Transcription
Very glad to have you here and maybe just give you a little update about the goings-on at the Kalos Institute. If someone could please raise their hand if they can hear me so I make sure I'm not talking into total space, that would be helpful. Up! Thank you, Melissa. It sounds like my sound is good and everything will be recorded. You guys want to listen to this, share it with a friend. This is like, if you listen to NPR when they have pledge drives, we're wish to already show you this is a free class. What you got listen to the ad.
So, we're starting a new training program next week and you guys got to sign up if you've been thinking about it. You know, I'll tell you, everybody that signs up loves in my class. If you love what we do tonight, you're going to want to be in the class because we do this night after night, month after month, and you really learn how to understand lab testing, analytics, paycheck, communication skills, all this good kind of stuff.
So, we're talking tonight about something extra special and a little bit about my last year, year and a half journey. And professionally, for setting the stage here, you know, when I'm in my middle 50s right now, which is a wonderful age to be. I'll tell you, my son just went off to college and, you know, I have a lot of bicycles, maybe I have a couple fast cars. You know, life is really good at my age. I'm enjoying it very much and I kind of figured I had, you know, plateaued in terms of lab interpretation knowledge. You know, kind of like I've seen a lot of these tests, you think I'd understand about now.
And about a year, year and a half ago, I connected with my new mentor, Dr. Richard Lord, who, as you know, wrote our book in our profession, the book on laboratory evaluations. And when I first met Richard, he was in the process of rewriting his book and he's like, "Hey, you wanna help?" Was of course, bow down to his feet and literally, we kissed the ground he walks on. And he's, you know, the one that developed the test that we're gonna talk about tonight. And rather than working on his book, the two of us got a little distracted and we've been spending the last year and a half now working day and night on understanding how to teach organic acids better, with him as a teacher and me as a student.
I'm here tonight to talk about a lot of the things that I've been learning and, in particular, I think one of the most important things that he has taught me, which is something he'd identified called, he calls it, Richard calls it, the hypo metabolic pattern. And we'll talk about how that relates to thyroid and some of the breakthroughs that we've been discovering at the Kalish Institute. And, you know, I'm very much just the messenger. You know, I get to sit here and teach classes, I get to work with people like Dr. Lord and, and then I get all this feedback from the wonderful doctors in my training program. And together, we've put this into a clinical package, which I think is one of the most relevant issues that we could all be dealing with because, as you know, every single one of our patients, just about, is dealing with, you know, weight loss resistance. And it's a hard thing to correct, it's a hard thing to even understand. At least I feel like we're starting to understand it. So that's what tonight is about, my journey.
And I'll tell you that in this last year and a half of working with Richard, I feel like I've learned as much as I had in the previous 15 years. Not that's not an exaggeration. We spend hours every Monday together and just being downloaded with that amount of information has been really the the highlight of my professional career. I feel like if anything, I'm just starting to peak right now. So I'm going to be doing a whole series of free webinars next year, like a whole curriculum on this. You guys are welcome to join and we'll be launching that in 2018. Says tonight, and we'll have another free class in about a month. These are kind of the warm-ups for for next year's series.
So this is me, if you don't know me, if you're new to the Kalish Institute. I've been in practice for a while, 25 years. We train doctors in the Jewish method. And I do actually have a really strong spiritual bent. You know, I wake up every morning around 3:00 in the morning, which is insane, I know. And I meditate for, gosh, today, from 3:00 a.m. today was a late day, 3:00 a.m. until 7:30. You know, and that's really a probably the biggest part of my life is the spiritual practice. But I have a patient practice, I teach doctors too. And really happy to be here tonight talking with you all. And I do find that, and I'm trying to follow in the footsteps of my teachers, you know, all my really great functional medicine teachers, including Dr. Lord, very deeply spiritual people, all of them. All of them, not like a few of them, all of them. And so I feel like the spiritual practice is what makes us great as doctors. Know how could we not do that?
So let's jump in here and talk about what's really on the agenda. So, and you know, I've pieced this together over the last couple of years with the help of a lot of different people. But what we're really seeing strongly now is a constant, repetitive hypermetabolic pattern on organic acids that ties in with thyroid dysfunction. And how much sense does that make? We're talking about the role of environmental toxins in weight gain and fatigue through the damage that happens to mitochondrial health and the inflammation that then triggers thyroid imbalances. And you get, you know, you always, at least in my practice, you get half of this, like, "Oh, I got the thyroid figured out, but why isn't that patient losing weight?" Because you may have missed that hypo metabolic pattern on the mitochondria, or you might be working with a mitochondria and not realize that there's a subclinical thyroid problem that's preventing that patient's metabolism from restoring itself.
And those of you that have followed me for a while know that, you know, my first 10 years of functional medicine training, I was 100% very deep in the swimming pool, deep into the swimming pool with the adrenal oriented doctors and was all about adrenal hormones. And I can tell you, the patients with this hypo metabolic pattern of mitochondrial dysfunction and thyroid dysfunction are my consistent adrenal failures. But I didn't say that right. The patients in whom I do nothing, I work on, I see, I tell renals, I see that there's cortisol problems, I put them on a program and there's no discernible change. They gain weight instead of lose weight, they don't get more energy, they don't sleep better. The adrenal programs just don't work with these folks that have hypo metabolic and thyroid dysfunction combined. Now, if you just have a thyroid problem, an adrenal program could help a lot, for sure. But if you have a thyroid problem and a hypo metabolic problem, I'm almost going to guarantee you that any kind of adrenal protocol you're trying to run is going to fail. And man, does that explain a large percentage of my practice all these years, hammering away on people's adrenals, not realizing that I'm never going to restore adrenal or thyroid function until we get the mitochondria kicked back in.
