Irregular periods = Liver Disease: Is There a Genetic Link?

WOMEN. WARNING! Your #irregularperiods could be a sign of undiagnosed #LiverDisease. What is this? Why does it matter? Is there a #genetic link? What can you do about it?

Show Notes
0:34   Are women's irregular periods linked to liver disease?
1:59   If you're suffering with PCOS You want to hear this
3:35   If a diagnosis has the word Syndrome in it, it's a poorly defined diagnosis
6:11   What's the real definition of PCOS? and why you need to understand it
16:49 Is insulin resistance plaguing your health?
11:43 Why we really need to do 20 minutes of exercise daily

QUOTES
"I'm obsessed with root causes, and symptoms that manifest from these root cause imbalances.  And I'm obsessed with preventing conditions that are preventable"
                                                                                                                                                      ~ Dr Brian G Brown

Interesting in finding the root causes of your health issues? And finally resolving them? 
Get to know more in Dr Brian's FREE 5 day Gene Hack Boot Camp
https://drbriangbrown.com/genehack/bootcamp

Transcript

EP65 Irregular Periods = Liver Disease,  Genetic Link?

SUMMARY KEYWORDS

PCOS,  gene, insulin, insulin resistance, liver, liver disease, sugar, glycogen, criteria, low glycemic diet, fat, fatty liver, fasting blood sugar, 

Dr Brian G Brown  00:00

The mission is simple: to help high achievers naturally eliminate emotional and physical obstacles, so they can optimize their life for higher achievement. Welcome, you just entered the Genesis zone. This is Dr. Brian Brown. Thank you for taking time out of your busy day to join us. 

I got a topic today that is kind of near and dear to my heart. And it deals with women's health. Women, I want to talk to you about something that a lot of a lot of women don't think much about, but I want you to think about it a little bit differently. Could your irregular periods be a sign of undiagnosed liver disease? Results from a recent study show that it may be. 

Now what is liver disease anyway? Why does it matter? Is there a genetic link? And what can we do about it? We're gonna be talking about this in detail in this particular show segment. In the study that I'm reviewing today, researchers found a correlation between women who have irregular menses and liver disease more specifically, nonalcoholic fatty liver disease or NAFLD. You can actually look that up. It's an actual official diagnosis. And it just means it's a fatty liver disease that's not associated with alcoholism. 

Some of you may know this about me, but some of you might not. Before I shifted into gene biohacking, and epigenetic modification, my functional medicine practice consisted mainly of bioidentical hormone management for both men and women. Now, just under a third of the women that I saw had an undiagnosed condition that was causing them to have prediabetes or either full blown type two diabetes, or fatty liver, this nonalcoholic fatty liver disease, or irregular periods just to name a few of the symptoms that are related to this order. 

PCOS

This condition that I'm talking about is PCOS or polycystic ovary syndrome. Now hang in there with me because I'll explain how PCOS is actually linked to irregular menses and liver disease. And it's important that we talk about PCOS for many reasons. But before I explain the link between irregular menses and liver disease, here's what you need to know about PCOS in general.

PCOS, first of all, is horribly named, because less than half of women with this condition have ovarian cysts in the first place. So why in the heck, that scientists make the name of this disorder center around one symptom, there's actually a list of just over 30 symptoms. And if you look at all the symptoms, they occur plus or minus 7%, about 50%. Either way, you know, so, this misnaming has always been a huge frustration of mine. It's a bad name for a poorly defined disorder. But it's only poorly defined in the United States. 

Now, you need to know that when you hear any diagnosis that has the word syndrome attached to it, it means that it's poorly defined, it means that we don't understand it. Okay, so anytime you hear syndrome as a diagnosis, it means it's poorly defined. And in fact, the name PCOS, polycystic ovary syndrome was coined from the United States criteria. 

The cool thing is that the rest of the world literally uses a different criterion. Because what they started realizing was there's more to this syndrome than meets the eye. And the rest of the world actually admits that it's poorly named. There is actually a world committee that is in place to rename this disorder, but they can't agree on a name. Imagine that. But the criteria I'm talking about is the European criteria. The rest of the world literally uses it, Asia uses it, Latin America uses it, Canada uses it,  everywhere except the United States, and it is excellent for diagnosing PCOS. 

So, to better explain the difference between the two criteria. When we use the US criteria for diagnosing PCOS. We literally only capture about 5% or less of the female population of childbearing age. But when we use the European criteria, we're able to diagnose and capture nearly 30% of the female population of childbearing age. 

