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Why Am I So Fat? 9 Reasons to Consider

​That may seem like a harsh title, but I am asked that question almost daily in my medical practice.  ​People that struggle with their weight are desperate for answers.

​As most people would guess, diet and exercise ​​play a huge role in your ability to lose weight, but​ there are​ multiple other things ​also going on that are making ​it ​difficult for you to drop the pounds.

In this article, I will discuss 9​ commonly ignored reasons that anyone should consider if ​they are ​failing in their weight loss attempts.

These include thyroid issues, stress, poor sleep habits, insulin resistance, and many others…

More…

​9 Reasons That May Be Making Weight Loss ​Difficult

​Most Americans need to lose weight.  The latest statistics show that 7 out of 10 people are overweight or obese.  ​Interestingly,  only 36% of people think they need to lose weight.

If you are reading this article, ​I suspect that you need to lose weight but you don’t know how.

I’m going to discuss 9 reasons that may be a hurdle in your weight loss journey.  All of them may not apply to you and your specific situation, but chances are most of them do.

​1.  Standard American Diet

​Let’s start with the obvious.  ​What we are eating in America is slowly killing us.

If you don’t get your diet under control, nothing else that I discuss in this article will be enough to help you lose weight.  What you eat is the cornerstone for everything else.

As the percentage of Americans that are considered obese continues to skyrocket, so are conditions such as heart disease, cancer, and Type 2 diabetes.

A big reason why is obviously our diets.  Many people have chosen convenience over health.  Eating out has replaced cooking at home for a large portion of Americans.  This includes fast-food restaurants.

​Even if you choose “healthy” options from a good restaurant, you have no input on the quality of food that is served (for instance, grass-fed beef vs corn-fed), what kinds of oils are used, how much sodium and other chemicals are added, etc.

Our priorities are totally out of whack.

According to the USDA, almost 1000 calories per day in the Standard American Diet (SAD) come from saturated fats and sweeteners.  Fruits and vegetables account for only about 200 calories!

​The biggest source of calories comes from grains, which is a 45% increase ​from 50 years ago.  Not only that, the quality of the grains consumed has changed.  Read “Wheat Belly” by Dr. William Davis if you want to learn more.

Even more concerning is the fact that sugar consumption has gone from about ​40 pounds per person per year in 1900 to ​​over 100 pounds per person per year today!

Source: http://wholehealthsource.blogspot.com/2012/02/by-2606-us-diet-will-be-100-percent.html

Last but not least, about 2/3 of the calories in the standard American diet (SAD) come from food-like substances and processed food.  It’s not even real food!

http://wholehealthsource.blogspot.com/2012/02/by-2606-us-diet-will-be-100-percent.html

​Note that the typical SAD diet consists of about 2500 calories per day.  

Depending on your metabolic rate, most people burn about 1800-2000 calories per day.

While I don’t prescribe to or recommend the “calorie in, calorie out” model of weight loss, it ​only makes sense that if you continue to consume more calories than you burn each day, you aren’t going to lose weight.

This is especially true if you have some of the other issues going on that I will discuss in this article.

​So What is the Solution? –

You should immediately change to a nutrient-dense, high quality, real whole food diet.

As a general rule, I recommend the ratio of the macromolecules in your diet to be in these ranges:

  • check50-70% good, healthy fats
  • check20% protein
  • check10-20% carbohydrates

​A good starting point would be to start with one of these diets.  There is a ton of online information and recipes for each:

Whole 30 Diet

Ketogenic Diet

Paleo Diet

All these diets have been shown in studies to help with weight loss and reduce insulin resistance.

– Intermittent Fasting

​Another tool that can be extremely helpful with weight loss is intermittent fasting.  Learning when NOT to eat is just as important as learning WHAT to eat.

When used appropriately, intermittent fasting can actually INCREASE your resting energy expenditure.

I typically recommend 2 types of fasting:

14-16 hour fast – Eat an early dinner, then don’t eat again until lunch the next day. 

2 consecutive 24 hour fasts – For example, eat a good dinner on Friday night, then don’t eat again until Saturday night​.  You have 30 minutes to eat at that time.  Then don’t eat again until Sunday night.

Fasting is ​so effective that you need to be careful if you have severe adrenal fatigue or if you are diabetic and are on certain medications that increase insulin.  In these situations it can cause ​your blood sugar to drop to dangerous levels.  Talk to your doctor first and monitor your blood glucose closely.

​If you want to learn more about intermittent fasting, read my article here.

You may ultimately need the help of a knowledgeable nutritionist if you are having difficulty.

​2.  Lack of Exercise

​While there is no amount of exercise that by itself will get you to your goal weight, it can be an invaluable tool to help ​with your journey.

​Exercise has been shown to directly help ​reduce weight.  ​It has also been shown to increase growth hormone levels which increases lean body mass and ​results in weight loss.

Exercise not only helps with weight loss, it has been shown to increase cognitive function and overall quality of life.  It also reduces symptoms of anxiety and depression.

​It is important to know what ​KIND of exercise and how ​MUCH of it to do.  Too little of it will not have enough of an effect while too much exercise can actually be harmful.

If you have adrenal issues, even light exercise may exhaust you.  Get your adrenals functioning well first.

​If you are currently not exercising at all, then start doing ​SOMETHING.  A brisk walk for 15-30 minutes 4-5 days per week is a great start.  Let your fatigue level guide you on how much you can progress.

Ultimately, you will want to​ add high intensity interval training (HIIT).  HIIT has been shown to reduce abdominal and total body fat.

HIIT consists of doing all-out, maximum bursts of exercise followed by 30-60 seconds of recovery time then repeating the cycle 5-6 times.​

This can be done with any equipment you have (elliptical, treadmill, bike, rowing machine, etc), or even by jogging/walking or using a jump rope.

HIIT training only needs to be done 1-3 times per week for 10-15 minutes.  Yes, you have time for that!

If you want to lose weight, get started with an exercise program TODAY!.

​3.  Stress

​If you have ever read any of my other articles, you know that I mention stress as a factor in almost all medical conditions.

The fact is, stress undermines our health on multiple levels.  You will never reach your maximum health potential if you don’t learn how to better manage your stress.

When I say stress, I am talking about physical, emotional and mental stress.  This could include an injury or illness, work stress, relationship stress, death of a loved one, and many others.

Stress causes our adrenal glands to secrete cortisol, which signals the mitochondria in our cells to increase energy production to get us through that stressful time.

This is great for acute stresses, but bad when the stresses are chronic and continuous.

Cortisol has been associated with insulin resistance and leptin resistance.  It also promotes hypothyroidism.  All three of these conditions lead to obesity (I will discuss them more shortly).

​So What is the Solution?

Remove ​any stressors in your life that you can.  That may include changing jobs, getting rid of toxic relationships, ​or getting marriage counseling.

If there are major stressors that can’t be removed such as an illness in a family member, kid troubles, etc., you will need to work on improving your coping mechanisms.

​Ways of reducing your stress ​includes:

  • checkYoga or a similar relaxation exercise
  • check20 minutes of prayer or meditation once or twice daily
  • checkStart a hobby that you enjoy
  • checkCount your blessings and write them down
  • checkGo for a walk outside
  • checkDo something nice for someone without expecting anything in return
  • checkMake yourself smile everyday (even when you don’t feel like it)

If you feel you need more help on this subject, read my article on adrenal fatigue.

​4.  Poor Sleep Habits

Lack of sleep has been directly linked to obesity.  It increases inflammation in the body and causes weight gain.

Your quality of sleep directly impacts your melatonin level which increases your cortisol.  Your sleep quality also impacts your metabolism which affects your body weight.

