Episode Transcript
[00:00:00] Speaker A: Hi, welcome to it's Kinetic thing with Karen K. I'm Karen and today we're going to talk a little bit about lab work and lab values and how that might differ for functional medicine practitioners versus your primary care physician.
[00:00:16] Speaker B: So I bet you hear all the time people come in and say, I went to my primary care, we did blood work, he said everything looks normal, but I feel awful. What's, what's wrong with me?
[00:00:26] Speaker A: So a couple things is one, normal at the lab is set based on an average of what a bunch of other people of your sex and age their results are.
So do you want lab that's like a bunch of other 60 year old women or would you rather have some lab that looks like a 30 year old woman?
So that's part of it. And then the other thing is there's a, there's a wide range in those lab values. Just for instance, a normal range may be 2.5 to 4.2. 2.5 is normal according to a bunch of average people your age.
But that doesn't necessarily mean your body does well at that level. And so the best way I can explain it is it's kind of like being back in high school. You can pass a class with the D minus, it's still technically passing.
Or you can pass a class with an A, which one do you think is going to be better for your future? You want an A, right? So same thing. If Your lab is 2.5, that's in the normal range. But you're probably not going to feel very good that way. You're probably going to feel a lot better if you're at 4.2, the high end of the range. I always say, you know, there's a difference between normal and optimal. And we now know with a bunch of research that what optimal range should be for most people.
And we really don't want that D minus, we want that A plus. And so that's why we as more functional, holistic, we're going to look more at getting you at the high side of normal where you're feeling better. And sometimes we may even push it above normal to what we call super physiological levels. Some of your primary care physicians, mainstream medicine will freak out about that because for instance, let's say your thyroid number is higher than normal. If you have a disease of your thyroid, then that could lead to some distressing symptoms like a rapid heart rate, hair loss, tremors, things like that. But it's the disease that is causing that, not the blood level.
And so the blood level in A disease process is a symptom of the disease. But if your thyroid is healthy and we purposely, with supplements, medication, drive that up to high normal or even above normal and you feel great and you don't have a disease, then it's not an issue and we don't need to get too excited about it. You know, thyroid's another one I talk about a lot because in mainstream medicine primarily your physician is going to do a tsh, a thyroid specific hormone. And again, if that's anywhere normal, they're going to say it's not your thyroid, you're fine. But when I do a thyroid, I'm going to do the TSH.
That TSH inside our body splits into two enzymes, T3 and T4. T3 is responsible for about 80% of your metabolism and things that your thyroid primarily does. T4, only 20%.
So I'm going to check your T3, your T4, your free T3, which means what's not bound to protein and your body can actually use. In your free T4, you may have that normal TSH that your primary care doc checked, but your free T3 is really low, meaning you feel sluggish and tired all the time and no energy. You can't get weight off no matter how little you eat. And so I'm going to look at all that and I still may treat you even if that TSH is normal, as your primary care doc said. I'm also going to look for antibodies, things that tell me that something's attacking your thyroid and we're going to treat that if we find that.
So that's the big difference between oh, I was just normal and I'm optimal. Same with your hormones. You know what the lab, at least our lab considers a normal?
Total testosterone for a female is anything less than 55.
So zero is okay.
Yeah. We want your testosterone as a female total to be around 200. That would be if I lied to the lab and said you were a 20 year old female, that's the kind of result it would say is normal. But because I put in you're a 45 or 55 year old female, it's saying you can be from 0 to 55 and you're normal, but you got no libido, you've got no energy, you're constantly losing muscle mass, you can't get weight off. So that's not good. And so we're going to shoot for optimal, not normal in my practice.
[00:05:20] Speaker B: Well, and also I think when we're 20 years old, we feel really great. We have tons of energy, everything's great. And then as we get older, that normal changes. But we want to still feel like we're 20. And you actually, you actually help people get there with that.
[00:05:34] Speaker A: Exactly, exactly. We can, we can control, you know, like I said, we get you to that optimal level where you feel good but not so high that you're having adverse effects. You know, we don't want females to be growing a full beard and a giant Adam's apple and, and things like that. We, we want them to feel like a 20 year old.
[00:05:57] Speaker B: And so giving them 200 isn't going to make that happen. No, still within range. It's going to make them feel better, but they're not going to start looking like a man.
