Burned Out, Brain Fogged & Running on Empty? The Hidden Reasons Your Energy Is Crashing

Welcome back, Senergy listeners. Last time Dr. Sam Che joined us, he introduced a concept that clearly struck a nerve with many of you. The idea that the mitochondria are the body's factory for energy. Dr. Sam is an expert in this area, and we are thrilled to have him back. And we're going to take this conversation even deeper today because for many people, that factory, that energy factory, is not running the way that it should. This isn't about just feeling tired. It's about brain fog. It's about burnout. It's about poor recovery, low motivation, inflammation, hormone changes, loss in drive, and feeling like you're just pushing through life instead of living it. This is also June and it's Men's Health Month. And so we wanted to pause and take a deeper conversation in what happens to men. And honestly, so many of our high-performing people as well, when they keep trying to lead, they're providing, they're parents, they're working. And they're serving, but their, their tank is empty because eventually pushing harder, it just doesn't work. So today we're diving into the hidden physiology behind low energy, mitochondrial dysfunction, hormone imbalance, toxins, stress recovery, and what it actually takes to rebuild capacity from the inside out. So this is a conversation I think many people deserve to hear, and I'm super excited about having Dr. Sam back. So, Lori Esarey MS, what about you? What do you want to dig into today with Dr. Sam?

Well, you know, in our practices every single day, one of the common, common complaints that people come in with is fatigue. I mean, that's just common, right? So, and I really want to dig deeper into this idea around and the concepts that Dr. Sam, you articulated so well last night, last time, and you kind of left a little hook that we just had to come back to go deeper because it's not just about the mitochondria. We talk about the mitochondria all the time, but we need to understand the why and the what and how it all works. So I'm ready to, to break it all down in easy terms, layman's terms, so people can walk away today with something they can do differently to improve their energy and honestly their future health.

Absolutely. So if we want to understand what, what are the mitochondria, why are they so important, and why is it a big buzzword aside from being an amazing Scrabble word— you got like M's, T's, N's, G's, like it's a lot of points there. So mitochondria are The, the, the, the energy factory of the cell, the powerhouse of the cell. What does that actually mean? And so to, to make it real, if you look at a big city, New York, San Diego, and you cut off the electricity, it's gonna take turn in, it's gonna take 3 days until it turns full Mad Max. So a city without electricity is not only unusable, it's dangerous. And you cannot run a city without electricity. What is the major debate that's happening right now is where are we gonna get all this electricity for the data centers, the AI, et cetera?

Yeah.

And then suddenly like nuclear power is cool again. Uh, like it's like, oh my God, look, it's the best. And then now you've got talks of like micro, micro reactors that you can fit on the back of a truck that could power a city. Like there's, there's now entire new, um, economic sectors devoted to massive, massive, massive amounts of electricity. 'Cause you can't run the thing unless you have the juice to run the thing.

Mm-hmm.

So if you understand that electricity is critical for a highly complex interwoven society, it's less critical if you are a nomadic tribe of 150 or less wandering around the, the steppes in Central Russia and back 500,000 years ago. But there was no electricity. There was, there wasn't a big enough thing to make it a necessity. Now we are— we, we require it. So if you've got low electricity, then if you, if you got no electricity, then things are really— then you're, you're basically dead. If you've got low electricity, then things struggle. You've got power outages, you've got rationing, you've got certain essential services are kept on, other non-essential things are shut off. So the analogy works in the body just as well. But one thing that is— may not be clear to people is that it's like, oh, we need electricity factory, it runs the No concept of just how big the electrical grid and electrical factory is relative to the size of the city. So the mitochondria take up, depending on what paper you read, anywhere between 5 to 10% of the entire human body weight. Your entire human body weight. So I just want people to conceptualize— imagine 5 to 10% of the entire footprint of Manhattan or Dallas or Austin or Salt Lake City or whatever is the electrical grid, 5 to 10%. That means every 10 feet you travel, 1 foot is around about the electricity.

Mm-hmm.

