We’ve had some requests for an “Ask Dr. Miranda” feature, so here is the first question we’ve been sent:
Q — I’m trying to lose weight and my biggest issue is my stomach. How do I get it down? Any suggestions?
A – – First, you are not alone! Many people tend to accumulate weight below the belly button far easier than above, it is inherent to our general fat distribution and certain hormones. In fact, very often abdominal weight isn’t just fat under the skin, but rather includes the more dangerous visceral fat that you’ve read about, so it is important to address. For the record, any male with a waist circumference of 40+ inches, or a female with 35+ inches, is considered to have dangerous levels of abdominal fat. So given that, there are several proven ways to target abdominal fat: Let’s take a minute to look at the major ones.
1) Kick sugar to the curb! Sugar in ALL of its incarnations, including High Fructose Corn Syrup (HCFS) is probably your number one trigger for abdominal fat. Now, remember, to your body, a carb is a carb to a great extent. White bread, potatoes, pasta, sodas, etc. all get broken down into glucose, and what you don’t immediately use up for energy expenditures, you store – and your gut is the numero uno place the body starts to store fat! I am going to go out there on a limb and say that added sugar in general is a no-no! It is unhealthy, and has strong, negative effects on your metabolism. Now, sugar is composed of half glucose and half fructose, it can ONLY be broken down in the liver in any significant quantity. So, if you are exposing your system to sugar daily, your liver gets overworked. Your pancreas gets overworked. Your body has no choice but to start storing as much as it can as fat. Listen up fruit eaters – you don’t get off scot-free, fruit contains a large percentage of fructose, and large amounts of fructose were never meant to be eaten by us. Most wild fruits are small and were only eaten in small amounts seasonally. Our ancestors rarely got the opportunity to chow down on a giant bowl of fruit salad every day for breakfast. Fructose is also directed into fat storage! That is why I have specific guidelines on how much fruit you should eat for optimal fat burning AND specific times you should eat it. Large amounts of fructose also tend to make the gut leaky, and cause digestive imbalances with your good bacteria, which leads to GI discomfort and the development of allergies. Very often, the health benefits of fruit are not outweighed by their sugar content. You have to really educate yourself and look at the difference between whole fruit (and its beneficial fiber content) and fruit derivatives, concentrates, and parts. Keeping this in mind, the top way most people intake sugar, is by drinking it. Don’t drink your calories is one of our important Lifestyle List tips for that very reason. If you audit your daily sugar intake – most people fall short here. Your brain doesn’t recognize liquid caloric intake in the same way it recognized calories that were chewed, and sugar-sweetened drinks are associated with a 60% increased risk of obesity. So, a simple solution is to just avoid it as much as possible. Now, if you are sitting there at home telling me you don’t drink soda – this also applies to sweetened teas, sports drinks, coffee drinks, and fruit juice.
- Count grams of protein, not calories! Protein is the best fuel for your metabolism, and getting in enough high quality grams of protein per day is absolutely crucial for optimal fat burning. No, this doesn’t mean that you need to eat an 18oz porterhouse steak 3 times a day, but you need to be cognizant of how much protein you are consuming. For most people, 80-100g per day is a good range to shoot for. If you are over 60 lbs overweight, you should be in the 100-120 g per day range. If you’ve followed me for any length of time, you know that I’m a huge advocate of protein for breakfast. it is my belief that having a high protein, low carb breakfast is the most important thing you can do for your metabolism and insulin levels. Your first meal of the day literally sets the stage for how your metabolism responds for the rest of the day – so make good choices. So, lets say you are trying to keep the 80-100 g of protein in mind, divide this up into the number of meals you consume daily to get your average per meal. Most people eat 3 meals per day, so if you aim for a protein intake of 30g per meal, you fall exactly in the middle of the range! Furthermore, protein provides key amino acids that reduce cravings by upwards fo 60%, and boost the amount of calories you burn by 80 or more calories per day. Studies have shown a link between the quality and quantity of protein consumes and a reduction of abdominal fat. People consuming enough grams of protein typically decrease their caloric intake by over 400 calories total per day, and if you’ve already lost your weight, eating enough protein helps you from putting the pounds back on — so it’s a win-win food choice!
- Tell carbs to take a hike ! Carb reduction is one of the most studied and most consistently successful ways to lose weight. Now, no one is saying ALL carbs are bad, because carbs found in whole vegetables are just fine, but the starchy, sugary carbs head straight for your midline. There are literally dozens of studies that show that low-carb diets lead to 2-3 times more weight loss than low-fat diets. Low carb diets are difficult for some people however because they are addicted to carbs and the serotonin rush they get from eating their comfort foods, so you have to either make drastic cuts or gradual cuts based on what suits your personality best. Low carb diet specifically target abdominal fat, so if you need to lose belly weight – cutting carbs is crucial. Men should look at keeping carbs below 50 g per day, women should aim for 45 g per day, however this number will vary. Some women tell me they have done low carb but a review of their food journals show they are still getting in 60-80g of carbs per day, and the weight doesn’t start falling off until they hit 40g. YMMV, but the above guidelines are a good place to start! And please – keep your servings of carbs for lunch and dinner – we want breakfast to have as few carbs as possible.
- Poop. Is one meal coming out for every meal that goes in? We have become the constipated generation. I guess it wouldn’t take much to convince you that your friends and coworkers are full of it! Unfortunately it is true – most people consume a Standard American Diet (SAD) and it is SAD — it is nutritionally devoid of protein, nutrients, and fiber. It is a hot mess. The result is that they estimate that ~70% of the population deals with regularity issues. To be blunt – for every meal that goes in, one should come out. If you eat 3 meals a day, you should be having 3 bowel movements per day. If you are not, that is your sign that you need to clean up your diet, add more fiber and fiber rich veggies, add magnesium, and drink more water. Now, many of you are familiar with fiber associated with grains, and while that can be true, fiber is indigestible plant matter. So, if you are reading a box of flax seed toasts – and it says 18 g of carbs per serving, 11 g of fiber. You can subtract the g of fiber from the total amount of carbs to get your NET carbs. In this case – 18g – 11g = 7 NET g carbs! That makes that piece of flax toast a lot healthier looking, doesn’t it? Now, not only does fiber help fill you up and satisfy certain cravings, but it keeps you full and satisfied longer. It helps to hold water in your bowel, so your stools are not dry little bullets that need chemical laxatives (or dynamite) to dislodge. One study showed that adding an additional 14 g of fiber per day to the diet increased weight loss by 4.5 lbs over 4 months doing nothing else! The best sources of fiber include seeds, vegetables, legumes, oats, etc. There are also plenty of fiber supplements on the market that make it relatively easy to increase your fiber intake without adding additional calories.