So we want to talk about this breakthrough discovery that Dr. Lord has been training me in, the hypo metabolic pattern as represented on organic acids, and then try to tie that into thyroid. I don't know how we're gonna do this in an hour, but let's just try. Maybe we'll have a part two or something because I got a lot of slides. So, and I'm going to skip through some of these slides pretty quickly because I'm assuming we're all on the same page about a lot of these things. You know, but just want to make mentions of, for example, there are 80,000, you know, chemicals in the environment. Pretty much everyone that we're working with is exposed to them. You can't really separate out the toxic from non-toxic patients any longer. Newborn babies have somewhere around 50 plus toxins the day they're born. You know, we're just swimming in a sea of toxic exposure. And that's just the way things are. And that doesn't sound like it's going to change next year.
And so what happens when this is, when when our tissues are exposed, is we go through oxidative stress, right? And you cut an apple in half, it turns brown. That's oxidative stress. Now, I was just in the tropics, you know, my mom turned 80 in September and I took her back to her hometown. She's from this really small town on the Big Island of Hawaii called Honokaa. And so we ran Honokaa and of course, as soon as you get to Hawaii, first thing all the relatives do is bring over a bunch of pineapples that they've grown. They bring coconuts from their yard. And, you know, my family goes back, I think, five generations to this town in Hawaii. And so we have a lot of relatives there. And there's always a mango, right? You can't be in Hawaii without a mango. And so what happens when you cut a mango in half? Does it turn brown? Not really. If you ever tried that, if you put an apple in half and a mango in half and put it right next to each other, mango is gonna be pretty orange for quite some time because the antioxidants are so rich in the inside of that mango. Whereas, of course, the apple carries its antioxidants in its skin.
So this is a process that's happening to us, right? Where our mitochondria don't look like mangoes that have been cut in half for half an hour. They look like apples that have been cut in half for half an hour. So you imagine that brown apple just after, like, I don't know, 37 years of exposure to oxidative stress, how crappy would that apple look? That's what's happening to our patients' mitochondria, right? They're being damaged by oxidative stress from environmental toxins. We're not even talking about toxins and food and emotional toxins and all this. We're just really kind of focused on the environmental toxin issue because I think that's probably the largest problem. But of course, this extends out to people who consume caffeine and alcohol and, you know, prescription drugs and recreational drugs and all the other ways that we can create toxins in the system.
So in a normal, healthy mitochondria, you have two things going on. You have very few free radicals, you can see right there it says it, and abundant ATP. So that's what, does that mean? That to have abundant levels of energy? It means that your body is cranking out a lot of energy. You're burning fat, well, your energy levels are good, your liver's working, right? You know, you've got a whole system that's engaged in functioning really, really well. Okay. Now, if you don't have that going on and you've got mitochondrial damage, then what's going to occur? Well, you're going to have an overabundance of free radicals, and that's depicted over here in the picture, and a shrinking supply of ATP. When this gets to an extreme, the mitochondria become so damaged that they're not functioning properly. And in fact, you can lose mitochondria. Not lose them like you lose your wallet or you lose your keys or something, but lose them like they're gone, like they're dead, like lose them like you lost your spouse. Like if someone says, "I lost my spouse," you don't usually think that you wonder, "Oh, is she at the supermarket or something?" No, they're dead, right? So we're talking about lost mitochondria, gone, dead, out of the picture, and damaged mitochondria that are suffering and sort of limping by, just barely.
This is a slide just to remind us all that there's a bigger picture here. It's not just about mitochondria, right? There's an adrenal thing going on that we're, we're saying for tonight's patients, yeah, you can work on the adrenals. I'm telling you, it's not going to help. I've been working out with adrenal programs, you know, for 25 years and doesn't help these people, just doesn't. If you could get an adrenal program that can help these people, I would be massively impressed and I will do a whole series of lectures about it, but I don't think it's possible. And not just my own opinion, but all the doctors in my group, we just can't figure that part out. So I don't think that's going to work.
And then we have this thyroid side here, right? And the thyroid is now going to be impacted by the inflammatory damage of the toxins. And of course, most people that are highly toxic are going to eventually develop some kind of thyroid issues, as well as some kind of adrenal issue. Now, if we go back to here, and I'm just going to real quick cut over to a lab, just so you can get a little practical example here. And, you know, in the training programs, we lead, we're always every week, we're in class and we're looking at lab tests. It's just what we do. And so I can't really think unless I have a lab in front of me. So let me just show you one example here. I want to show you the two extremes so you get a sense of how to do this. Now, if you are not at the present time ordering organic acid testing on every patient, you should probably stop listening to this talk that'll be recorded. You should probably go to your computer and order a whole bunch of organic acid tests because this is the most important test that we could run for this kind of a problem. We've got to have these tests. Well, you're not gonna be able to see the the pictures that we're talking about here. And in fact, you know, I really do train like a lot of doctors every year and I just did a bunch of exit interviews today for doctors that graduated from the program. And the organic acid test is life-changing for practices consistently. If you're not doing this, you're really missing out on a lot of the fun that is inherent in functional medicine.
Let me show you the two extremes here real quick. And if you're familiar with these tests, this will make some sense. If not, then you should take my class. Here we go. Here's the one extreme. And you guys have all seen these, right? Where there's a whole bunch. Here we go. Finally found it. Sorry, I was scrolling around there. Yeah, this is the first page of the organic acids panel. And what we're looking at is fat, carb, fat and carbon metabolism and energy production. And when you see a panel that comes back like this and all these numbers are just cranked up, that means that fat burning is not working, carb metabolism is not working, and energy production is not working. There's an excess of all these different chemical, chemicals, there are all these different organic acids. And that's clogging up or representing the fact that the citric acid cycle is not, is not burning fat and carb. Okay.
