Functional Genomics Pattern Recognition and Genetic Variables Demonstrated in Amino Acid, Fatty Aci

Hello folks. I hope you are doing well. I hope you are doing very well.

I have sort of like, it's more like a workshop, I guess, than a presentation that I just wanted to go through. And I want to kind of, kind of catch you up with all the things that I've been learning in the last couple years, which have been so exciting for me. And a little introduction to where this all comes from and what this is all about. And then we're going to look at some labs, InDesign, some programs, and see if that stimulates some thoughts on your part.

So today's topic, functional genomics. It's a phrase that Richard Lord coined, Dr. Richard Lord. And pattern recognition, another Richard term. And you'll, my take on all the work that he's been doing with me for the last couple. So I introduce you a little bit to Richard, if you're not familiar with his work. If you're an older practitioner like myself, then you probably met Richard, talked to Richard, knew him pretty well.

And I'll just show you this one, this one image here, which is this. Cracks me up. So, you know, when, when I was first learning functional medicine, my very first doctor that trained me was a man named Dr. Bill Timmons. And he was six foot four, Irish guy, grey hair, kind of older. He seemed old to me. I was like 29 or 30 years old. He was probably in his 50s, seemed really old at the time. I'm probably the age that he was when I met him. And, and Dr. Timmons was very patient with me. He spent, you know, six years training me in lab interpretation. And very generous with his time. He and I taught seminars and conferences together. And I just learned an incredible amount from him.

And the interesting thing about Dr. Timmons that I didn't know until after he died, but there was a day after he died, shortly after he died, I was riding my bicycle. I'm a hardcore bike rider, I love it. I was riding my bicycle across the Golden Gate. I was in San Francisco. And I had a vision, like where he, like came and was talking to me. Who, kind of freaked me out. And so I've on the bridge, I got off my cellphone, I called his widow, Joan. And I was like, Joan, I think Bill was talking to me or something. He's dead. And she was like, ah, Danny Boy. Yeah, you know, he's, they used to call me Danny. You know, um, you know, of course, start, you know, Bill or Dr. Timmons was, you know, primarily a spiritual healer. You know, we work together shoulder to shoulder for six years. He never once mentioned, mentioned religion or spirituality. Never once. But it was a very intensely spiritual. And I didn't really understand this until after he died.

Dr. Richard Lord, very similar, intensely spiritual man. And, and yet a great scientist and leader in our field, all at the same time. So here's a picture of Richard Lord many, many years ago. And you can see he is in Lake Tahoe. If you recognize this map. And he is pointing his finger to a place on the map, randomly. Right. This is in his new book. This picture. And I'm looking at his picture a couple months ago. And I'm like, holy moly, that's Lake Tahoe. And then I realized he's pointing almost exactly to where I live right now. Okay. This is a picture taken decades ago, you know. And he put it in his book, not knowing that I was gonna move to Lake Tahoe. And here he is, anyways.

So Richard's very tuned in energetically, spiritually. He is the man that wrote this book, Laboratory Evaluations for Integrative and Functional Medicine. Which is the only primary text in our field for lab interpretation. The book is out of print now. You can get copies from Richard Lord directly if you're interested. And then he and I have collaborated together. And he has written two new books. Part of what we're talking about tonight. One called Paths to Health: Organic Acids. This is available as an iBook. Highly recommend you go to iTunes and buy it. And he wrote another book, I don't know, there's a couple hundred pages under hard time for this. Path to Health: Gut Microbes. This is about the GI Effects test. Okay. So these books are available now on iTunes or iBook.

And I want to talk a little bit about, you know, these last couple years. Sir Richard Lord and I have been working together for two and a half, almost three years now. And every Monday, we spend the day together talking about labs, interpreting labs. And he's been training me in the original work. So Richard was the scientist that developed what we now call organic acids testing. Amino acid testing was in out of his lab. The fatty acid testing, all these basic nutrient profiles that we do. The names we give them now are the organics test, the Nutra-Eval test. The basically he was the bench scientist that developed all these. He's seen every one of these labs that was run for, you know, for over 30 years. And so he's decided to put all his energy into training me now. In with the understanding that I'm gonna get out and training other doctors. Which is why I'm doing this talk tonight. So this is all based on Richard's work and his intensive training that he's been putting me through in the last couple years.

Who am I? I'm Dan. There's a picture of me. Lead faculty now for IFM in the practice implementation division. So I'm at every IFM module and conference teaching now to, you know, help doctors about their practices. I'm also doing the Kalish method workups. Which you guys are interested in. We'll have a Kalish method mentorship be starting in about a year. And that I mean, starting at the airline mentorship, they're starting in about a month. And that class is divided up into three different sections. We have a really robust curriculum. Much of the work that we're doing now is based on Richard's newer work. So we have a lot of new information that we're teaching. We have a community that's really active. And we have a special offer. If you're interested in the class, you can save a thousand bucks. And the class is gonna start in early April. Okay. So if you're interested in that, let you know, we'll let the office know. You can reach out and we'll give you a little bit of information that, you know, has been coming at me now. And this is what we do when we look at labs and figure out what the heck's going on with people.

