Six weeks of healthy eating alone are enough to heal chronic symptoms for many people. As you have added in supplements, relaxation techniques, and exercise, and you have begun eliminating toxins from your environment, I am sure you have seen additional improvements in your health. If you are in the 80 percent of people who have great results in the first six weeks of the program, then that is all you will need to follow. But if you don’t feel better, or haven’t lost weight, or your blood sugar is not in better balance, then you may be in the 20 percent who have deeper imbalances in the seven core systems of your body. This chapter will guide you through a process of finding your unique imbalances and correcting them. It is the closest you can come to being treated by a functional medicine doctor without actually seeing one.
I will help you personalize The Blood Sugar Solution program with additional steps I call self-care. For most people, that will be enough. However, some will need to follow up with medical care— further testing and treatment that I outline in How to Work with Your Doctor to Get What You Need at www.bloodsugarsolution.com.
Here’s how to personalize your self-care. The big secret is that most health problems don’t require the attention of a doctor. You can fix them yourself if you have the right information. By following these additional steps, you will experience a process I use successfully every day with my patients.
Go back to Part II of the book and take the diagnostic quizzes in each step now. If you took them before, take them again at this stage as it’s likely your healthy eating and lifestyle plan has already impacted your biology and you may not score the same way you did. You will use your current scores to personalize your plan. Here’s how:
Complete the quizzes, then note if you qualified for self-care or medical care in any of the body’s key systems.
Record your scores in the chart below.
Stay on The Blood Sugar Solution program for an additional six weeks as you integrate the steps in this chapter for the step (or steps) where your score still indicates self-care or medical care.
You may be surprised at how much your scores have changed in six short weeks. If so, this is a good indication you are on the road to healing.
However, if you do not see improvement in all areas, it may mean you have deeper imbalances that require a little extra help.
If your score for any step still indicates self-care or medical care, go to the relevant sections in this chapter. For example, if you scored above 7 on the Inflammation Quiz, you would go to “Step 3, Reduce Inflammation,” and add the steps outlined there to your plan. Try these additional steps for six weeks, then retake the quiz. If after this you still don’t see the results you want or you still qualify for medical care, it may be time to seek the help of a practitioner experienced in functional or integrative medicine. I have outlined some of the testing options and treatments you and your doctor might consider for each step. More information can be found in How to Work with Your Doctor to Get What You Need.
If you qualify for self-care or medical care in more than one step, simply stay on the program for an additional six weeks and add the recommendations for each step you scored high on. Start by addressing one step at a time in the order I note below. Add recommendations for each new step every three days.
Improve Your Digestion. The gut is often the source of health problems and inflammation. Start here and extraordinary results may occur.
Reduce Inflammation.
Boost Your Nutrition.
Maximize Detoxification.
Regulate Your Hormones.
Enhance Energy Metabolism.
Soothe Your Mind.
Though this process may take some time, I encourage you to follow these steps. The results are worth it.
In the sections that follow, there are further options for correcting key systems, including more intensive dietary changes, additional supplements, and even medication. I have kept my recommendations to a few suggestions for each step; however, further treatment could be carried out with the help of an experienced practitioner. Some advanced and innovative tests may be needed, and you may find that the average physician will not order them. How to Work with Your Doctor to Get What You Need, at www.bloodsugarsolution.com, will help you find the right practitioner and understand what additional tests or treatments may be needed.
Of course, we invite you to team up with our doctors, nutritionists, and health coaches at The UltraWellness Center in Lenox, Massachusetts (www.ultrawellnesscenter.com). We have been working together for 15 years to help thousands regain their health and solve complex chronic health problems.
Now, here are the steps you need to take to personalize the program and rebalance each of the seven steps.
The most important tool you have to heal yourself is your fork. Food is the most essential medicine. When used intelligently and deliberately, it is powerful enough to heal most chronic illnesses. Yet for some, even the healthiest diet may not be enough to overcome certain nutritional deficiencies.
The nutrition recommendations in Week 1—how, when, and what to eat—and the supplements outlined in Week 2 are designed to work together to heal diabesity.
However, for those whose score indicates they are deficient in omega-3 fats, vitamin D, or magnesium, more of the foods noted below should be included.
If you scored over 3 on the Magnesium Quiz, focus on eating the following foods.
Also, add one (not both) of the following:
Use magnesium citrate if you tend toward constipation (reduce the dose if you get loose bowels). Use magnesium glycinate if you have normal bowels or tend toward loose stools or diarrhea.
