Transcription
I'll wait. Everyone started streaming in. Still, so I just got back from Phoenix, Arizona, and I was at the SHYON conference. Dr. Ben Lynch invited me to give a talk. I gave this talk on neurotransmitters, although it was quite a bit longer, about twice as long. And I gave a talk on H. pylori, which was really wonderful.
And if you don't know about Dr. Ben Lynch, I think everybody's heard of Dr. Lynch by this point. But anyways, brilliant doctor, excellent teacher, puts on an awesome conference. This was the second annual SHYON, and, um, big focus on everything to do with functional medicine, from detoxification to autism and GI problems. We had a soil expert who gave a riveting talk about soil and how soil affects nutrition. And Dr. Lynch gave several talks also that were really enlightening about, uh, subjects, uh, like liver, gallbladder issues, mitochondrial energy.
Um, what I like the most about the conference, I mean, it's really good information. It was four days, it was action-packed. The speaking lineup was good, but what I liked about it even more than the intellectual information was just the group of people there. They just were incredible, mission-oriented to an extreme, which I really appreciated. And it was, for me, just inspiring to be around those people. And I'm honored to be a speaker there as well.
So, anyway, SHYON, uh, Ben Lynch. If you didn't get a chance to go this year, check it out. You might want to sign up for next year. Okay.
And we have a big subject on our hands today, and it is, uh, neurotransmitter dysfunction based on organic acids testing. So the problems that we're thinking about here would range from ADD and ADHD, depression, anxiety, uh, memory problems, and then the ever-present, most common complaint, complaint that we all see, which would be fatigue.
And I found organic acid testing to be an incredibly valuable tool. I'm a very strong proponent of it. Now, in my clinic, I test every single new patient with an organic acids panel, and I find it to be one of the most invaluable tools that I use. So, I want to share this information. And, um, if you're not ordering this kind of test yet, I really encourage you to do it because it's fascinating and really helpful.
So, for those of you that are new to me, haven't been to these before, I've been in practice for a long time. I work with, I've worked with a lot of different kinds of patients all over the place. We have a training program that I'll talk about in a moment, uh, where we teach doctors how to do this work over the course of a year. I have a lot of, uh, experience with meditation, and I managed to leave the United States for several years and lived in monasteries in Japan and Thailand, in the woods, in the forest, away from humanity, with monks. I really like monks, and I really like living in Asia. And who knows, maybe one of these years I'll go back there when my mission here is done.
But for now, I'm involved in functional medicine. I'm always kind of curious about functional medicine philosophy and practices and how we can become better practitioners. And I see, in general, as a theme as I develop myself, that physical health that we can establish through functional medicine is the platform that we can build for our patients so that they can go out and have the emotional and spiritual growth experiences, which is what everyone is really looking for. You know, I don't see physical health as the point of all this. I see it as the beginning step so that we can go out and do the things that we're on this for. And that's why it was so great being around these mission-oriented doctors, because it's so inspiring, uh, to see people who have been on a mission for 40 years and haven't given up and are going to figure out soil, or figure out toxicity, or figure out how to treat autism. You know, and I think, um, I just am honored to be in a group like that and to be able to get inspired by those kind of people.
So, we're going to kind of bring it back down to the granular level and talk about organic acids and how they work and how we test for them. And this is a mini-art series we're doing throughout the year. We're going to focus now on, um, the brain specifically and neurotransmitters and how various factors affect the brain that we can measure. Um, we've looked at all kinds of different things. In, in terms of the actual structure of the test, it's such a huge test. I think you break it down into these component parts. When I teach this test in my training program, it takes four months to go through this. And, you know, we're trying to do all these subjects in an hour, but it's really just an introductory level so you get a general sense.
But the structure of the test, to me, is really interesting. In the first part of the test, we're looking at underlying metabolic imbalances. How those metabolic imbalances are being expressed? Is there a carnitine problem that indicates the person is inflamed and insulin resistant? Is there switching from the Krebs cycle and to Corey cycle in terms of how the burning, person's burning fuel? Is there mitochondrial dysfunction? And for anyone who has an inflamed, tired, or sugar-craving patient, these are really mission-critical things to figure out because, as you all know, everyone we work with is sugar-craving, tired, and having trouble with their mitochondria. And so that kind of an assessment is critical.
Environmental stressors are also covered, and we're going to talk a lot about this tonight. The psychological stressors that we're all under, and how homovanillate indicates high catecholamines, a stress response. Also, how toxicology that is shown on this lab tells you the impact. It shows you the impact of chemicals and heavy metals. And many of these chemicals and heavy metals are neurotoxins. Therefore, if we're toxic with a neurotoxin, we're going to have a brain-related problem. And we can look at that and start to investigate that on the test. And, as always, it also shows gut-related problems that can lead to inflammation that again would trigger problems with the brain.
We'll get into, you know, um, sort of detail on this. But, you know, if I was, when I was, I was at the SHYON conference there. You know, there were a couple hundred, two, three hundred doctors in attendance, there's a couple dozen speakers, some of the best and brightest people in in the country, in the world, really. People from Canada, from the UK, from all over the world, from the Netherlands. And, you know, I just imagine if I had had a 10-year-old kid with me for those four days and I said, "Okay, listen, kid, I want you to listen to all these talks. I want you to pay attention and take notes. And at the end of this, I want you to tell me what you think everyone has said." Okay?
So, at the highest, highest level, all these experts speaking on all these different topics, at the end of the day, it really comes back to these fundamental concepts of toxins, infections, and stress causing all these problems. And it's nowhere more important than when we're looking at the brain. When we're looking at the brain, and we want to avoid the common mistakes that happen with organic acids, just make sure that you don't take these tests at face value. You know, there's a depth to the testing that can happen as you start to explore it.
