Restoring Mitochondrial Function and Addressing Cellular Aging

Hello everybody and welcome, welcome, welcome! Super, super excited to be doing this. This is the first time I've done this talk. It's something I've been obsessing about, uh, intellectually, academically, clinically for a really long time, and I'm just excited that anyone else wanted to hear this. And so, and we got a great turnout. So if someone could just raise their hand to make sure my sound is fully functional, that would make me super happy. And we're all good? Okay. And if my sound is not good, just you can complain in some way. All right.

So, there's such a long story here. I'm going to try to keep the important stuff to the beginning because I know we're all busy. You guys hopefully have families, personal lives, you want to go work out, and you're taking some time out to listen to this. So I'm going to try to make this as impactful as possible because I feel like this is like mission-critical information. So let's say we're talking about cellular aging and mitochondrial support. Extraordinarily hot topic, right? And we're going to think about like two or three primary concepts. One is, how can you treat patients who have fatigue from mitochondrial problems? And how can you treat patients who want to avoid aging and dying before their time with mitochondrial programs? How can you treat patients who have had, you know, any kind of inflammatory slash viral slash parasitic slash yeast infection that's driven their mitochondria into the ground from all the oxidative stress? You know, how can you deal with all these kind of conditions that we see in practice, like literally every day?

And then secondly, for those of you that are medical doctors, and those of you that treat patients who are treated by medical doctors, right? Resolve us is, um, you know, what, what about statins? How does statins play a role in all this? Are statins good? Are statins bad? And let's just not be judgmental about statins. This is, hey, what's the effect of statins? How do they actually work? And so we can assess, as mature, science-based individuals, when statins are appropriate, when they're not. Okay. I think that needs to be, that concept needs to be revised.

So for those of you that have not attended any of my talks before, I am Dan Kalish. I am a little crazy. I was born in Berkeley, California. I'm 57 years old in a couple weeks, kind of getting on in my years. Been doing this for 29 years, practicing functional medicine. I love functional medicine. And when I love anything, except for my family and maybe my dog. Um, I've worked with the Institute for Functional Medicine. I've worked with the Mayo Clinic. I'm now currently in an intensive training program myself with Richard Lord. A lot of the work we're talking about today, it's based on his curriculum. Tells you that, no, Richard, I still am in practice. I don't know. I think it's Wednesday today. I don't even know what day of the week it is, but I had patients all morning. I know that. So I actually use this stuff in practice, like for real. It's not like a sideline, "Oh, I teach," you know, and then I kind of talk about it. No, this is like, I actually deal with really sick people every day. And we teach a lot of stuff at the, uh, at the Kalish Institute. We have a couple classes coming up you might be interested in. There's, um, uh, the dates on here are a little bit wrong, but anyways, in August, there's a Telehealth Business Essentials Bootcamp. That's one of our most popular classes of the whole year. We do that once or twice a year. If you want to jump into your business and look at business planning, financial planning, all that kind of stuff, you're welcome to join that class. And you get a 20% off discount with this Designs for Health discount code. And then that should be saying Fall 20, uh, in the fall, but in the, in September, we're going to have a Cardio Metabolic Health Bootcamp. Which again, is a two-month deep dive into what we're actually talking about today. Same thing, you get 20% off of that class with the Designs for Health discount, DFH21. Okay. So the Telehealth Bootcamp Business Essentials is August, and the Cardio Metabolic one is in September. Right.

And so for today, for today, we want to look at mitochondria, how they make energy, how you can really get into mitochondrial health. This is a pretty technical talk. I don't know. I was going to try to defend it in some way. I don't know that there's any way that you have to understand this stuff. We learned everything that I'm talking about today, most of it anyways, in high school biology, and certainly in some physiology or biochemistry class. You just got to dredge that stuff out of the deep recesses of your mind because it turns out it's totally 100% applicable to things that we see in practice every day. And that there are pretty straightforward, simple supplement-based solutions for these complex problems that people find themselves in with the mitochondrial health issues. Okay.

So I want to talk a lot about, uh, production of CoQ10. How we make CoQ10. How we make CoQ10. Let me say that again. How the body makes CoQ10. And then how we use CoQ10. And how that relates to the electron transport chain. That's a key component in energy production, right? If that's not working, then energy production doesn't work. And then how this can get messed up with either oxidative stress as a culprit, or with commonly used medications as a culprit. And you want to kind of take a step back too and think, you know, okay, how's your body really work? What's happening here? Is that the major source of oxidative stress or reactive oxygen species in the body? The major source of oxidative stress is coming from your own body making energy. It's coming from the mitochondria. As they're making energy, they generate the bulk of the oxidative stress that the human body faces. Okay. So too much oxidative stress, ironically generated by the mitochondria, is damaging to the mitochondria. How ironic is that? And what prevents that from happening? What prevents the mitochondria that generate oxidative stress from being damaged by the oxidative stress that they're generating? Is glutathione. That's the main antioxidant that's designed in the human body, that we synthesize, that stops the negative stuff from happening. Okay.

And so that's great. But then there's one other thing you got to wrap your mind around, which is that glutathione production is constantly an ongoing process, and it's constantly competing with methylation. So patients that have methylation defects, you've got to watch your glutathione. If they have a glutathione problem, you've got to watch your methylation. If we have time at the end of this, I can review some labs. You can see some practical stuff. Everything that we're talking about today is analyzed on these commonly used lab tests, okay? That are, you know, sort of the basis of functional medicine practices worldwide, right?

So now let's think this thing for a moment here on B vitamins. We're going to talk a lot about B vitamins in a minute. And I know it doesn't get more basic than that. Yeah. I mean, again, it's like high school biology class. It's just that B vitamins kind of, I don't know, you learn about them and then you're like, ah, let's just move on. I want to learn something else. I want to, is it really going to be like a B vitamin treatment that saves this patient's day? You know? Yeah, a lot of times. And I think what we're finding more than anything else that I've ever seen is that lots of people have genetic issues with B vitamins. Meaning, you give them like a basic B complex, it's not enough. You need to really attend to the single, uh, the SNPs, single nucleotide polymorphisms, right? The genetic defects in the processing of B vitamins that a lot of patients have. Which means that their B vitamin needs, and could be quite a bit greater than what you would think they are. Like a lot greater. Like maybe they need, you know, a thousand milligrams of one B vitamin, not 50 milligrams. Okay. The needs can be dramatically more than what we would anticipate. So you have to really kind of expand your consciousness a little bit there.

