Transcription
Which I guess is an auspicious number. So just watching people flooding, it's like when you're at a stadium and you're watching people coming in. So I'm just killing time here to give another minute for Beulah login. But I am from Oakland. I do live in Oakland, and my office is in Oakland. My training program is based out of Oakland, and I just went to an Oakland Warriors game. If you haven't, even if you don't like to watch basketball, even if you don't care about Oakland or the Oakland Warriors, watching these guys on the court, it's just the most amazing thing. They are just like flowing with this energetic thing. You can't even believe they don't even look at each other. They pass the ball, they make baskets that no one else has ever made in the history of the game. It's really inspirational to be alive and well in Oakland right now. Super excited about the Warriors, and I go to games whenever I can. Pretty exciting.
All right, enough chitchat. You guys, just jump into it. So I want to talk tonight about restoring mitochondrial function. And this is a second in a series of talks. If you haven't heard the earlier ones, they're all recorded. Welcome to go back and listen. And for those, those that are new to all those new to me, I've been in practice for a long time, over 20 years, with thousands of patients. We've trained a lot of practitioners in understanding this basic model of functional medicine that I use. I have spent more than my fair share of time in monasteries throughout the world, mostly in Thailand and in Japan, and a little bit in Nepal for a few months. And you know, one of the things that really strikes me now, I was working with patients all day today, and you know, what really strikes me now is how much my spiritual practice and spiritual training with the monks, and my current training that I do now with the Daoist teacher, how much that impacts my patients directly. You know, you would think it would be kind of subtle, but when you run the same protocols, like I have for 20-25 years, and you see better and better results with the same exact supplements, you know, it's not the supplements. I'm doing the same things I did 15, 20 years ago, but it's that deeper spiritual connection that I can strike with patients now. I'm just getting better at it. I mean, after 25 years, one would hope you would get better at it. I'm sure another 25 years from now, I'll be that much better. But one of the things I think that's accelerated my practice, the growth of my practice, the profit of my practice, the results I get from my practice, the patient referrals in my practice, with the real great accelerator of that in the last decade has not been me learning more about, you know, what CoQ10 does, you know, mitochondria, which is what we're talking about tonight. But what has really killed this growth for me personally and professionally is a spiritual war. So I just want to encourage you, if you're not doing your own spiritual practice now, it really is one of the keys, if not the key, to success. You know, what we're doing, and this is my basic platform, understanding that physical health is our way towards, you know, emotional and spiritual growth.
So now we get into the science of it all, which is equally important in a lot of different ways. You know, we're talking about organic acids testing, which is basically a framework for looking at metabolic dysfunction. We're not really going to be focusing on specific markers, although I will show them to you today. But what we're really focusing on is what's behind the marker, what does that mean behind the scenes, what's really driving this, okay? What's really driving this? And another thing is, they got to see this because it's so important. I'm going to say it every single time, is that it's a micronutrient test. But we always start with macronutrients. What does that mean? It means, okay, well, if they have arginine, lipoic acid, and vitamin C deficiencies on the lab, it doesn't mean you start with arginine, lipoic acid, and vitamin C. Those are the micronutrient deficiencies. They're a second-tier issue. Where we start with is with the macronutrients. Perfect example of that today, patient of mine named Patricia, older woman, maybe mid-60s, horrible sleep problem, horrible sleep. On sleep, two or three hours a night. We kind of got her sleeping seven hours a night now. Strictly based on organic acids test results, which is incredible and wonderful. She's, I'm happy for her, but you know what really provoked the biggest change in all this was getting her to eat the right amount of dietary protein, which was again, a result that I had determined, you know, an amount of protein and determined based on the lab. So we always want to start with macronutrients, protein, fats, carbs, getting those ratios down, and then we start to work our way over towards micronutrient deficiencies, okay? So these are the common mistakes again that we just see. CoQ10 is that normal, and we just take that at face value without looking deeper. What we're looking at tonight is the most amazing combination of variables that strike together in a way to drag people down into this sort of endless pit of fatigue. But it's a combination, boom, boom, boom, kind of punch thing that's happening here, okay? So, in other words, there's mitochondrial problems that we're going to look at that are caused by oxidative stress. And we're going to look at that that is caused and turned by digestive or toxin-related problems. So you have digestion or toxin-related problems generate a lot of oxidative stress. The oxidative stress to excite your mitochondria. Patients tired. So we can fix the mitochondria, the oxidative stress, and we can go all the way back to the source and fix the actual problem, which is usually going to end up being either a gut or a toxin issue.
So these are the organic acids markers, and I just show this to impress upon you how ridiculously smart I am. Done company. I'm, you know, this is like, I'm like the dumb guy, I'm like the basic guy. I'm the guy that looks at charts like this and freaks out and goes, "Wow, what am I going to tell the patient tomorrow morning, Dr. Timmons? What am I going to tell the patient about her sleep problem, Dr. Moss?" You know, so all the people that trained me, I'm like, "Okay, I'm really into this five-hydroxyl acetate form array, then Amanda lay kind of biochemistry thing." And like, you know, I got decent grades in biochemistry class, I'm not dumb. But really, I want to be able to explain this in the language that we can communicate to patients. So this is a chart to show you that what we're going to focus on tonight is energy production markers. That's how you make energy inside the cells. Very important. And we're going to look at what would make their, what would create a problem there, what would cause a problem with your mitochondria. It would be if you had a lot of oxidative damage. And these are not two things that are necessarily intuitively connected, right? You wouldn't necessarily look at the antioxidant markers and go, "Oh, that's what's causing this mitochondrial energy problem." But that's, in fact, how the body works. So we're going to look at these two kind of seemingly disconnected factors, energy production over here, and oxidative damage over here, and tied together how oxidative damage causes energy production marker problems. And so we're not only going to be working on improving energy and reducing fatigue by looking at the mitochondria, but taking a step deeper and looking at our state of damage. So now, if you want to go one step deeper than that even, okay, one step deeper than that even, what's causing the oxidative damage? And that's going to be coming from either toxins or gut-related issues. So it's like a boom, boom, boom kind of thing, right? Toxins or gut-related problems cause oxidative damage, and then that ricochets over here, causes energy production problems. Now the person is tired, they're fatigued, and we have to unravel this. And that's what tonight's talk is about.
