The Livy Method Podcast - The 4 Main Reasons Why Your Weight Might Be Slower to Move Part 2 with Dr. Paul Hrkal - Spring 2025

Episode Date: May 29, 2025

In this thought-provoking episode, Gina and Dr. Paul Hrkal go beyond food and fitness to unpack what’s really going on when weight won’t budge—even when you’re “doing everything right.” They explore how gut health and the microbiome influence more than digestion, touching everything from cravings to hormones. They also get into SIBO, gallbladder removal, and stubborn bloating—and why these symptoms matter. The conversation shifts into insulin resistance and how it can stall progress long before any diagnosis. Plus, they break down the connection between stress, hormones, and weight loss, especially through perimenopause and menopause. Dr. Paul wraps with five simple, practical steps you can take right now—and the real takeaway? This journey isn’t about being perfect. It’s about getting curious, tuning in, and recognizing that your body is on your side.Where to find Dr. Paul:Instagram: @drpaulhrkalwww.paulhrkalnd.com If you are in the Spring 2025 Support Group, you can check out the full video here:www.facebook.com/groups/livymethodspring2025 Hosted on Acast. See acast.com/privacy for more information.

I'm Gina Livi and welcome to the Livi Method Podcast. This is where you'll have access to all of the live streams from my 91 Day Weight Loss program. With a combination of daily lives, guest expert interviews, and member stories, there is something new almost every day. Miss the Morning Live? Want to relisten to one of our amazing guest experts? Well, this is the place.

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Vacations. Visit SellOffVacations.com to start planning your next trip today. This is an opportunity to become curious. To learn some things. How do we help you feel less overwhelmed so you can continue on your journey? Keep believing in yourself and keep trusting the process. Just be patient. Why isn't your weight moving? Why isn't it moving?

Even though you are trying so hard and you want it so bad and you were eating all the things, you are eating less, you are exercising more, why is it? So Dr. Paul is back to continue his two-part series. So he was back with us on Tuesday, if you missed it, we talked about four reasons why your weight might be slower to move. We talked about inflammation, which is a big one,

food sensitivities, we touched on gut dysbiosis and your microbiome a little bit, and then also hormones. So we're going to get into the last two a little bit more today. I also have a slew of supplements I want to talk to you about. I want to ask you, I got a lot of questions for you on what you think people need to do. So hi, Dr. Paul. Good morning. That was a good one. And if you haven't listened to the Tuesday session, go back and listen to it because I think that's going to be an awesome lead up into our conversation today.

But we're going to build on that. Just like you said, Gina, it's such a big, huge conversation. I'm sure you and I could talk all day, every day on these things. I mean, hours for sure. And you know, I think the goal for us, like we try to leave off Tuesday's convo was, okay, there's a lot of info that we can get into. I enjoy getting the weeds. That's what I do with my with my patients when necessary.

But at the same time, I like to zoom out to make sure that what is the takeaway that people should be really understanding from this conversation? You know, not everyone here is a PhD in nutrition, nor do we expect you to be. That's why I'm here to talk to you and distill it down. What do you think our, and thank goodness for you, what do you think of our, what do you think the takeaway from last conversation was?

Yeah, you know what? I think that just like I kind of try to state is that there is a number of factors that are independent of just what you're putting in your mouth and eating that are leading to the equation of whether you are holding on to your weight or whether you're losing weight. And we try to articulate some of the top four that I've seen in my practice and there are other ones as well.

Dr. Beverly has talked about the psychological side of weight loss. And there's, I would say that's a massive component that we haven't even really touched on. And that actually has its kind of roots and tentacles in all four of the areas that we talked about. For example, if you're under a lot of stress, your gut microbiome and your gut lining is not going to be functioning optimally. There's an increase in permeability

right away. There's a change in your microbiome. So we're trying to look at one aspect, one piece of the pie of some of the underlying things. And I hope that from that Tuesday combo and from today's combo, something will resonate. Something will ring a bell being like, huh, you know what? I haven't really thought about that before. Maybe I should look into some of those foods that, you know, I just know I don't feel good after, but oh well, I'm just going to eat a little bit less of them. We also talked a lot about alcohol, which is a little bit of a touchy subject. And so I love how you dove right into that. So if you want to know more about that, go back and listen. But I really hope people

leave inspired and actually a little bit more empowered to seek out some of these underlying issues, whether it's with yourself and also with your healthcare team. Great. Where do you want to start today? Well, I think we kind of left off really talking about the digestive system, you know, the gut and dysbiosis. And I've already, you know, just mentioned just the huge impact that has on the whole body. I wanna just start off with that

because I think it really is a key foot fulcrum of this conversation. When your gut microbiome, the trillions of bacteria that you have in our bodies, you know, we don't fully understand what that perfect breakdown is. And in fact, I think what research is showing is that there is no one perfect microbiome. And that's, I think, a frustration is that we know that this system, we know all these bacteria, they produce all these different things and they can regulate things like cravings. They can regulate things like appetite. GLP-1, this whole rage around this class of medications

is heavily influenced by your microbiome. For example, in the US, where some of my patients travel and I keep really on top of some of the newest, latest formulations from a new suiocle world, there are probiotics coming out to look at complementing these class of medications because certain bacteria can play a role in enhancing GLP-1 production, for example, because it is produced by gut cells,

