Transcription
Hello everybody. I am Dr. Dan Kalish, and welcome to our mentorship mini-series. This time, we're going to talk about amino acid treatments, which is a big subject, which we have a lot of classes on, and I'm going to try to give you a summary of the whole thing today.
When I sit down and look at my patient programs after the whole haze of the lab interpretation phase is done, and I talk to the patient, and I wrote the whole thing down, and then I send it to my staff, and I look at it, I mean, every single patient program I design has amino acids in it. And sometimes the programs are, you know, 75% combinations of different amino acids for different reasons. So this is a pretty important topic.
And I thought I knew a lot about this topic about 10 or 12 years ago. And then I met a scientist named Dr. Richard Lord, who is the developer, was the developer of, uh, amino acid testing originally in our industry. And he just kind of slapped me upside and down with some biochemistry. And actually, the last 10 or 12 years with Richard, I've learned more about amino acid treatments than I could ever possibly imagine. And to give him some credit, he was at the bench in the science lab running these tests for, you know, 40 years and saw a lot of them and trained a lot of physicians in them. So I, I have a lot of experience now, personal experience, and knowing all the training with Richard. And that's what I really want to talk about today.
So for those of you that are new, we're going to cover off on mitochondria, GI, and brain. Talk a little bit about depression, fatigue, anxiety, GI issues. And the way they have these structured, usually is I'll do a presentation, a little bit of a lecture, but try to keep it relatively short. And then start to show you some labs that we've picked out that have been sent in from mentorship students in the past couple weeks of my class. Look at some real cases that we've just worked on. We've got one that's a post-vaccine injury case that one of the doctors sent in recently to class. And then there's another one that's a rosacea, autoimmune, chronic fatigue kind of case. So we'll do those two designs and programs using amino acid treatments.
Before we get to that, I want to mention Rupa Health. We have, and I was just in my Rupa, what do you call it, you know, platformy thing a minute ago. I'm gonna just, I had it pulled up here. I don't know what happened to it. Um, so Rupa Health has done kind of for lab ordering what Apple did for the telephone. You know, so we used to have a phone that we dialed, if you remember, if you're old enough, or you push the buttons on. And then all of a sudden, we got, everybody's got one of these iPhone things now, right? It's pretty different. So the whole process of lab ordering is something that my practice struggled with for 25, almost 30 years. It's a hassle, it's complicated, and it's hard to do it well. And then Rupa came along and just kind of iPhoneed it. And they just turned it into a tech thing that works seamlessly. They do better customer service than my staff ever did. They do better tracking. They consolidate all the labs. It's easier to order from. It's a better patient experience. It's a good experience for my staff. It's a better experience for me. It's just kind of like a no-brainer. So if you're not using Rupa, check them out. You can look at that QR code in the corner there with your phone and, and QR the heck out of that. You get $100 off your first order if, um, you're a student of ours and if you haven't, have not ordered from them yet. Okay, so check them out. They're kind of a must-use in the current era.
And then if you're interested after this class in the class materials and you want to do more, we have our big 12-week amino acid course coming up. We don't do these very often. You can scan that QR code if you want to take this intensive. And I mean, it's intensive. This is a really, like, so much good information in this class. Like, it's, it's a couple years of my life I put into this class. We've got Richard Lord doing lectures, uh, by the hour on amino acids, who just mind-numbing science stuff. And then me talking about how to apply this to all kinds of different, different situations. So this is not a joke when we say this is an intensive class. This is like a lot of information. Just for those of you that really want to learn how to do amino acids, you know, come prepared and just sign up and make it happen. All right, so that's for you guys. When you get a, a discount here, you get a discount if you're watching this mini-series. Use the code mini amino 23. 23 mini Amino 23. You get a discount off the regular price on that. Okay.
Okay, so now let's get to the subject matter at hand. There's two really big subjects that you have to wrap your mind around in order to understand amino acids. And this is both very simple and very complex. So amino acids primarily, you know, in terms of life-sustaining activities, are involved in protein synthesis. So that is, amino acids are what we make insulin from, hemoglobin from, of every antibody, your entire immune system runs on amino acids turning into proteins. Okay.
Then there are the non-protein synthesis roles. The non-protein synthesis roles, they're totally different. So again, that would be something like making glutathione. The inflammatory response, we're going to talk about this. That would be something like the, the role that amino acids play in methylation. They donate all the carbons to the methylation process. So amino acids are critical for their role in protein synthesis. And you want to kind of separate that out in your mind. This includes enzymes like the ones we've all studied, the cytochrome P450 enzymes for detox, things like pyruvate dehydrogenase, which is what you use to regulate your blood sugar, right? To, you know, keep yourself from having problems with insulin, lactate dehydrogenase, all these different mechanisms that the mitochondria rely upon, that everything relies upon, is is based on proteins. So if you don't have all the amino acids present, it can't make proteins.
Then the non-protein roles are really specific. Like tryptophan makes serotonin. Everybody knows that. That's a non-protein role. It's a specific role of one amino acid. And when you learn this stuff, at least when I, I've seen this with almost everybody, including myself, when you learn this, you think, okay, well, tryptophan makes serotonin, so I'm going to give tryptophan to everybody that needs more serotonin. End of story. And we've all kind of glossed over the major role of amino acids, which is protein synthesis writ large. All proteins in the body. What proteins? All proteins in the body require amino acids.
Now, for clinical purposes, for the purposes of this class, really, we want to just kind of divide this up into three subsections. Mitochondrial use of amino acids. That includes things like making glutathione that protects the mitochondria. It includes using amino acids, free-form amino acids, in large dosages to stimulate mTOR. That's a really fantastic treatment that you can do. If you get free-form amino acid powders and you give them in the 8 to 10, 8 to 12 grams per dose range, you're going to stimulate mTOR, which is a wonderful thing to do. You don't want to stimulate mTOR in cancer patients because it stimulates cell growth. But for all patients that need to heal that don't have a history of cancer, stimulating mTOR can be really helpful with amino acids. And then of course, we use tyrosine. We'll talk a lot about today to stimulate dopamine production. And then the GI tract, you can use glutamine for GI tract tissue repair.