That's a huge difference! That's the difference in diagnosing 50 out of 1000 women versus 300 out of 1000 women. And that's a sixfold increase or six-fold difference in the number of diagnoses between the two criteria. That's huge. Now, on the surface, it may seem like I'm obsessed with diagnosis, I'm not. 

I'm obsessed with root causes, and symptoms that manifest from these root cause imbalances. And I'm obsessed with preventing conditions that are preventable. And when you understand the root causes of PCOS, in many cases, symptoms such as irregular menses and liver disease, even nonalcoholic fatty liver disease can be reversed. 

Endocrinopathy / Insulinopathy

Now, with that said, the European criteria more accurately does that. You see PCOS is an endocrinopathy, more specifically, it's an insulinapathy. Don't get hung up on those words. But these two words endocrinopathies, Insulinapathy are 1,000% the crux of today's topic. 

What do I mean when I'm talking about endocrinopathy and insulinapathy? It simply means that it's an endocrine disorder where the body's cells are too resistant to insulin. Now, you may have heard this referred to as insulin resistance. So PCOS is a disorder of insulin resistance, plain and simple. No questions asked, bar none, that is the definition of PCOS. 

Now, the US criteria doesn't capture that. It's really sad, the European criteria does. 

Insulin resistance

Now what is insulin resistance? It's where your body's cells become resistant to the effects of insulin. Wow, Shazam. Brian, that was a tough definition or explanation? No, no,no, let me let me go a little bit further. But first, we really need to understand the role of insulin inside the body.

The best analogy I've got is like a Bellman at a five-star hotel, the person standing there at the front door to the hotel and opens the door for you. Its main job, and I'm referring to insulin, its main job is to open the door to your cells, and escort sugar from your bloodstream to the inside parts of yourself for storage, so that when you need energy later on, you can pull the sugar out of storage and use it on demand. 

Now, when you are insulin resistant, it takes a lot more Bellman to open the door. The cell is simply resistant to opening, it's stuck. So, the Bellman have to use brute force. And the only way they can do this is with sheer numbers. So, more Bellman get called to the scene, and they have to come along and help the sales door open. And this process works both ways. It works for letting sugar into the cell. And it also works for letting sugar out of the cell. If sugar can't get out of the cell, your blood sugar crashes, and you become energy depleted. If sugar can't get into the cell, guess what you develop Type Two Diabetes, because your blood sugar goes way too high. And sugar is very damaging to your organs, your blood vessels. Every system in your body will respond negatively when your sugar is too high. 

So, we need to shuttle that sugar to the inside part of the cell. So, it works both ways. Eventually, in time, no matter how many Bellmen there are, if you continue to remain insulin resistance, the doors are just not going to open or close properly and left untreated for decades, a condition like type two diabetes will develop. But I know you're asking but Dr. Brian how does all this relate to irregular periods and liver disease? I'm getting there. 

In the early stages of insulin resistance. There's a hormone regulating chemical called sex hormone binding globulin or SHBG, don't get again, don't get hung up on that name. Just know it's a regulating chemical that helps put other hormones in check. And it becomes imbalanced When insulin is imbalanced, and it kind of works in a seesaw fashion. If one goes up, the other goes down. So, with higher levels of insulin circulating around sex hormone binding globulin becomes too low to regulate hormones like testosterone and estrogen. And these two hormones when they're running willy nilly doing their own thing. They are the ones that cause many of the symptoms of PCOS, including irregular periods. 

Now, with regard to fatty liver, this is pure and simple a direct effect of the Bellman issue that I explained earlier. Remember when I said it works both ways? Well, if sugar can't get out of the cell, for energy demand, but more sugar keeps being stored inside the cell, then we've set the stage for obesity in general, just in the body. And it usually is stored that type of obesity usually occurs around the middle and on the hips. I know there's nobody that's listening to this that can relate to that. Wink, wink.

Dr Brian G Brown  10:47

But did you know that your liver can become obese as well, the liver is responsible for storing excess sugar in the form of glycogen. And this is that immediate release, used in emergency only situations type of sugar energy. So, the liver stores its sugar in the form of glycogen. Now, back in the day, glycogen was critically important as a fight or flight survival mechanism. So, when the saber-toothed Tiger got after you, and you had to run very quickly, your liver released massive amounts of this glycogen for an immediate burst of high-octane energy. 

