Following Your Gut Podcast #7, Unveiling the Silent Epidemic: Non-Alcoholic Fatty Liver Disease

Show Notes

About the Guest:

Dr. Tracy Tranchitella is a highly regarded naturopathic doctor with an extensive background in integrative health, focusing on gut health, hormonal balance, and the stress response. Currently associated with the Sunrise Center for Wellness, Dr. Tranchitella has a deep interest in metabolic syndromes, particularly focusing on non-alcoholic fatty liver disease (NAFLD) and its implications on overall health. Her work includes clinical consulting and educational outreach, with contributions to scientific writing, including articles for ZRT Laboratory, a leader in salivary hormone testing and metabolic markers.

Episode Summary:

In this captivating episode of the “Following Your Gut” podcast, Roland Pankewich sits down with Dr. Tracy Tranchitella to explore the intricate relationship between gut health and liver function, particularly focusing on the Gut Liver Axis. As Dr. Tranchitella delves into the realm of NAFLD and NASH, listeners are guided through the latest insights into these pervasive yet preventable conditions. The discussion emphasizes the profound impact lifestyle choices and dietary habits have on liver health and underscores the importance of holistic approaches to healing.

This episode offers an insightful look into the physiological changes occurring in the liver due to NAFLD and its alarming rise as the leading cause of liver transplants. Dr. Tranchitella details the role of metabolic syndrome, insulin resistance, and sedentary lifestyles in the progression of NAFLD, highlighting how these conditions interconnect with gut health. The conversation extends to explore the often-overlooked psychological and lifestyle factors contributing to chronic liver issues. By understanding the holistic nature of health, listeners can appreciate the intricate dance between lifestyle, diet, and disease, motivating them towards sustainable wellness strategies.

“The microbiome of our digestive tract is like the soil of our body."

Chapters

• 0:02 Exploring the Gut Liver Axis with Dr. Tracy Tranchitella
• 1:04 Understanding Non-Alcoholic Fatty Liver Disease and Its Implications
• 14:04 Gut-Liver Connection and Its Impact on Health
• 23:01 Exploring Dietary Approaches and Longevity Insights from Blue Zones
• 26:35 The Impact of Stress and Lifestyle on Health
• 30:41 Holistic Health: Building Foundations Beyond Quick Fixes

Transcript

0:00:02 Roland Pankewich: Welcome back to the following your Gut podcast, where health science meets clinical wisdom. And today I’m very excited to have the other half of a guest we’ve had previously, Dr. Tracy Tranchitella. And I said that right? I’m so, so proud of myself. Welcome. Thank you for being here.

0:00:17 Tracy Tranchitella: Well, thank you for having me and thank you for saying my name correctly. Good job.

0:00:21 Roland Pankewich: Thank you. I mean, we did practice before we started and I’m just not that amazing.

0:00:27 Tracy Tranchitella: Even though that’s pretty good, though.

0:00:29 Roland Pankewich: Thank you very much. So, Dr. Tracy, how are you today?

0:00:31 Tracy Tranchitella: I’m doing well, thank you. How are you? I’m enjoying sunshine. And spring is coming, so, you know, we’re all happy and thawing out up here in Bend, Oregon.

0:00:39 Roland Pankewich: It’s a great time of year. The new cycle of spring brings new energy in the air, new projects to start, and hopefully for people listening, a new hunger for more information. Because I’m really excited that we’re going to talk about something I’ve never talked to someone about on a podcast before. The Gut Liver Axis or all things within that realm. And my favorite acronyms, NASH and nafld.

0:01:04 Tracy Tranchitella: I know we hear about them a lot, but a lot of people don’t really know what they are. And I took an interest in, you know, nafld, as you said, it stands for non Alcoholic Fatty Liver Disease. And the, the interesting component of that is we know that liver disease can be associated with excessive alcohol consumption, but there is a, an emerging issue with nonalcoholic fatty liver disease where you have this chronic, ongoing liver disease that is related more to diet and lifestyle. And, you know, typical things of metabolic syndrome, insulin resistance, sedentary lifestyle, all of those things that can be associated with cardiovascular disease, hypertension, type 2 diabetes.

