A Day in the Life Being a Patient of Dr Kalish

Buddy, if someone could please raise their hand, just so I know that my stand is working up. Thank you. Doing that? Worry.

All right, where it's action time. So I have a new approach we're gonna try it. We're going to talk about it. What it's actually like to be in my clinic. And this is, um, to a certain extent, to educate you guys about how functional medicine practices work. And also, to a certain extent, to see if you're a good fit for my clinic. You sign up, become a new patient, they'll be awesome. And let's see. I just fill you in a little bit about what's happening in the functional medicine world first, just so you can get like an update.

So I just got back from the Institute for Functional Medicine seminar in Denver, Colorado. I got in yesterday, and it's pretty inspiring to be around a group of hundreds of doctors who are really trying to pursue this work. All is to for functional medicine, of course, is to sell out. They have a huge amount of interest right now, which is very heartening. And for the first time, I was on the stage at the IFM conference, presenting in the evening session on practice implementation. It was a really wonderful experience, and I got to spend a lot of time with their faculty. I really, really appreciate that group of doctors and all that they're doing. And know, and Marshall Mason, it's just starting to go through this, you know, burst of growth. And not time, you ask me.

So let's take a look about, you know, the subject for today. A day in the life of a patient, you know. And this, you know, my practice runs in a similar way to a lot of practices out there. If you haven't been a patient yet, or you're wondering about being a patient, even if you don't sign up with me, then you go find a good IFM certified doctor near you. And, and, you know, get this whole process started. Sooner than later is better.

So I wanted to have a little bit about patient perspectives. And I want to show you some of the details about how my practice actually works. And what you should expect from a good functional medicine workup. And let me show you here. He started, same thing that you might not know. And there's certainly a lot of, I don't know, not all functional medicine is good functional medicine. You know, you want to be a somewhat discriminating patient and have a general sense of how this is supposed to work and what to expect. And I also want to show you some cases, real cases from my practice, okay?

And so let's start with like expectations. Like in functional medicine, there's this patient perspective, which is that you have some pains or problems. You have some things you want to gain, what a change. And then you have your life goals, now, you know, being held back from because your health isn't perfect. And then from the doctor's perspective, we have this whole other agenda going on. You know, for better or worse, in functional medicine, there's this really big drive to figure out the underlying cause of your problem.

So as a simple example, an underlying cause of your problem could be heavy metal toxicity. And the fact that there is, you know, 80,000 toxins in the environment. And that everybody by listening to this call is saturated with somewhere between 122 to 700 toxins. Everyone, you guys, I am too. We all are, okay? So if the underlying cause of your depression, anxiety, or health problems is, you know, toxin-related, it may or may not make you feel better to detox. So treating the underlying cause for a lot of patients can make them feel worse. And but yet, on the other side of it, you know, the goal here is to try to relieve human suffering. So it's, it's hard when you're doing functional medicine because sometimes the stuff that you want to do to treat the underlying cause is going to make the person feel worse.

And so we always have this tension in functional medicine about getting the patient's goals met, relieving pain, making sure that you're achieving your life goals and whatnot, and still staying true to functional medicine and finding the underlying cause and treating it. There's not an easy thing to do. However, I think all the good functional medicine doctors will get people feeling better in the first three or four months of treatment. And no man, to address the underlying cause that may make you feel worse. You don't have to address the underlying cause first. That's it. The weird thing about functional medicine, sometimes the most important thing that we treat is the last thing that we treat. And isn't it like that in life in so many different ways? You know, the really important things that you get out of a long-term relationship, you know, probably don't happen on the first date.

So you go out on your first date with somebody you just met, and you know, you may not plumb the depths of your psychological pain and share everything that you're existentially worried about on that first date, right? That might happen later, once you've been married for a few years, really have a bond, and you can trust that this person's gonna be there for you. You share your feelings, right? So it's the same in emotional medicine. You know, the very beginning, you don't have to treat the underlying cause, even if that's a really, really important thing. We can just get people feeling better and motivated on a lot of different levels. And the three body systems approach that I use with patients really helps deal with that.

So I show you that real quick. I was gonna be skipping around these slides because I want to kind of talk through what I do in my practice here. So in my practice, we work with vices at one, that's a neuroendocrine system first, okay? So we work with adrenal hormones, with neurotransmitters, with thyroid support. Can the person feel better first? Then we address digestive issues if they're present. Then at the end, we address toxin or heavy metal issues if they're present. Again, if you haven't talked someone any problem, it could be the most important thing. We're just not going to address it first because if you do detox too early in the process, people feel worse, and that's a bit of a turn-off. We don't want to do that. We correct the body systems in the order in which the problems occurred for a variety of reasons, to get people feeling better, and also because it sets the stage. Treating the adrenals first, or this could be thyroid, or this could be brain, this is the neuroendocrine system. Treating a neuroendocrine system first, the thyroid, the brain, the adrenals, gets you feeling better. It also reduces inflammation and also helps improve gut function and all these other things that happen when the hormonal system comes into balance. But then when we get to the GI treatments, or easier to do when your GI tract is working better. It's easier to remove toxins. So again, working on the GI tract before you detox somebody allows that detox process to go much more smoothly, fewer side effects, less problems, because a lot of the toxins that you're going to eliminate in that third phase where you're looking at detox are gonna be going out through the gut. So neuroendocrine, GI, and detox, we usually treat in that order. And that gets people feeling better first, and then kind of leads them down this road where they're going to start to respond to treatments better, okay? So that's like a big picture starting point.

