From PCOS to PMOS; Why Hormones Are Not the Only Problem

Transcript

Okay, we are here at the Bell training and there’s a couple hundred clinicians here, about 400 people here in
between lectures with Doctor Smith. And a lot of people are asking, what is this PMO s thing? You moved from PCOS
to PMO? S and honestly, I really haven’t even had time to read some of the theories yet. So count on you to educate
us. Well, finally, PCOS is now poorly endocrine, metabolic ovarian syndrome. So PMO s so I’ve been talking about this
for years. I know you have too, but instead of just focusing on our ovary as the problem and our hormones, we’re
focusing on the whole metabolic system. Yeah. Because there aren’t a lot of women. What I found is with classic
PCOS don’t even have cystic ovaries. And then there’s some women that are not overweight. There’s n type. So
there’s all these different classifications which can confuse the picture. So the renaming makes a lot of sense. Yeah.
So and we’ve been talking about this forever. And I wrote a book earlier this year and we talked about it in the book
before this was a very classified, but there are six different types of PCOS. Some people are very lean, some people
don’t cast this thunder ovary. Some people don’t have high testosterone. But the problem is the metabolic
component. So the high insulin, the high insulin, the inflammation and the gut issues are what drive a lot of the
issues. So when your insulin is high, it’s going to affect your estrogen.
You’re gonna get inflammation, you get gut issues that’s going to affect your progesterone. And so we start getting
this cyclic issues in these hormonal issues. And we just blame our hormones when it actually it starts with your gut
and your insulin. And that’s what other issues. Well, and I think too, what’s interesting, you know, I’m thinking about a
patient that I had one time that before all this reclast, it was really many years ago when I understood that PCOS was
really a metabolic issue. And then we could talk about the gut because now the literature that’s coming out is like,
well, the etiology is really probably in the gut first. So which thing first? This is what your book is all about. But she
she was just normal body type. She didn’t look, you know, she wasn’t super scary or had a lot of, you know, mid-life
hair growth. That is possible. The one and only symptom she had was irregular menstrual cycles. And she was was
diagnosed with PCOS. And they she was trying to get pregnant. So when she was younger and not tried to get
pregnant, she was on birth control pills to manage the symptoms of her PCOS. No one ever lifted her again. No one
ever was looking at her insulin doses because they just assumed, because she’s thin, it’s not a metabolic issue. Right.
This is now, I love the reclassification, just making clinicians think.

But what’s crazy is another part that a lot of clinicians don’t understand. And you already mentioned it is that key
MOS or classical PCOS patients are very low progesterone. They took her off her birth control pills, put her on Clomid
so she could get pregnant and she got pregnant. And then she was like, you’re pregnant. She just happened to
mention to Judy and Casper. And because I knew that progesterone levels are low, I was like, let’s get your
progesterone level. It was a four. And she was like, hey, you pregnant? I was like, well, we need each other
progesterone or you’re gonna miscarry that. Oh, and then we got her on Jasper Burley and got it up to 24 and she
looked great. But there’s so much information clinicians don’t understand about this whole process. So break it down.
I mean, and I think two, if somebody comes to you and they’re having irregular cycles, there’s an issue. Yeah. And so,
you know, we blame it on all sorts of stuff, stress, thyroid. But a lot of times it’s you’re done, right? All of our
hormones are metabolized in our die. If we have a gut dysfunction, we start metabolizing our estrogen kick in
correctly and our progesterone incorrectly. And then our insulin levels go up and our cortisol goes up. And that
affects the production of our hormones. And so we just end up in this big metabolic mess like a dumpster fire.
Yeah. And people just forget to look at the actual metabolic clinic. And if you don’t fix that, you’re going to continue
to have these problems. And so for years, we’ve given people birth control because it regulates their cycles. It fixes
these symptoms. If somebody showed up T but it doesn’t take Cipro, right. And then when they get off the birth
control, we have a bigger problem because this metabolic dumpster fire has burned for years. Yep. Very, you know,
just kind of suppressed and suddenly just everything’s worse because birth control actually affects your dog, right?
