How to Heal Your Metabolism

Are you tired all the time? Are you having sleep issues? Are you not losing weight despite an optimal diet? If so, you may have a metabolic dysfunction.

Metabolism is the process by which the mitochondria of our cells convert calories (fat, protein, and carbohydrates) into cellular energy, which we call ATP. Carbohydrates serve as the primary fuel source. The carbohydrates are broken down into sugars which are then processed by glycolysis and the citric acid cycle to generate redox metabolites (e.g., NADH and FADH₂) that are capable of entering the electron transport chain. Electrons generated from this process are ultimately transferred to oxygen which will be converted into water. The stepwise transfer of electrons down an energy gradient promotes the formation of ATP, which is the currency of usable biochemical energy in our bodies.

Symptoms of Metabolic Dysfunction

While weight is not the only symptom of metabolic dysfunction, it is true that people who have poor metabolic function are more likely to gain weight or have trouble losing weight. If we do not burn calories efficiently, we are more likely to store them as fat. However, it is not necessarily true that all patients presenting with metabolic dysfunction are overweight. From a health perspective, we actually care more about the idea of “energy” than weight. One of the foundational principles of Functional Medicine is that energy drives function. Every cell, tissue, organ, and organ system in the body requires energy to support whatever it is that it needs to do. Thus, if the body as a whole does not have enough energy, a patient will complain of fatigue, tiredness, and/or feeling the need to nap during the day. If the brain does not have enough energy, the patient will complain of brain fog and trouble concentrating and may report feeling depressed or irritable. If the gastrointestinal system does not have enough energy to function, the patient may complain of constipation, bloating, gas, or reflux, among other symptoms. Likewise, if the immune system does not have enough energy to function, the patient may have frequent minor illnesses or be prone to allergies. Similarly, if the hormonal system does not have enough energy to function, the patient may complain of low libido, sexual dysfunction, and abnormal menstrual periods. In other words, all systems in the body need energy. Because energy drives function, any system that does not have sufficient energy will eventually become dysfunctional.

Symptoms of metabolic dysfunction include:

• Overall: Fatigue, weight gain, cold sensitivity/low core temperature
• CNS: Brain fog, trouble focusing, depression, anxiety, irritability
• Cardiovascular system: Low pulse, poor circulation, cold extremities
• Musculoskeletal system: Poor muscle mass, poor strength
• Gastrointestinal system: constipation, bloating/gas
• Hormonal function: Low libido, poor sexual function, abnormal menstrual periods
• Immunologic function: Frequent minor illnesses, allergies/asthma/eczema, autoimmunity

Subcategories of Metabolic Dysfunction: Fuel Deficiency versus Engine Malfunction

It is helpful to consider two specific subcategories of metabolic dysfunction. The first subcategory of metabolic dysfunction is fuel deficiency. In this situation, the body perceives that there is “not enough gas in the tank,” and may be indicated by low cholesterol and/or blood sugar levels. This situation might arise because the patient (1) is not consuming a sufficient number of calories or carbohydrates, (2) is not absorbing carbohydrates effectively, and/or (3) has problems with carbohydrate storage and cannot store sufficient glycogen in the liver and muscles (i.e., a patient with liver dysfunction or poor muscular tone). In this case, the system will respond by reducing the metabolic rate (via secondary hypothyroidism) to prevent significant weight loss in the context of the pseudo-starvation state.

The second subcategory of metabolic dysfunction is engine malfunction. This is a situation in which the mitochondrial machinery becomes dysfunctional. One common cause of engine malfunction is called primary hypothyroidism. Because the thyroid is the gas pedal, primary failure of the thyroid will cause a reduction of the rate at which the mitochondria/engine burns calories into energy. Engine malfunction cause backup of fuel and elevated fuel markers in the blood.

Factors that affect mitochondrial/engine function are listed below:

Physiologic phenomena with a major impact on mitochondrial/engine function	Specific nutrients	Bioenergetic model metaphor
Thyroid status	T3	Gas pedal
Oxygenation efficiency	Antioxidants (copper)	Battery/spark
Mitochondrial enzyme function	B-vitamins and Magnesium	Motor oil
Gut-Liver Axis	Bile acids
Adrenal/sex hormone function	Pregnenolone, Dehydroepiandrosterone (DHEA), Progesterone, Testosterone	Shock absorbers

Diagnosis of Dysfunctional Metabolism

• Biometrics
  • Low heart rate
  • Low core body temperature
• Basic laboratory diagnostics
  • Thyroid Panel (TSH, Free T3, Free T4, Reverse T3)
  • Carbon dioxide (CO₂) – the exhaust of the system, will generally be low in patients with metabolic dysfunction.
  • Blood urea nitrogen (BUN) – elevated levels suggest excess protein catabolism and may be a sign of metabolic dysfunction.
  • Fuel Markers – these will be high in cases of engine malfunction and low-to-normal in patients presenting with fuel deficiency.
    • Lipid panel – specifically LDL-cholesterol
    • Hemoglobin A1c – generally evaluated as a three-month moving average of blood sugar levels.
    • Glucose – spot measurements of blood sugar levels
• Advanced Functional Medicine Diagnostics
  • Organic acid test – elevated levels of lactic acid, citric acid cycle intermediates, and ketone bodies in the urine are markers of metabolic dysfunction

Healing the Metabolism Through Nutrition

Macronutrient Balance

The overarching principle of healing your metabolism is balance. Every meal should contain a balance of carbohydrates, fat, and protein.