Or 1, you know, or, or 1 to 20 feet, you know, 10 to 20 feet is depending on what paper we'll just call 10% just 'cause it's easier for people to, to lock on, but the significance of it. So 10% of your body weight is the factory. Now the factory, the 10% is not the, is not the electricity. It's the thing that makes the electricity. The electricity is called in the human body ATP. You cannot— you, you make roughly your entire body weight worth of ATP per day. That's why you can't eat purified ATP. It is worthless. You'll do nothing. It's going to cost you more to chew than to swallow whatever ATP you got in a little ATP bite. So what you're trying to do— the factory is so valuable because what it does is that even though it's like fragile and expensive and requires a lot of moving parts, it is efficient. It's efficient. Burning a piece of wood on a campfire is not as efficient at scale as breaking apart two atoms to get nuclear power. The nuclear power plant is bigger, complex, expensive, et cetera. But the sheer scale and cleanliness of it, like, yes, there is residue left over from a nuclear plant, but you're talking like no carbon in the air. And it's quite like you can, you can just kind of like build it.. And it's not— you're generating logs, logs, logs, logs, logs more of electricity compared to what's in this quick-to-make little dinky campfire. So that's why the mitochondria are so precious and so important, is because they allow us to generate our body's weight worth of electricity using only 5 to 10% of our body weight. If we understand that The mitochondria is the factory, and there— and takes up the 5 to 10% of our body weight. Anything that damages, impairs, or slows this factory is going to affect our cells, which is the city in this metaphor. Like, mitochondria— the cell is a city. It's going to affect not only the individual city, but if you have blackouts rolling across multiple cities, you now affect the country. You affect the whole organ, you affect the world, which is the whole body. So if we have a global energy drop, the whole world is in trouble. You get one system— imagine if you just suddenly lost half your power to your liver. The entire— like, that's a country. The whole world economics is going to stumble at that point and possibly fatally. So this is why there is so much hype around— deserved hype, I should imagine, I should mention on around the mitochondria. So now how do we make this more granular and more practical? If you think of the factory, what does a factory need? And for those who are visually engaged, there's a slide, but you don't need to— if you're listening, you— I'll spell this all out. You don't actually need this slide. It's just for the people visually to help follow along. So to run a factory that's generating electricity, you need fuel delivered to the factory to burn. So you've got 3 different fuel sources, fats, carbs, and proteins. Each of those fuel sources has a trucker's union that delivers them. The trucker's unions are all paid in different currencies. If you don't pay the trucker's union, they don't deliver. So you've got the fatty acid trucker's union likes B2, and magnesium and glycine and especially carnitine. You don't pay in carnitine, they don't deliver. The amino acid truckers union likes B vitamins, especially B6. The carbohydrate truckers union also likes some B vitamins, but they also like using like chromium and lipoic acid and some other things. Like, so it's— there's some crossover occasionally, but you got to pay the truckers union in all the currencies they want to be paid in in order to deliver the fuel to be burned. So right, so when I'm starting to describe these ingredients or these, these currencies, you're like, oh, B vitamins, that I, I'm supposed to take those. Yes. The— what is a multivitamin? A multivitamin is a, an attempt based on the quality and dosage of the multivitamin. It's an attempt to provide all of the things the mitochondria needs to keep running. That's basically what a multivitamin is. It's providing just the things So B vitamins, some minerals, et cetera. Okay. And then, so now you, now you've got fuel for delivery. So you've got truckers unions are paid. Okay, great. Now you've got the factory itself. The factory has walls. Those are specialized fatty acids that make up the walls of the mitochondria. Then you've got other amino acids that are the building blocks to help build the infrastructure and make all the different enzymes and all the rest of it. So, and then you've got the machines in the factory. Those machines are called vitamins. At the center of each machine is a computer chip. We call those a mineral. So B12, it's got cobalamin. It's, you know, cobalamin, literally cobalt. So the reason why heavy metals are so damaging to your mitochondria is because heavy metals are bad computer chips. So imagine trying to run a 2026 MacBook Pro computer on a 1996 Mac chip. At best, it's going to be slow. At best, if not completely inoperable. That's why heavy metals are so damaging. If you just have that analogy of the computer chip being swapped out, everything clicks, right? And that's also why the machine shuts down.

So heavy metals are way more prevalent today than people understand, right? I think we all understand today that mercury in our mouth— and the way of amalgams, it's not the healthiest thing we could have in our mouth, to say the least. But there's so much just environmental toxicity with arsenic, cadmium, lead, even lead times. Yeah, that, that can really change the landscape of what happens with energy production, and oftentimes that component gets overlooked, right? And that depletes our minerals. When we're trying to out-process our toxic burden, we deplete our minerals. With our athletes that sweat it out every day, they're depleting their minerals. And then we get into a really sticky mess with low minerals, high heavy metals.

Yeah, you've got, you've got an abundance of bad chips and, and a deficiency in good chips. I mean, you— we're, we're literally almost at a, uh, at a kinetic war with other countries over the lack of NVIDIA's other chips, right?

Like, we—

at the moment we're recording, we have the two presidents of the US and China talking right now, and you can guarantee chips are on the table. Pun intended, right? Like, like NVIDIA is the most valuable company on the planet right now. Yeah, these chips are everything.

And that's what's going on at the cellular level inside of us. If you're struggling with low energy and you're doing all the things, maybe you're eating a whole food-based diet, maybe you're working out, you're protecting your sleep, but you're like, something is not working. I still don't have the energy that I deserve to have. This is not making sense. Then looking a little bit deeper into these other components, like your mineral status and your heavy metal status, can be part of that equation.

Absolutely. Everything I'm mentioning here can be looked at in a functional test. So we're talking about You're talking about all the currencies to pay the truckers unions, talking about vitamins, talking about minerals, heavy metals, CoQ10. Everyone talks about CoQ10 for energy. Why? CoQ10 is actually an enormous molecule. It's not as big as B12, but it's pretty big. And the best analogy I can come up with CoQ10 is that it's the conveyor belt inside the factory. When you look at CoQ10, so when you look at schematics of mitochondria, it's like CoQ10 is a tiny little dot. No, it's the thing that all the other things are interacting above and below it. So, so if you think of CoQ10 as a conveyor belt, you can't really run a factory without conveyor belts. That's not a thing. I mean, that was a whole revolution that Ford developed where the widgets move to the people, not the people move to the widgets.

And CoQ10 deficiency— as we age, we lose capacity to, to have enough CoQ10. So, I mean, that's an age-related change. Do we know why that is?

