EP 185 WTH?!?: Hormones & Brain Health: Unpacking the Mitochondrial Connection with Dr. Dan Kellams

Foreign. Welcome back, everybody. Dr. Greg Eckle and what the health. Today's topic is hormones and their impact on neurodegeneration, brain health and longevity. My guest is Dr. Dan Kellums. He, he's at the staff and leader of Peak Vitality out of Denver, Colorado, and he's dedicated to helping patients with chronic health conditions. He specializes in and embraces a functional, holistic health approach and often helps patients in the Denver area and around the country with autoimmunity and chronic health disorders live longer, happier lives with longevity care. In addition, he helps patients maintain optimal hormone levels and improve their reproductive health. Welcome aboard. Dr. Dan.

Happy to be here. It's good to see you.

Hey, I am really excited. We both are educators for a functional medicine group called Go Wellness and you have been the blood work guru for over a decade. And before we got in the air, you're talking about, you're just kind of reinvigoration with hormones and how that fits into the healthcare puzzle here. And, and so I'm really excited about this because I always learn new things from Dr. Dan. So that said, no pressure that, but let's talk about, you know, hormones. You know, there's been a lot of discussion about bioidentical hormones, hormones in general. I can't believe there's still controversy around hormone therapy. And let's talk about it in brain health and longevity components, what you're finding, what you're seeing, maybe how you measure these things.

Yeah, absolutely. You know, it's, it's interesting. I, I think what, you know, really drove. We were, you know, in our conversation, we were talking about, you know, where we've started to shift focus and looking at these hormones, you know, from, you know, the beginning of life, the end. And what was surprising, you know, the, the importance of, of brain health and you know, when, especially with that aging brain. And we were really honing in on its impact on mitochondrial function. Right. But our, our, the, the depth of our, our, you know, knowledge on it, we started to expand that because there was some really good research that, you know, when you're an infant, like day one, when you're born, a lot of infants will actually have higher levels of sex hormones in their brain than their adult counterparts. And so it's like the, the, the formation and the specialization of these neurological tissues are so, are so critically reliant upon healthy sex hormone levels. And you know, you, you, you actually, they say you kind of go through like an infant pause because right after birth those levels then drop back puberty. But yeah, the I think if we, we honed in on mitochondrial specific because that, you know, it's like if we're talking about the aging process or any health conditions and I know in your world you really focus in on like if you have enough energy, if something has enough energy, there's some really massive changes that can be made. But you take a person who is in a bioenergetic deficiency or crisis and it's like, okay, now you got a case where it's really hard to get turned around if you can't get those energy levels optimized. And that's where you know the, there's a huge role to be played by the steroid and sex hormones on mitochondrial health. And that's where we really started to hone in. I think one of the, the first impacts that we saw was the, you know, looking at the fast impact that a massive drop in estrogen can have on neurodegeneration and psychosis in females. And so it's like, okay, what is that mechanism? Why is that so important? You know, so the, the, the enzyme that PGC1alpha that we see on like Odyssey and exercise and fasting and cold therapy is, is massively activated via estrogen. So estradiol drives that. And so one, the, the estrogen has a huge kick in activating mitogenesis. And where on testosterone can have a kick on that as well, but usually through those nuclear related factor pathways. Right. So we get that pro oxidative trigger that drives mitochondrial health. And you know, they did a really, did a really in depth study on cardiac mitochondria and they were looking at these specifically they found testosterone actually improves the CRIS diet inside the mitochondria. So structurally you're, you're going to be able to create more mitochondria, have healthier mitochondria and then all of the sex hormones, estrogen, progesterone, testosterone offset the oxidative stress in the electron transport chain. So we're just talking about bioenergetics. You can't have that discussion without considering the role of these sex hormones and how to keep those optimized.

So interesting. Yeah. So, so let's, let's paint that kind of the meta picture there. So with really looking at the sex hormone steroid hormones, interchangeable those terms with their antioxidant and mitochondrial protection role. And just for the lay listener, mitochondria, why are they important and what happens to them as we age?

Yeah. So mitochondria that you know, everybody says, when you say what's mitochondria if anybody's heard anything, they'll say it's the powerhouse of the cell, right?

Yeah.

