This week we are talking about leptin. What the heck is leptin? It’s a hormone that has a lot to do with our appetite. I’m really excited about this interview because we don’t talk about leptin enough. It usually keeps our appetite suppressed and under control. Whereas grehlin is the opposite hormone. It’s our hunger hormone. They kind of work against each other to keep us feeling full or feeling hungry. So many of our other hormones impact these hormones.
My expert guest today is going to talk about leptin and leptin resistance. She’s going to talk about why it’s such an important issue to figure out and how it can impact your health.
On this podcast, we are going to talk about…
How leptin and Grehlin work in your body.
What happens when they get out of whack.
What is Leptin resistance?
How to find out if you have Leptin resistance.
How to heal Leptin resistance.
How Leptin resistance can impact fertility.
About Dr. Bindiya Gundhi
Doctor Bindiya Gandhi is a double board-certified integrative and functional medicine doctor. She helps thousands transform their overall health. She is the medical director at ReviveAtlanta M.D. Atlanta Functional and Integrative Medicine. It’s a comprehensive clinic focused on total body healing.
After dealing with her own medical crisis and eventually improving her overall health to rebalance her hormones Dr. Bindiya was able to conceive a baby naturally. She’s been focused on finding the cause of the issues instead of treating the symptoms and she holds a special passion for helping patients with female hormonal issues. She’s worked with professional singers, athletes, and helped them to reclaim their health. Her podcast Reset, Renew, Revive has gained tons of traction since its launch in April of 2020 and she regularly engages with her community of over 24,000 followers via Instagram where she produces compelling content and educational material to continue to inspire people to live healthier lifestyles.
Welcome, Dr. Bindiya to the Gutsy Gynecologist Podcast!
Dr. Bindiya:Thank you so much for having me, Dr. Tabatha.
Dr. Tabatha: I’m so excited for this conversation because nobody talks about leptin. So how the heck did you get into this area?
How Did You Get Into Functional Medicine?
Dr. Bindiya: Let’s talk about what leptin is because leptin is a hormone that nobody talks about and it’s so important. My journey started really back in um in medical school when I realized in my pharmacology class that I did not want to keep prescribing medications only to prescribe more medication. I remember sitting in my pharmacology class and we were talking about blood pressure medications. The professor said if you prescribe a prescription blood pressure the patient would eventually have a side effect of leg swelling at some point! It was inevitable. I was like, whoa, so someone’s going to come in for blood pressure and I’m fixing one problem, and then I’ve got to fix their leg swelling the next visit.
I said that doesn’t make sense. I knew very early on that there was more to medicine than just pharmaceuticals. That’s also when I was dabbling with my own stress management. I became yoga and Reiki certified during medical school. I remember my colleagues saying, what are you doing that for? Is insurance going to pay for that? I knew that I wanted to heal patients in other ways. There had to be other ways than what I was taught in medical school.
Fast forward to residency when life gets intense and hectic. I thought I was eating well, I was meditating and exercising like I should, but chronic stress really wreaked havoc on my hormones and my gut. When you’re in residency, you’re not sleeping well, you’re in a constant state of adrenaline rush 24/7. I was having a lot of G. I. Issues, I developed a rash on my face, I had acne and irregular menstrual cycles, headaches, you name it. I later found out that I had celiac and that was a huge contributor to what had been happening.
This whole time I thought I was healthy, I was working out, I was eating well and I was meditating, I was doing all the things that I had learned to do during medical school, but those things weren’t working for me anymore. That’s when I discovered functional medicine. I worked with a functional medicine practitioner to get to the underlying cause of my problems. Then I started helping other women and other patients achieve their health goals.
Leptin was Something I Didn’t Learn About in Medical School
Leptin is something that I only learned about in the last 10 years because I never heard about it in medical school, I wasn’t even taught about Leptin in some of the advanced training programs that I did. It’s such a newer hormone. Nobody talks about it.
What is Leptin?
Leptin is actually produced by your fat cells. It actually communicates with your hypothalamus. This is the part of the brain that regulates your metabolism. Leptin’s job is to tell your brain whether you have enough fat stored up to fuel your body and burn calories at a normal rate. In other words, it lets you know if you’re properly full if you need to eat some more.
Sometimes this communication is off and this literally impacts your waistline. When this communication is off, it prevents your brain from getting the message that you’re full. This can cause you to overeat, eat in between meals, etc. When leptin circulates at a higher level, it actually impacts not just your weight, but it starts impacting your appetite, food cravings, sleep, anxiety, and fertility.