If you scored over 3 on the Vitamin D Quiz, eat more of the following:
Besides taking a supplement of vitamin D3, the best way to ensure adequate blood levels is to get 15 minutes of full-body sun exposure between 10 am and 2 p.m. daily, without sunscreen (although I would recommend sunscreen on your face). This works only in the summer, so I recommend you take additional vitamin D to optimize your level. Most people require an additional 2,000 to 5,000 units of vitamin D3 a day.
If you scored over 4 on the Essential Omega-3 Fats Quiz, make sure to include plenty of the following foods in your diet every day:
In addition to my recommendations in the basic or advanced supplement plan, add the following:
In Chapter 21, “Relax Your Mind, Heal Your Body,” I focused on how to get your stress hormones back in balance. Here we will focus on balancing the thyroid and sex hormones, critical for optimal weight and blood sugar balance.
Low thyroid function affects 1 in 10 men and 1 in 5 women, half of whom are not diagnosed. To make matters worse, many patients on thyroid hormone replacement are not adequately treated. If your thyroid is low, you can’t adequately balance your blood sugar and your cholesterol or lose weight. That is why using a whole-foods diet, nutritional supplements, and optimizing thyroid hormone replacement are critical in resolving diabesity.
If you scored over 3 on the Thyroid Quiz, boost your thyroid with the following foods:
Certain foods can potentially interfere with thyroid function. Gluten, for instance, can cause autoimmune thyroid disease. Luckily, this has already been eliminated as part of The Blood Sugar Solution.
Soy foods have been linked to problems in thyroid function. Studies show that when eaten in the traditional forms (tofu, tempeh, miso, edamame) and amounts, they have no effect on thyroid function.1 The real problem is with what I call FrankenSoy—a by-product of soybean oil extraction—which is made into soy hot dogs, protein bars, and other assorted junk food. Soy in this form has been shown to disrupt thyroid function. Avoid these foods.
I would also avoid fluoride2 because it competes with iodine during the production of thyroid hormones, leading to potential difficulties in thyroid production. Buy toothpaste that isn’t fluoridated and filter your water as outlined in Chapter 23.
Doctors do not always do complete testing for thyroid function. They check something called TSH but not other numbers such as free T3, free T4, and antithyroid antibodies. This means, they may miss subtle thyroid imbalances. And to treat imbalances, they use only the inactive thyroid hormone (T4) found in Synthroid or Levoxyl. Most people respond better to a combination of the active (T3) and inactive (T4) hormone called Armour thyroid.
Guidelines for effective thyroid testing and natural thyroid hormone replacement are provided in How to Work with Your Doctor to Get What You Need (www.bloodsugarsolution.com). If you have significant thyroid problems or are already on thyroid medication, I recommend that you read my report or watch my webinar on The UltraThyroid Solution (www.bloodsugarsolution.com/ultrathyroid).
If you scored over 9 if you are a woman and over 4 if you are a man on the Sex Hormones Imbalance Quiz, the following foods can help get the hormones back in balance for both men and women:
In addition to the basic supplement plan, women should take the following:
Men should take the following in addition to the basic supplement plan:
Sometimes bioidentical hormone treatment is necessary. I often recommend topical testosterone cream or gel for men with low testosterone levels. It helps them build up muscle, lose weight, improve insulin sensitivity, have more energy and a better sex drive, and better erections. In advanced diabesity, nerve or blood vessel damage can occur and medication such as Viagra can be helpful. Women also may benefit from additional support such as hormone replacement therapy. Guidelines for sex hormone testing and natural bioidentical hormone replacement are provided in How to Work with Your Doctor to Get What You Need.
The two biggest causes of inflammation that lead to diabesity are, first, our high-sugar, processed food, inflammatory diet, and sedentary lifestyle, and second, hidden food sensitivities or allergens, most commonly gluten and dairy. Remember the domino effect of sugar—it causes insulin to spike, which leads to the storage of belly fat. Those belly fat cells produce tons of inflammatory molecules that inflame your whole system, leading to more insulin resistance and weight gain. Environmental toxins and microbes and stress also trigger inflammation.
The Blood Sugar Solution is designed to be a powerful anti-inflammatory program. A whole-foods, low-sugar, high-omega-3 fat, phytonutrient-rich diet, exercise,4 multivitamins,5 fish oil, vitamin D, and stress reduction are all powerful natural anti-inflammatories.
But for some, inflammation will persist, and that means you need to hunt for the cause, either by yourself or with your doctor. The most common and obvious causes are diet and lack of exercise. But there are many factors, and at times specialized testing and treatment are needed to find hidden causes such as a virus, parasite, or bacteria that might not cause immediately obvious symptoms; mold in your surroundings (hidden in walls, in damp basements, or in moldy bathrooms); a medication you are taking, such as the birth control pill; or toxins such as mercury or pesticides.
