Written by Christopher Kelly
June 26, 2014
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Christopher: Hello and welcome to the Paleo Baby Podcast. My name is Christopher Kelly. And today I am joined by Dr. Dan Kalish, founder of the world’s premier institute for functional medicine.
Dr. Kalish is special to all of us here at Nourish Balance Thrive because he is the doctor who trained us. But prior to that he totally turned around my life by revealing the hidden root causes underlying the myriad of health complaints I was suffering from at that time.
Hi, Dan. How are you?
Dan: I’m really great. Thanks for having me in.
Christopher: So I’d like to start by you giving us a bit more information about your background. How did you get started in all this?
Dan: Yeah, you know, when I was in my early 20s, my father died rather suddenly and I went to sort of an existential crisis. So I gave away all my belongings, I said goodbye to my family, and I went to live in a monastery in Southern Thailand in what they call a forest monastery which is really like a jungle monastery.
So I was living there for a couple of years with the monks and I’m meditating and doing all the things that monks do. By the time I came back to the US, I started to develop what we would call chronic fatigue. And it took me a lot of years, about 14 years, to piece it all together. But it turned out I had picked up a particularly nasty parasite in the jungles of Thailand and I was actually quite ill although the conventional medical world really couldn’t identify the problem.
So I sort of healed or repaired my own chronic fatigue issues from functional medicine and realized that this was kind of exciting and, hey, maybe I can make a career out of this and help other people as I had been helped. So that was my impetus for getting into this work.
Christopher: That’s awesome, yes. So I mean you did the same thing for me, right? You kind of really just totally turned around my life. But there’s a bunch of tests that you’ve been using I know and we’ve been using them too. The people that I talked to, they know quite a bit, they’re quite well educated. Someone has heard me on Rob Wolf podcast. They know what adrenal fatigue is and they know about the saliva test and they know about cortisones, DHEA, and some of the other hormones. And then quite often they know about the bugs too. So maybe they’ve heard of blastocystis hominis or Entamoeba histolytica. Those get a lot of attention too.
But there’s one other test and it’s a urine test that we’ve been using extensively in our practice and it’s extremely comprehensive. It’s got 46 different markers on it. And I wanted to talk today about that test because it really lifts the lids on the problems that we’re seeing on these other two tests. Does that make sense? So you see an adrenal stress profile that’s really messed up and I think one of the tenets of functional medicine is you don’t just go, "Okay, you got low testosterone. We need to bring that back up with a supplement." You dig deeper and you find out the underlying root causes and you address those. And then in some cases, the problems that we see on the original, say the saliva test can actually just go away by themselves. So it’s really cool for really getting down to the root causes.
So I wonder if you could start by telling us a little bit about this test, like what is and who might consider running it?
Dan: Yes. We look at this in terms of three body systems in the Kalish method, right? So we look at hormones, digestion, and then detoxification and nutrient replacement. So as you mention it, people run adrenal panels or hormones, thyroid hormones, female hormones, et cetera, run these digestive panels for infections and whatnot and figure out what foods a person should eat, what foods they should avoid.
And then the third body system is really based around this lab which is detoxification and nutrient replacement which is a pretty broad subject and it really encompasses everything to do with toxins, everything to do with how we get rid of toxins, and then the whole, really the broad subject of clinical nutrition -- what individual, specific nutrients are we low in, what specific body processes. Basically, it's like doing a biochemistry class basically. Where is your biochemistry sort of failing you?
The reason why it’s the third body system is because most nutrient deficiencies are result of stress, poor diet, digestive problems, eating the wrong food, et cetera. But at the same time, as we fix adrenal and digestive problems, we then need to make up for all the deficiencies that we’ve accumulated. And as you’ve seen through testing so many people, once in a while you get one of these labs back and it’s perfectly clear. But the majority of people that we look at have anywhere to two to 20 really significant nutritional blocks that are going to prevent them from getting well.
And so what's important to recognize too is that these tests are really different from anything done in conventional medicine. They are not a replacement for a standard blood test that would look at things like cholesterol and liver enzymes and your kidney function and whatnot. These are tests that are really done from a functional medicine perspective to, as you said earlier, dig deeper into the biochemistry of the body.
And they’re not designed to and they do not detect any disease, like can’t tell if you had a heart attack or if you are facing liver disease with these labs. They’re all functional in that they’re looking for problems earlier in the process when there is just dysfunction with organs and cells that no disease process.
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So even if you’ve had a standard complete physical exam as well as lab work with your conventional doctor, these tests can still reveal a whole another layer of problem that it would be hidden underneath that layer that the conventional doctors look at.
Christopher: Right. And then I think as an athlete and most of the people that were working with the athletes, I think the stuff is really important because it has to be perfect. As an athlete, particularly as an endurance athlete, you’re doing something pretty weird that your body wasn’t designed to do. So I’m a mountain biker going for five hour rides across rugged terrain on a daily basis is not something my body was designed to do. And then if I want to get competitive with that, then it’s important that everything is working perfectly.
And so we’ll go into the details in just a moment, but I think any one of the things that this test looks at could potentially be holding you back as an athlete. And then people always spend tons of money on equipment. So me being a cyclist, people will think nothing of spending $2,000 on a set of wheels, right? So which is more likely to make you go faster having a correctly functioning Krebs cycle and all the micronutrients that you need or this two and a half thousand dollar set wheel. I mean the wheels are nice. Don’t get me wrong. But I know where I’d spend my money first if I wanted to do well.
Dan: I know. It's so funny, isn’t it? It would be like if you are running an auto race, if you brought brand new wheels for your car but you didn’t get any fuel, it’s not going to do if you're not on the right fuel. So we’re really looking at the fuel sources here for athletic endeavors as well as the recovery because a lot of athletes are good out there as they’re competing. But they're prone to injury, they don’t recover well. They stack too many events too close together their performance starts to suffer.
