Transcription
Hey, hey, hey! How is everybody? Good evening, good morning, depending on where you are and what sort of part of the planet you're in. Um, can you give a shout out to our Australian people? Um, okay, so we have so much to talk about and so little time. So, um, I'll just introduce myself real quickly for those of you that are on this call for the first time. I'm Dan Kalish. Thanks for showing up.
I have done a lot of things in my checkered past. I've taught with the Institute for Functional Medicine. I did their Practice Implementation Program, which was some of the most fun years of my life. I've done research with the Mayo Clinic, which was the worst year of my life. I'm not kidding, that was horrible. That was a big project. I didn't really like that. And then I've done, oh, and what we're going to talk about tonight is, um, I've been working with Dr. Richard Lord. Those of you that are old enough to know Richard, he is still alive, he is still kicking. He's almost 80 now and sharper than ever. And in fact, um, you know, he's, he's an amazing human being and is like a father and a mentor to me and, uh, like a colleague and a good friend and all kinds of good things. And everything we're trying to talk about tonight is right out of Richard Lord's brain.
So those who know Richard from the old days, if you don't know who Richard is, in the 1960s, as a young scientist, he worked with Roger Williams, who you all know is the discoverer of many of the B vitamins and one of the most famous nutrition researchers on the planet. When Richard hit the 1970s, 1980s, he was working in all the different labs in our industry and was one of the founding members of Metametrix Lab. He basically created the idea of doing organic acids testing, amino acid testing, fatty acid testing. He was a scientist that would go out and buy the machines and set up all the testing that we do today. He's a scientist that developed the GI Effects test, which many of you, I'm sure, use. My one, the, you know, first kind of extensive microbiome analysis in our industry. Anyway, so Richard's done a lot of stuff. Now, Richard's focusing on training me so I can train you, and that's what tonight is really about. I'm still in practice. I still, I work with patients on the phone primarily and have managed to stay pretty busy all these years. I'll tell you that there's never a shortage of things to do. So that's me.
My computer is acting a little slow. I'm not sure why, but hope my computer is acting a little slow, but hopefully the sound is good. You guys can hear this. So I want to, you know, the big picture objective for today. We're going to look at a whole bunch of things, but the big picture objective is to understand that all these things that we look at with the lab testing exist on a spectrum. That's the big picture. This is one, you know, you work with someone like Richard for four years, and you know, he, we, you know, two days a week we've been together now, and, um, he asks me questions, he challenges me, he makes, forces me to learn these things in really complicated ways. And then when I, when I step back and I go, "Okay, what did I learn this year from Dr. Lord?" Well, everything exists on a spectrum.
So we all know that inflammation is bad. I think the entire planet accepts that, the whole medical world, right? And we all know that we're driving inflammation down, however you want to do that. You want to use a medication to do that, you want to use a steroid, you want to use some fish oil to do that, you want to use an anti-inflammatory diet to do that. We all agree that we want to drive the inflamed patient's inflammation down. But then the question comes, like, is there the possibility that there's not enough inflammation present? If too much inflammation is bad, do we just drive it down as far as we can? If too much cholesterol is bad, do we just drive it down as far as we can? If too much oxidative stress is bad, do we just drive it down as far as we can? Can you have not enough oxidative stress? I mean, like, I wish we were in a live room right now, I could see you guys. I'd say, "Okay, everybody put up their left hand if you think that you can have not enough oxidative stress." I'd say, "You guys are right. You can be not enough oxidatively stressed. That's a problem with some patients. You can see that on these labs."
What we're talking about right now specifically is there's been a judgment that we've all made in general, which is that omega-3s are good and omega-6s are kind of potentially bad. They've been sort of profiled to be bad. And that the assumption, therefore, is that we're going to always give people omega-3s, especially if they're inflamed, and that omega-6s, just stay away from them because they're bad. And what tonight is about is to understand that all these things exist on a spectrum. And I'll show you some real clinical case studies or examples from my practice that have been patients in whom the omega-6s were the main problem, despite what they're eating, despite all the things that we think about with these fats, that the omega-6, the lack of omega-6s was really their problem. And the idea of under-inflammation, that's just something I made up. That's just to get your attention so you sign up for this class. But obviously, we don't have a word for this really, I don't think. But as we go through the science tonight, hopefully, you'll develop some opinions about this. You can start thinking about it.
Okay, so that's the big picture. The specifics that we're looking at are how to understand fatty acids and their role with the brain. See why lab testing is critical. Like, you cannot hand somebody a fatty acid without a lab. Like, once after tonight, hopefully, you'll agree with me on that one, at least. Okay. And then, what are the potential long-term impacts of omega-3 supplementation if it's not regulated well? And then seeing inflammation as a source of brain-related problems. And then this big question I'm posing up front here, which is, can you be under-inflamed? Is there even a possibility of that? Can you have not enough cholesterol? Can you have not enough oxidative stress? Those are the big picture questions.