When all these levels are cranked up, what we're talking about now tonight is when these levels are not cranked up. In fact, the patient's not even able to bring up these organic acid levels. Levels. Okay. That whole system has failed. And rather than having this nightmare scenario, which is a whole screwed-up mitochondrial problem in and of itself, they have this kind of scenario here where you'll see marker after marker that says DL, meaning Under Detected Limit, Under Detected Limit, Under Detected Limit, Under Detected Limit. Okay. What does that mean? That means that the number was so low, the lab doesn't want to even try to report it because they couldn't detect it. But it's a, it means extraordinarily low. Right. Here's another, under. So this patient isn't able to make these organic acids efficiently. And what does that mean? Well, think about it. Let's look at the mitochondria. Totally makes sense. But you know, honestly, like you could look at these labs for 20 years, as I did, and not understand this because, like, okay, that's low. And low isn't low is good, high is bad. That means low is good. And, you know, when I started working with Richard, the, we, this man developed this test originally, has personally analyzed and seen every one of these labs ever run, you know, for decade after decade after decade. He started to realize, "What am I? I designed this test, intended to find high levels." But look what happens when these levels are low. What does that mean? And through his research in recent years, he discovered that the high levels obviously mean that there is a block, right? Something's building up because things are not flowing through this cycle. So if you have citrate high, it means that the energy production is not moving to that next step. If you have pyruvate high, it means that you're not pulling carbohydrates to that next step. So these high levels are bad and important to know about. But what does it mean when there's undetectable citrate? When there's undetectable hydroxymethylglutarate? When you've got six or more of these markers that are undetectable, it can, not in every case, but it can very frequently reflect a hypo metabolic pattern.
So think about this. If this thing is spinning around, but it's dysfunctional, at least you've got a bunch of high levels. And that's your typical patient who's not doing well. But those people are going to respond to treatment pretty quickly because you put them on the right supplements, you get this system working, the wheels already spinning, it's just a little off-kilter. But what if this wheel's not even spinning? What if the mitochondria just aren't there? Remember, the mitochondria in this example are damaged, they're lost, they're dead, they're gone, they're destroyed, or they're wounded, they're limping around. What if you don't have this wheel spinning properly? It's not even moving. That's the hypo metabolic pattern. And that's an extreme example of what can happen when people have mitochondrial dysfunction. How common this is? It's pretty darn common. You know, it's once you, you can like get the clue about how to find it, you're gonna see this all over the place. And he's going to be your worst patients. We just don't respond to anything because they don't have nutrient deficiencies reflected in these high levels of organic acids. They've got, like, I don't know, like mitochondrial collapse or whatever you want to call it. That's this hypo metabolic pattern right there. This thing is just, you know, it's not working. It's like if it was, if it was a car, because I always think of life in terms of cars because I'm a car guy. You know, the high levels of organic acids are someone who's got the gas pedal floor, they're going way too fast, and they burn through all their oil, and you're just sitting there waiting for the engine to melt. This actually happened to a friend of mine recently. It's not funny, but it's kind of funny. She ended up driving her car when the oil, after the oil light came on, and she drove it for a while, and then of course, the engine like overheated. But not like overheated like the, you know, the water's boiling over, like overheated like the engine seized up and melted. It's not funny, but it's kind of funny in a way. So I mean, that's that's like overproduction of organic acids. Well, what we're talking about tonight is like the engine's not even starting, right? If it's, this is just kaput. This is more serious.
So we're blaming this, just to have one victim to blame here, on toxins. Of course, there's many other variables, but I think toxins are probably one of the biggest variables that would drive this problem. And it's going to be part of your correction to want to try to deal with the liver and the detox capacity, restoring detox capacity. Okay. And when you think about liver, we think phase 1, phase 2, in terms of restoring liver function. And these are some of the basic nutrients that you need to do that. You're familiar with sulfur-containing amino acids, you got your B vitamins, your antioxidants. So you want to get the liver up and running. But, you know, one of the things that's not depicted on these charts with phase one, phase two, is that what's running phase one and phase two? And this, I described to patients, it's like a washer and dryer when you're washing your clothes, right? And so you throw your clothes in the washer, you wash them, and you throw them in the dryer, and then they were clean. But what if you throw your clothes in the washer and you forget and you leave them there for a week and you come back? Oh, not so nice, right? They get all moldy and gross. So you got to have both phases working. But what if you unplugged the washer and dryer and there was no electrical supply? There's no energy. Would the washer and dryer work? Not very well. So what is the fuel? What's the energy? What's the electricity that's making these pathways work in the liver? It's cellular energy called ATP. And that coming from the mitochondria that we're talking about. So guess what? If your mitochondria are so messed up that they're not making ATP, your liver is going to get even worse. And that's where our patients are at. They're in this vicious cycle where the toxins mess up the mitochondria, and then the messed-up mitochondria make the liver not work so it can't clear toxins. And that is, you know, chronic illness in America today. I think this is happening incredibly often.
