Join me on this episode of Test as we dive deep into liver health with Dan Garner. We explore the liver's vital roles, from detoxification to hormone regulation, and its impressive ability to regenerate. Discover the importance of biomarkers and how to optimize liver function through supplementation and lifestyle changes. We also discuss the impact of gallbladder removal on liver performance and the benefits of ox bile supplementation. Whether you're curious about the liver's role in overall health or seeking actionable steps to enhance liver function, this episode offers valuable insights. Don't miss the chance to learn how to keep your liver in peak condition.
Shrug family, this week on Barbell Shrug, Dan Garner is back in the house, friends. We are talking about the liver. We actually wait all the way until the end to talk about alcohol because everybody wants to talk about alcohol and their liver.
We're going to dig into biomarkers. We're going to dig into understanding what the liver's function actually is, what biomarkers you can be looking at, supplementation that you can be working on to optimize, and really just how does the liver play into optimal health as a whole, and walking away with some specifics on how you can take actionable steps today to increase the health of your liver.
As always, friends, make sure you get over to rapidhealthreport.com. That is where you can see Dan Garner and Dr. Amy Galpin doing a free lab lifestyle and performance analysis for one of our clients, super secret client that let us post his video.
You'll be able to see their lab lifestyle and performance analysis, which is just a small piece of what everybody gets inside of Rapid Health Optimization. So get over to rapidhealthreport.com.
Make sure you check out that video. You can schedule a call with me, discuss if Rapid Health Report, Rapid Health Optimization is the right protocol and program for you, and friends, let's get into the show.
Welcome to Barbell Shrug, I'm Andrew Varner, Doug Larson, Dan Garner, back on the podcast today.
Bro, how are you feeling after getting skeletal and getting super jacked and then taking 437 pictures of yourself and putting them on the internet?
I feel great, man. That's a good cruise to go through, dude. You did have kind of a wild year. You did marathon, bench 405, and did a bodybuilding show, internal bodybuilding competition, a challenge, we'll call it. You didn't actually go on stage, but you did it for yourself and for the team here. That's a lot of gangster gold, man.
I'm not kidding. I'm not kidding. I'm not kidding. I'm not kidding. I'm not kidding. I'm not kidding. I'm not kidding.
I'm not kidding. I'm not kidding. I'm not kidding. I'm not kidding. I'm not kidding. That's a lot of gangster goals in one year. You hit all into the spectrum of endurance, full strength, and physique.
Yeah. Yeah. I appreciate that, man. I knocked all those out in one year, and for a lot of reasons. I think that it's important to walk the walk as a coach.
I absolutely see it as a part of my job description to do wild shit. I think that if I'm going to take on pro athletes and I'm going to take on executives with big goals, then I should put myself in similar uncomfortable situations and knock out different ends of the spectrum, because a lot of people come to us here at Rapid with bucket list stuff.
Hey, man, I want to run a marathon. Hey, I want to get my bench. These are actually pretty common things people want to knock out, so I want to be a leading from the front in that perspective.
I also kind of, in a big way, father time is undefeated, and there's actually going to be a certain point in our life where I can't set these goals, and that kind of scares me.
It won't even be up to me. When you hit a certain age, you're not going to press 405. That's just something that's not going to happen, so I actually kind of see it as almost like a type of desperation.
There's a type of urgency to knock out all these crazy things while I still can and really just kind of continue to keep getting better and better and better.
So yeah, man, it's been a hell of a year, but it's been a lot of fun. Yeah, dude, the 405 bench press and the big squat numbers that I think you're going to be chasing here, to be able to mentally and physically stay in it, because I'm not saying
40 is like the end of anything, but mentally I don't have those. I have lost the desire to try to back squat 400 plus pounds anymore.
Yeah, man. I've been 40 for three days, and I think my back squat has gone down 50 pounds. I don't feel like I used to last week.
I've been 40 for three days, my back squat is down, my posture is hunched over, my libido is down. I can't just shuffle through the house grumpily.
You know like dad noises when you get off the couch and you're just like, ugh. That's right. It's not when I get off the couch, it's when I sit down onto the couch. That's how you know you're getting old is when you make noises by going down.
You sit down, you go, ugh. Can you sit down? That's a real dad noise. Yeah, man. I think it's important to set big goals, setting the things that I've got a couple of big goals that I'm after right now that I want to hit before December.
I just think it's important to stay fired up. The only way for me personally, I'm just speaking from experience, for me to stay personally fired up is to do shit I haven't done before.
Get leaner than ever, or bench the 405, run a marathon. These things are all first for me, so I'm always just chasing that thing that I've never done before, and I'm going to do it again.
Love it, dude. Today we're going to be talking about the liver, and I'd love to just start at the highest level of what is the liver's role when it comes to overall health, well-being, and then really the optimization side, which we'll be digging into with biomarkers and just understanding how this plays into really peak health.
What is the liver's responsibility? Man, the liver's responsibility is so many things. The liver is one of those things that if you're as dorky as me, this stuff can get you so I'm serious, man.
fired up. I deem certain organs as underrated. That's how much of a nerd I am, so I'm like, not enough people are talking about the Golgi tendon organ, stuff like that.
I hope when you're at a party, someone brings up the liver and says something that's 65% true, and you're just like, don't say it, Dan.
Don't say it. Don't. And then you can't help yourself. Well, I won't be able to help myself because people could be over there talking about the Super Bowl, and I'll be like, yeah, let's talk about something else.
I hear an incorrect fact about the liver over there, and I'm all over that guy. Let's go talk about an organ. But I think this is actually, so the liver, man, it's three to four pounds in weight.
It's about the size of half of a football, and we would die if we didn't have it. It's absolutely critical. It's not like you can lose a kidney or you can lose an appendix.
There are some things that we can kind of go without. You cannot go without your liver. It does so many cool things. It's a manufacturing facility.
It is a processing facility. It is a storing facility. It does so many cool things. From a storage perspective, a lot of people know that it stores glycogen.
Liver holds onto some glycogen, and it releases it in times of lower blood sugar, but it also stores fat-soluble vitamins and keeps them on an as-needed basis. So you're storing vitamins A, D, E, and K in the liver, and then you can release them on an as-needed basis when the body needs them.
The liver can also store up to 10% of your body's blood at any given time. So it's a warehouse storing a lot of things. From a manufacturing perspective, it produces so much.
It's producing structural components. It's also producing chemical components. Your liver is producing transporter proteins like albumin.
We've discussed on this podcast a bunch because of its importance in blood chemistry. But your liver is also making cortisol-binding globulin. It's making sex hormone-binding globulin.
Your liver is making hormones. It's making IGF-1 in order to get us jacked after the gross hormone pulse at night. It's making angiotensinogen in order to regulate our blood pressure for the people out there looking after their health.
The liver is converting inactive vitamin D into active vitamin D. The liver is what's actually synthesizing our cholesterol. The liver makes cholesterol every single day, and we use cholesterol to make hormones.
The liver makes bile. Bile is very important for detoxification and for acting as an antimicrobial component to ensure we don't get pathogens coming in from our food.
It breaks down our fats. So, I mean, that covers the warehouse and the manufacturing component. But from a processing perspective, the liver is also a processing plant.
Like, it filters our blood. The kidneys typically get a lot of the fame for filtering and cleaning the blood. The liver absolutely also cleans the blood.
There's a reason why it can store 10% of our blood at any given time. It is a cleaning facility all by itself. And then from a processing perspective, I'm sure a lot of the audience would predict me saying that the liver is a massive detoxification organ.
So it's processing a lot of things in terms of metals, environmental pollutants, our own hormones, a lot of that stuff. So between it being a warehouse, a processing plant, a manufacturing facility, we need it or else we would die.
And there's actually a really cool study done in 1931 where the scientists, and scientists can do some fucked up shit sometimes, but the scientists actually, they cut two thirds of a rat or a group of rats.
It cut two thirds of their liver off. By the end of the next week, they had their full liver weight back again. The liver is like a zombie.
It actually regenerates. It's super, super cool. Like you wouldn't think of any organ or limb or anything actually regenerating. The liver regenerates.
It is very, very, very difficult in order to truly damage your liver. And that's why people can be on medications for decades and the liver can just keep on processing.
You can be an alcoholic for 10 years before you actually get liver cirrhosis. The liver is unbelievably tough and unbelievably regenerative.
So I think that's probably a good overview on how important this thing is and all the different roles it's involved in. Is that mostly because it's just so incredibly vascular? It's very vascular and its ability to hypertrophy its own cells is massive.
So it's actually, it's not producing brand new cells. It's actually hypertrophying current cells in order to get back to its current weight. So super, super, super cool stuff.
How would people know if their liver is working optimally? There's a lot of symptoms, man.
So the reason why I laugh, it's a good question. So one of the symptoms of your liver not working properly is unexplainable anger. And I was like, oh, my liver is gone.
Hold on a second. Everybody just peaked their head up like, but maybe it's this anger thing I have. Every night my liver acts up right around bedtime.
Every time I go to put my kids to bed, my liver acts up. Shrug family, I want to take a quick break. Weird. Good. If you are enjoying today's conversation, I want to invite you to come over to RapidHealthReport.com.
