Training With Metabolic Dysfunction- Episode 52

The term "metabolic damage" is often misunderstood and over marketed. This term should ring true for you if you have experimented at all with metabolic compensation through diet and exercise. In this episode, I dive deep into the ways that metabolic damage can possibly happen through means like overtraining and adrenal fatigue as well training methods to overcome them. 

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Jade:    [01:17] Ok, welcome to today’s show. Today we’re going to be talking about something that’s been coming up a lot for me, and obviously, many of you were introduced to me through these concepts and have used these concepts successfully. But I haven’t done a dedicated podcast to this yet, so I’m going to do it now. This is the concept of metabolic damage. Here’s the interesting thing about this – first, we got to get some terminology out of the way. So, when we use the term metabolic damage, it’s a nice term to use for the lay public, but I know many of you are very savvy professionals. Most of my listeners are medical doctors, and nutritionists, and personal trainers, and chiropractors, and functional medicine practitioners, and we don’t necessarily like this term metabolic damage because it’s more of a marketing term than it is a term we really think is actually happening. In other words, you don’t really damage your metabolism. Much of what is happening with sort of this overtraining situation has to do with the fact that the metabolism is just doing what it naturally does. So, is that really damage per se? However, it is a very descriptive term for the lay person, and they certainly feel as if their metabolism is damaged. Now at the same time, if you have a disease and you actually have been diagnosed with something, like Hashimoto’s thyroiditis, or adrenal insufficiency, or something like that, these diagnoses – or an autoimmune condition, which can often times comes along with overtraining – then we call that a metabolic disease. That’s also a form of metabolic damage.

            [03:01] So, there is some nuance in here and a little bit of semantics; but really, when we talk about metabolic damage, we’re talking about several different things. We’re talking about maybe overtraining, the different stages of overtraining in an athlete. We’re talking about things like adrenal fatigue, which, again, is not a diagnostic term; it’s more of a descriptive term. And because there’s several different aspects of this and there’s no real clinical diagnosis, or real sort of specific diagnosis, we rely on clinical terms and clinical frameworks to describe this stuff. So, metabolic damage sort of falls under this, and under this rubric, we’ll talk about adrenal fatigue as being synonymous with metabolic damage, and even over the different stages of overtraining in athletes being synonymous with this sort of metabolic damage model. Let’s go through the model real quick and then I want to focus today on mainly how to train and exercise to overcome some of what’s happening. To me, I like to conceptualize this, and many of you know me through the conceptualization of the different stages of “metabolic damage.” So, let’s go through these really quickly. The first stage is a very normal stage. In fact, every single person who’s ever dieted using any variation of eat less, exercise more, whether it’s a keto diet and lots of exercise, whether it’s just your standard low calorie diet and lots of cardio, or any of these diets that are essentially cutting down calories and ramping up output, every single person who does this eat less, exercise more model will, at some point – typically within about two weeks – confront this metabolic compensation, or metabolic adaptation. Essentially what this is, is that when the body, which it can best be described as one big stress barometer – that’s what the metabolism is. It’s measuring stress, and then it’s instituting reactions as a result of that. Now, the major evolutionary stress that our metabolism evolved with was the stress of starvation, so it has many, many different, redundant mechanisms to keep us from starving. Some of those are raise hunger, raise cravings, make our energy sort of unpredictable and unstable – in other words, lower energy and lower fat burning – conserve the nutrients that we already have on our body. Many people know what this is – this is metabolic compensation. So, after about two weeks of being in this eat less, exercise more state, you will begin to have changes in what I call HEC or SHMEC; HEC being H-E-C, hunger, energy, and cravings. I use this funny little acronym HEC. I also use a funny little acronym, SHMEC – sleep, hunger, mood, energy, and cravings. Hunger, energy – let me just let this plane fly over. I’m sitting out here on my deck in Santa Monica. My apartment has this big sort of garage door. But HEC and SHMEC – hunger, energy, cravings, HEC, and SHMEC – sleep, hunger, mood, energy, cravings, S-H-M-E-C, are sort of these different biofeedback signals that we can tap into to let us know when our metabolism is under stress or not.

