Navigating the Challenges of Functional Medicine Testing: Insights from Dr. Bryan Walsh

Hello, my friends, and welcome to Perfect Practice. You're in for a treat today. I'm in for a treat today. We're talking to the one and only Brian Walsh. Brian and I actually just recently bumped into each other at eco, which is the cell core conference. And we pulled each other aside. It was kind of something that is long overdue for us to kind of connect in this way. And we just started shooting the breeze and all of a sudden, next thing you know, we were like, hey, I need you to come and talk to my community. I need you to share what you're doing with the world. And I want to spread it far and wide if I can help it. Because as you'll soon come to learn, Brian is somebody who is extremely passionate about functional medicine, and he's also extremely critical of functional medicine in order for us to create amazing and outstanding results. And what you'll find today is he's going to bring his over 25 years of experience in helping us become better clinicians, looking at our patients through a slightly different lens, maybe upgrading our paradigm so we can be of better value to the people that we want to serve the most. So without further ado, Brian, thanks for joining me today. Appreciate you for taking time out of your busy day.

Great. No, listen, I appreciate all that. That was. That was. It was heartfelt. I could tell you meant that. So thank you for that and I'm happy to be here. I'm looking forward to the conversation.

Yeah, me too. You know, we've been in this game for a while. You've been in it a little bit longer than me. And we both come from a background of really wanting what's best for people and, you know, wanting to make sure that whatever we put out there produces a result is evidence based, driven by, you know, as much awareness as we can possibly have. And as many people know, you and I probably know just as well as anyone else that there's more and more tests that are coming onto the market. It's almost like there's a new one every week. There's new supplements that are coming on the market. There's more and more research being done every single year. So how. How does one even begin to imagine keeping up? So I'm curious what your philosophy and strategy is around trying to keep up with everything. That's.

That's a good question. So, you know, if. If I can just to put some context on this, I think I'll. I'll just jump back to when I first got started, so way back, and at some Point. I don't know how old you are, but you stop counting, right? It's like, it's just, it was after, after a couple decades, you're just like, I don't count. So when I first got interested in the industry, it's a personal interest, right? You know, you get into. I was a fitness professional, I was a massage therapist. I did a lot of orthopedic kind of stuff. I was reading gobs of stuff about nutrition. And I kind of got into it before I even went to naturopathic school because I went to a functional medicine weekend seminar put on by a lab. And they, dude, I. I mean, you remember these kind of things. Like, I was like, these lab. You can run these labs. These are amazing. Like adrenal salivary cortisol tests and, you know, urinary endocrine and all these different things, which they're not fancy, but I was like, this is amazing. And it was through the labs that I was hooked, right? And so then fast forward a little bit. You know, my wife and I went to net. Well, we met in naturopathic school. It was the best part about naturopathic school. Super expensive really, when you meet your wife there, but as a date. But I, I came out and again, you know, I just. You go to the seminars, they're put on by supplement companies, they put on by the lab companies. And I am embarrassed to say that you just, you just take what you're given and you say, here's the. And. And I'll just say this really quickly. I don't put down any particular person or brand or company just as a. It's easy to do. I mean, you and I, off, off camera could talk a lot about the industry, I'm sure, but I don't do that. That's not what I'm about. I hate. So I'm not saying anything bad about any particular person or company or anything, however. So I'll name labs like an organic acid test or a salivary cortisol test or a urinary hormone test, or you just name the test. Stool tests, what? Hair, mineral, tissue, mineral analysis test. I did them all. You know, you learn about them, you get trained in them, you do them. You don't know how to interpret them yet because it's your first patient, you just run it. So you call the tech support company and they tell you what's going on or you read their interpretation anyways. And you know, this too is all you need is to find one error somewhere and you're like, wait a Minute, like, and so it might be from a guru that you listen to way back, and they, they say something wrong. You're like, wait a minute, that's not true. What else has this person said that's not true? Or you hear about a supplement, same deal, or in a lab. And so what basically happened? And I don't know if I'm old and cranky now or more critical than like critically thinking like you mentioned, but I am so darn skeptical. And, man, it's justified. When I started to look into something, you. You just see one piece of information. Like with detox, there's a phase zero, right? I'm like, wait, nobody told me about phase zero. What's this phase zero I'm reading about in the literature? And so then you start thinking that all the stories that are being told in the industry are just. That they're stories. And so, and like I said, it just takes one thing. And you're like, wait a minute, this marker is wrong. What other markers are. What other tests are on. What the heck am I doing running all these expensive tests when I actually don't know if there's any scientific validity behind these things? Because I never looked into it because I just did what I was taught at the seminars and what all my other colleagues and friends are running and the whole darn industry is running. And that's what I've done. And at this point now in my career, I can tell you, we can talk about specific tests if you want, but you know, the scientific literature is not friendly to a lot of these biomarkers, a lot of these tests, and we're running them. I was actually just thinking about this before I call. You know, imagine as a homeowner, you decide you want to test for radon, and you test for radon. And some dude comes in and he has some fancy expensive gadget. It's the fanciest gadget on the market. It tests radon in ways that no other buddy tests radon. And it comes back, it's high, and you have to get mitigation, remediation, and it puts you back like $3,000. Then you come to find out that that unit or something about it is just flat out wrong. It's not accurate. You wouldn't be happy, you'd be upset. You're out $3,000, you're probably not going to get your money back. And now all of a sudden you become skeptical of any other person that comes into your house to try to help you out. And that's my fear in this industry is these tests, many of them are not accurate. I'm sorry to say that they're not accurate. I'm going to, I mean, if we, depending on what we talk about, we're going to burst some bubbles today. It burst my bubble first, just to be super clear. I read about it. I'm like you, why were you, how, how were you running these tests on people? You, these are not accurate tests. Shame on you for not knowing better. And that's how we all are. I'm not, you know, and so, yeah, so that's kind of where I am now. And it's just highly critical, highly skeptical. You know, in our emails, we always end it by raising the bar. What we're trying to do is raise the bar in the industry. Better practitioners, healthier patients for less money, faster and more evidence based. And so my wife and I run our business. We are trying to raise the bar in the industry as much as we can. So I'm not sure if that gives you the background you're looking for, but that's kind of where like 25 years and, you know, about five minutes.

No, I love that and I love, I love the approach that you're taking. So the way we're framing this is that we're holding the entire industry to a higher standard, not just the labs. Right. I think as clinicians and coaches, you know, however we want to position ourselves, we also have to feel really solid and strong about the tests we're ordering on somebody because our confidence and essentially the foundation of our business is the outcomes that we produce hinges in the balance. And you know, one thing that I used to, I still say this is that if you can test everything, are you really testing anything? Because there's like a plethora of, there's, no matter how many tests I run, I'm still missing something. Yeah, right. And I could run another test and find something wrong and you just start really going down all these rabbit holes. And I think what I came to realize is that what I wanted to do, and I'd love to hear your thoughts on this, but how do I create a program that is independent of the labs, it produces results every single time, that has tons of evidence and ancient WISD wrapped up into it and common sense wrapped up into it, and develop a lifestyle design program that isn't dependent on lab testing or if nothing else, it's dependent on perhaps some sort of feedback loop, because that's what testing often is, is a feedback loop, such as wearable tech. So we started including oura rings for our patients so they could measure their progress in ways besides labs. Right. Irrefutable ways that their health and, you know, health is moving towards vitalism, was easy for us to measure without using labs. So I loved, I love to learn where, where this kind of insight led you. Did you stop doing tests? Did you order. Stop ordering specific tests? Like how did you, how did you approach that kind of internally?

