This basic principle applies to any surgery , albeit different organ systems are affected, but for our purposes, we will relate this to gallbladder surgery (cholecystectomy).
ANY time you have surgery (of any sort) you can experience fatigue. Your body only heals when you are asleep – so that is nature’s way of getting you to slow down – so you can heal efficiently [while sleeping]. That said, most people didn’t go into surgery with a fully functioning gallbladder. It could have been dysfunctional or essentially non-functioning for months or even years before that. So , that means you have months or years of digestive issues and not getting the building blocks your body needs to make hormones or repair itself. Surgery brings its own issues, as it increases the demand you have for certain nutrients – like vitamin C, B vitamins, protein, glutathione, etc . So, when you have gallbladder surgery – you go from just being deficient in the fat soluble vitamins (A,D,E,K) and essential fatty acids to being potentially deficient in most of the major vitamin categories. To compound matters, they typically put you on a significant dose of antibiotics after your surgery – which kills off the good bacteria in your gut along with the bad, and since 80% of you immune function comes from the gut and those good bacteria, your immune function goes down , making your MORE tired and susceptible to catching everything that goes around. It is a hard thing to dig yourself out of. You have to overhaul your diet (and you rarely get that advice), you have to get optimal levels of sleep, and you have to get out in the sunshine and fresh air and get some exercise. Otherwise you feel like you are trying to dig yourself out of a hole with a plastic spoon. Now, occasionally people feel great after surgery, but they are the exception to the rule. In 12 years of practice, I have rarely met anyone who didn’t have to make changes to feel better afterwards. Sooner or later their underlying nutritional deficiencies caught up to them and affected their health.
Your body uses cholesterol and vitamin D as precursors to make many of your hormones, including your sex hormones. Fats are necessary for life, and your brain is largely a fatty organ. This is why people taking anti-cholesterol medications (statins) frequently experience decreased libido, or even sexual dysfunction. They also often experience short term memory issues.
I have heard doctors argue that the gallbladder is unnecessary. They say that since the liver continues to make bile, then fat absorption continues. I disagree with this. First, I don’t believe we were designed with unnecessary parts. We may not realize their full worth or function yet, but that is a human limitation, not a limitation of our creation. Science only ‘discovered’ what the appendix was for within the past few years (It acts as a reservoir for healthy bacteria to recolonize our intestines after fever or illness). Since cholecystectomy is one of the most commonly performed surgical procedures in this country, it makes sense that there is more money in removing them than figuring out how to save them. But I digress, let’s get back to the liver making bile – it does keep making it. The level it makes it is dependent on whether you have fatty liver degeneration or not. But let’s say that you don’t have fatty liver — the liver is going to drip, drip, drip 27-34 oz bile out in a steady stream. That bile is very caustic, and would normally be funneled over to the gallbladder where it is collected and concentrated, up to 18 times – down to 1-3 oz. It is this highly concentrated bile that is designed to break down the fatty acids and fat soluble vitamins you consume. The pre-concentrated bile, while caustic and irritating to your gastric mucosa, can’t hold a candle to the concentrated bile your gallbladder should hold. There is never enough, and never enough at the specific concentration required to absorb those key nutrients out of your diet. So you become deficient and your body goes into conservation mode. Some experience this immediately, others find it takes 6-24 months to fully start experiencing the effects. People find it harder and harder to lose weight, or they find themselves gaining weight despite eating the same diet they always did, or exercising. They find they get fatigued easier, and that they are more susceptible to colds and flu. If they have autoimmune disorders, they may find themselves experiencing a greater degree of symptoms.
So what can you do? I will be the first to admit that I don’t have all of the answers. If anyone suggest that they do – RUN! I can tell you that what my research, and my experience has led me to works for most people. First, you need to keep a food journal and track every meal you eat and how you feel afterwards. Gas, bloating, and diarrhea are the most commonly experienced repercussions from having cholecystectomy. 1 in 15 people who have had their gallbladder removed experience Habba Syndrome, which is commonly misdiagnosed as IBS, or even Celiac Disease. 5-40% of cholecystectomy patients will experience post-cholecystectomy syndrome (persistent right upper quadrant abdominal pain, bloating, gas, nausea, diarrhea, and general malaise). Often, these people will know the whereabouts of every bathroom in their vicinity, because they experience issues almost immediately after eating. Dietary changes will be necessary. Certain foods aggravate a significant number of people with no gallbladder. These include greasy foods, carbonated beverages, dairy, and simple carbohydrates. Wheat products, including breads and beer, can also elicit a negative response. Please don’t take this as a reason to stop eating healthy fats — you NEED to consume them in order to maintain your health and shift your waistline. Use specific dietary supplementation to replace some of the action of the gallbladder. I recommend a blend of ox bile, beet concentrate and pancrelipase to substitute for this action. If you avoid fats, you will make matters worse. Since digestive enzyme production decreases with age, if you are over 40, adding digestive enzymes to your meals can also cause significant relief. make sure you are getting adequate levels of sleep so that your body can repair itself and so that levels of stress hormones can decrease.
