Fats, Heart Disease and Energy with Andrea Nicholson, BCHN

Episode 107:

Fats, Heart Disease and Energy with Andrea Nicholson, BCHN and Evan H. Hirsch, MD

Evan H. Hirsch, MD 00:07

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

chronic fatigue ME/CFS and Long COVID so that you can live the life you deserve. So

really excited about today because we're gonna be talking about how to boost your

energy naturally by tapping into body fat. So you gotta stay tuned in order to know

exactly what that means. And we're going to be doing that with my friend Andrea

Nicholson. So let's learn a little bit about Andrea. So Andrea transitioned from crime

scene investigator to functional health investigator after solving her own health

challenges with insulin resistance, chronic constipation and advancing heart disease.

Today, she uses those same investigative skills with her clients to identify and solve

underlying health challenges associated with insulin resistance and metabolic health.

Andrea is certified in holistic nutrition, a certified nutrition nutrition therapist master

level three restorative wellness practitioner and has completed several continuing

education courses in low carb nutrition therapy practices. Her practice is entirely virtual,

based out of Parker, Colorado. Andrea, thanks so much for joining me today.

Andrea Nicholson, BCHN 01:14

Yeah, absolutely. Thank you so much for having me. This is gonna be a lot of fun.

Evan H. Hirsch, MD 01:17

Yeah. And so I got a, I got to understand what this whole crime scene investigator thing

is first, because that that whole transition from crime scene investigator to functional

health investigator really is the best tagline that I've ever seen.

Andrea Nicholson, BCHN 01:31

It is definitely a unique story, and probably not one that you'll find anyone else that last

year. So yeah, it's an interesting story. That was my career at the time. And it seems

unrelated, because it kind of is, but that just happened to be my career at the time when

I was going through my own health journey. And so through that, you know, heart

disease is obviously a big deal for everyone. It's a really big deal in the field of law

enforcement. And it's a really big deal in my own personal family. That's the biggest

family history My family has. Thankfully, I was adopted as an infant or would have been

orphaned at 15, when literally, my entire family had all passed away from heart disease,

well, including both parents fairly young, my mom was only 49. And so that was always

a big thing in my mind. And then in law enforcement, you know, with high stress and

crazy hours, and just all the things. It's also a really big deal in law enforcement. And so

working as a crime scene investigator, I was around that. We had a sheriff at the time,

who was very interested in helping the staff not to go down that path. And so he brought

in this comprehensive cardiology panel with a local doctor that, you know, they were

doing the NMR profile testings for particle size, and they did the carotid scans, and they

did the EKGs and the stress test, and they didn't, you know, this whole big thing. And in

my mid 20s, I had heart disease already developing. And so that was kind of like, okay,

this, this is really serious. I wasn't obese, I was reasonably active. I thought I had a pretty

good diet. I didn't have any health considerations. I wasn't on any meds. Like I really

thought I was going to come out, okay. And I didn't. My arterial age was like four years

older than my chronological age, I had all the wrong lipid profiles, had high

inflammation, just like all the things and I'm like, Oh, this isn't good. I'm halfway through

my life if I continue down the same path as my family, and you know, if I pass away

early, like my mom did, and so that was really not okay with me. But the doctor was like,

you know, just eat a heart healthy diet, exercise, don't smoke, and you know, don't get

overweight. And I'm like, Okay, well, I'm already not overweight. I've already never

smoked a day in my life. Like, I already thought I had a pretty good diet, and he couldn't

really tell me any more detail than heart healthy diet, just, you know, standard advice.

And I'm like, okay, so I ended up just kind of doing my best I did my own research, you

know, I looked up the American Heart Association and like, all their recommendations,

went down that whole path ended up throughout the next year, transitioning to a fully

plant based diet, you know, all the fiber, low fat, you know, cut all the saturated fat really

watched my calories, started working out, like twice a day just really tried to do

everything I could do. The year later went back to the exact same panel again, and it

was worse. Like significantly worse. Now, my arterial age was 11 years older than I was,

inflammation was even higher, like everything just went the wrong direction, doing all of

the right things. This was not Oreos, and Doritos. This was plants and whole grains and

you know, lots of fiber and low fat and balanced calories. And I was just at a complete

loss. And so that's when I really just had to use those investigative skills to figure out

what the heck was going on. Because none of the standard advice was working for me,

and in fact, it was making me worse. And so that's where the investigation side of it

comes in.

Evan H. Hirsch, MD 04:57

That's awesome. And so I actually you know, We'll come back to the belly fat thing. But I

think this is really interesting. And it's a topic that we haven't really discussed before. So

I'd love to go down the heart disease rabbit hole, if that works for you. Yeah. Great. So

then we're all kind of on the edge of our seat here. So then, so then what happened

next?

