Transcription
So, we had my staff laughing at me because I'm a wiseass. We had, we had this largest signup we've ever had. How many people signed up? MRSA, 814 people signed up for this webinar, which is great. That's our highest ever. Which either means that you all think I'm amazingly funny and handsome, or it could be this is a really hot topic. I'm not sure which one that is true. But I got to tell you this one little story before you start because I'm waiting for people, people are still coming in. Okay, so we'll have this business coach, Lennie Coco. He's was my business coach for 25 years. And Lennie always had this thing about manifesting. He's like, if you just say it enough times, other people will start saying it, and then it'll eventually happen. And so his thing was, he was a chiropractor. So Lenny was like, "I am the best chiropractor in Northern California." And that was his thing. And he was just say it every time you saw Lenny. "Hey, how you doing?" "I'm feeling great, Dan. You know, I'm the best chiropractor in Northern California." Honest, I was kind of this hokey thing. So I started this joke with my office manager where whenever I call in the office, I mean, she knows it's me because she can see on the caller ID that it's Dan calling. But I, I started saying, and I'd chip on the phone, and she would pretend that she didn't know it was me. She had gone to his office. And I would say, "Hi, it's the famous Doctor Kalish." This was our joke for like, you know, 10, 12 years. Every time I called, I was just saying it. And then this happened. I was at a seminar in Atlanta and someone came up to me and I said, "Oh, they looked at my nametag and they said, 'Oh, are you the famous Doctor Kalish?'" I was like, "No, I don't know who that is." And it was just really funny. So if you say something enough times, I'm now convinced that other people will start to say it too.
All right, you guys ready to go? So let's jump in. So this is like naturopathic medicine 101, right? The naturopaths have known for hundreds of years that as the gut goes, so goes the brain. As that, as the digestive problems clear up, the anxiety goes away. As the digestive problems clear up, the depression goes away. Mood is enhanced by clearing out the gut. Damn, this is not a news flash to any naturopath out there. This is one of the fundamental principles of natural medicine that goes back hundreds, if not probably thousands of years. The amazing thing about tonight's talk is that the science that we're engaged in now in conventional, you know, research and modern life is backing up this idea that there is a pretty strong gut-brain connection. So tonight's talk is about, you know, how the gut gets messed up, the common problems with the gut, also a little bit about the brain and how the brain gets inflamed and how you can start to see this connection. But the gist of it all is that if your gut is inflamed and the tissue in the gut is damaged, it's going to have a direct impact on neurotransmitters in the brain. Now we understand the mechanisms by which this works, so it seems a little bit more real. Also, now with the current lab testing that's available, we have really specific ways to treat the brain problems that are generated from gut issues.
So I'll tell you, in my naturopathic medicine training, I'm a chiropractor by license, but I like to think of it like those movies you see on TV where there's like this boy that gets lost in the forest and he gets raised by, raised by wolves and he thinks he's a wolf. You know, I was a chiropractor in school, but I was raised by and trained by naturopaths. So I kind of act like I'm a naturopath. And, you know, does this concept in naturopathic medicine was always, it was really evident to me, which was that as I was taught, was that as we fix the gut, the gain of the brain gets better. But, you know, honestly, in those days, 25 years ago, I was not taught, "Oh, the gut is inflamed and it's causing these brain problems, and here's exactly what you can do to fix the brain part of this." We would really focus on fixing the gut and watch the brain get better. But tonight's talk is about how modern science is kind of integrated with, you know, thousands of years old naturopathic medicine concepts to be able to say, we can target brain corrections for inflammation that's come from the gut and damage the brain, and we're going to get into the detail on that tonight. Okay, so that's where the biggest, I think, news flash of the talk. Again, some of this information is kind of old, thousands of years old, and some of it is, you know, current and new.
And within the training model itself, I always like to talk about with patients these four different things. What's the underlying cause of your problem? It's inflammation from your gut impacting your brain. Tonight's theme. But what kind of physiological damage is going on? Well, there's, you know, a pathogen or a food that's triggering this inflammatory process, making you catabolic, causing insulin resistance, causing oxidative stress. That's kind of physiological damage going on in the body. Which body systems are affected? Tonight we're talking about the brain primarily. So the gut is impacting the brain. And what symptoms could come from that? Well, it could be anything from IBS to depression, from heartburn to anxiety and mood swings. Okay. But when I'm working with patients, I always want to try to identify to them and let them know what, what's what. So in other words, if they have a symptom, this would be the classic setup, right? The most common version of this that we would see. If they have a symptom like a depression that seems like a brain-related symptom, but we can track that down through the body systems to identify that it's a brain-related problem that was generated as an up by an underlying cause of a gut issue. Then we can kind of tie this together. And so very important, know when you explain this to patients, because if you're going to treat symptoms, for example, the depression with some amino acids, which we're going to talk about later tonight, you also want them to know that the underlying cause of this is the gut inflammation. So that they don't walk out the door with their bottle of amino acids, if you like, their depression is gone, and not stick around long enough to treat the underlying cause of the problem as well.
So I like to lay this out for patients. I think it's clear. It helps patients understand the full extent of the different programs that we're going to do, so that they know that some of the treatments that we're going to offer are symptomatic, some of them are really, you know, looking at the underlying cause, and that we're explicit in what we're doing, so that patient knows and then they don't get misled in any way, shape, or form. Okay. Then in terms of that patient experience, what we try to do is literally map this out on a treatment model. I use this exact form in my practice now. So what are your underlying causes of the problems? Okay. Where you've got some emotional trauma from the past, maybe you have some dietary issues, a gluten problem, etc. The damage that that's causing, looking at the body system is impacted. Tonight we're talking really about GI and and neuro. And what are the symptoms? How does that manifest? And the symptoms of course can vary. You could have someone with a GI problem that has pain or allergies. Someone with a GI problem that has brain fog or insomnia. The expression of these problems varies quite a bit, but the underlying cause is a very short list. You know, when you really think about the underlying causes of all the health problems we treat, toxins, infections, scratch, emotional stress, diet, you know, there's six, eight, ten, twelve, fifteen max. There's a pretty limited number of underlying causes. There's a huge number of potential symptoms that come about from that.
