Your Labs Are “Normal” – So Why Do You Feel BAD? With Lisa Rosch

00:04
Kevin
One. Hi, guys. This is Kevin with N of one. Glad to have you guys back. I know it’s been a hot minute since we’ve had a podcast, but we have somebody near and dear to our heart today. This is going to be Lisa Roche. This is with us. She’s our nurse practitioner. She is one that helps us out with all of our functional medicine, and she has a great breadth of knowledge. Dr. Jamie’s here with me as well.

00:28
Jamie
Hey, guys.

00:29
Kevin
So we’re gonna kind of jump straight in. I know we’ve done a podcast in the past over functional medicine, but I think Lisa’s gonna provide a little bit different angle on what Dr. Brad Watts kind of talked about. She has worked very closely with Dr. Watts, but she has her own unique experience and on her own personal journey. So I will kind of turn it over to Lisa to give her an idea of what her background is to start off with Lisa and, you know, kind of where you came to functional medicine.

01:00
Lisa
All right, great. Thank you for having me. First off, it’s great to be here. I’m Lisa Roche, and as you said, nurse practitioner, and I have my own journey. Initially, I started as a nurse back in 2011. I was a CNA, became a nurse in 2011, and did all types of nursing, from med surg to oncology, urology, forensic nursing. And my favorite ER nursing was my favorite. So after that, I decided I wanted to further my education. So I went to school and got my doctorate in nursing at Arizona State University and got my first job right out in a liver clinic. And that’s kind of where I found out how important the liver is, all of the body functions. And I, during that time, I was. Got pregnant, had a baby. I was, of course, a geriatric pregnancy, being over 40.

02:09
Lisa
And so my hormones were already strong, starting to go out of whack. And then you add pregnancy to that, and they’re really out of whack. So I was fatigued, and I couldn’t lose the weight that I had gained, and I just felt like there was a weighted blanket over me. Brain fog. I was working out six, seven days a week and staying below 800 calories, and I was still gaining weight. And I couldn’t figure out why this was happening. And so that’s kind of how I got into the functional medicine world. And realm did a little digging myself because the doctors were telling me my labs were normal and basically telling me, stop closet eating, which I wasn’t.

02:55
Kevin
Any other symptomology. Lisa, when you were going through all this Other than just weight gain, just.

03:00
Lisa
The brain fog, the weight gain and the fatigue. And they kept saying it’s because you’re a new mom and so you’re fatigued.

03:07
Kevin
And get some sleep.

03:09
Lisa
Yeah, yeah, get some sleep. And I mean, I would sleep. I would get up after sleeping at eight hours because I actually had a good sleeper after six months. She was a perfect.

03:21
Jamie
You’re lucky. You’re lucky.

03:24
Lisa
She slept 12 hours and then. But I’d get up and as soon as I got home, I’d lay down and fall right. Asleep, you know, and it’s not great when you’re. You have a little one. And so it was just. That was the big thing.

03:38
Jamie
Lisa, I would say, you know, one of the common patterns that I’ve seen in people who are in this space of functional medicine have very similar stories to yours where they go to traditional physicians to solve everyday problems. Fatigue, weight gain. I mean, one would think modern medicine would be able to handle these problems. Right. And yet you are pushed into a protocol driven therapy. A lot of this is driven by electronic medical records where if it’s outside of specified disease processes that you’re paid for by an insurance company, you’re not going to get really any answers. Okay. If it’s outside of whatever the protocol is, and that’s what I think makes functional medicine so exciting, is all right, we’re going to start dealing with these issues directly.

04:31
Jamie
And it’s not protocol driven, it’s patient specific, which is exactly, I think, what the public is dying for now. And so, you know, as far as your functional medicine practice, that’s kind of why we’re in this space, because what we see is stories just like what you have. Simple stories.

04:48
Kevin
Very common.

04:48
Jamie
Yeah, very common that, you know, we ought to be able to address. It’s not like fatigue is a really, you know, cerebrally difficult thing to work your way through. Why are you fatigued? Oh, well, your closet eating and you’re really.

05:02
Kevin
Come on.

05:02
Jamie
All right, you know, and so that’s the beautiful thing about this functional medicine space is we can start to actually intervene in people’s lives and actually show some outcomes that are going to be functional for them, for lack of a better term. So tell me what your practice is and how this sort of motivates you.

05:22
Lisa
So I think the biggest motivating factor for me, well, I guess the practice is getting to the root cause.

05:30
Jamie
Amen.

05:30
Lisa
Everybody has a root cause. There’s always a reason. I, I know in the best western medicine world, Idiopathic is a word that.

05:40
Jamie
Is used and not a particularly satisfying word, is it?

05:44
Lisa
Yes, exactly. And so I really, I don’t believe in that. I know that everybody has a root cause and sometimes it’s multiple root causes. And so that’s mainly what the goal is finding the root cause. And from there just seeing the motivating factor is seeing the success stories. Even in the first week or two, some people I’ve seen just in a couple of days to where they’ve said, wow, I’ve noticed a big difference.

06:18
Jamie
All I had to do was this, right?

06:20
Lisa
Yes.

06:21
Jamie
Well, what was your root cause? What was your root cause?

06:25
Lisa
Biotoxin illness.

06:27
Kevin
Wow.