These are the 20 aminos that are just, you know, required to build proteins. So if you run an amino acid profile on someone and they're low in any of these aminos, you have to give them in order for them to make proteins. That's the primary role, right, of amino acids. So tryptophan, if it's low on an amino acid test, that means that this person doesn't have enough tryptophan to make serotonin. Well, yeah, but way more important than that, they don't have enough tryptophan to make any proteins in the body. Because you need all 20 of these amino acids to make every protein in the body, with the exception of collagen. Collagen is an outlier. Collagen requires just three. But if you forget about collagen, every other protein in the body requires all 20 of these amino acids.
You want to know a really strange fact? You use, every protein in your body except for collagen, not only uses the same 20 amino acids, but it uses about the same amount of each amino acid. It's not even like, you know, insulin has, you know, 10 times more tryptophan than hemoglobin or something like that. They're all using about the same. It's the sequencing of the amino acids that that makes the proteins function differently.
Okay, now here's a nice little snapshot. You could take a picture of this with your camera of, uh, non-protein functions of amino acids. Non-protein functions. So protein functions, you have to have 20. Non-protein functions, much different. Non-protein functions versus protein. You want to separate that in your in your mind. So if you run low on glycine, it's just a simple example. Let's say that you're the person is exposed to environmental toxins and they start to run low on glycine because they've kind of used that up. So you're not only going to have a problem with all the specific non-protein roles of glycine, which you can see right here, see the non-protein functions of glycine. Let me circle that for you so you can see. And this is a conceptual thing, but if you understand this concept, you're going to be so far ahead here. So glycine is required to make heme, creatine, bile acids, glutathione, nucleic acids, methyl group metabolism. And it, I mean, it's pretty important. These non-protein roles are really, really important. Like, I don't know how long you would survive if you couldn't make glutathione and bile and heme. Not very long. So these are very, very important things. But if your glycine is running low, you can forget about all this. You're not going to be able to assemble any proteins in the body. None of them. Because glycine is one of the 20 that you have to have. So if something forces the body to run low in glycine, you're going to have problems with your gallbladder and problems with your glutathione. But you could potentially have problems with all protein synthesis throughout the entire body. And that's why you see patients, and everybody sees these patients every day, that have everything wrong with everything. It's like their whole system is just cattywampus and falling apart. So low glycine could cause a hormone problem, a neurotransmitter problem, a guideline problem, a joint pain problem, an immune problem, anything that has to do with protein synthesis will be impacted if just the one amino acid is low. So you have to replace these, or the people can't heal.
And then we're going to talk, I guess, the, the focus of today, we're trying to narrow this down subject-wise, is to think really strongly about mitochondria and inflammation, and inflammation and cytokines, these categories. So there are inflammatory cytokines that are produced. Like in this particular example, we have on the board here, um, there's a virus. Viral replication is happening. And then in response to that, we're making inflammatory cytokines. So inflammatory cytokines require the use of tryptophan. And we'll show some pathways on that in a little bit. And that can cause some pretty serious depletion problems. So if you have a virus that you're fighting, I think there's one that a lot of us got recently, last few years, right? But this is true for all viruses. You're going to make inflammatory cytokines as a response to that. With COVID, it was this cytokine storm. It got pretty serious. A lot, a lot of people died from this problem. Um, and those cytokines require the use of tryptophan. So you can deplete tryptophan if you're fighting a viral infection. But then you can't make any of these amino, you can't make any of these proteins, because it's one of the 20 that is required. So that's a little confusing, but that's kind of what we're trying to talk about.
And the same thing with mitochondria. Mitochondria are impacted by oxidative stress. And oxidative stress can damage mitochondria. And you'll also see here, you can have a problem with a virus that's going to interfere with normal mitochondrial function. And mitochondria change quite a bit when they're, the cells attacked by a virus. So both brain through tryptophan depletion and mitochondria through the way that viruses attack. As if you want to study that in depth, there's something called the cell danger response. It really gets into depth on that. But the cell danger response shows how mitochondria in the presence of a viral infection start to do some pretty crazy stuff. Okay, they start to generate a lot of oxidative stress and cause a lot of dysfunction in the body.
So here again, we have pro-inflammatory cytokines, tryptophan, kynurenine. And we're measuring all this stuff. Kynurenic acid, or kynurenine. We're testing that. And we're testing for tryptophan. So you're going to be seeing on the labs, if tryptophan levels are low, or kynurenic acid is high, you've got a problem potentially here, right? If kynurenic acid or kynurenine is high, that's going to mean that there's inflammation in the body, which is depleting your tryptophan. You see that on the labs. And then of course, you want to, you know, reverse that.
There's also another one. Oops, sorry, hit the wrong button there. There's also another one you really got to know here, which is called quinolinic acid. So if you get enough inflammatory cytokines going, the kynurenine pathway gets activated. Kynurenic acid goes up. And eventually, you'll have high levels of quinolinic acid also. Okay. And that is a neurotoxin. Not good. Damages the brain. We're testing quinolinic acid. And the correction here is obviously to stop the cytokines thing from happening.
So when you see inflammation in the body, one of the main ways, if not the main way, that we stop that inflammation from being a problem is by making glutathione. You can make it. It's pretty amazing. Your body can't make vitamin C. Your body can't make a lot of antioxidants. But your body can make glutathione. And it makes it rapidly and in large amounts from three amino acids: glutamine, cysteine, and glycine. Those three come together and they make glutathione. And that glutathione is the ultimate protector of the mitochondria and the ultimate protector of the brain from the inflammation that we were just talking about a minute ago. And of course, we can measure glutamine, cysteine, and glycine, and measure glutathione. I'll show you all that on the labs.
