Correcting a Hypometabolic State – The Role of Mitochondria and Thyroid

Hello, I am testing, testing, making sure my sound is working. Could someone raise their hand if they can hear me speaking? And then I will know. Oh, thank you, Pablo. Thank you very much. I can't ask you to raise your hand if you can't hear me speaking because then there wouldn't be any logical. Anyways, it's always good to know that my equipment's working.

So we have a fun show for you tonight. We're going to talk about something kind of new and kind of interesting. I've talked about this bunch of times, probably. We're hearing this a few times. If you haven't heard it yet, which is all about the mitochondria and the thyroid connection, and how you can really get people who have fatigue-related problems better quickly based on labs in an efficient way that really works, that's not kind of some fake-out thing.

Let's talk about me first. We have one slide on me, minimal. I am Dan Kalish. I hope that you are new, you know, maybe, or maybe you've been doing these classes for a while. I am now lead faculty for IFM's Practice Implementation Program. Run the biggest honor of my career to be able to work with IFM. Honestly, never thought I'd be able to be on the faculty for IFM. What that's pretty amazing. You know, it wasn't even a career goal. I thought it was like beyond what I could ever achieve. So it's so exciting. It's the most amazing group of doctors in the world. I get to go to all the faculty meetings at the conferences, and it's just, it's just the greatest group of human beings you could ever meet. So it's a lovely experience for me.

I have this other thing going on in the last couple years as well, which I'm working with Dr. Richard Lord. So everything I talk about tonight is straight out of Dr. Richard S. Lord's brain. He wrote this book, the book on laboratory evaluations. This book is kind of out of print, you can't really get any more. And anyways, what we're talking about tonight is not in the book. We're talking about tonight is the new cool stuff that Richard's been doing. And so Richard is the lead scientist that developed organic acids testing, the GI FX test. He's the scientist that is behind what we now call the Nutri-Vaal or the Ion Panel. The idea of testing fatty acids and organic acids all came from his brain. He's still alive, and I work with him every Monday. And then every Tuesday, when I teach classes for the training program, I teach everybody what Richard just taught me. So now the Kalish Institute training program is really morphed in the last couple years to be the, it's kind of like the Richard S. Lord Institute because I spend all day one day learning from Richard, and then all day Tuesday, it just gets dumped into the brains of all the students. And it's what Richard wants. It's a wonderful experience for me. And again, who would have thought? If you don't know who Richard is, it means that you're young, and that's a good thing that you're young. The old-timers, when they hear that I talked to Richard every week, they're like, "What? You talk to who? How did you figure that out, kid?" Anyways, I'm very, very fortunate to be able to do that.

I've trained a bunch of doctors, and people always like to know this little personal tidbit thing, you know. So I actually did spend two years in a monastery, shaved my head, and you know, did all that kind of stuff. And it was probably one of the better experiences of my life. Now I'm out in the world in a worldly manner, you know, doing worldly things.

So tonight, we're going to talk about hypo metabolic patterns on organic acids. This is new information for most of us. We'll review a bunch of labs. I'll keep flashing back and forth between the screen and the labs. We have a bunch of case studies that I pulled out from last week's classes as well, so you can see a little bit about how the training program works and how we interpret labs in class. And the themes here are the role of environmental toxins in weight gain and fatigue, as environmental toxins damage mitochondria, and then how the thyroid and the mitochondria interact to conspire and cause weight loss resistance. And then this new breakthrough discovery of Dr. Richard Lord's about what a hypo metabolic pattern is and how we can see it on the testing. How exciting for him, you know, to have invented this test, you know, 35 years ago, and then to see new applications for it. It's pretty cool. You know, it's funny because every Monday, I really do spend all this time with Richard, and uh-huh, it's like having this book come alive in an older Southern gentleman who can talk to you and tell really good jokes and is really a wonderful man. It's just like, you know, and I thought at the age of 54, I kind of had had my time of learning new stuff. And the work I've done with Richard in the last few years has been the most exciting of my professional career in terms of learning and and just realizing that the learning process just never really ends.

Okay, so let's jump into it. And this, I'm gonna slip through the slides kind of fast, just, you know, kind of make a few points here so we have time to go through some labs and actually review some labs. So we can all agree there are a lot of chemicals in the environment. If you could count them, 80,000, 82,000, something like that. And there's probably more. Who knows? There's probably a hundred thousand we don't even know about that people have made. And you know, there's pesticides, hundreds of them. Every baby, they measure this. The CDC, Centers for Disease Control, measures this. How depressing that job must be. Every newborn baby in the United States has somewhere between 50 and 70 toxins at birth. We used to have this fantasy that the placenta somehow protected babies from toxins. Wrong. You know, so pretty much every American has somewhere between 120 and 700 toxins in their body. It's everybody that we work with has this problem. It's just a matter of how good are their detox systems to handle the toxin load they're in there. No, there are no longer toxin-free individuals, at least in the United States of America. And that may be true for the entire world. Okay, it's just everybody that you work with has some kind of environmental toxin burden. And what happens is these toxins cause oxidative stress, as you know. They trigger inflammation. And inflammation, and you know, is basically oxidative stress. And so if you cut an apple in half and it looks all fresh and nice, after a few hours, it's starting to turn brown and starting to oxidize. Our tissues inside our body go through the same process. The ox, and generally it means that they're wearing out and not doing well. And it turns out that certain tissues in the body oxidize really readily, and certain tissues are kind of resistant to it. And unfortunately, there's a lot of damage that can occur from environmental toxins directly assaulting the mitochondria.

And then this is just a total aside, but I just think it's an interesting little factoid. Like, why does the apple turn brown? Well, it's oxidizing, and there's not a lot of antioxidants in the white part of the apple, right? If you cut a mango in half, you can't really cut a mango in half because there's a big seed in the middle, but if you try to cut a mango in half, you kind of cut it, you know, in half, sort of, and you leave it out for a few hours, it doesn't turn brown because the mango, which is bright orange, the antioxidants are in the actual flesh of the fruit. Okay, so I don't know, that's kind of an interesting thing. With an apple, the antioxidants are in the skin, so the inside of the fruit doesn't have a lot of antioxidants. I don't know what that means. So that means you should go eat a mango or what? But I like mangoes a lot, and I think that's kind of my pro-mango argument there.

