Transcription
Hello, hello, and welcome to our lab review session. I hope you all are good out there, given the state of the world. Um, if someone could raise their hand, assuming that my sound is good, just so I can be sure that we're having good sound. Oh, thank you, Ann. All right, so we are, um, in action mode, and I want to talk a little bit about what this is all about tonight. We have a ton of information for you guys, and I'm going to make a little announcement about what is happening around the Chaos Institute.
First, we are planning out for next year. We are wrapping up 2020. We are having the busiest year we've ever had because everyone has decided that telemedicine is a good idea, finally. So, just to announce, on November 10th, in just a couple of weeks, we will be launching our last one-year mentorship for the year, which includes all the advanced testing. We're going to talk a little bit about it tonight. We're not going to have time to probably talk about the genomics much, but maybe in the last five minutes, I can talk about that. Really starting to integrate genetic testing, or I shouldn't say genetic testing, really starting to understand how to interpret organic acids and fatty acids and amino acids with a genetic perspective, so you can see these genetic disorders leaping out at you off the page of these Nutra-Vaal tests and these ion panel tests and organic acid tests that we do. Very, very, very important to understand that and absolutely critical, and, uh, not just kind of it's because it's fashionable now, because it's really necessary to understand for patient care. So, it's a one-year class. We talk like we do every week. We have a lab discussion, like we're about to have right now. There's also this massive curriculum that I've built over the years and a community of other doctors. You get a thousand dollars off if you enter this code right here. Okay, so if you like tonight, you want to do a year of this intensively and, and have a curriculum that backs it up, then you can check out the mentorship. Okay, talk to one of our staff about it. You can talk to me about it and see if you're a good fit. But tonight, it would be a good example because a third of the mentorship, one-third of the course, is live calls like tonight. We do these every week with a small group of doctors to go over labs and talk about, uh, clinical models and how all this works.
So, um, we've got a few labs that were sent in. Uh, Jerry here has a lab, and, um, and then we have, I think, maybe two others. There's Stuart that sent in a couple of tests. So, let's start, start off the conversation with Jerry here. See if I can unmute Jerry. Jerry, there, uh, I'm trying to unmute you. Let's see if that works or not, so you can talk. Unmuted. Self-muted. You should be unmuted on my, oh, there you are, Jerry. Yes. Yeah. Hi. Hey. Well, thanks for sending the lab in. You want to tell us a little bit about this particular patient and how I could help with questions you have? Uh, yes, it's a 65-year-old male, um, highly stressed. And this is the Nutra-Vaal, right? Uh, no. Oh, no. This is this test. Oh, sorry. Yes. Yes. Sorry. Am I, let me make this a little bit bigger. There we go. There we are. Okay. So, highly stressed male, and you've got, um, the salivary cortisol testing, right? Yeah. Yes, that's correct. Okay. All right. And anything else we should know about him or what your goals are in terms of his top complaint? Uh, just, uh, high stress. Is he kind of freaking out in general? Like, he's, you know, not sleeping well, or those kinds of things? Yes. Yes, that is correct. All right. So, let me, I want to show you guys, um, we're going to, thank you, Jerry, very much for sharing this. So, I'm just going to show you guys some systems-oriented stuff. So, we're going to look at this lab, and then we have a Nutra-Vaal lab, then we have a couple of gut tests that Stuart sent in. But the biggest picture, the biggest picture here is that for every lab test, you need to contextualize it. You need to put it into a clinical model, or it doesn't really make any sense. It's not going to help anybody. So, like when we do a lab test, in any kind of test, like, I don't know, you could have an x-ray of your knee, you could have a cholesterol test, you could have a scan for cancer, you could have, uh, you know, um, you know, urine test to see if you have a urinary tract infection, right? With every test that's ever done, is done not in an isolated individual way, but in a, in a systems-oriented way, right? We're looking for something that relates to a body system. And so, in functional medicine, we, I really want to encourage, and this is what the whole mentorship program is about, teach you guys a system that you can put every single test into. It's an adrenal lab. Where does that go? It's in the neuroendocrine body system. How does that relate to GI and detox? Well, let's talk about that. And this is for patient education purposes. This is for your sanity in trying to do this work because if every test and every patient starts from scratch and is different, you just can't have a practice like that. You're not going to be successful. You know, yes, everyone is individual. Yes, everybody is special, like a snowflake. They're a little different, but the bottom line is people have one of these 12 problems on the board right now. A lot of people have them all. And we're going to test and figure out whether we're going to fix the neuroendocrine, GI, or detox systems. Within each system, we're going to figure out, like, for the adrenals, are they stage one, two, or three? For the GI tract, are they a stage one, two, or three of the GI tract falling apart? For the detox pathways, which detox pathway is messed up? And then we're just going to treat those basic things. As I, you know, some of you may have known the, as the music producer is old now, I think he's still alive, Quincy. Quincy Jones, right? And there's a, a really great, uh, you know, biography of him on Netflix now. It's a couple-hour show about his career. He's just a wonderful and interesting man. But one of the things that Quincy Jones says, he's talking to this, you know, he's like in his 80s or something, right? He's old, but he's been in the music business forever. He's talking to this young rapper, and he's like, "Hey, you know, man, there's only 12 notes." All of Western music, all of Western music from Bach to punk rock, there's 12 notes. Just depends on how you put them together. And it's like, "Whoa, that's some words of wisdom." So, in F and I, when I heard that, I was like, "Hey, that's what I teach in my class every day." Quincy, yes, there's only 12 problems that your patients can have. They're on the board right here: adrenals, and that also means