This is a, this is a slide that's meant to instill fear and intimidation into you. I'm kidding, but it is kind of complicated. If you look at the actual test, I mean, I would freak out if I was just looking at this for the first time and I would say, "I don't even know if I want to order that test because I don't even know how to interpret half this stuff." But my whole purpose, apparently, in life right now is to try to simplify these things so that clinicians like myself can get out there and actually order these tests. I'm in practice two or three days a week. I actually interpret these tests with real people and set up programs in a cash practice, which means that if I'm not getting people better, they're not going to come back, and I'm not going to be able to pay my car payment every month, right? So I'm in the trenches doing this work every day. And, you know, it really is incumbent upon us to simplify this work so that we can communicate it to patients. If you start using terms like alpha-glutarate, hydroxymethylglutarate, I mean, I'm impressed I can pronounce them, vanillylmandelate, people are just going to glaze over and not understand what's happening.
So, the point of today's talk is to kind of introduce a new language and to start to talk about this in a language that's, um, communicable, that we can communicate with patients in. And, okay.
So, here's another kind of like shock and awe, intimidating kind of thing. Like, all these markers, what am I going to do? And we're going to try to simplify this by looking at the biggest picture possible, which, in my mind, is the body systems model that I use in all my training programs: neuroendocrine, GI, and detox. Three body systems. Doesn't need to get more complicated than that. We're talking today about this little component here, the neurotransmitter component of neuroendocrine. And what is impacting what? Well, if the neurotransmitters are not doing well, there's typically going to be either stress hitting them, GI inflammation from food or pathogens hitting them, or toxins, that means chemicals or heavy metals hitting the brain. So, the brain can be under emotional stress, digestive stress, or toxin-related stress. And it's really that simple. There doesn't have to be a whole lot more going on than that.
We talk about the four horsemen, and this is how I look at, um, the physiological damage that's occurring in the body at a deeper level. We can look at this from a perspective of organic acids markers, like individual markers, and then ultimately, all this stuff is only relevant if we can present it to a patient and deal with common patient complaints. So, like, someone's overweight, and you have to take this test, interpret it, and explain it to them. That's really where this all comes, you know, to fruition. And again, if you can say beta-hydroxybutyrate, that's pretty cool that you took biochemistry, but that person's just exhausted and overweight. You have to be able to talk about these subjects in a, in a language that people can understand.
Okay, so the four horsemen, and these are the four problems that we see revealed on this test in a variety of different ways. Is the patient inflamed? If so, what's happening? How's that inflammation impacting them? Is a person catabolic, or are they breaking down tissues? If so, what systems is that impacting? Are they insulin resistant? And how much oxidative stress are they under? So, you can look at this entire lab from this perspective of inflammation, catabolic physiology, insulin resistance, and oxidative stress and start to get an understanding of the ways that your patient's systems are being damaged.
Another way to look at this test, it's a complicated test, is by, um, systems. And I like this one a lot, and this is usually what I use for patients. There's a neuroendocrine component to the test, there's a GI component to the test, and there's a detox component to the test. Again, doesn't have to be simpler than that. Just grab each one of these sections, throw them in a category. When you're getting into patient program design and actually giving people supplements, it really helps to organize it along these lines. Okay, again, neuroendocrine, GI, detox, putting each portion of this lab into one of these three body systems, so you're not dealing with seven variables, you're only dealing with three.
Depression, anxiety, all these things we're talking about symptomatically. Where we want to go now is to start to break this down into a couple of different lanes. Is the person suffering from, uh, inflammatory-based neurotransmitter problems, or are they suffering from, uh, some kind of, you know, stress-induced version of that? Okay. And you'll see when we look at the lab results themselves that we can divide people pretty easily, neatly into those two categories.
Now, amongst the different things that we see going on with the brain, I often see deficiency types. And that means that that person doesn't have the nutrients they need to make the key chemicals in the brain. More often than not, we're dealing with the damage type. Damage would refer to the fact that the brain cells themselves are damaged from chemicals, heavy metals, or trauma, blows to the head. Some people are born with these issues, and this is what the, folks like Dr. Lynch, Dr. Ben Lynch, talk a lot about, the genetic component in all this. And some people are suffering from a deficiency, some damage, and genetic tendency all at the same time. But these are the three common types of brain issues if you're starting to, you know, try to categorize people in terms of specific areas that you think they may have a problem.
Now, when we're trying to heal the brain, we're going to want to correct the neuroendocrine system. We're going to want to decrease the inflammation coming from the gut, and we're going to want to reduce the toxic burden that would impact the brain. So, once again, we have a neuroendocrine system that we're fixing. But is there a GI component? If so, we need to address it. Is there a toxin or detox component? If so, we need to address it. And if the brain is inflamed, which we see on these labs, it implies there's GI inflammation or toxin-related inflammation that we need to address. If the brain is under stress, and you see the stress markers, then you want to deal with the emotional stress component to this initially.
Now, inflammatory brain issues, again, two categories. That's that's it. GI inflammation from foods or pathogens, and toxin-related damage that's generating oxidative stress and inflammation. And if you can fix the foods, the GI pathogens, reduce the oxidative stress, and reduce all the inflammation, you're going to take the pressure off the brain if there's an inflammatory brain-related problem.
So, when the brain becomes inflamed and tissues in the body are inflamed, cytokines change their production pathways. We'll look at that in detail in a moment, and you end up with depletion of brain chemicals secondary to the inflammation. So, then clearly, the inflammation is the main thing that has to be treated, otherwise you're just going to be kind of, I don't know, chasing things around for a while.