So here's your mitochondria on the upswing, you know, when you have a happy mitochondria. And what is it doing? It's powering the cells. It's making energy. One of the main reasons why we breathe, if not the main reason that we breathe, is to provide oxygen to the mitochondria. So if you're ever wondering about how important the mitochondria are, I have a little exercise that I do with patients now, and I think this is funny. It's a little wiseass, but it kind of proves the point. And to save time, I say it in a very specific way, and we can all do this now. Just do stand-up or take a breath, or just relax for a second. We'll do the exercise. So the exercise is, you take a deep breath in, you breathe all the way out, and then you hold your breath out. See how long you can hold your breath out. It's faster than holding your breath in to get to the point where you realize, "Wow, I really better breathe right now because I don't have enough oxygen." And why is that oxygen important? Why do you even care about oxygen? Because the oxygen that you're breathing in goes to the mitochondria of the electron transport chain, and it makes all this energy. Basically, if you think about it, it's like a furnace. You're taking protein, carbohydrate, and fat and breaking down those food molecules and releasing the energy from those foods. But you have to have oxygen in it, just like if you're making a fire in a wood stove, right? The, if you don't have airflow in your fireplace, you know, if there's a deprivation of oxygen, there's no oxygen, then there's no flame, right? You're like trying to get a fire started, you flame it, you need oxygen to release energy. And that's really true for the human body. So if people are not breathing well, and that's true for most of our patients, they're not going to be getting enough oxygen for the mitochondria to work properly. But what we're going to talk about tonight is not breathing exercises, but about how they might, excuse me, how the mitochondria can become damaged.

On the other side of the diagram here, you have a damaged mitochondria, which instead of having a lot of energy being produced, has just a tiny little bit of energy, and instead of having very few free radicals, has a lot of free radicals. Okay, so when the mitochondria becomes damaged, it's not functioning as well. You end up with a lot of free radicals, which in turn generates even more oxidative stress. But what we're worried about in general is not like the damaged mitochondria, but how it gets damaged. So environmental toxins come in and hit mitochondria, very sensitive mitochondria, and physically damage it to the point where it's not operating properly. Back with a patient population we're going to look at tonight, there's so many hits to the mitochondria that there's destruction of mitochondria. They're not only damaged like this one over here, but they're actually dead. They're gone. They've been destroyed. I don't know if you can kill a mitochondria, cause it's not really a cell, but you get the idea, right? They're physically no longer present. And that's the definition of a hypo metabolic state. Not just that the mitochondria are messed up, that's like a garden-variety cell energetic problem, but that the mitochondria are actually gone. Fascinating. And you can see it on the labs, and there's all kinds of scientific evidence for this too. I'm not going to go into it because, um, I don't understand it, to be honest. But, uh, Richard Lord has all this stuff. If you're desperately dying to know about it, you can email, I guess, me. Maybe I don't even really have all the research ties. We have to just kind of trust it. Richard's actually been researching this for 35 years. And so when he talks about mitochondrial retraction, or I talk about a hypo metabolic state, it's in the scientific literature, as well as being represented in the labs that we're looking at.

Okay, so the adrenals play a role, but we're not going to talk about the adrenals tonight, other than to say I do a lot of adrenal or HPA axis programs to reset the HPA axis, deal with adrenal exhaustion, adrenal fatigue, HPA dysfunction, whatever you want to call problems with the adrenal glands. And we're not talking about that tonight, other than to say that in people that fail with adrenal programs, in other words, in the patients that I've worked with where the adrenal program offers no benefit, no relief of symptoms, I found a hundred percent, nearly, nearly a hundred percent of those people are hypo metabolic. Meaning that they have an adrenal problem, yes, but perhaps more importantly, they have both a thyroid and a mitochondrial problem. And it does seem to me that the people that have what we're talking about tonight, this hypo metabolic state, this weakened mitochondrial system, and a messed-up thyroid, don't do real well on adrenal programs. So right off the bat, if you're in practice and you got a bunch of patients that you try adrenal protocols with and they really didn't help much, you might want to, you know, run organic acids tests and see if they're in this hypo metabolic state.

So thyroid is important in regards to what we're talking about. And if you have, I don't know, like if you have like a hundred doctors in a room and you just say, "What is the thyroid do?" You know, someone's gonna say, "It regulates basal metabolic rate," because that was in some textbook that we all studied, you know, on a ton, I'm sure on a ton of exam questions, whether you went to medical school or chiropractic college or naturopathic college or acupuncture school, right? It's just everyone kind of knows that thyroid regulates basal metabolic rate. This is one of the things that I read does. And then another way to start to think about thyroid in regards to mitochondria is, you know, we all have these kind of hormone action, you know, kind of like reflexes. So like if I say insulin, you're gonna think blood sugar regulation. That's probably the first thing that you think. I say insulin, you say blood sugar regulation. I say testosterone, you might say something like sex drive or, you know, increased muscle mass or something like that. Or, and if I say estrogen, you might say, you know, female reproductive hormone, cell growth. If I say progesterone, you're going to say it's a pro-gestational hormone, promotes pregnancy. So, you know, we have these kind of quick associations that we make about, okay, this hormone is responsible for doing that. And then thyroid, again, it's like basal metabolic rate. But when, when we say basal metabolic rate, whenever you really mean, like, what is the thyroid regulating? If estrogen is regulating, you know, female hormone, female reproductive stuff, and insulin is regulating blood sugar, the thyroid is regulating metabolic rate. That's just a fancy way of saying the thyroid is regulating the regulating the mitochondria because the mitochondria are carrying out this metabolic burn, right? So, and, you know, when I ask this question, we don't have time to do it in this group because there's so many of you, but when I ask this question in a small group of doctors, no one ever gets that answer right because we just don't think about, we think about thyroid and basal metabolic rate, and everybody knows that, everybody memorized that, but you're not really thinking what's carrying out that metabolic process. So the thyroid is regulating mitochondria, like estrogen is regulating cells in the uterine lining, like insulin is regulating the blood sugar response. Okay, so or you could say insulin is regulating, you could break it down to a cell if you want, or like, um, like epinephrine and norepinephrine are regulating neurons, the actual boots-on-the-ground stuff that's making that thyroid's mission of regulating basal metabolic rate happen, or the actual mitochondria. So it stands to reason, if the mitochondrial system is weak or hypo or underactive, you're going to have a weak or hypothyroid situation. The more you think about it, the more you kind of have to have these two things together. So you'll see with the more and more and more severe hypometabolic people who have damaged mitochondria, you'll see a more and more more high likelihood that they're going to be hypothyroid and have an underactive thyroid. And so again, that fail on an adrenal program, think about the mitochondria patients where you diagnosed they have a thyroid issue, but the thyroid hormones didn't really solve the whole problem. Very likely have a mitochondrial issue.