thyroid, neurotransmitters, mitochondrial energy, sex hormones, GI has pathogens, leaky gut, microbiome, detoxes, detox loss, GADs, and methylation. There's only really 12 problems that encompass almost all functional medicine. You can stick almost everything into here. Lyme disease, I don't know, you have to kind of cram it into a corner somewhere, or mold, or, you know, there may be one or two things that are kind of not in this model, but in general, this encompasses almost everything that a functional medicine practitioner does. Okay. So, what we're talking about now with Jerry's patient is just this one little block here, this adrenal block. But where does that fit in? Okay, it fits into the neuroendocrine system. What are we going to treat first? Where we generally treat neuroendocrine first, then GI, and then detox. So, this also shows you the order of treatment, as well as the 12 different things that you need to understand. And if you can move around these little blocks here, and you know how to do an adrenal and a mitochondrial program, and you know which one should come first, you'll be super successful doing this. If you don't have a system to put all this into, you're going to be doing different things with every patient. You're going to be giving people too many supplements, and it's not going to work very well. Okay. So, we want to be really systems-oriented. And I'll show you one more thing, and then I promise we'll get to the lab interpretation part. Just want you guys to see this here. So, and did I make up this system? Not really. You know, I, uh, I digitized it and put it in an online class. This is what I was taught over the decades of my training. None of this is new. You know, I'm just putting it together in a way that people can understand. And I have a really great platform in that we have this online program, so I can kind of show people. So, when we think about systems, right? There's this neuroendocrine system. There's this GI system, GI tract. And then there's the detox system. So, when the way that people get sick, there's a death in the family, there's a divorce, you have your second or third kid, you're working too hard, you've got financial problems. The neuroendocrine system starts to falter. This weakens our immune response. This starts to thrash the gut lining for two primary reasons. Number one, because when we're stressed, we become catabolic, and when we're catabolic, we start to break down and chew up the gut linings. You get leaky gut. Number two, because when we're stressed, our immune regulatory systems in the gut don't work real well, right? Cortisol regulates secretory IgA. So, when we're stressed, IgA gets all messed up. Your immune system and your gut weakens. You become catabolic. You break down your gut lining. So, now you've got weakened immunity in the gut and leaky gut. Not a bad, not a good combination, right? So, eventually, GI problems start to happen. And then, if that goes on for long enough, then we get super toxic, and all these other kind of environmental toxin issues pop up. So, that's the basic model of how we get sick. The model of how to correct people: treat, test, and treat the adrenal hormones, like we are with Jerry's patient right now. Do all the coaching around lifestyle. Then fix the GI. Then fix the detox pathways. Okay. So, three body systems we treat in the order in which the problems occur. And this is an explanation to patients about why they're sick, as well as an explanation on this slide about how we're going to get them better. It's a cohesive, organized system that incorporates these 12 different body systems in it, right? So, that's the context that we're looking at Jerry's labs in. Is that okay? This is a first body system. We always want to start here. How stressed is this person? We're going to do lifestyle coaching, which we're not talking about tonight because this is lab interpretation. But we're assuming this guy is meditating, eating right, exercising, and getting tons of sleep. That's the lifestyle stuff. We're assuming that's happening. And then we're looking at his lab and we're saying, "Oh, wait a minute. His cortisol in the morning is low. That's not good. His cortisol at night is low. That's not good either. Melatonin's on the low side. That's not great." And then his DHEA is at the very low end of the okay range, but I would call that low normal. Okay. So, basically, he's what we would call in the system that I teach, a stage three. So, let's look at the adrenal stages. So, uh, let me show you here. And again, with every, and this is patient education stuff, too, right? This is not just about, you know, analysis and program design, but each of the adrenal stages has a slightly different protocol to it. And when we define stage one, two, and three here, we are here. So, I would show this slide to the patient and I would say, "Gosh, you know, I don't know his name. It's called Adam. Gosh, Adam, you know, when you're first under stress, cortisol levels shoot up. If cortisol goes up for a long time and stays high, we call that a stage one. If cortisol levels are dropping down and they're low, and DHEA is coming down too, we call that a stage three." And that's when people are exhausted but wired, they're anxious but tired, they're stressed, and they don't handle stress real well. And it's, you know, an accelerated sort of degeneration or dysfunction with what we call the HPA axis. The HPA axis and having a protocol, there's a protocol for stage one. It's a little different than stage two, a little different than stage three. What we're worried about, Adam, is your HPA axis not communicating adequately or properly with your adrenal glands. So, these hormone pro, you know, patterns or production patterns aren't working really well, right? So, then, in, in response to that, then we want to rebuild the adrenal glands and reset the HPA axis so this system can come back online and that you're not going to feel horribly stressed all the time. All right. So, then we just look at stage one, stage two, stage three protocols. Pretty straightforward. And, um, let me show you guys here. I think, yeah, here, here's another way of looking at it. And again, I use a lot of patient education materials. And in the mentorship, we really want to focus on communication skills because if you're communicating to people well, you know, they're going to refer. So, we're looking at the circadian rhythm, right? This is the normal fluctuation of cortisol. And in this case, in this patient's case, they're what we call a stage three, where the cortisol levels are dropping down and the DHEA is also low. Okay. So, there's a specific stage three protocol. And I'll show you guys what it is right now. And Jerry, you're welcome to use this with your patient if you want. Does this