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Leptin and Leptin Resistance: Everything You Need to Know

Obesity is usually not caused by greed, laziness or a lack of willpower.

Leptin resistance may be one of the main reasons people gain weight and have such a hard time losing it.

If you’re concerned you may be resistant to leptin, there are several steps you can take to live a healthier lifestyle — and possibly improve or reverse your resistance.

Many people are told that "eat less - exercise more" is the answer to losing weight. 

Scientists discovered already over 25 years ago that a hormone called leptin is involved in obesity - and even breast cancer.  

When our body does not respond to Leptin - called leptin resistance - we have a leading driver of fat gain in humans

What is Leptin?

Leptin is a hormone that is produced by your body's fat cells. It is often referred to as the "satiety hormone" or the "starvation hormone." It works directly on the brain — particularly an area called the hypothalamus. The more body fat we carry, the more leptin we produce

Its main role is regulation of energy, like the number of calories we eat and expend, as well as how much fat we store in your body. Leptins job is to tell your brain that — when you have enough fat stored — we don't need to eat and can burn calories at a normal rate when our fat storage is full.

Apart from this Leptin also has many other functions related to fertility, immunity and brain function.

Leptin is a hormone produced by the fat cells in our body. Its main role is to regulate fat storage and how many calories we eat and burn.

Impact on Our Brain

High levels of leptin tell our brain that we have plenty of fat stored, while low levels tell our brain that fat stores are low and that we need to eat  When we eat, our body fat goes up and leptin levels go up, so we eat less and burn more.

Conversely, when we don’t eat, our body fat goes down, our leptin levels drop, telling us toeat more and burn less.

What Is Leptin Resistance?

People who are obese have a lot of body fat in their fat cells - and very high levels of leptin. Logically, obese people should now naturally limit their food intake as leptin tells them via their brain to do so. 

However, their leptin signaling may not work - the brain doesn't seem to see it and erroneously thinks that our body is starving — even though it has more than enough energy stored. This is known as leptin resistance and now believed to be one of the main biological contributors to obesity. 

If you have leptin resistance your Resting Metabolic Rate [RMR] is likely to be below normal, making you burn 500 to 600 calories less each day than someone of equal body mass.

Our brain then encourages us to:

  • Eating more: We must eat in order to prevent starvation.
  • Reduced energy expenditure: In an effort to conserve energy, our brain decreases our energy levels and makes us burn fewer calories at rest.
Thus, eating more and exercising less is not the underlying cause of weight gain but rather a possible consequence of leptin resistance, a hormonal defect. Willing ourselves to overcome the leptin-driven starvation signal is next to impossible. 

Impact on Dieting

Leptin resistance may be one reason that many diets fail to promote long-term weight loss. 

If you’re leptin-resistant, losing weight still reduces fat mass, which leads to a significant reduction in leptin levels — but your brain doesn't necessarily reverse its leptin resistance.

When leptin goes down, this leads to hunger, increased appetite, reduced motivation to exercise and a decreased number of calories burned at rest Our brain then thinks that we are starving and initiates various powerful mechanisms to regain that lost body fat.

This could be a main reason why so many people yo-yo diet — losing a significant amount of weight only to gain it back shortly thereafter.

What Causes Leptin Resistance?

Several potential mechanisms behind leptin resistance have been identified. These include 

  • Inflammation: Inflammatory signaling in our hypothalamus 
  • Free fatty acids: Having elevated free fatty acids in our bloodstream 
  • Having high leptin: Having elevated levels of leptin in the first place seems to cause leptin resistance.

Most of these factors are amplified by obesity, meaning that we might be "trapped" in a vicious cycle of gaining weight and becoming increasingly leptin resistant over time.

Can Leptin Resistance Be Reversed?

The best way to know if you are leptin resistant is to look in the mirror.

If you have a lot of body fat, especially in the belly area, then you are almost certainly leptin resistant.

