EP 17: WTH ?!? Dr. Alan Christianson, Metabolism Reset Diet

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All right, welcome back, everybody, to what the health. I'm Dr. Greg Eckel and today I've got my friend and colleague Dr. Alan Christensen on from Arizona. Phoenix, Arizona. Super excited to have him on today. Dr. Alan Christensen is one of the preeminent thyroid experts in North America. He's a naturopathic endocrinologist, focuses on thyroid function. Hashimoto's thyroiditis, hypothyroidism engraves all things with the thyroid. He's been actively practicing in Scottsdale, sorry, not Phoenix Scottsdale, since 1996 and is a founding physician behind the integrative health clinic that he founded down there. He's the New York Times best selling author of the Metabolism Reset Diet, which we are going to talk about today, the Adrenal Reset Diet and the Complete Idiot's Guide to Thyroid Disease. So he's been on Dr. Oz, the doctors, the Today show. He is a celebrity and a great friend. So thank you so much for coming on today, Alan.

Hey, Greg. Happy to get an excuse to hang out with you.

Indeed. So I got this book earlier this year from you and the Metabolism Reset Diet. And I love how you put together really a simple action plan for folks. And I'm wondering how you came about to write such a book.

One of the biggest struggles that people have talked about for decades has been just trying to get their weight right, you know, and dropping a few pounds and keeping it off. And I've seen so much conflicting information about some things working sometimes. And I want to just pull together what we knew today about best practices for effective, rapid, lasting weight loss. So, yeah, awesome.

It is such a, it is such a hard one for folks, right? I like to say, you know, we are not a weight loss clinic. We are a health promoting clinic. And as a result of promoting health, you know, you're going to get fit and lose weight, right? So on, you know, you obviously have put together something that it's time tested, right? I mean, the way that you write about it in the book, you've had over two decades of practice with folks trying to lose weight and really you're a health promoter and having them come around to, you know, to actually get well. Um, what, what challenges, what challenges do you see right out of the gate when you start talking about metabolism and diet, like misperceptions or misconceptions that folks have about it.

Boy, that's an awesome question. And I guess those answers kind of evolve as the various fad diets cycle through, you know.

Right.

Come up a lot is the idea that, you know, the only way you can lose fat is by going ketogenic or that you have to eat lots of fat to burn fat or that you need to starve yourself for long periods of time. There's. And a lot of things can kind of work sometimes for some people. But I want to figure out what's going to be most effective for the largest number of people to shed weight and really to waste as the main goal to decrease waist size and make it lasting. So that was, that was the impetus behind that.

Yeah. To have their waist size shrink. Got it. Well, yeah. What I mean, the fad diets, like I know we've talked through the years of you cannot demonize a macronutrient.

Right.

And you know, we see this pendulum swinging side to side of okay, it's carbohydrates, now it's fats, now it's all food. You know, what do you do with that? So, you know, what, what who is this diet for? Metabolism diet.

You know, this is for someone who's had a hard time with, with diets and feels like their metabolism is off in some way. And, and that's the other pitfall is that a lot of ways you can just plummet your food intake or cut out a lot of food categories. Like you said, avoiding a macronutrient. There may be some short term gains, but there's often long term harm to the metabolism. And people get set up on this cycle to where they're dieting more and getting less out of it and their metabolism is getting more and more suppressed. It's totally real phenomena. So the exciting news is that that can change. You know, you can make a difference in ways that can yield short term gains, but can also make it to where your body's left healthier and more able to maintain and spontaneously be at a good size.

What do you see? So, you know, we also have gone through multiple cycles of HCG diet, you know, basically what we are calling fad diets. Now I have seen that one work for some folks that are morbidly obese. So I'm wondering, like, is there is, is this specific for you got to lose £30, £20 or you're basically. This is a good program across the Board.

Yeah. You know, I struggled a lot with how to focus the audience for this because there's a story we'll get into, I'm sure, about the liver function and how the liver can be a big part of this. So there are those who don't so much need to lose much weight, but do have problems with fatty liver or liver issues. And in those cases it does take modifications. This really is for someone who does have inches, especially inches around the waist that they wish to lose and they'd be healthier for that and you know, usually several. So if they're at their target weight, at their target inches size, it wouldn't be a helpful necessary fit. But if they are above that, it can be. And the degree to which they're above that, you know, if they're within about 2 inches of what their, their preferred waist sizes, they do what may do well on a single cycle. I broke this down into a 28 day cycle. I've seen a lot of data saying that if you do something that's a reduction in food enough to cause weight loss for longer than that, you probably make things worse. You probably end up rebounding quite a bit. So some people that have Many more than 2 inches of their waist to lose, they do well to do multiple cycles with breaks in between. So yeah, the main thing is just if someone does have some inches they want to lose, it can be a good fit. If they have many, they may do better doing multiple cycles.

Got it. And that's that component that you talk about between over fat versus overweight. Right. And we've got this epidemic of fatty liver disease as well. So what are you seeing? Like, are you seeing, you know, profound shifts on people's metabolic panels, lipid panels along those lines? And how quickly can, can you expect to see?