Now, I sell a lot of supplements in my practice, like a lot. And yeah, I'm against use of supplements unless you absolutely have to take them. It's kind of ironic, isn't it? And so this is a really tricky one. Most of my new patients are taking stuff that they just don't need. They are, and they're taking things and they don't know whether they're working or not. And they're taking things because their friend told them they should order, or because it helped their friend. And I'd say three-quarters of the stuff I see people taking is a waste of money, wasted time. Most of the supplements people take are dangerous, but they're certainly not getting the job done. And so I'm just a really strong advocate of lab-based supplement programs. I know the labs are expensive. I mean, talking to me and ordering a bunch of labs is a couple of thousand dollars. There's no way around that, even before you bought all of your supplements. But the amount of money that people spend trying to get better, and the amount of money they waste on supplements they don't need, if you could just gather all that money up and save it for a year, probably cover everything that I would charge you. And the efficiency of doing a lab-based program is totally worth the money upfront to spend, you know.

It's like when I had, this is true. I always think about cars because I'm like a car guy. I love cars. When I had, I had this problem. I had a, it wasn't that really, the old BMW, it was my, every 1972 big BMW, but this was like a late 80s, 19 BMW. So it wasn't like the vintage, but it was all nuts, not worked very well. No. And so it kept having this overheating problem. And I actually got stuck on the freeway, like a couple of times. It's like serious, serious overheating problem. We have to pull over, and you're like, crap. I went away for a tow truck. And it's, it's kind of dangerous because always tried, you know, cars ready by you're setting other ways. It. And then I brought it in to my favorite BMW mechanic. I love this guy. He's really good. And he first of all changed the radiator, and then he changed how these hoses, and then he changed the water pump. And he just kept trying different things, and none of them worked. And at the very end of this whole process, thousands of dollars later, he finally changed, I don't know, it was like the thermostat actuator button, there's some weird piece, good part, you know. And then I was hunting. It was fixed. And so the next time I got rid of that car, it was kind of not my favorite car anyway. Didn't anyway. So long story. Anyways, that car went away. So when I got my next BMW, I went to man, that is my mechanic. And I looked at that and I said, it's got an overheating problem. And he looked at me, he remembered this last thing because it wasn't, it was painful for him to have to charge me that much money too, right? He was not enjoying the fact he couldn't pick this out. First BMW. And I looked at Matt, he looked at me, and said, you know, the best thing, Dan, is if we just changed the whole cooling system. It's gonna be $3,500. And I just did it. So he did the radiator, the hoses, the pumps, the belts, he's just like, rebuilt the entire cooling system of this beautiful car. And it cost a fortune. But you know what? It's just like finished a problem. And if you've added up all this time and stress and tow truck driving fees and all other stuff from it, it was probably cheaper than in the first round of repairs.

Okay, so getting this right the first time makes the big difference. And that's why I'm such a strong advocate of doing the testing. And when I show you some examples of how this works, because, you know, I've been in practice for long enough to know that I mean, I can't figure this stuff out without a test. Oh, you guys gonna figure out? I've spent devoted my whole life to this full-time. How you guys gonna figure it out?

Let me show you real quick here. These are some sample tests. And I'll show you what I do in every case with every patient. Is the order in adrenal lab to look at stress, unless there's some exceptions. But in general, after look at all the GI stuff, and then we look at organic acids. Well, I just show you some examples. So here's a typical case, 35-year-old. It's an adrenal lab. It's gonna measure your cortisol and your DHEA. And from that, I can tell basically how much stress has worn your ass down. And how much is, you know, the stress and the wear and tear of life causing a problem. We have low pH. Yeah, your cortisol is all over the map. That lets me know a lot about how to rebound the adrenal hormones. And whether you're gonna really benefit from that kind of work or not. So you see some people that have cortisol levels that are in the mid-range. We'll see some people like this lab will have cortisol levels that are super low, like a cortisol over 14. And that's a really exhausted person. DHEA of the one that's really, really low. Keep things. And then you'll see some people, which is amazing and wondrous, who have a lab that looks like this, where their cortisol levels are super high. Like the last one, that was down low, and this one is up at a 53. The range is like 20 to 40. We have people that are low, call that a stage 3. You know, people that are high, call it a stage 1. And the treatments are completely different. Okay, with a high cortisol, you want to knock that down, and that makes that person feel better pretty quickly. Usually, with a super low cortisol, let's find another one here, so you can see more examples. Here's a good example. So no cortisol is low for this person, it's 9. Okay? That means they're making 9 units of cortisol throughout the day. And you're supposed to make 20 to 40. That's exhausted, right? And so that person needs their cortisol levels uplifted, and that'll make them feel better. And there's special supplements and protocols to do that. Whereas that person we looked at a moment ago, here, plan a high total cortisol, and we got to show you some other examples so you can see. Okay, this person's got a total cortisol of 68, 86. That's high. So we want to bring it down. So we use supplements that bring it down. So this is all lab-based. And you can't really look at someone and just say, I think your cortisol is higher. Though it varies, that's why we do the testing. So that's the first round of testing. We do it to everybody.

