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Insulin Resistance, Type 2 Diabetes, and Thyroid Health: An Interview with Dr. Beverly Yates

On Friday April 9th I interviewed Dr. Beverly Yates on insulin resistance and type 2 diabetes, and below is the written transcript. If you would prefer to watch the interview you can access it by clicking here [1]:

Here is the transcript:

Dr. Eric:                                                                                       

I have a very special guest, Dr. Beverly Yates. Dr. Beverly is a diabetes expert and author who has over 27 years of experience working with those who struggle with blood sugar issues related to Type 2 diabetes and prediabetes. And she is the creator of the Yates Protocol, which is a simple and effective lifestyle-based program for people who have Type 2 diabetes or prediabetes. It helps them to achieve blood sugar control, healthy A1C, and fasting blood sugar levels.

Dr. Eric:

Dr. Yates, she’s on a mission to help 3 million people heal from Type 2 diabetes and prediabetes. She is an internationally recognized speaker and expert in the field of diabetes and heart disease. She is author of Heart Health for Black Women, A Natural Approach to Healing and Preventing Heart Disease, and co-author with Jack Canfield of the Soul of Success, volume two. Dr. Beverly, I really look forward to talking with you about insulin resistance and Type 2 diabetes. Thank you so much for allowing me to interview you.

Dr. Beverly:

Hey, it’s my honor. Thank you so much, Dr. Eric, for reaching out. I’m delighted to have this conversation with you today. I hope we are able to help folks get motivated and to feel inspired and to have maybe some more clarity about how these things can happen, how they interact, and most importantly, what they can actually do that would be helpful for themselves.

Dr. Eric:

Yes, I agree. Why don’t we start out with some basics. For those who might not be familiar with insulin, if you could just describe what insulin is, why insulin is important.

Dr. Beverly:

Sure. Insulin is a hormone that is made in your pancreas, and it’s made in a particular part of the pancreas called the islets of Langerhans. And specifically as that’s secreted, insulin does some amazing things for you. It is what grabs up your blood sugar, also known as glucose, and makes that energy ideally available inside of your cells. Insulin does a lot of things for you. You don’t have to think about it consciously. This all happens in the background if your body still makes insulin. If you don’t make the insulin naturally, if you have no insulin production at all, then that person is a person who is diagnosed as a Type 1 diabetic. That is a distinction and that’s different than people who have Type 2 diabetes or prediabetes where their pancreas does indeed still make insulin and perhaps their body’s just not as sensitive to it anymore or is insulin resistant.

Dr. Eric:

Okay. So is prediabetes then the same as insulin resistance?

Dr. Beverly:

Some would say yes, some would say no. That could be a point of controversy and you could say it’s just wordplay, maybe it’s semantics. I think it like this. Prediabetes is watching this train wreck in slow motion. That’s how I explain it to my patients. And so a lot of people will comment and will say, oh, well, I’ve been watching this with my doctor for years and we haven’t really done anything about it. I’ll come back in six months. Then we test certain blood markers, whether it’s fasting blood sugar, or it is A1C, things like that. And then they’ll say, “Well, come back in six months. We’ll see how you’re doing. We’ll just keep an eye on your sugars.”

That’s a common conversation anywhere in the country, perhaps maybe even around the world, but certainly in the US this is often standard conventional medical treatment. And the person’s blood sugar unfortunately will often start to creep up, creep up, creep up, creep up over time. And then when they finally hit a certain number, then they have Type 2 diabetes. And to me, that’s watching the train wreck in slow motion. If you had an actual physical train on the tracks, Dr. Eric, would you be okay with watching that train wreck in slow motion?

Dr. Eric:

Nope.

Dr. Beverly:

Yeah. We’re on the same page. I know we are.

Dr. Eric:

So obviously diet and lifestyle play a big role with both insulin resistance and Type 2 diabetes. And I guess, because you also mentioned Type 1 diabetes, so how does Type 2 diabetes differ from Type 1? And there’s also…I don’t know if you want to get into Type 3 diabetes, but at least Type 1 and Type 2 and maybe differentiate between those two.

Dr. Beverly:

Yeah. People are more familiar with that. With Type 1, it’s one where there’s usually been an autoimmune attack on the pancreas and it has made it unable to produce insulin naturally. That’s typically what is the way Type 1 can unfold. Historically, it used to be something that happened at childhood, a sort of an illness, childhood onset. I definitely know adults who’ve had onset of Type 1. I think a lot of things are changing in our world, whether it is the chemical soup we’re all in, the amount of stress that we are under that is just relentless, etc. Any number of things I think can provoke that autoimmune attack. And so Type 1 diabetes is not strictly anymore just childhood onset.

Similarly, it used to be that Type 2 diabetes in any medical setting was always taught as being adult onset and usually older adults, people in their 60s, 70s, 80s. Now you can have unfortunately people with Type 2 diabetes in their 20s and even as young as 10 years old, which I think there’s a lot that’s wrong in that situation. And nutrition can play a huge part here, regular consistent exercise, but there’s also two pillars that people usually don’t talk about that are every bit as important. That is consistent, great sleep and being able to alleviate stress so that the person isn’t chronically and severely stressed, huge difference because sleep and stress can just run off with blood sugar.

People often accidentally become diabetic. They certainly aren’t trying to have health problems. And unfortunately, the way the conversation often goes, at least here in the US, and I know this is on the internet so people can see it from all over the world. But at least here in the US, people often talk about Type 2 diabetes and prediabetes with a tone of blame or shame as if people are trying to struggle and to have a hard time. I always want to dispel that myth and call out that nonsense right up, because it’s not fair, it’s not true. And it’s not helpful. No one’s trying to correct their health, but now here they have this situation. We need to be able to embrace people, have empathy and help them to make their situation so much better.

Dr. Eric:

You mentioned stress and sleep can cause blood sugar issues.

Dr. Beverly:

Yes, most definitely.

Dr. Eric:

And I guess it’s a little bit of a catch 22 because if someone has blood sugar issues, they might also have problems sleeping, correct?

Dr. Beverly:

One can be like a chicken and egg, which one came first. Similarly with thyroid. People often present with thyroid problems and they often say they’re fatigued. Well, when they have blood sugar issues, they’re often really fatigued. Fatigue is a tricky thing. There’s at least 80 things that could cause fatigue at least. It’s a big list.

