Wed, Jun 28, 2023 9:00AM • 1:35:54
SUMMARY KEYWORDS
patients, increase, fat, put, weight loss, called, talk, doses, parasite, day, milligrams, plan, high, blood sugars, diet, week, weight, questions, glucagon, program
SPEAKERS
Bill Clearfield
00:09
Hi everyone, and thank you so much for joining us here today for our webinar. We’re going to hang tight for about a minute or two just to let any late people in the door and then we’ll go ahead and get started.
Bill Clearfield 00:28
Looks like we’re doing pretty good. So far.
00:39
40 people so far.
Bill Clearfield 01:10
slipped me recording my host and I can’t have to admit Katrina my host because I’m getting the to admit people here.
01:38
Yeah, you’re a co host. But don’t worry, I’ll cover all that.
Bill Clearfield 01:44
I mean, I saw a familiar name I think one of our folks just showed up.
01:51
Awesome. All right. So we’re gonna go ahead and get started. Let me go ahead and fully share my screen here
Bill Clearfield 02:10
I may if I may have muted you. That was me. Sorry about that.
02:15
No worries.
02:15
Thanks for letting me know. We’re gonna go ahead and get started here. Thank you all for joining us for the new face of weight loss Webinar. My name is Katrina I’m VP of Operations here at body sight. And with me today I have Dr. Clearfield a wonderful doctor and client of body sights. So just a little summary of the agenda today. We have some housekeeping items to cover. I will be covering bodysuits new semaglutide program. I’ll pass it over to Dr. Clearfield for his great presentation that he’s prepared for us. And then we’ll go into a brief q&a session regarding questions as you have questions throughout the presentation today, whether they’re related to body sites semaglutide plan any questions about semaglutide that Dr. Clearfield might be able to speak into or questions about anything he covers? In his presentation? Go ahead and send those in the chat box and then we will cover those at the end during the q&a session. All right, so as many of you probably know we have our new semaglutide weight loss plan. This plan is a 10 week support program that is really used to help you provide additional value and support to your patients who are using semaglutide. This program includes education about semaglutide the benefits it has and how how to video has healthy recipe ideas tasked to increase compliance and general health and wellness tips. So basically the overall plan details of this new program number one like I mentioned, it’s 10 weeks in length. This plan just like all body site plans are fully customizable. So if you wanted to change out the video on day one, if you wanted to add your own personal touch to it, you can customize anything about this program includes a weekly tasks for administering the injection, as well as a weekly tasks for tracking weight. As I mentioned, there are daily general health and wellness tips for overall wellbeing as well as daily breakfast, lunch and dinner recipe ideas. These recipes are lower in fact, with lean proteins, including plant based protein options that incorporate whole grains, fruits and vegetables. I would say the overall diet approach is that of a paleo or anti inflammatory like approach. Optionally as some people have asked about this, the plan can be paired with an exercise or movement program, such as body sights at home fitness plan, that new hip plan or even just a basic walking plan. We understand that everyone is kind of at different levels so we’ve intentionally not put a specific exercise program into this program. Instead, you would basically put your patient on the semaglutide program, as well as the exercise or movement program. And it’s very easy to toggle between plans and both the web platform as well as the mobile app.
05:54
Awesome, as I mentioned earlier, we have with us today, Dr. William Clearfield he is a graduate of La Salle College and the College of Osteopathic Medicine and Surgery, completed a rotating internship and served as an OBGYN resident at the Metropolitan Hospital certified by the American Board of family medicine after completing a family practice resident in 1982 at United Health and Hospital service services and Kingston PA, Dr. clearcoats. Since 1982 has been a lead figure in family and integrative medicine, with graduate expertise in areas ranging from cardiac rehabilitation to age movement and non surgical aesthetic medicine. Dr. Clear field a leading authority on cutting edge medicine as a prolific and popular speaker regularly addressing the age management Medical Group, the American Academy of anti aging or mi d, the American Osteopathic associations scientific convention, among others. So thank you, Dr. Clearfield for being here with us today. We’re so grateful for your expertise. So I’m going to pass it off to you to share with the group.
Bill Clearfield 07:08
Thank you. So I’m assuming most everybody here is a body site. The customer resident correct me if I’m wrong.
07:22
So it’s kind of like a mix. We I think we have some body site subscribers some non but most should at least a somewhat.
Bill Clearfield 07:34
So I’m going to be alluding a lot to body sight I’ve been I was maybe one of your first customers. I’ve been with you for however long you’ve been I think at least 10 years. Yeah, from way back when when I think you had three, three plans in their MCD or something. And if you’re new to body sight, I mean it’s really a great tool. We use it every single day. And it saves me a lot of time. It saves me from having to we have we do have a nutritionist that we hire out but from hiring an in service, an in house nutritionist. We made our own programs. And if you’re if you’re new to it, get get familiar with it and it really is something that I always wanted to do on my own. So just a little bit of background in 1984 Way back in the dark ages on an Apple to see computer if you remember those you probably don’t remember that Katrina. It had a five and a quarter inch floppy disk. And 128k of RAM. We actually wrote a diet program for individuals and we will put their name in their height and their weight and when we give us a recipes and menus for a week. And it was kind of crude, but you know it was it was a big hit. And I was actually on the news back where I was in Pennsylvania and it was it was a something of a sensation. I was never able to put it together the way you guys have. And I’m really happy. You know we’ve been really happy with with the whole thing. So today’s topic, this this talk actually came out of something that I did at AMG and in April the new face of weight loss, since we want to concentrate on semaglutide. And I’m going to I’m going to change it a little bit and I talked to you about this yesterday. I’m going to call it the incretins because there’s more than one now. So myglue tide was the first one that was released but there’s two and I’m going to show you actually a third one with up to the minute information stuff information that was published on Monday, about one of the incretins. So we’re going to that will be our emphasis but we’re going to look at an overall view of dieting how we handle it at least in our in our practice. We’ll go over some diet over over overviews. I’m not going to go into any any details. We’ll talk about semaglutide and to parasite which are the FDA approved substances that are available other to Pierside is not FDA approved for weight loss at the moment, but it’s coming and we will talk about some other some other other interventions that we do. We’ll talk about complications, how to handle the complications, and we’re going to talk a little bit about maintenance also, there’s a big big thing going well you’re gonna gain two thirds. There was a study out just recently two thirds of the of the weight gain is the way it is regained once the patients stopped the the medic the medication, so we’ll talk about how to get around that also with also something fairly fairly new. So this was a CME lecture or part of it was is a little bit different than what we did at AMG. So we have, we don’t really have anything to disclose. We’re going to talk about a brief history of diets I shorten this now down I like doing this first because what it does, what it does is it shows that everything old is new again. And you I’m going to show you two diet plans that were that were developed in the 1800s and you won’t believe me you won’t believe I didn’t believe it at first and I thought this was a great a great thing to show you show everybody. How did we get here, up to 70% of the US population is now considered obese in some counties. We’ll talk about the four pillars of weight loss and again, we’re going to talk about interventions. Mostly that’s that’s the topic for today. But we’ll talk a little bit about evaluation practitioner interventions. And we’ll give you some some tips and tricks. So, so where to begin. So, you know, there’s a lot of confusion with diets. This was Time Magazine over here. On the left in 1984. Cholesterol was bad 2014 cholesterol was good. And as you know anybody who’s worked with with with overweight with weight issues and an obesity you know the the misinformation is is as long as your arm you know what’s so great about kale will read right read me kill me. You know one week coffee is good for you. Now the week coffee is bad for you. high fat diets are out high fat diets are in high sugar diets are out high sugar diets well maybe it’s not so bad at only rot your teeth out so we’ll try to dispel a couple of those myths. So I’m going to start here in 1825 Believe it or not, this fellow was John. He was French John and feel brilliant. And he was a chef. He was also a politician, but he was a chef. And he wrote this book called the physiology of taste. And it was one of the one of the early sort of pamphlets, and what he said was that carnivorous animals never grow fat and herbivorous apples do not grow fat easily until they age with reduced