So we have a class coming up starting at the end of March. It's our one-year mentorship with advanced testing. We're kind of doing a little mini version of it right now today. And if you guys are interested, it's a full-year program. You get to do this kind of session many, many, many hours a week. We have case reviews going on all throughout the week. Different groups you can join. We have hours and hours of, you know, case studies recorded. We have all the actual courses, you know, the actual sort of lecture portion of the class, in a very active community of doctors. It's a really great group. If you want to devote a year of your life to really understanding advanced labs and how to make this work as a business model, then you should sign up. And you have a thousand dollars off if you remember that code. If you forget that code, you can ask my staff. And again, we're starting at the end of March.
Okay, so there's many different types of neurotransmitter imbalances, obviously. And we're just going to focus on a very small segment of this now. We're just going to look at, you know, the, the things that revolve around fatty acids and, and the things that revolve around inflammation. Not to deny that there's genetic issues, there's stress-induced problems, there's drug depletion-related problems. Many people have inflammation in their brain because of GI-related issues and microbiome imbalances, all that. So we're just looking at a subset of how these things can, can work. And, and hopefully, one that's sort of provocative for you and some things that you may not have thought of before.
So this is the stereotypical view of essential fatty acids that I was taught and I believed until recently, um, because I didn't have anything to tell me any different. That omega-6s, those are the ones from plants, the plant oils are good, you know, but really, you get enough. In fact, the bias really is that most people get too many of the omega-6s in the types of diets that most people eat because they're getting so much corn oil and all that kind of stuff, fried foods, everything. And then the standard, you know, dogma then is that the omega-3s, maybe we don't get enough of those, you know, and that especially DHA, very important for the brain and visual development, and that they're good, really good. And we need to make sure, perhaps through supplementation, that we need, that we get the omega-3s that we need and we avoid the omega-6s. And so the central principle of this course is that sometimes that's true, but if you don't do a lab test, you have no idea what's really going on in that person's brain or with their fatty acids. I don't think any of us are at the skill level, at least I know I don't know anyone who's at the skill level where they can just look at a patient's aura and just go, "Okay, your DHA looks pretty good, but I think your sixes are low." You know, this requires some kind of analytical tool, which is called a lab test.
So the things that can happen when this is going bad, too much or too little of the threes or sixes, would be fatigue, depression, constant food cravings or alcohol cravings, anxiety is a really common symptom with this problem, and so is insomnia. Some people are just in pain all the time, right? And they're having pain all throughout their body, or their brain's just not clicking, it's not working that well. You maybe sometimes call that ADD or ADHD, different titles for that particular problem.
So, um, the, the standard, again, we want to start with kind of where we're all at for the most part, and I think we, you know, most of us accept this, probably if you've been around in the functional medicine community for a while. Uh, standard thing being that we have inflammation that's bad, especially when there's inflammation in the brain. I mean, it's not a great thing to have an inflamed ankle because you twisted your ankle and it's sore, you know, but that's going to get better pretty much on its own. You ice it, maybe rest, you know, a little bit. But the idea that your brain could be inflamed, that's kind of gruesome, you know? It's like, really not a good thing. And so all kinds of books and research on this if you want to get into it. The main pathway that most people think of when they think of the brain being inflamed is the kynurenine pathway. And so there's also been more studies than any of us could ever read, right, about how kynurenine, or the kynurenine pathway, depletes tryptophan, depletes tryptophan levels down as your body is forced to make these inflammatory cytokines. So the idea being that there's inflammation in the brain, just like a twisted ankle is getting swollen, but it's happening in the brain, it's inflamed. And in order to generate that, uh, inflammatory response, your body is burning through or depleting tryptophan. And that inevitably then leads to a depletion of serotonin, which inevitably makes people not feel that great. That, that's kind of like the sequence, right? Brain gets inflamed from some infection, often the inflammation depletes tryptophan by jacking up kynurenine, and we see this all the time in all of our practices with chronic low-grade infections.
And this was a nice little article I picked up the other day. Um, here's a quick quote: "Indeed, many features of what is often referred to as sickness behavior may be linked to cognitive metabolism, including anxiety or apathy that seems to be induced by the activation of IDO." So IDO is the link here. When you look at the pathways, when basically the person is inflamed because of an infection, the IDO pathway gets stimulated, kynurenine goes up, and then serotonin gets depleted. And here's a little schematic of the actual mechanisms, which I think is kind of helpful to see.
So let's just break this down step by step so you can see what's happening here. Now, first of all, there's inflammation, right? And stimulation here, the immune system. So typically, oftentimes, this is, you know, your body's fighting an infection. Whereas the infection, in functional medicine, we kind of always blame the gut, but it could be somewhere else. It's a viral infection, a bacterial infection, or some kind of infection that's driving this pathway, right? And then you have this IDO enzyme here, right, that's taking your tryptophan, converting it to kynurenine. Eventually, that also gets converted to something called quinolinate. And that quinolinate is an agitator of the brain. It's an excitatory factor in the brain. It agitates the brain cells, right? And what ends up happening if that goes on for long enough is that brain cells get overly excited, and the person gets anxious, depressed, brain not working well, right? So it starts off with inflammation and an immune response to an infection. Bursts of cytokines are produced, and then eventually this whole IDO enzyme pathway with kynurenine and quinolinate is stimulated.
