132. Leptin Resistance with Dr. Bindiya Gandhi

Dr. Bindiya Gandhi 0:05

there's a direct correlation between low leptin anxiety as well as estrogen levels

Dr. Stephanie Gray 0:14

Welcome to the your longevity blueprint podcast. I'm your host, Dr. Stephanie gray. My number one goal with the show is to help you discover your personalized plan to build your dream health and live a longer, happier, truly healthier life.

You're about to hear from Dr. Bindi and Gandhi. Today we're going to discuss leptin resistance, hormone balance and weight loss resistance. Let's get started.

Welcome to another episode of The your longevity blueprint podcast. today. My guest is Dr. Vidya Gandhi, who is double board certified by the American Board of family medicine as well as the American Board of integrative and holistic physicians. She completed her family medicine training from Georgia Regents University Medical College of Georgia in June of 2014. She completed her undergraduate training at the University of Georgia with a Bachelors of Science in biology and psychology in 2004, and her doctor of medicine at American University of Antigua College of Medicine in 2010. She completed an integrative medicine fellowship at the University of Arizona with Dr. Andrew Weil in 2016, and completed functional medicine training with the Institute for Functional Medicine and 2017. Her interests include integrative holistic and functional medicine, women's health, preventative medicine, International Medicine, and healthcare reform. She is also a certified yoga instructor and Reiki master, she used to practice emergency medicine as well. She is a media expert and contributor to numerous sites, including the Daily Mail MindBodyGreen, Pop Sugar, clean, plated well and good and more. When she's not working or writing. You can find her in her kitchen cooking, doing yoga, or enjoying time with her family. Welcome to the show, Dr. Gandhi,

Dr. Bindiya Gandhi 1:42

thank you so much for having me. Well, I find most people I know you have a podcast as well, I'm sure you also find that most individuals we have as guests on our show have their own stories as far as how they came to work in this field. So can you elaborate on your story a bit for us? I know you're a weight loss expert, but kind of tell us what brought you into functional medicine and what you're doing today? Well, you know, again, thank you again, so much for having me. You know, my journey is like so many others it was because I got sick and I was not getting the answers in the conventional world that led me to dig more and realize that there's this whole other world that exists. We hear this a lot but you might mess became my message right? I was in residency I thought I was eating well, I thought I was exercising. I thought I was the epitome of good health. You know, I had I had learned all of this in medical school. But in residency, a lot of things started going around I started gaining weight I started having acne I start having irregular cycles, a lot of headaches, chronic constipation, but it wasn't until a rash on my face that really got me to seek help because at this point, it was kind of like managing symptoms right? That's what we do in medicine. It's like managing symptoms oh you're constipated take the MiraLAX Oh, you have a headache take this ibuprofen but the problem didn't go away. Right and so but it was the rash on my face. It kept getting worse. I had been to dermatologist I had done allergy testing I did everything spent 1000s of dollars on steroids on antifungals on antibacterial you name it every prescription I probably took it tried it oral cream, I was desperate to get off of my face, right. And of course I would was self conscious of it and would cover it up with makeup and it would make things worse, and it would come and it would go this honestly definitely went on for two years. And I kept asking and I was spinning my wheels, you know, kind of like just going in circles and had biopsies done still nothing, everything was normal. Finally, I went to an allergy immunology doctor and I was kind of like essentially begging for additional testing. I was like, do I have an autoimmune conditions? I have my nutrient deficient like something is going on. I don't know what it is. But this is cannot be normal. Like this is not normal. You know, I couldn't pinpoint anything. He didn't want to do any allergy testing. And he didn't want to do any testing on me. And at that point, kind of in Scituate insinuated sorry that it was in my head like oh, you're just a burnt out stressed out resident kind of suck it up and deal with it. And I was like so distraught, disappointed and discouraged at that time and kind of was like this is it. I've got to take my health back into my control. I found a functional medicine doctor. Long story short, found out I had celiac and how gluten, constipation went away acne, went away cycles, got better headaches, went away, lost some weight. I mean, you name it. It was kind of that was the beginning of my journey. And then I was like, I've got to learn more about functional medicine and integrative medicine. This is the time I also enrolled with Andrew Weil, the University of Arizona's program and yeah, the rest is history. But it was my own health and since then was able to kind of balance my hormones. It took me a while to get pregnant with my first baby. And now I'm blessed with three kids. It's just different. It's once you're able to biohack yourself and you understand what's going on with your body. Your body will work for you. No I love that your body will work for you. I know you don't know my story, but my story is actually similar to yours. I didn't have a rash but I also had some issues from glue

