Transcription
Hello everybody, and welcome to a little clinical rounds kind of thing. So, this is something different. I don't think I've done this exact same idea before. So, these are real-life lab cases from our real-life classes that I teach every week. And, you know, one of the things, and I talk to people about my one-year mentorship program, it's really hard to explain how enriching it is for people until you experience it. Everybody that takes it loves it. If you've met a student that's taken it, 98% of them absolutely love it and feel like it's worth all the money. But it's hard to explain it, you know? And so, this is an attempt to show you kind of behind the scenes what the classes actually like when you're actually in it, and we're in the action of of studying and stuff. So, I'm gonna do a little quick introduction, and then we'll talk a little bit about the class, and then we'll look at a bunch of cases.
So, introduction. This is me, Dan Kalish. Hey, I'm now a very proud faculty member of the Institute for Functional Medicine, their Practice Implementation Program, which has been, I'd say, probably the biggest professional honor of my career to be working with those people. Every time we have a faculty dinner before we go onstage, I'm always looking around like, "Well, am I in the room?" You know, this is such an esteemed and wonderful group of human beings. I managed to do a research study with the Mayo Clinic, bunch of Mayo Clinic docs. Took my class. Right now, probably the most important thing emotionally, spiritually, and professionally is that I work with Richard Lord. Those who don't know Richard, if you have been in the industry for a long time, I'm sure you know Richard. You probably have met him. If you haven't, he's the man. Our main textbook for the industry, Laboratory Evaluations for Integrative and Functional Medicine. I dragged him out of retirement about three years ago, and we work together every Monday developing curriculum. And so, if you join the Kalish Institute, in fact, even if you don't join the Kalish Institute, if you just look at our free stuff, you'll see some of Richard's greatest hits. He's calling them "Collisions to Masterclasses by Richard Lord," which is very generous of him. And it's all his latest research and information. So, we have a lot of that stuff posted online for free if you want to check it out. And we have hundreds of hours of his materials that I teach in the actual mentorship. He's a scientist that developed much of the work that we do. The man that was behind organic acids and fatty acids, the GI Effects test. He kind of indirectly designed the Nutri-Eval. It's a long story, I won't bore you with. But anyways, he's been around for a long time. He's really the main scientist that's responsible for most of the basic testing that we do in functional medicine. Okay. And then I'm proudly IFM certified. Didn't practice for more years than I would like to count. The class itself has a year-long curriculum, which is pretty good. Yeah, we have a very active community that is, you know, has a couple thousand case studies, all these doctors interacting, all kinds of lectures and special topics. It just goes on and on and on and on. And we have a special offer. If you sign up in the next couple of weeks, you can get a thousand dollars off the one-year class. We'll be having our final class for the year starting November 5th. So, if you're curious, contact my staff. And today, hopefully, we'll give you a little taste of what the class is like.
So, just to explain the experience. You, you sign up, you pay all this money, it's like a grand a month, whatever. It's, it's worth it. You'll pay it back with your first three or four patients that you test. Okay? So, it's not, it's not a huge expense. It seems like a huge expense, but if you're actually active and you're doing three to five patients over the whole year, you're gonna earn all the money back for the class. Okay? So, it shouldn't be a huge financial burden for any of you. Most people end up paying for the class by their third or fourth or fifth month of the class. And that's the goal. We're trying to price it in a way so you don't go into the hole or get it in any way. And you get access to the year-long curriculum, you get access to the community. And then every week, doctors submit these labs like we're about to look at, and we go through cases, like real-life cases. So, I've got some that were submitted recently. I've got, uh, let's see. I don't even know what these are. I have my staff home. I say, "Just make it a surprise." So, I don't really know what we're coming into here. But the idea is that we're gonna look at a bunch of labs and then get into some program design, and you can see how this can. So, it's just, I don't know, spec to start with this one. So, this got was submitted earlier this year. The doctor is Dr. Lisa. The patient is mysteriously L45, meaning she's 45 years old. She's not on a bunch of medications. And this is exactly what Dr. Schmidt in the classroom at the history. Skin problems, fatigue. It's a follow-up from a previous test. Complaint started a few years ago. And then some questions of the doc cast here. And you guys are welcome to ask questions today too. If you have questions, just type them into your low box there, and we'll get to you. Do we refer to see the two GI for C-diff? What's the relevance of toxins A and B? What do you do about viral pathogens? So, here's your basic GI test. And let's see what's going on.