There are several things you can do:

  • Avoid processed food: Highly processed foods may compromise the integrity of your gut and drive inflammation
  • Eat soluble fiber: They can help improve your gut health as food for the microbiome. 
  • Exercise: Physical activity may help reverse leptin resistance
  • Sleep: Poor sleep is implicated in problems with leptin 
  • Lower your triglycerides: The best way to lower triglycerides is to reduce your carb intake 
  • Eat protein: Eating plenty of protein can cause automatic weight loss, which may result from an improvement in leptin sensitivity

Though there is no simple way to eliminate leptin resistance, you can make long-term lifestyle changes that may improve your quality of life.

Test your Leptin Levels

If you want to know how high your leptin levels are - and to monitor the effect of changes you are making to your lifestyle, you can test them.

Blood - venous - NOT a finger prick test!

7 days turnaround time

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Food Matters 2018

CountryHealth spent two busy days at this years food matters LIVE in the London ExCel We made several excellent contacts.

Many of our clients have food intolerances, especially to gluten. We were on the look-out for clever solutions and found two companies who can offer our clients an excellent alternative to bread, pasta and even waffles.

BEST gluten free bread in the world ...

We met the team from Davina Steel who has been winning prices for the BEST gluten free bread in the world for several years running - even in the gluten bread category. 

Not only are the breads the best we tasted, we can even offer a 10% discount to our clients. 

You can also make yummy and easy pizza ...

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Why you struggle to lose weight on a diet

Successful weight loss is doomed to failure unless the reduced intracellular thyroid levels are addressed. Chronic and yo-yo dieting, frequently done by a large percentage of the population, is shown to be associated with reduced cellular T4 uptake of 25%-50% (2-7). Following repeated cycles of dieting, weight loss occurred at half the rate and weight gain occurred at three times the rate compared to controls with the same calorie intake (1). The reduced cellular thyroid level is generally not detected by standard laboratory testing unless a free T3/reverse T3 ratio is done.

Finally a study explained why it is very difficult for obese patients to lose weight; as calories are decreased, thyroid utilisation is reduced and metabolism drops. Additionally, there are increased levels of free fatty acids in the serum with chronic dieting, which further suppresses T4 uptake into the cells and further cellular hypothyroidism (8-12).

In a study published in the American Journal of Physiology-Endocrinology and Metabolism, Van der Heyden et al studied the effect of calorie restriction (dieting) on the transport of T4 and T3 into the cell (13). It was found that dieting obese individuals had a 50% reduction of T4 into the cell and a 25% reduction of T3 into the cell due to the reduced cellular energy stores, demonstrating that in such patients standard thyroid blood tests are not accurate indicators of intracellular thyroid levels.

Many overweight individuals fail to lose weight with dieting. While it is always assumed they are doing a poor job of dieting, it has been shown, however, that chronic dieting in overweight individuals results in increased levels of NEFA, which suppresses T4 uptake into the cells (14). This suppressed T4 uptake results in reduced intracellular T4 levels and subsequent T4 to T3 conversion and a reduced metabolism (14-18).

How you can find out, whether you are affected?

Standard TSH, T4 and T3 testing will not detect this problem. Instead, a free T3/reverse T3 blood test can aid in the diagnosis of reduced uptake of thyroid hormones and intracellular hypothyroidism. It is proving to be the best physiologic marker of intracellular thyroid levels and supplementation with T3 should be considered.