Dr. Eric:

Yeah. A good point. There could be numerous causes of fatigue, numerous causes of sleep problems, not just blood sugar obviously. So when it comes to your patients, it sounds like that you, just like I do, I talk about the importance of stress management, importance of sleep in addition to eating well. So diet wise, and again, I don’t know how deep you want to get into the diet, but what typically do you recommend from a diet perspective? Do you recommend more of a ketogenic diet or more of a Paleo diet or just like a whole foods, low sugar, low carbohydrate diet?

Dr. Beverly:

Yeah. In terms of levels I’m always mindful, right? When I talk to my patients, I’m listening carefully about what their history has been with food. Some people’s history is very simple and uncomplicated. For people who have issues where they have emotional eating, or if they know they’ll eat with a lot of stress, they’re stress eater is how they usually say it, or if they truly have disordered eating and they know it. If they have a history of anorexia, bulimia, things like that. I know I need to tread very carefully on any nutritional recommendations I make, else we trigger and set people up to have a problem and to fail. And that’s not what we’re here for. We want to see our patients succeed and thrive.

So I don’t necessarily recommend exclusively one approach over another. What I do emphasize is that they eat a more whole foods regimen relative to what’s going to be safe for them and that they can be successful with. Sometimes I have people do lab testing for food intolerances because food intolerances or food sensitivities can often set up all kinds of problems, including frankly, blood sugar battles. It can also cause cravings because of that oddball reaction where you get that 15 minutes of dopamine pleasure from eating whatever it is that isn’t a food intolerance and then the crash that comes after it and your blood sugar might do that same thing. Go up and bam, it crashes.

So with food, here’s the things that I tell people to do for whom the main conversation is around blood sugar health which is focused on having them become friends with two kinds of food groups, high fiber along with leafy green vegetables. Leafy green vegetables are so full of hydration and water and nutrients. They’ve got lots of vital nutrients. They’ve got vitamins, minerals, antioxidants, polyphenols. They’ve got it all. And that fiber helps to fill you up so you feel full. A lot of times people forget to drink water if they had to drink anything, and then when they finally do, they tend to go towards maybe sweetened beverages, even if it’s artificially sweetened. So they’ve got these fiber goodies in them, these leafy green vegetables and other sources of fiber, it often helps to mute the damage. It helps to get that blood sugar instead of it being this rollercoaster event, make a much more even blood sugar throughout the day. Something I tell people to do is controversial.

Dr. Eric:

What’s that?

Dr. Beverly:

I have people start their day with leafy green vegetables. We make it a featured element of breakfast. And then we add it into lunch and to dinner. And at first people are like, “Dr. Bev., you got to be kidding me. Who eats vegetables at breakfast?” I’m like, “I do. A lot of people, the people who work with me do.” And then after time people love it because they begin to realize it sets up a whole day for success. That one simple thing.

Dr. Eric:

So you recommend it as part of a salad?

Dr. Beverly:

It could be a salad, it could be its own dish. It could be like for instance some… Well, before the pandemic, some of my patients traveled a lot. And so I would tell them wherever you land, get a bag or a pre-washed box of leafy greens because now salad boxes, things like that, it’s like $3, $5. Anywhere in the country, it’s gotten so much more affordable and convenient and get a handful. If you’re going to eat a buffet at a hotel or something like that, bring it with you. That way you’re not at the mercy of somebody else’s idea of breakfast, which is probably some sort of variation of a white bread and some sort of greasy kind of meat. And that’s it for breakfast, right? Bring your veggies with you. It could be steamed spinach. It could be a salad if you like. It doesn’t need to be as fancy as a salad. Literally a handful of say leafy greens. You could have already cooked some if you’re at home. It could be kale, it could be chard, it could be collard greens, bok choy, broccoli. Anything leafy and green, eat it.

Dr. Eric:

All right. I have to ask you then, because I do eat leafy green vegetables for my first meal, but it’s usually in the form of a smoothie. I personally don’t have any blood sugar issues, but for someone who is pre-diabetic or has Type 2 diabetes, is there an issue with both juicing and smoothies? Smoothies is keeping in the fiber, but still some will say maybe that those with blood sugar imbalances shouldn’t have smoothies and maybe they should have a salad. So I’d love to hear what you have to say about that.

Dr. Beverly:

Sure. That’s a great question. I’m so glad you’re calling that one out specifically. I think smoothies are fine for everyone. However, now that I just said that, to me, a smoothie has probably a base fruit in it like say banana, something like that. Bananas have electrolytes, including potassium. Many people are low in potassium. Apricots, plums, dates, things like that, they’re all good for potassium. Typically when people are taking medications, and many people with diabetes often have blood pressure issues so they might well be on a med that’s causing them to leak potassium. So of course they eat the banana from a blood sugar point of view, it’s high on the glycemic index.

Now, not everybody gets a spike in their blood sugar from eating bananas, but some people do. That’s why I say test, don’t guess. When you eat, check your blood sugar, find out if you are having a big response to a food. And if it’s out of bounds, you either cut that food in half, or maybe you just need to eliminate it depending on how sensitive you are. But for smoothie, though, Dr. Eric, I will have people add protein powders along with the banana. We might add ground flax seeds in there for additional fiber boost. And then we can add in things like fresh spinach. We can add in celery, we can add in ginger, apples with the skin on.

I have people eat their fruit with the skin on unless it’s a banana, that’s a little much. But if it’s like peaches, apricots, apples, please don’t peel them because sometimes you will even get say peaches from a can or a jar with a syrup on it and they’re like, “No, ditch that syrup take that peach and rinse it.” You don’t need the extra syrup. And better if you can get the peach fresh, local and in season. You know what I’m saying? Set yourself up for success. So that base smoothie, you can add avocados. There’s just so many things you can add to a smoothie. So I don’t rule things out based on the name. I say, make sure we make it nutrient packed so that you can be healthy and whole and help that blood sugar to heal. That’s what we’re after.

Dr. Eric:

All right. That sounds good. I typically add berries to my smoothie, usually like half a cup of like blackberries or blueberries.

Dr. Beverly:

Berries are great. Those are usually gentle on blood sugar for most people.