So, right off the bat, you can see a person has C difficile toxin B, but not toxin A. So, if you only have one of the toxins positive, it's not considered what the medical docs would call C difficile. So, it's usually not treated in conventional medicine. Usually, they don't have a lot of serious symptoms either. And when you see most of these viral bugs, they're considered to be self-limiting, to go away on their own. So, you can still treat C difficile if there's only one toxin positive. It's just usually done with Sacro-b-i-o-t-i-c or R-S-P-L-E-R-A-T-I. And then this patient actually has an H. pylori also with a couple of virulence factors. So, that usually means that the H. pylori is causing some inflammation and problems. And then a whole host of dysbiotic bacteria and crew. And a little bit of a yeast or fungal overgrowth and Blastocystis hominis. I have to honestly say, I don't remember this case with them. It was from like three or four months ago. So, um, let's dive in and just see what we would do.
Okay, so first of all, if you've been watching any of these in the past, you know I'm a really strong proponent of models. And so, I want to show you some of the basic models that we work with in class every week. And the idea here is that if you're trying to learn all of all of medicine before you start treating patients, you know, you could be twenty, thirty years of study and still not have helped anybody. So, we want to use in the beginning, and to me, the beginning is the first ten years, we want to use in the beginning some basic models that we can follow, some programs or protocols. We're not talking about something cookie-cutter and preset and bad for people. We're talking about, you know, bringing some sanity and structure to all the work that we do. And so, I still use the basic model that I developed, you know, fifteen, twenty years ago. Most practitioners that take my class, I think they use it for a little while, six months for a year, and then they make their own, which is kind of the whole point. And hopefully, they go on, you know, do different things. But this is a starting point. And so, when we're working with GI cases and like this, there's, you know, eighty, ninety percent of the time with that many infections. Remember, this person had a little bit of C. diff, a little bit of C. difficile, but not the full amount, both toxins. They had a pretty nasty version of H. pylori, a Blastocystis hominis, and yeast overgrowth, and like it looked like at least six or eight different dysbiotic bacteria. And so, the temptation then, if you don't have a model, the temptation is just to treat the GI tract first and foremost. And that has to be a mistake, right? That has to be a mistake because that's symptomatic treatment. You know, you're seeing this one isolated problem with the gut, you're doing this one isolated gut test, and then you're just treating the gut as if it was functioning independent from the rest of the body. And that's just never how this works. What pretty much happens almost 100% of the time, 93% of the time, you know, the vast majority of the time, is that there is an underlying problem first with something to do with the neuroendocrine system, either adrenal or thyroid issues, or neurotransmitter problems, or mitochondrial problems, or something's going on, right? That's weakening the immune system. Maybe the diet is not very good, and that allows all these GI pathogens to obliterate. And so, if you just take a person with a GI lab like we just saw, and you just do a GI program, you'll, you'll have very inconsistent results. You'll get frustrated in a couple years, and you'll probably want to quit your practice because it's not going to seem like what you're doing is working.
If you're wondering, this is not an injury drinker. This is a new thing I just bought. It's a Pellegrino fizzy water. I've been doing all kinds of experiments with different sparkling waters. And I have to say, I don't own any stock in Pellegrino or anything like that. I'm not short selling it either. But it's not that great. It's like, okay. But I thought somehow the can would be different. And I don't know. Anyways, I like sparkling water, but I would give it like a B.
Okay, so you want to treat, in general, on a systems-oriented basis with neuroendocrine, GI, and detox, and typically in that order, if you can get away with it. Man, it is some patients, you can't get away with that. But oftentimes, you can. And so, it's nice to have this system basically so you're not reinventing the entire treatment model with every new patient. And so, I'll just show you real quick here what seems to work very well, not just for myself, but for all the hundreds of students that I've trained, is to think about it like this. Now, we have a patient, and let's just pretend that we know that the underlying cause of their health problem is the GI issue, GI infections. That's really why they're sick. What do they actually have? Who cares? Doesn't really matter, does it? ADHD? They can have allergies. They could have chronic back pain. They could have skin problems or autoimmune disease. It doesn't matter because what we're doing is not symptomatically oriented. We're not treating diseases, right? We're treating the whole body. So, that GI infection origin, that underlying cause coming from the GI tract, can cause all kinds of symptoms. And it really seriously doesn't matter because you're going to treat the GI tract no matter what. However, if the main symptom, for example, of the GI tract infections is depression, then you really want to think through not just fixing the GI tract, but making sure that you set the person up for success, and that you treat the symptom depression at the same time. That, to me, is the artistry level of functional medicine. So, let me say that again. We're acknowledging that there's an underlying cause, GI infections in this particular example. We're acknowledging that the symptom of depression is a result of that underlying cause, and we're gonna methodically treat the underlying cause and treat the symptoms at the same time. That's the highest level of functional medicine in my mind. The low, the low level of natural medicine is someone comes in and they're depressed, and you give them St. John's Wort. You don't even do any lab work. You give them some 5-HTP, give him some fish oil, whatever, right? You're just doing this for that treatment. They're depressed, for you give them 5-HTP. Okay, that's symptomatic treatment. If they come in, and you're doing underlying cause treatment, root cause treatment, you find there's a GI tract infection, and you just start treating right there, it usually doesn't, it's not consistently going to work. You have to be a little more strategic. Okay? So, you want to get the patient feeling better by addressing the depression at the same time as they're setting them up to successfully get rid of the underlying cause of the problem.
