Amy Berger: More Keto, Less Crazy - #60

Keto without the crazy. Low-carb and keto-oriented nutritionist Amy Berger's goal is to provide information about the keto diet without the fuss of different apps, spending too much, or weighing every molecule of food.

Her knowledge of low-carb diet started during her college years, thanks to Dr. Atkins and his book New Diet Revolution. She was already practicing low-carb diet when she took her master's degree in human nutrition. Already aware of its effects and benefits, it prompted her to delve deeper into its relation to different metabolic syndromes, Alzheimer's disease, thyroid, and depression.

In this episode, she shares the life-changing information she got from her studies on Alzheimer's disease as her graduate thesis, the heartbreak of seeing people misdiagnosed for decades, and the tips she has on how to get lab tests even without a doctor’s consent.

Quick Guide:
01:10 Introduction
05:49 Keto without crazy
07:00 People may not need the same keto diet
11:25 Cut the carbs
15:39 Common symptoms that a low-carb approach can help resolve
21:41 Symptoms that you’re getting insufficient fats
24:17 The unconventional nutrition education
27:43 The Alzheimer’s Antidote
34:21 Diet and lifestyle affect the brain too
36:53 Thyroid problems and depression
47:36 Misinformation related to health and nutrition

Get to know our guest:
Amy Berger is a Certified Nutrition Specialist who offers private consultations and creates online courses about keto. She authored the following books: The Alzheimer’s Antidote, The Stall Slayer, and End Your Carb Confusion, written with Eric Westman, MD.
 
"So just because you're normal doesn't mean you're going to feel well. I really, really wish that more doctors would go by the symptoms versus the numbers." - Amy Berger

Connect with her:
Twitter: https://twitter.com/tuitnutrition
Blog: http://www.tuitnutrition.com/
The Stall Slayer website: https://stallslayer.com/
Adapt Your Life Academy: https://adaptyourlifeacademy.com/
YouTube: https://www.youtube.com/channel/UCmDz-SYYhoerycynsCm7L8g
Amy Berger talks about thyroid:

Chances are, you wouldn't be listening to this podcast if you didn't need to change your life and get healthier.

So take action right now. Book a call with Dr. Ovadia's team. 

One small step in the right direction is all it takes to get started. 

How to connect with Stay Off My Operating Table:

Twitter:

• Dr. Ovadia: @iFixHearts
• Jack Heald: @JackHeald5

Learn more:

• Learn more about Dr. Ovadia's personalized health coaching
• Get Dr. Ovadia's book Stay Off My Operating Table on Amazon.
• Take Dr. Ovadia's metabolic health quiz: iFixHearts
• visit Dr. Ovadia's website: Ovadia Heart Health
• visit Jack Heald's website: CultYourBrand.com

Theme Song : Rage Against
Written & Performed by Logan Gritton & Colin Gailey
(c) 2016 Mercury Retro Recordings

Transcript

S3E06: Amy Berger

SUMMARY KEYWORDS 

people, eat, low carb, keto, alzheimer, protein, book, work, insulin, fat, carbs, grams, nutrition, diabetes, low carb diet, keto diet, diet, amy, normal, brain 

SPEAKERS 

Amy Berger, Female Age 61, Dr. Philip Ovadia, Jack Heald 

Announcer  00:10 

He was a morbidly obese surgeon destined for an operating table and an early death. Now he's a rebel MD who is fabulously fit and fighting to make America healthy again. This is Stay Off My Operating Table with Dr. Philip Ovadia. 

Jack Heald  00:38 

And if I read this right, we are live, welcome. It's the Stay Off My Operating Table podcast with Dr. Philip Ovadia. I'm your co-host or his co-host, or somebody's co-host, Jack Heald. And we are joined today by nutritionist Amy Berger. I actually started this conversation late because I've got deep into some of the stuff that she's written. And probably be better if we get into it while we're recording rather than while I'm by myself. So, Phil, set the table for us here, man. 

Dr. Philip Ovadia  01:10 

Sure thing. So, Amy is a nutritional badass, I will say. And, she's, again, one of the early, early people that I probably came across in the low-carb keto world. Her first book, which I'll now say the Alzheimer's antidote, is certainly one of the key texts that I think people should be reading. And then she's had two books since then, she's had The Stall Slayer, which is really just a great practical guide to doing keto, and we'll get into a lot of that, and her most recent book End Your Carb Confusion, again, just a powerhouse of a book when it comes to nutritional approaches. And I was fortunate to meet Amy, have now shared the stage at some conferences with her, and really excited to have this conversation and to bring her to our audience. So, with that, Amy, why won't you fill in a little bit of the details about your background, and kind of how you got to where you are today. And then we can dig into all of the great information you have around nutrition to share with us. 