And you know, they have a lot of roles story and you know, storing calcium, triggering apoptosis. You know, they, they, they regulate a lot of our aging process. But it's also where the sex hormones are made. But the is their activation and creation of ATP, that's our energy. And they take those substrates, our glucose and our fats, and only in special cases will take protein, but they'll take glucose and fats and they turn those into the energy that our body requires Every, every cell. And you know, to give you an example, if you think about, you know, if you ask the question, which tissues never get a chance to take a break and you think, okay, heart, brain, you know, lungs and liver, these things are constantly working. They have the highest mitochondrial density. You know, we have lots of it in the prefrontal cortex in the frontal area of the brain. So one, you, you, you have to have these to make energy. And in the tissues that require the most energy, that's where you find the highest density. And they say it can make, they, they make up like 10 to 15% of your body. We, how important these things are. But that's where we get all of our energy. We think okay, we eat food. Where how does that make energy? What's the mitochondria? And it's creation of this ATP. So one, that's where we get all of our energy as we age, free radicals, nutrient deficiencies, you know, stress on our bodies just we get this age related decline. Right. And so these things are constantly going through a recycling process where they're renewing themselves, you know, so you age a little bit slower and better. The less oxidative stress you have, the less stress you have in general, the better your micronutrient intake is. And all the other hormones like stabilizing this is blood sugar and glucose levels and keeping like thyroid healthy, you know. And when you eat, I think, you know, some of the early presentations I, I actually learned from you was the role of like all these things that impact like in early studies on the neurodegeneration. It's like you gotta have your hormones, these tropic factors and regulating that blood sugar and offsetting inflammation to maintain a really healthy brain. And so energy is required for all those things to work. And then we get this age related decline in those things. And so the harder you live and the faster you live, the faster you get that decline. But it's really the free Radical damage that accumulates in our bodies at our age that really damage those mitochondria. And if, if we're not doing things to keep them healthy, of course we age faster and we, we are more prone to all these chronic disease and illness.

Are there specific ways that you are measuring that or certain patterns that you're seeing with your patients?

Yeah, I mean, I'll tell you honestly, the biggest thing, Dr. Eckel, that, that we see that's a good indication of mitochondrial health is a in office neurological exam where we find when that brain fatigues really fast because you know the, if there is a neurological or mitochondrial issue, you're going to see it typically in the brain first or in the gut. And when, when you're having someone do like little exercises like finger tapping and you know they quickly fatigue out and start messing up or you're having them change different things. Whatever, whatever it is, you'll see fatigue hit. A lot of times we'll see it in certain behaviors like maybe it's reading or just standing, listening to music. Whatever area of the brain seems to be the most impacted, you'll see the neuronal fatiguing in that area first. And that, that is one of our biggest and simplest indicators that there is a decline in total mitochondrial health and it's really going to show through neurological situations. That's why I was so excited to talk to you because I know, you know, with everything that you've been doing in the amazing work and the outcomes you get with people, I know it's like, I'm sure you see that.

Yeah, there's, you know, there is a new kid on the block. It's called me Screen Himel Patel out of ucsd. I'm going to share it with our, our network when it's ready for prime time. But it, I know that you're going to love it because it is a mitochondria test, one of the best ones that I've seen out there. And it measures four succinct areas and one of them being reactive oxidative species on the mitochondria. And you know, I think we'll just try to say mitochondri as many times as we can during this podcast. And, but it is that important and, and looking at all chronic illness when it comes down to that energy factory, these are really dynamic organelles and I think, and you had mentioned then the next step of the process from that kidney bean shaped organelle of the mitochondria goes creating ATP, then it goes through that electron train Chain transport. And there's a lot of research coming out. We're going to see a lot of people talking about that next step is going to be the, it's the next horizon of research that's coming out. So, you know, we are living at an amazing time. I still, you know, there's so much to kind of push in on and explore, but in the real world, it really matters. Are we moving the needle for our patients? And so maybe you want to share some stories of folks where you did some optimization of their hormones and you, you found some really great breakthroughs for them.