So when Dr. Lord was first designing what we now call organic acids testing, or the Nutra-Eval, okay, way back in the day, 30-some years ago, his intent with developing these tests was to screen functional medicine and integrative medicine patients for genetic disorders, for what he calls functional genomic problems. This obviously 30 years ago predates the idea of testing for SNPs and all the genetic testing that many of you guys do now. And so in those days, what Richard knew as a scientist was that in conventional medicine, regular pediatric community, they screened for many inborn errors of inborn metabolism, metabolic issues in newborn babies using organic acids. And he thought, hmm, maybe we could use that same basic technology of organic acids testing, or milder versions of these, you know, genetic flaws that are expressed not in a life-threatening kind of way, but in a way which is, you know, going to cause some kind of chronic illness. And that's their origins of the organic acids test. The origins of the fatty acids and all of this were really, you know, designed to screen for genetic disorders. They can also be used as nutrient deficiency tests, right? So you can see these markers on these labs and say, that marker is off, that means you need biotin. That marker is off, that means you need vitamin C. Which is great. And that's what Richard calls horizontal knowledge. You know, that's like the, the entry-level way of thinking about these tests, nutrient screening. But the point of the test, the deeper point, the reason why Richard created these, was because he wanted to be able to find inborn errors of metabolism. We wanted to find genetic defects. And that's what I want to talk about tonight. Okay, how you can use these tests to screen for genetic problems.

Now, this is just like a fun little lab. One of the doctors in the training program presented this last week. And it's the doctor who's aged 48 and his son who's aged 17. And he put, and this would, this just showed up in my inbox last week. So I just thought I'd show it. It's nice, it's kind of cool. So this doctor, the 48-year-old on the left, does it, his son. And the son had just had a head injury. And he just ran the test on himself and his son and compared them. Now, what you can see here is very interesting. Is there is some similarity in the labs. So, for example, if you look at their mitochondrial markers, you can see these three are identical in father and son. This one is identical. Oh my gosh, that one is a point eight. That is a point seven. That's pretty close to a pinnacle. This is identical. And this is pretty much the same. The lowest quintile. This is undetected. Basically, the entire mitochondrial section is within a decimal point or so of identical father to son. And that's not a very common pattern that you see either, is it? You know, when's the last time you saw since that connotated isocitrate low? It's just not a common pattern. So anyway, it's kind of a fun little thing to show you how the genetics can play out.

On the second page of their organic acids test, father and son. Oh gosh, those three are about identical, aren't they? Okay. This one's a little on the high side, so was it for the son? This one's on the low, on the low side, so for the son. These two are exactly the same, father and son. Like literally exactly the same pattern on the B vitamins. Their methylation markers aren't similar. They're identical, guys, right? Look, point five, point six, point five, point five. These two human beings methylate like exactly the same. And then when you get to the brain, it's even more interesting. They both have exactly the same pattern in curves with catecholamine production. These are the catecholamine markers here for epinephrine, norepinephrine, and dopamine. Not similar, but the same. Okay. And then these quinolinic and picolinic markers, very unusual to see both of those low. Also not similar, but the same. So a large part of this test, father to son, is is nearly identical. Which I just think is kind of cool. So when you look at their liver detox markers, it's almost exactly the same. Look. And what are the odds? You know, you, if you looked at a lot of these tests, you realize that these are not like common patterns that you see them all the time. These are almost exactly the same. These are kind of in similar positions. You know, obviously they have, you know, different backgrounds. I mean, the son probably doesn't eat exactly the same food as the father does. But very, very similar lab. Okay. So that's this kind of a little thing to start off with. And you'll see I have, you know, it's interesting. I'm not going to show this one because I don't have time. But I have a mother and daughter pair that we just tested. Totally different. Okay. Their, their health problems, the way their labs manifested were totally different. So you're not always going to see, you know, siblings or, or, you know, parent and child combinations that are exactly the same or similar. But you often do. We even have one case from about five, six years ago where it's the girls, Sydney is like nine, the mom is like in her thirties, and the grandmother's in her sixties. And their labs are like literally interchangeable. Like you could change the name on it, you wouldn't even know that it was a different person. In three generations of females. So there's a really strong genetic component that we're looking at here. And I want to kind of bring that out and show you ways that you can figure that out on the labs. Okay. Which was Richard's intention when he designed these. And somehow that information just got lost in translation here. Okay.

So I mean, I've got a bunch of sample cases here. I'm gonna poke around a little bit and show you guys a few different ways that you can do this. And a little couple of fun lab interpretation tricks. Okay. So, oh, and there's also something I wanted to show about oxidative stress. But let's do the genetic part first. Okay.

