Keto Chat Episode 141: Naturopathic Doctor Weighs in on Keto and Autoimmune Thyroid
Interviewee Bio:
Dr. Guillermo Ruiz NMD graduated from the Southwest College of Naturopathic Medicine. While attending SCNM, Dr. Ruiz became interested in the treatment of endocrine disease with a focus on thyroid health. Under the mentorship of Dr. Alan Christianson, Dr. Ruiz expanded his knowledge on the treatment of Hashimoto’s and Grave’s disease and has completed advanced endocrinology training in order to better address and resolve endocrine disease.
Dr. Ruiz currently offers his expertise through @GoHealth an online practice focused on patient wellness through the merger of lifestyle intervention and modern medicine. @GoHealth was founded on being evidence and science-driven, a willingness to explore and building real relationships with patients.
Transcript:
Carole Freeman:
Hey welcome everyone to this episode of Keto Chat. Oh my gosh, I’m so excited, I’ve got Dr. Guillermo Ruiz here. Welcome, welcome.
Dr. Guillermo Ruiz:
That’s [crosstalk 00:00:28].
Carole Freeman:
Oh my gosh. Yay. Oh my gosh. Oh my gosh. I’m going to say, oh my gosh, a thousand times, because I have been searching for a… Not only just keto-friendly functional medicine doctor, and I’ve been searching high and wide, far and wide all over the internet and asking for the referrals. And I’d found one to refer my client to somewhere… I don’t remember, somewhere in the Midwest. And they had some concierge package, and it was going to cost her five or $6,000 just to work with this doctor. And I was like, “Ah, I don’t know, hold off, hold off. I don’t think you need that extensive of stuff.” And I just happened to ask Tyler Cartwright of Ketogains one day, because I was looking for somebody for myself, and it turns out that here we’ve got Dr. Ruiz that not only works virtually, but he’s in my backyard here in the Arizona area. So welcome Dr. Ruiz that was a very long-winded, why I’m so excited to have you here.
Dr. Guillermo Ruiz:
Yeah, we need to go… We need to go out for dinner and I…
Carole Freeman:
Yeah.
Dr. Guillermo Ruiz:
We could go to a couple of places that are very keto-friendly and listen, I’m a Texan, I was born in Texas, and man, the barbecue out here puts it on notice.
Carole Freeman:
Okay. I think you recommended one place to me, and I’ve been to a different one, but yeah. And I’ve been to Texas a couple of times and you’re right, the barbecue there, like… Nobody.
Dr. Guillermo Ruiz:
I know. And listen, just wait. Yeah, no, it’s really cool because when I started with naturopathic medicine, when I wanted to become a doctor, I wanted… I didn’t want people that you could tell, “Hey, you know what? Let’s go gluten free.” It’s like, what? It’s so simple, and people are so much more sophisticated than that. So in reality, I was looking for those tough cases. I know we have a mutual friend, people like Robb Wolf, people like Chris Kresser, and that’s who I was interested in, the people that are doing an ancestral lifestyle, are changing their habit.
Dr. Guillermo Ruiz:
And then things don’t change. It’s the classic, “Oh my goodness, my husband stopped drinking beer and he lost 20 pounds. I haven’t looked at a carb in three years, and I gained two.” It’s like-
Carole Freeman:
Yeah, yeah.
Dr. Guillermo Ruiz:
That’s who… That’s where I geek out. That’s where [crosstalk 00:03:08] that like a patient that I like.
Carole Freeman:
So cool. Well, you’re so… I’m so excited to have you on our team, start referring people to you. And I can see we’ve got some people watching live, so I can’t see who you are unless you comment. So go ahead and post a comment here, let me know you’re here. If you’ve got any questions for Dr. Ruiz, either already queued up in your mind, or as we’re talking here, go ahead and type them in the chat box there, and we’ll make sure we get to all the questions as well too. So just to give a little more background, I’m going to read a little bit of your… I’ll give you more an official introduction here, but Dr. Ruiz is a graduate of medical… Is a graduate medical student from the Southwest College of Naturopathic Medicine. And his aim is to use research, to advance naturopathic medicine, using an evidence-based approach, and focuses on finding evolutionary connections between our modern and traditional healthcare systems. He practices endocrinology in Scottsdale, Arizona and…
Dr. Guillermo Ruiz:
[inaudible 00:04:09] Atgo Health that’s [crosstalk 00:04:11].
Carole Freeman:
Atgo Health. Yes, specializes in metabolic optimization. So I’ve got a… Well, we’ll talk about what is metabolic optimization which is actually really cool. His hobbies are boring.,I got to say, research, learning and practicing what he is doing. So, no, that’s awesome. And he sits on the board of… Several boards directors for ancestral and evolutionary diet and lifestyle as well as supplement companies. And so hopefully you can know why I’m so excited to have him here and have discovered him. He’s my personal naturopath now, and we’re working on some stuff that’s cropped up for me. So anyway, so glad to have you here. How did you… So you said, you’re from… You grew up in Texas. How did you get interested in becoming a doctor?
Dr. Guillermo Ruiz:
It’s a funny one. I’ve always wanted to be doctor. I had a Fisher Price plastic stethoscope, and the yellow one with the blue thing. I always knew that I wanted to be a doctor. I grew up in Mexico, lived in Mexico 14 years and then moved to Texas, did my freshman year in Texas, and then we moved to Florida. And I lived in Florida, I’m a graduate of the University of Central Florida in Orlando. And it took me a while to find my path, always in the back of my head, I want to be a doctor.
Dr. Guillermo Ruiz:
Around 2010, okay. I was struggling with weight, and I’ve I’ve been a vegan, I’ve been, vegetarian, I’ve done Atkins, South Beach, the whole gamut. And eventually I got a book, my friend loaned me a book called Good Calorie, Bad Calorie.
Carole Freeman:
Okay. Yep. Yep.
Dr. Guillermo Ruiz:
That was my first hit, and of course you start reading all the research on how wrong we’ve gotten things. And there’s a lot of things that have been debunked with… Since 2010 until now, and our understanding of ketogenic diet has changed so much. It’s gone from like, “Oh, we get to eat bacon with lard.” Into a more refined approach to it. And science doesn’t deal in paradox. Around that time, my [inaudible 00:06:40] daughter’s mom passed away from cancer. Yeah. And it was a very rare form of cancer that starts with a gluten allergy. And there’s some studies, it’s so rare that the few people that actually get it, they get studied. And there was this study where three sisters got it, it’s a jejunal cancer in the first part of the small intestine. And the first one died, and then the other two were diagnosed with celiac disease, and it was early enough where they were able to reverse the disease process.
Carole Freeman:
Oh, good.
Dr. Guillermo Ruiz:
So I’ve been geeking out on that, and how grains affect gut health. [inaudible 00:07:31] health starts in the gut. At the time, I was working in a level one trauma center for kids in Arnold Palmer, and all of the doctors at the hospital were like, “No, you don’t want to go into medicine. You’re going to be miserable, blah, blah, blah.” And in the back of my head, that five year old kid was like, “No, you’re going to be a doctor.”
Dr. Guillermo Ruiz:
So I’ve been listening to to the Paleo Solution back in day and…
Carole Freeman:
Oh yeah. With Robb Wolf, okay.
Dr. Guillermo Ruiz:
With Robb Wolf ever since, and one time he had Chris Kresser on the show, and he said the word naturopath, and I was like, “What’s that?” So I started investigating, and I always wanted to be the type of doctor that we could do lifestyle modifications, such as diet changes, supplements, who doesn’t take supplements? But if I needed to prescribe an actual prescription, doing a prescription, doing… Ordering labs and things like that, and it just so happens that naturopathic medicine is that. It gives me a very broad scope of practice.
