Low on energy? Check your digestion.

(audio transcript below)

Welcome to AIM For Health: Root Cause Conversations with Dr. James Biddle. All content from the conversations in this podcast are created and published for informational purposes only. This is not intended to be a substitute for professional medical advice and should not be relied on for personal medical decisions. Always seek the guidance of your doctor with any questions you have regarding a medical condition.

Hello! Welcome to our podcast. I’m Dr. James Robert Biddle, aka: ask Dr. Jim Bob, and today’s the 2nd of July, 2020, and I have our new patient coordinator, Joy Lambert here to help me. Hi Joy.

>>   Hello, Dr. Jim Bob. Hello everyone!

What are we going to talk about today?

>>    We had someone call in and they wanted to know more about the practice and they said they’d been listening to the podcast.  I asked what they’d like to hear about, and they would love to learn more about how what we eat affects our energy levels. How different foods, or what goes on with digestion….how can we eat some things and we feel really good…and other things might make us feel heavy groggy…..what’s that all about? 

Right. Well, I guess first we got to talk about digestion.

>>   Yes. What is digestion?

There’s four main phases to digestion. I mean, once you find it and catch it, that’s the first place (we start) Hunter-gatherer, right?

>>   Haha, right. Procuring it!

Then you got to chew it and break it down into smaller particles and mix it with your saliva. And saliva actually has enzymes in it that breaks starches into sugars. So a lot of people are very proud. They’ll say, I’ve cut out sugars and I’ll ask them what they’re eating. And there’ll be like, well, I had a banana or this and that, you know, or bread or potatoes, pasta. And guess what? By the time those things hit your stomach, they are sugar. And so you can get a very good blood sugar rush, even though you think you’re eating complex carbohydrates. So that’s the first phase.

>>   Is Chewing?

It’s chewing and saliva.

>>   And the more you chew the better. That’s what we’ve heard. That’s not just a myth. You actually are supposed to chew your food up really well. 

It’s not just for the fancy ladies and finishing school. You’re supposed to chew each bite 30 times. You really should chew your food well, and one of the greatest meditation practices that I ever heard about, from a tradition in the country of India, is to put your fork down after you take a bite, and chew consciously…and be aware of the food going all the way down your esophagus and hitting your stomach before you pick up the fork to take your next bite. Which is very different from the way most of us are taught to eat, especially in medical school and residency.

>>   You’re just shoveling it in.

You just shovel it in, so you can run on to do the next task. So conscious eating is a whole different ball game. It could help a lot of people, especially who have esophageal swallowing dysmotility problems.

>>   Well, and if you’re slowing down and chewing and eating deliberately like that, that gives you more time to enjoy dinner conversation or lunch conversation. 

It does. And it also activates your relaxation response and turns off your fight or flight response. And that turns on your vagus nerve, which then actually helps you to make stomach acid and the protective layer of mucus that protects your stomach from your own acid, and helps your pancreas to make bicarbonate and digestive enzymes. So if you’re eating in as even a subconscious anxious state of mind, or in a hurry, you’re shunting all your blood to your muscles and your brain and not to your gut. And so you’re not really digesting efficiently.

>>   Wow.

Yeah. So it goes even deeper than that.

>>    I did not know that. Thank you!

So the next phase is in your stomach and your stomach makes mostly stomach acid.

>>   And what is that acid?

It’s hydrochloric acid. The stomach is supposed to have a pH of 1- 2, which is extremely acidic, kind of like put a penny in the bottle of Coke and watch it dissolve over a few weeks. That type of acidic! And as you grow older, you’ll lose that opportunity to make acid. And so by the time you’re 70, there’s a 70% chance you’re low in stomach acid – and who gets told to take acid blockers all the time?

>>   Who?

Older people! But you know, they’re not low in acid. You know, they’re not high in acid. I mean, maybe if you’re a 30 or 40 year old executive with high stress or something like that, you’re high in stomach acid, but most people did not have too much stomach acid. And in fact, what they have is not enough mucus to protect their stomach lining from their own acid.

>>    So they feel the effects of the acid, which is why the acid blockers are recommended, but that’s not what’s needed?

That’s right. It does relieve your symptoms, but then you get malabsorption of your nutrients, many of which require acid to be absorbed, especially all your minerals and your B12. And so that’s why these acid blockers have been associated with an increased risk of dementia and kidney failure and a whole list of other problems long term.

>>    Now I don’t want to get too far off topic potentially…

Good, because I love to!

>>  Haha…are there things we can do to actually help retain mucosal lining of the stomach so that we don’t feel that? 