[00:06:06] Speaker A: Exactly. And you know, when you feel good and you have energy and you have a normal libido, you can maintain your muscle mass and your weight. It's amazing what happens in your personal life. You know, a lot of, I see I don't do counseling, but I end up, kind of end up being marriage counselor, relationship counselor because, you know, a female doesn't understand why her spouse never wants to be intimate and be close anymore or vice versa. The spouse, spouse is, still has good energy and libido and his wife is constantly turning him away. That's, that's not a good relationship. You know, intimacy is really important in a happy life and healthy relationship. And then again, like I said, muscle mass is a big deal. You know, there's so much research out there that loss of muscle mass is one of the biggest indicators of how well you age. If you've got good muscle mass, you're less likely to have falls, poor balance, weakness, fatigue. If you, you know, you're somebody that stays up and is moving and you've got good muscle mass, you're going to have a much healthier older age than you would if you didn't.
[00:07:21] Speaker B: I mean, you see that everywhere. I mean, that's such a big thing right now is muscle mass compared to aging and being debilitated, you know, as you get as a senior. And I saw that so much in my family.
[00:07:33] Speaker A: Yeah, my, my, myself included. You know, my mother was always a pretty big, strong, independent lady.
At 83, had an episode where she passed out and she had an open fracture of both bones in her right lower leg and then a horrible strain sprain in her left ankle. So six weeks she was absolutely bedbound to no weight bearing. She went from being this completely independent, functional woman to being gone in a few months because of just loss of muscle mass and loss of mobility.
[00:08:11] Speaker B: And you hear that all the time. And I'm going to ask you, this may be a little bit off topic, but they always say a senior person, when they make they fall and have a break, it's usually within a year, they're not around anymore. And is that truly just the loss of muscle? And it is.
[00:08:28] Speaker A: There's some research out there that if you are 80 or older and you have a fracture, you are 80% likely to not be here a year from now.
[00:08:39] Speaker B: I had people tell me that when my mom broke her ankle, they said, lisa, be ready. She'll be gone in a year. And she was gone literally two weeks to the year of when she broke her ankle.
[00:08:48] Speaker A: Yeah, it's a very big predictor. Recurrent falls and fractures in the elderly are a huge predictor of mortality and death. And so you want to maintain that muscle mass and that mobility, you know, and, you know, playing into the hormones again, estrogen or estradiol in females especially is really important in maintaining bone mass and healthy bone. And so, you know, one of the things that I always remember by the physician that I've done a ton of training with, he formerly was an emergency room doctor and he started learning about hormones because his nurses in the ER kept asking him to write scripts for hormones and thyroid. And he kept going, but yours are normal. And they're like, no, but I don't feel good, I feel horrible and I feel better. And he said it got him thinking and then he got him reading research and now he's a world renowned expert on hormones. And he always says, if I had my way, every person over 70, every female over 70 would be on estrogen, estradiol, because they wouldn't be coming in my ER with fractured hips and urinary tract infections. We are prescribing estradiol for men, especially men with a high cardiovascular risk, because estradiol is the only thing out there that not only stabilizes plaque that's already been built up in the artery. And so if it's stable, it doesn't fracture off, you don't get a heart attack, a stroke, things like that. But over time, it reverses plaque buildup. Your lipitor, your statins, you know, all of those meds don't do that, right? They lower your blood, your reading of your lab results, but it doesn't really lower morbidity or mortality.
Estrogen does.
[00:10:35] Speaker B: And that doesn't. It's not going to affect men negatively to be on estradiol or estrogen.
[00:10:40] Speaker A: No, you know that that's a common misconception is, oh, you give a man, just like, you know, you give a woman testosterone, they're going to grow a beard. You give man estradiol, and they're going to grow breasts and start crying at every kitty cat commercial. And the deal is balance, obviously. Balance. You want estradiol to testosterone levels to be balanced in men, Obviously for men, it's much higher testosterone, much lower estradiol. And same with women. You want a balance of estradiol and testosterone in that optimal range, but women are going to have much more estradiol and much less. Less testosterone.
[00:11:15] Speaker B: You know, it's funny because I think women get such a bad rap forever. I think women, even in our young years, when we're going through PMS and all the things about, you know, men always say women are crazy.
[00:11:26] Speaker A: Yeah.
