Dr. Phillip Gallegos’ personal health journey, from battling chronic conditions to dealing with stress-related ailments, led him to embrace holistic health. Now, as co-owner of THRIVE Performance and Regenerative Medicine in Houston, TX, he’s a strong advocate of the transformative power of understanding and preventing metabolic health issues through lifestyle changes. A former full-time anesthesiologist and Medical Director at a busy orthopedic and spine hospital, part of how he found himself pivoting in this direction was through his own health journey. Read on to learn more about his philosophy, thoughts on the current gaps in healthcare, and how Nutrisense, with the support of a CGM and expert nutritionist support, was pivotal on his journey to better health. Thank you for having me. I'm excited to share my insights and experiences with metabolic health, particularly in the context of using Nutrisense, with the CGM and nutritionist support. Certainly. I'm an integrative and regenerative physician and co-owner of THRIVE Performance and Regenerative Medicine in Houston, TX. Our clinic focuses heavily on metabolic health as we believe it serves as a cornerstone for overall well-being. Many, if not all, modern-day chronic diseases can be traced back to dysfunction in metabolism, making it a crucial focus in our practice. I was inspired to change directions as a physician when my stressful, fast-paced lifestyle led to illnesses in my late 30s. At the time, I was a full-time anesthesiologist and one of the Medical Directors at a busy orthopedic and spine hospital. I had 24-hour calls every few days; I managed the anesthesia services… I was also eating poorly, not exercising enough, highly stressed, and had dysregulated sleep. All of this affected my health: I ended up with low thyroid, low testosterone, adrenal fatigue, and autoimmune disease (both thyroiditis and arthritis)! I was doing very well as a physician and was highly successful. But underneath the surface, I was dying a slow and painful death. I had put on a significant amount of weight, was burnt out, aching all of the time, and felt generally unwell. And the traditional medical system fell short. I initially went to see a concierge doctor who was a classic allopathically trained physician. He was very good but did not offer any insight as to why my health had declined or a roadmap of how to fix it. He did not address the root cause of my condition; he prescribed me medication but did not mention any nutritional or behavioral changes that could help. If I had used a CGM with the Nutrisense program at the time, it would have been extremely helpful for me to visualize, in real time, the damage I was doing with my food choices and lifestyle habits. I went to see an integrative physician; this was my first exposure to a functional medicine approach to addressing health issues. He spoke about metabolic dysfunction and how this was related to all of my health issues. I began to focus on improving my metabolic health. I went gluten-free and drastically changed my behaviors, which actually led to improvements and allowed me to heal over time. I was fascinated by the change as well as by this style of medicine since I was never taught this approach in medical school. You could say my interest in integrative medicine was born out of the old adage, "Physician Heal Thyself." I started studying function, integrative, and regenerative medicine, first to help family and friends, then transitioned into using it in practice with the clinic. My own journey with metabolic dysfunction sparked my interest in the importance of metabolic health in preventing and healing the majority of our modern-day chronic diseases. Yes. In my opinion, the CGM is a revolutionary tool. I genuinely believe everyone should use it at least once in their life as an experiment to see how different foods affect their unique glucose response. That said, expert support is essential. Reading the data is one thing, but interpreting it requires expertise. Having a trained physician or specialized, expert nutritionist guide people on this journey is essential: it’s how you can derive the most meaningful insights and make informed lifestyle and behavioral changes based on the data the monitor collects. Early in our practice, Dr. Langley and I looked for different solutions and devices to track patient data to help people see what I had not seen for so long in my own health journey. We found Nutrisense and were fortunate to connect with two of its founders, Dan and Kara. We also had the honor of interviewing Kara, who is a metabolic expert, on a podcast. This further sparked our interest in using CGMs in our practice to help assess and treat metabolic dysfunction. And, of course, we wanted to use it ourselves to see how it would help with our own health journeys. Dr. Langley and I went through the three-month CGM subscription and had a nutritionist we worked with to help interpret the data. It was. The Nutrisense app was super easy to use, and the platform to communicate with my nutritionist made it simple to analyze my data to make behavioral changes. The website has abundant educational material, so even the layperson can understand glucose metabolism and utilization, metabolic health, and general healthy habits. I initially used the CGM with the Nutrisense Program as a data collector, experimenting with various foods, timing, and macronutrient orders. Tracking responses to exercise, stress, sleep, and alcohol provided a comprehensive understanding. Collaborating with my Nutrisense nutritionist allowed me to make changes and observe how my glucose responses evolved over subsequent sensors over three months, providing crucial insights into my metabolic health. Initially, I tried various foods based on their glycemic index, to see how I responded at the time to each food. I also played around with the timing of various foods: eating them in the morning versus midday versus evening, for example. And, of course, collecting data with the order I ate macronutrients: carbs, fats, proteins, with the impact of