Okay, isn't that amazing? Doesn't that make so much sense when you just think about it? You're like, "Wow, why didn't I think of that?" So obvious. In fact, that question that I ask is so obvious that people, you know, sometimes the really obvious questions are hard to get right, you know, because we have so many assumptions around things. And, you know, I'll tell you one thing I've learned from Dr. Lord is, um, to ask the right questions. You know, you know, to really think about what you're doing and and then think through, "Well, wait a minute, if this thyroid is under active, what is that thyroid not regulating properly? What system is down? Oh, it's metabolic. It's metabolism. Oh, it's mitochondria that are controlling this whole show." And so this obvious overlap between thyroid and mitochondria obviously makes sense. You actually already knew that, but we just never put it in those terms.

So you're gonna take fat and carbohydrate and protein, hopefully mostly fat and carbohydrate, and burn them up for fuel within the mitochondria, within the citric acid cycle, and eventually, if you have enough CoQ10 and enough magnesium, enough, remember, oxygen, you're gonna make ATP. And if this process is broken in any phase, in any place, you're not going to have enough ATP, and patients are going to complain that they're tired. The number one complaint is, my in my clinic is that people are tired. Pretty much every patient that I see, 99% of them have a complaint of fatigue, and it's almost always one of their top complaints, or top three or five. So this is a problem that we see in practice, and you need to learn how to address it all the time. And I want to show you on the labs, like the way that that can actually, in a really simplified manner, okay? You don't even have to guess, you can do it based on the test.

So toxins, we're worried about toxins are damaging the mitochondria, you know, so obviously there's a whole another element of treatment here, which is to detoxify people. We don't have time to talk about that tonight, other than to mention, you know, that should be part of the program as well. There's detox pathways, phase one and phase two. These need to be assessed and addressed, and that's a big part of fixing your mitochondria because the toxins, otherwise, if they remain, are just going to continually damage the mitochondria. You don't want that. So phase one is based on B vitamins, glutathione, the key antioxidants like C and E. Phase two liver detox based on sulfur-containing amino acids. So these are also assessed on the organic acids profile. I can show you real quick how we do that and we get to that portion. All right, okay.

So now we're gonna pause for a moment for a brief commercial introduction, you know, interlude here. So we're starting a training program in like a week. You should sign up if you've been thinking about it for a while. You get to do this fun stuff with really cool doctors. This is going to be the rocking group of the year. September, we'll have another class going. In November, if you're not quite ready next week, then join the November group. But we're really on a roll right now. We got Richard Lord teaching stuff through me at the highest level. We have a really great curriculum. I just released this whole new Fundamentals of Functional Medicine course, which is part of the training now. It's all this basics on clinical nutrition. We have a lot of really great stuff going on. And I'm pretty excited also to just show you real quick what the classes look like. So we have, I've built over the last 20 years a whole series of different things. So one of them is this community, which is a massive world of software that has, you know, houses classes and it has, you know, the other practitioners that are in here. It's like an internal Facebook kind of. And within this, we have a case study library with a couple thousand case studies. So let's say that you're curious about mitochondria, apropos of what we're talking about now, you can just go and look at mitochondria. Or say, "Oh, this is your thyroid." How about that? Type that into the case study. It's the wrong button there. There we go. And then thyroid case. This is a discussion in class. This is from the module. Case study number 443 is the thyroid or the adrenal, the primary problem. Okay, we have thousands of case studies now, covers pretty much every situation you're ever going to see. And each of the case studies is in a video format. It's also transcribed, which is pretty cool. So we have that on the clinical training side. On the business training side, we also have within the program. Let's say you want to know what's legal issues, you know, and you're having a legal issue and you want to kind of investigate a little bit. Oh my gosh, well, we have Michael Cohen discussing legal issues in integrative medicine. We have advanced clinical rounds recording about legal. Again, just like endless, endless hours, like literally thousands of hours of content here on anything from mitochondria to legal issues. So that's the community feature. Then we have the regular curriculum that rolls out, which is pretty incredible as well. And that's, you know, like a one-year class basically on how to do all these things. And then we have the weekly calls. And I'm going to show you a weekly call right now, and we're going to do a quick case study. So I do all the teaching myself still, which is cool. And then if you join the course, you get thrown into a small group of doctors, and we review cases. And so this is from last week, the 5 p.m. call. Maria, Dr. Maria sent in these labs. Talk a little bit about the patient here first, and then we can look at the actual tests. If it's a GI test that we reviewed, and I'll get to the organic acids when a second, that should be one in here. Let's see. And in this case, I think it also included, there's a couple of GI tests. So we looked at a couple of GI tests, talked about that for a while. And then the patient, I think it also submitted. Oh, no, sorry, that was just a GI case. Okay, so then we reviewed and talked about what the protocol would be. Here's the next case. Kerry, one of the doctors in the class, submitted, talking about a patient who's on Synthroid and Zyrtec, has got chronic skin problems and depression and anxiety. Did an adrenal panel, we went over that. Did the GI test, went over that. And then let's look at the organic acids. I'm pretty sure there's one right here. Yeah. And then they did an organic acid test. So by, ooh-ooh-ah-ah, you know, each case is anywhere from five to 15 minutes. We review them all. And then here's the organic acids. So on the organic acids, what we're looking for, and if this was a regular class, you know, in part of the training program, we'd actually be talking about the patient and designing protocols. So what we're looking for for a hypo metabolic state is more than six markers out of the first 21 that are low. More than six markers out of the first 21 that are low. Now, this patient is not hypo metabolic. You can see the majority of the markers are high. That's a normal mitochondrial damage situation, not the exaggerated one that we're talking about tonight. Okay, and again, if the, if more than six of the first 21 markers are low, it's very likely that you have a hypo metabolic state, according to Dr. Lord, who's been obsessing on this for 40 years. Here's Verona submitted a case. Here's a good one. It's a little bit cleaner copy. So let's look at this real quick. So this is an organic acids class test that we looked at last week. And in regards to, we're talking about tonight, if you have six or more of these markers of the, of the first 21 markers or low or undetected, then you have a hypo metabolic person on your hands. If you have a pattern of numbers that are super high on the organic acids markers for the mitochondria, then you have the regular kind of garden-variety cellular energetic problem that still causes fatigue. And you can see with this particular patient, all these high markers here. So that's going to be blocks within the mitochondrial production of energy that lead to increases in various compounds. And then you want to work on the mitochondria. But, well, we're going to look at tonight, and I'll show you one example right here. This is Pam, one of the doctors in the class, made this one. And here's an example of a hypo metabolic state, kind of extreme. But of course, DL means underneath the detected limit. So we're going to add up how many of the first 21 markers are low or undetected. One, two, three, four, five, six, seven, eight, nine, ten, eleven, twelve. There's a little too easy. But anyways, twelve. So we're already past six, right? Thirteen, fourteen, fifteen, sixteen, seventeen. So out of the first 21 markers that look at cell energetics, there were 18 that were low. So that's an extreme example of a hypo metabolic state. And what does it mean when these are, there's so many of these markers that are low? Okay, well, funny you should ask. Let me show you here. I'll sign up for the class. Just sign up. We're gonna have a really great group. That's the end of the advertisement part. Oh, and you get about a week to make up your mind, but sign up.