- If you want to lose it, you’ve got to move it! It has been often repeated that you cannot out-exercise a bad diet, and that is true, however that doesn’t negate the importance being active is to your overall health. There is no such thing as spot fat reduction when it comes to exercise – that is entirely a myth, but — when you consistently exercise, you lose weight from everywhere you’ve stored it, and since bellies often have a greater percentage of stored fat, you should notice fat loss there first. Aerobic exercise has long been found to reduce abdominal fat. It is also good for increasing your basic metabolic rate, reducing inflammation , normalizing blood glucose levels, and increasing energy levels.
- Write it down or it didn’t happen! One of the top predictors of whether people will be successful in losing weight is whether they are consistent about documenting everything they consume. Food journalers are typically FAR more successful at achieving and maintaining their weight goals. Most people will tell you they eat a good diet, but an inspection of their food journal will reveal otherwise! Many people have no clue of what they are truly consuming in the course of a day. Most over-estimate or underestimate what they are eating. Now, I love a plain old paper food journal, but tracking apps like MyFitness Pal are a wonderful addition to your program. Log everything, no matter how insignificant you think it is. You don’t have to do it forever, but until you achieve your weight goals – it is a good idea, and it is a barometer of your success. Food journalers find it easier to stick to their diet. They find it easier to turn down snacks and impulse food consumption. It is an easy way to hold yourself accountable.
- You’ve got to consume (healthy) fats in order to lose fat! Yep – that low-fat diet you’ve been told to follow is bad for your waist line. Your body is a fat-burning machine. Certain nutrients are fat soluble, and other faty are essential to your health, so when you avoid adding healthy fats to your diet, you create a deficiency state that leads to your body going into conservation mode – where it tries to hoard fat instead of burning it. Hoarding is bad – don’t be a hoarder – sneak small amounts of healthy fats into your meals. Not only do they help you assimilate more nutrients out of your diet, but they increase satiety, and are crucial for your health. If you have IBD or you are missing your gallbladder and fat digestion is difficult for you – use an appropriate digestive aid to facilitate the process.
In post #2 of Hidden Reasons You Can’t Lose Weight series, I am going to explore protein: one of the most common nutritional deficiencies I see among dieters.
Full disclosure: I am a dedicated omnivore. My first course of study was anthropology. For that reason, I tend to look at things from both an anthropological and a physiological perspective. All of that firmly points me to the assertion that we are protein driven creatures – that is why we have the brains we currently have. That is why we have mixed dentition, and our current collection of digestive acids and enzymes. That is why we have one stomach and 23 feet of small intestine and 6 feet of large intestine. If you are a dedicated vegetarian, you are not going to like what I have to say. I don’t have the inclination or the time to argue with you, so just take this as a forewarning that you might want to skip this post! We will have to agree to disagree.
When you think of protein, you might think of juicy steaks and succulent chicken thighs. You probably don’t really give it much thought. You certainly don’t think it is something that you could be deficient in. If you are a habitual dieter, or if you have unsuccessfully been trying to lose weight, you may be completely wrong. One of the key deficiencies that I identify when I am doing my ‘Plateau Buster’ consultations, is an overwhelming need for increased protein intake.
Protein is an essential macronutrient. It is comprised of varying combinations of amino acids and those amino acids make up every tissue and substance in our body. They truly are the building blocks of life. There are two key types of protein: complete, and incomplete. Complete proteins contain the full complement of essential amino acids and they are associated with animal sources. Incomplete proteins, contain a partial array of essential amino acids and are typically associated with plant sources. You need to have ALL of the essential amino acids for optimal health, and that means consuming adequate supplies of complete protein. When you consume foods, whether plant or animal in origin, your body breaks those foods down into those amino acid building blocks. Now, it can’t store amino acids for a rainy day — it is a ‘use it’ or ‘lose it’ system. Complete proteins must be consumed on a very regular basis to fulfill your body’s daily requirements. If you do not intake enough protein, your body pays the price!
So, could you be protein deficient?
If you are a current or former dieter, if you don’t eat high quality meat sources 4+ times a week, if you are a vegetarian, if you are over 55 year old, if you have had recent surgeries, or if you tend to consume a considerable amount of processed foods – chances are good that you are protein deficient. If you have been dieting and your weight has hit a plateau – then it is most definitely one of the factors that you need to consider.
SIGNS OF PROTEIN DEFICIENCY
|· craving sweets and carbohydrates
||· fatigue, especially after activity
|· joint pain, muscle pain
||· get sick frequently
|· feeling hungry soon after you eat
||· slow wound healing
|· brain fogginess
||· various scents make you nauseous
|· hair shedding
|· fragile hair: breakage, split ends
||· depression/ anxiety
|· ridges on fingernails and/or toenails
||· tendency towards constipation
|· dry skin or frequent rashes, flaky patches
||· poor muscle tone
||· sleep issues
Let’s have a look at some of the larger signs and symptoms:
1) Chronic muscle and/or joint pain. As a chiropractor, we see this musculoskeletal sign frequently. This is partly to blame on the Standard American Diet (SAD) which is heavy in junk. We can also see a huge shift in our diet since World War II. Prior to that, most parts of an animal were utilized. We ate organ meat on a regular basis. We made soups with the bones and joints of the animal carcass – and this rich bone broth supplied us with an incredibly supply of protein, gelatin, glycine, proline, and amino acids that supplied our own muscles and joints with premium building blocks so they could maintain optimal function. Families used to cook more meat on the bone, and people would fight over who got the gristle! Now, our diets are ‘sanitized’. Our kids have not grown up helping us prepare anything. To them, meat consists of hotdogs and hamburgers (often the worst cuts of meat on the animal). Our soups are completely processed and come in convenient red and white striped cans. We find eating with our fingers distasteful, so if you can’t eat it with a knife and fork – we don’t bother. Many of us don’t consume any meat that is not processed or prepackaged, and then we wonder why we hurt all of the time. We hurt because we are putting hollow building bricks into our bodies. You can’t build your temple with wet cardboard! I would also like to add that your daily protein requirements increase significantly after surgery or during periods of elevated stress, so if either of those things affect you — adjust your diet accordingly. Also, as we pass 40 years of age, our ability to produce stomach acid and digestive enzymes decrease (it declines much faster after age 55), so your ability to assimilate protein decreases as the years tick by.