always work? No, it works a lot. You know, like, more often than not. There's a very, very effective protocol. It's been around since the '70s. Um, I learned this from my teacher, Dr. Timmins, and I've been repeating these protocols for the last 28 years, and it's, it's an amazing, it's like a magic trick. So, he's a stage three. So, we'd probably start off with the DHEA at three drops. DHEA drops. Um, several companies make these liquids. I get all my stuff off of Fullscript, which is, uh, online dispensary. If you guys don't know about Fullscript, they're a great company. That way you don't have to stock everything. Then they also have pregnenolone drops, also from Fullscript. For stage three, we usually get 15 drops three times a day. And then for a stage three with low cortisol, we'll also use some adaptogenic herbs. So, herbal adaptogens. All the companies have them, right? And then you also definitely want to do blood sugar support because the adrenals are highly reliant upon stable blood sugar to heal, right? So, cortisol is a glucocorticosteroid. So, you need to have blood sugar support. Again, whatever your favorite company's version of that is. And some extra vitamin C. The adrenals use up a lot of vitamin C. So, usually in the vitamin C range, you want to be between two and five grams a day. If they cause loose stool, then back off on them. So, herbal support, blood sugar support, and then I usually almost always toss in some kind of a multivitamin. And that would be a stage three adrenal program. Takes about six months, maybe 12 months to really start to stabilize people. Usually within the first month, they're starting to feel quite a bit better. The DHEA and pregnenolone are pretty phenomenal in terms of their effect. Obviously, the DHEA helps support the DHEA, which was tested low. And then the pregnenolone is the main support for cortisol. Okay. And that works incredibly well also. Okay. So, that would be a basic stage three protocol. And thank you again, Jerry, for sending that in. And let's look at the next one here. And then we got a complicated one from Helene here. Uh, I don't see Helene on the line. Clean, I don't see you. She may be planning on listening later. No problemo. We can still look at the lab. Uh, no, Helene. Okay. All right. Let's go back here. And now this is a Nutra-Vaal from Genova. This is a beast of a test. There's a lot going on with this lab. And so, in the beginning, which, to me, is the first 10 years of doing this, the beginning 10 years, the beginning of your practice, the first 10 years, you want to think about the Nutra-Vaal. How that's a Quincy Jones question, right? It would be like if you were beginning your classical music training or something, would you learn, could you possibly learn like everything Beethoven ever wrote? You know, no, not really. You're going to start you off with like scales and basic stuff. So, the first 10 years of doing this, when you're looking at a complex test like this, you want to make it really simple so that you can wrap your mind around what's really happening. Okay. And so, simple are these 12 things. But 12 is a lot. So, let's just look at three for the time being. Okay. So, for this particular test, maybe three or four. Let's see if there's a problem in the neuroendocrine system. Let's see if there's anything obvious with the GI. And then let's see if there's anything related to toxins that shows up. That's a lot, just right there. And that's enough for most patients to get a significant improvement. Okay. So, again, when you're looking at the bigger the test is, the more complicated it is, the more simple you want your approach to be. I have a personal distaste for these little graphy things. You know, I know the labs are doing this to try to make it easier for us to understand, but I really like to look at the real test test because I feel like you should understand the test test part and not look at the cheat sheet summary stuff. It's like cheating in class or something. It's like looking at someone else's notes in a class, and you're cheating on the exam. So, let's look at what's really going on here with the lab. When you see the real markers, let's start to interpret these. But remember, we're really looking for three problems: neuroendocrine, GI, and detox. Neuroendocrine, GI, and detox. So, right off the bat, you can see this whole GI section here, and pretty obvious, there's a lot of things in the red. There's a major dysbiosis. There's a major yeast overgrowth. This person has a huge problem with their gut. So, I would recommend 100% of the time, you do a stool test at this point and make sure that you really understand the gut. This is great. You could treat the dysbiosis and yeast based on this also, but you should always do a stool test to make sure that you're getting more detail, right? Then, so we got one thing knocked out already: GI, big GI problem. They need a dysbiosis and yeast program. And I'll show you how to do that in a minute. And then the second thing we're looking at here is the neurotransmitter markers. Yikes. 5-HIAA is super high. Quinolinic acid super high. So, there's some kind of either B vitamin problem or inflammatory problem. Now, 5-HIAA can go up if the person's on an antidepressant. So, that could be a drug-related thing, or if they're taking 5-HTP or tryptophan, okay? But it looks like there's some issues going on with the brain. And then the mitochondrial markers over here, you can see there's four or five that are high. So, there's also some mitochondrial issues. And then the last category here, let's look and see, uh, is there something going on with detox? Yikes. Yeah, all the detox markers are high. You guys, look, all four of them are either in the yellow or red zone. Okay. So, this person is a mess. So, let's just start with that. Now, the test has a ton of other things. I'm not saying these things are not important, but, you know, you can't deal with all of this at the same time. It's just not possible. So, let's look at the priorities here, which are getting these 12 body systems working. So, this particular patient we just saw has some kind of a neurotransmitter problem. Maybe it's related to B6. I'm not totally clear. If the person was on an antidepressant, that may change what you think about that. Person had a major mitochondrial problem, regardless, right? They had, uh, GI, let's say, on my elite, a microbiome issue, at least a yeast and fungal overgrowth. And then they had some major detox issues. That's a lot. So, then, if we're going to do program design, let's take away our, this is our old adrenal program from Jerry. Let's take this away. So, now, remember, with a, the more complex the test is, the more basic and fundamental you want to be. You know, and there's beauty in