And then I want to do a little game throughout this class, too, is to follow the electron game. It's like, isn't it, there's some thing like follow the bouncing ball thing that you've seen, you know? So when, when we're looking at the basics of biochemistry, and this is again, Richard Lord teaching me this. And for those of you that don't know Richard, he's literally wrote the book, right? Laboratory Evaluations for Integrative and Functional Medicine. He's still alive. He's kicking back in his cabin in the woods of Georgia. And he's more prolific and more working harder than ever. And he and I have been working together for the last four years on all this new content that we're releasing at Kalish Institute. His book has been expanded. It's 300 pages. It's got 4,000 scientific references. And he's just written a whole new huge section on CoQ10 because I was like, "Hey, Richard, can we work on CoQ10 for a while?" And so, um, this lecture is just a little snippet. It's like one percent of one percent of, uh, what Richard knows about all this work. And, um, but, you know, one of the things he's really schooled me on all these years working together is that really, we're looking at the flow of electrons, right? That's what defines biochemistry and human physiology. So we want to look at the flow of electrons in this process that we're about to. And again, this is high school biology, right? We look at this flow of electrons. And in the middle of this, you're going to see CoQ10 grabbing electrons. Okay? You're going to see CoQ10 grabbing electrons in the electron transport chain, one at a time. It grabs electrons. How does it do it? I don't know. It's kind of a miracle. It's a cool molecule, right? And then you're going to see NAD, NADH ushering them along. And then you're going to see these, these protons. Remember the protons moving? And I'll show you diagrams and all this stuff. But I just want to let you know that there's supplement solutions for this, and there's lab tests for this. Okay? They have, it's in a supplement form. You can buy it. It's amazing that whoever invented this should be given, like, not the Nobel Prize. I don't know. Like something more important than that. Like a really big prize. Okay? Because the fact that you can buy NAD, NADH supplement as a supplement, like it's mind-numbing. They can even manufacture that. CoQ10 has been around for a long time. It's equally amazing what it does. Magnesium, probably arguably even more important. That's been around for a while. Maybe not as exciting. But if you don't have the NAD, NADH, we'll see in a minute, things fall apart. If you don't have the CoQ10, critical error. Magnesium is the final step. So these are the key nutrients you need to be thinking about. B vitamins, and special B, you know, specialty versions of B vitamins like NAD, NADH, CoQ10, and all the things that go into making and, and using CoQ10, right? And then magnesium. And if this system is broken down, you don't have enough magnesium, cellular aging. You don't have enough CoQ10, cellular aging. You don't have enough NAD, NADH, cellular aging, right? The cells are going to age and die, brown out, get crispy, if these processes aren't working properly. And all of this is negatively impacted if the person is not eating well. And all of this is negatively impacted if the person has a lot of oxidative stress. Okay.

So that's kind of like the setup for what we want to talk about. And now, um, I have some studies, but, you know, the way I set up my computer here is wrong. So I'm just gonna, oh, yeah, look, I can see him. I got him. Okay. I'm in better shape than I thought. All right. So this is gonna get a little technical. Um, you may wanna listen to this later. You may wanna get a copy of Richard's book and, and read about this later, too, okay? But, um, I'm of the opinion now that if you really understand the biochemistry behind this, you're going to be able to help a lot of patients. So I think it's worth learning this. And I wouldn't, um, be teaching this if I didn't feel like it had direct clinical implications, right? I use this information in my practice with patients for real, like, well, literally every day. Not every single patient, but probably more than half of them. So as, as sciencey as we're about to get, you know, I want to also just emphasize that this is not like a science lecture. This is like a "how to help people that have mitochondrial problems" lecture, okay? And what we're seeing at the Kalish Institute, you know, I work with, we have, you know, hundreds of doctors I work with every year. We've got 120 of them in my mentorship program. And they're submitting lab after lab after lab. Five days a week, I'm getting labs. We got like more classes going than I can even keep track of. And in every class, we're reviewing labs for an hour, right? And so what we're seeing more and more with people who have been exposed to COVID is massive mitochondrial problems. So this is not going to get better, right? In the coming years, this problem is going to be exponentially increased, um, by this virus that swept through the world, okay? So you want to learn these skills because when people come in and they have fatigue, and they, you know, have a history of a viral infection, you should be able to do these labs, get these supplements going, start to fix these problems that are, you know, nutritional in nature, let's say.

So mitochondria, they're why we breathe. They consume almost all the oxygen that you breathe. So when I'm talking to patients, I half-jokingly say, "Do you know how important your mitochondria are?" They look at me like, "What is a mitochondria?" I say, "Well, let's just hold our breath together and see how long this works, you know?" And to make it fast, I'll say, "Take a deep breath in, breathe all the way out." You guys should do this with me too. And then hold your breath out. And just see how long you can do that. And why can you not do that for very long? It's because you need oxygen in the electron transport chain. The longest I've ever held my breath is just around two minutes. Can't get beyond that. Anyways, this is not peripheral, this is central, right? This is a central issue. And oxygen serves as the, as the ultimate electron receptor, okay? This is the end result. Remember, we're going to follow the bouncing electrons. The electrons end up getting accepted, connected with oxygen, they make H2O, right? That all happens at the end of the electron transport chain. And that's what allows ATP to be generated. So, very important part of a mitochondrial repair program, the lifestyle part is dealing with oxygen. So when you think mitochondria, you think NADH, NAD, you think CoQ10, you think magnesium, and you think oxygen. And how do you get your patients oxygenated? You give them simple breathing exercises, right? So they breathe, and they get plenty of exercise, physical exercise as well. Okay. So that, anyway, that's the lifestyle thing. I'll forget about. Then glutathione is worth mentioning, okay? Because it's the ultimate protector here. And I just want to, just in passing, this is not really a class about methylation, but just to point out that we make glutathione, okay? And that's what protects the mitochondria. And we do that in a process that's in constant competition with methylation. So depending on how much oxidative stress there is in the body, anybody senses this second to second, you're either going to methylate, okay, or transsulfurate. But down this pathway. So your body's like, let's say I'm making a little, a little silly here, but let's say you're at a low oxidative stress moment, okay? Your body's like, "Oh, well, that's nice. I'm going to do some methylation here. I'm going to make some stuff. I'm going to make some hormones. I'll repair, you know, get some DNA going. Maybe if I'm in a really good mood, I'll make some neurotransmitters. I'm going to methylate. I'll make some muscle energy. I'll make things. I'll make some cell membranes. What the heck, I got some free time." Okay. Now the oxidative stress has shot up. I don't know. It could be a bunch of reasons. I don't know. Maybe you have, you know, chemical exposure, or you're on the freeway and a diesel truck just drove by, drove by you, and you breathe in all these diesel fumes. And your body's like, "Whoa, that's not okay. We got a lot of oxidative stress coming in here." Okay. So then your body goes, "Oh, well, methylation, that's for another moment, right? Now we're going to shift all our resources towards transsulfuration because we're going to have to make glutathione to protect our bodies, to protect mitochondria, among other structures." We're talking about mitochondria today, obviously, but other, obviously other structures are protected too by the same process. So your body's in a constant state of, "Am I going to methylate? Am I going to make glutathione?" Back and forth, depending on the oxidative stress. And what we want is to have a low enough level of oxidative stress and a high enough level of glutathione that everything stays protected. Okay? If the patient's not methylating well, and they're not making enough glutathione, then this entire system is sort of fragmented, and the mitochondria are going to pay the price of that. Okay? And if you have a patient who doesn't have enough glutathione, and you get them to methylate more, you're going to have some problems because the body preferentially, 100% of the time, is going to choose glutathione production over methylation because glutathione production protects the cells from dying. Methylation is a luxury when you compare it to making glutathione. Methylation is perhaps the second most important body process, but glutathione is the most important. So your body will make glutathione and sacrifice methylation. Now, if someone's already low in glutathione, and you force them to methylate more, that may or may not end well, right? So that's just something to keep in the back of your mind, okay?