Second to this, there can be stress-induced brain issues, and the test looks for this. I'm sorry I spelled Bradley Cooper's name wrong, there's supposed to be an E in there. And I'm sorry, Brad, if you ever see this or listen to this, I apologize because you're a great actor and I love you. Bradley Cooper, he's made an amazing number of great films. But one of the films he made more recently was American Sniper. If you haven't seen it, go out and rent it. It's a great, great show. And basically, the short version of the story, he plays a real-life character who was the most decorated sniper in the American military, and he had many tours in Iraq. And he shot, obviously, you know, several hundred people, usually in the head, and killed them. And so this is a man that sort of typifies intense emotional stress. And there's some really great scenes in that movie where he comes back from Iraq, and he's sitting at his, in his living room in Texas, in his suburban home, but he's just seething with anger, resentment, violence, fear, and all the things that are happening because he's a good human being whose job is to assassinate other human beings, and it's taking its toll on him.
So, that kind of intense emotional stress, you know, and and and Bradley Cooper doesn't overact it. He's not screaming and yelling and beating up anyone. He's just sitting in his chair, losing it. And I see this in my patients all the time, whether they're sitting in their car for an hour and a half trying to get to their job in Cupertino to go work at Apple, or whether they're dealing with a divorce. Whatever it may be, stress-induced brain issues are very real, and they cause a very real effect that we can measure with this test.
So, now let's take a look at a few pathways. We don't overwhelm ourselves with too much science, but I think a little bit of this is helpful just to understand what the heck we're talking about. So, when we're having normal physiology, we take tyrosine, convert it to L-DOPA, we then make dopamine, norepinephrine, and epinephrine. On a happy day, we make some of this, everything's going well. We break it down to homovanillate and vanillylmandelate, and it gets dumped out in the urine as homovanillate and vanillylmandelate. These are the metabolic, um, byproducts that we're measuring with the organic acids. So, you take that dopamine molecule, you act upon it with MAO and COMT enzymes, they break it down. All of a sudden, you have a bunch of homovanillate in the urine. So, when we're measuring homovanillate and vanillylmandelate, if those numbers are super high, it implies that we're making a lot of these catecholamines because of some kind of stress. So, if these numbers go up, we see a stress-induced, a stress-induced problem with dopamine, epinephrine, and norepinephrine produced in the adrenal medulla.
In the opposite situation, if we're not that stressed, but we're very inflamed, then what do we do? We make inflammatory cytokines. And if we're very inflamed from what? From gut or liver problems, remember, from GI issues or toxins, then picolinate and quinolinate, and this other marker not on this diagram called kynurenate, will elevate. So, what this all means is that if you see high picolinate or quinolinate, it means the person is inflamed. If you see high homovanillate or vanillylmandelate, it means the person is under emotional stress.
Now, simple math. I'm very proud of my son. He's 17 years old, he's a great kid. And, uh, he just got into, this is a big deal. He's, you know, junior in high school, goes to public high school here in Inland California, just got into MIT for their summer program, which is a really big deal because half of these kids go on to actually attend MIT. So, he's super psych. So, he's really, really good at math. He's taking like third-year college math in high school. My math, not so great. Keep the numbers simple. Let's say you have a thousand units of tyrosine, and your body is really, really inflamed. You're going to take that tyrosine and divert it down towards these inflammatory pathways. So, if you really, and again, we're keeping the math artificially easy here, let's say that you have to make 900 units of these inflammatory cytokines from our mythical thousand units of of tyrosine, that means you only have 100 units of tyrosine to make your catecholamines. So, if you're inflamed and you're diverting your tyrosine molecules down here, you're not going to have enough dopamine, norepinephrine, and epinephrine to function well. Okay? And then you're going to get depressed, anxious, hungry all the time, OCD, poor memory, etc.
Similarly, if you're really stressed and you're making huge amounts of dopamine, norepinephrine, or epinephrine, you're going to see these numbers go up, which means you're burning through and using up your catecholamines super fast. Okay? So, this test allows us to differentiate: Is there an inflammatory brain problem or a stress-induced brain problem? And why does that matter? Because the stress-induced brain problem patient needs to meditate, garden, exercise, relax. The inflamed brain patient, you've got to figure out where that inflammation is coming from. Is it coming from the gut pathogens or foods? Is it coming from the liver, heavy metals, or chemicals? Are they toxic? Do they have a GI problem? Or both?
Okay, so this is the main way that we differentiate. Again, stress-related markers: vanillylmandelate, homovanillate, 5-hydroxyindoleacetate. These are the markers that indicate that the person's under stress. The inflammatory markers are below there: kynurenate, quinolinate, picolinate. I don't have to memorize all these names, but you'll see when we get to the tests how this all works. And I already talked about this. I have a bunch of slides on here that are kind of extra.
Oh, and then I want to say, you know, I just love meeting really smart people. And one of the things that's made me so successful in my career is that I can identify smart people, and then I can get close to them, and then I can learn what they learned and kind of, you know, integrate it in some way in my own brain cells. And do I just want to say, I can't say enough good things do about Dr. Ben Lynch. And this is his Pathway Planner that he's developed. If you want to learn more about this, check out his seminars. If you want to get into the genetic level of all this, you know, that's a little over my pay grade. I like to keep things simple, but a lot of you are interested in this more complicated work, and you should check it out.