Dr. Guillermo Ruiz:
So I like to say that naturopathic medicine found me, not the other way around. And yeah. And so I hauled my ass all the way to Arizona, and here I am loving… Just loving what I do.
Carole Freeman:
So, will you clarify for people, because there’s going to be some people watching that don’t understand the difference between a naturopathic doctor and a medical doctor, and they also think that like, “Well, a naturopath’s not a real doctor.” So will you clear that up?
Dr. Guillermo Ruiz:
Well, the first thing that we need to clear up is that I don’t like the term alternative medicine. Medicine, it’s either medicine or not, there’s no alternative to health. And how we reach health is going to depend on whoever is in front of me. In Arizona I have full scope, I am a licensed naturopathic medical doctor. I have a DEA number, I have an NPI number, I can prescribe, I can diagnose I am afforded all of those tools. And then my scope is cool because my scope basically covers anything that is natural. So, imagine it’s like I can prescribe a supplement, I can prescribe biodentical hormones, I can prescribe all of these things that happen organically plus I have a pretty extensive ability to write prescriptions and order labs and everything that comes with it. So it’s pretty… It’s a pretty cool… Probably the best hidden profession, the best hidden secret in healthcare.
Dr. Guillermo Ruiz:
And on top of that, I can do IV infusions so people that need a little bit of immune support, or if you have iron deficiency, anemia, we can do iron infusions, and all of these different, cool tricks. And I am not limited by two things. I’m not limited by, “Hey, what’s the nutrition? You’re not a nutritionist.” “Well, no, that’s a natural treatment, and I am able to prescribe diets.” And on top of that, I can also do all of this cool IVs, and all of this cool supplements, and have the pharmacology when needed. And I try to use the most effective and most economical, I guess, way to achieve health.
Carole Freeman:
Okay. Well… And where I got all my nutrition training and my psychology training was a comparable naturopathic school up in the Seattle area. You went to school down in Scottsdale, is that where…
Dr. Guillermo Ruiz:
Tempe.
Carole Freeman:
Tempe. Oh, okay. Okay. yeah, so I always looked at… And I had experiences myself with traditional medical care from MDs, and then going to see my first naturopath, and the whole process was just so enlightening, right? Whereas a normal doctor will spend normal, regular doctor will spend five or seven minutes with you, whereas the naturopath, your first appointment’s typically 60 to 90 minutes.
Dr. Guillermo Ruiz:
Yeah.
Carole Freeman:
And after spending more time at the school, and just understanding that basically you go through the full same medical training that a medical doctor would do. And on top of that, you learn supplements and nutrition, and…
Dr. Guillermo Ruiz:
In Arizona, I learned acupuncture, manipulation, so. And, that’s a big thing. I think my friends in the hospital and listen, emergency medicine is amazing, and-
Carole Freeman:
We need that. We need that.
Dr. Guillermo Ruiz:
I know we need that. For example, my niece she had an ear infection, and it progressed to mastoiditis which is an inflammation, infection of the mastoid bone. And she had to have emergency brain surgery.
Carole Freeman:
Oh.
Dr. Guillermo Ruiz:
I can’t do that. And I think that the dislike of not wanting to be a doctor is because you get these cases… You get, for example, I was proxy to diagnosing nine year olds with diabetes. They would come in with a UTI, with a urinary tract infection, and we would run their glucose on the P strip, and their glucose would be through the roof. And you’re peeing all these glucose, bacteria take advantage of that, they get a hold, and they start reproducing. And then you give them an antibiotic, and then you say, “Go to your primary and try to fix it.”
Carole Freeman:
Yeah.
Dr. Guillermo Ruiz:
And then they go to their primary and they have a five minute visit. They only have basically one choice, just to prescribe something.
Carole Freeman:
Right.
Dr. Guillermo Ruiz:
Because I am outside of the insurance model, I get to determine what my value is, and I get to put a fair value for my time. And I get to spend an hour with you, and giving you all of the different paths that we can follow to achieve true health. So in the conventional model of medicine, yeah I bet it would be so frustrating. You have a mom coming in on a Friday afternoon with a kid with an ear infection, and they’re like, “Listen, I need an antibiotic because if my kid doesn’t get better, I can’t go to work.” And we understand that antibiotics don’t work against viruses. And we are trained, our friends in the conventional model of medicine know this, but they’re between a rock and the hard place. So switching and taking advantage and being fully responsible and advocate for your own health allows you to go outside of that cookie cutter model, and go into a deeper type of preventative care.
Carole Freeman:
Yeah, absolutely. Yeah. I think that some of my clients are struggling with understanding like, “Well, I’ve got medical coverage, I’ve got a doctor already. Why would I need this other guy to help me?” I understand, but what would you say about the big difference between somebody who’s got insurance that covers routine medical care, and why would they want to pay out of pocket for somebody that… For another doctor?
Dr. Guillermo Ruiz:
Yeah, well, I think that the system is broken. And if you’ve read books like Chris Kresser’s Conventional Health or if… It’s the same as saying, “I’ve been eating waffles for breakfast or cereal for breakfast, and then a sandwich for lunch, and a salad for dinner because that’s healthy. Why would I change the way I eat?” Well, we’ve been lied to. And in having this third party system where you have some suit on a tower somewhere telling the practitioner what they can and cannot do at that point, who is actually practicing medicine?
Carole Freeman:
Yeah.
Dr. Guillermo Ruiz:
So when you are fighting against red tape to get the care that you need, that’s when it becomes really, really frustrating. For example, a very simple example, HRT, hormone replacement therapy, for people that need a little bit of testosterone, testosterone is dirt cheap. Bioidentical testosterone, you can get a five month supply for around 60 bucks. And because it’s not necessary, because as we age our hormone levels are going to drop off, the insurance companies don’t want to shell out that money. And they make it super uber complicated for patients to optimize their health.
Dr. Guillermo Ruiz:
So, we’re fighting against sick care where someone is looking for that pill, for that antibiotic, for that… Rather than, “We’ve done all of this, we are in a better health status. What’s the next thing that we can do to make us superhuman, to make us feel like bad asses?” And insurance companies don’t see that… Don’t look at that as being necessary. So they’ll do a couple of things. They’ll… First, they’ll say, “Okay, that’s not medically necessary.” And then they’ll have you fill out all this paperwork to do it. They’ll have you do prior authorizations, meaning that… And then they’ll charge you a copay, and they’ll do something really funny, they’ll make you go monthly for your prescription, rather than giving you a [vial 00:18:33] that covers you for a couple of months, because now you are paying every time you go in. And now you are having to go through all this different steps to prevent you from continuing the care.
Dr. Guillermo Ruiz:
Where you can avoid all of that by just paying cash. And it’s the same thing with labs. There are so many cool options for you to take care of your health and pay cash for your labs. And insurance companies do different things, for example, if you want to vitamin D level, you have to have a special code in there for them to cover it. And if you don’t have it, that’s it, you are… That bill is yours. Where a vitamin D level is pennies on the dollar. And especially with what’s going on in the world, and the way that we are not able to go outside as as freely, with the food infrastructure that we have, and how little nutrition there is actually in food. Right now micronutrients is just so damn important, and we should be able to… We should be able to say to a person, “What’s your vitamin D level?” And that person should be like, know where they were in the past six months.
Carole Freeman:
Yeah, yeah. So the… I think the primary difference for people to understand is that our core medical system, our medical doctors are set up just to keep us more one step above death. It’s not about… It’s not about optimizing health, it’s about keeping you alive enough, and minimizing the expense that the insurance company has to pay for you. And like you said, we want to clarify that, if you need insurance, you need emergency care, there no better place to be than the United States. But if you’re trying to be healthy and as well as possible, that’s where I see that people like me helping people make long-term habit change to their eating habits, and then somebody like you that can help with the fine tuning of all the other parts of optimizing your health as well.
