Tuesday Integrative Health Webinar
Tue, Apr 11, 2023 4:51PM • 1:40:28
SUMMARY KEYWORDS
patients, day, decreases, diet, week, fat, milligrams, increase, dose, stay, weight loss, good, eating, pretty, foods, protein, gluten, reduces, calories, sugar
SPEAKERS
Bill Clearfield
00:00
Good Hi there. Hi. How are you? Good. How are you?
Bill Clearfield 01:34
Nice to see you.
01:35
Nice to see you and Mr. Johnny B. Not your sound is off Hello.
01:51
Oh, you’re doing excellent.
Bill Clearfield 01:53
Okay. Since I couldn’t I couldn’t find any I found David Kahn late, late last night. They said he would do it and then I forgot to change the the flyer this morning so we’re gonna have him in a couple of weeks. So you guys get me today. Yay. But I’m gonna need I’m gonna need Somebody to be a co host to let folks in. Either either of you do that or both of you? Today? Yeah,
02:23
yeah. Okay, now that Jack Jacqueline do it that she looks like she looks way more together and
02:36
you know, way more than I do.
Bill Clearfield 02:38
All you have to do is you’ll be able to let them manually it’ll be at the top of your screen there. It’ll say. Well done. Just let them in. Okay. You had to sign in sign in, though. You had to do a registration. Yeah. Yeah, that’s good. I can’t I can’t believe I actually did it without having to spend another $1,000 on something else. So
03:00
it worked fine. Last week, too.
Bill Clearfield 03:04
Yeah. This will be the third week so this week. I got a I got our logo on there. Did you notice that John? Gosh, I
03:11
think I did.
Bill Clearfield 03:13
Not Oh no, I didn’t pay attention to these things.
03:17
Well, when it flashed up, sign and it said Tuesday weekly integrative webinar. I didn’t know if that was me or you.
Bill Clearfield 03:27
What you do another one.
03:29
I play around with it. I want to do that. $1,000 When you say we can’t afford
Bill Clearfield 03:35
Well, we got Oh, I didn’t tell you. We got $7,300 from the AOA from our videos from you know we didn’t do last last year was out but they sent us third $7,300 So
03:49
Wow. Well, you need to go on a few special trips. So I hope that can pay. Well.
Bill Clearfield 03:54
I’m thinking maybe I’ll go to the AOA House of Delegates meeting in July again, but if they’re out to represent, I’ll have to I’ll have to be somebody off the representative atta I guess. Last year they didn’t have anybody who just had a couple of students there.
04:08
Well, we have way more friends than they realize we have. Also, I will mention the new medical school that’s going in about 30 minutes from my house and they’re very focused on research. Right who looks at the facts realizes how important integrative medicine is and it appears this medical school also believes that integration is the way of the future. They believe in the research and everybody in our crew here, you know loves research because it tells the truth. He usually gets down to the nitty gritty so now everything’s positive they I think the whole way away is gonna go a little bit integrative and about.
Bill Clearfield 04:53
Well, they think they are now right. Isn’t that their philosophy and all of that baloney that
04:59
they Well, reciting? Well, we went through a level of hypocrisy that blew us away but first of all I don’t think
Bill Clearfield 05:08
they liked that what I wrote on the remember last summer I said the hypocrisy is too damn high.
05:13
Well, it’s it was the truth and the truth eventually comes out doesn’t it does. What’s in issue is that a Florida School?
05:22
Oh yeah, that’s Nova Southeastern University. That’s the school in Florida. What are you doing
05:29
there? I’m
05:31
assistant professor of family medicine. I teach the physical diagnosis class and physicals or clinical medicine procedures.
05:40
It’s fantastic.
Bill Clearfield 05:42
I probably no more than we forgot,
05:45
say a century in a school. Do you think it’s important that medical students get a little bit of a touch of research and their very first year and so
05:54
well? Yeah, we have actually a research course for the for the end once. That’s wonderful.
Bill Clearfield 06:03
Young Scholars full of mush.
06:06
Yes, they are residents, they they have to, you know, especially if they want to compare it to if they’re gonna have a competitive specialty they have to research from the start. It’s fantastic. Yeah, so we have a research question at the very beginning.
06:27
I was thinking, maybe we could help Nyan Patel and his gluta real. What a perfect subject to research would be here.
Bill Clearfield 06:37
He could do a little better job. Do you ever use that stuff? Smells.
06:42
I’ve written to him and said I’ll buy it. Full cost half cost or research costs whatever he wants to do, but I haven’t heard back from him then but we did get the criteria for the research what he wants to look into. Okay. And how do you pronounce your last name? Mold? Joe?
07:03
Yeah. Wow.
07:05
You’re the only one mold Joe I know. Are you familiar with the gluteal? We’re speaking of
07:12
that’s the one that we talked about last week. Yeah, the week before? Yeah.
07:16
He was mentioning how it lowers a one C and I have a strong interest in that.
07:23
So yeah, I didn’t I don’t think I got
07:30
he was just giving us a few cases where the a one seed dropped from 10 to 514 to five, doing nothing more than Bluto real spray. Yeah. So it’s like, if that’s well, I don’t know. I don’t think they expected those results. So that’s why we need to look into it a little bit. And I’m looking into it because I might mine has climbed from about six to 10 because I can exercise lately. It made a real difference. Yeah. I’d like to try that on my Tommy to see what happens. Yeah. Do you have any of it? I don’t have any that’s why I say he hasn’t really turned me on. I was going to ask you how I order it. Can I order it through you this crew or what?
Bill Clearfield 08:17
He gave a call What’s your name? So the email every week is Jackie golden golden, Brooklyn. She’ll get it for you. Okay, then.
08:29
All right. We have saved the website.
08:33
Yeah, I think it’s gluta real.com.
Bill Clearfield 08:37
It’s all wellness. A URL web LLNE s s.com.
08:45
Why say that again?
08:50
Bill
08:58
This is
Bill Clearfield 09:04
see a very popular here this. There’s the three of us. It’s five o’clock
09:12
that’s the lowest number yet. You went oh there goes Oh, okay. Thank you. I got it. Yeah,
09:19
I think that’s what it is. now.
09:22
I’ll call him again. But I think it’s really important what he’s talking about. With the increase in diabetes and the increase in cancer, we should be looking at glutathione I have seven There we go.
09:52
Those
10:08
well says 10 participants 10 People in in love.