And I ended up being I ended up testing positive for celiac. My biopsy was negative. So I didn't have full blown celiac, but I was very close. I was on the way. Right. And I had cardio and infertility and other issues as well. And so our journeys are somewhat similar. We do not like gluten. Gluten is the devil. It does not. I know. It's so funny because like before, like when I first was diagnosed, I'm not gonna lie I was I cried, I was depressed I was and it was definitely it was literally like a couple of days before Thanksgiving when I found out the result. And I was like, so upset. I was like, You're telling me I can't have gluten and it's Thanksgiving next. Like, I remember being so upset. And now like, literally, it's been like 10 years later. Now, it's like, not a big deal. And I'm like, you could look Assange in my face and a donut. And it's like, I don't even want that. Like I don't, I'll never go down that road.

Dr. Stephanie Gray 5:44

Agreed. And I remember the moment when I had ordered testing on myself, actually. And I came through and I have, oh crap, right. I'm one of those people on what I have to.But it made me empathize with my patients, because I had already been advising individuals to go gluten free. And this was also like, a decade ago. And then I had to like, oh, my gosh, I have to do this myself. And so I think it was very helpful for me to be on that journey with my patients and to be able to empathize with them. And it was harder back then I think it's easier now there are some oh my god, I'll say that.

Dr. Bindiya Gandhi 6:11

Yeah. I'm so grateful for all the readily available stuff back then. I mean, it's still expensive. Don't get me wrong. It's still a little pricey to eat gluten free, but like back then I remember like a loaf of bread being $7. And as a poor resident, like I was like, can't afford to eat. Like, I'd rather just not eat the bread, like you're picking and choosing like what you can eat, you know,

Dr. Stephanie Gray 6:30

so my sister in law, I remember they're living on the East Coast. She's had celiac, I think over 15 years. And back then there was like one restaurant in New York City that had gluten free pizza, like in New York City, one restaurant and now you can find them everywhere. So times have changed so it is becoming a little easier. But well, I digress. Let's get back to weight. And also that impact on fertility and hormone so I just want to kind of dive into weight loss, maybe we'll focus on fertility.

Dr. Bindiya Gandhi 6:55

Yeah, we can talk about all day every day. So what I love sharing is there's a lesser known hormone that people are not aware of it's collected. And people don't realize that that didn't really impacts your metabolism, your weight, your waist line, but it also impacts other things. It impacts your estrogen production, it impacts your blood sugar's it impacts your cortisol, your thyroid is so much more. And so it's a little hormone. It's produced by your fat cells, and it communicates with your brain. And essentially, leptons job is to let us know Are you full duty to eat some more or less? It's your satiety hormone, right? When your body is not getting the signals, you're either over eating, you're not eating enough, most of the time, you're snacking, you're just not full, right, the message and the signaling is this is why this is so important. Because when there's a miscommunication, you're more likely to have other things go on, right? You have higher food cravings, you have weight gain, you have sleep disturbances, a little bit of anxiety, you're again, you're more likely to have inflammation, I could go on and on. Like it's just an important hormone to be aware of because it impacts so many of us. Honestly, Stephanie, you and I can relate to this, like we have been told wrong information from as long as we were born, okay, like we were drinking milk because that's what we were told that was good for our body. We were in the phase of in the 90s of eating, low fat, everything and diet, everything and because of all those changing diet cultures over the years, that's impacted our microbiome that's also impacted our insulin resistance, our glucose insulin levels and our leptin. So there's so many different things and so many reasons why our Leptin hormone is now often again, like all these crazy intense diets now and I'm not labeling any diet as bad but like the extremes of keto and intermittent fasting and this and that, like it just has messed up all of our metabolisms.

Dr. Stephanie Gray 8:46

They're saying leptin is important because it's a satiety hormone right tells us we're full quit eating so many individuals now leptin resistance, is that the problem? And if so how are we becoming once leptin resistance?

