Insulin Resistance: Key Signs & Indicators You Need To Know – With Thomas DeLauer

Dr. Mindy
For starters, it’s really fun to have you on my podcast, I have to say even though YouTube is kind of both of our big platforms, it’s really fun to have you here in a podcast setting. So thank you for joining me. You bet. So here’s what I think would be really helpful for people is I really want to dive into the nuance of insulin. So one thing that I feel like is the world understands that insulin resistance causes diabetes, type two diabetes, we also know when I can’t lose weight, I must be insulin resistant. But outside of that, or maybe I know if I go to my doctor’s office and my hemoglobin a one C is high. Outside of that, I feel like we’re insulin resistant, illiterate, like we don’t understand what exactly it is. So can you talk about what some of the signs are? Let’s start there. How would I know that I’m insulin resistant outside of those things that I just mentioned?

Thomas DeLauer
Yeah. First off, I mean, with insulin resistance in the first place, it’s nebulous territory, because people want to kind of pick it apart as like, Okay, well, we can’t really talk about reducing insulin we can’t do because insulin is important, and we need it and yada, yada. But when you look at the fact that, you know, like 40% of adults are, at least 40% of adults are insulin resistant. So that’s, that tells us there’s a lot going on, there’s probably a larger number than that. And it is something so in a healthy individual, like insulin management isn’t as important of a thing. But the problem is that the lion’s share of people are not healthy individuals. So it does become very important. And yeah, people think insulin resistance think, Okay, well, I just have to measure my glucose and and just have to look at that. And even that can give you really skewed results. Because that’s not you’re not measuring your insulin, right, like, you might, you might eat some carbohydrates, you might eat some potatoes, and then measure your glucose in your glucose goes to 160 and 180. And you think you’re insulin resistant, when in reality, if you were to measure two hours later, and everything went back down, your body essentially did what it’s supposed to do, right? So it’s not just a and that’s where people think, okay, insulin resistance and high blood glucose. Although they do go hand in hand, they’re not the same thing. They’re not the exact same thing. And one of the first ones that I want to talk about specifically is like, is extreme hunger, like it just flat out, like, if you wake up in the morning, and you are really, really hungry. I mean, it is a very simple thing, that your body is neglecting fuel, it’s not work, it’s avoiding fuel, because it can’t receive the fuel, right? So it makes sense that you would be very, very hungry. And there’s really just interesting research about how insulin plays a role with the brain. And I talked about this recently in a video, so it’s very fresh, in my mind, there was a study where they gave subjects intranasal insulin. And if you give someone intranasal insulin, they can cross the blood brain barrier pretty quick, and they can do that stuff. So they have half the subjects a placebo, Half the subjects, intranasal insulin. And then they did an fMRI scan, where they looked at their brain activity. And they found that the subjects that received insulin that the insulin actually traveled to the brain, they ended up having better connectivity between the brain and the body, and ultimately ended up having a better connectivity between the prefrontal cortex and the hippocampal region. And essentially, what that is saying is that if insulin actually gets where it’s supposed to go and gets to the brain and gets into the cells in the brain, it can actually impact in a very positive way, our satiety and how we actually crave food. But when we are insulin resistant, it goes beyond just what’s happening in the periphery, like where our cells aren’t getting nutrients, it literally like if the insulin is not reaching its target properly, and we’re not even getting insulin in the brain, we could argue that we’re it’s altering our satiety cues, and especially in the morning, because most people are, you know, they haven’t been eating all night. So they’re already waking up. They’re in a fasted state, and they’re going to be more hungry. So it just makes sense that that would be exacerbated in someone that’s insulin resistant. And it’s such a simple thing that, you know, it gets often overlooked. So,

Dr. Mindy
are you saying then, and this is a key point, that I could love the number on the scale, I can be the thinnest person in the world. But if I’m hungry all day, I can’t go without food. That could be the beginning signs of insulin resistance.

Thomas DeLauer
In a lot of ways, yes. Yeah. Because it’s, you know, weight is not always a direct reflection, right, whether you’re underweight or overweight. I don’t want to say that, you know, being overweight is healthy, but there are people that are overweight that are not insulin resistant, right. adipose tissue in and of itself is sort of a master regulator of a lot of things and has its own set of problems, but it doesn’t necessarily constitute an insulin resistance issue. And vice versa, right? Like if so if you’re, but if you’re also satiated, or you’re not that hungry all the time, like sometimes that can be a late stage insulin resistance issue. And the reason that I mentioned that is that imagine this Imagine you have gone so long with your body not recognizing glucose very well, okay, and this has happened for years. And it went unrecognized. Well, to at a certain point, your body has no choice but to up regulate fatty acid oxidation, it has no choice because it’s been deprived of fuel. So in an advanced stage of insulin resistance, kind of moving towards diabetes, this happens like you can actually see where in diabetes, like a lot of times, they actually increase the rate of fat oxidation, because their body is forced to have to use another substrate. So the reason I mentioned that is like that, that can arguably be good for people with weight, you know, for weight loss, but it’s not exactly the way you want to go for it, right? It’s not you don’t want to, I want to become diabetic so that my body oxidizes fat. That’s not the goal. So it’s a very interesting thing. So usually, when you start feeling the lack of hunger, a lot of times you notice that happen with like a type one diabetic, where it’s a very extreme situation, right? Where they’re no insulin, they need artificial insulin or exogenous insulin. And they get to a point, but they don’t know it yet. Right? It’s like, I have a family member that didn’t realize they were type one diabetic until they’re in their mid 20s. And couldn’t put on weight, right? It was like the body is neglecting glucose. So it’s one of those things to really pay attention to.

Dr. Mindy
Yeah, and we’re back at that conversation of like, the it’s the balance, right? And we made health black and white, you know, when this number shows up on your cholesterol, your healthy when this number shows up on hemoglobin a when see your diabetic, like we make it too linear, but what I hear you saying is too much hunger, not enough hunger, you’re now tipping the scales where you may be in insulin resistance land.