Yeah, that's so, so to, to kind of piggyback on what you just said is my view is a lab test should not give you any new insights into the person. It should just confirm what you already believe to be true. And that means going back to your clinical skills, your history, taking your symptom questionnaire. If you're doing a physical exam, you know, that, that we, we nowadays. And I've known some practitioners that I, I hate how they do this. They'll just. Every new patient gets like $3,000 of testing. It's just like this fishnet. You're going to try to catch whatever and all you have. H. Pylori. Do you really. You sure about that? You know, do they have symptoms that suggest that? So any, like, I'm not opposed to certain tests and I'll tell you that the hands down, I think the best test there is out there. I'm not opposed to certain tests that I know of that I, you know, we researched a bit, but it should, it's not a fishing expedition. It's. I think this is going on with you. I just want to confirm this. And so when you get the results back, you're like, yeah, that's just what it. Let's. We just prove this, essentially.

So like a spear instead of a net.

Yeah, absolutely. Yeah. So I mean, okay, so here's a great example is like let's say somebody has hyperglycemic symptoms, of which if some, if they're actually hyperglycemic, that's probably something going on. Now what my question is is how bad is this? Right? So because then you have some metrics, you're like, wow, your fasting glucose is, you know, 120, 130. You have a one C and the sevens or eights or whatever, it might be cool. Now we have some hard data where we can do all the lifestyle interventions you're talking about and we can actually track your progress over time. So, you know, again, if somebody has all the hypothyroid symptoms in the book, let's run a complete thyroid panel and just see really where the defect is. So, you know, you should you should know what the, what you're going to be testing and find it in the person. I do believe in metrics because that is, it helps with compliance. It helps know just again, how bad is it really? I mean, what are we really looking at? We're looking at a little berberine. Are we looking at like the full fledged, like let's give you every, you know, hypoglycemic agent in the book. So hands down, and I have, I have studied this brother like so much. This is, I have two passions in my life when it comes to your extra family activities in terms of what I study and blood chemistry is one of them. And I can tell you I have spent a good part of the past 15 years really looking into their whole story as to why that happened too. But hands down, standard blood chemistry is easily the most studied lab. Let's just say it's a bunch of biomarkers. But around the world it's internationally respected, it's been scientifically validated and proved over and over and over again. The reference ranges may have changed, but that's a consequence of, you know, people and health and demographics and those things. It's inexpensive, what you get. And there's no other test that will tell you as much information on a fairly standard couple hundred dollar blood chemistry than anything else out there, hands down. I will argue anybody to the grave about that if you know what you're doing and you have a better reference range and you're up to date on the modern literature as to what these markers are. And I'll just give you a quick example. You know, I forget when, but it was years ago. I was sitting there. I kind of have a love affair with albumin that's been like my, my go to. I, I just, I, there's something about albumin that it kind of got me into blood chemistry and, and then one day I was thinking about it, I'm like, I guarantee you there are researchers who are still researching album, right, as old as it is, that they're trying to find new inferences in it. And so indeed, when you look at the literature, I'll just use air quotes. Old markers have new reasons that they might be high or low that absolutely have implications to us as practitioners. And so if you combine this old test and people like new stuff, right? That glittery but old test, not sexy black and white serif font, two pages, not 20, scientifically validated, internationally respected, inexpensive and volumes of information about just about any system in the body that you're really looking at. Combined with updated research on the markers can tell us as clinicians far more than, you know, we're using in the past. I'll just give you a quick example. If you want, like hdl, there's a paper done just a handful of years ago. It was only on men. Unfortunately, it was a rather small cohort. But what they found was that that HDL was positively correlated with leaky gut. I'll just say that intestinal permeability, like lipopolysaccharides and Fantastic, fantastic piece of information. So if you see a high normal hdl, one of the things that should make you think of is, I wonder if this person has intestinal permeability. In which case, if you wanted to run that test to confirm that, which is the reason why we should be running tests, go for it. Or maybe that's just good enough because their symptoms correlate with leaky gut, if you want to put it that way. And then you look into it. Well, why would HDL be a marker of leaky gut? That's, you know, it's the good cholesterol. And then you read about it and you find out that it's actually one of its jobs, is mopping up lipopolysaccharides. That's what HDL does, is the janitor for lipopolysaccharide. So then all of a sudden it makes sense. And, you know, where was that when we were in school? That was a super helpful, cool marker. And you could take just about any marker, even the old ones. And there's updated information that researchers are doing. There's, there's calculations that you can do using existing markers. You think about where researchers are. They're trying to find better, trying to find better ways for doctors, you know, in the middle of Arkansas, you know, to be able to evaluate their, their patients better, more effectively with all the fancy, expensive machines that are available only to some or in rural communities or areas, even around the world. And so you have these brilliant researchers who are like, you know, fatty liver is a problem. AST and ALT basically completely suck in terms of finding it. You'll find it way too late if you're just waiting for those to go up. Let's put together some calculation using basic markers that are found on just about every or metric on a blood chemistry panel or anthropomotor, anthropomorphic data. And they come up with these calculations to predict fatty liver. So there's so much out there we don't need all these ridiculous, expensive, colorful pathway driven Tests that in many cases have no scientific validity. And I'll tell you, in some of them, some of the world's Experts, world's experts, 80 years old, been studying redox for 50 of their years of their life, say, you know, they'll name certain markers that shouldn't even be used in research. Guess what those markers are on some of the functional medicine labs. And they say that those are just completely worthless markers. They shouldn't even be run. And we're running them every day of the week.

I mean, I mean, first of all, tell me how you really feel.

Well, let me start it.

And I could, I 100 concur because, you know, one of the, one of the challenges. Forget about everything you just said, but the other challenge is like, what does the marker lead to in terms of overwhelming the clinician? Right. And kind of them not having the certainty that what they're doing is actually going to work. And so I feel like there's, there's a whole can of worms that gets opened up when we start ordering labs. It could be really a slippery slope on a runaway train, I feel like.

And I know, you know, you talk with loads of practitioners. I've heard that all the time. You know, it's like you get too much data and then you don't know what to do with it. Do I work on their hormones or their brain or their liver or their thyroid or, you know, and then you get all the people that are like, well, you have to treat the thyroid before you treat the adrenals. And then you get the other people that say the opposite. And then the brain runs the show, or the liver runs the show, or the gut runs the show, or, you know, and then practitioners are as, they're more confused than ever. And, and I think that that's why if you take this, my wife hates the phrase, but just a back to basics approach, just go back to the absolute fundamentals that we. I don't want to say no, because it's a. More of a belief, but that we strongly believe and have some evidence empirically that improve people. Um, yeah, and, and you know, you said, you know, tell me how you really feel. The thing, the thing that gets me though is people are suffering, practitioners are suffering through inaccurate tests and figuring out what to do. And then they'll run one and something doesn't calculate, it doesn't compute. And we have to come up with, well, you know, you're excreting more than you did before, whatever. You know, like we make up stuff for what's A lack. In some of these tests, the patients are suffering because they're spending an obscene amount of money on things that might lead to undue stress, that they didn't need to know in the first place, that these markers are out of range. And, oh, guess what? You have autoimmunity.

Great.

Wonderful. You know, I mean, in some cases, that's helpful, but in some, if the, if the test isn't accurate and it's leading to stress or fear in somebody's life, that. I'm sorry, deep down in my heart, I have a huge problem with that. It's not even the financial part. It's, you know, you do a hair tissue test, and your. Your lead is screaming high, you know, and then, oh, my gosh, I have lead.

I'm gonna.

I, I think, you know, my brain hasn't been working as much lately. I think I have lead toxicity, and it's making me stupid. Like, but before they walked into the office, they were fine. You know, and, And I. Listen, I even. This is a bigger conversation. I, I just. We could even talk about this with testosterone. I mean, like, a basic thing. So here. Here you are, like, 50 years old. You go into the office. The doctor's like, well, you never had your testosterone run. You're about the age where it's important because it's a cardiovascular protector. If you have it, you run it. Like, the dude was feeling fine when he came into his office. He loves his wife. He's passionate about her. He has mojo, you know, like, he. He's not huge and ripped anymore like he was in his 20s, but he doesn't really care so much because he's more heady than he was. Like, body. And then it comes back. It's like, you got low testosterone. Like, well, I was good. Like, why did I need to know that piece of information? Now all of a sudden, I find out I have, like, castrate levels of testosterone and of. Well, gosh, now I guess I'm depressed. Something new to worry about, you know? And I, I. I wonder. This is more like ethically and philosophically, but I wonder, like, are we doing more harm than good when we think that we're running these important markers on people and in fact, it's actually causing that. You know, the person was good. They just came in for a checkup, and they leave knowing that they have H. Pylori and, you know, low testosterone, and they're. You're, you know, the, the things that practitioners, you know, your. Your body's actively breaking itself down right now. What a Horrible thing to say to somebody anyhow.