  1. Brownell KD, Greenwood MR, Stellar E, Shrager EE. The effects of repeated cycles of weight loss and regain in rats. Physiol Behav 1986;38(4):459-64.
  2. Lim C-F, Docter R, Krenning EP, et al. Transport of thyroxine into cultured hepatocytes: effects of mild nonthyroidal illness and calorie restriction in obese subjects. Clin Endocrinol (Oxf) 1994;40:79-85.
  3. van der Heyden JT, Docter R, van Toor H, et al. Effects of caloric deprivation on thyroid hormone tissue uptake and generation of low-T3 syndrome. Am J Physiol Endocrinol Metab 1986;251(2):156-E163.
  4. Leibel RL, Jirsch J. Diminshed energy requirements in reduced-obese patients. Metabolism 1984;33(2):164-170.
  5. Elliot DL, Goldberg L, Kuehl KD, Bennett WM. Sustained depression of the resting metabolic rate after massive weight loss. Am J Clin Nutr 1989;49:93-6.
  6. Manore MM, Berry TE, Skinner JS, Carroll SS. Energy expenditure at rest and during exercise in nonobese female cyclical dieters and in nondieting control subjects. Am J Clin Nutr 1991;54:41-6.
  7. Croxson MS, Ibbertson HK, Low serum triiodothyronine (T3) and hypothyroidism in anorexia nervosa. J Clin Endorinol Metab 1977;44:167-174.
  8. Brehm A, Krssak M, Schmid AI, Nowothy P, et al. Increased Lipid Availability Impairs Insulin-Stimulated ATP Synthesis in Human Skeletal Muscle. Diabetes 2006;55:136-140.
  9. DeMarco NM, Beitz DC, Whitehurst GB. Effect of fasting on free fatty acid, glycerol and cholesterol concentrations in blood plasma and lipoprotein lipase activity in adipose tissue of cattle. J Anim Sci 1981;52:75-82.
  10. Lim C-F, Bernard BF, De Jong M, et al. A furan fatty acid and indoxyl sulfate are the putative inhibitors of thyroxine hepatocyte transport in uremia. J Clin Endocrinol Metab 1993;76:318-324.
  11. Lim C-F, Docter R, Visser TJ, Krenning EP, Bernard B, et al. Inhibition of thyroxine transport into cultured rat hepatocytes by serum of non-uremic critically ill patients: Effects of bilirubin and nonesterified fatty acids. J Clin Endocrinol Metab 1993;76:1165-1172.
  12. Elliot DL, Goldberg L, Kuehl KD, Bennett WM. Sustained depression of the resting metabolic rate after massive weight loss. Am J Clin Nutr 1989;49:93-6.
  13. van der Heyden JT, Docter R, van Toor H, et al. Effects of caloric deprivation on thyroid hormone tissue uptake and generation of low-T3 syndrome. Am J Physiol Endocrinol Metab 1986;251(2):156-E163.
  14. Lim C-F, Docter R, Krenning EP, et al. Transport of thyroxine into cultured hepatocytes: effects of mild nonthyroidal illness and calorie restriction in obese subjects. Clin Endocrinol (Oxf) 1994;40:79-85.
  15. Leibel RL, Jirsch J. Diminshed energy requirements in reduced-obese patients. Metabolism 1984;33(2):164-170.
  16. Elliot DL, Goldberg L, Kuehl KD, Bennett WM. Sustained depression of the resting metabolic rate after massive weight loss. Am J Clin Nutr 1989;49:93-6.
  17. Manore MM, Berry TE, Skinner JS, Carroll SS. Energy expenditure at rest and during exercise in nonobese female cyclical dieters and in nondieting control subjects. Am J Clin Nutr 1991;54:41-6.
  18. Croxson MS, Ibbertson HK, Low serum triiodothyronine (T3) and hypothyroidism in anorexia nervosa. J Clin Endorinol Metab 1977;44:167-174.
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Autoimmune Paleo Diet


The Autoimmune Paleo Diet is an elimination diet that has been specifically designed to help those suffering from autoimmunity determine their food allergies and sensitivities, reverse nutrient deficiencies, balance gut flora, and heal their bodies over the long-term. The protocol, otherwise known as “The Paleo Approach” has been developed and refined by Dr. Sarah Ballantyne, and is outlined in detail in her book The Paleo Approach. We believe this is the best and most specific elimination protocol for those with autoimmune disease, and following it gives you the best chance to come up with your personalized healing diet.

