Chapter Content
Alright, let's dive in, shall we? So, I wanna talk about something *really* important: how bad energy, you know, that feeling of blah, is actually the root cause of a lot of diseases.
Take Lucy, for example. She was only thirty-six, but she was dealing with *so* much – acne, bloating, low mood, anxiety, insomnia, and trouble getting pregnant because of polycystic ovary syndrome. She'd been to a bunch of doctors, but nothing was really working. She was even about to start expensive in vitro fertilization treatments. She came to my practice because she wanted to feel better, look better, and finally start a family. She knew, deep down, that she wanted to address the *real* reasons behind her health issues, not just treat the symptoms.
Lucy was, statistically speaking, a typical American woman. She wasn’t about to die, but she didn’t feel great. And hey, who *does*, right? Turns out, so many women are on antidepressants or dealing with polycystic ovary syndrome, it’s almost seen as “normal.” But Lucy had that nagging feeling, that intuition that things *could* be better.
During a long first appointment, we started digging. All those separate issues – fatigue, acne, stomach problems, depression, insomnia, infertility – seemed like totally unrelated problems, right? But I told Lucy we were gonna look at things differently. I told her that all those conditions, even though they were in different parts of her body and had different names, were probably just branches of the same tree. Our job was to figure out what that tree *was* and how to heal it, yeah?
Now, if Lucy had just gone to a regular doctor, she might have said she "eats and sleeps well," and that would have been that. But we dug *deeper*. We found out her husband went to bed later than her, and the cat kept jumping on the bed, which messed with her sleep. Her diet was full of refined and overly processed foods and added sugar. She was doing yoga and hiking, but mostly she sat at a desk all day. She was lonely, stressed about her job, her aging parents, and not being able to get pregnant. Her water wasn’t filtered, her skincare and cleaning products were full of toxins, and she drank wine several nights a week. And she spent all day staring at screens, then more screen time at night, plus she didn't spend enough time outdoors!
So, we made a plan that involved seeing food as medicine, getting better sleep, lowering stress, protecting her gut, reducing toxins, and getting more sunlight. And guess what? Over the next six months, almost *all* of her symptoms disappeared! Her periods got normal, her period pain got better, her mood lifted, and her digestion improved. She even got off her meds and postponed in vitro fertilization because her hormones were coming back into balance. She not only felt better *now*, but she also lowered her chances of getting serious chronic illnesses later on. It was incredible!
And you know what? I saw similar things happen with other patients when they made those same lifestyle changes. It all came down to three simple truths:
First, most of the chronic symptoms and diseases we see today are connected by the *same* root cause: cellular malfunction that often results in bad energy. All symptoms are from our cells being out of whack; they don't just appear out of nowhere. And for most Americans, metabolic dysfunction, which is when your body has trouble processing sugar, is a *big* reason for that cellular malfunction.
Second, chronic conditions from bad energy range from things that aren't immediately life-threatening like erectile dysfunction, fatigue, infertility, gout, arthritis to more serious stuff like stroke, cancer, and heart disease.
And third, “mild” symptoms today should be seen as clues that bigger problems are coming.
Now, how can I explain how all these “small” and “big” diseases are connected? Well, I’ll tell you a story about my mom and me.
Back in the 1980s, when my mom was getting ready to get pregnant with me, she followed all the nutritional advice of the time: *tons* of grains, bread, crackers, and low-fat snacks, because fats were considered bad! Protein was an afterthought. She also didn't love vegetables, and she mostly ordered takeout food since she never learned to cook. She walked sometimes, but she wasn’t really into exercising, and she was known for staying up late. And, yeah, she smoked.
So, what was happening inside her body, invisibly, was that these metabolic issues were going on that she unknowingly passed on to me in the womb. You don't just become a super big baby for no reason! And having a large baby raises the risk of future metabolic problems for both mom and baby, things like type 2 diabetes and obesity. Turns out there are some mechanisms at play: large babies can often have insulin resistance, inflammation, and more and bigger fat cells.
Because I was so big, my mom's doctor insisted on a C-section. But because I didn’t go through the birth canal, I didn’t get her good gut bacteria. She also had trouble breastfeeding because she couldn't lift more than ten pounds, and I was almost twelve! So, I missed out on the benefits of breast milk, which shapes a baby's gut for life.
Then, in early childhood, I ate *all* the standard kids' foods: sugary cereals, processed snacks, all that stuff. And the bad energy warning signs popped up *fast*. I had ear infections and tonsillitis all the time, and my mom was always running to the doctor for antibiotics.
I now understand that those infections were likely related to a weak immune system, which is largely determined by our gut bacteria and the lining of our gut. Since I was a C-section baby, formula-fed, ate processed foods, and took a bunch of antibiotics, my gut function was probably a *mess*. This contributed to a cycle of worsening metabolic health, cravings for processed food, and a weak immune system.