06:29
Jamie
Tell me about that.

06:31
Lisa
Yeah, so I apparently growing up, come to find out after talking to my dad was grew up in military based housing and had a lot of mold issues. And in doing testing, I did my HLA drdq, which actually looks at your ability to detoxify mold. And of course I was not able to detoxify mold. So that really was my root cause.

07:01
Kevin
So you’ve been treating yourself. I think that’s kind of how all medicine seems to start out with whether you’re a psychiatrist or whatever. Right. I mean, the best psychiatrist in the world is always wondering what’s wrong with themselves. Right. So in this case, how long have you been doing functional medicine? Just so our patients can get an idea of your expertise?

07:20
Lisa
Gosh. Now I would say probably four years at least now.

07:25
Kevin
So a number of patients that you’ve gone through, you’ve seen a lot and you’ve done a lot and obviously you have healed a lot. So this is good news for our patients. Just to know the access that you have to knowledge that can help us here at n of 1 and help themselves. Because ultimately I think everybody needs to understand that you’ve got to have a good why in order to kind of put yourself through the process of getting through functional medicine. So in my mind, the difference in functional medicine and just going and grabbing a supplement off the shelf has always been that you tend to think I can supplement my way to health, which is somewhat true, but not absolutely true.

08:11
Kevin
And certainly if you want to get healthy quickly, you need some functional medicine help to understand how to use these things with the other tools that we have available in order to get healthy quickly.

08:22
Jamie
So Lisa, tell me in your practice, what is the most common complaint that you have? What are the patients, what are they coming to see you for? Okay, let’s drill down to this. Is patient Specific. And I want our patients to hear, what exactly is it that they’re coming in to get fixed by you?

08:43
Lisa
I would say there’s a definitely common theme. Brain fog is going to be one of them. Fatigue is another. And I did a lot with diabetes patients, so blood sugar issues is going to be another thing. So that’s going to be probably the top three. I mean, I guess if I could narrow it down, those would be the top three. Brain fog, fatigue, and blood sugar instability or insulin resistance, I guess you could.

09:15
Kevin
Say we talk a lot about that here.

09:16
Jamie
Absolutely.

09:18
Kevin
So you think those things were happening 20 years ago, or were people just ignoring them, or has it gotten gradually worse?

09:25
Lisa
I think that it’s gotten gradually worse, unfortunately, just due to more toxins in our environment. The food that we eat, you know, food can be healing. And unfortunately, the food here isn’t always the best.

09:45
Jamie
One of the things I always teach my patients, you know, particularly, you know, I’m a bariatric surgeon. And so one of the things that, when they first come to see me, you know, I. I want to say, look, you know, the way out of this problem is lifestyle. Okay? And so why do you feel this way? And so I always say that, you know, insulin resistance and its comorbidities, or at least it’s. It’s what I like to call symptoms. I believe it’s about 80% of the problems that are seen in a traditional primary care practice. If somebody has insulin resistance, they’re going to have, you know, obviously near diabetes, type 2 diabetes. They have it. They obviously have inflammation issues, they have hypertension, they have hyperlipidemia, they have obstructive sleep apnea, they have joint problems.

10:28
Jamie
And so what I always say to my patients is, look, your body is not designed to eat carbohydrates all the time. The way that God designed our body is that we consume foods that are available based on the time of year. And so certainly in the, you know, during the harvest time in autumn, we would eat lots of carbohydrates. And there was a functional purpose for that, because when you eat lots of carbohydrates, your blood sugar goes up, and guess what? Your body releases insulin. You need to be insulin resistant because you need to prepare for the next season where there’s no carbohydrates lying around and you have to chase down your food and your diet consists of fats and proteins. Now, we have lost that in modernity.

11:07
Jamie
We, you know, we eat whatever we want, whenever we want, and yet our body expects to go through these moments of starvation. And it’s not a bad thing. And this is why I make such a big deal about fasting. And fasting is the way to eliminate insulin resistance if you can do it safely.

11:24
Lisa
I agree, definitely. I am a proponent for fasting and just even in certain treatments, preventative for cancer, other things, just to create that autophagy.

11:37
Jamie
Autophagy, that’s a great word. That’s a great word.

11:41
Kevin
So tell us what autophagy means for all the lay people out there. I’m always the guy that’s trying to explain this to people, so don’t talk over their heads, guys.

11:49
Jamie
Yeah, Lisa, I’ll take this one. So, you know, one of the great, you know, research, you know, topics that’s out there in the functional medicine space is, is asking the question, what happens when your GI tract is empty, right? When you are not, when you are not digesting or processing food, such as in a fasting state. And I think logic would have it, you know, in rationally we would think, well, nothing, it just doesn’t do anything. But that’s not true. That’s actually not true. That actually those resources that your body would normally use to digest and process food, it takes those and it surveils your body for cells that are somewhat worn out. In fact, these have, these cells have very interesting names, are called natural killer cells.

12:41
Jamie
And through a process that we call apoptosis, they can actually take those worn out cells out of circulation. And what I tell patients is, hey, this is part of the reason why you feel better that fasting in many ways can be the fountain of youth. Your body can be recycled and, you know, and you don’t get that opportunity when your body is spending so much time and energy processing the food that we eat. We know in America, I’ll guarantee the majority of people out there got something in their guts all the time. I can, I tell my patients, as soon as you’re done eating breakfast, guess what, you get some lunch, you’re not done digest breakfast, and by the time dinner rolls around, you’re not done digesting.

