Episode Transcript
[00:00:01] Welcome to Anti Aging Unraveled, the podcast where we redefine aging and empower you to age your way.
[00:00:08] I'm Dr. Laurie and this show is rooted in the lifeevity philosophy. Living life the way you want to with energy, clarity, purpose and longevity. Here we break down integrative functional medicine, bioidentical hormones, peptides, metabolic and brain health, gut immune connection, and cutting edge longevity therapies. So you're not just living long, longer, you're living better.
[00:00:34] If you believe aging should be intentional, personalized and on your terms, you're in the right place. Welcome to Anti Aging Unraveled. Let's unlock longevity and help you age your way.
[00:00:47] Welcome to my Anti Aging Unraveled podcast followers. I'm so glad to be here with another podcast for you all and this one is a fun one and it's exciting and it's talked about a lot right now. And and that is the benefit and use of GLP1s not just for weight loss anymore.
[00:01:06] So we are going to dive into the fact that they are anti inflammatory, heart protective, brain balancing help with sleep and just an overall metabolic booster. So decreases inflammation in the body, but it also helps to detoxify. It has some great benefits. And I know that everyone thinks and talks about GLP1s being for weight loss and I'd like to say that it's kind of like using the analogy that a smartphone is just from making cell phone calls. It really has so many things that it signals on a regular basis, but not only that, that signaling trickles down because we know how important sugars and insulin response are on the whole entire rest of the body. So it affects inflammation, heart disease, cholesterol, immune balance, and even brain chemistry, which we're going to dive into today.
[00:01:54] And we're really going to talk about why personalization of dosing matters. And it's not really about pharma company versus Compounded. It's about realizing that in pharma they have to dose and make their dosing parameters very specific to get approvals from the FDA process. And by doing so they have to have auto injector pens and set formulations. Whereas in the compounding world we can do it a little differently with vials and microdosing and really dosing according to what we're trying to treat and what we're seeing clinically works. So we're using the least amount that we can get our hands on to work effectively as opposed to sometimes with the pharma companies where we try to push a drug that maybe is for weight loss, where we're seeing benefits for inflammation. But the dose is too high in these pens and the way that it's currently manufactured. So I want to really kind of dive into the personalization that functional integrative medicine is able to accomplish with these compounded GLP1s as opposed to using a pen dosing scale. All right, so first thing we're going to talk about is inflammation and how GLP1s are an anti inflammatory therapy. And it's one of the biggest benefits, I think, because really just controlling that insulin response, it's a natural gut hormone released right after meals in this, in the gut, at the GLP1, when signaling properly, it actually improves insulin sensitivity, reduces insulin production and actually lowers the inflammatory cytokine production. So actually the cells that call in inflammatory cells, but when you have chronically high insulin, that's turned on all the time. So we have this chronic inflammatory response which over time can stimulate the immune system to be overactive downstream. Which we're going to talk about next is autoimmunity. So just in controlling these sugars and controlling the inflammation from an insulin perspective, we are actually modulating the whole inflammatory response cascade. So it's really interesting and I think that you're going to see that some of these trials actually also suggest that even on laboratory findings, we're decreasing that inflammatory cascade. For example crp, which is a generalized inflammatory marker, we're seeing that go down in some of these trials, specifically the select trial, looking at systemic inflammation lowering labs. We're also talking about lowering triglycerides, apob, which is sticky dense cholesterol liver enzymes, getting rid of some of that fatty liver insulin being high and sugars being high allows sugar to get stored around our liver and that creates organ fat or belly fat. And that is actually a higher risk of metabolic dysfunction. So we also wanna decrease that. And it's showing that those ALT and ASTs, those fatty liver numbers go down.
[00:04:39] Ferritin is another reaction that comes from elevated inflammation that's going down. Cytokines, cells that call in the troops, they call in other cells for inflammation, which are IL6 TNL alpha, they're going down. So again, you know, I love to test and don't guess those numbers are huge to see that in some of these studies that these numbers are going down. What do people notice when they go on low dose GLPs for inflammation?