- Keep a food journal to log your physical responses to foods and beverages. Learn what your body can and cannot handle.
- Use specific dietary supplements to increase your digestion and resolve your underlying nutritional deficiencies.
- Get 7+ hours of uninterrupted sleep per night.
- Get out there and move. Aerobic activity and weight bearing exercise is crucial for your recovery. Walking is a great way to get started. Walking in the sunshine is even better (get some vitamin D while you are at it!)
Image courtesy of Ohmega1982 at FreeDigitalPhotos.net
This is an aspect of weight loss that perplexes a lot of people – they start a new diet and notice their clothes getting looser, or their face getting thinner – but their weight is staying the exact same! It is frustrating, because you *think* your diet is working but you step on the scale and feel like a big old failure.
Well, I am here to tell you that you can relax! You are not a failure! You are experiencing the wonders of the fat cell in action (I can hear you saying, “big whoop — skinny thighs are what excites me!”).
Let’s start off with a little physiology lesson. In your body you have 10-30 billion fat cells, and that is if you are of a healthy weight. Overweight people can have 75 billion fat cells or more, and it is not unheard of for morbidly obese people to have 250-300 billion fat cells overwhelming their boney frames! That is a LOT of fat cells (adipocytes). Picture each fat cell like a little deflated balloon. That balloon can be relatively empty or filled to the brim and be stretched over 10x its normal size. Now these fat cells are stubborn creatures – you can always make more, but once you have them, they are yours for good. Up until very recently1, it was thought that the only way to get rid of fat cells was to cut them out, but you can deflate them — and this is the key to losing weight effectively.
You see, fat cells are little storage tanks, and despite your most heartfelt desires to the contrary, they are remarkably efficient at storing fat in the form of triglycerides within the cell. When we want to burn fat – it isn’t an easy matter of having your brain tell your body, “we need more energy – let’s burn that love handle”. It doesn’t work that way! We need two enzymes, hormone sensitive lipase and adipose glyceride lipase to break down the triglyceride within fat cell where it is then released into the bloodstream as FFA’s. The more blood supply an area has, the better it can whisk away those FFA’s that are getting dumped from the fat cells. You can see this on your own body — take a second and poke your facial cheeks. See, the fat there is nice and soft because it has a good blood supply. Now grab the fat on your belly or on your butt. Feel the difference? It is dense and hard. It doesn’t have a good blood supply to whisk fat away. This is why when you start losing weight, it usually leave the ‘soft’ places first – your face, breasts, and arms and leaves you feeling like a saggy humpty dumpty for a while. This blood flow issue also leads us to our key point – when you start a diet and are burning fat, the scale often stays immobile despite you noticing that you are shrinking. This happens because the body abhors a vacuum. When the adipocytes dump out their fatty contents, your body doesn’t like to see an empty cell – so it shuttles water into the cell to fill up the space the fat just occupied. This is also why fat loss can be considered an inflammatory process and why you often feel bad, tired, sick, or swollen when you are dieting (there are other chemical factors, but we will discuss those at another time). Your body is literally replacing the fat with water! This process is more extreme for some people than for others, and some fortunate souls experience very little of this water replacement. This is also why your stomach or thighs can feel mushy or spongy when you are losing weight – you are replacing a dense fat with water.
So, what you can do, especially if you know that you have resilient fat or are a water hoarder? Well, there are a few simple things:
- Stay hydrated. I know, you’re thinking, “Why put more water into a swollen body?”, — Well, you need to flush out the metabolites from breaking down those FFA’s.
- Limit Caffeine and Alcohol. A little of either substance is OK, and small doses of caffeine can even be beneficial because it has a mild diuretic effect. Large amounts of either (and by large I am referring to more than 3 caffeinated beverages or more than 1 glass of wine or beer each day) can cause you to swell up like a balloon at the Macy’s Day Parade AND make your hard-earned weight loss come to a grinding halt.
- Shake your booty. Yes, I said it. The largest lymphatic pump in your body is the quadriceps muscles in your legs, so anything that gets those quads pumping — like walking, dancing, or biking, increases your lymph flow and your blood flow. If you work yourself up to a decent exertion point, then you will really increase systemic blood flow, and breathing (and breathing is the means by which your body excretes the metabolites of burnt fat cells!). Dig out those Richard Simmons’ shorts you’ve been hanging onto for the past 20 years — (they are back in style) and get ‘Sweatin’ to the Oldies!’