Yeah, again, the best thing you can do is to get into the relaxation mode when you eat and throughout your day to not be constantly cranked up into anxiety and a fight or flight response. But beyond that, you can take things that are kind of emulsant…things that are kind of slimy and slippery that help this. So things like licorice, if you have high blood pressure, you can’t take that. So you take DGL, which is deglycyrrhizinated licorice…the glycyrrhizin raises your blood pressure…so this is just the part that coats the stomach lining. Other are the extract of marshmallow, and I’m not talking about the candy!

>>   No! Marshmallow root!

Exactly right. Also Slippery Elm Bark.

>>   And that actually feels very slippery. I’ve had it in tea. It’s thick, viscous.

Very slippery…also Okra. Okra is very slippery. So any of those…ground flax seeds even. Have you ever soaked flax seeds and see slippery they are!?

>> Chia pudding (too)!

Chia pudding. Yes, all those things that have that kind of slimy slippery stuff is all coating to your stomach and helpful there.  And to get to make more acid is to use Apple cider vinegar before you eat. And if you use the liquid, you always want to dilute it a little bit with water and you drink it just before you eat…or five minutes before you eat. We also have it in capsules. I was even surprised (to see that) I didn’t know we could put Apple Cider Vinegar in capsules! But it’s a dried powder and it certainly smells like Apple Cider Vinegar. And you take that about 10 or 15 minutes before you eat so the capsule can dissolve, and that kind of primes the pump to get you to make stomach acid again.

And if you’re really low, you can actually take capsules of hydrochloric acid called betaine HCL. So there are usually 650 milligrams per capsule. The average healthy stomach would make 10 capsules worth to digest a meal. Now we usually give people one to three capsules per meal to augment their own stomach acid. You gotta get a little bit careful…if you’re really thin in mucus, you can burn your stomach lining with that, but it can be very helpful for people who are poor digesters. And if you don’t have enough stomach acid, you don’t break down your proteins enough and then those incompletely digested polypeptides…they go across the leaky gut in your small intestine. That’s how you get food allergies.  (*leaky gut syndrome)

So food allergies have been increasing dramatically over the last few decades. And a lot of that, I think his gut disruption from stress and from toxicities like glyphosate or Roundup, and from gluten sensitivity, all that kind of goes together. So stomach is the second part. And then the third part is your pancreas. Your pancreas….after your food comes out of the stomach, into the small intestine…your pancreas releases enzymes and bicarbonate to neutralize the stomach acid and to further digest the food. And then your gallbladder releases bile to emulsify the fats so that you can (emulsification means basically like what you do with soap. It makes the fats into water soluble compounds) so they can then be absorbed.  And the last part of digestion is then reabsorption of water in your colon. So all most of the nutrients are absorbed in the small intestine. And then when it empties from your small intestine into your large intestine, it’s still liquid. But then hopefully by the time it comes out, it’s at least formed or semiformed. And most of that is reabsorbing the water. And unfortunately, when you’re reabsorbing the water, you also tend to reabsorb a lot of toxins. So this is where a lot of fiber (is good)….

>>    Right? Cause we’ve talked about that before. You don’t want that to just stay in your body for too long.

Because then you reabsorb it and your liver has to do all the work of excreting it again. So you want fiber. So you poop out the toxins rather than reabsorb them. And so that your good gut bacteria have something to ferment…because your good gut bacteria, fermenting fiber is what makes these really healthy short chain fatty acids like butyrate. Butyrate is what gives butter it’s smell and that’s what heals and nurtures the stomach…the intestinal lining of the stomach. So we need to have a lot of fiber because that’s what supports our good gut bacteria and binds our toxins. So that’s kind of how we get there. Now, when your food is actually that absorbed, it’s got to be in very small particles you know…and it gets absorbed across the small intestinal membrane and goes through your liver, and then gets distributed to your body. And the way we actually make that energy…which is one of the questions you had…

>>   Right, how does the food actually turn into usable energy? 

Yeah. That’s in our mitochondria at the cellular level. Our mitochondria takes these molecules of food, (carbohydrates and fats) and breaks them down to create ATP.

>>   What’s ATP?

ATP is the currency of energy. It’s what your cell uses to move a muscle or to grow a hair or anything is going to do to create proteins, it uses ATP to achieve that. And so I’m not going to try to get into the complexities of the biochemistry of exactly how that works.

>>   That might be another podcast, haha!

That’s even beyond me to really….I understand it….but I don’t understand it well enough to teach it, but that’s cellular respiration and that’s why we need the oxygen and why we release carbon dioxide because we are breaking down those foods and creating energy out of them. And then releasing…we need the oxygen basically to burn it, and then release the carbon dioxide, just like a fire does.