            [06:16] When the metabolism starts to compensate for the first time, you will see changes in hunger and energy and cravings, and a slowdown in metabolic rate, the ability to burn fat. Most people, when they encounter this, most people will simply relent. The urges that the body is putting are too strong, and so they stop exercising, they start overeating, and they just stop altogether. This is sort of the typical thing that we understand in the Western world, where we see all these people – spring comes and they decide they’re going to go on a diet and get in shape - and you see ‘em all running around like squirrels, you know, out jogging for the first week in spring. And by the second week in spring, they’re all gone, all back to eating doughnuts and burgers and pizza, and no more exercise, because these urges were so great. However, there are certainly people, many of you listening to this, myself included, who can push beyond this and have some self-discipline. So, if you keep doing this eat less, exercise more approach, you can possibly – and I say can possibly – go into metabolic resistance. Now, when I say ‘can possibly’, this is just because many people don’t actually ever get there because the gap they are creating, the calorie gap, is not too big, and not too extreme, so they are eating less and exercising more in a very narrow window – which I would actually refer to more directly as eat less, exercise less, where you’re sort of cutting down calories as a result of very little food intake, but not exercising a whole lot; or eating more, exercising more, where yes, they’re exercising a ton, but they’re also eating a ton. That creates a very narrow calorie gap. As opposed to eating more and exercising less, the couch potato, or eating less and exercising more, the chronic dieter or exerciser, those two create very big calorie gaps. It’s that gap in calories between intake and output that can be an extra stress to the system. Most people who do this, within about 2 weeks of eating less and exercising more, they will start to see negative effects – changes in hunger, energy, and cravings. Their H-E-C, or their HEC, goes out of check, which tells them that their metabolism is now compensating. Now, this is pretty easy to deal with. All you have to do is move from eat less, exercise more model to maybe an eat less, exercise less or an eat more, exercise more approach. Now, if these terms are tricking you and throwing you off, you can go to, I think it’s episodes 11 and 12 in this podcast to understand more about these metabolic toggles. But all you really need to understand now is that the calorie gap, the amount between intake and output, of the amount of food you’re taking in vs. the amount of energy you’re burning up through exercise, is a key determinant of this.

            [09:02] Now, if you’re someone who can push past this, you get into what I would call the next stage of overtraining, or adrenal fatigue, or metabolic damage, or whatever you want to call it – and this is what I call metabolic resistance. This is when all of a sudden, now the hunger, energy, and cravings come along with sleep disturbances and mood disturbances, and some digestive disturbances. In other words, now you also start to have sleep issues, you start to have hunger or mood issues, and sort of the protein shakes and certain foods that you could tolerate previously now start to cause issue – gas and bloating, heartburn, all of these kinds of things. Also, you cannot seem to lose weight at this point. In other words, the dial stays still, no weight loss is happening. It’s not that it’s slowed down, it’s that it’s potentially stopped, and for some people, because they increased their food intake a little bit more, they actually may gain weight. In other words, the amount of calories that they’re burning through exercise are compensated, or even overcompensated with food as a result of this hunger and craving urge. So, metabolic resistance is this place that feels like I’m doing everything right, I’m exercising like crazy, and the dial will not move. Not only is HEC out of check – hunger, energy, and cravings – but sleep, and mood, and digestion are also there. What you might also begin to see is changes in the libido, and menses, and erections for men. This is because, obviously, the metabolism’s primary drive is to reproduce, and women, because they’re the gender of child rearing and childbearing, are a little bit more sensitive to this. As this dysfunction gets deeper, you can start getting into menstrual irregularities, libido changes, in addition to changes in digestion, and mood, and sleep, and hunger, and energy, and cravings. So, all these signs and symptoms are telling you how deep the dysfunction is going. You also can have changes in exercise performance and exercise recovery. In other words, that euphoric, relaxed feeling you used to get after a good workout turns into a drained sort of feeling, where you just feel like – your nervous system is kind of short-circuited, or you feel like you got monkey-mind all the time, and you’re wired all the time. We often call this stage wired but tired. So, you’re fatigued, but you’re wired vs. tired and tired. You’re wired in the head, but tired in the body. Then, of course, you can go into the next stage, which I call metabolic dysfunction or metabolic disease. This is where things start to get so dysfunctional that you actually start getting nutrient deficiencies, your immune system starts to potentially attack certain tissue, so immune issues start to pop up, autoimmune conditions start to pop up. This is where you start actually getting into real diagnoses that the doctor can now pick up. If I run blood labs on you, I can start picking this stuff up. So, these different stages are sort of important to understand, and if you understand these stages, this takes into the account some of the research on overtraining in athletes, it takes into account some of the issue with nervous system function, hormone dysfunction that we know what happens with cortisol and adrenaline and things like that, and also immune dysfunction.

