How to Protect Your Muscle Mass on GLP-1s - Episode 325

When people come into us on a GLP1 is, yes, they've lost weight, but what kind of weight have they lost? Right. In fact, we see people that have lost almost no fat and all muscle. He went from saving hearts as a

cardiologist to rewriting the entire Aging Playbook.

Dr. Jeffrey Gladden believes 100 is the

new 30, and he's got the science to back it up. This is the Gladden Longevity Podcast.

Welcome to the Gladden Longevity Podcast. Autumn, it's great to see you.

Great to see you, too. In person, in person.

Right.

Happy to be.

We haven't done one in person before.

No, we have not.

First time. Yeah. And you've been with us for the last couple days getting some stuff done. Yeah, yeah.

Doing all my checkups, running all the tests. Very excited. Got some. Already got some really helpful information back. So that's good.

I love it. Yeah. You just did a little brain tap session also.

I know. I was like, oh, I'm a little relaxed.

Okay. And that's. That's a good thing for you. It's great, right? Very good. Yeah. We find that brain tap is really great. It's just kind of allowing you to slip into that more relaxed, calm brain state. Right.

I felt like I was, like, at the beach.

Right.

Looking at the sky with the sun.

That's right.

It was great.

No, that's awesome. Well, cool. Well, one of the things we wanted to talk about, you actually brought this up to me, that there's a lot of conversation around GLP1s, GLP2s, GLP3s, and there's a lot of, I think, controversy around those medications. There's also some good that they can do, but also they come with some potential side effects. And we see a lot of people, you know, regain the weight that they lost. And I thought, would it be helpful to kind of walk through and get your questions on some of the GLP1? And I printed off a bunch of stuff, looking at some things and integrating some of the ideas that I have around how actually a person can safely taper off a GLP1 and not regain weight. Right.

Yeah.

So I've got some stuff to share there as well. But in your world, what are you seeing with the GLP1s?

So fitness and nutrition expert. In my world, obviously, it's talked about nonstop right now, and it's almost like this buzzword that everybody wants to jump on. It's, like, turned into the trend.

Yeah. Okay.

But I think so many people don't even really understand what it is. It Kind of goes along with peptides, right? Like, what are peptides? What's the GLP1? What is all of this? So is GLP1 a peptide?

It is a peptide, right?

Exactly. So maybe what we could do is, in the most basic terms, explain what a peptide is and explain what the GLP1 is.

Yeah, exactly. So essentially your body has many peptides. A peptide is simply any signaling molecule that's made up of amino acids. And so insulin, for example, is a hormone, but it's also a peptide. Glucagon, which is the sort of the opposite of insulin, is also a signaling peptide. So the body makes lots of signaling peptides. The peptides that are out there that are commonly talked about, BPC157, GHKCU, TB500, CJC1295, and some of the mitochondrial peptides like Humulin and Mot C and SS31, those are all essentially just strings of amino acids that, when they are put into the body, signal the body to do something. So the beauty of a peptide is that unlike in the pharma world, where you look at a biological biochemical pathway and you say, oh, well, if we had less of that coming through, they'd have less pain, they'd have less inflammation. So will develop a molecule that blocks the development of that molecule.

Right.

So that's the pharma model. The problem with the pharma model is that, yes, it will decrease that, but the precursors have to go somewhere, so they go down other pathways and then you end up with side effects and some other things happening. Right. So when peptides are used wisely, actually sets off an entire cascade of sort of healing benefits. For example, BPC157, which is probably the. The grandfather of all peptides, probably the one most people are familiar with, when you put it into the body, it doesn't do anything except basically stand there like the head domino, which then knocks all the other dominoes down to engage the body in the healing process.

So BPC157, I've used that for healing, sure. Okay. Do we have BPC157? Naturally? So let me ask that question first. Everybody's jumping on peptides. Are we all just deficient in peptides? Is this. Do we all need it?

So these are peptides that we make. Some of them we don't make. But the point is that with BPC157, we make it in our gut. Right. What's been found, however, is that when you increase the concentration of it, you can facilitate healing in Other parts of the body as well, whether it's even the brain, the shoulder, the knee, the hip, the gut, you can take it orally. And when you take it orally, typically unless it's modified in its delivery mechanism, if you just take it orally, it can heal the gut, but it's not going to do anything for any other part of the body.

Okay.

It doesn't work systemically, but if you inject it just below the skin, a sub Q injection, then it will travel systemically to wherever it needs to go. You don't have to put it into the area that's actually hurt.

Okay.

But you can do that if you choose to, but you don't have to. Right. So we are, in an essence, not deficient physiologically, but we benefit from an extra boost of it, is the best way to think about it.

Right?

Yeah.