Then there's this list of supplements associated. And again, this is like total overwhelm. And remember, we just said that the micronutrients, we're not just doing micronutrient replacement here. But I just want you to see this because you've got to, you've got to know this too, then you've got to forget it. You know, and I know that, um, the soaps are so true in so many parts of life. When I was training to be a classical pianist, when I was in high school, I, I thought I was going to go to a conservatory and play classical piano. Those my whole thing. And so, um, you know, I played piano five, six hours a day. I was just really going into playing classical piano. I loved it. And any part of classical piano is, you have to practice scales. Oh, no, hours. Okay. But once you're practicing scales over and over for hours, and then you're actually playing a piece in front of a group of people, you forgot about the scales. You're just playing, right? So we need to understand some of these basic concepts like this, but then we need to forget that when we're working with the patient, start to think with this model here, in a patient-centric kind of way. Patient-centric kind of way. So we can look at it from the Four Horsemen, and that's my arrangement of catabolic physiology, insulin resistance, inflammation, oxidative stress, you know, the big physiological problems that are happening to people. We can look at it from a body systems perspective, which is where usually how we do the lab work, right? We do neuroendocrine, GI, detox labs, research titles together. You can look at the individual markers, and I'll show you all the markers tonight. But if that's overwhelming or confusing, don't worry about it because, you know, honestly, it's not important. That's not important. What's important is the patient, not whether they have a beta-hydroxybutyrate problem. So don't worry about them. Don't, you know, not do the test because the markers are intimidating. You know, then that happens to a lot of people. I help them sort of happen to me for a long time. And then we want to look at the most important part as a patient, what they're going through, okay? So they're tired and overweight, and we want to fix that, okay? And whether you understand all the intricacies of beta-hydroxybutyrate or not, you're going to be getting these people better, okay? So don't want to get hung up on the science too, too much, as much as we may enjoy the science.
So the Four Horsemen of physiological damage. So number one, inflammation. And these are the common factors that are going to be happening in all the cases that we're talking about tonight. You're gonna see these all, these problems, pretty much consistently. There's going to be catabolic physiology, these people are breaking tissue down. There's going to be insulin resistance, which is sort of the root of all evil, isn't it? And then the Pale Rider, the fourth of the Four Horsemen, you know, oxidative stress, which is what we're going to focus on tonight. Oxidative stress. But obviously, these are all linked. Inflammation causes oxidative stress. Oxidative stress, inflammation. Inflammation causes insulin resistance, and insulin resistance causes inflammation. You can go back and forth on this forever, right? But what we're doing is breaking this out into practical terms. You can see, "Oh, wait a minute, oxidative stress, yeah, it's caused by all these other variables, by inflammation, by insulin resistance, etc." But we want to actually measure it and correct it, you know, what kind of a patient-centric level. So this is, we're going to have talks on all these sections, and they're all recorded. You can email my office and ask them about how to get a hold of the recordings. There's no problem. We got everything kind of tucked away somewhere on the server. And the basic subjects that we're going to cover off of these sections, but you can see we're kind of methodically. We're going to look at the neuroendocrine system, and this is how I see this test. This is all just 100% organic acids, carbs, energy, and neurotransmitters. We're going to, later on, in a different lecture, talk about the GI and how this looks at small intestinal bacterial problems, an amazing test for that purpose. And then we're going to get into detox, oxidation, and methylation pathways, all these kinds of things. So this test tells you about each one of these. We're just breaking it out because it's such an overwhelming thing to take on. And tonight, we're really going to focus on oxidative stress and energy production. And why have I linked these two? Well, because you can treat them together. One causes the other. And the most common complaint that we see is fatigue. So why not kind of start here, right? And so I've also put energy production or fatigue-related issues up in the first body system. So we address this early on in every case. But you need this cellular energy for a lot of different things, right? You need the cellular energy to detox. You need the cellular energy just to walk up the stairs. I mean, it's pretty important. Metabolic energy, mitochondrial energy is pretty important.
So I kind of think that mitochondria energy production is a little bit of a mystery, and it certainly was to me for a long time. You know, and I also think it's something that we kind of skip over and ignore a lot. And well, I kind of know it's a problem, maybe you went to a few seminars about it, but, you know, because we don't have a practical tool for solving the problem, just kind of ignore it, you know, just kind of leave it alone. And so I really want you to get excited enough about this that you want to get into it and at least order some of the tests and starting to see how amazing and how effective this can be. So the goal is here, and we, I have an hour, obviously can't do everything. But how to get a general sense of assessment, why single nutrient protocols don't work, and then so basic treatment, so you can understand, you know, how these things poorly. Now, here's everything that we really need to know, which is that we're looking at the citric acid cycle or energy production here. And eventually, the outcome of the citric acid cycle or Krebs cycle is that we make energy, ATP, 30-some units of energy, right, are coming out of each cranking of the citric acid cycle. Now, what's going into the citric acid cycle to make the energy is, of course, our macronutrients, fat, carbs, and protein. So this is why macronutrients come before micronutrients. Because if you have a problem with all these amino acids down here in the citric acid cycle, what if that's happening because the person is not digesting dietary protein? Maybe they're eating a lot of protein, but they're not digesting it. You want to have, you have to make sure that the protein is being absorbed and they're eating enough of it to meet their dietary needs so that this is happening. So in other words, you don't want to be throwing a bunch of CoQ10 at someone if the problem is that they're not eating enough protein. The problem is they're not digesting the protein properly. So macronutrients before micro. I mean, when somebody told me that, that was just like a light bulb went on. I was like, "Really? Nobody told me that before? I've been doing this for 10 years." You think someone would have mentioned that the most important thing is, what I may hate to say, is always back to diet. Then, of course, there's fat, adequate fat, and carbohydrate, and how we're processing these. And we talked about in an earlier talk how carbohydrates go through pyruvate, lactate, how the fats are relating now. So basically, we're using these as fuel. But tonight, we're really going to focus on this portion of the whole scenario.