Christopher: Right, yeah. And so this test can actually reveal to an extent whether your diet is working for you. So there’s two kind of factors here. There’s like what you eat so that you could have a potential micronutrients efficiency because you are not just eating the foods that contain those nutrients. That’s a possibility. But then more likely and this is what we see with the people that we work with is that eating the very best quality, organic, grass-fed, all of those great words. But if their digestive health is not brilliant, then they’re not going to digest and assimilate those nutrients and that’s going to result in the problems that we see on an organics test.
Dan: Yeah, absolutely. And the other thing, as you mentioned earlier, is that I’ve worked with a lot of elite athletes, endurance athletes and weightlifters, soccer players, football players, basketball players -- every sport you could imagine. But a lot of endurance athletes, cyclist and tri-athletes and runners, one of the things I’ve learned is that their nutritional needs are extraordinary because they’re doing things, as you mentioned earlier, that are sort of in the typical human repertoire, right?
You can’t, for example, typically get enough antioxidants from vegetables if you are on a bicycle five hours a day running across France, right? So the needs are really oftentimes exceeded by anything you could do even with a perfect diet and perfect digested health so that we just need to supplement and see where the gaps are so that a person can stay at their maximum performance.
It’s really the different routine working with something like a Toyota or a Honda and a Ferrari, you know. I’m looking at buying a Ferrari now. Actually, this is kind of funny. But you know these older Ferraris, you have to rip them down. The 10,000 or 15,000-mile check-up is almost like an engine rebuild, right? I mean when you do a maintenance on a regular Ferrari, it’s like $10,000 yearly maintenance thing just to do a tune-up because they have to take the engine [0:09:18] [Indiscernible].
So you got to think of the athletes like a Ferrari where a typical person is more like a Honda. So the fuel needs, the repair needs, the fine tuning, it has to be done on a four carburetor motor on a 1970 Ferrari. It’s a really different thing than if you bought a brand new Honda.
And so you guys as athletes go out of tune really easily. The other thing that’s great, not unlike a Ferrari, is that when you get an athlete in perfect tune, they become, number one in my mind, very, very healthy which is my job is get people healthy. But from an athletic performance perspective, they just crush the competition. It’s not even fair to take a nutritionally balanced person with perfect biochemistry and match them bike for bike against someone who is eating poorly and hasn’t done the testing. I’m sure you’ve seen this in your competitions as well. It gives you what I would almost say an unfair advantage in terms of competitive sports.
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Christopher: Yeah, absolutely. I mean the difference in my performance has been quite remarkable. I think I’ve talked about this before in a previous show, but there was one thing in particular that showed up on the organics profile and that was an inability to use fat as fuel. So we’ll see this in the fatty acid metabolism, the example that we'd go over in just a moment. But I started supplementing with a micronutrient called Carnitine, and that just totally changed the way in which I feel on the bike.
So for me as a primarily aerobic athlete, I want to be using fat as fuel. Hence, with this micronutrient deficiency, that was impossible. Carnitine is a micronutrient that shuttles fatty acids into the mitochondria and without them you can’t really use your stock using sugar as fuel basically. So this is big. You can’t really eat enough sugar in a five or six-hour event. So this was a huge one for me. But in general, I noticed that –
Dan: I just want to point out that that is specific to your physiology, right? It would be the guy on a bicycle next to you that is fine with quarantine but he is low in CoQ10. And so he can’t get energy inside of mitochondria for a completely different reason. That’s how we can individualize programs based on the latch for specific issues.
Christopher: Yeah, that’s huge. I mean lots of people I talk to are spending tons of money on supplements. And the truth is, and they really admit this, they have no clue why their taking any of it. They just heard something on a podcast or in a magazine and it sounded like a good idea and they tried it and maybe it helped, maybe not. I’m not really sure. And then of course you never stop taking any of this stuff, right? So it just accumulates in these bags that you carry around with you everywhere.
And then the thing that's great about this test is it can really show you what you actually need, how well is this process actually working. So it takes all the guesswork out there and it really gets down to your needs as an individual.
Dan: Yeah. It’s a beautiful thing really. I would say just vastly underutilized and not so much known about, part of it is, as you’ve seen from doing a training program with me is that it’s an overwhelming test to learn how to interpret. You've got 46 different parameters to juggle with, each one of which reveals a lot of complex biochemistry.
And so I think a lot of practitioners know these tests are out there but it’s just daunting to try to interpret them and apply the information. So they’re not as well used as they should be or as frequently as they should be.
Christopher: Yeah. Sure. So I thought we’d go on -- I mean we will have to be careful about doing too much stuff that’s going to be visual because obviously this is a podcast, but I’ve got an example here from a super fast girl that we’ve been working with. She’s a marathon runner and her PR was two hours forty which is pretty darn impressive I think. She was doing great then she just started pushing it a little bit too hard. She’s like the Ferrari that you talked about. She is super highly tuned but maybe didn’t do a few of these things, perhaps she was deficient on a few micronutrients and she started falling apart.
We’ve actually got some really nice data for her that somebody else collected on her adrenal hormones so we could actually see over time how she progressed from like a perfect -- she was the perfect textbook example of hormone balance. Cortisone was perfect, DHA was perfect, everything is perfect. And then we looked at it two years later after overtraining in marathons and she's really starting to fall apart and she’s kind of what we call a late stage. Her cortisone signs dropped and her DHEA is less than half of what it was two years prior.