Bill Clearfield 10:15
Oh yo, you’re letting people in okay and see that. Okay. Great. Okay, are we ready to go? There? Okay, all right, you guys are gonna let them in right yeah. All right. I’m gonna start recording and so well. Welcome, everybody. Thank you for coming. We had a few hiccups here without speaker tonight and David Kahn had graciously volunteered at the last minute and unfortunately, I didn’t get get to change the flyers on the emails on it. So I’m going to proceed as advertised and we’ll have a one on one in a future talk. So this, we’re gonna call this the new face of weight loss. And this is a presentation that we will be giving in about three weeks at AMG in Florida. So if you’re not going to make it you’re going to you’ll see it here. And because there’s been all sorts of changes and new things have come out in the last couple of years that have really sort of revolutionize things. They said this is a CME lecture. So here’s my disclosures which are none and in objectives. I always find this a little bit fun. So I what I did is I went back and did a little short history of diets. I’m gonna go through everything because we could spend all day doing that. And then again, how to get out of the debt. Here are the four things the four sort of pillars of what we look for, and what we try to address which include chronic inflammation, nutrition, hormone balancing and Mind Body lifestyle program that I have and if you want I have a handout on that, that the AMG people are getting and I can send that to you. Um, it’s an eight week program the then we’ll go through that pretty quickly. practitioner interventions is which we’re, we’re most interested in and there is an off label component to this and what I call the game changer. So a brief history of diets. So you know, us physicians, we’re all geniuses. In the late 70s, early 80s, low fat diets became became the thing. And it started actually in the late 50s and early 60s with a doctor named Ancel Keys who did something called the Seven Nation study and what he did was he studied European and African nations for heart disease. And he found that the the areas that during World War Two that were deprived of meats and saturated fats and then later on the cultures that are more vegetarian had much less cardiac and heart disease. He kind of cheated a little bit though, because he actually looked at 22 countries, but they didn’t all fit into his, his sort of hypothesis. So we only took the seven that did so he like I said he kind of cheated a little bit. And as we all know, by now, you know, just lower eliminated cholesterol was really kind of kind of a boondoggle. So this was a cover of Time magazine in 1984. Cholesterol was bad. 2014 cholesterol is good. And then of course, there’s, you know, what’s so great about kale will read me kill me and what to eat now. So this brief history of diets and like I said, it’s kind of fun. And I start with this one here. This was this was a pamphlet written in 1862 by a funeral director, his name was William Banting. And here’s it, here’s a picture of him on the left. And in 1869, there’s a picture of him on the right. And his quote was that of all the parasites that affect humanity, I do not know of or cannot imagine any more distressing than that. Of being obese. There was a term that came to be known as to ban. He stated that he could not stoop to tie his shoes and or attend to little offices and humanity requires without considerable pain and difficulty, which only the corpulent can understand. I have been compelled to go downstairs slowly backward to save the jar of increased weight on his ankles and knee joints. And he’s was obliged to puff and blow with every slight exertion, especially going upstairs. The problem was that he had quote, unquote, no direct bill of fare to know what was really intended. In other words, he didn’t have a roadmap. He didn’t have any type of guidelines, he was spared no pains. To remedy this by low living, a moderation and light food was generally prescribed and it seemed to make things worse. Instead, his system was brought into low impoverished state without increased corpulent without decreasing the Corpulence this little this was the cover of the pamphlet. He sold like 60,000 of these remember, this is 1862 I think there were printing presses then so that was quite a quite a achievement at the time. He had many obnoxious Boyle’s appeared, with two rather formidable carbuncles for which he had to be operated. On. And then he was fed into increased obesity afterwards, he came up with a cure his cure for copper Corpulence, for moderate meals a day versus three large ones, vegetables of all kind grown above the ground except peas. He stated that weight was gained from eating peas, fruit was less likely to increase weight of cooked without sugar rather than eat raw fat was to be skimmed off of rabies and jellies and expressly prohibited bread milk, butter, beer, sugar and potatoes. Does that sound familiar? Eating 62 or root crops including carrots, turnips, parsnips, sweet and beet roots, they were actually discouraged. This was his routine, and it sounds kind of disgusting actually one tablespoon of an alkaline corrosive to carry the weight. The dregs of acidity left in his stomach after digestion. At 90 MB had five to six ounces of beef, mutton, kidney or boiled fish, a couple of large, large cup of tea or coffee and a small biscuit or one ounce of dry toast making six ounces solid nine ounces liquid. At two o’clock he had the same thing he had some fish, except he said except for salmon earnings reveals any meal except for reveal any vegetable except potatoes parsnips, beet roots, turnips, or carrots, an ounce of dry toast, fruit out of a pudding not sweetened any type of game or poultry and two to three glasses of good color Ray, Sherry Madeira champagne word. Champagne port and beer were forbidden. At six o’clock he had a tea without sugar or milk, two to three ounces of fruit and a rustler 202 his alcohol, three to four ounces of meat at nine o’clock similar to 2pm and a glass or two of clear array of sugary water and he had a tumbler of grog or one or two glasses of clear razor Sherry as a nightcap. He stated that five ounces of sugar distributed equally over seven days will augment his weight by nearly a pound a day. This was the calorie breakdown. And this was actually considered almost radical. Only 23% of his calories were consumed via alcohol 1700 calories a day and you can see the breakdown there and he had so 27% of protein 22% fat and 28% carbohydrates. So pretty pretty even, you know pretty much what we see in the Paleo diets here except for you know 23% of your calories and alcohol. So going back even further and 8000 BC stone stone age this is your paleo meet needs some plants and more meat. The first diet book that was recorded was in 1558 by an Italian named Luigi Corona Corona Carneiro He limited food to 12 ounces per day mainly egg yolks and wine and wine take 14 ounces a day and 1614 a jet Giacomo Castile vetro and Italian and England touted the benefits of a protein rich diet in fruits, herbs and vegetables of Italy. The British weren’t really all that excited about it. In 1825 A John really aren’t soberano I’m sorry about my French published the physiology of taste. He was actually he was a chef. He stated the cause of obesity was a natural predisposition and conjunction with the flour and fabuland substances which man makes the prime ingredients of his daily nourishment. The effects of this were potatoes, grains or any kind of flour were soon sooner when sugar was added to the diet. So again, you know carbohydrates 1860s We talked about this was the cord litter of Corpulence. In the 1930s, a studio starlets prescribed were to prescribe the Hollywood diet half a grapefruit before every meal coupled with restrictions of calories. The cabbage soup diet that one didn’t go over too well. I’ve mentioned Ancel Keys in his seven Country Study in 1958. He linked dietary fat consumption to coronary artery disease. In the mid 1950s urban legend and opera singer Maria Kallos callus dropped 65 pounds by swallowing tapeworms nothing not not really recommended in 1960 Nathan Pritikin and Dr. Lester Morrison postulated that animal fat deprivation was seen in World War Two led to a lowering of cholesterol and heart disease became eventually the Pritikin plan, which was a less than 10% saturated fat diet. weightwatchers was founded in 1963. They were all pretty much the same. 1960s and American physiologist and Salerno Ely published the first scientific study on the Mediterranean way of eating 1970s The grapefruit diet made another comeback by a fellow named Mayo who called himself the Mayo Clinic and he became rather well known because it was mistaken for the real Mayo Clinic. The Sleeping Beauty diet was was touted by Elvis and in which he sort of drugged themselves for two or three days and so he would meet and you know, unfortunately drugged themselves to the point where he didn’t wake up. In 78. Atkins published the diet revolution and remember this was right when the low fat diet you know, no fats were any good, which claimed that avoiding carbohydrates would peel off pounds and lower the risk of metabolic syndrome diabetes and high blood pressure. There was actually hearing in Congress where he was he was upgraded also the you know the medical community. Much like today decided that he was a persona non grata. Stone Age diet introduced Manta to again back to the Paleo diet. Dr. Sanford Siegel in Miami formulated a special cookie SlimFast that was always a favorite shake for breakfast, a shake for lunch and a sensible dinner. That you know, morphed into Optifast and Medifast in the late 80s. I was actually ran a program in our hospital with tied to the cardiac rehab program or their their doctor at Taunton torn hours published the Scarsdale diet, which was a moderate calorie, fat, carbohydrates and protein diet. He was shot by his girlfriend, Fen Fen federal federal probe and olamine became a trademark name in 1979. It was it was formulated with phentermine and it was linked to heart valve disease and increased strokes and the PPA the federal probe and olamine was taken off the market in the year 2000. We can still get phentermine. In the 90s the Atkins diet had a revival with a second release of the book, The Zone diet which was a specific ratio of carbohydrates, fats and proteins the South Beach Diet was sort of the Atkins and Mediterranean put together. In the 2010s, the