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GUEST EXPERTS
How Mitochondrial Dysfunction
Causes Metabolic Disease
with Jess Peatross, MD, IFMCP
Click here to watch this interview!

Daily Detoxification
with Vivian Chen, MBBS, MRCP,
MRCGP
Click here to watch this interview!

The Simple and Forgotten Compo-

nents of Disease Prevention
with Donna Mazzola, PharmD, MS, MBA
Click here to watch this interview!

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learn about living a healthier and happier mit team, thank you for downloading these
life, and we hope you’ll make us a regular transcripts -- we hope you learn a lot from
part of that journey! them!
1

How Mitochondrial
Dysfunction Causes
Metabolic Disease
Jess Peatross, MD, IFMCP

Dr. Elmore: Dr. Jess Peatross has a passion for Dr. Peatross: Oh, good question. So I’m going to
uncovering the mystery behind chronic illnesses, terrorize you guys with biology 101. But you may
whether they be stealth infections, heavy metals, remember the word mitochondria from biology,
stress, trauma, or other environmental toxicities. and they’re actually way more important than
She is a visionary for the future of healthcare most of us are led to believe. And they are inside
and left her position as a board-certified internal every single cell of your body, except for red
medicine hospitalist to pursue functional blood cells. Those are the only cells in your entire
medicine in order to better serve her patients—by body that don’t have these little mitochondria.
getting to the real root causes of why the body is And the mitochondrion is a certain organelle
malfunctioning, correcting those root causes, and within the cells. It has an inner and outer
empowering patients to live healthier lives. membrane. And what it does is it’s able to
Dr. Jess Peatross, it is always good to talk to you generate electromagnetic potential, which
again. Welcome to the Metabolic Makeover Summit. means that it transfers pluses and negatives or
hydrogens and electrons, mostly electrons, along
Dr. Peatross: Thank you, Ms. Lindsey. I’m a Krebs cycle to generate a potential.
honored to be here.
And that means to generate energy. Or, as you
Dr. Elmore: Oh, so pumped because today we guys may remember, mitochondria, the endpoint,
are talking all about the mitochondria because is making ATP or cellular energy, which runs every
the thing I love about you, you are so passionate single function and every single process in our
and knowledgeable about pathophysiology and body.
the actual steps that lead to the breakdown of the
These are very sensitive organelles within the
body systems.
cell. If anything gets in the way of generating that
And today, we’re going to be talking all about gradient with electrons being transferred back
the mitochondria, but we are going way more in- and forth from the Krebs cycle to make 32 ATPs
depth than just the powerhouse of the cell. and then on in the electron transport chain if any
Dr. Peatross: Yeah. We’re getting nerdy on you of that potential gets messed up, or you’re not
guys. able to transfer electrons, you are unable to make
the energy or ATP you need to make blood sugar
Dr. Elmore: Please let’s do it. Let’s talk all the regulation or to make proteins or to run every
electron transport chain, all the things. Talk to reaction in your body and make you think straight
us first, please, about what is the structure and and feel healthy.
function of an optimally working mitochondria?
And so it’s this huge deal because we all talk

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about organs. But if the mitochondria are then you aren’t able to digest and use those
what make up those organs cellularly, how can nutrients like you think you should be able to.
we ask the organs to function properly if the
Dr. Elmore: It’s so simple, really, when you think
mitochondria are not?
about it. You have to be able to get your food
Dr. Elmore: Absolutely. So I love how simple that down to hydrogen, oxygen, and carbon. It is the
is. What we’re ultimately doing is making ATP via very basis of life on earth—period. That’s it. I
the generation of electrical potential, but a lot, I’m mean, if you don’t have carbon, oxygens, and
sure, goes into actually making that happen. So hydrogens, you are not a living life form in this
let’s say that I eat a meal or otherwise consume world.
some calories that we’re like, okay, well, when we
Dr. Peatross: That’s ultimately what our body is
consume calories, those become energy. Talk us
doing with herbs. Why do herbs work? They don’t
through that whole process.
work if we can’t break it down into those very
Dr. Peatross: There’s a lot that goes into that. I simple structures where they’re usable for the
could probably talk about this in detail and bore body.
you guys for two hours on this. But it starts in the
Dr. Elmore: Absolutely. Okay. So if we take the
beginning when you actually smell the food. Your
food and we break it down into hydrogen, oxygen,
digestive enzymes, your mouth starts to salivate.
and carbons, great. So we know that we need to
Those are your digestive enzymes coming into
optimize our digestive system. But to effectively
play to get ready to break down and assimilate
run the Krebs cycle and to actually generate this
your nutrients.
electrical potential, what are some of the key co-
And so it begins with smelling the food. It begins factors that we need to ensure are in our diet?
in the mouth with the breakdown, chewing well.
Dr. Peatross: Right. That’s really important,
And then your body has to perform a lot of
you guys. I’ll give you an example, and Lindsey,
energy. In fact, it takes 40% energy expenditure of
you’re the expert at this, actually. We know how
your daily energy expenditure to digest. So that’s
certain medications can block certain enzymes.
a lot of energy used to break down, tear down
I’m just going to use an example of how this could
our nutrients, and then you have to absorb them
happen.
properly.
So you really need coenzyme Q10 in the Krebs
So if there’s a lot of inflammation, if you guys
cycle. That’s a really important one. Most of you
don’t have that energy generation from the
guys have probably heard of coenzyme Q10.
mitochondria, you’re going to have trouble
They really promote it for cardiovascular health.
breaking down that nutrition to carbons,
And that’s because the heart has the most
hydrogens, and oxygens, which are the building
mitochondria along with the brain.
blocks of life that we have to use.
So you need coenzyme Q10 to run your
Every herb, every bit of nutrition you take has to
mitochondrial processes in Krebs cycle. But
be broken down into those very basic skeleton-
Metformin, which is a diabetes medication, will
building structures of life. And that’s a lot of
block coenzyme Q10. So then you guys can’t
energy and a lot of processes that go into that.
absorb that as well. Birth control pills as well.
And if you guys aren’t generating that
Dr. Elmore: And statins.
electromagnetic gradient, you aren’t able to run
the processes necessarily because you got heavy Dr. Peatross: Yes. There you go. And statins.
metals in the way or BPA or something like that, And so you guys, we’re looking at all these things

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that are caused by mitochondrial damage, such obviously, with diabetes, it’s not just the pancreas.
as diabetes. And then we’re giving a diabetic It’s the liver that really does a lot of regulation
medication that causes more mitochondrial with blood sugars. The pancreas’ job is to make
dysfunction, which is the underlying cause of the insulin.
diabetes. It’s kind of crazy.
[10:00]
And so riboflavin or B2 is really important.
But what regulates that glycogen, breaking down
Coenzyme Q10. All B vitamins are actually
the big groups of glucose into small groups, small
important too. NADH is super important. NAD,
single unit glucose, glycogen to glucose, it’s the
nicotinamide, it transfers that H. It is a hydrogen
liver. The liver regulates the blood sugar that
that is transferring along the electron transport
then tells the pancreas to make the insulin or not
chain to generate a potential.
based on what the blood sugars are doing. And
So if you don’t have hydrogens or oxygen, you’re the liver, heart, and skeletal muscle, and brain
going to get stuck in that process with NADH have the most mitochondria.
because it needs NAD to NADH, a hydrogen
So in your liver, there is a lot of things going
added. There’s lots of co-factors like that. And
on. You have your CYP450 enzymes in phase
some of the things that get in the way are arsenic,
one liver detox, and they have to be recycled
mercury. Heavy metals totally block the cycle of
every single time they’re used. How do they
generating electromagnetic potential. So do PCBs.
get recycled? Passing electrons and hydrogens,
So do some of the BPA, BPS, BPF. All of these
oxygen, and hydrogen along to recycle CYP450. If
endocrine disruptors look like similar structures in
you don’t have enough to go into the Krebs cycle
our body and can fool our body.
in all your cells, you probably don’t have enough
Dr. Elmore: Absolutely. And we talk with Dr. electromagnetic gradient to recycle your CYP450
Anthony Jay all about the environmental estrogen enzymes either.
exposures that are happening all over the place
If phase one in liver support gets messed up,
that are disrupting our metabolism. Now, you
phase two doesn’t work right usually either.
said something profound, which is mitochondrial
Then the whole regulation and the liver’s job
dysfunction is the root cause of diabetes.
of making proteins, detoxifying our body from
How does mitochondrial dysfunction lead to xenoestrogens and xenobiotics, breaking glycogen
diabetes? And I just remember you saying at the down into glucose starts to become dysregulated
beginning that there are a lot of mitochondria because energy generation is malfunctioning.
inside of the pancreas. So talk to us about how
Dr. Elmore: So the energy is not being produced
mitochondrial dysfunction leads to diabetes
in the same way. So how does this lead to
symptoms.
hormonal dysfunction?
Dr. Peatross: Right. So you guys probably
Dr. Peatross: Great question. So if you guys
have heard diabetes is under that umbrella of
know the liver’s job, you could always go back to
metabolic dysfunction. Heart disease, obesity,
what its responsibilities are. And one of them is
diabetes are all kind of lumped together. But I
to make steroid synthesis, which is how we make
like to go a little bit deeper than that. I like to ask,
cholesterol. Cholesterol is a steroid. It is in the
what’s the cause of metabolic dysfunction?
steroid synthesis you go on to make progesterone
And ultimately, it’s really mitochondria that are and then cortisol. And then all the different sex
driving this process of metabolic dysfunction. hormones from DHEA, testosterone—aromatizes
And that’s why we’re talking about this today. So into estrogen—that’s all from cholesterol