So when you're, when you're looking at these labs, especially under the organic acids selection, right? The way that the reference ranges are distributed, they're intended to show you what's a genetic marker and what's not. So let me try to break this down. You can see at the top of the test, you have quintile distribution. This is a basic organic acids profile, part of an Ion profile from the lab companies, you know, okay, organic comprehensive profile in this case, is part of the Ion profile, alright, from Genova. So here you have the quintile distribution at the top. And obviously quintiles, there's five of them, right? First, second, third, fourth, and fifth. And so when they're, uh, we're calibrating these machines, as every good lab scientist in the world has always done for all of human history, many, the neighborhood's originally called Metametrix, now Genova bought them. But when they were originally doing this back in Metametrix, they were, you know, went out and they did the standard bell curve. So let me just show you exactly how this lab gets developed. And you guys probably know this, but just to restate the obvious. So you have a patient population that you measure and you create a bell curve, which looks like a bell. And then 95% of people fall underneath that curve. 5% are outside of that. Two and a half percent are going to be considered your low levels. And two and a half percent are going to be considered your highs. And 95% of people are considered normals, right? And that's how every lab in all of human history is calculated. So you can know if you're low and you're high and you're normals, alright? So they did the exact same thing when they set this test up. And you can see graphically, they're trying to represent that 95% of people are going to fall into one of these quintiles here, okay? And two and a half percent are going to be on the low end, two and a half percent are going to be on the high end. Those are the lows and the highs. And that all is within this reference range. And here's your 95% reference range number. So, for example, for adipate, that number is 11. For succinate, that 95% reference range max is 4.4.6. For ethylmalonate is 6.3. Okay. So if you start to get above the 95% reference range number here in the right-hand column, you're starting to look more and more like there's a genetic disorder. If your, if your reported marker here is double this 95% reference range column marker, then you're definitely looking at a genetic problem. And that's how I, and Dr. Lord, originally set these labs, guys, to screen for genetic disorders.

So the way that the statistical analysis goes, I'm not a statistician. I can barely balance my checkbook. I'm not like a math person. My son, I'm very proud of, Asa Kayla, she's getting a math and physics degree at University of Washington, University of St. Louis, right now. In fact, in his second year of college, which he's doing right now, he's taking, I think, his third graduate-level math course. Guys, like I'm a math genius. Me, not so much. Very proud of him though. He's super good at math. But I can do this. If there, if the number is double or more than double the reference range, it becomes statistically impossible for that to be a nutrient deficiency. Okay? And it is most likely, almost for sure, going to be a genetic disorder. Okay? So the way you pick out the genetic disorders on this portion of the test is if the marker is double or more than double the reference range number here, you're looking at a genetic flaw. That is not something that's a diet-related problem necessarily, right? They're not eating their way into that. It's not necessarily something that you're gonna supplement and fix. That's a long-term problem that person has faced since the day they were born. It's important to know which of these problems that we see are genetically based. So again, if it's more than double the reference range, the way the lab will print that out is tricky because they'll just put a black dot here. It really should be like over here, off the side of the paper, right? Like way over there. But they don't do that. So you've got to look at the numbers that they're reporting. If it's more than double this reference range here, you have a genetic issue of some kind. And in Richard's new books, you can, in fact, click around because it's an iBook. I still can't believe he got that photo pointing to my house. And in his iBook, you can click around and he has references to all the research studies. Okay? So, like, for example, here's a biomarker. What the heck is this? Oh, here, that's an example. Let me just find one for you so you can see how this works. So here we go. Adipate, succinate, ethylmalonate. If it's high, means this. If it's low, it means that. And then he goes into the specific genetic markers here, right? You can just click on that and it'll take you out to the research study that talks about that particular marker. Okay? So it's all very well referenced. I think his larger book that he's working on now is 7,000 scientific references. So every time he says, okay, this is related to a genetic problem, you can click on that. It'll go right to the research study that he's citing. And boom, you know, you've got, you can, you know, read to your heart's content about how that gene is playing out, etc., etc. Okay? If you're, if you're really into the techie science, nerd part of this, that is a great tool. And the book that I mentioned, the organic acids book, has citations. And for each one of these markers, I'm going through now. If you want to get into the science behind it all, so you can say, oh gosh, that one looks like a genetic issue. Click, click, click. You can read about the genes.

So let's go through and see now. The, it gets a little tricky. So this marker here, for example, beta-hydroxyisovalerate is an 8.5. That's high. But it's below the 95% reference range. So that is just a straight-up biotin deficiency. Not necessarily anything about a genetic abnormality. So you could supplement that, figure out the dietary problems, that kind of thing. Again, here, the formiminoglutamate marker, that's also called FIGLU. It's a marker for folate. This marker is high. And that means a person is low in folate. It's their numbers 1.3. The reference range is 2.2. You're well below the reference range. So that is a nutrient deficit marker for folate. And as we go through these, you'll see. Let me show you some examples of the opposite here. Hang on a second. Well, maybe we'll just come to one here. I'll just let it unfold. Oh, and find one for you. Just so you can see it. And I'm gonna have to skip around because each of these labs are different examples here. Let me find one that makes sense. I had a patient today with this, but I don't want to pull her thing up here. There should be one here. Oh, here we go. Well, that's not a great example. But well, yeah, it is. Methylhippurate. No, no, that's not a good example. Let me find it. Clear. I'm just gonna make up one because I'm not finding one easily here. So let's say that you had a marker. This, I'm picking one that's sort of classic. Let's say you had a marker where I'm just gonna make up the numbers so we don't waste time here. Let's say you had a 3-hydroxybutyrate marker, right? And the cutoff is 0.46 for the 95th percentile. And let's say that that marker, and I've seen them this high, they say that marker was like a three. Okay? The marker here was a three. That is far more than double this, right? So if you get double or more the 95% reference range, you're looking at a genetic problem. So that would be a genetic problem with vitamin B6 that the person will have had since the day they were born. Okay? So that's one easy way you can start to see these genetic patterns. Is just looking at the 95% reference range again. That's in the far right-hand column of the test here. And if the patient's lab value is double or more this number in the column here, then you know you're looking at the genetic issue. So again, let's do some simple ones. They say that this marker was a 17 instead of a 1.7. And a 17 there, that's more than double six, right? So that's a genetic issue with carnitine metabolism and the ability to burn body fat. So again, if it's more than double this number here, you're looking at a genetic issue. Okay? And that's the simple way to look at the organic acids. I'm going to look at some more complicated ones now. I hope this is making sense. If you have a ton of questions, just kind of go ahead and ask. Happy to answer questions too. Okay.