Amy Berger  02:34 

Yeah, thank you. I don't think anyone's ever called me a badass before. So that's the best introduction. I think for anyone who doesn't know who I am, I am a low carb and keto-oriented nutritionist and a writer. And I got into low carb eating the way a lot of other people do. I used to be heavier. And I was doing what I thought were all the right things, I exercised a lot, I dutifully ate my whole grain cereal with my skim milk and I put light margarine on my whole wheat bread and all that. And I could not lose weight no matter what I did. And I came into this from the Atkins diet. I actually read Dr. Atkins’ New Diet Revolution and this was over 20 years ago when I was in college. And I was not ready to make it my permanent way of life at that time. So, anyone who's listening, like if you have started and stopped and started and stopped, welcome to the club. I don't know anyone who learns about low carb or keto and just does it and that's it forever. They never stumble, they never go back. But I mean, I've been at this now a very long time and I changed careers. I was fortunate in that I was not a nutritionist or dietitian who was conventionally trained. And then I had to kind of deprogram and relearn everything new. I actually went to graduate school for nutrition after I was already eating a low carb diet. So, I was able to learn all of the biochemistry and physiology in the context of already having experienced all the different things that low carb diets do. And long story short, now I am in private practice, I do see clients but I also do a lot of writing. And I always say at this point, knowing what I know about low carb and keto diet, and you probably feel the same way, weight loss is one of the least impressive things that this can do. And if you're living with morbid obesity, I mean yes, weight loss can change your life. I'm not trying to downplay that. But you could also literally be free of type two diabetes, be free of PCOS, get rid of heartburn, get rid of migraines, fatty liver, so weight loss happens to be like a little fringe perk benefit that happens on the side of all that other great stuff happening. 

Jack Heald  04:59 

So, somewhere on your one of your websites, I saw that phrase “Keto Without the Crazy.” First of all, well done. Good title, good marketing. Secondly, expand on that. What do you mean keto without the crazy? 

Amy Berger  05:20 

Yeah, the way that actually happened is I have a YouTube channel and it just came out of my mouth one day and I thought, oh my God, that's good. I'm gonna have to keep that. And that has become my motto now and my trademark, but so like I said, I learned about this a long, long time ago, when I was new to low carb. Twitter did not exist. Facebook, Reddit, YouTube, Instagram, Zoom. None of this even existed. And it was so much easier to start then because all there was the Atkins book, there was the book Protein Power, and there was like one or two old school message boards. 

Jack Heald  06:03 

Protein Power. I remember that book. I may even have that book. 

Amy Berger  06:09 

Yeah. Mike and Mary, Dan Eades. And so, there was less information, but there was less misinformation, there was less conflicting and confusing information. And if I were new to keto now, I don't even know how I would possibly begin. I don't know where I would choose to get information. And so, the “Keto Without the Crazy” is like, here's how to do it. How and why. And here's how to do it without going bankrupt, spending a kazillion dollars on all kinds of gadgets and food. And yes, you can do it without apps and spreadsheets and weighing every molecule of food you eat. And for the people that like that, great, do it, but for the people that want it without the crazy. That's what I'm here for. 

Jack Heald  07:00 

Okay, so the crazy is a combination of the flood of information and the reality that there's, a lot of it is misinformation. Is that, have I got that about, right? 

Amy Berger  07:14 

Yeah, some of it's misinformation. But some of it's not necessarily misinformation. It's just not appropriate for certain situations, and I'm sure like Dr. Ovadia, you probably see this all the time. Certain things that are appropriate for one scenario or not for another like, you can use a ketogenic diet for a lot of different things. The kind of diet that a child needs to prevent epileptic seizures is not necessarily the same kind of keto diet that works for weight loss and a postmenopausal woman, they look different. So, it's like, it's not that anyone is overtly wrong. It just may not be appropriate, depending on what somebody's trying to do. 

Jack Heald  08:00 

I'd love to hear details, like examples, like, you gave two very different scenarios. A child, an epileptic child, and a postmenopausal woman. Come on, what's the details here. 

Amy Berger  08:14 

For kids... So, the ketogenic diet was created for epilepsy, it's a diet that works to prevent seizures in at least some people, it doesn't work 100%. And everybody's different, even within the epilepsy world. Some kids need to be not only very, very low carb, but they actually have to watch their protein intake and they have to be more mindful of the ratio between their protein and fat and their carbs. Whereas somebody who's trying to lose weight, especially if like they are in that sort of menopausal, postmenopausal women where that is the most difficult category for people to lose weight. And some of those women, we cannot have the ultra-ultra-high fat. So, when they talk about keto being a very high fat diet, that theory’s wrong. What it really is, is very, very low carb. Most of us could benefit from more protein and kind of eating fat and enjoying fat, but not going crazy, not deliberately loading all our food up with melted butter and cheese and oil. So, both diets are low in carbs, but the fat is going to be different. 

Jack Heald  09:27 

We had Steak and Butter Gal on several months ago. And she talked about when she flipped over from, I think she was a hardcore vegan, wasn't she Phil? She decided that that was killing her or something. And so, she started snacking on frozen sticks of butter. But granted, this is a woman in her 20s. It's a little different. Okay. 

Dr. Philip Ovadia  09:51 

Yeah, I mean, so, what I love about your approach, Amy, is that practical, the way you just boil down, there is all the science and you can get way deep in the weeds. And you can be reading all these studies, and what the mechanisms of action are and all of this, but ultimately, for most people, they just want what do I eat, and keep it simple. And the simpler you can keep it, the more successful, I find that it tends to be, and the more that it's able to resonate, and most importantly, the more that people are able to stick with it, because I think one of the biggest issues I see out there today in the nutritional world is that people realize that, well, when they come to the realization that what they eat is a determinant of their health. That's sort of step number one. And then they start getting into it. And they're bombarded with all these different camps of nutrition. And you have the vegans and the carnivores, and you have the hardcore keto people, versus more of the just eat low carb, prioritize protein type thing. And you have a good way of kind-of breaking that down, and helping people to understand that this doesn't need to be complicated. 