And this is extra, extra important because if any of those are low, then what we are just talking about here, this neurotoxic cytokine problem, damages the brain. And the inflammatory oxidative stress type stuff also can damage the mitochondria. So mitochondrial damage, that's going to be a damaged metabolism, higher risk for cardiovascular disease, diabetes, things like that. If the brain gets damaged, higher risk for depression and anxiety. And we're testing for every one of these things. We're testing all these little bitty mitochondrial pathways. We're testing for the cytokine reactions in the brain. We're testing the actual neurotransmitter metabolites. We're testing glutathione. All this gets tested in the lab. And then you start to fix these things. But there's a universal correction here. If glutamine, cysteine, or glycine is low, you replace them. If glutathione is low, you replace it also. You can do all of these four things at the same time if you need to. And that's going to then protect the mitochondria and protect the brain.
And so here's a kind of more explicit version of the same thing. So here's our SARS-CoV-2 infection, which triggers gut dysbiosis. You get these gut microbial metabolites. And then you get damage to the gut lining. Okay. And so we want to test and correct the gut lining too. And the main amino acid that we usually think of in regards to gut lining repair and reversing leaky gut is called glutamine, which is also one of the ones you use for glutathione. But the dosages are quite a bit different if you're trying to do gut repair. And this is a nice little kind of tie-in here between the gut and again, we're back to our cytokine storm thing. It always comes back to this inflammatory response with all these different pro-inflammatory cytokines depleting things. And again, we use glutamine for gut lining repair. That's been around. I mean, the naturopath that trained me 30 years ago was using glutamine. And he learned about it in the 1970s. It's a pretty old-school naturopathic treatment.
Oh, you know why this slide is in here? We should almost have a quiz right now. And we could ask me like, why did you put the slide in, Dan? Okay, because this is a reminder for me to say that we should think metabolic. And so there's an article that just says, "Think Metabolic in Adults with Diagnostic Challenges." So if you have more complex patients, you should think metabolic. By that, we mean that you should, I mean, highlight this here for you, you can see it. Neurologists, or let's just say all of us. Let's say instead of neurologists, across that, all of us should consider the possibility of an inherited metabolic disorder in adults with neurological symptoms. Okay. All of us should consider the possibility of an inherited metabolic disorder in adults with neurological symptoms. So that would be anxiety, depression, fatigue, the common symptoms that we see all the time. And so when we're looking at these labs, you want to also have an understanding of how some of these problems can be genetically based and inherited. And you can even see on the labs, based on the ranges for organic acids testing and fatty acid testing, and how far off the normal range is, these labs come back, you can see suspected genetic conditions in these very same tests. And the tests that we're going to look at today are the Nutrival and Metabolomics from Genova Lab, and the Omics test from Diagnostic Solutions. And on either of those tests, they don't have this built into the test where they say, "Oh, that's a genetic problem." You've got to learn how to interpret the lab. But that's why we're in this class, right? So you can learn how to do that.
This is a slide that's meant to just sort of make you think, "Oh man, what is he even talking about?" So I have to get my glasses out because I can't see this. Oh, yeah. This is the mitochondria. That's what it is. So this is just a slide to say, this stuff is really, really complicated. And that any one of these mechanisms can go wrong. And that when you have a system that's this complicated, it's very possible that there's going to be a problem that's genetically based because there's so many enzymes floating around and so many genes moving here and there that it's easy for things to get screwed up when it's, when a system is that complex. I don't know, it's like the difference between, like, if you ride your bicycle around, which I just did today for an hour or two. I mean, how many things can go wrong with a bicycle? I mean, not that many. You can get a flat tire, the chain could break. But how often does your chain break? Like, never. You know? So it's pretty, pretty durable. It's pretty simple mechanism. But if I was driving around in like a 1949 Ferrari or something today that has a million different parts that could break, I mean, they've been much more likely that after an hour or two of driving around, it would have broken. So complex stuff is more likely to break. And there's nothing that gets more complex than the mitochondria. Okay.
Have all these different enzymes that are floating around. And there's this one that is my favorite. I talk about a lot called succinate dehydrogenase. And succinate de-, succinate dehydrogenase, that enzyme is right here. That's what it looks like. That's it. That's it. So it is the enzyme that you can, you can see if it's dysfunctional if succinate on the lab test or succinic acid is high. And we'll show some examples of that. Okay. That means that this enzyme is not working well. That means that the electron transport chain isn't working well. Okay. And so this is the enzyme that's very often damaged from environmental toxins and the inflammation and oxidative stress that comes with that. See how we're back to the same exact problem? Oxidative stress, which generates inflammation. Oxidative stress targets this enzyme and screws it up. And that's going to interfere with your body's ability to make energy inside the mitochondria because this enzyme is taking a hit. Now, there's many other enzymes get, get hurt. It's just, this is just showing you one example so you can see a visual on how that actually works. You can also have this process of enzyme damage that has to do with carnitine and carnitine moving around. Here's the electron transport chain again. Each one of these things is pretty complex.
And I want to talk for a minute. And we just have a few more minutes. And we're going to go look at some labs and try to tie this together for you. Um, here we go. Let's get into the brain part. Okay. So conditions impacted by dopamine. And it's all the common stuff we see every day, right? Way a person's overweight, they want to lose weight, they're tired, not have enough energy, they're depressed, they have a mood problem, they can't focus, they have addictive behaviors, compulsive behaviors, they just don't feel good about themselves. All those kinds of things. So when we're thinking about neurotransmitters and amino acids in reference to neurotransmitters, it's just like we were saying with the mitochondria, and just like we're saying with the inflammatory stuff, you're going to have three different factors here, right? You can have a deficiency that's due to stress. You can have damaged neurons. Again, it's the same environmental toxins that damage the mitochondria, damage your brain. It's not really any different. Oxidative stress is going to damage the neurons. And just like with the mitochondria, where you can have variations in those enzymes based on genetic factors, you can have variations in how well people produce dopamine based on genetic factors. That's a pretty common thing. So whether it's mitochondria or brain, it's basically the same. You can have a deficiency state of nutrients that you just don't have enough of what you need to make everything or to make the processes work. You can have damage to the structures from environmental toxins or oxidative stress. And then you can have genetic issues. And on the testing, you can tell the difference. This is, it's really cool. So there's specific markers that, that's what we looked at a minute ago, remember kynurenic acid and quinolinic acid. Those tell you that there's neural inflammation. That's so cool. You can see it. Okay. That means something's damaging the neurons. It could be long COVID. It could be an environmental toxin. You know, you have to do other testing to figure that part out. But then there are also neurotransmitter markers that will tell you if there is a depletion state. The metabolites will tell you if there's something that's depleted. And then the neuroinflammatory markers tell you if there's inflammation. And then if you learn how to read between the lines, you can see the genetic factors on these tests as well.