13:21
Jamie
And so we can keep on stacking on food into our GI tracts and that there are health benefits if you stop doing that if you don’t eat as frequently.

13:30
Kevin
So, well, since you’ve explained autophagy and.

13:34
Jamie
We’ve talked about fasting, autophagy in natural cell death are much the same thing.

13:40
Kevin
Okay, so Lisa, since you’re a female, you’ve sitting here with two guys. What’s the Difference in fasting for men and women. We get this all the time.

13:49
Jamie
Absolutely.

13:51
Lisa
So as far as a women, unfortunately it is not the same. I, I’ve talked a little bit about this before in terms of cycle and needing to fast during certain periods for women versus men can do it at any time.

14:09
Kevin
Right.

14:09
Lisa
And it’s easy. But women need to actually be aware of when their cycle is if they’re not tracking it. And even after being aware of symptoms or how you’re feeling because you don’t want to create more strain on your body.

14:30
Jamie
So when you’re talking about a woman’s menstrual cycle.

14:34
Lisa
Correct. Yes.

14:34
Jamie
And when in her cycle is it.

14:36
Lisa
Optimal for her to fast after the menstrual cycle?

14:40
Jamie
So immediately after the menstrual cycle. And so in what? And so how long should they fast? Do they fast for the first two weeks of their month long cycle or.

14:51
Lisa
I would say, yeah, the two weeks. Because you definitely don’t want to fast the week before.

14:57
Jamie
I see.

14:57
Lisa
That’s the time where you want to avoid fasting.

15:01
Jamie
So in the process of ovulation you want to back off of fasting. And why is that?

15:06
Lisa
Just like I just creating more strain on the body and being more in sync with your hormones. Because then if you do the fasting, it creates more inflammation for your body at that time because of stress on the hormones. So you’ll have inflammation and you just want to pair it, making sure you’re pairing it correctly with spikes in estrogen, progesterone, things like that.

15:35
Jamie
And cortisol.

15:36
Lisa
Absolutely, definitely.

15:38
Kevin
So I’ve even heard when Lisa and I do these reviews, we end up talking. I’ve heard her say that you should even be careful about when you’re working out according to your cycle because it can cause inflammation. If you’re working out really hard or.

15:52
Lisa
Just even in general, if you have overall inflammation and your cortisol, you have adrenal, I guess adrenal fatigue, but just your cortisol is not optimal. You don’t want to create more strain on your body. So it causes more of a distress than a eustress. Eustress. So creating thereby creating more inflammation. Because then your body’s already in this fight or flight zone and then you start working out, it’s already thinking it’s getting chased by a bear and you add more to it’s just going to create further inflammation. Rather than come to find out my orange theory workouts were not good. So all now I don’t do any high intensity exercises anymore. I basically walk and lift weights. So that’s how I get my.

16:37
Kevin
It’s great information for women. I think that there’s so much information, and particularly we talk about studies and things in all kind of realms, and all those studies seem to be very targeted toward men and skewed toward how a man’s body would react. And nobody seems to get really down to the details of when you should be doing certain things as a women. And nobody, no, nobody’s coming to a woman and saying, your general practitioner doesn’t do that. They don’t come to you and say, because you’re a woman, don’t do this. They’re just saying, get out of the closet and stop eating. You know, instead of saying, hey, why don’t we examine when you’re eating, how you’re eating, when you’re working out and how you’re working out. So it’s very important information, I think, for our patients and for the people, the listening public.

17:22
Jamie
Well, I think for fasting, I think that makes complete sense because think about, you know, when you are ovulating and you’re in the second half of your cycle as a, you know, of your menstrual cycle, you know, the body is preparing for, obviously, pregnancy and implantation. And in doing so, it has to have a certain, you know, hormonal setup there. And if you’re fasting, if you’re not feeding, that in fact, and certainly in pregnancy, we accept a little insulin resistance, obviously because of, you know, because of the circumstances of the pregnancy. And so that completely makes sense that you would want a woman to fast during the first two weeks of her cycle before she ovulates.

18:02
Lisa
Yeah, definitely. I think it’s like you were mentioning there are, and I’m not plugging the book or anything, but there are books, though, that women can read if they’re interested. One is called Fast Like a Girl so that you can figure out, you know, the best time for you. And again, much like anything with functional medicine, it’s not a one size fits all. It is going to be geared towards the individual. So maybe it might work for most people, but not all. So it’s really just listening to your body and your cues and what works for you.

18:37
Kevin
Well, since I brought up general practitioners, when you first meet a new patient here at Interborne Wellness, what are the cues or key clues that you have that we should be investigating functional medicine over conventional medicine? Like, what is the distinction? Everybody says, well, I’ve got a GP and they’re not telling me this when.

18:58
Jamie
Kind of like what happened to you?

18:59
Kevin
Yeah. So, I mean, I think your story is so common among our patients and everyone out there, because we’ve been conditioned to believe this guy knows everything. And he knows a lot. He just doesn’t even have time to explore what your individual problem is. Hence the name NA1, the study of one person. But, you know, when. When does just, hey, I need to go to my doctor and be able to find out what my lab say versus, hey, I need to probably be exploring functional medicine and switch over for you.