Andrea Nicholson, BCHN 05:16

Yeah, so you know, the same, the same thing I asked again, the next year, I'm like, Okay,

here's all the things I've done for the last year, and it got worse, like, literally, what am I

doing wrong? Well, I must be doing something not right. And he really still could not tell

me anything helpful. You know, none of my like lipid panel stuff, even though it was all

the wrong profiles, none of it rose to the level that he thought I needed to be on a statin

or anything. So he wasn't, you know, pushing any drugs on me, which, thankfully, that

was true, because I was definitely not interested in going that route at all anyway. But he

still couldn't tell me like, why it was getting worse, what was actually going wrong, what

was I doing wrong, I really just didn't want to sit back and blame my genetics, that would

have been the easy thing to do, because that was my entire family history. And I knew

that. But I just, I knew enough to know that genetics aren't guaranteed, they don't mean

you're automatically going to get the whatever the disease is, in most cases. And so I

just didn't want to kind of play the victim card. And, you know, just sit back and say, Well,

I guess I'm gonna die young, like everybody else. I really wanted to understand why it

was happening. I knew there was something. And so I just started doing different

research. And I'm like, Okay, well, clearly the advice of all the conventional American

Heart Association, all of the, you know, standard fitness and nutrition stuff that was kind

of on the front of every magazine, and those kinds of things. That was all the stuff I was

doing, and it wasn't working. So I had to find something different. And so that's when I

kind of turned to different sources, and different people who were looking at it

differently, who were actually doing the research who were in what we know, today is

functional medicine. And this was, you know, 20 years ago, that wasn't really a big topic

of conversation. Back in the day, nobody really knew those terms and that kind of thing.

But there were other tests, you could get done, there were people who were looking at

things in a different way. And that's when I kind of stumbled into this whole world that

we now know, is functional medicine, and learned a lot more about my body and how it

was working and why, you know, plaques developed and what actually drove cholesterol

and all of those kinds of things. And really then looked at my own diet and found that,

yeah, I was eating a lot of really good foods, all these, you know, great plant foods. But I

was essentially eating all carbs. I was super low protein, I was super low fat. So I was

deficient in all the fat soluble vitamins. I had lots of other nutritional deficiencies. My gut

was actually a mess. I didn't even know it at the time. But through this journey of

learning more about my body, that's when I discovered that I was chronically

constipated. I didn't know that's all I've ever known. That was just my normal. And so

that really made me look at my gut. Realize that was a mess. I had basically no bacteria

despite eating all that fiber, all this fiber that's amazing for your gut microbiome. I had

basically no microbiome I had a couple of pathogens and very low good bacteria. So

you know, just kind of working my way through all those things. And I found this whole

world of blood sugar management and insulin resistance. And I knew a little bit about

that, because my adoptive mom is type one diabetic, so I knew about blood sugar from

her perspective. I didn't really know anything about insulin resistance. I knew I wasn't

like type two diabetic. But I did have insulin resistance. My insulin was high and my

agency was climbing and I was going down the wrong path. And yeah, when you look at

what I was eating, was eating all carbs. I was eating frequently, because not only do

carbs not keep you full for very long, but that was the advice. Eat every two to three

hours. Keep your metabolism stoked. So like, I literally looked at everything. I was doing

everything I was eating, my eating schedule, my eating habits, my workouts, all the

things and I was just literally doing all the wrong things for my body.

Evan H. Hirsch, MD 08:59

So then the next year, so then you did all the right things. As you're kind of going through

this. You go low carb. You What else did you do? Yeah,

Andrea Nicholson, BCHN 09:08

I started doing more fasting, eating less often. Getting back to just eating like meals, not

meals and snacks and you know, constant food all day long. I implemented a couple not

very often but a couple of longer fasts to just sort of kind of reset the body and you

know, just break some of those eating habits cycles that I had. I also worked on the gut

health so I eradicated the pathogens and rebuilt the microbiome and got the gut kind of

working again. So over the next several years, I really changed all the things I added

more animal proteins back in I added healthy fats back in. I really started scrutinizing

every label. You know, I was still getting a lot of vegetable oils and stuff because with all

the vegetables, I was eating a lot of salads and those kinds of things. And so the salad

dressings are full of all the battle oils, and there was a lot of things that I just didn't

know. And so through this process, I really started scrutinizing labels, really paying

attention to the food quality, you know, increase the protein, increase the healthy fat, you

know, changed my eating schedule, I also changed up my workouts, I was doing a lot of

high intensity cardio. And I wasn't doing as much strength training stuff. And so I

needed to build more muscle. And I needed to stop stressing my body as much as I was

with the chronic cardio that was really causing a lot of inflammation, and I could feel it

in my feet, and my legs, my joints, everything was sore, I was stiff, even on the days I

didn't work out, it just really wasn't working super well, for me. You know, the career

alone had a lot of stress, you know, crime scene investigation as a 24/7 job. And so

there was a lot of sleep disturbances and, you know, having to hit drive throughs or

having to eat, you know, pizza, or burgers or whatever they brought to you on scenes.

Thankfully, that wasn't an everyday thing. So I did have control over the bulk of my diet.

