Mentorship Miniseries: Lab Review

Hello people, and welcome to a kind of special edition of Lab Review. These are kind of fun little things we're doing for some of you that have taken master classes, or some of you that are just curious about what we do. And the mentorship class. So, the mentorship class is basically a year of this. And for those of you that have not done one of these before, just introduce myself. That is me, uh, Dan Kalish. I've been doing functional medicine for a long time. I'm on the faculty at IFM. I teach their Practice Implementation courses. I have done some research studies with Mayo Clinic. I'm working right now with Richard Lord on advanced lab interpretation skills, and he's been my teacher for the last three years. If you don't know Richard, he's the scientist that developed the Organic Acids Test, that created the GI Effects Test, the Ion Panel. The Nutraval was a copy of his work that someone else did. So, basically, he's the scientist that's behind most of the lab work that we do in functional medicine, and he's been by my side for the last three years. A couple times a week, we've been doing recordings and trainings and all kinds of good stuff. So, my lab skills are up to speed, let's say, after 25 years doing this.

And we have a bunch of stuff going on in the fall. If you guys are interested, we have these new courses that we're doing, which are kind of entry-level classes. They're like around a thousand bucks, give or take a little bit, and they are our Business Essentials. So, we've got one starting in September, which is about supplement program design, how to really make the supplement programs work, kind of the heart and soul of every practice. And then we have another Business Essentials Bootcamp in November, more about telehealth, telemedicine, patient communication, workflows, a little more sales and marketing kind of stuff. So, those are, they're both around a thousand bucks, they're both around eight weeks, and it's our work to do something that's a little more entry-level for you guys.

And then, of course, we have our sort of flagship year-long mentorship class that is gonna start at the end of September as well. If you're really interested in lab review, okay, the class costs, like, I don't know what we charge nowadays, 12 grand, 15 grand, whatever. But, you know, for in your first three or four patients, if you're successful, you're going to pay for the whole freaking class, okay? So, it's not, in the scheme of money, it's not a big dollar amount. Any good patient you have should bring in three or four thousand dollars to your clinic. For patients, in you should have paid for the entire year-long mentorship, okay? So, if you're worried about money, you know, don't let that hold you back from furthering your education because you just end up in this cycle of not knowing what you're doing and not being able to make money and then kind of, you know, recycling around and around in that world.

So, let's grab Eileen. Eileen, are you there? Can you hear me?

Yes, I can hear you.

Hey, this is your patient that you sent in, right?

Yes.

Okay, without giving away anything, can you just, like, tell us your top three symptoms and or top two symptoms and kind of what would help you as we look at the lab?

Um, so at this point, there was a lot of fatigue, muscle pain and aches, uh, low energy, um, also menopausal symptoms. Okay. I think that kind of sums it up.

And is there anything special that would help you? I don't know how many of these you looked at in the past, if this is new to you or...

Yeah, not that many. No.

No, okay. All right. So, and this, so let's look at this lab, which is a beast of a lab, right? Just from the perspective of fatigue and muscle aches, and what are the things on this test that could help her relieve fatigue and muscle aches? Okay.

