WHOOP Podcast - The Keys to Better Health: Hormone Optimization and Balance with Dr. Kyle Gillett

Episode Date: February 22, 2023

On this week’s episode, our VP of Performance Science Kristen Holmes is joined by health expert Dr. Kyle Gillett. Dr. Gillett is a dual board-certified physician in family medicine and obesity medicine and an expert in optimizing hormone levels to improve overall health. He leads the Gillett Health clinic where he preaches a holistic approach to health and believes each person requires precise attention to their body, mind, and soul to achieve optimal health. Kristen and Kyle will discuss Dr. Gillett’s path to medicine (2:40), what are hormones (5:21), conditions caused by hormonal imbalances (6:55), heart rate and homeostasis (9:32), how hormones impact exercise performance (12:30), the entry point into resistance training (15:13), the connection between sleep and body composition (17:55), exercise and metabolic function (20:50), Zone 2 and Zone 5 cardio work (24:00), fueling the body and staying balanced (26:40), protein and hormone optimization (30:05), hormone health and sleep (37:55), tips to get better restorative sleep (41:40), intentional stress vs. unintentional stress (44:10), creatine and supplements that impact strain (48:35), and melatonin, magnesium, and other supplements Kyle focuses on for health (52:15).Resources:Gillett HealthThe Gillett Health PodcastSupport the showFollow WHOOP: www.whoop.com Trial WHOOP for Free Instagram TikTok YouTube X Facebook LinkedIn Follow Will Ahmed: Instagram X LinkedIn Follow Kristen Holmes: Instagram LinkedIn Follow Emily Capodilupo: LinkedIn

Hello, folks. Welcome back to the WOOP podcast. At WOOP, we are on a mission to unlock human performance. I'm your host, Will Ahmed, founder and CEO of Woop. All right, we got a great episode this week. Our VP of Performance Science, Kristen Holmes, is joined by health expert Dr. Kyle Gillette. Dr. Gillette is a dual board certified physician in family medicine and

obesity medicine, and an expert in optimizing hormone levels to improve overall health. Dr. Gillette describes the six pillars of health as exercise, diet, sleep, stress, sunlight, and spirit. He leads the Gillette Health Clinic, where he preaches a holistic approach to health and believes each person requires precise attention to their body, mind, and soul to achieve optimal health. Kristen and Kyle discuss what hormones have the most impact on the body and what they are controlling. This includes thyroid enzymes, dopamine, and norepinephrine, conditions that cause hormonal imbalances and how to manage them.

They get into menopause, estrogen production, optimizing hormone profiles for exercise and performance. Lower lean body mass can lead to osteoporosis. Resistance training becomes very important in those cases, so that was a very interesting insight. The rule of insulin resistance and exercise for metabolic function, had to stay fueled and wanted to eat proteins. This was interesting. Animal-based proteins in the morning may be favorable

versus plant-based at night. That was a recommendation from Dr. Gillette. The role of sleep in hormone regulation. and growth hormone production, human growth hormone for recovery and muscle regeneration, the impacts of intentional and unintentional stresses. It's, I think, important to differentiate between intentional and unintentional stresses, and supplements that Kyle recommends to help regulate hormone levels, including creatine and magnesium, both of which I actually recommend. If you're new to Whoop, use the code Will, W-I-L-L, when you're checking out and get a $60 credit

on WOOP accessories. That is at Woop.com. If you have a question, you want to see answered on the podcast, email us, podcast at whoop.com. Call us 508-443-4952. Without further ado, here are Kristen Holmes and Dr. Kyle Gillette. Dr. Gillette is a dual board certified physician in family medicine and obesity medicine and an expert in optimizing hormone levels to improve overall health.

Dr. Gillette is here to offer his insight into how someone can tailor their lifestyle to match their specific hormone needs in order to maximize health and performance. We will pull back the curtain on the behaviors that have the biggest impact on the hormonal environment and specific protocols that you can take on to really improve your health and get it moving in the best possible direction. Dr. Jolet, thank you so much for coming on the podcast today. My pleasure. Thank you for having me. Well, to start, we'd love to hear a little bit about your path.

You're obviously extremely passionate about health and human flourish. And I love how you incorporate spirit as one of your six pillars of health. And we're going to dig into all those pillars. But what prompted you to open up your own clinic and kind of put you down and set you down that path? Even when I was young, 12, 14 years old, I've known that I've wanted to go into medicine. My father is a family physician from Kansas. And I saw him practice holistic medicine, pray for his patients, et cetera. and I thought that that was a good way to look at both the mind, the body, and the soul.

So that's kind of what I mean by holistic medicine is looking at the person, not just their physical body. I didn't know exactly that I was going to have my own clinic. I thought that I would work at the same clinic that he worked at, actually, that he still works at. But that's kind of a long story. And basically, it's hard within the conventional medicine system, for example, just going to your doctor and your at your GP or your family doctor and having optimal health and getting more than just preventing pathology. True preventive medicine is past that and for example, insurance usually doesn't cover it. So that's why I went off on my own. But I've tailored

my education to basically meet the demand for like true preventive medicine and health optimization. And common pathologies are what people tend to ask questions about. And hormonal pathologies like menopause or slightly low testosterone are immensely common. Medabolic syndrome and obesity are very common. So I've sought out extra education in those areas. Amazing. Well, so, you know, I think to start, perhaps you can give us an overview of just a role of hormones. And really what do you believe everyone should understand about their hormones, just as kind of a baseline? As I like to say, hormones are the literal signaling molecule. So if you look at the definition, that's how you send a signal from one cell to another. Endocrine hormones,