Amy Berger  11:25 

Yeah, I appreciate that. I mean, that's definitely what I try to do, because it's like you said, it doesn't matter how effective something is if no one can actually do it, if no one can actually keep doing it for 10, 20, 50 years. And I think it's like you said, on social media, there's all these people that love to debate, the minutiae of this one metabolic pathway and this one enzyme, but how much does that actually matter to the person that just wants to lose 50 pounds, to the person that just wants to get off their insulin for type two diabetes? They don't need to know that. And I see so many people who are so overwhelmed by thinking that they have to address so many different things at once that they give up because it's like, I can forget it, this is impossible. Whereas for most people, just cutting the carbs is going to take them very far. Like, they might have to add in some other stuff over time. But just the reduction in carbs is so powerful, that they may not have to worry, everybody, now, you have to go in the infrared sauna. And you have to get sunlight in your eyes first thing in the morning, and you have to fast and you have to do all these things. And no, you don't. And if you love that, do it, but people have been using this for hundreds of years. Carbohydrate restriction is not new. This is centuries old. We didn't need all this other stuff, like all we needed to do was cut the carbs. 

Jack Heald  13:07 

Well, when I was researching you, I like to make notes as questions come up. And one of the questions I was going to ask was, what's the fastest simplest nutrition hack most people should adopt? But I think you just answered it. Cut the carbs. Would you expand on that? Let's get into more detail. What does cutting the carbs look like? 

Amy Berger  13:34 

Yeah, that's a great question because I was actually going to say about... Phil, one of the things that I really liked about, I read your book, one of the things that I really loved about your book was you're not a Keto zealot, you were very clear. Some people do well with paleo, which is not a super low carb diet, necessarily. Some people can eat just what I don't like these terms, but what we would call real food or whole food, not everybody needs an ultra-ultra-strict keto diet. So, when I say cut the carbs, it depends because I think the sicker you are, the more severe your health situation is, the stricter an approach you need to get out of that and to start getting healthy again. So, if you have out of control type two diabetes, if you want to lose 100 pounds or 50 pounds, if you have metabolic syndrome, I think that the fastest and most effective way is to do a very low carb or keto diet so that cutting carbs in that sense means not just the obvious sources of sugar like not just the pastries and the sweets and the ice cream and the potato chips and stuff. But even some of the things we would consider a healthier wholesome food like beans, potatoes, sweet potatoes, fruit, there's some people who are so sensitive to the effects of carbohydrate that they have to cut all of that. But some people aren't some, some people can have, I hate to give numbers but 50, 100 grams of carbs a day and they're fine. And but some people in order to really make a dent in those metabolic problems, I think you need to be very low, but maybe not forever. Some people, they go on a very low carb keto diet, they lose the weight, or the health problems go away. And they can gradually reintroduce small amounts of sugar and starch. And they're fine, but they probably can't go back to eating huge amounts of that. 

Jack Heald  15:39 

So, it occurs to me that there's probably two categories of people who would benefit from this. I'm sorry, I should clarify, of unwell people. There's the people who have serious problems and know it. And then there's the people who have serious problems and aren't aware of it. And I'm thinking of myself 17 years ago, I had what eventually led me into nutrition as a way to be healthy was severe heartburn. And it was certainly a royal pain in the neck. But if you just said to me, Oh, Jack, you're deeply unhealthy. I would have said, no, I just, I need more Tums than most people. So that's just a way of setting up the question. What are some fairly common symptoms that people walk around all day long thinking is normal or mildly irritating that is actually, hey, you got a problem and a low carb approach will help? 

Amy Berger  16:53 

I could not love that question more. Oh, my goodness. Because no, I really do think there's millions of people, like you said, who know they're sick, they have diabetes, they have pre-diabetes, they have PCOS or something. And then there's this whole other portion of the population that most of their blood work, not all of it, most of it looks okay. They don't have any major problems. But they have all these like every day nagging little things that they don't realize are actually a big red flag. That's so normal, and they've had them for so long that they don't even think about them anymore. So, one of those would be, like you said, heartburn. Believe it or not skin tags. That's a big one. That's surprising. Not only some people that have multiple skin tags, that's a sign of too much insulin because insulin is a growth signal and it's literally, you're growing too much skin. Then men with BPH enlarged prostate gland could possibly come from chronically high insulin, migraines, hypoglycemia, which we were just at the symposium for metabolic health in San Diego and Dr. Brian Lenzkes gave a great talk on the use of CGM, the continuous glucose monitors. And he and his patients had discovered that he had a patient who was having what she thought were panic attacks, turns out they're not actually panic attacks. It was hypoglycemia manifesting as that. So, I think that's a big one. I think irritability, road rage is I think that's also unrecognized hypoglycemia. So many others, I can't. 

Jack Heald  18:41 

Well, I think you've given us a good list. 

Amy Berger  18:43 

Yeah, definitely brain fog, any of these things benefit from low carb, 

Dr. Philip Ovadia  18:48 

The brain fog, the being tired, the joints that hurt that everyone just attributes to old age. And most of these things are related to what we're eating. 

Jack Heald  19:04 

All right, so.... 

Dr. Philip Ovadia  19:08 

What I was gonna say, the people that you work with, what are some of the common, I always hate to say, things they're doing wrong, but what are some of the common missteps that you find that people make when they start to sort of dip their toe into this water and they say, okay, I realize I'm unhealthy. it's because of what I'm eating. I'm going to do this low carb keto thing, and then it doesn't work and hopefully, they're kind of persistent enough that they find someone, they find you, they find someone to work with on this. What are those common sorts of problems that you see people have, that can be corrected to make it work better for them? 