19:32
Lisa
I think that’s a great question. Most people will. I think it needs to be addressed if they have chronic inflammatory conditions that are not being controlled with medications or just being controlled. I’ve seen people that I’ve treated that have been on four different blood pressure medications. And so to me, if you’re going to keep adding onto it and nothing’s happening, then something needs to change and addressed. Or just chronic joint pain that people have had cortisone injections for or different treatments and they’re not seeing any improvement, then that’s another reason to be go down this avenue and be interested in having labs completed. I think, personally, I think most people should have an extensive comprehensive lab panel done, because most of these chronic diseases can actually be prevented if you have the information before you.

20:46
Lisa
So I know we always talk about, Kevin, that you have the genetics there, but that doesn’t mean you need to play turn on those. The that gene. You can have it, but doesn’t mean you need to turn the lights on.

21:01
Kevin
Right. So I think this is probably a question for both of you, given your general level of training, especially through medical school. What is the. What are you taught with labs? When you get labs back, how much are you taught then? I know how much you know now, Lisa, but what were you taught back then? And how has functional medicine really kind of skewed and changed and made you more impassioned about how we can understand what these lab values actually mean?

21:36
Jamie
Well, my education is 30 years old, so it’s been a while since it’s hard to remember. And I think that the reason I say that up front is that the testing has gotten so much more complex and more specific in the intervening 30 years since I was in training. And so it does require that you keep up with it. But the other thing is, obviously, with more testing, it’s very easy to have too much testing and get lost in the weeds with all kinds of different things. And so that’s why? You need to have an initial battery of tests to say, all right, well, okay, well, does he have, you know, elevated homocysteine? So do we need to go down this pathway so that we can trim it down? That’s something that’s not done in most allopathic traditional office spaces.

22:28
Jamie
Now, I think 30 years ago it was, I think we addressed these issues much better 30 years ago. But as it is now, we’re pushed into protocol based therapy. And so again, you know, your primary care provider, they’re going to get a lipid panel, they’re going to get your thyroid panel, they’re going to get a CBC and a cmp. And if there’s anything outside of that, you know, it’s really hard for them to pursue anything outside of those initial labs. Gosh, that’s what we get for everybody. And you know, it’s not necessarily helpful in these circumstances. You’re not going to pick up on the reason why somebody is fatigued necessarily with a basic metabolic panel unless it’s obvious. Right.

23:06
Kevin
What’s your opinion, Lisa?

23:08
Lisa
So I think the homocysteine is important, but insulin is another one that should be tested. But my opinion is they teach you in school. What I was taught is as long as those lab values are within that range, then you’re the patient’s good. They don’t. Yeah. And it was never brought up to me until after that. Who are the people that get the labs the most? Well, it’s going to be on a regular basis. People that have chronic disease or chronic.

23:39
Jamie
Conditions that, whose issues aren’t being addressed. They’re going to keep getting the same labs. I mean, you know, and they’re going to keep saying the same things. Well, I can’t figure out what this is. Stop closet eating, you know, get better sleep. Right. I’ll give you something to help you sleep. I mean, that’s as, that’s as far as it goes.

23:57
Lisa
Yeah. And they don’t tell you like there’s, the ranges are so big. Like I always joke and say you could drive a truck through the ranges because, you know, it’s just so such a wide range versus an optimal range that we like to talk about with functional medicine.

24:17
Jamie
So for instance, you know, like hormonal therapy, you know, like a 55 year old gentleman comes in with fatigue and tired and weight gain and we’re like, all right, well, he’s probably got low testosterone, you know, and you go to your primary care provider and say, you know, I feel like I Got low testosterone. And the primary care provider is going to check that testosterone, and they’re going to say, normal for your age, which is absolutely true. And so my point is, that doesn’t solve the problem. You don’t. You want somebody’s testosterone levels to be the same that they were when they were 30. That’s what they’re asking for. That’s what they want. But yet they don’t go that far.

24:55
Jamie
Okay, if you got a Testosterone level of 150 and you’re 55, you’re good, you’re gonna feel bad, you’re gonna grow man boobs, and you’re gonna gain weight and you’re gonna be tired and you’re gonna have no libido, but, okay, you’re normal for your age. That’s what I’m talking about. This is a specific example of, you know, we get these labs and, okay, well, they’re normal for your age, but that doesn’t address the problem.

25:17
Kevin
Yeah, I think it’s kind of interesting because we send off all these labs, and I’m sure everybody has a medical portal from their physician. So they go in and they access their labs, and they go through it, and they go, no flags. Because they’re looking at these ranges. They’re like, I’m good. They answer questionnaires for us, and we analyze those labs, and we’re going through there, and they’re like, oh, the only thing the lay person looks at, and they go, I have low magnesium. I just need to take a magnesium supplement. I have low potassium. I just need to eat more bananas.

25:44
Jamie
Right.

25:45
Kevin
I’m great otherwise. And some people live life from that standpoint. But then by the time we answer these questions and Lisa takes a good look at it and Jamie takes a good look at it, we’re like, you’ve. Between these eight to ten other markers, we know what your reason why you’re feeling the way you’re. You’re. You’re reporting that you feel. Not telling you that you should feel normal when you know actually you don’t and come up with a plan to fix that particular issue. Again, like, Lisa brought up the. From the root cause.