Oh, hey, that's me in a in a nice shirt talking. And this is my reminder to tell you that you should take the class. We're really are starting a class in a week. I'm more excited about it than ever, mostly because Dr. Lord has up-leveled my understanding of labs and I'm as accurately as possible communicating what I learned each week to the students. So we have our regular curriculum, which rolls out, which is excellent and has been for many years. But then we have this overlay, a much more advanced understanding that's come my way in the last year, and I'm sharing that as rapidly as possible in every class, every week. So we really got, um, I don't know, I've up my game quite a bit in the last year. If you've been hanging around for a while and not taking the class yet, this is a good time to do it. Okay. And if you're an existing student, you've already been through the training, we're gonna be releasing these materials as well. You can join the community if you've been through the class already and and get access to this stuff. So the class has a community feature where we have a couple thousand case studies. I was talking to one of the doctors today and she said whenever she would get a complicated case, she would enter in the parameters to our database and up would pop something that would help her tremendously. In other words, we have two thousand case studies in here of real patients and there's an endless amount of learning that you can do within the community feature. You can also connect with other doctors and, and there's really wonderful things in the community. And then the, the curriculum rolls out here in terms of, you know, structured videos that are the course itself. And then we have the live weekly calls where you view labs. So those are the three components: there's a community, there's the curriculum, and then there's the live weekly calls review labs. Okay. And we're opening up on our enrollment. Yet, 500 bucks off if you can remember that code, SEP 17 MNT R. That seems kind of complicated. I don't know why we made it that complicated. Sept 17 M and TR. Yeah, five hundred bucks off the class if you enroll in the next week or so and you can remember that code. If you can't remember the code, you can email me, we'll give it to you.
Okay, let's get back to the good stuff here. So oxidative stress. If we don't need to talk a lot about that, everybody kind of knows what that is, right? It just messes people up. We could, there's a whole, you know, we could do hours on that. The key here is, you know, the analytics. I think that it can slip by because I don't see this stuff being taught everywhere. Organic acids testing is going to check the detox pathways, it's going to measure mitochondrial health at the same time, and it's going to measure oxidative stress. So, in other words, you're actually testing for everything that shows up here. Every step of the citric acid cycle, highlighted here, is tested for. That's important. So, you know, the ATP supply can be restored. And hey, I'm telling you, half the time, this is the major problem. They just don't have enough ATP. So nothing's working. You can't force someone's liver to detoxify, don't have the energy supply to make that happen. You can't force someone's brain to think properly if they don't have ATP. You can't get someone to exercise or move their muscles around if their ATP levels are low. So those are the three big systems we see getting nuked from mitochondrial problems. Liver detox pathways get sluggish, the brain doesn't work very well, and muscle tissue and exercise kind of stuff becomes a challenge. And those are the patients who will come in and they'll say, you know, "I just walked up a flight of stairs and I'm tired. I can barely get to the car and get to work." They're not making it up. They just don't have enough ATP.
So now, think, think about this. Maybe get a little technical for a minute here. Organic acids are intermediates or end-stage markers of metabolism of energy production. Most of them. Most that test is now. There's other things on there, obviously, like, you know, transmitter markers and, you know, there's a whole series of GI markers. But that, the bulk of the first couple pages of the lab are really about metabolism. High levels of these intermediates is bad. And that's what we think of as a nutrient deficiency that we're going to fix. But low levels mean there's not even enough amino acids, there's not even enough of these components to make the metabolites. So you get these markers that are low, after low, after low, after low. So if you're tired when these amino acid, when these organic acid markers are high, you're going to be extraordinarily tired when the levels are low. And then the goal, then the job, then becomes to identify these hypo metabolic patterns, see if there's a thyroid component to it as well. It's super important, gotta check thyroid. And then start fixing the mitochondria and the thyroid together. And boom, you're gonna get someone who gradually starts to come out of this nightmare versus just wallowing in it.
And I had, I mean, this happens to all of us, doesn't it? You know, this happened to me today, actually. I don't always do this right, to be honest. And this patient came in and she's, "I've been on this program for three months, I'm doing everything you said, and I'm gaining weight." Now, my defense, turns out that this is her story. The patients are so funny, is that she did the program perfectly for like a month, and then in the middle of July, she stopped all the supplements. And then now, I don't know, what is it, September? So she didn't really execute things very well. And it wasn't totally my fault. It was my fault in a way that I didn't get her to stay on the program. But the stuff works, typically. It's just slow going when people have this much damage going on. My mitochondria, you know, makes our energy. You're not gonna worry too much about that. There's another image of your mitochondria. And of course, you might have country needs carnitine to to process fat and whatnot. But let's think about the corrections here, like, how are you gonna get your mitochondria to come back online if you have this hypo metabolic pattern? You know, what are going to be the keys to making that happen? Well, there's a few things that are sort of extra special that are required. One, if you form amino acids, you need them to make that Kreb cycle spin around. You see a lot of those markers on that Kreb cycle diagram, or amino acids. You need, of course, CoQ10. And that's, or the central player, PQQ. Most of you are probably familiar with that. That's a product that restores or repairs mitochondria. B vitamins, some generalized mitochondrial support, that's like a multivitamin. You got your magnesium, all the stuff that, you know, you need for energy. And then tryptophan. And that's a strange one, isn't it? So, you know, tryptophan, it's a weird, it's a weird amino acid, right? Because I don't know, was this 30, 35 years ago, something like that, a long time ago? One bad batch of tryptophan landed on the American shores from Japan and a bunch of people died from it. I don't know, 20 or 30 people died. I actually went to college with a guy, Eric, who's mom was one of the people that died from the tryptophan toxicity problem. And so the FDA banned tryptophan and every supplement company stopped selling it for quite some time. And they've been a bit gun-shy, even though it's decades ago now, to bring tryptophan back. So a lot of the formulas that we use that have, you know, combination freeform amino acids do not have tryptophan in them. And, you know, I never really thought that much about it until I was challenged by my teacher, Dr. Lord. And he said, "Dan, what's the rate?" And he does this every week, every Monday, he'll ask me questions that he knows I don't know, just to mess with me. It's kind of funny. I've gotten used to it. At first, it was really embarrassing, but I've gotten used to it. So he's dead, "What's the rate-limiting step in protein synthesis for all proteins except for collagen?" I'm like, "Oh, man, I'm like, I know that." And I just threw out all these answers that were totally wrong. And he's like, "No, tryptophan." And I was like, "No way, that is not possible." Okay, you can look it up too. I did. I looked it up, but I didn't believe it. If I'm telling you, if I didn't believe it when he told me, why would you believe me? I'm like, way less credible than Dr. Lord. So look it up. Tryptophan is a rate-limiting step in protein synthesis in all proteins except for collagen. So you can't repair your mitochondria. Repairing and building new mitochondria is about protein synthesis, correct? You can't do it without tryptophan. And this is why we're so screwed, right? As most of the formulas that we use that have freeform amino acids have 5-HTP or no tryptophan or no 5-HTP even. But it doesn't matter if it's 5-HTP because 5-HTP doesn't do this. Only tryptophan does. Go figure. So tryptophan becomes a central player in getting these mitochondria to work again. Of course, we also use tryptophan for serotonin and melatonin problems and other stuff. But it becomes sort of, if it's not in the program, it's gonna be really hard to get those mitochondria that were damaged to repair and it's gonna be hard to get the patient to produce new, more new mitochondria. So tryptophan is an essential component of it. I know that sounds a little strange, but it really makes a big difference. And in fact, these people will have this hypo metabolic state in general, love tryptophan. It just makes them feel really, really good for a variety of reasons. You know, some of what we're talking about, of course, it's also going to kind of extend out to problems that are more associated with serotonin production, melatonin production, that kind of stuff. Okay.
