S1 E5: Understanding Metabolic Type on an HTMA


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Amanda: Hey, this is Amanda, women’s health dietitian. 
Emily: And I’m Emily, nutritional therapy practitioner. 
Amanda: And this is the Are You Menstrual? podcast where we help you navigate the confusing world of women’s hormones and teach you how to have healthy periods. 
Emily: Each week we will be diving into a different topic on women’s health and sharing our perspective using nutrition, female physiology, and metabolic health. 
Amanda: Our goal is to help you wade through conflicting health information and empower you on your healing journey. 
Emily: We hope you enjoy it.

Emily: Last episode we walked you guys through a breakdown of the macrominerals and the ratios that you can see on your hair test for mineral status. But this week we’re going to be covering one specific part of the HTMA, or the hair tissue mineral analysis, and that is going to be the metabolic type or the oxidation state. This can kind of be a confusing part for some people just because there are different ways of doing things when it comes to metabolic type. For example, some people talk about eating certain foods or eating a certain way based on your metabolic type. But we’re gonna share with you our perspective on why metabolic type, or oxidation state—which those two terms are interchangeable so if you hear one, we just mean the other and vice versa. What they mean when we’re looking at a hair test and why we think it’s important based on what it says about you and the state of stress you’re currently in. But if you want to look at a hair test, you can Google image “TEI HTMA”. I’m going to say that, again, it’s “TEI  HTMA”, to see what the hair test looks like and your metabolic type section in the hair test. Just so you can follow along with us as we talked about it.

Amanda: Yeah, it’s at the top right, you should see it. I’m sure if someone has done a hair test, if you have yours, you can just look at that. And we’re gonna go through this mainly because it’s, it’s kind of like our first part of the test we review with our clients that we’re, like, what kind of stage of stress are you in? Right? Like where, where are we starting from. 

And the whole concept of metabolic typing was actually first outlined by Melvin Page, and he had the Page Foundation. He started to differentiate metabolic types based on certain measurements. Now, I…his are, you know, I’m not, I’m not totally well-versed in the way that he did it. But he did a lot with, like, upper and lower extremity measurements along with some blood work parameters. So he was looking more at like physical characteristics, how they compared to your bloodwork, and was defining metabolic type in that way. 

From there, that’s when George Watson…he expanded on this. And he’s the first person that really started to divide metabolic type into fast versus slow, which are the two main categories we’re going to be focusing on. And really diving more into, like oxidation rate, how your body makes energy, right? That ATP, we talked about this in the metabolism the first episode. So he started looking more at your metabolism, how your cells are making energy. And that’s when he started to define metabolic type being fast versus slow. And, like, fast being person is in the sympathetic fight or flight state and then slow meaning that the person is in the parasympathetic or rest and digest state. 

And from there, that’s when Dr. David Watts, he went much further into different types of metabolic types. So he actually is the director of research and founder of Trace Elements. And when Emily said “TEI” like Google that—that stands for Trace Elements Incorporated. That’s the lab that we use for hair tests. So if you’ve ever worked with us, or if you’ve gone through a Master Your Minerals course, in order to hair test—that’s where it’s from. And Dr. Watts, he came up with different subtypes of metabolic types after reviewing hundreds of thousands of hair mineral tests. So it’s basically connecting, not just fast or slow, you’ll see, like, fast 1, 2, 3, 4, slow 1, 2, 3, 4. And those numbers, that is a subtype and that’s connecting more about not just are you in the fast or slow state, but what are your adrenals doing? What’s your thyroid doing? And that’s really kind of where metabolic typing came from and how it’s evolved until how we use it today.