Amy Berger  19:57 

Yeah, the two the two biggest so you mentioned my book, The Stall Slayer, basically wrote a whole book about things that get in the way of fat loss on low carb. The two biggest are too many carbs, too much carbohydrate. And the second is too much fat, and with too many carbs, and I was very, very lucky to have, well, I still work with him with Dr. Eric Westman, who's been in this, it's about as long as anybody. He did some of the earliest research in low carbon keto diets. And his method has always been total carbohydrate, not net carbs. So, in other words, you don't subtract the fiber or the sugar alcohols. So that doesn't leave room for all these newfangled, the Keto bars and the Keto cereal and the Keto ice cream that gets in the way for a lot of people, those excess carbs, it's not like they're eating rice and noodles, but they're eating all these keto products that they don't realize they're actually having way more carbs than they realize. And then the other big one is the fat. Like I mentioned earlier, it really kind of irks me when everybody calls keto a high fat diet. It's not. What it really is very low carb, and, or, depending on the situation, right? But a lot of people, the excess fat, when they think they have to hit a fat macro, or that their diet is supposed to be 80% fat or something. So, they're adding extra fat even when they're not hungry for it. They don't need it. They're like melting oil and butter on everything because they think they're supposed to. And that very often gets in the way, especially a fat loss. 

Jack Heald  21:41 

Are there signs and symptoms that you're getting insufficient fat, like the other the other side of the of the problem that you just described? Not that you're getting too much, but that you're not getting enough? 

Amy Berger  21:59 

Ah, are you talking about on a low carb diet specifically? 

Jack Heald  22:02 

If you're on a low carb diet, but are there any signs that, you're really being way too strict with your fat? 

Amy Berger  22:09 

You’d probably be hungrier, I mean, fat does help satisfy us and keep us going between meals. I think this would be true of any diet. But if you go long enough, without enough fat, you'll start to have like dry skin and your hair might start to get kind of dry and not look so shiny and nice. But most of it is probably going to be the hunger, you're just going to be hungry. Because protein will fill you up, but you can't you can't live on protein alone. I'm trying to think though, Phil, do you know of anything else? Like specifically? Nothing's coming to me at the moment. 

Dr. Philip Ovadia  22:49 

I was just gonna say lack of energy and the tiredness, the other thing that I oftentimes see with people, and this is something that I do encounter, because, being in the heart disease world, of course, everyone has had it just hammered into their brains that low fat is the way to prevent heart disease. And despite the fact that we know that that is just wrong. We have all the data we need at this point, but people have a hard time getting past that. And so oftentimes, when I'm working with them and saying, it's the carbs and the sugar, and you got to cut that, and then they but they still kind of stay low fat, and now they're kind of low carb, low fat, and that's probably the biggest thing I see is that then they're just like, I'm tired all the time. And I don't have the energy. And they don't see the benefits, what, basically you're putting your body into starvation at that point, oftentimes, and so your body fights it and you don't lose the weight and you don't get the mental health benefits and all the other benefits that we see from doing a low carb diet that's better formulated. 

Amy Berger  24:09 

Yeah, no, I agree. That's how I totally forgot that's like I knew there's big ones that I'm forgetting it read the energy level the fatigue and yeah. 

Dr. Philip Ovadia  24:17 

Yeah, you gotta get your energy from somewhere ultimately. So, I think that's important. So, talk a little bit... One of the reasons I said you're a nutritional badass is because you learned a lot of this stuff, you started doing it. And then you decided to go back and get your degree, like you said, and I think you kind of knew going into it that you were going to be fighting the battle, you're going to be having to answer the questions on the test the way that you might not, the way that you know is not exactly true, but tell us what that was like going through your nutritional education, having already learned so much and knew so much about keto and low carb. 

Amy Berger  25:08 

I was actually pretty fortunate. I chose the specific program I chose because I knew they wouldn't be conventional; they wouldn't teach me like the food pyramid and that kind of thing. And it's a fully accredited program, it was a real university, but I just I just knew that that program would be not quite as conventional. And biochemistry is biochemistry, right? Anatomy is anatomy, those don't change. So, I loved those classes, because I knew a little bit about how low carb work. But once I really started learning the deep science, I was able to, oh, that's why this, that's why insulin does what it does, oh, that's why this amino acid does what it does. That's why low carb does what it does, like at the molecular level, learning about the Krebs cycle or fatty acid ox, I mean, that was amazing. I was very lucky. Like, we didn't get taught that you have to eat these many servings of grain or so. Because I'm not a dietitian, I'm not an RD, my training, I mean, they of course learn all the science as well, but I think they learned a little more of that conventional nutrition teaching. Most of my professors now, we certainly didn't learn keto, but most of my professors knew like, we're probably all eating a bit too much carbohydrate. And there was one of the biochemistry professors was... He knew, I guess he was not opposed to saturated fat because he's like, the chemistry of this, I don't understand how this would be harmful. So, I feel really fortunate I was able, like I didn't have to unlearn things that I was taught. I have a lot of RD friends and other nutritionist friends who did go to more conventional programs. And they learned about this on their own. And they sort of had to like deprogram their brain and learn all this new stuff, but it's even going through the same science classes. Like my fellow students could come away from it with very different interpretations, right? Okay, if this is how this pathway works, and what should we eat? We could think very differently about it. But I do, I feel fortunate that I didn't have to unlearn a lot. 