So let's go here. Build more, repair some. So you want to build more mitochondria and then you want to repair the ones that you can. So I have this wonderful car. It's one of my two Alfa Romeos. And just since somebody here, let's see, let's just show you a picture of it. Oh, I could show you a picture of the other Alfa too, but let's show you the '71. And this is actually, I bought this car. This was a very, very bad idea and I'm not proud of this. There it is. There's my Alfa. So I bought this car and then of course, I ripped it down to the metal and we repainted it. And there, this, this guy in the picture here is a very famous restoration expert in Ferraris and vintage Alfas. And there he is working away on my car. And we took this whole thing apart. Now, this was the worst idea I've ever had. It's a, it was a 1971 Alfa Romeo. There I am with my Alfa. It's not even worth that much money, honestly. And to rip it down to the paint and to repaint it is just ridiculous. But the fun thing about this car is that it's sat for like 30 years. It only has 60,000 miles. Lyman. Okay. It's like a 50-year-old car with hardly any miles. But it's sat for, you know, like 30 years. And so guess what happened to the engine and all this other stuff? Not really good stuff happened to it. So every little thing in here, once we started to tear this car apart, it had to be rebuilt and restored. And it's just become this insane project. So if you leave something in an inactive state, whether it's an automobile or a mitochondrial system that's not getting any exercise, getting it back up and running is going to be a serious pain in the ass. Okay. And so if someone's very physically fit their whole life, it's going to be easy to get their mitochondria back on line. If they've crossed over to that point where their thyroid and their metabolic rate and mitochondria are so poor that they haven't exercised, they don't have much much muscle tissue and they're not physically fit, then getting them to build more mitochondria is going to be like me fixing that '71 car. Okay. It's just going to be, I mean, I put probably three times the value of the car into trying to fix the car and it still doesn't work very well. And I still haven't given up. I'm just not going to give up on that car, no matter what. But does that make a lot of sense? No. Now, if someone had driven that car every year and maintained it, it would have been really easy to fix. So these hypo metabolic patients are like a car that's been sitting outside for 20 years and hasn't been run. It's a lot of work to get it, you know, to get these mitochondria back. And a lot of this is going to center around, obviously, their ability to exercise. And the mitochondria levels, you know, clearly are so high in muscle tissue, that's a super, super important thing.
All right. So now we talk for a moment about thyroid. There's not a thyroid lecture by any means. I just want to skim over thyroid so we get a general sense of how that ties back to the hypo metabolic state. Because here's the problem. Well, first of all, here's the problem. So the patient comes in, you do your adrenal program perfectly, and they're not any better six months later. Bummer. The thyroid didn't respond, their adrenals didn't respond, nothing responded. Patient comes in, you do the best thyroid workup ever known to humankind, and they don't respond. They respond like 50%, but you just are not really hitting it. Those are the patients that typically have this hypo metabolic pattern with the mitochondria not revved up, remember, but collapsed, not going too hard and not just throwing off all these high markers, but throwing off these undetectable markers. That's your classic person. Now, if you just try to correct this with the mitochondria alone, you'll get a decent response, but it won't be the same as if you correct the thyroid and the hypo metabolic state at the same time. In fact, I guess it makes sense, right? This is how we think about metabolism is being regulated by thyroid. So if your mitochondria are that damaged that all these minute block processes are slowing down, it makes sense that there's going to be a compensatory slowdown with the thyroid. It's all kind of pulled together, right? These interactions between these. And of course, the things that screw up the mitochondria are the same kinds of things that screw up the thyroid. And if you want to blame it on something in a word, you could say inflammation, right? That's inhibiting or preventing T4 conversion to T3. And you may or may not see that on the labs. In the subtle or cases of this particular pattern, the thyroid testing can look pretty good. And what, and I've learned this from the doctors in my group. So, you know, Richard taught me this concept, I taught it to my doctors, and six months later, you know, we're on these phone calls in the class and I got like three or four doctors in a row saying, "Oh yeah, I'm using that hypo metabolic block pattern with all my thyroid patients." I guess. And that's how all this, you know, just sort of breakthrough discovery thing came about. But the correction of the thyroid in this instance, if the blood work on thyroid isn't so bad, can be very simple. General thyroid treatments that are non-prescription items, the seleniums of the world and the thyroid gland jewelers of the world and those kinds of products combined with the hypo metabolic support for the mitochondria can be enough to restore thyroid and mitochondrial function. And if it's not enough, which it typically has been in these cases, then of course, you can escalate and get prescription thyroid treatments set up as well. Not against doing that. We're just saying that most of the doctors in my group doing this are trying to get the thyroid back online in the non-prescription kind of way and see if they can reboot the system. And if not, they're escalating to the, you know, prescriptions for thyroid.