Dr. Eric:

Sticking to the topic of fruit…when I first made smoothies years ago, it was more of a fruit smoothie and over time I made the transition to more and more veggies. Now I have five, six, sometimes seven cups of veggies and only a small amount of fruit. Is there any problem with the opposite, having like three or four cups, maybe not five, six, seven cups of fruit, but three or four cups of fruit, or does it depend on the person?

Dr. Beverly:

I’d say it depends on the person. But as a general guideline, if blood sugar is your primary issue, you really don’t want to run a muck with fruits. That doesn’t mean you have to avoid them entirely. Fruits, just like vegetables, are full of nutrients. They have the polyphenols, the antioxidants, the vitamins, minerals, all kinds of goodness, fiber and water. They have hydration actually just packed in there. The thing about fruit is sometimes if a person has a tendency to have a sweet tooth, that you crave sweets, it might be something that kind of pushes them that way. And some people just don’t know when it’s enough. They don’t really measure and they just pour, pour, pour.

And so instead of say having up to a cup of fruit in a smoothie, they might have three, four, five cups of fruit which their blood sugar tolerance, their situation is probably not going to be very kind about. Not a good idea. So I always tell people to start with a small amount, like say a half cup of something, like say a blackberry or a blueberry or a strawberry, raspberry, because those little Harry Berry fruits, they have plenty of fiber, other nutrients. And again, test. Test, don’t guess. Use your glucometer, check that blood sugar, see how you respond. And if your blood sugar is in a good place, it’s okay. But if you have three, four or five cups and you find your blood sugar has spiked, now you have your answer. It’s too much at one time.

Dr. Eric:

Okay. No, that’s great. Just to clarify, do you recommend a glucometer? I assume pretty much all your patients have either prediabetes or Type 2 diabetes. So would you say just people in general, even those who don’t have blood sugar issues, should use a glucometer or mainly those who are pre-diabetic or have Type 2 diabetes?

Dr. Beverly:

Great question. Those who have already been diagnosed with prediabetes or Type 2 diabetes, absolutely you should have a glucometer and should do testing. Now we have even the continuous glucose monitor options, CGMs. I don’t have one, I don’t have diabetes, but just letting you know. I’ll just pan this because that’s where they go now, which is really an amazing piece of technology which is so helpful, so people aren’t constantly having to stick their fingers to get that proper blood. I would recommend if someone has a family history of diabetes, and I do know people who are vigilant this way, that they too check their blood regularly, get that glucometer, get the glucose strips and test so that you too know.

Don’t wait for the train to wreck because sometimes this stuff comes up pretty silently. It can be rather sneaky and you may not have any idea your blood sugar is in that range for either prediabetes or Type 2 diabetes. And then they’re often shocked when they show up at their doctor’s office. You can do this for yourself at home quite safely. There’s just no mystery around how to do these things these days.

Dr. Eric:

All right. How about blood testing for blood sugar? There’s glucose, of course. Fasting glucose I assume is what you recommend, and then hemoglobin A1C, we have insulin. I assume you use at least some if not all of those markers.

Dr. Beverly:

Yes, yes. I look at people’s fasting blood sugar, their fasting morning glucose levels because that’s an important indication of blood sugar regulation. It really should be under 100 when they awaken and go to the lab because they’ve had an entire nighttime’s worth of sleep. Hopefully they had a good night’s sleep. We want to know if the body has reset. So many things happen in sleep. That’s a different interview. So many things happen in sleep, but that blood sugar should reset. It absolutely should be under 100. Ideally, it’s somewhere, in my opinion, between 80 to 90 for good blood sugar relation. It’s not too low so that they feel hypoglycemic and it’s not over 100 and all where their blood sugar didn’t dip low enough that their metabolism reset. We really need those resets throughout the day. I feel like your soul, your body, your spirit, your mind, everything has to reset with sleep.

Dr. Beverly:

And then for A1C, I always love to see it in the fours. Of course, if somebody has prediabetes or Type 2 diabetes, their A1C is not in the fours. From about 5.6 to 5.7, it’s still not yet technically considered pre-diabetic. When I start to see that upward creek, now I’m getting concerned for that person. Then when they hit 5.8, 5.9, 6.0 and up to 6.3, that’s the range, from about 5.8 to 6.3 for prediabetes. 6.4 and higher is considered Type 2 diabetes. If they’re on medications, their doctor might say, oh, well, as long as your blood sugar is under a 6.4, then you’re well-controlled, and they may not consider you. Technically they still have Type 2 diabetes, but if you go off the meds and your blood sugar is still there, you do have Type 2 diabetes.

The good news is that it can indeed be reversed. But if you go back to anything that was causing it beforehand, it will return. So this is the big, big work. The coaching, the support, the encouragement, the practical information and tips to guide people safely and sanely as something they can sustain to keep that blood sugar in good shape.

Dr. Eric:

All right. I’d like to talk a little bit about the treatment, getting into the diet and lifestyle. We spoke about diet, but maybe dig a little bit deeper. So with the testing, you ideally, like to have a hemoglobin A1C of less than five, but for someone without blood sugar issues, you like to see that hemoglobin A1C in the fours?

Dr. Beverly:

Ideally. If they don’t have blood sugar issues, absolutely. If it’s 5.2, I’m not going to freak out, or 5.4, that’s okay. But if I see that trend over time where, like I said, they start out in the fours maybe and then suddenly it jumps maybe as they approach ages 38 to 42, or as they head to either menopause or andropause where hormonal balance might be shifting as aging starts to be more of the conversation that their body’s having, and they see a jump and it jumps maybe four-tenths. So it goes from like say 5.4 to 5.8, now they’re on the low end of prediabetes. Maybe the next time you see them it’s 5.9, 6, stays at 6, then it goes to 6.2. That’s watching the train wreck in slow motion in my opinion.

So they hit 5.8, 5.9, now we need to put a program in place to get it to go back down. I’m not one who’s going to sit there and in good conscious watch someone climb on board the Type 2 diabetes train unnecessarily. I’ll do all I can to help them and encourage them and help them figure out how to make sure the rest of their life supports getting that blood sugar lower. At worst case, it goes no higher. Best case, it goes back to the healthy range in the fours.

Dr. Eric:

All right. No, it makes sense. Now, I’m sure you’re familiar with Dr. Mark Hyman. He’s written a few books on blood sugar and he talks also about insulin. I don’t know if you look at fasting insulin with your patients as well.