In a nutshell, the Autoimmune Protocol calls for removing foods that are most likely to be problematic for people with autoimmune disease—grains, beans, legumes, dairy, eggs, nuts, seeds, nightshades, as well as food chemicals and additives. In addition, nutrient-dense foods are added to restore nutrient status, such as bone broth, high-quality meat and wild-caught fish, as well as organ meats, fermented foods and a wide variety of fruits and vegetables. Over the course of the elimination phase (which can last from a month to a year), you take note of the changes you experience in your health. When it comes time to slowly and systematically reintroduce foods, you will be able to tell exactly which foods are holding you back, and able to use this information to construct a diet that will best support your healing needs.


Autoimmune disease is all about an immune system that has gone awry. Micronutrient deficiencies are common in autoimmune disease. The Autoimmune Protocol provides us with a clean slate.

  1. It removes foods that may trigger an immune response, are harmful to the gut, and lead to hormone dysregulation.
  2. It restores nutrients and flora that promote a healthy gut and well-regulated immune function.
  3. It provides a framework for building a life-long diet exactly suited to you.

CountryHealth takes no responsibility for any links shared in this blog. Please see our disclaimer. 

Paleo in the UK

Offering a complete resource for the Paleo Diet and Lifestyle and the Autoimmune Paleo Protocol run by a UK-based Functional Medicine Consultant & Health Coach

Paleo-Vegan = PEGAN

The pegan diet is a style of eating inspired by two of the most popular diet trends — paleo and vegan.

According to its creator, Dr. Mark Hyman, the pegan diet promotes optimal health by reducing inflammation and balancing blood sugar.

The Pegan Diet features 21 simple, straightforward principles that answer the question, how do we eat to prevent and beat disease?

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What Are The Differences Between Functional Medicine And Conventional Medicine

A science-based, natural way to become healthy again

Functional Medicine is patient-centered medical healing at its best. Instead of looking at and treating health problems as isolated diseases, it treats individuals who may have bodily symptoms, imbalances and dysfunctions.

As the graphic of an iceberg shows, a named disease such as diabetes, cancer, or fibromyalgia might be visible above the surface, but according to Functional Medicine, the cause lies in the altered physiology below the surface. Almost always, the cause of the disease and its symptoms is an underlying dysfunction and/or an imbalance of bodily systems.

If health care treats just the tip of the iceberg, it rarely leads to long-term relief and vibrancy. Identifying and treating the underlying root cause or causes, as Functional Medicine does, has a much better chance to successfully resolve a patient's health challenge.

Using scientific principles, advanced diagnostic testing and treatments other than drugs or surgery, Functional Medicine restores balance in the body's primary physiological processes. The goal: the patient's lifelong optimal health.

How Functional Medicine Heals a Key Health Care Gap

Today's health care system is in trouble because it applies a medical management model that works well for acute health problems to chronic health problems, where it is much less successful.

If you have a heart attack, accident or sudden lung infection such as pneumonia, you certainly want a quick-thinking doctor to use all the quick-acting resources of modern medicine, such as life-saving technology, surgery and antibiotics. We are all grateful about such interventions.

However, jumping in with drugs, surgery and other acute care treatments too often does not succeed in helping those with chronic, debilitating ailments, such as diabetes, heart disease or arthritis. Another approach is needed.

The Two-Pronged Healing Approach of Functional Medicine

To battle chronic health conditions, Functional Medicine uses two scientifically grounded principles:

  • Add what's lacking in the body to nudge its physiology back to a state of optimal functioning.
  • Remove anything that impedes the body from moving toward this optimal state of physiology.

Plainly put, your body naturally wants to be healthy. But things needed by the body to function at its best might be missing, or something might be standing in the way of its best functioning. Functional Medicine first identifies the factors responsible for the malfunctioning. Then it deals with those factors in a way appropriate to the patient's particular situation.

Very often Functional Medicine practitioners use advanced laboratory testing to identify the root cause or causes of the patient's health problem. Old-fashioned medical diagnosis helps too, in the form of listening carefully to the patient's history of symptoms and asking questions about his or her activities and lifestyle.