[00:11:26] Speaker B: They're not crazy. They're just. I think we're all just. Our bodies are screaming for help. Because when you're going through pms, it's all fluctuating.
[00:11:32] Speaker A: Yes.
[00:11:33] Speaker B: You go through a pregnancy, it fluctuates, and then as you get older, you're losing it all as you go through perimenopause and menopause. So it's not that we're crazy, it's just that we feel horrible.
[00:11:43] Speaker A: Yeah. And we've. We've had hormone depletion. There's so much research out there.
Postpartum depression is a progesterone deficiency. That's what it is. If you treat a woman with postpartum depression with progesterone, you'll be amazed how much better they feel, how much quicker they get over that issue.
You know, I met a really interesting psychiatrist in Tennessee who also had a hormone clinic. And I'm like, what in the world? How psychiatry did you get into? Hormone replacement? And he's like, because doing a lot of research, the majority of anxiety and depression and mental health is hormone deficiency and imbalance. And once I started treating that, they really didn't need a psychiatrist anymore. And he said, so that's how I kind of roamed into that category. But they're finding that more and more.
So it's very interesting. You know, we tend to just want to throw pills at stuff when we actually have more and more natural tools to just bring us back to balance, to homeostasis. And our body wants to be healthy, and we need to let it be healthy. And throwing a bunch of drugs is not always the best way, which is always what?
[00:13:05] Speaker B: Because everybody goes to their primary care, and that's the first thing that happens is you get a prescription for Adderall or something that's going to help with depression when it's not necessarily depression, it's depression caused by such hormone fluctuations.
[00:13:18] Speaker A: And you know, and obviously in the US too, it's really, it's a shame because our research and our therapy for men is light years ahead of our research and therapy for women.
You know, if a man can't get an erection or perform sexually, it is a national crisis.
[00:13:39] Speaker B: Right.
[00:13:40] Speaker A: You know, and we so, you know, insurance will pay for man to have testosterone if he's deficient. We now even know it is widespread main medicine that a gentleman that's had been treated for prostate cancer. As soon as his prostate specific antigen, his PSA is back to normal, there's no sign of cancer, they immediately restart them on testosterone because they how important it is for his muscle mass, his bone health, his quality of life, his mental health.
But women go into menopause and they lose theirs. And it's like, it's just part of getting old. Deal with it. Yeah, just deal with it. Well, no, that's crazy. Yeah. There was a great article came out by Dr. Stanley and I'm really shocked that they. She got it published in Mainstream Medicine Journal. But it really outlined all of the research on hormone replacement for women. And it's like, why are we still treating women from. With research that was done 30 years ago when we know better now? And why aren't we doing better?
[00:14:47] Speaker B: And why is that? Why is it just they don't want to do more research?
[00:14:51] Speaker A: I think it's confirmational bias. You know, they went to Men's School 20, 30 years ago and they were taught hormones are bad. They heard about it. They didn't even know.
They never even actually read the research paper that had some negative comments about hormones. It's just they were told and told and somebody else told them and they don't even know what that research showed, which it was based on synthetic hormones and it was published erroneously. And. And there was a huge call to have that research paper redacted and they wouldn't do it because I guess it made them look bad that they published a false finding. So now that myth has been perpetuated all these years.
[00:15:33] Speaker B: Such a sad thing.
[00:15:34] Speaker A: Such a sad thing what women have to go through.
[00:15:36] Speaker B: And then I keep going back to that, that, you know, that people, I hear it all the time from men. Women are crazy. Yeah, it's like, no, we're not. We're not crazy.
[00:15:44] Speaker A: You're not Crazy.
[00:15:45] Speaker B: No, it's just what we're going through. And sadly, somebody can't get that fixed or go to the wrong place to get it fixed.
[00:15:52] Speaker A: Yes. Yeah.
[00:15:53] Speaker B: Well, I also love that you, in all your blood work and how deep you dive into the blood work, you also see things of deficiencies and, like vitamins or that you can then start recommending for people. So it's sort of an overall health balance.
[00:16:08] Speaker A: Yeah. You can't just look at a silo and only look at testosterone and estrogen, because, like I said, they may be very low in B12, they may be low in vitamin D. Their thyroid may be off, you know, and they can do everything they can to lose weight, but if their thyroid is underactive, they're not going to lose weight. If their hormones are very deficient, they're going to have a hard time as well.