You know, that's the exciting thing when the body's given the right opportunities and the right circumstances. Yeah, the ship can right itself really quickly. It can recover very fast. Changes you mentioned some. We'll see differences in terms of lipids, cholesterol, triglycerides, fasting blood sugar, liver enzymes, longer term markers of blood sugar. These are the big things. Blood pressure. And you know, some of those can change in the order of weeks pretty radically. We see many people go from being in a state of fully defined as being in diabetes or having elevated liver enzymes from fatty liver. And within that whole four week cycle, no longer being there, you're seeing those things shift afterward and for sure that person still could be at risk for lapsing into things that Caused to happen before. But by and large, with pretty basic amounts of steps for maintenance, it can stay stable. And the thing that excites me the most is when someone says, hey, I already eat pretty well, but nothing works. And then they do the reset and then afterward they say, you know, now I'm doing what I did before. I'm not really doing anything differently, but it's working differently. My body's responding to it better. So that, that's the cool thing. There's a lot of ways you can just drop a few pounds, but it's so awesome to see someone just reset their metabolism and get a new lease on all of it.

Yeah. So the new. You're like actually resetting the set point. Right. You know, I hear oftentimes, especially, you know, women and men as they start to go through either andropause or menopause and it gets even harder to get weight off. And it's like this perpetual creep. Every decade it's like, oh, I've got, now I got five more pounds, now I got ten more pounds. You're seeing this work even for those folks.

Yeah, and not only that, but I love the most when I hear feedback for someone who's like six months later and they say, yeah, I really came back to my goal size in that reset cycle. And, and now it's months down the road and I'm staying there and I'm not doing anything different than I did before it. I was already doing some good enough habits, but now I'm getting more mileage out of those same habits. So that's, that's the coolest thing to hear.

Ooh, lovely. Well, and when you're talking about multiple sets of inches to lose and you're talking a 28 day cycle and we'll get into the diet, everybody, I promise. We're getting, we're getting there. But how, how many, what time, what timeframe do you, do you pause or what do you recommend for a cycling of that.

Yeah, 28 days, then at least two weeks off. Okay. Some, some that need to do many or wish to do many, two weeks is enough. Others will do one a quarter for a couple times. It's pretty rare for someone to need more than two or three cycles initially. And then one per year is a good thing for maintenance.

Awesome. And this is, you know, I guess there are a couple different ways to go here. So on this maintenance component, because this is such, I mean, this is an epidem in the United States, right. And we're, there's so many Conflicting things. So one I want to circle back to, you know, ketogenic diet and you know, caloric restrictions and no carb. The carnivore diet, like there's so many conflicting and you know, somebody follows one of these and they're going to get some results. But then my, I always ask them, is this a sustainable diet? Right. Is this something that you can actually live on long term and look at a longevity or a healthy outcome? Right. How do you get people off of the merry go round of even just the diet thought? Right. Because this is what you put together is a sustainable, really actionable four week program for folks. And then maybe you can launch into like what's unique about the approach. And I'm going to talk about, we'll bring up the liver because you already did. But that's the secret.

Yeah, so a couple of big distinctions, one of which is that I encourage people to realize that during periods of weight loss your body is going through challenges, there are stressors on your system and I encourage really avoiding most types of exercise during that window. So that's, that's pretty different from people typically here. I encourage very basic amounts of movement and small amounts of walking and stretching, but not doing hard exercise. So, so yeah, during that 28 day window there's the diet which we'll talk about, but minimal activity. Also really binging on sleep, you know, getting high amounts that may be more than what typically does, then realizing that.

Oh, we got you froze, we just froze you there. So after the binging on sleep, so.

Binging on sleep, so high amounts of sleep, we build up a very real sleep debt. It's not enough to say that you don't get enough, but also not getting enough for long periods of time creates an actual deficit. You're behind on that and you've got to pay that back to some degree. So yeah, so paying back that sleep debt is important. And then things are different for the maintenance phase. The maintenance phase is pretty easy as far as some dietary suggestions. And then I highly encourage good regular amounts of many types of exercise for maintaining that. But one of the biggest distinctions that is unexpected is that people are not told to exercise during the weight loss phase.

Yeah, that's huge. And you know, it isn't just more, you know, less calories and more exercise. So calories in, calories out. You're not a big proponent of that.

You know, it's something that in controlled settings is never wrong. But the question is, is it effective for people and long term results and it's often not, you know, even if you do change your scale weight by that one algorithm, it's pretty easy to lose muscle mass and actually end up getting in a worse place for your resting metabolism, your resting metabolic rate. So the trick is, how do you improve body composition, how do you focus on fat loss and especially waist loss over just total scale weight loss? There's some simple distinctions. There's a relationship between inches on the waist and pounds on the scale and on the program. The amount of inches lost per pound, or I should say pounds lost per inch, it's often about between 2 to 4 to 1. So 2 to 4 pounds come off for every inch that someone loses. So it's common, however, that people can lose 6 to 12 pounds for every inch that they lose. And whenever that happens, if someone's losing 10 pounds to lose an inch from their waist, they're not healthier. They're set up for failure because they had to lose a lot of muscle mass. And it was so many pounds for so little waist inches.

Yeah. So that. That's what's happening there.

That.

Is that why they feel so just miserable dieting?

Yeah. And also why they have such a hard time maintaining afterward. They've had a suppressed metabolism, their body's in starvation mode, they've got higher amounts of stress hormones, and it's like forcing yourself to hold your breath. You can't do it. You know, you will rebound.

So that's the yo yo that we see a ton of our patients coming in on. And that's the struggle, which is really real. And why it's a million dollar dieting industry, right?

Totally. Yeah.

So on the kind of the gimmick or holding your breath, that's a great analogy. I also really love the concept of binging on sleep.

Right.

