How Blood Sugars Can Cause Your Fatigue - Is It Diabetes? with Beverly Yates, ND

Episode 108:

How Blood Sugars Can Cause Your Fatigue - Is It Diabetes? with Beverly Yates and

Evan H. Hirsch, MD

Evan H. Hirsch, MD 00:00

Hey everybody, welcome back to the EnergyMD Podcast where we help you resolve your

long COVID, chronic fatigue ME/CFS and MCAS so that you can live a better life. So

excited today about speaking with my friend Dr. Beverly Yates, because we're going to

be talking about the Yates Protocol, and diabetes and fatigue. So let's learn a little bit

about Dr. Beverly. So she is a licensed doctor of naturopathic medicine and the nation's

leader in online type two diabetes care. Her virtual practice has programs and

supplements to help people lower their blood sugar naturally at home, without ever

having to step foot in a clinic. I love that. She is the creator of the Yates protocol, five

practical, enjoyable steps to reversing type two and pre diabetes and living the life you

love. Her training as an MIT engineer turned Doctor inspired her to tackle the diabetes

crisis. She's helped 1000s of people restore healthy blood sugar levels and heal from

the damage of diabetes. And she has been seen multiple times on TV. Bev, thanks so

much for joining me today.

Beverly Yates, ND 01:11

Hey, you're very welcome, Evan, thank you for the invitation. I'm happy to be here and

have this discussion with you, and hopeful to be a helpful partner with you and helping

people reclaim their energy and be able to live that life that they love. Yeah,

Evan H. Hirsch, MD 01:23

And you know, blood sugars play a big role in that. So let's kind of get back to basics

here. So so how do how to blood sugars play a role in energy?

Beverly Yates, ND 01:33

Yeah, that's a great question. And, you know, let's start there with this discussion. Blood

sugar is what your body uses, also called glucose, in order to fundamentally provide

your energy so you can get up and out of bed in the morning, be able to get through your

activities for the day, you know, to do your work, do your chores at home, live your life

have a relationship, all of the things right, your self care. And when your energy is

compromised, if it's disrupted, if it's out of balance, you really got a problem, a

fundamental problem.

Evan H. Hirsch, MD 02:02

Yeah, so and so then blood sugars affect our ability to make energy, right? Like they're,

they affect the mitochondria in some way. How does that work?

Beverly Yates, ND 02:15

Yeah, mitochondria, one of my favorite things to talk about. It's funny, it's really been in

the news lately, which I'm glad about. So we may or may not have learned hopefully, we

did in high school biology. And the mitochondria are in all of our cells, and that they are

the energy powerhouses, so to speak in the cell. And the thing that's so interesting

about energy and energy conversion is your mitochondria make ATP, and they're

brokering it and all the good things happen. But if there's a disruption there, if you have

compromised your mitochondria, your experience, your lived experience of your energy

will not be the same, you're really going to struggle. And it's one of those things where,

shoot, you know, and a lot of times people are blamed for their illnesses, and they're

blamed when they're fatigued, and they blame they don't feel well. And they're like, Well,

why won't you go and exercise? You know, five days out of the week? Why don't you

cook your own meals? Why don't you you know, the What about right, just lots of finger

pointing, blaming and shaming. But when someone's exhausted, oh, come on, let's get

let's get real. It is so hard to do those really, really basic things. In fact, that should be a

red flag, the fact that the person is struggling to do those red, those basic things really

should tell you something's broken. It's not all in their head. They're not making it up.

There's no secondary gain from this. So with that, in mind, your blood sugar is a very key

component of your energy. You need to have enough blood sugar in the right places

doing the right things. You definitely don't want to middle blood sugar, and you don't

want too much. You want to balance them out.

Evan H. Hirsch, MD 03:41

Sounds good. It sounds like the Goldilocks dose, right? Blood sugar. Yeah, it really

much. So then how does somebody know we're talking about blood sugar? Let's talk

about what's the difference between like a blood sugar issue and diabetes.

Beverly Yates, ND 03:57

Okay, so there are blood sugar issues that are not diabetes, diabetes would be

technically defined today, particularly if it's type two diabetes have a hemoglobin a one

C, commonly known as an A one C lab test of 6.5 for a number or higher, so 6.5 7.289

10, etcetera, right? So that's a one C, prediabetes is the range we're in a one C is

measured at 5.7 to 6.4. So it's the stage before something is formally diagnosed as type

two diabetes. Now I want to make an important distinction so people don't get

confused. type one diabetes is auto immune and its root cause it means that the cells

have been attacked that are in the pancreas that make insulin, and therefore that person

can no longer make their own insulin. Insulin is the key hormone that interacts with

glucose in order to keep you healthy. If someone's a type one diabetic, they need to be

on insulin taken from the outside, whether it's injectable or from a pump, or however

they're getting their insulin for the rest of their life. Right now. We don't have a way to

bring that pancreas back to life yet. I'm hopeful though there's been some new

technologies and some other arenas that, you know, like CRISPR for, let's say sickle cell

anemia that are just amazing to me that that's even a possibility. But right now, that's the

deal with type two diabetes, typically pre, certainly pre diabetes, but typically with type

two people are not on insulin replacement therapy unless they are really, really high for a

while and see if like a 910 and 11. And in the danger zone. So those are some important

distinctions to know.

