase. To that point, it can lead to breast cancer, fibroids, and endometriosis in the long term. Women can get stress, hot flashes, and decreased libido due to that hormonal decrease in their bodies.
Conclusion
Other issues like stress can cause increased cortisol formation, anxiety, inflammation, simple carbohydrates, et cetera to the body associated with joint and muscle pain. They can also inhibit sex and sex hormone production directly and indirectly. So this is where people have to be concerned if they’re giving DHEA because DHEA can convert itself into sex hormones. So that can be a good thing if you’re dealing with hormonal deficiency. But if you give too much DHEA, you can overproduce hormonal function.
Dr. Alex Jimenez, D.C., presents how hormonal dysfunction can be assessed and treated through various therapies specializing in hormones and how to regulate them in this 3 part series. This presentation will provide valuable information to many people dealing with hormonal dysfunction and how to utilize different holistic methods to optimize their health and wellness. Part 2 will look at the assessment for hormonal dysfunction. Part 3 will look at various treatments available for hormonal dysfunction. We refer patients to certified providers incorporating various hormone therapies to ensure optimal health and wellness. We encourage and appreciate each patient by referring them to associated medical providers based on their diagnosis when it is appropriate. We understand that education is an excellent way when asking our providers intricated questions at the patient’s request and understanding. Dr. Alex Jimenez, D.C., only utilizes this information as an educational service. Disclaimer
What Are Hormones?
Dr. Alex Jimenez, D.C., presents: Today, we will look at utilizing foundational PTSD treatment strategy steps. As a treatment strategy, it is about the production, transportation, sensitivity, and detoxification of the hormone in PTSD. So let’s start with how interventions and major factors that influence these pathways within the access impact other body areas. How does an intervention on one hormone affect other hormones? So did you know that thyroid replacement can change the HPATG access in the body? So when people are dealing with hypothyroidism or subclinical hyperthyroidism and are being treated with suppressive thyroid hormone replacement, it induces changes in their bodies. This means they will become hypersensitive from ACTH to CRH or corticotropin-releasing hormone.
What this means is that they will produce and release more ACTH. When the patient becomes hypersensitive from an influx of hormones, it could lead to various issues with the other body systems that affect organ and muscle functionality. This is another reason patients feel great on even low doses of thyroid replacement; it stimulates the adrenals. Many patients tend to overrun their adrenals, and when they get treatment, they get a little hit to their adrenals when their doctors are helping their thyroid. So looking at the thyroid, we see the thyroid gland is producing t4, forming reverse T3 and t3. So when doctors look at the thyroid pharmacological doses of glucocorticoids, which is what they give for anti-inflammatory therapy to their patients, or if people have elevated glucocorticoids as in Cushing syndrome, what that does is it inhibit thyroid secretion because it reduces the TSH response to TRH, which makes less TSH. When there is less secretion in the thyroid can lead to overlapping issues associated with unnecessary weight gain, joint pain, and even metabolic syndrome.
To that point, stress inhibits the thyroid. In contrast, estrogens have the opposite effect, where they increase TSH secretion and the thyroid gland’s activity. So that’s a reason why women feel so much better on even low doses of estrogen replacement. So just like thyroid replacement in low amounts that bump the adrenals, if we’re giving low estrogen doses, it can bump up thyroid function. However, many doctors have to go slow when providing hormone treatments to patients because the additional hormones will affect the other hormones in the body. When it comes to hormone replacement therapy, it is important to learn how interventions within the communication node impact other nodes in the matrix. So, for example, let’s look at how the communication node affects the defense and repair node in the body. Research studies reveal HRT’s effects on inflammation markers and look at 271 women who used conjugated equine estrogen alone, who had a 121% increase in CRP after a year.
And if they used that in addition to synthetic progestin, they had a 150% increase in CRP after a year. So synthetic estrogen is not bioidentical; this is synthetic pregnant mare’s urine, and synthetic progestins are pro-inflammatory. What about the communication node and the assimilation node? This is an interesting study because many doctors are trying to help their patients and the future generation in society. So it’s important to know when the mother is stressed during pregnancy since that can change the baby’s microbiome. That means doctors have an opportunity to support early intervention in microbiome support. Knowing this is vital for prenatal stress based on questionnaires or elevated cortisol was strongly and persistently associated with infants’ microbiome and colonization patterns.
So we’re also here to learn how interventions on the matrix affect the hormone node or the communication node. So as an example, we’ll look at what happens in the assimilation node involving the communication node, as this affects antibiotics on the intestinal metabolome. Everyone knows about antibiotics’ impact on the microbiome, but a metabolome is a change in the metabolic function of a particular organ, the intestine. To that point, when there are so many metabolic pathways that antibiotics affect, the metabolism of steroid hormones was the most profoundly impacted. So eight metabolites that are part of this hormone pathway, which gives us PTSD, were increased in feces after antibiotic treatment. Then we have another way that the gut affects hormones, and this is looking at metabolic endotoxemia. Many doctors learn about metabolic endotoxemia in AFMCP, which mentions leaky gut or increased intestinal permeability. When many individuals are dealing with gut issues affecting their well-being, like problems in their joints or muscles causing them pain, we provide various solutions and develop a treatment plan with our associated providers based on the diagnosis.
Endotoxins Affecting Hormones
Dr. Alex Jimenez, D.C., presents: Endotoxins or lipopolysaccharides are from the cell membranes of bacteria. So bacterial endotoxins are translocated from the gut lumen because of increased intestinal permeability. So with that increased permeability, those endotoxins are translocated, which starts an inflammatory cascade. When endotoxins cause GI issues, the inflammatory markers can affect the upper and lower portions of the body and the gut-brain axis. When the gut-brain axis is affected by inflammation, it could lead to joint and muscle pain associated with somato-visceral and visceral-somatic problems. To that point, the inflammatory cascade from the leaky gut affects the ovary, reduces progesterone production, and contributes to luteal phase deficiency. That’s incredibly important for doctors to take care of patients that are there to optimize fertility. It is especially important for patients to let their doctors know when they have excess estrogen and that they are producing as much progesterone as possible. So we must worry about gut permeability in ovulation, luteal phase deficiency, and estrogen-progesterone imbalance. What about the biotransformation node? How does that affect the communication node? In preschool children, phthalates and thyroid function have an inverse association between the metabolites or the amount of folate and thyroid function in the system measured in children at age three. When inflammatory issues affect thyroid function in children, it can affect cognitive outcomes, thus reducing phthalates production in the thyroid, leading to mental problems.
How do mental, emotional, and spiritual considerations contribute to the communication node? We want to start with the bottom of the matrix like we always do, which involves functional medicine. Functional medicine provides holistic approaches to identifying the root problem affecting the body and developing a personalized treatment plan for the patient. By looking at the lifestyle factors at the bottom of the Living Matrix, we can see how hormone dysfunction affects the communication nodes in the body. A recent paper found that there was a positive relationship between menopausal symptoms and social support and that menopausal symptom decrease as social support increases. Now let’s talk about how stress impacts HPA access. By looking at how stimulation from the sex hormone-producing parts of the body or the goads, the thyroid access, the adrenals, and the sympathetic nervous system (fight or flight) can add up all the stressors affecting us, called allostatic load.
And allostasis refers to our ability to respond to those stressors through stress-coping mechanisms. Many patients are asking us for guidance. They’re asking how they can frame their personal experiences and stressors. Still, they’re also asking how they prepare the societal events in a larger context, And many of us as functional medicine practitioners are seeking the same thing. And so, we’re going to show you in detail what stress does to the body and how to find ways of decreasing anxiety or stress in the body to prevent future issues in the organs, muscles, and joints.
How Stress Inhibits Estrogen
Dr. Alex Jimenez, D.C., presents: Does stress creates adrenal stress, and does it affect our fight or flight primary response hormone (adrenaline)? Stress can cause the sympathetic nervous system to increase blood pressure, respiration, heart rate, and general alertness while redirecting our blood to increase our adrenaline. So when you are in a situation, your adrenaline can cause you to fight or run, which causes your muscles to get blood, which decreases blood to your core or your non-essential organs. So the functional medicine model would identify various triggers or mediators, whether acute or chronic, that can act as an instigator of hormone dysfunction that can create overlapping issues that can disrupt adrenal function in the thyroid.
So, looking at these responses can help us see the physical problems that are happening if adrenaline is chronically increased over the long term, leading to anxiety, digestion problems, et cetera. Now cortisol is our vigilance hormone that helps maintain the emergency response to back up or support the adrenaline. An example would be a fire truck or police that come in after the immediate first responder. So cortisol facilitates the quick adrenaline response to keep the body going as needed. And it has many other roles as well. It helps with increased blood sugar and causes fat storage. So when people come in with weight around the middle and dealing with overlapping issues in their body, think of cortisol since it’s anti-inflammatory and regulates the nervous system. Cortisol can be both good and bad for the body, especially when an individual is dealing with stressful events affecting their health and causing issues affecting their mobility.
So now, let’s talk about how stress impacts the entire body and the immune system. Stress can increase susceptibility to infections, increasing their severity in the body. So here we see stress affecting the defense and repair node, leading to immune dysfunction and stress-induced immune dysfunction. An example would be if a person is dealing with a disorder that affects their gut, like SIBO or leaky gut; it can increase the production of pro-inflammatory cytokines and causes joint and muscle pain to the lower back, the hips, the knees, and overall wellness. When the pro-inflammatory cytokines affect the gut system, they can also cause thyroid dysfunction, disrupting hormone production.
So if someone’s taking that hormone replacement therapy (HRT), it can increase their inflammation, especially if they are stressed. So, as functional medicine practitioners, we’re always thinking and looking for pattern recognition as we start thinking about things differently from conventional methods regarding health and wellness.
What is it when you see a person dealing with chronic stress, and what is their response? They will usually answer, “I sweat a lot; I get nervous and anxious just remembering what has happened to me. I’m afraid of experiencing that ever again. Sometimes these pathways give me nightmares. Whenever I hear a loud noise, I think of carbon rings and get nauseous.” These are some tell-tale signs of someone dealing with chronic stress associated with PTSD, which can affect the hormone levels in the body. Many functional medicine providers can utilize available treatment regarding hormonal dysfunction in PTSD. So the general strategy for treating hormone dysfunction is the production, transport sensitivity, and detoxification of hormones in the body. Remember that when you have someone dealing with hormonal issues, it is best to devise a strategy to deal with this issue.
So what can we do to affect how hormones are produced or have been over-produced in the body? We want to look at how hormones are made, how they may be secreted within the body, and how they’re transported. Because what if they’re transported in a way that the transport molecule is low in concentration, allowing them to be free hormones? So that’s the interaction with other hormone sensitivity, and how do we change or look at cellular sensitivity to the hormonal signal? For example, progesterone affects estrogen receptors which cause detoxification or excretion of the hormone.
So before we think about giving or replacing a hormone, we ask what we can do to affect that hormone in the body. Specifically, how can we influence the hormone’s production, transport, sensitivity, detoxification, or elimination? So when it comes to hormone production, what are the building blocks for thyroid hormones and cortisol? So if we’re low on thyroid hormones, we want to ensure that we have the building blocks of serotonin. So what affects synthesis? If a gland is inflamed with autoimmune thyroiditis, it may not be able to make enough thyroid hormone. And that’s why people with autoimmune thyroiditis have low thyroid function. What about hormone transportation? Do the levels of one hormone in the body impact the levels of another? Estrogen and progesterone are often in a dance in the body. So does a hormone transport from the origin glands to the target tissue, which can impact its effectiveness?
If there is an overproduction of hormones attached to the transport protein, there won’t be enough free hormone, and there can be hormone deficiency symptoms. Or it can be the opposite if there needs to be more transport protein, then there will be too many free hormone molecules and hormone excess symptoms. Therefore, we want to know if we can impact the free hormone level and see if it is transformed. So we know that T4 becomes the active form of T3 or a thyroid inhibitor, reverse t3, and can we modulate those pathways? What about sensitivity? Are nutritional or dietary factors influencing the cellular response to cortisol, thyroid hormones, testosterone, estrogen, et cetera? With many cell membrane binding proteins, the cell membrane is involved in hormone metabolism. And if the cell membranes are rigid, insulin, for example, has a hard time getting in it now as we look into hormone detoxification. How do we alter the metabolism of estrogens or testosterone?
And what can we do to affect estrogen’s binding and excretion? So, can estrogen have to be eliminated healthily? And that depends on whether there’s hydroxylation on a particular carbon, but it also has to be excreted in terms of total amounts. So constipation, for example, will decrease the quantity of estrogen excreted. So we use the vault as a metaphor and the theme, as we said, is to treat the matrix first before directly addressing hormone dysfunction.
Cortisol Affecting The Communication Nodes
Dr. Alex Jimenez, D.C., presents: In the Living Matrix, we have to unlock or treat all the nodes to open the vault to get inside and address hormones. This is because the endocrine system is so complex it often self-corrects when other imbalances are addressed. And remember, hormonal imbalance is often an appropriate response by the body to imbalances elsewhere. That’s why treating other imbalances often addresses the hormonal issue. And also, remember hormones like picograms are in very low concentrations. So it’s very hard to be precise when we give patients hormones and allow the body to auto-correct. That’s why we say to treat the matrix first. And when we get inside the communication node in the body, we look at the center of the matrix and discover the body’s emotional, mental, and spiritual functions to help normalize hormones. And while these are addressed, how can we fix the hormonal communication nodes?
When inside the communication node, the treatment must follow an order: adrenal, thyroid, and sex steroids. So these are important concepts to remember, treat adrenals, thyroid, and finally, sex steroids. And the way we depict the pathways will be consistent. So here you see the standard representation we will use for the steroidogenic path. And you see all of the different hormones here. The enzymes in the steroidogenic pathway are color-coded, so many doctors can know which enzyme affects which step. Next, we will look at the modulation of the steroid pathways through lifestyle, like exercise, and how stress affects aromatase, making estrogen.
Now, as we get into the real, heavy part here about the steroid pathways, we inform many of our patients to take a deep breath as it shows that taking a deep breath can increase a person’s cognition and provide the ability to understand everything. So the big picture here is everything starts with cholesterol and how it affects the hormones in the body. So cholesterol forms the mineral corticoid aldosterone, which then develops cortisol, ultimately creating androgens and estrogens. When patients are given consultation on what is going on with their bodies, many don’t realize that high cholesterol could potentially lead to chronic stress, which is associated with cardiovascular issues that can ultimately invoke visceral-somatic disorders.
Dr. Alex Jimenez, D.C., presents: When a female patient is dealing with fibroids or endometriosis, many doctors devise a treatment plan with other medical providers to reduce the formation of the estrogen hormones by inhibiting and modulating the aromatase enzymes. This allows the patient to make small changes to their lifestyle habits by ensuring their zinc levels are normal, not drinking alcoholic beverages constantly, finding ways to reduce their stress levels, and normalizing their insulin intake. Each treatment plan caters to the individual as they find ways to reduce their cortisol levels and regulate healthy hormone production. This will allow the body to increase estrogen production while decreasing the aromatase. So when we are discussing stress, it can negatively impact the hormone pathways directly by increasing cortisol, thus causing the pituitary glands to increase the CTH when stress is responding to the body. Many individuals are dealing with chronic stress in their bodies, which can cause overlapping risk profiles to the musculoskeletal system, causing muscle and joint pain.