signal throughout the whole body, paracrine hormones signal through basically systems that are near each other, and autocrine hormones, signal throughout the same system. For example, a lot of of effects during exercise and like muscle cells are autocrine. So the like why they're important other than the body cannot talk to itself well other than the nurse. So it's the nervous system and the hormone system. There's a lot of different categories of hormones. When people say hormone, I like to define what it is. Or when people say peptide, I like to define what it is. So a lot of people think of testosterone, which is your kind of the main well well known androgen estradial, which is the main well-known estrogen and progesterone, which is the main well-known progestogen. So a lot of people

think about those as the only hormones, but there's also cortisol, prolactin, growth hormone. There's a lot of other categories, even vitamin D is a hormone. But a lot of people like to focus on androgens, estrogens, and progestogens, partly because there's a lot of, I guess, misconceptions about what you need to do versus what you can do with those hormones naturally and via therapy. Amazing. That's a beautiful overview. Thank you. What conditions are caused by hormone issues? So just kind of high-level, you know, laundry list.

When we have the hormonal imbalance, is what's actually going on? Yeah. As far as like causatory versus correlated, there's a difference between the causation of something and the correlation of something. But one good example would be mitapause. or even andropause, aging in general, or adrenopause. And menopause is kind of an easy example to go with, because when the ovary ceases producing estrogens and progesterone, it actually a lot of times the ovaries still produces some testosterone

that declines a little bit later, kind of like how the adrenals decline. But that would certainly be caused by that function. There's a lot of things that are correlated with menopause, or the lack of estrogen or progesterone coming from the ovary, examples of that would be a change in body composition or a change in the quality of sleep. We call that vasomotor symptoms or a change in the quality of other things.

For example, we call that genitirinary syndrome of menopause. So I would argue that all those things are caused by hormone dysfunction and then everything else that's downstream to that can be correlated from it because not every individual who goes to menopause has those things. but it's certainly something to be on the watch for. And if you could just, so if I understand this correctly, there's about a 50, over 50 hormones in the human body, you listed some of them.

What exactly do they control? So like metabolism, growth of development, there's probably a long of list of things that it controls. Yeah, essentially every process in the body. So one good example is thyroid hormone, which we haven't even mentioned yet. it has many different types of enzymes that convert inactive thyroid hormone to active thyroid hormone. And this actually happens inside the cell. So even when you're checking your serum levels of thyroid hormone, you don't know how often the thyroid receptors inside the cell are being bound.

And that's going to regulate things like lipolysis or breaking up a fatty acid so that you can burn them in the cell throughout the body. And even things like how fast your heart rate is. So a lot of times you can look at both laboratory data and biometric data, and you can say, yes, there has been a significant change, and you can tell whether or not that's correlated with something like hypothyroidism or even a hyperthyroid storm, is an extreme example. You mentioned heart rate. So this is, I would imagine, the process of homeostasis potentially. Can you just dig into that a little bit more? Yeah. So the heart is controlled by a couple different systems. One of the main ones is the sympathetic nervous system. Think about sympathetic ganglion lately for some conditions that are correlated with high heart rate. For example, pots, people can get a stellate ganglion nerve block. That's a main sympathetic fighter flight ganglion. And then you have your arrest and digest. So that's your parasympathetic ganglion.

your vagus nerve is actually a cranial nerve, cranial nerve, 10. It comes down and it actually innervates part of the gut, but also the heart. And then the heart rate is usually controlled by, and this might be a bit too esoteric, but I think we can tie it in clinically with some actionable takeaways. Sinoatrial node and atrial node, so S.A. and A.V. node. And looking at the changes in those, and some people listening to this podcast are probably familiar with, like, a resting heart rate or heart rate variability. We measure those, too.

beautifully pretty much perfectly yeah yeah those those two are certainly a huge plus to track clinically because they're kind of like an early warning system again as people as need of this podcast are probably aware of but as far as like the hormonal input I actually consider things like dopamine and norepinephrine and epinephrine hormones for example you can take a tyrosine amino acid so there's sterol-based hormones which are like androgens, there is peptide-based hormones like insulin and growth hormone and amylin. Then there's also amino acid-based hormones. So those are like dopamine, noropenephrine or noradrenaline and epinephrine or adrenaline. And those will certainly have a profound effect

on the heart rate changes, specifically sympathetic. So another way to think of this is if your signaling molecules are just neurotransmitters, then they are acting outside the central nervous system. So are they a neurotransmitter when they're in the central or peripheral nervous system, or are they also a hormone when they're doing other functions? Of note, phyroid hormone is also synthesized from that same amino acid tyrosine. Excellent. Okay, great. So this is a good lead-in to kind of the first pillar that I want to talk about, which is exercise. And I think for just a framework, I think kind of approaching the conversation from the standpoint of, all right, what are the behaviors that we know are going to move around our hormone functioning the most? And then trying to provide our listeners with as many just very specific actual protocols

that we can, I think would be, would you be hugely beneficial. Maybe before we kind of start hitting on these behaviors and kind of hitting pressure pillars, is there anything that you feel like people need to know before kind of entering into this discussion? Like, is there anything kind of high level that you feel like is really important to kind of set the baseline? Yeah, a good thousand foot view would be, in general, the same activities that you are doing for positive health outcomes will also lead to positive, like, hormonal outcomes. Right.