inactivity. They fatten quickly as soon as they are fed on potatoes, grains or any kind of flour. Does that sound familiar? The chief causes of obesity is flour really and starchy substances which man makes the prime ingredients of his daily nourishment and all animals that live when ferruginous food grow fat Willy Lilly and man is no exception to the universal law. So he’s advocating a high fat low carbohydrate diet and eating 25 So that was he was a Frenchman this young man was a funeral director in 18 in the 1860s in London. This was his picture of him on the wrote this it was called the letter letter on Corpulence in 1862. And this is actually believe it or not the same man in 1869. And he stated of all the parasites that affect humanity I do not know of nor can I imagine any more distressing than that of obesity. He could not stoop to tie his shoes, nor could he attend humanity’s offices of humanity without considerable pain. He had to go down backwards from stairs due to save the jar of weight. Increased upon his ankles and knee joints. And he was obligated to puff and blow with every slight exertion particularly going up the steps. Yeah, this was he had no bill of fare or he had no no roadmap to do didn’t know what was really intended. And he brought himself into a low impoverished state. By following the guidelines of the day, he had many of noxious boils appear in to fat rather formidable carbuncles, which had to be operated on. He was then fed into increased obesity. So his cure for Corpulence he cut down from four meals to three, he recommended vegetables of all kind from above the ground except peas. Fruit was less likely to increase weight if it was cooked without sugar. Fat was to be skimmed off of gravies and jellies and expressly prohibited bread milk, butter, beer, sugar and potatoes and all root crops, including carrots, turnips, parsnips, sweet and beet root. This was his daily breakdown. This was for breakfast, lunch, dinner, tea and supper, and he had 1700 calories on average 115 from protein 22% 42 calories from fat 119 from carbohydrates, but this was the big controversy of the day. Only 23% of his calories were allowed to come from alcohol. And for this he was denounced actually in the British Parliament for being you know sort of a heretic. So again, this was 1862 You know, fast forward 100 years 1972 The Atkins in the midst of the beginnings of the low fat craze, you know, stated that it was low fat diets and and high high fat diets and low carbohydrates were the keys were the keys to a healthy body. So again, the point being is that you know, there’s nothing new under the sun. These are obesity trends. This was from the US Department of Agriculture in the 1919 90, which was you know, 30 years ago. The light blue is less than 10%. The darker blues were 10 to 14% of the population and 9090. Those of you don’t know I live in Nevada which is here which was white which you know, they didn’t bother. So, in 2000 Most of the country most of the western part of the country was at 15 to 19%. And the middle of the country 20 to 24%. By 2010. It was even worse and greater than 30%, especially here in sort of the Bible Belt. And here this was a different colored graph. But in the in the darker reds here, we’re up to 40 and 50%. So you can see the trends from you know, 10 to 15% of the population to more than half of the population. So what happened? So every cardiologist that you talk to will say the patient’s cholesterol should be zero. I mean, I’ve heard that they wanted the LDL less than 70 and fat you know, fat is your enemy. You know, when we point out to them that the brain has 60% cholesterol, they don’t want to hear it. So it’s a kind of a constant tug of war. So the low fat high carbohydrate diets took hold in the in the early 80s to late 80s. And within five years of the medical community’s acceptance of low fat diets. Of course, we’ve developed a health crisis. So the US Department of Agriculture, this was those of us of a certain age. You can tell by my hair, it’s silver, by the way that I’ve been doing this for a while. This was the USDA Food Pyramid. And at the bottom was six to 11 servings of bread rice cereals and pastas. And at the top you know a little bit of fat maybe meat and poultry here two to three servings milk, yogurt, cheeses over here also two to three and vegetable somewhere in between. I remember vegetables even though they’re there. Most of them are good carbohydrates are still and fruits are still carbohydrates. Fruits, as you know, have sometimes contain a lot of sugar and our rule of thumb for that. I didn’t go but I didn’t have time didn’t go into the glycemic index here but fruits that are watery if you bite into them and you get all wet and sloppy and you need to clean yourself up like melons, oranges, those kinds of things. Those are high in sugar. The moderate glycemic index fruits are the ones that are left a little bit of water so we’re talking maybe apples and oranges, even pears and the berries seem to be the best the bunch. So what happened? You know, we did it. Our doctors did it. You know, we we started this dumpster fire and right here. This is where the low fat craze began. And the about 15% of the US population was obese in 1985. And by the 2010 2006 it was up to 40 to 50%. And I’ve seen in some areas over 70%. So so just like the Hashimotos on autoimmune thyroid crisis that we force foisted, fostered in the late 40s and early 50s. It’s really on us we did this because we thought we knew better so what are we going to do about it? So in our group, what we do is we we look at what we call the four pillars of, of sort of a healthy healthy lifestyle and weight loss. So we’re going to look at some nutrition, we’re gonna just do a little bit. Those of us that are a little bit more mature, especially as well, I’ll talk for myself, I really had a difficult time with this concept of chronic inflammation as being the root cause of all disease. So we’ll talk a little bit about that. I’ll give you a short analogy. Hormone restoration is vital. Our practice is mainly focused on hormone optimization. And that’s, you know, a whole year’s course. I’ll provide you with a little chart that will tell you you know which hormones what each one does, actually, there’s actually some doses in there and what to look for with deficiencies, but that’s really not the focus here. And I sent to Katrina and if you if anybody wants it, we do have a Mind Body program and it’s an eight week program that we use with the diet our diet program. It’s pretty much a handout checklist, the patient’s fill it out at home, and they bring it in and we’ll go over it. And if anybody wants that, you’re more than welcome to have it. It’s eight weeks of sort of mental and mental exercises really so nutrition. So the standard American diet creates inflammation. We I think we all agree on that. There’s no There’s no no question about that. We take in too much fat. We resulted in chronic inflammation and insulin resistance. We also eat too much salt and sugar and the aforementioned auto immune prices when the the US government decreed that they were going to take iodine out of the food supply because it had been determined erroneously that it was a poison and also at the same time fluoride was put in the water supply in 1947 and 60 major US cities, it took five years for the auto immune insufficiencies to show up in a major way. And and so, so they of course, they realized they had made a mistake and even then politicians don’t, don’t ever they never make mistakes. So what they did was they stealthily decided, What do Americans eat too much of it came down to salt and sugar. So they decided on salt so I that’s where I had an ice salt comes from actually. So we had an ice salt so to try and put the iodine back in the food supply that had been taken out. And it was hailed as a great breakthrough. But, but that’s a story for another day. So chronic inflammation insulin resistance resulted in increased triglycerides, blood sugars, abnormal cholesterols. At increased blood, pressure’s waist size, sleep apnea, and it leads to all sorts of chronic diseases that you see down there at the bottom of that pyramid. This is a chart just of sort of some popular diets, that that came about in the in the in the aftermath of the low fat, low fat high high carbohydrate craze. And the one that became the most popular was that was the Ornish Diet. It was Dean Ornish was a physician in I think at UCLA. Now I was living in Wilkes Barre PA and he came actually to the biggest theater there and it was like a big show and he put on he had a 3000 people show up in an indoor theater in Wilkes Barre PA, which is not that big a city and he advocated a 70 to 80% carbohydrate diet, less than 10% fat if anybody’s ever tried that. It’s you know, it’s pretty difficult and 20% protein. And, you know, this was hailed as you know, the new normal didn’t quite work out all that way. Earlier, there had been the Mediterranean diet was actually written about in the New England Journal of Medicine in the 1960s. And that’s pretty much a balanced 40% carbohydrate, 40% Fat 20 20% protein. It’s pretty close to the Paleo diet, and it’s almost the same, and the Zone Diet was another another, you know, just a little bit of slight alteration, the keto diet. The ketogenic diet is a high fat diet with about 20% protein and just about 5% or 10%, carbohydrates, and Atkins Robert Atkins was a physician in New York City. He had written the Atkins diet in 1972. He was actually subpoenaed in front of Congress to explain himself, and he was determined it was the decree that he is methods were medically medical suicide, quote unquote. He made a resurgence again in the late 90s. After you know, it became pretty clear you know what happened with the you know, the the low fat the low fat diets. So what do we do with this? So we’re going to measure, we like to do some measurements. So we look at blood sugars, of