Carole Freeman:
So I see it as… I don’t know. What’s a good analogy of like, if you just want something that’s like the basics that can get you around, but it’s not going to be fast and fun. The basics of medical care is going to get you there, but if you actually want to-
Dr. Guillermo Ruiz:
It’s like, we saw a little bit of a revolution with travel in the eighties and nineties, where people would go to a travel agency, and then do some negotiation with the travel agency, but remember that the travel agency had to take a cut. So there is a little bit of profit margin that needs to be… And it’s not a profit margin, but cost saving… Health cost minimization-
Carole Freeman:
Right.
Dr. Guillermo Ruiz:
… with healthcare. And that’s how they get through the ethics of making profits the health of people, so it’s a profit margin that they have to keep. And the internet pops off, and now people can go directly to the airline and buy directly without a middle man. So there is no other industry where you would go to a restaurant, and then have to pay someone else for your menu. And then, they bring you your food, and then you still owe some money for the service while you’re continuing to pay someone else. And you never know how much that meal cost.
Carole Freeman:
Yeah. And you can’t actually get at what you want, you have to get what somebody else says is the cheapest food that you’re allowed to get.
Dr. Guillermo Ruiz:
That it’s okay for you to get, yes. Yeah. Imagine if that was a restaurant, you go to a restaurant and it’s like, “But I’m keto.” And they’re like…
Carole Freeman:
[crosstalk 00:22:40] with Uber Eats, right? That’s a weird model now that this other company’s taking a cut, and there’s all these fees on top of it, and sometimes you get the food, and it’s soggy, and not the thing you ordered and…
Dr. Guillermo Ruiz:
Yeah. It’s… And that’s no disruptor. That’s no disruptor and… I’m old enough to have traveled and used taxis, so you land in the airport and that’s it. You are completely slave to whatever company they are using. So, then you jump in that taxi, you don’t have any idea what their rates are, and you don’t have any other options. So then Uber enters and they’re like, “Listen, we’re going to have this competition. You’re going to have a GPS. We’re going to pick you up. You’re going to know how much you’re going to pay before you get there.” And once you get there originally, you didn’t even have to tip. It was like, “No tipping.” So what happens, they disrupt this model of taxis.
Dr. Guillermo Ruiz:
And then last time I flew into Arizona, I was in Los Angeles and I came back to Arizona, and I looked at my Uber, and the price was tripled. So I actually went into the taxi and guess what happened with the taxis? They had a predetermined route, they gave me how much it was going to be in advance. And so everyone is benefiting by disrupting the system, and being able to be a disruptor, especially in something that’s important as healthcare, I’m pretty proud of that.
Carole Freeman:
I don’t know if it’s going to happen in my lifetime, but I would love to see that the population gets so healthy that we wake up and realize that most of the food that’s being fed to us out there and marketed to us is destroying our health. And we… That we all go, “You know what? Never mind, let’s all eat really healthy.” And we get so healthy that we don’t need these insurance companies, that they have to switch, that they then… They have to figure out all the big insurance companies that used to make money off of us staying moderately sick, now they make money maybe from selling Fitbits or encouraging us to have stress management software, and things like that that are just actually optimizing our health rather than just trying to maintain all these medications that they have us on.
Dr. Guillermo Ruiz:
And that’s why I decided to go into this specific type of medicine., and even more granular into naturopathic endocrinology, so the ability to modify hormones. Because I see it as two gears, you have your lifestyle and then you have your physiology, okay? And what I see… I am not interested in helping people who just started in their journey, meaning that, that they were eating a standard American diet, and then they want to jump to me, and help them. No, we need health coaches. We need people to… I am not an expert on lifestyle. I need people like you, Carole to help me with lifestyle. You would be wasting your time asking me for what should I eat for breakfast. And I would say, “I don’t know, maybe a salad.” Yeah. And then it’s really crazy because I have no sweet tooth, so I’m very lucky about that [crosstalk 00:26:30]. I’ll tell you, I don’t… I can even tell… I cannot tell the difference between like sugar and stevia.
Carole Freeman:
Oh, okay.
Dr. Guillermo Ruiz:
There is no difference, to me, it’s just sweet. So what I’m interested in is the people that put in the time, that they’ve done a healthy lifestyle for two, three months, okay? So they’ve done it, the lifestyle is there, and nine times of 10, lifestyle is there, physiology just meshes with the gears, and magic happens. Sometimes physiology is there, sorry, the lifestyle is there and the physiology isn’t. And that’s where I come in. That’s where I investigate what is it about the physiology that is not actually working? And we optimize it so the lifestyle get better. Very interesting though, because we see weight gain, we see obesity, we see weight gain as a disease. And tell me if I’m wrong, but the most difficult people to convince to change their lifestyle are those bastards that are skinny that are eating whatever the hell they want, because they’re like, “I’m skinny.”
Carole Freeman:
The gym rats that were born with a six pack, right?
Dr. Guillermo Ruiz:
Yeah. The problem is that I don’t see weight gain as a disease, I see it as a symptom.
Carole Freeman:
I agree. Yeah.
Dr. Guillermo Ruiz:
Some people will have that symptom, some people will not, but the outcome is the same. There’s going to be an increase in sickness and morbidity if you don’t change the lifestyle. And the first step… The first step in changing your lifestyle is to join a group to, to join… To have a health coach, to have accountability partners, to have people that can help you keep you honest. And nine times out of 10 that’s going to work. It’s that 10% that I’m interested in, that I can really help them achieve those goals.
Carole Freeman:
Well, that’s such a good partnership then, because that’s what I’ve been looking for is that there’s a… The basic bundle of labs that I’m looking at, metabolic markers that I feel comfortable in interpreting and helping people with their lifestyle change, adjust those. But once in a while there was something that would crop up that I’m like, “I’m not an expert in this.” Somebody’s thyroid panel, ferritin, for example, the iron things. There’s some things that I’m like, “I don’t… I’m not an expert in this area. I don’t feel confident.” I need that other person that I can help somebody, “Go to this person. Go to Dr. Ruiz now.” And he’s going to be able to help you dive in a little bit more than that.
Carole Freeman:
So for example, I had one of my ladies that her iron labs, I had to run the full panel and things were wonky. One was high, one was low, one was this. And I’m like, “I don’t know what’s going on here. We need somebody.” I referred her to you too, I’ll make sure she gets in touch with you again as well. That’s the one of the only other person I had to refer to was $6,000 for a full package. It’s like, “I don’t think she needs that much. Just some tweaking.” Yeah, so.
Dr. Guillermo Ruiz:
I’m not… I actually wrote an e-book about iron, and the [crosstalk 00:29:54] iron. So I’ll send it to you, and we can make [crosstalk 00:29:56].
Carole Freeman:
That’s great. Where I became… I didn’t… In school, we didn’t learn much about optimal lab ranges. We were taught that there are those, you should be aware that the standard lab ranges is not optimal, but we didn’t get into really functional medicine type of looking at those labs. Where I learned a little bit about ferritin got my eyes open to that was through Dr. Mercola’s book that he wrote, that was his keto book. He has a whole section in there about ferritin, and how when it’s too high, it’s very pro-oxidant. You need to be wary of that, and I was like, “Okay.” So that started to be something that I would have my clients… Especially if they were talking about having fatigue, that they didn’t get that magical energy once they got into ketosis. Okay, it’s time to dig in a little bit more and figure out something else is going on. So…
Dr. Guillermo Ruiz:
More interestingly is that… So there are certain situations where that ferritin becomes very important. For example, women that have low ferritin, very common and very underdiagnosed, okay? So in fact, let’s take one step back. Let’s talk about anemia. What’s anemia? Okay. My favorite definition of anemia is anemia is the inability for your red blood cells to bring nutrients to your other cells. Okay? So you can get it to a car accident, you start bleeding, you have anemia blood loss, because you don’t have enough blood to bring all those nutrients. You can have a B12 abnormality, and you can have pernicious anemia, so now the B12 is not there to create healthy cells. Or you can have iron deficiency anemia, iron being super necessary for life. Iron helps bind oxygen. Now imagine you have low levels of iron, now you are literally asphyxiating while breathing, okay.