So, same exact thing. Let's say we have another patient. Their main problem is toxins, heavy metals, and chemicals, just saturated with this stuff, and they're depressed. That doesn't mean that you're going to treat the toxins first just because they're the most important thing. But don't always do the most important thing. In fact, if you think about most human relationships, you don't do the most important thing first. Like, if you meet somebody and you fall in love, you don't ask them to marry you 45 minutes into the first date. Hey, you're doing some preparatory stuff, you maybe get engaged, and you live together for a year or whatever before it, right? So, you don't have to treat the most important thing first. In fact, you want to kind of lead the person to the point where that treatment is going to be appropriate. You know, and you have to take time, take time to develop this, you know, therapeutic strategy. Now, you do need to address symptoms right away because if people don't feel better, they're not going to come back and they're not going to heal. You know? So, you can't just only treat underlying causes, and you can't just only treat symptoms. And what I generally recommend is these pairings that we're working with in class, and you see these a lot, where if you see the GI tract issue, the GI tract is is inflamed and has as many infections as this person does, you always want to test and correct the adrenals and improve the immune response in the gut, reduce the inflammation in the gut by working on the adrenals. And you'll find almost everybody with this many pathogens is going to have a related adrenal problem. And it's not a coincidence.
So, let's look here. Adam, you see I've got some slides on that here. We go. And it's pretty straightforward in terms of causation, right? When we're under stress, the neuroendocrine system starts to fail. The mitochondria, the brain, the thyroid, whatever it may be, right? When that neuroendocrine or endocrine system sort of crumpling, the immune response in the gut weakens, and we become very susceptible to picking up GI pathogens, or low-level infections that we've had for a long time start to flare up. So, you almost always see this pairing of adrenal and GI issues. So, prior to doing the GI treatment, you want to make sure that you set them up on a really great adrenal program. So, let's find the adrenal lab here. I know it's in here somewhere. Sorry, I'll come back to some of these later. Hang on. Saying, oh, wait a minute. Move it. It's right here. Yeah. Nope. Wow, we've got a lot of examples in here. Can't believe this is one night of class. TV. I said I didn't. We do a lot of work in one hour in the class. Here's a good adrenal one. All right. So, you got this patient with multiple GI tract infections, and you look at their adrenal hormone production, cortisol, and DHEA. And you'll see typically with people that have that much going around their gut, they're going to have usually low cortisol and borderline or very low DHEA. And so, you want to set up a program where you're dealing with the adrenal program protocol, the adrenal, you know, healing part of the program, along with what you're going to do with the gut. And I'll show you the exact protocol that I would use. Let's see here.
And so, I'm not making this stuff up. I was taught all this by my teacher, Dr. Bill Timmons, 25, almost 30 years ago. We, and Bill had done this work for decades before I came on the scene. We did a research study of this exact protocol I'm about to show you with a group of practitioners from the Mayo Clinic's. Who Cutshall and Larry Bergstrom from Mayo Rochester, at Mayo in Scottsdale, Arizona. And if you look at the research study here, and I can upload it, or you guys can email my office and ask for it, you'll see the exact protocol that I'm about to show you is right here. It's exactly what we did with Mayo. Here we go. Look at this, right out of the study. DHEA drops, pregnenolone drops, vitamins, minerals, support of the blood sugar. And then even if you look at the protocols for killing the bugs, mastic gum, candida, they're clearing, you know, S. B-O-L-L-A-R-D-I. It's the exact same stuff that I'm about to show you. Okay.