course, and we look at blood sugars three different ways. So we look at it and I liken it to the Christmas Carol, we’re going to look at blood sugars of the past, present and future like the the, we’re going to look at the you know, Christmas of past, present and future. So the past is actually going to come next but the fasting blood sugar, we consider that the present. Now when I was an intern way back in the dark ages at Metropolitan Hospital in Philadelphia, which is actually in our condominium, it’s not even hospital anymore, but but patients would come in if they were diabetic, as long as their blood sugar was under 200 That was considered acceptable a fasting blood sugar. It then was kind of standardized at 125 and now it’s at 65 to 99. And that’s considered normal. We look for optimal that those ranges are just way too wide. And this paper down here was written in 2008 by Nicholas and and friends and it was he looked at normal plasma blood sugars, and they follow these patients for 15 years. And what they found is that patients who had that had blood fasting blood sugars of greater than 84 for every point over 84, they had a 6% increased incidence of diabetes. So patient who has a blood sugar of 94, fasting blood sugar, they have a 60%. So 1010 points over 84 times six 60% incident increased incidence of diabetes within five to 10 years, that was the timeframe that they looked at. So I do this every with every patient all the time, and it’s you know, we tell them you know, that’s normal, it’s just not optimal. And it’s we that’s kind of what we want to look at. Hemoglobin a one C, that’s pretty standard of blood sugar over three months. And it’s, it’s a percentage of the hemoglobin that’s glycosylated with glucose in the bloodstream, less than 5.7% is considered normal. 5.7 to 6.4 is pre diabetes and greater than 6.5 is diabetes. There’s a lots of false positives and negatives, but this is a pretty standard test and I’m sure everybody on here who deals with patients knows a little about it. We also look at insulin, so we do fasting insulin normal is 2.6 to 25. Almost, our goal is really less than five we want the patients to use as little insulin as possible, and we can calculate an insulin resistance and we follow this along so fasting blood sugar times fasting insulin, you want, you’re going to divide it by 405. That’ll give us the proper units. We want it to be less than 1.9. And we’re going to follow this along. So you’re going to find a patient that has a fasting blood sugar of 90, and a fasting insulin of 15 is going to have a high insulin resistance. And again, this is another clue that even though they’re normal, they’re not quite optimal. And one of our goals is to sort of head off as as long as we can any of these long term obligations. We also look at homocysteine homocysteine is a is a form of looking at at New some nutritional markers. It’s also a marker for artery damage, particularly coronary aren’t damaged and also carotid artery damage. heart attacks and strokes are normal is less than 11 are optimal or our goal is less than 10. Our remedies are methylated B vitamins, vitamin D, we can do a whole seminar just on that. It’s necessary for calcium absorption, bone strength, the immune system, the heart, the brain, anybody that dealt with, you know, the COVID patients over the last three years knows that the higher the vitamin D levels, the less the less severe the symptoms were normal and most labs is 30 to 110. Optimal is 50 to 80. We do a whole laboratory thing. I’m not going to go into where we got that but if you’re interested, let me know and I’ll I’ll give you the calculations. This is a micronutrient test. There’s lots of companies that have it. This is a this is a serum test, and they’ll measure deficient, sort of borderline and adequate nutrients. There’s 32 specific nutrients in this test. These are vitamins from ATK and the antioxidants, neurotransmitters and also give you a balanced score. Here’s an organic oat organic musical Oh at organic acid test. That’s what it is, is another one. It’s a little bit more sophisticated. It takes a little bit more time to interpret. These are some of the some of the Quickstart things that we use to get the patients going on you know on on their journey. Body site has a has at least one, one program for each of these. And you can just type in any you know, elimination diet or auto immune protocol. protein sparing modified fast and intermittent fasting are pretty much the same thing. And then we’re going to talk about some of our game changers. I’m just gonna mention inflammation briefly. Again, you know, having been raised in a previous medical paradigm, the concept of chronic inflammation is a little bit beyond me. So I spent I lived for 30 years in Wilkes Barre, Pennsylvania coal country. This was a town about 6070 miles southwest of it. And basically what you’re seeing here is that due to a series of political mishaps, the town was set on fire underground that was it was an underground fire that it was set on fire in 1962. It’s still burning. And this is what you see you’ll see smoke coming out of the out of the ground. And actually Biden by 2002, the town was condemned. Here’s a picture of the town in 1962. This was Main Street, and this is a main street in 2002. And you can see it’s completely it’s completely wiped out. And so this is kind of an analogy this underground mind fire is supposed to keep burning until those of you that are Star Trek fans will know that Jack Captain Kirk was born in 2250. And it’s estimated that that’s when this fire will burn itself out. It’s called Centralia, Pennsylvania, there’s even this burning even as we speak. If you’re at all interested in it, it’s kind of an interesting history. So what are we going to do to look for inflammation? So we’d like C reactive protein there is sed rate, but I think this one’s a little bit more sensitive. Zero to Three is normal. Our goal is less than one. It looks at inflammation primarily in the cardiovascular system. It gives us a good handle on chronic diseases. Now if somebody has a cough or cold and infection, these numbers are going to be quite high. I had a patient come in with ulcerative colitis, and it was it was 71 but that’s not really what we’re looking for. We’re looking for subtle changes. So a patient who started out six months ago when he was 0.8. And today he’s at 1.4. They’re both considered normal. Your lab studies will not flag it. And that’s that’s a concern to us. These are not specific. These are telling you something’s going on to go look for it. Or remedies actually for this though, when they’re when they’re high when they’re over 1.0. We’ll look at omega three fatty acids and tumeric and anti inflammatory substances and you know it will make it three fatty acids are good as an anti inflammatory and anti platelet that supports mental health or is it hasn’t some antidepressant properties and some cardiovascular health. Turmeric or Curcumin is a good as a liver detox. Make sure you use it with black pepper. Or bio Preen. It’s called other Dalvin be absorbed. LP PLA is a marker for vascular inflammation for it’s a it’s a predictor of coronary artery events. It has to do with plaque vulnerability the next one NPO Myeloperoxidase has to do with plaque rupture. So a high LP PLA and a normal MPO says you know that’s warning Will Robinson high MPO which is going to be the next one tells us that you know we have an we have a more serious issue. Niacin omega three fatty acids statins and fibrates. Our goal here the normal lab values up here NPO as I mentioned before, this oxidizes LDL bad cholesterol. This index high numbers here indicate plaque rupture and this is more this is a more serious issue. PLM is pomegranate seeds, believe it or not curcumin aged garlic and corseting This is our hierarchy then for the road to inflammation. A high carbohydrate diet leads to increased insulin and chronic inflammatory response. We get the cytokines these inflammatory proteins become elevated. We start losing glutathione and our our ability to handle the inflammatory compounds. We get fat accumulation and skeletal muscle inflammation. As you know it’s the road to chronic diseases. The labs we just mentioned C reactive protein LP PLA and MPO. Chronic inflammation leads to weight gain. I didn’t know you knew I’d get around to it. Eventually Katrina so chronic inflammation leads to a decrease the T four to T three which leads to a state of thyroid resistance. Thyroid holds in weight thyroid is your gas pedal that tells your body how fast to go. It affects every cell in the body, low thyroid function leads to weight gain and increases insulin resistance and increases leptin levels and increases appetite and increases the inflammatory cytokines of those inflammatory proteins interleukins one six and TNF alpha. It also can lead to a lower testosterone levels which increase can lead to increase in aromatase leading to high estrogen levels, high estrogen levels lead to, to fat is particularly in the belly. hormones need to be balanced and we do this with every patient that you know that’s kind of our specialty. I’m not going to go through this because this is a whole different story. But what I’ve given you here is basically just a hormone summary with the properties, what to look for, for each hormone, the functions and deficiencies here so again, that’s a whole nother course. And I actually have a put into a shameless plug. I actually have a CME accredited video course on hormone optimization from the beginning. So that’s our shameless plug here is our evaluation. CRM, you can do saliva and urine. A lot of my colleagues will only do saliva and urine. The State of Nevada doesn’t like that. So they sort of forced us to do serum. And so I got quite comfortable with it. But if we’re stuck with anything, we’ll certainly do the saliva or the urine test. And pretty much everything that we talked about here. And so let’s now let’s