Hormones, Metabolism, and the Energy Equation

Riordan Clinic [00:00:00]:
The information contained on the Real Health Podcast and the resources mentioned are for educational purposes only. They are not intended as and shall not be understood or construed as medical or health advice. The information contained on this podcast is not a substitute for medical or health advice from a professional who is aware of the facts and circumstances of your individual situation. Information provided by hosts and guests on the Real Health Podcast or the use of any products or services mentioned does not create a practitioner-patient relationship between you and any persons affiliated with this podcast. This is the Real Health Podcast brought to you by Riordan Clinic. Our mission is to bring you the latest information and top experts in functional and integrative medicine to help you make informed decisions on your path to real health.

Drew Rose, DO [00:00:56]:
Welcome everybody, back to another episode of the Real Health Podcast. I am Dr. Drew here with Dr. Ron. We are going to have a Lunch and Learn next week, February 26th. Uh, it is a precursor to a Check Your Health, um, promotion that we’re having in March. So we are talking about how hormones and metabolism shape your energy, mood, and wellness. So Dr. Ron, uh, just kind of kick things off. How would you do— describe hormones and metabolism to somebody just walking by on the street and they happen to ask you?

Ron Hunninghake, MD [00:01:27]:
Well, there’s two kind of responses I get when I first start the conversation of hormones. There’s a kind of like a little bit of a fear response because there was a era when synthetic hormones were actually creating additional risk for people. But a lot has changed, I would say, in the last maybe 20 years or so, and we’re finding out now that hormones are not the bad guy. Hormones are what you have when you’re young and you’re youthful and your metabolism is good and you can eat what you want, not have to gain so much weight. Uh, so anyway, there’s a changing understanding of the value of hormones, and I think it’s related to the fact that we can now measure hormone levels, and we do measure hormone levels, and we can use bioidentical hormones to make a big difference on, like, a metabolism.

Drew Rose, DO [00:02:17]:
Right, right. So you’re saying that hormones, metabolism aren’t necessarily independent of each other?

Ron Hunninghake, MD [00:02:22]:
No, they’re very, uh, very intrinsically related. And, and once again, the measurement is the key thing. If you just start talking about hormones and slapping hormones on, that would be a little possibly risky, even though hormones are, are generally safe. But the idea of, of individualizing it to the person, uh, at whatever stage they’re at, you know, they can— that woman can be slightly premenopausal and still need some hormones because they’re starting to dip down, and so we can calibrate that to fit that particular situation.

Drew Rose, DO [00:02:59]:
That’s a perfect segue into my next question because I see this all the time with co-learners coming in and, you know, they’re telling us that, hey, I’ve had my labs checked before, everything’s normal, but I still feel awful. So why do the numbers appear normal but they still have symptoms?

Ron Hunninghake, MD [00:03:15]:
Well, I mean, obviously we’re very complex beings in our, our habits, our sleep, our exercise, our stress. These can all have impacts upon hormones as well as nutrient levels. The Riordan Clinic, we kind of mostly came aboard talking about nutrition and nutrients, but this whole idea of hormonal regulation of metabolism, I think, is a big news story that more and more men and women are beginning to see, hey, this is not a danger, this is a big advantage if I can get precisely adjusted on my hormones, so I’m not really getting too much nor too little.

Drew Rose, DO [00:03:51]:
So what kind of examples are like different hormones and symptoms? I mean, what, what do you see when you start having some hormonal deficiencies?

Ron Hunninghake, MD [00:03:59]:
Well, the one that I work the most with is the thyroid hormones, uh, and, and we, we have a special way of precisely calibrating it based upon the free T3 and the reverse T3, which most doctors don’t do. So again, that calibration can make a big difference besides just a TSH. So that’s just one example. Adrenal hormones are something that people don’t think about, but most people are stressed and fatigued, and, and very often their adrenals are not able to keep up with the stress and, uh, efforts that they’re trying to make in their lives. And so once again, we can do saliva testing and at different times during the day because the adrenals work differently at different times during the day. So that’s again a precision way of using hormonal therapy.

