Episode 86
· 32:12
Yeah. It's too early to tell. Too early to tell... We do, man. He's a freak.
Grant:He's a baller.
Dr. Barrett:He's a freak. Yeah, it is true, you know, and I would tell you Billy's career will hinge on whether he plays a 5 year veteran quarterback or a true freshman. He plays the 5 year and they go, you know, mediocre season. He's done. But I think if they, you know, go all in on the freshmen, I think they give him another year. Yeah. We'll see.
Dr. Barrett:Well, welcome back to another episode of the Real Health Podcast where we are diving in to talk about, you know, pharmaceuticals on the market today and conditions associated with those drugs that are typically used. Yeah.
Dr. Barrett:So 1st week, we really had a conversation on cardiovascular health. We kind of dived into the idea of statins and cholesterol-lowering drugs, and is it right to just lower cholesterol and assume that you're gonna reduce your risk of cardiovascular disease, and we kind of debunk that myth. Today, probably the biggest blockbuster drug since Lipitor or statins is GLP-one agonist, or what you would commonly hear them as, is like Ozempic, which is on the market. Now, there are, just to frame this out, multiple GLP-one or GIP agonists on the market. So this is Ozempic- is not the only one.
Dr. Barrett:Ozempic is what we probably are marketed the most right now- as an injectable, but these drugs have been around for a while. Even the- a peptide that has been around for a while, semaglutide. So when looking at these drugs and we're gonna just kind of take Ozempic out of the picture for a second just kind of talk through GLP-one agonists and we're gonna talk about the risks, we're gonna talk about the dangers of these medications so that you can be aware as a consumer what you're getting into if you decide to go down this route. Or just have awareness like "Hey, is this really like a blockbuster drug that's helping a lot of people or not?" So this is a hot conversation.
Dr. Barrett:Anytime you get into overweight obesity conversations, this is a hot, hot conversation. I think it's important to frame out that we are severely overweight as a society. So I want to establish first that when we talked about kids a couple episodes ago and how poor our nutrition is in this country- I think it's important to start off with this. Hey, we're overweight and we're severely obese.
Dr. Barrett:In developed countries, developed nations, we are the fattest. And and so when we look at blaming, like what's to blame, right? Where do we put the finger? The first thing I want to debunk is the myth that it's genetics. Okay?
Dr. Barrett:So when we look at, autistic rates, for instance, that have just been on the rise, that are just absolutely insane, we look at is it genetics? And we have to associate this with this idea, genetics have not changed in the last 100 years, last 10 years, last 50 years, last 500 years. Human beings, our genetics have not changed. So why are autistic rates going from 1 in a 1000 to 1 in 1 in 25 in just a few short decades- just a couple decades? Why are our overweight and obesity rates climbing?
Dr. Barrett:Okay. Now would I say they're genetically based? No. Is there an epigenetic concern? Yes.
Dr. Barrett:What do I mean by that? Is it purely based on our genetics? No. But are there genes that can be up regulated or turned on in families because we do know that if mom and dad are fat, that baby's gonna be fat, like we do know that. We do know that overweight and obesity does transfer from generation to generation.
Dr. Barrett:Why? Environment plus genetics. Epigenetics. Environment plus genetics. The environment is how is that child being raised?
Dr. Barrett:What we see are kids are being pretty much born into pre-diabetic states. This is wild. So the mother and dad are now becoming insulin resistant and it is transferring to baby, where we're seeing type 2 diabetes with kids at a very early age. So we're seeing this transfer of insulin resistance in this overweight obesity issue associated with that. So I also want to separate that group of people that it's environment plus genetics from another group of people where we see like type 1 diabetics that's autoimmune and and because their immune system has assaulted their pancreas and they're not making insulin and they have too much blood glucose. Hey, this is a group that can be overweight and it's really difficult to navigate their metabolic health and they're doing everything they can but they still are unable to lose a certain amount of pounds, maybe it's 20, 30, 40 pounds.