it's produced by your gut. So what I wanted to say about this is that it's important that we find a way to balance it. Now, a couple takeaways. Number one, how do I know if I have this gut dysbiosis? You see this on your screen right now. You're listening to this. Maybe it's a word that you're not super familiar with. It is the imbalance of your microbiome from what is optimal. If you have a history of antibiotics, if you have a history of crash dieting, if you have a history of eating junk food, if you have a history of eating or taking something like a medication like acid locking medication, these are all potential risk factors, well

known risk factors for changing your microbiome. If you don't have any symptoms, Gina, then I think, and what do I mean by that? Gas, bloating, changes in your stool, inconsistent stool, then I don't necessarily want to make something out of nothing. I think that if you feel good in that area, then it's not necessarily something that you need to go hunting for if that's not an issue. But if it is, and it is resonating with you, maybe that is causing one of these obstacles. And that is related to inflammation. That is related to the excessive production of inflammation when your gut is not happy, food sensitivities, and actually even the integrity of the lining of the microbiome, of the lining of the gut can play a role. So I think that's a good place for us to start.

What do we do about that? Do we take probiotics, prebiotics, digestive bitters, fiber? What are we doing? All of the above are actually really good. So I'm glad that you brought all that up. So the easy route, the route that is probably the most accessible to people is let's take the prebiotic, probiotic, though they are in the primary supplements, the first ones we talked about last month. I think that's for a good reason that they're there. The prebiotics help fuel the good bacteria in your gut, but they can also fuel some of

the bad ones. So if you take prebiotics or probiotics and you actually feel worse off, that's actually a little red flag to say you might have this thing right here on the screen, the dysbiosis. And if you take probiotics and you don't notice any sort of difference, that doesn't mean they're not doing anything. They may have a protective effect. So I don't think it's a bad idea to take it as kind of, I would say, a bit of an enhancement or an insurance policy. But you will find out fairly quickly if that probiotic is not going to be

tolerated by you. So start with that probiotics, Gina temporarily modify the microbiome. That's literally the definition by Health Canada. These are lots of bacteria. Prebiotics are the fuel for that bacteria and there's lots of research showing that it can really improve all sorts of different factors including things like weight and inflammation. So not just gut stuff. So that's a good place to start. You mentioned a couple other things. Bitters. Bitters are part of the primary supplements. Again, just as a review for everyone,

they just help your digestive system do its job to break down food better. So enhance the production of stomach acid, enhance the production of your own digestive enzymes. You're pulling out your book there. It's all written out there, right? Yeah, it's all here, which is why I'm just gonna remind people,

this is in the book, but all the same information is in the Facebook support group. And in the app, if you just search supplements, it'll come up because when people first start the program, we have the supplement conversation about the basics and week two people are like, I don't need that. They're not really paying attention. They think I got this. I'm just going to eat less exercise more. And then this is sort of where now if they're having a harder time, I'm hoping that they're paying attention. And this is where you want to go back to that first set of supplements. Yeah, it's a reasonable strategy to start with, you know, the foundations, especially if you're newer to the program, you

kind of just trying to get your head around all the different food changes, everything that is being talked about and asked, it can be quite overwhelming. So this is a good time. And this is why I'm bringing it up, is that circle back to both the primary and now even the secondary supplements. This is a great opportunity to level up, especially if you're feeling that you're not really making the progress that you want. So gut, I think, is absolutely integral to proper function. And I'll be honest, researchers still are just scratching the surface, Gina.

We really don't fully understand all the different nuances of your gut and how it's related. All they know, and this is what all the research papers show, all they know is that it's related somehow. However, exactly what bacteria and exactly what I need a remover at that is not that is a bridge too far that's a conclusion we can't draw and so I really want to make sure we understand that okay and we do have more

information on probiotics prebiotics probiotic prebiotic foods as well in that supplement post that we originally had um probiotics prebiotics what about digestive bitters what about? Did you say enzymes too? No, I didn't say that. Well, I just it just popped in my mind that some people may have heard that between enzymes and bitters. Yeah, one of them helps. So the bitters helps your own body produce more enzymes, where an enzyme supplements actually gives you the enzymes to break

it down. And so there are different benefits to either one, but I think that generally the bitters are my favorite because it helps your body actually do what it's supposed to do. Okay. These are bitters. This is St. Francis. St. Francis Canadian bitters. There's a number of other formulas. In fact, bitters are used in traditional alcoholic beverages, digestivos, operativos, these types of amados, these types of traditional bitters for thousands of years, actually. So there's been a long history of health benefits with these herbs. for thousands of years actually. So there's been a long history of health benefits with these herbs.

So I know when my digestive system is off, I take my probiotic and prebiotic, especially when I start to get bloated, gassy, also tends to fall in line with I'm stressed, not doing the other things in my life. And then my bowel movements are off. Can that be a sign that something is off? Like how else can we tell if our microbiome needs a little love? Yeah, so your bowel movements is a huge one. You mentioned gas,

bloating, any sort of digestive distension and upset I think are key signs. I also encourage people, and this is why this conversation is like a web, because it's related. Okay, what did you do the day before? What did you eat? Did you eat in a state that you were stressed? So sometimes there's a huge influence of stress, and also your digestive function. If you're eating on the run, if you're eating on the go, just something as simple as that can not truly enough can really influence this. And also, which is a good segue into what we're going to talk about next. Some