Now, and the labs. I don't know. I mean, I'm fascinated by these tests. You can test for lipid peroxides. If it's high, it implies that there's a lot of lipid damage, lipid oxidation, oxidation to lipids. And that means that there's membrane damage. Potentially. We're going to look a lot at membranes in a minute. You can measure CoQ10. You can measure magnesium. You can test for each one of these things. You can't really measure, you know, oxygen in the way that we might need. But everyone needs to do the breathing exercises anyway. You can use organic acid testing to check for all the different steps in mitochondrial function that we're about to look at. And maybe we can spend the last few minutes of the class looking at, um, some lab testing examples and answering questions, okay?

So, um, oh, and for sure, this is going to be recorded and sent out. Links to the recording will be sent out. Share with your friends, please. Um, Designs for Health is amazing to having helped support this. And, you know, I've known, uh, Jonathan Lazad and the crew at Designs for Health, I mean, I hate to say it, for 29 years. Just kind of say how old we all are now. But, you know, from the very beginning, um, been a strong supporter of the company. They've been a strong supporter of everything I've ever done. And so, thank you, Designs for Health, for organizing this, by the way. Um, yeah, this is an amazing group of human beings. Let's see. Um, you can also measure detox capacity, okay? That would be toxins that build up and damage mitochondria. And of course, you can measure oxidative stress. It's a whole different, there's got to be a dozen different ways you can measure oxidative stress. So these are the kinds of things that you're thinking about. You can measure mitochondrial markers on organic acids. You can measure oxidative stress markers. You can test for everything that we're talking about today. And we can look at some labs in a minute. All right.

So the key nutrients I'm going to talk about: CoQ10, magnesium, the B vitamins, including tryptophan, niacin, NADH. Okay? Tryptophan, niacin, NADH. Those are grouped together. I know tryptophan is an amino acid, but you can convert tryptophan when you break tryptophan down. I know this sounds a little strange, but it can be broken down into niacin, of all things. Yeah, it's true. A little weird. So here they are themselves. The mitochondria. The mitochondria, the primary source of oxidative stress. At the same time, excessive oxidative stress damages them. Okay? And so what we want is to have healthy mitochondria. And there's a couple of central problems here. Oh, the name of the book. It's Lab, Laboratory Guides, and it's by Richard S. Lord. Laboratory Guides, Richard S. Lord. And it's available wherever you buy your iTunes stuff. It's an iBook. So you can buy it. Unfortunately, you have to have either a Mac or a Macintosh computer, or you have to use an iPad for it, okay? But it's an interactive book. That's why it's, it's on the Macintosh platform because Richard likes that. So here's your healthy mitochondria. And let's note some things that are of importance. It's got an inner membrane, which kind of implies it has an outer membrane, right? I guess inner and outer membrane is double membrane, you know that's interesting. A lot of membrane, okay? And it's highly susceptible to free radical damage. And it's generating all the body's ATP. When the mitochondria is damaged, you have a shrinkage of the supply of ATP, and you have a ton of free radicals happening. And a couple of things can happen to mitochondria. They can either kind of underperform, you know, not work as well as they should, or they can be destroyed, eliminated, wiped out. And there's a whole area of research going on now in mitochondrial populations, like how many mitochondria are there in a cell, and what does it take to destroy them, and what does it take for them to grow back? And believe it or not, of all things, my son, very proud of, just graduated with his undergrad degree and, and basically in biophysics, you know, I don't know, it's a complicated subject. But anyways, cellular geometry, they call it, you know, but what they do in my son's lab is measure the numbers of mitochondria. Yeah, it's like a whole big thing in science to do that because they're trying to crack the code on aging, you know?

All right, so let's see here. Now I'm going to show you. This is where things are going to get a little complicated. But try to follow along. You need a cup of coffee, or you need a shot of bourbon, or whatever it is you use to get your brain working, okay? So we're about to talk about energy production in the mitochondria. And so for that to happen, the body's going to take fat or carbohydrate, or sometimes protein, and convert it into acetyl-CoA. Acetyl-CoA. So remember that. Acetyl-CoA. But see, all roads go to acetyl-CoA. You see that? So it doesn't matter if you're burning fat, carbohydrate, protein, whatever the fuel source, it's all going to end up coming down here to acetyl-CoA eventually. And then from there, the acetyl-CoA goes into the citric acid cycle, and we start to make energy. Another thing that happens with acetyl-CoA, I'll draw a little arrow out here, is it goes over that way, okay? And acetyl-CoA also is what we make cholesterol from, what we make CoQ10 from, and what we make, or how we do this process that's called protein prenylation, okay? Now we're into some new territory now. I can already feel, even through the internet, the tension level has gone up a little bit because I just mentioned a few things you don't know. So just take a deep breath, one more sip of bourbon. And again, acetyl-CoA is going to convert into cholesterol. It's how we produce cholesterol. It's how we make CoQ10. And that's how we deal with something called protein prenylation. This is going to matter in a minute, so I'm just kind of setting us up for that, okay? What's supposed to happen with acetyl-CoA is it happily enters into the citric acid cycle, and we start spewing out energy, right? And all these NAD and NADH are bouncing around, electrons are moving, protons are going here and there, right? And energy is being produced. And it's not like a biochemistry class. We have to get detail on it. But important point, important points are that, and you can see it in this diagram, NADH, NADH, NADH. Well, there it is over there. NADH, NADH dehydrogenase. Oh, there's an FADH. So, right? The carrying of the electrons and the transformation of these molecules from one to the other that allows the release of energy is, you know, directly connected with NADH. The fact again, I'm going to say this one more time. The fact that you can get that stuff in a supplement now is mind-numbing. I mean, it's almost like cheating. It seems like it should be a little harder to fix mitochondria. You can just buy this stuff in the pill and take it, okay? If the person's not making it. And the way I'm kind of joking that's only, that's sort of cheating, but you're not really, you know, because it's really hard to figure out how to get citrate to work better, or how to get alpha-ketoglutarate to work better. It's taking me like 20, 30 years of study. And the idea that instead of learning all that stuff, you can just give someone NADH in a bottle, it's kind of a little bit like cheating, okay? But anyways, they didn't have that stuff when I started learning this word. Now they do. Okay. So remember, take-home message here: acetyl-CoA. That's going to be super important. And we say this one more time because when we get to the more complicated diagrams, you got to remember this, or it's not going to make any sense, okay? And what happens if you like eat too much, or you eat too many carbs, you get a ton of acetyl-CoA. It doesn't fit into the citric acid cycle. So you go off and you make what? Fatty acids. You make body fat. But you can also make cholesterol. You can also make CoQ10. And you can also make, or facilitate this process called protein prenylation, okay? So it's all from acetyl-CoA. All right. Just want to tie that into it. Now, there's some more technical diagrams coming up. But this is a good basic one. All right.

