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GLP-1's with Dr. Kristin Oja · Mocktail Minutes

0:22
Hello, everyone.
0:23
Welcome back to this week's episode of Mocktail Minutes.
0:25
This is Bailey.
0:27
And this is Brianna.
0:28
And this week I am drinking.
0:31
I forgot what I put in here.
0:32
Oh, orange element today.
0:36
So we're getting some extra sodium and salt and see if that helps decrease some swelling in the feet.
0:42
I, I desperately need element today because I'm like melting in the Texas sun, but I don't have any.
0:49
So I'm doing the vital proteins.
0:51
They're like collagen electrolyte packs.
0:54
I don't know if you guys have seen those, but they're pretty good and they're pretty potassium forward.
0:58
So I stole it.
0:59
It's my husband's.
1:00
He's, he buys vital.
1:02
Have you guys ever noticed the collagen get to be like gel like in your drinks?
1:08
Or do you notice a flavor in the unflavored collagen?
1:12
It's no flavored in the unflavored collagen, but they will like get jelly in my drinks.
1:17
If in my cold drinks.
1:18
Yeah.
1:19
I never had that issue.
1:20
And I had someone tell me, she's like, I hate the unflavored it's flavored.
1:22
I'm like, I can't taste it.
1:26
Well, today we have a special guest.
1:29
So I'm going to, I'm going to let you introduce yourself.
1:32
I'm gonna let you introduce Perfect.
1:34
Well, thank you guys so much for having me on here.
1:36
I am a little bit horse today, so my mocktail is lemon water with honey.
1:40
So thank you guys for bearing with my voice.
1:42
But I'm Kristen Oja and I started a company called SAP wellness and we're the nation's first functional medicine and functional movement practice.
1:49
So we're a one stop wellness shop and we really treat everything and anything.
1:53
And we have dietitians, health coaches, functional medicine providers, kind of all of that under one roof.
1:59
And I like to keep, Life crazy.
2:02
So I have a three year old and a two year old and three business locations.
2:05
So just a lot of, a lot going on all the time, which I love.
2:09
Yes.
2:09
And I've been to one of your locations when Megan had her book signing.
2:13
So.
2:14
Oh yes.
2:14
That was our Roswell location.
2:16
Yes.
2:17
Yep.
2:17
I was there.
2:18
Oh, well, that was our second location we opened.
2:20
It's an 1850s millhouse and you probably saw this, but the hardwoods in the waiting room are original from 1850.
2:27
So like you cannot wear stilettos in that room or your feet will go through like the floor.
2:32
You don't want that.
2:33
No, no.
2:34
So you got to be careful on that floor.
2:35
But we did refoundation it.
2:36
So nobody is going to, nobody's going to fall through.
2:38
So yes.
2:39
No, it is very neat out there.
2:41
And your kids were there too, weren't they?
2:44
So yes, I think they might've been for a little bit with Tuli because I know Megan brought her daughter.
2:48
So I either brought both my girls or one of them and they put the resistant bands all around their neck, like necklaces.
2:53
Did you see them?
2:54
They had like, I'm like, that's not a tricking hazard, you know, run past the doorknob now wild, wild girls.
3:06
Well, today we are talking about GLP ones.
3:09
So Kristen is going to give us some really good insight to this.
3:13
I have heard her talk about them before and Brianna and I decided like, she's going to be a good go to person for this because we know about them, but I feel like you have worked with so many more people with them and you're prescribing them.
3:27
So.
3:28
We thought, okay, let's just bring an expert here.
3:30
So we're excited to pick your brain today.
3:33
Yeah, me too.
3:34
I think it's such a hot topic, obviously.
3:36
And I, I think with anything, there's the good and the bad.
3:38
So we'll cover both of them today.
3:40
But I love talking about this topic.
3:42
So thank you.
3:43
Yeah.
3:43
And for those of you who are like, okay, GLP one, we're talking like Ozempic, semi glutide.
3:49
Manjaro, Manjaro, however you say that.
3:51
I don't, right.
3:53
But basically the hot, like weight loss shot going around right now.
3:58
So let's just like, I don't know.
4:00
Let's dive into it because this is, first of all, these medications are not new, like they've been around for a long time.
4:06
So what are they typically used for?
4:09
Yes.
4:09
Well, so we can talk about, do you mind if we talk about first, like what GLP 1 is?
4:14
Yes, we definitely should.
4:15
Because I think this is such a key thing that a lot of people don't realize GLP 1 is glucagon like peptide and our body naturally makes GLP 1.
4:25
So I think it's really important to understand that peptides are actually naturally occurring in our body and peptides are chains of amino acids.
4:33
So when you just mentioned taking collagen with your mocktail today, Collagen is one of the most popular peptides, right?
4:39
It's chains of amino acids.
4:41
And so glucagon like peptides, or GLP 1, is compromised of 30 amino acids.