0:01:48 Tracy Tranchitella: And now we have like a particular organ which is kind of taking a hit with those kinds of factors. And it’s occurring because you’re getting this fatty accumulation in the liver because of lifestyle. And I remember years ago I used to do some clinical consulting for a lab, biohealth lab. And I was speaking to a gastroenterologist and he was talking about non alcoholic fatty liver disease and how it is the number one cause for liver transplant. The number one reason now people are getting a liver transplant. And I was stunned to know that because I’m thinking, okay, these are preventive issues. You know, this is lifestyle driven, diet driven.

0:02:36 Tracy Tranchitella: And it’s gotten to the point now where these, these poor diet and lifestyle can essentially lead to, for some people, the, the need to replace an organ which to me is like very extreme, especially when we consider that it is absolutely prevent. And he felt that it would reach epidemic proportions. When I was researching, I wrote an article for ZRT lab. I do occasionally write for their lab and ZRT is a lab that focuses on salivary hormone testing and other metabolic markers.

0:03:13 Tracy Tranchitella: I wanted to really relate this topic to what goes on hormonally in my research. I came across the research and it says basically 30% of the US population has some degree of fatty infiltration in the liver. So some degree on that spectrum of non alcoholic fatty liver disease. So this is like a third of the population and it’s probably about 25% globally. So this is definitely a problem. It’s sort of like this gastroenterologist was saying that this is almost like epidemic proportions. We have issues with this fatty infiltration into the liver.

0:03:55 Tracy Tranchitella: And the liver is obviously vitally important. You know, you don’t have more than one of them and you can’t live without it. So, you know, we really should love our liver and take care of it. And it’s not just avoiding alcohol and certain toxicants that we know are bad for the liver, but it’s just all of those underlying lifestyle factors that can contribute to this fatty accumulation that we have to really take into consideration is that big picture.

0:04:24 Roland Pankewich: And as you’re saying that, I’m, I’m pretty sure most people are thinking back to their four or five years in college, just going, oh my gosh, I’m so sorry, liver, what have I to you? But the reality is it’s not the acute stuff, it’s the stuff people are doing on a daily basis, in many cases out of ignorance or unawareness, because they’re not connecting diet with how it’s causing liver dysfunction. So within nafld, nafld, Non Alcoholic Fatty Liver Syndrome, what starts to happen to the liver? Like how does it physiologically change as it accumulates fat?

0:04:57 Tracy Tranchitella: Well, the fat accumulation occurs in the hepatocytes, which is like the basic structural unit of the liver. Those are the liver cells. And anything that is going to affect structure is going to essentially affect function. The liver is going to ultimately become less efficient at doing what it’s supposed to do, which is detoxify. Phase one and phase two. Liver detoxification are essential for our bodies to detoxify and process both metabolic byproduct and things that we encounter through environmental factors and through our food.

0:05:33 Tracy Tranchitella: I also always refer to phase three, liver detoxification, which is bile production. And so those biliary Pathways may become less efficient, maybe through dietary factors, People not consuming enough types of food that are rich in choline, that support bile production and thinning the bile so that the liver can actually detoxify. So anything that affects structure is going to affect function. And what can happen with the presence of the fat is that it can stimulate adipokines, which are cell signaling molecules that are produced by fat tissue.

0:06:13 Tracy Tranchitella: And these can ultimately result in just an inflammatory process. And so when we talk about NAFLD and what can occur after nafld. So NAFLD just describes the process of this fatty infiltration into the liver. It’s a state that the liver is in, but as that accumulates, you can get this progressive inflammatory process. And that’s when it evolves into something called non alcoholic steatohepatitis. So anything with the itis on the end we know is an inflammatory process.

0:06:47 Tracy Tranchitella: You’re getting this infiltration of fat into the liver and it’s now becoming an inflammatory process that is low level chronic inflammation. And we know that low level chronic inflammation can lead to tissue damage ultimately. And through that tissue damage you get structural changes. So you can get liver fibrosis that can ultimately advance to cirrhosis and even liver cancer. So that is sort of the progression of it.

0:07:16 Tracy Tranchitella: And so you may have people who have maybe a low level of fatty infiltration into the liver, if they turn things around, change their diet, stop over consuming carbohydrates and sugar and fructose, you know, become more active, exercise regularly, which can help to reduce insulin resistance and making sure that they get a good night’s sleep. All of these other factors, you can reverse the process of that fatty infiltration. The liver can start to clear some of that fat out.