Second round of testing, I do GI map, or it's a GI pathogens screen. And we're looking for all these different bugs. And here's a bunch of labs that we've done nationwide clinic. This person had C. difficile. How the heck would you ever know you have C. diff with that doing labs? You wouldn't. It's like that would, unless you have some amazing psychic person see into your abdomen, you really never know. Oh, this is a good one. And this was kind of a strange doctor thing, but I remember people based on their labs. Actually remember who this person is because this was a weird combination. This person had D.I. and to me, but Fragilis and Endo. Lie. Mix Nana. Again, like you're gonna intuit that? Yeah, my intuition is really good, but I wouldn't be able to differentiate what you have intestinal parasites someone has or doesn't have. And some people don't have parasites at all and they think they do. They'll come in, they'll say, I know I'm parasitic because something they don't. You don't want to treat things that don't exist. Sometimes do the test. This happened a few weeks ago. Sometimes doing the test and seeing that nothing's wrong is the most incredible experience for somebody, you know? Okay, here's another one. This is not so good. All right, this person needs a whole different kind of treatment though. See, they have two endo. Lie. Nexnano and they have a Candida overgrowth and this other yeast or fungal organism. So this person's going to need a parasite and an anti-anti- and a program. And the herbs for these different protocols are pretty different. Okay, so they're not all going to be exactly the same. So that's the, you know, some examples of the GI testing. See, get a sense of that.

So again, we do the adrenals, we do the GI, and then we do organic acids. Now, organic acids are complicated. Some of you that may have watched other webinars I've done know that already. I'll just go through the categories of stuff that we can find on the organic acids. And this is one of my areas of expertise. I'm quite highly trained in interpretation of these. So we look at fat burning. What happens if your fat burning doesn't work well? Get fat, basically. That sucks. Oh, put on body weight no matter what you eat and how much you've exercised. If these markers are messed up, you're just gonna have a big butt and a big tummy. And that's just the way it is. It just drives people crazy because they're like, I don't know, I'm eating exactly right. Paleo, AIP, PCB, you know, CD diet, whatever people are doing these days, you know, gluten-free and all that. And I'm not losing anyway. In fact, I'm gaining weight. You know, I'm not eating any calories. So if fat burning is messed up, you gotta fix it. To burn body fat is super important. Hey, get a red star their case. But services are important. You gotta know your carnitine. Now, carnitine is also really important for 19 functions. Really important for athletes too, who want to be, you know, working out hard. Okay, so that's the first part there. Look at carbohydrate metabolism. Let's do things like blood sugar control and sugar things. Look at energy production. That has to do with the mitochondria and how they make energy. And that's not all. Can the rest of this lab go on? It checks all the B vitamin markers, including what is super popular these days, which is the methylation markers, right? And people that are into MTHFR and all that good stuff. It actually measures methylation through looking at folate and B12. And then there's a neurotransmitter section. Checks out all the different things going on in your brain, which is very important.

Now, this gives me a moment to show off, perhaps. Perhaps this is me showing off. Perhaps it's just, I can't find it now. I'm trying to find it before the class is over. It's my organic acids test that I want to study. Yeah, no, wait. The time right now. Okay, so neurotransmitter markers, oxidative stress, really important to look at antioxidant levels, measures liver detoxification capacity, get a good sense of it. The liver's up to. And then it looks for basically, this is like a screening to see if you're eating enough vegetables and fruit. All these markers in here because these intestinal bacterial markers are affected by your diet. And if you're not eating enough vegetables and fruit, then these markers may be off. So we can tell a lot about diet for this as well. And then there's a Candida marker on here, okay? So if you, if you're paying, if you kind of tie all this together, there is a little method to the madness here. I'll show you, which is that there's three body systems, right? There's neuroendocrine, GI, and detox. And we do the neuroendocrine testing, that's for adrenal, thyroid, brain. You do the GI testing, that looks at all the pathogens. And then we do the detox testing, nutrient replacement, the oxidation, the methylation. That's all organic acids.

So my clinic, again, three tests: neuroendocrine, GI, and detox are covered. And with these labs, we're actually covering adrenals, neurotransmitters, on a conjuror, energy for women, female hormones. We're looking for pathogens, microbiome, remember I showed those bacteria, is analyzed. We're checking for detox pathways, oxidation, and methylation, and nutrient replacement and inflammation. That's a lot. Is that everything? No, but that's a lot. And if you get that much data on a person, and I sit down with you for an hour, we can figure out a tremendous program. Does this work all the time? Absolutely not. But it works a lot. It works a heck of a lot. And in fact, you know, we were just talking with one of the doctors on training now, this wonderful guy, and him, he's a urologist by training, but he's just started to do functional medicine. And he's, you know, he comes back to me and says, you know, all I did was he adrenal protocol. We're getting better left and right. You know, so in my practice, you know, now because I've been doing this for so long, and because I've been, you know, had so many teachers trained me so well, I can handle neuroendocrine, GI, and detox data, put it all together in a package, have it fit for that patient, and then start to get into designing programs. And that's really my expertise. And even though I charge a lot per hour, I understand I charge a lot. I get so much done in an hour. It's cheaper than working with someone for 16 hours that's still trying to figure all this stuff out. Basically, paying for a higher rate for someone that's just done this tens of thousands of times, you know. So it's more efficient. If I look at it like when I was charging $200 an hour, I stood first drive my practice. Probably took me three or four times more time to get people better than it does now. Though I also, I'm really personally obsessed with design factors because I found over the years, this really makes a difference. That we have to design a program that suits what you want, but your pains and gains and all that, right? We have to design a program that incorporates lifestyle changes, or this won't work. You're not going to just supplement your way out of adrenal exhaustion. You have to change the lifestyle. And then we have to, of course, supplement programs that are either maintenance programs or long for long-term or therapy programs. So we're going to integrate all these factors: what you want to get done, getting you to make lifestyle changes, and then supplement programs.