So that's why the pillars for hormone health are essentially the same pillars of just having a good lifestyle in general. Totally. All right. So let's start with exercise. What would, you know, what is your prescription? So someone comes to your clinic and they're trying to optimize their hormone profile. Like, what would be the conversation that you would have around movement and just if you

break it up into, you know, strength and aerobic anaerobic, you know, what are the proportion that folks should be spending? I imagine there's maybe some gender differences. There's obviously their starting points. are going to be different. There's a lot of individual variation, surely. But if you just kind of have a general, general principles that you use as a guidepost, I'd love to hear them. First and foremost, everyone should have a movement pastime to last a lifetime. So something that they can, they either enjoy doing it or they can learn to enjoy doing it. So both of those

things are certainly achievable by everybody. Has that, another, and this is, a little bit of a little bit facetious but there's truth to it i like to say a lot of gymbrose need to train like a lot of women do um like a lot of you know postmenopausal women and a lot of postmenopausal women like need would benefit from training like a gym bro but um i guess to parse out the um like the actionable advice from that lower lean body mass is going to lead to a lower metabolism is going to lead to more metabolic dysfunction and more body fat accrual. And in general, you think of like which individuals tend to have lower lean body mass, the same individuals that tend to get osteopenia and osteoporosis tend to get sarcopenia.

So in general, postmenopausal females, but certainly if there is a male, even a young male with osteoporosis, then resistance training is of particular importance. Whereas if there's an individual who does not do any cardiovascular training, not even any zone two cardio, that's going to be of particular importance, not only for health, but to improve REM sleep and to improve mitochondrial function. Love that. So resistance training, really important. So what would be, you know, if someone is new to resistance training, what would be the entry

point there if we're looking to kind of derive these benefits to metabolism and all these down to effects? For the average person, an entry point could be body weight training. if there is, and I'm a fan of Dexas scans, as a lot of people know, because there's a lot of negatives and positives of just going by weight and BMI. So I'm certainly a fan of Dexa and other things like Bod Pod Pot are fine too. We get a lot of comments about which body composition is optimal or not optimal. My friend Grant Tinsley, it's a PhD at Texas Tech,

and he has done a lot of research. He recently published one on different bioimpedance body fat measuring devices. So if somebody wants to go down that rabbit hole, that's enough data to look into it. But yeah, if your Dex scan shows lower bone mineral density, then would be expected for not only like your age group and your gender, but also considering what your body composition looks like otherwise, then certainly axial loading exercises. For example, anything that's weight bearing, like a squat, a deadlift, axial loading, so it's loading from top down. for bone mineral density specifically. And then for just like anybody who has lower lean body mass than expected, you're going to look at like other general resistance training exercises

and not waiting too heavily towards cardio. And also if there's a high level of body fat at the same time, working with a healthcare provider that can help you lose that very, very slowly. because when you do lose weight, about 33 to 35% of that weight that you lose is the lean body mass, which is previously metabolically active. So there's this turn called metabolic damage thrown around. And there's not an ICD-10 code for it,

but it's a real phenomenon. And it's mostly related to people who lose weight too fast and lose lean body mass along with that weight. So gaining that weight back, which you need to be in a chloric surplus to do, In addition to optimal resistance training, so at least three times a week, training major muscle groups, if not more, and ideally working with a trainer as well, especially if you're not an experienced resistance train athlete is of primary importance. We're going to talk about sleep in detail, but just as it relates to body composition, what is the connection between sleep and body comp? So we're trying to exercise to improve.

Obviously, all these things are phase-related and related. But what would be your, what do you understand from the literature that helps us understand the relationship between Bonnie Comp and sleep? First and foremost, when you are sleeping, you are generally not eating. There's actually something called sleep-eating syndrome where you eat and you're half-asleep or even borderline all the way asleep. You're kind of in-between sleep cycles as you eat. And there's also night-eating syndrome.

syndromes. There's a lot of syndromes that lead to overconsumption of calories after 7 p.m. or even at night. And some of those are related to an imbalance in what's called anorexogenic signaling and orexigenic signaling. So the anorexigenic center of the hypothalamus is exactly what it sounds like. You're sleepy and you're not hungry. You're anorexic and which means I'm not wanting to eat. It's also a disorder, of course. But then there's orexigenic signaling where people are hungry, angry, and awake. Some people call it hangary. And a lot of the new sleep meds are orexin inhibitors. And these also happen to be weight negative. So you think about a lot of sleep meds, like especially tranquilizer sleep meds, those are weight positive you put on weight.

Because they have the same receptor as alcohol. Whereas the orexin inhibitors are weight negative. They turn that desire to eat off. And eventually they'll probably be used off label and like sleep eating syndrome. But that's a second thing to think about. The third thing to think about would be if you are not sleeping, for example, if you have sleep apnea or other sleep pathology, you're not producing your growth hormone and testosterone. So growth hormone is a pulsatile secretion mostly during sleep. And testosterone is released because LH is released, which is released because GNRH, which is basically a hormone that's released in pulses during sleep. So if you're not having long periods of sleep together, then you're not going to get the pulsatile release of those

very important hormones. And those two hormones in particular, growth hormone leading DIGF1 and LH leading to testosterone and other androgens, those are going to be good for the accrual of lean body mass and the prevention of building up body fat. Yeah, there's a, you might have seen us. I think it was published in 2017 out of the University of Chicago. I think it was pen of's lab, but the study basically looked at, showed that when subjects come back on their sleep, one fourth of their weight loss came from fat, which I thought was, and that study as you said that earlier in the conversation, it reminded me of that study. And I thought that was fascinating. But yeah, sleep really does matter. And I have a couple more questions around