But there were those days when it's like, I haven't eaten anything and 12 hours, and they

just brought pizza. So you know, you're going to do what you got to do when you're at

the scene, and you can't really leave and you can't really take your food with you. So, you

know, there were lots of things like that that did factor in. But ultimately, yeah, it was

cleaning up the diet, changing the foods I was consuming, you know, eliminating the

vegetable oils and some of those inflammatory ingredients that I didn't know about

previously. And then changing up the workouts really paying attention to just you know,

quality diet, the right exercise, sleep, stress management, all of those kinds of things.

And over the next several years, those were the things I really focused on and just

improved. All of those things. And yeah, when I went back, to redo the panel one more

time, all of it was gone. They couldn't find any plaque. All my lipid panels were correct.

My inflammation markers were ideal. I had no more insulin resistance. My arterial age

was now younger than my chronological age, like it all reversed.

Evan H. Hirsch, MD 12:04

That's awesome. So you ate more. I mean, it was a combination of all these things, but

you ate more meat. I did. Right? And you got better, better blood vessels and less

plaque. Can you talk a little bit about the myth around that,

Andrea Nicholson, BCHN 12:19

you know, there's so much misinformation that we've all been fed for so long. And this

takes a long time to kind of wrap your head around, because you end up kind of doing

the opposite of what we've been told for all these years. And now, it took me a long time

to kind of get used to like intentionally eating fat again, after all those years of trying to

avoid it, and trying to really, you know, go low fat, which automatically lowers the

calories. And so when you're focused on calories and fat, you know, you end up

eliminating so many great things, but we need healthy fats, our brain uses a ton of fat,

we need the fat for our hormones for our cell membranes for just so many things in the

body, that we really have to have fat in our diet. Now, of course, there's a wide range of

types of fats, there's different sources of fats, there's, you know, industrially produced or

modified fats. And then there's the natural fats that come with our foods. And so I'm a

big fan of all of the range of natural products. So I think, you know, we do need the fats

that come with our animal products. We do also benefit from the fattier fruits like the

olives and avocados and coconut, I think we need to avoid the chemically altered and

fake fats, those kinds of things that are damaging our cell membranes and our cell

receptors and our cell signaling processes and all these things, you know, that's true of

any fake ingredient, really, whether that's a fake sugar, or fake fat, chemical additive

preservative, they're chemicals, and our body doesn't really know what to do with them.

And so we definitely need to stick with, you know, the whole foods. But we've been told

that fat is what clogs your arteries, and you know, that like, logically seems like it makes

sense you eat fat, it goes straight through your body, you know, into your blood and gets

stuck in the cell walls, or in the blood vessel walls. That logically seems like it makes

sense. But that's just not how biology actually works. That's not how the body processes

fat. It has to go, you know, through various systems, it goes through the liver, it gets

packaged, it gets carried on proteins, it doesn't just freely float in the blood. Like if you

actually understand anatomy, physiology, biology, then it's actually really easy to look at

it differently. Because that's just not how fat works. It doesn't just freefloat straight from

our stomach through our blood and then land wherever it lands. That's just not how it

works. And so we've been told to fear the fat, frankly, based on core science, and so we

really need to just completely unwind that narrative and get back to eating real foods. I

mean, if you look at human history, back in the day before industrial food plants existed,

we ate eat natural fats on animals from all the fatty, you know, just all the things in

nature, we ate the fat and it didn't cause heart disease. You know, 1000 years ago,

people didn't die from all these chronic diseases back in the day. They do now, because

of the processed foods, the chemicals, the altered nutrients, if you can even call them

that and our food today. And so fat is not what we should be fearing. It's the processed

foods, the industrialized foods, the chemical fake things that we're now consuming that

really we need to get out of our diet.

Evan H. Hirsch, MD 15:34

And weren't the vegetable oils kind of like a byproduct of some of like the industrial? The

company's you know, and they were like, how can we sell this?

Andrea Nicholson, BCHN 15:45

Yep. Yeah, they were a lot used in like engine manufacturing. And they were used as

lubricants. And then it was like, Hey, we can actually sell this as food. You know, a lot of

the cereal products are the same thing. Those were a lot of that wheat bran was a waste

product. And they were trying to figure out what to do with it. And they turned it into

cereal, and then told us all that we need breakfast cereals, because breakfast is the

most important meal of the day. So sadly, a lot of our food that we think of today, never

was food to begin with. And it certainly isn't a natural product. And so just as much as

we can get back to eating real, whole natural foods, the better.

Evan H. Hirsch, MD 16:27

Yeah, well said. And so you talked a little bit about this, but kind of the, I guess the

difference between like the saturated fats and the unsaturated, which ones are better,

because the saturated are like those that seems like they harden at room temperature.