0:07:50 Tracy Tranchitella: The issue is once you evolve into this state of inflammation and damage has occurred, you can’t really reverse it from that point. And so I feel like it’s such an important topic because as you say, it’s one of these. It’s a slow burn process, those bad choices that we make more consistently through time that can contribute to this process. And there’s a point at which you can reverse it, and then there’s a point beyond which you can’t.

0:08:21 Roland Pankewich: Very interesting, because as you’re talking, I’m trying to think about how someone would know if this were them. Are there a lot of symptoms, telltale hallmarks in terms of how the body’s presenting itself? Is it a classic thing where if the person’s holding too much adipose tissue on their body, there’s likely the assumption they have a fatty liver or is it sometimes someone wouldn’t know. They would think they’re healthy until, unless they went for some sort of scan or you know, checkup right in that.

0:08:48 Tracy Tranchitella: And that’s a really good question because I think the only definitive way to diagnose fatty liver disease is through a liver biopsy. And so that’s not a common procedure. I mean, given how common it is for people to have fatty liver. If 30% of the population has it, 30% of the people aren’t getting liver biopsies. You know, that’s an invasive procedure and most people aren’t going to opt for it. And is it going to change what you do in the end to, you know, do an invasive procedure like that only to determine yes, you do have fatty liver disease, as we may have suspected.

0:09:22 Tracy Tranchitella: So you know, if, if the result is just getting people to change their diet and increase their activity, you know, I don’t think you need to do an invasive procedure. You can do certain types of scanning. Probably an MRI would be good. But I think most commonly what they use is basically just an ultrasound. The issue though with an ultrasound, I mean ultrasounds are easy to do, they’re non invasive, you know, it doesn’t hurt anybody. And they’re performed, they’re commonly performed.

0:09:49 Tracy Tranchitella: The with doing an ultrasound is it’s not going to pick up on that fatty infiltration unless it’s like greater than 35%, you know, and so it’s, it’s not the best diagnostic tool. You know, it’s not specific, it’s common, but you know, it’s what we have. So I think the assumption, another thing that you said, when you, you look at body type, you can look at other markers like if somebody has insulin resistance, they have high fasting glucose, they have elevated total cholesterol, elevated LDLs, and you see that they’re carrying around and like a, you know, that, that kind of central obesity.

0:10:31 Roland Pankewich: Spare tire as it’s scientifically called.

0:10:34 Tracy Tranchitella: Spare tire, yeah, we can call it the spare tire or visceral adipose tissue, you know, the acronym for which is vat. And you know, so when you can look at that body type and kind of assume perhaps that they have some issues there, but even sl, some people can have fatty infiltration into their liver because they may have a poor diet. So we can’t always assume that the person is going to be carrying around a lot of extra body weight. It could eating and they could just be genetically kind of thin.

0:11:07 Tracy Tranchitella: Maybe they don’t Exercise very much, but they over consume carbohydrates. There could also be, you know, you look at certain conditions which can contribute to nafld, like obviously metabolic syndrome, insulin, insulin resistance, but pcos, you know, polycystic ovarian syndrome, you know, that is, that is a, a very common hormonal disorder amongst women of menstruating age. And it occurs in the presence of insulin resistance and hyperandrogenism.

0:11:44 Tracy Tranchitella: And so we can commonly see these women. And the thing about PCOS is that it kind of exists on a spectrum. You know, I really feel that there’s a lot of that are pcos ish, but they don’t really fulfill the diagnostic criteria. But if we were to approach treating them as if they did have the full diagnosis, like working on their diet, reducing carbohydrates, trying to get their insulin to be more sensitive and responsive, getting them to maybe lose a little bit of weight, trying to reduce androgens, they’re usually going to respond well.

0:12:22 Tracy Tranchitella: But the issue with NAFLD and PCOS is same kind of underlying issues. It’s like a metabolic disorder, but it manifests in hormonal dysregulation in women. And so you can see women with PCOS who may have a tendency towards having NAFLD as well.