women will experience more digestive issues around their typical PMS time before their periods. So that also influences. So there's a lot of different factors that could influence your digestive tract. We're calling you to be more mindful about it. A lot of times people just take for granted that, oh yeah, I'm just like, I'm and farty, that's just who I am. Well that's telling you that there's something that you're consuming that is causing that or there's some factor in your microbiome that is not allowing you to break it down. It's finally I'll say your microbiome is not just gas and loading, it's also your immunity. I had a patient yesterday that was just getting

sick nonstop, four times a year getting colds and flus all the time. Your digestive system, your bacteria that's in your gut, regulate your immune reactivity both to itself and also to bacteria. So 60% or 70% of your immune system is like waiting around your gut ready to Determine is this healthy? Is this something we want or don't want so it could have to do with your immunity It can have to do with your inflammation and then finally there are other symptoms What are called extra intestinal? 50% of symptoms of people that have celiac disease are extra intestinal, meaning they have nothing to do with the gut. Yeah, celiac erodes the lining of the

gut. It's a huge immune reaction to gluten, but there could be things like headaches, brain fog. So if you're noticing that you have these symptoms that always are happening after you eat, you get that two o'clock crash and I'm so tired all the time. Consider maybe it's the food that you're eating that's influencing your gut and then your gut is creating a response. Okay, everyone's what probiotics, what digestibiter.

So we have all this information posted in that first supplement post. So I don't wanna spend too much time going back over that today because we already had that conversation. Some of the products, if any that we mentioned, like the Canadian bitters from St. Francis Herd Farm, this is not an ad, people are just asking.

I will list them for you after the segment is done. Before we move on to hormones, I want to bring up SIBO, SIBO, and what if someone is missing their gallbladder? Yeah. I know those are, those are kind of two people are asking about. I would say the gallbladder one is really common. So removing a gallbladder is usually happens because there's some sort of

stones or there's sludge in your gallbladder. You can start, it can start by having a little bit of pain in the right side of your upper kind of rib area, your abdomen. And oftentimes, the solution that everyone's presented with just get it out. So they just go in, cut it out, sip it out, and you're missing your gallbladder, which is the key organ that stores bile that's produced in your liver, which breaks down fats. So I'll tell you, I've introduced the

concept called the rule of threes last time. And I'll say this, this really works out with gall, with gallbladder removal too. Um, when people have the gallbladder removed, which is actually more common in women, cause there's a connection with estrogen being out of balance with too many gallstones being produced. So that's my clinical observation. A third of people really notice that they're like, okay, my symptoms went away. Amazing. So this is the best case scenario. Then there's a third of people that are like, you know what, I actually feel a lot worse with taking my gallbladder out. And so there is that population. So just it's not a patch for everyone. And then there's a third of people that are like,

you know, when I get a little bit of symptoms still, it didn't really make a huge difference. You have to be more mindful of the amount of fat that you're eating. So again, this is a trial and error, very personalized. Some people have no issues with eating all the fat that we're talking about during the diet, you know, MCT oil, good fats, olive oil.

Sometimes that's harder to break down. Fish oil is one that we talked about in the initial supplementation. Sometimes those people that have trouble breaking down fats, and I want you to think about this, if that you know, if you're seeing some bad in your stool, if you're seeing kind of was like an oily, like if you're noticing after heavier fatty meals, you just feel kind of like nauseous and, and distended. That could be

what's called fat malabsorption. And those people need digestive enzymes with actually the bile in it to break down the food that your bile from your own gallbladder now is no longer there. So you know, because so many people do end up getting their gallbladder removed, especially after they've lost a significant amount of weight through those really quick fix kind of crash diets. And I'm surprised at the number of people who are just don't know any of this after they've gotten their gallbladder removed.

It's just, it's not the norm to explain, okay, this is what now you need to do, right? Ongoing for the rest of your life. That's really interesting. Okay. And SIBO, because people ask about that. And when we talk probiotics, prebiotics and things that people need to keep in mind. So SIBO stands for small s intestinal bacterial overgrowth. And this is your bacteria as you go down your intestinal tract in your stomach, there's very little, there's a bit more in your small intestine which is next in the path and that's that big like

spaghetti, it's a really long one. Most of your digestive absorption of let's say your vitamins and breakdown of food happens in your small intestine. And then finally the last part is your large intestine which has the majority of the bacteria in your gut. Small intestinal bacterial overgrowth is you have too much bacteria that have crept up from the large intestine and now have populated the lower part of the small intestine. And that leads to chronic, really disruptive symptoms in the digestive system, primarily like gas, bloating, pain.

But then there's a lot of things like brain fog, fatigue, muscle pain, headaches. There could be other symptoms that again, the gut is causing. This is the poster child for dysbiosis gena. And this does require eradication. And I actually do work with medical doctors on using either antibiotics or antibiotic herbs that just stay in the gut,

eradicate the bad bacteria, and then put in the good bacteria after. But I will say, this condition is not something that I suggest you DIY yourself. This is something that you seek out the help of a naturopathic doctor or someone that really understands these conditions to address it because it can absolutely

change your majorly change your bowel habits and influence your metabolism. Okay, that's S-I-B-O people are asking and then Pam is asking what is that the same as leaky gut? No, it's different. So leaky gut can happen throughout your entire entire intestinal tract. There's only one cell that differentiates the gut actually inside the mucus and the bacteria compared to our body. So there's this one cell lining and then there's these little junctions that keep that lining or we'll call it the border in check. And so if those junctions become disrupted, like for example, if you had some bad sushi and you get a gastroenteritis, you actually get leakiness. And so what can result

in that is more inflammatory molecules from your guts start getting pulled into your body and you have, you feel crummy and then eventually the body will heal and that can happen. So that's the acute piece, but then what if now that's a chronic piece? I work a lot with concussion patients. You've heard me say that before. There's research showing that within three hours after getting hit in the head, so this can apply to a car accident,

this can apply to a concussion, whiplash, or any sort of trauma, including psychological trauma, the leaky gut occurs within three hours and can last up to two to three days in basic concussion. So that means your body is up regulating inflammation on purpose to try to heal. But now if you don't resolve that now it's chronic. And there's so many conditions Gina that have been related to leaky gut, but that doesn't necessarily directly correlate with SIBO. Sometimes it's happening with SIBO for sure, but you can absolutely have leaky gut without actually having SIBO.