Okay, so let me just show you here the thing here. So when you see these high markers on the test, it means that there's a block. Like, for example, if there's a block right here, then citrate is gonna go up, and then you're going to want to give a specific nutrient to make that pathway clear up again. If there's a block right here, then these other markers are going to build up. So we see a high level on organic acids test, it means there's a nutrient deficiency that you can fix. And the super, super important ones that you should just know off the top of your head, if someone says mitochondria, what's the most important, you know, most most important stuff for the mitochondria to work properly? There should be three things that just pop into your head like immediately. And let me write these down for you so you get them. So the person says, "Okay, I got a mitochondrial problem." Well, you see these high markers on the lab, and you're like, "Oh crap, what am I gonna do? I don't know. I don't know what I'm supposed to do." And then take the organic acids class. Didn't sign up for his class yet. I don't know what to do. So you would think, first of all, oxygen. Number one. Why? Well, try holding your breath. How long do you last without your breath? Right? You have to have oxygen to make energy. You have to have it. So that's breathing exercises, that's whatever you need to do to get people to figure out their oxygen needs, right? And then right after that, you're gonna think magnesium, because magnesium is involved in every step of energy production. And then you're gonna think good old CoQ10. So oxygen, magnesium, CoQ10. Those are the essential things for the mitochondria. When we get to designing programs for rebuilding mitochondria, we can expand on that, but these are the three Biggies, whether the patient's markers are low or high, wherever they are, mitochondrial problem, oxygen, magnesium, CoQ10. Okay, all right.

So let's pick it up again here. Class starts September 25th. Here's our liver markers. So we just briefly talked about phase one and phase two. Don't want to forget about this because you need to address the liver when you're trying to fix the mitochondria, otherwise toxins are going to continue to build up, right? And that's basically what this slide that says. So I'll show you one of the organic acids, how you check detox pathways, will show you about mitochondrial health, and we're gonna just do that real quick, and then we'll come back and we'll look at the hypo metabolic patterns. So it's just really not as hard as it looks. You know, I was talking to Dr. Lord about this on Monday. I'm like, "Richard, people don't understand these tests. How is anyone gonna get better if doctors don't understand?" And he just told me, he just said the most beautiful thing. He said, "Dan, they, the problem is my problem is that the more you learn about this stuff, the more you realize it's really helpful to learn more stuff, but then you have to get started. If you're a doctor, you can't just wait around until you understand everything and then start helping people." So Richard's point was that even if you do the basic things, people are going to get better. So if you just give someone some liver support, tell them to breathe deeply, give them some magnesium and CoQ10, they're gonna get better. If you understand that depth of mitochondrial patterns that we're talking about tonight, then it's even okay. But the basics work. Oxygen, magnesium, CoQ10, you know, breathe, take your magnesium, take your CoQ10.