sleep, but we'll get there. But back to exercise, you talked about insulin sensitivity, just maybe the role of exercise and really helping with metabolic function and, you know, what would be, just tell us a little bit about the research there and, you know, how you think about that interaction with your patients. Exercise certainly helps potentiate the effect of dietary changes for insulin sensitivity. For example, there's been plenty of studies that compare, and by the way, with insulin sensitivity, the gold standard is usually an insulin clamp study where, they look at the changes in like a specific cell or the uptake or use of insulin within a certain

system. That's how the studies on Inamon looked at the insulin sensitization effect of inamon. And it's also the studies on male versus female biology responding to exogenous testosterone, trying to explain why exogenous testosterone is an insulin sensitizer in males, but but causes insulin resistance in females. So all that to say, if you look at the, like, different insulin sensitization medications, for example, metformin or GLP1 receptor agonist, you can compare them to a dietary change, whether it's time-restricted feeding or intermittent fast or a fasting mimicking diet, an aggressive fasting regimen or a caloric deficit, of course, especially when combined is going to be

a very powerful insulin sensitizer. This is why a lot of bodybuilding or fitness coaches, after a period of bulk or midway between a period of bulk will have a, I hate this word, but they call it a mini cut. But there is clinical significance to this because you can restore

your insulin sensitivity quite fast. Maybe it's not clinically significant unless you're on a pretty hardcore bulk, but some athletes often are, and a lot of times that's necessary, for example, in strong man competitions. It's certainly a good idea to consider. So all that to say the exercise component of it, sorry for a long-winded answer.

That's great. It's your tank of total nutrients. So your main carb in the blood is glucose, and your main lipid in the blood is triglycerides. Three fatty acids with a glycerol backbone. And I think of this is the total pool of energy. And the way that the insulin sensitivity of the dietary changes is, is you're putting less into the pool. But exercise is going to take out of the energy. And I think of the pool. So if you're trying to decrease your total pool to help increase insulin sensitivity, let's say you take your average fasting triglyceride level from 150 to 70, and then your average fasting glucose from 100 to 85, that's certainly going to improve insulin sensitivity,

chicken or the egg at that point. But exercise is going to help you achieve that much, much faster. Awesome. So basically in some exercise is going to help modify your hormone levels and help reduce the risk of probably all sorts of, I mean, cardiometabolic disease for sure, but also prevent muscle mouse decline. All right. So now we tackled exercise. Anything that we forgot that you think is important for folks to understand related to exercise? I think we covered the basics. We briefly mentioned Zone 2 that is particularly important for mitochondrial health and as other benefits. I suppose I should also say, and a lot of people that like to wear whoops, Say this when I did it. There is certainly a benefit of very vigorous exercise, cardiovascular exercise. And my rule of thumb for that is once a week.

Great. So four more. Zone two and what would be how many minutes per week should folks, what should they strive for in zone two, would you say? The average person, if they're getting 60 to 90 minutes of zone two, that's quite good. But it is beneficial to go above that. Yeah, in zone five. So if we were to bucket it, we've got, we've got our resistance training. And there's obviously lots of different ways that we can weight train. I don't think we need to go to the specifics, but just basically body weight if you're new, heavier resistance, heavier weights. If you're if you're newer, if you're more experienced, obviously prioritizing technique. So two minutes. And then zone five, what would you recommend and just maybe describe briefly what zone five is and how many. minutes you would recommend folks spend in that cardiovascular zone. Yeah. Essentially, it's maximum effort. It will be hard to spend many minutes in this zone. So it's just literally a few minutes. Yeah. So just flat out for 30 seconds with a rest. So a one to three rest roughly. So bring your hurry back down and then repeat that, what, six to eight times? Yeah, that seems pretty reasonable. The first couple times that you try to do this, even if you just do it

one or two or three times. That's fun. Yeah. So the idea is just getting out of breath and whatever that means for you and do that once or twice a week. Yeah. An example of this that would be very simple is doing, you know, 200 meter sprints. You could do four different 200 meters sprints and obviously warm up appropriately and such. Nice. Nice. I just did 16 the other day. But I was a track athlete. So, all right, cool. Let's talk about fueling. You know, under fueling, overfueling, both are, I would imagine, not great for hormonal balance. Maybe just, just principally, how do you think about eating and what are

your recommendations there in terms of, you know, what actually is, helps us maintain a moderate weight while thinking about optimizing kind of our hormonal profile. And then I'd love to dig into just also time restricted eating. My research is in circadian rhythms. So I spend a lot of time thinking about time restricted eating. And we can talk about fasting as well, which is very different than time restricted eating, but how your clinic thinks about both of those and what your prescriptions are for patients. Yeah. Regarding prescriptions or nutrition or diet, there are many different things. I have forms that I'll circle. I'll post these on my

website at some point, by the way. But I circle these various things. And the goal of the prescription is to find a diet to which the patient can adhere to long term. They don't necessarily have to love it right off the bat, but they

certainly need to be on board with learning to like it. Just like during exercise, you want your effort to feel good. And yes, testosterone does help with this, you want your effort that is being put towards optimizing your diet to feel good as well. So for most people, this is a balanced diet with all macronutrients. There are exceptions, of course, but it usually incorporates healthy carbohydrates,

healthy fats, and healthy protein. During a caloric deficit, so if it is someone that is losing weight for total testosterone, maintaining a higher total testosterone in a caloric deficit, dietary fat is of particular importance, even in isochloric diets. So you'd think, well, maybe the people that were given fat were just consuming more calories. But even if the calories are the same,

having more fat relative to carbs is important for keeping testosterone. However, if you eliminate all carbs, your free testosterone often goes down significantly. an SHBG, which is sex hormone binding globulin, it's a protein that binds up androgens and estrogens, but it especially strongly binds androgens, especially strong androgens, like testosterone and HT. That tends to rise, which makes free testosterone decrease. So, good rule of thumb is if you are in a slight caloric deficit, continue consuming some carbohydrates. Around the time of exercise seems like a great time to do that.