When you get to RapidHealthReport.com, you will see an area for you to opt in, in which you can see Dan Garner read through my lab work. Now, you know that we've been working at Rapid Health Optimization on programs.
for optimizing health. Now what does that actually mean? It means in three parts, we're going to be doing a ton of deep dive into your labs. That means the inside out approach. So we're not going to be guessing your macros, we're not going to be guessing the total calories that you need, we're actually going to be doing all the work to uncover everything that you have going on inside you. Nutrition, supplementation, sleep, and then we're going to go through and analyze your lifestyle. Dr. Andy Galpin is going to build out a lifestyle protocol based on the severity of your concerns. And then we're going to also build out all the programs that go into that based on the most severe things first. This truly is a world class program. And we invite you to see step one of this process by going over to rapidhealthreport.com. You can see Dan reading my labs, the nutrition and supplementation that he has recommended that has radically shifted the way that I sleep, the energy that I have during the day, my total testosterone level, and my ability to trust and have confidence in my health going forward. I really, really hope that you're able to go over to rapidhealthreport.com. Watch the video of my labs and see what is possible.
And if it is something that you are interested in, please schedule a call with me on that page. Once again, it's rapidhealthreport.com. And let's get back to the show. Every single time I'm on the road, and I got to make a left turn, my liver is just absolutely irritated. But yeah, the symptoms of somebody's liver not working properly, oh, you can absolutely have hormone imbalances. So then those symptoms can go a long way.
So that's typically, you know, a lot of people are looking directly at hormone levels for symptoms. But you know, something I've said a lot on this podcast before is the symptom is never the problem. The symptom is only ever the result of the problem. So if we've got symptoms in the hormonal world, be it erectile dysfunction, maybe low libido, maybe difficulties with fat loss and muscle gain. If you have mood disturbances, these things can all actually be trailed back to the liver. So that's a big one. The unexplainable anger, that's not a big one. That's just a funny one that I remember actually from fatty liver research, specifically. And another big one, if your liver is not functioning, normally, you're typically going to have a tough time with digestion, you're going to have a tough time with bloating, specifically in response to fatty foods.
So the liver, it manufactures this thing called bile. And then it puts this bile in this little bile warehouse that's that's right connected to the liver called the gallbladder. And then that bile is supposed to be secreted into the small intestine when we consume fatty foods in order to it's called emulsification in order to emulsify that fat into fatty acids so that we can take it up into the lymphatic system and properly absorb these things. But if we don't actually make bile, or there's a problem with bile flow, then that fat will sit in our gut and will remain undigested.
And that undergoes a process called rancidification. So your fats go rancid if they don't actually get eaten, or rather broken down properly by bile. And this happens to all the macronutrients.
If protein gets eaten by bacteria, it putrefies. Protein was supposed to be broken down by enzymes and hydrochloric acid. But if we have hypochlorhydria, or an inability to activate certain important protein enzymes, then that protein will be eaten by bacteria and it putrefies.
Carbohydrates, they ferment. In the context of this conversation, fats, they go rancid. So then you'll see, and it makes me think about the liver, if somebody has, say, whole eggs, something that's super healthy, really good for us, but it constantly bloats them and distends them.
If a steak bloats them and distends them, like some people say, red beet just kind of slows me down. It digests slow. That's probably a liver thing. That's not steak. There are millions and billions of people who digest steak just fine on a regular basis. Chicken thigh is same thing.
And something I've picked up across my career is you'll come across people who talk about the fish oil burps. That's a liver issue. That's a liver issue. You don't just have fish oil burps. That's a malfunction in the digestive tract. It's weird to me that when you take a step back, and imagine you were an alien, so you have no bias whatsoever. And you're like, these people have just associated a severe digestive symptom with just this thing. They called it fish oil burps. So now it's just accepted. That doesn't really make any sense. And I've actually identified that across my career as a bile issue. And we should probably be looking into the liver and supporting it. Yeah. When you said how connected the liver and the gallbladder are, what happens when people have their gallbladder removed? Does that affect the liver's ability to do its job?
It does. Yeah. So the liver is still able to make bile, and it's still able to secrete the bile, but not nearly at the same level. So I actually do recommend supplementing with ox bile for those populations. So if you don't have a gallbladder, in the same way, if somebody wants to supplement with enzymes, they're replacing a pancreatic secretion issue. If they want to supplement with hydrochloric acid, they're replacing an inability of the chief cells within the stomach to secrete hydrochloric acid. But a lot of times, people just get their gallbladder removed, and they forget that that housed bile. And bile is super critical for many, many things.
And in the same way that you would supplement with enzymes or hydrochloric acid, you should be supplementing with bile in fat-containing meals. So if somebody had their gallbladder removed, I would put in bile with fat-containing meals for a couple of reasons. I mean, first off, bile is what's going to emulsify those fats into fatty acids, so we can uptake them, right?
That one's kind of like pretty straightforward. But a lot of people forget that bile is what actually allows the catalyzation to take place of pancreatic enzymes. So when you eat a food with, say, just a normal square meal, right? That meal is going to go from mouth, esophagus, to stomach, and then ultimately is going to enter the first section of the intestines, which is the duodenum. You're going to get that food, it's going to enter the duodenum.
The duodenum, it's going to get a secretion of enzymes from the pancreas over here, and then it's supposed to get droplets of bile from the gallbladder on the other side. And then when the bile comes into contact with the enzymes, it allows those enzymes to catalyze, become active, and properly break that meal down. But if we have a poor secretion of bile or no bile, then the pancreas can't just activate its own enzymes. Hydrochloric acid and a low pH value of the food has been demonstrated to increase the catalyzation of enzymes, so acid does play its own role here. But bile activates enzymes, bile emulsifies fats, and bile is also what's supposed to regulate the pH of that food. So it's actually what restores some more alkalinity to the food once it's entered the duodenum so that it's not at the same pH level as the stomach. So yeah, dude, if you haven't been given any instructions post-gallbladder removal surgery, I'm a big fan of incorporating about 500 milligrams of ox bile with fatty-containing meals and probably going on a slightly lower fat diet. Yeah, I actually talked to a decent number of people that have had their gallbladder removed coming into the program, which is really cool. I don't know how many actual people are in there, but I hear a decent amount. I didn't know that it was like such a common thing. It's super common. It's actually kind of common because of the recommendations that were provided to us, say, from the Ancel Keys days in the later 50s, early 60s, where they said fat is what's going to kill you. So a lot of people said carb-dominant diets, and basically 90% of our diets were cereal, and we were told that that was the healthy and good way to go. If you have a very, very low-fat diet, then your gallbladder has very little reason to stimulate bile flow. And if it has no reason to stimulate bile flow and secrete bile into the small intestine, well, then bile becomes stagnant and creates gallstones.
Those gallstones build up in your gallbladder. All of a sudden, you need it removed. So I'm actually not a fan of going super low-fat in diets, unless you've had your gallbladder already removed. Then it makes a little bit more sense. But it's pretty common, actually, in bodybuilding right now to go hyper, hyper low-fat. And it's basically done for the purpose of maximizing insulin. In terms of, say, training specificity, if you want to get better at the squat, you just need to squat, right? In terms of dietary specificity, a lot of bodybuilders approach the off-season anabolism, anti-catabolism. That's the only thing that matters in my life is over the fractional synthetic rate beating the fractional breakdown rate of my skeletal muscle tissue. But if you zoom out and take a little bit of a bigger picture view, the avoidance of needing gastrointestinal surgery in the long run is going to be beneficial for your anabolism and anti-catabolism. Not to mention, the bile does activate enzymes. The bile is antimicrobial. The bile does regulate pH. The bile actually plays a role in how effective the thyroid is as well.
So there are many things in this department as to why you would want to incorporate some fats in the diet. They'll generally go really low-fat because they figure the more insulin
I can produce, the more anabolic and anti-catabolic I am. And I don't need fats because fats typically increase testosterone in natural individuals. But if I inject my hormones, then I don't really need those fats. And I can get away with it because I'm getting synthetic versions of those hormones. So it's generally the rationalization made there. But I absolutely think that in the big picture, it loses its efficacy in the long run. And even in bodybuilders, I recommend at least 25% of your daily caloric intake coming in the form of fats. Yeah. You mentioned earlier fatty liver disease. What is fatty liver disease? And then how does that play into probably the downrange effects of obesity, probably getting into some sort of diabetes-type things? What is the relationship between fatty liver disease and some of these more common, really nasty problems? Well, I'm glad that you said more common because fatty liver is so common. It's crazy, you guys. There's calculators that you can use online. You can do fibrosis score. You can do the fatty liver index. You can do the NAFLD calculator. These are predictive values that don't just look at one marker because there's no one marker for fatty liver. It's a relationship of several markers that predicts fatty liver. And you can actually have normal AST and ALT, which are typically representative of liver health. You can have normal AST and ALT and have fatty liver. This has already been demonstrated in the research.
pattern between markers that is predictive of fatty liver. And holy crap, when you start doing that calculation on all the blood work, like say that comes my way, you have no idea how common it is.
No idea, it's so, so, so common. But then you start to dig into it and then you start to realize why it's so common. One of the biggest things that causes fatty liver is insulin resistance.
One of the largest problems in America is insulin resistance. So you start to see those, the similar patterns actually present themselves. So when you're looking at a lab and you start to see, okay, there's elevated cholesterol here, there's elevated AST and ALT, and there's elevated GGT, and there's elevated glucose.
Fatty liver, that's like the boom, boom. That's like the, that is absolutely 100, you have the elevated glucose because you're insulin resistant.