And so what we really have to do is figure out what is causing this, what is driving this, and then fix it. And if you ask
people with PCOS or PCOS, most of them will tell you what, I lost 10% of my body weight, everything more or less
normal. Like I don’t know what happened, but as a context, it’s just not normal. Well, that’s because their fat cells are
adequate cells, which is part of the interbrain system, or should be stopped releasing toxic cytokines, which helps
lower their insulin, which then helps them make estrogen, which then lowers their cortisol, which helps they think
more progesterone. Now we’re circulating a hormone store gut correctly. Everything is better. Well, so, you know,
this is another big topic that’s really kind of trendy on social is all these young girls that are really now super
concerned about their lack of regular menstrual cycles and, you know, not really knowing what to do because
classical biology, a lot of times, if you must specialize this or mainstream, they kind of don’t really know what to do.
And great. I have a couple of friends that are gynecologists and they’re like, I don’t even know what to do with this.
They’re learning more and more when they’re paying attention to literature. But what is, you know, these young girls
that are having irregular menstrual cycles that are maybe they’re not married yet, or maybe they are married and
they’re looking they want to start having children or whatever. What what’s kind of what you think to you? What’s the
first thing you what they should do? Yeah, I think that’s a good question. Well, get a bunch of labs so you know what’s
going on, right? So I think evaluating your thyroid and, and not just your TSH, but your T3, evaluating your insulin,
evaluating your cortisol, evaluating all your results, and then also looking at your lifestyle, right? Like your symptoms
that you have when you eat. So your gut is a big part of it if you’re bloated and if your acne and skin breakouts, all
these things are symptoms. And so we need the, we need the lab evaluation. We need all the symptoms. Ideally, if
it’s a gut study, because then we can tell, are you metabolizing your estrogen or not? I mean, if you put it all
together, figure out where do we start doing some of these basic lifestyle changes.
You know, sometimes it’s not super sexy. It’s just like, you’ve got to get off your phone before you lay down at
midnight, and you’ve got to get eight hours of sleep and eat real food and see the sun and walk. Right. I love that you
sent it to because, you know, for years we’ve been teaching what it was classically PCOS. And before all this re
terminology that you have to address instead of resistance, address the gut, fix the thyroid and fix the low
progesterone. You could give some other medications to maybe some of the side effects of zestril or whatever. That’s
not going to fix the historical. I think most clinicians would prescribe like spironolactone or some androgen blocker to
block the systems. Again, one of the things we’re talking about here a lot this weekend is getting away from the
allopathic model of you’ve got to sent in the prescription to treat the symptom, but not getting to your root cause.
And I think that’s really where a lot of people are questioning like, okay, I don’t want to be on birth control pills. I
don’t want to be on spirolactone. I want to figure out what is wrong with me and I’m ready to have a baby, you know,
how can we have a baby? Right? And I think that is the key is right.

And the problem is if you suppress this and you don’t address it for years now, people are waiting to have babies till
later and later in life. And then you come off birth control at 33, and it may take a year or two for your cycles to
return. And then now we have insulin resistance. We have all these things he didn’t know. And, you know, I wrote in
my book the the birth rates in this country in 2023 hit like an all time low ever. And they just got more every year. So
it’s kind of scary. Yeah, it’s very scary. But you think this is on both sides, not just ppmos but also on the nail side and
enacted testosterone levels are lower than ever and not repelling nails. So if they don’t have that drive and that
desire to get out there and create it, rather sit, you know, gaming or something, I don’t know, whatever. I need my
our younger daughters or my now my youngest daughter, he’s the only one left, you know, was still not married. And
she’s just like, guys just don’t just, just not really interested. I wonder if they’re ever met. His testosterone is just
probably part of that. You know, this strains, the strains destroy our circadian rhythm. They destroy how we see the
world. Actually just did a podcast about a guy who talked about how screens and blue light actually can start to
change your eye muscles and your visual depth and perception of the world.