Dr. Bindiya Gandhi 8:59

Yeah, so I tend to see that many more people are becoming leptin resistance. So because that miscommunication is off, their metabolism is off, and it can happen at any age, it's not Oh, in your 50s, you're now leptin resistant. Any age, we're seeing this happening, there used to be a correlation to your body mass if it's interpreted via blood work, but I don't always see that correlation to be correct, I can still see someone who's a little bit leaner and still have a leptin resistance. Of course, you and I noticed when we talk about body mass index, it does not take into account for like muscle mass and other things that can be contributing to your actual body mass. It is a good number, but it's not something that we should solely rely on for people. So yeah, it is really important when we when we kind of identify, you know, who was leptin resistance and why this could happen. But one of the reasons that this is happening is because we're more stressed to these days, you know, we've been eating the standard American diet. Our lives are crazy and hectic and a life of convenience. You know, we're microwaving things we're eating processed foods. We're out

Dr. Stephanie Gray 10:00

A lot of prescription medications and all these things over time have started to impact our microbiome, our blood sugar levels, inflammation, we're more just exposed to crap and toxins and we're more inflamed. And all of these reasons are the reason why our leptin levels are off. And when you say off, do you mean elevated? Are you testing leptin levels in the blood and your patients? You also look at adiponectin too, is that something that

Dr. Bindiya Gandhi 10:24

Yeah, I do look at adiponectin when I looked at leptin, so we'll kind of rewind a little bit. If you think that you have leptin resistance on some of the symptoms that you tend to notice as maybe you're eating every hour, I can't stop eating, I'm hungry. I don't know why I need to eat. That's one symptom. You've tried everything you're exercising, lose, you're exercising, or I should say over exercising and under eating and still not losing weight. You're like, tried everything in the books, it's not working, maybe you hit a weight loss style. So you kind of have the inability to lose weight no matter what you have constant fatigue, you're exhausted, you have low energy, but you're like been told everything is normal, right? Maybe you have worsening of your hypothyroid symptoms, right? Maybe things these things are kind of worsening. So if you have any of these symptoms, I encourage you to go to my website, which is Dr. Bonilla md.com forward slash quiz. Take a free quiz to identify Could you be leptin sensitive, leptin, clear or leptin resistance, okay, there's different categories I have because if your leptin is above 11, most of the time you are leptin resistant. If your leptin is between seven and 10, you're probably in a good range. Anything below that, you know, you should be fine, your leptin, clear leptin again, like so many other hormones that your DHEA, that kind of thing. It's like I call it my Goldilocks hormone. We don't want this level to be too high. But we certainly don't want it to be too low. Stephanie, especially if we're talking about fertility, if our leptin levels are low, then we're having a harder time getting pregnant. I see this all the time, what's the relationship with low leptin, and sex hormones? What tell me the connection there that I don't know, we definitely don't want to be too high. But when it's a low, what's also happening is we are now having a little bit more anxious cortisol production is a little bit up. But there's a direct correlation between low leptin anxiety, as well as estrogen levels. I see this commonly in my athletes, my female athletes traditionally, and they have lower body mass, they have lower circulating estrogen, and their leptin levels are below three. And that's problematic, so that they're most likely most of the time probably not ovulating, or they think they're ovulating, but they're really not. Stress hormones are a little bit up because they're trying to rebound. And they're also more likely to have osteopenia or osteoporosis. There's all these different things happening at the same time. Bone turnover is a little bit high. We also tend to see Stephanie, that their T three free T threes ended up being a little bit lower at that in that state as well, which then they're getting the memo, their brain is getting the memo that they're not healthy enough to carry a child, their brain is getting a memo that they're in starvation mode, their brain doesn't get a memo of when are they going to eat again, when it when is food coming? Their brain thinks that they're in a famine state. And so this is why if you're if your brain and your body thinks that, then consumption is like not going to happen.

Dr. Stephanie Gray 13:11

So I think what you're saying which I'm going to just dumb down a teeny bit for the listeners we've talked a lot about, they'll fight or flight being in a high stress state on this podcast. I've mentioned many times stresses your body's biggest hormone hijacker. So it kind of sounds like you're saying maybe individuals who are over exercising, who are stressed whose cortisol is high, may have low sex hormones and also low leptin. Is that the combination that you're saying that you see, okay, yeah, so you are testing levels for leptin? And then you what you said you really want to be so over 11 is bad. I mean, your leptin resistant? What about adiponectin? Do you test those levels? Do you see value in that? I