Paleo diet was sort of just a repackaged ancient meal plan of meat, eggs, fish, protein, and low to no processed foods. And it became popular through CrossFit. Um, in 2011 H the HCG diet which had actually been formulated in the 1930s and sort of had a revival and we’ve tracked quite a bit HCG, you know, the pregnancy hormone increases LH FSH and TSH. But it was paired with a really strict diet like it was supposed to be 500 calories and just fluids and it was always you know, we always thought, well, if you just ate 500 calories a day you didn’t really need the medication. But it did. Like I said it does increase FSH LH and TSH the Mediterranean diet was was studied and found to reduce heart heart attacks and strokes by less than 30%. I can use trade names here. So this is Contrave, which is low dose Naltrexone and Wellbutrin was approved for weight loss. I’ve never had a lot of success with that one. I don’t know what else says and we’ve we’re now at the GLP ones. The the credence the diabetic drugs that secrete. With stimulate insulin secretion in inhibits glucagon, controls appetites and cravings. It slows emptying time from the stomach and increases resting energy expenditures and improve sleep. A 68 week study showed a mean weight loss of almost 15% with 30 30% of the patients losing more than 20% of their body weight. And most almost 90% of the patients lost 10% of their body weight. The issue with the you know the incretins and especially semaglutide We’re going to talk about that a little bit later on is that we’re almost half the patients there’s severe side effects that they can’t take, can’t take the medication so, but we’ll talk about ways around that. So our four pillars of weight loss are inflammation, nutrition, hormone restoration and our mind body balance. So inflammation you know, for us old guys was a really hard concept for me personally to to, to sort of wrap my head around it was it’s just seemed foreign. But we’ll talk about that. You know the the low fat diet should have lowered coronary cardiovascular disease. And the problem was, it only looked at you know, narrow the narrow numbers that you know the lipid numbers and it didn’t look at the whole body. And, you know, it really wreaks havoc with with a lot of lifestyles. And the you know, the the sort of the dogma that you have to get the LDL down to 70 or lower and it didn’t matter how you did it as long as you did it and it didn’t matter what the rest of the patient’s life was like. You know, we have Dr. Lilith Lilith Willow in our in our group who’s one of the lipid ologists I mean, you can’t can’t convince him otherwise, so I don’t try anymore. So, you know, like I said the Holy Grail of dieting was low fat, high carbohydrate diets. And I remember, you know, when we had a diabetic we had to prescribe the ADA A’s recommendation which was about a 70% carbohydrate diet, which of course only made things worse. It’s an add, you know, I can set low fat equals fat and it seems counterintuitive, but if you look at the low fat guidelines where they came in, in the late 70s, early 80s 15% of the US was considered obese in 1985. And then as time went on, you can see the obesity lines go up and now it’s in some places up to 75 70% in some areas of the country, and you know, it’s at least 20 to 30% Almost everywhere. And so what happened was that the food companies, you know, happily took fats out of their out of their products and put sugar in. So, you know, so what happened, you know, A Funny Thing Happened on the road to load to the low fat diet and saving saving carts. This was the food pyramid that was produced by the US Department of Agriculture in 1992. And as you can see that the basis is six to 11 servings of bread, rice, cereal, pasta and pasta, three to five servings of vegetables, two to four servings of fruit, two to three servings of the meat, fish nuts, and then you know, fats sparingly or not at all. And so this was the food pyramid and it really should have pretty much been turned upside down. So so what happens with those kinds of diets is we end up with you know, sort of internal inflammation and like I said, I like to use this as an analogy. The reason being is that for us old guys, the you know, the again, the concept of chronic inflammation that caused the unit was sort of the cause of all disease. Well, we’ve been studying this for a long time now. But if it’s I like just like, like I said, just use this as sort of an analogy. This is a town that was about 6070 miles southwest of Wilkes Barre, where, you know, he spent many, many years was called Centralia, Pennsylvania. This was the picture of it in 1962. This was the downtown Centralia, Pennsylvania in that year, the you know, we it’s cold country to grow call you have to have dark wet damp weather. And you know, this is the perfect the perfect place for it. Summer starts at right about Memorial Day and it ends in about the middle of August and invite by Labor Day it’s full, and by the end of September winners it sets in and if you get three days in a row of Sun between the end of September and the end of April, that’s actually considered a good winter. So so the summertime is is rather cherished there although even though it’s 100 degrees and 100 degrees humidity. And so the town elders in 1962 decided that for the Memorial Day Parade they were going to have a town cleanup and they got all of the the four H club and the the boys clubs, the the Girl Scouts and you know all of the service groups. They got them all together and they collected 20 tons of trash, and then they didn’t know what to do with it. So being the honest Upright Citizens that they are of course one of the town elders who owns some land and he sold it to the to the city that they could use it to dump all this trash in. So they dug up so he sold it, you know at five times what it really was worth. They dumped that they dumped the trash in there and they burned it. Unfortunately, it was a coal vein right under right under the where they dumped the trash and they burned it in a caught fire. It actually didn’t take them very long to figure out that it was that something had happened down there. But they did so they went to the Lehigh coal company and which was the main one of the main coal companies then, and a Lehigh coal company wanted a $20,000 for the go in there and put it out, which of course they didn’t want to spend. So this was by the end of the summer, these plumes of smoke were coming up from under underground. And as time progressed, this was about a year later now there’s these plumes of smoke so so the the coal fire burned underground, and it veering towards the center of town from the edge where the where the where the dump was. And so by by this time here, the ground started cracking and we started getting smoke coming from it from the from the mountainside. And today today it’s down 2023 It’s still burning, the town has been condemned. The state of Pennsylvania paid the residents there. cost them so far $400 million to route every one up from from Centralia and move them and the town is no longer there. This again here’s the main street in Centralia 1962 And here’s the main street in 2002. And as you can see, there’s nothing here. It’s this the same street corner here. And so that’s sort of my concept. This sort of was my aha moment of what a underground with what if chronic inflammation is, again, here’s a photograph of the same road. And as you can see, there’s nothing here and it’s condemned. It’s the town is closed. So we want to measure inflammation and we want to do something about it when we measure it. So we like C reactive protein, we do the cardiac C reactive protein, our goal is less than 1.0. And this gives us an idea about inflammation in the cardiovascular system. And if we treat it if we get it early, we can you know reduce again chronic diseases. Remedies for elevated C reactive protein as our omega three fatty acids and curcumin or Tumeric I usually save the curcumin or Tumeric for Joint Pain. Make sure it has black pepper in it. Bio cream or black pepper omega three fatty acids are anti inflammatory. They have anti platelet activity they support support cardiovascular health and mental health. We use we start here with usually with 1000 milligrams twice a day for the omega three fatty acids. The tumor usually if you use it in pill form comes 500 milligrams and you can use one or two of them twice a day if necessary. We’ve seen very little GI issues with tumeric and it’s quite a good as a as an anti inflammatory and for Joint Pain. LP PLA two is specific for vascular inflammation. It’s pro atherogenic. It’s a marker of plaque vulnerability. Again, a marker for cardiovascular events and acute coronary events. And so, you know, what we want to do is make sure that we’re looking at the whole patient and not just you know, just you know the diet and so that’s that’s why we look at these things. These are our remedies here. Niacin, omega three fatty acids and then statins and fibrates. If you’re if you do prescribe medications we I’ve actually done quite well with with you know, fibrate 145 to 160 milligrams and there’s actually an antidepressant side effect from it. So it actually works quite well. We’ve actually used it in that and lower doses in autistic children and it improves their social mobility status. I tried to stay away from it because it you know, it wrecks the whole hormone cascade. Now Myeloperoxidase is is when this is elevated, it means that you have a ruptured plaque. So the one before was just you have plaque vulnerability, this is a plaque is there and if this is elevated than the Myeloperoxidase then then we’ve had a ruptured plaque and that’s more serious and then usually I smell similar folks off to the cardiologist for that age garlic, curcumin, pomegranate seeds and remember pomegranate seeds will increase testosterone levels, and your quercetin, which is good for your reactive reactive reactive VOCs oxidative stress. Lots of diets there’s we saw we talked about a whole bunch of them before the Standard American Diet This is our you know our inflammatory diet and the yellow is the the percent intake of patients that you are deficient in recommended vegetables, fruits, dairies, and oils. And then over here, this is the elevated amounts of sugars, saturated and salt so diet, you know the inflammatory diet will increase insulin resistance and create a chronic inflammation. Increased triglycerides blood sugars will give you an abnormal cholesterol. Sleep apnea is