You don't really hear those in the same sentence. So that's awesome. Thanks for that. Yeah. So what, how does somebody know if they're at risk for being over fat versus overweight? Right. Because they. It may be not looking so rotund in the midsection. I mean, that's the telltale sign that everybody knows is like, you know, waist circumference to cardiovascular, you know, worsening of just health in general. So this concept of being over fat, what do you got there?

Yeah, Pretty fascinating stuff. For a long time, there was a bit of a conundrum in the research around like diabetes, for example, they would see that many people, apart from type 1, more so early onset, more so autoimmune, that a lot of adults would develop diabetes. And it was Very common in those who were overweight. But the conundrum was that many would develop it who are not overweight. They were. They could be quite thin and not heavy and still get it. And then work was done that looked closely at body composition, and they saw that the thin, light people that were developing diabetes, they might have had a good scale weight, but they had too little muscle mass, so they had too much relative body fat. And the easiest way someone can know about that. There's many versions of body fat testing, which some have advantages over others, but the very simplest thing is just one's height to waist ratio. So quite simply, your height in inches compared to your belly button circumference, not like, I guess, not the belly button circumference, but your waist circumference at your belly button.

Got it.

And it's healthy to have that be a ways away from half. So math example, if a woman were 5ft tall, 5 times 12, so 60 inches. So if her waist circumference at her belly button was more than 30 inches or at 30 inches, she would be at risk for over fat and these complications. But if she's got several inches below that, if she's 28, 26, that's not the case, then.

Got it. Oh, that's great. So, yeah, so it's not at the hip ratio, it's at the belly button. Right.

So everybody makes data about waist to hip ratio as well, and that's especially relevant for fertility. So, yeah, comparing belly button to hip can give some different numbers, but in terms of impaired metabolism, fatty liver risk, diabetes risk, cardiovascular risk, height, waist ratio is one of the more powerful predictors.

Awesome. Awesome. All right, so when we look at, you know, in the book, you talk about your metabolic flexibility.

Yeah.

And the whole thing is on. You know, everybody understands metabolism. They want a faster metabolism, so it means they're burning more fat. Right. In just general public, specifically, what are you talking about when you talk about metabolic flexibility?

Yeah, so you talked about, like, calories in, calories out, and we never exactly. That's one of the problems. We never exactly get the right amount ever. We always get more or less to some degree, and our metabolism buffers that. You know, a day when we get less food than we need, we draw some energy out of stores and we keep the lights on. You know, if we're healthy, we feel fine, and we can function pretty well. If we get more food than we need, we can put that away for a future date without it being stuck and trapped in forms of toxic fat. When we're not healthy though. Those things don't work as well. We have a less flexible metabolism. Too little food means that we crashed, we have cravings, we have brain fog. And then too much food means that we store that away in ways that we cannot reverse. We can't tap into it later on when we need it as well.

Got it. And so you're not looking, you're not having folks look at their calories when they are eating.

No, I don't encourage for the program, I don't suggest, I need a measuring or quantifying calories.

Yeah, I love that. Right. Because it's not you're getting away, it's more on how you're feeling. It's on the inches that you're losing and how you're feeling like, you know, physically, emotionally, how's your brain working rather than just looking at numbers and that calories in, calories out component.

So.

But you are, you are encouraging folks to measure.

Yeah. And I encourage you to put more, more emphasis on their waist changes than their weight changes because that's predictive of health. Whereas your weight is not always. You can drop a lot of weight but just lose muscle mass and not be healthier for that. But waist inches changes as an adult. That's a good thing. You're better, better shape for that.

Yeah. And I don't know anybody who's as we're aging that really isn't looking at that. Right. I mean, it's a big player. So how does the liver fit in here then? So, you know, we're talking about, you know, on the title of your book, you know, you've got it up here in the corner, you know, with a life changing four week liver detox. Right. Are you a naturopathic physician or what?

Right. So I talked about the metabolic flexibility in the body, storing fuel and accessing fuel, you know, that's all your liver that's doing that. The liver is storing fuel in different ways. And when it's healthy, it's got room for that. You know, you eat more food than you need, your liver holds onto that just temporarily. It's not attached to it, but it lets that come out and power your body at another time when you have less food than you need, when the liver is not healthy, that stored fuel is stuck fuel and that becomes toxic fat. And that creates this cycle of having a harder time generating energy, more fatigue, more food cravings. But also that can damage the liver over time and create this fatty liver syndrome.

Are there some specific symptoms that just jump at you like somebody's got, you know, their constellation of symptoms that they really should be like, I need to do this.

You know, easiest things to think about would be first off that height, weight ratio. But then also, you know, how you feel when you do change your food intake. If you're someone that if you eat less, if you feel horrible and you have bad cravings and big dips of your energy, well, that's a sign that your body is not able to buffer that change in fuel intake. That's a real clear sign that it's all not working well. And also just if you find yourself resistant to weight loss, if you eat less and you feel poorly from that, but you don't necessarily see a lasting good change in weight, then that's another big sign.

Boy, that is so frustrating for so many folks. They, they get on some majorly restrictive diet and they up their, their exercise and they're just stuck, right? They feel like crap, their energy tanks, you know, they're cranky, no fun to be around, and then, you know, and all for not right. So on. What do you find with folks that have like, you know, sleep issues, so they're not getting enough sleep, so they're running in a high stress level. Will this work for them?

Yeah, and that's the exciting part, is that sleep itself, just taking the time for it and structuring things in a way to improve on that. I give a lot of tips and ideas. The book also encourages an intake of a dietary compound called resistant starch. And it stabilizes the blood sugar throughout the evening, even when you eat it in the daytime. And it turns out that a lot of sleep disturbances relate to drops in blood sugar that cause big increases in stress hormones. We shouldn't make a lot of stress hormones at night, but if we do, they wake us up and take away from our sleep quality. So it's awesome to see that change for people.