Emily: So as Amanda said, when you’re thinking about your metabolic type, it’s going to be telling you what your nervous system is doing, what’s dominant. And so are you more trending towards that sympathetic state, that fight or flight state or the more parasympathetic rest and digest state, as Amanda mentioned. And that’s either going to be a “fast” or a “slow”. So if you’re in the fast type, you tend to be, be more…have the chronic overstimulation of the adrenal glands and/or the thyroid. Most of the time, they’re together, you have the overstimulation of both, and this shows the sympathetic nervous system dominance, so that fight or flight. Now on the other hand, if you are in the slow, that’s going to be associated with a depletion of the adrenal glands and the thyroid, which shows the parasympathetic dominance. So that rest and digest state. And this metabolic type is actually based on one ratio. It’s the first ratio that you’ll see in your HTMA, and that’s gonna be your calcium/phosphorus ratio. 

So calcium is a very sedative mineral. And that’s why if your calcium is higher, you’re going to experience more of that less stimulation of your adrenals and your thyroid or that slower, sluggish adrenals and thyroid. But if your phosphorus is high, that’s going to be more stimulating. So that’s where your chronic overstimulation comes in of your adrenals and your thyroid. So just as a little cheat sheet: fast is going to equal a low calcium/phosphorus ratio and slow is going to equal a high calcium/phosphorus ratio. And that’s just something to keep in mind. It’s just one piece of the HTMA puzzle, but it does give you a little bit more insight into how your adrenal glands or…I’m sorry, your adrenal glands and your thyroid is going to be working most of the time.

Amanda: And I think, too, just keeping in mind that, like, when you look up metabolic typing…so many different things come up. And that’s why we’re like, we just want to break down how we use metabolic typing. We don’t recommend certain foods based off of this. And it’s, it’s important to know that this is not set in stone, right? Just because you’re a slow metabolic type on your first hair test doesn’t mean you’re gonna stay that way. So, like, you’re gonna go back and forth. And it’s, it’s really based around your stress response. And that’s why we keep mentioning nervous system states, because depending on what stage of stress you’re in, you’re going to be more dominant in one end of that autonomic nervous system. So don’t freak out. If you’re like, oh my gosh, I’m a slow metabolic type—most people are. And take it in more as a piece of information as, like, okay, this is my stage of stress versus, like, this means I have…I will always have a slow metabolism. It’s likely going to change on your healing journey. And this is why we don’t recommend certain foods based on your metabolic type, right? Because it’s not just like, oh, I’m fast or slow so I can only eat these things, I shouldn’t eat these things. It’s so much deeper than that. And I think when we go more into these, which we’re going to do now and talk about the subtypes a little bit, then you’re going to grasp like, oh, it’s actually how my organ systems are working. It’s not just my metabolism.

Emily: So Amanda, would you say that focusing so much on your metabolic type is a smart thing or not really?

Amanda: It’s just a piece of the puzzle. So like, I think it’s important to acknowledge it. But I think even your subtype is a little bit more important to know. Like, what stage of stress are your adrenals in? And how is your thyroid working? When you really understand your metabolic type and your subtype, you recognize mineral patterns and mineral ratios. And we did go through the mineral ratios, I think in the…not the last episode, was it? Yeah, so the last episode, the end, we kind of talked about, like, how they compare different systems of the body. That’s what matters most. And that’s really what your metabolic type is telling you. So don’t get obsessed with fast versus slow and the word metabolism. You need to look deeper at, okay, what does this tell me about my metabolism and about my adrenals and thyroid?

Emily: And that’s something I feel like I had to learn when I did my first HTMA. I think I was so absorbed in what my type actually was that it wasn’t until I started focusing more on the ratios themselves and what my body actually needed, that it all started to kind of make more sense as far as what I was supposed to, kind of, do in order to get my health back into a good place. 