So many things happen with age. And why I, I, I think right off the bat has to— I think I'd blame it immediately on absorption, that, that if you're losing your capacity to absorb foods, particularly fatty, fatty-based nutrients, and, and then if you, if you can't absorb your nutrients properly, then you're going to lack the nutrients to be delivered to the mitochondria. So that's where I would first go to. The other is that CoQ10 is also a fat-soluble antioxidant, and what happens is that CoQ10 may be commandeered to deal with an ever increasing amount of fat-soluble free radicals that you're being exposed to over time, or simply just the amount of things you've accumulated have accumulated enough that you can't just— the one role of the fat cells of the body is that they're the dirty closets of the body. You just got to shove things in there, toxins, and just, just keep hoping that door stays shut, you know. And then you hit a limit as, as you're aging of how much you could store in there and Maybe the— I mean, I'm just speaking from first principles here, but maybe CoQ10 is now being like, uh, some stuff's leaking out of the closet, we just need to patch, you know, kind of keep it at bay.

I'm just speculating, but you just said a mouthful though, because I had not considered the toxic burden and oxidative stress burden being a component in low CoQ10. I just— that's not something I've ever really conceptually thought of, and that is huge. That is really huge. Fat-soluble toxins— our toxins come in as fat-soluble particles. Our liver has to transform that into water-soluble. But as it's coming in, it's coming in as a fat-soluble toxin. And so that's a huge connect there.

Yeah. CoQ10 is— I mean, the thing I don't want people to walk away is, oh my God, I need to load up on tons of CoQ10. That's Western medical thinking. That is supplements for symptoms. That is, oh, if I take the one magic thing, then all the magic will reappear in my life. No. That's, that's, that's a Western allopathic pharmaceutical model being swapped using natural ingredients. Philosophically, it's still a pharmaceutical model. What we're looking at, what I'm, what we're, we're articulating here is like, you got to look at the entire milieu, the entire environment of the mitochondria. I'm using the word— for those of you savvy, the difference between Buchamp and Pasteur, I use the word milieu very specifically. It's, it's, we're looking at the entire picture, the ecosystem, the landscape that the factory is. The factory is its own ecosystem, but it's in context of the ecosystem of the cell itself as well. And many things influence it. So when we're talking about nutrients, it's about the multivitamin. The multi is actually the important bit there because you need all of these things to work synergistically together. I mean, your Synergy, literally Synergy podcast, we're looking at this synergistically. So other, other things you need in the factory is that you need, um, janitors in the factory to catch all the sparks from burning the fuel. When you burn wood in a fire pit with oxygen and a match and wood, you get sparks. Now if you get enough sparks that are big enough and strong enough and too numerous and they go far enough, other things will catch on fire that should not catch on fire. These sparks when you burn wood are the equivalent of the free radicals that are released when you burn carbohydrates, proteins, and fats. So the sparks are the free radicals, and you need people to catch the sparks so the factory does not catch on fire. And in fact, uh, one of the, one of the main, um, mechanisms that people's mitochondria can become damaged and inflamed is actually from free radical damage causing inflammation from the inside out. 95% of the free radicals in the body are generated in the mitochondria. That's really, really important. 95%. So you need to have some really good janitors and you've got genes, mNSOD, GPX1, CAT, or manganese superoxide dismutase, glutathione peroxidase, and catalase. If you want more Scrabble words to add to your armory for your next game. These are the janitors. MnSOD, who I lovingly call Mr. SOD. Mr. SOD is the head janitor. He's the most important person there. He's the head janitor. He needs to catch the sparks first before handing them off to his subordinates, GPX1 and Cat. So if you genetically, like I do, have really bad variations of MnSOD and GPX1, that means my janitors are very slow. And they can't catch all the free radicals fast enough unless I follow a very disciplined lifestyle, diet, nutrient plan that is specific for my genetics to upregulate, or rather help spur and speed up Mr. SOD and his subordinates along to catch all the free radicals. And this is where genetics, the first discussion of genetics, comes in to intersect with this. So then you also have to deal with a factory with thieves and vandals. We call these viruses. Viruses can come in, come in and take over. Like World War II, you had the Russians came into German territory and labeled brick by brick, took every single thing of a factory and brought it all back. They just literally stole the factory, like the whole thing, and brought it back.

So I feel like we could have a full podcast on viruses alone, totally, because as we've all experienced the last few years, post-COVID, and we're seeing people stuck in this pro-inflammatory state who may or may not have had a severe case of COVID right? And people, you hear their story when they come in with fatigue that's been chronic, and, you know, kind of episodic times in their life where they've had profound fatigue. You back— you go back in their history, even pre-COVID, and a lot of time viral episodes like Epstein-Barr cytomegalovirus, things like that are part of that story. And so I feel like having some tools for the thieves and vandals, you know, how do you improve the immune system enough to where those thieves and vandals are, you know, suppressed? Because they're not going to go away as far as I know, they're going to be there. But how do we protect the body enough to where they're not creating havoc that's uncontrollable?