So the pituitary system produces cortisol when the body calls for it directly when the individual is dealing with acute stress. However, chronic stress can indirectly increase cortisol levels; it causes the enzyme 1720 lyase to be inhibited in the body, causing a decrease in anabolism, thus slowing down the body’s energy levels. So stress inhibits this enzyme. So when stress inhibits the 1720 lyase enzyme in the body, it can cause the pituitary system to produce more cortisol and cause more issues like joint to affect the individual. So those are the two ways that stress leads to more cortisol directly through ACTH and indirectly by inhibiting 1720 lyase.
Inflammation is important in the body as it also has a two-way path, as it can impact these pathways the same way stress does. Inflammation can inhibit the 1720 lyase enzyme, causing the body to be pro-inflammatory and can stimulate aromatase. Like stress, when the body is dealing with inflammation, the pro-inflammatory cytokines stimulate aromatase enzymes to cause an increase in estrogen formation. When this happens, it allows the doctors to notice why their patients are overly stressed and have inflammatory markers in their gut, muscles, and joints. To that point, inflammation can also increase an enzyme called 5alpha reductase. Now, 5alpha reductase causes the formation of a hormone called dihydrotestosterone (the active form of testosterone in the body cells other than the muscles, causing hair loss. So insulin, stress, and inflammation contribute to hair loss because insulin has the same effect. Insulin or blood sugar gives the body energy to move throughout the day. When individuals have too much or too little insulin in the body, it can lead to insulin resistance, correlating to metabolic syndrome associated with hair loss.
Holistic Methods For Hormones
Dr. Alex Jimenez, D.C., presents: How do insulin, cortisol, and inflammation play their part in the thyroid? Well, all of these hormones help make the body functional. When the thyroid has an underlying condition like hypo or hyperthyroidism, it can cause the body to over or underproduce hormones to regulate healthy normal body functions. So this forward feed cycle can cause the individual to have various issues affecting their body due to hormonal dysfunction. This combination of insulin resistance, high insulin, weight gain, and stress affects many patients, causing metabolic syndrome. To normalize hormonal function, we must look at all these factors driving hormonal dysfunction in patients.
When going for hormonal treatment, it is important to know about the different nutraceuticals and botanicals because before, it was called a lifestyle change back in the day. In a health clinic, specific neutraceuticals and botanicals can affect estrogen formation through the enzyme aromatase. However, various factors like diseases, medications, toxins, and elevated insulin can also increase aromatase enzymes, leading to more estrogen in the body. And then diseases, medications, and toxins do the same thing. A research study reveals that when men and women interact, the men’s cognitive performance declines, followed up with a mix-sex encounter. This can change how hormone function in the body when there are changes in formal function that can affect the central nervous system’s cognitive function in the body.
When middle age patients get examined by their doctors, the results can show if they have elevated insulin, an increase in stress and if there is inflammation in their bodies. This allows the doctors to work with associated specialists to develop a treatment plan that caters to the patient to begin small changes in their health and wellness journey.
Dr. Alex Jimenez, D.C., presents how to assess different hormones in the body and how different hormone tests can be used to determine the level in the body. This presentation allows many individuals to know what to expect when they are being diagnosed by their primary doctors. We refer patients to certified providers incorporating various hormone therapies to ensure optimal health and wellness. We encourage and appreciate each patient by referring them to associated medical providers based on their diagnosis when it is appropriate. We understand that education is an excellent way when asking our providers intricated questions at the patient’s request and understanding. Dr. Alex Jimenez, D.C., only utilizes this information as an educational service. Disclaimer
Assessing Hormones
Dr. Alex Jimenez, D.C., presents: Welcome to everything you need to know about assessing hormones and how to do the testing. We have decided to do this as a webinar because we only have a little time to do it during the module. After all, that’ll make your life easier. You’ll need to have this information under your belt because here is the most important thing you need to know. Hormone therapy is an art, not a science. If you find five or six practitioners who do hormone therapy, you will find five or six different ways to make a prescription and way more ways than that actually to do testing to monitor it.
Dr. Alex Jimenez, D.C., presents: The important thing is that you keep in mind what we know scientifically is a better or not-so-good way of taking care of the patients in terms of testing. Then find what works for you and become the expert in that. Because if you are consistent over time, you can work around the pros and cons of every given testing modality and figure out what you need to do, regardless of what type of test you end up doing. All right, so what do we need to worry about? There are many potential problems in measuring hormone levels because so many hormone levels fluctuate significantly. In order to evaluate hormones in the body, doctors need to know what, when, and who to test. So we’re going to talk about all of that.
Diagnosing Hormones In A Patient
Dr. Alex Jimenez, D.C., presents: Some vary during the day, some vary during a cycle, and some hormones don’t vary at all. So you need to remember which ones you need to worry about in terms of fluctuation. The studies that have been done don’t measure hormone levels. So, finding normal hormone levels is sometimes problematic. It may be different from what the labs currently use. And in the studies where they have come up with normal hormone levels, a lot of them are much older studies, and the methodology was more unreliable than what we use now. So by keeping that in mind regarding what people call normal hormone levels, many of these studies also would average out non-comparable groups. What this means is that they would be comparing, let’s say, a group of apples, oranges, and grapes and put them all together and say, oh yeah, so this average is going to work.
Dr. Alex Jimenez, D.C., presents: So it’s like doing a meta-analysis, and if you are taking a bunch of different data, you can’t necessarily say that this average makes sense. You probably are already aware of the fact that other labs end up developing different reference ranges. And so if you use multiple different labs, you can’t necessarily compare the test results you’re getting because the reference ranges are different. And, sometimes, even within a given lab, depending on which test kit patients use, like a test from Quest, they may one day use one test kit. So a reference range will be XYZ, and they went to the same lab another day, but they used a different test kit and have an entirely different reference range. And so you have to the point that out to the patients. If you’ve got a smart patient trying to track what’s happening with themselves, they may have the wrong impression during an examination.
Estrogen & Progesterone
Dr. Alex Jimenez, D.C., presents: If you’ve got different reference ranges showing up on your test results, it is best to keep track of that in case you need to remember. Now there are big variations between individuals and even within the same individual. The serum concentrations of both natural and synthetic steroids might need to be clarified between other individuals. There’s a huge variation irrespective of the root of the administration of the hormones. What you expect from one person may be different from the next person. And, of course, within any individual, you’re going to get levels of fluctuation throughout the day based on lots of different things. Everything from perceived or actual stress that will change their hormone levels to foods they were eating that day can make a difference. Hydration status can make a difference. So some of the variations you see within a person, but with different blood draws, can be based on what was going on that day.
Dr. Alex Jimenez, D.C., presents: So try to impress upon your patients as you’re getting testing done to keep the blood draw days the same. Now measuring in different body fluids like serum, urine, or saliva doesn’t necessarily tell us about concentration in other tissues, and doctors need to keep this in mind because the patient may get a false sense of security, and it won’t necessarily have anything to do with the tissue they are trying to treat. Now, many doctors must remember all the different kinds of estrogens they might need to keep track of during examination. So, when they notice estrogen, there’s an estrogen pool. There is free and bound estrogen in the body and estrogen production in the woman or a man in themselves. There are exogenous estrogens that you may be giving them. There are stored estrogens, metabolites, and all these different estrogens doctors need to keep track of. So this is just one example of having many estrogen levels in the body, and the patient is wondering, what is it the doctor is looking at? Could one test give me all this different information? And this is only estrogen. The same thing is true, although not quite as complicated. The same thing is true about the other hormones in the body.
Dr. Alex Jimenez, D.C., presents: Now for progesterone, it is the same ordeal. Other results look like this for estrogens and testosterone, and this is to remind us of all the different variability there is. By showing the variation between different people at their biological stages, for example, premenopausal and postmenopausal. The results that the doctor presents to the patient establish a lighter shade of green on the outside of the intercycle variability from within a given woman. And then the yellowy green is the inter-woman variability, meaning one woman to the next. And then that blue line in the middle is the average; this provides what information they might need to diagnose.
Testing Hormone Levels
Dr. Alex Jimenez, D.C., presents: All right, so let’s look at testing and assessing hormones as we look at all the hormone types, the different ways of testing them, and the pros and cons. There are decades of well-validated research on serum hormone levels. So for the estrogens, estrone, estradiol, and estriol, as well as the estrogen metabolites in the serum, the good news is it measures endogenous hormone production. So if you get a serum hormone level, we know what those results mean.
Dr. Alex Jimenez, D.C., presents: The bad news is these results give you the free and bound hormone. It shows you the total estrogens. However, you can’t order total estradiol and free estradiol test as they don’t offer them. There are limited data regarding serum levels of these metabolites in terms of prediction for health risk. And it can be difficult for some labs to get accurate quantification in postmenopausal women because the estrogen levels are very low. So, keeping that in mind is a matter of knowing your lab and how accurate they are. Now when it comes to saliva, the good news is it’s non-invasive. Patients can do this at home, making it convenient if doctors try to do a serial measurement of estradiols across a whole cycle in a premenopausal woman. Cause no one in the right mind will go to the lab and get blood drawn daily.
Dr. Alex Jimenez, D.C., presents: Knowing that salivary estradiol correlates well to free estradiol in serum allows doctors to see what’s in the saliva and what they want to see in the serum. The bad news about saliva is that there are fewer validation studies than serum. There are still quite a few, so it’s a valid testing method. It’s just that it’s not as well validated as a serum because it still needs to be done. Again, it can be very challenging for some labs because the estrogen levels in the saliva are much lower than in the serum. So doctors must ensure the lab is doing a good enough job assessing these very low levels. All saliva testing can be contaminated by blood from the oral mucosa.
Saliva Testing
Dr. Alex Jimenez, D.C., presents: So if the patient has periodontitis or something along those lines, doctors don’t want them to salivary levels; it is important to tell them to do it before they brush their teeth, not after, in case they bleed when they brush their teeth. But that’s true of any salivary test; you can’t get estrogen metabolites done through the saliva. And the bigger problem in a postmenopausal woman is that many get dry mouth after menopause. And so, it can be really difficult to do the test because they need to produce more saliva to get an adequate specimen. Now, if that happens, they can go for a 24-urine test. The 24-hour urine testing for estrogen and estrogen metabolites can be helpful if you’re trying to get the total daily production of the hormones. You can get measurements of estrogen metabolites, which are stable for a long time.
Dr. Alex Jimenez, D.C., presents: You have plenty of time for processing and get both free and conjugated estrogen measurements. So that’s helpful. The bad news, which is true for any 24-hour urine test, is it relies on accurate volume measurements and complete collections by the patients. Many patients will inadvertently screw that up. When they have a busy day, they’ll go pee and need to remember what they are supposed to do, which can be a problem. So, making sure the patient understands can help with the test results. You cannot use this for people with renal dysfunction because it’s based on creatinine correction. So if their creatinine is abnormal, they will need to be able to give you an adequate, appropriate level and sometimes give you some of these tests that do 24-hour urines will provide you with many metabolites that could be more clinically useful but are not.
Dr. Alex Jimenez, D.C., presents: Now for dried spot, you’re in testing, and you can get estrogen metabolites, which is good because the metabolites are stable for a long time, so that’s no problem. And you can measure both the free and conjugated estrogens on these spots in urine tests. The biggest problem here is that it has the least clinical validation studies. So, it’s a newer way of testing. It is popular and easy for patients, but there is little concern because of the few clinical validation studies they’ve done. Now, additional challenges are mentioned: to think about what a lab has to do; the measurements they need to be able to provide can vary enormously because there are very low levels of estrogen in older women, not on hormone replacement therapy.
Dr. Alex Jimenez, D.C., presents: And then up to measuring these super high doses in women getting ready for IVF. And, you know, the levels can vary by 10,000. Is it reasonable to assume that any test will be accurate for all those circumstances? It is also difficult to assess estrogen levels in women treated with aromatase inhibitors because they will likely have very low estrogen concentrations. So that may not be accurately detected by standardized testing. And then specificity is a problem because we talk about how estradiology focuses mostly on how it gets broken down into estrone and then how the estrones get broken down. But the reality is that estradiols convert it to more than a hundred different metabolites, which may interfere with accurate quantification.
Serum Testing
Dr. Alex Jimenez, D.C., presents: So, labs must keep that in mind and ensure that they’re getting adequate specificity for you. Another interesting tidbit is that exogenous sources of S-trial can lead to falsely elevated estradiol levels. So keep that in mind if you have a funny test result that makes no sense.
Dr. Alex Jimenez, D.C., presents: Progesterone and progesterone metabolites in the serum; there’s lots of literature to support using a progesterone level drawn hopefully on day 21 of a 28-day cycle to confirm ovulation. Progesterone has problems as it differs from estradiol. So it is acceptable to use serum progesterone levels for that, as the reproducibility of serum levels is limited if the serum levels are low. So if what that means is if you were to take a person in the first half of her cycle and draw a progesterone level three days in a row at the very beginning of the process and the progesterone should be low, you may not get similar numbers just because the hormone levels are low.
Dr. Alex Jimenez, D.C., presents: So the reproducibility makes doctors a little crazy, but that’s something they need to keep in mind with the serum. Again, saliva testing is not invasive; it’s convenient if you want to follow an entire cycle in a premenopausal woman. Also, research shows that a salivary level of 17 alpha hydroxyprogesterone is just as acceptable as a serum level for diagnosing congenital adrenal hyperplasia. Now the downside for progesterone’s metabolites salivary levels of progesterone in its metabolites is that you’ve got a rapid fluctuation of progesterone levels in the saliva. So, if you’ve got somebody who doesn’t wanna get their blood drawn and doesn’t mind spitting into a tube, you can use this instead.
Dr. Alex Jimenez, D.C., presents: So you should use more than one test result to make a decision; you may need serial sampling to get a feel for the average. There’s also a problem with cross-reactivity that might interfere with immunoassays and affect the results. And again, the same problem is having much lower progesterone levels in the saliva than in the serum. So for some labs, that can be challenging to get preliminary analysis and the same problem in terms of contamination by blood; however, that’s true of all cellular tests. The 24-hour urine and the spot dry urine testing for progesterone have the same problem because the progesterone metabolites will correlate with symptoms. So they’ve studied, for instance, allopregnanolone in urine. The level of that does connect with the sleep quality in perimenopausal women.
The Different Implications Of Hormone Testing
Dr. Alex Jimenez, D.C., presents: The implication is that if it’s correlating, it’s probably an accurate level; however, progesterone is hard to quantify in urine. And so, they use metabolites for assessment and determine the progesterone level based on the metabolites. That’s great, except there’s no literature describing the clinical utility of progesterone metabolites. So progesterone in the urine is relatively problematic regarding the accuracy and what you are getting. Part of the issue with serum progesterone is that very little of it is available, and non-protein ground, most of it is bound to all and other proteins; it’s the free progesterone that is available to the target tissues and also to saliva. So the progesterone that you’re measuring in the serum is mostly the bound-up progesterone, not what is clinically important.