Dr. Bindiya Gandhi 13:43

do check adiponectin. So if I'm more thinking that you're more insulin resistance, or hemoglobin, anyone see may be normal, but I'm still suspecting there's insome insulin issues, that's when I'll check adiponectin it's not one of my go to Profile for every single person. So once someone is discovered their leptin resistance, what do we do about this, lots to do lots to do. The first and foremost thing is I know people are gonna think I'm like ridiculously crazy when I say this, I actually encourage people eat actually encouraged people eat food, because again, because our metabolism is so skewed from different diets and different things. It's kind of like we're starting by Re feeding our body. So if we have low leptin that kind of helps kind of help with that. If we have high leptin, it kind of helps with that. It's kind of resetting the metabolism. Because we've been in the starvation diets, and we've been at the extremes for so many years. It basically helps us identify how can we get our metabolism working in the right direction. So by starting to refeed our body, we're actually slowly revving up our metabolism. But the key is not to just refeed any crap. It's like eating the proper foods. So making sure we're getting adequate amount of protein in our diet daily is essential.

Dr. Stephanie Gray 14:57

What do you recommend? How much do you recommend? I usually

Dr. Bindiya Gandhi 15:00

To say, at minimum for my females, because this is at minimum could even be hard minimum get about 60 grams of protein a day. And that's still very low, that's still very low. But for what do you when you talk to so many people, they're not even hitting that 60 grams of protein a day, right? Because we're in a very high carb society, eating a lot of process stuff, right? So it's changing that focus and saying, How can we get at minimum 60 grams of protein a day? And if we can achieve more than that, that's awesome. That is great. So just starting off with like, the basics, the question I asked is, can you get protein for breakfast, lunch and dinner? If you can get some sort of protein at breakfast, lunch and dinner? You're doing an amazing job? Keep at it.

Dr. Stephanie Gray 15:39

I think a lot of my patients, this is where protein powders come in? Because a lot of them are they're putting collagen protein in their coffee, or they're making a smoothie in the morning or getting that 20 grams, at least 20 grams.

Dr. Bindiya Gandhi 15:49

Yes. Plus, if you also have meat, what's that, right, bacon and eggs or whatever sausage, you're getting even more protein. So I think you're starting today with also heavy protein breakfast via food. And the shake is a good way to get in a heavy amount of that. But it's such a great, great example and a great idea because many people struggle with getting protein in the morning. It's just we're used to carbs and bagels and cereals and toast right? And there's no protein. And so if you can start up your day with protein that starts your metabolism the right way. But more importantly, Stephanie, if for some reason if your day gets arrived, because you've got kids or work and things happen, at least you got some protein in the morning. Right? Exactly. It's like, it's like making sure you're starting your day for success.

Dr. Stephanie Gray 16:31

What's the relationship between like triglyceride levels and leptin levels?

Dr. Bindiya Gandhi 16:35

Oh my goodness. So many people, maybe they don't realize this, but our triglycerides are actually metabolized in our liver, and so is their thyroid and so is our leptin, right. So the liver is really important. Triglycerides are also the precursors to our two diabetes or pre diabetes or insulin resistant. Triglycerides are very important. And when we talk about triglycerides, one of the ways if you find that your triglycerides levels are elevated, if you go to your doctor and your doctor says okay, you know your your triglycerides are in the 210 they really shouldn't be between 70 and 91 of the things that you can do is actually what I recommend is getting rid of high fructose corn syrup. Because there's data there are specifically fruit sugars or processed anything processed sugars will start naturally decreasing your triglycerides. Now the connection is if you want to decrease leptin, guess what else you need to do? Slowly get rid of fruit, okay, or fruit sugars or fructose. So that is why again, because it's all being metabolized and their liver, they're all kind of working together. When you significantly cut out, bring down your triglycerides and you cut out fruit. If you're leptin resistant, not everybody needs to kind of fruit I want to make that distinction, okay? Because fruit is good and has some great benefits. But if you're significantly leptin resistance and you cut out fruit, you will see leptin numbers move in the right direction.

Dr. Stephanie Gray 17:53

What about since we're talking about triglycerides, right, which are three glucose molecules that's talking about just blood sugar in general?