Oh, that's awesome. The resistant starch, you know, that's, that's amazing for so many things. I use that a ton. For folks that wake up with migraines in the morning or headaches. How about with. Have you ever found or do you ever notice.

Just.

I'm just curious. Off the side, side topic is folks that get startled awake at night, like as they just start to dip into parasympathetic activity and then they just, you know, launch. What's your thoughts around what's happening there?

You know, in many cases there's. They're having big drops of blood sugar occur right before that experience so the tie in is that you're one of your main stress hormones, cortisol. It's in the category of glucocort corticoids. So it's a glucose regulating hormone. And if your blood sugar dips, one of the many ways your body rescues you from that is it raises cortisol. So you pull sugar, you break down muscle tissue to make that into sugar. So for quite a while, I would use a thing called a continuous glucose meter with people and have them record their blood sugar levels, you know, like 24, seven, for like four or five days. And I would have them make a note on. They'd press a button on the machine and it would show a timestamp on when they had symptoms like, just like you described, like waking up and feeling panicky, your heart's racing. So they would timestamp that. And then when it was all done with a collection, we would look back over the tracing of their blood sugar graph and see where those timestamps showed up. And pretty much in all cases, those types of experiences, those symptoms, they were right. When the blood sugar either got very low or was rapidly declining, you could also see the rate of change. So, so yeah, for many cases, that rapid drop in blood sugar correlated with a spike in stress hormones and it made someone just wake up and feel panicky. There's a normal response to, where we make a higher amount of cortisol to wake us up in the morning. And so there's a natural mechanism by which we respond to it. But if it occurs in a dramatic way and at the wrong time, that's one thing that can cause someone to just wake up in a panic in the middle of the night.

Interesting. Yeah, that's, that's huge. So what do you do for some, what do you. What's your recommendation for somebody that. That for.

The whole program? So we do it.

Yeah, just get in on this thing. And I have the links actually in the chart in the notes here. So folks can definitely find all of your contact info. I'm going to take a quick station break here. This is what the Health. I'm Dr. Greg Eckel. If you're just tuning in, I've got my friend and colleague Dr. Alan Christiansen on the show today. If you're just tuning in, I want you to go to naturecuresclinic.com and watch this from the very beginning. Also, encouragement to share this with your loved ones. You're getting information here that you aren't finding elsewhere on the web. This is the real stuff. Here. So it is again, a pleasure to have you on here. We're talking about your book, the Metabolism Reset Diet. There's this. So we just talked about metabolic flexibility. I took us down a side trap around sleep. You mentioned some sleep recommendations for folks. So I always like asking that tips for our listeners out there. What are the big traps that you see for folks around sleep issues? I mean, it's really pandemic in our culture as well.

You know, three things, and I intentionally won't mention items that are talked about quite a bit. Three things that are big factors, one of which is not getting adequate light activation in the morning. So there's this thing called the cortisol awakening response. And the more we get a good cortisol spike in the morning, the more we can shut off cortisol and get good deep sleep. We don't get that spike unless we get exposed to sunlight. And not even like bright lights, not even like lots of lights on in the room, but something like sunlight. We need at least about half an hour within our first hour or so of being awake to get healthy circadian rhythms back again.

Interesting. So that. Okay, so that's. You got. That's one.

Yep. Another big one is that each decade that we live, our livers get a little bit slower at breaking down caffeine. And it's a little misleading. You'll hear a lot of data talk about how, you know, we get rid of caffeine over the course of six to eight hours usually. But what we get, what we make it into, is other compounds that have very similar effects. And the whole process of getting rid of caffeine and all the caffeine, like derivatives, that can take up to a full day. And for many of us, based upon just our variances in our age, that can start taking more than a day. So if you're in that boat and it takes more than a day to completely make caffeine harmless and you have a dose every day, you're actually living in a backlog. You're living with a constant backlog. And this is not everyone. But anyone who does struggle with sleep, you should take at least about two weeks. And just watch how going caffeine free affects your sleep. If it has no effects whatsoever, go back to your coffee and have fun with it. But if it makes a big difference, you'll know that you've got one more tool in the toolbox. And if it does help, it's not something you have to avoid forever, but you may do well to skip a day per week. Or take a couple weeks off every year or so. But just be aware if caffeine is having a relevant effect with you or not.

That's a huge one. Right? Like an extra cup of stress for folks. Right? That's what I talk about with folks, especially anxiety and sleep issues. Right? Yeah, that's a great one. Okay, so third, so three of three.

The book before this one was about the adrenal reset diet. And that one talked a lot about how carbohydrate helps in the evening. So many people either are avoiding carbohydrate across the board or they're avoiding it in the evening. And kind of like how you can raise blood, you can raise your blood sugar by stress hormones. Well, you can't shut off your stress hormones if there's nothing you have to make into glucose. So especially in the evening you want. And not even just carbohydrate, but you want actual glucose, which you get starchy vegetables, whole grains, beans, legumes. But without something in that category, even just like fruit or vegetables in general, you won't get adequate glucose to really lower your nighttime cortisol. So having good carbs at night with your evening meal is essential for good sleep.

That's awesome. And you never hear that. You never hear that. Yeah. Thank you for those. Yeah, just knowledge bombs there. So on. Do you have like folks, I mean, I live in the northwest. I mean it's dark up here in the winter. So do you recommend, you know, like the satellites or, you know, 10,000 lumen type of thing and just put, just get in it. Right.