26:17
Jamie
The root cause. That’s right.

26:19
Lisa
Yeah. Yeah, definitely. I think it’s. It’s interesting that it made me, for some reason, think of the way sometimes animals get treated better than humans, because if you take your dog in, they’re going to do a stool test for your dog, but they don’t do all the time.

26:37
Kevin
Have you ever been out in the yard trying to collect stool for your dog.

26:42
Lisa
So it’s like, wow, my dog’s getting like a stool test, better treatment than I am. And the stool test is something that can also give you a lot of insight on how your gut is doing.

26:53
Jamie
Well, without seeming too cynical, you have to pay cash money to a veterinarian, and if you’re paying cash money out of your own pocket, you expect results. Whereas in our society, you know, some other company is paying, you’re paying for it, but, you know, at the end of the day, they aren’t as accountable to the outcome as a veterinarian would be. That’s why you feel that way, Right?

27:15
Lisa
True.

27:17
Kevin
So there are a lot of, I mean, we in this practice medicine, again, kind of an Eastern and western kind of philosophy, which means that we incorporate a lot of different things. So, you know, if you need a particular medication and we know it works and we can’t get you to start addressing it from a functional medicine, we’re absolutely going to turn around and say you should do something about it. You shouldn’t live like this. If you’re hypertensive, take something if you need it. If you’re not willing to go back and fix the root cause. Right.

27:43
Jamie
That’s right.

27:43
Kevin
Fair enough.

27:44
Jamie
That’s fair enough.

27:45
Kevin
So I say this because we have many different podcasts on GLP1 drugs. We know that it is a peptide that honestly, I don’t understand why it’s considered a drug. It’s a peptide in the first place. And I don’t understand how somebody can patent a peptide because that’s a naturally occurring substance in your body. But for patients using GLP1 medications, what do you think the biggest mistakes you see in sabotaging long term metabolic health happen as a result? I know this is kind of an interesting topic for us because again, we provide them, but we’re always working with people to use them as a tool to get to a place where they don’t have as much insulin resistance, where they’re actually living a better life so that they’re not dependent on this peptide or drug the rest of their life.

28:32
Jamie
Absolutely. What do you think, Lisa?

28:35
Lisa
Well, I think in this might, being with your history, it might go with it is a lot of people don’t change their habits. So keep the same habits because, well, if this drug is doing the work for me, like I, I can eat the Cheetos. Yes, I can. I don’t really have to change that much because this is working for me. So unfortunately, we have a society that wants a quick fix and doesn’t want to put in a lot of work due to convenience. I mean, most of us are have a lot of hustle and bustle. It’s go, go, go. You don’t really have the time to focus on other things. So it’s not because of laziness or anything else. It’s just time. You know, having families and working and just, it’s doesn’t permit a lot of time and convenience.

29:24
Lisa
It’s a lot easier to go through a drive through than it is to take the time to cook something at home. So I think that’s one of the big things that I see.

29:36
Kevin
I think the synopsis would be that you have, yes, there are patients that are not going to be willing to put in the time for functional medicine and given your situation, that is the best option for you. A GLP1 is going to work for you and it gets you started on something and then it gives us and of want a chance to have an ongoing educational conversation with you about why do you want to continue to spend this kind of money on something that you’re dependent on.

30:03
Lisa
But it’s good you do that. I feel like most people won’t, most clinics, some of the clinics are doing it because, oh, it’s a moneymaker and they don’t take the time to do that. So I think that’s.

30:15
Jamie
Well, I think from a 10,000 foot view, this is disease management and not disease cure. And so, you know, I was trained in a time that, you know, the goal of medicine is to cure, to end disease. And if you can’t end disease, you try to mitigate its effects as much as possible. Whereas all of these treatments, you know what happens when you come off of the GLP1? Nobody really wants to answer that question. Well, the great majority of the people regain their weight even worse. These GLP ones make their insulin resistance worse because it causes their body to release insulin inappropriately. And so they’re even further behind than they were before. And so the whole idea of obesity. Okay, well, the easy thing is shoot them up with Ozempic once a week and you keep going and there’s no endpoint.

31:08
Jamie
We didn’t cure this, we’re just managing this disease. Well, I think that there is a cure for obesity and it’s not pharmacologic and it needs to be brought up and it needs to be addressed. And people want to make excuses saying it’s about time. You know, it doesn’t cost you any time to fast doesn’t cost you any time to not eat. You can still get about your day. In fact, you have more time because you don’t have to sit down and eat something. And so, you know, that’s a. That’s a weak excuse in my mind. And so, you know, most all therapies that we have nowadays, treating hypertension the same way we could cure hypertension, we can cure hypertension in people through lifestyle. I ultimately believe that there are some people that obviously need to be treated for hypertension.