So, for an adrenal lab, let me show you here. When you see the low cortisol on the low DHEA, we call that a stage 3. And you want to do a program that's going to bring the cortisol, DHEA back. And you're trying to stimulate internal production to come back online. So, for stage 3, is usually we use these DHEA and pregnenolone drops. You can use capsules as well. So, for DHEA, if it was in the liquid form, we would use like three drops. If you're using a capsule form, that would be around 9 milligrams. Since they don't make 9-milligram pills, you probably have to give them 10, right? And you give that low dose a couple times a day. And then with pregnenolone, again, you can easily use the liquids, that would be around 12 drops. Or if you want to use capsules, be around 50 milligrams a few times a day. And that's where the base or core of the adrenal program. And this is the preparatory work to get the body ready for doing the GI clearing. And then some blood sugar support. Every one of the companies that we work with has blood sugar support. I work specifically with three companies very closely: Managed Anax, Pure Encapsulations, and Designs for Health. I know their product lines really well. I talk about them in class all the time. And they all have some really great blood sugar support products. Just pick one. Usually, it's got "gluco" in it, gluco-vie for glucose support or gluco-balance. We so want that. And then usually, we want to use some kind of adaptogenic herbs, right? Again, those are Adreno-Tone or Adreno-My, Adreno-Buzz-to-Jenna, whatever. Or right now, have the typical suspect, the Ashwagandha of the world, in their Rhodiola, all those kinds of things. And then some extra vitamin C. And you got to make sure that vitamin C has bioflavonoids. And this exact protocol here, give or take a little bit, depending on, you know, where the person is at in terms of where the person is at in terms of adrenal exhaustion. I mean, the, the, the protocol is vary a little bit. I'm just trying to show you the most commonly used one. Was at stage 3, these work beautifully within a month. People are starting to feel better. Usually, once they're starting to feel better, you've got the inflammation down, you've been working on their diet now for a month, maybe six weeks, and then you go in and start to kill things, right? And this is where it gets kind of fun.
So, once they're again, one or two months on the adrenal program, one or two months on a good diet, then you would go in. And this patient in particular had C. diff, remember, but only one toxin. They had Blasto, H. pylori, and these are real cases, right? This is right out of class from a few months ago. And a Candida overgrowth and a bunch of dysbiotic bacteria. So, right out of the word or the mouth of Dr. Timmons from a million years ago, what do you do when you got this much going on? Just start at the top, work your way down. So, stomach would be at the top, right? So, we'll treat the H. pylori first, always. We treat the parasites second, if needed. Depending on how deep you get into this case, you would probably want to do the yeast and dysbiotic bacteria, often done together. And that way, usually be done towards the end. And there's lots of strategic reasons for that. You know, starting with the H. pylori obviously gets the stomach working well, so they can start to digest stomach acid and just their stomachs working better. That makes it easier then to kill whatever you can do next. Getting rid of the Blasto often has a really strong killing effect on that Candida anyways, right? Because a lot of herbs overlap. And in general, sometimes just getting rid of the Blasto is enough, and the Candida overgrowth to be gone. But if not, at the end, you know, you can do another round of Candida killing. And so, each of these programs is usually two months, and they're never overlapping. I never do them at the same time. You do one, and then wait, and then do the next one, and then give the person a break. And you don't give him a week or two. We between programs. And this whole time, you're running the adrenal support. And that simple combination protocol of the adrenal program that looks like this, with, you know, again, you do the adrenal program for a month or two with the diet first, then go after and start killing things one at a time. That has worked in my practice thousands of times, in the training program, you know, with doctors I have trained, probably literally tens of thousands of times. So, it's a really effective old-school naturopathic protocol. Usually, the adrenal programs run for straight six months. They got programs or about two months each, typically. Okay.
All right. Now, if you're in the actual class, you know, you would be like watching videos about how to do all this stuff. And it, you know, would be a little different. There's one more in here I want to pick on here. Oh, here we go. Let's do this. All right. I love it when doctors write all over things. So, this is from earlier this year, Tuesday's call. Tuesday morning's call. John, Dr. John. Patient initial C32, a male fireman, new patient, coming in for infertility. Has all kinds of problems. And let's take a look. So, there's a couple, like, these are like, what do they call them? Clinical pearls. Right? These are things that you just have to know. You have to know the answers to these questions here. You have to know about how to deal with the omega-3 and omega-6s. That's mission critical. You have to understand the magnesium and sulfate dyad. If you don't, if you've never even heard of that, then, you know, get off your phone, stop checking Google, come back, listen to this. The rest of the, the rest of this case here. Okay? It's really important. What does it mean when amino acids are high? I don't know. What does it mean? Well, let's look at that. And then what's the hypo-metabolic state? So, those are, these are like basic, basic things we should all know. Okay? So, let's look at this. And this is right out of the doctor board playbook. I'll give the water like a B-plus. It's not as bad as I was letting on. It was okay.