2) Constant Cravings. Not all cravings are caused by protein deficiency, but many are. If you have a tendency to crave sweets and carbohydrates, then you could very well be protein deficient. If you feel hungry frequently, or if you feel hungry shortly after you eat ( see Satiety Index), then you are probably not getting in enough protein. Instabilities in blood sugar lead the body to want to correct itself, this means that one of the first things the body does in response to blood sugar instability or fluctuations is to cause you to crave sweets or carbohydrates (for you bread lovers). This is a stop-gap or a band-aid approach, but your body senses an issue and aims to correct it with as little effort as possible. If you have a secret stash of candy, if you are someone that has to snack between meals, if you are vegetarian (or just don’t eat much meat), and if you get absolutely ravenous if you skip a meal — you have strong indications that you don’t consume enough high quality complete protein.
3) Your hair, skin, or nails are a wreck. This is a trickier sign, because you might do a bunch of things to abuse your hair, skin, or nails – like flat iron your hair three times a day, or slather yourself in the latest & greatest skin acid lotion in the hopes of warding off wrinkles. As a general rule though, if you find yourself shedding hair often or if your hair grows slowly, or is fragile – it breaks or splits easily, then that is a clear indication that you need more protein. Similarly, if your skin is thin or dry, if you get frequent skin irritations or blemishes, and if you take a long time to heal – then you certainly need more protein. You will notice that people with protein-poor diets tend to get premature aging, their skin thins in places, and they get lines and creases on their face before they probably should. Their nails are thin, or they contain ridges, and they tend to peel or break. Again — all of these things are signs that your body has run out of building blocks. Think of it this way: when you don’t consume enough of the complete protein your body needs, it has to break down YOU to get the necessary building blocks to support life. It doesn’t target your love handles, it goes after your muscles, your energy reserves, you hair, skin, and immune system.
4) The inability to lose weight. Is protein deficiency the main reason why people stop losing weight? No, but it is in the top 10, and it is one of the most common nutritional deficiencies I see among dieters. As part of what I do when I put on my “Plateau Buster’ hat when I work with someone to figure out why they are having such a hard time losing weight — I have them complete a multiple-day food journal. More times than not, I see people starting off the day with fruit and dairy products, they might have a sandwich at lunch, and maybe a burger or nachos for supper. They usually snack on more fruit or granola bars. They are eating meal after meal that spikes their blood glucose and they are not getting in near enough protein! This results in maintaining elevated insulin, and leads to insulin resistance — which we know is associated with weight gain. In fact, some healthcare practitioners believe that as few as 5 extra pounds is a sign of insulin resistance. There are several different ways to calculate protein need, but for otherwise healthy individuals looking to lose weight, I use the formula :
IDEAL WEIGHT divided by 2 = # of grams of protein you should consume daily
So, if you currently weight 200 lbs, but your ideal weight is 160, you take the 160, divide that by two to get 80, and use that as your guideline for protein intake. I have seen many people move out of their weight loss plateau simply by adding 20 more grams of protein to their daily intake. Sometimes it is the simple fixes that work the best! Following this, I am a HUGE advocate of starting your day off with protein. I have other blog posts which go into considerable on the science behind WHY I find this necessary, but suffice to say – I believe that a protein rich breakfast starts you out on the best footing to have the protein requirements you have to initiate fat loss, it minimizes the cravings that can sabotage your diet, and it helps you to maintain steady blood glucose levels that are necessary for burning fat.
You can consider your body as being lazy, or as a highly tuned machine: either way, it attempts to maintain a steady state – or equilibrium, at all times. It wants to get the most work done for the least amount of effort, and it likes to prepare for those inevitable rainy days. If your body is in a deficiency state, it goes into self-preservation mode, or ‘conservation mode’. It realizes it doesn’t have everything it needs and so it saves itself for later. This is why it is so darn hard to lose weight sometimes. This is why you can be eating like a bird but the scale refuses to budge.
So, how do you correct protein deficiency? Quite simply, you need to consume more protein. Let me correct that, more high quality complete protein! Beans, legume, lentils, etc are fine for some of your protein needs, but they are incomplete, and they contain fiber – which binds to the protein, making it less available to you. You should be adding fresh, high quality meat to your diet, at the least – every other day. Organ meats and bone broths are one of the best things you can do for your health. A study published in the British Journal of Nutrition found that soup eaters tended to weigh less and have smaller waists than non-soup eaters1. Compared to muscle meat, organ meat is much more densely packed in just about every nutrient, especially B12, B6, B1, B1, folic acid, and the fat soluble vitamins A, D, E, and K. Grass-fed animals provide an even better source of these nutrients over their commercially raised counterparts. Now I am not suggesting that you need to eat an 18-oz porterhouse steak every day, but it behooves you to keep a food journal and use one of the popular fitness apps to track your dietary intake. You may be shocked to see what you actually consume. I will add a caveat here – many of the fitness apps I have seen grossly underestimate the amount of calories you consume, so please don’t go by that alone. This is partly due to user input errors; people guestimate their portion size to the lesser degree, and completely omit certain food items, like the cheese on their sandwich, or the three packets of mayo they used. I advise my clients that aim to lose weight that they need to consume at least 20 g of protein with every meal. Eggs, fish, nuts, aged cheese, etc. are all great sources of protein as well.
The cornerstone of my Plateau Buster program is achieving balance, because when your body is out of balance – health issues result. Where weight loss is concerned, there are several key factors I look at:
What does the diet look like?
How much physical activity is occurring? (you can’t out exercise a bad diet)
Does the person have a gallbladder or not?
Is there evidence of thyroid dysfunction?
Is there evidence of adrenal dysfunction?
How is their digestive system working?
Is there evidence of gross nutritional deficiencies?
Are they on medications know to inhibit weight loss?
Do they have other health conditions associated with weight gain?
What diets have worked well for them in the past, and which ones haven’t?
What emotional factors are weighting them down?
In essence, there can be so many different factors that cause excess weight, and you are not restricted to only having one issue on the list. Many of these things, including protein deficiency, are things you can trouble shoot yourself. If you are sitting there reading this, thinking, “meat irritates my stomach” – then you need to read my blog post on gallbladder dysfunction, and look into digestive enzymes. For more information, please join my community on facebook – Weight Loss Resources with Dr. Miranda.
Did you know that calcium absorption is a major issue for bariatric patients? Approximately 85% of all calcium supplements sold in the United States contain calcium carbonate (also known as limestone, or chalk) – and this form of calcium is rarely recommended for bariatric patients because of several key features: 1) it acts as a functional antacid, 2) it requires a highly acid environment to be absorbed, and 3) as a direct result of surgical alteration of stomach size – most people will no longer have the physical capability to absorb any of the elemental calcium from it.