So if you want to get a little bit more sophisticated than that, remember the first 21 markers here are all sort of referendums on your mitochondria. So that includes fat metabolism, carb metabolism, energy production, and then the B vitamins. The B vitamins on the next page here. Now, if you're running Nutri-Vaal instead of these particular panels, this is an organics profile from Genova. Genova also has Nutri-Vaal, and with the Nutri-Vaal, you can make the conversion. You just got to kind of do a little, it's like a language conversion. So they have all these same markers. They're the B vitamin markers. They're just like the ones before on the on the other formatted, in the test format, the other way. I think they even have like a little thing that gives you a clue about CoQ10, etc. And see, it's just a little easier to read it on the other test just because of the way the test is formatted. But you can do it with this one as well. And here, instead of lactate, it's lactic acid. Instead of pyruvate, it's pyruvic acid. Instead of beta-hydroxybutyrate, it's, you know, butyric acid. And they, etc., etc. And instead of citrate, they call it citric acid. Instead of isocitrate, it's called isocitric acid. Instead of alpha-keto glutarate, they call it alpha-keto glutamic acid. So if you see a, they call it, uh, itaconic acid. So, uh, malate, it's malic acid. So these are the exact same markers. Instead of a type of acid, it's adipic acid, suberic acid, etc. So if you look at the form, the the version that I always use here, you can't, you can transfer this over, right? It's the same markers. Like here's your citrate, instead of citric acid, your isocitrate, bubble of it. So it was, I'm just so used to these. It's and then these are all grouped in the easier to understand way. So in the first 21 markers, more than six are low, you have a hypo metabolic state. If you see a whole bunch of these markers that are high, then you have a nutrient depletion state that you can fix. Is what most organic acids are intermediates or end-stage metabolism of energy. Primal to end-stage metabolism of energy production. High levels of the intermediates is typically trouble. Low levels means there's not enough amino acids, which means they are not enough components to convert into metabolites. So in other words, when we see these really low marker tests, they don't even have enough mitochondria. They don't even have enough amino acids to make these reactions move forward. Mitochondria consume 90% of the oxygen used by the body for oxidative phosphorylation, and oxygen serves as the ultimate electron receptor. So you don't really think about, well, like think about this way, like if you think about gut repair, there's a lifestyle change you want the patient to make. Eat better food that's, you know, anti-inflammatory. Don't eat pro-inflammatory food. Get on a gluten-free, dairy-free diet. You want to fix your gut. So you've got a gut problem, you're thinking lifestyle changes, better food. If you have a stress problem, you're thinking other lifestyle fixes. You want to meditate or do something that's for, you know, relaxing. If you have a mitochondrial problem, the lifestyle change is to teach them breathing exercises so they get the oxygen they need. Otherwise, you're not going to get their mitochondria working. Okay? And then there are also some, some key nutrients like carnitine that play into this. And the basic organic acids testing, I'll show you how all that works. When I talk about tonight is a little bit more about the advanced work because this is hard to get your hands on this kind of information, which is what happens if you've got damage to the mitochondria and you need to rebuild the system. You need to build more mitochondria. The fancy-pants name for that is mitochondrial biogenesis. You know, build more mitochondria. You want to repair the ones that are still there, restore the damage, you want to get them all to work properly, but you need to get more going. And here are the key nutrients for correcting a hypo metabolic pattern: freeform amino acids, CoQ10, something called PQQ, which is specific for mitochondrial repair, B vitamins, some kind of combination formula, tryptophan, magnesium, and oxygen, right?

So let's look at an actual lab and then a protocol real quick so you can see how that would roll out. And remember, you can do this with Nutri-Vaal, you just have to kind of reinvent them a little bit because the formatting is different, but they're the same markers. So let's find a, let's find the next one of these sample ones here. So these are all actually taken from class. Al Keys, a doctor in the class, has a patient. Top complaints: joint pain, body aches, fatigue. And here's the organic acids. So fatty acid metabolism, all three markers are low. Now, typically with the interpretation of organic acids, you would say that's normal and fine. Typically, you would think if these markers are high, there's a problem. So if these markers are high, it indicates that the person has a carnitine deficiency. If these markers are low, and you see six or more total, more than six total low, then you're dealing with a hypo metabolic state. That means that this is a problem because there's not enough mitochondria to even register a reaction. So when Richard originally designed this test, Nutri-Vaal, organic acids, whatever you want to call it, the only thing they were really thinking 35, 40 years ago was if there's a high marker, there's a problem. Now the science has come along so far, we realized if there's enough low markers, it's an even more catastrophic problem. Kind of makes sense in retrospect, took like literally 30 years to figure this out. So here's three lows, four, five, six, seven, eight, undetected, that's nine, undetected, DL is undetected, that's ten, eleven, twelve. Okay, we're already past six. So this is a hypo metabolic patient. They don't have enough mitochondria to even mount a response. And we're seeing a cluster of low levels, more than six that are lows. Okay, again, if there's high markers, you're looking at nutrient deficiencies and blockages, you know, nutrient problems that are blocking mitochondria from working well. If there's more than six that are low, you're looking at a hypo metabolic state. And that carries over to these nutrient markers here as well. Another one, two, three, four, five that are lows. So we're way beyond the six lows required. So this is a hypo metabolic patient. So the, say you get this lab back and you're like, "I understand why you're so tired. You have damaged mitochondria, and there's not enough mitochondria." You know, either, "What are we going to do?" Okay, well, we're gonna give them an exercise, a lifestyle change, right? So what's the lifestyle change? And isn't it lifestyle change? Isn't functional medicine the whole point of functional medicine? Lifestyle change. Breathing exercise, whatever you want to do, some kind of a breathing exercise so they breathe more deeply. But they got to really do it. You can't just show it to them and then they walk out and they never do it. You got to convince them to do it.