Yeah, there's, there's two, there's two elements there I want to expand on. One is that, that there will always be thieves and vandals, just like there's there's always 5% of the population that's aversive personality, that, that aversive personalities— there's narcissists, psychopaths, sociopaths. I actually, in my comedy show— I know it's a serious subject we're talking about right now, but I'm actually, I'm a professional comic, don't let the academic veneer fool you. Uh, I have a show called Neuro Spicy: Love, Life, and Comedy on the Spectrum because I have Asperger's syndrome. That show, Neuro Spicy, just put in Dr. Sam Shane Neuro Spicy into YouTube, you'll find my free show. That's my advocacy work. I actually talk about sociopaths, psychopaths, and narcissists as a public service to help people better recognize them, because it's a parasitic strategy. From an evolutionary psychology strategy, you will always have parasites within a social organism, social, social group, because, uh, freeloading and hoarding are, uh, whether it is, is, is a successful strategy, but only in very small percentages, because you get too many, they either start finding and fighting each other or everyone else recognizes, wait, you're bad, you're bad news, and then they all start to create— they, they suppress and stop them from taking over. So what happens is that your immune system is really— can be really good at suppressing thieves and vandals, but they're just waiting. They're just waiting in the wings, just waiting for when there's a weakness and they can jump in. So doing things to help your immune system keep a vigil is really important. But there's one aspect about things like long COVID and other people who've had an infection then developed chronic fatigue. I saw this all the time in practice when I was practicing in, uh, abroad. People go on vacation, they would have— I don't know if you've seen this, but I saw so many times they go abroad. I go— I was abroad. They go on vacation, they get food poisoning, and then within 3 months later, then they suddenly have chronic fatigue, fibromyalgia. Yes. Okay, now clearly the food poisoning is over, but what happened? What happened is— and, and they have a virus, and then they get rid of the virus, but then like suddenly their fatigue just get crashing, crashing, crashing. There's dealing with the thing, like the virus or the vandal, but then there's repairing the damage they did. That's the second half. It's not just about stopping the vandals and thieves, the viruses, and helping your immune system. That's important, that's valuable, that's critical, but actually repairing the damage that was done is the missing piece. This is— you also see this in multi— I'll put this in mold. In this category as well. Mold is like extra special awful because it's both a toxin and an infection, and it's— it, it, it— mold is just awful. I'm dealing with mold poisoning right now. Like, I, I left a moldy apartment, um, a little over a year ago, and I'm still detoxing from it. Like, mold is— mold is truly awful.

And you're in good company. Lori and I have both had our own individual experiences with mold and with other biotoxins, and— it's, it's, it's extra special to navigate that. I think it humbles us as providers. I know Lori would say this too. I remember a very vivid conversation with Lori when she was being exposed and not aware that she was being exposed, where she described to me that her brain was hijacked by aliens. And she's got the best brain on the planet. And I'm like, oh, you're fine, you're fine, you're just having some hormonal shifting.

Can I actually talk about that hijacked by alien thing? So it's been proposed Haunted houses. So people go into a house and they're like, suddenly people have nightmares or they start having— acting real strange, and it's like, oh, a ghost possessed me. Well, from an evolutionary biologist lens as opposed to a spooky lens, those haunted houses are likely packed with black mold or other similar mold, and about 10% of the population is genetically vulnerable to nightmares when exposed to bad mold. And there's a thing called— and when you have mold on the brain, you destroy your mitochondria. And what is the one part of the brain that requires the most amount of mitochondria and is the most fragile? It's the frontal lobes.

Yes.

And what do your frontal lobes do? They inhibit your limbic system, meaning that they suppress your more animalistic, hyperreactive states. So when you get mold poisoning, you can end up with nightmares and mood changes.. You can also end up with something called mold rage.

Yes.

And you just, you just can't control your anger because you lack frontal lobe inhibition. I know, again, more Scrabble words for the enthusiasts out there, but I had a functional neurology background for 9 years and it's like we talked about prefrontal inhibition all the time because when people were hyperreactive, instead of blaming it on an SSRI deficiency or they're, you know, stressed, it's like maybe there's a brain issue where their mitochondria is dysfunctional and they just simply don't have the electricity to do the things to shut down the emergency response system. So, so when you have, uh, you know, you feel your brain was taken over, uh, by mold, yeah, yeah.

I want to step into this amazing conversation to which I have been observing and wanting to say so much, but it's so enthralling. I first want to say I love your analogies, I love the way that you describe things, and I really hope that our listener is really willing to lean in, go back, listen to this again and again and again, because when a person can really understand all this. They understand how complex the human body is and how there is not one pill. I don't care if it's good, like, you know, whether it be a prescription or a vitamin or a nutrient or whatever. It's, it's, yeah, it's, it's the, it's the big, it's the big picture. And then I want to go back because I did, you know, I, I had that moment laying there. We were at a conference and I just didn't feel like my processing speed was what it was before. I didn't feel like I had the ability to assimilate information and I had no way of articulating it. I just couldn't explain how I felt. And all I said is, I really feel like an alien stole my brain. And I love my friend, you know, it was the first person I was willing to share because I thought I had cancer. Like, I thought I had cancer. I thought I had a brain tumor. Like, something is clearly wrong. And she's like, you are the smartest person I know. What are you talking about? I don't notice a thing.. And I'm like, but I do, I do. And to your point, I didn't know I was exposed. It really did feel like something was clearly wrong. And what we're saying right here is something was clearly wrong. It was metabolically wrong, right? It was metabolically all wrong. And it was layered on top of years of different things as well, things in the past that, of course, unfortunately, it's not—

it— we—

the body keeps the score, right? It just keeps the score. If it's okay, I want to go back and just ask a question. You had mentioned, you kind of set the stage beautifully and I really appreciate it. If there was one thing in your career of all of these things that you have seen environmentally to be the biggest offender, would you say that there has been the biggest thing Or the most common thing?