So there you have it! Know that you are not hallucinating – your face is thinner, your breasts are shrinking, and those bingo wings are real. Your scale just hasn’t caught up with your body! The more you follow the above steps – the faster you will purge that excess water (and inflammation) and the scale will start moving in the right direction.
One of the few negative things about weight loss is that some people are left with focal areas of saggy skin. Not only is this skin unsightly, but it can create hygiene issues and physical discomfort. Even minor weight loss can result in lumpy, less resilient skin that is prone to cellulite. Larger amounts of weight loss can leave some people with excessive amounts of hanging, sagging skin; which can be prone to skin irritation and even infection or chronic inflammation. Some people find their abdominal skin is so loose that it appears more like an alien landscape than the body they have come to know. It just doesn’t feel like “you”.
It used to be that you had two options on dealing with it – you could live with it or you could get it surgically removed. Well, I am here to tell you that there is a lot that can be done, and if you are still in process with your weight loss journey, there is even more we can do to minimize those dreaded bingo wings and abdominal aprons (pannus).
I remember looking at my own abdomen shortly after my second child was born, and thinking “when did I become a shar pei?” You can be ecstatic about accomplishing your weight loss goals but feel demoralized every time you look in the mirror. It is not fun, and has to be the least sexy feeling in the world! So this is what I did, and this is what I recommend to my patients and clients:
Wrinkles and skin folds are cute on babies and dogs. On us, not so much!2
First, never under estimate the power of DRY BRUSHING. Dry Brushing is a technique involving a dry brush (shocking, I know!) where you make long sweeping passes lightly over your skin. Always moving towards your lymph nodes and heart.
Arrows indicate the direction of your passes with the dry brush1
I recommend that you start with your feet and work up towards your waist, then move to your hands and brush towards your heart, finishing with your neck and torso – also directing all brush strokes towards the heart. Remember, always use a dry brush, and do this before your shower so you wash off any toxins that you release. Some people chose to purchase two brushes for this task, one a small brush that straps to the palm of your hand, and the other, a similar brush attached to a stick to make reaching inaccessible areas easier.
So how does this work, well, first we need to remember that your skin is your largest organ, and is occasionally referred to as your third kidney because it eliminates approximately a pound of toxins per day, mostly through your sweat glands. In addition, over 33% of your blood supply is directed to your skin but it is one of the last areas to receive nutrients, so it is subject to showing signs of deficiency. The skin closely interacts with the lymphatic system, another powerful system of detoxification.
ü Dry brushing stimulates lymphatic drainage and the elimination of toxins
ü It encourages circulation and revascularization of hypoxic tissues
ü By increasing blood flow, it encourages nerve conduction and wound healing
ü It stimulates your immune system
ü It stimulates the production of collagen and elastin, thus tightening skin that has lost some of its elasticity
ü It removes layers of dead skin and encourages the growth of new skin cells
ü It improves skin texture and reduces signs of cellulite
ü It stimulates hormone production and oil gland secretion
ü It helps with more even distribution of fat deposits
ü It improves nervous system functioning by stimulating nerve ending firing and receptors in the skin
ü It is quick and inexpensive
Tips – use a light touch on thinner areas of skin, and a stronger touch on thicker areas of skin (like the abdomen, legs, and feet). It should not hurt, but it should feel invigorating. Do 8 to 10 strokes on each area before moving on. When you first get started with dry brushing, you may only be able to tolerate a few minutes of it. Once established though, it should take 10-15 minutes to cover your entire body. Do not brush moist skin as you can cause micro tears in the outer layer of skin. If you can dry brush during your weight loss journey, then you may avoid loose skin all together. If you have stubborn areas, like under the arms, love handles, or a pannus, – you can spend extra time brushing them to stimulate the skin. If you have areas that are especially sensitive to the dry brushing, you can avoid them for the time being, the same can be said for damaged or wounded skin. Never dry brush skin wounds or infections. Always shower after dry brushing, and if you can end your shower with 15 seconds or so of cold water, that will further stimulate the skin. I recommend dry brushing 6 days per week, and using a salt or mineral scrub on the 7th day. This gives your body a break to further detoxify and regenerate. After your shower, massage a high grade plant oil (olive, coconut, almond, flax, sesame, avocado, castor oil with essential oils, etc.)