So, effects of suboptimal thyroid function, pretty straightforward. They'll know that. And then it's stress-related, clearly. We know that. And the problem can express hypothyroidism. But remember, a lot of patients with this hypo metabolic/thyroid pattern, the blood work for thyroid will be okay. And here's the disease, the tricky part is that the things that mess up your mitochondria, inflammation, stress, infections, it's the exact same list of problems that messes up your thyroid, right? This is a thyroid slide. We could just swap out. You can either put mitochondria up here or thyroid up here. You wouldn't have to change any of these other things because they're the same. Which is why this pattern seems to be so consistent, okay? So inflammation, yes, mitochondria damage and thyroid damage. Stress, absolutely. Infection, absolutely, right? Each one of these items, even insulin resistance, is going to damage in mitochondria and thyroid equally. So, does high cortisol? Of course. GI problems. And then toxins, which is kind of focused. So it's the same list, right? That makes sense. And it's funny how things that you, you learn, you know, when we're talking about this last week in class, and it just all makes so much sense. The more you think about this, it's like, how do we not notice this before?
So inflammation, you know, it's at the heart of all these things that we're talking about that decrease in T4 to T3 conversion. So the, you know, conventionally run thyroid test can miss this problem. If you're not doing the more in-depth thyroid workups, you can have an issue there. Okay. And then everything's coming about because of inflammation. That's kind of an everything's happening slide. But I'd like this one more here because what's going to happen then, obviously, if you have problems with T4 as it should be converting to T3, the more active hormone, then what's going to happen to your reverse T3? It's going to go up. So in this hypo metabolic pattern, we commonly see high reverse T3, low T3. There's a common connector to this hypo metabolic pattern. However, I will repeat that you can also have perfectly normal blood work for thyroid and have a mild version of this problem going on, which you can treat then with non-prescription treatments. But this is all just basic thyroid. We're thinking about reverse T3. You obviously don't want those levels going up. It can become harmful over time. And eventually, there's this downstream effect, you know, that cascades throughout the body. So we're looking at TSH, T4, T3, free T3 and T4, and then thyroid antibodies. And just saying, basically, if you get a patient who's thyroid labs are not too bad yet, or a patient whose thyroid labs look normal, but they have this hypo metabolic state on the mitochondrial side, non-prescription thyroid support combined with mitochondrial support is often enough to really make the difference. Whereas if you just do one aspect of that, just the thyroid, just the adrenals, just the mitochondria alone, you're gonna get what would you say? Poor outcomes, inconsistent outcomes, inconsistent outcomes, let's put that way, or partial corrections. And just like, you know, you didn't quite get it all.
So when we're thinking about thyroid treatments, again, this list is, you know, generic to all the things that we do, right? Inflammation, treated. Correct the insulin resistance issues with diet and supplements. Correcting the adrenals. Although in the hypo metabolic state, this doesn't help a lot. In fact, in my patient practice now, I'm not even bothering with adrenal program answers radical. I'm, I hope I don't get into trouble with with my, so for saying this, but it's true. I'm stating truth. So in my practice now, if I identify this mitochondrial/thyroid problem, I don't even touch the adrenal programs. I don't even start patients on them. I feel bad saying that, but I don't because I just have a gut feeling it's not gonna work. And, you know, and I kind of started to stumble on this. And, you know, half a dozen doctors in my training program all came to the same conclusion. And a few months ago, I was just like, "Screw it. I think why I try to beat the adrenals into some balance when just not ever seeing it work." And so this is a, you know, one of the rare cases where I would just say, "Hey, I know your cortisol is not doing very well, but we're going to focus on these other issues." And there may be a deeper, not a deeper, but a different level of correction here that we could achieve. And then of course, we do not skip all these other things. We still balance the GI tract and we still look at the microbiome. And doing a lot of extensive work right now with the GI FX test and analyzing the microbiome. GI FX test is another one of Dr. Lord's projects. He spent 10 years researching for that test. And so, you know, this, it's not in isolation that we're doing these thyroid and hypo metabolic pattern treatments. But, you know, it's a really important component.
So let's take a look one more time. I want to show you some of these labs again so you can see how this manifests on an organic acids test. So let's look at what it's not first. So if you see across the board high levels under fat metabolism, carb metabolism, and energy production, look at this. There's a high, borderline high, there's a high, there's a high, two more high levels, borderline high, high, high, high, elevated, elevated. This is a mitochondrial system in distress. But this is the car that's going too fast with the gas pedal all the way to the floor and the engine's melting down. But it's still running. That engine light just came on. And if you hurt it like my friend did, engines really do melt. I just kind of think it's cool that that can even happen. Like, who would have thought that it could even happen? Did an engine could melt? But yeah, they can melt. So this is like the engine right before it's, it's getting ready to melt, but the car's still running fast. And it's still a problematic pattern to fix.
And let's look at what these markers are, so you're really clear on that, in case this is relatively new for you. Adipate, succinate, and ethylmalonate. That's how we shuttle fat acids into the mitochondria for fuel. And that's regulated by a nutrient called carnitine. So this patient needs carnitine. Pyruvate, lactate, and hydroxybutyrate are markers that show how carbohydrates are burned up for fuel. I'll show you an example of that in a sec. And then this is the actual mapping of the citric acid cycle itself. These steps here, 7 through 14. And then if you flip to the next section here on the test, you'll see the other component here of the metabolic burn rate are all these B vitamin markers. So that's going to include markers for B6 and biotin and B12 and folate, all these. So now, in a patient who has high levels here, or normal levels here, or a few lows here or there, we're figuring, hmm, mitochondria are damaged, but at least the wheels are still spinning. At least, you know, it could be a lot worse. If you want to see a graphic representation of that, let me just cut over to that so you can see. I don't know, I always have to visualize things, but I don't really understand that. Maybe know if that's just me or not, but here.