Dr. Guillermo Ruiz:
So, because of society… It’s very funny. I was in Toronto, and I went to this steakhouse with [Luis 00:32:08] and [Tyler 00:32:08]. And we’re sitting down, and I’m about to order a steak, okay? And I look at the steaks, all the steaks were between 900, 1100 calories. Then I was looking at the salads, and those salads were 13 to 1600 calories. And what do we teach society? “Oh no, you don’t order a steak. You’re you’re a girl.” And now you’re eating more calories with less nutrition than if you have ordered steak, okay? Plus females have a period. So now you’re shedding a little bit of blood, and if you have problems with insulin, and you have PCOS, and you have things like that, now you’re going to be even more anemic.
Dr. Guillermo Ruiz:
On the opposite side, guys we evolved to be hunter gatherers. We were supposed to go to war and we were supposed to get into fights and get injured. So guys have the opposite. We tend to hold onto iron tightly. So when I see a guy that is anemic, my ears perk right away. There is a leak somewhere, and we need to find it and plug it, because we can get into the same problems that conventional medicine gets. And it’s like, “Oh, you’re anemic, here’s your iron.” Yeah. Let’s replace it, but why are you bleeding as a guy? [crosstalk 00:33:42].
Dr. Guillermo Ruiz:
When I see a woman that has high levels of iron, yes, very pro-inflammatory. So one of the cool things that your body does, it’s called anemia of chronic disease, okay? And when you have anemia of chronic disease, the body grabs all those iron molecules, and it stores it in ferritin. And the reason it does that is to put it away, hide it from bacteria and viruses, because the virus and bacteria use this to procreate. So then you are anemic, because you’re not utilizing your savings and then there’s still a infection. So if you were to treat a person with anemia of chronic disease, with iron, you can have increases in levels of bacteria, and your infection becomes worse. The WHO has a paper about some good Samaritans that went to Africa, and they were testing for iron deficiency on kids. And they were giving them iron supplements, and they were dying at a higher rate from malaria, because their body, it was so wise that it was like, “You know what? We’re going to make ourself anemic because it’s going to keep us alive for longer.” Okay? While we deal with this malaria.
Dr. Guillermo Ruiz:
So in that case, in a woman that has high levels of iron, we have to investigate why. So, you can get into the thing where you just do blood draws, therapeutic phlebotomy, but if there is an infection, until you fix that infection, that’s when those ferritin levels are going to be like, “Okay.” The infection is gone, and now you can rush that iron back into where needs to be.
Carole Freeman:
Well, and also with the history of weight loss surgery as well, where the intestinal tract has been modified, that’s going to affect… People have a much harder time absorbing all nutrients, right?
Dr. Guillermo Ruiz:
All nutrients, yeah. In fact, if anyone that’s listening has had stomach reduction surgery, or [inaudible 00:36:02] or whatever, one thing that you can do really easily is get bariatric specific vitamins, which they make. And there’s a couple of different ways of taking them. There’s liquid forms, there’s there soluble ones, because you’re right, shortening the digestion, lowering the digestive power is going to prevent you from absorbing things.
Carole Freeman:
I have another friend that has been talking with me for years of about, “How do I do keto?” And it turns out that he’s got decades long chronic fatigue, and not in any chronic fatigue syndrome, but just always he’s felt fatigued. And so I had a suspicion that he likely had iron overload, and same thing where it was like his physician wouldn’t order that. And I finally had him, “Just go get it yourself.” And the number came back at seven or 800. And I was like, “Okay, here we go. This goes along with… You need to…” And then I said, “You need to find a doctor that can deal with this for you, because…” And so he went to three different doctors, and they all said, “I don’t think…” Because it… Also, I have suspicions that maybe that he has familial hemochromatosis.
Dr. Guillermo Ruiz:
Yeah.
Carole Freeman:
His father had just passed from Alzheimer’s and I know that that’s… There’s a correlation with that as well. And I said, “This is really important that you go get this investigated and you get this checked out.” But doctors would say, “Oh, well, the other numbers are fine. So I don’t think that’s what this is. You’re just overweight right now, so just lose the weight.” But they hadn’t really investigated further to see that this was something that… This fatigue is something he’d had for decades. And it wasn’t something that was just new with recent weight gain. And so I gave up on trying to save him, because I was… I kept trying to say… And I’ve referred him to you as well to just get another a opinion, because everybody else was telling him like, “Ah, that’s nothing to worry about. No big deal.” And, so…
Dr. Guillermo Ruiz:
Yeah, iron is very inflammatory. Iron literally oxidizes things. Iron is so necessary not just to bring oxygen to your cells, but it is an integral part of your immune system, and we use iron to oxidize bacteria. So, yeah.
Carole Freeman:
Interesting.
Dr. Guillermo Ruiz:
The only thing that we fight now is our keyboards, and we are not shedding blood like we used to. We are not at a mismatch, and it can be as simple, Carole, as just donating a little bit of blood, donating a couple of pints of blood, keeping in mind not to go over the levels. And then see how you look, feel and perform like Rob would say, and it could be a very, very simple fix.
Carole Freeman:
Yeah. Yeah. So I wanted to talk also about just defining metabolic optimization, and then… Also then get into the thyroid thing, which I know you’re really passionate about. So just some basics of what is metabolic dysregulation? What’s metabolic optimization?
Dr. Guillermo Ruiz:
We can get in a lot of trouble with the way that we live our lives. The best theory, the best hypothesis for iron overload, sorry for insulin resistance, okay. For insulin resistance. The best hypothesis and something that I follow really closely is the calorie imbalance. Having high levels of energy coming in, and every time you push a molecule of glucose into the cell, and goes into the mitochondria and does its thing, it creates reactive oxygen species, okay?
Dr. Guillermo Ruiz:
So it’s like parking your car inside garage and having it running. It’s going to create a lot of CO2, and if you stay inside the car, you will die. So basically when we’re just pushing, pushing, pushing, pushing the energy consumption, it is better for the cell to say, “You know what? We’re going to stop accepting insulin to stop creating those reactive oxygen species.” So it’s like turning off the car. And there are a lot of cellular models where they… If you want to make cells in the lab, insulin resistant, grab the Petri dish with the cells, and you put… You ozone down, you put ozone, and the ozone causes a lot of oxidative damage. And then glucose won’t go into the cell, insulin receptors get down regulated.
Dr. Guillermo Ruiz:
There is a study of people with high levels of iron that were type 2 diabetic. They gave them a chelating agent called deferoxamine without any changes, without anything, as soon as those oxidative levels of iron went away, they stop being insulin resistant. Okay. So there is a component to oxidation. Okay. And if we lived in backwards world where the pyramid looked very different and we were pushed to eat unlimited amounts of fat just like they pushed unlimited amounts of carbs. And then we had a very, very restrictive, low carbohydrate diet. And we… And all of this come companies made this delicious, full of preservative junk food, which we have some, we would have something very similar, but instead of being insulin, we would be looking at a different hormone.
Carole Freeman:
That’s what my fear right now with this, most of the keto snack food products that are out there, they’re not doing us any favors.
Dr. Guillermo Ruiz:
No, no.