4:47
And our body makes GLP 1 in our small intestines in response to eating.
4:53
And so when we eat food, we make in a healthy state.
4:56
GLP one that helps us make insulin to help lower our blood sugar to keep us balanced and to also feel full.
5:04
And what's really interesting.
5:05
And I'm sure you guys have worked with clients like this.
5:07
There are people that have a really hard time regulating their appetite.
5:11
They don't know when to stop eating when they're full.
5:14
Right.
5:14
And they're going back for seconds and thirds and binge eating disorders or food noise all the time, all day long.
5:20
They feel like they're hungry.
5:21
And what are they going to eat next?
5:22
Right.
5:23
So we know some people don't effectively make GLP one.
5:27
And I think this is where there's still a gap in research of, okay, well, what are some of the reasons we really think the microbiome plays a role.
5:34
So Hippocrates said, you know, over 2000 years ago, All disease begins in the guide.
5:39
And we still agree with this.
5:40
The microbiome plays a huge role in how we make GLP 1.
5:44
So we can break that down, but I just wanted the listeners to first know that GLP 1 is naturally made in all of us in response to eating, just to different degrees and different effectiveness.
5:54
And so then they created a medication version of GLP ones, and I like to call it a peptide instead of a drug, even though it is a pharmaceutical and a prescription.
6:04
And there's kind of two main classes.
6:07
You have the GLP ones by themselves, which is the Ozempic, the Wigovi.
6:11
And then you have the GLP ones and the GIPs that are a little bit studied to be a little bit more effective with a little less side effects.
6:18
And that's the Mengero and the Zep Bound and what's called Terzepatide.
6:22
Okay.
6:23
But these are once a week injections that you can get from a regular pharmacy or you can get from a compounding pharmacy, which we can also break that down.
6:30
But that's to help the body make more GLP 1.
6:34
Okay.
6:34
And do we, do we have a way to test, like, if we know how efficient we are at making GLP 1 or is it kind of like trial and error?
6:43
No.
6:43
So the best way we can tell if people are in need for more GLP 1 is by looking at fasting glucose, insulin, A1C.
6:51
So, you know, if you're insulin resistant, if you're pre diabetic, if your fasting glucose is really elevated, either it's a dietary change.
6:59
So I always like to say, first and foremost, we're always going to want to work on lifestyle, right?
7:03
Like, You know, maybe we do have room to clean up our diet a bit.
7:06
Nobody is perfect.
7:06
We don't strive for that, but you know, maybe we need a little more protein and whole foods.
7:10
You know, maybe we need a little bit more strength training and building muscle.
7:13
Maybe we need to prioritize sleep and work on our stress level, but some of our patients are truly doing it all.
7:19
And so what we call this, you know, meta inflammatory cascade, right?
7:23
They're got microbiomes in balance.
7:25
They're inflamed.
7:26
They're insulin resistant.
7:27
They're prediabetic.
7:28
Maybe they have PCOS, whatever it may be.
7:31
And they get very frustrated.
7:32
I have women come into my office crying, like, I am doing everything.
7:36
I've spent money with a dietitian.
7:37
I'm logging everything.
7:38
I'm eating.
7:40
I'm exercising.
7:41
Right.
7:41
And I can just sense this discouragement.
7:43
And so those are instances where we're like, there's something going on with your guide and the GLP one production.
7:49
But I wish there was a way for us to measure GLP one.
7:51
That'd be awesome.
7:52
Maybe I'll, maybe I'll come up with that.
7:54
Yeah.
7:55
And I think Like you bring up a good point because we work with women, weight loss primarily is kind of like their goal and we get really deep into blood sugar balance because I'm both of us are on the side of even if you do not have diabetes or insulin resistance yet, you should be eating for blood sugar balance because number one, you're going to help to prevent it.
8:15
Did it disease like regression?
8:18
And also you're just going to feel good.
8:19
So we do get a lot of women who are insulin resistance.
8:22
We see, I see a lot of PCOS and they're always asking, do I need this?
8:28
Like, cause they, they feel stuck.
8:30
They feel overwhelmed.
8:31
So.
8:31
When you say like, first we need to do like this lifestyle modification, what does that look like and how long are you really making your patients or clients kind of trial some things out before you just go, yeah, let's do it.
8:44
So some people come to us and they really have exhausted everything first.
8:48
So there is very, very seldom times where we're like, I agree with you.
8:52
I think a GLP one is a good next step.
8:54
So I don't want everybody listening to like, we like torture them through like six months of our protocols before we agree.
9:00
But in general, any lifestyle change you make, it's going to take three months of consistency to really see the change and labs and body composition.
9:09
And this is even true with GLP ones, which we'll talk about how we dose it at stat.
9:12
Cause we have a very specific way to GLP ones.
9:16
But we're going to want to make sure, like, one of the big things we're really big on is actually wearing continuous glucose monitors.
9:21
We have them in stock at all three of our locations.