Offender, meaning things that harm the mitochondria?

Yes.

So, so I'm, uh, okay.

Um, I like the way you're hesitating. Yeah, that's the question we get all the time. Okay, so Dr. Shade, they're inundated with so much to do, you know. They come, you have all these things going on, where do I start? So that's really why I'm asking that question.

Let me, let me give not the one thing, let me give the one framework. Okay, I think that that's going to be more useful because just to say it's one thing is deadly inaccurate and presumptuous.

I get it.

Uh, and so, but what I can do is give a framework for which people can then piece together where the particular mitochondrial decay puzzle has formed. I'm just going to close this window because there's construction outside. Give me a second. All right, also buys me time to think of the frame to articulate the framework. Okay, did it work? All right, is it plausible? Uh, so So when you think about frameworks, there are two major frameworks. If someone's coming to a functional practitioner, they— in my opinion, functional practitioners should always have two frameworks: a framework for lifestyle and a framework for labs. Labs and lifestyle. You combine labs and lifestyle together, congratulations, that's holistic medicine.

I love it. So thank you.

The framework— so the, the— that's the one framework, lifestyle and labs. Lab subframeworks. Now we're gonna split— see, I'm splitting the, splitting the hairs here. So now we have two frameworks to look at: a lifestyle framework and a lab framework. The whole point of a lab framework is to be able to analyze someone from the inside out. The whole point of a lifestyle framework is to analyze someone from the outside in. That's why when you combine them together, you get holism. So from a lifestyle perspective, um, look, I have my 10 pillars of health. I love my framework. Obviously I made it, you know, made it over 14 years ago. But to be, just be really clear, I don't really care what framework you use. Just have one. Just have one, you know? And so I'll, I'll briefly rattle off my 10. And the reason I picked 10 is because I met a guy with 37. I was like, you can't teach that, bro. It's not gonna happen. And some people are like, oh, I just have these 4. I'm like, that's a little narrow.

A little now.

So 10, I think people could understand and it could capture enough. Anyway, the 10 are, uh, they all begin with a B because I like alliterations and I'm a word nerd. Uh, brain and hormones. Second is bowel and digestion. Third is body, which is structure, unresolved injuries, head injuries. Bad dental work, uh, is in that as well. The fourth pillar is burst exercise, movement, and recovery. Fifth is biotoxins and inflammation, which we talked about a bit already— not inflammation, but the toxins bit. Um, pillar 6 is bio-nutrients, diet, and things that you metabolize. That includes oxygen and sunlight, which you do metabolize technically. Uh, the seventh pillar is breakfast and routines, morning and evening routines. I developed that when working with night shift nurses. Like, wow, they are some of the sickest people on the planet as a profession. Because the hospital is playing human Tetris with their cycles and their rhythms. They're not doing well. So breakfast and routines was its own pillar. Then it's the 8th pillar is, uh, bothers, stress, stressors, and unresolved trauma. Bothers was the only B word for stress I could come up with. Open to another one.

I love it.

Uh, 9th pillar is bugs, hidden infections, and mold. Uh, you can put in cytomegalovirus and all the, the other ones in there as well. Then the 10th pillar is bedtime and sleep, like quality, consistency, duration, depth, et cetera. So 10 pillars: brain, body, bowel, burst, biotoxins, bio nutrients, breakfast, bothers, bugs, bedtime. That's the 10 pillars.

Love it.

It's a framework. Find, use a framework, whatever it is.

Right.

So when you ask me like, what's the main thing? Um, so when I've analyzed, I, I've taken a, a 20 20 random, uh, clients of mine. And when I do a 10 Pillars analysis, everyone has the same 10 pillars, but they don't have all the same priorities. Like Pillar 10 is bedtime for teaching purposes.

I love it.

That's my point.

Yeah. It's so, so what I saw, I did a heat map, uh, where I took all 10, 20 people and I color-coded each of the 10 pillars, and then I put them in the order of priority that was appropriate to them after analysis. And what I saw were some themes. And the themes that I saw were that the top 4 were they had terrible routines. They had the, the, so they, they had the bedtime and, um, routines. They had, uh, bothers, the stressors and trauma, bowel issues. They weren't digesting and weren't pooing properly. And then bedtime sleep. So bowel— so digestion, sleep, stress, and routines were the most commonly in the top 4. Yes. Exercise was either priority 1 or priority 10. Like, people either had their exercise dialed in or just non-existent.

So true. Maybe they're over-exercising.

Well, I include that as well. I include that as well.

Crushing, right?

Yeah, yeah.