And the ones that you know, you see the coconut oil, and you see the butter, and you're

like that's getting in your arteries. And that was kind of like, you know, what we were we

were told, you know, 2030 years ago, and even still now, right by doctors who just aren't

in the know. So can you talk a little bit about the difference of those? Yeah,

Andrea Nicholson, BCHN 16:59

so they're basically just a different chemistry set, they've got a little bit of a different

chemical structure is really the only difference. The thing that I think we all need to

understand is there are no foods that are like 100%, saturated fat, even butter, or

coconut oil is a mix of all the different kinds of saturated and unsaturated fats, you're

getting a wide range of all of them in everything that has fat. So even the foods that

have like the highest percentage of saturated fat, it's really like 2%, it's not that much

saturated fat in the grand scheme of the total food, you know, if you're looking at like

bacon, or you know, red meat, that those are the things that are often or vilified. When

you look at how much of it is water content, how much of it is protein content, how

much of it is, you know, other nutrients, other things that are in there, and then you look

at the fat, it's, it's really not that much actual saturated fat, we're getting the wide range

of all of them in all the foods that have fats. So I think that's the first thing for people to

understand is we're not just eating saturated fat, so you can avoid butter and coconut oil

all you want, but you're still going to get some saturated fat in other sources. Even like

olive oil is going to have some, it's gonna have unsaturated it's going to have

polyunsaturated, and it's going to have a little bit of saturated fat as well. So we need to

really stop kind of vilifying any one of them but alone, because you don't you get them all

together anyway. The thing I think that also awakened me as a lot of the fat that our

bodies produce, when we're taking nutrients, and we're creating fatty acids to be stored

for later use. A lot of what our body makes is saturated fat. Well, why would your body

make something that's dangerous for you? That's designed to kill you just doesn't even

make sense. So why are we fearing something your body naturally produces? So I think

we really do need all of them. And we need to maybe not even hyper focus on how much

of each one like of course, there's going to be individual variations and people are going

to react differently to certain kinds of fats or certain just like we do with certain foods,

some people are allergic to peanuts. Not everybody is that doesn't mean everyone

needs to give up peanuts. And so I think we need to really look at it from an individual

standpoint, what makes you feel the best? What gives you the best results personally? Is

it a whole natural food? Are you getting the natural composition of fats in that food

because it's from nature, that I wouldn't worry about it as much I do worry about the

foods where they've artificially altered the fat profile or removed the fat from it because

you're also losing some of the cofactors and the other things that go with those

ingredients. When you you know take like milk for example, if you go skim milk versus

whole milk, when they take all the fat out they're also taking some of the enzymes and

some of the The other cofactors that you need to actually use that milk appropriately,

not that milks necessarily the ideal thing for anyone, or everyone for that matter. But

that's just an example of when you alter the fat content of a food, you're not just altering

the fat content, you're also altering the overall profile of that food. And as much as we

can just leave things as they were created in nature, the better off will be.

Evan H. Hirsch, MD 20:26

Amen. So it's good to go back to thinking, you know, how did we live 10,000 years ago,

you know, and what does that actually look like? So let's talk about quality of fats. You

know, we've got the animal proteins, the animal products, and then you said olive,

coconut avocado, you talk about, like, when you're choosing these particular items, what

should you be looking for?

Andrea Nicholson, BCHN 20:54

You know, I'm a big fan of all of them. Frankly, I like all the animal proteins and fats that

come with those proteins, and I like the fattier fruits as well. And for some people, I think

dairy can also work well, for some people, that's a inflammatory thing. For a lot of

people, it doesn't work for some people. So that's a very individualized thing, just like

every other food frankly, is, but I'm a big fan of the fats that just naturally come with

these foods. So as much as we can just lean into, you know, enjoying the fat that comes

with our meat, enjoying the whole egg, enjoying, you know, fattier fish, or those kinds of

things. And then whether you like avocado or mashed up in kind of a guacamole form,

or if you like, you know, any of the coconut products, I think those are all fine. I think just

all of those are good, we just want to make sure we're getting quality products. So you

know, when it comes to produce, as much as we can try to get, you know, organic, good

brands so that you can actually trust you know, that's the problem with anything that

comes in a package. Especially oils, you really don't know for sure what's in it, they say

it's 100%, olive oil or avocado oil. But unfortunately, a lot of kind of stings studies have

been done and found that they're cut with canola oil, they're not actually filled with the

right oil in the bottle. So those are a little bit of the risks with oils. It's again, why it kind

of like whole natural foods, because nobody can substitute the oil that's found in an

avocado, but they can substitute with an avocado oil bottle. And so the more whole food

you can get, the better you'll be. So when it comes to produce, you know, as much as

you can get organic, you know, that's the best from good quality brands and sources.

When it comes to animal products. You know, grass fed, grass, finished organic, all of

those kinds of things are going to be important when it's fish, you know, trying to get

wild caught, flash frozen, those kinds of things where you know, it's the best quality

seafoods possible. I'm just a bigger fan of trying to get all of our nutrients straight from

the whole source. I would use oils less often just because they are you know, they are

processed it minimally processed food if it's a good quality, but it is still not the whole

original food. So as much as we can eat that whole original food, I think we're going to

be better off.

Evan H. Hirsch, MD 23:11

And with olive oil, oftentimes, we're looking for extra virgin this that and the other thing,

what do you think is high quality olive oil that we should be aiming for?