And then let's look at the actual supplements. So we already talked about CoQ10. Let us do it in order. Sorry, magnesium. And you want them on at least 400 to 600 a day, however you do that. More, maybe I'll put a question mark, maybe more, but that's like a minimum. With CoQ10, you want them on at least 200 a day. I mean, that's wimpy. Let's just say at least 400 milligrams a day. I'll put more because, hey, if that's not working, you might need to give them more. Have some people up to as many as a thousand milligrams a day of CoQ10. It gets really, really expensive. I wouldn't start anyone on that amount because it just costs a fortune. You need some freeform amino acids. Every company has a powder, and you want to dose it in a very specific way, about 7 to 10 grams at one time. So there's a bunch of research that shows this. And this is interesting because it's counterintuitive. Usually with amino acids, you want to spread them out so the absorption happens over the day. When you're trying to repair mitochondria, you'll get more mitochondrial repair if you do larger single dosages of amino acids. What happens is the body starts to uptake the amino acids using for its regular day-to-day stuff. And if you overload the body and you give this much freeform aminos at one time, that extra amount that's not used for cellular stuff in the moment is going to be used for mitochondrial repair. So very specific with amino acids. Don't dose them in a graduated way throughout the day. One big hit, 7 to 10 grams all at once, at least once a day. I'll put more. I don't know, it just depends on how sick they are and how much you need to give them. So they may need to do more. So magnesium, CoQ10, freeform amino acids. You can also use a combo product. And this is your Mito-Tone, your mitochondrial energy, your Mito-Vite, your Mito-Five is your combination product. All the big companies have them. Mito-Tone, that's the Douglas one. I developed that one. You want to be nice by that one, it'll make Douglas feel happy for me having developed it. These are all equivalent though. Mitochondrial Energy, that's designed for health. Buy from them if you like them, they're a great company. I love Jonathan Lozad. Doesn't get better than John Kalish. I, he's like a wonderful person. He's the man that started that company and a good friend of mine. And then Mito-Vite from Metagenics. I mean, without Metagenics, none of us would even be here, right? They were the premier, first out of the gate, functional medicine company. If you like Metagenics, buy from them. It doesn't really matter. You know, pick one of those companies that you like and get your combo product. I think if that, it's like a multivitamin for the mitochondria. Okay? And then PQQ, which everybody has, usually that's around 20 milligrams daily. Usually is spread out like 10 and 10, like that. You could do a little more if you have to. And then, uh, did I forget something? You feel like I'm missing it? Well, the B vitamins are in there. I feel like I actually, this might be about the whole list right here. Let's see. Let's go back to our handy PowerPoint slide. Oh, I forgot the most important thing. I always do that. That was a story of my life. I just forget the most important thing. All right, so this is quiz question time. All right, is major quiz question? Ready for this? You're thinking, all right, take a deep breath. If someone gets this right, I will give you, I don't know, like, I'll send you a free copy of, I'll send you a free calendar. How's that? If someone gets this right, so you type in, if you think you know the answer, type it into your little text box. All right, you ready for this? That's cheating. Pah, that's funny. Okay, Pablo just answered the question because he knows what I'm about to say. All right, Joe, no, it's like, that's so. The question is, what's the rate-limiting step in a synthesis of all proteins? Oh my god, you guys are getting it. Jesus Christ. Oh, that's even. Okay, all right, well, I guess the word is out. I used to ask this question, no one got it. The rate-limiting step in the synthesis of all proteins is tryptophan. And now there's like 10 people are running in tryptophan. That just cracks me up. I think you guys have been listening to my other lectures. The rate-limiting step, I rescind my my calendar offer because this is like people are cheating. You guys already knew all this. So the rate-limiting step, and this is like a, this is like a mega important thing. The most important thing in human repair is being able to fold proteins, make proteins, and fold them properly. We can all agree on that. It doesn't matter if you're making a brain cell, or you're making a neurotransmitter, if you're making a mitochondria, or you're making a hormone, you have to be able to take amino acids and turn them into proteins, right? And the rate-limiting step in us building protein in all tissues except for collagen is tryptophan. For those of you that didn't get the question right. So now, through this strange twist of fate, tryptophan, there's one bad batch made in all of human history in Japan. They had some bad filters, they're doing this fermentation process, those bottles were shipped to the United States, and like 20 or 30 people died. Strangely enough, I went to college with this guy whose mother was one of the people that died from tryptophan. So it was a really big deal when it happened. But this was like a hundred years ago, and since then, there's not been ever a problem with tryptophan. But a lot of companies don't sell tryptophan, and it's not in a lot of formulas, and you're not going to get the mitochondria to repair without it. So you have to have 500 milligrams of tryptophan, or oftentimes a lot more. Give it at sleep at bedtime, you know, if they have a sleep problem, and then combine it with the freeform amino acid powder. So give them like, you know, a thousand milligrams with the powder or something like that, and then give them another little bit at bedtime if they have trouble sleeping. And without that, it's like the secret ingredient in this whole thing. If you don't have it, you're not gonna be able to synthesize proteins, and most people are, you know, gonna need the tryptophan to rebuild. So combine it with a freeform amino acid and milligrams, and then plus, if you want another 500 or a thousand at bedtime, just depending on how sick the person is, you can regulate this. That is so funny that you guys all got that right. That just cracks me up. That just cracks me up. Richard, I have Richard Lord, if he could hear this, I'm gonna send him over a copy of this tape. He would be crying right now. He heard laughing or crying, he'd be so happy that you guys are actually understanding all the stuff that he's teaching me. So cool. It's like biochemistry 101, right? What's the rate-limiting step in the synthesis of all protein except for collagen in the human body? Like we should have all been taught that the first day of whatever school you went to. What, you know, tryptophan, tryptophan, tryptophan. And people are usually tryptophan deficient. They can't get it from their diet in the amounts that they need. So that's the key ingredient. And I forgot it. Look how, I mean, I'll put it last. This was important thing, and still in my brain that doesn't show up in the proper order, even yet, even though I know it's the most important thing. Okay, so tryptophan, essential, essential, essential. You have to have tryptophan to make this work. All right, enough of that.

So thyroid-related issues. It makes sense now, right? So you could have underactive thyroid, just straight-up hypothyroidism. You could have an autoimmune thyroid condition. That could be part of this. Generally, we're not talking about hyperthyroidism with hypo metabolic states. You should have an underactive thyroid, whether there's an autoimmune process or not, but it would be Hashimoto's or hypothyroidism, but not Graves' disease, right? Graves' disease would not make you suspicious about this because it's obviously a hyperactivity going on. So again, with suboptimal thyroid function, you've got all the same part and parcel stuff going on, right? You've got the fatigue and the insulin problems, you've got the.