Jack Heald  27:43 

You're rare. We have guests after guests after guests trained as professional health care providers who tell us stories about all this stuff. They had to... That was just wrong. It was just completely wrong. So, let's talk about was Bridgeport, that was the name of the university? All right. So, for those of you listening and wondering where the heck did Amy get a decent nutrition education? Bridgeport. Look it up. University of Bridgeport. Hey, I want to ask about Alzheimer's. It wasn't very long ago that it was revealed that the root cause of Alzheimer's as had been reported, what was it 15-18 years ago, that the researcher basically just made up his data. And we spent literally billions and billions and billions of dollars chasing a joke. It was worse than a joke. People died and, and money was spent on things that were just, there was never going to happen. Talk about Alzheimer's, what you have learned. It's relation to nutrition. I read that you that you had published three books, but I didn't realize the Alzheimer's almost the first. So, I'd like to hear first of all, why that was the first one and then kind of give us headlines. 

Amy Berger  29:14 

Yeah, um, that book The Alzheimer's Antidote was, it is my first book. And the reason it was the first is that was actually my graduate thesis. It was a much, much smaller. I did a literature review on Alzheimer's disease. And after I graduated, I felt like it was really potentially life-changing information. I'm like, this is going to sit on my professor's computer. No one's ever going to know anything about this. So, I expanded it into, it was a PDF e-book that I sold myself and a publisher found it and offered me a book deal. I will never be that lucky ever again. So that I expanded it that much more into the book it is now. For anyone who happens to be brand new to this concept like, why on earth would a nutritionist, let alone a low carb nutritionists have anything to say about Alzheimer's? They routinely now call Alzheimer's disease type three diabetes, or diabetes of the brain. And where this comes from is the main problem in the brain of somebody with Alzheimer's is that neurons, for whatever reason we don't know why, they have lost the ability to take up and metabolize glucose. So, they're not getting fuel. It's you think of it as a fuel shortage or like an energy crisis in the brain. So, of course, these cells are kind of starving. Of course, you're gonna have memory loss. Of course, you're gonna have personality changes and all the things we see. So, the most promising, most encouraging thing that we know about Alzheimer's right now is that even though the brain is not taking up and using glucose properly, it still takes up and uses ketones. So, if we can provide, maybe this this other type of fuel to these otherwise starving cells, maybe we can improve the cognitive function. And the research says that's true. Maybe not 100% in everybody, but it is the most promising thing going on right now, I think, in Alzheimer's. 

Jack Heald  31:28 

I want to make sure I understand. What is currently diagnosed as Alzheimer's is, in the brain cells essentially the same thing that's going on in our bodies with insulin resistance, inability to make use of, I mean, you need insulin in order to get enough glucose into the cells, of which, this is the idiot layman trying to explain diabetes. So, the brain is, that's the same kind of situation in the brain. But because our cells can also use ketones for energy, rather than glycogen, if you flip your system over into ketosis, you're now providing your brain the alternate fuel that probably uses a different pathway than glycogen? I don't know. Am I... 

Amy Berger  32:36 

No, that's basically it. But the insulin... Insulin and glucose have kind of a different relationship in the brain, you actually don't need insulin to get glucose into the brain. But insulin does other things in the brain. And if there's not enough, and so the Alzheimer's brain actually has, it looks like or so far, it looks like there's less insulin in the brain. So whatever insulin is doing is not happening. And the glucose, I mean, that's related, though, that the glucose is not being taken out properly. But I can't, that's not because of insulin, glucose would get in the brain anyway. But I can say that I'm chronically... So, type two diabetes, and chronically high insulin, even if you don't have diabetes, and this I cannot emphasize this enough, even if you don't have diabetes, so if your blood sugar's normal, if you have chronically high insulin, that is a huge risk factor for Alzheimer's. Huge. 

Dr. Philip Ovadia  33:40 

Yeah. It also plays into, I mean, we had Christopher Palmer on not too long ago, and of course, all of the work that he's doing, and so many others are doing out there, discovering the effects of high sugar, high insulin on the brain in many different scenarios. Alzheimer's is certainly one of them. But when we start to look at some of these mental health issues, and we see that same picture emerges, and it's clear at this point that high sugar is not good for the brain, I think we can certainly say that. 

Amy Berger  34:21 

Yeah, I mean, everybody's heard of metabolic syndrome, which basically comes from high insulin. The connections now between metabolic syndrome are chronically high insulin and Alzheimer's and the precursor, mild cognitive impairment, those associations are so strong, they now, they have the phrase metabolic cognitive syndrome. So, they're not unrelated. With cardiovascular disease and like diabetes and obesity, we don't even question that those are driven by diet and lifestyle. People might have different opinions as to which diet is causing it or which diet’s the best solution, but nobody pretends like diet and lifestyle aren't the major factors there. But when it comes to the brain, whether it's mental health like Dr. Palmer and Dr. George II talk about or whether it’s cognitive function, we like dismiss even the possibility that these could also be diet and lifestyle things. And I think, of course, with mental health, there's so many other things that go into a trauma, so many other lifestyle circumstances can affect mental health, of course, but let's not ignore the possibility of how much of it is driven by diet. It's just like all the other things that go wrong in the body. Things are gonna go wrong in the brain too. 

Jack Heald  35:47 

It sounds like the message there really is, I'm thinking about, when somebody knows they're unhealthy and is trying to get healthy with their body, oftentimes, they get stymied emotionally or psychologically or mentally, whatever. There's stuff going on upstairs, that just, they have trouble pushing through. It sounds like the message is, hey, eating this way will also help you just have better cognition, better, you'll think better. You'll emotionally be a little more stable. You and am I overstating that? 