You should be getting at least 7 hours of quality sleep per night.  When you wake up, you should feel refreshed and energized.

If that doesn’t describe you, consider making the following changes:

  • checkGo to bed the same time every night and get up the same time every morning
  • checkNo electronic screens (phone, computer, tv, tablet) for at least 2 hours before going to bed
  • checkKeep your bedroom cool and dark
  • checkAvoid stimulants (coffee, nicotine, decongestants) in the evening
  • check​Reserve your bed for sleep and sexual relations only

​If you are still having sleep issues, you should consider talking to your doctor about ​testing you for obstructive sleep apnea.  In this condition, the muscles in your throat and neck collapse as ​you fall asleep which in effect chokes you, sometimes dozens of times per hour.

Your brain has to wake you in order to overcome the muscle relaxation so that you can breathe.  As a result, you never get into the restful stages 3 and 4 of sleep which are required for you to be refreshed.

This may require you to undergo a sleep study, which will​ consist of sleeping in a sleep lab while you are monitored.  

If you have obstructive sleep apnea, you may need to sleep with a nasal CPAP machine which will keep the air pressure in your airway high enough t​o prevent your airway from collapsing while you sleep.

​If you can lose the weight you ​need to lose, there is a high likelihood that your sleep apnea will resolve and you will no longer need a CPAP machine.

If obstructive sleep apnea has been ruled out but you are still struggling with sleep, supplements may be necessary.  My favorites are below:

How to Supplement to Improve Your Sleep

Why I Like It

May help improve energy levels

May help to decrease levels of inflammation

May help reduce brain fog and mental slowness

Requires lifestyle change for best results

How to Tell if You Need It

    • You should be getting 8 hours of quality sleep every night.
    • If you find yourself waking up exhausted then you should consider checking for sleep apnea or a trial of the following supplements to improve sleep

How to Use

    • Take each supplement as indicated on the bottle or as recommended below
    • In addition to these supplements make sure you practice adequate sleep hygiene, that means: black out curtains for your bedroom, noise cancelling ear plugs, having a consistent sleep schedule, and avoiding all electronics 3 hours prior to your scheduled bed time

My Recommended Brand and Product

For minor sleep issues start with supplements containing 5-HTP which may promote proper melatonin production and induce sleep naturally (take 100mg 30 minutes before your scheduled bed time):

Get 5-HTP Here

For more difficult cases consider the addition of melatonin + 5-HTP, start with 1-3mg of melatonin and don’t be afraid to use melatonin if you need it.

Get 5-HTP and Melatonin Here

For more the most difficult cases consider using serotonin and GABA potentiators. These supplements help enhance GABA and serotonin neurotransmitters in the brain and help induce deep sleep.

Get GABA/Serotonin Potentiators Here

​5.  Thyroid Issues

​The statistics show that over 12% of the population is hypothyroid.  Some experts suggest that it could actually be closer to 40%.

​About 2/3 of people with thyroid issues don’t even know they have it!

Since the thyroid is the ​”metabolism factory” of the body, it only makes sense that people who are struggling with their weight may have an issue with their thyroid.

In my practice, I see people with undiagnosed and untreated or undertreated thyroid conditions several times a day.

The vast majority fit into the following 3 categories:

– Hypothyroidism

​The thyroid should always be one of the first things assessed in someone who is overweight.

That is especially true if the person also has many of the other common symptoms seen in hypothyroidism – fatigue, constipation, cold intolerance, hair loss, brittle nails, etc.

​Only checking the TSH blood test may miss a large percentage of hypothyroid patients.

That is why you need to ask for a complete thyroid panel:

​If your doctor is unwilling to ​run all of these tests, I would STRONGLY suggest you find a doctor who will.  Your thyroid status cannot be fully evaluated without them.

Read more about how to interpret your results in my article here.

– Hashimoto’s Thyroiditis

​Hashimoto’s is the common name given for autoimmune thyroiditis.  

It is estimated that up to 10% of the population has Hashimoto’s.  It is 7 times more common in women than in men.

​Some experts estimate that Hashimoto’s is the cause of up to 90% of hypothyrodism.

That’s why it is important to have your thyroid antibody levels checked if you are hypothyroid.  If either the TPO antibody level or the thyroglobulin antibody level is >35, the diagnosis of Hashimoto’s can be made.

Hashimoto’s can cause the same symptoms that you see in hypothyroidism (including weight gain), but it may have some additional symtoms as well.  These include joint pain, muscle aches, throat swelling, and even low grade fever.

​Click here to learn more about how to treat Hashimoto’s thyroiditis.

– Reverse T3 Dominance

​Reverse T3 is an inert hormone that is made normally by the ​body in small amounts.  

It binds to the thyroid receptors on the cells of the body, but it does ​it has no function.  In effect, it serves as a “brake” for our metabolism.

​It is another way that the body can regulate its own metabolism.

In acute situations (such as an infection or injury), it helps the body to reserve its energy stores by lowering the metabolism.

​However, many people have chronic inflammation in their body due to things such as obesity, insulin resistance, leptin resistance, poor diet, etc.  All of these conditions cause the reverse T3 level to be chronically elevated, which is called reverse T3 dominance.

​When this occurs, the TSH and T4 levels may be normal, but the elevated reverse T3 ​blocks the action of the active T3 on the cells of the body.  Hypothyroidism at the cellular level results.

The above labs are from one of my recent patients.  If you just looked at the TSH, it would show that she has normal thyroid function.  The free T3 and reverse T3 tell the true story.

If your reverse T3 level is >15 or if your free T3 to reverse T3 ratio is ​< 0.2, you have reverse T3 dominance (also called thyroid resistance) that needs to be addressed.​​​

Read my article on Reverse T3 Dominance to learn more.

​6.  Metabolic Damage from Yo-yo Dieting

​Most people that I know ​who struggle with their weight have tried tons of different diets.  Some have worked, some haven’t.

Many of these diets such as the HCG diet require severe calorie restriction (as low as 500-600 calories per day).  

This severe calorie restriction can damage your metabolism for many years and make it impossible to lose weight and keep it off.

The typical story goes like this – the first time they went on the diet they lost 40 pounds, the next time 25 pounds, then next time 10 pounds, then next time none at all.

​The​se diets cause this by​ re-setting your basal metabolic rate.  Instead of burning ​the usual 1800-2000 calories per day, after severe calorie restriction, your body may only burn about 800 calories per day.

That’s why you eat less than anyone else you know but still gain weight.

Never go on a severe calorie-restricted diet or recommend any friends or family to do it.  It can be devastating to your body.

Correcting this can be very difficult and will require the help of a knowledgeable doctor and/or nutritionist. It will most likely take a long time to fix.

​7.  Insulin Resistance

Insulin is a hormone made by the pancreas.

Its function is to bind to ​glucose (sugar) in the bloodstream and carry​ it into the cells where it can be used for energy production.  It also carries the glucose into the fat cells and liver cells where it is stored to be used later.

With insulin resistance, the process doesn’t work like it should.

​When people eat a diet too high in sugar (as in the standard American diet), the cells in the body become so bombarded with the sugar that it can become toxic to the cells.

As a protective measure, the cells down-regulate the insulin receptors, meaning it reduces the number of insulin receptors that are available for the insulin to attach.  As a result, the insulin level in the bloodstream increases (as does the sugar levels).

Eventually, the sugar level increases to the point that it measures high on a blood test.  Pre-diabetes or diabetes is then diagnosed.

In other words, diabetes is really just advanced insulin resistance.

Having high levels of insulin is bad in many ways.

​Insulin causes us to gain weight by increasing the size of our fat cells.