Dr. Beverly:

I have looked at fasting insulin. I’ve found sometimes it’s helpful to figure out with people how sensitive their fasting insulin level is. Again, that whole idea of reset. Given your work with thyroid, I’d love to hear what your interactions have been with your patients about this. Because I found fasting insulin sometimes can help explain when people have really tough problems with weight. When their obesity is just beyond sovereign. That patient comes in and they’re just doing everything. They’re busting their butt and they cannot get their weight to move. And I found that the lab testing for fasting insulin sometimes helps uncover what’s behind this. It doesn’t always correspond, in my opinion. That’s not been my clinical experience. How about you? What have you seen?

Dr. Eric:

Yeah, that’s another topic with the relationship between insulin resistance and weight gain and yeah, if someone has not only higher insulin levels but higher hemoglobin A1C levels. But a lot of times they do go hand in hand. I did recently have a patient where the hemoglobin A1C looked pretty good. It was just 5.0, yet their fasting insulin was around 10. I know the lab reference range is like up to 24, but he talks about ideally you want it below five. If I see someone like six or seven, I don’t really get too concerned, but reaching double digits. But it was just a little bit of an unusual situation because the hemoglobin A1C looked good.

But I know there’s no perfect test either. That’s why you got to also, you mentioned a glucometer as another method, fasting glucose. But yeah, you are correct where if someone does have higher insulin levels, not all the time, everybody is different, but I certainly agree that many times it might cause difficulty losing weight. So it, again, depends on the person. I work with a lot of people with hyperthyroidism and Graves’ disease and there are some people with hyperthyroidism that gain weight, but a lot of people lose weight. And I will say probably even I do see insulin resistance in some hyperthyroid patients, although it probably is more common in those with hypothyroidism Hashimoto’s.

Dr. Beverly:

I would agree with that.

Dr. Eric:

Yeah. Diet and lifestyle, again, that could play a big role, but would you say it’s true that for those with insulin resistance/Type 2 diabetes just cleaning up their diet alone isn’t always enough?  I mean, you did mention that earlier when you said sleep and stress management. But I guess also from my research and what I’ve seen, inflammation is a big driving force in these people too. And diet of course could play a big role as well as getting proper sleep and stress management. But sometimes I find that there could be other factors affecting blood sugar or affecting that inflammatory process, which could be at least a contributing factor for blood sugar issues.

I don’t know if you find that as well where it’s not always as simple as just, because you get people who are like, I’m eating low carb, low sugar, I’m getting proper sleep. They might say they’re managing stress. We don’t know for sure but they say that they’re blocking out time for stress management. Yet they still are gaining weight. And again, there could be other factors. It could be they could have low thyroid hormone levels, they could have problems with adrenals which also could relate to blood sugar. But do you find that there are also other factors too that might make it not easy to lose weight just with diet and lifestyle?

Dr. Beverly:

Okay, let’s have this piece of the conversation. There’s the data. There’s the A1C. There’s their fasting blood sugars. There’s their thyroid numbers. There’s insulin as a measurement, their fasting insulin. There’s all this data. Then there’s our patients and our friends and our neighbors, our colleagues, family members, there’s their lived experience. And sometimes the data and the lived experience don’t match. So you’ll find people back in the day, probably decades ago, you could say to someone, “Eat less and move more.” And that might work. Today’s world is far more complex. I know lots of people and I think at this point it’s got to be tens of millions of people, maybe 100 million people for whom the eating less and moving more is inadequate. That’s simply not a helpful treatment plan.

You run the risk of getting punched right across the desk because they’ve already done that and it’s not working and people are so frustrated, they’re really upset. And often they feel like their body is betraying them, as if they’re broken or something’s not working right, or just whatever. And so then when I think about some of these other factors, whether it is chemical and industrial pollution, environmental toxicity, many people have grown up or currently live around places that are very, very toxic. We know that mammals in general struggle with processing toxins because their bodies weren’t made to process a lot of toxins. They were meant to detoxify things that either we ate that were food poisons, break down hormones, stuff like that, as opposed to a constant bombardment of all these other outside exogenous chemicals.

Now you flash forward to 2021. We live in a very different world than what our ancestors had. So if you look at pictures, if you have them in your family, of your great-grandparents, your grandparents, parents. I certainly have in my family. I could see the difference where taller with these generation was also way a lot more. And in this last 20 years, it’s just been this acceleration. When you look at the explosion of Type 2 diabetes here in the US, it is stunning, and around the world. It’s just amazing to see how many more people are struggling with their blood sugar. We’re going from a number where it’s like more than one in three in the US people struggle with blood sugar and are diagnosed, and who knows how many aren’t diagnosed. But who are diagnosed with Type 2 diabetes and prediabetes, we’re approaching one in two.

So that means if you’re in a room full of nine, 10 people, three out of the 10 people to four out of the 10 people have this problem and we’re approaching, it’s going to be five out of the 10 people. It’s not sustainable. And so if it’s environmental causes, if it’s nutrition, strictly speaking, if it is stress, sleep or exercise, really we got to do something about this. And I’ve had success working with people for whom exercise is actually not an option because they’ve been severely injured, maybe they have a knee and/or a hip that hasn’t been replaced, et cetera, where their ability to really move those big muscles of the body and do that metabolic fire is gone.

So it forced me clinically to rely on that electrical engineering background from MIT, that science side, to really look at this from a systems point of view, along with naturopathic medicine with treating the causes and peeling back the layers of that onion to figure out what is it we’re missing. That’s where I got off the train of eat less and move more because I realized it was inadequate. I wasn’t meeting people where they were at. So from my training and clinical experience in the ’90s to now, I really shifted where my focus is and to help people address the things that they actually can control so they don’t feel so out of control, they don’t feel like their body has betrayed them and they are now active players in their own success. I find that is critical in helping people to get the results in the day one, whether it’s blood sugar, weight control, better cholesterol profile, getting rid of high blood pressure, you name it.

Dr. Eric:

All right. Thank you for that. That was great. How about supplements, because everybody loves supplements so a lot of people will try to shortcut the process. Not to say I never give supplements for blood sugar, but just wanted to get your perspective on things like berberine or gymnema or chromium, which is a mineral, and there’s alpha lipoic acid. Where do you stand when it comes to taking supplements to support blood sugar?