Let me just cruise around. I'm going to show you some other patterns, stuff that are important. And then none of this is abstract, right? These are actually really important things to know as you go through cases because you can really help a lot of people. To get into this higher level of detail. So we're going to skip through the amino acids and let's look at the fatty acids section, which is up here. There we go. So, and this is one I've seen in a bunch of my patients this past year. This really helped me with several hard cases. So now we're looking at Omega-3 and Omega-6 fatty acids, right? And one would assume based on diet that most Americans will have more than enough Omega-6s and will be Omega-3 deficient. But what you'll see with these labs isn't interesting because, and this is probably skewed because of the type of patients I get in my practice, to say, you know, 20 really tough depression cases in the year, it's not your average American, right? And oftentimes these patients are eating really clean and really healthy diets. And you'll see patterns like you're looking at right here, where the Omega-3s are low as a group, right? And the Omega-6s are okay, but not great. You'll have people who are taking a large amount of Omega-3s or fish oils, who will still have these markers be incredibly low because their genetic need for Omega-3 fish oils or Omega-3 oils is extraordinarily high. So sometimes you'll have cases where the diet or the supplementation that they're doing doesn't match the test. And I think in almost every one of these situations I've been in where you just get a cognitive dissonance, right? There's a, this lack of, it makes no sense, right? You have a lab that doesn't match anything that's going on with the patient. You often find if you start to dig, that there's a genetic component to that fatty acid problem. There could be an enzyme defect in terms of the fatty acids converting to one another. And I'll show you some more examples of that because it shows up a lot with the fatty acids. And these people are very happy to be on, you know, a GLA supplement if it takes away their lifelong depression. It's not like as a problem that they have to take GLA the rest of their life, right? When you figure it out, some major issue like that.

Let me show you another example here. It's the fatty acids, and especially with the Omega-6s, I didn't do a lot of work with them until recently. And so that's really been kind of enlightening for me. There's one in here I saw earlier. Let me just pull it out. There it is. This is it. Yeah. So this is, this is pretty darn interesting. Okay. Look at this. And the way that these are set up, and these are set up in the order in which the fats convert, right? So these fatty acids go from this one to this one to this one, like that, you know? And so you can see here, you have a really low linoleic and then a really high gamma-linolenic. How could that even happen if one is converting to the other, right? So you'll often see with these fatty acids that there's a genetic block in one of the enzymes and that they're not converting. Down here's another example. Like this fatty acid here, the DGLA, right, is high. And yet that one right after it, arachidonic, is low. So there's a problem right here, probably genetically based, with the enzymes that convert your DGLA to your arachidonic. And I don't have all of them memorized. It's just like these G6 saturates, whatever, I forget the exact name and enzyme. Up in Richard's book, well, you know, that's something that you can just look at any one of these charts and find out. So when, when you're analyzing these tests, you're looking for these anomalies, like, for example, this fat not converting into this fat. And then suspecting that there's a block in here which is causing that to occur. So some people might need large amounts of linoleic, right, to make all of this work, even though there are other fats like the gamma-linolenic or the DGLA are actually high. So you see these impossible patterns that don't make sense based on one fat converting into the next. And you usually have some kind of genetic flaw. Or, and this happened to me the other day, when I was maybe six months ago, but we had a patient who actually was taking fish oils. And then this is true. She's actually owns and runs a restaurant that only sells fish. And she's eating salmon like literally every day. We won't talk about her mercury levels or anything like that. But, you know, taking fish oil supplements and eating fish every day with really low Omega-3s, you know, there's got to be a genetic component to that, assuming that you've ruled out things like, you know, absorption problems.

Another little trick when you're interpreting these, too, just while we're on fatty acids, is you can, there's a marker in here that Dr. Lord put in as a way to see what the duration of the problem has been. So, like, for example, you could have a patient who just doesn't eat enough foods that have Omega-3 or Omega-6 in them, and that would throw off these numbers, right? So this number here, this marker here, Mead's number 12. Mead is an Omega-9 polyunsaturated Omega-9 fat. And if Mead is high, if Mead is high, it shows that there's been a long-term disruption of the other fatty acids. Okay? So I'll say that again. If the marker called Mead's number 12 is high, it shows that this is a long-term disruption here. And the most likely not dietary in nature. Okay? So the person just has a bad diet. You're usually not going to see Mead elevated. Also, Mead, there's an indicator that's been going on for a long period of time, unless they've really had a horrible diet for their entire life. That's usually going to mean that there may be some other component going on besides diet. Okay? And let's see here. Let me show you a couple other examples. Oh, here's a perfect one. This is actually, I don't even know to make it up. So here, when we talked about B6 is a very common nutrient problem that has a genetic basis. This person's xanthurenic marker is 2.29. That's indicates if it's high, that it's this marker. If it's high, means they're deficient in B6. You can see again, the cutoff is 0.46. So this person is what, six times, five times, five and a half times the cutoff. So when you get to be double the cutoff number here, 0.8 or above, indicates that this is a genetic disorder. So this person has a genetic defect with vitamin B6. And when you think about all the things that B6 does, that becomes extraordinarily important. And they may need, the other thing about with the genetic issues, why this is important to figure out, is you may put them on 50 milligrams of B6 and wonder why they don't improve. Or if they have a genetic problem with vitamin magnesium, right? They may have, they may have been on magnesium for a long period of time, but their, their dosage requirements can be dramatic. Like, as someone with the marker like this for B6, you might need 200 milligrams a day. I've had some patients that didn't turn around until we hit 300 milligrams a day of vitamin B6. And that's not something you're generally going to hand out, right? So that is just another issue to think about. Yeah. And with all of these labs, you're assuming that you're dealing with malabsorption issues and gut issues. That's already been taken care of, because kind of like a foundational principle for functional medicine.