That's the—

I, I, I miss— I wasn't coming to you with that phrase. They're doing exercise was imbalanced either severely or it was perfect, either too much or not at all, or like it was great. So that I, I found, I found exercise just to be like wildly inconsistent, the biggest delta. So I, I won't spend more time going to more details, but we get the point of like, of like the other pillars. It's so, so some people like their num— I, I had one, I had one client, it was so tragic. She, she called me up. Up she said hey I saw you do a lot of work with adrenals can you send me adrenal supplements? And I said no! And she was like what?! Anyone can send you adrenal supplements how about you come in and we actually analyze your 10 pillars it's like no but I have all the symptoms I read your book I'm like no no no no no no no for— No, come talk to me and so Alhamdulillah finally agreed Did her 10 pillars. Within 3 minutes, I knew what was going on. She had mold all over her house. When she wrote— when I asked her all these mold questions, it was like visible mold in multiple places. And then she sat in my office when I had an office at the time, and I said, adrenal supplements will do nothing when you're dealing— when you're inhaling mold all day. And she just burst into tears because they had just got the house she worked from home. And I said, I can't— yeah, you've got to deal with the mold first. I can't— I, at best, it's like patching a leaky bucket with tiny Band-Aids.

Well, and also, you know, the adrenal supplement, to those out there struggling with fatigue and they do have some exposure going on, sometimes it's the fuel to keep the inflammation going. Sometimes it can make you worse. Like, you may feel better in the short term, but you're burning through things a lot faster, reserves a lot faster doing that.

There may be another mechanism also. Like, the— a lot of adrenal supplements have a B vitamins, and that's pushing phase 1 really hard. And so sometimes what people need is, one, stop exposure, but then they need to support phase 2 before they drive tons of B5 through their system. Yes.

And that goes back to gut for phase 2. Those of you that don't know about phase 2, that's elimination, being able to poop it out. If you ramp up phase 1 and you're running it through the liver and dumping it, but you can't poop it out, you're just recycling all of that.

That. And then on top of it, you're supplying them with adrenal cortex hormone, the whole gland, and you're creating more anxiety in a lot of these individuals too. And that doesn't solve anything either. So unless you—

just in Dr. Wilson's defense, the one who trained me on adrenal stuff— unless you get the adrenal with the demed— they basically demedulate the—

whatever the word is, they remove the part that has the adrenaline But the point is creating more symptoms by just transitioning what you said earlier, taking traditional medicine practices and converting those same practices into functional medicine by just supplying another pill. Yeah, that's not the answer.

Yeah, so lifestyle, totally. We got to have a whole lifestyle analysis. So that's, that's the sub-framework of the soup of the meta-framework of, you have Lifestyle Labs. So then we have a lab lab framework. If people are struggling with fatigue, then, and you look at their lifestyle, because there'll be all sorts of those 10 Pillars reasons why people have fatigue. Sure, enough stress will cause anyone— knock anyone out. Uh, now you've got the labs. So now you've got 5— my framework around labs is 5 types of labs: gut labs, hormone labs, mitochondria metabolism labs, the weird stuff, genetics. So every one of those has subcategories. The weird stuff is metals, mold, toxins, infections— things you don't want. And unfortunately cluster together because when you wear the body down in one of those, the other things come to play because now the body's weakened. Under mitochondria metabolism, this is organic acids, fatty acids, amino acids, minerals, vitamins, blood sugar, anemia panels, um, like, like all the core blood tests. It's mitochondria metabolism. It's massive. I've helped design mitochondria tests. I helped design the Nutrisystem stat test, and it's a lot of stages. So you can have up to like 250 markers, uh, to check for mitochondria. Um, and then you've got the gut testing, roughly 3 subcategories. You've got the bigger gut test where it's GI-MAP or GI-360 or GI-FX or CSA or whatever. It's like the bigger broad spectrum digestion markers, inflammatory, immune, and beneficial bacteria and infections. That's one subcategory. Then you got SIBO as another subsection of gut testing. Then you got food intolerances as another subsection of gut testing. Then under hormones, you've got adrenals, testosterone, as, uh, adrenals, sex hormones, thyroid, melatonin as the 4 main hormones. And then under genetics, that, that's one of my major specialties, right? That's, you've got exercise genes, diet genes, immunity genes, and longevity genes. And, and which are mostly around controlling inflammation, free radical damage, liver detox, and so on. One, right? So you've got, you've got 5, you got a model, a framework for labs to figure out why are you tired. Any one of those lab categories could explain fatigue, any one, much less in combination.

Yeah. So I want to dig in a little bit and talk about hormones because so many of our men start noticing a decline in energy, right? Not functioning, not having the motivation that they used to have. And the knee-jerk reaction for their primary care, and now all of these men's hormone clinics that are around, is let's just test hormones Let's just test sex hormones. Let's be clear and give them testosterone.

And let's only check total testosterone. Let's not look at sex hormone binding globulin. Let's not look at free.

Let's not look at inflammatory markers. Exactly.

Let's just give you testosterone. And we always say in our clinics, Kelly and I always say this is, you know, you can in the temporary, I can make you feel better, but am I helping you be better? And at the expense of you and your health. Just giving you hormones is not making you better. You're only going to feel better in the short term, if that.

Yeah, so with— I agree with everything you just said. So with, with testosterone, look, the way to— testosterone is very much, uh, pharmaceuticalized in its philosophy. If I just take this thing, I'll feel better. I feel like I'm in my 20s or whatever, you know. And The— there, there's so many, there's so many. It's like, like just fixating on testosterone is like just fixating on TSH and thyroid. Like, it's the same, it's the same narrow fallacy. So when— so what I want to do for the men listening, my intention right now is to scare you about just running to get testosterone. I'm going— I'm being very explicit with this. I'm not hiding the ball.