Thomas DeLauer
Exactly, exactly. And it’s, it’s, you know, it’s a very fine line, right. But it’s a I always say it’s a it’s a fine line, but it’s a very bold line at the same time. It’s like once you cross that line, it’s, you know, it’s very hard to get back. And another thing that happens that we don’t always think about is greasy skin, okay. Now, there’s a lot of evidence that suggests that like kind of a patchy, weird red skin that you see in people that are diabetic. That makes a lot of sense. But what about like earlier stages in the morning, okay, we all have woken up where we’ve felt like our skin is greasy or oily. And sometimes we can equate it to certain things. But if it starts becoming something that’s happening every day, and you’re an adult, and you’re starting to get like greasy skin and acne, one of the things we have to look at is that when insulin is high, like it’s not actually it’s being produced, but it’s circulating of high circulating insulin. Insulin is actually going to promote the production of androgens. Okay, so androgens alone are going to make you your skin greasy things like that. I want you to think, you know, think of a kid that is going through puberty, a 12 year old boy or a 13 year old boy, all of a sudden his skin is getting greasy, and he’s got an acne popping up everywhere, then his hormones are raging, right? They will insulin when it’s in its normal values. When it’s spiking. It can be a very positive anabolic thing, right? There’s a reason why in the bodybuilding community, they want insulin to be spiked for a certain level, right. In fact, even in the extreme bodybuilding cases, people will literally take exogenous insulin, they will use insulin to try to grow muscle, not a healthy thing to do don’t recommend it. The point is, but it will grow muscle because it’s very anabolic, and it will also stimulate androgen production. But you don’t want this happening. Hey, if you’re not a bodybuilder, be if you are just a regular person trying to live your life, and it could probably be a very clear indicator. So what ends up happening as far as the greasy skin is concerned is it ends up becoming just a result of those androgens. But additionally, when IGF is also elevated as a result of insulin, so IGF is insulin like growth factor. When IGF gets elevated. This is a very pro growth thing, which can be good for recovery. But as we get older, it’s not necessarily something we want circulating at high levels. That happens, but additionally, what has been demonstrated to happen is with hyperinsulinemia, you also end up having a decrease in the IGF binding protein, so you have higher levels of circulating IGF with less places for that IGF to go. Now, when this happens, it sort of deforms and throws a wrench in sort of the proliferation and the apoptosis of various keratinocytes. So the skin cells, and when that happens, you have skin cells that are dying, when they shouldn’t die, skin cells that are growing, when they shouldn’t grow, and you have this imbalance. And that itself is going to lead to greasy skin and acne and clogged pores. So it’s, it’s it’s wild, but you wouldn’t associate greasy skin with it. But if you start noticing it happening, it doesn’t mean you’re insulin resistant, but it means like, you know what, these things are starting to stack up. I should probably look deeper into this and do like a Homa IR test and really figure this out. So interesting.

Dr. Mindy
So okay, if you take this 17 year old boy who’s got packed with acne, is there an insulin resistant part to that?

Thomas DeLauer
No, because that’s usually going to be well, that’s a good question. I don’t know entirely right. I’m sure there is probably some links to that. Because when you look at You know, younger individuals like and what they’re eating these days, I’m sure there is some link to that, right? I can probably the correlation doesn’t equal causation. I can’t say with certainty. But usually like, you’re having just big pulses of androgenic compounds and essentially big pulses of testosterone and other androgens. So with that, it’s a direct correlation less so with the insulin. I would imagine, however, that if a kid is insulin resistant, and they are also going through puberty, it wouldn’t make sense in theory that it would exacerbate that issue and possibly make acne worse. Right? So it’s, it’s a strong theory that probably stack stands up,

Dr. Mindy
you know, my son, he turns 20 Next week, and he’s barely had a pimple on his face his whole life. And I’ve tried to figure out what it is like, why is that? I mean, he’s eaten obviously really clean in our home, but I he’s not he doesn’t eat clean what outside of my home, so. So it’s just an interesting, I’d never really thought of that correlation. And then we do know that like PCOS, so women who have PCOS that now start to get hair on their face, that there’s an insulin resistance piece to that. So could we flip it and even say the 30 You know, the 30 year old woman who, maybe it wasn’t diagnosed with PCOS, but all of a sudden nose notices when she goes in to get her eyebrows done that she needs to maybe get her moustache done? Is that a potential sign of the beginnings of insulin resistance?

Thomas DeLauer
So it’s interesting that you say that because, you know, I filmed some content surrounding this whole topic not that long ago, which is why it’s probably so even the studies are fresh in my mind. And in the day that I filmed this, I went to the grocery store and I it’s no offense to the lady I saw a woman with a full fledge beard, right and like a full fledge, like, go tea. And I’m sure she says, nice person. And but it was like, I looked at her and I’m like, wow, thinking about what I just talked about. I tried to connect that.to Right now, not necessarily with PCOS, she was an older woman. But I’m like, There’s clearly is some androgenic issue going on there where she’s producing male hormones to a certain degree, right? At her age, she was an older person, and probably in her 60s, there could be a number of different caddywhompus hormone things that are the result of that. But it did get me thinking about just this very thing. And like with PCOS, it’s such a strong interplay between the hormones and insulin resistance. It would make sense that you also see, you know, with PCOS, you see these instances of patchy little facial hair, things like that. It does add up, right, because they’re somewhere along the line, these hormones are getting skewed. And again, if insulin resistance is the cause of it, that would make sense because there’s so many other things that add up. Again, we can’t say with 100% certainty, obviously. But we do have to look at all these different correlative pieces and sort of generate our own hypothesis with us, and especially when it’s something that’s so easy to potentially course correct. Yeah, then I feel comfortable saying that.

Dr. Mindy
Yeah. And I think what we also need are indicators like the symptoms we’re talking about, because you know, people are stepping into their, their doctor’s office maybe once a year, and getting this this blood evaluation, if they don’t, if their hemoglobin a once either fasting, insulin fasting, glucose is off, there’s going to be a recommendation and then they’re not going to get checked for another year. Exactly. So we need more of this stuff. What do you think of like eyesight, so we have the most amount of mitochondria in our eyes. And we know that diabetics, that’s one thing that happens when they become insulin resistant. Could we look at changes in eyesight, light sensitivity, things like that as signs of insulin beginning insulin resistance?

Thomas DeLauer
I strongly believe that you could, and there was some data that kind of looked at this where it was like, I can’t remember the actual specifics of it. But essentially, it was like, Okay, if you took a look at people that were diabetic versus insulin resistant, and they kind of measured the blurred vision, they measured kind of the issues with the eyes in general. It wasn’t really that detectable of a difference. But then when they actually dug deeper and they sort of retro actively, like, kind of algorithmically look at the data, they’re like, Okay, wait a minute, we could actually recognize that there are signs of insulin resistance, as far as their vision is concerned, that is not necessarily detectable through their eyesight, but by looking at actual data and looking at like, the eye itself. Now with that, I do think as far as licensed activity and things like that are concerned, like if I go and I have a bunch of sugar, which isn’t very often and I go and I walk outside, I feel like I have a hard time even adjusting to the light. I feel like everything is messed up, everything is out of whack. And it does make sense right? Like if even from a very acute standpoint, I think a like super high spike acute spike in glucose for a period of time probably does impact eyesight, right that those capillaries are very easy to kind of jack up and when you end up having chronically high levels. There’s that again. It’s the same car So if you have, you know, chronically high levels of glucose, then obviously advanced glycation end products, all this stuff can affect the eyes. As far as hyperinsulinemia, and high levels of insulin that I don’t know. So we know glucose, obviously, if glucose is high that can affect vision. I do think that it’s, again, one of these things where, although we can’t say with certainty, if you were to start keeping a tally of these things that we do know are correlative. I think it helps you because the problem is, if I were to walk into my doctor’s office right now and say, I really want to get like a home IR test, I want you to check me for insulin resistance, they probably won’t, and I wouldn’t have, I wouldn’t really be able to get insurance to cover it. So I’d be forced to go out of pocket and do that, which is whatever. But at the end of the day, for a lot of people, that’s very frustrating. And the medical system is difficult to navigate to begin with. So it’s like it does kind of come back to you. So although I have hesitation saying, Does this Yes. Yes, mean your insulin resistant, I feel comfortable saying at least saying all these correlative aspects stack up. And if you keep a tally of them, and you’ve got seven out of eight of them, or nine out of 10 of them, plus your glucose is high. And looking at the statistics, it’s probably a decent chance that yes, you have insulin resistance.