9:25
And so we're like, Hey, I want you to actually wear a continuous glucose monitor and see what's happening with your blood sugar daily.
9:30
So some examples of this is like, I have some patients that for some reason, no matter how much protein and healthy fat they eat, sweet potato always spikes their blood sugar, right?
9:40
And so they're able to change their sweet potatoes to lentils and now their blood sugar is super stable.
9:45
Right.
9:45
And that was like one of their main carbs because it's so healthy.
9:48
Right.
9:49
Sometimes rice, like I see rice, I don't put that in a bad food group.
9:52
Right.
9:52
I don't like to think about food as good and bad.
9:53
It's a great carb for a lot of people, but when people wear CGMs, sometimes they see rice just spikes them, even if they're eating it with 35 grams of protein, you know?
10:02
So.
10:02
We want to take an individualized approach because we can talk about what the evidence says.
10:06
We can talk about, Hey, we need more fiber.
10:08
We need more protein with each meal.
10:10
We need to eat the colors of the rainbow.
10:12
Maybe we add a two to five minute walk after meals.
10:14
We've got evidence that shows that lowers post preannual blood sugar, right?
10:19
And then we always like to change the narrative from, instead of trying to lose weight, how do we build muscle?
10:24
Because to me, that feels a lot more positive, right?
10:26
And if we're eating to build muscle and we're strength training and we're walking after meals, you know, the metabolic health will follow as inflammation comes down.
10:35
And you guys are probably aware of this, but we experienced a thing called sarcopenia.
10:39
Really even starting at 30 years old, we have muscle loss.
10:42
So, you know, if I see a person that's 50 years old, that hasn't been having a strength training routine, they're the amount of muscle they've already lost.
10:49
And now they're also menopausal.
10:50
They have no hormones.
10:52
I believe in the physiological change that happens when our body tries to put on fat.
10:56
To make more estrogen when our ovaries stop making it, we try to find it in places.
11:01
So we have these physiological changes too, that are working.
11:04
I don't want to say against it, but making it harder, like the things that worked when we were 20 might not work when we're 40.
11:09
Right.
11:10
So we're definitely going to take an individualized approach.
11:13
We're going to have people wear continuous glucose monitors.
11:15
We're going to talk about nutrition.
11:17
We are very fortunate to have everything under one roof.
11:19
So we can get them in with a dietitian, get them in with a health coach.
11:21
We'll try to do all of that.
11:22
We want to make sure that they know how to strength train.
11:25
I've found this through we've had sat open for now, January will be six years and what I thought when I talked about strength training, cause of my background in education, I realize is not what they think strength training is right.
11:37
Like five pound dumbbells for 16 reps.
11:40
I'm like, Oh, we need to actually know what strength training is.
11:44
Right.
11:45
And so we're going to do all of that, but you know, three to six months, they're feeling really discouraged.
11:50
Their insulin hasn't moved.
11:51
Sometimes when they start doing more, I actually see their A1C go up.
11:54
Like they're trying everything because of the stress.
11:56
Right.
11:57
They've now lost, like, I've stopped meeting my friends to go out to eat because I'm trying to be perfect.
12:01
And I'm like, wow, now we're seeing adrenal issues and more blood sugar issues.
12:04
Like sometimes less is more.
12:06
But usually I would say three to six months is where we really want to hit the lifestyle hard and some natural supplements for GLP one production too.
12:14
We're getting a little bit more evidence in that space too.
12:17
And we're actually going to be starting to launch some studies at sat to verify this further.
12:21
Because we, we want to avoid GLP ones mainly because how much are we working on the root cause, right?
12:27
If you started GLP one and you have weight loss, how do we come off?
12:32
And we have had success.
12:33
And again, we're going to talk about that I'm sure on this episode.
12:36
But you want to exhaust everything you can before jumping to a GLP one.
12:39
What would you say are kind of like, quote, unquote, the dangers of just jumping into a GLP line?
12:45
Because I feel like a lot of people are like, well, people are seeing results of why can't I just do all these things, like work on the lifestyle changes and do the GLP one, like right now.
12:54
Yeah.
12:54
So the way we dose it, I think there's less side effects in general.
12:59
So we like to say that we micro dose GLP ones and we monitor body compositions and weights really closely.
13:06
We do not allow our patients to lose more than one to two pounds a week, max.
13:10
And they get very frustrated because they're like, well, 40 pounds in a month.
13:15
And I'm like, what?
13:16
Well, Karen next door is going to have liver issues and gallbladder issues.
13:20
She's going to blow up in two years.
13:22
Like she's lost her muscle.
13:24
Right.
13:24
So like, we're not going to do what Karen's doing.
13:26
So we don't want more than one to two pounds of weight loss.
13:29
We want it to be a tool for healthy metabolic health.
13:32
Right.
13:33
And I think that's the big thing is like, don't, if you're listening and you want to be on a GLP one, don't try to have it be a fast fix because you cannot have a fast fix and stay metabolically healthy.