So now here's a zoom in on the citric acid cycle itself. So this is kind of like Grand Central Station for the mitochondria. This is like where a lot of the action is happening. And so we want to understand how this process works and when it's not working right, how to fix it. And you can see on organic acids testing that we're measuring this. We're measuring citrate, cisconate, we're measuring isocitrate and alpha-ketoglutarate. And if you see one of these markers high, you know that there's a problem that has a specific nutritional solution to it. If you don't have the time or energy to memorize all that stuff, you can use what I call at the Kalish Institute classes, um, a multivitamin for your mitochondria, right? And the version of that the Designs for Health has produced, and I've used it for years, is called Mitochondrial NRG. Mitochondrial NRG. And Mitochondrial NRG has a little bit of every nutrient that's used in all these different processes. So you don't have to memorize what citrate to cisconate buildups mean. You just give Mitochondrial NRG and knock on wood that they've already figured this out and it's in there, okay? So as you're learning this work, if you really want to figure out when alpha-ketoglutarate goes high, there's a specific set of B vitamins that you can give, okay? And you can look that up and read about it in the genetic literature. And there's all kinds of science on that. But if you're like, "I don't know if I really have time to look up each one of these markers," just give the Mitochondrial NRG. It's got everything you need to make this whole process work in one pill. Again, it's kind of like cheating. But let's make our lives easier. You just need to figure out what's the right dose to make it work, okay?

So here's our acetyl-CoA again. And as we look around, we see, well, wait a minute. Here's pyruvate, that's coming from glucose. Then there's our NAD+ NADH. There's another one, NAD going to NADH, right? So you can see the facilitation of this conversion, NAD+ going to NADH, and we're kicking off protons right there. There's the H+ protons. And we're starting to release electrons throughout this process, okay? And again, you can cheat with a Mitochondrial NRG that covers the whole gamut. And then you can cheat extra cheat with the new stuff that Designs has now, the NADH. So again, you're looking here at the pathways for central energy production. Central energy production. This is most of the energy in the body is produced this way. The body needs this ATP desperately. You wouldn't last very long, maybe 30 seconds or so, if this process stopped. You'd pretty much be dead on the way to hitting the floor, okay? So that's another kind of pictorial representation. Oh, and this is like, okay, what can skip that? You can read through these slides later if you want to see. There's some detail in there. It's probably a little too much detail. But let me just show you this here because this is important. Sometimes I put slides in with a lot of writing, and then people sometimes go back and they listen to these. You can, you can read about it. Um, we'll send out recordings. You can freeze on that frame if you want. But remember, here's all the H's, okay? Here's all the protons. And here's our inner and outer mitochondria membrane that we just saw a minute ago. And this is what's called the electron transport chain. So your body's taking electrons that are being, you know, spewed out from over here, right? And it's using the electrons to pump the protons into this space here. And so you're getting tons and tons of protons up here. And then the protons come down through complex 5. This is complex 1, complex 2, complex 3, complex 4, complex 5. This is the basically what your mitochondria is doing all day long. In fact, we looked this up the other day, and there's something like, it was 4.7 billion units of ATP produced in one cortical neuron at rest per second. 4.7 billion times a second. This is happening in one neuron. And that's a lot, okay? So the body's pushing the air. There's just a natural flow of the protons back here, and that spins around complex V, and that's what finally makes ATP. But what we want to focus on for today and for practical purposes is the nutrient here. See that CoQ10? It's sitting right in the cellular membrane, and it's facilitating the movement of electrons. See, it's grabbing the electron there and moving it over there, and grabbing the electron there and moving it over there. And there it is again. It's grabbing that electron and moving it over there. So let's look at CoQ10 again. It's one by one grabbing an electron from complex 1 and bringing it over to complex 3. It's grabbing an electron from complex 2 and bringing it over. Just going back and forth and back and forth and back and forth. And if you don't have CoQ10, this whole thing shuts down. And the entire concept of cellular energy and cardiovascular not health, but cardiovascular functioning stops. Okay. The same catastrophic thing would happen if you cut off oxygen over here, right? If you didn't have oxygen here's the oxygen. If you didn't have oxygen, you know, accepting the hydrogens and making water, then the whole thing would shut off. So when I use that example of patients, like, "How important is this? Try holding your breath." And see, how much does that really matter to your well-being? A lot. CoQ10 matters just as much as oxygen, right? Because if it's broken, that doesn't work. Just like if you don't have enough oxygen, that doesn't work. It's equally important when you think about it. All right. And that's going to matter in a minute, uh, for a variety of reasons that you're about to see.