No, you know, I think in the defense of most practitioners, including my younger self and perhaps even your younger self, we didn't know this, right? We're bright eyed and bushy tailed and we have this tool that we assume is going to be insightful and helpful. And then you start running them and you're realizing, okay, this is great and this is helpful, but how do I action all of this and how do I know that I'm actioning all of it simultaneously? And sometimes you almost get nervous to run the second lab because you don't know if what you did worked right and what's going to happen next.

So you know what?

Totally agree with you.

I love that you said that because this, one of the things that I see not happening in the industry is people being plain honest about it. Like I distinctly remember, like, oh dang, here we go running that next test. Like, I sure hope that that was, that's, that absolutely is real. That is a real feeling that you shouldn't have. If you rely, if you trust these tests and you're doing stuff that, you know, has some, some level of evidence to it and it's not all this, you know, like frivolous sort of latest glittery stuff or you know, part of the latest functional medicine story. I love that you said that. That's, that's just an imposter syndrome. You know, all these things, these are so real for people. How many times did you, did you recommend something to somebody and you're like, in your head you're like, well, you know, here we're gonna, we're gonna support phase one and phase two because you seem like your pathological whatever it was you know, at the time or like, you know, and you'd be like, man, I sure hope this works. You know, like, I just like when, when deep down, like, you know, it was a mindful recommendation and, and to your point, not even my younger self, I'm gonna look back at myself now and be like, gosh, the moron at my age now too. Which is just, that's just the, the journey of life. And if we don't know better, we just do the best we can. And you know, that's, that's why, you know, yourself and myself, we're trying to educate practitioners so they don't have to suffer through so many things in the past and look back at themselves and be like, dang, that was stupid. You know, why the heck did I run these salivary cortisol tests? Completely inaccurate or Whatever it might be.

So I'm curious. You gave me a great clinical pearl about the hdl. And I remember in chiropractic school we learned when we were learning blood chemistry that when HDL was high represented autoimmunity, or to dig deeper into autoimmunity. And now you explain why, because it gobbles up the lipopolysaccharides. So that's a wonderful clinical pearl. Is there another one or two that you could offer?

There's a bunch, yeah. So back to HDL real quickly. So the thing about the autoimmunity thing is. So there's an sort of an autoimmune pattern which I know you're familiar with, but if, if triglycerides are, you know, low, lower than one should expect, HDL tends to be a little bit high. It really doesn't matter what the total or LDL is doing. Typically what we see too is a slightly elevated lymphocyte, slightly decreased neutrophils, usually in women. And then you start to get the, like the high normal potassium, low normal sodium because of their low cortisol, because low aldosterone. And they want low cortisol to kind of ramp up in their immune system so that they can attack the autoimmune. And like, that's, so that's like the basic pattern they get, they get dizzy when they stand up, they have low blood pressure. That's like the classic, you know, female autoimmune kind of thing, which you can pick up on a basic lab, you know, the markers. I just said, yeah. So I look, I've looked really hard at hdl. There is an immunological component to it beyond like polysaccharides. You know, there's, there's an oxidized version, non oxidized version. It can be bad, it can be good. There was one paper that I found a really long time ago, they didn't report it. It was in the, it was in the data tables, but they didn't report this necessarily. But people that had a higher HDL also had a higher incidence of cancer. And so there, there's a HDL immunological component. And I think it's beyond. This is just for you. And I, I, I've seen, I have been seeing HDL higher than LDL more in the past five years than I've ever even seen before, which is unheard of. That's, that's dyslipidemia as well, if you really think about it. It's not supposed to be that way. And that's really high HDL at that point. So I've searched and searched and searched and you know, the literature is just rife with why it's so wonderful. And so sifting through literally hundreds of papers on the wonders of HDL and why it should be high and all these things to find those papers has been really tough. Just some classic ones. So like, GDT is fantastic. I think that the papers on ggt, if you just read a handful of them, you'll be like, why does any doctor anywhere not run ggt? Like, what do we learn in school? Alcohol consumption? Maybe something with a biliary tree or something like that. But first of all, one of the things I've spent a lot of time on is looking for an optimal reference range. And the, the short history, as you know, in this industry is without naming names, there was one dude way back who taught this idea of functional blood chemistry ranges. And there was two guys who went to his seminar and basically ripped him off. I mean, that's all I can say is all the ranges were the same of these two people and they matched this guy's and they added a little bit of this and that to their thing over the years and whatever. And I knew both of them fairly well. And, and I mean, I full disclosure, I taught a little bit for one of the companies and was a part of a lot of these seminars. And the question would come up almost every single time, where do these ranges come from? And there was never an answer. I was sat in the seminars. I've seen many practitioners teaching these things and they're like, well, it came, you know, it was just, they're sort of like muttered under the breath. Well, it kind of came out because it didn't, it came from this one guy, brilliant guy, who put all these things together. And it was, and according to him, it was based on his data that he had from all his patients in hospital or whatever. But they never answered. And so I, like I said about 15 years ago, I was, I started looking into that myself. Like, are there evidence based, optimal reference ranges based on the scientific literature that I can confidently say. And I'll, if I may tell a quick story I would tell, I would talk about this functional ranges, right? That we all do, to a woman who took it to her doctor and her doctor said, there's no such thing as functional range, there's no such thing as optimal ranges. And who looks stupid, me, because I'm talking about these functional ranges that I have no justification or evidence of. So now I Have stacks of references that I can say, here's my range for whatever marker, read the papers, here's the papers of how I came up with this. And so I say that because GGT very clearly, very clearly in the literature says high normal levels, which basically means in the upper 20s, maybe 30s is more accurate as a pathophysiology marker than CRP, than some metrics like blood pressure, then A1C it is a robust marker of pathology. It turns out it's a marker of. I'll just ramble off a few things that are all very related. One is xenobiotic exposure. Multiple studies and usually industry workers, GGT will be elevated. Two is because if you understand where that enzyme actually is found on the cell membrane and it's what its actual role is, is glutathione. It's low glutathione. It's, it's, it's essentially looking at water lack of. Put it this way, high normal GDT to me is an indication of water soluble oxidative stress due to. If you look at xenobiotic exposure and you look at what GDT is, is glutathione deficiency. There's one paper that says hepatic glutathione deficiency and elevated ggt. So you know, nowadays everybody's like an acetylcysteine crazy, right? Oh, we all need that. We all need glutathione. So you can like bathe in it, you can liposomal glutathione, you can nebulize it, you can rub it under your armpits, all these things. But some people are kind of old school. They'll be like, well I'm going to use whey protein and acetylcysteine and let the body just kind of boost its own levels, right? How cool though to have a marker that justifies your use for N acetylcysteine, if I can put it that way. And we don't need to get into the organic acid test now, but pyroglutamic acid, the glutathione marker on organic acid test is actually lower in autoimmune patients, which is really funny, which you'd think that they're the ones that everybody says they need more glutathione. Well, according to the pyroglutamic acid in autoimmune patients in the scientific literature, theirs is lower than is people that are healthy anyhow. So high normal GTT and glutathione, if we're going to talk about oxidative stress Bilirubin. Bilirubin is period, a marker of fat soluble oxidative stress. End of story. There's when it's, when it's low. I'll never forget that too. I was just at one of these seminars, these functional medicine seminars, and I was sitting at the airport waiting to go home. And you know, people would ask like, what's the low, what's the functional range for bilirubin? What's the low end? They'd be like, there's no such thing. 0.0, 0.1. There's no such thing. That's what was said by these experts. And I remember sitting in the airport, reading my phone, looking up papers and it was very clear that below 0.4 was highly increased risk of mortality. Bilirubin was below 0.4. And the, the thought was, is you're looking at fat soluble oxidative stress and where do we have that cell membranes, right? So, so low bilirubin, fat solo oxidative stress. And then you have your fat soluble oxidative or antioxidants, you know, CoQ10, vitamin E. So it's cool to know that because you have some justification. Like you can look at bilirubin and say ma' am or sir, it appears that you have excess fat soluble oxidative stress. A, we need to figure out what's coming from. But B, in the interim, let's support you with some fat soluble antioxidants and, or ggt. And then you look at water soluble and things like glutathione. And there's papers that show that high normal GGT and they'll take N acetylcysteine, 1200 milligrams a day divided dose and their GGT comes down. So there's loads of this stuff, man. It's, it's. And there's even some novel and new markers too. It's, I'm talking about old markers on that 200 panel, but there's loads of them.