Dr. Barrett:Hey, that's a that's a tough group. I'm not really I'm not talking to you. This is not a conversation about type 1 diabetics. This is a conversation about the culture that we live in where we can we can do something about us being overweight and obese, and it's an emotional conversation to have like with a lot of people, it's a heavy conversation, but it's not a "don't do anything" conversation. It's a conversation of hope that "Hey, we can have a plan and we can execute a plan that can hopefully reverse poor metabolic health that we've been maybe taught by our parents."
Dr. Barrett:To not just assume because our parents are unhealthy, overweight or obese that we too are gonna be in that situation. So let's talk about epigenetics. Environment plays a role. So if your environment wasn't great growing up, hey, let's change our environment. And when we change our environment, we can absolutely affect our genetics.
Dr. Barrett:We can down regulate even those overweight obesity genes in our 20s, 30s, 40s, and so on. So today's conversation is going to be are we taking the easy road by using Ozempic or GLP one agonists? Let's talk about this and the effects that it's having on our body. To properly have an understanding of Ozempic, we have to have an understanding of what's happening in the body from a hormonal standpoint because this is really a hormone drug, it's a hormone drug. So let's talk about then just the basics of hormone physiology.
Dr. Barrett:Like when you eat, what happens? So when you consume a meal, then that meal goes into the stomach and it releases into the small intestine. The small intestine releases certain hormones. Okay? So specifically, the pancreas will release insulin.
Dr. Barrett:You'll also have other hormones that are released. Specifically, you'll release a GLP 1 hormone. You'll also signal the brain to release hormones, specifically hormones called Leptin. There will be hormones released in the stomach called Ghrelin. So we have this hormonal symphony- this hormone symphony of certain organs releasing certain hormones to to really signal a few things.
Dr. Barrett:When we eat, we should feel full, therefore, that full feeling is is a hormone released in the brain called Leptin. Leptin is a hormone that signals to the body, release from the brain, that says, "Hey, I'm full. It's time that we're in a feed state. It's time to break down. It's time to break those nutrients down."
Dr. Barrett:The pancreas releases insulin, which takes your meal and puts it into cells. So in essence, this is our kind of our catabolic hormone. Okay? So this is a a unique system of pulling sugar out of the blood and and putting it into muscle or liver. It's if we eat too much, it may store as fat.
Dr. Barrett:The brain signals, "Hey, we're we need to be in fat burning mode, okay? We need to do something metabolically." So we're gonna we're gonna say, "Hey, stop eating, right, leptin, stop eating, burn fat, burn, burn, burn." Okay? So this symphony of hormones are happening every time we eat.
Dr. Barrett:So insulin increases, and then when we stop eating, after a couple hours insulin slowly goes down. Our blood sugar typically has a spike to it and then slowly goes down as insulin controls blood sugar and then it returns back to a state of homeostasis or balance. And then the next time we eat, this symphony of hormones is released again and then we go through this kind of up and down, up and down. Now we have this conversation in the office with patients all the time. What we don't wanna see is high spikes and quick drops.
Dr. Barrett:This is poor metabolic health. This is like hyper to hypoglycemia. Now, if you don't know this, I am using my hands as I communicate, as I do all the time, and so if you wanna see me using my hands to understand these hyper and hypoglycemic spikes, check out our YouTube page as all of these podcasts are recorded as well at the Real Health Co. YouTube page. So, hey, we get this high burst spike, this hypo drop, and if it's too high and too low, we feel this effect, we feel this hypoglycemic reaction. What does it feel like?
Dr. Barrett:It feels like light headedness, like you're going to pass out, like you're shaky, irritable, anxious, sweating, and you could literally pass out. If you have had moments where that has happened, let's just say you've gone 6 hours without a meal, 12 hours without a meal, 24 hours without a meal and you experience this hypoglycemic response, you have poor metabolic flexibility. You have poor metabolic health. You must do something. You are in a state of prediabetes.
Dr. Barrett:Your body is not healthy hormonally. We are having an imbalance in our insulin and glucagon system. We have a poor system of metabolic adaptability where we can't efficiently use fat as energy and we've been consuming and utilizing carbs and spiking your insulin way too much. So we need to work our metabolic system. That is kind of how the hormonal system operates.
