Transcript Of Today's Episode
Dr. Martin, Jr.: 00:03 You're listening to The Doctor Is In podcast from martinclinic.com. Although we share a lot of practical, and in our opinion, awesome information, what you hear on this podcast is not intended to diagnose, cure, treat, or prevent any disease. It's strictly for informational purposes, so enjoy.
Dr. Martin, Jr.: 00:25 Hi, I'm Dr. Martin, Jr.
Dr. Martin, Sr.: 00:26 I'm Dr. Martin, Sr.
Dr. Martin, Jr.: 00:28 And this is The Doctor Is In podcast, and this is Episode 180. Today, we want to talk about question and answers, specifically, our last episode, we said that we were going to answer some questions from the webinar that we already answered but we had thought about some more, and we would like to give more information on those question and answers. And then we started talking about B12 and then 30 minutes later, we were still talking about B12, so we decided to postpone that one week. So, here we are on this episode, we're going to answer some of the questions from the webinars, and some of the big questions, right?
Dr. Martin, Jr.: 01:02 The one question that a lot of people asked throughout the thing differently, all came down to liver fat. And specifically, they wanted to know can you reverse liver fat. What I laughed at was, at the same time during the webinar when I read the question, at the same time, you and I both said that, "Absolutely." We sounded like a boy band. We sounded like we were singing it. It was in harmony. It was pretty good, actually. But, we just, at the same time, answered "absolutely," and the way that we said it, we were emphatic about it, so it sounded like we were quite excited.
Dr. Martin, Sr.: 01:40 Because we are emphatic about it.
Dr. Martin, Jr.: 01:42 So the question is, can you reverse liver fat? As we said on the webinar, as we'll say again, yes, absolutely. Liver fat ... And let's talk about first of all, let's break it down and talk first about how a liver gets fatty, and then also why that's way more common, and then also how that is a stepping stone.
Dr. Martin, Jr.: 02:05 So, if you were to imagine in your head a door, and then there's like a couple of steps up to the door, and the door says Type 2 Diabetes. Once you walk through that door, you have type 2 diabetes. One of the steps to get there is fatty liver. Again, I'd have to look this up more, but a majority of the people that have type 2 diabetes have a fatty liver.
Dr. Martin, Sr.: 02:34 And without even knowing it, most of the time.
Dr. Martin, Jr.: 02:36 Yes, that's right. And it has to do, again, that's what we'll talk about, how does a liver get fatty. And why does a liver get fatty? Right? What happens there? We're going to do an episode in the future on liver because we get enough questions about it. People have an idea that the liver is a filter, right? You hear that all the time. But the liver is not a filter.
Dr. Martin, Sr.: 02:57 It's not the oil filter in your car?
Dr. Martin, Jr.: 02:58 Yeah. People find it kind of funny when I say this, but I mean, I know nothing about cars. Right? I mean, literally. Now, you don't even have a key to stick in and turn it. It's just you have a key in your pocket and you start your car. I don't know anything about cars, right? I mean, mechanics will talk to ... I got a friend of mine who's a mechanic who looks at my car, and he'll talk terms, and I'll nod my head like I know what he's talking about, but I mean, literally I have no idea what he's talking about. I have no idea.
Dr. Martin, Sr.: 03:29 It's Greek.
Dr. Martin, Jr.: 03:30 Yeah. I understand a little bit of Greek. I don't understand mechanics. I'm not good in that area. Right? But I do know, because I've seen it, you bring your car to those oil change places, and bring them there, and they change your oil. The guy always ... You're sitting there having a coffee as he's changing it, and you're reading the three-month-old magazine. Now people just sit there on their phones, right?
Dr. Martin, Sr.: 03:54 Yeah.
Dr. Martin, Jr.: 03:55 But for those that are listening that remember the days before phones, waiting rooms were the worst. The magazines were old. The newspaper articles were old. Everything. You would end up reading the back of anything, because you were bored.
Dr. Martin, Sr.: 04:08 Popular Mechanics.