0:12:40 Roland Pankewich: That’s interesting. So it almost sounds like, you know, if we’re comparing it to pcos, which is driven, as you said, by endocrine disruption, there’s a, a chaos, if you will, an entropy in the organs, it sounds like. And, and I might be making this a little reductionist, that NAFLD might be like an ultra insulin resistance of the liver specifically, so it’s not able to process energy effectively and it’s starting to store stuff.

0:13:06 Roland Pankewich: Does it connect at all into people who have gallbladderectomies? Because if the liver and the gallbladder, like, you know, they’re, they’re very much connected, they connect into the common bile duct and, and it’s almost like nowadays in medicine, oh, gallbladder don’t need one of those. They’ll just take it out in any, you know, any scenario where there’s, there’s an accumulation of stones. But have you seen that NAFLD connects to gallbladder issues at all?

0:13:32 Tracy Tranchitella: You know, I think about it in terms of like the gallbladder, you know, I mean, there’s definitely a hormonal connection to gallbladder function in women. You know, a lot of women who maybe carry a lot of excess adipose tissue tend to be higher in estrogen you know, they have that the issue, like women like mid age tend to have gallbladder issues. You know, they’ve had children, they’ve been exposed to a lot of estrogen, they may have a little extra weight, so they may have a little more estrogen circulating around, and so they tend to get some gallbladder issues.

0:14:04 Tracy Tranchitella: But in terms of its relationship to nafld, I could certainly draw a connection there, because when we think of how the gallbladder is basically the exit point of all of the detoxification processes of the liver, if you’re going to go through phase one and phase two liver detox, the liver is going to do all of what it needs to do to detoxify things. How does it actually physically get rid of it? It’s got to enter the biliary system, and it’s got to be released into the upper bowel, and it’s got to be released through the body, through the stool.

0:14:39 Tracy Tranchitella: That’s how your body has to have an exit point for all of that stu. And so if you remove the gallbladder, you’re basically taking away the store of some of that bile that exists there. So bile is kind of one of these components that the body tries to preserve. It tends to reabsorb it in the proximal portion of the large bowel, so it doesn’t have to keep making those bile factors over and over again.

0:15:08 Tracy Tranchitella: It wants to recycle it and use it and have some place to store it so that it can more efficiently excrete stuff from the liver. In order to do that effectively, it has to be very liquid, it has to move. It can’t be sluggish. I think what happens with biliary issues and the need to remove the gallbladder, people usually develop gallstones. They get this sluggishness where it just sits and it doesn’t move and it begins to solidify and you just don’t get a breakdown of it. And then it can’t function optimally anymore and causes a lot of digestive upset or pain in the right upper quadrant whenever somebody eats something that’s fatty.

0:15:49 Tracy Tranchitella: So it just doesn’t function anymore. And when we think about moving fat, if the liver is starting to accumulate fat, a way to break down that fat is by pushing it into the biliary system, because that’s what helps to break down those bonds between the fat so the body can make it more liquid and get rid of it. So that was a long answer to a question. Yes, I do think there’s a Connection for sure.

0:16:15 Roland Pankewich: It was a great answer though, because your answer prompted at least five different questions in my head to which I want to ask you now. So you some you mentioned about things coming out of the digestive system, so we talked before. There’s a very intimate connection between the liver and the rest of the GI tract. It’s the closest organ. Have you read any research or can you draw any conclusions, even just kind of hypothetically about how someone with gut issues might actually be accelerating, advancing their NAFLD scenario? Like, is there a strong connection between dysbiosis and digestive dysfunction and fatty liver accumulation?

0:16:52 Tracy Tranchitella: Yeah, most definitely because of that gut liver axis. You know, everything that we consume in our gut, it’s how does it make it into general circulation? It gets absorbed in that enterohepatic circulation where it gets filtered through the liver before it goes off to, you know, general circulation. So the liver is the first to receive everything from the gut and that’s a good thing. You know, we want it to kind of operate as that gatekeeper, you know, not allowing us to be exposed to too many things that we shouldn’t be.

0:17:25 Roland Pankewich: Like a first filter.

0:17:26 Tracy Tranchitella: Exactly. It’s a first pass. I mean, that’s what the liver is referred to, a first pass. And you know, so if you’ve got gut issues, if you have dysbiosis, if you have an overgrowth of gram negative bacteria that produced of polysaccharide, and in conjunction with that you have other pathogens going on that are promoting inflammation or certain toxins in the gut, and along with that you’ve got some leaky gut issues, you’re going to get a lot more permeability and leaking of that stuff from the gut going to the liver, which is going to ultimately drive inflammation.