Dr. Mindy
Yeah, yeah. So well said, what, what about now you got me thinking of all the other symptoms that people have that we dismiss? That could be insulin resistance? What about cavities? Do we have any interesting information on that?

Thomas DeLauer
I don’t, that’s not my wheelhouse for sure. But again, when I speculative, like, if you’re looking at a blood flow, I mean, that’s going to be a big piece, too. We don’t really think about like our gum health, we don’t think about that. And you know, there’s evidence that high blood sugar, pale pasty gums, right, and gums that bleed easily. So all this stuff adds up. And when you look at even just the relationship between like when people are sick, in general, it manifests in sort of their gum and teeth health. And when your glucose levels are chronically high, and everything is kind of at that level, then yeah, it would make sense that you’re unable to repair, you’re unable, your sort of your ION transport your ability to sort of properly properly mineralized and have calcium form where it’s supposed to form to keep your teeth strong. I know there are some links with osteoporosis and insulin resistance. So when you start looking at that, again, osteoporosis, we’re not really looking at our bones every day. But we are looking at our teeth every day. But no one’s necessarily talking about the relationship between teeth and insulin resistance. When they are in fact a bone. And if you have osteoporosis and your bones are brittle, there’s a good chance they’re gonna have pores brittle teeth, too, right?

Dr. Mindy
Yeah, I mean, and this is why I bring it up is like when you started to break down, all the things that could be can have a root cause of insulin resistance, you almost you almost could tie everything to it. And part of what like got my brain thinking about that was I don’t know about you. But during COVID, when we first went into quarantine, I was like, at first I thought, oh my gosh, everybody’s gonna take care of their health, then I was like, okay, nobody’s taking care of the health. They’re just sitting at home and eating. And I and you could see that there was this connection between metabolic syndrome and, and immunity. So could we see and then you started to see that so many people that were infected with COVID, and had either died or had really bad symptoms had some form of pre diabetes or diabetes? Could we look at immunity and immune function being in poor immune function being connected to insulin resistance?

Thomas DeLauer
I think as far as inflammatory response is concerned, there’s definitely a correlation there, right, there’s probably more than a correlation, because one thing that is pretty well documented is the interplay between inflammation and of course, insulin resistance in the first place, right? So and that doesn’t necessarily have to do with high levels of glucose that just has to do with sort of the inflammatory like sort of Il six TNF alpha that kind of elevates when you’re hyperinsulinemic. So with that, if inflammation is elevated, and your immune system is activated to a certain degree, then you’re kind of like chronically having this undulating like immune system activity, which is not exactly a good thing, right? You don’t want to have this white blood cells, and you don’t want to have a low scale attack or a low grade attack happening all the time. And then it’s perpetual, and then it kind of goes into his vicious cycle, because then you have an inflammatory response, which sort of I kind of liken it to almost like static, it’s like the cells can’t communicate properly, they can’t receive the signal from insulin can’t dock in the insulin receptor properly, because you have so much of this inflammatory storm going on. So of course, it makes logical sense that your immune system would be suppressed as a result. So when you kind of look at illness and metabolic syndrome in the first place. Yeah, I mean, that’s kind of your first line of defense. And I think, you know, we think metabolism we think, Oh, this is what’s responsible for gaining and losing weight. I mean, the metabolism is, is every energy down namak in our body, so it’s the equation of taking energy from food and ultimately creating energy for our body and producing ATP. And if that is deranged in one way, it’s gonna have a trickle down effect across all kinds of systems.

Dr. Mindy
Yeah. And now you’ve even got me thinking like people who get injured, like from working out, and they can’t seem to repair from that, like, you start to correlate when you look at it from that inflammatory standpoint. I mean, it’s almost like it’s, you can correlate almost everything to it. So, yeah, it’s so fascinating. My other interesting that I don’t know if you and I chatted about this, but I brought a net Boz onto my podcast, you know, Dr. Baz? Yeah. And you know, she’s a big believer in hemoglobin a one C, and that if it’s over five, that you’re now insulin resistant, and it’s affecting oxygen flow to your cells. So everything from brain cognition to muscle repair to energy is going to be affected. But she really says it from the standpoint of its oxygen, its lack of oxygen, because all that glucose gums up the red blood cells, and those red blood cells are moving oxygen to your tissues to keep them healthy. Have you heard that? And do you have any any thoughts on that?

Thomas DeLauer
That’s interesting. I mean, that has some merit to it, for sure. I think the caveat with that would be if you’re a very active person, like a really active person, I don’t think it’s as big of a deal to have over a five HPA one C, because you’re just the amount of circulating glucose, you that can reflect in your HPA want to see if you’re a really active person, and you’re someone that consumes a fair amount of carbohydrates, but you’re also active. So I, there’s that’s with that caveat. It doesn’t make sense. As far as the oxygenation piece is concerned, I think that, you know, with that, there’s kind of these two pieces that we have to look at metabolism in general, probably more than that, but realistically, you’ve got fuel getting into the cell glucose, fat getting in the cell, whatever, okay, fuel substrates, but oxygen is also a fuel too, right? So we have oxidative phosphorylation, we have we require oxygen for any kind of aerobic activity. And to a certain degree, you know, even though anaerobic is literally without oxygen, I mean, for the the tasks that are going on, sort of underneath that the baseline tasks, though, it’s still involving aerobic metabolism. So if you have poor ox, you know, oxygenation, then that’s not going to work very well. I don’t know I’m sure there is some literature out there somewhere about sort of circulating glucose gumming up that ability. I’m not aware of it, but it doesn’t mean it doesn’t exist. Because that’s a really strong theory, it makes sense. It makes