get to it the interventions. So I’m going to reach us briefly mentioned some of the some of the older things that that we use. phentermine. Topiramate Bupropion naltrexone with the trade name is Contrave HCG which we can’t really get any more can only get it in the commercial product. We did use that quite a lot paired with a five to 800 calorie diet and I know body sites still has your your program for that on there. Now trek zone let’s low dose Naltrexone actually and what we sometimes do implants on that and then we’ll talk about the our incretins. Down at the bottom here these are some of the add on things that we’ll use as to increase metabolism, burn fat and a couple of other things, especially if the patients can’t tolerate the incretins. We like Tessa fencing and Mazzi which is a peptide, and I’m going to talk about this combination here. This is really hot off the press. And we’re we’re starting to use this now for our maintenance program. And I’ll give you the reference on that. This just came out in April of 2023 with using this combination of metformin 500 milligrams once a day, and it’s my burdock is that is the trade name. They used 100 milligrams, and they found over six months about a 17% weight loss just usually a a paleo diet and this combination so we’re starting to use this as our as our maintenance program. We’ll talk about my verdict there’s a there’s an issue with it. That’s a little bit vexing. So just real quickly, feta mean basically is speed. It’s an adrenergic uptake. reuptake inhibitor, it stimulates the nervous system, anybody who’s taking it, you know, especially if you’re sensitive to it. I have high blood pressure, you’ll start shaking like a leaf. It increases energy. It’s an amphetamine like a medication 37 and a half milligram scored tablet, you can break it in half. It can be made as low as 15 milligrams, you take it an hour before breakfast, and side effects. There’s a lot of them. tachycardia, elevated blood pressure, dry mouth. There’s a lot of drug interactions here. You need to be a little bit careful with it, but we have used it fairly extensively. A lot of patients do especially the younger patients do fairly quite well with this. And they’ll lose five to 10% of their body weight over about a six month period on here. If they’re if they stick to again stick to an exercise program and a in a in a reasonable diet to a pyramid Topamax was always paired with it. We used to use phentermine in the morning and Topiramate at night. It’s an anti seizure medicine. This is an off label use. Well actually it’s not off label now because there’s actually a combination that’s called I can use trade names right is that okay? trade names are okay. Okay, so So this combination down here is called Q Sema, Q sy Mia I think it is, and it’s Topiramate and feta mean in one pill. It’s a lot more expensive than if you just get them take them separately. And off label use for Tahir made as migraine headaches, prevention of prevention, bipolar disorder, seizures, and actually excellent frontal cortex to reduce appetite. The doses that I’ve seen are anywhere from 25 to 800. milligrams usually 50 to 100 milligrams is is that is adequate. As as an adjunct to the faint Jeremy use this one at bedtime, and some side effects or memory loss, dizziness, fatigue, brain fog, quite frankly, we get I don’t use this much anymore because of all the new things but when we did use this it was pretty benign. We rarely had any side effects from this at all the Fed to me, and we did have some problems with with, you know, increased our heart rate. So now, Trek’s own view pero Bupleurum is so low dose Naltrexone is a potent anti inflammatory and it increases endorphins in anything less than 4.5 milligrams that’s that’s in in the separately it has that has to be compounded. This is a combination. This is an FDA approved drug. It’s called Contrave, quite frankly, I’ve never really had a lot of success with it. Theoretically, it should, it should help. It targets the CNS pathways influencing food intake. naltrexone suppresses neuron inhibition in the hypothalamus. It should increase energy and decrease appetite. You have to use a lot of pills. It’s it like I said, it’s FDA approved. In my experience, it’s not we’ve not had a lot of success with it. low dose Naltrexone is a compounded, watered down version of naltrexone. And again, this is a whole nother topic that we can spend time on. But in the realm of weight control, it reduces insulin resistance and increases growth hormone, which will increase metabolism. It burns fat and reduces lean body weight, it decreases cravings. Is modulates the opioid pleasure receptors and acts as an anti inflammatory and it improves sleep and it increases that conversion of T four to T three remember the inflammation slows that down. Very few side effects. I found in the literature it says nausea 32%. In our experience, we use this a lot for a lot of things. We use this for all sorts of auto immune issues. We rarely have anybody have to stop it because of nausea. We do like to dose it at bedtime. It works by blocking the opioid receptors for six hours, then it wears off in the six hours that it’s working. It creates endorphins and stimulates any inflammatory cytokines. When that when the medication wears off, the opioid receptors are then flooded with the anti inflammatory cytokines and the opioid receptors about temporary leads so we’d like to dose it at bedtime so that your your your patients are ready to go in the morning. But about 10% of the patients experience insomnia it’ll happen the first night or two that that that will happen and you’ll know right away there’s a whole schedule of decreases that lowering that taking it to hours earlier until the insomnia goes away. It got to be a little bit too much for me. So if the patients have insomnia, I just tell him to take it during the daytime. We’ve not had anybody have to stop it because of that. The other thing is there the books call it vivid dreams which are nightmares and there’s actually 20% of the patients will report that and they’ll tell us some kind of wild stories. Again, a lot of them like it. And we don’t we don’t really have anybody have to stop it because of that. naltrexone can come as an implant to like a pellet and the pellets are 1.1 to 2.2 grams. We can use them. The last they’re good for about four months. And again, they’ll they they’ll eliminate not all cravings but the lower cravings. You still have to do your lifestyle changes. And so that comes that took us now now we’re now we’re up to it now so I’m going to call them the increase in hormones. I’m going to change it from semaglutide because there there are two of them that are FDA approved. And there’s a third one that just two weeks ago on May 30 was started their phase three studies and a big study came out just on Monday and I have it here. So increasing hormones are good peptides that are secreted after nutrient intake. They stimulate the increase in insulin secretion of a by two to three, three times three fold. There are two types glucagon like peptide one and glucose dependent insulinotropic polypeptide. So there’s two different types. They worked a little bit differently. The first in Crete and came out in 2005 it was called by eta. It was a daily injection. A newer version came out a couple of years later caught cold bindura which became a weekly injection. So to glucagon like peptide one stimulates insulin secretion and it inhibits glucagon. It controls appetite and cravings. It slows emptying time from the stomach, it increases resting energy expenditure and it improves sleep and that this is your GLP one. This is your semaglutide I’ve also heard it pronounced some magnetite and some some places too. So I’m going to use semaglutide because I’m from the East Coast. So glucose independent insulinotropic polypeptide is the second of the incretins. This one activates glucagon receptors, it induces insulin secretion and prevents apoptosis, which is means death of pancreas cells. This is where insulin is secreted from generated it stimulates glucagon secretion and fat accumulation and influences hippocampal regulated memory and appetite and satiety and it actually works in somewhat in bone remodeling and has been used as an adjunct for osteoporosis and fractures. So, so the GLP one, that’s your semaglutide the gap that is GLP one gap, that’s your two parasite I think it’s I can never pronounce it right more John. Oh, mon, Juro, something like that. And so those are your to increase. These were all of these are all the increase. So these are the early ones. And you see here Genovia, which is an oral agent is actually considered an increase and also so the first one came out in 2005 by Durand, which was the CIM the weekly one was 2012 Victoza and 2010 trulicity this one here I’ve not really heard much about trulicity was has been out since 2014. And we used to get calls for this for you know for weight loss also. But um, you know, the, it was kind of cost prohibitive. So in 2017 Novo Nordisk came out with semaglutide a once a week injectable with improved glycemic control. And this was a big jump this was this was really one of the first the the better stuff, you know, this white side of the weight loss is a side effect, basically. I mean, it turned tells your brain not that you’re not hungry, but and there was it was three times the it was three fold increase in weight loss with semaglutide ozempic. Then then with all of the other incretins, and even, you know, our other interventions, rebels, this is the oral form, I don’t have a whole lot of experience with that. Maybe somebody does does here and then in 2020 21, Novo Nordisk took semaglutide reformulated it a little bit changed the doses and it got it had got an FDA approval for weight weight control. In 2022 to Zepa tide came out, mon Jarrow, which is your GLP one and G G IAP agonists. And then and I have a hard time pronouncing this