What? You know a very popular test these days is testing for mold exposure.

Yeah.

Is there? I'd love for you to talk about that. I'd love your thoughts on what's an appropriate way to test and you know, I know, yeah. Urine for that. Is there a blood, blood marker that you like?

No. And, and here's the reason I'm a, I'm a late adopter. I mean, you're talking about wearables and gadgets stuff. I am, I am. So I would probably still have a flip phone if I had My druthers, quite honest, embarrassing to say, very late adopter. Like, when the bandwagon goes by, I wait for it to turn around and then come back, and then maybe I'll hop on it after it's been around. And that just comes with experience. I've just been burned on tests, on supplements, on things that I thought was great and. And what I don't want to do, like, I've been wrong so many times. I don't want to be giving a supplement. And they're like, hey, that causes cancer, you know, and it's the fancy, schmancy, newest, latest, greatest supplement. I don't. I don't. I don't want to be in that. That's it. That's a bad feeling to be in. So I wait. So, I mean, I suppose, you know, everybody knows his name but Dr. Shoemaker, you know, he's one. He's the one that really popularized a lot of these very novel lab markers and mold. And there's something to be said about a guy who. That's all he does for his entire career. I can tell you when you look at published literature on you with people on those markers that aren't associated with him, you have a harder time finding some of those connections. I also, I hate to say this, so I just want to be really clear with what I say. Like, mold is insidious. Clearly it is nasty, nasty, nasty, nasty stuff. I feel like there has been this sort of trend of, like, hyper mold stress. I don't know how to say it. There's some very interesting papers about people talking about, you know, kind of the antithesis of some of these things when it comes to mold, but it's real. I'm not saying it's not real. And mold, you know, building exposure, illness, all that stuff is super real. I'm not questioning that. I just feel like nowadays, you know, we kind of get this insight into something, and then everybody's like, oh, I mean, listen, hell, you've been in the industry for a while. It wasn't long ago Candida. Everybody had Candida. Everybody. Well, I didn't test positive. It doesn't matter. You still have it somewhere in your body, I guarantee you. And then it's been like heavy metals, right? There's. There's these trends that sort of, like, become super popular. You know, I mentioned hair testing that was really popular in the early 2000s because everybody thought they had a heavy metal toxins. That's kind of gone by the wayside. So mold seems to be one of the Newer ones for me, I guess it's. Well, and this is a funny story too, so Great Plains or Mosaic, I guess they changed the name, has a mold panel that if I felt like I needed to run on somebody, I've, I've seen those panels. I run them maybe on one or two people. You know, if I really wanted to look for something, if that makes sense. There's nothing on a. There's nothing on a blood chemistry that I personally run in order to look for mold, to answer your question. And I've looked deeply into this stuff, just so you know, lymphocytes and, you know, some people make claims about some of the white blood cells, and it's just not in the literature. And if it's not in the literature, love is not in the literature. You know, like, like the feeling that my wife gives me when I turn the corner and she's there. You're not going to find that feeling anywhere in the literature. So just because it's not proven in this literature doesn't mean it doesn't exist. There might be some fantastic mold markers, but I like to see some evidence somewhere that's not biased. And I just haven't seen that yet.

Okay, you mentioned ggt, you mentioned hdl. Is either one of those your favorite mark, or is there another one that you really love?

Oh, no, it's too. That's too hard. Listen, albumin. Albumin is a wildly useful marker too, just by itself. Gosh, I mean, you don't get me started on this stuff. There's so many. But albumin. So albumin, when elevated, the only thing it is is dehydration. There is like, you remember if, like the Fishbok book, right? The blood chemistry book. You look at high calcium and it's this whole like two pages of what it could possibly be if somebody has high calcium. Albumin, it has always been and continues to be one thing, and that's dehydration. So if you need a solid dehydration mark and it seems to be fairly stable, I'll put it that way. It's not like, you know, I. I didn't drink enough water this morning. It's a reliable marker. On the, on the opposite, low albumin is a phenomenal marker of inflammation. That's a negative acute phase react. So even if you're not running crp, or even if you don't have things like transferrin or ferritin or ceruloplasmin or any of these acute phase reactants, albumin's low. There's some degree of inflammation going on, which is, which is super helpful. I think globulin can be helpful. You know, there's some things that, you know, this too is, is you'll run markers a certain way for a while and then something. What's kind of what I said before is you'll see an error on something. Back in the day, all, believe it or not, again, embarrassing. All we used to do is fasting glucose. This was, you know, this is a while ago. That's all people did, right? And when it was high, then I would run a 1C just to follow up until I saw a woman with totally normal fasting glucose and her AOC was like eight. I was like, oh my gosh, how many people have I been missing? And the same thing happened with C peptide as the insulin marker. Only when somebody would have a high A1C and a fasting glucose, then we would run C peptide until I saw somebody with totally normal A1C, totally normal fasting glucose and a crazy C peptide. I was like, oh my gosh, how am I missing all these things, right? Globulin is, as you know, is a marker of all the globulins. So IgG is the, the IgG antibodies are the greatest contributor to serum globulin, which is super helpful to know because if it's elevated, like autoimmunity, you know, and you have a woman who's like taking estrogen for some reason, she's going to have high globulin. And that's the reason why here's. You want a little clinical tip? Here's a good one. To make globulin requires more tryptophan, right? So tryptophan is utilized in the, the production of globulin. So if you see somebody with high normal globulin, like I said, autoimmunity, it'll be high active infection because of IGG antibodies, it'll be high because of sex hormone binding globulin, which is also a globulin. And if a woman's taking exogenous estrogen, birth control, hormone replacement, whatever, will tend to drive it up. These women, typically women might have mild depression because of a relative tryptophan deficiency, because all their tryptophan is being sucked up to make globulin, for example. So if you see high normal globulin and someone has mildly depressive symptoms, it may be that they are meeting their tryptophan requirements, dietarily speaking, but they need extra because their body is like, I don't care if you're a little sad. I got some proteins to make over here. So I'm just going to use all that tryptophan for this, if you don't mind. So that's a little trip, but anyhow. So protein electrophoresis, crazy old test. Like nobody runs that anymore. One of the most useful darn tests. When you're looking at globulin, I can make an argument on the standard lab because you get to see is it high IGG that's contributing to this or is it one of the other globulins that are contributing to that? And that's hugely important. Listen, the CBC you can look at just from an oxygen deliverability standpoint, you ask a great question. There's so many.

There's so many. Yeah, there's so many.