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So, just to give you the background, like, if you're actually in the mentorship, you have a year-long curriculum where you're listening to all these lectures and you're learning about each one of these lab markers. And then you run the lab, then you present the lab in class, like we are today. And then, you know, you basically have questions based on the curriculum that you've been studying. And then most people will submit the lab plus a program. They'll say, "Hey, it's the program I was thinking about putting together. Could you give me some feedback on if you think this will work or not?" Or, but, you know, there's a very clear delineated, here's what we do with adrenal labs, here's what we do with organic acids, here's how you look at the stool testing. So that it's not like this confusing reinvention of the wheel every time. And we're going to just hit the highlights of this one because this is one of this is like the advanced test. So, in the regular mentorship, we do adrenal hormones, gut, and organic acids for the first year. And then if people stick around for year two, we move into this more advanced class where we do these Ion Panels. So, I think it's easier just from a learning perspective to just do the organic acids first and kind of master those. But since we got an Ion Panel in front of us here, we might as well just deal with it. And again, for those that don't know, this is the Ion Panel from Genova with the 40 amino acids. Now, right off the bat, you can see that there's a variety of essential amino acids that are low, right? And just the first nine markers, six of them are low. So, there are no five, so there's two aspects to that. One is, you know, is she low in amino acids because she's got a gut problem or a gut infection that you want to investigate? Or if she's just low in amino acids for some other reason, she's exhausted them, whether it's a gut infection or other reasons, you still want to give her a hefty dose of free-form amino acids, which should, in a matter of weeks, improve her energy. All the companies have them, they're in a powder. It'll be amino acid replete or supreme or boost or whatever, whatever company you like, um, you know, from the professional brands, free-form amino acids in a powder. And usually, you can dose it out by teaspoon. So, someone like this would need one or two teaspoons twice a day on an empty stomach. The big caveat is that some of the companies do not include tryptophan in their essential amino acid powder, which means that it doesn't have all the essential amino acids, which means you cannot assemble proteins, which is the whole point of giving someone these amino acids, right? So, you may have to add some extra tryptophan. If you're using a brand that doesn't have it, it's not a big deal. Just order some tryptophan and put in like one or two capsules of tryptophan to each dose of the powder, and then you'll have it making your own kind of essential that has. That's one of the more profound things because if you're low in even an individual amino acid, you cannot synthesize proteins throughout the body, right? So, nothing can happen without these. These are the basic building blocks of life. So, that's sort of step number one.

And then some of these amino acids are particularly low, like tyrosine got flagged. Tryptophan doesn't look very good either. And these are ones that are strongly related to brain chemistry. You might want to separately give her some extra tyrosine and tryptophan if you want to boost the brain up separately, okay? And usually, it's like three grams a day of tyrosine in divided dosage, and then maybe an extra 1500 milligrams of tryptophan, usually at night because it makes people a little drowsy. You could spend a year just on this first part of the test. She's also got a urea cycle defect, right? You can see three of the six amino acids related to detoxing ammonia are low. So, that means she's going to have a buildup of ammonia that's going to impact her brain. Wow. So, the easiest way to deal with that, and you might not want to do all this at the same time, is to give her at least 3,000 milligrams of arginine in divided doses and see if that lets's start to get her clearing ammonia, okay?

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So, that's three things already: free-form amino acids, brain treatments, tryptophan and tyrosine, and then the arginine to get her going on the well, on the amino, on the ammonia clearance. Her minerals look really good. And we're just looking for fatigue-related issues. Arsenic, clearly, that's not a great thing to have a lot of arsenic in your body. So, she needs a little detox help. Yes, there's some random things that are low here. Let's just kind of skip through this because we don't have a million years to go over this. But the omega-3s look pretty good. The omega-6 is not so great. So, she needs some omega-6s. That's probably not going to resolve her fatigue. So, maybe that is like a second-tier problem. Saturated fats, odd genes. And let's look at again for energy levels. You would think about mitochondria and energy production. And as we look at her mitochondrial markers here, they actually look really good. Look at that. So, that's her mitochondria just laid out right in front of you. And each one of those markers is normal, except for fumery, which is low. But that's a really good mitochondrial set of markers there. So, right off the bat, the thing that I would have thought first of all, she would need help with the most, mitochondria. She doesn't have brown. You can take that off your list of major issues to deal with. Um, neurotransmitter markers, um, interestingly, they look okay. But the amino acids from which these are made are not okay. So, that's kind of quirky. But she needs the tyrosine and tryptophan, you know, from the other part of the lab. The marker number 23 is a little high. So, that's going to be related to the tryptophan. 23. And these were not great, but they don't look like a disaster. And then that doesn't look so bad here either. So, if we're going to, like, like, let me show you here, like the bigger picture here, because I think of this in terms of body systems, right? And what body systems need the most work? And actually, I have a better diagram. Let me show you the better one.