[00:05:04] Less puffy, joint stiffness goes down, their fatigue is less, their brain fog is clearer. So again, talk about teasing apart some of these hormonal pictures from inflammation. We get some of these benefits just by putting you on a low dose GLP1. Skin rashes and skin inflammation goes down. Like I talked about some fatty liver disease, even some osteoarthritis from some of the systemic metabolic inflammation can go down. So we're seeing, you know, again, all of these reduction in symptoms and numbers with data just from low microdose GLP1s, not at the doses that are so high for weight loss. Why? Because we want to have no side effects. We want people to still lose weight and take an adequate protein and not be in a protein starved state so they don't lose muscle mass. But we want just enough for the anti inflammatory benefit, which is a much lower dose than what you're getting from some of the diet dosing with the GLP1 pen. So this is about metabolic regulation and not only about appetite shutdown. Right? We want to have that fine line. So let's take this a step further. Let's talk about autoimmune and immune balancing. We know that the gut is the driver of the immune system and autoimmunity in the, in the body is one huge driver. So again, just that insulin response and getting those sugars lower decreases the inflammatory signaling pathway and reduces the triggers on the gut over a long term. It reduces visceral fat, the b, the belly fat and that liver organ fat, it lowers leptin resistance, which actually helps us to get full. So we're able to actually tell our bodies, hey, we have enough, right? It improves again that insulin signaling, but it decreases that cellular and immune activation. So our body is not thinking as many things are foreign. That immune system on the other side of the gut is not constantly being triggered towards foreign activation. So we get a decrease in our body's confusion because when our body's immune system is overburdened, it gets confused and we become autoimmune. Okay, so decre sed rates, which is again another inflammatory marker that we can see in labs. Again, that crp, it's again another generalized inflammation marker. We're going to talk ad nauseam about insulin, but reducing that insulin helps that inflammatory response to go down and then subsequently the autoimmune and the immune system regulation. So when we have less immune triggers chronically, our immune system can actually work on what it really needs to work on, which is balance. All right, what do we see clinically? Fewer flares of autoimmune disease, Lower auto antibodies like thyroid antibodies, less swelling, better recovery, more stable energy, a much kind of smoother energy response. And we're seeing this in many conditions. But rheumatoid arthritis, with some metabolic overlap or not psoriatic arthritis or psoriasis, inflammatory bowel disease. You're going to see a ton of ongoing research on inflammatory bowel disease. Even just clinically with my patients, I see a huge reduction in symptoms. With my inflammatory bowel patients, especially at micro doses, I don't want to dose them so much that their bowels slowed down, but I want to actually do it so that their inflammation is cut in half. Autoimmune, thyroid disease and autoimmune flares of any kind, even if it's musculoskeletal, the air quotes, fibromyalgia patients, we're seeing a lot of that flare activity go down again. But this goes down to a low dose, small personalized dosing scale. When you get too high of a dose, it actually can work to our detriment, and the dose can be too fast, it can stress the system. Cortisol can be a little bit aggravated, and that can honestly, if it worsens fatigue for an autoimmune patient, they're not going to be happy, especially when their sugars are too low or if they're too exhausted. And especially for nutrient intake in these patients, we need to make sure they're getting a good, adequate nutrient density. So we want to make sure that we're getting immune balance and not complete metabolic burnout. So keeping those doses low and going slow with a micro dose is key. This is probably one of the more exciting. The next we're going to talk about is our part three, which is our heart and lipid protection. This is where GLP1 probably has some of the strongest data right now. And it's probably the furthest along because we know that GLP1 receptors are in blood vessels and in the heart. So because they are located there, we know that the inside lining of those blood vessels, the endothelial function actually improves. It gets less irritated, it's actually more elastic, it actually is more responsive. It also dilates those blood vessels, gives better blood flow by increasing nitric oxide, reduces the inflammation inside the vessel and it lowers the stress, the oxidative stress inside those vessels. So oxidative stress is actually what starts to make plaque unstable, especially from a coronary artery or vascular disease process. So if we can reduce that inflammatory process and oxidative stress, we're going to give you some cardiovascular protection and we're going to actually stabilize plaque, improve the endothelium on the inside of the