Evan H. Hirsch, MD 05:25

And the role that insulin is playing with these blood sugars. Like why would some of

those people need insulin?

Beverly Yates, ND 05:31

Yeah, people would need the insulin because, you know, your glucose needs to be

carried, so to speak, are transported into the cell to make it available for energy. So your

blood glucose is literally in the blood, your blood sugar is in the blood. And on the cell

wall, these insulin receptors and insulin grabs up the glucose that comes along and

takes it and brings it inside the cell and make it available for energy. If you have

chronically high levels of blood sugar, it can overwhelm if you will, the ability or capacity

of your insulin to be able to do its job. And as such, you get into a state that's often

called insulin resistance. If you're not insulin resistant, if you've got healthy blood sugar

levels, that means you're insulin sensitive, those insulin receptors on your cell are

overwhelmed and are able to effectively grab up that extra glucose or normal amounts

of glucose, excuse me in the bloodstream, bring it inside the cell, make your energy

available. If you have chronically high blood sugar for too long, what's going to happen

is insulin is becoming more and more resistant, less effective or insensitive. And as a

result, then that extra blood sugar will start to be stored as fat typically in the liver, and

then in around the belly. So then you get the problems with the visceral fat or belly fat,

abdominal fat, and can be off to the races with a whole host of other problems because

of all the inflammation that causes

Evan H. Hirsch, MD 06:47

and when you were talking about diabetes and pre diabetes, and you were mentioning

those numbers of a one C, those are determining the amount of blood sugar that's kind

of floating around in the body for a period of time, is that correct?

Beverly Yates, ND 06:59

Yeah, to some degree, it's an average number, it's a snapshot, you know, typically, your

red blood cells are going to turn over every 90 days. So think of it as quarterly. Like if you

have a business, or if you're in school, or something like that, there's definitely a

quarterly rhythm to the year. And so every three months, you get a whole brand new

fresh set of red blood cells, your bone marrow is making those red blood cells for you,

it's a beautiful thing, you don't have to think about it, it just happens. So if your agency is

checked multiple times a year, you're getting a snapshot of what's the average exposure,

and I'm going to emphasize this, we're gonna talk about some other blood sugar

problems in a moment, it's the average exposure of the red blood cells specifically to

glucose is that's what they're looking for. So in that assessment, then if you have a

higher agency, it says that your baseline instead of being at a healthy level of blood

sugar, it's getting higher, higher and higher. It's getting too much as you go from pre

diabetes to to type two diabetes. So your glycemic control is not the same.

Evan H. Hirsch, MD 07:56

And this doesn't happen overnight for people to get to type two type type two diabetes,

right. So what does that progression look like from birth?

Beverly Yates, ND 08:04

Yeah, so typically, back in the day, when you and I were in our respective medical

schools, and you know, before then, it was not an overnight progression. This was

typically something that happened to people who were older, like in their 60s 70s 80s,

right? These days, we have kids as young as eight, being diagnosed with type two

diabetes, which is shocking and absolutely not sustainable for human health. We can't

let this get worse. We just can't right. We hope to thrive as a species if we have this

international phenomenon just completely continue to run amok. Having said that, the

typical progression for people is that it might be something where prediabetes used to

be didn't show up until 50s. Right at the time when everyone's hormonal balance was

shifting, you know, you leave the more active reproductive phase right women absolutely

do in their 50s men, I would argue with andropause or have a different shift pattern, but

it's a shift. It's not the same, right for fertility. And now we frankly, it's kind of 20s 30s

teams, you know, it's amazing to me how much younger the shift has become for type

two diabetes or prediabetes. I, like you know, it's just not sustainable. We can't keep this

up.

Evan H. Hirsch, MD 09:14

And so is it just from eating a different kind of diet? Are there foods that that people are

eating that are causing this?

Beverly Yates, ND 09:21

There's multiple factors. So a fast way to get type two diabetes, for instance, can be

certain viral illnesses, they can cause it quickly, even though the person eats well, gets

great sleep has good meal timing, they're exercising, they're not stressed. So a viral

origin specifically for type two diabetes is a possibility. So that's one that's a quick path.

Another one that can happen is for nutrition is when someone is eating a lot of fast food

or junk food or highly refined Ultra processed food because there's no nutrient density,

right? They're literally starving in an interesting way. They have lots of calories, but

they're starving for nutrients. It's that odd paradox that we get where people Eat a lot of

the foods from the Western world. And when we transport that around the world,

unfortunately, the diseases go with it. That's another, you know, root cause etiology.

Another one can be like severe stress, and trauma that absolutely can happen, whether

it's one big Whopper kind of stress or if multiple hits. You know, you'll see people who

are first responders, for instance, who who definitely show up more commonly, with type

two diabetes, for instance, you have people who have the personal habit of they just

want to eat fast food, they prefer it, they could afford healthier foods, they could actually

cook for themselves, they've chosen not to, they got into an unfortunate habit, and now

it's going to bite them in the butt. Right, another root cause issue could be poor sleep,

for whatever reason, there's lots of reasons people sleep gets to be messed up, that can

result in type two diabetes, a classic one that might be really familiar to folks here in this

community would be issues with sleep disorders, like sleep apnea, that absolutely can

cause type two diabetes. If someone is overweight or obese, that also can cause type

two diabetes, the inflammation that you get from the sleep disorders, so that you get

from the obesity or extra body weight, particularly held in the abdominal area puts

someone at more risk for diabetes. And that's why sometimes if you solve one problem,

you can solve the other problems because they're related, you know?

