Weight Gain, Insulin, and Leptin Resistance Post Mold Exposure

by Dr. Susan Tanner, MD

Addressing the impacts of mold and mycotoxins on the hormonal system is part of the puzzle in helping a patient recover after significant exposures and the resultant total-body toxicity.  We have previously written about hormones going haywire, toxin exposure and gaining body weight, and what patients can do to assist in healing. But, an area we have not discussed in depth is mold’s impact on blood sugar, body weight, and a hormone called leptin.

Weight fluctuation during or after significant exposure to mold and mycotoxins is not unusual.  A number of patients will lose weight and/or muscle mass due to damage to the small intestinal lining where absorption of nutrients takes place as well as to the development of food allergies/sensitivities. Malnourishment and dietary limitations which can often be extreme for mold sufferers can make eating unpleasant and uncomfortable resulting in weight loss.  There are also significant numbers of patients who actually gain weight and experience great difficulty losing it, even when their environment has been cleared of mold. Toxins are stored in fat which can be part of the reason for this weight gain, but a hormone called leptin also plays a large role. As you will see, not only does leptin influence sugar metabolism and insulin levels, but it also controls hunger signaling, fat storage, and therefore overall toxin accumulation in the body.

Obesity, Toxins, and Hormones

The news media reminds us frequently that obesity is on the rise as is the incidence of Type 2 diabetes; the two often go hand in hand.  Certainly, abundant processed foods, excessive sugar intake, decreased physical activity, and larger portion sizes contribute to these epidemics. But, what does not get discussed, is the role that toxins play in these conditions.

The mechanisms of Type 2 diabetes are quite complex and I will not get into all of those, but the issue of cell membrane damage and subsequent insulin resistance cannot be overlooked.  In a nutshell, increased toxicity leads to increased cell membrane resistance, which then leads to increased insulin production but poor utilization of that excess insulin, which leads to higher blood sugar levels, and so the cycle goes. The addition of medications to lower blood sugar and improve insulin utilization may be necessary but create another series of byproducts in the body that must be also filtered through the liver and kidneys, organs that may already be stressed to the max by a moldy environmental situation.

The detoxification steps and dietary plans for individuals with mycotoxin exposure have been detailed in prior articles, and these are definitely the first steps if you are finding yourself with the signs and symptoms of Type 2 diabetes.  However, leptin, another hormone discussed much less often than insulin, may be at play in this situation and can thwart some of the efforts made in controlling both body weight and blood sugar levels.

What’s Leptin Got to Do With it?

Leptin is a hormone produced by your fat cells. There is also new evidence that small amounts of leptin are also produced by other tissues, including the stomach, skeletal muscles, pituitary gland, and mammary gland. For the most part, leptin acts on the central nervous system and signals to the brain and body whether or not there is a need to store more fat. Typically, leptin “tells” your brain that you have enough fat stored. Once you’re exposed to mycotoxins, though, the resultant inflammatory cascade can lead to leptin resistance, causing your body to think it is starving, even when that is not the case. In response to faulty signaling, your body conserves energy (slowing the metabolism) and does everything it can to store more fat.  Thus, the more fat cells that accumulate, the more leptin produced by the body. A problem many overweight people face and also a common problem with mold-injured bodies is that the cells become resistant or quite literally blind to the abundant leptin. In other words, even though there is plenty of leptin floating around, the body is insensitive to it and craves food.

Elevated Leptin

Leptin is a powerful signal to the hypothalamus of the brain, controlling hunger. And while we hear a lot about insulin resistance, much less is written about leptin resistance. In fact, rarely are leptin levels tested in routine clinical settings, even though a lot can be learned about a patient’s overall health and energy metabolism from looking at their leptin levels. As more research is done on leptin and its impacts on weight and health, as well as its intimate relationship with Type 2 diabetes, we may well see leptin testing more routine, but for now, you may have to request that your doctor run the test.  It is not expensive and is as simple as any other blood draw.

If you test and have elevated leptin levels, then this means assessing your air, your diet, and your other hormones!   First and foremost, do you still have exposure to mycotoxins?  If so, then this has to stop!  We may sound like a broken record here, but nothing will get better if you continue to have the influx of toxins that caused the problem in the first place. It is entirely possible that the increase of leptin occurred while toxin levels were high and then remained in a “switched on” mode.  Elevated leptin is an inflammatory marker and is present in many autoimmune and inflammatory diseases. It is a symptom that something is wrong and that signaling mechanisms in the body are off because their proper communication is being disrupted. Mold and mycotoxins are huge disruptors for ALL body systems, so addressing the environmental piece of the puzzle is of paramount importance if it exists in your individual case. Then, doing things to reduce the leptin levels themselves is still under investigation but is an area of evolving information.

Here are some steps that may help if you know or suspect high leptin levels are part of your health issues:

1. Address your diet. This does NOT mean calorie restriction. In fact, quite the opposite. Yo-yo dieting and calorie restriction can actually contribute to leptin resistance. Diet should, in general, be lower in carbs–especially carbs that are not whole fruits and vegetables, and higher in quality protein. Not eating after 6 PM, and starting your day with about 20 gms of protein is also helpful as protein is a slower-burning fuel and does not tend to raise insulin or spike blood sugar. Other dietary recommendations may need to be made on an individual basis, as issues such as food sensitivities and gluten intolerance must be taken into account. Digestive enzymes, probiotics, and gut-repair supplements may also need to be considered on an individual basis.

2. Exercise. Moderate exercise on a regular basis is key: this helps mobilize fat and build muscle mass and needs to include both aerobic exercise and resistance (weights). I cannot reiterate this enough. You MUST move and use your muscles to whatever degree you are able.

3. Sleep. Get adequate sleep. Ghrelin, yet another hormone, is secreted during sleep and may suppress the further secretion of leptin. Good sleep hygiene, just as your air and food, is a must!

4. Address cell membrane function. This can help with the hormone resistance factor in both leptin and insulin.   As cell membrane is largely comprised of phospholipids, the use of these to add stability can be quite helpful.  Phosphatidyl Choline is excellent for this.

5. Balance your other hormonal systems. This includes the thyroid, pituitary, adrenals, and sex hormones. It is much simpler to correct a problem if the supporting structures are strengthened as well.

Additional Information on Leptin Resistance

There is likely a genetic component involved in some patients with high leptin and leptin resistance, just as we see in Type 2 diabetes.  There have been ongoing studies using medications for diabetes, such as Actos, in patients with high leptin. The jury is still out on whether or not these work in the long term without activating other side effects.  As with most everything, we prefer to try the lifestyle and nutritional interventions first and foremost.

Finally, because we know that leptin is produced by the white adipose tissue of the body, it has been suggested that the judicious use of liposuction to remove some of these fat cells may be helpful for some patients.  Surgical risk and expense would, of course, need to be considered.

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