Dr. Alex Jimenez, D.C., presents: Transdermal progesterone is extremely difficult to measure because anyone gets metabolism by five alpha reductases in the skin. It’s rapidly absorbed by red blood cell membranes and delivered to the tissue. And really, it comes down to that after the patient uses exogenous progesterone cream or gel, they get these crazy high levels of progesterone in the saliva and the capillary beds, but not in the serum. And so there could be a better way to measure what’s happening to the patient. So transdermal progesterone, trying to follow that with any testing is difficult.
Dr. Alex Jimenez, D.C., presents: There are decades of research on serum hormone levels. In serum testing, testosterone, and its metabolites, you can get both a total and a free hormone level test, and you can also get a DHT level, which is helpful. There are established serum ranges for the diagnosis of androgen insufficiency. So serum levels for testosterone are fine in general. It can be difficult to assist the whole serum if the levels are low, like in women and kids and hypogeal men. So, you need to know your lab and its methodology. Suppose you’re assessing testosterone in women, hypogeal men, or kids because they must ensure they’re doing the appropriate serum test to get these really low levels accurately.
Dr. Alex Jimenez, D.C., presents: For saliva testing, it is very convenient to obtain the sample. There are established ranges for diagnosis of antigen insufficiency, and it’s easy to use this testing for differentiating between gonadal and hypogonadal men. And you can get a free hormone level as lots of published research on using salivary levels for assessing testosterone. However, the problem is like with progesterone; you get this rapid fluctuation in saliva. You might need more than one saliva test result to get reliable information. So you don’t necessarily want to decide based on just one result. And again, you need to know your lab because the levels are much lower than in the serum. So it is challenging to get an accurate story and be careful about blood contamination. In urine testing, the 24-hour and spot urine have slightly different issues.
Dr. Alex Jimenez, D.C., presents: The 24-hour urine testing for testosterone can be used to get a total daily testosterone production. Patients will get a free hormone level and metabolites, which is nice. They can use that information to indirectly assess five alpha-reductase and aromatase activities based on how many different metabolites they’re getting. Only a few data support the clinical utility of all the measured metabolites. There is a polymorphism of UGT to B17; if the patient has that, their urinary testosterone level will return to zero, so keep that in mind if you ever get a test result. After all, it’s so low because it may be that your patient has this issue. Now spot urine will give you some of the same pros as you will get free hormone levels and metabolites. This allows you to use that information to assess the five alpha-reductase aromatase activities; however, the problem is there; like with the other hormones we’ve discussed, this testing generally has fewer clinical validation studies because it’s a newer form of testing, so keep that in mind.
Cortisol
Dr. Alex Jimenez, D.C., presents: Cortisol and its metabolites in the serum are similar to the other hormones mentioned, as there are validated reference ranges for cortisol. Lots of peer review literature detailing the use of this test, and patients can feel comfortable getting these results. It will tell them just total cortisol, not their free cortisol. So by keeping that in mind, they’ll get the diurnal pattern. They can only get a four-point test as they would with saliva because they don’t have normal ranges for four different times in the day. And many patients mention to their doctors as they get the serum cortisol, they go, “Wait, you don’t understand. I am so scared of my blood being drawn that it shoots my cortisol up, and I don’t normally look this bad.”
Dr. Alex Jimenez, D.C., presents: Keep in mind that in serum, they only have normal reference ranges for two times of the day, 7 to 9:00 AM and 3 to 5:00 PM. So you have to ensure that if you use serum cortisol, they go in fasting before nine o’clock, or they can go later in the day. And if they go later in the day, they don’t have to fast. So if you get cortisol at 10 or 11 in the morning, it isn’t very helpful to the results. Now the salivary testing, lots of people are becoming familiar with this.
Dr. Alex Jimenez, D.C., presents: You can get your diurnal pattern because many companies have kits where you’ve got four or five samples throughout the day. There is abundant peer-reviewed literature detailing the use of this. And this is for cortisol, not for the cortisol metabolic. It reflects the unbound plasma concentration, which is not what we’re seeing with the serum. The problem is that 11 beta hydroxy steroid dehydrogenase is an enzyme in the salivary glands that significantly converts cortisol to cortisone. So there are some questions about the results doctors are getting in the salivary cortisol and what’s happening or did it get converted to cortisone, and you’re not picking that up in the test?
Dr. Alex Jimenez, D.C., presents: So when looking at cortisol metabolites in the saliva, which some companies do and some don’t, the salivary cortisone correlates with cortisol exposure over 24 hours. There’s a moderate level of literature using this test but enough that you should feel comfortable. There are issues when your serum cortisol is really low, making it seem like the patient is crashing or under hydrocortisone therapy. That makes the salivary cortisone a superior serum marker compared to the salivary cortisol. Under these circumstances, because of how this is being processed, only a few companies are even looking at cortisone directly in the saliva. So at this point, because especially of the moderate literature level, you will primarily be doing cortisol levels in the saliva.
Urine Testing For Hormones
Dr. Alex Jimenez, D.C., presents: So let’s move on to the urine test. Now, in a 24-hour urine test, you can assess the cortisol ratio, which can be helpful when diagnosing. And 24-hour free cortisol correlates with the serum-free cortisol level; however, the only problem is there are limited clinical validation studies for this. And, in the 24-hour urine test, you’re not getting a diurnal cortisol pattern. And, in the spot urine, you can get the cortisol ratio, which can be helpful. You can have the patient do the spot urine test multiple times a day so you can get the diurnal change just like you would with saliva. But unfortunately, the spot you’re in testing has the least clinical validation studies. So you have to keep that in mind. So with this, primarily, people feel most comfortable with using either serum levels done at the right time of day, understanding that you’re not getting the unbound cortisol, or they’re doing a four-point salivary test.
Dr. Alex Jimenez, D.C., presents: The four-point salivary test could see a pattern between what the patient told their doctors about their energy level throughout the day and how they felt and compared that with what the result returned. Many doctors note what they had expected the test result to be before the national labs even had it available.
DHEA Testing
Dr. Alex Jimenez, D.C., presents: We will discuss DHEA and DHEA sulfates separately since DHEA in the serum has many clinical validation studies that can make you feel comfortable getting adequate results. Now, DHEA has a diurnal pattern. So you have to ensure they get it done at the right time of day since this is fasting before nine o’clock in the morning, just like with cortisol. A DHEA done later in the day means nothing; however, a DHEA sulfate in the serum doesn’t follow a circadian pattern, so a single test done at any time is okay.
Dr. Alex Jimenez, D.C., presents: There are numerous clinical validation studies about DHEA; unfortunately, there is a problem with DHEA sulfate since it has a little circadian pattern. You may miss small variations in a DHEA over time in a person based on how they’re feeling and stressed out. So occasionally, it’s nice to check the DHEA in a patient as long as they’re done in the morning because then you’ll get a feel for the changes over time in the same individual you wouldn’t see with the DHEA sulfate.
Dr. Alex Jimenez, D.C., presents: Salivary testing for DHEA is where you measure free DHEA in the body, which is great. There’s a correlation with serum levels, and it’s not invasive. The problem is that the concentration is inversely related to the salivary flow rate and is also affected by the salivary pH. An example would be someone walking past the bakery, starting to salivate heavily based on what they just smelled. This could change their results for their salivation rate when they are doing their DHEA test. DHEA sulfate has the same basic problem in the saliva, related to the salivary flow rate and the salivary pH. So keep that in mind if you’re looking at salivary levels in urine, whether this is 24-hour or spot urine; there are no clinical validation studies about looking at either DHEA or DHEA sulfate in the urine. So, keep that in mind if you’re doing urine testing and they’re giving you a whole panel that includes DHEA or DHEA sulfate, you may need to know what those results mean.
Dr. Alex Jimenez, D.C., presents: For pituitary hormones, the preferred testing is the FSH, LH, and prolactin serum. Not convenient for serial measurements throughout the day to detect the LH surge, for instance, but the results are very accurate. And in saliva, there’s limited peer-reviewed literature detailing salivary pituitary hormones and whether or not they’re adequate. LH detection kits at home are convenient for urine tests since they are widely used and have been around for a long time. The LH surge correlates with the urine and works well with the LH surge’s serum. So if you’re trying to help people figure out where they are in their cycle and whether or not they’ve ovulated, this test is the way to go. It doesn’t do a good job of quantifying it; it just tells you there’s a surge because these are bigger hormones, so they don’t get into urine very easily.
Dr. Alex Jimenez, D.C., presents: So you’re going to know whether or not you’ve gotten the surge, you’re not going to know what the actual level is, and that’s okay because most of the time, it doesn’t matter what the hormone level is. So essentially, unless you’re just trying to find out if they got an LH surge, you want to use the serum for either FSH, LH, or prolactin. For sex hormone-binding globulin, most clinical validation studies are in the serum; you can’t measure it in saliva or urine, so that’s easy to remember. So we’ve already talked about the issues with different forms of testing, and there are only a few forms of testing that will give you everything you need to know about every hormone you need to know.
When Is The Best Time For Hormones?
Dr. Alex Jimenez, D.C., presents: So now, when is the best time to test hormones? Early morning is when the hormones will be the highest for most hormones. So, the best way to go and test hormone levels like cortisol and gonadal hormones is first thing in the morning since you have to be consistent and fast because what you’ve eaten can change hormone levels. So if you’ve always fasting, at least you’ll find consistency between specimens and the same person. You also need to know where they were in their cycle for certain tests. So, women patients who are still cycling need to record the first day of their next period to know what day you did their testing. Otherwise, they’ll have to use ovulation kits to know exactly where they are.
Dr. Alex Jimenez, D.C., presents: And of course, the downside here is that if you’re trying, for instance, to get a day-21 progesterone, and she typically has a 28-day cycle, so you tell her to go on day 21, but that particular month she has a 35-day cycle, you didn’t get the level that you were looking for. So it can be a little problematic, but remind them to keep track of it so that you won’t be able to look back and know where they were when they had their tests done. So, when do we want these tests in pre and perimenopausal women? Suppose you want progesterone on day 21. You can also do a sex hormone-binding globulin on that day. Menstruating women shoot for as close to day three for estradiol, estrone, FSH, testosterone, or a sex hormone-binding globulin.
Dr. Alex Jimenez, D.C., presents: Now, even though these are ideal, can you get them on other days of their cycle? Yes, but they will have different accuracy. And, of course, it may be an additional day than day three because what if day three happens to land on the weekend and the lab’s not open? So, please consider that what you are looking for here is to test the hormone levels when they’re at their highest. And that’s why we’re shooting for three and 21. So, you know, here’s day three and four. And so the FSH is going to be a nice level here. The estradiol bounces around a lot at this point, so trying to get it in this part of the cycle would be less helpful. And, with progesterone, you’re going to get your peak here, so that’s why you want to try to shoot for 21 days because you know that’s going to be the easiest way to ensure you’re getting it. And also, it’ll help you be more consistent from cycle to cycle if you’re always trying to get it at the same time of the process.
Hormone Replacement Therapy
Dr. Alex Jimenez, D.C., presents: Now here’s where it gets tricky since it’s one thing to find out where the person is before you put them in any hormone replacement therapy; however, monitoring hormone replacement therapy gets more problematic still. If you’re using oral estrogen, it is recommended to get a serum baseline before HRT and then monitor during treatment; if you’re doing oral estrogen, the salivary levels don’t reflect the exogenous estrogen use at all, so they’re not very helpful.
Dr. Alex Jimenez, D.C., presents: And oral estrogen or any hormones that undergo this test must accurately reflect the liver’s first-pass metabolism and the urines’ levels. So if you’re doing oral estrogen replacement therapy, the only way to assess it is with serum because doctors will convince the patient with the module, so you probably don’t want to use oral estrogen anyway. If you’re using sublingual estrogen, the levels will rise and fall rapidly within hours. And so the serum’s not effective in terms of measuring. The saliva will make no sense if you’re doing sublingual because you just had your estrogen there. So what does it mean? It means that 24-hour urine and drive urine testing with sublingual hormones aren’t recommended because there’s always a question of how much you are swallowing and how much is getting absorbed sublingually.
Dr. Alex Jimenez, D.C., presents: Now, if you notice that it says in sublingual, there could be better testing methods. Since you don’t know how much was swallowed and got the first-pass metabolism effect, the result in a 24-hour or dried spot urine may need to be clarified. So that’s problematic. You can still do sublingual estrogen replacement therapy; it just means there’s no great way to test it. If you’re using estrogen creams, serum testing can be effective, and we know that clinical parameters correlate to serum levels when using estrogen creams, so we can do that. In saliva, estradiol and estriol are actively transported into the saliva; the levels are way higher than you would see in the serum and are highly variable. So salivary levels for creams don’t make sense, and there are no good peer-reviewed studies detailing the effective estrogen cream on urinary levels.
Using Hormone Creams & Patches
Dr. Alex Jimenez, D.C., presents: It is probably not a great idea to use urine levels for someone using estrogen creams at the time. If you’re using labial or vaginal estrogen, the serum test appears to be the best choice for monitoring absorption. The salivary levels don’t reflect any dose changes. So basically, it’s probably a waste of time to get a salivary level trying to do urine testing; using vaginal or labial estrogen might be problematic because how do you know you didn’t contaminate the urine specimen. And if you’re using a patch, serum values will rise dose-dependently and then rapidly decline the following removal. It may be helpful, we know that the serum values change based on when you put the patch on and when you take it off, but it is still problematic.
Dr. Alex Jimenez, D.C., presents: There’s no peer-reviewed evidence showing that salivary estrogen can be used to monitor the estrogen patch. And when it comes to the urine testing and the estrogen patch, it does appear that the values in the urine will go up dose-dependently. It may be relatively accurate, but it’s not the best clinically validated test for an estrogen patch. The take-home message here is that no testing is perfect and many of us adjust the dose to the lowest amount, the lowest level we can get, and still have our symptoms controlled. That doesn’t mean they don’t test; you must try to ensure you’re not overdosing on this person. But keep in mind that there are a lot of limitations around what testing can be helpful depending on what form of estrogen replacement you’re using.
Dr. Alex Jimenez, D.C., presents: Now, progesterone and oral progesterone, if you’re using that, the levels rise and fall quickly. You may not be able to catch a serum level that makes sense if you’re taking your progesterone in the evening and then measuring in the morning. Because most women, if they’re taking oral progesterone, will take it in the evening because it helps them sleep. There’s also a problem with the cross-reactivity of metabolites with the immunoassays. So progesterone replacement therapy, if oral, you must take the serum levels with a grain of salt. The same thing with saliva and 24-hour urine testing. We talked about how you’re not getting progesterone; you’re getting progesterone metabolites, so that might be useful. But there’s the problem of how clinically valid the use of progesterone metabolites is. So oral use of progesterone, getting a level, and following it is a little tricky.
