Podcast 33 - What is Insulin? (Part 1 of 3)


Dr. Chad Edwards: This is Dr. Chad Edwards and you’re listening to podcast number 33 of Against the Grain.

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Welcome to Against the Grain podcast with Dr. Chad Edwards where he challenges the status quo when it comes to medicine. We get into hot topics in the medical field with real stories from real patients to help you on your way to a healthy lifestyle. Get ready because we’re about to go Against the Grain.

Marshall Morris: Hello, hello this is Marshall Morris and today I am joined by Dr. Chad Edwards who believes that eighty percent of medical recommendations are crap technically speaking here and he is the author of Revolutionize your Health with Customized Supplements and he served in the U.S. Army for 23 years as both an enlisted soldier and as an officer as a physician. He graduated medical school at Oklahoma State University and he is the founder of revolutionhealth.org and the Against the Green podcast. Dr. Edwards thanks so much for joining us today Tulsa prolotherapy.

Dr. Edward: Always a pleasure, always excited to be here.

Marshall: I was just thinking I just feel incredible today and I’m pumped to be get into this podcast episode.

Dr. Edwards: As I was like preparing this I was just thinking you know this is such a boring topic. But in reality it matters so much to so many people it’s just like what’s going on behind the scenes for so many different issues. We’re actually going to break this out into a three part series. We’re going to do part one today is going to be just some of–I don’t want to say about chemistry because I don’t want people to shut down and not pay attention but just kind of what’s the physiology? What is this stuff?

Then we’re going to go into the pathology meaning, what’s the disease process what’s the step two and the third part which is what I really want to get into is. How the gut micro biome the bacteria in your gut, how it influences this whole thing and how it influences weight loss and how it– that’s going to be like the home run. But you’ve got to get the guy down first and second before you can get that grand slam. So that’s what we’re doing.

This topic today we’re going to be talking about insulin and the effects of insulin.

Marshall: Hot topic there.

Dr. Edwards: Exactly and it sounds really creeping right? But I think if our listeners will understand insulin then it helps you understand diabetes, it helps you understand both Type 1 and Type 2 and why there’s a difference in those kinds of things. But then it’ll also help you understand why you can’t lose weight. You go get on a treadmill and you run for twenty minutes and you’re like, “I’m doing all these things and I can’t lose weight,” and this is one reason why so I think its important understand that whole concept and what insulin does Tulsa prolotherapy.

Marshall: So let’s get into it. What is insulin? What’s the function of it and why do we need it? Why is it important?

Dr. Edwards: So insulin is absolutely a life critical hormone. It’s a hormone released from specific cells in your pancreas and they’re called the beta cells. Now in Type 1 diabetes- we’ve talked about this before-in Type 1 diabetes you have an auto immune destruction meaning your immune system attacks the cells for some reason a those cells are no longer able to make insulin or kill off the cells. Type 1 diabetes is a deficiency of insulin.

When you see Type 1 diabetics you tend to see a slimmer patient that has lost weight. They’re always thirsty, they’re always having to pee go to the bathroom. But it’s that weight loss that skinny appearance and why is that the case? Then with a Type 2 diabetic they tend to be a little more obese have extra body fat. There’s certain characteristics that go along with it but these are generalities and the patients don’t necessarily like we often say the patient doesn’t always read the book Tulsa prolotherapy.

So even though we like to describe it this way you have to understand the physiology and it changes how we’re going to treat that patient. So Type 2 diabetics have I won’t say excess of insulin but they have more insulin than normal physiology but that insulin doesn’t work. So when you think about a hormone which is what insulin is. A hormone is a chemical that’s released from one part of the body and it goes to another part of the body and it binds to a receptor and that receptor when it’s activated it causes a whole host of changes inside the cell.

So insulin specifically does a lot of things. It does so many more things than just regulate your blood sugar. So one of the things that it does is when it binds to the receptor on most of our cells like our muscle cells and things like that it causes a release- I guess that’s probably the best way- but a release of these glucose transporters and these transporters will bind to the cell membrane and allow glucose to be taken into the cell and with the exception of exercise glucose almost can’t get into the cell without that insulin mediated glucose transporter.