All right, so low. You can also have low levels of these chemicals, the vanillylmandelate and homovanillate, and that means the person's even worse. Okay? They're going to get anxious, they're going to be depressed, all these things are going to exaggerate. Now, one thing to keep in mind too, is that these chemicals are made in the adrenal medulla as well as the brain. Kind of an interesting thing that we make the catecholamines in both places. And there's another marker for you there. And these are the basic pathways. I'm including for those of you that love to see pathways. And same exact thing here. I'm kind of slipping through, sneaking through these slides because I want to do some cases, but I want to include these if you want to review them later.
High levels or low levels, either way, it's bad. And this one we didn't talk yet about. This is the marker for serotonin. So, here's your serotonin right here. If your body is, if your, if your system is stressed, your 5-hydroxyindoleacetate is going to elevate. That's going to indicate that you're burning through serotonin at a really high rate. Now, that marker, be a little careful. It can also change if someone's on an SSRI. Okay?
Now, if you're having any technical problems, um, let me just close the camera. Some people are having trouble with the camera. I'll take that out. That's bugging people. Um, but I'm pretty sure the sound is working. So, if you're having technical problems, you might want to log out and then log back in. Okay? 5-HTP is a precursor to serotonin, as we all know. 5-hydroxyindoleacetate is the breakdown product. This goes up, people are in trouble. Again, here's some more detailed explanation of that. And be on the lookout for people taking antidepressants because they can change all this as well.
Now, there's another marker here, which we didn't talk about, so I want to mention this one. And this is the pathways for that. Kynurenate can elevate if you're inflamed, and you make kynurenate from 5-HTP. So, just like we saw with dopamine, epinephrine, and norepinephrine, you're inflamed, your brain chemicals drop. Same thing happens with 5-HTP. And this test helps you differentiate which of these chemicals is taking a bigger hit. Some more inflammatory markers there. Again, high kynurenate means inflammation, implies that serotonin levels are dropping. And here's another schematic of the same thing. Kynurenate goes up, serotonin goes down, and also melatonin goes down. And then people get depressed, can't sleep well, blah, blah, our typical sickness behavior patient. Quinolinate, remember that's the inflammatory marker. Picolinate, again, the inflammatory marker. And the kynurenate pathway is the one that's related to serotonin.
Right now, I'm going to, I'm going to talk about our mentorship class. I'm going to give you guys a little mental break, but I also want to talk about something else, which to me personally is a little more important. This is a scientific break. A week ago today, we published a research study on "Evaluation of a Functional Medicine Approach to Treating Fatigue, Stress, and Digestive Issues in Women." And I'm happy to share copies of this with you, those of you that are interested. But I just want to point out, because I am proud of this accomplishment, Sue Cutshaw, who's at the Division of General Internal Medicine at Mayo Clinic in Rochester, Larry Burstrom, who's at the Division of Consultative Medicine at Mayo Clinic in Scottsdale, and Dan Kish, that's me, who's in private practice in Oakland, California, published a research study where we analyzed adrenal and GI labs, treated 25 patients, did pre and post workups with the labs. I was, uh, the treating physician in this whole project. I treat, did all the patients myself, and then we sat down together and wrote it up. And Sue and Larry are amazing people. They're very generous with their time and effort. And we found wonderful results.
At the end of the day, and if you, those of you again that are statistician people, can look at all the stats here. If you're really into stats, I have literally a 100-page book about what really happened. I'm happy to send anyone who's interested in reading it. But the bottom line was, people got better. We, no one got hurt. Some people didn't get better, but most people did. It was significant, you know, significance was approaching whatever those P values are, thing, you know. And basically, the program worked really well. And this is exactly what I teach in the training classes: adrenal, GI workups is kind of our fundamental, you know, get start with a P, get getting started with a patient kind of approach.
So, I'm very excited about this because, um, I've not done a lot of research in the past myself. And, uh, it's really great to see science proving what we all know as clinicians, which is that this stuff works really well. And it's also really great to have people like Sue Cutshaw and Larry Burstrom from Mayo Clinic involved in wanting to validate this information and share this with the larger medical community. And, um, out of the patients that we tested, we found 19 different digestive tract infections total on about 15 people. Some of the women had more than one infection. At the end of the study, when we retested, we had cleared 18 of those 19 infections. That really didn't show up in the results in the right way because of the way the stats were done, but man, this really worked well.
And what did we do? Besides my charming personality, we told people to get off gluten, dairy, soy, sugar, alcohol, etc. We put them on an adrenal supplement protocol straight out of what I teach in my training program. We tested their guts. Those that had infections, 15 of the 25, we treated with herbs. And this stuff really, really works, you guys. And it's nice to see it all written down in this way that makes it, uh, more real. And it's, you know, one thing to say, "Oh, you know, I treated 25 patients, I think most of them got better," which is what I've been doing for the last 25 years. But to actually track it with this level of specificity was, um, inspiring to me and gives me even more faith in functional medicine that we can say, "Hey, yeah, this works. This isn't just, you know, a few odd doctors here or there, you know, in Boulder, Colorado, and Sedona, Arizona, who think that this is cool. This is like real. This is happening. We want to make people better, and functional medicine is a great tool for that."
So, very excited about that collaboration and, uh, hopefully, there's more to come with, uh, research in the future as well. So, our next mentorship class starts May 25th. If you're interested in learning how to actually do this, sign up. Sign up for a call with me. We have a completely upgraded program now. It's a year class. We've got four months on the organic acids. We've expanded the content. We've got thousands of case studies in this thing. We've got hundreds of doctors that are pretty amazing people. And I think you'll find that you learn as much or more from the other practitioners in the class as you do from me. We have this community, which is mind-blowing. I'll show you a little bit of our community here. We have a live Q&A call every week. Here's the community live, right? What's going on right now? People post questions, people answer questions, people do homework assignments, we answer homework assignments. I'm in this community pretty much every day. We have a lot of experts that we interview. We have a searchable database. You can learn a lot and meet a lot of people. The content here is phenomenal. It's basically a year of these kind of classes, but with a really strong clinical application. I have a treatment map, fix videos. So, when you're needing to do a treatment program, let's say you're like, "I forgot that neurotransmitter thing I learned the other day," you go in, you click on the protocols, all the neurotransmitter protocols are popping up right here. You listen to them, you know what to do with that patient. You walk in the treatment room, and you're not going to be caught off guard.