And so, what, there's these 12 different body systems that I try to focus on throughout the mentorship. And if you master each one of these, you could treat just about anything from toenail fungus to suicidal depression. It's pretty profound. You don't have to learn a hundred different things, you just need to learn 12. You know where I heard this from? Um, you know, Quincy Jones, the music producer and musician. You've heard of him? Yeah. He's got, he's got this quote in his documentary, and he's talking to this young rap artist, and he's like, "Hey man, there's only 12 notes." You know, for the last 700 years, all of Western music is 12 notes. Whether you're Bach, or you're Jay-Z, whether you're like the Rolling Stones, or you're like some punk band, or you're like some classical of the, you know, violinist, 12 notes. And it's just a combination of those, right? So, I thought, wow, it's exactly what I teach in the mentorship. There's these 12 body systems, right? And pretty much all human dysfunction is going to come down to one of these categories. So, for this person, we're seeing neurotransmitters, the amino acids from which you make neurotransmitters were screwed up, right? There was a pretty big problem with ammonia detox and, uh, some other detox pathways that kind of glommed over. And then there was a really big problem with the free-form amino acids, which would be under, like, nutrient replacement here. And surprisingly, there is not a big problem with mitochondria. You didn't test the adrenals, so we're not sure yet, just kind of put that on hold. Um, the gut didn't look that bad. A lot of these things didn't look like there was huge amounts of inflammation. Oxidative stress wasn't perfect, but didn't look horrible. So, these, these are like the headlines here: neurotransmitter support with tyrosine and tryptophan, detox support for the ammonia clearance, and then nutrient replacement with their free-form amino acids. That would be the focus. And you should notice that each one of these incrementally improves her energy in a pretty substantial way.

Can you still hear me, dude?

Yeah, you're good. Huh?

Um, I want to tell you, after three days, because I listened to your classes, I, I'm in the, you know, the $99 class, and I listen to all your mini-series. After three days of the amino acids, the pain almost was completely gone.

For you personally?

Well, yeah, I'm the patient. Yes. After three days of amino acids? Yes. It was like a miracle. I mean, I don't, I don't want to, you know, my girlfriend just like literally slaps me when I get cocky. But, you know, it's like, I hear that every day. Yeah. Every day, patient after patient, like, "All my pain is gone, Dr. Kelly." And it's not because I like have this charming personality. I'm not even like ridiculously smart. I'm like average smart, right? But not like extra smart. It's just like, it's the, it's the Quincy Jones thing, right? There are these 12 systems. You just learn how to manipulate these really, really well, and you really understand this. And, you know, what everyone does is everyone wants to skip and do complicated things. They want to learn about mold and cognitive decline, and they don't master the fundamentals. And I think that's what trips up with most of the doctors that are getting trained these days. So, like, if you had seen you as a patient, you could have fixed you, right?

Right. Yeah. Yeah. I think how many are out there? That's a business, right? That's a whole viable business model if you can really make people's lifetime pain go away in a few days, right?

Yeah. It was amazing. Thank you so much.

Oh, you're welcome. Yeah. Now you got to sign up for the mentorship, okay? As soon as you can afford it. We'll see. All right. That's your next, your next goal, your aspirational goal. All right. Thanks, Eileen. Appreciate it.

Thank you very much.