Okay, got it. I want to get into insulin resistance, but I know we also have to get into hormones, but is that part of hormones? So can we go there? It's part of hormones, yeah. It's definitely part of hormones. Let's talk about it. All right, insulin resistance. I've actually seen a lot of this these days. I don't know, like it's coming across my patients a lot. I saw two just yesterday and this was in people that were not massively always overweight. It is a pervasive. So what is this? This means that your body when it when

it ingests sugar or breaks things down in sugar, and this could be like breaking carrot down to sugar doesn't necessarily mean that you're just drinking pop all day. But that obviously is a lot worse your body secretes insulin to get to rebalance the bacteria rebalance the glucose levels in your blood stream. Okay. And so that helps bring things down to homeostasis. But if you continue to have these big spikes, your body will have these big insulin reactions

to eliminate that. So if that keeps happening, then you become insulin resistant. It's kind of like that old fairy tale or fable, the boy who cried wolf. If you keep crying wolf, eventually the insulin is just going to say, I'm not going to be made anymore.

And the pancreas which produced these insulin eventually can become sluggish and doesn't make it as well. And so now you have too much blood sugar damaging your cells and insulin is not able to actually respond to it. But their insulin resistance piece is that phase that happens before you get to the point that the insulin can't work anymore. That's why like the nth degree of diabetes is you actually have to start injecting with insulin. Right. So what does that mean for us? It's kind of like the early stages to say, Hey, you're on the wrong track and,

and your blood sugar is bouncing all over the place and your insulin is now really high. So you can test for fasting insulin in your blood, Gina, and you can test for hemoglobin A1C and fasting glucose. But, and all three of those markers together will tell you, all right, if my insulin levels are high, I have what's called insulin resistance. And that's associated with a lot of inflammation. That's associated with a lot of metabolic dysfunction, AKA your cells don't work well, and you're going to have a tougher time losing weight. Yeah, I was just gonna say, how does that factor in?

It's interesting, because we just talked about leaky gut, which isn't officially recognized by the medical associations, but neither was insulin resistance not too long ago. And now it's like insulin resistance is like, it seems like it's the root of everything PCOS when people talk about diabetes, menopause, everyone is talking about insulin resistance. So, so what do people do about insulin resistance? Okay, so the first step is you're already on the best thing you can be doing,

which is avoiding the big blood sugar spikes by following a diet that is high in fiber, high in a lot of plant-based antioxidants and protein. So those are the big things. So avoid foods that are going to be big blood sugar spiking foods. Now, the caveat I will say, and this is what I work with patients on is sometimes we eat foods that we think are perfect

and healthy and they for us, Gina, cause insulin resistance. So I had a patient yesterday, I was working with them on their concussion and they actually started the Gina Levy program. They've been on it, they've been slowly losing weight. But we noticed that her blood sugar was going higher and higher. Well, this doesn't make sense. You're following the diet, you're saying you're exercising more, and your blood sugar is going up. Hmm, what's going on here? My strong suspicion is that there was something that they're

eating. And it could be something like, okay, I'm eating oatmeal in the morning with some nuts and seeds, but that for you may be the big spikers. So if you're one of those people that still feel like despite your diet, you have not really turning things around, you might be in this insulin resistance phase. So sometimes tracking your blood sugar.

We talked about that continuous glucose monitoring thing before Gina, that actually can be a strategy for some people that continue to feel like they just can't change their blood sugar trajectory. And then there may be some foods and meals that you think are great, but not great for you. And that's where I think that personalized side is coming. So first um, first step is diet. Second step, 100% has to be exercise because here's the hack. Exercise opens a door that is insulin independent, meaning it doesn't work on insulin. So it's like a bypass mechanism for the glucose to get in your cell. There's like two different, glute receptors that pull that glucose in.

So exercise is like a backdoor sneak in. And when you exercise, that's one way of clearing the glucose really quickly. Also, going for a walk. Walking after big meals can be great. Yeah, exactly. Great option. There's also little things like consuming your salad that's like a vinaigrette base before. There's research showing vinegar, and this is where apple cider vinegar comes in, actually helps

decrease the blood sugar response after you eat, just by having even something sour, pickle juice, vinegar, balsamic, regular, like apple cider, lemon juice, these things are helpful. So a lot of cultures might eat their salad after. I suggest switching and eating something that's a little vinegar based before that blunts the blood sugar response. And that will ultimately help with insulin. Your door to big deals is on DoorDash right now.