Now, I'm going to skip over some of these slides because I'm reacting a little too much and I'm a little behind time-wise, okay? Um, because we still have time for everything. But this is important here. Uh, let's see. If you only see me and you don't see the slides, you just need to, um, reset your thing. Your, uh, let me see here. Let me make sure that this is working right. Uh, I'm just going to turn the camera off in case there's a setting problem here. Okay. Now you guys should only see my screen, even if you have the wrong window open, right? There's a way you can toggle between the windows. But that should have fixed it right there. All right. And you can send me a text if it didn't. If you have it set right, you see me on the screen. If you didn't have it set up right, then you just see me, which is kind of not really the point. Um, it's a setting problem. And if you like, screwed you up, you can come back and listen to the recording, okay? Because the recording has it properly done. All right. So now here we are with the cell membrane. And here we are with our lipid or fatty acid. And this fatty acid that's in the cell membrane, there's a whole bunch of them already, obviously, you know, but they tend to be around 16, 18 carbons long, okay? So this tail here is 16, 18 carbons long. So you get two of these tails opposing one another. You can do the math. It's like 30-something carbons long, plus you got the little bit of space for that phospholipid, what you call it, um, your head at the head of there, right? And so this whole thing is, you know, let's say 36, 38 carbons long, plus a little bit. That's going to matter in a minute. And if you think about it, what's happening? These are lipids. These are fats. Think of it, it's like the consistency of olive oil. If you've ever had olive oil, you imagine putting some olive oil on your fingers and kind of moving it around a little bit, right? It's oily. And it's, you know, would you literally trust that as a structure to like completely hold together and protect every, you know, vital thing in your body, like the nucleus here that's got all the DNA? Well, not really. You would think, well, that's not going to work very well. It's like olive oil. And we're talking about room temperature, body temperature, right? This is not like it turns into a hard solid object like a piece of butter or something, right? So it's a lipid, and it's really soft, and it's mushy, and it's oily. And so for these things to hold together, you need to have a couple of things. One is, good news is that your body is mostly water. So they don't like water, right? So the fats are like orienting themselves to get away from the water. That's why the tails are inside here, and the water's out here, yeah? And then the other thing that happens is that your body strengthens this whole system by putting proteins in it, by putting cholesterol in it. And there's a variety of ways that we make the membrane, membrane super strong, regardless of what the, um, temperature and other conditions are, okay? And so here's another picture of the membrane. And you can see here, cholesterol in the membrane, okay? One of the roles of cholesterol, one of the main roles of cholesterol, is to act as a structural support for that membrane. And so cholesterol is a solid or tougher, grittier kind of fat. And so it's able to hold together the cell membrane even when it's really warm inside your body versus really cold. It allows the right amount of fluidity into the membrane so the membrane doesn't fall apart but doesn't get overly rigid, okay? And again, you can see the dominant fatty acid chain length, 16 to 18 carbons. That depends, that, that determines the viscosity, right? And the thickness of it. And, and this is true throughout many different life forms, not just humans, okay?

Now we're looking at the electron transport chain. Remember we saw this a minute ago? Now we're kind of tying together the concepts here. So we've got the electron transport chain, but where is it? Holy moly, it's stuck in the membrane. Yeah. How cool is that? Who thought of this? I don't know. I don't know who thought of this. It's just a really cool idea though. This is the mitochondrial membrane. The electron transport chain is crammed into the membrane. And remember what's making this thing work besides the oxygen, right? Which is really important. What's there? Your CoQ10. It's sitting in the cell membrane. How is that even possible? How does it get there? How does it stay there? That's a really good question. Really, really good question. And remember, this is again, if you don't have oxygen, you know, this fails. If you don't have CoQ10, this fails. This is not like, you know, some peripheral thing that we're talking about. So now here again, the mitochondrial membrane. Remember, now we know it's thick. How thick? 36, 38 carbons thick, right? Here's our citric acid cycle kicking off our NADH, NADH, NADH. Again, this kind of pisses me off that they have that as a supplement because it's like almost cheating. You can just give it and you don't have to know all this complicated stuff. But anyways, we should all give it all the time. It's, it's a scientific advancement. You guys should be using that with, with pretty much everybody. Um, and then, uh, CoQ10 and magnesium also, right? So NADH, CoQ10, and magnesium are the punch lines here. Those are the three that you should be using with everybody on a regular basis for these kinds of problems. I'm just trying to show you why. Here's our CoQ10 again. Remember, it's accepting electrons. Where is it accepting them from? From complex 1. There's your electron. From complex 2. There's your electron. No CoQ10, no complex 1 and complex 2 electrons moving anywhere. That means there's nothing to hand off over here. That means oxygen might as well just go to something else, okay? When you get that complex 1 and complex 2 working, that CoQ10 is working, you got your NADH cranking up, right? The hydrogens are moving, the electrons are moving, right? The hydrogen ions are the protons. And here they all are. And then they swoop back down. So remember, you're getting these. When they say NADH is the H part that we really care about, right? Where's the H? Well, here are the H's up here. Here are the protons. Okay? They're going into this space between the membranes. And when there's enough of them, they come back down. You see the arrow coming down? And that forces this water wheel type device to spin around. You get some magnesium glommed on there, and then poof, you got ATP. Okay? So let me review this one more time. Supplement use. CoQ10. Why would I give CoQ10? Because it's pretty important. Because it grabs each electron one at a time and brings them from complex 1 and 2 over to 3. You've got to have that. Gotta have CoQ10. If you test it and it's low, there's a problem. If you don't do a lot of labs, just give it. Okay? Cheat. Just give it. You don't have to do all the testing like I do. Just give the CoQ10. Just cover your base there. What about the H's? Where's all that happening from NAD to NADH? Okay? That's facilitating the movement of these biomolecules around, right? And then ultimately, the protons are ending up up here, all these H's, right? And ultimately, those H's, those protons are coming down through complex 5. They're spinning this water wheel like thing in here. You cram some magnesium onto it, and you got ATP. So the magnesium, the CoQ10, and the NADH. There's the scenario. And if any of these are missing or low, we have cellular aging. We have fatigue. We have weight gain. If any of these are low, we have cellular aging, fatigue, and weight gain. CoQ10 is low, screwed up there. NADH is low, you don't even have a chance. Magnesium is low, get screwed up there. Okay? That is pretty cool.