So what I'm seeing, and this is going to lead into the GLP1, is a lot of people like peptide this, peptide that, lose weight, get shredded. Everything's just use the peptide to do it.

Yeah. So that's an interesting.

That's an interesting moment.

Right. Let the peptide do the work. Right.

It kind of let the peptide do the work, which is we know that some peptides we'll talk about GLP one can help us lose the weight, but the peptides aren't going to do the work without us doing the work as well.

Correct. They're great partners, but they're not surrogate actors. Right. They can't do everything. Right. They need us to do our part too. Right. Like, you can take BPC for your gut, but if you're continuing to drink alcohol and, you know, eat the wrong foods and whatever else, and you're destroying your gut biome, the BPC can't overcome that. So physiology cannot overcome bad habits, so to speak.

You're not going to out peptide the bad habits.

That's right. You're not going to peptide your way into actual great physical fitness. Right. If you're on a track for physical fitness, you can actually accelerate and augment and enhance the outcome of the work you put in with the peptide. But the peptides there as a. As a partner, not as the thing that's doing it for you. Right. So you can't hire the peptide to mow the lawn. You got to mow the lawn. But it'll make the lawn look much better and you'll do it much faster.

It's like being on the riding mower instead of the push mower. Might make it a little easier. But it's not going to do it for you.

That's right. That's right.

So when we get into GLP1, let's. Yeah, let's just really, I'll just, for lack of a better word, let's dumb that down. What is it exactly? And because we're seeing it in injectables, obviously, we're seeing it in pill form. We're seeing it in sort of like take this powder in a drink form, it starts to go. What's the one that's really doing the work? Are all these. Is everybody just slapping a label on to say, GLP1 to market off of it? What are we talking about?

We make our own, right. So to speak. And so we have GLP1 receptors. So when we take a GLP1, it actually does a number of different things.

And when you say we take it, you're talking about the injectable.

I'm talking about the injectable. Okay, right.

So we inject GLP1.

Right. We inject GLP1. So I've got biochemistry here that we could go through. But the interesting thing is that in the neurological system, it actually increases the excitatory neurotransmitter glutamate, but it also increases the inhibitory neurotransmitter gaba. Right? And keeping that balance is important. So if you're using a GLP1 and for some reason you notice that you're not sleeping as well or whatever it may be, that you're getting too much of the glutamate effect and not enough of the GABA effect, and you might need to work on the GABA effect, right? Like things like taurine and things that will actually boost gaba, staying away from foods that are high in glutamate, that kind of thing. So that's one thing to keep think about. The other thing to know is that the GLP1s, like any peptide, they go systemically and they. And they go to different receptors. So what happens is they go to the hypothalamus in the brain and they decrease a hunger peptide called ghrelin. So they decrease the production of ghrelin. Right? So all of a sudden you don't have. You don't have the same hunger, right? And the other thing that happens is they go into the gut and they actually slow gastric emptying. So your stomach is, you know, not. It stays full longer, Right? Right. So you have more of a sense of satiation just from the food you do eat. And then the other thing is they will actually increase insulin release from the pancreas to control blood sugar. So those are good things that it does. But it also decreases glucagon. Glucagon is the hormone that's anti insulin. Insulin putting blood sugar into your cells. Glucagon is actually causing you to release blood sugar from the liver to support blood sugar levels.

Okay.

So when you combine less glucagon with more insulin effect, it's going to lower the blood sugar, which is why these drugs were actually developed for diabetics. Right, Right. People with metabolic syndrome, pre diabetes are wonderful drugs to help control the blood sugar. And in that context, they have wonderful effects also that have been shown to improve blood vessel function and decrease heart attacks and improve kidney function. So there are organs that actually benefit from the impact of the GLP1s. This is through the medical lens. Right. The situation comes where they have other impacts. And we'll talk about that in a second. But that's a GLP one.

I have so many questions.

Okay, let me tell you about a GLP2.

Okay.

And then a GLP3, and then we'll take your questions. Is that okay?

Yes.

Okay. So tirzepatide.

Yes.

Is both a GLP one and a gip.

Okay.

Agonist. Right. So what the GIP does is it increases insulin production even further, and it also improves fat handling in the fat cells.

Okay.

Right. So it improves that. It may be a little bit better tolerated. Now, the Last 1, the GLP3, let's call it, is not FDA approved. It's retatrutide. Now, retatrutide has been available, but the FDA is now kind of clamping down on certain pharmacies that have been selling it. Okay. So it is available inside research protocols. But Eli Lilly kind of those locked up at the moment, where it stands with FDA approval is it's now in phase three trials. So it's passed a safety study. It's proven efficacy. Now they're doing it in larger populations to find out what the side effect profiles are before they approve it, before they release it. So that's where it's. It's probably going to come out in 26 or 27. Okay, just to put that in perspective, the beautiful thing about retatutride is it actually adds this glucagon receptor agonist. Right. And what happens with that when you do that is an increased energy expenditure. Right. Whereas a GLP1 actually decreases energy expenditure.