Amy Berger  36:32 

No, I don't think you are. I think what we eat has a huge influence on our mood, on our behavior. But I don't want to dismiss the other factors that contribute. It's not all diet. But I think you're absolutely right, diet plays a huge role. 

Jack Heald  36:53 

All right, well, if you don't mind, I want to turn the corner again. Hypothyroidism, thyroid, and depression. I'm not rare in that I have had a number of people in my life who have dealt with some form of thyroid dysfunction. And it just appears from the outside to be hell. What I haven't heard is a connection between thyroid and depression. I just love to... Enlighten us, tell us what you've learned about thyroid problems and depression. 

Amy Berger  37:33 

Yeah, I am not a medical doctor. So, this is not just my opinion. It's some my opinion, it is my own personal experience. And it's my reading of the published literature. My next book, the book I'm writing right now is about thyroid and I think the chapter on depression is probably the second longest chapter in the book, second only to the chapter on weight. I see so many clients who are on antidepressants, and on statin drugs, and on all kinds of other medicines, when what I think they really need is thyroid medicine. So, when your thyroid hormones are not, if they're low, and they're not where they need to be, your whole body slows down, ever. This is what you have constipation, even the muscle contractions in your colon slow down, you lose your hair, your metabolic rates, everything slows down. This is why you gain weight, or you have a really hard time losing weight, and the depression, and for some people, it may not, they may not think of it as depression. In a lot of people, it manifests as apathy, kind of a flatline, they're not especially low, but they're not... They just kind of make do every day. It's like you said, it can be hell. It can be absolutely debilitating. It can rob you of relationships, it can rob you of self-esteem, of trying to go for promotions at work because you just feel so awful all the time. And if I seem a little passionate about it and a little like my heart is breaking right now, it's because I am and it is. This and the worst part is that so many people and women are affected far more than men. Men can have thyroid problems, but it's about a nine to one ratio that women are affected way more, and they can go for years, sometimes decades without being properly diagnosed. And as some of that is because the reference ranges that are used are not appropriate, but you can just lose years and years of life to feeling miserable because of on diagnosis. 

Jack Heald  39:58 

Is it even... So go ahead, Phil. 

Dr. Philip Ovadia  40:01 

No, I was just going to jump in and say, even once they are diagnosed with a thyroid problem, it's oftentimes not, I guess the root causes of that thyroid problem aren't investigated. And so oftentimes it ends up getting treated in an ineffective manner because we're not really addressing what led to the thyroid problems in the first place. 

Amy Berger  40:31 

That is definitely true. And it's also true. I think it's not always easy to identify the root cause. So, in the meantime, if you have to take thyroid medicine, I think let's take advantage of medical technology where we can, I mean, not every drug is bad for us. Unfortunately, the most commonly prescribed thyroid medicine, the T4 only, the levothyroxine, does not work for a lot of people, they can take it and they still feel awful, they still have all their same signs and symptoms, because that T4 is not being converted into the T3, which is the one that actually has the biological effect. And some people do really, really well on the levothyroxine. But a lot of people don't. And I see this all the time, I just see it all the time. 

Jack Heald  41:25 

The daughter of a close friend struggled with serious thyroid issues. First, several sets of blood tests and whatnot. Her numbers came back within range. And she just, nothing ever changed for her, she finally got a hold of a physician who seemed to have some understanding of it. And he ran much more detailed tests and was able to point out, okay, this is normal, this is way the heck out of what normal is, but we don't even know what normal might be for you. And we can objectively say that these numbers are just completely wrong. I don't want to get into a doctoral dissertation here. But can you give us kind of some headlines about what people should be getting tested for if thyroid dysfunction is suspected? 

Amy Berger  42:25 

Yeah, again, my book, well, I want to say goes into it, will go into great detail once it's out. The problem is that when you ask for a thyroid test, doctors usually and when I say doctors, that also includes nurse practitioners, PAs, whoever may be ordering the tests because I have a co-author on the book, and she's a nurse practitioner, she would kill me if I like left out the importance of these other medical professionals. They will only order one or two tests, and they test the TSH, sometimes they test the T4. And like you were saying with this person you know, it is not uncommon for those things that they test to be normal. But there's four or five other hormones that should, in my opinion, should be included in a comp, they call it a comprehensive thyroid panel. And where those one or two are normal, if you dig deeper, you will see that the other, there may be one or two other specifically the free T3 that's in the toilet. And the other issue, you brought up the great issue, that even if you fall within the normal range, that might not be, normal does not mean optimal. So, if you are at the very bottom of the range, you might feel like a new person if you were closer to the midpoint or higher, but still within the normal range. So just because you're normal doesn't mean you're going to feel well. I really, really wish that more doctors would go by the symptoms versus the numbers. And this like we see this even within the other metabolic things you would measure for something like diabetes or metabolic syndrome. Most labs will tell you that a fasting insulin of what, 20 or 25 is normal. Right? That's crazy. I think those of us in the low carb world think that's kind of nuts. We don't like to see it that high. So, it just, the art of medicine, I think the art of doctoring needs to be factored in, you can't just look and you see that they fall within the range. Great. Who cares where they fall within any particular range when they're sitting right in front of you and they're telling you I'm depressed, I'm constipated, my hair's falling out, I'm cold, I haven't had sex in nine months because I have no sex drive and all of these things? How can you ignore that and say, well, your numbers are normal. See you next time. 