Amanda: I think too, like, when you do see that slow 1, you’re like, ah, like, that was my first I was, like, oh my gosh, I’m a slow 1. I’m like the slowest thing ever. And you kind of start to freak out. Or in your retest, like, if I get a lot of people where their metabolic type doesn’t change, and they’re kind of nervous. And they’re like, oh, my gosh, I’m still slow 1, or I’m still slow 3, like, what does that mean? When in reality if then we look at their ratios. And the ratios are on the second page, so if you guys are looking at the hair test, go to the second page—it’s in the top left corner, it’s a purple box called significant ratios. That is when you see the change, right? It’s…but it’s really easy to get obsessed with your type. And if you don’t see a difference on your retest, people start to freak out. But it’s all dependent on your ratios. And sometimes they’re…it’s not enough of a change or they flip flop. And so then your type doesn’t really change. But don’t, don’t obsess over the type—we just want you to understand, like, what they mean. 

So we’ll, we’ll get into the fast metabolic type first. This is when we are really more in that actively stressed state. So if we’re thinking about, like, that alarm stage of stress or we’re making lots of cortisol, we’re prioritizing that fight or flight. And that’s really when fast oxidation is showing that the body is under stress. So if you see a fast no matter what the number is, then know that that means your calcium/phosphorus ratio is lower and that you are definitely more in that fight or flight mode. These people tend to be more anxious, irritable, in a hurry, aggressive—especially if you’re really fast, like a fast 1, or a fast 2. They’re usually somewhat emotional, short tempered, high strung. So it’s, like, you’re, you’re just…you tend more towards anxiety and you’re easily wound up.

Emily: Right, and to add to that, I mean…this isn’t always the case, not all of these symptoms are going to go with you just because you’re a fast. But a lot of the times higher cortisol levels in fast metabolizers will equal some higher blood sugar, some blood sugar dysregulation. You’ll maybe see some weight gain in the abdomen. You might also see because of salt and water retention with the high sodium, some higher blood pressure, you might sweat more easily. One good thing is that you might also feel like you’re constantly drinking caffeine. Like, you have that fast brain activity where you can kind of think on your feet whenever you get stressed or nervous. I don’t know if this happens to you, Amanda, but I tend to have some digestive issues, like, frequent or loose bowel movements, which some fast metabolic…metabolizers can see. And then on the more serious side of the spectrum, things like, with the anxiety [and] the high blood pressure, you can start seeing heart attacks, panic attacks, and then maybe some arthritis and sore joints…things of that nature. So like I said, not all of these symptoms are going to go with every fast, but it is a little bit more on the common side for a fast metabolic type over a slow.

Amanda: And when we think about, like, how does this present in a person or a client and on a hair test. Remember, there’s different types of fast—it’s fast 1, 2, 3, 4. We’re going to talk about those once we get through kind of, like, the general fast versus slow.  

But we have a little case study that we’re going to do from a client, Tammy, that we worked with, and she is a fast 1. So she’s, like, very fast. That means that not only is she in that fight or flight state, but her adrenals are working very quickly. And same with her thyroid. And so fast 1 is fastest of the fast. Tammy is someone where she…it’s interesting because we chose her because she’s…it’s not always what you think of when you think of a fast metabolic type. A lot of people think of, like, they have difficulty keeping weight on, they definitely associate it more with their weight. They might not think about, like, when we think of the stress and everything and the fast thinking and all that stuff and high cortisol…you might not always think of things like brain fog. But that was one of Tami’s main complaints. She had a really difficult time losing weight, irregular cycles. She wasn’t diagnosed with PCOS, but she had a lot of symptoms of it. And she had hypothyroidism. And so I think a lot of people would assume that she’d be a slow metabolic type. But she actually was a fast 1. And if we think about her health history, she came to us…she had been struggling with hypothyroidism for a while. So her thyroid wasn’t working as well as it should have been. She has a history of allergies, ADHD, anxiety—those are definitely more associated with the fast metabolic type minus the hypothyroidism.  