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synthesis. is broken. It’s a traffic jam. It’s not a car broken

And you need a lot of different enzymes to go down. It’s a traffic jam.
through the process to convert progesterone to And your mitochondria, therefore, cannot
cortisol and then so on. That all happens in the produce the electromagnetic gradient—the ATP
liver, and specifically, cortisol and progesterone needed to run that process through endoplasmic
are made in the mitochondria of the adrenal reticulum, to run that process through the
glands as well. mitochondria. It takes a lot of energy and a lot of
So all this is wrapped up in one. If the liver isn’t enzymes and reactions to get to make cortisol.
functioning right, you’ll start to see problems If this is blocked, you start to see cortisol levels
and abnormalities in cholesterol synthesis. Next, dropping, but your adrenals are not burning out.
you’ll see abnormalities in sex hormone synthesis Dr. Elmore: Yes. It’s just there’s too much in the
because that comes from cholesterol, all made in way. Now, I’m still a little bit confused because
the liver. everybody talks about how cortisol is bad and
Dr. Elmore: So if cortisol is made in the we need to reduce our cortisol. And what you’re
mitochondria of the adrenal glands and we’ve got saying is like-- it sounds like what you’re saying
mitochondrial dysfunction, doesn’t that stand to is like, no, there is great physiological value to
reason that you’d be making less cortisol? having appropriate levels of cortisol.

Dr. Peatross: Yes. So the mitochondrial dysfunction is not

necessarily leading to this hyper cortisol state
Dr. Elmore: Okay. Talk to us more about that. that we would see resultant of stress. What we’re
Dr. Peatross: Yes, 100%. Actually, we just have actually seeing is a lack of cortisol awakening,
a little chart to show you guys here. I do in one where we don’t get enough cortisol early in the
of my PowerPoints, but it makes it a lot easier if morning that gives us motivation to go and work
you can visualize this. So I encourage you guys to out and all of the things.
look this up and research it. What happens is the Now, what we discussed a moment ago about the
adrenal glands, they have all mitochondria. Again, liver and steroid synthesis, I think, is so important.
remember every organ in our body and every But what a lot of people don’t understand is that
cell in our body, except for red blood cells, have when you generate all that estrogen and all of
mitochondria. that testosterone and all of the sex steroids, you
So if you look at the steroid synthesis pathway, then can’t detoxify them.
it actually goes inside of the mitochondria to So talk to us more about this phase one and
help make cortisol. You then go out of the phase two metabolism and how that ensures that
mitochondria into the endoplasmic reticulum we’re not getting this huge overabundance of
to make some of the synthesis to progesterone, estrogens that could lead to metabolic problems.
then back into the mitochondria to make cortisol,
which is then pushed out into the bloodstream Dr. Peatross: Yeah. I actually just had a talk on
when needed. this. This is a really interesting topic, and it’s
similar-- I want to make the association as well
So if you have a lot of different PCBs, plastics, with cortisol. Sometimes people’s cortisol is high
Teflon, for every chemical, heavy metals that get because they can’t break it down. Not that they’re
in the way, it’s not that you’re not able to produce producing too much. And it’s the same thing with
adrenaline or cortisol. It’s not that your adrenals estrogen, same exact thing.
are burned out. There’s nothing wrong. Nothing

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Sometimes you’re not making too much, but your diabetes, when they think about Alzheimer’s
liver is stuck. It’s almost like-- and I liken it to the disease, when they think about this slow march
analogy of draining a bathtub. So the bathtub of towards metabolic disease, it’s all just that matter
estrogen can’t drain because your liver is sluggish. of insulin creeping up over the course of years. So
And what happens is you make testosterone. It talk to us about the mitochondria and insulin.
turns into estrogen via aromatization, and then Dr. Peatross: Yeah. Honestly, my dad has
you have three different types of estrogen. You diabetes, and he’s just not letting me help him. So
have a good type. You have one that’s kind of this is an area I’m really interested in for you guys
predisposes to breast cancer and one that’s super too.
estrogenic. It means you’re going to be kind of be
Dr. Elmore: Isn’t it amazing how your parents
moody. That is phase one liver detoxification.
are the hardest to convince? I mean, yes, I have
We make the three estrogens, E1, E2, E3. Then you people in my family that are like, I have pre-
must methylate them or use the COMT enzyme diabetes. I have diabetes. And I’m like, you know
to really make them water-soluble and inert, so you can reverse that in like six weeks. Like it can
they can pass through phase two liver detox in instantly be reversed. And as long as you continue
the liver. doing these things, it will not come back.
Oftentimes, if you’re stuck in phase one, you can’t Dr. Peatross: You’re right. But girl, ain’t no guru if
methylate very well. You have low methylation. they changed your diapers. That’s just the rule.
You have a low COMT enzyme activity. You get
Dr. Elmore: I know. Oh my goodness. Okay.
stuck with a biotransformation of those estrogens,
and then they aren’t able to drain the bathtub out Dr. Peatross: So the question about insulin
the liver because the liver is stuck, or you have a and diabetes. It’s just creeping up. People don’t
genetic mutation. understand it. They just think a medication
or a shot is going to fix it. And you’re right. It’s
Phase two goes through if you’re able to make
something you can correct in like six to eight
it inert so your body can process. It then goes
weeks.
through phase three, which is bile, and the gut
is involved. The gut has to metabolize estrogens. So what I tell people is, for example, what I did
The liver and the gut have to work in unison so for my dad. He’s on mitochondrial support. He’s
you could poop that estrogen out. So a lot of on things like NADH, coenzyme Q10, alpha-lipoic
people are constipated. They can’t methylate acid, resveratrol, acetyl-L-carnitine, D-Ribose.
well. They have genetic mutations, or their liver is These are all--
stagnant. They may have problems with estrogen Dr. Elmore: Give us a crash course. All of our
dominance. listeners and viewers are going to want to hear
Dr. Elmore: Oh, my goodness. And we are going what do these things do. So we mentioned the
to talk in upcoming days about all of the ways hydrogen donation of NAD and NADH but talk to
that we can ensure that our drainage pathways us about ALA, about all the stuff that you…
are nice and clear. We’re going to talk about how [20:00]
we can enhance this detoxification through phase
one and phase two metabolism. I always think that’s the mark of a good physician
or a good pharmacist or a good nurse. What
So let’s get back to insulin. So we’ve talked a lot would you want your closest family member to
about sex steroids, but let’s get back to insulin have?
because I think that when people think about