You know, you don't have to live in it. But you're right. There's many parts of the country or parts of the world to where, you know, per your latitude, per the time of the season, and per the time of day in which your day starts, you may not be able to step outside and have sunlight. So yeah. The seasonal affective disorder lights, 10,000 lux is a threshold by which they're effective. And there's some data, some little nuances. There's data showing that they are more effective when the light is from an overhead source. So a lot of them are ones you could put on a. Maybe have a stand, a tall stand from the floor on the desk. But you actually want the light. It's like the sun, like angle actually matters. Yeah, it's straight on or from below. It seems to not work as well. And there are some that are full spectrum and others that make high amounts of blue light, like blue tinged wavelength light. And the Idea there is that the light at dawn is more blue tinge. So it seems plausible. But the drawback is there's theories that those types of light may cause macular harm. So. So, yeah, you want full spectrum, you want 10,000 lux, and you want it somewhere above you. And again, you don't have to live in it, but a half an hour, within an hour of your first part of the day, being awake is huge. So. So, yeah, if you're somewhere in the northwest, just set that up where you have your breakfast, you know, your breakfast and read the paper. Whatever you do in the morning, just have a light source like that above you and overhead. That's all it takes.

That's awesome.

Good ones are seventy, a hundred bucks. They're. They're not expensive anymore.

Yeah, that's great. And are you. When you're measuring that cortisol awakening slope, right. You're seeing changes over a month's time or two months.

Yeah. Rarely more than about four to six weeks. To see shift in that, you can see that through blood or salivary markers, but it turns around pretty quickly. There are those. One thing I should mention, too, apnea can skew that. So those that have sleep struggles, those have a low morning cortisol that's shown up. Something to screen for, to consider is apnea. That can be a big, big barrier for their recovery.

Got it. Yeah. That's awesome. All right, so coming back around, so you've got. I have a question for you is how can your liver block fat loss? And, you know, I guess I wanted to ask about the sleep aspect because that's such a big thing for folks. And I know if you're not getting that adequate rest, you're not able to truly reset your metabolism. Right. Because you're just in that fight or flight stress response. So then we're looking more at the liver in particular and metabolism there. You know, all of our hormones are getting. A lot of the hormones, I should say, are getting metabolized in the liver. It's filtering the blood. It's a major filtering organ for our bodies. So when you talk about, you know, we're wanting to lose fat and inches in particular, what's. What's happening here? What do you see with that?

Yeah, to be really precise, I talked before about your liver storing our fuel. Well, fuel can be carbs or fat from the diet. And the liver stores that, as carbs are fat. It's basically, there's a type of fat called triglyceride and the kind of carb called glycogen and your liver needs both, you know, it needs some carbs to burn the fat. So when your liver is too low on glycogen, it can be full of fat but it can't burn the fat. Almost like you've got a lot of logs you'd like to burn but you've got no matches, you know, so yeah, it needs carbohydrate to burn fat for fuel. And that's what we see in fatty liver syndrome is the ratio of those two things get thrown off.

Got it. And it is again, fatty livers, non alcoholic fatty liver disease is kind of a untapped or unknown major epidemic in our society. Right, so how does somebody know to screen for that or how do they know they might have it? Because you know, even a lot of primary care providers are just not tuned into that.

Totally. Yeah. The first easy thing would be some of those symptoms we talked about, like the struggles with weight or also then the height to waist ratio can be a clue. Blood tests are helpful. Now many people have high liver enzymes, especially alt and they're told it's not important, it's not really pursued or diagnosed. So one step is it's got to be diagnosed. You got an explanation for that?

Right.

And other things can cause that. It could be a incompatible medication like a statin or antifungal or something, or even oral contraceptive. Or someone could have a hidden low grade infection in their liver and also have autoimmune hepatitis, which is more rare, more dangerous. But there's things to think about. But barring another explanation, fatty liver is quite common. So one thing is you can see just blatant elevation of liver enzymes. But even within the normal range, liver enzymes can point toward fatty liver. And here's the numbers. So there's more and more times in which people get copies of their blood test. It's great for people to be aware of that. If you're a woman and your alt score is above 19, some say 18, but definitely above 19, there's something not right. And that's well within normal.

Oh yeah, that's low, that's low for on the ranges, right?

Yeah, some ranges I see, I see the top end of the range as low as high 30s and as high as the low 60s. Yeah, yeah, you could be well inside the normal range. But if you're above 19, you're a gal. Something's not right. That needs to be sorted out. The most common thing, barring something more serious, is fatty liver. Guys, we got leeway up to about 30. I've seen some say 25, but yeah, we've got a little more leeway. But also well within the. Said the normal range.

Yeah, yeah, I've got, I draw, I draw the lines. 25 for men, 18 for women. And that is, you know, that goes. Not even looked at. Right. Because it's well within the range, the reference range. So, you know, fatty liver. If you've got nothing else out of this talk today, get, get, pull your numbers and look because they're on everybody's lab work. Their annual exam should be there. Awesome. So what about. So, okay, so we're talking about weight and you know, you've got your specific reset diet and. But there's been no discussion about thyroid hormone. What go. What goes with that, Dr. Christensen?