So it can literally affect your anxiety and or depression. And so you just have all these times on screens where it’s
changing the chemistry of our brain, and then our brain is stressed, and then that stress signal goes to our gut. And
then now we’re not making serotonin and dopamine, which affects our mood. And it’s like this vicious cycle of not
wanting to to do anything but play your video game. Yeah, man. Everybody should go to modern India and find
Doctor Kasey Smith and watch that podcast. It’s incredible. It is such good information. But I think a lot of people will
watch it because ignorance is bliss and they don’t want to know the truth. Want to know the truth? Go find it. You
know another thing that I was thinking about that I love that we classification is when we’re up here to Chicanos and
women that are, you know, in your 40s and they’re going through all these hormone changes and they’re we need a
pause or maybe they’re, they’re done having children and they look PCOS or PMOS but we’re not diagnosing them
that because they’re not wanting to have children. Right. So fertility is the issue, but we still have to treat them very
differently. So woman’s come in, she wants testosterone pellet therapy. She’s had irregular menstrual cycle. She has
a clinical patient where she kind of looks PMOSE, right? Maybe she’s got some midline hair, or maybe she.
But her testosterone is really low. What are some context clues that we should really kind of pay attention to? This
person, rather than just giving her the normal whopping dose of testosterone? Well, I think anyone who’s had issues
with their menstrual cycles, like you say, anyone who has a lot of gut symptoms has anyone who has a high insulin.
I’m always like, okay, do you have something going on androgen levels? Right. So I think symptoms are in the big
giveaway. Obviously, the whole lot of gut issues. I’m asking more questions. And then when you look at their labs,
like look at their insulin levels, if you’re worried about it, look at their D, g, a d, e, G, I s levels. But honestly,
sometimes with PCOS, these women, they do great with this. Often they just don’t eat as much, right? While you’re
simultaneously, but hopefully working on that on the diet. Another thing I’ve seen in these women is they’ll have a
low serum testosterone, but their free testosterone is higher than what I would expect. And that’s because your sex
hormone binding globulin is low, which is a dictator, right? And your free testosterone and also balancing elements,
right. So if their free is a little high, then give them some progesterone. If they eat that, if they’re not trying to get
pregnant. And if they are, do it in the back half of their cycle, but continuously and then trying to balance out their
estrogen, because we forget estrogen is really powerful.
Yeah, we want estrogen. So just trying to get all their hormones to balance ours is what’s really important. And a lot
of times to do that because our estrogens metabolizing through our gut is not working correctly. They’re just
dumping all their estrogen or not making it because their insulin through eyes. And that’s where you have to go back
and really hone in on the insulin and fix that so your body can make your estrogen and then also your gut metabolite.
Yeah. So what are your thoughts? I know you just released that great book, Fix Your Fix of Woman’s, but what are
your thoughts on like some literature that I’ve come across in 2020. Divide is really pointing to get this by SSD. The
root cause of PMS and even endometriosis. What are your thoughts on that? I think it’s very likely because there are
serving bacteria that are responsible for metabolizing our estrogen. Is our gut microbiome healthy. And and these are
the bacteria that then are going to is metabolizing our estrogen. Then we’re going to get the signal from our brain
Hainanese pork. So it’s like this whole cycle. And when you don’t have those bacteria and you’re not getting that
healthy reminder from your brain to make estrogen, your body kind of starts to stop. Same thing with your
progesterone.

So I do think that there’s a huge correlation. A lot of these girls with PMS also, if you talk to them, there are people
that are very stressed. They have a lot of anxiety, just a lot of stuff going on, which we also know that extra diet. So
everything that you feel and see and hear and vector dot. And so I do think that there’s a huge correlation between
what’s going on in your gut and what sort of Some doorman. Yeah. Disruption. And then, unfortunately, for years of
just getting these girls birth control, which destroys the bacteria, they need to fix it even more. So it doesn’t even
make sense. So now we’re not telling our brain to make hormones and we’re not telling our gut to recycle. So we’re
giving them a synthetic hormone that is not what they have. And then we’re like, well, why aren’t they getting better
now? And we wonder why certain cancers are on the rise and all that kind of stuff. So I’ve always been curious how
then maybe the reclassification will change the education on it, but it just doesn’t seem like endocrinology or
gynecology or even any ology really has ever had a firm grasp on PCOS. Unless you went to some advanced training
or you did some sort of integrative training or whatever. Why is that? What’s the dictionary? Well, I think it’s because
it spans so many body systems, right? So in medicine, we’ve compartmentalized everything.