So we ran some more labs on her and one of them was this organics profile, and there’s a lot of stuff going on there. So I thought although everybody can’t see this, we'd start looking at this lab result, and then maybe I can post a link to it. I have this lady’s permission to actually use her result and make it public; obviously I’ve removed her name. But I wonder if you could look at that lab result and there are so many different things on here. I’m looking at page 2, Summary of Abnormal Findings it says. And then there's these categories, fatty acid metabolism, carbohydrate metabolism, there’s all these words that are kind of quite confusing. I wonder if you could just sort of -- how do you even start with a result like this?
Dan: Yeah. It’s a bit overwhelming. Most people can’t even pronounce some of these terms like home ventilator, hydroxymethylglutaryl. So I think the point of it is that we’re breaking down the systems. I mean look at this all from a global perspective versus getting involved in an individual biochemistry component. So we’re looking at basically hormone, gut and detox along with nutrient replacements, so those three big categories.
So what do we need to stabilize our hormones in the body, everything from insulin to cortisol to testosterone, right? What do we need to improve digestive function is also included on this panel. And then what do we need to do to detoxify, to get rid of toxins, to protect ourselves from toxins; and that could be either internally generated toxins or ones that come from the outside.
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So coming from the outside, example of that would be you eat some fish that has some mercury in it or you put some lipstick on that has some lead in it or you eat a food that has some kind of pesticide, herbicide. But then we have internally generated toxins which are a big concern for athletes because of the large amount of exercise they’re doing. They’re generating toxins that the liver has to build down that are normal byproducts of the process of exercising a lot, right?
Christopher: Right.
Dan: And then we have nutrient placements. So hormone control; digestive function, detox, getting rid of the bad stuff; and then nutrient replacement -- so those big categories. So when I look at these tests I'm just thinking about those variables, and the whole first page centers around how we use nutrients for energy and then how we produce energy inside the cells, right?
As you mentioned earlier, there’s fatty acid metabolism, that means how we burn fat for fuel; there’s carbohydrate metabolism, how we burn carbs for fuel; and those two are also very strongly in line with the hormonal control because we have hormones like insulin and cortisol that are regulating blood sugar, but we also have the need to actually be able to use macronutrients like carbohydrates and fat for fuel.
And so obviously if you can’t burn fat, if you can’t burn carbs for fuel efficiently, then the hormones are going to have to step in and get involved in a way that they’re not really designed to. So if we can maximize fat burning, obviously for athletes, that’s huge because you have a large amount of fat and the tissues that you can use for fuel and obviously you’re going to burn too the glucose reserves pretty quickly if you're doing an endurance sport and you’re going to just have almost like a turbo charger or after burner you can turn on. If you can access those fat stores, it’s like flipping a switch, and you have access to energy that the other 10 people around you may not have. So that one is huge.
And then of course carbohydrate metabolism is huge too because it has to do with energy production and hormone control as well, right?
So those are sort of two general categories that the lab starts off with. Their energy production refers to how we produce energy inside the cells which is obviously an issue with mitochondria, et cetera, which is a big issue for athletes. And then there are some other sections that if you try to just look at the bigger picture here, probably a little overwhelming, we can kind of gloss over a little bit, look at B vitamin markers, which are important but most people can trigger that part out just by taking a multivitamin.
The second body system to do with digestion is a huge section. It’s the last page of the lab report that looks at bacterial overgrowth, looks at yeast overgrowth, looks at intestinal bowel overgrowth of bad bacteria. So it’s a really comprehensive workup to see. And in this case, she’s got a fair number of problems, how well is the digestive tract working in terms of good and bad bacteria.
Christopher: Yes. So that was -- actually, the main complaint here from our client is she just had a sudden period of very rapid white gauge. She’s not really changed anything else. I mean the training has been going on for a while. But that was one of her main complaints was like a really puffy, bloated feeling. I mean she’s obviously incredibly lean, very fast marathon runner. Her body fat is probably way too low to be healthy for a woman but she’s doing it to be competitive but super puffy, super bloated. And then how do we – I mean we can almost see that on this lab result, right? So if you look at these compounds of bacteria or yeast fungal origin, we see all these elevated markers.
Dan: Exactly. And so this lets you know that there’s a bit of a war going on in the digestive tract and that you need to flush out and remove any potentially harmful yeast or bacterial organisms and make sure that this system is re-inoculated and flooded with the good guys. That’s pretty straightforward. Obviously, that also helps with absorption so then a person is able to more easily absorb other nutrients that you’re trying to provide.
Christopher: Yeah, exactly. So what we’re looking at really is a dysbiosis of the gut floor, right? This is not right. And then you know the poor digestion and assimilation and the micronutrient efficiencies follow shortly after. So now we’re kind of – these things are really stacking up on each other and how can you even be healthy, let alone perform well? It’s like I feel like the health needs to come first and then you can worry about performance.
Dan: Yeah. You know, the really interesting thing is this is so obvious; it’s almost silly to say it, but I’ve always was trained to basically make people incredibly healthy, fit. And as you know, there are many fit people who aren’t very healthy -- fit. But it turns out that if you have the good structure, the good bones for building an athlete and they have the motivation and the interest in doing it and the experience, if you get them physically healthy, their athletic performance in every sport they’ve ever worked with excels beyond what they could have imagined.
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So we don’t have to make these things exclusive. You can be very, very healthy and perform at a top level. And this woman is a good example of the opposite of that where the training regimen that she was on for those couple of years actually may have made her fit but made her less and less healthy and eventually that catches up with you and your overall performance starts to fall apart. And most of the time, the response to that is for athletes to work even harder, which makes them even more burned out and more depleted and even less able to perform properly.
So really trying to reverse that trend and have people think through this carefully, use the labs to guide you so that you can maximize your health and your fitness simultaneously, not work against yourself.