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brands they hear when listening to podcasts. If you want your business to be top of mind, podcast advertising with Acast is the way to go. Book your campaign today by visiting go.acast.com slash ads. So someone was asking me without testing, how do we know that we have insulin resistance? What would be the markers or sign that someone could maybe think that they have it? I know you're probably not going to like when I say this, I said those three tests. So that's like the, I would say the confirmatory piece. The other one is if, and this, this is based in some research, if you have adiposity around your

waist, there's evidence showing that you have the beginnings of insulin resistance. So if there's fat accumulation around your waist, that's a sign that, you know, that visceral fat, the fat that kind of like goes in around the organs, that's driven by a lot of the insulin resistance. So that's one sign that you can say, you know what, I already assume I have some, but blood work will always check that to see how far along we are on that. So just because somebody is overweight

doesn't mean that metabolically they're gonna be all of a sudden majorly dysfunctional. The chance increases, of course, but these are just kind of like body morphic signs that we that we sometimes look at. But that's probably the one that kind of comes to the top of my mind, there isn't really any other way of checking it other than signs of actually like full on diabetes, which are, you know, a little bit more serious, like numbness, tingling in the feet

and loss of like some vision changes. But that is a different story than insulin resistance. Insulin resistance happens a lot earlier than that, Gina. Yeah, and I mean, this conversation is for everyone, of course, but you know, most people who follow the Libby Method are losing weight just fine. They're not having an issue, but for those that are like, what is going on?

I am doing all these things, what can it be? This is where we're kind of like trying to bring awareness to this, ultimately at the end of the day, it's a great idea to make some notes, go back to your healthcare providers and be like, look what I am doing, I'm eating this and this and I'm exercising, I'm doing this and I'm doing that.

If you really truly feel like you're doing all the things, you gotta get curious, you gotta get investigative because there's no way around this because at the end of the day, even if you took a GLP-1, even if you did surgeries, medical intervention when it comes to weight loss, you'd still have to address these things. You'd still have to address these things, especially if you want to be healthier and be able to maintain and sustain the way that you lose. Okay. Where do we go? Just one more question. If someone has fatty liver, can they also assume

that they also have insulin resistance? It's one thing that I would explore. I think that's in medicine. We don't assume anything like that, but I would say that we can probably say that there's definitely some sort of excessive accumulation of fat and that can lead to more insulin resistance. Again, the liver doesn't produce insulin, but it has a big role to play with the production of all sorts of proteins that carry around insulin and have to do with blood sugar. Okay. And is there like, are we hearing more about it because people are more informed because it's actually a thing now or because, you know, we're dealing with people who are older, women who are going through menopause, noticing in that midsection, like why do you

think the stress that we're under, the way that we're living our lives, why do you think it's becoming more prevalent in our lives? You're talking about insulin resistance or fatty liver disease? Yeah, insulin resistance. Okay, yeah. I think that there finally is a recognition in the research that is trickling down into the family practice.

I would still say family medicine is so reactive that I think that people miss the insulin resistance phase. Like the family doctors really start really getting involved when they're in full-on diabetes or what's called pre-diabetes. With my patients, I'm so much more proactive. We run all the markers I just said and we're looking at patterns as early as possible. And I'll say, you know what? Hey, you have point A, point B, point C, and once you start having some of that data, you can actually draw meaningful conclusions.

We're not thinking, whatever you're doing right now is working, keep doing it. Or if it's not, and this is probably relevant to people that probably are not losing weight, what are the patterns that we're seeing? Okay, there's like chronic low grade inflammation. Family doctors don't care about that. They're going to say, Oh, you know, okay, well, so what, you know, I don't know, you know, just the classic thing is, let's just watch it. I have a couple of members here talking about how

they're on GLP one. So GLP one, someone asked, what is that? It's this new classification of weight loss medications. And there are other ones that are coming out with. Took it, didn't really lose weight, did help with blood sugar, but is that a case where it could be something else or underlying issues that need to be addressed? For sure, like any medication, GLP-1 agonists that are working on this particular receptor, it's not going to be a magic bullet

for everyone. Now, everyone's really excited about it in the medical world because it finally gives some tools for addressing fat loss and that have not really existed up until now. I think we're just starting to scratch the surface of really understanding how to use these medications and how to apply them. I think we're already trying to at least myself and I you and I have had conversations about how do we optimize the use these medications but it's appropriate to bring GLP ones up right now because the GLP ones are prescribed at least here in Canada and covered covered by healthcare, is by for diabetes

and for pre-diabetes. So there is that angle. So they first and foremost were originally were discovered and marketed for diabetes. And now that the fat loss benefits, the weight loss benefits, I should say, were kind of the secondary thing that which has really exploded this class of medication. So I think there's a role to

play in it. I would 100% do GLP-1s before I would do any sort of invasive surgery for a thing. There's no doubt in my mind. I think that there's definitely a dose response. We talked about microdosing, which is, you know, not in line with the research, but there is some doctors that are claiming it works. Then there is doses of, you got to get over one milligram to really get some sort of benefits on weight loss where at one milligram you get the blood sugar effects. So anyways, there's a lot of nuance here, Gina, but I absolutely think you can use this to help regulate blood sugar, which will ultimately

help insulin resistance. So I think there's a role for these medications, but we just have to support them wisely. And we can't be like they're a cure all we got it can't forget about the root stuff here. Okay, I'm going to get into some of the supplements in a sec with my time that I have left, but we got to get into, we have to get into hormones. I know that's a big conversation.