So as a simple example here, we can kind of follow the flowchart. So we've got a person who's gluten sensitive. That's the underlying cause of the problem. The damage or physiological damage that's occurring is inflammation that's affecting the adrenals, perhaps also the brain, and that's generating depression-related problems. All right. So I would throw in adrenals and output brain in here too. Okay. Then treatment-wise, you know, you might treat them by cutting out gluten. You might treat them with curcumin to knock the inflammation down. You might treat them with an adrenal program. Or tonight, we can talk more about amino acid programs for the brain. And you might treat them with fish oils and vitamin D or something like that. But if you're clear about where you are with each treatment, so that the patient knows, "Oh, this is my symptomatic supplement that's going to do a certain thing and take me to a certain level." But then here's the underlying cause of the problem. So again, people don't get deluded into thinking that a bottle of amino acids is going to solve their problems when really it's coming from a dietary source. Same exact example with leaky gut and GI infections.
Okay. So I also like to talk to patients about these four horsemen. So the Four Horsemen or the four common things that we see in all of our chronically ill patients. They're inflamed, they're catabolic, they're insulin resistant, they have a lot of sedated stress. You know, these four issues just permeate every single patient complaint that we have. And it could be arthritis, gastritis, it could be a literally toenail fungus or an anxiety attack. Ma'am, pretty much everyone we're working with is inflamed, catabolic, insulin resistant, and oxidant, and has a lot of oxidative stress. So we have a lot of treatment options just within that framework. You know, you can treat inflammation, you can treat catabolic physiology and the resistance, oxidative stress. I have a whole talk on these four. I'm going to give that, I think, early next year. If you guys are interested, you can come in and check out that talk because I talk about specifically how to, you know, treat each one of those areas. But tonight, we're going to focus on, you know, the GI brain connection. Yeah.
So we want to start by looking at the GI portion of this. Here's what an intestinal lining looks like when it's healthy. In an ideal world, and you have it, it's a beautiful structure. Really, whoever designed this should be complimented because it's almost perfect. Well, this is perfect. I'll be more than perfect. So you have the, the villi sticking up, right? And then you have the intestinal crypts that are deep going down. These are the normal structures. And when someone's under a lot of inflammatory stress in their gut, the crypts get deeper, which is not a good thing because parasites can hide in the bottom of those crypts. And the villi get damaged. And I think of it just like an old World War II movie where they're doing a bombing raid over Germany and you see like the German town before their bombing and right after. And what happens after a bombing? There's lots of big craters in the ground all throughout the town, and the big buildings are blown up and, you know, dismantled. In this sense, that's exactly what happens with inflammation. The root word meaning flame, just like a flamethrower, just like a bomb exploding on a city. And what ends up happening then is the gut lining is traumatized and damaged. The tissue is inflamed and the structures and the architecture of the structure starts to change. And we end up with people that look like this, where there's crypt hyperplasia. Again, this is like the after the bombing picture. But again, remember that not only are the villi destroyed, but those intestinal crypts get deeper and deeper. And that is very significant because we can have what they call crypt hyperplasia.
So another sort of offshoot of this particular problem would be leaky gut, right? Now, again, you can imagine a, you know, a city that's been bombed. There's leaks everywhere. Like the architecture, the structure, the topography has changed now. And that can then lead to all these different kinds of problems. We're going to talk specifically just about how this affects the brain tonight, although of course, leaky gut could trigger anything from an autoimmune problem to someone to get overweight, you know, pretty quickly and easily. One of the, one of the interesting things too, is that the way that gut's set up, you know, is that we have these mucosal membranes, these lining tissues. So they're comprising the interface between the internal and external environment. So they're a protective barrier. And most absorption of nutrients comes through this mucosal tissue. And most absorption of toxins comes through these mucosal membranes. Is to so pathogens can enter the body, especially if our secretory IgA levels are low, if the immunoglobulin levels in the gut lining are low, we don't have that immune defense that we're mounting successfully anymore. The gut lining is permeable, the gut lining has lost its immune defense, and the gut lining is inflamed and being broken down. And those things all add up to a leaky gut.
Now, I don't know why it took me, I don't know, 24 years to realize this, but this is something that's really basic. Is if you're sitting in a chair somewhere and you're, you just came back from your third tour in Iraq and you're, you know, active duty military, but you're hit back here, you're stateside now. You spent your years in the Middle East driving around, getting blown up, shooting at people, you know, bad things have happened to you. You're just sitting in the chair having a beer, watching a football game, and this comes from a scene in the movie American Sniper where eyewitnesses in the movie. And you're seething with an internal stress that's generated from the trauma of war. Okay? You don't have to have anything wrong with your gut. You don't have to have any food reactions, or you don't have to have any pathogens in your gut. Just the emotional stress alone will trigger an inflammatory response, which is going to cause you to be catabolic and break down tissues. And your body is going to go right for the breakdown of lean muscle mass and gut lining tissue because it wants to use that glutamine in the gut lining for fuel. Because when we're stressed, we need extra ancillary sources of fuel. And we will shred the gut lining to pull those amino acids from the gut lining, just like we pulled from lean muscle mass to use those amino acids to convert them into glucose to use them for energy. And I know this is a ridiculous system, it's an emergency response, but it's what people do. Emotional stress alone, in and of itself, with nothing else wrong, can cause a massive leaky gut because of catabolic physiology, because we're inflamed.
So in other words, when we're perceiving stress on an emotional level, your body's gearing up for something really bad to happen. It's getting ready to fight an infection, even though there is no infection present. So it's really important in my mind to remember, emotional stress alone can trigger a leaky gut by making us catabolic. We also think of the more common things, right? Lifestyle factors like stem, you know, diet, the eating the wrong kinds of foods, like really toxic environment in terms of chemicals. These kinds of things can obviously all throw us off. As well as gluten sensitivity, you know, these are things we're all more familiar with now. Once the gut is inflamed, again, it could be emotional stress, could be dietary stress, could be some other kind of pathogen or something going on. Once the gut is inflamed, of course, we may, we may get constipation, diarrhea, alternating symptoms of them, gas, bloating, IBS, etc. But at least half the patients in my practice, I don't know what my patients represent, whatever they represent, you know, people that are attracted to my practice. At least half of them with massive GI inflammation that we find on these labs, have no digestive symptoms whatsoever. And this is, I think, for most of us, one of the most complicated areas of functional medicine to understand. Is how could this person have this outrageous GI inflammation going on and not have any GI symptoms whatsoever? It happens. It's frequent. We were just talking today in the community. I did an interview in our advanced class with Kerry O'Reilly, a wonderful dentist. And Kerry was saying that the, there is very common to see root canals or dental assistant, make it more broad. It's very common to see people with dental infections, even very significant dental infections, that don't cause any dental pain or any teeth related symptoms whatsoever. And he x-rays his patients very completely, is very complete, thorough analysis. And he sees these active and significant infections consistently in people that don't have any tooth pain. It's the same thing with the gut. Exact same thing happens with a gut.