0:18:02 Tracy Tranchitella: And that inflammation is going to add to just this chronic ongoing state of oxidation and tissue damage. And so when it comes to the whole fatty infiltration, I mean there’s, there’s so many things that can promote that. When we think of like adipokines and just the presence of fat itself, it’s an active tissue. It’s not just the storage tissue. You know, it makes things and it can make pro inflammatory chemicals that signal this whole response.

0:18:39 Tracy Tranchitella: One of the things that triggers that inflammatory response in the liver, like for example, if you have pathogens in your gut, it can stimulate toll like receptors in the liver, which is kind of what responds to pathogens. It’s that first response, but it triggers that whole cytokine response. So it really does add to this inflammatory process in the liver.

0:19:03 Roland Pankewich: So interesting. So. So it sounds like also, and this has occurred so many times in the body, there could be a central area of compromise that drives an issue in another area and vice versa, and it creates these feedback systems. So it’s probably fair to assume that most people dealing with said condition, not only are they struggling metabolically, they’re probably struggling endocrine wise, they’re struggling gastrointestinally.

0:19:29 Roland Pankewich: So, you know, I have this whole thing of there’s nothing separate in the human body. You know, like the DNA in your brain cells knows what the DNA in your toe cell is doing, so to speak. It’s a ridiculous example, but it just illustrates the point that nothing is separate. So it sounds like resolving this has to be kind of a global, holistic approach of dealing with someone’s individual body health. It’s way more than, oh, let’s take some milk thistle and let’s take some, you know, sulforaphane. Not to say those things are great, you know, and sulforaphane is an inducer of phase two detoxification. But I would imagine if someone’s liver is compromised, you don’t want to push the liver and upregulate detox. There has to be a methodical approach.

0:20:10 Tracy Tranchitella: I would agree. You know, I always think of, you know, detoxification is great. I mean, that’s like a cornerstone of naturopathic medicine is you’re, you’re trying to level the playing field and remove obstacles to cure. So you’re trying to get in there and remove things that are not allowing somebody to heal. So it’s a great starting point and as I say, kind of leveling the playing field. So. But when I think of liver detoxification, the first thing I think of is the bowel.

0:20:41 Tracy Tranchitella: You know, we have to start there. If somebody has gut issues, they don’t move their bowel very well. How are you going to, you know, push those liver detox pathways? Where is it going to go? You know, so before doing any kind of liver detoxification, you have to get the bowels working well and you have to try to introduce good bacteria and fiber and feed it so that, you know, you have a presence of good bacteria.

0:21:10 Tracy Tranchitella: Just doing stool testing where you’re looking for the, you know, the balance of the microbiome where you can look and see, okay, do you have enough good bacteria? Are you dealing with any pathogens? Are you in a state of dysbiosis? Are you in a state of inflammation? Are you sensitive to gluten? Is this Part of your problem, why you can’t eliminate and detoxify? Well, do you have certain food sensitivities that are creating an inflammatory state?

0:21:35 Tracy Tranchitella: So all of it goes back to, you know, as you say, some of these things can sound so simple on the surface, but when you’re really looking at organ function, you’re like, okay, what can be the things that are interfering with the healthy function of this organ? So you want to go in and remove those obstacles, you know, and try to get the gut functioning in a, a better way. So that when you want to go in and maybe work on liver function and helping to reduce this fatty infiltration into the liver, it has a place for it to go. Because if you do have fatty infiltration into the liver and you want to remedy that situation and reduce that fatty liver content, it’s got to sort of metabolize it and break it down and release it. And it’s ultimately going to be released from the body through the bowel. So we have to always think of the bowel optimize function there first before we consider really pushing the liver.

0:22:31 Roland Pankewich: But imagine diet would be probably another consideration before pushing the liver because from what you said earlier, abuse of carbohydrates, sugars, high fructose, corn syrup, things of that nature. So it’s interesting that most people likely don’t draw the connection because you can correct me if I’m wrong, excessive glucose and fructose not able to be utilized for energy or metabolized, gets converted to fat in the liver. So it sounds like you’re just, you’re packing the suitcase, so to speak, by over consuming these things.