simplicity. And the biggest mistakes I see in my, uh, in my, um, you know, the doc, I, I have a pack, I teach a lot, obviously, but I have a practice too, and I get patients literally every week that have been put on programs by other practitioners, and they're always just too complicated, and they don't work. When they're too complicated, you have to keep this really simple. So, this patient specifically, then that Helene sent in, number one, has a neurotransmitter problem, but we need to learn more about that. If they were on an antidepressant, that's going to change that test result. So, I'm not sure what that means, but they had a mitochondrial issue for sure. So, they need more mitochondrial energy, right? Mitochondrial support. They had a major detox pathway problem, and then they had, um, when I miss, oh, gut. So, gut means you should test with a stool test to confirm. You could also, or you can, you know, as soon as they do the stool test, you could treat the yeast and for the dysbiotic bacteria. So, that's a whole program unto itself, right? But remember, there's a sequence to this, and we're not reinventing this. Just because this is, you know, it doesn't really matter if this person has an autoimmune problem, if they have toenail fungus, if they want to get pregnant, if they're 95 years old and they just want to be able to walk up the stairs faster, or if they're 15 years old and, you know, to have a horrible menstrual cycle. It doesn't really matter what the symptoms are. We're going to treat in this sequence: neuroendocrine first, getting the, in this case, the mitochondrial energy, maybe the neurotransmitter, is not sure yet, um, working. Get that, those systems working for a few months, then go after the GI problems, and then do the detox. Once they're a little bit healthier, you don't generally want to detox somebody who's, you know, compromised, not healthy, because you make them sicker. So, CoQ10, right? As much as the person can afford. It's just a financial issue, you know, because it's expensive. And then magnesium. These are the key ingredients. Any kind of magnesium that you want. There's so many different forms of magnesium. Let's say around 200 milligrams a couple of times a day. And then, um, some general broad-spectrum mito support. So, sometimes it's Mito-Tome, Mito-Plus, Mito-Boost, mitochondrial energy. Other companies will have a mitochondrial support product, right? This sort of broad-spectrum. You do a couple of those, and then that would be the mitochondrial program right there. A really simple one. Detox was messed up. So, you want to support phase two. So, again, every company will have a phase two product. That'll be a sulfur amino acid product. If you just want to keep it simple, you can use NAC or N-acetyl cysteine. Let's say a thousand milligrams of that three times a day. There's many other choices there, but they're trying to keep this simple. Okay. Maybe one other liver support because their liver didn't look that great. So, I would say herbal liver support. And the lateral liver supports are all the same, right? They're going to have, um, your silymarin. You know, some of them are kind of combined with gallbladder stuff, and they'll have some things related to beets or whatever. But, you know, a good quality liver support as well. That could be a basic program starting off, um, with a mitochondrial support first for one or two months, then getting into the GI, and then after the GI, you would do the, the liver support, right? So, again, neuroendocrine, GI, detox. And, uh, I didn't put the GI program in here. I probably should. But it would go like this. Let me write out the sequence here. So, start with mitochondrial support. We don't have the adrenal lab, so I'm not sure what's going on with there. Then GI treatments, right after a month or two. And then after GI completed, after GI done, support liver and detox, liver. Right now, oftentimes you have to change the sequence. This is just the idealized sequence that we want to try to follow. And that would be my summary for that Nutra-Vaal. And this, this is work. I mean, this stuff works. It works almost every time. All right. It's a complicated test, but we're trying to keep it simple for the patient's sake. Here's another one of these. So, again, the more complex the test is, the simpler we're going to make it. Now, around, round two here, see if we can do a little better this time. Those digestive markers, three or four are high. Now, you know that means you order a stool test. Gotta order a stool test. There are transmitter markers, not so bad. Kynurenic acid is high. That usually, if it's high by itself like that, it usually means there's a B6 problem. Vitamin markers, not, it's not as bad as they could be. Carbohydrate metabolism, not nearly as bad as the last person. Okay. Detox, okay, one is high, pyruvate, pyroglutamate, but not nearly as bad as the last person had four elevated levels. Okay. And then this person's a little more complicated. Now, what stands out here is all these amino acids are running low, you know, borderline low. That's catastrophic. So, this person has a major problem with amino acids. That is a very bad thing. And then what's equally bad, or maybe even worse, is the urea cycle marker, as you can see here, low. Okay. Now, we're trying to go with what's the most important thing. So, let's go back here to the schematic for this patient number two here. Remember the 12 notes of what we're dealing with. Now, this particular person, the main thing I saw there was nutrient replacement. That was amino acids. And they have a big detox problem with the urea cycle. That means they don't clear ammonia very well. Okay. They're not getting rid of ammonia very well. And you don't want ammonia building up in your brain. That does not feel good to people. So, now, this person, going to design a program for them. They have, number one, an amino acid deficiency. Remember, all those aminos were low. And why is that important? Because we use amino acids to assemble all proteins, right, in the body. So, that's going to have global effects. You have to fix that first. And then they had a urea cycle problem. Maybe a cycle problem. That means issue. That means a buildup of ammonia. That's really important too. I don't know exactly what this patient's symptoms are, but I would start off with free-form amino acids. And you give one to two teaspoons twice daily. You have to give a bunch of B vitamins with that, or it doesn't work that well. So, some B complex. And then for the urea cycle, you want to specifically give arginine, somewhere between three grams and six grams daily, in divided dosages. You know, sometimes I overdo it with this. If you give a person too much, they're not going to feel very good. So, start