Yeah, insulin is a hormone, Gina. So I think we're right on track here, right? So insulin is a hormone. It's produced by the pancreas, but there are other hormones and Dr. Olenka and others are going to talk about the reproductive hormones. And I will just address it just from my perspective. I'll be honest, the majority of people that I see that are struggling to lose weight are in that kind of

pre-peri-metapause-metapause category. Like I would say 90% of people. So it is a thing that once you get to that state, that there's a shift in hormones, and it's not always obvious exactly what the magnitude of that shift is. And if the shift kind of like goes down and gets better, because sometimes the first thing that people get is irregular periods. And then we'll notice, you know, I'm gaining weight around areas that I haven't gained before and now I can't lose it. I'm sure you've heard this a thousand times, you know, that when women hit menopause, it doesn't mean you are now slated to be overweight, but it does absolutely change your metabolism. And a lot of women will complain that they're gaining weight

when they used to not. So that's my observation. Yeah. And I'm a weight loss expert. I went through that. I gained like 16 pounds, I swear, right in my like midsection. It's taken me the last two years to get a handle on it.

Heart palpitations, vertigo, frozen shoulder, brain fog, heartburn, all of that. And it's cause I was stressed out, trying to cardio it off. Think I just gonna eat, you know, like follow the program and it helped but my stress was through the roof, like my stress was freaking crazy, wasn't sleeping, all of that. So when it comes to that conversation, we have our new our learning series coming up next week, is that like 80% of that is lifestyle. Yes, you can take hormone therapy and supplements,

but at the end of the day, it's these things that Dr. Paul is talking about that can make a difference. I see someone here, my C-reactive protein has been high for the last year. It's always been. Anything that they can do to help with that? It always depends on how high it is because if you're overweight,

20, 30, 40, 50 pounds plus, whatever it is, it's been my experience that those people that are overweight have a slightly elevated C-reactive protein. So I mean, it's obviously, it's a bit cliche for me to say it, but it's like losing weight is the best thing to lower this type of inflammation. Okay. And is that due to stress? Okay. And is that due to stress? No, that's well, stress is a, is a big term, Gina. Like it's not, it's not all to do with emotional stress. I would say it has to do with metabolic stress, which is the combination of everything we just talked about.

It's a combination of hormonal changes. It's a combination of, uh, you know, gut issues. It's a combination of aging. It's like, you mix all that into one and you, and you add in that extra weight and your liver's a little fatty. And CRP, which is a general marker of inflammation, will go up when you're carrying around that extra weight, but there's a difference between it being over 10 or 20. Now we're starting to look at like bonafide inflammatory conditions, autoimmunities. So I wanna make sure we understand the magnitude in this case makes a difference.

And so how do we reduce that? Magnesium, curcumin, fish oil, these are all things that can help, but ultimately it's let's continue that weight loss journey and this is what we're trying to learn right now. Okay. We talked about, so the conversation with women and their hormones, estrogen, progesterone, testosterone,

what are the big ones just in general that, and then is it different for men? It is different for men. Primarily, I'll answer that right off the top is that it mainly has to do with testosterone. Testosterone is the main male hormone and it has a lot to do with lean body mass. It has a lot to do with libido in both men and women, both men and women. So women still have testosterone and, you know, wise clinicians are looking at women's testosterone as well because it plays a role in brain function and lean muscle mass, which

is exactly what we want to try to build. But primarily estrogen progesterone are a female problem. Men have a little bit of them. The only time estrogen becomes really big issue for men is when they have gynecomastia, which is the man boobs and that is an excess amount of estrogen, and maybe a decrease in testosterone as well. There's a bit of a genetic component to it too. But primarily a decrease in estrogen. So for you, Gina, you just mentioned frozen shoulder, some of the body changes, mentioned, frozen shoulder, some of the body changes, brain fog,

these are all estrogen deficiency symptoms. When it comes to my sleep is disrupted, my moods off, I feel more anxious. This has more to do with progesterone. So progesterone has a really big calming effect. estrogen is more of the action hormone. That's why when a woman ovulates when her estrogen kind of spikes, she feels sexy, she feels vibrant. And so that that's kind of what estrogen does it increases dopamine in the brain, where our progesterone increases GABA, which is our calming neurotransmitter. And that's that imbalance of estrogen progesterone is

magnified in women that have PMS. Now when you hit menopause, all bets are off because those hormones are fluctuating all over the place and they're decreasing. And so women get sleep issues. Plus they get these hot flashes that annoy them during the day and disrupt their sleep at night. They get mood changes. And so working with a healthcare provider, after you've done all the things, and I'll say this really clearly, following a plan like what we're talking about here and moving your body in a healthy way, which we've talked about previously,

that is the absolute bedrock foundation of helping a woman go through menopause because you can just clean up your diet and follow the plan. And a lot of the symptoms I mentioned, they just clean up your diet and follow the plan. And a lot of the symptoms I mentioned, they go away. I hear it all the time. But if you're one of those unlucky women that have still residual symptoms after doing all that stuff, that's when you start looking at, you know, what Dr. Olinka is saying. What I'm saying

is that, you know, let's, let's get somebody on your team that can help you. Do not suffer with hot flashes and night sweats needlessly for years. What hormones does the human body have? I know one's ever asked me that question. I have no idea, Gina, because there's organ hormones and there's also local hormones, like little tiny hormones that are produced by the pancreas and the gut.

So, I mean, there's something like incretin and everyone's heard of things like growth hormone, progesterone, estrogen. So those are the major ones. Yeah. There's probably a good dozen of those. There's also brain hormones that stimulate organ hormones like thyroid, TSH is actually a pituitary hormone.