You have the elevated AST, ALT, and GGT because your liver is under distress and you have high levels of cholesterol because that cholesterol is not being processed through the liver properly and secreted through the bioflow.
You have this relationship that is absolutely representative of fatty liver. And then that actually sends you down a pathway of things that you really don't want to be connected to because then fatty liver creates more insulin resistance and insulin resistance creates a worse high fatty liver.
So you end up in this cycle that puts you down a pathway of things. Fatty liver has been connected to early cognitive impairment.
Fatty liver actually inhibits phase two detoxification. So your ability to deal with things like environmental pollutants or clear hormones out of your body.
Both those things are inhibited. When typically, when you say phase two detox, people think environmental pollutants, and it is true, but we do need to metabolize our own hormones as well.
And those go through the same phasic processes that occur in the liver. It's been connected to so many things. So you're gonna see insulin resistance cause it, and then you're gonna see the symptoms of this manifestation create things mentally, physically, in a huge net across the entire body.
And a lot of the things that you would kind of see as basic are the things that help here, exercise and resistance training. One of the top things that reduces fatty liver.
Why? Increases insulin sensitivity. Fatty liver is not created because you're eating fat. Fatty liver is typically created through de novo lipogenesis of carbs to fat.
So that's why insulin resistance is what's creating a lot of fatty liver. And the process of resistance training, which increases insulin sensitivity, is one of the most effective things that you could do in order to get out of that fatty liver situation.
But there's a lot of supplements and strategies and protocols and things that you can do in that department if you wanna walk down that road too. Yeah.
Yeah, let's dig through, you just mentioned phase two, detoxification and clearing hormones. I think a lot of people just think you have a certain amount of hormones in your body.
They don't think about you always producing new hormones and clearing out old hormones and then having some net balance there, income, expenses, revenue, profit type calculation.
How does all that work? And if you can't clear hormones, what does that mean for, you know, most people hear hormones and they instantly think like testosterone.
Like that's like kind of like the hormone that most people are wanting, or at least for myself. Anyone else just turned 40? Like I just said earlier in the show, I just turned 40.
I want my testosterone to stay as high as possible so I can stay young and youthful for as long as possible and have energy, et cetera, et cetera. How does all that play together with the liver?
Yeah, so phenomenal question, man. So when we have hormones, we're supposed to make hormones, we're supposed to use hormones, then we're supposed to clear hormones.
That is a process that's supposed to happen There's a reason why there's pulsatile releases. every single day. Like I mentioned earlier, pulsatile release of growth hormone happens within the first few hours of falling asleep.
You have a pulsatile release of testosterone in the first few hours of waking up. There are things that happen in pulsatile releases and that's because hormones aren't stagnant.
Hormones are allostatic. They are going to adapt and pulsatilely release in response to the current stress load of the body. So we are supposed to create hormones, we're supposed to use them, and then we are supposed to metabolize them.
What metabolizes them? The liver. The liver has a giant role in metabolizing and clearing these hormones. And it happens through four phase processes.
It's important for people to understand this, to really lay this out in a way that they can grab onto. There is four things that the liver is going to do in order to clear, if it's going to be an environmental pollutant or a hormone.
Same process, all right? Phase zero, one, two, and three. Phase zero, detoxification is discovered in 2006. And this is the process to where a transporter protein grabs onto something fat soluble and brings it into a cell, okay?
So just to kind of back up, if we're going to detoxify something, whether it's a hormone or it's an environmental pollutant, the entire goal is to convert this fat soluble thing into something that's water soluble, so that we can sweat it out, or it can go out in the urine, or it can go out in the feces.
You can actually detoxify through your tears or your spit. Anything that's actually water soluble, that's excretion, is viable way for something to get out of our body.
So this detoxification process, the goal is to convert something that's fat soluble into something that's water soluble. And it is phase zero, one, two, and three.
Phase zero is what actually is the transporter protein that grabs onto this fat soluble thing and brings it into a cell that's capable of detoxification.
So since this episode is about the liver, we'll talk about a hepatocyte, hepatolivercyte cell. So it's important to point out though, too, that liver is famous for detoxification, but the lungs can detoxify, the skin can detoxify.
Like, and this makes sense, too, right? The skin has all phasic detoxification ability, because if we have exposure to something on our skin, it's purportant that we're able to detoxify it.
There's type two alveoli proteins within our lungs that are capable of detoxification, too. So we breathe in something, we should have ready-to-go detoxification capacity there.
Our Sertoli cells on our testes have full capability of detoxification. And it's thought that that was an evolutionary protective mechanism to allow us to reproduce despite our bad decisions about what we put in our body.
There's detoxification to protect our sperm in these scenarios. So we've got phase zero bringing something into a cell that's capable of detoxification, our trusty old hepatocyte in the zombie-like liver.
Phase one, now that it's in the cell, by the way, phase zero, fun fact, can be inhibited by piperine. So that common black pepper that you see added to curcumin all the time, phase zero can actually be inhibited by piperine.
That's already been demonstrated. So it's interesting to where if somebody has a type of detoxification issue and they're slamming tons of curcumin in order to do whatever they're trying to do, those populations tend to kind of do those things, piperine can actually inhibit phase zero.
So that's already been demonstrated. But besides that, phase one of this process is when you add a molecule of oxygen to this thing. And what you're doing is you're exposing, the details of this aren't as important as the big picture, but you're exposing something known as a hydroxyl group.
And this essentially is what creates this intermediary metabolite. So people in the world of detoxification have probably heard about if something goes through phase one but doesn't go through phase two, then it's possibly more dangerous and more damaging than what the compound originally was.
And that's often case, it's not always true, but it is often true to where in phase one, you're actually changing the molecular structure of this damaging compound.
And if that compound doesn't successfully go through phase two and then reenter circulation, it can create more free radical damage than it was originally ever going to.
So it's very important for phase two to actually take place. Now we've changed, okay, so phase zero, we got it in the cell.
Phase one, we've changed the molecular structure. Phase two, this is now biotransformation, to where this is a successful transformation of making this thing water soluble.
There's many different ways to do this. You can go through glutathione conjugation, you can go through glucuronidation, you can go through sulfation.
There's many different ways in which to accomplish phase two, but this is broadly considered the phase where this is now where it becomes water soluble.
This is now when it's ready to enter into phase three. Phase three is excretion, okay? So phase three is getting it now out of the cell.
So phase zero, enter. Phase one, change the molecular structure. Phase two, make it water soluble. Bam, now we're ready for phase three.
It's water soluble. So now that it's water soluble, it can enter the bloodstream and be sweated out, peed out, moved in the feces, whatever it's going to go.
That is the excretion process. That is the metabolism process. And phase three is actually dramatically accelerated by something called St. John's wort. There's a supplement called St. John's wort that it's one of the most researched-
We'll never take that without you saying it's a supplement that you should take. Take wort, St. John's wort. I know, that worst marketer ever, right?
It's one of the most researched supplements of all time, though. And it's not because it's so magical. It's researched actually by the pharmaceutical industry because it's so effective at excretion that it makes medications less effective because medications are in your system for a shorter period of time because if you take St. John's wort with it, it excretes it out much faster.
So you'll actually see St. John's wort on a ton of medications. I say do not take with St. John's wort. And that's because it's so effective And that's because it accelerates the excretion process of getting the medication out there sooner than it otherwise would have so that its half-life is shorter and it's not as effective as it otherwise would have been.
That is, it sounded like a super long-winded answer, but believe it or not, that is a very abbreviated version of what detoxification truly is.
Each of those phases involves a ton of biochemistry. To get all the way back to Doug's point, this is what's actually going to be happening in areas like TRT and testosterone.
And this phasic process and the efficiency of this phasic process is important to understand because let's just go with TRT, okay?
The average person who's after TRT, probably insulin-resistant, if you are after TRT, then your lifestyle has created low testosterone, okay?
I've been quite vocal about that to where. The symptom is never the problem. The symptom is always the result of the problem. So it's not the question of, hey, I've got low testosterone.
Let me take testosterone. That's not the question. The question is, why was testosterone low to begin with? It probably had something to do with sleep, probably had something to do with stress, probably had something to do with diet, probably had something to do with insulin resistance, possibly inflammation, lack of activity, or some combination of all the above.
Regardless, in this type of physiologic profile, a lack of liver efficiency is extremely likely, especially if you've already tried certain other things and they're not working for you.
You still have the symptoms of lower libido. You still have the symptoms of difficulty dropping body fat and building muscle mass and strength, but you just don't have the competitive drive that you used to have when you were younger.
This is inefficient liver. And what can happen is you have insulin resistance, which creates a type of inefficient liver, which we've already discussed can inhibit, slow down, or even completely inhibit phase two detoxification.
This can create estrogen dominance in a male because you're gonna create estrogen. Estrogen is supposed to be excreted from the body.
If it's not excreted, you don't have an estrogen production problem. You have an estrogen metabolism problem. So you might be 40, 45 and getting kind of man boobs, and it's not because of your age, it's because of your lack of estrogen excretion ability currently taking place.
And when you have estrogen building up, well, that's gonna run antagonistic with testosterone. Testosterone is going to be lower. So this is where we start to create that liver testosterone connection to where if you have an estrogen clearance problem, well, then you are going to create estrogen dominance, not because of your estrogen production, but because of your lack of clearance.