So here we've got your patient with the inflamed brain. Then clearly, you want to calm the inflammation down based on what the lab tests are showing you. And you can measure each one of these variables, right? You can measure tryptophan with a simple test. You can measure kynurenine and quinolinate with a simple test. You can even measure magnesium. So you can see where all the levels are. You want to guess about this, and you'll see a lot of patients that have low magnesium, high kynurenine, high quinolinate, and a ton of inflammation and a bunch of infections in their body. And then, you know, everyone's wandering around, wandering around thinking, "Why am I depressed and anxious?" Well, maybe this is part of the problem. Solve the infection, get the pathways figured out and sorted through, reduce the inflammation, and then people feel better.
Okay, so that's, that's kind of like part A. And there's, I don't know, I find this pretty interesting myself. But there's a whole bunch of stuff that's going on with quinolinate and its NMDA role and, and how it stimulates these, um, glutamatergic neurons and all this stuff, you know. So if you want to get into the science behind it, it's really pretty interesting. You can check it out. And then I always include this slide in every talk that I do because I think it was so funny when I first saw that that there's actually an International Journal of Tryptophan Research. Like, someone's actually, you know, started this. Like, it's how crazy is that? But anyways, for this one amino acid, there's a journal, and it's really, really important. And then I'm not trying to put down tryptophan. I think it's really important. If I had more time, maybe I would join the staff of this journal because I really do believe in tryptophan.
So now we're saying that tryptophan is depleted. We're saying that tryptophan can be depleted by brain inflammation. So that's part A, remember? So then you just want to take a deep breath for a second and think, "Okay, what are the ramifications of that biochemically?" Now, regardless of why tryptophan has been draw, you know, TR levels are lowered, let's just say tryptophan is lowered because your patient has an infection, they have the cytokine production problem, they got kynurenine cranked up, the IDO enzymes work in overtime, so tryptophan levels are dropping. So you're looking at a human being in front of you whose tryptophan levels are dropping. What else does that mean? Well, let's look at what else tryptophan does based on the International Journal of Tryptophan Research. You think these people would know the principal role of tryptophan? The principal role of tryptophan in the human body is as a, no, it doesn't say serotonin there. And no, I see, I tricked you. The principal role and TR of tryptophan in the human body has nothing to do with serotonin. The principal role of tryptophan in the human body is as a constituent of protein synthesis.
So let's say that again. The principal role of tryptophan in the human body, I don't see serotonin anywhere in this sentence. It's not to do with serotonin. That's a peripheral thing. Turns out making proteins is more important than making serotonin. So, in other words, the most important thing in the human body that tryptophan does is help you make proteins. Which proteins? All proteins except for collagen have to have adequate tryptophan levels, but you're not going to be able to make them. That could be anything from insulin, is a protein, last time I checked. Hemoglobin, those are pretty important, right? No one would argue with those being important. It could be a muscle tissue, cardiovascular tissue, a cell, you know, any kind of protein, any protein. The enzymes that we use to metabolize our food, all these are proteins. So if you don't have enough tryptophan because you're inflamed and you're depleting it because you have this kynurenine problem, serotonin is the least of your worries, right? You can be depressed, and tens of probably hundreds of millions of people are walking around depressed because their brains are inflamed. That's not something that necessarily completely destroys you, right? People still survive somehow being depressed. But if you can't make proteins and you can't make enzymes, you're not going to be around very long.
So your body prioritizes, and again, the principal role of tryptophan is as a constituent of protein synthesis. Now, it is also, of course, a precursor to, as they say right here, important metabolic pathways like kynurenine, which we're talking about now, or kynurenine and serotonin. Okay, we're not denying that. We're just saying that the most important thing that it does is make proteins. Which proteins? All proteins in the human body except for collagen have to have tryptophan, or you will not assemble them. Everything that regulates your blood sugar has to have, all those enzymes have to have tryptophan, or they won't be produced. So you can see if your brain is inflamed and your tryptophan levels are dropping, it can have effects all over the body in all kinds of different ways. And you really want to, you know, deal with this for your patients because it can cause a whole bunch of different issues that, you know, may be broader than you would even think based on what we're talking about here with the basic, uh, you know, biochemical pathways.