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Dr. Peatross: That’s right. That’s exactly right. production of free radicals is a part of the way
You should say, would you do this for your family that the body functions. You cannot eliminate the
when you see your doctor? Okay. So alpha- free radicals, but you can support your body’s
lipoic acid known as ALA and resveratrol, even ability to neutralize them using a combination of
glutathione, all these are master antioxidants. antioxidants that help to make the body--
Resveratrol also has some antioxidant capabilities, When I think of neutralizing a free radical, I just
which means that if you guys make free radicals, think of making the body more at ease, making
think about when you go through the electron the body less panicked on the very microscopic
transport chain, you go through the Krebs cycle. level. Okay. What else did you do for your
You’re generating; you’re transferring electrons. dad? So we’re on some mitochondrial support
So there has to be something that attracts those supplements.
electrons. Usually, it’s oxygen. Oxygen is the final Dr. Peatross: For sure. And I love Metformin,
electron acceptor. And so you’re generating these but once his blood sugars were a little bit more
electrons and its current, and if any of that gets stabilized, I took him off that medication. And
messed up, then you’re really in trouble with I mentioned why earlier. It’s because it really
transferring electrons. inhibits the absorption of coenzyme Q10, which is
So when you’ve transferred them, they become a necessary co-factor. It’s like a truck bringing in
reactive. If an oxygen picks up an electron and the co-factors in the Krebs cycle.
it’s got a single electron, that’s extremely reactive And so, if you don’t have that driven there, you
in the body. It’s definitely going to go react with actually are compounding the problem. So
something in a good or bad way, and that’s called although Metformin is a great medication, it
a free radical. And sometimes, they bind your does have that problem. And because my dad is
DNA, and they damage your DNA. suffering from diabetes, I wanted to treat it more
So we want them to be neutralized very fast. naturally.
And that’s what a lot of people get in trouble Other things you guys can do, most people who
with. The Krebs cycle with mitochondria is have problems with blood sugars do have a
they’re generating too much reactive oxygen deficiency in chromium, and chromium is super
species because of everything they’re exposed to important. That’s because it mostly comes from
environmentally and all the toxins. wheat and gluten. Some people are avoiding
So how do we scavenge those free radicals? How that now, but it’s really important for blood
do we neutralize them? Antioxidants. They have sugar regulation. It has a number of antioxidant
the ability to protect against oxidative damage capabilities itself.
and those free radicals that bind our DNA. So I definitely supplied him with chromium. He’s
And so they scavenge them, and they could do a doing a little more cinnamon and vanadium,
chemical reaction, which neutralizes that highly which are also helpful nutrients to help diabetes
reactive oxygen species. And then we’re safe. and blood sugars. And then I’ve got him on a liver
We don’t have anything to react with our DNA. cleanse because the liver regulates blood sugars
And that’s why those antioxidants they have the and makes all the steroids and hormones. And
capability and the structure to be able to protect so, it’s such an integral organ. I would be remised
you that way. if I ignored that along with the mitochondrial
damage.
Dr. Elmore: Oh, it’s so amazing because the
Dr. Elmore: Oh, absolutely. I love that so much.

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And viewers, if you’re listening today and you say, our health.
I really would like to get off of Metformin or off
And I love especially the exercising after meals. I
of my statins, go ahead and set that as a goal.
think it helps with the digestion. It helps with the
Your physician may look at you like you’ve got 17
colon activity. And it is also particularly useful for
heads, and your pharmacist may tell you that it’s
any listeners who go out and maybe imbibe one
impossible, but do all the things that we’re talking
too many drinks with alcohol or has some excess
about during this summit.
sugar intake because it’s going to help to move
And when you begin to get to what your physician that glucose through.
is going to want to know, is like, are they at goal?
That way, your liver is not simultaneously having
Are they at goal for where I want them to be? So
to detoxify alcohol and build glycogen, which is
be diligent about checking your blood sugar and
just exhausting for it.
being sure that you’re tracking it on the regular.
Be sure that you’re going in. Dr. Peatross: Not good, you guys.
And if it’s not being offered for you to have an Dr. Elmore: Yes. Not good. We’re almost to the
A1C every three months, six months at most, ask end of our time here together. If you had to really
for it because it is an unfortunate truth that a lot sum up in all of your learning-- you have had
of people get put on medications, and then just an extraordinary career because you studied
nobody ever sits down and truly reassesses is it biology. You studied psychology. You have an MD.
still appropriate? And is there some alternative You worked as a hospitalist. You realized I’m not
solution to this? healthy as a hospitalist. So how do I help other
people become healthy as a hospitalist?
Dr. Peatross: Amen, you guys. And something
else I forgot too. If you guys would get up and And you detoured into Gerson therapy and to
walk 15 or 20 minutes after every meal, you functional medicine and to Nutrigenomics, ozone
wouldn’t believe what that can do for your blood therapy. You have Kill • Bind • Sweat method,
sugar regulation. And another thing, it’s not which has this passionate following on social
always about supplementation, you guys. Your media of women and men that you encourage
mitochondria they’re charged by the sun. They’re to sweat on the daily to help open up those
charged by the sun. It’s actually an electrical detoxification channels. If you had to sum up in
reaction. just a couple of minutes, what do you think the
overall solution to metabolic disease and just
So in the mornings, the first thing that I have my
disease in general is?
patients do is go out into the sunlight and walk,
or if you’re lucky enough to move your body and Dr. Peatross: For me, I think that to really help
privileged enough to be able to do that, then people, I truly believe that a dirty terrain, meaning
exercising in the morning sunlight, one to two if your body’s full of toxins, it attracts and makes a
hours, that is like-- it’s like a battery that you’re dirty germ. And pathogens are attracted to toxins,
recharging literally. and we are overloaded. If you guys even knew on
your daily how much you are exposed to, you’d be
Dr. Elmore: Absolutely. And also, getting out into
angry.
the sun within 30 minutes of awakening also helps
to spawn that appropriate cortisol response so And so, for me, I truly believe that to be healthy,
that then you don’t have excess cortisol that’s just we must turn our back on the technological
panicking when it’s 10 o’clock at night. We need to revolution and return to nature. And that is what
use circadian rhythms as a way to help regulate makes people healthy, sunlight, healthy food

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unaltered, without pesticides or herbicides, grown It’s all the things. It’s all of the things. There is no
naturally and blessed by the earth and the people. magic bullet. The white horse is not coming. This
Community is immunity. is about a relationship to yourself. That inspires
Learning, love, and learning that nature provided me so much about you is you’re like, look, I want
everything for us in the form of herbs. And then to actually know my body and actually appreciate
we went and patented things and acted like we it and value it. And I love that.
knew better. Dr. Peatross: I know. We’re very similar, Lindsey.
And for me, when I return my patients to nature I appreciate everything you’re doing to wake
and the circadian rhythms, that earth-promoted, everyone up about how powerful they are.
the herbs, the food, clean water, it’s amazing what Dr. Elmore: Oh, thank you so much. Where can
the body can do. It’s a miracle how much you our listeners go and find out more about you and
guys can heal and not have been told you have it. the work that you do?
You can. It’s a miracle if you only knew. And that’s
Dr. Peatross: Well, there’s tiers to this. So if you
what I think I would tell people.
like free information, I’m super active online on
Dr. Elmore: Oh my gosh, that’s bringing tears Facebook and Instagram, so [Link]. If you
to my eyes because I so wholeheartedly agree want more of my attention and handholding, then
with you. There is a way out of the perpetual you can go-- I have a subscription website at app.
cycle of the average adult being on five different [Link], where I do two-hour webinars
medications. It does not have to be that way. We with you guys twice a month. You get to ask me
simply have to do the basics over and over again questions. You send in questions. I make root
every single day. cause quickies and holistic solutions for you.
[30:00] We have a community forum. You can direct
Dr. Peatross: People look at me and say, is it message people. It’s a social media site beginning
really this simple? I don’t believe it’s this simple. so that there’s no censorship for anyone. We talk
And I do a good job of explaining very complicated all the controversial things. So if you want my
things in lay person’s terms, but ultimately, it’s attention, that’s how you get it. Also, I have my
really not as complicated as you guys think. regular website, [Link], where there’s
a ton of free blogs and a how-to on Kill • Bind •
Dr. Elmore: I know. Viewers, you will be so sick Sweat.
of hearing me say this by the end of this summit.
But the whole key to health is loving yourself Dr. Elmore: Nice. Dr. Jess, thank you so much
enough to do the basics every single day. It’s for coming today and speaking on the Metabolic
loving yourself and caring about yourself enough Makeover Summit.
to eat right, to sleep well, to go outside in nature, Dr. Peatross: I love you, Lindsey. Thank you so
to reduce your stress load, to cut out toxic people, much for having me.
to find clean water, to intentionally detox.

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Daily Detoxification
Vivian Chen, MBBS, MRCP, MRCGP

Dr. Elmore: Dr. Vivian Chen is a UK-trained can go and check out my interview with Vivian on
medical doctor with 15 years of clinical The Lindsey Elmore Show, one of my very first
experience. She is board certified in both internal episodes. So let’s dive in because we want people
medicine and family practice. Her world turned to walk away from today’s presentation with some
upside down when her daughter was hospitalized tangible, implementable, easy-to-do daily things
soon after being born with symptoms that doctors that will help to eliminate their toxic burden.
could simply not figure out. And we’ve talked a lot about toxins, especially
Through doing her own research, she was able estrogenics, along the way of the summit. Tell us,
to help her daughter recover. And she realized what are the environmental toxins that you just
after many years of her own chronic fatigue, acne, think in your head throughout the day? Okay. That
and brain fog, that she was also in need of some is an exposure that I need to avoid. Talk to us just
detoxification from all of the environmental toxins about how broad this category of environmental
around us. This simple change in her life opened toxins is.
her eyes to the root causes of disease in our body, Dr. Chen: Sure. It’s a true passion of mine to
unlike anything she had ever considered as a talk about it because it affected me personally. It
conventional medical doctor. affected the health of my children. And sadly, as
She moved to San Francisco and decided not you said, environmental toxins are all around us.
to become a licensed MD in the United States. It’s kind of what we’ve produced and put out into
Instead, she coaches her clients back to health the environment over the last 80 years through
by helping them to identify root causes and this better living, through chemistry.
implementing lifestyle-focused solutions. We’ve produced all these chemicals to improve
She is on a mission to help people reduce convenience, improve quality of our life, but at the
their toxic load because she believes that expense of our environment. And these chemicals
environmental toxins are one of the most have now got into our water supply, into our soil.
important root causes of many chronic health So now, I know it sounds very depressing, but it’s
conditions. Dr. Vivian Chen, welcome to the in our food, in our air, in our water.
Metabolic Makeover Summit. And the agencies, the regulations that are
Dr. Chen: Thank you so much, Lindsey, for having supposed to be there to protect us, haven’t done
me. It’s such a pleasure to be here. so. So over 85,000 chemicals registered for use
with the EPA, only a handful of them have ever
Dr. Elmore: I always enjoy talking to you. And
been tested for human safety. So only a few out
listeners, if you enjoy our interview today, you
of the 85,000 we know to be safe for humans.