So now I have a passion and a love for film, and it extends out to watching poor quality movies. And with that, I've only walked out of a few movies in my life, but I like to watch everything. Star Wars, Star Trek, I've seen them all, okay? And now, the way I think about this, let me explain this to patients, is that of the Star Wars movies, or if you're more my age group, you can say Star Trek. So there's always a scene in every one of these Star Wars films where there's a starship that has to be destroyed. You know, and it's an intact, functional, living starship full of Klingons or Darth Vader, rich people, or whatever, depending on the film. And then somehow, you've got to, the good guys have to destroy it, right? And so they have to come in, and they have to launch enough missiles that they hit the starship enough times that the thing just blows up. And of course, if by the end of the movie, this is always going to happen. So think about your mitochondria. It's like a spaceship floating around in space. And there's things that you want to protect it from, right? The missiles coming from the ships that are trying to destroy it. And the missiles in our scenario here are free radicals. So free radicals are coming in, this is oxidative stress, right? Free radicals generated from oxidative stress are physically attacking the mitochondria. Now, we have this shield, as in all these movies, they're always, every spaceship, every starship has a shield. And that shield is this golden layer of protection. And the missiles just bounce off the shield. And even in the most recent Star Wars movie, they have to knock the shield down, then they can penetrate. That's always the same story. So that shield, these are our antioxidant protection. But antioxidants, do they prevent us from getting damaged by oxidative stress or free radicals? So if this shield is up, starship is saved, mitochondria is not damaged. But when the shield drops, you know, it's just a matter of time before that missile hits and, bam, starship is gone. So the mitochondria are just exactly the same. Out there, floating in space, they're these random free radicals from oxidative stress coming along and hitting. A couple of hits here and there, not a problem, especially if we have our, our antioxidant protection, our shield is up. Then you really don't have a problem because the free radicals just bounce off that. No big deal. But if the shields down, you know, what does shield down means? Shield down means there's not enough antioxidants, there's not enough protection, and there's a lot of free radicals coming in. Then, boom, boom, the thing blows up. And that's what's happening to all our fatigued patients. They don't have enough of that shield of protection. Their antioxidant levels are low, and they have a lot of free radical damage. And so the mitochondria are getting just like, literally exploded. Not a good thing.
So here's mitochondria, powerhouse of the cell. Is that amazing? Mitochondria consume 90% of the oxygen used by the body for us to date of phosphorylation. There's a lot of stuff going on here. And if you remember way back in school, you know, inside the mitochondria, you have all these things going on, the citric acid cycle, beta oxidation. You're basically making ATP and using a bunch of oxygen to help all that out. In terms of the mitochondria, it looks like, remember, has these cristae, these little involuted things that are kind of going back and forth, and has an inner and outer membrane. And what we're talking about here that we're worried about is what would happen to this delicate and beautiful structure if a bunch of missiles were launched into it? Kaboom, kaboom. And you don't have enough protection. The structure starts to physically become damaged from oxidative stress, from free radicals. And that's when we really start to worry about it because it's like blowing up the engine of a car. My son, until recently, in my lab, more than anything in the world, had a 1964 Thunderbird. And he loved that car more than anything in the world. I love that car. It's a beautiful car. If you guys don't know what a T-bird looks like, Google 1964 T-bird. They're just badass cool cars. And one day, he starts it up, maybe he was driving too fast, I don't know, I wasn't there. Boom, engine blows up. And I have a picture of the car. I'll show that later if we have time. It's the tow truck taking that car away out to the junkyard, basically, because it wasn't, or it was like six grand to fix the engine. It just wasn't worth it. It was gone. So that's what's happening to us. Our engines, where we make all our energy, are being destroyed. And it's really hard to repair them. And most people are even aware or cognizant that this is what's going on. What's happening inside the mitochondria? We're making ATP. There's all these other fancy things going on. But here's the sort of the most important part of it all, is that we want to be able to make energy using the Krebs cycle or citric acid cycle. It's a final common pathway for all our nutrients, remember, our macronutrients, protein, fat, and carbs. And it then produces in turn all these compounds. And you can see all the diagrams. You get into the biochemistry later, you can study this. But these are very relevant because we're going to see each step of the way when we can measure these different variables.
Now, what happens when the mitochondrial energy production is not working properly? Let me just get back if you're side so you can see. When this is working well, we generate some 36, 34 units of ATP per swing around of the citric acid cycle. And again, we're taking food and converting it into energy. So there's a gain of 30-some ATP, and that's what we'd like to see. And that's a normal energetic person. "Hey, I just had a healthy meal of food, now I have a lot of energy." That's that. Now, a lot of our patients, in fact, most of our patients, aren't using the citric acid cycle properly because they're under stress and they're not able to run these ATP production pathways under the citric acid or Krebs cycle. So they're using an alternate pathway. It's called the Cori cycle. And this, we learned in school a little bit, but we didn't focus on it too, too much. But it's very important because most of our patients are doing this. So instead of making energy and a plus 36 ATP when we run the Cori cycle because we're stressed, we have a net loss of energy of about four units of ATP. It's in that loss. So in other words, when we're stressed and our mitochondria is not working properly, we're not making energy properly, what we do is, it's not like my son's car, okay? 64 T-bird engine blew up, car didn't move, tow truck came, took a car away, very sad for all. But with a human being, when the engine blows up, the mitochondria are damaged, we have a backup system. This Cori cycle is like a backup engine on a car, if you had a second engine. But this doesn't work very efficiently. It's a horrible long-term solution. Horrible, horrible long-term solution. So what happens with the Cori cycle is we can take glucose, if it goes through glycolysis, we make all this ATP, right? We make a couple units over here. It ends up as lactate. This all starts to happen in the liver, okay? Liver gets stressed as well. We go through gluconeogenesis, but it takes six ATP to make this wheel spin, and you only get two back. So it gains you two, but it costs six. This would be like that, or no, like the entire country of Greece, right? If you start to spend more money than you're earning, you can do that for a little while, but eventually your economy collapses. If you haven't seen The Big Short yet, it's a wonderful film. We'll kind of discuss how if you loan out billions and billions of dollars for home loans, but eventually people can't pay you back, the whole thing collapses. So if you're running your energy production at a net loss of four units of ATP, you can make the energy, you can force yourself to get up those stairs, but you're going to be exhausted. And this is where most of our patients are at. They're running the Cori cycle instead of the Krebs cycle. Not a good thing. Negative, negative, not a good thing. You want to stop that. So if we can just fix the mitochondria, we can pull people out of this. And of course, this has to do with emotional stress, dietary stress, inflammation. There's lots of other things. I'm simplifying it. It's nice so we can just learn a chunk of this. I'm not saying this is the only thing you need to do. This is just a key thing to do that most people don't know about, okay? But of course, you want them eating properly and all these other things as well.