Drew Rose, DO [00:04:45]:
Oh, I think that’s a, a great insight there. You know, back in my training, I was always taught that the thyroid is kind of like the metronome of the metabolism. So there’s that interplay between the hormones and then the metabolic rate. So I think being able to fine-tune that has been a fascinating thing to learn.

Ron Hunninghake, MD [00:05:04]:
We talk a lot anymore about the mitochondria, and what my insight is, is that the T3 level has a very close relationship to how well your mitochondria are functioning. So if you’re— if your thyroid numbers are low or your ratio is bad, that could be a reason why you not only feel bad and not sleep well, and— but maybe why you’re getting sick all the time, maybe why your cancer is not getting as well as you’d like it to get with whatever therapy you’re doing.

Drew Rose, DO [00:05:32]:
You mentioned something there, the ratio, and I, I, you know, have the privilege of being able to work across the hall from you and learning from you over the past couple of months since I’ve been here. Uh, could you speak a little bit to what is the reverse T3?

Ron Hunninghake, MD [00:05:44]:
Well, you know, uh, where it came about is, uh, I started to deal a lot with women with fibromyalgia and chronic fatigue. Uh, they often go together, and I happened to read a wonderful book by a chiropractor, 1,200-page book on how important the thyroid was and that, that T3 was the key. But if you didn’t measure the reverse T3, you could have a wonderful T3, but the reverse— think of the T3 as the accelerator, but the reverse T3 is the brakes. I’m literally— people are driving around with one foot on the accelerator but a big foot on the brake that’s slowing them down. So, so we have ways to modify that, uh, but if you don’t measure it, you know, this is one of Dr. Riordan’s things, you know, if you don’t measure, you don’t know.

Drew Rose, DO [00:06:34]:
Oh, so many people on the conventional side of things, which is where I spent the past decade of medicine, you know, TSH is the only thing that we would test, and then if that’s abnormal, maybe look into some of the, the free T3, free T4. But reverse T3 was something I definitely had to learn when I first came here.

Ron Hunninghake, MD [00:06:49]:
Yeah, there’s a lot of stressors, toxins, infections, and various things that can modify that. And especially with the people that we see, because oftentimes the people we are most dealing with are people that have been to multiple doctors and had various workups, but they’re still not getting well.

Drew Rose, DO [00:07:04]:
Oh yeah, definitely. Now you mentioned a little bit ago about the adrenal glands too, and I’m just wondering, how important are the adrenal glands?

Ron Hunninghake, MD [00:07:14]:
Well, between, between the adrenals and the thyroid, they are what regulate your, your biological energy. And so, uh, since the pandemic, it seems like everyone that we see has low energy, so So we have to look at that as a, a primary means of helping people to deal with it. Now, the other side of the adrenals is that if they’re highly stressed, that stress can deplete adrenal reserve, right?

Drew Rose, DO [00:07:40]:
Adrenal glands, I think, are fascinating, and I think it’s very underappreciated how much the effect— either too much or too little— can have on your overall symptomatology.

Ron Hunninghake, MD [00:07:51]:
Yeah, well, you know, and, and Dr. Lee, he is one of our consultants. One of the big conversations we’re having now is that if people are adrenal depleted, they’re probably not making enough cortisol, or they’re not using vitamin C in combination such that they can get better uptake of vitamin C into their cells. So that’s one of the things that the adrenals do that are not looked upon or not thought about in terms of conventional therapy, right?

Drew Rose, DO [00:08:17]:
And always remember too that the adrenals have 3 separate layers, so 3 separate layers of hormones that affect your entire body. So cortisol, sex hormones, and then sugar regulation too, right? So I was wondering if you kind of speak to how do you explain to somebody what insulin resistance is and how that could really, I don’t know, affect their overall well-being?