Okay, so now, again, just saying the same thing, but now I have a diagram. Proteins, tryptophan. A small percentage of it goes over here to serotonin. The majority of tryptophan goes to making body proteins. All the proteins in the body, all the enzymes, all the important stuff, all you, I mean, most of your tissues, most of your organs are made up of proteins. And you cannot assemble any proteins except for collagen if you don't have the tryptophan. Okay, so you can see why brain inflammation makes a really big, it can create a really big impact on all parts of the body. And this isn't like even some wacky alternative medicine idea. This is a basic kind of biochemistry. So far, we haven't even talked about anything kind of natural medicine oriented yet, right? Here's our tryptophan going off primarily to protein synthesis, but also capable of going towards kynurenine if there's an infection and inflammation. And then, you know, all these things that happen that we talk about. Okay, so it's just another way of looking at the same thing. And we're going to, I'm going to, you know, get through these slides pretty fast, and then we're going to look at some cases. You can see.
Okay, now, now this is where it gets a little complicated. So if you are overwhelmed, um, I don't know if you're overwhelmed, just, you know, listen to this a second time or something. Okay. So fatty acids, your body gets omega-6 and I've got like six of these diagrams we're going to look at this a bunch of different times. Okay. So you, about your body gets omega-6 and omega-3s from the diet, and then it starts to convert them using these enzymes to convert them, right? So the sixes, again, black currant seed oil, primrose oil, borage oil, hemp. And then on the foods, the things that people eat all the time, sunflower oil, safflower oil, sesame, canola, grapeseed, corn oil, etc., etc., soybeans, right? And then on the threes, you guys are familiar with flax, hemp, and mostly famous with the fish, right, fish oils. So your body takes both the threes and the sixes and it uses this delta-6 desaturase enzyme, which requires vitamin B6, magnesium, and zinc, to convert this one fat to the next. And it does that on both sides of this diagram. So your body is converting this omega-3 to this omega-3, and then this omega-3 to this omega-3. And it's converting this omega-6 to this omega-6, and then this omega-6. So these are these pathway charts here are how your body's converting these different fats.
And why does this matter? Well, sometimes people have a problem with these enzymes, and so this conversion doesn't go that well. And then people have deficiencies with the downstream versions of these fatty acids. And why does that even matter? Well, look at the ones that are way down here. Remember in school, we all had to learn this. I totally remember the exams for this. Prostaglandin series 1, prostaglandin series 2. Remember you had to memorize that? And then prostaglandin series 3. Remember you had to memorize those because they're really, really important. And if you don't have these fats, these 20-carbon fats right here, you can't make the prostaglandins. And that's not like an optional kind of nice-to-have thing. That's not like if you're buying a car and you're like, "Oh man, I think I want the leather seats, so I'll just get the upgrade and I'll pay the extra $1,500. Let me get the leather seats." This is not like an upgraded kind of nice thing. This is like, you have to have prostaglandins. You have to have them. Okay. I know that they're at the bottom of these pathways, but it doesn't mean they're not important.
So if you don't have the enzymes, so there's a genetic defect with the enzyme, or if you don't have enough B6, magnesium, or zinc, then these conversions aren't going to happen. Okay. There's other enzymes in here too. There's something called the elongase enzyme. You can imagine based on the name, it makes these fats longer, right? Well, obviously, the delta-6 desaturase does a desaturase function on them. It's kind of named for what they do. And there's also a delta-5 desaturase. Now, the reason why you got to know these enzymes a little bit is because the enzymes preferentially convert the threes over the sixes. So if you give somebody omega-3 fish oils for a really long time in a really high dose, these enzymes are going to work over on this side, and the omega-6 side is going to be negatively impacted. Okay? If you give too many threes for too many years, the sixes are going to be negatively impacted because these pathways share the same enzymes, but there's a prevalence or preference or leaning towards the omega-3s for these enzymes. They prefer to convert the threes if they have a choice. So if you're giving a lot of threes, the sixes are going to start to suffer. And again, we have like five of these diagrams, so we're going to keep harping on this as we go through.
And then why does this even matter? Well, um, we're not against EPA or DHA, right? Because these are like super important, and they're important for your brain, for your joints, for your heart, for your mood, okay, for your immune function. So the omega-3s are very important. This is a slide so that you guys don't think I'm anti-omega-3 or something like that, okay? Um, and then, you know, there's another slide to just say, okay, I'm not anti-omega-3. That's not what we're saying. We're just saying that you gotta think this one through. And now we're back to our regularly scheduled diagram here. Okay.
Now let's just dig into this one more time because hopefully by the end of tonight, you just get this and then you won't have to worry about memorizing it or anything. Okay. So remember, now we switched the sides here. Now the omega-3s are on the left. That's just to keep you on your toes, right? So cold water fish, flax oil, omega-3s, alpha-linolenic is the first one. And note this little marker here, see where it says 18? That turns out to be very important. That's the number of carbons in the chain, okay? It's an 18-carbon long fatty acid. You take that delta-6 desaturase enzyme, and then you make this fat. And then you take your delta-6 elongase and you make this one. And then you take your delta-5 desaturase and you make this one. Now you're an EPA. And then you do another couple steps and you're down here at DHA. And look carefully, the EPA, you'll see, is 20 carbons long. DHA is 22. So guess what? As the fats are going down these pathways, they're getting longer and longer and longer, from 18 carbons down to 22.