Dr. Bindiya Gandhi 17:59

Yeah. So talk about the importance of blood sugar balance to achieve weight loss, one of the things that most people are getting are doing if let's let's talk about this, this is probably my timeframe is off, but maybe like 10 years ago, the recommendations were you need to eat every two hours, you need to eat every two hours, right? And many people, including myself, probably were guilty of okay, well, if I eat every two hours, this is going to rip up my metabolism. And I'll be skinny, right? Right. No, what that was doing was giving us an insulin and blood sugar spike, eating every two hours was actually doing that. And when you do that, Stephanie, number one, your guts not getting any rest. So your microbiome is is constantly working, and digestion is working, which is not good. But secondly, when your blood sugars are not stable, because they're constantly going up and coming down, going up and coming down. That is what's causing a lot of insulin resistance. That's not the way to do it, your blood sugars actually need rest. This is why this is why we encourage eating three meals a day, no snacks, or this is another reason why we will sometimes encourage some form of intermittent fasting to allow the blood sugars to stabilize, because when you're stabilizing your blood sugars, you're also decreasing your triglycerides, you're also managing your blood sugar's better, also essentially decreasing leptin in other ways.

Dr. Stephanie Gray 19:21

I want to go on a tangent for intermittent fasting just for a moment here because I know I've had many guests come on the show, as I'm sure you have had on your show to talk about how great intermittent fasting is. And I feel like this is just my opinion in my observation. I feel like intermittent fasting has its time in place there it is a good fit for some people, especially who have a lot of weight to lose. It can be a great strategy for them to almost train their body that they don't have to eat every two hours I get that. However, I do feel like intermittent fasting is not a good fit for some people. And I do feel like this is just my opinion and I'm just curious to know yours. I feel like in the intermittent fasting world. A lot of individuals skip breakfast and then they have like lunch and dinner or just dinner But I know that we're more insulin sensitive in the morning. And I feel like the proper way to intermittent fast would actually be to have breakfast, you're going to be exerting more calories through the day have food on board, and then to skip dinner. So I'm curious to know your opinion on that. And then I want to say one more comment on intermittent fasting.

Dr. Bindiya Gandhi 20:17

So that actually may actually work out really well. I can totally see that. Again, I think psychologically, it's probably easier to skip breakfast. Because even for me, I'm actually not hungry in the morning. Like, it's just like, if let's like, I'm on the go, go go like breakfast is the last thing that I'm thinking about. For me, I actually have to force myself to eat breakfast, because I'm not hungry. But theoretically, I think that would be a good idea. And it's in the morning, that's when we Exactly, yeah, exactly. And we actually call that reverse intermittent fasting, because it's kind of like changing the difference. It's kind of intermittent fasting just at a different time. So I think that it would be like an experimental thing for some people to be like, maybe we don't eat at night, because guess what, that's when your metabolism slows down. It makes more sense, right? Like, why are you eating at night, but this is why if you're gonna do anything fascinates eating, like, by PA, you know, it's like eating a lot earlier before you go to bed. The one thing I will say about that, Stephanie, for some people that are insulin sensitive, if they're not eating before, like, if they're not, if they're skipping that dinner meal, most likely, what could potentially happen, I have seen this in some patients is they will have cortisol spikes, and it'll wake them up at night, because their blood sugar's are not stable. So I think from that perspective, I think eating in the evening will help certain patients, but then I think we're certain other patients that they may could benefit by just skipping that meal completely. I think it would just be kind of like experimenting, and kind of seeing the data on that.

Dr. Stephanie Gray 21:38

So the other thing I find, I mean, it's some individuals who intermittent fast, they love it, it's great for their lifestyle, they lose weight, right? They're all of their, you know, biometric markers improve that that's common, but what I sometimes see is for patients who are intermittent fasting, who I think are actually overdoing it, I actually see blood sugar rise in the morning. Yes, I commonly see that can do you see that? And can you explain that kind of phenomenon, the other extreme of intermittent fasting, and I'll just kind of share my two cents on it.