Okay? And again, I'm here to just guide people as much as I can, show them everything I know, be a mentor as I was mentored myself, and offer as much as I can in terms of help and support to people that are interested in learning the work. And I know when I was being taught by Dr. Timmons, um, you know, he had hundreds of doctors that went to his seminars, and some of you may have actually met him if you're old enough. Um, and at, when he had his funeral, when he died, you know, I went, of course, I flew down to San Diego and I went to pay my respects to his family. And and there were about 10 or 15, maybe 16 doctors that were there like me. And I met them all. I was like, "Wow, how, how are you Kurt? How are you Larry?" You know, people that I kind of heard their names, but I didn't know them that well because we didn't have an organized class. We'd all just studied with him at a certain phase of his life. And when I was at his funeral, and I looked around and I saw 10 or 15 doctors, I thought, "Wow, that is not enough." If Dr. Timmons was teaching for 20 years and he only captured 10 or 15 people and really got us up to speed, the kind of people that would come to the funeral, I was like, "When I have my funeral, I want like two, three, 400 people there. I don't just want 10." And that's really been my goal ever since I was at the funeral is to get relationships developed with other doctors such that when I die, you're going to drop everything, come to my funeral, and pay your respects and tell my son how amazing I was because we're on that level of communication. It's not about the money. It's not about you paying for my class. It's about me passing the torch on so that you learn everything that I was taught and you're a competent practitioner and you're out there helping other people.
Okay? We offer people, um, bird discount. If you sign up, get $500 off the class. You can schedule a time with me to talk about the class. We have live calls every week. We go over cases. It's a really, really good group of people that you'd be associating with. Okay? And the folks that sign up for the class are usually doctors looking to implement functional medicine, but they want a clinical model. They want the how-to part of all this. We also have a practice management component to this. So, we get practitioners who are just looking to be able to make more money as they treat patients, not because they want more money in their pocket. I have never had a doctor in our class who is greedy. It's always the same story. They want to increase their revenue so they can take a little time for themselves because they're a little burned out. We also work with a lot of doctors that are transitioning from insurance to cash. But the crowd that we attract is really quite phenomenal.
There's also the Kish Method 101 that we set up. And if you want to do that, it's an introductory level class. It's eight or nine hours of information that'll get you kind of basic started. And we have a special on that if you're interested in doing as well. Okay? We have a new website. We just redesigned a few weeks ago. If you haven't been there recently, check out KishInstitute.com. And you can call, schedule some time with Leslie or myself and see if this is good for you. Okay?
All right, back to our regularly scheduled programming. So, let's look at what we actually treat with tyrosine, amino acid. Here's some details on it. The key points with tyrosine are that it's going to support dopamine, epinephrine, and norepinephrine. Also, in a sort of sideway, it helps, uh, support thyroid. Well, that's not really the purpose of what we're doing. There's also L-DOPA that you can be used, um, or Mucuna is often the way the herb is represented on a label, and that helps with the body's natural production of dopamine. Also, most companies have something. Again, usually the label will say Mucuna. And then good old 5-HTP. Can you use tryptophan? Absolutely. 5-HTP is a little more consistent, a little more reliable. So, I usually recommend people use this, although it's certainly not, um, what would I say, uh, it's not, I don't have anything prejudiced against tryptophan, but 5-HTP is usually a little more effective. Okay? Vitamin B6 is important, and the organic acids profile has specific markers that will let that will let you know if the person is deficient in vitamin B6 or not. How handy is that? We'll skip through some of these and let's look at some case studies. We have some time for this. All right, here we go.
So, again, history here. 45-year-old female, mother of two autistic children. How does that translate? That translates into highly stressed, full-time caregiver, moved to a new state, lost most of her support network when that happened. She's depressed, she can't sleep well. Her dad died recently. Um, now I'm remembering who this is. Now, these are actually all my real patients. Now I'm remembering who this is. Um, yeah, yeah, yeah. She's fighting with her siblings over estate issues. Um, this was an interesting case, you know, so they had, oh, I don't know, I'm guessing like 50 to 100 million range, um, that the father's company was valued at. And then when the dad died, the siblings were trying to figure out how to sell this thing and how to split the money. Not a pleasant situation to be in.
Okay, I'm going to show you the standard workups that we use. I run an adrenal panel, look at that salivary cortisol. We look at, um, GI testing. You know, in this case, she had Cryptosporidium. Cryptosporidium, right there, which is a parasite and can cause a fair number of problems. And then here's her actual organic acids test. And, you know, lots of things going on, but we're now focusing right here on the neurotransmitter markers. The key point I want to make is that if this isn't that, that hard. Okay? And, you know, I want to, you can make organic acids incredibly complex, and there are many, many different layers of understanding you can acquire over the years that you do these tests. But tonight, I just want you to get started if you're not using these labs and not, and and to reduce the intimidation that you may feel towards this.