13:43
Like, I think that's like, no matter what, we cannot have a fast fix and stay metabolically healthy.
13:47
And that's something I feel really strongly with stat is I don't want to destroy your metabolism on any weight loss journey.
13:54
So we require our patients to at least tell us that their strength training three times a week.
13:59
Cause I'm like, you have to shrink, train and maintain muscle.
14:01
We do the lowest, most effective dose.
14:03
Most of our patients don't get above 0.
14:05
5 milligrams and the max is 2.
14:07
4 milligrams.
14:08
So a lot of our patients say on a really, really low dose if they have side effects, we reduce the dose.
14:13
I have some patients on only 12.
14:16
5 or 0.
14:17
125, which is half of the non therapeutic loading dose.
14:21
And they're seeing results.
14:22
Right.
14:23
So you shouldn't have side effects.
14:25
And then we want to make sure our patients are eating three meals a day.
14:28
They're still getting enough protein.
14:30
So we cannot also use this.
14:32
Like we did the HCG diet.
14:33
I don't know if you guys remember the HCG diet that everybody did where they were eating 500 calories a day, losing, you know, I feel like the Ozempic is being talked about, like HCG was.
14:42
And I think that's, to me, mismanagement and miss follow up on patients.
14:46
If we're as medical professionals prescribing and then not seeing them for six months and they've lost 200 pounds and they have no strength training and they haven't been eating.
14:55
That's just, I think negligence in my opinion.
14:58
It scares me, especially when I see anyone over the age of 30 and I'm like, Oh, drastically lost 30 to 40 pounds.
15:06
I'm terrified for you.
15:08
I know, I know it's going to be a, it's going to turn into like a problem later.
15:12
That's just way harder to get out of because now you're so much more metabolically inflexible.
15:18
Yes, you're exactly right.
15:19
It's hard as a weight loss dietitian, especially when people find out you're a weight loss dietitian, or that's what they're literally coming to see you for because they'd be like, oh, I lost six pounds last week.
15:29
And I'm like, Wait, what happened last week?
15:32
Cause that's a lot of weight to just randomly lose.
15:35
And, or like, you'll have people that are like, Oh yeah, I lost 20 pounds in a month.
15:39
And you like, don't want to discourage them, but I'm also like, I'm a little concerned for you, like what happened here?
15:47
Yeah.
15:47
And we talk about it very openly, like at stat we're like, Hey, if you're losing that much weight, you're under fueling and you're losing muscle.
15:54
And we use the body composition to gauge that too.
15:57
And we don't want more than a 10 percent muscle loss.
16:00
And so, you know, if you lose 20 pounds, you know, and you lose two pounds of muscle.
16:05
Some of that is going to be muscle.
16:06
If you have, you know, 20 pounds, you're losing.
16:09
But if you lose 20 pounds and 10 pounds is muscle, you're slowing down your metabolic rate, right?
16:15
Like we're slowing it down.
16:17
And now we're going to have to rely on this tool long term.
16:20
Or you're going to have the weight gain back.
16:22
So for us, in order to keep prescribing it again, it's a slow weight loss.
16:26
Like what would be considered healthy weight loss?
16:28
One to two pounds a week.
16:29
It's maintaining muscle, right?
16:32
And it's not getting into a calorie deficit.
16:34
Like I want you eating like you would, if you weren't using a GLP one, right?
16:38
Because the trick is we GLP one to help with insulin production and glucose regulation in response to food.
16:46
So the goal is not to not put food in.
16:50
And not try to get that GLP one effect from food.
16:54
Right.
16:55
So like, it makes no sense to me where we won't eat breakfast, lunch, and we'll have a really small dinner and take a GLP one once a week because our body naturally makes it in response to food.
17:06
So if we're decreasing food, we're decreasing the production of GLP one.
17:09
I have like this whole like theory that The reason why we see so many women, 30s, 40s, 50s, that have these issues is because of our diet culture telling us eat really low calorie, really low carb.
17:24
And I think we've really impacted it.
17:26
And so things you're doing in your twenties and maybe early thirties, well, now it's caught up to you.
17:31
And then we think again, Oh, I'm eating too much food when the whole time we've just been drastically under eating for like two decades of our lives.
17:40
Oh, that is, I mean, I talk to patients all the time and I think a herbal deck for breakfast is enough.
17:44
Yeah.
17:44
And I'm like, why did our culture start teaching us that a herbal egg for breakfast, 70 calories is enough to fuel our day.
17:51
Right.
17:51
No, it's not even a snack.
17:56
I know.
17:57
So we, I do think you're exactly right.
17:59
And this is where I tell people, and you guys all know this but like you can't eat less.
18:03
Like sometimes when I meet patients, it's like, You cannot eat less.
18:07
You're already eating 1200 calories a day.
18:09
Like we can't, how can we talk more about a calorie deficit?