The two forms of calcium that bariatric patients hear bantered about most frequently are CALCIUM CITRATE and CALCIUM LACTATE. Both of these are excellent sources of calcium, however, one has a distinct advantage over the other. If we are speaking about the best form of tableted calcium for people who have not had surgical alteration of their GI tract – then I would agree that calcium citrate pills are ideal. However, when you take into account how bariatric surgery affects the stomach and/or small intestine, and knowing that a large percentage of bypass surgeries involve bypassing at least part of the duodenum (which is where calcium is normally absorbed) – then calcium lactate becomes the winner.
Furthermore, calcium is a bulky mineral. You have to take a lot of it to be able to absorb the percentage you actually need. That is why calcium tablets are usually fairly big. Knowing this, vitamin manufacturers have two choices when they configure their supplements – they can either divide the dose into multiple tablets or capsules, or they can compress it into one or two giant ‘horse’ pills and compress them to the point that they are veritable cement bullets. This leaves bariatric patients in a catch-22, — they usually do not want to feel full and bloated from taking a lot of pills, but they also know if they take one of the highly compressed tablets, that they will likely absorb very little from it.
The solution is to take powdered calcium, and the ideal form of powdered calcium is calcium lactate. Calcium lactate is considered to be one of the most neutral forms of calcium. It is not chalky or soapy like calcium carbonate, and it lacks the bitterness of calcium citrate. If you need a calcium that is readily absorbed, and has a high solubility factor, which means that you can easily mix it into any beverage you so choose — then calcium lactate is the one to choose. It is significantly more soluble over other forms so you can fit a larger dose in a smaller serving size. Naturally gentle on the stomach, powdered calcium lactate provides the most available surface area for absorption once it passes into the small intestine.
That isn’t to say that you can’t get calcium citrate in powdered form. There are a few commercial preparations that use it, but powdered citrate does not mix readily into beverages. If you put a spoonful of it into a glass of water, you would have to stir and guzzle the contents very quickly or you would lose a significant amount as it would settle to the bottom of the glass or stick to the sides. Having to chug a big glass of bitter, gritty calcium, 2-3 times a day may not be appealing to many people.
That said, it is my belief that most Americans do not have a calcium issue. Per capita, American’s has one of the highest calcium consumption rates in the world yet they have one of the highest rates of osteoporosis. This tells me that we don’t have a calcium issue, but a magnesium and co-factor issue. We know that 80% of women are magnesium deficient. If you are going to supplement with calcium, please speak to your physician about adding a magnesium supplement to your regimen. Vitamin C enhances the absorption of both calcium and magnesium, so they are good nutrients to pair together. My office carries a supplement which contains a balanced ratio of calcium, magnesium, and vitamin C. Please contact us for details.
If you’ve never had gallstones, you’ve probably never thought about your gallbladder. However, if you have had gallstones, chances are good that you have had your gallbladder removed. Either situation has its own inherent issues, and one thing that healthcare providers rarely tell gallbladder patients is that surgery will forever impair their digestion and may make losing weight very, very difficult.
The gallbladder is a small, pear-shaped organ under your liver that concentrates and stores the bile that your liver produces to aid fat digestion. Most people don’t give it a second thought until it starts to trouble them, and unfortunately, for many years, the medical establishment didn’t realize the full importance of healthy gallbladder function. They felt its removal had few, if any consequences. I am of the opinion that we were not designed with unnecessary parts, and the gallbladder is no exception. In fact, science is just beginning to understand the true importance of healthy gallbladder function and the detrimental consequences of its dysfunction or removal.
Each day, your liver produces ~27-34 ounces of greenish-brownish-yellow bile, which is concentrated anywhere from 5-18 times, and then 1-3 oz is stored in the gallbladder awaiting your next meal. When you consume foods containing dietary fats, your gallbladder is triggered to release this concentrated bile into the first part of the small intestine, the duodenum, where it acts as an emulsifier to break down those fats and aids in the absorption of the fat soluble vitamins, A,D,E, & K, and any essential fatty acids. If you have ever vomited until a bitter, yellow substance came up — that was bile, and while you may not have thought so at the time – bile itself is an amazing substance. Comprised of bile acids, bile salts, cholesterol, phospholipids, pigments, water, electrolytes, and amino acids, bile is a bitter, acidic substance that breaks down fats into components that the body can use. Healthy fat absorption is crucial to our health. In fact, we were designed to eat fats rich in healthy fats. Our brains, our hormones, and even our very cell walls are dependent on a steady and healthy supply of fat soluble vitamins and essential fatty acids.1 Vitamin A is an important antioxidant that plays a crucial role in cell division, cell differentiation, reproduction, immune function, growth, and vision. Vitamin D is a prohormone which not only regulates calcium metabolism, but is essential for the functioning of the nervous system, for bone health, for muscle strength, for immune function, regulating blood pressure, hormone production and for cell differentiation. Vitamin E is a blanket term for eight different nutrients (4 types of tocopherols and 4 types of tocotrienols) that have string antioxidant properties and also play a role in immune function, healing, repair, and cardiovascular functioning. Vitamin K is a nutrient that scientists are just starting to devote research time to. It is known to play a key role in bone health, blood clotting, and heart disease, but studies are showing that it may have many more far-reaching effects. Essential fatty acids (EFA’s), such as omega-3 fatty acids, are ESSENTIAL to human functioning. Long recognized for its powerful anti-inflammatory benefits, EFA’s are required to make the cell walls of every cell in your body and they play a key role in immune functioning, musculoskeletal health, cognitive function, and heart disease. Considering the overwhelming importance of fatty acids and fat soluble nutrients to general health, it makes no sense to willingly cut out gallbladders with no plan of action to compensate for the deficit caused by its dysfunction or removal. Whether you have a gallbladder that isn’t doing its job or you have already lost yours – there is a solution.
So, how does all of this apply to lack of weight loss — or worse, weight gain?
In simplistic terms, the body is a finely tuned organism. We need 17 nutrients in specific quantities just to make adequate levels of stomach acid and other digestive substances. When gallbladders dysfunction, two things can happen: First, the bile gets too thick and stagnant, which creates an ideal situation for gallstone formation. Second, when gallstones impair or block the emptying of the gallbladder, fat digestion decreases dramatically, which in turn, puts your body into starvation mode. The body requires the absorption of those fat soluble vitamins and essential fatty acids, but it recognizes it is in a chronically deficient state – so it hangs on to the fat it has (which unfortunately may be that stomach pooch) for dear life. You in turn want to lose that stored fat, and may erroneously take on a low-fat diet at the advice of your healthcare provider, which only makes the matter worse.