​Insulin is one of the most inflammatory substances in our body​.  That inflammation increases our cancer risk.  ​Insulin resistance has been shown to be directly linked to thyroid disorders which also results in more weight gain.

A hemoglobin A1c level > 5.3 is suggestive of insulin resistance.  A total fasting insulin level >5 also indicates insulin resistance.

Anyone who has the diagnosis of pre-diabetes or type 2 diabetes by definition also has insulin resistance.

To learn more about how to diagnose and treat insulin resistance, read my article here.

8.  Leptin Resistance

What in the world is leptin resistance? 

In order to understand leptin resistance, you need to understand the function of leptin.

Leptin is a hormone made by fat cells.  Yes, they do more than just make ​our clothes to not fit!

Leptin is our “satiety” hormone.  It’s primary function is to signal to our brain that we have plenty of fat stored in our body and we don’t need anymore.

The brain then increases our metabolism and reduces our hunger until the leptin levels drop.

In leptin resistance, something happens that is similar to what happens in insulin resistance.  Our brain becomes desensitized to the high leptin levels and basically ignores the signal.

As a result, our metabolism becomes locked in the “low” setting and our hunger sensation stays locked in the “high” setting, a perfect storm that results in weight gain and obesity.

The weight gain results in more fat cells which results in more leptin production, and the cycle feeds itself (literally!).

Leptin resistance typically occurs simultaneously with insulin resistance.

Leptin resistance also triggers an increase in reverse T3 production (reverse T3 dominance) that also results in weight gain.

Leptin resistance is diagnosed by checking a serum leptin level.  If it is >12, the diagnosis can be made.

​Long term successful weight loss will not be possible until the leptin resistance is treated and eradicated.

Click here to learn more about leptin resistance and its treatment.

​9.  Unresolved Emotional Issues

​If you have ever watched a show where they follow ​people on their weight loss journey, a common theme emerges.

They lose a little weight, then the weight loss stops.  They ​don’t begin losing weight again until they have a “breakthrough” regarding a​ trauma​ from their past.

Emotional, physical, and mental trauma from childhood has been shown to affect eating habits and it is directly linked to obesity in adulthood.

Many of these traumas may have been locked away in your brain.  You may not recall them, but they may be subconsciously sabotaging your life in many ways.

This may or may not be playing a role in your particular situation, but you owe it to yourself to deal with any past trauma if you have any.

I strongly recommend ​that anyone struggling with their weight should see a licensed professional counselor to ​assess if ​they have any past issues that need to be addressed.

Seeing a counselor is a sign of strength, NOT weakness.  It means you love yourself enough to deal with any issues that are impacting your quality of life.

​Summary

​50% of the US population is either overweight or obese.

Many reasons are to blame.  While diet and exercise play a major role, hormonal and metabolic issues are most likely involved as well.

If you can’t lose weight, it is important for you to consider and address your diet, exercise, stress level and your sleep quality.

You should also be tested for any thyroid issues, insulin resistance, and leptin resistance.

If you have a history of severe low calorie dieting, your metabolism may be damaged which will require long term, intensive treatment.

Finally, you need to address any past trauma in your life to finally release its grip on you.

​Now it’s your turn…

​Have you ever asked the question in this article title?

If so, what has helped you with your weight loss?

What have you tried that didn’t work?

Leave your comments below…

The Best Natural Treatments for PCOS

​If you have PCOS (polycystic ovarian syndrome), you know how hard it is to treat.

​You were probably told to “lose weight.”  Easier said than done.  You were probably also told to cut back on your sweets and carbs.

You may have even been prescribed metformin, which is a medication for diabetes.  Or perhaps a birth control pill or an antidepressant.

​Like most health problems, if you truly want to have success at reducing or eliminating your PCOS symptoms, you must get to the root causes instead of just treating symptoms.

​In this article I will discuss PCOS, what causes it, common symptoms associated with it, how to diagnose it, and several natural treatments that can help you manage it.

Here we go…

More…

​What is PCOS?

​PCOS (polycystic ovarian syndrome) is a combination of several hormonal imbalances in women​.  The symptoms that you have depend on which hormones are out of balance and to what degree.

Most PCOS patients have the following hormonal imbalances:

Not all women will have all of these hormone imbalances, but most PCOS patients will have 1 or more of them.

​The primary culprit of all of these hormone imbalances is insulin.  

Insulin resistance develops which starts a chain reaction that results in all of these hormonal issues – high testosterone, high estrogen, low progesterone, and ​leptin resistance.  The symptoms of PCOS then follow.

These imbalances commonly result in the development of metabolic syndrome, which is a group of risk factors that increase your risk for heart disease, diabetes and stroke.

These hormonal imbalances prevent the normal ovulation cycle.  ​As a result, multiple immature follicles or cysts develop in ​the ovaries which can be seen on ultrasound, which is where the name polycystic ovarian syndrome ​originated.

​Common PCOS Signs and Symptoms

​​If you have PCOS, the symptoms you have will depend on ​WHICH hormones are out of balance and how ​MUCH they are out of balance.

​Some of the more common PCOS symptoms include:

  • Excessive Hair growth – Caused by excess testosterone and insulin resistance
  • Weight Gain (even when eating well and reducing calorie intake) – Caused by a combination of leptin resistance, insulin resistance, and hypothyroidism
  • Menstrual Irregularities – Caused by an imbalance in estrogen and progesterone
  • searchMultiple Ovarian Cysts – Caused by an imbalance in estrogen and progesterone
  • searchHair Loss – Caused by hypothyroidism, nutrient deficiencies, and androgen/testosterone excess
  • searchDepression and Mood Changes – Caused by hypothyroidism and sex hormone imbalances
  • searchFibrocystic Breast Disease, endometriosis, PMS – Caused by excess estrogen and/or low progesterone
  • searchInfertility – Caused by hypothyroidism and low progesterone

​How to Diagnose PCOS

PCOS is diagnosed if you have at least 2 of the 3 conditions:

1.  Absence of ovulation, which leads to irregular menstrual periods or no periods at all.

2.  High levels of androgens, or signs of high androgens, such as excessive body or facial hair.

3.  Cysts on one or both ovaries.

​If you are having some of the symptoms that we have discussed, it is reasonable to assume you either have PCOS or are in the process of developing it.

​Natural Treatments for PCOS

The conventional approach to treating PCOS is to mask the symptoms.

This may make you feel better in the short term, but it does not result in long term improvement.

My conventional training taught me to treat PCOS patients with oral birth control pills, metformin, and anti-depressant medications.

While none of those treatments are bad in and of themselves, most of them don’t get to the root cause of the issues.

Birth control pills ​artificially regulate the estrogen and progesterone levels, but ​they don’t address the ​cause of the imbalance that is preventing you from having a period in the first place.

Anti-depressants may help you sleep better and will help control your mood swings, but it doesn’t address the hormonal imbalances that ​are the cause of the moodiness.

Metformin has some practical use ​for treating insulin resistance.

If you decide to t​ake these medications for a short time to control your symptoms while you make the other changes I discuss, that is reasonable.  

However, PLEASE don’t let these symptomatic treatments be the ONLY thing you do for your PCOS.

​The sooner you can begin reversing the hormonal imbalances in your body, the sooner you can begin feeling better and avoid the future complications brought on by the imbalances.

If you remember anything from this article, please remember this:

All women that are diagnosed with PCOS should be treated for insulin resistance.

To read more about insulin resistance, please read my article here.

Every treatment that I discuss below focuses on reducing the insulin resistance in your body.

You will need to aggressively do ALL of the things discussed.  Doing only 1 or 2 of them will most likely not be enough to give you the improvement you are seeking.