Other things you can do now to avoid your outer shar pei and encourage skin tightening:
1. Limit sun exposure. Avoid sunburns and tanning beds.
2. Get a massage. Massage therapy stimulates circulation, and can release pockets of inflammation.
3. Keep hydrated! Another reason for you to be drinking that water.
4. Increase your consumption of raw foods. Raw foods contain enzymes that promote immune function and digestion, and decrease inflammation.
5. Consume high quality protein. Your body needs high quality protein to replace and repair its own supply. Collagen and elastin both require protein building blocks.
6. Make sure to wash chlorine from skin after swimming. Avoid putting chemicals or artificial creams or moisturizers on your skin.
7. Use alcohol in moderation. Alcohol can severely impact collagen synthesis.
8. Use seaweed or other ‘wraps’ to help tone the skin
9. Take at least 1 Epsom salt bath per week to pull toxins and to increase your serum levels of magnesium (at least 2 cups of Epsom salts in a bath for at least 20 minutes)
10. Use an abdominal or sports wrap on areas you tend to be losing too quickly from so that the skin remains compressed.
11. Avoid cigarette smoke at all cost!
Healthy skin requires normal levels of collagen and elastin. Dry brushing will encourage the production of these, but supplementation is likely necessary.
Vitamin C is the backbone of collagen formation. 500-3000 mg per day is the average daily requirement range. If you are losing weight quickly or already have lose skin, you will require doses towards the higher end of the spectrum.
Magnesium is required for hyaluronic acid production (the gel-like substance that is found in skin, joints, and soft tissue). It is also required for over 200 different biochemical processes in the body.
Omega 3 fatty acids support the fatty membrane structure of all cells and improve skin repair and turn over.
Lysine, argenine, glycine, and proline – amino acids necessary for collagen and elastin production. Glycine also plays a role in blood glucose regulation, muscle repair, digestion, and glutathione production. You can supplement with these individually or use a broad spectrum amino acid containing supplement like whey protein to get in all of the amino acids.
Bone Broth – One of the traditional foods that is rarely found in the modern diet, it has been suggested that a lack of bone broth (and its associated minerals, gelatin, and collagen) is one of the major reasons why arthritis is so prevalent now. Minerals found in bone broth are highly absorbable, far more than from most dietary supplements. If you make your own bone broth (which I highly recommend) roast your bones first, then gently boil them with your cut vegetables and 2 tbsp of apple cider vinegar to help make the minerals more absorbable. You know you’ve made a great bone broth when you refrigerate it and find a thick layer of gel on it. When you cook meat, try cooking it on the bone for additional collagen and proteoaminoglycans.
Green tea – a potent source of catechins, which help with collagen and elastin production. Enjoy a few cups of green tea each week to reap its benefits.
Copyright (c) 2013 Miranda Jorgenson. All rights reserved. This material may not be published, broadcast, rewritten or redistributed in whole or part with out the express written permission of the author. You are welcome to share this link or print this page and use in its entirely.
1. Drybrush picture. Retrieved 12/3/2013 from http://mayamoonhealingarts.com/dry-skin-brushing/
2. Shar pei. Source: imgfave.com via DoanPhuong on Pinterest, Retrieved 12/3/2012 from http://www.gracielushihtzu.com/baby-shair-pei
3. Pannus. Retrieved 12/3/2013 from: http://www.eplasty.com/index.php?option=com_content&view=article&id=627&catid=173:volume-12-eplasty-2012&Itemid=121
There is so much information and misinformation about weight loss on the internet that it is hard to wade through it all. Everyone has a different theory – it is fats, it is carbs, it is meat, it is dairy, it is preservatives, it is too many calories, it is not enough exercise, it is an inevitable part of aging, it is estrogens, it is not enough testosterone, it is mercury in retrograde… blah, blah, blah… Surely someone must have some answers!
Well, ten years of nutritional practice has taught me that no one has all of the answers. If you find someone who claims otherwise – RUN the other way! Weight loss science is constantly changing and it is as mercurial as the people who espouse individual diet plans. Quite simply, there is no quick fix and there is no single plan that will work for 100% of everyone. Period.
What I can tell you is that there are certain hormones that play key roles in many people’s weight gain or inability to lose weight.
1. Your body is not producing enough adiponectin. Adiponectin is a protein specific to fat cells and it is believed to play a role in the development of insulin resistance and atherosclerosis. Typically, the more body fat you carry, the lower your adiponectin levels, with increased levels of visceral fat (that fat hidden in your abdomen, packed around your internal organs) being especially correlated to decreased levels of adiponectin. Almost every symptom associated with metabolic syndrome or insulin resistance can be directly tied to adiponectin, so – how do you make more of this hormone and head off these problems? First, you need to increase your magnesium intake with supplements (like BioCleanse, or magnesium glycinate) and magnesium rich foods (raw spinach, pumpkin seeds, nuts, seeds, beans, lentils, fish, brown rice, bananas, figs, avocados, dark chocolate, etc.). Second, you should look into fish oil (omega 3 fatty acid) supplementation and exercise to increase your adiponectin levels.