18:13
How can we talk about eating less?
18:14
We have to talk about eating more and building muscle and changing your resting metabolic state.
18:19
And I know that change has to happen gradually, right?
18:21
You can't go from eating 1200 calories to 2, 500 calories in your body composition, not change overnight.
18:26
It takes time, but working with people like you guys to gradually do it in a very safe and effective way.
18:32
Makes the world of difference.
18:34
And then maybe you do have a little period where you can get into a calorie deficit, but you're right.
18:38
Our diet culture has put us in a place where we can't, we can't get into more of a calorie deficit.
18:43
I get the question a lot is like, I literally feel like I can't eat anymore.
18:47
Like my appetite is not there.
18:49
I feel like I'm going to throw up if I eat anymore, like what to do.
18:52
So the people that I've worked with, I'm like, okay, let's definitely focus on getting that protein and fiber in.
18:57
And I've been eating at least three times a day, like.
19:00
Just try and get something in where I don't want anyone to be like stuffing their face so that they're like, well, I'm trying to force myself.
19:07
So now I'm puking.
19:08
I'm like, well, that's not going to help anything either.
19:10
Right?
19:10
So what is your advice?
19:12
Kind of there when people are like, if I eat, I feel like I'm just going to vomit.
19:17
They, in our opinion would be on too high of a dose.
19:19
So like, for example, we have patients that are like, Hey, Kristen, I went two weeks and didn't lose weight.
19:23
So they keep wanting to increase their dose.
19:25
And then they're like, well, I can't eat at all because now I'm nauseous every time I eat.
19:29
And so then I tell them like, We have to decrease the dose.
19:32
And if within our parameters of no side effects, the one to two pounds of weight loss, like GLP ones also don't work for everybody.
19:39
So I think that's also like, I have people at very low doses having side effects, and I'm not going to prescribe you Zofran to take every day.
19:46
That also slows down your gut to manage side effects of a GLP one, right?
19:50
So I would imagine that the person you're talking to, that's not able to eat.
19:54
Maybe like a reasonable size meal, you know, maybe they're only able to eat like a 600 calorie meal and they have to add some snacks in to get some of those calories up because we never want anybody to drop below 1800 calories and really prefer it to be even higher.
20:06
I would say, Hey, have you tried reducing your dose until your gut has tolerated it and then maybe go back up or be okay with slower results and stay on a lower dose without side effects.
20:17
So I would not be prescribing at that same dose if my patients are on the verge of throwing up with a meal.
20:23
And it's really interesting because I also have some people that I started working with that their doctor prescribed a GLP 1 and they basically, when they go, they are increasing it until they have side effects.
20:35
I'm like, but if you are feeling good and you're seeing results, like you don't have to increase it.
20:42
So that's kind of a concern I have is that we're just going to keep increasing it until we like, I feel like that's a great approach or they just like have the same protocol, like every four weeks go up.
20:54
So start at 0.
20:55
25, then go to 0.
20:56
5, then go to one, then go to 1.
20:58
25, then go to 2.
20:59
4.
21:00
Like some have like a copy and paste template where everybody just increases to the max dose, which some people in their mind believes that's the maintenance dose.
21:08
And to me, I'm like, no, I really don't want anybody to be on the max dose.
21:12
Right.
21:13
So yeah, I think there's a lot of mis prescribing or, you know, you read about this girl that's throwing up, you know, six times a day and never stops giving herself an injection and has gastroparesis and then has to go to the ER.
21:25
Right.
21:26
It's like, I think we also as society need to use some common sense.
21:29
If we're throwing up six times a day, Like maybe it's not the best option for us or the right dose.
21:36
Because I would say I am very, very cautious and mostly avoid if somebody has a history of gallbladder issues and pancreatic issues, because those patients are going to have a lot more nausea too, because of the way it slows down motility.
21:48
That's like the second mechanism of how it works.
21:50
It can be really hard on the gallbladder and pancreas.
21:52
So if there's underlying issues, they can be amplified.
21:56
So, Also with that patient that's throwing up and can't eat a whole meal.
21:59
Like, do you have a history of gallbladder or pancreatic issues?
22:02
Decrease the dose, or maybe you're not a good candidate for it.
22:05
It's my number one question.
22:07
Now, when I see people between the age of 30 and 40 in the hospital, we're there with gastroparesis, like, have you started taking a weight loss injection from a med spa?
22:18
And I can't tell you how often it's like, yes, I have.
22:21
I'm like, now your gut doesn't work right now.
22:25
It's like literally not working.
22:27
It's terrible.
22:27
No.
22:28
Well, and it's partly because it does slow down motility one, but two, if you're not eating at all, I think that stops working, right?
22:35
Like we make digestive enzymes in response to food, we make stomach acid in response to food.
22:41
So part of our digestive process is stimulated by chewing, right?
22:46
Like we know we look at food and we make salad.