Dr. Mindy
a lot of sense. And I’d never really thought about it, but you actually added another layer to it. You’re right, if you’re moving around, you’re going to be delivering more oxygen to tissue anyways. So we also

Thomas DeLauer
have to think about like physiological insulin resistance, because that’s kind of where I look at things too. Because if let’s say if your low carb becoming insulin resistant, is a protective mechanism by reallocating glucose to go to the brain, why would your body give your cells glucose, if it doesn’t need the glucose, if you’re fasting or if you’re very low carb or if you’re carnivore because you’re you know, if, like my HPA when c is a hair over five, if I’m fasting a lot, if I dropped below, if I stopped fasting a lot, it drops below five. So that doesn’t mean that I’m metabolically deranged and insulin resistant, it means that I doesn’t mean I have pathological insulin resistance. That means that that’s the problem with HPA with CS. It’s not factoring in a hyperinsulinemia. And it’s not factoring in what’s being allocated to the brain. Because it’s simple. It’s not as simple as just the fight or flight, right, like when we are in a fasted state, people say, Okay, well, you’re stressed. So your glucose levels are elevating, not necessarily like you could take someone that is calm, and not having high levels of cortisol when they’re fasting. And they’re still going to develop this physiological insulin resistance as a means to, again, protect the cell because that excess glucose in a lot of ways, could actually travel to the liver, it could change and alter into what’s called serum palmitate, which ultimately becomes a saturated fatty acid. And then that saturated fatty acid, serum palmitate can affect insulin resistance. So a lot of times you see, okay, the glucose is being allocated and going into the brain, which is one of the reasons that I theorize why you might have more brain energy on a fast now, I haven’t seen data to back it up. It’s purely a theory. But it’s like maybe it’s not just the ketones that are making our brain feel better when we’re fasting. Maybe it’s purely the reallocation of glucose, and we’re actually getting more glucose into the brain. Because the brain does like to run on glucose. Let’s not deny that. So if you’re sparing glucose physiologically throughout the periphery, and it’s allocating to the brain, that would light up your brain more, I just haven’t seen data to back it up. It’s all just my own hypothesis.

Dr. Mindy
It’s really interesting. And maybe it’s the combination of glucose with ketones because if you think about it when you and this leads me to my next question, but if you think about it, when we go into a fasted state, especially the longer fasts, we’re seeing the dumping of the stored sugar, and you’re also seeing the Rise of ketones. So it’s one of the only scenarios where we see ketones or glucose go up at the same time. And maybe that’s where the brain really thrives is in that moment. What do you think of that?

Thomas DeLauer
Yeah, no, totally, I think that makes a lot of sense. And you see that with a lot of the exogenous ketone research to is that that’s what makes it really unique is you are putting yourself in a very interesting state like, so the body having high levels of backup for second having high levels of insulin, and high levels of ketones at the same time is, I don’t want to say it’s impossible, but physiologically, pretty much impossible, right? Like you cannot have this crazy spike in insulin from carbohydrates and also be producing ketones. So that’s why like with exogenous ketones, it creates this physiologically impossible state. And that’s why it works so well as an ergogenic aid because like for a Tour de France athlete, it’s working well because they are in a very unique, almost unnatural ability to utilize carbs and ketones at the literal same time, because insulin is present. So anytime you have like this high degree of overfeeding, that is actually being used for fuel not just overfeeding and being sedentary. That’s why I’m like if you’re using exogenous ketones, don’t just sit on your ass like actually be doing something because, yeah, you’re in a hyper fed state, which cannot indwell if you’re not active, no matter how you look at it. So fast forwarding to like the glucose side of things, that’s also a very in the brain is the only tissue that’s really going to be able to kind of run on both at the same time, because there are regions and portions of the brain that seem to prefer glucose and portions of the brain that seem to prefer ketones when available. So all of a sudden, you have like glucose, a flux of glucose that’s going into the brain, and you also have a flux of ketones going into the brain, satisfying whatever cells in the brain want to use whatever they want to use. So you’ve got this huge burst of energy in the brain simultaneously. You know, this is again, another theory but with glucose, okay, glucose is very oxidative produces a lot of oxidative stress when you utilize it. That’s not good, bad or ugly. It’s just the way it is, right? So my theory is that okay, well, maybe ketones come into the brain to actually buffer some of the inflammatory response and the reactive oxygen species that comes as a result of the heightened levels of glucose in the brain. So to paint a picture of this, you’ve reallocated a lot of glucose to the brain. So in theory, you just created a lot more reactive oxygen species and a lot more reactive or just oxidative stress in the brain. Ordinarily, that would not be a good thing. But since you have the presence of ketones, you are granted a little bit of amnesty and have some protection from said ketones to actually protect from the oxidative stress occurring from heightened glucose metabolism. Hopefully, that makes sense.

Dr. Mindy
It makes perfect sense to me. And you actually have me thinking about exogenous ketones a little bit different because my standard line has been, you don’t use it when you after you eat, because you’re now going against a natural state of your body. But what if you you know, what if you are, you know, you ate a big meal, and you know, your glucose is high, and now you’ve got to go into a big meeting at work. Could you do some exogenous ketones to create that buffering? So you get better mental clarity? Could we come in with exogenous ketones in those moments? And would that be harmful to our body’s ability to make ketones when we’re in a fasted state?

Thomas DeLauer
Very interesting, interesting thought. I think it would depend on what you’re eating. And I think, you know, first addressing it, like if you were to eat like a total crap meal, and then do it, I don’t think it would necessarily protect you from that. But if it was maybe even healthy, yet high carb, in theory, maybe it could protect you from that. Is it going to affect your ability to endogenously produce ketones? Absolutely. But that’s temporary. Like I don’t, I haven’t seen any evidence that shows that utilizing exogenous ketones are going to, like permanently stopped ketogenesis. Like, it’s just for the time being, you know, you’re, I always put it as simply as like, if you have a sink, and you have a garbage disposal on in the sink, and you put food down this in the sink, it’s fine, it’s gonna go down the garbage disposal, but if you turn off the garbage disposal, and you keep filling up the sink, whether it’s fats, carbs, ketones, whatever, it’s got to burn through whatever you’re putting in and ketones at the end of the day are you know what we are considering a fourth macronutrient even in an exogenous foreign body, still gonna have to burn through them. So I can theorize that again, like the likelihood of storing the glucose from the food that you ate might be higher. So I am a pretty big proponent I used to, I used to like not be a proponent of exogenous ketones at all. And then understanding research and working with SOCOM working with kind of special operations with this and understanding military applications for it. I realized that you know what, like, Okay, I kind of opened my eyes to it a little bit. And then I realized, like from an ester side of things, like for performance, like that’s where that’s where they really shine like if you train yourself to be really adapted to utilizing fats during a fuel during a workout as fuel. So you train fasted a lot. You’re trained in a low carb state You’re even glycogen depleted a lot, then you’re optimized for that. Then when it comes time for competition, or it comes time to really level it up, then you go into that workout fueled with a carbohydrates and exogenous ketones, because then you’re giving your body to fuel sources that it’s already adapted to using. And it’s like running on jet fuel. So it’s pretty, pretty profound.

