Listener Spotlight: Alessio’s Metabolic Wake-Up Call

Well, just from this bit of the history that we've listened to, you think about the SIBO, small intestinal bacterial overgrowth.

And it's kind of a popular diagnosis now.

It's great that Alessio got the testing to say, yes, the breath test was positive for that.

But one of the things to think about with that is, is it occurs due to fermentation in the small intestine so it could be like the the stomach emptying too fast and dumping into that small intestine and things just fermenting there so it can be sometimes related to mechanical issues so that's why trying to treat it by avoiding foods you know, or even taking antibiotics doesn't lead to long-term success usually because you're not really addressing the mechanical piece of it.

So a lot of people with that, I think from my own clinical experience that it could be related to already pre-existing dysfunction going on with the hormones that regulate our GI motility.

So when you think about that, you do think of maybe GLP-1, GIP, the incretin, a family of hormones, cholecystokinin is another one.

So there are a lot of hormones that our body produces that regulate the pace of our stomach emptying and things.

And so just the SIBO itself might've been like a clue, something might've been off metabolically, but then it sounds like with all of these other aspects that had been identified over the years, that are pieces and parts of metabolic syndrome that we've described in many podcasts before with the cholesterol profile, particularly triglycerides, HDL, cholesterol being off balance, and then blood pressure being elevated, fatty liver disease.

Those are all aspects of metabolic syndrome.

And so it's so great that you ended up with an endocrinologist that recognized that right away and said, oh, we're in the metabolic dysfunction arena here.

Because you know, the body weight that you describe, we wouldn't consider that very high.

I mean, we don't like to focus on numbers, you know, here in terms of calories or weight numbers and things too much because everyone is different and everyone has different frame size.

And as you said, different body composition, but kind of like we've described with Mark's case, it's not somebody with big obesity that's coming in with this metabolic syndrome.

And we've discussed that before.

That's a um and so it's great that they put those little pieces together and usually these things have a big strong genetic basis so that would be interesting to know your genetics and sometimes there are aspects of it that start even as early as childhood so this may not have been something that just cropped out of the blue but i think that the dietary recommendations with the SIBO really Because once you do something like that, as we've described, when you restrict the food intake and food groups and carbs and fats, and then maybe even still encouraged to exercise and then you're under fueling.

Of course, that is going to lead to metabolic adaptations that represent a weakening of the metabolic system.

So if it was already a little bit hampered because of this underlying metabolic syndrome and potential metabolic dysfunction, then introducing that kind of restriction could have really exacerbated all of the underlying problems and weaknesses.

And it did.

And if we go, you know, do a bit of fast forward to when I started, because there was a moment in which this nutrition plan overlapped with the Manjaro.

And this was the last six months of last year.

And I arrived at the end of the year with what I'm pretty sure was low energy availability status.

I was shivering from cold, losing hair, lost lean mass.

And back then I was still thinking that all of this was caused by the drug itself and not by how I wasn't fueling or eating enough.

And that's, I think I found out about your podcast around December, January.

And I do remember something very curious that, for example, during the Christmas holiday, I would go back home.

Well, just from this bit of the history that we've listened to, you think about the SIBO, small intestinal bacterial overgrowth.

And it's kind of a popular diagnosis now.

It's great that Alessio got the testing to say, yes, the breath test was positive for that.

But one of the things to think about with that is, is it occurs due to fermentation in the small intestine so it could be like the the stomach emptying too fast and dumping into that small intestine and things just fermenting there so it can be sometimes related to mechanical issues so that's why trying to treat it by avoiding foods you know, or even taking antibiotics doesn't lead to long-term success usually because you're not really addressing the mechanical piece of it.

So a lot of people with that, I think from my own clinical experience that it could be related to already pre-existing dysfunction going on with the hormones that regulate our GI motility.

So when you think about that, you do think of maybe GLP-1, GIP, the incretin, a family of hormones, cholecystokinin is another one.

So there are a lot of hormones that our body produces that regulate the pace of our stomach emptying and things.

And so just the SIBO itself might've been like a clue, something might've been off metabolically, but then it sounds like with all of these other aspects that had been identified over the years, that are pieces and parts of metabolic syndrome that we've described in many podcasts before with the cholesterol profile, particularly triglycerides, HDL, cholesterol being off balance, and then blood pressure being elevated, fatty liver disease.

Those are all aspects of metabolic syndrome.

And so it's so great that you ended up with an endocrinologist that recognized that right away and said, oh, we're in the metabolic dysfunction arena here.

Because you know, the body weight that you describe, we wouldn't consider that very high.

I mean, we don't like to focus on numbers, you know, here in terms of calories or weight numbers and things too much because everyone is different and everyone has different frame size.

And as you said, different body composition, but kind of like we've described with Mark's case, it's not somebody with big obesity that's coming in with this metabolic syndrome.

And we've discussed that before.

That's a um and so it's great that they put those little pieces together and usually these things have a big strong genetic basis so that would be interesting to know your genetics and sometimes there are aspects of it that start even as early as childhood so this may not have been something that just cropped out of the blue but i think that the dietary recommendations with the SIBO really Because once you do something like that, as we've described, when you restrict the food intake and food groups and carbs and fats, and then maybe even still encouraged to exercise and then you're under fueling.

Of course, that is going to lead to metabolic adaptations that represent a weakening of the metabolic system.

So if it was already a little bit hampered because of this underlying metabolic syndrome and potential metabolic dysfunction, then introducing that kind of restriction could have really exacerbated all of the underlying problems and weaknesses.

And it did.

And if we go, you know, do a bit of fast forward to when I started, because there was a moment in which this nutrition plan overlapped with the Manjaro.

And this was the last six months of last year.

And I arrived at the end of the year with what I'm pretty sure was low energy availability status.

I was shivering from cold, losing hair, lost lean mass.

And back then I was still thinking that all of this was caused by the drug itself and not by how I wasn't fueling or eating enough.

And that's, I think I found out about your podcast around December, January.

And I do remember something very curious that, for example, during the Christmas holiday, I would go back home.