Yeah, super important. So for many people, one of the biggest factors that can affect basal metabolic rate is thyroid function. And in fact, I've been reading a lot about the history of thyroid disease and history of thyroid treatment and measuring basal metabolic rate was how they used to diagnose thyroid disease and how they used to treat it. And what they learned was that someone with impaired thyroid function may have a 40 to 60% slower rate of metabolism. So, you know, give average numbers most. I was just at a. Where was that? I forgot there was some supermarket or restaurant. Oh, we had a staff celebration. Met at a nearby healthy breakfast place. And they talk about, here's the menu items and here's the calorie count, they're saying based on a 2000 calorie day diet. So a lot of general recommendations will say that's kind of a starting place. And for sure there's ranges. But anyway, to use that for numbers, if someone had impaired thyroid function, it was 60% off. They might be only burning 800 calories per day.

Yeah.

And to have to have weight loss occur, you usually need a deficit of like 500 or so calories per day. So that means they could never maintain the nutritional needs and be in a weight loss range. So it's huge. And unless it's identified and treated when it's off, people cannot successfully lose weight or regain health.

Wow.

Yeah.

That's huge. That is huge. So on. I'm curious, as the thyroid expert that you are, what's a complete thyroid panel in Dr. Christensen's Integrative Health clinic down there?

You know, simple thing, there's what you test and then how you look at it. And almost all cases, if anything, thyroid is tested, the TSH is done, and that's good if you're in the normal Range, that's better than not being the normal range. But there's a lot of evidence saying how healthy people and those that have the lowest rates of long term disease risks and the lowest complications of obesity and the lowest body fat amounts, they're in a narrower part of that TSH range. And to be precise, the TSH is backwards. So the higher it is, the more your thyroid is underperforming, and the lower it is, the more your thyroid is overactive. So you actually want to be having a low tsh, not below range, but on the low side. That corresponds with being further away from the hypothyroid range. Now, a full panel for someone who's not been diagnosed would also include the active hormones made from the thyroid, the free T3 and free T4. It would also look at markers of thyroid autoimmunity, such as antithyroglobulin, thyroid peroxidase, thyroid stimulating immunoglobulin. And the last thing is, it would look at the markers of thyroid cell turnover, which is thyroglobulin by itself, not the ante. And then finally want to structurally evaluate the thyroid, which is done by an ultrasound.

Got it. Awesome. And are you guys running the ultrasounds in your clinic or you refer out for that?

Dr. We use a radiology group that we partner with for the ultrasounds. Dr.

Awesome. Yeah. So with. So the thyroid obviously is not just by itself. Right. There's some feedback loops of the other hormones that we've been talking about. And so that really brings in, you know, obviously you've got to have them all in balance in your, in your optimum levels there. So that, that is a big piece of the puzzle for folks. So, you know, I just want, you know, people to realize, you know, if you are struggling and have been struggling with this, please get some support to go through this. Of course, the first starting spot is get the book and plug in with Dr. Christensen and his amazing and utilize his clinic there. You guys do remote consults?

Yeah, we do. Yeah.

That's awesome. All right, so where to go from here? So what other nuances to this discussion around your metabolic reset diet? What else would you like folks to know about there?

Well, something else I talked about was protein is important. You know, proteins are a critical thing. And it's, it's a, it's a difficult discussion sometimes because we hear a lot of, lot of strong ideas about protein being bad or unnecessary or we eat too much or, you know, we can't really get deficient. We don't need all that Much. And there's some truths to a lot of that. We can't really get deficient if we're getting enough food. But there's really strong evidence that in terms of our hunger levels being appropriate, our metabolism, our body composition, how stable our blood sugar levels are, that the amount of protein that works best for those areas may be an amount that people are not getting. So a few more numbers. It seems that those best amounts correlate with about a gram of protein from a complete source per pound of someone's lean body weight per day. So lean body weight, here's another example. Say a woman was 140 pounds. Let's say she was 25% body fat. So 25%. 140. That's going to be what, 35 pounds. So we would subtract that to be left with 105. So that's her lean body mass. So we take out that fat mass and think about the remainder. So that's about how many grams of protein she would want per day. Per day. If she were having struggles with maintaining her weight or keeping her energy level steady, that amount could serve her more than less than that can. And you know, when someone thinks it through and looks at their diet, unless you're thinking about it and trying, probably not getting enough to help you the most.

Yeah, that's a lot, right? I mean, 104 grams of protein a day for 140 pound woman, that's a, that's a lot of, it's a lot of protein.

You know, I should distinguish too. It's not so much that it's beefsteak. You know, protein from vegetables is awesome and they have manages to. But, but yeah, that's a, that's a day's total. And it's something that we used to think that maybe you couldn't absorb a lot at once. Now we know you can, but we're always borrowing some protein from our muscle tissue every several hours. So it's good to get that spread out throughout the day for best benefit of muscle tissue and just better metabolism.

Oh, that's awesome. Do you? So how about if we just throw one nuance in on this around folks that are lifting weights. Do you have a preference for people to eat before or after they're working out or does that make a difference?

You know, funny thing, I've done a fair amount of reading and talking to experts on that rather recently, and the jury's out as to whether there's a window of time that's critical. However, for many athletes, it's a convenient habit. You know, it may be just a handy way to be regular about getting that extra serving in. So probably fine to do right afterward before training. If someone's talking about half hour, 45 minutes, low to moderate intensity, what they do right beforehand won't have a big difference upon how they perform. If you're talking about much longer than that and you're talking about endurance exercises that are hard and sustained or very high intensity strength training or longer high intensity interval workouts, in those cases, it's better to have about a 4 to 1 ratio of carbohydrate to protein or even a little bit less in terms of just your performance effects. For most people who are exercising in typical amounts, the timing is not, not critical. They could do okay with just eating on a regular schedule and getting enough protein.