So they're these various stages of leaky gut. Most of you probably familiar with this. Starts with local GI symptoms, okay? Sometimes those symptoms can go away. And sometimes, I know it seems counterintuitive, where the gut lining is getting more and more damaged, but the GI symptoms start to fade. And other problems start to come up. Anything from an autoimmune situation to something like we're talking about tonight, which is more focused on the brain. Okay.
So we're going to do an advertisement spot for a minute, and then we're going to get back. And the slide right after this one is like the most interesting slide, kind of set it up that way to kind of to mess with you guys a little bit. But hey, we have a new class starting November 11th. I think that's a week from tonight. There's a couple spots left. We've had a bunch of people signing up, which is very exciting. It's the last class of this year. It's the last time when we're going to offer in my course at this fee, which is 84.95. In 2016, or we're adjusting our fees upward. There's also something unique that's happening with this group is that we have a practice management course, which we're going to start selling next year for around $5,000, which is included free in the group of people who start in November. So it's the last chance to get our old pricing schedule, and it's last chance to get the free practice management course, which has been really really popular. People are loving that class. So if you're interested in practice building, it's a good time to sign up. And one more announcement here, which is that it's probably brand new. This is something we just created. I'm pretty excited about. So we're starting it in December, December 1st. And it's the Kalish Method 101. It's a basic, simple class. And it's for people who are just getting started with all this, right? It's inexpensive. It's like three, four hundred bucks. It's for people who are wanting to build a practice. They want to get a start, to get a sense of a clear canonical model. You want a lot of languaging, a lot of under, you know, explanations for how you can explain this rather complicated work to patients, the way that I have. All these classes set up, including the Kalish Method 101, a little bootcamp thing here, we have it's about a month-long course. Is that everything she's taught in the language with which you can explain this to patients. That can help doctors a lot because a lot of us struggle, and I did for a long time, with, um, am I going to explain this to someone? I mean, I understand the science behind it. I've been to all the seminars. I really get the deep level of physiology and all that kind of stuff. But how am I going to communicate this to a patient in a way that's meaningful to the patient? So we have that baked into this little mini course. We have, we also have, you know, where to start with each patient. And I'm showing you some of the tools they use in my practice as well, some case studies. It's pretty cool. The 101 course, the case method 101 course, it covers stress and sex hormones, GI toxins, and brain issues. So it's a smattering of what we do in the full year-long course that I teach. But it's enough to get you started, enough to get you into thinking about this conceptually, to give you some ideas to start with to work with patients. So thinking of it like a one-month boot camp to get you started in functional medicine. If those of you are interested, right? So check it out. If you want the way that it's structured, have an introductory lecture. Then there's lectures on stress, fatigue, leaky gut, the microbiome, toxins, detox, brain balances. They're about an hour each week on those. And then each week, we have an extra bonus lecture covering male and female hormones. There's a big section on food addiction, brain inflammation, kind of related to what we're talking about tonight. And then a section on meditation. And then I have a case study each week, all these bonus clinical topics as well. And then there's a monthly live call with me. If you want to have questions, you want to present some cases, you want to go over some things. Everything is transcribed and we include a bunch of books and stuff with it too. So it's for people who are wanting to get started in functional medicine, but you don't want to make a huge leap. It's 397 right now. Do that class. It takes about a month. You get me. I'll probably need at least three hours of time each week, maybe three, more like four hours of time each week to get through all the materials. And it's a way to just get started. If you're interested in and taking some of our other classes, you can apply that the cost of that to the to the bigger courses that we teach. But I wanted to have an intermediary class, like a beginning class, that people could just start to get familiar with this. If you're not really ready to commit to a huge training program, you can check this out. We're going to launch it on December 1st. Kay.
Now, here's the best slide in the whole talk. And this is what I was saying earlier, where we've known for centuries that when people's gut gets better, their brains heal. But now we can map out the exact pathways and how this actually works. And you can run this test called an organic acids profile and discover exactly which neurotransmitters are getting messed up because of the brain inflammation. And I can't imagine anything more profound than that. Now, so now obviously, there's two components to this, right? You want to test and correct for the gut inflammation. And that is going to involve everything from, well, leaky gut protocols, anti-inflammatories for the gut, figuring out what are the pro-inflammatory foods, cutting them out, figuring out what pathogens or infections that person has. So we're not skipping that. We're talking about that has to be done as well, right? And you can use J repair powders, probiotics, enzymes, hydrochloric acid. You can test for all the pathogens, treat what you find, get all the fire put out, get all the inflammation calm down. In my practice, I use gluten-free diets with great success. And we treat for the pathogens that we find in the gut within three to four months with most patients, we're calming down the gut inflammation. And that side of this is being taken care of. Also use adrenal programs to calm down the gut inflammation as well. Okay, that's kind of rolling in the background. And then now we can address the effect of the inflammation on the brain specifically. And so there's a series of pathways. There's one right here on the board, kynurenine. And you can measure this with an organic acids test. It's fascinating. You can just do this lab. So when this is elevated here, okay, it means that the body's making a lot of inflammatory mediators. It's inflamed. And the fascinating thing is that we make these inflammatory mediators from tryptophan. Now, before you write like a complaint letter to the design team here, this is a beautifully designed system. And I have nothing but respect for the human body and the people or places or gods or whatever it was to put this whole system together. Because what you will, your body is saying basically in the design sense, okay, this person is inflamed. Maybe they just got hit in their butt with a poison arrow. And we're going to have to deal with the bacteria and the wound healing. So we're going to be working on some anti-inflammatory projects here. Roger, and Roger, you're just going to sit down. And if you're a little sad or depressed while you're dealing with this information, that's okay. Because in fact, Roger, we don't want you happy and sexually active because you just got an arrow in your butt and