Okay. Yes. Part of my question. Yes.

And then it also increases fat lipid utilization. So in other words, it's utilizing fat as a fuel source. It's increasing energy production and it's using fat to fuel that.

Okay.

Which is a good thing.

Right.

So it's increasing fatty oxidation. So those are the differences right there. And so when you compare them for weight loss, semiglutide, GLP1 has an effect, tirzepatide has a greater effect, and retatrutide has an even greater effect.

For weight loss.

For weight loss. Right. For weight loss specifically. This is why a lot of people are really fascinated by retatrutride at the moment.

Right.

And then in terms of insulin sensitivity, GLP1s increase that insulin sensitivity. Right. So blood sugar, better controlled GLP2s do it even more. GLP3s also do it more.

Okay.

So that's how that works. And then when you look at the cardiometabolic effects and risk, semaglutide decreases it by a factor of, let's call it one, the GLP2 by a factor of two and the retatrutride by a factor of two. Okay. Okay. So you're getting, as you add in these other components to a GLP1, you're getting more benefit and more effect, if you will. And in terms of Apache control, they're all strong. They all work on the girdle. And in terms of energy expenditure, the GLP1 decreases energy expenditure. The GLP2 is neutral, and the GLP3 increases energy expenditure. That's why people are so taken with retrutite. Right, okay. And I think rightly so when it comes to fat mass loss, it can happen with a GLP1, although you have to be careful in how you do this. We'll talk about that. It can happen with a GLP2, but the highest fat loss is with the GLP3. And the reason for that is because you're increasing energy expenditure. Right. So with the GLP3, one of the big side effects that we see in the practice when people come into us on a GLP1 is yes, they've lost weight, but what kind of weight have they lost? Right. And what we see is that muscle mass is going down proportionally more than fat mass. In fact, we see people that have lost almost no fat and all muscle because they've suppressed their appetite. Right. They've decreased energy production. Okay. But they're eating less, they're exercising less, and they're losing muscle because the body can burn fat as a fuel, but it actually needs more than just fat to burn. And so it gets other minerals and things from the muscle. So it has to go break that down. Right. We had a guy come into us who was doing a water fast and he did a water fast for 14 days. He was, he was going to do it for 28 days. We had done an inbody on him before he started this fast upon benoist does he decided to do this. He'd done it previously in his life.

Okay.

He came back and said I'm doing a 14 day water fast. And I said that's interesting, how's that going? He said I'm losing weight. I was like great, let's have him do an inbody for you. He had lost weight, I don't, maybe 15, 20 pounds. 100% of it was his muscle. He had lost no percent body fat. Brutal, right? Really brutal. Maybe a little bit of fat. And the bone density was also down. So when people go into starvation mode, Right. This is not the way to quote unquote lose weight. Right. And so we're interested in the strategies of how do we actually take advantage of the benefits of either a GLP 1, 2 or 3 and yet maintain muscle mass. Right. So that comes down to your neck of the woods, which is nutrition and fitness, right. So you've got to basically be doing resistance training exercises that's stimulating the muscle to grow and maintain its mass and you've got to be feeding it appropriately. One of the best ways that we found to do that is a lot of people out there saying, well just eat a lot of protein. It's like, okay, well let's think about that for a minute. Because only, even the best protein, only 48% of that protein goes into making protein in your body. The rest of it turns into carbohydrate.

It's my pet peeve right now.

Right. And so how much protein do you want to eat? How much methionine do you want in? Because we know that people on high protein diets actually age faster, activate more mtor, they don't live as long and they end up with more cancer and kidney disease. Right. So this is not exactly what we want. Right. What you want is to build protein. And so the, the logic is, well, if I'm going to build protein, I need to eat a lot of protein. Well that's the wrong logic. What you need to do is build a lot of protein. How do I do that without having to eat a lot of protein? Well, you can do that really nicely with perfect aminos. Perfect aminos is a great product that basically has all the essential amino acids, including a lot of leucine which stimulates muscle growth. Right. And you can, you don't have to take in protein to get the benefit of the protein. And when you combine it with creatine, that becomes really pretty magical in terms of maintaining muscle mass because now you can work out harder.

Right.

And creatine basically enables your body to make ATP, bypassing one of the main ways you make it. It's kind of a, it's kind of a shortcut to making ATP for energy. So if you take creatine before you work out, you can take your perfect demeanors then or after and you do your workout now, you're actually teeing yourself up for success in maintaining muscle mass. Right. And if you're taking a bone density supplement with Also with vitamin K2 MK4, not MK7, but MK4, you can maintain your bone density as well as your long as you're doing, you know, training where you're basically loading your, your bones.