Ron Hunninghake, MD [00:08:43]:
Well, if your insulin’s not getting in, yeah, you’re not getting— not, not only are you not regulating your blood sugars very well, but you can’t get vitamin C into the cell without insulin. I mean, that’s a— that, that’s an interesting thing that people don’t realize is that there is an interplay between insulin and vitamin C. And vitamin C, of course, is kind of the for— cornerstone of what we do here at the Riordan Clinic. And so all of these hormonal things do, uh, pair with nutrient functions as well.

Riordan Clinic [00:09:13]:
Are you looking for a delicious way to boost your immune system? Meet Sufficient-C, the crave-worthy immune support drink that makes staying healthy a treat, not a chore. Packed with 4,000 mg of non-GMO vitamin C, Sufficient-C is more than just a drink. It’s a powerhouse of immune-boosting goodness with added L-lysine, bromelain, and 96% pure caffeine-free green tea extract. Every sip is a step towards better health, and the best part? It tastes amazing. Our lemon peach immune aid mix is sweetened with pure stevia. No sugar, no guilt. Plus, it’s plant-based, gluten-free, kosher, and completely caffeine-free. So why settle for boring when you can have a flavorful immune-boosting refreshment? Visit SufficientC.com and mix up your health routine with Sufficient-C, because your health deserves a delicious boost.

Drew Rose, DO [00:10:11]:
So when we’re talking things about stress and just overall hormonal health, metabolic health, where exactly does sleep— sleep lie in this whole pattern of, of health?

Ron Hunninghake, MD [00:10:21]:
Yeah, so, uh, sleep is probably a true sleeper in terms of the real cause of why people are not getting well, is that they— if they’re tired, you know, this sounds weird to say, but a lot of people are too tired to sleep. Yeah, they can’t, they can’t get into a good rhythm of sleep, or they’re, they’re eating too late at night.

Drew Rose, DO [00:10:41]:
Yeah.

Ron Hunninghake, MD [00:10:41]:
Or, uh, there are other, uh, the sex hormones I think have a lot to do with the— progesterone is a very important hormone in terms of helping regulate good quality sleep, especially in women. So hormonal imbalances can disrupt sleep, and then sleep— if you’re not sleeping well and you’re not resting and rejuvenating, well then that will cause your hormone levels to be lower. So it’s a vicious cycle.

Drew Rose, DO [00:11:06]:
Yeah, I, I always hear the term wired and tired at the same time, and that’s kind of— I love how you say that you’re too tired to even sleep. So, uh, I’ve been there.

Ron Hunninghake, MD [00:11:16]:
Um, oh yeah.

Drew Rose, DO [00:11:17]:
And I think that’s something that I think, uh, there’s a lot of lifestyle modifications that go into that as well, but there’s definitely things that you can overlook like the nutrient profile and your hormonal profile to get good sleep.

Ron Hunninghake, MD [00:11:28]:
Yeah. The other big factor that I think of in terms of hormones is that we have so many environmental toxins that are affecting us. Like for example, in men, I think there’s a number of environmental factors that are causing young men to have low testosterone levels. And, and you don’t think of a young man coming in with low testosterone, but we see it quite frequently.

Drew Rose, DO [00:11:51]:
Often. Yes.

Ron Hunninghake, MD [00:11:52]:
Yeah. And so once again, uh, if you don’t measure it, you won’t know. But if you do find out that it’s low, not only are we putting people on calibrated levels of testosterone, males and females, but we’re carefully monitoring it as well. Without the monitoring, then yeah, it can get a little dicey. But with careful monitoring, you can individualize it to that unique person’s experience.

Drew Rose, DO [00:12:15]:
Absolutely. I think, uh, that is the foundation of functional medicine, is being able to actually test what’s going on for the biochemical standpoint. And if you don’t test, you don’t know. And I— speaking to that point, you know, I think you’re, you’re absolutely correct. We’re seeing more and more young men come in with lower levels of testosterone explaining a lot of their symptoms, and that seemed to be almost mythical, uh, you know, several decades ago. Why would a young man not have testosterone? So, you know, being able to kind of bust those myths right open— I mean, are there any others you want to try to clear up before our Lunch and Learn?