a good result high blood pressure increased waist circumference and lead to all of these chronic diseases. macronutrients again you know to way too many carbohydrates too many empty or junk calories leads to obesity leads to activation of K I can’t Jay AR toll like receptors increases on pro inflammatory TNF alpha interleukin six and decreases at Depoe nektan. So these are some things that we can we can actually address. I’m not going to go through all these micronutrients but you have you have this list here that will make sure that this gets up on the on our website. But you know all sorts of vitamins. Vitamin b1 By the way, take take a better look at that. There seems to be a real sort of homeless syndrome of deficiency not or insufficiency not deficiency, causing lots of mental issues anxieties, depressions and, and the such as a lot. A lot of times we’re looking at b1 deficiencies. This is again I’m not going to go read all this but there’s a list of essential micronutrients and we want to make sure that we cover all of these. These are the energy components of some popular diets. And down here you can see the protein diet or Mediterranean diet is about 20% protein, about 40% carbohydrates and about 40% of fats. The Atkins diet is about 65% fat and about 10% protein and or carbohydrate and about the 25% of 25% fat protein 65% lipids 10% fats. This is a ketogenic diet is pretty close to the same. Here’s the Zone diet and the Paleo diet. You can see they’re pretty much the same. And here’s that Ornish Diet. This was the you know, the high carbohydrate diet and I guess you know, in some some circles in medical students this this is still the gospel. I’m not sure why blood sugars. So when we look at blood sugars, I always tell the patients we’re going to look at blood sugars three different ways just like the Christmas Carol. So the Christmas Carol was you know the ghost of Christmas past present future, we look at the blood sugar of past, present and future. So this is the present fasting blood sugar, normal 65 to 99. But for everyone, this is your reference right down here for every point over 84 There is a 6% chance of developing some sort of blood sugar abnormality within the next five to 10 years. So you have a fasting blood sugar, say of 94 minus 84 is 10 times six. That’s a 60% chance of developing a blood sugar issue within the next five to 10 years with again in normal blood sugar. 99 is normal. 99 minus 84 is 15 times six, that’s a 90%. So so you can use this as a as an you know, the patient’s a sort of they sort of look wide eyed at that. You know, we tell them that it’s normal, but it’s just not quite optimal. We always get a fasting insulin normal is about two and a half to about 25. We want it to be less than five and then we calculate insulin resistance and insulin resistance is the fasting blood sugar times the fasting insulin you need to divide it by 405. That’ll get us our units even. And it’s a ratio less than 2.9 is normal. Less than 1.9 is our goal. Hemoglobin a one see that your blood sugar of the past that your average blood sugar over 90 days, three months. It’s a percentage of hemoglobin coded glycosylated with glucose from the bloodstream. Normal is less than 5.7 prediabetes 5.7 to 6.4 Diabetes is greater than six by there’s a whole bunch of reasons to have false positives, but this is pretty accurate. Homeless homocysteine is a marker for vascular damage with increased risk of strokes, blood clots, heart attacks, and circulation. Normal is less than 11. Our goal is less than 10. Our remedy here is methylated B vitamins, B six feet tall folic acid but make sure that they’re methylated. I had a patient come in a couple of weeks ago, a new one is in his homocysteine was 32. I sent him right over to the cardiologist and sent him for a cardiogram which was sort of equivocal he had no symptoms. cardiologists called me up and called me and told me I was an idiot. What am I sending this guy for? Not six days later, he was in the ER having a heart attack. He had a 99% LED lesion so you know pay attention. Vitamin D, you know, we sort of beat this one to death. Normal vitamin DS 30 to 100 Our goal is 50 to 80. The point is 65. And so inadequate vitamin D is necessary for bone strength, the immune system, the heart, the brain blood vessels, and as you know, it’s quite those those who had adequate vitamin D levels were fared much better with our viral infections. micronutrient testing, this one is Spectracell. I had the dream once that I was going to measure all of these and then come up with a customized vitamin pack for the patients but it turned out to be way too expensive. They were costing six and 868 $100 a month. But in the white so this is a blood test in the white here this is the normal this these are B complexes needed some amino acids here. The yellow was sort of equivocal and the blue is low. So you do want to replace these these it if necessary. Necessary. And so our road to inflammation is our high carbohydrate diet increases insulin increases inflammatory cytokines which are noted here, decreased antioxidants and when you get fat accumulation abdominal fat that produces inflammatory toxins itself leads to chronic disease. So this is kind of our growth, inflammation. So that’s inflammation. We’ll talk about a couple of diets, especially sort of Quickstart things. The first one will be the elimination diet and so this is the poor man’s food sensitivity test. And again, the art standard American diet causes postprandial blood sugar spikes, increased lipids and triggers atherosclerotic changes and you get a postprandial dyslipidemia we get a lot of food sensitivities with these kinds of symptoms that are sort of nonspecific, a lot of the patients if they’re paying a little even a little bit of attention will tell you you know, if I eat you know, Brazil nuts I’ll you know, I’ll have headaches and I’ll be sick for the next two days. And that’s what we’re looking for. It’s not food allergies, there’s a difference. Allergies like a peanut allergy, you know, it was an anaphylactic reaction. This is a food sensitivity. It’s an IgG reaction. It’s headaches, low energy, depression, mood swings, you can get skin irritations, you know, a lot of times eczema and psoriasis are from from what the patients are eating, joint pain, difficulty losing weight, asthma, any inflammatory foods. Now remember, way back when we started we talked about the Banting and the 1862. Funeral Director who stayed away from fatty fish, but we’re in favor though, so you know, salmon, mackerel, sardines. Those are the fatty fishes, grass fed beef and buffalo, nuts and seeds, dark leafy vegetables, red and blue colored fruits. Extra virgin olive oil, although I hear that’s on the outs nowadays, moist heat cooking under low temperatures and certain spices. You want to stay away from the Frantage foods the trans fats, the refined sugars, foods with high glycemic response, high omega six oils such as corn and soy, gluten containing foods I’m almost convinced that everybody should should just stay away from gluten. And I pretty much tell everybody all my patients that now and I try to do it myself. saturated animal fats, dairy containing foods, high temperature cooking with fats. This comes from the Institute for Functional Medicine. This is kind of an elimination diet plan the green is is good. The yellow is sort of in between and the the red is the stay away. And again, if you want the slides there, it’ll be on the video and if you want the slides let me know and I’ll get you this. The autoimmune protocol also reduces inflammation. It’s a lot like the elimination diet and you’re we what we’re trying to do is either prevent or heal our so called leaky gut, the leaky gut triggers on the development of the auto immune issues. And there’s certain against certain foods that are sort of notorious for that. These are the yes foods, all vegetables except nightshade, which are potatoes, tomatoes, eggplants, and all peppers except black pepper. You want to limit fruit to 10 to 20 grams of fructose or two to three pieces a day. coconut products are okay remember back in the no fat days that the coconut was was was no good. Also avocados were no good. Fermented foods are on our list. The oils and fats are the plant based ones and grass fed meat a wild caught fish in fat fish three times a week. Non si herbal teas green teas, vinegars, coconut, red wine, apple cider, sweeteners, honey maple syrup spirit syrup, use sparingly, try to stay away from the artificial ones. Fresh herbs and binders sort of grass fed gelatin arrow starch are permitted if needed. The starches can cause adrenal issues and bone broth they are the no foods. Again tomatoes, potatoes, eggplants, peppers, except black pepper seems to be okay. Artificial sweeteners, corn, wheat, buckwheat, rye and you know mostly most of the grains, dried foods fruits vegetables, vegetable oils, and animal oils. Eggs are not on the AIP diet, especially egg whites. You can experiment with that and see if you have a reaction to that all alcohols is off on herbs from seeds are meant to stay away from too and gums and binders. And so here’s that list there. Okay, gluten is a combination of glutenin and Gliadin proteins found in wheat, barley, rye and triticale, which is a combination of the two gluten triggers an immune response in the lining of the small intestine. Small Intestine damage interferes with nutrient absorption increases the risk for bone disease, anemias and even cancers to avoid gluten and GI issues and the inability to digest food the consequences are bone loss, weight loss, iron deficiency. Gluten sensitivity, we call it there are antibody tests. If they’re negative, I don’t even bother really with them anymore unless the patient insists you know if they’re sensitive to gluten and and then we do a blood test and it comes out negative I mean there’s still sensitive gluten. There does seem to be less small intestinal damage in gluten sensitivity, symptoms or bloating, joint pain fatigue, irritable bowel syndrome or even brain fog. And then here are the symptom GI symptoms and the nine GI symptoms for gluten sensitivity and celiac problems added you know, usually the ones on the right or the or the or the vaccine one you know most of the folks know if they eat something that it makes them makes the meal they’ll truck those try to stay away from it. But it’s the non GI issues sort of bone pain. Dental defects, depression, fatigue, headaches, itchy rashes, joint pain. A lot of these