one. This is brand new, this this information came out and I’ll show it to you a little bit later. June 26 2023. Today is June 28 2023. But this has been studied for a little while. And this is called Read accurate tight. It’s not FDA approved yet. They just finished phase two studies they started phase three and this is a GLP one gi P and glucagon agonist according to the, the the Guru’s in this field. This this is supposed to be the holy grail of the weight loss incretins. And what you’re going to find is that the weight loss is much better here with much less side effects than with even semaglutide and their tears. To parasite. So we’ll talk about semaglutide First, because this became our first game changer. This was a study done in 2000 came out in 2021. It was a 68 week study, patients had have 14.9 Almost 15% average weight loss, a third of the patients lost 20% of their weight and 70 of them for 70% of them lost at least 10% of their weight. And that’s pretty much been our experience. It’s that holds pretty well. Unfortunately, men get lose weight better more easily than women. But even we’ve had women lose up to 30 pounds in a week in a week sorry in a month with an average weight loss of about a half a pound a day for women and about a pound a day for men. If they follow it follow with diet. It controls appetite and cravings it slows stomach empty and time. It stimulates insulin secretion in this one inhibits glucagon. It improves sleep and increase increases resting energy expenditure. That’s how it works. It’s 89% bioavailable, it peaks in one to three days. You get steady states over over a week. And you get a in a week it’ll sort of stabilize and you’ll get a steady state and over four to five weeks. The half life is about seven days. So it’s a long acting medication this was a 40 week study done in 2021 with Wigo V which was the 2.4 milligram per week. And the highest dose here in this 40 week study was 16.2% weight loss. This is placebo here. This red one here. This is trulicity. This was one of the older ones, and these are other doses of the semaglutide. The higher the dose, the more the weight loss. This shows again, this was this that 68 week, weeks, this was a placebo and this is the 16% weight loss or average weight loss with semaglutide. But there’s danger Will Robinson again. Those of you over certain age will remember Lost in Space and the robot here there’s a high incidence of side effects. And according to the this is the official rate, nausea 44% on nausea to the point where the patients can’t take the medication. And there’s a high incidence of discontinuation of the medication because of this diarrhea vomiting constipation, abdominal pain, headaches and fatigue. Now there’s some ways around it. The most important thing you need to you need to emphasize for the patients if they’re going to just continue they’re eating ways. They’re going to get sick. If they’re going to eat junk, if they’re going to eat McDonald’s three times a week. If they’re eating, eating, you know if they’re not eating a whole foods, plant based foods, if they’re just eating, you know, if they’re just you know, going, you know, you know, their high carbohydrate diet, they’re going to get sick. The patients who don’t get sick are the ones who change their eating habits. And you know and they do much better and almost to the point where we have less than 4% discontinuation rate when we follow that plan. So this is what we do. So again, most important no junk food, you also have to limit your the size of your portions also 500 calories in a meal, you know, is probably, you know, probably the max that you want to do. We don’t really have people count, you know, count calories, but you know, I mean, you can’t go to the to the buffet at the casino and just load up on it. I mean, you’re going to get sick. The body sight program is really great, you know, and it saves us a lot of time and effort. You know, we just put the patient’s name names in there. We send them we send it off, we check in with them, make sure that make sure they’re doing it they’ll check in with us also. We always have our patients get some fresh ginger ginger seems to be seems to really calm the nausea from the semaglutide. And so we tell we tell our patients to always have some fresh ginger around as far as interventions. Prescriptions promethazine. Zofran Pepto Bismol. It those of us in the sort of alternative world zinc carnosine. Is that as a as a good choice? l glutamine is another good choice. Again, I’m allowed to use the brand names so we like orthomolecular makes a powder called gluta shield and it has has the zinc carnosine in it. It has the glycerin at licorice which we use for gastro esophageal reflux disease. It also has glutamine in it and has some digestive enzymes we really liked that one is not expensive and it actually tastes good also have the vitamin B six. We’ll talk about that and BPC 157. If you’re not familiar with that, that’s a it’s a peptide. It’s a it’s a kind of a growth hormone derivative. It comes from gastric juices, and they’re they’re potent anti anti nausea agents. And we’ve used these very successfully to decrease our nausea and actually diarrhea incidents discontinuation rate, our discontinuation rate is less than 4%. And you know, the official from the company is 44%. So I think we’re doing a fair job. And these are the two main agents will use I’ll talk about them in a minute. Diarrhea, you want to increase the fiber. You want to make sure they’re hydrated and a little pyramide. Imodium? If they need that vomiting against the same as the same as nausea, the promethazine Zofran you want to avoid really high fat diet foods, especially right around of or the day or two after the injection. And again, there’s their l glutamine decoiler three licorice, zinc carnosine and aloe vera and RB six and BPC 157. Constipation is is fairly common because you know you are going to decrease gastric emptying and that’s what the drug does. You’re going to increase the use of high fiber foods figs, dates, green leafy vegetables, MiraLAX Metamucil you know the old standards cod liver oil has a lot of good uses and and effects magnesium particularly magnesium citrate, aloe pectin, these are all you know, it’s sort of remedies abdominal pain. So one of the one of the sort of, you know, be on the lookout for is pancreatitis, I’ve not seen it. We’ve been using this for drug for over well over two years, two years in this form now, and we’ve not seen it, but you know, we’re it’s always in the back of her mind. So you always need to make sure somebody who’s called starts calling about abdominal pain with make sure that they’re not didn’t get not suffering from pancreatitis. We use castor oil pack plaque packs, Epsom salt baths again licorice root black cumin is a good choice. And again, ginger and mastic gum and usually these comes in combinations. That gluta shield works nicely. There’s the apex energetics makes one called gluco flam be gluco gels you see OPHLA And I think Google flan headaches 14%. Make sure you check their blood sugars. One of the nice things about the semaglutide and all the ingredients that we use is that if the patient’s blood sugars are normal. We rarely ever see an episode of hypoglycemia. I think I have some statistics coming up just and you’ll see it’s almost non existent. That was one of the things we worried about. gluten free diet, I’m firmly convinced that everybody should be on a gluten free diet. You know, regardless of your status, and gluten is just not good for anybody. Increased fluids magnesium, if you like essential oils, peppermint oil, lavender oil, arnica, you know Rub, rub the oils on the back of your neck or your temples. Arnica, feverfew, butterbur vitam vitamins B one and B six. If it seems to be related to menstrual menstrual cycle, we use some progesterone cream on the temples. Fight you can get a 2% or 5% over the counter. You don’t need a prescription for it. And one of my other hats as you can tell, I get bored easily so I go and learn lots of stuff. So I’m actually an acupuncturist also. So battlefield acupuncture is taking little tiny gold needles and putting them in nice spots in the in the ear and usually within 10 minutes. The headaches are gone. I mean it’s pretty dramatic fatigue. We want to we want to watch out for food sensitivities, the leaky gut syndrome. Again, b one b six replacement D ribose. Is a B type vitamin which is good for energy, a mag checked or magnesium checked or potassium and of course stress reduction techniques. Some other tips for success. The weekly dose I have it here on Friday. You want to make sure especially early on that they’re free the next day or two. You don’t want them to have a big presentation on Thursday and hadn’t user shot on Wednesday and especially right at the beginning and have them become ill. So you want to have so we usually were encouraged them Thursday or Friday, especially if they’re off on the weekends to have light meals for the next two days. And to test things out and again, no junk food. We have ginger on hand for them. We tell them to have a little Pepto Bismol on hand. And a little bit of a it seems a paradox but a little bit of a fat snack so some coconut oil or some avocados usually will help ease that ease the nausea also make sure they drink a lot of water six to eight ounces eight ounces a day. Remember what the drug does is it decreases their appetite and we have seen it on occasion rarely, but on occasion someone you know is not drink enough and they end up with a bit of dehydration. We usually haven’t put a half a teaspoon of sea salt or pink Himalayan salt in the in the in one of the glasses of water. They need to do some physical activity. You know, do what you like to do. move throughout the day. You know some of us sit in front of a computer and flap our Jazel day like I’m doing and I thought well that’s what Katrina does too. So you need to move around a