Andrea Nicholson, BCHN 23:23

Yeah, I like the extra virgin. That's that's kind of my go to when it comes to the olive oil. I

think avocado oil usually is just virgin. And then same thing with coconut oil. It's usually

virgin or unrefined, depending on the label. So those are all terms I would look for

anything that says refined or enriched, I would avoid whether that's an oil grain, any kind

of packaged product, that means they've removed things and then tried to put some

stuff back in. But a lot of times what they put back in is, is either synthetic or never

existed in that food anyway, kind of like vitamin D and orange juice. There's no vitamin D

in oranges. So why are we adding vitamin D to orange juice? It's a fat soluble vitamin,

there's no fat in orange juice, you're not gonna get any vitamin D out of that so save your

money so yeah, I'm a bigger fan of the extra virgin olive oil when it comes to that and

then you know just organic if you can do it and from a good reputable brand, preferably

one that's been third party tested so that you know that it really does contain olive oil

and not other fillers.

Evan H. Hirsch, MD 24:27

Tell me a little bit about the stability of oils, you know in terms of which of the oils that

we can be putting on salads, and which are the ones that we should be cooking our

turkey bacon with. You

Andrea Nicholson, BCHN 24:40

know, this is a hotly debated topic and you can find research on a wide range of

spectrums here. There are some research that says you know, pay attention to smoke

point and if you've got a low smoke point, you shouldn't cook with it. And then there's

other studies where like they cooked with various oils and butter and lard and all these

things and like Olive Oil actually came out as one of the best in that particular study

based on looking at like polar compounds being developed and those kinds of things in

the cooking process. And so that particular study, I think it was out of, I want to say

Sweden, I can't remember offhand, it's been a few years since I read it. They actually

said olive oil was the best for like regular cooking, like saw Tang, baking those kinds of

things. And so, you know, I honestly don't know that we really know for sure, because

there's different compounds that are developed as things are cooked. There's different

things that are destroyed as things are cooked. And so there's gonna be pros and cons

across the board. I think when it comes to cooking, like animal products, I like using the

animal fats for that, you know, whatever's either naturally with it, or like using either

butter, lard, you know, those kinds of things, I think, is really good. Coconut oil tends to

be okay, but not everybody likes to flavor depending on what you're cooking. You know, it

does add a little bit of a different flavor. I think it's reasonably low temperature, you can

probably get away with avocado oil and olive oil. Grilling maybe not so much, because

that's often so much higher. So you know, I think it really depends on what kind of

cooking you're doing. What temperature you're going to be cooking it at how long is it

going to be cooking for? You know, how much do you really need to add a lot of things

we can cook without adding any cooking oil of any kind or any kind of added fat, it'll

naturally come out of the food. And so we don't necessarily always need to cook with

any.

Evan H. Hirsch, MD 26:28

Let's pivot back to heart disease. You had mentioned, the doctor did not want to put you

on a statin drug. Can you talk a little bit about you know, when somebody comes to you

and says, Hey, my doctor wants to put me on a statin? What do you tell him?

Andrea Nicholson, BCHN 26:46

Well, I am not a medical doctor. So I do not recommend or avoid. Or I don't get into the

pharmaceutical game too much directly. But I do try to educate people on you know,

resources they can go look at for to just be informed consumers informed patients

understand the risks and benefits of whatever they're considering or someone's

recommending to them. I think the same thing is true, whether it's a nutrition plan, a

fitness plan, a supplement a medication, we need to be taking more control over really

being educated and fully informed around these things so that we can make the best

decision for ourselves. So statins, like every pharmaceutical drug have pros and cons.

They are capable of doing what some of them claim they do, which is you know,

lowering LDL cholesterol. It's debatable if that's a good thing. You know, there's some

newer research that showing that, especially as we age having a little bit higher LDL

cholesterol might actually be protective. It's you know, LDL is another one called like,

dairy fat or dietary fat that has been vilified. But LDL is actually a big part of your

immune system. It helps carry out bacteria from your blood, it helps reduce your sepsis

risk it, it's one of the responders to your for your immune system. That's why it's actually

part of plaque is it's responding to deal with the wound or the injury or the damage. It's

it's not actually a problem. It's a responder, it's kind of like the ambulance that shows up

to the, you know, the accident scene, the ambulance didn't cause the accident, but it's

there trying to help repair the damage or, you know, clean up the scene. And so the

problem I have with drugs, like statins and a lot of others are similar is they can increase

your risk for things like diabetes, you know, they can deplete your energy because they

changed some of the other cellular pathways in your body like statins for one, kind of

block the pathway that we need to synthesize co q 10, which is tremendously valuable in

energy and, you know, muscles and just all the things that we need to live our best lives.