Now over here on the six side, same, same thing is happening. Linoleic is the initiator of this or fat, right? Then we use that same enzyme, delta-6 desaturase, to make GLA. Then we make this one. Then we make arachidonic, which is the very famous one, which is again 20 carbons long. That turns out to be important later, okay? So arachidonic acid typically is considered the bad one because it's more related to producing inflammatory eicosanoids, whereas the, uh, happier, friendlier, right, um, constant production is happening over here with the EPA and with, uh, DHA. And there's, there's some details in here you probably don't need to worry about, but anyways, that's the big picture. The bottom line thing to remember is that these fats have to get longer, and you gotta make one to the next, and you need enzymes to do that, and sometimes the system doesn't work very well.
Okay. And then at the end here, the caution waves themselves. Let's look at arachidonic acid. Why do we even care about that? Because it's helping us make things like leukotrienes, thromboxane, right? These are very, very important things for the inflammatory response, and very important things for the immune system. This is not like a sideline here. These are very important physiological processes for us to have in order to not be overly inflamed, but not be under-inflamed, and to have an immune system that's regulating and working really well.
Now, remember I said 20 carbons long? And here are the three 20-carbon long fatty acids from which we make our series 1, 2, and 3 prostaglandins. Okay? Now, when I was in college, my dad was a psychologist, you know, and so he kind of, I don't know, we had this unspoken pact that I was going to become a PhD in psychology, and I just kind of knew that's what my dad wanted to do. So I was setting out to do it. So I got a, I got, I majored in psychology when I went to college, and I was like working at a graduate level by the time I was like 10 years old, and that was all because of Dad. But what I was really interested in was science. So I got a degree in physiological psychology, if you can believe that, my undergrad, because I spent all the time in the science department taking physiology classes. Okay? I just find this stuff really interesting. And now that I'm actually treating patients, it's like, wow, you better know this stuff.
20 carbons long, why does it matter? Because all these fats here that are 20 carbons long, okay, are how we make our series 1, series 2, and series 3 prostaglandins. Now, and it's, and what we're trying to debunk tonight is that the inflammatory, pro-inflammatory ones are all bad. Can you always, is it always just bad, bad, bad, bad arachidonic? No. We're going to see some cases in a minute where the arachidonic was too low, and that led to a health crisis. Okay? You can have not enough arachidonic. You can have not enough of the PG2 series. Okay? That can happen. That can happen. That can happen. Okay?
So now let's go on. Enough of this science stuff. I made up this name, "under-inflamed." I don't know what to call it. It just means that the person doesn't have enough arachidonic acid. That's all I'm trying to say. They don't have enough arachidonic acid. Here's another one of the same thing, same pictures. And remember, as you're going down through these pathways, you got to have all these enzymes in place where this doesn't work. Remember, you need B6, you need magnesium, you need zinc. Zinc is like super important. If the person is low in zinc, none of these things are going to happen. You're not going to make these conversions. So as you go further down this scale here, you're more and more vulnerable to it not working right because each one of these enzymes can be defective. You could have a genetic problem with any of these enzymes, or you could have a nutrient deficit that's screwing up one of these enzymes. So it's very common for people to have these problems.
And here's an article about delta-6 desaturation. We don't have time for that, but I'm running a little behind here, sorry. Origins of arachidonic acid deficiencies. It could be that the patient's been taking too many omega-3s for too long. They're chugging flax oil. I did, I had this happen a few months ago, maybe six months ago. I had a patient, and she's making a smoothie with like a gallon of flax oil every morning. I was just insane. I forget how much she was taking, but it wasn't a gallon, but it was a lot. You can take, if you take that many threes, you're going to lower your sixes. If you're chugging flaxseed oil every day, you think that's the best thing for you? You're going to have some problems. When we say flaxseed oil, we're like a tablespoon a day, right? One tablespoon, not a pint. Okay? So you can also have problems with omega-6 deficiencies because you're just not intaking them right. You're not getting those fats in. You could have a delta-6 desaturase genetic polymorphism. That's also known as a SNP. There could be a SNP or a genetic defect with that delta-6 enzyme that we just saw. It means the enzyme's just not working right. Maybe they've got a digestive problem, they don't absorb fat. Maybe they have a mitochondrial issue and they're not making, uh, the fatty acids in the mitochondria.
