Transcription of Patty Hagge for the show Patient-Centered Wellness #146
Dr. Lisa: Today, we have with us on the show an individual that I’ve known for a very long time. In fact, we did a writing workshop I believe in 2006 together, and then I interviewed him in one of our very early shows, I think show number two. This is Dr. Richard Maurer. I’m so proud and pleased to be interviewing him and talking about his book, ‘The Blood Code’ today because I feel like I’ve known him from early on in this whole thing.
Dr. Richard Maurer practices integrative medicine in Portland, Maine and helps people resolve metabolic conditions such as pre and type 2 diabetes, hypothyroidism, heart disease risk and weight gain. He strives to help people catch and reverse metabolic conditions as early as possible heralded by symptoms like restless leg syndrome, high triglycerides, migraines and fatigue. He is the author of ‘The Blood Code’.
Congratulations and thanks for coming in.
Dr. Richard: Thank you, Lisa. It’s a pleasure.
Dr. Lisa: The other individual we have with us is Patty Hagge. Patty is a client of Dr. Richard Maurer and is also the writer and residence of ‘The Telling Room’. She has master’s degrees in social work and creative writing, three children and two grandchildren. She lives on Munjoy Hill.
Thank you for coming in.
Patty: You’re welcome. Thanks.
Dr. Lisa: We actually have had your husband on our show not so long ago, Cyrus Hagge.
Patty: Yes you have. Yes.
Dr. Lisa: I’m excited about this book, and I’m excited for you, Richard because I know that you’ve been working on this for a while. I’m excited about this book also because as a primary care doctor, I spend a lot of time with patients that I know need to make alterations in their diets. This book gives us some hard evidence that tells us what direction these alterations need to take and that’s new and different. This isn’t something that people have been talking about.
Dr. Richard: Right. Right. After practicing 20 years, I had followed so many different diets over that time. If I go before that, I was a child born in the ‘60s. Growing up in the ‘70s, my mother at some point read Adelle Davis, and all of a sudden, we started eating brewer’s yeast smoothies with a raw egg and a banana for breakfast.
I’ve been affected by the natural health movement throughout my life. It was no surprise in naturopathic medical school in the late ‘80s, early ‘90s that I pursued what I thought was the right diet. I was a vegetarian and it seems like the right thing to do, I had seven grain cereal … If anyone needed to know that there’s more than five grains, there are seven grains. There’s even nine-grain cereal.
I was eating what … Boy, the American Heart Association would say was a fabulously healthy diet. My first year of medical school was one of the sickest years of my life. I got chickenpox again, I threw my muscles out all the time, I developed allergies, I had a skin infection that was bizarre … It was not a healthy time in my life. I was very thin so people would think, “You must be so healthy,” but something wasn’t right.
It took me many years to really figure it out. Part of this work is a little bit of my experience, but it’s also framed in 25 years of naturopathic natural health practice, a medical practice that emphasizes really getting to the root of the problem and finding a dietary or nutritional or the exercise approach to really resolving and removing the underlying cause of an illness. I think that’s what steered ‘The Blood Code’. I think that’s what has really helped me successfully watch people reverse type 2 diabetes and no longer have it.
It’s not like they’re treating it or managing it, it’s not there anymore as long as they’re eating and living in accordance with their blood test results and some of what I wrote about in the book. It’s a fun time for me to break the shackles of what is a healthy diet. This book is not about what a healthy diet is, and I don’t go around preaching to people what they should or shouldn’t eat. I will say that I’m not a vegetarian anymore. That was a terrible, terrible diet for me and would have probably caused more illness early in my life.
Knowing I’m eating truly right for me and I can back that up with hard evidence on blood test to panels on myself and I can do this as well on hundreds of patients over the past years is rewarding. I hope this book can bring it to people who can bring it to their doctors or bring it to people who can bring it to their families and re-empower themselves to figure out what that right diet is.
Dr. Lisa: We’re going to talk about that, because I know people are going to be very interested as to what your approach has been. I want to find out from Patty why you thought that you needed to do something different in your own health, in your own wellness situation.
Patty: In 2009, my son was a teenager, he was diagnosed with severe sleep apnea. The doctor turned to me and he said, “It’s totally genetic. Who has it, you or your husband?” My husband and I both said, “It’s me.” I had to have a sleep study and I have a sleep study. I didn’t have severe, I had actually mild sleep apnea.
The doctor said, “Yes. You lose 10 pounds. You’d be fine, 10, 15 pounds, you’d be fine. Don’t worry about it.” I tried to lose weight and I could not lose weight, and I couldn’t. I couldn’t figure it out. I had seen Dr. Maurer off and on for years. I said, “Okay. Help me figure this out.” He said, “Okay. This is what you need to do. You need to go get …”
This is 2009. He said, “Go get a glucometer and take your blood sugar several times a day before you eaten, after you’ve eaten, in between and keep a journal and come back and see me in a couple of months.” Nothing else had indicated that I had any insulin resistance at all, like my primary care physician hadn’t even mentioned it.