If when we look at what, what we saw on her hair test. Yeah, she was a fast 1, so everything was really fast. But she had some of your classic mineral imbalances that occur when you’re a fast metabolic type, which is things like retaining more sodium and potassium. So typically a fast metabolic type…they burn through calcium and magnesium a lot quicker. And so they need more of those. And on Tami’s HTMA… obviously, you guys can’t see it. But her sodium was very, very high, which is telling us that her…or she’s making lots of cortisol, which is going to lead to more aldosterone being expressed, and then she’s going to have more sodium retention. So on the hair that’s going to look like very high sodium levels. And that’s just telling us that she is very actively stressed. We kind of knew that even by talking with her but she was very shocked to see that she was a fast 1 on her hair tests. And I don’t know if you kind of want to walk through some of her nutrition, Emily? What she was typically eating?

Emily: Yeah, so according to her initial intake and her food journal, she was someone who occasionally or frequently skipped breakfast. And as you probably have heard from a lot of our different platforms like Instagram and our blog, we are huge proponents of eating breakfast right when you wake up because of the way it affects metabolism and your thyroid. So as Amanda said she did have some hypothyroidism going on, and skipping breakfast or not eating very frequently can definitely exacerbate these symptoms. She also had a difficult time eating enough food, which again, kind of goes hand in hand with this. We need enough nutrients, we need enough fuel to give our thyroid and our adrenals what they need. And then she ate a lot of her food later in the day, which I don’t feel like meal timing is as important as, as many, as many calories and good quality foods that you are getting in during the day. But we do talk a lot about eating every three to four hours so that your blood sugar doesn’t drop too low, your cortisol doesn’t go too high. And this was something she was already experiencing with the higher cortisol. 

So whether you’re fast or slow, making sure that you’re eating regularly…we do think also adds to your overall health and well being. And then she experienced being wired but tired a lot. So just that kind of anxious, but also just exhausted, which I’m sure a lot of us have experienced before. But it’s very typical with a fast metabolizer because of just the way our cortisol is working. So she definitely didn’t have a terrible diet or anything like that. It was just these little things that she could have been doing better that was maybe making her symptoms worse, like the skipping the breakfast, the eating food later in the day, the going longer time frames in between eating, and then not eating enough. That was definitely causing some cortisol, blood sugar issues.

Amanda: And I think the big thing to remember is, like, so for Tammy, she had a lot of family stuff going on at this time. And you know, lots of stress, mental [and] emotional stress, physical stress, driving long distances to see family like on a regular basis. And so when we have that kind of stress going on, we have to take responsibility in other areas and just take care of ourselves, you know. Like, feed yourself breakfast. So that’s one way because when we wake up, you’re going to have high cortisol. If you don’t eat because your blood sugar is low, you know, you haven’t eaten all night. So for her, that was the first thing that she did, she started doing to, like, help reduce that stress. Because she’s kind of like…when you see your hair test results, and you see like a fast 1, typically, a lot of your minerals are very high. So you’ll see like black bars going all the way up the screen, it’s kind of scary. And it just shows you, like, okay, so I do have a lot of stress going on. It’s nice to visually see it, I think it makes it a little more real.  

And it wasn’t what she thought, like, she thought she was already in that exhaustive stage of stress. Like, she wasn’t actually there yet, her body was still fighting pretty hard. Which was great to know, because it’s like, hey, we can get a handle on this. And we can minimize how this is gonna affect your health in the future. And there was a lot of different science…we won’t go into everything because I feel like it might be confusing if you can’t see the hair test. But that’s just to give you an idea of, like, what a fast 1 typically can show up like. It’s not always what you think it is—hypothyroidism, brain fog, inability to lose weight can be a fast metabolic type. And again, like, this is why we don’t change food recommendations based off that—it’s really just kind of looking at, like, for her, for example, not eating breakfast, eating most of her food later in the day. And then typically not sleeping super well. It’s, like, all that’s just going to exacerbate the stress. So fast, fast types do well with eating more frequently

Emily: For sure, and I think we will talk about this more next week. But I think it is also worth mentioning that she does have a lot of markers on her hair tests that could indicate excess iron in the body. Iron being one of the high on hers..

