Your golf swing improves when you have a stronger core. Let us help you out. Bacon and eggs for breakfast and EMSculpt Neo for 20-30 minutes at lunch. . .
Call us for your appointment today! EMSculpt Neo
(623) 584-7805
Pass on the pretzels and the peanuts. We’ve got what you really need.
Keep following your ketogenic or carnivorous lifestyle and don’t throw that red dress out. We have your 20 minute treatment waiting for you at the office. . . EMSculpt Neo
I just added two amazing treatments to our office toolbox: EMSculpt and EMSella. I am so excited about these two treatments.
Why add these to the practice? As a family practitioner who focuses on the treatment of insulin resistance, pre-diabetes, diabetes and obesity, I’ve been looking for safe and effective ways to improve muscle and decrease fat. Ketogenic and carnivorous diets are the most effective way to do this naturally, of course including a good exercise program should be a significant part of these diets. Yet, many of my patients over 40 are already seeing the effects of aging, obesity and muscle decline.
Lack of core strength leads to gait instability, weakness, increased likelihood of falling and breaking a hip. Poor core strength is also a factor in incontinence, erectile dysfunction and poor sexual function.
We know that improving core strength has a very powerful positive effect in reducing these problems. Yet, a significant number of my patients over 65 have a hard time exercising due to arthritis and other diseases.
These are revolutionary devices that simultaneously emit both radiofrequency and high-intensity electromagnetic energies (HIFEM).
The end result is more fat reduction and muscle growth than any single gold-standard product for less time and less money. . . 25% more muscle and 30% reduction in fat on average after just four treatments*.
When used with a ketogenic or carnivorous diet, these treatments are a game changer for getting rid of that last bit of stubborn fat.
In combing EMSculpt for the abdomen and EMSella for the pelvic floor, it creates “core to floor” muscle strengthening and stability that is an amazing and very effective adjunctive treatment to a regular exercise program.
These treatments are perfect for postpartum mothers, men, elite athletes and women who suffer from incontinence. They are all a perfect fit for this treatment as results include improved strength, balance and posture; alleviated back pain; and improved urinary issues and sexual health in both men and women. When EMSella is used in conjunction with other muscle development devices like Emsculpt, you’re building core strength, posture developments and sexual health improvements for both men and women.
And, although core strength is not something you see, it is something you can definitely feel.
Call our office for your first treatment today!!
*US FDA clearances:
Your results may vary. You may feel intense heat during the treatment, but it should never be painful. If you experience pain during the treatment, immediately discontinue the treatment and speak with your treatment provider. Treatment should not be applied over scar tissue, or if you have electronic or metal implants. As with any heat-based therapy, burns may result. As with any medical procedure, ask your doctor if the EMSCULPT NEO® procedure is right for you. EMSCULPT NEO® is indicated for non-invasive lipolysis (breakdown of fat) of the abdomen and thighs and reduction in circumference of the abdomen and thighs with Skin Type I to Skin Type VI; and for non-invasive lipolysis (breakdown of fat) of the upper arms limited to skin types II and III and BMI 30 or under. EMSCULPT NEO® is also indicated for improvement of abdominal tone, strengthening of the abdominal muscles, development of firmer abdomen; strengthening, toning, and firming of buttocks, thighs, and calves; and improvement of muscle tone and firmness, for strengthening muscles in arms.
In past posts, we’ve discussed how to effectively and efficiently lose weight and open the gates of the fat cells. We’ve talked about the keys to the back doors of the fat cells that must be opened to create effective lipolysis (releasing of fat from the fat cells) and weight reduction.
I want to focus, today, on another key found in the brain. The brain neuropeptides play a huge role in metabolic balance of the body and have direct relationships to anxiety, stress and post-traumatic stress disorder (PTSD). In the last few years, research into the hormones of the brain (neuropeptides) and body demonstrates that the “autonomic nervous system” plays a very significant roll in losing weight.
The autonomic nervous system is the part of the nervous system responsible for “fight or flight responses.” If a bear rises up in front of you while you are strolling in the woods, and begins to chase you, the autonomic nervous system kicks in to speed up the heart rate, shunt blood to the muscles and turn down the processing of food in the gut while you run from or fight the bear. This autonomic nervous system is also the system that links emotions (like happiness, sadness, stress, anger, depression) between the conscious and subconscious mind and creates the attachments of these emotions to specific memories.
A disconnect or poor communication between our conscious mind and subconscious mind wreaks havoc in the balance between memory, emotion, cognitive function, endocrine glands and immune system. One example of this is the onset of panic attacks for no reason. Another example is chronic fatigue and many symptoms found in autoimmune diseases. This same autonomic nervous system, when malfunctioning, plays a significant roll in our ability to lose weight. The subconscious mind triggers the autonomic nervous system without the conscious mind’s involvement.