Dr. Beverly:

I think supplements for supportive blood sugar are wonderful and I use them with my patients all the time. I have from the very beginning, it’s really very helpful, I call it a healing partner. It’s really a great help. And sometimes with things like where we’re in, you can get multiple coverage. Some of my patients have both diabetes and heart disease. My focus areas are those two. And sometimes I get people with both, and we can get a lot done. So instead of them having 12 bottles of things, they might have three or four that are their key supplements to take. It’s in those evidence-based clinically research levels of therapeutic dosage and it’s just really, really helpful.

And in today’s world, I had read some studies, I can’t remember if it was on FDA’s website or USDA, one of those government websites had analyzed the soil from this was in 2008, I think 2009, and compared it to soil samples that they had from the ’40s, ’50s, ’60s, ’70s, 80s, so 1940s, 1950s, et cetera. They found that the average amount of nutrients in the soil in the US nutrient density had really declined precipitously, had gone down a lot. As a result, the food that we eat from the soil is not giving us the same nutrient density that our grandparents and great-grandparents enjoyed, which would explain why I could easily observe having been around my great-grandmother and then my grandparents and all that I could see like, oh, wow, no wonder they wanted a small portion of something and they were delighted with it. They felt satiated. They were satisfied.

I think that’s one of the struggles that isn’t talked about a lot. In my opinion, in the popular media, we don’t talk about people’s satisfaction. It’s almost like we are all bottomless buckets. We just cannot seem to feel full. And I don’t know if it’s strictly speaking some of the chemical additives to the food, is it the lack of nutrient density upfront, or all of the above? I’m not sure.

Dr. Eric:

Yeah, you make some good points there. Unfortunately, these days it’s very difficult to get everything from diet. A common supplement in the world of thyroid health is selenium. I have a lot of people ask about Brazil nuts, which are high in selenium. And I agree. They are high in selenium. You just don’t know how much selenium you’re getting. It’s variable. If you’re eating organic Brazil nuts, it will be probably higher in selenium than non-organic, but still you don’t know you might be getting anywhere from like 10-20 micrograms to 70-80 micrograms. I mean, it is preferred over supplementation for maintenance, but even then, it’s still variable.

Dr. Beverly:

I think in today’s world, for best results for patients and clients, supplements need to be a part of what is that they do for their own health and wellness. It’s just too variable. You can’t predict it. I would love if it were just food, but I don’t think that’s true. I think you need to do food along with supplements.

Dr. Eric:

Yeah, I agree. Is there a time and place for medication such as Metformin?

Dr. Beverly:

Yeah. Metformin can be really helpful and some people do super well on it. Some people are really aggravated with it and get the side effects, not necessarily the benefits, especially the GI side effects. So I always tell people, you know what, make your best choice, understand what you’re choosing, let’s see if there’s side effects. If you’re okay with them, then try it and see how you do. I think it’s a fine bridge strategy. For the people who are well motivated and who want to take on the lifestyle side of things, I think it’s fine if they’re already on medications, prescription meds. I’m not someone who says, “Oh, you can’t take that.” That’s silly, that’s ridiculous. You take what you need to take. And legally I cannot nor would I unprescribe something. I didn’t prescribe it, therefore I can’t unprescribe it. I think everyone listening needs to know that. Everybody has to stay in their lane.

But with that in mind, if you’re going to make the lifestyle changes and oh my gosh, I sure hope you would, then recognize that your blood sugar may well start to decrease. And if it gets to sort of healthy range, your need for prescription medications may decrease with it. You must, must, must test. Do not guess. Use your glucometer or your continuous glucose monitor, so you know what your blood sugar is doing and make sure you’re in conversation with whoever prescribed your diabetic medications for you and adjust as appropriate. Don’t go and decide you saw a blog somewhere and you’re going to do it yourself or take advice from your mechanic or the nice lady at the hair salon or whatever it might be. Go to the actual expert who prescribed it for you. This is not a time to go rogue for your own safety. I just feel like I have to put those disclaimers in.

Dr. Eric:

Yeah, I’m glad you did. I face the same thing with people on thyroid medication as well.

Dr. Beverly:

I know you do. I have a lot of patients that are on medication. I know you see people just go and do some strange things, don’t you?

Dr. Eric:

Yeah. For those with hyperthyroidism, Graves’ disease, those side effects could sometimes be pretty bad with the antithyroid medications. So I can understand people not wanting to take it. I actually dealt with hyperthyroidism and took more of an herbal approach, but it’s a little bit different with Hashimoto’s because if someone needs thyroid hormone, then there’s really not an herb or something else that they could take as a substitute for thyroid hormone. But sometimes in people with Hashimoto’s, you balance the immune system, and they might be able to get off of thyroid hormone or reduce the dosage. But again, it’s best to go to the prescribing doctor rather than try doing that on your own.

Dr. Beverly:

Yeah. We have those keys to inflammation. For Hashimoto’s thyroiditis, that inflammatory aspect, the “itis”, you always want to be able to dial in on that inflammation. I know with your work, that’s a powerful part of that healing conversation that really help people get that awareness of what is driving inflammation for the immune attack. There’s something behind it.

Dr. Eric:

Oh definitely. For both Graves’, Hashimoto’s and really all autoimmune conditions, that’s a big goal. Try to find the triggers and underlying imbalances. One thing I also wanted to say just because the topic, again, relating to insulin resistance, there’s evidence that insulin resistance can cause thyroid proliferation, maybe resulting in a goiter, swelling of the thyroid gland. And then also nodules too. There could be other causes of nodules like problems with estrogen metabolism, but blood sugar also potentially plays a direct role in thyroid health. But then there’s that inflammatory process as well associated with many cases of insulin resistance. We were just talking about inflammation in relation to Hashimoto’s and Graves’ disease as well. So blood sugar is definitely important, and having healthy blood sugar levels is important with anybody, but that also includes those with autoimmune conditions such as Graves’ and Hashimoto’s.