low, you can build them up. And arginine will start to get that urea cycle clearance going. You may want to do some other liver or, you know, sort of protective supportive stuff for the liver and whatnot. But that would be like the core of the program for that particular patient. Right now, there's a bunch of other little things, but as we go through the labs, we're trying to pick on the most important things that are going to most import, most dramatically impact the patients, how they're feeling. Okay. So, I think those were the two from Helene. And so, we move on. The, the joy in doing this work is taking very complicated labs, boiling them down to simple things. Remember, there's only 12 things that we're doing here. The labs look really intimidating, but the net net result here of what you're actually treating is not as bad as it looks. Okay. If you, if you have a system, if you don't have a system, then it's going to be a really painful and negative experience for both you and the patient. So, you know, have a system, please. It makes a really, really, really big difference. There we go. Now, to make this a little smaller here. Now, I'm just going to pause for a commercial break and tell you once again, for those of you that joined this late, that we are starting a new mentorship class on November 10th. If you use this discount code VIPNOV20, you get a thousand dollars off, which is great because it's already very fairly priced. And this 12-month class, we review labs every week like this with a small group of doctors. You get all your labs reviewed. I have this huge curriculum that we've built over the last 15 years that teaches you how to interpret the labs. We have a community of doctors that are all doing this together, really focused on building practices and building businesses. And during the class, you start testing patients in the very first month. You run labs and show them in class, and we talk about them. So, you should pay for the class while you're in the class. In other words, you know, your first three or four patients that you run through the class, that you work, do the workups on in the class, should cover the entire course fee if you're charging appropriately. And if you're not charging appropriately, you can talk about that in class, you know, what your fees should be. Okay. And we're starting one soon. This will be the last one for the year. So, if you guys really want to learn how to build a practice, all the practical business stuff, all the lab interpretation stuff, then you can contact our office and get signed up for the mentorship. Uh, let me see here. For some reason, this is looking a little weird. I'm not sure. It's just the way that the thing came in. Let me see if I can make this better. Uh, there we go. Here's, uh, so, here we go. Sorry, I, I'm not scrolling very well here. Let me see. Sometimes my, uh, there we go. This should be better now. Okay. Let's see if that works better. Okay. So, this lab came in from Renee. And let's see if Renee is on the line now. Renee, I think you are here. I'm going to unmute you. Is that you, Renee? You're unmuted on my side. There's an unmute button you have to hit too on your side. They made the security on this program a little tougher recently, so it's harder for doctors to figure out. Let me read this out, and Renee, you're unmuted on my side. If you can unmute yourself, you can talk. So, from Renee: Major complaint, severe gas, bloating, belching every day. That doesn't sound very good. Lifelong IBS, GERD. Otherwise healthy. Two concussions as a kid. Now 70 years old. Oh, cool. A trumpet player. Love that. And, um, diagnosed with GERD, IBS. Been on meds for a long time. Minimal abnormal results. No pathogens in the first place. Seed attachments. Uh, colonoscopy is normal, but not symptoms indicate SIBO. You have tested negative. Treatment plan: treat H. pylori, get off acid blocker to restore HCl, give enzyme therapy to help with digestion. All right. So, let's check out what we can do for this patient here. Pretty classic case, right? We all see patients like this all the time, basically with kind of low-grade GI problems. So, this is a GI-MAP from Diagnostic Solutions Lab. If you have not familiar with these, and you can see the way they report these is the H. pylori is present, but it was below the range that would trigger the lab algorithm to crank out a high. So, it's sort of a borderline. A lot of doctors treat the borderlines, even if there's, especially if there's a lot of symptoms. And then we look at the normal bacterial flora. Those are high. So, that means there's something wrong with the microbiome. It's a little bit off. It's not perfect, but we don't know exactly what. And then the dysbiotic bacteria, there's three of those that are high. And then that's about it. Secretory IgA is high. So, when IgA is high, it indicates that there is, uh, the immune system is fighting something, right? So, let us look at, uh, where are we at? Where we're talking about body systems now? We're in body system number two. Can you treat body system number two in isolation from the rest of the body? Well, that would be like if I went to see a personal trainer, and she put me on an exercise program, and she said, "Well, we're only going to work out your left arm for the first year." And I feel like that's so stupid, lady. I'm gonna just exercise my left arm for the first year with all these ridiculous exercises. Give me, she's like, "Yeah." I'd be like, "That doesn't work. That's like not the whole body. We have to look at the body as well." Can I work out both my arms and do my legs and back? And that? No one would do that. You would not go to a personal trainer whose whole philosophy was just working out the left arm. You would say, "That's stupid," and you would walk out and you would say, "Find a personal trainer," and say, "Oh, yeah, we're gonna do, you know, dumbbells with both arms and not one-handed push-ups, but two-handed push-ups." So, you can't treat the GI tract in isolation from the rest of the body. It's like doing a workout for a year with only your left arm. That is not okay. You can't do it. It doesn't work very well because it's an integrated system. How is the system integrated? Well, let's look at the model. I hope I'm not talking too fast. I'm kind of excited about this tonight, so I'm kind of jazzed up. So, when I get jazzed up, I cut, and I kind of talk fast. If I need to slow down, you know, you can like raise your hand or something, or put up like a braking system sign or something on your thing, or just type into your little text box, "You're talking too fast." All right. So, three body systems, remember, if the GI tract is messed up, it means that the person went through a process to get there. They were stressed. They