Dr. Barrett:So, let's insert now a GLP one drug. Let's talk about when we insert that drug, what happens hormonally. So, when we make that higher production, when we create a high production of GLP-one? Well, on our own, GLP-one will sit in our system for a couple hours, and it's a small dose. But when we take a macro dose, a heavy high dose of GLP-one, it actually can sit in our system for days.
Dr. Barrett:And not only that, it's a extreme high dose. So what happens to our physiology? Our physiology changes dramatically. We get this squeeze of our pancreas. So our pancreas gets overworked, so we get this high insulin production.
Dr. Barrett:Now what this will do is it'll keep your blood sugar really low. Okay? Now this can be a good thing but unfortunately the dosing of it is a bad thing. This is why we see pancreatitis with GLP-one drugs. One of the known side effects is that the pancreas enlarges.
Dr. Barrett:Why would it enlarge? Just like a muscle that's overworked and can then grow, the pancreas when it's overworked will grow. Pancreatitis, inflamed pancreas and a large pancreas, because of these medications is really in response to the high dose of GLP-one causing a high dose of insulin. And this high release or dosage of insulin into the body is just like someone that takes is takes insulin as a as a Type 2 diabetic or maybe even a Type 1 diabetic would take insulin to lower blood glucose. We're doing that through a different means.
Dr. Barrett:We're doing that through a GLP agonist, GLP 1 agonist drug. So this is creating a pancreatitis effect to the body. This is not good. This is really concerning over time. GLP 1 drugs specifically in they affect and trigger insulin from the pancreas.
Dr. Barrett:That's the first thing it does. The second thing it does is it blocks glucagon secretion. So glucagon is a hormone that your body uses to raise blood sugar. So GLP-one agonist drugs prevents more glucose from entering your bloodstream. So not only does it reduce blood sugar by making your pancreas make more insulin, it prevents glucagon secretion which keeps your blood sugar levels really low.
Dr. Barrett:So that's the second thing it does. The third thing GLP-one agonists do is they they stop your stomach from releasing food too fast. So this is called gastroparesis or paralyzing the stomach. It literally is stomach paralysis, okay? So when we get a stomach paralysis, we get a slow dumping of food into our small intestine.
Dr. Barrett:Now, theoretically, this is good because it would slowly release food into the body which slowly releases glucose. And again, glucose, balanced glucose or a healthy balanced level of glucose throughout the day is very important for metabolic health. So in theory, this is great. But in reality, we're paralyzing the intestinal system. We're paralyzing the stomach.
Dr. Barrett:Gastroparesis, gastroparalysis, we're getting this slow release of food and this is the 3rd action of GLP-one agonist is gastroparesis, gastroparalysis or slow gastric release of your food that you just ate. And the other thing that this drug does specifically by affecting leptin levels of the brain is this medication, it affects neurotransmitters. It's literally affecting your brain's perception of what's happening. Okay? This is probably the biggest concern that I have is it is creating this metabolic dysfunction that does not exist in nature.
Dr. Barrett:Like, this signaling does not exist in nature. Okay? So what is it doing? It's signaling to your brain that you're full. This is a satiation signal.
Dr. Barrett:It tells your brain you're full, but you're not full. You haven't eaten very much and you actually don't wanna eat. So it triggers to your brain this high production of leptin saying, "Hey, I'm full," which should signal to your body, "Hey, I'm full. That means I'm in a feed state. I'm feeding. I'm full. Signal burn, burn, burn, burn. Let's burn. Let's let's create metabolic action here." The issue is you are not full.
Dr. Barrett:You have not consumed enough nutrients and this is where we get into the downstream effects of GLP-one agonists. You have caused a trigger release of insulin, you have blocked glucagon, you have slowed the release of food from your stomach, and you signal to your brain you are full. The biggest issue that I have in this moment, this metabolic moment, is you are deprived of nutrients yet your body is signaling you're full. It is the this idea that you're stuffed of nutrients and with food and fuel and how we need to use all these nutrients for energy, yet your brain and your brain sees that, yet the reality of your body is that that's not happening. You don't actually have nutrients.