Yeah, I combine my EAAs, my perfect Aminos and my creatine every day for my weight training.

And how's that working out for you?

How do you. I love it. I feel great. Like that has definitely been something I started probably six or seven months ago and it feels really good. But I want to back it up. I have a lot of questions and I think people watching are listening are going to have a lot of these questions. So GLP 1s, 2s 3s. Does everybody need to be on it?

No.

Right, exactly. But everybody's getting on it or everybody's trying to get on it.

Yeah. Here's the thing. If you have the ability to modulate your Diet, let's say GLP1s didn't exist for a minute, how would we go about optimizing somebody's weight?

Nutrition?

Yes. The first thing we would do here, what we've learned is to do a five day fast mimicking diet. Because with a five day fast mimicking diet, what happens is there's enough carbohydrate in there and enough protein that you actually don't really lose muscle mass during that five days. What happens with a five day fast food making diet that is so critical is it resets your taste buds so that you no longer are craving the same things you were before. It also resets the hypothalamus, so it lowers the ghrelin. It also increases leptin sensitivity. So leptin is basically the hormone that gets released from the small intestine and fat cells to tell you to stop eating. People that are obese have leptin resistance. They simply, they have a lot of leptin, but they're not getting the signal because they have resistance at the receptor. They don't get the signal to stop eating. Right.

Well right now you're hearing this term food noise. Have you seen this? Like it's like a buzz phrase. I'm taking this peptide, I'm taking GLP1. It's gotten rid of my food noise.

Okay, so food noise is basically like

I'm thinking about food or I feel like I'm thinking about food all the time, it's consuming me. And these are not necessarily obese people. These are people who might have 10 or 15 pounds to lose. So does the person who has even 5, 10 or 15 pounds to lose, is that, does that, should that person be using a GLP 1, 2 or 3 or does that person need to get off the over processed, highly stimulating your taste buds, foods and put in the work?

So here's the trick. That person can take the GLP123. The problem is when they get off of it. Because when they get off of it, what happens is basically they still end up with, especially with the GLP1s with decreased energy consumption or production. Right. So they're, they've slowed their metabolism essentially. Right. And yet the ghrelin, which has been suppressed by the GLP1 working in the hypothalamus, Right. Suppressing ghrelin, suppressing appetite, that rebounds. So now it comes back stronger. So now you come back with a stronger appetite and a lower metabolism. What's that going to do? You're right there. You're right back where you started, if not worse. Right. So there's really two questions here. One is if we were to use a GLP 1, 2 or 3 now the GLP 3s are a little better because you've raised your metabolic rate, but you still have the ghrelin rebound to deal with. Okay, but if you, if you were to say, okay, I'm not going to go down a GLP pathway, what would I do? Okay, well I would do a five day fast mimicking diet because it resets ghrelin, it resets your taste buds, it resets your gut biome. People don't realize that a lot of their appetite is fueled by the bacteria in the gut.

Yes.

If you're eating sugar all the time, you are basically growing a garden of sugar loving bacteria. And when they don't get sugar, they start moaning about it and they're sending signals to the brain. Hey, hey, hey. What about food noise? It's like little birds in a nest. Feed us, right? So you can actually reset the gut biome by doing the five day fast mimicking diet. You can quiet that noise. So when you think about food noise, some of it is psychological, some of it is gut biome creating it, and some of it is the level of ghrelin in your brain. So when you do the five day fast mimicking diet as a starter, then you're resetting all of that and that's what you want to do. We'll come back to that as a tapering technique also. The other thing that we like is we like sugar to fiber. Sugar to fiber is a really interesting product because it actually takes carbohydrates, it has some enzymes in it and breaks them down. Instead of you absorbing and raising your blood sugar, it actually turns it into fiber, which feeds your gut biome in a healthy way, right? So now all of a sudden I'm not getting that sugar spike from what I am eating, right? I've reset my taste buds. When I am eating some carbs, I'm not getting the sugar spike. That's fueling the whole problem, right? And I'm getting fiber from my gut. The other thing we like to add is, we like to add a probiotic, one called Metabolic. It's made by a company called Prodrome, I believe, and it's refrigerated, which is a little cumbersome because it's harder to travel. But you just take one a day and it has Akkermansia in it, has a number of other bacterial strains. I think there's five bacterial strains in it. And it actually will create a population of bacteria in your gut that increase your endogenous, your own GLP1 producing capabilities. So now you're getting your own biological GLP1 in a very physiologic way. So now you've reset the table, you decrease the carb consumption, you're eating the perfect aminos and the creatine for power and energy and production. And you've got this metabolic probiotic that's actually giving you some GLP1 to help modulate it. We think that combined with protracted cardio and some weight training and things like that, is a much better way to go because it's actually a durable plan, right? And if you want to repeat the fast mimicking diet in a month or six weeks or whatever, three months, to kind of help you continue on your path, then go ahead and do that. You can do it monthly, really. So we think that's a really sane way to go. Now, let's say that you have diabetes or you have a metabolic disorder or problem, or you're 60 pounds overweight and you want to use the GLP1 to help you. We don't snivel at that because it's a big deal. And there's a lot of health costs too, carrying all that weight. Right. So use a GLP1 2 or 3. We do think the GLP3 is going to be the ticket once released.