So now with the brain treatment, people always come to these, you know, and you want to have something that you can actually do. And I'm an advocate for something that, you know, not just wasting your time learning about this is kind of a cool pathway, but something you can actually do. So I want to have, by the end of tonight, you should feel like you could try free-form amino acid treatments for the mitochondria. And we'll get into those. And then you should start to think about using glycine and cysteine or N-acetylcysteine for glutathione production and to help also with the, in protecting the brain, protecting the mitochondria. And then tyrosine, uh, for sure, you should start to use tyrosine. And maybe Mucuna if you're kind of more advanced. So tyrosine versus Mucuna. These are what we use to boost up dopamine. Tyrosine, I would always start with first. And once you're familiar with how tyrosine works and you've used it for, I don't know, 20 or 30 cases, then I would kind of up it and start to use Mucuna. And then if you're going to get tyrosine to work to help with the brain, you got to have all these other nutrients, these sulfur compounds, you got to have B6, and you have to have folate. Okay. And then if you, if you've been using, let's say you're 20 or 30 patients into this, you've been doing this for a while, you're like, "Oh, I really like using tyrosine." Then you can start to up your, up your game a little bit and add in Mucuna. Mucuna is quite a bit more powerful for boosting up dopamine, right? And then we're going to test for all these things. We look at the labs. It should become a little more obvious. I'm going to skip through some of these. Yeah, let's get to this one. This one's good because this will be like a nice summary for you here. Okay.
So when we're talking about the beginning part of this class, we talked about inflammatory cytokines. And that is going to be related to both mitochondrial impacts and to impacts on the brain. So here you can see the quinolinate or quinolinic acid. That is that marker goes up when the brain is being impacted by inflammatory cytokines. And you make this stuff from L-DOPA, which you make from tyrosine. So go figure, you're going to deplete your tyrosine as you make more and more and more quinolinic acid. Just like you're going to deplete your tryptophan as you make more and more and more kynurenic acid. And then what happens is, if there's a lot of inflammation and quinolinic acid is high, you don't have a lot of L-DOPA going to dopamine, which is where you want it to go, or norepinephrine, or epinephrine. And so you end up with depletion of the brain chemicals because of inflammation. You see that's the same exact thing. So then you can pump in some tyrosine to start to correct this, figure out what's causing the brain inflammation, and then people get better. And then you'll also see these markers that we measure, homovanillate, also called homovanillic acid, depending on what lab company you use, and vanilmandelate or vanomandelic acid. And those are the urinary byproducts or the breakdown products of dopamine, norepinephrine, and epinephrine. And very importantly, there's an enzyme here. You see that where it says COMT? COMT. That enzyme there, can barely see that. Catechol-O-methyltransferase is named for what it does. It's so convenient. Catechol or catecholamine methyltransferase. It transfers methyl groups onto catecholamines. So this enzyme here grabs a carbon, kind of mushes it on to, or with a dopamine molecule, and it breaks it, metabolizes, makes the dopamine down. Okay. So that's the process of methylation of dopamine. And it turns it into homovanillic acid, which we then measure on the test. So if this enzyme's screwed up, if you have a methylation problem, this process doesn't go very well. Just to point that out.
And here's another blow-up of the same thing, but in a slightly different way. So here we have our tyrosine going to L-DOPA with B6. You're going to make dopamine. And then the urinary byproducts, homovanillic acid, vanilmandelic acid. And remember, there's this pathway down. Whoops, sorry, I drew that wrong. There's a pathway down this way to cytokine land. If your brain is inflamed, this whole thing gets disrupted. So if your brain is inflamed, everything gets cut, like here. Okay. And then all this gets, let me just draw out. This is all this gets messed up. And that's not good because then people get depressed and anxious and all these bad things happen to them. So glutathione is the master protector for all these. It protects the mitochondria. It protects the brain. It's found in all life forms, which means, you know, it's extra, extra important. If you supplement glutathione, you're going to help with the catecholamines. You're going to protect the brain. You're going to help the catecholamine production. And if the catecholamine, if the glutathione levels are depleting, you're going to deplete catecholamine levels. If the glutathione levels are depleting, you're going to have damage to the mitochondria. So glutathione is regulating both the brain and the mitochondria in this case. Glutathione is busy. Glutathione has a lot of work. It's detoxifying all kinds of neurotoxins all the time, all the time. And again, as we mentioned earlier, it's made from glutamate or glutamine, cysteine, and glycine. So oftentimes the supplementation here is using NAC or N-acetylcysteine along with glycine to bring up these levels. It's interesting, you also use cysteine or NAC to bring up low levels of dopamine.