31:50
Jamie
But again, when you got someone for any hypertensive medications, really, okay, you know, are we going to do the same thing and consider it not insane? I told this story before, you know, I saw a cardiologist, she’s a friend of mine, he works out at my gym. And I said. I said, hey, you got high blood pressure? He said, yeah, I’m on three meds. I mean, he’s a cardiologist. I was like, dude, you’re a doctor, you know, and we’re going to keep. Are you going to take a fourth? Do you really think that’s going to work? And so, you know, obviously he’s at the gym, he’s trying to take care of himself. Well, our patients get. Should get the same sort of treatment. We know to do it. We can tell our patients to do it. But guess what? We’re not paid to educate.

32:30
Jamie
We’re paid to diagnose and write prescriptions. And that’s the big problem. That’s the big difference, I think, between this space and traditional medicine in the year 2026.

32:42
Lisa
Yeah, definitely. And like you mentioned, with the high blood pressure. High. High blood pressure, high cholesterol, that’s just a sign that the body has chronic inflammation.

32:51
Jamie
It’s dysregulated. That’s right.

32:52
Lisa
Yes, it’s dysregulated.

32:56
Kevin
So what do you do with a patient that says, I know what to do, I just don’t do it, Especially when it comes to, like, nutrition, movement, stress. How do you motivate them? Because I will tell you know, being one of the owners here at n of 1, I said, the GLP one, that’s a motivator for people, because when they use it, they’re usually spending a bunch of money. And at some point, we’re coming to them and saying, are you done spending a bunch of money? Are you done? Are you really done? Are you tired? You’re tired of that shot, right? Well, I’m gonna go to the pill. That’s the new thing that’s coming out well, are you tired of having to take that pill? And are you. When are you willing to do that? So I’ll kind of restate this again.

33:37
Kevin
I know what to do. I just don’t do it. So what do you do around their nutrition, the way that you approach them with their movement, their stress levels, that kind of thing? Because most people don’t. I mean, they kind of intrinsically understand stress, but they don’t get what they’re not doing. Because we’re all spiritual people here, all three of us, and I think there’s a component to be said of some things that are outside of medicine that doctors never really like to talk about.

34:03
Jamie
Some do I like to talk about it. Go ahead, go ahead, Lisa.

34:09
Lisa
Well, I think that when that happens, a lot of times, I like to get to why. Why did they want to have their laps drawn? Why did they come and see me? Why will tell me a lot as to how it guides their motivation. If they don’t have a really big why, so to speak, the reason for doing this, and sometimes you have to ask multiple questions to get to their why. It’s not just because, well, I want to lose weight. It’s a lot deeper than that. And there’s been different people who have said because they want to be able to see their grandkids graduate or be able to play on the floor with their grandkids and not have to hurt getting up. And so it’s just different.

34:57
Lisa
Finding their why is the big thing if you can’t make motivation happen for someone, if they don’t want to do, if they don’t want to put in the effort, they’re not really going to see success. I think they need to kind of hit their rock bottom, so to speak, in order to really be motivated. And I will say, once people get started and see how good they feel and see how good they’re doing, then it’s like, oh, I got this. This isn’t bad at all. This is easy. And so I would say just one.

35:30
Jamie
Of the anecdotes I would use to dovetail off of that, Lisa. You know, when I have an initial consultation with somebody who’s interested in a gastric bypass and weight loss surgery, these are obviously people who have pursued me for surgery to solve this problem. And so most of these folks, they’re at the end of the road. You know, they’re morbidly obese, they feel terrible, they don’t sleep well, they have no energy, their mood is low, they have all these other health Problems. And so when I first sit down and talk to them, I say, you know, look, the way out of this problem is your lifestyle and we need to start discipline in your lifestyle. And so I start them on fasting. And so I’ll start them on intermittent fasting. I’ll say, alright, well what are you going to get out of this?

36:15
Jamie
I want you to fast for a month. And I give them very specific protocol to do so. What are you getting out of this? Because you’re not going to lose much weight. You know, fasting is not really necessarily for weight loss. It’s to eliminate insulin resistance. And what I tell them up front is there are some things I can assume about you and tell me if I’m wrong to a patient. If you’re, you know, in pre operative consultation with me, I ask them, how you sleeping? Well, they sleep terrible. You know, half of them have sleep apnea which contributes to it. But even with insulin resistance and inflammation that they have, they’re not sleeping well. And so they want to.

36:50
Jamie
And so when they wake up, they don’t wake up refreshed, they’re tired all day, you know, and they have, you know, obviously issues with the fatigue all day. And I say, you know, you fast for a month and you eliminate your insulin resistance, you’re probably, you may lose five pounds. And that’s fine. That’s not what I’m really worried about. But imagine when, you know, you remember back when you were a teenager and you got a good 8 to 10 hours of sleep and you woke up refreshed, energized, ready to take on the day. Wouldn’t you like to feel that way again? You do this for a month and what I found is I’ll start them at intermittent fasting.

37:21
Jamie
If they do intermittent fasting for a month and they do it as I asked to a patient that will ask me, can I do it every day? Can I do it every day? Which tells me, okay, they get the connection between lifestyle and how they feel. And again, they’re not going to get that from a primary care provider. They’re not going to get that. And something as simple and that costs nothing. It costs nothing. In fact, it costs less than nothing because they’re not spending money on food that they would otherwise be spending.