Causes/Risk of Gallbladder Dysfunction
- hypochlorhydria (low stomach acid)
- low fat diets
- high fat diets
- food allergies and sensitivities
- gluten intolerance
- being overweight
- dieting, rapid weight loss
- sedentary lifestyle
- birth control pills or hormone replacement therapy
- use of antacids and Proton Pump Inhibitors (PPIs)
- 40+ years of age
- females are at greater risk in the United States (in other countries, males can be at higher risk – it is thought that alcohol consumption plays a causative factor there). Women that have birthed children also have a greater risk of developing gallbladder dysfunction
- alcohol use (the more you drink, the greater your risk)
- bariatric surgery
- ethnicity (more prevalent in Native American populations and Hispanics)
- family history of gallbladder issues
- extreme diets which eliminate any key food group
- elevated cholesterol, especially high triglycerides or LDL
- consumption of statin medication or immunosuppressive medication
- medical conditions including hypothyroidism, diabetes, insulin resistance, inflammatory bowel disease, PCOS, hemolytic anemia, etc.
- western diets, diets high in refined carbohydrates and sugars
That’s a long list of risk factors – it’s a miracle that anyone has a normal functioning gallbladder given our Standard American Diet (SAD) and reliance on fried and processed foods. In fact, gallbladder dysfunction is so common that clinicians refer to it as the 4-F syndrome: Female, Fat, Forty+, Flatulent. However, most people with gallbladder dysfunction are asymptomatic. Studies estimate that anywhere from 67-80% of people with gallstones have no symptoms. That said, many people discount gallbladder symptoms as being related to poor digestion or other factors. Everyone with gallstones started off with thick or stagnant bile. You have to have one to lead to the other. The pattern of symptoms associated with gallbladder dysfunction is so varied that many people without digestive pain may not associate their muscle pain, dry skin, poor wound healing, dry (or shedding) hair, headaches, heel calluses, or inability to lose weight despite doing everything right with a gallbladder that is not operating at par.
Symptoms of gallbladder dysfunction: Most commonly: pain or discomfort after eating. This can include gas, bloating, belching, heartburn, nausea, queasiness abdominal discomfort, extreme fatigue, pain under the ribs, particularly on the right side, or shoulder pain. Additional symptoms include headaches over the right eye, constipation or diarrhea, light colored or ‘floating’ stools, dark urine, offensive body odor or breath. People with gallbladder dysfunction tend to have bowel extremes — they experience diarrhea (up to 10 bowel movements per day) or constipation (often having days between bowel movements) and rarely have normal bathroom habits.
Have you had your gallbladder removed? You are not alone. Over half a million gallbladders are removed every year in the US. It is one of the most commonly performed surgical procedures. Symptoms of postcholecystectomy syndrome (PCS): gas, bloating, belching, heartburn, nausea, queasiness abdominal discomfort, extreme fatigue, pain under the ribs, particularly on the right side, or shoulder pain. The need to run to the bathroom immediately after eating is fairly common. Additional symptoms include headaches over the right eye, constipation or diarrhea. Notice the symptoms are almost exactly the same for people with NO gallbladder as for those with a dysfunctional one? Researchers estimate that at least 40% of people who have had gallbladder removal continue to experience significant abdominal pain.2 It is estimated that 5-40% of people who have had a cholecystectomy experience long term symptoms from it . 3 One British study looking at the after-effects of gallbladder surgery found that 87% of men and 68% of women experienced weight gain after cholecystectomy and urged physicians to caution patients about this ‘side-effect.4 I can easily say that in my 12 years of practice, I have NEVER had a gallbladder patient tell me that they were informed of the likelihood of weight gain prior to their surgery!
Where Weight Gain & Weight Loss Issues Come into Play
Having a dysfunctioning gallbladder or having no gallbladder are both associated not only with difficulty losing weight, but with weight gain. Anecdotal reports are abound of women having few issues maintaining their healthy weight until they had gallbladder removal surgery. On a functional level, we know that nutritional deficiencies are associated with difficulty losing weight, and by drastically impairing fat digestion through having stagnant bile or by surgical removal of the gallbladder – we create the foundation for broad-spectrum health disorders. Our bodies are designed to maintain an equilibrium, or steady state. It craves balance. So when we have gross nutritional deficiencies, our bodies inherently want to hang on to its stores of fat and nutrients. It doesn’t want to exacerbate its deficient status by losing more of anything – and that includes your love handles.
So, what can you do about it?
1) First and foremost, you need to concentrate on eliminating the nutritional deficiencies. This is imperative if you want to get your body out of starvation mode. I suggest that you take a high-quality, highly absorbable multivitamin. Look for a high potency multivitamin that contains more than the 100% RDA amounts. Those amounts were designed to keep a person out of gross deficiency status, they are not amounts your body needs for optimal functioning.
2) The second thing I recommend is supplementing with pancrealipase and organic beet extract. I carry two different formulas – one for people with gallbladders who need to thin their bile so their digestion works better and another for people who no longer have a gallbladder and who need to add ox bile extract in addition to the pancrealipase and organic beet extract so they can start breaking down those dietary fats , get themselves out of a deficient status, and start losing weight. Either formula can be ordered directly from me (message me through facebook), or through the manufacturer. These supplements are only sold through licensed healthcare providers, and I am prohibited from publishing prices publicly, but if you visit my facebook group https://www.facebook.com/groups/weightlossresources/ and check the FILES section. I have included complete ordering information along with a discount code for my clients.
3) Limit your intake of refined carbohydrates. Not only are these typically ’empty’ calories, but they rob you of minerals like magnesium and chromium, and your b-vitamins. They also induce insulin spikes which further stress your liver and gallbladder.
4) Increase your magnesium intake. Whether you take oral magnesium preparations, or you use epsom salt baths – magnesium has been shown to prevent gallstone formation. It is also required for making appropriate levels of stomach acid.
5) Increase your intake of taurine-rich foods. Taurine is one of the major amino acids found in bile. Healthy digestion depends on getting adequate supplies of taurine. Meat, eggs, seafood, certain dairy products, and brewers years are all good sources of dietary taurine.
6) Eat healthy fats! Your body needs fat in order to lose fat. If fat digestion troubles you, start slowly with small amounts of unrefined organic coconut oil and slowly add other healthy oils into your diet. Let your body accommodate to them. Healthy fats include grass-fed butter (which is a source of vitamins A,D,E,K, as well as selenium, and CLA), ghee, lard, egg yolks, organ meat, palm oil, olive oil, most nut oils, etc. Bad fats include corn oil, soy oil, canola oil, sunflower oil, safflower oil, cottonseed oil, margarine, and anything listed as ‘hydrogenated’. These refined oils are a source of omega-6 fatty acids which not only contribute to obesity but cause inflammation within the body, and that includes liver and gallbladder inflammation.