Got it. So on that topic, what's your take on the multiple small meals versus like three set times or two set times? I'm guessing you're going to say it depends. But.

So for a while there was thought that there was some magic benefit by eating really often, that you would boost metabolism by doing so.

Right?

Yeah. Getting the protein is important for maintaining metabolism, but you don't so much, you can't eat all the time and hack the system. You know, like let's say again that it was 2,000 calories. It doesn't seem that if you were to do 10, 200 calorie meals, you'd be getting some better benefit. So what happens is you, you take out from muscle tissue every four hours or so. So if there's not protein coming in at that frequency, there's a, there's an imbalance between how easy we break down muscle and how hard it is to replenish muscle. So it's good to have some at a frequency about like that. But most can do that with, you know, three or three or four feedings throughout the day. So it's not that one needs to eat all the time, like greater numbers, but most do better for maintaining their muscle mass with about that frequency.

Nice. Yeah, right. That's such a good, I think also timing, if you've got a stress imbalance happening, they're really bringing the food in around the same time every day is very important. Right?

Yeah. So consistent timing, that's a huge factor. It's a hugely good point. The first meal is essential that way for setting circadian rhythm. But amongst the biggest drivers of your body's daily cycle. I should expand on that for the listeners. Your, your stress hormones, they work In a rhythm. We make a lot in the morning. We shut them off at night. Of course, if our stress level is high, the timing can be altered. But that affects many parts of our body's health. We call this the circadian cycle. And one factor that helps us reset and govern and stabilize that circadian cycle is just when we're eating. The first meal is a big one, but the timing of other meals is huge towards that.

Awesome. All right, so we are coming down the home stretch of what the Health again. This is Dr. Greg Eckel, and I've got my colleague and friend Dr. Alan Christensen on the show today. If you're just tuning in now, please go back to naturecuresclinic.com and check the podcast button and you can listen to this great discussion from the very beginning. Also, encouragement to share this with your loved ones, your friends and family. Get the word out. You know, it is. There is a component why I called the show what the Health. And so this is the moment in the show, Dr. Christiansen, that I told you about beforehand. If you would share any what the health moments. Right. We were talking before we got on here. You do a huge training of your staff and your physicians down there, and maybe something from that or some story, you know, and I say it with a smile on my face, but really the ultimate thing is it's kind of like you hit your head on. On your hand of like, what the health. Like, I can't believe this occurred when it could have just been solved like this. Right. So I. Yeah, sure, sure.

So probably the biggest categorical answer would be people trying to improve upon their metabolism, improve upon their thyroid by taking iodine supplements. And it seems really intuitive. It's something that. It does make sense, and it's something that someone could be in a smart enough person, educated, and have it come out the way they wouldn't expect. So your thyroid needs iodine to work. However, one of the more surefire ways to disrupt thyroid function is to have just a little bit too much iodine. And the range between a good amount and too much is ridiculously narrow. So it always makes me sad when someone has been struggling with thyroid disease, not making progress, trying harder and harder. And it turns out they've been taking iodine supplements all along. It's just like, you know, your car won't go well, but the parking brake is on. So it's something that, yeah, always, always frustrates me because it creates a lot of unnecessary suffering for people.

Wow. So what. I mean, it just slows down the so they're taking thyroid and taking iodine.

Or not on thyroid, but their thyroid is under active or they're symptomatic from it, whether they're on it or not. But any of those cases, iodine can slow things. A bit of a paradox, but it's almost like, well, I'll back up a step. So what's unusual about iodine? Many things. One of them is that the amount you need for your thyroid is not reflected by how much is in your blood. Your blood doesn't have enough. And that's not true of other nutrients. So things like magnesium, B12, calcium. Your blood flows through your tissues and almost like they're a sponge. And the amount of the nutrient, assuming you've got it, is adequate for your tissues needs. But iodine is not like that. There's a special concentrator, so your thyroid can pump it in as much as 100 times more concentrated than what is in your blood. Now, once the thyroid gets iodine, it's kind of a done deal, a foregone conclusion that it will make hormone out of that. So whenever you get a lot of iodine, if you didn't have any way of regulating it after you pumped it in, you would make so much thyroid hormone you could make your heart stop. It can be hugely dangerous. So your body has a fuse built in and any surge of iodine just blows the fuse and you shut off your thyroid for about three weeks. Wow. Many people don't regain normal thyroid function again. And what we've also learned is that we used to think it was like an all or nothing fuse. Now we know it's also like a parking brakes. If you're getting a little bit too much, you're going to throttle your thyroid a little bit all the time and make it somewhat underactive.

Interesting.

So.

And you see, I mean, there's a reason why we added iodine to salt, right? So in the. But in the northwest, and I don't, I'm. I'm guessing in most of Metropolis areas, you know, folks have gone into, you know, the fancy salts, Right. We've got the Black Sea salt, we've got the Mediterranean salt. And a lot of these do not have any iodine in them. So are you seeing. Yeah, go ahead.

A lot of stuff there. So we added, we added it in. We started that in the mid-20s. There never was really a federal referendum. Most states did adopt it. Many companies did. And when we did that, the rates of goiter went down by tenfold, which is a huge win. But between salt Iodization and the first three decades of it in the few counties that recorded the rates of autoimmune thyroid disease went up by 52 fold.

Wow.

Fortified of iodine.

Yeah.