0:23:01 Roland Pankewich: But now we have these extreme dietary measures. You know, we have keto, we have carnivore, and for some people, you know, no carbohydrates in an all meat diet, they lose 90 pounds and they feel like a new person. Someone else does a vegan thing for a while, it works for them. How do you approach diet for this specific condition?

0:23:21 Tracy Tranchitella: Well, I, you know, it depends on the population of people you’re working with. You know, there’s some people who come to you who just really need, you got to start at ground zero. You know, they, they need to reconstruct their diet by just starting to get rid of really bad processed food, bad fats, bad ingredients, and focus more on the quality of the food. And then we work on structuring whatever dietary program is going to be best for them.

0:23:53 Tracy Tranchitella: I try not to go too extreme with a lot of people, you know, because it’s you’re going to lose them. That’s like I. People go on the carnivore diet because they want to try the carnivore diet. And I think that’s great. You know, I’m not probably going to promote that for a lot of my patients because wherever they might be in their process of moving towards health, it may be super extreme for them. But I think ultimately what you’re trying to do is promote the idea of just improving the quality of your food first and foremost, you know, before you start restructuring how they consume their food and there’s different dietary programs, I think that can be helpful. But I think by and large, if you, if you look at it retrospectively, you know, I like referring back to like the blue zones. You know, you’re familiar with the blue zones where we’ve been around the world and they looked at dietary and lifestyle patterns of people who tended to live the longest.

0:24:51 Tracy Tranchitella: And if longevity is your goal, obviously they’re doing something right if they’re able to stay on this planet longer and still live a fulfilling and healthy life. So when you start to look at dietary patterns of different people around the world who live to be 100 and over, we have to take a look at that. So I think by and large, a Mediterranean diet with really high quality foods is probably a good way to go for most people.

0:25:21 Tracy Tranchitella: They get it. Yeah, yeah, no, they get it. And it’s not extreme. You know what I mean?

0:25:27 Roland Pankewich: That’s a brilliant starting point. And it just. You. I’m sorry to cut you off there. I thought it was done. There’s a little lag. But I wanted to jump in with something about the blue zones that I always found hilarious. So I, I knew a gentleman who went and did this documentary called the Human Longevity Project. And he went around to the blue zones and he interviewed everyone. And the thing that blew his mind, he was in Sardinia, he was in Italy, he was in Ikeria in Greece. And he said he’d be up till three in the morning partying with the 80 and 90 year old. They’d all be dancing around the fire arm in arm, so they didn’t count calories, they didn’t necessarily go to bed at 7:00pm you know, they didn’t have their biohacking tools and their mouth tape not to, you know, crap on that stuff, but, you know, people take things so seriously. But you know what he said? The one thing he noticed was if they were gonna go to work on a Tuesday and they saw their friend on a bench, they just sat down on the bench and they just missed the bus on the way to work. And sometimes they just didn’t go to work that day and they didn’t stress about it. He said the one thing that was so apparent to him in these blue zones is the absolute lack of modern stress that these people’s lives didn’t, you know, contain.

0:26:35 Roland Pankewich: And I think about some other forms of medicine practice. I love Chinese medicine, Right. So the meridian systems relate to the organs and Chinese medicine, liver and gallbladder, anger and bitterness. So, you know, I wonder if. If. And obviously you don’t have to name any names, but do you notice some psychological patterns, some personality traits to people who are struggling with said things? Is that a common thing that you observe in your practice?

0:27:00 Tracy Tranchitella: Oh, yes, every day. I mean, if you think about it, it’s just stress. We talk about the chronic stress response, and I think that’s a great observation because beyond just what we eat, you know, it’s. Again, it’s the bigger picture. It’s experiencing joy and not having so much stress and having a sense of community and compassion for other people and having the time to express that, I think is really important because when you look at just stress, what the chronic stress response does, if you just look at cortisol as a tool that we can measure, and we look at that chronic stress response, and then we look at the effect of high cortisol levels. And I always just use as an example, like somebody who has Cushing syndrome, because that’s the most extreme example of high cortisol.