Okay? So, remember from the earlier slides, there's either a stress-induced problem that's affecting the brain, or there's an inflammatory-related problem that's affecting the brain. Either way, we're going to use the same supplements to resolve it, but it may vary quite a bit on what we recommend the, uh, that the patient do in addition to the actual supplements. In this case, you can see vanillylmandelate very low, homovanillate low, and 5-hydroxyindoleacetate low. And actually, the lab tells you right here that indicates the person needs tyrosine. Tyrosine and 5-HTP. And that tells you that they have an epinephrine and norepinephrine problem, a dopamine problem, and a serotonin problem. So, this poor woman has problems with all four of the neurotransmitters that we're talking about. Obviously, then you want to address the stress component to this, because just giving her a bunch of tyrosine and 5-HTP is not necessarily going to solve the problem. And ultimately, you want to be able to relieve some symptoms in the earlier stages of the treatment and then work your way over to the point where you start to, um, relieve stress. Right? Because in the beginning, when people come in, obviously we can't just say, "Oh, you know, you're stressed. We're going to relieve your stress," and that's going to make these markers better. In fact, you know, we want to use the supplements in that first few months to get the person feeling better, and then we can talk to them about how they can reduce their stress once they feel like they have a grip on things.
Now, in the very beginning of the talk, and just to refresh your memory, I I mentioned something about the four horsemen. If you remember, um, one of the four horsemen is inflammation, one is catabolic physiology, one is insulin resistance, and one is oxidative stress. I just want to point out here that when a person is catabolic, they're going to be breaking down amino acids at a very rapid rate because they're using those amino acids for fuel. What you will then often see on these tests are results like this: free-form amino acids indicated based on these markers. Person's very low in free-form amino acids. Well, we look at the brain chemicals, actually, all the indicators for treatment here are amino acids. Tyrosine, phenylalanine, and 5-HTP are all amino acids. Detoxification indicators, free-form amino acids. You see the theme here? Even under this marker here, with hippurate being very elevated, what's the solution? Glycine, which is an amino acid.
So, when people are stressed, they're not absorbing nutrients well, they've got lining that is damaged in her case with Cryptosporidium, you're going to see a lot of amino acid deficiencies. So, we don't want to just give glycine, free-form aminos, tyrosine, 5-HTP, phenylalanine, and call it a day. Even though that'll make this patient feel tremendously better, we want to address the underlying cause at the same time. However, my personal opinion at this point in my career is that it's a totally reasonable thing to do to buy a patient time and get them feeling better with a boatload of amino acids in that first couple months to give you the time to figure out how to solve the underlying problem.
I think the most important thing I've learned about functional medicine recently, and this to me was a revelation, is that you don't have to treat the underlying cause first. Really don't. When I first learned about treating underlying causes from Dr. Timmons, I just assumed that that was the only thing that we did, and it was the most important thing, and that everything else was sort of secondary. Now I realize that it's really quite the opposite. We're treating a patient, not the underlying cause. We want the patient to get better and feel better, and as that process unfolds, we want to deal with the underlying cause. But in my practice now, I often address the underlying cause later on when the person is starting to feel better, and I don't feel like I have to aggressively attack the underlying cause in the beginning because I can use these kinds of labs like the organic acids to get that person feeling better. And, you know, if you had come up to me 20 years ago, I would have said, "No, I'm not going to have this person feel better. I'm not doing that kind of feel-good treatment. That's what other unenlightened doctors do. I only treat the underlying cause." And it's a very arrogant position that I took, and I think it really led to less than best outcomes for a lot of patients.
So, now I realize, hey, we can treat all these problems on the organic acids profile. I know that stress is driving it for this case. I know that she has crypto. Let's get her feeling better and give her a few months of feeling better, and then address these other issues. Okay? And with this example, too, you can see there's other things going on. There's mitochondrial problems, so of course she's tired in relation to mitochondrial energy markers, U, but here we see the real blood bath on the neurotransmitters. These markers are all low. So, what happens when you're first under stress? They elevate. These markers go up. If that stress continues, they can deplete or drop. So, the fact that these three markers are low means that she's in even worse position than she was when they were elevated. And what's sad but true is a lot of people that have low markers for catecholamines, like these two top ones here, homovanillate and vanillylmandelate, get really anxious. They know the end is near. They know their neurotransmitters are burning out. It does not feel good when your brain just hit empty.
I have a thing about cars. And I have a really old BMW, and the gas gauge really doesn't work that well. But I, kids can't give up this car. And so, and I tell this story all the time, but I was driving on the freeway, I don't know about a year ago, and, you know, on a big freeway, like a five-lane freeway here in the Bay Area, which is kind of a scary thing to do, no matter what. And then all of a sudden, the car just stalled. And I looked at the gas gauge, and I was like, "Oh no, I miscalculated the gas." And I don't know if you've ever had this feeling before. Most of you are probably smarter than me to avoid this. But this feeling like, "Oh my God, I'm going 80, 85 miles an hour, I'm ripping down the freeway in this ancient BMW, and I'm out of gas." This is not a good feeling. You know? And it was totally miraculous. I, there was an exit. I swear this was dictated by some higher power. All of a sudden, there was a freeway exit. I took a radical turn across all these lanes of traffic. I coasted down this freeway exit. This is a true story. This is absolutely exactly what happened. I saw my engine is not running anymore, right? I'm coasting because the gas tank is empty. I saw a stop sign at the bottom of the intersection, but then I saw a gas station like a half a block away. And I was like, "Screw it." I just ran a stop sign, and I had just enough energy in the car to cruise up to the gas pump, and I was done.
