Why can't I lose weight? I've tried everything!
Updated: May 20, 2020
This is the question that I get asked most frequently in my practice!
Here, I explain how the Organix test is an invaluable tool for my patients who are struggling with weight loss
Remember, weight loss should be the end result of a healthy metabolism. Unfortunately, we often confuse it as being the most primary problem when really it's a sign of something going wrong elsewhere in your body.
With weight loss, we’ll often find that an adrenal or thyroid program will get the person to lose a certain amount of weight and then they’ll plateau. We need to then look at testing and correcting the gut and liver. A common combination would be an H.pylori infection and a bunch of issues going on with the liver that are interfering with your ability to lose weight.
Let’s look at how human beings burn fat. There’s a sequence to all this that makes a fair amount of sense. If we put weight loss first, then it tends to end up not being so great. Your adrenals may not be the main issue, so we still think there’s something going on with the gut because you may have all the symptoms and we haven’t done testing yet ... it’s probably true that you've also got some detox and oxidative issues, maybe even some inflammatory problems. We’re going to check for pathogens, gut related issues and food, make sure that your detox/antioxidant systems are working and any kind of inflammation in the body is reduced. This would all center around toxins. Toxins cause detox systems to not work, they cause oxidative stress and inflammation.
There is a sequence to this that works the best. You test and look at the adrenals. Now you’re going to do more investigation with the thyroid, then you look at the gut and at the same time you can also look at liver detox capacity. This is where things get a little bit tricky. You want to stage things in the right way. Even if the liver detox is the most important, it usually works better if you make sure to test and correct the gut.
Oftentimes in functional medicine, we end up doing what may seem to be the most important thing, a little bit later in the process.
We don’t want to just jump to the most important thing and skip the intermediary steps. Let’s say that the liver toxicity issue is the most important problem. Even if the gut problem in your case is peripheral, if you don’t have that corrected you’re going to constantly be working with liver support since you’ll have this ongoing stress coming from the gut. In my practice, we do all this in the same week: we test the adrenals, gut and liver detox pathways with the organic acids upfront.
When I say sequence it, you don’t have to do it one after the other. If there’s a sense of urgency, we do them all right away.
The organic acids profile is where you start to see detox, oxidation and potential inflammatory problems. Let me show you a real example of this. Let's say a patient needs to lose 20 pounds (this is actually a real case I had). They already had their adrenals worked on and they’re doing quite a bit better. Their energy is amazing and they feel great. They had H.pylori which has already been treated, so the gut has already been dealt with. The adrenals and hormonal component were dealt with - in your case maybe the thyroid, the H.pylori was treated. The guy is pretty healthy now and he wants to take 20 pounds off. He’s eating a paleo diet, but he’s eating too much fat and protein. There are so many ways you can interpret this test, but let’s look at it just in terms of getting someone to lose weight.
Now let's say we have antioxidant markers and detox indicators, both of which have problems. The detox indicators show that he’s toxic. He’s not able to get rid of xylene, benzene, toluene, mercury, lead, cadmium, PCB, DDT and so on. His phase 1 and phase 2 are not working well enough for him to get rid of toxins, so they’re going to be building up. He has one of the antioxidant markers. You’re seeing phase 1 and 2 liver support problems, and the inflammation and oxidative stress that comes from that toxic burden. Your liver is responsible in a large part for burning fat. If your liver is distracted trying to get rid of xylene and the detox pathways aren’t working well, it’s impossible for it to burn fat in the way that you’d want to lose weight. We have to get the liver healthy and functioning well so that the person can burn fat. we’ve heard the term fatty liver. When the liver is really unhealthy, the fat just accumulates. We want to get all the fat out of the system and get the liver healthy, so instead of storing fat it’ll burn fat and get rid of it. That’s one variable that you can see in the organic acids.
Another variable is how you’re actually burning fat at the level of ATP. This test also measures that – fatty acid metabolism, carbohydrate metabolism and energy production markers were all a problem for this guy. In order to make energy in the citric acid cycle, we require fat, carbohydrate and potentially proteins. If you want the person to burn body fat, you need to make sure that they can take fat and convert it into energy. There’s only one way to do that. Fat has to get converted into Acetyl CoA and then you burn it up in the citric acid cycle. You can’t shunt fat over to carbohydrates and figure that that’s going to work. You cannot convert fat to glucose, you have to burn up fat in the citric acid cycle. If there’s any problem with the citric acid cycle, you’re not going to burn fat. If there’s any problem getting the fat over there, you’re not going to burn fat. You have to physically transport the fat to the mitochondria where it’s burned up. The transport mechanism that makes that work is called carnitine. A lot of patients lack carnitine, which means there’s a block here ... adipate, subarate and ethylmalonate start to build up. That’s an indicator that they’re not burning fat because they can’t transport it. It’s completely different than the toxicity issue. This guy may have high ethylmalonate on the Organix test, which means his fat transport molecules are not working. Another part of the story is we saw the liver toxicity. We were suspecting on this patient that the liver is not working properly.
The liver has 2 phases, it’s going to break down these toxins so we can excrete them. On this lab that we’re looking at, phase 2 is not working well meaning he needs sulfur containing amino acids. He also had some antioxidant problems, which are related to the earlier stages of liver detox. If the liver can’t get rid of toxins, they’re going to build up. We want to make sure the liver is working properly so they can flush toxins out. Many of the toxins that are making the liver unhealthy are coming from an unhealthy gut. That’s why we always treat the gut and then work on the liver.
What’s the direct mechanism of action here? When we have a lot of oxidative stress, a series of bad things happen. Here you have healthy mitochondria where you have a ton of ATP, which means you’ve got energy. Happy mitochondria mean you have very few free radicals. When a person gets toxic, they have a lot of oxidative stress. The free radical damage is going to increase and damage the mitochondria, making it not work right. Now your energy supply shrinks because of oxidative stress that’s damaging your mitochondria. This image shows distressed mitochondria. We’re counting on our mitochondria to burn up fat for fuel. If we have a lot of oxidative stress, it’s really hard to burn fat. This patient had 3 reasons why he couldn’t burn fat. One is because the liver toxins were damaging the mitochondria, so he wasn’t able to make energy inside the cells. He also didn’t have enough carnitine to pull fat in and burn it up for fuel. Even if he could burn the fat, it wasn’t getting there. The third problem was with carbohydrate metabolism, which is more related to blood sugar. You’ll see these other markers here: pyruvate, lactate and beta-hydroxybutarate. If those are elevated, then carb metabolism is not working well. If any of adipate, subarate or ethylmalonate are elevated, the person is not burning fat.
This patient had both those things and this is pretty crippling. The fact that this guy was toxic was creating a lot of oxidative stress. That’s interfering with his ability to make energy and to burn fat and it’s making him inflamed. The solutions are really straightforward. We want to use liver support for phase 1 and 2. We want to use antioxidants, we want to deal with anything with the gut so it’s not getting dumped down here ... then people start to heal and lose weight.