Ron Hunninghake, MD [00:12:51]:
Right. Yeah, a lot of women, uh, even today will come in and say, well, I’ve heard those hormones are— I, I don’t want to get breast cancer, I don’t want— I don’t want to get cancer, so I don’t think I better do any hormones. Well, again, that comes out of an era when women were getting synthetic hormones, or even though they were natural, they were coming from, you know, pregnant horse mare urine. But the, but the, the synthetic progesterone, actually, when they did the Women’s Health Study, which was a huge study, thousands of women, it turned out that that particular medicine, which is not identical at all to natural progesterone, that was where, where the risk to increase risk of cancer was coming from. And so by using bioidentical natural hormones and monitoring their levels and getting it to fit what that individual woman’s needs are, we can keep— we can keep them in a safety range, but in an effective range so that women have better metabolisms, they have better sleep, they have better energy, their bone health is better, their heart health is better, their cognitive function is better. Their sexual function is better. And a lot of women, that’s important, and, and we, we can’t just let that slide, uh, but yet that fear is there until people realize that by using the lab, we can, we can keep women in very safe levels as well as getting that effectiveness of whole health living again.

Drew Rose, DO [00:14:18]:
So it’s a combination of, you know, being within that reference range but also looking at the patient as a whole and seeing where their symptoms are, correct?

Ron Hunninghake, MD [00:14:26]:
Yeah. Yeah, this was, uh, when I first started, holistic medicine, right, was the big name, you know, and it’s alternative, but it was holistic. And I feel hormones are a part of that holistic approach to the patient, as well as nutrition, as well as lifestyle and sleep and all these things. But, but hormones, I think, are what really give vitality to the person.

Drew Rose, DO [00:14:47]:
Definitely, it’s, uh, you hit the nail on the head there. I’ve actually had multiple people tell me, especially from a man’s standpoint, that, uh, it’s almost like they lose the zest for life there, and it’s— you can’t really put your finger on exactly what that is.

Ron Hunninghake, MD [00:15:02]:
Yeah, and I, I think with proper measurements you can take the fear out of hormones, but, uh, but a lot of people still— they still have that old notion that it’s really a problem. You know, it used to be there was a black box in the, uh, the PDR regarding hormones. That’s gone now. That’s been taken away.

Drew Rose, DO [00:15:23]:
Good to know.

Ron Hunninghake, MD [00:15:23]:
Research is clear that they’re safe If properly administered, correct.

Drew Rose, DO [00:15:29]:
So just another question, as far as— since we’re talking about bioidentical hormone replacement therapy, there’s always that concern, um, that once you start hormone replacement therapy, you’re going to become dependent on it for the rest of your life. Is that your experience in your, your practice, or is it something where, you know, you might be able to kind of get a boost and then maybe make some lifestyle modifications, detoxify, and maybe kind of decrease your doses?

Ron Hunninghake, MD [00:15:54]:
Well, you ask it, is that my experience? That was my experience. I actually was low in testosterone and was on it for about a year, and then for whatever reason didn’t fill it, and we happened to redo the testing. The testosterone had come back for me.

Drew Rose, DO [00:16:07]:
Really?

Ron Hunninghake, MD [00:16:08]:
Now, that’s not always true for everyone, but I— it, it actually started regenerating it. So, so I think people— now, that may not be true for menopausal women, and, and, and certainly for some men it may not be true But I think, uh, if you play your cards right, get the nutrition up, get the sleep back, get the exercise going, eat the right foods, your body possibly could start to regenerate more of its hormones than what it was.

Drew Rose, DO [00:16:34]:
So it’s just another piece of the entire puzzle, you know.

Ron Hunninghake, MD [00:16:37]:
Without measurement, we don’t know either.