And so, you know, they have downsides. And so I think we all just each need to be really

well informed so that we can make our own best decisions. And then know that it is

your decision to make what you take. It's your decision to make, you know what food

you eat, how often you eat, what kind of exercise you do, what kind of pills you take all

the things you actually get to say to your body. And so your doctor may make a

recommendation for a particular prescription or a particular procedure. But you

ultimately get to say no one else can make you do anything. So I think you know that's a

big part of it is just being well educated. And sometimes we just need someone to tell

us like Where can I go learn more. You know, the internet is an amazing thing. But it can

also be kind of a scary rabbit hole and not always super helpful because you can end up

with the wide range of opinions and a wide range of conflicting information. So

sometimes it's nice to you know, ask people like you or ask people like me, for

recommendations on where to go get differing opinions and I think that that's just where

we need to go with, with all the decisions we're making, we need to take back control

and ownership over these decisions and being informed consumers.

Evan H. Hirsch, MD 30:11

Amen. Let's talk a little bit about labs. So coming back to or staying with heart disease.

So are there particular labs that you'd like to look at to determine, you know, somebody's

heart attack or stroke risk?

Andrea Nicholson, BCHN 30:28

You know, I mostly start off with a relatively basic panel, the stuff that your doctor is

probably already running, you know, your normal CBC and your comprehensive

metabolic panel, your lipid panel, just, you know, the standard stuff. Let's start with that.

And let's see, if there's any indications of problems there. Let's see where there's, you

know, underlying imbalances, do you have blood sugar issues, you know, those kinds of

things, I like to also look at, you know, fasting insulin, because insulin resistance is one

of the primary drivers for heart disease. And so I really want to know where your insulin

resistance is at. So hemoglobin a one C, and a fasting insulin, in addition to the glucose

that's going to come with the comprehensive metabolic panel, that gives us a really

good picture for the blood sugar handling side of diabetes and heart disease risk. You

know, the lipid panel, of course, plays directly into, you know, those kinds of things. So

triglycerides is actually my number one thing that I really like to look at, we really do not

want high triglycerides, it's, it's just dangerous for all of the chronic diseases, the stroke

risk, the heart attack, risk, hypertension, all the things it's directly related. So that's the

number one thing I look at on the lipid panel. And I also want to see a good HDL level,

which is, you know, considered the good cholesterol, we want that to be, you know, a

good robust amount. And then, you know, just looking at the total package there as well,

you know, what is your LDL, you know, total matters less to me, because it's made up of

the good and the bad, and it doesn't really tell you a whole lot about what's going on. But

looking at the fractions of the rest of those I think can be helpful. And sometimes that

can then dictate, okay, maybe you do need to go for something more comprehensive

and actually look at, you know, the particle tests, or do a coronary calcium score, or do

you know, some more advanced testing to see if there's something there. Sometimes

those can also just kind of put you put your mind to rest, if your doctor really is like

pushing a drug that you don't want to do. Sometimes you can ask for the more

advanced testing to really weed out what your real risk is, because sometimes the basic

panels can look a little risky, and then you run the more advanced panels, and yeah,

there's like a coronary coronary calcium score, and it's a zero, so you have no hardened

plaque, you know, that they could find. And so I think there's a wide range of things.

Those are some of the top from what kind of a basic lab standpoint, inflammation

markers, of course, make a big difference as well. So looking at things like C reactive

protein, high sensitivity, C reactive protein, homocysteine, you know, those kinds of

things, I think are also really helpful.

Evan H. Hirsch, MD 33:08

Very cool. fibrinogen. Milo, peroxidase, any of those you like, Yeah,

Andrea Nicholson, BCHN 33:14

I think those can also be helpful. You know, depending on the client, depending on the

situation, I think those actually do provide a lot of extra information. I don't frequently

see those on standard panels that most doctors are running, at least the ones that my

clients bring to me, they rarely have those markers on them. I think if somebody was

already at risk, or like just came through some kind of surgical procedure or something.

And so you know, sometimes those get included, but those I rarely see those on panels

that my clients bring from what their doctors have run.

Evan H. Hirsch, MD 33:44

Yeah, that's helpful. And so what do you like for fasting insulin? What do you want it to

be?

Andrea Nicholson, BCHN 33:51

You know, the lower? Well, I would generally say the lower the better. But obviously, we

don't want zero because you do need insulin, you just don't want it to be too high. So

generally, I like to see it, you know, for sure, under 10 is a good thing. two to six or seven

is really ideal in the US.

Evan H. Hirsch, MD 34:10

And what do you like for hemoglobin a one C,

Andrea Nicholson, BCHN 34:14

ideally under 5.3. But same thing, I mean, we don't need to be striving for like a three, we

don't need to go too low. We do still need some some of that to be found. Because that's

an indication of what your blood sugar's have been doing for the last roughly 60 To 60 to

120 days. And so if it's too low, that could indicate a different situation. So generally, you

know, upper fours, low fives.