blood vessel dilate those blood vessels, bring your blood pressure down and actually improve blood flow for not only cardiovascularly but peripheral vascular disease. So, you know, for veins as well, you know, for legs, for people that have intermittent claudication and peripheral vascular disease in the legs and the feet, it can actually improve that as well. You know, I love my numbers. So what are we seeing reductions in from some of the data, we're seeing triglycerides go down, little sticky dense particles called LDL and APOB cholesterol go down because APOB is a genetic variant, obviously fasting insulins and blood pressure is going down. So what we're, what are we fixing here? We're helping with arteriosclerotic cardiovascular disease, coronary artery disease risk factors, we're modifying that and bringing them down. We're lowering triglycerides and improving metabolic syndromes. We're making those sticky dense particles, those LDL and APOB's, less sticky, less dense and in a better profile and less honestly oxidized. We're decreasing that hypertension, which is actually linked to insulin resistance as well. And cardiovascular disease, we know is part of our triad, we're bringing that down. And we're helping with type 2 diabetes risk, obviously because we're bringing down sugars and insulin. So again, this is where dosing matters as well. And I actually have seen cholesterol go up transiently from GLP1s, especially when you advance their dose too quickly because the liver can't actually, actually metabolize the lipids quick enough. So I do find that the lowest effective dose is the best way to go with these, especially if we're trying to reduce vascular inflammation and avoid muscle loss. Because in these patients, muscle is really important. We need to maintain their muscle in the aging population. So we're focusing on cardiac protection now. If we need to get weight off, obviously we can escalate that dose and then de escalate, just like with, for inflammation and autoimmunity. We can escalate to lose weight and then de escalate to level off and maintain pain. All right, because we want to maintain that low level anti inflammatory benefit, but also this cardiovascular benefit and lipid lowering effect. All right, and we're seeing tons of data on this. This is not just anecdotal. I think most physicians and cardiologists will agree that GLP1s are probably one of the best things that have come out in the area of cardiovascular disease and prevention for mortality and morbidity improvement in the last probably 15 to 20 years.
[00:12:31] So let's talk about what I think is one of the more interesting, helpful things for a GLP1, which is brain, mood and addiction pathways, and sleep for that matter. So we're gonna talk a little bit about how actually we'll talk about sleep second. We'll talk about brain and mood first and how this works. So GLP receptors are deeply involved in the brain's reward and impulse systems.
[00:12:55] So think about it like kind of like an SSRI or a medication that you would take to raise serotonin, but it acts in the hypothetical thalamus and on the dopamine pathways. So the feel good pathways. Right. So what we know is that it actually reduces food noise by actually kind of putting these blinders on you. And we know that that works. And that's one of the reasons GLP1s work for weight loss. But it also works because it improves satiety and fullness with leptin pathways and dopamine, that positive reinforcement pathway, and it decreases the reward driven cravings, stabilizes stress and emotional eating habits.
[00:13:30] So we are seeing such a shift in people's thought process around food. Instead of using it as a social event, you're using it as a sustenance event. Right. They eat when they're hungry, they eat when they need it, not because they crave it or have to have it. Same thing with alcohol. We're seeing emerging research, and we have been for quite some time on the reduction of alcohol cravings and compulsive behavior. We know that neuroinflammation, gut inflammation, insulin response can be linked to mood disorder. But now we're seeing if we can calm down that neuroinflammation by calming down the whole entire inflammatory pathway, we can actually help some mood disorder. With these GLP1s we're seeing, patients are seeing lower anxiety, especially around food. Fewer binges, reduced alcohol, improved focus. When you have a more stable insulin and sugar response, you're going to have a more stable focus anyway. But now we're seeing neuroinflammation decrease. And we're seeing that on top of stable sugar levels, we're getting much more focus for the ADHD people.
[00:14:32] And even my people that are hormonal, that are still having trouble with despite progesterone with that brain fog, I'm seeing a huge improvement with GLP1s stable mood. And what are we still studying this for? Well, I will tell you, the early research is really positive for alcohol abuse and other drug abuse disorders and compulsive eating disorder behaviors. Mood instability. We talked a little bit, but I think that that's going to be emerging because we know that it does play a role with this dopamine response and the pleasure center.