So in the mitochondria, you should have aerobic respiration, right? That's with oxygen. And what happens when things are not going well is this shuts down. There's our ATP getting generated, 34 or 36 units of ATP. That's the good part. This gets shut down due to stress. We start to, instead, go through anaerobic processes, right? Without oxygen. And this is where we start to lose energy rather than gain energy. So fixing the mitochondria has a lot of repercussions. There's another variable to this which is important for people that have excess body fat, which is that we use carnitine for fuel as well. I'll be, I'm sorry, we use fat, fatty acids for fuel as well. And in order to take fat, fatty acids, and use them for fuel, we have a nutrient in the body called carnitine. The carnitine is kind of like a, it's like a truck that's just moving things from place to place. It's like a semi-truck, okay? So carnitine picks up fatty acids and pulls them over to the mitochondria where the fat is burned up for energy. And if you don't have enough carnitine, you won't be able to burn fat for energy. And this is another reason why a lot of people are tired. They don't have enough carnitine in the system. Now, you can get too much carnitine, of course. And I'm not saying that carnitine is like the single solution to burning fat for everyone. Carnitine levels are lost due to inflammation. So there's a lot more going on behind the scenes here. But there's a basic mechanism we should know about. And when carnitine is not performing well, ethylmalonate, adipate, and succinate will build up. And you'll see that on the testing later. So just remember that ethylmalonate, adipate, and succinate, those build up when carnitine is not working. But as with all things, that comes back to inflammation and other issues, okay? But carnitine is super, super important for energy production and for the specifically for the ability to burn fat for fuel. Very important.
So now, here's a summary of everything we talked about so far. So let me look at this. Let's try to title it together here. We have our healthy starship. This is the starship that, you know, is not under attack. Remember, it's got a really good shield system. So there's very few free radicals. See the free radicals? They're relatively few free radicals. For the most part, it's protected. Relatively few free radicals. And it has abundant ATP. Abundant energy. Energy is abundant. More energy than you know what to do with. Abundance of energy. Is abundance mean that abundance means there's more than you need? To me, there's an abundant amount of energy. This is how we should all be, hopefully. Now, when our healthy mitochondria become structurally damaged due to oxidative stress, then this scenario happens. Free radical damage increases. Now the shields are down, right? The missiles are coming in and just blasting away. And this is not a pretty process. This is the mitochondria. I don't know. It's a violent and negative thing that's happening. I mean, it's happening at a molecular level, but it's no different than a human being stabbing another human being. And you see that, you'd be like, "That's horrible. You're stabbing that person. That's not good." This is a horrible thing. Mitochondria at this little minor, you know, level, we can't really see, are being structurally destroyed or damaged by free radicals. And what happens when that goes on? The ATP supply shrinks. And this is a really big problem. See the little green balls here? That's the ATP. Had abundant ATP over here, and abundant ATP means you can detox. When your detox pathways, you can think, you can run up and down the stairs when you feel like it, you can go to work, you can do everything because you have energy. When the ATP supply is shrinking and shrinking and shrinking, and the free radicals are building up and building up and building up, we have more and more chronic disease, more and more fatigue. Now, you could say, rightly so, "Hey, then the least some of the problems for these patients is our mitochondria." What about free radical risk factors having to do with cancer, heart disease, diabetes? Absolutely, yes. Having oxidative stress puts you at higher, higher risk for cancer, heart disease, heart disease, diabetes. Although chronic degenerative illness are triggered by and fueled by oxidative stress. So this has ramifications beyond just people who are retired. This has ramifications, you know, for people who are facing potentially life-threatening illnesses. So oxidative stress is bad. We're just talking about oxidative stress in regards to energy because this is something concrete you can do something about, you know. And I don't know, in at least in my practice, I do not treat cancer patients that actively have cancer. I do work with a lot of cancer patients that have been treated already and they want to make sure the cancer doesn't come back. And I don't work with heart disease patients who have just had a heart attack. You know, it's just not my practice. You just don't do that. Some of you may. And I don't work with very many diabetics, a few, but not a lot. So I don't usually orient this towards diabetes, cancer, and heart disease in my patient practice because that's just not the people I've seen. If your practice is different and you work with primarily diabetics, everything that we're saying is even more important, you know. It's just that we're also looking at how oxidative stress would affect other things besides just the mitochondria. So tonight's talk is about fatigue, but I just want to let you know that this expands out and oxidative stress is certainly a much bigger problem than it just has to do with with a single issue of energy. So oxidative stress, free radical damage, long-term damage of oxidative stress associated chronic diseases. Just talked about that. Cancer. Now, where does this all come from? I mentioned earlier, it can be from pathogens, can be from toxins, ie, it can be from the gut, can be from the liver. You can even have a lot of oxidative stress just from over exercise. You know, over the years, I worked with a lot of high-level athletes. I get the strangest patient referrals, but I've worked with Olympic athletes, professional sports teams, just really, like, I don't know where these people come from, they just show up. Anyways, you can work with professional, especially endurance athletes, they always have a ton of oxidative stress from all the working out, okay? But that's going to accelerate aging processes, premature aging, all these things can be a problem, really, toxicity damage. So again, it's more than just the mitochondria that we're worried about here. Free radical elimination. We look at some labs in a moment. You'll see a whole bunch of this all.