Dr. Alex Jimenez, D.C., presents: Now with creams and transdermal progesterone, none of the tests makes any sense because you get mentally increased levels in the serum that don’t rise in any particular way that makes sense. Like all steroid hormones, these are fat-soluble, so if it goes and sits in adipose rather than getting into the bloodstream, it doesn’t necessarily reflect a serum level. Doesn’t necessarily reflect the tissue levels in the uterus and the breast, which is where we care about it. So a serum level for progesterone cream is problematic. Salivary levels after progesterone cream go way up and don’t correspond to symptoms at all. So don’t bother getting salivary level after a progesterone cream. There’s some evidence in urine testing that you can get small increases in the pregnant dial three glucosides if you use progesterone cream. And so it may turn out that we can use that as a measure of what your progesterone is doing.
Dr. Alex Jimenez, D.C., presents: But this still needs some more testing. So it would be best if you remembered that there needs to be a reliable method to track what’s happening when a person uses progesterone cream. So please take your time with getting a level and making a decision based on it. Now, vaginal progesterone suppositories have the same problem. You get minimally increased levels in the serum, which will not give you an adequate result. Progesterone melts or atrocious; you can use serum levels in at troche because you get a more accurate level in the serum than if you had taken it orally. There’s a lack of peer-reviewed research on salivary levels after vaginal progesterone suppositories. And you have to be careful if you’re trying to do urine testing because how do you know you didn’t contaminate the sample?
Dr. Alex Jimenez, D.C., presents: You can’t use a salivary level because you just had the troche or the melt in the person’s mouth. And then, there is at least a potential problem with getting a urine level for a troche or melt because, like a sublingual, how much of this are you swallowing? Individuals may consume some of it and are subject to first-pass metabolism, which means you won’t be able to pick it up in the urine. The larger portion will be absorbed into the capillary blood and probably be accurate in the 24-hour or dry urine test. But that needs to be adequately studied, so keep that in mind if you’re using atrocious or melts. And this is a study that showed that after applying topical progesterone, the saliva and the capillary blood levels were very different compared to those seen in the serum or whole blood.
It’s Important To Do Research
Dr. Alex Jimenez, D.C., presents: So this is just an important research study to remind you of the reliance on serum levels for progesterone. If you’re monitoring, topical dosing can lead to underestimated tissue levels, so you’ll give more than you need. So, be careful about relying on serum levels for topical progesterone because you’re going to overdose people like crazy. And remember, if you overdose on progesterone, it’s high up in the steroid hormone pathway, and you don’t know what this person’s body will do with it; they might turn it into pretty much anything else. Now, testosterone replacement therapy creams or gels can cause blood levels, and the serum level rapidly increases with the application and doesn’t reliably reflect dose changing, any dose changes. So the serum and blood levels are probably not the great way to go. In the saliva, the levels are much higher than the serum and are highly variable since they may give a false indication of overdose.
Dr. Alex Jimenez, D.C., presents: In the urine testing, there’s not good in the 24-hour urine. You probably want to use something other than 24-hour urine. The good news is the dried urine. Now in dried urine, the epitestosterone can be measured if there’s going to be suppression due to exogenous testosterone production if that’s what you think is going on. You can measure the epitestosterone in dry urine testing, which will tell you whether or not, you’ve suppressed this person’s production of testosterone by giving them some. Now, vaginal or labial application of testosterone, there’s no good way to get a blood level that makes sense. The salivary levels, like any other cream or application we might have on your hands, you have to be careful because if you’re handling the specimen vials, to get the saliva, you might get it into the testing medium.
Dr. Alex Jimenez, D.C., presents: And then, just like any vaginal or labial application, if you’re trying to get urine specimens, you have to be careful that you’re not contaminating the urine and getting a falsely elevated level. Blood levels are good if you’re doing testosterone injections, either injection or pellet. Get one-third baseline, and use them for monitoring. It gives you adequate levels. You’ll get a significant elevation in saliva after an IM injection, but there’s wide variability from person to person. So you must take that with a grain of salt regarding how accurate your result might be. The same thing happens in the 24-hour urine specimen. You’re going to get an elevation after an IM injection, but then, there’s a great deal of variability, so who knows how accurate it is?
Dr. Alex Jimenez, D.C., presents: With a salivary level, there’s only some correlation to the bioavailable testosterone. If you’re using a testosterone patch, you can get adequate levels, and there are good studies to show that a blood level will be okay. If you’re using a testosterone patch, the urinary levels, both in 24-hour urine and dry urinary levels, will reflect the increasing doses. You’re getting a reasonably good level with using that. Now, if you’re using DHEA treatment or oral DHEA, you’re going to get a rapid increase in the blood levels right after the oral supplementation as you get with the saliva. You get that also in saliva and also in urine. So you’re picking up on the fact that you took the DHEA test.
Conclusion
Dr. Alex Jimenez, D.C., presents: The problem is variability in the blood, saliva, and urine results. Many don’t particularly appreciate using a lot of oral DHEA anyway because, like all steroid hormones, your body’s going to take it to the liver, and the liver has the opportunity to change it into something else before it even gets into the bloodstream to do its job. Other applications may be more helpful, like transdermal DHEA or topical DHEA; you’ll have to see how the patient feels in terms of symptoms because if you use topical DHEA, the blood levels you’ll get a big rise right after the initial application.
Dr. Alex Jimenez, D.C., presents: So what does that mean because it drops right away? Then, in the saliva after transdermal application of DHEA, the levels will increase, but not linearly. So that doesn’t make any sense. And there is no peer-reviewed research detailing what happens in DHEA levels in the urine after transdermal application. The bigger issue then becomes you might want to keep an eye on what the downstream breakdown products are doing because if you’re not able to get a good DHEA level, you might want at least look at testosterone and estradiol. And that’ll give you some fuel if you’ve overdosed or underdosed on the DHEA. Now, with the vaginal or labial application, the levels in the blood don’t go off at all.
Dr. Alex Jimenez, D.C., presents: There’s no research detailing levels after vaginal application looking at salivary or urinary levels. So you can’t use that as a way of monitoring it. So again, this will be just a matter of following the person and how they feel after using it. You’re not going to need to worry about getting any measurements afterward. It’s simply clinical. The test you choose depends on what you’re giving the person, the form you’re giving it in, and then what you’re trying to find out. By finding a treatment form you like and feel comfortable with, understand whether or not to get testing depending on the structure and replacement you’re using. And then, make sure that you are getting helpful information and not misleading information.
In today’s podcast, Dr. Alex Jimenez DC, Health Coach Kenna Vaughn, Truide Torres, Alexander Jimenez, and Astrid Ornelas discuss and focus on a deeper look at understanding metabolic syndrome.
Dr. Alex Jimenez DC*: It is a special day, guys. Today we’re going to be talking about metabolic syndrome. We’re going to be focusing on the sciences and the understanding of what metabolic syndrome is. Today, we’re going to be bringing out some specialists and people from all over the globe in different directions to discuss the topics of metabolic disorders and how it affects people in our local communities. The particular issue that we’re going to be talking about today is metabolic syndrome. Metabolic syndrome affects a whole lot of people now in terms of it to be diagnosed with metabolic syndrome; we have to have a couple of disorders situations that present them that are things such as blood sugar issues, high blood pressure, the ability to have triglycerides off high-density lipoproteins and also the measurements of belly fat in our diet. So today, one of the remarkable things that we’re going to be doing is bringing a panel to us to you guys to see what metabolic syndrome is now. Today is a special day because we’re going live on Facebook Live, and we’re presenting the information for the first time. So this is our first go at it, guys. So give us a thumbs up if you feel we did well. If not, let us also know because we’re learning and going through a process to get to our communities and teach them about metabolic disorders. Today, we have Astrid Ornelas, who will be talking about metabolic syndrome and specific dietary nutritional dynamics to help improve it. We also have Kenna Vaughn, which is our coach, that’s going to be discussing how we interact with patients. We also have our patient here, Trudy, a live individual who has had metabolic syndrome. And in the distance, we also have Alexander Jimenez, who’s out at the National Unity, Health Science, and Medical School, to discuss the associated and linked to metabolic disorders to give us detailed information. Detailed insights as to what metabolic syndrome is and how it affects our communities. Now what to be critical about it is, is this is a severe subject matter. It seems kind of that we chose this particular topic because that it’s affecting so many people. So many of my patients that we see today, even though I have a musculoskeletal practice, are directly related to inflammatory disorders. And when we’re dealing with inflammatory issues, we’re going to be dealing with insulin and how it affects the body. Now, as insulin goes in this process, every one of these particular dynamics that we’re going to be discussing and our future podcasts when we deal with metabolic syndrome is directly related to insulin and its effects on the body. So as we go through these dynamics, what we want to do is we want to bring out each point. I can present today Kenna Vaughn; who will be talking about what happens when we offer a patient and what we do when a patient has metabolic disorders? So we’re going to present it to Kenna. Kenna, can you tell us a bit about what happens when a patient presents with metabolic syndrome, what they look for, what we look for, how we assess it, and how we treat the issues?
Kenna Vaughn: I’d love to. So when the patient first comes in, and we see those signs of metabolic syndrome, the patient isn’t always aware because, on their own, these symptoms that make up metabolic syndrome are not necessarily a red flag. However, when we start to see them getting combined, we realize that we need to take control of this right now. So when that patient first comes in, and they’re telling us about the symptoms that they’re having, we start tracking it, and we make a detailed history on them to see if it’s something that has been going on for a long time, if it’s more recent, things like that. And then we’re going to take it from there. And we do more detailed lab work, and then we look at the kind of even their genetics. Genetics is a huge part of it. And we see what diet would best work for them and just make those realistic goals. But we also really want to make sure we give them that education they need to be successful. Education is tremendous, especially when it comes to something that can be as confusing as metabolic syndrome.
Dr. Alex Jimenez DC*: We discuss how we can give our patients take home dynamics and things of value to change the metabolic syndrome once we determine that someone has metabolic issues. Now the whole idea is to create a direct path from the kitchen to genetics. And somehow someway we have to bring science to the kitchen to understand what we can eat and what we can do and how we can avoid certain foods to change the dynamics expressed at our genetic code level. So we’re going to try to give a little bit of broad, you know, expansive understanding of the processes that can take on each of these five particular issues. One at a time. So in terms of, let’s say, the kitchen, how do we help people help themselves in the kitchen, Kenna?
Kenna Vaughn: One thing that we love to do in the kitchen is smoothies. Smoothies are so beneficial because not only are you feeding your body the proper nutrients you need. You can also provide the right nutrients to your cells, which will make the difference inside your body. And you’ll still feel satisfied and full, not going to be something that’s, you know, you’re left hungry like you just ate a little bit of birdseed. So it’s something that I recommend everybody starts with. One great thing to add to those smoothies is going to be flax seeds. So flax seeds are very high in fiber, a good fiber. So if you put those flax seeds into the blender first and blend them up, opening them up, you start adding in your healthy fats like avocados to make your smoothie nice and smooth. And the almond milk, low calorie, and low carb fruits, things like that. It’s going to just unleash a powerhouse inside that gut. So one main thing that it’s going to do is the fiber is going to stick around. So it’s going to feed your prebiotics and your probiotics every single bug in that gut. And it’s also going to help take things out of your body system that usually gets reabsorbed, such as salt, and let it be able to get excreted the way that it should be, rather than sticking around, like I said, getting reabsorbed and just causing these underlying issues.
Dr. Alex Jimenez DC*: So these dynamics and mainly when dealing with flaxseed, I know Alexander knows a bit of the flax seed dynamics in terms of how it works with cholesterol. And that’s one of the issues, the HDL component. Tell me a bit of what you’re what you’ve seen in terms of the flaxseed, Alex, in terms of our experiences with flaxseed and diminishment of cholesterol and helping out with metabolic syndrome.
Alexander Isaiah: So, flaxseeds are suitable not only for nutrients but like Kenna said, they’re outstanding in dietary fiber. So we have to ask ourselves, why is dietary fiber essential? We can’t digest it, but it can bind to other things that are within our gut. And one of the main things that it does to lower cholesterol is it binds to bile. Now, bile from our gallbladder is around ninety-five percent cholesterol. And I’m sorry, 80 percent cholesterol and ninety-five percent of it gets recycled and reused most of the time. So why have a large amount of fiber within the gut? The fiber binds to the cholesterol. The body’s mechanism to compensate for that is to pull cholesterol from other parts of the body, specifically from the serum of the blood, and pull it back in to rejuvenate those levels of bile. So not only are you forcing your gut to work properly that it is meant to, but you’re also lowering your cholesterol within the inner side of the body.
Dr. Alex Jimenez DC*: So the component of cholesterol can be assisted by fiber. Now, I know that Astrid got some ideas about lowering the blood pressure and bringing a little bit of control in nutraceuticals. And in that respect, she’s been going over some particular topics, and she’s the resident scientist that helps us see the NCBI, which is the national research center that provides daily information about what’s happening with metabolic syndrome out there. So she will be presenting a little bit of some nutraceutical topics that we can touch upon at this present time. Astrid, hello.
Astrid Ornelas: Hello. So, first of all, for those people who are barely coming into the podcast who are barely coming in to listen to us. I want to bring up again what metabolic syndrome is. So metabolic syndrome, as many of you might know, it’s not a condition or disease in itself. It’s more so a cluster of a collection of, I guess, other health issues that can increase the risk of things like heart disease, stroke, and even diabetes. So with that being said, the metabolic syndrome doesn’t have any apparent symptoms, but probably one of the most visible, I guess. You know health issues that are obvious in people with metabolic syndrome is waist fat. So with that being said, some of the nutraceuticals I want to talk about today, as you can see, I’ve listed several nutraceuticals that I discussed the last time. And these nutraceuticals can help with metabolic syndrome in a variety of ways. But I added several on here that specifically target weight loss. Since, as I mentioned, one of the apparent signs of metabolic syndrome is excess waist fat. So I want to bring in one of the nutraceuticals that is that several research studies and I’ve written articles on it that can help promote weight loss in people with metabolic syndrome is niacin. Now niacin, it’s a vitamin B3, and you can usually find it when you buy those supplements that have a kind of B-complex. It has a collection of various of the different B vitamins. So niacin, several research studies have found that it can help reduce inflammation associated with obesity people that have excess weight, of course. Usually, these people have increased blood sugar and blood sugar levels, leading to inflammation. So taking B vitamins, specifically vitamin B3, or as it’s well known for niacin, can help reduce inflammation. It can also help promote metabolism, our body’s capacity to convert carbohydrates, proteins, and fats into energy. So when we take vitamin B and specifically niacin vitamin B3, I want to emphasize that research studies have found that it can help burn calories much more efficiently.
Dr. Alex Jimenez DC*: When we’re dealing with niacin and the nutraceuticals, we are going. I know Alexander’s got some issues. Are you still with us, Alexander? Yeah, I’m here. It’s OK. It’s all good. I can see that we deal with and we’re learning about our technical issues as we go through them. I’m going to go back to Astrid, specifically about belly fat. Now she had mentioned the belly fat. Let’s be very specific when we’re dealing with belly fat. We’re dealing with issues where a male has a greater than 40-inch waist. OK. And for females, they have a greater than 35. Is that correct? Yes. So when we do the measurements, that’s one of the components. So as we discuss these particular issues, we want to make sure that when we’re talking about the belly fat and the weight gains and the BMI issues and the BIA issues, it’s the basal metabolic rate and impedance assessments that we do. We’re looking for those particular aspects. So she’s mentioning in the niacin and terms of niacin, what’s your experience with niacin, Alex with your dynamics that you have put in place?