Dr. Mindy
It’s brilliant. Yeah, that is brilliant. Like, you’re just I thought I knew everything about ketones. And now you just gave me a whole nother level. That was amazing. So I’m going to try it, especially with some of the high performers we work with is like putting them in doing things exogenous ketones, and after a carbohydrate rich meal,

Thomas DeLauer
it’s, again, it’s questionable. Okay, so like, Don, the Augustino, obviously, super good friend of mine, he, he swears up and down that exogenous ketone esters trigger a small insulin spike, whereas ketone salts do not. So he’s a huge proponent of salts and less so of esters. I tend to agree however, from a performance or ergogenic side, if there is a small spike in insulin that still occurs from exogenous ketone esters. I don’t think it matters if it’s for activity, because who cares if your insulin spikes a little bit because it’s putting you into that? Once again, I think it could actually be advantageous where if it does spike insulin, maybe it’s only helping and we’re talking a small spike, but it may be it’s helping that cell uptake, glucose even better. And if you’re again, active, and you’re moving hard, and you’re really going for performance, I think it’s a non issue. I don’t think it matters at all. So

Dr. Mindy
interesting. Okay, and explain just for people the difference between salts and esters.

Thomas DeLauer
So yeah, ketone ester is basically like a pure, pure beta hydroxy butyrate, in like an SSRIs form that can cross through the gut layer, without the use of having to be bound to like a salt or receiving salt. So like a ketone, salt usually has to be bound to a sodium, potassium, or magnesium or a combination of all three in different ratios. The downside with ketone salts is the likelihood of GI upset is pretty high. So for an athlete, that can be a big problem, especially in endurance athletes, because that’s already, like, a large area of the complaints for athletes anyway, is like, okay, they already deal with GI issues when they’re working hard, let alone adding this into the mix. So I guess just to put it into context, I think ketones salts are tremendous if maybe you’re fasting, and you just want to have a little bit of satiety. I think ketone salts are great. If you’re just looking for a little bit of mental clarity. I think ketone esters are head and shoulders above salts for actual, like immediate performance.

Dr. Mindy
Amazing, amazing. Yeah, that I can’t wait to try that out. Okay, now let’s go, I want to go into fasting because we know, fasting is an incredible tool for insulin resistance. But my question to you based off all your research, what fasting length do you think is best? If I’m, if I know I’m insulin resistant? What do I need to lean into?

Thomas DeLauer
Yeah, I’ve always been a budget and say always, but over the last couple of years, I’ve been a really big fan of like, 18, I think 18 is a really good number. And the reason I say that is, I feel like 16 is like just when benefits are starting. And I feel like at 20 for the average person, if they’re not adapted to it, they’re starting to like creep into a length that might be a little long. Now I’m all for 20 hour fastball for 20 to 24. I’m all for it. But generally, if you’re looking at the whole population, like I think 18 hours is doable. And I think after 1516 hours, you know, that’s when the rate of gluconeogenesis starts to go up, which indicates that amtk can go down and really started to get the benefits of like the fast versus just a caloric deficit piece. So I think generally I lean into like 18, like three or four days a week.

Dr. Mindy
Yeah, I’ve I recently had a conversation with Megan Ramos, you know, Jason Fung, is that right hand gallon or in this clinic, and they believe in that in their clinic and they’re dealing with type two diet severe type two diabetic situations that even going into 36 and 48 hours for insulin resistance is she they’re actually not fans of the shorter fasts. They’re more fans of 36 and 48 hours, and I think you got to play with it. But to your point, I think you got to go longer than 15 for sure if you’re gonna walk if you want to get a result.

Thomas DeLauer
I totally agree on that. And I mean, I went through like a period for like eight months where I just did a once a week, Monk fast, 36 hours. And I felt phenomenal. It was very to work really, really well. I mean, I still revert back to that time again. But you know what, like, personally for me right now, I usually fast like 18 to 21 hours, like two to three days a week. I keep it relatively do it relatively sparingly. You know, I might go into a period of time where I do a little bit more. But yeah, if someone’s just getting started, then you know, sometimes jumping into a longer fast is actually and doing that like once every couple of weeks, sometimes even easier. There’s just like a switch that people can flip with on or off. And they just say, You know what I’m just not going to eat, stop eating at 5pm tonight and not going to eat until the net not the next day, but the next day in the morning. And it’s just easy for people to turn the blinders on and do that rather than just get super granular about what they need to eat their their eating, period, yada, yada.

Dr. Mindy
Yeah, I would agree. I’ve watched a lot of people do that where and I used to be a proponent of like, ease your way into the into fasting. And then I’ve seen somebody who just all of a sudden goes into a three day water fast, I’ve never fasted before they drop weight, and their metabolism is completely different after that, so and their food behaviors, all of that, it’s, it’s really pretty amazing. I always say like, when I’m in the airport, and I see people that are like in wheelchairs that are like super puffy and carrying extra weight, I look at those people. And I think if I could take you home with me, and you could like live with me for a week, and we could fast you and get you the right foods, you would see have such a different experience with your body. And once you have a different experience with your body, your behaviors would change. So it’s really interesting how that works. Talk about food. So we all hope. I mean, we’ve talked a lot and I think my audience knows what foods to avoid. But let’s talk about what foods you would add in to help yourself become more insulin sensitive. Is there a category of foods or spices that we you know, what do we think of apple cider vinegar? Like? Are these things actually working?

Thomas DeLauer
Yeah, so you know, there’s categories of foods that blunting the glucose response, and certainly that helps from a lifestyle piece. And then there’s categories of foods that, at least in vitro, and in some like mechanistic models, and in various rodent models, studies are showing a lot of promising effects for like beta cells in general, like helping the cells produce more insulin and to be more responsive and insulin receptors. And a big one is good old mono unsaturated fats, so like things like and then the interesting thing is, like Omega seven fats, which are macadamia nuts, that’s a tremendous source of just a combination of mono unsaturated, and those Omega sevens, which kind of make mono unsaturated, as well as omega three is more available in the body. So omega sevens are quite a complicated fat to talk about.