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And Lindsey, you know this. Every time a drug is into all of those aspects. So phthalates, for
made, what do we do? We put it through several example, used to make plastic flexible, it’s in toys,
phases of clinical trials to make sure it’s safe for in shower curtains, and these phthalates actually
humans. Well, these chemicals are coming into can come out of the shower curtain incorporated
our bodies every single day, sure at much lower into dust particles, and we then breathe it in, so in
concentrations than pharmaceuticals, but studies our air.
are showing that even at very low concentrations,
It’s also in our water. We’ll just discuss that.
they can still affect our health. They can cause
And it’s in our food. So plastic-wrapped food,
endocrine disruption.
phthalates could come into our food that way.
So the endocrine system is hormones. So these So when we’re looking at big levers, I feel like just
are chemical messengers in the body that the thinking about anything that involves plastic and
body uses to communicate with organs and reducing our use of plastic is better for our health
tell the organs what to do. So insulin being an and better for the planet too.
example of a hormone. Sex hormones regulate
Dr. Elmore: Absolutely. So let’s dive in because
our fertility.
you mentioned that environmental toxins are
And I know this is the metabolic summit. So we in the soil, the water, the food, and the air. So,
got to be talking about hormones on a metabolic in addition to not storing food in plastic and
summit. Thyroid hormone regulates our not drinking out of plastic water bottles, one of
metabolism. Insulin regulates our blood sugar, the things I love about you is that detoxification
which then is the basis of metabolism as well. extends to many different areas of your life.
So the main way these chemicals in our And so how can people-- like think about the
environment can affect our metabolism is through gadgets around your home that you love that help
endocrine disruption. And the biggest-- we’re to reduce toxic load. What are some of your daily
talking about action steps here now. So the activities that you do to say is it-- what are you
biggest lever I feel in this area is plastics. So the doing to eliminate these toxic exposures as well
plastics leach these endocrine disruptors into our as eliminate them from your body?
water.
Dr. Chen: I love that question. So the first thing
So if you’re using a plastic water bottle and I do is to open the windows in my house in the
especially if there’s heat, the sun actually mornings. That is a really simple, easy, and free
encourages the leaching of these endocrine step to clean the air inside of your home because
disruptors. Things like phthalates, a group of the EPA has shown that indoor air can be two to
chemicals that are often used in our plastic that five times more contaminated than outdoor air
can leach into the water. because of the off-gassing of the chemicals from
And phthalates have been associated with insulin our furniture, from our carpet, from everyday
resistance, thyroid problems, fertility issues. items like household cleaners as well.
It can affect our mitochondria function, and So open the windows, let fresh air in. Of course,
mitochondria then can affect our metabolism there’s wildfires or smoke outside. Think about
because it’s the battery inside of cells. It provides getting an air filter for your home. I have an air
energy for metabolism. So I feel like plastics is filter in every room that I spend a significant
where I would start first, and then we can look at amount of time in, especially with the bedroom
things like our air, our water, our food. because we spend the majority of our time in that
And then the fact is plastics actually incorporate location in bed.

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So I have an air filter there, and I open the I love to remove and minimize toxin exposure
windows to allow ventilation. That’s the first thing. inside our home.
And then I drink a big glass of water. So I want to
And then I’ve done things like switching my plastic
hydrate my body. And that helps to actually carry
Tupperware to glass water bottles, just stainless
away the toxins that have been generated while
steel or glass. And then I’ve also looked into
we’ve been sleeping. We want to eliminate those
household cleaning products. So making sure
toxins.
that the products don’t contain contaminants like
But when we’re drinking water, going back to phthalates.
water, water can be heavily contaminated. Tap
Dr. Elmore: I love that because much of what
water has been shown to contain pesticides, even
you just described for us is free. Opening your
pharmaceutical medications, glyphosate, and also
windows is free. Drinking a big glass of water is, in
PFAS, the non-stick group of chemicals that can
essence, free for most Americans at this point.
affect our thyroid and immune system.
And simply getting an inexpensive filter or
So if you can, try to filter your water. So there are
switching out plastics, which I thought I would
different types of water filters. It can be a very
hate using glass containers, but then you grow to
confusing area. And the best way I’ve found to
love them. And they’re so much easier to clean.
find tap water that suits you is to actually look at
And you can just tell that your food’s not being
what contaminants have been found in your tap
affected by the plastic. It’s really amazing.
water.
Now, how do you help your clients understand
So if you go to the EWG water database, so if you
that their body is eliminating well? I hear people
just type in EWG water database into Google,
say you got to make sure that all of your drainage
you’ll find this registry where you can enter your
pathways are open. And so, how can people know
zip code, and your water quality report comes up.
that they are eliminating toxins from their body
[10:00] effectively?
Or you can contact your local water utility Dr. Chen: That’s a really good question. I think
company, and they are obliged by law to give you I would go by your symptoms because our
the latest water report that will show you what bodies are very clever. So if something is not
contaminants are found. quite right, our body gives us signals in the form
And based on that, then you can pick the right of symptoms. So signs of toxicity can really
filter, whether it just be charcoal, which is great manifest in a myriad of ways, but common ones
at removing chlorine. We know chlorine can are fatigue, brain fog, fertility issues, hormonal
affect our gut microbiome and dysbiosis. A issues like endometriosis, PCOS, gut issues—if
disturbance in the microbiome is then linked to you’re bloated, if you have chronic constipation,
insulin resistance, type two diabetes. So a simple diarrhea, reflux.
carbon filter that’s not very expensive can remove Some people get a pain around their liver if their
chlorine for you. liver is sluggish. And that’s kind of the right upper
So if that’s all you can afford, that’s okay. You’re area of your abdomen. Gosh, what else? There’s
still doing great for your health. But beyond that, so many different symptoms.
there’s things like reverse osmosis, there’s Berkey, Dr. Elmore: Skin rashes, acne, redness.
and you can look into that. So I would say that
Dr. Chen: Oh, yeah, absolutely. Skin problems.
my air filter and water filter are two gadgets that
Dr. Elmore: Even reflux and things, I would think

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12

as well. then they may even start to gain back the weight
Dr. Chen: Yeah, definitely. So there’s so many is because there are environmental toxins that’s
different symptoms. And I like to think about being released from stored tissues like the fat.
health and detox as a plant almost. So if you go When you burn fat, and you lose weight, these
to the garden, if there’s a deficiency in a nutrient toxins can be released into the bloodstream. And
in the soil, different plants will produce different then when it’s in the bloodstream, it’s not cleared
outward signs. So some plants might show yellow through the detox organs, then it can impact your
leaves. Some plants might show brown dots on thyroid and other organs.
their leaves. Some plants might just not flower or
So one of the most important things is to actually
might not give you fruits.
work on your detox pathways while you’re losing
So we’re like the plants. We all show up with weight as well. And in fact, what you’ll find is that
different symptoms, but ultimately at the root if you employ these detox-supporting measures,
is very often a shared cause. And one of the like eating the right food, the right lifestyle
biggest causes at the root is environmental toxins strategies, you naturally lose weight without
because it can affect so many different aspects of having to focus on the number on the scale.
our health.
So what we’re talking about, and I did a really
We’ve discussed mitochondrial function. It can great post with you, Lindsey, on Instagram, Detox
affect our gut health. It can affect our brain Basics, is that the detox organs are liver, the gut,
function. So yeah, I think symptoms are a great sweat glands, our lungs, and kidneys. So those
alert, and it really almost doesn’t matter what are the main organs. And how I like to think of it is
symptom you have. Whenever you have a that it’s like a marble run. Okay.
symptom, you should think something is going on
So the different organs are at different stations
in my body. Now I need to investigate and find out
on that marble run. And when a toxin enters our
what’s going on.
body, usually it goes first to the liver because most
Dr. Elmore: Well, let’s say that some of our toxins are lipophilic. They’re not water-soluble,
listeners are having gut problems and fatigue and which means that they can’t really be filtered out
brain fog, and they’re probably having problems in the kidneys or the sweat very easily. They need
with insulin levels or just can’t take off the extra to be inactivated and made into water-soluble
15 pounds around the midsection. How do you compounds so that they can leave our body.
help people facilitate moving the toxins out of
So the bulk of that work is actually going on in the
their body faster?
liver. So people quite rightly so think, oh, if I detox,
Dr. Chen: Yeah, so this is very interesting because I need to supplement with liver supporting herbs
there have been studies that showed that people or supplements. But actually, they forget that
who lose weight very rapidly, they have higher in order for whatever is inactivated in the liver
levels of toxic chemicals in their blood. And there’s to come out of our body, we need optimal gut
been a study also looking at the correlation function. Because what happens is after the liver
between that increased level of chemicals in their has done its work, they pass the toxins over to the
blood with decreased thyroid function. gut to be pooped out.
And we know that if your thyroid is slower and Now, if you have dysbiosis, meaning if you have
sluggish, then your weight is going to climb back an unhealthy balance of bacteria in the gut, they
up. And they hypothesize that this is perhaps actually can break that bond and let toxins be
one of the ways that people hit that plateau. And reabsorbed into the body. So then, now the toxins