Like iron deficient. You can talk about a darn iron panel. So there's something that's really, really important. Important and that is here, if you want a little clinical. Iron has sucks as a marker. It just. Absolutely. And the reason why is there's something called. It has a variety of different things you can call it, but within person variability. Right. So how much might iron fluctuate in you? So this is an important concept. So I'll take, I'll just make like homocysteine. Okay, let's just talk about homocysteine and then I'll relate this to iron and how bad of it is marker. So homocysteine has, and it depends on the paper that you're reading, it's suggested to be a within person variance of about 8%. Okay, now what does that even mean? Let's say somebody's homocysteine is 10 and moles per liter. If there's an 8% within person variance of that, what that means is if you were to just randomly run this person's homocysteine over the course of, let's just say a year, let's say every month for a year with 8%. And this gets a little technical. Plus or minus. Plus or minus standard deviation of 2 either way would be as low as. Well, it's as high as 11.2 and as low as something like 8.4 or something. Now where that becomes important is with homocysteine, you know, people are crazy about homocysteine, right? You know, they have that special super perfect amount. And if it's over or under be like, oh, you're an over methylator. Oh, you're an under methylator. When in fact there is within Person variants of homocysteine. 95% of people will have plus or minus two standard deviations of that 8%. I don't know if you're following this, gets a little technical, but about 8.4 to 11.2 and that's going to be normal for that person. Iron has a 32% variance. It's all over the. It's huge. And here's the real problem is, you know, iron saturation as a percentage. That's on the. And everybody's talking about iron overload too. Well, serum iron is part of the calculation for that, you know, percent saturation. Well, if iron is all over the darn place, guess what, Your, your that's going to be all over the place too. That saturation. Like, oh my God. And I get. We have, you know, we have a mentorship program, we have clinic. Oh, my gosh, this person has iron overload. I'm like, no, rerun that panel because it may very well be that it comes back down. If it's high again in 30 days, then consider some iron overload and protocol. Here's a great one. Actually, this is a, a newer marker, if you will. So, I mean, I could quiz you if you wanted to.

Quick question just to follow up on the iron conversation. What are you using to measure iron? Are you using ferritin or is there a different.

Well, that's what I was just going to say, so I was just going to lead into that. So a standard iron panel will be iron ferritin and tibc or transferrin. You know, everybody argues about transferring and tibc. Oh, well, here. So you want to go with the variance. So ferritin has a fairly high variance. I think it's somewhere. It depends on the paper, but around 20%. Iron's like upwards of 32%. Like, you can't even look at iron and really take it seriously. Tibc, on the other hand, has a really low variance. And so, you know, for any practitioner that's been doing this for any period of time, you know that tibc is the marker that you look at. When that goes up, the body's looking for more iron, period. And so of those markers, that's why tibc is so incredibly valuable, is high, normal. And again, we get these practitioners that will ask these questions and be like, follow the tibc. If the TIBC is going up, that's telling you the body's looking for iron. Now, I was fortunate. I interviewed a pair of researchers that have done this. All this on this iron overload kind of theory. As it pertains to bacteria and these subclinical co bacterial infections that don't go septic. It's pretty cool stuff. But they, they were talking about, what got me into them was the idea that if you have an infection, your body intentionally sequesters iron. And similar to what I said about the tryptophan and globulin, your body doesn't care if you're, what kind of mood you're in, you know, if, if you're happy today or not, it needs to make globulins and it's going to take the tryptophan to do it. Well, if you have an infection, what's worst case scenario with an infection? You die. Right. Ultimately. So from a evolutionary point of view, what does our body do? It sequesters iron. There's one of the greatest quotes is iron is like chocolate to bacteria. They love iron. It helps them replicate and reproduce and grow. So then the question becomes, if you see low iron, let's say you see low iron, low ferritin, high tibc in somebody, what are the two possibilities? Well, okay, no, they're iron deficient, they don't have enough iron. Their body's making more tibc, more transferrin. They're looking for it. Ferritin's low. They don't have stores of it. The question then is why? And in the case of an infection, their body is maybe sequestering iron. So this marker is called soluble transferrin receptor. Have you heard of that one? You familiar with that? So this is one of the coolest markers that's come out and I don't know again the past five years, but let's see, how do I put it? So just follow the name. Soluble transferrin receptor. It's a receptor for iron on transferrin. Totally straightforward, right? Scientists aren't all that creative when they name these things, but so check this out. So this marker, believe it or not, I get chills about this. Is that a problem? That's a problem, I think if I get chills about markers. But just follow this because right now you have a patient, you have a woman, she's fatigued, she, she has exercise intolerance, she gets, you know, tired too early when she does any kind of. She's low. Iron is associated with bmi, it's associated with glucose regulation, it's associated with lipids, all these things. You're like, well, you need more iron. But hang tight, because the soluble transferrin receptor looks at the receptors for iron on transferrin. If they're not there the body is low in iron, but doesn't want any. I picture it like, like catcher's mitts, you know, like a baseball glove on transferrin. So you picture these trans, these protein transferrin molecules circulating on the liver. And it has these hands that are coming out, right? Like, I want iron. So it's like its hands are waiting for iron. Let me look for it. You still make transferrin, but if it doesn't have the receptors for iron on it, your body doesn't want iron. So that soluble transferrin receptor marker is the one that differentiates. Is this low iron due to an infection? And yes, they're low in iron and they have all the sequelae of low iron, but you don't give it to them because you'll be sabotaging their body's desire to fight off the bacteria versus they're low iron and they need it. So that is the marker. Because people will ask, well, should I give iron? I'll be like, unsoluble transferrin receptor. It will tell you if it's high normal, they want iron, give it to them. If it's low normal, their body doesn't want it for some reason. So don't give it to them. I know they're tired and they might be depressed and they're a little bit fat because they're low iron. But clear it up first, whatever reason, otherwise we're sabotaging it.

You said infection, so we're talking about parasite, bacterial, low grade, chronic.

That's a good question. That's a good question. So iron is utilized for most microbes to reproduce. I think from my understanding, the most, the, well, most well known are a number of bacteria, viruses, indirectly, when you think about it, because viruses use the host material in order to do so. But we need iron to run the mitochondria, to be able to run our cells, to be able to produce the things that the virus needs to, to replicate itself. So viruses do indirectly parasites. You know, that's a good question. I, I'm just going through the recesses of my brain here to see if I can pull something out, but I'm not entirely sure. I wouldn't be surprised if they do. As a, you know, extracellular organism that, you know, most mitochondria do need iron in order to function properly. Most of the literature that I've looked at though, is definitely bacteria. So if you see low iron patterns and that soluble transferrin receptor, I wouldn't, I wouldn't look for a parasite is what I'm saying. I would consider more of some kind of subclinical bacterial, like subclinical sepsis kind of situation.

Okay, and in that same vein, would you go to the gut? Would you look at like a.

No.

No.

Okay. No. And here's why. Here's why. So going this is coming full circle, right? So back to the HDL thing. So that, that, that couple that I told you I, I interviewed, their whole premise is, is that we can have dormant bacteria in the blood, but because it's in the blood, it's not really going to replicate and overproduce itself, but it can be woken up. And iron seems to be the thing that does that. The thing that I think we miss as practitioners and is when we think of infections rightfully so, we think gut, that's a major point of entry for it. But, but it can go systemic and not be septic. So there's something in between. And honestly, it's probably a leaky gut situation. How else will some of these bacteria, unless you get some kind of abrasion or wound on the outside, how else are they going to get entry into the body? And so if it is inside the body, it probably came in via gastrointestinal tract in some way. And there was probably some degree of intestinal permeability for them to squeak out of the gastrointestinal tract and into the system. But once they're there again, according to these researchers, they don't really replicate. They can become, they can wake up, in which case they're producing lipopolysaccharides and other inflammatory cytokines in the humoral level, right in the blood. But they don't proliferate, so you don't get this raging sepsis. And so that's where this HDL comes in. So you think HDL lipopolysaccharides, most people, I think, mistakenly. Well, you know, this is what we're taught, but mistakenly think lipopolysaccharides come only from the gut. And I humbly think that that's not true, that we can have. What would you want to use? Like silent subclinical bloodborne bacterial infection producing lipopolysaccharides, creating a low grade inflammatory cascade that raises HDL a little bit. So on the other hand, and this is the other thing is where did most of the supplements that we give people go to the gut, but they don't just stay there. Like that's, you know, when we talk about a gut protocol, most people, that's an immune protocol. I mean, these things get absorbed. These metabolites from these botanicals and things, they get absorbed and so it's not any. So that's why I don't really differentiate between a gut protocol and a non gut protocol because honestly it's. These are immune modulators and they do get absorbed. You know, I mean you take mushrooms and, and you know, you know what kind of mushrooms I really mean, you know, natural killer cells. Well, how the heck do your circulating natural killer cells get turned on by mushrooms that you consume in your gut? So I don't think there's a difference between a gut. Unless it doesn't get absorbed in the gut, like diatomaceous earth or something. Unless it doesn't get absorbed. That's gut. But pretty much all these botanicals that we're taking, I, I see them as a systemic immune modulating protocol that might also impact the gut because it's just going through in order before it gets to go systemic.