Dr. Mindy
Yeah, they’re not talked about often. Yeah, it’s

Thomas DeLauer
and you know, that’s not a whole lot of foods that have copious amounts of them. So macadamia nuts, I think are really powerful insulin resistance food, you know, lower set. And again, I don’t want to go on what not to eat. And I know I’ve made some enemies by talking about this. But we do also have to, like in for normal people that are not doing a ketogenic diet, like, you should not be having like a ridiculous amount of saturated fat. Like, I think it’s these, these lines get blurred, where you’re like, Okay, if you’re doing keto, you’re in a different ballpark. Like it’s things are different. But if you’re not doing keto, like, unfortunately, the saturated fat discussions still does stand like sat epidemiological data and observational data doesn’t lie, like a lot of saturated fat. We’re talking like upwards of like, 30 40% of your daily fat calories coming from saturated fat. There’s very clear links to fatty liver very clear links to insulin resistance. And it’s just as profound as high glucose is, yeah, so that can scare people and make them think like, Ah, I thought saturated fat was great. I thought butter was great. It is like we still need saturated fat. Like it’s not a problem. But when you’re not doing a low carb protocol, and you’re not a healthy person, there’s a reason why the standard American diet is a problem. It’s a high processed hyper palatable, high carb foods and high saturated fat, the two worst combinations that you could I mean, the worst combination you could possibly have. So I usually recommend like okay, take a look at your diet, how much saturated fat are you having, I’m not saying you need to be like Ancel Keys and go super low fat. I’m saying consider the ratio of fats I usually recommend. Okay, look at your total if you’re consuming 100 grams of fat a day, try not to consume more than 30 of that from saturated and let the rest come as much as possible for mono unsaturated polyunsaturated is great too but Paul polyunsaturated fat, you know, usually coming in like alpha linoleic acid and stuff in plant forms might not be the best route either i i tend to I don’t want to go down the rabbit hole too much. But you know, all obviously like I had talked to Paul Saladino on my channel a while ago. And he’s very interesting things to say about seed oils as triggering the cannabinoid receptors like the actual actually affecting our brain. And I know people rain on the parade with him a lot like they people always have things to say about Paul and I know Paul is Paul, he’s an inflammatory guy. That’s how he is he’s an agitator. That’s his. That’s his, his attitude and his brand. But I’m gonna give him a little bit of the benefit of the doubt when it comes to stuff that the brain because people like rain on him all the time because they’re like, you’re a psychiatrist, and then I’m like, when he’s talking about endocannabinoids when he’s talking about the brain, he’s actually someone I would listen to. Yeah, because he doesn’t know the brain he, you know, excuse me, you know, clinically trained, traditional medical doctor in terms of psychiatry, so he knows the brain. So when he talks about Things like that. It makes sense, right? So without going off on a tangent, I know he’s not the biggest fan of like mono unsaturated fats. But he is a big fan of, you know, reducing the seed oils because that’s what’s relevant to this discussion. Another food that’s rich and mono unsaturated fats that I know Paul would agree with are straight up avocados, right? Avocados, you’re getting the combination of fiber. Yeah. So when when?

Dr. Mindy
Yeah, avocados is everybody’s hero. Like I don’t I can’t find anything wrong with an avocado.

Thomas DeLauer
Yeah. And then I think, you know, the number one food is protein period. I think that’s one thing that we just all could stand to have more of. And it doesn’t matter if you’re plant based. If you’re vegan, if you’re vegetarian, If you’re pescatarian. Like if you just prioritize protein, that’s probably the best thing you can do for insulin resistance. Not only is it going to slow the kind of blood sugar response, but it’s also just flat out good for our tissues. It’s good for our muscle cells, which is going to be ultimately what allows us to suck up glucose in the first place. Apple cider vinegar, yes, certainly, lemon water, same kind of category of amylase inhibitors that kind of slow down the carbohydrate absorption, which if you’re insulin resistant, like again, for a healthy person, people say people question when I talk about that stuff like, Well, why would this matter? Why would I want to slow down the glucose response? If you are unfortunately one of the few people that is healthy and doesn’t have an insulin resistance issue? You’re right, like maybe it doesn’t matter. Maybe it’s splitting hairs. But if you are insulin resistant, being able to slow down the glycemic response of a food gives your body a chance to actually produce the insulin and time so that whole system can calibrate again.

Dr. Mindy
Yeah. Oh, my God. So brilliant. Brilliantly said, Okay, what about exercise, so if i is all exercise is going to make me insulin sensitive, or there’s certain exercise routines I need to do to really facilitate that sensitivity process better.

Thomas DeLauer
Yeah, I think, you know, head and shoulders resistance training is best for insulin resistance. That being said, that doesn’t mean that you neglect cardio, like there’s a lot of myths out there saying that, you know, doing cardio or aerobic work is only good for the cardiovascular system. I mean, yes, that’s true. It’s good for the cardiovascular system, which has huge downstream effects, but also a lot of evidence that suggests that the more aerobic capacity you have, and the more ability to do cardio in the first place, actually helps your ability to build muscle and helps your ability to recover and helps your ability to do resistance training in the first place, and to develop the tissues that you need. So resistance training is best as far as glucose metabolism is concerned. But that doesn’t mean like if I had to, if people had to say like, Okay, you have to pick one or the other, I would kind of split down the middle and say, I still want you to resistance training, but with really short rest periods, and I want you to still be getting your heart rate up. The caveat there is okay, well, then, yeah, you’re not able to push it to the max because you’re breathing heavy and you’re exhausted. Okay, but are you trying to be a bodybuilder and squeeze every little 5% of muscle growth or because hypertrophy, muscle growth is going to come from muscles, like stimulating the muscle and then having enough protein? It’s that simple. So resistance train, just keep the rest periods short and get your cardio if in that way, if you’re short on time, yeah. And

Dr. Mindy
do you feel like I was listening to a lecture recently with Dr. Gabrielle Lyon, and she was talking about how there were two ways to improve muscle strength. One is obviously as we know, through weightlifting, but then it also is through activating the protein sensors, amino acid sensors in the muscle getting at least 30 grams of protein. She’s a big fan of one gram of protein. For every pound of body weight that you want to be. Do you feel like when we go to build muscle that we it’s the same tool to lift weights as to eat protein? Will those increase muscle in the same way? Or do they operate differently?