The problem is today, we don't have to run from saber toothed tigers. But that mechanism still exists. So, what we have to do is we have to exercise. Have you ever heard that you have to exercise for 20 minutes, at minimum in order to have any type of fat burning effect and the rest of your body? The reason is, is takes about 20 minutes for all the glycogen in your liver to be depleted before it starts pulling from the fat around your middle and off your hips. If you didn't know that I'm sure that's an epiphany for a lot of you. That's why you got to do at least 20 minutes or the workout, preferably 30 minutes’ worth of workout. So, you get at least 10 minutes’ worth of peripheral fat burn from off the body. The rest of its just coming from the liver. 

So back to the story. If the Bellman can't get the cells to open their doors, guess what I'm talking about in the liver. If they can't get those liver cells to open their doors and release that glycogen that's been stored in that liver. The glycogen just stays there. And eventually, the cells that store the glycogen become oversized, they swell. And this obstructs the normal function of the liver. See, the liver is full of tiny blood vessels, big blood vessels, bile duct components and things like that. And when those swells become when those cells become too swollen, they impede the function. They squeeze in on those vessels. And they can't do what they're supposed to do. 

So therefore, on bloodwork, on just routine blood work, you'll see liver enzyme numbers start to go up. And you'll start to see those changes. And then you do a liver ultrasound, and you'll see they've got nonalcoholic fatty liver disease. So that's the process that's going on. 

I want to put this into perspective from the frame of today's study that we're talking about that was done that that showed an association between irregular periods and nonalcoholic fatty liver disease. Now this study actually looked at 72,096 women, that's a huge study. The cool thing was, is that they were all under age 40. So, they're 18 to 40 years of age, perfect population for PCOS. Guess what? 28% of them had irregular periods. At the risk of coming across as just plain old ticked off, or at minimum sarcastic, isn't it ironic that the European criteria for PCOS identifies that about 30% of the female population has PCOS? Which is caused by insulin dysregulation? 

And isn't it ironic that 7% of these women in this study had nonalcoholic fatty liver disease which is caused by insulin dysregulation, insulin resistance, and it occurs about the same frequency in the European Studies among PCOS women? Isn’t that ironic in functional medicine, we've known this for at least two decades?

Why is mainstream medicine just now catching on? I mean, truthfully, fatty liver and diabetes can be identified years or even decades before they occur. Because we can identify the insulin resistance that early, there's absolutely no need for women to have to go through this, none at all. 

Now, I'm off my soapbox. This stuff fires me up. I'm passionate about it, because it is one of the most underserved, women are the most underserved population. First of all, I think it become comes from a paternalistic system, where men kind of control the system. I hate to say that, but it's true. 

And they just don't think in in the form of women. I mean, you look at the pharmaceutical for the benefit of women, a pharmaceutical industry, most drugs, even female drugs are tested on men. Why? I don't understand it. And this is so unnecessary. The rest of the world seems to get it. The United States, not so much.  But functional medicine people do get it. We've known it for at least 20 years. And we've been on top of this insulin resistant thing for 20 years. 

I don't think in terms of diagnosis, I don't think in terms of PCOS. Yeah, if you want to give it a label, sure, that's what it is. And sometimes if a patient can't afford to pay cash for lab work, and they have to use insurance, we've got to give it a diagnosis. And we call it PCOS. But at the end of the day, it's just insulin resistance. And we treat it as such, it is the root cause. 

Epigenetic Components

Now, I want to wrap up with this in my clinical experience. Since I've been doing gene hacking, I've had this unique perspective of doing a lot of years bioidentical hormone management, women's hormones, men's hormone, PCUs, management, that type of thing. Now that I've started, in the past several years doing gene hacking, or gene bio hacking, I've seen several genes that I that are associated with higher risk of fatty liver disease, PCOS, and type two diabetes, aka insulin resistance in my population. 

This is not a study; this is just my population. But here's what I found. When you look at methylation genes, and you've heard me harp on methylation before, when you look at methylation genes, and I check 14, methylation specific genes, because I'm looking at all five phases in the methylation pathway. When you look at those 14 genes, you can see that a lot of times people who carry this insulin resistance, they have very poor methylation, that's no coincidence, we're starting to understand that there are relationships between the two. 