Okay, thank you.

So, uh, buckle up now, uh, If you just give free testosterone, uh, and you have not checked for your downstream estrogens, like say E2 or even E1 if you're going through the endogenous pathway, whatever it is, if there's an enzyme called aromatase and that testosterone— that, that enzyme converts testosterone into estrogen. So here, what is what can happen, and I have seen personally happen happen. A man takes testosterone and he develops man boobs and gets fat. What happened? Because that enzyme was overactive. You give testosterone, but it immediately converts into estrogen. Not the outcome you were looking for, presumably. So that, that's happened. Um, I've seen it happen. So why is the enzyme overactive? Oh, I don't know, inflammation, toxicity. Uh, all sorts of reasons why. This is why looking at inflammation, which Lori, you mentioned, like, uh, just— I think you didn't even— I think it was in the same breath as mentioning testosterone, you mentioned inflammation. So this is one mechanism why you have to track inflammation around testosterone, because if you give testosterone, you just can careen— it can just careen right into estrogen. Um, the other thing is that testosterone does a lot of things, and And if you don't have the nutritional grunt to deal with all the things it's going to do, you're going to create nutritional deficiencies and imbalances elsewhere in the body. Like, testosterone is not some benign magic thing you inject in. It's like, oh my God, look at me, I'm 25. That doesn't— that's not a thing. It— if you've got all the other infrastructure and support to help you, then if— then testosterone can help, assuming all the other pathways are working properly. Now testosterone is used by the mitochondria not to— is more like repair and maintenance and genesis, not, not actual running of it. It's more like helping with the repairs of it. So that is one plausible mechanism why testosterone can help people feel better. But it's, it's like giving testosterone— another analogy is like you can feel it like it's glorified, uh, energy drinks. Like those things come at a cost. Yeah, unless— and, and yes, it can be quite liberating to just take a thing and then suddenly you're feeling better. And the, the people who are promoting testosterone, who are like big biohackers and public figures and big fancy functional— you know what they're also doing? All the other things. They're not doing testosterone in isolation. Like, so they're— even though they may be talking about testosterone exclusively on a podcast or in a blog post or whatever company line they're pushing, they are actually doing the lifestyle and labs framework that I discussed earlier. And, and even in— and when I was trained in the Institute for Functional Medicine and when I also studied with Dr. Kalish for 4 years, like, sex hormones were downstream. It went, you know, adrenals, thyroid, sex hormones. So you got to deal with your stress response system, then you got to work on your thyroid, and then what's left? Then, like, you— by that time, your sex hormones may have been addressed already. And this is also not to say, oh, I'll just test my adrenal glands, give— and then we're back. We're just now— yes, we're up at a higher level, but we're still applying the same pharmaceutical philosophy to a specific nutrient class around a specific organ. As opposed to looking at the whole thing.

So, Dr. Sam, what I'm, what I'm hearing you say to our men is that you deserve a workup. You deserve a full functional workup looking at lifestyle impact and looking at testing and really digging into what is going on so that you can be the man that you want to be, be the person that you want to be, do the things that you want to do, and feel good and age well, right? Not just putting a pill or an injection on top of a symptom and calling it a day. And unfortunately, some just don't like to go in to be evaluated, right? We feel judged.

I'll tell you what they will tolerate. And I practiced in New Zealand, so we have a lot of— there's this kind of suppressed machismo in New Zealand male culture. They're not as extroverted as, say, Aussies, but there's a real kind of quiet macho in and, you know, you tell, you tell some, you tell them, you know, typical stereotypical male psychology is like, oh, just run this stress test, and the results come back terrible. Like, well, I was just stressed last day, right? You know, and, or I did a mitochondria test, it didn't come out. Well, I'll just eat more bacon or whatever, like, to get the amino acids up or whatever it is. And they can just excuse away from whatever transient thing excuse they can latch on to. However, You show them their genetics test, they can't argue with it.

The—

and I've done this before, and I said, look, look, you— in your case, like, alcohol is really not appropriate for you given the genetic realities. And they start arguing, and I just like— I do think this is where being— I have an unfair advantage being a comedian because like they can't heckle me, like I'm impervious. And they start arguing with this thing, oh Oh, you're gonna argue with your genetics? That's adorable. Go on, I could use the entertainment. Go on, argue. Go on, I can use the entertainment. Come on. And they have nowhere to go. They have nowhere to go. Genetics is such a hard-nosed science, and it's not— your genes don't change. They change, their expression changes in how you live, but the actual hardwiring doesn't change based on what you ate or did or didn't do, or your age or whatever, right? So they cannot argue. And then like the look of defeat— this sounds terrible— the look— I'm waiting for the look of defeat on their face and be like, okay, what do I need to do? That's what I'm looking for. I'm looking for that. And again, this is a very stereotypical male psychology shtick you do in the office, but sometimes it's— what's my goal here? My goal here is not to do power over a game. It's like, how can I help them in a way they're going to listen?

That's That's right.

They're gonna listen. They're not, they're not, they're not fighting with me. They're fighting with themselves, literally, quite literally. And, and, and they'll, they'll, they'll lose.

And that's true for most of us, right? That's true for most of us, where most of us are fighting ourselves whether we want to admit it or not. That's our human nature.