Same triggers typically that are going to damage mitochondria are going to damage the thyroid. The person is inflamed, they have emotional stress, there's an infection, they're eating really crappy food, they have an insulin problem, they have super high cortisol, they have GI problems. Like, who doesn't, right? All these are going to kind of contribute to simultaneously damaging the thyroid and damaging the mitochondria. It's the same list of bad guys, okay? And inflammation is kind of the easy way to summarize all that.

The body's inflamed, thyroid is going to respond. You're gonna have all kinds of suppression of thyroid hormones and of conversion problems, right? So you've got a test incorrect thyroid. That's not really what tonight's class is about. It's a lot of really great courses on that. If you guys are interested, I could give my two cents on it sometime. But you've got to analyze the thyroid. Whether you're a medical doctor and you prescribe, or your acupuncturist or chiropractor and you do the herbal or nutritional support, or you do some combination of both, want to make sure that as part of looking at the mitochondria, you at least test the thyroid to see if that's an issue or not, okay?

And so let's look at a few more labs. We've got a few more minutes, and then I can look at a few questions here too. Let me see. I'll pull up the labs first. This is really important stuff. I'm glad you guys are into it too. Here's another lab. Let me look at questions. Is there's difference and impact on the mitochondria with hypothyroidism if it's caused by autoimmune? I don't think so. I don't think so. I think it's the same basic problem, you know, either way.

Oh, what about B5 and B6? Man, that's a good question, Everin. That's a really good question. Let's look at that really quick. Sorry, I'm gonna cut back over here. That's such a good question. That is such a good question. Where are we here? So there, every company carries something with B5 in it. The found a famous one is a metagenics product called CoQ-10 B5 B6. But okay, look at, look at this for a second. What we're talking about is making energy. Energy that fuels your brain, your heart, and your liver, and your muscles, right? Without this ATP, your brain stops working, your heart stops working, your muscles don't do anything. You're just like, catastrophic failure. You wonder how important it is? Try holding your breath, right? So what's really happening behind the scenes is, oh, we're taking fat, carbohydrate, and protein and breaking it down to fuel the citric acid cycle. And where does B5 sit in all this? Right here. So you ain't get nothing past this red line if you're low in B5. Nothing's gonna happen. You could eat the finest quality fat, you could be high carb, low carb, whatever. You could be like, getting the best quality protein on the planet. You could have enough CoQ-10 to fuel a racehorse. You could have enough magnesium for it doesn't matter if you don't have pantothenic acid or B5. It's sitting right here. See, acetyl-CoA. This is B5. It's in a sense, like this linchpin position here. Nothing's going to happen without the B5. So Everin, that's a really great question, okay? Because that's super, super important. And I was gonna say it's a little off topic, but it's a little subtle kind of question. But yet, you have to have B5. And typically, the B5 is going to be in a multivitamin. If they need more than that, you can give them like, you know, a 500 milligram B5 a couple times a day.

Oh, Jason, that is asking a question. How much overlap does this approach have for cancer patients? So, you know, like, I don't work with cancer patients at all. But and I listen to people that do. And so, um, all my colleagues that are real experts in this area, I just hear more and more and more about how mitochondria are tied in with cancer, more and more and more. And in fact, if when you talk to the science people about this, the really hardcore science people, they look at, they look at this. Let's go. This really messed up person here. The really serious science people that are investigating the connection between metabolism and mitochondria and cancer. So metabolic theory, right? Would say that this kind of a pattern here where you've got all these low mitochondrial markers is kind of a, honestly, a precancerous pattern. And you really study that stuff. So if you're into these metabolic therapies and the things around cancer, this would be a pre-cancer pattern. This would put this person at high risk for having cancer. And if you already have cancer and you have this problem, then, you know, you're kind of in the deep end of the pool. You've got some serious problems there.

Oh, and then the B vitamins, I just use the B vitamins that are in the combination mitochondrial product, plus I'll usually layer a multi on top of that, okay? And now there's a more complicated answer to that question, though, Jason, too. Which is that, you know, if there are specific markers that are off on the test, you might do other specific B vitamins as well. You know, can taking carnitine for high levels of fatty acid metabolites cause a hypothyroid state? Shouldn't be able to if you're dosing people properly. I would not think so, okay? And any of these companies that we're working with should have good quality products. No. And the three main companies that, you know, I totally believe in 100% through personal experience because I've been selling their stuff for 25 years, Pure Encapsulations, or Douglas, however you want to slice it, kind of the same company, Metagenics, and Designs for Health. I have long, long histories with all three of those groups, you know.

Alright, let's look at. Let me look at this one. I think because this question always comes up, I don't know why people always ask this question, but let me just answer it because I have an answer for it. Hang on a second. I have to get this other slide up, though, or it won't make sense. So Joe is asking this question, and I'm gonna add, I'm trying to answer the questions like I know that people ask all the time. And let me just show you here. Thing that's really cool about these answers I'm giving you guys is that, you know, honestly, like five years ago, I would have been giving you like, an answer like, kind of based on what I know. But now it's like a Richard Lord answer. And you don't even understand like the quality of upgrade that is. It's like going from an old beat-up 1982 Honda to a brand-new Mercedes 600 series car, you know? Like these are not just when I kind of think maybe that's what it is. It's a damn answer to like, oh, this is what Richard Daley, I mean, like the top scientists in our field think. So let me just show you this marker. These markers here. This question always comes up. So if the brain is inflamed and you have high kynurenate or quinolinate or any of that kind of stuff going on, you can give tryptophan, and there's not going to be a problem. It's not gonna make the inflammation worse at all, okay? I just, I know theoretically it might happen if you're doing, if you're doing a full. Now, if you just take someone who's really sick and give them tryptophan by itself, that's just stupid. You don't to do that. But if you're working with a patient in a holistic way, and you're controlling their inflammation, you got them on the right diet, you're working with the liver, you're working with their gut, the inflammation is knocking down, you can give the tryptophan. Again, if you just gave out tryptophan randomly to inflamed people, that would from flame brains, I'm sure most of them would get worse. But in functional medicine, from day one, we're doing these lifestyle changes. Well, I'd say the first lifestyle change, and I really realized this today in practice because this woman said it to me, basically, is that when they meet you, and you are a healer already, they're less inflamed just from meeting you, and they take a deep breath and they realize things are going to be okay. So right off the bat, inflammation is down. You put them on a gluten-free, dairy-free diet, inflammation is down. You put them on an adrenal program, inflammation is dropping down. You get the gut fixed, inflammation dropping down, the liver. So while we're doing this metabolic correction, we're doing all these other things. So the inflammation in the brain is dropping like a rock, and then you're not going to ever have problems with tryptophan again. If you gave tryptophan out randomly to sick and people and didn't do the whole healing vibe thing and get them on the right diet, then who knows what happened. They could, you know. But I've never seen that happen. If you're doing the complete picture, you know, you shouldn't have that be a problem, okay?