Now, everybody knows that you should go to bed at night. Everybody knows that you should drink three or four quarts of water a morning today. Everybody knows that you should meditate every day. And everybody knows basically what healthy. So the lifestyle stuff is not mysterious. It's a matter of finding what's going to motivate that person. How are you going to get the lifestyle changes done? And how is that going to interface with the supplements? For example, it doesn't make a whole lot of sense to do a liver detox program and drink alcohol and caffeine, does it? No. I mean, it makes no sense at all because the alcohol and caffeine get metabolized in the liver. So when we're doing liver detox programs, we say you can't have any caffeine or alcohol. And then how do people feel when they stop caffeine and alcohol? A million times better, right? So there's this tie-in between the lifestyle factors and the supplement programs. It's really important.

All right, so I want to show you some real cases now and how this would actually play out. Oh, and then I got to talk about how the clinic works too. So let me do that first. As the process can be a little confusing for people. And so the way the process works in my clinic is I have Mark Herbert, who has been with me for 11 years. He took my functional medicine training program in 2006, 2007. He was the only practitioner in the history of the world who listened to my weekly doctor calls for nine years in a row. Okay, this is a six-month class. Mark was in it for nine years. So at that point, I was like, okay, Mark, I'm just gonna hire you. You know more about this stuff than I do. He's a really wonderful guy. He does all of our intake. You know, I look over your health history. He'll figure out the best labs for you. In fact, you know, I'm, when I, when I first hired Mark, I was like, I was kind of nervous. Like, how's this gonna work? You know, because I've always done it by myself. We have better patient compliance. We have better and more accurate lab data coming in now that Mark is here. In other words, Mark is better at this first new patient hour than I was. Kind of take a little bit of an ego hit to say that because I thought I was like the best and the one who could better. Turns out I was wrong. So he always, you talk to Mark first. I think that's he's straight and sort of sets off the whole process. And then after you meet with Mark, we send out, I review everything, of course. Mark and I email and talk, you know, for every patient. So I'm in the loop, although you don't talk to me first time right away. Then my office, once Mark and I agree on what should happen, office sends out an email with the labs that we're gonna recommend. If I, the labs online, who call the office, and then you get your test kits, you mail them in, then you schedule your consult to follow up with me. So I do all the follow-up. Meet me. Follow. I mean, the labs are now in, and we're trying to figure out what to do. And I do welcome, you know, hook up a little bit in advance. He just goes a little bit ahead of time. My office will help you with all that stuff. And then we get you a copy of the lab, and then we'll go over them together. And then I'll recommend supplement programs and lifestyle changes based on the labs.

Now, my, and then I know I have a philosophy of all this too, though, which is that, you know, people don't get better because they buy a bunch of supplements. That's just not how this whole thing works. They will get better because they believe they can get better. And a practitioner who finds out actually what's going wrong in the first place. They connect with me, they get the right supplements in the right time. No, none of this stuff lasts for very long. Six months to a year. None of these supplement programs are permanent. Okay? That's my job. We put Leo calm. Permanence. We call them supplements. There's supplemental, right? You know, better. I do my job. The faster we get your office stuff. And for just depends on how sick people are. If I can put in six months to appearance, you good. Some people take a little bit longer. Yeah, better just because they've been sick for so long. Um, the process falls apart, you know, for some predictable reasons. Number one, patient makes no lifestyle changes, no matter how much I try to bribe them or talk them into it. Number two, patients start supplement protocols, do it for a month, and then they stop. That doesn't work either. You have to have some consistency if you really want to do this. There's what else are common reasons? Sometimes what doesn't happen often, but sometimes you might just not connect with me. It just happened to a patient a couple weeks ago, kind of sad. I just, I mean, he didn't really do the program, but then he didn't really want to. And no, maybe it was my fault for not inspiring him.

Now, if people make the lifestyle changes, take the supplements, have a little belief that they can get better, then these things work really well. But again, I've been doing this for a long time. It's not like I'm saying I'm gonna help everybody, but I help a lot of people. And if I can't help you, then what I try to do as best as I can is figure out who could. And at this point in my career, I'm very privileged to know pretty much all the top functional medicine doctors in the state. So if you really have some weird genetic disorder that I just can't handle, two or three people I know that I can't. You really have like the worst case of SIBO that ever existed, and I can't figure it out. I know Allison C. Becker very well, Lemon, that created this whole SIBO. I'm thinking I know Brindis Lemon very well, who's one of the best people in treatment doctors I've ever met. So I'll just get you connected with the right person. I mean, this the other day, we had this young girl, you're all really severely depressed. I didn't even take her case. I just referred the mom to the psychiatrist I know that works with. As a kid was already medicating appropriately for me to jump in, you know, with someone who's suicidal and already medicated, that was way over my pay grade. So I got her connected with a really great psychiatrist that I know. Now, often times I'm in this role of referring people out. And if I give a 15-year-old who's suicidal and overly medicated to a psychiatrist, it's better. Know, like I did my job. I don't have to be the one that executed every treatment, right? I'm way past the point in my career where I have to have that kind of control. And, and one of the advantages of working with me that I know when I can't help people, and I know who to direct people towards. And I'm really, really comfortable doing that. Whereas, you know, when you're in your first 5, 10 years of practice, it's hard to know who you can help and not help. You kind of hope that you could help everybody, you know. And, and you may not have like a deep referral network like I do now. And there's some real advantages to working with someone that's for a while that's in case. Oh, they'll show you look at about how the protocol is actually work. Let's actually like it's not that bad. I mean, certainly not a painful experience. Most people like working with me. I don't get other people or anything, you know, I'm pretty nice in general. Let's see here. I'll show you what a program is like. Mmm. All right. I still do all these from scratch. And I know I could just make a template up or something and just top that. I feel like there's some benefit to me actually writing it down for you specifically, you know. I do every single program customized from scratch. Hey, we don't have any templates. So this is for Joe. Well, let's make it how about Dana Smith, because that could be a female or me. All right. Yeah, Smith. And so it's pretty straightforward. Then it's look at the three body systems. I'll show you how I would design a protocol. Now, remember, we've got neuroendocrine, that's brain and hormones. Got GI, and then we've got detox. So let's look at a typical case. And then I'll show you how it gets all that together. And here's a case to have them all. Yeah, here we go. Okay, so here's an adrenal lab. It's quickly here. Very low cortisol, it's down to the nine. Should be up around a 30. DHEA is a one. Should be up around a 10. The low cortisol, low DHEA, that's one problem, right? And we look at the GI portion of the test. Oops, H. pylori. So that's a stomach problem, the bacterial overgrowth in your stomach. So we need to deal with H. pylori. So now we have two problems, these three, adrenal and H. pylori. And then we look at their organic acids. And that's just do the simple version of this. K, don't want to get into the hour on organic acids. But they have an energy problem, methylation problem, meaning B12, and then a really bad detox problem. That, oh, these detox markers, oh man. Okay, we're gonna send a little time just showing how this is all tied in. And this is part of the elegance of functional medicine. So here's a patient with a lot of detox problems. That means that they're not getting rid of toxins. When toxins accumulate in their body, what do they do? They damage the mitochondria. So you're seeing the damage to the mitochondria here. And what's a nutrient that you need to detoxify? B12. So these are three different issues that are all the same issue. And I'll show you, I have a PowerPoint for this.