[00:15:02] And obviously insulin dependent or insulin resistant associated cognitive fog. I see this all the time in my patients that eat sugar and then get hypoglycemic right after their sugars drop and they get these fog episodes and we need to keep them on a lower carb or kind of a resistant starch diet and keep them more level.
[00:15:22] We're seeing that with these GLP1s that we can keep that brain fog and that brain energy level much more even.
[00:15:28] Again, as I'm concluding all these sections, it goes back to dosing. Dosing matters especially for brain because I can tell you at too high of a dose, you drop the sugars too significantly and the brain does not want to work off of a low glucose state very quickly, especially up front. Because if anyone's gone on a keto diet, we know what that keto fog feels like. That can be very persistent and you can get very lethargic and sometimes people don't get used to it and it can be a problem. So I will tell you that low and slow is the way to go for doing this for mood or brain. And then likewise, once the weight is off, I would 100% recommend going and titrating down to the lowest amount possible to keep those blinders on so that you still have that, that food balance and you don't want the cravings anymore, but that you're not breaking down muscle mass and you can start to actually build back up lean muscle and have a nice metabolism that's robust. So we want brain balance, not burnout and side effect profile. Which again is why I really do believe in. If you are going up in dose, dropping down to that lowest minimum dose, we need to kind of. And actually duration, sometimes it's spreading that out over two weeks, maybe even a month. These are very long acting drugs and they are very. They're like this. The light switch will turn on for quite some time in some people. So you don't need a lot of it to get a good response. Okay, now let's take that a step farther to. We'll keep on the energy wagon here, but let's talk about sleep and true metabolic flexibility.
[00:16:55] Resetting that metabolism, I think is part of what we miss talking about with this.
[00:17:00] But sleep is a big one as well because we need to be able to turn that brain off. And when insulin and sugars are not stable, the whole metabolic rhythm is disrupted. Right? So when you stabilize inflammation and you bring it down, you actually improve metabolic rhythm and that improves cortisol, sleep, melatonin, all the things that help us to kind of relax our brain, which we talked about a little bit earlier. On the last section, GLP1s are going to give you fat burning in between meals, which is going to give you a higher metabolic flexibility. It's kind of like, you know, we talk about hiit workouts, right? And these workouts that are going to keep you burning longer. That's one of the huge important roles of GLP1s. You're burning for a longer period of time, your mitochondria are more efficient, so your powerhouses of your cells are actually working more efficiently again. If we can train them to work better and be more appropriate, then you're going to lose weight and then we can hopefully try to whittle that down to a low enough level where we can maintain that effect.
[00:17:55] And sometimes it's putting back other things like NAD and other peptides. But we want to make sure we're keeping your system metabolically flexible and we're not stuck in this high insulin, high glucose response pathway. We're also going to give you again this cortisol rhythm. We want a spike of cortisol in the morning and then have it go down as the day goes on. If we are not getting that cortisol spike and trough, we're not going to sleep appropriately and we're not going to have a good morning wake up.
[00:18:21] This is where that insulin and cortisol and sugar and all of that come into play. Because we need to start to find this rhythm of flexibility and we can get that with GLP1s. At low doses, we can absolutely achieve stability with blood sugar and cortisol rhythm. And then once you start sleeping, then everything else starts to get better as well. It's kind of like fixing the gut, right? You fix the gut, the immune system starts to get better, you fix the sugars, the inflammation goes down and now our cortisol starts to get regulated, we start to sleep and then the whole internal reset starts to work, right? Because that's what we want eventually, is that our body to reset itself. And what are we seeing? People sleeping through the night, not waking up in the middle of the night, able to fall asleep, More stable daytime energy, fewer crashes from sugars and glucose fluctuations, right? So that nice steady metabolic burn and less nighttime snacking. If you're not snacking at night, you're not getting those spikes in glucose before you go to bed and then those crashes in the middle of the night will also keep you awake. Okay, it can definitely keep you awake.
[00:19:25] So what can benefit from this? Well, obviously we know the obvious is the metabolic syndrome, the insulin resistance, the high sugars. But how about people that are just inappropriately spiking their sugars at the wrong times, middle of the night? I call this metabolic inflexibility, right, or metabolic resistance. It's basically like insulin is being released at inappropriate times or lack thereof. We want to make sure that these people, they're having trouble losing weight, but you never see it on their blood work, right? So sometimes actually testing or having a glucose monitor really helps because I'll see their spiking in the middle of the night for no reason.