>>    So if it’s the mitochondria…and there’s mitochondria in every cell in the body?


>>   If it’s the mitochondria that’s converting our food into energy, is all food equal in that regards, in terms of its potential to give us energy?

Well kind of, except for fats are denser…proteins and carbs have four calories of energy per gram of food. Whereas fat has nine calories per gram. And that’s why people who are trying to lose weight will often choose to limit fats because you’re getting less calories. But when you talk about wanting to burn energy, it’s much more efficient to burn fats for energy than to burn carbs for energy. Because you’re getting more energy per gram. So one of the things I say is that burning carbs for energy is like burning rolled up newspaper in your fireplace and burning fats for energy is like burning well-seasoned Oak in your fireplace.

>>   Big difference!

Yeah. It gives a good, strong, slow burn. It’s much more stable. And I think really the point is, is when you primarily eat carbs, you’re inducing enzymes at the cellular level to burn those carbs, to process them.  And when you switch over to eating more healthy fats and burning fats, then you have to change over your enzymes…and that takes like two or three weeks assuming you’re not severely insulin resistant. If you’re really insulin resistant can take a lot longer. They studied this actually in Canadian troops, marching them, and then they changed their diet….and for the first few weeks they really sucked wind when they changed from a high carb to a high fat diet. But after three weeks, they got much, much better because they shifted their enzymes and were then able to use the fats at the cellar level efficiently, once they flipped over their enzymes. So fats are actually much better to burn for energy.

>>    And if you’re burning fat for energy, does that then promote fat burning – as it pertains to weight loss? 

Exactly! That’s what we teach in our nutrition classes. You want to actually eat fat to burn fat. And this is kind of at the cellular level, how that mechanism happens. But first you have to reverse insulin resistance, because insulin tells the body to store fat, store fat, store fat. Make cholesterol, raise your cholesterol, and store fat. So if you’re insulin resistant, then you’re storing fat rather than burning fat. And, of course, why are you insulin resistant? Because you’ve been eating sugar and carbs.

>>   Right. The spikes.

That’s right. So you’ve got to make that switch over. And that can be hard on people. And sometimes it can take months. I mean, if you’re really overweight and insulin resistant and diabetic, it can take months to make that conversion. And people sometimes don’t feel so good when they’re making that conversion because now they’re not able to access energy very well for awhile. So I understand that it’s tough for people sometimes to make that conversion. This also kind of ties into the energy of ups and downs. Why do some people get reactive hypoglycemia? Why did they get this blood sugar drop and other people don’t?

>>    Right. That’s a good question. Why do they?

Why thank you! Well, you know what goes up must come down. And how high it goes up correlates to how far it comes down. They’re getting the blood sugar drops because they’re getting the blood sugar highs. And when you convert over to eating more from carbs to fats, then you stop getting the blood sugar highs. So you’ve stopped getting the blood sugar lows. The other thing that exacerbates this is adrenal weakness. If you tend to have weak adrenal glands, that makes it harder because when you have a blood sugar drop your adrenals kick in with that kind of cortisol and epinephrine response to bring your blood sugar back up. So if you have weak adrenal glands, it won’t kick in as well. And then your blood sugar will stay down enough for you to have a reactive hypoglycemia.

>>   So talking about a cortisol response reminds me of another question. Does that have anything to do with the phenomenon of “hangry”? You’ve heard of hangry?


>>   And we tell people, please eat your breakfast before you come in for a nice long visit so you’re not hangry, but what is hangry? Is that part of it? If we’re triggering a cortisol response in order to digest?

Partly. But it’s also combined with the low blood sugar, you know, people can’t think if their blood sugar is too low.

>>   That is real!

Especially if they’re used to burning carbs for energy. If you’re used to burning fat for energy, you hardly ever get hangry because your body is that adapted to burning fat, and even the thinnest of us have enough fat to run several marathons. So if we can access our stored fat, and your enzymes are induced to burning fat, you will almost never get hangry.

>>   Really!?

Yeah. And that, that brings us….I see another question I had written down…is it better to eat six times a day…

>>   Grazing.

Grazing, yes. Or is it better to do intermittent fasting where you eat once or twice a day? And then you go 18 hours without eating.  And I’ve got to say in the short run, when I find people who are having the blood sugar rollercoaster…and in my old nutrition lecture, I used to teach to eat six times a day…to stabilize your blood sugar. But what I’m teaching them to eat is low carb, adequate protein, and high fiber and high healthy fat. And so that ends up stabilizing their blood sugar and then gradually they can shift over into spacing out their meals. And I do think it’s much healthier these days to do the intermittent fasting because once you’re able to stabilize your blood sugar, then you can start to start to go longer and longer between meals. And you can go the 16, 18 hours without getting hangry….once you’re burning fats for energy, and then that induces your body to burn more and more fat, and it also reduces cancer risk by breaking down abnormal proteins, which are what leads to cancer.