Evan H. Hirsch, MD 11:22

Yeah, and when you're talking about stress, oftentimes, we're talking about how stress is

affecting the adrenals. And how the adrenals and cortisol and other hormones are

affecting insulin. Can you talk a little bit about that interplay? Yeah,

Beverly Yates, ND 11:35

so that interplay is really an interesting one, I don't think that is talked about enough.

When we are stressed, there is a normal natural release of extra cortisol so we can

respond to the moment I think of cortisol as being the hormone of the superhero, right,

that's where you hear the story of like a 95 pound woman picks up a car off her kid, or

something like that, right? You know, a more petite framed man is able to do these

amazing things like there's someone in danger, and he leaps is really tall fence. He's not

an athlete, but he's able to rise to the moment and do it. That's cortisol and adrenaline

partnering, right, got a hormone and neurotransmitter doing beautiful things for a

moment. In today's world, sometimes we are so stressed chronically, it is the steady

beat. Unfortunately, for a lot of people, they don't have enough recovery and rest time.

This means them back cortisol that was meant to be helpful for a moment, it does have

you release more of your glucose, your blood sugar, they should happen together.

Because in your in superhero, Mo, you need your energy, you need your blood sugar,

these two are partners. The problem is if your cortisol levels instead of being at a

normal level to get pin high, then here comes your blood sugar, it was at the normal

level, now I got pinned high too, they're going to track together. So for some people

stress and their extra release the or the chronically high release of cortisol can get them

in trouble. And the next thing you know, now they start to suffer with problems with

glycemic dysregulation or a lack of good blood sugar control. That's another place that

can break people who eat really late at night, and eat big amounts of food, particularly

unhealthy kinds of foods or who are constantly snacking. You know, that's another way

that you can get into the large pool, unfortunately, of what leads to type two diabetes,

these are all possibilities. You cannot exercise this one either. You can't out exercise it.

Nope. You know, just like me, like just like the personal trainers and athletes will tell you,

you can't out exercise a bad diet. The thing I've observed is that you can exercise all you

want if you don't take care of the other steps that are a part of you know what I've

packaged up as the eighth protocol, you're still gonna have diabetes, you cannot beat it

with just exercise, you have to take care of what you're eating, sleep stress meal timing,

you just gotta people don't always want to hear that. But that's the truth. The good news

is two or three things are what's going to matter there. Right? So you want your energy

to be organized. You want that mitochondrial cellular energy, you know, you want your

blood sugar energy in the right places, so it can do the right things for you. So

Evan H. Hirsch, MD 14:00

let's dive into the AIDS protocol. Tell us about it.

Beverly Yates, ND 14:04

Yeah, so over the years, you know, I initially started my work working with people who

had problems with their gut people who have problems with their heart. I did a lot of

work with people with cardiovascular things like congestive heart failure, and atrial

fibrillation and things of that nature. People who were really stressed they were having

sleep problems. And over time, I noticed in my clinic, I'd say in the early to mid 2000s,

this steady increase, and then a big increase of people coming who had pre diabetes,

type two diabetes, excuse me. And for the people who had all of these blood sugar

problems and had PCOS, polycystic ovarian syndrome. This was an interesting change.

Because you know, before in the 80s 90s, there was this big increase, at least in the US

and heart disease, cardiovascular problems, then I saw the shift. Boy, was it a shift

towards these issues with diabetes. And so I came to understand that it was no longer

the old 1950s advice that frankly actually goes back to 1950 Have team around, eat less

and move more? It was not adequate. In fact, it was insulting because you know, in

today's complex, busy stressed out world, there's a whole lot of people who are eating

less to the point where they're starving themselves, frankly, and they're exercising

sometimes two, three hours a day in the gym. They aren't having good success with this

blood sugar problem. I was like, well, that's weird. What changed? What? Well, you know,

you think about it our background, right? We have some things in the news right now

they're talking about these forever chemicals, PFA s. So toxicity in terms of our

background chemicals is changed, the quality of our food supply is crap. It's much

lower. And I would argue that our grandparents and great grandparents had higher

nutrient density, in many foods, then probably wouldn't need to be labeled organic,

because they were, you know, and if you'd said to your great grandmother, or to your

grandfather, oh, I'm gonna have some grass fed beef or Oh, I'm gonna go get organic

celery, they will look at you like what's wrong with you? Of course, cows eat grass. Did

you follow her hit your head? Like what's wrong with you? You know, or the salary

organic? What do you tell him? Like, I can just picture my great grandmother, right? That

we have changed this planet. And I think that one of the contributors we don't talk to

enough about diabetes has to be toxins, environmental toxins, whether they are

manmade, or a cluster of naturally occurring ones. We really got to be on our game

these days. If we want to be well, we don't get a free ride a lot of times for that.