So, this is an ion panel, and it looks at amino acids, fatty acids, and organic acids, plus a bunch of other things. When you're approaching a piece like this, well, we should at least look at what's a person's problem again. I already threw out, I think you're seeing fertility, right? Infertility. That's a little interesting with a male, right? And fatigue. So, let's just see what's going on. So, you look at the amino acids, and we're just looking for patterns at the basic level. And what do we see here? Well, first thing I notice is none of the amino acids are low, correct? None of them are low. Not a single one. And a significant number of them are high. So, that should just catch your attention. Remember, these are amino acids in plasma. So, let's look at the next page of amino acids. Again, suspicious, isn't it? These are all amino acids, and we're seeing none of them are low, which you would expect. Wouldn't someone who's sick? And a significant portion of them are high. So, what does that mean? Does that mean they have too many amino acids in their diet? Could be. But, you know, if you eat a lot of protein, your body just kind of breaks it down most of the time. When you see a pattern of high amino acids, they're circulating in the bloodstream, and they're not getting into the cells. You're not utilizing them very well. And it's vitamin B6 that helps you break down amino acids. So, this is a B6 classic B6 deficiency. Except for, think of all the things that would happen with the B6 deficiency as it's just or are happening with this patient. For example, tryptophan is high. That means it's high, it's circulating in the bloodstream, it's not being broken down and being able to be used by the cells. So, that's going to have a negative impact on your brain. Methionine is high, which means it's circulating in the bloodstream, it's not being broken down by vitamin B6, and so you can't use it for detoxification. So, there's a detox problem just right there. Every one of these amino acids that's high, taurine, for example, is high. That means it's circulating in the bloodstream, you're not putting it into the cells, you don't have enough B6 to use it, so you're not gonna have enough taurine, which is important for neurotransmitters and for detoxification. So, if you see a high level of a neurotransmitter, that amino acid is supposed to do, ain't happenin' very well. Okay. And so, this shows you how important B6 is. This is like a great lesson. And I know my very first naturopathic teacher, a wonderful and kind gentleman named Glenn, he spent, you know, a good five years teaching me everything he knew. I will always be indebted to Dr. Glenn. But one of his big tricks was B6. He would just look at people and put them on like a couple hundred milligrams of B6. And I always thought, "That's a little crazy." But I get it now. Super important. Okay. So, is that's that's what we can think of here. Unless we're gonna skim through this test, kind of hit some highlights, because I planted the seed. What's that magnesium sulfate dyad? So, magnesium is low. Then you see low magnesium here. It means they don't have enough magnesium. Now, the first thing that you do when you see low magnesium is you start to wonder, "Hmm, how is that affecting the various body systems?" And with, when the first things you think of with magnesium is energy production, right? Magnesium is involved in all these steps of ATP production. So, we go right over here to the organic acids section, that looks at the Krebs cycle, citric acid cycle, when we see fat burning, carbohydrate burning, energy production itself. And we get this curious kind of thing here. You can see, Dr. John, there's sort of circled a few of these where a large number of these are actually low. So, when I first learned about organic acids, I'm sure as you did, we taught that, you know, when these markers are high, there's a nutrient deficit. And so, there's all these red zones at the high level, right? But we weren't really taught what it means when these markers are low. And in fact, you know, just the lab report itself, you can see this kind of green down at the bottom there. So, just kind of thinking, "Well, that should be fine." Turns out, not so much. So, when you have more than six of these initial 21 markers on the organic acids that are low, it means the person's in what Dr. Lurie calls a hypo-metabolic state. So, let's count. One, two. VO means undetected, so that's low. Three, four, five, six, seven, eight. We're already up to eight. Okay? So, over six of the twenty-one is hypo-metabolic. Nine, ten, eleven, twelve, thirteen, fourteen, fifteen, sixteen. So, this person has 16 of their first 21 markers low. That means that there's not enough mitochondria present to produce energy. And then the next thing we want to look at. We know there's a magnesium problem. We know there's a mitochondrial problem. The next thing we look at here, or the glutathione markers. And there's three of them. So, Dr. Lord felt glutathione was so important, he put three different markers on this test to differentiate glutathione problems. They all mean the same thing, though. These are low. Alpha-hydroxybutyrate, pyroglutamate, sulfate. Anyone of those are low, you need to be suspicious about low glutathione. In particular, low sulfate. So, if sulfate's low, pyroglutamate in this case is low also. It kind of backs up your findings that is low glutathione. And glutathione and magnesium interact with one another. When we make cellular energy, we need magnesium to do that. When we make cellular energy, we need glutathione for its free radical capacity, you know, free radical quenching capacity to deal with all the oxidative stress. So, these two are paired together. For anybody that has fatigue, or any kind of brain problems, mitochondrial issues, chronic pain, you want to look and see the sulfate levels and the magnesium levels, and you need to give them both together. So, the supplement for sulfate is usually either glutathione itself, and all the companies have liposomal glutathione or different kinds of glutathione. Or, if you're more old-school, usually you can use N-acetylcysteine, 3,000, 4,000 milligrams a day of an acetylcysteine, plus, you know, 400, 600, maybe more milligrams of magnesium. Okay? So, those two together will bring up the energy systems. If you just give this patient glutathione, it's not going to be very effective because it's not enough magnesium to allow the glutathione to work. If you just give this patient magnesium, it's not going to be very effective because there's not enough glutathione to make it work, right? You have to use these two together if the findings indicate that. So, anything else on here that's kind of a lot, right? There. Oh, this one other thing. Let's go back and look at the fats. This is one of the more important things I've learned in a long time. So, if I