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are not leaving. In that marble run scenario, you’re [20:00]

putting the marble in, but it’s getting stuck, and it’s
Herbs are great as well. Turmeric, Rosemary both
not coming out—just recirculating through.
can support the liver. And then kidneys. Plant-
So working on the gut is really important. And based diet help with kidney filtration because if
we’re both plant-based, and I love a plant-based your urine is more alkali-- I’m not talking about
diet for gut optimization because we know that blood pH. I’m talking about urine pH. If your
fiber is what supports or what feeds the friendly urine is more alkali, then the pumps that actually
bacteria in the gut. So it can encourage a healthy pump these toxins across the membrane and the
gut microbiome. Fiber also binds onto toxins. kidneys work much better.
So the more fiber you eat, the less toxins you’re And if your urine is more acidic, these toxins can
going to absorb, and the more it’s going to be actually re-enter again. So again, it’s stuck in that
pooped out. So gut function is number one. And marble run and not coming out. And then we
then we do want to support liver, but rather than want to move our bodies. So lymph is actually the
jumping into supplements, I always start with fluid that carries these toxins away from the cell
food. to the liver, to the kidneys, to be eliminated.
So we’re thinking about phase one, phase two If you’re not moving your body, your lymph is not
detoxification. These are different steps the liver flowing because the lymph system doesn’t have
uses to break down and inactivate these toxins. a pump. So it only moves when you move. So we
And the liver needs a lot of nutrients for that to need to move our bodies to move lymph. And
happen. We need the right amino acids, which is then the last thing is we want to sweat as well.
going to come from protein.
So sweat has been found to contain
We need antioxidants. We need vitamin C, vitamin environmental toxins like heavy metals, BPA. And
E. So these are all nutrients that’s needed. So so sweating-- exercising is a great way to sweat.
eating a well-balanced nourishing diet is really And not only do you sweat out toxins, exercise
important for detox. And I see all these diets can boost glutathione production, and glutathione
floating around like, oh, ketogenic or carnivore is one of the master antioxidants that help bind
diet. onto and eliminate toxins. And it helps the toxins
I just wonder where your fiber or your come out of that marble run. So those are kind of
antioxidants that are needed for detoxification is summary of the strategies that I take.
going to come in. Plus, animal-based foods are Dr. Elmore: I love this so much, really thinking
naturally higher in environmental toxins because through every single organ that is involved in the
they’ve accumulated these toxins over their detoxification system because where modern
lifetime. medicine fails us in a lot of ways is by trying to
So studies have shown that the biggest sources piecemeal the entire body where it’s like-- and you
of environmental toxins is actually animal foods, said it best. There is a shared cause. And the good
especially the fattier ones like cheese, bacon, and news is that there is a shared solution as well.
also fish as well. And there was a really depressing There is a shared solution to every disease, most
study that actually showed human milk as a disease that is out there.
source of environmental toxins. Yeah. So I would And great suggestions, well-balanced
go with working on the gut to optimize that first nourishing diet, full of fiber because another big
and then supporting your liver with food. misconception is people want to jump straight
to the supplements like you said, and they want

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to take probiotics, which are going to repopulate that it’s important to work on detox pathways as
that gut. But those probiotics, they are like you are losing weight.
tourists through your gut. They do not stay in your
Is there a specific protocol that you really like to
gut. It is only the diet that can change your overall
use as far as how to educate people who are just
microbiome.
starting on that weight loss journey? We’ve talked
So one of the things that I would love a little bit of a lot about plant-based diets. Some people aren’t
more clarity. So you mentioned how important it going to get there. And so, how do you encourage
is to alkalinize the urine. That is something that people to show up at their plate every single day
we haven’t talked about on the summit so far. And with their health in mind?
it makes me wonder if you could give us a couple
Dr. Chen: Yeah, I think it’s important to consider
of tips on how do you alkalinize the urine so that
where people are at. So we talk about plant-based
you optimize that kidney elimination pathway?
diet, and I understand some people are not there,
Dr. Chen: Plant-based diet again. So the foods and it’s kind of about just adding the next step of
that generate acid in our body is mainly animal- what you can manage.
based foods. Plants tend to not produce any acid
So if you have two vegetables on your plate,
when it’s metabolized and used by our body.
maybe think about adding another one or maybe
So then our urine is more alkali when we’re on a two or three every week. Think about adding in
plant-based diet. And antioxidants from plants new vegetables that you maybe haven’t tried
can actually help to drive blood through the before. And you might like the taste.
kidneys. And in driving more circulation and blood
So it’s about manageable steps. And trying to
flow to the kidneys, it’s improving filtration. So
increase fiber slowly is also important because if
yeah, plant-based diet all the way.
you do it very rapidly, you’re going to get bloated.
Dr. Elmore: Yeah. And viewers, I don’t want you Your microbiome is actually not going to be used
to be discouraged. We’re not saying that you have to digesting all of that fiber. So going slow. So
to eat 100% vegan for the rest of your life but if you don’t eat any beans, maybe think about
focus on plants because, as you said, you’re going adding a little bit of beans for fiber.
to reduce the toxic intake and create a system by
And also, if you can’t tolerate a lot of beans,
which you are more able to eliminate from the
maybe just adding in one extra tablespoon at
body. So, Dr. Vivian Chen, this was such a rich
every meal. So I don’t really believe there’s a
interview. I thank you so much for the time that
one-size-fits-all for everybody because we’re all
you spent with me today.
different. We all have different lifestyles. And so, I
Dr. Chen: Such a pleasure. I always love talking to think the goal is to aim for the next step that you
you, Lindsey. And I learned so much from you too. can take rather than perfection.
Thank you for putting this summit together and
Like, no, you’re not going to go from three
helping everybody.
vegetables to 20 vegetables. How about we go
Dr. Elmore: Absolutely. So I know that I got so from three to four, three to five, and then from
much out of this as far as how we can support our five to six, six to seven. And that’s how we actually
thyroid hormones, our mitochondrial function, can gain a lot of traction and incorporate these
our sex steroids. And you know what? Before steps into our lifestyle so it’s enjoyable and it’s
we go, let me ask you one more question. You easy, and it’s sustainable because we want these
mentioned that people who lose weight really changes to be sustained. That’s the main thing.
rapidly may have an accumulation of toxins and

Metabolic Makeover
15

Dr. Elmore: Absolutely. Don’t worry about going

from zero to 100. Go from zero to one. I love that
advice so much. Listeners, I strongly encourage
you go follow Dr. Vivian Chen on Instagram. She
produces some really stellar educational content.
And thank you again for coming today.
Dr. Chen: Thank you, Lindsey. Thank you,
everyone, for listening.