​1.  Change Your Diet

​Changing your diet will not by itself completely reverse the symptoms of your PCOS, but nothing else will ​work if you don’t address your diet.

​So what dietary things can you do to treat your PCOS?

Let’s start with some basic guidelines that are helpful for almost any health condition:

  • Eat whole organic-based foods
  • Avoid ALL processed foods
  • Eliminate sugar from your diet
  • Avoid most gluten and dairy-containing foods (some people can eat more than others)
  • Not ALL carbs are bad (but most people eat way too many)
  • There are times you should eat and times that you SHOULDN’T

​These guidelines can be applied to whatever diet you choose.

All of these diets should be looked at as a starting point only.

Every person is different and may require slight modifications for their particular situation.

For example, someone with severe adrenal fatigue many need a higher ratio of healthy carbs than the diet suggests.

With that in mind, the following diets are approved for patients with PCOS:

​I would strongly suggest hiring a nutritionist or health coach to help with your diet.

It can be very difficult and confusing to monitor your macromolecule ratios and make appropriate adjustments depending on your particular situation and symptoms.

​Your diet will require some adjustments along the way that would best be monitored by a professional.

​2.  Exercise the Right Way

​Exercise is critical to help reverse the hormonal imbalances of PCOS.

However, not all exercise is created equal.

Doing the right ​KIND of exercise and the right ​AMOUNT of it is vital.

Some forms of exercise such as walking on a treadmill for an hour may have very little impact on weight loss and hormone changes that are needed in PCOS.

​There are 2 ​things regarding exercise that you should focus on when trying to reverse your PCOS:

1.  Shorter and more intense exercises

2.  Building up more lean muscle mass

​I have mentioned high intensity internal training (HIIT) in several of my articles.  It is an outstanding treatment for PCOS.

Why?

Because it helps reduce insulin resistance.

​As a reminder, insulin resistance is the primary root cause of PCOS.  If you want to reverse your PCOS, you must address the insulin resistance.

Increasing your lean muscle mass is also very helpful for PCOS because it increases your resting metabolic rate.

When exercising, it’s important to match your level of exercise with your level of energy.

Over-exercising can be as harmful as not exercising because of its impact on cortisol levels.

3.  Manage Your Stress

​Stress may be the most overlooked cause of health issues that we have, yet it is one of the most important to address.

​I’m not just talking about the severe forms of stress – divorce, loss of a loved one, severe sickness or injury, etc.

The daily stresses also take a toll on your body – traffic jams, family conflict, job issues, kid issues, and others.

These stresses affect our cortisol levels which can cause bad things to happen in our body.

Stress has been found to be associated with the following:

Weight gain

​- Hormonal imbalances

Autoimmune diseases

Premature death

Most people think stress is just “a way of life” and there isn’t much they can do about it.

That just isn’t true.  We can do a lot to reduce the negative effects stress can have on our lives.

Here are some things that you can do to help you better manage your stress:

  • ​Listen to music that activates delta waves prior to sleephttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3374921/
  • Get 8 hours of quality sleep EACH night
  • Eliminate toxic relationships from your life
  • 20-30 minutes of yoga or meditation every day
  • 1-3 days of quality exercise each week
  • 30 minutes per day of activities that you enjoy and relax you
  • Mentally change how you manage stress and how you internalize it
  • Consider hiring a life coach or health coach

Pick at least 1 or 2 of the things above and start doing them each and every day.

You won’t get healthy until you address your stress and improve how you manage it.

That is true for any health issue, not just PCOS.

​4.  Decrease Inflammation

​Inflammation in the body is the root issue of almost all diseases.

That is true for PCOS as well. ​

Inflammation leads to insulin resistance, leptin resistance and weight gain.

It also worsens hypothyroidism by increasing the production of reverse T3.

​As I have already discussed, PCOS is caused by inflammatory conditions such as insulin resistance and leptin resistance.

To make matters worse, PCOS leads to increased inflammation which will itself worsen the hormonal imbalances, thus creating a vicious cycle.

So what can you do about it?

Check your inflammatory markers (CRP and ESR).  If they are elevated, begin looking for possible sources of the inflammation.

If you can find the source, you can work on eliminating it which will help to balance your hormones.

Some common sources of hidden inflammation in the body include:

1.  Undiagnosed low grade food sensitivities

2.  SIBO or other intestinal overgrowth issues

3.  Chronic infections -EBV, CMV, H. pylori and others

4.  Standard American Diet – high in processed foods

5.  Autoimmune Conditions – Hashimoto’s and others

6.  Hormonal Imbalances – these alone can be bad enough to raise the inflammatory markers

​5.  Use the Right Supplements

​Supplements should be a cornerstone in the treatment of PCOS.

Be very careful and selective with which supplements you consider using.

Make sure you get them from a reputable source.  Not all supplements are created equal.

Supplement manufacturers are not under as strict of regulation as pharmaceutical companies.  That’s why it’s critical that you buy only from good companies that self-regulate themselves.

​Make sure you focus on the following areas when choosing your supplements:

  • Reducing and reversing insulin levels
  • Reducing inflammation
  • Reducing leptin levels
  • Reducing androgen and testosterone levels
  • Improving the metabolism of estrogen

​I will quickly go through each of these and give you my recommended brands for each supplement.

Supplements that Help Lower Insulin Levels:

  • Alpha Lipoic AcidALA helps reduce insulin resistance and lower blood sugar levels.  Use up to 1800mg per day in a sustained release form for best results.  Use up to 6 months.
  • Berberine Berberine can lower the A1c as much as metformin.  It also helps with weight loss in patients with insulin resistance.  Use up to 2000mg per day for up to 3 months for best results.
  • GlucomannanThis is a viscous fiber that reduces carbohydrate absorption and helps you fill up faster with results in weight loss.  Use 4 tablets 15 minutes before a meal for best results.
  • Krill oil + Astaxanthin Fish oil can reduce insulin resistance by lowering inflammation and leading to weight loss.  It can also increase lean muscle mass.  You will need 2-4 grams per day to get this benefit.

​Supplements that Help Lower Estrogen and Estrogen Metabolites:

  • DIMhelps reduce the conversion of testosterone into estrogen, plus it helps the body metabolize estrogen through the least estrogenic pathway.  Use up to 300mg per day for up to 3 months.
  • Calcium D Glucarate – increases liver metabolism of estrogen and androgens.  It can also increase the elimination of endocrine disruptors.  Use up to 3000mg per day.  

Supplements to help lower testosterone:

  • Zinc + Saw Palmetto – Zinc and saw palmetto help reduce the conversion of testosterone into its active metabolite DHT.  This can help reduce acne, hair loss and mood swings.  Use 60mg of zinc and 600mg of saw palmetto together daily for best results.

​6.  ​Monitor All of Your Hormones

​Remember, PCOS is usually caused from several hormones becoming imbalanced in the body.

Don’t get stuck on just thinking about the sex hormones (estrogen and progesterone), since they seem to cause the majority of symptoms.

Consider monitoring these hormones as well:

  • Leptin ResistanceCheck your fasting leptin level.  If you are overweight and your leptin level is above 12, you have leptin resistance.
  • Insulin Resistance a fasting total insulin level > 5 is indicative of insulin resistance.  This should be your primary focus when treating your PCOS.  Lowering your insulin will help to normalize all of the other hormone levels.  
  • High Testosterone – check the free and total testosterone levels.  Most PCOS patients have high free testosterone and often normal or slightly high total testosterone levels.
  • Cortisol check your am cortisol level.  Normal ranges are 14-16.  Any level above or below this indicate adrenal issues and could be affecting your energy levels.
  • Hypothyroidism  Hypothyroidism and PCOS are closely linked.  Make sure you get a complete thyroid panel (TSH, free T4, free T3, reverse T3, TPO antibodies, thyroglobulin antibodies) plus a sex hormone binding globulin level. 
  • Low Progesterone – PCOS patients commonly have very low progesterone levels which should be addressed.  