Dr. Beverly:

That’s right. In literature, all the different aspects of metabolism are in good harmony. And when you’re not in good harmony, different problems can show up. And so you can see multiple things in parallel. Insulin resistance, you could have thyroid nodules. A person might have fatigue. They might have muscles that seem to be atrophying or they don’t get the same kind of benefits like maybe they used to from exercise if they used to do weight training, things like that are a number of shifts that can be really good clues that the metabolic system is really starting to shift.

Dr. Eric:

Yeah, definitely. How about one other thing before we go into, I do want to make sure we answer some questions. We did talk a little bit about weight gain. I don’t know if you want to expand on that just because it is a big issue, more so probably with Hashimoto’s than with Graves’, even though with some people with Graves’ they also experience weight gain. Hashimoto’s, again, we got to factor in the low thyroid hormone. So perhaps to summarize, if someone is struggling with weight gain, what steps do you have them do? Is the first thing you have them do is to just modify their diet? Do you have them do testing to look at their blood sugar levels and maybe other markers such as thyroid?

Dr. Beverly:

Yeah. The first things we would do is to make sure that they have current lab work. So we have the baseline for the data just to make sure we haven’t overlooked anything because sometimes health problems are blamed on weight when they aren’t necessarily related. We have certainly seen where patients have come in and they’ve lost 80 pounds and they still have their original presenting symptoms. So clearly weight was not the cause, was it? You want to be sure that as a doctor you’re not hiding behind that where weight is a shield for thinking about any other problems.

And then from there, look at how they’re eating and what they’re eating and also what time of day they’re eating. Sometimes what I found is that if people eat from early in the morning to late at night, so they never really have a fasting period throughout their day, that that can be a problem. Particularly people who eat really late at night and then go to bed within a half hour, they almost always have a weight problem of some kind.

Then you look at the quality and quantity of the food. Make sure portions make sense, and that they’re eating in a healthy manner for whatever are the foods that are best in agreement with them. I prefer that if people have high fiber diets with healthy protein, healthy fats, and then slow burning complex carbs. I love things like lentils and chickpeas to try to get them in the mix because they are packed with, it has healthy carbs, slow burning, it has fiber and it has protein, all in one convenient little package. You get a lot done with lentils and chickpeas, and they’re delicious. There’s many different ways that you can prepare them.

From there, I don’t insist on exercise. I love it for mental and spiritual reasons, stress relief, for people to exercise. But I’ve had the opportunity to work with so many people for whom their knees or their hips, their back, they’re in so much pain. They just can’t do it. And so I learned to not make that the centerpiece of the treatment.

So then our next stop is either going to be after we’ve looked at food, which is the target, we’re going to look at either stress issues or we’re going to look at sleep. I talk to people about sleep. Typically if they’ve raised kids or if they remember their own childhood, if they had a good childhood, did you have a regular bedtime? Did you have a regular wake time? And if you didn’t have good childhood, what would you have liked for your younger self? Because what you don’t want is chaos in your sleep world. Have that one to two hours of clear transition to sleep.

Give your body every possible signal that it’s going to be time to go to sleep now, and then get out of bed at the same time. So your day and night make sense. Let your hormonal system settle, because if you get up at really different times and go to bed at really different times, guess which system is going to least be able to handle that is your hormonal systems. Your thyroid will be affected, your pancreas, your ovaries or testicles. All of the various organs are sensitive to that. Your digestive system, it really loves regularity. It wants you to go to bed at the same time and get up at the same time.

And just getting people’s sleep ordered from their stress. Some people have extraordinary levels of stress that they carry now in their adult lives, or maybe as a kid. Childhood was awful and they could have a lot of what are now called ACEs, adverse childhood experiences, where they really, really got pushed and their stress systems were always in high drive. It wasn’t the emergency, it was nonstop constant emergencies. And in that environment, it’s just really hard. So now here they are 20, 30, 40 years later and where their health should be in a pretty good place relative to how their life is lived now, they’re starting to fall apart. The problem started a long time ago, now we’re seeing the results.

Dr. Eric:

All right. Well, thank you for that. Again, I would like to get into some questions, but  is there anything else you’d like to add?

Dr. Beverly:

No, I think we’ve covered this really well. For our first conversation, I’m thrilled to be a part of this. I don’t want people to think it’s complicated because kind of in a way it’s not. But it’s not always obvious. As I tell people, the things I ask you to do, and you might have this conversation too with your patients, Dr. Eric, the things that I ask you to do are simple. I never said they’re easy.

Dr. Eric:

I agree. Well, where can people learn more about you, Dr. Beverly?

Dr. Beverly:

Sure. Welcome to visit my website. Https://dr, the abbreviation for doctor, and then my name Beverly, B-E-V-E-R-L-Y, Yates, Y-A-T-E-S.com. You can find me on Instagram. The handle is the same thing @DrBeverlyYates. On LinkedIn, you can type in my name and find me there. And soon I’ll have a YouTube channel that’s repurposed specifically for blood sugar issues. Those are the primary places. You can also find me on my Facebook business page. Feel free to check in there as well.

Dr. Eric:

All right. Wonderful. Thanks again for getting together. Are you okay with diving into some questions?

Dr. Beverly:

Yeah. Sure.

Dr. Eric:

All right, great. Let’s take a look.

Dr. Beverly:

Someone asked if Type 1 diabetes can be reversed. Let’s clear that up. No. Type 1 diabetes, based on today’s knowledge right now in 2021, April 9th, no. Type 1 diabetes where someone’s pancreas no longer makes insulin unfortunately cannot be reversed. People can benefit from very similar strategies around having a healthy blood sugar in all of the goodness that we were sharing earlier, but unfortunately we don’t have a way to reverse Type 1 diabetes at this point in time. I want to be crystal clear about that.

Dr. Eric:

Those with Type 1 diabetes, do they have to be on insulin?

Dr. Beverly:

Yes, it is mandatory they will need to add it. Otherwise any of the blood sugar that their body is making, their glucose, will not get into their cells successfully. You have to have insulin, it’s a requirement. There’s insulin pumps. There’s all kinds of things that are, again, kinder and gentler than what used to go on back in the day. Treatment has improved, but we’re not at a place yet to reverse Type 1.