[00:19:58] That reactive hypoglycemia, we talked a little bit about that. Low blood sugar, we see that get fixed, chronic fatigue during the day because of low sugars or instability.
[00:20:08] And again, that nighttime spike or swings in glucose is huge. And we don't really think about it. But when you have a low dose GLP1, you don't get that fluctuation.
[00:20:18] So again, it goes back to dose, right? We know that you need low doses for this.
[00:20:23] Once you start getting too high, then again we get back into, am I making you too low blood sugar? Are you having cortisol? Basically, stress, is your body too stressed? And we don't want that, especially when we get to metabolic flexibility. Once we get the weight off, we want to make sure that we're giving our body a chance to do it itself, okay? To fix it itself. And the only way we can actually sustain that or achieve that is to decrease this to a low enough level where our cortisol starts to self regulate. We're sleeping, we're doing the things on our own to create metabolic flexibility with the low dose GLP1. So whether that's putting back things that you're deficit in fixing thyroid, fixing other things around it, we really want to make sure that they're all set and then we get you down to a low enough level possible with the glp. So, you know, what I talked about today is really about balance. Again, I'm not talking about like pharmaceutical company being bad, compounded being good. It's about personalization of protocol and dough.
[00:21:22] And we don't have that flexibility with the pharmaceutical pen dosing. They're designed for trials, they're designed for FDA approvals for a given condition. And some people thrive there. And they're great There. And listen, you're getting it paid for there. I totally understand that. But most do better with slower titration, slower dose adjustments and finding the lowest effective metabolic dose for what we're trying to achieve. And GLP1 should support physiology, not overwhelm it and drive it to the other extreme.
[00:21:51] So, you know, our big picture takeaway here are they're not just weight loss medications, GLP1s, they're metabolic signaling therapies that lower inflammation, support immune balance, protect the heart, our peripheral vascular disease, all kinds of vasculature, lower hypertension, improve lipids, improve liver function and fatty liver, stabilizes the brain and mood. Right. Helps with focus, brain fog and sleep, reduces cravings and impulsive behaviors, addiction or otherwise. Right. So. So I do find that for my ADHD patients, they actually love being on a GLP one because they can focus so much more efficiently. And weight loss is just the visible side effects of deeper metabolic healing and obviously an advanced dose. We want the weight loss because the weight loss does give us some of that benefit. So, yes, do we need the weight loss? Yes. But we can always back off to the minimum dose needed to keep these inflammatory pictures and these autoimmune pictures and this cardiovascular help in check and in play without going overboard in longevity medicine. It's not just about the highest dose for us. Right. It's about the right dose for your biology and that's how we keep you truly aging your way. Right. That's why you listen to this podcast. So, you know, I would love to have you guys ask me more questions about this. Of course we do low dose GLP1s. We are very concrete in how we do them. We have an intake process. You go right to our website, you can fill out an intake, you'll meet with one of our providers and you'll just discuss how GLP1s are best for you. We will do all the lab work necessary. I am a big tester, a nut guesser, you know, that's one of my mottos on this program. So we will do labs and we will see how is the best way for you to use GLP1s or other peptides to get the best metabolic response and physiology and version of you possible. So I hope you guys like this podcast. Feel free to go to my website, mydrlori.com and fill out that intake.
[00:23:45] Follow me on YouTube. Share this with your friends if you know somebody that you think would be interested and join me for my next episode of Anti Aging Unraveled. Thanks everyone.
[00:23:54] Thanks for joining me on this episode of Anti Aging Unraveled, where longevity is personal and you're empowered to age your way. If you found today's episode helpful, be sure to subscribe to the podcast or our YouTube channel, Anti Aging Unraveled. And, of course, follow us on social for more tools, insights, and conversations rooted in lifeevity philosophy. Living life the way you want to take your next step? Visit mydrlori.com, click Get Started now and fill out your wellness or weight loss intake to begin your personalized longevity journey. Until next time, keep living with intention, vitality, and purpose. Here's to longevity, lifeevity, and aging your way.