All right, you guys. If you don't sign up for the mentorship, I can't afford to keep teaching this free stuff. So, if somebody's got to sign, it's kind of like when NPR does their, you know, charity drive. They're like, "Join the membership now." You're thinking, "I don't want to spend $100 on a coffee cup. I'll let someone else pay for it." But you're listening to NPR, you know, and other people are footing the bill. All right, let's see here's Michael. Ah, is Michael on the call? I don't see a Michael B here. If Michael B is here, please raise your hand. If not, we can still go over the lab and maybe Michael can listen to the recording. Uh, 28-year-old, acne and mood swings, low energy. And this is a Dutch test. So, most of you are probably familiar with this. This is an adrenal lab. So, the first thing you want to do with a Dutch test is figure out where is the DHEA at. And you go to page three for that. And at the top of page three, you'll see D-H-E-A-S, and you can see on this young woman, it is quite low at 18. So, right off the bat, you know, bingo, there's a significant adrenal problem. The DHEA is low. End of story. Question then is, besides DHEA, do you also want to give her some support for cortisol? Is cortisol either high or low or normal? So, you boot yourself back up to page number one, and you see the free cortisol, which is the cortisol in the tissues, is quite high. So, high free cortisol and low DHEA is what we coined as a Stage One many years ago. Stage One just means it's just a simple way of trying to classify people. It means the cortisol has gone quite high, the free cortisol, the cortisol in the tissue is quite high, and the DHEA is low. So, then there's a sort of preset Stage One protocol, which is DHEA and pregnenolone, and then all the other adrenal stuff you can imagine: adaptogenic herbs, blood sugar support, extra vitamin C. But the DHEA and pregnenolone are kind of the heart and soul of it. I like to use these liquids or drops. You can use any kind that you want, but. And so, for someone like this, usually we would give five milligrams of DHEA three times a day to gradually bring up the DHEA, and then around 10 milligrams of pregnenolone three times a day, okay? And that's in the liquid form. If you use the, uh, capsule form, they don't seem to work quite as well. The dosages are a little different. You got to multiply what I just said by about three, three times, okay? And there's tons of other stuff on these Dutch tests. Um, probably for a woman with hormone problems, we should look at her progesterone and estrogen. The estrogens all look kind of low on the low side, and the, uh, progesterone looks really low. So, you could also give her progesterone. For a woman who's still cycling, two weeks on, two weeks off, starting in the middle of the cycle, around day 15. Again, I like to use the liquid. Lots of companies have them. And doing the progesterone twice a day, 10, 20 milligrams twice a day, from days 15 for two weeks, and then stop. And that combination, DHEA, pregnenolone, and progesterone, helps the vast majority of young women feel quite a bit better without having to use any estrogen or other hormones. That's something I've been doing for almost 30 years. It almost always works. If she has acne, you want to be a little careful with the DHEA and keep the doses just kind of conservative, you know, because sometimes DHEA can make acne worse.

All right. And then we have Daniel. I think he's on the line. He helped me grab him. Daniel Wasserman, Daniel, you there? Can you hear me?

Yeah.

Oh, hey, this is a, I think a combo, right? There's an adrenal lab and a GI lab. Yeah. Yeah, of me being the patient. Oh, okay. Top two complaints?

Um, energy and skin rashes.

Okay. So, your DHEA is really good. It's in the mid-range of normal. Yeah. And then your cortisols are going like, it's almost like this stair-step, high, higher, higher, highest. Yeah. So, it's like, um, but the DHEA is hanging in there as a good number, right? So, when we look at the HPA axis dysfunction and the use of DHEA, if your DHEA is normal, then obviously we don't need to use DHEA. But we would want to lower the high cortisols down, right? And there's a product called Cera-Phos that does that very consistently. I've always seen it work all these years. So, Cera-Phos, you can also use some other companies' phos-serine, phosphatidylserine. And you want to give it a few hours before the high cortisol. So, your cortisol is starting to go up in the evening. It's quite high at night. So, you probably want to take the Cera-Phos at dinner time, one or two capsules of it at dinner time. And then throughout the day, something that's calming for adrenal glands, so adaptogenic herbs, blood sugar support, maybe some tyrosine, things that help calm down the adrenals when people are making too much cortisol. Okay. But the Cera-Phos is the real key to helping, you know, with that nighttime level. And you could use pregnenolone, but you don't need the DHEA. So, pregnenolone helps a lot with people that are high in cortisol. Again, you can get the liquid drops, about 10 drops, three times a day, 12 drops, three times a day, like that. That'll usually really help quite a bit. More than pregnenolone, probably helps the adrenal stress cases more than any other single product I've ever seen. And most people don't use it. You know, it's weird. I don't know why. It just never kind of caught on. And I, you know, if we trained like a thousand doctors now in this class, and I, I trained when I was getting trained, there was hundreds of us getting trained, and somehow the whole pregnenolone message never really caught on in the, in the field in general. But it's one of the more effective supplements for people who are stressed out and people who have adrenal issues, and very few side effects. It helps women, helps men. It's pretty darn effective, especially in a liquid form in the drops. You don't have to take it for that long either, you know, you're not in bad shape. Maybe take it for three months or six months, and then stop.