0:27:51 Tracy Tranchitella: And you kind of look at what they look like. That describes the person that we’re talking about, Right. Somebody who has Cushing’s disease has truncal obesity. They have, you know, loss of muscle mass. They have the dowager hump. Yeah. And they have insulin resistance. So. So that’s an extreme example of what high cortisol can do to your body and your physiology. That’s a person who, I mean, and they notoriously have fatty liver infiltration because of the way their body functions because of high cortisol.

0:28:28 Tracy Tranchitella: So stress plays a role. So if we dial that back a little bit and say, okay, so the chronic stress response, we just live our lives. This is how we are. Everybody’s like pedal to the metal all the time, trying to, you know, accomplish whatever they’re trying to accomplish in life and creating a lot of stress. And, you know, a lot of that has to do with our perception of things. And, you know, some people can live a very, you know, intense lifestyle where they Work a lot, but if they enjoy it and they have purpose, it’s not stressful for them.

0:29:00 Tracy Tranchitella: But if somebody is resistant to it and doesn’t like what they’re doing, it becomes a major stressor in their life. So perspective plays a big role in all of this. But going back to the relationship between stress, diet, lifestyle and this, you know, thing that we started talking about, not non alcoholic fatty and liver disease. Stress can definitely play a role through cortisol, and it’s the way it causes you to store fat around the middle.

0:29:29 Roland Pankewich: Cortisol also drives insulin resistance in a way of kind of like self preservation because you want fuel in your bloodstream if you’re running from the tiger or the bear or you’re fighting someone to save yourself. So it’s, I always say the body doesn’t make any mistakes. It’s our inability either as individuals or more importantly as practitioners not to understand these patterns. So I just, I love everything that you’ve been saying here because you’re bringing awareness to how interconnected and multifaceted it is. It’s not, as we said before, take the pill, the liver gets better, you’re good, you can start toxifying again. And, and you know, we talked about this offline, but I think it’s worth mentioning the things that are not super exciting that people get drilled into their head so much to the point where they ignore sleep, rest, mobility, circadian rhythm, grounding, as you mentioned, having purpose and joy in life in addition to taking the right kind of supplementation to, you know, eating the highest quality food that you can justify purchasing for yourself and just being mindful of your own health and wellness. You know, no one’s coming to save you. We all have to be as proactive as we can. If you own a body, I kind of think it’s your responsibility.

0:30:41 Tracy Tranchitella: I would agree with that. I, I’ve, and it’s maybe an overused sort of statement in that, you know, a lot of people treat their body like their car. You know, they just haul it around with them all day and they turn it over to somebody else to take care of, of without, like, you know, without taking the responsibility and the ownership of your physical body and, you know, understanding some of the really foundational principles that we need to implement to take care of ourselves every day, that they need to be habits that we have that we don’t have to think about.

0:31:16 Tracy Tranchitella: And I think that’s the hardest thing for a lot of people is, you know, it’s like this idea of a diet, like people Go on a diet, you know, where there’s a beginning, an end, when it’s like, well, what are you going to do after that? You know, it shouldn’t be a diet, it should be, I’m going to change this forever because it’s going to support my health for the rest of my life. And people think short term, you know, and, and we’re so quick fix oriented and so supplement oriented even in our own industry.

0:31:48 Tracy Tranchitella: And you know, I’m, I’m very attuned to it as well that I try to be very aware of like not putting people on too many supplements because there’s a certain reality associated with that. It’s like, how long can you really keep this up? You know, we’re going to use these things to try to get you to a point along with all of the lifestyle stuff so that maybe you can reduce the amount of supplements and you’re just kind of on a maintenance program or the, the, the things that you’re using are specific to your unique needs or genetics and, and then you’re still implementing all of these great lifestyle things that, that keep you stable and healthy moving forward.

0:32:27 Tracy Tranchitella: It’s just much more doable and practical for the majority of people.

0:32:31 Roland Pankewich: Oh, I agree. And it’s, you know, using supplements strategically can be wonderful because what they provide the body is the input signal of what the supplement does, allows the body to self heal as opposed to a pharmaceutical which is blocking a mechanism of action and hoping it doesn’t cause, cause a chain of events down the line. And, and of course in certain scenarios either supplements or pharmaceuticals can have, you know, essential places in someone’s protocol. But the whole goal is to try to heal the body so the body doesn’t need to be so dependent upon a multitude of external things to keep itself going. And I love that you said that because I believe that in.