But now that we have a lack of clearance of estrogen, the teeter-totter relationship between estrogen and testosterone is going to keep testosterone lower. So then when you inject testosterone and bring testosterone back up, well, you never actually solved your liver problem that is still going to be there.
But a second thing too, is you're just gonna now become even more estrogen dominant because a lot of that testosterone is just simply going to be converted to estrogen from a bunch of aromatase in the body.
That's another big conversation we can get into. But there is a huge, huge door to be opened for people to balance their hormone through a healthy liver when it comes to estrogen dominance, or when it comes to low testosterone due to a byproduct of estrogen dominance.
We also did an entire episode on the thyroid hormone connection, sorry, the thyroid-liver connection last year and how many roles the liver plays in T4, T3, RT3, many, many different things.
So if you're somebody who has hormone imbalances and you're not somebody who has done a comprehensive look at your liver function, or had somebody look at a comprehensive understanding of phase zero to phase three and all the things that you could possibly be doing to be inhibiting these things, which is many, then that's your next step in order to become a better version of yourself.
Yeah. Also, if you can't clear testosterone, do you also, does your body down-regulate the production of testosterone?
If you can't clear testosterone, will your body down-regulate the production of testosterone? Not only will it down-regulate the production of testosterone because it's seeing free floating in the surface, you'll actually down-regulate your sensitivity on the receptors as well.
Because if clearance is never taking place, then you're going to have an elevation or a stabilization of a hormone that should be having a pulsatile situation allowing for sensitivity of the receptors to take place.
To go back to kind of a bodybuilding example again, this is a big reason why guys actually go periods of time on a very, very low dose or even completely off to resensitize certain receptors of the body so that when they go back on testosterone, they have this sensitization and new hypertrophic potential from that process.
Cause they've given their body, you could say a quote unquote break from a receptor perspective, but they've allowed their levels to come back down so they can bring them back up again to resensitize receptors.
On a much lower and non-super physiologic scale, that's also what's happening here if you simply don't clear your hormones. Nice.
Let's talk about how do people kind of avoid this nutritionally, training, supplementation.
What are some like active steps people can take that are worried about their liver? I mean, action steps.
You want to look at AST, ALT, GGT, fatty liver index, fibrosis score, cholesterol, glucose, the hemoglobin A1C.
These are all things that are really connected. Well, the liver's involved in so many different things. Yeah. So there's a lot that you can look at in that regard and trail it back to the liver because when it's a warehouse, a manufacturer, and a processor, you're going to see it in many areas in the blood.
But as far as like immediately actionable items, intermittent fasting has actually been demonstrated to really help with fatty liver. It creates a deepening of the liver and it creates a type of autophagy effect within the liver to where it activates certain AMPK genes within the liver to help really reduce fat content of the liver.
So uniquely for the liver, I'm not always a fan of intermittent fasting, especially for things like body composition or performance. But if somebody has fatty liver issues, I am certainly a fan of utilizing intermittent fasting for fatty liver.
I think reducing fructose intake is definitely ideal. Fructose is only two metabolic steps away from being stored as fat in the liver. It's very, very easy for the body to convert fructose into liver fat.
So if that's coming in the form of soda, that's coming in the form of way too much fruit. True story, by the way. I had a client about 10 years ago, so hopefully she doesn't listen to this podcast.
But I had a client about 10 years ago who had about a 60 to 90 minute commute, something like that to work.
She would eat a bag of apples on the way to work. A bag. A little too much fructose.
That seems like a lot to begin with, yeah. Yeah, are apples unhealthy? No, are a bag of them unhealthy on the way to work. All right.
Yes, okay. So when I say reduce fructose, I'm not saying fruit is bad. I'm saying let's reduce soda because that's got tons of high fructose corn syrup.
But don't go crazy with fruit either just because it is very direct in its way in which to impact de novo lipogenesis within the liver.
Increasing choline intake is actually very important. Something we didn't bring up in this podcast is choline. So non-alcoholic fatty liver disease, or NAFLD, you'll see it as people say it sometimes, that's actually been touted as a choline deficiency.
So in the same way that you get rickets, if you don't have enough vitamin D, if you don't have enough choline, you get non-alcoholic fatty liver disease.
So it's a deficiency in choline that will directly cause that. This has absolutely been demonstrated already. So sources of choline like egg yolks are excellent for your liver health.
So getting some choline in there, getting some fasting in there, reducing your fructose intake, and then increasing sulfur. Sulfur foods tend to bump this phasic efficiency that we talked about previously.
Eggs contain sulfur, so you're getting kind of a one-two hit there with choline. Choline's in egg yolks though, so we can't just go with egg whites. But eggs contain sulfur, garlic contain sulfur, broccoli contain sulfur.
These are all like the dietary things that you can do between fasting, choline, eggs, and sulfur. From a supplementation perspective, it's a little bit unique because you can take specific approaches depending on your own unique issues and possibly what your lab work looks like.
You could take a choline supplement if you don't like whole eggs, or if you have an allergy to eggs, then you could just take a choline supplement. That'd be very effective.
NAC, N-Acetylcysteine, that's a precursor to glutathione, which helps promote phase two glutathione conjugation. It's very effective at improving liver health, and it really helps recover the liver as well.
If the liver has been damaged, that's one that you can utilize to actually acutely recover the liver. A lot of people don't know, milk thistle is not one that you would wanna use to acutely recover the liver.
Milk thistle actually has a type of hormetic effect on the liver, to where it's kind of an acute stressor to the liver. But in the long run, this is what helps protect your liver.
So if you wanna use milk thistle for liver health, you actually wanna do it during periods of purity. So like during a time where you're very healthy, and you don't take a bunch of milk thistle after a brutal night of drinking, because that's actually, you're using it at the wrong time.
That's where something like NAC would make a lot more sense. So choline, NAC, Tudka is definitely another big one.
Tudka helps stimulate bowel flow. Tudka also improves insulin sensitivity. So beyond getting bowel flowing, you are getting insulin sensitive, which helps reverse that fatty liver process.
We're gonna use milk thistle for resiliency. And that's it. Those are really the big ones.
Between diet and supplements, those would be the big rocks that you would wanna knock down. Anything more sophisticated than that, and even including that, would really depend upon your labs.
Yeah. We kind of intentionally avoided just talking about alcohol for an hour here, which is obviously like the most, it's like the thing that everybody's going to associate with having an unhealthy liver.
How long does it take to kind of clear the alcohol out of your system? I would assume this is like a consistency of alcohol starts to create a lot of problems in there, where if it's like once a week, once every other week, once a month, something like that, it's not going to have that dramatic of an effect on liver health.
If there was a, obviously, if you're an extreme alcoholic, that's going to be a problem.
But how long does it take to clear alcohol? Really, if you were to like touch on that just for a little bit, on the effects of alcohol on the liver, and how long does it take for it to get healthy?
Yeah, so we bring cutting edge information Sure, sure. here at Barbell Shrugged. Alcohol is bad for your liver.
Okay. Why we stayed away from it. It's very common. Yeah. It's a common information that everybody wants. We waited until minute 15.
to talk about it. Yeah. No, dude. So alcohol, alcohol absolutely is bad for your liver.
Alcohol damages the liver. There's a reason why, you know, one is called non-alcoholic fatty liver disease because it's already so prevalent that you can have alcoholic induced fatty liver issues.
It damages the liver. It actually scars the liver. That's what you're assessing a lot on fibrosis scores is actual organ scarring. It's connected to brain shrinkage, which we've talked about in the past.
Alcohol typically as a, as a clearance from, from a half-life perspective, you typically want to have the rule of one drink takes about two hours to clear and that stacks. So if you have five drinks in one hour, it's still going to take about 10 hours to clear.
Okay. And that creates a problem because when you have alcohol in your system that you're not metabolizing anything else and it creates a lot of de novo lipogenesis, which creates a lot of fatty liver.
Okay. So it's, it's like basically the fastest way to have liver problems is to have a lot of alcohol.
But I will provide something unique that a lot of people probably don't know. Serotonin, actually excess serotonin increases cancerous growths in liver tumors. So excess serotonin has been connected and linked to excessive and accelerated growth in the tumors in cancerous tumors in, in livers.
So it's not alcohol-specific serotonin. That's one of the reasons why alcohol makes us feel so good. It dramatically increases serotonin, which is a big problem all by itself. But excess serotonin increases cancerous growth in livers.
And on top of alcohol's damage directly to the liver, one of the reasons alcohol makes us feel great is because it increases serotonin, but then that's a problem for cancer in the liver.
Yeah. Wait, hold on. The downstream effect of, of processing alcohol, is it that it also can't be doing all the other jobs it's supposed to be doing because it's so, it's so involved with processing alcohol.
So it's not just alcohol is bad for it, but it's also not doing like clearing hormones like I mentioned earlier, or any other job that it's supposed to be doing because it's, it's so tied up with the alcohol.
You got it, man. A very layman's term way to say that. Totally. Right. But then in the layman's answer too, like he had five drinks, 10 hours of being tied up and not dealing with anything else.
And then getting a backlog of everything else that it has to do after it's already been damaged. Where can people find you, sir? I can be found at Dan Garner nutrition on Instagram.
You're on fire these days on the instance, by the way. Yeah, man. I just got a lot of energy. I want to help a lot of people.
Let's rock and roll. There you go. Doug Larson. On Instagram. Douglas C. Larson. I'm Anders Varner at Anders Varner. We are Barbell Shrugged.