Right. Uh, I'm going to start taking the sterile, the phosphatidylserine from the, um, Designs for Health.

Oh, good.

Maybe I'm taking it a little too late. I think I'm taking it around nine or ten, two capsules at night.

Yeah, yeah. Take it maybe like more like six or seven, okay? In the evening. Yeah. Okay. Yeah. And if that doesn't work, then you can try the name brand Cera-Phos, which is phosphorylated serine, not phosphatidylserine, which shouldn't be that different, but seems to work a little differently for some people.

Okay. Interesting.

But yeah, give it a few, give it like a month or two on the one you're already on. If that's not working, you can switch.

Okay. And then here we got your GI test. This is the GI-MAP for people that haven't seen these before. And you've got some normal bacteria that are high. That's Clostridia. That's a good organism, so we're not worried about that. Akkermansia is low. That's a good organism. You want a little more Akkermansia. Berberine helps Akkermansia grow out, so you could try some berberine if you want, okay? Um, and then there's more to do here though, that's probably important, more important, which is that there's some of these opportunistic bacteria, four of them that are overgrowing, and a little bit of yeast, but not quite enough to trigger a problem.

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And then not much in the way of parasites. So, it's mostly a dysbiosis or bacterial overgrowth kind of coupled with, um, the low digestive enzyme marker, elastase, being low. So, you just kind of load up on enzymes and do an anti-dysbiosis program for two or three months.

Okay. So, I, I've, I've started in the last few weeks. I'm taking GI Revive. And what about the, um, H. pylori being detectable?

Yeah, that wasn't high enough to trigger it. So, I would just let that go. But you want to go after the dysbiotic bacteria, the red, white, the ones in red here, okay? So, that would be, if you're using Designs for Health, you can use GI Microbex, okay? And the Berberine Synergy. Those two together, two capsules of each, three times a day, two of the berberine and two of the GI Microbex, three times a day. That would be a good start. And see, give that a month or two and see if that's enough to knock those bacteria out along with some digestive enzymes.

Uh, what about GI Revive for the dysbiosis?

Yeah, that always helps with repair, but it's not going to kill anything, okay? But it helps with the repair part.

Okay. Yeah. And you've got one more here too. You're kind of on a roll here.

Uh, oh, yeah. This is GI Effects. Yeah. You have a GI Effects as well, too. This is, um, different. No, different patient. Lots of gas, sometimes bloating, um, um, not, not, not super symptomatic, but, um, definitely found some stuff when we ran this test. So, they have this cheat sheet here. So, this is a GI Effects from Genova. They just put out this new report a couple months ago. So, now rather than actually having to figure anything out, they just tell you what's going on. Which I don't know about you, but this is great because it's something you can show patients that we can relate. So, starting at the far left, fecal fats are high, right? So, gallbladder problem. And gallbladder problems are like the most, uh, the most, uh, stealthy problems, you know, that you could imagine. Meaning that they're, um, you always, I always underestimate them in terms of like, what's the real severity of the problem? You know, and I don't know why because it just seems like, oh, it's a gallbladder, like it's not that kind of, you know, what could that really cause? But gallbladder causes a lot of problems. So, hang on, I gotta do something. I'll be right back. Sorry. It's amazing I'm even alive right now. Okay. Um, uh, so don't under, I always underestimate gallbladder. So, just don't do that. Get, don't take it really seriously. We see a gallbladder problem because when the gallbladder is not making enough bile, the result of that is that the bacteria in the small intestine start to overgrow. You can even get what we call SIBO from that, okay? And so, it's easy to just kind of not take gallbladder problems seriously enough and just think, "Oh, it's a gallbladder, whatever." But that can be the origin of all the bacterial dysbiosis that this person has, okay? So, just keep that in the back of your mind. It's not always the case, but it's often enough the case that it's worth, you know, writing that down somewhere, right? And then trying with, it's really simple, right? You give advice about how to eat, so chew your food and don't eat too much fat, and, you know, take your time with your meals and give your gallbladder a chance to make all the stuff it needs to make. And, you know, here's some gallbladder support to see if that alone is enough to get rid of the bile, I mean, get rid of the bacteria, because that's one of bile's jobs is to be a natural antibiotic to those bacteria in the small intestine. So, the fecal fat problem or gallbladder problem could be generating the dysbiosis. I personally like to kill things, no matter what. So, I always do dysbiosis or yeast programs if I'm given even half the chance. So, I would still do an anti-yeast protocol for this person, as well as a gallbladder support. And then there's also a parasitic issue too. So, let's look at that. This is a beast of a test, right? You couldn't begin to understand this test within, you know, it would probably literally take someone several years to begin to understand what's going on here. It's very complicated. I made a few highlights myself. So, yeah. And so, we can do, you know, we just look at the, like, the most important stuff here. So, my computer can't even handle it. My computer's freaking out. It's like the heart, the hardest part of this test. We're not going to talk about, but I just want to show it to people so you guys can see, which is the commensal bacterial page here. Each one of these different bacterial markers has some profound meaning to it, you know, and it's, and there's 24 of them. And then they're, they have profound meaning in relation to one another, like, in other words, if, like Akkermansia is low and Bacteroides is high, that means something. And something else if the opposite is happening. So, this is like a lifetime of study just to get this one page down. And Richard Lord has books about this. We have hours and hours of tapes of classes about this. It's just this one page is hard, but it's important because it's your microbiome, right? It's an attempt to really understand the microbiome. Um, and I've been working with Richard nonstop for three years, and I, I don't even pretend to understand this page. I just know that it's really important and that I should be studying it more than I do, probably. But, you know, I probably put a couple hundred hours into studying this one page here, and I like barely understand it because each one of these organisms is a whole other story. So, we're just kind of skipping over that, but don't forget that.