So that plays a role. So there's many, but I don't actually know the amount. We should Google that. We didn't even get into sort of thyroid issues, Hashimoto's, those are also, we also, you know, we talk about insulin, there's cortisol, there's your sleep hormones, there's your hunger hormones, all of that. Dr. Linca Trejo is going to join us next week and talk about sort of those types of hormones as well. Um, all right. Can we talk about hormones for a hot second here? Yeah. Just really quickly,

because I kind of touched on it and you said it. I think just if you look at, we're gonna specifically talk to the women here because of what we just talked about, the menopausal transition. Yeah. When a woman hits menopause and in around those years, somewhere usually just because of the childbearing years and the way that it works out, your your

your kids are born in your 30s. And then they're little throughout your 30s and into your 40s. And by the time you get to mid 40s to 50s, your kids are now going away to university or college, or they're getting a job and life starts allowing you to start, yeah, you exactly, life starts allowing you to start thinking about yourself again for the first time. So for the last 20 years,

you've thought about everybody else and you've put yourself on the back burner. Now, there's a lot of psychological things that unpack there. So it's not just your physical changes, which all these things are starting to happen. You couple into that, the psychological side of things where there happens to be a lot of stress that happens around that time. Also, I'll mention, I hear this a lot, in comes this what's called a sandwich generation where at that time women particularly while their kids are still not quite out of the house they have to deal with aging parents and I find that combination is very stressful. So it's a great dovetail into the topic about your stress resilience system called the adrenal system.

And this is a connection between your brain, your pituitary and hypothalamus, these areas that are influenced directly by your emotional centers, the limbic centers in your brain. And when you perceive to be out of control, when you perceive to be stressed, that creates a cascade of hormones that go down to these glands called the adrenal glands right above your kidneys. And they produce a couple hormones. So the one that I think is worth talking about the most is cortisol. Yeah, cortisol is your stress resilience hormone. It's essential. It's anti-inflammatory, but it needs the Goldilocks effect. Too much is a problem, and that leads to anxiousness, insomnia, you're going to have belly fat accumulation

because there's more hormonal receptors for cortisol around your waist, and very low is a problem because you're exhausted, you have no resilience, you feel burnt out, your immune system's shot. There's a whole bunch of things associated with that. So it's about a balance. But if you've been under a lot of stress previously

and finally you get to this stage and you hit menopause and your ovaries stop producing estrogen progesterone, guess who has to pick up the slack? Your adrenal glands. They produce 30% of your estrogen progesterone, so You got a lot on these adrenal glands a little bit. How do we do that? Well, we kind of get ourselves into a state where we're always just go go go and we're in this fight-or-flight mode

We're in the sympathetic mode, but we got to get into that Parasympathetic mode, which is the opposite rest, recover. And so I think this is where mindfulness comes in. This is where adaptogens come in. This is where avoiding stimulants, going to bed on time and getting really good sleep hygiene and really looking at mental, emotional stressors, cutting toxicity. You can either remove, reframe or reduce stressors.

Those are the three things you can do. You can't really do anything else, right? So I know I dropped the big one here at the end because I know a lot of people listening to this are like, yeah, that's me. But I really believe this is the crux of 80 to 90% of what I see in my chronic pain patients. Yeah, it's a big, huge conversation.

I think that's how we started this conversation. Again, never meant to overwhelm, always meant to inform, empower. We're gonna keep the conversation going. Dr. Paul's gonna be back on the 24th of June, I believe. I wanted to get into these supplements. I wanna talk creatine, I wanted to talk fiber with you. I wanted to talk creatine. I wanted to talk fiber with you. I wanted to talk, you know, adrenal support.

I got my gonna my got my Bacopa. I got my co q 10 here. The curcumin you mentioned my MCT oil. I mean, I got the knack. And that I got the knack. That's like a song. It's like a start to a song. I got the knack. That's like a song. It's like a start to a song. I got the knack. I got the knack. Uh, you know what, let's, let's talk about a couple of things here just to finish up. Um, you know, I don't want to leave people with this big, you know, big thing because I know that stress is a huge component and your body is designed to deal with stress. Everybody.

I want everyone to take and make that a takeaway. Stress does not always have to equal bad. However, everyone always interprets it that way. Stress becomes stressful when you feel you can't deal with it, cope with it, feel overwhelmed by it. How do you cope with it more? By building up some of those things I just mentioned. So the solution to adrenal dysfunction is to look at caring for yourself and fueling yourself in the right way. Adaptogens, like you mentioned, you want to pick up the adaptogen there, the adrenal formula, that is actually a combination of herbs that helps your body's adrenal system cope with stress better. It's not going to get rid of the fact that your body's adrenal system cope with stress better.

It's not gonna get rid of the fact that your mom's, in long-term care and you're dealing with caregivers, it's not gonna eliminate that, but it's gonna maybe buffer the stress on your cellular systems a bit. So that's what it's gonna do. It might help with your energy levels a little bit. So that's what the research shows on herbs like ashwagandha

and Siberian ginseng and rhodiola. Gondha is ashwagandha in a high dose, has a very nice calming effect. It lowers cortisol. It has studied to reduce anxiety and improve sleep. Great evidence based herb can be useful. So if you're feeling overwhelmed, look at all the mindfulness things So if you're feeling overwhelmed, look at all the mindfulness things I talked about. Look at kind of decluttering your life, detoxifying your life in every way, including psychologically. And then maybe adaptions can be helpful for you to augment that.