Barbell underscore shrugged. Make sure you get over to rapidhealthreport.com. That is where Dan Garner and Dr. Andy Galpin are giving a free lab lifestyle and performance analysis, which everybody will receive inside of Rapid Health Authentication.
You can find that over at rapidhealthreport.com. Friends, we'll see you guys next week.
We're going to dig into biomarkers. We're going to dig into understanding what the liver's function actually is, what biomarkers you can be looking at, supplementation that you can be working on to optimize, and really just how does the liver play into optimal health as a whole, and walking away with some specifics on how you can take actionable steps today to increase the health of your liver.
As always, friends, make sure you get over to rapidhealthreport.com. That is where you can see Dan Garner and Dr. Amy Galpin doing a free lab lifestyle and performance analysis for one of our clients, super secret client that let us post his video.
You'll be able to see their lab lifestyle and performance analysis, which is just a small piece of what everybody gets inside of Rapid Health Optimization. So get over to rapidhealthreport.com.
Make sure you check out that video. You can schedule a call with me, discuss if Rapid Health Report, Rapid Health Optimization is the right protocol and program for you, and friends, let's get into the show.
Welcome to Barbell Shrug, I'm Andrew Varner, Doug Larson, Dan Garner, back on the podcast today.
Bro, how are you feeling after getting skeletal and getting super jacked and then taking 437 pictures of yourself and putting them on the internet?
I feel great, man. That's a good cruise to go through, dude. You did have kind of a wild year. You did marathon, bench 405, and did a bodybuilding show, internal bodybuilding competition, a challenge, we'll call it. You didn't actually go on stage, but you did it for yourself and for the team here. That's a lot of gangster gold, man.
I'm not kidding. I'm not kidding. I'm not kidding. I'm not kidding. I'm not kidding. I'm not kidding. I'm not kidding.
I'm not kidding. I'm not kidding. I'm not kidding. I'm not kidding. I'm not kidding. That's a lot of gangster goals in one year. You hit all into the spectrum of endurance, full strength, and physique.
Yeah. Yeah. I appreciate that, man. I knocked all those out in one year, and for a lot of reasons. I think that it's important to walk the walk as a coach.
I absolutely see it as a part of my job description to do wild shit. I think that if I'm going to take on pro athletes and I'm going to take on executives with big goals, then I should put myself in similar uncomfortable situations and knock out different ends of the spectrum, because a lot of people come to us here at Rapid with bucket list stuff.
Hey, man, I want to run a marathon. Hey, I want to get my bench. These are actually pretty common things people want to knock out, so I want to be a leading from the front in that perspective.
I also kind of, in a big way, father time is undefeated, and there's actually going to be a certain point in our life where I can't set these goals, and that kind of scares me.
It won't even be up to me. When you hit a certain age, you're not going to press 405. That's just something that's not going to happen, so I actually kind of see it as almost like a type of desperation.
There's a type of urgency to knock out all these crazy things while I still can and really just kind of continue to keep getting better and better and better.
So yeah, man, it's been a hell of a year, but it's been a lot of fun. Yeah, dude, the 405 bench press and the big squat numbers that I think you're going to be chasing here, to be able to mentally and physically stay in it, because I'm not saying
40 is like the end of anything, but mentally I don't have those. I have lost the desire to try to back squat 400 plus pounds anymore.
Yeah, man. I've been 40 for three days, and I think my back squat has gone down 50 pounds. I don't feel like I used to last week.
I've been 40 for three days, my back squat is down, my posture is hunched over, my libido is down. I can't just shuffle through the house grumpily.
You know like dad noises when you get off the couch and you're just like, ugh. That's right. It's not when I get off the couch, it's when I sit down onto the couch. That's how you know you're getting old is when you make noises by going down.
You sit down, you go, ugh. Can you sit down? That's a real dad noise. Yeah, man. I think it's important to set big goals, setting the things that I've got a couple of big goals that I'm after right now that I want to hit before December.
I just think it's important to stay fired up. The only way for me personally, I'm just speaking from experience, for me to stay personally fired up is to do shit I haven't done before.
Get leaner than ever, or bench the 405, run a marathon. These things are all first for me, so I'm always just chasing that thing that I've never done before, and I'm going to do it again.
Love it, dude. Today we're going to be talking about the liver, and I'd love to just start at the highest level of what is the liver's role when it comes to overall health, well-being, and then really the optimization side, which we'll be digging into with biomarkers and just understanding how this plays into really peak health.
What is the liver's responsibility? Man, the liver's responsibility is so many things. The liver is one of those things that if you're as dorky as me, this stuff can get you so I'm serious, man.
fired up. I deem certain organs as underrated. That's how much of a nerd I am, so I'm like, not enough people are talking about the Golgi tendon organ, stuff like that.
I hope when you're at a party, someone brings up the liver and says something that's 65% true, and you're just like, don't say it, Dan.
Don't say it. Don't. And then you can't help yourself. Well, I won't be able to help myself because people could be over there talking about the Super Bowl, and I'll be like, yeah, let's talk about something else.
I hear an incorrect fact about the liver over there, and I'm all over that guy. Let's go talk about an organ. But I think this is actually, so the liver, man, it's three to four pounds in weight.
It's about the size of half of a football, and we would die if we didn't have it. It's absolutely critical. It's not like you can lose a kidney or you can lose an appendix.
There are some things that we can kind of go without. You cannot go without your liver. It does so many cool things. It's a manufacturing facility.
It is a processing facility. It is a storing facility. It does so many cool things. From a storage perspective, a lot of people know that it stores glycogen.
Liver holds onto some glycogen, and it releases it in times of lower blood sugar, but it also stores fat-soluble vitamins and keeps them on an as-needed basis. So you're storing vitamins A, D, E, and K in the liver, and then you can release them on an as-needed basis when the body needs them.
The liver can also store up to 10% of your body's blood at any given time. So it's a warehouse storing a lot of things. From a manufacturing perspective, it produces so much.
It's producing structural components. It's also producing chemical components. Your liver is producing transporter proteins like albumin.
We've discussed on this podcast a bunch because of its importance in blood chemistry. But your liver is also making cortisol-binding globulin. It's making sex hormone-binding globulin.
Your liver is making hormones. It's making IGF-1 in order to get us jacked after the gross hormone pulse at night. It's making angiotensinogen in order to regulate our blood pressure for the people out there looking after their health.
The liver is converting inactive vitamin D into active vitamin D. The liver is what's actually synthesizing our cholesterol. The liver makes cholesterol every single day, and we use cholesterol to make hormones.
The liver makes bile. Bile is very important for detoxification and for acting as an antimicrobial component to ensure we don't get pathogens coming in from our food.
It breaks down our fats. So, I mean, that covers the warehouse and the manufacturing component. But from a processing perspective, the liver is also a processing plant.
Like, it filters our blood. The kidneys typically get a lot of the fame for filtering and cleaning the blood. The liver absolutely also cleans the blood.
There's a reason why it can store 10% of our blood at any given time. It is a cleaning facility all by itself. And then from a processing perspective, I'm sure a lot of the audience would predict me saying that the liver is a massive detoxification organ.
So it's processing a lot of things in terms of metals, environmental pollutants, our own hormones, a lot of that stuff. So between it being a warehouse, a processing plant, a manufacturing facility, we need it or else we would die.
And there's actually a really cool study done in 1931 where the scientists, and scientists can do some fucked up shit sometimes, but the scientists actually, they cut two thirds of a rat or a group of rats.
It cut two thirds of their liver off. By the end of the next week, they had their full liver weight back again. The liver is like a zombie.
It actually regenerates. It's super, super cool. Like you wouldn't think of any organ or limb or anything actually regenerating. The liver regenerates.
It is very, very, very difficult in order to truly damage your liver. And that's why people can be on medications for decades and the liver can just keep on processing.
You can be an alcoholic for 10 years before you actually get liver cirrhosis. The liver is unbelievably tough and unbelievably regenerative.
So I think that's probably a good overview on how important this thing is and all the different roles it's involved in. Is that mostly because it's just so incredibly vascular? It's very vascular and its ability to hypertrophy its own cells is massive.
So it's actually, it's not producing brand new cells. It's actually hypertrophying current cells in order to get back to its current weight. So super, super, super cool stuff.
How would people know if their liver is working optimally? There's a lot of symptoms, man.
So the reason why I laugh, it's a good question. So one of the symptoms of your liver not working properly is unexplainable anger. And I was like, oh, my liver is gone.
Hold on a second. Everybody just peaked their head up like, but maybe it's this anger thing I have. Every night my liver acts up right around bedtime.
Every time I go to put my kids to bed, my liver acts up. Shrug family, I want to take a quick break. Weird. Good. If you are enjoying today's conversation, I want to invite you to come over to RapidHealthReport.com.
When you get to RapidHealthReport.com, you will see an area for you to opt in, in which you can see Dan Garner read through my lab work. Now, you know that we've been working at Rapid Health Optimization on programs.
for optimizing health. Now what does that actually mean? It means in three parts, we're going to be doing a ton of deep dive into your labs. That means the inside out approach. So we're not going to be guessing your macros, we're not going to be guessing the total calories that you need, we're actually going to be doing all the work to uncover everything that you have going on inside you. Nutrition, supplementation, sleep, and then we're going to go through and analyze your lifestyle. Dr. Andy Galpin is going to build out a lifestyle protocol based on the severity of your concerns. And then we're going to also build out all the programs that go into that based on the most severe things first. This truly is a world class program. And we invite you to see step one of this process by going over to rapidhealthreport.com. You can see Dan reading my labs, the nutrition and supplementation that he has recommended that has radically shifted the way that I sleep, the energy that I have during the day, my total testosterone level, and my ability to trust and have confidence in my health going forward. I really, really hope that you're able to go over to rapidhealthreport.com. Watch the video of my labs and see what is possible.