Anyway, we came back and he looked at the stuff. He said, “Yes. This is what’s going on. You have insulin resistance.” What he actually said to me was … He said, “This is what you have to do. You have to change your diet. You have to take out some of the carbs and replace some of the carbs with fats instead of carbs.” I said, “Okay. I have no idea how to do that,” but I eventually figured it out. Trial and error, and I kept on testing my glucose levels and kept on going back to him saying, “Okay. How does this look?” until we figured out what exactly how to tweak my diet.
Now, if you took my blood work, you looked at my blood work, I do not look pre-diabetic at all. I look like a pretty healthy person.
Dr. Lisa: Are you feeling better?
Patty: Yes. Yes. Yes, I feel great. I mean, I have to work at it. I can’t give up. I have to stay on my diet. I have to exercise every single day. I have to keep going. Yes. Yes, I feel much better.
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Dr. Lisa: There has been some association between animal proteins and increased inflammation, and maybe not in everyone. You’re looking at me as though you’re going to tell me that’s just not true. Was that not true?
Dr. Richard: As a rule, that is not true.
Dr. Lisa: Okay.
Dr. Richard: Even some of the early studies, what was happening is the association error of science. We pool a bunch of surveys from Greater Framingham, Massachusetts and that’s called the ‘Framingham Study’, an ongoing study and we’re in the second generation of Framingham participants. You pool all those people in the mid ‘80s, and you find that the highest quintile about the …
If you’re in the top 20% of meat eaters, you had a little more heart disease and you had perhaps more inflammatory conditions than the lowest 20% of meat eaters. It made sense for someone to jump up and say, “Ah-huh. It’s meat that’s causing this.” What that is is a hindsight association. That was when a lot of these errors began, some of these survey studies, when you control for vegetable intake.
Say the highest 20% are typically the people that ate no vegetables. This was a McMuffin for breakfast, this was a roast beef and fries for lunch, and it was a pepperoni pizza for dinner. Say we change them, we say, “All right. Let’s take people that ate no less than four servings of vegetables a day, now take the highest 20% of meat eaters and the lowest 20%.” All those associations disappear.
Vegetables do seem to be a great equalizer. If you’re trying to wrap your fats and proteins in bread and fried oil, there’s going to be a problem. That’s the inflammatory diet. We want to point our fingers to the one thing in that meal, and a number of people have wanted to claim that it’s the meat or it’s the animal-based protein. Again, the evidence doesn’t support it. When you control for the other variables, it’s not an issue.
That’s certainly coming to light now as we saw ‘The New York Times’, Mark Bittman’s work and a number of investigative journalists that don’t quite have the same bias. They haven’t published something that they’re trying to protect, so we have a much more open expose of what the research really shows. To demonize meat and to demonize saturated fat, the emperor wears no clothes. It turns out these foods are not harmful to our body, perhaps how they were eaten in those survey studies was harmful.
Processed meat and fried oils, these are a problem for our health, and a whole foods diet also means that the skin is still on the chicken. We can bring those saturated fats and those animal-based proteins served with plenty of vegetables. I think I eat far more … I know I eat far more vegetables than I ever did as a vegetarian.
Dr. Lisa: Let’s talk about ‘The Blood Code’, because what I found most interesting as I was reading this book was that your lab tests are … they’re not new and different. They’re pretty straight forward. You just have a slightly more extensive panel than I think what most primary care doctors are offering right now in their offices. You talk about getting a cholesterol panel, you talk about getting a Vitamin D level which a lot of doctors are starting to do now, but you actually talk about also looking more into the thyroid, so not just doing a straight forward TSH which is a standard test, but also doing more test than that, and you talk about doing a ferritin level. You just go a little bit deeper but nothing wacky.
Dr. Richard: Thank you for that. It’s very true. I mean, I think there have been books that have tried to claim some proprietary test or tried to make one test. An esoteric test have more meaning than it should ever have. These are very straight forward tests, to look at a hemoglobin A1c. This is a very common test used to manage people with diabetes. I’m just asking people to do it before they have diabetes.
Running a serum insulin test is probably one of the tests I’m most passionate about. A baseline fasting serum insulin, this test provides a wealth of information and that with the glucose can really help me map whether someone is or isn’t insulin resistant and how severe it is or isn’t. Just that serum insulin on a fasting test is tremendously useful.
I shiver when I see people put on medications that raise their insulin level before anyone ever measured where their underlying baseline insulin was. I think it’s a very simple metric and provides a wealth of information. As far as cost, our local lab here, this test only costs about $28, so I’m never far from a lot of information. The information is accessible and affordable.
There’s a movement right now where it’s relatively recent. The federal government has made a statement that people have the right to receive their blood test results directly from the lab that orders them. This is part of a federal mandate to the labs, and the labs are thrilled with this. This way, the results go to the doctor and to the patient, as long as the patient requests it.
A number of other states will allow people to go and pay cash for test panels. This drives the cost to be even more affordable. I think the movement will be for people to be able to go to a local pharmacy or any local draw station, and for a relatively affordable cash price be able to get a panel of blood tests, and then see if that can steer them whether they can pivot off of those results to better navigate their diet and fitness habits.