Christopher: Yeah. I mean what I found is I’m starting to wonder about training plans in general. I feel like this is stuff is so much more important than any training plan a coach could hand you. So there’s a number of things you can go out and do. I feel like this year because I had a baby and been more busy, I’ve actually done quite a lot less value. But the results are showing that I'm actually going faster and I wonder whether that’s not because -- it's got nothing to do with the training. Maybe I could have been faster [0:21:49] [Indiscernible] but the real thing that you can go after, the lowest hanging fruit on this tree is the health, like get that bit in order and then there’s like a number of things that you can do in terms of training plans that will get you to where you want to be to achieve your goals in competition.
Dan: That is so true, and that is true across every sport, from competitive weightlifting to cycling, to running. It’s even true -- I’ve worked with several college basketball players -- even true for basketball. You see, performance improvements as people’s overall health improves. And very few high level coaches and trainers are aware of this and so the way that they were raised – I see this with athletes in a row, the crew athletes. They were just raised in a culture where higher volume, harder workouts seven days a week instead of five days a week is better, better, better, better. And so the overtraining becomes the norm. It’s very hard for people to see that backing off on the amount of training and getting the person very healthy can dramatically improve performance.
Christopher: Yeah. I mean everybody’s first response to not doing very well, say you’re that Ferrari and you’re starting to fall apart and the reason is because of some of the things that we’re seeing on this lab test. Well, the first thing people would do when they start seeing the performance decrease is they train harder which of course is like the opposite of what they really need to do.
Dan: Yeah. But now the thing is if I get an athlete in my practice and I get my hands on someone who has that level of motivation to work harder and harder and harder and you just redirect it and you show him the labs and you just tell him, “Look, this is not like a fantasy thing. This is going to happen quickly. Your overall performance is going to improve if we rearrange how your workouts are working but more importantly focus on the fueling of your system properly." And it kicks in. As you know, within a month or two, people are performing at a level that they couldn’t have imagined and it sort of changes your mindset too.
So you can save that mental crushing momentum that athletes have, that competitive thing, not turn it against yourself but make training easier so that when you’re actually out there and you want to win, that you have the mental effort you can put into 100% while you’re competing versus -- it’s almost like people are competing against themselves unintentionally by training too much.
Christopher: Right. So I wonder if you could talk -- I mean what you’re famous for I think to an extent is your understanding of neurotransmitters. And there is a whole section on this lab result and sometimes people make the mistake that this is a urine test that’s looking at levels of, say, dopamine and serotonin in the urine. But that’s not quite true, is it? What exactly is going on here in this neurotransmitter metabolism marker section of this test?
Dan: Yeah. So we have again three body systems: hormones, digestion, and then detox and nutrient replacement. So strangely, I put the brain chemistry as sort of under the rubric of toxins. I'll explain that in a minute. So when you make serotonin or dopamine or epinephrine or norepinephrine, there are four major neurotransmitters we measure the effects of, you make them in the brain. You also make them outside of the brain and other parts of the body. And when you’re making these chemicals and then you break them down, their breakdown products can be found in the urine. And so when you’re looking at the neurotransmitter markers, they’re actually looking at the breakdown products of those chemicals.
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Christopher: So they’re not looking at the actual thing itself, this breakdown.
Dan: Yeah, because the chemicals are isolated to the brain and there’s something called the blood brain barrier which keeps the serotonin and dopamine in the brain in the brain. And in case the serotonin dopamine gets outside the brain and the rest of your body from getting into the brain, so these neurotransmitters cannot cross the blood brain barrier.
So you’d have to literally go inside the person’s brain or the cerebral spinal fluid to actually look at the levels. You have to hurt the person pretty severely to do that. But because you make these chemicals in the brain, they’re broken down and then the byproducts of them are dumped out in the urine, you can just measure the byproducts in sort of a sneaky way of reverse engineering what’s going on inside the system, inside the brain itself.
Christopher: Right. So what’s going on here in this particular example, we see here a bunch of different organic acids, evaluate stress issues, B6, magnesium, immune support, see this inflammatory cytokine simulation. What does all this mean?
Dan: Yes. So it’s an integrated system, and there are four major chemicals. But to keep it simple, we can just talk about two of them, the two important: dopamine and serotonin.
So dopamine is an excitatory neurotransmitter so it gets you up off the couch. It makes you want to jump on your bike and do things. Serotonin is an inhibitory neurotransmitter, kind of calms us down. They are integrated together as a system and when you impact one, you impact the other. So you could never disassemble them. They’re together. And this test sort of breaks it out so you can see is there a problem with serotonin or dopamine. But again, if there’s a problem with one side of the system, then the whole system has to be corrected as an integrated unit.
And so when you are under stress, you burn through or use up more of these chemicals. So sometimes we’ll see abnormal brain chemical levels because of stress. You could also have abnormal brain chemistry because you’re not eating the nutrients needed to make these chemicals in the first place, amino acids perhaps. You're not getting that protein in your diet or you’re not absorbing protein well. So there’s a lot of different reasons why this can happen.
But I think the most important reasons that’s directly related to this lab is the connection between the brain chemistry and toxins, right? You can measure this on this particular test, I think your detoxification indicators also show it positive. And so what’s happening basically is your liver is trying to break down and remove stuff that’s bad for you and a lot of the stuff that’s bad for you or toxins are going to be either endocrine disruptors or neurotoxins.
So what that means is that these chemicals are either going to damage your hormones, your endocrine system, or they’re going to damage your brain. And so when you see high-level toxins in the system and the detox pathways aren’t working well, you can assume that some of these toxins are neurotoxins and they’re going to have a negative impact on the brain. And then you can correlate that with the brain chemicals and see if the brain is taking a hit or not. In this example, we have both.
So we have neurotransmitters that are elevated and not working properly, and the levels in the urine are high, which means the levels inside the brain are low. And we have toxins that are able to get flushed out quickly. So when you are addressing this, you want to look at the toxins and the neurotransmitters again as an integrated system, so you fix the whole system.