​7.  ​Consider Prescription Medications

​I am all for doing as much as we can naturally to keep our bodies running smoothly.

However, there is a time and a place when prescription medication may be necessary.

Think of PCOS as a spectrum.  On one end the hormonal imbalances are relatively mild.  Making the lifestyle changes and using the supplements I have discussed may be enough to reverse the condition and improve symptoms.

On the other end of the spectrum, the hormonal disruptions are severe.  

Lifestyle intervention​s and natural treatments may improve symptoms to some degree, but they may not be enough to fully reverse the condition.

In those cases, it may be necessary to consider medications to treat the insulin resistance, leptin resistance, and sex hormone imbalances.

You will need the guidance of a knowledgeable doctor to walk you through these treatment options.

​Summary

​Polycystic Ovarian Syndrome (PCOS) is a syndrome ​caused by several hormonal imbalances in the body.

These include elevated androgens, insulin resistance, low progesterone, and leptin resistance.

Rather than just treating the symptoms, it is important to identify the root causes and address each specifically.

All PCOS patients should be treated for insulin resistance.

Like most conditions, diet, exercise, stress reduction and proper supplementation are foundational to treatment.  Medications are sometimes needed as well.

​Now it’s your turn…

Have you been diagnosed with PCOS?

What treatments have you tried?

What has helped?  What hasn’t?

Leave your comments below.

How to Treat Insulin Resistance

​Have you been diagnosed with insulin resistance, pre-diabetes, or even diabetes?

​Even if you haven’t been diagnosed with insulin resistance, there is a good chance that you have it and don’t even know it.

Insulin resistance is primarily a dietary disease – what you have been eating has played a major role in causing you to have this condition.

The good news is that by changing what you eat and how you live, you can ​make major strides in reversing this condition.

​In this article I’m going to discuss a comprehensive approach on how to treat insulin resistance.  

This will include a proper diet, activity level, supplements, medications, and much more…

​What Is Insulin Resistance?

​In order to understand insulin resistance, it’s important to understand what insulin is and what is does NORMALLY in the body.

​Insulin is a hormone that is secreted by the pancreas.

When we eat a meal that contains glucose (sugar), the pancreas is signaled to secrete insulin​ into the bloodstream.

The insulin will attach to the sugar and move it into the cells where the sugar can be used as fuel for energy.

It also moves the sugar into fat and liver cells where it is stored to be used for fuel at a later time.

That is how things should work.

​With insulin resistance, things get messed up.

​When we eat too much sugar (which is most people in the US), the cells get bombarded with so much sugar that it can be toxic to the cells.

To protect the cells from this toxic load of sugar, the cells downregulate the insulin receptors.

In other words, they reduce the number of channels that the insulin ​can use to enter the cells, kind of like locking several of the doors that ​go into your house.

The results?  Insulin is not as effective, so the pancreas releases even more of it and the blood sugar level gradually increases.

The process gradually worsens over time.  Your insulin and blood sugar levels continue to rise until someone checks your blood sugar and diagnoses you with pre-diabetes or diabetes.

Has this happened to you or someone you know?

The shocking part is this process is occurring right now in about 50% of the people in the United States.

​This is an epidemic that must be addressed.

By the way, when discussing diabetes in this article, I am referring to Type II diabetes.

Type I diabetes is an autoimmune condition where the body’s immune system attacks and kills the cells in the pancreas that produce insulin.  Those folks therefore don’t make enough insulin and must take insulin shots for the rest of their lives.

​Insulin also does a lot of other really bad things​ as well.

It is one of the most inflammatory substances in our body.

​Insulin causes cancer.

​Insulin causes us to gain weight by increasing the size of our fat cells.

Insulin increases our risk for heart disease​ and Alzheimer’s Dementia​ as well.

​Are you beginning to see why it is so important to keep your insulin level as low as possible?

​How Do You Know If You Have Insulin Resistance?

​There are a few symptoms that can indicate that you may have insulin resistance.  

They include:

  • checkBelly fat
  • checkFrequent cravings for sugary foods
  • checkIrritability when going long periods without eating
  • checkDizziness and lightheadedness between meals
  • checkInability to lose weight

​There are also a few lab tests that are very helpful in diagnosing insulin resistance.

​Ask your doctor to order these tests:

1.  Fasting ​insulin level – should be < 5

2.  Hemoglobin A1c – should be < 5.3

3.  Fasting blood sugar – should be < 85

4.  Possibly a 2 hour post-meal glucose level – should be < 120

If any of these labs are higher than these optimal levels, you have evidence of insulin resistance and you need to incorporate the treatment recommendations that I will discuss below.

It is critical to your long term health!

​How To Treat Insulin Resistance

​Now that we have identified that you have insulin resistance, let’s discuss treatment options.

One of the biggest issues with treating ​diabetes is that the current treatment recommendations of ​many conventional medicine organizations ​focus purely on lowering blood sugar and do little to address insulin resistance.

​A large part of their recommendations, especially in regards to diet, ​are obsolete.  New research has shown that a lot of what we thought was true isn’t anymore.

​For example, the American Diabetes Association still recommends multiple portions of carbs from grains and other sources daily, then using insulin to keep the blood sugar levels low.

This is recommended despite that fact that studies show that simply​ lowering blood sugar levels has no benefit in reducing mortality.  In fact, adverse events are actually INCREASED due to increased episodes of low blood sugar (hypoglycemia).

That is unfortunate because by the time the blood sugar is high enough to get the attention of most doctors, the insulin resistance has probably been around for quite awhile and has been causing problems.

Diabetes is really just advanced insulin resistance.

In my own practice, I had a patient that presented to my office complaining of uncontrolled diabetes with glucose levels running in the high 200s.

​I put him on a whole food, low carb diet.  However, he really didn’t ​want to change his diet, so he requested that I send him to a certified nutritionist at a local hospital.

​The nutritionist actually told him that he wasn’t eating ENOUGH carbs and increased his carb intake substantially!

A month later, he called back to my office complaining that his blood sugar had gone up into the 400s!

That is why it is important that you do your homework and learn as much as you can about insulin resistance and how to reduce it.

You are in charge of you!

Insulin Resistance and Weight Loss

​You will never lose weight unless you get your insulin resistance under control.

That is because when your insulin levels are high, your body is unable to burn your fat cells as a fuel source.

The burning of fat cells in the body is controlled by an enzyme known as hormone sensitive lipase.

​This enzyme is inhibited by insulin.  

Therefore, you MUST reduce your insulin level if you ever want to get the weight off.

Insulin resistance is also closely associated with leptin resistance which I discuss in this article.

If your leptin levels are elevated, it will be almost impossible to drop any significant weight.

​Diet

​Changing your diet may be the single more important thing that you can do when treating insulin resistance.

You will not have success if you don’t change what you eat.

​However,​ keep in mind that diet alone may not be enough to lower your insulin levels.

​It is going to require a comprehensive approach involving everything we discuss in this article.

​- Foods to Eat

​When deciding on what food to eat, ask yourself this simple question – Did God make this food or did man make it?

In other words, eat only whole, natural foods and avoid processed food.

Most vegetables are good.  Try to stay away from starchy ones such as potatoes except on occasion.

When eating fruit, stick primarily with the berries and cherries.  Also kiwi, lemon and limes.