you got to be sitting down, a little depressed, a little sad, so you can rest up and heal. So in other words, when we're inflamed, we sacrifice tryptophan. We pull it out of the serotonin pathway, the happy chemical, and we shunt it towards the production of inflammatory cytokines. It's actually kind of a brilliant idea, really, even think about it. Because it means when you're sick or inflamed or infected, you don't feel great, so you rest. Okay? You're not going to like go out to a bar and have beers with your best friends and play pool if you just got an arrow in your butt and you're sitting there and it's inflamed and infected. So it's a beautifully designed mechanism. It gets everything done. It's very efficient. We're taking tryptophan, which could be going to serotonin and to melatonin, could help us with mood and sleep, and saying, "Hey, there's more important things happening right now than mood and sleep control. We're going to deal with shunting all this tryptophan down towards a pathway that helps with inflammatory mediators." Okay. And there's some other ones I'll show you in a second too. So this is not like a mistake. The problem is that if you have an arrow in your butt and there's a poison dart and you're, you know, dealing with bacterial infection and wound repair, this all makes a lot of sense. However, if you're sitting in your car driving from Oakland, California to Cupertino, California, like thousands of people do, because you got a job at Apple computer or at Facebook, and you can't afford a house in Silicon Valley, so you bought one where I live in Oakland, California. And you're stuck on 880 freeway for an hour and a half to two hours every morning just trying to get to work. And then forbid, there's an accident, it's two and a half hours just to get home sometimes. You're sitting in that car, you're still creating all this inflammatory response, but there's nothing to fight. Okay? So someone stuck in a car for a couple hours everyday commuting is going to go through the same potential mechanism because inflammation can cause, because just by the emotional stress. Now, most of the patients that we're working with, the same my Silicon Valley area here where I live and work. Let's say they're eating a doughnut on their way to their job at Google and drinking some coffee. So they're driving, their adrenals go nuts. Got enough sugar and gluten in it to cause inflammation in their gut. Maybe they have some H pylori. So they've got like sixteen reasons why their gut is inflamed. They're stressed, that's contributing to the inflammation even more. And so all of a sudden, the inflammation rises so far up that their tryptophan stores drop, and their serotonin levels drop, and their melatonin levels drop. And all of a sudden, I come in and they can't figure out why they can't sleep and why they're depressed and why they're on a sleeping pill and a depressant. It doesn't really seem to be working.
Okay. Now, this is the second aspect of this. I think this one's, though I don't know, to me, this is even more interesting because I think dopamine is more interesting personally than serotonin for a lot of different reasons. But when we're inflamed, we take, and here's the pathway right here, L-DOPA. And we convert it over to colinate and quinolinate. And again, picolinate, quinoline. And it can be measured on an organic acids test. You can see the exact level of these chemical compounds and know if this is happening or not. This isn't like a guessing game. What that means is that your body is taking tyrosine, converting it to L-DOPA, and instead of making dopamine, norepinephrine, and epinephrine, you're producing these inflammatory mediators to deal with the inflammation. So what happens? Dopamine levels drop, norepinephrine levels drop, epinephrine levels drop, and you end up with low catecholamines. Bummer day. Now, you add a little bit of emotional stress on top of that, you got a high burn rate for catecholamines, you got a lack of supply, you're going to be walking right into a perfect storm of anxiety and depression that's being generated because of inflammation and stress. And we see this all the time in patients. Um, it doesn't happen to everybody. Miraculously, we, you know, the training program now, doctors are ordering a lot of organic acids profiles. So we're seeing these every week, more so than ever before. I don't know what's happened, but anyways, we, it's kind of a new trend in the class. And so not everybody has these problems, but when you identify someone that does, you can really turn things around with them. You can treat the markers in the brain that are positive while you're still clearing up the sources of inflammation. So you don't have to get the inflammation to 100% under control. And what are you saying are the potential treatments? You're wondering? Well, the treatments are not that hard. If you see the lab work, there's really only a couple choices here, right? We've got tyrosine, which is going to help with this kind of a case. You can use an herb called Mucuna. Mucuna appears is an herbal form of L-DOPA. Often times we use them both, tyrosine and Mucuna together. And some supplement companies actually package them all together in a single pill, which is highly convenient. Of course, you want to stop the inflammation, so you're stopping the drain here. Of course, you have to provide vitamin B6 to make all this work. I mean, there's a lot of other little variables that are involved. But by and large, you're using tyrosine or L-DOPA along with 5-HTP. But what happens in it, when we're saying this this morning in class, because we had a case this morning where the patient and all these serotonin markers that were that were off, and it was just a hundred percent clear based on the lab, this person's major problem with serotonin. When you see that on the lab, you can get really aggressive with the dosing. You don't have to namby-pamby around with little 25 milligram pills. You know, you can start to bring out the heavy guns and give people a therapeutic amount of 5-HTP, tyrosine, or Mucuna based on these labs. And that can really move the needle in people, really relatively quickly. These solutions have been pretty last.
Okay. So those are the two different basic pathways that we're the most concerned with when we're thinking about inflammation. Number one is this one here, picolinate, quinolinate. And again, these markers are measured on an organic acids profile. And then the other one is the kynurenine pathway that has to do with serotonin. So combined, we're covering serotonin, dopamine, epinephrine, and norepinephrine all together. Oh, by the way, B6 is over here to see there. B6 is important for the serotonin pathways as well. So B6 plays a role in both of these. Where B6 is there, B6 is here. So B6 is ultra, ultra important. Now, it turns out that the microbiome makes a really big difference as well. We're about 10% human, they say that for every human cell in the body, there's about 10 microbes. A lot of these are harmless, some of these are potentially beneficial, but some of these can be quite harmful if things go bad. And of course, the origin of the microbiome comes when we're born, going through the birth canal, you pick up all these good bacteria from your mom. If you're born by a C-section, that's not going to be quite as great. And of course, you can also get the good bacteria from mother's milk. So if you're working with patients that you take their health history, a C-section baby or weren't breastfed, they're much more likely to have a potential inflammatory problem because they won't have inherited or started off their life with a complete intact microbiome.