Christopher: Okay, yes. So one of the things I noticed or went through your system and did your protocols is my stress response completely changed. I used to be that guy by grace that would have to take an hour to warm up. I’d be a psycho cross race. I’d be there with my little turbo train. You put your bike in it, and I’ll be warming up and have to sweat onto the ground. I need to see sweat on the ground before I could possibly consider starting a race.
And then usually I do caffeine pills as well, helps as well. Just get that. And the reason for that was like the gun would go and you have to be on it like a hundred percent and I just couldn’t find that anymore. I was asking for it consciously. I was like, "Okay, let’s go," and there was just no response. And now, I feel like I've been fired up a cannon. I can go from resting heart rate to almost maximal in less than a minute which is just very different stress response from the one that I saw prior to doing all this work.
Dan: Isn’t that interesting?
Christopher: Yeah, it’s funny.
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Dan: Yeah, because if you think about it, like what’s the original design here, right? Like human beings weren’t bike riding 50,000 years ago but 50,000 years ago you might have been sitting around the leg and then like a mastodon showed up and a saber-toothed tiger was on the other side. So he who could grab the spear quickly and kill the beast will survive, and the guys who are like not able to get that excitatory response got shredded.
So this is like basic human instinct and survival. The problem is that if your adrenals are burned out and if your brain chemicals are depleted, you can’t even make that emergency response anymore which is what you are trying to do in a race, right? You’re trying to get yourself into a purposeful fight or flight response.
Christopher: Exactly, yes. So the difference is I’m doing every day so where in the past, it might have been something that happened to you every six months. Now as a competitive athlete, basically every time I go out on my bike, I’m trying to activate this fight or flight response. I just don’t think that we were designed to work this way and it’s not surprising when it breaks down if you try.
Dan: Yeah. And then there’s also a really interesting link between the brain and the adrenals, right? So when you’re under stress, you make a lot of cortisol, as we all know, and you also make more of what are called the catecholamines. And so the catecholamines include dopamine, epinephrine and norepinephrine. Those are three really important chemicals.
Another name for epinephrine is also adrenaline. It’s the same chemical. So adrenaline, obviously made on the adrenal glands, named for that, and that’s that adrenaline rush that we all associate with the go, go, go feeling. So the interesting thing about adrenaline and noradrenaline and dopamine is that they’re made in the adrenal glands by the adrenal glands but they’re also made in the brain by the brain.
So they’re kind of hormones because they’re made in a hormone-producing gland, but they’re also kind of brain chemicals because they’re made inside the brain. So they’re like we can call them catecholamines to get around the problem but they both have the characteristics of a hormone and characteristics of a neurotransmitter.
And so those are really important chemicals which we can deplete and we can see on this test this individual has very much depleted that system. So when we’re starting to rebuild, we want to rebuild with amino acids that can give the person a serotonin and the dopamine that they need, as well as flush out the toxins from the system so they don’t have any more damage to any of the brain cells and then do all the stress reduction stuff so that they’re not overtraining and burning themselves out even more.
The next really big subject is to think about -- and this is complicated, there’s a lot of information here -- but to think about liver detoxification Phase 1 and Phase 2.
Christopher: Yeah, please, do tell us more about that. I’m just kind of interested to know what that means. What exactly is Phase 1 and Phase 2? It’s something I hear all the time. What does it mean?
Dan: Yeah. So you think about it -- again, back to the original design, you’re sitting by the lake, you pick up a mushroom and eat it, and it’s poisoned, right? Or you are sitting by the lake and there’s a bad tribe across the other side of the lake and someone shoots a poison dart into your butt and you have a poison. So originally, we detoxified or these detox pathways were set up so you could survive the exposure to something that was toxic or poisonous. This is the pre-chemical era, right?
So now we are exposed to literally thousands of chemicals on a regular basis. The average American estimate now has somewhere between 400 and 700 chemical toxins in their body at any one moment. The average baby in the US is born with at least 50 toxins the day its born. We used to think that the placenta filter these things out but it turns out it doesn’t. So basically, we’re all toxic to a degree which is ridiculous.
And so your detox pathways have to try to deal with these toxins, again, on a day in and day out basis. It’s not just that occasional rhinoceros charging at you or the occasional poison dart. It’s just like we see with the adrenals being exhausted and the brain being exhausted with constant stress, we’re also seeing this constant exposure to toxins wear us out these detox pathways.
So the system was designed quite beautifully with these two phases called Phase 1 and Phase 2. Phase 1 breaks down the toxin into an intermediate. Phase 2 makes it water soluble so you can dump it out through the sweat or through the stool or through the urine. And Phase 1 and Phase 2 have really distinct nutritional requirements. Phase 1 requires B vitamins and antioxidants and Phase 2 requires sulfur-containing amino acids. And they actually measure Phase 1 and Phase 2 on this test. So they have a specific test for the B vitamins; one for the antioxidants and then one for the sulfur containing amino acids.
Based on the lab, you can see where in this person’s detox system is there a breakdown. And it’s important to put in things that are healthy; water and food that’s good for you, vitamins and nutrients that you need to run your system, but it’s equally important, maybe even more important, to get rid of the toxins that are so damaging. And remember, the toxins damage the endocrine system, the endocrine disruptors. They mess up your hormones or they damage the brain, the neurotoxins.
[0:35:13]
So when we’re talking about brain and hormones, in order to reduce our sort of liability or exposure to potential problems, getting Phase 1 and Phase 2 working so you can flush these toxins out is one of the more important things you can do.