In short, having gallbladder problems or no gallbladder whatsoever need not cause you issues. There are simple solutions that allow your body to work the way it was intended to. You can get the weight off and avoid the bizarre food cravings that come along with those nutrient deficiencies. You can feel normal after meals. You can have normal bowel movements, and you can get rid of the fatigue that overwhelms you. If you combine healthy food choices along with the simple supplements I suggest, you will see results. If you are able to combine the two with lifestyle improvements you will see results that much faster. I sincerely wish that more medical providers educated their patients on the detriments of gallbladder surgery before they submitted to it, so they could take preemptive action, however, in the words of Mick Jagger, “you can’t always get what you want, but if you try sometime, you just might end up with what you need”. So, in closing, I hope this information is what you need. Please visit me on facebook at Weight Loss Resources with Dr. Miranda. If abdominal pain persists, you may have a problem caused by something other than the gallbladder. Other possible causes of abdominal pain include irritable bowel syndrome, inflammatory bowel disease, stomach ulcers, or pancreatitis. Please seek the advice of your licensed healthcare provider to rule out serious health conditions.
♥♥♥Other posts of mine that you may find helpful (click on any of the blue text below to open) :
2) Hearing, L Thomas, K Heaton, L Hunt
Post-cholecystectomy diarrhoea: a running commentary Copyright © 1999 BMJ Publishing Group Ltd & British Society of Gastroenterology.
4) Weight gain after cholecystectomy. BMJ 1984; 289 doi: http://dx.doi.org/10.1136/bmj.289.6455.1350 (Published 17 November 1984)Cite this as: BMJ 1984;289:1350
1. Bates T; Ebbs SR; Harrison M; A’Hern RP.Influence of cholecystectomy on symptoms.
Br J Surg. 78(8):964-7, 1991 Aug.
2. E Ros, D Zambon . Postcholecystectomy symptoms. A prospective study of gall stone patients before and two years after surgery. 1987 BMJ Publishing Group Ltd & British Society of Gastroenterology
3. CAROLE MACARON, MD,MOHAMMED A. QADEER, MD, MPH, JOHN J. VARGO, MD, MPH, Cleveland Clinic Journal of Medicine March 2011 vol. 78 3 171-178, Recurrent abdominal pain after laparoscopic cholecystectomy
This isn’t an exciting post but we have to stop throwing the word ‘detox’ around. If you do not define what you mean by it, the term is meaningless, and the vast majority of people are using the term as a symptom catch-all and that is simply not how detoxification works.
DETOX. For such a little word, it is sure used a lot in dietary supplement claims and reports.
Starting a new supplement & you’re feeling bad? You must be detoxing!
How does supplement X work? It detoxes you!
Have a headache? You are detoxing!
Do you have gas & bloating? You are detoxing!
Constipation? Diarrhea? You are detoxing!
You have a rash? You are detoxing!
Not losing weight? Your fat cells need to detox!
Blah, blah, blah.
Let’s start by detoxing the term detox!
I really don’t like the word DETOX. I think it has become highly overused, and most people don’t have a clue what it means or what they are actually referring to when they use the term. So in effect, it has become a vague term that people use when they don’t have anything better to say. In fact, in one British study, a network of 300 career researchers investigating ‘detox supplements and products’ found that no two companies even used the same definition of “detox” and most companies made vague claims without even referencing what “detox means or proof that it actually works.”1
Do I believe that the body accumulates toxins which impair health? Absolutely. Can I think of any science proving or even suggesting that a specific supplement can detox the body of all of these environmental toxins? Absolutely not.
To be clear, this isn’t an exciting blog post. There is nothing exciting about detoxification, especially when so many people have it so spectacularly wrong. First, let’s review some basic physiology. Everything your body ever comes in contact with, and everything you ever breathe in or consume needs to be processed through either your liver, your kidneys, your lungs, your bowels, or through your skin. Water soluble substances don’t pass through the skin readily but are filtered by the kidneys fairly efficiently. Oil-soluble substances can be absorbed readily through the skin and are processed by the liver, and sent through the bowels for elimination. Gaseous substances, like anesthetic, are cleared directly from the lungs. Most of the toxins you are exposed to will be via your mouth in the form of what you eat and drink. Looking at the digestive tract for a moment, consider it a ~30 foot tube connecting your mouth to your anus. Approximately 80% of your immune system is centered in and along that tube, and maintaining its balance is a single, fragile layer of cells only one-cell thick. If this layer of cells is damaged, the selective barrier loses its selectivity, and foods, toxins, and other substances that would normally pass through your system with little consequence, can now be absorbed directly into your system (where your body can mobilize antibodies and inflammation for protection against this onslaught). In addition, there is an intricate balance of over 500 different types of bacteria (about 3 pounds worth all together) that live along is this tube which form part of a collective ecosystem to help you digest food, produce vitamins, make nutrients available, regulate hormones, and excrete toxic byproducts of your metabolism. When this lining or bacterial ecosystem become impaired, then you suffer from a wide variety of health complaints because your organ systems simply cannot operate at full function. Now, your body being the masterpiece of engineering it is, it tries to maintain an equilibrium, or ‘steady state’. So it takes these substances that it recognizes as foreign and it walls them off or stores them in the tissues it deems less critical for survival. As far as your body is concerned, your fat stores are less critical to your immediate survival needs than the health of your ligaments, nerves, and muscles. So initially, your body packs away these metabolites and toxins in fatty tissues and this can lead to cysts, lipomas, or benign tumors. Next in the line of potential storage spots, your body likes the myelin sheath – that fatty layer of insulation that surrounds your nerves and aids with nerve conduction. Connective tissues like ligaments, bones, and blood, and then tissues such as nerve and muscle tissue come next. Areas bathed in fluid, like joints are always prime targets for metabolite deposition (an example would be uric acid crystals depositing in joints in people with gout). If toxic and metabolite exposure goes on long enough, entire organ systems can be affected and thereby become dysfunctional.
Getting back to your gut, many supplement companies do not take into consideration actual human physiology when they talk ‘detox’. I swear that most people think the word detox is synonymous with the word poop. Let me be very clear, just because something makes you have a bowel movement – that doesn’t mean you are detoxing. Every symptom you have is not a sign of detoxing, nor is it a sign you need to detox. Nothing gets me more wound up than all of these ambiguous posts online that blame every negative side effect or symptom on toxins. And please, don’t get me started on all of these posts where people come to a group forum and ask a legitimate health question, only to have their symptoms brushed off or minimized by some well-intentioned but ill-informed individual under the guise that “all is fine, you are just detoxing!” As a health care professional, when I see someone referring to the word ‘detox’, I read their statement as “I don’t know what I’m talking about and have nothing better to say, so I am going to baffle them with BS”.