Evan H. Hirsch, MD 34:43

And what about the lipid panel? What do you like to see for cholesterol, LDL

triglycerides,

Andrea Nicholson, BCHN 34:51

it actually varies a little bit based on age. There's some research that shows you know,

as we age, we actually want a little bit of a different profile. Albon we do when we're

younger, and then there are some variations, male, female as well. And so the ones I

really look at I like triglycerides to be under 100. Ideally, you know, 50 to 70 kind of thing

is, I think pretty reasonable. LDL, you know, 150 or under is generally a good thing. But

same thing, we don't want it to be too low, especially as we age. So we do actually want

LDL to be present, we don't want a super low value, because that comes with its own

problems. HDL is gonna vary a little bit women, we typically want to be higher. So you

know, 65 to 85, is pretty good. Men, generally more, you know, 55 to 75 kind of thing. So

just a little bit lower, seems to work pretty well. Total, I really don't pay attention to a

whole lot. But you know, kind of a standard number people aim for is usually 200 or less.

But I think if you've got a robust HDL and a good LDL, you could actually be a little bit

higher than that. And so I don't really care so much about total.

Evan H. Hirsch, MD 36:07

Yeah, in my family, we have some of the familial hypercholesterolemia. And so we're

always running around 250 to 300 generally mean, because our HDL is like, 100 110.

What do you think about? What do you think about those numbers? What do you

recommend to those people?

Andrea Nicholson, BCHN 36:27

You know, I think if it's truly a genetic situation, then I don't care so much about those

numbers all by themselves, if they're in the context of ideal health, and all the other

categories. So if you don't have any evidence of metabolic disorders, you don't have type

two diabetes, or prediabetes, you know, have high inflammation, like if everything else

looks good, and you're in the ideal ranges for all of the other kind of key markers. I kind

of don't care as much. I mean, if you really want to know, you could do the CAC scoring,

you could do you know, the CT scans of the arteries and just see what the plaque

situation looks like. You know, I think there's other things that you could do to really

know for sure. But I think if the rest of your stuff looks really good, I'm less concerned

about high total, especially if you've got good HDL and good triglycerides, those are kind

of the two that I would care most about.

Evan H. Hirsch, MD 37:24

Yeah, and I think what's important for people listening to this and watching it right now,

is to realize that, you know, the, what you're getting from your conventional Doc is like,

you know, just the cholesterol. And there's so much that we're talking about here, that

needs to be looked at to get a complete picture. And before you go, and you get a statin

drug that has a whole bunch of side effects, you need to kind of explore a number of

these things and look at okay, well, what can you do first, in terms of being more natural,

getting back to basics, getting back to nature? Yeah. Awesome. So let's talk a little bit

about energy with the time that we have left. So in terms of insulin resistance, what is

the relationship between insulin resistance, and energy?

Andrea Nicholson, BCHN 38:08

Yeah, so if you have insulin resistance, your body is producing more insulin to do the job

that it's supposed to be doing with less. So it's kind of like the boy that screamed wolf

too much. And then, you know, nobody was listening anymore. The body is like

screaming at the cells to take in the glucose. And they're like, Nope, no vacancy, we're

not listening. And so your cells are not responding to the insulin anymore. So now you've

got higher insulin. And the body's not responding to it well, but what that means is you

can't really get the fuels into your cells where they can be converted into cellular energy,

or ATP. And so if you can't get energy into the cell where it can be converted, then you

don't have energy. If your cells don't have energy, you don't have energy. So your organs

don't work as well, your brain doesn't work as well, like all of these things just don't work

as well. And so we do need the appropriate level of insulin to be able to tell the cells

what to do, because insulin plays lots of roles in the body, one of which is to get blood

sugar, the sugar out of the blood into the cells where it can be used. But it's also then

telling the cell what to do with it. And generally speaking, when insulin is elevated, it's

telling the cell to convert it into something that can be stored. So insulin is a storage

hormone. It's a growth and storage hormone. So we're naturally highest in insulin, when

we're inactive phases of growing. So pregnancy, puberty, these kinds of things. We

naturally have some insulin resistance because we're trying to grow we're trying to store

and build new tissues. The problem comes in with those of us that are not pregnant or

in puberty. We don't really want to be growing necessarily because usually that means

you're gaining fat. You're getting larger, that can also fuel cancers and grow tumors and

those kinds of things. It's a growth signal. And so we don't, we don't want that

necessarily to be true. So we want to bring that insulin level back down so that the cells

can kind of repair that whole cell signaling system. And they can more efficiently use the

the fuels that are coming in. So most of us think that we can only really run on glucose

most of the time. But what that's actually not true, we can run on fats that we're

breaking down from our stored fats, we can convert some of those fats into ketones,

which are water soluble, short chain fatty acids that can actually float freely through the

blood, unlike fat, the blood is mostly water. And so fatty acids themselves can not just

float through the blood, because that's kind of oil and water, you can do that. So those

have to be carried on proteins. But ketones are water soluble, so they can float through

the blood. And they're also really tiny, so they can even cross the blood brain barrier. And

they can fuel the brain. So some, some of the newer research has shown that certain

tissues actually prefer to run on fats and ketones over glucose. So even in the presence

of both, they'll prefer the fats and the ketones. And so that includes the brain, that

includes the heart that includes, you know, lots of these different tissues that are pretty

high metabolic tissues, they use a lot of energy, you know, the brain is one of the biggest

energy stocks, you know, uses a ton because it's doing so much. And so the problem is,

you can't release fat from your fat cells, if insulin is high, because insulin blocks the

hormone needed to allow that fat to come out of your fat cells to be used for energy. So

if you can't break down these stored fuels, not only can you not really lose weight very

well, because you literally can't liberate that fat to be used or burned. But you're also

hungry more often, you have to really run on glucose, then you have to run on sugar. And

so you either have to be taking in that sugar, in the form of carbohydrates, of any kind

could be simple sugars could be vegetables, you know, any of those kinds of things. Or

you have to be converting other things into glucose, which our bodies are really good at.