Let me show you here. So I'm clicking on the wrong thing. Will be clicking all day. There we go. So here we have carnitine pulling fats. That's that first series of markers. At a paid super a Tafel Melanie, we have our carbs getting burned up for fuel. Remember pyruvate, lactate, hydroxybutyrate. So if these markers go up, it means that there's a block in these processing. Something's blocked. It's not working. Similarly, when you look down at the citric acid cycle here, if something like citrate goes up, it means there's a backlog, right? It's not moving forward to that next step. Anyway, I try to explain to patients, it's like a chain, like a chain that you lock a bicycle up with. If there's a broken link, you know that the chain's not going to function well. And so in this particular patient that we just looked at, there's a broken link in the chain here. There's a broken link here. There's a broken link here, right? All these levels are elevated, implying that this system is not pushing forward as it should. Well, chemically.
Now, that's step one of messed-up-ness with mitochondria. Now, when we look at this next lab here, and you know, this isn't too hard to identify once somebody tells you about this. And there we go. This is just a lab from class from the other day. So now, that's again, look at the same markers. We're looking at fat metabolism. Yeah, it's okay. Looking at carb metabolism. Woops, undetected, undetected. Then we go down and we look at energy production. Now, some of them are okay. But wait a minute. All these DLS underneath detected limit, underneath detected limit. This one's borderline low. This is these three in a row or so low they couldn't find them. So if you get six or more that are low or underneath the detected limit, low being, you know, in the first quintile here or underneath the detected limit, you start to think that this could be a hypo-hypo metabolic state, and the person's just not making enough of these chemicals to get reactions going, right? It's like again, this is the car that won't even start, just fixated and stuck. And that explains why people come in and they'll say, I don't know, I'm eating 1,200 calories a day, I'm at the gym working out for an hour and a half every day, and I still put on weight since I saw your last doctor. Killers, how could that possibly be? And then you're thinking, well, either you're lying about your food, or you don't work out at all. Like, why are you still chubby? And you know, realize that, hey, it's cause your metabolic processes are kind of turned off, right? Things have shut down. Things are not working properly anymore. And that is the state of affairs in America here, where we are almost all becoming fat. And how many am I? How many of us are toxic? You know, just about everybody.
So key concepts: adrenal and thyroid issues arise together. Our immune theory is a common problem. Thyroid problems mean look deeper. But when we're looking at the hypo metabolic state, these basic roles that I usually apply don't apply because it basically means that the hypo metabolic state is overriding these normal connections between adrenal and thyroid. This metabolic state is generating so much tissue damage and so much of an inability for the body to do its normal processes because, you know, ATP is such a mission-critical ingredient. And all that, that even the best adrenal program is going to fail. But if you can get a decent thyroid protocol together along with a mitochondrial support program, you're going to start to see results in people. Now, this is not a quick fix. This is a gradual kind of improvement thing. It's gonna take place over time. All right.
So our class is starting next week. Yeah, it's the 25th. We have, as I mentioned, expanded the content dramatically. We have a wonderful curriculum that is just getting better and better. We have our community with thousands of case studies and all kinds of clinical application tools. We have live Q&A time with me every week. We just review lab after lab after lab. And we have, I think now, just it's just a wonderful community of doctors that I really enjoy teaching and working with. And it's a very collaborative effort. You know, we're all in this together. A very action-oriented group. You get a discount, $500 off if you enroll in the next week or so with our impossible to remember code down here, Sept 1700. And TR stands for mentorship. I get it now. It's September 17 mentorship. Okay, it's September 17 membership. The year 2017. That makes sense now. Don't use that for your code for your like bank account or something because now it's all over the internet.
I'm going to open it up for a couple minutes of questions and then we'll wrap up. So let me see. You got some questions that came in here. My hat, my staff is stalking me now because I, I didn't know you were listening. Oh, I get in trouble so easily. But and like I think that these things aren't recorded, you know, like I can't get away with anything because everything that I teach is recorded now. So and I, if you notice, I didn't hardly swear at all tonight. That gets me in trouble. If I talk about politics, I get in trouble. I just try to keep a low profile as much as humanly possible. Okay, let me look at some questions here. Um, how does autoimmune relate to this? That's a good question. Well, we've talked about this quite a bit in class. Some of these patients have autoimmune thyroid, but that's not, it's not all of them. So I don't know that there's a necessity that autoimmune gets dragged into this, although we do see that in some cases.
Next question. We can't order the test with lactate and dr. Bennett halls are still worth running? Oh, absolutely. Yeah, yeah. You're only missing two markers and that's fine. I would, I would totally run the tests without those markers. In New York, let's see. Do you have patients just take the test or come off nutrition first? It's a personal way that I do it. I always have patients stop their supplements prior to the test. It's very legitimate and many doctors have patients stay on supplements during the testing. I don't think that's a problem. It's just easier for me, you know, to remember because think about it. If you have patients taking supplements while they do the tests, then you've got to remember and have written down exactly how many milligrams of everything they were taking. And I don't know, in my practice, that would be a near impossibility. We'd have to wrestle patients to the ground. We'd have to handcuff them to my office manager. She would have to walk home with them, get their supplement bottles, take pictures and send it back because people just don't self-report very accurately on that stuff. So in order to save that kind of a fiasco, I just have a blanket rule, just stop all supplements prior to the test so that we can get an accurate baseline. That's how I explain it. I'm, I'm all about not having to track things that are impossible to track.