Now let's see here. Uh, oh. Oh, well, there's so much to talk about, but we're going to transition to one more subject. Okay. So let me just show you the transition part here. Okay. Remember I started off talking about this a while ago. Glucose or sugar in the diet, carbohydrate converts to acetyl-CoA. Remember, fat, fatty acids, when we break them down, either from the diet or fats that you make, convert into acetyl-CoA. And then the acetyl-CoA is what triggers this whole process here. So we're going to look at another role of acetyl-CoA. Remember, it goes off here and it does something else. If there's too much acetyl-CoA, you'll make fat. I know it's a little strange. You make acetyl-CoA from fat, but then you make fat from acetyl-CoA. It's a little strange, but anyways, that's the way your body works. But the acetyl-CoA also, and we're about to see this, can make cholesterol. It's how you make the CoQ10. And it's how you do something called protein prenylation. Okay? So let's take a look at those processes. Uh, this is just a repeat of what I just said, so you don't have to get into that. And we're, oh my gosh, I love complex 2, but I think it's a little beating a dead horse there. So let's give some of those guys. Let's get to somewhere that's more important here. I have so many favorite slides. I apologize. I couldn't just pick, you know, it's like your children. You're going to pick one kid and just take them, you know, to the movies. No, you take all your kids. I, I, I always grab too many slides. I apologize for that. But then, okay, this, this is another way of seeing the same thing. But, uh, here, this is even better, okay? So now we're kind of transitioning into this idea that we got to make all these things. And this is going to be super important clinically, okay? This is kind of really the main thing I want to talk about. So your body makes CoQ10 from acetyl-CoA. We just saw that, okay? And this is an image of a, of a, or a chemical representation, right? Of a diagram of CoQ10 itself. So I just want you to see the CoQ10 molecule. It is 50 carbons long. 550. It's 50 carbons long. We're talking about these fatty acids that form cell membranes that are 16 or 18 carbons long. This thing is longer than two fatty acids put back to back. This huge molecule. Can you imagine how much work it is for your body to make this? Okay? I say this again, it's 50 carbons long. This has to be constructed. It just doesn't happen. Your body has to make it, okay? It's a big job. It's called CoQ10 because it has 10 of these five-carbon isoprene units. 10. There's actually a CoQ9 too, I think that's like implants or something. But anyways, all life form, animal form life has CoQ10. Somehow the world figured out how to make it. Now, when something has this many carbons in it, it's extraordinarily resilient, resistant to water. It doesn't want to mix with water at all. And here's our CoQ10 sitting in the electron transport chain again. And that's a long, big molecule, like extra big, okay? And takes a lot of work to make it. Now, believe it or not, there's scientists that figured this out. And I love this title because I don't even really understand half the words. But "Localization of CoQ10 in the Center of a Deteriorated Lipid Membrane by Neutron Diffraction." I don't know exactly what all that means, but I can see what these guys figured out is pretty cool. It's like, "Our data show CoQ10 at the center of the hydrophobic core, parallel to the membrane plane, not as it might be expected, parallel to the lipid chains." So here's the, uh, the structure, okay? So here's the, um, fatty acid here, right? Here's the other fatty acid here. This is the cell membrane. Here's your CoQ10. It's lying this way in the cell membrane. You see how deep in the cell membrane it is? Deep in the cell membrane. Fascinating. Just sitting there, sitting there. And remember, it's longer than the cell membrane is wide. That's why it has to orient this way. Fascinating. Just nudges itself right in there. So cool. And then it's handling, per cortical neuron, like 4.7 billion transactions a second. I mean, it's a lot of stuff going on. All right.

So the production of CoQ10, remember, it starts with, um, acetyl-CoA. And we also make cholesterol. And this stuff called protein prenylation, prenylated proteins, is all taking place from the same basic pathway. And so what happens in our culture is the majority of people die from heart disease. And we have taken it upon us to develop medications which can help save a lot of lives, sure, called statins. And statins block HMG-CoA reductase. They block the enzyme right here. So this is not an anti-statin argument. I, I don't know.

If I had a heart attack right now, I'd probably go get a statin, get on it. I'm not against statins, but we should just understand how they work so we can determine who should be on them and who shouldn't. Just basic common sense and physiology and biochemistry. And I don't think everybody should be on a statin in the whole world. Probably people that just had a heart attack should, especially if they don't want to change their diet and clean it up, right?

So let me show you another blow-up of this same thing here. Here's another image, the same thing, but it's a little more detail. There's a study. I just found this study a few days ago, so it's not on the slides yet, but here we go. So you see the acetyl-CoA at the top, okay? That's acetyl-CoA. And again, let me just say this again because whenever I say anything, you know, interesting, people just think I'm criticizing. I'm not against statins. It's not an anti-statin argument. This is a, "Just, uh, let's understand how they work" argument. Here's your acetyl-CoA. Statins act right here and they block this pathway. So by necessity, that's going to block this stuff called journal genoa, general journal. I'll show you some other pictures of that in a second. And that's going to also block, um, that's the protein prenylation part, okay? And it's also going to block the production of cholesterol. And then it's also going to block the production of CoQ10. Oops, sorry. Here. Okay. So when you block that higher up enzyme, you're going to block cholesterol production, you're going to block prenylation of proteins, and you're going to block the production of CoQ10. Those things happen simultaneously, okay, when you have a statin in the picture.

Okay, so now let's look at, um, go back to our. Oh, and while I'm here, here's the mitochondrial energy product, right? That has a little bit of everything you need to fix this. If you don't want to get into the labs, here's the product, which kind of upsets me almost because it's like cheating. Like, how could they even do this? You can just get NAD+ in a pill. Okay? We just saw why that's important. It's important for like 1600 different reasons. Just give this stuff to everybody and they're gonna, it's almost like fixing their citric acid cycle without having to eat better. Okay? And then what we're about to talk about, I think this may have even bigger ramifications over the years, is this anato GG. Okay? The designs came out with, and this is the, um, journal Jeremy all stuff. Okay? Uh, I'm gonna show you the pathways here. Is right now, okay? There's the general PP right there. Okay? But I have some better diagrams on this in a second.

So now, if you don't have enough CoQ10 in your body, you're gonna have primary CoQ10 deficiency, right? And what are the things that that can cause? It's a beautiful article that was written a few years ago about this. It's like literally from head to toe, right? From encephalopathy to seizures to depression type problems to peripheral neuropathy, liver problems, lung problems. The list just goes on and on. You can have secondary CoQ10 deficiency. That's not so great either. Blah, blah, blah. You know? So CoQ10 turns out to be super important. And, um, here's our protein prenylation thing. Okay? So I'm going to try to explain this a little bit. So this general general stuff turns out to regulate protein prenylation. And this is the process of protein prenylation. What's happening is your body makes proteins, and it has to get the proteins into the cell membrane so they can do stuff, right? So cell membrane proteins have to transport themselves to the cell membrane. So your body makes them. Endoplasmic reticulum is where you make the protein, right? But somehow they have to get over to the cell membrane. And so your body has this miraculous ability to make these little squiggly things here, you see these? Right there. And it crams that little squiggly thing onto the protein, and then it transports itself over. Sticks that little squiggly thing into the, uh, I'm sorry, into the membrane, right? Grabs on the squiggly thing, gets stuck on the protein. The squiggly thing gets stuck into the membrane. And that's how you locate or transport your membrane-bound proteins. So anything that interferes with protein prenylation is interfering with this transport mechanism of putting proteins into the right place in the cell membranes. Okay?

So these three things are linked. Remember, CoQ10 production from acetyl-CoA, cholesterol production from acetyl-CoA, and geranylgeraniol production. This whole PPP thing, PP thing from acetyl-CoA. It's all the same pathway. All three things are blocked by statins. CoQ10 production is blocked, cholesterol production is blocked, and protein prenylation is blocked. And they're starting to have scientific papers on this. So you can see, oh, is that a great idea? I don't know. Could be a good idea, could be a bad idea. I'm not being judgmental. I'm just saying this is what's happening. We should think about it.