Dr. Tabatha: You hit on a key point that it’s produced in fat cells and the point of leptin is to prevent you from getting fat, essentially right? It’s an appetite suppressant and it helps to control your appetite.
Could you Explain What’s Going on With Leptin?
Dr. Bindiya: Yeah, a lot of times people are not aware that our brain is supposed to get a message when we’ve eaten enough food. This is why portion control can work for some people and not work for other people. If your brain is not getting the message that you are full, you tend to overeat because your fat cells keep sending more leptin to increase hunger. Then your brain thinks, yep we need more food.
It’s really important to fix the miscommunication because when this happens, you start seeing things like inflammation, insulin resistance, etc. Not only do you become overweight, but you increase your risk of cardiovascular diseases, high blood pressure, stroke, and other medical problems as well. It’s not just about overeating and your fat cells not getting the message. It’s really about understanding and resetting your metabolism in the appropriate way so your leptin levels can circulate at a normal level and not be circulating at a higher level.
Dr. Tabatha: I kind of think of it the same way that insulin works. Your blood sugar goes up, your pancreas produces more insulin. The insulin takes the blood sugar, brings it into the cells, and stores it. If the brain doesn’t get the signal to stop producing insulin, it thinks we make more insulin. This causes us to get elevated insulin levels and insulin resistance. Is that what’s happening with leptin?
Dr. Bindiya: Exactly! Some of the same things. Unfortunately, as females, we have other hormones as well. So we tend to have higher circulating leptin in general compared to men. This can be a challenge because not only are we dealing with leptin, but we’re dealing with our adrenal hormones, thyroid hormones, sex binding hormones, etc. All these hormones actually communicate with each other so it’s really important for us to be aware of what’s really going on with our metabolism and our body.
When the leptin communication is not happening, the circulating leptin levels will start getting higher and higher, because we eat more, so we feel like we need to eat more… this causes the leptin levels to keep going up and that’s what causes leptin resistance. I have some patients in my clinic who will come see me with circulating levels in their 70’s (normal is a 7.) That’s a big difference. In some patients, you might suspect that their leptin levels are higher because they are overweight. Sometimes I’ll get somebody with an average BMI, but their leptin levels will be higher too.
Watch the full video interview here.
Does that help your patients feel vindicated?
Does that help your patients feel vindicated because now they know why they can’t lose weight and have cravings?
Dr. Bindiya: Yes, for sure, because a lot of times, people have cravings and they have no earthly idea why they are hungry all the time. Most of the time, it’s the sweeter, higher-carb comfort foods. They think their body needs it. It’s important to listen to your body, but sometimes we’re feeding it with the wrong types of foods. Sometimes the signals and messages you’re hearing shouldn’t be listened to because they are fueled by hormone imbalances.
Dr. Tabatha: Exactly! Then, it’s more of a warning sign. Once you find out you have elevated leptin then what do you do?
What do you do once you find out you have elevated leptin levels?
Dr. Bindiya: One of the first things that I have people do is take my leptin quiz. Then we check their blood levels to see what the actual level is. We often track levels periodically to see if what we are doing is working. Ideally, we want to make sure that your leptin is at seven that’s where the magic number is.
Is There a Correlation Between Insulin Resistance and Leptin Resistance?
Dr. Tabatha: Do you often see insulin shift along with leptin?
Dr. Bindiya: That’s a great question. You can see patients with leptin resistance who have an A1C that’s normal. However, you can see A1C levels improve if someone loses weight and gets their leptin level back to normal. So, there is no direct correlation between the two, but they can impact each other. Does that make sense?
Dr. Tabatha: Yeah, it’s so complex. You know it’s never straightforward with hormones.
Is Leptin Impacted by Our Hormones and Hormone Changes?
Dr. Tabatha: Are our leptin levels impacted by our other hormones?
Dr. Bindiya: Yes. Great question. Your hormones are not static, they are changing throughout the day. As a female, we have a 28-day cycle that we have to pay attention to as well. Leptin will be a little bit higher especially at the tail end of your cycle. That’s because this is when progesterone starts rising. You’re craving some foods that your body needs at this point in the cycle. Typically you need more healthy carbs at this point (I want to emphasize healthy carbs and not cookies or ice cream.) Two things happen at the tail end of your cycle. Either you’re going to conceive and your body has to get ready for fertilization and growing an embryo or it’s going to shed the lining and you will have a cycle. It’s really important to be aware that leptin levels go up at this time.