All right. So then there's also what they call visceral somatic and somatic visceral links, right? You've got connections between, excuse me, the musculoskeletal structure and the GI tract. You've got connections between the GI tract and the brain. So we can have all kinds of different things. When a GI problem is chronic, you have a microbiome imbalance, you can have anything from back pain to anxiety or depression based on how all these feedback loops work. Now, you always hear this, but you know, no one ever talks about it really thoroughly. And a few years ago, I started to study this in depth. And I spent about 12 years studying neurotransmitters pretty actively. And, you know, I had to, I stumbled across this. And you always hear, you know, the main source of serotonin is from the gut, right? So your enterochromaffin cells in the digestive tract are producing serotonin. But what's important to recognize is that the serotonin that's produced in the gut never enters the brain. It can't, because there's a blood-brain barrier. Serotonin cannot pass the blood-brain barrier. So this 95%, 97%, whatever, 90% plus of serotonin we're producing in the gut stays in the periphery. It doesn't enter into the brain itself. The brain produces its own serotonin. The kidneys, for that matter, produce their own serotonin as well. And just as an aside, because this came up yesterday morning in class, I want to mention this. Is a doctor submitted a neurotransmitter test and it was a baseline test for serotonin and dopamine in the urine. So if you're running a baseline test for serotonin and dopamine in the urine, what you're measuring is the kidneys' production of serotonin or dopamine. So the kidneys make serotonin locally in the kidneys themselves from amino acids from the bloodstream. And the urinary serotonin that we're measuring is actually produced by the kidneys in the kidneys. Then remember, serotonin produced outside the brain cannot enter the brain. So a baseline test for serotonin and dopamine is really a test for kidney function and how much serotonin and dopamine the kidneys are making. It bears a distant relationship to what's going on in the brain. Let's just cut them at an aside, which you mentioned anyway.
So these outside the brain sources of serotonin, like the gut serotonin, are really important. And of course, serotonin is named for what it does. Cero, I mean, ysera, more blood tone, in a tone of fire. So serotonin has control of the vasculature, right? It conveys a dilated nasal constricted sub-8. It's involved in the veins of dilation of azo constriction of blood vessels. It also is really important for the peristaltic action in the intestinal tract, which is why we have so much of it in the gut. Again, we don't always think about peripheral serotonin as being super important, but it's pretty important. If there's a reason why it's circulating. Um, abnormal serotonin levels can cause someone to be constipated. Abnormal levels of dopamine could cause someone to be, you know, to have inflammation or tissue damage in their gut itself associated with Crohn's disease. So there's a lot of ways that serotonin and dopamine outside the brain are directly tied into gut function. And we'll see cases of long-term IBS clear up sometimes when we clear up 5-HTP and tyrosine related imbalances. So when we're using supplements like amino acids, 5-HTP, tyrosine, and Mucuna, they go and impact both peripheral serotonin and the central serotonin in the brain. They impact the peripheral dopamine made outside the brain and the dopamine inside the brain. So when we're doing an amino acid treatment, it's important to remember you're altering the levels of peripheral serotonin as well as altering the levels of serotonin essentially located in the brain. So what does that mean? 5-HTP could relieve constipation in someone's been constipated their whole life because the 5-HTP is boosting the serotonin in the gut, allowing for normal peristaltic action. That same 5-HTP will come, will get through the blood-brain barrier. Amino acids go right through the blood-brain barrier. So the 5-HTP will go into the brain and increase serotonin levels. But remember, the serotonin made peripherally outside the brain can't get into the brain. And importantly, the serotonin in the brain can't get out of the brain either, right? Because the blood-brain barrier keeps it in the brain. That's why we measure these urinary markers because they're representative of what's going on, but they're not a direct measurement of serotonin or dopamine. For some reason, in our industry, people have forgotten about the blood-brain barrier. And these all these lab companies that are running tests on baseline for serotonin and dopamine, there are ways you can test for serotonin, dopamine in the urine, but they're very complex and it's not done from a baseline test. So anyone who's doing baseline testing for serotonin and dopamine, I mean, there, it just doesn't make sense in terms of any of the science that we have. Okay. And I think most doctors that order those tests get pretty frustrated because if they're not an accurate reference representation, what's going on.
Now, I don't know. I just kind of got interested in peripheral serotonin because like, well, what for making 90% of it outside the brain? What the heck is going on there? So most of the GI produced serotonin is picked up in the bloodstream by platelets. How crazy is that? I mean, it's fascinating, isn't it? And the serotonin stays inside the platelet for about five or six days, then eventually starts to break down, goes to the kidneys, and then it's released, you know, in the urine. Okay. But it's not released to serotonin, right? It's broken down into the amino acids. 90% plus serotonin made in the gut, we already said that. It's stored in the platelets. That's basically the body's reserves or reservoir for serotonin. And of course, it's in the platelets because when there's a problem, the platelets are involved and wants to serotonin err because remember, its effect is with cero, you know, serum blood tone, Antonio fire, right? Or to do with blood vessels. So when there's a decrease in serotonin in the platelets, the result would be coagulation problems because you don't have enough of it to get the blood to be kind of sticky.
Now, this is an interesting little factoid. And I had to look this one up like three times so they didn't believe it. But when you take an SSRI medication, within two, three, four weeks, it depletes 90% of the releasable stores of serotonin in platelets. You should Google that if you don't believe me. It's incredible. I didn't believe it. I saw this in a presentation. I was like, that's not possible. But it's true. That's not a good thing. It was just a whole another reason why to not take in any depressant because you'll want to have that serotonin around. It's pretty important for a lot of different reasons. The effects of low serotonin levels can really start to impact our diet as well, right? Because when your serotonin levels drop, and remember, this could happen because you're inflamed, you're going to start to get really hungry. And people just can't stop eating. And of course, that makes people fat and overweight. So a lot of the patients that we're working with, it struggle with their weight, have a problem with serotonin or with dopamine or both. And again, inflammation could trigger this problem. And when their levels of these brain chemicals go down, the appetite just becomes insatiable. And these are people who eat a healthy meal, but then they're hungry. And they eat more. They go back for seconds. They have to have dessert every night. You know, those kinds of things where they're just compulsively overeating. They just can't stop.
Let's see here. I want to show some treatment stuff for you real quick. Do a little wrap-up on the talking part, and I'll show you a little bit of treatment stuff. So wrap up on the content for the lecture part, and I'm going to show you some treatment options. The gut and brain actually connected, right? Gut inflammation, sensitivities, allergies, any kind of anything that's inflaming the gut, it's going to cause leaky gut. And that's going to trigger potential problems. Changing the diet, reducing the inflammation in the gut can impact the brain directly. And we can test and correct the gut with the labs for pathogens, food allergies, those kinds of things. And importantly, and I think this is the new information, really, we can test and correct for the different neurotransmitter imbalances that are potentially present.