Christopher: So it seems like it’s very little because these environmental toxins are everywhere. There’s limit to how much you can affect that exposure. So I’m always going to get exposed to a certain level of this. But what I can do is make sure that my Phase 1 and my Phase 2 detox are working appropriately so that my body can deal with these. Do you think it’s ever possible to be perfect? Do you think you could ever balance this? Is it possible for your liver to still work correctly given our environment has changed so much over the years?
Dan: You know, I think I see that, maybe in very rare circumstances. Like the last case I have like that was a young man in his 20s. He had grown up on a farm in New Zealand. His first 24 years were on the family farms. So I’m like, "What did you eat?" And he’s like, “What do you think we ate? We ate what we grew.” He was physically active, not a professional athlete but very athletic and he was in a good relationship.
So I mean if you have all those variables covered and you really know about this stuff and you can take care of yourself, I think it’s possible. But as you know, for the average person who has an occasional alcoholic drink once in a while, who lives in an urban area and is breathing the air in an urban area who maybe eats mostly organic but not all organic, it’s almost impossible in a normal urban environment for people to keep themselves totally pristine.
Christopher: Yeah, absolutely. And then the other question I had was, say, I’m looking a result like this and what are my chances of being out to fix this without taking any supplements at all? Do you think you can do that? Say, I’m an athlete, I'm a marathon runner and I get this result back and it seems pretty messed up and definitely supports the case for some supplementation at least in the short term. Do you think I could ever get into the point where I could fix all of these micronutrient deficiencies with food alone?
Dan: Yeah. You have a calculator handy? I have a pretty clear answer for that. So I’ve been monitoring this for 22 years. I'm pretty sure this is right. So the people that we have tested who have a perfect lab, very clear shared characteristics, and we’re talking about, if you take out a calculator and you multiply 30 by 365 by 3, that should be about 32,850.
Christopher: It is.
Dan: If you have about 32,850 perfectly balanced meals under your belt, you could knock this thing out, no problem. I'm not kidding. It takes about 30 years, maybe 20 if you are lucky, of three means a day, consistently perfect nutrition, and you could have a perfect organics profile even if you started off looking like this woman here.
Christopher: Right.
Dan: I’ve seen that really consistently because when I do my lectures, we talk about this. We would look at the labs, and I ask people, okay. You’ve got a perfect lab. Stand up. Just tell us your history. That’s always this 24 years on the New Zealand farm.
This other guy we had recently was also an athlete. His wife is Okinawan, and she has been cooking like 36 years worth of really healthy meals. This guy is in his, I don’t know, 60s or 70s, whatever, perfect lab. But it's not going to happen if you clean up your diet for 18 months or become a vegan. It's not like a trendy kind of thing. You have to have decades of good quality nutrients to turn this kind of stuff around.
Christopher: Yeah. And then so I mean we’ve seen one of the services we’re offering is my wife Judy, who’s also been trained by Dr. Kalish, she has this service, nutritional coaching, where we give people food diaries. So we see what people are eating and even in the last week they’re not even coming close to that type of perfection and especially – I don’t want to pick on anyone in particular but it seems like the low carb community of which I’m part, I'm in ketosis right now, you have to really watch it because it’s so satiating that you don’t really want to eat much. How can you get enough of these B vitamins? How could you get enough of the antioxidants if you’re only eating 800 calories a day? Especially for the women, it's like a really easy trap to fall into and then you’ve really got a problem.
Dan: Well, that’s the beauty of the labs because if you are doing any kind of extreme diet or really strict diet, just run the testing and you can then make up for the things that you are missing based on labs or maybe even adjust some of your dietary needs based on the testing versus just kind of what you are guessing at.
[0:40:16]
Christopher: Yep, absolutely. So I should say a little bit about the test actually, how you do it. So most tests that people use to running, you go to your doctor and they’d send you to the lab and you get some blood drawn and then they get the results back. But this one is kind of cool and different in that you can actually order it yourself online on our website in nourishbalancethrive.com. And we send it to you. It’s just a kit and then you collect the urine and then you freeze it and then you send it into the lab by the prepaid FedEx mailer and then the results come back to us electronically. So it’s super simple to do. You don’t even need to go and see a doctor or anything to do this. It’s a really cool test.
Dan: Yeah. It’s important to distinguish also because we haven’t talked about it is from a urine sample so you don’t need to get your blood drawn. It’s not a medical test. So it’s really detecting these what we call functional problems which occur prior to the onset of the disease. So like, for example, talking about liver, your Phase 1/Phase 2 liver pathway, liver detox pathways will fall apart long before a standard blood test will show that you have a liver problem.
Christopher: Right. Yeah. So I mean, yeah, this is kind of like cheating for a nutritionist really, this test, isn’t it? It’s like kind of the nutritionist hustle this training background and they know what should work but this lab work kind of is almost like cheating, like, oh, this is how it’s actually working. And so that’s how I can do it. I’m not a doctor. I’m just like someone that knows a little bit about food. But using the power of this lab test, I can sort of cheat and tell you exactly how well it’s going for you.
Dan: Yeah. It’s also a very strong indictment of how dialed in your diet is. We see tests like this in our training program where the test comes back nearly perfect. There are some people who just have intuitively figured out how they should eat and they’re quite balanced. I mean that does happen.
Christopher: Yup. And then just one final question while I’ve got you. Enzyme CoQ10. My understanding that it’s not very well absorbed apart from the ubiquinol form which is fabulously expensive. And so you know, I’ve been looking at this a lot. How can I get this from foods? And the only place I really see is beef heart or any type of heart meat. It's kind of interesting that the one place that needs it the most is the one place where you find it in food which is the heart as an organ from another animal. But what do you think? Do you ever recommend people take CoQ10 as a supplement? And what form should they take?
Dan: Yeah. So I do recommend it. I mean not too many people want to eat raw beef heart. But some people do.
ChristopherI do.