Metabolic Makeover
16

The Simple and Forgotten

Components of Disease
Prevention
Donna Mazzola, PharmD, MS, MBA

Dr. Elmore: Welcome back viewers to the me. I’m excited to be here.
Metabolic Makeover Summit. I am your host, Dr. Dr. Elmore: I am so thrilled. We’re getting the
Lindsey Elmore. In this interview, I want you to pace going here in the summit, and we’re really
meet my friend, Dr. Donna Mazzola. going through today trying to understand
A pharmacist with a master’s degree in functional the interrelatedness of the body. And in this
medicine and human nutrition. After she got her presentation, we’re going to talk all about the
doctor in pharmacy, Donna realized that medicine thyroid. So start us with the basics. What does the
has a place in healing, but it’s the balance thyroid do for our bodies?
between nutrition and medicine that truly impacts Dr. Mazzola: Well, we should start that question
disease. with actually what does the thyroid not do for our
Following a diagnosis with Hashimoto’s in 2015, bodies? And so, for those of you that may not be
she realized that it was difficult to find reputable familiar, the thyroid gland kind of sits here in your
scientific information to help support her healing throat, and it’s a little butterfly gland, and it’s a
journey. As a result, she created the blog, small gland with a huge impact that it has on the
[Link] and can be found on body overall.
Instagram and Facebook at drautoimmunegirl. And really, when we think about the thyroid gland,
She wanted to become the source that she we really think about it as the hub of cellular
had needed at the time of her diagnosis. Dr. metabolism overall. I mean, its responsibility
Autoimmune Girl is a blog with a mission to in regulating metabolism, regulating hormone
identify the root cause of disease and empower synthesis, regulating our sleep cycles, impacts on
you to take control of your health. inflammation, our blood sugar levels, I mean, it
really is kind of the hub. And it’s like I always say,
Recently, Donna co-founded the Autoimmune Tea
it’s this tiny little gland with a huge impact on your
Brand, and these are tea blends that support the
overall health.
immune system and help to manage day-to-day
symptoms. Autoimmune Tea blends have been Dr. Elmore: So it’s the hub of cellular metabolism.
created with the science behind the herbs to How does that play out in daily life? So what’s the
help those who suffer from symptoms of chronic thyroid kind of doing all day long?
illness. Dr. Donna Mazzola, thank you for coming Dr. Mazzola: Yeah, absolutely. So it’s essentially
in and talking to me today at the Metabolic creating thyroid hormones. And so let’s kind of
Makeover Summit. break down how that happens so that we can get
Dr. Mazzola: Absolutely. Thank you for having to kind of the point of what is the effect of these

Metabolic Makeover
17

hormones on the body. from the pituitary. And it triggers this response to
And so, some of you may have heard of the term generate and produce more hormones.
TSH or thyroid-stimulating hormone, and that When our body has enough hormone, then that
hormone really does exactly what it says it does. feedback mechanism comes back and says, hey,
It helps to send a signal to say, hey, we need you we don’t need to release any more or synthesize
to stimulate more thyroid hormone. And so that any more of these hormones. We have plenty.
is sent over from the pituitary gland essentially So that kind of gives you an idea of how it’s
to the thyroid gland to then start developing our regulated. And like I said, it’s such a small gland,
hormones. but with such complex processes.
And the thyroid hormone, like we said, is essential Dr. Elmore: Absolutely. So once I’ve got this T3,
for cellular metabolism, but there are two that we I’ve produced it, the TSH has done its job. Where
really want to emphasize, and those are our T4 else does T3 go throughout the body, and what
and our T3 hormone. And why it’s so important does it facilitate? What does it stimulate?
to emphasize those two and really kind of layout
Dr. Mazzola: Yeah. So T3 is literally everywhere.
the differences is because your T4 hormone is
So there are T3 receptors all over your body.
created at a rate of 90% while your T3 is more so
And so when I talk about symptoms of
at around 10% developed.
hypothyroidism, where we don’t have enough of
And what’s so unique about this is that your T3 this hormone, where we don’t have enough of this
hormone is actually your active hormone. And T3, you’re thinking you’re overall sluggish.
your body actually has to convert from T4 to T3 so
So you’re now thinking constipation. So now we
that we can get that active hormone. So I always
have an impact on our gut. Dry skin, we have
tell people if you’re feeling symptoms related
even impact within the skin. Fatigue, excessive
to like a slow and sluggish thyroid, it’s because
fatigue, imbalances within other hormones
your T3 hormone is low because that’s the one
because hormones don’t work in silos. They’re
where we attribute to symptoms. That’s the one
communicators together. We can talk a little bit
we attribute to actually producing the beneficial
more about that.
effects that we get.
But I mean, really when we think we need these
And so we’ll get a little bit a little more later, but
hormones throughout the various receptors
conversion problems related to other hormones
all over the body-- I mean, even in the brain,
and other external factors can actually impact that
when you hear common symptoms people
process. Now, what’s unique about the thyroid
complain, brain fog, just kind of that memory loss
hormone synthesis and activation is that it’s
essentially, or just can’t get your focus, you have
controlled with a feedback mechanism. And so
low thyroid hormone that potentially is leading to
it’s regulated via this feedback loop that involves
causing these symptoms.
the hypothalamic–pituitary–thyroid axis. That was
a mouthful—the HPT axis. We’ll just use that for Dr. Elmore: Yeah. So having that overall just can’t
short. get going feeling. And that is just the worst feeling
that you can have. Although having high thyroid
So basically, what happens is when there’s low
is-- high thyroid hormone is also a very sick
hormone concentrations, like we said, then there’s
state. You do not feel good if you’re experiencing
a signal that’s sent through for the hypothalamus
symptoms of hyperthyroidism.
to release the thyroid releasing hormone, which
then leads us to the thyroid-stimulating hormone And so talk to us a little bit about the symptoms

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of hyperthyroidism and what’s my risk. Like, am I causing so many people to have Hashimoto’s and
more likely to be hypo or have low thyroid, or am I to have sluggish thyroid?
more likely to have high thyroid?
Dr. Mazzola: Yeah. That’s the million-dollar
Dr. Mazzola: Yeah. So hyperthyroidism is honestly question, Lindsey. So when we think about-- and
the complete opposite of what I just stated. So if we really target looking at thyroid dysfunction
you’re almost like you’re wired. Your metabolic from an autoimmune lens because that is the
rate is too high. You may have symptoms more predominant reason of why we’re seeing this
of diarrhea. Like you’re on the go more so if you excessive amount of hypothyroidism being
want to think about it that way. Like I said, you’re developed.
wired too much excessive, almost energy, too
There’s always that genetic predisposition that’s
much metabolic rate. You’ll experience weight loss
part of the equation. But the other two factors
because your metabolic rate is so high.
that I always like to bring up and many don’t
And that feedback loop isn’t working. So like we necessarily consider are environmental factors, as
said, there’s a point where your body knows to well as our gut and our gut integrity overall. And
stop producing a hormone. Like, hey, we have really, it just comes down to diet.
enough. You can stop producing. With hyper,
What are we putting in? And what other lifestyle
there’s a break there. And so your body continues
factors are we doing that’s negatively impacting
to produce that excessive amount of hormone
our gut overall that’s causing this overall immune
constantly being stimulated. And so that’s why
dysregulation because we know that 70% of our
you kind of get that excess response that we’re
immune system is within our gut. So it all ties in
describing here.
together.
From a likelihood standpoint, you’re much more
But factors that inhibit the proper production
likely to have hypothyroidism as opposed to
of thyroid hormone include things like stress,
hyperthyroidism. And predominantly, one of
lack of sleep, trauma that may have occurred,
the most common causes of hypothyroidism
infection. So previous viral infections that may
is actually related to autoimmune disease
have occurred, exposure to medications, such
dysregulation called Hashimoto’s.
as antibiotics that may be have destroyed the
And so when we talk Hashimoto’s, we’re really abundance of bacteria, good bacteria in your gut
talking about an imbalance within our immune that help protect you.
system that’s being impacted by several external
Various chemicals that we’re being exposed to
factors,
and toxins on a daily basis, whether it be from
[10:00] pesticides to excessive thyroid-- I mean, sorry,
But essentially what’s the result of that is an fluoride exposures or mercury with the cavities
attack on our thyroid gland that’s impacting that that we’ve had filled, lead exposures. I mean, so
thyroid hormone production. So definitely greater there’s just an abundance of it.
abundance and prevalence of hypothyroidism I recently read an article. Genetically, we haven’t
overall. changed over the past, I don’t know, let’s just
Dr. Elmore: Yeah, absolutely. And that really leads say 50 years, but our environment has changed
to a lot of metabolic problems, and we’ll get to significantly over the past 50 years. And so, when
that in a minute. But before we get there, what we think about what is impacting this thyroid
causes my thyroid to be out of balance? What is pathophysiology and this development of disease,
it truly is our environment and our exposures that