​Protein – chicken, turkey, fish (not tilapia), eggs, deli meats

Fat – coconut, avocado, olive oil, nuts and seeds (not peanuts), chia, flax

​- Foods to Avoid

​​If you have insulin resistance, you need to avoid any foods that will be rapidly absorbed and are high in sugar.

These include:

  • flagSugar – Any source of sugar should be avoided.  That includes high fructose corn syrup, honey, cane sugar, and brown sugar.
  • flagRefined Carbohydrates – This includes breads, pastas, tortillas, chips, bagels, pizza crust, etc.
  • flagBeer and Alcohol – These are loaded with carbs and sugar and will increase your insulin levels.

​There ​is a general rule that you should keep in mind:  Eat when you are hungry and stop eating when you are full.  Quit focusing on calorie counts and listen to your body.

One caveat to this rule.  If you also have leptin resistance, it could affect your perception of hunger and you won’t be able to trust what your body is saying to you.

​- Macros

Macros is short for macromolecules.

There are 3 macromolecules we talk about when discussing diet – carbohydrates, proteins and fats.

​The conventional approach to treating insulin resistance is to just go “low carb.”

However, carbs aren’t the only macromolecule that can increase insulin levels.

​​Proteins also increase insulin production, so it is important that your diet be low in both carbs AND proteins.

That means you should eat a diet high in good quality fats.

Your ratios of these macros should be in these ranges:

  • check50-70% fat
  • check20% protein
  • check10-20% carbohydrates

​You may need to adjust these ratios depending on what kind of a lifestyle you live.

If you have more muscle mass you may need more protein.

If you are extremely active, you may need more carbs.

Just make sure that most of your food comes from high quality fats.

​If all of this seems overwhelming, you could consider one of these diets that have lots of online support, recipes and other information:

Whole 30 Diet

Ketogenic Diet

Paleo Diet

​All of these diets have been shown to help with weight loss and reduce insulin levels.

​- Intermittent or Prolonged Fasting

​The one thing that is probably overlooked more than anything else when treating insulin resistance, obesity, and other conditions is fasting.

Going without food is probably the most effective strategy for lowering insulin and blood sugar levels.

​And yes, when done correctly, it is safe and very effective in repairing your metabolism.

Fasting should be done in conjunction with diet, supplements, and even medication to work the best.

It is extremely important for you to know that fasting should ​NOT be done without physician supervision, especially if you are diabetic and are on a diabetes medication or insulin.

Fasting is so effective, it will drop your blood sugar which could potentially cause serious hypoglycemia.

Also, if prolonged fasting is used excessively, it can cause prolonged calorie restriction which can damage your metabolism and make insulin resistance worse.

In other words, fasting can be very effective when used correctly, but can be harmful when done incorrectly.

​How does fasting work?

The longer you go without eating the lower your insulin levels fall.

Once your body uses up the majority of stored glucose in the liver for energy, it switches over to using the triglycerides that are stored in your fat cells.

You then start burning fat for fuel and your body becomes more sensitized to insulin.

There is one other important caveat that you should know:

Your adrenals and thyroid should be working optimally before trying intermittent fasting.

If you try fasting and you develop symptoms of dizziness, lightheadedness, tremors, increased thirst or urination, that may be a sign that your adrenals or thyroid are not working optimally.

​Get them working well then you can try fasting again.

​If you are ready to try fasting, start with this simple program:

– Start with a 14 hour fast

– Eat an early dinner

​- Eat an early lunch around 11am the next day

– Repeat this twice weekly

Click here to read more from my article on intermittent fasting.

​Exercise

​​Exercise is very important in treating insulin resistance.

Now if you aren’t exercising at all, doing anything is better than what you are doing now!

​Simply taking a 15 minute walk will do wonders for your body and metabolism.

However, the best exercise for insulin resistance is High Intensity Interval Training (HIIT).  Studies show that it helps sensitize the body to insulin.

It sounds complicated but it’s not.

HIIT focuses on doing small bursts of all-out, maximum effort for 30 seconds followed by 60-90 seconds of moderate exercise.

This is repeated 5-10 times in a single session at least once per week.

This can be done while walking, on a treadmill, regular or stationary bike, rowing machine, etc.

Doing HIIT training for 10 minutes is more effective than just walking on a treadmill for 30.

Stress Management

​Cortisol plays a big role in insulin resistance.

If you are under ​stress, your body will increase cortisol production.  The cortisol decreases your body’s sensitivity to insulin which makes insulin resistance worse.

This is true for chronic stress but also acute stress.

That is why it is essential for you to develop some healthy stress reduction habits if you want to decrease your insulin resistance.

These can include yoga, prayer time, good sleep, and fun hobbies.

It may also mean changing jobs or avoiding toxic relationships.

​Just think of the word “balance.”  We need balance in every facet of our lives.  Without it, we will start breaking down physically, emotionally, and mentally.

​Supplements

​There are a few supplements that have been shown to improve insulin resistance.

​Only taking these supplements will not get rid of your insulin resistance.

However, they are another tool in your toolshed that when used with the diet and lifestyle changes we have discussed can be very helpful.

The best supplements for reducing insulin resistance include (click on each for my recommended brand):

​Medications

​Unfortunately, many people with insulin resistance may need to consider medication, especially when it is advanced.

The diet, lifestyle changes, and supplements may simply not be enough to lower their insulin levels.

With that in mind, you have to be VERY careful about which medications you should use.

Remember, as a general rule, conventional medicine is more focused on lowering blood sugar levels than reducing insulin levels.

In fact, many prescription medications lower blood sugar by INCREASING insulin levels!

When insulin resistance is the cause of the elevated blood sugar, why would we use a medication that worsens the insulin resistance?

​It makes no sense.

The good news is there are several medications that actually lower BOTH the blood sugar and insulin levels.

As an added bonus, they typically cause some weight loss as well.

Compare that to other medications including insulin that result in significant weight GAIN.

I’m not going to go into great detail about the “good” medications for insulin resistance, but I will list them below.  

If you and your doctor determine that your insulin resistance is bad enough to merit using a medication, you should consider using one of these:

  • checkMetformin
  • checkAcarbose
  • checkSGLT-2 Inhibitors
  • checkGLP-1 Agonists​ – These are especially helpful if you are also dealing with leptin resistance.​​​

Each of these medications have their own set of precautions and contraindications, so make sure that you and your doctor discuss them thoroughly and monitor for any potential side effects or problems.

​Summary

​Insulin resistance is an extremely common and dangerous condition, affecting up to 50% of the US population.

Untreated, it can lead to pre-diabetes and ultimately Type II diabetes.

It will be almost impossible for you to lose weight until you reduce your insulin resistance.

Diet is a crucial part of managing insulin resistance.

Lifestyle interventions such as exercise and stress management are also critical.

Supplementation can help and prescription medication will often be needed, at least for awhile.

Incorporating ​ALL of these modalities will be necessary for you to have success in reducing your insulin resistance.

Now it’s your turn…

​Do you have insulin resistance?

What helped you to lose weight and reduce your insulin levels?

What advice do you have for others in your situation?

Leave your comments below.

The 6 Step Leptin Resistance Treatment Guide

Are you tired of gaining weight despite eating very little and exercising?

Have you dieted off and on your entire life but just can’t keep your weight off?

Do you eat like a bird compared to friends and family yet you can’t lose weight like you once could?

Are you eating less than you ever have but are still gaining weight?

Do you feel like something is wrong with your metabolism yet your labs always come back “normal?”

If you answered yes to any of these questions, you are likely dealing with leptin resistance.