So let's go back and look at a little bit of the treatment options stuff here. So I think this is always important. So remember, we have too many things that we're talking about tonight on the inflammatory side, which is tryptophan can get diverted. You need B6 and 5-HTP to help correct that. Tyrosine and L-DOPA can get converted to the inflammatory mediators as well. And you can use tyrosine and L-DOPA and B6 to correct for that. If there's a lot of inflammation in the system, and why did I say 5-HTP and not tryptophan? Well, if there's a lot of inflammation in the system, guess what? You want to be careful with tryptophan because if you give that patient tryptophan, it could come down and potentially make the inflammation worse. It could feed this pathway. And until you've dealt with the underlying cause of the inflammation, that's a risk. So you don't want to use tryptophan. But guess what? We can use 5-HTP. And why can we use 5-HTP or 5-hydroxytryptophan? Because 5-HTP is one step further along in this pathway here. And guess what? How convenient is this? 5-HTP cannot go down this way. Can't. Cannot. Cannot happen. So 5-HTP just goes that way, which is wonderful. So in people who are inflamed, you don't want to use tryptophan. You want to use 5-HTP instead. Okay, little clinical pearl there. And you may wonder why, hey, sometimes people don't seem to respond to tryptophan or they get worse from it. That's why. Okay. I was excited when I learned about that pathway because I had seen that in practice, but I didn't never know why. And then plan B here, let's say you have a catecholamine problem. You could potentially use tyrosine. You could potentially use L-DOPA or the herb called Mucuna.
All right. So you've got tyrosine as a potential treatment. We've got Mucuna as a potential treatment. Now, let's take a deep breath and think about this. All right. So let's talk about the easy parts first. So the easy part is that either tyrosine or a Mucuna. Mucuna again is a herbal form of dopa or L-dopa. Either tyrosine or Mucuna will convert to all three of the catecholamines. That's convenient. Meaning that tyrosine or Mucuna will help you make dopamine, norepinephrine, and epinephrine. Three of them. You can see the pathways here how that works. So you can use tyrosine and Mucuna when people are inflamed. I promise that it's going to work. It's pretty, pretty effectively, extremely effective. So you don't have to be worried about that. The question is, do you want to use tyrosine? Do you want to use Mucuna? Do you want to use a combination of the two of them? And so a lot of supplement companies will kind of resolve this for us by making combination products that have the Mucuna and the tyrosine together. So you can just use them both together. And that probably for most of our patients is a convenient way to do it. And then the question is, you know, how do you want to dose it? And what are the, what are the different variables that you want to look at when you're dosing these products?
Let's talk about the tyrosine and dopa first. So for tyrosine, I routinely start patients on 3,000 milligrams a day. So a thousand milligrams of tyrosine breakfast, lunch, and dinner. See if that's enough to start to resolve the problems. If not, I feel very comfortable going up to 5,000 milligrams of tyrosine a day. And tyrosine is pretty self-limiting. You know, if it's going to cause a problem, it'll be pretty minor and people will report it to you right away and just lower their dose. Mucuna on the other hand, the herbal form of L-DOPA, packs a much bigger punch. And I know they look like right next to each other in these pathways, but the Mucuna product is quite an order, I would say an order of magnitude stronger than tyrosine. It's pretty significant. And so I use the product Dopa-Boost from Designs for Health. I'm sure there's many other companies that have Mucuna. I just like Designs for Health as a brand. So I use them. And the thing with the Mucuna is that if you give too much Mucuna to somebody, if you ramp the dosages up too high, too quickly, or you just give them too much in general, they'll report back to you that they just don't feel good. And it'll last for two or three hours. And they'll say the same thing. They'll say, "I don't know what's in that stuff, but I just didn't feel right." And it's, it's a vague sense of unwellness. It's not something that anyone's going to.
Really, you know, be upset about, and you can warn people about it ahead of time. They just still take it an hour too later. They won't feel right. I don't know what it's like. It's like if you missed a night of sleep, like you're up, you only got three hours of sleep because you had an early plane flight. You just don't feel that good that day. You know, it's kind of like a vague, "I don't feel that great" kind of feeling.
And so, the L-dopa sprint or mucuna is pretty self-limiting because people, you know, they take too much of it, they just won't feel well. And you can use these, and sometimes you'll see this on labs, in combination. You can use these together as another option. Okay.
So, most important things to remember. You can use the 5-HTP. And dosage-wise, on the 5-HTP, sorry, I went the wrong direction there. I usually start people at a 100 milligrams minimum. If you're giving the 5-HTP by itself, usually you have to give it at night because it makes people a little drowsy. And then I'll bring people up to as much as 300 milligrams of 5-HTP at night and see if that's starting to affect them or not.
If you have a case where all these pathways are blocked and you have problems with most serotonin, dopamine, epinephrine, and norepinephrine, then you can use tyrosine and 5-HTP together, which is really convenient because you can give that during the day together. And the sedating, relaxing effects of the 5-HTP are usually counterbalanced by the stimulating effects of tyrosine. And so, it's usually extremely effective to give them together during the day. And the dosage then would be 100 milligrams of the 5-HTP that we mentioned already, with a thousand milligrams of tyrosine, together breakfast, lunch, and dinner. And then as needed, starting to bump up one or the other depending on whether you feel like they need a bigger boost on the dopamine side or they need a bigger boost on the serotonin side.
And if you combine this use of amino acids with the anti-inflammatory treatments for the gut, which would be anti-inflammatory diets, things like curcumin that can calm down inflammation in the gut, highly effective, maybe some GI repair powders, maybe some digestive enzymes, treating the pathogens, you'll get pretty consistent resolutions to these brain inflammation-related problems.
Now, there's other reasons why people can have obviously brain inflammation. I'm sorry, problems with neurotransmitters besides inflammation. That's not the only thing. And I just wanted to show you an example lab here so you can see what the heck we're talking about. Let me pull up one real quick and hang on one second. I'll have this up in one sec. Here we go. Linda ba. So, check this lab out. I was going to say this stuff isn't that hard, but it's really hard, you know. And I'll tell you a little bit about my history of teaching this work is that here, here's the organic. Let me just skip through real quick. I'll just show you. So, you know, with most patients, we do an adrenal lab. There's an adrenal lab. We do a GI test. There's a pathogen screen. And then we do the organic acids and look at the brain markers, okay? Not always, but usually. And we try to treat these problems in that order, right? Neuroendocrine, GI, and then detox.