Carole Freeman:
Because they’re just as tasty… I don’t know. Arguably, let’s say a keto version of a Ding Dong and a non-keto Hostess version, arguably I don’t even know that the keto version would be that much healthier. Maybe just slightly less trigger overeating than the other version, but leading to…
Dr. Guillermo Ruiz:
I’m going to say, firstly, I would rather my patients eat an apple than a keto donut. And it’s like, it’s… I had a patient today. She was like, “Well, doc, I’m doing some… I’m doing a little bit of fruit. I’m having some blueberries.” And I’m like, “What? Why are you apologizing?” The pro problem is that even a little bit of fruit can be a trigger for other things.
Carole Freeman:
Right.
Dr. Guillermo Ruiz:
It can definitely be a trigger, but I’m… Before I found out that I had autoimmune viral disease, this is last year around March, April. My weight just skyrocketed. I got up to 189 pounds, and I was doing everything and anything that I know to do to lose the weight, and it wouldn’t budge, it just wouldn’t budge. I was… And I’m a doctor, and I have to respect that… Sometimes I see patients face to face, so I have to be very, very careful with infections and stuff like that.
Dr. Guillermo Ruiz:
So I can count in one hand, how many times I went out to eat at a restaurant in 2020, I was cooking all of my meals. I was… Everything, organic, everything… All of that. And I kept gaining weight. So I started doing OMAD, I started… At one point Carole, I was running laps around the parking lot in the summer heat, I haven’t done cardio in six or seven years, and my weight wouldn’t drop. So I ran some labs, and I went to a doctor because a patient that treats himself… A doctor that treats themselves himself has [inaudible 00:44:36] patient, and I had a lot of input. I got to admit, I had a lot of input in what he was doing.
Dr. Guillermo Ruiz:
Yeah, my thyroid was broken. And then I realized when I was looking at my trackers that I was eating too damn much. I was [inaudible 00:44:58]. I was eating… One of the hobbies that I had decided to pick up during this global pandemic was, I wanted to start getting into wine, so I would go to Whole Foods and I would buy myself a rib-eye steak or a New York strip. And I would make myself a sweet potato, put some bacon in and butter, and some Brussels sprouts with foam broth, all really, really healthy food, but that was clocking in around 2,600 calories for one meal.
Carole Freeman:
Oh, okay.
Dr. Guillermo Ruiz:
For one meal. And then I would open a bottle of wine, and that bottle of wine, that one glass of wine turns into a bottle of wine. And when I started quantifying what I was eating, I was like, “Damn, dude you can put a bunch of calories out.” So then, Louis and Tyler twisted my arm and I did a Ketogains bootcamp. And when I was trying to do my Sunday meal, okay. If I was… If I wanted to have a steak, some Brussels sprouts, and forget about the sweet potato, I modified it. And I was eating a Sirloin steak, which is way lower in fat. Forget about the Brussels sprouts, I would’ve had to eat seven Brussels sprouts to fit my macros, seven. Who wants to eat seven [crosstalk 00:46:38]? Instead I switched that to a half a head of cabbage. And I don’t know if you’ve ever roasted a head of cabbage, it’s the most delicious hack I’ve ever… You roast half a head of cabbage, a pound of Sirloin, and then some pickles or, whatever. I was as full, as eating that 2300 calorie meal by eating 600, 700 calories.
Dr. Guillermo Ruiz:
So yeah, our ability to pack in a bunch of calories in a healthy meal is essential, and it’s going to continue that way. Now, hey, I love whiskey. I love wine. I love me a steak. And I don’t want to eat Sirloin steak and half a cabbage for the rest of my life, but what am I doing? I am chunking my time and trying to keep at an appropriate weight level for me, so I can have that bottle of wine every once in a while, that Bourbon.
Dr. Guillermo Ruiz:
I’m doing this because I enjoy life, and I want to be there for my patients, and for my family and for my friends. I don’t know if you’ve ever heard, people come to you and say, “I just want to be off of all medication. I want to be off all medication.” Now, it is going to be on your deathbed and be like, “You know Carole? She never took a leap.” No, one’s going to say that when you’ve died. What they’re going to say is like, “Carole helped thousands of people. She was… I could call her at midnight and she was there for me. I could… Carole had so much energy, and she was so vibrant. And she was able to rescue kitties and kick ass at the gym.”
Dr. Guillermo Ruiz:
And that’s what people are going to remember. So if it takes you, taking a little bit of thyroid medication, taking some supplement, doing periods of time where you restrict calories, where you restrict carbohydrates, and when you are super [inaudible 00:49:01] about what you eat, in order for you to have that vibrant life, in order to enjoy life. Why not do it?
Carole Freeman:
So what’s your sense then? So are you saying that you developed autoimmune thyroid issues, because you were overeating? Do you think that’s the driver of it? Or what’s… Tell me about your theories-
Dr. Guillermo Ruiz:
[crosstalk 00:49:27].
Carole Freeman:
… your take on what causes thyroid disruption? What makes it not work right? Because I’ve got… So working with you, we’re working on supporting my thyroid a little bit. So a little bit of maybe some autoimmune thyroid, not sure exactly. But my cat, one of my cats who’s 17 years old has hyperthyroidism, he has too much thyroid. So it’s interesting that both of us in the same household are experiencing the opposite sides of that.
Dr. Guillermo Ruiz:
So autoimmune thyroid disease has been pretty much… It has been studied for a very long time and it happens when your stress levels become so high, that your immune system goes haywire and it starts attacking something that it shouldn’t be attacking. The first case of autoimmune thyroid disease was recorded in France from a little girl who fell down the stairs, broke her back. Yeah. And then she became hyperthyroid. Okay, So hypothyroidism and hyperthyroidism are basically the same disease, just two sides of the coin. Why do we develop thyroid disease? We live in a very, very dirty environment. There is not only inflammation from all of the bad stuff that we eat, but we have lots of pollution in the air, mold, heavy metals and then a genetic predisposition. So what ends up happening is that women usually get diagnosed with autoimmune thyroid disease after the birth of their first kid.
Dr. Guillermo Ruiz:
So what is the most stressful time in a woman’s life? Is usually… If they decided to have babies, usually going through a pregnancy and delivering a baby. I have… As a doctor, I’m a chronic hypochondriac, it’s like, we… In the healthcare field, we are always looking at stuff. And my mom, both of my sisters, we have a long history of thyroid problems. So, ever since I was in school, I’ve been checking my thyroid thinking, “It’s going to break, it’s going to break, it’s going to break.” So, 2020 was my baby. I didn’t lose my job. I decided to open a new practice. I’m a type A personality, adrenaline junkie and the stress was enough for that change to happen.
Dr. Guillermo Ruiz:
And sure enough as soon as I started taking the thyroid medication, I remember going into the living room and being like, there’s something wrong. Two o’clock in the afternoon and be like, there is something wrong, I’m just going to lay down and close my eyes for a couple of minutes, and then just give me 20, that’s not me. And as soon as that thyroid kicked in, man it was like all that energy that people talk about when they wake up, all that stuff started, you’re just through the roof. The funniest thing, Carole, is that I am hyper aware of these things. For many years, my thyroid would test between 1.1, 1.3, on the TSH, thyroid stimulating hormone. Thyroid stimulating hormone is a hormone that’s produced in the brain that orders the thyroid to make more thyroid.
Dr. Guillermo Ruiz:
So the higher that number is, the more hypothyroid you are. Okay. So my TSH was between 1.2, 1.3, 1.15. Guess when my thyroid broke?
Carole Freeman:
March of 2020.
Dr. Guillermo Ruiz:
It was… Probably, it clocked in probably April or May at 1.89.
Carole Freeman:
Okay.