alcohol... Oat milk and almond milk blew my mind with how high my glucose spike was and for how long it remained. I always thought this was a healthy milk alternative. It was as bad or even worse than drinking a sugary drink. And a lot of this experimenting led to valuable lifestyle changes. For example, with meal frequency and timings, I processed carbohydrates much better earlier in the day than in the evening, which drove me to have a less carbohydrate-rich meal for dinner. With activity, I was doing fasted workouts in the morning. While wearing a CGM, my glucose would be on the lower side and increase appropriately as I converted glycogen into glucose. Still, it was insufficient for me, as my performance would suffer. With help from my nutritionist, I added a protein shake with some fruit in it before working out, and it worked! My glucose levels were more stable, and my performance improved exponentially. I realized everyone is unique, so blanket recommendations (like working out fasted) should be taken cautiously because "one size fails all." Seeing my actual data and correlating it with how I felt guided me into making a better decision about my workouts. I have since taken that further by testing with PNOE VO2 Max to assess my fat and glucose utilization while exercising. Definitely. In that first phase, I was also tracking what the data revealed when I was under stress, and had a lack of sleep versus a whole night of quality sleep. I also tracked my sleep with an Oura ring to correlate my data with how I felt. I also noticed (when I was working in the hospital setting as an anesthesiologist) that my sugar would be higher during those hours, presumably due to higher circulating levels of cortisol and epinephrine/ norepinephrine. My sugar would be all over the graph when I was on call and working late at night or overnight, even with healthy food choices. Sleep dysregulation and moments of stress would have the most significant impact on my glucose regulation. The stress of the job had a significant effect on my metabolic health. Rewind to when I was sick a decade ago—I can only imagine what my data would have looked like when I was eating poorly and sedentary, combined with the high stress and lack of sleep! After I collected my data and looked it over with an expert nutritionist, I shifted into the next phase of my CGM experience. This involved taking the knowledge gained from my interactions with my personal nutritionist and making small changes that worked specifically for me. Over the following three sensors I used, I tracked the tweaks I made with my food and lifestyle to see how much my glucose responses would change. Since the first three months with the CGM and Nutrisense, I have used it intermittently as my metabolic health and body composition have changed to see how my glucose utilization has improved. Your responses to the same foods change over time as you get more metabolically healthy and flexible. Foods you may not have tolerated too well can demonstrate a different response after increasing muscle mass, improving HbA1C, and decreasing fat mass. And it’s not just that: going through the whole process of wearing a CGM myself and learning more about glucose responses has made me a better physician when working with patients to improve their overall metabolic health too. I tell patients that the CGM is "the truth-teller." There is no guessing or postulating; the device gives you real-time glucose responses so that you can start finding patterns to guide behavioral changes. It’s a very valuable tool if used appropriately and guided by a professional who understands how to interpret the data so you can use it to make changes to become more metabolically healthy. As physicians, we have been indoctrinated that you don't implement specific devices, therapies, or treatments until a patient already has a "disease.” There is little emphasis on the preventative approach to help the patient avoid it. It is traditionally thought that a CGM is only used with those patients with type 1 diabetes, needing insulin therapy to help guide dosing, or those patients with severe insulin-dependent type 2 diabetes. In the latter, if we had instituted the CGM earlier, combined with education on their data, the patient could have been spared being put on insulin in the first place. And more than that, if we institute CGMs in a preventative or optimization approach, we could all but prevent metabolic dysfunction, prediabetes, diabetes, and metabolic syndrome. In my clinic, we steadily implement the CGM in all of our patients at least once to educate them and open their eyes to the consequences of their daily food choices, stressors, inactivity, and poor sleep. This experience with the CGMs has made a significant impact on our patient population at THRIVE, to help use them to guide positive lifestyle changes for their overall health. We follow the mantra "test, don't guess" with our patients and use many different types of biomarkers and data to help optimize our patients’ health. Insights that I personally gained from my CGM experience include: No naked carbs, Food order matters (protein, fiber, & fat before carbohydrates), Stress (actual acute that I felt & stressors I physically could not perceive) raised my blood sugar, Alcohol and poor sleep derail your glucose response, Late-night eating was really bad for me, Walking after meals really does improve your glucose response, The glycemic index does not always correlate with glucose response. My advice would be to use a CGM under the guidance of a professional who understands how to interpret the data. The data should not cause you to fear certain foods or carbohydrates but more to help guide your decisions on what foods will serve you best so you can either lose or maintain weight, change body composition, optimize fitness performance, and become metabolically flexible and healthy. I firmly believe that everyone should use a CGM at least once to help them understand how food affects their unique body and, hopefully, drive behavioral changes to improve their health.