On a very simplistic level, when we were embryos and our guts formed, one collection of nerves, the ‘neural crest’, forms and divides with one section becoming the central nervous system and the other section becoming the enteric nervous system. These two nervous systems are connected by the longest of your cranial nerves – the vagus nerve. This vagus nerve starts in the brain and terminates in the gut and this is the source of the brain-gut connection that you read about. It is also why you have ‘gut feelings’, why eating certain foods are addictive or simply make you feel good, why you want to eat when you are stressed, why food sensitivities can cause behavioral changes, and why medication such as antidepressants can cause stomach upset or nausea.
When most people refer to detoxification they are referring to liver function, or to Phase 1 and Phase 2 conjugation in the liver specifically. This is truly your major site of detoxification and it is the organ most intimately connected to hormone balance. In Phase 1, blood carrying toxins enters the liver, and the liver prepares these toxins , usually moving them towards being water soluble, and makes them more accessible to Phase 2. In Phase 2, there are a sophisticated set of reactions involving a multitude of things, including Cytochrome P450. In all, there are 6 main types of reactions that occur in the liver – with each one being completely chemically different. That is why there is no magic detoxifying agent that can clean you out entirely. Of these 6 main reactions, 3 (glucuronidation, methylation, and sulfation) are the most likely to be impaired, and the other three are more likely to affect your hormone levels.
- During sulfation, your body adds sulfur groups to certain toxins so they can be removed. Your body requires sulfur-bearing amino acids like cysteine and methionine, and B-vitamins like B12 and B6, and folic acid for these processes.
- During methylation, your body requires methyl donors to facilitate the toxin removal. Up to 40% of the population may carry genetic anomalies which hinder this process.
- During glucuronidation, your body requires glucuronic acid, various B vitamins and a significant amount of specific magnesium ions to work properly.
This all leads to glutathione conjugation, where your body then uses master antioxidants like glutathione, superoxide dismutase, and catalase, along with the antioxidant vitamins A, C, E, and selenium.
OK, so have I bored you to death yet? This is as exciting as watching paint dry, right? But if you have stuck with me this long, you might be asking me what this really means? In a nutshell, it means that there is no single supplement or product that can act as a total detoxing agent. Anyone who suggests otherwise, is steering you wrong and just doesn’t understand basic physiology. CBC Marketplace (click link to watch the video) , Canada’s version of 20/20 style news exposè , recently did a show where they had a group of sorority girls from my alma mater follow Dr. Oz’s popular 48 hour detox or act as a control group. Extensive blind testing was provided by a team of medical specialists before and after the ‘detox’, and would you be surprised by their conclusion that they could discern absolutely no differences between the two groups upon the completion of the detox program? This leads us to a very important point, if you can’t find any biochemical proof that toxin levels are decreasing, then what are you really doing? There is an incredible lack of scientific literature that supports most detoxification claims; not only can people not agree what detoxification is, but they can’t prove that they are causing it.
You can take specific supplements or combinations of supplements to pull, chelate, or adsorb (not absorb) specific toxins from the body, like using chlorella to bind with excess mercury you may have in your body from consuming shellfish or having amalgam fillings; using EDTA to pull lead from environmental exposure; or using N-acetyl-cysteine to detoxify from acetaminophen exposure. But (big BUT) when it comes to detoxification, there is no magic bullet. You can’t go around claiming that every supplement under the sun is ‘detoxing’. They just don’t work that way, and even if a substance supports a step of detoxification, it doesn’t cause detoxification in its own right, and blaming all negative symptoms on detoxification is haphazard and potentially dangerous.
I have kept a running list of the ‘detox’ references I have seen in the online groups I follow over the past few weeks. Here is a list of symptoms that I have seen people blame on supplementation:
- hives and other skin rashes
- weight gain
- nausea, vomiting
- inability to concentrate, mental fog
- heart palpitations
These are not symptoms of supplement-induced detoxification!!! These are symptoms of dehydration and starvation. When many people undertake a detox plan or a new diet, they dramatically cut their caloric intake and unfortunately the do not consume enough water, or consume substances with diuretic properties which therefore increase their odds of becoming dehydrated. On day one of a typical ‘detox ‘/ diet, people often feel bad. They are hungry, may experience dizziness or irritability, and feel fatigued. By day two, their body starts breaking down muscle mass to provide them with energy and they may experience additional mood swings, difficulty sleeping, or overwhelming fatigue. By the third day, they are likely having headaches, muscle pain or stiffness, and even dizziness or nausea. Rolling into the fourth and fifth days (if they have lasted that long), their body has started to adapt to the new situation and slowed down your metabolism so they don’t feel the same degree of hunger, but they still may be dealing with altered mood, headaches, and nausea. Many people who report a 6-8lb weight loss during the initial period of any detox or diet are truly losing water and a small degree of muscle mass. They are not losing fat! You will notice that when you look at symptoms in this light, they are nearly all truly the result of dehydration and lack of calories, they have nothing to do with ‘detoxing’.
Yes, we can take steps to reduce our intake of toxins, and that may be the most practical approach to detoxification, but we can also take supplements which reduce inflammation or support optimal liver functioning so that our livers are best equipped to deal with the chemicals we assault them with. For anyone interested in detoxing, it should be clear that this isn’t a process you undertake in a few days or weeks, it should be a lifestyle change where you eat ‘clean’ and provide your body with a variety of fresh fruits and vegetables, along with vitamins and minerals, and other key nutrients to ensure that our systems are always handling toxins adequately. When someone tells me that they want to ‘detox’, my number one question is what they want to accomplish. Most commercial detox programs are nothing more than fancily packaged bowel stimulants. They make for expensive laxatives, and have no proven, measurable results, and for that reason, I do not recommend them.