So now I just want to mention this briefly in case you're wondering, because it's kind of interesting and it's actually clinically relevant. So tyrosine converts into L-DOPA, and it does that through this enzyme called tyrosine hydroxylase. So if your L-DOPA gets up to a certain level, or your dopamine gets up to a certain level, this enzyme can sense that, and it shuts down the conversion of tyrosine. In other words, you take a certain amount of tyrosine, it'll bring up your dopamine. If you keep cranking the tyrosine dosages up, eventually it won't raise dopamine anymore. There's a shutoff valve there. Your body goes, "Oh, there's too much tyrosine here. I'm going to not convert it into dopamine. I'm going to do other things with it." There's plenty of other things you can do with tyrosine. So if you're using tyrosine, you're not getting anywhere, the patient, it's not really helping them much, then you can use Mucuna. Mucuna is a plant-based form of L-DOPA. And as you can see in this diagram, it's one step past the rate-limiting enzyme. So Mucuna, L-DOPA, Mucuna will convert into dopamine freely. You know, just, it'll just keep going. There's no break on that. So that's good and bad. It's bad because if you screw up the dosages, it could screw up the patient. So that's why I'd say it's a little more of an advanced product. Um, but it's good because if tyrosine is not helping the person, you want to make the program stronger, you can use the, uh, Mucuna or herbal form of L-DOPA to boost it up. Okay. And that's a little diagram showing the same thing. And that's the same thing again.
Okay, now I'm going to mention one other thing. This is the whole slide I had on adult-onset metabolic disorders. So I just want to mention one of them. There's whole books written about this. Whole careers where people just study this. It's a pretty interesting subject matter. In fact, I joined like the International Metabolic Disorder Disease Organization that's based out of London a couple of years ago. And they couldn't figure out who I was. They made me fill out all these forms. It was like being questioned by the FBI or something. They're like, "This is Kalish's guy. He's a chiropractor." Like, they're really, really suspicious of me. It was kind of funny. I just wanted to like build or read their articles as well. But anyway, so there's whole groups of scientists that this is all they do. You can have adult-onset PKU. Go figure that. That's even possible. We all learned about PKU in school. Everyone thinks it's just for newborn babies. Absolutely not. You can have this in adulthood. And what we see in our functional medicine practice is a lot is very, very mild, very, very mild adult-onset metabolic disorders. Okay. And it's right here due to mutations in the phenylalanine hydroxylase gene. Some people just genetically don't do a great job of turning phenylalanine into tyrosine. So they're perpetually low on tyrosine. I have tons of patients like this. You give them tyrosine, they feel better. You stop taking it, they feel worse. You give them, you test them, their tyrosine levels are low. You give them tyrosine, they take it for months. It takes 6,000 milligrams a day for six months. And then they stop for a week and you retest them, and they're still low. You're like, "Well, that's strange." Okay, we take it again. Then you do it for eight months. This time, they just never get their tyrosine levels up because they, they can't convert it internally. Your body needs to be able to make tyrosine from phenylalanine for normal function. And a lot of people have a genetic flaw there. So those people just need to take tyrosine. That's just kind of the way it is. But that's one example of a genetic metabolic disorder that you can see on these tests. Okay.
Um, oh, then dopamine. Dopamine. We're talking about dopamine. So dopamine is super important. A lot of people are low in dopamine. And they crave alcohol. A lot of people that are low in dopamine crave activities that are kind of exciting, like downhill skiing or driving cars fast. Um, and this is a really old book, but it's a really good book. If you have a lot of alcoholics in your practice, I suggest getting this. It's got to be 20 or 30 years old, but it really opened up my mind to the connection between dopamine and alcohol, which is important. You can also have either neuron damage or, as we said earlier, mitochondrial damage from environmental toxins. I mean, alcohol could do this too, obviously. So damage to the neurons, just like damage to the mitochondrial enzymes, is going to mean that they don't function very well. And so we can use nutrients to re-establish normal function. That's kind of the whole point of this.
There was a pandemic in 1918, as many of you know, and, uh, the Spanish flu. And there was a neurological condition that developed in a large number of people after that pandemic 100 years ago. And in fact, they made a movie about this. If you, if you really, um, it's Robin Williams and Robert De Niro in the film. It's a really good film. If you haven't seen it, I'd recommend renting it. It's called Awakenings. I mean, it's kind of depressing. It's not a happy movie. You want to definitely, if you're not in a, it's not an uplifting film, but it's a good film. Okay. So you have to be kind of ready to handle a little depressing story. And the ending is horrible too. But I don't want to spoil it. But other than it's not a happy, there's no happy ending in this movie. But it's based, it's a true story based on this neurologist, it's quite famous, named Oliver Sacks. And they used L-DOPA to correct these people who had brain damage from the Spanish flu. Isn't that cool? I don't know if that's gonna happen from this pandemic, but who knows. And the interesting thing was that the programs didn't work very well because they didn't really understand all the consequences of treating with L-DOPA. They didn't understand all the cofactors that you need to to use. And so in order to get a dopamine program to work, you'll have to also have B6 in there. You have to have some of the sulfur compounds. And you need a really good multivitamin. And if you do that, you should be in pretty good shape. If you're kind of nervous, maybe do a B complex as well. Okay.
So we're going to take a look at labs now. And we're going to talk about mitochondrial repair programs and brain repair programs, primarily because those are the complex ones. If you joined us late, just to let you know, we have a 12-week super intense boot camp coming up on amino acids for those of you that are interested in really delving into this subject and just tearing your hair out and learning how to do this for real. You can scan the QR code there. You get a discount. Entering in mini amino 23. You get a discount. This is a three-month commitment to really learn the work. Okay. And then again, if you joined us late, Rupa Health. We strongly recommend. If you scan that little QR code, you'll get $100 off of your first order with Rupa Health. All right. So now let's look at some labs and then do a little program design, kind of like the fun part. Let me pull up a program here. It is. And get to work. We got some labs for you set up right here. So let's look at this one first.