[00:16:33] Speaker B: That same thing happened to me when I was going through chemo and gained so much weight. The oncologist said, I think we killed your thyroid. I want to send you back down to the lab and have them run a thyroid test on you. Well, they ran the one test and it came back normal, perfectly down, normal range. And she goes, well, no, I guess that's not what happened. I think to this day that's exactly what happened, too. But they didn't run the test to know, and I didn't know any different at the time to ask for more, ask for a different test, but that you're getting it done at a cancer research center. They're running the test. The basics.
[00:17:06] Speaker A: Yeah.
[00:17:07] Speaker B: That they need to see the numbers for.
[00:17:09] Speaker A: They're not interested in how you feel overall. They just want to know if the cancer cell was killed. Yeah.
[00:17:15] Speaker B: And they said that's it. So, sadly, I think that happens all the time. I think you see it all the time with people coming in, and I do.
[00:17:22] Speaker A: I do. And, you know, it's. It's sad because I have a lady right now, I think she's down 45 pounds, and she has. She said for two years she's begged her doctor to check her thyroid, and they check a TSH and they tell her it's normal to give her latest physician credit. She went back with the lab I drew, and she goes, oh, I guess you were right. You really were kind of underactive. I guess it's good that lady's treating you.
[00:17:48] Speaker B: How sad is that?
[00:17:50] Speaker A: How sad is that? Like, I'm not doing some special test you can only get from one lab. It's. It's a standard full thyroid panel. But most of them don't do it.
[00:17:59] Speaker B: And why do you think it is? They just don't. To them, the th TSH is the number to look at.
[00:18:04] Speaker A: And that's what they were initially taught, you know. But TSH is going to be the last lab that goes abnormal before your thyroid antibodies get elevated or your free T3 is low, or your free T4 is low. So it's going to. It could take months, a year for your TSH becomes abnormal. Even though those other labs, I know myself, my TSH basically shows it's off the chart. But my free.
I can barely get it to the bottom of the normal range.
So if I had gone to primary care, they'd be trying to take me off my thyroid medicine. In fact, mine did. And I just ignored her and went and did what I knew is the right thing to do, you know, But I've just learned not to let her draw thyroid panels on me because it freaks her out and she gets upset. But I know what my body likes and how I feel when I'm adequately replaced at an optimal level.
[00:18:59] Speaker B: And so if somebody does come to see you and their thor. Their thyroid off, you prescribe them a thyroid medicine.
[00:19:06] Speaker A: We do. We do. Now, obviously there are times we have to worry about other things and we may have to. If we see those numbers way off or something concerning, we may have to do an ultrasound of your thyroid or other things. But if it's just, you know, some numbers off, typically we're going to go ahead and treat that.
[00:19:23] Speaker B: And is it something that you can repair or fix?
[00:19:26] Speaker A: You can somewhat. You can change your diet, decrease inflammatory responses, gives your thyroid the supplements and vitamins it needs to be healthy. So sometimes you can do that.
It's not going to be instant. So we may add some thyroid medicine as support while you're working on improving your lifestyle and diet and things. But it's possible.
[00:19:50] Speaker B: And once you're on thyroid medication, can you get off of it and stop.
[00:19:53] Speaker A: Taking it if you.
[00:19:55] Speaker B: The numbers pop?
[00:19:56] Speaker A: It's possibility. Yeah.
[00:19:58] Speaker B: But you gotta. It's a process.
[00:19:59] Speaker A: It's a process. Yeah.
[00:20:01] Speaker B: So anybody that comes to see you, the weight loss injections or hormone issues or peptides or whatever that is, you're going to run this full panel of blood work so you can check out everything.
[00:20:12] Speaker A: We always do. Yeah. Men, women, we do a full panel on them, regardless of what they're coming in for.
Because there's so many times I find things. You know, I had a gentleman come in specifically just for weight loss.
Well, he's diabetic and a pretty severe diabetic young man, never been, Nobody tested him.
And so, you know, not only were we able to get him the weight loss injections, I was able to get it paid for by his insurance because he was diagnosed as an actual diabetic. And so now he's lost 140 pounds, he's feeling great. We've got his hormones optimized. He was extremely low in testosterone. Own nobody had diagnosed that or found that. And we've got his blood sugar back down in the normal range.