went through something bad. Their neuroendocrine system got messed up, and then the gut got taken out. I've been doing this job for almost 30 years. I've had like one patient who had a gut problem that was unrelated to anything else. It was actually two patients. It was a married couple. They were on their honeymoon, and they were in Egypt, and they were going down the Nile on a river raft boat thing, and the boat tipped over, and they fell into the Nile River in Egypt, right at the same time when that specific spot in the Nile was experiencing a raw sewage flood. So, they basically were swimming around in the Nile River for a little while while there was raw sewage pumping all around them. Not a great scene on your honeymoon. They both came back to the United States, and they both had a whole bunch of parasites and all kinds of bugs. That's the only time I've ever seen a gut problem happen completely unrelated to the rest of the body. Okay. 99% of the time, the people that we're working with are going to have problems with body system number one. So, you want to test and correct the neuroendocrine system as an integrated part of doing the GI treatment. Okay? That's really, I don't like the word holistic because it sounds kind of airy-fairy, but that's like a whole body or a systems-oriented approach to doing this kind of work. Okay. So, all that being said, this person had a couple of problems. So, then we would test and correct the adrenals or get the neuroendocrine system working, deal with the stress and inflammation. That would be one step. And then it's for the gut program, which is step two. Then we would go after those dysbiotic bacteria. Now, they were, those markers were actually high. The H. pylori marker was kind of a question mark. Now, he has a lot of H. pylori symptoms, so I probably would do the H. pylori treatment too, just, you know, symptomatic relief for sure. But then I would do a pretty aggressive antimicrobial gut program for the dysbiotic bacteria. Okay, there was three dysbiotic bacteria that were high. So, that's going to cause all the symptoms that you were just talking about in the patient history there. Okay. So, um, I'll try to describe it in kind of vague terms where you can see a combination formula. Everybody has it. It's GI Microbex, or it's Microbex, you know, my antimicrobial with oregano or tricylin or some combo product that is effective against, in this case, bacteria. But then you want to do a single ingredient product. No, it could be oregano, could be grapefruit seed extract, could be any of those things. And then you want to do typically a second single ingredient product. It could be colloidal silver, it could be berberine, whatever you want. So, whatever program you do that you really want to go after these gut bacteria pretty aggressively: combination formula and two single ingredient products. And it could be grapefruit seed extract, berberine powder, ARCO, it could be, um, Artemisia, it could be black walnut, just depending on what the actual bugs are. In this case, you'd want to get the ones that are kind of antibacterial oriented. And then for H. pylori, you always want to do mastic at around a thousand milligrams three times a day. So, whatever company you're using, they have a mastic product. It would be a mastic, a thousand milligrams three times a day. I usually do that independently and first. Once they've done that, then you could go back and get the dysbiotic bacteria. So, this would be like a two-pronged approach, right? Killing the H. pylori for two months first with the mastic, then going after the dysbiotic bacteria. And if it's not working, or you're worried about it not working, you know, one of the keys there again is to be sure that you're doing the neuroendocrine part of the treatment because you don't want to just work out with your left arm, right? Well, you want to work with the whole body. As we're doing these programs, you want to make sure that you're dealing. And in fact, you know, the gut problems come about because of chronic stress. That's one of the reasons why if you just deal with the gut in isolation, it's not going to work that well, or not, it's not going to be consistently effective, especially with GERD. That's often a really strong stress component there. All right. We got one more set of labs here, and this is from Stuart. Let me see if I can unmute Stuart or not. Stuart, are you there? I'm here. Ah, tell us, sir, about this patient, please. Which one is that? Uh, it says, I believe this is a stage three adrenal, low DHEA, borderline, borderline cortisol. 78-year-old. Well, the 78-year-old. Okay. So, um, this is an interesting issue. It's interesting because, uh, her complaint was, um, she had a GI complaint and, uh, sort of chronic diarrhea. I put her on an elimination diet. She did remarkably well after two weeks. A lot of her symptoms were gone. She also had high blood pressure and a little elevated A1c. So, I put her on a cardio-metabolic diet. I gave her two digestive enzymes and a good probiotic, and she did great. I mean, it was miraculous. Okay. She loved going on a cardio-metabolic diet. I mean, broadened out her diet. But then her diarrhea started to come back. And questioning her, there wasn't anything new that she did. She did, you know, she did, she, and she's pretty disciplined. She, and she's very fit as well, but, you know, considering her age, she's really quite fit and health-minded. So, she didn't do anything different with her diet. She, she, and she took, she didn't change the supplements, and she wasn't taking any new stuff. So, after I did the, the adrenal test, I was, I was more leaning towards that her, that her GI problem really was caused from her adrenals. It was caused some stress. She was all, you know, covered, really disrupted her whole life. And so, when I looked at this, I saw that, you know, she sort of has this low borderline, low flat curve. She's overwhelmed by daily stresses and stresses in her life. She just, you know, she gets tired and overwhelmed. Things bother her. So, I felt I would treat this. And then I thought, because it was that sort of, you know, all those, all those thousands of, how many nerves go into your gut, that I felt that that, that her gut health was not something that she had been, that she was doing the diet wrong, or she wasn't taking the supplements. It was really this stress-related. I sort of interpreted that. What we're talking about, do you have a specific question about either the labs or should I just review them for everybody? What would help? Well, yes, I do. I have, I have a specific. I mean, I'm pretty, I feel pretty grounded in when I, I can, I, I know I can identify when someone has stage one, stage two, more or less, and stage three. But with this, you