All right, with the halfway break, I'm going to have to talk a little bit about the class. So our next class starts March 23rd. People, we want to get some of you to sign up. Just a few, and not everyone. You couldn't take all of you because there's a thousand and one of you, but a couple who are appropriate. We have a newly upgraded protocol, a program that we put together. It's been about a year and a half, almost two years working on it. It's nine integrated modules now. It's definitely the best work I've ever done. It's a synthesis of having taught for 10 years now. I'm really starting to understand what doctors are looking for. We have structure and organization. We have case studies in the thousands now. We have clinical topics more than probably you could ever listen to. And it's all organized and presented in this wonderful way in a community setting. So it's not just my charming personality. It's all these other amazing doctors that are in the course. And we really attract wonderful, wonderful people. So you get community support, you get my support 24/7. We're really trying to make this an environment of learning and growth so you all can go out there and start to really change the world in terms of practicing functional medicine. So I hear the things that when I talk to doctors, and I do every week, here are the things that kind of slow people down. Not having confidence right off the bat. We just have to build confidence. I know when I used to get a new lab back, I can remember my first couple years of doing this. I would get a new lab back, I would look at it, I'd be like, "Wow, I never treated Giardia before. I don't even know what to do. And this person that has Giardia, but they have, you know, an adrenal problem. My double, I don't know what to do. I don't even know if this is gonna work. How do I know if it's gonna work? I've never done this before. I don't even know what to do. I don't know if it's gonna work." I was going to give up. So what, what do I do? I'm calling Dr. Timmons, get him on the phone, go to his office, talk to him. And he would just say, "Kid," he used to call me Danny Boy, "just look at me. Yeah, hey, Danny Boy, what you do?" And you know, clearly he had treated thousands of cases of adrenal problems and hundreds and hundreds of cases of Giardia. And to him, I was like, "No big deal." It's like confidence. He wasn't even confident. Slight is the right word. He just knew. He had a knowing. You know, and I never would have gotten this far without that kind of relationship. Some older person has been doing this for a long time, they can just look at you and say, "Here's what you do." And you look at that and go, "Really?" And they're like, "Yeah, of course, it's what you do." So whatever with this, "Oh, I didn't," you know, "I mean, just like that." That's my job, giving you guys the confidence so that you can do this, whether it's organic acids or Giardia. You're maybe getting a system together so you have a certainty of where to start with any patient. This is another really huge problem. When we polled our doctors a few years ago, this is the number one problem. I'm just not knowing where to start. Okay? That's a really big thing that we want to focus on. And you have to start getting people better. You can't start a protocol that makes a patient worse, right? So there's some certain rules to this guidance and support on how to launch and uplevel your practice. Most of the doctors coming into our classes are pretty burned out themselves, to be blunt and honest about it, okay? Usually, they want to work on themselves too because they're not feeling so chipper on top of the day. You know, probably 70, 80% of the doctors coming into the class actually not only want my support and the support of the community, but they want to get healthier too, so they can bring their vibration up and help more people. We have clinical application training. We have a practice management course. And we have the most amazing practice management consultant that teaches this class. There's one call a month, you get to pick her brain. There's a six-module curriculum on practice management, which is, you know, for those of you that need to work on that, it's very, very helpful. There's a live weekly calls. I teach all the live calls myself. That's kind of my job is to just be there. I want to be the, like, it's like having me in the room right next to you in your clinic. It's Tuesday morning, you got a patient coming in Wednesday, you're not sure exactly what to do. You get on the call, you present your labs, we talk about what to do. You go ahead and do the next day. That's how this course is designed. And then on an online community, again, we have thousands of case studies. Everything's transcribed. We have all kinds of discussions going on between medical doctors, naturopaths, chiropractors, acupuncturists, physical therapists, psychiatrists, oncologists, from, you know, people who specialize in physical medicine to people who specialize in working with the brain. It's really a wonderful group and community. So check it out. Think about it. You can set up a call with me. It's divided up into a lecture hall structure. We can listen to lectures. And then we have the online community, which is sort of like an integrated Facebook. We have a ridiculous amount of content. There's also, for those who they're just thinking about signing up that aren't ready yet, we created a Kalish Method 101. It's $397. It's eight hours of online lectures and lay out everything that we're doing in the training program, okay? So it's a way for you to see if this style of functional medicine is going to suit you, okay? And there's a bunch of case studies in there. There's all kinds of resources we threw into this program. Kalish Method 101, again, if you just want to sort of stick your foot in the water a little bit and check it out, you don't want to sign up for the class, you want to talk to me yet, get the Kalish Method 101. It'll explain what we're doing in the class and the Lisa bill deal will give you a ton of helpful information you can use in your practice right away, okay? That's kind of what we're all about. So a special offer. You sign up for Kalish Method 101 by March 22nd, and you get a credit towards your mentorship if you're going to sign up for the full class. You can just flip it over there and check out the new website we've just put together. It's KalishInstitute.com. This just got released on Monday of last week. And then you can also connect with one of our consultants to see if it's a right program for you. And we don't, um, may, I'm not a mean or unpleasant person, but I definitely talk to every doctor that signs up for the class. And I definitely give you an honest opinion about whether I think this is appropriate for you or not. It's too small a group to have people in the class that aren't loving it, okay? So everyone in the group is, I don't know, it's not like we screen people and turn people away in droves, but we make sure that people that sign up, it's appropriate for. So I mean, that's part of my job is to make sure that that works. Yeah. All right. And if you've taken some of my classes before, contact us because there's ways you can sign up for things that are a little different than people that are brand new, right? Okay. Sign up starting like in a week or two. Back to the matter at hand.