Dan: You can blend it up. I’m not saying that I do this all the time because I don’t but I’ve tasted it a few times. You can blend it out with tomato juice and just get it in like – I don’t know if you want to call it a smoothie and drink it first thing in the morning. I used the CoQ10 produced by either Ortho Molecular or Designs for Health. Those are both pretty good companies.
Christopher: Okay.
Dan: Because you have to be careful these days because I just found this out recently is that companies or there’s unscrupulous people who are getting like Designs for Health or Ortho Molecular labels and just slapping them on fake labels and slapping them on to bottles that have like a Costco poor quality CoQ10.
You got to make sure that you are buying your supplements from a practitioner who you know is sourcing them properly. And be careful about just buying things randomly from Amazon. There’s a lot of fake labels out there now and a lot of narcofs, even in the supplement industry. You have to be aware of that.
Christopher: Yeah. You know, I thought about this a lot actually and we use a lot of Thorne products and they are very – like a number of manufacturers are really funny about you selling stuff on the internet. And it’s tempting to think, oh, well, this fulfillment that I spend so much time doing, I buy this stuff from Thorne and then I send it out to people and it’s very, very small. I buy things in lots of 10, viable 10. And so basically I’m not really holding any inventory at all.
And so I could see how it would be tempting for someone just to buy a big pallet of this stuff and then you send it off to Amazon and then it sits in their hot warehouse for a year and then eventually you come on to the website, Amazon.com, and then buy one of these products and really you have no idea what it is or how long it’s been there or anything.
Dan: Yeah. And the beauty of the kind of practice that we have is that we retest people. So for example, if you are low in CoQ10 and lipoic acid on your initial test and then you retest six months or a year later and you have been taking it and you are still low, then you know that either the person is not absorbing it all or they’re just using an inferior quality product. And this happens all the time where we run a lab, get a low in CoQ10 and lipoic acid and then wait a minute, I take that every day and have for years and you look at the quality of the product, you realize that they’re just not taking good quality products.
[0:45:18]
So the lab testing keeps these supplement companies honest for doctors like myself because we’re retesting everybody and if their products aren’t going to work, I would be out of the business and the retesting with the labs would show that there’s a huge problem, right? So if there is some way to control this in terms of quality with the follow -up testing so you know what you’re taking is actually doing the intended job.
Christopher: Yeah. I love that about these programs, the fact that there is an exit strategy, right? It’s not just a lifelong dependency on CoQ10 or some other supplement. That’s what do almost. We establish the need with the lab test. We make the lifestyle changes, improve gut health so that you digest and assimilate these nutrients better. In the interim, we supplement, retest, and then you’re done and that’s the end of it. I’m not like trying to make you into a customer for life.
Dan: Yeah. That’s my favorite patient joke is they’re supplements, not permanents, right? It’s supplementary. It’s a matter of getting the right ones for the right amount of time. If it’s a good quality of nutrient and you retest and the levels are normal, then you should stop. And it’s an important general concept is the things that get you healthy, you don’t necessarily have to keep doing it forever when it comes to supplements. I mean you are trying to get your system back to normal. You’re not trying to go over the amount that you may need of any of these products.
Christopher: Right. So then finally I wanted to ask you about I’ve had lots of people -- so we’ve been on a couple of podcasts now and there’s definitely a category of person that’s contacted us who is either a registered nurse or they’re a fitness instructor or someone that’s really well educated on all of this stuff already and maybe they have some kind of practice, say, they're a fitness instructor and so they’re getting these people into the gym and then shouting at them and then making them sweat, and they’re still not seeing the results that they want. They're starting to realize that maybe these lab tests could help their clients a lot more than the way that they’re currently doing it.
So I’m thinking, so obviously those people could come to you and get trained. Is that right? How does that work?
Dan: Yeah. So we have like Kalish Method Training Programs which is at kalishinstitute.com. And so basically my job in this current life is to train people in functional medicine so they can apply it towards chiropractic practice, GM environment, medical practice, acupuncture, natural medicine, nutritionist.
I mean it’s very interesting we had these meetings with the groups and we’ll have like a medical doctor, a naturopath, a trainer, a nurse practitioner, acupuncturist and nutritionist all doing the Kalish method because functional medicine can be applied in all these different contexts. It’s not really medicine. Maybe that’s not the best term. It’s really more functional and nutritional or body function improvement.
So you don’t have to have a medical problem. You don’t have to have a medical degree to do this. Most of this is orientated as you know around basic common sense like what we should eat, how much and when we should exercise, how we can reduce stress, how much sleep we should get. The biggest treatment that we really espouse is just people getting an adequate amount of sleep. And it’s not exactly rocket science; the basic things that any parent would do with a child who’s five years old -- did you get your nap, did you skip your breakfast, are you going to get to bed on time, did you get outside, away from the TV and work out a little bit, just the basic things that we do with a five-year-old kid. Are they getting bullied at school? Are they stressed? This is just the heart and soul of functional medicine, just oriented around the lifestyle coaching.
Christopher: Yeah, absolutely. When I quit my job as a computer programmer at Quantitative Hedge Funds to do this stuff, and I thought I was getting into diet and lifestyle coaching. That’s what I'd spent the bulk of my time doing. And it’s true that the essence of what we are doing is diet and lifestyle coaching -- chasing people, making sure they’re doing their guided meditation, what have you.
But the truth is most of the people that have come to us in the recent past have been people that listen to the Rob Wolf podcast, listen to Ben Greenfield, listen to Chris Kresser, and they’re so well educated. They know all of this stuff and yet there’s still that tiny missing piece they’re not sure about. And that’s again is where the labs come in. It’s like so powerful which is sort of lift the lid and find out exactly what is going on for those people. They’re doing everything else otherwise right.