Amanda: It was so high… 

Emily: But there’s also things like manganese and chromium that are high, which can indicate this iron in the tissues or the liver. And we are going to do a whole episode just on iron and copper and how they go together and why they’re important. So definitely catch next week’s episode when we go more into that, but just wanted to throw that out there too, Amanda.

Amanda: Yeah, that’s…it’s a, it’s an important marker, especially because she is hypothyroid. Right? Because obviously, like most of that iron is going to accumulate in the liver. And where does that thyroid hormone conversion happen? In the liver. That’ll be like a whole thing we’ll get into on that episode. But I…that’s also, like, why she could you know…she’s hypothyroid, but she’s still a fast 1. So there’s, there’s so many other pieces of the puzzle. And that’s why we don’t just look at the metabolic type. 

Emily: Okay, so now we’ll move on to talk about the slow metabolic type in a little bit more detail. So slow oxidation is going to mean you have a slow metabolism of nutrients. So that, that means that your body takes longer and requires more energy for your cells to take the nutrients from the foods you eat and turn them into energy. Okay, so a lot of people, as Amanda was saying was, they see oh, I’m a slow oxidizer, that must mean I have trouble losing weight, like, I need to be fast in order for my body to be working right. This is not totally the case. It just is an area of stress, your state of stress that you’re currently in and you are leaning a little bit more towards that depleted state. But you could also be in this resistance state where your body is trying to compensate. 

Okay, so what you’re often going to see is, like, a slower thyroid function, a slower metabolism, which is gut function, fatigue, hormone imbalances. And that is where your adrenals are also slowing down. So things are just kind of getting into that slow…stuck in that rest and digest state. Okay, so if you’re experiencing…if you’re just tired all the time, if you have a hard time sleeping at night, you feel cold, like, your hands and feet are cold, you’re experiencing thinning hair, hair loss, and then constipation or, like, a slower transit time with your food and your digestion…That’s often what we see in slow metabolizers. And a lot of this is due…So physiologically what’s happening is that you’re gonna see your calcium and magnesium higher than your sodium and potassium. So in opposition to what’s happening to a fast metabolizer, with a slow metabolizer, we’re going to see the calcium and the magnesium go up. And then the sodium and potassium is going to be decreasing. So when you’re looking at an HTMA, this isn’t always the case. But a lot of times, especially with a slow 1, we’re going to see that downward slant, starting with the higher calcium/magnesium and going down to the sodium and potassium levels.

Amanda: So that typical pattern that we’re seeing with the higher calcium/magnesium relative to the sodium/potassium…a lot of this is based on adrenal function, right? So if we think about stages of stress, if that…you…most of the fast types are in the alarm and resistance stage of stress. As we move through those, you’re using up a lot more minerals. So as that sodium/potassium start to decrease, that’s going to impact thyroid function. Nothing works independently in the body, right, it all works together. And so if we are thinking about depleting certain minerals, of course, that’s going to come back and impact how our thyroid is working, how we can get that thyroid hormone inside the cell, you know. And, like, as that calcium increases, that slows down the adrenals. 

Because remember, as Emily said in the beginning, like, calcium is very sedative, and it’s controlled by that parasympathetic branch of our nervous system. And so that’s why when we see in slow oxidizers, when we’re looking at that hair test…remember, the slow 1, 2, and 3, 4 are going to differ a little bit…but in general, we’re gonna see a much more depleted sodium/potassium, so they need more of those minerals. It’s really important to get enough. Whereas in the fast metabolic type, you really want to make sure you’re getting enough calcium/magnesium, so they’re just opposites. Everyone’s gonna vary a little bit based on their test results.  