symptoms are similar to mold toxicity when darker Campbell was here talking to us. So, um, you know, it’s sometimes a little bit difficult to to distinguish between the two. Here’s a gluten free food list and again, I’m not going to read this but you can have this sort of part of your arm of a terrarium labels to check again, lunch meats, ground meat, so you know, prepared things. Those are the ones that you really need to be careful with. And Boston soups again they have a lot of salt in them and they have they again they have a lot of gluten in some of these foods are not gluten free. French fries, donuts, cheese cakes, you real boys, those kinds of things. There are some that are labeled as gluten free. You still have to be a little bit careful with even with the gluten free foods. Sometimes it slips in there, and it’s usually not totally 100% that way anyway. protein sparing modified fast. This is less than 1000 calories 500 800 calories a day as usual. You need one and a half grams of per kilogram ideal body weight of protein one to two servings of a non starchy vegetable, vitamins and nutrients supplements need to be provided on five grams a day of cecl usually put it in some water and you need about eight to 10 glasses of water. You can use a flavored sparkling water again sparingly, it’s probably not good to do that all the time. The portion size for protein about the size of your palm and the fruits and vegetables. Make pretend you’re standing in front of the Fae here. At one of the casinos and you you when nobody’s looking scoop your hand in there, make a scoop. So two scoops of salad dressing is about about the right of these are just feeding schedules for protein sparing modified fast. And so this one shows you know liquid protein 90 only eating up only eating a dinner on HCG which we can’t get anymore. The FDA sort of sort of outlawed it for to be used. You know the dietary as a dietary aide. But we did use this for a long time we were very successful with it. Five to six meals a day. So small meals, patients you know only eight five to 800 calories. So and then things to watch out for things like watery fruits which are high high have high glycemic index versus the the the lower glycemic index foods. So anything you bite into, that’s all watery, I’m gonna get you all wet and sloppy. So melons are a good example of that are usually high in sugar. And they’re even higher than sugar than some candy bars. Even though they’re natural. The neutral ones are sort of apples, bananas, those kinds of things. Pears, you get a little bit of water. Those are sort of neutral in the best of the best are the berries, so blueberries, strawberries, blackberries, and raspberries are probably the best of the best. Oranges are pretty watery, and they can they can actually you know sort of keep weight weight up. Again, no alcoholic beverages no white flour, white white bread, oil based cosmetics, and moisturizers are that are absorbed for calories from the skin MCT oil helps with energy especially after exerting yourself and his anti inflammatory and the plant based oils are the good ones. So olive oil, canola and coconut. I know there’s some some some of the latest literature out says that some of those aren’t so good either. But we generally we’ve done pretty well. This is a feeding schedule for HCG diet, and this was what to eat on it. So basically meat fish chicken or a vegetable based protein, fruits, vegetables and then those are the oils. Okay, this is a list of side effects from hCG. I mean, the doses that we use, I’ve never seen X and quite frankly I’ve never even seen it in the in the doses that we use for you know for young men to boost testosterone which can be up to 3500 units. Two or three times a week, which is a really high dose. And I’ve really not seen any any side effects but it’s in the literature so here it is. Um, if you have a bad day patients have a bad day and they go off the wagon or on the wagon. There’s if you’re if you’re don’t want to deal with meats you can have an apple day you begin at lunch. You patients have one apple every three hours throughout the afternoon and evening and they drink water only you can put some lemon in it. And then in the morning you pick it up and so when you get up and then two more, two or three more apples in the morning and you stop at 12 noon, you can use Bragg’s amino acids or apple cider vinegar and with lemon juice as a flavoring. That’s the apple day the state day is pretty much the same. You can have an apple or tomato you can have one large portion of steak already even chicken and again 100 ounces of water split up over 24 hours at red meat and provides a large amount of slow digesting protein and improves cellular recovery. So this is a way to sort of sort of get around you know sort of going off the wagon even try this for 24 hours. If you’re starting somebody want to plan the mini fast with bone broth so you two meals a day within an eight hour period usually between 11am and 7pm and fast for 16 hours. Two to three high protein high fat snakes, snacks and snakes between meals are permitted to plan your exercise sessions along with bone broth intake at the time of the fest and it seems that breakfast is the best time to fast even though we’re told you know breakfast is your main meal but breakfast said we seem to get a better response and actually a much better weight loss on production. Make sure they get hydrated. You don’t want them to get on. You don’t want to want them to get on dehydrated. And usually one or two of the glasses put in at least half a teaspoon of either Himalayan pink salt or sea salt. Make sure that patients don’t go hungry make sure they use the low glycemic index foods. Again remember the berries and the neutral ones are the mini mini watery ones apples and bananas those kinds of things. Stay away from fruit juices white flour or artificial sugars, diet sodas and dairy and then that that meal plan that we had for HCG a couple of slides back you can use that as sort of a guideline. Here’s a feeding schedule here for mini fast with bone broth. Then just different ones. So bone broth is interesting. It you know it became all the rage about 10 years ago in New York City kiosks. We’re selling it on the street for $10 For a little cup when I got the ingredients and I realized that this is my grandmother’s recipe my grandmother did this all the time. She made she made bone broth she just didn’t know she was making bone broth which was good for you. I guess. Anyway, here’s the here’s the Here are the ingredients. And then here’s how to do it. Basically you’re cooking the the the meat or the chicken or the meat or whatever the with the bones for more than 24 hours and then let it cool and you store it and usually in mason jars and then you know you can make it you know on a daily or weekly basis and discard or compost the bones and start over again. So it gave you my bobby Clearfield some bone broth recipe, and then there’s paleo and keto. And so the keto diet is high, high, high fat, low, low, low carbohydrate. Paleo is sort of moderate. And then there’s a difference between them. They overlap with a healthy animal proteins non starchy vegetables, the super foods and bone broth and no refined sugars, grains, beans or legumes. That seems to be the theme. That’s keto. You can have berries but that’s it. Low Carbon fats and in the Paleo detect food sensitivities on natural sweeteners, bone broth. This is just a sort of a percent carbohydrates of all of those diets. Look another look at that. Here’s a breakdown for paleo of proteins, fats, carbohydrates and vegetables. Again, you can look at, you know, what’s in each category, but you can see the vegetables is 40% protein 30% fats 15 carbs 50 This is just another paleo you know, the left is good the right is to stay away from legumes are actually not permitted on the on the Paleo diet so soy beans and lentils peanuts are out and the industrial ends and seed oils are also out keto diet is mostly fat and with some 20 to 25% protein and a little bit of carbohydrate. And these are the no the noes are down there. So breads, pasta, sugars, milk, corn, hormones, you know, this is a whole nother subject. And I will I did here and you can you can again get the slides. This is just a summary of these are all the hormones we use and the the indications for them and deficiencies. You know, we want we want to be Goldilocks with our hormones, not too much, not too little. On the hormones that regulate weight and and then fat or testosterone, thyroid and growth hormone. So we want to make sure that those are in balanced oxytocin, there’s some literature on it, that it will improve the sort of the metabolic balance and weight issues. I know Dr. Colossae and Mike beamer from AIMEX. They were working on a plan. I’ve tried it a few times and I’ve not really had a lot of success with it. But if somebody out there has let me know. This is our evaluation and again, this is pretty much all we do here. So we have that. And then Matt there’s medications so phentermine Topiramate you Pro on naltrexone, which is Contrave HCG, we talked about now trek sound you can have now tricks on low dose Naltrexone implants the GLP one agonist, which is what I want to want to sort of talk about a little bit here. A NPK is a metabolic pathway and there’s a lot of supplements that can drive that butyrate it will increase gi motility, oxytocin and we’re talking about oxytocin, we talk about it in intranasal oxytocin. AOD 9604. Is a peptide that has been touted as for a weight, weight, improving weight loss but not had a real lot of success with that. That’s the amino acids 177, the 191 I believe, of the growth hormone chain test. So fencin is a new as a new peptide, and I don’t have one here, one we’ve just started looking at is called matzah mo T S dash c. So those are new ones. So feta mean is adrenergic uptake inhibitor. It stimulates the sympathetic nervous system and recent releases norepinephrine. It’s the amphetamine like it’s, it’s speed, it is a controlled substance. It usually comes 37 and a half milligrams is a score tablet. It does come as low as 15 milligrams of you right for the 37 and a half milligram you can have the patient’s break them in half. It’s a little bit too strong. Make sure they take it in the morning, usually before 10am And again, tachycardia, elevated blood pressure, dry mouth, those are the issues there. These are all the contraindications and drug interactions would fit to your immune so you know you