The cardiologists want to take care of the heart, and the endocrinologists want to take care of your thyroid or your
diabetes in the primary care doc, you’ve got to look at this person as a cold because it does poly endocrin. I mean,
it’s multiple symptoms or systems, right? So it’s not only your hormones, but your insulin and your cortisol HPA axis.
And we’re talking about your gut and your fat cells. So I think it’s just nobody has really grasped it. And we just
haven’t had the research with gut. Like there’s not a good and I wish there was like a functional medicine gut. He had
a little shit. Yeah. Right. Okay. There’s an idea. There’s some idea. But I mean, if you had that, the crazy thing would
be like, we might not need all these other boxes. Because if you start there, then everyone’s really healthy. That
might be why you feel like every time you’re up there on that stage lecturing. And I kind of picked up on this too, or
somebody has a question, you’re like gut. I mean, gut hits the gut. It’s because for years I tried to treat people, you
know, their hormones correctly, and you can make them look perfect and you can get them everything. But people
don’t feel better. That’s right. And the question is why? Well, it’s because the hormones not getting into the cell
where Aids to go. Well, why it’s not that you’re not giving the women.
It’s not that the cell doesn’t work. It’s that the cell membrane door is blocked. Yeah, well, why is it locked? Because
you had an inflammation. Where is it coming from? Always the gut. Yeah. Because of our stress and our what we’re
eating and everything. Yeah. Some of it’s coming from fat cells. But mostly that’s coming from fat cells is directed
from the yacht because insulin is our signaling molecule in the gut. And then when it’s high, our cytokine levels are
going up. Just stressing our body out, telling our body to store everything is bad. Now our fat cells are releasing toxic.
I mean, it’s just this big literal dumpster fire. Yeah. Metabolic dumpster. Right. So there’s two things that you said
that I want you to kind of clarify, because I’ve heard you say it before and it’s so worthy. And to talk about for
listeners on both of our, of our sides is you’ve said multiple times that fat cells are full fledged endocrine cells. So talk
about what you mean by that Because, you know, again, we’ve moved so away from looking at obesity and
overweight because all this shaming, it’s not about shaming, it’s about living a long, healthy life. And, you know, even
just shifting the nomenclature to metabolic. And he knows I can hopefully open up the conversation. But talk about
what you mean by fat cells being endocrine in nature. They’re really an endocrine cell.
And you’ve also said that they’re really toxic, that a lot of toxic chemicals. So talk a little bit about this. If you can
kind of understand the role that excess adipose plays, also, fat cells are gonna regulate what happens in the binary.
So I think of an endocrine. Endocrine just means a hormone. And hormone just means I’m giving you a signal to do
something right. It’s kind of like the person that’s directing traffic at school or, you know, it’s, it’s, that’s what a
hormone is. It’s directing an action to be, I got it. And so your fat cells direct a lot of action that we don’t that we
don’t want it. And the reason is our insulin. So our insulin is going to drive food into our fat cell, which will meet some
of the energy storage. But the problem is our fat cells, most eagles end up really full and full of a lot of things. And so
then we have fat. As it breaks down, it releases bad chemicals. And so if you have a lot of extra fat, that’s just kind of
breaking down as it wants instead of as it really needed for energy, it releases bad. Simon toys, right. Inflammatory
cytokines and cytokines are a signaling molecule to our audiences. So when all of these fat cells are kind of letting all
this smoke up into the air, our immune system is like, oh my gosh, are there really 10,000 fires in your body or what
is going on? Are these.

Yeah, our immune system doesn’t know what to do because it’s supposed to go anywhere. There’s a fire. And what it
does is to kill bacteria and fungus. There are certain cells in our immune system that go to cancer when our cells
start to fold inappropriately and say, hey, this isn’t right. We’re going to eat you. Yeah, right. And but when you have
ten 000 smoke signals, it’s like, well, where do I go? Yeah, yeah. And the problem is 99% of them are just your fat
cells releasing toxic. You know, it’s almost like if you ate the wrong food and then this is kind of gross. But if you eat
really bad Mexican food and you’re releasing all this nasty gas because yeah, they’re all that great. It’s all the same
thing. And our emphasis, right? And so the problem is we also know that adipose tissue, the amount of adipose tissue
you have, obesity and age are the number one risk factors for cancer. And everyone’s getting cancer. It’s like, why?