Yeah, absolutely. And to touch back on one of the other tests that we find is a really good breakdown of the mitochondrial components and these, the organic acids is the metabolomics. That's really great because you get to see, you know, you know, the Krebs cycle production, you get to see the electron transport chain production. You also get to see the metabolites being produced by utilization of the fatty acids and the, the glucose. So that's a really. Have you done that one? That's a great picture. You know, it's, I'm really interested in the ME screen, but that metabolomics is a great picture. We'll, we'll pull that in when we need to, to narrow things down. But, you know, when we started to look at hormone optimization, you know, first, like your, your master hormones, like regulating that, the cortisol, getting the adrenals healthy, really stabilizing the thyroid. And then, you know, one of the things that I, I think is super surprising and a lot of the people that we find have some really low hormone and low energy is their, their iron status is just horrible. Right. Like, okay, you know, I know with aging we tend to see some people and women, I think we see quite a bit of accumulation of excess iron. But if that iron status is not balanced, you know, that's a really key piece. So, you know, as far as, like some of the outcomes, what's incredible, and this is where the fertility, you know, really made a massive change, is, you know, the highest density of mitochondria you're going to find between males and females is actually going to be in the ovaries. So it takes so much energy to create a spark of life. Right? And that makes sense, like, okay, how much energy do you need to create a human being? A lot, actually. And so, you know, you got to have all this mitochondria there. So when our, one of the, one of the key principles behind our fertility program has been optimize energetic output in these bioenergetics. So when we start working on these things, we have to optimize these hormones. And that's been a key piece, is identifying. We can do that a lot of different ways. But when we. We do our initial labs, I love the Dutch test, and, you know, we'll look at, you know, some of these markers in the blood. The Dutch test, we're going to get like, you know, all of the hormone pathways. So then you can identify in there where those hormones are off. And what's interesting is when you optimize those chains, you start to see a turnaround in someone's energy levels. And that's why a lot of times, you know, the. The quick fix is to put someone on bioidentical hormones. And what happens, Energy turns on. They start getting that. That drive, that perseverance, you know, to get in there and do the work. Motivation increases, libido increases. But the. The amount of hormone receptors in brain and neurological tissue really are incredible when you see that, because people start to feel like they're themselves again, and it clears brain fog very quickly. And so that's something that we see consistently across the board. Regardless of how you're going about optimizing those hormones, once you get them to where they need to be, you. You'll find a person say, I feel like my. Myself again.

Cool. That's really awesome.

Yeah, it's been. It's been incredible. And, you know, there's a lot of natural ways. I think a lot of people are looking for, you know, like, this one pill. Like, I hear a lot about the Tonga Ali and, yeah, these things to optimize testosterone. But the reason it's low or the reason the estrogens are low is you want the big picture, you know, and you and I are. Are pretty. Pretty similar in our. In our efforts to get down to root cause and look at the labs and say, okay, yes. You know, when someone says, I have low testosterone, the question is why? Or, you know, if you're, you know, if you're low energy, like, what do I take for low energy? Well, you tell me why you have it, and I'll tell you what you need to take. Right?

Yeah. Everybody wants to know, well, what can I take? And it's like, well, it's a different path to get there. It's the why that really matters. And in that assessment, so in that endocrine triangle that you've been talking about, the adrenal glands and then the steroid sex hormones, estrogen, progesterone, Testosterone. Thyroid is up there. What are you seeing thyroids function with the brain health, glial health in particular.

Yeah. So you know, there's some really good research both on hypo and hyperthyroidism. And what's interesting is in hypothyroid states, glial cells, they, they have to be attenuated by healthy thyroid. And if you have low T3 specifically, you tend to see that those glial cells, they start leaching out inflammatory cytokines. So one, that's, that's a big piece on the neurodegenerative side. The next thing is, and it's so multifactorial when it comes to thyroid. One day I, I sat and I thought well, how many different mechanisms specific to thyroid are going to disrupt brain health? So we go, okay, low T3, we have this, this glial cell disruption and we get a pro inflammatory state. The next thing is, is you start seeing structural deterioration in your neurons and your astrocytes because that thyroid hormone is necessary for the reparative drive. And it's metabolic feature. Right. So if the thyroid regulates metabolism and the activity or the ability for these cells to be turned on, we have to keep that turned on to maintain healthy repair and clearance of out of the brain and keeping that also that blood brain barrier integrity in place so the, the lymphatic system can work properly. And so then, then it, so you got a metabolic feature, you got energetics. Just in general because thyroid hormone has two really specific receptors inside mitochondria. So we have ATP production, we have just metabolic features of activity, of reparative processes and clearing out that all that toxin and accumulation in the brain. And then we're going to see this glial activity not being properly attenuated due to a low thyroid state. So those were three really massive mechanisms that we see there. So I think those are huge. And then how the gut has an impact and the thyroids role in gut health. And so if you get it, you get downregulation in the gut, the mitochondria in the gut, because the thyroid, now some of these neuropeptides like VIP and BDNF and then also again not having gonadotropin releasing hormone in the, in the, the, the gonads producing and the adrenals producing these sex hormones to then have those available for neurological tissues is crazy. So the, it's like this crazy spider web. It's like, okay, once it's off, that's not good. Right.