Alexander Isiah: Niacin, or vitamin B3, is an excellent vitamin B because it is a free product. It reacts to a specific response precisely where it takes hold during glycolysis and the citric acid cycle. It plays a significant role in the citric acid cycle because it is used as the pre-product to synthesize NADH. Now, if someone has metabolic syndrome, this can upregulate that citric acid cycle. So if they’re trying to burn fat or use their carbohydrates at a more efficient rate, it will help upregulate that cycle and allow them to use their mitochondrial metabolism a lot better.
Dr. Alex Jimenez DC*: That’s awesome. Now, going back to Astrid, tell me a bit about what supplements we have here. We may not get through all of them, but little by little. We’ll break this thing down, so we’ll give you guys tidbits. So that useful information so that we can take on metabolic syndrome and change people’s lives. Go ahead.
Astrid Ornelas: OK, so the next nutraceuticals I’m going to talk about, I’m going to talk about these two together vitamin D and calcium, specifically vitamin D3. I want to emphasize that. But both of these nutraceuticals can also help promote fat mass loss. And several research studies have also found that this one, just like B vitamins, just like niacin, vitamin B3, could also help improve metabolism to make the body more efficiently burn calories. And then the next nutraceuticals I want to talk about is DHEA. Now I want to, I guess, one of the things that I want to highlight about the DHEA is that, first of all, this is a hormone. This is a hormone that is naturally produced in the body. But then, of course, you know, some people can supplement it if you talk to your health care professional. And they determined that you need more DHEA in your body because your body’s not naturally producing enough of it, then they can supplement that as well. So specifically about the DHEA, according to the Washington University School of Medicine, DHEA can also help metabolize fat much more efficiently. I guess one of the things that I wanted to discuss goes together with the DHEA. So when we consume excess calories, you know, the daily caloric intake on average, according to researchers, we need to take 2000 calories. But so what happens to the body when we eat excess calories now? These calories are stored in the body as fat. So when the body naturally produces, I guess, sufficient amounts of DHEA, our body can metabolize DHEA. I mean, metabolize fat. I’m sorry, much more efficiently so that our body gets rid of excess fat rather than storing it.
Dr. Alex Jimenez DC*: Got it! So let me ask you, DHEA is a hormone, and one of the things that I notice is that it is a hormone found over the counter. And one of the unique things with some passages of recent laws is that DHEA made it through the FDA to be used over the counter. So you’ll see the product is dispersed through all the stores and depending on the quality, you can see it more every day. And the reason you see it more common over the last couple of years is that the FDA found it, and then through a loophole, it was allowed to remain in the markets. Go ahead. Kenna wants to mention something regarding this particular component in the assessment of those specific issues.
Kenna Vaughn: I was going to add something when it comes to talking about body fat and how Astrid was saying that body fat gets stored. So what happens is when you have those excess calories, you create these things in your body called triglycerides. And triglycerides are composed of glycerol and fatty acids; and however, those in general triglycerides are too big to enter that cell membrane. So what happens is another hormone that controls almost everything, and it’s called insulin, and the insulin gets called in. And from here, we have the lipo…
Dr. Alex Jimenez DC*: Lipoprotein lipase?
Kenna Vaughn: Yes, that one. It’s a tongue twister, so that gets called in and then kind of breaks those apart. The insulin is coming in again and activating something called the glut4transporter, which will open up that cell membrane. And now we’re going to see that fat cells get stored full of glucose, triglycerides, and fat. So that’s how those fat cells go from not having anything to then having those excess calories. Now they’re being converted through this process. Now they’re getting nice and full, and they’re hanging around your belly.
Dr. Alex Jimenez DC*: I’ve noticed that certain people have more efficient LPLs, which is lipoprotein lipase. Some people may say that you know what? I gain weight by just looking at food, and it may happen more as you get older. A whole different control system controls this particular issue. What kind of control systems are the ones that control lipoprotein lips and the glut4, along with hormone-sensitive lipase, that you have there?
Kenna Vaughn: Insulin controls everything else. And it’s like I said, it’s that hormone, and it’s going to come in. And also, on top of that, we have PH that affects enzymes, temperature, and things along that line.
Dr. Alex Jimenez DC*: You know, a lot of things that when we look at enzymes, we realize that the thing that determines the enzyme’s activity or sensitivity or ability to function is encoded in the genetics in terms of lipoprotein lipase and the breakdown of the fatty acids. I know, Alex, you have some points there in terms of the fat breakdown information. What do you have there that you can help the public understand a little bit more?
Alexander Isaiah: So, without going too much into the biochemical pathways, this is just showing the mitochondria’s inner mitochondrial matrix. So after I guess you’ve been well-fed and all your cells are satisfied with energy production through ATP synthesis, if you have overconsumption of caloric intake, specifically through glucose, you end up having a large amount of acetyl-CoA being produced or hanging around in the end here. So what the body does is buy high levels of insulin. This enzyme, called citrate synthase, is induced. So what citrate synthase does is use oxygen acetate and acetyl-CoA to make citrate. Now, citrate can then exit the mitochondrial matrix, and then significant accumulations of citrate will start accumulating in the sidewall of the cell. As that happens, ATP citrate lies will break them apart again and bring acetyl-CoA and auxtyl-acetate. Because auxtyl-acetate and acetyl-CoA don’t have specific membrane transporters, they can’t cross that mitochondrial membrane. Only specific ones like citrate do so as acetyl-CoA gets taken out into the cell; taking a look over here, we have acetyl-CoA, which gets turned into methylmalonyl-CoA. And it’s actually this enzyme acetyl-CoA carboxylic is induced by insulin. So usually, acetyl-CoA carboxylic has a phosphate group on it, which inhibits its activity. But when it interacts with insulin, insulin turns on a protein phosphatase. So phosphatase are enzymes that take phosphates off, and then it becomes acetyl-CoA carboxylic. So now acetyl-CoA carboxylic is active to make methylmalonyl-CoA. Now, why is this important? So methylmalonyl-CoA is like putting the boulder on top of the hill; you’re going to start a different chemical process. So methylmalonyl-CoA inhibits fatty acid breakdown and begins fatty acid synthesis. So when you start making methylmalonyl-CoA, you’re going to, without going too much into fatty acid synthesis. The end goal is palmitate, which is the type of fatty acid. Now, palmitate chains will combine with glucose to form triglycerides. So here, we can see how a large dietary intake of carbohydrates, glucose levels, proteins, and insulin activates triglycerides. And if you have diabetes, you pretty much get halted in specific pathways. And that’s why you end up with too much acetyl-CoA. You have too many ketone bodies floating around in the blood, so you are going through without going too much in-depth; we can see that having a large number of dietary triglycerides, large amounts of glucose will force more triglycerides or try sealed glycerol within these kinds of microns within the lumen of the blood vessels. And this is going to cause a chain of reactions. So without breaking down too much here, we’re showing where it’s all going, so we have acetyl-CoA going to methylmalonyl-CoA, going to palmitate, and then we have palmitate forming these triglycerides. So like Kenna said, these triglycerides can’t enter the adipocytes. The adipocytes are fat cells without lipoprotein lipase. So with the combination of lipoprotein lipids allows these cells to get in there. You allow for the storage of the fat, so the cool part to notice is that by doing so, the first one will use fatty acids to be your heart. The heart relies on around 80 percent of its energy from fatty acids. Then it’s going to be your muscle cells. But this is in conjunction if you’re exercising regularly. If you’re not doing that, the adipose cells will favor storing the triglycerides or triglycerol more often. And then you’re also going to use more LDL, which means you have the potential to have more oxidized LDL, causing a higher event of atherosclerosis formation.
Dr. Alex Jimenez DC*: You know, as you go through this process, it seems natural, but for a lot of us, it’s a deep, deep story, and it’s far, and it’s dynamic. And what I want to do is to bring the people back to Kenna as to the diets. In terms of getting this basic understanding. How is it that we assess an individual where these particular issues? I can assure you that when we first evaluate a metabolic syndrome patient. We do a lot of blood work, blood assessment, a lot of enzyme testing. We can even do DNA testing. So we got to go back to a patient and describe precisely how we can better improve their lives by our assessments. So, Kenna, you got some cool stuff in there for us. What do you have in front of you?
Kenna Vaughn: Yes, in front of me, I have a sample report from one of our patients on who we ran the DNA blood test. And one of those things that we can see is a gene pulled up right here, and it’s called TAS1R2. And what this gene does is it’s a tissue that can be found in the gastrointestinal tract, the hypothalamus, and the pancreas. And it’s known for regulating your metabolism and energy, and homeostasis. Also affects that food intake beyond the detection of your sweet taste on the tongue. What does that mean? So what that means is it is nicknamed the sweet gene. So, somebody with this gene is more likely to be drawn to sweet foods because it’s almost like their sweetness is enhanced. So when they taste ice cream, it’s a 10 out of 10, no matter the flavor, versus someone who doesn’t have this gene. Maybe it’s more of a seven out of 10. It hits them differently.
Dr. Alex Jimenez DC*: That makes perfect sense. Or some people that, you know, they love that ice cream and that dynamics, I know that I want to take a little bit of a detour because a lot of patients will wonder, Well, what are we going to do to get into being assessed and what kind of things we can? How does someone get? Where do they go? And for that, we have our clinical liaison here, Trudy, who walks patients in and first determines that the patient is qualified because we do have questionnaires that assess the determination of if someone is a talented individual or does have presentations that are predisposing to metabolic syndrome that require further assessment. And once we do in the situation that a person does have it, they want to understand what to do. So actually, Trudy, you do us help people and guide them through the process. What do we do in the office to help guide an individual through the beginnings of metabolic assessment?
Trudy Torres: OK, well, basically, you know, when people call in, we go ahead and email them a questionnaire. It does take about 45 minutes because it’s a very in-depth questionnaire. We want to pinpoint and get to the bottom of their main concerns. The main issues that we’re going to target for the process to be successful. Once we get that questionnaire back, we set up an appointment with Dr. Jimenez and our health coach Kenna, and they will go in-depth as far as the target areas that we need to address for the process to be successful. And that’s one of the things that I wanted to ask Kenna because I know it can be a bit overwhelming as far as what is it that they get? And as far as what is the following process? So once we get the questionnaire, I know that’s when they’re going to go ahead and do the different types of lab work to determine what will be successful in the kitchen.
Dr. Alex Jimenez DC*: I know you see the patients when they walk in; how do they feel in terms of that Trudy? What is it that they typically will tell you before being further assessed?
Trudy Torres: Well, they’re tired of, you know, all the different changes that you go through as, unfortunately, as we age. You know, some of the DNA genes that we have, that they’re dormant, you know, they become active. And that’s when you start to experience a different type of bad syndromes, you know, like metabolic syndrome. And that’s one of the things that we address. You know that we go ahead and do the DNA testing and see what different genes are dormant that are not dormant.
Dr. Alex Jimenez DC*: I think that also, you know, whether you’ve noticed too and you’ve mentioned this to me, they’re just tired of feeling bad. They’re just tired of feeling like; I guess crap is a good word, right? So they’re tired of just they don’t recover. They don’t sleep well. They feel stressed. They feel like they’re being choked with high blood pressure. It’s not. Their lives are different. They’re in distress. They don’t sleep. So these are issues that the patients present to you, and I know you help them guide them. And then, Kenna, tell me a bit of the assessment you do to qualify an individual on the metabolic syndrome programs we have?
Kenna Vaughn: Like we were saying before, we go through that detailed history to look at that family history. And then we also decide, like Miss Trudy noted, the lab work gives us a lot of these underlying answers because the lab work we do is more detailed than the basic. So we get more numbers, more genetic codes, and more of all of these things. And from there, we’re able to take it and see what will be the most successful path for this patient. What supplements are they going to be able to intake better? What diet is best for them, whether it be the ketogenic diet or the Mediterranean diet? Everybody’s body is different because everybody’s insulin sensitivity is different, and everyone’s hormones change, especially for females. It’s different than male patients, and we create that individualized package for them because we want them to leave at the end of everything, not just that first visit. Still, we want them to leave feeling empowered and healthy and strong and not just they’re alive, but that they’re living. And that makes a massive difference to their families and their friends. And just everything gets impacted, all from the start of these questionnaires.
Dr. Alex Jimenez DC*: You touched on a subject matter there about being left alone. We go through a process, and we do keep connectivity with our patients. With today’s technology, there’s no reason we can’t have a person or an individual connected to our office and give us information such as BMI BIA information, which is basal metabolic stuff, the scale weight, the fat densities. We can have this information today. We have Fitbits that connect to us, and we can understand that that data is now available in a private way, and someone on the other side is reading that tell us what you do with individuals in terms of the coaching that we offer people; for specific metabolic syndrome?
Kenna Vaughn: Of course. For coaching, we have a scale. And like Dr. Jimenez was saying, this scale not only tells you your weight, but it also sends your weight, your water intake, how much of your weight is water weight, how much of your weight is lean muscle? And it also can track it and see the percentages of where you’re changing. So we can follow that maybe the number on the scale hasn’t moved. And some people might start to feel discouraged. But when we look at the numbers of what that scale tells us, we can see that you are losing body fat and being replaced by muscle. So even though that number is the same, your body inside is chemically changing. You’re making those differences you need to make to keep up with it and not to quit because, as I said, it can be discouraging for certain people.
Dr. Alex Jimenez DC*: So there’s a Mind-Body connection here. A mental component, teamwork dynamics, is essential when we’re working through metabolic syndrome. We can’t leave people here, here, take the football and run 80 plays. No, you have to huddle in each time to discuss and change the adaptive processes. Regarding the other areas with fat analysis, I know Alex has some additional areas and Astrid that will be discussing in a few minutes. But I’m going to focus on Alex right now to tell us a bit of what people can do with exercise or fitness that could stimulate or dynamically change their metabolic processes at the biochemical level.
Alexander Isaiah: Well, I would first, in all honesty, be honest with yourself; you will probably be the best observer of your situation. We all know what foods we do well with. We all know what foods we don’t do well with. We’ve always had some intuition as we’ve grown into the people we are today, knowing what foods work well for us and what foods don’t work well for us. For example, I know that if I consume a large carbohydrate consumption, I tend to put on weight pretty quickly. But I am pretty active. So the days that I have strenuous activity, I make sure that I have a balanced meal with proteins, fats, and a decent amount of carbohydrates. But the days that I’m not very active or haven’t gone to the gym. I make sure that most of my caloric intake sometimes comes from good fats or proteins. And that’s going to be the best thing is just be honest with yourself. See how you’re doing, find your BMI, find your basal metabolic rate, and then put numbers on paper. Because if you keep track of things. Odds are you’re going to do better and control the way your body’s responding. The next thing is I would find a health coach like Kenna, to stay on track and find any recommendations. The good part is that we have the internet out there and sources like yourself, Dr. Jimenez, that can provide information to the public on a new level and be able to understand and grasp the concept from a different perspective and give people more information that they didn’t know that they had at their fingertips.