And if it is something that you are interested in, please schedule a call with me on that page. Once again, it's rapidhealthreport.com. And let's get back to the show. Every single time I'm on the road, and I got to make a left turn, my liver is just absolutely irritated. But yeah, the symptoms of somebody's liver not working properly, oh, you can absolutely have hormone imbalances. So then those symptoms can go a long way.
So that's typically, you know, a lot of people are looking directly at hormone levels for symptoms. But you know, something I've said a lot on this podcast before is the symptom is never the problem. The symptom is only ever the result of the problem. So if we've got symptoms in the hormonal world, be it erectile dysfunction, maybe low libido, maybe difficulties with fat loss and muscle gain. If you have mood disturbances, these things can all actually be trailed back to the liver. So that's a big one. The unexplainable anger, that's not a big one. That's just a funny one that I remember actually from fatty liver research, specifically. And another big one, if your liver is not functioning, normally, you're typically going to have a tough time with digestion, you're going to have a tough time with bloating, specifically in response to fatty foods.
So the liver, it manufactures this thing called bile. And then it puts this bile in this little bile warehouse that's that's right connected to the liver called the gallbladder. And then that bile is supposed to be secreted into the small intestine when we consume fatty foods in order to it's called emulsification in order to emulsify that fat into fatty acids so that we can take it up into the lymphatic system and properly absorb these things. But if we don't actually make bile, or there's a problem with bile flow, then that fat will sit in our gut and will remain undigested.
And that undergoes a process called rancidification. So your fats go rancid if they don't actually get eaten, or rather broken down properly by bile. And this happens to all the macronutrients.
If protein gets eaten by bacteria, it putrefies. Protein was supposed to be broken down by enzymes and hydrochloric acid. But if we have hypochlorhydria, or an inability to activate certain important protein enzymes, then that protein will be eaten by bacteria and it putrefies.
Carbohydrates, they ferment. In the context of this conversation, fats, they go rancid. So then you'll see, and it makes me think about the liver, if somebody has, say, whole eggs, something that's super healthy, really good for us, but it constantly bloats them and distends them.
If a steak bloats them and distends them, like some people say, red beet just kind of slows me down. It digests slow. That's probably a liver thing. That's not steak. There are millions and billions of people who digest steak just fine on a regular basis. Chicken thigh is same thing.
And something I've picked up across my career is you'll come across people who talk about the fish oil burps. That's a liver issue. That's a liver issue. You don't just have fish oil burps. That's a malfunction in the digestive tract. It's weird to me that when you take a step back, and imagine you were an alien, so you have no bias whatsoever. And you're like, these people have just associated a severe digestive symptom with just this thing. They called it fish oil burps. So now it's just accepted. That doesn't really make any sense. And I've actually identified that across my career as a bile issue. And we should probably be looking into the liver and supporting it. Yeah. When you said how connected the liver and the gallbladder are, what happens when people have their gallbladder removed? Does that affect the liver's ability to do its job?
It does. Yeah. So the liver is still able to make bile, and it's still able to secrete the bile, but not nearly at the same level. So I actually do recommend supplementing with ox bile for those populations. So if you don't have a gallbladder, in the same way, if somebody wants to supplement with enzymes, they're replacing a pancreatic secretion issue. If they want to supplement with hydrochloric acid, they're replacing an inability of the chief cells within the stomach to secrete hydrochloric acid. But a lot of times, people just get their gallbladder removed, and they forget that that housed bile. And bile is super critical for many, many things.
And in the same way that you would supplement with enzymes or hydrochloric acid, you should be supplementing with bile in fat-containing meals. So if somebody had their gallbladder removed, I would put in bile with fat-containing meals for a couple of reasons. I mean, first off, bile is what's going to emulsify those fats into fatty acids, so we can uptake them, right?
That one's kind of like pretty straightforward. But a lot of people forget that bile is what actually allows the catalyzation to take place of pancreatic enzymes. So when you eat a food with, say, just a normal square meal, right? That meal is going to go from mouth, esophagus, to stomach, and then ultimately is going to enter the first section of the intestines, which is the duodenum. You're going to get that food, it's going to enter the duodenum.
The duodenum, it's going to get a secretion of enzymes from the pancreas over here, and then it's supposed to get droplets of bile from the gallbladder on the other side. And then when the bile comes into contact with the enzymes, it allows those enzymes to catalyze, become active, and properly break that meal down. But if we have a poor secretion of bile or no bile, then the pancreas can't just activate its own enzymes. Hydrochloric acid and a low pH value of the food has been demonstrated to increase the catalyzation of enzymes, so acid does play its own role here. But bile activates enzymes, bile emulsifies fats, and bile is also what's supposed to regulate the pH of that food. So it's actually what restores some more alkalinity to the food once it's entered the duodenum so that it's not at the same pH level as the stomach. So yeah, dude, if you haven't been given any instructions post-gallbladder removal surgery, I'm a big fan of incorporating about 500 milligrams of ox bile with fatty-containing meals and probably going on a slightly lower fat diet. Yeah, I actually talked to a decent number of people that have had their gallbladder removed coming into the program, which is really cool. I don't know how many actual people are in there, but I hear a decent amount. I didn't know that it was like such a common thing. It's super common. It's actually kind of common because of the recommendations that were provided to us, say, from the Ancel Keys days in the later 50s, early 60s, where they said fat is what's going to kill you. So a lot of people said carb-dominant diets, and basically 90% of our diets were cereal, and we were told that that was the healthy and good way to go. If you have a very, very low-fat diet, then your gallbladder has very little reason to stimulate bile flow. And if it has no reason to stimulate bile flow and secrete bile into the small intestine, well, then bile becomes stagnant and creates gallstones.
Those gallstones build up in your gallbladder. All of a sudden, you need it removed. So I'm actually not a fan of going super low-fat in diets, unless you've had your gallbladder already removed. Then it makes a little bit more sense. But it's pretty common, actually, in bodybuilding right now to go hyper, hyper low-fat. And it's basically done for the purpose of maximizing insulin. In terms of, say, training specificity, if you want to get better at the squat, you just need to squat, right? In terms of dietary specificity, a lot of bodybuilders approach the off-season anabolism, anti-catabolism. That's the only thing that matters in my life is over the fractional synthetic rate beating the fractional breakdown rate of my skeletal muscle tissue. But if you zoom out and take a little bit of a bigger picture view, the avoidance of needing gastrointestinal surgery in the long run is going to be beneficial for your anabolism and anti-catabolism. Not to mention, the bile does activate enzymes. The bile is antimicrobial. The bile does regulate pH. The bile actually plays a role in how effective the thyroid is as well.
So there are many things in this department as to why you would want to incorporate some fats in the diet. They'll generally go really low-fat because they figure the more insulin
I can produce, the more anabolic and anti-catabolic I am. And I don't need fats because fats typically increase testosterone in natural individuals. But if I inject my hormones, then I don't really need those fats. And I can get away with it because I'm getting synthetic versions of those hormones. So it's generally the rationalization made there. But I absolutely think that in the big picture, it loses its efficacy in the long run. And even in bodybuilders, I recommend at least 25% of your daily caloric intake coming in the form of fats. Yeah. You mentioned earlier fatty liver disease. What is fatty liver disease? And then how does that play into probably the downrange effects of obesity, probably getting into some sort of diabetes-type things? What is the relationship between fatty liver disease and some of these more common, really nasty problems? Well, I'm glad that you said more common because fatty liver is so common. It's crazy, you guys. There's calculators that you can use online. You can do fibrosis score. You can do the fatty liver index. You can do the NAFLD calculator. These are predictive values that don't just look at one marker because there's no one marker for fatty liver. It's a relationship of several markers that predicts fatty liver. And you can actually have normal AST and ALT, which are typically representative of liver health. You can have normal AST and ALT and have fatty liver. This has already been demonstrated in the research.
pattern between markers that is predictive of fatty liver. And holy crap, when you start doing that calculation on all the blood work, like say that comes my way, you have no idea how common it is.
No idea, it's so, so, so common. But then you start to dig into it and then you start to realize why it's so common. One of the biggest things that causes fatty liver is insulin resistance.
One of the largest problems in America is insulin resistance. So you start to see those, the similar patterns actually present themselves. So when you're looking at a lab and you start to see, okay, there's elevated cholesterol here, there's elevated AST and ALT, and there's elevated GGT, and there's elevated glucose.
Fatty liver, that's like the boom, boom. That's like the, that is absolutely 100, you have the elevated glucose because you're insulin resistant.
You have the elevated AST, ALT, and GGT because your liver is under distress and you have high levels of cholesterol because that cholesterol is not being processed through the liver properly and secreted through the bioflow.
You have this relationship that is absolutely representative of fatty liver. And then that actually sends you down a pathway of things that you really don't want to be connected to because then fatty liver creates more insulin resistance and insulin resistance creates a worse high fatty liver.