So then let's look at it. Now, if, for example, they have liver detox issues, which most of these people do, then you want to do some liver support. And N-acetyl cysteine is kind of standby, isn't it? 500 milligrams, and you give that, you know, two or three of those twice a day, and that's enough liver support usually to get by with this, okay? And that everybody is going to be able to take that much stuff. So you're not always be able to sneak in the liver support. But if you can, it's not a bad idea. All right, let me see. There are other great companies out there, by the way, that I didn't mention. I just don't have personal relationships with the ownership and with all the sales reps. So the three companies that I mentioned, I've known either the owners or the CEOs and sales reps from those companies, you know, since like 1992. So they're kind of like my friends. But there are other really, really good companies, okay? I'm not just saying those the only ones. I just don't know them as well.

I think we got. What if your carb, fatty acid, and energy production markers are normal or high, but your amino acid markers are almost all zero, and primary complaint is fatigue? So Beth is asking that. Yeah, yeah, you can use amino acids in those people as well. Well, they put it another way. That's, I mean, actually, is that there's a question behind that question. Let me just show you here real quick. Oh, man, I feel like Richard is giving me these superhuman powers. I really mean that. Like, I feel like he's just up-leveled my skills so much. So let me show you here. So we're talking about using amino acids in high dosages, concentrated amounts, 7 to 10 grams once or twice a day to build more mitochondria. Okay? That's like the theme of tonight. You can, and often should, use freeform amino acids. Just because the person's low in amino acids, that's a whole different problem. So actually, let me write this out, and we're going to end on this thought because this is like a kind of a cool and interesting thought. This is Beth kind of stimulated this question. Let me write it out here for you because I didn't really understand this until recently, and maybe you guys are missing this too. So there's, there's at least two ways we use nutrition. So there's a low level of magnesium. We give magnesium. Patient better. It's a basic deficiency. The person is physically low in magnesium. Can you give magnesium to someone who's not low in magnesium? Yes, absolutely you can. That could be my, you know, political slogan if I ever run for president. Yes, you can. All right. So then, by the way, that's not gonna happen. But the magnesium, just simple example. Magnesium is a vasodilator. So you got a patient that has migraine headaches. Who cares if they're low in magnesium? Just give them magnesium and see if their headaches go away. You're using magnesium like someone we use a drug. You're using it because you know it has this predictable effect of being a vasodilator. Much, apparently I can't spell. Okay. So are they low in magnesium? You don't care. You're just giving magnesium and the therapeutic dose so their headaches go away. Cure headaches, okay? But you're not treating low magnesium. So with amino acids, you think about it this way. If you're low in amino acids, yeah, yeah, yeah, you give them. You know, you give freeform amino acids. We're not talking about that. We're talking about using amino acids to force increased production of mitochondria. It's explicitly not a deficiency of amino acids. We're using this huge amounts of freeform amino acids so that your body starts to make more mitochondria. Now, are a lot of these people also low in amino acids? Yeah, they probably are. But they don't have to be. So another way of saying that is to say, you're running amino acids on somebody, and the amino acids are all normal, but they're in a hypometabolic state. Do you use amino acids? Absolutely. You're not trying to replace a deficiency. We're doing amino acids for an explicit purpose of getting more mitochondria to grow. Whether the patient is low in amino acids or not is irrelevant. If you have a patient with migraine headaches, you might use magnesium because it's a vasodilator and often relieves migraine headaches, whether or not they're low in magnesium. You don't care. You're getting a therapeutic effect out of it. And the way that they talk about this is that you can have a relative deficiency or an absolute deficiency. So a relative deficiency means that you're using the product in the therapeutic way, whether or not there's an absolute deficiency. An absolute deficiency means you're just low. So like if you're, you're wandering across the desert for three weeks, you are deficient in water, right? You're absolutely deficient in it. If you're doing a detox program and you're dumping out tons of mercury, you may be well hydrated, but you might want to give the patient extra water so they can dump out the mercury. You're not giving them the extra water because they're dehydrated. You're giving you in the extra water because you want them to dump the mercury out, okay, by sweating a lot or peeing a lot or whatever. So when you think about nutrients, think among these two categories. You can give magnesium or give amino acids if the levels are low. But you can have normal amino acids in a patient that has mitochondrial destruction. That could definitely happen. And you're gonna then use, then you have to explain to them, we're using your amino acid levels are fine on this test. We're using these freeform amino acids to build more mitochondria. And that's the whole point of the treatment that we talked about. So anyways, that was a really great question. I think Beth asked that one. Thank you, Beth. Let me see if there's anything else before we wrap up here. You know, for kids, usually you want to be extra careful. Usually base the dosing on body weight. So if the kid is like 50 to 100 pounds, usually you give a half of the adult dose. If the kid is under 50 pounds, usually it's somewhere around a third. If you're concerned or you're worried, just start really low and you can taper up, okay?

All right, everyone, thanks for attending tonight. Oh, and let's end on an up note because you're all now gonna rush to my website and sign up for the class that's starting next week. And, okay, I understand you're so busy. You can do September. I'll have another group in November. You can go sign up for that. All right. And if I haven't convinced you to sign up for class yet, then I will see you at the next free one of these. We do these once a month, usually, okay? We'll be in touch. All right, bye for now.