Denmark just ran this experiment in the year 2000. They carefully tracked it and for 15 years running after they fortified, they saw an average annual increase of 50% of all types of thyroid disease. Wow. Wow.

And are you predominantly finding on your testing most folks have the autoimmune type of thyroid or.

Doctor, most thyroid disease is autoimmune. The tricky thing that a lot of doctors aren't clear on is that thyroid antibodies, they're useful tools and they can show if they're positive, that confirms someone has autoimmunity. If they're negative, they do not rule out autoimmunity. Upwards of half of people with autoimmune thyroid disease never have measurable thyroid antibodies. Yeah, yeah.

And so on that. You know, I see a lot of docs that are treating the labs and they'll, they're following the antibody levels, which I have not seen that to correlate to somebody's status of, you know, how well they're feeling.

That's a great point. Actually. I was just talking with a group of interns about that a few hours ago. The antibody levels, they fluctuate randomly. They can go up and down. They don't really correlate with many health outcomes. With a couple of exceptions, they may at their extremes, TPO, more than 3,000 may be a factor for fertility in some populations. By and large, they don't correlate with the risk of autoimmunity being higher, lower, or the progression of thyroid disease being different. They're, they're really not useful things to track. However, there are other lab values like TSH to where it's not a perfect marker. However, we can't so much ignore it and just let someone TSH go far too low because there are dangers from that.

Do you have what's your ideal or optimal TSH range?

There's a lot of ways we personalize that in our practice based upon age, gender, pregnancy status, cardiovascular health, things along those lines. But as a general parameter, there's a lot of evidence showing that total mortality, disease risk, general well being, overall metabolism is better when someone's between the bottom end of the normal range, like 0.4 and up high end of about. So you'll see different studies, some as low as like 1.5, some as high as 2.5, but somewhere around that 0.4 to 1 1/2 or 2 range seems to be optimal.

Awesome. What do you find with, you know, the endocrinologist when somebody comes in with a 0.4 TSH, they start to get a little bit concerned. But you know, you're saying, well, optimally it should be on the lower end, right?

For that's, that's about as low as you'd want to see it.

Yeah, yeah, yeah, yeah, got it. Thanks for that clarification. So, all right, so what else on kind of Optimum Health? So I'm going to change gears a little bit, you know. Well, I'm going to give you an opportunity to come back to that. What the health. So you brought up the iodine, talked about iodized salt, fancy salts too. So you are not a big proponent of folks taking iodine. Is that what I'm gathering from you?

Well, it's not a good thing or a bad thing. We need it. We need to some it just happens to be that it's easier now in the modern world to get too much than it is to get too little. So most do better by being mindful of not getting extra unusual sources. It's hard to get too little with being on a modern living in the modern world. We get plenty of that because it's.

Mainly fortified in a lot of foods.

Is that why it's fortified in foods? It's a contaminant based on industrial processes. It's very erratic in certain food amounts. So processed bread, many types of sea products like some types of seafood, sea vegetables, dairy products, egg whites also then the salt you mentioned, then supplements. These are all things that can have quite erratic amounts of iodine.

Dr. Lovely. And is it in particular, is it more concerning with the Hashimoto's or autoimmune type of thyroid issue with the iodine products or on that balance really all.

Kinds of thyroid disease, including thyroid cancer, graves, subclinical hypothyroidism, non specific hypothyroidism. So it's relevant to all of those.

Great. All right, so on to a little bit different topics. We're just kind of rapid fire here towards the end of our show. We got two minutes to go. What is the biggest lever that you've moved in your own life that has made the best, biggest difference in your health?

You know, something I would talk about that's distinct from what others might mention. I would encourage others to emulate too so much evidence on this, but just time in nature, you know, mountains of data about this being helpful for us in very direct ways. You want to Understand. But also many indirect ways that can seem odd and hard to comprehend, but our bodies are really anchored to being in natural environments. It seems the minimal effective dose is somewhere around 20 minutes per per day. But that's something that I try very hard to stay on top of. And if I. If I ever can't, I think it affects me more than many other things. So, yeah, I'd highly encourage listeners to think about their RDA for exposure to nature and getting some daily minimums into their life.

That warms my heart so much, Alan. Thank you for bringing that up. You know, it is, you know, kind of the pat answer coming from the naturopathic doctor.

Right.

But it is. We are part of the planet. Like, it makes total sense and we feel better for it. Right. No, I know. You know, you live in that wonderful area with, like, hundreds of trails right outside your door. It makes it super easy to do it. Right. So for folks that don't have adequate access, it's just getting outside, really. And, you know.

Yeah, getting outside, even just in a small backyard, even if you're putting some plants around you, even indoors. But any way to be around elements of the living world is just super, super effective.

Yeah. I thank you so much for coming on. It's been so fun talking with you here, and I hope you know, again, everybody, this is his book. I've got the contact information for Dr. Christensen under the. Under the notes here. Please subscribe to the channel. Share this information with your loved ones. I'm hoping to bring you the best info. If you've got questions, please contact me through naturecaresclinic.com Again, this is what the health. We are here every Tuesday from 2 to 3pm Pacific Standard Time. Again, thank you, Dr. Christensen. Any final wisdom bomb?

You know, for those who are listening, it's critical to have someone in your corner to guide you and sort these things out. We can't all figure it out on our own. So connect with Dr. Greg and, you know, work with him in his practice for your general health. Follow his work and stay on top of that. Get a good resource like that and be consistent.

Yeah. Thank you so much. All right, everybody, we'll see you next week.

Sam.