By the time I was only ten years old, I was overweight. I had low-grade anxiety, painful periods, acne, headaches, and tonsil infections. And I didn’t even see them as red flags. They seemed like normal kid stuff. It just seemed common to have cramps, headaches, zits, and strep throat here and there. I didn't realize they were all signs of *seriously* messed up biology!
Then, when I was fourteen, I became passionate about getting healthy. I read a bunch of nutrition books and cookbooks, learned how to cook, joined a gym, and went there every day. I lost all the extra weight pretty quickly and healthily over about six months. My other symptoms got better, too. Without even realizing it, I probably reversed the insulin resistance and chronic inflammation that had been causing problems since I was a baby. Then, by being an athlete and chef, I kept the symptoms away.
Fast forward ten years, when I was a twenty-six-year-old medical doctor, and I fell *right* back into that cellular misery! As a surgical resident, my life became *incredibly* stressful. My pager was always going off, the hospital lights were always on, I slept poorly, ate processed cafeteria food, barely exercised, drank *tons* of caffeine, and breathed stale air. I’d even go days without sunlight. My body was, once again, full of bad energy, and it showed up *immediately* in a bunch of symptoms.
First, Irritable Bowel Syndrome showed that my gut cells couldn't do their job. Then I didn’t have a solid stool for almost two years. IBS can look like a lot of things, and for me it was painful gas and watery diarrhea all the time. Studies show that people with IBS have less energy production in their gut cells, and it's strongly linked to insulin resistance and problems with bad energy!
Then acne showed up on my face and neck. That was because elevated glucose and insulin levels were causing hormonal changes. Studies have found that people with acne have higher insulin levels, and high insulin is linked to making more male hormones that make more skin oil. Too much oil can clog pores and create a place for bacteria to thrive. It’s been found that if you follow a low-sugar or low-carb diet, your acne can get so much better.
The acne and all those skin problems were also related to a high burden of oxidative stress and mitochondrial damage, which are both hallmarks of bad energy. A whole bunch of skin conditions are downstream of those issues, including hair loss, eczema, sun damage, rosacea, and so many more. And that dysfunction in various skin cells can show up as a whole bunch of different skin conditions and symptoms.
Then came depression which has a metabolic link. The brain is *extremely* sensitive to oxidative stress and inflammation and uses a *lot* of energy. And bad energy stuff like mitochondrial dysfunction, inflammation, and oxidative stress is known to affect brain function and mood, just like it affects gut function in IBS. Turns out the toxic work environment and residency lifestyle broke the energy-producing pathways in my gut and brain.
The gut-brain axis is all about the communication between the digestive system and the central nervous system. And that connection is *super* important for depression. Your gut bacteria help make neurotransmitters, which control your thoughts, feelings, mood, and behavior. And most of serotonin, the "happiness" hormone, is made in the gut, *not* in the brain! So anything that messes with gut function – like IBS – can *strongly* affect mental health. Studies have also found that changes in gut bacteria can influence depression-like behaviors. If you transfer gut bacteria from depressed animals to healthy animals, they quickly develop depression-like behaviors.
Problems with bad energy in our cells can lead to all these depression issues. The mitochondria that usually are responsible for energy production in our bodies can lead to decrease energy production and therefore alter how our neurotransmitters signal. Mitochondrial dysfunction can also lead to an increase in oxidative stress, which can trigger inflammation. Unstable blood sugar can derail the brain's cells. It can cause the brain's cells to promote the production of more stress hormones, creating an endless feedback loop of stress and dysfunction. And some research shows that every increase in fasting glucose and triglyceride-to-HDL ratio increases the rate of developing depression. When I was describing my feelings of depression, I tearfully told them I felt as if my brain had rapidly gone from the full-color spectrum to black and white. My creativity, ability to synthesize concepts, and sharp memory were gone. A few times after thirty-hour call-shifts, I had the disturbing sense that it would be easier just not to exist. It all makes sense to me now.
Even the neck pain I had as a young surgeon was probably related to metabolic issues. Research shows that poor mitochondrial function and insulin resistance can play a role in chronic pain. The pain that I attributed to the repetitive neck bending over the operating room table was probably happening due to the dysfunction in the energy-producing pathways of my cells. Turns out, I was not alone.
Turns out the sinus infections and migraines that the patients who found themselves under our scalpels had were not being looked at through the right lens either. In the case of sinusitis, the higher a person’s blood sugar, the higher the likelihood of their having sinusitis. For migraines, sufferers tend to have higher insulin levels and insulin resistance. Research has even suggested that migraines could be treated by restoring levels of vitamins B and D, magnesium, CoQ10, alpha lipoic acid, and L-carnitine. Having high markers of oxidative stress, a key bad energy feature, is associated with a significantly higher risk of migraine in women.