Dr. Alex Jimenez DC*: I’m going to take it back to Astrid. Thank you, Alex. But one of the things is I want people to understand we’re going to assault. We’re going to assault on metabolic syndrome because this is a big problem and affects many in all communities around the United States. And we have to have an open forum to be able to open up. And sometimes, we don’t have 10 seconds, and this is not a 10 second, two-minute thing. We must understand that there needs to be a teamwork integrative medicine approach that helps the patients. So I know we’re going to go with a couple, I don’t think we make it through all of them, but we’re going to get through as best as we can because this is all recorded and can be dynamic and time purposes used later. Tell us a bit of the omega, berberine, and all the other supplements you had planned to talk about.
Astrid Ornelas: OK. Well, first of all, for those of you who are barely coming into the podcast right now, the nutraceuticals that are currently listed up there can all help improve metabolic syndrome in one way or another. The majority of these specifically target they specifically lower help lower the risk factors that can cause that could increase the risk of developing issues like heart disease, stroke, and diabetes. But I want to emphasize several of these because they do they’re more efficient at promoting weight loss associated with metabolic syndrome. You know, if you’re going to improve metabolic syndrome, you want to promote weight loss, so that the last nutraceutical we talked about that’s up there was DHEA. The next nutraceutical I want to talk about is NRF2. So just like DHEA, it is a naturally produced hormone in our body. Well, NRF2 is also found in our body naturally. But unlike DHEA, which is a hormone, NRF2’s actual name, I guess the full name is the NRF2 pathway. It’s what’s known as a transcription factor, or it’s an element that regulates several cell processes if you will. And so I’ve done quite a few articles on this myself, and there are several research studies out there, quite a few to be exact, but NFR2 can also help improve metabolism. So if you improve your metabolism, especially in people who have metabolic syndrome, your metabolism can make it much more efficient for you to burn calories and therefore burn fat more efficiently.
Dr. Alex Jimenez DC*: The Omegas and NRF2, what we’re dealing with here, along with berberine, is inflammatory issues, OK? So what we want to deal with is when someone has metabolic syndrome, we suffer from inflammation, and inflammation is rampant. And that’s what’s causing the discomfort, the joint pain, the overall swelling, the bloating. Those are the kind of things that help, and they affect the blood pressure in insulin does happen, and we haven’t talked about that yet. But we’re going to be discussing that. I know Alex has got some ideas about Nrf2 factors and Omegas and berberine, and tell me a bit of what you’ve seen in terms of the nutraceuticals, and you read in terms of its effect on metabolic syndrome.
Alexander Isaiah: So the way we need to look at the different types of fatty acids is that most of the surface of each cell is composed of a fatty acid. It depends on what type gets incorporated based on the consumption or dietary intake that you have daily. So the main two components that your body’s going to use is cholesterol. That’s why we still need cholesterol and healthy fats that we get. But at the same time, if you’re taking in a lot of red meats, you’re also going to use arachidonic acid, which makes different types of fatty acids. And it also makes a transcription factor called PGE two, which is known for its very informative process or aspects. So what fish oils do, specifically EPA and DHEA, are by incorporating these into the cell membrane. You upregulate NRF2 and downregulate NF Kappa B, which is the inflammatory response. And not only by doing that, but as we talked about before with green tea extract and turmeric, otherwise known as curcumin. These also inhibit the pathways for inflammation. Now there could be the argument Well, do these pathways inhibit the inflammation? So let’s say I get sick or something, right? Well, the cool part is that two different pathways are stimulating the same response. By doing the dietary regimen of curcumin, fish oils, or even green tea, you’re inhibiting it from the body overexpressing these genes. Now, suppose you still get sick in a sense, right. In that case, you could still allow these cells to proliferate, specifically your macrophages, to do their job correctly, so you’re not inhibiting them by overstimulating them. You’re allowing them to be more proficient in their job. And suppose you are virally infected or with some unknown pathogen or let’s say. In that case, a cell decides to go rogue and start producing cancer cells, allowing the body to be more proficient in extracting these pathogens.
Dr. Alex Jimenez DC*: In essence, we’ve learned that if we try to suppress inflammation, we create a huge problem. The question is, let’s stop inflammation from progressing to be too extreme. So, in essence, to keep it at a workable dynamics, and that’s what these curcumins and the green teas do. I know Astrid has something to mention in terms of this particular concept. Tell me a bit about what you’re thinking.
Astrid Ornelas: Yeah. So as Alex mentioned, green tea is a fantastic drink. It’s actually in my nutraceutical list that’s up there, and I wanted to talk about green tea because it’s a very easily accessible drink, you know, for those of you who like tea. Green tea is delicious as well. And green tea has a variety of research studies demonstrated to be super beneficial for people with metabolic syndrome. So as many of you know, green tea contains caffeine. Of course, it has much less caffeine than a cup of coffee, for example, but it still does have caffeine, and green tea is also a powerful antioxidant. That’s another of the things that it’s very well known for. But just like NF2, you know that the interruptive pathway, green tea, has been demonstrated to help improve metabolism tremendously. You see, it promotes the body’s ability to burn calories, to burn fat. And because of its caffeine, I guess amount because even though it is less than a cup of coffee, but it’s just enough, it can help improve exercise performance. And you know, for those people who are looking to lose weight because of the, you know, the issues that they have associated with metabolic syndrome. Drinking green tea can help promote and improve their exercise performance so that they’re more able to engage and participate more efficiently in their exercise and physical activity to burn fat.
Dr. Alex Jimenez DC*: So basically, you’re indicating that as a good option instead of, let’s say, a whatever kind of drink or a juicy drink, it’s wise to keep sort of in the background green tea throughout the day. Is that correct? Or how much the water is good? The green tea’s good; a little bit of coffee and a little bit of this fluid is essential to keep our bodies hydrated through the process. Since it’s already available, green tea is a great option not only for metabolic processes to stop inflammation but also to help with the burning of the fat too?
Astrid Ornelas: Yeah, definitely. Green tea is a great drink. You can pretty much have it throughout your day. You know it has less caffeine than, say, you know, coffee, as I mentioned. And it will, you know, for those who have green tea, I love green tea, and I will have it. And you do get that little, that extra amount of energy. You feel it when you have green tea. But, yeah, you can have it throughout your day. And you know, it’s essential to stay hydrated, drink plenty of water. And you just want to make sure that if you do exercise enough, you don’t want to lose your electrolytes. So, you know, drink plenty of water and just stay hydrated.
Dr. Alex Jimenez DC*: I know that we’re going over there. I know that Kenna wants to speak something, and we’re going to go in that direction right now because Kenna wants to talk about specific dietary changes and things that we can do from a health coach’s point of view.
Kenna Vaughn: I just wanted to say that green tea is super beneficial from Astrid’s point. But I don’t particularly appreciate drinking green tea, which means that all hope is lost. They do have green tea and capsules as well, so you can still get all of those great benefits without actually drinking it because, for some people, it’s, you know, their coffee over tea. So you don’t have to drink the tea. You can still get all those great benefits that attitude was talking about but through capsules.
Dr. Alex Jimenez DC*: yeah, we got exciting, sneaky ways to help people. To help people understand and to come into our office. What can they do, Trudy, in terms of being facilitated in the office if they want to make, if they’re going to have questions or for any doctor, they have out wherever they may be because this is reaching far.
Trudy Torres: I know this can be very overwhelming to just the regular population. You see, we went in too deep, you know, as far as all the physiology behind it and everything else. One of the things that I can tell you is that when you call our office, we’re going to walk you step by step. You’re not going to be alone. You’re going to walk out with a lot of information and know what works for you. Like Kenna was saying, everybody’s different. This is not a cookie-cutter program. We take the time and talk one on one with everybody who walks in and make sure that when they walk out and have a lot of information with them, they also walk out with just the lab work; they will walk out with recipes. Kenna is going to be constantly following up with you. It’s a highly successful approach when you have accountability from a health coach. So you’re not going to be by yourself.
Dr. Alex Jimenez DC*: You know again where our goal is to make the kitchen to the genes and from the genes to the kitchen, we got to give the understanding maybe not of the deep biochemistry as Alex has taken us into or the nutraceutical dynamics, just know that there are ways that we can monitor. We can assess; we can periodically evaluate. We have diagnostic tools to determine blood assessments that are way beyond what was done ten years ago. We have dynamic metabolic testing in our office to determine fundamental critical aspects of weight density, the limb way to the body, and how much water you have. We use things like phase angle to assess the health of the cells and how they’re functioning. So there’s a lot that goes on in this process. So I want to take the opportunity to thank my guests today because from Alexander, all the way far on the north side of the United States, to Astrid, who assesses things at the NCBI because we need to have our finger right on the research that has been done. To our clinical liaison, which is Trudy, and one of our dynamic health coaches. I can be a health coach, but sometimes I’m with a patient, but she’s really with you all the time, and she can connect with you via email, which is Kenna. So together, we have come with an intention, and our purpose is to understand what the process is. A metabolic syndrome to break it down to deep levels will get down to them as you can see, to the genes, to the kitchen. And that’s what our goal is to educate people on how to feed our children. We intuitively know how to feed our families. Moms know what to do. However, today’s technology and research offer us the ability to break it down and specific to the sciences. And sometimes, when we get a little older, we realize that our bodies change and our genetics change, and that’s preordained based on our past, our peoples, our ontogeny, which is the generations in the past. But we have to realize that we can make a change and we can stimulate. We can activate genetic codes. We can suppress genes that want to get active if you improperly diet or do a proper diet. So our goal today is to bring this awareness, and I want to thank you guys for allowing us to listen in. We look forward to getting different subjects, maybe not as intense or dynamic, but this was our first run at the process. And we’re going to learn, and please ask questions so that we can kind of make it better for you and give you the information you need. So we thank you very much, and I want to tell you from all of us out here in El Paso that we look forward to offering the world information into metabolic syndrome that affects so many people. So thank you, guys. Thank you for everything.
In today’s podcast, Dr. Alex Jimenez, health coach Kenna Vaughn, chief editor Astrid Ornelas discuss about metabolic syndrome from a different point of view as well as, different nutraceuticals to combat inflammation.
Dr. Alex Jimenez DC*: Welcome, guys, welcome to the podcast for Dr. Jimenez and crew. We’re discussing today’s metabolic syndrome, and we’re going to be discussing it from a different point of view. We will give you excellent, useful tips that can make sense and are easily doable at home. Metabolic syndrome is a very vast concept. It contains five major issues. It has high blood glucose, it has belly fat measurements, it has triglycerides, it has HDL issues, and it pretty much has a whole conglomeration of dynamics that have to be measured in the whole reason we discuss metabolic syndrome because it affects our community very much. So, we’re going to be discussing these particular issues and how we can fix them. And give you the ability to adapt your lifestyle so that you don’t end up having. It’s one of the most important disorders affecting modern medicine today, let alone once we understand it. Everywhere you go, you’re going to see a lot of people having metabolic syndrome. And it’s part of a society, and that’s something you see in Europe as much. But in America, because we do have a lot of foods and our plates are usually bigger, we have the ability to adapt our bodies differently by just what we eat. No disorder will change so quickly and fast as a good mechanism and a good protocol to help you with metabolic disorders and metabolic syndrome. So having said that, today, we have a group of individuals. We have Astrid Ornelas and Kenna Vaughn, who will discuss and add information to help us through the process. Now, Kenna Vaughn is our health coach. She’s the one who works in our office; when I’m a practicing physician on physical medicine and when I’m working with people one on one, we have other people working with dietary issues and dietary needs. My team here is very, very good. We also have our top clinical researcher and the individual who curates much of our technology and is at the cutting edge of what we do and our sciences. It’s Mrs. Ornelas. Mrs. Ornelas or Astrid, as we call her, she’s ghetto with the knowledge. She gets nasty with science. And it’s really, really where we are. Today, we live in a world where research is coming and spitting out of the NCBI, which is the repository or PubMed, which people can see we use this information and we use what works and what does it. Not all information is accurate in PubMed because you have different points of view, but it’s almost like a finger on a pulse when we have our finger in. We can see the things that affect it. With certain keywords and certain alerts, we get notified of changes for, let’s say, dietary sugar issues or triglyceride issues with fat issues, anything about metabolic disorders. We can kind of come up with a treatment protocol that is live adapted from doctors and researchers and PhDs around the world almost instantaneously, literally even before they’re published. For example, today happens to be February 1st. It’s not, but we’ll be getting results and studies presented by the National Journal of Cardiology that will come out in March if that makes sense. So that information is early hot off the press, and Astrid helps us figure these things out and sees, “Hey, you know, we found something really hot and something to help our patients” and brings the N equals one, which is patient-doctor equals one. A patient and therapist equal one that we don’t do specific protocols for everyone in general. We do specific protocols for each person as we go through the process. So as we do this, the journey of understanding metabolic syndrome is very dynamic and very deep. We can start from just looking at someone to the bloodwork, all the way to dietary changes, to metabolic changes, all the way down to the cellular activity that it’s actively working. We measure issues with BIAs and BMI, which we have done with previous podcasts. But we can also get into the level, the genomics and the changing of the chromosomes and the telomeres in the chromosomes, which we can affect by our diet. OK. All roads lead to diets. And what I say in some weird way, all roads lead to smoothies, OK, smoothies. Because when we look at smoothies, we look at the components of smoothies and come up with dynamics that are abilities to change now. What I look for is when I look for treatments, I look at things that make people’s lives better, and how can we do this? And for all those mothers, they understand that they may not realize that they do this, but a mom doesn’t wake up saying, I’m going to give my kid food. No, she’s kind of doing a mental lavage of bringing the whole kitchen because she wants to infuse the best nutrition for their child and offer their best kind of options for their baby to go through the world or daycare or elementary school, through middle school, through high school so that the child can develop well. Nobody goes out thinking that I’m going to give my kid just junk and. And if that’s the case, well, that’s probably not good parenting. But we won’t talk about that well; we will talk about good nutrition and adapting those things. So I’d like to introduce Kenna right now. And she’s going to be discussing a little bit of what we do when we see someone with metabolic disorders and our approach to it. So as she goes through that, she’s going to be able to understand how we evaluate and assess a patient and bring it in so that we can start getting a little bit of control for that individual. Kenna, it’s all yours.
Kenna Vaughn: All right. So first, I just want to talk about the smoothies a little bit more. I am a mom, so in the morning time, things get crazy. You never have as much time as you think you do, but you need those nutrient nutrients and so do your kids. So I love smoothies. They’re super fast. You get everything you need. And most people think that when you’re eating, you’re eating to fill your stomach, but you’re eating to fill your cells. Your cells are what need those nutrients. That’s what carries you on with the energy, the metabolism, all of that. So those smoothies are a super great option, which we give our patients. We even have a book with 150 smoothie recipes that are great for anti-aging, helping diabetes, lowering cholesterol, controlling inflammation, and things like that. So it’s one resource we give to our patients. But we do have multiple other options for the patients who come in with metabolic disease.