Dr. Martin, Jr.: 04:09 Yeah. Because that's all you had to do. So you would sit in these waiting rooms, and I remember, and then the mechanic would come out. He would come out and he'd be wearing his full outfit and he's got grease all over it, and his hands are greasy. He's got the safety glasses on and they come up and he's quite concerned. He's quite worried. He'll show you a filter. He said, "This is your air filter." He'll show you and he'll say, "This is really dirty. We got to change your oil filter. What do you think?" And I'm like, "Well, since I really don't know anything about ... I guess we got to change it." Right? Because he'll show me a healthy one, and he'll show me a one, and visually you could see, yeah, there's something wrong. Then he tries to explain why a good air filter, what it traps, and the debris and all that kind of stuff. You end up ... because it's very visual, right? It's very smart to get the mechanic to come out and show you. Rather than saying, "Hey, do you want us to change your air filter?", they bring it to you, and then they show you the air filter, and you're like, "Okay, I guess it's bad," right? The mechanic's saying it's bad. It looks bad. So it's bad. Change the ...
Dr. Martin, Jr.: 05:16 But they think that's how the liver is. The liver doesn't have a ... It's not a filter that just gets clogged up. It doesn't get clogged and then you do a detox, a liver detox, and all of a sudden your liver just, the air filter, like you change it at your house, and everything's better. That's not ... That's marketing. That's not how the liver works. The liver doesn't work that way.
Dr. Martin, Jr.: 05:38 But, one of the functions of the liver, it's digestive. Right? The liver also has a very metabolic function. Every time you eat food ... I remember reading a quote by one endocrinologist saying that if people were able to see every chemical reaction that happens in their body after they eat a meal, they would eat a lot less. Because as soon as you introduce food into your system-
Dr. Martin, Sr.: 06:10 A lot of things have to happen.
Dr. Martin, Jr.: 06:13 Oh, millions of things happen. It sets off-
Dr. Martin, Sr.: 06:14 The manufacturing plant just ... here we go.
Dr. Martin, Jr.: 06:17 Top to bottom, everything gets going, right? So you think about, you digest it. Think of all the stuff that happens digestively. The esophagus, the stomach, and the gall bladder and everything-
Dr. Martin, Sr.: 06:29 All the enzymes in there.
Dr. Martin, Jr.: 06:30 ... breaking the food down. Yeah, breaks it down, right? What happens is that food ultimately becomes glucose, energy. It becomes glucose. The faster it becomes glucose, and the faster it ends up in your bloodstream, the higher your blood sugar spike and the more dangerous that becomes. But at the end of the day, everything ends up in glucose. And then here's the thing. Glucose, in itself, has to be used right away. You can't store glucose as glucose because it's in your blood. Either your body says, "Yep, let's burn it right now for energy," or we have to move it. We can't keep it in your blood.
Dr. Martin, Sr.: 07:12 Yeah, dangerous.
Dr. Martin, Jr.: 07:13 It's dangerous. You can't have high blood sugar levels. It's not good for you. It's dangerous. So you eat some food, your blood sugar levels go up, and then your body's like, "Well, we don't need all this energy, so we better do something." That's when your body says, "Okay, we got to lower our blood sugar," so then in comes insulin. Insulin is secreted. It brings your blood sugar down. But it doesn't just magically bring your blood sugar down. It has to get rid of the glucose in your blood, in a sense. So that's why they say that insulin is a partitioning hormone. It kind of directs. It's like a little bit of a-
Dr. Martin, Sr.: 07:46 Traffic cop.
Dr. Martin, Jr.: 07:47 Yeah, it directs. It tells, right? It helps with uptake and all that. But anyways, to keep it simple, that glucose in your blood has to go somewhere. You burn it or it goes somewhere. You have three storage units. Imagine this for a second. You have three ways that you can store glucose, because you can't leave it in your blood. It has to go somewhere. You have three storage units. You have your muscle, and the more muscle you have, the more glucose you can store. It's not stored as glucose. Your body takes glucose, converts it into glycogen and stores it in your muscle. Glycogen could be broken down quickly for energy, so you can get that energy quickly, right? So, if you're really active and you need energy, your body will take the storage of glucose in muscle, which is glycogen, break it down, boom, you have energy. You can store about 500 grams. It's a medium-size storage. It's not a bad size of storage. But that fills up.