know, um, these, the her her values look like, what, what do you do for someone who has a low borderline in the yellow zone on these Genova? How do you interpret that? Oh, and also, the other side of it, what do you do for for someone that has these, you know, borderline elevated in the yellow zone? How do you, how do you look at that for the GI, for the adrenals, or both? Or the adrenals. Okay. All right. So, let's look at that first. All right. Thanks, Stuart. So, let's go back to our schematic here. All this really works. So, back in the day, when I was a young man, I was in my early 30s. Dr. Timmins and I, Timmins was, oh gosh, in the late '70s, maybe early '80s. Timmins and Elias went to Germany to a trade show. They found that the Germans were running these salivary cortisol tests, and they're like, "Wow, this is kind of cool." So, they brought back that technology, the German test kits, and they started to test people in Elias's garage in Los Angeles, California. And then Elias ended up going, "Hey, I could turn this into a career." He's a PhD and a very sophisticated guy. He moved up to Washington State. He opened a lab called Diagnostics, which was the original American sort of integrative medicine adrenal testing company. And he and Timmins were like buddies for, I don't know, 15, 20 years until Elias died. And so, when they used to teach these seminars when I was young, and I would go to these, they had 11 different stages of adrenal stuff going on. And I was like, when, when Timmins asked me to help him teach, you know, after we'd worked together for a few years, one of the first things I said was, "Hey, Bill, you know, nobody understands these 11 stages. Like, it's just too complicated. Can we just make it three stages?" And he looked at me, and this is like 11 at night in his house, and I was actually walking out the door to drive home. I remember this so clearly. He was like, "Yeah, we could do that." Uh, stage one, stage two, stage three. And I'm like, "What are the stages going to be?" Because we were teaching that weekend, right? What the stages gonna be? He's like, "Well, stage one will be high, stage two is dropping, stage three is slow." I was like, "Really?" He's like, "Yep. Let's do that this weekend." I was like, "Okay, thanks, Bill." So, that's how this all started, you know, a little bit of history there. But it's interesting. So, this is a, the stages are like an attempt to achieve order and organization on a coherent, incoherent thing, which is the human body. Um, there's also three stages that Hans Selye talks about. Those are totally different. That's like the alarm phase and all that stuff, right? These are like based on a person who is not in good shape: high cortisol, dropping cortisol, low cortisol. This patient of Stuart's is right in here. They're right kind of a two, kind of becoming a three. Okay. And the protocols that Timmins and I developed, or Tim has developed, that I teach, are, you know, based on the stages. And so, the amounts of cortisone, DHEA shift around. Now, this person is also quite low in DHEA. So,
We go back up to our adrenal program here. Oh, I deleted it, and that was dumb. Hang on. Let's just make a new one here. And so for stage three, and this person is kind of borderline again, the DHEA drops, they work incredibly well, and this person had quite low DHEA, didn't they? So let's say maybe four drops of DHEA. And then pregnenolone drops. This is for the cortisol. The cortisol is quite low. Well, actually, they were more of a two, so they would be around 12 drops of cortisol. And then, uh, let's see where we, uh, oh, they needed some of the licorice. Licorice brings up the low cortisol. So licorice root drops, probably around 10 drops here and 10 drops here. And then we want to stick with what we mentioned earlier, which is blood sugar support, blood sugar control help, and vitamin C. Okay, so that would be the appropriate program for this person. Oh, and you can do adaptogenic herbs if you want to, the Ashwagandhas of the world.
Okay, so then let's look at the GI test now. With the GI tract, again, we're going to, I'm going to show you this lab. We only got a few minutes left. I'm going to try to wrap up with this. This is a complicated lab. So let's just look at this. This is a GI Effects test from Genova, the number one selling test in our industry, most popular test done by doctors worldwide doing functional medicine. This is the test done in Asheville, North Carolina. The thing's been around when I started 30 years ago. This, the original CDSA version of this had been around. This has been going on for a long time. Asheville has been running these probably since the 70s, I think, maybe since the 80s, not this exact panel, but you know, something very similar to it.
So if you look at the test real quickly here, this, look how complicated it is. I mean, she's Louise. People like, just this one page alone, you could spend years trying to understand what's really going on, right? It's a complicated test. I challenge anyone on this call, or anyone that anyone on this call knows, to try to interpret this page right here. I don't know of any. I know of one human being on this planet right now that could really sit down and give a go at telling you what this exact test here thing means. There's probably some PhD microbiology people at some fancy pants universities that could take a stab at it too, but there's very few functional medicine doctors that are in practice that can sit down and tell you what every one of these markers on this page means. There's probably like five or ten people in the country that could do that. This is a really complicated test, just this one page here. This is your microbiome, right? These are the commensal bacteria, and that's not all, right? It goes on and on page after page. There's so much information here. Try to understand this, that would take you another five or ten years.
Okay, now the point is that we have patients we got to treat. We got the lab. You're not going to be able in this lifetime to really understand every marker on here, okay? It's just not, it's just too complicated. So because of that, you need a simple system, all right? So then I have developed a simple system for this, and this works really, really well. Since my three stages of adrenal exhaustion was so popular 30 years ago, I decided to just make up three stages of GI dysfunction so we can communicate this to patients and we can really start to understand how all this works, okay? Stage one for the GI is normal bacteria out of balance. It's a microbiome problem. Stage one is all about the microbiome. Stage two, there's an organ problem. The GI organs are involved. In stage three, it's pathogens. So it's basically microbiome, GI organs, or pathogens.