Thanks to the work of John E Sarno, MD, and Candace B. Pert, PhD, the link between our subconscious mind and the autonomic nervous system is much more clear. This opens the door to our understanding how the subconscious mind can have a profound effect on obesity.
This field of research requires one to understand a concept about the psyche initially outlined by Dr. Sigmund Freud and his colleague Dr. Josef Breuer (the Father of Psychoanalysis) in the 1880’s. Misconceptions regarding the basic drives of the human psyche aside, they identified through their clinical evaluations that the human psyche is made up of three parts, the subconscious (the id), conscious (the ego), and the super-conscious (the superego). They identified an essential concept that the subconscious is a more primitive and childish component of the mind functioning much more instinctually, and that the ego and super-ego house the intelligent, ethical, and moral consciousness. They also identified that a split or division can arise between these two partitions causing physiological conflict to arise (i.e. – onset of a panic attack for no reason).
It is important to understand, as Freud pointed out, that you cannot divide the mind into neat compartments suggested by these three divisions. The mind acts as a single unit. However, understanding the “id” and it’s instinctual functions being tied to the autonomic nervous system is central to understanding how subconscious can derail weight loss.
Freud and Breuer identified in their Studies on Hysteria that a simple subconscious idea or instinct could be strong enough to exert powerful physical responses without sufficient intensity to become conscious thought recognized by the individual. This means that a physiologic motor response in the body could be stimulated without being conscious of the reason for the stimulus. They, along with Jean-Martin Caharcot, Alfred Alder, Franz Alexander and Allan Walters, witnessed this multiple times clinically. They came to the conclusions that pain and other nervous functions could originate and could actually be created by the mind.
Dr. Pert’s research over the last 40 years has been able to clearly identify a communication system between the brain, the endocrine system and the immune system. Dr. Pert’s research identified that memory and/or subconscious idea is directly tied to emotion through the brain hormones called neuropeptides that, when triggered, reproduce stored memory, emotion physical autonomic responses (like changes in heart rate, dry mouth, dilation or constriction of the pupils, sweating of the palms or trunk, chest pressure, etc) and even auto-immunity.
Neuropeptides also participate in memory sorting, storage and recall . In his recent book, Beyond Order, the clinical psychologist and professor Dr. Jordon Peterson explains that the miracle of memory is not that we remember, the miracle of memory is that we forget and that we only remember what is necessary. The miracle of memory is that we only remember those things that are important and teach us meaning. Because we can forget, we don’t drag the horrible details of the past along with us. Our memories allow us to get free of the past. All you need is three sleepless nights in which you cannot dispense with the past and you would understand that life would be a literal hell if we cannot dispense with the day, the memory and the emotions of each day. We must renew ourselves in this cyclical unconsciousness we call sleep and resetting of the memory. It is during this time that memory, emotion and neurohormones are tied together.
Signals in our environment from very stressful life experiences on a daily basis, chronic underlying stress, chronic anxiety, radiation exposure, infectious organisms (such as bacteria and viruses), xenobiotic chemicals, allergens, intestinal bacterial metabolites and food-derived bioactive substances (including phytochemicals), all have influence on messages received by our genes that then influences their expression. Gene expression can turn on and off neuropeptides. This can effect the autonomic nervous system turning the metabolism up or down. The expression of our genes in turn controls our health and disease outcomes. This is one of the reasons COVID-19 seems to effect some people more dramatically than others.
The hormonal counterbalance of blood sugar is regulated, in part, by the autonomic nervous system. Changes to this system increase or decrease cortisol & glucose production, thereby affecting production of insulin and other weight mediating hormones. Changes in neuropeptides from stress or anxiety can act just like eating a meal.
As blood sugar falls, the autonomic nervous system responds to balance the blood sugar. If this system is dysfunctional or under chronic stress, cortisol and adrenalin will cause higher blood sugars due to the stress response and can trigger increased hunger inappropriately.
This is why chronic stress, poor sleep, or even getting cut off while driving in traffic is the equivalent of eating a donut to your hormone responses. If you’re not exercising, theses hormones will cause weight gain without any change in your diet, and even with caloric restriction.
It may take your body and body’s biorhythm 3-4 weeks to adjust to changes you make around exercise, journaling, protein & sleep habits. Be patient with yourself.
Knowing that these challenges plague people on and off throughout the year, and, seeing people get hung up on these issues, I’ve created the Ketogenic Lifestyle 101 Course. This program gets you jump-started into ketosis and gives you the tools to overcome the individual hurtles you will experience on your health journey.