Thomas DeLauer
I think they operate somewhat different I mean, they come together it’s like kind of like a two ropes that are twisted, right? Like it’s they’re, they’re very important and they work together and one doesn’t exist without the other in certain ways. But the other thing is, like, more and more research both from the cognitive side and from just the purely like, muscle side shows that stimulation is the most important thing like stimulating the muscle is what’s going to allow you to keep the muscle probably more so than diet. Now that being said, eventually if you’re stimulating the muscle and you’re not getting enough protein, yes, you’re going to end up in negative nitrogen balance, you’re gonna have less more muscle protein breakdown then you have synthesis, but it’s it’s a little bit more hairy than just that. So I have Dr. Tommy wood on my channel and it’s such an interesting guy and like he just published a paper surrounding a cognitive stimulus, right it kind of in the same vein, he’s done other work surrounding muscle stimulus but cognitive stimulus to like, the biggest thing that we can do to stave off cognitive decline. is actually use our brains, right is doing puzzles, doing things like that is if you don’t use it, you lose it. And even from a fasting standpoint, it makes so much sense that when we’re in a caloric deficit or when we’re fasting, that that is when we should be moving. Because that is the the least opportune time for our body to break down muscle tissue, it makes a lot of sense that we would actually be performing better in a fasted state. And it’s actually an ideal time, like, why would the body want to break down muscle at that point in time, it’s more inclined to keep it as long as you’re stimulating. So especially when you’re fasting and your calories are low, because the muscle stimulation effect really counts for something. And you see that, like, I’ve seen it with myself just with fasting, like, if I fast aggressively for a couple of weeks, and I resistance train pretty aggressively during that time. I don’t lose muscle, I don’t lose strength, but I do lose fat. And so I mean, how do you explain that? It’s I think there’s a lot that we don’t know about muscle, and how we retain it and how we build it. And right now we chalk it up to stimulus and protein. But I think there’s a lot more going on that we don’t know. Yeah, I

Dr. Mindy
think you’re absolutely right, that, you know, one of the first times I realized that connection between fasting and muscle is I was in a yoga class. And this woman who was 10 years older than me, came up to me and she’s like, Hey, I’ve been doing yoga with you for the last couple of years, and you’re really growing a lot of muscle. What are you doing? And at that time, I was doing so much fasting, I was all kinds of fasting, and I kind of chalked it up to well, maybe you can just see the muscle more. But I you know, to your point, why would the body break down muscle in a starvation state, if we’re going to call it that because it has to go fine food, so it needs to be stronger? So when you hear people say, Well, my muscles shrunk. While I was fasting, do you think that was just glucose? It got released? Is it a? Is it a perception that it shrunk? And that didn’t actually shrink? It absolutely

Thomas DeLauer
could be I mean, when you’re especially if you’re not adapted to fasting, and the first time, you know, first time you fast and your body doesn’t spare glycogen very well. So it just depletes everything and you flatten out. Yeah, absolutely.

Dr. Mindy
So so it’s not like the muscles eating itself or breaking itself down for nutrients in the fasted state. I mean, maybe on a three day water fast it might be, but on a 24 hour omad kind of situation. You’re literally cleaning the glucose. And then, you know, if you follow that up with some protein, are you still a big believer of like breaking a fast with protein, especially after a workout to stimulate mTOR?

Thomas DeLauer
Oh, yeah, for sure. Yeah, I think I mean, that’s, I mean, insulin sensitivity is still at an all time high at the end of the fast and it’s also very high at the end of a workout. So like combining those two just works really, really well. Now, when it comes down to just fasting in general and sort of the how much protein do you break down during a fast? I mean, it all depends, right. But I would argue that if you took someone that was fasting and sitting on a couch all day, that then they might atrophy. But I’m a firm believer that if you don’t use it, you lose it. And if you use it, your body will do what it can to preserve it because it deems it necessary. It makes a lot of logical sense, right? Like if I, if I’m out actively moving while I’m fasting, my body is saying, oh, okay, well, this tissue is relevant, because clearly he’s using it. Right. So I think it’s going to do what it can to preserve that.

Dr. Mindy
Yeah, because it makes so much sense. Okay, let’s talk about hacks. The last thing around insulin resistance, you know, we’ve got cold plunges and red light, we have supplements. I’ve even you know, I’ve got a hyperbaric oxygen chamber. And I’ve done some really interesting research on the metabolic upside of, of oxygen. What hacks do you know? Or do you like to if somebody’s doing all the things and I leave it at the last thing? Because I feel like everybody wants to go to the hack first. But, you know, we’ve got to do the work, like we’ve talked about. But once I’m doing that work, do I have other tools to speed up my insulin sensitivity?

Thomas DeLauer
Yeah. I mean, recently, I’ve been a big fan of like, a couple days a week, eating some carbohydrates, like intro workout now, like during my workout, right, so I’ll eat a little bit of watermelon intro workout. And the reason behind that is it’s that as a, a, a way for you to be able to get your carbs and not effectively store them, but be you to potentially kind of increase the uptake of glucose into the cell. Now, it’s insulin independent, meaning when your muscle is contracting, you’ll suck glucose into a cell without insulin being needed. So that means I could eat that watermelon like during my workout or in between sets, and the likelihood of it ever even requiring much insulin is pretty low, because it’s getting sucked up immediately I’m eating it. It’s the absolute one transporters bringing it into the into the bloodstream, and then it’s being burned. Now, do I lose fat loss effects on that workout? Possibly who knows? Like we could talk about that but that’s not what I’m after. I’m after being like, Okay, now I’m able to sort of condition myself to be able to still utilize glucose, but I’m doing it in a way with very little risk. So that’s sort of a hack to be have your cake and eat it too, like, doesn’t mean that you walk around the gym like dripping pizza and like watermelon everywhere. But like, you know, if you’re like doing a little workout at home or something like that, and you’re like, you know, I really want to have some watermelon, but you will find like, it’s actually done the Augustino that taught me that in theory originally, and then I just took it and ran with it. And notice that wow, that my workouts actually performed pretty I do pretty well, compared to like, if I were to have carbs, maybe an hour before a workout, it’s like at that rate, and the carbs are already halfway through glycogen synthesis, and, and I’m not really getting that active ability of them. Okay, but moving into sort of other hacks.

Dr. Mindy
Let me say one thing on that I’m thinking this through and to your point of your pointing, you’re telling the body what to focus on. If you do the watermelon, you’re up it you’re up, you’re up in glucose, the muscle, it’s gonna go immediately to the muscle because you’re in the middle of a workout. And so now the muscles can be able to perform a little bit better, it’s gonna grow itself stronger, you’re gonna have more insulin sensors to be able for that next meal to be able to absorb it and store glucose again. So that makes actual really brilliant logic.