Okay, yeah, that, I love that, I love that reframe and perspective. Because you know, normally when you take something for your gut, you just assume that it stays there, right? You, you don't realize, hey, like this is getting absorbed like all the other supplements I'm taking that are supposed to get into my cells. Right.

Well, and that would be like saying are you, are you eating your food or your, your gut or your system, you know, proteins that gets all broken down, mucilaginous stuff that stays. Right. That just forms a gel like substance like marshmallow and licorice root, some of those things. But no, we, we break these down and they become systemic. So if you take your name it Echinacea. Like you know, like let's, let's. Some like wormwood, you know, Artemisia. Absolutely. Anti parasitic. Or how about some of the great essential oils, you know, like clove and oregano and, and all those like super caustic things. Those are, those will wipe anything gut. You better believe those things get absorbed. They're fat droplets, you know, those absolutely get absorbed. So a lot of this stuff is. I don't, I don't have a gut versus non gut immune protocol necessarily. It's, it's going to impact everything unless it doesn't get absorbed. Like you know, fiber, you know, some of those kind of things. Like I said diatomaceous earth or you know, whatever. Whatever stays in there. Charcoal, not a lot of that gets absorbed. So anyhow.

Okay, so that makes sense in terms of where things are going, where they end up. As clinicians, we want to be sensitive to that, and mindful of that when we're making recommendations, and I love that we're not just focusing on one side of that barrier, we're looking at the whole person in order to ultimately get to what the issue is. Doc, I would love to know, without naming names, what are some tests that you would advise us perhaps to put on the chopping block?

So, yeah, I can give you classifications of them because there's a number of labs that offer them, quite honestly, the organic acid test. And listen, I already know people are like, oh my gosh, that's like my baby. Here's the deal. There are some markers on an organic acid test that I think have some merit. And that's what I'm saying. I'm not just here to say that all this stuff is horrible and be a buzz killed in the whole industry. There are some markers on an organic acid test that have some merit. There are some that are, I mean, what else could I say? Just completely inaccurate into what they're purporting to measure. I, I, we, we could go deeply into this. But like the citric acid cycle metabolites. Give me a break. They, they do not. And I could walk you exactly through, I could tell you the literature about it. You know, the literature is very clear that those are just not accurate. Some of the microbial ones, I think do have some merit. Vitamin C is glucose dysregulation can cause abnormalities in that marker, but it also is low. Or when someone's vitamin C deficient B6 is a mess. Some of the neurotransmitter ash, if you will, or metabolites, those are accurate in terms of what to do about them, I think is a little bit harder for people, but those tend to be accurate. A salivary cortisol test, okay, so and I want to be really clear on this. It is an accurate test. It is measuring accurately cortisol levels that do correspond with serum levels. Okay, so let me be really clear about that. I have entire presentations on this man. You just, your mind would be blown when you see some of the data on literature. The problem is that cortisol is all over the darn place. There are studies where they had multiple people take salivary cortisol throughout the course of a month. And in the same person. One morning it was flatline low, another morning it was really high. The cortisol awakening response is all over the place. The rhythm is all over the place, the levels all over the place. So if we as practitioners are taking a single snapshot, salivary cortisol that is not necessarily who that person is. And I've trained practitioners on this and some of them have adopted this. They will do serial salivary hormone testing in order to try to get. And in the literature it's called trait like. What we're looking for is not situational in this person. There's one paper that looked at people on a workday or non work day. It was completely different. Whether you have nightmares impacts your cortisol awakening response and your cortisol level levels. There's just so many things. So if somebody wanted to run it, you have to do it serially a couple, few times over the course of a week and then you might start to see some patterns. But to just run it once and to say, oh, you have low cortisol, like do what you want, not you, but you know, I, I just, I would never do that. I have done it, I did it in the past because that's what I was taught to do. And again, I'm shamefully embarrassed that I did. But now knowing that I, I don't run it. I don't because I can find adrenal issues on, on just a blood chemistry. I told you. Sodium, potassium, eosinophils, lymphocytes, you know, there's patterns that you can see, plus, you know, orthostatic hypotension and some of those things as well. So I don't even need to run it, quite honestly. The organic acid does the, the hair tissue mineral analysis test, I mean, super cool, but when you look at the literature, there's a number of papers where people split, sampled their hair from their. Just researchers like hanging out in the lab, like, hey guys, what do you want to do? Let's cut our hair and like send it to a bunch of labs all over the place. They're accurate at measuring minerals, they're accurate at that, by and large, depending on the paper that you look at, they're accurate. However, the reference ranges vary. So you might send your hair to one lab and you're like, hey, you're low in iron. And this is in the paper. Another one's like, you're low in selenium and cobalt and zinc. And the other one's like, you're low in molybdenum. None of them agree. And you said this at the beginning of this interview, that the problem with that is, is we are predicating what we're doing with these patients based on the lab results. So if you went to one practitioner, you're low in iron. What Are they going to give you iron? If you went to the third one where it was low in molybdenum, not iron or selenium or zinc or whatever, the other one said they're going to give you molybdenum. Right? And so which one's right? That's a huge problem. My favorite paper in the hair tissue mineral analysis realm, though, is this one guy serially looked at his hair levels of stuff not for two years, but for two decades, 20 years. This guy has data, and the conclusion is basically the only thing that it's valuable for, and you'd have to run it serially to know, is looking at high levels of certain metals, like cadmium, for example, or like a real deficiency. So copper in the hair, if someone's deficient, will be low, but it will be low over a long period of time. And so you can't just look at one lab. You cannot look at one lab and, and say that it's an excretory product, right? It's not like glucose. You look at glucose and you're like, your glucose is low. Let's just double check one more time. And it's still low because glucose is regulated by the body. You know, excretion rates coming out of the hair is not regulated. I, I don't want to upset anybody. I think the only benefit of a stool test is looking for a significantly overt infection. I don't think we should use it for anything else. Like, do you have a parasite, H. Pylori, some raging infection, fungus, candida something. Don't, don't nitpick over the microbiome and all that stuff, because I have a reason why I say that, which I'll say in a second. I think the same about genetic testing, too. I mean, it's like, I know people are going to start like throwing organic tomatoes at me for saying all this stuff, but I just. The reason why I say this, just so, just so you know where I'm coming from, I spent a lot of time looking in the literature, right? There are old, old, old pathways. Okay? My favorite biochemical pathway, hands down, is the pentose phosphate pathway. Always been enamored by it. The reducing agents that are made. It's this. It's a phenomenal pathway. Do you know that that was the second discovered biochemical pathway after glycolysis, which is like the oldest, most primitive pathway. It's found in all sorts of cells, red blood cells. The pentose phosphate pathway has been known for about 100 years. Okay, and what, what are these Biochemical pathways. Metabolite, enzyme. Metabolite enzyme. Right. Conversion. Conversion, that's it. I mean, it does, it's like a five year old. It's so, so basic. You'd think we'd have that down, right? Well, it wasn't until about five years ago that on the pentose phosphate pathway, researchers were like, hey, guess what humans make erythritol. We had no idea. Like, wait a minute, you've been studying this primitive pathway. Enzyme metabolite, enzyme metabolite for a hundred years. That's the way I described it is like you go into your glove box in your car and you find some fork that's been in there forever. You're like, wait a minute, how long has this fork actually been in here? This is embarrassing. So if we're still learning things about albumin, about the function of insulin and what it does or maybe what it doesn't do about old, old, old pathways that are so. Man, you think we have the microbiome nailed down? You think we have like, you know, the, the genome nailed down and how to test these things? So that's why I said, before bandwagon passes, I'll let the bandwagon pass by my house a few times and then maybe I'll jump on. I just like, we, we like to think and, and we're humans, we like to think we're smarter than we are. Right? We like to think we're better looking at that, where everybody's a better driver than everybody else. That statistically isn't even possible. So I just, I am extremely humble in how little we actually know. And like, when you, when you go back into. This is great, just go back a few hundred years into medical history and what we thought was a good idea. And you look at us now. So they thought what they were doing at the time was brilliant and smart and the best idea. We look at it now and we're like, the heck were you thinking? Now we know what, you know, in 100 years from now, they're going to look at what you. Like, you fools were given vitamin D and like, you know, 50,000 IUs. Like, what were you thinking? Here's a great example. Medicine came up with this idea, basically. I mean, look, they used to give, they used to give like parasites for weight loss and, you know, and, and heroin and opium, opioids and cocaine and, you know, but the, the best one of all, if you've heard, you've heard the phrase smoke up someone's, you know, rectum, I'll just say well, you know where that comes from. That's an actual phrase. Because I think it was the 1600s, if I'm correct. 16 or 1700s. I think I may be wrong in the, on the century. But along the Thames river, they actually carried billows, you know, old billows that you'd stoke a fire with, like an accordion kind of thing. Yeah, they would have billows on the boats on the Thames river because it was believed that if somebody had a near drowning experience that you could take a billows with hot ash, put it in someone's rectum and then that would revive them. Because. Because it happened once when, you know, when in reality the hot, hot embers on that area probably are going to wake up just about anybody that's halfway dead. Right. But that's what they did. So. And you look back at like, you're like, how would that re. How would blow and smoke up someone's rectum? Revive, really? But that was. They did it. There's billows on these boats at the time. So, you know, go back just a couple decades. Low fat was the way to go. Right. Now we're like, well, that's stupid. You're going to give everybody gallstones or, you know, cholesterol is the cause of heart disease, and then it turns out it's not. Or. Listen, we've been. You and I have been around a lot. It was in the 80s where how are we supposed to eat every few hours to manage insulin? But now we realize that the more frequent meal consumption leads to more insulin dysregulation. So 20 years ago, we were flat wrong with these things. And so I look at this now and I was like, what do we. And I crack up at people that were like, we used to think this, but now we know. Do you really. It's more of, we used to think this, now we think this cool, and tomorrow we're probably going to think something else. We're all just doing the best that we can, you know, and so anyways, that's. I'm very humble with all these things and our stupidity and our ignorance and that we're all just doing the best that we can. I mean, you can't argue with that. I know you are. I am. Everybody is. And then you learn something new and you're like, shucks, I got that wrong. But I'm going to try not to make that mistake again in the future. So that's where I live with this. I'm. I started out more liberal, I guess, more aggressive in my, in my protocols. I'M so conservative now. 200 blood chemistry evidence based supplements working. And I know we talked about this at that conference, you know, the mental emotional component is absolutely imperative. Somebody's purpose, their, their, their connectedness, their reason for being here in the first place and how that impacts physiology, you know, and, and listen, I. Not running all these labs, not getting crazy about all the supplements, not getting, you know, insane about the best diet has been a huge stress reliever for me in practice.