GENE SNIPS:  FABP2

Now there's, there's another gene snip, called the FABP2 gene snip, and it is related to increased fat absorption. So, when a person has this particular gene snip, they actually uptake fat more quickly from their diet, which means they've got more fat circulating around in their blood, well, your body has to do something with that, and it will convert fat to sugar or usable energy at some point. So, you end up with glycogen issues, because your fat levels are too high. FABP2 more at risk for insulin resistance. 

PPARG

There's another one called PPARG. PPARG is the nickname of the gene snip, but it's PPARG and people with this particular gene snip, they have increased fat storage. So, you can imagine if you've got the one that I just talked about the FABP2 and now you got PPARG, you're absorbing more fat from your diet, and you're storing it more readily. And the PPARG also disrupts fat mobilization. So, in other words, once the fat is stored in the cell, it won't let go of it. So again, it kind of contributes to and is related to this insulin resistance issue. 

ADPIOQ

The next gene snip that I've noticed is the ADPIOQ gene snip. Now with this particular gene snip, there's increased metabolic instability with high glycemic foods. So, these people, if they eat the least little bit of sugar in their diet, and these are even foods that convert into sugar by the way, so like white potatoes converted into sugar, corn converts into sugar, grains of all kinds convert directly into sugar. They have increased metabolic instability with these foods that are have a higher glycemic impact in their body, so they actually need to eat a lower glycemic type of food profile. 

APOA2

And then there's another gene snip was called the APOA2. These folks have an increased incidence of obesity. Now we don't understand a lot about the APOA2 gene, we just know that people who struggle with obesity and weight management tend to have the APOA2 gene presentation, not all the time. But in many cases, we do see that.

APOA5

And then the APOA5 puts us at an increased risk for hyperlipidemia. What do I mean by hyperlipidemia? Hyperlipidemia is just either high cholesterol, high LDL cholesterol, high VLDL cholesterol, high triglycerides, high lipoproteins, APOA. So, hyperlipidemia. So, we have more lipid issues, we're putting more stress on the liver, and we're more prone to fatty liver types of conditions and insulin resistance. Hyperlipidemia / insulin resistance go hand in hand, and then directly related to insulin resistance, it's all by itself. 

ATG5 / ATG16L1

We have two autophagy genes, the ATG5 or autophagy5 gene and the ATG16L1 or autophagy16L1, directly influence insulin resistance. So, if you have those gene presentations, you will actually see people, they're just insulin resistant. And we've got to keep a really, really close eye on those people; checking lab work on a regular basis, because they can change from one quarter to the next when you're doing lab work. 

So, if I see somebody with that gene presentation, I really like to repeat their metabolic labs on a quarterly basis that first year, just to make sure everything's on the up and up. After that, every six months for the next couple of years. And then if they're stable at that point, every year after that.

Anyway, those autophagy genes are critically important. 

Recommendations

Now what can we do? What can you do, without knowing your genetic profile? Here's some recommendations I've got for you. You can try intermittent fasting that needs to be 12 to 15 hours. Now there are differences between men and women when it comes to intermittent fasting. Men can get away with intermittent fasting on a more regular basis, like on a daily basis, even 5,6,7 days a week.

Women, research has found and this is not the case. For every woman, I do have some women, female clients that fast every single day and they do great at it. But for the most part, as a general rule, my female clients that try to fast every day, that stagnates some, they don't do as well. But if they do like two or three fast per week, they do exceptionally well. So, you've got to find that happy medium for yourself, but it needs to be 12 to 15 hours. 

Intermittent Fasting

Now, if you're a fasting purist, you're not going to want to do anything. You're going to want to have creamer in your coffee in the morning, sugar in your coffee in the morning, artificial sweetener, those types of things. BUT you can do black tea, you can do hot tea, unsweetened, no cream. You can do hot coffee, no cream, no sweetener, or you can do either one of those cold or you can do water, but don't eat, don't have anything added to your drinks. Those particular two drinks, teas, coffees, and you'll be good to go.

Some people say okay, I can do a bulletproof coffee, if you're not familiar with what that is. It's just a common coffee that's loaded up with MCT oil  and things like that. That's fine. I mean, if you want to do that, I personally have found with my own personal journey and checking ketone levels. It knocks me out of fasting. When I have bulletproof coffee, some people it doesn't. I don't know why. 

But anyway, it's one of those things you have to test. So intermittent fasting, low glycemic diet. So even if you're doing intermittent fasting, you may want to try a low glycemic impact diet. You can look that up on Google and get more than you information then you want. Just look up low glycemic impact, that's critical. Because you don't want a low glycemic diet, it's totally different.