So we're going to look at a Nutrival. We're going to look at a Metabolomics. Sorry, I didn't, oops. Hey, a second. Let me get this better here. Uh, uh, there's Metabolomics. And we're going to look at an Omics. Very similar tests. Diagnostic Solutions, Genova, and Genova. So let's start with a Nutrival. So this is a recent patient from our mentorship class who had a post-vaccine injury after the COVID vaccine. They had some neurological problems that were pretty severe. You know, kind of like not, I'm in the hospital severe, but like, I can't work anymore severe. And so I thought this would be a good one because what happens when people either have long COVID or a COVID vaccine reaction, there's going to be inflammation and cytokine production that's excessive and damage to the mitochondria. And in many of these patients, there's also going to be inflammation that affects the brain, just like we were talking about in a lecture. But you get to see this in real time. So you can scan the summary page here and see, okay, is there inflammation that makes sense that would be impacting the brain or mitochondria? Well, just from the little bit that we talked about in the session today, you should immediately think, "I don't know, I probably should look at the glutathione levels." Yep, there's glutathione. It's low. So right away, you know that you do not have the protection for the brain or the protection for the mitochondrial enzymes that are required for those to operate properly. And then you're thinking, okay, well, and I'll ask this as a question. There's a couple hundred of you there. I hope somebody could get this right. All right, you ready for the question here? So what, okay, now we know glutathione is low. So what are the structures that surround the mitochondria, make up the outer part of the mitochondria, and that make up the outer part of the neuron? What's that structure called? And what's it made of? The cell membrane, right? Yeah, it's phospholipids. It's fat. It's lipids. So is there a marker on here that tells you if lipids specifically are being damaged? Oh, gosh, there is. And it's called lipid peroxides. That's handy. Let's look at it. Lipid peroxides are high. So now you know two really important things. In fact, you could stop right here. It's worth doing this lab. It's only like three or four hundred bucks. It's worth doing the lab just to get these two markers. This patient's low in glutathione. That means that the mitochondria are just taking hits constantly, constantly, constantly. Oxidative stress, cytokines, bam, bam, bam, mitochondria. It's like a, it's like a, I don't know, like a World War II movie where the Germans had those really good machine guns and they're just like shooting at the guys on the beach in Normandy, right? And there's no protection here at all. Glutathione is gone. So that's pretty bad. So mitochondrial enzymes, you would expect to be damaged. And neurons are getting damaged. But then you're thinking, well, I don't know, it's not that bad, is it? Because there's the protection that we have. There are these membranes that we have, cell membranes. And mitochondria have two membranes around them. But no, look, lipid peroxides are high. That means there's physical damage. The lipids are getting hit, right? There's like machine gun bullets going into the lipids. And that's going to obviously put you at higher risk for things like cardiovascular disease. But forget about that for a minute and just think about what it does to your mitochondria and to the neurons themselves to have lipids being oxidized. Not good.
So two treatments are going to jump out at us right away before we get any further. One is that we want to crank up the glutathione using amino acids. And you know them now: glycine, cysteine, or usually people use NAC or N-acetylcysteine, and maybe even some glutamine, depending on how the labs look. So at least the glycine and NAC. And then for the lipid peroxides, you can use vitamin E or CoQ10 or some kind of fat-soluble antioxidant. Let's see. Oh, and we've talked about methylation. Remember we looked at how methylation is involved in neurotransmitter metabolism? Methylation is involved in the production of neurotransmitters. Methylation is involved, uh, in just about all these different processes, right? And so methylation gets a pretty high score here. So there's some pretty significant problems with methylation too. And we'll go down a little bit further into the lab. Let's see. Wow, look, that's a lot of markers that are messed up. We don't have time to talk about each one of these for sure. We don't. If you were in the mentorship class, you, you know, we'd have a lot more time. We'd be going over your labs right now, talking about your cases. See, or take the amino acid class, and you'll have 12 weeks of this. Okay. And the amino acid class, uh, the boot camp involves, I didn't say this, I should explain this better. Get kind of distracted here, but this boot camp, we're going to be reviewing your labs that you guys submit in this class as part of the curriculum during the live calls. So I have live calls scheduled throughout the 12 weeks. I forget how many, but you have to look at the schedule and see. So those live calls that are designed to be going over your labs in real time in the class, so you can design programs. This is a huge curriculum and then the live calls, so you can figure out how to actually do this stuff. All right. So let's look at the, well, those markers, I'll show you the markers here, but they're fine. But that's, that's all right. This is normal here. So, um, kynurenic acid and quinolinic acid. These are both okay. If those were high, that would be neuroinflammation. And in fact, the catecholamine markers are all pretty good. The only one that's a little high is the serotonin marker. So there's a little bit of a serotonin problem, but it's not a bad serotonin problem. So this is pretty straightforward treatment-wise, you know, you want to do a ton of glutathione support and a ton of fat-soluble antioxidants and really protect the mitochondria. And then in addition to that, you have this section here, and we want to look at this in regards to amino acids. So when these markers here, you'll see there's, there's a few that are a little on the high side. There's a few that are a little on the low side. And honestly, for either one of those patterns, you can use free-form amino acids to help with mitochondrial function. So that's another thing we can do there. And that's probably enough.
So let's go to a program and set one up here. So we just said free-form amino acids. And the one that I use, it's called Amino Replete. That's from Pure Encapsulations. And you want to do, for this particular purpose, for mitochondrial help, you want to do one teaspoon two times a day, away from meals. Okay. So that would be a powder. Should mix it up, drink it down twice a day. And then we also saw that you need glutathione support. So you want to use NAC. Pure makes it in a 900 milligram version. And you want to give at least one of those three times a day. You may want to bring the dose up later, but I would start with that. And then you can also use glycine to make an even bigger glutathione response. And you can get that in 500 milligram capsules. And you could give a thousand of that three times a day also. So now you've got a really big push on glutathione here. You could, if you wanted to, add in glutathione itself, but that might be a little overkill. And then you'd want to use CoQ10. That's say the 100 milligram, 120 milligram. I think is what Pure has. And the lipid peroxides were high, right? So you want to give at least like that much CoQ10. It's kind of expensive, but it's worth it. And then for the mitochondria, they have what's called an Energized Pack from Pure. And it's a pack, uh, multi-pack that has kind of skewed towards mitochondrial support. And then if you're a little paranoid, not the right word, concerned, give some extra B complex just to make sure that everything works out. You know, there's B vitamins in the Energized Pack. Yeah, yeah, yeah. But not a lot. And so I'd probably add in the B complex. Let me think. Yeah, it's a pretty good program right there. That'll probably help this person a lot. Okay. All right. So that's case number one. And then we'll do, um, questions at the end. Let me do one more quick case and then we'll do questions. Okay. Uh, let's grab here. We got our Omics. Oh, so this was the patient, um, again.