I was going to say, why would somebody use the GLP1 if the GLP3 seems to do.

Yeah. Better right now. You can't get the GLP3. Right. That's, that's the reason. Unless you're going outside of traditional things. Right. Which as physicians with a medical license, you can't do. Yes, but people will find a way. Right. So the GLP3 is probably the ticket. Okay. GLP2 is better than the GLP1. Right.

And people can get the GLP2 right now.

They can. Yes, that's right. Okay, so let's say you need that, so then you do that. But nonetheless, I would do it this way. I would start with a five day fast moving diet. Why not make your life easier? Why not make the work of the GLP1 or 2 easier? So start with a 5 day fast moving diet. Do the other things we talked about and then use it. And what you want to do is you want to titrate it up slowly because you get more muscle wasting when you go up faster. So you titrate it up slowly. You're doing the other things now you actually have a synchronized program. And when you actually want to come off of it, you can use the five day fast mimicking diet again to reset garland. Right. So you can actually come off of it and not have the rebound spike. Right. Okay.

So, so I have another question.

So.

And again, I'm referencing this only because of what I'm seeing so much in like the fitness world and who's using these. And it's of course people that, like you said 60 plus pounds. Obviously that makes sense. But when I see people that have like that 10, 15 to 20 pounds. Does every person that has 10, 15, 20 pounds to lose have a blood sugar problem?

You know, it's shocking. They typically do.

Okay.

They don't know it. They. One of the things that we do here at Glad Longevity is we measure a two hour glucose tolerance test, right. With an insulin curve. So what does that mean? Well, it means that when they come in, we check a fasting blood Sugar, we check a hemoglobin A1C. We check something called fructosamine, which is a two week look back at whether they're spiking their sugar. Normally their doctor will just do a fasting sugar and a hemoglobin A1C, which is a three month look back at what your average blood sugar. Sugar. Right. But what we find is that when you check a fasting insulin, you can see if they're running higher insulin. They should be running insulins around two, three, maybe four. As a baseline, we see a lot of people come in with that extra 15, 20 pounds. They're running insulins of 9, 10. Right. Well, then you challenge them with 75 grams of glucose. It's like a stress test for your pancreas and your worst and your metabolic. I know you love it, right? It's good for you. So I think it was exercise.

Yes.

So anyway, we challenge them with that and then we remeasure the insulin and the glucose at one hour, and then we remeasure the insulin and the glucose at two hours. And what we can see is if your baseline insulin is eight, it shouldn't go up by more than four to five times at one hour and then it should be back down to eight again. So eight to 40 to eight, then that would be, that would be good. And particularly if you're controlling the blood sugar, which means the blood sugar starts at, let's say 95 and it goes to 135 and then at two hours it's back to 95. But what we see all the time is that it may start at 95, but it goes to 180, which is diabetic. The insulin goes from 8 or. Yeah, from 8 instead of to 40, it goes to 85. And at two hours it's still at 75.

Okay.

This is classic insulin resistance. That's totally missed because they were just looking at the fasting sugar and hemoglobin A1C. And we can see the degree to which what's happening. Right. We can also tell people who are have damaged their pancreas by overworking it so much that they've actually lost the capacity to even begin the game. For example, their blood Sugar maybe is 115. At rest, their insulin level may be 6. We give them the glucose, their insulin level can only go to 14, but their blood sugar goes to 250. Right. So this means the pancreas are shot.

Okay.

So now they're actually looking more like insulin. So unless this is actually done, you can't really tease apart where somebody is. Right. And it's really important to get this right, because when you. When you either have high blood sugars, which are damaging your arteries, accelerating aging, or you have high insulin levels, which are also stiffening your arteries, increasing senescent cells and accelerating aging, you got to know about that. Right? Right. So.

So what about all the people that are just sort of like, jumping online and getting it sent to them, and they don't know any of this.

Right.

They don't know actually if they have high blood sugar or not. They just know I want to lose weight.

That's right.

What kind of risks are they maybe putting themselves at? Because if you don't have high blood sugar and it drops your blood sugar, are we in a danger zone?

Well, here's the thing. You couldn't develop pancreatitis with these drugs. Okay. You can also develop thyroid tumors, small tumors.