Dr. Martin, Jr.: 08:46 When that fills up, then you have your liver. Your liver also can store glucose. It can store it. You can convert it into glycogen. You can store it. Liver is a small storage facility. It holds about 100 grams, roughly. And then of course, anything left over, you have fat cells everywhere. When those fat cells get full, you make new fat cells. That's what happens.
Dr. Martin, Jr.: 09:09 Now, the liver has one extra funny thing to it, more so than the other areas. I always tell people it's kind of like a family of six gets into a minivan and they pack. The kids bring all their suitcases.
Dr. Martin, Sr.: 09:26 They're going on holidays.
Dr. Martin, Jr.: 09:28 Yeah. I remember going to my in-laws for Christmas. We go down to visit them every year in the States. We bring our whole house with us. We're there for 10 days. We got our whole house with us. It's like we might as well just attach a trailer to our house and bring it. So we get down there, and then of course, they get Christmas gifts, right?
Dr. Martin, Sr.: 09:45 Yeah.
Dr. Martin, Jr.: 09:45 I remember one year ... My mother-in-law listens to our podcast, so I'll keep this ... But, I remember one year ... My daughter really wanted this play kitchen ...
Dr. Martin, Sr.: 09:55 But it doesn't come in little pieces.
Dr. Martin, Jr.: 09:57 No, so she told us ahead of time this is what we're getting her. And then I said, "Okay, great. We got a minivan, so how much space? Give me an idea so that when I pack I can make sure to leave that much room on the way back. I remember this. She gave me a size of the box. I said, "Okay." Anyways, Christmas Eve, they opened it up, and that box is definitely not the size that she said it was. It was much bigger. It was much bigger. I'm thinking, as my daughter is opening it up, I'm like, "How are we going to get that home?" There's no way. We brought our whole house with us. I left a spot for this size of box. It's not going to fit.
Dr. Martin, Jr.: 10:38 Imagine that. Now, one of the options, I mean, I could've run down to a local store, picked up a rack for my minivan, and then throw stuff on there and then cover it up. The liver does that. The liver has the ability, once it's full, the liver can say, "Ah, you know what? I can do this." I can get more in there. I could pack it. I pull out the plans. I'm a good packer when it comes to these kind of trips. The liver says, "I can fit more. Let's strap some fat around the liver." That's what happens.
Dr. Martin, Jr.: 11:14 So the liver is full, and then like a minivan with-
Dr. Martin, Sr.: 11:18 Extra suitcases.
Dr. Martin, Jr.: 11:19 ... it's packed. The fat packs around the liver.
Dr. Martin, Sr.: 11:21 And it has an uncanny ability to make fat. Your body has an uncanny ability to make fat around the liver.
Dr. Martin, Jr.: 11:30 Well, especially in the culture that we live in today when foods are so high energy. The combination of crappy carbs, sugar, fructose, and high fat, especially-
Dr. Martin, Sr.: 11:42 Not good fat.
Dr. Martin, Jr.: 11:43 Well, listen, if you ate sugar and good fat, you're going to get fat. I mean, it's too much energy. You can't ... Think about the combination for a second when you eat fat and carbs.
Dr. Martin, Sr.: 11:56 [inaudible 00:11:56].
Dr. Martin, Jr.: 11:57 Yeah. Thinks what happens. The energy in the carbs are burnt off. And usually there's more carbs than you need there anyways, but what happens to that fat? There's a ton of energy in that fat that you're eating, but the carbs get burnt off right away, so the fat gets broken down, but guess what? You don't need it either, so it goes into storage. You can get fat eating fat. The problem is when you combine. It's the combination, right? What makes low-carb very effective is not only is it great metabolically for keeping your blood sugar levels stable, and it's got so much metabolic advantages to low-carb for people that have metabolic issues, but what makes low-carb very good is that you're not combining fat and carbs. I mean, that's one of the advantages, as well. You end up eating less energy. There's no question, right?
Dr. Martin, Jr.: 12:48 So the liver gets fatty, and the problem with a fatty liver is ... Well, there's a few problems. One of them is it's highly inflammatory. A person that has a fatty liver is full of inflammation. They're full of triglycerides. They're full of ... I mean, it's not good for you. And then what happens is they're one step closer to diabetes, because when the liver gets fat, the fat cells start to fill up and then it's a spillover effect. And then a person becomes diabetic.