Dr. Bindiya Gandhi 22:02

It's not for everybody. So certain females like for myself, my area, my age group, I would say, probably not the best to do long intermittent fasting, and I'm talking about 24 hour fasting. So if you're cycling, if you're if you're having a cycle every month, if you're trying to conceive, I actually don't recommend intermittent fasting more than 12 hours, 12 hours, I think is baseline I think is appropriate, I think is great. Anything past that you're starting to mess up, your sex hormones are starting to mess with their cortisol hormones, and you're starting to impact your thyroid hormones, which again, if your body's getting signaling that you're not stable, you're not going to get pregnant, or you're not going to carry the baby to full term, etc, etc. So, just want to get that out the way intermittent fasting works really, really well for menopausal years when your hormones are different. Okay, so we have to take that into consideration. But it's really important to understand that most people when they start interment fasting, they get some really, really great results. Everybody I know that doesn't even fasting, especially females, they're like, Oh, I lost, like, you know, 10 pounds in one month. And it's been great. It's amazing. But you know what happens and Stephanie, they hit that weight loss doll. That's what I see happen. It works really well. But then they can't lose a single ounce. And you know what's happened now, now they're eating even less calories. And now they're only eating like twice a day. And this is what causes more leptin resistance, because it's now messed up their metabolism. So this is what the problem is. And a lot of times what happens with intermittent fasting, you're doing two things. One, you're when you're already intermittent fasting, you're already calorie restricting, that's already camped out. And that's another reason why you're probably losing weight. But what ends up happening for so many women, they now intermittent fast, and then they're eating even less calories than they normally would. So if they're eating, say 1800 calories in a 24 hour day by eating three meals, but intermittent fasting, they're now eating about 1600, or maybe even less, but 1400 calories, say, but then they're also taking a step further, now they're eating two meals, but now they're only eating 800 calories a day. And so when you're doing that and keep restricting, you keep restricting your calories, it messes up your thyroid hormones, like messes up your cortisol production. This is why they're having the blood sugar instabilities in the morning, right? They're having that peak in the morning, your cortisol naturally rises in the morning, we shouldn't see that. But when your blood sugars are shooting up in the morning, not okay, right, like so that all these different mechanisms start happening. And that messes up your metabolism.

Dr. Stephanie Gray 24:20

And that's when I tell patients we need to back off intermittent fasting like I have patients who have done 24 hour fast even every other day and I'm seeing a once a year and I'm seeing fasting glucose numbers rise and I'm saying this is not good. We need to back off like the body is stressed. The body's telling us something so and I mean so. So doing like a 12 hour fast. It's like a normal hormetic stressors. That's normal. That's okay, we can recover from that. But we're not putting our body in prolonged stress state, bad things happen.

I agree. I agree. Let's go back to blood sugar balance and what supplements do you highly recommend to help? We obviously recommend diet changes, but then of course, exercise and whatnot, but what supplements are you

Dr. Bindiya Gandhi 25:00

Using, I use a couple that I really like, I kind of look at the overall picture to kind of get an idea of like, what, what could be working what what's not, I'm what I'm looking for supplements, a couple of things that I'm looking at a couple ingredients, and I'm looking for things like Berberine. I love Berberine, although not great for everybody. Berberine is one of my go twos for blood sugar and balancing, chromium, cinnamon, those are really good supplements I like to use in corporate with blood sugar balanced inositol if I think they're, you know, we've got some hormonal stuff going on as well. So the combination or one or the other, or just making sure that they've got enough like B vitamins as well, to help metabolize you know, things. So that's kind of my go to I also like apple cider vinegar, apple cider vinegar really does well, for blood sugar stability for some people. So yeah, those are just some of my go to, I'm happy to have them take that as at once a day, or is it with meals or is it so apple cider vinegar, if I'm going to have them do it, I like them to do it first thing in the morning on an empty stomach. And a couple of things. I actually like the tabs that are in the capsule, or sorry, that the capsules or tabs better than the actual liquid. And that's just because I'm not gonna lie, like when I take it, I feel like it burns my throat, it's gross, it's not something that you want to do first thing in the morning. So take it as a supplement form and like a capsule or tablet, and you're just gonna get the same amount of benefits. How does it impact glucose? Like, is it just improving digestion? So a lot of times of apple cider vinegar, it does decrease your appetite. So that's one of the things that's happening, it starts decreasing your appetite does start stimulating the gastric juices to kind of start working early in the morning. And so that's how that usually works when it comes to one of the reasons why I'll recommend it if we're if we're trying to manage blood sugars, so it's a great alternative. Again, you know, it's it's hit or miss. Some people do really well with it, and some people don't.

Dr. Stephanie Gray 26:42

I agree. Yep. What about fish oil? Do you use a lot of omega three fatty acids?

Dr. Bindiya Gandhi 26:45

I do. I do use it. But you know, I cannot definitively say there's a correlation between omega three fatty acids and blood sugar balance. I'll use it for multiple reasons. But I can't say I see if I'm giving you official ice once you come down or your blood sugar's fasting blood sugars there. I have not seen that in clinical practice yet, but I do recommend it for inflammation for managing cholesterol levels. Lower triglycerides. Yep. Yeah. appropriately. Exactly. Yes. And that's a key. Everybody listening, you have to actually take high high doses of omega three fatty acids to get the beneficial results. You know, a lot of times just taking one omega three fatty acid, and that dose probably is I'm just gonna guess maybe like 800 milligrams is not going to do anything for you actually have to be up to like 4000 milligrams or four grams for something to happen.