One of the things, and I haven't told my son this yet, but I say this every week, that one of the things that's gonna be on my tombstone is that he had a PowerPoint for everything. I tell ISA that I'm very proud of my son. I just visited him last weekend. He's at the University of Washington, St. Louis. And he has decided to be a math and physics major. He's in his freshman year, and he's being really well. Really happy for him. Find the right PowerPoint here. We go. So this patient had a detox problem. What toxins do is generate a lot of oxidative stress that damages your mitochondria. And again, just a quick little review here, when your detox pathways are messed up, and this latch about these problems with phase two, these two is not working well, and also see vitamin B12 is part of this whole process for getting rid of. There's B12 right there for getting rid of toxins. Now, the toxins are building up because the detox pathways aren't working. And then those toxins are coming along and lacking the mitochondria. How do I know all that? Because the lab says that this is all one problem. That's the point. So here's the lab version. When I just subscribed liver messed up, what does that mean? It can't carry the toxin. Yikes. Toxins are hitting the mitochondria. How do you know? See these markers must attempt one of the nutrients involved in the liver, 12 packet. These are not three different isolated problems. This is one integrated messed up problem coming from your liver, right? So let me show you how to program that would be. Don't run that. So let me write out the different variables we have. So we're on the same page. But here's a quick review. This person had stage 3 adrenal burnout, and that translates into low cortisol and low DHEA. This person had H. pylori overgrowth in stomach. And this person had poor detox capacity with damaged mitochondria and B12 problems. And remember, a poor detox capacity, damaged mitochondria, and B12, that's all one big problem. That's why I put it all online. So now let's go back for a second and look at the three body systems. And where do we have problems with this particular patient? Do we have a neuroendocrine problem? Yeah, stage 3 adrenal burnout, that counts. Do we have a GI problem? Yeah, we have H. pylori, that's a pathogen, that counts. Do we have a detox problem? Yeah, we have detoxification pathway issues and we have a methylation problem. Boom, boom, boom. So how are you gonna treat these things? We're gonna start with your endocrine. When that's rolling along, we're gonna deal with a GI one. When that's getting better, we're gonna knock out the toxin. And then what happens? Happy, healthy patient.