And I think magnesium might be the most confusing part of this, because people see the high levels and they think, oh my gosh, I’m getting too much magnesium, I’m taking too much of my magnesium supplement. But in reality, it just means you have a higher demand for it. People that are slow metabolic type typically want to go really slowly when supplementing with magnesium. And you really want to focus on your sodium and potassium first. So I know we’re always talking about adrenal cocktails, but there’s a reason for it—it’s because most of us are slow metabolic types. And a lot of us aren’t getting enough of those minerals in our diet. And so adding them in very mindfully via the adrenal cocktail…that’s going to help improve sodium/potassium levels. And slow metabolic types do so well with those. And then as you build those up, then you start to tolerate that magnesium a lot better. Whereas when you’re a fast metabolic type, you typically do great with magnesium, right, because you’re using it up so much and so quickly. So those are kind of some of the main differences between those. And if we’re going to look at a case study, we’re actually gonna look at Emily as our case study for the slow metabolic type.

Emily: Yeah, so we get to talk about my situation for a bit, which I feel like Amanda, I am a classic or very typical slow 1. If you kind of just know what I was going through, which I’ll summarize a little bit. I was experiencing pretty severe brain fog, constipation, digestive issues, bloating was a huge one for me. Acne was always a very big problem growing up, struggled acne for probably 12, 14 years, somewhere around there. I also had irregular periods from the start, and then intense sugar and carb cravings. I had also been diagnosed with hypothyroidism, PCOS, and I did have eating disorder tendencies for a couple years there as well. And I think that was mostly due to just wanting to be healthy and thinking that a restrictive way of eating was going to be the best thing for me. But on a low-carb diet, I was still experiencing some blood sugar dysregulation as well as Candida. I did a GI map, or a stool test, and I did have some Candida issues on that test as well.  

So those are things that I experienced, and when I did my first mineral test with Amanda I was a slow 1. So if we are looking at my HTMA, the first thing that I saw was my calcium levels were through the roof. So that could kind of explain why I was experiencing so much fatigue, just because calcium is a very sedative mineral. And as a slow 1, I was stuck in that rest and digest state. So my body could not get out of this resistance state or this place of just being parasympathetic. So I also had very depleted sodium and potassium levels, as we were talking about, that’s a really big sign of a slow metabolizer. And so my thyroid ratio was completely off. I think it was through the roof because of my low potassium—I just wasn’t getting that thyroid hormone into the cell. So that was a huge problem. And if we’re talking about blood sugar, which obviously I was having a lot of issues with…potassium is huge for blood sugars. So potassium helps thyroid hormone and insulin get into the cells and do what they need to do. 

So I was experiencing both of those issues, probably because my potassium was so low. And what’s interesting about my diet was that I was on a low-carb diet, so I wasn’t eating foods with potassium—things like potatoes or coconut water or these other root veggies that are high in potassium. I wasn’t really eating a lot of that, which could explain why my levels were probably bottomed out. So those were just a few things that I had to balance out and get that sodium and potassium up, get that calcium shell to come down. And we did that through a lot of adrenal elixirs as Amanda mentioned, and then balancing out my macros to incorporate some of those important potassium-rich, whole food carbs—that really, really helped. And that’s when I started feeling better, like, my blood sugar issues are completely gone because of how I balanced out my macros and incorporated those nutrient dense foods. So just an interesting, like, tidbit on how you know, we think a lot of times PCOS and things like that, metabolic issues can come from eating too many carbs or, or eating too much. And it’s actually most of the time, the opposite.

Amanda: I think too, like, one thing for you is that you were testing your blood sugar, remember that? You were actually monitoring your blood sugar. And, like, Emily was very nervous about adding certain foods in and it was, like, you had in your head that you’re, like, but I can’t eat this food. Remember, like, well, I have these blood sugar problems well…and obviously we can see there were some elevated blood sugars, but I think your fasting was pretty high. And I’m like, this is the perfect example of why we need more carbohydrate

Amanda Montalvo

Amanda Montalvo is a women's health dietitian who helps women find the root cause of hormone imbalances and regain healthy menstrual cycles.

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