can find this here. Wow, that doesn't look very good, does it? Okay. So, sad. What happens? People, you know, you look at this. You guys, it's like a human being. How people live their lives like this. Okay. So, omega-3s, they're all low. That is grim. Alpha-linolenic, Eicosapentaenoic, that's EPA, right? You've heard that's a fish oil. EPA. The other famous one here is Docosahexaenoic, DHA. This one sometimes called ALA. This one's really not called anything. People don't really pay attention to that one. But ALA, or alpha-linolenic, that's the one you see in flaxseed. EPA, DHA, kind of famous fish oils. Look, all these are low. So, now you go down here to the omega-6s. You also have problems. And this is going to be a very unhappy person, right? They don't have enough of the essential fats to make their cell membranes. If you go down a little further here, you'll see even in the mono, the monounsaturated, and even the saturated fats, incredibly low. So, who knows what's going on with this person? Could be a gallbladder problem, a dietary problem. We're not sure on all the detail. Some massive gut infection, something's just completely stripped out this person's fat capacity. Let me show you one other thing here. And so, the solution obviously is to give omega-3s. And not, not just a little bit, right? Usually, we give, typical patient, you, if you didn't test and you thought they wanted one to give, Chris Schwartz, probably give him like a thousand or two thousand milligrams. With someone like this who's really low, let's see where they go like that. Honestly, I give him like six capsules a day, three times a day. So, that's like triple the normal dose, not forever, just for the first little while until they kind of kick into gear. The first little while, I don't know, the first month or two. Something happens magically with fatty acids around 90 days. So, maybe the first 90 days, and then cut him back, you know? So, you don't even want to keep him on these forever. Let me just show you one other thing here because it's really important. This is the most important thing I probably learned all year. I must share with you my PowerPoint. Wilkin, sorry, I'm trying to drag this slide over there. There it is.
Alright. So, again, we're thinking about iron panels. This is Richard Lord's masterclass on fatty acids. Okay. They did. Let me show you the pattern here. Here it is. So, this is right off an ion panel. And you see, now we're looking at the saturated fats. So, if you see what Richard calls a lesser than sign, you can see right here, palmitic and stearic, they're quite low. And then these others come out like this. The way that this is listed, see capric to lauric to mysteri. You can, what you're looking at is an increasing chain length of the fat. So, when you see the capric, and then there's a 10 there, that means it's 10 carbons long. Lauric with the 12, 12 carbons long. This mysterious, Mr. Hal-yard, pronounced at 14 carbons long. Palmitic, 16, right? So, your body is making these fats, and it's making them longer and longer and longer and longer through the basically just synthesis of fatty acids in your liver. Alright? So, your liver is taking nutrients, a lot of it's from sugar, a carbohydrate, and then slamming it together into these fats. So, these saturated fats are partially from the diet, but for the most part, they're being produced in your liver, right? So, these are not. All these cases are mine, but some of these are. Here's another example of what he calls the lesser than sign. We see very low palmitic and very low stearic like this. So, the reason why this is so important is because if you're this low in fats like palmitic, there's absolutely no way your brain is going to function normally. And most of the patients that I found with this particular pattern have pretty severe anxiety or depression or fatigue. This palmitic, which you may not even really heard of, you've probably crossed over if you look at these labs, turns out to be one of the more important fats. And why? Well, just look at the numbers. So, for example, let me go back here. Well, let me see if it's down here. Yeah, it's probably easier. Let's just look at this one. This will be, this will be good. So, if you look at the far right-hand column here, you can see the amount of the fat that's present. So, for example, with palmitic, the amount of fat that should be present is somewhere between 600 and 2500. Okay? And so, in a healthy person, they should have a thousand, two thousand units of palmitic floating around in their bloodstream. Okay? Now, you're thinking, "Well, what does that really have anything to do with anything? Why is that even, why is even talking about this?" Well, let's look at the amount, the relative amounts of these other fats that we all think about all the time, like the omega-3s. For EPA, arguably, you know, an essential fat, right? Arguably one of the more important. You're supposed to have around five to two hundred units. Five. Remember, we just said you could have a couple thousand units of palmitic. Look at DHA, 30. Look at GLA, gamma-linolenic, five. So, you see these essential fats that we're all kind of personally obsessed with, you know, in terms of supplementation, exist in tiny, tiny amounts. And then look at palmitic. Okay, I've got it. Other numbers down here. You're supposed to have a couple thousand units of it. So, in a healthy person, you can have five units of EPA circulating while you have 667 units of palmitic. Right? It's orders of magnitude larger. And palmitic, then, because there's so much of it in the healthy person, is going to control the way that all these fats are distributed throughout your bloodstream. And so, it's going to control, basically, how your body starts to work on and repair cell membranes. And so, it seems like an abstract kind of like, "What is this important thing?" But if you have a patient that's low and palmitic, and it has, and they have this pattern like this, it's not dietary. It's an endogenous production. It's their inability to make these fats internally in their liver. And they can't eat their way out of that. But if you give them, we've had really great results, Dr. Laura, in the last year or so. If you give them high dosages of three omega-3 and omega-6s, depending on what the lab says, you will see a turnaround in these patients in a matter of like a month, or like I say, at the longest, maybe 90 days. And these usually are people who have been suffering for a long time because this is endogenous production we're looking at, not dietary. Okay? This is the internal production. Dietary factors play a role. But if you want to get into, like, the science behind all that, you can listen to Richard's masterclass. He goes into the, you know, the details of why that's true. Okay. Some ways, that's a super important one just to think about when you're looking at labs.