So you end up in this cycle that puts you down a pathway of things. Fatty liver has been connected to early cognitive impairment.
Fatty liver actually inhibits phase two detoxification. So your ability to deal with things like environmental pollutants or clear hormones out of your body.
Both those things are inhibited. When typically, when you say phase two detox, people think environmental pollutants, and it is true, but we do need to metabolize our own hormones as well.
And those go through the same phasic processes that occur in the liver. It's been connected to so many things. So you're gonna see insulin resistance cause it, and then you're gonna see the symptoms of this manifestation create things mentally, physically, in a huge net across the entire body.
And a lot of the things that you would kind of see as basic are the things that help here, exercise and resistance training. One of the top things that reduces fatty liver.
Why? Increases insulin sensitivity. Fatty liver is not created because you're eating fat. Fatty liver is typically created through de novo lipogenesis of carbs to fat.
So that's why insulin resistance is what's creating a lot of fatty liver. And the process of resistance training, which increases insulin sensitivity, is one of the most effective things that you could do in order to get out of that fatty liver situation.
But there's a lot of supplements and strategies and protocols and things that you can do in that department if you wanna walk down that road too. Yeah.
Yeah, let's dig through, you just mentioned phase two, detoxification and clearing hormones. I think a lot of people just think you have a certain amount of hormones in your body.
They don't think about you always producing new hormones and clearing out old hormones and then having some net balance there, income, expenses, revenue, profit type calculation.
How does all that work? And if you can't clear hormones, what does that mean for, you know, most people hear hormones and they instantly think like testosterone.
Like that's like kind of like the hormone that most people are wanting, or at least for myself. Anyone else just turned 40? Like I just said earlier in the show, I just turned 40.
I want my testosterone to stay as high as possible so I can stay young and youthful for as long as possible and have energy, et cetera, et cetera. How does all that play together with the liver?
Yeah, so phenomenal question, man. So when we have hormones, we're supposed to make hormones, we're supposed to use hormones, then we're supposed to clear hormones.
That is a process that's supposed to happen There's a reason why there's pulsatile releases. every single day. Like I mentioned earlier, pulsatile release of growth hormone happens within the first few hours of falling asleep.
You have a pulsatile release of testosterone in the first few hours of waking up. There are things that happen in pulsatile releases and that's because hormones aren't stagnant.
Hormones are allostatic. They are going to adapt and pulsatilely release in response to the current stress load of the body. So we are supposed to create hormones, we're supposed to use them, and then we are supposed to metabolize them.
What metabolizes them? The liver. The liver has a giant role in metabolizing and clearing these hormones. And it happens through four phase processes.
It's important for people to understand this, to really lay this out in a way that they can grab onto. There is four things that the liver is going to do in order to clear, if it's going to be an environmental pollutant or a hormone.
Same process, all right? Phase zero, one, two, and three. Phase zero, detoxification is discovered in 2006. And this is the process to where a transporter protein grabs onto something fat soluble and brings it into a cell, okay?
So just to kind of back up, if we're going to detoxify something, whether it's a hormone or it's an environmental pollutant, the entire goal is to convert this fat soluble thing into something that's water soluble, so that we can sweat it out, or it can go out in the urine, or it can go out in the feces.
You can actually detoxify through your tears or your spit. Anything that's actually water soluble, that's excretion, is viable way for something to get out of our body.
So this detoxification process, the goal is to convert something that's fat soluble into something that's water soluble. And it is phase zero, one, two, and three.
Phase zero is what actually is the transporter protein that grabs onto this fat soluble thing and brings it into a cell that's capable of detoxification.
So since this episode is about the liver, we'll talk about a hepatocyte, hepatolivercyte cell. So it's important to point out though, too, that liver is famous for detoxification, but the lungs can detoxify, the skin can detoxify.
Like, and this makes sense, too, right? The skin has all phasic detoxification ability, because if we have exposure to something on our skin, it's purportant that we're able to detoxify it.
There's type two alveoli proteins within our lungs that are capable of detoxification, too. So we breathe in something, we should have ready-to-go detoxification capacity there.
Our Sertoli cells on our testes have full capability of detoxification. And it's thought that that was an evolutionary protective mechanism to allow us to reproduce despite our bad decisions about what we put in our body.
There's detoxification to protect our sperm in these scenarios. So we've got phase zero bringing something into a cell that's capable of detoxification, our trusty old hepatocyte in the zombie-like liver.
Phase one, now that it's in the cell, by the way, phase zero, fun fact, can be inhibited by piperine. So that common black pepper that you see added to curcumin all the time, phase zero can actually be inhibited by piperine.
That's already been demonstrated. So it's interesting to where if somebody has a type of detoxification issue and they're slamming tons of curcumin in order to do whatever they're trying to do, those populations tend to kind of do those things, piperine can actually inhibit phase zero.
So that's already been demonstrated. But besides that, phase one of this process is when you add a molecule of oxygen to this thing. And what you're doing is you're exposing, the details of this aren't as important as the big picture, but you're exposing something known as a hydroxyl group.
And this essentially is what creates this intermediary metabolite. So people in the world of detoxification have probably heard about if something goes through phase one but doesn't go through phase two, then it's possibly more dangerous and more damaging than what the compound originally was.
And that's often case, it's not always true, but it is often true to where in phase one, you're actually changing the molecular structure of this damaging compound.
And if that compound doesn't successfully go through phase two and then reenter circulation, it can create more free radical damage than it was originally ever going to.
So it's very important for phase two to actually take place. Now we've changed, okay, so phase zero, we got it in the cell.
Phase one, we've changed the molecular structure. Phase two, this is now biotransformation, to where this is a successful transformation of making this thing water soluble.
There's many different ways to do this. You can go through glutathione conjugation, you can go through glucuronidation, you can go through sulfation.
There's many different ways in which to accomplish phase two, but this is broadly considered the phase where this is now where it becomes water soluble.
This is now when it's ready to enter into phase three. Phase three is excretion, okay? So phase three is getting it now out of the cell.
So phase zero, enter. Phase one, change the molecular structure. Phase two, make it water soluble. Bam, now we're ready for phase three.
It's water soluble. So now that it's water soluble, it can enter the bloodstream and be sweated out, peed out, moved in the feces, whatever it's going to go.
That is the excretion process. That is the metabolism process. And phase three is actually dramatically accelerated by something called St. John's wort. There's a supplement called St. John's wort that it's one of the most researched-
We'll never take that without you saying it's a supplement that you should take. Take wort, St. John's wort. I know, that worst marketer ever, right?
It's one of the most researched supplements of all time, though. And it's not because it's so magical. It's researched actually by the pharmaceutical industry because it's so effective at excretion that it makes medications less effective because medications are in your system for a shorter period of time because if you take St. John's wort with it, it excretes it out much faster.
So you'll actually see St. John's wort on a ton of medications. I say do not take with St. John's wort. And that's because it's so effective And that's because it accelerates the excretion process of getting the medication out there sooner than it otherwise would have so that its half-life is shorter and it's not as effective as it otherwise would have been.
That is, it sounded like a super long-winded answer, but believe it or not, that is a very abbreviated version of what detoxification truly is.
Each of those phases involves a ton of biochemistry. To get all the way back to Doug's point, this is what's actually going to be happening in areas like TRT and testosterone.
And this phasic process and the efficiency of this phasic process is important to understand because let's just go with TRT, okay?
The average person who's after TRT, probably insulin-resistant, if you are after TRT, then your lifestyle has created low testosterone, okay?
I've been quite vocal about that to where. The symptom is never the problem. The symptom is always the result of the problem. So it's not the question of, hey, I've got low testosterone.
Let me take testosterone. That's not the question. The question is, why was testosterone low to begin with? It probably had something to do with sleep, probably had something to do with stress, probably had something to do with diet, probably had something to do with insulin resistance, possibly inflammation, lack of activity, or some combination of all the above.
Regardless, in this type of physiologic profile, a lack of liver efficiency is extremely likely, especially if you've already tried certain other things and they're not working for you.
You still have the symptoms of lower libido. You still have the symptoms of difficulty dropping body fat and building muscle mass and strength, but you just don't have the competitive drive that you used to have when you were younger.
This is inefficient liver. And what can happen is you have insulin resistance, which creates a type of inefficient liver, which we've already discussed can inhibit, slow down, or even completely inhibit phase two detoxification.
This can create estrogen dominance in a male because you're gonna create estrogen. Estrogen is supposed to be excreted from the body.
If it's not excreted, you don't have an estrogen production problem. You have an estrogen metabolism problem. So you might be 40, 45 and getting kind of man boobs, and it's not because of your age, it's because of your lack of estrogen excretion ability currently taking place.
And when you have estrogen building up, well, that's gonna run antagonistic with testosterone. Testosterone is going to be lower. So this is where we start to create that liver testosterone connection to where if you have an estrogen clearance problem, well, then you are going to create estrogen dominance, not because of your estrogen production, but because of your lack of clearance.
But now that we have a lack of clearance of estrogen, the teeter-totter relationship between estrogen and testosterone is going to keep testosterone lower. So then when you inject testosterone and bring testosterone back up, well, you never actually solved your liver problem that is still going to be there.
But a second thing too, is you're just gonna now become even more estrogen dominant because a lot of that testosterone is just simply going to be converted to estrogen from a bunch of aromatase in the body.