            [12:19] Now, this whole system we refer to in functional medicine as the neuroendocrine immune system, the combination of the nervous system, the hormone system, and the immune system whenever you push the body too far. So, now let’s say that you’ve gotten to this place. We talked about metabolic compensation, stage 1, that’s pretty easy to deal with. You just move to a more narrow calorie gap and you can keep doing what you’re doing. Once you get into metabolic resistance and the dysfunction has gone that deep, what you need to do now is kind of jump back and forth between a period of time when you’re eating less and exercising less - like maybe a traditional Parisian or European, or traditional hunter-gatherer; they’re walking a lot, but they’re not doing a lot of CrossFit and crazy exercise, and they’re not eating much – and then, jumping back and forth between an athlete. So, you kind of toggle and jump back and forth between these two toggles, spending part of the time in sort of an intense workout phase and part of the time in sort of a relaxing phase. Many women can do this with their menstrual cycle too, by the way. Training when estrogen levels are high, they can essentially train harder and eat more during that part of the menstrual cycle; and they can do the opposite when in and around menses, where they can eat less and exercise less. I covered this in episode 2 of this podcast, I believe. So, the issue then though is what happens when you get to stage 3. At that point you only have one option. When you’re in metabolic dysfunction and leaning toward metabolic disease, the only thing that’s going to work is eat less, exercise less. I want to sort of go through this in detail. Now, I’ve gone through the eat less, exercise less protocol previously – I think that’s episode 33 in this podcast – but I want go through this specifically as it pertains to exercise. Because a lot of people say well, what do I do here? Is eating less and exercising less meaning no exercise at all? And no, it’s not, because we certainly want to benefit from exercise; we just need to decrease the intensity, and the nervous system drive, and hormonal output of exercise. There are certain types of exercise that can restore function to the hypothalamus, pituitary, adrenal, thyroid, and gonadal axis, and there’s certain ones that can further dysregulate it. Any type of activity that is very long or very intense tends to continue this negative cycle of nervous system dysfunction and hormonal dysregulation that comes along with stage 3 metabolic dysfunction or disease. So, what can we do? Well, in the eat less, exercise less model, what we’re doing is moving people to walking primarily, and in particular, very slow walking. Now, why walking? Walking is – and why slow walking? ‘Cause walking is one of the only forms of movement that simultaneously lowers stress hormones, both cortisol and adrenaline, and sensitizes the body to insulin. It is very balancing to the sympathetic stimulating side of the nervous system and the parasympathetic relaxing side of the nervous system. The key indication that the sympathetic and parasympathetic arms of the nervous system are out of balance is digestive dysfunction. Heartburn, gas, bloating, constipation, diarrhea, irritable bowel syndrome, all of these things, because the gut is the seat of – it’s the seesaw of the autonomic nervous system. The sympathetic vs. parasympathetic balance is reflected in the digestive tract. So, what we want to do is choose exercises that balance this out.