Okay, here's another really good one. So kynurenic, the main marker for neuroinflammation. Kynurenic, the main marker for neuroinflammation, is a 14. 3-hydroxyacetic acid, the main marker for serotonin levels is 120. And was the cutoff nine. So the serotonin marker is 12 times higher than the highest cutoff number here. The kynurenic marker is but like six or seven times higher. All right. So these are genetically based issues that are impacting the brain. Genetically based. Let's see if we find another one. Oh my gosh, this is a really good one. I didn't even plan this one this way. My staff picked these for me earlier today. Glucuronate. This is a marker for phase one, phase two detoxification. Usually glucuronate elevates in patients who have trouble handling medications. And your liver's just not working as it should. This glucuronate number, it's 74. Okay? The cutoff is 10. The 95% reference range is 10. So if you're above a 6.3, you're considered to have a problem, right? So anything above a 6.3 gets a red flag here. Anything above a 10, you're getting into this impossible range, right? 95% reference range. Above this person is seven times higher. So if we were going to chart this, right? You know, and that's the problem. The computer can't really tell you what's happening. It's seven times above the reference range. They would be like, you know, three feet to the right here, off the screen. You'd have to have a piece of paper that was like six feet long to represent them. They're the little black dot would be way the heck out here. I mean, look at it. It's seven times higher than the 95% reference range. The cutoff is six. The extreme cutoff is ten. And they're at the time, seven. That's okay. Seven, right? So just to give you an idea, that is a genetic problem with the liver not being able to handle medications or caffeine or whatever those things may be. Okay. This again was the whole point of Richard setting up this test. On a superficial level, to find the basic stuff. Nothing wrong with that. I do this every day. Nothing wrong with the basic stuff. Like, let me find something basic. Let's just make up a basic thing. So let's say that your adipate is a five. No, no, an eight. It's right here. Your adipate is eight. Ah, that is bad. It's carnitine. You need support for your fat burning. It's gonna cause fatigue and depression and all kinds of problems. So that's the horizontal knowledge. Just like adipate is messed up, we're going to give you some carnitine. But what if that adipate marker is a 70? Right? That's a genetic problem that you're going to really want to take a lot more seriously. The dosages are going to have to be higher for most of those people. And they may have to be on these supplements for a very long period of time. They're not going to just get better in six months, right? Because they have a lifelong deficiency and a genetic predisposition to not handle that particular nutrient well. In other words, their need for B6, or their need for carnitine, is going to be double or triple what their regular populations would be just to get normal functioning. And that's the whole point of this functional genomics is to ask, what are their genetic breakdowns? And to support that with a nutritional program. So you can restore normal function, normal physiology. So it's really cool. And the more that you look at these tests, and this has happened to me over the last couple years, the more these genetic problems just literally jump out at you. You see these unusual patterns. And it's just incredible to, to really start to see this stuff. It's, I don't know, it's one of the more exciting things I've done in a long time is to be able to understand these labs at a deeper level.

All right. Now, because I have you all on the phone here, I just want to go to a couple, cover a couple other really important things that are like, I wish I had known this a long time ago. Things. Okay. And these are not necessarily genetically related, but I think it's just super important. We should all know this if you're looking at these labs every day. So I'm gonna, let me go find in the example I'm looking for here. And I'll show you this a few times because it's a little confusing, more than a little confusing. This is super confusing. But I wanna show you a few examples of it. And I think at the end of today, you'll get the idea. So let's start with this one first. So now we're gonna hone in on one area here, which is a whole cost at the oxidants, right? And so let me just show a few graphic images here so you can see what the heck we're talking about. Oh, and wait a minute, don't forget to sign up for my class. When your mentorship. Yeah, it is every week for hours and hours and hours and hours and hours. We have hundreds of hours of classes recorded. And we have a gazillion hours of class that we do every week. Let me see here. There it is. This guy. So I'm just, quick little two seconds on oxidative stress. So we're worried about oxidative stress because as oxidative stress levels go up, mitochondria can become damaged, DNA can get damaged, all kinds of bad things happen. Lead to cancer, heart disease, metabolic syndromes, diabetes, bad, bad things happen. We have a lot of oxidative stress. So you want to be able to perform a really good analysis for the oxidative stress load on your patient. In fact, if you're doing anti-aging programs, or just general health prevention, or you're treating chronic illness, I mean, there's really two things you always have to address, right? Inflammation and then, you know, oxidative stress. Those are top of the list for every functional medicine doctor. You just got to know how to treat inflammation and oxidative stress. So I just want to show you a higher level of analysis for that. And this is like super cool. Oops, sorry, it's the wrong one.