Evan H. Hirsch, MD 16:30

Yeah, so. So in the protocol, you've got a number of steps, right? Can you take us

through?

Beverly Yates, ND 16:35

Sure, sure. So nutrition is going to be the bullseye of the target, we have to be sure that

not only you're eating unhealthy diets, but that your nutrition is nutrient dense, and that

your body likes those foods. And by like, I mean, you're eating things that are friendly to

your blood sugar, and that you are not having unusual blood sugar responses to

otherwise healthy foods. One of the things I've come to understand and see because I

work with people often and we use CGM, continuous glucose monitors in software and

apps so we can really look at their lifestyle elements look at you know, their sleep, their

exercise their moods, it's become really clear to me some people are having unusual

reactions to otherwise healthy foods. So something like cauliflower or blueberries or

quinoa, they can sometimes be provocative and cause that person's blood sugar to

spike. These are otherwise healthy foods. Most people don't have a problem and a

generically healthy list of foods to eat works for many people. There's a substantial

number of people who that's actually not true. What is finished spikes your blood sugar

that sounds crazy on its on its head. But if it's happening, you need to know if you have

food sensitivities, food intolerances, those sometimes correlate one to one with

moments if you have a CGM to see a blood sugar spike. And the reason I call it the CGM

is because we get more continuous real time data. It's so painful to get that drop of

blood, put it on a test trip, stick it in with a commoner and most people stop doing

regular testing, who are type two diabetics who have pre diabetes because it hurts it's

painful. Ouch. Nobody wants that, right? A CGM is so much easier. And unfortunately,

it's not considered an over the counter medical device in us and so you need a

prescription. So you need easy ways to get access to a CGM. But anyway, if you can get

that data, it's actionable insights are right there for you. So you will know or whoever

you're working with your health professional can guide you on that. So nutrition. That's

key. It's not the only player However, next, I would say which is really underappreciated is

going to be meal timing. Sometimes people who have type two diabetes have a set of

habits that I'm going to call out here. And it's not because I'm trying to be judgmental. I

want people just to be aware, often they'll eat breakfast, which is great. We need to fuel

our brain and get ready for the day. They skip lunch, and it's not on purpose. Often life

just gets away from folks, they are busy at work, they tend to be the rock in their

community, they are the one that's the go to person who gets stuff done. That might

true be true work. It might be true in a place of worship, it could be in their

neighborhood, whatever it is. And this means then that self care is missing. And so they

don't have a plan for lunch. They get busy, they get stressed, they get some surprises.

They haven't eaten lunch, they've gone too long between breakfast and dinner. By the

time they get to dinner, the desire to eat healthy and the wherewithal. If they don't do

meal planning and have those good habits in place, they're far more likely to reach for

something that's going to be immediately comforting and satisfying. But maybe isn't the

best for their blood sugar. It's just a real risk thing can lead to a spiral unfortunately and

downward one there. So that's two steps right nutrition mealtime. Next one I'm going to

prioritize asleep. I don't think people are aware how much sleep is a beautiful invitation

every night to hit the reset button, to restore to recharge to do the repair your gut so

many things in your body are doing all of the cleanup work your brain and your first

phases of sleep is literally washing itself and getting rid of any leftover Over gunk that

can help you avoid things like dementia and Alzheimer's. So if your sleep is

compromised, this is actually a big deal. Sleep is when your blood sugar should reset

and should go back to a healthy normal range if it wasn't already there at bedtime. So

when you awaken in the morning, you're fasting morning blood sugar numbers, ideally

should be around 75. To 90, many would say 70 to 99. Not going to argue fine points.

But we don't want it too low. And we don't want it over 100 either. Otherwise, that a one

C now is going to creep up. So that's another, you know, opportunity to look at, hey,

what's my blood sugar? Do it is it is it good for me or not? Then your next partner here

for healing is going to be looking at stress, as we've already alluded to stress with the

release of cortisol and adrenaline will cause your blood sugar to rise. And if you have

chronic stress, if you've had trauma, this is absolutely a potential vulnerability. And so

you got to address that. And then finally, we're going to look at exercise and strength

training. And I always share with people the concept that strength training because I

emphasize that of all the options for exercise because it helps us avoid falls as we get

older. It helps us to optimize our blood sugar that active working muscles, our blood

sugar sponges, it's an easy way to get a hold of your blood sugar. So with that in mind,

yeah.

Evan H. Hirsch, MD 21:19

So that is that. So nutrition, mealtime, sleep, stress exercise and strength training. That's

the five steps.