Dr. Barrett:The feeling of fullness, the decreased appetite, the appetite suppression is so significant that actually people vomit and throw up. And it's one of the side effects of these medications is this severe nausea, vomiting effect. The stomach is literally just sitting with food 24/7, and this delayed gastric emptying is creating this this feeling of fullness 24/7. So we are so undernourished, yet our body perceives it being in this like nourished state that is metabolically trickery. It is tricking the brain.
Dr. Barrett:And who knows what this honestly- who knows what this is doing? I don't know what this is doing. Like I can postulate, I can hypothesize, I can come up with some some really good- like- ideas, but we really don't know what this is truly doing to the body and really what it's doing long term? Like are we just totally down regulate are we creating severe leptin resistance that that can't be reversed? Are we creating severe insulin resistance because of the excessive insulin production?
Dr. Barrett:Are we are we driving a further, you know, concern of, you know, this- I don't know, this metabolically medication induced diabetic state. Alright? It's like diabetes who were driving us more insulin resistance because of a high insulin production, yet we're not getting the same effect because our blood sugar isn't high. I don't know. Gosh, I don't know, but here's the effects.
Dr. Barrett:We're getting these these problems in our pancreas, pancreatitis. We're getting these problems in the brain of this metabolic dysfunction, leptin resistance, insulin resistance. They're getting gastroparesis, gastric paralysis. And, and then the effects we're seeing is nausea and vomiting and low energy. Because in essence, we just don't have the amount of calories our body needs to survive and function.
Dr. Barrett:So what are we what are we seeing in our country today? Well, the usage rate is really high. About 1 in 8 people currently have taken the medication. It costs, it's out of pocket, costs about 15 for most people, $1500 a month. And when we look at the amount of of medic the amounts of people on it, 12%, about 50,000,000 people in our country, have used the drug or are using it actively per month.
Dr. Barrett:I mean we're talking about a multibillion dollar a month drug per month. Per month. So this is definitely a blockbuster drug. This is a massive money making drug. And this is a drug that inevitably we were kinda saying, "Hey, you can be on for the rest of your life."
Dr. Barrett:So a multimillion dollar per person medication. When we see the effects so this is some of the research that's coming out. This was in JAMA, the Journal of American Medical Association put out severe wasting muscle wasting syndrome. So what we're seeing is this like unknown metabolic state, never been seen before. And when we look at the weight loss that people are having, is it quality weight loss?
Dr. Barrett:Are we getting good weight loss? The reality is we are not burning fat only. And we're seeing rates in JAMA reported at 40% of your weight loss is muscle. There are other reports that are showing 50%, percent. So we're gonna say 40 to 50 percent of your weight loss is directly muscle being wasted, muscle being chewed up, eaten up, and those muscle proteins are being lost, and potentially lost forever.
Dr. Barrett:And this is this is the biggest concern because muscle is a longevity organ. When we talk about how to live longer, when we talk about anti aging, when we have conversations about how do I reduce this, my aging system, right? It is build lean mass. Lean muscle improves metabolic health, metabolic flexibility, it is harder to gain lean mass as we get older. It is more important to gain lean mass as we get older.
Dr. Barrett:We have to work harder as we age, but lean mass, skeletal mass is so vital to longevity that it should be a primary focus of anyone's health. This should be measured whether you're measuring at your functional medical doc's office, or you're measuring it at your chiropractor's office or you're measuring it at your, MD's office, we should absolutely be measuring our skeletal lean mass. And what we're realizing and what we're seeing is that we're getting up to 50% of our of the weight that's being lost is muscle. And the problem that we're getting into is not only is this a metabolic organ that's wasting away, but when we then take our human body and we eat all of this muscle and then we get let's just say we get off Ozempic and we're seeing this massive amount of weight come back, are we getting muscle regeneration? Are we getting our muscle to come back?
Dr. Barrett:And what we're seeing is that a 100% of the weight that comes back is fat. So we go through this this loss of muscle, 50% of our let's just say you lose £50, £25 £25 of muscle is lost. And then we're gonna gain 50 back, but £50 of that is fat. We're in a worse state than when we started. There's no question about it.