Social media and YouTube are filled with information about imbalanced diets. A large part of this is “low-carbohydrate” diets, including Paleo, Keto, and Carnivore. On the other end of the spectrum, some advocate for a vegetarian diet, which usually ends up being low protein. We believe, however, that the best approach is the balanced approach. If anything, carbohydrates may represent the most important macronutrient class because they represent the primary fuel of the body. Because the fuel status is such an important part of our metabolic function, it does not make sense to restrict carbohydrates (apart from intentional weight loss for some patients).

Carbohydrates

Consume high amounts of natural sugars (i.e., fruits and roots):

• Fruit (with every meal and snacks; 4-5 pieces per day)
• Fruit juice
  • Ideally freshly squeezed
  • If not, then a product that is 100% juice, no added/artificial sugar, not from concentrate, no added chemicals
• Tubers (potatoes, yams, sweet potatoes)
• Root vegetables (squash, carrots, beets)
• Cruciferous vegetables (broccoli, cauliflower) [must be cooked]
• Natural added sugars (honey, real maple syrup)

Consume moderate amounts of grains:

• 1^st tier: Ancient Grains (Spelt, Kamut, Farro, Barley, Oats, Buckwheat, Teff)
• 2^nd tier: Other non-wheat cereals
  • Rice
  • Corn
• 3^rd tier: Other wheat
  • Breads
  • Pastas

Consume moderate amounts of raw vegetables

Avoid processed/refined sugars: candy, soda, sugar-sweetened beverages, high-fructose corn syrup

Fat

** Moderate the total fat intake (most people consume too much fat)

Most of the saturated fat should be saturated fat (SFA) and monounsaturated fat (MUFA):

• Saturated fat
  • Milk (best raw, organic whole milk OK, coconut milk if GI issue)
  • Yogurt (or coconut yogurt)
  • Cheese
  • Eggs
  • Coconut oil, butter, ghee
  • Animal fats
• Monounsaturated fat
  • Olive oil
  • Avocado

Omega-3 Polyunsaturated fat (PUFA) in moderation: salmon, salmon roe, oily fish (herring, anchovies)

Avoid Omega-6 Polyunsaturated Fatty Acids (PUFAs):

• Seeds
• Nuts
• Vegetable oils (canola oil, safflower oil, sunflower oil, soybean oil, etc)

Examples of sources of vegetable oils (omega-6 PUFA) in diet:

Food	Serving	Total Fat	Omega-6 PUFA
Mayonnaise	2 tbsp	20.6g	10.8g
Fried rice (Panda Express)	1 order	14.4g	6.0g
General Tsao Chicken	3 oz	13.4g	6.0g
Ranch salad dressing	2 tbsp	11.0g	5.5g
Blueberry Muffin	1 muffin	15.5g	4.9g
Potato chips	1 serving bag	9.6g	4.4g
Almond butter	2 tbsp	17.3g	4.3g
French fries (McDonald’s)	1 small order	10.3g	4.1g
Peanut butter	2 tbsp	16.6g	3.9g
Doritos	1 serving bag	8.1g	3.7g
Granola bar	1 bar	7.1g	3.6g
Tortilla chips	1 serving bag	5.9g	2.7g
Italian salad dressing	2 tbsp	7.0g	2.4g
Tofu	½ block	6.8g	2.3g
Microwave popcorn	½ bag	18.5g	2.2g
Crackers (Ritz)	5 crackers	4.2g	2.1g
Chocolate chip cookie (store bought)	2 medium cookies	4.9g	1.8g
Ice cream (Ben and Jerry’s chocolate chip cookie dough)	½ cup	14.0g	1.2g
Vegan butter	1 tbsp	11.0g	1.1g
Gluten-free bread	1 slice	2.3g	1.1g
Almond milk	1 cup	2.3g	0.6g
Coffee creamer	¼ cup	4.3g	0.5g
Whole wheat bread	1 slice	1.3g	0.5g

Protein

Consider adding one or both of the following superfoods:

• Beef liver
• Raw oysters

Otherwise, most people need about 80-100g of protein per day of any of the following:

• Chicken
• Dairy protein
• Seafood: non-fatty white fish (cod, haddock), crab, clams, shrimp, mussels
  • Some fatty fish (tuna, salmon)
• Ruminant meats: beef, lamb
• Collagenous protein: bone broth, collagen peptides, or gelatin

Vegetarian protein sources: Lentils, beans, dairy, quinoa, tofu/tempeh (in moderation)

** Try to get meat organic, antibiotic-free, hormone-free, free range **

Water and Salt

• Drink water to thirst and when exercising (or doing something stressful)
• Salt your food! (iodized sea salt, Celtic sea salt, Himalayan sea salt)

In addition to a balanced, metabolically-optimized diet, your Functional Medicine provider may add nutritional supplements to help boost your metabolism directly or indirectly by balancing your hormones, stress, and vitamins/mineral levels.