If your Inflammation Quiz score was over 6, take the following additional steps:
If you qualified for medical care on your quiz, see How to Work with Your Doctor to Get What You Need (www.bloodsugarsolution.com) for further testing and treatment options for inflammation, allergies, hidden infections, and toxins.
One of the most surprising discoveries of the last decade is the link between gut problems, obesity, and diabetes. It seems odd, but scientists have found that two major problems in the gut drive weight gain and diabetes: a leaky gut and bad bugs. You learned about this in Chapter 11. When the lining of the intestine is injured by medication, poor diet, food allergens, irritating food proteins such as gluten and dairy, and imbalances in the gut ecosystem, then undigested food particles and proteins are absorbed and trigger inflammation, which, as you now know, causes weight gain and insulin resistance.
Fixing your digestive system is something that many people can do on their own with a few simple steps. Not only can this help you lose weight and reverse diabesity, but it can also help you fix many other chronic health problems, including fatigue, mood disorders, headaches, arthritis and autoimmune diseases, and more.
If your gut is healthy, you can keep bad bacteria out and prevent allergens from leaking through your intestinal barrier. This will lower inflammation, help control your appetite, and prevent bad bugs from extracting more calories from your food. That means that you end up with more food on your lips and less on your hips!
Here are some things you can try. But for those of you who have very bad bacterial overgrowth or weird bugs such as parasites, worms, or yeast, medical testing and treatment will be necessary to kill the bugs.
If you scored above 8 on the Digestion Quiz, here’s what you can do:
Here is what I suggest:
Too much stomach acid can cause reflux and other symptoms, but too little can cause bloating, an inability to break down food or active digestive enzymes, and an overgrowth of yeast and bacteria.
If you are taking an acid-blocking medication, this may, in fact, be part of the problem. See if diet changes and other recommendations in The Blood Sugar Solution help your reflux, and work with your doctor to get off that medication.
I usually recommend that betaine or hydrochloric acid supplements be used carefully, under the supervision of a health care practitioner. However, if you follow the guidelines below, they can be very helpful while your gut is healing.
These essential ingredients support intestinal health. Our poor-quality diet, overuse of medication, and stress all alter our normal, healthy intestinal flora or bacteria. Abnormal flora can trigger toxin release into the body and generate local inflammation and weight gain,6 both of which trigger systemic inflammation. I believe that given all the stresses on our guts, probiotics are needed for the vast majority of people for long-term health.
Preparations include freeze-dried bacteria packaged in powder, tablet, or capsule form. It is important to take a combination product with multiple species of organisms. If you are dairy-sensitive, seek out dairy-free brands.
Zinc, omega-3 fats, vitamin A, and other gut-healing nutrients are part of the basic plan, but a few other things can be very helpful.
L-glutamine, a nonessential amino acid, is the food for the cells that line your intestine. It generally comes in powder form and is often combined with other compounds that facilitate gut repair. Quercetin is a potent anti-inflammatory that is helpful in restoring balance in the gut.
Testing for gut problems and fixing them is one of the most powerful things I do in my practice. Unfortunately most conventionally trained physicians do not know how to diagnose common problems such as a leaky gut or food sensitivities, or do the right tests to identify bacterial or yeast overgrowth, parasites, or worms. In How to Work with Your Doctor to Get What You Need (www.bloodsugarsolution.com), I explain the testing and treatment for gut problems. There are safe and effective medications for bacterial overgrowth, parasites, and yeast that can help people get better faster. If you scored over 13 on the Digestion Quiz or feel you might have a problem (even though you don’t have digestive symptoms), seek out a functional medicine practitioner.
Toxins are often invisible. They are in our air and water, and in the food we eat. Slowly, daily, inevitably, our bodies accumulate more and more toxins. A high body burden of toxins can prevent you from losing weight, or worse, damage your metabolism and lead to a weight loss plateau.
Living clean and green is a cornerstone of creating health, losing weight, and preventing diabetes. You learned how to do that in Chapter 21. However, some people have accumulated such a high body burden of persistent organic pollutants (pesticides, PCBs, phthalates, flame retardants, etc.) and heavy metals (mercury, lead, arsenic, etc.) that they need additional support for detoxification using detox-boosting foods, supplements, herbs, saunas, and sometimes chelating medication to get rid of heavy metals (to be done under a doctor’s supervision). If you qualified for self-care or medical care on the Toxicity Quiz in Chapter 12, then you should add these next steps to your program.
Our bodies have a natural intelligence and are designed to help us mobilize and transform toxins. Given today’s toxic environment, it is important that you learn how to boost your body’s own detoxification system.
It’s not that difficult.
If you scored over 6 on the Toxicity Quiz:
You can take all three of these supplements, or just take NAC, which I think is the most important.