Low glycemic diet vs low glycemic impact

For example, a low glycemic diet would allow you to have grapes, but a low glycemic impact diet would not. So make sure it says low glycemic impact diet. It's really, really critical. And then you may want to consider bumping up your protein. But I'm not talking about fatty proteins with a lot of saturated fat. I'm talking a higher protein levels with lower saturated fat. So, you're going to need to allow unsaturated polyunsaturated fats and things like that. Monounsaturated fats are fine. So, if you're getting your fats from fish or like avocados and things like that, or olives, you're good to go. Those are unsaturated fats. I'm specifically talking about saturated fats that you find a lot and red meats and things like that. So, staying more in your chicken, fish line with your higher protein, lower saturated fat diet. 

So, we've got intermittent fasting, we've got low glycemic diet, and we've got a higher protein, but lower saturated fat diet. If you can do those things and start playing around with that, you're going to be able to figure out what works best for you. 

Exercise / Movement

And then I want you to start moving your body, you've got to move. I mean, it's just like the example that I gave about glycogen being stored in the liver. We're not chased by saber toothed Tigers anymore, we have to move in order to deplete those glycogen stores in our liver, so that we can start working on peripheral fat and start depleting that fat. And when we do that, insulin resistance actually goes down drastically, it's amazing how rapidly it occurs. 

Check Metabolic Markers

The next thing I want you to do is get some get metabolic markers checked routine, at least every six months in the beginning, possibly every three months if there's an issue. I've already explained what those are. 

You're going to want to check:

- Fasting blood sugar

- Fasting insulin

- Hemoglobin A1C doesn't have to be fasting

And you need to work with somebody who actually truly knows how to interpret these labs and calculate an insulin resistance score. 99% of health professionals worldwide do not know how to calculate an insulin resistance score. It's super, super easy, but it needs to be done. And you need to understand where you are in your insulin resistant journey.

As we age, as hormones decline, we become more insulin resistance anyway. So, we've got to be aware of this. But you need to have the fasting blood sugar, insulin, hemoglobin, anyone see checked on a regular basis. And I will tell you this 99.9% of health professionals worldwide, only check a fasting blood sugar. 

Guess what? It literally takes years for a fasting blood sugar to change when there's insulin resistance. Because the body is so amazing at compensating for issues. When insulin is high, guess what blood sugar stays in check. But it will do that for 10, 15,  20, 30 years before it starts losing the battle. And all of a sudden, insulin can't keep up, you become so insulin resistance that your blood sugar actually starts going up. And that's something that we have to really pay attention to. And that's why we need to look at the whole picture.

Genetic BioHacker

And lastly, I want you to consult with one of us, genetic biohacking people, to discuss your need for genetically targeted supplements. When we understand your genetics, we can understand exactly the plan that needs to be put in place. And I believe personally with what I do now, and how I do things by starting with genetics first, that is critical to do that. 

So that's all I've got for today. I have if you're one of those people that has kind of said, okay, Brian, I know I need to get this checked out. I'm curious about it. I need to know more. You know, you're struggling with maybe some PCOS type stuff, irregular periods, or you've been diagnosed with fatty liver, that nonalcoholic fatty liver disease. You know what epigenetics; I believe is the foundational starting point. 

Aside from the labs, I've created a five-day boot camp called the Gene Hack Boot Camp. And by the end of that five days, you will have a keen understanding of exactly where you need to focus in your wellness journey and your health recovery journey. You will learn about the exact genes you need to have tested in order to address any hang ups that you have. And you'll learn some of my favorite genetic modifying natural supplements.

Dr Brian G Brown  29:02

Also, you can begin to feel better and feel fully optimized. And ultimately, so you can live the way you want to live. Right now, we're running a promotional special on the boot camp. It's free. Normally it's $47. But it's free right now. I can't promise you how long it's going to be that way. But right now, you get this amazing deal. And you're able to attend for free. So, to enroll, go to 

https://drbraingbrown.com/genehack/bootcamp

And there you'll be able to register and take the first step in getting the answers that you deserve. Tune in next Thursday at noon eastern standard time for our next in the zone segment where I'm where I'll be sharing the latest research that I've done today and my insights about that research as it relates to optimizing your genes and optimizing your physical and emotional wellness journey. Most informed most trusted and I'm most grateful that you spent this time with us today. We're always grateful for that. Thank you. Stay in the zone. I'm Dr. Brian Brown.