Well, because we’re all fat sprite excess energy stored as fat. Absolutely. And so all these cells are releasing all these
toxic cytokines all the time. And cytokines, again, are a signal to your immune system that like, hey, come check this
out. Right? And so here comes your immune cell. And then it misses the actual cell that’s folding in correctly and
becoming cancer.
It misses the thing that you eat that makes you sick and misses, you know, so a lot of people who are overweight will
also tell you they’re sick all the time, that they get every, you know, URI or upper respiratory tract infection. And
they’re always sick. They get devonia. It’s because their immune system is putting out 10,000 small fires that aren’t
even real. It’s just their fat cells are releasing. So the point of fixing these metabolic issues is let’s go to these fat
cells. Let’s deplete them of some of these bad toxins that they’re releasing so that they are just holding energy when
you need it and releasing it as we need it. So you just have to rebalance the chemical signals in the cell. But it’s a
hormone. It’s an endocrine system because it is giving signals that hijacking our integration system. Obviously, we
talk about that with fertility for men and women, not just renin and ppmos. There’s probably a male version of Ppmos
that we have to label and really treat. And then there’s two other things I want to ask you about. One is this concept
of people that this myth that they think if they’re thin, they’re healthy. So we refer to the skinny fat. And really
basically what that means is you’re thin, but you have a lot of metabolic dysfunction. So dispel some of those myths
because these people don’t have a lot of excess adipose per se, but they metabolically look like someone who does
right? What’s going on there.
So maybe you’re lucky enough that you’re not super overweight, but still your insulin has been hijacked, your insulin
and your leptin. And so if you’re somebody who’s maybe eating things, you’re not supposed to be getting that are
hyper palatable, that cause our blood sugars to spike and make us make insulin. Or maybe you’re somebody who’s
just super stressed, you know, not sleeping enough on screens all the time. Again, that stress your gut will get access
to that by way of the vagus nerve. And then if you are, you know, some people just eat terrible food and eat once a
day. So it’s like, oh, from a calorie perspective, I only eat 1000 calories a day, but it is complete garbage and none of
it is good. So when you do eat, your body is releasing this giant amount of insulin. So those people are just as insulin
resistant, like they can’t metabolize the food that they’re eating because first of all, it’s garbage. Or second of all,
they’re so stressed, their body can’t actually get the nutrients out of it. And the signal they’re getting from their body
is like, oh my gosh, you’re dying. Yeah. And so everything that they’re eating is just really hard for them to get
nutrients out of it and then put it back where it needs to go. So these people become insulin resistant too, just from
the massive amounts of stress and cortisol.

And then when you have high insulin, again, it’s going to get the wrong signal. Yeah. It doesn’t give you the signal of,
oh, put all that food in your cells on muscle or put it in your liver so we can utilize it. It goes and says, okay, let’s put
all everything you ate. That’s us within those fat cells start up spewing stuff. Even though they might not be overly
full, you might only have 30 fat cells instead of 300. There’s still 30 fires that shouldn’t be there, and it hijacks your
immune system and it just gets worse. And so it is definitely a metabolic issue. One of the things that we teach to
obviously address PMOs is addressing this resistance. We do that in a couple of different ways besides the general
diet exercise, fix your gut, because I’m always curious of what came first, the gut dysbiosis and then the insulin
resistance or vice versa. It’s hard to say. Can he either. Right. But with your work that you did in your programs and
the research, you did get GLP ones. You were on the forefront of these allegations. And what are your thoughts on
the GLP and just transitioning, because we’re starting to see now that they’re being so utilized. What’s your opinion
on how they’re not being utilized? Well, and I’m seeing we’re creating a we’re trading one health problem for another
health problem.