Beverly Yates, ND 21:26

That's the five steps. And the good news is for most people, usually it's two, maybe

three they have to pay attention to, it isn't necessarily all five. Because if you have great

sleep, for instance, and you're eating well, chances are your self care is going to be a lot

better. And then you can notice what stresses you and deal with it, you're going to have

the motivation and energy to exercise, you won't be so exhausted. And then on top of

that, you're going to keep that rhythm around your eating. So if it's breakfast, lunch and

dinner, or if it's simply lunch and dinner, whatever you feel best and most consistently

energized by, you're going to do that, right. I had an amazing experience recently with a

patient. And she does such a great job. You know, Pam is one of the people who

inspires me. And so in her case, when she first sought out care, she was over 25 years

dealing with type two diabetes, it has been a long, long, long struggle. And I say good on

her for reaching out and not giving up. Right. So she gathered her courage and asked for

help. And we started to work together. And in her case, she had some issues with sleep

that she had addressed and successfully resolved. And so yay, because that can be a

tough one. But she noticed how much her feelings around depression, not necessarily

anxiety. In her case, it was depression and a profound sense of fatigue, even just

profound fatigue. And I know you can appreciate this was your expertise, right? She just

didn't want to do anything but sit, even though she knew she needed to be up and be

active. She had intellectual information. She has desire, but couldn't get moving. And

because her exhaustion was so profound, we work initially with some supplements, I

was hopeful of able to spark that energy to get her going. So therefore the rest of the

pieces would come along. And after about a month and a half, she had a big turn around

her energy came back. She went to the gym, she hired a personal trainer, she started to

work out simultaneously with that she looked in her cabinet and she said, You know, I'm

always craving crackers, and crapola I got all this stuff in my cabinet that I know is a

problem. She got rid of it. And she literally said I went from craving crackers and crapola

to craving three bean salads. And because we worked in her case, that root cause issue,

I felt that my assessment was her energy, rather than saying, Oh, you're bad, you're not

exercising, oh, you're bad. No, no, it's not helpful. If it was just blame or shame was an

effective treatment option. And nobody would have these problems, right? Nobody. So

that's not it's not helpful. It's not respectful. And look, you know, we gotta as clinicians

do better by folks right? And assess what's really wrong. She clearly was motivated, why

would someone reach out and ask for help and then not want to do it right? That's silly.

So she did the things. So the biggest changes for her were around her energy, therefore

then to the interest in the exercise in strength training. And with that energy, she was

feeling better. She was more socially engaged with her family and friends. She was

feeling happier, right? She looked at her nutrition realize it was a hot mess. And she

needed to be responsible for it. And she took the steps. She bought into the whole idea

of doing meal planning that made it a lot easier for her. So then when life throws

curveballs because life throws curveballs that you live in a bubble life throws curveballs,

you get surprises, you get a phone call, maybe that a loved one has died. You get a

phone call that her friends in trouble, whatever it might be or text message or a DM on

Facebook, however you communicate these days. And with that, you know, she was able

to respond and you know what the beauty of this was? She didn't get off track why she

had her energy back. It was central in her case for recovery. Now this is a woman who

had been dealing with this for over 25 years, there's most people like, you got it, you'll be

okay. Everybody has it, that we shouldn't normalize sickness, you know?

Evan H. Hirsch, MD 25:12

Yeah, I appreciate you sharing that. So for those of you out there who have blood sugar

issues who have diabetes, it can be a significant cause of your fatigue, and has to be

remedy. So then, how do I? Well, I guess the first question is, how do people know that

they have a blood sugar issue? And then, and then you will answer that first, and then

we'll go into how to fix it. Okay.

Beverly Yates, ND 25:37

So one of the most problematic things about blood sugar issues is that often, at least in

early stages, they're silent. Some clues you can have, I'm going to share these are things

you can observe about your own body, you may notice that your skin becomes a darker

color than whatever is your normal natural baseline color, definitely around your neck,

especially in the back of the neck. If you see that it's gotten darker, or you look in the

mirror, if you live alone, other people can look and observe that, you know, just get that

feedback or use your cell phone, selfie mirror, in a mirror, and you can look and see

what's going on the back of your neck, right? So make sure people have thought through

how can I look back? And notice have the skin color change? Do you have the

accumulation or what are called skin tags around your neck collar where there's little out

pocket things? of skin tags, right? That's a key sign of insulin resistance, and often the

onset of pre diabetes or type two diabetes will be marked by that. Similarly, the same

skin tags you might notice in your armpits, no matter how hairy they are hair less look in

your armpits? Do you see skin tags there? Do you see darkened skin color patches only

in your armpits, let's say back of the neck. Those are two spots, your third one is going

to be in your groin area. And move if you are still quite hairy in your pubic region. But

Bonaparte and look and see has the skin changed color is it substantially darker than

what your normal natural baseline color is? Those are great signs that something's

going on. I know it's not common, at least in the US, for everyone to always be assessed

for their fasting morning blood sugar number and for the agency. But I would advocate

everyone should be checked at least twice a year for this is a cheat those lab tests are

cheap, we're talking three, four bucks, there's no reason to not have them done. People

shouldn't be held hostage about data from their own body.

Evan H. Hirsch, MD 27:20

And so when somebody realizes that they have an issue, I mean, the thing is, is that the

remedy, or at least we're gonna go into diet at this point. Like everybody needs to be

doing this right? If you don't, if you don't eat a good diet, you have the potential of getting

blood sugar issues, pre diabetes, diabetes, is that true? Yes.

Beverly Yates, ND 27:38

It's a risk. It's definitely a risk. Yeah, cravings could be another symptom people might

experience typically as they have poor sleep or lots of stress, they're far more likely to

have cravings, whether it's for sweets, or it's for high calorie, savory umami kinds of

foods, you know, they don't just want one serving they want three that's a that's a sign

something might not be right with your blood sugar. And then of course, gaining weight

and it may be a weight gain doesn't make sense. You're not on corticosteroid

medications or something like that.