In this article I will discuss leptin resistance, how to diagnose it, and give you a 6 step treatment guide that you can use to help reverse leptin resistance.

Here we go…

More…

What is Leptin Resistance?

Leptin​

It is highly likely that you have never heard of this hormone, much less know what it does in the body.

Don’t feel bad.  Most doctors have little to no knowledge of leptin either.

I myself was unaware of leptin until just a couple of years ago.

Leptin is called the “satiety hormone.”  It is produced primarily by fat cells.

Its primary function is to signal the hypothalamus in the brain that we have plenty of fat stores and we don’t need to store anymore.

This causes our appetite to reduce and our metabolism to increase so we can burn the stored fat.

There is another hormone called ghrelin which basically does the exact opposite of leptin.  It makes us hungry and slows our metabolism.

The 2 hormones together normally strike a healthy middle ground to keep us in energy ​balance.

Leptin Resistance

So what is leptin resistance? 

For reasons we don’t completely understand, the brain begins to ignore the elevated leptin levels and continues to signal to our body that we are hungry and need to store more fat.

When you brain ignores the leptin signal, it goes into starvation mode.

Think of someone stranded on a desert island without food.  What would their body do to compensate?

Their metabolism would slow down to conserve energy, and their appetite would increase to stimulate them to find food.

The same thing happens in leptin resistance even though the patient has an excess of fat stores.

This leads to more weight gain and higher leptin levels which just worsens the cycle.

Connection with Insulin Resistance

A similar thing happens with insulin resistance.

With insulin resistance, the body ignores the elevated insulin levels and it therefore requires more and more insulin to move the sugar from the blood stream into the cells to be used for energy.

The insulin causes an increase of inflammation in the body which worsens the insulin resistance.

High levels of insulin cause you to store calories that you eat in the form of belly fat.​

At some point the blood sugar levels begin rising and type II diabetes develops.

Leptin resistance and insulin resistance typically run hand-in-hand.  It is rare to find one without the other.

Both conditions cause the metabolism of the body to slow which results in weight gain and obesity.

Read more about treating insulin resistance in my article found here.

Connection with Hypothyroidism

In leptin resistance, as your leptin level increases and your metabolism slows, your reverse T3 levels will increase.

This is a normal compensatory response by the body.

Thyroid hormone is responsible for the majority of the metabolism in the body.

As your leptin levels rise in leptin resistance, your overall basal metabolic rate slows.

This decrease in metabolic rate signals the body to convert T4 to more reverse T3 and convert less to active T3.​

Here are the results from a recent patient of mine that demonstrate this:

Reverse T3 serves as a brake for your metabolism.​  As your leptin levels rise your reverse T3 levels will also rise.

Reverse T3 actually competes on your cells for binding with the free and active T3 hormone.

This results in a further lowering of your metabolism and causing damage to it.

​A prolonged elevation of reverse T3 is called thyroid resistance.

Signs and Symptoms of Leptin Resistance

The typical patient with leptin resistance has problems losing weight unless they are on an extremely strict diet.

The damage to their metabolism means they have to eat an extremely calorie-restricted diet just to maintain their weight.

Even just occasional cheating will cause them to put on pounds.

Patients with leptin resistance tend to experience at least 2 of the following symptoms:​

    • Inability to lose weight despite eating a calorie-restricted diet and exercising regularly
    • Constant weight gain accompanied by a ravenous appetite
    • Constant food cravings, even after eating a large meal
    • Constant fatigue, low energy, or feeling “sluggish”
    • Cold body temperature (less than 98.0 degrees F)
    • Low resting heart rate (defined as 50-60 first thing in the morning assuming that the patient is overweight and not aerobically conditioned)
    • Worsening symptoms of hypothyroidism (hypothyroidism frequently accompanies leptin resistance)

​Having 2 or more of these symptoms doesn’t guarantee that a person has leptin resistance, but it means there is a high chance that they do.

Diagnosing Leptin Resistance

The only way to definitely diagnose leptin resistance is by doing labwork.

You will have to ask your doctor specifically to order these tests.  Remember, there is a strong possibility that he or she will not know what leptin is or know how to interpret the results.

The gold standard for diagnosing leptin resistance is by checking the fasting serum leptin level.

Your serum leptin level should be less than 10-12.

If you are at least 20 pounds overweight and your fasting serum leptin level is > 12, the diagnosis of leptin resistance can be made.

Please note that most labs will list a reference range that is based off of your BMI.

Don’t let this fool you into thinking your leptin level is normal just because it falls within the reference range.

Of course leptin levels will go up as your BMI increases.  That is the point of this article!

That just confirms that the majority of obese people have leptin resistance.

I would also recommend ordering the following tests in addition to the serum leptin level:

    • Uric Acid
    • Complete Thyroid Panel (specifically a reverse T3)
    • Fasting Total Insulin Level
    • Hemoglobin A1c

Uric acid is an indicator of how well your body is metabolizing fructose.  This is important because fructose combined with a high fat diet can worsen leptin resistance.

If you uric acid level is > 5, that indicates that you are consuming too much fructose or your liver is having a hard time metabolizing it.

​A reverse T3 level > 15 indicates thyroid resistance that also needs to be addressed.

A fasting total insulin level and hemoglobin A1c will indicate the presence of insulin resistance.

A fasting total insulin level > 5 is indicative of a problem.  So is a hemoglobin A1c level > 5.3.​

Like I said earlier, it is very rare to find leptin resistance without insulin resistance.

Leptin Resistance Treatment Guide

So, now you have the lab tests you need.  Based on those results and the symptoms you are having, the diagnosis of leptin resistance can be made.

So what can you do about it?

This is a difficult condition to reverse, but it can be done if you are fully dedicated.

The vast majority of treatments will be up to you.  How committed you are to reversing this will determine your level of success.​

Trying just one or two steps in this guide will only give you limited success.

To ensure the best chance at success, you will need to incorporate as many steps as possible.​

Finding a​ doctor that understands leptin resistance and how to manage it will also be important if the first few steps are not enough to reverse the condition.

1.  Improve Your Diet​

Changing your diet is critical to reversing leptin resistance.​

– Get rid of all processed foods and eat only whole, natural foods.

The Standard American Diet is full of processed foods that increase inflammation in the body.

Inflammation causes the leptin levels to increase and only worsens the condition.​

Dietary changes alone will probably not drop your leptin levels to normal, but you will never be successful with reversing leptin resistance if you don’t change your diet.​

By the way, there is something very important that you need to keep in mind.  Too much protein can actually increase your leptin.​

Protein increases leptin by interacting with mTOR.​

Many of the currently popular low carb diets are also high protein, which can actually increase leptin levels!​

Carbohydrates cause an increase in insulin levels which signals the body to store fat and gain weight.

Eating protein increases mTOR levels which can also signal the body to store fat and slow metabolism.

Fat does not send such a signal to the body.​

It is therefore important to get 60% of your total calorie intake from good, healthy fats.

20% of your calories should come from high quality complex carb sources.

The remaining 20% of your calories should come from high quality, organic proteins.

Eating this way will allow all 3 levels to decrease – your leptin, insulin, and mTOR.

– No more calorie restricted diets!​

​It has erroneously been pounded into our brains that in order to lose weight, we need to reduce our calories.

Yes, we need to stop over-eating, but many times people take it too far.

​If you don’t eat enough calories, you body will go into starvation mode and lower your metabolism to conserve energy.

​If you do this long enough, you metabolism can get damaged permanently.

The best thing to do is listen to your body – if you’re hungry, eat.  When you’re full, stop eating.  However, be careful with this rule if your leptin level is high.

Quit paying attention to calories except to make sure you percentages of macros – carbs, proteins, and fats – are in the recommended levels.