From the mentorship class, someone submitted who had rosacea and autoimmune problems, not related to COVID at all. Just like, kind of, just not a healthy person. Oh my gosh, look at this. This doesn't look very good, does it? Look, the summary, when the summary has very little green, you know you're in trouble. That's not good.
Okay, so this is an Omic test again. If you're confused, Omic's from Diagnostic Solutions. They're the company that does the GI Map. Ouch. These are real cases, you guys, that were just submitted in class this week. Um, I don't usually take a lot of time in class, so sometimes in these classes I look at them, I'm like, "Oh my gosh, look how bad that is." So pyruvic acid and lactic acid, just sky-high. That has nothing to do with this course today. It has nothing to do with amino acids, but that's just like insulin resistance times 100, you know?
Oh, but here we go. This is actually relevant for us today. So these markers here, you see how this is the Krebs cycle? These are the mitochondrial markers. Remember how I said my favorite one is succinic or succinate dehydrogenase, or succinic dehydrogenase? That enzyme, look, check it out, it's super high there. So these markers going high means there's a mitochondrial problem. And now you can use amino acids to help with that. How cool is that? So that's a good example.
And then we're going to kind of scan through this test. It's complex. I'm going to scan through the parts that are amino acid related. Now, some of these amino acids, they just are the amino acids. So like phenylalanine is low, you see that? So you can give phenylalanine. Oh, here, this is perfect, apropos of what we were just talking about. Tyrosine. If tyrosine is low, supplement with tyrosine. Give them 3000 a day, a thousand milligrams of tyrosine three times a day. You may want to add in a little phenylalanine too. Remember, phenylalanine is the precursor to tyrosine, and then tyrosine is a precursor to dopamine. And here's our dopamine marker, homovanillic acid, and it's undetectable. Hmm. Does that make any sense? Yeah, it does. Let me show you why. Oh, the total branched-chain amino acids are low too, look at that.
Now, this is like a perfect lab. Just pick these at random, you know, because I want to challenge myself a little bit. But let me show you why that, why that all matters here. Let's go back to the lecture notes. This is a perfect example of that slide that I was showing a minute ago. Here you go. Here, don't forget to sign up for boot camp. Don't forget to sign up for Ruba. Uh, here, this slide, we just, we're just seeing this slide play out in real time in a human body that's all screwed up. Low phenylalanine, low tyrosine, low homovanillic acid. What do you think is happening to their dopamine? You know, not good.
Now, we want to look, is that happening because of brain inflammation, or is it happening just because they're stressed out of their mind? Okay? And how do we determine that? Well, we're going to look for the quinolinic and the kynurenic and see where they're at. So that's kind of hunt for those guys. Oh boy, this is perfect. I was gonna say, I should use this as a sample test, but we are. Look, quinolinic acid, it's a little high. So there's some neural inflammation going on. It's not horrible, but it's there. It's in the fifth quintile. See how that fits together like almost perfectly? Really perfectly. So high quinolinic. Let me go back to that diagram so you can see this here. This is literally represent, this patient is literally representing this diagram from Richard Lord's book. Phenylalanine is low, that's a problem. Tyrosine was super low, big problem. Homovanillic acid was low, that means dopamine has to be low. The input and output are low. And the quinolinic acid was on the high side. So the L-dopa is going down this way because there's some brain inflammation. Who knows what's causing it? Could be a toxin, could be infection, we don't know what's causing it. We're not really covering that today, but that brain inflammation is depleting this whole system. So the solution is, start with tyrosine, maybe a little phenylalanine, and figure out what's inflaming the brain. And these kind of patients will get better immediately, within a month, they're going to feel better, almost right away, almost right away.
Uh oh, gosh, look, cystine is low. Cystine is low. Oh my gosh. Oh, this is like, look at this. These are the markers for glutathione. They're both high. When these go high, it means glutathione levels are low. So we got plenty to work on here. Let's go design a program. I can guarantee you this patient would feel better. Guarantee you're going to get this person better.
All right, so this second program, we had low tyrosine. So you can have tyrosine. It's not that hard, right? Tyrosine 500 milligrams three times a day. If that doesn't work after a month or so, use Mucuna. I would do some phenylalanine too, because the phenylalanine was low. Not a lot. I didn't spell it right. Not a lot, a little. If you only is kind of strong, I wouldn't give too much, like a little bit. Don't give it at night, that might stimulate him. Like a little bit. You could crank it up later if you want. Oh, that's wimpy. Hang on. Like that. But don't give them a ton of it. And then, uh, we said cystine or cysteine was low. So NAC, just like the last one, of those two times a day. Uh, the branched-chain aminos were low. So you can use a branched-chain amino acid. They always come in a powder, and it'll be like one scoop, one or two times a day. You get this many amino acids, you have to give B vitamins. K? Or they're not going to work very well. So B complex, a couple times a day. And then, uh, what was happening there was inflammation in the brain. Oh, when quinolinic acid goes high, I forgot to mention this. You want to use magnesium. Magnesium is the ultimate bringer-downer of high quinolinic acid. So magnesium glycinate, 100 milligrams, multi-pack. Did I forget anything? Uh, gosh, that's a lot right there. I mean, I would start with that. I mean, there's probably more things you could do for this patient, but that's a lot. Yeah, that's a whole lot. Uh, and then give it a month. You know, one of the things I've learned recently, just in the last year or two, is that these program design things, I spent my whole career just thinking I needed to get the perfect program, you know, right up front. But then I realized, like last year, when the Denver really works, the perfect program is the program that you set up, that the patient does, and then you alter it and change it and modify it for that person. You know, that's really where perfection comes. It's not in you getting it perfect, but are you getting a decent program right away and then having the patient start it and then modifying it with that person over the course of a few weeks or a few months, and then it becomes perfect. You can't really design the perfect thing until the person is taking it and you see how they respond. Okay.