Jack Heald  44:51 

Well, you're talking to the to the healthcare practitioner and I'm talking from the standpoint of the person who's going to be sitting in the chair. Well, what do you say to those people to say to their health care provider? Hey, I need you to check for, is it what you call it a comprehensive thyroid panel? 

Amy Berger  45:13 

You have to ask... Yeah, you have to ask for the comprehensive thyroid panel. And then even if your doctor or nurse practitioner is willing to order it, you have to confirm with the lab when you get the blood drawn because I've had clients who say, oh, my doctor said they ordered the full panel. But then when they get the results back, there's only that standard one or two things. But that I don't know, if I should get into detail, I think there's a couple so that a comprehensive panel... 

Jack Heald  45:43 

Here's what I'm after. People are listening to this, and they're starting to recognize themselves, give us enough information to at least send them in the right direction to get the details they need. 

Amy Berger  45:55 

Well, I have a video that we can maybe link to or if you go to YouTube, and you search Amy Berger thyroid, few video should come up. But I think and I don't know if we can maybe link to it, if you if you do show notes. But we'll put some links then. But ask your doctor for a comprehensive thyroid panel. If your doctor does not want to do it, some of them won't, if you live in any state in the US, except New York, New Jersey, and Rhode Island, except for those three, you can do this testing on your own without a doctor. You can go to directlabs.com or ownyourlabs.com. Or I think it's order a test. There's a lot of different testing websites where you can order your own labs without a doctor. And then, the issue then would be you still need someone to help you interpret them and to prescribe you the medication if you need some. So that may still be a battle. But the first step is to do the testing. And yeah, if I am talking to anyone out there who has lots of symptoms of hypothyroidism, but you've been told for years you’re normal, there was a good chance you are not normal, you need this full testing panel, you cannot just go by the normal tests. And if you are taking the T4, the most common brand name in the US is Synthroid, but it's called it's levothyroxine. The most common brand is Synthroid, if you've been taking Synthroid forever, and you still feel like garbage, there is help for you, you need the more advanced testing because your T3 is probably in the basement. 

Jack Heald  47:36 

Now this is the point, or nearly what I would love to get into the chemistry of three T3 and three T4 and what I would what all of that kind of stuff, but that's for another time. We have discovered, well, we being me, mainly through Dr. Ovadia that we've been lied to, or misled, let's say misled, we've been misled about the role of cholesterol and heart disease, the role of serotonin and depression, the root cause of Alzheimer's, about whether or not diabetes is reversible. For decades. And we've made choices based on that misinformation. Is there another giant glaring realm of misinformation as it relates to health and nutrition that you'd like to address? 

Amy Berger  48:33 

Ah, those are the biggest ones, I mean, the cholesterol thing, the saturated fat thing. I will lump red meat in with the saturated fat. But if I had to choose another one, it's protein. Because I think women especially have been sort of brainwashed over the years that our protein portions should be about the size of the palm of our hand or a deck of cards. Women's magazines have been telling this for 40 years. And there is not one shred of scientific evidence to back that up. There is nothing about the human digestive system that says we should eat that much in a meal. And I think it's done women a huge disservice because they're afraid to eat a substantial piece of protein. And so, they're still hungry, but they're afraid of fat. So, they'll have a granola bar or they'll have some cereal or they'll have a rice cake. And they wonder why they're hitting the ice cream at midnight because they're starving and they're still hungry. Or we think it's on lady like to eat a big piece of steak. I'm not. I don't think it's on feminine. Maybe I'm not a feminine woman. I don't know. It's this, I think the protein and you could say the same is true of men but I just don't think men have not been scared into eating have very small amounts of protein the way women have. 

Jack Heald  50:04 

So, there's a social pressure on women that is not on men. That's hardly science. But that may be the most powerful thing we've heard today. Ladies, get over it. 

Dr. Philip Ovadia  50:19 

Eat more protein. 

Jack Heald  50:22 

Oh my. 

Amy Berger  50:23 

I think not only will you be less hungry, you won't need to snack between meals, forget this little three ounce, like eat. And you may even find that your moods are more stable, especially if you cut the carbs and sort of replace some of that with protein, your blood sugar is going to be more stable, your mood. I think that's a huge missing piece for a lot and women who were all their lives, they've had weak, soft, brittle nails, and they buy all these special lotions and potions to put on the nails. Double your protein intake and see what happens to your nails and hair. 

Jack Heald  50:58 

Is the protein intake recommendation for women basically the same as it is for men? One gram of protein for every kilogram of body weight? 

Amy Berger  51:09 

So... 

Jack Heald  51:13 

I don't know need to open the can of worms. 

Dr. Philip Ovadia  51:16 

Well, yeah, I understand that. The official recommendation is more like, the RDA, the recommended daily allowance is .4 grams per kilogram of body weight. So, that's the official recommendation. I think the one the one gram per pound that so many of us here in the low carb world talk about, yeah, I don't see that as being different for women than for men. 

Amy Berger  51:49 

Yeah, I don't think it is, I think, but like... 

Jack Heald  51:53 

A gram per pound. 

Dr. Philip Ovadia  51:56 

That again, that's what I recommend. 

Jack Heald  52:01 

And the official RDA is .4 grams per kilo of body weight. 

Amy Berger  52:08 

It's .8 grams per kilogram. 

Jack Heald  52:11 

Yeah, that's still just crazy. 