I just want to show you one more thing for those of you that are kind of lab nerds, that just really need to see that one more thing. I'm going to show you that one more thing because it's, yes, you're cool. See that? Oh, wait a minute. It's the wrong labs. Sorry. I guess we open here. That it. Well, I'm just gonna have to. Yes, I lost my window. Dead here. That's why I show you is one thing on the testing call. This is a different one. Oh, well, that one's gone for now. We'll do it. What did the next case? I'll show you. Okay, so let me show you how this VI. I know. All right. So you've been an adrenal problem. So I start with that. Wait, this is the first body system. So we give DHEA drops, then 1.2 milligrams per drop. And what was it at stage 3? So stage 3 is get it appealed. Really low amount. That's like three milligrams, three times a day. And I'll give pregnenolone drops. Now, this varies from person to person, obviously. This is generally how it works. So I, 1.2 milligrams per drop. And these threes get a lot of pregnenolone. Yeah, like 15 drops times a day. You also use a special kind of licorice root for the really low cortisol. That's also in the drop, really well absorbed. That. And then I had these special multi packs that use for adrenals that has the vitamins, the minerals, all that stuff. Don't worry about that. And then we may give some herbal or glandular support. Glandular support, that depends on how messed up the tired there are. Basically, that's a nice little adrenal program. And that would run for six months. I had a patient asked me the other day, I'm not making some. I did it. I didn't laugh at the time. It took me a few minutes to realize how funny this was, but they were serious. She was like, how long do I do my six months? That, you know, croak em for it. And I was like, that's a sick. But yeah, you're gonna do that for six months. He was like, okay, great. This adrenal program for six months or six month dream program means you're gonna need to do this for six months. Ready to feel there. The goal for all of these kind of adrenal protocols is within the first three or four weeks, you're starting to feel better. And I want to hit 10% improvement per month with everybody. Oh, we're not doing that job. Okay. So when I get that going, and then we wanna, well, there's another component of this. So let's say adrenal and energy program because they also had the mitochondrial issue, right? And I'm gonna put that in here. So adrenal and energy program. That means mitochondrial energy. I'm gonna add your renewal Evan energy boost here. And that's specifically for mitochondrial energy. And I'm putting it in with the adrenal program because these are both gonna be feel-good, energizing. And I have, you know, it's kind of a system that I use. So this kind of a protocol is gonna get this person feeling like a normal human in a couple months. They should feel considerably better in three or four weeks. And we roll that out first. That's the first body system. Remember, by someone aged 3, adrenals, we start to fix that. Now, once that's in place, usually it's about two months later. Two months later, start H. pylori program. And for H. pylori, we'll just call this H. pylori. H. pylori have a really wonderful herbal combination I've used for 25 years. Then I make this up, you know, did the same herb for 2500 years, literally called mastic. And it's a 500 milligram capsule. And you take the full load of that. And it takes a couple months to knock it out. You see along with that, we'll give some anti-inflammatory stuff like DGL. And that's the whole H. pylori thing right there, okay? But it doesn't start right away. Remember, we're gonna do that. Get the H. pylori cleared out. And then we're gonna get to the fun part. Once H. pylori is gone, why did we wait? Because we wanted to get the digestion working. Because your digestive system is gonna be responsible for eliminating a lot of toxins. So then the detox protocol is going to be for six months. Well, three to six months. Let's be optimistic. And that's gonna involve my Renu 12. And that's phase 2. And this person have phase 2 liver detox, phase 2 detox product. Let's say we give like that 3 and 3. And then you see for these more messed up liver cases, I usually give some liver support. That's when you choose its herbs for liver support. And that's what their whole program would look like. Let's go through this again. I'll do it in color so you can see. So remember, we start with neuroendocrine. That's the adrenal and mitochondrial program. What does that do? Boost up cortisol and DHEA, stabilizes your blood sugar, get your energy better, your sleep better, your sex drive better, your skin looks better, and exercise more, you feel more fit and vibrant. Kind of can't go wrong when you're working with the adrenals and mitochondria, okay? Then, once you're like getting better and a few months has gone by, we hit that H. pylori and just get it out of your body. Get rid of the bad guy, okay? It's gone, hopefully. You only do that once. Two months and it's over forever. Done. And then once your H. pylori is settling down, it's mostly gone, then we start the liver program. And we start to detoxify, okay? And those would be the different steps. And now, when I didn't talk about yet are the lifestyle changes that accompany all that. All right. And that is complicated. Again, I want to show this later. Um, and the last thing I don't want to get into that now is complicated. But you know, I have to somehow figure out getting the person to better on the earth, meditating, exercising more, exercising less, eating different foods, eating the same foods, getting off that crazy diet, getting on a crazy diet, getting your mother-in-law to move out of the, you know, basement apartment in your house, getting your mother-in-law to move into the basement apartment in your house if she's thick. Now, whatever it is, you're caring for a spouse that's dying, your child was just killed, your husband is a drug addict, you just lost all your money, you just made a ton of money. I mean, every day we hear these stories. And the lifestyle changes are customized based on what's going on to that personal plaything. And honestly, sometimes it's a matter of joining a prayer group. Other times it's a matter of stopping all caffeine. It's just various. And part of the magic of this is me helping you figure out what are the lifestyle changes that are going to make a huge difference right away. But this is a typical program. None of the stuff isn't done all at one time, you know, it's spread out over time. You start off with your neuroendocrine protocol, a few months later, you do that H. pylori thing. When the H. pylori thing is done, then you start the liver. And we'll try. And you have to make it. I have to make it doable. So it's not as overwhelming, crazy town experience, okay? All right. So let me show you again here. Laughs. I'm gonna close down a few of these windows so I don't get overwhelmed. Maybe I'll show you, uh, let me show you one other. You got enough time here? Yeah. Okay, so let me show you one other case, but it's kind of a little different, not exactly opposite, but substantially different, okay? So here we go. All right. And I'll just, I mean, they take it like a 30-second commercial just to just a second here. You guys, a little mental break. And I'll just show you what I've been up to lately. So besides of this meditating all the time thing, I do, I'm sorry, I go to bed every night. You can ask my staff, I'm not making this up. I go to bed every night between 8:00 and 9:00 p.m. I mean, I'm for sure always asleep by 9:00. But I wake up around 3:30 in the morning. So it all kind of works. Top, you know, that's crazy. And then I have, you know, if you're up at 3:30 in the morning, like who else is up at 3:30 in the morning? He can't, I can't text people. I'm adding email people that would want, you know, it's kind of weird. If you start getting email, if you know, I email a patient or a doctor at 3:00 in the morning, they're just gonna think I'm a little crazy. So I don't email. So basically, I'm stalked by myself, alone at 3:00 in the morning. And what do you do? So I meditate for a couple of hours. And basically that every day, except when I'm traveling. So here's the real love of my life. Is my helper, Mayo 1970. Went out for Mayo. So this was not a rational thing, but I took this car and we completely ripped it apart and rebuilt it. And it's, it's really, really fun to drive now. I finally got it running. It took about a year and a half. But man, it just is humming along now. And it's just like flashback to 1971. You can smell the oil burning, you know, the brakes don't work that good. I mean, it's all rebuilt, but it's just like all, you know, me and it's just, it's just a beautiful thing to behold, though. So anyways, that's one of my, my great passions in life was rebuilding that thing. And then just because I could, I went out and I bought a used for a mayor for seat left for secret. They're just, it's a not also an Alfa Romeo. Is obviously brand new car. What was used? It was two years old when I bought it, but it only had a couple hundred miles. Life. And this thing just hauls ass. So I don't know. I don't even drive. I ride my bike to work every day. I hardly drive it. Off. I have all these cars. It's kind of silly. I understand that. It's late. But that's just one of the things that's weight. As my ex-wife and she knows me so well, she's like, say this to my son a couple years ago. And I, she's like, well, you know, your dad is really careful about money. Except for two things. And when I son said, yeah, cars and bikes. She was like, yeah, fires and thank you. Okay.