Thomas DeLauer
Yeah, it’s been fun to experiment with. And I don’t do it with every workout. Like I love my fasted workouts. So, you know, I’d say, you know, three to four days a week, I still train fasted, and then a couple days per week, when it’s generally more like hypertrophy focus, like it’s more muscle building type stuff. And I’m not saying like, Hey, I’m doing this workout for fat loss. No, I’m doing this workout to get stronger. I’m not as concerned about being in a fasted state during it, I’m going to play around and have some carbs and have some fun. So that’s, that’s a big thing. I’m also a big fan of cold exposure, I feel like you know, anytime you can increase brown fat, you’re increasing the potential to be able to kind of up regulate glucose uptake. And there’s evidence that more brown fat leads to, you know, less glucose circulating. So that’s always a good thing. I’m always a, it’s kind of the same generic stuff. But I am a huge fan of sauna. I do feel like from a mitochondrial dysfunction side, like sitting in, I would take a sauna over a cold plunge any day of the week. That’s just my preference. I just love that. You know, I do feel like there are definitely metabolic advantages there. Because your body does massively increase glucose during that time. And it has to find a way to effectively deal with it. So I feel like did you kind of train your body? I don’t do it for read I do dry. I’m a sudden I’m a big fan of dry. I mean, I don’t not like infrared. I just, I prefer dry sauna because I’d like to get really hot. I mean, I probably do, it may not be the best recommended thing. But I really, you know, a lot of the Swedish and Finnish people like they really like to get them up well over, you know, north of 200 degrees. So I kind of rigged my sauna to get up to like 215 to 20. And I just sit in it for 10 or 15 minutes. So I do relatively short stints at very high heat. Just make sure you wear a sauna cap because you will burn your hair. It will like I noticed I was like oh shoot my hair is getting brittle. And yeah, the guys over at Nord axon and we’re like why are you that’s why they make Sonic caps it’s the otherwise you’re gonna fry your hair.

Dr. Mindy
Interesting. That’s interesting. Okay, I would agree with you on sauna for sure and cold plunges just that not Yeah, not you know, I don’t gravitate to cold plunge.

Thomas DeLauer
So there’s kind of weird, like it’s mixed, right? Like cold plunge is good to a certain degree. But it’s a hormetic stressor that you can take too far too. So and it’s like people like a cold plunge every morning. I don’t I don’t know if that’s good. Honestly, I don’t I’m not here to say it’s bad. But I don’t know if it’s good to cold plunge every day. I think it should be something that maybe you maybe do a few times per week. I don’t know. I just don’t it is still it still does trigger reactive oxygen species. And, you know, like, it’s just like fasting every day. It’s like you shouldn’t fast when you feel like you’re getting sick. Right? Like, it’s, it’s at least my two cents.

Dr. Mindy
Yeah. Okay. Anything else? Any other hacks? What about supplements? You got lots of people buying Berberine? You know, a lot of people are going into spermidine for a toffee G like do we cinnamon I’ve heard what do we think of these? Are they going to help us with insulin resistance?

Thomas DeLauer
I think good all like vitamin b1, like Ben voti mean is a really powerful one. That’s not talked about enough. I did a video on it like months ago and it kind of exploded and I think garnered a lot of interest. I think it’s you know, it’s been Foty Amin is required to basically in under high glucose load. So it’s not just like required for just glucose uptake in the first place. It’s required to kind of help manage when glucose is high. So I feel like if you’re suffering from high glucose, vitamin b1 is something you could definitely and Ben Foty mean is a fat soluble form. So it doesn’t, it doesn’t just get excreted and you don’t just pee it right out.

Dr. Mindy
Yeah. Oh my gosh, amazing. So many. It’s funny, just when I think I know everything I can know about insulin resistance. Now you like I’ve got my brain really thinking differently. So this was amazing. I really appreciate it. And here’s what I’m gonna I’m gonna go completely off the insulin topic. What we’ve been doing in the recenter podcast this year is really emphasizing what people are grateful for. So do you do you have a gratitude practice a daily gratitude practice? And if so, what is it and what are you grateful for this year?

Thomas DeLauer
Yeah, every night when we put our kids to bed, we call it thankfulness for them. Just say what? Your What are you thankful for? And my little two year old, she’s so funny. Like, she’s so intense with it, like she puts, she points her finger, an inch from your face, and like so aggressively. He says, What are you thankful for? Like, she’s like, it’s like a drill sergeant. Like, she’s serious about it. But we, we definitely do it. And you know, and sometimes it’s frustrating for them, sometimes they don’t want to do it, sometimes they get awkward and shy about it. But now it’s become this thing where they just expect it. And then we’re like, you know, it’s time for bed. And we’re like, you know, Daddy has time to come do thankfully, you know, it was like, so it’s a really, it’s just a good practice. And sometimes, you know, you fake it till you make it sometimes, right? Like, sometimes sometimes there’s days where you’re like, I’m, I’m grateful for nothing. Like, I feel like crap today. Today was a bad day. But then when you stop, and you look at your kids in the eyes, and you look, you know, and I’m just like, and they say that they’re so thankful for the simplest thing, you know? Yeah, like, you know, I’m so thankful that, you know, we saw a bird at the park today, like that’s, you know, something like that. It’s just like, that makes you stop. Yeah, I’m, I’m so thankful you said that, you know, and that’s, so that’s a very good thing. And then you know, right now, you know, I’m grateful, obviously, for, you know, for my family, I feel like in a world where social media can be pretty dark and be pretty lonely and scary. Sometimes, just because you’re just you’re so much inbound, a positive and negative. And, you know, it really just allows me like, when I look at my kids, I look at my wife, and remember, that is absolutely what matters. You know, I’m also thankful for, it sounds funny to hear me say I still am thankful for advances in modern, like surgical medicine, and recently with my wife surgery, and I’m still like, I’m still blown away. I know, like, sometimes I have negative things to say about our healthcare system, because it’s frustrating to me. But at the end of the day, sometimes our technological advances in surgery and in certain things with Western medicine, I have to stop and pause and still thank my lucky stars that we have what we have today. You know, like with my wife’s recent surgery, if that was, you know, she would be in so much pain if it wasn’t for that. And so I try to be grateful for things like that, too.

Dr. Mindy
Yeah, I love that. You know, I think where we’ve fallen apart in the healthcare system is in chronic disease. And you could almost look at Amber situation as more of an acute situation that needed it needed a go to a quick go to. So they I would have 1,000%, but when we’re looking at a chronic problem, this is where we can’t lose sight of lifestyle. So 100% Yeah, yeah. Amazing. Okay, where do people find you? I hopefully you all know that he’s on YouTube. But where else can people find you?

Thomas DeLauer
Yep, YouTube, just type in my name. And then Instagram. Also just type in my name. Thomas de lauer.com. Just if you want to join my email list and things like that, other than that, I’m, I’m kind of everywhere.

Dr. Mindy
Yeah. I love it. And I just I continued to be inspired by your YouTube channel. I, you know, I look ahead and go wow, like what you’ve accomplished on YouTube. As somebody who’s putting YouTube videos out there. It’s pretty profound. And of all the social media platforms, YouTube’s the harshest. Comments are really gnarly. So I applaud you with three 1 million followers to you know, be sticking in there and continuing to educate us all. So thank you, Thomas. This was amazing. Appreciate you