glycogen and energy or before exercise, but you want to consume some carbohydrates, but plenty of healthy fats. And you would probably say that you want the fueling. You just mentioned if you're exercising, some carbohydrates. So fueling should really match your activity requirements, right? So whatever the activity you're requiring from you, you want to try to match up what you're putting in your body, would that be makes sense, right? For advanced athletes, it can certainly get more complicated.

It might not be pertinent to the average person, but. For females, you can certainly time things around the menstrual cycle for advanced athletes on, like, mesoc cycles. So if they're having, like, a harder or a delode time period, then you can certainly time both your macronutrients and your caloric intake in general around those times. But, yeah, again, for the average person, it's not necessarily for that. You mentioned, you know, healthy macronutrients. What, you know, when we think about carbohydrates and protein fat, I'd love to talk a little bit about protein. Obviously, protein has a massive role in hormone optimization. And I think most folks don't eat enough protein. Do you prioritize protein with your patients and how many grams do you

recommend per meal? What is, are all proteins created equal? You know, what's your take on just protein in general? And how can really think about that in terms of hormone optimization? Yeah. I also love talking about protein. I think we just had a podcast for, I don't know how long it was, but we had a podcast just on protein. But a good rule of thumb is for the average person, get at least 0.7 grams per pound of body weight per day. And this, of course, will change if you have very high or very low body weight. But as an example, if you have someone that is body weight of 200 pounds, every day around at least 140 grams of protein. and then if you're in a particularly difficult, like, exercise phase or whatnot, then you can

certainly push that higher. Or if you're in a specific category, for example, a very old age group, then you can push this even higher, for example, up to even one gram per pound of body weight. Personally, that's about what I like to eat. And that way you know that that is not the rate limiting step for maintaining muscle protein accrual after you break it down. Excellent. As far as the quality of protein, we could split this a couple different ways. We could split it into plant-based proteins, which tend to be lower in amino acids like methionine and leucine. Methionine, of course, is involved in many different synthesis cycles, for example, glutothione,

and you don't want to have too much because you can build up homocysteine, which is an oxidative stress marker. But on the other hand, you want to have plenty of methyanine and leucine because this helps with body composition and recovery. So as far as like a sleep standpoint or a circadian rhythm standpoint, not eating within about three hours of sleeping is probably ideal. It's just not like socially, like a lot of people are not able to do that because of social reasons, which I certainly understand. Just like a lot of people for social reasons, the only time they can exercise is very, very early in the morning. So that kind of is what it is. My rule of thumb for a balanced approach to health from a performance standpoint and also a longevity standpoint or a long-span standpoint, if you skew your animal-based proteins more towards the morning. So weigh and casein, egg protein, and then you have slightly more plant-based proteins in the evening, then you're going to have more easy to utilize protein sources throughout the day.

And you're also going to have more mTOR activation throughout the day and slightly less in the evening. So it might bring some of the same benefits as, say, like, an evening dose of rapamycin will from time to time. It's slightly less cell turnover during periods of sleep. And no, the anabolic catabolic switches are not magically turned off and on. There's a little bit of both at the same time, of course. But that's my rule of thumb to have a balanced approach. Cool. How does protein impact hunger hormones? And maybe how does fat and how does carbohydrate? So we can talk a lot about hunger hormones. There's a response called a gustatory response. Even if you have food in the mouth, you're still going to have a response where you feel hungry and then satisfied at a certain time period later.

GLP 1, which is glucagon like peptide 1, it's produced in many areas, the alpha cell, the pancreas throughout the gut as well, but you also produce it even if you just put a food that you like in your mouth. And this is released very quickly for carbs over a period of minutes, but then it goes away very quickly. For protein, it's released over a long period of time, not right away, but it's released for much longer than for carbs. So it's a better satiety response, but slower. So not necessarily better, but it probably is better for the average person to have a satiety response that lasts more than an hour or two. Because it kind of makes sense. If you think about it, if you eat something with just carbs, often you are hungry an hour and a half later. For fats, it's released even slower than protein, but protein is kind of like that happy medium of satiety response from GLP1.