Do you have the keys to your “fat lock-box?”
Lock-boxes have always fascinated me. Lock-boxes with special keys are even more fascinating. The more I’ve learned about fat cells (adipocytes), the more I think about them as special fuel depositories or fat lock-boxes. Before the invention of refrigerators, fast-food, Bisquick and beer, our bodies preserved and reserved fat as a precious commodity.
The body, when given fat with carbohydrates or excess protein, quickly places the fat into a lock-box for safe keeping. It does this for two reasons. First, the body can store fat very efficiently. Second, hormone signals stimulate fat storage when other fuel sources (carbohydrate & protein) are present in excess. The body can access this stored fuel only when the right presentation of hormonal keys are present. Fascinatingly, we now know from recent research, there are actually three types of lock-boxes for fat in the human body (white adipose tissue, brown adipose tissue, and tan adipose tissue).
The greatest challenge for the obesity doctor is getting into the fat lock-box. Some people’s boxes are like the “Jack-in-the-Box” you had as a child – just add a little exercise spinning the handle and the box pops open (These are those people that say, “Oh, just eat less and exercise and you’ll lose weight.”) For the majority of the people I see, it’s more like the lock above with a four or five part key required to turn the gears just right. (And, that key often only seems available on a quarter moon at midnight when the temperature is 72 degrees.) Fat cells, called adipocytes, require four, and possibly more, keys to open them up and access the fuel inside. Exercise is only one of those keys. However, exercise alone often fails.
Over the last 18 months, I have been surprisingly impressed with the results patients have by the addition of both medium chain triglycerides and exogenous ketones. A number of people have asked me, “Why do you encourage the addition of exogenous ketones to a person already following a ketogenic diet?”
Others just accuse me of self promotion, saying, “You’re just trying to sell a product!”
Or they exclaim, “Giving more ketones is just a waste of time and money.”
A few of the uneducated holler from across cyberspace, “You’re just going to cause ketoacidosis!”
Believe me, I’ve heard it all. And, the skepticism is understandable. I work with people every day, looking closely at weight gain/loss, metabolism, cholesterol, blood pressure, inflammation, etc. With any “low-carb” or “ketogenic product,” I test it out on myself and my family, before I offer it to my patients or even consider encouraging its use in my practice. I have this desire to understand “the how” and “the why” before I prescribe the who and when.
First , let’s talk about the adipocyte as a fat lock-box – and where you find the keys. Then, we’ll discuss how products may or may not help.
There is only one door INTO the adipocyte for the fat, and the key to that door is insulin. Insulin stimulates an enzyme called lipoprotein lipase that essentially pulls the fat from the cholesterol molecule into the fat cell. Without insulin, fat doesn’t enter the fat cell. As a result, type I diabetics (those that make absolutely no insulin) look anorexic if they don’t take their needed insulin. Insulin is also the first key to the back door on the adipocyte. Actually, if there is too much insulin in the system, fat enters easily through the front door but cannot exit the back door (Picture 1). Insulin seals up the back door so that fat cannot exit very effectively.
That’s why insulin is the master hormone when it comes to obesity. You’ve got to lower the over-all insulin load to get the adipocyte slowing fat entry and increasing fat exit. If you don’t do that, I don’t care how much you exercise, 85% of the population will struggle with weight loss. Hmmm, seems kind a familiar to the last 50 years of our obesity epidemic, No?
The second key to the back door of the fat cells are the catecholamines. These are adrenaline (epinephrine), norepinephrine, adrenocorticotropic hormone (ACTH) and even serotonin. These hormones are produced in the adrenal glands through exercise, fear and even recollection of powerful memories. Medications can also stimulate production of these hormones. The catecholamines stimulate cAMP. cAMP opens the fat cell, releasing fatty acids for fuel.
The thyroid hormone conversion of T4 to T3 also plays a role in uptake of the catecholamines by adnylyl cyclase (AC). Low levels of T3 (like those seen in hypothyroidism or in cases of thyroiditis) also inhibit unlocking of the fat lock-box. Conversion of T4 to T3 is driven by the presence of bile salts in the gut. Increase fat intake increases the presence of the bile salts which naturally leads to better T3 conversion. Hence my constant references to eating more fat and bacon. .
The third key is an inhibitory effect on adenylyl cyclase (AC) activity by alpha and beta adrenoreceptors, adenosine, prostaglandins, neuropeptide Y, peptide YY, HM74-R & nicotinic acid. These inhibitory and inflammatory hormones produced in the brain, gut and other areas decrease cAMP activity in the fat cell and slow fat loss. The fancy long names are all hormones causing inflammation. Of note, many are also stimulated by medications including blood pressure lowering drugs. Check with your doctor if the medications you are taking may be causing weight gain, or halting your weight loss.