Oh, and Mayor Dodd is reminding me, you could also use free-form amino acids. That would be ImmunoPleat, uh, one teaspoon two times a day. I guess you better do, if you're going to get into that, we've got to do something like, uh, the mitochondrial ATP from Pure. That's got a little bit of everything that the mitochondria need. Do a couple of those. Is that too strong? Let's see. I would just start one product at a time and every few days add the next product. And maybe if you're going to do this, if you're going to do the free-form aminos, I would take the phenylalanine out because I think that's too much. So I do something like this. This is reasonable here. That's not going to get you in trouble if you do something like that. Okay.
So I'm going to hit the pause button here on me doing stuff, and I'm going to look at questions. And I know we're right at the hour now, so a lot of you probably have to leave. You have children or families or other things you have to do. I will put this up so you can get the QR codes if you want to join us. And then let me grab the questions and talk, talk through these. I may not be able to get to all of them.
So, what would amino acid elevations mean in someone who's not on a high protein diet? So amino acids are broken down. Well, let me get this back up and say what it means. So if you're doing a blood test and you see high amino acids in the bloodstream, that's a combination of what the body is taking in from the diet. But a lot of the amino acids in the bloodstream are you breaking down proteins that were formed in your body, and then those free-form, those free amino acids now enter into the bloodstream. And then of course, the bloodstream, uh, there's amino acids leaving the bloodstream on a regular basis. So, um, the pull of producing proteins and using glycine for, you know, gallbladder bile support and all these things. So amino acids are coming in and out of the bloodstream constantly, and they're coming in from the diet, but they're also coming in from you just breaking down proteins through normal cellular processes and those getting dumped into the blood and then you're using them up, right? So if the levels in the bloodstream are high, they shouldn't be high from a high protein diet, by the way. Your body should be adjusting for that. But if the levels of amino acids in the bloodstream are high, again, it shouldn't, should not be from eating too much meat or something. If the levels are high, it generally means that they're not being metabolized or broken down very well. And that is accomplished by the metabolic. I already said this like a minute ago. Do you guys remember that the, the nutrients that break down amino acids are B vitamins. So high levels of amino acids on a test, most often mean deficiencies of B vitamins. All of the B's are implicated. The one that's the most strongly implicated is vitamin B6. So that kind of a patient should take 100 or 200 a day of B6 plus a B complex.
Okay, um, let's see. Do we see a lot of post-vaccine neurological issues? Yes, we do, sadly, but true.
Uh, let's see. Review what the colors mean and which test was that? Is that the Omic's or the other one? I guess I could go through them both. I don't know if that's too complicated. Each marker is different. You know, we're talking about this in the mentorship the other day. I mean, some of these markers, like, um, it matters a lot if it's high or low. Some of them, it doesn't matter at all if it's low, but it matters a lot if it's high. And sometimes the colors kind of fit with what you would think they do, and sometimes they don't. So you kind of have to learn that on a marker-by-marker basis, unfortunately. There's no like generic thing I can say, you know.
So then Debbie is asking about, uh, oh, then let's see. Dharma, Dharma, Dharma Rajon, Tamara John. Tamara John is asking, how is our course different from IFM? Easy summary of that. After all these years, first of all, I'm an IFM certified doctor and a big IFM booster. IFM is like the medical school, and the Cancer Institute is like the residency program. So IFM teaches you all the background stuff and everything you need to know about pathways and all that. And the Cancer Institute is like this, like when we're in the heart, in the heat of one of these classes, in the Chaos Institute, it's like, pyroglutamic is high, that's you got to start with 3000 and acetylcysteine and go to 6000 after a few weeks, and let's add in some glycine at 3000 a day too. And if the liver is going to be working that hard, let's do some dietary fiber also, you know? So the Cancer Institute programs are practical application. We're reviewing labs and working on patients for a year, just pounding away at that. Where these shorter boot camps, we do it for a few months. IFM is brilliant as the medical school, and again, I'm more like the residency program where you're actually getting trained in how to do this. And most, if not all of our, many of our students, I'd say at least half of our students, have done either all or part of the IFM course.
Okay, so then Jody said, I have a new client today who has major neurological issues after COVID last year, pain all over, inability to work, weight loss, loss of appetite, feels like he's getting electrocuted, constant pain and burning sensation for six months. Yeah, that is neuroinflammation, viral-generated neuroinflammation. You run these labs, you're going to start to be able to help those people.
Okay, so Beth's form of B complex. I use the one from Pure Encapsulations. I use mostly Pure Encapsulations in my practice. There's a lot of other good companies out there.
Let's see. Compare that. Oh, and one last question before we wrap up from Debbie, which is, what's the difference between plasma amino acids and urinary amino acids? So for our purposes of analysis, a blood test for amino acids is going to help you a lot more. That's what's actually circulating in the bloodstream, what's coming from the cells and going into the cells. That's where all the action is. The urinary levels of amino acids are obviously what you're excreting. And so for our clinical purposes, it's much better to do a plasma amino acids and much, yeah, as much as you can, I would just always do plasma. Okay. And if you can't do a plasma amino acid, that's fine, you can interpret the urinary ones, but you're not going to get nearly the same amount of information as you would from the plasma.
Okay, I'm going to wrap it up, or write a little bit over time here, and I'll end with this as a thought. I hope some of you guys sign up for the class. This is a doozy. If you're really ready to learn how to do the work, I'll step you through it in this 12-week intensive. Okay. All right, take care everyone. We'll talk again soon. Thank you.