have to be a little bit careful with this one, though it is is quite popular. So pyramid eight is an anti seizure drug and Topamax is off labels used for migraine headaches, treatment of bipolar disorder and it says weight loss here but there’s actually a combination FDA approved drug now called kusina, which has phentermine and Topiramate in it, so it’s not off label anymore. It acts on the frontal cortex of the brain to reduce appetite and the activates the addictive centers of the brain doses or at least the start at 50 milligrams. I’ve never gone higher than 125 to 800 is in the literature. Side effects are brain fog was a mental alertness, memory loss, dizziness, fatigue, dry mouth, back pain hair loss. There’s a combination of phentermine and Topiramate called Q Sima U S y Mia, and that is a lot more expensive than just using the separately usually we use the phentermine in the morning or use it to appear made at bedtime. inflammation that we talked about a little bit earlier or effect on way to decrease this T four to T three conversion leading to a state of thyroid resistance that increases insulin resistance. It will lower testosterone and increased expression of aromatase leading to high estrogen levels. It will increase leptin levels increases appetite and it will increase cytokines particularly interleukins one six and TNF alpha which are pro inflammatory cytokines. Now trek zone you prone which is Contrave is low dose low dose Naltrexone the mechanism of action is a combination of an opioid antagonist and an antidepressant. It also increases beta endorphins and targets the CNS pathways influencing food intake. It suppresses the PO o MC nor neuron inhibition in the in the hypothalamus and Bupropion activates it so it’s sort of a counterbalance. When you dose it, you start at one tablet for the first week and then two tablets for the second week and then two or two in the morning, one at night and then two and two. That’s that’s sort of the high dose. Nausea is quite common. 32% Constipation settings vomiting. I don’t know if any, any there anybody listening to us this. We’ve not had a whole lot of success with this one. I kind of use this as almost like a last resort. low dose Naltrexone reduces insulin resistance increases growth hormone. increased insulin equals D will decrease growth hormone so that’s what the insulin resistance is burns fat, reduces lean body weight, decreases cravings and modulates appetite by modulating the opioid or pleasure centers. It acts as an anti inflammatory agent and decreases leptin and estrogen which will lead to weight loss particularly as strona the sort of cancer causing estrogen will lower that it improves sleep and it will increase total T three levels and improves the T four to T three conversion. That’s not right. No Oh yeah. So side effects. So we usually dose it at night. You know, there’s a whole we have a whole lecture on low dose Naltrexone. It will last about six hours depending on the dose and then it wears off. So that the idea is that you were loaded up with endorphins when we’re ready to go in the morning. About 10% of the patients though have some sort of insomnia from it. And so we used to just back it down to 8pm 6pm. Now I just tell the patients this usually in the morning, and they seem to do quite well. I got this for literature nausea at 32%. I don’t really see it we have a couple of people can’t have nausea. I don’t have I don’t think I’ve had five patients since 20 years that we’ve been using this, that we’ve had to stop low dose Naltrexone and we cause nausea, so I’m not really sure where that number came from. And in nightmares, we do see that about 20% The books call it vivid dreams with patients do tell us some wild stories. Usually they go away. Again, I don’t think I’ve had anybody stopped using this because of nightmares. That’s pretty much it for side effects there. There are now Trek’s own implants we’re going to plant 1.1 or 2.2 gram cylinders in the lower abdomen, in the buttocks or the lower lumbar spine, which is where we do it. It lasts about three to four months before it wears off. And you still need lifestyle changes you still need it you still need to watch what you eat, but it it lowers greatly cravings and it reduces desire for eating and drinking and smoking. semaglutide This is the new kid on the block. This is the incretins they came out about not 2010 The first it wasn’t a once a day shot and they became weekly. And so we found all of these controls appetite slows the stomach emptying time it’s FDA approved for diabetes and weight loss, the trade names for semaglutide or ozempic and would go either different doses that a glucagon glucagon like peptide analogues they stimulate insulin secretion, improve sleep and increase energy expenditure. They’re quite potent by decreasing appetite, usually by more than 50% 32% of patients lost 20% of their initial body weight and 70% of patients lost at least 10% of their initial body weight. So it’s quite potent. It’s way way more effective than pretty much anything else. We’ve talked about. This. These are just some of the statistics here. It’s got a half life of one week about and so it’s a once once weekly injection. This is the from the studies from from Novo Nordisk, who, you know did this and you can see the different doses here and the changes in body weight this is placebo here. This is similar blue tide 0.4 milligrams a day. And this one here is I think this one’s trulicity. So that’s sort of moderate. And as you can see a different doses we get a really nice weight loss and this was on average our patients so we’re gonna I’m going to show you a little bit different way to go about this. So and again, as you can see, placebo is here, weight loss and this is semaglutide. And this was over a year’s time. Here’s the dosing schedule. Started 0.25 milligrams and for four weeks and then every four weeks go up by a half milligram and then for the weight loss those you can go up to 2.4 milligrams, and this is an im shot weekly. You have no dosage. Changes for GI issues or renal or hepatic issues. You need to be careful with insulin and oral diabetic meds. It does not seem to affect your blood sugar if you’re not diabetic, it will increase. It will decrease your blood your fasting blood sugar by approximately 10 to 15% and on average it will decrease hemoglobin a one c by about 1.2 milligrams. But there’s always about the button is there’s a high inst high high incidence of nausea to the point where the patients can take it up to 44%. As this this again kind of came from the the company itself. fairly high incidence of diarrhea vomiting constipation, the one we hear about is nausea. And it can be quite severe. It’s also usually not a covered you know insurance covered medication. Sometimes the company puts out a coupon but it’s not insurance covered. And the last I looked with a discount coupon it was $1,350 a month. They usually come in a four four pin pack that’s once a week shot. And then as you know the pharmacies won’t take it back if you can’t take it. So you know can be quite expensive and then you have to give it away because you can’t use it yourself. So I’m contraindicated in a family your personal history of medullary thyroid cancer, and even that’s kind of I mean, that’s in the package literature. I mean, they fed the Fed rats 75 times the equivalent adult doses and some of them developed this vigilante thyroid cancer, so I’m not sure that that’s even you know, legitimate but it’s in the literature, routine monitoring of serum calcitonin and using thyroid ultrasound is uncertain value and early detection of medullary thyroid cancer in patients treated with semaglutide. All weight loss drugs have an issue with they can you can develop colleagues with biases from hypoglycemia, and a slight increase in heart rate and suicidal behavior and ideation as not specific to this one or any of them. And again, the cost is 1715 to $1,700 a month. And now we’re gonna go off label because we fixed it. So we took semaglutide We for some reason were able to get the raw material. We mixed it with vitamin B six, which is what we use for pregnant women that are have morning sickness and BPC 157 which is any inflammatory agent that came from gastric juices. And if you know anything about this, you know it’s quite potent as an anti inflammatory especially for joints. And it’s also quite quite potent as a as an anti GI disease issue and it’s it’s quite potent and healing. It’s useful for all of these things that you see here. Leaky Gut GERD, irritable bowel syndrome all sort of colitis, vomiting, diarrhea, and it comes in pill form it comes as an injectable and we’ve been able to get it put together two as a in a solution all three they’re compatible. And we use a very tiny doses we start at 0.2 cc sub q and we do it five days a week instead of doing a once a week shot and we’ve had much less nausea and vomiting or discontinuation rate. Remember it was 44% for the for the the official rate. Ours is less than 4%. We started using this actually on January 1 2022. This solution I was actually with my first guinea pig My birthday is February 12. So six weeks later, I went from 177 to 155 pounds today away 157 were able to keep it off. It worked quite quite nicely. I just didn’t feel like eating I’ll tell you the truth. And we we we go back to it once maybe every three to four months and we’ll do we’ll do another round the bottle will last five weeks. If you do it at two tenths of Assisi. Some of the patients there like I said, we have a 4% discontinuation rate. And, and for some reason, it’s all all our discontinuation patients or women I don’t not sure why. But it is. And I really haven’t figured out why and I tried to predict who it might be and haven’t been able to do that either. But we’ve been quite successful for this. We have over 500 patients on it that are less than 4% and have had to stop because of the side effects. On average men will lose up to a pound a day, up to 30 pounds in a month. And women usually about half to three quarters of a pound. I have had some women lose 30 pounds. The worst or worst patients was five pounds. In the fight the bottle last five weeks. We’ll do two rounds. If they need it that that much. Then we thought we have to take a break. One of the things that we found out is that if you use it continuously, it will you’ll become accommodated to it. It’ll stop working. So this is actually this is quite potent. It works quite nicely. And are we our wholesale price is $159. That’s with needles, and then there’s a shipping cost to what we found out is there where are we getting it from there? They’re shipping it they’re charging $45 to ship it which was a lot for per person but they ship it to the office. They’ll they’ll send it once a week to us and involved in only charges $45 for the whole week. So that’s the what that’s what we’ve been doing now. So this is kind of our whole plan. Um, so we use the semaglutide five days one, five days one, two days off. We started out telling patients to do it 20 minutes before their biggest meal, but it seems that we seems to work better if you just do it in the morning. When you get up before before you eat anything you get we better off we do 10 weeks on two to four weeks off and then we kind of cycle it that way. We use a&p K, which is a central regulator of energy homeostasis. I’m the coordinator of metabolic pathways. We have We if you were on a couple of weeks ago, we saw the body site program we use this and we have you know, we have all of these diets. It’s very easy. I type in their their name and their email address, and they’ll get recipes and menus for 30 to 60 days and pretty much any kind of diet you want. You can even write your own. If you have a sweet tooth killer like I do, two tablespoons of apple cider vinegar and six ounces of water seems to take care of that. We do have a couple of add ons. So butyrate will help with digestion and try butor in is the usable form. Oxytocin 24 units AC and Hs I like I said that Dr. Hall ASA likes this I’ve not had good success with it. We’ve used a little bit of pesto fencing, it’s kind of expensive, and one milligram a day, and really so we’re still we’re playing with Mazzi exercise we like high interval, interval training and high intensity interval training and again on the body site program. There’s videos on that, um, you can just have the patient’s Look at that. It saves you a lot of time. And then for them to move a little bit I tried to find things that they didn’t have to go to the gym for, and I went back from the 80s and 90s couldn’t go on YouTube, you can find pretty much anything from back then. I like the eight minute abs, eight minute legs so they’re short and they don’t take a whole lot of time. You can do one or two of them a day and patients keep them moving. And if you have kids around the house, you know it looks a little corny and whatnot. But they’re kind of fun. Also, Richard Simmons sweating to the oldies. There’s a 13 minute video on YouTube and you can use that for aerobics also. So ANP K. M is actually a system it’s a cell sensor. We had Dr. Carl felt gave us a talk on this about a year ago. It’s the metabolic regulator and it compasses all sorts of things insulin leptin adiponectin it switches cells from ATP consumption to production. And it is with eight NPK am PK deficiencies. You get this mitochondrial dysfunction which seems to be one of the watchwords these days, chronic inflammation, heart failure, increased cellular stress, high LDL loss of insulin sensitivity. It it it drives skeletal muscle tonicity inhibits mTOR and NF Kappa Beta. It activates the nerf to skn one receptors and it’s activated by heat shock exercise. phytochemicals Metformin, AICPA and methylene blue GCDs are an Metformin are a NPK activators you can use that you can also we like Berberine and resveratrol and there’s a couple of companies that make a combination one with one we use as a NPK activator. We actually get it from life extension. And we use that as pretty much as a fat burner. It inhibits cholesterol and triglyceride synthesis. It’s good for muscle, muscle glucose uptake, cellular uptake of glucose and it’s actually on his biogenesis of that glucose transporter. Here’s an a&p que. stimulators methylene blue, metformin, a car, ginger, a gingko, butyrate and Gynostemma, which is a Chinese are transports faster to cells that reduces fat storage. It’s been shown to reduce insulin resistance up to 35% and reduces glucose production by 29%. And this is the main ingredient in that a NPK activator of life extension. It’s about 17 or $18. Wholesale a&p que transfer does Gynostemma transports fats to the cells to be used as energy, decreases visceral fat, and as I mentioned, it decreases insulin resistance by 35%. Decreases glucose production by 29%. And it has anti aging properties also butyrate is a short chain fatty acid that’s fermented in the large intestine also reduces insulin resistance enhances adaptive thermogenesis increases mitochondrial function inhibits glucose growth and differentiation of abnormal cells is anti neoplastic. It increases energy expenditures, you want to use the pro drug which is a tribe uterine butyrate is metabolized to quickly Buterin is sort of like a coded unit rate and you get a better plasma concentration levels with that it’s an anti inflammatory and inhibits interleukin 12 increases in anti inflammatory interleukin 10 and it decreases TNF alpha interleukins one, one B and six. It’s useful for weight reduction, it decreases visceral or brown fat it has no effect on brown fat decreases white fat attenuates fatty infiltration of the liver and plants, plant sources butter ghee and there are some supplements you can get for this. Here’s the references for that. Oxytocin. Again, like I said, this doctor also is sort of the proponent of this. We’ve tried it I’ve not had good success. There is some literature that it works. Well it plays a role in glucose and metabolic homeostasis. insulin sensitivity, decreased regulate down regulates the HPA Axis decreases cortisol facilitates insulin secretion, and glucose metabolism. Metabolism is inversely related to oxytocin levels. Suppresses sugars and carbohydrates, decreases food intake and visceral fat and decreases food consumption in men greater than women and in bigger patients that rather than smaller patients. The dose is 24 international units which you can we haven’t made in 120 milliliter 20 unit per milliliter solution, and so it’s 1212 international units per spritz into the nose. So two and a one on each side in the morning, one on each side at night. Studies have showed weight loss just just using oxytocin of up to 9.8 kilograms in eight weeks. And this is just a summary sort of how oxytocin works. And acute effects on reduces calorie intake reduces respiratory quotient and proves beta cell response. Activity. Decreases body weight waist circumference and lowers total and LDL cholesterol cholesterol. AOD 9064 And I’m going to skip over this one. I’ve not had a lot of good success with this one either. It has been touted for weight loss. There’s no change in IGF one levels no effect on insulin levels a side effect of headaches has been also used for osteoarthritis osteoporosis poster pedak neuralgia is in migraine headaches, it stimulates tissue repair, it stimulates lipolysis and lipo Genesis is the literature for that this is the new Kiriona back to parasite side which is where JOHNNo is the trade name is from Lily, this has this is semaglutide but it also has a glucose dependent insulin polypeptide added to it 510 15 milligram I am weekly usually started 2.5 And it has better hemoglobin a one seat improvements versus assembly glue tight and also weight reduction. The side effect profile is pretty much the same but seems to be less. We’ve not been able to get the raw materials of this to trend so sort of make it into our our rooms. So you sort of at the mercy of the of the drug company with this one. And it’s quite it’s not as expensive as semaglutide it’s about $1,000 a month and the patients seem to do quite well there there seem to be shortages with it. And Tessa fencing is a presynaptic uptake inhibitor of dopamine, serotonin and norepinephrine or noradrenaline. 15% increase in fat oxidation improves utiles insulin utilization 6% increase in energy expenditures. doses are 0.25 to one milligram weight reductions or up to 12.6 milligrams in 24 weeks. And side effects are pretty rare. I don’t see this we’ve used I haven’t used this a lot. It’s really expensive. It’s like $250 a month just for this stuff. The good stuff anyway. I’ve seen knockoffs that don’t seem to work too well. So insomnia, dry mouth, constipation, tachycardia, diarrhea, constipation, increased heart rate Mazzi is a metabolic or a mitochondrial Energizer. i We’re just really getting started with this one. This is also quite expensive. five milligrams every, some few every five days would cost wholesale about $200. So again, we’re just getting started with this one. I don’t know if anybody else has had any experience with that. This is our game changer. We call it SMB semaglutide to EPC and be six and appoint to CCS every five days. This this is kind of your take home slide right here. This is the whole plan right there. And so you can make a few changes and you know we can do you can do kind of quite well. There’s some diet tips here. Here’s on the glycemic index. And you can always find the tables like this. Stay away from you know sugar, artificial sweeteners, fruit juices, dried fruits. We like amino acids or amino acids or apple cider vinegar for Sweet Tooth a couple of other things behavioral support. Glasses are good make sure that patients sleep well we like Rescue Remedy for that or a combination of vitamin D melatonin and magnesium Tory that’s two hours before bedtime for that are body mind things so we have a 10 week program and or an eight week program rather. And what we do is we set goals we identify a family relationship spiritual contributions, physical and nutritional goals. I have handouts on all these week too. We rate we have a happiness scale. We have patients rate themselves from one to 10. We go back to it every four to eight weeks and we follow progress. We ask them to sort of think ahead, think ahead about where they are right now. If we meet back in six months or five years what happened in your life to to enhance it so you know a lot of people don’t do that kind of thing. We try to set goals for the week, the month in the year. We talk about a bucket list. We talk about six month vision six weeks ago you did a life plan. How’s that change? And seven, week seven we have them write a letter to themselves and put it in an envelope and put it away and have it reviewed a long time in the future. And we get to have them writing goals for the next eight weeks. So So that’s that these are the the role of references and
1:26:46
we do any questions?
1:26:55
Anybody out there? Vector? Toss questions. In the chat.