Okay. So here's an example of a test. All right. And we're right where we should be time-wise here, okay? So let's just think about this for a second. Big picture, omega-3s, are we against them? No. Just because I'm talking about omega-6s doesn't mean we're against omega-3s. And so this example here is very good because this person has low alpha-linolenic and low DHA, right? This marker here is DHA, the one that we just said is really important for the brain. So you would want to give them flaxseed oil or flax seeds, whole, you know, ground-up flax seeds that you eat every day, not a lot, tablespoon, you know, of ground-up flax seeds, and some DHA to normalize their brain health, their omega-3 balance. And that's all good. We're happy that we're doing that, and this is a very good thing. However, look at her omega-6s, and are they all okay? No, they're not. You know, really, in fact, they're really not good at all. And look at how low they are. All these guys are low. And you see this one, arachidonic, that we all think is such a bad thing. It's not good if it's too low. It's very bad. If it's high, what we're trying to do is develop a nuanced sense of of understanding, a nuanced sense of perspective on this. So just because arachidonic is extremely bad when it's high, does not mean it's okay when it's low.
And what was going on with her? Depression, mood problems, anxiety, skin problems, chronic GI problems with Crohn's and IBS. She had Giardia and H. pylori. She got a lot better, but just really wasn't on it, you know, just was not quite where she wanted to be. This is a patient of mine. And the main problem for her, really, was the anxiety. So it's a very interesting woman. She went on to become a stand-up comic, which I think is really cool. And, um, anyways, that's a whole other story, but she's a very interesting person. I'm still in touch with her. So when we put her, let's call her Ann, that's not her real name, when we put Ann on the threes, that's a generic thing, like you could probably most of you do that all the time anyway. But when we put her on the sixes, the anxiety just went away. And this young woman was eating one of the healthiest diets you could imagine. Like she was like waking up and living the organic life. She was not eating junky food. It wasn't for a lack of healthy omega-6s in her diet that was happening. In fact, she had enough of the linoleic. You can see there, the problem started right here. Okay? So with it, when there's enough of one fat and then the one next in line is not there, you're starting to think, "Okay, wait a minute. This enzyme right here is not working right. Is it a genetic defect? Is it a co-nutrient defect? You know, like not enough zinc, not enough magnesium, not enough B vitamins?" It's going to be one of those, typically. If you see one fat is okay and the next one is quite low, okay, you can see the break for her here is right here. That's where she's having the problem between linoleic and gamma-linolenic, right? And this is not the hardest thing in the world to treat, right? We just do it, you know, double up, triple up the dose of GLA, omega-6s, and then boom, you know, 90 days later, people are feeling better.
So I just want to show you this one more time that the, uh, let's see, this is not the best example. Let me go back to this one. So for that patient here, remember we said the linoleic was okay, and then the GLA was not. So here's where her problem was. We can identify it pretty, in a pretty targeted way. Can you see that here? Let me just draw it for you. So in other words, oh, hang on, there we go. This guy was okay on her. This guy was not. So the problem was right here in this step. That problem was right there. Okay? There's a block there. What is that? The desaturase, delta-6 desaturase enzyme, not working. Okay? She's not being able to convert her linoleic to gamma-linolenic, and then that was having a problem downstream with all these others, right? So is it magnesium, B6, or zinc deficiency? Is it a genetic defect? Turns out, you guys don't really know the story here, but turns out we ran labs on her father, exact same pattern. Suspicious, perhaps, is genetic. We don't have proof, but it's pretty suspicious. Put Dad on the exact same GLA formula, his anxiety and depression went away too. Kind of cool, suspicious. So what do you call it? A suspected genetic connection there. Um, in fact, and his labs were virtually identical to her. So I'm pretty sure there's a genetic role there, more so than it was that they were both low and via, you know, zinc or something like that. Okay.
All right. So now we're at the 30-minute mark. We talked about this. There's a bunch of studies in here. There's a low zinc. I already talked about like low zinc turns out to be super important. Wow, look at this though. All right, here's, here's another way you can see this. Now, I mean, you guys got to learn how to do this stuff. It's just so cool to be able to tell people what's really going on. Okay. Now look at this one. Now this case is low in zinc. Okay? This is the case that's low in zinc. And look at the omega-3s are all fine. They're all normal. The omega-6s are normal at the 18-carbon length, normal at the gamma-linolenic, normal at the 20-carbon length, normal at the 20-carbon length here. And then boom, not normal. There's a break there. Something's wrong with the enzyme that's converting that guy to that guy. You see that? There's a snap right there. Everything's fine up until then. You can go back on these charts and you can look and you can see exactly what it is, or you can just memorize it's either a genetic defect, or B6, or just say B vitamins, zinc, or magnesium. If you don't even want to memorize that, just give them a really high potency multi to make sure they get B vitamin, zinc, and magnesium. Maybe give a little extra zinc, okay? Because zinc is very important for this. And again, low arachidonic. So there's not enough of this arachidonic acid to make those eicosanoids that we're looking at, to make those prostaglandins. That's a big problem.