0:33:11 Roland Pankewich: And I just really dislike using the term alternative medicine. I was talking to a guy recently and he was this old Russian guy and he, I said alternative medicine and he giggled at me. He’s like alternative, he said, do we have alternative rockets when we want to go to the moon? And I just thought like that’s such a brilliant statement. It’s medicine, health practice. But in this context of what I’m speaking about, there has been this move of just taking that, well, let’s throw pills at it.

0:33:36 Roland Pankewich: And that’s the only solution. And the things that people don’t want to hear are the boring things that actually work in addition to creating a really good supplement protocol. And A nutrition plan. Maybe we can extricate the word diet from the English language entirely. Maybe that’ll fix it. We just never said the D word right.

0:33:54 Tracy Tranchitella: No, I. I agree with you. It’s. I. I feel I was listening to an interview, and I think it was. It was Dr. Mark Hyman, and, you know, he was. He was talking about. The interviewer said, do you. Do you feel like functional medicine or whatever we want to call this is be getting very, like, very specific, you know, very condition specific? And he said, no, I feel it’s. It’s the opposite. I think we have to have a broader view of how everything is interconnected.

0:34:26 Tracy Tranchitella: And, you know, for myself as a naturopath, you know, I feel like what I do is so foundational to good health that it can address many different conditions. So it’s easy in this field of functional medicine to go out there and be very condition specific, to attract that kind of person or patient. But the reality is what we do can help so many people with so many conditions, because what we’re trying to do is really build health as much as we’re trying to address disease processes.

0:35:04 Roland Pankewich: That’s beautiful. And the nature of learning about health is you will never learn more about health by more deeply studying disease. It’s just a fundamental tenant of it.

0:35:14 Tracy Tranchitella: Right. Something’s breaking down somewhere.

0:35:16 Roland Pankewich: Correct.

0:35:17 Tracy Tranchitella: You know, so we’re like, trying to figure out, where is that breaking down? Well, let’s. Let’s sort of level the playing field. Let’s get you on a healthy diet, let’s detoxify, let’s do all of these things to see if we can make a difference and move the needle. Because so many of the things that people might be dealing with are really diet and lifestyle related. So, I mean, I’m sure you’ve had this experience too, where people come in and they have like a laundry list of symptoms, and it’s sort of like, well, you can’t address every little symptom. It’s just. That’s just an expression of dysfunction that the body is showing you right now.

0:35:52 Tracy Tranchitella: And so you don’t go in and treat every little symptom. You go in and try and build health and see if a lot of those symptoms just resolve on their own so that you’re not just sort of putting out brush fires everywhere, which is very allopathic in its approach.

0:36:06 Roland Pankewich: Exactly. And that’s the difference. And that’s one thing that I’m trying to do with this podcast, is to teach clinicians that perspective. But not only clinicians. Individuals who are just, you know, what I call health warriors who want to learn for themselves because the more educated they get and the more in the know they are, they will challenge their clinicians to become better health practitioners.

0:36:27 Roland Pankewich: So I love that. I love that. That’s probably the best possible way to end an episode. That was the best note to hit the climax of today. Dr. Tracy, thank you so much for all this interesting stuff. I’ve always wanted to cover the gut liver axis and it very naturally just happened. So I appreciate all your wisdom, your advice. Is there anything that you want to share as a final thought with anyone or is there somewhere where people can connect with you if they want to know more about what it is you’re doing?

0:36:53 Tracy Tranchitella: Well, we have a website, it’s mysunrisecenter.com and you can find us on Facebook and we have other social media and all of that. So I think Facebook is probably the best way to, to look for us or to go to our website and we are available, taking patients and love to talk with people with all different kinds of things going on. I do like to focus on the gut a lot and hormones and stress response, lifestyle stuff, stuff.

0:37:24 Tracy Tranchitella: And I think there’s always something that naturopathic medicine has to offer to get somebody moving the needle towards health. So thanks for having me.

0:37:33 Roland Pankewich: Oh, it was absolutely wonderful. Thank you again for your time and thank you for being on the following your gut podcast. Until next time. Thank you, everyone. Take care.