So now when you're talking about oxidative stress, what's getting damaged? You have two general compartments, right? You have fat-soluble and in defense, you have water-soluble antioxidants. So the fat-soluble antioxidants are obviously protecting the fat. And the fat are these fatty acids that are in our cell membranes, as well as other places in the body, right? And if those fats get damaged, bad things happen. The cell membrane can't do its normal job. And you're going to be in some serious trouble. So there's fat-soluble antioxidants that protect the cell membranes. And then there's water-soluble antioxidants, like vitamin C and glutathione, that protect the water component of the cell, right? The cytosol, the little liquidy part of the inside of the cell. And very importantly, those water-soluble antioxidants also protect the inside of the nucleus of the cell, which contains DNA. So if you get free radicals into the nucleus of the cell and they damage your DNA, and your DNA replicates abnormally, that's what we call cancer, right? That is a very bad thing. You don't want the DNA. Equally bad, you don't want these free radicals to get into your lipid membranes that are responsible for just about everything in the body, right? All the things that are being transported in about the membranes. These membranes are extremely important. If those fats get oxidized, you're damaged, you're in serious trouble too. So I just want to point this out. There, there's two general categories here. And I'll do questions in the last few minutes, case you guys have questions. I'll call on you for sure, okay? So there's, and the way that this, again, we're looking at Ion panels from Genova. This is the fourth page of the Ion panel. And you see here how when Rich, when he set up the test, he's very careful about how he organized these. And I'm just beginning to appreciate this. So this section here is the fat-soluble antioxidants. Does it say that? No. You're supposed to know that. Yeah, you're supposed to know. If you didn't know that, well, now you know. Did I know that? Well, I know if I thought about it for a few hours, could have figured about CoQ10, alpha-tocopherol, gamma-tocopherol, vitamin A, and beta-carotene are the key fat-soluble antioxidants. Meaning they're hanging out and then around the fat, the cell membrane, protecting that cell membrane from oxidative stress. So they're all kind of clumped together here. Very convenient. In this patient, they're all normal. Yahoo! That's a good thing. Lipid peroxides are a measure of the damage that has occurred to the lipids or fats. So if lipid peroxides go up, it means there's a lot of oxidative stress that's screwing up your lipids, which is means your cell membranes are getting shredded. This person has normal lipid peroxides. That fits with normal fat-soluble antioxidants. All good in this case, right? So he paired these together. And then we'll skip over that one because it's confusing. And then the third component to this, you got the fat-soluble antioxidants, you got the lipid peroxides. The third component to this are the fats themselves, okay? The Omega-3 and the Omega-6 fatty acids. So let me like this because this is complicated. And I don't even think you put this in his new books. But think about it this way. The lipid peroxide marker is going to move up or down depending on a couple of variables, okay? If you have a lot of antioxidants, that's going to kind of put the brake on damage to the cell membranes. So the lipid peroxide number is going to drop. Okay? If you have lack of antioxidant protection, there's a lot of free radicals, then the lipid peroxide number is going to go up. Okay? So obviously, lipid peroxides up is bad. Peroxides down is good. Fat-soluble antioxidants normal is good, low is bad, right? But there's another variable that's going to control where the lipid peroxides move. And that's how many lipids you actually have. So if you have low Omega-3 or low Omega-6, that's going to drop this lipid peroxide number down. Okay? And this has really significant clinical implications. So let's look at a couple examples. I'll show you this one. I wanted to start off with was normal, but it's look, yeah. And let me just have you imagine this. Let's say that you take somebody who has normal lipid peroxides but low lipids, the Omega-3 and their Omega-6s are low. You give them Omega-3 fatty acids. You give them Omega-6 fatty acids. You give them some fish oil and some GLA or borage oil or primrose oil. So I thought you're going to give them more fat. That's going to have, that's going to push the lipid peroxide marker up, right? So they're going to need more antioxidant support, even if they start off normal. So in other words, the Omega-3s and Sixes are low here, right? Will you give that patient Omega-3s and Omega-6s, you're gonna force this number up, which means even though their antioxidants are normal, they're going to need more antioxidants because you're about to dump in more lipids into the situation. So you gotta assess this. You give fatty acids, Omega-3s and Sixes, you got to think, do they need, you know, antioxidants as well to make this work?

Let me show you some other example of this because this is kind of profound. Oh, and by the way, just before I forget, the water-soluble antioxidants that we're talking about are represented here very conveniently. Para-hydroxyphenyl lactate and 8-OHDG. These are the water-soluble antioxidant markers. These are the ones that are protecting your DNA. So if these markers are high, means you're in experiencing structural damage to the DNA itself. The DNA gets nuked by some free radicals. This marker goes up. And this marker goes up. Obviously, that's a very bad thing. The other water-soluble antioxidant markers here are very clearly represented with these three here. Alpha-hydroxybutyrate, pyroglutamate, and sulfate. These are all three indicators of glutathione status. And glutathione is, as you know, the master antioxidant, right? So again, it's water-soluble, right here. Water-soluble ones, right here. These are the ones where you're worried about DNA damage. The other fat-soluble ones, you're worried about lipid damage. And this actually starts to make a lot more sense. It doesn't have to be a cancer patient necessarily, but, you know, if you see someone who's having a lot of fat-soluble antioxidant problems, you're gonna see problems with lipids in their history. If you have a person that has a lot of water-soluble antioxidant problems, you're gonna have more that side, you know, you might see more water-soluble toxins or you might see other things on the lab that makes sense in that way. All right.