Dr. Eric:

One question, Type 2 can be reversed, but is there a point of no return where certain people with Type 2 can’t really… I know you can’t guarantee that anybody can be reversed…

Dr. Beverly:

I tell people that there is always a potential with Type 2 diabetes for healing from the damage from diabetes. For some people that will include reversal of the diabetes diagnosis to where their blood sugar will lower to the point where it’s out of the diabetes diagnosis range. So for Type 2, once they get under 5.8, so let’s say if their blood sugar goes to 5.6, 5.5 and back into the fours, they’ve reversed for sure. Now, that doesn’t mean they are no longer susceptible to having the problem and if they were then to, if it was at all a lifestyle or habit based, if they were to go backwards in time and go back to the situation that got them started in the first place, it’s likely to return.

I mean, I want people to be sure that they understand that if they have figured out what are the most healthy levers to pull, so to speak, for themselves, and they’ve got that dialed in, they need to stay that way. If they then decide, “Oh, hey, I’m better,” and then they start to do things that just don’t make sense like they let their sleep just cycle all around and get out of control, lots and lots of stress, no exercise and eat poorly, it’s very likely that Type 2 will return and probably return quickly.

Now, is there a point at which it’s the point of no return? I always tell people I’m not a psychic and I don’t play one on TV. I’m also not God. I don’t feel like that kind of an answer is in my hands. I do think that there is a place at which there’s so much damage that they may not get the full benefit they would have gotten if they’d done something sooner. That’s like watching that train wreck in slow motion or in some cases wreck in fast motion, real time.

If someone has a severe compromise of their circulation, if they’ve lost one or more body parts, if they’ve lost vision and have gone blind in at least one eye, if they’ve lost or are rapidly losing kidney function, if they have severe pain from peripheral neuropathy or they’re flat out numb, these are all great indications about how much healing potential is left. Whatever they can do, even if it’s at end stage severe is not too late, but it might mean that they might not get all the way back to the status of reversal. Make sense?

Dr. Eric:

Yes, definitely. Thank you for that explanation. We have a question from Vicki. How do you stop the constant sugar craving?

Dr. Beverly:

Yeah, sugar cravings are so very annoying. Let me share with you guys a fun factoid. I discovered this in some of my research several years ago, and other people have since brought this forward to share with me. Did you know that the cells on your tongue turnover every 10 to 21 days? So every week and a half to three weeks, you get a brand new layer of cells on your tongue. That’s where your taste buds are. Now, this is important because if you’ve got a taste for sugar, if you have a sweet craving, if the sugar bug has bitten you, you’re going to need to give yourself some time. This is not something that’s going to go away in 24 hours. But you can make a change over the course of 10 to 21 days, for sure.

I find that the herbs can really help, like gymnema and especially fenugreek, with that craving for sugar. Also those leafy green vegetables, like I said, at the beginning of our interview time here. Those leafy green vegetables. In the Facebook group, we have this hashtag of GreensBabyGreens. Those leafy green vegetables can really help get that desire for certain foods to be shifted gradually, steadily and permanently towards the healthier desires. So if you’re constantly battling that desire, that brain-based urge for sugar, that’s a great way. Either the herbs, the veggies.

Dr. Beverly:

And then another tip is simply to try and eat some things that you don’t normally eat, especially if they tend to be bitter. Get your tongue and your palate used to eating things that are a variety and have different flavor profiles than sweet. So much of US food, especially fast food, is all about sugar and salt.

Dr. Eric:

Yeah, that is true. Someone just made a comment here about the protein. There’s so many different protein powders out there.

Dr. Beverly:

Yeah, there are.

Dr. Eric:

Let’s see. Jenny, I can’t lose weight despite thyroid and insulin in range with menopause and no other conditions.

Dr. Beverly:

That’s interesting. With menopause, as we all know, the reproductive hormones for women shift. And so you’re no longer losing that menstrual lining every month. Now, for some women, that leads to a certain kind of peace and calm that maybe they didn’t have before, particularly if they had difficult menstrual cycle. If you had a pretty easy time, then hopefully the dust will still settle. From menopause, you’ll be okay. If you’re finding you’re struggling with weight, including when you have thyroid problems or don’t have thyroid problems, I found a great way to go is to try intermittent fasting.

Intermittent fasting, which if you think about it, the spiritual traditions of the world, every single one of them has some kind of fasting baked right in there. I can’t think of one that doesn’t. I think humans have been wise for thousands of years and we’re just getting caught up now about this and documenting it and giving it the proper credit. I would really suggest to consider intermittent fasting and try and see what happens for you. It is a great way to reset issues with insulin resistance, that’s for sure. And if that’s at all the issue, hopefully you would get some benefit from that. I think trying that out might be a safe, good way to go.

Dr. Eric:

Yeah. I’ll also add what we were discussing earlier. Remember there’s the lab ranges and there’s the optimal ranges. Like the thyroid hormone levels might be within the lab range, but they might be on the low side. It depends on the lab, but for example a free T3 of 2.1, a lot of labs would consider that to be normal, but that is really on the lower side and the active form of thyroid hormone. Same thing we are talking about insulin. The person who had an insulin of 10, the lab didn’t red flag that as being out of range, but from a functional perspective, from an optimal perspective, it’s definitely higher than we’d like to see. And then there could be other factors as well. I mean, I agree with Dr. Beverly. I personally do intermittent fasting as well.

I do think some people need to be cautious, especially when dealing with hyperthyroidism. When I was dealing with hyperthyroidism, I lost over 40 pounds. So in that case, I probably wouldn’t have wanted to do intermittent fasting. And then maybe if someone has really stressed out adrenals too. But overall, , intermittent fasting can many times do wonders for weight loss. But if there’s something else going on, like an inflammatory process, or again, there could be numerous factors, those do need to be addressed. But yeah, I do agree about the intermittent fasting. And then here, it takes a lot of willpower to eat healthy, especially now in the COVID environment.

Dr. Beverly:

Yes, it does.

Dr. Eric:

Yeah. I think it’s always a challenge. Once you’re in the routine of eating healthy, it’s definitely easier. But I grew up eating everything that you shouldn’t be eating. Eating fast food and refined sugars. It wasn’t easy making that transition, but once you start feeling better and you’re maintaining a healthy weight and you have energy, it’s still not easy. I still get temptations. I’m sure Dr. Beverly gets temptations. I’m not saying I never want to indulge and I can’t say I never indulge, but yeah, you are correct. I mean, over the last year, arguably for many people, it has been more of a challenge.