Let's see. That's a good question. J2 might've conscience and thyroid treatments boost agay? I don't know yet. I haven't really been. I don't know yet. I wish I didn't know that, but I don't know the answer to that. If lactate and pyruvate are high despite a lower carb diet and my toe markers are moderate, what would you suspect? Well, here, and the lab that we used here, this is an organic acids profile from Genova Labs. It's panel number zero-zero-nine-one, organic acids comprehensive organic acids. So, um, let me show you the answer to that one here. So if, now this is, we're gonna get a little deep here for a moment. All right. Originally, this test was designed by Dr. Lord, according to Dr. Lord, as a way to screen for genetic disorders. Okay? So 35 years ago, 40 years ago, Richard sitting down thinking, hmm, how could I run a lab that would identify genetic disorders related to nutrition? Okay? And this is like, two generations before 23andMe was conceived. This guy was so far ahead of his time, it's mind-numbing. And so he thought, well, wait a minute, how do we screen for genetic disorders? Now, we use organic acids tests, organic acid tests, a few of them to determine, to determine inborn errors of metabolism in newborn babies that are potentially life-threatening. Hmm, I wonder if that would work with adults. And that was the birth of organic acids testing. Was that concept that he came up with? So this test was originally developed, and you got to really remember this is like its most important fact of tonight, okay? So I'm glad you asked this. I think Karen or Doreen, I forget who asked this. I was Joanne. Glad you asked this. Most important concept for tonight is that the origins of this test are to determine genetic disorders of metabolism that do not kill you when you're an infant, but that can really screw you up as an adult. So if you see an extremely high marker on a patient, and it doesn't make sense because it doesn't match what they're doing with their diet, and this happened to me today actually, it was with a B6 marker. A patient who has been on B6 for years. I put her on an even better quality B6 and we redid her organic acids twice. This is going on for a year and a half. And on the third test, guess what? Her B6 markers are still totally screwed up. That's an inborn error of metabolism. That's a genetic defect in B6. And if you want to run all the SNP testing, you can correlate it with organic acids. It should jibe perfectly. It should connect perfectly. So high levels of an organic acid that don't make sense can often be a genetic disorder, a SNP, right? We would now, in the modern era, call it a problem with a SNP. And if you ran enough SNP panels, you'd probably figure out exactly which one it was. But what that means is that the implication of that is profound, which is that this test is a functional assessment for problems with SNPs. The question is, is that SNP expressing itself? Is that genetic disorder expressing itself or not? There's a general rule of thumb to determine if you think the problem is genetic or not, which is that you look at the reference range over here, 95% reference range. If it's double that range or more, if it's double the reference range or more, then it's very likely there's a genetic disorder. And it doesn't matter how the person eats. It doesn't matter how my patient today, how much B6 she could take. She could take a gallon of B6 every day for 16 years and we would retest her. She would still be low in B6. It's a, it's just a perpetual ongoing need. And then the patient's gonna ask you this question, does this mean I always have to take B6? And the answer is, yeah, if you want your B6 to be okay. If low B6 isn't bothering you, then maybe it's okay. If you want optimum nutrition, then, you know, you should be on B6 basically for the rest of your life.
Doreen is asking, can this mitochondrial dysfunction be related to secondary hypothyroidism? Absolutely yes. We've discussed that quite a bit in class. And as one's pituitary become fatigued? Well, it's all the pituitary, isn't it? You know, so it's the HPA axis. The HPA axis. So if you really want to start blaming tissues in the human body and you wanted to escalate your blame level, you could go up to the pituitary and probably have a pretty strong argument there as well, in terms of thyroid dysregulation, then there, adrenal hormone dysregulation. I like to blame the adrenals and thyroid because most people don't know what the pituitary is. But I know that's interesting. Joanne just said that this person does have some SNP problems, the pyruvate lactate person. All right.
I think we got one more minute. Amazing. I have one more question before time expires. This is again, the organic acids lab from Genova. I can show you like the header here. We don't have it. These are all stripped out, but yeah, so it's Genova Labs. There it is. Lab number zero-zero-nine-one, organic acids comprehensive. It's for most of the doctors that I work with in our training programs. Really, you know, 50, 60% of my practice is oriented around, you know, intervening with results that are great, you know, you know, results that are based on this test leading to interventions. In fact, I mean, I practiced for 15 years without doing these on patients consistently. I can't imagine. I can't imagine even talking to a patient without these numbers in front of me now. I would just feel like, what's the point? It's such a critical test. Look how I messed up this person is. Look at that. Like you just got to know their stuff and you can't look at someone and tell that this many markers are off and understand what the priorities are, what it all means, you know? Wow. We didn't look at this one yet. We're gonna wrap up. We got like 30 seconds, then we're gonna stop it, promised. But look how messed up this person is. And LI N means above the limit that they can measure. That marker was so high. Holy moly. Look at this. Wow. Look at this. That's 87 on a lactate. Look, it's a, it's, it's considered elevated above a 12. Okay? This person's at an 87. Right back to our genetic disorders of metabolism, right there. There's one right there. You can pick out so many different ways to look at the test. You can find out all these cool different patterns. You learn about the genetic disorders that your patients have. You get an understanding of where to start them with supplements, how long they're going to need to be on supplements. It's a wonderful test. If you don't know all about it, sign up for the class next week. Everybody loves the class. We're talking about it today. Everyone that I can talk into doing the class loves the class. Somehow that's how it works. If you're skeptical, give us a call and we'll connect you with one of the doctors that has taken the class that loves it. And you can become part of our special community of wonderful people over here at Catalyst Institute. All right guys, we'll do another one of these free calls in about a month or so, six weeks before the year's up. And I hope you have a great rest of your evening. Goodnight for now.