Metabolic Makeover
19

we’re living every single day. And essentially, with a lot of those cases I always
Dr. Elmore: I know. It’s so sad how we’re told point to, it’s the stress management piece we
fluoride, it protects your teeth, but it messes need to target and impact so that we can reduce
up your thyroid. And here we’re just going to that reverse T3 and therefore kind of allow our T3
put herbicides and pesticides that have never hormone to bind to those receptors and produce
been tested on to all of your food and all of the the effect that they’re supposed to produce.
food that your food eats as well. It is frankly Dr. Elmore: I think that is a really good transition
astonishing that we don’t take a greater look at point to really talk about how thyroid hormone
what is needed to really properly nourish thyroid and cortisol and insulin and our overall metabolic
production and avoid damage from happening. health is related. So take a big step back for us
Now, another aspect of thyroid metabolism that and talk to us about the relationship between
I’d really like to touch on is reverse T3. Because we thyroid imbalance and diabetes or thyroid
have talked a lot in the summit about how much imbalance and syndrome X. How does all of this
stress can cause metabolic illness. And one of the connect?
things that many people have talked about is the Dr. Mazzola: Yes. Okay. We said the thyroid
need to have proper body weight. But if people gland is our hub of metabolism. That’s what
are doing caloric restriction, sometimes that can we’re focusing on. So essentially, its effect is
mess with thyroid hormone production. And talk to increase our basal metabolic rate, increase
to us about reverse T3 and what it means for our our metabolism. And so when it’s impacted
body. and sluggish, it’s unable to do that, but it also
Dr. Mazzola: Yeah. So reverse T3 is-- so, like we has a direct impact on protein metabolism,
said, we need to convert T4 to T3 to get that active carbohydrate metabolism, and fat breakdown.
form of thyroid hormone. Now, when our bodies Okay.
are under an abundance of stress, if we’re just So when we talk about overall metabolic health--
focused on stress, then it can lead our thyroid when we think about protein metabolism, when
gland to actually convert T4 to what we refer to as you have hypothyroidism, you actually have
reverse T3. decreased protein synthesis. So you have a
That almost is like a dud. And when it binds to the decreased ability to create protein. And this is
receptors, it does nothing. So it takes up space super important because when we think about
so that where you do have T3 hormone, it can’t the lack of protein that we have, and then we
actually bind and produce its metabolic effect that correlate that to symptoms, that’s when we get
it’s supposed to produce. So your level-- let’s say our brittle nails, our dry hair. Our hair’s falling out,
you are diagnosed currently, and maybe you’re dry skin.
on medications, or you’re monitoring your levels. That’s really kind of that correlation. And then, of
They may look really good looking at, oh, your TSH course, it also impacts, like I said, carbohydrate
looks great. Your T4 is pretty good. Your T3 is not metabolism. And so talk about glucose regulation
too bad. issues. That’s where the thyroid plays a key role
But the issue is that your reverse T3 may be with insulin and keeping that in balance so that
elevated, and therefore your T3 hormone is we can regulate our glucose level, taking the
unable to bind to produce that metabolic effect. glucose out of the blood. And so that we are able
So you’re still feeling quite symptomatic, and you to break down those carbohydrates.
can’t really figure out how to fix it. And then you have the breakdown of fat. So when

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you have low thyroid hormone, you actually have you more reverse T3, and then it directly inhibits
a decreased ability to break down fats. And that’s thyroid-stimulating hormone as well. And so
where you kind of see people have a hard time cortisol is just terrible for your thyroid.
losing weight because of that reason.
And then what you said is like if your thyroid is not
And so when we think about thyroid and how working, your glucose metabolism gets jacked.
it impacts just from a metabolic standpoint, it’s And then you’re going to start to show some of
really central to all of those things. And that’s not those symptoms of insulin resistance, which is
even getting into the details around really the going to even further help you to put on more
hormones that impact that. toxic fat. It is one big broken system.
And so, I always like to start with cortisol. Many Now, when you came to be on my podcast, you
people are familiar with cortisol, recognizing quoted an absolutely amazing study about Brazil
that’s really your main stress hormone. When nuts. Eating two Brazil nuts a day has been shown
people think, oh, I’m stressed, they think cortisol to provide enough selenium to help people have
immediately. And why is cortisol so important proper thyroid function.
when we talk about thyroid metabolism, thyroid
So if some of our viewers think that maybe they
function is because cortisol helps to convert that
are experiencing some of these symptoms of low
T4 to T3.
sluggish thyroid, feeling fatigued, feeling like you
So if we have an issue with cortisol, we have just cannot get up and go, talk to us about the
excess stress, we’re impacting that conversion. proper nutrition that goes into this. And what is
As a result of impacting that conversion, we don’t your total lifestyle prescription for someone who
have our active hormone T3, and therefore, you thinks that they might have Hashimoto’s or some
have that downstream effect of symptoms that other form of hypothyroidism?
results as a result of that, essentially.
Dr. Mazzola: Yeah, absolutely. So nutrients have a
So really, cortisol secretion is controlled by your huge impact on thyroid function and really thyroid
hypothalamus. It’s controlled by the same HPT hormone development. And I think that’s often
axis that your thyroid hormone is controlled by. overlooked. And so when we talk about our diet,
And so we think about this. It regulates our blood what are we consuming? Are we providing our
sugars. It regulates our metabolism, regulates body the essential nutrients it needs in order to
our sleep and wake cycles, helps to reduce actually create T4, actually lead to the conversion
inflammation, and just impacts our hormones of T4 to T3, actually release it so that it can be
overall. taken up by the body?
I always tell people cortisol, and your thyroid And so many of those nutrients that are essential
hormones almost go hand in hand. And so when to doing so include things like magnesium. You
we’re really trying to manage it, medications is need adequate iron in order to synthesize T4 and
one thing. Food is one thing, but stress is often T3 hormones. Selenium, as we expressed that’s
overlooked and has a direct effect on your thyroid found in Brazil nuts. That’s an essential nutrient
function. in order to convert from T4 to T3. Zinc is another
[20:00] one that’s involved in overall thyroid metabolism,
and it also helps to down-regulate the activity of
Dr. Elmore: Yeah. It has an absolute direct effect your thyroid releasing hormone.
on thyroid function because it’s going to get you
less T3 like you just explained. It’s going to get So it’s involved in that feedback mechanism. So
from what you can see, if you’re not intaking a

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proper nutrient-dense diet, and I always say, you essential and non-essential amino acids from
don’t have to make it complicated. You’re really various plant-based sources so that we’re getting
just looking for eat fruits and vegetables, 9 to that complete amino acid profile.
12 servings a day with a variety of colors. If you
But really ensuring that our diets contain an
can do that, limiting high fat, saturated fat foods,
adequate amount of protein per day, consuming
sugary drinks and snacks, processed foods, so if
protein with every meal is helping us to ensure
you can shift that balance, then you’re essentially--
that we’re taking in the adequate amount
That’s a starting point to give your body the of protein and that our body is able to then
nutrients that it needs in order to at least have break that down and utilize those amino acids
a ground where it can utilize those nutrients for appropriately. And that kind of brings up a whole
its proper metabolic function. But at the same separate conversation and topic related to liver
time, you want to limit what you’re putting in and function and the ability to break down that
what you’re exposing your body to because that’s protein as it goes through our body.
what’s going to throw that balance off.
Dr. Elmore: Well, that sounds really intriguing.
And like I say, and I’ll say it again, it’s that small Maybe talk to us a little bit more, if you don’t
gland with a big impact, and that little small gland, mind, about how does liver function impact the
the tiniest alterations that you cause to it can function of the thyroid.
actually throw it off substantially.
Dr. Mazzola: Yeah. So your liver, I refer to it,
So maintaining that balance, it’s probably the everybody, as your body’s natural detox system.
greatest challenge that people have when they’re And our body is amazing. Okay. Let’s just start
diagnosed with hypothyroidism is to kind of keep with that. And its ability to recognize toxins, detox
it balanced, keep it functioning optimally without them, break them down, remove them, and then
impacting it with so many of those environmental pull out the appropriate nutrients it needs, it was
factors and toxins that we’re exposed to every made and equipped to do that.
day.
The problem with what we’re doing today is that
Dr. Elmore: Absolutely. We are so overexposed we’re overburdening it with those toxins. So that it
to environmental toxins that have massive impacts that ability to break them down, remove
impact on our thyroid. Now, in addition to all of them, et cetera, which then obviously is leading to
the micronutrients that you just mentioned, the this development of disease.
magnesium, the iron, the selenium, the zinc, we
And so if we’re able to control what we can
also need amino acids.
control by what we eat, what we’re putting in our
And I think it’s also worth to shout out to iodine body, putting in the proper nutrients, our liver
out there with the critical nutrients. And so, what can handle the rest. That’s how I always put it to
is your approach to getting good amino acids? people. Don’t overstress about everything that
Because we got to have tyrosine in order to build you control. Control what you can, and your body
our thyroid hormone. will control the rest.
Dr. Mazzola: Yeah. Essentially, amino acids are And so, our liver really goes through multiple
the building blocks of protein. So ensuring that phases of metabolism and breakdown. And it’s
our diet is adequate in the complete protein fascinating in that it needs essential nutrients and
profile. So for some people that maybe don’t vitamins in order to go through what we call the
consume animal protein, that can be a little bit phase one metabolism, where it utilizes these
more challenging. Ensuring that we’re getting both various nutrients—essentially makes things more