Please note that the first three keys have effect on the cAMP pathway for release of fat from the adipocyte. These three keys turn on or off effective function of cAMP leading release of fatty acids from the fat cell.
The fourth key follows a separate pathway. This is why I’ve clinically seen patients experience weight loss even in the presence of higher insulin, inflammatory disease or hypothyroidism. This key activates release of the naturitic peptides (ANP, BNP). These hormones are released from the heart when it squeezes more powerfully. As the cardiac muscle contracts, it releases ANP & BNP hormones. These hormones stimulate the cGMP pathway in the adipocyte. It then activates hormone sensitive lipase (HSL) and perilipin to release free fatty acids. Again, this pathway is separate from the pathway by which the first three keys released fat. Exercise increases heart contractility, but is inhibited by high insulin levels. However, ketones themselves also stimulate this increased contractile effect.
There actually is a fifth key not referenced above. The fifth key to the fat lock-box amplifies testosterone’s presence through the HPG axis. Insulin resistance and leptin resistance lower testosterone in men and raise it in women, causing poly-cystic ovarian syndrome (PCOS). Normalizing insulin levels (with a ketogenic diet) while at the same time increasing ketones as the primary fuel powerfully resets the HPG axis through a complex series of hormonal reactions. Growth hormone is balanced and testosterone returns to a normal range.
Clinically, 60% of the people I see in the office have abnormal testosterone due to insulin resistance. This leads to hypogonadism in men and PCOS (abnormal periods, facial hair growth and/or infertility) in women. Restricting carbohydrates and maintaining nutritional ketosis by diet and/or addition of exogenous ketones has a powerful corrective factor in these people.
Testosterone influences the up-regulation of the alpha & beta adrenergic receptors (the 2nd & 3rd key above). Hence, if your testosterone is low, it has a suppression on the way that the catecholamines influence fatty acid release from the fat cells. If your testosterone and growth hormone are normal, muscle development and adrenaline stimulus from exercise helps amplify the use and mobilization of fat from the fat cell. In people with insulin resistance and leptin resistance, exercise and the catecholamines don’t have the same fat burning effect.
Yes, I have greatly simplified a series of very complex hormonal pathways in the explanation of the keys above. Why do you think understanding obesity has been so difficult? Think of your adipocytes as a fat lock-box.
What’s even more important is the knowledge that the fat cell DOES NOT open or close because of calories. There is no dogmatic calorie-meter on the wall of the fat cell. There is no calorie key to the fat lock-box. Really, . . . in the 50 years of studying fat, researchers haven’t found one. (Prove me wrong when you show me an electron micro-graph of a calorie-meter in the wall of a cell). Science has demonstrated multiple times that the lack of food from starvation or excessive fasting suppresses thyroid function (an inhibitory effect on key #3). Restricting calories actually inhibits fat loss in many people.
The fat lock-box keys I refer to above are hormone responses to the presence of macro-nutrients (food). That means, first reduce your carbohydrate intake by eating real food from good sources. You can learn how to get started by registering for my FREE six part weight loss mini-course. Second, be as active as you can. Third, reduce stress and medications that have inhibitory effect on catacholamines. Fourth, balance your thyroid. And, fifth, get into ketosis and consider adding exogenous ketones to your dietary regimen. It really is that simple.
(For those of you that still believe there is a calorie key – or just need something to do while in the bathroom):
Is bacon grease really healthy? People in my office stress out about getting all the healthy fats and the right amino acids. I am asked all the time, which protein powder they should be taking? Do I prefer fish oil or krill oil? My answer to this is simple.
“Bacon grease.”
I know, I can see it on your face now. . . the blank stare of disbelief.
Yes, I said “bacon grease.”
If you are following a low carbohydrate or ketogenic diet, bacon grease is your essential oil. Let me explain why:
Bacon, and the grease it creates, contains all the essential amino acids. Yes, even the coveted branched chain amino acids (BCAAs). Go ahead, have 3-5 slices for breakfast, but keep the grease and re-use it to cook with. Because your saving yourself from having to buy expensive protein powders and less tasty versions of these essential muscle building blocks.
Bacon grease is a great source of choline, an essential nutrient for stabilizing cell membranes and making the neurotransmitter acetylcholine. Acetylcholine is one of the neurotransmitters absent in memory disorders and muscle disease. Fascinatingly, choline helps in the prevention of fatty liver disease, a disease caused by the standard American diet that often progresses to non-alcoholic liver disease.