But anyways, long story. The point is that when you get that feeling, that sinking feeling like, "Oh no, this is not going to end well." This is what happens when people are low in their transmitter markers like this. It's not like they're low and they're more relaxed. No, they're low and they're feeling like, "Wow, intuitively, this is the end. You know, this is not a good thing." And so often, people with really low catecholamines are really high with anxiety and panic attacks at the same time. They can either have high or low cortisol. So, they can be wired and anxious and exhausted all at the same time, maybe not in the same moment, but in the same day. Okay? These, these three markers here again are the stress markers. These three down here, remember we talked about these earlier? Kynurenate, quinolinate, picolinate. These are the three inflammatory markers that let you know, is the brain responding to inflammation by making all these cytokines?
Another case study. 39-year-old male, computer programmer, Silicon Valley, poor diet. You can't even make these stories up. This guy was really interesting. A lot of people now in the Bay Area, you know, live in San Francisco but work down in the valley, and it's a brutal commute. It's a hard, uh, kind of high-stress life. Everyone's, it's like what San Francisco was like in the 1840s and 50s. It's like the Gold Rush. Right? Everyone's coming out here now to try to make their millions of dollars on the internet, all these tech companies. But it's, it's work. You know, it's hard on people. And a lot of people get worn down, as this fellow did. So, his main complaint, well, not his main complaint, but his the reason why he came to see me, let's put it that way, was because he was in a meeting at work at one of these tech companies like Facebook, Twitter, Apple, whatever it was, you know, and he's a pretty senior manager person, but not at the vice president level, you know, but, you know, he's an important guy. He's got a team under him, probably 30, 40 engineers, something like that. And he's at this important work meeting, and he starts crying. He just breaks down into tears. So, if you know anything about engineers.
And Silicon Valley culture that is just not a cool thing to do, you know? In the middle of a really important work meeting with all your bosses around to just start crying. So he was at that point where he couldn't control his emotions. He couldn't just do this stiff upper lip thing and power through the stress that he was under.
He went to see his regular doctor. Everything looked fine. He stumbled in to see me. We ran his labs. Now, of course, I do all these other things, and I'll show you some of these other things in the lab. We checked his adrenals. They weren't that bad. We checked him for the GI infections. Looked like he had H. pylori. Whoops! That's a big problem. If nothing else, that's a huge generator of inflammation. Inflammation with H. pylori is the rule, not the exception.
And then when we actually ran his test here, you can see neurotransmitter markers, quinolinate and picolinate, very high, indicating that he's inflamed, making a lot of cytokines and depleting his brain chemicals in the process. Why is he inflamed? Could be the stress. Could be the H. pylori. We're not sure yet. We're going to treat all these things. As you remember, in addition to infections like H. pylori, these markers or, oh, sorry, I drew the long rine line wrong. These markers here are really important too. Oxidative damage, detox indicators, showing problems with his ability to handle toxins, chemicals, and heavy metals in his system. He's not eliminating well. Detox pathways are not working fully.
So now, when we're saying, saying the "why" question, why is he inflamed? Why are we seeing this? Well, here's part of the "why." He's toxic. These toxins are damaging the brain. The other part of the "why" is down here. He's got this intestinal bacterial overgrowth along with H. pylori that's also damaging the brain. So let me draw that in colors because my color scheme is always the same, right? We have neurotransmitter system, neuroendocrine is always in red, and then orange is forgot. So why is his brain inflamed? Why is he? Well, here we see bacterial markers here that's going to create this problem here. And you want to add to that H. pylori also creating gut inflammation and brain problems. And let's get one more color in the mix, which is green, which is a wonderful color. Antioxidant levels and toxin levels high. He can't detox properly. We see these detox pathways are blocked. That's going to contribute to the inflammation too.
So remember when we started off in the very beginning, inflammation, GI, toxins. You can see it all with this test combined with, um, uh, still testing and maybe a little adrenal panel just for good measure. Some of you probably also would check thyroid and sex hormones. And we obviously kind of doing a a shortcut version of this. But here, let me show you how this looks on the lab. Here we go. Quinolinate and picolinate elevated. Now you know, oh gosh, he's inflamed. And that is going to be depleting his catamin. Why is he inflamed? H. pylori, bacterial infections, and toxins.
So now you think about, oh, I don't know, like, how am I going to treat this fellow? What am I going to actually do? And I'll take the last few minutes here to show you my super special treatment map. So I, I do a lot of meditation and, uh, I'm pretty convinced at this point that this information is coming from somewhere else. But I don't know. The summer we were in Hawaii with family and, um, you know, we got this really nice little cabana thing. We're sitting on the beach every day. And everyone else seemed to be reading non-fiction or fiction. I don't know. They're reading like books like you buy at the airport. And I had this series of 25, 30 hours about organic acids that I was listening to. Looked like I was listening to music, but I was actually listening to a a lecture series on organic acids testing. And then I would do that all day long. And then at night, I would just like write all these notes. But I came up with some pretty good stuff. I want to just show you a couple of these things that I developed because, um, we use these every day in the training program. It's pretty cool little nifty tool. And, you know, what, what one really great teacher told me the other day is that we're not teaching information really, we're teaching, uh, a thinking process. So I just want to show you my thinking process.