To me, it’s very self-empowering. It’s an incredibly optimistic message that people can learn this and really better understand themselves and act on it. I think our doctors, as doctors, we need to facilitate that partnership and really put the power back in the person who needs to make these diet and fitness changes.
Dr. Lisa: Is that true, Patty? How did this all … Working with Dr. Maurer and knowing your labs, how did this make you feel compared to maybe your past experience with … I don’t want to say primary care doctors, I don’t want to blame anybody, but how did your relationship with Richard, Dr. Maurer … how did that change when you had your own information in front of you and he was explaining it and you really understood it more thoroughly?
Patty: I sought out Dr. Maurer in the beginning because I am that kind of person anyway that wanted to take more control of my life and didn’t want to have somebody else figuring things out for me. He always believed in test and talking about the tests and seeing how your blood work was going, and I feel like this really isn’t that new of a thing that you’ve been doing.
No. Numbers don’t really stay in my head, but it felt very real. This piece of paper explains what’s going on. “Look, and let’s compare it to last year.” I mean, I’ve seen him so long, he has a lot of these papers. I mean, we can see over time if something is shifting and I can say, “Okay.”
For instance, recently, my blood work looked good. One little thing was getting a little high and also, we haven’t talked about the calipers but the skin caliper thing, I had … In last … I don’t know, maybe a year, I started gaining weight again, and the little skin caliper said that I was collecting fat a little bit more. He said, “Okay. You have to start working out more,” and he started this fitness thing. It’s all like … It’s just very clear like, “This is what’s going on,” and if you do X, Y and Z, you can keep your blood work good and healthy and strong.
It’s very clear. It feels very clear, and then I feel like I can experiment within that. Like, “Okay. What is it that I really need?” I need to eat a little bit of protein, but mostly vegetables like he said, like, “I get it. I need to exercise every single day and every other day has to be with weights.” It does make me … I’m totally in control and I get to make decisions and I know what I need, so it does. It feels good and I feel like he’s supporting me, and when something happens like I feel like, “Wait. Why am I randomly gaining weight?”, we can look at the blood work and we can tweak it and figure it out.
It’s great. I like that way of working. It makes sense to me.
Dr. Lisa: The skin caliper measurement is an important part of what you’re suggesting, Richard because the skin caliper, anybody who’s listening doesn’t know, you take a fold of skin and you put it in between sort of a pinching instrument, and it doesn’t’ really hurt, and you just find out how big this fold the skin is. It’s very basic, very straight forward, not expensive … Sometimes, it can be a little humbling, but it’s not a hard test, but it does give you a good baseline.
It does tell you, “My upper body is in need of some conditioning”, and it helps with this.
Dr. Richard: Right. It’s another simple, inexpensive metric to steer people towards diet or fitness changes. For less than $20, you can get an extremely accurate caliper. With a little practice, you can do it on a buddy, you can do at some points on yourself. You won’t be able to do all four because one of them is on your back.
I’ve used calipers for 20 years in my practice. The simple little rules that I state in the book, in ‘The Blood Code’, if the triceps are measuring higher than right above the hip bone, then there probably needs to be more exercise. This is a deconditioned state. Some people with hypothyroid will start to move in this direction because on a day off of exercise, people with hypothyroid will go even more metabolically asleep. They’ll slow down even more.
If people have a higher measurement at the hip, it means they really need to do a more ambitious attempt at reducing their carbohydrate intake. Really, to steer people towards dietary changes or exercises changes, the caliper is a simple measurement to help me do that. If someone is even, it may be a little 50/50, where diet and exercise really are both emphasized the same.
Dr. Lisa: I’m very excited about the book. I’m very excited about the opportunities that this presents for people and the possibility of partnership with their doctor if that’s the way they choose to utilize it or even if they just choose to read it on their own. It sounds like Patty, you’ve had a great experience in terms of partnership and understanding your own body better.
Patty: Yes.
Dr. Lisa: How do people find out about your book, ‘The Blood Code’, Dr. Maurer?
Dr. Richard: People can go to ‘Thebloodcode.com’. That’s a website and a real resource for people to sign up for an ongoing newsletter, to utilize some of the posts that the other people in ‘The Blood Code’ community are bringing to light, things that they’ve tried in their life that have been successful or not, and building that conversation and that community really helps again I think reinforce the empowering message that type 2 diabetes is not something we treat, it’s something we can make no longer exist if we live in accordance with it. It’s changed my perspective and I think the ongoing conversation at the website and in the book will really help people see their bodies in a more optimistic light.
Dr. Lisa: I appreciate you both coming in and speaking with us today. I encourage people to go to your website and read the book, ‘The Blood Code’. We have been speaking with Patty Hagge, a client of Dr. Richard Maurer who is also the writer and residence of ‘The Telling Room’, and with Dr. Richard Maurer who’s the author of ‘The Blood Code’. Thanks so much for coming in.
Patty: Thanks for having us.
Dr. Richard: Thank you, Lisa. It’s a pleasure.
Dr. Lisa: You have been listening to the ‘Dr. Lisa Radio Hour and Podcast’ show number 146, ‘Patient-Centered Wellness’. Our guests have included Dr. Ralph Thieme, Dr. Richard Maurer and Patty Hagge.
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