We can also talk about adiponectin or ghrelin. or leptin, which all can change very fast. But those are the adipose brain axis hunger hormones. Leptin is also a satiety hormone, whereas Grellin is not, Grellin's a hunger hormone. But the leptin can change very quickly for some individuals. You'd think that people at very low BMI would have higher levels of leptin because more satiety, but it's actually opposite. You can develop a degree of leptin resistance if you have a very low BMI's would have a higher levels of leptin,

if you have a high body fat because the adipose cells are making a lot of leptin, but it's just for whatever reason not causing satiety. So there's a couple ways to help reverse this. One of the major ways is control of triglycerides. For example, if you put someone on EPA that can decrease triglycerides, then their leptin signaling returns slightly more to normal. Excellent. Okay, I think so would you say to bias protein,

You mentioned plant-based proteins in the evening, but biased protein in the evening, especially if you're trying to, if you're kind of restricting your feeding windows, i.e. leaving, you know, three hours or so prior to when you intend to sleep, calorie-free. Does protein kind of help with that? I would say based on what you said. Yeah, it absolutely does. And it's not necessarily a hard and fast rule. It does not mean to have completely plant-based diet unless you want to for dinner, but especially when it comes to shake. So if you're going to take a large number of grams of protein in a shake, especially in the evening, I think it's a very reasonable time to utilize plant-based protein. And the podcast with protein went over several studies, including

one just on casing protein. And then they had a vehicle protein shake, which basically means they did not have any grams of protein in it, but they put a lot of other various cake powders to make it taste like a protein shake, the poor people to take that. But it was interesting to see because they had one group take the casein shakes in the evening and one group in the morning. The group that took them in the evening,

they were not statistically significant, but it may have been clinically significant. It was a group of a few dozen people. So if they had a larger group, then perhaps it would have been statistically significant. But from an athletic performance standpoint, yes, it might be slightly, better, at least acutely over a period of six weeks, but that response will likely diminish as

time goes on, and it's probably not worth the potential deleterious health outcomes. For example, the more BCAAs you have, in general, it's circulating the serum, especially at night. You tend to be slightly more insulin resistant. So if there's an athlete that has a fasting insulin of two, that's probably a good thing, whereas if it's someone that already has a fasting insulin of 18. That's not something that you would want. Cool. All right. So we're going to move into things that impact recovery. One of those things, of course, is sleep. And you mentioned we had a quick sidebar about sleep and body composition. But now just, you know, maybe if we can dig into, you know, if we think about it from an insufficient sleep perspective, so not spending enough time in bed,

what are we missing out on and, you know, and quality? Why do the, why does sufficiency and quality matter in terms of hormone health, and how do you think about that with your patients? Yeah, we mentioned a growth hormone release and how it's pulsatile during sleep. The longer you sleep, then kind of the better that builds up. Think about it kind of like REM sleep, too. Your REM sleep, at least the time of REM sleep, is going to be much more of the second half of the night. And then we also mentioned testosterone and release of GNRH. That's the hormone that causes the release of LH and FSAH. That's why if you're looking at people with sleep apnea,

then they're probably going to have lower testosterone, lower sperm counts, actually, and also more body fat, less lean body mass. So if you look at studies that give people exogenous testosterone and exogenous growth hormone, it certainly helps body composition, but if it is due to a sleep pathology like sleep apnea or even like shift work,

there's lots of studies on people, people who have to work night shifts from time to time. And that also leads to some optimal sleep, even if they're sleeping the accurate number of hours. I know you are an expert in this. But I guess all that to say, it's not just the level of the hormone. We can certainly talk about REM sleep and its ability to lead to improved recovery. So often if people wake up after a night of very poor REM sleep, they will not feel as refreshed. So I assume, I'm not a like a biostats or data scientist, but I assume that that is how they make the algorithm to give you your score of how ready to go you are.

Yeah, we definitely look at quality. And it is interesting when you look at the literature and the relationship between HRV, for example, which is a nice marker of how recovered you are and how prepared you are to take on the challenges of the day and respond and react to those challenges. REM and sleep actually are more predictive. The quality of your sleep is most predictive of, of HRV, whereas time in bed actually isn't. There's no relationship in the data whatsoever in terms of time in bed, although we know that really matters. And there's obviously a relationship between your quality, I suppose, and your time in bed in some ways.

But yeah, that is indeed what we see in the data. And just to, I think oftentimes people think about sleep in the context of just what's of just the experience and not really, I think, appreciating that there are myriad of behaviors that are happening during the day that are going to influence the quality of our sleep. Certainly, sufficiency is really about making a very, you know, conscious decision about when you're going to bed and when you're waking up and how much time you're actually spending at bed, and that's going to, you know, differ for most folks. But if we think about quality and understanding how important that is for fertility and, you know, just hormone production and,

you know, how hungry and how full we feel the next day. I mean, it could, sleep is obviously hugely impactful. But what are the behaviors would you say? And I'd love to tap on your sunlight and spirit and stress because I think you're going to tell me that how we think about those and how we manage those, those things throughout the day is going to have a direct impact on the quality of our sleep. So if you want to maybe kind of segue into kind of talking about how those support our sleep experience and how you think about that with your patients. Definitely. I do like the 10-3210 rule. So no caffeine within 10 hours. And yes, some people test their genetics and they see if they're hyper slow metabolizer. But in general, 10 hours for caffeine,

three hours and then two hours for eating and exercise. And then one hour for bright white or blue light or screens and then zero snooze in the morning. In addition to that, after your zero snooze in the morning, you of course get your morning sunlight as our friend Dr. Andrew Huberman like I said, tell everybody, morning sunlight, low solar angle, et cetera. So looking at the natural light in the morning. And that, of course, is affecting our melatonin production, which is the hormone of darkness. And yes, definitely circadian rhythms for melatonin and also cortisol has a rhythm as well.

I guess on that note, the sunlight pillar of health is not just about light. It's also about cold exposure, heat exposure. So perhaps ending your shower on cold in the morning or not getting too much cold exposure too close to sleep, actually. Could be a very reasonable intervention. As far as spirit and stress, it's a little bit more difficult to explain. Think of diet, exercise, and sleep as the dominoes that actually hit the, like physiologically are going to change hormone release and synthesis, whereas the domino behind it is sleep and

stress. And in a new pillar, health, I added social pillar, ritual. that convinced me that I should add one, so I did. Because it is true. Outside of stress and outside of spirit, social health can certainly be that other domino that's kind of hitting the other ones. We know this pretty well from nicotine cessation studies.