So, you know, the way that the organic acids profiles are often taught is as if the, it's like it's just a micronutrient imbalance, like, like for example, here on this lab here, like it's just CoQ10. And if we just give CoQ10, then this energy production problem will get better. And I've just found that to be absolutely not true and never to work at all in practice, ever. Once, even, you know. And what I've resorted to over the years of studying this is realizing that these are intricate and really tightly related systems, and we want to address these as systems, okay? And you'll get much better clinical results in that way.
Now, I'm sorry, I pulled up the wrong lab, but we should do this one second because it's going to confuse you guys. Hang on a second. So, I'll show you this one. I promise we'll come back to it in a second, but that was the wrong one. Here, let's try this one here. These are real patients from my office, by the way. Here we go. This is right. No, it's the wrong one too. Oh, well, you're going to see all the labs I guess after because I want to show you an example of what we just talked about if I can find it here. The way that these labs are taught traditionally is hisk. It just seems to be confusing to people, to be honest. You know, it just doesn't really seem to help clarify things.
So, I'm going to show you the actual section of the lab that reveals all this, and then we can kind of talk through how that actually works. Here, we just pop it up here. I'll just go, I'll just use this test. We'll cut to the actual section. This would make sense. I mean, there's lots of other stuff in this test we're not talking about obviously, but let's just look at the important part. Here we go.
Okay, so remember we've been saying that there's these three markers and here you see them that are inflammatory markers for the brain on your innate. Remember that's the one that implies that tryptophan is converting. So, if that marker is high, you have a problem with serotonin. We have quinolinic. And remember that was on the dopamine, epinephrine, norepinephrine pathway. So, if that one's high, it means you have a problem with catecholamines. And then picolinate, just like the quinolinic, if that's elevated, you have a problem with catecholamines. All right.
So, if you see one or two or all three of these elevated, you know you've got a significant patient problem with that particular neurotransmitter. People might have all three. Some people might have one. So, it really helps you kind of pick a lane. If this is, if this is the only one that's elevated, you can go down the 5-HTP pathway and be really comfortable that you're going to knock things out of the park and really help that person. And that can make a huge difference. So, you don't have to like stumble around and try to worry about which amino acid might be related to inflammation, which one not. If you just see quinolinic or picolinate or maybe both these elevated, you can be really comfortable on that tyrosine, mucuna side to bring those numbers up dramatically. And you're going to get results within days or weeks from doing that.
Now, remember, this isn't solving any of the inflammatory problem itself. We're just really dealing with that how the brain is responded to inflammation. But I want to show you these labs because I want to show you one other thing before we wrap up and don't take some questions. Kay. The one other thing is that there's another aspect to this test which we're not talking about tonight because this is about GI. But you see vanillylmandelate, homovanillate, and 5-HIAA. Those are urinary byproducts of serotonin, dopamine, epinephrine, and norepinephrine. As you can see on this lab, those levels can go up. That indicates an increased utilization, increased burn rate of these brain chemicals, which increase that, which indicates that the person's under stress.
So, with this lab, you can differentiate between stress-mediated neurotransmitter problems and inflammatory-mediated neurotransmitter problems. Now, of course, you can have bad enough stress that it causes inflammation, okay? So, they can be an overlap here too. But it really helps you differentiate. Do I want to treat the gut and deal with inflammation in the gut, or maybe there's some toxin-related inflammation? Or do I want to more coach the person about lifestyle changes, meditation, relaxation, and things like that if these are elevated?
So, anyways, these labs, you know, they give you this level of detail where you can see, this is a low serotonin person because their gut is inflamed, perhaps you see on their stool tests other evidence of that, etc. This is a low serotonin person because they're stressed out of their minds. We need to more work on their adrenal glands. We need to more work on their meditation and rely and all that. So, these labs are wonderful in that they help us distinguish between the reasons why a person could have a brain-related problem. And it's important because it guides your treatment. If you have a stress-related dopamine problem, you may treat that entirely differently than if you have an AI-related dopamine problem.
And of course, how we're also helping differentiate this is that we're doing more lab testing then that's just these couple of tests, right? So that we're able to see if there's other things going on. Like, for example, I'll show you here, if the person has a bacterial overgrowth like Klebsiella, that could generate inflammation that would lead to problems with inflammation, right? Or if they have, let me just pick up one more here and I'll show you here. It is. If they have a GI marker that looks, a GI test that looks like this and they have Cryptosporidium, they must have a lot of inflammation in their gut from the crypto. You then see the inflammatory marker is elevated on the organic acids profile. You put two and two together. Well, this crypto is causing inflammation in the gut. The inflammation is lowering the serotonin. Have to treat the crypto. Why not treat the brain at the same time? If we get the crypto cleared out, we're going to solve this brain-limited problem. Anxiety and depression will get better. But we're going to use the amino acids to fill things in.
If you see the opposite happening, the gut is clear, but the person is on a huge amount of stress and you see the stress-related neurotransmitter markers elevated, then you would have a completely different kind of treatment plan. All right. So, there's a lot of interesting stuff you can do with these labs. And somehow, it has become my passion in life to teach people this stuff, which I really enjoy. So, again, we have a class starting in a week. If you're interested in the full program, we have this new sort of mini-course that's available starting December 1st. You can check out more detail at KelshInstitute.com. And let me go grab some questions here. They've come in. Go through these all.
All right, so let's see. Let's see. Read out some of these for you. So, this actually is one who's on the line who's a dentist, which is great. I would love to talk with you about our training program for interested in taking the class. You know, we have a really strong interest in teaching dentists this work. I would love for you to take the class. So, feel free to sign up for a time if you want. And that's Adriana. Thank you. See you next question here is Patrick. What stops tyrosine and L-dopa from going down the proinflammatory pathways more? I don't know what the exact mechanism is, but I've never seen that be a problem. So, I'm pretty sure that there's a natural break on that, but I don't know the exact pathway. Okay. And I've used, I've used these protocols with a couple thousand patients. So, I'm pretty sure I would have seen some problems. In other words, people that are really inflamed can handle the tyrosine and L-dopa really easily.
Do you ever use the Genova GI FX profile or only the BioHealth for 1H? So, this is a constant discussion that we have in the Kales community. And we have doctors posting side-by-side comparisons with all the labs, the different lab companies. Right now, we're recommending the BioHealth for 1H, but we use a lot of other companies as well. Some of the doctors use Genova, some of the doctors use Doctors Data, some of them use a newer company, Diagnostic Solutions, some use Dr. G Labs. So, there's a whole plethora of labs. And again, yeah, so the answer, which lab for the stool test is called BioHealth. BioHealth is the name of the company that use.