Drew Rose, DO [00:16:38]:
Precisely. You’ve got to work on all aspects of life, not just the biochemistry, which I totally appreciate there. So talking about all the different symptoms that we talked about, you, you mentioned things like, you know, brain fog, you know, inability to sleep, you know, just lack of energy, fatigue, all of these things. You know, what would be one question you would encourage all of our different co-learners to ask their providers sooner rather than later in life?

Ron Hunninghake, MD [00:17:03]:
Well, I think you can always ask your provider to at least measure your hormone levels. That could— and we do with our— when we see a new patient, we always put that in. We always check thoroughly the thyroid, we check all the sex hormones. So I think again, the, the Riordan Clinic started because of the term functional medicine. Riordan believed that if you— matter of fact, uh, when he would go and give a lecture, you know, the, uh, the old saying from the real estate agent, you know, location, location, location.

Drew Rose, DO [00:17:34]:
Yes.

Ron Hunninghake, MD [00:17:34]:
Measure, measure, measure was Riordan’s battle cry. And so I think the Center for the Improvement of Human Functioning was all about measuring and then taking into consideration what the lifestyle symptoms were, lifestyle was, what the symptoms were, the age, the, the environmental toxins. You have to kind of take that holistic perspective and kind of create a kind of a symphony of interventions, not just here’s your one pill that’s going to solve everything. Let’s, let’s see if we can identify where the gaps are. Let’s start filling those in. You start making better lifestyle choices. Let’s get those hormone levels up. And all of a sudden, the age process kind of starts to reverse.

Drew Rose, DO [00:18:18]:
Yeah, it’s— I think that is a fascinating analogy there, is that you’re calling it a symphony. So many times I tell people, as a physician, you’re— it’s almost like you’re trying to conduct an orchestra, and you’ve got the strings, you’ve got the brass, you’ve got the percussion, you’ve got all of these different things that you’re trying to balance here. And that is why we always try to get our co-learners to be an active participant in their own health. We talk about things like lifestyle modifications, detoxification, satisfying. And I think, you know, when it comes down to it, talking about hormones and your metabolism really takes into everything into an account. And that’s exactly what we’re going to be talking about next week at our Lunch and Learn. Yeah. So, you know, with the last couple minutes here, I mean, what else do you want to let people know about?

Ron Hunninghake, MD [00:19:03]:
Well, it’s, it’s still an integrative approach. I mean, we’re, we’re— I tell patients that you really need your primary care doctor, you really need your specialist, you really need your cardiologist or your oncologist, but they’re trained to make a specific diagnosis, and very often it’s a specific intervention which may very well be appropriate. But on the other hand, that holistic element of looking at hormones and nutrients and lifestyle, uh, these things oftentimes are not taken into consideration. So, uh, our— I think our evolving understanding here at Riordan Clinic is that we need to have the best of both worlds.

Drew Rose, DO [00:19:41]:
Absolutely. It’s, it’s integrative in every single definition of the word. And that is how people are gonna get healthier. Um, education is key. Uh, and that’s exactly what we wanna do next week. Again, we have a Lunch and Learn next week. I think— believe it’s Thursday, correct? Yes. Thursday, February 26th. Uh, at 11:30 is gonna be lunch. Uh, 12:00 PM is the lecture portion. And again, it’s titled How Hormones and Metabolism Shape Your Energy, Mood, and Wellness. So here on the Wichita campus, you’ll also be able to watch it on our YouTube channel.

Ron Hunninghake, MD [00:20:15]:
Please come and learn with us, and you can ask questions too, because that’s important too. We want you to be a part of this presentation so that you can profit from it in terms of your own health and well-being.

Drew Rose, DO [00:20:27]:
Thank you, everybody.

Riordan Clinic [00:20:30]:
Thank you for listening to The Real Health Podcast. If you enjoy this episode, be sure to subscribe and leave us a review. You can also find all of the episodes and show notes over at realhealthpodcast.org. Also, be sure to visit reardonclinic.org where you will find hundreds of videos and articles to help you create your own version of real health.