Just literally somebody else in the house that is using or not using nicotine or also quitting at the same time can make a huge difference. But spirit is basically your self-actualization or your metaphysical goal. It does not have to do anything with religion. Yes, I'm a Christian, but at the end of the day, Maslow's hierarchy of needs is a pyramid of physical needs at first and non-physical needs.

The top of the pyramid is called self-actualization, and that's just what your purpose here on life is. And that can absolutely be the domino. If people are devoid of a purpose that they are happy with, then oftentimes the other things like sleep and diet and exercise. wide behind. Yeah, I was a question. Well, that is an excellent summary. In terms of stress, so you mentioned cold and hot, and we've, we just had Dr. Susanna Soberg on the podcast, who very expertly described the various protocols and the benefits of cold therapy. Maybe just

talk about intentional stress versus unintentional stress and what the differences are and how that impacts our system kind of differently and, you know, kind of horvices versus just chronic stress and what that does to our system. Yeah, I like to make the stress analogy to stressing your muscles during exercise. So if your muscle is stressed and you are not ready for it, for example, let's say you're driving a car and get in a car wreck and when you get in the car wreck, it bends your body to the side and it straightens out your arm that can be extremely painful and disconcerting, whereas if you're on an exercise machine and you're twisting,

and you're straightening it after your arm, then that can be very different, even though it's the exact same movement. Part of exercise is making that effort feel good and the stress of life, whether it is a stress at work or a stress at home, the kids are screaming and it's that time before bedtime. That's just always going to be terrible no matter what. Finding a way to help that feel as good as possible is that adaptive response to stress that can, be beneficial. So there's actually interesting studies with human and their dogs. So the humans or sorry, the dogs and the owners. And when the dogs and the owners are stressed, the dogs that win tend to have their cortisol go up. And if their cortisol went up, their owners

tended to have higher testosterone as well. So there's that, I guess, positive features. mechanism. So when you win, your testosterone goes up. When you win more, your testosterone goes up again. Although it's winning. Yeah, so it's very interesting. And it is a bit different between species too. Because then you look in the animal kingdom and it was postulated that the like the alpha or the wolf that was in charge would have the highest testosterone. But that was certainly not the case. With dogs, it appears very related to cortisol. Cortisol being one of the stress hormones. Adrenaline is sort of a stress hormone as well, or a neurotransmitter again. But the cortisol was significantly the highest in the alpha waltz in the pack,

whereas it was lower in the other ones. So I suppose that learning to help have the stress feel good in those individuals led to more success. Interesting. And we can increase our stress tolerance with cold therapy and heat therapy. What would be just a couple others on your list that kind of help us be able to adapt to stress in a more functional way? Meditation, whether it's mindfulness, whether it's prayer. That certainly plays a part. Yoga Nidra. There's a lot of different techniques that I guess there would be actionable tools to improve the resilience and response to stress.

Those would be applicable. Also, sleep again. So sleep would definitely improve the response as well. There's an interesting brainwave called alpha waves, kind of the calm, cool, collected waves. We know that monks tend to have a high amount of alpha waves, probably not because they're born with it, but probably because they practice the lifestyle tools

that monks tend to do to develop a lot of this calm, cool, collected brainwave, and we can certainly do that as well. Love it. All right, let's talk about supplements. One of the supplements that our members track a lot is creatine. We have over 38,000 members tracking, making a creatine entry during basically a 90-day period. What was interesting, want your thoughts on this. On average, members strain, which is a measure of their cardiovascular load, and it's on a scale of 1 to 21, the higher the strain, the more load you know, you're putting on your body.

in it was an average of 12.3 on days when they recorded taking creatine, which was 12.2% higher than on the days without. So I thought that was interesting. So I would imagine creatine increases capacity potentially. So people's output is higher. So they're putting on more load. I'm not sure. So if you have a comment on that, that'd be great. If not just generally, what are your thoughts about on creotin? And is this something you recommend for your patients? How does it impact hormonal profile for men and women? What are your thoughts on that?

The way I explain creatine is it's a backup fuel tank for your energy system. So you think about creatine, it can make sure that there is still fuel for your mitochondria or fuel in general for your cells when other fuel sources have been depleted. So there's a lot of intricate detail that we could get into. For example, we could talk about whether lactate or lactic acid is good or bad. Eventually, we'll be tracking that with like chronic continuous monitors as well. That would be particularly interesting, but a lot of athletes certainly do finger stick lactate. But that's a buffer.

And there's other buffers that you can add, for example, malate or malic acid. but one of the main energy systems is NAD plus, which can come from NMN, which is another supplement, or NR, which is nicotinide riboside, leading to nicotanumide mononucleotide. And then coenzyme Q10 is basically the activator or the, it is a catalyst that converts NAD plus into ATP. So creatine is kind of a backup for this, and then carotene, or L-carnatine, acetyl, L-carnatine. and those are all carnitine sources is a dipeptide. That's the pump. That pumps a lot of energy into the mitochondria. So it makes sense that people would have a higher load

when they are consuming creatine. We do know, and this might be because of its effect on the testes as well, so both in the testes and the ovary, it's going to provide more fuel for the cell to do the processes that they do. for example, spindle formation during fertilization. That's after leave the ovary, but in testes specifically, and actually an ovary as well, a cell called the thika cell.