People all over the world have used sauna and heat therapies for hundreds of years to purify mind and body. Recently the Environmental Protection Agency found sauna therapy helpful for supporting excretion of heavy metals (lead, mercury, cadmium, and fat-soluble chemicals such as PCBs, PBBs, and HCBs).7 It also improves quality of life in patients with type 2 diabetes.8 It helps lower blood pressure, lower weight, and reduce stress. I think of it as the lazy man’s way to exercise.
Follow these guidelines for safe detoxification. More intensive detoxification protocols should be used only in conjunction with a physician or health care practitioner.
If your score suggests that you should seek medical care, your practitioner may test you for heavy metals such as mercury and lead, and recommend additional detoxification strategies, including supplements, intravenous nutrients, and chelation.
I have found that over 80 percent of the patients coming to my practice (who admittedly are sicker than average) have elevated levels of mercury, and 40 percent have very elevated levels. But the body hides these metals in organs and tissues, and so regular blood tests aren’t accurate. I recommend a special test called a chelation challenge with medication such as DMSA or DMPS, which pulls out hidden stored mercury and other metals and gives a better picture of your total body burden. If you have elevated levels, there are medical treatments to help clear metals from your body. In How to Work with Your Doctor to Get What You Need (www.bloodsugarsolution.com), I explain the tests that can assess your body’s own detoxification system and levels of persistent organic pollutants and heavy metals. I also explain treatment options. This is often a critical step in helping people lose weight and correct diabesity.
By following the basic plan in The Blood Sugar Solution, you will already be doing things to enhance your metabolism—eating a plant-based antioxidant-rich diet, exercising, reducing toxic exposures, and lowering inflammation. By supplementing with mitochondrial-protective and antioxidant compounds, we can preserve and restore our energy metabolism to optimal function.
If you scored above 6 on the Energy Metabolism Quiz, follow the steps below.
Most people with diabesity have poorly functioning mitochondria and need help burning calories and fat. A number of special nutrients become essential under conditions of stress, toxicity, and aging. Taken as supplements, they can dramatically improve energy production and mitochondrial function, as well as protect the mitochondria from damage. Alpha lipoic acid has been well studied9 and is the most important mitochondrial nutrient for weight loss, blood sugar control, and diabetic neuropathy. That is why I included it in the basic plan of supplements, but higher doses are often needed for more advanced diabesity. Here is what you should add to your regimen.
A functional medicine doctor can check your mitochondrial function and oxidative stress through a urine test that measures organic acids. He or she may recommend additional supplements such as D-ribose, creatine, glutathione, and arginine. To learn more about testing and treatment for your mitochondria, see How to Work with Your Doctor to Get What You Need at www.bloodsugarsolution.com.
Stress finds you. You don’t have to look for it. It is an unavoidable part of life. But deep and profound relaxation and calming of the nervous system do not happen automatically. We are not taught the antidote for our chronic stress. We try to look for it—we drink alcohol, numb our emotions with sugar and junk food, zone out in front of the television or computer screen. But these are maladaptive behaviors. They actually make the problem worse. We have no idea where to find or how to push our pause buttons. But this is key to health.
We have unabated, unremitting stress. Our cortisol levels stay elevated. That’s bad news because high cortisol makes you gain belly fat and lose muscle, makes you hungry and crave sugar, and causes diabetes.
Everybody has a different pause button. Seek out yours. There are many wonderful resources and programs available to help you achieve this goal. This is key to long-term metabolic health. We have to make it part of our daily lives.
If you scored over 7 on the Stress and Adrenal Dysfunction Quiz, the following steps may help you find balance again.
I have found many ways to hit my pause button, and have used many with my patients. You have to find what works for you. But please, find something and do it! In the Resources section at www.bloodsugarsolution.com, I provide more detailed recommendations.
Stress can deplete the nutrients needed for deep relaxation of the nervous system, including magnesium, the B vitamins, and vitamin C. When you follow the basic supplement plan, you will make sure to have enough on board.
Certain plant compounds known as adaptogens help modulate and balance the stress response, correcting some of the negative effects of chronic stress.15 I most often recommend a combination supplement of cordyceps, rhodiola root extract, and Asian ginseng root extract.16 When taken with meals, ginseng can lower blood sugar and improve insulin function.
You can add the following stress-reducing supplements to your regimen if you are imbalanced in this area:
Some of my patients need more support for handling chronic stress. They may need therapy, coaching, or even medication as a short-term bridge to get through the toughest parts of life. I refer them to a good psychotherapist, psychiatrist, or life coach. See Resources and The Blood Sugar Solution website (www.bloodsugarsolution.com) for more information on finding the appropriate help.