Dr. Tabatha: Do you try to check it on a certain day of a woman’s cycle then?
Dr. Bindiya: I usually interpret the blood work based on the date of their last cycle.
Does Intermittent Fasting Effect Hormone Levels?
Dr. Tabatha: Does intermittent fasting (time-restricted eating) play a role in leptin levels?
Dr. Bindiya: Yes. Intermittent fasting can be a game-changer for many women. Keto diets and different protocols can be a game-changer for certain women. Guess what happens after a while? Your body starts thinking you’re in starvation mode. Sometimes women will do keto for two months, or intermittent fasting and they’re like, “oh my God, doc I lost all this weight, I feel so great and then I can’t lose a single pound. I’m not doing anything different. Why can’t I lose any weight”?
Your body starts thinking you’re in starvation and it starts holding onto fat cells. It slows down your metabolism to save energy. This also happens for people that have done many yo-yo diets. They start having an inability to lose weight because their metabolism has slowed down.
Dr. Tabatha: Oh my gosh, I couldn’t agree more. I have a seven-week program where I teach feast, famine cycling because you need to remind your body that it’s not starving. You have times of fasting so your body can heal and conserve the production of insulin and really get control of your blood sugar, but you want it to not turn down that metabolism as a result.
How Does the Thyroid Play Into This as Well?
Dr. Bindiya: The thyroid really has a big role when it comes to leptin resistance for a couple of reasons. If you have an autoimmune condition like Hashimoto’s, which is an autoimmune thyroid condition, inflammation can cause your leptin to be a little bit off. More importantly, what we see is people have chronic stress. They tend to have something called low T3 syndrome. This is where it gets a little bit complicated. If your body thinks you’re starving, your body is going to hold on to everything. When your body thinks you’re starving, one of the first things that happens is your T4 will not convert to T3. Then your T3 will be a little bit low reverse T3. T3 will start becoming a little bit higher and that’s what becomes a little problematic. You start getting into Low T. Three Syndrome. This is very common in a lot of my patients that have underlying leptin issues. We have to fix that low T3 syndrome and the underlying thyroid issue. We really have to look at the whole thyroid picture. It’s not just looking at your TSH. It’s looking at the other numbers and how they’re working together to figure out how to balance your metabolism.
Dr. Tabatha: Yeah. I would say that most women don’t realize they have this issue because their T3 and reverse T3 are not even being measured by their conventional doc.
Dr. Bindiya: No. Unfortunately, other doctors and even endocrinologists are not checking reverse T3 and T3 and total T3. It really is important to assess this hormone. If you’ve done intermittent fasting for a while or you’ve done a lot of yo-yo dieting, ex. you’ve done weight watchers, you’ve done low carb, you‘ve done all these diets, one of the first things that I will tell you to do is stop starving yourself. We’ve got to improve the thyroid resistance because improving that will improve leptin resistance.
Women’s Bodies Don’t Respond to Things the Same Way Men’s Bodies Do
Dr. Tabatha: That’s such an important point. You really need to start loving on your body and reassuring it that it’s not starving to death. We are made completely different than men. They can get away with intermittent fasting and keto. They don’t have the extra hormones that we do that play a part in our full metabolism. We have to be mindful of our cycle and what’s going on with our body 28 days at a time and other components that are impacting us.
Dr. Bindiya: Without a doubt. We wanna be powerhouses, doing all these badass things, running businesses, running marathons, and doing all these things, but our physiology wants to get pregnant and carry a baby. That’s what our bodies go through every month and you can either fight against it or you can work with it. You’ll be so much better off if you just work with it.
We need to get in tune with our body, listen to its cues, not resist and try to do what everyone else is doing.
Dr. Tabatha: Yeah, I couldn’t agree more. I find that if you really want things to happen, you need to not be so resistant and fight against it. Just listen and work with it.
So, women should potentially get their Leptin levels checked. They really need to remind their bodies that they’re not starving and most likely this is affecting their thyroid and downregulating their metabolism. Really adding to this weight loss resistance issue. Is that the full picture or am I missing something?