So I'm going to breeze through these slides. I put them in here too so you can see them, but not so we can go through. But this is, you know, I don't want you to feel like you're missing out on anything. So we have a slide on every one of these markers, basically. We're looking at the different aspects of the Krebs cycle or citric acid cycle. Don't have to memorize this. Don't even have to learn this, you know, in detail, okay? And don't let this intimidate you. But you should be able to at least, like, glance at it. So these are energy production markers. And you'll see now, let me show you maybe the context for this here. So when you look at a blow-up of the citric acid cycle, and for example, we're looking at this rate. We look, there's citrate, right there. It's that first step where you take acetyl-CoA and you start to turn it into citrate. And then it goes down to this pathway, and then this is, it rather than alpha-ketoglutarate, then it goes over here and ends up in fumarate and malate. So each one of these markers that we test is a link in this ring of energy production. So the point that's important is that if it's just like a chain, if you have a bicycle chain and you're locking up your bicycle, and one of the links is broken, then the chain is pretty much useless. So if citrate is not working properly, but citrate is building up and you're not converting citrate into the next step, then this pathway, this series of pathways, is dysfunctional. If you had a bicycle chain that had five links that were broken, it would be even worse. What if your citrate, malate, fumarate, alpha-ketoglutarate, and isocitrate were all not working properly? That would be like five links in its chain not working. Would you even lock your bike up? No. You would think this is kind of dumb because someone might not notice one link broken, but there's five. Let's probe it. It's a useless chain, right? So the citric acid cycle can be rendered useless if there is damage or problems to this linkage. Look a bit like a bike chain, let's link one step to the next. So now when we look at these slides, and I'm going to skip over there's each one of the links in the chain, yeah, the citrate to isocitrate, the alpha-ketoglutarate, and each one of these key steps is related to certain key nutrients. But think of it this way, if one link in your bike chain was broken, you're gonna get a whole new bike chain. You're not gonna probably, you know, fake it there. So when we see one link in these pathways broken, we're not just going to look at that the citrate marker and say, "Oh, that's the whole problem. If I just give a micronutrient to fix that, then everything's going to be okay." Now, why does that not work? Well, because number one, we're saying that it's oxidative stress, it's, um, these things that are coming in that are causing the problem in the first place. And what's causing the oxidative stress is gut and liver problems, anyhow. So just giving someone some CoQ10 to just fix a single pathway in a chain, in the chain link of events being caused by all these other factors, never works, okay? That's why we don't want to use micronutrients. So again, here's the next link in the chain. Arginine is related to that. Here's another one. Arginine, isocitrate. Here's another one. Alpha-ketoglutarate. Here's another one. Succinate. Here's another one. Fumarate. There's not one. Malate. Here's another one. Hydroxymethylglutarate. Okay, you can see they go on and on and on. But the key point here is that we want to look at this as an integrated system. So if this system is not working, we want to fix this whole system. We don't want to just pick on little broken parts of it. And part of that has to do with oxidative stress. Part of it has to do with gut and liver, which is not really talked about tonight. And part of it has to do with macronutrients, right? Now, there are some general categories here. We thought I would mention this earlier. Remember I said this is going to come back to haunt you. Adipate, ethylmalonate. If these numbers are elevated, it indicates a need for carnitine and that you're not burning fats very long, which makes people tired. If you can't burn fat, plus if these people are overweight. So people like that. Now, here's a blow-up on that one. So really simply put, fat gets converted into fatty acids. We then use carnitine to bring those fatty acids down here, convert them into acetyl-CoA, and eventually they get burned up in the mitochondria. And that carnitine is the transport mechanism. So if carnitine is not available sufficiently, adipate, succinate, and ethylmalonate build up. And that's what you see in a while. Now, is it purely a carnitine problem? No, it's not just a micronutrient deficiency. Carnitine could be low because the person's inflamed. Carnitine could be low for a lot of different reasons. And here's succinate, ethylmalonate. Went through all these. No, there's also B vitamins that are important for this. When I kind of skip through the B vitamins, the way I solve B vitamin issues is I just give it every patient B vitamins. It's just part of my standard protocol. So let's look at some real labs so you can see how this actually works. So energy production, here's the portion of the switch of the organic acids profile that we're talking about. Here are the steps that we kept looking at, remember, citrate, succinate, alpha-ketoglutarate, alpha-ketoglutarate, succinate, fumarate, malate, hydroxymethylglutarate. Okay, those are the chains, the links in the chain for energy production. And here's our fat-burning, adipate.
Super rate methyl Melanie that has, dude. Quarantine. So we're grabbing that fat molecule, pulling it down here. Now, if there's problems in this section here, the first thing we think about is, why is that happening? Not only what micronutrients can we give? And you can see right in here, they tell you the micronutrients: B vitamins, Co Q 10, amino acids, and magnesium. You see those right there? They're all listed right in there. That's not that hard to figure out. It's right written right there for you.
Now, this look, the same patient. Let's find another one here. Okay, here's another one. That different patient. So, different patient. Not see what's happening here? Okay, fatty acid markers are all good. But under energy production, we see citrate, sick sis aconitine, I can never see that one right. Second aid, boomer aid, malate, hydroxymethyl glutamate. These are all problematic. Oh, okay. So, this is like having a chain with one, two, three, four, five, six broken links. In fact, if you look at it carefully, it's easier to count the links that are okay. So, imagine locking your bicycle to a pole, and that it had all these links, and only two of them were actually intact. You would think this is not going to work. Okay? You would think this is really, really not going to work. And then my bicycle probably won't be here when I come back. So, how can you expect a patient to make cellular energy when you see this amount of problem? It's just impossible. So, of course, you're gonna be tired.
Here's another example. The can is starting to see these patterns. We're going to go familiar with it now. This person has both. They have a fatty acid problem here. Add a page, super8, ethyl malonate are all elevated. That's triple bad. And they have the energy production workers down here as well. So, that is an extra double bad, right? Because they're not able to burn fat for fuel, and at the same time, they're unable to get the energy production pathway it's going as well. Let's just keep looking at these. I think there's one more. And I wanted to show you one. Let me show you an example of another one. Hang on a second. Give me a second here to pull this up. This isn't part of the PowerPoint, but I've got it sitting right here. So, now I just wanted me to see how the other side of this work. So, we talked about mitochondria, energy production being down. You can see the labs. Most of the time, these markers are elevated. The organic acids are high. Sometimes you see them low. Oh, there's one little thing you have to be on the lookout for. Chilling to show you this as an example. If you see multiple, there's one zits thing to be able to look out for because this happens once a while. People are not aware of it. To this whole thing goes out the window. I'm gonna pull up an example of this. Here's some other.