You know, I've got, I want to be sensitive to your schedule. Do you have a few more minutes?

Cool, A couple more minutes. Yeah. But my family, I'm the, I'm the cook around here. I gotta make some dinner for the family.

All right.

Hungry people upstairs.

So I, Yep. He has six kids by the way, so that's, that's what he's referring to because there's a few things that, and you don't have to give an extended response, but I'm just curious of your thoughts. One is a CGM. So what are your thoughts on CGMs and where do you see, where do you see this technology going? Like, is there an application for cortisol or other hormones or other markers in, in there?

Yeah, yeah, yeah, that's great. That's good. So, yeah, I haven't gotten on that bandwagon either and man, I know again, this is like heresy. I realized like what, this guy doesn't like cgi. I, it's fine, it's cool. I, I've seen, I've had patients that with my assistance have kind of tested them, if you will, like going to a, doing an oral ghost tolerance test and, and I've looked pretty closely in the literature and you know, a lot of them are very pro CGM and the interstitial fluid and the, and the glucose level of the interstitial fluid relating to that of, of the, of the blood. I have a few concerns about their accuracy sometimes and once again causing really a lot of undue stress. Like oh geez, I didn't know my glucose is going up to 180 after, you know, I eat chips or whatever. Sometimes more data is not good, you know. And I have another quick bit on that I wanted to tell you about. There's a study on this. In fact, I, you know what I think we do, I feel like a good idea comes out and then we bastardize it, you know, so like the, the CGM in the first place, super cool. And who is it for? It's for diabetics. You try to make sure that they're you know, they're regulating their gluc better and then you get all these like health hacks, right? They're like, hey, I can check mine too. And I just, I feel like that sometimes it can cause more problem than good, Personally. My big issue, however, focusing on glucose is it says nothing of what's actually going on surrounding glucose. We, I think we're, it's a, it's an easy target to go after. But what I want to know is what are your counter regulatory hormones doing? Because that's really what's going on. So if somebody has hyperglycemia, is it because they don't have any insulin because that's going to cause that, or does it because they have too much insulin, but it's not working anymore? Those are two different protocols. That is two different people, two different lifestyle, two different diets, if you will. Supplements, the whole bag, right? And so all we tend to focus on is the easy part, like, oh, you have high glucose. My question is, why do you have high glucose? Is it because. Is it because you're not making enough insulin? Is it because insulin is late to the party and you have a blunted first phase insulin response? Is it because you have hyperinsulinemia and insulin resistance? And I will also add, this is maybe a conversation for another time. There is. So we already talked about insulin resistance. There's hyperinsulin sensitivity. And what that's caused by is that I can see too much GLP1. And so in these people, this is a trip because they'll actually have totally normal glucose, which if that's your endometric, they're good. Your glucose is fine, keep doing what you're doing. But in fact, what's happening is because they have so much GLP1, they're having a hyperinsulin response. And because of GLP1 makes their insulin receptors more sensitive to insulin peripherally. And none of that's good. That is not normal physiology. And so my problem with CGMs is all we're focusing on is the easy one. You know, like the bouncing ball going around. But what we're not seeing is who's hitting that ball or who's, you know, who's involved in that. So I've never recommended one to a client. I've had loads of clients and patients that used them and the data is great. You know, I use it, I'll totally. Is it. It doesn't always add up to me, I can tell you that. I think there's a. I don't know if it's a latency or a lag between serum levels and interstitial levels. You could probably speak to that. So, yeah, it's cool. But. But listen, here's another thing. So you know, regarding these sleep trackers, there's actually a study on this. I won't get into details for the reasons of time, but basically the short version is, is they took a couple people and the clock in the room was wrong. Then they had them do math computations. Some people had a great night's sleep, but they thought they had a restricted sleep. And then they had them do math and they did poorly. How did you feel? So tired. They slept eight hours, but they thought they slept four. I'm tired, I'm exhausted. And then do poorly on math. The other group slept four, thought they slept eight. How do you feel? Wonderful. Refreshed. I'm feeling great. And you know what? I'm going to crush this math test. And so I don't use. I mean, and again, teach their own. I don't use that stuff. I have. I've had it, I've used it. But I remember distinctly, I wake up, I'd be like, man, I feel great. And I'd look at my phone and be like, you slept horribly. I'd be like, oh, man, I must be tired. You know, And I was like this. I'm letting this thing impact how I actually feel. That's going back to the testosterone thing. You know, I love my wife. I have whatever mojo I want. I can lift weights. I feel good. If I have some doctor, I haven't tested my testosterone. I don't care. I'm good. You know, like, if you have a problem, then you should test it. So anyways, that's my problem with the CGMs and all these gadgets is like, a little information is good, but I think we can sometimes get taken a little bit too far. Like what a wonderful world we live in right now where we have access to this. These things. I just think as a tool, we need to use them as the tool that they're defined to be and not take it too far, because then we're going to cause new problems.