– Try Intermittent Fasting

Another popular but wrong concept is eating several small meals throughout the day to keep your metabolism burning.  I have been guilty in the past of telling my patients this very thing.

In effect, eating multiple small meals increases the time our body spends processing calories.  This causes the insulin levels to surge which can ultimately lead to insulin resistance.

If you eat larger but less frequent meals, your body will spend more time without insulin which will sensitize it to the insulin and allow it to work more efficiently.​

This is called intermittent fasting – you eat the same amount of calories per day, but you eat it in fewer meals.

An example would be skipping breakfast 2 or 3 days per week. 

Remember, it’s important to still get your total calories in for that day.  That means lunch and dinner need to be larger than they would be if you ate breakfast.​

There are other types of intermittent fasting that are more effective, but I would recommend starting with this first.

2.  Start HIIT Exercise Training

Exercise is important to reduce leptin resistance, but doing the right type and amount of exercise is critical.

Going for a casual walk or bike ride are great for family time, but not so much for weight loss or leptin resistance.

Conversely, over-exercising can be just as harmful.  This is because if causes cortisol levels to rise, which affect insulin levels, which will make losing weight and lowering leptin difficult.

The best exercise for leptin resistance is High Intensity Interval Training (HIIT).

HIIT training has been shown to lower leptin levels – but it could take months.

HIIT training is simple to do and doesn’t require extra equipment.

Instead of just walking, try walking as fast as you can for about 30 seconds then drop back to a slow pace to allow your heart rate to come back down.  Once it does (usually about a minute later) repeat the process.​  Do this at least 5 times.

The same thing can be done on a bicycle, rowing machine, treadmill, elliptical, etc.​

The heart rate variability is what increases metabolism and helps lower the leptin level.​

If you are not currently exercising, make sure you take it slow so as not to cause a cortisol increase.

Start with 1 session per week for 10-30 minutes then increase your frequency and intensity as tolerated.  Let your level of fatigue be your guide to show you when it is time to increase.

3.  Improve Your Sleep

If you aren’t sleeping well, it will be much harder to lose weight.

Lack of sleep has been found to increase leptin levels and leptin resistance.

Getting good sleep will help to accelerate weight loss, while poor sleep will slow it down.

Sometime just breaking bad habits can make a huge difference.

For example, avoid caffeine or other stimulants in the evenings.

Set a consistent sleep schedule – go to bed at the same time every night and get up at the same time every morning.

Cut off all electronic stimulation (TV, phone, computer) at least 2 hours before bedtime.

Make sure you have a comfortable, supportive bed and a good, supportive pillow.

If that still isn’t enough, there are some great supplements that ​can help.

How to Supplement to Improve Your Sleep

Why I Like It

May help improve energy levels

May help to decrease levels of inflammation

May help reduce brain fog and mental slowness

Requires lifestyle change for best results

How to Tell if You Need It

    • You should be getting 8 hours of quality sleep every night.
    • If you find yourself waking up exhausted then you should consider checking for sleep apnea or a trial of the following supplements to improve sleep

How to Use

    • Take each supplement as indicated on the bottle or as recommended below
    • In addition to these supplements make sure you practice adequate sleep hygiene, that means: black out curtains for your bedroom, noise cancelling ear plugs, having a consistent sleep schedule, and avoiding all electronics 3 hours prior to your scheduled bed time

My Recommended Brand and Product

For minor sleep issues start with supplements containing 5-HTP which may promote proper melatonin production and induce sleep naturally (take 100mg 30 minutes before your scheduled bed time):

Get 5-HTP Here

For more difficult cases consider the addition of melatonin + 5-HTP, start with 1-3mg of melatonin and don’t be afraid to use melatonin if you need it.

Get 5-HTP and Melatonin Here

For more the most difficult cases consider using serotonin and GABA potentiators. These supplements help enhance GABA and serotonin neurotransmitters in the brain and help induce deep sleep.

Get GABA/Serotonin Potentiators Here

4.  Treat Insulin Resistance

As I discussed earlier, insulin resistance and leptin resistance are usually both present at the same time.

If you follow all of the steps in these leptin resistant treatment guidelines​, your insulin level will drop as your leptin level drops.

Several hormonal abnormalities have already hit by the time leptin resistance develops.

Since insulin resistance is present in about 50% of the population, chances are you may have it whether you know it or not.​

If your fasting insulin level is >5 and your hemoglobin A1c is > 5.3, you are already showing evidence of insulin resistance and are on the road to developing Type II diabetes if you don’t make the changes we have discussed.

You may want to consider using these supplements to help lower your blood sugar and insulin levels.

5.  Treat Thyroid Issues

– Is Your Thyroid Medication Correct?

As discussed earlier, elevated leptin causes an increase in conversion of T4 to reverse T3, which means less is converted to active T3.

Giving T4 thyroid medication to a patient with elevated reverse T3 only adds fuel to that fire.​

​That’s why the addition of T3 medication such as Cytomel or sustained release T3 can be very beneficial.  It allows you to completely bypass the whole conversion process.

This forces the active T3 levels higher and lowers the reverse T3 levels.

Reducing your T4 dose can also help by removing the substrate that is converted to reverse T3.  This includes T4 only medication like Synthroid but also NDT medication such as Armour Thyroid or Nature-throid.

– Improve your T4 to T3 Conversion

Many hypothyroid patients are deficient in nutrients that are essential for normal thyroid function.

By boosting these nutrient levels in the body, it can help with the conversion of T4 to active T3.

Supplementing for the 2 most common nutrients needed for T4 to T3 conversion can often be very helpful.​  Click on each to see my preferred brands.

    • Zinc – Zinc is a powerful anti-inflammatory and helps with the conversion of T4 to T3.  Use in doses of 30-60mg daily (60mg is best in leptin resistance).
    • Selenium – Selenium helps reduce inflammation, balance the immune system, and helps with T4 to T3 conversion.  Doses range from 200-400 mcg daily.

6.  Consider a GLP-1 Agonist

​Steps 1 through 5 of this Leptin Resistance Treatment Guide are critical to reduce leptin resistance.

However, they may not be enough to completely reduce the leptin levels back into the normal range.

It may require a certain medication for a short time.

GLP-1 agonists have been shown to dramatically reduce leptin levels and lead to significant weight loss.​

This class of medications includes Victoza, Byetta, Bydureon, Adlyxin, Tanzeum, and Trulicity.

These meds treat many of the issues that occur with leptin resistance:​

  1. They reduce leptin levels.
  2. They cause significant weight loss even in the absence of diabetes.
  3. They reduce the rise in leptin levels that often occurs after rapid weight loss which can help patients keep off the weight long term.​
  4. They reduce insulin resistance and blood sugar.

The medication may only be needed for a few months but will need to be monitored closely.

The trick will be finding a doctor that understands leptin resistance and how it relates to insulin and thyroid resistance and who is willing to prescribe it in this scenario.

Summary

Leptin is a largely unknown, but an extremely important hormone.

Leptin resistance is a common cause of obesity and a big reason why many people can’t lose weight and keep it off.

In order to improve leptin resistance, it typically takes a multi-faceted approach which includes diet, exercise, improving sleep, reducing insulin resistance, optimizing thyroid function, and even medication.

Only doing 1 or 2 of the steps in the Leptin Resistance Treatment Guide will most likely not be enough.

It is critical for you to find a doctor that is knowledgeable about leptin resistance who can walk through the treatment with you.

Now it’s your turn…

Do you think you may have leptin resistance?

Have you been diagnosed with leptin resistance?

What has helped you in your treatment?

Leave your comments below.

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