If you were to ask my wife, current and past co-workers, and kids what I really suck at, I’m sure it would take them about a microseconds to spit out EMPATHY.  It’s enormously difficult for me to relate emotionally with someone else’s struggles.  It doesn’t mean I don’t care.  I just hard for me to shed a tear…except for the movie Rudy.

But the more I dive into looking at the disruptions at the cell level and even genetic level, my view of individual’s health struggles is starting to change, especially when it comes to people that struggle with obesity.  The empathy really grows when I see them do so much that is right but can’t seem to have a break through.

One of the biochemical factors that keep the person unsatisfied is because often times they are starving.  Really.  In other words, what they are eating isn’t being shuttled into the cell to produce that universal energy currency we all learned about in high school biology called ATP.  One of those main reasons for an overfed but under nourished state is due to inefficiencies of the Kreb’s cycle. As a result, the person is going to crave more and more energy substrates (usually carb type foods) to flood the system to ultimately produce ATP.

Courtesy Genova Diagnostics

From the chart, you can see that what you consume (fats, carbs, and proteins) should all gets converted to a single molecule called Acetyl CoA.  Why is this little guy so important?  It’s a major starting point of energy production in the body.  If the Kreb’s cycle isn’t welcoming of this molecule, it will go and find other things to do.  One of those things is the production of cholesterol, which is blocked by a statin.  As a result, we have the unintended consequences of also blocking CoQ10, which you can see is also another precursor to ATP.  The empathy portion happens by understanding that one of the reasons cholesterol may be creeping up in addition to the body weight isn’t just an overconsumption of foods but major inefficiencies in the Kreb’s cycle, exacerbated by a statin medication because their cholesterol is creeping up.

Looking at the reactions in the body, efficiency of reactions need substrates (ingredients) and an enzyme (recipe) to produce a product.  In this case, the substrate would be Acetyl CoA and the enzyme would be ACAT.  ACAT needs co-factors to help perform.  Think of these co-factors like spices.  From the chart above, major players are the B vitamins.

But before slamming your system with B vitamins, consider other factors than just the lack of consumption of these nutrient powerhouses.

Synergism and Strategery…

You’re not alone in this journey of health.  In fact you’re a minority in this journey, at least you should be.  I’m talking about your microbiome, all those buggers that protect you internally.  For every 1 human cell, there should be 10 beneficial bacteria.  One of their roles is to synthesize and supply nutrients for the use of the rest of the body.

What I’m trying to say is that if you’re fighting the battle of the bulge, stop looking at the gut visible on the outside and start looking at the gut on the inside.  If the ecosystem of your inner tube from mouth to anus is imbalanced, this can create a lack of nutrient conversion that inhibits fuel for your cells.

Low Carb Latency…

The insulin resistance associated with obesity can damage the mitochondria and therefore wreck your ability to utilize fat as a source for fuel as well as decreasing your exercise capacity.  This is when I see the person’s energy just tank after they have started a keto diet and gone to high intensity type exercise. While I’m fan of these, I have seen a number of people that use this strategy backfire because there are often underlying, not-so-obvious issues.

TSH Chase…

The next step most take is to go have their thyroid checked since they are doing everything right but are still suffering.  Your traditional provider will run a TSH and prescribe medication to get that number back in ‘normal range.’  The problem is that about 15 percent of the 10-12 million people in the U.S. with hypothyroidism, or an underactive thyroid, continue to feel sick despite following the standard of care recommended by the American Thyroid Association.

A recent study published in the Journal of Clinical Endocrinology and Metabolism found that individuals on levothyroxine (synthetic T4, like Synthroid) who had normal TSH levels were significantly more likely to be taking antidepressants than peers with normal thyroid function. The individuals taking thyroid medication were also less physically active, suggesting lower energy levels. They weighed about 10 pounds more than peers of the same height even though they consumed fewer calories, after adjustments for body weight. Plus, they were more likely to be using beta blockers, a drug frequently prescribed to lower blood pressure, and statins that reduce cholesterol levels.

“Doctors should be telling their patients, ‘I’m going to normalize your TSH, but you’re going to be at a higher risk for gaining weight, experiencing depression and fatigue. It is also more likely that your cholesterol will go up.’ That’s what we should be telling patients, based on our study. This conversation is particularly important for any patient that is considering surgical removal of the thyroid gland.”

Don’t Guess…

For most, they have tried everything before showing up at my office.  They are fatigued from both internal dysfunction as well as fighting the frustration of perceived failure for years.  So what is there to do?  Let’s not guess, let’s test.  Let’s look at root cause testing.  Let’s look at the mitochondria, the Krebs cycle, your B vitamin usage, your gut ecosystem, and your ability to utilize your nutrients.

For this, I like a a nutritional test from Genova Diagnostics called the Organix Comprehensive Profile.  It’s non-invasive using urine in the comfort of your own home.  Here’s an example of someone that from a lifestyle perspective was doing great but feeling tanked in energy.  Her mitochondria were starving, which dilutes the production of ATP, and therefore energy is sapped.

If you feel you’re doing everything right but are still suffering, reach out, I have empathy for your situation.  Probably not too may other situations but definitely yours.  You know how to find me.