For treatment, Functional Medicine practitioners use a combination of natural agents (supplements, herbs, nutraceuticals and homeopathics), nutritional and lifestyle changes, spiritual/emotional counseling, and pharmaceuticals, if necessary to prod a patient's physiology back to an optimal state. In addition, educating the patient about their condition empowers them to take charge of their own health, ultimately leading to greater success in treatment.

Treating Symptoms Versus Treating the Person

In the dominant health care model today, medication is used to get rid of people's symptoms. If the patient stops taking the medication, symptoms generally return.
Functional Medicine approaches health problems differently. Instead of masking the problem, it aims at restoring the body's natural functioning. Although Functional Medicine practitioners may prescribe pharmaceuticals, they are used to gently nudge the patient's physiology in a positive direction so the patient will no longer need them.

For example, conventional doctors would normally prescribe pharmaceuticals like Prilosec, Prevacid or Aciphex to treat acid reflux or heartburn. When the patient stops taking such drugs, the heartburn symptoms come back. In contrast, a Functional Medicine practitioner might find that a patient's acid reflux is caused by Helicobacter pylori bacteria. Eradicating the Helicobacter pylori might very well lead to the end of heartburn symptoms, permanently.

It's also important to note that in Functional Medicine, treatment for similar symptoms might vary tremendously for different patients, according to their medical history and results of laboratory tests. Factors that can come into play in producing the same symptoms include toxic chemicals, pathogenic bacteria, parasites, chronic viral pathogens, emotional poisons like anger, greed or envy, and structural factors such as tumors or cysts.

The Roots of Functional Medicine

Sir William Osler
You may be surprised to learn that Functional Medicine isn't new. It actually represents a return to the roots of modern scientific medicine, captured in this statement by Sir William Osler, one of the first professors at Johns Hopkins University School of Medicine and later its Physician-in-Chief: "The good physician treats the disease; the great physician treats the patient who has the disease."
Another important saying by Osler is "If you listen carefully to the patient, they will tell you the diagnosis." This encapsulates the importance placed in Functional Medicine on taking a thorough history from the patient.

Dr. Ron Grisanti of

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Your Gut – Your Second Brain

In recent years scientists have discovered that our gut contains a vast amount of bacteria which are called the microbiome. The number of genes in these bacteria is about 3.3 million whilst the human body has around 23.000. The total weight of the microbiome is about three pounds – the same as our brain, which is why it is also called the Second Brain.

One millilitre of colonic contents contains more bacteria than there are humans on this planet.

One of the important functions of the microbiome is to provide immunity (70% of our immune system is located in the gut), and this starts at birth. The birth canal is filled with lactobacilli – which prevent the growth of candida (which causes vaginal thrush). Lactobacilli are the first thing that enters the baby’s mouth during birth.

When mothers have C-sections the child does not get these beneficial lactobacilli. 80% of babies born via c-section are likely to develop asthma versus those born naturally, and they are also more likely to develop diarrhoea in the first year of life, have a tendency to be allergic to cow’s milk and have food intolerances.

Mothers milk also contains lactobacilli. They help to break down lactose, which is the major sugar in milk. The first milk also contains a lot of antibodies for the baby. Later breast milk contains carbohydrates (sugars) and prebiotics which provide food for the microbiome.

People often say they have a “gut feeling” and this is true as the brain is connected to our gut and vice versa.

The gut contains as many nerve cells as the spinal cord. The microbiome affects not only our nerves and immune system, but also our endocrine system. It modulates our emotions, desires and moods. The microbiome also produces neurotransmitters. Imbalances or deficiencies of neurotransmitters are known to cause, among other things, behavioural problems in children and psychiatric problems such as depression.

Environmental chemicals can change the gut microbiome. They can trigger inflammation and metabolic disorders.

Functional medicine is the new way of investigating how your body works and can often provide answers for chronic diseases.

Healthy regards

Dr Oliver Frey, MD MRCGP

Picture: UAB Comprehensive Cancer Centre
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