Yeah. So I would say to them, I would say to them, to the men out there listening, like, yes, lifestyle and labs. And if you were to triage to one lab that you cannot argue with for your benefit. Do a genetics test and then look at your diet, your exercise, your lifestyle. Start there. And it's, it's like you don't— you know, we're no longer arguing, we're just strategizing. Okay, based on reality.

That's a perfect lead-in to— I mean, as always, our time with you is amazingly beneficial to not just This is exactly right. It's not only fun conversation, it's just very insightful. It's very intriguing, it's very thought-provoking, and it's very educational in a way that people can really chew on it and apply it. You know, sometimes as clinicians and people that are kind of nerdy— you kind of said it today, and I would consider Kelly and I nerds too— we don't always do a great job.

We all have the big oversized glasses. Yes, I think we win the nerd alert. You know, we're literally You can put— if you're not going to put nerd as a tattoo on your forehead, you just put on glasses that are roughly a quarter of the diameter of your face and you're good.

That's right.

So you do such a great job at articulating, and I think that's what we as nerds, you know, in the field, we don't always do a great job at making it understandable, and you do that. So first of all, I want to thank you for all of that. We could continue to go on. All of this was so amazing. But what I heard you saying today Lori Esarey— several things. Obviously we need to understand the mitochondria. We need to understand the milieu. You said that today, right? The environment. We need to understand that there needs to be a framework in the way which we work up the conditions or the symptoms that people have. There's not a single pill out there. To seek out— don't ignore symptoms. Be engaged with a clinical provider who can take you on that journey. Journey. You named a ton of tests today, or at least categories. Yeah, categories of labs today that we know now that people can order those labs. We know at the end of the day, it's not the lab, it's the interpretation of that lab in respect to who you are and where you're at. Such good stuff. I would love at some point to continue, honestly, this conversation because there is so much more. But I want to thank you for your dedication, for how you do what you do, for taking time out of your schedule to be on here today, um, and for just being, just being the teacher that you are. Um, so thank you again from Kelly and I. Um, we know that it's hard to carve out time to do this.

I love chatting with you too. It's like, I love— it's like I'm being surrounded by fellow nerds. And I'm sure if you run into each other at a conference, it will be the insufferable triad in the back of the room just chatting while the lecture is up there, like, talking about something, or at lunch, and it's just like, like every, every word will have a minimum 5 syllables. Like it's a 5-syllable limit, like minimum, like a 2-drink minimum. It's like a 5-syllable minimum, you know.

That's right, that's right.

Yeah.

So as we're, as we're closing up today, what is the one thing that you would leave our listeners with as the thing that's made the biggest impact for you and your health journey to inspire them on their health journey?

Work with an expert who has those two frameworks, lifestyle and labs. Like, like, it's, it's, it's very tempting to— it used to be you were just listening to podcasts and suddenly you thought you were a biohacker. And now it's even more tempting to just now throw into things into your favorite LLM and think that, that you're, you're a diagnostician. Um, uh, it's still the most important thing to save time, money, and energy over the long term is to work with someone who it is their profession to do this, right? And you now have a filter to know who is even more qualified. Do they have a framework for lifestyle and a framework for labs? And that is the best, best, best place to start. I think you want your own personal blueprint, you want your own personal roadmap of your life, your lifestyle, your genetics, your physiology,, and then you can prioritize what is the most important things to do based on lifestyle and labs.

I love it. And I just want to say also, um, we wish you the best on your healing journey.

Thank you.

And we know that it's not linear, and oftentimes the journey that we go on teaches us so many lessons that we then give back to the community. So I just bless you in that and hope that it's as linear as it can be.

I have so many blessings in that department, I'm a little dizzy with the blessing. I think I think I'm blessed enough, thank you very much, with the having to deal with the chronic things that I learned then. Like, that's so blessed.

Yeah.

So blessed.

So blessed.

Oh my God, the blessings. And listen, I mean, literally there's a constellation called Chiron, the wounded healer. Like, it is such a cliché. It's in the stars.

Okay. Well, for our listeners, how can they access your information? Where can they find you out there in this World Wide Web?

Sorry, I'm up to here with the blessings. Thank you very much. I've hit peak blessings.

Enough with the blessings.

Obviously that's a trigger.

No, it's not. I'm not triggered. You are. So where they can find me. Okay, so for people who are interested in functional testing and lifestyle, so you can go to my personal website, drsamshay.com, D-R-S-A-M-S-H-A-Y.com, drsamshay.com. If you're a layperson just interested in genetics, you can go to fitgenesusa.com, F-I-T-G-E-N-E-S-U-S-A.com. And look, say, find, look, click on find a practitioner. Or if you are a certified health coach or licensed practitioner and you want to run my genetics in your practice, and I've developed a genetics system that cuts interpretation down from 2 hours to 20 minutes, and I can prove it, I can help integrate that into your practice. You can go to fitgenesusa.com, and then I will, and you can sign up and register, and then I can show you how to run genetics in your practice and make it really, really straightforward and easy to understand and implement.

Thank you for all your contributions because that is incredible to the layperson, to your community, to abroad, and to us as practitioners as well.

Happy to do it. And, and thank you for putting on these podcasts. You know, this, this is a form of teaching and scaling out teaching, and just, I, I salute any teacher in their efforts to help reduce suffering in the world. And you, you we're definitely doing that.

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