So in the short run, frequent eating. In the long run, less carbs, more healthy fat, adequate protein, lots of fiber, lots of fiber in your diet. And then you shift over to the intermittent fasting for longer term health. It doesn’t have to be every day, but at least two days a week, you try to go 16 to 18 hours between meals. Now, most people, when they do that, they find it easier to skip breakfast. But here’s the problem with that. If you’re skipping breakfast, that means you’re eating later at night and you’re going to bed with food on your stomach, and that’s not so good way better to go to bed with an empty stomach.

>>    Well, and doesn’t breakfast jumpstart the metabolism for the day…?

It does kind of, but all these people would say, Oh, I don’t like breakfast. I’m never hungry in the morning. Well guess what, not being hungry in the morning and having the urge to snack at night is a classic sign of leptin resistance, which is basically a cousin of the insulin resistance, but especially for leptin, which is a hormone, I don’t completely understand, but you can look it up on our favorite medical site of “Wikipedia” and read about leptin. But people who are leptin and insulin resistant, won’t want to eat breakfast in the morning. They’re not hungry, but when they fix that, then you’ll wake up and you’ll actually be able to eat breakfast within an hour of getting up. So it’s much healthier to eat breakfast, let’s say at 8:00 AM, and then lunch at one or 2:00 PM, and then to be fasting from 2:00 PM to 8:00 AM. And so, you know, that is your 18 hours, right there. It’s much better than eating lunch and dinner. Much better for your metabolism.

>>    So my gears are turning as I’m processing all of this. Am I correct then in understanding that it’s not…this isn’t a matter of whether or not you have food in your stomach…if you’re going to have higher or lower energy levels. It’s really about getting your whole body working as a machine where it’s burning your fats, it’s processing to maintain your energy levels.

That’s right.

>>   Okay.

Well, there is one other part to that and that is that if you have weak digestion, meaning low stomach acid or low ability to make enzymes, then after you eat you’re going to be like a snake that just ate a whole Guinea Pig or whatever it is…you’re going to be sluggish and tired. Because it takes so much energy to eat a big heavy meal. It takes a lot more energy.

>>    And that was another question I had. It’s the whole phenomenon…some people call it the food coma or the itis, or, you know, you just have to take a nap. Why do we get tired after a big meal? 

Yeah. And some of that’s just how much energy it takes to digest your food. And I think part of that’s natural. And some of it can sometimes be food allergies. If you have certain foods you’re allergic to, that could be a problem or sensitive to, and other ways besides just allergy. Yeah, so I think there’s some naturalness, but if it’s excessive…if you’re really getting knocked out…then you might want to experiment with, is it the type of food you’re eating? Is it the balance of food? Is it too much food all at once? Or are you having food allergy reactions?

>>    Well, since you’re mentioning food allergies, you want to talk about that for a little bit?


>>   Because you know, sometimes people think that, well, if I don’t have an immediate reaction, if I’m not having signs of anaphylaxis, then I don’t have food allergies. How do we know what’s actually happening? Can you have delayed reactions? Can you be reacting to foods and not even be consciously aware of it? 

Sure. And I get to use my own daughter as an example of that. In conventional medicine, food allergies are generally just the immediate reactions, and those are measured in the bloodstream by an IgE antibody. And you usually know if you have it because you eat shrimp and your lips swell up, or you eat peanuts and you can’t breathe…something like that. And it shows up on skin testing. The delayed reactors are an IgG antibody reaction and they’re usually delayed by 6 to 48 hours. They don’t show up on skin testing because of that, and because of that, the regular allergists don’t believe in them. And the whole medical profession doesn’t really believe in them. We find they’re about 95% of the problem are for people with food allergies.

>>    So what is a delayed food allergy reaction? 

It can be almost anything. For my daughter it was eczema. For many people it’s migraines, for some people is just fatigue, or pain, for some people it’s irritable bowel syndrome, it shows up in the gut. It could be brain fog. It could be a tendency towards auto immune disease. For example, the reactivity to dairy and wheat can show up as Hashimoto’s thyroiditis as a cross-reactivity. There’s a very strong correlation between the wheat sensitivity and Hasimoto’s, and that’s not an IgE reaction.