Dr. Guillermo Ruiz:
1.89, which is, well, well, within the range.
Carole Freeman:
Oh, you saying, what level was it? Okay. Yeah.
Dr. Guillermo Ruiz:
Which is really funny because I started dosing with thyroid medication, and I started with a… So I thought to myself, “Okay, 1.8 to 1.15, I probably just need to baby those thyroids.” So I started with quarter grain of thyroid, checked my levels and my levels actually went up. So my theory was that my brain was like, “Holy shit, it’s working. Finally, you’re listening to me.” So then I went to half a grain, three quarters of a grain and once I hit 16 milligrams or one grain of natural [inaudible 00:54:35] thyroid, my thyroid right now is about 0.97, 0.8. But it was insane that a lot of people think that, “Oh, the higher the number, the more thyroid you need.” Not necessarily, not necessarily.
Carole Freeman:
Fine tuning and adjusting. Okay, well that makes sense then, because last year was stressful for a lot of people. Not only was there global pandemic, but I also chose to pick up and move, living in the Northwest for almost 50 years of my life and then moving down to the desert and lot of stressors. And then I had one more move, I moved to another place about three months ago as well. So that correlates with my issues popping up.
Dr. Guillermo Ruiz:
[crosstalk 00:55:25].
Carole Freeman:
Yeah. Yeah. All right.
Dr. Guillermo Ruiz:
What sucks is that our bodies are resilient. Our bodies are resilient, so you probably have had a need for thyroid that was not overt. Okay, so you probably had a need for thyroid that didn’t appear as a highlighted thing on your labs for a long time. So seeing those numbers.. Seeing those numbers, as you know in a functional way, makes a whole lot of difference in how fast we can diagnose an autoimmune disorder.
Carole Freeman:
Interesting.
Dr. Guillermo Ruiz:
And then there’s other things that show up, so what is a thyroid? I’m not sure how much time we have, but I can talk forever. What does the thyroid do? The thyroid, it’s basically your metabolism, it helps with your metabolism. It makes your things work. The reason why people lose their hair is because thyroid unlike insulin, thyroid hits every cell in your body. We have some passive receptors in our brain for sugar where you don’t need insulin to activate, but thyroid hits every cell in your body. So imagine if you’re going hypothyroid, what is your body doing? And we really need hair. What’s more important to have, to continue breathing and your brain working, do we really need hair? So it starts shutting down things systemically, non important things go first, and that’s why we start being really cold. We start losing our hair.
Dr. Guillermo Ruiz:
And then your thyroid starts to grow because your brain is yelling at your thyroid so much that your thyroid is like, “I don’t know what to do, dude. I can’t make anymore. So let’s start growing, get more surface area, and try to meet demand.” And that’s when we can start having cysts, nodules and problems where those could develop into thyroid cancer. So early detection with antibodies and an ultrasound is so important to prevent that.
Dr. Guillermo Ruiz:
One thing… So again, the thyroid is trying to break down things and one problem that I see a lot with my keto people is cholesterol. Sometimes cholesterol goes really, really high, and I have a lot of tolerance for cholesterol. We know that cholesterol levels have a U curve. Can I share my screen?
Carole Freeman:
Well, let me… I’ve… If it lets you, sure. Let me see, do I have to do anything?
Dr. Guillermo Ruiz:
I don’t know. I think, let me see.
Carole Freeman:
I don’t know if… Let’s see, edit mic settings. I think I only have the option to do that. I don’t know. Oh, oh, here we go.
Dr. Guillermo Ruiz:
Look at that.
Carole Freeman:
Teaching me tricks here.
Dr. Guillermo Ruiz:
Yeah. So, I have this know this patient, come to me, and he lost a bunch of weight, changed his lifestyle, was feeling like a badass, and 60 year old dude. And this is his change.
Carole Freeman:
Wow. Yeah.
Dr. Guillermo Ruiz:
And his doctor tells him, “Your cholesterol is high. I don’t care if you have more energy. I don’t care if you have a six pack.” He’s my spirit animal. I want to be like him. “Yeah, you need to change what you’re doing, because your cholesterol… You’re going to die of a heart attack.” So these are his labs, and they’re very small so I’m going to read them. There you go. So check this out. So his liver function was high, his cholesterol was 224.
Carole Freeman:
Oh. Which.
Dr. Guillermo Ruiz:
And they were freaking out telling him-
Carole Freeman:
Yeah, I know, that looks good to me.
Dr. Guillermo Ruiz:
Yeah. Telling him to go back… Look at his triglycerides, look at his HDL.
Carole Freeman:
Yeah.
Dr. Guillermo Ruiz:
So, I want to show that there is a U curve with cholesterol.
Carole Freeman:
Well, if I can share a little story of when I was in… When I was in school and whatever class it was, where we’re learning about cholesterol levels and recommendations and the correlation with mortality, basically mortality. And there was a bell curve there. And it showed that if somebody’s total cholesterol was 180, the same risk as it… My hands are off here, but at 220. And this was at the time where they just arbitrarily at that time had said, “200 was the cutoff of your total cholesterol.” Now they’ve moved on to just focusing on VLDL.
Carole Freeman:
But this was the time when they were just focused on total cholesterol. And so they said, “Total cholesterol above 200, problem.” And so I raised my hand, and asked my professor, I’m like, “Wait a minute. Why did they pick that number when you actually have a lower risk at 220 than you did at 200?” And she said, “Well, it was just a nice round off number, easy to remember.” And I’m like, “This is blowing my mind.” That it’s not even about health, it’s not even about optimal health. It’s just, “We got to draw the line somewhere. So let’s just pick a number that’s easy to remember.”
Dr. Guillermo Ruiz:
And this is exactly what is showing right here. If you go below 180, you have a higher risk of all death, all cause-mortality. And if you go and… But this is the thing, Carole, if you go above 300, you start losing… You start losing the benefits. So we have to be… And that’s where our bias can bite us in the ass. So, there are a couple of people that say, “Oh, no, it’s a cholesterol hybrid… Lean mass hyper responder.” No, at some point we have to make sure that we are taking care of our patients, because sometimes that can be a problem. So we were looking at his numbers, and I found out that his thyroid was at a 3.5.
Carole Freeman:
Oh, wow. Yeah.
Dr. Guillermo Ruiz:
And his microsomal antibodies, 33. Now check this out less than 60 is okay.
Carole Freeman:
That’s what the lab says. Yeah.
Dr. Guillermo Ruiz:
And I’m like, okay, so you’re in your castle, and you have 33 people outside attacking your castle. Are you going to be like, “You know what? No, let’s wait until 60 get here. And once 60 get here, we’ll do something about it.” No, let’s do something about it now. And now these are his levels. His liver functions are better, his cholesterol is too low now.
Carole Freeman:
Wow. Yeah.
Dr. Guillermo Ruiz:
Yeah. But look at his his triglycerides, his HDL’s beautiful, VLDL is beautiful.
Carole Freeman:
Interesting.
Dr. Guillermo Ruiz:
And his thyroid is perfect now. So, basically…
Carole Freeman:
We’ll be very curious then to see how mine does, because tended towards high cholesterol my whole life. But I was like, pre-keto metabolic syndrome definitely had metabolic syndrome. my total was between like 220 to 240-
Dr. Guillermo Ruiz:
Which is not [crosstalk 01:03:30].
Carole Freeman:
But that was mostly high triglycerides, they’re probably… I think my triglycerides were 220 . And HDL has always been very low for me, like 32, 34. And so the picture of metabolic dysregulation, right? And so going keto, more my personal story here, but I’m trying to remember how far I was in… I was working some health events where we had access to the little cholesterol measures. And I had been weight stable at this point for six months. So I lost 60 pounds, feeling the best I’d ever had. And one of my co-health advisor people… We’re working this event, and I was like, “Hey let’s sneak over and check… Let’s check my cholesterol. Let’s see that… I haven’t checked any of my numbers or anything.”