You know it, it really speaks to the matter of when you have neurodegeneration and only going to a neurologist who is not looking at any of that, they're really missing the boat in that, you know, of course, it's all connected and one entity and to. To, you know, that this. That's what I love functional integrative approach, is that it really puts the whole. It's a systems approach. It puts all of it together. And you see, I mean, you know, we start talking about the thyroid, and you're like, well, it's integral in the gut and the gut connection with the thyroid, which then has the brain connection. And so you have all of these regulatory components feeding feedback loops where you can't just address the neuron. Right. I mean, and then if we take it one step further back of like, okay, well, how do we prime for the hormones? Right. I know you wanted to talk about that today, too, around the, you know, omega 3s, omega fatty acids, and how important those are in this discussion of hormone production in brain health, et cetera. So I'm just going to lob that to you, Daniel.

Yeah. You know, one of the things that. That popped into mind that we hadn't even talked about was the role of thyroid and these hormones and how they also regulate specific aspects of the immune system.

Ah, yeah.

And that's a. That's a whole other component on this. And like, and. And so, like, to your point of go to an endocrinologist, they're not looking at what the immune system's doing. You go to a rheumatologist, they're not looking at what the hormones are doing. And then the neurologist certainly is not.

It's.

It's. It's so broken. I remember one of the first conversations I had with you when you first. You wrote your first book, Shake it off, and I was like, you know.

What are you doing?

You're like, I'm looking at everything. Right. And you were.

I was like, oh, my gosh.

Right.

That was a dumb question.

I should have known that was the answer. Right. So that was so exciting. But, yeah, so, you know, to. When we. When we take that step back, first we want to get an assessment. And you almost, you know, you have to take this from a priority standpoint. You know, you say, okay, you know, we know these things are disrupted. How do we first start to optimize these? Now, from a generic endocrinology standpoint, from a functional, you know, perspective, one thing you want to do is make sure that a person doesn't have Any massive micronutrient deficiencies. Right. And that's a critical piece because these are precursors 1. They're building blocks for all of our tissues, our proteins and, you know, so. And our carb, you know, the carbohydrate intake that we need to create some energy. So micro and macronutrients are so critical. And then we don't just need these for building blocks. We need these cofactors and enzymes in order to, to make hormones and make tissue. And that's still a critical piece. And that's where like omega fatty acids and vitamin D status are so incredibly important. And people can get some lab measurable increases in their sex hormone levels just by adding those back into their diet. If they are in fact deficient or, you know, in. Our level of deficiency is way different than that. 30 to 100 on the vitamin D scale. Right. I like it on the upper limits, 75 to 80. And you know, we had in. In really to talk about how important that is. You know, we know vitamin D has a massive impact on brain health. I. I've had. This has happened multiple times. We'll have somebody come in for infertility and they don't feel good and we'll run their labs and, you know, we'll see these micronutrient efficiencies. The top ones we see are D and zinc. And you get them started on that and you'll see them turn around. You know, they've called. This has happened multiple times where we'll, we'll get a call and like, you know what? I, I really wanted to work with you guys, but I took the supplements. You told me I was lost in or lacking and I'm pregnant. Like, oh, well, that's what you needed. Clearly that was important. And so, you know, it's so important if it's, if it's needed to spark a life, it's definitely needed to keep a life going. Right.

So, yeah, I'm curious on that front. Have you tuned into the copper cure with morally Robbins at all? And copper's role in, with the vitamin D and the zinc and those ratios.

It's okay, just.

I'm throwing you a curveball live.

Oh, no, I, I'm always. That's why I said at the beginning of this. I'm gonna learn something today. So you said that. It's called the copper cure.

Copper. Copper cure. Okay. Basically it's called. Yeah. Cure your fatigue. How balancing three minerals and one protein is the solution that you're looking for. Well, I'll have him on here, Morley Robbins, you know, he's opinionated, but also has some great research and it kind of ties into some of these discussions around micronutrients and balancing the hormones. So it's kind of, it's a fascinating, maybe a little controversial read, but well worth our, our attention. I'll just say. I'll just leave it at that.

Yeah, yeah. Well, I mean clearly, you know, if it's worked for some people and enough where someone said, hey, I'm seeing this consistently enough, I want to write a book about it.

Right, right. Yeah. So on let's talk about the omega omega fatty acids and why are they important to measure and how does that fit into this conversation?