22:48
We increase our digestive enzymes in our mouth or amylase.
22:51
We chew food and that signals our stomach to start making food.
22:54
More stomach acid and our pancreas to prep, right?
22:57
So if there's no food going in all day long, and these GLP ones are already slowing down motility, how are you going to eat one meal a day and expect your body to make these enzymes and stomach acid effectively and move the food through you?
23:09
Right?
23:10
Like, I just feel like so much of this, I just go like, we aren't designed to eat one meal a day.
23:14
That's 200 calories.
23:16
No.
23:16
And thrive.
23:17
You're not going to feel great either, by the way.
23:20
So you, you said the whole 1800 calorie thing, which I think a couple of people are going to hear that more than a couple and be like, Oh my God, but you talked about 1800 calories at least kind of like strength training, you know, really focusing on protein.
23:34
What would be your like, okay, this is what my, all my eggs that I want to make sure in the basket before starting a GLP one besides those, is there anything else?
23:43
There's been a lot of talk about fiber.
23:45
Yeah.
23:45
So we do, we aim for 30 grams minimum of fiber a day.
23:49
And then most of the time, some of the natural things that we haven't talked about yet in the supplement space.
23:54
So if you were to even take supplements aside, what's kind of interesting is there's some early research that pomegranate seeds are really helpful for making GLP one.
24:01
So pomegranate seeds have been studied to help with acromantia production, which is a bacteria that's been shown to improve metabolic health.
24:10
And so we believe this acromantia plays a role with GLP one and how do we make more acromantia.
24:16
More gut microbiome diversity.
24:18
How do we keep our gut microbiome diverse prebiotics, which is fiber, right?
24:23
This is food for the good bacteria in our gut.
24:25
And so you can't like, this is one of the huge things, like we cannot be on low fiber diets and be metabolically healthy.
24:32
And we see this a lot with like research on keto versus vegan.
24:36
It's like, what's the area that's affected the most keto diets drop fiber.
24:40
And so our gut microbiome suffers on that, right?
24:43
So we really aim for 30 grams of fiber.
24:46
We'll have patients start to play around with pomegranate seeds.
24:48
You can add that on top of yogurt in the morning.
24:50
You can throw it in smoothies.
24:51
You can just keep it in the fridge and take a couple spoonfuls.
24:54
We love diluted apple cider vinegar with water for post meal blood sugar and digestion.
24:59
And then we also use berberine is probably the one I've seen the most success with.
25:03
Berberine is our kind of natural.
25:05
You could call it natural metformin, natural GLP one.
25:08
But I've had people's sugar cravings completely go away with berberine.
25:11
I've had people be able to control their appetite better with berberine.
25:15
Some of that like food noise, binge eating disorder, that space.
25:19
Berberine has been really, really helpful PCOS.
25:21
It's been really helpful.
25:23
So we'll use berberine.
25:24
I also love butyrate and butyrate is one that I have to remind myself.
25:29
If I take it, I have to remind myself to eat.
25:31
I feel that decreased appetite that you get with the glp one from butyrate.
25:35
And if you guys don't know what butyrate is, it's a short chain fatty acid.
25:38
It's a, it's a Postbiotic that really feeds our gut microbiome, but also our intestinal permeability.
25:45
So it feeds the colonoscopies that line our intestines.
25:48
And so butyrate is really, really good for gut health and metabolic health.
25:51
So I'll usually do all the lifestyle things we've talked about with the strength training.
25:55
Making sure we're getting at least 30 grams of protein, really up our fiber add in the walking after meals, do the apple cider vinegar before meals, wear a CGM, start the Berberine, the butyrate I will do acromancia too, depending on how much somebody wants to do.
26:09
You can take all three of them.
26:11
That feels like a lot to me.
26:12
So we might start with one of them and then we track the fasting glucose, the insulin, the A1C.
26:17
Okay.
26:17
Sometimes when I meet with people, they went down from an A1C of 5.
26:20
8 being pre diabetic to 5.
26:22
5, but they're just starting to see a couple of pounds of weight loss.
26:26
I tell them you're on the right track, right?
26:28
You're becoming much more metabolically healthy.
26:30
We're not going to start a GLP one.
26:32
Like you just proved to me, we can do this now.
26:33
We just have to give it a little bit more time.
26:35
Yes.
26:36
Right.
26:36
So sometimes it's the, Encouragement for people that like, it is a journey and it takes a long time.
26:42
And we are very metabolically unhealthy in the U S we're really, we struggle with our metabolic health and our team, like our functional medicine providers, we have a threat all the time.
26:54
And they're constantly reaching out like anything new in the weight loss area.
26:57
Like this is, people are struggling everywhere.
27:00
Right.
27:01
And.
27:01
There's not a one stop, like, there's not a solution that's going to work for everybody.
27:06
And I think that's what we also need to understand.
27:07
And I find when people take an approach of actually loving their body and doing things that make them feel good, how much some of the weight loss comes from just the mental shift in that.