Carole Freeman:
And again, this was weight stable, because they say you want to check it. Actually, I don’t think I had been, now that I think about it, because I thought… I was like, “Okay, maybe it’s just because I’m still in… It has been six months of being weight stable.” But my number, that check I got, was my total was 400 something, my LDL was 380, my HDL was still less than 50. And I was just like, “Oh my God, what happened here?” And I was in shock, but I felt the best I’d ever felt. So I was just like, “I don’t know what to do with this information.” And it’s calmed down much since then, but I still don’t fit into the optimal range. And really the last lab… So me following low carb, mostly keto for six and a half years now, my HDL has come up to 55, the highest it’s ever been my whole life which I think is good.
Carole Freeman:
And my triglycerides tend to be 90 to a hundred, but my LDL still runs much higher than what the doctors would say, so my total is somewhere in the 300s. And so I’ll be very curious to see with this thyroid medication coming on board, what my cholesterol panel start look like.
Dr. Guillermo Ruiz:
And a couple of things, I don’t know if you noticed I’m Mexican. And then, people from the equator, people that have ancestrally more access to carbohydrates have less access to saturated fats.
Carole Freeman:
Okay.
Dr. Guillermo Ruiz:
So I tend to hold on really tightly to saturated fats. So if I do a ketogenic diet, which I do. And I do things like, coconut oil, lard, things like that, my lipids go up, but if I switch my saturated fats for monounsaturated fats, meaning instead of cooking with coconut oil, I use avocado oil or olive oil. I use my butter, butter increases your lipids more than almost any other food stuff. if I use butter… I use butter as almost like a seasoning meaning, I’ll make some collard greens, put it on the plate, and then I’ll put a dab of butter, and eat as a seasoning, not as the main cooking oil.
Dr. Guillermo Ruiz:
And just modifying the saturated fat that I add, the added saturated fat, I really don’t worry about meat, I really don’t worry about like chicken thighs or things like that. Just the added saturated fats helps keep my lipids around 201, 206. Yeah. That little change, but yeah, no, my lipids can go sky high if I start using coconut oil, if I start using my main cooking, I use saturated fats.
Carole Freeman:
Yeah. I’m primarily European descent, so.
Dr. Guillermo Ruiz:
Yeah, it would be a cool experiment because-
Carole Freeman:
One thing at a time, we’ll see what the thyroid modified.
Dr. Guillermo Ruiz:
I bet the thyroid turned up those numbers, but it’d be coolest experiment because in reality, it’s not that hard. It’s not something as leaving carbohydrates, that’s difficult, but instead of buying coconut oil, buying avocado oil, that there’s no flavor in it and it’s a very easy switch.
Carole Freeman:
I love Bariani olive oil, I don’t know if you’ve tried that or not, but-
Dr. Guillermo Ruiz:
Yeah. Cool, so olive oil…
Carole Freeman:
Fresh from Italy. Yeah.
Dr. Guillermo Ruiz:
Olive oil, monounsaturated fatty acids, that’s going to be very, very helpful.
Carole Freeman:
Yeah. Yeah. So one last question for you. You threw this idea out to me, which has my head spinning, and I’ve been chatting with my clients about this, but your take, your position for women is that they shouldn’t really do intermittent fasting, and that they should be eating three meals a day. So talk to me about that. What’s your experience with your patient clients with that?
Dr. Guillermo Ruiz:
That’s a really awesome thing. That’s a really awesome topic, especially talking to a female health enthusiast, because it just so happens that a lot of the people that are putting this ideas out are guys. So you have some guy telling you, “I personally do intermittent fasting. I do a lot of intermittent fasting, it makes me so much more efficient. I don’t have to stop and eat.”
Carole Freeman:
And I personally have just… I’ve never been hungry in the morning. I prefer, so I’ve just… Usually my first meal is in the afternoon. I just wait until I’m hungry to eat, and then I eat. And that’s what I’ve been directing all my clients to do as well is to not force yourself to eat. I find that if I eat first thing in the morning, that I’m hungry the rest of the day, but I also know that that’s a sign that your metabolic rate is increased is if you’re hungry. And yeah, I come from a family of people, my mom, for example, never ate breakfast, almost never ate lunch. She always just ate one giant meal at the end of the day. I remember growing up and telling her like, “That’s so bad for you. You got to eat six times a day.” I came through that time of health and stuff, so.
Dr. Guillermo Ruiz:
Yeah. And I love OMAD, and I’ve done OMAD a whole bunch of times. And the first thing that I do when my adrenal function is falling is I have breakfast. That is the first thing that… For example, if I’m waking up in the middle of the night and I’m using the bathroom, if I feel fatigue, if I know I’m going to be under a lot of pressure, the first stressor that I remove is intermittent fasting, two types of stressors.
Carole Freeman:
Do you know the salt before bed trick for the waking up in the middle of the night?
Dr. Guillermo Ruiz:
So, yeah. So that’s going to maintain the levels of aldosterone a little bit lower, and it’s going to prevent you, but another trick that works, you don’t even have to do salt, you can do a little bit of carbohydrates. So, yeah. So that’s the thing, you are gaming the system.
Carole Freeman:
I’ve done the carbs before bed my whole life, that didn’t do me any favors.
Dr. Guillermo Ruiz:
So, when you’re stressed, you’re going to release cortisol, okay? So cortisol released, you release glucose, and then that’s going to retain water. And that water needs to end up somewhere, but the idea is to get carbohydrates, get salt, prevent the stimulation of the adrenal glands. So now you’re not releasing the hormone that is going to retain water, and now you don’t pee. Okay. So thought experiment, or I’m going to ask you four questions.
Carole Freeman:
Yeah. Yeah.
Dr. Guillermo Ruiz:
How many calories does it take? Well, before we do that. Okay. So the… Let’s see if we agree on this. The healthiest a human being can be is when they are fertile.
Carole Freeman:
When they are fertile. Yeah, yeah, yeah.
Dr. Guillermo Ruiz:
Yeah. Yeah. So being-
Carole Freeman:
Oh, I’m downhill. I’m going.. I’m done.
Dr. Guillermo Ruiz:
Well, we have HRT we can do. When… So the body is going to do anything and everything to prevent, to… Our lesser brain, we just want to procreate. And that’s why we have this innate want for calories, and that’s why we bypass things, and we can eat, and eat, and eat, and whatever. Okay. How many calories does it take for a guy to produce one load of ejaculate?
Carole Freeman:
Oh, just… Oh, I don’t know the exact question is like… Everything it takes to metabolically create it, or just how many calories equivalent is that?
Dr. Guillermo Ruiz:
Just to metabolically have the savings in order to be able to procreate.
Carole Freeman:
I don’t know, 2,500 calories, I’m just going to…
Dr. Guillermo Ruiz:
- 140 calories. 140 calories and that’s it. 140 calories you can procreate. Okay.
Carole Freeman:
Okay.
Dr. Guillermo Ruiz:
How many calories does it take for a woman to create a baby?
Carole Freeman:
Oh my gosh. Well, let’s see. I know back from school, it was 250 calories a day in your first and second trimester, and then 500 there. Or is it 250 a day average for the whole pregnancy, and then 500 a day for lactation. I can’t remember the exact numbers, but a lot.
Dr. Guillermo Ruiz:
75,000 calories which equal… So, 75,000 calories, if you do, over nine months, it’s around 150 extra calories per a day. So that’s 150 extra calories per day, that doesn’t mean that’s going to give you all the calories you need for your own things. The reason I’m bringing this 150 calories a day is because that preconception of, “Oh, you got to eat for two.” No.