>>    I can speak from experience on that. I’ve been diagnosed with Hashimoto’s and one of the first things recommended from Kamila, our nurse practitioner, was to change my diet. I stopped eating dair,y whea,t and soy. And five months later, my antibody numbers dropped by about 40%.

And that’s basically most of what you do.

>>   Showing that my body was reacting to those foods. Whereas prior I never thought about it. I never realized or felt that I was having a reaction, but yet here it was setting something up that I don’t want to perpetuate. So I was begrudgingly happy to make those dietary changes.

Exactly. And being able to avoid foods like that is great. And why not? What I run into is people who have a lot of food allergy reactions, and then avoiding those is not only challenging, but sometimes doesn’t work, and sometimes it can backfire. So the way to make a food allergy worse is to avoid it for about three weeks and then get exposed…and avoid it for three weeks and then get exposed. And pretty soon you’re cranking up into anaphylaxis with it. And how do they desensitize kids with peanut allergy now? They take a microscopic amount of peanut dust and put it under their times. Then they gradually increase that until about a year later, they’re taking a tablespoon of peanut butter a day. And as long as they do that, they can tolerate peanut butter and peanuts and peanut butter. But if they stopped doing it in a few months they’re anaphylactic again. So that’s inducing tolerance. That’s just like taking a ragweed pollen and injecting into your arm every week for desensitization. And that’s what we do with the foods is we put the proteins of the foods into a dropper bottle and squirt it under your tongue two to three times a day. And that’s what I did for my daughter. And after about a year of that, no more eczema. That’s fantastic. And also, you know, asthma is a lot easier to control. I can’t say no more asthma, but a lot less. Also treating for inhalants.

>>   Yes, and it’s not painful. She can do it herself. It doesn’t taste bad.

No, it tastes good. Actually. Luckily it’s in glycerin, so it tastes very good. So we can do that for foods and we can do it also for the inhalants, like ragweed and dust and mold and things like that. So those are parallel programs. We can do all the testing by blood testing. So we don’t have to do skin testing anymore.

>>    Right. And the blood testing, not only does it look at immediate and delayed reactions, but just so everyone out there listening knows that blood testing will also rank – not just are you reactive or are you not – but it’s on a 1 – 5 five scale of how reactive are you?

Yeah. Then we can start you at where you need to be treated, and then gradually move the treatment up. Whereas with the skin testing, they usually just start everything at the lowest level and move it all together, which isn’t the most efficient way to treat. And again, with the shots, people have the risk of reacting to the shots – and sometimes having an anaphylactic reaction. So a few people across United States die every year from that. And with the drops, nobody’s ever been shown to be injured by the drops under the tongue, your nose can get a little itchy, back of your throat can get a little itchy, but that’s about the worst that ever happens. So, you know, I have been profoundly moved with how positively oral drop desensitization has changed our practice over the last 15 years. And I’m not sure how I’d practice without it anymore. It’s just a great tool. And then of course, when we have people with food allergies we’re looking at, how do we support the digestion so they don’t develop more food allergies in the future?

>>   Right.

To break that cycle.

All right. Well, what else did we need to talk about…specifically to food and energy levels? Did we cover it?

>>    We’ve gone through most of the questions. Oh, what about the resources our body needs to digest food, and does that pertain to our energy levels…like our gut flora, or our hydration level, or hormones or things like that?

Well, you do have to be hydrated because you have to have water to make your stomach acid and your bicarb and all that. So dehydration is not so good. I think being relaxed is probably the single most important part of digesting well…is to manage your own stress levels. And last week we talked about different things to manage your stress. I think in the future, we’re going to do one specifically about stress and anxiety and the types of supplements we can take for that.

>> Yes!

Besides the behavioral changes, I think the gut flora has a much more to do with the health of your intestines. And what’s interesting…we all love probiotics. I prescribe probiotics, and we try to avoid antibiotics when we can. Because we all have an intuitive knowing that that changes our gut flora. However, in the studies on the microbiome, they’ve shown the only thing that actually changes the microbiome of adults is how well you eat and how well you exercise. So how well you eat means not eating a bunch of pesticides that kill off your gut flora. And eating plenty of fiber that your gut flora can ferment and metabolize. And exercise all types of exercise. That’s what really affects your microbiome. So, it comes back to eat your vegetables and your ground flax seeds.

>>   And keep moving!

Keep moving. That’s right. I think that’s it. I think maybe we’ll leave it at that for today.

>>    Yeah. We’ve gone through all the questions. Thank you, sir.

You’re welcome. If you have questions, send them in to info@docbiddle.com. We’ll talk to you next week.

>>    Thank you. Bye bye.


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