All right. Let's see if we have time for just another little case. I'm trying to see this. Fine. Maybe a simple one. I, one was kind of complicated. Okay. I got a couple minutes. Oh, here's a good one. Let's go. This. Okay. This is from Michelle. This is a 62-year-old. She's a woman. Rheumatoid arthritis and pain for 20 years. Doesn't sound very good. Eats great, but has a lot of pain. Gave information. Horrible. So, at the bat, you're looking, she's stage 2 for the adrenal exhaustion type patterns. So, you could go back and do something pretty similar to that adrenal program. Usually, with the stage twos, we give a little more DHEA, a little less pregnenolone, but ballpark, it's about the same as that other program. And then for someone that's in chronic pain, you're thinking, "Okay, is there something going on with their mitochondria? Something going on with oxidative stress and inflammation? Or something going on with your brain?" And the neuro, and the mitochondrial markers, or it's a couple that are high, two or three, but it doesn't look like a total bloodbath. And then you look at the neurotransmitter markers, and you're like, "Whoa." There are five out of six or high, and the last one here is just a little behind. So, this entire section here is elevated. So, these markers here show increased production of epinephrine, norepinephrine, dopamine, and serotonin. And then these markers here are inflammatory markers. So, this person's, you know, we already knew they're in a lot of pain, but their neurotransmitters are just on fire. And so, you want to find out where the inflammation is coming from and try to calm the whole system down. And then typically, you know, we're looking at either gut-related inflammation, emotional pain, perhaps, you know, emotional stuff, spiritual stuff, could be toxin-related. So, just taking a look at this test, you can see right away that a couple of the detox markers were quite high, like gluco-create markers extremely high, and prior glutamate. So, those have to do with phase 1 and phase 2 liver detoxification. As I mentioned earlier, there are these pairings that you're gonna see, or I see, like very consistently. So, one of the pairings is the adrenal and gut pairing, where when you see a really bad gut case, they almost always have something going on with their adrenals. So, these two are paired together, and that makes sense, right? Because as the body of stress, the adrenals were out, secretory IgA starts to fail, and lookup becomes leaky. And so, people tend to be prone to gut-related problems when they have adrenal exhaustion. And similarly, neurotransmitters seem to oftentimes, not always, but, you know, more often than not, be tied into detox-related problems. Many of the toxins that build up in the body are neurotoxins that come and damage the transmitter system, cause tissue damage, inflammation. What kind of stuff? You could obviously also have a GI pathogen that's triggering that. And you're entitled to more than one problem at the same time. You can have some GI pathogens and some toxin-related issues that are all contributing to the neurotransmitters. We see high neurotransmitter markers like that, you're gonna find either typically GI pathogens or some kind of major toxin overload that's present. Okay.