Okay.

That's probably not such a high risk, but pancreatitis is. Okay. We've had people that we've known about end up in the hospital. Not that we were prescribing for, but people we know about that ended up in the hospital, in the ICU with acute pancreatitis.

Okay. So another big thing we're seeing is for women like me, I'm 45, I'm in perimenopause, and we're hearing it talked about to microdose.

Yes.

As you go into perimenopause, because we know, like blood sugar, insulin shifts, that has a cascading effect on all of our.

The microdose is interesting. Right. So I think that can work.

Work.

And that can work well because you're really kind of avoiding a lot of the side effects when you're doing such low doses.

Okay.

And I think the microdose is probably. Okay, I will say this. There's another agent out there that I have yet to mention.

Okay.

It actually was discovered in New Zealand, and it comes from hops. Although you can't drink beer and get it.

Okay. Okay. Sorry, ladies.

Yeah. So it's called Callocurb.

Okay.

Is the name of it. Right. And it's. It's basically in New Zealand. They basically studied over 3,000 different compounds from various plants, trying to find something that would suppress appetite. And what they found with Callocurb is that it activates bitter taste receptors throughout the GI tract. So you have some in your mouth. That's why when we eat bitter things, it's actually good for us. Right. We've kind of been Trained by the food industry to go after salty, sweet, savory. Right. But actually bitter things, bitter plants, bitter roots, Anything that's bitter actually is good for us. It's nutritionally dense, and it actually suppresses appetite. Anyway, with this hops thing, if you had. If you've ever tasted hops, it's pretty bitter, right? Yeah. So the thing is that when you have these taste receptors, these bitter receptors, they're in your mouth, they're in your esophagus, There are a lot of them in your stomach. There's the most of them in your small intestine, and then there's even some in the colon.

Okay.

So it's really the whole GI tract that you're affecting. And what it does is it's also a GLP one. It. When you. In other words, it activates a release of your endogenous GLP1.

Okay, so it's not the same as injecting yourself.

That's right.

But. And this is. So this is a pill.

It's a pill.

Okay.

It's a pill. Callocurve. Yeah.

So my other question is, obviously all of these suppress appetite. What if somebody is not an overeater? Or are they automatically an overeater? Because I will. So I'll use myself as an example. I mean, I'm not looking to take a GLP1 or anything, but I've been the same weight for 18 years. 110 pounds, give or take a pound or two. The only thing that has changed for me being in perimenopause is my fat mass to my muscle mass.

There you go.

And I still work out five days a week. I still lift incredibly heavy. I. I don't overeat.

But this is a really good point.

So would somebody like, what would somebody like me do where my fat mass is shifting to being a little bit. Having a little bit more fat and a little bit more. Less muscle.

Right. It's optimizing your sex hormones at this point.

Okay.

So when we go through either menopause, perimenopause, andropause, periandropause. Right. I mean, men go through similar situations.

Right.

Body mass changes. This is why men start to look like this. Right. Women tend to put it on more in the hips than the thighs. So it's really important if you want to maintain body composition, which is, you know, the fat mass where you want it, the muscle where you want it. Just keep your sex hormones optimized. So we think that, you know, initially hormones were only prescribed when women. Let's say had symptoms, hot flashes. Okay, we'll give you a bit of estrogen to calm those down. Super short sighted, right? Progesterone actually protects you from cancer and many other things. Women without estrogen, their brains do not do as well. You know, a lot of women will complain of memory loss as they go through perimenopause or menopause, and a lot of it has to do with low estrogen. Men have the same thing. And one of the worst things that people can do for a man is to go to a T clinic, a testosterone clinic, and put on testosterone and then something that blocks the production of estrogen from it. Because we want to be manly, so we're going to have all this testosterone. Well, guess what? Your brain needs the estrogen. Your bones need the estrogen, right? Even to burn fat, you need the estrogen. So men need estrogen and women need testosterone. It's just a question of balance, right? So you really want to optimize that as you go through perimenopause. You don't want to wait for symptoms, you want to actually start optimizing, measuring your hormones throughout your cycle and making sure that you're on doses that will optimize them. There are also things like maca and things like that will actually help the body regulate the hormones, right? So we're fans of something called Mighty maca. We have a lot of people taking that. Men and women can benefit. The other thing about that, sex hormones and brain fog, is that if you have a gene like APOE4, right? Like this is the Alzheimer's gene, APOE4, I had it, okay? APOC1, TOM40. If you have that trifecta, you have APOE4, APOC1. So if you have that, estrogen is mandatory because in order for your brain to function properly, you have to have estrogen. And it's even accentuated when you have Apoe 4. So getting the sex hormones right not only saves your brain, but enables you to actually have the body comp that you're looking for. So I would say that you're probably underdosed if you're starting to notice changes in terms of the sex hormones that

they this point, I think my estrogen's a little low. Even though I've been on it, I might need a higher dose. So that's obviously something we'll look at.