While I am at it, I want to tackle ‘gluten sensitivity‘ and ‘candida overgrowth’. As these are two other catch-alls that get as much ill-informed press as detoxification. First, let’s look at gluten. Do I believe that gluten is an issue? Yes. Do I think it is anywhere as prevalent as what people like to say? No. In fact, a recent study2 found that people with self-reported (and to be fair, the gluten sensitivity tests are horribly unreliable) gluten sensitivity actually had no physical reactions from consuming gluten and instead experienced a total elimination of all of their GI symptoms by eliminating FODMAP’s (Fermentable Oligo-Di-Mono-saccharides and Polyphenols, or rather fermentable, poorly absorbed, short-chain carbohydrates) from their diet. FODMAP’s are what we would traditionally consider to be high-residue foods, things that linger in the gut and prove a fertile ground for bacteria to grow and feed off of. When bacteria thrive in disproportionate quantities or in imbalanced ratios, people can experience significant gas, bloating, cramping, constipation, diarrhea, etc. So what are these FODMAPS? The most common ones are fructose containing substances such as fruit, agave, honey, and HFCS. Oligosaccharides such as beans, lentils, wheat, onions, cabbage, and the other cruciferous vegetables. Disaccharides like dairy (particularly in unfermented dairy products), and sugar alcohols like xylitol, malitol, and sorbitol, which are found in many diet products. So looking at this list, you can be eating what you think is a perfectly healthy diet but causing undue havoc with your gastrointestinal tract and immune system. A lot of people are jumping on the gluten-free bandwagon as of late. In fact, I have colleagues who make their living being gluten-free gurus. I have sat down with internationally known scholars in the field and I just don’t see that gluten is the whole answer. Face it, we were all raised on gluten, and while there were a small portion of the population that have celiac disease and cannot metabolize gluten, the majority of us, for hundreds of generations, did just fine with it. It was the advent of genetic modification that heralded the onset of all of this gluten fuss. It countries that do not allow GMO wheat, they do not have the same gluten issues that we face in the United States. I will say that in the allergy blood tests I run on people, I frequently see wheat as an allergic agent but infrequently see gluten, so my personal experience supports the findings of this and other studies.
Lastly, I have received a bunch of questions lately about candida, and specifically the validity of the candida saliva test. I am of the professional opinion that everyone has candida, it is just a matter of whether your immune system keeps it in check or not.
Truthfully, candida is like Epstein-Barr virus; if you go looking for it you are going to find it. It may be more advantageous and easier on your wallet to simply treat for candida if you believe you have symptoms of candida overgrowth. Now, the candida saliva test (where you spit a mouthful of saliva into a glass of distilled water and look for ‘strings’) isn’t overly accurate.3 It can be better said that it is a test of saliva viscosity or thickness, it isn’t reproducible, nor is it specific. Yes, some people have oral candida (also called thrush) and will produce a positive spit test, but many people have candida-free mouths but may have candida over growths on their skin, or in their intestines or vagina’s. Yeast is an equal-opportunity offender. You can spend hundreds of dollars having blood, stool, or skin tests done, but does that really change your course of treatment? If you believe you have it, it may be a lot easier and cheaper just to treat for it, and treat for the appropriate length of time* (*most treatments need to be for a minimum of six weeks to be truly successful). Now I am officially on the record as saying I feel the candida saliva test is a no-harm-no-foul test. You can do it if you want, it doesn’t cost you anything but 10 minutes of your time, and it may or may not help you confirm that you have an issue. I do not think it is fool-proof or diagnostic by any means, but some people need to see things in order for them to believe them, and this is a tangible test that anyone can do but it should not be something you bet the bank on!
1. Detox Dossier. Retrieved 1/24/14 : http://www.senseaboutscience.org/data/files/resources/48/Detox-Dossier-Embargoed-until-0001-5th-jan-2009.pdf
2. No effects of gluten in patients with self-reported non-celiac gluten sensitivity after dietary reduction of fermentable, poorly absorbed, short-chain carbohydrates. Retrieved 1/24/14 from http://www.ncbi.nlm.nih.gov/pubmed/23648697
As I mentioned in a previous blog post, My Doctor Doesn’t Recommend Plexus Slim (or supplements in general) , statistics show that the average medical doctor received only 23.9 hours of education in nutrition during their entire medical school career.1 Typically that education centered around fat, protein, and carbohydrate metabolism, and identifying overt signs and symptoms of nutrient deficiency or toxicity because National Boards love to ask questions about things you will virtually never see like beriberi (thiamine deficiency) or pellagra (niacin deficiency). So, in all actuality, most physicians never learn much at all about individual nutritional substances outside of common vitamins and minerals unless they have taken a personal interest in it and searched out more information on their own time.
So when you show up to your doctor’s appointment wanting them to approve you taking a supplement, chances are very high that they will be completely unfamiliar with the ingredients and their knee-jerk reaction will be to tell you not to take it.
So, how do you get your doctor’s consent to take a supplement when they don’t know anything about it?
The single most important thing you can do to aid your doctor in their decision is to provide them with appropriate information. Your doctor doesn’t have the time or the resources to look up 15 separate ingredients while you are at your appointment, so you need to do this for them. If you present to the doctors office prepared with the following, you have dramatically increased your odds of getting appropriate medical advice as to whether that supplement is worth you trying.
- Print off the SUPPLEMENT FACTS box/sheet on the product you wish to take. This is the ‘snapshot’ of the label that lists all ingredients, in order of quantity, and lists product dosing, and any warnings or contraindications. You can get print these off from any supplement company’s website as they are required to make these available to you.
- If your prospective supplement has a study published on their website, print off a copy of that too. Remember though, that many supplement companies do not publish studies on their supplements so they do not run into hot water with the FDA by making a product claim.
- Look up the main ingredients in the product and print off an information sheet about each one. Use reputable websites that your doctor would be inclined to positively receive information from such as MedlinePlus, WebMD Supplement Center, or the Physicians Desk Reference – Herbal Medicines. Please don’t use Wikipedia or other questionable sources! If at all possible, keep the print out on each ingredient to a single page – that way your doctor can quickly skim the information.
- Use Pubmed to print off Abstracts (not the full studies) of any of the ingredients in relation to health conditions you may have. Here is an example I searched for – chlorogenic acid, weight loss and this study pops up. ***Be careful here, because few nutritional journals are indexed at Pubmed, and the nutritional studies posted in medical journals are often AGAINST supplementation, or use rat or other lab animal models and are not based on human trials.
- Lastly, have these all together in a file or envelope that you can present to our doctor and NEVER ask them “I want your approval to take ________”. This type of question opens them up to legal liability . It is far better to word your question the following way, “Is there anything in this supplement that would be contraindicated with my medications or health history?” That way you are not asking for their personal opinion, nor their approval, but you are doing your due diligence that the supplement should be safe for you. Remember, the doctor works for you, and you hire them for their expertise. If they shoot down all supplementation, then they are not working in your best interest. For this reason, I recommend you also print out my blog post My Doctor Doesn’t Recommend Plexus Slim (or Supplements in General) because it covers the exact statistics of risk for dietary supplements and counters any arguments an uninformed doctor may give you.
1. Adams, KM, Lindell, KC, et al. Status of nutritional education in medical schools. 1,2,3,4. Am J Clin Nutrition, April 2006, vol 83. No 4, 941S-944S.
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