Dr. Bindiya: No. Here’s the other thing that ends up happening. We’ve been talking about people who have leptin levels circulating at a higher level, but there’s also a population of people who have leptin levels at a really low level, which can just be as problematic. This is especially true for women who are trying to get pregnant because it impacts fertility. It impacts anxiety as well. Low leptin can be problematic just as much as high leptin.
Again, like everything we do, it has to be about moderation. It’s finding the balance that works for you. We want our metabolism to rev up just enough to do what it needs to do on a daily basis for us.
Let’s Talk About Fertility
Dr. Tabatha: I love that. You mentioned fertility. Is this something that we should be looking into when it comes to fertility?
Dr. Bindiya: You know I think it’s not a bad idea. There’s still probably needs to be a lot more research that needs to be done as far as like studies and that kind of thing. What we have noticed is two things. If your leptin levels tend to be low, it makes it harder to get pregnant because that’s probably also impacting your T3 and your thyroid conversion. The other thing is if your leptin levels are circulating at a higher level, there is data saying that you’re probably more likely to end up with gestational diabetes during this period too. So it’s really important to get leptin levels checked as a part of a fertility workup.
Dr. Tabatha: Oh my gosh, without a doubt. I see that being on the horizon. That sounds like some awesome work because we really need to understand that fertility is way more than just our ovaries and her vagina right? It really is our endocrine system and everything working together.
Can You Share a Success Story?
So do you have one patient success story that you can share with us about leptin?
Dr. Bindiya: Yes! I have helped so many people over the last few years improve their leptin resistance and get to the point where they can lose weight and keep it off. One particular story I love to share is actually of a male patient. They can have leptin resistance just as well. A male patient who was about 30-35 years old came to me. His leptin levels were 50 and he was having a lot of other issues as well. He was having mood and gut issues too. Over the six months that I worked with him, we were able to take him from a 54 to a 10. He’s put in the work with diet and exercise too, but he’s lost 40 pounds and kept it off.
Is There One Food Plan That Works for Everyone or Do You Need to Tailor Them?
Dr. Tabatha: That’s awesome! I think that’s the most important part is keeping it off. Are you tailoring their food plan and what they’re eating to them for any specific reason? Or does everybody seem to do well on one food plan?
Dr. Bindiya: I am doing personalized protocols for a lot of my patients starting with diet supplements. Sometimes people need a prescription, sometimes they don’t. It’s definitely a personalized approach to getting them the results that they want. That’s when I see people have an amazing transformation because our hormones are different, our gut health is different, our inflammation is different. So everything that I do is very individualized and when we do that, that’s when people feel amazing.
Dr. Tabatha: That’s amazing! So where can my listeners follow you and get the leptin quiz?
How hunger hormones flow and interact in the body.
Where Can My Listeners Follow You and Get That Quiz?
Dr. Tabatha: Awesome! I think everybody needs to take this quiz. That is really good information to have. You also work with people one on one with functional medicine, you know in Atlanta right?
You See Patients One on One Right?
Dr. Bindiya: I do, yes. We have a clinic in Atlanta, it’s called Revive Atlanta M. D. We do in-person appointments as well as virtual appointments. It’s been amazing because we’ve had so many people transform their body, their lives, their health, but even more than that they improve their self-esteem and their self-confidence. It’s not just about the scale. We all love to have the scale in our favor, but it’s about other things that happen when you have the energy, your confidence back and you have the ability to live your best life.
Dr. Tabatha: Thank you so much for speaking to me today. This was awesome!
Dr. Bindiya: Thank you so much for having me today.
To Wrap it Up
Alright, ladies, I hope you found that interesting. I know that I did. I love that we’re really starting to put the pieces of the puzzle together when it comes to women’s health, how our body functions, and how all the intricate systems work together to help us feel amazing. I hope you got one golden nugget out of it. I know I did. She mentioned that when you do intermittent fasting, you also need to make sure you eat enough when you do eat. I teach the feast famine cycle and so even though you have times where you’re restricting and you’re not eating, you’re doing these fasting periods or time-restricted eating. When you do eat, you want to make sure to remind your body that you’re getting enough nourishing healthy foods, enough healthy fats, enough clean lean proteins, enough fiber, and that you really aren’t restricting when you are eating. That’s the key for women when it comes to fasting and hormonal health. That was my key takeaway. And I hope you got something to add to what you’re already doing because we’re moving forward one step at a time every day. It’s a journey that we’re on together and I am feeling so blessed and honored that you allow me to be on this journey with you.