37:51
Kevin
Yeah. So there’s a mindset upgrade that I think is happening in the public these days. People tired of this, fair to say, I mean, you see it based on the way that your insurance works, the way that your physician works with insurance and the physician works with you as a result of the pressures that they feel just from a business standpoint. So let’s talk about the patients themselves. What kind of mindset has to change in them in order to get well here at Najuan or frankly, guys, if you’re not, if you’re listening this from anywhere else and outside of the Tennessee area, go to somebody get some help. But what kind of mindset has to happen? Because I know I’m, and probably people have heard on this podcast, I’m a big habit formation person, you know, improve your process.

38:42
Jamie
Right? That’s right.

38:44
Kevin
So those processes every day make a difference. So what’s your take on all that? What’s the mindset that has to change for them?

38:52
Lisa
I definitely think the mindset is huge. They have done different studies on how important the mind is. In fact, it just plays on how you feel. So if somebody, for instance, somebody says, oh, you’re sick, you’re a sick person. And the person thinks that I’m sick, their mind is their whole body is going to follow suit because I’m sick. So I think it’s really important when going through this that you say I’m well or you think of where you want to be. I have more energy kind of putting it out there and your body will follow suit. So I think the mind is a very important tool in this process and accompanying the whole goal you wish to achieve.

39:43
Kevin
Well, if you’ve had, if you believe that, I’m sure you’ve had a patient sit in front of you and you’re like, this isn’t going to work. It’s not going to work for them. They, they refuse to change their mindset. They’re negative Nelly, you know, they’re just not. But yet they’re going to go ahead and try to invest in this thing. Have you ever just told somebody, no, you shouldn’t do this. You’re just not the person. You’re not prepared for this?

40:10
Lisa
Yes, it’s worked up in the favor and against it. Like some people will just say no, okay, fine. Whereas other people, it has actually motivated a couple that I could think of to where they’re like, now. Like, they really wanted to do this and reverse psychology. No, it works that way. And so it was great. And they totally killed it with and followed and the lifestyle is now theirs. And so yes, it’s, I think it’s important because you actually want to see in any practice, you want to see Somebody succeed, and if you know they’re not going to succeed and not want to willing to put in the work or do the work, then, you know, it just kind of lets you both down. So I think it’s important to be able to decipher who’s. Who’s able to and motivated enough to do it.

41:07
Jamie
Well, you want to get them invested in, obviously, your ideas of treatment. And I think that, you know, most of treatment these days is about preventative care. Okay, we’re going to give you. We’re going to control your blood pressure, we’re going to control your cholesterol, because you’re going to have a heart attack in 40 years if that happens. Well, what does that have to do with me right now?

41:27
Lisa
Okay?

41:28
Jamie
How can I own that right now? What motivation do I have to take your blood pressure pill? I don’t care, you know, I have a heart attack 40 years from now, you know, okay, you’re gonna give me a pill. And so it becomes impersonalized and the patient becomes separated from the lab work and becomes separated from the treatments. You know, I have patients all the time who, I say, who are on 20 medications, and I have this exercise all the time. Do you know what this does? And they have no idea. They have no idea what it’s even there to treat because they have such a long list of medications that nobody even explained it to them. What does it do? What’s its point? And it has become so impersonalized. And so, you know, if you want to prescribe somebody a pharmaceutical, that’s great.

42:08
Jamie
Tell them what it is. Tell them what’s there to do, right? And so it’s just become so impersonalized over the last 10 to 15 years that, you know, again, I think that this is. This is easy. The second point I’d like to make is, you know, for years in the first part of my practice, I had, you know, friends all the time who would come up to me and say, jamie, I can’t find a primary care provider. Can you find me a primary care provider? And, you know, for years, I would find them a primary care provider. I’d call somebody up on the phone and say, hey, will you take on this patient? Now you can’t even find a primary care provider. Nobody really has primary care providers anymore.

42:42
Jamie
If you have something acute happen, you’re going to go to an urgent care clinic or an emergency, you know, but again, I think that functional medicine should be the primary care that is not being given now in 2026, by allopathic medicine. So just my thoughts in there.

42:58
Kevin
And we can do all that in N1?

42:59
Jamie
That’s right.

43:00
Kevin
And we do. And when we don’t, when we get outside of our purview, we refer them out.

43:04
Jamie
That’s right.

43:05
Kevin
We will figure it out. But I mean, going back to the patient thing, I mean, I have no problem telling a patient, I don’t think you have the ability nor the need or want to get involved in doing this. And because ultimately, I think about it from a business standpoint, since I’m kind of the business guy in the whole thing, I don’t want the bad recommendation. I don’t need the bad Google review. Because the bad Google review isn’t about us. It’s about you. It really is about you. And because if you didn’t put in the work, I don’t know if you’re in the closet eating to go back to the very first thing. I don’t know. And if you’re not committed to it, chances are I even tease people. I think it was one of our last consults. Lisa. I sat him down.

43:48
Kevin
I think you were off of our call at the moment. And I said, look, if we provided this thing to you for free, would you do it? He goes, oh, yeah. I said, how successful you think you’d be at it? Long pause. Super long pause. The reason I say that is people have to have skin in the game. They need to feel like, okay, I can’t have that glass of wine because I have paid for this.

44:17
Jamie
I want my parents to own their labs as much as I do.