Dr. Stephanie Gray 27:36

But what about semaglutide? So the GLP one agonists do you use those medications we've been using the last couple of months, and we've had incredible success with weight loss in our practice. So this is not I'll say replacement for lifestyle changes. But what are your results? What are your thoughts on it? How do you use it,

Dr. Bindiya Gandhi 27:53

I think there's a place and for everything I actually personally do like semaglutide, it works really well for my patients, especially for my patients that are already eating well, exercising or on the other end are not doing that either, you know, I use it for a wide, wide array of patients, it is very hard to get a hold of you know, insurance does not like getting a nap does not like paying for it, it's hard to get it approved. But the people that we've had it on have had some amazing results. Side effects so far are not so great. But that's expected. And that's just because of how it's working. I love them. Because semaglutide Does multiple things. It is decreasing appetite, which is one way but then it also impacts leptin, which is one of the reasons why I like it, because I was gonna get Yeah, you get full faster, so that might eating a couple bites of something, your chicken you're already full, which then you're that messaging, and that signaling for leptin works really, really well. So most people are bound to lose approximately about 10 pounds a month with it. And I do love it, it works really well. But not everybody's a candidate for it, you know. So if there's a thyroid cancer history in the family or in the individual, they're not a good candidate, if they have a history of pancreatitis, not candidate for that, and you need to make sure you stay super hydrated with it, but it doesn't work.

Dr. Stephanie Gray 29:12

Yep, I agree, I find the same thing. So I want to go back to this leptin resistance, because I feel like a lot of my patients potentially have that. And I'm just trying to summarize kind of what the take from you is on helping to improve that. So if the levels are too high, are you saying in most of these individuals, they're not eating enough? Is that the main take home? No, it's not necessarily they're not eating enough. It's kind of tricky, because every individual multiple things could be happening for them. Right. So if we're talking about someone who has 38 year old woman who has leaped enough 33 Maybe she has a body mass index of like 30 Maybe she has an A one C of like, 5.9 Okay, I'm just gonna throw that up just a bunch of numbers out there. Right. So in her case, she did He has leptin resistance, she already has insulin resistance as well. Now, she may be someone that is intermittent fasting right now, because she's been told that intermittent fasting is good for her in her situation 70, it may be that she's not eating enough calories. And that's why she's she's having she's at a weight loss doll and is having some blood sugar instability as well, versus someone else who is on a typical standard American diet, same age, same same numbers, but as on a standard American diet, but it's actually eating maybe like 4000 calories a day, does that make sense? We're doing different things for different people to kind of bring that leptin down, I'm not going to improve her leptin resistance. By telling this woman who's 38, who's already intermittent fasting to intermittent fast, I'm going to worsen her leptin level, I'm going to worsen her metabolism. On the other end, if someone same age, same profile that's eating 4000 calories a day, if I get them to cut out one meal a day, and I get them to like even 12 hour two fortunate enough and fast don't leptin level come down. So it is very individual.

Maybe I should have opened the podcast with this. But why do you feel like many diets never seem to work and people just gain their weight back,

Dr. Bindiya Gandhi 31:04

because it's short term, and it's hard to sustain. And let's be honest, we like to eat our culture's our society is revolved around food, you know, like, you can't go to a birthday party or holiday function or anything without food. And we like good tasting food, let's be honest, right. And when you are restricting somebody for extreme periods of time, at some point, they're gonna be like, I'm done. Like, I can't do this anymore, I want to go back to eating that pizza, or I want to go back to eating a certain way. It's not sustainable long term. And this is why diets fail. This is why we have to talk about long term resolution and results because all of us are different. It's finding what works for you, the individual personally, and how we can make your metabolism work for you and rev it up. So you can still enjoy eating foods and keep you healthy and still not feel deprived.