Choline has also been shown in a number of studies to help ward off Alzheimer’s Disease.
Bacon fat is a superb source of all of the necessary B vitamins. It is also a superb source of Vitamin D, phosphorus, magnesium and iron. In fact all of the fat soluble vitamins – any vitamin that sounds like a letter of the alphabet: A, B, C, D, etc.- are found in animal fat.
Long-Chain fatty acids are satiating. Bacon grease is a great source of the longer chain fatty acids and has a wonderful effect on suppressing your appetite. That’s why Dr. Nally talks about it so often. Bacon is the duct tape of the culinary world, and acts to suppress the cravings for the pie that might arise 30-60 minutes later.
When have you ever felt a frown after eating bacon? That’s my point . . . you just smiled when that thought crossed your mind. Seriously, don’t deny it . . .
Put a piece of bacon in your mouth, and it doesn’t really matter who the president is, what Kim Kardashian recently posted, or that you’re late for work . . . seriously. Bacon in your mouth reminds you how good life really is. If I die while eating a plate of bacon, my life will be complete.
My wife fries eggs in bacon grease for breakfast when she cooks. I tell you . . . it’s edible love.
Bacon grease also contains a significant amount of medium chain triglycerides (caproic, caprylic, capric, and lauric acids). These medium chain triglycerides (MCTs) are all the rage in helping to maintain a ketogenic diet. MCTs convert rapidly into ketones after absorption into the liver from the gut. Rapid conversion of fat into ketones stimulate more effective contraction of the heart. When the heart contracts more effectively, it releases atrial-naturitic peptide (ANP), that opens the “back door” in the fat cell allowing for more efficient fat burning and maintenance of ketosis.
Many people us essential oils for the aromatic effect they produce on mood and anxiety. Next time you cook bacon, check your mood. Never has there been an aroma that is so inviting and calming. Very few other aromas actually bring people to a dinner table. And for you men out there, bacon grease improves your manhood. Increased presence of ketones, and the appetite suppressing effect of bacon grease helps to stabilize testosterone and leucine. This improves muscle development, enhances libedo, and prevents the progressive decline in testosterone leading to the “girly-man” status that occurs with so many men eating the standard American diet.
Let me leave you with one last question. When is the last time you saw left-over bacon?
Exactly – the same time you saw leprechauns riding unicorns down your street after a rain storm.
So, cook that bacon . . . and save the grease. Use it to cook your eggs or bake with it. You’ll thank me later.
Watch as we discuss how a ketogenic diet lowers your blood pressure . . . yes, fat drops blood pressure to normal ranges. We talk about the four mechanisms causing blood pressure to rise and how ketosis improves those mechanisms. . . pull up some pork rinds (Pork Clouds are my favorite) and guacamole and enjoy . . .
Watch as we discuss Type II Diabetes from the perspective of insulin resistance and how using a ketogenic diet/lifestyle as well as exogenous ketones, KetoEssentials Multivitamin and supplements like berberine play a role in improving your health.
Grab your bacon, butter and pecans, . . . pull up a chair, and enjoy!!
For those of you who may be considering their use, or those who are using exogenous ketones on a regular basis, there is a 15% OFF SALE going on with my favorite exogenous ketone maker, Pruvit©, thru January 29th. Now is the time to buy and save.
I’ve become a big fan of exogenous ketones for myself and my patients with a little more challenging insulin resistance. My clinical experience has been great, both personally and with my patients, in helping people to get into, and maintain, a more successful level of ketosis that drives energy, fat loss, improved mental clarity & focus, and diminished inflammation throughout the body.
I’ve been using a packet 2-3 times a day for the last year, personally, and have found these to be the greatest addition to my ketogenic lifestyle. I’m stocking up right now. . .
If you haven’t tried exogenous ketones, now is the perfect time. Buy yours now before this special ends.
Why should you consider using a ketogenic lifestyle? There are many reasons. This is part 8 of a 25 part series and this one focuses on how ketosis improves testosterone in men and estrogen in women.
Watch and enjoy!!
Many people ask me, “Dr. Nally, why should I always be in ketosis even if I burn fat and lose weight without restricting carbohydrates as much as you do?”
The answer is fat burning efficiency. Shifting into ketosis changes your ability to burn fat, and do it efficiently by turning on cGMP in the adipocyte. I explain how below:
Enjoy!! You can click the link below to ramp up your ketosis through the use of exogenous ketones at DynamicKetones.com. Yes, I make a profit from the sale of exogenous ketones, but I just gave you the magic bullet for opening up the adipocyte for FREE!
Merry Christmas!