little bit. Try some new recipes, you know, body sites great for that. They have all sorts of recipes in there. And there’s all sorts of you know all sorts of diet plans. And before the body the semaglutide diet plan, we would pick out one for the patient or we would offer it to them and we our most favorite favorite were either the paleo or the Keto or the Mediterranean gluten free That one seems to be pretty popular too. Some warnings, family history of medullary thyroid cancer is considered a country indication. So if you ever see how some of these studies are done, they feed rats 534 100 times or 500 times what a dose would be for their body weight. And then the rats ended up with medullary thyroid cancer so any anybody with a history of it that’s considered that’s considered a no no routine monitoring of calcitonin or using thyroid ultrasound is kind of uncertain. And so just just be aware of this. Again, I’ve not seen it at all. I haven’t seen anybody have a thyroid issue with with with the semaglutide or to parasite weight loss in general. We’ve seen we’ve seen this over the years hypoglycemia again, this is a hypoglycemia drug, although we’ve not seen this Callie lithiasis with rapid weight loss. This is an entity. So be aware of that. You can get a little bit of an increased heart rate. And you know, the patients that were previously depressed get a little bit less depressed and it’s been it’s been documented a suicidal behavior and ideation. Again, I’ve not seen any of this. I mean most of our patients are over the moon. This is this is probably the bet one of the best things we’ve done 40 years food choices and I told Katrina I stole this right out of the body site and program. So the foods, your fruits, non starchy vegetables, whole grains I put in with caution. You know, grains or gluten is not so terrific for anybody nuts and legumes, high protein foods, then your good fats coconuts and avocados and stay away from the junk fried food white flour, white sugar, dairy is actually if you’re sensitive. You can get an allergy likes and syndrome, refined grains and sugary drinks alcohol is not so good for you either. So right now our main recommendation is the body site plan plus the gluten free diet. Here’s the dosing schedule. We’re going to for the semaglutide We’re going to start at point two five milligrams once a week. For a month for every four weeks, every four weeks, we increase the dose and you go up to 2.4 milligrams. That’s what govi if you’re using ozempic, it only goes up to one milligram, quite frankly, we see pretty good results with up to one milligram and we rarely go go any higher just don’t really seem to need it. Somebody else has a different experience. I’m going to kind of let us know. But the lower doses as long as you your moderate what you’re reading and get some exercise seem to do quite well. So one of the problems is cost. So at the moment, there are some off label ways to get around that but I think it’s going away and I don’t even want to get into it anymore. At this point. The drug companies and FDA seem to be cracking down on the compounding pharmacists that have been making it. So So for right now, what we’re doing is we’re going to be doing a once a week shot as as prescribed. And we’re going to add in our are going to add in our little extras here. So this little chart here is kind of a summary for semaglutide. It’ll tell you what it does and what you know what it is gluco glucagon like peptide one analogue approved for FDA for diabetes and the the higher dose will go V’s approved for weight loss and what it does controls appetite craving slows emptying time increases resting energy, energy expenditure BPC 157, like I said, is an anti inflammatory agent that actually comes from gastric juices. It was actually identified in 1904 by Pavlov of Pavlovian dog fan. He didn’t really know what he had but the they were using it Czarist Russia for G upper GI issues. And was identified fully in 1993. It is an anti inflammatory agent and promotes vascular formation that comes as an injectable. It comes as an oral form and an injectable form. It’s extremely effective for joint disruptions joint pain, arthritis, those kinds of things, any pretty any type of Gi issue leaky gut, irritable bowel syndrome, ulcers, ulcerative colitis, it has a good effect on it is a potent anti inflammatory agent and vitamin B six is used 25 milligrams up to three times a day. They it’s used in OB OB now for morning sickness. And so we put it all together. We got our weekly semaglutide shot the BPC 157 B six we’ll use that as our anti nausea agent. We do 10 weeks on two to four weeks off. The literature tells us that you need to use it continuously. It’s been our experience that if the patients don’t take a break, they get accommodated to it and it stops working especially for weight loss. We added in another so so Berberine is considered the herbal semaglutide And we added in we added this brand in which is again I can talk about brands is from numedica so it’s Berberine vezo q x three times a day it improves energy demand. It’s a central regulator of energy homeostasis, and it contains Gynostemma which is an a&p K or energy regulator. Basically it’s a fat burner. So a lot of us have you Berberine said we didn’t really lose weight but you have to use it in a fairly high dose you need 1500 milligrams a day. So the diet was a we recommend or is body site. The body site program we sometimes do Mediterranean keto paleo or the auto immune diet. If you have a sweet tooth, two tablespoons of apple cider vinegar and six ounces of water and you can do that two or three times a day usually kills the sweet tooth that works quite well for exercise, high interval and high interval intermittent training that H i T I’m not saying that right. And then we decided to have a little bit of fun. So we went back into the archives. YouTube is great for this now, those of us of a certain age probably spent $100 for for a tape for eight minute ABS eight minute legs, sweating to the oldies, buns of steel. You can do all these exercises in eight minutes. There’s no equipment you don’t need it. You don’t need a gym, you don’t need, you know, a parison you know, you didn’t need a pair of shorts and a T shirt. You don’t have to go anywhere. It doesn’t cost anything. And the exercises are perfectly fine. They’re wearing the you know everything looks campy, they got the 819 80s hairstyle and and in spandex and whatnot. Those are kind of fun. There’s a lots of lots of them. And that’s kind of what we recommend. And it works out quite well. I’ve been doing eight minute ABS now for myself for more than two years. For maintenance, we talked a little bit about the Metformin and my Burdock. The problem with my mid beer and the beer around my burdock is that it’s a at the moment trade name only, and it’s quite expensive. So we can for Metformin if you don’t want to use medications, we can use the Berberine he need 1500 milligrams a day. chromium picolinate about 1200 milligrams a day. For the my Burdick we use resveratrol, 1500 milligrams a day and curcumin and you can use either one of these you don’t need both. These are a couple of other things that we can add in. So So now let’s talk about to parasite How am I doing on time here? We okay. Okay, so it’s a parasite. This is a Mirjana right, they say right, Mirjana. So, this is from Lily and this is the GLP one, one agonist and gi p. So this, this is semaglutide with the other increasing hormone you get an increased satiety, increased weight loss, decreased appetite, the dosing numbers are different. Basically, we see a better weight loss with less side effects with the parasite then semaglutide This actually is here’s your weight this is the weight difference from two parasite to semaglutide. We get the lowest dose This is the lowest doses of each you get about 1.9. This is the difference in weight loss 1.9 kilograms. Better with the parasite, the highest dose five and a half kilograms, which is about 12 pounds for the parasite versus the semaglutide. The side effect profile as you can see here, is almost the same but a little bit better for to parasite then semaglutide And hemoglobin a one seed a blood sugar response is much better with the parasite versus the semi glue tie. I mean, it’s not bad for semaglutide but it’s a lot better for the parasite. The weight loss here is much better with with the two parasite also it’s a little bit more expensive though. Hemoglobin again hemoglobin a one C is better. Cholesterol difference is better also. This is the HDL this is you know this is one you want to go up semaglutide is in gray. The different doses of the superior side are in the light, medium and dark blue. Incidence of nausea is less with your parasite also. And the incidence of hypoglycemia here is really quite small. I mean there was one patient in the five milligram and one patient in the 15 milligram category and none in the semaglutide. So pretty much none. And I’ve we’ve really not seen it either injection site reaction and we don’t really see a whole lot of that either. These kinds of side effects are really pretty minimal so that now there’s reattach we’re tight again I have a hard time pronouncing this and reattach your tight is a has three receptors so as your GLP one gi P and they put it has glucagon in it, which is further suppresses appetite and increases energy expenditure. This was just finished this study was done in September of 2022. It was a phase two trial. There was a 24% weight loss in 40 weeks versus 20% For Pierside. And this was published Monday, June 26. So I want you to know that we’re right on top of everything here. 24% weight loss at the highest dose within 48 weeks. And the these are the other the other doses for the Tatra tide. I don’t have a trade name for it yet. They just started may 30th was just starting the phase three trials. It’s not supposed to end until September of 2025. But I have a feeling