Dr. Beverly:

Yeah, that’s real.

Dr. Eric:

So LDN, low-dose naltrexone. So I could answer this.

Dr. Beverly:

Yeah, go ahead. I’m curious to hear about LDN.

Dr. Eric:

Low-dose naltrexone, that’s a medication that modifies the immune system. It can potentially calm down the immune system in autoimmune conditions. I’ve written some articles on low-dose naltrexone. Definitely check those out on my website. I like LDN, but it’s more hit or miss and it doesn’t work for everyone. When it works, it could do wonders. And it also, it’s not addressing the cause of the problem. So I guess that’s another thing too. I do have patients that take LDN but just keep those things in mind. One, it’s doesn’t work in everybody. And this also for Graves’ too. You mentioned Hashimoto’s, but it can help with other autoimmune conditions. But again, I find it’s hit or miss. And then also you still want to do things to address the cause of the problem ideally and not just rely on the LDN.

All right. And then we’ve got, Dr. Yates is so very knowledgeable. Yes, definitely. I enjoyed this as well. Thank you for that comments. Okay. This is, yeah, I don’t eat after 7:00 on most days. Yeah, I also agree with that trying not to eat late.

Dr. Beverly:

Yeah. Give three to five hours before you go to bed. From your dinner time to sleeping, three to five hours. Just let your gut really go into CP time so now it can do its renewal because that’s the only time it can do its renewal is when you’re asleep.

Dr. Eric:

Yep. I agree with that. I guess we didn’t talk really about duration of sleep, but most will say like seven to eight hours. I guess I would agree with that, but then also take into account if you don’t fall asleep right away. So if you’re in bed for eight hours, but it takes you a while to fall asleep, then I wouldn’t count that time.

Dr. Beverly:

I’ve started to talk to people about this a little differently after reading, oh boy, he’s a researcher over here at UC Berkeley, Matthews. I can’t remember his full name. He has a book on sleep, wonderful book, to talk about sleep with people around give yourself the opportunity to have eight to nine hours of sleep a night. Therefore, if it takes you time to get to sleep, you’re still good. People just seem to relax a little bit with that idea. So otherwise then that’s part of why they don’t go to sleep. They’re stressing them because they can’t sleep easily.

Dr. Eric:

Yeah, that is true. Once you’re in a pattern of not falling asleep, some of it does become psychological and then, yeah, it is helpful if you try to go to sleep earlier. But again, sometimes I have to practice that too. I mean, I’m pretty good with sleep, but again, I can say every single night I get eight plus hours sleep. But I’m also not a night owl, fortunately. So I’m not one that stays up to midnight or one o’clock. All right. Let’s see. I know we got to wrap things up. And I will be on Facebook next week. So if there’s any questions that are unanswered, next week I’ll be doing a full Q&A, so definitely save your questions. But I’m trying to see if there’s anything related.

Janet, my best meal plan for a Hashimoto’s insulin resistance. I mean, since the topic was insulin resistance, I know Dr. Beverly said she doesn’t really recommend a specific diet. She did say the fiber and the green leafy vegetables is what she recommends across the board. And then of course the basics with not eating refined foods and sugars and just really trying to eat a whole foods diet, plenty of fiber, plenty of green leafy vegetables. Anything you want to add, Dr. Beverly?

Dr. Beverly:

Yeah. Those healthy lean proteins and the healthy fats, the avocados, nuts and seeds. And for your carbs, you want those complex slow burning carbs, especially like lentils and chickpeas, because you just get so much nutrient density from it without any problems. I found that to be really helpful. Some of my patients have Hashimoto’s or they have hypothyroidism without necessarily being Hashimoto’s and combination with insulin resistance. So far we’ve not had any problems with people than if they had a history of disordered eating or eating problems that it hasn’t triggered anything. Because I find sometimes if people have those issues, if you put them strictly on something like Keto, they can get kicked pretty hard. So if they start to introduce carbs later, they sometimes really just go hot wild with it has been what I’ve seen happen. It doesn’t happen to everyone. Most of the time people are fine, but for a few I’m like, Ooh, is there some tuning I could have done to avoid this?

Dr. Eric:

Yep.

Dr. Beverly:

Maybe there’s one here I’d like to address. A lot of my patients are Asian. Shout out to Asian folks, hello. I totally get what you’re saying here. The comment is, I used to not crave sweets, but since Graves’, this person has been craving every day, and vowed to stay away from it. Starting to eat brown rice. I totally get, in Asian culture, white rice is preferred. Brown rice has the fiber jacket on it. I get the deeper issues here. I used to practice it in Hawaii and I’m here in California in San Francisco, Bay Area. Lots of conversations have been had around this very topic. So I would simply encourage you to do this.

If you’re going to have white rice, go ahead and have it, enjoy it and consider maybe if it’s a problem for you, cut that portion in half. I have found that that by itself has really helped people, especially if you’re in family events or special celebrations where white rice is absolutely going to be served and you’re not going to be able to get wild rice, brown rice, etc. There’s no point in struggling and trying to fight that river. Instead, maybe look at your portion and make sure you have lots and lots of fiber with it. And I think that that combo will be practical and helpful. It certainly has helped others of my patients who are Asian and who’ve had a similar concern, whether it was food intolerance or it spiked their blood sugar or they craved it or whatever the case might be with rices, in particular white rice. I hope that’s helpful.

Dr. Eric:

All right. Well, thank you for that. Thank you so much for, again, getting together Dr. Beverly. And again, can you let people know one more time where to find… Someone also did mention about your Instagram. I did see over there.

Dr. Beverly:

Yeah. So Instagram is the same. It’s @ sign, and then my name, DrBeverlyYates.

Dr. Eric:

Okay. And your website one more time.

Dr. Beverly:

So the website, if you go to the Google or however you do your web searches, if you put in drbeverlyyates.com, you’ll go right to my website.

Dr. Eric:

All right. Wonderful. Well, again, thank you again for getting together. I think that this was great. Hopefully everyone found it very helpful. I know I learned a few things as well.

Dr. Beverly:

Thanks so much. Take care.

Dr. Eric:

Bye-bye. Thank you, Beverly. Take care. Have a great rest of the day.

Dr. Beverly:

You too. Bye-Bye.

Dr. Eric:

Bye.