2. Insulin imbalance. Think of insulin as a key that unlocks your cells so your body can take the glucose (sugars) in your blood stream and store it away in the cell for later. If you don’t have enough insulin, your circulating blood sugars remain too high, and these negatively affect your vasculature system, your fat storage, your blood pressure, your ability to heal, and even your brain. Much of the medical community thinks that insulin resistance stems from the body not having enough insulin, but other researchers, like Dr. Mark Hyman, MD, believe that too much insulin is the problem. He postulates that elevated levels of circulating insulin are even more problematic, and that many of the drugs and methods used to treat elevated blood sugar levels , actually cause the body’s tissues to be flooded with too much insulin, which slowly cause your body’s cells to become resistant to it, which means that greater and greater levels of insulin are needed to see any effect, which leads to vicious blood sugar and insulin swings, making these hormones rollercoaster throughout the day. The ingredients in Plexus Slim support the normalization of your insulin resistance. In addition, some studies have shown that consuming 2 tbsp. of apple cider vinegar before a high fat meal may work as well as drugs at decreasing blood sugar levels. If you consume artificial sweeteners, do yourself a giant favor and STOP!
3. Too much ghrelin. Ghrelin is your hunger hormone and it is found in the cells that line your stomach. It stimulates the hunger center of the brain and makes you desire sweet or rich foods. In fact, it is so efficient at stimulating your hunger centers, that elevated levels of ghrelin will make you feel the same way as if your were in full starvation mode – desperately craving the richest, highest calorie foods you can imagine. Furthermore, it makes you feel unsatisfied with the amount and quality of food you have eaten, whether you are truly full or not. It’s why you can slip in that piece of pecan pie or chocolate cake for dessert when you are already uncomfortably full from eating that big turkey dinner. A classic sign that you have too much ghrelin is that you feel you have room for dessert, or you find you are a bit hungry an hour or so after you eat. You fridge-cruisers know who you are! Ghrelin cycles in 4 hour increments, so typically you would be hungriest 4 hours after your last meal. So how do you address ghrelin? There are a few different things you can do. First, make sure you are getting enough sleep. 8 hours of sleep per night is the ideal. If you are getting less, or have poor quality sleep, please know that sleep deprivation causes your ghrelin levels to increase. Protein intake also staves off the release of elevated ghrelin levels, so make sure that each meal starts off with high quality protein sources (this is particularly important for breakfast). Consuming a small bowl of broth or soup before a meal is an excellent way to prevent ghrelin levels from rising too much.
4. Cortisol overload. We are designed for fight or flight. Cortisol is produced as a response to stress (and who isn’t stressed nowadays?). It increases your cravings for sweets and carbohydrates, it increases muscle breakdown for energy production, it increases the percentage of fat that is stored in your abdominal area, and it increases your levels of depression and anxiety – which make you eat more, which further increases your cortisol levels, creating a vicious cycle, resulting in you feeling tired and burnt out all of the time. Supplements such as fish oil, Rhodiola, lactium, magnesium, DHEA, and b-vitamins can all help reduce cortisol levels. Other things that have a positive effect include slow exercise like yoga or walking, meditating, praying, or just getting into a ‘zone’ where you let your creativity reign. Limiting coffee, and making sure you get enough sleep are other ways to keep cortisol levels normal.
So before you give up he fight, have a good look at these factors and see which ones may pertain to you and take the action steps needed to achieve your ideal weight. I have found Plexus Slim to be an excellent tool for my patients and clients in achieving their ideal weight in a safe and efficient manner. It truly is the non-diet, because it never involves meal replacements, shakes, calorie counting, points, or anything else. It simply helps to normalize insulin resistance and inflammation levels so your body can release the weight it’s been hanging on to. In addition, it makes it easy to make healthier food choices. You didn’t gain those 40 extra pounds in a month, and it will take you time to lose it, but the key is you. You have to draw that line in the sand and start something. 4 months from now, you can be the same weight you are now (or even heavier!), and still have those aches and pains, fatigue, gastrointestinal issues, etc., or 4 months from now you can feel like a million bucks. No one can ever force you to change because the choice truly is yours, but, if you want help and are sincere about making change, I will help you every step of the way!
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