Okay. Now talk about this. Okay. So mentorship, it starts at the end of the month. You guys should sign up. A few of you hopefully will get a thousand dollars off with a VIP discount. Um, it was VIP March, uh, March 21st. And then, um, what's happening with this thing? When you sign up, you get an introduction and orientation. You get thrown into a class where we're reviewing labs every week. You get a massive curriculum that you're studying from month after month after month. And then you're running labs on your patients, you're running labs on yourself, you're learning how to interpret these things, and people are getting better. And it's, in general, a really great experience. If we get the right person at the right time, then this class is just like magic for people. Okay? And if you're interested, you can contact the office and we can give you more information about the course that's coming up. We have a particularly lively group of people in the class right now. I just admit, if any of you listening to this call are from the class, uh, you know, you are the lively group. And you know, I see Shireesh there. You know, I don't know, I love teaching this stuff, and I love nothing more than when doctors get it, you know, and then you guys can go out and help people. That's a really cool thing.
All right. So that's, um, let's look at a couple of cases and then we'll go through some questions. All right. So let's see. Let me get a case up here first. Uh, let's see where are my cases? This stuff really works, you guys. Like, I know when I was first starting out, you know, the funny thing is, I'm 56 years old now. I don't know how that happened. I act like I'm 25, probably most of the time. But, you know, you can ask my fiancé about that. But, you know, when I was first learning this stuff, I was like 29 years old. I don't know how that is. And my teacher, Dr. Timms, I remember thinking, "God, this guy is so old." He was in his early 50s when I met him. He was younger than I am now when I met Timothy. And I remember one of the things, one of the things that always stuck in my head the first couple years I was working with Dr. Timms, or Bill, which we call him Bill. He used to call me Danny Boy. But when the first, you know, was like, I would always look at him and I always think, "I don't know, this guy looks old. He must know what he's doing." You know, like he's been in practice for 30 years. He looks really old. He's got gray hair, his skin is kind of wrinkly. He must know what he's doing. And so I would just, you know, if he said, "Give him omega-6s," I would give him omega-6s. I didn't question any of this stuff.
And, um, but part of the joy of it is that, and he knew this too, when I was a very young man, I remember that little twinkle in his eye. He knew that I was gonna get it eventually. And he knew that someday I was gonna be like, "Oh my gosh, I can't believe how well this works." I mean, there's a sort of miracle magic to this to just give someone like Ann triple the dose of GLA and watch her lifelong anxiety and depression go away and watch her, you know, blossom into this comedian in Los Angeles. I mean, it doesn't get better than that. It doesn't get better than that as a person. I mean, just so privileged to have had these experiences all these years. Okay. Okay.
So now we're doing this little quiz time here. Magnesium is low. Zinc is low. Right off the bat, you don't have the nutrients you need to run all those enzymes. Remember, because those enzymes require magnesium and zinc. So right off the bat, this person might have a problem. We don't even know. Oh, and if they had, they're high in mercury. Now, when you don't have enough fatty acids, you're going to have a lot of problems with cell membranes, and those types of people tend to get quite toxic, don't they? We don't have time to go through all these things, but let's look at the threes. Okay? So now this person has one omega-3 that's low, and you can see a majority of the omega-6s are low. So yes, they need some omega-3s, but more so they need omega-6s. And when I say triple the normal dose, the typical dose that I've used in the past for the average person that there's no lab test, you're just giving out sixes, I don't know, like for a hormone-related problems like that, you'll be usually around four or five hundred milligrams a day. So when people are this low, we start them off on two capsules, three times a day of GLA. That's around a little under 1500 milligrams a day. So it's around 500, three times a day. I usually do that for 90 days and then have them cut it in half because you don't want to give them high dosages of sixes forever. That's going to interfere with their threes, right? So again, around 500 milligrams, three times a day, around 90 days, assuming their anxiety is gone, they're feeling better, than cutting the dosages back. Okay? That's sort of a standard. And with the omega-3s, this person is just moderately low, right? Just one of them is low. Usually start with around two grams a day or two thousand milligrams a day. You can certainly give more if you want to speed things up, but that's a typical starting dose for the threes.
All right. Now let's look at one more here. Okay. Again, low magnesium. So the new magnesium to make this work. Cofactors are important. Um, what's a whole other problem here? Low CoQ10. That doesn't look very good, does it? Uh, let's see. Oh, a little twist here. This is similar to the one that's in the book that I just showed you. Now EPA is low. Two of the omega-3s are low. The omega-6s are lined up beautifully, except arachidonic is low. Okay? So now this person needs both threes and sixes. You do both. Simple. And then how do you know when to stop? How do you know what you do around the six-month mark? You stop and you re-test. And these are, by the way, if you don't use these tests, these are Ion Panels from Genova. You can also use their Nutreval to get the same data. So either the Nutreval or the Ion Panel from Genova will give you this information. Here's case number three. Hopefully, once you see a bunch of these, okay. High homocysteine, low magnesium. Kind of already getting in the understanding how many people, low magnesium. Oops, high in lead. Well, that's not good. And again, when fatty acid levels are low, cell membranes are weak, people become really toxic, don't they? Well, that does not look pleasant. Wow. God, look what happens to people, you guys. Every single omega-3 is low. All but GLA on the sixes is low. Oh, how are you thinking you're going to, you know, get up and run through the day like that? Just bad, bad, bad. Now the mono-unsaturates are really low as well. So now what are we all thinking? Well, either this person, you know, has got an eating disorder and they don't eat fat, that's one possibility, or they have, you know, a major gallbladder or digestive problem that's interfering with fat absorption. So good example where you give the threes and the sixes, they will feel better, but you really gotta, you know, test and correct the gut. Or because again, this person's low in omega-3s, they're low in omega-6s, almost all of them. Okay, we understand that that's a problem of the things you're talking about. But wait a minute, they're low on the mono-unsaturates as well. So now we're looking more at dietary absorption type problems, right?