Dan: Well, yeah. This is important because if the lifestyle piece has already been mastered and the person is reading blogs and podcast, listening to podcasts, is really up on what they should be doing with their diet exercise, stress, all that kind of stuff, if they are not getting clear, consistent, complete relief from all the health problems, then, as you know, they really need a functional medicine work-up.
[0:50:16]
And so if you are already in the position where you’ve made the lifestyle changes and it doesn’t make sense because you’re not completely relieved or whatever symptoms or problems you’re having, that’s really where the lab testing comes in, as a complement to doing the second part of a program, based on the foundation of the lifestyle changes, adding in these nutrient-based protocols completely changes people’s lives very, very quickly if they have that foundation placed already.
Christopher: Yeah. So that was my story actually when I came to you. I’d already really done the hard work. I found the Paleo diet and that helped and then I did the autoimmune version of it, which is more strict which helped even more. And that kind of set the wheels turning, like, okay, so if I can do this, what else is possible? And that’s when I found you and then that was as much change again, I would say, like the difference between the foundation it was laid by the Paleo diet and what you did for me with these tests and fixing these micronutrition deficiencies and other problems was about the same amount of improvement again. So it can be huge.
Dan: Yeah, yeah, that’s an interesting thing and I’ve seen that with patients very consistently and say just say that you changed to a Paleo diet and the right kind of exercise. That amount of improvement that you experienced from that change can usually be equaled, at least equaled by the changes you've experienced from the lab-based programs.
So in other words, what that means is that when people have made all the lifestyle changes, they’re usually about 51% better. And then the labs take them that extra 50%. It’s very consistent. I’ve heard that from thousands of patients over the years. It’s a very consistent kind of general ballpark number.
Christopher: And I don’t think – it’s almost like the diet and lifestyle stuff, it’s almost like a prerequisite in that -- I mean sure you can do all at once. You could come to me eating pizza and getting four hours of sleep every night and drinking booze every night and you could do all of this at once. I could do the diet and lifestyle coaching and you could run the labs and we could see where you’re at. But you can’t skip. You can’t just do the lab test and take the stuff and skip eating pizza or keep drinking two bottles of wine every night and keep smoking and all the rest of it and have the same result or even 50% of results. That’s just not going to work, right?
Dan: No. And this is the way I teach the courses too is that all the protocols are designed in such a way that it requires the person to make lifestyle changes to get the full benefit. There’s other ways you can do this. You can do functional medicine in a way where you don’t expect any lifestyle changes and you just adjust the dosages and protocols for a person who’s drinking beer and eating pizza every night. But that to me is like kind of backward thinking because you’re just perpetuating the problem that you’re trying to solve and it’s just sort of a yo-yo thing.
Christopher: It can get easier though. I mean sometimes you find that your weird sugar cravings, like I used to have this thing that I just had to eat something in the afternoons and it would be usually – because I was on the Paleo diet and you shouldn’t be eating whatever, something sugary and processed, like a Snickers bar. I just go for something that’s considered Paleo like nuts. And so I would go after those in the afternoon but now I just don’t have that need. I don’t even think about it. It doesn’t cross my mind. And I’m sure it’s not an accident. I’ve cleaned up my acts. It’s just as simple as that.
Dan: There’s another subgroup of people too, I’m sure there are some folks listening that are in this category, where if they want to make lifestyle changes, as you are saying here, but they can’t. So like they know they want to go Paleo. They know they did it for 30 days and they felt better than they ever had. But then they’re back on the gluten or back on the sugar or back on the alcohol or whatever it is.
And so for people who are struggling with making the lifestyle changes, the functional medicine approach can give them that boost that can balance their brain chemistry, balance their hormones, balance their blood sugar, whatever it is they need, get rid of that yeast overgrowth, whatever it is they need so that it’s feasible for them to make the lifestyle changes.
So what people are struggling especially with food for a long time, if we balance their biochemistry, all of a sudden their diet gets to be easy because they’re not being driven by these cravings that are really result of poor hormone production, poor brain chemicals, et cetera.
Christopher: Yeah, absolutely. And it becomes increasingly hard. I have to try and – I almost need to work at empathizing with people and they say to me, "I’m having this insane craving. I’m in Starbucks. I didn’t really want to go there. I knew these cookies were going to be there and I just have to eat them. I don’t know what’s wrong with me. I think I’m going to have to eat them." And I’m just sat here thinking I can’t relate to that. I don’t have that. I saw and know what you mean from five years ago, but yeah, it’s hard. But it gets easier and these labs can make it a lot easier.
[0:55:01]
Dan: Yeah, and it’s doable. So we make sure people feel inspired and hopeful because as you and I, we do this for work every day. I mean it’s totally doable and make all these changes and it’s very, very difficult to do it on your own. It really helps to have a coach and someone that's kind of guiding you through a process.
Christopher: Yeah, absolutely. Okay. Well, that’s brilliant. I want to thank you so much for your time today. I owe you like such a massive debt of gratitude, not just for fixing me personally but then also to give me the opportunity to help other people by letting us into your institute which is just being the most amazing and fun experience.
As soon as I got my hands on those videos, we just consumed them, like we spent – Julie and me just spent hours and hours and hours. We watched all of it like back to back. It was like, you know, when people get into Breaking Bad or something, they download it on DVD or whatever, they just like watch the whole thing. I watched the whole season of the Kalish Institute Training Course. That was kind of how our life was when we got hold of it.
So I’d highly recommend it to anyone that’s thinking of doing this stuff.
Dan: Thank you much. I appreciate it. I'm glad to see you guys are out there helping people. It’s really great.
Christopher: Yeah. Thank you very much. Cheers then, Dan.
Dan: Yeah. Bye for now.
Christopher: Thank you. Bye-bye.
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