Evan H. Hirsch, MD 28:07

So then, what do you recommend for people to choose when it comes to food? I

Beverly Yates, ND 28:12

think you should start with looking at your plate and what's on it and what are the

proportions. I'm always a fan of having people focus on eating leafy green vegetables

with every meal, yes, this includes breakfast. i That's the hardest one for people to do. I

will admit that straight up, I do it. I don't have the problems. But I have a family history

that is profound. My father's side of my family's diabetes has been a complete wrecking

ball. So I'm doing what I can to manage genetic vulnerability, right, making sure your

plate has at least half leafy green vegetables. Then for the remaining half, you're gonna

have a quarter that's left you know like think of it like slices of a circle here. So half of its

gonna be leafy greens a quarter can be your healthy proteins, things that will burn evenly

along because we don't want blood sugar rocket rides like you know, the highly

processed Ultra Refined things like cookies, cake, biscuits, biscuits in gravy, particularly

power combo that could be problem. You know, things like that right? And then the

remaining quarter of your plate can be the healthy fats and other foods that we want to

emphasize. Right so we've already gotten the fiber portion we've already gotten the

protein portion. Now we want to look at the healthy fats and the slow burning resistant

starches and carbs. That can be nuts and seeds. We can absolutely focus in on beans,

peas and legumes. There's many different kinds. If you have a lot of gas or farming or

flatulence, you know, rinse your beans and give them to soaks. That makes a huge

difference in the amount of potentially combustible material so that you aren't

embarrassed all the time. But the beans are neatly packaged right. They've got your

carbohydrates in there, you've got your protein, you've got your fiber, they've got all the

nutrient density you could want. My favorites are lentils and chickpeas. I find those are

the least likely to cause people to have a lot of gastric distress which Do things that are

embarrassing when they are around others. Those are the things we focus on. And then

if you're going to eat grains, I'd say check your blood sugar. If you have access to a CGM,

please get one and see if you're okay. Some people can have grains, whole grains and

be fine. So that's going to be brown rice. Wild Rice is oats for some people are fine. For

some people, it's a disaster nation eat oats. That's where testing and finding out what

your blood sugar is actually doing in response to your food is invaluable. Because a lot

of times diabetics are given the advice to start off their day with just plain oatmeal.

Although a lot of people that's a blood sugar rocket ride, you know, it's not actually a

good idea. So test don't guess find out what's going on for you. I would de emphasize

grains unless you are testing and no, you're okay. And it could be portions. So some

people are okay with a half cup, let's say of any of the grains, other people when they go

to a cup, it's borderline Okay, and maybe go to two cups, it's too much their blood sugar

goes crazy. So always consider portions for any of this. And if

Evan H. Hirsch, MD 31:02

somebody is using a continuous glucose monitor what is abnormal for an increase?

Beverly Yates, ND 31:08

Generally, when you eat your blood sugar will probably rise if you're in a healthy zone

already about 25 to 30, maybe 40 points. If you see your blood sugar's rising 5060 100

or more points, like it's really going up there, you got some work to do. And these days, C

DMS are a smaller profile. And then like with the FreeStyle Libre three, and I think Dex

calm is coming out with the seventh or eighth right now. They are continuous data. So

they give you real time data. In other words, you don't have to take your phone and swipe

the back of your arm in order to get the information via Bluetooth to the device. It's

always communicating to your phone, which is really awesome. So when you're asleep,

you'll get all the information what happened when you were asleep. For instance, if you

were feeling stressed if you got into an argument, if you're someone who is like a Navy

Seal or professional mediator or a lawyer you might find that conflict does not stress

you your blood sugar is not going up someone else's a preschool teacher and they love

being around little kids who are yelping and Yellin You know, we all have different things

that we enjoy and things that drive us crazy. And so your blood sugar might reflect that

for you.

Evan H. Hirsch, MD 32:14

And so those CGM are they how do they read the blood sugars? Are they just sitting on

the skin and they're like some infrared scanning? Or do you actually have to put a needle

into the skin,

Beverly Yates, ND 32:25

they are working on infrared scanning, I can't speak to that just yet. But it'll be breaking

news from technology, we're keeping an eye on that one. Right now for the ones that I

know of, they have a needle in them. So when you take the CGM out of its packaging,

right, it's sterile open, obviously, I will use one before, you can see there's a needle here

in the center. And so when you put it over your skin, and you push down the plunger, it's

going to inject that needle for you, you might feel a little pain still a little stick, then it's

mildly does a slight momentary pain or you might not feel anything, it really depends on

whether or not you've hit a surface nerve and it has adhesive around it. So it will stay

put. So you can shower with it you can swim etcetera, follow the directions the

manufacturer has applied supplied, rather, they will tell you what the parameters are.

And in that it is checking actually assessing the blood sugar levels in your fat cells not in

the bloodstream, I want to make that distinction. So when you get a drop of blood from

a finger stick and you put that right on the finger on the you took the drop of blood from

the finger stick onto the test trip and into the glucometer. That's reading the blood. If you

use a CGM, it's actually accessing the information from a fat cell. So the delay is about

15 minutes in the data. So it's showing you something for 15 minutes ago. So I want to

be sure people understand is a little time lag there.