And the testes is called the latex cell, the synthesis of testosterone. So creatine is going to increase testosterone, and then somewhat equitably to that, Dht, which is dihydrotestosterone. Interesting. Okay, that's great. is there anyone who you would not recommend take creatine? I don't think so. My colleague James O'Hara, he brought up a study of a patient that was on

anti-retroviral therapy treatment. And this individual began taking creatine, and a marker called creatin, which is usually a marker of kidney function, went from 1.0 to 5 or 6. So this is a sign of like fulminate kidney failure. So after that lab came back, he was sent to the hospital, he was hospitalized, got a nephrology consult, and had a full workup, which probably consisted of checking a cystatin C. And it just turns out that with sign medications, creatine will precipitously increase creatin. So for people that are on higher doses of creatine, occasionally it can be helpful to take more than five grams a day, especially if there's someone who is a non-responder. Then checking that cystatin C instead, that's spelled C-Y-S-T-A-T-I-N-S-C, that's a much more accurate measure of what's called G-FR, which is the filtration rate of the kidney.

Okay, perfect. Okay, excellent. So a lot of members also track melatonin and magnesium. So your thoughts on, and if there are any other supplements that you would recommend, or maybe not recommend, I would love to hear that. Yeah, I suppose I briefly touched on carnitine and Inamid or NR when we were talking about creatine to some degree and Kocintin too. A lot of things, I just like to test objectively.

So I love data, as a lot of people listening to this podcast, also like objective quantitative data. And it can be like it's not prohibitively expensive to check, for example, different omegas or your CO-10 or, you know, even your carnitine, totaled carnitine, free carnitine and estrified carnitine. And I post those panels in my website, too, if people are interested in seeing what they can order and not order, as far as the other supplements that a lot of people should consider vitamin D. Now is the perfect time to consider vitamin D supplement, not as much sun. It's not a complete replacement for

the sun, but D3K2 can be very reasonable. And I think you asked about two others as well. Melatonin and magnesium. Melatonin is bioidentical hormone, I suppose. People love talking about the pineal gland and calcified pineal glands. But what I'd like to mention is as light comes through, again, that low solar angle in the morning, goes through the optic nerve, and then kind of shuts down the release of melatonin from the pineal gland. That's my understanding of it as a nod-ed neuroscientist. So, but melatonin does have three receptors, I believe.

Melatonin receptor 1, 2, and 3. There's actually melatonin receptor agonist, Rosarim, which is a medication that's been around for a while, I believe is the agonist at the two of them. The third melatonin receptor is somewhat involved in the modulation of release of LH and FSAH. So very high doses in pediatric populations, for example, through puberty, is probably not a great idea to use consistently. One time or two times is not going to be of particular like, you know, too worrisome. But jet lag or when you're traveling across time zones

is probably the one time when you could consider a melatonin receptor agonist, whether it's bioidentical melatonin in a dose that you can tolerate, or whether it is a prescription melatonin receptor agonist. So that's kind of how I think of melatonin. And sorry, I think there was one other. And magnesium. And magnesium. Yeah. So magnesium is certainly interesting from a variety of different perspectives. Most people don't get enough magnesium or potassium in their diet.

If you do get enough potassium in your diet, but your magnesium is too low, you can still have persistently low potassium. So if your potassium is still, for example, 3.3 on your blood test and you've tried increasing sources of potassium, potatoes or whatnot, then look at magnesium and that is certainly important. Magnesium is also in what I call the Huberman sleep stack, which I can't take total credit for, but I think about magnesium that crosses the blood brain barrier. So glycinate, which is the same thing as diglycinate or bisglycinate or therinate. And this can be combined with L-theonine, which is actually not going to make you sleep, but relax you again, those alpha waves that we talked about earlier. And then either anastatol or apiagin. So anastatol can concentrate in central nervous system. There's a huge variation in doses, but the law of diminishing returns applies, so most people I don't do the ultra-high dose regimen of anastatol. There's myo-anostitol and de-chiro-anostitol for most people. Myoan-oanostitol, which is regular anastol, is just fine. And for people that take a lithium medication or supplement, so even lithium or rotate, if it's a mood supplement, that can deplete anastol levels in the brain. So that's an important one to consider adding in as part of a sleep stack. Then api-genin is kind of a similar molecule. to an ostetol. My favorite one is apigenin glycoside. There's a specific apigenin glycoside called iso-vitexin. There's a couple different supplements that have this in it. And taken, I usually like a relatively high dose of apogenin, like 800, 400, 800 milligrams. That specific one is important. It's a weak monomone oxidase inhibitor. So I think it helps

sleep and actually cravings as well by increasing the amount. of dopamine and actually, to some degree, serotonin that is available during sleep processes. Wow, very cool. That's super helpful. I know we're at time here. This has been just a terrific conversation and appreciate how you were able to simplify very complex ideas and concepts. So I definitely feel like this information is super accessible and excited to, you know, for our members to be able to learn from you. So thank you so much for coming on. Where can folks find you? My main base is on Instagram, Kyle Gillette MD, Gillette Health, all other platforms.

I've been following you for years. So I love, I love, I just, yeah, I just appreciate all the good work that you're doing to educate folks. And, yeah, hopefully you'll keep going strong and make all of us better in the meantime. So thanks for your work and hope we get to connect again soon. Thank you. My pleasure. Big thank you to Dr. Kyle Gillette for joining us this week to talk about. about our hormone profiles and how they impact the body. A lot of good tips there.

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