So, in the context of, you know, regular patients, you know, we're not obviously just doing inorganic acids tests. So, I went an adrenal panel. There's a real problem. I run the GI panel. There's H pylori. Okay. And then get the organic acids. So, it's all in a context. Oh, it's nice. A single one. So, like, for example, here, if you look at energy production, there's two energy production markers that are problematic. And now we're going to take a deep breath and a step back and saying, okay, we know there's some amount of oxidative stress. We know there's probably coming either from toxins or the gut. And then you can look down here and you see all these liver detox markers. You can think, oh, wait a minute. Maybe the liver is not eliminating toxins well, and that's part of what is damaging the mitochondria. So, you start to make these connections in a bigger sense, rather than focusing on a micronutrient and saying, this person needs Co Q 10. That's going to work. By the way, I did this for so many years, so many years, hitting my head against the wall. I actually didn't hit my head against wall. I would not do that. But figuratively speaking, handing people bottles of Co Q 10 after seeing that their energy production workers were low and wondering why year after year, no one ever came back better because that wasn't the problem. It wasn't a micronutrient deficiency. Could have been a macro nutrient deficiency. Could have been oxidative stress. Could have been coming from the liver. I never realized at the time that when you see energy production, you can treat it. Yes, of course, that's what we're talking about. But that you have to then chase down where that's coming from to get a more long-term solution. Right?
Now, if you see, I'll actually, what I think is, this is like one of those little tricky things that no one tells you. And you're going to be like confused the rest of your career. All right, here. This is a great example of it. If you see one of these little doohickey things here, see where it has no arrow and then DL? And that stands for underneath the detective limit. And then you see it again here. And I think he won't let it lie me. So, deep breath, thinking about it. What does that mean? Well, this is an organic acids test. Religion E messes. And these acids in general are made from amino acids. You never thought about chemistry. Amino acids, you know, lead to organic acids. So, if you get a test back and you see lots of these things low, I have my Micah's today. If you had fun, you're like, wow, that's weird. And this is tricky because you could look at this at a superficial level, go, oh, you look great. You know, Rebecca, all these numbers are really low. And it's bad. And these numbers are high. Well, in fact, if you're, you're still lab that's skewed, and there's a lot of low numbers, it can mean that there's not enough amino acids for the person to react and make these organic acids. I'm going to say that again because that's a little confusing. If you don't have enough amino acids in your system, you can't even make the organic acids that show up on this test. So, if you have someone who's incredibly sick, and you run his tests, and all you see are these underneath detected limit markers everywhere, it doesn't mean that they're okay. It means that they probably don't have enough amino acids in their system to even make these results happen. So, in other words, you can get false look negatives or really their false low levels. You put a person on an amino acid product or a protein powder, give them a couple weeks, and retest, and this thing will just light up like a Christmas tree. I just did this today. It was awesome. This patient, her original organic acids test just came back like, what? Then, like, no way. This, what's going on in this lady's body? There's no way that this test is right. There's all these underneath it detected limit markers. Everything looked like so low. It was like perfect. And there's just no way. Put her on a protein powder for a couple of weeks and retested her, and there's like, literally twenty-five markers popped up. Okay. I don't know where you're supposed to learn that. I didn't know this. I mean, I'm being totally honest here. I, I ran these tests a lot of patients for a good dozen years before I was taught that what these labs are coming back that I thought were fine were actually the really messed up people that didn't even have enough amino acids in their system to make a respond. That's like super critical. That one was worth listening to this whole hour-long rant that I'm giving now, okay? Because you get one of those back. Here. Look. You just get that look. You see. You see the underneath to take the limit thing there. That should make you suspicious. You see everything's, you know, if everything's low. Oh, look at this. This is a great example. Look. Look at the how many of these are, how many of these are low? Okay. That should raise your suspicions. Oh, wait a minute. Is this even an accurate test? So, be on the lookout for that. High. Most of our patients are regular or sick people. You know, if there's such a thing as a regular sick patient these days, is acidic and has tons of organic acids floating around. But it's the bad things when we're trying to figure out fish. Yeah. So, in that situation, you're going to want to just treat what you see. But if you have someone who's incredibly sick, who's very catabolic, and doesn't have enough amino acids in their system, you're going to get these levels that look ridiculously low. And this is where you just have to have a little common sense and just go, eight a minute, that doesn't make sense. I can't believe your nutritional status is perfect. You're so sick. Let's give you some protein powder and retest you.
Here's a good one. So, here's somebody who has energy production marker problems. And you can see the temptation here, staring you in the face. Arginine, compute n, arginine, Co Q 10. Hey, if you want some arginine or cookie 10, I will sell you all my remaining supplies. As a matter of fact, I won't even saw to you. I will like literally give you all the arginine and cookie can't have mine clinic for free because it says never immerse. Doesn't it's not a micronutrient problem. I have thrown away so many bottles of Co Q 10 and arginine. I'm not kidding. It's just like ridiculous. It's not a micronutrient problem. It took me a long time to understand this. Now, there is a way that you can treat the mitochondria and a more global sense. And most every company has these products around. How do I like to use? I love Designs for Health, Ortho Molecular, Thorne, Douglas. Anyway, these companies, Metagenics is going to have a mitochondrial energy product. And they're all pretty similar. And they all should have what should they have in them? Every one of the micronutrients that's related to producing energy in the mitochondria. And that's going to include carnitine, Co Q 10, a bunch of B vitamins, magnesium, etcetera, etcetera. So, these companies to have, you know, have equally intelligent formulators, you know, and they've put together. You can compare them. I use the one from Designs for Health now, but it's equally paired with the ones from the other companies I mentioned. And you can support with the energy production marker labs like this person using a single product that has all the mitochondrial energy supported in it. Then all you need to do is figure out how you gonna dose it. You can just increase the dosage depending how bad the labs are. And then you can add on top of that individual and nutrients if you want. But remember, there's a context in all this. But you know, you can treat. You don't have to wait until the person's liver and God are perfect before you do any treatments. You can treat them earlier in the process. You don't have to wait to the end. Then my friend, that's usually what I do.