So, a bunch of these, uh, bacteria that they grew out in the culture were high, right? So, there's some of the dysbiosis markers there. And there was some parasite. Let's get in the back here. Uh, Blastocystis hominis, right? Yeah. So, now you've got Blasto, yeast overgrowth, dysbiotic bacteria, and a gallbladder problem. So, there's a preset sequence that I was taught, and I do exactly what Timmin taught me 30 years ago, and it works really well. I don't even, I haven't changed this one little bit from the way I learned it. If, and this is the sequence in which you kill things. If H. pylori is present, go after it first. But that, that's not the case here, right? If a parasite is present, go after that first, after H. pylori. So, I would go after the Blasto first with antiparasitic herbs. Give the person a break of a week or two or a month, and then go after the yeast overgrowth and the dysbiotic bacteria at the same time. But do the parasite program first. So, that would be antiparasitic herbs like black walnut, Artemisia, you know, the combination formulas that are antiparasitic in a reasonably high dose, two months of that. Give them a break. And then do a kind of yeast bacterial program with slightly different herbs. And so, the yeast are more like, the medical doctors use Nystatin. If you want to prescribe, that's fine. The non-medical doctors or non-prescribers usually will use things like oregano oil extract, or caprylic acid, or antisonic acid, or things that are more kind of classically anti-yeast. But you always want to try to clear the parasite out first, if you can, okay? So, a two-month Artemisia or black walnut type program. Yep. And then an anti-yeast program. And all the while, probably worth supporting the gallbladder that whole time. So, that's just, um, enzymes, bile support. Yeah. So, it's going to be specific. They're specific for gallbladder. Some, some companies have combination products where they put the enzymes in together with the gallbladder support. Some companies will have it separate, okay? So, they'll have bile, let's just say on the label, bile, you know, so, you know, bile oxide or bile acids or something. And then other companies will have a specific gallbladder only product. You could use either a combo or a specific one.

Okay. And is there a therapeutic dose for that, or for the gallbladder support?

Yeah. Um, yeah, depending on what you're using. So, most of the companies will have like a combo herbal product, and it's usually one or two capsules, three times a day. And it'll be called like Beta-TCP or Gallbladder Plus or something like that. If you're using the digestive enzymes, it's a little harder because they're not going to have much ox bile in it because it's going to be a combo product. So, when it's specific to gallbladder like this, it's probably worth just looking through the catalog and finding the gallbladder specific products from that company and using those.