So let's pull up another one of these test examples here. There's so much to go over in here. I'm just kind of scratching the surface. All right. So here's another example. So again, we're talking about the fat-soluble antioxidants first. CoQ10, vitamin E, the different tocopherols, vitamin A, right here. We have again, this person, normal antioxidant levels for protecting fat. But their lipid peroxides are getting up there, okay? So there's something to be worried about. There's some lipid, right on the edge of the lipids being damaged. Not quite over there yet. Not quite spread over to the bad point. And the Omega-3s and Omega-6s are a little on the low side. So again, if you gave this patient Omega-3 fatty acids, which you should, and you give them some mixes, which you should, what's that going to do to their lipid peroxides? It's going to drive them up because you're putting more fat, or more lipids, into the system. So if you give this patient 3s and 6s, you can expect lipid peroxides to go up. And what happens if it goes up even a little bit? It's gonna be high. What does that mean? They need antioxidants, right? So you gotta think, if you're giving Omega-3s and 6s to people, do they need antioxidants as well? This patient would be a definite yes, because they're right on the edge already. You dump a much, a bunch more 3s and 6s in, this number's gonna go up, and they need an EHA, even though their antioxidant markers are normal. Okay, this is a more advanced level of interpretation. Even though these numbers are normal here, you're gonna put in Omega-3s and Omega-6s, they're gonna need some fatty, there's gonna need some fat-soluble antioxidant protection. And this explains why sometimes you give people stuff when they react poorly, right? Because you're pushing this one of these mechanisms in the wrong direction, unknowingly. And believe me, everything I'm trying to say tonight has got direct clinical implications. And it's easy to screw up these things. And again, just a quick reminder, the water-soluble antioxidants here and here, okay? And this particular person, they have a problem with the water-soluble ones too. That would be your glutathione, your vitamin C, all that good stuff.

Let's find one more example, then I'll open it for questions. See here. Hope this is helpful, you guys. That was not a good one. Let me find a better one. I think the one at the end was really good. Oh, yeah. Ha! This is a really good one. Oh, this is the one. Yeah, this is the one that led to this whole thing. This is, these are all my patients, people. These are all people I've been working on the last couple of weeks. Okay. So you ready? Now, we're, now this is cool. You can figure this one out. This is totally doable. So what's going on with this person? Okay. First of all, we're looking at fat-soluble antioxidants, all grouped together. Does it say that? No. You're supposed to know that. These are fat-sol. CoQ10, the tocopherols, or vitamin E, vitamin A, fat-soluble. What are

They're doing they're protecting our cellular membranes. You really couldn't get a more important job in the body than protecting membranes, right? Membranes are where everything is happening or not happening. So, CoQ10 levels low, gamma tocopherol low, beta-carotene low, this person is missing their antioxidant protection.

I think of it like at a football game. I actually watched a Super Bowl this year. I thought it was a good game, even though it was like this defensive battle. I really thought it was more like watching a soccer game than a football game. But anyways, when the guy hikes the ball, you should have like five really big guys up front that protect the quarterback from the other team. That's what's supposed to happen. So, this is a basic first line defense for a football, right? Imagine if you hike the ball and then three of the guys up front just fell down. The other team would get in and damage you, and then the quarterback would just like be busted up. So, this being low, this being low, and this being low, you've lost your antioxidant protection, right? Those free radicals are just gonna zoom right in and trash your cell membranes, and then your cells aren't gonna work properly. I don't know, it's like somebody, you know, hitting your car with a truck and then you can't drive a car anymore. I mean, if your cell membranes are getting hit by free radicals, the cell's not going to function properly. The whole thing is just going to be screwed up.

Okay, now in this particular patient, the lipid peroxides are low. Does that make sense? No, it doesn't make any sense at all because if you don't have protection from free radicals, this lipid peroxide number should be really high because that shows that there's a lot of damage going on to the lipids or the cell membranes. But it's low. So now we're confused because like, that doesn't make any sense. Why is that lipid peroxide low? And you go to the next page and you're like, oh crap, that's why it's low because the omega-3s are low themselves. Remember? So if the omega-3s are low, and here's omega-6s low as well at the bottom, those are low, what's going to happen? It's gonna drive that lipid peroxide number down. If the omega-3s and 6s are all low, you don't have a lot of lipids to get damaged, okay? So again, these low levels of omega-3 and omega-6 drive that lipid peroxide marker down, and so you get a false negative on your lipid peroxides.