And so, then when you're looking at program design for that, let's find some space here. Let's get a fresh one. And I always do these from scratch. It's a little old-school. I really probably should just have some templates or something, but I don't. So, we did an adrenal and GI one, right? So, now let's do kind of neurotransmitter, neurotoxin, or toxin one. So, when all those markers are elevated, typically you can use either 5-HTP or a little bit of tryptophan. Some people only use the amino acids when those markers are low. But when the inflammatory markers are up, oftentimes it means the person is burning through, we're using up the neurotransmitters. So, you can do that. So, I'll put a question mark there. Not everybody would want to do that. It's the same with tyrosine. Some people think it's the opposite, you know, that if those markers are up, the person is burning through the neurotransmitters, but you want to, you know, want to supply more amino acids and make it worse. I found a lot of times people actually calm down when I do this. So, it helps the beginning. But either way, you'd want to do some liver detox support. And so, there's, I kind of divided up in my mind as phase two products, typically those are the sulfur amino acids like N-acetylcysteine, methionine, kinds of things. And you don't want to be shy, you know, you want to give whatever formulas you're using at least a thousand milligrams three times a day, whether it's a straight N-acetylcysteine or if it's some combination product that you might want to use. Okay. And then for phase one, you know, some kind of antioxidant formula. And then you always, always have to have, you know, B vitamins in the mix. And then it is a major liver detox problem. I always use some kind of herbal liver support, that's the Silymarin, beet leaf, kind of, you know, beetroot kind of things. And then now, question here. I'm going to wrap up in a minute. But if a patient is on an antidepressant, if it's, if the medication is an SSRI, then the SSRIs will raise that marker here, 5-hydroxy-indoleacetic acid. Okay? So, if someone's on an antidepressant and this marker is high, that's a normal effect of the antidepressant. It also means that they're burning through or using up their amino acids quite quickly. So, in general, if the person wants to stay on the antidepressant, so now this, this, let's read from figure this. Let's say antidepressants, say, patient on antidepressants, you want to give them a little bit of the amino acids because they need these amino acids in order for the drug or drugs to continue to be effective. So, 5-HTP, you might give 100 milligrams to 200 milligrams a day. Tyrosine, you don't want to give around 1,000 to 2,000 milligrams a day. And again, you're providing these not in order to make their brain better. You're providing these because the person uses up these nutrients while they're on the antidepressant. You also need to solve for compounds that we've been talking about. You need vitamin C, you need folate, and of course, B6, B6. So, put B6 three times, so you know it's important. B6. So, if someone's on an antidepressant and they want to stay on the antidepressant because it's working, then they should be on, unless some of these dosages may be a little high. This that make you nervous? So, let's just bring this down a little bit. So, I was thinking we're in class, but we're not. We're doing like a free webinar, so that's not freak people out. Let's say 100. This is reasonable. This is really reasonable. 100, 1000. And then the sulfur compounds, vitamin C, folate, sulfur compound, cysteine, and N-acetylcysteine. Those things. B6, B6, B6. So, these are the nutrients that are depleted from the use of the medications. And so, the medications become less and less effective over time. And if you just want a person to stay on their SSRI and keep working, this kind of nutritional program will really help. And that's why a lot of times the drugs stop working after a certain number of years because the person is just nutritionally deficient. We say. All right.
So, I, let's see here. Can't believe the time. Always go so fast when I do these things. Let me get this out of control. There it is. So, it's also coming to the end of the year, which is hard for me to believe. So, we have a class starting in November. If you're interested, get in touch with the office. If you're really interested, you can use this promo code and can save some money on signing up. So, what's happening new for the mentorship right now? We have Dr. Lord doing the master classes. We have me talking to him every Monday. And then, you know, during the week, during all the classes I teach live, explaining all the things that he's been teaching to me. So, the curriculum is really up-leveled in the last three years from what I learned, you know, over the years to relate the latest research that Richard Lord has been doing. And it's pretty quite fantastic. I think the students love it. A lot of things like the magnesium-glutathione dyad, things like a hypo-metabolic state. It's a lot of cutting-edge information. Now, if you've been in practice for a while, I think you still learn a lot. And the way we have the program set up, we have, we give you access to all kinds of different sort of features. So, I'll just show you real quick before we wrap. Book. This is the software that you get when you sign up for the class. So, you get, you know, all the regular and recordings and everything. But then we also have just this massive set of resources here where you can type in just about anything. No magnesium. And we have literally hundreds of clips, lectures, case studies that just cover it. It just goes on and on and on and on. And discussions between doctors, interviews that I've made with experts and whatnot. Let's say organics, and something like organic acids. I've got, you know, probably a couple dozen extra hours of how to interpret those tests. And now we're getting into ion panels, thanks to Dr. Lord. So, whole sections on that as well. And again, this is, each one of these topics goes on forever. So, it's a huge resource here, as well as the actual lectures and classes. We have a lot of information that we're trying to distribute quickly. And we get people trained and functional in a practice, you know, by the end of the year. It's really the goal. Okay. I hope to see some of you in class in November. It's coming up soon. I'm taking off for Ireland in about a week, and we're excited about that. I'll be lecturing at a functional medicine conference in Dublin. And I hope to see you at the next webinar that I teach. Okay. Take care, everyone. Talk soon.