And someone missed the first part of the webinar. Absolutely, Rick. We're going to have this recorded and we'll send out recording links tomorrow, probably. And see, hey John, thanks for the note here. So, the mini class is just a four-week little primer, you know, it's a four-week introductory class. The mini, the mini class is just a four-week introduction class. And the, the mentorship is, you know, this massive, you know, financial involvement and time involvement. And is, we call it a mentorship because I'm really, you know, working with you week after week directly. Much different. The other one's really just an intro class. Let's see.
You've got a few more questions. And we'll wrap things up. Dosages in children? That's complicated. Depends on what we're using. Oftentimes, it's done by body weight. And then there obviously some of the supplements we can't use in kids. So, I don't have a generic recommendation on that other than if the child is under age 18, usually the amino acid dosages are cut in half. And of course, that the kid is like two years old or five years old, really tiny kid, you probably wouldn't want to use them in the child that young. Okay.
How quickly do these people sponsor amino acid dosages? Sometimes within hours, always within a week or two. If you get the amino acid dosages about right, you're going to see responses within one or two weeks. Okay. So, this tyrosine, the evening with dinner effects sleep? Now, there's a fair amount of clinical information I've had on this over the years. And so, the answer is about 15% of people that we work with will, will take tyrosine and they'll sleep like a baby when they take tyrosine. About 85% of people that we work with, 5-HTP has an improvement as an effect of improving their sleep. And some people, both of these help with sleep. I'm in that 15% group. Like I could take, I'm not going to do this because I don't need it, but I could take 3,000 milligrams of tyrosine tonight right before I go to bed and it would just help me sleep better. About 15% of people respond that way. Okay.
Now, tyrosine in the average person, 85% of the time, is somewhat stimulating and will keep someone awake if they took it at night. But beyond that, scout for that because 15% is a lot of people, you know, you're going to have patients in your practice and tyrosine will calm them down and help them sleep better. It's counterintuitive, you know, because you think it would be the exact opposite. Let's see here. Yeah, so we're going to send out again, we'll send out a recording on this class so you guys can see all that. Let's see.
Ah, but um, if anxiety is high but clear dopamine is an issue, which you still consider tyrosine? Absolutely. Tyrosine helps people who are anxious calm down. It's very interesting. Matter of fact, some of the patients that have required the largest dosages of tyrosine have been the patients who have been the most anxious. Of course, this is all based on the labs. Okay. Let's, you've got a few more questions. Can the tyrosine model? Which I can't read that one. I see.
So, this sir, will amino acid dosages have effect on the muscles? Well, you know, one interesting thing here is that they're not going to learn this after about a thousand patients was I mean, meaning I did all these amino acids with a thousand people and I figured this out, is that, um, when people are well, there's some kinds of musculoskeletal complaints, chronic pain, fibromyalgia type pain, migrating joint pain, those kinds of things. There's a certain small percentage of people with those problems who, when they take mucuna or tyrosine, get significant relief from their pain. So, there are some people in whom these pain syndromes are coming about because of abnormal dopamine levels. It's a pretty small percentage, but when you hit a patient like that, it can be really life-changing for them.
So, how would you differentiate between a serotonin or dopamine issue? Some clinical symptoms? Well, in general, what anxiety could be either way. Most of the time, sleep problems are related to 5-HTP, but not always. A compulsive overeating can be either. In general, we think about things like uptight, stressed, irritable, moody being more on the serotonin side, whereas brain fog, lack of motivation, physically exhausted more in the dopamine side. It's pretty hard though when you start to work with patients. I don't think just talking to someone and getting their symptoms is very accurate way to do this. Often, you know, you'll see that the labs won't match that.
So, for someone who takes Ambien every night or someone who's on an SSRI, you can still use the amino acids just to be careful with your dosing and make sure that the doctor that's prescribing the drugs is aware of what you're doing because sometimes there can be side effects of the medications once you give the amino acids. And we can do a whole separate talk sometime on the amino acids themselves because it's pretty interesting. Let's see, one or two more questions here.
Oh, ADHD. So, we do have significant improvement in kids and adults with ADD, ADHD with these different protocols. They tend to be people who are more on the tyrosine and mucuna side, along with absent compulsive disorders, restless leg. There's certain conditions that much more tend to be towards the dopamine side more frequently. Okay.
And then, can you use these patients already on an antidepressant? You absolutely can, but you have to be really careful. I'm gonna end on this question, Kay. So, if someone's very depleted in serotonin, for example, and they're on Zoloft or Prozac, and you give them 5-HTP, what do you think is going to happen? That drug now was not able to be effective because they didn't have enough serotonin or 5-HTP in their system. If you then give them 5-HTP, it's going to greatly enhance the impact of that medication.
So, what happens frequently? Patients put on Prozac, Zoloft, helps their anxiety, things are better. A couple of years go by, not working so well anymore. They increase the dosages. Couple of years go by, they increase the dose again. Now it really doesn't work that well. The anxiety is back. Patient tries to go off Prozac or Zoloft, but then they get even worse when they go off it. So, they're kind of stuck on this drug, but they still have their old problem that came back. That's a classic serotonin-depleted person. If you then give that person 5-HTP, you're going to activate the drug. All of a sudden, the drug is going to have serotonin to shuffle around again. And so, they can get some side effects from the medication which were not present previously because there wasn't enough serotonin to cause problems.
So, you can cause major issues with it's not a drug-supplement interaction so much as it is your re-potentiating or you're reactivating the effectiveness of the medication that is in effect worn off by using the amino acids. And of course, if that does happen, the best thing is to work with a psychiatrist and prescribe the drugs in the first place so that the person can drop the dosage down to an amount which would be effective. Because typically what happens is the 5-HTP comes up, they don't need that much Prozac or Zoloft. They can cut their drug dose down and, and sort of, you know, balance things out that way. So, be careful with this because you can definitely cause symptoms in people if, if you're not careful.
All right, gang. It's been an hour. I want to thank you for hanging in there. And I hope this talk was helpful for everybody. And we'll have another one next month. And we'll send out copies of the recording. All right, everyone. Have a good night. We'll talk to you soon.