So again, let's go through this one more time. This is the best example. You've got a lack of antioxidant protection. The reason why the lipid peroxides are not sky-high is because they don't have enough omega-3 and omega-6 to get damaged, right? So if you start to give this person fatty acids, which they so desperately need, you better load them up on some extra fat-soluble CoQ10, vitamin E, vitamin A, all of them, right? To get these levels up to protect those fats that you're dumping into the system. So even though the lipid peroxides are low, they're low because they're low on fatty acids in general, right? So that's a false negative. And you start to supplement with the omega-3s and omega-6s, you want to bring up the CoQ10 and vitamin E and vitamin A. You may even want to bring up these fat-soluble antioxidants first before you give the omega-3s and omega-6s. Maybe give them a couple weeks of high-dose CoQ10, vitamin E, vitamin A, beta-carotene first, and then bring in the omega-3s and omega-6s. And you know, I have to tell you, I've just had so many miracle stories in the last 12 months working with these fatty acids. I can't tell you. I've had so many hard cases that I've just completely solved using these, using these, you know, simple protocols, right? Using a lot of GLA, a lot of evening primrose oil, borage oil for these omega-6 people, fish oils when it's appropriate, flax oil, you know, or flax seeds. As many different options you have. But for chronic lifelong depression and anxiety cases, that's several that I've, you know, helped with. Skin problems, neurological stuff. I mean, pretty profound. If you fix cell membranes and you fix these fats, it's just like turning on a light switch for a lot of people. And a lot of people that I tried other protocols with, we're not successful.

Okay, so I'm going to wrap it up for now. But those are the two major themes, right? Theme number one we started off with was that you can look at an organic acids test as a genetic screening tool or a functional genomic tool. Look at this 95% reference range number here. If there are two times that or more, you're looking down the barrel of a genetic problem. You're probably going to need higher than typical dosages to make a difference. Don't be afraid to bring that B6 up to 200 milligrams a day. They're gonna, you know, be responsible obviously and retest people. Obviously, it's responsible and retest people. But don't be afraid to bring dosages up when there's a genetic issue. And then be real careful too as you're fixing these antioxidant problems, which we should do for every patient. This is one of those central problems with humanity now, right? Is fire, mental toxin exposure, and problems with antioxidants, lack of fruit and vegetables. This is like, you know, top item for any functional medicine practitioner, inflammation, oxidative stress. So you really need to know how to fix this. So you're going to really crank up the CoQ10, vitamin E, and beta-carotene, vitamin A in this person, right? You're gonna realize that that lipid peroxide number is going to shoot up when you start to give them more omega-3s and 6s. So maybe you get them on the antioxidants first for a few weeks or a month or so under control, and then hit them really hard with the threes and the sixes. And boom, you start to see people just flip and change. It's really quite dramatic and quite wonderful. Okay. All right. So let us see options here. Where's my office located? Well, I saw you shot in the picture, right? It's right there on the map. It's in, I describe it as North Lake Tahoe. Where's the mo? I won't buy find a map picture anyway. So yeah, it's in, in North Lake Tahoe. Now, although I work with patients almost all on the phone, so we're not talking about dietary change. So for with these particular labs, we're talking about, well, you have to be able to differentiate this comes from clinical skills, I guess, between functional genomic problems and just a plain old dietary deficiency issue.

Okay, let's see. And then Laurie had a question, just work on a Great Plains test too? It should, I'm not sure because I don't interpret those. All my practice, I would assume it if the reference ranges are set up the same, I'm assuming it would, but I'm not totally sure. Does carnitine take a cause hypothyroidism? Have taken too long? Anything can cause anything if you take it too long. So when, when if we do a program like this, say the person has a genetic carnitine deficiency, you put them on carnitine, low, medium, high dose, whatever it is, six months, you stop and you retest. You will never cause a long-term problem if you do that. So it's just at the six-month mark, have them stop all the supplements and retest. If they refuse to retest because it's too expensive, you just say, that's fine, just don't take these supplements because we don't know if you still need them. So I don't keep anybody on anything long term without retesting. It's an important question. When determining a genetic issue, may nutritional intervention, even at high levels, not be sufficient? I don't know. It's working for me pretty consistently now. I'm sure it doesn't always work, but I've been having great results. So I'd say most the time it's going to work if you can really nail this down. What is the best fish oil? I use three different companies kind of interchangeably in my practice. Designs for Health, Pure Encapsulations, Metagenics. There's another half a dozen out there that are really good too. I use a little bit of Douglas. I think if you're working with any of these good quality companies, they're going to have good quality fish oils.

Okay, let's see. If lipid antioxidant tests already in normal range or high level and omega-3 and 6 are normal range, but lipid peroxide is still high, what else can we do? So if the lipid peroxides are high, but the oil, the fats are okay, then you would just use the fat-soluble antioxidants to knock that number down.

Does Dr. Lauren include the genes and specific SNPs that are related to the markers in his book? Yeah, yeah, that's all in his newer books that are on iBooks. Obviously, his old book was a printed copy, so you can't just click on things. But the old book also has thousands of citations. But the new one is much more genetically oriented. And in deference to me being confused, basically, these new books are like a guide to my mind because they're Dr. Lauren and I talking about things that I didn't understand for a couple of years. And every time we have a discussion that I don't understand something, he writes another chapter. It's pretty hilarious. When I first saw that first edition of the first book, he just wrote, I was like, wait a minute, he just answered every question I've had for the last two years, and he put it in a book. Am I okay? But it's probably questions that you're gonna have too. And then let's see, I think I answered another question about supplements. Yeah. So in general, I retest people every six months. And if you're concerned, you can do it every three months, but that's usually a little bit too early.

Okay, all right gang. I'm gonna wrap it up. We're up at our hour here. I hope this was helpful and kind of stimulate some thoughts for you about look at these tests and okay. Have a great rest of your week. Okay, we'll catch up you the next time. Bye for now.