27:19
So.
27:20
You know, maybe just start with like positive affirmations on your mirror, like a sticker on there.
27:24
Like you are beautiful.
27:25
Like eat.
27:26
What makes you feel good?
27:27
Move your body in ways that feel great.
27:28
Like, I think this message needs to keep getting out that it's like health can be all different sizes too.
27:35
Yeah.
27:36
Yeah.
27:36
Yeah.
27:36
And I think people can struggle in all different ways.
27:40
And we talk about mindset a lot on here, pretty much every episode it comes up because I I don't think we realize how important it really is.
27:49
And if you're in this constant battle of, this was another client I was talking to where her doctor had recommended starting the semi gluten.
27:58
And she was like, I just don't want to do it because I don't want to take the easy way out.
28:01
I don't want to do this and that.
28:02
I'm like, well, if that's your automatic mindset around this, then you're not probably going to do well.
28:08
Like, let's not go into this, just being like, I'm just going to do this to cop out type of feeling.
28:13
And so I think One of the good first steps when starting a GLP wine is thinking about like, what is your mindset around this?
28:20
Like it doesn't have to be a cop out.
28:23
I think there's a good approach to it, which is everything that you've talked about today.
28:27
So any thoughts around that mindset when people are always like, It's, it's the easy way out.
28:32
Just take those in big, just take this.
28:34
Well, I mean, I think you guys probably all know my opinion on this.
28:37
It should never be an easy way out and it should never be the only thing we do like a GLP one.
28:42
I always tell people, I want it to be something in the background that you don't even think about that you're doing and still continue to do all of these lifestyle things we're talking about.
28:50
Right?
28:51
Like, I don't want us to even focus and dwell on it.
28:53
Like I want to keep doing all of the things we need to for metabolic health.
28:56
For mood, for energy, because I will tell you one of the things that I see, and we will have people re wear a CGM when they are on a GLP 1 because we don't want low blood sugar during the day either, because the one thing I will see as people's pregnenolones, which is a adrenal hormone, a master hormone, I'll start to see them decline.
29:15
And so I'm like, huh, what's going on with your nervous system and adrenal health.
29:19
And when I have them wear a CGM, some of them are dropping their blood sugar.
29:23
Like they're dropping a 50 when they're sleeping.
29:25
They're dropping a 50 in the afternoon.
29:27
And so we have to reuse that as a conversation of, are we eating enough?
29:31
Are you getting a carb, a protein, a fat, right?
29:34
So GLP ones can trigger anxiety for people.
29:37
They can trigger depression.
29:39
We've seen suicide rates increase.
29:41
And my belief on that is because people are not eating and their body's going into fight or flight and they're becoming anxious and their gut's getting off.
29:48
They've got microbiomes getting off.
29:50
Right.
29:50
So.
29:51
These, these cannot be used lightly and they cannot be just prescribed and I'll see you next year, like, we need a lot more tracking we need a lot more safety around them.
30:01
So, but I will tell you the people that have come in and like I've had people come in and tears that GLP ones have changed their life like I was at an ADHD.
30:10
And they're like, I can now focus.
30:11
Right.
30:12
I thought about what I was going to eat next, every single moment of every single day.
30:16
And they asked me, Kristen, have you ever thought about food every single moment of every single day?
30:19
And I'm like, honestly, no, like I eat my meals and I don't think about food for like four hours.
30:24
And I'm like, huh, I'm starting to get hungry again.
30:26
So I think, you know, some people, I can't imagine what it would feel like to wake up and be like, what am I going to eat?
30:31
What am I going to eat all day long?
30:33
It's there's a lot of food noise.
30:35
And I think our diet culture has led for that to be worse, right?
30:39
Because where you think about good food, bad food, and there's so much stress and pressure around food.
30:43
But I think that's, to me, Why I love these so much is because they really can be earth shattering when done correctly.
30:50
They'll start to see changes with the way they're working out, but the way they're eating, they start to see their body composition change for the first time they start to feel like, Hey, I'm at a party and I'm not feeling like I have to scarf my face on every single thing in sight.
31:01
Like I'm able to eat a plate of food and talk and not keep thinking of don't go back.
31:06
Right?
31:06
Like it's, There is a, again, some really, really good positives and there's a lot of negatives too.
31:13
Yeah.
31:14
I think like, cause I've had a couple of clients that have had to start taking it.
31:18
And I think it, it, they're excited in one way and then they feel defeated in another, like I just couldn't do it.
31:24
And my response is like, You shouldn't have to feel bad for needing help with something that's going.
31:30
Our bodies are all individual.
31:32
You've done the work.
31:33
It's okay if you need to be on one, just like it's okay if you need depression medication or ADHD medication or literally any medication for anything.
31:41
It's all about your mindset and how you use it.