So it helps keep our blood sugar at a very normal and tight range. That part makes sense. I think that’s how–I think most people can put their head around that. But insulin also does another very important function and it does far more than one function but basically if you think about insulin as the storage hormone. It’s the hormone that puts stuff away. You’re saving for a rainy day. That’s what insulin does. So when patients are trying to–whether they’re overweight they’re trying to lose weight all those things, what’s going on there?

When you look at American diet we eat horrible. The junk in our food. Our food is not just plain old simple single ingredient stuff we don’t get clean for the most part. Some of our listeners maybe eat just incredibly clean but your average American-

Marshall: It’s super hard to eat incredibly clean.

Dr. Edward: It really is I mean you need to shop at a local farmer’s market and basically from the farmer to the table thing, we don’t do that. Even whole foods and things like that you pick up the box and you read the back it’s got multo dextrin and zenthin gum and all these F D.N.C. yellow number five and all these kinds of things and it’s difficult, very difficult to get–in fact I’d challenge you go– anything that you get from the supermarket that’s in a box. Try and find something that only has three ingredients Tulsa prolotherapy.

It is so completely rare. Even you know beef jerky has like and it’s supposed to be just beef, like beef and salt and those kinds of smoked flavoring or something again that’s not normal or natural they add that in for that smoked flavor. But it’s just difficult to eat clean and we and we know that. So the kind of foods that we’re eating causes a whole host of problems and eating too many carbohydrates stimulate you’re kind of bombarding your cells. Let me step back just a little bit and let’s talk a little bit about how overall kind of the normal effect so.

When you eat a meal – and we may have talked about this on another podcast but I want to make sure we drive this home – when you eat a meal you eat carbohydrates the carbohydrates the destination of those carbohydrates is your– you get the blood sugar in your blood sugar, you get the glucose in blood sugar goes up insulin is going to come in and try and regulate tells that stuff where to go. So the first thing or one of the things it’s going to do is replenish your muscle glycogen. Glycogen is a storage form of glucose. It’s a chain and you link all these things together.

You’re going to replenish your muscle glycogen, you’re going to replenish your liver glycogen and then all of the rest of that stuff gets converted to fat. So when you think about someone that’s basically a couch potato and they don’t really do much other than they get up and they walk to the refrigerator and they get whatever it is that they’re getting and then they go and sit back down and they watch T.V. all day long. Or even if you work at a job and you’re but you’re sedentary you’re not real active if you’re using a fit better or a pedometer or one of those things and you’re only getting 3000 steps a day, you’re not really active. You’re not really doing much. So you’re not utilizing your muscle glycogen to a significant extent at all. So if the tank holds 10 and you drop it down to nine or eight.

Because there’s other fuel sources that you’re utilizing those kinds of conditions. When you only drop it down to like an eight, you only have to fill from eight to 10. The insulin is going to drive that glucose in to replenish that muscle glycogen. Now, if you are very active, if you went for a run, you might deplete your muscle glycogen from 10 down to two. Well now it goes from two to ten fill it and you got eight that’s got to go in there. There’s a bigger difference. Same thing in your liver, you’re going to replenish the liver glycogen and then the rest of that stuff goes to fat, period. I mean that’s the way the bio-chemistry works Tulsa prolotherapy.

You can only do so much and insulin’s job is to normalize that blood sugar. If you can’t convert all of that stuff to fat then, your blood sugar goes up and the glucose molecule, I know we’ve talked about this before when we talked about Hemoglobin A1c in the previous podcast and that glycation or what we call Advanced Glycation end products are it’s almost like rust inside your body.

Glucose is a toxic molecule when it goes too high. You don’t want that. You have to have insulin to regulate that stuff so it’s an important, critical hormone. But you’re driving glucose into fat, normal physiology. If you eat too many carbs, if you don’t exercise enough, you’re going to drive more into fat. It’s such a simple way that it is. After we come back, let’s talk a little bit about why this is a more of a problem and why some people can’t lose weight, those kinds of things.