Carole Freeman:
Right.
Dr. Guillermo Ruiz:
You don’t need to eat 4,000 calories a day, okay. So women have a smaller trigger, okay? For hormone dysregulation from calorie restriction.
Carole Freeman:
Okay.
Dr. Guillermo Ruiz:
Where guys, if you skip one meal, you’re going to make up 140 calories by the lunch and dinner. And women are going to be… You skip one meal, your pituitary is already freaking out, “Oh my goodness. Oh my goodness.” And it stops… It starts making you tired by diminishing the amount of metabolic things that it’s going to produce. Now, what does that mean practically? What does that mean practically? Does it mean that no woman should use intermittent fasting? No, intermittent fasting is a really cool way of reducing calorie intake, because you are skipping one meal. The thing is that you have to work with someone that knows their shit to tell you exactly how many calories you need in a day.
Dr. Guillermo Ruiz:
So if you do calorie restriction with appropriate nutrition, CRAN, calorie restriction with a proper nutrition where you are eating enough calories in a day to satisfy those physiological things, you’re going to be okay. Additionally, another hack that you can do is that you really don’t need that many calories. So avoiding… Doing intermittent fasting doesn’t mean that you need… That you are going to do zero calories. In fact I… Yeah, I don’t know how many people are going to be pissed off at me for the saying this, but intermittent fasting is not like, “Oh my goodness. I just tasted a little bit of cream, I’m out of the fasting state.” No, it it’s a gradient. In fact, yeah. Dr. Valter Longo has a product where you eat all day, and you are doing intermittent fasting.
Carole Freeman:
Well, don’t bring up the Fast Bar, that’s a whole lie, but anyway.
Dr. Guillermo Ruiz:
But listen, I’ve done it. He sent me a box very early on, and I was hungry the whole day because I would rather not eat. I would rather not eat, then once I have something, forget about it.
Carole Freeman:
Yeah. I’m the same way. Yeah.
Dr. Guillermo Ruiz:
But the thing… What I’m trying to say is this, it can be as easy as okay, doing a protein shake in the morning, getting 25 grams of protein in the morning. You will not completely shut down the the… All of the benefits from fasting, and you will support your hormonal health. Now, if you have a hormonal problems, you should work to get those hormones to where they need to be. So then you can earn the ability to do calorie restriction with appropriate nutrition.
Carole Freeman:
So you’re saying… I’ve never heard this CRAN thing, love it. So is it more… Is it along the lines of what Marty Kendall’s doing with his Nutrient Optimization? So really focusing on nutrient dense foods.
Dr. Guillermo Ruiz:
In the sweet spot, Carole, is for hormonal health, because let’s be honest about it. If you want to lose weight, at some point you have to cut calories. To protect that hormonal health, being around 60 and 75 grams of fat in a day, that helps you. Because remember, hormones have a backbone of cholesterol. So, for example, if you were doing intermittent fasting and you are doing it on a high carbohydrate diet where you don’t have enough fat, your hormones will suffer more than if you doing an appropriate calorie restriction with enough cholesterol and enough fat to help you maintain your hormonal level. And so there’s two types of stressors in this world.
Dr. Guillermo Ruiz:
Traffic is a stressor you cannot control. Deadlines, your job, those are things that you cannot control. There are stressors that you can control. For example, exercise, fasting, those are things that when I am getting super stressed, those are the first things that I am going to start cutting back and easing up on. But what we hear is, “Oh my God, I’m so stressed out. I’m going to eat that Ben and Jerry’s.”
Carole Freeman:
Right. Right.
Dr. Guillermo Ruiz:
And now you’re admitting that you’re super stressed. And now you are adding more junk, which is going to stress your body even more. The more stressed we are, the less leeway that we have for this hormetic stressor. So someone that is metabolically deranged, or has hormonal problems is going to have less of an ability to have that intermittent fasting, but you can earn it if you’re sleeping well, if you’re eating really healthy food, if your hormones are better, then you can earn that ability. So what happens is that all these guys who, we can fast like nothing, we get on social media, and we talk about fasting. And then women do it, they fail at it because physiology. And then they double down, and they go, “You know what? Fasting 14 hours didn’t work, I’m going to go 16. You know what? I’m going to do 18. I’m going to…” And then they get deeper and deeper in the hole.
Dr. Guillermo Ruiz:
And that’s why I am so happy and so proud to have met you, because we need more women in healthcare. Because 90% of the people that I see are women, and they should be listened. And we should be able to take care of women by women, because it’s going to be completely different than what works for me.
Carole Freeman:
Yeah. Well, excellent. Thank you so much. Amazing. I should make a little… I’m going to make a little banner here really quickly so that people know where to go. Is it okay if you… If I send you some more people?
Dr. Guillermo Ruiz:
Oh my goodness. Yeah. You send them.
Carole Freeman:
Okay.So… Here we go.
Dr. Guillermo Ruiz:
And most importantly, the best thing you can do is just send an email to M-E-G-A-N dot M-A-C-K, megan.mac@atgohealth.com. And tell them, we’re going to do a special rate for people that you send us, people that are part of your program.
Carole Freeman:
So Megan… What was the… Megan at?
Dr. Guillermo Ruiz:
Megan.mac.
Carole Freeman:
Say what?
Dr. Guillermo Ruiz:
Megan. Megan period. M-A-C-K @atgohealth.com.
Carole Freeman:
M-A, oops, A-C-K. Okay.
Dr. Guillermo Ruiz:
Yeah. And just-
Carole Freeman:
Is that right? Did I spell it right?
Dr. Guillermo Ruiz:
Beautiful. Yeah. That’s it. Just send an email. Before I do anything, I do like to sit with prospective patients for 15 minutes for a couple of reasons-
Carole Freeman:
That’s this one here, atgohealth.com for… Okay.
Dr. Guillermo Ruiz:
Yeah.
Carole Freeman:
But you’ll take care of that for…
Dr. Guillermo Ruiz:
Yeah. And I like to sit with them, and I like to do a free 15 minute consultation to see if we are… A lot of times I go, “You know what? Now I go talk to Carole. I’m not a nutritionist, I’m not… You would be wasting your time. Why don’t you do her program first? See what gets better, and then if that doesn’t get fixed, then you can come to me.” But I’m going to give them a special rate for people that are part of your program. Yeah.
Carole Freeman:
Excellent. Excellent. Well, thank you so much for everything. Like you said, I’m sure we could talk all night long. I’m supposed to go meet my friends for dinner. They just don’t understand this lifestyle change thing. Unfortunately, both of them are on various medications, they just think like, “No, I have to be on Lipstatin that’s because I have a statin deficiency. That’s why I need to be on those.”
Dr. Guillermo Ruiz:
Yeah. The only thing we can do for our friends and family is be an example.
Carole Freeman:
Yeah. Yeah. We talk about anything but nutrition. I’m off the clock when I’m hanging out with my friends and…
Dr. Guillermo Ruiz:
Yeah. We can be an example, and when they see the light, when they see… When we shine, they’ll see it, and that’s when they’ll… On their own accord, they’ll be like, “Help me.”
Carole Freeman:
Well, thank you so much for everything you’ve shared, so much good stuff. So thankful that I’ve met you, and have to be able to share you with the world too.
Dr. Guillermo Ruiz:
Let… Remember we’re going to give you that iron deficiency, iron book.
Carole Freeman:
Okay. Yeah, yeah.
Dr. Guillermo Ruiz:
Yeah. And so, I’ll email that to you and then we’ll talk soon.
Carole Freeman:
Yeah. I’ll wrap. Let me close up this broadcast. Thank you everyone for watching. We’ll see you all next time. Bye.