            [16:04] Now, there’s two types of exercises that are best for this. One is walking ‘cause it very gently restores autonomic nervous system function. So, you want to do as much of that as possible within reason, maybe between 2 hours and 4 hours daily. Now, I know that’s a lot for a lot of people, but remember, the metabolism could care less whether you think that is convenient for you or not. What you’re doing is you’re giving up all the other intense stuff that you’d probably be spending 1 hour, 90 minutes in the gym anyway, and all you’re doing is adding another 30 minutes, and you’re walking preferably out in nature, in green settings. This is woosah walking. If you’re on a treadmill, this is less than 3mph on the treadmill. By the way, woosah – I don’t know if you guys know that reference. I use it a lot, but remember that old movie Bad Boys with Will Smith, and I think Martin Lawrence. There’s this part of that movie where their sergeant – they’re two cops – their sergeant is essentially taking a meditation course, and he’s basically in the office trying to calm down saying “woosahhh, woosahhh,” so it’s just a way of telling you to relax. Very woosah based relaxing, or om-based relaxing. This is relaxing walking, not trying to powerwalk with dumbbells in your hand or a pack of weights on while you’re doing it. This is breathing, relaxing, smelling the roses, walking the dog, talking to your significant other, just time. Now, the other thing that can work well here is a form of interval training, and to me, it’s the original form of interval training – and that is traditional sets, reps, weight training. This is one of the best things you can do for balancing the sympathetic-parasympathetic nervous system. When you exert yourself in one of these traditional weight training type of workouts, what you’re doing is you’re spending time under tension, the nervous system has to output drive, you’re kind of very sympathetic, you’re pushing through, let’s say, a 8-12 rep max, right? So, you’re getting 8-12 reps. You’re doing 3-5 sets of this exercise – usually a full body exercise – let’s say squats for example, and your nervous system will be jacked up. It will be pushing out hormones. It’ll be pushing out these nervous system signals, adrenaline will go up. Your body will be exerting major force. You rack that weight and then you take a long rest period. There isn’t any going and running on the treadmill, there’s no doing a bunch of burpees, there’s no juggling or doing hula hoops or all the stuff that you see nowadays, and kettlebell swings in between. That stuff can be great if you are not in metabolic dysfunction. But if you’re in metabolic dysfunction, you can’t tolerate that. You need time for the parasympathetic system to get some exercise too. You need the brain and nervous system and hormone system to calm down. So, this time between sets, this 3-5 minutes between sets – and I would say that’s basically where you want to be, between 2 minutes at a minimum, and 5 minutes at a maximum after a hard set of traditional weight training is time for your parasympathetic nervous system to kick into gear. Now, you could do some nice, relaxing stretching here, but the idea is to exert, get out of breath, get your body straining under heavy weight, and then rest for a period of time where now the parasympathetic nervous system helps you recover. Then, you repeat it. Now the sympathetic kicks in, then the parasympathetic kicks in, then you repeat it. The sympathetic kicks in, and the parasympathetic kicks in, and this trains the body to get out of this stuck nervous system overdrive. So, walking is very calming, pushing down the sympathetic to parasympathetic, and then also this traditional resistance training helps balance out the sympathetic- parasympathetic by doing a set, resting, doing another set, resting, doing another set, resting.