Dr. Alex Jimenez DC*: Before you go in there, Kenna. Let me just kind of add that what I’ve learned is that we have to make it simple. We got to take homes or takeaways. And what we’re trying to do is we’re trying to give you the tools that can help you in that process. And we’re going to take you to the kitchen. We’re going to grab you by the ear, so to speak, and we’re going to show you the areas where we need to look at. So Kenna is about to give us the information in terms of smoothies that will assist us with dietary changes that we can provide our families and change its metabolic disaster that affects so many people called metabolic syndrome. Go ahead.
Kenna Vaughn: OK, so like he was saying with those smoothies. One thing that you should add to your smoothie is, which what I love to add in mine is spinach. Spinach is an excellent choice because it gives your body more nutrients. You are getting an extra serving of vegetables, but you can’t taste it, especially when it gets covered up by the natural sweetness that you find in fruits. So that’s a great option when it comes to the smoothies. But another thing that Dr. Jiménez was mentioning is other things in the kitchen. So there are other substitutes that we’re kind of wanting our patients to use and implement. You can start small, and it’ll make a huge difference just by switching out the oils you’re cooking with. And you’ll begin to see an improvement in your joints, your kids, and everyone will just improve immensely. So one thing we want to get our patients into using is those oils, such as avocado oil, coconut oil, and… Olive oil? Olive oil. Yes, thank you, Astrid.
Dr. Alex Jimenez DC*: That was olive oil. That was Astrid in the background. We’re getting the facts out excellent and continue.
Kenna Vaughn: When you switch those out, your body breaks things down differently with those unsaturated fats. So that’s just another option that you have in that kitchen besides making those smoothies. But like I said before, I’m all about quick, easy, simple. It’s way easier to change your lifestyle when you have a whole team around you. And when it’s easy, you don’t. You don’t want to go out and make everything super difficult because the chances of you sticking to it aren’t very high. So one thing we want to do is make sure that everything that we’re giving our patients is easy to do and it’s attainable for everyday life.
Dr. Alex Jimenez DC*: I’m very visual. So when I go to the kitchen, I like making my kitchen look like the cocina or whatever they call it in Italy, the cucina and I have three bottles there, and I have an avocado oil one. I have the coconut oil one, and I have the olive oil right there. There are big bottles there. They make them pretty, and they look Tuscan. And, you know, I don’t care if it’s an egg, I don’t care. Sometimes, even when I’m having my coffee, I grab the coconut oil one, and I pour that one in and make myself a java with coconut oil in it. So, yeah, go ahead.
Kenna Vaughn: I was going to say that’s a great option too. So I drink green tea, and I also add coconut oil in that green tea to help boost everything and give my body another dose of those fatty acids that we want.
Dr. Alex Jimenez DC*: I got a question for you when you have your coffee like that; when you have the oil in it, does it kind of lubricate your lips.
Kenna Vaughn: It does a little bit. So it’s also like chapstick.
Dr. Alex Jimenez DC*: Yeah, it does. It’s like, Oh, I love it. OK, go ahead.
Kenna Vaughn: Yeah, I also have to stir a little bit more just to make sure everything gets it right. Yeah. And then another thing just talking about something our patients can do when it comes to at home, there are tons of different options with eating fish. Increasing your good fish intake throughout the week, that’s going to help also. And just because fish provides so many great things like omegas, I know Astrid also has some more information on omegas.
Dr. Alex Jimenez DC*: I got a question before Astrid gets in there. You know, look, when we talk about carbohydrates, people, is it what a carbohydrate is? Oh, people say an apple, banana, candy bars, and all kinds of stuff people can rattle off carbohydrates or proteins. Chicken, beef, whatever they can rile up. But one of the things I found that people have a difficult time with is what good fats are? I want five. Give me ten good fats for a million dollars. Give me ten good fats like lard, like meat. No, this is what we’re talking about. Because the simple fact that we use and we’re going to add more to it relative bad is going to be avocado oil. Olive oil. Is it coconut oil? We can use things like butter oils, different types of margins, and not margins, but kinds of butter that are from, you know, grass-fed cows. We basically can run out of creamers, you know, non-nondairy creams, very specific creamers, those we run out of it, right? Real fast. So it’s like, what else is fat, right? And then we search for it. So one of the best ways to do it is that we’re not going to always put creamer on top or our butter on top, which by the way, some coffees they have, they put butter in it and blend it, and they make a fantastic little java hit. And everyone comes with their little ginger and oils and their coffee and makes espresso from heaven, right? So what else can we do?
Kenna Vaughn: We can, like I said, adding those fish in, which is going to help to give our bodies more of those omegas. And then we can also do more purple vegetables, and those are going to provide your body with more antioxidants. So that’s a good option when it comes to the grocery store. A rule of thumb that I love and heard a long time ago is to not shop in the aisles is to try to shop on the edges because the edges are where you’re going to find all that fresh produce and all those lean meats. It’s when you start to get into those aisles, and that’s where you’re going to start finding, you know, the cereal, those bad carbohydrates, those simple carbohydrates that the American diet has come to love but does not necessarily need. The Oreos?
Kenna Vaughn: Yes.
Dr. Alex Jimenez DC*: The candy aisle that every kid knows. OK, yes.
Kenna Vaughn: So that’s just another great point there. So when you come into our office, if you’re suffering from metabolic syndrome or just anything in general, we make your plans super personalized and give you so many tips. We listen to your lifestyle because what works for one person might not work for another. So we make sure that we provide you with information that we know you’ll be successful with and provide education because that’s another huge part of it.
Dr. Alex Jimenez DC*: All roads lead to the kitchen, huh? Right? Yes, they do. OK, so let’s zoom on precisely for the fat and the nutraceuticals. I want to give you an idea as to what type of nutraceuticals are appropriate for us because we want to bust down these five issues affecting metabolic syndrome that we discussed. What are the five guys? Let’s go ahead and start them up. It’s high blood sugar, right?
Kenna Vaughn: High blood glucose, low HDLs, which will be that good cholesterol everyone needs. Yes. And it’s going to be the high blood pressure, which is not considered high from a doctor’s standard, but it is deemed to be elevated. So that’s another thing; we want to ensure that this is metabolic syndrome, not a metabolic disease. So if you go to the doctor and your blood pressure is 130 over eighty-five, that’s an indicator. But yet your provider might not necessarily say your blood pressure is super high.
Dr. Alex Jimenez DC*: None of these disorders here by themselves are clinical states, and, individually, they’re pretty much just things. But if you combine all these five, you have metabolic syndrome and feel like not too good, right?
Astrid Ornelas: Yeah, yeah.
Kenna Vaughn: Another one is going to be the excess weight around the belly and the higher triglycerides.
Dr. Alex Jimenez DC*: Easy to see. You can see when someone has a belly that’s hanging over like a fountain, right? So we can see that you can go to it sometimes Italian restaurants and see the great cook. And he sometimes I got to tell you, sometimes it’s just, you know, we talked to Chef Boyardee wasn’t a thin guy. I think that Chef Boyardee, you know what? And the Pillsbury guy, right? Well, it wasn’t very healthy, right? Both of them suffer from metabolic syndrome just from the outset. So that’s an easy one to see. So these are the things we’re going to be reflecting on. Astrid will go over some nutraceuticals, vitamins, and some foods that we can improve things. So here’s Astrid, and here’s our science curator. But here’s Astrid, go ahead.
Astrid Ornelas: Yeah, I guess before we get into the nutraceuticals, I want to make something clear. Like we were talking about metabolic syndrome. Metabolic syndrome is not a, and I guess per se, a disease or a health issue itself. Metabolic syndrome is a cluster of conditions that can increase the risk of developing other health issues like diabetes, stroke, and heart disease. Because metabolic syndrome is not, you know, an actual health issue itself, it’s more so this group, this collection of other conditions, of other problems that can develop into much worse health issues. Just because of that fact, metabolic syndrome has no apparent symptoms itself. But of course, like we were talking about, five risk factors are pretty much the ones we discussed: excess waist fat, high blood pressure, high blood sugar, high triglycerides, low HDL, and according to health care professionals. To doctors and researchers, you know you have metabolic syndrome if you have three out of these five risk factors.
Dr. Alex Jimenez DC*: Yes. Three. Now, that doesn’t mean that if you have it, you have symptoms. As I see it was evident on. But I got to tell you in my experience when someone has more than three or three. They’re starting to feel crummy. They don’t feel right. They just feel like, you know, life’s not good. They have just an overall. They don’t look it right. So and I don’t know them, maybe. But their family knows that they don’t look good. Like mom doesn’t look good. Dad does look good.
Astrid Ornelas: Yeah, yeah. And metabolic syndrome, as I said, it has no apparent symptoms. But you know, I was kind of going with one of the risk factors with waist fat, and this is where you will see people with what you call the apple or pear-shaped body, so they have excess fat around their abdomen. And although that’s not technically considered a symptom, it is a factor that can; I guess it can give an idea to doctors or other health care professionals that this person who is, you know, they have prediabetes or have diabetes. And, you know, they have excess weight and obesity. They could have an increased risk of metabolic syndrome and therefore developing, you know, if it’s left untreated, developing other health issues like heart disease and stroke. I guess with that being said; then we’ll get into the nutraceutical.
Dr. Alex Jimenez DC*: I love this, I love this. We’re getting some good stuff, and we’re getting some information.
Astrid Ornelas: And I guess with that being said, we’ll get into the nutraceuticals. Kind of like, how Kenna was talking about what’s the takeaway? You know, we’re here talking about these health issues, and we’re here talking about metabolic syndrome today. But what’s the takeaway? What can we tell people? What can they take home about our talk? What can they do at home? So here we have several nutraceuticals, which I’ve written several articles in our blog and looked at.
Dr. Alex Jimenez DC*: You think, Astrid? If you look at 100 articles written in El Paso, at least in our area, they were all curated by somebody. Yes. All right.
Astrid Ornelas: Yes. So we have several nutraceuticals here that have been researched. Researchers have read all these research studies and found that they can help in some way and some form improve, you know, metabolic syndrome and these associated diseases. So the first one I want to discuss is the B vitamins. So what are the B vitamins? These are the ones that you can usually find them together. You can find them in the store. You’ll see them as B-complex vitamins. You’ll see like a little jar, and then it comes with several of the B vitamins. Now, why do I bring up B vitamins for metabolic syndrome? So one of the reasons like researchers has found that one of them, I guess, one of the causes of metabolic syndrome could be stress. So with that being said, we need to have B vitamins because when we get stressed when we have a hard day at work when we have, I guess a lot of you know, a lot of stressful things at home or with family, our nervous system will use these B vitamins to support our nerve function. So when we have a lot of stress, we will use up these vitamins, which increases stress; you know, our body will produce cortisol. You know, which serves a function. But we all know that too much cortisol, too much stress can actually. It can be harmful to us. It can increase our risk of heart disease.
Dr. Alex Jimenez DC*: You know, as I remember when we did this, all roads lead to the kitchen in terms of getting the food back in your body. All roads lead to the mitochondria when it comes to the area of the breakdown. The world of ATP energy production is surrounded and wrapped around with nicotinamide, NADH, HDP, ATPS, ADP. All these things have a connection with vitamin B of all sorts. So the vitamin B’s are at the engine in the turbine of the things that help us. So it makes sense that this was the top of the vitamin and the most important one. And then she’s got some other endpoints here on niacin. What is with niacin? What have you noticed there?
Astrid Ornelas: Well, niacin is another B vitamin, you know, there are several B vitamins. That’s why I have it there under its plural and niacin or vitamin B3, as it’s more well known. A lot of several are so clever. Many research studies have found that taking vitamin B3 can help lower LDL or bad cholesterol, help lower triglycerides, and increase HDL. And several research studies have found that niacin, specifically vitamin B3, can help increase HDL by 30 percent.
Dr. Alex Jimenez DC*: Incredible. When you look at NADP and NADH, These are the N is the niacin, the nicotinamide. So in the biochemical compound, niacin is the one that people have known that when you take it the good one or the one that’s supposed to be, you get this flushing feeling and it makes you scratch all your part of your body, and it feels good when you scratch because it makes you feel that way. Right, so lovely. And this huge.
Astrid Ornelas: Yes. Yes, and also, I just want to highlight a point about B vitamins. B vitamins are essential because they can help support our metabolism when we eat, you know, carbohydrates and fats, good fats, of course, and proteins. When the body goes through the metabolism process, it converts these carbohydrates, fats, and protein. The proteins turn into energy, and B vitamins are the main components in charge of doing that.
Dr. Alex Jimenez DC*: Latinos, in our general population, know that we have always heard of the nurse or the person who gives vitamin B injection. So you heard of those things. Right. Because you’re depressed, you’re sad, what would they do? Well, you know what would inject them with B12, right? Which are the B vitamins, right? And the person would come out like, Yeah, and they’d be excited, right? So we’ve known this, and this is the elixir of the past. Those traveling salesmen, who had the potions and lotions, made a living off of giving B vitamin complex. The first energy drinks were first designed with a B complex, you know, packing of them. Now here’s the deal. Now that we’ve learned that energy drinks cause so many issues, that we’re heading back to the B complexes to help people better. So the following vitamin we have there is that one that we have the D, we have the vitamin D.
Astrid Ornelas: Yeah, the next one I wanted to talk about is vitamin D. So there are several research studies on vitamin D and the benefits, the benefits of vitamin D for metabolic syndrome, and just how I discussed how B vitamins are beneficial for our metabolism. Vitamin D is also helpful for our metabolism, and it can help regulate our blood sugar, essentially our glucose. And that in itself is very important because, like one of the predisposing factors of metabolic syndrome, high blood sugar. And you know, if you have uncontrolled high blood sugar, it can lead to, you know, it can lead to prediabetes. And if that is left untreated, it can lead to diabetes. So research studies have also found that vitamin D itself can also improve insulin resistance, which is pretty much one that can lead to diabetes.
Dr. Alex Jimenez DC*: You know, I just wanted to put out the vitamin D is not even a vitamin; it’s a hormone. It was discovered after C by Linus Pauling. When they found it, they just kept on naming the following letter. OK, so since it is a hormone, you just have to look at it. This particular vitamin D or this hormone tocopherol. It basically can change so many metabolism issues in your body. I’m talking about literally four to five hundred different processes that we’re finding. Last year was 400. We’re now almost 500 other biochemical processes that are affected directly. Well, it makes kind of sense. Look, our most significant organ in the body is our skin, and most of the time, we ran around in some sort of skimpy clothes, and we were in the sun a lot. Well, we didn’t stand to reason that that particular organ can produce a tremendous amount of healing energies, and vitamin D does that. It is produced by the sunlight and activated. But today’s world, whether we’re Armenian, Iranian, different cultures in the north, like Chicago, people don’t get as much light. So depending on cultural changes and closed people living and working in these fluorescent lights, we lose the essence of vitamin D and get very sick. The person who takes vitamin D is much healthier, and our goal is to raise the vitamin D is a fat-soluble vitamin and one that embeds itself by it and is saved in the liver along with the fat in the body. So you can raise it slowly as you take it, and it’s tough to get toxic levels, but those are at about one hundred twenty-five nanograms per deciliter that are too high. But most of us run around with 10 to 20, which is low. So, in essence, by raising that, you’re going to see that the blood sugar changes are going to happen that Astrid is speaking about. What are some of the things that we notice about, particularly vitamin D? Anything?