So summary here. The mitochondria sustain damage from a variety of sources. Once they're damaged, things aren't working so well. It's going to cause a lot of symptoms. If you want to go for, you know, supplement solutions, magnesium, CoQ10, NADH, or NAD+. It's kind of cheating, but you should use it because you don't have to learn all the science stuff. You can just supplement with that. And then our whole, you know, correction for protein prenylation with the anato GG. Okay? Those are the potential solutions here. And you can use anato GG, NAD+, CoQ10, and magnesium in someone with labs to correct a chronic fatigue type situation. You can also use them just as general anti-aging programs, right? So that you're getting people to feel better just based on, um, just based on, uh, not based on labs, but just based on this is an anti-aging program, right? And I think that's enough science. If you maybe listen to this once or twice, so you can start to explain to patients.

So a couple of things that are coming up then. We're going to go to questions. We've got 5-10 minutes left. Telehealth Business Essentials Boot Camp starts in August. There's a misprint on here. The Lab Interpretation Boot Camp on Cardiometabolic Health is in September. Okay? And we'll be sending out emails to that. If you're interested, you get 20% off of either class. Both of them are the same format. They're two months long. We talk every two weeks live and go over tests and details. The cardiometabolic one is a deep dive into what we're talking about today with a ton of information. And we have a whole set of lectures that Richard Lord has done for that, as well as myself. And then the Telehealth Business Essentials is more about financial planning, business planning, you know, marketing and sales and that kind of stuff. Okay? So that's what we have coming up at Cash Institute.

All right, so now let's take a look here. And then let me just do a reminder here on what we're talking about product-wise. This is the one I'm sarcastically referring to as cheating. Just give it, you know, it's a miracle that this has even been created. I, you know, it's incredible. You can just take it in a pill. NAD+ NAD+. Just take it in another liquid. I mean, take it in a supplement form. So that's right off the bat, kind of a no-brainer for people that are not doing well with the mitochondrial energy. And this is like the classic mitochondrial energy. Think of it as like a multivitamin for your mitochondria. I usually give three or four twice a day. I don't know what the official thing is, Designs for Health, but maybe that's a little too high a dose. But let's say two to four twice a day, somewhere in that range. A very effective product. I've used that for years.

And then another new one on the market, the anato GG. Again, this is the general Jeremy all, okay, which is very similar to general journal. It converts back and forth to general journal. So general general, general journal, and general Jeremy all convert back and forth. But anyways, this is the thing that helps with protein prenylation. This helps with a bunch of other things too. You want to read these tech sheets later on. But the protein prenylation thing, to me, is the most interesting because it's the transport and placement of all the membrane-bound proteins. Okay?