[00:21:04] Speaker B: And so he's not having to do insulin?
[00:21:06] Speaker A: No.
Last thing you want to do is insulin if you can help it.
[00:21:10] Speaker B: That's crazy. So how does that relate to you? Probably get people coming in all the time. It's just like cortisone levels are really, really high stress level.
Does that tie back into hormones as well?
[00:21:21] Speaker A: Sure it can, yeah. If you wake up and you can't think about eating breakfast, you're not hungry, that's probably high cortisol. If you can't turn your brain off at night and you lay there thinking about a million things, that's probably high cortisol. Anytime you have a high cortisol, you're going to put more belly fat, visceral fat on. That's harder to get off.
You're not going to sleep well. You put your body in an inflammatory state where sometimes the organs start attacking themselves, they work against each other, your joints ache all the time. All of those things are symptoms of high cortisol and imbalanced hormones. And things also play a part in that.
[00:22:03] Speaker B: High cortisol. Is that equal to hormones being off? Do those kind of go hand in hand?
[00:22:08] Speaker A: They can for sure.
[00:22:09] Speaker B: Okay.
[00:22:10] Speaker A: Can be, you know, it's not quite that simple. That's always the cause, but it can certainly be a part of it.
[00:22:15] Speaker B: And is there anything to do to help with high cortisol? Is it just more?
[00:22:20] Speaker A: Yeah, I mean you want to do things like an anti inflammatory diet, getting plenty of rest, learning stress management techniques. We're all going to get faced with stress, but it's how you deal with it and what you let your body go through as a part of it.
[00:22:37] Speaker B: That's crazy. There's so many little things like that that I think we go for a yearly checkup with our general care doctor and you go back and you still feel just like you did and you go back the next year and it's just a vicious cycle until you find someone like you and your clinic that and actually dig in there and find out what's really going on.
[00:22:57] Speaker A: You're convinced that that's just how you're supposed to feel because you're getting old. You know, Dana White. That is over the MMA fighters and things. Yeah, he. He really talks about, like, he was feeling awful. He had horrible obstructive sleep apnea, high blood pressure, multiple meds, felt horrible. Went to somebody that really understands the science of the body at the cellular level.
He's now doesn't have sleep apnea. He's dropped I don't know how many pounds. He feels healthier than he's ever felt. But he had been convinced by his mainstream physician that that's just the way 55 feels. And you're supposed to feel like crap. No, you're not.
[00:23:37] Speaker B: That's so awful to me that a physician actually tells somebody that.
[00:23:41] Speaker A: Yeah, that's just the way it is.
[00:23:43] Speaker B: I've heard that so many times about women, but I have not heard that. If someone say that to a man that, well, that's just what happens.
Yeah.
[00:23:49] Speaker A: My own sad. My own husband went to. I can't remember what physician he went to, but he was asking him, you know, how do I burn fat and build muscle? And he goes, oh, you can't. At your age, you just. You just can't, you know. And he said, I felt so good coming back a year later. I've been at the gym, I've lost weight, I put on so much muscle, I have energy again. And I'm like, doc, you're wrong. You can't. Can. You can at our age, if you.
[00:24:16] Speaker B: Get the right stuff in your body. So he's on hormones, obviously making a big difference. Okay, well, I'm convinced because I. I mean, cortisol is. I didn't even know about cortisol till like the last year or so. And it's. Boy, it's a. It's a game changer on how you feel.
[00:24:35] Speaker A: It really is. I'm. The root of all illness pretty much is inflammation in your body.
Diabetes is an inflammatory state. High blood pressure is an inflammatory state.
They now, you know, they're saying Alzheimer's is type 3 diabetes.
It's caused so elevated blood sugar, smoking, alcohol, sedentary lifestyle for diet, all of those lead to inflammation, which over time is going to lead to a disease process.
[00:25:06] Speaker B: That's crazy.
[00:25:07] Speaker A: Yeah.
[00:25:07] Speaker B: Okay, so how do people find you?
[00:25:10] Speaker A: They can reach us. Kinetic Clinic. We're in Tulsa, Oklahoma. 918-574-2376. Or you can email contactineticclinic.net and our website is www.kineticclinic.net and that's K I n E T I C.