we’re going to see this a lot sooner. The other bonus with this as you have relatively liver liver fat reduction of 86% So this actually improves fatty infiltration of the liver, and 90% of them have a resolution of their hepatic CSDA ptosis. So this is again, this is something new, and you know, it’s pretty spectacular. So in this phase two trial just as a summary 48 weeks 24% weight loss at the highest dose, an average of average absolute of 58 pounds. The weight loss thresholds for all all doses was 100% and 12 milligrams nearly half of the patients lost more than 25% A quarter lost more than 30% and you had very good lipid profiles hemoglobin a one C’s also, this is another one I can’t pronounce on this is an oral agent as of the same it’s also by Lily retap through triad is also from Lily this will be an oral agent This was also in phase two studies. And after 36 weeks, a little bit less weight reduction. But this is a pill This is not a shot. So and this one’s fairly new also. So this is just a comparison head to head from the lowest dose to the highest dose. So Simmons semaglutide, the lowest dose ban and 8% weight loss versus the attacher tide and 16% appears IDs are about the same highest doses about the same weight loss and a big jump again and reattach your tide. So when that one comes out, that’ll be the game winner. What to do when the party’s over again we talked about metformin and Mira veg Ron I can’t say these are my burdock which is a approved for overactive bladder. And again the issue with my burdock is that there’s no generic and it’s really expensive. My verdict there was a 11% decrease in body weight over 40 weeks. By itself. There was a 4% weight weight loss with metformin and 500 milligrams twice a day by itself. In the combination there was a greater than expected 17% decrease in body weight. So so we what we started to do. So a lot of our PE we use a lot of Berberine. So we’ve been using Berberine and resveratrol as a substitute. And we have some studies on reds virtual that’s fairly comparable to these medications. At again at a high dose 1500 milligrams a day. And we’ll report back in six months or so and let you know how that goes for us. Okay, the problem with this my this one here in the mid better on the way Burdick this is with a good RX $400 a month so that’s kind of not not practical. I tried getting it wholesale and it was like $700 for you know, five doses, so reds really too expensive. So what it does what they do both of those drugs, they they they convert white fat to brown fat. They increase thermogenesis and fat burning. The Metformin doesn’t work all that well alone, there was a 4% decrease in body weight, but when you add it in with the with the MC Berta run, we end up with one plus one equaling four. The subjects also showed an increase in glucose utilization. A couple of other things and then we’ll wrap it up. So a&p que is a energy pathway. There’s lots of ways to address it. Especially with when NPK is deficient. This happens a lot, you know, with with aging we get abdominal obesity, loss of insulin sensitivity, increased cellular stress, mitochondrial dysfunction, chronic inflammation. So when we when we stimulate this pathway, it increases fatty acid oxidation and ketosis. It inhibits cholesterol and triglycerides. It inhibits at the podocyte lipo light laces. So these are a NPK activators methylene blue, which is actually a commercially is a dye does come in a in a food grade substance. It’s used in autoimmune issues. And so there’s Metformin there’s ginger we talked about ginger butyrate is short chain fatty acids fermented in the liver decreases insulin and reduces insulin resistance and this Gynostemma which is a Chinese herb and transferred fats into the cells and it decreases fat storage and improves insulin resistance by 35%. That Berberine a VA s o x x from numedica contains Berberine and Gynostemma. So that’s one of the reasons we like that. This is some more information on Gynostemma butyrate as a short again, short chain fatty acids it helps with weight reduction. There’s references for that. Oxytocin, you know, the love hormone has some weight loss component also. So here’s a again a summary. This is our semaglutide term parasite injection. Plan, we’ll use the semaglutide into parasite interchangeably. And there’s appears a couple of ridiculous things now. So you’re going to we’re hearing this nonsense and you know, some people are just never happy with anything. So anybody’s heard of ozempic face. So you know, it’s a big surprise that if you lose weight, you’re going to lose some fat in your face. So this was if you look up ozempic face I blocked out her eyes. This is actually a picture that I got off of the ozempic face article. I think she looks pretty good. So and then there’s ozempic finger you may have heard of this one. So you’re gonna lose some some some fat in your finger and the rings and bracelets are falling off. You know, this is first world issues. So I came up with a couple of my own. I also also was Empik but there’s another one. So here’s my own ozempic Calvin’s because you know you’re going to lose weight or events, you know, and, you know, then you’re gonna have to go buy new jeans. Here’s ozempic dress or is Empik Chico’s because, you know, you’re gonna have to go get some new dresses. We also have a like I said, a Mind Body program. There was also I skipped over this was ozempic Cat and ozempic foot. So these are more these are more things that we can we can complain about. If you go on YouTube and put in some of these things. You’ll find these people saying what are you doing this for? You’re going to end up with ozempic foot or ZMP face. So if you only have one ozempic face and end up with increased wrinkles, we can fix that too. We do a lot of aesthetics here. I’m going to stop there. Any questions? Comments, complaints?
1:19:28
Yeah, so we have a couple of questions in the chat. Box. I’ll go through those for you and then you can speak to them and anyone else. If you have any questions as we go through those. Feel free to send them in the chat. So the first question that came in kind of earlier in your presentation was is the H s CRP more specific for cardiac disease and should that be used instead of a regular car? Yeah, that’s the
Bill Clearfield 1:19:51
one we use. So I you know, I we use it so often that I just I forget that there’s two of them. We do to use the HS one. Yes. Okay. Okay.
1:20:01
The next question is do you use LPW? A and A POB as a screen for further CV inflammatory markers.
Bill Clearfield 1:20:11
The answer to that one is yes. Also. Enter easy Okay.
1:20:19
Another question is will you address the lean body mass loss using semaglutide antorus appetite?
Bill Clearfield 1:20:27
Again, adequate exercise adequate, you know, lifestyle changes, you’re gonna get a little bit of lean, lean body mass loss, but on the whole, the patients you know, do quite well, and we’ve not really seen a real issue with that. I guess I could be wrong, somebody could be up you know, you know, could have have a different take on it. But you know, our patients lose a substantial amount of weight they feel better. And you know, this has been a real game changer for us. We do use intermittent fasting as one of our plans. And Katrina has the Mind Body program, and she’s more than more than welcome to send it to anybody who wants it.
1:21:14
Next question is about your side. Says appetite is given I m is given SQ Correct.
Bill Clearfield 1:21:21
That I put a put Iam that was a mistake. Yeah, sub q
1:21:28
this question, did they just come out with a new oral version? I think that’s in regards to this latest one the r1 Correct.
Bill Clearfield 1:21:36
That one that was the one that I showed you beginning with the oh that I can’t pronounce? That’s not out yet. There’s one called Rebel sis, which is actually semaglutide in a pill form. And we’ve had two or three patients use it and they do lose some weight with that. I don’t think it’s as good as the as the injectables and quite frankly, I think using the injectable there’s a psychological component to it. Also, taking a shot versus taking a pill. I think we’ve always we’ve we’ve always done some injectables in one form or another. Sometimes we use peptides we always do better with the injectables than than oral form in the interventions that we do.
1:22:17
Next question, you can speak into it if you do this personally. And then I can see I can speak into what syncs with body sight. Do you follow body composition and is there a Preferred device to measure that?
Bill Clearfield 1:22:28
I don’t because I don’t have I don’t have the equipment. We have a scale that gives us body fat, but you know, there are, you know, very sophisticated body body composition machines. Most of our patients don’t go to a gym, they’ll go to a trainer they’ll have that. So personally, I don’t would I like to do that. Yeah, but someday maybe when I have a couple extra topics.
1:22:54
I can speak into the devices that sync with body sites. So we have the no tech home scale, which obviously is not as accurate as those that you can, you know, hold with the hands. For appendages. It’s no check scales things directly with the app so the data comes through automatically. And then we are also integrated with the InBody scale. So if you do have a brick and mortar where you have that in office that syncs with the platform, as well. Another question that just came in, I’ll just get my little tidbit is is it better to use the body say inner minute plan or the semaglutide plan the semaglutide plan? That is breakfast, lunch and dinner. The recipes are lower in fat with lean proteins including plant based protein that incorporate whole grains, fruits and vegetables, whole grains with caution of course. I don’t know if there’s preference. Dr. Clearfield I don’t know if you want to talk into if intermittent fasting is better. Perhaps it’s not what’s best for everyone.