Well, and well, maybe I should tie this off for you guys. Like, what's an example of a membrane-bound protein? This would be the quiz question for the day. Do those look like membrane-bound proteins? Kind of look like membrane-bound proteins to me. That's the electron transport chain. It's in the mitochondrial membrane. Those guys have to get there somehow. They get there because of protein prenylation, right? If you take a statin, it interferes with that process. Whether it's worth risking that over the risk of a heart attack, I don't know. I'm just saying you got to really think it through. Membrane-bound proteins, right? There's a lot of them. We talked about in the whole class. Okay? So anyways, I'm going to stop yakking for a minute and I'm sure there's a bunch of questions that come in. Let me try to get to the questions and, um, all right, let's see here. So is there a need for both anato and CoQ10, since it now has GG as well? I know it depends on how sick the person is and what the labs look like, right? So you would want to give. That's a, that's a question. That's a good question. So in, in the extreme case, you would use the anato GG, right along with the, uh, I mean, let me show you the products. It's kind of abstract otherwise. Hey, a second. In the most extreme case, you'd want to use the anato GG, right along with the, uh, I mean, let me show you the products. It's kind of abstract otherwise. Hey, a second. In the most extreme case, you'd want to use everything. Now, this can get costly. You can't use everything with everybody, right? Obviously. But in an extreme case of serious fatigue, you'd want to use the anato GG, right, to get the whole sternal journal journal Jeremy all thing going. You'd want to use mitochondrial energy. It's like the mitochondrial multivitamin. And you'd want to use a liposomal NMN synergy for the NAD+. Why not? Why don't I deprive anything? And then remember, you also need magnesium to make this work. And then, um, oxygen, which is breathing exercises. So you've got your NAD+, you've got your journal Jeremy all, you've got your mitochondrial energy, some extra magnesium, and some oxygen. And maybe some CoQ10. That's a very robust program. If you really want to get the mitochondrial biogenesis going, to the further growth of mitochondria, then you add in mitochondria, MitoCoQ, Designs for Health has Mito PQ. The PQQ helps with the growth of mitochondria. Okay? Uh, all right, let me see. Let me go back up and see if we can get to some questions here. I might not be able to answer all the questions in the time we have, but let me try to get through. Um, oh, how do you deal with mitochondrial damage to cardiac muscle? Well, that's the most dense location of mitochondria, I believe, right? And George is saying, is 5,000 mitochondria per cardiac muscle cell? Game on, man. Just give them these products. When I had a really complex patient this morning, and I won't get into all the details, but I gave him a ton of supplements in a ton of different ways, including CoQ10 and vitamin E and all these antioxidants and magnesium and PQQ and all that stuff. And we redid his labs, and I was underdosing him. So I'm like, Johnny, we're gonna double up on the dosing. He's like, yeah, let's do it. Because we did an initial test, he was deficient in all these nutrients. I gave him what I thought was therapeutic dose. Labs came back, wasn't enough. So we're doubling up, honey. So you base your, you know, dosage assessments on the labs and then retest to be safe. Because any of these nutrients can be a toxicant, right? If you give too high a dose of any of these nutrients, it can be a toxicant. So you don't want to give huge amounts of anything unless you have lab work. If you're doing generic programs, just for anti-aging, just keep the dosages low to the what the label strength is on the bottle. You won't get into trouble. Okay? Is there a test to identify the amount of mitochondrial damage? Absolutely. That's what organic acids testing is for. Let me just show you an example of one if you guys aren't familiar with these. This is something I've obsessed on for 29 years, and I can show you exactly what we're talking about here. Let me pull up an example. Sorry, that went the wrong way. I'm using a different computer than my normal one. Sorry. All right, here. Um, let's see here. In a second, let's go pull this up. So with organic acids, you can assess a whole variety of these markers. I'm just going to show you some examples from this morning's class that I taught. We should have one right here. Oh, look at that. How handy. So this is from this morning's class, hot off the presses here. One of the doctors submitted this class, and we reviewed it. So here we are. It's an organic acids test. There's several different labs that do these. There's a neutral valve, there's an ion panel, there's organic acids from Grape Plains. You have a whole bunch of different testing choices, but you can measure beta oxidation, carbohydrate metabolism. You can measure each one of these steps in the citric acid cycle itself, okay, that we've just been looking at. It's like a cisoconate, isocitrate, alpha-ketoglutarate. And if these markers are high, you know you have a really big problem. If they're very low, you have an even bigger problem. And then you can measure all of this. Everything that we're talking about can be tested. You can test for the CoQ10 levels. Everything. Okay? So that's all lab-based. And we're going to do that. The Lab Interpretation Boot Camp. We'll be talking about that in September. You guys want more information on that, and that's what we do also in the mentorship class I teach. Oh, so again, it's Richard Lord and the book is Laboratory Guides to Health, and you have to buy it from iBooks or iTunes and download it on an iPad or Mac. Okay. Let's see here. I'm just going through these. More cost-effective means than CoQ10? Yeah, I know CoQ10 is really expensive. It is. Yeah. What could you do? I don't know. Maybe just keep the dose slow. Let me just keep it like 100 a day and try to get these other things going, you know? Yeah, you certainly have to be careful. Deborah's asking a question about contraindications. So you have to be careful, like that you can't give each one of these products to every patient, right? So you have to do your due diligence and check the patient, their history, what medications are on, make sure that they're compatible with these things. Are there other pathways for CoQ10 if the patient's on statins? You know, you can make a little bit of CoQ10 from tyrosine, but, um, not much. So there is an alternative pathway from tyrosine, believe it or not. What's the coupon code? Oh, Designs for Health 21 doesn't work. [Music] Sorry about that. We'll have to send. I'll check with my stuff. Maybe we'll screw that up. Let's see. I'm trying to get through all these questions. Let me see. So when you're looking at genetic disorders, SNPs, whatever, do the lab testing and see what's actually functionally wrong. So if someone has an MTHFR problem, do the testing for folate, B12, and B6, see how it's expressing. You can't supplement based on a SNP. You supplement based on a SNP directing you to order a lab and then correcting based on the lab. Okay? And then Suresh is saying, you say you don't want to promote detox pathways too early. If someone has mitochondrial energy production problems and low glutathione, which you pred, which would you prioritize first? Yeah, so Suresh is like one step ahead of all this here. He's thinking, wait a minute, if you fix the mitochondria and they're already low in glutathione, won't that make them worse? The answer is yes. So if they're low in glutathione and they have a mitochondrial problem, you got to get the glutathione up the day that you start to improve the mitochondria, or you'll give them more oxidative stress, right? Let's see here. With this, help with neuronal health? Almost assuredly, if only because of the role of ATP in the brain, just for that one reason alone. Yeah. Um, let's see. I don't know what the effect of red rice yeast is in terms of this. I don't know if it's the exact same pathways or not. I have to look that up. And those supplements be used while on statins? I think that's the point, really, is to do that. Like, if you're giving a drug that blocks general journal and CoQ10, why don't you just give the person the general journal and the CoQ10, or the geranylgeraniol and CoQ10? Um, that seems reasonable, right? That seems like almost like a requirement, really. Okay, somebody wants to see some more labs. So let me show maybe one of the labs. Uh, do we have time? I don't know. I can't see my clock. Uh, we're way over. Okay, well, you guys, if you need to go, go. If not, I want to show you one more lab. Okay, so you can see one more lab, but we're over time. So I understand if you got to take off, go for it. But if you've got an extra minute, let's go over time. We'll do a little bonus session here. So let me just show you another lab example. I'm not saying that if you're in my mentorship class, that you'd be looking at these labs every day, but yeah, I'm saying that kind of. So this is from this morning's class. Oh my gosh, look at that. We've reviewed a lot of labs. It's like 161 pages of labs. We got through this in an hour. I really love teaching and I love my classes. I learn as much as the students learn, let me tell you that. It's just such a great group of people. I love them. I probably don't tell them I love them enough. You know, it's a great group of human beings, and everyone's trying so hard to learn this stuff. Here we go. Here's an example of another lab. So you can also measure all the amino acids, right? We're not talking about that tonight at all. So it's kind of glossy. That minerals. Oh, magnesium. Okay, that's relevant. You can measure magnesium. Very important for what we're talking about. There's your CoQ10. This person had normal CoQ10. Very important for what we're talking about. These are the fat-soluble antioxidants. What do they do? Protect cell membranes. Remember talking all about membranes? That's where your electron transport chain is. You can measure the damage to cell membranes with lipid peroxides. It tells you exactly whether cell membranes are being damaged or not. A very valuable piece of information. You can measure the lipids themselves, okay? And these are the threes and the sixes, omega-3s and omega-6s. And then you can measure all the fats that make up the membrane, the palmitic, the stearic. That's what you're making these membranes out of. But look at this person. They're low in palmitic, low in stearic. How are you going to be making cell membranes if you don't have enough palmitic acid and stearic acid? You can't. That's a person. This is a patient who can't make cell membranes, mitochondrial membranes, neuronal membranes. The nerve cells are long, squiggly things, remember? Massive membranes. The mitochondria, they have the inner and outer membranes. Low palmitic, low stearic, can't make membranes. How can you be healthy if you can't make membranes? That's a neurological problem just staring down the barrel of you, whatever that expression is. Okay? Then here's organic acids to answer the question that was asked a little more specifically. Um, by the way, this is what the boot camps were for. The boot camps are lab interpretation, right? So you can measure fat metabolism, carb metabolism, energy production. You obviously can't get through all this, but, um, you can measure every aspect of the citric acid cycle, of of the beta oxidation process, of the methylation process. All this gets measured on the testing. So everything is lab-based. And once we get all that figured out, so that's what the cardiometabolic boot camp is for, really. It's like a just a crash course in this concept of testing and starting to figure out how to prescribe some of these things. Okay? All right, so let me see. I'm going to wrap it up because we're way over time. I always keep these to an hour, but there's a lot of questions that are coming in. Oh my gosh, even more questions now since I started talking. Uh, red rice active ingredient is a statin, same pathway. Thank you, Roberta. Okay, so the same thing would happen with red rice yeast. I'm going to say this one more time. It's not that statins are bad, and they save lives. We just got to think through what's the appropriate use of them, right? When is a good time to use them, and and when not? Like, if I was a healthy 45-year-old with no history of heart disease, I don't think I would want to take a statin. If I was 57, my age, and I had a massive heart attack and I survived, I don't know. I'd probably think about taking one, right? So it just got to be logical. It's not that we give them to everybody, just hand them out like candy. You can measure the CoQ10. I, I use Genova Lab for that. Um, you can also give glutathione as a supplement. Absolutely. We do that all the time. Um, see, I think we're going to run out of time here. I'm sorry I couldn't get to all the questions, but, um, I hope to see you again soon. One of these other events, two boot camps, one in August, one in September, and we'll have a another one of these courses, uh, pretty soon, I'm sure. Well, just pay attention to your email. We'll be sending out info. Okay, take care, everyone. Have a good rest of your evening. Thanks for hanging in there with this long, kind of overtime session. Bye for now. Bye.