Oh, here's a really good one. Oh, man. Look at that. These were all my patients. You know, this is a perfect one. Okay. Let's look at this from there. We're to wrap up. We can look at this. We got a couple more minutes. Don't get you guys out of here. Okay. Let's see. Okay, fatty acid. Remember we said Anna paid super 8, high, bad. Okay. Not burn fat for fuel. Tired, right off the bat from that. Not a good thing. Talked about carbohydrate metabolism last time. Double, not good thing to have insulin resistance. Tight when you called metabolic syndrome, all that stuff. That's easier on the eyes, isn't it? There we go. Fatty acids, not good. Card for last session. And here's our energy production workers. This is a perfect example of tonight's talk in the human being who's suffering. One, two, three, four, five, six broken links in the chain. Arginine and Co Q 10 not going to help. Combination product for energy production. So, you're supplying all the nutrients that the mitochondria needs. Even more importantly, or as importantly, we have this marker down here from oxidative damage. And this is 8-hydroxy-2-deoxyguanosine, which everyone calls 8-OHDG because who wants to say 8-hydroxy-2-deoxyguanosine all the time? Nobody does. So, they call it a 8-OHDG. And that's a wonderful and amazing marker for oxidative damage. So, this tells you when it's high that they have a lot of oxidative stress or oxidative damage. And now we can see, well, wait a minute. How much damage do they have? Well, they got enough damage that those free radicals are coming up to the mitochondria, just taking swipes at it. Remember, this is where the missiles are coming from. Kaboom, BAM, tired. Boom, BAM, even more tired. Kaboom, BAM, tired. And if you don't have this shield, a way to preserve your little starship in the form of antioxidants, your mitochondria is just sitting ducks. They're just going to sit there and just take hits until the person falls apart and gets tired. So, antioxidant. You can see what is going right. What are you gonna do? Supplementing? Well, you're going to give them the nutrients they need for energy production. Like I said, combination product from any one of those companies for the mitochondria. Increase the dosages depending on the patient, how messed up your mitochondria are. And then you have to provide tons of antioxidants to protect, prevent the oxidative stress. Now, perfect example is patient. And of course, they're going to be tired. How could you not be tired with this much? Plenty. Life would be impossible to field. It's just impossible. Now, I would also say, just as a general concept, I've been doing this for a while, you guys. It works really well. You know, it really does. And everyone's tired that we work with. So, quick summary here. We're looking at sections of organic acids test. You can order these tests from Genova, you can from Great Plains. The two main companies that run these in the United States. We're looking at carbohydrate metabolism and energy production in the first two talks. Next talk, we're going to look at neurotransmitters. We're just going to march down the list here till we get through everything. And then the next one is April the 27th. We're going to get into neurotransmitters and how those work. And that is class for the year-long training program is March 23rd. And I'm more excited about this than you can imagine. I'm happy to talk to you about a training program. If you're interested in signing up, make sure that you mention the special offer. If you're like me, I'm not sure I want to do a whole year at this guy. Check out the Cabbage Method 101 and see if it makes sense. So, learn a ton of stuff. You'll laugh, you'll cry, it'll help you in your practice. And it's only my $400 bucks. You know, it's a way to just check things out. New website, tons of information on there. We just launched it a week ago. Take a look. Tell us what you think. And then if you want to just talk to someone, you can set up a call with Leslie to see if the class is right for you. To see what's going on. Questions like, what is this practice management thing you guys are doing now, which is amazing, six module thing that we added. You know, when, how's the class really? Where ever, what's the online community like? Wow. Look at this. Want to talk to you. Buy all that guy stuff. All right, so, um, thank you for hanging in there to the bitter end here. I hope this was helpful. Kind of get you stimulated to start to do these tests. And I will look forward to talking to you next time. So, I'm gonna let all you go because it's been an hour. There's a couple questions that came in. I'm gonna try to answer them, but feel free to take off if you need to go have dinner with your kids, whatever you all are doing. Oh, hi back, Sandy. For me, no love burrito, my friends. I'm going up to tell home tomorrow. I'm learning to ski. Is it possible to access part one? And absolutely. We have them all recorded. Just email. Go to the website and just email. Contact us by email and say, ask for the. I'm also doing a series of patient-oriented ones. These are the doctor-oriented ones. So, if you've maybe seen some confusing stuff there, if you've taken my class before, you can absolutely. We have ways to get you real balls. So, for those of you asked that question, I'm happy to, you know, talk to. Last names will tell you the different things. Do. Oh, this might grab the great question, Sandra. Thank you. Do you run this test with every patient, no matter what their complaint? 100% absolutely yes. And I think I'm the only doctor in the United States is doing this now. I'm run the organic acids profile on every single patient. Doesn't matter if they're 20 years old or 50 years old. If they want to have a baby, or if they're tired all the time, if they have the autoimmune disease, if they have it. Doesn't matter. This is like, to me, 50% of my practice is based on this test. Importance of energy production work. As we talked about that, when they're low, if, if you see high levels of five hydroxyl acetate, it usually means that they need 5-HTP. Not that they don't need that. That's usually. And absolutely yes. Genesis is from Genova. When retesting, I do a lot of retesting on this. And I like to retest people while they're, what depends? You can do it on the supplements or off. It depends if you want to go back to get a baseline and see what kind of improvement they've made, or if you want to see what the supplements doing. I usually have people stop to someone's for a week before before we, you know, do anything else. Oh, protein loading before our testing. You can use anything that's in a amino acid in a pill, or you can use protein shakes, protein powders. Those are all fine. Are there parallels with the 205 in the organic test? Not so much. All right. And we have, if you're interested, you have ever signing up for some of the classes. There's a ton of information of a practice management. Also, to answer one last question here, is the cameras method 101 course includes a whole bunch of practice management info. Okay. It's a little teaser so that you signed up for the real practice management class. Right. Take care, everyone. Have a great rest of your. I'm going to the mountains tomorrow. I'm actually taking two days off. My staff has kicked me out. They won't let me work. And they know I need a break. So, I'll be out of touch for a couple days. But I'm happy to get back to you all at the end of the week if you have email questions or whatever. Okay. Have a good day, everyone. I know.