But, you know, I mean, there's a whole list there. Maybe we'll talk about them a bit more next time, Gina. But yeah, I don't know if there's a couple last questions we want to get to before we leave people off. You'd be five things that someone can do if they're having a hard time losing weight, like just action items. Oh, wow. Okay. Like the whole thing. We're like wrapping it all up here. Okay. Yeah. Five things. And the assumption is, is that we're already trying to follow the plan. Okay. So I'm going

to say like you're already, you're here, you're listening to this,'re already fall trying to follow the plan. Okay, so I'm gonna say like, you're already you're here, you're listening to this, you're already trying to follow the plan. I would say the first thing is, I've said this before, I'll say it again, less is more. So if you feel like you're in need to like, hit that extra workout and pump it up to a hit class, sometimes doing something that's more restorative is helpful. Listen to your body.

Sometimes that garment or a ring will tell you, my body battery is really low. Those days are things you shouldn't blast yourself and push yourself, number one. So less is more. Number two, look into food sensitivities, foods that are not agreeing with you. Everyone has some, some I had patients yesterday, part of the program had one or two. And I've some that

had 10 that needed addressing really high foods that they eat every single day. That's another way of eliminating inflammation. And they can keep a journal, get tested. Yeah, exactly. Absolutely. If you're confused, work with a naturopath to help you out on this. This is perfect right up there, Allie. Number three, make sure your sleep hygiene is tight. If you feel overwhelmed and you're kind of like, you don't know where to turn, focus on making sure you're getting seven to eight hours of good deep restful sleep. That is one of the best ways to break the

cycle of being in this chronic state of stress. So that is massive. And so that I know we talked about that a little bit. It's not directly part of the program. But I think that's really, really important. Number four, take some of the supplements that maybe you've been hesitant to hold out hold out on take some of them. I know I'm the supplement guy. So I'm going to be a little bit biased. So that's like probiotics would be a good one the adaptogens would be a good one. You know I think MCT oil with them a good fat perspective would be a good one bitters might be a good one because that also helps with your own GLP-1 and you know there's a whole bunch of things that help with that so I think that would be you know a really good strategy. And the fifth one Gina

I'm going to ask you after all the thing you listen to, what do you think that people should take away from this and add in? The fifth one, the last one. I would say don't underestimate how stress factors into your life. Good point, I like that. Or lift heavy weights, what are you gonna say?

No, I actually love that. I think that a lot of times when people are like, I'm doing all the things, Dr. Paul, I'm doing all the things. I'm exercising. I'm working with a personal trainer. And then we start like diving into their case. We start diving into their life and they're like stressed to the max. And then I'm like, no, you're wondering why your body's not responding because every piece of food, every thought, every piece, every movement, every emotion, it's a signal. It's a message to your body. And is that are those messages positive or negative? And so sometimes we can avoid some of these things, but don't underestimate how powerful the impact of stresses is. And stress doesn't always equal,

I'm having a mental breakdown or I'm anxious. You could be absorbing this stress. A lot of people are like sponges. They somatically absorb this stress and your body still is perceiving it's under stress, but you're like, no, I'm fine. I'm thriving. Or it's just like, it's also, it's your norm because you're maybe just used to that. Yeah. I wanna keep this conversation going, but it's time to go, what's your takeaway for people after this two part series that we've had today?

I mean, we should do our own separate series. People are saying we should do a series. We'll do a series, but doctor, we've talked about this so many times. We should definitely do a series outside of this group. But what's your takeaway? What's the takeaway for people after the last two conversations we've had?

Other than go back and listen again and again. Honestly, the takeaway is empowerment. We dropped a lot of knowledge on you today and on Tuesday. I want you to be empowered by that information to then now make better decisions to either investigate some things or for you to maybe eliminate some things that maybe you've just kind of been keeping. Maybe it's that alcohol piece. Maybe it's those foods that you don't want to hold, you wanted to hold on to and don't want to let go. Maybe it's the realization that you're trying to do all the things and you

maybe shouldn't do all the things and maybe you're doing too much and stress is actually holding you back. Whatever your takeaway is, for the last few days, I want you to focus on what you can action and not feel like you're overwhelmed and start with one step. The hardest step on a journey is the first step. So start that. And you're already in this program. So you're already doing an amazing thing. This is meant to enhance that and start the investigation process. You know, I'll leave you off with this. You have one body in your life, you can't switch it. And you need to get curious about that body where for so many years, we've kind of gone through life with just like, assuming your body will be there for you. And we haven't really treated it right. And now it's your time to love on it again.

And this is part of you being curious about, hey, you're not losing weight right now. And this is part of you being curious about, hey, you're not losing weight right now. I don't hate you. I want to, I want to work with you. I want to figure this out. I love that. I adore you. If you want to follow Dr. Paul over on Instagram, you can find them at Paul Herkel, H R K A L. If you want to reach out to him or his team, you can head over to Paul, Paul Herkel

nd.com. We're going to continue this conversation. Dr. Paul is going to be back later in June and Dr. Alink is going to join us next week to talk more about hormones. Just expand on the conversation that we touched on today. Have an incredible rest of your day, everyone. Thanks for joining us. Go back, listen to it again and again and again and again and again and take notes. Thank you, Dr. Paul. Bye bye. Thanks, Chidam. Mm-hmm. is on DoorDash right now. Sign up for DoorDash and enjoy a free Big Mac on your first McDonald's order of $20 or more. Only on DoorDash now until June 15th. Terms apply.