Amy Berger  52:15 

See that? The problem with that... But that was not intended as the ideal or optimal amount. That is the minimum amount to not waste away. And so, I think for people, I agree with the one gram per pound, but I want to stress I agree with Dr. Ted Naman, who one gram per pound of your desired weight. So, let's say you weigh 300 pounds, but you want to be 205. Don't eat 300. But I also... This is when I say keto without the crazy or just nutrition without crazy. You don't have to hit that exact number every single day. It's okay to be lower, sometimes higher, sometimes that's a general ballpark. And then the other thing, your listeners and viewers probably know this, but in case they don't, because it amazes me how many people don't know this. If we say eat 100 grams of protein a day. That is not 100 grams of a protein food on a food scale. 100 grams of protein is different from 100 grams by weight of chicken or fish or beef. The rule of thumb, I don't want to confuse people, the rule of thumb is each ounce of a protein food like beef or pork or seafood. Each ounce contains approximately seven grams of protein. So, a three-ounce piece of fish or chicken would be about 20, 21 grams, general ballpark. So, if we say to eat a certain number of grams of protein, you cannot assess that by weighing the food on a scale. It's a different measurement. 

Jack Heald  53:57 

It's a calculation though. An ounce of protein. Seven grams of protein. 

Dr. Philip Ovadia  54:10 

Okay, no, I think since you and I like to keep it simple, Amy, the general rule is eat more protein and eat less carbs and for the vast majority of people that's all you need to pay attention to. And you're going to you're going to end up in a better place. 

Jack Heald  54:28 

All right, I want to say one last thing. I was looking at your website and I saw, I'm scrolling down in the blog and it says The Stall Slayer and thank you for illuminating us about what that actually meant. Cause I thought it was a bathroom serial killer, to be honest. She writes murder fiction. Okay. Amy, it's been a pleasure. This has been, for me as a non-medical professional, this has been just packed with practical things to know and to be able to implement. I have one last question I want to ask you. Is there a celebrity, a nutrition celebrity you'd like to duct tape? 

Amy Berger  55:26 

Duct tape, how? So, they never say anything again? 

Jack Heald  55:31 

Across their mouth. Tie them to a chair and beat them? I don't know. 

Amy Berger  55:37 

It would be hard to pick one. Again, and I don't want to name names. I think everybody is coming from a good place. Everybody wants to help, everybody means well, we just might disagree a lot over the best way to accomplish good health. 

Jack Heald  55:57 

Well, I gave you a chance there. 

Amy Berger  56:03 

Well, better for me to not name names. 

Dr. Philip Ovadia  56:05 

We'll try and keep our guests mostly out of trouble. So, Amy, just tell people a little bit about, how you how you work with people, how they can find you. 

Amy Berger  56:21 

Yeah, thank you. My main website and blog is tuitnutrition.com T U I T nutrition.com. The website’s in massive need of overhaul, but I do have private consultations, but you're better off going to stallslayer.com and clicking on work with me for further consultation so stallslayer.com. And I also do, I help a company called Adapt Your Life do online courses about keto and that's at adaptyourlifeacademy.com. And you can follow me on Twitter @tuitnutrition. And I have a YouTube channel which I just changed the name. So, it goes by my name now it's Amy Berger. And that's B E R G E R. And it's keto without the crazy. So, all my videos are there. And yeah, I do. Like I said I do the consultations. But I also think if you're brand new to this, check out the book that I wrote with Dr. Westman called End Your Carb Confusion. That's the book I would want to have. If I was brand new to all of this now, that the simple straightforward way to do it. 

Jack Heald  57:32 

Good stuff. All right. Well, for our listeners, as always, we'll make sure that this contact information shows up in the show notes. So, you'll just be able to click and get there. Phil, anything you want to wrap before we wrap it up. 

Dr. Philip Ovadia  57:46 

Now, just another great week, another great conversation. Really, want to thank the audience because the show has been growing significantly. And we're just so happy that it's, we're getting this information to so many people that need to hear it. 

Amy Berger  58:07 

Yeah, and Phil, I want to, before we close, I want to reiterate that I appreciate your, I mean, it is so fabulous, not only to have more medical doctors who understand this, but a cardiac surgeon, for goodness' sake. I mean, that's incredible to have a heart surgeon who says it's okay to eat butter and it's okay to eat red meat. But also, that you, like I said in your book, Stay Off My Operating Table that you were very clear that maybe not everyone needs keto. As much as I love keto and I know how powerful it is, not everybody needs to go that far. Some people can just sort of clean up their diet. So, I appreciate you, respecting that different people need different things. 

Jack Heald  58:52 

Well, I guess we're gonna have to put it into the love fest. But yeah, it's been great. Amy, it's a pleasure to meet you, a lot of fun to talk to you. I personally have learned some things. I've gotten some questions answered today that I've had for a long time that I didn't know I had until I started reading about your stuff. So, I want to thank you for being here. Well, this is the Stay Off My Operating Table podcast with Dr. Philip Ovadia. You can follow Dr. O on Twitter @ifixhearts, go to his website ifixhearts.co. Take a metabolic health quiz just to find out exactly what you may or may not need to do. And you can also reach his website at Ovadiahearthealth.com. Until next time, I'm Jack Heald. Thanks for joining us. 

Jack Heald  59:44 

America is fat and sick and tired. 88% of Americans are metabolically unhealthy and at risk of a sudden heart attack. Are you one of them? Go to ifixhearts.co and take Dr. Ovadia's metabolic health quiz. Learn specific steps you can take to reclaim your health reduce your risk of heart attack and Stay Off Dr. Ovadia’s operating table. This has been a production of 38 atoms