Okay. Yeah. They have Fullscript. So, yeah, you'll have a bunch of options here.

Okay. All right. Thank you.

You bet. So, that was gut. This is kind of good. We got an organic acid, and then we got an Ion Panel. We got an adrenal, we got a cup, a gut thing. Now we have J.E. Oh, and here's J.E. Can you hear me there?

Hello.

I got you unmuted on my side. While we're waiting for J.E. to unmute herself, I'll let you do a little advertisement. So, we have for you starting September 30th, this is the first time we've run this one, Business Essentials Bootcamp, all about how to prescribe supplements, program design. We've tested this class on a bunch of people. It's really good. I think you guys like it. It's around a thousand bucks. It's around eight weeks long. Oh, hey, J.E., let me just finish this. Let me talk. Um, and that's really good if you don't want to do the supplement one, or it's like too early, it's not ready. November 18th, we'll have a final bootcamp for the year, and this is straight-up business stuff. A big section on telehealth, telemedicine, since that's an urgent need for that right now, patient communication skills, sales, marketing, financial planning, all the good business stuff, okay? So, these are the two bootcamps we have coming up. And you guys come. We'll send out emails about these, I'm sure, and you can go to callsinstitute.com to learn more, too. All right, back to our regular programming here. J.E., you have an organic acid test, right?

Yeah. Yeah.

So, what are the top symptoms and what are the questions you have?

Oh, yeah. This patient is a very long chronic disease, and mostly related to the digestion. Could not handle too much, uh, different kind of food. We are sensitive. And her gut motility seemed like were slow. Even she eat a little bit more, she always said her stomach is stuck. And also she has a lots of muscle kind of circulation. She, she said the circulation are good. She needs to keep stretching.

Okay. Have you worked on her yet, or is this like the first time?

No, this is her. Uh, I, I sent you two tests that, you know, this is a last year's, uh, uh, I am panel. I, I also signed in like a couple weeks at the, uh, the organics. And, Joshua, yeah. Okay. Yeah. Let's look at the current one then. That's perfect.

So, with organic acids, this is one of the more intestine, one of the more important tests to really master and understand for our field. Understanding this test is like a medical doctor understanding a blood chemistry and a CBC. I mean, this is like the central physiological systems of the body. And you have to master this one. And I, I'm telling you, I practiced for 10 years without really understanding how to do this lab, and I missed a lot of problems. I can't tell you. I would say in my current practice, 50, 60% of what I do is oriented around this one test. And once you master it, how do you master it? You take my mentorship, and I'll teach you how to do this. Take about a year, you'll just be at this whole other level of understanding for the rest of your career. Okay.

So, right off the bat, there's three big sections here. You're looking at cellular metabolism, you're looking at neurotransmitter and brain function, and you're looking at detox capacity. This particular patient has a high L-lactate, which means lactic acid is building up in their tissues, and that's not going to feel very good. So, you want to use B vitamins and CoQ10 to get that number down. And which B vitamins? Well, it's B1 and B3. Usually, people use a B complex that has a hefty amount of B1 and B3. But you don't, you know, not 25 milligrams. You need like 100 milligrams or more of B1 and B3 every day. 100 milligrams or more of B1 or B3, and then CoQ10, 200 to 400 milligrams. And that'll start to knock that lactate down. Their achiness will go away, their energy will start to get better, they start to burn carbs better, they'll start to lose weight. So, that's an essential component. The rest of this person's, um, energy production pathways on this page are good. So, it's really just focusing on the lactate being built up.