Dr. Martin, Jr.: 13:19 As long as a person can continue to make fat cells to store energy, they won't technically be a diabetic. But, when they start spilling over too fast, and they just cannot make even fat cells fast enough, they become diabetic. And some people don't have the ability to make fat cells so they get diabetes even though they're not overweight.
Dr. Martin, Sr.: 13:39 Yeah, there's skinny diabetics.
Dr. Martin, Jr.: 13:40 That's right. So, people are always like ... Diabetes does not have to do with obesity. Obesity is a symptom of the issue, but not everybody gets that symptom. Just like, every disease that's out there, they list symptoms. It doesn't mean you get every symptom of that disease, right? It's not like you go and you're like, "Okay, do you have this?" "Yes" "This?" "Yes" "This?" "Yes" "This?" "Yes" "This?" "Yes" "That?" "No" "Sorry, you don't have it." That's not how it works.
Dr. Martin, Jr.: 14:06 Diabetes is the same way. "Well, I'm not obese." Well, that's a symptom. It doesn't mean you don't have it. That's just one symptom. You have everything else.
Dr. Martin, Sr.: 14:15 But almost for sure, skinny or not, the precursor to diabetes is fatty liver.
Dr. Martin, Jr.: 14:22 Yes. Because skinny, overweight, they could have fatty liver and not even know it, not even know it, right?
Dr. Martin, Jr.: 14:30 And fatty liver, again, when you end up with fatty liver, it's not going to end well. You're heading down a diseased path. Heart disease, dementia, Alzheimer's, type 2 diabetes, joint pain, it's not going to end well. So fatty liver is a big deal.
Dr. Martin, Sr.: 14:48 Big deal, because, and we talked about this on our webinar, too, is think of what happens in the liver. Two things, big, big things, that happen in the liver. 80% of all your cholesterol that your body needs to transport, right? Cholesterol is FedEx on the highways of your blood vessels, transporting your hormones and that. That's done in the liver, 80% of it. And we talked about this on the thyroid, the conversion of T4 to T3, the 80% of conversions of T4 and T3, the active form of your thyroid hormone is made in liver. So if you got fatty liver, if your liver is not functioning properly, your thyroid's not going to work properly.
Dr. Martin, Jr.: 15:36 That's right. It's like so many things are processed metabolically by the liver, that, as you mentioned, all of a sudden other things start to happen, which is why ... You know, we don't talk ... We talk enough about fatty liver, but really fatty liver is a big issue for a lot of people.
Dr. Martin, Sr.: 15:54 Yeah, and it's a major concern today, major concern.
Dr. Martin, Jr.: 15:57 And then somebody in the webinar asked us, can it be reversed? We always say the answer is absolute yes. There's a few things we want to mention on that. First of all, there was a study that we wrote about a while ago, and I found it interesting that how long ... Somebody asked this question a while ago. How long does it take to start storing fat on your liver? How long does it take? That question was answered in the study. It was fascinating. They found that seven days-
Dr. Martin, Sr.: 16:25 Out of a bad day.
Dr. Martin, Jr.: 16:26 ... of higher energy glycemic, fat, whatever, seven days is all it took to start increasing liver fat. Think about it. You go on holidays for a week and you eat bad for a week. You have the beginnings of liver fat. So, imagine, stretch that out over a period of time, liver fat, I mean, if you're not eating well, you have liver fat, right? I mean, that's unfortunately-
Dr. Martin, Sr.: 16:51 You have to assume it, and don't wait to get the diagnosis. This is why we do these podcasts. We want to inform you. We always get that feedback that, yeah, we're trying to be very proactive. We want you to understand how your body operates, and that organ, the liver, you want to keep a healthy liver because your liver has ... I mean, it does, what, 600 things? The liver. You can live without a lot of things. One thing you can't live without is the liver. Your body just can not operate without a liver. There's just too many things happen there. Right? It's absolutely essential because if that thing starts to get gummed up with fat, your body is on its route to disaster.