Um, as you all know, very simple three body systems treating in this order generally: neuroendocrine, GI, and detox. And then when we get into like, how does this actually work? Let's take a few examples here. So let's take these out. You guys kind of familiar with that? So we have our electrical engineer in Silicon Valley. We would want to treat his neurotransmitters first, so he's not crying in meetings all the time. We would want to treat his pathogens. That in his case is H. pylori and those bacterial overgrowth. Probably have to deal with repairing his leaky gut. And then I do believe he had the toxin markers, so we're going to need to detox him at the end. So this would be my protocol for him. In terms of protocol design, 60 days, maybe a little more on the neurotransmitters, get him feeling great, get that emotional stuff cleared up, work on the diet, get him to meditate, all the good stuff that we always do. Treat the pathogens, a couple months into this, get rid of the H. pylori and those are back and those bacteria. Repair his leaky gut. As you heal the pathogens, as that program is going away, then we can start to detox. So you're rolling out one program at a time. Of course, you're going to overlap these. There may be several programs running at the same time. Usually in my practice, the way this actually happens is I'll show you. I would do the neurotransmitters for a month or two, then pathogens. The pathogen treatment is done. We start to do some leaky gut repair. Oh, let me pull it over there. We start to do some leaky gut repair. As that's happening, we start the detox process. And that's maybe like a six-month protocol altogether. But the key point is that we always try to treat in the same order: neuroendocrine, GI, and detox, unless there's a really strong reason not to. And remember, for many of these patients, many of them, the toxins are going to be the underlying cause of all their problems. It's very common to see that. Doesn't mean you have to treat the toxins first. In fact, if you treat toxins too early in the process and they're is not working well to get rid of toxins, you can make the person worse. And we really want to prevent any of our program design issues for making people worse. So just because you think it's the most important thing doesn't mean you have to do it first.
Let's give another example. The patient with cryptosporidium pathogen. That may be the main problem. Why she was sick was because of the crypto. But we want to work with her neurotransmitters, strengthen her immune system for a couple of months first to increase the odds that when we go after the crypto, we're going to be effective. So again, if the pathogen is a main problem, it doesn't mean you have to treat it first. And when I've made my most obvious mistakes is when I see the crypto and I want to treat that first, and I ignore everything else going on. I see the toxins, I want to detox a person aggressively before I do anything else. So walking into treating the underlying cause first can lead to problems down the road. And just want to be a little bit aware of that, right?
So now let's take a look at anything else we have here. Oh, the next class we're going to talk about assessing small intestine gut dysfunction on the organic acids. Another driver of inflammation. Should be aware of, okay? Those of you that are interested can tune into that. We do record all these as well, so you're welcome to listen to the recordings or share the recordings with friends. And again, those of you that are interested in a training program, please reach out and contact us. We're starting a new group May 25th. Class is better than ever. We've got all kinds of amazing information for you. And, um, super excited to have a great group of doctors. You get a $500 off thing if you sign up by May the 6th. And here's, we already showed you this. I want, I didn't show you the lecture hall though. Let me show you this feature first before we wrap up here. So we've got, I showed you the community, which is an online community, which is very active and fun. And then the actual lecture hall looks like this. So we have, you know, modules. Here's an example, organic acids module. Here you go in, we have lectures, you listen to, we have homework assignments. You get all this in detail. You can see, oh, here's a Four Horsemen of Inflammation, catabolic physiology, a lecture on each one of those subjects. Very practical. We try to make this class almost 100% practical application. That's really what doctors are interested in. And that's kind of like my niche in a lot of ways, okay? So we have lecture hall, we have the community. And we have for those of you that want to just stick your feet in the water, Kay Method 101, $397 bucks. It's a 8-hour online lecture series. It gives you a brief introduction to every single thing that we do. And then we also have a live call for that group. I'm happy to talk with you and answer questions that you may have, okay? And there's a ton of resources that are provided in that for those of you that just want to check things out and see if this might be a commitment that you want to make. A year-long class is a really big commitment, I understand that. And you're not going to necessarily do that until you have some time to explore and see if it's worthwhile. Um, and again, you get a discount or credit if you sign up for these courses now. And if you're interested, check out the website and you can schedule with Leslie. And if you're super interested, you can schedule some time with me and we can go over all this, okay?
So let me answer some questions now that have come up. Uh, let's see, um, looking for questions here. Here we go. Okay, yeah, so this is all recorded, so you can watch it again. Absolutely. We'll send out links to that. Um, would I consider hypoxia type of trauma? I.E. endurance cyclists who compete? Absolutely. I've worked with a lot of, you know, very high-level endurance athletes over the years. And one of the things that you see is major mitochondrial dysfunction, okay? Um, yeah, if you're interested in a copy of the article of the Mayo Clinic's, uh, study that we did, you go ahead and just email us and we'll send that out. I'm happy to do that, okay? Um, maybe we'll just send a copy out to everyone in the group. I'll ask my team if we can do that so you don't have to, uh, bother Lissa, okay? I'll see if we maybe just post that along with the, uh, recording, okay? So you guys can see that. Um, when we usually do email follow-up for all of you, we'll just do that for everybody. Um, how much does the class cost? It's around, depending on how you pay for it, it's around $11,200 for the one-year program. [Music] Um, let's see. Before ordering the test, do you recommend patients stop using caffeine? Um, I don't think it matters a whole lot. I mean, it's always better to get people off caffeine, but, um, you definitely don't want them to drink a ton of it right before the test. I might get them a little bit jacked up. Uh, let's see. Look, are nutritionists welcome in your program? Most of the people in the classes that I teach are licensed medical doctors, chiropractors, naturopaths, acupuncturists. We have a few nutritionists and health coaches, but you have to be working with a doctor that can help you order the labs if you want to do that. Um, all right, I hope that helps you guys and get you warmed up. Do some testing, get into it. Nothing better than organic acids. And I think it's a long-term project to learn how to do organic acids testing, but hopefully this will at least get you thinking about it. Order a couple labs and start interpreting them. Okay, have a great rest of your evening. I appreciate all of you taking the time out to cover all this and look forward to connecting with you next month when we do our next in the series. Bye for now.