So now, let me, let me glance at some of the questions here and we'll see if I can answer a few of them. Uh, yeah, all right. Um, so testing for brain inflammation, that's done from organic acids. Um, so the, not the best, but the preferred type of amino.
Acid testing for me is done from blood. So a neutral vowel or a um ion panel from Genova. Let's see, is there a way to know if you need one or the other without testing? Not unless you're, you know, a mind reader.
Now, there are some doctors, mostly chiropractors, that do muscle testing. Totally support muscle testing if that's what you're into. So those folks can do it. Um, but I prefer the labs personally. So everyone's a little different, right? Some people need the three, some people need the sixes, some people need both.
If you can't see the slides, it means there's a little tech issue and you're gonna minimize your camera. Okay, so if the person has a snip, you can overcome the snip by giving the nutrient in a supplement form. That's the whole idea of personalized nutrition. You have a snip, your delts, your delta-6 desaturates doesn't work that great. What's the workaround? Take fatty acids. Or, you know, once you normalize or stabilize them, you know, you can try to do it long-term with diet.
So then for uh dosages of magnesium, typically 200 milligrams twice a day, morning and night. I use a chelate, you know, magnesium chelate. So it's bound to a bunch of amino acids. B6 is typically 50 milligrams either once or twice a day. And zinc is somewhere between 20 to 40, maybe as much as 50 milligrams a day, depending if they're low or not.
Now, remember, some of these labs you're going to see that they're testing low in those minerals as well. Oh, there's Jennifer. Hi, Jennifer. See, we do have some of the students in here. Um, so let's see, I'm trying to get all these. Oh, the low with the low monounsaturated. That's either their gutting eating disorder, no, not eating anything that has fat in it, or more likely they have a gallbladder or a digestive problem. So you want to go hunt that down, right? I just, that example was, I would actually didn't put that in on purpose, but that example was there. That was a patient that had a digestive problem.
Okay, and then people are high in saturated fat, then you want to have them cut out or reduce dairy products and animal products and whatnot. If they're high in saturated fats, we didn't see any of those tonight. But let's see. And magnesium is around 200 milligrams twice a day, typically a good quality magnesium. B6, 50 milligrams once or twice a day. I like the ion panel. I'm just used to the format. The neutral valves just being redone and they have a new format for it, which is much easier to read. So they're, they're basically interchangeable tests. Okay. All right, I think I got through most of the questions there and we're going to wrap it up now. I think, because we're right on time. Oh, look at me.
Okay, so, um, oh, the amazing. One more time to answer Brian's question. The GLA dose is around 400 to 500 milligrams, depending what capsule size you're using, three times a day for 90 days, assuming the test low. So that's triple the typical dose, right? You're tripling the dose for 90 days and then cut it back to just two or three capsules a day and then another 90 days of that and then retest. And never give a high dose. That's the whole point of tonight's talk, right? Never give a high dose of three or sixes without testing and then retesting. You can't just put someone on a high dose of six because they're low in sixes and keep their fingers crossed that that's going to work.
Most of the time, I use zinc picolinate. And, you know, we had a, I don't have time to get into this stuff, you know, but you guys sign up for the class for one, okay? Then you can talk with me every week for hours and hours. But they just ended on this one thought, like zinc is so much more important than any of us really think about. If you really look, if you just spend a couple hours reading about all the things that zinc does, you're just going to want to run out and just take zinc all the time. But zinc in excess lowers copper. So you can't just give everybody high dosages of zinc. You got to do the test. Zinc in high dosages lowers copper. And lowering copper is a bad thing because copper is important for transporting oxygen around in your body. And that's a pretty important function, right? So high dosages of zinc are warranted when people test low in zinc. When the test comes back normal, then you stop. High dosages of omega-6 are warranted when people test low in omega-6. When you retest them and the levels are normal, you stop. You don't want to overcorrect and put people on these high dosages for long periods of time because that'll just make them worse.
All right, gang, we're going to wrap it up for now. I think this is a mini-series, which means there's more of these coming up and we should be able to cover that. I'm sure you'll be getting emails on whatever the next one is. And I do have a patient practice. Any views that want to do a consult, you can schedule through my patient practice and I'm happy to review labs for you if you want to become a patient. Okay, goodnight everyone. I'll talk to you soon.