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toxic. break out of that mindset and truly understand

And so they have to go through phase two in that everything is related.
order to be conjugated, which means they’re And viewers, I’m going to spoil the punchline.
basically like leeched onto and removed from the Everyone that you are going to hear from on
body. Well, what you need in phase two in order the summit is going to tell you the same things.
to do that, what’s the most important thing? Is It comes down to food, to exercise, to sleep, to
protein. stress reduction. That’s it. That is the whole key.
And so ensuring adequate amount of protein So before I let you go, just give us your daily
ensures that your body, your liver is able to routine. What are some things that you say I really
conjugate those toxins after they’ve been broken do this on the regular because it makes me feel so
down and remove them and ultimately, pull good?
out what it needs from a nutritious standpoint Dr. Mazzola: Yeah, absolutely. So biggest
and maintain those within the body. And then takeaways is, like I said, eat the rainbow, eat fruits
obviously, the third step is to eliminate that. and vegetables at every meal. You will hit those
So if we’re doing all this, but then we’re 9 to 12 servings in no time. Start your day with
constipated, or we’re not hydrated enough a smoothie. Have a salad at lunch and dinner.
to eliminate via the kidneys, all those toxins You’re probably more than halfway there already.
essentially just get recirculated back into the body. Sleep—sleeping seven to eight hours a day is key.
And that’s where we’re also seeing an abundance So we talk about cortisol. How do we bring that
of metabolic disease result. cortisol down and allow our melatonin hormone
And what’s key is actually our hormones, our to just rejuvenate our body? Your body needs to
sex hormones, like estrogen. That gets broken shut down and rejuvenate in order to get back up
down through our liver. And when we talk back to the next day to do what it’s supposed to do.
thyroid hormone, when you have excess estrogen, If you’re not giving it a minimum of seven to
that actually negatively impacts your thyroid eight hours, then that right there, that’s like low-
function and hormone production. hanging fruit that I always tell people that you
And so you want to be able to metabolize that can do. Managing stress, so control what you can
estrogen through your liver so that you can control. We all have stress in our lives.
maintain that balance with your thyroid as And one thing I always tell people is stress is
well. As we said, it’s complex, but big takeaway always going to be there, but it’s your perception
is hormones do not work in silos. They’re the of it and how you react to it that’s going to actually
communicators of the body, and they all work impact how your body responds. And so if you
together. And so maintaining that balance can take a step back from it and recognize it and
between all of them is essential for optimal not allow it to control you, but you control it, that’s
health. one thing.
[30:00] And meditation is just a phenomenal thing that
Dr. Elmore: I love that so much because the body, you can incorporate into your daily practice. I do
it does seem complex. But when you can make it right before bed. So if you think you don’t have
that mental jump from the cardiologist and the time, you have 15 minutes before bed. I often
endocrinologist and the nephrologist and this fall asleep before the meditation is over. That’s
-ologist and the pulmonologist, when you can how good it is. And that’s how well it relaxes the
body. And so, I mean, those are some key things

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is just eat right, sleep, reduce your stress. And the medications, or I’m taking my supplements.
final thing is exercise. I can’t go a day without my I’m ensuring, but what’s going on? And it’s that
exercise. mental, emotional focus that we’re not really
And I find that I wake up in the morning. I have looking at.
my alone time, which is also essential, which is And so as a result of that-- so it’s easily
that hour where nobody else in the family is up. overlooked, but I constantly tell people don’t
It’s quiet, and you can reflect. And then I get into disregard that. Having that overall emotional
the gym, and I put in at least 30 minutes to get well-being, reducing anxiety, finding ways, stress
my body going because the benefits of exercise outlets really does have that beneficial effect
specifically on your hormones is-- overall on your well-being. So, yeah, it’s one that’s
I mean, the science is out there. It’s phenomenal. commonly looked at. It’s like I don’t think it really
But really, that’s how you start your day. And has that deep of a level of effect, but it’s all in your
so you start your day with that. You’re able to brain, and your brain is powerful.
function and take control of your health in that Dr. Elmore: Your brain is so powerful. And I
regard. know I’ve told you twice now that this is my last
Dr. Elmore: So this next question may catch question, but I promise, final question because I
you completely off guard, but because I follow think it is so common. What advice do you have
you on social media because your content is for our viewers who are just really wanting to get
super educational and fun and understandable off of thyroid medications?
and relatable, I know that you practice yoga. How can our viewers do that safely, do it
And there’s a lot of thoughts in traditional effectively? And do you have an opinion of
medicine about thyroid disorders and emotional Levothyroxine versus a porcine or a bovine, a
imbalances. Have you ever explored any of the more natural option? What are your thoughts
emotional connections with the thyroid? about conventional thyroid treatments?
Dr. Mazzola: Yeah, absolutely. So there’s data Dr. Mazzola: Yeah, so I’m not opposed to
and science related to trauma, previous trauma conventional thyroid treatments. I think we’ll start
impacts, current stressful situations. I mean, with that. And I don’t want anybody to feel that
the stress on the body related to an emotional they’re doing something wrong because they
feeling, negative emotions, that’s really what we’re need conventional treatment in order to get to
focusing on. I mean, positive emotions will have a that next step. And so, I always look at everything
positive effect, but it truly does have a direct effect as a balance between nutrition and lifestyle and
on your thyroid, on your body’s ability to produce medicine.
hormone.
And so if you’re currently on that medication
And it really all comes back down to cortisol. And and you’re starting to improve your lifestyle
so that trauma, that effect produces that stress. modifications, now you’re tipping that scale. The
It’s just the snowball effect. That stress increases goal is to be able to reduce that dose. The goal is
our cortisol levels. Those cortisol levels impact the to eventually be able to get off of it but recognize
conversion of our inactive to active thyroid. that it’s going to be a marathon. It’s not something
Therefore, we have reduced metabolic effects that happens quickly or easily, and there’s nothing
because we don’t have that active thyroid. We wrong with that.
have this whole slurry of symptoms, and we’re So know that this is a progressive disorder,
telling ourselves I’m eating right. I’m taking my and so you want to slow it down and slow that

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progression. And you’re going to do that by that people that switch from just T4 to a T4-T3
implementing those lifestyle and dietary factors. blend of medication actually find a reduction in
For some people, unfortunately, because it takes symptoms and just overall feel better.
an average of about 8 to 10 years for somebody
So on paper, they may both look the same, but
to actually be diagnosed with thyroid disorder, the
those that are on the combination just feel better.
damage can be irreversible.
And that’s likely a result of the T3 because, as
So if the damage has been going on to the thyroid we said, it’s the T3 hormone that’s producing the
gland and you’ve been suffering for 8 to 10 years metabolic effect. When there’s not enough of it,
before you’ve officially got a diagnosis and have that’s what’s producing your symptoms. When
been able to take control, for some people, they there’s too much of it, that’s what’s producing
may need to be on medication forever, but that’s your symptoms. So always just keep that in mind
okay because again, your goal is to slow that that it’s the T3 that you really want to hone in on
progression. So it’s okay if you’re able to maintain that’s producing the metabolic effect.
that same dose, but you’re doing everything else.
Dr. Elmore: Absolutely. And we absolutely have
Then again, it’s that balance between nutrition
to wrap up. And as we do, I think I would just also
and medicine.
encourage our viewers, work with someone who
And your second question as it relates to what really understands how to interpret labs when it
type of medication would I recommend, which is comes to the thyroid.
most important. So there’s Levothyroxine, which
[40:00]
is T4 only. Remember we talked about T4 is our
inactive. It needs to be converted to T3. Some Because if you’re working with most providers
people do fine on T4. They are able to convert to out there, they’re looking at what the lab says is
T3. normal, but we want to get that thyroid function
[Link] that’s a much smaller window that
Some key nutrients like we talked about that
we are searching for and questing for. So just
help to do that are selenium, ensuring you have
be sure that when you’re trying to come off of
appropriate selenium content so that you’re able
medicine, and you’re working on your lifestyle,
to convert to the active form. Unfortunately, many
that monitoring piece is so key.
people can’t. There is that conversion issue. And
so, there are porcine options, which include both Dr. Donna Mazola, thank you so much for
T4 and T3 hormones. So you’re actually getting a being a guest today at the Metabolic Makeover
touch of the active form as well as the inactive. Summit. Viewers, you can go and check out more
about Donna and the work that she does at
So your body’s able to do a little bit of the
[Link].
conversion, but you also have an additional
amount of T3 coming from the medication. And
studies have been done that have demonstrated

Metabolic Makeover