Bill Clearfield 1:27:01
I see that okay. I’m gonna stop the share here and I’ll go to the chat here. Okay, so thank you all for listening. Is there anything so things such thing as a safe gluten like organic? Quite frankly, I don’t know. Like I said, I keep telling my patients stay away from gluten. I tell them Well, I tried to stay away from it myself. I feel much better without it. It’s difficult sometimes. You go to Italian restaurant. It’s hard to stay away from the bread but do the best you can. Those for status so for as a binding agent to decrease triglycerides and I would do pretty well actually with total cholesterol and LDL cholesterol with it also, I usually start at 145 milligrams and highest will go is 160. Like I said there’s some behavioral components to it especially for autistic kids. There you want to go about 45 milligrams to 290 old. Can you insert naltrexone pellets along with hormone pellets? I would separate them only. I don’t really know. I wouldn’t do that. I would step I would do them separately. I wouldn’t put them in at the same time. Does insurance cover semaglutide for weight loss? I have no clue. We don’t deal with insurance. So I have known probably covered for prediabetes. Actually we’ve had a couple of people that we keep getting getting but we don’t we don’t Bill insurances but we’ve had some people tried to get get covered and they keep sending back these pre authorizations and they sent one back every day for two weeks in a row and fine I told him I’m not filling them out anymore. Just ridiculous. So allegedly, that should probably wants you to do 16 Other things ahead of time that are cheaper for before that but allegedly you should be able to get it at some point strength of the naltrexone implants 1.1 mil 1.1 gram or 2.2 grams. I usually start with the lower one to begin with and if they if they do, okay, and they don’t have any side effects again nausea insomnia and with they usually don’t have that, but nausea and nightmares if they’re okay with that. We’ll go up to 2.2 on the second one, and again, that’s not a complete it’s not just we’re going to do these implants and you’re done. You still have to they still have to do it. They don’t decrease their appetite but you still have to do a diet you still have to do the lifestyle thing. You can do it I mean every three to three to four months. It’s fairly effective. I mean, you know, it’s a tool. It’s like I said it’s not a be all and end all. Pharmacy source is on hallandale pharmacy for that they do it that they’ll get it to you. And it’s pretty inexpensive stomach at the time to aid in fullness for a longer period of time. What about the transit time digestion mistake which stays in the stomach 72 hours. So therefore slow slows emptying time doesn’t seem safe? Well, again, you get it you can get nausea, you can get some diarrhea and constipation. But what it does is it decreases your appetite to the point where you’re really most of our patients don’t don’t are eating way less than half of what they normally. So it’s usually not really all that I mean if you’re going to gorge yourself it can happen you know without without eating, you know, without taking anything. But like I said, your intake is greatly decreased and patients don’t seem to mind it. So that’s you know, it’s really kind of a moot point. Have I seen patients who don’t respond to semaglutide Only the ones who want either can’t take it or they don’t take it. They don’t want to take it. They don’t want shots. I know there are pills. We haven’t tried them yet. We’ve had used semaglutide With Zofran. The other things that we’ll do is we’ll decrease the dose to 0.1 milligram every day or five days a week then every other day if need be, or even every third day. And do I increase the dose of semaglutide Only if they said some people seem to get accommodated to it a little bit so it can get you know doesn’t work quite as well so we can do increase it. I’ve never gone more than 0.45 nights a week. And I’ve seen other combinations. We haven’t used them I’ve seen them with B 12 In a combination and I’ve seen them also at least average I haven’t used it myself advertised some from like a compounding pharmacies, though they’ll send you a five milligram bottle with the 12 in it and you fill it with five cc’s of of bacteriostatic water and they’ll do it once a week like like the commercial products. But again, we’ve had very good success with this with very low incidence of discontinuation and really good results. I you know, always trying to build a better mousetrap but for now we’re pretty content with this. B six for pregnancy V six for pregnancy. 100 milligrams I am thank you this is what it is. parameters to stop semaglutide Well again, the patients can get accommodated to it. So you don’t want to uh, you don’t want to, you know, you don’t want to overdo it. We will taper it off and have them use it. recycle it every every three months every four months. Um, that seems to be a after after, you know two cycles. So like I said, each bottle will last five weeks. So we’ll do two in a row. We’ll give them two to four weeks off, then we’ll do another another bottle if they need it. Then every third the fourth month after that, we’ll keep them on that amtk activator and also the buter you Buterin try try butyrate a supplement also. And those seem to work pretty that seems to work pretty well as as as an aid, you know, for maintenance, compounding pharmacies, we like create pharmacy we like luxury pharmacy creates our main one that we get we get it from so it’s CR e the number eight there in down in Texas. They’re really good. They will you know they get to get it to us pretty quickly. And you know if there’s a problem I would say every once in a while shows a broken or something. No replace it. You have to keep the stuff cold. So we’ve had a terrible winter and Reno here. It was a Wilkes Barre pa winter. And so that wasn’t a problem. But just today, just yesterday or Sunday, the weather finally broke. It’s finally spring. So you don’t want it sitting out in a mailbox all day because it’ll become inactivated. You need to need to keep it cold. So we’ll have the patient’s you know, having to send it to us and haven’t picked it up here or make sure that there’s going somewhere that it’ll stay in a refrigerator. Okay. Okay, got a couple of thank yous. If you’re interested in the game changer program, well give me a call later and we’ll I’ll tell you how to get started. Cost of semaglutide so we charge 359 for the bottle for five weeks. We charge $38 for the ANP K so through about 398 total. Sometimes we’ll do a we’ll do a we did a Christmas special it was 260 It costs us 159 without shipping so the to sit when we do the 260s we have to have an all shipped here because it’s $45 for all of them. And otherwise it’s $45 goes to goes to each one as it seems a little bit high for that but again, it does have to come in a cold pack. Supplement source we use Emerson ecologic so that’s where we get most of our stuff from the Go To Life Extension itself. I mean, their prices are really, really pretty, really reasonable. We’ve been getting some stuff from them. full script is another one you can go to. And we sometimes deal directly with some of the font or some of the supplement companies we like zymogen Douglas and pure which if you don’t know is the same company. He tried to fool you and designs for health we use and numedica So there’s those are the supplement companies we keep any office and any other questions.
1:35:46
Comments,
1:35:48
great talk a lot of information so much
Bill Clearfield 1:35:52
any any anybody else have any experience with
1:35:54
this? Yes, no? No? Jen. Okay,
Bill Clearfield 1:36:07
so next week, we’re going to have Dr. Chris Miletus. He’s going to be talking about think he’s, he’s he’s, again, he’s involved with some sort of nitric oxide. So he’s a naturopath. And if Jackie’s on or Maria Watson, you would know about them. David, thank you so much for volunteering. And, but I’m sorry, I didn’t get to change the email. So we’re gonna have David Kahn on May 16.
1:36:39
And so
Bill Clearfield 1:36:41
he’ll still be be telling us about his EMF program. So anybody else have any comments, questions? And complaints. Okay, got a couple more here. I’ve got a thank yous. Dr. Richwine says I’ve listed 16 pounds, I’m assuming last sub cube. Now Trek’s own is about $400. We charge for that game plan. Thank you. So thank you all. I hope this was sort of useful. You know, I don’t like to hone in on this but we had a bunch of dropouts. And we needed somebody we needed to fill in. So anybody who was new here, thank you so much, and for coming. Please don’t be a stranger. anybody has anything they want to contribute. If you want I would like to present as you can see, it’s a non threatening environment. The only thing scary here is Dr. Burgesses beard. And then, of course, my my sidekick. Joe was off today. He’s, he’s out gallivanting around somewhere. That’s the other one. That’s the other beer. So John and Dr. Moho. Thank you for hosting here. So I didn’t have to do that. And everybody will see you again next week. Same time, same station. I’ll have the video up on the on the website, which is aos, rd. Board, slash webinars. And I think what I’ll do is I’m going to put the slides on there too. So you’ll you’ll be able to get them from there. So other rather than me sending them out to 20 different people. So, okay, so thank you all so much. Thank you for your attention, and I will see you next week. And like I said, we’ll have Dr. Chris Miletus. If you have anybody if you don’t want to present anything and Oh, in two weeks, by the way, Dr. Dr. Blanchard stone is going to be speaking for us on pandas and acute immune encephalitis. So that’s a little bit more complicated than this sounds. So if you have anybody know anybody who wants to present and even if they’re afraid to this is kind of a non threatening environment. Basically, we’re looking at a screen and I know, Dr. Burgess and Fred are looking back at us, but you know, I can’t see them when I’m looking at the slides. So makes it good. Okay. Thank you all. Thank you. Thank you for helping. Thank you.
1:39:21
Great talk.
Bill Clearfield 1:39:23
Am I going to changing life seminar April 29. No, I’m going to AMG. It’s the same weekend and actually giving this talk there. So So you saved yourself? $700 You don’t have to you don’t have to go to that. So so I will not be going to the changing life seminar, unfortunately, take notes. And I will. I’ll try and try and make it another time. So Good night, everybody. And thank you so much. I’m gonna Okay. I am awesome. Okay, thank you. Okay, then I John. Good night, everybody. Good night. Dr. Moho. Thank you for your help. Thanks, David for being here. As always, Dr. Stone we are anxiously waiting to hear from you. Dr. Nereo. Thank you Dr. Smith. Of course, Ron. Carry Porter. Raphael. Thank you all. And we’ll be here next time next week. Same time, same station. Thanks