And we can turn certain amino acids into glucose, we can turn certain components of

fatty acids into glucose. And of course, we can turn other sugars into glucose as well.

And so when insulin is high, when you have that insulin resistance, you can't use those

stored fuels. And so you're left to just eat for energy. And you can only really burn what

you're consuming. And so you can't keep up your energy unless you're eating. But then

you also can't really lose weight or lose fat effectively.

Evan H. Hirsch, MD 42:49

And so what's the solution?

Andrea Nicholson, BCHN 42:52

So the solution is to really get a hold of the insulin levels really bring those down. And

the easiest way to do that is through what you're eating. So carbohydrates have the

biggest blood sugar impact. And when you have a big blood sugar impact, you get a big

insulin response. And so that's going to be the primary driver is, you know, how much

glucose Are you literally taking in with your diet. But it's also driven by how often you're

eating, you know, every time you consume something, you get some level of blood sugar

spike and some level of insulin spike. So if you're eating every couple of hours, like I

was, when I first found that I was insulin resistant, you're getting a constant release of

insulin. And so it never has a chance to come back down to baseline between meals or

snacks. The only time it's really good opportunity is overnight, when you're fasting. And

so changing up the diet is one thing are really looking at how much you're taking in

looking up how often you're taking things in. And then obviously, portion sizes do play in

so calories do matter. Because if you're over consuming anything, you're gonna get a

bigger insulin spike period, just because you're over consuming, and the body's got to do

something with all of that coming in. And insulin is what's telling the body what to do

with it. And so we really need to get a hold of what we eat, when we eat and how much

we eat. And so if you dial in all three of those levers, then insulin will start coming down.

And there's a wide variety of ways to do this. You can do it through low carbohydrate

eating, you can do it through you know, intermittent fasting, you can do it through you

know, lots of different dietary strategies to really get a hold of your overall insulin levels.

Once those come back down, now you've got a little bit more metabolic flexibility so you

can burn sugar when it's available. And you can burn fat when you're not actively eating,

you can burn the fat that you've got stored, and that you have years worth of energy

stored on your body. Even the leanest of people can survive on fat for a very long time.

And so then you have sustainable energy all the time because your body can break

down that fat to keep everything running smoothly all the time, even if you're not eating.

Evan H. Hirsch, MD 45:05

And this is the work you do with people correct? It is. And where can people find you

online, we're what's the best place to go?

Andrea Nicholson, BCHN 45:14

The best place is my website, which is healthy life with andrea.com. And you can find all

the other ways to, you know, work with me or learn about the things that I put out in the

world.

Evan H. Hirsch, MD 45:26

And then you have a free gift for our audience, the metabolic mastery manual, you want

to tell us about that?

Andrea Nicholson, BCHN 45:31

Yeah, it's just a comprehensive guide around it covers some of the lab testing that can

be really helpful, some at home tools that you can use, like, if you want to use blood

sugar meter at home, if you want to use a continuous glucose monitor at home, those

kinds of things. So it goes through some of the tools that can be really helpful. It goes

through some nutrition strategies, lifestyle strategies, we talk about the three levers of

you know what to eat, when to eat, how much to eat, those kinds of things. So it's just

kind of an overall view of all the things that play into your metabolic health and what you

can do about it.

Evan H. Hirsch, MD 46:03

And this is incredibly empowering, you know, you don't need a supplement. Yeah, you

know, it's kind of the choices that you can make every day. And then you have your

metabolic mastery membership. Can you tell us about that?

Andrea Nicholson, BCHN 46:14

Yeah. So this is my signature offer. This is a one on one program that I work with people

on to address their metabolic challenges, whether that be insulin resistance, diabetes,

heart disease, hypertension, you know, whatever their condition may be. And it's just set

up as a monthly fee. And, you know, constant contact with people direct access to me

for as often as you need. And we just really dial in the right nutrition plan for you the

right eating schedule, the good eating habits, you know, exercise, sleep, stress, all the

things and we just dial in your metabolic health naturally, trying to avoid unnecessary

medications.

Evan H. Hirsch, MD 46:53

I love it. And you're 100% virtual like me, right? I am. Yeah. It's awesome. Excellent.

Andrew, this has been amazing. I think you dropped a ton of gold nuggets. I hope this

helps a lot of people. Thanks so much for joining me today.

Andrea Nicholson, BCHN 47:07

Yes, thank you so much for having me. This was so much fun.