31:43
And why, like, yeah, if you're using it at high doses to drop 40 pounds in a month, you're probably not in the right space, but if you're using it to really increase your health and you've tried everything good for you, like, let's do it.
31:53
I don't see why not.
31:54
So I think there's like stress on both sides.
31:58
And I just had a patient who's, we took a lot of particle size for cardiovascular health.
32:02
It's like a deeper dive in cholesterol, and they're small LDL particles.
32:06
I had a patient that went from 1400, it should be under 500 to 303 months of being on a GLP one.
32:13
And there's a lot of research that it decreases your risk of having a cardiovascular event, even if you're not diabetic.
32:20
So.
32:21
There is some huge research, even Alzheimer's, there's more research coming out because we refer to that as type three diabetes.
32:26
So some of these patients, their risk for Alzheimer's, cardiovascular disease is so high, you could take those risk factors out if prescribed safely.
32:37
It's all about informed, like informed health choices, really knowing what am I getting into?
32:43
What's the pros, what's the cons.
32:45
And then working with a provider, that's going to make sure that they're following you the whole way.
32:48
And not just looking at one marker.
32:50
When I see doctors just looking at weight and BMI, it drives me crazy because I'm like, we have to be thinking about everything else.
32:57
Well, and we had a, we sent one of our functional medicine providers to a functional medicine conference on weight loss.
33:04
And we were like, you need to go, let's hear what's new in the space.
33:07
And he said, almost all the functional medicine providers use GLP one to some degree, but not one person he met had any protocol around it, like how to measure the safety.
33:16
And so Kyle was like, Chris, and we've got to launch this, like how to use GLP one safely nationwide.
33:23
People aren't doing a consistent thing in practice.
33:25
And this is where the message gets lost, right?
33:29
You know, you just send them on their way to work up to one milligram and one milligram for someone maybe throwing up twice a day and not eating meals, but happy that they've lost 20 pounds, you know?
33:38
So That's not the goal.
33:39
No, not the goal.
33:41
Yes.
33:42
Well, I feel like we could honestly talk about this forever.
33:44
I think this conversation has been super interesting and you've answered a lot of our questions and a lot of our listeners questions.
33:50
I mean, we might have to have you come back for a part two.
33:54
I would love that.
33:55
I could talk about this stuff all day or any functional medicine topic.
33:58
I love adrenals.
33:59
I love it all the guy.
34:00
So yeah, if you want me to come back, adrenals is another big one.
34:05
A big one where you're like, Ooh, like high topic.
34:07
I love, I love adrenals and everybody asks me about this all the time.
34:10
Cause I, you know, my two kids, the three businesses I'm like, I love adrenal optimization and still living the life that you want.
34:17
Right.
34:17
Yeah.
34:19
Yes.
34:20
It's just being real intentional with a couple of things.
34:22
Like if this is the life I'm choosing to have, I gotta do that.
34:26
But yeah, so maybe, maybe we'll do that.
34:28
Cause I already like want to hop into it and that's not over.
34:31
Well, thank you guys so much for having me on here.
34:33
And next time my voice will be a hundred percent.
34:35
So hopefully everybody can hear me and understand me.
34:38
Some people told me that the hoarseness is sexy.
34:40
So I'm like, all right, we can go with that.
34:42
My sexy radio voice.
34:45
Thank you so much for doing this with us.
34:47
And we're happy Glad we were all able, able to hop on.
34:50
I didn't know if you knew this or not, but I'm actually pregnant and we're expecting a baby like any time now, any moment.
34:56
Like, congratulations! I thought I was gonna have to do this by myself because Bailey is like, I'm 4 centimeters dilated, 70 percent of face, and I was like, oh my gosh! Are you having contractions as we're talking?
35:07
I've had a few, but I mean, I'm still breathing through them, so I'm like, it's fine.
35:12
I texted her like an hour before and I was like, how are you feeling?
35:16
Are we having a baby or are we not?
35:18
Oh, thank goodness.
35:19
That's so exciting.
35:19
Is this your first?
35:20
Yes.
35:21
Okay.
35:22
I love everything.
35:23
Babies.
35:24
I love deliveries.
35:25
I love all of that.
35:26
So we can also talk about that when you are with your little baby at home.
35:29
Yes, absolutely.
35:30
We'll have to do that.
35:32
Best of luck to you.
35:33
I hope it all goes well and you would never know at all through the zoom.
35:37
I know.
35:38
Like in early labor, so.
35:40
Yes.
35:40
I mean, we just, we got a little belly here.
35:43
Aww.
35:43
She's so cute.
35:45
She just likes her little basketball belly.
35:48
It is adorable.
35:49
So yeah, I'm glad I was able to make it and thank you again for coming on.
35:52
We'll drop all your information in the show notes too, so people can find you too.
35:56
Awesome.
35:57
guys so much.
35:58
Good luck with everything.
35:59
Thank you.
36:00
Bye.
36:01
Bye.
36:01
Bye.
36:02
Bye.