Marshall: Yes, we’ll take a quick break. Now, that we have the set-up for insulin, we’ll come back and talk about why it’s on-going problem for a lot of people. Cool.

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Marshall: Okay and we are back here with Dr. Chad Edwards. We’re talking about insulin and why it’s a problem for diabetics and really a lot of people in general and how insulin really affects the entire body and what we put into our bodies contributes to that. Dr. Edwards, why is insulin a problem and what can we be doing alternatively help the body use insulin, regulate insulin, regulate glucose?

Chad: Sure, to be clear. Insulin is not a problem. Although it’s a problem for many people.

Marshall: Itself is not a problem.

Chad: Correct. You have to have it. It’s vital. You need it from starvation, sustainability, you have to have this stuff. Without it, you will die. Before we had animal insulin that we could give humans, people died of diabetes. Not as soon as they are diagnosed but shortly thereafter. Nowadays, we got things that we can give so people don’t die because they don’t have any insulin. It is but Type 1 Diabetics that don’t take their insulin. We see it all the time.

Marshall: True.

Chad: It is awful and that is a condition that I would not want to have. Insulin like I said it normalized blood sugar but basically it stores things. It also helps flip the switch on what sources of energy you are going to utilize. What fuel source you’re going to utilize. People that want to lose weight, this is fundamental to why many people can’t lose weight. It’s insulin resistance, inflammation, gut micro biome which plays in all these and we’ll get into that in the third part of this series and how the hormones play into this and how there’s what we call, insulin sensitivity.

If you have insulin resistance or a lack of sensitivity then, you have a lot of insulin and these tissue- we talked about muscle, we talked about liver, we talked about adipose or fat cells – and each of one of them will have a different level of insulin resistance. The insulin hormone comes out, binds into its receptor and it’s just not working and if that’s the case, then, you got to consider something like chromium because chromium is required for insulin to work with that receptor and if you’re chromium deficient then, you can have trouble with insulin and its sensitivity.

Some patients benefit traumatically from a chromium supplement and I talk about this on the website, revolutionhealth.org and you can just Google, search you get revolution chromium. Just search for that on the bar there and there’s some post on chromium and things like that. One thing to consider. But insulin will flip the switch on, are you going to burn fat? Are you going to burn carbohydrate or glucose as your energy source? It’s all in the ratio of insulin and glucagon and glucagon is almost the anti-insulin, also secreted from pancreas. But it raises blood sugar. It gets blood sugar up. Several hormones do that as well. Cortisol, [unintelligible 00:15:57] means like epinephrine and those kinds of things are also going to be involved in getting blood sugar levels up.

People don’t– by the way, some people get concerned about their blood sugar being too high especially in diabetes that is a long term problem not so much a short term problem. Blood sugar being too low is a short term problem, you can die overnight of not enough blood sugar. That’s an important piece to understand. As we treat diabetics, it’s why we only go especially the Type 1 diabetic on insulin will only go, I am less aggressive on my Hemoglobin A1c. If I’m getting it between six and six and a half and that’s being very aggressive and you had to be very careful on those patients that if you give them too much insulin, their blood sugar goes too low. You got to be very, very careful because that can kill them.

Marshall: There’s definitely a side that you want to air on.

Chad: Absolutely. I would rather have a little too much than a lot too little. You got to be very careful. In the periphery of your physiology in the fat cells. So insulin flips the switch so that you actually activate hormones that will store fats. They will get this triglycerides that are made in the liver because of the influence of insulin and insulin almost grabbing a hold of all of those triglycerides that are floating around your blood and stick them into fat cells and that fat cell is then growing and that’s your storage of energy. When you get your lipids, your cholesterol measured one component of that is triglycerides.

When a patient comes in to me and they have elevated triglycerides, the very first thing I look at is what is their blood sugar? How are they handling their blood sugar? What’s their insulin sensitivity? When they’re in the 200 and 300’s on their triglycerides which is too high, if you’re fasting, your triglycerides need to be less than a 100, non-fasting less than 150 is my goal. If you’ve got too much of that then, to me, the first thing I’m going to look at is there a blood sugar insulin problem and from a functional medicine perspective that’s what we’re going to look at. It’s not a medication deficiency, it’s physiology problem.