Bill Clearfield 1:24:01
We do it individually. The sunlight your semaglutide plan is fairly new to us. So the jury’s still out. But you know, it’s a paleo light and that’s what we’ve we’ve recommended and we usually we asked the patients you know what, what if they have a preference? If they don’t, we usually do go with either a paleo keto. And like I said, I like gluten free for everybody. I don’t think anybody should be eating gluten or ever. Whether you’re on a diet or whether you have any kind of medical issues or if you’re just you know, it’s 14 years old. You know, it’s just not good for anybody as far as I can tell. Patients just feel better when they’re when they’re when they’re when they’re off a gluten. It’s not easy to do and you know, and it’s getting easier but it’s not it’s not an easy thing to do.
1:24:50
Can you comment on compounded similar? Yeah, well,
Bill Clearfield 1:24:53
I just did you know, that it’s, it seems to becoming a problem, you know, I guess they were too was too successful. And, you know, we can’t have can’t have nice things. So, it was a lot it was a lot less expensive. And it was it was very successful. So of course, you know, we have to you know, we have to we have to put the kibosh to that. So, what can I say? So, like I said, I gave you the, the, our version or version of the the commercial product, so and again, the intermittent fasting is beneficial to everyone agreed.
1:25:31
On I do need a check, but I’m actually pretty sure that our semaglutide planet has whole grains but I think that it actually might be fully gluten free. I need to do a double check. So don’t quote me on that everyone here but I’ll send I’ll include that in the recording as well. Once I get confirmation on that,
Bill Clearfield 1:25:51
you’re gonna you’re gonna fix that if you’re going to fix that or put put up another one,
1:25:55
right? Yeah, I’m pretty sure it is. Yeah,
Bill Clearfield 1:26:00
I think you need to change the name of it to semaglutide to Pierside or in cretin. You know, to include the other the new ones and the ones coming down the road. So
1:26:11
yeah, since you brought that up, you guys can be the first ones to know that we will be launching a trans appetite program and then based on Dr. Claire fields suggestion, we’ll also be launching just a general increase in weight loss plan so it won’t be specific to any one medication. As you’ve seen here as early as two days ago. This new research is coming out out about this one. So we want to make sure that we have some evergreen plans for you guys to use as the research develops, and more and Korean medications come out. All right. Have you used a metabolic breathing machine? No.
Bill Clearfield 1:26:54
Shame. So if anybody has information on it, let me know. And I can I put in another shameless plug. Tuesday night as you know Katrina because you’ve been on we have a an integrative medicine webinar every Tuesday night, eight o’clock Eastern 5pm Pacific. We’ve been doing it for two and a half years and if you have any information on the what was it, metabolic something breathing machine, we’d be happy to hear about it. So can I put my email address in the chat? Can anybody wants to do that? Okay,
1:27:32
of course, of course. And I’ll keep going to these questions while you do that. I’m Eileen, you asked to your How does your intermittent fasting program look like? We have three intermittent fasting programs. One is the clean 28 intermittent fasting which clean 28 Eliminate sugars, gluten, dairy alcohol. Then we have the gluten free Mediterranean intermittent fasting plan, which Dr. Clearfield mentioned earlier is pretty popular in his practice the gluten free Med and then it’s just the intermittent fasting version. And then we have the intermittent fasting paleo plan based on our paleo program, intermittent fasting nother question or prediabetics being covered by insurance companies for ozempic and Manjaro.
Bill Clearfield 1:28:15
I have no idea. We gave up we gave up on dealing with insurance companies about two years ago and haven’t looked back so I really don’t know. I guess some of them might cover it. Some of them don’t. We get we get every day we get pre authorizations for this or that and we if we gave up on that too, you know, we give the patients a letter where they start with a say we’re not going to do it because it was taking hours. I mean, we had one we had one person just doing pre authorizations. And, you know, you know, we like it or not, we’re running a business. I mean, I can’t pay a person 40 hours a week, you know, to generate nothing. So insurance companies can turn turn us down. Don’t ask about testosterone replacement. This is another story. So the answer is I don’t know.
1:29:07
And that’s okay. Well, I think that’s all of our questions that we have here today. We will be sending out the recording later this afternoon. We will also be including in that blog article that has the recording the mind body connection handout that Dr. Clearfield mentioned earlier in his presentation. If you have any questions feel free to email Dr. Clearfield his emails there in the chat. If you have any questions about body sight or this new semaglutide plan that we launched, you can email me directly at Katrina with a k@bodyside.com. So thank you, everyone, and I hope you have a great rest of your Wednesday.
Bill Clearfield 1:29:48
Thank you, Katrina for voting.
1:29:50
Is there a link?
1:29:51
Thank you again, someone’s asking if there’s a link to your Wednesday
Bill Clearfield 1:29:55
class I gave, I gave you that my email address is right here.
1:30:00
Okay. Yeah, email him and then
Bill Clearfield 1:30:04
get your go in there. Okay. All right. Thank you.
1:30:08
Thank you, Dr. Clearfield for being here. with us. Thank you
Bill Clearfield 1:30:17
Great, thank
1:30:19
you. You were fast to
Bill Clearfield 1:30:22
well, it was an hour and a half. Somebody that nine o’clock zooms out. Really.
1:30:29
Oh shoot. We let him know you’re done. Yeah.
Bill Clearfield 1:30:41
ozempic ci goes I call it g goes. As we’re Judy goes. clothes shopping. Right. I gotta go clothes shopping. I lost weight. It’s your fault.
1:30:57
So we’re gonna bombard him I am and then have a barbecue real quick because I need if you don’t mind, I need to get this done real quick. So, Faith said that you were in going to increase her pill count was yes to 180
Bill Clearfield 1:31:16
Here’s her she makes it up.
1:31:20
Oh, she said. She said you told Ken
Bill Clearfield 1:31:25
when when I told him I wouldn’t even bring it up
1:31:31
don’t know
Bill Clearfield 1:31:37
these people I didn’t tell him to cut it. This one this is the third time with this
1:31:54
okay, but her daughter’s gonna be here to pick up that stretch. That’s why I’m just asking for that.
1:32:00
I know you’re busy
Bill Clearfield 1:32:04
because this one here and Elisa.
1:32:07
I don’t think she’s in yet. Let me go check. Well, no, I know but I did leave a message and asked her 1030 to come in because I wasn’t sure so.
Bill Clearfield 1:32:33
So we get these numbers in here and
1:32:36
I just want to make sure it’s up front when her daughter pops back in.
Bill Clearfield 1:32:41
All right. So are we out here?
1:32:46
Was it good? Good. I talked
Bill Clearfield 1:32:50
about so you heard about I told you about ozempic face? Yes. Yes, I made up a couple of my own hat was epic flood was epic. Calvin’s kind of got messed up here and it was epic. She goes like that. Right? Yeah, I lost weight. Now I gotta go buy new clothes. True or false?
1:33:29
So dad is technically sick. I put him on the A and the D treatment and even started some ivermectin just in case got some flan. Do you recommend like a Roman tessen or something like
Bill Clearfield 1:33:41
that? Yeah. You know what I liked the
1:33:46
day quilt. A quilt actually works pretty well and Nyquil. Well just equal. Okay. Leave the NyQuil alone. Okay, cool.
Bill Clearfield 1:33:56
What am I doing here?
1:33:58
Oh for her compound for five milligram this one. No, no, it would be.
Bill Clearfield 1:34:15
Thing is that hydro? Hydro. Yeah. 616
1:34:25
I just did this last time.
1:34:29
Oh, did actually go in
1:34:30
see what you got.
Bill Clearfield 1:34:35
Oh, notice was an add an extra 180
1:34:38
Yeah, because she takes it by types right Oh, she probably shoes
Bill Clearfield 1:34:55
five times a day would be weighed 150.
1:34:59
Oh, okay. So now we’re increasing it then. Okay
Bill Clearfield 1:35:04
to six times a day,
1:35:05
I think so. She just and she sent me a picture too. She just had
1:35:13
like a squamous cell removed. And she’s got another one growing already
Bill Clearfield 1:35:22
she was known as PPP because that first what’s kind of nice. Oh support protoplasm Gotcha. All right.
1:35:41
Okay, perfect. Crisis. Yes. Perfect.