Yeah. So you know, one massive anti inflammatory pathways. Right. So your epa, your dha, and we know that those are really important specifically for cardiovascular tissue and brain health, but they have, it's massively, massively anti inflammatory. And on that, one of the key features when it comes to hormones is the prostaglandin pathway. The PG3 prostaglandin 3 pathway requires omega fatty acids and most of us are depleted. And so that is a primer for every hormone receptor and hormone function. So you can really improve the pituitary output of the gonadotropin releasing hormone. You start to see better improvements in production and utilization of the sex hormones, the estrogen, progesterone, testosterone. So really with the anti inflammatory role and the primer and improving these receptor sites with the role of its, the prostaglandin 3 pathway, that is such a critical piece that a lot of times overlook. So you know, that is a, that could almost be its own segment of saying, hey, from a functional perspective, got to make sure those omegas are optimized. Right?

Yeah. Yeah. And how are you, what, what do you like there? I mean you're just going, I mean that's an omega 3 index that you run. Yeah, that's in a, basically all, all any lab across the United States. You can get those.

Yeah. And you know, Boston Health has put together a really good panel and they graph it and you can get that through your lab core or you know, we use a lot of Avexia, but their whole profile is really good. But I like to get the whole of the omegas because they all have, you know, one, they all have their, their, their space in our health. But also understanding what those ratios are, your omega sixes to omega 3s because you know, our, our standard American diet is so omega 6 rich and very omega 3 depleted. So that ratio is almost as Important as also just getting a read on your total Omegas and Omega 3. So y. Great, easy labs to get.

I, I am looking Forward to the Dr. Dan course on blood chemistries. When's that coming out?

Oh, pretty soon. You know, I've actually been working on putting the details, you know how I get like rabbit hole after rabbit hole. I was going to call it the rabbit hole of blood chemistry. So still putting some pieces together but I'm gonna, I'm working on a certification course for you know like pretty much like a, just a functional course to understand like the translation of the labs into you know, a. In a clinically effective, you know, standard to start with.

So I think that is so needed Dr. Dan and I really encourage you. I, in fact I'm going to give you a pom pom moment, pom pom on that to do that and we'll have you back on when it's ready to for prime time. I have a lot of clinicians and providers that do tune in to what the health. So would love to get that out there. What would you. So you know, kind of bringing this thing into the station a little bit. So we've been kind of this way in that. What, what's the take home message for people listening for with hormones and brain health? Let's say.

Yeah, so I'd say first is get a read on where your hormones are. You know, if, if you don't look, you don't know. Yeah. You know, you can't say I think I got perfect, you know, hormones. You know when people say I'm healthy and I'm say, you know, what's your measure of success there then you know, if you're healthy. So one, get a measure on it. Two, hormones don't act in an isolated environment. They're reliant upon your, your big features. So when it comes to those hormones, you want to get them optimized too to get them there. There's, there's a, I'd say there's these five eyes that you want to be looking for, want to reduce your inflammation because that's going to make the body use those resources elsewhere. There's a really good study on the endocrine system and the impact of inflammation. And so one, look at your inflammation. Two, make sure your insulin is where it needs to be. Get your, you know, any imbalances in your nutrients. You want to get those honed in. You want to make sure you don't have any chronic infections. Right. And the last is that iron status. So those are the five eyes. I'd say, look, we see these five things impact those hormones, and both directly and via the hormone pathways impact the brain health. So, you know, brain's a part of the rest of the body. And if you want that brain to be optimal, you want those sex hormones to be optimized as well.

Awesome, awesome. Great take home right there. Any last parting words that you'd like to share?

No, I think one, people need to stay tuned to this, this podcast because you're, you're, you're constantly growing, expanding, and you, you constantly, over the years, we've been friends for a long time. You've challenged me to constantly be a better practitioner. So one, I can't encourage that enough.

Oh, thank you.

Yeah. And then two, you know, once you, once you start down the pathway, just stick with it and, you know, make sure that, you know, you don't want to assume success and you don't just like you don't want to assume health. So get it measured.

Get it measured. All right, Dr. Dan Gelums, thank you so much, everybody. If you like today's show, give us a thumbs up, get out there, give us a five star review and put down a take action moment. Like, what did you learn? What are you going to do? And share that because that's how the change happens. It's coming right here through that green dot to you, in your living room, in your car, wherever you're listening. We wouldn't be doing it without you. So thanks for tuning in and we'll see you soon.