So when we look at this incredibly complicated lab, you just need to make three decisions. Is there a microbiome problem? Excuse me, yes or no. Is there a GI organ problem? Yes or no. Is there a GI pathogen problem? Yes or no. That's it. Microbiome, organs, pathogens. That's it. Three things, right? And that will enable you to very accurately interpret these tests, now not when you understand exactly what Akkermansia muciniphila means. So now as you look at the summary page here of the GI Effects test from Genova, you'll see, wait a minute, what's going on? Well, let's look at infections in the far right. Oh yeah, the person has some bacteria and yeast overgrowth. Check right there. There's the infections or pathogens are present. And you're wanting, is there a microbiome problem? Well, look right in the middle. Need for microbiome support. Dysbiosis is four. Yep, they got a microbiome problem too. And then there's an organ problem. That's over on the left where it says maldigestion. Uh, yeah, they do. So if you go back to my schematic here, and we're looking at the lab, this person has a microbiome problem, a GI organ problem, and some GI pathogens or infections. They have all three of these stages present now.
Now, now, now, which one are you going to treat? That's the question. Which one do I treat? I always treat the pathogens first, maybe along with the organs, but I focus on the pathogens, then the organs, then the microbiome. So I start with the three, then do the two, and to do the one. Could you do it the other way? Absolutely. Do really smart people do it the other way? Absolutely. Do I do it that way? No. I just don't like to. It's a personal preference thing. I love to get rid of GI pathogens. I don't know why. It just makes people get better so quickly. It's kind of fun. GI organ dysfunction makes a huge difference, and the microbiome corrections are hard, complicated, they take a lot of work. You got to really, it takes a long time. It's not a great practice builder necessarily. Getting rid of GI pathogens, it's just very satisfying, you know? I don't know. It's like when you see an old rusty bicycle and you just get it working again, you know? It's like you're fixing something. It's very concrete, and I like that. Now, you can treat in the opposite direction. You can do a stage one, and then a two, and then a three. You can do the microbiome first. I'm not against that. I just don't do that. I have a lot of friends that do it that way who are really smart. So you can do it that way.
So then what would you do for this particular lab? You would treat the infection and then get rid of the bacteria and yeast first that are bad. Then you would go after the organs that are causing a problem and get those working better. And then you would work on the microbiome itself, okay? So we're taking this really complicated lab and boiling it down to these essential questions of what we're actually going to treat. Now we got like two minutes left here. Um, so let me just cover this just so you can see how cool this stuff can get. Now, this, this particular page here, I've been studying this one page for three years now. So the doctor, the, the scientist, I should say, the scientist that developed this test originally is a man named Dr. Richard Lord. Let me, I'm going to close down my camera because my internet's acting a little weird here. The man that invented this test, developed this test, uh, years and years ago, it's Dr. Richard Lord. He's my sort of personal tutor. I work with Richard twice a week. We spend hours and hours together every week, and he's the one that picked out these markers and decided to design this test the way it is. And so you can and should at some point in your career really focus on each of these bacteria and learn what each one of them does and figure out why it's so important for the microbiome. You can see some of these bacteria relate to immune function, some control cardiovascular function, some control whether the person is obese or not, right? So there's all kinds of gold hidden in these microbiome markers, and I'm not against learning about them. And I've devoted the last three years of my life to really studying this intensively. However, if you just want to get started with treating patients, you can take this simple approach. And then as the years roll by, you can learn about Methanobrevibacter smithii and Akkermansia muciniphila and Faecalibacterium prausnitzii. You can learn about all of these, and it's really cool and interesting. But you don't have to be perfect at understanding the details of the test before you start treating people, right? That's the whole point. When I get you out there treating people and making all this stuff actually work in a clinical practice.
Alrighty, now let me do a little advertisement here. We are starting a mentorship in a couple of weeks. If you think this stuff is interesting and you really want to have a full functional medicine practice, you should inquire. Talk to our sales people, talk to me, see if it's a good fit. It's a one program, it's a big commitment. By the end of that year, you will understand how to interpret these labs at a higher level than most other people that are out there. There's a lot of learning that comes in. You'll do a live call like we are doing today every week, along with a curriculum that explains exactly how to interpret the labs, shows you all the different stages, so you can really make all this stuff work. So we have an online course that's recorded, we have the live classes every week, and we have a very active community of doctors. We have more case studies and lectures than you could probably ever listen to. Everything is recorded, so you can listen to it over and over again. And we're really dedicated, basically, or I'm really dedicated, and my team is really dedicated to getting practitioners up and running in practice. Get a thousand dollars off if you use that code, okay?
All right, now there's a couple questions that came in, and we got about 30 seconds left. So let me answer Elizabeth first. How do you prevent detox reactions with bacteria die-off? Give liver support. Totally fine. Give liver support before you do and during the bacterial treatment. Why don't you recommend Mastic and antimicrobials at the same time? If you're giving a thousand milligrams of Mastic three times a day, that's a lot, and that's enough for the body generally to handle. If you try to push it and do some additional killing, it can make people react pretty poorly. Do you have any pearls for Morganella in the gut? So if you're struggling with Blasto, you're struggling with H. pylori, you're struggling with Morganella, it's not about the gut. Remember, if it's hard for you to clear any organism in a person's gut, it's typically because there's a neuroendocrine problem. Go back, you would test the adrenals, the brain, the mitochondria. You get the neuroendocrine system working, you'll have a much easier time treating the gut. Stuart's asking about DHEA capsules. If you'd rather use capsules, then one milligram of a liquid is about four milligrams of a capsule. And then you don't want to use the hormones on kids. So ages 16 or older, you can use the DHEA and pregnenolone. Under age 16, I usually don't use the hormones themselves, but you still can do blood sugar support, adaptogenic herbs, vitamin C, the herbals, all that stuff can still be done even if the person's a child, okay?
All right, we're going to wrap it up right now, right at the hour mark. Thank you guys for hanging in there for this whole time. I hope you have a good rest of your evening and look forward to talking to some of you in the mentorship. All right, bye for now. You.