And then the other marker that's a problem is xanthurenate is high. When you have high xanthurenate, it means your B6 levels are low. And so, if you want to look at, uh, there's a, let me just blow up an image here so you guys can see why this even matters. So, lactate being high means, uh, I have a couple different images, but I still think this is the easiest one to see on. Yeah, lactate being high means that you can see up here on the top of the diagram, pyruvate and lactate. So, when we eat glucose, anything with glucose in it, you have to take that glucose, convert it into pyruvate, and convert it into lactate, pyruvate, and then down through acetyl-CoA to make energy. So, if lactate is building up, this process is not working. So, that means you're robbing the person of acetyl-CoA, and there's not enough energy to run the citric acid cycle. Not only that, but the lactic acid itself, as it's building up, causes achiness and all the soreness and just makes people feel horrible, right? Just like when you have lactic acid buildup in your muscles from working out too much, except for they feel like that every day when they don't exercise, right? They're just like, "If I went for a two-hour run and worked out in the gym lifting weights for two hours today, you know, tomorrow I would have a huge amount of lactic acid achiness in my joints, those are my muscles." Right? Those people that have high lactic acid or high lactate, they feel like that all the time, even though they don't exercise.

And then xanthurenate being high is just straight up B6. At least 100 milligrams, sometimes people need more. And then she's got all three of the stress-related neurotransmitter markers either elevated or close to elevated. So, these three here. So, you can help with obviously de-stressing or whatever you do, meditation or relaxation or exercise. And then you can use tyrosine and tryptophan to help with these as well. And then this marker is high, which can either be a B6 marker or a, um, or a marker for, uh, inflammatory problems with the brain. That's a pretty, two different subjects, right? So, you kind of gotta learn how to differentiate those two. I tell you a story. Very interesting. You know, Dancin' Urine? I majored her for four or five years. Now, this is the first time. Hi. Do you know why the first time? Interesting. Yeah. Designs for Health to change the formula. Do you know the Lord B1 from like a 50 milligram to 2.3, and Dancin' Urine, that B6 that like a 2.5, summer milligram? Because I did not know. She discovered, you know, she took this low dose for three, four months. Okay. Yeah. So, high xanthurenate can either mean neuroinflammation or B6 deficiency. So, if you see high xanthurenate, enzyme, thyroid is also high, then you're looking at a B6 problem with this one, not a neuroinflammatory problem. That's a pretty important thing to be able to distinguish. So, yeah, she needs 100, maybe 200 milligrams a day of B6. She needs some vitamin C.

And then the major problem seems to be around the detox markers here. So, we're talking earlier, there's three things you look for in organic acids: mitochondrial health, brain, or detox. And she's got a little bit of a brain issue, a little bit of a lactate issue, but the biggest problem seems to be here under detox. And so, she needs phase one and phase two detox, as well as arginine support, as well as glutathione support. So, she's got a lot of toxin-related issues built up there. I tested her. She's sulfate, always on the high end. I don't know how, why is that for years? Yeah, she's well, she's using it to detox something, probably. Yeah. All right. And then you can also use arginine and then phase one, phase two support. Maybe that'll help her. Maybe the ammonia is causing a problem or something like that. But, uh, that would be the ways to get started there.

All right. Thanks, J.E. Thank you.

You bet. Okay, you guys, I'm gonna wrap it up for today. I hope you got a little bit of inspiration about learning how to do these labs more. If you have the time later in the fall, check out our bootcamps. We have two bootcamps coming up. The one on supplements starts in a couple weeks, and that one's really good. Program design is my favorite thing. Eight weeks long, a bunch of live calls. I think there's four live calls. It's eight weeks of materials. There's tons of lectures and stuff online for you to learn from. And then if you want to do more straight-up business-related things, then, uh, the Business Essentials Bootcamp in November is more about telehealth, business workflows, sales, and marketing, and that kind of stuff. And if you have time and you have some extra cash lying around, join the mentorship. We're starting at the end of this month with a new group. It'd be great to have a couple more students sign up so we can kind of fill out that class. And that is basically a year of lab review intensely like this, every week, all your cases. There's a massive curriculum online that you listen to. There's always other students involved, and it's a pretty exciting and great clinical experience. And we lowered the monthly fee and extended it out a little bit because, COVID, people's finances are a little tight. It's around a thousand bucks a month for the class. It's like in the 12 to 15,000 range for the entire year, depending on if you use payment plans or not, okay? So, you guys are wondering about that, contact the office. Otherwise, I'll see you or hear from you at the next one of these, okay? Thanks, everyone, for sending in labs. Bye for now.