Evan H. Hirsch, MD 33:48

So when you eat food, you just have to take that into account. Yeah,

Beverly Yates, ND 33:52

yeah. So if you have like say a coffee drink from you know one of these major mega,

mega mega bucks corporations who will just name it that and you have something

that's like you know, a latte or cappuccino or whatever, you know, name you're calling it,

you might, you might want to see what your blood sugar is knowing you might be

surprised, even might be like a soda for you.

Evan H. Hirsch, MD 34:13

Right. And so when you talk about beans and you're talking about rinsing beans, is that

also soaking beans?

Beverly Yates, ND 34:23

Yes, yes do two wins is same if you soak them and you're gonna cook them on your own

either, you know, on your stovetop or in a pressure cooker due to full rinses. If you

struggle with a lot of gas and farting and flatulence it really can help. So

Evan H. Hirsch, MD 34:37

is a rinse just putting it under the water and letting it rinse? Or is it sitting in the water for

a period of time? Great

Beverly Yates, ND 34:43

question. So if they're canned and they've already been cooked, you can just rinse them

twice. If it's fresh, it hasn't been cooked yet. Then you're going to rinse them and soak

them overnight in their water, pour out that water. So let it soak for like at least six hours

and then do a new batch of four water and let them soak again. So you're going to need

some more time for that. And then you'd like water out and soak them.

Evan H. Hirsch, MD 35:07

And do you like water or saltwater? I've heard both both.

Beverly Yates, ND 35:13

Yeah, you know, I work with some fairly good people. I work with a very salt sensitives. I

would just say water. You can experiment though, if you aren't salt sensitive. I don't see

any reason why not? I don't remember. Or know that salt. Does anything specifically

helpful? For leg wounds? What What are your thoughts on that?

Evan H. Hirsch, MD 35:28

I don't know. It's a meme. Maybe it's just been a taste thing. But yeah, I mean, that's how

my wife does it so hard to ask her? Perfect. Great, this is this is wonderful. So then in

terms of coming back to the foods, so what does then breakfast look like that? I mean,

does. Do you have to cook every breakfast? Are there ways to kind of get these leafy

greens in a way where you don't have to always cook every breakfast?

Beverly Yates, ND 35:57

Yeah, that's a great question. So let's talk about it. Because some people travel a lot or

you get surprises and you're not, you know, at home, or you just want to be bothered

with cooking. I tell people hit the easy button where you can these days, certainly here in

the US in many supermarkets and stores, it's really easy to get already Washington prep

greens, particularly salad greens, this is just a game changer. It's revolutionized a lot of

things. And it's made it easier for me to prescribe a healthy nutrition that is mobile, you

don't have to be at home to make this work. So even if you're traveling, you can have

Instacart or something like that deliver it for you. You know, the the basket of the box of

the salad greens is $3 $5 $6 Depending on the size, and you just grab two or three

handfuls, you know, and make it part of your breakfast plate, right. So your breakfast

plate, even if you're traveling or if you don't want to cook can be you know, two to three

handfuls of these leafy greens, partnered with let's say boiled eggs, or nuts and seeds.

Maybe you brought those with you so that you again can limit the wildcards. Maybe it's

the sausage that the hotel gives you as part of the built in price you paid for your hotel

room, you know, however it is you're eating, whether you're plant based or not plant

based, you can absolutely make this work. If you have access to fresh fruit, why not

have a piece with its skin on so apples skin on, you know, bananas are a really nice

choice. Berries are great, they tend to be blood sugar friendly. Like there's some people

who have blood sugar spikes from bananas, okay, you can swap them out, focus on your

berries, you're gonna have peaches, apricots, skin on please the skin has fiber and other

nutrients to offer to feed your guts microbiome, to help that blood sugar ratio regulation

be friendly. There's a lot of ways you can work around this without having to spend

hours and hours cooking.

Evan H. Hirsch, MD 37:37

Excellent, very helpful. So you talked about how sometimes people are skipping lunch

because they're very busy. What about skipping other meals, like skipping breakfast and

doing some intermittent fasting,

Beverly Yates, ND 37:49

intermittent fasting can be really helpful, particularly when it's done? Well. Historically,

certainly ancestrally for all of us on this planet. As humans, we've always grown with

periods of time a feast and famine, it is a natural part of the rhythm. For some of us

based on our religion or spiritual practices, fasting may well be baked right into the

culture, great, I'd say lean into it and follow it. I feel like in today's world where we have

such an exposure to highly processed Ultra refined foods, and maybe a lack of density

of nutrient density, it makes sense to do intermittent fasting because intermittent

fasting invites the body to remember and restore insulin sensitivity. And to give you a

real tool that helps you deal with and break up issues with that metabolic flexibility and

insulin resistance. So I think intermittent fasting is great, I think you could do it and find

that eating window that works for you. So that way, you aren't getting yourself into

trouble with what's appropriate. Some people do well with an 18 Six fast. Well as let's

say they eat at noon, and they they're eating Windows starts at noon, and they end at

6pm. Other people it's going to be maybe a 1410 Right? So they start at 10am. And

they'll stop eating like at 6pm Whatever the logistics are for you. Pregnant women,

breastfeeding women should never fast that is not the time of life to be fasting. And

religious and spiritual practices. Absolutely talk about that, like this is known this, that's

not a fasting state. You just don't want to do it. It's metabolically too demanding. Other

than that, I think it's great. It's a simple, easy healing tool because you're not eating. How

simple is that?