And that's not all, the hearing loss in the ENT department wasn't being looked at through the right lens either! The likely mechanism for this is that the auditory system requires high energy utilization for its complex signal processing. In the case of insulin resistance, glucose metabolism is disturbed, leading to decreased energy generation. It is essential to assess early metabolic function and levels of insulin resistance is essential.
Then there’s autoimmune conditions that research indicates has a strong metabolic link. People with autoimmune diseases have been shown to have a much higher rate of insulin resistance and metabolic syndrome when compared to people without these conditions. It all comes down to a cell that can’t make energy properly, then sends out danger signals, and that triggers the immune system to invade.
Also there’s infertility, for both men and women. The PCOS that Lucy experienced that causes cysts to grow on the ovaries has a driver of high insulin, which stimulates the ovaries’ theca cells to make more testosterone and disturbs the delicate hormonal balance of sex hormones and the menstrual cycle. Sperm count has fallen precipitously this century and metabolic dysfunction is one key reason. Low sperm count hits obese men particularly hard because fat tissue contains enzymes that convert testosterone to estrogen and disrupt the delicate hormonal balance required for sperm production. And not to mention rising sexual dysfunction due to metabolic disease and reduced blood flow. There can also be issues with pregnancy like gestational diabetes and miscarriage that can also be a result, in part, of metabolic strain.
Finally, there’s chronic fatigue. Reduced ATP production, unstable blood sugar levels, and hormonal imbalances, all hallmarks of metabolic dysfunction, contribute to persistent fatigue and dysregulated sleep. This is often a warning sign of bad energy in our body.
And that’s all just for adults. Turns out, issues with bad energy occur with children as well.
The prevalence of childhood obesity has increased dramatically and that leads to nonalcoholic fatty liver disease, now the most common liver disease in kids. Then there’s the kids brains. About 20 percent of all children will have an identified mental health condition in any given year. A mother with obesity and diabetes has quadruple the risk of having a child with autism, and she has double the risk of having a child with ADHD.
The following are just a sampling of health conditions that are increasing in children and are known to be related to poor cellular energy production, mitochondrial dysfunction, or oxidative stress: ADHD, autism spectrum disorder, type 2 diabetes, NAFLD, cardiomyopathy, depression, anxiety, high blood pressure, high cholesterol, IBD, asthma, atopic dermatitis, allergies, acne, psoriasis, eczema, schizophrenia, bipolar disorder, borderline personality disorder, and hidradenitis suppurativa (HS, a condition of painful inflammatory lumps under the skin). Not to mention tonsil infections, ear infections, and a dependence on antibiotics.
It’s this simple: kids’ bodies, just like adult bodies, are made of cells that need energy to function.
And then we get to those 50 and beyond where there’s the rise of life-threatening chronic conditions.
There’s stroke, which is well established that high blood glucose increases your risk.
Early-onset dementia and other devastating cognitive diseases can come down to impaired glucose uptake caused by insulin resistance, which may, over time, starve brain cell mitochondria of the energy they need to function properly, creating a state called hypometabolism, which research indicates is a potential cause of Alzheimer’s disease.
Then there’s heart disease. High blood sugar leads to oxidative stress, and these cell-damaging free radicals lead to inflammation, which damages both large and small blood vessels by deteriorating their inner lining.
And there’s chronic obstructive pulmonary disease (COPD), a progressive inflammatory condition that causes damage to the lungs and makes breathing difficult. Cigarette smoke contains a multitude of toxic chemicals, including cyanide, which can directly damage the mitochondria within our cells.
Let’s not forget about arthritis. Emerging research shows that even musculoskeletal pain, like arthritis, is downstream of bad energy processes, just like many of the other chronic cardiometabolic diseases.
And in early 2020, came COVID-19. This acute disease cruelly ravaged the bodies of those who, often unknowingly, had a foundation of chronic conditions and diseases of bad energy caused primarily by diet and lifestyle. The connections were clear in scores of quality peer-reviewed papers.
This is the largest blind spot in medicine: these “small” conditions are invitations to become curious about the metabolic dysfunction brewing in our body. Bad energy will almost certainly result in more serious conditions down the road if left unaddressed. In medicine, we call two or more conditions that tend to go together comorbidities—they happen comorbidly, meaning, we “happen to see them together.”
And what happened to my mom? Her doctors did not know that the extra fat on her body was a sign of cells that were overwhelmed and undersupported. She was let down by the siloed medical system, which saw every health issue she faced as an isolated incident. The large baby, the inability to lose weight, the high blood pressure and cholesterol, the prediabetes, and, ultimately, the pancreatic cancer were all branches of the same tree.
So, we’ve lost our way, but we can change course quickly. Our cells have an incredible capacity for adaptability and regeneration. They are doing it all day, every day. Broken cellular functions can be repaired and restored quickly. This information applies to people of all ages.