There's different kinds of estrogens too. There's E2 and E3 and E1 and it's E2 that does the work, right? So if you're going to use topical, you want to make sure that it has plenty of E2 in it and not just E3 with a smidge of E2. Right. So it's really important to get the right combination. Yeah, yeah, yeah.

So, yeah, it's not always about just suppress your appetite.

No, that's right.

And I think that's something that's overlooked, too. It's like, oh, okay, I'm gaining weight. I must need to suppress my appetite. I just have to eat less. And it's not always that.

I'll tell you another thing that's missed all the time, and that is. And something we do here routinely for every client is to measure the resting metabolic rate. So that's measured basically by wearing a mask, and we measure O2 in CO2 out. From that, we can actually calculate if they're on a bike while they're doing that. We get VO2 max anaerobic threshold. That's great. But in a chair, if you sit there for 20 minutes, we simply get, what's your resting metabolic rate? And we find that many people are hypothyroid and they don't know it. And so if the set point on thyroid is lower than it should be, your metabolic rate is already slower. Right, Right. And so if you add to that, take out some of the hormones and the other things that cause you to be more anabolic and, you know, using calories to build stuff, all of a sudden, now you're really shifting fast. Right. So I think if you're going to optimize weight, you have to start with a resting metabolic rate. And the reason is that thyroid blood work is not the holy grail. You cannot look at blood work and know what the metabolic rate is. You'd like to think you can, but you can't. We've looked at so many of these, we just know you can. So a resting metabolic rate, hormones are critical. You get that? Right. Then some nutrient values. Do you have enough chromium to actually make your insulin receptors work? You know, you got to look at. Get all the pieces of the F1 car.

Yes.

Why isn't it running right? Oh, it's not running right. Because of these. Well, if we fix those four things, maybe you don't need a GLP one. Maybe you just actually need to get your hormones optimized in your thyroid and you're good to go. Right, Right. So what we found is that precision in the diagnostics is typically what's missing. So you have people that, like, I need to lose weight. Oh, GLP1. I'll grab it. Where were the diagnostics? Non existent, right? Non existent.

Right, right. And sometimes it's just clean up your lifestyle. Sometimes it's just that, yeah, move a little bit more, sometimes it's a little bit deeper. It's. We need to look at thyroid, we need to look at sex hormones.

Yep, that's right. It's a really interesting topic and I do think that there are good indications for GLP 1, 2 and 3, depending on, you know, any underlying medical need. I think the GLP3 is probably going to be probably the best for weight loss and I think in any of these situations because when you stop it or try to taper off of it, you get this ghrelin rebound which is going to drive your appetite real high. You want to have a strategy around that and you can't just stop it. So I think the five day fast mimicking diet, the sugar to fiber, using the metabolic probiotic and adding in the callocurb. Right. That becomes a really nice way to transition out of a GLP 1, 2 or 3. And so you're not on it forever. Right? Yeah. And I think many people can actually get where they want to go just using that without ever needing to get the prescription.

Well, I can speak from experience, obviously. You know, I created a hormone health program for women of all ages, all phases, fitness, nutrition, stress management and a couple supplements. And we did all the labs and everything. And so for people like we, we showed you can balance your blood sugar, improve insulin sensitivity. And actually in those labs that we ran, we saw women's hormones balance out, improve estrogen, go up, thyroid, everything balance out. So like that's right before you jump into I have to do all these things, it's. Can you optimize your nutrition first? I know that's not the easiest thing because I know, look, we all want to have the glass of wine every night. We all want to have the dessert. I love pizza too. Moderation portions, things like that. Getting the fiber in in our diet, getting those nutrients in, moving our bodies, we sit so much.

That's right.

I think it's so important to have that part of that conversation too. Of yes, there's all these other things that can help optimize. But if you're not looking at your lifestyle first.

I agree. Here's the problem, I think that people run into, and you tell me if you think this is right, is that we all have willpower in the morning and nobody has willpower at night. Right. So if there's ice cream in My refrigerator at night at 8:30, I'm going to eat it. It's not like I have super willpower. Right. What I've done is I've architected my environment to support the mission. There's no alcohol in the house. There's no ice cream in the house. There may be some dark chocolate.

Yes.

You know, there's some stuff, but if I don't do that, I'm like everybody else. So I think you've got to architect your environment. If you're listening to this, you've got to architect your environment. Otherwise nobody has enough willp hour to do this. And then I think you can help yourself by resetting the whole system with like a five day, fast mimicking diet using the calicob, the right probiotics, you know, the sugar to fiber. Next thing you know, it's like, oh yeah, I'm not really hungry for that anymore.