And I’m seeing a lot more patients come to me. They’re on GLP one. And it got jacked up guys, and they got out there
and they’re using muscle. What’s your opinion on all of this and what we’re doing it. Yeah. So there is no there is no
magic pill. No magic pill. Your lunch is never free. Ever. Ever. So are they great medications? Yes. They help start to
reverse insulin resistance, but you have to do the work. So, like, my favorite quote is your health’s not owed its rent
and the rent’s due every. So it will help you do the work, but it’s not free. And so if you do this out of laziness and just
take these medications and don’t work on getting your body, not your guy. Yeah. Things don’t mitigate your stress.
Correct. Then you’re going to lose a lot of muscle as well, because in order to lose weight correctly, you need to be
moving your body so that your muscle can build itself and then utilize that extra energy to get, you know, take care
of your fat cells. But if you’re just taking something and starving yourself, the easiest thing for your body to do is eat
your muscle. Yeah. That’s easy. Break it. It’s harder for it to go get fat out of your fat cells. So unfortunately, a lot of
these people are losing weight, but they’re losing muscle because that signal, that insulin signal that’s been high
forever has made it where things don’t come out of our fat.
They just go in. And so things will continue to go in. So your body’s like, I have to have energy. So I’ll just break down
muscle because that’s easy. Yeah. And so if you’re not eating protein and you’re not moving your body and you’re
not doing things you’re supposed to be doing, your body will figure out a way to compensate. It just doesn’t want you
to die, but it’s going to do it at the fact that it’s eating your muscle. And then metabolically long term, that makes you
much worse. So you’re gonna stay on this medication, you’re gonna kill off one day, and your insulin is gonna go from
5 to 50, because now you have even less muscle and more fat. So it doesn’t. So you’re creating a lot of skinny fat
people. Yeah. And so the problem is that providers don’t know how to use it. I see patients all the time that come to
me and say, well, I got a line and I got a telehealth visit. Obviously, those things are going away. And somebody sent
me a bio and they told me to take five units for four weeks and then just keep doubling it every four weeks. And I’m
like, okay, well, who’d you follow up with that crap? Nobody. And like, how are these people not getting sued? Like
getting.
Shut down. Now that MTA is really going after a lot of these platforms that are not monitoring their patients
appropriately. For sure. And the big one just got shut down for selling online groceries out. And it’s not even not FDA
trials, right. It’s a fully illegal. I had another patient come in just this week that she’s going to a clinician and she’s in
her 70s. This patient, and she’s going to a clinician once a week and getting a shot of red alert in that office. I’m like,
where is she getting it from legally? And in Texas, you can’t legally dispense. So it’s really just covering. So a lot of
people are playing in the gray and black market here, which is what you’re talking about. And then the other piece of
it, even the clinicians that want to do it right and then really are monitoring their patients. I’m still seeing so many
clinicians not addressing their diet, not doing body composition, not seeing baseline, what their muscle is and how
much they’re losing over time, not making sure the patients are on some sort of pre-admission and other
supplements to make sure they don’t over, you know, lose their muscles are just not doing some of these basic
things and definitely not encourage anybody to get in there and lift some weights muscles, the currency of labs AG
you know. Yeah. And addresses sleep hygiene, which is so, so important. So GOP ones are great, but I’m predicting
that if we don’t get some really good GOP1 education, and we do that here with our permissions with buckle of all
teaches, I’m in that very systematized metabolic friendly way to a green musketeer lens. But if we don’t really get a
handle on this, we’re going to see a whole new crop of GLP one related diseases, I believe. But as an endocrinologist,
I just love European directive for current this stuff. Like what do you think? Yeah, no, I think that it has to be
responsibly.
Given.
When we studied it.