There are other reasons that your triglycerides could be elevated and beyond the scope of this particular podcast. We’ll talk about that more in the future. That’s the first thing I look and it has to do again with that insulin, glucagon ratio and too much insulin floating around, driving these carbohydrates into fat cells. When we eat too many carbohydrates, you’ve got insulin floating around, we start developing some insulin resistance. Insulin resistance occurs at different rates in different tissues. The muscle cells can only hold so much glycogen. The liver cells can only hold so much glycogen so that absolute remainder of any carbohydrate that you eat is going to go to fat.

Now, the other piece of that is if you go out to exercise. Since insulin levels that ratio of insulin and glucagon is what triggers these hormones to store or release fat when you have insulin resistance and too much insulin floating around which is fairly common, we measure that in our clinic. You had too much insulin floating around and you go out and you do a 20 mile or 20 minute walk, jog, whatever, you may spend 15 and even 20 minutes of that, you may spend with the entire thing depending on what you got going on, getting your blood sugar down a little bit and letting your insulin levels because insulin usually follows glucose, getting your insulin levels down to a point that the switch flips and now, you’re able to mobilize fats.

You may actually only be burning fat for two minutes of that 20 minute walk or jog and if you’ve got profound insulin resistance, then it maybe longer than that. Many of our patients will go out and exercise and they’re not getting anywhere. I’m not losing any fat. They’re burning calories but they’re not losing fat. And it’s because the machinery is not — if you got two fuel tanks; one of them burns glucose and one of them burns fat and the switch is flipped, you can’t get into that auxiliary tank. It’s just not going to happen. You got to let those hormones balance.

One of the things we look at in our patients is that insulin component. What are their insulin levels? What’s their insulin resistance and how is that playing into their ability to lose weight? That hormone is incredibly important and we’re going to talk more about that and the disease processes in the next podcast.

Marshal: So the introduction to insulin — correct me if I’m wrong but it sounds like, you’re seeing patients who come to you with a problem, “Hey! I’ve tried x, y and z medication, dietary and my doctor say that there’s nothing wrong. Superficial. They’ve examined me and I can’t lose weight. Or I’m not diabetic.” Or a whole host of things that nothing appears to be wrong but really there could be some underlying hormone issues especially as it relates to insulin that could be — maybe something’s out of balance or there’s insulin resistance in the body that’s not allowing the body to actually lose weight.

Dr. Edwards: Absolutely. When you consider that most — I was trained, that I didn’t really care about their blood glucose and handling of all of those things and I was a Exercise Physiology Major. So I spent a lot of time looking at cellular energy production and I didn’t care about this until their Hemoglobin A1c got above 6.5. Until their fasting levels, fasting blood sugars were above 126 on two repeated labs. By the time you get to that point, you have a disease. Most of my patients that come to see me don’t have a disease. They’re physiology is beginning to crumble a little bit but they don’t have the disease. So it’s that — I’ll call it a gray area. It’s not a gray area but it’s where you go to your doctor and they measure and they’re like, “Well, you’re not a diabetic.”

We want optimal physiology, period and these people don’t have optimal physiology. They may not be diabetic but it’s just crap that we don’t consider the underlying, “How is this physiology working?” It’s a paradigm shift in the way we think about physiology and the way we evaluate that patient’s physiology it’s not — we’re not looking for disease. We’re looking for optimal health. I know it sounds like it’s not that big of a difference but it’s a dramatic difference in the way we evaluate and we treat our patients because we’re looking optimal and not disease.

Marshal: That’s the whole idea behind Revolution Health. We’re trying to get the body to optimal performance. Optimal physiology.

Dr. Edwards: Absolutely.

Marshal: Okay. So this is the beginning of a three-part series on insulin and some underlying diseases associated with it. In the next episode, we’re going to get into that. For today, Dr. Edwards, thank you so much for joining us.

Dr. Edwards: Until next time. Thanks Marshal.

Marshal: Until next time.

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