Right.

And you. And then now it's reinforcing. Now if you've got an environment that reinforces it. Now you've created a system around yourself. Right. And it's only systems that win. Right. It's not willpower. Right. Willpower never wins. So you have a system that helps you win. And I think that's the key, no matter what strategy you're taking. Yeah.

I tell people all the time, being prepared isn't half the battle. That's the battle. So you prepare yourself. You have the healthy food on hand.

That's right.

You know what the easy go to meals are? It drives me crazy when people are like, well, I was really hungry so I grabbed something fast. I'm like, an apple is just as fast as the cookies.

If it's in, if it's in the crispr. Right?

Yeah, but it has to be there.

But it has to be there.

Exactly. And same thing, thing. I love ice cream. I love dessert. I don't really keep it in the house. I keep dark chocolate. It doesn't mean I don't ever have ice cream. It means that if I'm gonna have it, it's a treat, I don't have to go get it. We're gonna go somewhere, we're gonna get really good quality. I'm gonna enjoy that gelato. That's exactly what I'm gonna have, is gelato. My son actually works at a gelato place and that. But that's it. Like, I'm not gonna bring it in to the house where I would eat it every day. You know, I know when my workouts are gonna happen. I know when my Rest days are gonna happen. And I think, I think that is where a little discipline comes in. That's where a little motivation and willpower comes in to just set up those plans and those strategies.

I think the discipline is in the structure you create. Right? Yeah. And then I think it's really important if you are using a GLP. 1, 2, 3. And even if you're trying to lose weight in general, that you have this strategy of using the perfect aminos, the creatine. You're doing the weight training that enables you to have the muscle. You're doing the cardio training that allows you to have VO2 max and a good respiratory capacity.

Right.

And then when you, when you piece all that together now you can actually lose weight. But what's really important is you've lost fat, gained muscle. Right. Like when I had my own health journey. Right. And I was hormonally depleted and I got on testosterone and DHEA, I lost 20 pounds of fat and put on 10 pounds of muscle.

Amazing.

Right. So that was what I was looking for. For. And that's, that's really what everybody's looking for. Right. Let me lose 20 pounds of fat and put on 10 pounds of muscle. I lost 10 pounds. I don't care what the scale says. I look good, I feel good. Yes. Right. You can't get married to a number on the scale. It's got to be body comp. Right. So, yeah, huge. Yeah.

Like I said, my number on the scale has been the same for 18 years, but my body doesn't look the exact same.

Exactly. It's shifting.

The composition is shifted. Now, I'm not unhappy about it, but it's. But I'm always looking to.

Well, you could use a bit more estrogen potential. Yeah.

Tweak it, dial it.

We'll check it out.

There might have been a hot flash that happened while we were sitting here.

Flash in there somewhere.

It's okay. I deal with them.

Well, great conversation.

I think this has been super helpful so that people can really understand, go ask the right questions, do their own research about what's going to be right for them.

That's right. And do the diagnostics. Oh, my gosh. If you can do the diagnostics and actually understand who you are, where you are. Do I have insulin resistance? I don't. What's my body composition? It's really easy with an inbody. You can get a, a good estimate of it. You know, having a diagnostic that you can leverage off of to see what kind of progress you're making. Am I losing muscle mass? Am I losing fat mass? What's actually happening as you go through the process? The things that we've shared with you here today been things that we've seen enable people to lose weight but also improve their body composition with more muscle mass and less fat mass. So that would be kind of the take home message.

Yeah. I think there's one thing that people should keep in mind and it is bio individuality. It's that we're surrounded now with social media. You're seeing not just like the people in your community, you're literally seeing everybody around the world. And not everybody's always sharing exactly what they're doing. But even if they are, you're looking at it and you're like, but this worked for them. And so this exact plan should work for me too. And it doesn't always work that way.

In fact, it never works that way. It almost never works that way.

We're all in different places. So you gotta tweak it for yourself. Somebody might have some good strategies, they might have a good baseline plan, but you still have to figure out how to optimize for yourself. You still need to learn how to listen to your own body and your body's cues.

Yeah. And it comes back to the diagnostics. Who are you? What are your genetics? What are your fat genes? You know, what are your, what are your genes around being able to control appetite? And all these are genetically predetermined. So if you understand your genetics, if you really understand yourself, you can actually get where you want to go if you just keep throwing stuff at the wall. And it's not like working. It's not working. And now I just lost 20 pounds, but now I regained it all. This is what happens when you don't fully understand what's going on. So I would really encourage you to do the deconstruction. Understand your N of 1 you. And then you can get a great plan. Yeah.

Makes it so much easier to put a plan in place.

Good.

Great to see you as well.

All right, thanks.

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