44:20
Kevin
Yeah, but if you, if they don’t, you don’t give them a reason or they don’t have their own reason, they will fall off the wagon and they will have bad results. And then they’re going to say, I made a terrible investment. My own health. And. And you are a part of it. And now I’m going to grade you as such. So got no problem telling people, I don’t think you’re ready. Come back to me when you’re ready. It might be months. This isn’t a sale. This is about you getting well. And if until up until that point, I’m not interested.

44:46
Jamie
Right.

44:46
Kevin
We’re not in the business of making people do things they don’t want to do. We’re in the business of helping you do the thing that you don’t know how to do.

44:53
Jamie
Correct.

44:53
Kevin
God, that’s a really good quote. I should write that down, put it on the website. So kind of get this thing Kind of getting toward the end here because we’ve been on a minute from Yalls perspective, especially you as a nurse practitioner. What are the biggest bottlenecks that keep functional medicine from being more widely available in mainstream healthcare?

45:20
Lisa
For most people, I think it’s going to be cost and if it’s, I think if it were covered by insurance, we would see a lot more people interested in functional medicine. I think another thing is that, and I’m hoping within the next few years, I think people are already starting to recognize its importance and know, oh, seed oils aren’t good for me. Or the glyphosate and atrazine, I’ve heard of that. They cause cancer. Other things like it’s becoming more wide known. So I think making it more available to the general population, the information available is key in it as well. So I think both of those things. Cost is one of the big things though that I’ve noticed where people really want to do it.

46:11
Lisa
I’ve, I’ve seen people ask other people for loans and money just so that they can do it and feel better. And unfortunately it’s related to your health. I feel like that’s not something you should have to do. But at the same time it’s a, it’s a difficult.

46:30
Jamie
Well, I’m an eternal optimist and I think that there is insurance reform on the horizon. It is happening as we speak. And I think that people are beginning to recognize that the traditional insurance payment system, third party payment system is not working currently. And as our president says, if, you know, he wants to put the money back in the hands of the consumer and they begin to choose this. I think that this is going to be a big explosion in medicine in America today. I think another one of the. And it’s becoming less so.

47:04
Jamie
One of the other, you know, obstacles to this taking off is there’s still a perception there that this is, you know, this is burning sage incense and you know, and checking your key and all this, you know, stuff that is not based on, you know, sound western medicine science. Well, you’re looking at an allopathically trained western medicine surgeon. And I believe in it. I believe, I think this is absolutely a far better way to approach everyday problems. And so I think the perception is changing and I think it will change actually much more in the next year or two as things begin to reform from an insurance front.

47:44
Kevin
Well, I think there’s a lot of things out there that are going to come to the forefront in a short order that we don’t think of as medicine, sound therapy, I mean, we talk about cold therapy and those types of things here. Those are all important pieces. And there’s gonna be more science that we’re gonna see around it. I mean, I don’t know about you guys. I think back to, I’m older, so I remember my parents going, you can’t listen to Metallica. That’s rot in your brain. That’s gonna kill you. That’s devil music. You shouldn’t listen.

48:18
Jamie
I might have been on to something.

48:19
Kevin
I don’t know, maybe they were. And I certainly can understand that now because if you surround yourself with that kind of imagery, that kind of sound and information, because we talk about Lisa and I do in a lot of these consults, is you are your environment.

48:36
Jamie
That’s right.

48:37
Kevin
Protect your environment. Your environment is just not the trees out there. It’s not just the room you sit in. It’s not just the food you consume, it’s the news you consume. This is kind of how I’m going to end this, guys. But the news you consume, that the day to day sounds you consume. How you perceive your own environment is probably the most important thing. As Lisa was saying earlier, perceive your item, your world in a better way and you will see the truth. I always go back to that analogy of you seeing that car and you go, I’ve never seen that car on the road before. Right? And then all of a sudden I want to buy that car. And now all you see is that car.

49:15
Jamie
Right?

49:16
Kevin
Because your brain is naturally attuned to tune out useless information or what it perceives as useless information until you start recognizing it. So as you go through this process of functional medicine, you will start to recognize the signs, the symptoms, the things you’re consuming that drive your day to day behaviors. How you behave around your kids, your parents, your spouse. You know, what drives you know, even the simplest things of sex with your spouse and those kinds of things. If you consume bad information, you will be putting, having, putting extra strain and stress on your body. So you guys have anything to add on that?

49:55
Jamie
No. Good, clean Christian living. That’s what we’re preaching.

49:57
Kevin
Absolutely. Lisa, we can’t thank you enough for being on and we’d continue to like to have you on, especially as topics come up because you are a fantastic resource and we’re blessed here to have you as part of our team.

50:09
Jamie
Yeah, thank you, Lisa. God bless you.

50:11
Kevin
So thank you everyone. I’d like to recognize Maxgen before we leave. They are genetic testing company. As we talked about earlier, when you talk about your genetics, they’re important. These tests can give us a lot of great information about how you methylate all the foods and supplements that can go through your body. And we can help keep you from picking the wrong tune, if you will, because we always refer to genetics as a piano. You can have a piano in your home all day long, but all of us know how to play Mozart. Some of us only know chopsticks. So with that being said, we can help you help understand what those triggers are and help prevent those ones that are bad and definitely lift up the ones that are good. So with that being said, again, thanks guys.

50:58
Jamie
Enjoy this. See you next time.

Transcribed by https://fireflies.ai/