Astrid Ornelas: I mean, I’ll get back to vitamin D in a bit; I want to discuss some of the other nutraceuticals first. OK. But pretty much vitamin D is beneficial because it helps improve your metabolism, and it helps improve your insulin resistance, at least towards metabolic syndrome.
Dr. Alex Jimenez DC*: How about calcium?
Astrid Ornelas: So calcium goes hand-in-hand with vitamin D, and the thing that I wanted to talk about with vitamin D and calcium together. We often think about these five factors that we mentioned before that could cause a metabolic syndrome. Still, there’s, you know, if you want to think about it, like what are the underlying causes for a lot of these risk factors? And like, you know, obesity, a sedentary lifestyle, people who don’t engage in an exercise or physical activity. One of the things that can predispose a person or increase their risk of metabolic syndrome. Let me put the scenario. What if a person has a chronic pain disease? What if they have something like fibromyalgia? They’re constantly in pain. They don’t want to move, so they don’t want to exercise. They don’t want to aggravate these symptoms. Sometimes, some people have chronic pain or things like fibromyalgia. Let’s go a little bit more basic. Some people just have chronic back pain, and you don’t want to work out. So just you’re not choosing like some of these people aren’t choosing to be inactive because they want to. Some of these people are legitimately in pain, and there are several research studies, and this is what I was going to tie in vitamin D and calcium with that vitamin D and calcium. You know, we can you can take them together. They can help improve chronic pain in some people.
Dr. Alex Jimenez DC*: Incredible. And we all know that calcium is one of the causes of muscle spasms and relaxers. Tons of reasons. We’re going to go into each one of these. We’re going to have a podcast on just vitamin D and the issues in calcium because we can go deep. We’re going to go deep, and we’re going to go all the way to the genome. The genome is genomics, which is the science of understanding how nutrition and the genes dance together. So we’re going to go there, but we’re kind of like we’re penetrating slowly in this process because we have to take the story slowly. What’s up next?
Astrid Ornelas: So next, we have omega 3s, and I want to specifically highlight that we’re talking about omega 3s with EPA, not DHA. So these are EPA, which is the one that’s listed up there, and DHA. They are two essential types of omega 3s. Essentially, they’re both very important, but several research studies and I’ve done articles on this as well have found that I guess taking omega 3s specifically with EPA, it’s just more superior in its benefits than DHA. And when we talk about the omega 3s, these can be found in fish. Most of the time, you want to take omega 3s; you see them in the form of fish oils. And this is going back to what Kenna discussed before, like following a Mediterranean diet, which mainly focuses on eating a lot of fish. This is where you get your intake of omega 3s, and research studies have found that omega 3s themselves can help promote heart health, and they can help lower bad cholesterol to your LDL. And these can also improve our metabolism, just like vitamin D.
Dr. Alex Jimenez DC*: Want to go ahead and blanket all these things under the fact that we’re also looking, and when we’re dealing with metabolic syndrome, we’re dealing with inflammation. Inflammation and omegas have been known. So what we need to do is to bring out the fact that omegas have been in the American diet, even in a grandma’s diet. And then, like again, we hear back in the day when grandma or great-grandma would give you cod liver oil. Well, the highest omega-carrying fish is the herring, which is at about 800 milligrams per serving. The cod is next when it’s around 600. But because of the availability, the card’s much more available in certain cultures. So everybody would have cod liver oil, and they’d make you close your nose and drink it, and they knew that it correlated. They would think it’s a good lubricant. Still, it was an anti-inflammatory specifically with people, and usually, grandmothers who knew about this right helps with the intestines, helps the inflammation, helps with the joints. They knew the whole story behind that. So we’ll go deep into the Omegas in our later podcast. We have another one that’s here. It’s called berberine, right? What’s the story on berberine?
Astrid Ornelas: Well, pretty much the next set of nutraceuticals that are listed here, berberine, glucosamine, chondroitin, acetyl L-carnitine, alpha-lipoic acid, ashwagandha, pretty much all of these have been tied into what I talked before about chronic pain and all of these health issues. I listed them up here because I’ve done several articles. I’ve read various research studies that have covered these in different trials and across multiple research studies with numerous participants. And these have pretty much found, you know, this group of nutraceuticals here that are listed; these have also been tied in to help reduce chronic pain. You know, and as I discussed before, like chronic pain, you know, people who have fibromyalgia or even like, you know, let’s go a little bit simpler people who have back pain, you know, these inactive people who have sedentary lifestyles simply because of their pain and they can be at risk of metabolic syndrome. A lot of these research studies have found these nutraceuticals themselves can also help reduce chronic pain.
Dr. Alex Jimenez DC*: I think the new one is called alpha-lipoic acid. I see acetyl L-carnitine. We’re going to have our resident biochemist on the following podcast to go deep into these. Ashwagandha is a fascinating name. Ashwagandha. Say it. Repeat it. Kenna, can you tell me a bit about ashwagandha and what we’ve been able to discover about ashwagandha? Because it is a unique name and a component that we look at, we will talk about it more. We’re going to get back to Astrid in a second, but I’m going to give her a little break and kind of like, let Kenna tell me a bit of ashwagandha.
Kenna Vaughn: I was going to add in something about that berberine.
Dr. Alex Jimenez DC*: Oh, well, let’s go back to berberine. These are berberine and ashwagandha.
Kenna Vaughn: OK, so that berberine has also been shown to help decrease the HB A1C in patients with blood sugar dysregulation, which will come back to the whole prediabetes and type two diabetes situations that can occur in the body. So that one is also has been shown to decrease that number to stabilize the blood sugar.
Dr. Alex Jimenez DC*: There’s a whole thing we’re going to have on berberine. But one of the things that we did in terms of metabolic syndrome definitely made the top list here for the process. So there’s ashwagandha and berberine. So tell us all about ashwagandha. Also, ashwagandha is the one. So in terms of blood sugar, the A1C is the blood sugar calculation that tells you exactly what the blood sugar does over about three months. The glycosylation of the hemoglobin can be measured by the molecular changes that happen within the hemoglobin. That’s why the Hemoglobin A1C is our marker to determine. So when ashwagandha and berberine come together and use those things, we can alter the A1C, which is the three-month kind of like the historical background of what is going on. We’ve seen changes on that. And that’s one of the things that we do now in terms of the dosages and what we do. We’re going to go over that, but not today because that’s a little bit more complex. Soluble fibers have also been a component of things. So now, when we deal with soluble fibers, why are we talking about soluble fibers? First of all, it is food for our bugs, so we have to remember that the probiotic world is something we cannot forget. People need to understand that, though, that probiotics, whether it’s the Lactobacillus or Bifidobacterium strains, whether it’s a small intestine, large intestine, early on the small intestine, there are different bacteria to the very end to see come to the back end. So let’s call that the place that things come out. There are bacteria everywhere at different levels, and each one has a purpose of discovering that. There’s vitamin E and green tea. So tell me, Astrid, about these dynamics in terms of green tea. What do we notice as it pertains to metabolic syndrome?
Astrid Ornelas: OK. So green tea has a lot of benefits, you know? But, you know, some people don’t like tea, and some are more into coffee, you know? But if you want to get into drinking tea, you know, definitely because of its health benefits. Green tea is an excellent place to start and in terms of metabolic syndrome. Green tea has been demonstrated to help improve heart health, and it can help lower these risk factors that pertain to metabolic syndrome. It can help, you know, several research studies that have found that green tea can help lower cholesterol, bad cholesterol, LDLs.
Dr. Alex Jimenez DC*: Does green tea help us with our belly fat?
Astrid Ornelas: Yeah. There’s one of the benefits of green tea that I’ve read about. Pretty much one of the ones that probably that it’s most well known for is that green tea can help with weight loss.
Dr. Alex Jimenez DC*: Oh my gosh. So basically water and green tea. That’s it, guys. That’s all. We limit our lives that are also, I mean, we forgot even the most powerful thing. It takes care of those ROSs, which are reactive oxygen species, our antioxidants, or oxidants in our blood. So it just basically squelch them and takes them out and cools their cool and prevents even the normal deterioration that happens or the excessive deterioration that occurs in the breakdown of normal metabolism, which is a byproduct which is ROS, reactive oxygen species are wild, crazy oxidants, which we have a neat name for the things that squashes them and calms them and puts them in the order they call antioxidants. So the vitamins that are antioxidants are A, E, and C are antioxidants, too. So those are potent tools that we deal with as we lower body weight. We free up a lot of toxins. And as the green tea goes into squirt, squelch them, cools them, and gets them out of gear. Guess where the other organ that helps with the whole insulin production is, which is the kidneys. The kidneys are flushed out with green tea and then also helps. I notice that one thing that you haven’t done, Astrid, is done articles on turmeric, right?
Astrid Ornelas: Oh, I’ve done a lot of articles on turmeric. I know because, from the list that’s up there, turmeric and curcumin are probably like one of my favorite nutraceuticals to talk about.
Dr. Alex Jimenez DC*: Yeah, she’s like gnawing on a root and a couple of times.
Astrid Ornelas: Yeah, I have some in my fridge right now.
Dr. Alex Jimenez DC*: Yeah, you touch that turmeric, and you can lose a finger. What happened to my finger? Did you get near my turmeric? The root, right? So. So tell us a bit about the properties of turmeric and curcumin in terms of metabolic syndrome.
Astrid Ornelas: OK. I’ve done several, you know, a lot of articles on turmeric and curcumin. And we’ve also discussed that before, and several of our past podcasts and turmeric is that it’s that yellow yellowish could look orange to some people, but it’s usually referred to as a yellow root. And it’s very popular in Indian cuisine. It’s what it’s one of the main ingredients that you’ll find in curry. And curcumin, pretty sure some of you people have heard of curcumin or turmeric, you know? What’s the difference? Well, turmeric is the flowering plant, and it’s the root. We eat the root of turmeric, and curcumin is just the active ingredient in turmeric that gives it a yellow color.
Dr. Alex Jimenez DC*: Guys, I will not let anything but the top type of curcumin and turmeric products be available to their patients because there’s a difference. Certain ones are produced with literally, I mean, we got solvents, and with the way we get things out and of curcumin and turmeric or even stuff like cocaine, you have to use a distillate. OK? And whether it’s water, acetone, benzene, OK, or some sort of a byproduct, we know today that benzene is used to process many types of supplements, and certain companies use benzene to get the best out of turmeric. The problem is benzene is cancer-producing. So we’ve got to be very careful which companies we use. Acetone, imagine that. So there are processes that are in place to extract the turmeric properly and that are beneficial. So finding suitable turmeric, all turmerics are not the same. And that’s one of the things that we have to assess since it has so many products in the world is running real crazy to try to process turmeric and precisely, even if it’s the last thing that we’re discussing today on our subject matter. But it’s one of the most important things today. We don’t even understand aspirin. We know it works, but the total magnitude of it is yet to be told. However, turmeric is in the same boat. We’re learning so much about it that every day, every month, studies are being produced on the value of turmeric into the natural diet, so Astris is in tune in on the target on that. So I’m sure she’s going to bring more of that to us, right?
Astrid Ornelas: Yes, of course.
Dr. Alex Jimenez DC*: So I think what we can do today is when we look at this, I’d like to ask Kenna, when we look at a metabolic syndrome from the presentations of symptoms or even from laboratory studies. The confidence of knowing that N equals one is one of the essential components that we have now in functional medicine and functional wellness practices that a lot of physical medicine doctors are doing in their scope of practice. Because in metabolic issues, you can’t take metabolic away from the body. Does the metabolism happen in a back problem? We notice a correlation with back injuries, back pain, back issues, chronic knee disorders, chronic joint musculoskeletal disorders, and metabolic syndrome. So we can’t tease it. So tell us a bit, Kenna, as we close out today a bit of what a patient can expect when they come to our office, and they get kind of put in the “Oops, you got metabolic syndrome.” So boom, how do we handle it?
Kenna Vaughn: We want to know their background because, as you said, everything is connected; everything is in-depth. There are details we want to get to know all so we can make that personalized plan. So one of the first things we do is a very lengthy questionnaire by Living Matrix, and it’s a great tool. It does take a little while, but it gives us so much insight into the patient, which is great because it allows us to, like I said, dig deep and figure out, you know, traumas that might have happened that are leading to inflammation, which how Astrid was saying then leads that sedentary lifestyle, which then leads to this metabolic syndrome or just kind of down that road. So one of the first things we do is do that lengthy questionnaire, and then we sit down and talk to you one on one. We build a team and make you part of our family because this stuff isn’t easy to go through alone, so the most success is when you have that close-knit family, and you have that support, and we try to be that for you.
Dr. Alex Jimenez DC*: We have taken this information and realized it was very complex five years ago. It was challenging. 300 300-page questionnaire. Today we have software that we can figure out. It is backed by the IFM, the Institute of Functional Medicine. The Institute of Functional Medicine had its origin over the last decade and became very popular, understanding the whole person as an individual. You can’t separate an eyeball from kind of the body as you can’t separate the metabolism from all effects that it has. Once that that body and that food, that nutraceutical that nutrient enters our body. On the other side of our mouth is these little weighting things called chromosomes. They’re spinning, and they’re churning, and they’re creating enzymes and proteins based on what we feed them. To find out what’s going on, we have to do an elaborate questionnaire about mental body spirituality. It brings in the mechanics of normal digestion, how the entanglement works, and how the overall living experience happens in the individual. So when we take into consideration Astrid and Kenna together, we kind of figure out the best approach, and we have a tailor-made process for each person. We call it the IFM one, two, and three, which are complex questions that allow us to give you a detailed assessment and an accurate breakdown of where the cause can be and the nutraceuticals the nutrient nutrients that we focus on. We push you right direction to the place where it matters into the kitchen. We end up teaching you and your family members how to feed so that you can be good to those genetic genomes, which you’re, as I always say, ontogeny, recapitulates phylogeny. We are who we are from the past to the people, and those people have a thread between us and my past, and everyone here’s past. And that is our genetics, and our genetics responds to the environment. So whether it goes in the south fast or exposed or predisposed, we’re going to discuss those, and we’re going to enter the world of genomics soon in this process as we go deeper into the metabolic syndrome process. So I thank you all for listening in on us and know that we can be contacted here, and they’re going to leave you the number. But we have Astrid here that’s doing research. We have a team established by many individuals who can give you the best information that applies to you; N equals one. We got Kenna here that there’s always available and we’re here taking care of people in our beautiful little town of El Paso. So thank you again, and look forward to the following podcast, which will probably be within the next couple of hours. Just kidding. All right, bye, guys.
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