            [20:07] And a very simple way to do this is just take 4 full body exercises – let’s call it a major push like bench press, a major row like bent-over row, a major leg mover like squats, and maybe add in another press, like something for the shoulders like a shoulder press. Bench, bent-over row, squat, and shoulder press – 4 big movements. 3 sets to 5 sets of each, 8-12 reps of each, so these will be heavy weights. You do this all in a row, by the way. You do your first set of bench press – 8 reps – you rest 2-5 minutes, you do your 2^nd set of bench press, you rest – take this long rest in between, you can be doing self-stretching or that kind of stuff, or just nice walking and breathing, meditative type of recovery. You do 3-5 sets of that, then you move on to the next exercise, and you maybe move on to bent-over row, and you do the same thing there. Push, rest, push, rest, push, rest. This will take you a little bit longer. It’s also a great way – it’s the original way to hold on to muscle, and even gain muscle for some people if you’re eating enough. But for someone who’s in metabolic dysfunction, they’re typically going to be eating very little because the metabolism can’t handle lots of food, and they’re going to be walking a lot, and they’re going to be doing 3 days per week of this traditional weight training. We’re typically going to do this for anywhere from 2 weeks at a minimum to maybe 8 weeks at a maximum; and hopefully by that time, the system is recovered, the body moves out of metabolic dysfunction, and gets back into normal metabolism where now – and how would they know? Well, their libido comes back, their menses comes back, their digestive disturbances lessen or disappear altogether, the wired/tired situation goes away, they start to sleep better, they start having more energy. Then, they can begin to go backwards from there; so, then they go into the metabolic resistance protocol. Because, remember, you don’t want to just – ok, now I’m better, now I’m going to use up all this energy again. What you do is you go back and you say ok, now I’m going to put in some eat more, exercise more athletic type training for 2 weeks maybe, and then I’ll come back to this eat less, exercise less type training until you are completely recovered, at which case you can start doing longer and longer blocks. Like, maybe you decide hey, I’m going to do a eat less, exercise more block now just for a short period of time, for like 4 weeks. But now your body can handle it. So, there’s nothing wrong with eat less, exercise more once the body can respond to it again, but we really want to realize that we want to live in these eat less, exercise less and eat more, exercise more type of arrangements, and then every once in a while push ourselves into eat less, exercise more for very brief periods of time; but we have to work backwards from there. A couple other caveats before I end this. I don’t want to ramble on, but there’s a couple ways that you can see how well you’re doing with this and see how dysfunctional your nervous system is when start this traditional weight training. When you undergo a heavy set of weight training your heart rate should go up. This is the idea of a sympathetic response. You can take your heart rate, or even wear a heart rate monitor, and what you’ll see is, let’s say, your heart rate spikes up to 120/130 when you do this set of squats, or maybe more. Once you rest, within a minute, your heart rate should drop about 30 beats or so. Within 2 minutes, it should be near your resting heart rate before you started that particular set. Now, if you are in severe metabolic dysfunction, it will stay elevated for longer. You also can use this to tell when to stop the workout or to ease up on some of the intensity, because if the workout is too intense, it will start out spiking and then lowering, and then spiking and then lowering, and then all of a sudden it will stay up and not fall.

[24:07] So, you want to use this heart rate recovery as an indication of not overexerting yourself. Likewise, you can use things like the Oura ring, which is something that I wear, that tells you your heart rate variability day to day, which can tell you if you are making progress on your recovery out of metabolic dysfunction into metabolic resistance, into metabolic compensation, and into normal metabolic function. The heart rate variability is a direct measure that we now have available to us to measure sympathetic vs. parasympathetic response. You can see with this tool once you recover from this, which can take some time – and by the way, some people say Jade, what’s the longest it’s taken you to get someone out of this metabolic sort of dysfunction? Typically, it’s going to take 3 months minimum to 9 months, or 3 months maximum to 9 months maximum. I’ve worked with people up to 9 months where they really had to just – traditional weight training, lots of walking, and eating; and part of the reason it took them so long is because they wouldn’t relent. Their brain – sometimes the brain is our worst enemy, that we think we have to do these things – so they kept slipping back into cutting calories way too much, or every now and then doing a hot yoga class and it was just too much for them. Typically, when people do this and they actually follow this protocol, and do just the walking, just the traditional weight training, and this eat less, exercise less protocol, it doesn’t take long. By the way, briefly – I’ve covered this before – but briefly, at the eat less part is very important because the digestive system can’t handle a lot of this food anyway. Typically, people who have gotten this far into metabolic dysfunction have multiple allergies and sensitivities to food, they’re dealing with heartburn or diarrhea and/or constipation, they’re dealing with lots of digestive issues, and so we take a lot of the food away. Sometimes these calories can be very low, but remember, a very low calorie diet without a ton of nervous system output is very different than a very low calorie diet where you’re trying to do athletic training. It’s just very, very different there. So, these are the tools that you can use. Walking and traditional weight training, that’s what you want to be focusing on with this metabolic sort of damage protocol. I’m going to stop there. I wanted this to be short and hopefully concise, and I will see you on the next podcast.