Dr. Stephanie Gray 31:55

So how can a listener improve leptin resistance? So they go to their doctor, they have their leptin level checked and their numbers high? Is there something that they can do today to improve that? Or are you really saying there has to be an individualized approach,

Dr. Bindiya Gandhi 32:07

there is an individualized approach, but I do have some like general recommendations that I'll recommend for you guys. And if you actually go onto my website, Atlanta, weight loss dr.com, I have five ways to kind of start revving up your metabolism. And one of the things that I'll start telling you to do is majority people, if we start eating three meals a day, three meals a day, with protein, we're already starting to rev up your metabolism, okay, three meals a day, whether you're on the lower end of leptin or high end of leptin, you're changing that conversation you're having with your body by ensuring that you're getting three meals a day, eating every four to six hours in between No snacks, getting lots of protein that's already gonna start robbing improve metabolism. For people that have higher circulating leptin levels, having them cut out a fruit or decrease that will start decreasing leptin levels too. The other thing that's really, really important that people take for granted is making sure you're getting good quality sleep, when you're getting good quality sleep, maybe that means you're taking a melatonin or oil supplement to help with sleep. Or maybe you're not, you're just kind of optimizing your bedtime routine that really helps with metabolic flexibility that really helps a blood sugar control. That really helps with so many different things bouncing your cortisol levels, sleep, sleep, sleep is important. The other thing I'm gonna harp on for every single person, depending on where you are on the scale stress management guys like adaptogens adaptogens adaptogens are your best friends. Like if you are in a perfect world and you can be a Buddhist monk and meditate all day and be in zen mode. 24/7 like I praise You okay, but let's be honest, many of us can't, like we always have a go, we're in a hectic society, we've got kids, we've got work, we've got family, it's just so many things coming at us. You have to learn how to manage your stress. If you don't know how to manage your stress, you cannot control anything else. When your stress levels are off. Cortisol levels are spiking, you're not sleeping, your blood sugars are off leptin is going to be off inflammation, yada, yada, yada. It's all goes together. So, first and foremost, find something that can help bring your stress management down, do activities that you love doing. Vacations help with their short term, you know, so adaptogens are my go to I love adaptogens

Dr. Stephanie Gray 34:15

What are your favorite, which ones to use when

Dr. Bindiya Gandhi 34:17

I love ashwagandha Ashwagandha is my favorite. I will talk about ashwagandha all day because it does so many wonderful things. So that's my personal favorite. Again, not everybody's a candidate for ashwagandha. But talk to your practitioner about that to see if it's if it's good for you. But if you could learn how to manage stress, so many positive impacts and changes happen from that. Awesome, awesome. Well tell us again where your leptin quiz is and what your websites are and kind of where listeners can find you. So definitely take my quiz. It's at Dr. Binda md.com forward slash quiz. So it's Dr. B I N D I Y amd.com Ford slash quiz. You can get a free download at Atlanta weight loss doctor.com. So it's at L A N ta W

E IG HT Lss d oc.com. We Atlanta, weightless dr.com. Just click on the link, and you'll get a free download of how to roll up your metabolism. And those things really work, I promise.

Dr. Stephanie Gray 35:12

Hey, I'll check that out myself. Well tell us your top longevity tip, they had to pick one.

Dr. Bindiya Gandhi 35:17

So I had to pick one that probably already said this before, but I'm gonna say it again, manage your stress, you've got to learn how to manage your stress. Stress, unfortunately, can be the reason why you have a heart attack. It's the reason why you're depressed. It can be the reason why you have an autoimmune condition. So learn how to manage stress. So many of us, myself included, we've been exposed to trauma we've been we've dealt with hurt, grief, so many different things. And we kind of have to get to the root cause of this stuff. So learn how to manage stress, whether it's lifestyle changes, therapy, meditation, yoga, adaptogens, quitting your job, getting divorced, whatever, whatever you need to do seriously, manage stress, because if you never manage stress, you're just causing a whole slew of other problems that are going to be like snowballing into effect. So learn how to manage stress and you will live longer and you will have a more fulfilled and joyful, happy life.

Absolutely agree. Thank you so much. Thanks for coming on the show today and really sharing how important identifying and treating leptin resistance is. I'm sure my listeners will get a lot out of this great topic for January.

Thanks so much. Thank you so much, Stephanie.

Dr. Stephanie Gray 36:25

Great topic for this time of year. If you haven't had your leptin levels checked, consider having this done and also be sure to take her left and quiz link of which will be posted in the show notes.

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The information provided in this podcast is educational no information provided should be considered to be or used as a substitute for medical advice, diagnosis or treatment. Always consult with your personal medical authority.