Evan H. Hirsch, MD 39:35

Yeah, and I think that both the dietary recommendations that you made and then also

fasting, they're kind of changing the way that we're using fuel or we're using different

fuel in the body, right, because you talked initially about glucose being a major fuel that

we use, but sometimes and and metabolically it's actually not the best fuel. So what

other fuels do we have in the body that we can use? Instead of glucose, yeah,

Beverly Yates, ND 40:02

so we have glycogen storage backup form in our liver. And if we are in a fasting state, if

we go into ketosis because we're doing a Keto program, we're going to tap the stores of

fat that exist in our liver, or we're going to tap the stores of fat that exist in the

abdominal area, the belly area, right, that visceral around the organs. And in Oregon's fat,

we want to tap that fat because it's troublemaker fat, that particular fat gives off

inflammatory products, really, cytokines that are just trouble. We have good kinds of

inflammation. Like if you get a paper cut on your finger, your body responds to that cut

with healing, cytokines, healing inflammatory markers, we want that what we don't want

is the ones that cause the heart attacks, the strokes that interfere with the flow of blood

and other goodness to our brains and can set us up for things like dementia and

Alzheimer's, damage the kidneys, etc, that inflammation, it can be a real bugger, but it's

worth getting in front of it. So it doesn't hijack really your ability to live long and live well

and enjoy your life. You know?

Evan H. Hirsch, MD 41:03

Well, this has been absolutely wonderful. So for people who are listening to you, and

they're like, Man, I really want a CGM, because I want to see what my blood sugar's look

like they've got diabetes, maybe or pre diabetes, and they really want to work with you.

Where can they learn more about you? And do so? Sure,

Beverly Yates, ND 41:19

sure, they can go to my websites, we're between two because we had some issues with

one contractor, they could go to natural healthcare.com. Spelled just like it sounds and

ATURALH e a l th ca r e.com. And they can also go to my name Dr. Like the abbreviation

for Dr. So Dr. bevrlyy@s.com, and get more information about that. They're

Evan H. Hirsch, MD 41:50

excellent. And we will put those links into the show notes as well. And you have the

100% virtual practice, correct?

Beverly Yates, ND 41:58

Yes, there's 100%, telehealth I had adopted telehealth back in 2009. Because one of my

patients at that time just traveled so much. They weren't always able to get in person to

the clinic, right? They were all over the planet. And as that technology became more

mature and available, you know, I was able to get some people on board. Some people

didn't want to do it. And then with the pandemic, everybody's like, I need help, and I

needed and so that really has changed it and now they love it. It's just so interesting how

things could change over time.

Evan H. Hirsch, MD 42:25

Yeah, that's Yeah, it's so important that people have access. So that means you can

work with people all over the world, is that correct?

Beverly Yates, ND 42:33

Yes. Because in this case, if they're outside of this area, then we can have more of a

health coaching relationship and take it from there. The things that I am suggesting are

all in the lifestyle realm anyway, if someone is on prescription meds, and this is just it's

both the legal requirement, and I feel like it's the moral ethical requirement. If you aren't

the health professional prescribe that you don't and prescribe it or change it, you can

certainly educate this person about what it's doing potential interactions or side effects,

but it's not yours to mess with. So I always tell people, if you're on meds, whoever

prescribed them is the one you need to have that conversation with. Meanwhile, we can

help you with your nutrition, your stress your sleep, get you going with your meal timing

and help you think about what's appropriate for you for exercise and strength training.

And if you're injured in pain, don't despair, we can still work with it. It doesn't have to be

that you know, basically become an Olympian. That's not a requirement.

Evan H. Hirsch, MD 43:24

Excellent. Yeah, I'm 100% virtual as well. And I think it's, it's a really great service to

people who can't find the help where they need it.

Beverly Yates, ND 43:31

Yeah, there's a lot of people who are basically in health deserts. We don't talk about it

like that, but that's what it is.

Evan H. Hirsch, MD 43:37

Yeah. Agreed. So you have an exciting event coming up.

Beverly Yates, ND 43:41

Yeah. So we have the reversing type two diabetes Summit. 2.0. We're back baby. And Dr.

Evan Hirsch Shaw, he is one of our amazing speakers on that summit. In fact, his

particular episode, right? We'll be live on May 10. So do check the summit out, please

come join us. It is free during the time period where it's available and open for everyone

to come and get that information. And if you want to purchase it that helps to support

this work. And to make sure that we have the money in the bank so that we can go and

continue to promote and do these kinds of things. And so everybody gets to be healthier

together. Brilliant.

Evan H. Hirsch, MD 44:17

Dr. Bev, thank you so much for joining me today.

Beverly Yates, ND 44:21

Very welcome. Thank you for the invitation. I appreciate it.

Evan H. Hirsch, MD 44:24

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