You know, maybe I need a. Maybe I need a fast. A fast from my, My little tech gadgets to, you know, to. To just get away from them for a week or two and see if there's any. Any impact.

Listen to me, I. And I'm not. I'm not kidding you about this. Do that for me, please. And I would, I would love to hear in a week from now just, you know, message, email, whatever the impact. I'm. I'm in the process of doing some fasts of my own and experimenting with some various things. I don't do that. I don't use that stuff. So I'm not fasting from that. But I'm very. I would like you to do that just.

And I'm doing it right now, taking it off right now and I'm putting it on my desk.

Good for you, man. You know what, it says a lot about you. That really does because I think we get addicted to these and we start to focus on the wrong things. And one of the things I think is one of the biggest health issues that we have right now is that we are hyper focused on ourselves and no longer focused about life, our community. When back in the day, who you were, was who you were to the community. You were the gardener, you were the house builder, you were the shoe repairman and that's where you got your identity. And that's great because that's who you were. People loved you for it, they needed you for it. You woke up in the morning as the shoe repair guy and, and like that was your built in purpose in that community. And now it's this hyper focus on ourselves. Like, what's my glucose? What's my sleep, what's my, this, what's my brain waves? You know, like what, what's all this stuff? We're looking so in ourselves. I don't think we look out anymore. And I think that when, when everybody's focused on themselves, nobody's focused on anybody else anymore. And so I think, I think one of the, and this is not established in literature, I personally think one of the greatest health crisis we have right now is a bunch of people running around with lacking purpose, lacking being, lacking knowing who they are, being connected to other people. And I think that's showing up as physiological as well. I think it's showing neurotransmitters, I think it's showing up as hormone issues, I think it's causing issues. So maybe we eat more, move less, whatever it might be anyhow. So, yeah, no, listen, it's funny how one action, like one sentence can tell you a ton about a person. The fact that you're so willing to do that and you're going to do. I think that's awesome. Congrats. That's super cool, man. And I want to hear.

Oh, thank you. I appreciate you not holding anything back and just saying it like it is and standing, you know, standing true in what you Believe in and listen, I'm a student for life, just like you are, and willing to learn and willing to adapt and do what? At least I'm willing to experiment, right?

Yeah.

And I'll report back and this ring will sit here for the next week. My wife is going to be like, where's your ring? Because it's. It's become my.

That's not easy. Listen, that's not. It's not easy. I'm impressed. And if you find yourself like, freaking out in the middle of the night and you go to find your ring and put it back on, that's when you know it's a problem. Right? That's like. That's like the Oura ring junkie. You got it. You got to get your. Your aura ring fixed. So find out. I'm proud of you. That's great.

Thank you. So two more questions, and then I'll let you decide how long you want to take to answer them. But one is AI. What's your take on AI in the blood chemistry world?

So that's a. That's actually a long and painful story. I'm not going to really tell too much about that. I was kind of involved in that. I think it has fantastic potential by fear. I will tell you the. The thing that I see is practitioners, people, not just practitioners, we don't like to think. You know, it's like you're familiar with hormesis. Thinking is hormetic, by the way, so. And. And there's papers on that, by the way. So we are so averse to thinking. We just want a protocol. You know, my PCOS protocol or whatever, my, you know, metaphysics protocol. And listen, I do stuff that's literature based. The stuff in the literature about AI as it pertains to interpret, like blood chemistry predictions, if you will, is very cool. Very. It's. It does what we are trying to do with the patterns on a blood chemistry, mentally, manually.

Right.

And kind of does it for us. My concern is, is that once that starts happening, we're not gonna just. We're not gonna do anything. We're like, oh, this says this, and we're just going to totally get rid of, you know, our senses, our ability to, to, you know, palpate and smell and look and observe and come up with those ideas, and they're just gonna let it do it for us. So that's huge. And I have experience with this. I can tell you firsthand, super cool, very attractive. But I know that I look at the lab first and then what it would tell Me not wanting to be biased or jaded by it, but you know, you know how people are. They just like, give me the report.

Hey, you know, Jim Rohn always says you can't have someone else do the push ups for you, right? If you want to build the muscles, you got to do the push ups. And. Yeah, and the same thing. Like, you know, we're, we're in the marketing space and we help practitioners get their message out there. And AI can be a great tool for that. But I always tell them, how are you if you're not a good copywriter, how do you know it's writing good copy?

No.

Right. So if you're not good at interpreting blood chemistry, how do you know that it's interpreting it correctly? So it can do some of the heavy lifting or some of the lifting for us. But, you know, I think that, you know, there's more to a person even than what the blood chemistry will ever show us. And so we got to keep our, our clinical sword and kind of our emotional and inhuman sword, you know, and connection sword pretty sharp as well.

Totally agree.

So last question for you. Where can people learn more? So if this. And they're super fascinated and they want to dive a little bit deeper into your world, where can we find you?

Yeah, so my wife and I have our business and it's@metabolic fitnesspro.com we, like I said at the beginning, we, we have a, we're trying to raise the bar and we believe that life is short, not that it matters to too many people, but we're Christian and we run with humility and integrity. And that's. God is our, our primary thing. So my, our hope is, is that everything we do is, comes and emanates from there. So it's, you know, we, we really are truly trying to, in, in a, in a world of, of, you know, shysters and marketing and all this stuff, practitioners who are biased and ego based and they get, what's it called, the proceeds after the supplements they designed. We try to do stuff with humility and integrity. And so, you know, the, what, what you and I just talked about is that's how I talked to my wife about this. Hey, sweetheart. I found this really cool study on this thing. You know, it's like this is, there's no smoke and mirrors. It's, it's kind of take, take what you get. And yeah, so if you go to metabolic fitnesspro.com, we have a number of courses that people can get. We have a mentorship program that we run that has Been super cool and really seeing people just, you know, this. Improve in what they do in their practice and see them not just be successful because it's not about the money. It's about like feeling good as about yourself as a practitioner and, and seeing that happen is great. So anyhow, that's, that's the short answer for that. They can head over to that and learn more about us and contact us and all this.

Awesome. And then just, just to close a loop in terms of the lab testing, do you have a particular set of labs that you like to order? Is that something you share in the mentorship program or.

Yeah, yeah, we're. And in fact, you know, as you said, lifelong student. Right. I, I'm like, I can say I've always considered myself rather dumb and, and think that that's good. I don't want to be smart, you know, I, because when, when, when you're, you're dumb, you keep, you keep trying to be smart, you know, and it's like, it's like my wife, I, I still try to impress my wife and, and she doesn't impress easily, which is. Makes it really good because I'm constantly trying to imp. I constantly will and I like that. You know, I want to do that. So it's like, it's like that. With this, this knowledge acquisition, we are working on some things right now where we're going to create a lab with some, some pretty cool markers that aren't on standard labs, but the evidence suggests that they probably should be. So. Yeah. And we teach people what markers. We have a course in blood chemistry interpretation, blood chemistry analysis, and we cover the major markers in there. But we're going to be coming out with some new ones that we think should probably be on every basic panel because of all the stuff you can learn from it. Constantly growing, though. Yep.

Well, thank you. This has been so enlightening. I really enjoyed our conversation. If it's okay with you, I'd love for this to be maybe one of several that we do together because I know there's so much knowledge that you've got bottled up inside of you that the world needs to hear. And I'd love to invite you back to speak at perhaps our events and, and to our audience as well in, in our mentorship. So I think this will be a great training that you can offer. So thank you once again.

I very much appreciate it. I like the opportunity and I love what you do, so thanks so much.

Awesome. Well, go impress your wife. And I don't want to. I don't want you to be late to get. Get that dinner ready. So have a great one. Lots of love.

Thanks, Ash. All right, bye.