For diabetes, right. These people had maxed out the weight to lose, etc. and that’s a little different. I I think, though,
even some of the dosages that you use with diabetes are a little crazy. Yeah. But I mean, they’re very super
therapeutic. But I think if you’re trying to use it in more therapeutic dosing and it’s monitored and you’re looking at in
body scans, you’re looking at lab levels that it works. The problem is people are very impatient, right? So I had a
patient who came in this week, and she was on one milligram of tirzepatide in pretty low dose. And I, you know, I was
like, you need to stay there. Like you don’t need to be on a higher dose. But she got a little flustered because she
was only losing a half a pound a week. So she that’s sustainable, you witness. So she decided to give herself three
times that. And then even more than that, and then started developing all these side effects and then was like kind of
embarrassed or ashamed to tell me about it. And I was like, you know, it’s just frustrating. It’s like you didn’t gain
weight. Oh, in a way. Yeah. And you’re not gonna lose it in a week. And when you try to do that, you’re, I mean, it’s
it’s to have a scary. Uh, so I think that people just have to be realistic. Like I have realistic conversations with my
patients, hey, we’re going to be on this for six months and we may lose in six months, 12, 13 pounds and we’ll be
happy, but we’re gonna do it correctly and we’re gonna lose fat fast and we’re gonna gain muscle mass.

And I think people forget when you lose fat mass, but you gain muscle. I tell people, you gain 1 pound of muscle. It’s
like losing three gobs of fat. Yeah. So if you gain 1 pound of muscle, lose 1 pound of fat, you really lost like 5 pounds.
And that’s why I think the body composition skills are so important. Because if people can go, oh, I only lost 1 pound.
Okay. I’ve shown I’m like, but you lost 3 pounds of fat and you gained 3 pounds of muscle, like, you know, so it’s so of
course, then also, you know, water with water retention is a thing to keep it up. Right? And we gotta drink enough
water. You have to have enough electrolytes. Your body. I’ve, I’ve seen a lot of these patients when they’re basically
in starvation mode and their body’s just hanging on to food, hanging on to everything, you know, and they just form.
I also think people need to realize like, I didn’t feel. Yeah. So these people that leaves, you know, 2 or 3 blocks, but
they’re like, oh my gosh, my pants feel better. And I felt like I was talking to a lady yesterday and she’s like, well, I’ve
only lost 4 pounds, but I’m less tired and I’m sleeping better and I’m good because she literally just stopped eating
garbage.
Yeah, she literally got my book away for the first two steps, which number one is remove all sugar sweetened
beverages. And number two is remove all processed foods. So like just read those two. Just you’re not. She had lost 4
pounds in a month and she was like, no, I only lost 4 pounds, which is great, which is like, but I feel astronomically I
don’t need to change those. Yeah, I know, and I’m like, yeah, so that matters too, right? Like literally she was taking a
nap every day. She would put her kid down for a nap. And then she was like, I had to lay down or I could have kicked
you the recipe. Now she doesn’t have to do that. Like that’s you. So it’s, you know, knowing that the gut is the root of
a lot of evil Metabolic disease and inflammatory wise and knowing that the GLP one medications definitely slow
down, get utility. What do you do in your practice to try to help address and mitigate long term problems down the
road, like Sibo or certain bacteria overgrowth in the large because they’re just not moody, there’s not enough fiber.
What are the news? So we have a great I have a couple great nutritionists. I’m so thankful to have that. But they
really work with people on fiber.
Yeah. Making sure that we’re getting enough fiber, 35g is what’s recommended. Most people get tetanus, if that. So
we really work on fiber. We really work on hydration. So making sure that, you know, you need to get half your
weights in body weight in water, at least if you exercise probably closer to 75% of your body weight in water. So work
on hydration, we work on fiber, and then you work on literally removing processed foods and sugars. And after that,
it’s just like eat cold food. You know, those are huge things. And then listen to your body because these medications
are gonna make you full. So when you’re full, stop eating. Keep eating. When you’re full, we’re gonna have problems,
right? But if you eat really good whole nutritious food, I mean, we use supplements sometimes we’ll use. I love
Aquaman. Yeah. So like you’re a big sculpture. Oh, so but we use the codex. But the main thing is hydration, fiber.
Don’t eat crap, sleep and move. You sleep. And I’m full circle metabolic PMOS and you know, all of the metabolic
outcomes that can happen with, with that and utilizing dopamine. And I said, this extra time, she’s about to get up on
stage and teach all of these conditions. And they’re all about the gut and it gets relationship to hormones. And I
learned something new from her. I rsp thank you so much for hanging out.