So here's another case. Now we've got a normal adrenal lab, normal DHEA, holy moley, normal cortisol. This person is not in adrenal exhaustion. So just cross off the whole adrenal theory. That's really important to know. You.

could do adrenal supplements forever. And, in fact, what this woman's her progesterone is good, or estrogen is good, shouldn't have a hormone problem. But is your G problem? Yeah. So Diane, see me before Angelus. That's not a good thing. That's an infection in your intestinal tract. That's gonna really screw you up. And then let's look at her ganic acid. Okay, now we're talking. Remember, the adrenal labs were normal. Of course, she's incredibly tired. So what's going on with this person is energy production markers, the mitochondria, not the adrenals. So how are you going to know that? Because the symptoms are identical. And you know me, being an adrenal treatment guy, I would treat the adrenals all day long if I could. But when they're normal, gotta just give that up. And look, how many markers are positive? One, two, three, four, five, six. And some of them are very high, which is a very bad thing. So might a major mitochondrial problem. The detox indicators are not very good either. Remember we talked about that in the last case? There's a connection between things.

So let me show you a little bit of detail again for the lab geeks out there. Now, how hard is this? Let me just blow it up so you can just see it really clearly. Our adrenal labs were normal. How do we know they're normal? Because the DHA was an eight and the cortisol was almost the 30. The numbers are normal. But look at this. There's nothing normal about this. You cannot miss these black dots in the red zone. That's bad. Black dots in the red zone. That's bad. The red H is kind of give a little bit away. And even the markers that are normal are pretty high. So this is a mitochondrial system that is just in bad shape. When these numbers are high, it means mitochondrial production of energy is failing. Okay, so the higher these go, more messed up that person is in terms of energy production. And in fact, on this particular test, what we can tell, there's a genetic component to this problem. And the way you can tell that is when the numbers reach a certain elevation above the reference range, it becomes statistically impossible for it to Tran deficiency. So this is what my teacher Richard Lord would call a functional genomic energy problem. Meaning this person was born with poor functioning mitochondria. That number there gives that away. It's a genetic problem. Doesn't change what you do in terms of treatment. It's just kind of cool to know that he were born with this, you didn't necessarily even do anything wrong. Okay.

So we had a genetic issue there with the mitochondria. And then this is the most catastrophic thing that can happen on this particular lab is that the sulfate marker drops low. If sulfate drops low, very bad. Means you don't have glutathione to protect your tissue. Now, a low sulfate is not so great. And remember what we said earlier, that when the liver is not in good shape, this is the detox marker sulfate. The liver is not in good shape, you're gonna have trouble protecting your mitochondria. This person has a genetic tendency of mitochondrial problems, plus they got the little sulfate. Though they're just walking through a world of pain within mitochondria. Let's just look at the mitochondria real quick. Little reminder. Let that really mean. And let me show you some mitochondrial pitch. Uh, well, I say this is different, but let me just show you. Well, write it. I'll locate. Look at the mitochondria second. But I hang a second. Let me just show you here. This is helping you guys see how this lot workers. What I do all day, every day with patients. Okay. Neuroendocrine system. Was there an adrenal problem? No. Was there a neurotransmitter problem? No. Was there an energy problem? Yes, yes, yes. Mitochondrial energy problem. Remember everyone, those markers was high or borderline high. Was there a GI problem? Yeah. Dientameba fragilis. Was it H pylori? No. Totally different treatment. Was your detox problem? Yeah. Worst possible problem. Detox indicator called sulfate was low. So this person has a mitochondrial problem and Dientameba fragilis, and the sulfate is low. Those are three things that you want to work on.

And then it's just one more series of pictures here. We got about another five, ten minutes. We can't knock off for the night. You guys can go here at your regular lives. That's why I show you what happens in the mitochondria. Messed up. And the mitochondria this messed up, it means that you're not making energy very effectively. And so that means that you're gonna put on body fat, which is unsightly. And you're not going to have the na cool your brain and your muscle. This person is not making ATP. Remember all these markers we saw that were high means that this system, this system of the citric acid cycle is not working properly. Alright. So what do you do about all that? Well, we said there's three problems that this person. And that's I guess we should start from scratch, huh? And don't have an adrenal problem. So that's kind of convenient. Can it put up in one here? Yeah. Second. It is. So the thing is interesting to me is that you can't tell what's going on. Maybe this may be longer you do this jobs unless you trust just guessing. You can't tell what's happening with somebody until you really get in there and do the labs. Because that mitochondrial exhaustion pattern that we're seeing this patient can be exactly the same set of symptoms as the adrenal exhaustion stage 3 thing that we saw in the first person. Can tell. And you know, after years of guessing and you know, second-guessing, I just now 100% trusted labs. There's no damn accurate way. More accurate than my personal opinions would be. Way, way more accurate. It's just taking me all these years to really understand that.