Dr. Martin, Jr.: 17:40 Well, and it's the inflammation that it causes, as well. Because in our last episode last week, we talked about how inflammation in your midlife, 40s, 50s, and 60s, determines the health of your brain in your 70s and 80s. So, midlife inflammation, we did an article on this of all the dangerous effects that midlife inflammation has, right, so if you have inflammation. Well, a major source of inflammation in midlife is fatty liver. Again, fatty liver today could give you dementia, Alzheimer's in your 70s. Again, it's a big issue.
Dr. Martin, Jr.: 18:14 Now, how do you get rid of fatty liver? And listen, there was a lot of research on this, but by far, the most effective method of getting rid of liver fat is a low-carb diet, no question. In fact, I remember there was a study done in the journal of Cell Metabolism that talked about how a low-carb diet almost immediately starts the process of reversing fatty liver. Three low-carb meals in a row starts to take away liver fat. What I found interesting is they ... I remember the quote from the researcher said. This is what he said. I wrote this down, because I found it fascinating. He said, "We observed a rapid and dramatic reduction of liver fat and other cardiometabolic risk factors when they followed a low-carb diet."
Dr. Martin, Jr.: 18:59 A low-carb diet is the prescription for liver fat. It's the prescription. And what else was interesting is they found that when you restrict carbohydrates, even if you're not "losing weight," you're still going to get the metabolic markers of liver fat. Now, so a low-carb diet is the best method to eliminate fatty liver.
Dr. Martin, Jr.: 19:25 Now, if you want to take that to the next level, if you want to hack ... They love the word hack, right? ... If you want to hack that even more, a lower-carb diet and time restricted eating, which is fasting-
Dr. Martin, Sr.: 19:38 Intermittent fasting.
Dr. Martin, Jr.: 19:40 ... in my opinion, would be like the best thing for your liver to get rid of liver fat. Right? Those would be the two things that you do. That, also research, exercise, burning off the storage, weight lifting, resisting-
Dr. Martin, Sr.: 19:57 Empty the muscles and then guess what?
Dr. Martin, Jr.: 19:58 High-intensity interval training, they call that glycogen depleting exercises. It takes the glycogen ... because you don't have enough energy now to burn when you go to these things, and you have to break it down. And then listen, there's a lot of talk about fasted exercise. Whatever. I think, again, my own personal opinion, exercising while fasted, if you can, especially in the ... I'm not talking about crazy, crazy stuff here. But just like the average person exercising fasted, to me, it causes glycogen depletion faster.
Dr. Martin, Sr.: 20:34 That's what you want.
Dr. Martin, Jr.: 20:36 You have to get energy from your muscles. You have to break down glycogen, break down glycogen from your liver. You start to take fat from fat cells, breaking it down. That's just my opinion. I could be wrong, but to me-
Dr. Martin, Sr.: 20:46 No, I think you're right.
Dr. Martin, Jr.: 20:48 That's how it is. So, again, low-carb eating, hack that if you want with time-restricted eating, add some exercise, some glycogen-depleting exercise into the mix, and then you've got a formula right there to help get rid of liver fat. That's how you do it. Again, by doing that, by attacking liver fat, you're protecting yourself from diabetes and from every other thing that liver fat can cause, as we've mentioned. So that's how you do it.
Dr. Martin, Jr.: 21:19 Now listen, we've answered one question. We had more to answer. But again, we're out of time, so we'll do ... In some future episodes, we'll come back and answer some of these questions. Again, we gave a ton of information on liver fat. I hope we shared with you the importance that something as simple as liver fat has on health, and why you want to take that seriously, and why you want to get at that as fast as you can.
Dr. Martin, Jr.: 21:41 So, again, thanks for listening and have a great day.
Dr. Martin, Sr.: 21:45 Thanks for listening to The Doctor Is In podcast from martinclinic.com. If you have any questions, you can reach us at firstname.lastname@example.org. If you're not a newsletter subscriber, you can head to our website and sign up for free. We also have a private Facebook group that you can join. It's a community of awesome people. Finally, I do a Facebook Live every Thursday morning at 8:30. Join us again next week for a new episode.