Dr. Barrett:And not to mention, we disrupted our hormonal symphony so severely that it's gonna take months years potentially to reverse the effects of it. So this is really what's happening and this is my big concern. The big concern is that the brain thinks that we are overfed yet we are under nourished. It thinks that we're in a high caloric state, yet we're in a low caloric state. The brain thinks that we should be in a catabolic state, breakdown, breakdown, breakdown, yet we are not, and therefore we are breaking down our own body at the for at the sake of a scale that's changing, the number is changing, yet we're getting into a worse metabolic state.
Dr. Barrett:So hey, what do we do? Like is there a way to do the same thing, do the same thing in a healthy way? Right? And there absolutely is and it's called fasting. Fasting is so incredible.
Dr. Barrett:It unlocks your anti aging genes. It unlocks your body's ability to do what it was designed to do, what God designed your body to do, which was burn fats, but preserve skeletal muscle. The coolest thing about fasting is that when you lose weight, when you look at a 7 day fast, a 10 day fast, a 3 day fast, a 30 day fast, whether it's water only fasting or whether you are in just a reduced caloric state, what we would call a fasting mimicking diet, when you look at the numbers, you have lost fats, but you have not lost muscle. Will your muscle get smaller? Yes.
Dr. Barrett:Why? Because you are removing glucose from your body. Glucose is stored in muscle. When glucose stores in muscle, water is stored in muscle. So will that muscle be bigger?
Dr. Barrett:Yes. But are you, during a fasted state, actually losing, burning, eating away skeletal muscle? You are not. You're not. And so that's why when we see people reintroduce nutrients post fast, we get this surge of growth hormone, these new stem cells come forth, we get this amazing metabolic change, we get insulin sensitivity, we get low blood glucose levels, we get efficient fat burning machines, and we've kept our muscle.
Dr. Barrett:This is why I'm so passionate about fasting because not only are you stepping into states of autophagy and burning and and allowing your body to heal and killing cancer and regenerating immune health and restoring stem cell production, but you're also preserving a longevity organ muscle. And not only that, but you are doing so much to your body that you're adding quality and quantity to your years long term. It is so important that we understand what we're getting into before we get into it. And so the idea here is I'm not saying take Ozempic, don't take Ozempic. I'm saying, "Hey, we should be aware of what's happening to our body."
Dr. Barrett:We should be aware of what's happening so that, hey, if you decide that Azimpic is a route for you that we understand that, hey, through this process, okay, gastroparesis, low emptying, leptin resistance, insulin production is high, I'm gonna lose muscle. When I get off of this medication, if I achieve my quote unquote number weight loss goal, then I'm gonna add back skeletal muscle. But if we've never changed our mindset pre Ozempic, what is it prove to me that you're gonna change your mindset post Ozempic. Okay? And prove to me you're gonna do that by changing your caloric intake.
Dr. Barrett:Okay? Prioritizing protein, quality plants, fruits. We're gonna consume healthy fats and we're gonna do it in a moderate state. Okay? A state that our body needs to utilize those nutrients for energy, but not store as fat.
Dr. Barrett:And unfortunately, if you look at the population today, we're using these medications short term without understanding the long term risks and effects. And this is what we do. This is our society today. So hey, be aware, be educated, and make an informed decision. I'm not saying do it.
Dr. Barrett:I'm not saying don't do it. All I'm passionate about is informed consent. Knowing the effects and knowing how to properly utilize, if you're gonna go this route, utilize nutrition to make sure and strength train to make sure that we regain that skeletal mass if you go that route. Hey, and if not, let's talk about fasting. Let's talk about blood sugar management.
Dr. Barrett:Let's talk about reducing actually reducing insulin resistance. Alright. Reversing insulin, reversing leptin resistance through a ketogenic diet. And these are these are staple hallmark longevity nutrition plans that your body was designed to operate in ketosis, autophagy. As we continue the series on medications or big pharma or whatever we how we want to frame it, today's conversation is about metabolism- metabolic health.
Dr. Barrett:So be passionate about metabolic flexibility. Be passionate about the ability to fast and not feel the effects. Be passionate about quality protein, healthy fats and quality plants that support nutrition, support energy every day without being so much that we're storing it as fat, and teach it to our children so that we can change generations to come. Thanks again. As always, thank you so much for listening to another episode of the Real Health Podcast.
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