That's another big conversation we can get into. But there is a huge, huge door to be opened for people to balance their hormone through a healthy liver when it comes to estrogen dominance, or when it comes to low testosterone due to a byproduct of estrogen dominance.
We also did an entire episode on the thyroid hormone connection, sorry, the thyroid-liver connection last year and how many roles the liver plays in T4, T3, RT3, many, many different things.
So if you're somebody who has hormone imbalances and you're not somebody who has done a comprehensive look at your liver function, or had somebody look at a comprehensive understanding of phase zero to phase three and all the things that you could possibly be doing to be inhibiting these things, which is many, then that's your next step in order to become a better version of yourself.
Yeah. Also, if you can't clear testosterone, do you also, does your body down-regulate the production of testosterone?
If you can't clear testosterone, will your body down-regulate the production of testosterone? Not only will it down-regulate the production of testosterone because it's seeing free floating in the surface, you'll actually down-regulate your sensitivity on the receptors as well.
Because if clearance is never taking place, then you're going to have an elevation or a stabilization of a hormone that should be having a pulsatile situation allowing for sensitivity of the receptors to take place.
To go back to kind of a bodybuilding example again, this is a big reason why guys actually go periods of time on a very, very low dose or even completely off to resensitize certain receptors of the body so that when they go back on testosterone, they have this sensitization and new hypertrophic potential from that process.
Cause they've given their body, you could say a quote unquote break from a receptor perspective, but they've allowed their levels to come back down so they can bring them back up again to resensitize receptors.
On a much lower and non-super physiologic scale, that's also what's happening here if you simply don't clear your hormones. Nice.
Let's talk about how do people kind of avoid this nutritionally, training, supplementation.
What are some like active steps people can take that are worried about their liver? I mean, action steps.
You want to look at AST, ALT, GGT, fatty liver index, fibrosis score, cholesterol, glucose, the hemoglobin A1C.
These are all things that are really connected. Well, the liver's involved in so many different things. Yeah. So there's a lot that you can look at in that regard and trail it back to the liver because when it's a warehouse, a manufacturer, and a processor, you're going to see it in many areas in the blood.
But as far as like immediately actionable items, intermittent fasting has actually been demonstrated to really help with fatty liver. It creates a deepening of the liver and it creates a type of autophagy effect within the liver to where it activates certain AMPK genes within the liver to help really reduce fat content of the liver.
So uniquely for the liver, I'm not always a fan of intermittent fasting, especially for things like body composition or performance. But if somebody has fatty liver issues, I am certainly a fan of utilizing intermittent fasting for fatty liver.
I think reducing fructose intake is definitely ideal. Fructose is only two metabolic steps away from being stored as fat in the liver. It's very, very easy for the body to convert fructose into liver fat.
So if that's coming in the form of soda, that's coming in the form of way too much fruit. True story, by the way. I had a client about 10 years ago, so hopefully she doesn't listen to this podcast.
But I had a client about 10 years ago who had about a 60 to 90 minute commute, something like that to work.
She would eat a bag of apples on the way to work. A bag. A little too much fructose.
That seems like a lot to begin with, yeah. Yeah, are apples unhealthy? No, are a bag of them unhealthy on the way to work. All right.
Yes, okay. So when I say reduce fructose, I'm not saying fruit is bad. I'm saying let's reduce soda because that's got tons of high fructose corn syrup.
But don't go crazy with fruit either just because it is very direct in its way in which to impact de novo lipogenesis within the liver.
Increasing choline intake is actually very important. Something we didn't bring up in this podcast is choline. So non-alcoholic fatty liver disease, or NAFLD, you'll see it as people say it sometimes, that's actually been touted as a choline deficiency.
So in the same way that you get rickets, if you don't have enough vitamin D, if you don't have enough choline, you get non-alcoholic fatty liver disease.
So it's a deficiency in choline that will directly cause that. This has absolutely been demonstrated already. So sources of choline like egg yolks are excellent for your liver health.
So getting some choline in there, getting some fasting in there, reducing your fructose intake, and then increasing sulfur. Sulfur foods tend to bump this phasic efficiency that we talked about previously.
Eggs contain sulfur, so you're getting kind of a one-two hit there with choline. Choline's in egg yolks though, so we can't just go with egg whites. But eggs contain sulfur, garlic contain sulfur, broccoli contain sulfur.
These are all like the dietary things that you can do between fasting, choline, eggs, and sulfur. From a supplementation perspective, it's a little bit unique because you can take specific approaches depending on your own unique issues and possibly what your lab work looks like.
You could take a choline supplement if you don't like whole eggs, or if you have an allergy to eggs, then you could just take a choline supplement. That'd be very effective.
NAC, N-Acetylcysteine, that's a precursor to glutathione, which helps promote phase two glutathione conjugation. It's very effective at improving liver health, and it really helps recover the liver as well.
If the liver has been damaged, that's one that you can utilize to actually acutely recover the liver. A lot of people don't know, milk thistle is not one that you would wanna use to acutely recover the liver.
Milk thistle actually has a type of hormetic effect on the liver, to where it's kind of an acute stressor to the liver. But in the long run, this is what helps protect your liver.
So if you wanna use milk thistle for liver health, you actually wanna do it during periods of purity. So like during a time where you're very healthy, and you don't take a bunch of milk thistle after a brutal night of drinking, because that's actually, you're using it at the wrong time.
That's where something like NAC would make a lot more sense. So choline, NAC, Tudka is definitely another big one.
Tudka helps stimulate bowel flow. Tudka also improves insulin sensitivity. So beyond getting bowel flowing, you are getting insulin sensitive, which helps reverse that fatty liver process.
We're gonna use milk thistle for resiliency. And that's it. Those are really the big ones.
Between diet and supplements, those would be the big rocks that you would wanna knock down. Anything more sophisticated than that, and even including that, would really depend upon your labs.
Yeah. We kind of intentionally avoided just talking about alcohol for an hour here, which is obviously like the most, it's like the thing that everybody's going to associate with having an unhealthy liver.
How long does it take to kind of clear the alcohol out of your system? I would assume this is like a consistency of alcohol starts to create a lot of problems in there, where if it's like once a week, once every other week, once a month, something like that, it's not going to have that dramatic of an effect on liver health.
If there was a, obviously, if you're an extreme alcoholic, that's going to be a problem.
But how long does it take to clear alcohol? Really, if you were to like touch on that just for a little bit, on the effects of alcohol on the liver, and how long does it take for it to get healthy?
Yeah, so we bring cutting edge information Sure, sure. here at Barbell Shrugged. Alcohol is bad for your liver.
Okay. Why we stayed away from it. It's very common. Yeah. It's a common information that everybody wants. We waited until minute 15.
to talk about it. Yeah. No, dude. So alcohol, alcohol absolutely is bad for your liver.
Alcohol damages the liver. There's a reason why, you know, one is called non-alcoholic fatty liver disease because it's already so prevalent that you can have alcoholic induced fatty liver issues.
It damages the liver. It actually scars the liver. That's what you're assessing a lot on fibrosis scores is actual organ scarring. It's connected to brain shrinkage, which we've talked about in the past.
Alcohol typically as a, as a clearance from, from a half-life perspective, you typically want to have the rule of one drink takes about two hours to clear and that stacks. So if you have five drinks in one hour, it's still going to take about 10 hours to clear.
Okay. And that creates a problem because when you have alcohol in your system that you're not metabolizing anything else and it creates a lot of de novo lipogenesis, which creates a lot of fatty liver.
Okay. So it's, it's like basically the fastest way to have liver problems is to have a lot of alcohol.
But I will provide something unique that a lot of people probably don't know. Serotonin, actually excess serotonin increases cancerous growths in liver tumors. So excess serotonin has been connected and linked to excessive and accelerated growth in the tumors in cancerous tumors in, in livers.
So it's not alcohol-specific serotonin. That's one of the reasons why alcohol makes us feel so good. It dramatically increases serotonin, which is a big problem all by itself. But excess serotonin increases cancerous growth in livers.
And on top of alcohol's damage directly to the liver, one of the reasons alcohol makes us feel great is because it increases serotonin, but then that's a problem for cancer in the liver.
Yeah. Wait, hold on. The downstream effect of, of processing alcohol, is it that it also can't be doing all the other jobs it's supposed to be doing because it's so, it's so involved with processing alcohol.
So it's not just alcohol is bad for it, but it's also not doing like clearing hormones like I mentioned earlier, or any other job that it's supposed to be doing because it's, it's so tied up with the alcohol.
You got it, man. A very layman's term way to say that. Totally. Right. But then in the layman's answer too, like he had five drinks, 10 hours of being tied up and not dealing with anything else.
And then getting a backlog of everything else that it has to do after it's already been damaged. Where can people find you, sir? I can be found at Dan Garner nutrition on Instagram.
You're on fire these days on the instance, by the way. Yeah, man. I just got a lot of energy. I want to help a lot of people.
Let's rock and roll. There you go. Doug Larson. On Instagram. Douglas C. Larson. I'm Anders Varner at Anders Varner. We are Barbell Shrugged.
Barbell underscore shrugged. Make sure you get over to rapidhealthreport.com. That is where Dan Garner and Dr. Andy Galpin are giving a free lab lifestyle and performance analysis, which everybody will receive inside of Rapid Health Authentication.
You can find that over at rapidhealthreport.com. Friends, we'll see you guys next week.