So now this person, remember, write down their protocol here. Mister, that's very. What we're not doing. I wouldn't normally do this, but just so you can see. No adrenal program. David. No neurotransmitter program. Even I didn't show you that, but the neurotransmitter markers are normal. Not doing any of that stuff. So we're going to start off with mitochondrial energy protocol for six months. How long is that last? It's just one song. Then we're gonna have to clear the parasite, be fragilis, and then we had a sulfur for problem, right? Low sulfur or low sulfate. Improve through the thigh on and liver function. That's all this person needs. Mitochondrial energy, get rid of the D done T. Me refresh list and get the liver working better. Now, if this was a real, well, this is a real patient. But if you were like listening and like you were the patient, I would be saying this right now. I was saying, hey, let's get your mitochondria working. So I give you my room eleven energy boost. That's I think that's like a multivitamin for your mitochondria. I don't give a boatload of it. Person's messed up. And then I would give Co Q 10, two hundred milligrams, which is a hefty amount per pill. And I'd go real high on that because the person's messed up. And then I give P Q, which is for mitochondrial repair. And then everybody with this level of exhaustion needs magnesium. So give some extra magnesium. You could do that at night. The house people sleep. And then, uh, oh, and then sulfur compound, right? Let's say that's my Renu 12 detox over compound. A lot of that. That would be the person's program. Well, control energy and liver support. Boom. Just start now. And then as a few months rolled by, we would do the parasite treatment, herbal for D fragilis. Some people use antibiotics. Most people don't want to use anybody. Let's to have to. And so I actually may change the order on this around a bit because it would be more like this. It would be mitochondrial energy program for six months. Most all fake and the liver working right away. And then after two months, there the deep down to me graduates. And again, the lifestyle changes are gonna vary depending on what person's at.

Let me show you one more time. How do I know all that stuff magically? Well, here's is a sulfate marker that's low. That's important. That means the liver is not working properly. And then the other one was like a no-brainer, right? You couldn't miss that. But you'd be amazed doctors get confused by this stuff. Really complicated. But these energy markers are all bad. They're all high. You know, there's a big mitochondrial energy problem. Even though I based my whole career on adrenal programs, why we do the testing is not up to what I think your problem should be. What absolutely. That's absolutely what the lab says. And this is a normal adrenal profile. First, they had normal DHEA. It's at eight, almost a nine. Cortisol is normal. It's 27, almost 230. There's one low level here, which you could probably deal with by getting them to eat a healthier breakfast. So this is a normal adrenal lab. You don't treat normal. Those yahoo, congratulations, your adrenals are normal. We're gonna focus on these other problems that are causing all this fatigue. Now, we go back again here, just one more time to show you. Under the neurotransmitter neuroendocrine system, their transmitters were fine. Adrenals were fine. Energy production was where we found a problem. There was a GI pathogen. And there is a sulfate or detox problem. So there we got one, two, three. And we treat in that order. Okay. Except for I mixed it up a little bit because I'm like, I feel bad for this person's weight. Giving them the detox in the beginning. So it's more like energy and detox or one. And then two is gonna be the pathogen. All right.

Now, let us see. All right, I think I got most of the things covered I want to talk about. You guys, I gave you a cave couple of cases, talked about how the clinic works with Mark, the patient process. If you're interested in getting started, Mark has new patient appointments available. You can sign up any time. I'm around. Not going anywhere. At some point, I'm going to retire. But I'm, let's see if I can last a little bit longer. I'm 53 years old. You know, I think most doctors like me retire in their 70s. I'm gonna make it to 80. Not a whole lot of people who are actively practicing in their 80s. So that means you got, I don't know, maybe 17 years. But don't wait. That's going to schedule. No, if you're not feeling very good, you could schedule down. I think I'm kind of hitting my prime. You know, doing this for 25 years, kind of have made all the mistakes that you're gonna make by now. I don't make mistakes very often. You know, some things I don't know. But my mistake level is really pretty low now. I think you want to catch doctors who don't work with me. When I catch doctors not the baby likes first five years. Everybody that does this perpetually. You know, find someone with a little bit of experience. Or if it's a younger doctor and they're in their first five years, if you're really attracted to their personality and you feel like they're really smart. And sometimes a really smart young doctor. So I've been doing this a couple years better than an older, slightly burned out chill. And this way to celebrate. They kind of got a judge all that. They're young and super smart. And they're really into it. And that's good. If they're older and burned out, not so good. So I think it's as much sort of vitality and level of interest of the doctor. Because the younger doctors in the first few years, they're super smart. They'll figure things out if they're really dedicated to you. And they, well, they're, you know, but sometimes you get more attention that way. So avoid people who have burned out. And if they're older, just make sure that they're still in that enthusiastic phase of life. And that they're not overwhelmed. And you know, I'm not kind of feeding out. You're still kind of taking care of themselves. And they're physically healthy. They look like their kin. You know, handle somebody hit. All right. All right.

So we have an extra one minute. I'll open it up for questions. We have one question that came in that's kind of convenient. And the question is from Francine. Is do you test for thyroid along with the adrenal panel? And so, yeah. So part of the neuroendocrine system is checking also for female hormone imbalances, thyroid hormone imbalances, neurotransmitters, adrenal, mitochondria, all those things. And that is something that we often do, although not always. We don't always do all of them. All right. Let me wrap it up for tonight. Thank you guys very much for joining us. We're gonna start doing these once a month again routinely. I got a little slack for a while, but we'll have another free patient webinar next month. I hope you join us for that one as well. Okay. Bye for now.